4 Month Visit Bright Futures Handout edited by Mark Simonian MD 

How is Your Baby Doing?
1. Take time for yourself
2.Take time for your spouse
3. Spend time alone with your othr children
4. Encourage your spouse to help care for your baby
5. Choose a mature, trained, responsible babysitter or caregiver
6. Hold, cuddle, talk to, and sing to your baby each day
7. Massaging your baby may help the baby go sleep more easily
8. Get help if you or your partner are in conflict

Feeding Your Baby
1. Feed only breast milk or iron fortified formula in the first 4 to 6 months
2. If breastfeeding plan for pumping and storage of breast milk

If formula feeding
1. Make sure to prepare, heat and store the formula safely
2. Hold your baby so you can look at each other while feeding
3. Do not prop the bottle or give the bottle in the crib

Solid Foods
1. You may begin to feed your baby solid food when your baby is ready
2. Some of the signs that your baby is ready: Opens mouth for spoon; sits with support; has good head and neck control, is interested in the food you eat
3. Avoid foods that are common causes of allergies like peanuts, tree nuts, fish, and shellfish
4. Avoid feeding your baby too much by being aware of signs of fullness like turning aware or leaning back

1. Use a rear facing safety seat in the rear seat of all vehicles
2. Always wear a seat belt and never f=drive after drinking alcohol or taking drugs
3 Keeps small objects away from the baby including plastic bags
4. Keep a hand on your baby on any high surface from which the baby can fall and hurt him or herself
5. Prevent burns by setting your water heater below 120 degrees F
6. Do not drink hot drinks when holding the baby
7. Never leave your baby alone in water even in a bath seat or ring
8. The kitchen is the most dangerous room. Don't let your baby play there except in a playpen or high chair
9. Be cautious of baby walkers in a home where the floors are uneven for concerns about tipping over

Your Changing Baby
1. Keep routines for feeding, naptime and bedtime
2. Put your baby to sleep awake or drowsy, on his or her back, in a safe crib at the same time each day for naps and bedtime

Crib and Playpen
1. Lower your babies mattress before he or she can sit upright
2. Make sure the sides are always up on the crib
3. Do not use loose or soft bedding such as quilts, pillows, of pillow-like bumper pads
4. If using a mess playpen, make sure the opens are less than 1/4 inch apart

1. Learn what things your baby likes and doesn't like
2. Encourage active play
3. Offer mirrors, floor gyms, colorful toys to hold
4. Promote quiet play
5. Hold and talk with your baby
6. Read to your baby often

1. Give your baby a pacifier or allow him or her to use their fingers or thumb to suck when crying

Healthy Teeth
1. It is important to keep your teeth healthy so don't pass bacteria that causes tooth decay on to your baby
2. Do not share spoons or cups with your baby or use your mouth to clean the babies pacifier
3. Use a cold teething ring if your baby has sore gums with teething

What to Expect at 6 month Visit
1. Introducing solid foods
2. Getting help with your baby
3. Home and car safety
4. Adding Fluoride to the diet
5. Reading to and teaching your baby

Poison Control: 1-800-222-1222
Child Safety Seat Inspection: 1-866- SEATCHECK; www.seatcheck.org