The first year of an infant's life is filled with many developmental changes. A baby experiences tremendous physical, mental, language, and social development that is very exciting. Knowledge of proper growth and development can help caregivers plan appropriate activities for each developmental stage.

No two babies are identical. Some babies are very calm and quiet, while others are more active and demanding of attention. In addition, different babies will reach milestones at different ages. This is all completely normal, and activities should be individualized to each infant's needs. A child who reaches developmental stages, such as walking, at an earlier age is not the "better" baby, just the one who started walking earlier. While each baby has his or her own "schedule," all babies develop in similar patterns. Those patterns will be discussed in this article, along with general age guidelines. If there is concern that a baby is not developing properly, a physician should be consulted.

The First Three Months

Infants three months old and younger are observing the world around them. They enjoy eye contact, recognize parents' voices, and smile. Babies like to look at items with high contrast, and will begin to laugh and coo. A three-month-old baby can lift his head and chest and turn his head side to side when lying on his stomach. He can wiggle and kick arms and legs, and will grasp a toy that is given to him.

Face-to-face interaction with parents and caregivers is of utmost importance for young infants. When caring for infants three months old or younger, talk and sing to them frequently, including when feeding, diapering, and providing care. Make eye contact. Point to and say the names of baby's nose, eyes, fingers, etc. Hold, cuddle, and rock and sing to her. Give the baby toys to reach for and play with. Provide "tummy time" when she is awake and active; place the baby on a blanket on the floor on her stomach, talk to the baby, and play with her. Provide colorful, interesting items for the baby to look at, reach for, and play with. When placing an infant in a swing or bouncy seat, provide interesting things to look at; and do not leave her in the swing or seat for long periods of time. Take care of needs promptly, such as feeding a hungry baby and consoling a crying baby.

Six Months

A six-month-old baby is rolling over and beginning to wiggle forward on the floor. He can pull himself up to a sitting position if you grasp his hands and can sit with support. The baby will reach for and grasp objects, putting a lot of them in his mouth. A six-month-old can help hold a bottle during feeding and open his mouth for a spoon. He can transfer objects from hand to hand, and bounce when held in a standing position. The baby will babble, laugh and squeal when playing and happy. A six-month-old baby knows familiar faces, including his own, and will smile at himself in the mirror.

Interaction with caregivers continues to be important for six-month-old infants. Continue to talk and sing throughout the day and at caregiving times. Diaper changes are opportunities to count toes or play with the baby's feet. Feeding times are opportunities to repeat the names of foods, colors, and objects such as "spoon" and "bowl." Play simple games, such as pat-a-cake and peek-a-boo. Hold toys for the baby to reach. Read simple books, with big pictures and few words. Provide play time on the floor on a clean blanket with a few simple toys, such as rattles and teething rings. Show the baby what he looks like in a mirror. Hold, rock, and cuddle the baby; and sing lullabies or other quiet songs.

Six to 12 Months

By the age of 12 months, a baby has undergone tremendous developmental changes. Active and mobile, the baby crawls on hands and knees, pulling up to a standing position and beginning to walk. She can independently move across the floor to get something and pick up small objects using a thumb and index finger. She also will begin to communicate by pointing or reaching for what she wants and begin to drop and throw things. The baby will explore toys visually and by touch, showing a growing curiosity. A 12-month-old is beginning to feed herself finger foods, can hold a bottle or cup, and will begin to eat and sleep at regular times. She can say simple words such as "mama," and can follow simple requests (such as "wave bye"). At this age, a baby will look up when her name is called and show recognition of familiar people. She also may be shy or anxious around strangers.

When caring for babies who are ages six-12 months, provide a clean, safe area for them to crawl and pull themselves up, and walk. Provide toys that are developmentally appropriate, and play with the babies on the floor. Provide toys that squeak or make other noise and have a variety of sizes, shapes, textures, and colors. Roll a ball or place a toy so that the baby must crawl or reach for it. Continue to talk to her and name each toy as you are handing it to the baby. Play simple games, such as peek-a-boo and pat-a-cake. Provide containers for the babies to fill with blocks and then dump out. Talk to them about what you are doing together and what is next, such as "after lunch, it will be time for a nap." Read simple picture books together. Establish a routine, and begin to set limits. Allow them to feed themselves finger foods, naming each food as it is eaten. Begin to set limits, calmly teaching what behavior is acceptable and not acceptable. Instead of constantly saying "no," let them know what is acceptable. For example, instead of saying "don't throw the toys," say "this is how we play with these toys." Play a variety of music. Let babies see your excitement and pleasure with each new accomplishment. Continue to hold and rock them.

When providing care for infants, it is important to address the special needs of each age. A baby cannot simply play and entertain himself, but needs consistent and nurturing attention and interaction from caregivers to continue growing and developing.

Early Intervention

Different babies will reach milestones at different ages. It is not usually cause for alarm if a baby does not pull himself up to a sitting position or point to objects he wants at the exact same time as other babies his age. However, only a trained health care professional can accurately assess whether a child is growing to his full potential or if he might have a developmental delay.

When a child is at risk for developmental problems, providing services and support as early as possible is crucial. For example, the Centers for Disease Control and Prevention recently issued guidelines for parents and caregivers to aid them in observing possible signs of autism because early intervention can increase outcomes for autistic children. Local health departments often provide intervention services and can help with staff training if an infant in your program needs specific care.

By Kay Lyles, RN, BSN

INTERNET RESOURCES

Kid's Health, www.kidshealth.org

Maternal and Child Health Library, www.mchlibrary.info