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Developmental Goals:

·         Place baby on his or her belly for tummy time during supervised play to build arm and neck muscles.  This aids in learning to roll by 6 months.

·         Reaching and grabbing begins at 3-4 months.  Offer toys for baby to grab and chew.   It is normal behavior for babies to put everything from toys to toes in the mouth!

·         Language is developing, so talk and sing often to your child.  Don't use baby talk.

·         Sing, play peek-a-boo and allow baby to look at self in a mirror.

·         Encourage sitting.  Have baby sit on your lap, sit him on the floor with pillows and gradually allow more independence as the muscles strengthen.  Most babies can sit independently by 8 months of age.

·         Read to you child 20 minutes each day.

·         Turn the television off.

Diet:

• Breast milk or formula is all that is needed nutritionally until 6 months, but cereal can be started at 4 months if baby has good head control and shows interest in foods.  When they eat cereal well off a spoon, begin other pureed foods.  Click here for more information.
• Expect a mess as baby learns!
• No juice!
• Vitamin D is recommended for all infants not getting 33 ounces of formula.  Breast milk does not add into this volume, since minimal vitamin D is in breast milk.
• The American Academy of Pediatrics recommends an iron supplement for all infants over 4 months who are breast fed.  This is in addition to iron rich foods for all infants who have started solids.
• Do NOT heat bottles in microwave.

Discipline:

• As baby begins to explore, protect him/her from danger.
• Use distraction to divert attention from dangerous situations.

Safety:

• Never allow smoking around your baby or in the home, even if baby is not around.
• Turn the water heater down to 120° F.  You can use a meat thermometer to check the hottest water temperature from the tap.
• Never hold a baby while cooking or drinking hot liquids.
• Never use a walker with wheels.  Exersaucers are acceptable.
• Watch for small objects a child may choke on (toy parts, buttons).  Get down to their eye level to childproof.  Notice door stoppers (the tip might come off!), cords that can be wrapped around a neck or cords that can pull heavy or hot objects down.
• Never leave baby unsupervised on a changing table, sofa or bed.
• Never leave young children alone in a bathtub or near water.  Close the bathroom door when not in use.  Put toilet seats down so children don't try to climb in!
• Always use your car seat facing backwards until 1 year of age.  We don't recommend heavy clothing (such as sweaters or coats) to be worn when in a car seat.  It is safer and more comfortable to be in a regular shirt with a blanket on top of the seatbelt.
• Never place a car seat in front of an airbag.
• Always leave contact information with babysitters.
• Do not dispose of medications by flushing down the toilet or pouring down a drain.  To learn how to safely dispose of medications, click here.
• Have baby sleep on back until rolling over to tummy on own.  No pillows, loose blankets, stuffed toys, or bumper pads in bed to decrease ‘SIDS’.
• All parents should learn CPR and refresh skills every 2 years.  For a list of CPR classes for both non-medical and medical professionals, click here.

Sleep:

• Start a regular bedtime routine.  Keep sleep times at the same time daily.  Do quiet activities before bed, such as reading a book.
• Rocking to sleep is a tough habit to break.
• Put baby to sleep awake.  If they feed just before bed and fall to sleep, you can waken them with wiping the gums/teeth with a soft cloth.
• Never put baby to bed with a bottle.

Health:

• Use Acetaminophen (Tylenol) as directed.
• Most children get 8-12 colds per year.
• Antibiotics don’t cure viruses.
• Use saline nose drops with bulb syringe for any nasal congestion.  The Nosefrida nasal aspirator is one recommended brand.
• OTC (over the counter) cold medicines are NOT recommended.
• Wipe baby teeth daily with cloth or toothbrush.  For more information on teeth, see our dental pages.

Immunizations:

• Fever is common after shots.  Give Acetaminophen every 4-6 hours as needed for fussiness.  There is research that shows that giving fever reducers diminishes the effectiveness of the vaccine, so avoid routine use to prevent symptoms. 
• Sugar solution to suck on during injections has been shown to decrease the pain of injectable vaccines.  This can be made by simply dissolving sugar in water and dipping a pacifier into the solution before the shots.
• Bring your shot record each visit!
• Review the VIS (Vaccine Information Sheet) before visits.

Be sure to obtain any required health forms at your well visit!