Four Month Old Milestones | Pediatrics East
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Four Month Old Milestones

Your Baby At Four Months

Click here to access a printable PDF. 

Well, these four months sure have passed quickly or maybe not so quickly. Hopefully by now you have settled into a very manageable routine and have learned to put up with each other fairly well.

This is a very fun time in the development of your baby in that he has become much more stable and interactive. It’s really fun to watch them grow through this age.

Your baby should be sleeping all night every night by this point. If not, it’s time to do something about it. You must train him to put himself to sleep and sleep all night. Ask for information about sleeping if you’re still having difficulty with this.

Feeding Your Four Month Old

Most people at this point are beginning to have ants in their pants regarding feeding this little bottomless pit. While feeding solid foods is not necessary until six months, it is acceptable by me if you cannot resist the desire to begin introducing solids at this point.

To introduce solids, begin with rice cereal and offer little “hungry jack” a spoonful. If he gobbles it down and likes it, continue feeding him rice cereal until he turns his head away or pushes you away and refuses to eat more. This may be five spoonfuls or five gallons.

If he does not like the cereal with the first try, forget it and try again in a few days. Continue to try every few days until one day he decides to eat the whole kitchen. Once he’s a pro at feeding once a day, go to twice a day feedings and when he’s a pro at twice a day feedings, you may begin the introduction of fruits and vegetables. Save meats until 7-9 months.

The exact combination and schedule of what to do first is controversial, so ask your pediatrician how to proceed. Be sure and take your time with this, it’s not going to starve to death while you introduce solids.

While advancing the baby’s solid intake, it will be normal for the baby to have a slight decrease in the amount of milk that it desires. Never force the baby to eat whether it be milk or solids; let the baby’s appetite be your guide as to how much he eats.

If at any time you see a rash or the baby begins to have diarrhea or vomiting, stop feeding any new foods that you’ve introduced in the past couple of weeks and see if the symptoms disappear. If they do, you may reintroduce the foods one at a time that are in question and if symptoms do not reappear continue to advance feedings. If they do reappear you may assume that that food is not well tolerated by your baby. Please call us with any further questions. 

Develolpment Milestones

Things that you should be seeing or beginning to see are good social interaction with smiling and laughing and playing with his hands. The four month old may or may not have rolled over by now but is expected to do so between now and six months.

Four Month Old Shots

Today we will give the second DTaP (Diphtheria, Tetanus, and acellular Pertussis), Comvax (Hepatitis B & Hib), and IPV (injectable polio). There should not be any fever or reaction to the shots. At 6 months, we will give the third DtaP (only one shot!!).

Baby Illnesses

By this time you may have encountered your first cold which would be manifest by runny nose and possibly a cough and low grade fever. If your child is happy and alert this can be treated symptomatically the same as you would an adult: with decongestants for the nasal congestion and generous nasal suctioning. The nasal suction is very important in that nasal congestion tends to be the main cause of sleepless nights in an infant with a cold.

Also, you may want to elevate the head of the bed, or even let him sleep upright in the infant seat, buckled in, of course. Other illnesses that are common at this time are stomach viruses with diarrhea and/or vomiting. The Pediatric Handbook (Yellow Book) can be consulted for specific instructions regarding these illnesses.