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The fourth month

What we will look at

  • Immunisation
  • Working mums who want to continue breastfeeding
  • Is your baby ready for solids?
  • Introducing solids
  • Your baby’s eye colour
  • Feverish? Don’t give aspirin
  • What you can do to help

What your baby can do

  • Starts to babble
  • Laughs
  • Lifts head up 45 degrees
  • Holds head steady
  • Recognises your face and scent

This month’s immunisation
At about fourteen weeks, your baby should be immunised for the third time against:

  • Polio (OPV)
  • Diphtheria, tetanus and pertussis (DTP)
  • Hib
  • Hepatitis B (Hep B)

Learn more about immunisation.

Working moms who want to continue breastfeeding

Expressing milk
Expressing milk is an answer for working mothers who still want to breastfeed.

  • She would need to express twice during her working day e.g. at morning tea time and during her lunch time. If she works full-time, she would also need to express mid-afternoon. Whatever was expressed on Monday at work would be offered to the baby on Tuesday.
  • She would need to hand express or to have a breast pump at her disposal. The breast pump should be sterilised at home and kept in a closed container at work when she is not using it. Note that breast pumps should never be re-used, shared, hired or sold.
  • It is not necessary to refrigerate the breast pump or the expressed milk until she gets home. However, breastmilk for preterm babies need to be refrigerated within six to eight hours – take a cooler bag with an ice block to work.

Using this method, mom will be able to fully breastfeed her infant over weekends and holidays, and mornings and evenings of the working week because she has had adequate stimulation and is still producing milk regularly.

Substituting daytime breast feeds with formula feeds

  • The baby would need to be weaned from at least two feeds a day in the week.
  • She should start weaning ten days before returning to work.
  • She would replace a breast feed with a formula every five to seven days. E.g. offer a formula bottle midmorning for five to seven days then offer a formula bottle midmorning and mid-afternoon.
  • She would need to continue in this pattern of mixed feeding over weekends and holidays.

The mother should consult a lactation consultant or her clinic sister for advice on the formula and the quantities to be offered.

But I thought your eyes were blue!
You may start to notice that the colour of your baby’s eyes have changed. Many Caucasian babies are born with slate blue eyes. Between three and six months they gradually change to their permanent colour.

Feverish? Don’t give aspirin
There is a correlation between the incidence of Reye syndrome and children suffering from a viral illness, especially influenza or chicken pox, who are given aspirin to reduce their fever. Reye syndrome is a rare cause of encephalopathy (brain disease) and death in children.

Learn all you need to know about Reye syndrome.

What you can do to help your baby

  • Play “peek-a-boo” games – this will teach your baby object-permanence (if mommy hides her face, she is still there).
  • Make eye contact as much as possible.
  • Exaggerate all facial expressions.
  • Sing to her, play rhythmic games and clap her hands – this will encourage her to make sounds.
  • Make bathtime fun – give her cups and other plastic objects to play with and let her splash around.
  • Praise her when she accomplishes a task such as reaching for an object.
  • Give her toys that make a noise.
  • Hold conversations with her and name objects.
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