Milestones at 4 months
By 4 months babies start to use their bodies and voices on purpose. The list includes cooing, turning toward your voice and making sounds back when you talk, alongside steadier head control when held and pushing up onto the forearms on the tummy. Bringing hands to the mouth and swinging at toys are early steps toward reaching and grasping.
CDC's 4-month checklist lists 13 milestones: 3 social and emotional, 3 language and communication, 2 cognitive and 5 movement and physical development. The largest group at this age is movement and physical development, with 5 items. Each one is something most children (75% or more) can do by 4 months, so many children do it earlier.
No standardized screening is routinely scheduled at the 4-month visit, but you can ask for one at any visit if you have a concern. The checkpoint before this one is 2 months, with 11 milestones. The next is 6 months, with 12. For a baby born before 37 weeks, compare with the checklist for the corrected age until 2.
No standardized screening is routinely scheduled at 4 months; ask for one if you have a concern. Next checkpoint: 6 months.
Screening ages: AAP, via CDCSocial and emotional3 items
“Smiles on his own to get your attention”
Most children (75%+) by 4 months · many earlier · Source: CDC“Chuckles (not yet a full laugh) when you try to make him laugh”
Most children (75%+) by 4 months · many earlier · Source: CDC“Looks at you, moves, or makes sounds to get or keep your attention”
Most children (75%+) by 4 months · many earlier · Source: CDC
Language and communication3 items
“Makes sounds like “oooo”, “aahh” (cooing)”
Most children (75%+) by 4 months · many earlier · Source: CDC“Makes sounds back when you talk to him”
Most children (75%+) by 4 months · many earlier · Source: CDC“Turns head towards the sound of your voice”
Most children (75%+) by 4 months · many earlier · Source: CDC
Cognitive (learning, thinking, problem-solving)2 items
“If hungry, opens mouth when he sees breast or bottle”
Most children (75%+) by 4 months · many earlier · Source: CDC“Looks at her hands with interest”
Most children (75%+) by 4 months · many earlier · Source: CDC
Movement and physical development5 items
“Holds head steady without support when you are holding him”
Most children (75%+) by 4 months · many earlier · Source: CDC“Holds a toy when you put it in his hand”
Most children (75%+) by 4 months · many earlier · Source: CDC“Uses his arm to swing at toys”
Most children (75%+) by 4 months · many earlier · Source: CDC“Brings hands to mouth”
Most children (75%+) by 4 months · many earlier · Source: CDC“Pushes up onto elbows/forearms when on tummy”
Most children (75%+) by 4 months · many earlier · Source: CDC
Checklist items quoted from CDC’s “Learn the Signs. Act Early.” milestones for 4 months (Source: CDC). “Learn the Signs. Act Early.” materials are not a substitute for standardized, validated developmental screening tools.
If something is “not yet”
“You know your child best. Don’t wait. If your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early. Talk with your child’s doctor, share your concerns, and ask about developmental screening.”
Source: CDC, milestone checklist for 4 months
- Write down the items you answered “Not yet” or “Not sure”, with an example of what you see at home.
- Bring the list to your child’s doctor and ask whether a developmental screening is a good next step.
- Under 3? Call your state’s early intervention program and ask for a free evaluation. You don’t need a referral.
- 3 or older? Call your local public elementary school and ask for a preschool special education evaluation.