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Physical Development During Infancy (From Birth to 12 Months)
Babies grow up fast. It might seem just like yesterday that your little one was a fragile bundle of joy that fit snugly in your arms, and now, she's big, walking around and responding to your voice. As your baby gets older, she goes through a series of physical developments that are milestones and crucial markers for your baby's overall growth and development.
At What Pace Do Babies Grow?
You’ll see significant changes in your baby in the first 12 months of her life. Babies grow at a surprisingly fast rate, and change from being helpless to being able to communicate and move around. In the first year, your baby will experience rapid physical growth, development of motor skills, vision, hearing and communication. Your baby’s doctor will measure and track the growth and mark it against a standard growth chart.
Physical Growth
Not all healthy full-term babies are born in the same size, but you can expect your baby to nearly double her weight by 5 months, and triple it by the time she is one-year-old. In the first six months, she will grow about 1.5 to 2.5 cm, and put on weight at the rate of 140 to 200 g a week. Between 6 to 12 months, she will grow about 1 cm and put on about 85 to 140 g every week. However, it is important to bear in mind that all babies grow at their own pace; they experience periods of growth spurts and fluctuations in how fast they gain weight.
Motor Development
Although babies develop at different rates, the sequence of development remains the same. For example, they learn how to sit and crawl before they learn how to walk. Some babies reach developmental milestones such as sitting and walking earlier than others. Development also occurs from the top down - they learn how to control the movement of their head while strengthening their neck muscles as they do so. Hand coordination follows, which enables them to grasp and pull their bodies forward before they learn how to crawl. Once they begin to have better control of their lower body, they learn how to use their hands and knees to crawl. These developments all lead to finer motor control which enables them to walk eventually.
The maturity of their central nervous systems helps in their physical development. Babies are born with primitive reflexes such as the grasping and walking reflex. The reflexes have to be lost if they are to learn controlled movement of their limbs. You’ll notice that your baby’s walking reflex disappears by the end of the first month and the grasping reflex disappears around two to three months of age. While they kick and move their arms randomly earlier, as they mature, they learn to coordinate these movements as a response.
Vision, Hearing and Communication
Development of eyesight, hearing and communication skills is what you can expect as part of physical development during infancy. Newborn babies can only see things that are within 25 cm in front of them, while an 8-month-old baby has vision that’s almost as good as an adult's. Their hearing gets fine-tuned as they grow, and they develop the ability to respond to specific sounds and different people. Their ability to communicate also improves during their first year.
Physical Development in Infants from Birth to 1 Year
Given below is a list of developmental milestones you can expect in your baby regarding her physical growth and motor skills. Keep in mind, however, that your baby may reach them earlier or a little later, so do not be too concerned if she deviates from other children.
0-3 Months
Here’s what to expect out of your newborn:
1. Developmental Milestones
Her reflexes allow her to turn her head and suckle when you touch her cheeks
Flex her arms and legs, and extend fingers
Physical development of your one-month-old baby lets her follow a moving light briefly
Between 4-8 weeks, she can lift her head when she is placed on her tummy
She can recognise your voice and get startled at noises
By 6 weeks, her eyes can move together to see most of the time
She will kick enthusiastically by 2 months
By 3 months, she will be able to watch and follow a moving face
2. Signs of Developmental Problems
If she seems unusually stiff or floppy, and the head control appears particularly developed
You notice a difference in muscle tone between one side of her body to the other
Your baby always holds fingers in a tight fist
Difficulty with feeding which does not improve over time
Your baby cries for longer periods of time and is exceptionally hard to settle
She rarely cries, sleeps well consistently and is unusually good or mild-tempered
3. Tips to Encourage Development
Give your baby plenty of tummy time. It will help strengthen her upper body muscles and muscles that control the head and neck.
Let her have some nappy-free-time, preferably outdoors, under the shade of a tree. Babies like to wave and kick their legs around, unrestricted by nappies.
3-6 Months
Here are more things you can expect as your baby gets older:
1. Developmental Milestones
By 3 months, she can look at her own hands and play with her fingers
In between 3-4 months she will be able to grasp a light object
By 4 months, she will be able to lift her head and chest while placed on her tummy
She will be able to roll over between 4 and 6 months
Some start chewing, which is a marker of a 5-month-old baby's development
She can make and hold eye contact
She will enjoy looking at bright lights or brightly coloured objects
2. Signs of Developmental Problem
The muscles seem tight and have uneven tone throughout the body
Her fingers don’t extend spontaneously
Her arms and legs remain still most of the time
Her eyes don’t follow faces or objects
She is hard to feed and struggles to settle down
Weight gain occurs at an unacceptable rate
She has a disinterest in her surroundings
3. Tips to Encourage Development
Give her more tummy time than before; babies enjoy it.
To encourage motor and sensory skills, offer her a soft rattling toy. It helps babies build their grasping skills and learn to associate its movement with the sound of the rattle.
While on her tummy, put objects within her reach so she can learn to extend her arm out and grab. It builds a baby's hand to eye coordination and strengthens muscles associated with the movement.
6-9 Months
By now, your baby is more responsive and in control of her actions. You know what to expect of her behaviour and what she like and doesn't like. Here are more development signs to look out for:
1. Developmental Milestones
By six months, she would be able to grasp objects and take it to her mouth
Between 6-8 months, she can be taught to hold and drink from a cup with some help
She would be able to hold a spoon by 7 months, but would not be able to use it purposefully
Soft solid foods would be part of her diet by the time she is 7 months
By 8 months, she will be able to sit without support
By 9 months, she will be able to move around by crawling or rolling
2. Signs of Developmental Problems
She is not able to sit without support by 9 months
Her body is stiff and hinders her ability to stay in a seated position
She is uninterested in toys and does not reach for them by 8 months
3. Tips to Encourage Development
Spend more time playing on their floor with her. Sitting and crawling will help her muscles get stronger.
During playtime, arrange toys around her in a way that they are just out of her reach, prompting her to crawl to the toys
Let her play with food, even if it gets messy
Let her play with a range of textured toys
9-12 Months
You are probably surprised at how fast your baby has grown and acquired a personality. Here are more things you can expect as she continues to grow:
1. Developmental Milestones
She would be able to move around by crawling or shuffling by 10 months
She would be able to balance well while sitting and not topple over when reaching for a toy
By 10-11 months, she would be able to pull up with support and stand
By 10-12 months, she should be able to walk with the support of an adult
By 12, she would be able to pick tiny objects using her thumb and forefinger
2. Signs of Developmental Problems
She is not able to sit without support by 10 months
She hasn't developed ways of moving around on her own
3. Tips to Encourage Development
Give your baby ample opportunities to move around on her own. Do not restrict her to strollers or the baby seat when she can sit on the floor. The more time she spends moving around, the more practice she will have to build skills.
Give her more toys that move or roll. Balls are great as she will enjoy chasing after it.
Set up a safe play area for her where she can move around unrestricted and safely.
Let her have her own cupboard full of toys that she can pull out and put back in. She would also enjoy opening and closing the door.
Although not all babies reach these milestones in precisely the same time frame, their sequence of development remains the same. If you feel your baby is a late bloomer, be patient and continue encouraging her development.
Also Read: Emotional Development in Infants Read more
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Biophysical Profile: Procedure, Risks & Side Effects
With advancements in medical technologies, it is easier to perform tests that determine your baby’s health in the womb. The biophysical profile is a medical procedure that is performed to assess your baby’s growth and health when it is in the womb; it helps explicitly in checking whether the baby in the womb is getting enough oxygen or not. Biophysical profiling is done to check the general well being of the baby in case of high-risk pregnancies. It is a non-invasive and a painless procedure, globally accepted to track the baby’s health.
What is a Biophysical Profile?
A biophysical profile (BPP) is a combination of biophysical profile ultrasound and a non-stress test (NST). It is advised only if the gynaecologist sees a potential risk or complication in the pregnancy. It is done after 28 weeks of pregnancy. It shows the baby’s heart rate, breathing, movements, tone and the level of the amniotic fluid present. Following are some of the attributes that are checked during a biophysical profile:
Foetal Breathing: It shows how your baby's chest moves as she breathes
Foetal Heart Rate: It indicates the number of heartbeats per minute.
Foetal Movement: It records the number of movements your baby makes in 30 minutes but sometimes if the baby is asleep, it takes longer than 30 minutes.
Foetal Tone: It shows the ability of the baby to flex and extend an arm or leg, measured by counting quick and jerky movements.
The Volume of Amniotic Fluid: The amount of amniotic fluid surrounding your baby.
Who Should Opt for a Bpp Test? When Should it Be Done?
It is usually performed if it is a high-risk pregnancy, overshot the due date, twins, the mother has a high blood pressure or heart disease. It is also done in unstable pregnancies or with progressive foetus deterioration. Additionally, following are some other reasons for getting a biophysical profile test:
You are a diabetic and on medication
You are experiencing other medical conditions, which might affect your pregnancy.
You are experiencing gestational hypertension
Your baby is showing weak growth and appears smaller
Your baby is not very active
Your levels of amniotic fluid are not appropriate. It is either more or less than the normal range.
You’ve crossed the due date, and the doctor wants to understand how the baby is pulling along
You have a history of losing a baby during the third trimester of pregnancy for unknown reasons, and so the doctor wants to double-check this time to ensure everything is fine to avoid the chances of a repeated miscarriage
You or the baby has a condition, which requires monitoring
Although it is done during the third trimester, it is purely the doctor’s call to do the bpp test or not.
Procedure
There are two parts to a BPP. One of the tests is a non-stress test (NST), and the other is an ultrasound evaluation. These tests are usually done with a full bladder; the mother is asked to drink a few glasses of juice or water (6-7 glasses). This helps in pushing the intestines out of the way to a get a clearer picture of the baby. In full-term pregnancies, it might be needed on a full bladder as the baby itself pushes the intestines out of the way.
For NST, you must lie on your left side. It involves one belt strapped to the abdomen of the mother to measure the foetal heart rate and another belt to measure the contractions. These parameters are measured for 20-30 minutes. If the baby is not moving or is asleep a buzzer is used to wake up the baby, then the ultrasound is done by a skilled and qualified technician supervised by a perinatologist. This ultrasound might take about an hour. It is used to observe the body movements of the baby, flexing the arms and legs, also referred to as muscle tone, the baby's capability to move its chest muscles and diaphragm for breathing and the quantity of the amniotic fluid. The ultrasound test is similar to the obstetrical ultrasound, which is performed during pregnancy.
Risks and Side Effects
There are no potential side effects of this procedure since it is non-invasive, but the only concern is the prolonged exposure to ultrasound. The mother’s anxiety might cause some deviations in the parameters especially while doing the non-stress test. Hence, it is advised that you stay relaxed for the entire duration of the procedure.
What Does a Biophysical Profile Test Result Mean?
A bpp in pregnancy has five specific foetal parameters that are studied and “scored” during the procedure:
Biophysical Attribute
Normal
Abnormal
Breathing
1 breathing episode within 30 minutes
No breathing episodes within 30 minutes
Movement
2 or more limb movements within 30 minutes
(active continuous movements are considered as one single movement)
Less than 2 limb movements within 30 minutes
Muscle Tone
1 or more episodes of active extension/flexion of limbs, and so on. (For example, opening and closing a hand is considered as one tone).
Slow extension/flexion of limbs, partially open fetal hand, and so on.
Heart Rate
2 or more episodes of reactive heart rate acceleration within 20 minutes
1 or more episodes of unreactive heart rate acceleration
Amniotic Fluid
1 or more adequate pockets of fluid
Either no pockets or inadequate pockets of fluid
Every movement tested in the BPP is a result of efferent signals that are originating in different central nervous system (CNS) centres. It matures at various gestational ages. The total score is used by your doctor to determine the health of the baby.
The bpp profile ultrasound technician (sonographer) assigns a score of 0 – 2 for each parameter. A score of 8 or above is good, anything less than that is a cause for concern. If the score is 6, then the bpp scan needs to be repeated within 24 hours. If the score is 4 or less, there might be a need to deliver the baby immediately. Sometimes even if the scores are fine, the amniotic fluid levels might need monitoring. Depending on the stage of the pregnancy, delivery might be advised. An abnormal pattern is noticed in the umbilical cord blood flow followed by reduced FHR (foetal heart rate) and the loss of breathing. The movements of the foetus and tone are the last parameters that show abnormalities. If the abnormalities are closer to term, then immediate delivery is done. However, if it is far away from the term, then the comprehensive management of the babies health is planned out. This might include weekly or fortnightly testing.
A modified biophysical profile is a combination of the Non-Stress Test and the evaluation of the amniotic fluid levels. It is a more efficient version of the biophysical profile. If the amniotic fluid levels are less, it indicates that the baby is not making enough urine or the placenta might not be functioning properly. If either the NST or Amniotic Fluid Volume (AFV) is abnormal, then the complete bpp is performed along with contract stress test (CST).
A study titled, “The antenatal measurement of foetal urine production” mentions: "Two mechanisms help to explain the relationship between decreased AFV and perinatal morbidity and mortality. Decreased fluid may reflect uteroplacental insufficiency, especially in growth-retarded and postdate foetuses."
The bpp scan cost is not very high. However, it varies from hospital to hospital. Speak to the radiologist before consenting to the procedure.
A biophysical profile is a standard tool that helps us monitor the baby and possibly prevent fetal distress. It is a tool for providing antenatal fetal surveillance. The false-negatives in bpp is very low (0.77 mortality per 1000 babies), and hence it’s a reliable procedure. When the test results indicate a risk to the growing fetus, the physicians can take measures to intervene and avoid progressive metabolic acidosis, which can result in death.
Also Read: Foetal Echocardiography Read more
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Infection in Premature Baby - Signs, Diagnosis and Treatment
Premature babies are born with an immature immune system, which leaves them susceptible to infections, both internal and external. They may get infections from their mother or through external sources. Since their immune function is lower than term babies, it increases their chances of getting an infection.
Types of Infections That Are Common in Preemies
Premature babies are prone to several infections that may come directly from the mother or through external sources. Some of the common types of infections in preemies are blood infection or sepsis, lung infection in a premature baby that usually manifests as pneumonia, infection of the fluid around the brain or meningitis, and urinary tract infection or UTI.
Staph infection in premature babies can also be caused when the bacteria on the skin enters into the body and forms abscesses.
Why Are Premature Babies so Vulnerable?
Preemies receive a lower antibody count than term babies which contributes to their immature immune system. Since antibodies are the body’s primary defence against infections, the lack of them in preemies puts them at high risk of infection.
Also, premature babies often need intravenous lines, intubation tubes, catheters, etc., to assist with their development. These external pieces of equipment may introduce bacteria, fungi, and viruses into the baby’s system, causing infection.
Possible Signs of Infection in Preterm Baby
A preterm baby with infection may exhibit the followings signs:
Listlessness or lack of activity
Reduced or poor feedings
Body temperature fluctuations (below 36 °C or above 37.8°C)
Slow heart rate
Yellow skin (jaundice), pale skin, spots, rashes
Diarrhoea or vomiting
Poor muscle tone
Apnoea, rapid breathing
Bad odour from the infected area
Low blood pressure
Possible seizures in case of meningitis
How Is Infection in Premature Baby Diagnosed?
Fluid samples like blood, spinal fluid, or urine will be obtained to culture it in a laboratory to check for evidence of bacteria in the fluids. White blood cell count in your baby’s blood will also be measured to check if there is an unnatural change in the count. Significant increases or decreases and rise in the number of young white blood cells can indicate an infection.
How to Treat Infection in Preemies?
Your baby will be treated based on the type of infection he has contracted. Bacterial infections are treated with antibiotics. Your baby may be given more than one antibiotic as no single antibiotic can control all infections. Fungal infections may be treated with anti-fungal medications and viral infections may involve treatment with different drugs based on the type of virus, along with supportive nutrition or isolation.
Can There Be Permanent Problems From Infection?
Most bacterial infections can be effectively treated with antibiotics and pose no long-term harm to the baby. However, if your baby suffers from meningitis which is severe, he may have some permanent brain damage. Meningitis needs to be treated early to avoid serious complications. Preemies with low blood pressure issues for an extended period of time may also face some heart problems and brain damage due to lack of blood circulation to the organs.
Preemies are very delicate and a lot of care and caution is advised while handling them. Doctors will generally urge you to maintain hygiene and wash your hands before and after touching them to protect them from external infections. If you or any other members in the family have an infection, do not touch the baby until you’re clear of it.
Also Read:
Common Health Problems of Premature Babies
When and How to Wean a Premature Baby
Tips on Taking Care of Premature Baby at Home Read more
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Rashmi has added a new answer
Expecting Mom due in 5 months
16 hours ago
Q. I got faint line all my pregnancy test and I missed my periods for 10 days but USG and TVs test confirm there is no pregnancy is there any chance that it is very early stage that's why it is not visible???? or TVs test is the last thing that can tell that really there is no pregnancy
Read moreRashmi
Mom of a 9 yr 7 m old girl
16 hours ago
A. I think it would be advisable for you to get an ultrasound done with your doctor that’s going to give you a clarity because if there is a pregnancy it would be visible at least at least that sack is visible if it’s a regular pregnancy so it would be advisable to have a test with your doctor
Dr. Minal Acharya has added a new answer
Guardian of 0 children
12 hours ago
Q. mere twins baby girl and boyhai one month 8 days old kya mai ghutti de sakte hun ya gripe water de sakte hun aur kab se start kar sakte hun
Dr. Minal Acharya
Nutritionist
12 hours ago
A. dear Mum, you should not give any sort of gripe water or ghutti to your baby. these are unhealthy and dangerous and can cause infection to your baby. so, these should be completely avoided.
Dr Vandan H Kumar has added a new answer
Guardian of 0 children
11 hours ago
Q. I am currently 32 week pregnant.I recently had growth scan.mu baby is in cephalic presentation. Does this change as I approach my due date. Also my EDD is July 25 and EDC is July 2. what is my expected due date. Also what is EDC?
Dr Vandan H Kumar
Paediatrician
11 hours ago
A. edc is expected date of delivery only.
that is 40 weeks
You will get more information for your query with your family doctor. You may meet your dr in person for proper guidance .
It is important to remain in contact with your doctor.
Swati Kar Samanta has added a new answer
Expecting Mom due in 7 months
11 hours ago
Q. why I am getting dizziness in my pregnancy
I am going with 3rd month of my pregnancy it's a very strong dizziness I feel at times means every day .....no other symptoms of pregnancy .Please help with elaboration .All okay means isn't part of this journey.
Read moreSwati Kar Samanta
Mom of a 2 m old girl
1 hour ago
A. Do consult your doctor as soon as you can. It's important to find the real reason because without that, proper medication is not possible.
Dr Priyanka Kalra has added a new answer
Guardian of 0 children
11 hours ago
Q. I am currently 32 week pregnant and had growth scan recently.My baby is in cephalic presentation.does this change after 36 week or does this remain the same?
Dr Priyanka Kalra
Obstetrician and Gynaecologist
3 hours ago
A. usually fixed. better to show to specialist always as they get the correct diagnosis. try to avoid self and extra medication that will only complicate this and create more damage to the child
Rashmi has added a new answer
Guardian of 0 children
2 hours ago
Q. it's my 5 month n I still didn't went for check up yet not even once is it okay if I go now or?
Rashmi
Mom of a 9 yr 7 m old girl
1 hour ago
A. You should have started going from the very beginning itself once you get to know you’re pregnant but since you haven’t reached that now if you’re pregnancy has been healthy last five months please get it checked with your doctor also if you need to start with any supplements or diet the doctor would advise you after a ultrasound so please visit your gynaecologist
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