Infant Milestones

Have you ever heard the phrase, “is your child hitting all of their milestones?” and thought to yourself, “Sure. I don't actually know what the milestones are, but I think they're hitting them.” You're not alone. I see a lot of Moms (and Dads) that aren't sure whether or not their child is hitting all of their milestones because professionals assume parents just know what the milestones are!

Below are the list of milestones at all of the major growth spurts. I will add, that it's normal for some variability so if you're sweet baby is 1-2 weeks behind, that's okay. If things look a bit wonky for a week or two, that's okay too! If you have ANY concerns, you can schedule an appointment with your provider. If your little one plays catch up as soon as you schedule an appointment (and they often times do), you'll have confirmation that your child is right on track. If your child does have a delay, you can schedule an appointment with the appropriate provider, whether it's a PT, OT, SLP, feeding therapist or maybe an ENT or neurologist. There are often waitlists so being proactive can help you get an appointment in a timely manner!

Newborn Milestones

At birth, your baby:

• Should breathe through their nose with their tongue resting on the roof of their mouth

• Cannot hold their head up when you hold them

• Is relatively symmetrical when you lie them down - their head doesn't turn to one side and their head, tummy and pelvis are in a straight-line (they don't make a C-shape or S-shape with their body)

• Can do tummy time! But it's usually for a short amount of time and they can only briefly lift their head to turn it to the other side

• Has uncoordinated movements that seem jerky rather than smooth

• Startles easily! They have a primitive reflex called the Moro reflex and when they get startled they quickly stretch their arms and legs into the air

• Has a strong sucking reflex that doesn't change based on which arm they are in or which breast they are nursing from.

  • It is pain-free for you

  • Mouth should open wide for breast and bottle

• Brings their hand to their face

• Can see 4-6 inches in front of them…peripheral (off to the side) is easier to see than directly in front of them

• Prefers black and white patterns

• Has a strong grasp reflex in hands and feet - if you put your finger in their palm or on the bottom of their foot, their fingers and toes will curl around it

Talk to your provider if your newborn:

• Tilts their head to one side >60% of the time

• Is “super strong" for their age and can hold their head up

• Seems overly fatigued

• Does not feed well or feeds with difficulty (including pain for you!)

• Has excessive gas and spit-up or colic and reflux

• Feels stiff, rigid or or is difficult to bend (legs straight out, can't get dressed because their legs are pointed out)

• Seems overly tired

• Does not grasp your hand when you put your finger in their palm

• Has a flat spot, long skull or a deformed appearance

• Does not blink at bright lights or does not get startled by loud noises

How to Support Your Newborn's Development

• Skin-to-skin! Kangaroo care is phenomenal for everyone. Spend as uch time as possible with your baby lying directly on top of you. This helps their nervous system (and yours), helps calm their sensory sytem and allows both of you to co-regulate.

• Tummy time. In the early days, tummy time can look like them lying on your chest while you are in bed or on a couch. They should be able to relax when lying on you.

• Talk to your baby and look into their eyes. Remember they only see 4-6 inches away so it's important to be close to them.

 4-6 Week Old Developmental Milestones

At 4-6 weeks, your baby:

• Breathes through their nose with their mouth closed and tongue gently sealed to roof of mouth

• Their hand is in a gentle fist with their thumb outside the fist

• Starts to coo and babble

  • Will have different cries for different needs (hungry cry vs tired cry)

• Brings their hand to their mouth and sucks on their fingers

• Vision

  • Makes eye contact and smiles

  • Looks at objects further away

  • Is able to lift their head up 45 degrees and look up with their eyes

  • Can look both directions easily

  • Has better peripheral vision than midline (they can see things off to the side)

  • Can track items close by from their side to the middle of their body

• Responds to familiar voices (mom, dad, brothers/sisters) by turning head

• Can move their head side-to-side

Talk to your provider if your baby:

• Cries a lot or has a high-pitched cry

• Only looks in one direction

• Has difficulty nursing or takes longer than 20 minutes to take a bottle

• Seems to be in pain

• Seems to only use one arm/leg- both arms and legs should move equally

  • Or only brings one hand/arm to face, does not bring both hands together

• Doesn't like tummy time

• Has a flat spot on the back of their head

• Arches their body backwards, body is in a c-shape/banana shape, or does baby sit-ups

How to Support your 4-6 weeks old's Development:

• Tummy time - every minute counts!

• Make eye contact with your little one when talking and feeding them

• Skin-to-skin

• Baby massage if they seem frustrated or upset

• Explore the areas around them - baby's don't need a lot of toys at this age. Simply letting them explore different textures around the house (rugs, furniture, clothing, lights, shadows, windows, mirrors) is enough!

 3 Month Old Development

At three months, your baby should:

• Smile, babble and maintain eye contact

• Play with their hands (hand-hand contact) and start putting hand in mouth

• On their back

  • Hold both legs above the ground at 90 degrees (dead bug exercise position vs leg raise position)

  • Look side-to-side 180 degrees

  • Start to develop cylinder belly (belly is starting to no longer hang off to the sides)

  • If they try to grab an object it's using the outside of their hand (pinky and ring finger)

• Tummy Time

  • Hold their head up and look side-to-side when doing tummy time

  • Use arms to lift chest off the ground

  • Arms should be out in front of baby in tummy time

  • Legs can move when in tummy time

  • Hand is open and gently resting on ground

• Vision

  • Move eyes side-to-side without moving their body

  • Follow an object with their eyes

  • No longer goes cross-eyed when glancing at objects

Contact Your Provider if Your 3 Month Old:

• Struggles doing tummy time -“hates tummy time” or arches back when doing tummy time or they rest their head on the floor and don't lift chest and head up

• Has a flat spot or bald spot on the back or side of their head

• Has a preference to look in one direction or doesn't move neck freely in all directions

• Arches their body backward, is in a c-shape/banana shape, or does baby sit-ups

• Cannot hold/hover their legs over the ground

• Pushes legs into the ground and lifts their butt off the ground when lying on their back

• Is frequently upset or inconsolable

How to Support Your 3 Month Old's Development

• Tummy time is your baby's best friend. It doesn't have to be elaborate.

  • You can place them on different textures (soft rug, hard rug, tile, carpet, yoga mat)

  • It's also great to let them explore their surroundings- place them in front of a window can help them see/play with shadows and light coming through the window

  • Get at their eye level to support them looking up

  • Placing a mirror in front of baby is a great way to support tummy time

• When picking baby up after tummy time or diaper changes, roll them to the side and pick them up sideways. Try to roll them in both directions.

• Talk to baby and make eye contact! You can explain what you are doing and why.

• Get vestibular input!

  • Have baby lie on each side

  • Gently turn them upside down

  • Do “flying baby" with them draped over your arm

  • Have them relaxed in your lap and let their head gently hang over your legs so they are upside down

  • Dance party! Hold your baby in your arm and have a dance party. If you're looking to help them be more alert and playful, use upbeat music. If you're looking to help calm them, use more calming music

 4.5 Month Developmental Milestones

At 4.5 Months, your baby

• Smiles, babbles and makes eye contact

  • They may start “having conversations" where they exchange babbles when you talk to them

  • At 5 months they may start responding to their name

  • Starting to show emotions through a variety of facial expressions, laughs and tone

• Places hands on bottle around 4.5 months and holds bottle around 5.5 months

  • May start to take drinks with support from an open cup

• Grasp

  • Grasps objects from the side of their body using the ring and pinky finger to grasp at 4-4.5 months

  • Will start to reach with hand fully open at 4.5-5 months

  • Hand-genital contact - will place hands on inner thigh/groin

  • Hand-knee coordination

• Rolls from back-to-front (at 4.5 months, give or take 2 weeks)!

• On their back

  • Lifts both legs so their calves are parallel with the ground and hold this position

  • They can pass a toy from hand-to-hand

  • Grabs their thighs

  • Frequently puts objects in mouth

  • Feet will touch each other (foot-foot contact)

• Tummy Time

  • Fully lift their head and chest off the ground

  • Open palms, they will lift body off the ground

  • Single arm support! Can lean/put pressure on one arm and lift the other arm to reach for a toy

  • May “swim" where they lie on their belly with arms up and mouth open- this is common for a short period of time between 4.5-6 months when a child is trying to figure out movement and reach for objects anyway possible. It's normal for a week or two but then we want to see them start to move more.

• Can see color and see across the room! If you walk across a room, they should be able to track/follow you with their eyes

• Plays with toys! They can now grasp and release toys more easily.

  • May start playing the “Gravity Game" - if they drop a toy, Mom and Dad will pick it up

• May have a “sleep regression” due to a developmental leap and taking in and processing new information

Contact your provider if:

• C-shaped/banana shaped appearance, arch backwards frequently, does baby sit-ups or only look in one direction or tilts head

• Baby has a flat spot on the back of their head or their head appears flat or asymmetrical

• During tummy time they

  • Don't lift their head and chest off the ground

  • “Stiff” where they keep arms and legs stretched out tightly, making it difficult to relax the arms and legs

  • Avoid tummy time or scream at tummy time

  • Do not put weight on knees (only able to lift to pelvis/hips)

  • Doesn't reach across midline

• Unable to lift and hold legs in the air when on their back

• They don't babble or use facial expressions

• Unable to roll by 5-5.5 months

Supporting Your 4-5 Month Old's Development:

• Place them on their side frequently for play

• Read to them and use a lot of fluctuations in your own voice while reading

• Tummy time is your BFF! Tummy time can be in different positions, but make sure baby is in a safe place and can't roll of furniture

• Practice rolling from back to tummy. Make sure they roll to both the left and right

• Continue with vestibular input!

 6 Month Old Development

If your baby is 6 months old, they should:

• Socially

  • Play with parents and recognize familiar people

  • Show a range of emotions and express it through different sounds

  • Enjoy looking at mirrors (but they do not realize the reflection is themselves)

  • Start putting vowels togethers (“mmm," “dddd,” “bbbb")

  • Show curiosity with objects

• On their backs be able to:

  • Pass toys from one hand to another

  • Grab feet

• Tummy time

  • Pivots on belly button in all directions

  • Hand fully open

  • Fully support weight of body on elbows and hands

  • Start to lift up onto hand-thighs and then hands-knees -oftentimes it looks like a plank first and then moves into all-fours

  • Note: This is a really important time for a child to lift up as it helps increase what they can see and starts to develop 3D perception

• Roll from tummy-to-back and back-to-tummy (this was at 4.5 months) in both directions

Contact your provider if your 6 month old:

• Has a flat spot on the back or side of their head or only looks in one direction

• Is unable to roll from tummy-to-back in both directions

• Does not lift their legs when lying on their back or they frequently push their heels into floor and lift their butt

• Does not laugh

• Arches backwards or does baby sit-ups

• Has little body tension and is unable to support themselves when they are in your arms (support themselves when over your shoulder)

How to support your 6 month old:

• When picking them up after a diaper change, roll them to the side and then lift them

• Play in a variety of areas - inside, outside, soft carpet, hard carpet, tile, shadows, warmth from a window, etc

• Play while lying on their side, tummy and back

• Start solids! Not sure where to start? The Solid Starts: Baby Food App is a great way to know which foods are safe for your child's age, and how to cut them to minimize risk of choking

• Sing and dance with baby

 7.5 Month Old Development

If your baby is 7-8 months old, they should:

• Social

  • Start to understand “no”

  • Pitch starts to fluctuate

  • Starts to develop object permanence and plays peek-a-boo

  • May start to play “gravity game" where they drop a toy and know you will pick it up (learning cause and effect)

  • May experience separation anxiety

  • At 8 months, may be able to look at objects you point at

  • Make sounds to get your attention

  • Responds to their name

  • Can pass food from one hand to the other

• On back

  • Baby will eat their foot (this is a good thing) because it's for foot-hand-eye-mouth coordination

• Tummy time

  • Pivots in all directions

  • Goes on all fours (hands and knees/shins)

  • At 7 months, rocks back and forth in crawling position!!

  • Can lift one arm off the ground and reach upward

  • At 7.5 months they begin to crawl using both arms and legs (not army crawling)

• Sitting

  • Beginning to sit unsupported in a high chair at 7 months and transition to long sitting by 8-10 months

  • Side propped sitting / lower oblique sit / oblique sit - they should put themselves into this position while side sitting with support on one arm (50% of babies do this position at 7.5 months)

  • Able to sit upright and not slump over when sitting at 8 months

  • Able to transition from floor —> side —> sitting

• Can grasp objects and release using fingers - starts to use pad-to-pad grasp of index and thumb

At 7-8 Months, Contact your provider if your child:

• Does not roll or only rolls in one direction

• Does not go on all fours at 7 months

• Baby is unable to crawl or only army crawls at 8 months

• Cannot maintain eye contact

• Does not follow objects across the room or seem curious

• Has a hand preference or only grasps with one hand (while it is normal to develop hand preference in writing, at this age children should use both hands equally)

• Does not reach for toys

At 7-8 Months, you can support your child's development by:

• Reading to your baby and fluctuating your tone

• Letting your child explore food

• Play music and dance

• Play peek-a-book with you and objects

• Helping them pivot and crawl in all directions by placing toys off to the side

 9 Month Old Development

At 9 months your baby:

• Crawling

  • Crawls on hands and knees using opposite arm and leg

  • Crawls up steps/stairs - should be able to switch which leg goes up first

• Can sit unsupported

• Transitions from back to all-fours and back again

• Standing

  • Starts to pull themselves up to standing position - watch that the foot goes forward and not to the side

• Pincer grip (thumb and index finger) most objects

• Social

  • Starts to explore their surroundings more and is exploring their surroundings

  • Beginning to understand words including “no" = stop

  • Increased babbling

Contact your provider if your 9 month old:

• Doesn't cross-crawl (use opposite arm and leg work together to move child forward) yet

  • Butt Scootch Crawl: uses hands + butt to move forward

  • Crab Walks: uses one foot + one knee + hand to move forward

  • Army Crawl: uses elbows and legs to jet forward

• Bangs their head on furniture or the floor when upset

• Cross-eye appearance

Supporting your 9 Month Old

• Crawl in different planes and different textures

  • Stairs

  • Play couch or play steps

  • Crawl on different surfaces - carpet, rugs, tile, hardwood, etc

• Read to your child with fluctuating tones

• Dance and play music

• Continue vestibular support! Now that your child has more movement, it's important to continue going upside down, twirling, swinging and spinning

• Continue offering a variety of food textures and tastes

• Talk to your child

  • Say what you are doing out loud, “next we're going to lift your bottom up to change your diaper" or “let's go outside" or “here's the red ball” or “here's the blue car"

  • Try asking small questions, “Where is the red car?”

• Create a “yes space" where you can make sure your child is safe so you can do important things like use the restroom

 10-11 Month Old Development

If your baby is 10-11 months old, they should:

• Social

  • Start to understand basic social cues like “no" and “wave goodbye"

• Stand up while holding onto an object

  • Ottomans, endtables or couches with their cushions removed are usually a great height…just watch out for sharp corners and edges!

  • Cruising - side-step while holding onto an object (use arm to help support them walk)

    • It is OKAY for a child to stay in this position for awhile. They are building strength and coordination. There's no need to rush them into walking

  • May be able to go from the floor to standing without support

  • Stand with arm support and turn body in opposite direction

• Move easily from lying on stomach or back to sitting and crawling position

Contact your provider if your 10-11 Month Old:

• Is unable to maintain eye contact or baby has cross-eye appearance

• Does not react to name

• Cannot sit independently

• Does not stand

• Does not crawl or uses butt scootch crawl, crab walks or army crawl

Supporting your 10-11 Month Old:

• Continue vestibular input

• Continue playing peek-a-boo

• Read books with fluctuating tones

  • Some of our family favorites are “The Very Hungry Caterpillar,” “Brown Bear, Brown Bear," “Little Bee," “Dragon’s First Taco,” all of Sandra Boynton's books, “Press Here," “Little Blue Truck," “From Head to Toe"

• Practice strides (side steps) around objects like couch or endtable

• Stack toys

  • Now is a great time to introduce magnatiles. They will mostly place them flat on the floor at this age.

  • Large blocks

  • Duplos

• Continue practicing to crawl

• Play “What Does the Animal Say" game with sounds and movements

 12 Month Old Development

At 12 months, your baby may:

• Integrated gag reflex - gagging should be on the back of the tongue and only occur if something is reaching that space and should not happen regularly when eating

• Stand freely for a few seconds

• Walk around furniture or while holding your hand

• May walk independently

  • The average age range for walking is 10-15 months. If your child is crawling, it's okay if they aren't walking YET!

  • Walking is a milestone that depends on rolling, crawling and standing to develop strength. Babys don't need a walker to help them, they need more practice doing those tasks to build strength.

• Crawl up stairs

• Eat independetly using pincer grip or using a spoon

• Sit upright independently

• Social

  • Respond to their name

  • Connect words

  • Increased independence and ability to explore areas or “they get into everything”

Contact your provider if your one year old:

• Has an over-active gag reflex or chokes/gags frequently when feeding

• Doesn't crawl (or does one of the previous crawls)

• Doesn't stand on their own

• Doesn't explore their surroundings

• Is unable to babble or show facial expressions

• Has a hand preference or is unable to pincer grip

Supporting Your 1 Year Old's Development:

• Give them a “safe space" to play where they can safely explore their surroundings

• Play pretend

  • Talk on the phone

  • Eat play food (you will have to teach them the food isn't real)

  • Feed the teddy bear

• Read picture books

• Gently roll a ball back and forth

• Sensory tables

  • It's important to watch your child at this time but sensory bins with different textures are great to add at this age so they can begin to feel different textures, navigate how to move it through their hand and strengthen the tiny hand muscles

• Risky play!

  • Whack a mole

  • Change the surface - place stepping stones, pillows on the floor, play couches/foam or obstacles so your child has to navigate around them while changing elevation

  • With supervision, give your child a hammer and golf tees to whack into a pool noodle

• Encourage walking on different textures and heights

 13+ Month Development

At 13+ Months, your baby

• Walk without support

• Squat

• Bear crawl

• Jumping forward with one foot leading: 18-24 months

• Jumping in place with two feet together: 22-24 months

• Jumping off small platform landing with two feet: 24-30 months

• Jumping over obstacles: 30-36 months

• Jumping forward with two foot take off and landing: 36 months

• Hopping on one foot: 48 months

Contact your provider if your baby

• Is unable to stand independently by 12 months

• Does not put weight through both legs at the same time

• Drapes their body or leans over toys, furniture or objects to support weight

• Does not walk by 15 months

Supporting Your Child's Development

• Give them a safe space to reach different heights through crawling and climbing ramps or stairs

• Encourage reaching overhead, side-to-side and across their body

• Encourage them to use both arms (sidewalk chalk, chunky crayons are great but they will put them in their mouth!)

• Go barefoot to help increase input into the foot

• Change the environment - from grass to carpet to different textured rugs and tile

• Upright toys - tool stations, play kitchens, water tables, upright art easels are a great way to support upright movement and independent play