4 months


Vaccinations

DTaP | IPV | HBV | HIB | PCV13 | Rotavirus

Development

These skills tend to be quite variable. But at this age the typical child:

  • Holds her head high and raises her body on her hands when lying on her stomach.
  • Maintains head control when held uprigh; there is no head lag when pulled to sitting.
  • Rolls from stomach to back.
  • Opens his hands while at rest: can play with hands, holds a rattle.
  • Looks at a mobile and moves her arms.
  • Follows parents and objects with his eyes through a 180 degree range.
  • Initiates social contact by smiling, cooing, laughing, squealing; may be displeased or cry when a parent moves away.
  • Recognizes preparation for feeding and is able to wait a short time.

Safety

Injury prevention is proactive. Consider the following:

  • Use car safety restraints.
  • Never leave the child unattended on a bed or table.
  • Guard against ingestion of harmful objects and substances. Keep powders, baby cleaners, and small objects such as safety pins closed and out of the baby's reach at all times. Do not use the powder container to distract the baby.
  • Do not hold the infant when handling hot substances.
  • Check toys for vulnerability to breakage. Be aware of buttons that can be pulled off of clothes, toys, and furnishings.
  • Avoid the use of a walker.

Parenting

These activities provide good examples for modeling important skills and encourage your child to grow in a healthy and happy way:

  • Allow your child to play by him- or herself for short periods in a safe area such as the playpen.
  • Continue interactions with siblings.
  • Offer safe toys to your child.
  • Continue talking to your baby and responding to their vocalizations.

Nutrition

Good nutrition is essential to a growing body. Tips include:

  • Never place your baby in bed with a bottle.
  • You may want to discuss with your child's provider the introduction of solids at this age.
  • Choking can be a hazard at anytime during childhood; watch what your child is eating and putting in his or her mouth.

Behavior

Childhood behavior may go from one extreme to another. This age is no exception:

  • At this age, your baby may have developed a more set rhythm to her sleep patterns. This may include sleeping through the night and more predictable napping.
  • You may now begin to put your child to bed partially awake, in order for him to learn self comforting skills.
  • In the next few months, your child may begin to develop stranger awareness and anxiety.
  • Thumb sucking is a comfort behavior and may commonly be seen at this age.

Resources

The following items may be useful:

  • Brazelton, T. Berry. Doctor and Child. Dell, 1978.
  • Miller, Karen. Ages and Stages. Telshare Pub. Co., Chelsea, MA. 1985.
  • Nelson, Christine, MD. Should I Call the Doctor? (Warner Books)
  • Segal, Marilyn M. Your Child at Play. Birth to One Year. Newmarket Press, NY 1985.
  • Schmidt, Barton, MD. Your Child's Health (Bantam Books)
  • White, Burton. The First Three Years of Life: A Guide to Physical, Emotional and Intellectual Growth in Your Baby. Avon, 1984.

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