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Monday, January 10, 2011

Your baby: milestones, physical development and choosing day care

One of my friends is running a physiotherapy blog which has some very useful information posted for parents of babies and young children (there is a special paediatric section).  You can also ask Roberta your own specific questions about physical issues.

The blog is at

Roberta's physio blog

I was interested to note that Roberta supports my statement about young girls wearing high heels- it's a bad idea, not only due to the age-inappropriateness of sexualised clothing but also in terms of physical development- see shoes for children

She also supports encouraging children to be barefoot and stresses the importance of shoes that are not too small (slightly bigger is better, but not so big that the child can't run without tripping). Lots of other reassuring information about minor postural problems (like turned-in feet) is provided.

There is some great information for parents of babies whose head is out of shape, plus a list of the standard physical developmental milestones from birth to one year.  Knowing where your child is 'up to' in the milestones will help you to choose appropriate toys as well as giving you some idea of what to expect next (for example, if a baby's next physical milestone is rolling over, it's time to stop changing her on the bed unless you're hanging onto her at all times!).

Roberta stresses, and I concur, that milestones are only a loose guide.  Children develop at their own pace, and if some children are relatively slow to reach a milestone it doesn't necessarily mean there's anything wrong with them (and inversely, reaching a milestone early is not a cue to strike a medal- feeling inferior because some other kid at playgroup got a tooth first is ridiculous; take a chill pill!).  For example, my best friend's son was slow to talk, but grew up to be a very intelligent, well-spoken young man who still tends to think before he opens his mouth (surely a desirable trait!).  My cousin walked at 7 months, but this wasn't an indicator that she was MENSA material- just very determined and well-coordinated.

Nor do all children progress through the milestones in the same order; some children won't have crawled by the usual age, but may then just get straight up and walk at the expected time. I was a child who did this; interestingly, some children who haven't experienced that stage can be quite uncoordinated later, and benefit from the use of crawl-tunnel games which fill in the gaps in their physical experience. I wish someone had known that when I was a child- it may explain my complete hopelessness at ball games all through school!

A little knowledge about what's expected can be very useful if you don't try to use it as a bible.  For example, when you choose a childcare centre for your baby, do pay attention to the play equipment, space and staffing in the babies' room with these milestones in mind. If 'easy' babies get parked in a corner in a bouncer and ignored till they cry, their physical and communication milestones are probably going to be delayed due to lack of stimulation.  It's not enough for a centre just to be clean and quiet (in fact too much quiet can be a worry!)- staff need to interact with those babies in a big way if the care is to come anywhere near the standard of average to good mothering. Equipment and routines need to encourage toddling babies' mobility and socialisation; the room needs to be child-centred, not run according to what makes life easy for the staff.

I admit I'm not a fan of sending very young babies to day care, though I acknowledge some parents have little choice.  I remember little 'Rowena', whom I first met when she was enrolled at care the very day she turned six weeks old. She was a quiet, compliant baby in a room full of overworked staff and a full ratio of other louder, more mobile and more demanding babies, and she spent most of her time in a bouncinette with little to look at and nobody paying her much attention.  Two years later I came across her again; I wondered if she was perhaps autistic or developmentally delayed, because she failed to socialise with the other children, rarely uttered a sound and showed little or no emotion regardless of what happened around her.

I worked intensively with Rowena for some weeks, and discovered that her biggest problem was a lack of trust in adults.  Well, why should she trust us? Her emotional and social needs had been effectively ignored from the time she came to care; the squeaky wheels were getting the oil, as usual. I still remember the look of amazement on her face one day when another child grabbed a toy from her unresisting hand, and I spoke firmly to that child and gave the toy back to her.  It was the first genuine emotional reaction I'd seen to anything other than pain.

It only took a few more instances of me advocating for this almost silent child before she took it on herself one day to walk over and plonk herself down in my lap- the first evidence of attachment I'd seen.  Eventually she even became more verbal, but it took a lot of sustained work and encouragement.  There was nothing really wrong with this child except sensory and emotional deprivation.

This is not what you want for your child. Visit a centre before you commit, and have a long, quiet look.  Stay long enough for the staff to forget you're there. Are any babies 'parked' for extended periods, with human contact only for nappy changes and feeding? Are babies allowed to move freely and at will, or are they left in bouncers, walkers and playpens for long periods? If you don't see a developmentally friendly environment, walk away.  That's not good enough.

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