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

Your baby should still be taking breast milk or infant formula.
Some babies are now ready to start solid food. A baby is ready for solid food when she is able to hold her head up enough to eat from a spoon. Use a spoon to feed your baby, 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.

Babies are starting to roll over from stomach to back.
Reading to your baby helps your baby make the cognitive leap towards abstraction, understanding symbols and pictures that have meaning.
Babies also love to use books to practice memorization, predicting what picture will appear on the next page.
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.

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 his or her back.
Keep soft objects out of the crib such as pillows, blankets, bumper pads and toys.
Lower the crib mattress.

Your baby may begin teething. While getting teeth, your baby may drool and chew a lot. A cold teething ring is very useful.
After meals and before bedtime, clean gums and teeth (as soon as they appear) with a soft cloth or toothbrush. Use a small smear of fluoride toothpaste (no larger than a grain of rice).

Avoid Suffocation and Choking
- Remove hanging mobiles or toys where 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 him or her.
- Keep plastic bags and balloons out of reach.
- Use only unbreakable toys without sharp edges or small parts that can come loose.
- Never leave baby alone in the bathtub.
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.

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.

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.

4 Months