Milestones in children and their normal range - an insight by a paediatrician

Hello Dear Moms, how are you ?

How old is your little one, has she started to smile at you yet? Has his first tooth appeared yet? Am sure one of your's is babbling her cute nothings right now trying to make a conversation with you? Did you say your boy is wearing his shoes already, make sure to congratulate him on his achievement.

Is not it amazing and even magical to witness how the tiny human you gave birth to is now capable of doing so much more than he/she could and is growing up so fast that you want time to freeze in order to enjoy their childhood a little longer. I also know that motherhood is not all sunshine and roses, with motherhood comes responsibility and anxiety so as mothers we often find ourselves wondering and worrying about whether their lisping is lasting too long, are they too late to learn to walk without support while other kids his age are walking on their own already or that depression in their head (fontanellae) is still present while your older one's was closed by this age.

Today I am writing to address all these worries regarding the milestones in our tiny tots and let me begin by telling you that normality is a range and not a number also one milestone being a little late while others are on time and one of it even before time - all that falls under normal. Now lets talk about milestones in some detail for you to understand better and minimize that worry of your's.

The developmental milestones are understood under 5 main domains:

Gross Motor Head holding as the term suggest its the baby's ability to hold his/her head in position when being picked up or when trying to get up from a prone (lying on stomach) position. Begins by momentarily holding head at 1 month of age and achieve full head control usually by 5 months. Anywhere in between is normal.

Turning prone or rolling in lying down position can be observed as early as 3 months and confidently done by 6 months.

Sitting with caregivers support can be observed at 5 months and gradually is able to sit without any support and without risk of falling down by 10 months.

Crawling can be observed to start by 9 months of age wherein you will find your cutie-pie crawling backwards while attempting to move forward and by 10 months you can see him/her crawling nicely till they learn to walk.

Standing, they can be made to stand by holding hands as early as 6 months and they will be able to bear their weight and by 13 months you may find them standing without any support for few moments.

Walking begins by holding their tiny hands and helping them to walk by 1 year, before that if you will attempt all they will do is lift and replace one foot and mimic walking but are not able to do that before 1 year usually and by 1.5 years usually you will find them walking independently on a flat surface (you will also find them climbing up on a chair to sit, make sure someone is around in case they try to sit on a wobbly or plastic chair). By 2 years you may even find them going up & down the stairs but keep an eye on them to avoid any accidents.

Fine motor Grasping objects, holding objects such as rattle when given can be seen as early as 3 months but only for a moment and by 20 -24 weeks they are able to hold even their bottles themselves. And you know what by 13 months they can even hold 2 cubes in one hand, isn't that an achievement now!

Hand to hand transferring of objects from their one tiny hand to another is observed by the 28th week of life. But placing something on your hands dear moms is not going to happen before 44 weeks and then too they will not release the object completely (especially if they like it too much).

Pincer movements which is holding small objects between one finger and thumb which is also an important fine motor development in a growing kid and this is usually achieved by 36 weeks of life.

Removing shoes and building a tower of 2 cubes by 15 months. Learns to remove gloves & socks and turns 2-3 pages of his book at a time at 18 months. Its not before 2 years that he/she learns to put on his/her own shoes, socks, pants, one less task for you there!

Language development Well babbling is the first thing you are going to hear from their mouth which is basically repeated syllables over and over again and this can be observed by the time they turn 7 months to 9 months.

Around 11 months they are expected to say one word with meaning. After they have turned an year old they will be able to say 2 or 3 words with meaning.

The most entertaining part of their language is the jargon which can be seen around 15 months of age up to 18-19 months. Around 21 months they will be saying a 2 words sentence and may even repeat things said to them. Once they have turned 2 don't expect them to stop because then they will be talking incessantly and you might even feel overwhelmed answering their questions after that.

Cognitive and Social-Emotional development Up to the age of 1 year various cognitive developments can be observed like watching mother when she talks to them, opens & closes mouth when mother speaks to them, smiling can be noticed from 1.5 months onward, begins to follow moving persons with eyes.

Sense of perception can be observed from 3 months onward like recognising faces and begins to know if someone is a stranger, reacting to familiar sounds (squeals of pleasures can be heard which can immediately make you joyous).

By 4 months they may start to show excitement on seeing toys, imitate facial expressions. By 6 months they may even be playing peek-a-boo with you and you can hear their laughter while doing so.

From 7 months onward they will respond to their name, by 8 they will respond to your NO . By 9 months you can see clear like or dislike for food by the level of their excitement on seeing the food. well established concentration on playing with toys or getting objects, cries on seeing you leave and is shy around strangers. 9 months onward they will be enjoying picture books, pulling clothes of someone to grab attention, waving bye-bye.

By the time they have turned 1 they may be able to understand almost a dozen words, will kiss you on request and will even help you dress them by straightening their arms or legs. At 1 year 3 months will ask for objects by pointing at them, this is also when they start to inform mother after passing urine.

At 1.5 years they will point to the pictures in their book correctly, will carry out 2 simple tasks (e.g. put it on the table, bring it to me, etc), will play simple pretend like making tea for you and also imitate mother's or father's behaviour.

By 2 years they are following your 4 simple instructions, observe other children playing but not engaging with them yet, identifying 5 objects at least.

Between 2-3 yrs they can tell you their full names, repeat 2-3 digits after you, copy circles with pencil, sing nursery rhymes by now, join other children in play, may even have learnt counting up to 10 also 2.5 years onward they will be sitting on their potty seats without help except for wiping (but wait till 3-3.5 years for total control to establish).

Additional points to relieve your worry

Fontanelle closure: Those depressions in your baby's skull called Posterior fontanelle which usually closes by 2 months of age. Anterior fontanelle may close as early as 4-5 months and as late as 3-4 years (no bulging should be present though).

Teething: A child may be born with a tooth or teeth so if that is the case with your baby rest assured its normal and what else is normal is the appearance of first tooth at 13-14 months of age. Though 9 months is considered an average age.

So all that being covered, I would like to reiterate the fact that all the milestones have a normal range of age of development and even if one of the milestones is delayed but all others are on time then there is absolutely nothing to worry about, because there is nothing wrong with your child, it is normal.

Hope most of your worries regarding your little one were dissolved after reading this. See you next time Mommies, ciao!

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Dr. Bhavya Sehgal

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Dr. Bhavya Sehgal

Homoeopathic Paediatrician with 6 years of experience. B.H.M.S. from SKRPGHMCRC under DAVV University. M.D. Paeds (Hom.) from Dr. M.L. Dhawale Institute under Maharastra University of Health Sciences. Currently a PhD scholar at Homoeopathy University.