4 Months Archives - People's Community Clinic

Important Points About Your 4 Month Old Baby

Family

By this time, you may be thinking about going back to work soon. Make sure you have made plans for childcare. Prepare 1-2 weeks before going back to work, you may want to do trial runs of what your mornings will be like when you have to get ready with the baby before dropping her off at the nanny or daycare. This way the transition will be easier. Make sure that you make time for yourself, your partner, and your other children as well. You may also want to talk to your provider about family planning and get information on birth control options.

Development

Your baby should be smiling, laughing, and babbling. He should have good head control. He should begin to roll over and reach for objects. We encourage you to continue tummy time. Infant massage can also help calm and relax your baby when he is fussy. Continue to read to your baby.

Health

Setting up a daily routine for feedings, naps, and bedtime will help make longer sleeping stretches at night. Help your baby learn to put herself to sleep by putting her in her crib when she is drowsy, talking gently, and patting her to sleep. Providing regular structure and routines for your baby will help with her sense of security. The baby should not be sleeping in bed with you. Babies are very active at this age and can easily fall off of the bed.

If your baby is teething, he may be drooling a lot. Let him chew on cold teething rings. Wash your baby’s gums and teeth with a cloth and water twice a day, including once before bedtime. Never let your baby sleep with a bottle. Hold the bottle instead of propping it up and leaving it with the baby. Both of these things increase your baby’s risk of choking and tooth decay.

Nutrition

If your provider agrees, you can begin baby cereal with a spoon. Wait until six months to start other solid foods, beginning with mashed vegetables. Don’t give your baby any cow’s milk, honey, or egg whites until 12 months. If you are breastfeeding only and not using any formula, you will need to change from Vitamin D supplements to Poly-Vi-Sol with Iron.

Safety

Set your hot water heater at 120 °F. Never leave your child unattended in a place where he could fall. Never leave your baby alone in the car, even for a minute! The car seat should still be in the back seat, rear facing. Never place an infant in front of an airbag. Do not use a walker with wheels.

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Guidance for your 4 Month Old Baby

Tips for your 3-4 month old baby

HELP ME BE HEALTHY.

At this checkup, the doctor will:

Weigh and measure me.

Check me from head to toe to see:

How I move.

How well I hear.

How well I see.

Give me a few vaccines. Remember to write them in my health journal.

FEED ME AND TAKE CARE OF MY TEETH AND GUMS.

Ask the doctor or WIC nutritionist about eating cereal at 4 months. Rice cereal is the first cereal I should try. Please feed me my cereal from a spoon. Don’t put it in a bottle.

Hold me while I drink my bottle. It makes me feel safe and loved.

Don’t put me in my crib and prop the bottle up for me. I could spit up and choke.

Don’t put me to bed at night with a bottle. If I have a bottle in my mouth all night, the milk or juice could decay my new teeth.

Holding me at feeding time makes me feel secure and loved.

Clean my mouth with a soft, moist washcloth – even before I get my first teeth.

Once my teeth start coming in, use a very soft, infant-sized toothbrush to brush my teeth.

KEEP ME SAFE.

It’s time to make our house safe for babies. Look at it from my eye level. Crawl on your hands and knees and look around. Take away or move anything that I can reach or that could hurt me when I crawl around. Keep me away from cords of all kinds: telephone cords, drapery cords, and electric cords. Cover the electric outlets and put safety latches on the doors.

Keep me away from cigarette and cigar smoke. It makes it harder for me to breathe.

Make sure that the toys, pacifiers, and other things you give me are safe for me. They should not have any sharp edges or loose pieces. Toys should be big enough that I cannot fit them into my mouth.

Use the safety strap and keep the baby seat on the floor and away from steps or other dangers. I’m now strong enough to wiggle out of the baby seat or tip it over.

Never leave me alone on a bed, sofa or changing table, or in a walker or cub.

Keep me away from hot liquids like coffee, tea, and soup. When you’re holding me, don’t try to drink anything hot. A hot liquid could spill on me and burn me badly.

Keep balloons away from me. If a balloon covers my mouth, I can’t breathe.

PLAY WITH ME, IT HELPS ME LEARN.

Play “Talking back and forth.” First, I make a noise and you listen. Then, you make the same noise and I listen. We can do this many times.

Put me on my back and let me reach for toys hanging from the sides of my crib or playpen. Make sure these are tied tight so they won’t hurt me.

Read to me. I like rhyming words and stories that are short.

Play Peek-a-boo with your hands or a blanket.

Hold a rattle or toy in front of me. Move it to get my attention. Then let me try to keep my eyes on it while you move it from one side to the other, up and down, and in circles. This helps me use both eyes.

Let me babble to you.

WATCH HOW I GROW.

New things are happening to me.

When something new happens to me, I might fuss. Change is hard for me. You could get confused and angry with me. What I really need is for you:

To be patient.

To show me new things, new people, and new situations very slowly.

To let me try three or four times to get used to something new. I might like it better the second or third time I try it.

Each child grows and changes at a different rate.

Help me learn new skills by playing with me. Most babies have the following skills at the end of 4 months. If you are worried, talk to my doctor or nurse. To find a nearby Early Childhood Intervention program, call the DARS Help Line toll-free at 1-800-628-5115.

Watch for me to:

Smile at you.

Hold up my head without bobbing it around when I sit in your lap.

Hold a small toy, like a rattle, for a few seconds in my hand if you place it in my hand.

Laugh out loud.

Say “oo,” “aah,” and other vowel sounds. Sometimes I say these sounds fast.

Sometimes I say them slow and kind of sing them.

Hold my head all the way up and rest on my arms when I’m on my stomach.

Recognize sounds I hear a lot, like your voice, the sound of a favorite toy, or running water.

Let you know I recognize you as a special person. I get excited when I see people I know or my bottle.

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Cereal for Infants

Your baby is ready for infant cereal when he:

sits with help

turns his head away when full

can swallow cereal and not choke

doesn’t push food out of his mouth with his tongue

is between 4 and 6 months of age

Tips for feeding cereal:

Start your baby on plain rice cereal.

Feed cereal from a bowl with a small spoon.

Don’t put cereal in a bottle, unless told to do so by your doctor

Never add honey to cereal. It can make your baby very sick.

How to make infant cereal:

1. Measure 1 tablespoon of cereal into bowl.

2. Add about 4 tablespoons of breastmilk or formula.

3. Stir.

Too thin? Add more cereal.

Too thick? Add more breastmilk or formula.

Give your baby thin cereal at first. Thicken the cereal as your baby gets older and becomes better at eating.

Your baby will eat the amount of cereal he needs.
Don’t force him to eat more than he wants.

At first, offer your baby 1 tablespoon of cereal once or twice a day.

At 6-8 months, offer your baby 2-3 tablespoons of cereal about two times a day.

The Magic of Everyday Moments (4-6 Months)

Remember, everyday moments are rich bonding and learning opportunities. Enjoy the magic of these moments with your child.

These booklets brought to you by:

Johnson & Johnson Pediatric Institute, L.L.C., is a company solely
dedicated to improving maternal and children’s healthcare through the advancement of continued learning and research in pediatrics, child development, parenting and maternity care. Through partnerships with leading healthcare professionals, developmental specialists and international organizations, Johnson & Johnson Pediatric Institute, L.L.C., identifies, develops and implements initiatives and programs that help shape the future of children’s health around the world.

ZERO TO THREE is a national nonprofit organization of renowned pediatricians, educators, researchers, and other child development experts who specialize in the first years of life.

You’ve survived those first 3 months, giving everything you’ve got to help your baby adjust to his new world—no small feat. And your hard work has paid off. Now you know his signals. You know the special voice that he finds comforting, how to rub his back when he needs to burp, and how to make him laugh. He’s awake much more during the day, and he’s more eager than ever to be engaged with you.

For many of you, it is at this time that your parental leave comes to an end and you must return to your paid job—just when the fun is starting. This transition can be very distressing to moms and dads: “Can I find someone who will take care of my baby as well as I do; who’ll keep him safe and help him grow? Will I still be the most special person to him?”

Rest assured, your baby will always know you’re his mom and dad and you will always be the most special people to him. If you’re working, you don’t have to quit your job to nurture your child’s healthy development. As you read about how feeding and playing with your baby are wonderful opportunities to bond with and teach your baby so many important things, think of all the other moments you share each day that enrich your child’s life.

Download The Magic of Everyday Moments™ (4-6 Months)

Helping Your Baby Sleep

Being tired can be a big part of life with a new baby.

But parents can help babies learn good sleeping habits right away.

FOR THE FIRST TWO MONTHS:

1. Make up your own get-ready-to sleep steps.

For example:

Read a short book

Sing a lullaby

Give good-night

Kisses and turn out the lights

2. Put your baby in the crib while still awake but sleepy.

After you put your baby down, it may take 20 minutes for them to fall asleep.

If they cry, check diaper, burps, and rock or cuddle

Lastly, put them back down to finish falling asleep.

3. Do the same get-ready-to-sleep steps every night in the same order.

4. Make middle of the night feedings brief and boring.

5. Keep daytime naps to no more than 3 hours per nap.

6. Try to make your babies go-to-bed time the same as the last feeding of the day.

FOR 2-4 MONTHS:

1. Keep up the same get-ready-to-sleep steps, but add a new step:

Brush your baby’s gums/teeth with water and a washcloth.

2. Have your baby sleep in a separate room. Or:

Use a screen or furniture so the baby cannot see you from the crib.

Do not use a blanket over the side side of the crib as it could cause suffocation.

3. Delay middle of the night feedings.

Try only one or two feedings a night.

Do not lay your baby down with a bottle.

4. If your baby wake more often:

Try to quiet them with some gentle cuddling in the dark room.

Check diapers.

Burp your baby.

Check that your baby is not too hot or cold.

5. If your baby still will not settle down:

Feed your baby with less milk than what you gave during the day.

It takes patience, but you will get to sleep soon!

Adapted From:
Instructions for Pediatric Patients, WB Saunders Co. 1999, Barton Schmitt, MD

Domestic Violence is a Crime

Domestic Violence is a Crime

It may begin gradually as verbal or emotional attacks. It can start when your pregnant or when your baby is born. However, domestic violence is not okay.

What is Abuse?

Emotional Abuse

Constant criticism and jealousy

Making you feel bad and blaming you for when you are not at fault

Being lied to, punished, or threatened

Isolation

Preventing you from seeing friends or family

Your partner is very jealous of anyone else in your life

Threats

Your partner threatens your family, friends, pets, or property

Economic Abuse

Your control over money or income is threatened

Physical Abuse

Pushing, slapping, kicking, biting, restraining, use of weapon against your, or having things thrown at you

Sexual Abuse

You are forced to have sex or your partner refuses to practice birth control

Property Destruction

Smashing, destroying, stealing, or damaging things you value

Truths About Abuse

No one deserves abuse

Domestic violence is not mutual – it is not just an argument or a lover’s quarrel.

People who stay in abusive relationships do not enjoy violence – leaving is not simple, some people are too frightened while others hope the abuse will stop.

Abuse can be found in all parts of the community – people from any social group can be abused.

There is no excuse for violent behavior – violence is a choice, the abusive person is responsible for their actions.

If You are a Victim or a Survivor of Abuse

You are not to blame for another person’s violence.

You have the right to a safe, healthy relationship.

You deserve to be treated with respect.

Make a safety plan in case you need to leave quickly.

Establish contacts with friends/family to go to in an emergency.

Consider getting a protective order to protect yourself.

Abuse and Pregnancy

For 1 of every 3 women who are abused, the first abuse happens during pregnancy

An unhealthy relationship is not just physically hurtful. All abuses are dangerous to your well being and the well being of your unborn child.

Being abused before or during your pregnancy increases your risk of miscarriage, anemia, infections, bleeding during the first two trimesters, and having a low birth weight baby.

Reach Out for Support

You are not alone. Support and help are here.

Call the Safe Place 24 hour help line: 512-267-7233

National Domestic Violence Hotline: 1-800-700-7233

Austin Police Department Victim Services: 512-974-5037

Texas Department of Family and Protective Services: 1-800-252-5400

United Way Capitol Area: 211.

Dial 911 in an emergency.

This brochure is based on information provided by Safe Place.

Let’s Eat!

General Guidelines and feeding tips for baby’s first year!

BIRTH TO 6 MONTHS

What baby does?

Sucks and swallows breastmilk and formula

Pushes tongue out of the mouth when they swallow

New Foods:

Feed only breastmilk or formula with iron

What to do?

Be patient

Feed when your baby is hungry

Learn your baby’s hunger and fullness cues

AROUND 6 MONTHS

What baby does?

Sits with help

Supports and controls head

Can grasp an object and put it in mouth

Opens mouth for a spoon

Can keep most of the food in their mouth

Removes food from a spoon with a sucking action

Turns head away when full

New foods:

Try jarred or home-prepared single-ingredient foods like:

Pureed fruits, vegetables, or meats

Infant cereal

What to do?

Continue breastfeeding or giving formula with iron

Feed with a spoon

Start with a smooth and thin texture

Never put cereal in the baby’s bottle

Follow baby’s lead. Let your baby show you when they are full.

Wait two to three days between feeding new foods.

7 – 9 MONTHS

What baby does?

Sits without help

Moves food from front to back of the mouth

Begins side to side movement of the tongue

Begins to grasp objects with the whole hand and transfer from one hand to another

Starts to mash food with gums

Brings head towards the spoon

Drinks from cup with lots of spilling

New foods:

Plain, cooked, home-prepared foods, strained or mashed with a fork.

Try fruits, vegetables, and meats.

Yogurt, cottage cheese

Very small pieces of hard cheese.

What to do?

Continue to breastfeed or give formula with iron.

As baby gets better at eating, mix food to a thicker texture

Offer breastmilk or formula in small amounts from a cup

10 – 12 MONTHS

What baby does?

Picks up food with thumb and forefinger

Rotary or grinding chewing begins

Drinks from cup with less spilling

New foods:

Small pieces of bread, cheese, noodles, crackers, soft tortilla

Small pieces of cooked, tender, lean meat

Soft cooked pieces of beans and vegetables

Pieces of raw, soft, ripe fruits

What to do?

Continue to breastfeed or give formula with iron

Offer finger foods

Watch baby closely while eating

Keep baby seated in a chair, high chair, or carrier

KEEP IN MIND

Be patient. It may take more than one time for your baby to like a new taste or texture.

Begin with small amounts of foods. Offer seconds if needed.

Do not force your baby to eat or finish all of their food. Turning their head, closing their mouth, shaking their head, or leaning back are signs your baby is full.

Continue to breastfeed or give formula after solid foods are introduced.
Be sure your baby is drinking enough breastmilk or formula.

If your baby is ready for table food, spoon out the amount they will eat before adding salt, sugar, fats, or other seasonings to the food for your family.

Set a good example. Older babies will want to eat what you eat.

If you have a family history of allergies, there may be foods you want to avoid giving your baby. Check with your doctor or clinic. Signs of an allergic reaction include skin rash, vomiting, diarrhea, irritability, or wheezing.

BE AWARE

NEVER give honey to your baby. Honey may have botulism, a germ that can be deadly for your baby.

Do NOT put your baby to bed with a bottle.

These foods may be choking hazards in babies and children younger than 4 years old:

Whole hotdogs

Whole grapes

Popcorn

Chunks of peanut butter

Peanuts and other nuts

Raw hard vegetables

Round, hard or sticky candies

Signs your Baby May Be Hungry:

Getting hungry:

Stretching

Physical Movement

Hand to Mouth

Feed Me:

Crying

Agitated

Turning Red

Choking Hazards for Children Under One Year:

Thickly spread nut butters

Whole nuts and seeds

Popcorn

Raw carrots and other hard raw veggies

Whole grapes

Tortilla and other hard chips

What Your Baby Sees

Baby's vision at birth

FACES AND OTHER OBJECTS

When born, a baby can see faces at arm’s length but are attracted to high contrast edges like hairline or jawline. The image to the right depicts a newborn’s sight: no color, blurry, clear edges like hair and jaw.

Baby's vision at 2-6 weeks

COLOR

Babies start to see limited color around this time. Their eyes might be attracted to brightness, darkness, or contrast. Babies can tell white from black.

Baby's vision at 2-3 months

OBJECT IN FOCUS

Babies can now focus on different objects instead of seeing a blurred image of them.

Baby's vision at 4 months

MOVING OBJECTS

Babies can now follow moving objects with their eyes and can reach for them. Their color detection improves and their eye movements become steady and even.

Baby's vision at 3-5 months

DEPTH – CLOSE AND FAR

Babies have developed depth perception- the ability to see objects close and far away. They can now see in 3D.

Baby Blues

Baby Blues

Very common; can go away on its own, but talking to a health care provider can help.

Signs:

Crying

Not Sleeping

Feeling overwhelmed

Not wanting to eat

Short temper/mood swings

Postpartum Depression

Common anytime during baby’s first year; goes away with help from a health care provider.

Signs:

Sadness

Not wanting to touch or hold baby

Not wanting to talk to family or friends

Thoughts of hurting yourself or baby

Postpartum Anxiety

An intense worry that takes over your life; seek help as soon as possible.

Signs:

Uncontrolled worry

Not being able to sleep when baby does

Afraid that something will hurt baby

Afraid that YOU will hurt baby

Afraid to be alone with baby

Chest pain

Dizziness

Sweating/shaking

Postpartum Psychosis

Not common; SEEK HELP IMMEDIATELY.

Signs:

Hallucinations

Feeling very confused

Speech that doesn’t make sense

Severe insomnia

Thoughts about hurting yourself or baby right now

Where to seek help?

Postpartum Depression Hotline: 1-800-773-6667 (24-hour hotline)

Any Baby Can – Postpartum Support and Groups: 512-334-4444 (Parent Helpline); 512-454-3743 (Main phone)

Postpartum Support International: 1-800-944-4773

2-1-1 Texas from your cell phone: 1-877-541-7905

Postpartum Support International: www.postpartum.net

DSHS Pregnancy, Parenting and Depression Resource List

The National Women’s Health Information Center: www.womenshealth.gov

Parents Anonymous: www.parentsanonymous.org

Depression During and After Pregnancy

The Online PPD Support Group: www.ppdsupportpage.com

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