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4

4 months

Four months old: rolling and reaching

A steady head, the first roll and hands that grab everything.

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At four months your baby holds the head steady, reaches out and grasps, may roll from tummy to back and babbles in long strings. The third round of vaccines is due at the polyclinic.

Growth

Weight

6.1–8.4 kg

Length

62–68 cm

Weight gain slows a little from now on, to roughly 100–150 g a week. Typical range; your paediatrician tracks your baby on a growth chart.

What your baby is learning

  • The head is steady without support when your baby is held upright or sits in your lap.
  • Many babies roll from tummy to back around now, sometimes to their own surprise; back to tummy usually follows a month or two later.
  • Your baby reaches for a toy with both hands, grasps it and brings it to the mouth; everything is explored by mouth.
  • Babbling takes off – strings of sounds like "ba", "ga" and "ma" – with changes in pitch and volume, and squeals of joy.
  • Your baby pushes down with the legs when the feet are on a firm surface and may bear some weight.
  • Your baby recognises your face and voice, enjoys play and may cry when play stops.

Feeding

  • Keep to exclusive breastfeeding until 6 months, even if friends suggest starting porridge earlier; your baby's digestion and kidneys are not ready. Around 4 months many babies feed 5–7 times a day.
  • Signs of readiness for solids – sitting with little support, good head control, reaching for food and putting it to the mouth – usually come together around 6 months. Watching you eat with interest is not, on its own, a sign of readiness.
  • If you are using formula, do not add cereal to the bottle or thicken feeds without medical advice.
  • Continue vitamin D 400 IU daily and your own potassium iodide 200 µg while breastfeeding.

Sleep

From 4 months the recommended total is 12–16 hours in 24, usually with 2–3 naps and a longer night. Many families notice more waking around 4 months as sleep patterns mature; it passes. Always put your baby down on the back – once they roll both ways on their own they may stay where they settle, but the cot must be clear of pillows, quilts, bumpers and toys. Stop swaddling once rolling begins. Keep the cot in your room and never sleep with the baby on a sofa or armchair.

Check-ups and vaccines

  • At 4 months the third round of vaccines is due: OPV-3, Rota-3 and Penta-3, plus the first injected polio vaccine, IPV-1. After this round the next routine vaccine visit is at 6 months.
  • Expect the same mild reactions – a low fever, a sore leg and fussiness for 24–48 hours. Call 103 or go to the hospital for fever above 39 °C, a seizure, difficulty breathing, swelling of the face, or a baby who is limp and hard to rouse.
  • Monthly check-up at the polyclinic: growth, hips, head shape, vision and hearing responses, and a chat about how rolling and reaching are coming along.
  • Now that your baby grabs and rolls, start childproofing: nothing small within reach, no hot drinks while holding the baby, and never leave the baby on a bed or changing table unattended.
4 months: OPV-34 months: Rota-34 months: Penta-34 months: IPV-1

Play and everyday tips

  • Offer rattles, soft blocks and textured toys to grasp, shake and mouth; wash them regularly.
  • Tummy time becomes play time: place toys slightly out of reach to encourage pivoting and the first attempts to move.
  • Sit your baby propped on your lap facing outwards so they can watch the world and practise head control.
  • Babble back: when your baby says "ba", answer with "ba-ba" and a smile. Read aloud daily, pointing and naming.
  • A baby-safe mirror on the floor is a favourite at this age. Keep screens off until 2 years.

Call the doctor or 103 if

  • Fever of 38 °C or higher with breathing difficulty, a rash that does not fade when pressed, a stiff neck, repeated vomiting or unusual drowsiness: call 103.
  • No head control when held upright by 4 months, not pushing up on the forearms on the tummy, or very stiff or very floppy limbs.
  • Not following things with the eyes, not smiling or making sounds, or not reacting to loud noise.
  • Not reaching for toys or bringing the hands to the mouth, or using only one side of the body.
  • Refusing feeds, far fewer wet nappies, signs of dehydration, or inconsolable crying with a bulging soft spot.
  • If you notice any of these, call 103 or go to the polyclinic or hospital without delay.

Trust your instinct. If your baby seems unwell to you, call 103 or go to the polyclinic.

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