The First Few Months

The period from birth through the first few years is one of many changes. This is a time of rapid growth and continuously acquiring new developmental skills. Each baby has a unique personality in how he/she responds to people and the environment around him/her. Development occurs as an ongoing interaction between the baby and his/her world over time. Development usually takes place in a fairly predictable sequence, with the later stages building on the success of earlier ones. New developmental skills are often learned in spurts, with lulls or plateaus in between. The age at which a baby will reach a certain developmental milestone can vary greatly.

Your baby was born prematurely or was sick at birth and required intensive care. Most babies do very well over time, but following their development a little more closely is beneficial. We will refer to your baby's corrected age, or adjusted age, if he/she was born prematurely. Your baby's adjusted age is the age he/she would have been if he/she was born on the actual due date. For example, if your baby was born at 28 weeks gestation (three months early), when he/she is six months old, his/her age corrected for prematurity would be three months. We continue to use age corrected for prematurity until your child is about two and a half years old. In the NICU Follow-Up Clinic we use corrected age to follow your baby's growth and development.

The first several weeks after you take your baby home is a time of adjustment for your entire family. Your baby is learning to eat better and grow, and to settle into a rhythm of family life.

Newborns see best at six to twelve inches and usually prefer faces or contrast colors such as black and white. Their hearing is very good early, and they are usually very responsive to voices and touch.

Newborns have two different sleep states and four different awake states:

• Quiet sleep with little movement

• Active sleep with some movement and more responsiveness to the environment around them

• Drowsy

• Quiet-alert with minimal body movement and a bright, alert face (Your baby will focus on your face, voice or moving objects when she or he is in this state.)

• Active-alert; awake with much more body movement

• Crying

Babies are very responsive and have cues when they are ready to interact, such as looking at you, reaching toward you, smiling, cooing. They also have cues when they may feel a little overwhelmed and need a break. These may include turning their head away, crying, falling asleep, or even something as subtle as hiccuping.

After your baby has been home for a few weeks, he/she may start to cry more than when he/she was younger. This is very normal and something most babies will do as they become older. Even very young babies are sometimes able to calm themselves when they are upset. They will bring their hands to their face or suck on their fingers or hand. If you need to soothe a crying baby, you can try talking to him/her in a quiet voice, cuddling him/her, letting him/her suck on a pacifier, wrapping him/her snugly in a blanket or singing. Different things will work for individual babies. It may be best to try one thing at a time before trying something else.

The following pages detail a baby's development over the first few years. The items listed are important developmental milestones in the areas of gross and fine motor skills and cognitive and social development. It is important to remember these are only guidelines, and your baby may learn these new skills in a slightly different time frame. We have also included some activities for you and your baby which will help him/her develop some of these new skills.