Breast milk and/or iron-fortified formula are still your baby's main food sources. Most babies nurse 4-6 times a day or take 20-36 ounces of formula. Solid foods (if desired) supplement, but do not replace, milk. Babies often give clues as to their need to start solids (see our handout on "Starting Solids"). Your baby should be able to sit with support and keep her head steady enough to be able to spoon feed. Solid foods should not be started arbitrarily based on weight or age.
Finally, the majority of babies are sleeping 8-12 hours at night, and taking 2-3 naps. It is recommended to always place infants on their backs for sleeping. Putting your baby in her crib for all naps and bedtimes will help her learn the skill of falling asleep alone. This makes it easier for her to do this in the middle of the night should she start waking.
Starting solids will affect the color, consistency, odor, and frequency of stools. Breast-fed infants often have thicker less-frequent stools.
Car seat: Make sure your baby's car seat still fits her appropriately (babies often need to advance to the next car seat size when they reach 20 pounds) and is in good shape. For the best protection, keep your infant in the center back seat of the car and facing backward until she is 1 year of age and 20 pounds. All children should ride in the back seat until they are 12 years old. Like seatbelts, car seats only work when used correctly and consistently.
Life-preservers: Minnesota State Law requires all children under the age of 10 to wear a life-preserver when on any private boat. Find one that fits well.
Falls: This is the most common age for babies to roll off beds, couches, and changing tables. Make sure safety straps are intact and applied correctly, or the crib rails up, if you need to walk away from your baby. Taking into consideration siblings and pets, the floor is often a safe place for a baby, and also enhances development.
Grabbing and choking: Everything a four month old baby can get her hands around goes straight to the mouth. Watch out for jewelry, eye-glasses, tablecloths, coffee cups, small pieces of food, toys with detachable parts, coins, loose buttons (on your clothes and hers), hot or sharp items, etc. Anything that can fit inside an infant's mouth is a potential choking hazard. Use a playpen as an island of safety during times when your attention is needed elsewhere, but avoid using it for long periods of time. Your baby does need the opportunity to safely explore her world.
Remember, if your baby is crying a lot put her in a safe place and take a break. Call someone to help you or call the Parent Warmline (612-813-6336). If you continue to feel frustrated or feel you could harm your baby, call Crisis Connection (612-379-6363) or Minneapolis Crisis Nursery (763-591-0100).
The four-month age is thought to be the most social of the first year of life. Your child will often smile and coo at anyone, including doctors and nurse practitioners! Siblings often think babies are more "fun" now, as they can get the baby to respond to actions and talking. We encourage parents to evaluate their own personal time needs and arrange to have those needs met.
Please let us know of any side effects other than a low-grade fever or local tenderness at the injection site.
Your baby's next regular health care visit will be at age SIX MONTHS. By then she will be on the edge of mobility, getting more specific at grabbing things, babbling more, and possibly getting a little cautious of strangers. We will discuss advancing solid foods at that time. The scheduled vaccines are the third DTaP, Hib, IPV, PCV7, HBV and oral Rotavirus. The Influenza vaccine is also encouraged for all children ages 6-23 months (depending on the time of year). Please try to be at least 10 minutes early for all scheduled well-child visits.
Aim to be human, not perfect, in your parenting.