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Baby Development: Your 4 Month Checkup

The four-month milestone means it’s time to head to your child’s pediatrician for his or her well-baby check. A well child check is a time for your pediatrician to determine how your baby is progressing in terms of growth and development. There are also several immunizations your baby will receive at this appointment. 

Growth and weight

Your pediatrician will likely start the appointment with growth and measurement information. This includes measuring your baby’s weight without clothing on, as well as his or her length and head circumference. Your baby’s doctor will then compare these numbers to percentiles that range from 0 to 97. While the percentile indicates where your baby is compared to his or her peers, what percentile your child falls into depends heavily on genetics.

The truest measure for your baby’s growth is against his or her own growth. Your doctor is really looking to see if your baby is progressing over time. Remember also that babies tend to go through growth spurts. At one check-up, your baby may be in the 30th percentile, while the next month, he or she may be in the 50th percentile. Your child’s pediatrician will continue to map this progress over time.

Examining baby

Height and weight are not the only important factors at the four-month visit. Your baby’s doctor will also conduct a thorough physical. This includes:

Listening to the heart and lungs

Examining the eyes and ears

Watching your baby to see if he or she responds to sounds

Examining the mouth for potentially emerging teeth or infections

Placing your baby on his or her stomach to observe for head control

Moving your baby’s arms and legs to check for range of motion

During this exam, your doctor may also ask you some questions, too. This helps the pediatrician determine how your baby is progressing outside the office. Some questions may include:

What kinds of noises is your baby making?

Does he or she appear to be tracking objects with his or her eyes?

How often is your baby eating?

How long is your baby sleeping?

What are the color and consistency of your baby’s bowel movements?

What types of movements is your baby making — is he or she rolling over, doing mini push-ups, or sitting up while supported? 

Updating immunizations

Typically the last part of your visit will involve giving your child immunizations. Immunizations given at the four-month mark include:

Diphtheria, tetanus, and pertussis (DTaP)

Haemophilus influenza (Hib)

Pneumococcal (PCV)

Inactivated polio (IPV)


Any questions?

Just as your baby’s pediatrician has questions for you, it’s understandable you may have questions for him or her. Some common questions at the four-month mark include:

When should I plan on my baby starting to eat solids?

How will it affect my nursing schedule when my baby starts eating solids?

What do you recommend doing to stop teething pain?

When should I start thinking about childproofing my home? Do you have any practical tips?

You’ll also likely have several questions regarding whether or not certain developments are normal. This could include anything from activities to skin conditions to your baby’s height and weight. You may want to keep a small notebook where you can keep up with these questions (and possibly their answers) at the visit.

Get a pediatrician\’s perspective of the 4-month appointment with Bundoo Pediatrician, Dr. Sara Connolly.

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