Baby's Four Month Check-up

New milestones and another round of vaccinations.

As Baby grows throughout the first year, the time in between check-ups will gradually increase. You were going frequently in the first two months and now that it’s been two months since the last visit, it’s time to check in again to assess your baby’s growth.

So much is happening in the first months of your little one’s life. I’m sure you are noticing big changes already. That’s why it’s important to stay on track with the baby well visits.

What to Expect at Baby’s Four Month Check-up

Four Month Developmental Milestones

At about four months of age, your little one will develop some new skills and abilities. While some of these milestones overlap with two month list of milestones, you might see these more regularly or see your child doing them more proficiently.

Typically four-month-olds can:

  • Smile spontaneously, particularly at people
  • Mimic conversations by babbling and cooing in response to being spoken to
  • Copy facial expressions when interacting with someone
  • Cry in different ways to communicate different feelings
  • See an object and reach for it with one hand
  • Begin to move an object from one hand to another
  • Bring hands and toys to mouth
  • Sit with support (and may begin to sit unsupported for a short time)
  • Hold up head and chest
  • Begin to push up on elbows while on tummy
  • Roll from tummy to back
  • Hold up weight when standing supported on hard surfaces
  • Hold head steady when held upright

Questions to Ask at the Four Month Check-up

With all these new changes happening, you may have new questions to ask.

  • Eating solid food - When is Baby ready to start eating solid foods and which foods should you introduce first?
  • Teething - What are the signs for teething? How can I ease pain due to teething?
  • Sleep training - When can Baby sleep through the night? What are some tips on how to start sleep training?
  • Swaddling - Does Baby still need to be swaddled?
  • Transitioning out of mom and dad’s room - What are some tips for transitioning Baby to a crib in his own room and out of bassinet in Mom and Dad’s room?
  • Baby proofing - Is it time to baby-proof? Of which safety concerns should I be aware?

Physical Exam

As with the last well visit, measurements of your child’s weight, length and head circumference will be taken and compared to the measurements of the last appointment to make sure that everything is developing normally. The same full body examination will be given as well.

Four Month Vaccinations

At the end of each appointment, the nurse typically comes back in to administer the appropriate immunizations. At the four month appointment, it will be the next dose of the ones Baby had at the previous appointment:

  • Pneumococcal (PCV)
  • DTaP
  • Hib
  • Polio vaccines
  • Rotavirus vaccine (given orally)

No doubt, the next two months leading up to the six-month appointment will fly by as Baby grows and changes. Watch for milestones and enjoy the new things your little one can do. Keep track of questions you may have for the next visit, but feel free to call your pediatrician anytime you need to set your mind at ease.

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Annie Wiesman

Annie Wiesman

Annie Wiesman is the co-author of “Education Begins at Birth: A Parent’s Guide to Preparing Infants, Toddlers, and Preschoolers for Kindergarten.” She is a former kindergarten teacher turned stay-at-home mom who enjoys traveling, hiking in the mountains, and creating memories together with her husband and little girl.

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