Understanding Newborn Characteristics and Development

Your infant's appearance at birth may surprise or even shock you. How a newborn looks in reality is not usually how we picture her beforehand. For infants, a misshapen head, peeling yellow-tinged skin, swollen eyes and bright red birthmarks are common and nothing to worry about. All of these conditions will likely clear up in the first weeks of your baby's life. On this page, we'll describe some of physical traits that many newborns exhibit.

Baby's Head

A newborn looks very different from older babies and children. Whereas her head is relatively large, measuring one fourth of her entire length, her legs are only one third of her length. Clearly, in humans, brain development takes precedence over development of the rest of the body.

Aside from being large, your newborn's head may look misshapen and even a little bruised. The bones of the skull are separated rather than fused as they are in adults. This separation allows the bones to slide over each other as the head passes through the narrow birth canal. Also, this mobility is essential to accommodate an infant's rapid brain growth.

When you caress the top of her head, you can feel the soft spots, or fontanels, in the skull. Here the bones are widely separated, but the brain is covered by a tough membrane and scalp. You won't hurt your baby by gently touching these areas. The anterior fontanel, located in the midline on top of the head, usually closes between 9 and 18 months after birth. Behind it is the smaller posterior fontanel, which closes by four months after birth.

Hair. The amount of hair on a baby's head varies. Any amount is normal. Most of this hair falls out and is replaced. The color and texture of the new hair may be quite different from those of the hair she was born with.

Inside the womb, the baby's body was covered with fine, downy hair called lanugo. Unless your baby was premature, most of this body hair has disappeared, except for some fuzz on the back. Even this residual lanugo disappears in a few weeks.

Baby's Face

Eyes. Your baby's eyelids may be red and swollen from pressure during the delivery. In most hospitals, antibiotic drops are applied to the newborn's eyes. The drops may cause mild, temporary inflammation.

As your baby studies your face, you may notice one eye wanders or the two eyes don't move together smoothly. Unless one eye seems to be almost fixed in position (cross-eyed or wall-eyed), this wandering is normal and is corrected as the baby gains strength and coordination in the muscles that move the eyes.

Ears. The cartilage in the outer ear is very flexible in the newborn. If an ear looks folded, don't worry -- it will probably straighten out. If the problem continues, talk to your doctor.

Nose. At birth, the nose and mouth are often filled with mucus. After the delivery, your caregivers suction the baby's airways with a rubber syringe to clear them and help your baby breathe. Her own sneezing helps clear her nasal passages and is not necessarily the sign of a cold.

Mouth. An occasional baby already has one or more teeth at birth, which usually fall out. Your doctor may want to extract these teeth so your baby doesn't later choke on them.

If your baby did a lot of sucking in the womb, blisters may be present on the upper lip, as well as on the fingers, hands, or forearm.

Baby's Skin

Your baby's skin is wonderfully soft. It may not, however, appear as flawless as the complexion of an older infant. The newborn's skin often has a ruddier hue. For the first few days, the hands and feet may appear to be tinged with blue. Soon, the baby's circulation improves, and the skin color is more uniform.

Jaundice. More than half of newborns have some degree of jaundice in the first week of life. In most cases, this condition is due to the immaturity of the liver and is not a threat to the baby. The liver is the organ that helps to clear bilirubin, a waste product of broken-down red blood cells. Since the liver is not completely mature at birth, babies often are not able to excrete bilirubin as well as adults do. The deposition of bilirubin in the skin and the whites of the eyes gives them a yellowish tinge.

Jaundice first appears on the face and spreads downward as the bilirubin level increases. Normal newborn, or physiologic, jaundice usually is first visible between the second and fifth days of life, peaks between the fifth and seventh days, and clears within one to two weeks. In some breast-fed babies, jaundice may last a bit longer.

Unless your doctor determines the bilirubin level is too high, you can probably manage your baby's jaundice at home. The mainstay of home treatment is frequent feedings at breast or bottle. Bilirubin is eliminated in the urine and feces; the elimination can be accelerated by increasing fluid intake. Bilirubin is broken down in the skin, and light stimulates the action. The wavelength of light that hastens bilirubin breakdown in the skin passes through glass and plastic. Because this is so, sometimes just placing the baby near a sunny window for short periods of time is beneficial.

Your doctor may follow your baby's progress by checking the bilirubin level with a simple blood test. If the level rises excessively, the baby will require hospitalization for phototherapy treatment (exposure to light at a wavelength similar to that of ultraviolet light) and to determine whether the jaundice is due to something more serious than immature liver function.

In most babies, the jaundice resolves spontaneously. If your baby has jaundice, your doctor will tell you what to do to speed its disappearance.

Birthmarks. Birthmarks are a fairly common skin condition of the newborn. Babies of darker-skinned parents may have what are commonly called mongolian spots, a bluish pigmentation under the skin over the lower part of the back and the buttocks. Stork bites (also called angel kisses) are red, flat birthmarks usually located on the bridge of the nose, the upper eyelids, or the back of the neck. They usually disappear by the second birthday but may reappear with crying. Sometimes the spots on the nape of the neck persist into adulthood.

Rashes. Rashes often develop within the first few days of a newborn's life. Although parents tend to worry about these skin blemishes, most of these conditions are completely harmless and go away on their own. Milia are small white pimples on the face, caused by maternal hormones. They go away in several days without treatment. Erythema toxicum -- a rash of red bumps with yellow centers and a generally flea-bitten appearance -- occurs in half of all newborns. It is harmless and disappears on its own in about a week or so.

The skin of most babies peels a little after birth. Peeling is most noticeable on the palms and soles. It is more marked in babies born after more than 40 weeks of pregnancy. You might also notice a flaky condition on the scalp known as cradle cap. This flaking goes away by itself. Daily washing with soap and water is helpful. Click here for instructions on treating cradle cap.

Baby's Body

Chest.

Your baby breathes at a faster rate than you do. The normal newborn breathes between 30 and 50 times a minute. The rate is often irregular. If you watch closely, you may see a faint motion of the heart beating against the left chest wall. The pulse in new babies is also fast -- 130 to 160 beats per minute.

You may also notice your baby's breasts are enlarged. This enlargement, caused by exposure to high estrogen levels while in the uterus, is temporary.

Genitals. Exposure to maternal hormones may also cause swelling in the baby's genitals, especially the labia in girls. In the first few weeks, girls may have a white, blood-tinged, mucous discharge from the vagina due to withdrawal from those hormones.

In boys, the foreskin that covers the penis is not easily retractable. Don't try to force it back, as this may hurt your baby.

Abdomen. After the umbilical cord has been cut, a stump remains. If it is kept clean and dry, it falls off within ten days. Many hospitals recommend you gently clean the base of the stump with a cotton ball and rubbing alcohol. For directions on the care of your newborn's umbilical stump, click here.

Your baby's first bowel movements are sticky and greenish-black. This tar-like substance is called meconium. After your baby drinks breast milk or formula for a few days, her bowel movements appear yellow to brown.

Arms and Legs. Your baby can move all four extremities quite well. She prefers to keep them flexed and close to her body. Their exact position may resemble her posture during the last few weeks in the uterus. The legs often flop open at the hips, giving her a frog-legged look.

Extending her arms and legs makes her feel insecure. When she frets, you may be able to make her more comfortable by wrapping her snugly in a blanket and holding her close to you.

Despite some of the unusual physical characteristics of your baby, you undoubtedly believe that she's the most beautiful thing you've ever laid eyes on. During the first days of cuddling your baby and gazing into her eyes, you might wonder how much you baby is seeing and understanding. In the next section, we will explain your newborn's reflexes and responses.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

The reflexes and responses of a newborn enable him to react to his environment and to the people he sees. His reflexes are instinctual and serve to protect him, and all infants are born with the same reflexes. On the other hand, his responses are totally individual. For instance, what makes one baby smile may make another cry, depending on their personalities. On this page, you will read all about your new baby's reflexes and responses to stimuli.

Newborn Reflexes

After making the dramatic transition to life outside the womb, your baby faces the task of learning to survive in his completely new environment. Fortunately, nature has provided him with some reflexes to maximize his success until he is able to perform certain actions voluntarily. Your own instinctual responses will guide you in meeting your baby's needs.

Rooting reflex. Just as a mother's breasts are programmed to provide milk to nourish her newborn, a baby automatically knows how to respond to attempts to feed him. When you stimulate his cheek, mouth, or lips with the nipple of a breast or a bottle, his head turns toward it, his mouth opens, and his tongue moves forward. This movement of his head and mouth is called the rooting reflex and helps him find a source of nourishment. As soon as the inside of his sensitive mouth is stimulated, he automatically sucks and swallows in a coordinated fashion.

Hand-to-mouth reflex. A similar reaction, the hand-to-mouth reflex, occurs when you stroke your baby's cheek or the palm of his hand. His mouth roots and his arm flexes. After his hand and mouth find each other, he may suck his fist energetically for several minutes. This reflex helps babies suck and swallow any mucus that might have been clogging their upper airways (nose and mouth) after birth.

Righting reflex. When you slowly pull your baby to a sitting position from his back, he makes a gallant attempt to keep his head upright. This response is called the righting reflex. Because his head is heavy and his muscles are not yet strong enough to hold it steady, his head wobbles back and forth. You will quickly learn to support his head when you pick him up.

Tonic neck reflex. For the first few weeks, your baby lies with one cheek down when on his back. As his head turns to one side, the arm on the same side straightens and the opposite arm bends. This posture resembles a fencing position and is called the tonic neck reflex. Lying in this position gives your baby an opportunity to discover his own hand in the weeks to come. Because it is difficult to turn over on an outstretched arm, this reflex must fade before your baby can roll over.

Grasping and Babinski reflexes. A newborn baby has a very strong grasping reflex. When you place your finger in his palm, his fingers curl tightly around it. The automatic grasp reflex fades over the first two to three months to enable your baby to grasp objects voluntarily. Gentle pressure against the sole of his foot causes his toes to curl downward. Stroking the side of his soles causes his toes to spread and the big toe to extend upward. This Babinski reflex is the opposite of the normal adult response, in which the big toe turns downward.

Stepping reflex. Holding your baby upright and pressing the sole of one foot at a time to a firm surface elicits the stepping reflex. He alternately bends each leg as though walking. This remarkable reflex fades rapidly but reappears months later as learned voluntary behavior in preparation for true walking.

Stroking one leg causes the other to bend, cross the first leg, and push away the offending object. He moves as though to escape from a harmful stimulus.

Lifting the head. When placed on his belly, your baby lifts his head and turns it from side to side. He may even attempt to crawl. His responses make it virtually impossible for him to smother when he is lying on his stomach on a firm, flat surface. For this reason, you need not worry that your baby will have trouble breathing while prone. You should, however, be sure to keep excess bedclothes, pillows, toys, and stuffed animals out of the way, and never place your baby on a mattress that is excessively soft.

Moro reflex. The most dramatic reflex is the Moro, or startle, response. A loud noise or rough handling causes your baby to throw back his arms and legs, extend his neck, and cry out. Then he brings his arms together in an embrace and flexes his legs. Unfortunately, your baby's response disturbs him further. His own furious crying only serves to startle him again. You can help break this cycle by calmly bringing his flailing extremities close to his body; applying steady, gentle pressure with your hand against his chest and abdomen; or simply holding him securely against your own body. By three months of age, this reflex disappears.

Newborn Responses

Your baby is not simply a bundle of reflexes. Each baby is unique. From day one, your baby asserts her individuality and makes known her temperament. You will soon discern her particular style in responding to the environment.

Circle of trust. Within a few weeks, you will see her express her pleasure with coos and fleeting smiles and communicate her hunger, pain, or fear by varying cries of distress. You learn to read each other. If you are responsive to her needs, she learns to trust you. Your fostering of a sense of security encourages her to continue to reach out to you. This circle of positive interaction is gratifying to you all.

Newborns can't be spoiled. Many parents worry about spoiling their baby. Your infant, however, does not yet have the intellectual maturity to be manipulative. At birth, she does not know about people; she doesn't recognize she is a person separate from you. She is merely aware of her needs and expresses them as best as she can. Don't worry about picking up your newborn when she cries. From her perspective, she was carried about for nine months. Gathering her into your arms to comfort her only makes sense. It is probably safe to say you can't hold your baby too much during the first three months.

As your baby gets older, responding to her includes replying to her babbling sounds. Your verbal responsiveness promotes her listening skills and language recognition. Many specialists in infant development believe holding and talking to your baby are the most important contributions you can make to her future development.

It's quite gratifying to witness the baby's reponses to your voice and to your touch. But there are plenty of other ways to attract their attention, which we'll discuss on the next page -- The Newborn's Five Senses.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Your new baby is constantly receiving and responding to stimuli in his environment. By his seventh month in the womb, all of his senses were developed. As a newborn, he can already see, hear, feel, taste, and smell. Some of the newborn's five senses need time to fully mature. Yet, from birth, he is ready to learn about his new world and everything in it.

Failure to stimulate his senses can have disastrous effects on his physical and psychological growth and development. Happily, you, as loving parents, know how to provide the right kind of sensory input for your baby. Let's examine the different ways you can help your infant learn about his world.

The Newborn's Five Senses

Touch.

One of the most important means you have for communicating with your baby is touch. Babies enjoy gentle handling and rhythmic motion. While inside the womb, your baby became accustomed to being rocked by your movements. After birth, that same swaying motion comforts him. A fretful infant often becomes quiet if you gather him close to your body and gently rock him.

Even the most mundane activities -- feeding and bathing him, changing his clothes and diapers, holding him, walking with him in your arms -- stimulate your baby's sense of touch and movement.

Smell and Taste. At birth, babies demonstrate that they discriminate odors by turning away from unpleasant smells. Your baby quickly learns to recognize familiar smells, especially your scent.

Although his taste buds aren't completely mature at birth, your baby can tell sweet from sour and much prefers the former. It is no coincidence that breast milk is very sweet.

Hearing. During the last trimester of pregnancy, a baby listens to his mother's muffled voice as well as to the sounds of her heartbeat, breathing, and digestion. When your baby's head is pressed against your chest, he no doubt finds those familiar sounds comforting, and many a baby falls asleep in this position. You may notice he selectively listens to higher-pitched voices. Even men unconsciously raise the pitch of their voices when speaking to babies. As your baby gains more control over his head movements, it becomes clear that not only can he hear, but he can accurately determine the location of a sound source.

Loud, sharp noises often upset babies. Soft, rhythmic sounds calm them. Music boxes, toys that make pleasant sounds, and soft music stimulate your baby's sense of hearing. He enjoys listening to you sing and talk to him. Soon the monologue turns into a delightful dialogue as he starts replying with his own babbling sounds.

Vision. Upon emergence from their dim intrauterine environment, babies exhibit a protective reflex of tightly shutting their eyes against bright light. This response is called the blinking reflex.

Once you and your baby settle into an environment more subdued than the delivery room, you will notice your baby scanning your face with wide-eyed interest. Although his visual system is immature, a newborn sees quite well at a distance of 8 to 12 inches from the bridge of his nose. Parents instinctively bring their faces that close to inspect the new member of the family.

Like an old-fashioned camera, your newborn infant has fixed focus: He is not able to adjust his eyes to clearly see images closer than 8 inches or farther away than 12 inches. He quickly learns to accommodate -- to focus the eyes with changing object distance. The ability to accommodate matures by four months of age. In fact, at this age, infants not only see distant objects well but can focus on very close images better than an adult can.

The muscles that move the eyes to help them both focus on an object to produce a single image are immature at birth. You may notice one eye or the other occasionally wanders. As long as that eye is not always deviated in the same direction, this wandering is normal. Visual coordination is much improved within a few weeks. By the age of six weeks, your baby can smoothly move both eyes in concert as he follows a moving object. By eight weeks, your baby converges both eyes perfectly when viewing a stationary object.

The ability of both eyes to focus on the same image is essential to the development of depth perception, the capacity to distinguish near from far. Infants younger than two months of age are probably not able to perceive depth. Your baby can discern relative distances by four to six months. His ability to estimate distances matures after he has the experience of reaching and crawling. Until your baby has had experience with propelling himself around his environment, he probably will not have any fear of heights. If you leave him on a raised surface, for instance, he will blithely scoot over the edge.

Color vision is probably immature at birth. Color discrimination is learned early, starting with yellow and ending with blue. By four months, babies can see all colors well and often prefer red.

Providing visual stimulation for newborns.

At birth, babies prefer bold colors and high contrast. At first, babies prefer geometric patterns with stripes and angles. Soon they shift their preference to circular patterns, such as a bull's-eye. Keep this in mind when choosing a mobile for your baby's crib.

Within three weeks, the most exciting image in his visual field is the human face. Because your hairline and your eyes offer the most contrast, at first he concentrates his gaze between your nose and your forehead. Between four and eight weeks of age, your baby may break into his first social smile while studying your face. At three months, he is able to distinguish your face from a stranger's. By rewarding you with a special smile, he lets you know he recognizes you. By four months, his vision has matured. Like you, he enjoys looking at objects that are colorful, novel, and in motion.

How do you know when your baby finds something visually interesting? An alert, calm baby responds to a pleasing object in his visual field by brightening his face and moving his arms and legs rhythmically. An active baby stops moving and carefully scans the object with his eyes. He signals to you when an object doesn't interest him or when he has had enough stimulation by turning away and withdrawing.

Avoid bombarding your baby with visual input during the first two months of his life. During this time, while he is getting settled, keep all stimuli low-key. In these first weeks, he is becoming familiar with his hands and should not be exposed to a lot of visual stimuli that distract him from that familiarization process. Later, when he has begun to master basic visual skills and has gained control over his head and hand movements, he will be ready to explore his visual environment. As always, take your cues from him.

As adults, we often learn by reading about a subject or seeing a picture of an object. But in order for a newborn to learn, he must experience his environment by tasting, touching, smelling, hearing and seeing. Your baby's senses are developing quickly, just as his body is growing with amazing speed. On the next page, you will learn just how quickly you can expect your newborn to grow and when his teeth will begin coming in.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

A baby's growth and development begin inside the womb. In fact, her most rapid rate of growth occurs during the first four months of the pregnancy. After birth, she continues to grow rapidly. Each baby's pattern of growing and developing is unique, influenced by gestational age at birth, birth size, body type, general state of health, quality of diet and exercise, and the sizes and growth patterns of the parents. On this page, we'll explain the growth patterns of a newborn, including their birth height and birth weight and how quickly they may grow during the first two years. In addition, you'll find information on newborn teething: when baby's teeth erupt and how to soothe the irritation that tooth formation often causes.

Birth Size

After spending approximately 40 weeks inside the womb, the average newborn weighs 7 1/2 pounds. Most babies weigh between 5 1/2 and 10 pounds. The average length of a newborn is 20 inches (50 centimeters), with a range of 18 to 22 inches. The average head circumference (the distance around the head) is 14 inches (35 centimeters).

At each visit, your doctor charts your child's growth. The best indicators of growth are weight, height, and head circumference. Plotting these growth measurements is a simple and extremely useful way of monitoring your child's state of health.

Rate of Growth

During the first few days after birth, you can expect your baby to lose 6 to 10 percent of her birth weight. Most of the weight lost is in the form of extra body water. If you are a mother who plans to breast-feed, your milk comes in during this time. The first milk, or colostrum, albeit scanty, is high in protein and sustains the baby as your milk supply increases.

After three to four days, the baby begins to regain weight and should attain or surpass her birth weight by 10 to 14 days. For the next three months, your infant grows at the astonishing rate of approximately an ounce a day. Between three and six months, her weight gain declines to four to five ounces a week. Between 6 and 12 months, the weight gain slows to two to three ounces a week. After the first year, the growth rate further tapers. During the second year of life, appetite sometimes diminishes as physical activity increases, resulting in temporary plateaus in growth.

If you have an average-size baby, you can expect her to double her birth weight by five months of age, triple it by one year, and quadruple it by two years. The average gain in length or height is 10 to 12 inches in the first year and 5 inches in the second year. Keep in mind that these predictions are estimates for the average-size baby. If your baby was smaller at birth, she may grow faster; if she was larger, she will probably grow at a slower rate.

The growth curve isn't always smooth. Babies often grow in spurts. If your baby is ill or preoccupied with acquiring a new physical skill, her growth rate may temporarily decline (she may be burning more calories and may be less interested in eating). Also bear in mind that bigger is not necessarily better. Obesity at any age should be avoided.

Tooth Formation and Eruption

Formation. Tooth buds for your baby's first teeth begin to form at about six weeks of fetal life. Between the fourth and fifth months of fetal life, some tooth buds become evident. By about the seventh month of fetal life, the tooth buds for all of your baby's primary (deciduous) teeth are formed. At birth, the crowns -- the portions of the teeth visible above the gums -- of your baby's front teeth are already formed and contain most of their enamel covering. The crowns for some of the other primary teeth are partially formed, and the tooth buds for some of the permanent molars are forming. By the time your child is three years old, the crowns of some permanent teeth are fairly well formed, and the tooth buds for the last molars have formed.

Teething. As early as three months of age, your baby may begin teething. Teething is marked by drooling, fretting, and chewing on just about anything in an attempt to reduce the discomfort of sore, swollen gums. Some babies exhibit these symptoms for up to four months before the first tooth finally erupts. If your baby seems uncomfortable, you can help reduce the pain and swelling in his gums by giving him firm, smooth, cool, unbreakable objects to chew. Massaging the inflamed gums with a clean fingertip may also help. Medications to numb painful gums are also available.

Don't be alarmed if your baby seems less interested in the breast or the bottle while teething; sucking increases the blood flow and hence the swelling and pain of the gums. If he's old enough, you might try offering him fluids from a cup.

Baby's first tooth.

Your baby's first tooth should appear when he is four to eight months old. However, it is not unusual for a child to be ten or more months old before the first tooth appears, and occasionally a baby is born with one or more teeth already erupted. Although most babies cut six to eight teeth by their first birthday, some normal babies have just two teeth or fewer. If your baby is approaching the age of one year and no teeth are evident (you may see the outlines of teeth before they erupt), you should talk to your baby's doctor about having a dental evaluation.

Baby teeth and chewing.

Even though all of your baby's teeth may have erupted by the time he is 1 1/2 to 2 years of age, you must exercise care in the foods you give him. A child's chewing ability usually is not fully developed until about the age of four years. Do not give children younger than this such foods as popcorn, nuts (especially peanuts), raw vegetables such as carrots, whole grapes, hot dogs, and round candies. If these and similar food items are not properly chewed, they may lodge in a small child's windpipe and cut off the air supply.

Teething and nutrition. Because a baby's teeth begin to form so early in fetal life, what the mother ate, or did not eat, during pregnancy can affect the development of the baby's teeth. However, a well-balanced diet can easily supply the nutritional needs of the teeth and their supporting bones and muscles; an ample supply of calcium is essential. After birth, the diet your baby's doctor recommends will contain the proper nutrients for your baby's healthy growth and development, including healthy tooth formation.

As your baby grows and cuts his first teeth, he begins to develop both gross motor and fine motor skills. You'll find a thorough exploration of your baby's first year of physical development on the following pages.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

While your baby is busy growing taller, gaining weight, and cutting teeth, she is also learning how to interact physically with her environment. Of course, your baby's physical development did not begin only at birth -- you were probably well aware of your infant's intrauterine acrobatics. On this page and the next, we'll look at your newborn's physical development. Let's begin with your newborn's gross motor skills.

Development of Physical Skills

During the first three months of your baby's life, reflexes govern much of her behavior. As these newborn reflexes fade, more purposeful movements replace them. As she gains strength and coordination in her muscles, your baby explores and manipulates objects in her environment. Each day, she moves more competently.

Physical development is divided into two categories: fine motor and gross motor. Fine motor skills require precise coordination of the small muscles. Acquisition of hand-eye coordination is the focus of fine motor development. Gross motor skills are governed by larger, stronger, less exacting muscles. These skills include holding up the head, sitting, crawling, and walking.

Acquisition of developmental skills typically occurs in an orderly, predictable sequence. The precise timing of the mastery of any one skill, though, is subject to much normal variation -- something to keep in mind when you are tempted to label your baby as early or late in development.

Each baby approaches the world with her own unique style. Resist comparing your child with other children. As long as an ability appears within the normal range, differences within the normal range are insignificant. So, when you hear that another child is walking at nine months, don't despair because your child is still perfecting her crawl. Instead, focus on her special talents. For instance, your baby may be much better than another at picking up and examining small objects. No matter when it occurs, celebrate your child's every accomplishment with her.

Physical development follows three general patterns:

Gross Motor Development: Controlling the Big Muscles

Head control.

The first motor hurdle your infant must clear is to gain control over his relatively large head. If you imagine trying to lift your head while balancing a huge, unabridged dictionary on top of it, you have some idea of the challenge facing your baby. He spends the first three to four months learning to control his head movements.

Gradually, his neck muscles strengthen and his head becomes less wobbly. In the meantime, you need to support his head when you pick him up. By three months, he is able to control his head when gently pulled up to sit, though his head still bobs a little if you hold him in a sitting position. By four to six months of age, his head doesn't fall backward as you sit him up; and once sitting, he can hold his head steady.

Despite the head's relatively large size, your healthy newborn can raise his head long enough to move it from side to side when lying on his stomach. Hence, he can avoid suffocation. Over the next three months, he develops enough strength to lift his head 90 degrees away from a flat surface. Between two and four months of age, if his arms are extended in front of his chest, he can raise his head and chest above a surface.

Sitting.

As your baby gains strength progressively down his torso to his hips, he becomes able to sit. Around four months of age, he is able to sit with support for 10 to 15 minutes. At this point, he enjoys sitting with his back supported by an infant seat, pillows, or friendly hands. Stroller rides become much more fun because he can sit up and observe the world. He might even enjoy brief outings in a baby backpack. During meals, he can sit in a high chair with a pillow or blanket supporting the lower part of his back.

When he is between 5 and 7 1/2 months old, if you set him down with his legs spread apart, he is able to sit alone. You may still want to place pillows or blanket rolls around him to pad his fall should he topple over. For a while, he still needs to lean forward on his hands to maintain his sitting posture. But soon he balances himself, freeing his hands to finger interesting objects. By nine months, he can push himself into a sitting position. His increasing independence gives him hours of delight as he sits and plays with his toys.

Rolling over. Rolling represents your baby's first whole-body maneuver and his first means of locomotion. As the tonic neck reflex fades, his arm no longer automatically extends as he turns his head. When he has enough control over his head, torso, and legs, he can tuck his arm under himself and roll. His weighty head initiates the rotation.

At about three months of age, babies start to turn by rolling to their sides. Between four and six months, your baby first rolls from his stomach to his back. A month or so later, he masters rolling in both directions. Never leave a baby of any age unattended on a raised surface, as even young infants can accidentally flip themselves over.

Crawling. During the same time your baby learns to sit, he may also start to crawl. The onset of crawling is extremely variable. Some babies prefer to scoot along on their buttocks from a sitting position. A few babies seem to decide they would rather omit crawling and proceed directly to walking.

If a baby will learn to crawl, first attempts can begin as early as five months of age. If yours is a very active baby, he may then travel by half rolling and half pushing himself in the desired direction. He may start to crawl at seven months of age.

The average baby begins by creeping in the sixth or seventh month. Because a baby's arms are stronger and better coordinated than his legs, he may drag himself around by pushing with his arms, dragging his legs behind. His first progress may be in a backward direction. Later, he begins to dig in with his toes and knees. By eight months of age, he will probably scoot about on hands and knees in the traditional crawl position.

Once crawling begins, your child jubilantly explores all the aspects of the house he had to passively view from a distance for so long. He entertains himself for longer periods. The trade-off is you need to be especially vigilant about his activities. You must baby proof your house (check for safety hazards) before your baby can navigate on his own. He may be as curious about the electrical outlets in your house as he is about his toys.

Standing.

Between three and six months of age, your baby bears some weight on his legs when you stand him up. At first, he stiffly locks his legs. A few weeks later, he bounces by bending and straightening his legs. Check to see that he can stand with his feet flat. If he seems to stand on his toes (called toe walking), it may be a sign he is bearing his weight on his legs too early.

Your baby may begin pulling himself to a standing position as early as six months or as late as ten months of age. Most babies pull to a stand between the eighth and ninth months. You can help your baby by providing him with stable objects that won't topple over with his weight. Surround him with pillows to cushion him if he falls; but keep an eye out to make sure he doesn't suffocate.

At first, he is delighted with his upright posture. Happy gurgles may turn to wails of despair, though, when he discovers he doesn't know how to sit back down. You can help him learn to sit by sliding his hands down the supporting object to lower his buttocks to the floor.

During the 11th month, your child is probably able to stand well alone. About this same time, he may get himself to a stand by bending his knees and pushing off from a squatting position.

Cruising and Walking.

After he can pull himself up to a stand by holding onto a piece of furniture, he starts to cruise. Cruising consists of taking steps while holding onto the furniture for support. At first, he probably faces the furniture and shuffles sideways. As he gains confidence in his balance, he slides one hand as he walks forward. Cruising usually begins in the 9th month, but can begin as early as 7 1/2 months and as late as 12 1/2 months.

When your child bravely lets go of the furniture and takes his first solo steps, walking has begun. Learning to walk is as exciting for you as it is for your child. Walking with or without assistance usually occurs by a baby's first birthday, and most babies walk well by 14 months of age.

Your baby quickly grows more nimble and confident. By 18 months, he is able to walk backward. Between 14 and 21 months, he learns to walk up stairs, though it may be a couple of months longer until he can confidently walk down the stairs. At 18 months, he runs, albeit stiffly. In just a few months more, you'll find he will not look so precarious as he runs toward you.

Even as your baby is learning to move his body in space, she is also making leaps and bounds in her control of her hands and fingers. Move to the next page for a discussion of your newborn's developing fine motor skills.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

As we explained on the previous page, your baby's physical skills develop by progressing from the torso outward to the fingers. She has no ability to control her movements as a newborn, and really no concept that her body is her own. But she is a quick learner and she rapidly develops muscle "commands" through trial and error. On this page, we'll take a look at her fine motor skills from her first days through her first birthday.

Coordinating Hand and Eye

First six months.

As your newborn looks about her world, her own fisted hand randomly passes through her field of vision. This strange object may interest her, but she has no idea of what it is or how it got there. By compelling her arm to extend in front of her face when she turns her head to the side, the tonic neck reflex creates plenty of opportunities for her to study her hand. You'll find that during the first six weeks, she devotes more and more time to regarding her own fisted hand.

As the grasp reflex fades, she is increasingly able to unclench her fist. Similarly, her body unwinds from its flexed position. As the tonic neck reflex disappears, she spends more time looking up rather than looking to the side when she lies on her back. Hand-to-mouth activity, which began as a reflex at birth, becomes a more deliberate, conscious act. She moves her hands over her chest where she can look at them, explore them with her mouth, and finger one with the other.

Until three months of age, she looks at objects without touching them and fingers objects absently without looking at them. Then, the two systems for examining the world fuse. She feels something and turns her head to see what it is. She sees something interesting and reaches out to learn more about it by touch.

Her first attempts at hand contact consist of broad swipes. Her entire arm sweeps in a grand gesture as she bats at, and occasionally contacts, an object. The process of gaining coordination of her arms begins closest to her body-at the shoulder. At 6 to 14 weeks, sturdy objects suspended within an arm's length of your baby make good toys.

After this swiping period, you may notice your baby begins to make slow, labored attempts to reach out and touch an object with one or both hands. If you watch carefully, you might see her glance back and forth between the object and her hand as she calculates the remaining distance. Having not yet mastered the correct sequence for grasping, she may close her fist before she reaches the object. During this time (between 14 and 23 weeks), try to be patient when you hand her a toy. Give her plenty of time as she laboriously tries to reach out and grasp it. Practicing this sort of hand-eye coordination is important for her development.

Between 4 and 6 1/2 months, she masters the ability to smoothly lift her hand and accurately grasp an object. This is the time to introduce toys that help her to learn cause and effect, such as squeaky ducks or spinning bathtub toys.

Six to eight months.

During her sixth through eighth months, your baby avidly explores everything in sight with her eyes, hands, and mouth. She uses both hands simultaneously to explore objects; while holding an object in each hand, for instance, she may delight in banging the two together. Given a small block, she can transfer it from one hand to the other.

At six months of age, most babies can deliberately, but perhaps awkwardly, let go of an object. By ten months, your baby is quite adept at uncurling her fingers at will to release an object. Over and over, she grasps something and drops it for the sheer pleasure of watching it fall. For a while, she relies upon you to retrieve these objects.

Eight to fourteen months.

Between the ages of 8 and 14 months, your baby may spend long periods of time examining small objects. She learns to prod an object with a single index finger. Rather than raking at an object with her whole hand, she begins to oppose her thumb and index finger in a pincer grasp to pick up a small object. At first, your baby may need to steady the side of her hand against a firm surface as she learns the pincer grasp. By her first birthday, your child is an expert at plucking the smallest crumbs from the kitchen floor.

Your doctor keeps track of when your baby masters these motor skills. You may also keep a record that you can share with your child when he's a little older. He'll probably find it difficult to believe that there was a time he couldn't walk, much less lift his head!

From the moment you welcome your newborn to the world, you'll be constantly amazed by her. It's humbling to watch your baby progress through the milestones of newborn development, and a joy to celebrate each of these victories with her!

^©Publications International, Ltd.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.