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What to expect ... after the baby comes

October 25, 2012
Jennifer Zbozny , Mirror Moms

Happy Birthday! Welcome new baby!

Congratulations to the new parents - now don't panic!

In the first few years, babies progress in astounding ways. For parents and pediatricians, it's essential to stay on top of the signs and meanings of developmental milestones.

Article Photos

Mirror Moms photo by J.D. Cavrich
Dr. Fiona McLellan checks Timmy Ropcheck’s ear at Williamsburg Family Physicians in Williamsburg.

What should parents and professionals look for?

Julie Vitko, a registered nurse with the Maternity and Nursery department of the Altoona Regional, said a new baby is given a head-to-toe assessment to see if the baby has grown appropriately and is acting normally.

A baby's size (in weight and length) should correspond to gestational age. If it doesn't, doctors may look for things such as diabetes or other issues. Tone or flexion (meaning the baby should be "wiggly and moving, not flaccid"), reflexes and alertness are also checked.

Fact Box

Milestones by age

Birth to 4 months

Gross Motor: Baby can hold up his head, even if laying on his stomach. He can move his head from side to side and can roll himself from front to back.

Fine motor: Baby can move his arms and legs equally. He starts figuring out his hands, grasping a caregiver's finger in his palm. He can follow someone with his eyes.

Language: Baby starts cooing. He can demonstrate hearing by responding to a bell. He will also show a startle reflex.

Social/cognition: Smiles begin here.

4 to 6 months

Gross Motor: Baby can hold up his head, even if laying on his stomach. He can move his head from side to side and can roll himself from front to back.

Fine motor: Baby can move his arms and legs equally. He starts figuring out his hands, grasping a caregiver's finger in his palm. He can follow someone with his eyes.

Language: Baby starts cooing. He can demonstrate hearing by responding to a bell. He will also show a startle reflex.

Social/cognition: Smiles begin here.

6 to 9 months

Gross motor: Baby can crawl! He starts pulling himself up to stand.

Fine motor: Baby will use the fine pincer grasp to pick up small objects

Language: Baby begins to use "mama" and "dada" non-specifically.

Social/cognition: Look for

baby to wave "bye-bye". He will demonstrate he knows his name by looking.

By 12 months

Gross motor: Baby starts standing and begins creeping while holding on.

Fine motor: Baby will begin to feed himself.

Language: Baby will begin using "mama" and "dada" specifically.

Social/cognition: Baby will look at and respond to pictures. He can play simple games like peek-a-boo. He bangs objects together to make a noise. He demonstrates stranger anxiety.

By 15 months

Gross motor: Baby starts walking independently.

Fine motor: Uses a cup to drink.

Language: Uses three to six words specifically.

Social/cognition: Baby will have thrown his first temper tantrum.

By 18 months

Gross motor: Baby starts walking independently. He can toss a ball without falling and walk backward.

Fine motor: Baby can feed himself using a spoon. He can stack a small tower of two blocks.

Language: Baby starts naming common objects and can use at least 10 specific words. He begins making two-word sentences and can name one body part.

Social/cognition: Potty training can begin here. Baby can take off his clothes.

By 24 months

Gross motor: Baby starts walking up or down steps. Watch out now - baby can run too!

Fine motor: Baby can use a cup to drink. He can also stack a little tower of four blocks.

Language: Baby is able to follow a two-step command.

Social/cognition: Baby should be able to "help" around the house. He can wash his own hands by now too.

Sources: Drs. McLellan and McLucas

Beyond the baby's assessment at birth, Vitko said neo-natal caregivers also look for signs of appropriate adjustment in the mother.

"We care very much" and they make sure to send parents home with "lots of literature" so that mothers and babies can make a healthy adjustment to the home environment.

What's next?

Breaking things down by ages and stages of development illustrates how babies progress along individual growth curves. Doctors are trained to watch for specific signs but they do have their favorites.

Dr. Fiona McLellan, associate director at Altoona Family Physicians and Medical Director at Williamsburg Family Practice, said her favorites are "those first smiles, and when a baby starts looking at his own hands."

She said she finds it fascinating to observe the start of their self-exploration, the first few words and when a baby becomes mobile are parent-favorites in her practice.

Dr. Patrick McLucas from Southern Cove Medical Associates said his favorite is when babies start smiling. He particularly looks forward to when a baby starts "saying mama and dada and specifically recognizes its parents."

While there are generally accepted milestones, remember every baby is different. What's important is that children stay consistent within individual growth curves, professionals said.

McLellan and McLucas offered insights on infant milestones and what to expect through age 2.

When should parents worry?

"The meanings of [delayed milestones] are all over the map," McLucas said. "No two babies are exactly alike, so what may be delayed in some might be normal in another. Delays aren't necessarily related. If there is a delay in one area, it doesn't necessarily imply there will be delays in others."

"The loss of any milestone is significant," McLellan said. "A child may stop doing something temporarily but if it goes away entirely or progression stops, this could be a concern. If parents have [worries] it's essential they tell the provider so it prompts the doctor to look closely at any issues.

Both McLellan and McLucas emphasize the importance of honest communication with doctors. It's one of the best ways to ease parent's concerns and allow physicians to address issues quickly.

 
 
 

 

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