Four Month Well Check


Pediatric Associates of Austin, P.A.


What I can do now

  • Make "cooing" and "babbling" noises.
  • Smile, laugh, and squeal.
  • Open my hands, grasp at clothes and rattles, and hold my hands together.
  • I can control my head when I am held upright.
  • While lying on my stomach I can hold up my head and raise my body on my hands.
  • I will reach for or hit at objects.
  • I will watch a mobile or interesting object above my head.
  • I know my parents’ voice and touch.
  • I will smile immediately when I see others.
  • I may comfort myself and fall asleep by myself without breast or bottle.

Help me learn what to eat

  • Continue to give me breast milk or formula for my first year.
  • Between 4 and 6 months you may want to start feeding solid foods to me. An iron fortified single grain cereal such as rice is best to start. Please add only one new pureed food a week to be sure I do not have an allergy.
  • Always stay with me when I eat.
  • Avoid giving honey to me or any infant less than one year of age. It may have bacteria in it that is dangerous for me.
  • Hold me and cuddle me while I drink my bottle. I like the interaction. Propping my bottle can lead to an increase in ear infections, tooth decay, and sleep problems.
  • Be sure that everyone that cares for me feeds me properly.

Play with me

  • Hold me, cuddle me, rock me, talk to me, and sing to me, I love it!
  • Play pat-a-cake, peek-a-boo, so-big with me. I like playing these games now.
  • Encourage me to talk by talking to me during dressing, bathing, feeding, playing, walking, and while driving.
  • Read to me. I like to hear you read. I like music. Play music for me.
  • I like to smile at you. Smile at me.
  • Encourage me to play with toys for babies my age that you make or buy. I like bright colored objects or toys.
  • Talk to my doctor about my sitters or other caretakers.

Protect my teeth 

  • I may be getting my first teeth in the next few months. This may cause me to drool a lot, to have swollen gums, looser stools and fussiness.
  • You may want to use a soft cloth to clean my new teeth and gums.
  • Please do not prop a bottle in my mouth or put me to bed with a bottle. This will slowly ruin my teeth.

Concerns for Mom and Dad


  • Help me learn to go to sleep by myself by putting me to bed awake and having a bedtime routine that calms me.
  • Soon a small stuffed animal or other favorite toy may calm me at bedtime.
  • Sometimes I may sleep six hours or more in a row.

Keep me safe

  • Always keep me buckled in my approved, rear facing infant car seat when we drive. The rear middle seat is the safest place for me.
  • Never tie strings or pacifiers around my neck, these could choke me.
  • Never shake me.
  • Keep putting me to bed on my back.
  • Be sure there are smoke detectors with good batteries where I live and sleep.
  • Please do not let anyone smoke or drink hot liquids while holding me. I may grab them and get hurt.
  • Please continue to keep anyone from smoking in my home or car. Smoke is bad for babies (and adults)!
  • Keep testing my bath water temperature with your wrist to be sure it is not too hot before you put me in the water.
  • Do no leave me alone in a tub of water. Take me with you if the phone or doorbell rings.
  • Never leave me in high places such as changing tables, beds, sofas, or chairs. I am rolling over now and will fall, even from car seats or bouncers.
  • Walkers are dangerous, keep me from exploring with my hands, and will not help me learn to walk. Please do not put me in them.
  • Shade is best, but if unavailable, sunscreen may be used on small areas of my body such as my face and back of my hands. Keep me out of the sun when the rays are the strongest (usually between 10 AM and 4 PM).


  • On an average babies have 8 to 10 illnesses in the first year of life. I will probably have some illnesses in the next few months. I may show that I am ill by having fever, nasal congestion, cough, diarrhea, vomiting, or skin rash. I may not want to eat or may act irritable or sluggish. You can help by having a digital thermometer (no mercury please) and by knowing how to take a rectal or axillary temperature. The clinic nurse can help you to decide when to have me seen by the doctor. It will be helpful to have acetaminophen infant drops to reduce fever and oral electrolyte solution at home. Writing down what is wrong, my temperature, and any questions you want answered before calling the clinic will help to get all your questions answered.
  • Always keep the name of my doctor available for those who take care of me. The emergency number 9-1-1 and the poison control number (1-800-POISON-1) should be kept by the phone.
  • Ask my doctor or the nurse about books that might be useful if you do not have one. You may also want to ask about parenting classes if you are interested in more information.

Family relationships

  • My brothers and sisters may be jealous of me by now. Have them do simple things to help with my care. They should also spend some time with mom and dad to read, cuddle, or play. Help them talk about their feelings about me. I like to spend time with both parents.
  • Be sure to take some time for yourselves and with each other.

Before my six month visit I will

  • Hold my own head up as you pull me up.
  • Recognize both mom and dad separately.
  • Turn around to sounds.
  • Be frightened by strangers
  • Imitate "raspberry" sound, smile, laugh, or squeal.
If your child is seriously ill, please call us directly at (512) 458-5323

If your child is seriously ill, please call us directly at (512) 458-5323