DEVELOPMENT
Your baby may be holding his head steady when upright and is probably beginning to push up onto his forearms when lying on his stomach. He may begin to roll from front to back, and will begin bringing objects to his mouth. Talk to your baby. He will continue to make more and more varied babbling noises and may begin to imitate sounds. This is an important part of language development.

Some 4-month old babies will be sleeping through the night. If your baby does wake up in the middle of the night, give him time to get back to sleep on his own. If he does not stop crying within 20 minutes, check on him and verbally try to calm him. Try not to get into a waking routine but help him learn to put himself back to sleep. Avoid letting the baby go to sleep with a bottle in his mouth -- this will cause tooth decay. Some children get their first tooth around 6 months of age and many will chew on firm objects and drool a lot for a few months before any teeth actually come in.

NUTRITION
If you desire, your baby may begin to take solid foods now. Try to introduce cereal, then vegetables, and then fruits - some children may view fruits as a dessert. Adding one solid food at a time at intervals of several days is recommended. The amount of solid food per day varies among individual babies. Your baby still needs breast milk or formula to ensure a healthy diet. It is not recommended to give your baby eggs, citrus fruits or strawberries until 9 months of age to help prevent food allergies later. You may want to prepare your own nutritious baby food. Food processors will help you prepare food for placement in ice cube trays. After the food is frozen, place it in a sealable bag in the freezer. Carefully warm the amount you desire to use for each feeding, testing to make sure it is not too hot before giving it to the baby. Commercial baby foods are also convenient. If your drinking water is not fluoridated, you may need to add a fluoride supplement at the age of six months. Please discuss this with us.

SAFETY
Because we also are concerned for your baby's safety, remember to always use the car seat every time your child travels in a vehicle. Your baby should remain rear-facing in their car seat until 20 pounds and 12 months of age. The back seat is preferred for all children under age 12 years. Do not secure a pacifier around a baby's neck with a string. Now that your baby will soon be rolling over, be especially attentive, watching for potential falls. Protect electric outlets and cords from baby's exploring fingers. Passive smoke is dangerous to the baby's health now and as they grow. Walkers are potentially dangerous as well and, in fact, may actually delay your child's walking.

GENERAL WELL-BEING
Most of the illnesses your baby may now begin to experience will be caused by viruses, while some may be caused by bacteria. Babies build immunity with each exposure to the different viruses and bacteria. The frequency of these viral illnesses can be frustrating for child, parent and physician, but generally are not cause for alarm. Antibiotics are used only for bacterial infections. Many bacteria have developed resistance to antibiotics. For this reason we prescribe antibiotics with caution. If your child is running a fever he may need to be checked. The appropriate dose of acetaminophen (Tylenol) is 5-7 milligrams per pound every 4 hours as needed for relief.

NEXT APPOINTMENT
Schedule an appointment for your child’s 6 month physical. Your baby may be due additional immunizations at that visit.