Your Child at 4 Months

Pediatric Development Guide from Westside Pediatrics

The board-certified pediatricians at Westside Pediatrics have provided this pediatric development guide to help educate parents on some of the amazing things their child can do at this age and tips around care including activities that promote development.  Call (585) 247-5400 to schedule an appointment at our pediatric office in Rochester, NY.
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At this age your baby can probably:

  • Roll over (one way)…
  • Hold head steady when held upright…
  • Follow an object with her eyes and maybe reach for it…
  • Hold a rattle…
  • Squeal, coo, babble, laugh out loud…
  • Maybe raise chest when on stomach, supported by her arms…
  • Put her fist or other objects into her mouth…
  • Sleep through the night…

What You Can Do With Your Baby

Talk to him. When he makes a noise, answer him. Imitate the sound he makes.

Play with him. Show him bright objects. Let him explore safe areas. Babies this age often love noisy toys like pots and pans or rattles.

Make sure he has plenty of chance to see the world, both indoors and out. Take him for a walk outside and show him flowers and trees.

This is a good time for your baby to get to know relatives and brothers and sisters.

Hold him.

Being a parent is enjoyable but hard work. There is so much to learn! Sometimes it helps to talk to other parents or get some advice from someone outside the family. If you would like to find out more, call this number and ask about parenting programs in your area.

LIFELINE 275-5151

Feeding Your Baby

By now you may have started your baby on solid foods or are ready to try. Talk to your pediatricician or nurse about what to feed her. Here are a few tips to remember:

  • Formula or breast milk is still the most important at this age
  • start with iron-fortified rice cereal, unless she has problems with hard stools then use barley or oatmeal
  • next try vegetables and non-citrus fruits
  • add new foods slowly and one new food every 2-5 days
  • stay away from desserts and junk food—your baby doesn’t want or need them and they are not good for her
  • your baby does not need juice at this age
  • don’t put food in your baby’s bottle
  • all food should be pureed at this age—YOUR BABY IS NOT READY FOR TABLE FOOD YET!

Pay attention to your baby’s appetite. She knows best when she needs to eat or is full. If she spits up a lot or turns away from her bottle, she has probably had enough. Don’t worry—she will let you know when she needs to eat again. It is important not to over feed your baby. Don’t offer the bottle every time she cries. Children cry for many reasons and crying won’t hurt your baby.

Feed your baby like a baby. She doesn’t eat like an adult. She doesn’t need junk food.


Remember, car crashed are the biggest danger to your baby’s life and health.


  • Don’t leave your baby alone in a car.
  • Don’t smoke or drink hot liquids while you are holding your baby. She might get burned.
  • If you baby does get burned, call your pediatrician. Put cold water on the burn.
  • At this age a baby will put anything and everything in her mouth.
  • Don’t leave small objects around. Don’t feed your baby hard pieces of food.

Remember never to leave your baby on high places like beds, sofas or chairs. If you do, she may fall.

Call your pediatrician if your baby falls and hits her head, or if she does not move her arms and legs normally after a fall.

If you’re thinking about getting a walker, think hard. They are not always safe and many babies get hurt using them. If you do decide to use a walker, don’t use it all the time. Give your baby some time to explore on her own on the floor.

All doors to stairs should have a safety chain and a spring loaded hinge! Both items are available at most hardware stores and are inexpensive!

Poison Control Center

Remember to keep the number on or near your phone: 1-800-222-1222

Ear Infections and Colds

Until now your child has had some protection from infections due to factors that were passed from mother to baby during pregnancy.

These factors are lost in your baby by 4 to 6 months of age.

Now is the time you may see your baby start to have more frequent colds and ear infections. A baby may normally have 8 to 10 “colds” per year and some of the “colds” can lead to ear infections. An ear infection can cause a fever and can make your child wake at night from the pain.

If you baby has cold symptoms for a few days and then runs a fever or becomes more fussy, you should call your pediatrician.

Limit unnecessary exposure to sick children and practice good hand washing.

Helping Your 4 Month Old Baby Learn

At this age your baby is beginning to use his hands more and more to explore the world around him. He may like the feel of a soft blanket or a smooth kitchen floor. You can help him learn by giving him different textures to play with.

Here are some ideas how you can help your baby learn: Give him something soft and something hard to play with at the same time. You might use a soft toy or piece of material and something hard like a block or a plastic jar with the lid on. As you give them to him, talk to him. You might say, “This is a blanket. It is soft,” and touch it to his cheek. Or “This is a block. It is hard, “ and knock your hand against it.

Find things that have different textures for your baby to play with. Some useful things you might find around the house include something smooth (a rubber ball or a piece of wood), something rough (a piece of sandpaper or a brush), something soft (a piece of cloth), something heard (a metal spoon), or something squishy (a clean sponge).

Let your baby play with different fabrics. You might try leather, corduroy, flannel, and something smooth like rayon or silk, which does your baby like best?

At this age your baby is also probably starting to bring his hands together in front of him. These motor skills are important for your baby’s development. Here is a simple way you can help your baby learn; find two brightly colored socks and put them together, see if you can find other ways to help your baby learn motor skills!

Things You May Be Worried About at 4 Months Old

“My Baby Drools a Lot. Is She Teething Already?”

Drooling is common for babies at this age. It does not mean they are teething—just that they have started to make saliva and may not know how to swallow it yet. Trying to chew on objects also doesn’t mean he is teething. Babies are just exploring by putting things in their mouths. Most babies don’t start to teethe until they are about 6-7 months old.

Questions About Sleep

Sleeping Through the Night

Is your baby still not sleeping through the night? At this age, this may be because he has gotten into the habit of waking at certain times to be fed. By responding less quickly to his cries, and gradually adjusting the amounts you feed him, you should be able to teach your baby to sleep through the night.

Try to stretch the time between nighttime feedings. Instead of going to get him as soon as he starts crying, wait a few minutes. Give him a chance to fall asleep again on his own. Or try to soothe him without feeding him, by holding or rocking him. Keep the room dark. Try to add a half hour each night onto the time between feedings. Gradually your baby will learn to wake up at a later time, and you will learn to wake up at a later time, and you will both get more sleep.

Another reason your baby might have a hard time sleeping through the night is that he hasn’t learned to fall asleep on his own. It is normal for a baby to wake in the night. But he can also learn to fall back asleep on his own, without having to get up. Here are some tips to help your baby fall asleep on his own:

Try to put your baby down to sleep while he is still awake. This may be hard if he regularly falls asleep on the bottle, but it is important. If he always falls asleep feeding he will probably want to be fed in the middle of the night to fall back asleep. Likewise, if you are always there as he falls asleep, he will need you when he wakes in the middle of the night. Give him a chance to learn to fall asleep on his own.

Let him cry. Sometimes parents have a hard time letting their baby cry. But try not responding as quickly when he wakes at night. Give him a chance to fall back to sleep on his own.


By 5 months of age, most babies take 3 or 4 hour-long naps each day. But each baby is different. Some may nap 2 or 3 longer ones. This is fine, as long as your baby is getting enough sleep. You may want to teach your baby to take fewer longer naps if he wakes often at night, or so that you can get more done while he sleeps. To do this, make sure he has a comfortable place to nap, like a stroller or a crib. And make sure the room is not too hot or too cold. Don’t let your baby fall asleep right before mealtime or when his diaper needs changing. Also, try to keep your baby awake for longer periods between naps.


Before your next checkup, your baby may start to:

  • Smile…
  • make more noises…
  • roll over both ways…
  • turn his head on hearing a noise…
  • bring everything to his mouth…
  • play with a busy box or cradle gym…
  • scoot around…

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Schedule an Appointment

If you have more questions regarding pediatric development milestones and your child’s development, call our pediatric office in Rochester, NY at (585) 247-5400 to request an appointment with one of our exceptional pediatricians.

(585) 247-5400