Northwest Spokane Pediatrics

Child Development

Weeks


What should I expect from my 4-month-old?

Behaviors

  • Baby cries (with tears) to communicate pain, fear, discomfort, or loneliness
  • Babbles or coos
  • Loves to be touched and held close
  • Responds to a shaking rattle or bell
  • Returns a smile 6. begins to enjoy peak-a-boo games

It is normal for babies to cry. At this age you can't spoil a baby. Meeting your baby's needs quickly is still a good way to help him build trust.

Neurodevelopmental

  • Explores objects with mouth
  • Plays with fingers, hands, toes
  • Reacts to sound of voice, rattle, bell
  • Turns head toward bright colors and lights
  • Recognizes bottle or breast

Physical

  • Sleeps about 6 hours before waking during the night
  • Averages 14-17 hours of sleep daily
  • Lifts head and chest when lying on stomach
  • Follows a moving object or person with eyes
  • Grasps rattle or finger
  • Wiggles and kicks with arms and legs
  • Starting to roll over (stomach to back)
  • Sits with support
  • Rolls from side to side.
  • Holds up chest when lying on tummy.
  • Supports head when held in sitting position.
  • Sits with support for longer periods.
  • Enjoys using the legs in kicking motions.

Nutrition

Your baby should still be taking breast milk or infant formula. Most babies now take about 6 ounces every 4 to 5 hours.

If you give your baby breast milk, it is a good idea to sometimes feed your baby with pumped milk that you put in a bottle. This will help with baby learning to drink from different sources. They have better strength and can nurse from both the breast and bottle now. A small nipple opening is advised to keep the bottles' sucking requirements similar to that of the breast.

Some babies are now ready to start cereal. A baby is ready for cereal when he is able to hold his head up enough to eat from a spoon. Use a spoon to feed your baby. When you start cereal, start with rice cereal mixed with breast milk or formula. You may want to start with a thin mix of cereal and then thicken it gradually.

Sleep

Many babies are sleeping through the night by 4 months of age and will also nap 4 to 6 hours during the daytime. Remember to place your baby in bed on her back.

Teething

Your baby may begin teething. While getting teeth, your baby may drool and chew a lot. A teething ring is very useful.

Safety Tips

Avoid Choking and Suffocation
  • Remove hanging mobiles or toys before the baby can reach them.
  • Keep cords, ropes, or strings away from your baby, especially near the crib. Ropes and strings around the baby's neck can choke him.
  • Keep plastic bags and balloons out of reach.
  • Never eat, drink, or carry anything hot near the baby or while you are holding the baby.
  • Turn down your water heater to 120°F (50°C).
  • Don't smoke in the house or near the baby.
  • Use only unbreakable toys without sharp edges or small parts that can come loose.

Immunizations

  • DTaP #2
  • HiB #2
  • IPV #2
  • PCV #2

RED FLAGS

  • Infant cannot hold head erect and steady when held at an adult's shoulder.
  • Infant cannot maintain head centered and bring hands together when on their back.
  • Infant cannot hold onto a toy placed in either hand.
  • Infant's leg(s) are stiff and feet are plantar flexed (toes pointed) in most positions.
  • One or two hands are tightly fisted and/or the leg on the same side of the body is stiff.