FAQs with a Pediatrician :: Part One - Gross Motor and Language Development
Dr. Laine Racher is a pediatrician who loves taking care of babies. She ran a full-scope pediatrics practice for over a decade, has experience working with the Headshape Clinic at the Alberta Children’s Hospital, and also has a passion for working with transgender teens. When she set up her practice at Ensemble she narrowed her focus to supporting families with babies up to a year of age.
Her practice has a lot of variety, from well newborns in for their check-ups to medically complex babies navigating multiple health issues. Not surprisingly there are certain questions from parents that come up regularly during her clinic visits, so she thought it would be helpful to compile answers to some frequently asked questions.
Dr. Racher sees families by referral only (information can be found here), and she facilitates a session on Newborn Development and Headshape as a part of our Postpartum Group Program. You can learn more about her here and here.
Gross Motor Development
At what age should my baby starting rolling over? sitting? crawling? walking?
You can think about gross motor skills developing in a head-to-toe sequence as babies gain control of their actions:
Head and neck -> holding their head up around 1-2 months
Shoulder girdle -> pushing up into a cobra position around 2-4 months
Arms -> reaching around 3-4 months
Trunk -> sitting up and rolling over around 3-4 months
Hips -> pulling to stand around 9 months
Legs -> standing on their own around 10-12 months
Feet -> walking generally between 12-18 months
The AHS Healthy Parents Healthy Children website has lots more information about development.
Should I be concerned if my baby isn’t crawling or walking ‘on time’?
It comes as a surprise to many of the parents I care for that crawling is not considered a true developmental milestone. This is because many babies skip this step and there are such varied crawling styles.
Walking can start as early as 9-10 months, but concern should only arise if there is no walking by 18 months.
Language and Social Development
What are the signs that my baby is developing language skills?
Similar to gross motor development, babies follow a typical progression of their language skills:
Around 2-4 months babies start to understand that sounds make words. They starting by copying sounds that they hear.
Then, between 4-6 months they start babbling as they combine sounds like ‘ba ba’ or ‘da da’ .
Around 12 months, babies start to understand that specific sounds form words that have meaning.
How can I encourage language development?
When your baby starts to ‘wake up’ to the world around them, usually around 2 months of age, you can start engaging in ‘serve and return’ interactions with them.
Serve and return refers to the back and forth interactions where your baby ‘serves’ a gesture or sound, and you can ‘return’ by responding with an action or sound. This helps your baby’s brain to develop and enhances their ability to develop social and emotional bonds.
The AHS Healthy Parents Healthy Children website has a handout with serve and return ideas found here.
Is stranger anxiety a normal developmental phase?
Yes! Stranger anxiety typically peaks around 9 months of age as a natural protective mechanism.
It’s important to respect and honour your child's attachment needs during this phase - and remember that it will pass.
A Few Final Words
What are the best toys and activities for baby’s brain development?
You do not need to spend a lot of money on toys and activities to best support your baby’s brain development. Through their responsive interactions, parents and caregivers are the best developmental enhancement tools for any baby.
You can use household items for developmentally appropriate activities. For ideas, a great resource is the Canadian Pediatric Society’s Caring for Kids website.
Are there any other resources that you recommend to parents?
A couple of great resources are:
Alberta Health Services HEAL website - this site is published by the Pediatric experts from the emergency departments at Alberta Children’s Hospital and the Stollery Children’s Hospital. It provides videos to prepare for a visit to the emergency department along with general information about the causes, symptoms and home management options for common minor illnesses and injuries, and when to seek medical care.
My practice website! - I have compiled a number of resources that I direct my patients to all the time.
Lastly, remember, each child develops at their own pace. Guidelines help you understand what to expect and when to seek further advice if needed. Enjoy watching your baby grow and develop through these exciting early stages!