Infant Milestones

Introduction

• Babies grow at an amazingly fast rate during their first year of life. In addition to babies’ physical growth in height and weight, babies also go through major achievement stages, referred to as developmental milestones. Developmental milestones are easily identifiable skills that the baby can perform, such as rolling over, sitting up, and walking. These milestones are usually classified into 3 categories: motor development, language development, and social/emotional development.
• Babies tend to follow the same progression through these milestones; however, no two babies go through these milestones at exactly the same time. Babies also spend different amounts of time at each stage before moving on to the next stage.

The First Month

During the first month of life most of babies’ behavior is reflexive, meaning their reactions are automatic. Later, as the nervous system develops, babies will put more thought into their actions. Some of the newborn reflexes are described below.

• Mouthing reflexes: The sucking and swallowing reflexes. A baby will automatically begin to suck when his mouth or lips are touched.
• The rooting reflex is when the baby turns his head toward your hand if his cheek is touched. This helps baby find the nipple for feeding. The rooting reflex begins to fade around 4 months.
• Startle (Moro) reflex: The startle reflex occurs when a baby hears a loud noise or when he falls backwards, his arms and legs extend away from his body. This reflex is most noticeable during the first month and usually fades by 2 or 3 months.
• Grasp reflex: A baby will grasp a finger or object when it is placed in the palm of his hand. This reflex is strongest during the first 2 months and usually fades by 5-6 months.
• Stepping reflex: Even though baby cannot support his own weight, if his feet are placed on a flat surface, he will begin to step one foot in front of the other. The stepping reflex usually disappears by 2 months.

By the end of the first month of life, most babies may display the following:

• Raise head when on stomach
• Keep hands in tight fists
• Focus 8-12 inches away, looks at objects and faces and prefers the human face over other patterns
• Show a behavioral response when hearing a noise (such as eye blinking, acting startled, change in movements or breathing rate)

Age 1-3 Months

• Become more aware and interested in their surroundings.
• They might follow moving objects, recognize familiar objects and people at a distance, and start using their hands and eyes in coordination.
• Usually turn toward familiar voices and smile at their parent’s faces or other familiar faces.
• Begin to coo (make musical vowel sounds, such as ooo or aaa).
• The neck muscles become stronger during these first few months. At first, babies can only hold their heads up for a couple of seconds while on their stomach.
• By age 3 months, babies lying on their stomachs can support their heads and chests up to their forearms.
• Arm and hand movement develops fast during this stage. What was once a tight, clenched fist is now an open hand grabbing and batting at objects.
• Babies explore their hands by bringing them in front of their face and putting them in their mouths.
• By the end of this period, most babies have reached the following milestones:

Motor skills

• Support head and upper body when on stomach
• Stretch out legs and kick when on stomach or back
• Open and shut hands
• Bring hands to mouth
• Grab and shake hand toys
• Swipe and bat at dangling objects
• Push down legs when on a flat surface
• Follow moving objects

Language skills

• Make cooling sounds

Social/Emotional Skills

• Smile at familiar faces
• Enjoy playing with other people

Age 4-7 Months

From age 4-7 months, babies learn to coordinate their new perceptive abilities (including vision, touch, and hearing) and motor skills such as grasping, rolling over, sitting up, and may be even crawling.

• Babies will explore toys by touching them and putting them in their mouth instead of just looking at them.
• They can also communicate better and will do more than simply cry when they are hungry or tired or when they want a change in activity or a different toy.
• By this time, babies have developed a strong attachment for their parents and they may show a preference for their primary caretakers. However, babies at this age usually smile and play with everyone they meet.
• Once babies can lift up their heads, they’ll push up using their arms and arch their back to lift up the chest.
• They may also rock while on their stomachs, kick their legs, and swim with their arms.
• By the end of this period, babies should be able to roll over from stomach to back and back to stomach and probably are able to sit without any support.
• By age 4 months, babies can easily bring toys to their mouth. They use their fingers and thumb in a clawlike grip to pick up objects.
• By age 6-8 months, they can transfer objects from hand to hand, turn them from side to side, and twist them upside down. Babies also discover their feet and toes during this stage.
• Babies’ range of vision is apparent as they concentrate and focus on objects and follow movements.
• Babies like increasingly complex patterns and shapes. They also like looking at themselves in a mirror.
• Babies continue to babble, but now they raise and lower their voice as if asking a question or making a statement.
• By the end of this period, most babies have reached the following milestones:

Motor Skills

• Roll over both ways (stomach to back, back to stomach)
• Sit up with, and then without, support of his hands
• Reach for object with one hand using the raking grasp
• Transfer objects from hand to hand
• Support whole weight when on legs and held upright
• Explore objects with hands and mouth
• Explore objects by banging and shaking

Language Skills

• Laugh
• Babble consonants (like ba-ba-ba-ba-ba)

Social/Emotional Skills

• Distinguish emotions by tone of voice
• Find partially hidden objects

Age 8-12 Months

By age 8 months, most babies can sit up without support.

• Roll down to their stomachs and return to a sitting position again. Some babies are in constant motion; they’ll arch their necks and look around while on their stomachs and grab at their feet or objects while on their backs.
• Crawling is important for the development of integrated communication between the 2 sides of the brain. Some babies never crawl but rather scoot on their bottoms or move on their stomachs, like an army crawl.
• Babies become increasingly more mobile during this stage; now is the time to childproof so baby can explore and discover without the possibility of injury. Baby gates are important to block off stairs or rooms that could be dangerous (such as bathrooms).
• After crawling is mastered, babies begin to pull themselves up to a standing position. They then begin to take some steps while holding on to something for support. This will change into cruising around the furniture. As their balance improves, babies may gradually take a few steps without holding on. Many babies’ first steps are taken around 12 months, but earlier or later than this is completely normal.
• By the end of this stage, babies begin to use the pincer grasp, using the thumb and first or second finger to pick up small objects. As babies learn how to open fingers, they are able to drop and throw things. Babies also more thoroughly investigate objects by shaking them, banging them, and moving them from hand to hand. Babies are interested in objects with moving parts, such as wheels and things that open and close. They also like to poke their fingers through holes.
• Babies also show a lot of growth in their language development during this period. They begin to make recognizable syllables like “ma” or “da,” which eventually turn into “mama” or “dada.” They can also imitate speech sounds they hear others make. By age 12 months, many babies say at least one word (other than mama and dada) clearly. They understand the meaning of no and begin to follow simple commands. Babies communicate nonverbally by pointing, crawling, or gesturing toward desired objects. The can also initiate and play gesture games, such as peek-a-boo and pat-a-cake.
• Babies learn object permanence, the concept that an object still exists when taken out of their sight, during this stage. For example, if a toy is hidden under a blanket, babies will pick up the blanket and search for it. Babies also learn that objects have functions besides being just something to chew on or bang with (such as a hair brush or phone).
• Separation anxiety  and stranger anxiety usually begin during this period and are a normal part of babies’ emotional development. Separation anxiety occurs when parents leave a babies’ sight, resulting in great distress with fussing and crying. Separation anxiety usually peaks between age 9-18 months and fades before their 2-year birthday. Stranger anxiety is a reaction of distress when an infant encounters a stranger.
• By the end of this period, most babies have reached the following milestones:

Motor skills

• Get in and out of a sitting position independently
• Get on hands-and-knees position and crawl
• Pull self up to standing position, walk holding on to furniture, stand without support and, eventually, take a few steps without support and begin to walk
• Use pincer grasp (thumb and first finger)
• Place objects into container and take them out of container
• Begin to do more functional activities, such as hold a spoon or turn pages in a book

Language skills

• Say “mama” and “dada” and use these terms specifically referring to a parent
• Use exclamations such as “oh-oh!”
• Try to imitate words and may say first word
• Use simple gestures, such as shaking head for “no” or waving for “bye-bye”
• Play interactive gesture games, such as pat-a-cake and peek-a-boo

Social/Emotional skills

• Easily find hidden objects
• Use objects correctly such as holding phone up to ear or drinking from a cup
• Shy around strangers
• Cry when mom or dad leaves

On to Toddlerhood

• The first year of life is an amazing time for babies. They usually triple their birthweight and are about 28-32 inches tall by their first birthday. The once dependent baby who relied on reflexes to act and respond has become more independent and can move at will. Rolling over, sitting up, crawling, picking up objects, and standing are usually mastered in the first year. They may even be taking a few steps on their own. Babies can now use gestures, different cries, and some simple words to communicate their wants and needs. They have developed a relationship with their parents and caretakers and engage in purposeful two-way interactions. The next stage is toddlerhood, where babies further develop their walking, talking, and thinking.