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Medical Author:

David Perlstein, MD, MBA, FAAP

David Perlstein, MD, MBA, FAAP

Dr. Perlstein received his Medical Degree from the University of Cincinnati and then completed his internship and residency in pediatrics at The New York Hospital, Cornell medical Center in New York City. After serving an additional year as Chief Pediatric Resident, he worked as a private practitioner and then was appointed Director of Ambulatory Pediatrics at St. Barnabas Hospital in the Bronx.

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Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

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From 4-7 months of age, babies learn to coordinate their new perceptive abilities (including vision, touch, and hearing) and motor skills such as grasping, rolling over, sitting up, and may be even crawling. Babies now have more control over what they will or will not do, unlike earlier months in which they mainly reacted by reflex. Babies will explore toys by touching them and putting them in their mouths instead of just looking at them. They can also communicate better and will do more than simply cry when they are hungry or tired or when they want a change in activity or a different toy.

By this time, babies have developed a strong attachment for their parents, and they may show a preference for their primary caretakers. However, babies at this age usually smile and play with everyone they meet.

Once babies can lift up their heads, they'll push up using their arms and arch their back to lift up the chest. These movements help strengthen the upper body and are in preparation for sitting up. They may also rock while on their stomachs, kick their legs, and swim with their arms. These movements are necessary for rolling over and crawling. By the end of this period, babies should be able to roll over from stomach to back and back to stomach and probably are able to sit without any support.

By age 4 months, babies can easily bring toys to their mouth. They use their fingers and thumb in a claw-like grip to pick up objects. Because at this age babies will instinctively explore objects by putting them in their mouths, it is important to keep small objects out of reach to prevent accidental swallowing. By age 6-8 months, they can transfer objects from hand to hand, turn them from side to side, and twist them upside down. Babies also discover their feet and toes during this stage.

Babies' broadening range of vision is apparent as they concentrate and focus on objects and follow movements. Babies at this age like increasingly complex patterns and shapes. They also like looking at themselves in a mirror. They continue to babble, but now they raise and lower their voices as if asking a question or making a statement.

By the end of this period, most babies have reached the following milestones:

Motor Skills

• Rolls over both ways (stomach to back, back to stomach)
• Sits up with, and then without, support of his hands
• Reaches for object with one hand using the raking grasp
• Transfers objects from hand to hand
• Supports whole weight when on legs and held upright
• Explores objects with hands and mouth
• Explores objects by banging and shaking

Language Skills

• Laughs
• Babbles consonants (like ba-ba-ba-ba-ba)

Social/Emotional Skills

• Distinguishes emotions by tone of voice
• Finds partially hidden objects

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