| Development: |
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Laughs, smiles and squeals in response to others and to themselves. Sits with support. Gradually will be able to sit up on own for short periods, holding head upright and steady. May roll from front to back. Reaches for and grasps toys. Puts everything in the mouth. |
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| Nutrition: |
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The introduction of solid foods is a gradual process without a specific schedule of introduction. Rice cereal is usually added first since most infants tolerate it well. Start with one tablespoon mixed with a small amount of formula or breast milk to the consistency of thin oatmeal.
Barley and oat cereals may be tried 2 or 3 weeks later. Cereal should not be put in the bottle or in feeders because it will confuse the infant when trying to use a spoon. Use your baby’s cues to know when he is hungry and don’t overfeed or force feed him.
Avoid giving the baby a bottle in bed, feeding the baby lying down, or propping up the bottle. These methods contribute to tooth decay and possibly to ear infections. |
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| Breast- |
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All nutritional requirements are met by breast milk alone until 5-6 months of age. If weaning, chose an iron fortified infant formula. Cow’s milk should not be given until 9-12 months of age. |
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| Formula- |
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The infant will continue to have approximately 5 feedings per day, needing 28-34 oz. of formula. The number of feedings and ounces of formula will decrease as cereal and other solids are introduced. |
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| Solids- |
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Strained infant foods may be introduced after the baby has tolerated cereal well for about one month. Begin with vegetables or fruits. Give up to ½ jar two times a day, adding only one new flavor at a time every 4-5 days. Avoid the following foods until older: meats until about 9 months of age; until 12 months of age avoid fish ( including shell fish), nuts (including peanut butter), straight eggs (soft boiled or scrambled, although as ingredient is ok ), straight whole milk (as an ingredient milk is ok), and uncooked honey. |
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| Sleep: |
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Most infants will have one long sleep period that lasts about 6-8 hours and sleep approximately 15 hours total every day. They will remain awake at least two hour- long periods without fussing. Crying at bedtime may occur as the infant begins to be aware of the separation from his caretakers.
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| Safety: |
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Accidents, not diseases, are the major threat to your child’s health. Always use a car seat. An infant who can roll over is able to travel across the room and should be protected from stairways, electrical outlets, poisonous substances, etc. Use safety locks on cabinets and outlet plugs.
Do not leave the baby alone or with a sibling under 12 years old in the bath tub or on a high place where he could roll off, such as a changing table, couch or bed.
Use safety straps on high chairs, infant seats and swings. Set the infant seat on a safe, protected surface where it will not slide to the edge with the infant’s movements. The use of walkers is strongly discouraged because they can result in falls.
Cribs should be kept away from curtains and curtain cords.
Use smoke alarms and never leave infants alone in the house. |
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| Illness: |
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What to call for:
- Fever (above 101)
- Unusual fussiness or tiredness
- Rashes
- Poor Eating
- Vomiting
- Diarrhea
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| Immunizations: |
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At four months infants should receive vaccines for diphtheria, tetanus, and pertussis (whooping cough) (DTaP), haemophilus influenzae type B (HIB), polio (IPV), and invasive pneumococcal disease (Prevnar).
Minor reaction including mild fever and redness, swelling or tenderness at the site of the shot are not uncommon. Using one dropperful (0.8 cc) of Tylenol and placing a warm cloths on the site may provide some comfort.
Call the office if your child develops a high fever or other unusual reaction. |
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| Next visit at six months: Vaccinations for diphtheria, tetanus and pertussis (DTaP), haemophilus influenzae type B (HIB), polio (IPV), and invasive pneumococcal disease (Prevnar). |
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| Please call your insurance company before your next visit to find out if they cover vaccines. If they do not, it will be much less expensive for you to have the vaccines done at the Health Department. We can give you more information about this if you call us at 492-1999. |
