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2022 Nov

Normal Infant Development

Learn what to expect from each age of the first year.

Babies grow and change rapidly while developing new skills. Many parents worry that their baby may not be on track developmentally. All babies develop at their own pace. We must be careful about comparing one child to another; however, there are general guidelines to watch for to help identify any developmental delays as early as possible. Unfortunately, many children with delays are not identified early. The Centers for Disease Control (CDC) has recently adjusted the guidance on this issue (August 2022). Here is what to expect from each age of the first year.

Newborns to One Month

Crying Is the First Language

You may think that newborns do little more than nurse, sleep, and cry, but they do! They respond to sound by startling. They look at faces and follow a face with their eyes. They become quiet when they hear their parent’s voice. They will grab a finger. They move their arms and legs.

Crying is the first language. It is through their cries that babies express their needs. By meeting these needs, we are teaching babies that the world is a dependable place. You cannot spoil a baby by attending to their cries or needs. That cry may mean I am hungry, I am wet, I am tired, or I need to burp. They may be telling us that they are too warm or too cool. As you meet these needs, your baby feels confident and safe.

Two-Month-Olds

Look for Delightful Smiles

Two-month-olds have a social smile. This means when you smile at them, they will smile at you. Yes, it is absolutely delightful. They make other sounds than crying. They will watch you. They will open their hands and can move their arms and legs. They react to loud noises. While on their tummy, they can lift their head. Tummy time should be when awake, supervised, and on a flat surface where they will not fall. Please remember that all babies should sleep on their backs in a crib in the parent’s room without pillows.

Four-Month-Olds

Holding Toys and Increased Movement

Four-month-olds will coo, smile, and even chuckle. They can hold a toy. They will bring their hands to their mouth. When placed on the belly for tummy-time (when awake and supervised on a safe, flat surface where they will not fall), they push their chest up onto their forearms. Beware, their movement increases rapidly so they are a fall risk: do not leave them unattended. They can quickly and unexpectedly roll from off a sofa or changing table.

Six-Month-Olds

Laughing, Squealing & Tumbling

Six-month-old babies like to look in a mirror. They know their parents and those familiar to them. They can reach for a toy. They take turns making sounds with their parent, imitating a speech pattern. They love to blow raspberries and squeal. They will laugh, and if you have ever heard a baby laugh, it is amazing. Most babies can sit up with support (while leaning on their hands), although keep in mind that they often tumble over, so do not leave them unattended. Do not sit them on places where they might fall.

Nine-Month-Olds

Babbling and Peek-A-Boo

Nine-month-old babies babble (mamamama or dadadadada). They love to play peek-a-boo. They may be shy around strangers. They look if you call them by name. They lift their arms up to be held. They will bang two things together and move items from one hand to another. They have object permanence and will look for a toy that goes out of sight. They can sit up by themselves with stability, but do not leave them unsupervised, especially in the tub as they can tip over. Prevent accidental drowning.

One-Year-Olds

Picking Up Food and Playing Pat-a-Cake

At one, they pull to a stand and walk by holding onto furniture. They usually can say mama and dada to address their parents. They will wave bye-bye and play pat-a-cake. They will put a block into a cup. If you say “no,” they will briefly stop. They will pick up food with a pincer-grasp (using the pointer finger and the thumb) and feed themselves small bits of food. Be aware of choking hazards. Learn CPR so that you know what to do if your child chokes.

Please keep in mind that babies can develop differently so try not to compare your child with a friend’s infant. If you are concerned that your baby is not developing in a timely manner, please reach out to your pediatric healthcare provider. Have a frank discussion.

If there is a delay, the sooner that services begin, the better, although it is never too late to start services. Delays in movement may benefit from physical therapy. Language delays may require hearing screening and speech evaluation. Your child needs you to advocate for his or her needs, so do not be afraid to ask. The answer you get may be a very reassuring, “Your baby is developing appropriately for the age.” If not, then early intervention can improve not just abilities, but future performance.

Do you have an older child? Watch for next month’s article on toddler development!

For more information, visit:

www.cdc.gov/ActEarly/Materials
www.cdc.gov/Milestones
www.cdc.gov/Concerned

Melanie J. Wilhelm, DNP, CPNP

Dr. Melanie J. Wilhelm, DNP, CPNP, is a Doctor of Nursing Practice, and a Certified Pediatric Nurse Practitioner as well as core faculty member at Walden University. Her book, Raising Today’s Baby: Second Edition, is available on Amazon.com.

Website: www.RaisingTodaysChild.com

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