DEVELOPMENT
It is astonishing to think that the baby you have now is the same child you held only a few months ago. You see a great contrast between the little sleeping baby you brought home a few months ago and the bright-eyed noisy little person you see now. By 4 months of age, your child's weight should almost be double the birth weight.

WHAT TO EXPECT THE NEXT FEW MONTHS
Now that your baby is more awake and interactive, you need to provide appropriate stimulation in the form of toys, books, music and conversation. When choosing toys, remember that babies explore everything with their mouths. Even at this age your child will benefit from you reading to him or her. Reading to children at an early age may allow for earlier development of language skills.

This is a very exciting time. Babies now can probably hold their head steadily, roll over, reach with hands, smile, laugh and make cooing noises. Mom and Dad have become familiar to them and they enjoy just looking around.

Remember that crying remains a baby's primary means of communication. Make sure that nothing is hurting the baby and the baby does not need a feeding or changing. Rocking, swinging and holding the baby will usually calm him or her. If you increase the time you hold the baby during the day, he or she may cry less. If your baby cries inconsolably and you cannot find a reason, call your doctor.

Remember that babies develop and grow at their own pace. Comparing your child with other children will not help and may cause unnecessary worry.

NUTRITION
Your baby probably still only needs breast milk or formula at this age. If your baby is growing appropriately and is satisfied with breast milk or formula, you do not need to add solid foods. Continue nursing or giving the baby formula. The addition of solid foods can be discussed individually with your physician. The baby should be held while being fed. You should not prop the bottle. This practice can lead to choking, tooth decay, increased ear infections and other problems.

IMMUNIZATIONS
Your child may be receiving immunizations at the 4-month visit. Discuss with your physician which immunizations your child should receive and the potential side effects. To help with the possibility of some of the side effects, Tylenol® (acetaminophen) may be given every four to six hours over the next 24 to 48 hours. If you have any questions about your child's reaction to the vaccine, please talk with your health care provider.

SAFETY

• Use of a car seat remains a must.
• Babies have more mobility, never leave them on an elevated surface.
• When selecting toys, make sure the toys are age appropriate.
• Be especially aware of toys with removable parts that could choke your child.
• Choking also can occur with cellophane, plastic bags and rubber balloons.
• Toys with long strings and chains should not be given to children when they are alone, because these items pose a risk for strangulation.
• Be sure to keep all cords out of the child's reach.
• Make sure to place all cleaners and medications out of your child's reach.
• Never place cleaners in different or unmarked containers.
• Never leave the baby unattended in the tub for any reason.
• Place smoke detectors on every floor and in children's rooms. Change batteries annually.
• The water temperature on your water heater should be 120 degrees Fahrenheit or less.
• Do not use Q-Tips® to clean the ear canal as this practice may cause more harm than good.
• If you heat a bottle for feeding, test the temperature on your wrist prior to giving it to the baby.
• Walkers are not recommended for use with infants or toddlers.
• Make sure the home has no peeling or chipped paint that an infant may ingest. Ingestion of lead-based paint may place the child at risk for lead poisoning, which can lead to brain damage.

If you have more questions, please do not hesitate to call your physician.

SOURCES: American Academy of Pediatrics; Bright Futures.