Milestones: When to worry (or not)

Relax! Every child is unique, and developmental milestones are only a guide.

Aaaaaargh, help! My baby didn’t lift her head by one month, roll over by three, only walked at 18 months, kicked a ball at four, recited the Halleluja by five… and the chart says she should’ve done it earlier (not to mention all of my friend’s children who did)! All parents worry about their child’s development – of course we do, we all want to see our children thrive, flourish, reach their potential…

So it’s very easy to get sucked into worry about if, and when your child meets those ”golden standard” developmental milestones. But what are they really, and do I need to panic if my child isn’t meeting them exactly as the charts say they should?

WHAT ARE THESE DEVELOPMENTAL MILESTONES?

They’re simply a measure used by parents, caregivers and professionals to compare a child’s growth and development over time with researchbased norms (averages).

Basically, hundreds of thousands of children were studied a few decades ago to find out what the ”normal” age range is in which babies and children achieved various developmental milestones, such as sitting, smiling, crawling and walking. Milestone charts are used as an indicator to gauge a full-term child’s development, but there are a couple of things to keep in mind when using one.

Firstly, these charts are all about averages: if the chart says that the ”average” child can lift their head in prone position by month one, then it means that 50 percent can, but 50 percent haven’t managed to (yet).

Secondly, most charts give an age range for when a milestone is expected to be reached, so for example, being able to sit independently is normally achieved between four and eight months.

The average is six months, but it is still within the normal range for a baby to start sitting well into their eighth month. And finally, while each milestone is reached in a predictable sequence (for example a baby learns to sit before they learn to crawl and to pull up to standing before learning to walk), the exact timing or speed at which each milestone is reached is not a reflection of your child’s intelligence or their physical abilities later in life (now take a deep sigh of relief). There are plenty of Olympic athletes who did not walk at 12 months – and frankly very few of those athletes will have any idea of when they reached their milestones!

BUT WHAT IF MY CHILD IS NOT REACHING THE MILESTONES?

“There may be a number of reasons why your child may not ‘fit’ into the charts, and very few of these reasons are problematic,” says Tracy Prowse, a Stellenbosch-based physiotherapist with a special interest in children and development.

Exactly when your child will reach each milestone is determined by a unique combination of nature (including genetics, their innate personality) and nurture (your parenting style, the cultural and physical environments they are raised in). Genetics: Every child is unique, and your child’s individual, genetic make-up can play a role in when he or she reaches their milestones. Think back – or chat to your parents – about when you reached your own milestones.

While not an exact science, knowing when you took your first step may help you manage your concern or expectations about when your child will take their own first step.

Your child’s innate personality: Is your child naturally curious? Or cautious? Learning new skills is all about exploring and taking risks, and if your child is naturally cautious, the chances are they will take a bit longer to get going.

Take crawling, for example. The main thing that motivates a baby to start moving is wanting to reach for something new or get somewhere new.

If your child is perfectly content exactly where they are, then they won’t move. Simple. They will learn the skill; it just might take a bit longer.

Opportunities: You also need to think about the opportunities your child has to learn: for example, do you have balls around the house, and does anyone kick with your child at home? A child can’t reach the ”kicking” milestone if they never have any ball play. Parenting style: This idea can be a little controversial, but your particular parenting style can play a role in how and when your child will reach particular milestones – not unlike their innate personality. The children of overprotective, very cautious or helicopter parents can often lag behind the ”average” in terms of milestones. Why? Well, if you reach in to pick a child up and put them on a chair, they will never feel the need to try pull themselves up to it alone, for example. If you always pass them the toy, they will never feel the need to wiggle forward to get it themselves. Or if your child never gets the chance to practise using a spoon, then it will take longer for them to master self-feeding. “Your child needs to figure things out for himself,” Tracy explains.” He needs opportunities to struggle and fail in order to push himself into learning new ways of doing things. Leave a toy just out of reach, let them pull themselves up to the sofa, take a couple of steps and fall.”