4-Month-Old Baby: Feeding, Sleep, and Milestones by Month

The first few months of your baby’s life are a whirlwind of development and growth. As your baby reaches 4 months old, you will see an ever-growing list of milestones, challenges, and new routines. In this article, you will learn about the new aspects of your 4-month-old baby’s life, from milestones to feeding and sleep schedules, health concerns, engaging activities, and safety tips.

As your baby approaches 4 months, they start reaching new and exciting developmental milestones. The new motor skills they will develop include:¹

• Holding their head up without support
• Holding toys with their hands
• Swinging at toys with their arms when the toy is dangled above them
• Pushing themselves up on their elbows and forearms while on their tummy
• Looking at their hands with interest and bringing them to their mouths

Your baby will also develop new and exciting social skills during their fourth month. These skills include:¹

• Making cooing sounds, such as “aah” or “oooo”
• Repeating sounds back to you
• Smiling to get your attention
• Chuckling when you try to make them laugh
• Moving and making noises to get your attention

As your baby reaches 4 months old and beyond, their feeds start to space out a bit compared to the first 3 months of their life. Your baby will typically eat 4 to 6 ounces of breast milk or formula every three to four hours at this age.²

During this time, many infants experience a growth spurt and have periods of wanting to feed or breastfeed more often. This can make it difficult to have a consistent feeding or breastfeeding schedule. The frequency of their feedings will space out again after their growth spurt has ended. It is essential during this time to follow your infant’s feeding cues and feed or nurse them as frequently as needed.³

Many parents wonder when they can introduce solid foods to their babies. The introduction of solid foods is typically not recommended until your baby reaches six months old. If you have questions or want to start introducing solid foods sooner than six months, please consult your baby’s doctor.²

As your baby grows, their sleeping patterns continue to evolve. At this age, your baby will typically sleep 12 to 16 hours daily. Your baby will also take a few naps during the day. They usually take two naps that last around 1 ½ to two hours each. Your baby may take more frequent, shorter naps throughout the day, which is also normal.⁴

If you have not established a bedtime routine, this age is a great time to start. Begin with soothing activities like a calming bath, reading a book, or singing softly to help your baby unwind. As they wind down, you will notice that they become drowsy. It’s recommended to place them in their crib while they are tired but not yet fully asleep. This helps them to learn how to fall asleep on their own.⁴ However, this may not be true for all babies, and some may still require a caregiver’s help to fall asleep.

Another critical aspect of creating a bedtime routine is determining when your baby should sleep for the night. Aiming for a bedtime between 7 and 8 p.m. may be ideal, as putting your baby to sleep later may lead to overtiredness, making it more challenging for them to fall asleep and stay asleep.⁵ But it’s important to remember to follow your baby’s cues, such as yawning or rubbing their eyes, since not all babies require the same bedtime.

As your baby’s schedule becomes more predictable, now is a great time to establish a typical daily schedule. Your daily routine will still revolve around feeding and sleeping, but you can make a more concrete routine.

A sample daily schedule can look as follows:⁵

• 7 a.m.: Morning feeding after waking for the day
• 7-9 a.m.: Playtime
• 9-11 a.m.: Morning nap
• 11 a.m. – 1 p.m.: Feeding/playtime
• 1-3 p.m.: Afternoon nap
• 4 p.m.: If not awake from an afternoon nap, awaken and feed
• 4-5 p.m.: Playtime
• 6-7 p.m.: Start bedtime routine/feed
• 7-8 p.m.: Bedtime
• 11 p.m.: Dreamfeed (optional)

At 4 months old, your baby will have another well-child visit with their pediatrician. At this visit, your pediatrician will monitor their weight gain, perform a physical and developmental exam, and discuss any immunizations your child may need. Your doctor will check to ensure your 4-month-old’s weight is increasing appropriately. On average, most 4-month-old children should have doubled their birth weight and are gaining about 1 to 1 ¼ pounds this month.⁶ Your doctor will compare your infant’s weight at this appointment to their previous weights to see if they are growing as they should.

After your doctor checks your infant’s weight and development, they will discuss the vaccines your 4-month-old is recommended to get. These vaccines include their second dose of the following:⁷

• Diphtheria, tetanus, pertussis vaccine (DTaP)
• Haemophilus influenza (HiB) vaccine
• Polio vaccine
• Pneumococcal vaccine
• Rotavirus vaccine

Your baby’s 4-month-old well-child visit is the ideal time to discuss any concerns you may have about their development. Some concerns that you want to notify your pediatrician about are:⁷

• Your baby is unable to hold their head up.
• They have not started to babble or mimic sounds.
• They do not respond to your voice.
• They are not able to hold a toy in their hand.
• They show no interest in their hands or can’t bring them toward their mouth.

As your baby grows, they will continue to be exposed to illnesses, and there are some common childhood illnesses you need to be aware of. These include the following:⁸

Many of these illnesses can be treated at home, but it is essential to seek medical care if you have any concerns or any of the following occur:⁸

• A fever lasting longer than three days
• Signs of dehydration such as dry/cracked lips, decreased amount of wet diapers, or decrease in tears
• Difficulty breathing
• Increased irritability or fussiness
• Decreased energy

At 4 months old, your baby is more alert and active, and playtime becomes more engaging. Here are some ideas for engaging play with your little one:¹

• Talk, read, and sing to your baby
• Play peek-a-boo
• Play on the floor or play mat with your baby
• Let them reach for a colorful toy while you move it around
• Have supervised tummy time
• Give them soft toys to explore, such as rattles or cloth books
• Respond positively when your baby makes and mimics sounds

Maintaining a safe environment is vital for your baby at any age, but even more so now that they are more active and alert. It is crucial to assess your baby’s environment for any safety concerns. Some general safety tips to keep in mind include:⁹

• Make sure you are using the correct size car seat and that it is installed correctly
• Place baby gates at the top and bottom of the stairways
• Never leave your baby unattended, especially with pets or other children

Some general bathing safety tips include:⁹

• Using a slip-resistant infant bathtub
• Filling the bathtub no more than 2-3 inches deep with warm, not hot, water
• Staying within arm’s reach of your baby at all times during bath time

Sleep safety is an often overlooked aspect but is one of the most important safety threats to consider. Providing a safe sleep environment can help reduce the risk of SIDS or sudden infant death syndrome. Some sleep time safety tips to remember include:⁴

• Always place your baby on their back to sleep
• Using a firm/flat mattress with a tightly fitted sheet
• Not putting toys, pillows, blankets, unfitted sheets, or bumper pads in the crib
• Moving any object your baby can reach from their crib out of the way, including cords, ties, ribbons, or objects on a shelf or dresser

Watching your baby grow in leaps and bounds during this time can be rewarding and exciting for parents. A basic understanding of your child’s development, sleeping and feeding schedule, health concerns, and tips for keeping them safe will help make this time even more fulfilling.