Well Baby Visits - Four Months :: Nationwide Children's Hospital

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Well Baby Visits: Four Months

Your baby is now 4 months old! This can be a very rewarding time for caregivers, as baby is becoming more interactive by the day and learning to respond to social cues. You may notice your baby trying out new sounds. Some babies may start rolling over. Some infants will also begin to sleep for longer stretches of time, and your baby may even be sleeping through the night.
Your baby’s 4 month visit will include a second round of vaccines. These vaccines are similar to the ones your baby got at the 2 month visit. Most infants do quite well with these vaccines, but you if you have any concerns regarding vaccines, talk with your baby’s doctor.

Growth and Development

  • Your baby’s doctor will go over the baby’s growth chart at each visit. At 4 months old, your baby will smile, and may laugh during play. He or she may also practice making sounds. Babies at this age often make “aah-aah” and “buzzing” sounds.
  • Your baby will begin to reach for things and may try to bring them to his mouth to explore them. Most babies can hold their heads and chests up when put on their stomachs (see Picture 1).
Image of baby on stomach

Picture 1: Most babies can hold their heads up when on their stomachs.

Nutrition

  • If your baby had been spitting up, you may notice this happens less often or stops altogether.
  • At this age, your baby needs only formula or breast milk. Many experts recommend that infants, particularly if breastfed, start solids at 6 months of age. If you do choose to start introducing solid foods, at this visit please discuss with your doctor the safest way to do so.
  • Breast-fed infants need liquid vitamins made just for babies. You can buy these vitamins over-the-counter, or your baby’s doctor may be able to write a prescription.
  • Unless otherwise instructed by your baby’s doctor, your baby can safely sleep through the night without waking up to feed. Some infants may still wake frequently. If your infant is growing well, you may try other ways of soothing before feeding your baby.

Safety

  • Infants should remain in a rear-facing car seat in the back seat until are 2 years of age AND meet or exceed the maximum limits set by the manufacturer.
  • NEVER leave your baby alone in the bathtub, on a changing table, bed or sofa.
  • Babies put EVERYTHING into their mouths. Keep small objects away from them at all times.
  • Always place your baby on his or her back to sleep.

Other Issues at 4 months:

  • Giving your baby solid foods or cereal early will not help your baby sleep. In fact, your baby could get gas or constipation from mixing cereals with formula or breast milk and can make sleeping more difficult for your baby. Your baby will learn to sleep through the night - just be patient.
  • You may notice an increase in drooling. This is common and does not necessarily mean your baby is teething yet.
  • Babies at this age are learning to explore their bodies with their hands, and will often pull at their ears. Without other symptoms of illness, this does not indicate an ear infection.
  • If your child is in daycare – be aware that most infants in daycare get FREQUENT colds. Viruses spread easily among children in daycare. Most babies get about 6 to 8 illnesses in their first year of life. You may need to keep your child home from day care if he or she is sick. Most colds last a few days. If your child is not getting better in a few days, is sluggish or not eating well, please come in for your doctor to take a look at him or her.
  • Acetaminophen (Tylenol®, Pediacare®) is safe to use in appropriate doses for fever and discomfort in your infant at this age. It can be given every 4 hours as needed, in a dose that is determined by the child’s weight (see your doctor).
  • Do not use ibuprofen (Motrin®, Advil®) until 6 months of age or older. Please talk to your child’s doctor about safe amounts of these medicines and times to give them.
  • Teething gels that contain numbing medications (such as Orajel®) are not recommended, and may cause serious health issues in a certain group of infants. Please ask your doctor for more information.

About this Helping Hand

At each visit, your doctor will talk with you about your baby’s development, growth, and safety so that your baby grows up healthy. These handouts will help to remind you about the things your doctor will talk with you about at each visit. If you have any questions or concerns about your baby, please ask. We are here to help!

Other Helping Hands that may be useful:

  • Bottle Feeding: Formula Preparation, HH-IV-7
  • Breast-feeding Your Baby, HH-IV-69
  • Temperature: Oral, Rectal and Axillary, HH-II-27
  • SIDS Reduction (Safe Sleep Practices for Infants), HH-IV-69
  • Child Passenger Safety, HH-IV-14
  • Calming a Fussy Baby, HH-I-103
  • Home Safety for Infants and Toddlers, HH-IV-73

Well Baby Visits: 4 Months (PDF)

HH-IV-112 Revised 10/14 Copyright 2009, Nationwide Children’s Hospital 

Nationwide Children's Hospital
700 Children's Drive Columbus, Ohio 43205 614.722.2000