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Marking Milestones

By Elizabeth T. Jordan, DNSc, RNC, FAAN

Marking Milestones

Recognizing Milestones

Here’s what baby may be doing—and how you can help—during her first 4 months.

Children reach milestones in how they move, play, speak, respond and behave. Skills such as smiling, laughing, playing peek-a-boo, crawling and walking are called “developmental milestones.”

Milestones can occur at different rates and stages in baby’s development. Experts have created guidelines, like the ones in this article, to help you know what to expect of your baby if she or is developing like other babies of a similar age.

You are the most important person when it comes to baby’s learning. There are many things you can do to help your baby grow and learn during each stage of development. The American Academy of Pediatrics recommends that all children be screened for developmental delays and disabilities during regular well-child healthcare visits at 1, 2, 4, 6, 9 and 12 months after baby’s birth. Your baby may need more screening if he’s considered at risk for developmental problems from being born too early or having low birth weight, for example.

As a parent you know your child best. If you have questions about how your baby is behaving or growing, let your baby’s healthcare provider know immediately. Don’t wait—if indeed there is a problem, it’s important to get your baby help as soon as possible.

Baby’s First 4 Months

Personal & Social Development

Your baby may . . .Baby might . . .You can . . .
Express comfort and discomfort, enjoyment and unhappinessCry, smile, wiggle, fuss and use facial expressions


Enjoy soothing

Respond when she cries


Give smiles, hugs, and other warm physical contact to help baby feel secure

Calm herselfLearn to close her eyes, suck on a fist or turn head away from distractions


Be quiet when you rock, sing, talk to her


Close her eyes when she’s sleepy

Show baby your face and talk or hum softly


Place your hand on baby’s stomach or back


Pick baby up and gently rock

Show interest in adults she knowsFuss, cry, or coo to initiate interactions


Turn to voice that is familiar


Smile when seeing or hearing a person they recognize

Make eye contact with baby regularly


Use gentle facial expressions and tones


Play “peek-a-boo” with baby

Show awareness of other childrenMimic children he recognizes with facial expressions, noises or body languagePlace baby near others when awake


Let baby watch and interact with children of all ages in a supervised setting

Demonstrate attachment to certain peopleTurn her head toward a familiar caregiver


Look in the direction of your voice


Imitate your smile


Track your movements

Speak directly to baby


Make eye contact when talking to baby


Understanding & Communicating

Your baby may . . .Baby might . . .You can . . .
Listen and express himselfReact strongly to noise by either being soothed or frightened


Use sounds and facial expressions of pleasure or displeasure


Babble or coo when hearing a voice


Appear to “listen”


Turn head to look at you

Talk with baby directly and face-to-face


Follow her lead, and repeat sounds he is making


Avoid talking loudly


Play different kinds of music


Sing and hum to baby


Recognize and react to the sounds of languageReact to a new nursery rhyme by kicking legs; smile when hearing a familiar nursery rhyme


Repeat sounds, enjoy and experiment with different sounds


Coo to conversation

Repeat nursery rhymes, chants and language


Sing songs


Read with baby in your lap


Talk about everyday objects


Begin to build a vocabularyShow momentary attention to board books with bright colors and simple shapes, especially faces


React to colors and shapes by cooing or moving her hands

Speak to baby


Read and show baby simple books


Name objects


   Discovering and Learning

Your baby may . . .Baby might . . .You can . . .
Begin to understand that she can make things happenPlay with her hands


Explore toys with her hands and mouth


Turn her head to follow objects


Turn her head toward loud noises


Repeat enjoyable actions, such as shaking a rattle

Provide a safe and stimulating environment


Supervise baby on the floor to promote movement


Play “peek-a-boo”


Provide clean, safe toys for baby to hold


Smile and give baby your complete attention to help her focus and interact


Coordinating Movements

Your baby may . . .Baby might . . .You can . . .
Use many repetitions to move various body partsBring hands together to grasp and shake toys


Reach for objects and swipe at dangling objects


Raise her head, arch her body and flex her legs


Begin to try and roll over and sometimes kick herself over


Push up by hands or forearms when on stomach


Bring her hands to mouth

Give baby lightweight rattles or soft, bright patterned toys that make soft noise


Have daily supervised “tummy time”


Support baby’s head when holding her


Frequently change baby’s position when she’s awake

Elizabeth T. Jordan, DNSc, RNC, FAAN, is an expert advisor to Healthy Mom&Baby

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