1. Healthy Together Babies Next Steps – 4 Month Group
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2. Introducing Solid Foods Infant and Maternal Mental Health
Aims of the session
Housekeeping
Development
Play and Stimulation
Introducing Solid Foods
Vitamins
Oral Health
Safety
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Immunisation
Sleep
Infant and Maternal Mental Health

3. Promoting development
Current Development :- Visually alert, stronger in neck, turns freely to gaze around the room
Follows and reaches out to bat/grasp toys
Explores hands and feet
Quietens to sounds and voices, Studies faces
Responds with large excited movements, social smile/laugh, starting to vocalise
Start to roll, sit with support
Promote :- Lots of floor play and tummy time
Talking, singing and sharing books
Routines / parent interaction
Local baby groups
Reduced TV time
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4. What's the difference between choking and gagging?
Introducing solid foods
What about milk?
What's the difference between choking and gagging?
Reasons for 6 month guidelines - World Heath Organisation
Health related risk factors :- obesity, diabetes, allergies, food intolerances
Reduce health related conditions :- rickets, anaemia, dental caries
Not developmentally ready i.e sitting upright, no chewing reflex.
0-6 months - all the nutrients your baby needs is in the milk
6 months :- digestive system now mature and developmentally ready to cope with solid foods. No need to puree or sterilise bowls and spoons, full cream cows milk in foods, family foods, tap water with meals in a beaker/free flow cup.
(Bottles used for formula must continued to be sterilised until 1 year)
Debate on baby ready made jars/tins/packets
7 months family foods, finger foods, 3 meals a day, healthy snacks, reducing milk intake (no need for follow on milks)
Choking/Gagging
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5. Foods to avoid
Avoid :- Salt sugar Unpasteurised Cheese whole nuts Honey Shell Fish, Shark and Marlin
Water not juice
Discuss :- Full fat foods and Portion sizes
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6. Vitamins When to introduce vitamins - Formula feeding from 6 months
Breastfeeding from birth – 1 year
Mum needs vitamin C, D and Folic Acid if breastfeeding
Healthy start vitamin drops include A,C & D
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7. Healthy Teeth, Happy Smiles !
Oral health
Give water in a beaker with meals - drink from free flow or open cup
Stop bottle by 12 months
Brush twice a day when teeth cut through – good routines
Smear of fluoride toothpaste
Register your child with a dentist
Older children and adults ‘spit don’t rinse’
Restrict dummy
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Healthy Teeth, Happy Smiles !

8. Safety Close supervision of baby Car safety Sun safety
Safety around pets
Sleeping position
Use of safety harnesses
Never leave unattended - Soon to be mobile/rolling off beds/sofas/changing tables
Think about hot drinks, sharp corners, dangling wires
Get on their level to see danger
Smoke Free Homes – Sign up to Step right out/Quit/Stop
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Hot drinks
Water safety
Rolling / moving
Smoke alarms / CO detectors

9. Safer sleep for babies Things you can do; Things to avoid;
Always place your baby on their back to sleep in a clear cot or Moses basket
Never sleep on a sofa or in an armchair with your baby
Don’t sleep in the same bed as your baby if you smoke, drink or take drugs or are extremely tired, if your baby was born prematurely or was of low birth-weight
Keep your baby smoke free during pregnancy and after birth
Use a firm, flat, waterproof mattress in good condition
Avoid letting your baby get too hot
Room temp 18c – 21c
3 layers
No pillows/duvets/toys/bumpers
Self soothing and routines
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Place you baby to sleep In a separate cot or Moses basket in the same room as you for the first 6 months
Don’t cover your baby’s face or head while sleeping or loose bedding

10. Infant and maternal mental Health
Good/Bad days Realistic expectations Stressful relationships Social isolation
Impact on baby Brain development
Accept Help
Talk to somebody
Your Public Health Nurse can support you
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11. Immunisations NHS Choices website Health for under 5’s website
Red book
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12. Leicestershire and Rutland – 07520615382
What’s next?
Your month contact
If you need to access the service you can make an appointment to attend your local ‘advice clinic’
You can text a Public Health Nurse by using our ChatHealth messaging service on the following numbers;
Leicester City –
Leicestershire and Rutland –
Children and family centre groups /activities
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Use our websites

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14. Evaluations / Friends and Family Test Cards
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