Well Child Care
> Well child care: 4 Months
Well child care: 4 Months
Information regarding developmental goals, safety, immunizations, and nutrition information.
- Place baby on his or her belly for tummy time during supervised play to build arm and neck muscles. This aids in learning to roll by 6 months.
- Reaching and grabbing begins at 3-4 months. Offer toys for baby to grab and chew. It is normal behavior for babies to put everything from toys to toes in the mouth!
- Language is developing, so talk and sing often to your child. Don't use baby talk.
- Sing, play peek-a-boo and allow baby to look at self in a mirror.
- Encourage sitting. Have baby sit on your lap, sit him on the floor with pillows and gradually allow more independence as the muscles strengthen. Most babies can sit independently by 8 months of age.
- Read to you child 20 minutes each day.
- Turn the television off.
- See also Speech Development
- Breast milk or formula is all that is needed nutritionally until 6 months, but foods can be started at 4 months if baby has good head control and shows interest.
- For more information about breast feeding click here.
- Expect a mess as baby learns!
- No juice!
- Vitamin D is recommended for all infants not getting 33 ounces of formula. Breast milk does not add into this volume, since minimal vitamin D is in breast milk.
- The American Academy of Pediatrics recommends an iron supplement for all infants over 4 months who are breast fed. If a baby is on plenty of iron rich foods a supplement may not be needed. Speak with your pediatrician. For more information, see Iron Supplementation.
- Do NOT heat bottles in microwave.
- It is now recommended for most children to start peanut products between 4 and 11 months to prevent peanut allergy. If there is a family history of peanut allergy or if your child has eczema, discuss this with your child's physician first.
- For more complete information on feeding your 4 month old, especially starting new foods, see our Feeding Your 4 Month Old page and Dr. Stuppy's blog on Starting Solids.
- As baby begins to explore, protect him/her from danger.
- Use distraction to divert attention from dangerous situations.
- Never allow smoking around your baby or in the home, even if baby is not around.
- Turn the water heater down to 120° F. You can use a meat thermometer to check the hottest water temperature from the tap.
- Never hold a baby while cooking or drinking hot liquids.
- Never use a walker with wheels. Exersaucers are acceptable.
- Watch for small objects a child may choke on (toy parts, buttons). Get down to their eye level to childproof. Notice door stoppers (the tip might come off!), cords that can be wrapped around a neck or cords that can pull heavy or hot objects down.
- Never leave baby unsupervised on a changing table, sofa or bed.
- Never leave young children alone in a bathtub or near water. Close the bathroom door when not in use. Put toilet seats down so children don't try to climb in!
- Always use your car seat facing backwards at this age. We don't recommend heavy clothing (such as sweaters or coats) to be worn when in a car seat. It is safer and more comfortable to be in a regular shirt with a blanket on top of the seatbelt.
- Never place a car seat in front of an airbag.
- Always leave contact information with babysitters.
- Do not dispose of medications by flushing down the toilet or pouring down a drain. To learn how to safely dispose of medications, click here.
- Have baby sleep on back until rolling over to tummy on own. No pillows, loose blankets, stuffed toys, or bumper pads in bed to decrease 'SIDS'.
- All parents should learn CPR and refresh skills every 2 years. For a list of CPR classes for both non-medical and medical professionals, click here.
- Start a regular bedtime routine. Keep sleep times at the same time daily. Do quiet activities before bed, such as reading a book.
- Rocking to sleep is a tough habit to break - especially as babies get older.
- Put baby to sleep awake. If they feed just before bed and fall to sleep, you can waken them with wiping the gums/teeth with a soft cloth.
- Never put baby to bed with a bottle.
Use Acetaminophen (Tylenol)
as directed based on weight.
Most children get 8-12 cough and colds
Antibiotics don't cure viruses.
Use saline nose drops with a nasal aspirator for any nasal congestion. We don't recommend the bulb syringe, but our Cough and Colds page
has some suggestions.
OTC (over the counter) cold medicines are NOT recommended.
Wipe baby teeth daily with cloth or toothbrush. For more information on teeth, see our dental pages
- Fever is common after shots. Give Acetaminophen every 4-6 hours as needed for fussiness. There is research that shows that giving fever reducers diminishes the effectiveness of the vaccine, so avoid routine use to prevent symptoms.
- Sugar solution to suck on during injections has been shown to decrease the pain of injectable vaccines. This can be made by simply dissolving sugar in water and dipping a pacifier into the solution before the shots.
- Bring your shot record each visit!
- Be sure to obtain any required health forms at your well visit!
WIC (Women, Infant, and Children) provides nutrition counseling, breastfeeding support, and food to families who have needs. In 2011 a household of 2 who earns a gross income of less than $26,955/year or a household of 4 who earns less than $40,793/year may be eligible. For more information click here
Has your child had their 4-month well child care appointment? Click here to request one now.
Review your insurance contract to see who is responsible for payment of specific things within your well visit. Many companies do not require a co pay for well care visits, but if additional topics are discussed (such as ill topics or refills of medications) they might require a payment from you. They might also require you to pay for all or part of any labs or testing done at well visits.
If you have questions about how your insurance handles codes performed at the time of well visits, please visit our insurance pages on patient responsibility with billing
and Why am I being billed? I have insurance!