Dr. Carole Keim MD takes parents through all the different developmental milestones that babies go through from newborn to one year of age. She details the types of development, how to play with your baby to enhance development, and how much screen time is okay for babies.

Dr. Keim explains how your baby’s grasp will develop as they age through their first year and when they’ll be able to use their thumb and forefinger to pick up small objects, for example. She explains how far they can see when they’re newborn, when they start to recognize voices and then faces, when they develop object permanence (which is the same time they start to love playing peek-a-boo). She covers reflexes, speech patterns, tummy time, stranger anxiety, helpful play, and everything you need to know about how your baby is absorbing their world.

This episode will cover: 

• Types of development
• Developmental milestones by age
• How to play with your baby
• Screen time

Types: 0:42

• Gross motor skills - use large muscle groups
• Fine motor - small muscle groups
• Verbal/social - their interaction with family / peers
• Isolated delays are often benign; delays in 2-3 areas are red flags
• There is no advantage to pushing motor skills, but there is advantage in encouraging verbal/social skills

Newborn: 2:11

• Brief periods of wakefulness
• Equal limb movements
• Responds to parents voice/touch
• Looks briefly at parents
• Moves in response to visual or auditory stimuli
• Reflexes: grasp, rooting, moro

1-2 weeks old: 4:20

• turns and calms to parents voice
• Communicates needs (wet diaper, hungry, tired) but has the same cry for all
• Able to fix briefly on faces or objects
• Follows to midline
• Lift head briefly while prone 

1 month: 5:36

• Responds to calming actions when upset
• Follows parents with eyes; follows past midline
• Recognizes familiar voices
• Responsive smile
• Able to lift head during tummy time or while on parent’s chest
• Communicates needs

2 months: 6:57

• Start losing grasp/rooting/moro reflexes 
• Looks at parent
• Social smile
• Starts to comfort self
• Different types of crying
• Coos
• Can show signs of boredom
• Lift chest briefly during tummy time
• Head control while sitting supported

4 months: 8:41

• Elicits social interactions
• Looks at parents / watches them walk around
• Able to comfort/console self
• Starts babbling / cooing expressively, squealing, and laughing
• Responds to affection
• Indicates happy/sad
• Able to push up onto elbows (lifts chest fully while prone)
• Good head control 
• Start rolling (front to back)
• Start reaching for objects
• Can hold a bottle

6 months: 10:52

• Socially interactive with parents - takes turns babbling
• Mature babbling (consonants and vowel sounds)
• Recognizes familiar faces; beginning of stranger anxiety
• Starts to recognize own name
• Rolls over both ways
• Sits (tripod)
• Starts showing pre-crawling behaviors (getting to knees, rocking, army crawl)
• Turns while seated 
• Brings objects to mouth
• Transfers objects hand to hand
• Raking grasp
• Gets distracted while eating
• Diaper changes get more difficult because they try to roll

9 months: 13:40

• Stranger anxiety
• Seeks out parents
• Uses repetitive consonant and vowel sounds
• Points at objects
• Object permanence
• Interactive games (responds to peek-a-boo)
• Explores environment with eyes, hands, and mouth
• 3-finger grasp
• Pulls to stand
• 3D diaper changes

1 year: 17:07

• Imitates activities
• Hands books/toys to parent to play with them
• Waves bye
• Strong parent attachment; separation anxiety
• Protodeclarative pointing
• Imitates sounds/words (animal sounds)
• Speaks 1-2 words
• Jabbers with inflection
• Identifies people when asked
• Bangs two objects together
• Stands alone
• 2-finger grasp
• Follows simple directions 

How to play with your baby and boost their development: 19:46

• All ages: talk and sing to your baby, narrate your day
• Newborn up to 1mo: Help baby develop sleep and feeding routines; swaddle baby and place them face up to sleep in a crib or bassinet in parents’ room, use dim lighting and a quiet voice at night; help baby wake for feeding by picking them up, undressing, can use a wet wipe; tummy time on parents’ chests
• 1 month: Awkward time because they are awake more.  Develop consistent routines for sleep and eating, cuddle and talk to baby often, do tummy time 15-30 mins 1-2x per day; let them look out windows, at ceiling fans, or at bold patterns
• 2 months: Continue routines; hold baby, cuddle them, sing or talk to them; start to learn their likes and dislikes; continue tummy time 30 mins 1-2x per day
• 4 months: as above, but also can let them sit supported; watch for signs of food readiness; can play music for baby
• 6 months: Play time on the floor, let them sit in high chair (for meals and also to watch you / play), interactive/reciprocal play, make funny sounds, read to baby, hand them objects to put in their mouth, babies start to notice screens at this age (front camera feature, video chatting).  Officially no screen time til age 2 other than this.  Babies start to notice patterns and cause/effect at this age, can develop habits.  Start baby proofing at 6 months.
• 9 months: Consistent positive discipline (one pickup rule for thrown objects, have cause-and-effect toys, have a “yes” space), expect them to explore the environment, read together, hand them toys that make noise when you squeeze or shake them
• 12 months: Use distractions for discipline, verbally acknowledge good behavior, consider playgroups (they often won’t interact with other babies other than to point them out), encourage self-feeding, can help them start walking by holding onto hands or using rolling toys, say the name of objects they point to, name their emotions, tell them what’s ok to do instead of using ‘no’ 

Screen time: 33:10

• Officially, ONLY video chatting is ok up until age 1.5-2 years, 
  • age 2-5 years up to 1 hour per day, 5+ years up to 2 hours per day of recreational screen time
• At 18 months, ok to start educational programs, but you need to watch with them
  • PBS kids, Pocoyo, Baby Bus, Cocomelon
• Children are affected by sounds on TV - avoid anything scary or violent while baby is in the room
• Screen time is associated with developmental delays; it’s like overhearing a conversation as opposed to being engaged in one
  • You (and other people) are your baby’s primary entertainment source for the first 2 years 
• There are plenty of ways to entertain your baby that don’t involve screens: singing, talking, playing with them, reading to them
• If you need a few minutes: keep preferred toys in a “yes” space

Coming up, Dr. Keim will go through the checkups and advice for the next several visits. Now babies are being seen every three months, so the next few visits will be 9 months, 12 months, 15 months and 18 months. 

Carole Keim is also working on a third edition of The Baby Manual coming out soon. And another book called The Baby Manual Step By Step which will go chronologically, a one chapter at a time guide. You just need to read one chapter that will go with whatever age your baby is and the closest checkup to your baby's age.

All of the information in this episode is also in The Baby Manual book, which is available for purchase. Remember it is always okay to call your doctor or emergency services if you have concerns about your baby’s health.  

Resources discussed in this episode:

• The Baby Manual - Available on Amazon

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