We all love our mothers they raised, protected and loved us. One of the thousand reasons I loved my mother was that she kept a very close eye on me and my brother’s development as babies.

She had a book called “Baby’s Milestones” where she wrote every detail, measurements, weights and all of our health issues.

We all know that our Paediatricians did monitor our growth when we visited them, but when the child grows up and reads his mother’s notes about him it creates a lovely bond between them especially if he read them when he’s taking paediatrics as a Medical student such as my case.

Therefore, stemmed the idea of me writing this article of Developmental Milestones to encourage all mothers to keep a record of their observations.

Here I have stated a list of the major events that mother’s might like to monitor according to their healthy normal babies’ age:

• At Birth: 

Weight: Between 2.5–4.5 kg

Height: Between 45-52 cm

Head circumference: Averagely 35 cm

• By the end of their first month, most babies:

ü  Make jerky, quivering arm movements

ü  Bring hands near face

ü  Keep hands in tight fists

ü  Move head from side to side while lying on stomach

ü  Focus on moving objects 8 to 12 inches away

ü  Prefer human faces over other shapes

ü  Hear very well and respond to high sounds by crying or closing their eyes

ü  Sleep for 19 to 20 hours/day

ü  Recognize some sounds, including parents' voices

ü  Look at their mothers when they speak to him

• By the end of their second month, most babies:

ü  Raise head and chin above the bed while lying on stomach

ü  Raise head up for a bit when being held upright

ü  Open and shut hands

ü  Vocalise sounds (gurgling and cooing)

ü  Smile (Smiling is a baby's first social skill)

• By the end of their third month, most babies:

ü  Support upper body with arms when lying on stomach

ü  Kick vigorously and try to turn over

ü  Hold head steady while sitting down (Important)

ü  Grab and shake hand toys

ü  Begin to babble and to imitate some sounds (all produce same sounds whatever the nationality)

ü  Turn  head away while having their nose cleaned

ü  Bring hands to mouth

ü  Turn head towards sounds

ü  Follow moving objects with eyes at 180 degree angle

ü   Enjoy playing with other people

ü  Recognize mother’s face and scent

• By the end of their fifth month, most babies:

ü  Push up using their arms and arch their back to lift up the chest

ü  Can roll over (stomach to back)

ü  Laugh aloud

ü  Reach for objects

ü  Can distinguish between bold colours

ü  Sleep 16 to 18 hours/day

ü  Show an interest in mirror images

ü  Amuse themselves by playing with hands and feet

ü  Hug Mum and Dad

• By the end of their seventh month, most babies:

ü  Can roll over both ways (stomach to back and back to stomach)

ü  Sit with support

ü  Support whole weight on legs when held upright

ü  Transfer objects from hand to hand

ü  Explore objects with hands and mouth

ü  Combines syllables into word like sounds (Ba,Ba-Da,Da)

ü  Eat crackers on his own

ü  Enjoy playing peek-a-boo

ü  Distinguish emotions by tone of voice

ü  Cough to seek attention

ü  Develop full-colour vision and mature distance vision

• By the end of their ninth month, most babies:

ü  Crawl (Some babies never crawl but rather scoot on their bottoms or move on their stomachs)

ü  Sit without assistance (important)

ü  Stand while holding onto something (important)

ü  Alert to sound of own name

ü  Use pincer grasp (thumb and forefinger)

ü  Put hands on their face to avoid having it washed

• By their first birthday, most babies:

ü  Pull self up to stand

ü  Stand alone for a couple of seconds, may take a few steps alone

ü  Stop putting things in their mouth

ü  Say one or more words

ü  Respond to “no” and simple verbal requests

ü  Imitate sounds and motions

ü  Use simple gestures, such as shaking head “no” and waving bye-bye

ü  Help in dressing self (hands in sleeves, etc.)

ü  Play ball

ü  Begin to use objects correctly (drinking from cup, brushing hair)

ü  Find hidden objects easily

ü  Sleep for 13 to 15 hours/day

ü  Develop Separation anxiety (when parents leave a babies’ sight) and stranger anxiety (reaction of distress when an infant encounters a stranger.

ü  Easily find hidden objects  

• By their second birthday, most babies:

ü  Sit down by themselves on little chairs

ü  Run well, up/down stairs, open doors, jump(both feet off the ground)

ü  Kick a ball, Climb on and off furniture without help

ü  Can make a tower of six bricks

ü  Can dress, put on/off shoes/socks, lace shoes and feed self

ü  Scribble with crayon

ü  Half of their speech is understandable

ü  Can make short sentences

ü  Follow simple instructions

ü  Listen to stories 30 to 50 words long

ü  Recognize names of familiar people, objects and body parts

ü  Do not wet themselves at night (important)

ü  Imitate behaviour of others

ü  Show growing independence

When to worry?

Most of the time, kids who are slow to develop in one area catch up just fine. But sometimes late milestones can signal a problem. The warning signs:

* Your child is delayed in more than one area. For instance, she's 15 months old and hasn't uttered a word or taken a step, and she seems to be wrapped up in her own world, or she doesn't turn to look at you when you enter a room or say her name.

* The delay is two months or more from the norm.

You know your child best, so you're likely to spot any problems -- or potential problems -- early. Follow your instincts. If you're worried, bring it up with your child's health visitor. Look for your child to be walking by 18 months and trying to pull himself up to stand or cruising several months before then. And by 12 to 15 months, your toddler should be able to communicate his basic wants and needs, even if he's not speaking actual words yet. For instance, he may grab your hand, pull you to the fridge, and point to the juice. By 15 months he should be able to speak at least a few simple words ("Mama," "Dada," and "up," perhaps), and by his second birthday he should be able to put two words together into a simple phrase or sentence ("Mama go.")
 Often vision and hearing problems are hard to spot unless you're a professional, so eye and ear check-ups should be part of every development check.

Some infants are at a high risk for developmental disorders and their development should be monitored more closely. This includes babies with birth defects, genetic disorders (some are identified prenatally), metabolic abnormalities, and neurological problems (such as seizures or feeding problems).
 
If a delay in a child’s development is suspected, it is important to resist the temptation to wait and see. A child may be referred for hearing and vision testing or further specialty consultation and evaluation. Early diagnosis and intervention are very important in improving the long-term outcomes for developmental disorders of all types.

Dr. Sarah Rikabi

6^th year Medical student

Faculty of Medicine

University of Damascus

[email protected]