Name:​                     Date:​

Weight:​                   Height:​                        Head Circumference

Sleep: By four months almost all babies can sleep through the night (at least 8 hours). A consistent bedtime routine will help your baby wind down before bed. Most babies this age still need two naps, from one to three hours each. Some nighttime crying is normal and in no way harmful to your baby.

Feeding: Between four and six months your infant will be ready to start solid foods. Cereal is gentle for infants, and a very good first food. A general rule to keep in mind when feeding solids, is to introduce only one new food at a time about every four days. If a problem develops, this will allow you to know which food is responsible. When starting cereal, begin with a teaspoon of rice cereal mixed with enough formula or breast millk to make a thin paste (like mustard). Feed this with a baby spoon. Most babies will spit it out at first, but after a few days some cereal should begin to make it into the stomac! Your baby’s appetite will be the best guide to determine the amount you give; when he slows down, it is time to stop. Two tablespoons twice daily is an average amount at his age, but some babies can take 2-3 times this amount. Barley and oatmeal can be given now also. Keep in mind that most babies’ stools will become a little harder when starting cereals. For more detailed instructions please go to the Nutrition section of Online Education on our website. All breastfed infants and all infants taking less than 32 ounces of formula should begin taking a Vitamin D supplement (Trivisol).

Development: At four months many babies are reaching for objects and bringing their hands to the midline. They will follow from side to side with their eyes and begin to laugh and squeal. Most babies will raise their chest when they are on their stomach and some may begin to roll over.

Safety:
· Never leave your baby alone, except in a crib or playpen. (always keep the sides up)
· Avoid suffocation and choking by using an approved crib with a firm mattress that fits snugly.
Place your baby on his back. Pillows, blankets, wedges, positioning devices, and bumper pads are no longer recommended. Keep plastic bags, balloons, and baby powder out of reach.
· Prevent fires, burns and scalding injuries. Never eat, drink, or carry anything hot while near or holding the baby. Turn your water heater down to 120 degrees (F). Install smoke and Carbon Monoxide detectors.
· Car Safety: Use an approved infant safety seat, rear facing and never in the front.
(Parents should always wear their seat belts.)
· Never step away when the baby is on a high surface.
· Do not put your baby in a walker.

PHA Standard Immunizations:​  Pentacel #2, Prevnar #2, Rotavirus #2

Tylenol Dose:​​Next Visit:

Our well care handouts & Tylenol/Motrin dosing are available on-line at www.phapc.com