Growth and Development, Ages 1 to 12 Months

What to Expect

Babies usually grow in natural, predictable steps, moving from one milestone to the next. During the first year you will see gains in five major areas:

• Physical development . Babies steadily gain weight and grow in length throughout this first year, often in growth spurts.
• Cognitive development . This means how the brain forms its abilities to learn and remember. Babies soon begin to recognize familiar people. They gradually realize that people and objects exist even when they are out of sight. They begin to connect what is seen with what is tasted, heard, and felt.
• Emotional and social development . Babies form bonds with their parents and other caregivers. When cared for in a loving and consistent way, most babies begin to engage and interact with others.
• Language development . Babies start communicating with different types of cries, then progress to babbling. For more information, see the topic Speech and Language Development.
• Sensory and motor skill development . As your baby's brain, nerves, and muscles continue to grow, controlled movements become more refined, and newborn reflexes gradually fade.

Milestones by age

Each baby grows and gains skills at his or her own pace. It's common for a baby to be ahead in one area, such as language, but a little behind in another.

By around 2 months, most babies:

• Smile as a way to engage others.

By 4 months, most babies:

• Start using their arms with purpose. For example, babies may move their arms and squirm when excited or "swipe" at dangling objects.

By 6 months, most babies:

• Have doubled their birth weight.
• Are able to sit with little or no support.

By 9 months, most babies:

• Get upset when you or another caregiver leaves.
• May have begun to crawl.

By 12 months , most babies:

• Have tripled their birth weight.
• Are expressive and have formed a close attachment to their parents.
• Understand some words and begin to figure out the meaning of many others.
• May be able to say a few words.
• May be walking.

Premature infants typically reach milestones later than others of the same age. But they are usually on schedule for their expected time of birth. For example, a baby born 2 months early might reach milestones 2 months later than a full-term baby born at the same time.

Healthy babies who were born prematurely usually reach normal developmental levels for their age by the time they are about 24 months of age. Learning and thinking skills usually are first to catch up. Motor skills are often the last to catch up.

Common Concerns

During the first 12 months of a baby's life, it's very common for parents to have concerns about their baby's general well-being. Know that you likely don't have anything to worry about. But it is good to be aware of health, development, and safety issues to help prevent or respond to problems.

Sudden infant death syndrome (SIDS)

SIDS is the death, without a known cause, of a baby who is younger than 1 year old. Typically, a parent or other caregiver puts the baby—who seems healthy—down to sleep and returns later to find the baby has died.

SIDS is very rare, and it cannot always be prevented. But you can help prevent SIDS by taking certain steps. For instance, always put your baby to sleep on his or her back. For more information, see the topic Sudden Infant Death Syndrome (SIDS).

Sleeping

You may just start bragging to your friends and family how your baby is sleeping through the night when—suddenly—that's no longer true. The fact is, sleeping patterns change.

Your baby may suddenly start to cry when it's nap time or bedtime or may wake up during the night. Sometimes a baby gets too excited for sleep after he or she has mastered some new skill, such as jabbering or shaking the crib. Other times, hunger from a growth spurt, a change in routine, or not feeling well may interrupt a good sleep pattern.

Try to keep a nap and bedtime routine. Your baby will adjust if you stay consistent. And remember, napping can be good for tired parents too.

Feeding

You may notice your baby's feeding patterns change during this time. Parents often wonder whether their baby is getting enough nourishment. The quality and quantity of a baby's feedings probably are sufficient if the baby is gaining weight steadily, is content most of the time, and is becoming increasingly alert and active. For more information about feeding your baby, see the topics Breastfeeding and Bottle-Feeding.

Crying

Babies cry a lot, especially in the first 2 months. Crying is your child's first way of communicating.

The amount of time your baby spends crying usually increases from birth until your baby is about 6 to 8 weeks old. After that, your baby will gradually cry less as he or she finds other ways of communicating or consoling himself or herself.

If your child is crying, try to identify the type of cry. It helps to go through a mental checklist of what might be wrong and make sure your child is safe and cared for.

As you respond to the young child's other signals (such as whimpering, facial expressions, and wiggling), the child will usually cry less. For more information, see the topic Crying, Age 3 and Younger.

Choking

Babies love to put objects into their mouths. To keep your baby from choking:

• Be careful about the size of toys he or she plays with.
• Watch out for everyday items that your baby could swallow, such as coins.
• Be careful as you begin introducing solid foods to your baby around 6 months of age. Help prevent choking on food by not giving your child round, firm foods, such as hot dogs, unless you first completely chop them into very small pieces.

Diaper rash

Diaper rash occurs most often in babies who are 9 to 12 months old. Even though a diaper rash is uncomfortable, normally it isn't serious. Usually the rash clears up when you:

• Change diapers more often.
• Are careful about cleaning your baby's bottom.
• Apply nonprescription ointments to the rash.

Teething

Your baby is teething when his or her first teeth break through the gums. Teething usually begins around 6 months of age. But it can start at any time between 3 months and 12 months of age. Your baby may show signs of discomfort from sore and sensitive gums, be cranky, drool, and have other mild symptoms for a few days before a tooth breaks through the gum.

Sibling rivalry

It may take a few months before an older child shows signs of jealousy of a new baby. When your child realizes that the baby is there to stay, strong emotions and behavior problems may soon follow.

You can take steps to prepare for sibling rivalry. For example, you can:

• Help your older child adjust by setting time aside for just the two of you.
• Talk about how important it is for your older child to help care for the baby.
• Give your older child a role in daily care, such as handing you a fresh diaper when you change your baby.

Separation anxiety

Beginning around 6 months of age, your baby begins to feel uneasy when you go away. Starting around 9 to 12 months of age, he or she may cry and react strongly when you leave. This is called separation anxiety, or separation protest. You can help your baby manage these emotions by making sure your child is well-rested and well-fed before you leave. It may also help to distract your baby, such as with a favorite toy.

Promoting Healthy Growth and Development

A baby goes through so many changes that it can be hard for you to keep up with all the things experts say you "should be" doing to promote healthy growth and development.

Remember that the best things for your baby are usually the simplest. Loving, holding, changing diapers for, talking to, and feeding your baby are the things to focus on.

But you can always learn more about how to help your baby grow and develop in healthy ways.

Physical health and development

• Try to breastfeed for at least the first year of life. Breast milk is the ideal food for babies.
  • Breastfeeding
  • Weaning
• Learn your baby's rhythms . You will gradually get a sense of your baby's unique sleeping and eating patterns and be able to help establish a routine by about 3 months of age. But be prepared to make adjustments as needed.
• Help keep your baby's head from getting too flat . It's important to always put your baby to sleep on his or her back. But always sleeping on the back may make your baby's head a little flat. You can help keep it from getting too flat by changing his or her head position regularly.
  • Allow your baby "tummy time" while he or she is awake and you are closely watching. Tummy time also helps your baby develop motor skills.
  • Cuddle your baby while holding his or her head up as much as you can. Don't place your baby in car seat carriers or bouncers for long periods each day.
  • Change your baby's head position during sleep at least every week. (Remember to always keep your baby on his or her back during naps and at bedtime.) A good way to make sure your baby's head rests in different positions is to switch which end of the bed you place him or her in each week. Babies usually turn their heads away from the wall, toward the inside of a room.
• Start to care for your child's teeth as soon as you see the first baby tooth (primary tooth).
  • Basic Dental Care
  • Brushing and Flossing a Child's Teeth
• Keep your baby safe from injury, drowning, burns, poisoning, and other dangers.
• Choose child care wisely. Before you take your baby to a child care center, check the health policies of the center. Get the names of people and agencies you can talk to about the care center's safety record. For more information, see the topic Choosing Child Care.

Emotional health and development

• Encourage bonding . Consistently interact with and provide loving attention to your baby.
• Recognize and reinforce behaviors. For example, when interacting with your baby, encourage smiling and eye contact.
• Respond to crying. Your baby cries to communicate needs, such as feeling hungry or uncomfortable. You are not spoiling your baby by promptly responding to these cues. Use comforting techniques, like cuddling and singing.
  • Colic
  • Crying, Age 3 and Younger

Development of new skills

• Stimulate learning . You help promote your baby's cognitive development through emotional bonding, interaction and play, and unconditional love.
• Nurture speech and language development. Talking to, interacting with, and reading to your baby are all natural ways to promote language development. For more information, see the topic Speech and Language Development.

Behavior development

• Don't spank your baby or use other types of corporal (physical) punishment. A baby age 1 month to 12 months is too young to know that there are certain ways he or she should behave. Try distracting a child who is doing something wrong or something that might be dangerous. For example, if your baby tries to pull the dog's tail, you can find a toy to get his or her attention, and then move the dog to another area.
• Don't worry about "spoiling" your baby. You can't spoil a baby at this age. Hold your child, and give him or her as much love and attention as you can. Your love and patience are critical for helping your child grow into a happy and confident toddler.

Parenting help

Taking care of your baby is an exciting time, but it can also be stressful. Some days you may simply feel overwhelmed. Ask for help when you need it:

• Call a family member or friend to watch your baby and give you a break.
• Investigate community resources that are available to help you with child care or other needed services.
• Call a doctor or local hospital for some suggestions.
• Some communities have respite care facilities for children. A respite care facility is a place that provides temporary child care during times when you need a break.

Also, parents may find that they have a harder time communicating with each other. Feeling tired can make you more sensitive and lose patience more easily than normal. Learn coping skills to help you deal with anger and frustration. For more information, see the topic Stress Management.

When to Call a Doctor

Call 911 or other emergency services if you become so frustrated with your child that you are afraid you might cause your child physical harm.

Talk to your doctor anytime you have concerns about your baby's:

• Physical development. (For example, call if your baby's growth seems to slow significantly or if your baby isn't consistently eating well.)
• Cognitive development. (For example, call if your baby is not becoming more alert or active over time.)
• Emotional and social development. (For example, call if you are concerned about how you and your baby interact or if you feel unable to nurture or emotionally connect with your child.)
• Language development. (For example, call if your baby doesn't babble as expected or respond to your voice.)
• Sensory and motor skill development. (For example, call if your baby doesn't consistently meet motor skill milestones, such as purposeful rolling over or crawling.)

Also see your doctor if your child has lost a skill that was previously mastered.

Routine Checkups

Doctors recommend that babies have routine well-child visits every 2 to 3 months from age 1 month to 12 months. During these visits, your doctor checks your baby's growth and development to see if your baby is reaching the milestones for each specific age. During these visits, you also can discuss any concerns you have. When your baby is age 9 months, the doctor may do a developmental screening test.

At every checkup, the doctor:

• Looks at your baby's physical growth by measuring weight, length, and head circumference. These measurements are placed on a growth chart and are compared to previous and later markings to make sure your baby is growing as expected.
• Asks you about your baby's motor and sensory development, vision, and hearing. Your baby receives a thorough exam and gets immunizations.
  • Immunizations
  • Immunizations: Questions Parents Ask
• Assesses your baby's emotional and social development by observing his or her interactions with you. You will be asked questions about how you and the rest of the family are doing, how your baby is eating and sleeping, and whether you have noticed any changes in behavior.

The doctor will be especially interested in certain developments at specific ages. For example:

• At 2 months:
  • Is your baby smiling yet?
  • Do you have a routine feeding schedule?
  • Are you bonding with your baby?
  • Is the rest of the family adjusting to the baby?

• At 4 months:
  • Is your baby reaching and grasping?
  • Does your baby try to bring objects to his or her mouth?
  • Are crying spells getting shorter?
  • Is your baby settling in with the family, and is your family enjoying the baby?

• At 6 months:
  • Is your baby able to sit?
  • How are your baby's sensory and motor development and hand-eye coordination?

• At 9 months:
  • How is your baby eating?
  • Is your baby able to pick up objects?
  • Does your baby respond to his or her name?

• At 12 months :
  • Does your baby walk holding on to furniture?
  • Does your baby enjoy playing peekaboo or patty-cake?

Routine checkups are a good time for parents to ask about what to expect in the weeks to come. You may find it helpful to keep a list of questions to ask the doctor.