Four Month Visit
Printable Info Sheet
Breast Feeding
The typical breast fed infant will nurse 6-8 times a day. All your baby needs for optimal nutrition is your breast milk. Continue with Vitamin D supplementation.
Formula Feeding
Formula fed infants generally take 3-4 ounces every 3-4 hours for a total of 24-30 ounces a day. Use an iron fortified formula, not low iron formula.
Infant cereal may be introduced to a formula fed infant at this age. Start with one serving a day then increase to two servings of about ¼ cup per serving. Once your infant is doing well with two servings of cereal a day, you may introduce finely pureed foods (stage one). Risk of choking increases as food texture increases; never leave your infant with food while unattended.
Foods to Avoid
Four month old infants should not be fed dairy products nor honey products.
Oral Health
To avoid bad habits which may lead to tooth decay, do not put your baby to bed with a bottle or prop the bottle in the baby’s mouth.
Sleep
Generally four month old babies sleep 12-14 hours a day including night time sleep and naps. They should be placed on their backs to sleep, even for naps. If your infant rolls over by itself during sleep time, it’s okay. You may be able to start a night time routine, including putting your baby to bed in their crib awake. This allows your child to self settle, therefore, initiating sleep by his/herself.
There is a wide range for “normal” stooling. Where some infants may stool after every feeding, others may
stool every 2-3 days. The stool should be yellow in color and soft. Adding solid foods may change stool patterns.
Safety
Use a rear facing car seat placed in the car’s rear seat. Assure hot water at the tap is less than 120F. Use smoke detectors and avoid second hand smoke. Keep hot beverages, cigarettes, small objects and plastic bags away from your infant. Avoid sun exposure.
Activities
Your baby will enjoy playing pat-a-cake and peekaboo. The best toy for your infant is one which allows you to interact with them. Talk, sing and read to your baby. Four month old infants enjoy being held, kissed, cuddled and rocked.
While interacting with your infant is important, taking time for yourself will help you be a more effective parent.
Signs of illness
Signs of illness may include fever, failure to eat, vomiting, diarrhea, irritability, lethargy, rash, or cough. If your child experiences one of these symptoms or you are concerned, feel free to call our office for advice or an appointment.
Developmental Milestones
Verbal: Babbles and coos
Social: Smiles, laughs and squeals, turns to voice
Gross motor: On stomach hold head erect and raises body on hands, tries to roll
Fine motor: Opens hands, grasps, reaches for objects