A Child's Milestones Between Months 3 - 6

Overview of Milestones Expected Between 3 and 6 Months

Motor skills: pulls to sit up; rolls over; at six months may be able to stay sitting upright.

Cognitive development and fine motor skills: holds a rattle or toy; shakes a rattle; bangs objects together; passes objects from hand to hand.

Hearing, Speech and Language Development: gurgles; looks at the person speaking; vocalises to answer; laughs.

Social, Emotional and Behavioural Development: awake more during the day; smiles to initiate engagement; prefers familiar people; responds to other infants.

Overview of baby’s development at 6 months

By the age of six months, a baby’s motor skills will be evolving as muscle strength is increased. They will have improved head control, move their arms and legs with more purpose and rock on their stomach, eventually rolling over. When their hands are held, they will brace their shoulders and pull up into a sitting position.

Most babies of this age raise their heads when lying prone and begin sitting alone after being positioned upright, turning their head from side to side to look around. When held in a supported standing position with their feet on a solid surface, a six-month old baby will weight bear on their feet and try to bounce up and down.

Fine motor skills are developing, and they will pass a toy from one hand to the other, and bang objects together. A 6 month-old baby will probably grasp a finger, a rattle or a soft object and anything within reach is likely to be put in the baby's mouth.

Visually they will be very interested in their surroundings, their eyes will move in unison and they will stare at small objects within a 15-30cms range. They will begin to search for a dropped toy within their visual field. A baby will begin to show recognition of a carer’s facial expressions such as a happy or smiling face.

Vocally, a six-month-old will laugh and squeal when playing and make expressive sounds. They will immediately turn towards the sound of a familiar voice, even if no one is in sight. They will react enthusiastically to repeated games. If offered a rattle, they will reach for it and shake it to make a noise. This is the age, when a baby may start to show signs of shyness with strangers, especially if their familiar carer is out of sight.

Weaning usually begins at around six months and a baby will start sucking smooth semi solids from a spoon as part of the weaning process. This change in diet can be a trigger for nappy rash. [Morris, 2012]

Advice which may be useful for parents

At six months, a baby is likely to be: visually very aware and noticing even small details, trying to put everything into their mouth, becoming more mobile and better able to support themselves, communicating using a range of sounds.

• Talking to your baby as much as possible will help to develop their communication skills and vocabulary. Try telling them everything you’re doing and name everything around you. Repetition means this is all stored and processed in their brain.
• Reading to a baby helps speech development. Start with books featuring large, brightly coloured pictures and describe what's happening on each page.
• It is normal for babies to be anxious about strangers at this age, so it helps to encourage socialising, by going to Baby and Toddler Groups, where they will interact with other infants. This will help them get used to meeting new people.
• Stacking blocks and cups helps develop hand-to-eye coordination which is one of the biggest challenges for a baby, and this is a fun way to learn.
• Weaning onto solids can trigger nappy rash, so good skin care is essential. This includes changing nappies as soon as they are soiled, cleaning the nappy area thoroughly and using a suitable barrier ointment.

Health checks / interventions (3-6 months)

At 16 weeks, a baby should have the following vaccinations:

• The third dose of the 6-in-1 vaccine which protects against diphtheria, hepatitis B, HiB (Haemophilus influenzae type b), tetanus, polio and pertussis (DTaP/IPV/Hib/HepB).
• The second dose of Pneumococcal conjugate vaccine (PCV) vaccine.
• The second dose of Meningococcal B (MenB) vaccine.

Potential ‘red flag’ warnings (6 months)

At six months, any of the following could indicate a ‘red flag’ warning:

• Does not smile or interact with people.
• Does not bring objects to their mouth.
• Does not push down with their legs when feet are on a firm surface.
• Not holding head and shoulders up with good control when lying on tummy.
• Not holding head with control in supported sitting.
• Does not explore objects with their hands, eyes and mouth.
• Does not hold or reach for toys.

Reference sources

CF Dosman, D Andrews, KJ Goulden. Evidence-based milestone ages as a framework for developmental surveillance. Paediatr Child Health 2012;17(10):561-568.

Ajay Sharma, 2014, Mary Sheridan's From Birth to Five Years: Children's Developmental Progress 4th Edition

Red Flags early identification guide – birth to five years, Childrens Health Queensland hospital

Morris H, The bottom line on nappy rash, British Journal of Midwifery, 2012, Vol 20, No 9

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/831680/Greenbook_chapter_11_UK_Immunisation_schedule.pdf  accessed 18^th September 2019