Newborn Care Specialist

Child Development

Normal behavior for infants:

Child Development

        It is also important to know and understand how quickly babies grow and how the sustenance they need at various ages changes. Here is some important information regarding baby’s development:

At weeks 37-40 (while still in the womb), babies prepare for birth by building up a brown layer of fat, which they will use for the first few days after their birth[8]. This layer of fat they develop supports their caloric needs while they consume colostrum (“the first secretion from the mammary glands after giving birth, rich in antibodies.”) for the first few days after their birth, to build the microbial in the digestive system. Babies will consume about 5-7 ml of colostrum per feeding. Note that colostrum is all the mother will produce for the first three days before she produces breast milk. It is nicknamed “liquid gold” and looks like a thick yellowish serum.

It is also important to understand the size of a newborn’s stomach and how it grows:

                                                       

Rapid Growth

Note that growth is on a bell curve and developmental milestones are not necessarily set in stone.

After the first month, expect growth spurts at:

2 months:

  •         Starting to smile at people
  •         Beginning to calm themselves in stressful situations (if only very briefly)
  •         Attempting to make eye contact with parents, be paying attention to and recognizing certain people’s faces
  •         Making “coo-ing” and “goo-ing” sounds
  •         Responding to, and turning their head to sound
  •         Beginning to show signs of boredom if activities don’t change often enough
  •         Holding their own head up and push up a bit with their arms when lying on their stomach
  •         Beginning to have more fluid and deliberate movements

Red flags to be aware of at the 2-month mark:

  •         If the baby doesn’t respond to loud sounds
  •         If the baby doesn’t watch things move in their immediate surroundings
  •         If the baby does not smile at people
  •         If the baby is not bringing their hands to their mouth
  •         If the baby can’t hold their head up or push themselves up at least a little bit while lying on their stomachs.

*If the baby is having trouble with any of these things at this stage it is important to have the parents contact their pediatrician.

4 months:

  •         Smiling spontaneously
  •         Enjoy playing with other people and may be upset when the playing stops
  •         Beginning to imitate some of the facial expressions of the adults around them
  •         Starting to babble
  •         Starting to mimic different sounds they hear around them
  •         Have various different types of cries that are distinguishable
  •         Showing emotions such as happy or sad
  •         Responding to affection
  •         Reaching for toys with a single hand
  •         Developing hand-eye coordination
  •         Following things that move from side to side with their eyes
  •         Paying close attention to people’s faces
  •         Have increased recognition of family members and objects at a distance
  •         Holding their heads steady without any support
  •         Pushing down with their legs when their feet are on hard surfaces
  •         Be able to — or least be attempting to — roll over from their stomachs to their backs
  •         Holding and shaking toys without a problem
  •         Pushing up to their elbows when laying on their stomach

                   

Red flags to be aware of at the 4-month mark:

  •         If the baby isn’t watching things with their eyes as the objects move.
  •         If the baby doesn’t smile at people.      
  •         If the baby can’t hold their head steady.
  •         If the baby doesn’t “coo” or make different sounds.
  •         If the baby isn’t bringing their hands or objects to their mouths.
  •         If the baby isn’t pushing down with their legs when their feet are on hard surfaces.
  •         If the baby has difficulty moving one or both of their eyes in any direction.

*If the baby is having trouble with any of these things at this stage it is important to have the parents contact their pediatrician.

Also note “four-month regression” is a myth. This is actually a growth spurt, where babies experience an increase in caloric needs. Therefore, it is important that great attention is paid to the baby’s diet. (See below for more details)

6 months:

  •         Beginning to recognize someone as being a stranger
  •         Enjoy playing with others (especially their parents)
  •         Responding to other people’s emotions
  •         Enjoy looking in a mirror
  •         Responding to sound not only by looking, but also by making sound themselves
  •         Stringing different vowels together when babbling and enjoying talking to parents
  •         Responding to their own name
  •         Making sounds that express happiness or displeasure
  •         Beginning to use consonant sounds such as “m”s and “b”s
  •         Continuing to look around at nearby things
  •         Showing lots of curiosity about things and be attempting to reach things that have previously been out of reach.
  •         Starting to pass things from hand to hand
  •         Rolling over in both directions from front to back
  •         Starting to be able to sit without support
  •         Starting to try to support weight on leg/s when feet are on the floor and may bounce
  •         Crawling backward before moving forward –sometimes--

       

Red flags to be aware of at the 6-month mark:

  •         If baby doesn’t reach and try to grab things that are near to them.
  •         If baby doesn’t show any affection for known caregivers.
  •         If baby isn’t responding well to sounds around them.
  •         If baby has a hard time bringing things to their mouth.
  •         If baby isn’t making vowel sounds.
  •         If baby isn’t able to roll over in either direction.
  •         If baby doesn’t laugh or make noises such as squealing.
  •         If baby seems to be stiff or have tight muscles.
  •         If the baby seems overly floppy and has little control of movements.

*If the baby is having trouble with any of these things at this stage it is important to have the parents contact their pediatrician.

*Remember to increase food by 150 calories at this point, so that the baby is consuming 650 calories a day instead of 500.

9 months:

  •         Showing possible fear of strangers
  •         Be clingy or very attached to specific adults they recognize
  •         Have toys that are their favorites
  •         Understand the meaning of the word “no”
  •         Make a lot of different sounds and be able to almost say “mama” and “dada”
  •         Copy sounds and gestures of those around them with regularity
  •         Use their fingers to point at things
  •         Be able to watch something as it falls
  •         Start looking for things that they see you hide, (i.e. know that they are still there)
  •         Play peek-a-boo
  •         Put objects into their mouth
  •         Be able to move objects without any trouble from one hand to the other
  •         Be able to pick up small objects (such as individual pieces of cereal), between their thumb and index finger
  •         Be able to stand while holding onto something without trouble
  •         Be able to get into a sitting position on their own
  •         Be able to sit without support
  •         Use their arms to pull them up to stand
  •         Be able to crawl

                   

Red flags to be aware of at the 9-month mark:

  •         If baby isn’t able to bear their own weight on their legs
  •         If baby cannot sit up without help
  •         If baby doesn’t babble and make noises such as “mama” and “dada”, etc.
  •         If baby doesn’t play any sort of back-and-forth games
  •         If baby isn’t responding to their own name
  •         If baby doesn’t recognize people who are often around them
  •         If baby doesn’t look to where you point
  •         If baby isn’t able to easily transfer objects from one hand to the other

                   

*If the baby is having trouble with any of these things at this stage it is important to have the parents contact their pediatrician.

1 year:

  •         Have continued and increased awareness of when someone is a stranger and be either scared of them or shy with them
  •         Cry when parents leave them
  •         Have favorite toys and favorite people
  •         Be able to show that they are afraid
  •         Be able to hand you a book when they want to hear a story and understand this connection
  •         Repeat sounds and actions of others in an attempt to get their attention
  •         Know to put out their arms or legs when you are dressing them
  •         Have an increased ability to play games that require them to play back (like pat-a-cake)
  •         Understand and respond to simple requests made by you
  •         Use easy to understand gestures like shaking head “no” or waving goodbye
  •         Make sounds with changing tone (should sound a bit more like actual speech)
  •         Say certain words like “uh-oh”, “mamma” and “dada”, etc.
  •         Be trying to say the words they hear you say
  •         Be exploring different objects in ways they previously have not (by throwing, shaking, etc.)
  •         Be able to find things that have been hidden without too much trouble
  •         Be able to recognize names of different objects and know what the names correspond to
  •         Start to use objects for their designed purpose instead of just as a toy or something to be explored
  •         Bang objects together
  •         Be able to put things into, and take things out of, containers
  •         Start to let go of objects without needing help
  •         Point/poke with index finger
  •         Be able to follow simple directions like “pick up the toy”

                               

Red flags to be aware of at the 1-year mark:

  •         If baby doesn’t crawl
  •         If baby cannot stand when they are supported
  •         If baby doesn’t look for and reach for things they clearly see you hide
  •         If baby isn’t saying words like “mama” or “dada”
  •         If baby hasn’t learned simple gestures like waving
  •         If baby doesn’t point to different things
  •         If baby seems to lose skills that they had already previously developed

                   

*If the baby is having trouble with any of these things at this stage it is important to have the parents contact their pediatrician.

Brain Development:

Brain development research was a very understudied topic. In fact, it was not until 1960 that any research was being done for children under the age of 5 years. What we are discovering is that at birth infants have 1 billion brain cells and over 1 trillion by the age of 4 weeks. As you can imagine, during this time they will spend the majority of the day sleeping due to the fact brain repair is done during sleep.

There will be so much development in the first year and the best approach for infants is:

Nutrition for brain development: The brain will need a high fat dietary intake to maintain such growth.

Attention and Environment: The need to have eye contact and constant interaction to support healthy development.

Touch: Infants need to be bonded with and their systems being as underdeveloped as they are so dependent on an adult co-regulating their systems.

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