A Busy Medical Student’s Guide to Helping Your Infant Reach Developmental Milestones

In the summer before I became an osteopathic medical student at Pacific Northwest University of Health Sciences, my wife and I were blessed with our first child. The process of preparing for his birth was long and thorough.

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We went to the birthing classes, read the blogs, and had the baby showers. We were very excited to be on the other side of all of that the day we took him home. What I didn’t realize was the whole new world that was now open to us that wasn’t covered in the birthing classes.

We now had a child depending on us to love him, nourish him, and help him grow. Not long after taking him home from the hospital, we moved to Yakima, WA so I could start medical school. This meant that our new life with this child needed to be efficient, organized, and meaningful—especially for myself, with the limited time that my new school schedule allowed me.

As a future pediatrician, I am especially interested in the milestones that my child is “supposed” to hit. However, I didn’t realize that parents have the ability to help our children reach those milestones.  I offer to you the different strategies I discovered, while being a busy medical student, to help my child in his various life stages.

1st Month

In their very first month newborns are finishing the connection of neurons within their brain and the rest of their body. This manifests itself with the newborn growing out of the many of the reflexes they are born with.

Some reflexes remain with us throughout our lives, such as our Patellar reflex, which is demonstrated when the doctor uses a rubber hammer on your knee cap to elicit your “knee jerk” reaction. Like the Patellar reflex, a newborn’s reflexes serve as a response to a stimulus. As the neurons finish their connections, some of these reflexes will begin to fade, including:

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  • Rooting Reflex: The newborn will purse their lips in response to a light touch, allowing them to latch onto their mother’s nipple or bottle without thinking about it. Similarly, when he or she is hungry or senses their food source nearby, they will start “rooting” around and searching for their food until they find it. This reflex usually disappears by age 4 months.

  • The Moro Reflex:  Whenever the coffee grinder is turned on or a loud TV commercial break, a newborn will jolt and probably start crying. We are all surprised by loud noises, but a newborn will also reflexively fling their arms out as if to catch themselves from falling. This reflex typically fades between the ages of 3 and 6 months.

  • The Palmar Grasp:  One of the instinctive things people like to do when meeting a newborn is to offer their finger for their tiny hands to hold onto. This usually elicits a collective “aww” from everyone, but unfortunately it isn’t a sign of affection from the baby. It’s a reflex that helps the baby hold onto his or her mother while feeding or being held. This reflex disappears around 6 months of age.

  • Holding Head up while on Stomach: This is the one of the biggest areas you can influence your child’s development at this young age. The strengthening of the neck and back muscles in order to support the head is a crucial ability for an infant. Practicing this movement is commonly called “Tummy Time” and involves brief sessions of rolling your child onto their stomach and giving them incentive to hold their head up for a brief moment. The older they get, the longer they will be able to support themselves before giving up and crying. 

    This was a great job for me. During my study breaks I’d bring my son to the floor and sit in front of him, playing with his toys while he looked on. At the beginning these sessions usually only lasted one or two minutes, but the more we practiced the stronger he got.

3 Months

I’ve been told that after the baby is born, mom and baby undergo their “fourth trimester,” meaning that the both of them are recovering, resting, and need the same amount of care and attention that received in the last weeks of pregnancy. By three months, mom is more recovered and baby has a better handle of living a life outside of the womb.

  • Reaching and Grabbing:  If baby has been getting enough practice, they are able to pull their head up and explore their environment. They are now starting to be able to use their hand to reach and grab things they are interested in, such as a toy placed in front of them.

    Especially at this young age, we weren’t sold on the idea of needing to have a bunch of toys for our infant. In our eyes, he really doesn’t know the difference. As long as it wasn’t a choking hazard, we were able to use some brightly colored kitchen utensils and towels. Our son seemed to really fixate on our remote control. We let him explore, but took the batteries out so he couldn’t turn on the basketball game whenever he wanted.

  • Following with Eyes:  At three months, we really liked putting him in a baby bouncer and letting him watch everything. At this age, baby’s eyes are still developing so they can’t focus on anything more than a foot away from them. But if you stand close and move your head around, they should be able to start following you with their eyes.

  • Starting to Smile: With a newfound ability to track with his eyes, this is when our son started to recognize us as mom and dad. It took a little longer than three months as we desperately looked forward to intentional smiles.

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6 Months

Both baby and parents are starting to hit their stride. For us, this was around the time that our son was sleeping longer stretches at night. AKA, we got our sleep back!

  • Rolling Over and Crawling: Baby is pushing up on their hands and able to roll over front to back. This is also when they have enough strength and stamina to start crawling. Now it is especially important to be vigilant to baby proof the house, taking careful consideration to remove any objects that present a choking hazard.

  • Supporting Weight on Legs While Being Held: This is another opportunity to help your infant build muscle strength and coordination. They are at a point where you can hold them up and can start to support some of their weight on their legs. By doing this frequently you allow your child to understand the sensation of standing and develop the coordination to do so.

9 Months

I feel like this is when parenting started to get more fun. My son was exploring the world, trying new foods, and looking to me as his guide on this big, wild adventure.

  • Saying “Mama” and “Dada”: One the first words, especially if it’s one you practice saying in front of your child, will be “Mama” or “Dada.” At first it was obvious that he didn’t really know what he was saying, but as he grew older he started saying our names whenever we’d walk into the room.

I also want to stress the importance of talking to your infant. They don’t have the ability to respond quite yet, but they are learning from you. For us, this looked like narrating what we were doing, asking him questions, and modeling to him what conversation looks like.

  • Sitting Regularly and Pulling to Stand: Crawling is now happening all the time and baby will start reaching and getting into things they aren’t supposed to. If you have a safe area to practice, this is about the time that they are able to grab ledges and pull themselves up to stand. This could be the couch, coffee table or toddler stand-to-play toys.

  • Holding Attention while Reading Books: Standing still and holding attention is difficult for a baby, but one of my favorite parts of my day is putting my kiddo to bed. He gets his bath, changes into his pajamas, and then we read a nighttime book. From 3-6 months we would read him a book and he would mostly just play with the pages. But at this age, he was able sit still while we are reading and get excited every time we flip the page.

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Being a parent is hard and anything you are doing on top of that makes it harder. The thing that most helped us keep our sanity these first months of our child’s life was routine and habits. We found that if we were able to give a safe and predictable environment for our child, he became comfortable and open to whatever we are doing at that time. With the developmental milestones, we just incorporated practicing them into his routine, and he seemed to know what to expect and how to do what we were asking of him. We’ve come to love this new person in our life, enjoyed building a life with him in it, and have cherished every step along the way. 

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Boone Rhinehart

Osteopathic Medical Student - 2nd year (OMS II)
Pacific Northwest University of Health Sciences

Boone Rhinehart