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4 Months

What to Expect at the 4-Month Well Visit:

  • Second DTaP / Polio / HepB vaccine
  • Second Haemophilus influenzae type B (Hib) vaccine
  • Second pneumococcal conjugate (PCV) vaccine
  • Second rotavirus (RV) vaccine

See the full immunization schedule ›

Safety:

  • Your infant is moving more; be aware that they can fall off surfaces. Never leave the baby unattended on a bed, changing table or sofa.
  • Continue to use a rear-facing car seat secured in the backseat of the car.
  • Never drink hot liquids while holding your baby or near your baby to avoid burns from accidental spills.
  • Make sure your water heater temperature is set to a maximum of 120° F.
  • AAP recommends insect repellents should be less than 30% DEET and used for infants 2 months old and older. Wash off skin with soap and water when done. Wash clothes before wearing again. Do not use combination DEET and sunscreen products. Apply permethrin for ticks to clothes, not to skin.
  • Use a sunscreen with an SPF of 30 or higher, reapplying every 2 hours, and avoid peak sun intensity of 10 am to 3 pm.

Development:

  • Grasps objects and brings them to the mouth.
  • Sits with support.
  • Turns from front to back.
  • Squeals, laughs, smiles spontaneously at people.
  • Begins to babble, copy sounds and facial expressions.
  • Lets you know if he/she is happy or sad.
  • Recognizes familiar people.

Diet:

  • Breastfed infants continue until they are 6 months old.
  • Continue with Vitamin D 400 I.U daily.
  • Formula fed infants, once they reach 30 oz. a day, can start solids (preferably cereals initially). Mix formula with cereal and feed from a spoon. Feed this one new food for 3 to 5 days in a row. Then introduce a new food. No cereal in bottle at all.

Other Helpful Notes:

  • Make sure your infant is getting supervised tummy time to prevent flattening of head. Limit bouncy seats and swings since they put pressure on the back of their heads with prolonged use.

Watch Out For:

  • Please notify your provider if your baby does not watch things as they move, does not smile at people, does not push down with their legs when their feet are on a hard surface, does not coo or make sounds.