4-Month Guidelines

Infants (0-1 year old) Diet

Breast milk or iron fortified formula is the most important source of calories and nutrition. 28-32 ounces a day is normal for a healthy infant. Many pediatricians recommend waiting until 6 months of age to start solid foods.

If you and your doctor have decided to start solid foods, you may begin with 1 tablespoon of rice cereal mixed with formula, breast milk or a small amount of juice. Once your child takes the cereal readily from the spoon, you may begin to increase the amount of cereal to 2 or 3 tablespoons a serving in 1 to 2 feedings a day. After 2-3 weeks of cereal, you may begin fruits, the vegetables. Give only one new food every 4 days, watching carefully for any food allergy.

Safety Checklist

  • Car seat (rear-facing)
  • Set water heater to 120of
  • Protect your child from falling off of beds and changing tables.
  • Please do not smoke around your child; cigarette smoke has been associated with increased frequency of colds, ear infections and asthma attacks.
  • Smoke detectors are a must
  • Avoid walkers as they can be a source of injury and may actually delay walking.
  • A pacifier may still be needed for comfort, but please do not tie it around the infant’s neck with any cord or string.

Development by 6 months

Rolls both ways easily, sits with or without hand support, transfers objects hand to hand, babbles chains of consonants, responds to his name, enjoys social play, expressive sounds.


Saline drops in the nose followed by bulb suctioning is still best, but you may also give Pediacare infant drops or yellow Triaminic to relieve congestion. Please call the office for an appointment of your child has a fever greater than 24 to 48 hours or if the cold has lasted greater than a week and is accompanied by green discharge.

Vomiting and Diarrhea

If your child vomits, allow the stomach to rest 1-2 hours without any food or liquid. Then you may give him small, frequent amounts of Pedialyte, Ricelyte, or other clear liquids (1/2 ounce every 15 minutes). The amount of liquid can be increased every hour. After eight hours without vomiting, you can restart formula. If vomiting persists greater than 24 hours or if your child appears to be getting dehydrated with no urine in 6 to 8 hours, please call the office for an appointment.


A rectal temperature more than 100.5 is considered a fever. Fever is the body’s natural way of fighting off all infections from colds and other viruses to bacterial infections. Fever itself is not harmful to normal healthy children, but it will make them uncomfortable. Please give your child Tylenol if he seems uncomfortable. If your child seems lethargic and does not resume his normal behavior after his fever is down, please call us so that we may evaluate him. If your child has a fever that persists greater than 24 to 48 hours or if he has a high fever (103+), please make an appointment to have him evaluated.