Milestone Mondays! – 2-4 Months

I decided to add another series of posts that I will post on occasional Mondays, called Milestone Mondays.

For any clinician working in pediatrics, once parents are sure their child is healthy or once parents accept their child’s diagnosis, the next question that they ask a clinician is, “When should my child be doing a…b…c…?”

A number of my patients’ parents tell me that they have no idea what their child should be doing.  Some parents compare them to their older children, some compare to other children at mommy and me classes, and some compare to what they researched online.

Sooo with that, let’s start talking about milestones, and let’s start from the beginning, from 2-4 months! 🙂

I gathered this info from a site I brought up in a previous post: CDC’s Act Early Campaign, as well as 2 tests/guidelines I use when assessing developmental delays- Peabody Developmental Motor Scales, Gesell Developmental Schedules.

Milestones are generally divided into the following areas:

I’m listing all these areas because pediatric clinicians can never just focus on the area that they work on, they must look at the whole patient because a delay in 1 area can lead to greater delays in other areas.

Gross motor (I placed this one first since I’m biased :), these are the main things PT works on)
2 months:

  • Holds head bobbing slightly when held in sitting (unable to hold head nice and straight still)
  • Begins to hold head halfway up intermittently while lying on tummy

4 months:

  • Holds head steady when held in sitting
  • Able to hold half off back up straight when supported in sitting on the floor
  • Able to hold head up all the way while lying on tummy
  • Begins to roll from tummy to back
  • Begins to lie on tummy supported on 1 hand and 1 elbow
  • Begins to bear some weight on legs when held in standing

Fine motor (movements of smaller muscles like those in the hand, OT works on these items as well as some below)
2 months:

  • Begins to hold ring in hand

4 Months:

  • Begins to hold rattle in hands
  • Begins to scratch at various surfaces that they touch with their hands
  • Begins to grasp ring held in front of them.

Social/ Emotional
2 months:

  • Begins to smile at people
  • Begin to calm themselves (sucking thumb, bring hand to face/mouth, etc)
  • Tries to look at parent
  • Tracks objects (rattle) 45-90 degrees while lying on their back
  • Begins to notice their hands

4 months:

  • Smiles spontaneously
  • Begins to like playing with others (peek-a-boo)
  • Imitates some movements (smiling, frowning)
  • Plays with their own hands
  • Pats bottle with their hands
  • Tries to pull clothes up over face
  • Begins to track objects past midline (begin to follow objects like a rattle from left <-> right)

Language/ Communication
2 months:

  • Coos
  • Turns head towards sounds

4 months:

  • Begins to babble
  • Babbles with expression, copies sounds
  • Cries begin to be different for different needs (hunger vs pain vs tired)
  • Begins to laugh, squeal
  • Begins to talk spontaneously to people or toys

Cognitive (Learning, thinking, problem-solving)
2 months:

  • Pays attention to faces
  • Begins to follow objects/people with eyes
  • Begins to act bored if activities don’t change

4 months:

  • Begins to demonstrate happiness/sadness
  • Begins to develop hand-eye coordination (seeing an object and reaching for it with their hands)
  • Begins to recognize familiar faces
  • Begins to track objects from side to side, turning head to follow the object

I try to prevent parents from freaking out if they think their child isn’t right on track with the above milestones.  I always emphasize that these are not clearcut guidelines because every baby is different.  All the above have ranges and may not actually happen at 2-4 months.  I generally tell parents that it may take a month or 2 longer than what’s listed and not to worry yet.  To help ease parents concerns, I give them some of my tips and tricks so they can practice more at home to help their child reach the above milestones.

Though I do emphasize that there is a range to reaching milestones,  I will advise parents if I do see something that I feel needs to be addressed sooner.

The following is directly from CDC’s Act Early site:

by the end of 2 months:

Act early by talking to your child’s doctor if your child:

  •  Doesn’t respond to loud sounds
  • Doesn’t watch things as they move
  • Doesn’t smile at people
  • Doesn’t bring hands to mouth
  • Can’t hold head up when pushing up when on tummy

by the end of 4 months:

Act early by talking to your child’s doctor if your child:

  • Doesn’t watch things as they move
  • Doesn’t smile at people
  • Can’t hold head steady
  • Doesn’t coo or make sounds
  • Doesn’t bring things to mouth
  • Doesn’t push down with legs when feet are placed on a hard surface
  • Has trouble moving one or both eyes in all directions


So there is the first Milestone Mondays!

For parents or therapists out there, any comments regarding the above?  Any tips you’d like to share with other parents with kids in the same age group?

Thanks for reading!

Categories: Child Development, Milestone Mondays

Tags: , , , , , , , ,

3 replies


  1. Milestone Mondays!- 6-9 Months | Beyond Basic Play
  2. Milestone Mondays!- 12-15 months | Beyond Basic Play
  3. Please let your infant play on the floor, thank you! « Beyond Basic Play

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

%d bloggers like this: