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0-3: Infants/Toddlers

Infant/Toddler Development

Want to know what developmental milestones your infant/toddler should be hitting? Check this page for all the physical skills, social skills, and sensory milestones your baby should be hitting from 0-12 months. Check this page for all the physical skills, social skills, and cognitive thinking milestones your toddler should be hitting from 1-3 years. If you have questions or concerns about the pace of your child’s development, contact your pediatrician.

Source: American Academy of Pediatrics

Premature Babies

Premature birth occurs in 11-13% of pregnancies in the U.S. Almost 60% of twins, triplets, and other multiple deliveries result in preterm births. A “preterm” birth is defined as when a child is born before 37 weeks of pregnancy have been completed.

If your baby was born early, there are 2 important dates to mark on the calendar: the day your baby was born, and your estimated due date. By looking at the difference between the two dates, you can adjust your baby’s calendar age to account for prematurity and calculate his/her corrected age. During the first 2 years, using your baby’s corrected age will give you a better idea about which developmental milestones your baby should be hitting.

Because premature babies are born before they are physically ready to leave the womb, they often have health problems. Newborn premature babies have higher rates of disabilities and even death. Here are some of the most common conditions that occur in premature infants: respiratory distress syndrome, chronic lung disease/bronchopulmonary dysplasia, apnea and bradycardia, retinopathy of prematurity, and jaundice. For more information on these diseases, click here.

Caring for your premature baby will be different from caring for a full-term baby. Your baby may look, act, and require different feeding/handling methods than what you expect. This may seem scary and stressful to you, but knowing what to expect can help: Caring for a Premature Baby, Bringing Baby Home.

Source: American Academy of Pediatrics

Sudden Infant Death Syndrome (SIDS) and Sleep Safety

More than 3,500 babies in the U.S. die suddenly and unexpectedly every year while sleeping. This is often due to sudden infant death syndrome (SIDS).

SIDS is the unexplained death, usually during sleep, of a seemingly healthy baby less than a year old. The cause of SIDS is unknown, but research has found that it may be associated with defects in the portion of an infant’s brain that controls breathing and arousal from sleep. An infant may be made more vulnerable to SIDS due to a combination of physical and sleep environmental factors. Physical factors associated with SIDS include: brain defects, low birth weight, and respiratory infection. Sleep environmental factors associated with SIDS include: sleeping on the stomach or side, sleeping on a soft surface, sharing a bed, and overheating.

While there is no sure way to prevent SIDS, there are ways to create a safe sleep environment to reduce the risk of all sleep-related infant deaths.

  • Until their first birthday, babies should always be placed on their backs to sleep. This is not necessary when your baby is awake or able to roll over both ways without help. 
  • Use a firm sleep surface. It is recommended that babies sleep in a crib/bassinet/portable crib/play yard with a tight-fitting, firm mattress and fitted sheet. The firm mattress should not indent when your baby is lying on it. Nothing else should be in the crib except for your baby. Have your baby sleep in the same room as you, but not in the same bed. Room-sharing allows you to keep your baby nearby for monitoring, feeding, and comforting at night. It can decrease the risk of SIDS by as much as 50%. Do not let your baby sleep in your bed with you. Bed-sharing increases the risk of suffocation and overheating. 
  • Don’t overheat your baby. To keep your baby warm, try sleep clothing that doesn’t require additional covers. Don’t cover your baby’s head. Swaddling your baby is okay, but make sure that the baby is always on his/her back when swaddled. The swaddle should not be too tight or make it difficult for the baby to breathe. 
  • Try giving a pacifier at nap time and bedtime. This helps reduce the risk of SIDS, even if the pacifier falls out after the baby is asleep. If you are breastfeeding, wait 2-3 weeks after starting to breastfeed until breastfeeding is going well before offering a pacifier. 
  • Use caution when a product claims to reduce the risk of SIDS. Do not rely on home heart or breathing monitors to reduce the risk of SIDS. 

Contact your pediatrician if you have any questions about SIDS.

Breastfeeding

The American Academy of Pediatrics recommends breastfeeding as the sole source of nutrition for your baby for the first 6 months. Breastfeeding can be continued for as long as both mother and baby desire it, even after your baby starts eating solid foods. In general, the longer you breastfeed, the greater the benefits will be to you and your baby, and the longer these benefits will last.

Breastfeeding has many benefits for your baby. Breastfeeding provides physical contact that helps create a special bond between you and your baby. In addition, human milk is easier for your baby to digest. It contains all the nutrients, calories, and fluids your baby needs to be healthy. Human milk has growth factors that ensure the best development of your baby’s organs. Drinking breast milk will help your baby prevent diseases/infections such as ear infections, diarrhea, pneumonia, wheezing, and bronchiolitis by strengthening your baby’s immune system. Research also suggests that breastfeeding may help to protect your baby against obesity, diabetes, sudden infant death syndrome (SIDS), asthma, eczema, colitis, and some cancers.

Breastfeeding also has many benefits for you, the mother. Breastfeeding allows you to release hormones in your body that promote mothering behavior, return your uterus to the size it was before pregnancy more quickly, burn more calories, delay the return of your menstrual period to help keep iron in your body, reduce the risk of ovarian cancer and breast cancer, and keep your bones strong. Breastfeeding may also work as a contraceptive within the first 6 months after birth if you are exclusively breastfeeding and not giving your baby any other supplements, and if your period has not returned.

Some moms may find it more difficult to breastfeed than others, especially during the first few weeks of breastfeeding. If that happens, don’t feel discouraged! Remember that you are not alone. Check here for a list of common breastfeeding challenges and how to solve them. Lactation consultants can also help support you as you adjust to breastfeeding.

Formula Feeding

When needed, infant formulas can provide excellent nutrition for your baby. It is important to know which infant formula to choose and how to properly prepare it.

Some formula-feeding tips from the American Academy of Pediatrics:

  • Choose a formula product that has been reviewed by and meets U.S. Food and Drug Administration (FDA) minimum nutritional and safety requirements.
  • Always prepare baby formula according to directions on the label, unless instructed to do differently by your pediatrician because of a special medical need your baby has. 
  • Do not make a homemade formula from ingredients at the store, such as powdered cow milk or raw milk and sugar. 
  • Do not feed your infant under 1 year old cow milk or other milk substitutes. Young infants cannot digest cow’s milk as completely or easily as they digest formula. Cow’s milk also contains high concentrations of protein and minerals, which can stress a newborn’s immature kidneys and cause severe illness. Cow’s milk and other milk substitutes lack the amounts of nutrients that infants need. Do not use imported formulas from other countries that are not reviewed by the FDA. 
  • Do not water down formulas by adding more water when mixing powdered formula or adding extra water to ready-to-serve, non-concentrated liquid formula. FDA-approved infant formula is designed for just the correct amount of nutrition as described by the label. Adding extra water decreases and dilutes the nutrients and may cause serious growth problems or imbalances in vital nutrients that can lead to serious health problems.

Source: American Academy of Pediatrics

Teething and Tooth Care

Oral hygiene is important! Even before your baby’s teeth come in, you should start thinking about your baby’s oral hygiene. Wipe the gums twice a day with a soft, clean cloth: once in the morning after the first feeding, and once more right before bed. This helps wipe away bacteria and sugars that can cause cavities.

Most babies’ first teeth come in at around 6-12 months. Typically, the first teeth to come in are the lower front teeth. Most children will usually have all their baby teeth by age 3. When your baby begins teething, he/she may feel some discomfort. The gums around the tooth may be swollen and tender, and your baby may drool a lot more than usual. You can help ease teething pain by massaging your baby’s gums with clean fingers, offering solid teething rings, or gently wiping with a clean frozen/wet washcloth. It is normal for your baby’s body temperature to rise slightly when teething, but talk to a doctor if the temperature reaches 100.4 degrees Fahrenheit or above. This could be a sign of illness or infection that may require treatment.

Once your baby’s first tooth comes in, start brushing twice a day with a smear (rice-grain sized) amount of toothpaste. Fluoride should be added to your baby’s diet at 6 months. Fluoride helps prevent tooth decay, and is often added to tap water. Speak to your pediatrician about whether your local tap water contains fluoride and whether your child will need fluoride supplements. You should take your baby to the dentist by the time your baby is 1 year old.
 

Source: American Academy of Pediatrics