Here are some suggestions from Bright Futures experts that may be of value to your family.
How is Your Family Doing?
If you are worried about your living or food situation, talk with your health care professional. Community agencies and programs such as WIC and SNAP can also provide information and assistance.
Find ways to spend time with your partner. Keep in touch with family and friends.
Find safe, loving child care for your baby. You can ask your health care professional for help.
Know that it is normal to feel sad about leaving your baby with a caregiver or putting him into child care.
Feeding Your Baby
Feed your baby only breast milk or iron-fortified formula until she is about 6 months old.
Avoid feeding your baby solid foods, juice, and water until she is about 6 months old.
Feed your baby when you see signs of hunger. Look for her to:
- Put her hand to her mouth.
- Suck, root, and fuss.
Stop feeding when you see signs your baby is full. You can tell when she:
- Turns away
- Closes her mouth
- Relaxes her arms and hands
- Burp your baby during natural feeding breaks.
Feed your baby on demand. Expect to breastfeed 8 to 12 times in 24 hours.
Give your baby vitamin D drops (400 IU a day).
Continue to take your prenatal vitamin with iron.
Eat a healthy diet.
Plan for pumping and storing breast milk. Let your health care professional know if you need help.
- If you pump, be sure to store your milk properly so it stays safe for your baby. If you have questions, ask your health care professional.
If Formula Feeding...
Feed your baby on demand. Expect her to eat about 6 to 8 times each day, or 26 to 28 oz of formula per day.
Make sure to prepare, heat, and store the formula safely. If you need help, ask us.
Hold your baby so you can look at each other when you feed her.
Always hold the bottle. Never prop it.
How Are You Feeling?
Take care of yourself so you have the energy to care for your baby.
Talk with your health care professional or call for help if you feel sad or very tired for more than a few days.
Find small but safe ways for your other children to help with the baby, such as bringing you things you need or holding the baby’s hand.
Spend special time with each child reading, talking, and doing things together.
Your Growing Baby
Have simple routines each day for bathing, feeding, sleeping, and playing.
Hold, talk to, cuddle, read to, sing to, and play often with your baby. This helps you connect with and relate to your baby.
Learn what your baby does and does not like.
Develop a schedule for naps and bedtime. Put him to bed awake but drowsy so he learns to fall asleep on his own.
Don’t have a TV on in the background or use a TV or other digital media to calm your baby.
Put your baby on his tummy for short periods of playtime. Don’t leave him alone during tummy time or allow him to sleep on his tummy.
Notice what helps calm your baby, such as a pacifier, his fingers, or his thumb. Stroking, talking, rocking, or going for walks may also work.
Never hit or shake your baby.
Use a rear-facing–only car safety seat in the back seat of all vehicles.
Never put your baby in the front seat of a vehicle that has a passenger airbag.
Your baby’s safety depends on you. Always wear your lap and shoulder seat belt. Never drive after drinking alcohol or using drugs. Never text or use a cell phone while driving.
Always put your baby to sleep on her back in her own crib, not your bed
- Your baby should sleep in your room until she is at least 6 months old.
- Make sure your baby’s crib or sleep surface meets the most recent safety guidelines.
If you choose to use a mesh playpen, get one made after February 28, 2013.
Swaddling should not be used after 2 months of age.
Prevent scalds or burns. Don’t drink hot liquids while holding your baby.
Prevent tap water burns. Set the water heater so the temperature at the faucet is at or below 120°F /49°C.
Keep a hand on your baby when dressing or changing her on a changing table, couch, or bed.
Never leave your baby alone in bathwater, even in a bath seat or ring.
What to Expect at Your Baby's 4 Month Visit
We will talk about:
- Caring for your baby, your family, and yourself
- Creating routines and spending time with your baby
- Keeping teeth healthy
- Feeding your babu
- Keeping your baby safe at home and in the car
- Information About Car Safety Seats: www.nhtsa.gov/parents-and-caregivers
- Toll-free Auto Safety Hotline: 888-327-4236
Consistent with Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, 4th Edition
The information contained in this webpage 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. Original handout included as part of the Bright Futures Tool and Resource Kit, 2nd Edition.
Inclusion in this webpage does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is not responsible for the content of the resources mentioned in this webpage. Website addresses are as current as possible but may change at any time.
The American Academy of Pediatrics (AAP) does not review or endorse any modifications made to this handout and in no event shall the AAP be liable for any such changes.
American Academy of Pediatrics