Readers of Real Answers with Dr. Lavin will recall some earlier posts as I shared time with our granddaughters in Hong Kong as they grew up. Many visits to Hong Kong led to sharing how each of these wonderful young girls taught me about each of the ages they have achieved.
As with nearly all families, we too were impacted by the arrival of the SARS-CoV-2 virus, stopping the ability to travel to avoid transmitting a potentially deadly infection. To this day, travel to and from Hong Kong from the US is heavily regulated. For our son and his family this means if should come to visit, anyone traveling from the US to Hong Kong must observe 3 full weeks in true quarantine. Not like the loosely observed American quarantine where someone just needs to stay home, quarantine in Hong Kong means being put up in a hotel, free of charge, but not being allowed to leave your room, in this case for 3 full weeks. The same rule would apply to any of us going to visit them. Again, like so many families here in the US and around the world, we have been unable to be together for what will soon be 2 years. And so, I have not been able to spend time in person with our now 7 and 3 year old granddaughters, whose stores and weekly time on Zoom make clear that they are transforming in astounding and dramatic ways.
But in the last few months we have been so, so fortunate to welcome another member to our family, our newest granddaughter who is now almost exactly 4 months old. And we get to see her pretty easily, so I am so pleased to share some observations from our most recent visit, when she was in the full bloom of the essence of being 4 months old.
Many students of babyhood talk about the special nature of the first 3 months after due date, some even call it the fourth trimester, because of the rather radical dependence of the newborn. We come into the world far less mature than most mammals. Newborn horses stand up and walk around moments after birth, but we humans take on average a year. Anyone who has had a baby or knows a newborn knows how they can smell, touch, taste, eat, sleep, pee and poop. Some know they can hear and see. Many may recall from earlier posts in Real Answers that the very fastest time we grow across our entire lives is from birth to 4 months old, when many babies will attain rates of growth of 50 pounds and one foot a year, which far exceeds even the most rapidly growing high schooler!
But those wonders of the newborn also include limited abilities. We are all born with brains whose rhythms cannot sustain the complex patterns of sleep cycling, we have as yet unrealized powers of recognition. The lack of regularity to sleep patterns and the unique pressures of the most rapid period of growth in one’s life combine to make the first four months typically a series of periods of short bout of sleep punctuated by nearly constant intense feeding times. Our adult sense of regular alternation of a waking day and a sleeping night dissolve into unpredictable demands from our young infant to eat, at almost any time of day or night. The newborn and the early infant typically offer few long stretches of being awake or asleep.
Then comes the wonder of being 4 months old. Two events combine to radically alter life for the baby and her or his parents. First, the baby’s brain has achieved the full complexity of weaving adult-level sleep patterns and can now sustain regular, mature sleep cycles. And after 4 months of truly frenzied feeding vast amounts of food, the baby has attained a new size, and slows growing remarkable. The slow down is so marked that it gives the famous growth curve its very curve. That curve is the visual evidence of the slow down in growth. Never again will our children grow at a rate of one foot a year or gain weight at the rate of 50 pounds a year. Together, the sudden slowing of growth, and the initiation of sustained cycles of fully mature sleep that can be linked into 3-5 cycles a night allows the 4 month old infant to, yes, sleep through the night! Although no self-respecting 4 month old would ever say actually tell their parents this, these achievements of all healthy 4 month old babies mean no infant this age or older needs to fed any food at night, really across a 12 hour interval!
Our 4 month old granddaughter solidified these steps in her development and has been a regular all-night sleeper for some time, quite the change from the newborn days.
But this visit reminded me of the awesome power of the two major changes in life that happen to all healthy 4 month olds. Both are about connecting to the world, one by intent and one by hold. The hold is the hold of the hands. The step we are talking about is learning to grab anything you want by hand.
Hands and the 4 month old
When we are born, our hands are almost completely useless. They might wave about as newborns, but to no real purpose. A newborn has no evident knowledge their hands even exist. They will certainly feel hurt if they are pinched, maybe soothed of softly rubbed, but they have no idea that these remarkable instruments can do all they can do- be placed anywhere in the world within reach to create understanding through brilliant powers of touch, to grab anything their heart desires, to point to ask a question, to connect with another human or animal or plant.
Readers of Real Answers may recall my homage to hands following a bad fall on a slick of gasoline at a station about 2 years ago. I am now thankfully fully recovered, but at the time, nerve damage in my shoulder rendered my left thumb and its closest two fingers, not numb, but transmitting faulty information by touch. This taught me just how extraordinary the intelligence of our fingertips really is. I came to see we all have the same wondrous powers of knowing in our fingertips that elephants have in their trunks and octopi have in their tentacles. Take a pencil someday and hold it by eraser end and then lightly rub it along some paper, then some wood, then some foil. And then marvel that although the tip of the pencil has not nerves in it, it feels like you can feel the paper, wood, and foil textures at the tip of the pencil. Now grab that pencil and lift it, and then a laptop, and then a heavy book. Notice how your hand knows just how tightly to grasp, how to grasp, all towards total acquisition of the target, never mind how far away it is, as long as your body has put within reach.
None of this can be done at birth. But suddenly, at 4 months old, all this begins to happen. You see, at 4 months old, the hands come to life! We spent hours watching our granddaughter begin to use her hands during this visit, it really is a sight to behold. Now she can see something that grabs her interest, and you know when that happens because her face suddenly gets very serious, her eyes suddenly focus with great energy, she leans forward, she may even shout her amazement with a happy grunt or breath, and then, her hand or hands will dart forth, with great purpose. And she will, remarkably hit her target, and grab it. Think about it, just a few weeks, did she even notice these items? If she did, could she zero in her attention, could she get her hand precisely there? No. But now she can, and does. And once acquired, the target is often rapidly brought to the one place on her body where understanding the world has been concentrated, her mouth.
The mouth is also the destination because a new instinct awakens at 4 months old, the instinct to chew. We are born only requiring the ability to latch, suck, and swallow to sustain our intake of food to live. By 4 months of age, a new interest erupts, the urge to chew food, and so at that age we all started drooling and gnawing and seeking to try out chewing, well, everything. That instinct, activated at 4 months age, stays strong in us the rest of our intact, healthy lives, even for over 120 years if we live healthy that long.
Sometimes parents get to see the hand go from dormant to on with a remarkable thought process distinctive to 4 month olds. I am referring to the wondrous curiosity 4 month olds show about their hands. At about that age, for the first time, and for some the last time, babies will hold their hands in view and gaze on them with eyes bulging in wonder. They will hold them there for a bit of time, move them, rotate them, in amazement. Everytime I see this I am convinced they are discovering they have hands, perhaps for the first time at this level of awareness. Who knows what they are thinking, but I have seen my granddaughters stare at their hands looking transfixed, I do imagine their mind is activating myriad wires that connect brain, mind, and hand, opening the door to all that follows.
A Funny Story
The other extraordinary step 4 month olds take has to do with the intent to connect. All humans are born deeply connected. Every baby born experiences the touch and smell of their mother, and the touch and smell of the baby’s top caregivers are known to create the foundation of love that all our lives depend on. By 6 weeks to 2 months of age, all healthy infants acquire one of the greatest skills any of us will ever achieve, the power to smile. Many of us have had the pleasure of seeing 2, 3, 4 week old infants try to smile, achieving half a grin, but no jolt. But around 2 months of age, the attempts cohere into the full sunburst of a real smile. You know when a smile is real when it knocks you off your chair with the full power of a glowing burst of sunlight. There is no doubt that power is the result of the power of the intent to connect, specifically with you!
Very young babies may smile at lots of people, but almost never at everyone. So a smile is not only the contraction of the right muscles in the face, but a sign of recognition. A baby can l smile at you, but not you, only if they recognize you as you, someone they have selected to grace with the joy of a smile. The deeply held gesture, the fact it is only offered by recognition and most importantly, by choice, makes the smile perhaps one of the most powerful tools any of us have to connect to others. We all know that some smiles mean more than others, so they all tell us about that connection. Smiles are extremely powerful.
From the moment we are born, the actions of our babies as they grow up tell stories of connections chosen, and connections shunned, so the story of this person’s relationship begins to be told from the first touch, to their amazing smiles and beyond.
Just as the routines of sleep, and the ability to grasp announce to the world that the 4 month old is taking huge steps to connect and change their worlds, does the next step towards connection.
What is that next step? It’s the great gift of laughing.
We had heard stories that our 4 month old granddaughter was laughing, even seen a bit of video, but there is nothing like really being with someone and laughing together! Over many years, when I’ve had the profound privilege to see so many children at age 4 months old, I have always been struck by how suddenly people at this age seem to hold their heads up, look knowingly around the world, have a real knack for seeing the situation around them, and truly engaging in the world they are in at that moment, and move that world.
Our granddaughter did all that this visit. She loves being held standing up, holding her head up high with nearly infinite curiosity, eyes bugging out at wonder at this or that situation observed, straining to understand what she sees. We would go on walks with her and marvel at her staring at the sky, trees, dogs, other people, and really seem to probe with her eyes and wonder, what does it mean? So, so, so engaged.
Personally, I think this has lots to do with the mad dash of growing at birth. Who has time to stop and ponder when constantly eating and sleeping? But more positively, once all that eating has turned into body closing in on doubling in size since birth, the person has attained enough size and stability to look around. And as eating becomes less constant, as sleep concentrates at night, the person can begin to stay awake more of the day, and spend a ton more time awake not eating. All that gives the person the strength to really jump into looking at the world with lots of work to do to understand, and change it.
One may wonder, what does emerging from the haze of constant eating and beginning to understand and master the world have to do with laughing? I would say, everything.
At the heart of laughter, I think, is surprise. If something happens that we fully expect to happen with boring regularity, who would laugh? Is there anything funny about punching your time card at the same time every work day? Or finding out it’s Tuesday once a week? Or if you’re a baby, that you are hungry again and are being fed? I would say no.
But what if someone says something not usually said, or sees things very differently than usual. If we notice the difference, and the more we notice the difference from what is expected, we react. Sometimes the difference is alarming, but sometimes it is funny, and we laugh. Or we may laugh when an event brings lots of pleasure. Now think for a moment how many things are sudden, unexpected, out of the ordinary? So many, the world is entirely new to a young infant. Clearly new surprises are upsetting and we know that babies cry when they get upset, or at least frown. But some things are amusing and cause our babies to laugh. It is at 4 months of age that babies really put together the concept that a surprise can be humorous, it is at his age that they begin a life of laughing. We begin life with the ability to cry, but not to laugh. By 4 months of age, almost all healthy people have added laughing to their ability to cry.
The other reason we, and starting around 4months old babies, laugh, is a bubbling of happiness when something we particularly like happens. And a third reason we laugh, particularly when young, is when we are tickled- more on that later. Like the smile that we noted gives us all such pleasure to be loved and to give our babies such pleasure to be with us, now comes the laugh, which gives that sense of pleasure at being loved a turbo-charged power.
One of the most powerful experiences we had visiting our 4 month old granddaughter were her laughs. There is something incredibly joyful about the joy of a baby and young child. When she smiles it really feels like the sun is shining bright and all is well with the world, but when she laughs, it is like an explosion of happiness lifts you up, makes one giddy with joy. Over many years of pediatric practice I have been challenged with the question, why don’t we stay this full of joy as we get older. The ages of 4 months to 18 months are a time of tremendous happiness, and striking periods of deep contentment. The emergence of a higher level of awareness, of a wider consciousness, ushers in a period of more complex emotions at 18 months, a time when tantrumming begins in full force. But even so, there is an incredibly playful, happy way about young children. Just visit any playground and hear the peals of happy sounds- screams and laughs, high energy running around, tons and tons of happiness. What happens to that way of being? Why aren’t we happy in the same way as children when we grow up? Many answers come to mind, and they all make sense, but I still remain disappointed that the way we develop moves us away from this wonderful way to be in the world.
Which is another reason it is so fabulous to spend real time with a young child, to be reconnected to this time in all our lives when joy can be so incredibly explosive, powerful, bubbly, and connected.
When our 4 month old granddaughter began to recognize us (in a few minutes), and then shared that big toothless grin, and loud laughter, our souls soared and we broke out in laughter with her, every time. Everyone who got beamed her intense joy and laughter responded to with big smiles and laughs. Often the whole room of adults would burst out in laughter with her. What a power she has! What a power shared laughter is! We really love this time!!
Any meaning to a good laugh, and what about tickling?
Lots of animals laugh. For many years, many have claimed laughter is unique to humanity, but we know better now, the count is up over 90 other species laughing with joy. One trend across life is that laughing seems to occur in animals as a tool of forming tight connections, and the room bursting out in laughter clearly seems to fitting that purpose.
Across human life, we find all sorts of incredibly powerful ways to find a way for one person to connect to another, all towards achieving tremendous achievements together. One look around the world and you see the impact of how humanity has joined its forces, to form large groups such as families and nations, and structures such as homes and roads, and ideas as seen in books and posts.
Humanity in large part is defined by the ways in which we connect. We tell stories together, we sing together, we dance together, and we laugh together. Sure we can do each of things alone, but think about the power of doing any of them together, our differences suspend for at least a moment, and in that moment we are together.
Tickling is another window into laughter. It turns out socially connected animals like other apes, and even rats, have tickle spots that make the young animal laugh when stroked. There is little known about how tickling came about, mostly in mammals, but it is an established part of many animals’ lives, including ours. What parents has never tickled their young child? And who hasn’t succumbed to the tidal waves of joy of hearing our children erupt into peals of laughter?
The Power of Being Accepted, Recognized
The other meaning of laughter has to do with that sense of recognition hinted at above. We spend a lot of our day inside our familiar routines, with few surprises. But every day gives us something new to consider. And things that don’t fit into our expectations are perhaps one of the most powerful reasons for humor and laughter. Some even say funny is all about a surprise idea. How powerful to see that sense of surprise appear at such a young age!
I remain astounded at the power of the mind of a 4 month old, just a few weeks after birth, and as noted, they have achieved fully mature sleep cycle abilities, have organized their day into sleepy night time and more awake day time. They are so alert now, and engaged in the world. They are part of what is going on. They can read a room and a situation. They know if who they are with and where they are is familiar or not. They are beginning to shape their world, move it to their will. Even at birth people have very strong preferences, but they really blossom at 4 months old. They like seeing this person, or not. They like the taste of that food and dislike the taste of that one. Some babies love bath-time some hate it, some don’t notice. Same goes for diaper changes, going to sleep, sitting in a car seat, really just about any experience.
Those preferences extend of course to people. All healthy people have strong preferences for people. And the overall preferences are incredibly unique to each person and very strongly felt. We begin to see who our baby like, and don’t, around 2-4 months old, when we get to see who inspires that smile and that laugh.
My wife and I remain so profoundly grateful that it turns out all 3 of our grandchildren beam when they see us, we are definitely in their preferred group. I suppose that happens more often than not inside families, but we also know not everyone likes everyone in a family.
- The sum of it all is simply put, we really loved sharing tons of laughter with our 4 month old granddaughter, and laughed and laughed with her!
- Laughter is such a powerful joy we all share, and how amazing that we develop this ability and joy by 4 months of age. It brings so much meaning and power with it, but isn’t the fact this happens by 4 months of age amazing?
- Let’s all be inspired by our babies and children and share the incredible delight they bring to the world with them!
To your health,
Dr. Arthur Lavin