Nutrition
MILK – Breast milk or formula with iron should remain the only source of milk for the first year of life.  As baby foods are added slowly over the next few months, the baby’s reliance on milk will decrease.   All exclusively breastfed infants (or infants receiving less than 32 ounces of formula each day) should have a vitamin D supplement.  We recommend Trivisol 1 ml orally each day.

SOLID FOODS – may be started between 4 and 6 months The following schedule is commonly followed:

  • Allow your baby to tell you how much and how frequently to feed.   Most babies feed 1-3 Tablespoons 1-2 times each day
  • Start with rice or oatmeal cereal.  It is a good source of iron and is hypoallergenic.
  • Then advance to vegetables, fruits and meats.  Give each new food 3-4 days before introducing the next new food.  Avoid mixed foods for now.
  • If the baby develops a rash, diarrhea, or vomiting then stop the latest food.
  • Never put baby food in the bottle.

Safety

  • Always put the baby in a car seat while driving!
  • It is a good idea to use sunscreen every day.  Choose a product that is hypoallergenic and SPR 30 or higher.
  • Always bathe infants in very shallow water.  Never leave a child unattended near water.
  • Your baby will start putting objects into the mouth so items should be larger than the size of a golf ball.
  • It’s a good idea to make surprise visits to daycare or babysitters.
  • Do not buy or use an infant walker unless you take off the wheels and make it an immobile chair.  Countless babies have been injured falling down stairs and getting into dangerous situations because of walkers.

Development
This is a great age because babies are so interactive and social.  Normal development at four months allows them to laugh, squeal, and vocalize.  They have good head control and will start to try to roll over.  You will see them reaching for toys and holding onto objects.  You can test your baby’s hearing by seeing if the baby will turn his or her head to the sound of your voice.

TODAY’S IMMUNIZATIONS: Some of these immunizations may be combined.

  • DTaP #2, IPV #2, HIB #2
  • Pneumoccal #2
  • Rotavirus #2

(Please see the CDC website for the Vaccine Information Sheethttp://www.cdc.gov/vaccines/hcp/vis/index.html?s_cid=cs_748)

Less than twenty percent of babies will feel any effects from today’s shots.  If you see any signs of a sore leg or fever, give your baby infant acetaminophen (Tylenol).  If your baby has a fever of greater than 103 degrees, cries excessively or has any unusual behavior, please call us.

NEXT VISIT:    Your baby’s next routine visit is at 6 month of age.

REMINDER: If possible, please do not feed your baby 15 minutes before their vaccines at the 4 month and 6 month appointment.

NEED DAYCARE FORMS? Don’t forget to drop off your health forms at the front desk or submit them after your check-up here.