4 Month Check-Up Doctors Note Template printable pdf download

4 Month Check-Up

BECOMING SOCIAL

Name___________________________

Weight _____lbs. ______oz.

Age _____________

Length ___________

Date _____________

Head Size ___________

DIET

Breast milk or iron-fortified infant formula is the best sources of nutrition for the first 4-6

months of your baby’s life. If your baby is bottle feeding, you should not put the bottle in the

baby's bed or prop it in your baby's mouth. Breast-fed infants should continue on a

multivitamin with a 400 IU of vitamin D.

Between 4-6 months is the appropriate time to introduce solids.

Pay attention to feeding cues. When ready, your baby will show interest in and readiness for

solids. Feeding should be a happy bonding time between you and your infant. Never force

solid food. If solids are rejected, stop, wait a week or two and try again. Eating from a spoon

is a learning process and may be slow-going at first.

Start with iron-fortified infant cereals. Rice or barley will least likely to cause allergies. Mix with

breast milk or formula to make a thin milky mixture, then thicken as tolerated. Start with 1-2

tablespoons and work up to 1/2-1 cup per feeding. Start at 1 meal a day and build up to 3

meals a day over the next 2-3 months.

Once your baby accepts cereals, new food groups may be added. Infants seem to be more

accepting of sweet fruit so starting with vegetables may encourage long term acceptance

resulting in a more balanced diet. However, fruits and vegetables are equals in the nutritional

food pyramid, so pick one that looks good and try it. Start a single food item and watch 5-7

days to make sure that your baby does not have a bad reaction to the new food. Reactions

may include rash, fussiness, vomiting or diarrhea. It is natural for babies to initially reject a

food and it may take offering the food 8-10 times before your infant will accept it.

JUICE

Juice is a major source of calories and overuse is contributing to the epidemic of obesity in

children. Even 100% natural juice is mostly sugar water, so we do not encourage the use of

juice. If you decide to use juice, start after six months and limit to a total of 4-6 ounces per

day. White grape is often a reasonable first try.

Some infants (up to 8%) develop food allergies or sensitivities. Foods that are more likely to

cause reactions include milk, soy, eggs, wheat, nuts and fish.

In the past we recommended delay of introducing these foods. Research does not support that

delaying these foods actually reduces the risk of your infant developing a food reaction. If your

infant has a known food reaction or there is a family history of food reactions, be careful and

pay close attention for problems as new foods are introduced.

4 Month Check-Up Doctors Note Template