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Your 4-Month-Old - The New York Times

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My mother told me that I was rolling over at 4 months, but my baby isn’t. Should I be concerned?

No. This is one of those milestones that has changed over time. In the 1990s, the back-to-sleep-campaign aimed to reduce the risk of Sudden Infant Death Syndrome (SIDS) by counseling parents to put infants to sleep on their backs. As a result, many babies didn’t get as much stomach time as they used to, so they began to roll over at later ages. That’s fine! You can help by giving them extra tummy time while they’re awake and supervised, but don’t sweat it.

If my second child is slower to develop than the first, does that mean something is wrong?

No. My first child didn’t walk until he was 16 months old. My second child walked at 11 months. Both play on the tennis team today. What was important was that, globally, they were developing and progressing over time.

I still sometimes have trouble soothing my baby. Does this mean that he can’t hear me or that something is wrong?

Not necessarily. While your physician should confirm that his hearing is fine, many babies are still fussy at 4 months. Colic, or episodes of intense crying or fussiness for no apparent reason, usually peaks at around 6 weeks and improves by 3 to 4 months. Don’t be afraid to discuss this with your doctor.

If my baby is behind on a milestone, does that mean she will never catch up?

No. Babies catch up all the time. In fact, one of the reasons we screen using developmental milestones is so that we can pick up delays and intervene in order to help them do so.

  • As with the 2-month-old check-up, it’s important to discuss hearing and vision concerns with your doctor. Your doctor has been screening your baby for hearing issues, so things are likely O.K., but it never hurts to double check any hearing concerns. Watch for vision issues more closely at this visit. If your baby is still not using his eyes together (appearing cross-eyed), bring that up. If you have other worries about your baby not appropriately reacting to you, that’s always worth mentioning too.

  • You should also see steady progress in your baby’s strength and coordination. If you feel that your baby is moving her arms and legs reflexively rather than intentionally, tell your doctor. It’s also important to see more hand control, including the desire to pick up everything she sees. If she’s not, voice these concerns to your pediatrician. Data suggest that early identification and intervention for developmental disorders is key to future health and functioning.

  • Nobody knows your baby better than you. If you have any concerns, discuss them with your physician, even if she doesn’t ask about them. This is known as “surveillance,” and besides screening at the doctor’s office, it’s one of the main ways pediatricians pick up developmental delays in children.

  • You are your baby’s best teacher. The single best thing you can do to help her at this age is to spend time interacting with her. She will learn almost all of her language skills from you, and that starts now. Talk, sing, read – it doesn’t matter. Your baby will imitate your tone first, then the rest will come.

  • Practice makes perfect, so don’t hold your baby all of the time. Give him time to work on those arm muscles. Give her tummy time (always supervised!) to learn how to roll over. Hold him up and let him work on those legs. While babies are primed to learn these skills, they do so best when you give them the loving support to do so.

“Important Milestones: Your Baby By 4 Months.” CDC, October 22, 2018.

Child Development.” CDC, February 22, 2018.

“Developmental Milestones.” American Academy of Pediatrics, January 2016.

Bright Futures Previsit Questionnaire 4 Month Visit.” American Academy of Pediatrics.

“Ages & Stages - Baby” American Academy of Pediatrics, 2019.

“InBrief – The Science of Early Childhood Development”, Harvard University Center on the Developing Child, 2007.

“Safe Sleep.” American Academy of Pediatrics, 2019.

SIDS and Other Sleep-Related Infant Deaths: Updated 2016 Recommendations for a Safe Infant Sleeping Environment.” Pediatrics, 2016.

Identifying Infants and Young Children With Developmental Disorders in the Medical Home: An Algorithm for Developmental Surveillance and Screening.” Pediatrics, 2006.

Structural Growth Trajectories and Rates of Change in the First 3 Months of Infant Brain Development.” JAMA Neurology, 2014.

“Movement – Birth to 3 Months.” American Academy of Pediatrics, August 1, 2009.

“Your Baby’s Hearing and Communicative Development Checklist.” National Institute on Deafness and Other Communication Disorders, March 6, 2017.

How Well Do Newborns Hear?” WebMD, July 16, 2017.

“Infant Vision – Birth to 24 Months of Age.” American Optometric Association, 2019.

“How Well Can Newborn Babies See?” WebMD, August 1, 2018.

“Colic.” May Clinic.

“Pathways.” Pathways.org.

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