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What to Expect as Your Child Grows:
Well Child Care at 4 Months

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Feeding

  • 4-months Your baby should still be taking breast milk or infant formula. Most babies now take six to eight ounces every three to four hours.
  • If you give your baby breast milk, it is a good idea to sometimes feed your baby with pumped milk that you put in a bottle. Then your baby will learn another way to drink milk and other people can enjoy feeding your baby.
  • Some babies are now ready to start cereal. A baby is ready for cereal when she is able to hold her head up enough to eat from a spoon. Use a spoon to feed your baby cereal, not a bottle or an infant feeder. Sitting up while eating helps your baby learn good eating habits. When you start cereal, start with rice cereal mixed with breast milk, formula, or water. You may want to start with a thin mix of cereal and then thicken it gradually. Puréed fruits and vegetables can also be started between four and six months. Start a new food every three to five days to make sure your baby responds well to the new food.
  • Babies will respond gleefully when they see a bottle, but don’t give your baby a bottle just to quiet her when she really isn’t hungry. Babies who spend too much time with bottles in their mouths start to use the bottle as a security object, which makes weaning more difficult. Find another security object like a stuffed animal or blanket.

Development

  • Babies are starting to roll over from stomach to back.
  • Your baby’s voice may become louder when she wants food or wants to be held. In both cases, gentle, soothing voices are the best way to calm your baby.
  • Babies at this age enjoy toys that make noise when shaken.
  • It is normal for babies to cry.

Sleep

  • Many babies are sleeping through the night by four months of age and will also nap four to six hours during the daytime. If your baby’s sleeping patterns are different than this you may want to ask your doctor for ideas about ways to keep your baby alert and awake during the day and sound asleep at night.
  • Remember to place your baby in bed on her back.

Teething

Your baby may begin teething. While getting teeth, your baby may drool and chew a lot. A teething ring is very useful.

Safety Tips

  • Avoid Suffocation and Choking
    - Remove hanging mobiles or toys before the baby can reach them.
    - Keep cords, ropes, or strings away from your baby, especially near the crib. Ropes and strings around the baby’s neck can choke her.
    - Keep plastic bags and balloons out of reach.
    - Use only unbreakable toys without sharp edges or small parts that can come loose.
  • Avoid Fires and Burns
    - Never eat, drink, or carry anything hot near the baby or while you are holding the baby.
    - Turn down your water heater to 120° F (50° C).
    - Check your smoke detectors to make sure they work.
    - Check formula temperature carefully. Formula should be warm or cool to the touch.
    - Don’t smoke!
  • Car Safety
    - Use an approved infant car seat correctly in the back seat.
    - Never leave your baby alone in a car.
    - Wear your safety belt.
  • Avoid Falls
    - Never leave the baby alone on a high place.
    - Keep crib and playpen sides up.
    - Do not put your baby in a walker.

Immunizations

  • At the four month visit, your baby should have the following:
    - DTaP (diphtheria, pertussis, tetanus) vaccine
    - Hib ( Haemophilus influenza type B) vaccine
    - IPV (Polio) vaccine
    - Prevnar-13 (Pneumococcal) vaccine
    - Rotavirus oral vaccine.
  • Some babies also receive a hepatitis B shot at this age.
  • DTaP, Hib, and IPV are given together as the Pentacel vaccine.
  • Your baby may run a fever and be irritable for about one day after getting shots. Your baby may also have some soreness, redness, and swelling where the shots were given.
  • You may give acetaminophen drops in the appropriate dose to treat fever and irritability. For information on Tylenol dosages, click here. For swelling or soreness, put a wet, warm washcloth on the area of the shots as often and as long as needed for comfort.
  • Call your child's physician if your child has a reaction that concerns you.

Next Visit

Your baby’s next routine visit should be at the age of six months. At this time your child will get the next set of immunizations.