Stage2–4 m
2-4 months
Reflexes give way to intention
These two months are a genuine shift. Hands stop being reflexive fists and start reaching on purpose. Smiles stop being accidental and start being answers. Many families also meet the four-month sleep change here.
What to feed
- Milk
- Breastfed: 6-8 times a day. Formula: 120-180ml per feed, 5-6 times a day.
- Meal pattern
- Still milk only. Drooling at the sight of your dinner is teething and salivary glands, not hunger.
Can start eating
- Continue vitamin D 400 IU daily
Not yet
- Cereal, rice water, juice and all other solids
- Adding cereal to bottles to "help sleep" — it raises choking and overfeeding risk
Worth knowing
- Night feeds may reduce, then bounce back around four months. That is the sleep architecture changing, not hunger
- Around 900-1000ml a day is roughly the ceiling; consistently more is worth reviewing for overfeeding
- Spitting up drops off noticeably from three months
How much sleep
12-16 hours a day
- Daytime
- 3-4 daytime naps; nights may run 5-6 hours
Around four months sleep often falls apart. This is a permanent switch from newborn sleep cycles to adult ones, not a regression that reverses. Coming out the other side means a new way of falling asleep, not the old one returning.
Vaccines in this stage
Inactivated polio (IPV)Dose 1
2 months · National programme (free)
PCV13Dose 1
2 months · Self-paid
Self-paid, and there is an age window — miss it and it cannot be given. Plan ahead
RotavirusDose 1
2 months · Self-paid
Self-paid, oral. Prevents severe infant diarrhoea
Inactivated polio (IPV)Dose 2
3 months · National programme (free)
DTaPDose 1
3 months · National programme (free)
Mild fever afterwards is common and usually settles within 48 hours
What most children do by now
Gross motor
- Pushes up on forearms with head at 90 degrees
- Holds head steady when held upright
- May roll front to back around 3-4 months
Fine motor
- Reaches for things on purpose, not always successfully
- Brings hands together at the chest
- Takes hold of an object and moves it to the mouth
Language
- Strings sounds together in babble
- Laughs out loud
- Uses different sounds for comfort and discomfort
Social and cognitive
- Recognises main caregivers and lights up for them
- Enjoys mirrors
- Gets your attention with something other than crying
This is what most children manage in this window, not a pass mark. A few months either way is common. The signals worth acting on are in the doctor section below.
Height and weight reference for this ageWhen to see a doctor
If any of these apply, do not wait for the next routine check.
- At four months, still cannot lift the head at all when on the tummy, or the head falls back when pulled to sit
- Hands permanently fisted, or one side of the body clearly weaker than the other
- No smiling, no sounds, no response to noise
- Eyes do not follow moving objects, or eyes are persistently misaligned after three months
- Weight has dropped off its own curve at two consecutive checks
What to practise
- 01
A toy just within reach
How · Hang a toy that makes a noise 20-25cm above the chest, close enough to bat at.
Why · Reach, then sound is the first lesson in cause and effect, and it is worth far more than passive music.
- 02
A nudge towards rolling
How · On their back, put an interesting toy to one side so they turn to look, then gently help the hip on that side through the roll.
Why · Rolling is self-taught. Your job is only the last little push when they are almost there.
- 03
Read aloud anyway
How · 5-10 minutes a day at a fixed time with a high-contrast cloth or board book. Read out loud, point, name things.
Why · At this age they are taking in your rhythm and tone. Differences in vocabulary at age 2 between early-reading and non-reading households are already measurable.
Day to day
- Stop swaddling the moment rolling starts. Switch to a sleep sack
- Teething can start at four months: sore gums, drool, chewing. Offer a firm teether, chilled but not frozen
- Start a fixed bedtime routine: bath, pyjamas, book, lights out. The order matters more than the length
- Three-month check: length, weight, head circumference, gross motor development
Common questions
- Can we start solids at four months?
- WHO and most national guidelines say six months. In specific circumstances, never before 17 weeks, and only if the baby can sit supported, holds their head steady, has lost the tongue-thrust reflex, and shows interest in food. Ask your paediatrician first.
- What do we do about the four-month sleep change?
- Accept that it is structural and permanent, then do two things: keep a fixed bedtime routine, and let them practise being put down drowsy but awake. This is a bad moment to add new strong sleep associations like rocking or feeding to sleep.
- Still not rolling. Is that a problem?
- The normal range is wide, 3-6 months. The more useful question is whether they get enough tummy time. A lot of "not rolling" is really "rarely on the tummy".