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February 28, 2025
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Suite #100 Rockville, MD 20850
Contact us online now
Phone
Suite #100 Rockville, MD 20850
Breast milk and/or iron-fortified formula should remain the only source of milk for the first year of life. The AAP recommends introduction of solids at 6 months, but some babies may be ready sooner (see signs of readiness below). Discuss with your provider if you are interested in offering solids now.
All breastfed babies or infants receiving < 32 oz of formula daily should have a vitamin D and iron supplement. We recommend Poly-vi-sol with iron or Novaferrum with iron, 1 mL daily.
Your baby was born at term, they may be ready for solid foods around this age. Signs that they are ready include: when they can demonstrate good head control, show interest in food, are able to bring objects to their mouths
If starting solids <6 months, we recommend purees or infant grain cereals like oatmeal (we recommend waiting until 6 months of age if doing Baby-Led Weaning)
You do not need to wait multiple days before introducing the next type of solid. If your baby develops a rash, diarrhea, or vomiting after a new food – stop offering this food and discuss with your provider
Introduction of peanut-containing products is recommended before 6 months of age if there is no immediate family history of peanut allergy or eczema, as early introduction is proven to reduce the risk of developing peanut allergies. If this worries you, you can join one of our Peanut Butter Parties where an experienced nurse will be present while you introduce major allergens.
Check-up: Your provider will complete a comprehensive history and physical exam, review growth curves, answer any questions, and provide age appropriate guidance.
Vaccines:
Labs: There are no routine labs at this visit
ALWAYS... keep one hand on your baby when on a changing table. Never leave a baby unattended unless they are in a bassinet, crib or playpen. Babies can roll and fall off easily.
ALWAYS…be careful leaving toddlers and pets alone with the baby. Their actions are unpredictable.
ALWAYS... ensure safety in your environment. Check the smoke detectors in your home and make sure that your hot water heater is set to 120 degrees Fahrenheit.
ALWAYS… put the baby in a car seat while driving. The American Academy of Pediatrics recommends that children remain facing backwards in the center of the back seat until age 2. Never place a car seat in the front seat. Do not place any loose blankets or clothing in the car seat.
ALWAYS… ensure your baby sleeps on their back, in their own space, without any stuffed animals, toys or blankets. Never co-sleep.
ALWAYS… practice water safety. Keep one hand on your baby during bath time at all times. Never leave them alone in shallow water in a bathtub or infant tub. Fence in backyard pools.
ALWAYS... pay attention to choking hazards. Your baby will start putting objects in the mouth, so ensure no objects are smaller than a golf ball. Remove all button batteries and small magnets from play areas as these are life-threatening if ingested.
Fevers are no longer considered a medical emergency, but you can always schedule a visit with your provider if your child is sick/you are concerned. RSV prophylaxis is available at this age, so please talk to your provider if your child has not yet received this.
At 4 months of age, many babies will undergo a growth spurt and a sleep regression due to the maturation of their sleep cycles. This is when your baby suddenly starts to awaken more for feeding or comfort. Most babies at this age can sleep 10-12 hours at night without feeding. Since babies start to self soothe at this age, it is safe to sleep train your baby if desired. Talk to your pediatrician about safe sleep training methods. It is important to continue practicing safe sleep to reduce the risk of SIDS, and to stop swaddling your infant’s arms at this age since they are likely showing signs of rolling (it is fine to use a sleep sack if desired, with their arms free).
Development – Typical milestones at 4 months include: smiling, laughing, squealing, good head control, reaching for toys, holding objects, exploring hands with their mouth, and attempting to roll over in both directions. Drooling/ chewing on hands is a normal part of development at this age and not normally a sign of teething (which normally starts between 6-10 months of age).
Bug spray is safe to use at this age (DEET-containing repellent is recommended), but sunscreen is not recommended until 6 months of age so continue other physical methods of sun protection.
Potomac Pediatrics will always be fully focused on helping your child and you to overcome any healthcare hurdle, with innovative, comprehensive and compassionate care.
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