Development

Your baby receives an Apgar score at one minute and at 5 minutes after birth.  This score determines how doctors will treat your baby from that moment on to ensure that he gets the best medical care possible.

The higher the score out of a possible 10, the better is your baby’s general health condition. The score usually changes from the first to the second rating.  Doctors look at the following:

Appearance/ Color :

  • 0 = blue or pale
  • 1 = body is pink, limbs are blue
  • 2 = completely pink

Respiratory Effort:

  • 0 = absent
  • 1 = slow, irregular, weak cry
  • 2 = strong cry

Heart Rate:

  • 0 = absent
  • 1 = slow, less than 100
  • 2 = over 100

Muscle Tone:

  • 0 = limp
  • 1 = some bending of the limbs
  • 2 = active movement

Reflex Response to Flicking Foot:

  • 0 = absent
  • 1 = facial grimace
  • 2 = cry

A baby who scores 7 or higher on the first scoring is considered in good health. A low score however is not necessarily an indication that your baby is unhealthy, it may just indicate that he needs some immediate special care, for example suctioning. The majority of babies score 7 or higher at the 5 minute scoring.

Remember this scoring is no indication of your baby’s long term health.  It is just a tool for doctors to decide how to treat your baby.

When your baby is three months old, she should be able to:

  • Lift her head 45 degrees when she is lying on her stomach.

She will probably be able to:

  • Laugh out loud
  • Lift her head 90 degrees when she is on her tummy
  • Squeal when happy
  • Bring hand together
  • Smile spontaneously at you
  • Follow an object held about 15 cm above her face and moved 180 degrees, from one side to the other whilst watching all the way.

She may possibly be able to:

  • Hold her head up when lifted up
  • Raise her chest, supported by her arms , when on her tummy
  • Roll over
  • Grasp a rattle
  • Pay attention to very small objects.

She may even be able to:

  • Bear some weight on her legs when held up
  • Reach for a toy
  • Keep her head level with her body when she is pulled into a sitting position
  • Turn her head in the direction of a voice
  • Make vowel-consonant sounds
  • Razz – that is wet razzing sound.

Always remember that your baby’s rate of development is normal for your baby – you will cause yourself much distress by constantly comparing your baby to other babies in your friendship group. Remember as well that the skills babies perform from the tummy position can only be mastered if they get the opportunity to practice these skills.

By month 2 your baby should be able to:

  • Smile in response to your smile
  • Respond to a bell in some way for instance being startled, crying or quieting.

She will probably be able to:

  • Vocalize in more ways than just crying
  • When on her tummy she can lift her head 45 degrees.

She may even be able to:

  • Hold her head upright when picked up
  • When on her tummy raise her chest supported by her arms
  • Roll over (one way)
  • Grasp a rattle with finger tips
  • Pay attention to small items
  • Reach for an object
  • Make vowel-consonant combinations for example “ah-goo”

She may possibly be able to:

  • Smile spontaneously
  • Bring her hands together
  • Lift her head 90 degrees when on her tummy
  • Laugh out loud
  • Squeal in delight
  • Follow an object with her eyes about 15 cm above her head when it is moved 180 degrees.

If we look at what a baby should be able to master within her first month, we should remember that babies develop at different rates and that how quickly a baby reaches her milestones is not an indication of a more intelligent baby.  Babies who are born prematurely might reach the milestones later than their counterparts.

During the first month it is extremely important to give baby enough supervised playtime on her tummy.  This gives her ample opportunity to strengthen the different muscles that will help her to sit, crawl and walk.

Baby should be able to:

  • She should be able to lift her head briefly when put on her tummy on a flat surface.
  • She should be able to focus on your face.

Baby would probably be able to:

  • Respond to a bell by either being startled, crying or quieting.

Baby could possibly be able to:

  • Lift her head 45 degrees when on her tummy.
  • Vocalize by other means than crying (Eg. cooing)
  • Smile in response to your smile.

Baby might be able to:

  • Lift her head up 90 degrees.
  • Hold her head steady when held upright.
  • Bring both hands together.
  • Smile spontaneously.

Children’s work is play. Through every type of play, your child is honing one or the other skill.  The description “child’s play” might not be so apt, because while spending time at play, your child is learning how to control and interact with his environment. Play can be challenging emotionally, socially, intellectually and physically.  Playing evolves over time, becoming more mature as certain skills are acquired.

We find 6 different kinds of play , but elements of these types do overlap with each other.  This classification makes it easier to identify toys and tools that would assist in these kinds of playing.

  1. Active Play : As the name indicates, active play involves moving and physical activity. When children are active, they are running, riding, building, swinging or even kicking. During active play the child gets physically challenged. Through active play the gross and fine muscles are exercised and an integration of muscles, nerves and brain functions takes place. Toys that promote physical activity are balls, bikes, bats, playground equipment, trampolines, jumping castles and rackets.
  2. Cooperative Play : Cooperative play happens when two or more children interact in game that gives mutual pleasure.  This involves group play and can be inside or outside. This type of play is important in your child’s development, seeing that children learn through watching other children interact in a positive social manner.  Children learn acceptable social interaction through pretend play.  Type of games that require cooperation are sports, board games and pretend play.
  3. Creative Play : This type of play includes all kinds of imaginative games, constructive games, music, dance, building, painting, molding and other crafts.  Play dough, pencils, paint, building blocks and musical instruments will stimulate creative play.  Do make sure to provide the appropriate equipment and environment, otherwise your little painter might use your walls for his masterpiece. Creative play is the type of play which gives children a sense of accomplishment and empowers them to become good at manipulating words, ideas and concepts.
  4. Dramatic Play : Again, this type of play is built on the imaginative powers of the young ones.  It entails make-believe, dress-up, dolls and puppets.  Through dramatic play children start role-playing often imitating social interactions and scenes that they have seen before.  Dramatic play requires flexible thinking and future oriented thought.  Children can live out their experiences and dreams in a risk free environment.
  5. Manipulative Play : Manipulative play involves the development of hand-eye coordination and finer motor skills.  Children use tools to color and cut and manipulate pieces of a puzzle to fit.
  6. Quiet Play : This is the type of play that gives parents a breather.   Children intellectually engages in reading or paging through books, building puzzles or blocks or maybe even beading.  Quiet play gives your child a chance to think and reason, with his mouth closed and his mind open.

Children’s play develop through different stages:

  1. Uninvolved Play : During this type of play the child does not seem to be playing, but merely keeps himself busy through watching anything that he finds interesting.  If he cannot find anything in the environment that fascinates him, he will play with his own body, climb on and off furniture or just sits in the room looking around.
  2. Solitary Play: Here the child plays on his own with toys and does not try to make contact with other children.  He carries on on his own, despite what other children might be doing.
  3. Spectator Play : The child watch other children playing.  Even though he might be asking questions and talk to these children, he does not participate in their game.
  4. Parallel Play : Here the child plays independently next to other children, but not with them.  They might even be playing with similar toys, but no interaction takes place between the children.
  5. Associative Play : Finally the child starts playing with other children. Talking is the most common activity, but the passing of toys to each other and also following each others cars or dolls take place.  The child still does what he feels like, not taking the other one’s wishes into consideration.
  6. Cooperative Play : Children play in groups organized to reach a certain goal – the making of something or winning a formal game (hide and seek).  The children accepts certain role responsibilities and sees the group as an exclusive group with its own identity.

Even though play might from the outside look meaningless and a frivolous spending of time, different types of play equip children for the expectations held for older children and adults in our society.  It is therefore important to encourage a variety of play, maybe even  a variety of playmates to help children develop optimily.  Play is hard work for children.

Disney Book Club

Try, try and try again – that is the motto of a toddler. During the toddler years, your child learns through trial and error.  It helps the toddler that he can now recall things that happened hours or even days earlier.  Children begin to understand cause and effect and anticipate consequences.  If I drop the toy when I am sitting in a high chair, mommy will bend down and pick it up – again and again…

We can notice their cognitive growth even in their play.  Children start to pretend play.  In their pretend play they often imitate adults’ actions and language.  We often only become aware of our own unique little habits when we see our children imitate us. Where a lot of the childrens’ play were directed earlier at objects, it now shifts to people and events.

Your toddler’s language skills develop quickly.  They can give names to certain objects.  They understand words and commands given to them, and can respond appropriately to those commands.  It is important to remember during this phase, your child understands more than he can express – which leads to immense frustration when he cannot convey what he feels accurately.  Because his attention span increases, he can concentrate for longer and can recognize and identify familiar objects in storybooks with your help. He can also match similar objects or pictures. At 19 months a average child would be able use about 20 words accurately.  This increases to 100 words at 24 months.  A two year old starts combining his words to form two word sentences.

During the toddler years he starts recognizing himself as a person apart from his mother.  He forms a sense of self, becomes more independent and starts exploring his environment with enthusiasm.  Being not connected to his mother, he can start imagining threats and become clingy. Often toddlers become fearful of strangers due to an overactive imagination. A toddler becomes aware of his own body and can usually identify different body parts accurately.

In addition to these skills, they also develop certain practical skills:

  • They can throw things out of containers
  • They can tear paper
  • They can pull things over
  • They can put things in containers and take it out again
  • They can solve simple problems and
  • They can throw objects.

A parent needs to watch a toddler with hawk eyes – they are quick, innovative and extremely daring.  Some people will even go as far to say toddlers can be innocently destructive in their behaviour – who can be angry with the child drawing his first picture of him and mommy on the wall?

The neonatal phase is the period that stretches from directly after birth and encompasses the first two to four weeks in the life of the child.

Contrary to most parents’ descriptions, newborns are not exactly pretty – they have a swollen bluish and reddish face, a broad flat nose, swollen eyelids and ears that seem somewhat misplaced.  Sometimes the shape of the face is misshapened due to the long path down the birth channel.  The little body is covered in a white substance, vernix caseosa, which protects the baby from infection and dries off in a few days. Some babies are still covered in fine hair, lanugo, which falls out during the first month. Newborns exhibit prominent external sex organs and both sexes’ nipples are swollen due to high amounts of estrogen in the mother’s blood before giving birth.

In addition to these features, the body proportions of newborns differ substantially from the proportion of an adult body.
The head makes up one fourth of the total body in contrast with the eighth of an adult’s. The neck muscles are not able to keep the head up at this point in time.

The average weight of a newborn varies between 2.5 and 4.5kg, with most weighing between 3 and 3.5kg.  Girls tend to weigh less than boys at birth and firstborns tend to be lighter than siblings.

Most parents experience that their infants lose up to 10% of their body weight in the first couple of days in hospital, but will regain it with a week or two once feeding is established. Boys tend to be taller than their counterparts, with the average length being around 45 to 56cm. A newborn baby’s heartbeat varies between 120 and 150 beats per minute, going up when stressed and down when resting.

The apgar-scale is used to evaluate an infant at birth.  This evaluation gets done twice – one minute after birth and again 5 minutes after birth.
A:     Appearance (Colour)
G:    Grimace (Reflex irritability)
P:    Pulse (Heartbeat)
A:    Activity (Muscle tone)
R:    Respiration (Breathing)

Each of these aspects gets scored as zero, one or two, with zero being the worst score and two the best score. The scores get combined with a maximum score of ten.  Most babies score 7 or more.  A score of 4 is indicative of further evaluation and treatment.

Most of the babies’ awake time is spend on feeding in the first two weeks of his life. Time devoted to feeding differs from baby to baby, but it is commonly between eight and fourteen times a day; giving the mom/caregiver breaks of between 1 and a half and 5 hours at a time.

The debate between breastfeeding and bottlefeeding is ongoing with the proponents of breastfeeding pointing out the following advantages:

  • The anti-bodies in breastmilk provides the baby important immunity against various illnesses like allergies, bronchitis and pneumonia.
  • Breastfed babies tend to have healthier teeth and are less likely as adults to develop arteriosclerosis early in life.
  • Breast milk has the advantage of being easily digested by babies and the fat in mothersmilk gets absorbed almost 100%, while on average only 80% of the fat in formula gets absorbed.
  • The risk of obesity in bottlefed babies is higher than for breastfed babies.    The most commonly accepted explanation being that babies being breast fed stop sucking when they are not hungry anymore, whilst a mom bottlefeeding might believe that the bottle should be emptied.
  • Breastfeeding is more practical – being more economical, always available and at the right temperature. This mother also does not to carry all the preparations necessary for bottlefeeding when leaving the house.
  • Breastfeeding can give the baby an extra sense of security with the advantage of better bonding.


Their counterparts believe:

  • That bottlefeeding can give a similar bond between mother and child and does not hold any negative consequences for social relationships in the future.
  • It gives the mother a feeling of physical freedom which the breastfeeding mother does not have.
  • Substances like tabaco, alcohol and medicines can be transferred to the baby via breastmilk. This will not happen when the baby is bottlefed.
  • Some mothers cannot or do not want to breastfeed.  If these mothers can bottlefeed without the negative association with breastfeeding, the bonding process can continue unscathed.
  • The threat of transferring HIV to an infant should also be considered as a potential draw-back of breastfeeding.
  • It gives the working mother the opportunity to continue with her career, knowing that her child is getting sufficient nutrition.
  • Babies can be affected negatively by certain foods, and may even be allergic, this impacts on the mother’s ability to choose food and can lead to alot of anxiety around food choices.

The group of people supporting bottlefeeding are not by any way saying that  breastfeeding is bad, they would just like more tolerance and respect for mothers who decide to go the route of giving their child formula.

The neonatal phase and baby years are the first two years in a child’s life. It is a period of rapid change physically and psychologically.  The child moves from being completely dependent to becoming more independent.  During this stage a child forms bonds with significant people in their lives – the nature of these relationships have a lasting effect on future social relationships.  During this phase the uniqueness of the individual becomes apparent. Through socialization the child learns that certain actions are acceptable while others are not allowed.

In the first two years of a child’s life he has to master certain tasks:

  1. He learns to walk.
  2. He learns to ingest solid food.
  3. He learns the basics of communication through language.
  4. He starts to learn to use the toilet.
  5. He falls into a routine of sleep, eat and interacting.
  6. He develops an emotional communication with his parents and siblings.

The degree of success attained depends largely on the opportunities the child gets and the help and direction the child receives from significant others.

No two children are alike.  As a parent of two daughters, I have noticed just how unique and different children can be, even when the parents and social surroundings stay the same.  Temperament is the result of the combination of genetic and social factors that determine your child’s personality foundation.

Most parents will be able to describe their baby as one of these three temperament types:

  • The Easy Child :  This is the child whose parents walk around with a smile on their faces the whole day long.  These parents cannot fathom why other parents burst into tears from frustration and tiredness, because their baby is such an angel!  This baby is able to easily adapt to her surroundings and is generally in a good mood.  About 40% of parents are lucky enough to report their babies to be “easy children”.

  • The Difficult Child :  These parents basicly sleep walk and have dark rings under their eyes.  They often feel guilty for not enjoying their child and question their parenting abilities. This baby has irregular sleeping and eating patterns, finds it difficult to adjust to a strange environment, reacts intensely to any stimuli and cries alot.  About 10% of parents feel their child is “difficult”.
  • The Slow-to-warm-up Baby :  15% of parents report that their baby falls into this category.  This child is inactive, reacts slowly or little to stimuli and is experienced by the parents as somewhat negative.

The remaining 35% of parents felt their children had a combination of behaviour patterns.

Temperament affects the relationship between the parent and the child and as a result of that also the bonding process between them.  Three different types of bondedness have been identified:

  • Secure Bonding : This baby uses her mother as a security base from which she can discover the world.  When separated from her mother she will show unhappiness and will be delighted when reunited.  She loves physical contact from her mother, and when she comes into contact with strangers she will react positively when her mother is around.
  • Avoidant Bonding : This baby seems unaffected when her mother is around, barely taking notice of her.  She does not become upset when her mother leaves and avoids her when she comes back. She doesn’t explore her world when they are together and seems indifferent to the presence of strangers.
  • Ambivalent Bonding: This baby becomes anxious even before her mother leaves her.  When the mother does leave, she becomes extremely upset. On her return the baby behaves ambivalently – on the one hand she tries to make contact, while on the other hand she cries, kicks and hits her mom.  These babies are anxious and will not dare to explore their environment.  They do not like strangers even when their mother is present.

The way in which you bond with your baby is very important.  This is the first relationship that she forms in her life and it will affect future relationships.  The stronger the bond with the parents, the easier it will be for the child to leave her parents.  Babies also form important relationships with their fathers, siblings, grandparents and other care takers.

During the baby years, parents find themselves constantly scolding their baby and the word “no” seems to be a recurring theme.  This is the process of socialization where parents teach the young one what is right and what is wrong, what is expected from her and what is generally acceptable in their society.   The mother becomes the teacher.

Babies from as young as six months start interacting with their peers – they smile, touch and make little noises to communicate with each other.  These interactions are important in the socialization process.  Interaction between children evolves from being centered on a object like a toy to trying to elicit reactions from the other babies to being able to change roles with each other (for example giving toys to one another).

As parents we should foster our relationship with our baby and encourage positive peer interaction.  This should give her a good basis for future relationships that she will need to form through out her life.