,

B

Healthy Healthy Start,GrowSmart,
 

Your uilding 4-Month-Old a Bright Future Baby
 for

Your 15- to 17-Month-Old Child

Building a Bright Future for

Your 15- to 17-Month-Old Child

Healthy Healthy Start,GrowSmart,


Your 4-Month-Old Baby
 

Prepared by 

U.S. Department of Health and Human Services 

U.S. Department of Education 

U.S. Department of Agriculture 

2008 
 

Acknowledgments 

This publication was an initiative of Laura Bush as the First Lady of Texas and 

sponsored by the Texas Department of Health. President George W. Bush and 

Mrs. Bush have asked that this series of booklets be revised and distributed by 

the U.S. Department of Health and Human Services, the U.S. Department of 

Education, and the U.S. Department of Agriculture. 

We would like to thank the Texas Department of Health for their cooperation and 

assistance in bringing this publication to families across the United States. In addition, 

we recognize the contributions that Susan H. Landry, Ph.D.; Craig T. Ramey, Ph.D.; 

and many other individuals made in the development of the documents. 

This publication is distributed by the U.S. Departments of Health and Human 

Services, Education, and Agriculture and is in the public domain. Authorization to 

reproduce it in whole or in part is granted. While permission to reprint this publication 

is not necessary, the citation should be: U.S. Department of Health and Human 

Services, U.S. Department of Education, and U.S. Department of Agriculture, 

Healthy Start, Grow Smart, Your 4-Month-Old Baby, Washington, DC 20201. 

This publication is available to download on the U.S. Department of Education’s 

Web site at www.ed.gov/parents/earlychild/ready/healthystart/index.html. It is also 

available in Spanish on the Department of Education’s Web site. 

On request, this publication is available in alternate formats, such as Braille, 

large print, audiotape, or computer diskette. For more information, please contact 

the Department’s Alternate Format Center at 202–260–0852 or 202–260–0818. 

This publication can also be downloaded at the U.S. Department of Health 

and Human Services, Centers for Medicare & Medicaid Services Web site at 

www.cms.hhs.gov/LowCostHealthInsFamChild/03_HSGSPamphlets.asp. 
What’s It Like To Be 4 Months Old? ......................................................................... 1
 

Your Baby’s 4-Month Checkup.................................................................................. 2
 

When To Call Your Health Care Provider................................................................ 4
 

Feeding Your Baby ...................................................................................................... 5
 

Taking Care of Baby’s Gums and Future Teeth........................................................ 6
 

Helping Your Baby Fall Asleep................................................................................... 7
 

Keeping Your Baby Safe.............................................................................................. 9
 

Toy Safety Is Important ............................................................................................ 10
 

How Your Baby Grows and Develops ..................................................................... 11
 

Your Baby Learns From Experience ........................................................................ 13
 

Help Your Baby Every Day....................................................................................... 14
 

Coping With Stress.................................................................................................... 15
 

Dads Have a Role to Play.......................................................................................... 16
 

Babies Can’t Be Spoiled ........................................................................................... 17
 

Games You Can Play With Your Baby .................................................................... 18
 

Helping Your Baby Explore...................................................................................... 19
 

Talking With Your Baby........................................................................................... 20
 

Babies Respond to Angry and Happy Faces............................................................ 20
 

Is Your Baby in Distress? .......................................................................................... 21
 

Helping Big Brother or Sister Adjust ....................................................................... 21
 

It Takes a Family To Raise a Child........................................................................... 22
 

Where To Find Help ................................................................................................. 23
 

Here’s What’s Inside
 

I use both hands to grab toys and other 

objects. 

When I’m in the bathtub, I like to splash 

in the water. I always need to be held firmly so I don’t slide into the 

water. 

like to look at myself in the mirror. Sometimes I smile at myself. 

What’s It Like To Be 4 Months Old?
 

How I grow: 

When I lie on my tummy, I may roll from 

side to side. I may even roll over onto my 

back. 

I can hold my head up on my own. I can 

turn my head from side to side. 

How I understand: 

I may get excited when I see people I know. 

I like some toys better than others. 

How I talk: 

When you talk to me, I smile and squeal and coo. 

I like to imitate sounds. I like for you to talk to me and make sounds to 

me. 

I babble now. I make lots of different sounds. 

When I am happy, I coo, squeal, gurgle, giggle, grin, and laugh out loud. 

How I respond: 

I like to be touched and held. 

I may fuss if I am left alone. I get bored. 

I may cry when you take a toy away from me. I may cry when you stop 

playing with me. 

Your 4-Month-Old Baby 1 
 

 

 

Your Baby’s 4-Month Checkup 

Your baby needs regular health checkups. She 

needs the checkups even if she’s not sick. Checkups 

can keep her healthy. The 4-month checkup is very 

important to your baby’s growth, health, and development. 

During the 4-month visit, your baby will have 

another complete checkup. This includes her 

weight, length, and head size. Her heart and lungs 

will be checked also. The health care provider will 

check on how your baby holds her head up and 

uses her hands. Your baby’s hearing and vision will 

also be checked. 

Your baby will get her second set of shots. Shots will 

keep her from getting sick and keep her healthy. 

Several shots may be given, including: rotavirus
 

(Rota) (prevents certain types of diarrhea); 


diphtheria, tetanus, and pertussis (DTaP); inactivated poliovirus (IPV); 


Haemophilus influenzae type b (Hib); and pneumococcal conjugate vaccine
 

(PCV) (prevents certain types of pneumonia). Although it may seem that
 

these are a lot of vaccines, many are combined into one shot.
 

Ask your health care provider what to look for and what you should do if 


your baby has any reaction to these shots, including fever or fussiness.
 

During the 4-month visit, the health care provider should check your
 

baby’s development through a standardized test, such as the Denver
 

Developmental Screening Test or others. Different tests are used to test a
 

baby’s development. Be sure to ask the health care provider the name of
 

the test used.
 

2 Healthy Start, Grow Smart 
During the test, the health care provider will ask if your baby is doing certain things, such as smiling and babbling. The health care provider will also 

examine the baby’s strength, reflexes, and other things. 

Before the checkup, write down questions you have about your baby. 

Checkups are a good time to ask the health care provider questions like, 

“What are the symptoms a baby has when she has a cold? How should I 

treat her if she has a cold? What kinds of problems should I call you for? 

What temperature should I call you for?” 

If you are feeding your baby only breast milk, your provider may recommend that you give your baby an iron supplement starting at 4 months. 

Babies who are fed only breast milk can get iron deficiency. They will need 

iron supplements until they start to eat other foods. Eating solid foods 

usually happens around 6 months. Then they can get iron from other 

foods like iron-fortified rice cereal. However, breastfed babies should take 

iron supplements until the time other foods are added to their diet. 

Always ask the health care provider for a copy of your baby’s checkup 

results. It’s a good idea to keep the copy in a notebook. These records 

should be kept in a safe place along with other important documents, such 

as your baby’s birth certificate and Social Security card. 

If the health care provider tells you to give your baby any medicines, ask 

your health care provider to write down the names of the medicines and 

directions on how to give them to your baby. 

Make an appointment for your baby’s 6-month checkup. 

Your 4-Month-Old Baby 3 
When To Call Your Health Care Provider
 

When your baby explores the world and plays with other children and 

adults, she will have more contact with germs. As a result, your baby 

may get a minor infection, such as a cold or ear infection. If you don’t 

know what to do about her symptoms, call your health care provider. It is 

important that you treat these minor infections. If left untreated, they can 

become serious. 

Signs of serious illness to look for are a fever above 100.4 degrees 

Fahrenheit, refusal to eat, persistent vomiting or diarrhea, unusual fussiness 

and excessive sleepiness, wheezing or having difficulty breathing, and pulling on the ears. If these should occur, call your health care provider. 

Always keep your health care provider’s phone number where you can find 

it. This number should be on a list of emergency phone numbers that you 

can find quickly. 

If there is an accident or your baby chokes or stops breathing, call 911 

immediately for emergency services. 

About Antibiotics 

If your baby has certain conditions, she will need antibiotics to get better. 

You must see a health care provider to get a prescription for antibiotics. 

Antibiotics are used to treat ear infections. They are also used to treat some 

serious illnesses like pneumonia, sepsis, and meningitis. 

When you give your baby antibiotics, it is very important that you follow 

the instructions carefully. Give your baby the exact amount directed at the 

required time. Even if your baby seems better, continue to give her the antibiotics for the length of time directed by your health care provider. If you do 

not give her the antibiotics as directed, she could get sick again. 

4 Healthy Start, Grow Smart 
Feeding Your Baby 

Breast milk and/or formula are the only foods 

your baby needs during the first 6 months of 

life. Giving your child solid food during the first 

6 months can contribute to the development of 

overweight and obesity in infants and children. 

Early introduction of solid foods may also lead 

to the development of food allergies. 

Vitamin D supplements are recommended for 

babies who are breastfed. Babies who are fed 

formula do not need vitamin D supplements 

because formula is fortified with vitamin D. 

Once solid foods are added, usually around 

6 months, vitamin D supplementation is not 

needed if you give your baby foods containing vitamin D, such as rice cereals. If you have 

questions about the about supplements for your 

baby, ask the health care provider. 

Your 4-Month-Old Baby 5 
Taking Care of Baby’s Gums 

and Future Teeth 

It’s never too early to start taking care 

of your baby’s future teeth. Here are 

some simple things you can do for her: 

Never put your baby to sleep with a 


bottle.
 

If your baby uses a pacifier, do not 


clean a pacifier by putting it in your 


mouth, because your germs may 


cause the baby to get dental disease. 


Never dip a pacifier in sweet liquids, 


honey, or syrups to make it tasty. 


Germs in honey can make your baby sick. Sweet liquids and sweets may 


cause tooth decay when your baby is older.
 

Twice a day, gently wipe her gums with a wet, clean, soft cloth using only 


water. Start doing this even before her teeth come in.
 

Some babies show teeth as early as 4 or 5 months. Most babies show 


teeth between 6 and 10 months.
 

When her teeth begin to show, you may use a soft toothbrush for cleaning. Make sure it is a baby-size toothbrush. Or you can continue to clean 


her teeth every day with a cloth.
 

Gently brush her teeth with water only. (Do not use toothpaste until 


your baby is around 2 years old. She should be old enough to spit out the 


toothpaste after brushing.)
 

6 Healthy Start, Grow Smart 
 

Helping Your Baby Fall Asleep 

You can start putting your baby to bed while she is 

still awake. Remember to put her on her back when 

you put her to bed. Most 4-month-old babies sleep 

5–6 hours a night and nap about 5 hours during the 

day. However, every baby has a different sleep pattern. 

Let her go to sleep on her own, alone. When she awakens during the night, she sometimes may go back to 

sleep on her own. This is much easier on the parents. 

Your baby may wake up at night to be fed. You don’t 

have to wake your baby for feedings at night. If your baby sleeps through the 

night, she will feed more often during the day. 

By now, it is important to establish a routine for putting your baby to sleep. 

Feeding at the same times helps in setting routine sleep patterns. 

Whether babies sleep through the night or wake up during the night, they 

go between deep and light sleep several times. 

A baby in light sleep may cry out. She may move around in bed. This 

may wake her up. As she cries and moves around, she gets upset. She 

will settle herself if she has a way to comfort herself. She may comfort 

herself by sucking her thumb or holding a blanket. Or she may get into 

a comfortable position, which will also settle her down. 

Some babies have more trouble settling down than others do. Going to 

bed at the same time each night will help her settle down. Keep the house 

quiet. Loud television or music may keep your baby awake. 

To help your baby to relax, you can give her a warm bath, massage her, 

or rock her. Reading or singing to her may also help her settle down. 

Don’t rush to her if she starts to cry. She may calm down after a few 

minutes and fall asleep on her own. If she continues to cry, pick her up. 

What your baby does during the day can affect her sleep. If she had too 

much excitement during the day, she may not sleep through the night. It 

may take several days for her to get back to her usual sleeping pattern. 

Your 4-Month-Old Baby 7 
 

Continue To Put Your Baby on Her Back To Sleep 

At 4 months, your baby is still at risk for Sudden Infant Death Syndrome 

(SIDS) or crib death. Research shows 

that babies who sleep on their backs are 

less likely to die from SIDS. Also, don’t 

smoke around your baby. Don’t take her 

around others who smoke. 

Make sure your baby is warm but not 

too hot when you put her down to sleep. 

Dress the baby warmly for sleep, and 

do not use blankets in the bed. If you 

use a blanket, the blanket should reach 

no higher than the chest, and the ends 

should be tucked under the mattress. 

Other ways to keep your baby safe when 

she is sleeping: 

Do not sleep with your baby in your bed. You can roll over and smother 

her.
 

Keep your sleeping baby nearby. Be sure you can hear her if she cries or 

is in distress.
 

Use cribs that have slats on the sides that are less than 2 3/8 inches apart.
 

Be sure your baby is sleeping on a firm mattress. Don’t put your baby to 


sleep on soft or fluffy things. Keep stuffed animals out of the crib at sleep 


time.
 

Make sure your baby is warm but not too hot.
 

8 Healthy Start, Grow Smart 
 

Keeping Your Baby Safe 

As she grows, your baby is becoming 

more curious. At this age, she is already 

actively exploring, reaching for objects, 

and putting things in her mouth. To 

protect your baby, you must thoroughly 

childproof your home. 

Safety at Home 

Never shake or hit your baby.
 

Don’t smoke around your baby. 


Don’t take him around others who smoke. Babies in smoke-free homes 


have fewer colds and infections.
 

Do not leave the baby alone with children or pets.
 

Have at least one smoke detector per floor in your home and test each 


once a month. You should change the batteries in each detector twice per 


year.
 

Do not have guns or drugs in the home.
 

Do not hold hot liquids at the same time you are holding your baby, or 


when your baby is nearby.
 

Never leave your baby alone on a bed, couch, table, or chair.
 

Check the bath water before bathing your baby. Test it with the inside of 


your wrist or with a thermometer. If possible, set the water heater in your 


home to 120 degrees Fahrenheit.
 

Instruct caregivers carefully. Write things down for them. Make sure that 


everyone who takes care of your baby understands what you expect about 


how to treat and care for your baby.
 

Learn CPR. The American Red Cross has classes in infant and adult CPR. 


You may visit the Red Cross at www.redcross.org or at 1–800–RED–CROSS
 

(1–800–733–2767).
 

Your 4-Month-Old Baby 9 
Safety Outside Your Home 

Use sunscreen made for babies on areas that are not covered by clothing, 

such as the face and hands. Put the sunscreen on your baby before you 

take her outside. Even with sunscreen, try to keep her shaded when she 

is outdoors. Avoid the sun between 10 a.m. and 4 p.m. This is the hottest 

time of the day. 

Use car safety seats in your car or in a taxi. The National Highway Traffic 

Safety Administration Web site can help you locate a car seat inspection 

station where you can get help installing the seat correctly. You can visit 

their Web site at www.nhtsa.dot.gov. Most fire stations or police stations 

can help parents with proper installation. 

Never leave your baby alone in a car, not even for a few minutes or if the 

windows are down. 

Toy Safety Is Important 

Babies put things into their mouths, so it is 

important to make sure all toys you give your 

baby are safe. Here are a few things to look 

for when choosing toys: 

Make sure toys that you buy for your baby 


are labeled “nontoxic.”
 

Toys should have no sharp edges or points. 

Check toys often to make sure there are no 


loose parts. Older toys may break and have 


sharp edges.
 

Make sure small toys, such as squeak toys, 


rattles, and teethers, are large enough so that your baby can’t put the 


whole toy in her mouth. Smaller toys can get stuck in your baby’s throat.
 

Don’t give your baby toys with strings or ribbons. 


If you have toys like this, just remove the strings.
 

Don’t hang toys or a pacifier around your baby’s neck. 

10 Healthy Start, Grow Smart 
Don’t give your baby toys that have small parts. The parts can come off, 

and she could choke on them. Check for small parts such as buttons and 

eyes that are glued on. Don’t give her toys with beads that can be pulled 

off. Toys that are stuffed with small pellets can come apart, and your 

baby could choke on the pellets. Check the package on the toy for the age 

appropriate label. 

Don’t let your baby play with a plastic bag. It can choke or smother her. 

Don’t give your baby balloons to play with. The balloon can break and 

create a choking hazard. Don’t give pieces of popped balloons to children 

of any age. Babies and children can choke on balloon pieces. 

Don’t let your baby play with plastic wrapping from toys or other items. 

Older children should be told not to use loud toys around the baby. Such 

loud noises can damage her hearing. 

How Your Baby Grows and Develops 

When your baby reaches the age of 4 months, things will start to happen 

really fast. She is growing and learning about her world. She is interested in 

everything she sees or hears. She is reaching for things and putting them in 

her mouth. This is how she learns about them. 

When she is feeding, she stops and plays with your clothes, or she looks at 

other people in the room. 

She may try to roll over. The more she tries, the better she can do it. 

She smiles when she sees her parents and other people who care for her. She 

babbles. She tries to imitate your words as she makes sounds. 

She may start sleeping at night for longer and longer periods of time. 

She will love it when you sit on the floor and play with her. You can have a 

lot of fun with your baby at this age. 

Your 4-Month-Old Baby 11 
Watch for Developmental Delay 

Watch your baby carefully. Your baby will develop at her own pace, so it 

is hard to tell exactly when she will learn a new skill. The Healthy Start, 

Grow Smart booklets aim to give you an idea of what to expect as your baby 

grows. Do not be worried if she learns at a different rate. You should discuss 

with her health care provider your baby’s development and any of the following signs of possible developmental delays: 

Does not grasp and hold objects. 

Does not smile at people. 

Cannot support her head well. 

Does not begin to roll over and reach for toys. 

Does not babble. 

Does not try to imitate any of your sounds. 

Does not push down with legs when feet are placed on a firm surface. 

Organizations can provide help if you and your health care provider determine that there is a problem with your baby’s development. The National 

Early Childhood Technical Assistance Center has information on available 

programs at www.nectac.org/contact/ptccoord.asp. 

12 Healthy Start, Grow Smart 
Your Baby Learns From Experience 

Each brain, like each child, is unique. Here 

are some things you should know about 

your baby: 

The brain grows fastest in the first 3 


years of life.
 

It’s hard to describe how a child’s brain 


develops. It depends on traits that come 


from the parents. It also depends on the 


child’s experiences. You can influence 


the part that depends on experience.
 

Babies cannot see well when they are born. At 4 months, your baby’s 


vision has improved. Now, she may show interest in objects all the way 


across the room. Show your baby bright and colorful objects. Move them 


slowly to help her stay interested in them.
 

A baby’s hearing develops early. Talk to your baby often. A baby can 


remember patterns of sounds. She can remember the sounds of a story 


that you read over and over. She can also remember the sounds of a 


song. Tell her a rhyme over and over for several days. Read her a story 


over and over for several days. Or sing the same song for several days 


with your baby. Watch how she responds.
 

Touching your baby gently can help to quiet her or to stimulate her. 


It depends on how you do it. Massaging your baby gently can help her 


relax.
 

Your baby learns more when you respond to her needs.
 

Most infant memories do not last long. Even so, your baby’s memory 


is active.
 

Your 4-Month-Old Baby 13 
 

Help Your Baby Every Day 

Here are some important things you can 

do that will help your baby every day: 

Be your baby’s teacher. Babies learn 


when they have many good experiences with someone who loves them. 


Give your baby a rattle. Say, “Shake, 


shake,” as you move it, and make 


sounds together. Name things for 


your baby. For example, say, “Look 


at the tree. Let’s sit under the tree.” 


This helps your baby develop language.
 

Encourage your baby to explore. Your baby is at an age when she likes to 

be held up to look at things. Looking at things is important for her. Look 

at something together, and move it around. Your baby now is holding 

on to things and putting them into her mouth. This helps her explore. 

It also helps her develop movement skills. Find things she can play with, 

like unbreakable spoons or plastic cups, and get down on the floor and 

play with her. 

Get excited about your child. Show your excitement when she does 

something. Make sure you act immediately. Your baby will connect your 

pleasure with what she has just done. For example, when your baby sits 

up as you hold her, say, “Look at you! You are sitting up!” 

Repeat things with your baby. Babies learn by doing the same thing over 

and over. Your baby may learn faster when she has lots of time playing 

and talking with you. 

Communicate. Talk and sing to your baby. She has been learning about 

language since birth. Talking to her helps her to learn. 

14 Healthy Start, Grow Smart 
Coping With Stress 

Taking care of a baby may cause stress. It’s a big job. It’s normal to have 


moments of sadness, fear, frustration, or anger.
 

These feelings can be powerful. When you are angry, you may feel like 


breaking things or saying hurtful things.
 

There are other ways to deal with strong feelings. Here are some tips:
 

Talk about these feelings with someone you trust. The worst thing you 

can do is keep these feelings to yourself. 

Talk to your spouse or a family member. 

Talk to a friend, a health care provider, or a member of the clergy. 

Try to exercise. Put your baby in a stroller or in your arms, and take a 

walk. Exercise at home while your baby sleeps. Being active can make you 

feel better. Exercise can give you more energy to take care of yourself and 

your baby. 

Take time to relax. Take a moment for yourself while your baby naps. Do 

something that calms you down. Take a break from your chores. Take a 

moment to talk to a friend, read, listen to music, just be still, or enjoy a 

hobby. 

Don’t take your stress out on your baby by yelling at her or avoiding her. 

Get someone to help you for a while so that you can calm down or get 

rest. 

If your feelings of sadness are strong, it could be postpartum depression. 

Approximately 10 percent of mothers experience this kind of depression. 

Some of the warning signs of postpartum depression are: 

Lack of energy. 

Hopelessness. 

Low self-esteem. 

Your 4-Month-Old Baby 15 
 

 

 

Poor concentration. 

Insomnia (unable to sleep). 

Excessive sleeping. 

Change in appetite (either not hungry or overeating). 

Treatment is available and it is important to address this depression as 

soon as possible. Talk to your baby’s health care provider. Also, there are 

mental health providers in your community. Ask your health care provider 

where you can get help. You can also call the Therapist Referral Network 

at 1–800–843–7274 or find help at www.nmha.org. 

Don’t try to hide these feelings from your family or your health care provider. 

It is important to talk about what is happening. Get help if you need it. 

Dads Have a Role To Play 

Dad, it’s never too early for you to get 

involved with your baby. You have an 

important role in your baby’s life. She 

wants to play with you and learn from 

you. Showing your baby that you care 

about her will help her and make you feel 

closer to her. It will make taking care of 

her more fun for you and her mom. 

Babies learn from the adults around them. 


They need to be with both men and women. It’s good for your baby to have
 

someone besides her mom to learn from.
 

You and your baby’s mom can learn more about how to care for your
 

baby. Look in the Yellow Pages of your phone book under “support
 

groups” for parenting help. A “community service” section may be near
 

the front of the book.
 

16 Healthy Start, Grow Smart 
Be very gentle when you play with your baby. Use a calm voice. Here are 

some things you can do with your baby: 

You can hold her. 

You can talk to her. 

You can sing to her. 

You can show her toys. 

You can bathe her and dress her. 

You can comfort her when she’s fussy. 

You can help teach her how to talk. 

You can take her to child care. 

You can take her to health checkups. 

You can help feed the baby. If your baby’s mom is breastfeeding, she can 

pump some of her milk into bottles, and you can give this breast milk to 

your baby. When she is older and learning how to eat solid food, you can 

feed her with a spoon. 

If you do these things for your baby, she will reward you with smiles, happy 

sounds, and love. She will smile when she sees you, and she will reach for 

you when she wants to play. The bond you make now with your child will 

last a lifetime. 

Babies Can’t Be Spoiled 

“Whenever my baby cries, I pick her up. My 

friend says I’m spoiling her. Is my friend right?” 

No, you don’t have to worry about spoiling your 

baby. When you pick your baby up, you are 

doing the right thing. 

By reacting to her needs, you are teaching your 

baby that she can trust you. Holding her brings 

her comfort. It shows her that you care when she 

is hungry, in pain, afraid, or unhappy. 

Your 4-Month-Old Baby 17 
Meeting your baby’s needs makes her feel safe and loved. 

It’s good to respond quickly when your baby is crying. Her needs are immediate. When your baby is hungry, she wants to be fed. When your baby is 

wet, she wants a dry diaper. When she is uncomfortable or scared, it helps 

her to be held. 

When you are putting your baby to bed at night, it is okay to let her cry for 

a few minutes. This helps her learn to calm herself. If she cries for more than 

a few minutes, pick her up. 

It’s not good to ignore your baby. She depends on you to respond to her 

needs. She learns to trust because you respond to her needs. Your baby 

needs a lot of love from you. 

Games You Can Play With Your Baby 

Babies learn by playing. Here are some games you can play with your 

4-month-old baby: 

Play peek-a-boo. Place a sheet or baby blanket over your head, lift it up 

and softly say, “Boo!” Your baby will enjoy many ways of playing this 

game. 

Sing simple songs to your baby. You can sing nursery rhymes, or you can 

make up your own songs. 

Lay your baby on her back and sing a song while you gently move her 

arms in a big circle. You can also gently move her legs and raise her arms. 

Slip a colorful scarf through a plastic bracelet and tie the scarf to the arm 

of a chair. Lay your baby next to the plastic ring. Your baby will grab the 

ring and move the scarf around on the chair arm. 

Put a brightly colored sock on your baby’s foot. Your baby will notice her 

foot. In time, she will be able to grab it with her hands. Make a game out 

of it by helping her reach for the sock and helping her pull it off. 

18 Healthy Start, Grow Smart 
 

 

Helping Your Baby Explore

By the time your baby is 4 months old, she is 

beginning to learn to move around. She may 

even roll from her stomach to her back. Since 

she can now hold toys, your baby spends more 

time playing. 

At this age, babies need time to explore the 

world around them. It is important to give 

them time on a flat surface. Place your baby 

on a blanket on the floor or outdoors on the 

ground. If outdoors, make sure the blanket is in 

a shaded area. Let her wear clothing that allows 

her to move easily. Watch her very carefully. 

Do not walk away, leaving her on the blanket, 

even for a moment. 

Here are some activities to try: 

Place toys just out of reach so your baby will reach for them. She will learn 

that she has to wiggle and reach to get the toys. If she can’t reach a toy in a 

few seconds, place it within her reach so she doesn’t get frustrated. 

Spread a cloth on the grass and lay your baby on her stomach at one edge 

of the cloth. Gently raise the edge of the cloth so she will roll onto her 

back. Reward her with a hug and a kiss. 

Your 4-Month-Old Baby 19 
Talking With Your Baby 

At 4 months of age, your baby is already putting together ideas about 

speech and sounds. She does this even though she cannot speak. 

Even without speech, your baby already knows how to “talk” with you. She 

“speaks” by being fussy, babbling, or with happy giggles. She will learn more 

ways to let you know her needs, even before she learns to speak. She has 

learned to coo and laugh. 

Taking turns is part of language. When your baby coos or gurgles, be sure 

to listen to her. Then respond. Talk to your baby often. Use both familiar 

words and sounds and new words and sounds. This will get her attention 

and hold it. Talking to your baby a lot helps her learn. 

Babies Respond to Angry and 

Happy Faces 

A baby’s social skills start to develop long before she can talk. So do her 

emotions. Babies quickly come to know emotions and to show them. 

A 4-month-old baby can tell a happy face when she sees it. And she can tell 

an angry face when she sees it. She is also aware of a face with no expression. 

If there is a lot of yelling and screaming in the house, the noise and emotion 

will affect your baby. 

Another step in learning social skills is that your baby will show when she 

is angry or sad. She’ll do this when she doesn’t get what she wants. Anger 

and sadness are normal. Even so, you don’t want your baby to have any 

negative experiences that last a long time. Babies should have far more 

positive experiences than negative experiences. Always be sure to comfort 

your baby quickly. 

Babies differ in how social they want to be. Some babies want almost constant 

time with others. Other babies want more “alone” time. However, it can be 

very harmful to a baby to leave her alone too much or ignore her. 

20 Healthy Start, Grow Smart 
Is Your Baby in Distress? 

Infants cry for a variety of reasons. Crying is a way that babies communicate 

their needs to parents and caregivers. Very early on, parents learn to recognize 

their infant’s behavior cues. 

Your baby uses crying to tell you that she is hungry, has a wet diaper, or 

wants to be comforted. When your baby cries, the important thing is to 

respond to her. 

You will learn what your baby sounds like when she is crying to tell you she 

has needs that she wants met. This type of crying will differ from the way 

she cries when she is in distress. If she is in distress, her crying will most 

likely be louder and at a higher pitch than her regular crying. The most 

important thing is to respond to your baby and you will quickly learn the 

difference. 

Helping Big Brother or Sister Adjust 

If you have children other than your new baby, you need to make a special 

effort to help them to adjust to baby. Sometimes, when you bring a new 

baby home, older brothers and sisters can be jealous. As they get older, this 

can lead to competition and arguing. This is called sibling rivalry. 

With a new baby, older children may become aggressive or have tantrums. 

They may also begin acting more like a baby, such as wanting a bottle or 

wetting their pants. Younger children may have more trouble getting used 

to a new baby. They still rely heavily on their parents and have been used to 

more attention. 

No matter what the age of big brother or sister, they must understand that 

they are never, ever allowed to hurt the baby. Talk with them about how 

they can express their feelings if they are hurt or angry. There are also things 

that you can do with older children to help them adjust to their new baby 

brother or sister. 

Your 4-Month-Old Baby 21 
Spend one-on-one time with each older child. 

Make sure adults and other visitors to your home spend time with your 

older children. Don’t allow everyone to focus only on the baby. 

Give big brother or sister a special job to help you take care of baby. 

Talk to your children about how they feel, even if their feelings are 

negative. 

Make sure that your older children have special things of their own that 

they do not have to share with the baby. 

Read a book to all of your children. 

Spend time together as a family and encourage your older children to 

interact with the baby. 

It Takes a Family To Raise a Child 

Grandparents, aunts and uncles, brothers and 

sisters, friends and neighbors, and anyone else 

who is important in your life all have a role to 

play. These people are your family. 

Involving brothers and sisters in the care of the 

baby can help address sibling rivalry. Praise older 

brothers and sisters for their help. Praise raises 

self-esteem. 

Babies learn from those around them. 

Surrounding baby with loving people can 

increase her opportunities to learn. 

Family members and others can also provide an important break for mom 

and dad. 

22 Healthy Start, Grow Smart 
Your 4-Month-Old Baby 23 

 

Where To Find Help
 

You are not alone. Many organizations can help you keep your baby healthy and 

safe. They are there to provide support to all parents. 

Health Insurance: If you are eligible for Medicaid, your baby can get free checkups. 

You can call your local social welfare, health, or family services office to see if you 

qualify for Medicaid or State Children’s Health Insurance Program (SCHIP) services. 

To learn more about free or low-cost health insurance for children, you can call 

the U.S. Department of Health and Human Services Insure Kids Now Program at 

1–877–KIDS–NOW (1–877–543–7669). You can also visit their Web site at 

www.insurekidsnow.gov. 

Food and Nutrition/WIC: Families who are enrolled in the WIC program (Special 

Supplemental Nutrition Program for Women, Infants, and Children) can get information on breastfeeding, formula feeding, and nutrition at their local WIC office. 

Families eligible for WIC receive nutrition counseling and supplemental foods, such 

as baby formula, milk, and cereal. To find the WIC office nearest you, call your state 

health department or visit the WIC Web site at www.fns.usda.gov/wic. 

Education: For information about early childhood education programs, call the 

Department of Education at 1–800–USA–LEARN (1–800–872–5327) or visit 

www.ed.gov/parents/earlychild/ready/resources.html. 

Child Care: To learn about child care options, call the U.S. Department of Health and 

Human Services, Child Care Aware at 1–800–424–2246 or visit www.childcareaware.org. 

Postpartum Depression: For more information and resources on postpartum depression, breastfeeding, and many other women’s health issues, call The National Women’s 

Health Information Center at 1–800–994–9662 or visit www.womenshealth.gov. 

Breastfeeding: To learn more about breastfeeding, call La Leche League at 

1–800–LALECHE (1–800–525–3243) or visit www.lalecheleague.org. 
Poison Control: The American Association of Poison Control Centers (AAPCC) 

poison control hotline, 1–800–222–1222, should be on your list of emergency 

numbers. To learn more, you can visit the AAPCC Web site at www.aapcc.org. 

Car Seats: For information on resources that help families purchase or borrow 

child car seats, call the National Highway Traffic Safety Administration at 

1–800–424–9393 or visit www.nhtsa.dot.gov. Always test the seat to make sure 

it is installed correctly. 

Safety: To learn more about safety, call the Consumer Product Safety Commission 

at 1–800–638–2772 or visit www.cpsc.gov. 

Child Abuse—Preventing and Helping: For information on how to prevent or 

stop child abuse—or for help in a crisis, you can contact the Childhelp USA 

National Abuse Hotline. Call 1–800–422–4453 or go to www.childhelpusa.org/ 

report_hotline.htm. 

Remember to also take time for yourself. Your baby will be happier with happy 

parents. Try to do healthy things that make you feel good! 

Coming Next Month 

Is Your Baby Teething? 

Your Baby’s Sleep 

Playtime Is Learning Time 

. . . and much more!