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4-6 Month Developmental Milestones

Movement and Physical Development

Normal Development

  • Rolls over in both directions (front to back, back to front)
  • Begins to sit without support
  • When standing, supports weight on legs and might bounce
  • Rocks back and forth, sometimes crawling backward before moving forward

Possible Challenges from Treatment

  • Less chance to learn physical skills due to procedures and treatment
  • Hospital equipment and lack of space can keep baby from moving and exploring normally
  • Slower to learn movements such as rolling over and controlling head and upper body while sitting
  • Slower to learn small movements (especially hand/eye coordination and holding things with thumb and finger)

Ways to Help

  • Go to hospital infant playtime, if available, to help baby learn physical skills
  • Ask for floor mat for tummy time and movement
  • Put toys just out of reach to encourage rolling over
  • Give toys with texture to get baby interested in grabbing and moving objects
  • Play peek-a-boo and similar interactive games
As part of normal physical development, when standing, your child may support his weight on his legs and might bounce, too.

As part of normal physical development, when standing, your child may support his weight on his legs and might bounce, too.

 

Language and Communication

Normal Development

  • Responds to sounds by making sounds
  • Strings vowels together when babbling (“ah,” “eh,” “oh”) and likes taking turns with parents while making sounds
  • Responds to own name
  • Makes sounds to show joy and displeasure
  • Begins to say consonant sounds (jabbering with “m,” “b”)

Possible Challenges from Treatment

  • Less interest in being social and fewer chances to communicate due to feeling sick and tired
  • Might be slow to respond and develop language

Ways to Help

  • Watch for times baby is awake and alert to smile at baby and sing, read, and talk to your baby.
  • Talk about what is happening in the room
  • Repeat the sounds your baby makes
Watch for times your baby is awake and alert to smile at her, and sing, read, and talk to her.

Watch for times your baby is awake and alert to smile at her, and sing, read, and talk to her.

Social and Emotional

Normal Development

  • Knows familiar faces and begins to know if someone is a stranger
  • Likes to play with others, especially parents
  • Responds to other people’s emotions and often seems happy
  • Likes to look at self in a mirror

Possible Challenges from Treatment

  • Less interest in play and being social due to feeling sick and tired. Feels stress from hospital lights, sounds, and people.
  • More fussy, irritable, clingy, anxious, and sensitive than normal. Might have sleep problems.

Ways to Help

  • Play and pay attention to baby at awake, alert moments. If baby seems stressed, dim lights, swaddle baby, and play quiet music or use a “white noise” machine. Have regular routine and calm surroundings, if possible.
  • Parents and caregivers should take care of themselves to reduce stress. Use the same caregivers as much as possible. Hold baby when meeting new staff to make baby less anxious.
  • Balance playful activities with quiet time.
  • Hold your baby, rock them, and talk quietly or sing lullabies during snuggle time.
  • Pay attention to your baby’s cues; when your baby turns away, he or she may be telling you they need a break from playtime.
As part of normal emotional development, your child may respond to other people’s emotions and often seems happy.

As part of normal emotional development, your child may respond to other people’s emotions and often seems happy.

 

Thinking and Learning

Normal Development

  • Looks around at things nearby
  • Brings things to mouth
  • Shows curiosity about things and tries to get things that are out of reach
  • Begins to pass things from one hand to the other

Possible Challenges from Treatment

  • Mouth exploration is often limited for infection control reasons
  • Mucositis (mouth sores) may also limit oral exploration

Ways to Help

  • Try to introduce cause-and-effect toys like a jack in the box
  • Place objects just out of your baby’s reach and verbally encourage your baby as he or she reaches for objects
  • Offer your baby a baby-safe mirror to play with
  • Roll a ball and narrate as your baby turns his or her head to watch it
As part of normal learning development, your child may brings things to her mouth.

As part of normal learning development, your child may brings things to her mouth.