Early Childhood Development: Baby milestones come quickly

HealthWorks’ editorial staff spoke with Thomas Collins, MD, a pediatrician at Concord Hillside Medical Associates, about early childh ood development.

What are the key development milestones in a baby’s first six months?
During this period, every day is a new milestone, but the steps in a baby’s socialization and recognition abilities are key. When an infant is four months old, she will give a stranger as big a smile as she gives her mother. But within a few weeks, they develop visual memory, and they become more selective about whom they smile at. In terms of their motor skills, newborns can’t do much more than fidget, but at three to four months, they are reaching out and trying to take command of their environment. By six months, they are working at accomplishing goals, such as putting things in their mouths. Regular well-child visits are a good way to stay on top of immunizations and to discuss a child’s development.

What developmental delays should prompt a visit to the pediatrician?
As a pediatrician, I spend most of my day telling parents not to compare their baby to other babies. That said, if a dog barks, and the baby doesn’t jump, or if a bright light is turned on, and the baby doesn’t seem startled, it may make sense to see the pediatrician. Babies should be increasingly engaged over time—taking in all the sights and changes.
When this is not occurring, the child may need to be evaluated.

Should i be concerned if my one-year-old is not attempting to walk?
It depends.The normal range for learning to walk is between 10 and 15 months, but if a child was a bit slow in learning to roll over, they may be a bit late in walking. Motor skill development tends to happen in quarters, from head to toe. So by three months, an infant has gained control of his head, at six months he is sitting up, at nine months he is
crawling, and by 12 months, he is typically trying
to walk.

What about a child whose ability to talk doesn’t seem to progress?
Communication really begins at around four months with growling and babbling.This is how a baby gets someone’s attention. Long before it’s time to talk, I worry about a child who is not trying to communicate in this way. Although we expect a child to have a few words when they are 12 to 15
months old, it’s actually more important to the child at that age to move than to talk.They don’t really begin speaking words until they are up on their feet. At age one, they have six to eight words, toddlers typically have 20 or so words, and during the third year, vocabulary skyrockets.

Most toddlers have temper tantrums. when do they become a behavior problem?
Tantrums typically begin at around 18 months and are a very normal sign of frustration. The child has an agenda—she is probably trying to do something or wants to communicate—and no one understands her. Once a child reaches age three and is able to communicate, yet the temper tantrums continue, it is a sign of manipulation. It may help to talk with the pediatrician about the child’s behavior, the parents’ response to that behavior and how to break
the pattern. Discipline is the way we shape a child’s
behavior.

What is a good age to introduce toilet-training?
First of all, children need motor and language skills before they can be ready to potty-train, and it should never be about performance. These days, girls are usually “trained” by age three, and boys by age four.

For more information on pediatric care at Emerson
Hospital, please call the Physician Referral Service at
978-287-3456 or visit the hospital’s web site at
www.emersonhospital.org.