Milestones by the End of the 4th Month


  • Raises head and chest when lying on stomach
  • Supports upper body with arms when lying on stomach
  • Stretches legs out and kicks (on back or tummy)
  • Opens and shuts hands
  • Pushes down on her legs when placed on firm surface
  • Brings hand to mouth
  • Swipes at dangling objects
  • Grasps and shakes toys

Sight, Sound, and Speech

  • Watches faces intently
  • Follows moving objects
  • Begins to coordinate hands and eyes
  • Smiles at sound of your voice
  • Turns head toward direction of sound
  • Vocalizes (babbles, coos, imitates)


  • Develops social smile
  • Enjoys play with other people
  • Communicative/expressive with face and body
  • Imitates some movements and facial expressions

Watch List

Although each baby develops in her own individual way, failure to reach certain milestones may mean medical or developmental problems. Call your baby's health care provider if you notice any of the following in the 1 to 4 month range:

  • Still has startle (Moro) reflex after four months
  • Doesn't respond to loud sounds
  • Hasn't noticed her hands by age 2 months
  • Doesn't smile at the sound of your voice by age 2 months
  • Doesn't follow moving objects with her eyes by 2 to 3 months
  • Doesn't grasp/hold objects by 3 months
  • Doesn't smile at people by 3 months
  • Can't hold her head up well at 3 months
  • Doesn't reach for/grasp toys by 3 to 4 months
  • Isn't babbling by 3 to 4 months, or imitating your sounds by 4 months
  • Isn't bringing objects to her mouth by 3 to 4 months
  • Doesn't push down with her legs when feet are on firm surface by 4 months
  • Has difficulty moving one or both eyes in all directions
  • After 3 months, crosses her eyes most of the time (occasional eye-crossing is normal in the early months)
  • Ignores new faces or seems very frightened by new faces/surroundings

Continue to "Milestone: End of 7th Month" journey to parenthood

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Childbirth Connection is a national not-for-profit organization founded in 1918 as Maternity Center Association. Our mission is to improve the quality of maternity care through research, education, advocacy and policy. Childbirth Connection promotes safe, effective and satisfying evidence-based maternity care and is a voice for the needs and interests of childbearing families.
Most recent page update: 9/9/2010