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Hello!  My name is Meredith Dixon and I’m going to be contributing blog posts this fall.  I am a pediatric resident at Georgetown University Hospital, and I work with Dr. Heather Giambo.  It’s wonderful working with kids and learning all about them - both sick and well.  I thought for my first post, I would write about a topic very pertinent to this blog:   early childhood development over the first year of life.  I’m sure some of you have questions regarding what is “normal” or “expected” as your infant grows to be a toddler and hopefully this post can help.

Ask Dr. Dixon, Blog #6: First Milestones

So, what is development?  Development refers to how a child learns how to do more complex things physically and socially as they grow.  Development is not the same thing as growth; growth refers to the physical size of the child and is plotted at every visit to the pediatrician on a growth chart.  (Ask to see this at your next visit, so you know how your child’s size compares to others his or her age.)  Development refers to the idea that your child is constantly undergoing change and maturation.


When we refer to development as pediatricians, we are talking about skills such as:


Gross Motor:  changing positions, sitting, walking, running, etc.  Think:  large movements! 


Fine Motor:  using hands to be able to pick up a cheerio, draw, eat, etc.  Think:  smaller scale movements! 


Language:  speaking, using gestures, etc. 


Cognitive:  thinking, learning, etc 


Social:  interacting with others, developing friendships, etc 


Now, for today, I will review the first year of life, which obviously doesn’t encompass all of the above.  But, I figured this was a good place to start as many of you have little ones.


From a motor perspective, we expect children to gain gross motor milestones in a head-to-toe direction as this is how babies develop in the womb.  For instance, we expect babies can lift their heads at 3 months, sit on their own around 6 months, walk around 1 year and run around 18 months.  Of course, there is some variation on either side by a month or two, as these are estimates or averages. 


From a fine motor perspective, babies don’t have many fine motor capabilities in the first few months.  By age 3-5 months, babies can grasp a cube or toy, but typically first only with the outer aspect of their hand.  Once they master this, they can then use the inner aspect of their hand, in something we call “thumb opposition.”   Of course, after this stage is mastered, your child is putting any and everything into his or her mouth!  These motions then turn into a “pincer grasp” around 10 months of age when the child reaches for a cheerio or small object between their thumb and pointer finger. 


From a social perspective, we expect babies to transform a lot in the first year.  Babies develop a “social smile” around 1-2 months and start to recognize their parents.  Babies start to laugh around 4 months.  “Bye-bye” happens around 6-8 months.   Most babies can play peek-a-boo or pat-a-cake around 9-11 months.  Have you noticed that your baby develops anxiety with strangers?  This usually happens around 9 months as well, and occurs when your baby analyzes the face of a stranger and detects mismatch from your own and subsequently starts to cry and act fearful.  This is normal, and expected to resolve between 1-2 years.


And finally, In terms of language, babies usually can say “mama”, “dada” around 1 year of age.  More advanced language development, with the acquisition of many more words, will happen over the second year of life.  Babies start to babble and coo within the first few months, and then this gradually transitions to “mama” and “dada” (said with meaning to the parent) around 1 year.


So, those are the basic milestones in the first year we evaluate in our patients!  I hope you found this helpful.  Please let me know if you have any questions!



Dr. Meredith Dixon


Leave a comment or question for Dr. Dixon below or on her profile page. She's excited to hear from you!

[Views expressed in the blog series are not in whole or in part that of MCITP and offered solely as a family resource]



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