A New Born
Pregnant for 9 months - 40 weeks - seems like an eternity. Finally the baby has arrived - but what now? What do I do? How do I cope? How will our new born develop?
We have a series of article to help you along the way. They cover the development of your new born from birth all the way through to 5 years.
All normal newborns are intelligent and able to learn from birth. They can hear, feel, see, taste and smell, and by using their senses will begin to learn about their world and the people in it who are, in the beginning, their whole world.
A baby has both emotional and physical needs from birth. Frequent close physical contact is essential, particularly in the early weeks. Warm physical closeness promotes a feeling of comfort and wellbeing, of being loved and secure. By placing the baby on the mother or father’s chest, the baby will also be able to hear the heartbeat, which has been a familiar sound for the past few months.
Parents often don’t realise how much a new baby cries, and they find it very distressing. Crying is the new baby’s only effective way of communicating. The baby has a different cry for different needs. Gradually you will learn to recognise each one of them. Crying can be due to hunger or discomfort. Often ‚wind is blamed, but more often the baby’s need is for physical closeness, to be cuddled and comforted. Cuddling is reassuring. Providing love and comfort is not spoiling the baby.
Some babies ‚fuss before settling to sleep. After a while you will recognise your baby’s individual pattern of settling.
New babies can be sleepy. Some of them take a while to learn to suck vigorously. Feed times can be long, and you may need practice at keeping your baby awake in the first few weeks during the feeds. When your baby is hungry, give a feed. As you feed, more milk is made. Some dribbling or regurgitating during or after feeds is to be expected. If you think there is too much, mention it to the doctor or nurse.
Breast milk is free, natural, clean, and safe and has all the nutrients needed for good health. Breast milk is always available, is easy to digest and means less chance of infection. Warmth and close skin contact during breastfeeding also give your baby and you pleasure and satisfaction. Hold your baby close - chest to chest with baby’s chin on your breast. Support your baby. You can always get advice from your child health nurse or local Nursing Mothers’ Association.
This close physical relationship allows mother and baby to get to know one another quickly. Physical closeness with the father is of equal importance to the child’s learning and to their relationship.
If the choice is made not to breastfeed, the baby’s emotional needs can be fulfilled at feed time in exactly the same way. In this situation, fathers too can share in feeding the baby.
The need to suck will vary considerably among babies. Some will need to suck more frequently than others and for varying lengths of time. New parents may be confused if the baby’s need to suck is misunderstood. ‘If sucking means hunger, have I got enough milk?’ If your baby receives no fluids other than breast milk, appears alert and has at least six to eight wet nappies in each 24-hour period, it is an indication your supply is sufficient.
There may be only a small quantity of colostrum, the very first milk, but it is high in protein and calories. Colostrum has excellent anti-infective properties. These are also present to a lesser extent in breast milk. However, breast milk will not protect a baby against all illnesses - whooping cough for example. It is wise to keep your baby away from people with infections such as colds and flu, and to have your baby vaccinated at the recommended ages.
When the milk changes during the first week it may look blue and watery, but its food value is still excellent.
The time it takes to establish breastfeeding is variable. It may even take six to eight weeks, but baby will get all that is needed if feeding times are flexible.
Waking at night for a feed (or two) is usual. This helps baby to grow rapidly and establishes breastfeeding more quickly. It is the baby’s sucking that stimulates the production of milk, so the more sucking, the more milk there will be.
It is worthwhile learning how to express your own milk while you are in hospital. This can be a way of giving yourself comfort if your breasts are too full, or of collecting milk if for any reason your baby cannot go to the breast.
Careful personal cleanliness is important for a nursing mother, and breast pads need to be changed frequently. Avoid using plastic-backed pads. They tend to keep the skin soggy and encourage nipple soreness.
Commercial infant formula is recommended for bottle-fed babies and is more suitable than cow’s or goat’s milk or soy-based drinks. Babies should drink formula (and other milks) for the first 12 months of life before changing to cow’s milk.
The formula powder and boiled water must be measured carefully when making up baby’s bottle. Your child health nurse can discuss this with you. Bottle-fed babies should always be held and cuddled at feeding time, as they need the same loving and fondling as breastfed babies.
A baby may get thirsty between meals like anyone else, particularly in hot weather. Use a teaspoon or a bottle to offer a drink of boiled water (unsweetened) if baby is awake and unsettled. A baby may want a taste only or may drink 30 to 60 mL. Breastfed babies may prefer an extra feed. Let the baby decide.
There are many changes to the baby’s appearance in the first few weeks.
- Head shape: The baby’s head may be moulded from having to adjust to the birth canal. It will soon change.
- Skin: The skin is the protective covering of the baby. Rashes and blemishes are quite common and usually quite normal.
- Feet and hands: Soles and palms may look bluish and feel cold most of the time at first. This is normal and does not mean a baby is too cold - feel the body to judge warmth.
- Eyelids: Eyelids can look puffy for a day or two. Most babies are born with blue-grey eyes. It may be six months or even later before they acquire their permanent colour. Tears are not usually present at birth. They usually appear at about six weeks.
- Breasts: Breasts can be red and swollen in the first few weeks, in both boy and girl babies. This usually subsides without treatment.
- Umbilical cord: The stump of the umbilical cord always protrudes at first, but soon shrivels and falls off. If there is a slight discharge and bleeding from the navel, continue caring for it as you were shown in hospital. Don’t hesitate to ask the doctor or nurse if you are worried.
- Genitals: Genitals of both sexes can look large at first. With girls the lips of the vulva are usually swollen just after birth; a creamy pinkish discharge from the vagina is not unusual and will soon stop. The scrotum in boys may be swollen during the first few days but will settle. Circumcision is no longer routine for boys. Talk this over with your doctor.
A baby usually loses weight during the first week or so, possibly up to a tenth of birth weight. This is normal, and is usually regained quite quickly.
While you are in hospital, take notice of your baby’s breathing: then you will know what to expect when you are by yourself at home. In the first few weeks a baby’s breathing can vary, sometimes it is rapid and other times quite slow. Sneezing and snuffling are common at this age, and breathing can be noisy. Like all noises, it seems louder at night.
Most babies hiccup. It doesn't worry them so it needn't worry you.
The first few stools have a sticky consistency and look blackish. They change to a lighter colour when feeding starts.
A breastfed baby’s stools can vary from bright yellow to greenish yellow; the texture is fine, but there may be whitish flecks, like seeds. The smell is not unpleasant.
The bowel motions of a breastfed baby seldom need cause concern. The numbers can vary tremendously - from once a week to one before and after each feed. All are perfectly normal for a healthy baby.
A formula-fed baby’s stools can vary from a creamy yellow to khaki, depending on the formula. They are usually firmer than with breastfeeding, but less frequent. There may be one or more bowel motions daily, or even one every second or third day; it doesn't matter while the stool is still soft. If it becomes dry, hard and crumbly, offer 30 ml of boiled water between feeds until you can ask your child health nurse about it.
Cuddling, rocking, talking and singing can usually soothe unhappy babies. However, if all else fails to comfort, you may try a dummy; but strict cleanliness as for bottles and teats is important. So-called ‚cleaning’ the dummy in your own mouth merely puts germs all over it. Some are better than others for safety reasons; you can ask your child health nurse about them.
You may be nervous about bathing your baby at first, even though you have been shown how in hospital. Sometimes babies cry a lot during bath time; it is still very strange for them. However, if they are very distressed, just ‚top and tail’ them for a while. A small feed before bathing may help.
Rest and Sleep
Rest on your bed as much as possible while in hospital, and try not to do too much for a week or two when you arrive home. Extra cleaning can wait for a while.
Broken nights are part of being a parent. A mother usually feels constantly tired in the first months. With a new baby she is ‚on call’ 24 hours a day, and a routine is difficult to establish.
Rest is so important that it is worthwhile organising your time to include a nap during the day, to allow for sleep lost during the night.
Even the most welcome baby means some readjustment for everyone in the family. Other children, toddlers especially, but even the older ones, may take a while to adjust, and need understanding and patience. It is difficult for them to have to share you with another. Talking and planning during the pregnancy helps.
People want to help new parents, but their advice can be confusing. Remember, no one knows your baby better than you do.
Safety in the Car
Your baby needs to be restrained in a restraint appropriate for their age and weight whenever travelling in the car. Never nurse a baby or small child in your arms in a moving car. Should an accident occur, it would be impossible for you to protect your baby from injury or death.
In many countries the law requires that infant restraints be used when travelling in cars. Look for the relevant approval mark on any restraint you use. A restraint over 10 years old may not meet current.
Hints For Home
Forget about those unrealistic magazine photos of immaculate homes. They always look as though no one lives in them. If you find your spirits sagging about mid-morning, take the time to pep yourself up with a milk or fruit drink, and a healthy snack.
Sitting down to the job is one of the best energy savers; for instance, when you are preparing vegetables, cutting school lunches, or folding washing. Plan rest periods during the day. Even 10 minutes lying on your bed whenever you can is refreshing for your mind and body. Sit with your feet up or lie down.
It’s easier to supervise toddlers if you rest on a couch in the playroom, or in their bedroom. Give yourself a head start with the washing by throwing a load in the machine at night, ready to hang out early next morning. Cut ironing to a minimum for now and maybe forever.
How long you and your partner should wait before having intercourse after childbirth depends on how you both feel. A lot depends on how difficult the birth was for the mother. Mutual agreement is a much better guide than the advice of friends or others. Medically, intercourse is safe once the bright red blood loss has ceased.
It is important for both of you to discuss how you feel and any worries you may have about making love again. For about two out of three women, there is a decline in sexual feelings, behaviour and satisfaction. This may last several months. Don’t feel bad about it. Try to remember that a woman at this time of her life still needs to be loved, wanted and feel feminine.
Tiredness is a factor in a new mother’s loss of sexual feeling - babies take a lot of looking after. Scar tissue from episiotomies or tears, even though healed, can cause discomfort during intercourse. Try varying the positions you use. If you have painful scar tissue, ask your doctor to arrange treatment by a gynaecological physiotherapist.
Due to altered hormones following childbirth, the woman’s vagina may seem dry because it is not lubricating as much as before; this may last for about 12 months. Petroleum Jelly, saliva, or contraceptive foam, all readily available, can be of help.
It is possible for a woman to become pregnant again as soon as four weeks after a baby’s birth. Your own doctor or a family planning clinic can give you more information on avoiding an unwanted pregnancy
Getting Back Into Shape And Fitness
Pregnancy, childbirth and caring for your baby cause stretch and strain to your pelvic floor, stomach muscles, and your back. It is important to give these parts of your body extra care in the next few months so they become strong again and do not cause problems in the future.
- Strong pelvic floor muscles prevent vaginal slackness and leaking of urine or faeces so practice your pelvic floor exercises
- Care of your back is needed in all activities at home and with your baby, to prevent acute and chronic back pain
- Strong stomach muscles help towards a trim figure, and they support your spine.
A Baby 0-3 Months
Growth and Development
The rate of growth is not the same for all babies. Some will be small, others bigger, but provided children are contented and progressing, differences in weight gains between them are inevitable and unimportant.
All babies develop skills in the same order, but all are unique and progress at their own pace. It is amazing how broad this spectrum of normal development may be.
Babies’ early movements are uncontrolled, random responses. They don’t know yet that they have hands, legs, etc. or how to control them. By comparison, reflex movements - sucking, breathing, sneezing, swallowing and so on - are not random responses. They have survival value. In response to loud noises or to suddenly feeling unsafe, babies may throw their arms out, stiffen and cry. This reflex movement disappears within a few weeks.
All babies are able to learn from birth. They can hear, see, feel, taste and smell and by using their senses will begin to learn about their world and the people in it.
By one-month baby can already turn head and eyes towards light and will watch faces while being fed or talked to. They may smile to indicate pleasure. Babies focus best on faces that are quite close to them, about 20 cm away. This is often called the‚ cradling distance’ and is the best of learning situations - close enough to hear, see and feel.
Gradually they become stronger and when placed on their tummy can lift, not only their head, but also their upper chest, using their forearms for support. Floor time without a nappy will help. Interest in people also increases. This is shown by visual awareness of a person moving about the room. Social response to nearby friendly faces is quick and they show their pleasure by smiling and cooing. Joyful movements in anticipation of a bath or similar caring routine suggest that they are beginning to know what will follow.
Smoking and Your Baby
Because babies have very delicate airways that are sensitive to smoke and the chemicals it contains, care should be taken to protect them from tobacco smoke. Smokers should be discouraged from smoking in a house - certainly in the same room - where there is a baby. Infants exposed to passive smoking are more likely to suffer from asthma, bronchitis, allergies, chest infections and even Sudden Infant Death Syndrome (SIDS), than babies who breathe clean air.
If you are breastfeeding remember that some chemicals from cigarettes are transmitted through breast milk. However, this is not a reason to stop breastfeeding as breast milk has many excellent health benefits, including protecting against infection.
The Crying Baby
Crying is the only means of communication for babies and they come well equipped to use it. Babies never cry for nothing, always for a reason: they need something. Usually the need is simple.
The crying may be due to:
- Discomfort caused by hunger, pain, being wet, hot or cold
- The need for physical closeness
- Loneliness or fear
- A need to suck - sucking is comforting (longer sucking at feed times may help or, in some cases, offering a dummy)
- Parents’ anxieties that they are quick to sense
Attention to obvious needs may settle them, but if crying continues try:
- Extra cuddling or use of a baby sling
- A change of position
- A warm bath or shower and gentle massage
- Secure wrapping
- Background noise, music
Some babies tend to cry when they are put down, but if left for a few minutes they will very often settle. From parents’ consistent response to their cries, babies will learn quickly that they are loved and wanted, that someone can be relied upon to respond to their needs. This in time will lead to the development of a secure attachment to these special people and a sense of trust.
The development of this sense of trust is said to be one of the most important tasks of infant development. The more time parents spend with their baby, the sooner they will get to know each other. Babies will attach to whoever looks after them most, as well as to other family members. The degree of attachment is related directly to the amount of time the baby spends with a person.
Playing and Learning
Babies will get some play value out of every single, ordinary, pleasant thing you do with them, from changing a nappy, bathing, feeding or just being close. During the first three months babies will earn to smile, chuckle and coo, and turn towards sounds. They also make a major discovery - that they have hands that can be used to reach out and touch things.
- Parents - to feel, look at, listen to, taste and smell
- Colourful mobiles, leaves or curtains blowing in the breeze
- A variety of sounds to listen to
- Pram rattles or objects dangled on strings to encourage coordination of hands and eyes.
Use your imagination to expand your baby’s world.
‘Play is more than ‚just fun’ to babies. Play is learning and practicing what they have learned. It is finding things out and exploring what they find. It is anything that stimulates them to use their bodies and their senses and develop their thinking and their intelligence.'
(Penelope Leach 1977)
Immunity to certain diseases can be developed by giving babies small doses of specifically treated and therefore safe bacteria, viruses or their products (vaccine). This results in the right antibodies being produced. Once this is done, 'booster’ doses at appropriate ages maintain protection for many years.
This means that we can become immune to many serious diseases without ever suffering from them and their likely side effects, through this process of vaccination.
Your child health nurse can give you details on the vaccination service available in your district. The Health Department of Western Australia provides local authorities and general practitioners with the vaccines at no cost. If preferred your general practitioner will perform vaccinations, and an administration charge may be made.
Breastfeeding is nature’s way of providing not only food, but also warmth, comfort, pleasure and security – all those things essential for the development of the child’s self-esteem. Sucking is pleasurable, comforting and reduces tension, while the skin-to-skin contact of mother and child provides a feeling of security, the feeling that one is not separate, not alone.
Feeding done at leisure provides an opportunity for the mother to relax and enjoy her baby, as well as to give nourishment. New mothers sometimes find they have ‚so much to do’ that they experience some anxiety and feelings of stress. When they sit down to feed, it is a time to forget about other tasks and to devote themselves completely to being with the baby. Babies will react to any feelings of unrest, worry or preoccupation in their mother. If a baby is uneasy at the breast, it is usually because the mother is not relaxed.
Primarily breastfeeding can be a pleasurable and valuable experience for both mother and child and is best done in a calm environment. Concern about supply or worry of any kind can be counter- productive. Help is available from child health centres and the Nursing Mothers’ Association. Older children need not be excluded from this activity. Allowing them to be there, playing nearby perhaps, or curious, interested and involved, will mean less likelihood of jealousy and resentment of the new baby. They will need extra attention and the reassurance that they are special too.
Set up playthings nearby before feeding starts. If older children are included, their interest in the proceedings is likely to lessen and they will probably go back to their play.
If bottle-feeding is chosen instead of breastfeeding, the baby can still experience the same close and loving holding. ‚Prop’ feeding is dangerous not only because of the risk of choking, but also because it means that the baby is missing that important early contact with the parents. Never prop feed, but always hold the baby, first on one side and then the other, just as the breastfed baby is moved from breast to breast. This will stimulate both sides of the baby’s body as in breastfeeding. Contact your child health nurse for advice on formula feeding.
The role of parents is to fulfil the needs of their children (physical, emotional, intellectual and social). They provide and they protect and, in the beginning at least, this is a 24-hour-a-day job. How the child’s needs are fulfilled and by who doesn’t really matter, as long as it is in a way that is acceptable to both parents - they have the right to choose.
When parents share the nurturing role, there is an opportunity for both to have some time to them- selves - to relax, see friends, perhaps go to a film or continue with hobbies or sports. In this way there is less burden and so less cause for resentment, complaint or dissatisfaction within the relationship. Parents can each have time with their child and the child can really get to know both parents. So everybody benefits!
Parents need to remember that they are important people too, and need to spend time together as a couple. Occasional outings without the baby are recommended.
It is always important to choose a reliable baby-sitter - preferably someone you know personally, or at least who has been recommended to you.
From birth onwards the foundations are being laid for personality growth. It is important that early experiences provide the best possible basis for a child’s future development as a lively, stable, and responsible person, capable of giving and receiving affection.
Every year in Australia more than 700 children die from injuries. Thousands more are permanently scarred or disabled. Preventable injuries account for more admissions to children’s hospitals than any illness or disease. It is our responsibility as adults to maintain a safe environment for our children, to teach them safe attitudes and behaviour, and to protect them from harm.
To Keep Your Child Safe
- Babies’ early-uncontrolled movements can propel them in unexpected directions. Never leave them unattended on tables, beds, etc.
- Never‚ prop’ the bottle, whether you are there or not. It is possible that milk may be regurgitated and/or inhaled
- Always place your child in an approved child restraint in the car
- Remove bibs at sleep time to prevent suffocation
- Use thick, heavy gauge plastic sheeting in bassinets, cots and prams, and dispose of plastic with care
- A baby should be placed to sleep on his or her back
- A baby’s feet should touch, or almost touch, one end of the cot with the cot cover shortened so that a baby cannot slide under it
- Remove any loose ribbons or trimmings on clothing and blankets
- Use flat, firm mattresses and no pillows
- Protect baby from the sun and heat
- Make sure that no one smokes around your baby as passive smoking can damage sensitive airways causing asthma, bronchitis, chest infections and Sudden Infant Death Syndrome (SIDS).
Take special care with baby’s dummy.
- It has no ribbons or chains
- It is in good condition - no loose parts
- There are holes in the flange that fits around the baby’s mouth (if it does slip into the mouth, baby will be able to breath)
- There is a ring attached for quick, easy removal from baby’s mouth in an emergency.
A Baby 3-6 Months
Growth and Development
By three months babies become more visually alert and are attracted by nearby objects that move or are brightly coloured. Curtains, leaves, shadows, mobiles, etc. will be studied intently for a few minutes. You will notice that they now put their hands together over the chest and study them thoughtfully. They will then put them into the mouth for further exploration.
At about the same time babies will begin to produce more saliva and dribbling will increase.
Progressively they become aware of, and explore, other parts of the body - chest, genitals, knees, toes, and such. Slowly they learn 'what is me and what is not'.
Some time during these three months, babies will learn to turn over from tummy to back. Imagine their delight when, after practicing for weeks, they finally succeed and the entire view of their surroundings changes. The ability to roll over and move will develop more quickly (and safely) on a firm stable surface such as the floor rather than a bouncy soft bed.
At first they may cry for you to help turn them back, but they soon learn to do this for themselves and can move very quickly.
Most babies of this age will sleep less during the day than they did previously, but probably for longer periods at night.
Teeth are beginning to form in the baby’s gums well before birth. Eruption times, sizes and shapes of teeth are determined by inherited make-up. Babies may be born with a tooth, or may be still toothless at 12 months and, whichever way, it really doesn’t matter. What does matter is the exposure to any sweetened fluid or food such as honey, condensed milk, sugared fruit juices, sweet biscuits or sweetened milk, etc. These foods favour development of acid in the mouth, which can attack tooth enamel and is the major cause of early dental decay.
Babies are conditioned by what they are given to eat and drink. These early feeding patterns tend to remain throughout life. For example, if all the fluids are sweetened, babies cannot be blamed for preferring them to water.
Baby as a Social Being
Most babies will be starting to develop their own distinctive personality by now. They may be placid, impatient, easygoing or demanding. Most parents find that they feel differently towards each of their children. Possibly to some extent this is because each child is different and responds in an individual way. It is important to realise that babies bring their own personal contribution to the baby-parent relationship.
Probably the most outstanding characteristic is their friendly, social behaviour towards everybody.
So sociable are they that sometimes babies of this age seem almost to prefer playing to eating. Somehow they never come to very much harm and in the quieter hours of feeding take enough food to maintain good nutrition - though weight increase may slow down for a few weeks.
If their experience has been consistent with prompt response to their cries, they will have learnt that they get fed when they are hungry, cuddled when in need of comfort or reassurance and so on.
Four-month-old babies may stop crying and even smile when parents are seen or heard approaching, knowing that their needs will be attended to, and so begin to develop a sense of trust.
Learning Through Play
What is fascinating about being a parent is watching and helping babies to learn about themselves, their surroundings and what can be done with them. Most babies, provided they are given the opportunity, will show determined repetition of any new activity until its possibilities have been exhausted.
Before three months, anything put in the hand only provided experience in touching. From now on, babies will grasp and take objects straight to the mouth, using this as a means of investigation. This is the first example of using the mouth as an important means of learning.
The opportunity to learn is obviously reduced by excessive use of a dummy. Later, babies will examine things visually and match the information acquired from touching, mouthing and watching. They will now reach out to touch bright interesting objects, and toys that make a noise will be shaken deliberately.
Opportunities to look, touch, mouth and listen will help them to learn, and practicing helps develop coordination.
Interruptions when playing contentedly alone (although welcomed by babies) tend to encourage the need to be entertained by other people rather than to play by themselves.
Playthings which match the baby’s developing skills will provide stimulation and enjoyment, e.g. bright colourful objects suspended within baby’s field of vision, strings of rattles stretched across the pram or bassinet (within reaching distance), a soft ball or ‚texture block’ to grasp, a small lightweight rattle to hold, etc.
All toys need to be durable, washable, with smooth edges, and have no small beads or bells that could be swallowed. The average baby’s grasp is strong and they are quick and persistent. Cuddly toys are best stuffed with old nylon stockings. Crumbed plastic foam may be unsafe as children push pieces up their noses or ears, or may even choke if it is swallowed. Fur toys are best deferred until babies are older because of the intense interest in mouthing.
Sounds are interesting now and babies’ own vocalising is a new game. They will deliberately set about engaging attention by smiling and ‚talking’. Their enjoyment is matched by adults, because their obvious love of people is hard to resist.
Because babies enjoy them, bouncinettes and recliner chairs are frequently used. They are cool and easily carried. For short periods they can be useful, but they are no real substitute for being held.
For baby, a rug on the floor is the best place to exercise, learn how to control muscles and practice new skills. Baby walkers are not recommended because they do not allow this to happen. They can also be dangerous.
From this outline, it is evident that the baby’s own priorities are something like the following:
- First and most important - people
- Then the opportunity to learn and practice developing skills
- Safety, which is linked with development in early childhood.
- Understanding development patterns helps parents to anticipate the necessary precautions that must be taken to provide for their baby’s safety.
Between the ages of three and six months, babies learn to reach out and pick up objects, put things in the mouth, lift the head, sit with support and roll over.
To Keep Your Child Safe
- Always place your child in an approved child restraint every time you go out in the car.
- Never leave your child unattended on a change table, bed, chair or table, at a supermarket check- out or in a car.
- Never drink tea or coffee or smoke a cigarette with your baby on your knee.
- Protect baby from passive smoke as well as from the dangers of lighted cigarettes.
- Cigarettes are dangerous - if eaten, medical attention should be sought immediately.
- Always restrain your child in a highchair, shopping trolley or pusher to prevent falls.
- Never leave your child alone in the house when you go out.
- Always be present when your child is chewing 'finger foods’.
- Provide only safe toys.
- Make certain your child receives all the recommended vaccination.
A Baby 6-9 Months
Growth and Development
Six to nine months is a prime time for babies to develop hand skills. They have learned to balance the head; they can almost balance the body; they know how to grasp on sight, and are now eager to try these rapidly growing abilities.
They are never idle; they have a compelling urge to handle and explore things. They are building experiences that will help them understand more about their surroundings.
Everything will be taken to the mouth now, including feet. If things are dropped and fall out of sight, they do not look for them. By about nine months, however, they will search in the correct place for hidden objects and watch toys fall from their pram or highchair. This is thought to be due to an increasing awareness of distance and how things look as they fall, and the noise they make when they land. Little escapes their notice. They can focus on near objects and also follow the movements of people and animals across a room.
They are surprisingly mobile - they roll front to back, and learn quickly to roll back again, and may do this to reach an interesting toy. Some babies circle more or less on the spot, so are often frustrated because the toy is still out of reach. During this time, most children will progress from sitting with support to sitting by themselves. This leaves their hands free to explore everything within reach. Secured in their highchair, they can join the family at mealtimes and will enjoy trying to eat with their fingers, although they cannot manage a spoon yet. They will often accept a drink from a cup in imitation of adult behaviour, although spilling is common.
As a Social Being
Gradually babies have gathered many impressions of people and things. They can distinguish between the people they see every day and less frequent visitors. Allow them time to observe strangers from the security of a parent’s arms before advances are made towards them. Friends and relatives may need reassuring that this apparent alarm at the sight of them is nothing personal. It is part of an increasing comprehension of the world around them.
Some babies of this age will cry bitterly if mother disappears even for a short time. This does not mean that they are spoilt. They do not understand yet that, even when she is out of sight, she has not left forever. In the meantime, it will help if they can hear or see their parents when they are awake. Games where mother or father disappear and return - like peek-a-boo - will help reassure and teach them that people and things continue to exist even when they are out of sight.
Learning Through Play
Just as an appropriate diet is essential for normal physical growth, so it is for mental development. The most vital ingredients of this diet are play and language. Through them, the child explores the world and learns to cope with it. - Mia Kellmer Pringle 1980
Producing sound gives babies pleasure. They delight in shaking rattles, crumpling paper with hands and feet and experimenting with voiced sounds. High-pitched squeals please them and they may stop and laugh at the noises they can make. They imitate, quite realistically, the sounds they hear.
Syllables may be joined together - ma-ma, da-da and ba-ba are the most usual combinations, but as yet they are still just interesting sounds, not real words.
At first babies bring their toys towards themselves with a scooping action using both hands. By about six to seven months they can grasp an object in one hand and pass it from hand to hand as they examine it intently. Common household objects such as pegs, pots and pans, and such are of interest and they enjoy exploring their possibilities. As they handle and mouth them, they begin to learn about such things as warmth, coldness, roughness, smoothness, softness, hardness and smell.
During this time their ability to pick things up will develop from paw-like movement to poking at tiny objects with the forefinger and then eventually to picking them up precisely between thumb and forefinger.
Music is another form of communication. Singing and rocking rhythmically are relaxing and comforting and both parents and children enjoy this.
They will respond with delight to nursery rhymes that include bouncing and clapping routines, and soon will imitate the actions as they sing their own tune.
Books are important to everyone. Let them be important to babies too. Now their eyes can focus they can look at a picture book with you for a few seconds. Their concentration span is brief. Choose a book that is not easily torn, has bright clear colours and has only one simple object illustrated on each page. They will learn to love books because they love that ‚reading time’ spent with you. This is, of course, no substitute for conversation - which naturally also means listening to and trying to understand their messages to you. Your attention increases their interest in acquiring and practicing new sounds. You, as parents, are their first and most important teachers.
Choice Of Toys
It is important to select toys that are safe and the younger the child the more care is required.
- Toys with small or loose parts are kept out of reach
Dangling ribbons or elastic are removed
- Eyes in all toys are securely fastened (remove if in doubt)
- Squeaks in soft squeeze toys cannot be removed
Teething rings and rattles will not break or come apart
- There are no sharp edges or points
- Toys are smoothly finished and free of splinters
Paint is lead-free. (In Australia and the UK only lead-free paints are used. This may not always be true of toys imported from other countries)
- All stuffed toys are in good repair and inspected regularly. Choking or inhalation of foreign objects are among the commonest accidents in children under 12 months of age.
- Blind cords are not within easy reach
Playpens And Restraints
Mobility, though exciting for children, can also be hazardous. When they must play alone, or parents are occupied with activities such as cooking, washing or gardening, a playpen or a safe area should be provided. However, free exploration under adult supervision is still the best and most enjoyable learning situation.
Leather or fabric restraints should be used always for prams, shopping trolleys and highchairs. Plastic strips may stretch or break and are therefore unreliable.
During the six to nine months period, most babies will learn to sit without support, roll or crawl around on the floor and use furniture to pull themselves up to stand.
Baby walkers are unsafe and not recommended. They can tip over and they interfere with the baby’s muscle development.
The desire to explore and learn about the world is very strong and needs to be encouraged. Keep your child safe by removing as many hazards as possible before accidents occur.
To Keep Your Child Safe
- Always place your child in an approved child restraint every time you start the car.
- Always restrain your child in a highchair, shopping trolley or pusher to prevent falls.
- Use safety barriers to steps, stairs and rooms you don’t want your child to enter.
- Always stay with your child during bath time or pool play. A child can drown in less than 5 cm of water.
- Avoid giving your child small pieces of hard food such as nuts, uncooked apple and carrot.
- Continually check that kettle and iron cords are out of reach of young children.
- Always keep hot drinks out of a child’s reach.
- Cover power points when they are not in use.
- Always check for small objects such as pins before placing baby on the floor.
- Store medications, cleaning substances and any sharp or dangerous items in a cupboard with a childproof latch.
- Use a nappy bucket with a tight-fitting lid that cannot be removed by a child, and keep it out of a child’s reach.
- Blind cords are not within easy reach.
- Make certain your child’s vaccination are up to date.
A Baby 9-12 Months
Growth and Development
From nine to 12 months, babies will probably develop the ability to sit unsupported for quite a time. They can turn sideways, or stretch out and pick up a toy from the floor, without losing balance. The ability to move increases rapidly, probably progressing from rolling or wriggling to crawling on all fours. Some babies have their own individual crawling technique. It may not be the conventional way, but they are more concerned with reaching their goal than with how they make the journey.
When they first pull up on a support to stand erect, they will not be able to lower themselves slowly back to a sitting position. They may flop down or cry for help. But no sooner are they down than they are back on their feet again. This will never be more obvious than at nappy changing times.
Gradually, they will learn to walk, stepping sideways, using furniture for support. They will progress to walking when their two hands are held, then with only one hand held. They may stand for a few seconds or even walk unaided by the time they are one year old.
Their ability to use their hands is developing rapidly. At first, they will point and poke at small objects. They need to practice their newly acquired throwing skills, and do so with toys from the playpen or food from the highchair.
Their eating habits are also changing. Smooth foods are no longer necessary since they can chew - with or without teeth! But beware of hard foods, such as nuts, carrots or apple, which could choke baby.
Some children will show a preference for certain foods. They may enjoy finger feeding but need watching to ensure they don’t choke. At this stage, many are ready to make the change from sucking to drinking from a cup. Frequent small drinks (30-60 ml) give the pleasure of imitating adults and of finishing a task. Cups are easier to clean than bottles and eliminate the need for special equipment.
They are interested in all sounds and especially in voices, their own and other people’s. They love to babble for their own amusement, but can also indicate what they want by pointing and making sounds. Most babies produce their first word during the tenth or eleventh month. However, first real words are surprisingly difficult to identify from the sounds of constant babble.
As a Social Being
Positive experiences with people are satisfying to babies. They help them to develop confidence in themselves and a feeling of being worthwhile. Anxiety hinders development. Curiosity, exploration and learning can proceed when children know they are loved and wanted.
A well-developed sense of trust in the first year lays the foundations for a feeling of security that lasts for life. Babies aged nine to 12 months are more confident socially, although many object to new faces and strange voices. Later they may still be distressed if parents leave for even a short time. However, they can enjoy great social success because of their obvious delight in the attention of familiar adults. They are equally able to show their displeasure, and often do so by throwing themselves backwards, stiffening their body and yelling.
Learning Through Play
Playing is a happy way for children to learn about what they can do and the world around them. It is important for them to have a wide variety of play experiences. How much children enjoy and learn will largely depend on you. Playing and talking with your child can help and encourage development in a way you’ll both enjoy.
Games and playthings which match children’s developing skills will encourage practice and give pleasure. Suitable games for this age group include finger-toe songs and rhymes, games such as ‚peek-a-boo’, clapping hands, and opportunities to listen and copy the sounds they hear. Stimulating play things such as pull-along toys, balls, drums, and objects that fit together like stacking tubs, are best for this stage of development. Opportunities to explore and experiment with their new physical skills will help them to learn and keep them entertained.
A safe space to explore and play in is essential. Look around your home and remove any potential hazards before your baby gets into trouble.
Movement means opportunity.
Children of this age no longer need to wait for help. They can explore and even follow people if they want to. Steps, doors and gates are very inviting. Water is always an attraction, a hazardous one. This is a time when parents need to be particularly watchful. Babies can move not only quickly but also silently.
Always check where your baby is before reversing the car.
Visually, children of this age are more interested in people and in everything going on around them. They can now see and pick up pins, flies, fluff, buttons and so on, and everything still goes to the mouth. You have checked your own home, but take care in other places too. In fact, it is probably safer to bring the playpen on visits.
Restraints are more necessary than ever, as their experiments will extend to what can be done out of the stroller and in, under, or over the highchair. Even when restrained, active children can bounce a highchair or pram, or manipulate a playpen into a dangerous situation.
Low cupboards need to be secured. Heaters, fans, tablecloths, occasional tables, etc. are all objects by which small children can pull themselves up, or which they want to explore to see what they can be made to do. Prediction is impossible so constant care and protection is more necessary than ever.
Babies of this age have no understanding of danger and no knowledge of fire, poisons, height, depth, water, chemicals, knives or electricity.
Hot drinks are the major burn hazard.
Cigarettes spell a special danger to inquisitive babies. Cigarette butts and ashtrays can cause burns and even fires. It should also be remembered that cigarettes are poisonous, and medical advice should be sought immediately if baby eats a cigarette. Babies of all ages need protecting from passive smoking. Apart from the danger of burns from a lighted cigarette in a smoker’s hand, a baby exposed to cigarette smoke can develop sensitive airways leading to asthma, bronchitis and chest infections.
The chances of injury increase as the child grows. Hazards multiply as the baby learns to crawl, walk, climb and explore.
To Keep Your Child Safe
- Make the child’s environment safe by:
- Storing household cleaning agents, medicines, etc. well out of reach or, better still, in a locked cupboard
- Covering power points when they are not in use
- Keeping kettle cords out of reach and opting for cordless or curly-corded kettles
- Placing dangerous objects out of reach
- Fencing off hazards such as swimming pools, fires, heaters and stairs.
- Use protective devices such as:
- Approved child restraints in the car
- Full harness restraints whenever possible when the baby is in the stroller, highchair or shopping trolley.
- Keep smokers and ashtrays away from your baby! Protect baby from passive smoke as well as from the dangers of lighted cigarettes.
- Teach your child to avoid dangerous situations. Children learn best from copying what they see, so let your child learn good safety habits from you.
- Remember that at 12 months, baby is due for vaccination against measles, mumps and rubella, and for some babies, a third Hib immunisation.
- It takes a long time for children to remember and recognise dangerous situations. In the meantime, keeping a constant watch on them is the only way of making sure they are safe.
A Child 12-15 Months
Growth and Development
At this age most babies will be walking, talking and starting to climb. Every day they discover different aspects of themselves, and they want to explore the world around them.
Children learn from doing. It is important to let them try, and to encourage and praise their efforts.
They enjoy movement for its own sake and are constantly active. Walking opens up new avenues for exploration. They can now reach and climb and are busy with constant inquisitive investigations.
Dressing needs patience - they just cannot keep still. They may begin to insist on doing some things for themselves, such as taking off shoes or putting things on their head.
They want to feed themselves but the spoon is usually empty and upside down by the time it reaches the mouth. It takes hours of patient repetition to learn this skill. Finger foods are an effective way of allowing them to manage their own meals, and to encourage this growing independence.
As a Social Being
It is interesting how children’s dependence on their parents decreases gradually through the second year. As they learn more about people and the things around them, they become more skilful at performing tasks themselves.
At this age, however, bursts of independent behaviour are followed by insistent demands for their parents presence and attention. These changes are often sudden, but they serve to reinforce the child’s feelings of security.
The struggle may show itself as contrary or even antisocial behaviour at times. If parents can direct their disapproval at unacceptable behaviour rather than towards the child, they will encourage a sense of healthy independence and self-confidence. It is better to say: ‘What a mess’ - now we’ll have to wipe up all that spilt milk, rather than: ‘You are so naughty’ - look at the mess you’ve made. In this way, they are not made to feel that they are ‚bad or ‚not loved as people. This way of commenting on behaviour is difficult and requires practice and patience.
Genital exploration - or‚ playing with oneself - is a normal part of development. For children it is an extension of exploring their bodies, feelings and sensations. Some parents who feel uncomfortable about such behaviour want to distract children and give them something else to play with; if so, this should be done in an easy manner so children do not feel guilty or naughty.
Everyone benefits when the entire family can spend time together. For the child, it can mean a change in play and for the main caregiver, it is an opportunity to hand this responsibility over to the other parent for a while. Sharing the responsibility gives both parents the chance to spend individual time with the child - to talk and play together. Each parent has important contributions to make.
At this age, children understand familiar activities, such as preparations for a bath or for an outing. Now that they are becoming interested in watching things at a distance, they like to play where they can see people and activity. They are often content to amuse themselves until they hear movements, then eager anticipation changes to joyous greeting if someone they know appears. They may show shyness with strangers if they have not done so previously but this will not last long.
However, they are still likely to want to return to mother and father frequently for contact and reassurance. At the same time, they begin to realise that it is possible for parents to go away and not come back. This is a very frightening thought, and they keep a close watch on parents. Threatening to leave to get children to behave can increase this fear and make them clingier.
This behaviour is particularly obvious in children attending day care. It may help to prepare for this experience by leaving them with a relative or friend for short periods.
Learning Through Play
When children begin to crawl or walk, they are developing their large muscles; at the same time they are acquiring skills such as balance.
They learn to negotiate steps and to judge what spaces they can squeeze into or through, and what obstacles they can climb over or crawl under.
They enjoy sharing nursery rhymes, books and songs with you. They are listening to voices, practicing sounds and words, enjoying people and imitating what they do. Children of this age have probably mastered three to five words, most of which you alone will understand. They need to be with people who have the time to talk, listen and respond to them, all of which will encourage understanding and the use of words.
They need toys to cuddle, carry about and wrap up and objects they can feel, examine and sort out. They need time to play in the bath - time for fun. Finger and toe games, and dancing to music will delight them. Grandparents too like to share the baby’s pleasure in these activities.
Children watch their parents, their likes and dislikes - the way they talk with each other and the way they behave towards each other. They are learning all the time and will copy what they see. They are learning about love, affection and physical contact, doors, wheels, cups, spoons, chairs and how these simple objects that fills the world are used.
Things to suck and bite on are still needed, as are things to make a noise with, things to float in the bath, things to drop, and things to touch and smell.
This can be both a difficult and rewarding period for parents as the toddler vigorously explores the surroundings. Regard for safety is essential but care should also be taken not to prevent learning. Providing a safe and stimulating environment for play can do this.
At this age children are learning to walk, run and climb. They are also very curious and need to explore their world. Their rapidly changing interests may make it difficult to keep them in sight, so it is obvious that a responsible adult needs to be nearby. General safety precautions are now more important than ever. Toddlers can get into trouble but do not know how to get out of it. Their understanding of dangerous situations is very limited, so that constant supervision is the only answer.
Telling children ‘not to’ or otherwise stopping them does not mean that they have understood the danger - or that they will not return to complete their investigations. Consistent removal of the baby or the dangerous object does. However, too many ‚don’ts’ are as frustrating for them as for you - keeping them to a minimum is best for everyone.
Their body control is developing but it is still poor. Their coordination is insufficient for them to master their movements reliably. They may collide with anything in their path, and in trying to secure an item they want, may pull other objects on top of themselves. Once started, movements such as running, drinking or removing a hand are difficult to stop or reverse.
Statistics suggest that the following injuries are most common in this group to almost school age:
- Falls (because their balance has not developed fully)
- Inhalation of food and other substances (because the reflex of closing the respiratory passages when eating is not yet fully developed)
- Burns and scalds (because they find it hard to remove their hand from a burning object)
- Poisoning (because they find it hard to stop drinking from a tipped container)
- Drowning (because of their curiosity and interest in water)
- Motor vehicle injuries (because they are not properly secured in the car or are reversed over as a car leaves)
At this age they frequently, and often unexpectedly, run off. Leading reins may make shopping easier as well as safer for the child, and less of a risk for motorists.
In the car, the safest place for toddlers is secured in their seat in the back. This is also a legal requirement.
They still need 100 per cent adult protection. Consistent guidance helps them begin to understand that certain behaviours are dangerous. Like other skills, responsibility has to be practiced, and they have a long way to go.
Scalds from hot drinks are a major hazard for toddlers. The use of tablemats in place of a tablecloth, using wide-based mugs rather than teacups and ensuring hot drinks are in the centre of the table all help to protect the exploring child.
Cigarettes are a special danger to inquisitive toddlers. Cigarette butts and ashtrays can cause burns and even fires. Cigarettes and matches are poisonous - medical advice should be sought immediately if baby eats either of these. Children of all ages need protecting from passive smoking. Apart from the danger of a burn from a cigarette in a smoker’s hand, a child exposed to cigarette smoke can develop sensitive airways leading to asthma, bronchitis and chest infections.
To Keep Your Child Safe
- Lower the temperature of the hot water system to a medium or low setting, of around 50 degrees centigrade
- Keep kettle cords out of reach and turn saucepan handles inwards on stovetops
- Place hot drinks in the centre of the table, away from edges
- Store oven and drain cleaners in a locked cupboard or shed with pesticides and swimming pool chemicals
- Store medications and cleaning agents out of reach in a childproof cupboard
- If living in a remote area and further than half-an-hour to the nearest hospital, buy and keep a bottle of Syrup of Ipecac in the house
- Always ensure that your child is secured safely when in a cot, and away from curtains, blinds and cords
- Insist your child remains restrained at all times when in a vehicle
- Enclose the outdoor play areas your child uses
- Check where your child is before reversing the car in the driveway
- Always stay with your child near water containers of any kind (including nappy buckets and pools)
- Provide toys appropriate for this age.
Remember that 12 months of age is the time for your child to have his or her first measles, mumps and rubella vaccination.
A Child 15-18 Months
Growth and Development
By now, the rapid growth of the first year of life has slowed considerably and appetite has noticeably decreased.
One of the characteristics of this age is increasing independence and this will be very evident at meal times.
Children of this age enjoy drinking from a cup on their own. However, they tend to tilt the cup too quickly and spilling often occurs. They may demand to spoon-feed themselves, but often accept help towards the end of the meal.
Throwing objects is a favourite pastime at this age and these children will fling anything. They are just developing this complicated manoeuvre which, like any other important skill, they must have the opportunity to practice. Because they now have the ability to release an object voluntarily, they can place one block neatly on top of another. They love moving things in and out of containers - but seem to enjoy the dumping part the best.
They can, when they want to, assist with dressing by putting their arms and legs into their clothes - but ‘want’ is the operative word. It is more likely that they will need to be held bodily and worked into them. They are beginning to think they don’t always have to do as they’re told. This is quite important and exciting because it gives them the feeling that they can make choices for themselves.
Speech too is developing rapidly. They jabber loudly and constantly as they imitate conversational tones and phrases. They will probably say two to 20 recognisable words in proper context but can understand many more. They can also obey simple requests if they feel inclined. As speech is one of the most important developments in this second year of life, listening and talking with them is essential.
As a Social Being
Now they can walk, there is such a lot to see and do that they are almost totally absorbed in their own activities.
The parent’s ‘NO’ now falls on deaf ears as the child concentrates on the job at hand. However, concentration span is short at this age, and children pass rapidly from one occupation to the next which is just as absorbing. Suddenly, they are trying to do so much, so quickly and so constantly, that there isn’t a moment to spare.
Providing the initial approach is left to them, they will greet friends or strangers - human or animal - in the same joyous way. Their natural curiosity drives them energetically into every new situation.
Every day they discover something different about themselves and their world. They want to try things on their own and can be boldly demanding.
It may take them time, but children learn by doing. So it’s important to encourage and praise their efforts. Also do a quick ‘survival check’ to see you are one step ahead of their rapid development and have removed safety hazards around the house.
They love and need to be near people. (They are not really old enough to play with other children their own age although they may happily play beside them.) These children love to imitate. They will learn much from watching you and copying what you do.
Learning Through Play
One of the most important, yet least understood, roles that parents ever undertake is that of fostering the intellectual and social development of their children - parents are their children’s first and most important teachers.
This can be both a difficult and rewarding period for parents as toddlers energetically explore their surroundings.
Safety is essential but care must be taken not to prevent learning. This can be done by providing a safe and stimulating environment for them to play in, where they:
- Can feel secure and confident
- Are safe from hazards, but free to explore
- Have new experiences provided so that they can be actively involved
- Are given praise and encouragement for their efforts
- Have play things to match their stage of development
- Are able to spend time with parents.
Everything is of interest and they learn something from everything. Because they are attracted to the world outside, they enjoy watching movements through a window, and shout to anyone going by. Playing provides challenge for the body, mind and imagination.
They can relax; they can be boisterous; they can be serious; they can have glorious fun, all in a matter of minutes.
Some Play Ideas
A sandpit should be situated where parent and child can see other, and be at least 50 cm deep if it is to be useful for a few years. If it is surrounded by a wooden frame (railway sleepers are excellent but make sure they are carefully sandpapered to get rid of splinters) it provides seating and a table for sand cakes. White sand - such as beach sand - is preferable, as yellow tends to become very hard. Although it is illegal to remove sand from a beach, this does not apply to sand blown on car parks and pavements. Different sized tins, an old sieve, old plastic jugs and wooden spoons are all useful sand play tools. Make sure the sandpit is covered at night to keep out cats and dogs.
Walks, rather than drives, can be a great experience. They provide opportunities to feel grass or sand or puddles; follow a path; climb over logs; and see water, birds, animals and insects.
One clear familiar object on each page is still preferable at this age, but your child may be showing an interest in more detailed pictures or simple stories about everyday activities. Sharing a book with someone is what these children enjoy most.
Toys for sorting and placing
Shoe boxes can hold many treasures. They may be covered in plastic contact or painted in bright colours. Fill them with shells, gumnuts, cotton reels, tin lids (not sharp), square building blocks, pegs and different stones. All of these must be too big to be swallowed.
Toys to handle and fit together
- Nests of tins painted in different colours (make sure there are no sharp edges)
- Hammer toys
- Saucepans and lids and other kitchen utensils
- Plastic containers in the bath.
Toys to push and pull
- Large balls
- Box on wheels
- Strong cardboard boxes (big enough to get into).
Toys to cuddle and hug
- Stuffed animals
- Rag dolls.
Nothing other than supervision can prevent accidents. Know where your child is at all times.
Tots this age are intensely active and need a very high level of protection. Though the house has apparently been made safe, they always seem to be able to find a new trouble spot.
They can climb now, so a few extra barrel bolts high on doors and gates may be well worthwhile. Storage arrangements for medicines, detergents, cleaning products and other poisons need to take account of their climbing skills. Or you can have a cupboard with childproof locks installed.
Balancing is still a problem and toddlers can have many falls. Most of these are not important, and won’t even hurt enough to discourage them from trying again a few minutes later.
Swimming pools are a special hazard wherever located. It cannot be emphasised too strongly that any pool - anywhere - needs to be regarded as a constant danger both to your own and other people’s young children. The safest pool is one completely separated by fencing from house and play areas. But remember, there is no substitution for constant supervision and protection.
This is sometimes described as the age of dart and fling and, although these children will resent any type of restraint, a leading rein is still a good idea when walking in any area where road traffic could be hazardous, or in the local supermarket. A restraint clipped to either side of the shopping trolley will prevent a youngster on the toddler seat from standing and falling. This leaves the parent’s mind and hands free for shopping.
Cigarettes spell a special danger to inquisitive toddlers. Cigarette butts and ashtrays can cause burns and even fires, and it should also be remembered that cigarettes are poisonous - medical advice should be sought immediately if a child eats a cigarette. All young children need protecting from passive smoking. Apart from the danger of burns from a lighted cigarette in a smoker’s hand, a child exposed to cigarette smoke can develop sensitive airways leading to asthma, bronchitis and chest infections.
Toddlers still need full adult supervision to stay safe because:
- Their reflexes are slow
- Their body movement coordination is still developing
- They have not acquired likes and dislikes of taste and smell
- They are unable to lift their body weight up and out of danger
- They have short-term memory only
- They cannot predict events
- They have no understanding of the dangers of high places or deep holes, and are still learning to judge distances.
Children must be protected when too young to understand these dangers, and taught safety practices as soon as they are able to understand.
- It is important that you continue with the childhood vaccination schedule to protect your child against serious diseases. Vaccination due at 18 months are:
- fourth DTP (for protection against diphtheria, tetanus and whooping cough)
- fourth Hib (for protection against Hib meningitis, epiglottitis).
Ask your doctor or child health nurse for more information.
A Child 18 Months To Two Years
Growth and Development
Because 18-month to two-year-old children are going through a period of slow physical growth, weight gain will not be great.
They are beginning to try to control the world around them - including you, so they are likely to insist on using a spoon and refuse to be fed.
They usually manage a cup well, holding it with both hands and tilting it, and spill very little. Sucking is no longer important to the child, therefore bottle-feeding is unnecessary.
Eighteen-month-old children can move like quicksilver. They like to carry objects from one place to another and back again. This to-and-fro movement is much less aimless than it seems. .
How can you discover without exploring? How can you explore without travelling? How can you find out where you started without going back? Gessel
Each activity achieved, however small, is a personal triumph; for example, helping to empty the shopping basket, putting a few groceries away or drying the spoons and placing them in their drawer.
These youngsters need to do things for themselves. They learn by doing and looking, not by being told. They are more likely to cooperate if you give them something interesting to hold and examine, rather than just telling them to ‘stand still and don’t touch’.
At this age, they see other children as ‘something interesting’, and will pull, pinch, poke, push and pat them in the same way that they would handle objects. This may sometimes appear aggressive, but it is just their normal, energetic, boisterous approach.
In the months ahead they will progress from saying a few words to using simple sentences. They talk to themselves all the time, experimenting with tones and rhythms, especially during play.
They may not yet know enough words to hold a conversation, and speech may not be used although they understand just about everything that is said. They may grasp your hand to show things, and point to things they want, accompanying this with urgent noises or a single word.
By responding to their child’s attempts to talk, and guessing at what they are trying to say, parents can reward their child’s effort and encourage them to keep trying. Picture books will help language development. Toddlers can enjoy visits to the library and can be encouraged to pick books for themselves. At about two, though they understand what they are asked, they are likely to do the opposite. When it is time to go home, they are apt to walk the other way. Sometimes you can persuade them by saying ‘Let’s go to see Teddy or Pussy’, or whoever is prime favourite at the time. Threatening to leave them is frightening and makes them very anxious.
They will probably be able to point to, and perhaps name, some parts of their body, and it’s fun to find these on other people too. They enjoy simple nursery rhymes and may try to join in by echoing the last words of each line. If you are singing, they may hum and sway to the rhythm.
As a Social Being
Children at this age usually spend most of their time playing by themselves. But all the sensations they feel and the observations they make add to their knowledge of life. They cannot understand yet why things happen, but nothing that happens escapes their notice.
Socially, they are barely acceptable because they so enjoy ‘getting into’ everything. Pushing buttons on the TV, emptying baskets and answering the telephone are all legitimate activities in their eyes. When they tire, they become less tolerant of interference and a sit-down temper tantrum is likely. This is quite normal behaviour at this age. The unhappy situation can often be solved by picking them up and diverting their attention elsewhere.
If some of their things have their own place in each room, this may help them to understand what is theirs and what is not. With a bit of luck they may go to their own possessions first and only to other people’s when the possibilities of their own are exhausted (this is the theory anyway). They cannot, however, be trusted not to interfere with other people’s belongings.
Even though their span of attention appears to be short, they are constantly watching people and how they behave, and learn much more than we realise. They are becoming interested in household activities, and enjoy mimicking sweeping or dusting. They are equally able to imitate other adult behaviour that they find interesting. Their imitation of the angry adult can be very realistic.
Truthfully, they are tiring to live with, and it is very important to realise that parents need other adults for companionship sometimes. If the child spends some time with a grandparent or other caregiver, or at a childcare centre, this time apart can be of value to both child and parents.
Learning Through Play
Toddlers’ attention is likely to wander so that they play with many things in a short while. They want everything NOW, but as time passes, they may begin to respond to ‘wait a minute’. Many small children refuse to go to sleep without their favourite toy or blanket. When they are tired or in trouble, it can be a great comfort. They are beginning to recognise ownership and will return articles correctly - a bag to mother or shoes to father.
This beginning of understanding of ownership is very important. They have to experience ‘owning’ or having something belonging to them before they are able to share. This applies especially to sharing an adult’s attention. If they know that each day mother will have a special time for them alone, they may gradually tolerate interruptions at other times, such as those that occur when a new baby appears.
Help in tidying their toys may encourage them to understand that orderliness has value.
If their toys are always returned to the toy box, then that is where they will be found tomorrow. Of course, this will take time, repeated encouragement and consistency on your part.
Most toddlers seem to have unlimited stores of energy that can mean trouble if it is not used in ‘permitted’ directions. A few objects in the backyard - balls, small cardboard cartons, and a sandbox with some interesting utensils - will occupy them happily.
Frequent walks - even if you need to use reins in difficult situations - are enjoyed by both parents and children. Children can be allowed ‘off’ in an open space, such as a park. Just walking round the block can be full of interest for curious, energetic toddlers. Ball games are always a favourite and toddlers gradually become more skilled at directing the ball where they want it to go, such as into a tipped carton. Rolled-up newspaper held with sticky tape makes a useful ball for fun throwing. You can give them three or four. With care, these may be used indoors (wrapping paper on the outside will prevent grubby hands and protect walls from newsprint).
Hand puppets are great fun, especially furry ones. Adult ‘puppet talk’ will help both language and listening skills to develop.
Playthings such as building blocks, simple wooden jigsaw puzzles, posting boxes, stacking toys, screw toys and sorting games not only encourage manipulation skills, but also teach small children to concentrate, focus attention, understand how things work, and to remember.
With mastery of skills comes a sense of achievement and pride - a wonderful building block towards self-esteem.
Picture books with simple everyday objects such as animals, household items, cars, boats and familiar things are fun. They will also encourage language development, and increase the child’s understanding of the world. Ask your community nurse for leaflets on play.
As children grow and develop new skills, hazards increase within the environment. With the ability to run, climb, open cupboards, twist taps on, twist lids off and so on, their never-ending curiosity and energy will lead them continually into potentially dangerous situations.
Often accidents occur when parents are not aware of their child’s capabilities at that specific stage of development; they are ‘out of tune’ with their child’s needs, growth and level of understanding.
Periodic discussions with your community child health nurse will help you to keep pace with, or better still one jump ahead of, your child. Don’t forget that the fourth Triple Antigen and Hib injections are due at 18 months.
To Keep Your Child Safe
- Always insist that your child remains in an approved child restraint whenever travelling by car
- Keep medicines and household poisons in a locked cupboard
- Cover power points when they are not in use
- Keep electric cords out of reach
- Supervise outdoor and water play closely
- Keep pot handles turned to the back of the stove
- Place hot foods and drinks out of reach
- Make certain your child’s vaccinations are up to date.
A Child 2-3 Years
Growth and Development
During this year, weight and height will increase at about the same rate as in the previous 12 months (height increases by about 8-10 cm and weight by 2-3 kg).
Toddlers have spent the past few months practicing and coordinating their body movements. Walking is nearly perfect and most of them are running safely. Falls are common, partly because they are top heavy and partly because they do not have the ability to avoid obstacles in their path quickly. These difficulties sort themselves out with practice and by their third birthday toddlers go up and down steps, may tricycle with great ease, kick or throw a ball and jump from small heights.
By this time too they are able to pick up tiny objects with thumb and forefinger, and enjoy scribbling with a pencil and looking at picture books. They understand most of what is said but the number of words that each individual child can say varies greatly. Some can form short sentences and easily make their needs known, while others are barely past the ‘pointing and hoping to be understood’ stage. For the latter, life will still be full of frustrations and this indicates a delay needing assessment.
Listening and taking notice of what they say is probably one of the best contributions parents can make to help language develop. The more they are talked with, the more words they learn. The more words they know, the more clearly they can think, and the less frustrated they become. By listening to what they say we show them that we consider their opinions to be worthwhile. This confirms the feeling of being an independent and individual person. It is also important that they feel this emerging self is a good person to be.
By the time they are three their behaviour has changed again and they seem very much more ‘grown up’. They may now enjoy making choices between two alternatives. They listen attentively and seem to want to please.
Language helps children to learn to reason, to think and to understand the world around them; speech facilitates the making of relationships, both with adults and with contemporaries; and verbal communication is and remains a vital means of coping and coming to terms with life. Mia Kellmer Pringle
As a Social Being
Socially, toddlers are not advanced. They are more interested in things than in other children. Having no sense of property and being self-centred, they tend to come into strife with their own age group.
Two-year-olds are not really old enough to share play with other children their own age, although they may happily play beside them. They love, and need to be near, people whom they will watch, listen to and imitate.
Crying is still their main method of protest and, if frustrated, temper tantrums are a normal expression of anger. They often fear loud noises, animals, strangers and falling.
By now they help with dressing and undressing and by their third birthday many can do it for themselves if allowed to.
Remembering things is difficult and getting muddled about instructions is common.
Their ability to make a choice is still limited. However, where before they could see only one way, now everything has an alternative.
They will not tolerate change nor accept interruption. They cannot be forced. If parents persist, the result may be a temper tantrum from which it is more difficult to distract them. Some ‘don’ts’ are important and must be enforced. However, with some thought, some other way can often be found and acceptable behaviour redirected.
Many tantrums can be prevented by avoiding situations that are known to create frustration and boredom, such as going to the supermarket. It may be better, at this stage, to leave your toddler with a friend or at a childcare centre when you go shopping.
Frustrations breed tensions, and tantrums are one way of relieving feelings. All strong feelings are better expressed then bottled up. For children who cannot yet express anger in words, this is the obvious way to act out their feelings.
As children learn to express their feelings in words and begin to gain control of their emotions, temper tantrums tend to subside. Either to reinforce their anger with your own or to reward by giving in to their wishes is likely to prolong this sort of behaviour.
It is best for adults to ignore the situation if possible, but be aware of the risk of harm to the child. When the tantrum is over a cuddle and reassurance from you will help the child to know they are still loved. To completely lose control of oneself is frightening, particularly for a child who is striving for independence.
Learning Through Play
Early experiences and the encouragement or otherwise that toddlers receive from their parents have been shown to be far more important than previously realised. Much of their attitude to learning - which later affects what they learn at school - is established by the age of four-and-a-half.
Play is so essential that its importance can’t be overstated. This is the way they begin to get some understanding of many things, including size, weight, length, and volume.
Take water, for instance:
- It can be hot, warm or cold
- Poured on the ground, it runs away, but it behaves differently in the bath or on the floor
- Poured into a container, it takes the container’s shape and reshapes when poured into a different one
- It can be clear, coloured, muddy
- It can be frozen solid, and then melt
- Bubbles can be blown in it
- Some things sink in it, some float
- It is used to wash in; to make tea; boats sail on it and fish swim in it
- It can be the beginning of understanding such things as little, big, full, empty.
The list is endless. There are many other exciting discoveries about water and other things that children will make and be eager to share with you.
Watching children play may help adults understand how they are thinking and may also give adults a fresh perspective on familiar things. Given the opportunity, children will find out some of these things for themselves. Some they can only find out with your help.
A balance between helping too much or too little is important in order to encourage them to try, without experiencing too many failures. Your pleasure in their achievements will always spur them on to further effort. The pleasure they get from their performance helps to make them feel good too, another valuable boost to their developing self-esteem.
Ask your community child health nurse for:
- More play ideas
- Information regarding playgroups in your area
- Toy library locations.
Continuous supervision is still required, as children under three cannot foresee possible dangers. Though they seem to understand so much of what is said to them, they are not yet capable of taking responsibility for their own safety. The outside world is now full of interest; doors and gates need to be secure to protect the child from dangers associated with vehicles, pools, or even undesirable people.
Cigarettes spell a special danger to inquisitive toddlers. Cigarette butts and ashtrays can cause burns and even fires, and it should also be remembered that cigarettes are poisonous - medical advice should be sought immediately if a child eats a cigarette.
All young children need protecting from passive smoking. Apart from the danger of burns from a lighted cigarette in a smoker’s hand, a child exposed to cigarette smoke can develop sensitive airways leading to asthma, bronchitis and chest infections.
At home, too, they are wanting to be more independent, and things like matches, knives, scissors, electrical equipment and poisons need to be kept safely out of their way. The most common type of accidents occurring to children of this age group is:
- Scalds and burns
- Ingestion of poisonous substances
- Motor vehicle accidents
- Cutting and piercing.
- You can help prevent accidents by:
- Always insisting that your child remains in an approved child restraint whenever travelling in a car.
- Keeping medicines and garage, garden, pool and household chemicals in locked cupboards.
- Fencing your swimming pool with an approved fence and self-locking gate.
- Staying with toddlers at all times when they are in or near water, e.g. pool, dams, rivers, ocean, bath with water in and paddling pool.
- Turning the temperature of the hot water system down to 50 degrees Centigrade now that taps can be easily turned.
- Screening open fires or heaters and locking away matches.
- Keeping your child away from smokers (passive smoke) and ashtrays. Cigarettes (and cigarette butts) are poisonous.
- Dressing your child in close-fitting clothes before attending a barbecue.
- Supervising all play with ropes and toys with strings, such as pull-along toys.
- Always knowing where your child is, whether indoors or outdoors.
A Child 3-5 Years
Children change and grow up rapidly. They do not transform themselves overnight, turning from caterpillars to butterflies under your eyes, but this particular change from toddler to preschool child, whether it takes place at 2½ or 4, does have a sudden and magical quality. Penelope Leach
Growth and Development
Between the third and fifth birthday, height increases by 13-14 cm and weight by 3½-6¼ kg. These gains are likely to be lower for girls. Children’s initiative grows as they explore their world of people and things. They start looking for reasons, answers, causes, solutions and new ideas. Recognition of effort encourages them to try harder. They want to accomplish tasks that they set for themselves and may resent offers of help.
Parents’ continuing help in what they are doing is important. This will have far-reaching effects on how they manage at school later on. A man’s way of interacting with infants and children provides a unique contribution to a child’s experience of human relationships. In a family where the father is absent, male relatives or friends can help to provide this.
At this age a child may acquire an imaginary playmate - animal or human - to share the joys and problems of life.
The existence and rights of a ‘friend’ are defended, often strongly, and the whole family has to accept this, even to leaving the most comfortable chair vacant if the ‘friend’ is using it. It should not be taken as an indication that a child is lonely or ‘odd’.
Children still find difficulty in accepting responsibility for their own bad behaviour. It may be easier to blame the ‘friend’ until they are mature enough to acknowledge their own mistakes.
Three-year-olds are likely to be physically competent. They may ride tricycles expertly, turning corners without having to slow down, and climb play equipment confidently. About this time they can manage the intricate art of cutting with scissors, use a fork and spoon, wash hands (though they still need help drying them), and pull their pants down and up (but they still need a hand with buttons).
Because of the tremendous drive to develop physical skills such as climbing, balancing, running and kicking, they need to have the opportunity to ‘run wild’ out of doors whatever the weather.
For the very active child, encouraging this vigorous play will mean a happier household for everyone.
Four-year-olds gradually progress from climbing on household furniture and simple play apparatus to becoming expert on ladders, trees or anything else that interests them. Though they will need supervision, generally they will attempt to climb only what they can manage safely. However, it should be kept in mind that some adventurous children may be able to get up but not to get down alone. In their quieter moments they may show more interest and enthusiasm for play that involves fine hand movements, such as drawing, painting and building. These activities are forerunners to writing skills and may also be a source of great pride and satisfaction. Displays of kindergarten creations are familiar decorations in many kitchens! Giving these place of honour is important because it shows children their efforts are appreciated and helps encourage their development.
As a Social Being
One of the most delightful age groups in preschool children is three years or thereabouts. As their own fluency improves they start to enjoy conversations with an adult. Helping with whatever is going on is one of their greatest pleasures.
They begin to notice sex differences and may ask about them. They need to be told the proper names for body parts, such as penis for a boy or vagina for a girl. Competition in urinating is common and little girls too will often try to pass urine standing up. To ‘wait awhile’ is now a possibility, but patience should not be tried too far. They are capable of showing sympathy, can show affection for younger children, and would rather please you than not. They may even begin to understand about taking turns, but do not expect too much from them.
However, the latter part of this year may not flow so smoothly. Whingeing, demanding and blaming mother for anything that goes wrong are frequent symptoms of this stage of insecurity. Imaginary fears are also common. They may be afraid of such things as the dark, wild animals or noisy machinery. A bandaid may be demanded for even the slightest scratch.
Nail biting, blinking, masturbating or thumb sucking are common and may worry you. If so, discuss your concerns with your child health nurse.
Behaviour in a social situation is unpredictable. They can be shy today and ‘show-offs’ tomorrow. Feelings are easily hurt by failure or by being ignored, and they may try to protect themselves from this with ‘no’ or ‘I can’t’. These are all just signs of the general disorganisation of this age and will pass with time. Your patient support will help.
Four-year-olds are always wanting to be doing: ‘Let me ...’. The three-year-old’s ‘what’, ‘where’ and ‚who’ questions will now be changing to ‘why’, ‘when’ and ‘how’. This is an indication that they are trying to understand the world around them. They use a spoon and fork, and later a knife, quite efficiently. They are not so likely to dawdle and will enjoy taking part in mealtime conversations.
One often hears them giving themselves instructions before starting or stopping things that are difficult for them. In time they will no longer need to do this. They are, if anything, even more independent than before and not only undress, but dress themselves.
Not unexpectedly, this independence is shown in their behaviour by assertiveness and sometimes impertinent refusals to do as they are asked. They will, however, gradually become more self- controlled.
Not only will they understand about taking turns, but also they will be far more cooperative with their friends, and accept the need for rules and for fair play.
Learning Through Play
Children learn through play. It is their ‘work’ and helps them develop physical, mental and social skills. Children need to explore, experiment, and experience, as widely as possible, a variety of play activities. By providing these opportunities, we not only help our children develop, but also create a happier child and family.
There are play possibilities in everyday things for the parent with a ‘playful’ eye.
Make-believe and domestic play are very important during these years, and this becomes gradually more and more complex and planned. Preschoolers are able to carry images of situations and objects in their minds, increasing their ability to play imaginatively.
This imaginative play is an exploration of other people and their roles. Acting out situations will help them in later life. The fire fighter needs a hat and the doctor or nurses a stethoscope. Give them a variety of hats. Their imagination will do the rest. With imagination a small, open cardboard box can be a spaceship, a train, a car or a house. The possibilities are endless.
Adults should not join in this play unless at the child’s invitation. They will probably only be asked to play minor roles as guest, assistant, or supplier of needed props. Other children of the same age who can share ideas will stimulate other activities, and help to play and act out new make-believe adventures. If other children are not available, care and planning by concerned adults can provide new experiences, visits and fresh play materials.
If allowed, preschoolers may be very keen to help with such household jobs as unpacking groceries, washing and drying dishes, preparing vegetables and making cakes. Although it may take longer for you, this is the way children learn and practice skills they will need later on. So spend some time turning housework into house play!
Sharing a bedtime story at the end of the day can provide great enjoyment for children and parents alike. Children love stories about familiar objects, such as cars or trucks, and animals. You can buy books or borrow them from libraries. Children also enjoy making their own ‘special’ books or stories. By sharing a bedtime story you will increase your child’s knowledge and vocabulary.
Even more important, you will create a warm, secure feeling at the end of the day. This is an age to encourage listening skills.
Your child health nurse probably has pamphlets.
This is a good age to encourage listening skills. Focus their attention by asking them to sit quietly, watch you, and listen to a story.
Call their attention to new sounds in their environment: ‘What was that sound?’ or 'Where is that bird?’.
Children at this age enjoy reading familiar stories, rhymes and songs with you over and over again. Encourage listening by having the younger child complete the familiar sentence you have started or filling in the missing words. The older child will be able to retell the story from a book or children’s video.
Rapidly improving physical skills like running, jumping and climbing give the child freedom and opportunities for adventure - freedom to do things that ‘other children’ do, to do things ‘by myself’. These new freedoms increase the chances of injuries.
While it is the parents’ responsibility to keep children safe, it is for them to provide opportunities for the child to learn what can and can’t be done safely.
Supervision is still necessary, but this should now include an increasing amount of opportunity for children to practice making their own decisions. Complete freedom can be boring as well as dangerous. Over-restriction will reduce learning opportunities or push children out of bounds.
Protection is still needed, but education becomes increasingly important to enable children to take responsibility for their own safety.
Children learn best by copying what they see others do. Set good examples for your child to follow. Always talk to your child when doing things in a particular way and allow practice opportunities, with supervision. This will help you to know when your child can manage safely alone.
To Keep Your Child Safe
- Constantly supervise play in and around water.
- Always supervise play in parks and playgrounds and teach your child the safe way to use play equipment.
- Accompany your child when crossing a street and teach safe behaviour in traffic.
- Teach your child to use tools and kitchen equipment safely.
- Keep matches and cigarette lighters away from your child’s reach.
- Talk to your child about ‘stranger danger’.
- Allow your child only those toys suitable for this age group.
- Insist your child remains restrained at all times when in a vehicle.
- Make certain your child’s vaccinations are up to date.