Milestones of baby’s first year

There’s nothing quite like watching your baby grow and learn, writes occupational therapist Nicole Katzenellenbogen

EVERY MILESTONE, NO matter how big or small, is a wonderful experience for your family. These moments aren’t just something to record in the baby book, though, they also show you what’s going on in your baby’s development.

During his first 12 months, each new skill leads to the next as your baby barrels toward toddlerhood. Each milestone also acts as a marker to show you how he is growing up.

While each smile, gurgle or step is eagerly awaited, no two children will develop in the same way or at the same time. It is important to keep in mind that your baby has his or her own unique strengths and talents.

Don’t push your baby to master a skill and then rapidly move on to the next target. Babies need time to master and enjoy the skill they have acquired so that they can use this to develop and broaden into other areas.

1 FIRST SMILE AROUND SIX WEEKS

Finally, you’re getting a little response from your baby! You have been working hard at loving and caring for him for weeks, and may feel you don’t get much in return. Then at around six to eight weeks your baby will smile at you, and your world will change. This skill continues to develop and at around four to five months you may start to hear the giggles of your munchkin. It’s a sound you will love, even at 5am.

HOW TO HELP

• Use your face to communicate with your baby – smile at him, make funny faces, blink your eyes, and so on. • Babies love looking at their reflections, so hold your baby up in front of a mirror to smile at himself. • Talk to your baby often, using different tones of voice to communicate surprise, anticipation, laughter, and the like. Your baby will love to join in the fun.

2 NECK AND BACK CONTROL FROM TWO TO SIX MONTHS

By the age of two months, your baby will be able to lift his head off the floor while lying on his tummy and over the next two months will be able to push his entire chest up. Following this, he will then learn how to bear weight on his hands while in a prone position (lying tummy-down while resting on his forearms).

Tummy time is important to develop the muscles around the shoulders and back for crawling later on. Lifting his head against gravity also activates the movement system in his inner ear. This will be important for balance, postural control and control of his eye movements at a later stage. HOW TO HELP

• During tummy time, hold your baby’s favourite toy in front of him so that he has to push up on his front arms to look at it. • Walk to his left or right side or wave a toy from left to right during tummy time so that he uses his eyes to follow the movement. • You can let your baby lie over a rolledup towel or blanket to give him extra support under his arms. • Let baby lie on his tummy on your chest so that he has to look up at your face. You can also drape him across your legs so that he gets a new view of the world around him.

3 USING HIS HANDS AROUND 4 MONTHS

When your baby learns to use his hands willfully, you will see him bringing both hands together towards a toy, even reaching out and grasping it. The reflexively scrunched-up fists of early babyhood are gone, and his hands will be open and relaxed most of the time from now on.

HOW TO HELP

• To encourage your baby to use his hands, hold toys out for him at his midline, even from a tiny age. Imagine the midline as a line running down the length of his body, splitting it in equal parts of left and right. Learning how to cross his midline, reaching for a toy on his left with his right hand, for instance, has major cognitive and developmental benefits. • Hold out larger toys for your baby to grab so that he has to use two hands to hold them. • Take your baby’s hands and rub them over different textures (smooth, grainy, soft, hard, and so on) to encourage him to explore the world around him. • Let your baby put objects into his mouth. Remember that this action, called mouthing, is how he learns about new things. Always keep safety in mind, though, and watch out that he doesn’t insert choking hazards. • If you find that your baby is always in a fisted position and struggles to open his hands and/or his arms appear stiff, consult your paediatrician.

4 ROLLING OVER FROM TUMMY TO THE BACK: BETWEEN TWO AND FIVE MONTHS

(From his back to the tummy happens at about five to eight months.) Rolling over is essential for the development of movement, exploration of the world, motor planning and later on for midline crossing and developing coordination of the two sides of the body. This milestone prepares your baby for independent mobility and many more motor skills.

HOW TO HELP

• When putting your baby down, or picking him up after changes or naps, roll your baby to his side and lift him up from there. This will give him a feeling of how his body moves through the movement. • Let your baby play on his side. Roll a towel up and place it behind his back for extra support. Remember to do it on both sides, though. • Encourage your baby to play with his hands together in the midline and to move his legs from side to side when he’s lying on his back. This means the top and bottom of his body move in different directions. • If your baby is not rolling over at all by seven months it is worth seeing a neurodevelopmental physiotherapist for some tips and tricks. 5 GURGLING FIVE TO SIX MONTHS You may notice your baby makes his voice rise and fall, often in response to your voice and your facial expressions. Your baby is learning to communicate verbally, laying the foundation for talking later on.

HOW TO HELP

• Your baby loves your voice and finds it fun to chat to you. Encourage talking by copying sounds your baby makes and

allowing time for him to “respond”. • Talk to your baby throughout your day by letting him know what you are doing or where you’re going. • Reading books to your baby also helps with language development. • If your baby is not making sounds at all, not trying to copy noises nor making an effort to communicate with you, speak to your paediatrician.

6 SITTING FROM SIX MONTHS

At around six months your baby should be able to sit up with support (on your lap or with a pillow or two placed around him, for example). By eight months, your baby will be sitting well with little support and can play independently in this position.

HOW TO HELP

• Although there are great seat supports on the market, allowing your baby to sit in these for too long makes him reliant on the seat and minimises his core muscle development and balance control. You are the best support and when need be, pillows behind him do the trick to prevent him from hurting himself when he falls over. • Blowing bubbles or showing baby his favourite toy above him so that he has to sit up to see them can be a great motivation for him to sit more erect, and then learn how to use his hands for more support when he tires. • Make sure to position toys just out of reach once he is sitting well so that he has to turn and reach and use his body in different ways. This rotation and reach should then help get her into the crawling position.

7 CRAWLING SEVEN TO TEN MONTHS

Mobility and independence, here we come! Crawling is just another step on your baby’s road to mobility and it won’t be long now before she starts surprising you with even more new skills.

HOW TO HELP

• Then place a few toys or objects your baby loves in front of him, and just out of reach, so that he is motivated to stay in this position while reaching out for the objects. • If your baby isn’t making any attempt to crawl and seems “stuck” at sitting, it’s best to consult a neurodevelopmental physiotherapist or an occupational therapist for help.

8 PINCER GRASP & MORE EIGHT TO 12 MONTHS

This period of time sees a great leap in development of your baby’s ability to use his hands for function. This can be a messy business, but encouraging your baby to explore different textures will assist in his fine motor development.

During this period your baby will learn how to grab small objects, like peas or pieces of cereal, using his thumb and finger in the pincer position and next, to move objects from one hand to the other or even bang two objects together using both his hands. Between eight and 12 months he should also be able to let go of objects on purpose, (even dropping and picking up his toys), be able to put objects into containers that have large openings and take them out again, hold his own bottle or a spoon (even though feeding himself is still a way off) and wave hello or goodbye.

HOW TO HELP

• Chat to your paediatrician if you are not seeing your baby progress with any of the fine motor skills we’ve mentioned in this age band.

9 STANDING AND WALKING AROUND 12 MONTHS

Your baby will now be able to pull himself to stand and may enjoy cruising around th the house by using the furniture or walls for support. This is a precursor to walking. He will also be able to lower himself back to the floor without falling. He will also be able to stand alone for about five seconds and he can walk when holding your hand for four steps around now. After mastering these skills he learns to walk independently. HOW TO HELP

• If your baby is not trying to stand or walk by 14 months get in touch with your paediatrician or a neurodevelopmental physiotherapist.

WHERE TO GET HELP:

South African Neurodevelopmental Therapy Association (Sandta): www.sandta.org.za South African Institute for Sensory Integration (Saisi): www.instsi.co.za Occupational Therapy Association of SA (Otasa): www.otasa.org.za. YB

• Position your baby over your leg or over a rolled-up towel in the crawling position (hands and knees) so that he gets used to being on his hands and knees with your safe support.