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Baby Care and Development/Baby Development

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Stages

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Table illustrating child development stages

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Developmental Milestones[1]
Age Motor Speech Vision and hearing Social development
4-6 weeks Smiles at mother
6-8 weeks Vocalises
3 months Prone:head held up for prolonged periods. No grasp reflex Talks a great deal Follows dangling toy from side to side. Turns head round to sound Squeals with pleasure appropriately. Discriminates smile
5 months Holds head steady. Goes for objects and gets them. Objects taken to mouth Enjoys vocal play Smiles at mirror image
6 months Transfers objects from one hand to the other. Pulls self up to sit and sits erect with supports. Rolls over prone to supine. Palmer grasp of cube Double syllable sounds such as 'mumum' and 'dada' Localises sound 45cm lateral to either ear May show 'stranger shyness'
9-10 months Wiggles and crawls. Sits unsupported. Picks up objects with pincer grasp Babbles tunefully Looks for toys dropped Apprehensive about strangers
1 year Stands holding furniture. Stands alone for a second or two, then collapses with a bump Babbles 2 or 3 words repeatedly Drops toys, and watches where they go dressing, waves goodbye, understands simple commands
18 months stairs holding onto Handrail|rail. Begins to jump with both feet. Can build a tower of 3 or 4 cubes and throw a ball 'Jargon'. Many intelligible words cup with both hands. Feeds self with a spoon

Cognitive and creative

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Creative development could very well be seen as how the child learns in its environment through experimenting in different ways of doing everything. 6-9 months

  • Looks for fallen objects by 7 months
  • Plays ‘peek-a-boo’ games
  • Cannot understand “no” or “Danger”

8-12 months

  • Watches people, objects, and activities in the immediate environment.
  • Shows awareness of distant objects (15 to 20 feet away) by pointing at them.
  • Responds to hearing tests (voice localization); however, loses interest quickly and, therefore, may be difficult to test informally.
  • Follows simple instructions.
  • Reaches for toys that are out of reach but visible
  • Recognizes objects in reverse
  • Drops thing intentionally and repeats and watches object
  • Imitates activities like playing drum loudly

1-4 months

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Image:Babysmile.jpg|thumb|A baby's first smile usually occurs four to six weeks after birth.

Physical

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  • Average length is 50.8-68.6 cm grows approximately 2.54 cm per month.
  • Weighs an average of 3.6-7.3 kg
  • Gains approximately 0.11-0.22 kg per week.
  • Respiration rate is approximately thirty to forty breaths per minute.
  • Normal body temperature ranges from 35.7-37.5°C.
  • Head and chest circumference are nearly equal.
  • Head circumference increases approximately 1.9 cm per month until two months, then increases 1.6 cm per month until four months. Increases are an important indication of continued brain growth.
  • Continues to breathe using abdominal muscles.
  • Posterior fontanel closes by the second month.
  • Anterior fontanel closes to approximately 1/2 inch (1.3 cm).
  • Skin remains sensitive and easily irritated.
  • Legs may appear slightly bowed.
  • Cries with tears.
  • Eyes begin moving together in unison (binocular vision).

Motor development

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  • Rooting and sucking reflexes are well developed.
  • Swallowing reflex and tongue movements are still immature; continued drooling and inability to move food to the back of the mouth.
  • Grasp reflex gradually disappears.
  • Landau reflex appears near the middle of this period; when baby is held in a prone (face down) position, the head is held upright and legs are fully extended.
  • Grasps with entire hand; strength insufficient to hold items. Holds hands in an open or semi-open position.
  • Muscle strength and control improving; early movements are large and jerky; gradually become smoother and more purposeful.
  • Raises head and upper body on arms when in a prone position.
  • Turns head side to side when in a supine (face up) position; near the end of this period can hold head up and in line with the body.
  • Upper body parts are more active: clasps hands above face, waves arms about, reaches for objects.

4-8 months

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Physical

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  • Puts on 0.5 kg per month in weight, doubling birth weight
  • Grows about 1.3 cm in length per month; average length is 69.8-73.7 cm.
  • Head and chest circumferences are basically equal.
  • Head circumference increases approximately 3/8 inch (0.95 cm) per month untl six to seven months, then 3/16 inch (0.47 cm) per month; head circumference should continue to increase steadily, indicating healthy, ongoing brain growth.
  • Breathing is abdominal; ranges from twenty-five to fifty breaths per minute, depending on activity; rate and patterns vary from infant to infant.
  • Teeth begin to appear, with upper and lower incisors coming in first. Gums may become red and swollen, accompanied by increased drooling, chewing, biting, and mouthing of objects.
  • Legs may appear bowed; bowing gradually disappears as infant grows older.
  • True eye color is established.

Motor development

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  • Reflexive behaviors are changing:
  • Blinking reflex is well established
  • Sucking reflex becomes voluntary
  • Moro reflex disappears
  • When lowered suddenly, infant throws out arms as a protective measure.
  • Swallowing reflex appears allows infant to move solid foods from front of mouth to the back for swallowing.
  • Picks up objects using finger and thumb (pincer grip).
  • Reaches for objects with both arms simultaneously; later reaches with one hand or the other.
  • Transfers objects from one hand to the other; grasps object using entire hand (palmar grasp).
  • Handles, shakes, and pounds objects; puts everything in mouth.
  • Able to hold bottle.
  • Sits alone without support, holding head erect, back straightened, and arms propped forward for support
  • Pulls self into a crawling position by raising up on arms and drawing knees up beneath the body; rocks back and forth, but generally does not move forward.
  • Lifts head when placed on back.
  • Can roll over from back or stomach position.
  • May accidentally begin scooting backwards when placed on stomach; soon will begin to crawl forward.

8-12 Months

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Physical

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  • Infants reach approximately 1-1/2 times their birth length by first birthday
  • Weight increases by approximately 0.5 kg per month; birth weight nearly triples by one year of age: infants weigh an average of 9.6 kg.
  • Respiration rates vary with activity: typically, twenty to forty-five breaths per minute.
  • Body temperature ranges from 96.4°F to 99.6°F (35.7-37.5°C); environmental conditions, weather, activity, and clothing still affect variations in temperature.
  • Head and chest circumference remain equal.
  • Continues to use abdominal muscles for breathing.
  • Anterior fontanel begins to close.
  • Approximately four upper and four lower incisors and two lower molars erupt.
  • Arm and hands are more developed than feet and legs (cephalocaudal development); hands appear large in proportion to other body parts.
  • Legs may continue to appear bowed.
  • Feet appear flat as arch has not yet fully developed.
  • Visual acuity is approximately 20/100.
  • Both eyes work in unison (true binocular coordination).
  • Can see distant objects (15 to 20 feet away) and points at them.

Motor development

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  • Reaches with one hand leading to grasp an offered object or toy.
  • Manipulates objects, transferring them from one hand to the other.
  • Explores new objects by poking with one finger.
  • Uses deliberate pincer grasp to pick up small objects, toys, and finger foods.
  • Stacks objects; also places objects inside one another.
  • Releases objects or toys by dropping or throwing; cannot intentionally put an object down.
  • Beginning to pull self to a standing position.
  • Beginning to stand alone, leaning on furniture for support; moves around obstacles by side-stepping.
  • Has good balance when sitting; can shift positions without falling.
  • Creeps on hands and knees; crawls up and down stairs.
  • Walks with adult support, holding onto adult's hand; may begin to walk alone.

Psychological development

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Trust versus Mistrust (Erik Erikson)

Toddlers (12-24 months)

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Physical

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  • Rate of growth slows
  • Height increases approximately 5cm- 7.6cm with an average height of 81cm – 89cm
  • Weighs 9.6-12.3 kg; gains 0.13-0.25 kg per month; weight is now approximately 3 times the child's birth weight.
  • Respiration rate is typically twenty-two to thirty breaths per minute; varies with emotional state and activity.
  • Heart rate (pulse) is approximately 80 to 110 per minute.
  • Head size increases slowly; grows approximately 1/2 inch (1.3 cm) every six months; anterior fontanel is nearly closed at eighteen months as bones of the skull thicken.
  • Chest circumference is larger than head circumference.
  • Rapid eruption of teeth; six to ten new teeth will appear.
  • Legs may still appear bowed.
  • Body shape changes; takes on more adult-like appearance; still appears topheavy; abdomen protrudes, back is swayed.
  • Visual acuity is approximately 20/60.

Motor development

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  • Crawling|Crawls skillfully and quickly.
  • Stands alone with feet spread apart, legs stiffened, and arms extended for support.
  • Gets to feet unaided.
  • Most children walk unassisted near the end of this period; falls often; not always able to maneuver around obstacles, such as furniture or toys.
  • Uses furniture to lower self to floor; collapses backwards into a sitting position or falls forward on hands and then sits.
  • Enjoys pushing or pulling toys while walking.
  • Repeatedly picks up objects and throws them; direction becomes more deliberate.
  • Attempts to run; has difficulty stopping and usually just drops to the floor.
  • Crawls up stairs on all fours; goes down stairs in same position.
  • Sits in a small chair.
  • Carries toys from place to place.
  • Enjoys crayons and markers for scribbling; uses whole-arm movement.
  • Helps feed self; enjoys holding spoon (often upside down) and drinking from a glass or cup; not always accurate in getting utensils into mouth; frequent spills should be expected.
  • Helps turn pages in book.
  • Stacks two to four objects.

Cognitive development

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  • Enjoys object-hiding activities
  • Early in this period, the child always searches in the same location for a hidden object (if the child has watched the hiding of an object). Later, the child will search in several locations.
  • Passes toy to other hand when offered a second object (referred to as "crossing the midline"-an important neurological development).
  • Manages three to four objects by setting an object aside (on lap or floor) when presented with a new toy.
  • Puts toys in mouth less often.
  • Enjoys looking at picture books.
  • Demonstrates understanding of functional relationships (objects that belong together): Puts spoon in bowl and then uses spoon as if eating; places teacup on saucer and sips from cup; tries to make doll stand up.
  • Shows or offers toy to another person to look at.
  • Names many everyday objects.
  • Shows increasing understanding of spatial and form discrimination: puts all pegs in a pegboard; places three geometric shapes in large formboard or puzzle.
  • Places several small items (blocks, clothespins, cereal pieces) in a container or bottle and then dumps them out.
  • Tries to make mechanical objects work after watching someone else do so.
  • Responds with some facial movement, but cannot truly imitate facial expression.

Language

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  • Produces considerable "jargon": puts words and sounds together into speech-like (inflected) patterns.
  • Holophrastic speech: uses one word to convey an entire thought; meaning depends on the inflection ("me" may be used to request more cookies or a desire to feed self). Later; produces two-word phrases to express a complete thought (telegraphic speech): "More cookie," "Daddy bye-bye."
  • Follows simple directions, "Give Daddy the cup."
  • When asked, will point to familiar persons, animals, and toys.
  • Identifies three body parts if someone names them: "Show me your nose (toe, ear)."
  • Indicates a few desired objects and activities by name: "Bye-bye," "cookie"; verbal request is often accompanied by an insistent gesture.
  • Responds to simple questions with "yes" or "no" and appropriate head movement.
  • Speech is 25 to 50 percent intelligible during this period.
  • Locates familiar objects on request (if child knows location of objects).
  • Acquires and uses five to fifty words; typically these are words that refer to animals, food, and toys.
  • Uses gestures, such as pointing or pulling, to direct adult attention.
  • Enjoys rhymes and songs; tries to join in.
  • Seems aware of reciprocal (back and forth) aspects of conversational exchanges; some turn-taking in other kinds of vocal exchanges, such as making and imitating sounds.

Social

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  • Usually friendly toward others; less wary of strangers.
  • Helps pick up and put away toys.
  • Plays by themselves for short periods
  • Enjoys being held and read to.
  • Often imitates adult actions in play.
  • Enjoys adult attention; likes to know that an adult is near; gives hugs and kisses.
  • Recognizes self in mirror.
  • Enjoys the companionship of other children, but does not play cooperatively.
  • Beginning to assert independence; often refuses to cooperate with daily routines that once were enjoyable; resists getting dressed, putting on shoes, eating, taking a bath; wants to try doing things without help.
  • May have a tantrum when things go wrong or if overly tired or frustrated.
  • Exceedingly curious about people and surroundings; toddlers need to be watched carefully to prevent them from getting into unsafe situations.

Psychological

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Autonomy vs. Shame and Doubt (will)

  1. Seminars in child and adolescent psychiatry (second edition) Ed. Simon G. Gowers. Royal College of Psychiatrists (2005) ISBN 1-904671-13-6