Growth & Your Baby

Have you ever noticed how your baby’s tiny fingers instinctively curl around yours and close into fists? Or how he or she startles with a loud noise? These and other primitive reflexes were present at birth and will become less noticeable as your baby grows.

Doctors use certain milestones to tell whether a baby is developing as expected. There’s a wide range of what’s considered normal, so some babies gain skills earlier or later than others. Babies who were born prematurely reach milestones later. Always talk with your doctor about your baby’s progress.

Here are some new skills your baby may have:

Communication and Language Skills

• startles at loud noises
• makes sounds other than crying

Movement and Physical Development

• keeps hands in tight fists
• arms and legs move equally on both sides
• when lying on the tummy, holds head up briefly

Social and Emotional Development

• recognizes mother’s voice
• when upset, responds to a parent’s cuddles, voice, and affections
• becomes alert when hearing a pleasant sound, like music

Cognitive Skills (Thinking and Learning)

• will stare at an object placed in front of the face, especially something brightly colored
• follows faces

When to Talk to Your Doctor

As your baby becomes more alert, he or she will watch you constantly. And you’ll be watching your little one closely too, so it’s a good time to notice any subtle signs that could point to a problem. Tell the doctor if your baby:

• has one eye that is crossed or eyes that don’t line up in the same direction
• does not respond to pleasing sounds, such as “baby talk” or gentle music
• has legs or hands that do not move in unison: only one leg kicks, for example, or just one arm shakes

Your little one is now a toddler — and with this stage comes newfound freedom. If your toddler isn’t walking yet, he or she will be soon. Walking offers chances for exploring areas that were previously out of reach, and for practicing independence.

Doctors use certain milestones to tell if a toddler is developing as expected. There’s a wide range of what’s considered normal, so some children gain skills earlier or later than others. Toddlers who were born prematurely reach milestones later. Always talk with your doctor about your child’s progress if you have questions or concerns.

Here are some things your toddler might be doing:

Communication and Language Skills

• says “mama” and “dada” (specific to parents), plus one or two other words
• waves goodbye
• points to objects
• babbles with inflections that mimic normal speech
• understands simple questions: “Where is your nose?” or “What sound does a cow make?”

Movement and Physical Development

• bangs together cubes or blocks held in both hands
• stands alone
• walks with one hand held and possibly even walks alone
• can stack two blocks
• precisely picks up objects with thumb and forefinger
• during mealtime, uses hands to bring small pieces of food to the mouth

Social and Emotional Development

• enjoys peekaboo, pat-a-cake, and other social games
• likes being read to and looking at picture books
• cries when you leave the room
• feels proud when he or she gains a new skill like standing, walking, etc.

Cognitive Skills (Thinking and Learning)

• follows one-step commands (such as, “Please give me the ball.”)
• watches and imitates older kids and adults
• repeat behaviors that produce a desired effect, such as dropping a toy over a ledge so that you can pick it up
• will look at a book and turn the pages

When to Talk to Your Doctor

Every child develops at his or her own pace, but certain signs could indicate a delay in development. Talk to your doctor if your child shows any of these signs:

• walks with a limp or uneven stride
• when falling, falls forward instead of backward
• cannot pick up a small object (like a raisin) and does not feed himself or herself
• does not point at objects
• does not babble with consonant sounds (“ba, da, ga”)

Also, if you ever notice that your child has lost skills he or she once had or shows weakness on one side of the body, tell your doctor.

Though only a few days old, your baby already is able to interact in some ways. When alert, your baby will likely focus on your face. Babies are especially drawn to higher-pitched voices, so give into that urge to use “baby talk.” You are introducing your baby to language and your baby will enjoy it.

Doctors use these milestones to tell whether a baby is developing as expected. There’s a wide range of what’s considered normal, so some babies gain skills earlier or later than others. Babies who were born prematurely reach milestones later. Always talk with your doctor about your baby’s progress.

Here’s what your newborn might do in the first few days after birth:

Communication and Language Skills

• turns his or her head toward a parent’s voice or other sounds
• cries to communicate a need (to be held or fed, to have a diaper changed, or to sleep)
• stops crying when the need is met (your baby is picked up, fed, or changed; or goes to sleep)

Movement and Physical Development

• moves in response to sights and sounds
• rooting reflex: turns toward breast or bottle and sucks when a nipple is placed in the mouth
• Moro reflex (startle response): when startled, throws out arms and legs, then curls them back in
• fencer’s pose (tonic neck reflex): when head is turned to one side, straightens the arm on that side while bending the opposite arm
• grasp reflex: holds a finger placed in the palm; toes curl when touched on the sole of the foot

Social and Emotional Development

• soothed by a parent’s voice and touch
• calms self when upset
• has periods of alertness

Cognitive Skills (Thinking and Learning)

• looks at and follows faces when quiet and alert
• stares briefly at bright objects placed in front of the face

When to Talk to Your Doctor

Every child develops at his or her own pace, but if there’s something that concerns you, tell your doctor. Also tell the doctor if your baby:

• doesn’t suck well at the breast or on a nipple
• has an arm or leg that seems weaker than the other
• is extremely irritable and difficult to soothe

Babies this age are learning how to interact with the world around them. To get your attention, your baby might cry, fuss, or squeal. To get a better view of the room, babies may use newfound strength to pull up on their arms while lying on the belly.

Doctors use certain milestones to tell if a baby is developing as expected. There’s a wide range of what’s considered normal, so some babies gain skills earlier or later than others. Babies who were born prematurely reach milestones later. Always talk with your doctor about your baby’s progress.

Here are some things your baby might be doing:

Communication and Language Skills

• babbles with expression as a way to get your attention
• smiles, laughs, squeals, and blows bubbles
• begins to coo in response to your coos
• stares at your mouth as you speak
• has different cries for hunger, tiredness, or pain

Movement and Physical Development

• rolls from front to back
• begins to reach and grasp for objects
• bring toys to the mouth, often with a two-handed grasp
• has good head control when sitting
• holds up the head and chest, supported by the arms, while on tummy

Social and Emotional Development

• smiles when something pleasing happens, such as a belly tickle, and responds to affection
• initiates social interaction with coos or babbles
• self-soothes, such as sucking on a fist when hungry
• gets excited when a caregiver approaches

Cognitive Skills (Thinking and Learning)

• is easily distracted by surroundings (for example, a baby that used to be focused on nursing or sucking from a bottle is now interrupted by the slightest noise)
• starts to predict routines (for example, stops crying when placed in a nursing position or flexes hips in anticipation of a diaper change)
• repeats behaviors that produce a desired effect, such as batting a toy to move it
• grasps and examines own hands
• explores toys by grasping, mouthing, and looking at them

When to Talk to Your Doctor

As a parent, you are the best observer of your baby. Share your concerns — even little ones — with your baby’s doctor. Always tell the doctor if your baby:

• regularly babbles, but then suddenly stops
• cannot maintain head control when held in a supported position
• doesn’t notice when people enter the room
• doesn’t swipe at nearby toys
• doesn’t respond to voices or other pleasing sounds

Also, if you ever notice that your baby has lost skills he or she once had or shows weakness on one side of the body, tell your doctor.

From your baby’s first day, doctors will keep track of weight, length, and head size. Growth is a good indicator of general health, and babies who are growing well are generally healthy, while poor growth can be a sign of a problem.

How Big Are Newborns?

Just like adults, newborns come in a range of healthy sizes. Most babies born between 37 and 40 weeks weigh somewhere between 5 pounds, 8 ounces (2,500 grams) and 8 pounds, 13 ounces (4,000 grams).

A newborn who is lighter or heavier than the average baby is probably perfectly fine but might receive extra attention from the doctors and nurses after delivery just to make sure there are no problems.

A number of things can affect a baby’s size at birth. The length of the pregnancy is important. Babies born around their due date or later tend to be larger than those born earlier.

Other factors include:

• Size of parents. Big and tall parents may have larger-than-average newborns; short and petite parents may have smaller-than-average newborns.
• Multiple births. If you have twins, triplets, or more, you can count on your babies being relatively small. Multiples not only have to share their growing space in the uterus, they’re also often born early, which leads to small size at birth.
• Birth order. First babies are sometimes smaller than brothers or sisters born later.
• Gender. Girls tend to be smaller, boys larger, but the differences are slight at birth.
• Mother’s health during pregnancy. Things that can lead to a lower birth weight include a mother with high blood pressure or heart problems; or one who used cigarettes, alcohol, or illegal drugs during the pregnancy. If the mother has diabetes or is obese, the baby may have a higher birth weight. All conditions that can affect a baby’s weight should be closely watched by the mother’s doctor. Of course, women should not smoke, drink alcohol, or use illegal drugs during pregnancy.
• Nutrition during pregnancy. Good nutrition is essential for a baby’s growth in the uterus and beyond. A poor diet during pregnancy can affect how much a newborn weighs and how the infant grows. Gaining too much weight can increase the likelihood that a baby is born bigger than average.
• Baby’s health. Medical problems, including some birth defects and certain infections acquired during the pregnancy, can affect a child’s birth weight and later growth.

What About Preemies?

Premature babies generally are smaller and lighter than other newborns. A preemie’s weight will be largely determined by how early he or she was born. The time the infant has missed being in the womb was growing time, so the baby has to do that growing in the outside world.

Many pre-term babies are classified as having “low birth weight” or “very low birth weight.” In medical terms, “low birth weight” means a baby weighs less than 5 pounds, 8 ounces (2,500 grams) at birth. That’s the case for about 1 in every 12 babies in the United States, so it’s quite common. “Very low birth weight” means a baby weighs less than 3 pounds, 5 ounces (1,500 grams). Most babies with low or very low birth weight were born prematurely.

Premature babies are given special medical attention immediately after birth, and a pediatric specialist called a neonatologist may be involved in their care. Many premature babies spend time in the neonatal intensive care unit (NICU) while they receive medical care, including feeding and observation of growth.

Is Bigger Better?

In the old days, a “bouncing” baby with chubby cheeks and dimpled thighs was many people’s picture of a healthy newborn. But a baby born much larger than average may have special medical problems that need attention.

Some exceptionally large babies — especially those born to mothers with diabetes, including gestational diabetes — may have problems for a few days keeping blood sugar levels up and may require extra feedings, or even intravenous glucose, to prevent those levels from falling too low.

Will My Baby Lose Weight?

Yes, at first. Babies are born with some extra fluid, so it is perfectly normal for a newborn to drop a few ounces when that fluid is lost in the first few days of life. A healthy newborn is expected to lose 7% to 10% of the birth weight, but should regain that weight within the first 2 weeks or so after birth.

During their first month, most newborns gain weight at a rate of about 1 ounce (30 grams) per day. They generally grow in height about 1 to 1½ inches (2.54 to 3.81 centimeters) during the first month. Many newborns go through a period of rapid growth when they are 7 to 10 days old and again at 3 and 6 weeks.

Should I Be Concerned?

Newborns are so small, and it can be hard to know if your baby is gaining weight the way he or she should. You may worry that your baby has lost too much weight in the first few days or isn’t taking enough breast milk or formula. If so, talk to your doctor, who may ask you about:

• How many feedings a day your baby gets. A breastfed baby may feed about 8 or more times in a 24-hour period; formula-fed babies usually eat less often, perhaps every 3 to 4 hours. Breastfeeding moms may benefit from meeting with a lactation (breastfeeding) counselor, who can make suggestions to increase comfort and improve technique.
• How much your baby eats at each feeding. A baby generally nurses for at least 10 minutes, should be heard to swallow, and should seem satisfied when done. At this age, formula-fed babies may drink up to 3 to 4 ounces (90 to 120 milliliters) at a time.
• How often your baby urinates. A breastfed baby may have only 1 or 2 wet diapers a day until the mother’s milk comes in. Expect about 6 wet diapers by 3 to 5 days of age for all babies. After that, babies should have at least 6 to 8 wet diapers a day.
• How many bowel movements your baby has each day, and their volume and consistency. Newborns may have just one poopy diaper a day at first. Poop is dark and tarry the first few days, then becomes soft or loose and greenish-yellow by about 3 to 4 days. Newborns usually have several poopy diapers a day if breastfed and fewer if formula-fed.

What to Expect

Being small or large at birth doesn’t necessarily mean a baby will be small or large later in childhood or as an adult. Plenty of towering teenagers began life as small babies, and the biggest baby on the block can grow up to be a petite adult.

By the time they’re adults, kids tend to resemble their parents in size. Genetics, as well as good nutrition and your attention, will play a large part in determining how your baby grows in the years to come.

Whether your baby starts out large, small, or in between, in the next few months you can expect your infant to keep growing fast.