Health Library

Developmental milestones record - 4 months

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

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

I Would Like to Learn About:

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 their head 90 degrees when placed on their 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).
• Avoid television and other screen time until age 2 years.

References

American Academy of Pediatrics. 2022 Recommendations for preventive pediatric health care. Pediatrics. 2022;150(1):e2022058044. PMID: 35921638 pubmed.ncbi.nlm.nih.gov/35921638/.

Marcdante KJ, Kliegman RM, Schuh AM. Normal development. In: Marcdante KJ, Kliegman RM, Schuh AM, eds. Nelson Essentials of Pediatrics. 9th ed. Philadelphia, PA: Elsevier; 2023: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.

Review Date: 10/31/2022  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

A.D.A.M., Inc. is accredited by URAC, for Health Content Provider (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics. This site complies with the HONcode standard for trustworthy health information: verify here.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- 2024 A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.