Milestones

Your infant’s fabulous firsts

Your baby is finally here, and is at the beginning of a long road of accomplishments. Many new parents wonder just what to expect from their babies as they grow. Developmental milestones are skills that most babies have accomplished by a certain age. Contrary to the moniker, however, they are not set in stone, as individual babies reach them at slightly different times. This can be a result of innate differences, environment or a combination of the two. Almost all babies reach some milestones before — and some after — most of their peers.

Your newborn, although tiny, is already taking cues from you and her environment in order to put together the building blocks for her development over the next few months. Infancy is a time of rapid brain growth, and you will be amazed by how quickly your baby acquires new skills.

1 Month

Babies have started to emerge from their sleepy newborn shell. When lying on their bellies, they can lift and move their heads from one side to the other. They begin to make other movements on purpose, like jerking their arms out in front of them and trying to bring their fists to their mouths. They respond to sound, and may even turn toward the voices that they know. For fun, they like to look at faces and black-and-white patterns.

2 Months

Hints of speech are emerging as babies begin to gurgle and make ooh and aah sounds, also known as cooing. Some babies are smiling and laughing as well. The social smile is different from the smile on your baby’s face that occurs when he is passing gas or sleeping — it is a direct response to your face or voice.

Two-month-olds will get fussy at times, to demand attention when they are bored. They can hold their heads up for short periods of time and might begin to push themselves up on their arms when they are on their tummies, especially if they have been spending time in this position regularly (tummy time). Arm and leg movements become smoother, and they can follow objects with their eyes.

3 Months

The three-month-old social dynamo spends her waking hours interacting with people and things in her tiny domain. She mimics your facial expressions and speech, even tries to have “conversations” with you, cooing all the way. She will distinguish familiar voices and scents and will favor being with you above others. As her vision improves, she will recognize people and things she knows at a distance. She makes more voluntary movements, such as reaching out with her arms, opening and closing her hands, holding and shaking toys, and bringing her hands to her mouth regularly.

4 Months

The steady march towards speech and language rolls onward. Four-month-old babies begin to communicate more expressively, using sounds. Your baby will be able to announce he’s tired, hungry or uncomfortable through cries and body language (for example, rubbing his eyes when sleepy). He will respond to affection by smiling or leaning in toward you. Four-month-olds reach for toys, bear weight on their legs while held upright, and push up on their forearms when placed belly-down.

5 Months

A five-month-old continues to explore her universe, reaching out her arms with open hands when she sees an interesting object. She can roll over in one direction and play with her hands and feet. As her vision is developing, she can distinguish between bold colors, and sees in three dimensions. Her hearing is more refined now, and she will turn toward stimulating sounds like a rattle or your voice.

6 Months

To a six-month-old, all the world’s a gym. Your baby will be able to roll over in both directions (back to front and front to back), and can sit with support. When standing with support, he can bear weight on his legs for longer periods of time and has fun bouncing up and down. This activity helps him in his quest to learn. At this age, your baby is trying to get his hands on anything interesting he sees, feels or hears, and will bring those things to his mouth (not because he is hungry — it’s just another way to explore). That mouth is also used to talk, a lot. Your baby is babbling (combining consonants and vowels in strings like bababa and dadada).

You will notice that he takes turns with you while making sounds, and strings different sounds together during your chats.

Developmental Delays

Some babies have delays in their development, which might indicate a problem. Tell your baby’s doctor if your baby …

At One Month:

• Has difficulty sucking, is a slow feeder or gags while feeding.

• Does not respond to bright light or loud sounds.

• Does not track close objects visually.

• Seems very loose or very stiff.

• Rarely moves her arms or legs, or only moves one side of her body.

At Two Months:

• Does not smile when hearing a familiar voice.

• Does not seem interested in his hands.

• Cannot hold his head up while on his belly.

At Three Months:

• Does not smile at faces.

• Does not grab onto objects.

• Cannot support his head on his own.

At Four Months:

• Does not reach for interesting objects or toys.

• Does not bring objects to her mouth.

• Does not coo or try to imitate you.

• Does not push her legs down onto a surface when held upright.

• Is either not interested in or is overly distressed by new faces.

At Six Months:

• Does not roll over.

• Seems unable to bring things to his mouth.

• Does not reach for things close to him.

• Does not respond to noises.

• Does not laugh or squeal.

• Is not affectionate with his caregivers.

As the months progress, your baby will become more and more fascinating. It can be tempting to measure how your baby stacks up to the competition, but it’s important to know that all normal babies develop differently. It’s not a race, but a journey to enjoy!

Pediatrician Elizabeth Shashaty, MD, is on staff at Children’s National Medical Center and Medstar Georgetown University Hospital, both in Washington, DC. She is also the mother of three young children.