The journey to parenthood begins before a baby is born. Parents prepare by reading, seeking advice, and going for antenatal appointments. When the baby comes, they monitor their growth, celebrating each milestone. But what if your child is not growing well? And how do you ensure your child grows well?
A healthy brain
The brain controls all the areas of a child’s development. Brain development starts in the womb and continues into young adulthood.
The brain develops rapidly and doubles its volume in the first year of life. Everyday positive experiences support healthy brain development.
Children develop at their own pace but parents need to be aware of the different developmental milestones and delays that require medical attention.
Regular visits to a well-child clinic allow for developmental motor milestone checks, where parents’ concerns can be addressed and referrals made in case of any abnormality.
Promoting physical development
Gross motor skills control the large muscles of the body for sitting, crawling, walking, running, and other activities. These skills develop sequentially from the head to the feet. Let your baby play while lying on their back or tummy or when sitting with support to help develop these skills.
Red flags for delays in gross motor skills involve differences in muscle tone; either the baby is floppy or has stiff limbs, they are unable to support their neck or bear weight when their feet are placed on a flat firm surface by six months of age.
Use of their hands
Fine motor skills and hand, eye coordination develop over time.
Initially, the baby grasps your hand as part of a reflex, thereafter it becomes voluntary opening and closing the hand, transferring objects from one hand to another, use of fingers, and self-feeding. The progression of these abilities needs to be monitored. Let a baby play with safe-household items to handle, stack, or sort.
Red flags in infancy are the usage of one-hand to reach for objects (asymmetry) or the inability to grasp objects.
A baby’s first smile
Social-emotional development is evident in newborns. Soon after birth, a baby is ready to interact, and innately has a preference for human faces.
Responding to the baby’s needs from the first week of life helps them learn to trust and love their caregivers. The positive parent-child relationship lays the foundation for social-emotional, language, and cognitive development.
A social smile emerges at two months, laughing out loud at four months, discriminating between strangers and caregivers at eight months, and responding to their name at ten months.
Red flags in infancy in this domain are poor eye contact and not responding to their name by 12 months.
Tracking a child’s language development
A newborn baby can recognise their parents’ voice at birth. The progression of language development is dependent on hearing.
Ideally, screening for hearing should be done within the first month of life.
Language development has three categories; speech which is the ability to produce sound, receptive language which is the ability to understand what one hears and expressive language is the ability to convey information through verbal or non-verbal means such as gestures or facial expressions.
Babies begin to coo at two months, babble at six months, speak their first words at 12 months.
Talk to your child, sing songs, read age-appropriate books, and respond to your baby’s attempt to communicate.
Red flags in communication are regression (child stops using previously learned words to communicate), not pointing or responding, and no words at 18 months.
Taking care of a special needs child
An infant with special needs should be monitored by a specialist. Supporting their development should be individualised so as they grow well. Different specialists should work together in managing the child as well as connecting the parents to support groups.
Creating nurturing environments for the child through positive parent-child interactions helps support healthy brain development.
As a parent, remember that you know your child better than anyone else. If a child regresses on acquired milestones, seek help from a doctor.
The monitoring of these stages of your child’s development is important. Any red flags are well addressed during the developmental clinics, such as the one we offer at the Aga Khan University Hospital Nairobi.
Dr Wamithi is a developmental paediatrician at Aga Khan University Hospital, Nairobi.