Infant development in the first year
Paediatric occupational therapist Amy Faulkner guides us through a baby’s physical and mental milestones in the first year of life.
A baby’s first year is a time of rapid development. It is an important opportunity to lay down good foundations of development for your baby and refine their skills in all areas.
Milestone charts are helpful as a guide, however they should not be used as a definitive tool to assess your baby’s development. All babies are individuals and develop skills at different rates. The important thing is that you can see your baby progressing and that they are showing signs of developing new skills month by month.
In the first year, personality traits and characteristics (perhaps from one parent or both) become apparent. Developing a secure attachment with your infant and becoming attuned to their needs will help them to become a content baby who is constantly growing, adapting and learning new skills.
A newborn’s role in their first three months is simply learning how to self-regulate outside of the womb. Your role as a parent is to help them do so. By looking at your baby’s behaviours as their language you can learn what your baby is telling you and how they are feeling. For example, if they are happy and content they will have a good colour, their eyes will be bright and focused. Or perhaps if they are overwhelmed they might look away, be red or pale in the face.
Gross motor skills
It is important to offer your baby plenty of opportunity to lie and move around on the floor or on a flat surface. Your baby should be encouraged to move and stretch while lying on a play mat, in their moses basket, or pram. When supervised, your baby can lie on their back, tummy and in a side lying position.
1. Back to sleep, tummy to play
Tummy time is a vital foundation for helping babies to develop strong muscles in their necks, backs, tummies, legs and arms. This helps them to learn how to control the co-contraction of their muscles. Tummy time should be started from newborn and practiced a few times daily. The Irish Society of Chartered Physiotherapists have a lovely guide to tummy time. http://www.iscp.ie/physiotherapy-tummytime-your-baby
2. Head Control: approximately three months
At birth, babies will generally have weak neck muscles and will not be able to hold their heads up without support. With a newborn, you will need to fully support your baby’s head whenever you are lifting her. Through tummy time, floor time and being lifted and carried a baby’s strength develops, and by three months, she should be able to hold her head up independently when her body is supported.
3. Roll: approximately three months
Babies will usually learn to roll from their tummy to their backs first. They will often master this skill in one direction first then the other. They often discover how to roll by accident while perhaps trying to push out of tummy time position. Rolling from their backs to their tummy is trickier and requires increased motor control.
Babies usually develop this skill by reaching down and exploring their toes. As they do this they may end up rolling onto their side. By six months, babies are usually efficient at rolling such that they may roll tummy to back to tummy again. This is a novel and fun way for a baby to move around.
4. Sit: approximately six months
By now, baby has developed coordination of their back and tummy muscles to work in harmony to keep them upright and to manage their head control. Initially babies will not have ‘saving reactions,’ which is their hand going out to save themselves from falling over. So always keep plenty of pillows and play mats about when working on independent sitting skills.
5. Crawling: approximately nine months
Crawling is a very important milestone for babies as it sets down the foundations for bilateral integration, which is the coordination of the two sides of the body. Bilateral integration is an important skill for your child’s future coordination skills such as riding a bike, ball skills, handwriting etc. It also offers babies an opportunity to develop strength in their shoulders, pelvis and trunk, which is an essential motor skill acquisition and refinement.
Nowadays, tiled and wooden floors are commonplace in the home. These slippy surfaces can make learning to crawl that bit more challenging. Giving them opportunities to crawl on carpeted areas in the home, on a rug or foam play mats is important. Stripping them down so that their legs are bare from the knees down can also provide extra traction to help them get moving.
6. Stand/Cruise/Walk: approximately 12 months for independent walking
You might remember from the early days that your baby would ‘step’ when you held them with their feet on the ground. This was a stepping reflex. This is will disappear at around one to two months and will reappear later in the first year in preparation for walking.
Encourage your baby to weight bear through feet flat on the floor at couches, between your legs from about nine months. Some babies walk from nine months while others will not walk alone until 18 months. If your baby is learning crawling skills, stepping with hands held or holding on to furniture they are developing all the necessary skills for walking, so don’t worry if they are taking a little bit longer to get there.
Avoid equipment that suspends baby from their crotch e.g door frame bouncers, baby walkers on wheels as these pieces of equipment can impact on the development of the hips. They also may cause tightness in the muscles in the backs of their legs if the baby is pushing up onto tippy toes.
Your baby will start to bring their hands to midline, picking at their clothes and putting their hands in their mouths. They can grasp objects (reflex), however they have no true release. Encourage your baby to bat for toys in their play gym. To encourage development of their hand-eye coordination skills and exploratory touch give them light rattles, mirrors, and textured toys to play with.
Your baby’s hand skills are becoming more coordinated and stronger, although they are still not refined. They can transfer toys from hand to hand, hold an object in each hand, hold and bang a spoon. They tend to grasp with their whole hand and sometimes with fingers in a scissors like grip.
Play suggestions include play bricks to bang together, stacking rings and cups, and wooden blocks. Your baby may be weaning onto some solid foods around now and food can be a very motivating way for your baby to refine their hand skills. They do this through exploring and sticking their fingers in purées or chewing on a piece of baby biscuit.
Your baby’s hand skills are more refined now. They can pick up small items using a pincer grip (between thumb and index finger), and isolate their index finger to point and poke. At around 10 months old, your baby has developed a voluntary release so they will love picking up and throwing toys on the ground.
Encourage your baby to play with toys such as shape sorters, picture books with holes and flaps, or toys with buttons to press. Your baby may start to show a preference for one hand over the other by the end of their first year. However hand dominance is not fully established until four or five years old.
Your baby starts to develop their social skills from the minute they are born. Their first social interaction might be skin-to-skin contact with their mum or dad. This physical connection using positive touch is the earliest way of your baby developing social relationships.
In the first months of our baby’s life, they will rely on you to read their behaviours and communication cues and interpret their needs. Babies express themselves through eye contact, smiling, crying, vocalising, and touching and use these behaviours to develop bonds with their care givers. Babies can smile from as young as a couple of weeks old.
Face to face interaction with your baby is very important in developing their social skills. Faces fascinate babies, so there are lots of opportunities to play using your face. As they get older, they will start to pull at your face and feel the different textures of hair, skin, and mouths. You can use your face to develop facial expressions and encourage imitation as babies are able to imitate facial expressions from newborn.
Playing Peekaboo can be a fun way to interact with your baby. As your baby’s language skills start to develop around 10 months, you can develop your baby’s body awareness by asking them ‘where is my nose?’ etc. Round and round the garden, and this little piggy are a fun way to teach your baby concepts and social interaction. As your baby approaches the end of their first year, they develop what is called ‘object permanence’. This means they no longer think ‘out of sight out of mind.’ Your baby has a mental representation of the object or person, which means they will look for it or them if they leave or hide.
Car seats and equipment
Babies should not spend more than 30 minutes in their infant carrier car seat. This is because the car seat brings your baby into a flexed position, which is not a natural position for baby anymore as it once was when they were tucked up in mummy’s womb. Babies need to reach, extend and stretch to explore and learn about their environment.
Some proven risks of prolonged car seat include, increased reflux, risk of blocking off airways and reduced oxygen levels, and overheating. Time spent in the car seat should be limited to car travel only. The availability of equipment, such as seats, swings, or jumping gyms often leaves babies at risk of limited opportunity to learn and move independently. This may encourage and contribute to musculoskeletal problems such as torticollis, and plagiocephaly (flat head).