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4 Month Olds

My Four-Month-Old and Me

Parents often tell me at this age, “My baby is so much more interested in playing than eating!” It seems that it is usually said with a combination of wonder and concern on the part of the parent. Breastfeeding mothers are usually concerned that their milk supply will drop because Baby does not feed as long as she did at 2 months of age. There is a growth spurt that occurs around 3 months of age resulting in most babies reaching their “chubbiest” stage by 4 months. Now the growth is beginning to slow down a bit and your baby no longer requires as many calories.

Baby’s development will take huge strides:

  • Reaches and grasps her rattle or teething ring.
  • Does “push-ups” when on her tummy.
  • Kicks a lot and will stand up when lifted by the arms gently.
  • Leans forward when seated to support herself a few seconds before falling over.
  • Smiles, laughs and coos, especially when spoken to by parents.
  • Holds her head up when she sits.
  • Puts everything in her mouth, especially her hands and feet.
  • Follows parents’ face from side-to-side and up-and-down.
  • Rolls over occasionally. Do not leave her on a bed unattended!

Baby finds his new skills more delightful than eating at this age. He may want to play after eating for just 5 minutes! How could he possibly be full? Probably he’s not, but you cannot force a baby to eat. Let yourself have fun with his interest in playing, and don’t sweat the short feed. At this point in his life his development through play is just as important as his eating.

Some ideas for play:

  • Read board books to Baby. He will hit and mouth them. Believe it or not, this is a really good thing! Don’t worry about reading all the words. You can just point out pictures.
  • Sing songs to Baby. Some all-time favorites are animated songs such as “The Wheels on the Bus,” “Gulp, Gulp Went the Little Green Frog,” “Old McDonald Had a Farm.” What were your favorite songs as a child? Do you have any favorite spiritual songs? Sing them!
  • Light and Music Mobiles are fascinating for him now. He may reach for them.
  • Swing or Bouncy Seat Play Time will come in handy when Baby seems to want to play non-stop and you need a breather.
  • Go for a walk every day. Not only will this help Baby get ready for nap time, it is good exercise for you and starts a healthy family habit. You may find Baby is less likely to fall asleep on the walk if you put him in a backpack or Baby Bjorn rather than the stroller. Try tying a dryer sheet near Baby to help keep mosquitoes away. It is fine to use bug lotion and sunscreen at this age, but don’t forget to wash it off afterward. Remember to avoid extreme heat and cold. Try to walk before 10 am or after 4pm to avoid excessive ozone.
  • Play Peek-A-Boo! Use your hands or a thin blanket to momentarily hide your face or Baby’s face, then pull it off and say “Peek-A-Boo!” This helps baby practice “object permanence” and get ready for when you may be going back to work or dropping off at daycare.
  • Tummy Time. Put Baby on his tummy often during his playtimes to help develop his back, neck and trunk strength, to help round out his head, and to allow his bald spot to grow back in. There is a very typical bald spot on the back of the head at 4 months of age that grows back around 9 months. Interestingly this is also the time that most mother’s find they have hair loss also.

Feedings: Baby will take 4-6 breastfeeds (or formula bottles) per day. The amount in each bottle will generally be 6oz. Do not start juices or water just yet.

Bedtime:

Baby will move from 6 hours of sleep at night to 8-10 hours of sleep at night if you develop a regular bedtime routine that transitions him to sleep.

How do you know when he is ready to skip his late-night feeds? Developmentally, he is ready at four months. Your cue is when he begins sleeping through his late night feed on his own or when he takes less milk than his usual day time feeds.

Bedtime Routine

  • The bedtime routine should be short and occur at the same time almost every night.
  • A common routine is a bath, moisture cream massage and change into bed clothes.
  • Follow with a few minutes of reading and the last feed of the evening with soft talking, singing, prayer, rocking or quiet time. Dim the lights and avoid stimulating play.
  • Put Baby into his crib with his eyes still open and remember to put the rails up.
  • It is best to avoid use of music and light mobiles at bedtime as this may stimulate Baby.
  • Make a point of keeping the bedtime routine at the same time every night as much as possible. Remember that you decide when bedtime is, not Baby.

In addition to creating a bedtime routine that fosters sleep, you also have the job of learning not to jump at every little coo and whimper. This is a perfect time to move Baby to his own room (if he is still in your room) so that you do not hear every noise.

Baby may cry when laid down to sleep or when he drifts between sleep cycles at night. Give him a chance to console himself back to sleep. If you become part of his arousal pattern now, you will have to be there every 3 hours to console him back to sleep between each sleep cycle. In the long run, this does not benefit Baby or you.

  • When you put Baby down to sleep, lay your warm hand on his tummy for a few seconds, “shh” him and then quietly walk out of the room.
  • Most babies will fall asleep after 15-20 minutes of noise making or a little fussing.
  • If baby cries loudly, check on him, but do not pick him up or feed him. Follow the sleep training guideline and timing of interval checks in “My Two Month Old Baby and Me.”
  • Avoid turning on bright lights or making strong eye contact as this may stimulate him.
  • A few gentle pats,“shh” and observing that he is not too hot or cold or with a messy diaper is the extent of your checks.
  • Once you have assured yourself that he is okay, leave his room.
  • After about 5-7 nights, he will settle into his new routine.

Sometimes Baby may be ill, sore from shots, have not eaten well or have his schedule altered due to travel. Be flexible and give him extra care during those nights. Do not be afraid that his schedule is “permanently ruined.”

Nap Time:

Baby will take 2-3 naps a day. One nap will usually last for about 1½ to 2 hours. The other nap will be shorter (perhaps only 30-45 minutes). Some babies take their longer nap in the morning and some take it at mid-day. Avoid naps in the late afternoon (after 5 pm) as this will interfere with his sleep at bedtime. If your baby is resistant to taking a 3rd nap, just completely drop that nap and put Baby to bed around 6:30 pm. If Baby is resistant to the morning or mid-day nap, try feeding her. If she is not interested in eating, put her back down to finish her nap by gently patting her a moment and giving her the pacifier or her hand. This is a phase that may recur at different times during her infancy. f you find Baby cries excessively when first laying down for her nap, try gradually making the nap time earlier. She may be getting over-exhausted.

Typical Schedule:

The actual times may be different for each baby, but they should be consistent every day.

7 am Wake- Up Time** Parent picks baby up from crib and changes diaper.
8 am Play then Feed Time (usually breast-feed for 20 min. or 4-5 oz bottle)
9 am Morning Nap Time (allow her to awaken on her own from nap)
11 am Play and Exercise Time This is perfect for Tummy Time
12 pm Feed Time (breastfeed for 15-20 min. or 4-5 oz bottle)
1 pm Afternoon Nap Time (allow her to awaken on her own from nap)
2 pm Play and Exercise Time This is perfect for Tummy Time
3pm Feed Time (breastfeed for 15 – 20 min. or 4-5 oz bottle)
4pm Play, Walk Outside Time (sunlight exposure for 15 min).
5pm Exercise, Stretches, Bath, Massage Don’t forget to apply lotion.
6 pm Feed Time (breastfeed for 15-20 min or 4-5 oz bottle) with lights low.
6:30pm Bed Time (Place baby in crib with eyes still open)
7pm Mom pump time (20 min dual electric pump) then Mom to bed.
10 pm Mom pump time, Dad’s Feed time*** (give pumped milk or formula)
 Many babies can sleep 8-12 hours at night by this point. Please check with your pediatrician at the 4 Month Well Check before proceeding with any dropped feeds. Some babies may still want/need a “dream feed” around 10 pm and/or an early morning feed around 5 am. Avoid any feedings after 10pm or before 5 am.
See the Sleep Training section of “My Two Month Old Baby and Me” for instructions on eliminating night-time feedings.

 

Note: If Baby normally breastfeeds, but you want him to know how to bottle feed, be sure to let Daddy give him one bottle (with breast milk or formula) a day so Baby can practice this skill. Pump the bottle for the next day while Daddy feeds Baby.

The schedule above is just an example. You will find a schedule that works well for YOU and Baby. The key is consistency with wake-up time and bedtime.

Mothers who have returned to work:

  • You will find the best time to express extra breast milk is in the morning after the first a.m. breast feed and during breaks at work. Milk production slows in the evening. It is helpful to completely empty your breasts by pumping for 20 minutes with a dual electric pump before you go to bed for the night. If your baby still takes a dream feed around 10 pm, this milk could be given by bottle at that time. Freshly pumped milk may be at room temp for 4 hours.
  • Remember to drink plenty of water (12 cups per day) and take a multivitamin with calcium.
  • You can breastfeed again when you arrive home from work and at Baby’s bedtime. You may feel the urge to keep baby up late or continue to feed her at night since you are gone during the daytime. Remember that it is best for Baby to receive 8-10 hours of consolidated sleep at night. Sometimes this is more difficult for Mother than Baby!
  • Baby needs a happy and fulfilled mother. For you, this may mean work outside the home. Do not make yourself feel guilty. If you are not happy working outside the home, talk to your spouse or supportive friends and family about other possibilities.
  • Breastfeeding is no longer a reliable method of birth control. Talk to your doctor.

“When I approach a child, he inspires in me two sentiments — tenderness for what he is and respect for what he may become.” — Louis Pasteur, French chemist/microbiologist

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