My Baby's 4 Month Visit

Physical Exam and Immunizations

Four Months Already?

As your baby reaches the 4-month milestone, this checkup is an exciting opportunity to review their growth, development, and overall health. Here are some of the key topics we’ll cover during this visit to ensure your baby is thriving:

Physical Screening

We’ll perform a thorough head-to-toe examination, checking your baby’s weight, length, and head circumference. This helps us track their growth and ensure they’re developing physically as expected. We’ll also assess muscle tone, reflexes, and general physical well-being.

Milestone Assessments

At four months, we’ll look for developmental milestones like head control, rolling over, social smiling, and responding to sounds and visual stimuli. Tracking these milestones helps us ensure your baby’s cognitive and motor skills are on track.

Nutrition

Your baby’s nutritional needs may be evolving, especially if you’re considering introducing solid foods, like rice cereal, soon. We’ll discuss breastfeeding, formula feeding, or a combination of both and offer guidance on feeding routines and amounts to support healthy growth.

Sleep

Sleep habits at four months can be tricky! We’ll talk about your baby’s sleep patterns, review any challenges you’re facing, and provide tips for establishing routines that help both you and your baby get more rest.

Teething

Around this time, some babies start teething. We’ll discuss common signs, how to ease discomfort, and what to expect as your baby’s first teeth emerge.

We’re here to support you in every step of your motherhood journey.

Picture of Robert Hoki, M.D.

Robert Hoki, M.D.

Robert is board-certified in pediatrics and is a member of the American Academy of Pediatrics.

Milestones to Expect

  • Rolls over.
  • Sits with support.
  • Stands when placed and bears weight.
  • Grasps objects.
  • Transfers objects from hand to hand.
  • Begins to be interested in toys.
  • May shows signs of stranger anxiety.

Safety Reminders

  • Can start to introduce solid foods with a spoon (rice cereal).
  • Put your baby on their back to sleep.
  • Continue to use a rear-facing car seat.
  • Continue to test water temperature of baths and bottles with your wrist.
  • Keep toys with small parts out of reach.
  • Do not leave your baby alone in a tub of water or on surfaces such as changing tables, beds, or sofas.

Medicine Dosages

WEIGHT 6-11 lbs 12-17 lbs
Children’s Acetaminophen
(160 mg / 5 mL)
Can be given every four hours.
1.25 mL 2.5 mL
Infant's Ibuprofen Not safe at this age.
Do not exceed more than 4 doses in 24 hours.

Vaccine Information Sheets

Vaccine Information Statements (VISs) are information sheets produced by the CDC that explain both the benefits and risks of a vaccine to vaccine recipients.

DTaP VIS

HIB VIS

IPV VIS

Pneumococcal VIS

Rotavirus VIS

RSV VIS

  1. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP)
  2. Haemophilus influenzae type b conjugate vaccine (HIB).
  3. Inactivated poliovirus vaccine (IPV)
  4. Pneumococcal Conjugate Vaccine (PCV)
  5. Rotavirus vaccine
  6. Respiratory Syncytial Virus (RSV)

Rotavirus VIS

Bright Futures

At your visit, we’ll provide a summary of what to expect at this stage of your child’s development, as well as in the upcoming weeks and months. This resource, known as Bright Futures, is available below for viewing or printing online.

My four-month-old is already so full of life and personality, and it blows my mind how much he’s grown. He’s starting to roll over and his laugh is just the best. I can’t believe how quickly he’s changing—every day feels like a new adventure."

When to Call Your Pediatrician

  • If your baby has a fever.
  • If your baby doesn’t want to eat.
  • If your baby is vomiting excessively.
  • If your baby is irritable or lethargic.
  • If your baby has unusual skin rashes.
  • Any time you feel something is out of the ordinary.

From the Pediatric Blog

The Power of Play: How Fun and Games Help Children Thrive

Give your child the gift of play—fuel their growth, creativity, and happiness. Start today by making play a joyful part of your routine!

Movement Milestones: Babes 4 to 7 Months

Between four to seven months, your baby will start developing new skills as their strength and coordination improve. Encourage their progress with activities and toys that support movement and exploration.

Suitable Sleeping Sites: Safe at Night & Naptime

When setting up a crib for your baby, prioritize safety by using a firm mattress, avoiding soft bedding, and keeping the crib free of toys and bumpers. For safer sleep, it’s best to share a room but not a bed with your baby during the first year.