Peds Milestones - Week 1

2 week - 1 month: personal/social

- looks at parents face

- fixates, tracks

- follows to midline

- smiles responsively

- prefers bright colors

2 week - 1 month: fine motor

newborn reflexes

2 week - 1 month: language/cognition

- prefers female voice

- responds to sounds

- begins to vocalize

2 week - 1 month: gross motor

- equal movements

- lifts head

- lifts head and chin by 1 month

2 week - 1 month: weight

- 7.5-8lb average

- loses 10% of body weight after birth, gains back by two weeks

- gains average 0.5oz/day

2 week - 1 month: length

- average 20 in

- gains 1 inch/month for first several months

2 week - 1 month: head circumference

-13-15in

- gains average 0.5 in/month until 6 months

- posterior fontanel closes by 2-3 months

- anterior fontanel closes by 12-18 months

2 week - 1 month: nutrition

- breast milk q2-3h

- iron fortified formula 2-3oz q-4h if not breastfed

- vit D supp for breastfed & formula fed consuming less than 1L/day

- place on right side after feeding

2 week - 1 month: safety

-sleep safety

- nighttime routtine by 1 month

2 months: personal/social

- smiles spontaneously

- enjoys interacting with others

2 months: fine motor

- follows past midline

- newborn reflexes gone

2 months: language/cognition

- "ooh" and "aah"

- attends to voices

2 months: gross motor

- beginning head control when upright

- lifts head 45 degress onto forearms

2 months - nutrition

- breastfed with increased intervals

- formula 4-6oz 6x/day

- vit D supp " "

2 months: safety

- check environment

- know conditions to call HCP

- discuss preventing falls and burns from hot liquids

4 months - personal/social

- loves moving faces

- knows parents voices

4 months: fine motor

- follows object 180 degrees

- binocular vision

- bats objects

- begins to hold own bottle

4 months: language/cognition

- initiates conversation with cooing

- turns head to locate sounds

- coos with expression

4 months: gross motor

- supports weight on feet when standing

- pull to sit without head lag

- begins to roll prone to supine

4 months: nutrition

-same breastfed chedule

- formula 5-6oz 5-6x/day

- vit D supp

- begin iron supp for exclusively breastfed

4 months: safety

- car safety

- choking safety

-child proofing

6 months: personal/social

- interacts readily and noisily with parents and familiar people

- responds when name called

- may be cautious with strangers

6 months: fine motor

- rakes objects with whole hand

- begins to transfer

- puts stuff in mouth

- can hold object in each hand

6 months: language/cognition

- begins to initiate sounds

- babbles, can string vowels

- says single sounds

- begins object permanence

- aware of time sequence

6 months: gross motor

- tripod sitting unsupported

- gets on hands and knees

- bears full weight on legs

- "swims" when prone

6 months: weight

- birth weight doubled

6 months: nutrition

- introduce solids one at a time

- iron fortified cereals

- infant seat for feeds

- offer cups

- vit D

- can dc iron supp when eating iron rich foods

6 months: safety

- choking

- walkers

- drowning

- poisons

9 months: personal/social

- stranger wariness

- waves bye

- plays social games

- begins to indicate wants

9 months: fine motor

- beginning pincer grasp

- actively searches for out of sight objects

- bangs toys together

9 months: language/cognitive

- uses consonants and several vowel sounds,

says mama and dada

- beginning to attach meaning to words

- understands some symbolic language (blow a kiss)

- knows name

9 months: gross motor

-gets to sitting position

- pulls to stand

- creeps and crawls

- walks holding onto furniture

- may briefly stand

9 months: nutrition

- breastfed 16-32 oz/day

- vit D " "

- iron fortified cereal

- introduce various soft/mashed/chopped foods

- encourage cup

9 months: safety

- lower crib mattress

- watch household plants and poisons

- burn prevention, sunscreen

- avoid lead sources

12 months: personal/social

- rolls or throws ball with other person, social games

- explores

- drinks from cup

- indicates want without crying

- attempts to get parents attention

- assists with dressing

12 months: fine motor

-actively looks for hidden objects

- puts blocks in and out of container

- uses simple toys appropriately

12 months: language/cognition

- names appropriate parent

- says one to three single words

- understands simple request

- uses gestures to convey meaning

12 months: gross motor

- stands alone for increasing lengths of time

- stoops and recovers

- walks holding onto hand

- may begin to walk alone and climbs stairs on knees

12 months: nutrition

- can start whole milk 2-3 cups/day

- offer various food groups

- vit D

- start utensils

- 3 meals and snacks

- avoid foods high in salt and sugar

12 months: safety

-toy safety

- bike passenger helmet

- high chair safety

15-18 months: personal/social

- may exhibit negativism

- ritualism

- increasing tolerance of separation from parents

- undresses

- temper tantrums when frustrated

- may have transition object

- begins to understand gender differences

15-18 months: fine motor

- turns book pages

- begins to imitate vertical and circular strokes

- drinks from cup with two hands

- vision 20/50 by 18 months

15-18 months: language/cognition

- increasing receptive language

- begins to understand and say no

- may put two words together

- begins using memory

- basic moral understanding

- 30 words by 18 months

15-18 months: gross motore

- walks with confidence

- begins to run, climbs stairs by creeping then walking with hand held

- jumps in place

- throws overhand

15-18 months: anterior fontanel closes by...

18 months

15-18 months: nutrition

- caloric, protein, and fluid requirements decrease

- offer food q2-3h

- vit D

- utensils and colorful dinnerware

-physiologic anorexia normal

15-18 months: safety

- falls

- water safety

- firearm access

-toy safety

2 years: personal/social

- imitates activities, helps with tasks

- drinks from lidless cup, uses utensils

- removes difficult clothing

- stubborn, negativism, wants own way

- brushes teeth with help

understands "soon"

2 years: fine motor

- puts blocks in cup

- build tower

-imitates horizontal and circular strokes

- turns doorknob and book pages

- can unzip and button

2 years: language/cognition

- about 300 words

- 2 word sentences

- understands cause and effect

-object permanence

- sense of time

- 2 step directions

- uses egocentric language

2 years: gross motor

- stoops and recovers well

- walks forward and backward

- climbs stairs holding rail

- runs, jumps, kicks ball

2 years: weight

gains about 5 lb per year

2 years: height

- about half adult height, grows about 3 inches per year

- start tracking BMI

2 years: nutrition

- may begin low fat milk 2-2.5 cups/day

- 2-4oz protein/day

- 1 cup fruits/veggies/day

- 3 oz whole grains/day

- vit D

3 years: personal/social

- puts on clothing

- brushes teeth with help

- washes and dries hands

- notices genders and identifies

- knows name and name of friends

- understands taking turns and sharing

- begins fears

3 years: fine motor

- vision almost 20-20

- tower 8 blocks

- purposeful drawing

- can imitate circle and cross and draw person with 3 parts

- feeds self well

3 years: language/cognition

- increasing vocab

- intelligble speech

- dysfluency common

- names 4 objects

- begins color ID

- symbolic language use

- can tell full name/age/gender

- can count to three

3 years: gross motor

- jumps with both feet

- catches large ball

-balances each foot at least 2 sec

- begins to ride tricycle