4 Month Check-Up

3 Jan
Well, how have the first 4 months been?

Hopefully you listened to me last time and you don’t have your baby already eating table food but I’ve seen it all so nothing would really surprise me.

Here are the major topics I cover during the 4 month check up:

  1. Diet
  2. Sleep
  3. Development

If you pay close attention, you might start to see a trend in the topics I cover during checkups.


Most babies at this stage are taking somewhere around 4 ounces or breastfeeding every 3-4 hours with (hopefully for you) a longer stretch at night that can be all the way through the night.  A healthy baby with good growth can sleep all the way through the night without affecting his overall nutrition and growth.  At this point I’m pretty flexible with what parents want to do as far as sleeping through the night goes.  If you are ok with waking up several times a night, go for it.  However, if you want some tips on what I recommend to help a child with learning how to sleep, you can check out my blog on the subject here:

Are You Sleeping? Are You Sleeping?

The next component of the diet conversation is what to do about introducing solid foods.  I have a pretty laid back approach to how and when you start solids but I do have some general guidelines I like to recommend.  First, I do not think that babies should be started before 4 months because I prefer that be ready to sit up relatively well and have enough head control to take from a bowl and spoon.  If parents wish to delay past 4 months I am also ok with that as well.

I generally recommend starting with whole grain or oatmeal cereal.  I have gone away from recommending white rice (I figure if refined, white grains are bad for me why I am giving those to my babies for their first food).  Start with just a few teaspoons at first so there is less to throw away when it doesn’t go very well.  Then work your way up on volume.  You can mix the cereal with water and breast milk and if stools start to get firm, you can use a little pear juice.  If you want, feel free to skip the cereal all together and go with a regular whole food (I’m told avocados work well).

Anytime you’re ready you can move on to your other baby foods.  You can find more details about my feeding recommendations here:

What Do I Feed My Baby? Feeding FAQs

There is also a series of posts written by my wife about how she made our own baby food if you are interested…you can find those here:

Making Baby Food-Not Only for Granolas

Homemade Baby Food-What I Made and How I Made It

Homemade Baby Food-An Example Food and Process


Babies this age consistently need 16 hours of sleep a day but vary significantly on when they get those hours.  Some babies are sleeping through the night (10-12) stretch but many are still waking up 1-2 times per night to feed.  These babies then go on to take 2-3 naps during the day to get the remainder of their sleep.

At this point, there is definitely some choice in how you handle sleep with your child.  If you are happy waking up at night and feeding, then go for it!  However, most babies who are growing and developing normally at this age can begin to sleep through the night.

I have a “simple” method for helping your child to sleep but it does take some work on your part.  You can find help with this here:

Are You Sleeping? Are You Sleeping?.


Many babies this age are rolling over both front-to-back and back-to-front.  However, I’m happy if babies are rolling one way or the other or even just making a good effort but just can’t quite get over because they have an arm in the way or their too chunky.  (It’s hard to roll over when you’re too fat!)  The next stage in motor development is sitting up so I advise getting the Bumbo’s out or sitting the child up often to strengthen those core muscles.  Over-achieving babies can work with crunches but most just need a little practice sitting up every now and then.

Verbal development is also coming along during this time.  For the most part, babies are laughing and doing some cooing at this stage without many hard consonants like bababa and dadada (but those will come soon).  Studies have clearly shown that the best way to improve your child’s IQ is nothing more fancy than talking with them early and often.  The more words and sounds they hear, the better off they will be in the long run.  If you can’t think of anything to say, read books!

Next checkup will be the 6 month checkup…good luck with solid feedings!
Some other posts you might find interesting:

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