Four Month Visit
Your baby’s skills at socialization will blossom even further during this period. Cooing and talking are a big part of their interactions with others. “Talking back” with her encourages these beginnings of speech. They will now use their eyes more skillfully to follow objects and observe their surroundings. Toys to bat are challenging. Getting them outdoors for a change of scenery is encouraged. Different textures of objects or fabrics they can safely handle fascinate them. By this time many babies have mastered rolling tummy to back and a few have managed the more difficult back to tummy roll over. They will continue to perfect these skills over the next two months. Chewing and drooling start in earnest around this age. It is a developmental phase and not necessarily related to teething.
This is a happy age. Your baby will be responsive. They will thrive on your attention and affection. Keep them in the room with you as much as possible and stop frequently to talk, play, or read to them. You may get carried away by the fun you are both having, but you will treasure these moments which will be a memory all too soon.
A word about swimming lessons: Many parents ask about swimming lessons for babies. It can be a pleasant experience for parent and baby. This is no way to “drown proof” a baby and it is no substitute for constant supervision near and in the water.
Experience has shown that babies who wait to start solids until 6 months of age have fewer problems with obesity, the number one nutritional problem in our country, and also fewer digestive disturbances. The AAP recommends that babies be fed exclusively breast milk or formula until “about” 6 months of age.
The AAP recommends vitamin D supplementation for all infants, children, and adolescents. After reviewing the literature, it certainly looks like many children may benefit from vitamin D, although not everyone necessarily needs it. Some children are more at risk for vitamin D deficiency than others. Risk factors for vitamin D deficiency include dark skin (African-americans, Indians, Hispanics), time spent indoors and not out in the sunlight (particularly in the winter months), low amount of milk consumption (less than 16 oz a day), and exclusively breastfed infants. The recommended dose is 400 IU (international units) once daily. This can be bought over the counter in either a single drop form, or with a larger dropper. Read the label carefully when dosing this to your child. Too much vitamin D can be harmful.
Most babies are now sleeping though the night, usually about twelve hours. Daytime naps vary in number and length, though most babies will continue two: a short morning nap and a longer afternoon nap, totaling about fifteen to sixteen hours per day. Don’t put your baby to bed with a bottle, which can damage his soon to erupt teeth.
- Falls continue to pose a major danger for the baby, especially since they are rolling.
- Be sure that very small or potentially harmful objects, (safety pins or coins for example) are out of reach. plastic bags and balloons which can adhere to babies mouth and nose are particularly hazardous.
- Continue to use you car seat regularly in the rear facing position.
- Walkers are unsafe and should not be used. Recent studies have shown that walkers can actually slow motor development and they place infants at a significantly increased risk for injury.
Your baby will receive their second dose of Pentacel, Prevnar, Rotateq, and Hepatitis B if the first dose was not given in the hospital after birth. You can administer the appropriate dose of acetaminophen as needed for pain, swelling, or fever. Doses are listed on our website www.legacypediatrics.com.