Babies First Year: Age Appropriate Milestones for Age 0-3 Months

As a therapist, I know more than anyone how developmental milestones can be a stress point for new moms.  I worried a lot with my first child and tried diligently to make sure he met all his milestones on time.  With my second, however, I was much more relaxed.  I knew she would reach them on her own time frame. 

Every child is uniquely made.  While he/she may excel in one area, they might struggle with another set of skills.  That's the way we all are, isn't it?  Wired to have strengths and weaknesses?  Interests, passions and then those things you couldn't care less about?  

I get asked a lot of questions from friends about milestones and what is normal for each age.  I thought it would be helpful for those parents or caregivers out there to have a G U I D E L I N E for general milestones for each age group.  But please, use it just as that.  Don't stress yourself out if your child is a little behind in one area.  That is okay!  Let them develop when they are ready by learning through play.  However, if you see that your child is quite behind in one or more areas (gross motor skills, visual motor + perceptual skills, and fine motor skills) then talk to your pediatrician about your concerns.  Maybe there is something going on that needs a little more investigation.  

So enjoy! Pass this along to friends and send me any questions or concerns you may have.

This guideline has been developed through clinical experience and in combination with references Peabody Developmental Motor Scales 2 + The Beery VMI.  

Gross Motor Skills

Prone/On-Tummy:
Tummy time or what we call the prone position is one of the most important positions in which babies begin to learn anti-gravity movements.  While it doesn't always tend to be babies favorite past time, there are so many easy ways to make tummy time more fun.  See my previous post The Importance of Tummy Time & How to Make it Less Miserable for some helpful tummy time hints!  If your child cannot yet lift their head up against gravity, be sure to supervise them at all times while in this position.  But don't let your worries rob your child of this important developmental position.  It is truly the basis for all gross motor and fine motor developmental skills. 

Tummy Time Tip *Use a rolled towel under their chest

0-2 months: baby can lift face off floor briefly (1-2 seconds) 

• 0-3 months: baby should be able to lift and turn head to both sides & is beginning to be able to lift both head and chest off of floor by weightbearing on their hands and forearms (this skill should be established by 4 months)

Supine/On-Back:

Though tummy time gets all the spotlight (for good reason), there are some important developmental skills your baby is learning while on their back too!  I would just advise caution against letting baby spend too much time on their back and especially in car-seats the first few months to avoid plagiocephaly deformities and torticollis.  

0-2 months: baby should be able to raise legs off of the floor or mat

• 0-2 months: baby should begin kicking legs

• 0-2 months: in supine position (on back) baby can bring both hands simultaneously to midline of chest or face

• 0-3 months baby should be able to turn head to both sides

• 0-3 months: baby should be able to kick feet and pushes against objects
  Other:

• 3 months - baby should push legs down when feet are placed on a surface

• When placed on either right or left side, baby should be able to roll from their side to their back

• Rolling from back to tummy is a more involved skill but begins around 2 months (should be established around 5 months)

VISUAL MOTOR + VISUAL PERCEPTUAL SKILLS

At birth, babies' eyes and visual systems aren't fully developed.  In fact, the visual system is one of the last systems to develop.  Significant development occurs within the first few months of life as the eyes begin to work together and visually track and focus on objects and faces.

• 0-2 months: occasional eye crossing is normal

• 0-1 months: babies like black and white objects/patterns more than color because the high-contrast of the colors is easier for their underdeveloped eyes to see

• 0-2 months: baby really can only focus on objects placed about 6 inches from their face

• 0-3 months: baby should be able to focus on an object placed 12 inches from their face

• 2-3 months: when lying supine (on their back), baby should be able to track/follow with eyes a brightly colored object or rattle across the mid-line of their body

• 2-3 months: while seated on caregivers lap, baby should be able to track/follow a ball rolled from one side to the other (crossing mid-line of their body)

• 2-3 months: baby looks at his/her own hands and feet

• 2-3 months: looks into caregivers face with interest & responds to a smile with a smile

• At 3 months, they will begin attempting to reach for objects and toys but unable to reach and grasp or obtain object yet

Fine Motor + Grasp Development  

Fine motor and grasp development begins rather slowly, especially within the first three months.  During this time period, primitive reflexes override babies ability to really use their hands much and their hands are mostly in a fisted position.  The fisted posture of the hands (called a palmar reflex) should begin to go away around 4-6 months of age and this is when baby begins to volitionally reach for and grab objects.   

• 0-1 months: baby holds hands in tight fists when resting on back

• 0-2 months: baby can maintain grasp on an object (I.e. rattle) for about 30 seconds when object is placed in hand, does not yet reach

• 0-2 months: open and shut hands (but not necessarily intentionally)

• 3 months: can bring both hands to mouth at mid-line

Self-Help + Feeding Skills

Within the first two months of life, a deep latch (for breastfed babies) should begin to emerge and by 3 months, it should be established.  Talk to a lactation consultant if baby is having difficulty breastfeeding and be sure to check for tongue ties.  There are a lot of nursing positions that make deep latch easier for newborns.

• Baby is dependent on caregiver for all activities of daily living

• Baby communicates hunger, fear or discomfort through crying

Red Flags

Talk to your pediatrician if you have any concerns with the following:

• Baby having difficulty with latch or sucking patterns on breast or bottle (choking frequently on milk or uncoordinated suck and swallow)

• Baby not following moving objects with eyes around or at 3 months 

• Baby not startled by loud sounds or responding with movement (head turning) to sounds such as door opening, talking, dog barking

• Very notable head tilt to one side with difficulty turning head in one direction (noticable mostly in carseats, preferred sleeping patterns)

• Pelvis asymmetry (i.e. trunk rotated left while pelvis/hips rotated right)

• Baby not making eye contact or smiling in response to an adults presence

• Baby not bringing hands to mouth

• Baby can not maintain grasp on an object

• Unable to hold head up off of floor or mat when placed on tummy