Mercy Medical Center North Iowa - Pediatric and Adolescent Four Months

Mercy Network

Infants of this age are generally content with all caring adults. Colic typically resolves by 3 months of age.
Expect increased: laughing, vocalization, reaching and grabbing.
Infants often begin sitting by 6 months of age.

Up to sixteen hours of sleep per day is normal. Many infants sleep through the night and take 3 naps per day.
Establish a bedtime routine.
Encourage the baby to learn to console himself by putting him to bed awake.
Help the baby to learn self-consoling techniques by providing him with a stuffed animal, blanket, or favorite toy at bedtime or in new situations.

Nurture the baby by holding, cuddling, and rocking her, and by talking and singing to her.
Read to the baby. Play music.
Talk to him during dressing, bathing, feeding, playing, walking, and driving.
Play games such as pat-a-cake, peek-a-boo, so-big.
Stimulate your baby with age-appropriate toys.
Each parent should spend time individually with each child daily.
Encourage your partner and other children in the family to participate in caring for the infant.
Take some time for yourself, your partner, family, and friends.
Let the doctor know if you have signs of depression such as sad mood, feelings of hopelessness and helplessness. A mental health referral can be made for you.
Family planning-it is important to have adequate spacing between pregnancies.

Use a properly secured infant car seat.
Do not leave unattended on a bed or table, in a tub of water, or with pets.
Toys should be too big to swallow, unbreakable, and free of small detachable parts or sharp edges. Do not give the infant plastic bags or latex balloons.
Keep all poisonous substances, medicines, cleaning agents, health and beauty aids, and paints and paint solvents, locked in a safe place out of the baby’s sight and reach.
Use safety locks on cabinets.
Keep the baby’s environment smoke free.
Do not drink hot liquids or smoke while holding the baby.
Use sunscreen if the infant will be exposed to direct sunlight.
Infant exercise programs and swim classes are unnecessary.
Do not use an infant walker at any age.
Recognize early signs of illness: fever, failure to eat, vomiting, diarrhea, unusual irritability, or skin rash.
Immunizations are given at 4 months of age.

The number of feedings generally has been reduced to 4-5 per day. Bottle-fed babies can take up to 32 oz per day.
Continue to breastfeed or to use iron-fortified formula for the first year of the infant’s life.
Breastfed infants should continue to receive 400 IU’s of vitamin D daily.
Begin introducing solid foods with a spoon when the infant is 4-6 months of age.
Use a spoon to give him an iron-fortified, single-grain cereal such as rice. Do not put cereal in a bottle.
If there are no adverse reactions, add a new pureed food to the infant’s diet each week, beginning with fruits and vegetables.
Stooling patterns may change with the introduction of solid foods. Stooling should be comfortable for the baby.
Do not give honey or Karo syrup until 12 months of age to prevent infant botulism.
To protect the infant’s teeth, do not put him to bed with a bottle or prop it in his mouth.
Always supervise the infant while he is eating. Ensure that your caregiver is feeding the infant appropriately