Well-Baby Care Visits & Developmental Milestones (Age 0-12m)

What are developmental milestones for my baby?

As you adapt to your new role as a caregiver, your baby is adapting to their new environment. Your healthcare provider will closely monitor your child’s growth during their first year to make sure they are meeting milestones, which are things that your baby can do by a certain age.

Keep in mind that babies grow at their own pace and there is a range of time when they will perfect their skills to reach each milestone. If you’re wondering why your child might be “off-schedule” to reach one skill, they may be working on another simultaneously. If you have any concerns about the pace of your baby’s development, talk with your baby’s healthcare provider.

When should my baby get checkups?

During your baby’s first year, schedule checkups every few months, on a timeline advised by your healthcare provider. Most providers will recommend six to seven visits in the first year to monitor growth. The timeline for checkups during your baby’s first year include:

• 1 month old.
• 2 months old.
• 4 months old.
• 6 months old.
• 9 months old.
• 1 year old.

What can I expect during a well-baby checkup?

Periodic examinations by your healthcare provider offer a foundation for your baby to grow and provide an opportunity for you to ask questions about your baby’s health and wellbeing. The goal of each well-baby exam includes:

• Developmental milestone assessment (how your baby moves, speaks and plays).
• Physical examination and growth measurement.
• Health screenings, nutrition advice and vaccinations.
• Guidance on upcoming growth milestones.

Before each visit, identify any concerns you might have and prepare to discuss those with your healthcare provider, who will be able to assist your baby if you suspect anything might be abnormal with their development.

Developmental Milestones

How do developmental milestones track my baby’s growth during their first year?

Developmental milestones track behaviors that mark stages of growth for your baby. Each milestone of your baby’s development focuses on four aspects of their growth including:

• Motor skills.
• Visual or problem-solving skills.
• Language development.
• Social skills.

Each baby is unique and grows at their own pace. Some babies reach milestones more quickly than their peers, while others may have slightly delayed development. Keeping track of their progress and staying up to date on well-baby visits with your healthcare provider will make sure your baby is developing at a normal pace or they will supervise treatment if your baby’s development is abnormal.

Baby development milestones: 1 month

By the time your baby is 1 month old, they are adapting to their new environment and schedule. Developmental milestones for your 1-month-old baby include:

• Raising their hands to their face.
• Moving their head from side to side.
• Grasping their fists tightly.
• Being alert to sounds.
• Recognizing faces.
• Eating every three to four hours on a diet of formula or breastmilk.

What are safety tips for my 1-month-old baby?

Provide a safe environment for your baby to thrive in during their first month by:

• Installing smoke detectors. Test them once a month and change batteries twice per year (spring forward and fall backward). Consider installing a carbon monoxide detector in your home as well.
• Using a car safety seat properly. Make sure you have a car seat that is the right size for an infant (under 20 pounds). Read the instructions carefully and make sure that the seat is properly installed in the back seat of your car. Car seats should be rear-facing until your child is 2 years old.
• Never leaving your baby unattended.
• Never putting a necklace, pacifier or toy around your baby's neck.
• Allowing no more than a width of two adult fingers between your baby’s crib mattress and frame.
• Adjust your household’s water heater to 120°F (48°C) to avoid accidental burns.

Baby development milestones: 2 to 3 months

Your baby will start to perfect simple body movements as they figure out how their body works. Milestones for your growing baby include:

• Raising their head and chest when laying on their stomach.
• Making coos and gurgling noises.
• Unclenching their fists and reaching for objects.
• Following objects with their eyes.
• Smiling at people, especially caregivers.

What are safety tips for my 2- to 3-month-old baby?

Keep your 2- to 3-month-old baby safe by:

• Avoid drinking or using hot liquids while holding your baby.
• Using a playpen to keep your child safe, but avoiding the use of walkers as they are unsafe.
• Playing with toys that are strong, don't come apart, aren't sharp and are larger than your baby's mouth.
• Keeping tap water at less than 120°F (48°C).
• Never leaving your baby alone with siblings or pets.
• Never leaving your baby alone in a place where they can fall or drown.

Baby development milestones: 4 to 6 months

Between 4 and 6 months, your baby is much more active both physically and verbally. Not only does your child respond to your approach, but they actively participate with family members in play and initiate some of the interactions.

At 4 months, your baby might be ready to try new foods other than formula or breastmilk. An indication that your baby is ready for solid foods is when they have good head control and can turn their head away to tell you that they’ve had enough to eat. Start your baby on an iron-fortified cereal (whole grain rice cereal, barley or oatmeal) mixed with breastmilk or formula and feed them with a spoon. Your baby will find the new texture and consistency very interesting. Introduce pureed vegetables and fruit one at a time, every three to four days, to give your baby time to adjust to each new food.

At 6 months, your infant is now ready for three meals of solid foods a day. A recommended example is one cereal and two servings of vegetables or fruit each day. Each meal should also include breastmilk or formula. Your baby will most likely will take another bottle in the evening. It's normal for your baby to decrease the amount of breastmilk or formula at each feeding as their intake of other foods increases. Peel any skin from foods before giving it to your baby, as it can cause choking.

Developmental milestones between ages 4 to 6 months include:

• Rolling over and reaching with both arms.
• Holding their head steady.
• Laughing and babbling.
• Recognizing familiar people and identifying strangers.
• Responding to their name.
• Sitting upright without support by the end of this period.

What are safety tips for my 4- to 6-month-old baby?

As your infant becomes more mobile, consider the following tips to keep your baby safe:

• Installing guards on electrical outlets. Use electrical tape to secure electrical cords along baseboards.
• Putting small objects, knick-knacks and poisons out of reach or in a locked cabinet.
• Making sure that your infant cannot pull down lamps or other electrical objects by the cords. Secure cords on blinds and drapes to prevent accidental strangulation.
• Inspecting toys for small parts that can break off and keep them away from your child who might swallow those pieces.
• Keeping a flashlight in your bedroom in case of a power outage.
• Avoiding secondhand smoke. If there are any smokers in the home, encourage them to quit smoking.
• Limiting your child’s sun exposure. Make sure your child wears protective clothing (hats, SPF-protective clothing) if they'll be in the sun for a prolonged period. (The FDA does not approve sunscreen for babies under 6 months.)

Baby development milestones: 7 to 9 months

Your baby is developing skills that will enable them to explore the world. New discoveries come with more complex mental development and through the increased use of their hands (fine motor skills) and increased mobility (gross motor skills).

By 9 months, your infant probably has a large repertoire of foods. At this age, finger foods are important. Your child can now pick up and hold small objects and shows interest in new tastes and textures of foods. Finger foods are also important as your baby strives to become more independent.

Milestones between 7 to 9 months include:

• Using voice to express feelings of happiness or sadness.
• Playing peek-a-boo.
• Understanding the word “no.”
• Distinguishing favorite toys.

What are safety tips for my 7- to 9-month-old baby?

Your infant’s motor skills are improving, allowing them to touch and grab objects that may have been out of reach before this age. Keep your active child safe by:

• Avoid feeding your child peanuts, hot dog pieces, popcorn, frozen peas, beans, raw carrot sticks, pieces of raw apple, grapes and raisins because they can cause choking.
• Never leaving an infant in a vehicle in any weather.
• Gating or closing off any open stairways.
• Keeping poisonous house plants out of reach.
• Eliminating home hazards including dangling cords, pot and pan handles on the stove, accessible hot liquids, hanging table cloths and small objects your baby might try to swallow.

Baby development milestones: 10 to 11 months

Your baby is active, moving and preparing for their first birthday. They may become clingy to you and their caregivers or shy when meeting strangers. Your baby is verbally able to notify you when they want something and work to mimic sounds that they hear. Milestones for your baby between 10 and 11 months include:

• Speaking first words like “mama” and “dada.”
• Pulling themselves up to stand.
• Holding, shaking and throwing objects.
• Showing interest in exploring their environment.

What are safety tips for my 10- to 11-month-old baby?

Because your infant is now more mobile, safety measures need to expand to anticipate new activities. These safety measures include:

• Using gates at stairwells and installing safety devices on windows and screens if necessary. Increased mobility might lead to falls. Avoid gates with diamond-shaped slats, which provide footholds for climbing toddlers. Instead, use gates with straight, vertical slats and a swinging door.
• Keeping sharp objects (knives, scissors, tools, razor blades) and other hazardous items (batteries, coins, glass objects, beads, pins, medicines) in a secure place.
• Upgrading to a toddler car seat when your child weighs 20 pounds. Car seats should be rear-facing until your child turns 2 years old.

Baby development milestones: 1 year

Your baby accomplished so much during their first year. Now, your baby can fine-tune their motor skills and verbally express themselves in simple words or sounds with one or two syllables.

By the time they are 1 year old, your child can drink whole milk instead of formula or breastmilk. Cups should begin replacing bottles. Mealtime for your baby is starting to match that of your whole family.

Milestones at your baby’s first year include:

• Starting to walk, standing on their own or walking by holding onto furniture.
• Holding and using objects like a crayon or a cup.
• Speaking with tone and inflection like “uh-oh!”
• Attempting to imitate words.
• Copying gestures.

What are safety tips for my one-year-old?

Your child is mobile and is therefore at risk of many new dangers. They might already be taking a few steps without support and they're surely learning to fall like a champion. Falling while learning to walk is normal for all children as long as you supervise them to prevent injury. Safety tips for your 1-year-old baby include:

• Making sure there's nothing available for your baby to grab that might fall on them and cause them harm, including tablecloths, furniture, electrical cords, etc.
• Keeping your child out of the kitchen while cooking and placing them in a safe space like a playpen or a crib if you're unable to give them your full attention.
• Keeping firearms unloaded and locked away, out of reach from children.
• Securing poisons, medicines and chemicals in a locked cabinet. If your child does put something poisonous into their mouth, call Poison Help immediately at 1-800-222-1222.

Follow-Up

What are developmental health concerns for my baby?

During the first year of development, your child adjusts to the world around them. Their body may have trouble adapting comfortably. Some developmental setbacks might be due to:

• Constipation: While there's no correct number of bowel movements for your baby to have each day, the most important aspect is that your baby’s poop is of normal consistency and bowel movements aren’t painful. Normal poop consistency is a soft, wet and runny texture that may have a paste or seed-like consistency in brown, green or yellow colors.
• Colic: Your baby may cry for extended periods that can be difficult to soothe. If your baby is extremely fussy and cries a lot, let your child's healthcare provider know. Suggestions to calm a fussy baby include using a pacifier, rocking your baby while playing music or changing your baby’s diet.
• Respiratory syncytial virus (RSV): While your baby grows, their immune system isn’t as strong as yours, which makes them targets for viruses. RSV is a common respiratory virus that infects many children before they reach the age of 2. RSV spreads in young children through close contact with someone infected with the seasonal virus. Illness can prevent your baby from focusing on tasks when they don’t feel well.
• Hand, foot and mouth disease: Infants are likely to get hand, foot and mouth disease, which is a virus that spreads through close contact and touching contaminated surfaces. Hand, foot and mouth disease causes a rash and painful sores on your baby’s body, and your baby’s attention to the rash may delay and distract them from reaching milestones.

When should I call my healthcare provider?

You should reach out to your healthcare provider if you have questions about your baby’s health, no matter how big or small. Often, new caregivers have several questions since newborns don't come with an instruction manual. As a caregiver, trust your instincts. If you suspect something is wrong, don’t be afraid to call your doctor if your baby:

• Changes eating habits.
• Can’t calm down or there are changes in behavior.
• Has abnormal poop.
• Has fluid draining from their ears or ear pain.
• Coughs frequently.
• Isn’t crawling by 1 year.
• Loses skills they once had.

When should I go to the ER?

Visit an emergency room immediately if your baby:

• Has trouble breathing or has blue or purple skin or lips.
• Eats or drinks something dangerous.
• Is limp or not responding.
• Is bleeding or has blood in their poop or vomit.
• Has a yellow tone to their skin or eyes.
• Has a fever or a high temperature above 100.4°F before two months of age.

What questions should I ask my healthcare provider?

• Is my baby developing normally?
• Should I be concerned if my baby missed a developmental milestone?