Health Information

Caring for Your 4-Month-Old

: As your baby’s personality is emerging, try to keep older siblings involved in a way that is helpful to you and allows them to feel included in the attention the baby is receiving.

Find ways to spend time alone with each child, and also time alone with your partner. Make this part of your daily routine.

If you are returning to working outside the home, be sure that you have trustworthy child care in place. A resource to assist you is Child Care Aware (1-800-424-2246).

Consistent, daily routines are important.
: For exclusively breast-fed babies it is recommended to supplement vitamin D (400 IU/day), which is available at most drug stores/supermarkets.

Bottles should be held, not propped, for babies.

Mixing cereal in a bottle does not teach the baby how to eat; only feeding with a spoon will accomplish this.

Do not mix cereal in with a bottle.

Providing only breast milk for your baby for the first 6 months after birth provides ideal nutrition.

If formula feeding speak to your pediatrician about how many Oz’s baby will need.

It is okay to feed on demand.
: Regular, easy-to-pass, soft yellow stools at least once daily are common in this age group.
: Bathe your baby in a small tub/bathinette, using warm (not hot) water and gentle soap, as frequently as every day. Never leave your baby alone during bath time. Water temp should not exceed 120°F.

When the child is fussy, a change of scenery can be helpful, so if the weather cooperates, try going for a walk.

Teething may start at this age. Topical analgesics, such as Oragel, are not recommended.

Use a cold teething ring if your baby’s gums are sore from teething.
: Most 4-month-olds spontaneously smile and laugh, and love social interaction. Talk to your baby and prioritize face-to-face interaction. Baby should begin to turn head to voices/sounds.

Singing and cuddling with your baby will build trust and closeness.

Fussiness should start to decrease as baby learns to self soothe.

Reading to your infant will promote language skills.

“Tummy time” helps your baby develop strong muscles in the neck and back that will eventually allow the baby to sit up. Most 4-month-olds can keep their heads and chests up when lying on their bellies.

Around four to five months of age, babies will start to learn to roll over on their own, often from front to back at first.

By four months old, most babies keep their hands open (not clenched) when at rest, and they may start to swat at toys or reach for items. Place age-appropriate toys within your child’s reach to promote these new skills.

Most 4 to 6-month-olds can support their heads and bodies well enough to play in a stationary jumper, such as an ExerSaucer or Jolly Jumper. Ask your doctor if your baby is ready for these toys. Baby walkers with wheels are dangerous and not recommended.
: Always place your baby on his or her back to sleep to reduce the chance of sudden infant death syndrome (SIDS). Co-sleeping, sleeping with your child, increases the risk for SIDS. Infants should sleep in a crib with a firm mattress covered by a fitted sheet. Keep bumper pads, pillows, blankets, loose bedding and soft objects, like stuffed toys, out of the crib.

Teach your baby to fall asleep independently of being rocked or fed. Put your baby to bed when he or she is somewhat sleepy, but still awake, to build confidence in going to sleep on his or her own. You may need to let your baby cry for a while before he or she falls asleep.
: Some babies can roll over at this age. Do not leave your baby, propped or lying, on a sofa or a changing table.

Learn if your home or drinking water has lead and take steps to get rid of it. Contact your pediatrician and your county board of health.

Never leave your baby unattended in a tub or on sofas, countertops or other high surfaces.

Be sure pets and siblings are supervised when with the baby.

Keep the living environment (including the car) smoke-free. Do not smoke indoors and never smoke in the car.

Keep small items (choking hazards) and hot liquids (burn risks) away from the baby.

All babies this age must ride in a rear-facing five-point harness car seat in the back seat of the vehicle.

Interactions with you and others can help your baby learn about the world. Talk about things you are seeing and hearing when out walking or sitting in the park. Answer when your baby makes sounds. Play with your baby when they are alert and relaxed.

Resources

Read to your child daily. It’s never too soon to start good habits.

This document contains general parenting information based on American Academy of Pediatrics recommendations and is not meant to replace the expert advice of your pediatrician.