Understanding developmental milestones in a child helps parents recognize delays and seek timely attention from their paediatrician.
By Dr Anuja Pethe
The first year of life is the most important year for all babies as this is the period of maximum brain growth. Monitoring growth and development of a child is very crucial during the first year since delays during this time can result in significant impact on future quality of life of the child. Understanding developmental milestones in a child helps parents recognize delays and seek timely attention from their paediatrician. Early diagnosis of developmental delay can in turn help in instituting therapy and preventing long-term issues.
Skills that babies achieve such as smiling for the first time, crawling and waving “bye bye” are called developmental milestones. These milestones are grossly considered for various domains of development such as physical (motor), fine motor, social/emotional, and speech and language.
On an average, attainment of these milestones gives a brief overview of normal child development.
A new-born baby spends most of its time feeding and sleeping. Babies quickly learn to notice the mother’s face, voice and touch. They can’t focus beyond a small distance of a foot; just good enough to gaze at the mother’s face when spoken to.
In the first month of life, a baby starts to fix his eyes with the mother’s. The baby’s hands are usually fisted at birth; they start opening in the next 2 months. When these babies are pulled up with their shoulders supported, they can’t hold their head. During this period, a baby starts developing a sense of bonding when cuddled and held close.
Usually, by three to four months of age, a baby can control her head. When babies around 3 months of age are made to lie down on their tummy, some of them stretch their forearms and lift their heads up. During this period of life, babies start enjoying playtime and reciprocate their mother’s smile. A mother should maintain eye contact while talking with the baby. Hanging sound-producing toys across the crib are suitable for this age.
By 4 months of age, the baby starts exploring the world around her, initially by inspecting and touching her own hands and then bringing them to the mouth. This is also an important time for a baby’s safety as he learns to roll over from back to stomach. Parents need to make sure babies are not left unattended on an open couch or sofa to prevent falls. Shaking a bell or a squeaky toy over the baby’s head at this age can help him to turn his head and find the sound.
At around 6 months, a baby starts sitting with some support, however, without support she could be wobbly. Some babies can roll over from tummy to back again. Babies start crawling by the time they are seven to eight months old, whereas a few just shuffle their bottoms instead. During this time, a baby can transfer objects from one hand to the other. Sociability develops further at this age. This is a good time to start calling the baby by her name. The baby starts enjoying peekaboo and finding partially hidden objects. She also likes watching herself in mirror.
By 9 months of age, a majority of babies can pull themselves to stand; however, without support, it could just be momentary. They can move sideways by taking the support of furniture; this is known as cruising. During this time, their fine motor skills like grasp of objects improve. A baby can probe objects with his forefinger and sometimes pick it up using forefinger and thumb. This grasp becomes mature in the next month or two. She enjoys throwing objects on to the ground. This is known as casting. Showing pictures to your baby and talking to her can promote language development. During this time, babies develop stranger anxiety; they are reserved in the presence of strangers or even start crying at the sight of strangers.
By the end of the first year, most babies can sit without support, crawl and rise from lying position to sitting position. A baby can walk by now if her hands are held. In addition, a baby can hold a spoon and try to drink from a cup with help. She can even retrieve a hidden toy. The baby expresses her joy by clapping hands and giggling.
Remember, babies grow in a unique way: a baby who starts turning over weeks before her peers could be the last to learn walking. Since all babies are not born identical, there is variation in the stages of development. Still, they follow a particular pattern of development. The development also differs in various domains, for example, a baby who achieves physical milestones such as crawling and walking well ahead of babies of similar age, could take longer to talk.
1) The child will hand a book to her parent when she wants to hear a story.
2) She will start using things correctly as per accepted practices such as drinking from a cup or combing her hair.
Contact a paediatrician in case of missed developmental milestones
If a child does not display certain behavioural traits which signify the attainment of developmental milestones at his age or his development is lacking in basic growth parameters, the parents need to voice their concerns with a paediatrician.
The author is a Newborn and Child Specialist and Consultant Pediatrician at Nanavati Super Speciality Hospital.
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Dr Anuja Pethe