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Growth & Development



Bright Futures Parent Handout: 4 Month Visit

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Here are some suggestions from Bright Futures experts that may be of value to your family.

How Your Family Is Doing

  • Take time for yourself.

  • Take time together with your partner.

  • Spend time alone with your other children.

  • Encourage your partner to help care for your baby.

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

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

  • Hold, cuddle, talk to, and sing to your baby each day.

  • Massaging your infant may help your baby go to sleep more easily.

  • Get help if you and your partner are in conflict. Let us know. We can help.

Feeding Your Baby

  • For babies at 4 months of age, human milk or formula remains the best food. Solid feeding is discouraged until about 6 months of age.

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

    • Leaning back

    • Turning away

  • Ask us about programs like WIC that can help get food for you if you are breastfeeding and formula for your baby if you are formula feeding.

If Breastfeeding

  • Exclusive breastfeeding for about the first 6 months of life provides ideal nutrition and supports the best possible growth and development.

  • If you are still breastfeeding, that’s great!

  • Plan for pumping and storage of breast milk.

If Formula Feeding

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

  • Hold your baby so you can look at each other while feeding.

  • Do not prop the bottle.

  • Do not give your baby a bottle in the crib.

Safety

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

  • Always wear a seat belt and never drive after using alcohol or drugs.

  • Keep small objects and plastic bags away from your baby.

  • Keep a hand on your baby on any high surface from which she can fall and be hurt.

  • Prevent burns by setting your water heater so the temperature at the faucet is 120°F or lower.

  • Do not drink hot drinks when holding your baby.

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

  • The kitchen is the most dangerous room. Don’t let your baby crawl around there; use a playpen or high chair instead.

  • Do not use a baby walker.

Your Changing Baby

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

Crib/Playpen

  • Put your baby to sleep on her back.

    • In a crib that meets current safety standards, with no drop-side rail and slats no more than 2 3/8 inches apart. Find more information on the Consumer Product Safety Commission Web site at www.cpsc.gov.

    • If your crib has a drop-side rail, keep it up and locked at all times. Contact the crib company to see if there is a device to keep the drop-side rail from falling down.

    • Keep soft objects and loose bedding such as comforters, pillows, bumper pads, and toys out of the crib.

    • Lower your baby’s mattress.

    • If using a mesh playpen, make sure the openings are less than ¼ inch apart.

Playtime

  • Learn what things your baby likes and does not like.

  • Encourage active play.

    • Offer mirrors, floor gyms, and colorful toys to hold.

    • Tummy time—put your baby on his tummy when awake and you can watch.

  • Promote quiet play.

    • Hold and talk with your baby.

    • Read to your baby often.

Crying

  • Give your baby a pacifier or his fingers or thumb to suck when crying.

Healthy Teeth

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

  • Do not share spoons or cups with your baby or use your mouth to clean the baby’s pacifier.

  • Use a cold teething ring if your baby has sore gums with teething.

  • Clean gums and teeth (as soon as you see the first tooth) 2 times per day with a soft cloth or soft toothbrush with a small smear of fluoride toothpaste (the size of a grain of rice).

What to Expect at Your Baby’s 6 Month Visit

We will talk about

  • Introducing solid food

  • Getting help with your baby

  • Home and car safety

  • Brushing your baby’s teeth

  • Reading to and teaching your baby

Poison Help: 1-800-222-1222

Child safety seat inspection: 1-866-SEATCHECK; seatcheck.org

Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of external resources. Information was current at the time of publication.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

© 2010 American Academy of Pediatrics, Updated 05/2017. All rights reserved.

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