​Caring Hands Pediatrics

North Office: 412-369-7720
Robinson Office: 412-921-2345

Feeding
Your baby's nutrition still comes from breast milk or formula. Most babies take about 6 - 7 ounces every 4 to 5 hours, though this can vary from child to child.  You can start feeding your baby cereal between 4 to 6 months if he can hold his head up and sit well with support.  If your baby is content and not taking more than 32 ounces/day, wait until closer to 6 months to start solid foods.  If your baby is taking more than 32-36 ounces/day and seems to not be satisfied with the formula or breast milk, start with single grain cereal mixed with formula or breast milk. Initially, make the cereal more liquidy, but you can gradually thicken it as your baby gets used to eating more solid foods. Feed the cereal from a spoon, not in the bottle.  You can also introduce fruits and vegetables at this age; however, as you introduce new foods, try them for 2-3 days before introducing another new food into your baby's diet.  This way, you can monitor to see if your baby has a reaction, which might include rash, vomiting or diarrhea. Also, with trying new foods, it is better to start with single ingredients, rather than mixed foods, in case your child does show symptoms of food allergy.  New research suggests that starting peanut products (like peanut powder or peanut butter mixed into cereal) at 4-6 months decreases the risk of developing peanut allergy.  If there is a family history of food allergies or if your child has eczema, please wait to introduce foods until you discuss it with us.

Give vitamins if you are still breastfeeding and not giving any formula.

Remember, do not give honey to babies under 1 year of age.


Development

  • Smiles, coos, laughs, squeals
  • Plays with hands and reaches for objects.
  • Holds head high


Sleep

Babies should be placed to sleep on their backs. Most babies will sleep through the night by 3 to 4 months and nap 4 to 6 hours during the daytime. Try to place your baby in the crib when he or she is drowsy, but still awake. Do not put your baby in bed with a bottle. Try to establish a good bedtime routine to help your child learn to fall asleep on his or her own and be more likely to sleep through the night. When babies awaken in the middle of the night, they frequently need the same surroundings to help them fall back to sleep. So if your baby is used to being rocked to sleep, he will need to be rocked again when he wakes in the middle of the night. If you help your child learn to fall asleep independently, he will be more likely to put himself back to sleep on his own.

Teething
Many babies begin teething at this age. You may notice your baby drooling a lot and chewing on her fingers. You can use a teething ring. Oftentimes, babies will teethe for a long time before the teeth actually break through the gums.

Safety

  • Remove hanging mobiles from the crib.
  • Keep ropes, cords, necklaces and strings away from your baby to prevent accidental choking.
  • Continue to use a rear-facing infant car seat.
  • Place your baby to sleep on his or her back.
  • If you have gas appliances, install carbon monoxide detectors and ensure that they are working properly.
  • Make sure that your smoke alarms are working properly.
  • Do not smoke in the house, car or around the baby.
  • Be sure to test the water temperature before bathing your baby.
  • Turn your water heater down to 120 degrees F.
  • Never hold your baby while drinking hot liquids.
  • Never leave the infant alone in the house or car, even for a minute.
  • Never step away when the baby is on a high place, such as a changing table or sofa.​​


Immunizations


The DTaP, IPV, Hib, PCV13 are given as shots, but the Rotavirus vaccine is given by mouth.

Your baby may get a fever and be fussy for 24-48 hours after the immunizations. There may also be some soreness, redness and swelling at the sites of the immunizations. Acetaminophen may be given to help make your baby more comfortable.

For more detailed information about each vaccine, click on the above links. ​

4 month visit