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4 Months

IMMUNIZATIONS

needle
Please bring the shot record to each well visit. Today your child will receive Pentacel (DTaP, Hib, & polio combined), plus Hepatitis B and pneumococcal injections and oral Rotateq to protect against rotavirus.

FEEDING

feedingContinue breast milk or formula until one year of age.  It is now OK to start solids if your infant has met certain milestones we discussed during the visit.   Start with infant rice cereal mixed with water, breast milk or formula.  It is hard to tell you exactly how much food to give or how often to feed your baby.  As your baby learns to eat, (s)he will indicate when (s)he is full.  Generally there is no rush to add further foods during the next 2 months.  In addition to solids, I would like for your baby to drink at least 16-32 oz. of formula or nurse well 3-4 times a day.

SAFETY

safety

  • Always use an approved car seat. Remember to place seat in the back if your car has a passenger side air bag. Continue using a rear facing seat until your child is one year of age.
  • Keep all electrical and telephone cords out of reach.
  • ONLY give your child toys that are too large to swallow, too tough to break, and do not have sharp edges.
  • Don’t paint anything that your child might chew on with a lead based paint. Look for a label on the paint which say “Conforms to American Standard 266.1-1955 for use on surfaces which might be chewed by children.”
  • Never allow children to play with cellophane or filmy plastic.
  • Do not leave your child unattended on high surfaces like tables, beds, or sofas.
  • Keep hot liquids away from the edge of the table.

DEVELOPMENT

PHYSICAL

development

  • holds head steady when sitting including no head lag when pulled to sit;
  • sits with support
  • rolls or tries to
  • brings hands together in midline
LANGUAGE:
  • coos and gurgles; laughs and smiles easily
SOCIAL
  • enjoys people, may recognize mother and father
  • likes to be played with and held

Next appointment is at 6 months of age!