Stages of Development – 4-6 Months

Motor Milestones

  • Uses hands to support self while sitting
  • Rolls from back to tummy and tummy to back
  • While standing with support, begins to accept weight through legs and feet
  • Reaches for nearby toys while in prone
  • While in supine uses hands to play with feet
  • While in supine, transfers a toy from one hand to the other

Communication Milestones

  • Reacts to sudden noises or sounds
  • Listens and responds when spoken to
  • Begins to babble e.g. “ba, da, ga”
  • Uses babbling to get attention
  • Notices toys that make sounds

Sensory Milestones

  • Uses bilateral hands to play with toys
  • Generally happy when not hungry or tired
  • Mouths hands and objects
  • Able to calm with soothing rocking, touch, and/or gentle sounds
  • Is not upset by everyday household sounds
  • Enjoys a variety of movements

Feeding Milestones

  • Reflexive sucking is replaced with active sucking
  • Shows interest in food
  • Opens mouth as spoon approaches
  • Begins to eat stage 1 thin pureed fruits and vegetables
  • Moves pureed food from front of mouth to back

Red Flags

  • Unable to sit with support or slouches when sitting
  • Poor head control and/or unable to lift head
  • Difficulty bringing arms forward to reach out
  • Arches back and stiffens legs when pulling to a sit
  • Not using hands to reach for or play with toys
  • Does not bring hands or objects to mouth
  • Unhappy even though fed, napped and has a clean diaper
  • Avoids getting messy with purees
  • Does not visually track moving objects
  • Does not respond consistently to sounds or voices

  • Does not make any sounds

  • Avoids eye contact

  • Does not smile or laugh

  • Does not hold own bottle during feeding

  • Gags or vomits during feeding of purees

  • Avoids getting messy during mealtimes

  • Drools excessively