My baby at 4-6 Months

"Baby Times" information for you!


Saint Elizabeth offers you our "Baby Times" information from local and area experts on your 4-6-month-old baby! We have divided the information into useful "Time" categories. We want you and your baby to lead long and healthy lives.
Time to Eat!

Introducing Solid Food to Your Baby
By:  Michelle Walsh, M.D.
        Jamie Jeffrey, MSN, APRN, CPNP
Breast milk and/or formula meet all of your baby’s nutritional needs until 4- to 6-months of age, when you can start adding solids to their diet.  Introducing solids earlier makes feeding more complicated:  Infants are unable to be spoon-fed due to the tongue thrust reflex.  Also, early introduction of solids can increase the likelihood of food allergies. Research has also shown that in most cases starting solids earlier does not help your baby sleep through the night.

Rice Cereal
Between 4- to 6-months of age, iron fortified infant rice cereal may be added to your infant’s diet.  Mix 1 tablespoon of cereal with formula, breast milk, or water. Cereals should be fed with a small spoon and never given with formula in the baby’s bottle. Gradually increase the size and frequency of feedings.

One at a Time
Once your baby has accepted the cereal, slowly start introducing other foods around 5-months of age. Introduce just one new food at a time, and wait at least 2 to 3 days before introducing another.  Watch for allergic responses such as diarrhea, vomiting, or rash after each new food.  Strained or pureed fruits and vegetables are the next foods introduced to your baby’s diet.  Start with yellow and orange vegetables and fruits such as sweet potatoes, squash, carrots, pears, applesauce, and bananas.

Finger Foods
Around 6- to 9-months of age, you can advance to textured foods and finger foods.  Older infants may require 2 to 3 meals a day with a decrease in formula and/or breast milk intake.  Green beans, peas, crackers, teething biscuits, and unsweetened cereal are just examples of foods that can help your infant learn to feed himself. Fruit juices are optional and your child should not be given more than 4 oz/day. Tomato, orange, and other citrus fruits should be avoided.  Start to offer your infant a cup.

Table Foods
Around 8- to 9-months of age, deli meats such as turkey, ham and roast beef can be cut up into small pieces.  Between 9-12 months of age, the majority of food is table food. Do not give your child foods such as hot dogs, grapes, and popcorn, as they might easily choke on these.  Eggs, fish, peanut butter, and orange juice may be more likely to cause allergies than other solid foods.  Avoid adding these foods to your baby’s diet until 1-year of age.

Whole Milk
At 12-months, whole milk replaces breast milk and/or formula.  Consult your baby’s health care provider with any questions regarding your infant’s nutrition.

Dr. Walsh is a board certified pediatrician at Pediatrics, P.C. in Lincoln.  She has been serving the Lincoln community for five years.  Jamie Jeffrey is the pediatric nurse practitioner at Pediatrics, P.C.  She works in collaboration with Drs. Fletcher, Kinberg, Koch, Shriner, and Walsh.

Time To Grow
Baby’s Changes---A Routine!
You may have noticed that your baby is beginning to develop some type of schedule or predictability. The average amount of time that a baby sleeps is about 16 hours-a-day—but this can range between 12- and 20-hours!  Usually, babies will sleep for 3-4 hours between feedings., depending on how hungry your baby is, their temperament, their health, their activity level or their sleeping environment. 
Most babies will sleep through the night (7-8 hours) when they weigh about 12- or 13-pounds.  When your baby experiences a growth spurt (usually around 2, 4, 6,and 12 months of age—expect some abrupt changes in their “schedule”.  Suddenly they will want to eat more frequently and sleep so that their body can cope with its rapid growth! Usually, babies will take two naps-a-day until they are at least 12-months old.

Your baby’s natural desire to learn and explore will become more obvious—as they reach out for objects, try to put everything into their mouth, begin rolling or creeping towards objects and begin to try to interact more with you. You may notice that your baby is beginning to experience sounds—saying syllables over and over.  This is important in helping them learn to say “ mama” and “dada”!  You may even see your baby respond to familiar names of people or toys!

…“but those who wait for the Lord
shall renew their strength,
they shall mount up with wings like eagles,
they shall run and not be weary,
they shall walk and not faint.”
Isaiah 40:31

Healthy Time
RUNNY LITTLE NOSES
By: Harlan C. Shriner, Jr., M.D.
Jamie Jeffrey, MSN, APRN, CPNP
Children will have more colds or upper respiratory infections than any other illness! Colds are caused by viruses and unfortunately there is no cure. The common cold is a runny or stuffy nose that usually clears up in a few days without any need for medication or medical care.

When your infant starts displaying signs and symptoms of a cold, run a cool mist vaporizer in his/her room. This will help keep nasal secretions more liquid and keep your infant more comfortable.  Most health care providers recommend using saline nose spray or drops to help liquefy the secretions.

Nasal Treatment “Flip”
Quoting from Infectious Diseases in Children Journal, (1996), Dr. Harlan Shriner Jr, M.D., Pediatrics, P.C. from Lincoln, describes the “Shriner Flip”:  “I have parents instill 4-6 drops of saline nose drops into each nostril with the baby lying on its back, grab the feet and gently but quickly raise into the down position to let the drops go clear to the top of the nose for about 5-seconds and then continue on over with the feet so that the baby does a backward somersault, basically, and ends up face down. I then take some Kleenex and gently wipe away what secretions are coming out of the nose.  This does an extremely good job of flushing the sinuses.  Most babies, after doing it a few times, do not get upset with the procedure whatsoever if it is done gently.  Using saline nose drops is quite helpful in decreasing the incidence of sinus infections in infants”.

When a runny nose is accompanied or followed by other symptoms, such as fever for more than four days, difficulty breathing, or symptoms that last for more than two weeks, your infant may have a serious problem.  In such cases, you should consult your baby’s health care provider.

Dr. Shriner is a pediatrician at Pediatrics, P.C. He has been serving the Lincoln community for more than 30 years.  Jamie Jeffrey is the Certified Pediatric Nurse Practitioner at Pediatrics, P.C. She works in collaboration with Drs. Fletcher, Kinberg, Koch, Shriner, and Walsh.
   

Sick Time
SIGNS OF ILLNESS FOR BABY:

  • Not eating well.  Refusing 2-3 feedings in a row.
  • Crying a lot or differently—like a high-pitched whiney cry
  • Having dark, sunken eyes
  • Doubling up their legs.
  • Tugging at their ears
  • Rolling their heads from side to side
  • Has a fever greater than 100.5 degrees.
  • Is sleepy all the time and hard to wake
  • Is having trouble breathing or is breathing unusually fast
  • Has an unusual rash
  • Has diarrhea or stools that are too firm
  • Vomits.  This is different from spitting up.  When a baby spits up, stomach contents spill out—as if they ate too much. When a baby vomits, it may be forceful and often is larger amounts.
    If baby shows any of these symptoms, notify your baby’s health care provider.

TIMELY TOPICS
TEETHING
It is usually between the 4th and 7th months that your baby will begin the teething process. While this is an important milestone that excites parents, your baby may not be all that excited!

Days before you see any signs of teeth, your baby may act fussy, may want to chew or suck more, and may seem to try to rub at their mouth or nose area of the face.  You may also notice that your baby is drooling more, and may feel slightly warm.  If your baby is running a temperature greater than 100 degrees, it is usually not associated with teething and you should notify your baby’s health care provider.

Usually, the first teeth to poke through are the middle bottom teeth. It may be helpful for your baby to chew on a cold teething ring or a teething biscuit.

Even though these are only “baby teeth”, it is important that you provide good care for healthy permanent teeth.  You can keep your baby’s teeth clean by using a soft baby tooth brush or wiping them down with a soft cloth.  Most dentists prefer that you schedule your baby’s first visit when they are about 3-years-old and they have all 20 of their baby teeth.

The importance of starting good dental care habits cannot be stressed enough.  As parents, you can set the stage for the importance of good oral care for your baby.

PLAYTIME!
At this age, your baby begins to discover more of his/her body parts.  It’s fun for them to grab their toes.  As with anything they are interested in, what ever they grab hold of, tends to go into their mouth. This is their favorite way to learn about something!
Your baby may begin to play games with you such as “where did the ball go?” as you roll it away form them.  Musical toys that teach them cause-and-effect are good.  Soon, they will discover that if they move the toy, a sound will occur. Your baby learns more about his/her world, each time a new toy, song, type of music, texture, smell or sound is introduced.  However, you don’t want to overload your baby so it’s a good idea to gradually introduce these new activities.

 It’s also a good idea to include activities in your playtime that encourage movement, and help them develop a good sense of motion, balance, and space. Taking them for airplane rides, or including a swing or rocking during their day will give them a sense of rhythm and repetition, and help them learn how their body works with space.

Babies can now see most colors, and they will track or follow objects more closely. They are able to see about 2-3 feet away at 4-months, and will be able to see even further by 6-months.  Your baby will briefly try to Find an object if it goes out of range or his/her vision.

DADDY TIME
TIME FOR YOU & MOM TO EVALUATE LIFE-WITH-BABY
Are you both contributing to the care of your baby, or do you feel more like a babysitter, dad?
Do you both have clear expectations and a good understanding of the division of chores in the house?
Do you take the time to talk with each other and share feelings about parenthood, lifestyle changes, and what is important to each of you in your relationship?
Are you able to live out your goals for parenting and being a good father?
If not, what seems to be getting in the way?

These questions are important to doing “reality checks” along the way—to see if your relationship, parenting techniques, and your career are what you thought they would be.

Being an involved dad means making deliberate plans to interact with your baby and your other children. It’s great if you can have a special time with each child. This will long-serve as a special memory with your child.  If you feel like you are missing out on your baby’s exciting development, maybe you need to re-think your priorities.  Are you trying to do too much?  Can anything be changed: work hours? Responsibilities? You should feel you have an equal role in the development of your baby.

If one parent starts to feel as though they are carrying the bulk of the load with parenting, it could result in tension in your relationship.

Open lines of communication are critical, for the health of your relationship, and also for your baby to learn about communication. Your baby is constantly watching and learning from you, how to interact with others and how to respond to different tones and volume of voice, as well as body motions that go along with your conversations.

Alone Together
It would also be a good idea for mom and dad to spend some time alone as a couple.  In fact, regular nights out each week or month can serve as a great way to rekindle romance and stay in touch with your spouse.

If fatherhood isn’t quite what you thought it would be, here are some ideas to examine: can you share these thoughts with your spouse? Does mom give you the time, freedom and encouragement to help you feel that you are an important part of your baby’s life?  Do you need to re-prioritize some of the things to assure you have regular family time?  Or, do you need to change your non-verbal behavior so your children feel comfortable around you? Be sure you start off as a good role model for your baby—both in how you interact with your baby and other.
Your baby is learning from you!

TOOL TIME
STAYING IN TOUCH WITH YOUR BABY’S DEVELOPMENT
As parents, you are the best spokesperson for your baby if you have concerns that something is just not quite right.  Whether it’s a gut feeling or you have evidence there may be a problem, here are some key things to watch for:

  • Does your baby seem to hear OK?
  • Is your baby responding to you by trying to imitate your expressions and noises?
  • Does your baby like to play games?
  • Does your baby bring objects to his/her mouth?
  • Does one or both of your baby’s eyes track objects when they move by them?
  • Does your baby have good muscle tone—holding his/her head up, trying to sit up, and trying to move through creeping, rolling and/or crawling.
    If you are concerned about any of these developmental areas, be sure to contact your baby’s health care provider.

SAFE TIME
IS YOUR BABY’S WORLD SAFE?
As your baby begins to spend more time on the floor—creeping and sitting, it’s more important than ever to check your home for safety concerns.  Outlets, extension cords, sharp corners, cleaning supplies in lower cupboards, stairs, non-age appropriate toys and inappropriate foods are just some of the safety hazards that your baby might experience. Follow these guidelines:
1. Get down on the floor, on your baby’s level—and inspect all space between you and the wall.  Check for any plants, toys, purses/backpacks, objects on the floor, cords, sharp corners and/or outlets that might be a temptation for your baby to explore.
2. When your baby is sitting up on the floor, be sure to prop some firm pillows around him/her to protect them from injuries if they fall over.
3. Install gates at the top of stairs.
4. Always use your car seat, properly installed in your car—even on short trips.
5. Be sure to give your baby age-appropriate toys to play with (even if your baby seems advances for his/her age—the ages on the toys are there for a reason!)
6. When introducing finger-foods—avoid sticky substances  (marshmallows and peanut butter) that could cause a baby to choke. (hot dogs, grapes, popcorn, raw carrots—even bananas!)  It’s tempting to cut “across” food for a “bite-sized portion”, but this makes the food the exact size to get stuck in your baby’s throat.  Be sure to cut food into a size smaller than a ¼ wedge of a hot dog—and make sure the foods are soft enough for the baby to “gum”—or mash down with their gums before they swallow it.
7. Complete the next level of immunizations. These might include DPT, oral polio, and HIB at 4- and 6-months, and HB (hepatitis) sometime between 6- and 12-months.
8. Select a high chair that has a broad base to prevent tipping, and has belts to help secure your baby in the correct position.