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Physical Development
How can I tell if my infant or child is developing normally?

Parents are often the best source of developmental information to help the pediatrician make an evaluation of the child's development. Keep accurate records of development. Be sure and discuss your observations with your child's pediatrician. If you have questions, ask them.

Standardized developmental charts show the physical stages of growth and development for the infants and children. These can show where your child is in developing gross and fine motor, visual, language, and cognitive skills, and also to measure height, weight, and head circumference.

How your child reaches a growth stage is as individual as fingerprints. At each age a child is expected to master certain tasks -- in other words reaching a "developmental milestone."

Remember that there is a wide range of development. A child, for example, who is large for height, weight and/or head circumference might be slow to roll back and forth; for this child, then, it would not be considered a developmental delay. A toddler might walk anywhere from nine months of age to 2 years of age and still be considered developmentally normal. Caution should be used in comparing one child's development to another, especially siblings. What might be normal for one is not necessarily normal for the other.

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Should I breast-feed my baby?

Breastfeeding may prevent many illnesses in the younger child. Every time a person is exposed to a virus, he/she builds immunity to that virus. This immunity is passed through the breast milk to infants. Breast milk helps protect the baby against illness and allergies.

Breast milk is easily digested, helping the infant avoid becoming constipated or thirsty because he/she gets an adequate amount of water from the breast milk.

Sucking at the breast assists good oral development. Breast-fed babies generally have fewer speech impediments and good cheekbone development and jaw alignment.

Breast-feeding also is good for the nursing mother. The baby's sucking at the breast causes uterine contractions right after birth. The contractions lead to less bleeding for the mother, and return the uterus to its pre-pregnancy shape much faster.

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What about all this crying?

Every person must be able to trust other people so as to be able to function daily. Trust helps how we relate and interact with the world.

Babies and young children also need trust. As a child grows and interacts with the environment, he/she learns how to interact with others. The sense of trust begins very early. Your child learns to trust others, and how to interact with the world, by how his or her needs are met.

Crying is the normal way your child can communicate with others about his of her needs. Your child might cry because he/she is hungry or thirsty. Your child might cry to let you know that he/she is wet and needs to be changed. Or the crying might be due to gas or because your child is exercising his or her lungs.

Trust is developed by the responses given your child by her primary care- givers. It develops, or does not develop, through everyday routine happenings and responses. Your child learns that the world is a trusting place when needs are met. Responding to crying brings comfort and assurance that his or her needs are met. Babies must be able to count on their primary care-givers to be there for them. Consistency is important.

Sometimes there doesn't seem to be any reason why the crying continues. You've done all you think of, and still the crying goes on. Having and keeping a routine lessen the stress for both the young child and the parent. Even babies can get stressed. Keeping calm is important. Have a plan prepared that allows you to call on another caregiver to help with the baby when needed. A plan for needed back-up should be worked out before the need arises.

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What about immunizations?

Vaccines prevent many of the most serious illnesses from occurring. Your pediatrician can provide you with accurate information on the age at which each vaccination should be given. Receiving the immunization at the identified age is important. Immunizations are required at specific ages. See recommended guide.(Website here)

Keep the record of where and when your child received the vaccinations. Sometimes records are lost; unless you have the valid record, additional shots might be needed. To enter a pre-school or kindergarten, parents must show proof of immunization for their child.

If you have questions about your child's immunizations, talk with the doctor.

Excellent websites:

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What can I do about my child's weight gain?

Parenting skills are the foundation for successful treatment of childhood obesity, according to expert recommendations published by the American Academy of Pediatrics. Children with a body mass index (BMI) at or above the 85th percentile with complications of obesity, or children at or above the 95th percentile with or without complications, should be evaluated and possibly treated.

Talking with your child's doctor during regularly scheduled wellness visits about your child's weight can lead to a healthier life style for the whole family. Take advantage of the doctor's visit to determine if your child is clinically overweight. Ask your doctor for advice on a plan that incorporates good nutrition and exercise to promote a healthy life style for your child. Any decision to enter into a program should be made with the whole family. Having the support of family members is most helpful.

Early evaluation is recommended followed by treatment that focuses on healthy eating and increases physical activity. Creating a routine that incorporates both leads to the success.

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What kinds of physical skills does my 3-4- month-old have?

Three to Four Months

Gross Motor

  • Rests on forearm.
  • Good head control.
  • Able to arch back if held under stomach.
  • Rolls from front to back
  • Sits well when propped.

Visual and Fine Motor

  • Hands unfisted most of the time.
  • Able to follow an object in a circular motion.
  • Looks at hands and fingers.
  • Grasps and holds objects.
  • Brings objects to mouth.


  • Coos.
  • Crying varies with hunger, pain, excitement, frustration, dirty diaper.
  • Echoes the speaker immediately.
  • Smiles spontaneously.
  • Laughs.

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What kinds of physical skills does my infant have?

Looking at a physical development chart can help you find out what an infant's physical skills are.

One to 2 Months.

Gross Motor

  • Raises head slightly while on stomach.
  • Makes some jerky, uncontrolled crawling movements.
  • Lifts up chin.
  • Lifts head and chest off a surface while on stomach.
  • Holds head straight and steady.
  • Able to hold head and feet up if supported under stomach.
  • Head bobs erect if held sitting.

Visual and Fine Motor

  • Has tight grip and grips momentarily objects placed in hand.
  • Hands stay fisted.
  • Follows objects from side to front.
  • Will suck an object when placed in mouth.
  • Follows objects from side to side.
  • Fists clenched tightly only half the time.
  • Follows objects up and down.


  • May begin to smile.
  • Startles, moves or blinks in response to sound.
  • Smiles in response to being talked to.
  • Makes gurgling sounds.
  • Turns to voices.

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What should I do if I don't think my child is developing normally?

Become a good observer. Give your child your full attention. Watch and see what your child is doing. Look carefully. Watch how he/she does it. Look at what that child is not doing. Write down your child's accomplishments. Keep track of your child's doings. Write these observations in a notebook. Put a date with each observation. Note when your child does something new. Also note how easily and how often he/she does it. Look back on your notes from time to time. See if your child has made progress in physical skills.

Discuss these observations with your child's doctor. A clear and detailed history of the perceived problem or competency helps develop a plan of action for intervention or enhancement of the child's abilities. If you have concerns or questions about your child's development, discuss them with the doctor to help determine if they need closer attention. Remember: Children grow and develop at differing rates.

For more information please click on "How do I know if my child is developing correctly?.

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When should I call the doctor?

If you are concerned about the physical development of your child, talk with your child's doctor. This can be done during the child's regularly scheduled "well-baby" visits. Your child does not have to be sick for you to take him or her to the doctor's office. Regularly scheduled appointments need to be routine in your child's early years. This helps ensure that your baby gets the best care possible.

Get to know your child's behavior. If your child acts "sick" or is unusually lethargic, drossy or irritable, he/she might indeed be sick. If you think your child has a fever, take the temperature; don't guess that he/she has one. If your child is vomiting (not spitting up) or refuses several feedings or has frequent bowel movements with mucous, blood or foul odor, consult your doctor. The more information you can provide to the doctor about the child's condition as it differs from the norm, the better the doctor can prescribe appropriate action.

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