North Star Pediatrics

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Four Months to Six Months

Please remember that every child grows and develops at his or her own rate and that no two children are exactly alike at a given age.

Motor Development

On stomach baby rests on forearms and looks around. By 6 months of age baby can raise up on straightened arms and may lift upper abdomen off surface.
Can turn completely over--front to back and back to front.
On back, baby brings feet to mouth and sucks on his toes.
May anticipate being picked up and reaches out with his hands.
When pulled to a sitting position, baby will hold his head erect and steady. You will be able to feel baby help himself being pulled to a sit--he will flex his neck forward and bring his knees to his tummy.
By 6 months, baby will sit momentarily without support. Keep in mind that it’s normal for a 6 month old baby to have a limited ability to sit independently. After a few moments, baby will roll backward onto either side. It’s a good idea to place cushions around baby when allowing him to practice his sitting abilities. Later, he will prop himself up by placing his hands on the floor between his opened legs.
Baby sits for long periods of time when supported, as in a high chair.
When held in standing position, baby supports almost his full body weight.
Baby begins to be mobile during the next few months by rolling or scooting on tummy (army crawl).

Fine Motor Development

Baby’s aim at grasping for objects is much improved and he grasps with either hand. By 6 months of age baby can hold an object in each hand and can also reach for an object without it being offered to him.
Mouthing objects becomes quite strong during the next few months. Baby learns more about how things feel by this mouthing behavior. Mouthing is how baby learns about his environment and should not be discouraged. It will last for several months.
Baby’s first tooth is typically at 6-8 months, but this is not always the rule. One year olds without teeth are not rare.

Mental Development

Baby is becoming alert 1 1/2 - 2 hours at a time and looks about in new situations.
Baby wants to touch, hold, turn, shake and mouth objects. He’s discovering his environment and inspects things at length.
May be able to anticipate a whole object by seeing only a part of it. He will also lean over the edge of his high chair to look for a fallen object. These are steps toward object permanence--the idea that an object still exists even though it is out of baby’s sight.
Begins to discover cause and effect, for example, baby hits mobile to make it move; it is not an “accident” anymore.

Vision

Language Development

Baby vocalizes spontaneously to himself and to his toys. He may also vocalize to get attention. Baby is now adding some consonant sounds (d, b, l, n) to his previous all vowel sound vocabulary. By 6 months he may put them together (“goo-goo,” “boo-boo”).
Baby may begin to make well-defined imitations (coughs).
When babbling, variations in pitch, volume and tone may be noticed.
Baby will vocalize pleasure and displeasure

Social Development

Baby knows his name and turns when he hears it. He laughs at a funny face.
Baby can distinguish children from adults and by 6 months he may smile and reach out to pat children.
Will call parents for help -- definite cry. Also may express protest.
Baby will wake promptly at dawn, however is sleeping through the night.
Interest in breast feeding may begin to lag as baby takes in the world around him.
May begin to draw back from people with whom they are unfamiliar.

Age Appropriate Toys

Baby is ready for a variety of objects to handle and mouth (plastic keys, rings, blocks, rattles, squeeze toys).
Baby will like to bang things--give him spoons, plastic measuring cups, etc.
Bathtub toys are fun for baby as soon as he can sit up in the tub.
Teething rings may feel good to baby’s sore gums if teething.
Baby massage is good to stimulate baby's all-over sense of touch.

Safety

All toys should be small enough to hold with one hand, but large enough so they can’t be swallowed.
If baby can roll around on his own, get down on the floor and reassess your baby's play area for safety.
1. Gates at tops of stairways
2. Outlets plugged with protective caps
3. Wires out of reach--remember, baby mouths everything and doesn’t know safe from dangerous
4. Move cleaning supplies and poisons from lower cupboards, including dishwasher detergent
Never leave your baby unattended in the bathtub, even if he sits well alone.
Lower crib mattress BEFORE baby is able to sit.
Never give baby pacifiers on cords or toys with cords and be sure his crib is well away from window shade cords. Baby could get these cords around his neck and suffer strangulation.

Feeding

Four months is about the age that babies begin to desire more to eat. Some babies wait until 6 months. If your baby shows some of the “signs” that solid foods are needed, (waking up hungry in the middle of the night or requiring closer-spaced feedings in the day, etc.) then it is time to start solid foods.
The key to introducing solid foods to your baby is to introduce one new food at a time and continue to give the new food for 3-4 days before introducing a new variety. This way, you can detect any allergies and eliminate that food from his diet until a later date.
The usual order of introducing solid foods is cereals first, fruits second and vegetables third, although this is not a rule and can vary from family to family.
Between now and the 6 month check, you can work on getting your baby to a 3 meal/day schedule. A good goal to work toward by 6 months follows:
- BREAKFAST: Cereal and fruit followed by bottle or nursing.
- LUNCH: 1 fruit and 1 vegetable or 2 vegetables followed by bottle or nursing.
- DINNER: Same as Lunch.
- BEFORE BED: May offer cereal followed by bottle or breast feeding.
Remember that formula or breast milk is still your baby’s major source of nutrition. Solid foods are just extra experiences in taste and texture and should not decrease your baby’s intake of formula or breast milk.
Do not put your baby to bed with a bottle under any circumstances, as this will lead to tooth decay.