DEVELOPMENTAL MILESTONES IN INFANTS TO ONE YEAR

Dr. Tariq Jagnarine
Family Medicine, Endocrinology/Diabetes

Buckle up, parents! A baby’s first year is a whirlwind of milestones. You’ve already seen them take their first breath, heard their first wail, and changed their first dirty diaper. (Only a couple thousand more to go, this year alone!)
So, what’s next?
Developmental milestones are behaviours and physical skills children reach and master as they grow. Some first year-of-life physical milestones include:
* Rolling over
* Reaching for objects
* Sitting up
* Crawling
* Behavioural/social milestones include mimicking your expressions, and crying or laughing to show emotions.
So, get the cameras ready; here are the milestones to expect during a baby’s magical first year of life!

FIRST MONTH
It may seem that a baby is simply an eating, pooping, and sleeping machine at this point. But a lot is going on in that tiny body. Milestones to watch for include:
* Bringing hands and fists towards the mouth (though not always with great accuracy)
* Developing reflexes — flinching at loud sounds, shutting eyes at bright lights
* Focusing on objects brought within 12 feet of their face.
* Turning towards familiar sounds and voices — like yours!

SECOND MONTH
Babies start to act, well, more baby-like. By the end of 2 months, they are likely to be:
* Gurgling/cooing
* Trying to follow movement with their eyes (called tracking), although it may not seem very coordinated.
* Holding their head up and pushing upward with their arms while lying on their tummy

THIRD MONTH
Babies are progressing from dependent newborns to being more independent. This is when some of that cuteness overload starts to kick in. Watch for:
* Smiling at the sound of voices
* Holding their head and chest up and kicking their legs when lying on their stomach
* Grasping toys
* Putting their hand in their mouth with more precision
* Making more vowel sounds (ooh and ah)
* Recognising familiar faces and objects from a distance
* Trying to imitate your facial expressions.

FOURTH MONTH
At this stage, a baby is taking the milestones already achieved and perfecting them. For example, they may hold their head up more consistently and for longer periods, grasp toys with more coordination, and copy their expressions with more accuracy. Other milestones are:
* Holding a rattle and shaking it at the same time
* Perhaps starting to roll from tummy to back.
* Tracking movement more fluidly
* Pushing down on legs when held in a standing position.

FIFTH MONTH
The baby continues to grow, explore, and master. As their strength and coordination increase, parents may notice that their baby is:
* Rolling from tummy to back, and then back to tummy
* Grabbing their feet, and maybe even inserting them into their mouth
* Moving objects from one hand to another
* Showing interest in food, a sign they’re getting ready for solid foods.

SIXTH MONTH
The baby is all grown up! They may now be:
* Sitting up briefly without any support
* Saying consonant (mmmm) and vowel (eeee, ooooo) sounds
* Playing and expressing displeasure when playtime stops (keep those raspberries coming!)
* Trying to get things out of reach.
* Recognising their name
* Expressing emotion (by crying or whining when sad or angry, and laughing or squealing when happy)
Given that they are now getting better and better at grasping and holding objects, the American Academy of Pediatrics says 6 months is a good time to begin to encourage a baby to use spoons and their hands to feed themselves. A sippy cup or regular cup can be introduced with help.

SEVENTH MONTH
The baby continues to build on what they’ve already learned. Milestones include:
* Sitting up without support for longer periods
* Responding to the word “No!”
* Recognising emotions (happy, stern, etc.) by your tone
* Using their hand like a rake to reach for something (called the “raking grasp”)
* Responding to expressions — smiling at a smiling face, looking uncertain at a fearful one
* Putting objects in their mouth to explore them.
* Tracking objects more smoothly
* Stringing more consonants together while babbling

EIGHTH MONTH
Parents might notice that their little one can now roll over, sit up, and move objects from hand to hand or hand to mouth like a pro.
* Rocking back and forth on their hands and knees or scooting along the floor (precursors to crawling)
* Pulling up to a standing position
* Drooling — a lot (some babies will be cutting their first teeth around this age)
* Continuing to babble
* Developing stranger or separation anxiety. This is a kind of distress babies feel when they’re separated from their parents or primary caregivers.
* Don’t worry, separation anxiety passes. We promise you’ll eventually be able to go to the bathroom alone again.

NINTH MONTH
Your baby is on the move! They may be:
* Crawling
* More confidently pulling up to a standing position
* Playing peekaboo or looking for an object that was hidden.
* Using the pincer grip (which involves holding a small object like a piece of cereal or pasta between their forefinger and thumb)
* Pointing at things they want

TENTH MONTH
The baby continues to explore and experiment. Watch your baby as they’re:
* Moving from pulling to standing or crawling to “cruising” or walking, while holding on to furniture or objects around a room
* Banging objects together just to hear the sound they make — a kind of auditory assault rivalled only by your neighbour’s garage band.
* Poking at things
* Putting objects into a container and then taking them out again
* Feeding themselves finger foods
* Shaking their head “no” and waving “bye-bye”

ELEVENTH MONTH
In addition to reaching, crawling, and cruising, a baby may be:
* Continuing to explore language, giving you more mamas, dadas, and maybe even the occasional uh-oh! using the right inflection.
* Understanding simple declarative statements, such as “Don’t touch.”
* Copying your behaviours, like pushing buttons on a play phone and babbling to mimic conversation.

TWELFTH MONTH
Congratulations! Officially the baby is now a toddler. During their twelfth month, the baby would likely be:
* Cruising, standing briefly unsupported, and maybe even taking a step or two
* Exploring objects by banging, throwing, and dropping them
* Saying one or two simple words, such as hi, no, and bye
* Using objects correctly, if not clumsily (for example, using a spoon to eat and a comb to brush hair)
* Looking to the right object when you say, “Where’s the dog?” or “Where’s grandma?”

WHEN TO TALK WITH A PEDIATRICIAN
While most babies would reach milestones at roughly the same age, there’s a wide range of “normal.”
Babies born prematurely, or with a health issue or congenital disorder can also take more time to reach milestones. And one 2018 study found that girls tend to reach milestones before boys (although the differences weren’t huge).
All along the way, the baby’s paediatrician will be looking out for milestones and watching the baby’s progress. If the baby’s doctor feels there’s a need for intervention (screening, testing, or therapies, for example), they’ll let parents know.
Keep baby’s clinical appointments (typically 5 to 6 in the first year) and see them as an opportunity to chat with a doctor about what’s going on.

Next Week’s Topic: Developmental Delays