Babyquant

What should a baby be able to do between 12 and 15 months?

[mme_highlight] At this time your child can begin to walk. By the end of 15 months, toddlers know on average 3 words besides “mama” and “dada.”Children at this age like to draw attention to himself/herself and use various behaviors to achieve this. Kids also love to imitate their parents and perform pretend play. [mme_highlight]

During this period dramatic changes occur in the development of your child. Many parents are excited and can`t wait to see what will happen the next day, because the child begins to independently walk and says the first word. In addition, children enjoy imitating their parents and they develop new fine motor skills, so they can now use a spoon to eat.
However, the child is still dependent on his/her parents and he/she needs full care and attention. Therefore, parents should not leave the child alone with strangers, because in this period stranger anxiety is emphasized.

Cognitive development

Children enjoy their reflection in the mirror. By the end of 15 months, 28% of children can recognize the image in the mirror as himself/ herself. Kids also love to imitate their parents and perform pretend play:

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• 18 % of children exhibit pretend play by the end of 12 months;
• 40 % of children exhibit pretend play by the end of 15 months;
• 40% of children perform a synchronic imitation (imitation while watching their parents).

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Motor development

At this time your child can begin to walk.

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• 97 % of children can walk with assistance at the age of 12.4 months;
• 90 % of children can stand alone with 13.4 months;
• 75 % of children can walk independently with 13.4 months.

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Changes regarding manners of food intake are also noticeable:

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• 90% of children can remove food from spoon with lips between 12 to 14 months of age;
• 29 % of children can independently eat using the spoon between 12 to 14 months of age;
• 14 % of children can drink from regular cup without help;
• 90 % of children can eat bread or biscuit by the end of 15 months.

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Toddlers can squat and stand and squat again without assistance. Also, children can crawl up and down the stairs. Many of children can give “high five”.

Regarding fine motor skills, the child also uses one hand to hold the object and the other hand to manipulate it. Also, a child uses his/ her index finger to point.

Social/ Emotional development

The child still does not show interest in play with his/ her peers. If two or more children play together, they will perform parallel play. In this period, children still consider that they are the center of the world and treat other children like toys/ objects. The child is still afraid of the presence of strangers.

In addition, children at this age like to draw attention to himself/herself and use various behaviors to achieve this. They can begin to scream or laugh and then frequently use certain type of behavior which is the most effective in order to accomplish his/ her desires. This behavior is the part of socialization process.

Language development

Children understand the simple (one-step) commands and execute them without gestures. By the end of 15 months, toddlers know on average 3 words besides “mama” and “dada.” Now, children babble and combine vocals to invent new words. Children of this age are nodding their heads in order to say “no.”

What are the risk factors that can impair development?

As children in this period begin to say the first words, we should pay attention to the way in which they communicate, because parents detect some early signs of autism. If a child does not say any word at all or if he/ she cannot establish eye contact these can be early signs of autism, and therefore you should contact a pediatrician.

As children now begin to move independently, parents should pay attention if their child uses predominantly one side of the body over the other or if one side of body is too limp/ rigid. This may indicate a potential problem, so parents should contact a doctor.

What are the alarm signs parents should be aware of?

• The child does not say a word;
• The child does not know the function of objects such as a spoon, phone, hairbrush;
• The child does not walk (with or without assistance) by the end of 15 months;
• The child loses skills which had already been achieved.

What should parents do to encourage the development of toddlers at this age?

Parents must encourage children to talk, so they can play a kind of “repeat after me” game. Also, while parents are doing daily routines, they should explain what they are doing. This simple procedure also improves your child’s cognitive development.

A child of this age loves to use things that adults use every day. However, this can lead to injury sometimes. Therefore, children should be provided with copies of that objects that are safe (e.g. plastic toy keys instead of real keys).

Although children of this age do not play together, you can encourage your child to establish social contacts. So, you can provide toys that are designed to be shared with other children. In addition, children should be placed in many different situations in order to learn how to behave.

Summary and Recommendations

• Between 12 and 15 months, your child will show developmental progresses every day. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development: Children imitate parents and perform pretend play.
• Motor Development: most children can stand alone and the majority can walk by 15 months. Fine motor skills and eating skills are also improved: children can eat with a spoon, eat biscuits and some can drink from a regular cup.
• Social/Emotional Development: Children show a self-centered playing and behavior, using different strategies to be the centre of all attentions.
• Language Development: Children can understand one step commands and have a lexicon with 3 words other than “mama” and “dada”.
• Your child moves more and more, so parents must ensure safety of the environment where the baby stays, preventing falls, shocking, poisoning and drowning.
• Each child has her/his own pace, but if you think your child is not developing adequately, seek for medical advice.

[mme_references]
References

• http://www.parentingweekly.com/baby/baby_information/toddler_dev_12_15_mos.htm
• http://www.webmd.com/parenting/baby/milestones-12-15-months
• http://www.milestones4kids.com/pdf/dev_milestones/M4Kids%2012m-15m.pdf
• http://firstyears.org/miles/chart.htm

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Development milestones 10 to 12 months

[mme_highlight] During this period, the baby becomes aware that the objects, even if hidden, continue existing.  Children say their first word between 10 and 11 months on average. The child can stand with support and starts trying to stand alone, shows a pincer grasp skill to hold objects, can hold a spoon and crawls.  [mme_highlight]

Between 10 and 12 months, babies continue with a rapid development- they become more and more physically active, spend a lot of time in an upright position and continue to improve their communication skills. They show interest in more complex games and love to read books with parents.

Cognitive development

During this period, the baby becomes aware that the objects, even if hidden, continue existing (e.g. if you show her/him a toy and then hide it, it is probably that the baby manages to find the toy). In the same way, if you leave the room, the baby will realize that you still exist. He/she understands how to use objects which parents use every day. During this period, babies imitate their parents (e.g. love to use the phone or hairbrush).

Motor development

The baby develops more subtle motor skills.  Your baby will adapt the body when you dress him/her (e.g. she/he stretches arms when parents put on a sweater). By 10 months, all babies should be able to sit alone, while some children are also able to stand with the assistance of adults. Data from the World Health Organization is shown below.

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• 95% of children at the age of 10 months can stand with support of adult
• 99% of children have this skill at the age of 11.4 months

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During this period, baby becomes skilled at catching small items by using pincer grasp with fingers. In addition, baby uses its finger to point to the object that interests him/her. During this period, the child is improving motor activities such as holding a cup or a spoon (with a little help she/he is able to drink from a cup). Also, the baby improves “hand-eye” coordination.
Babies are very skilled in the crawling in this period. Some children in this period can also stand alone for a few seconds. The baby is more often on the legs, but she/he is still unsure and needs support to begin the first steps.

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• 90% of children at the age of 10.5 months can crawl;
• 97% crawl at 12 months;
• 50% of children begin crawling at age 10.8 months;
• 75% of children can stand alone at the age of 12 months;
• 10% of children begin to walk independently at the age of 10 months;
• 25% of children can walk at the age of 11 months;
• 50% of children can walk at the age of 12 months.

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Social/Emotional

Your 10 month old baby loves to play, but she/he is still focused on her/himself, so do not expect her/him to play with peers. She/ he loves to play peek-a-boo and pat-a-cake. Also, stormy emotional reactions are usual during this period. Babies have tantrums and express their dissatisfaction sometimes in a violent way; it was found that up to 20 % of babies bang their head and boys do that three times more than girls.

Language/communication

Babbling increasingly begins to resemble a speech of adults. When babies babble they mimic intonation of adults. During this period, the baby recognizes her/his own name and the names of close relatives and he/ she also understands the meaning of the words “no” and “wave bye-bye”. In addition, some children point out using the finger when parents name certain objects.
Parents can expect their child to say the first real words such as “mama”, “dada” etc. He/she understands between 20 and 50 terms on average. Also, baby is able to understand and execute simple actions such as “come to mama” or “do not”.

According to The YouGov research, children say their first word between 10 and 11 months on average. On the other hand, 4% of children had not said their first word by 3rd year of life.

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Age of first word

• 34% of girls said their first word before 9th months of age
• 27% of boys said their first word before 9th months of age

Most common first word

• “dadda” (15%) or “daddy” (13%)
• “mama” (10%)

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What are the alarm signs parents should be aware of?

• The baby doesn’t show desire to move, crawl or stand;
• The baby is not interested in communication, does not respond to commands of parents or does not make eye contact;
• The baby cannot sit at the age of 10 months;
• The baby does not babble in a “conversation” with others;
• Babbling doesn’t become more complex;
• The baby does not show interest in new facilities.

What are the risk factors that can impair development?

During this period, the baby begins to move more, crawl or walk by holding to the furniture. Therefore, parents must ensure the safety of the environment and of the baby- keep her/him away from stairs and other places where falls can occur, remove small items that can cause shocking and items that can lead to poisoning. Never leave your baby alone.

What should parents do to encourage the development of baby at this age?

The baby at this age loves to explore. Encourage your baby to move- set a toy on the floor and encourage your baby to crawl to reach the toy. At this age, babies understand both verbal and non-verbal communication, so when you say the word “NO”, you must be serious, and never laugh at this point, because the baby will be confused. Talk to your baby and read stories as much as you can, because this will help building vocabulary. Play “hiding” games.

During this period, the baby recognizes the images and characters from the books and can even understand the plot of a simple story, so it is useful to spend some time with your child and read to him/her. It is useful to give your child a bunch of different toys and encourage him/her to play with them, as this contributes to the development of fine motor skills and improves “hand-eye” coordination.

It is interesting to observe your baby while she/he plays with the telephone. It is useful to talk to the baby using sentences like “Who are you calling?” or “Hello…” and thus encouraging the baby to continue the conversation. When the baby has humor tantrums, parents must remain calm and try to soothe the baby too.

Summary and Recommendations

• Almost completing the first year of life, your child will show developmental progresses every day. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development: The child looks for a hidden object and tries to imitate adults.
• Motor Development: The child can stand with support and starts trying to stand alone, shows a pincer grasp skill to hold objects, can hold a spoon and crawls.
• Social/Emotional Development: Humor tantrums are frequent; however, your baby loves playing play peek-a-boo and pat-a-cake and also listening to stories.
• Language Development: Babbling resembles adult speech. Your child understands many words, including the meaning of “no”. Be serious when you say it. Your baby first words can be pronounced by 10 to 12 months.
• Your child moves more and more, so parents must ensure safety of the environment where the baby stays, preventing falls, shocking, poisoning and drowning.
• Each child has her/his own pace, but if you think your child is not developing adequately, seek for medical advice.

[mme_references]
References:

• Child development: Infants (0-1 year old). Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/child/documents/0-1YearOldsPositiveParenting.pdf. Accessed March 1, 2011.
• Shelov SP, et al. Caring for Your Baby and Young Child: Birth to Age 5. 5th ed. New York, N.Y.: Bantam Books; 2009:249.
• WHO Multicentre Growth Reference Study Group. WHO Motor Development Study: Windows of achievement for six gross motor development milestones. Acta Paediatrica Supplement 2006;450:86-95.

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Development milestones 8 to 10 months

[mme_highlight] By the end of the 10^th month, the baby has developed depth perception. The baby tries to put everything to mouth. Your baby should be able to crawl and stand with support. During this period, the baby develops stranger anxiety. An 8 to 10 month old baby typically babbles and speaks one or two words.   [/mme_highlight]

Developmental milestones are not absolute, but they nevertheless give an idea about the pace of growth and development of children. June M. Reinisch (1) conducted a study with 4653 infants to study the factors that may influence the developmental milestones and identified that development is faster in male infants as compared to female infants.
He also found that 3 out of 10 primary milestones are achieved earlier in male children as compared to female babies. He suggested that sex differences, physical and social and environmental factors greatly influence the age at which developmental milestones are achieved.

Cognitive development

By the end of the 10^th month, the baby has developed depth perception.

Hand- mouth coordination is established, and therefore the baby tries to put everything in his/her mouth and also may try to feed himself with hands.  In addition, baby uses one or more fingers to point objects around him/her.

Motor skills

By the end of this period, your baby should be able to crawl by using his/ her hands on the ground while knees support the weight of trunk. Crawling is initiated mostly in the backward direction but progressively baby learns to move forward while crawling. The baby is also able to stand with support and can hold objects with his/her index finger and thumb.
Now, a baby can sit without support and spends fair amount of time in a sitting position. According to a research report presented by Joyce S. Salls (2):

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• 50% of babies can sit without support at the age of 5.9 months ;
• 99 % can sit without support at the age of 10 months (unless they have a serious developmental condition).

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Regarding eating habits:

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• 11 % of children can use spoon without spilling too much;
• 10 % of children can drink from a cup;
• 70 % of 9 months old children can eat bread or biscuit.

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Social/Emotional skills

During this period, the baby develops stranger anxiety, which means your baby may not feel comfortable in the presence of unknown faces and she/ he may cry or get agitated if he/she is separated from his/ her parents. Between 8 and 10 months, a child responds or reacts to simple vocal commands and may have his/ her favorite toys.

Baby is interactive and shows interest in playing games like pat-a- cake and peek- a- boo. In addition, baby can play by himself by banging toys together to make noise. A baby also learns to wave bye-bye.

Language/communication skills:

An 8 to 10 month old baby typically babbles and speaks one or two words like “bababababe” or “mamamama”. Baby also tries to copy or imitate others by making different noises.

Parents should expect that their baby understands the meaning and context of “no” and may respond to his/ her name.

What are the alarm signs parents should be aware of?

By the end of 10th month, the intensity of weight gain and height slows down, suggesting the baby is maturing. Your baby’s bowel and eating habits also become regular. Make sure to seek the pediatrician if your baby presents with one or more of the following issues:

• If your baby does not put on weight;
• If your baby cannot stand with support;
• If your baby cannot sit properly (even with support);
• If your child does not say anything;
• If he/ she does not play any interactive games;
• If your child does not show any activity or response to name;
• If your baby does not seem to recognize familiar people.

What are the risk factors that can impair development?

• If the baby does not turn or look up when his/ her name is called;
• If the baby does not respond to the word “no”;
• If the baby does not listen when spoken to;
• If the baby does not know common words like “cup”, “shoe”, “mom”.

What can parents do to stimulate development?

Parents should make the physical environment around the baby as stimulating as possible. You can give him/her colored story books and take him/ her to different places to enhance his/ her memory. Parents should also try to enrich his/ her vocabulary by naming different objects.

Besides, parents can provide to child large toys that he/ she can drag or push in order to learn standing with support or walking.

Finally, parents must keep up with regular pediatric visits and take care of the immunizations of the baby. Healthcare providers suggest regular screening of infants at 6, 9 and 12 months of age. According to the reports of CDC, 1 out of 6 children has developmental disabilities.
According to CDC, a rise of 17.1% has been observed in the prevalence of developmental disabilities over the course of past 12 years; the overall prevalence of developmental disabilities being 13.8%.

Summary and Recommendations

• Between 8 and 10 months, your child will show developmental progresses every day. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development: Babies develop depth perception. Putting everything to mouth is normal and indicates eye-hand coordination has developed.
• Motor Development: Sitting without support, crawling and standing with support are major features of this period. The baby uses spoon and holds objects between index finger and thumb.
• Social/Emotional Development: Your baby loves to play pat-a-cake and peek-a-boo. Stranger anxiety is very common.
• Language Development: Babies babble and imitate sounds. They may say 1 or 2 words.
• Your child moves more and more, so parents must ensure safety of the environment where the baby stays, preventing falls, shocking, poisoning and drowning.
• Each child has her/his own pace, but if you think your child is not developing adequately, seek for medical advice.

Development milestones 6 to 8 months

[mme_highlight] By his/her 6^th month, your child can transfer objects from one hand to another and pick up the dropped objects. He/ She can almost stand with a little support from you. He/she can now recognize name and responds with a smile, eye contact or head turn. [mme_highlight]

In the short span of two months, between the ages of 6 to 8 months, a child achieves many important developmental milestones that parents should recognize to give support and a positive reinforcement and hence help their children development.

Motor development

By his/her 6^th month, your child can transfer objects from one hand to another and pick up the dropped objects. He/ She can almost stand with a little support from you. A sense of independence of child at this stage is obvious as he/ she can sit on a high chair. Good news at this stage is that your baby can sleep 6-8 hours at a stretch at night, so you can also expect a good night sleep after months of less or almost no-sleep. Some of the features of gross motor skills in this age group are shown below.

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• 90 % of babies can sit without support at the age of 7.5 months;
• 50 % of babies can stand with assistance at the age of 7.4 months;
• 28 % of babies can crawl at the age of 7.4 months;
• 10 % of babies can walk with assistance at the age of 7.4 months;
•  3 % of babies can stand alone at the age of 7.7 months.

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During this period your baby will also acquire some new eating skills.

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• 96 % of babies between 7 and 8 months of age can grasp food with hands;
• 42 % of babies between 7 and 8 months of age can drink from sippy cup;
• 5 % of babies betweenf 7 and 8 months of age can feed herself/himself with a spoon.

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Teething begins around 6^th month, so you can expect increased drooling. By 6^th month, you can also expect that the weight of your baby has doubled his birth weight.

Cognitive development

The most recognizable cognitive skill of this stage is anxiety before strangers. Your child can recognize you, often babbles one- syllable words (example: da-da, ba-ba) and imitates your actions. However they begin to fear strangers. Hence even going to the pediatrician for a check-up can be a hard task as the child will have stranger anxiety and may not cooperate.

Language development

Children at this stage play with sounds. They enjoy listening to their own voice and can locate the sounds. The vision at this stage is between 20/60 and 20/40. He/she can now recognize name and responds with a smile, eye contact or head turn. This stage is definitely very important as communication skills of your child will strengthen your bond.

What should parents do to encourage the development of their babies at this age?

Reading to your child since an early age helps him/her to build vocabulary. Read, sing and speak to your child as much as you can. Try imitating words such as “ma-ma, da-da”. This helps them to learn language and communicate. You can also start naming objects around the room. Children at this stage respond to voices, so get toys that have sounds and are brightly colored (avoid buying toys with small parts that can lead to choking hazard).
Play games like peek-a-boo, as it develops physical, social and language skills of the child. Your child is imaginative, hence provide him/her with paper and see how they tear them off. Though at one go, you may feel the act to be destructive, it actually is enhancing his/her physical and cognitive skill. Always remember to speak clearly with your child.

When buying toys, never select toys with small parts. They can accidently choke the epiglottis. Your 6 month-old child uses furniture to stand, hence avoid tables with edges that can harm your child. Furniture must be safe and steady.

What are the alarm signs I should be worried about?

• Baby cannot pick up small items using thumb and first finger;
• Baby cannot pass an object from one hand to the other;
• Baby cannot release objects voluntarily;
• Baby cannot sit on floor without support;
• Baby cannot move forward on tummy or rolls continuously to get an item.

What are the risk factors that can impair development?

In this period, children start eating solid foods, so parents should register the occurrence of allergies. Also, parents must gradually include solid food and especially foods which are rich in iron in order to prevent the development of anemia.

Summary and Recommendations

• Between 6 and 8 months of age, your child will show developmental progresses at a fast pace. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development:
• Motor Development: Your child transfers objects between hands and is capable of picking up dropped objects. Between 6 and 8 months children may stand with support. At this stage, new eating skills are acquired: children can use finger grasp to hold food, drink from a sippy cup or hold a spoon.
• Social/Emotional Development: fear of strangers is a typical feature of this age.
• Language Development: children recognize their name and localize sounds.
• Each child has her/his own pace, but if you think your child is not developing adequately, seek for medical advice.

[mme_references]
References:

• Feigelman S. The first year. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 8.
• Gill SV, May-Benson TA, Teasdale A, Munsell EG. Birth and developmental correlates of birth weight in a sample of children with potential sensory processing disorder.BMC Pediatr. 2013 Feb 25;13:29

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What should a baby be able to do between 4 and 6 months?

[mme_highlight] The majority of infants aged 4 to 6 months can lift and support their heads without help. Most infants can recognize their own name at this stage and understand the permanence of objects. The infants in this group can babble repeatedly. [mme_highlight]

Though children develop at different rates, each child’s development follows the same basic pattern. Development moves from simple to complex. Once a skill is mastered, the child moves on to the next skill eventually integrating all the different skills and using them spontaneously and appropriately.

In this age group, the baby is now more alert and and continues to grow and develop at its own unique pace. Development between 4 to 6 months includes overall development of motor, cognitive and social skills. Between 4 and 6 months, babies can lift their head up 90 degrees, laugh out loud, follow an object in an arc about 6 inches above the face for 180 degrees from one side to the other, roll over, pay attention to a raisin or other very small object, squeal in delight, reach for an object, smile spontaneously, keep head level with body when pulled to sitting and say goo-goo or similar vowel consonant combinations.

In the age group of 4 to 6 months, the baby is likely to develop motor skills, improve hand eye co-ordination, clearer vision, and develop social skills by babbling, squealing, gurgling and laughing.

Cognitive development

Most infants can recognize their own name at this stage. They also understand the permanence of objects and pay attention to a very small object such as a raisin and stay awake for 1 & ½ to 2 hours at a and may sleep through the night.

Motor development

It has been found that an infant’s ability to stabilize the head and balance the trunk is a prerequisite to sitting without support and using hand and arm movements in self feeding process. The majority of infants aged 4 to 6 months were reported to lift and support their heads without help. About 68% of children were studied to be able to grasp food with their hands.

Some of the features of gross motor skills in this age group are:

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• 98 % of babies can lift and support head;
• 78 % of babies can roll over on purpose;
• 65 % of babies can roll from front to back;
• 62 % of babies can roll from back to front;
• 50 % of babies can roll from back to front and front to back;
• 33 % of babies can sit alone without support;
• 10 % of babies can crawl when left lying on the stomach.

[/mme_databox]

Social and emotional development

The majority of infants between 4 to 6 months can turn towards a voice, react to and even imitate the intonation in other’s voices, particularly the voice of the mother. They may make wet razzing sound, shows signs of personality development, cries when family or caregiver leaves and demands attention.

Language development

The infants in this group can babble repeatedly when excited and can even say ah-goo or other vowel consonant sound.

What are the alarm signs parents should be aware of?

• If the baby’s muscles seem very stiff;
• If the baby’s muscles seem very floppy;
• If the head is controlled when body is pulled to a sitting position;
• If the baby reaches with one hand only;
• If the baby refuses to cuddle;
• If the baby does not seem to enjoy people around;
• If the baby shows no affection for the mother or care giver;
• If one or both eyes appear to be consistently turned in or out;
• If the baby does not respond to sounds;
• If the baby does not smile spontaneously by the end of 5 months;
• If the baby cannot sit with help at the end of 6 months;
• If the baby does not make squealing sounds or laugh by the end of 6 months;
• If the baby does not actively reach for objects by 6 months.

What should parents do to encourage the development of babies at this age?

Parents should provide opportunity to the baby for learning large motor skills, therefore baby’s position should be frequently changed and parents should force baby to stand or to sit in a frog position, fly through the air and lift up on all fours.

Blocks, soft dolls and stuffed animals, real or toy household objects, balls and finger games help in the development of the dexterity of baby’s little fingers and hands.

Parents should speak more slowly, more clearly with their baby, focus on single words and emphasize imitation. Sing songs to your baby and use books to read to him/ her.

Caregivers should encourage socialization; therefore, children must be exposed to a variety of people of different ages and be taught simple greetings and other basic social graces.

Play games that stimulate intellect, continue sharpening the auditory perception of the baby, encouraging imitation and ultimately encouraging language development. Introduce concepts such as “soft teddy”, “car goes fast”, “tea is hot” and so on. Encourage curiosity and creativity from this age. Give the baby a chance to experiment and explore. Encourage a love for learning.

You should provide quiet time to your baby – cuddling, kissing and embracing him/her gives him/her love and a sense of security.

Summary and Recommendations

• Between 4 and 6 months, your child will show developmental progresses every day. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development: Babies can recognize their own name and acquire the notion of object permanence.
• Motor Development: Babies can support their head without help, roll over and some can sit with support and grasp food with hands.
• Social/Emotional Development: The baby turns head to voice and shows initial personality development; cry is frequent whenever a loved one leaves.
• Language Development: Babbling and vowel sounds are the main features of this period.
• Your child moves more and more, so parents must ensure safety of the environment where the baby stays, preventing falls, shocking, poisoning and drowning.
• Each child has her/his own pace, but if you think your child is not developing adequately, seek for medical advice.

[mme_references]
References

• Academy, N. C. (n.d.). Child Developmental Milestones. Northern California.<7li> Milestones: 1 to 6 months. Retrieved from Babycenter: http://www.babycenter.com/0_milestones-1-to-6-months_1496585.bc
• Carruth, B. R., Ziegler, P. J., Gordon, A., & Hendricks, K. (2004). Developmental Milestones and Self-Feeding Behaviors in Infants and Toddlers. Journal of American Dietic Association, S51-S56.
• Eisenberg, A., Murkoff, H. E., & Hathaway, S. E. (1996). What To Expect The First Year. NewYork: Workman Publishing.
• Mayo, S. C. (2011, JUne 17). Infant and toddler health. Retrieved from Mayo Clinic: http://www.mayoclinic.com/health/infant-development/FL00099

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Development milestones 2 to 4 months

[mme_highlight] At this age, your baby puts toys and almost everything in the mouth, which indicates the presence of “hand-mouth” coordination. At two months, the baby begins to fixate objects and tracks moving objects with eyes. When the baby is positioned on tummy, she/he can lift the head and chest for 90 degrees while supporting on elbows.  [mme_highlight]

Between the second and fourth months of life, a baby continues the rapid development of both motor and cognitive function and also at emotional and social levels. The baby begins to discover its senses during this period.

Motor control over the arms is faster developed than the motor control over the legs, because the development of the nervous system occurs in this specific way – firstly, motor control is established over the muscles of the head and neck, then it follows motor development of arms and back and finally the legs.
Also, control of muscle is established from center to the periphery (e.g. firstly, motor control over the shoulder muscles, then upper arm muscle, then lower arm muscles and finally the muscles of baby’s hand).

Cognitive Development

During this period infants discover their own hands.

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• 37 % of babies become aware of their own hands between 8th to 10th week of life;
• 97 % of babies discover their own hands until the end of fourth months.

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At this stage, the baby starts to babble and use a variety of ways to show when he/she is hungry, thirsty or unsatisfied. Baby can mimic the facial expressions of the people they are looking at. Also, babies can recognize the voice of mother and can find ways of claiming for her attention.

Motor Development

At two months, the baby begins to fixate objects and tracks moving objects with eyes. When a baby is positioned on the back, he/she tracks with eyes a colorful toy, as well as the face of the person who moves it. The hands are more frequently open.

During the third month, the baby manages to partially lift the chest from the base relying on the forearm. The legs are now almost fully extended and knees are slightly bent toward the tummy. When baby is positioned on the back, she/ he turns head from side to side, cheerfully react when she/he sees a toy with vivid colors and extends hand in order to reach it. Three months old baby can keep up the head almost for a full minute.

At the age of three months, when the baby is lying on the stomach, she/he can detect the object that is in front of him/her and tries to grab it. Some babies are able to sit with using arms as a support.

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Sitting with support

• 50 % of babies between 2.5 to 3 months of age;
• 90% of babies at 4.5 months
• <1 % of babies are able to sit without support by the age of 4 months.

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During the fourth month, when the baby is positioned on tummy, she/he can lift the head and chest for 90 degrees while supporting on elbows. While positioned on the back, baby tracks the objects in front of him/her and tries to reach them (do not be afraid if it fails, because hand-eye coordination is not yet completely established). At this age, your baby puts toys and almost everything in the mouth, which indicates the presence of “hand-mouth” coordination.

From the age of 4 months, “eye-hand” coordination is established – baby can see the toy, try to reach and grab it. Some babies can roll over.

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Rolling over

• 50% of babies by 3 months can roll from stomach to back without rotation (the movement begins from the head)
• 10 % of babies are able to roll from back to stomach with rotation (more complex movement compared to rolling over without rotation).

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Social/Emotional Development

A baby begins to notice members of family that she/he sees every day. About 90 % of babies laugh by 3 months. Also, when parent tickles baby, loud laughter can be expected. At the age of 4 months, the baby begins to give spontaneous smile to loved ones. It loves to play with people and can start crying if the game stops.

Language/communication

At the age of two months, a baby starts to “communicate” with sounds such as “a”, “u” and “e”. Regarding the development of “sound signals”, at this age baby begins to produce “rrr” voices. At the age of four months, the baby begins to produce sounds.

What are the risk factors that can impair development?

During this period, parents should not give baby small objects. Baby pushes everything in the mouth (“hand-mouth” coordination is developed) and it can cause choking. The baby should be lying on a hard surface, for example on soft pillow. There is a risk of suffocation when the head is buried in a pillow, because the baby cannot to turn her/himself. Note that among children younger than 1 year whose cause of death was unintentional injuries, 81.5% died from suffocation.

Do not leave your baby alone or unattended, especially in places where she/he can fall when she/he is rolling over the bed. Do not ignore your baby’s cries, because it can lead to fear of separation. If you notice that your baby is too rigid, you should contact a pediatrician because it could indicate a developmental anomaly.

What are the alarm signs I should be worried about?

• The baby does not seem to be aware of hands by 2 months;
• The baby does not react to loud noises ;
• The baby does not fixate objects or does not track moving objects with eyes by 2 to 3 months;
• The baby can’t support the head;
• The baby doesn’t smile;
• The baby doesn’t notice new face or act upset when notices new face;
• The baby doesn’t grasp objects by 3 to 4 months;
• The baby doesn’t babble by 3 to 4 months;
• The baby doesn’t try to put objects in mouth by 4 months;
• The baby doesn’t try to imitate parents’ sounds by 4 months;
• The baby does not push down the leg when she/he feels stable surface under the feet by 4 months;
• The baby loses skills he/she had already acquired.

What should parents do to encourage the development of baby at this age?

The baby needs a soothing calm environment. Quiet music or gentle mother’s voice can contribute to the adequate development of a baby. While your baby is awake, you should put her/him lying down on her/his stomach, because this encourages the strengthening of back muscles.
Parents should encourage their baby to look at the toys, to track moving toys with eyes and try to catch it- all of these can be implemented through simple games when the baby is in the mood.

You should spend a lot of time with your baby out in the nature, because this is of major importance for your child to discover the world. Parents should talk and sing to the baby. While your child is on her/his stomach trying to reach a toy or other object, parents should provide stability, for instance, by putting their hand over the baby’s pelvis and press it lightly to the ground.

Also, parents should give a child an interesting toy with vivid colors and toys that make sounds. The rolling skill can be encouraged with this simple game: place a toy next to the right or left side of baby; the baby usually rolls from tummy to back or vice versa.
If your baby looks interested in this game, repeat this over and over again. In addition, parents can help improve the “eye-hand” and “hand- mouth” coordination through simple games.

Summary and Recommendations

• Between 2 and 4 months, your baby will show developmental progresses every day. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development: the baby recognizes voices, claims for attention
• Motor Development: your baby can now fixate objects and follow a moving object with her/his eyes. Eye-mouth and eye-hand coordination begin to be noticeable at this stage. Chest lift and holding head for at least a minute are also prominent achievements for the period between 2 and 4 months. Your child will also show rolling over skills.
• Social/Emotional Development: Your baby recognizes familiar faces and laughs at them.
• Language Development: You will hear sounds such as “a”, “u” and “e” from your baby.
• Each child has her/his own pace, but if you think your child is not developing adequately or if alarm signs are noticed, parents should contact a pediatrician as soon as possible.

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References

• Important Milestones: Your Baby at Four Months. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/actearly/milestones/milestones-4mo.html. Accessed May 13, 2013
• Important Milestones: Your Baby at Two Months. Centers for Disease Control and Prevention. http://www.cdc.gov/ncbddd/actearly/milestones/milestones-2mo.html. Accessed May 13, 2013
• Feigelman S. The first year. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics. 18th Ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 8
• Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web‐based Injury Statistics Query and Reporting System(WISQARS). National Center for Injury Prevention and Control Website. Unintentional fatal and nonfatal injuries, children ages 19 and under. Available from: http://www.cdc.gov/injury/wisqars/index.html. Accessed May 15, 2013.

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Development milestones birth to 2 months

[mme_highlight] During this period, baby shows interest in her/his surrounding (follows moving objects, recognizes faces). By the end of the 2^nd month, most babies develop social smile. Babies begin to control head steadiness, although neck holding is not usually achieved by this age.  [mme_highlight]

During the first weeks of life, the child is still adjusting to the world outside mother’s womb. Growth and development in young children should be monitored very closely in order not to miss problems or developmental delay. Educating parents is one of the safest methods to make sure that child’s growth and development is progressing at a consistent pace.

Cognitive development

The brain of an infant has 25% the size of an adult’s brain. Feel your child’s fontanels, depressible spaces between the growing skull bones, demarcating the site of junction of skull bones (one fontanel located at the front of the skull and the other at the posterior extremity of skull). Only 3 % of normal newborns have a posterior fontanel larger more than 2 cm. At the end of the second month the closure of posterior fontanel is achieved in the majority of babies.

During this period, baby shows interest in her/his surrounding (follows moving objects, recognizes faces) and also shows his/her irritation, agitation and anger by crying and moving limbs. The mean percentage of daytime sleep is:

• 4% in the first day of life
• 8% at 1 month.

Face recognition and memories develop further in the infantile period. Geraldine Dawson (3) suggested that autistic babies have difficulty in recognizing faces and this milestone alone can help in early identification of autism by utilizing electroencephalographic recordings to study high-density brain event-related potentials (ERPs) in high- risk children as young as 3 to 4 years.

Motor development

By the end of 2^nd month, the grasping reflex disappears and stepping reflex appears (when baby is placed upright on even surface, she/he dances or dangles). The baby can move his limbs while lying on his stomach.

During this period, babies begin to control head steadiness, although neck holding is not usually achieved by this age, nevertheless the head of baby is less wobbly. Overall, motor control is improved.

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• 50% of babies can lift their head at the age of 6 weeks and can make smothering movements while lying on stomach;
• 75% of babies can hold their head at 45 degrees at the age of 1.8 months;
• 50% of babies can roll from side to back by the end of the 2^nd month;
• 50 % of babies can lift themselves using arms when they are lying.

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Social/Emotional development

By the end of the 2^nd month, most babies develop social smile (smile when see a stranger). In addition, the baby starts to laugh at loved ones. This is in fact first real smile, because the smiles the baby may have expressed at an earlier age are mainly a reflex. In addition, they learn to maintain eye-contact with parents. Baby can suck his own thumb or can bring his hands closer to mouth.

Language development

By the end of 2 months, the baby start responding to sound or source of sound by turning his head in the direction of sound and most babies communicate by making gurgling sounds.

What are the risk factors that can impair development?

Special caution should be maintained while dealing with babies:

• Who were born pre-term (before 37 weeks of gestation);
• Who experienced moderate to severe birth trauma (birth asphyxia, prolonged labor, protracted labor, distress in labor, instrumental delivery, low APGAR score at birth);
• Babies whose parents have drug dependence issues ;
• If one or more of the siblings have a history of mental retardation or developmental deficits.

Research conducted by Steven A. Rosenberg (2) suggested that babies who were born with a birth weight below 1500 g or 2 Standard Deviation (SD) below mean weight are at increased risk for developmental delays.

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• 3 % is the overall prevalence of very low birth weight babies in United States

Among babies with very low birth weight:

• 12 % were diagnosed with developmental delays by 9 months;
• 8 were diagnosed with developmental delays by 24 months;

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The author suggested that different opportunities can be provided to prevent significant impairment in overall health and development if babies are diagnosed at an earlier age.

What are the alarm signs I should be worried about?

• Child is unresponsive to loud sounds;
• Child is unresponsive to move objects;
• Child has not developed social smile by the end of 2 months;
• Baby cannot touch her/his face or mouth with hands;
• Baby is unable to hold her/his head while lying on tummy.

It may be difficult to gauge the development and progress of your baby in the first few months of life; however, there are a few telltale signs that suggest a possible issue or problem. Parents should seek immediate medical help to assess, identify and diagnose any suspected developmental issue in order to provide early intervention.

What should parents do to encourage the development of baby at this age?

It is recommended to closely monitor the development of your child for the first few months and record the findings in order to discuss it with the pediatrician on periodic visits. There is variation in the developmental rhythm among children in the same age group (and even in children of the same family), but nevertheless failure to achieve one or more milestones is always a sign of concern. Early identification and intervention helps in managing minor and severe developmental issues.

Parents can additionally help by stimulating the motor and sensory skills. So, parents should expose the baby to different types of noise and sound from the environment, thus providing a stimulant environment (with bright color toys and surroundings). Finally, parents should talk to the baby and read books at loud in order to encourage early language development.

Summary and Recommendations

• Your baby will show developmental progresses right after birth. Knowing what to expect makes it easier for you to recognize the progresses and help the child to achieve them.
• Cognitive Development: The baby shows interest in the surroundings and recognizes faces.
• Motor Development: The baby moves limbs and begins to control head support, although this skill is not achieved at this stage.
• Social/Emotional Development: Your child smiles even to strangers (social smile) and laughs at familiar faces. She/he also learns to establish eye contact with familiar persons.
• Language Development: The baby turns the head to a sound or voice.
• Each child has her/his own pace, but if you think your child is not developing adequately, seek for medical advice.

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References:

• http://www.mass.gov/edu/docs/eec/prof-development/prog-reports/developmil-1108.pdf
• Rosenberg, S. A., Zhang, D., & Robinson, C. C. (2008). Prevalence of developmental delays and participation in early intervention services for young children. Pediatrics, 121(6), e1503-e1509.
• Dawson, G., Carver, L., Meltzoff, A. N., Panagiotides, H., McPartland, J., & Webb, S. J. (2002). Neural correlates of face and object recognition in young children with autism spectrum disorder, developmental delay, and typical development. Child development, 73(3), 700-717.
• Salls, J. S., Silverman, L. N., & Gatty, C. M. (2002). The relationship of infant sleep and play positioning to motor milestone achievement. The American Journal of Occupational Therapy, 56(5), 577-580.

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