FAQ

Babies walk at different ages and the age that they walk is dependent on development of all the motor skills needed to come to standing. It starts with the baby learning head control on their tummies. As they begin to learn to sit, babies develop the ability to control their trunks so they don’t topple over backwards, forwards and sideways. Babies under 3 months have a reflex that causes them to stiffen their legs when their feet are placed on the ground. This is NOT really standing and it is important not to place a baby on their feet too early. They are ready to bear weight on their feet when they are held and can begin to push into the ground to raise AND lower back down around 5 months. Next the baby will stand at a surface like the couch and squat down and raise up, strengthening their leg muscles. Then comes cruising around 12 months where they walk sideways while holding on to something like the couch. Here they are learning how to shift their weight from one foot to the other. Around this time they may come to stand briefly without support (exciting times!) As they begin to walk they have to have both hands held and then can do it with one hand held between 10 and 12 months. By 15 months most babies are walking independently. The use of infant walkers has become very popular because they make the baby happy and the mom happy by containing the baby. However, if the baby is not placed on the floor and allowed to develop all those skills needed to walk by themselves, independent walking may be delayed. So a balance between using a walker and letting the baby be on their own is important. Also in some cultures may be held and carried a lot. This may also delay their independent walking. But if this is the cultural value, it should be respected.

The age a baby starts eating solid food depends on multiple factors. Not only is motor development important, but the culture the child comes from also plays a role. A newborn’s tongue movement is limited to back and forth so they are ‘set up’ to suck from a nipple. They have a short neck and no head control. The larynx (voice box) sits high in the throat to protect the child from choking. The tongue is large compared to the size of the mouth so the baby can create a vacuum inside the mouth to suck. Their gag reflex is very sensitive and far front on the tongue, again to protect them from choking. (NOTE: unless an infant has significant reflux or some medical reason, cereal should not be added to a bottle to make a baby sleep longer. If solids are introduced too early it can trigger food allergies and can be a choking hazard). As the baby develops gross motor skills and begins to be able to raise their head up against gravity while on their belly (tummy time is important!) their necks are getting stronger. By the time a baby is sitting up with some help to not fall over, they have steady control over their head. The neck is longer, the larynx has dropped down and the tongue is not as large inside the mouth so it can move in more directions. In those first 6 months they are also ‘working’ on the fine motor skills to get their hands and toys to their mouths. This is important because it decreases the sensitivity in their mouths and allows the gag reflex to move farther back in their tongue and encourages tongue movement. If this doesn’t happen then they will gag whenever solid food is put in their mouths. All this occurs by around 6 months of age. The first ‘solids’ have to be puree because their tongue and jaw can’t handle solids. By 9 months of age most babies are sitting in high chairs. They have begun to develop the ability to move the tongue side to side which has to happen for them to be able to move food to their teeth. Usually by this age they have front teeth and are getting their molars in. By 12 months most babies can chew chopped table food and are able to feed themselves finger foods such as Cheerios that dissolve pretty quickly in the mouth. (NOTE: throughout all this process and up to at least 2 years the baby needs to be closely supervised when eating) An additional factor to when a baby begins to eat solids depends on the family’s culture. Some cultures introduce solid foods as different ages. So it is important to be sensitive to these differences.

Babies start to communicate from a very early age, those sweet baby sounds, gurgles and cries are the beginning stages of communication. In the first few months babies vocalize different cries giving specific signals to the caregiver. A more urgent cry may signal hunger or discomfort from a dirty diaper, a less urgent cry may signal the need for comfort. Typically by the age of 6 – 8 months an infant has uttered his first word, i.e. “mama,” “dada.” At around 11-12 months a toddler will use these names to call a caregiver by name. First words continue to develop from this stage and by one-and-a-half years a toddler should use between 10 and 20 words. However, you may notice your child’s vocabulary has leveled off or she is not using many new words. If this happens take notice of your child’s other developmental skills. It is very common for toddlers to slow down in one skill area while they are flourishing in another. For example, perhaps your child was saying a new word every few days and now hasn’t said a new word in a week. You may also notice during this time that your youngster has aced walking and is now able to get up and walk across a whole room with no falls. In this case the communication skills slowed down while the motor skills kicked in. If you have concerns about your child’s communication skills please check with your pediatrician, he/she can help you discern what is typical development or if there is a need for further evaluation.

Self-dressing is an important milestone for a young child towards independence. Earlier skills need to be intact before a child starts to self-dress. They need to know where their body parts are which is established by 2 ½ years as well as beginning spatial relations of objects to body i.e. place arms in shirt opening (2 years). Even earlier, children start to cooperate and assist with placing arms and legs in garments at around one year. Self-dressing coincides with beginning toileting skills as children start to pull pants up/down at around the 3-year mark. Balance skills are emerging between 2 ½ and 3 years to allow balance on one foot for a few seconds to place one foot in leg opening in pants in the standing position. Although, children will start off with dressing in the seated position. Baby’s will start to remove their socks at around 15 months but will not be successful with putting socks on until age 3-4 years. Taking off shoes occurs in line with removing socks but children typically find it easier to put on their shoes depending on the style between 2-3 years. Pre-school age children can typically put on shirts at age 4 and pants at age 5. Self-dressing will continue to develop and refine from early school age and up.

Most of us think the action of sitting up is a simple, natural act. It becomes much more complex when you think about all the skills involved in the process of learning how to sit. An infant requires core strength to hold the body upright as well as strength in the hips and legs to support the body. Balance is required to keep the body close to midline so as not to topple over. Coordination is required to move the body, legs and arms in a timely manner to stack the body upright. Most infants are able to sit between six and ten months old. Some babies are able to sit earlier than this by leaning on the arms for support, at around five months. By the time a baby is eleven months old he/she is usually sitting on his/her own and is able to turn the body to reach for toys without falling over.

One of the most exciting physical milestones for a baby is rolling over. This is the first physical way a baby controls movement and position in the environment. Those wiggling legs while on the back (supine) and pushing up on arms on belly (prone) are the first movements to prepare for rolling. At face value, rolling looks pretty simple, but the baby has to control the arms, trunk, legs and head in order to accomplish this milestone. At 2 months of age, a baby starts to lift the head to 45 degrees and at about the same time, rolling from the side lying position to the back begins. For the full rolling (prone-supine) to occur, the baby will develop strength in arms by bearing weight propped on elbows between the 4th and 5th month. Supine to prone rolling is typically consistent at the 7th month. Although rolling from prone to supine is typically the first step in the developmental sequence, some babies will first roll from supine to prone first. Rolling in either direction, requires a lot of coordination to plan the movement (motor planning). It is not uncommon for a baby to have a onetime success in rolling, with several weeks passing for consistent success to occur. This is not set back; the baby continues to work towards this skill with each incomplete attempt. Righting reactions play a big part in success with rolling. Baby’s first lead with their heads to “log roll”. This early rolling (4-6 months) is generated by the movement of the head which then activates the head righting reaction. The head rolls first, followed by the shoulders, trunk and legs. The more mature rolling is typically a consistent skill at 9 months. With this maturity, Rolling is most efficient with hips leading in a sequential rolling pattern.

Potty training is one of the most exciting milestones for many parents. Parents are usually ready to ditch the diapers, which can be a huge motivator for getting your child potty trained. There are several signs you’ll want to look for before you dive into potty training. One of the first signs you’ll notice is that your child notices the messy diaper and wants to be changed into a clean diaper. This occurs around the age of 18 months. Another telling sign is when your child “hides” while doing their business in the diaper. Most children are ready to begin the process of potty training around age two. At this point you may want to consider putting your little one on a schedule, such as attempting to use the toilet every two hours. Putting your child on a schedule helps because sooner or later they’ll go potty in the toilet which helps to solidify the concept. At two years of age most children can anticipate the need to go to the bathroom. This comes from the ability to notice and understand the way the body feels when it’s time to use the restroom. Some things to keep in mind during this time… boys tend to potty train a little later than girls. It’s also important to know that your child’s body must reach a certain level of maturity before toilet training is possible. If your child doesn’t have control over the muscles necessary to hold and release, he/she will not be successful at potty training.

Sleeping through the night depends on the age of the baby and the family’s night time routine. The concept of ‘through the night’ also depends on a number of factors. Newborns need to eat every 2 -3 hours around the clock. This means that for a baby from birth to 2 months, the definition of sleeping well can mean sleeping up to 3 hours for the first 2 months. Nights and days get mixed up for newborns because they have to refuel frequently. Establishing a night time routine as early as possible helps the baby develop the distinction between night sleep and naps. As the baby reaches 2 – 4 months of age they baby can last longer between feedings and may sleep 5 to 6 hours at a stretch. At this age a baby can begin to be encouraged to sleep longer during the night by giving them a full feeding before laying them down, and not disturbing them until they wake up to eat again. It is not ever good for a baby this age to be left to cry for a long time. A little fussing is OK, and they may settle themselves down. But all out screaming means they are not going to be able to get back to sleep on their own. Babies need to know they are safe, cared for and that someone will meet their needs to develop healthy attachment. Healthy attachment lays down the brain circuitry needed for normal development in all areas. An 11 pound 4 month old can go up to 8 hours before needing to eat, if they have been giving a full feeding before laying them down but they may wake up very hungry. So, count on maybe 6 – 8 hours at this age. By 5 – 6 months most babies can go a full 8 hours without eating, especially if put to bed with a full tummy. At this age they may wake up and want attention, but they don’t necessarily need to eat. Don’t give a baby cereal in their bottle to make them sleep longer. Giving solid foods too early can trigger food allergies and the baby can choke on the thickened formula.