The mother of a 4-month-old baby girl asks the nurse when should she introduce solid foods to her infant. The mother states, "My mother says I should put rice cereal in the baby's bottle now. The nurse should instruct the mother to introduce solid foods when her child exhibits which behavior?

A. Stops rooting when hungry. The rooting reflex, which helps newborns find the breast or bottle, typically disappears by 3–4 months of age. However, its absence does not indicate readiness for solid foods. Readiness is more closely linked to developmental milestones such as sitting with support and showing interest in food.
B. Awakens once for nighttime feedings. Nighttime feedings are common in infants up to 6 months and are not a reliable sign of readiness for solid foods. Frequent night waking is often due to normal growth spurts rather than an indication that the baby needs solids.
C. Gives up a bottle for a cup. Transitioning from a bottle to a cup occurs later in infancy, usually around 9–12 months. Introducing solids does not require weaning from the bottle, as infants initially consume solids alongside breast milk or formula.
D. Opens mouth when food comes her way. Readiness for solid foods, typically around 4–6 months, is indicated by signs such as good head control, the ability to sit with support, and showing interest in food by opening the mouth or reaching for it. The American Academy of Pediatrics recommends introducing single-ingredient, iron-fortified foods like rice cereal with a spoon rather than putting it in a bottle, which can increase the risk of choking and overfeeding.

A. Avoid any smoking inside the house. Exposure to secondhand smoke increases the risk of recurrent otitis media by irritating the respiratory tract and impairing mucociliary clearance. Reducing or eliminating smoke exposure is an essential preventive measure to lower inflammation and decrease bacterial colonization in the middle ear.
B. Give infant the full course of antibiotics. Completing the full course of prescribed antibiotics ensures that the infection is fully treated, preventing bacterial resistance and reducing the likelihood of recurrent or persistent infections. Stopping antibiotics prematurely can lead to incomplete eradication of the bacteria and increase the risk of future infections.
C. Schedule visit for pneumococcal vaccine. The pneumococcal vaccine protects against Streptococcus pneumoniae, one of the leading causes of otitis media. Ensuring that the infant is up to date with routine vaccinations, including the pneumococcal and Haemophilus influenzae type B (Hib) vaccines, can significantly reduce the risk of recurrent infections.
D. Instill benzocaine otic drops regularly. Benzocaine otic drops provide temporary pain relief but do not prevent or treat infections. Using them regularly without medical guidance may mask symptoms of worsening infection, delay appropriate treatment, or cause local irritation. Pain management should be used only as needed and in conjunction with appropriate medical interventions.