Milestones of child’s growth
Dr Wazir Ahmad
Every parent involved in the caring and nurturing of their offspring are at times quite confused or unaware of the proper growth and development of their children. Normal milestones of development is the corner stone in the development of a healthy child. From birth to adolescence every child tries to adapt to its environment by performing different skills like vision, hearing, talking, playing etc. Some children tend to acquire these skills slowly or it may be delayed, which at times may be familial or idiopathic without any pathology. But any suspicion or doubt should alert the parent to seek medical advice; delay in this regard will have disastrous effect on the child.In fact growth and development starts from intrauterine life during pregnancy. All pregnant mothers should monitor the growth of their child from the day of conception by regular antenatal check up. Delivery related problems should be ruled out after the birth of every child, which can have serious effect in the growth of a child. Here are some important milestones of development in chronological order from birth up to two years. Delivery
A healthy newborn baby after delivery is always active, pinkish and crying. They have very strong sucking reflex, when put to mothers breast will suck vigorously. Any deviation from these normal criteria needs proper care, attention and evaluation by a qualified medical personal. These babies need to be followed up carefully for any growth and development deficit. First three months
The development of brain is a very complex process with all its connections. Positive stimulus, with caring and nurturing has a good impact, which leads to better performances in life. Negative stimulus has an opposite effect. From 6 weeks onwards: a) Has a social smile and stares at speakers face. b) Startled by noise. c) Follows object. d) Can lie in prone position with head control. e) At 1-2 month turns from side to back drops toys. Can grasp an object by 3 month. f) Recognises parents. g) Engages in vocalisation and smiles spontaneously. From three months to five months
From three month onward a baby becomes more active, alert and responsive. a) Reaches for and brings object to mouth. b) Sits with support. c) Laughs d) Anticipates food on sight e) Turns from back to side. f) Pull to sit. g) Weight bears. From six to eight months
From six months onwards the child has more mobility, dexterity and communication skill. The child can sit independently; can pick up objects between two fingers, can crawl. Most children at this age have symmetrical movements of both hand and feet. Asymmetrical of one hand, feet or face is a matter of concern and should referred to a Pediatrician for evaluation. At this age the child can imitate "bye bye", rolls from back to stomach, he or she is inhibited by the word "no". Plays "peek- a- boo". Puts object into mouth. Responds to own name. From nine month to twelve month
At this age the child can independently perform lots of acts. Stands alone. Walk holding furniture. Follows or listens to verbal commands, like "Come here", "Give it to me" By the age of one year a child says "mama" and "dada" with meaning. Tries to build a tower of two cubes. Points to desired object. From twelve month to eighteen month
From this age onwards the child tries to learn new things very rapidly. Mentally and physically they are more adapted to the environment. They are more skillful and active, they are more communicable and responsive, says about four to twenty words. A normal child at this age throws ball, scribbles spontaneously; can sit in a chair, can feed itself. The child can walk independently and climb stairs with help. At eighteen months a child can indicate toilet need. Takes off shoes and socks. Holds spoon and put food to mouth. Points to eyes, nose and mouth, and can speak three or more words. The child can turn pages. Walk backwards. From eighteen months to two years
From this age onwards the process of learning, inter action and other activities gets more refined. The child learns to get toilet trained, remains dry through the day. Puts on clothing, plays alone. At two years a child jumps off floor with both feet, stands on either foot alone. Climbs and descends stairs, can kick a ball at will. Speaks short phrases. Gives names, uses plurals. To monitor proper growth and development there are certain parameters, which needs to be registered right from birth onwards. Immediately after birth the head circumference, length and weight should be noted and during subsequent visit to a Doctor this should be routinely plotted in a chart to evaluate the Child’s normal growth pattern. Evaluation of hearing and vision is an also a very important aspect of examination in the early days of life. There is a saying "if the mind does not know the eyes cannot see" so one has to know the normal development in order to know what is abnormal. Dr Wazir Ahmad is an Associate Professor of Neonatology of Chittagong Maa-Shishu O General Hospital.
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