Checkup Checklist: 4 Months Old

​​​Your baby is getting bigger! And at four months, it's time for another appointment. Expect the standard procedures this time—measurements, developmental, psychosocial and behavioral observations, and a physical exam. Here some things to plan for at this visit:

✅ Immunizations

At the 4-month visit, your baby may receive the second doses of the following vaccines​.

• Rotavirus vaccine

• Diphtheria, tetanus, acellular pertussis vaccine (DTaP)

• Haemophilus influenza type B vaccine (Hib)

• Pneumococcal conjugate vaccine (PCV)

• Inactivated polio vaccine (IPV)
  

✅ Screenings

• Hematocrit or hemoglobin screening: Your baby may receive this blood screening that helps detect anemia. Your pediatrician may ask you if your baby is drinking anything other than breast milk or iron-fortified formula, as it is a risk factor for developing anemia.

• Maternal depression: Your pediatrician will ask you how you are feeling. If you are having postpartum issues with breastfeeding, anxiety, or sadness, or anything else, please feel free to discuss it with your baby's pediatrician.

✅Feeding & development

Your pediatrician will measure and weigh your baby to make sure their growth is on track, observe their development and behavior, and perform a physical exam.

Questions your pediatrician may ask

• How does your baby fall asleep​? Are you giving them a bottle?

• Do you have questions about cleaning your baby's gums and teething?

• If you are breastfeeding, are you giving your baby an iron supplement? (The AAP recommends giving breastfed infants 1 mg/kg/day of a liquid iron supplement until iron-containing solid foods are introduced at about six months of age).

Questions you may have

• How do I know if my baby's physical development is on track?

• When do I start my baby on solid foods? Which foods do I start with?

• My baby drools and blows bubbles a lot. Is this normal?

• When can I start reading to my baby?
  

✅Safety

Questions your pediatrician may ask

• Where does your baby sleep at night? A safe sleep space is crucial.

• Are you placing baby in a rear-facing car seat?

• Was your home built before 1978? Have you tested your home for lead?

Questions you may have

• How do I help calm my baby when they get fussy?

• How often should I feed my baby?

• Is it safe to use amber teething necklaces?
  

✅ Communication t​ips

Never hesitate to call your pediatrician's office with any questions or concerns—even if you know the office is closed. If your pediatrician is unable to see you but believes your baby should be examined, they will advise you on the most appropriate place for your baby to receive care and how quickly your baby should be seen.

More information

• ​AAP Schedule of Well-Child Care Visits​