Dearborn Pediatrics
Four Month Visit

Four Month Visit

Milestones Matter
How your child plays, learns, speaks, acts, and moves offers important clues about his or her development. Check the milestones your child has reached by 4 months.
What Most Children Do By This Age

Socal / Emotional

  • Smiles spontaneously, especially at people
  • Likes to play with people and might cry when playing stops
  • Copies some movements and facial expressions, like smiling or frowning

Language / Communication

  • Begins to babble
  • Babbles with expression and copies sounds he hears
  • Cries in different ways to show hunger, pain, or being tired

Cognitive

Learning, Thinking, Problem-solving

  • Let’s you know if he is happy or sad
  • Responds to affection
  • Reaches for toy with one hand
  • Uses hands and eyes together, such as seeing a toy and reaching for it
  • Follows moving things with eyes from side to side
  • Watches faces closely
  • Recognizes familiar people and things at a distance

Movement / Physical Developement

  • Holds head steady, unsupported
  • Pushes down on legs when feet are on a hard surface
  • May be able to roll over from tummy to back
  • Can hold a toy and shake it and swing at dangling toys
  • Brings hands to mouth
  • When lying on stomach, pushes up to elbows

Feeding & Elimination

  • Breast milk or formula continues to be the most important source of nourishment. The number of feedings can range from four to six times per day by now. Bottle fed babies can take up to 32 ounces per day. Periods of high demand may indicate a growth spurt.
  • Between 4 and 5 months of age you may begin the introduction of solid foods. The AAP recommends that Moms who are exclusively nursing wait until six months of age to introduce solid foods. Your infant should have good head control in order to be able to feed safely.
  • The best time to feed solids will vary depending on our family’s schedule. It is important to create a relaxed environment and not try to introduce something new when baby is very hungry. Your baby will be more receptive if you introduce solid food about ½ hour prior to time of next expected feeding.
  • Introduce each new food no more often than every 3-4 days. Once your baby becomes accustomed to solids, they can eat them 2-3 times per day. The quantity at each feeding may vary from a few spoonsful to one 4-ounce jar.
  • Those with a strong family history of food allergies may wish to discuss an alternate food schedule with your Provider.
  • Never give a child under the age of 12 months honey or corn syrup as this increases the risk of botulism.
  • Infants under the age of six months do not require water. Breast milk or formula are both water based.
  • Begin getting your baby accustomed to gum and dental care at this age. Wipe the gums down with a soft cloth after feedings.
  • Never put a baby with teeth down to sleep without cleaning them or with a bottle in the mouth as this promotes tooth decay. Sleeping with a bottle in the mouth also promotes dysfunction of the middle ear and ear infections.
  • If your baby is exclusively breast fed or gets a least ½ of milk intake as breast milk continue to give Tri-Vi-Sol at 1 c per day.
  • Tool patterns will change as expected based upon changes in daily intake. They may be orange, green or yellow. They should be soft and may occur once a day or every 2 to 4 days.
Your Child Knows Best

Act Early

If you have concerns about the way your child plays, learns, speaks, acts, or moves, or if your child:

  • Does not watch things as they move
  • Does not smile at people
  • Cannot hold head steady
  • Does not coo or make sounds
  • Does not bring things to mouth
  • Does not push down with legs when feet are placed on a hard surface
  • Has trouble moving one or both eyes in all directions

The American Academy of Pediatrics recommends that children be screened for general development using standardized, validated tools at 9, 18, and 30 months and for autism at 18 months or whenever a parent or provider has a concern.    Ask your Provider about your child’s developmental screening.