Bright Futures Parent Handout: 4 Month Visit

How Your Family is Doing

• Learn if your home or drinking water has lead and take steps to get rid of it. Lead is toxic for everyone.

• Take time for yourself and with your partner. Spend time with family and friends.

• Choose a mature, trained, and responsible babysitter or caregiver.

• You can talk with us about your child care choices.

Feeding Your Baby

• For babies at 4 months of age, breast milk or iron-fortified formula remains the best food. Solid foods are discouraged until about 6 months of age.

• Avoid feeding your baby too much by following the baby’s signs of fullness, such as

  • Leaning back

  • Turning away

If Breastfeeding

• Providing only breast milk for your baby for about the first 6 months after birth provides ideal nutrition. It supports the best possible growth and development.

• Be proud of yourself if you are still breastfeeding. Continue as long as you and your baby want.

• Know that babies this age go through growth spurts. They may want to breastfeed more often and that is normal.

• If you pump, be sure to store your milk properly so it stays safe for your baby. We can give you more information.

• Give your baby vitamin D drops (400 IU a day).

• Tell us if you are taking any medications, supplements, or herbal preparations.

If Formula Feeding

• Make sure to prepare, heat, and store the formula safely.

• Feed on demand. Expect him to eat about 30 to 32 oz daily.

• Hold your baby so you can look at each other when you feed him.

• Always hold the bottle. Never prop it.

• Don’t give your baby a bottle while he is in a crib.

Your Changing Baby

• Create routines for feeding, nap time, and bedtime.

• Calm your baby with soothing and gentle touches when she is fussy.

• Make time for quiet play.

  • Hold your baby and talk with her.

  • Read to your baby often.

• Encourage active play.

  • Offer floor gyms and colorful toys to hold.

  • Put your baby on her tummy for playtime. Don’t leave her alone during tummy time or allow her to sleep on her tummy.

• Don’t have a TV on in the background or use a TV or other digital media to calm your baby.

Healthy Teeth

• Go to your own dentist twice yearly. It is important to keep your teeth healthy so you don’t pass bacteria that cause cavities on to your baby.

• Don’t share spoons with your baby or use your mouth to clean the baby’s pacifier.

• Use a cold teething ring if your baby’s gums are sore from teething.

• Don’t put your baby in a crib with a bottle.

• Clean your baby’s gums and teeth (as soon as you see the first tooth) 2 times per day with a soft cloth or soft toothbrush and a small smear of fluoride toothpaste (no more than a grain of rice).

Safety

• Use a rear-facing–only car safety seat in the back seat of all vehicles.

• Never put your baby in the front seat of a vehicle that has a passenger airbag.

• Your baby’s safety depends on you. Always wear your lap and shoulder seat belt.

• Never drive after drinking alcohol or using drugs. Never text or use a cell phone while driving.

• Always put your baby to sleep on her back in her own crib, not in your bed.

  • Your baby should sleep in your room until she is at least 6 months of age.

  • Make sure your baby’s crib or sleep surface meets the most recent safety guidelines.

  • Don’t put soft objects and loose bedding such as blankets, pillows, bumper pads, and toys in the crib.

• Drop-side cribs should not be used.

• Lower the crib mattress.

• If you choose to use a mesh playpen, get one made after February 28, 2013.

• Prevent tap water burns. Set the water heater so the temperature at the faucet is at or below 120°F /49°C.

• Prevent scalds or burns. Don’t drink hot drinks when holding your baby.

• Keep a hand on your baby on any surface from which she might fall and get hurt, such as a changing table, couch, or bed.

• Never leave your baby alone in bathwater, even in a bath seat or ring.

• Keep small objects, small toys, and latex balloons away from your baby.

• Don’t use a baby walker.

What to Expect at Your Baby’s 6 Month Visit

We will talk about

• Caring for your baby, your family, and yourself

• Teaching and playing with your baby

• Brushing your baby’s teeth

• Introducing solid food

• Keeping your baby safe at home, outside, and in the car