Growth and Development Milestones*



Growth and Development Milestones*





MILESTONES OF THE INFANT (NEWBORN TO 11 MONTHS)


PHYSICAL DEVELOPMENT


Newborn



  • 10% loss of birth weight in first 3 to 4 days of life


  • 73% of body weight is fluid


  • Head circumference is 70% of adult size


  • Needs to consume 120 cal/kg of weight per day


  • Sleeps 20 to 22 hours/day, with brief waking periods of 2 to 3 hours


  • Feeds every 2½ to 5 hours


2 to 4 Months



  • Posterior fontanel closes


  • Obligate (preferential) nose breathers (until about 5 months)


  • Begins drooling


5 to 6 Months



  • Doubles birth weight


  • Teeth may begin to erupt


  • Moves food to back of mouth and swallows during spoon feedings


  • Sleeps through the night for up to 8 hours


  • Goes 4 to 5 hours between feedings


  • Has 2 to 4 naps per day


7 to 9 Months



  • Begins teething with lower central incisors, followed by two upper incisors


  • Mashes food with jaws


  • Sleeps 14 to 16 hour/day, including naps


10 to 11 Months



  • Sleeps 14 to 16 hour/day and still naps


  • Stops drooling


  • Grows about 0.5 in/month


SEXUAL


All Infants



  • Oral stage oral gratification and sucking needs (Freud)


10 Months



  • Begins sexual identity


LANGUAGE


Newborn



  • Alerting


  • Social smile


2 to 3 Months



  • Laughs and squeals


  • Coos


  • Utters single vowel sounds such as “ah” and “eh”


4 Months



  • Utters two-syllable vowel sounds


  • Includes consonant sounds such as “m” and “b”


  • Produces belly laughs


  • Orients to voices of others


5 Months



  • Razzing


  • Intersperses vowel and consonant sounds


6 Months



  • Babbles


  • Uses about 12 speech sounds


7 Months



  • Makes “talking sounds” in response to caregiver while others are talking


  • Coos and squeals


  • Vocalizes up to four different syllables


8 to 10 Months



  • Uses “dada” and “mama” in nonspecific way


  • Responds to own name (receptive language skills develop first)



  • Babbles to produce consonant sounds


  • Vocalizes to toys


10 to 11 Months



  • Imitates speech sounds


  • Understands name and “no”


  • Understands “bye” and “pat-a-cake”


  • Imitates definite speech sounds


  • Uses jargon


  • Communicates by pointing to objects and by using gestures


  • Responds to simple verbal requests


VISION


Newborn



  • Fixates on human face and demonstrates preference


  • Blink reflex present


2 Months



  • Follows to midline


  • Produces rears


  • Visual acuity is hyperoptic


4 Months



  • Follows objects to 180 degrees


5 Months



  • Visual acuity 20/200


  • Recognizes feeding bottle


6 Months



  • Inspects hands


  • Fixates on objects 3 ft away


  • Strabismus no longer within normal limits


  • Develops hand-eye coordination


8 Months



  • Has permanent eye color


  • Depth perception developing


10 Months



  • Tilts head backward to see up


HEARING


Newborn



  • Startles to loud noises


  • Prefers high-pitched voices


  • Quieted by low-pitched noises


  • Responds to human voice over other noises


  • Reflexive responses to auditory stimuli as seen by generalized body movement (blinking or crying)


  • Recognizes certain sounds, ignores others; attends to quiet sounds more than loud ones—these are learned rather than reflexive behaviors


  • Turns to voice (quiet listening)


5 Months



  • Orients to bell (looks to side)


  • Stops crying in response to music


7 Months



  • Orients to bell (looks to side, then up)


10 Months



  • Localizes sound from above or below


  • Orients to bell (turns directly to bell)


GROSS MOTOR


Newborn



  • Turns head when prone but cannot support head


  • Adjusts posture when held at shoulder


  • May squirm to corner or edge of crib when prone


  • Arm and leg movement are reflexive


6 Weeks to 2 Months



  • Holds head up 45 to 90 degrees when prone


  • May hold head steady when in supported sitting position


3 Months



  • Rolls over from back to side


  • Holds head erect and steady


4 Months



  • When supported, sits with rounded back and bended knees


  • May bear weight on legs when assisted to stand


  • Head lag disappears when pulled to sitting position


5 Months



  • Pulls to sitting position


  • Rolls from back to stomach


  • Sits alone momentarily


  • Shows unilateral reaching


6 Months



  • Sits without support


  • May creep an inch forward or backward


  • Moves from place to place by rolling


  • Begins drinking from a cup


7 Months



  • Stands while holding on


  • Early stepping movements


  • Begins to crawl or hitch


  • Raises head spontaneously when supine


8 Months



  • Pulls to standing position


  • Raises self to sitting position


  • Palmar grasp disappears



9 Months



  • Walks with help


  • Crawls, creeps, or hitches when permitted


  • Sits down


  • Holds own bottle


  • Drinks from cup or glass


10 Months



  • Continues walking skill development with help


  • Stands alone


  • May climb up and down stairs


  • Sits without support


  • Recovers balance


  • Changes from prone to sitting position


11 Months



  • May walk alone


  • Begins to stoop and recover


  • Pushes toys


  • “Cruises”


FINE MOTOR


Newborn



  • Follows to and slightly past midline


2 to 3 Months



  • Keeps hands open predominately


  • Reflex grasp replaced by voluntary grasping


  • Grasps objects such as rattle in open hand


  • May bring hands together at midline


4 Months



  • Uses ulnar-palmar prehension with a cube


  • Reaches for objects


  • Hands predominantly open


5 Months



  • Attempts to “catch” dangling objects with two hands


  • Begins using forefinger and thumb in pincer grasp (opposable thumb-prehension)


  • Recovers rattle


  • Reaches for and grasps objects


6 to 7 Months



  • Can grasp at will


  • Holds and manipulates objects


  • Scoops pellet


  • Transfers from hand to hand


  • Demonstrates inferior pincer


  • Bangs objects together


  • Can release objects


8 to 9 Months



  • Combines spoons or cubes at midline


  • Retains two of three cubes offered


  • Achieves neat pincer grasp of pellet


  • Feeds self finger foods using only one hand


  • Releases objects at will


  • Rings bell


  • Holds bottle and places nipple in mouth when desired


10 to 11 Months



  • Plays “pat-a-cake” (a midline skill)


  • Puts several objects in a container


  • Holds crayon adaptively


  • Bangs two cubes together


  • Looks for hidden object (object permanency) (Piaget)


  • Achieves neat pincer grasp


PLAY


All Infants



  • Engages in solitary play


  • May be imitative


  • Explores and manipulates


5 to 7 Months



  • Resists toy pull


  • Picks up tiny objects


  • Plays “peek-a-boo”


  • Works to get toy that is out of reach


8 to 9 Months



  • Plays “pat-a-cake”


  • Recognizes self in mirror


10 to 11 Months



  • Plays ball


  • Achieves object permanence (searches for dropped objects)


COGNITIVE


Newborn

Substage I (Piaget)



  • Practice of reflexes and reflex-like actions


1 to 3 Months

Substage II: Purposeful (Piaget)



  • Reproduces reflex actions


4 to 7 Months

Substage III: Objects (Piaget)



  • Oriented and imitative actions


  • Accidental actions are repeated


  • Develops habits


  • Responds negatively to removal of a toy


8 to 11 Months

Substage IV (Piaget)



  • Coordination, intentional goal direction, and achievement



  • Experiments with object permanence


  • Imitates and models behavior


  • No concept of death


  • Enjoys “peek-a-boo” game


  • Attempts to flee from unpleasant events


  • Recognizes anticipatory signs


  • Repeats actions that elicit response from others


  • Dislikes restrictions


  • Shakes head for “no”


  • Appears interested in picture book


SOCIAL


Newborn



  • Regards face and establishes eye contact


1 to 2 Months



  • Smiles responsively


  • Enjoys cuddling and motion


3 Months



  • Smiles spontaneously

Jul 9, 2020 | Posted by in NURSING | Comments Off on Growth and Development Milestones*

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