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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

Definition

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

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.

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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.

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