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Developmental milestones record - 4 months

Definition

Typical 4-month-old infants are expected to develop certain physical and mental skills. These skills are called milestones.

Alternative Names

Normal childhood growth milestones - 4 months; Childhood growth milestones - 4 months; Growth milestones for children - 4 months; Well child - 4 months

Information

All children develop a little differently. If you are concerned about your child's development, talk to your child's health care provider.

PHYSICAL AND MOTOR SKILLS

The typical 4-month-old baby should:

  • Slow in weight gain to about 20 grams (almost two thirds of an ounce) per day
  • Weigh 2 times more than their birth weight
  • Have almost no head droop while in a sitting position
  • Be able to sit straight if propped up
  • Raise head 90 degrees when placed on stomach
  • Be able to roll from front to back
  • Hold and let go of an object
  • Play with a rattle when it's placed in their hands, but won't be able to pick it up if dropped
  • Be able to grasp a rattle with both hands
  • Be able to place objects in the mouth
  • Sleep 9 to 10 hours at night with 2 naps during the day (total of 14 to 16 hours per day)

SENSORY AND COGNITIVE SKILLS

A 4-month-old baby is expected to:

  • Have well-established close vision
  • Increase eye contact with parents and others
  • Have beginning hand-eye coordination
  • Be able to coo
  • Be able to laugh out loud
  • Anticipate feeding when able to see a bottle (if bottle-fed)
  • Begin to show memory
  • Demand attention by fussing
  • Recognize parent's voice or touch

PLAY

You can encourage development through play:

  • Place the baby in front of a mirror.
  • Provide bright-colored toys to hold.
  • Repeat sounds the infant makes.
  • Help the infant roll over.
  • Use an infant swing at the park if the baby has head control.
  • Play on the stomach (tummy time).

References

American Academy of Pediatrics website. Recommendations for preventive pediatric health care. www.aap.org/periodicityschedule. Updated October 27, 2022. Accessed January 11, 2023.

Marcdante KJ, Kliegman RM. Normal development. In: Marcdante KJ, Kliegman RM, eds. Nelson Essentials of Pediatrics. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 7.

Onigbanjo MT, Feigelman S. The first year. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 22.

Last reviewed October 2, 2020 by Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. Editorial update 01/11/2023..

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