How do you know when an infant is happy and healthy?

Every infant and child is different, with different personalities, and different temperaments. However, to be happy and healthy, all babies need to feel safe and secure – that their caregiver is “tuned into them”, will play and interact with them when they are happy, and will reassure them or meet their needs when they aren’t feeling well. Here are a few cues to look for at different ages to tell you that your infant is happy and healthy:

  • Newborns: turning to your face or the sound of your voice
  • 0-3 months: relaxing in your arms or snuggling in close when held
  • 3-6 months: smiling and laughing spontaneously
  • 6-9 months: babbling, getting excited to see you
  • 9-15 months: checking in with you, looking to you for reassurance or even crying when strangers enter their personal space (“stranger anxiety”)
What is too much crying?
When do babies start to talk, crawl and walk?

One of the most exciting things about being a parent is watching your child learn and grow. While every child is different, there are some predictable ages at which, on average, most children should show you a new skill (developmental milestone). You and your pediatrician will be paying attention to your child’s development and will decide if things are happening on-time or if they are delayed. Be sure to let your pediatrician know if you have any concerns about when or how your child meets her milestones.

Talking: Babies start communicating with us from the moment they are born. They start by watching our faces for non-verbal cues and by listening to the sounds and tone of our voices and the words we use. Most babies will start cooing and laughing by 2-3 months. Next, you might hear your baby by “jargoning” or “babbling” where they will express the tones and inflections of speech without words that we adults recognize. Most babies will start experimenting with consonant sounds (like ba-ba-ba or da-da-da) between 7 and 10 months of age, and most children with have a few words (commonly, “mama”, “dada”, plus one additional word) by their first birthday.

Walking: To walk, your baby has to develop the strength and coordination to pull to stand, balance on two feet, and then keep that balance while moving. On average, babies will start “cruising” (pulling to stand and walking along furniture for support) by about 9 months, and will start walking on their own around their first birthday.

Crawling: Believe it or not, crawling is not actually a developmental milestone! While many babies will learn to crawl before they learn to pull to stand or cruise, some never do! They may get around by rolling, or scooting on their back or bottom, or they may skip crawling altogether in favor of two-footed locomotion.

What’s the difference between breast milk and formula?
How do I know my baby is eating healthily?

As a newborn and young infant (through 6 months of age), the only nourishment your baby needs is breastmilk or formula. Infants shouldn’t drink plain water until they are at least 6 months old. If you choose to give your baby juice, wait until she is at least 6-9 months old, and then limit juice to no more than 4oz per day.

Signs of feeding problems in young infants under the age of 6 months include:

  1. Too much feeding – taking more than 6 oz per bottle-feed, vomiting most or all food after a feeding, or having very loose or watery stools
  2. Too little feeding – nursing less than 10 minutes per feed, wetting fewer than 4 diapers per day, having very hard or very rare stools, or always seems hungry
  3. Allergy –vomiting most food immediately after a feed, more than 8 watery stools per day or blood in stools, or bad skin rashes

Talk with your pediatrician if you have any concerns about how or what your baby eats.

When should babies start eating food?
Is it normal for toddlers to hit, scream and bite? How should they be disciplined?

There are three things parents need to remember about toddlers: (1) Toddlers have very little self-control. (2) Toddlers often act out when they are tired, frustrated, or just want your attention. (3) Toddlers are excellent mimics, looking to adults around them to show them how to respond to situations where they are angry or frustrated. An adult who strikes out or screams when angry tells a toddler that it is ok to hit and scream rather than use words to express their upset. Therefore, the best intervention is prevention: everyone who cares for your child should be a good role model, and they should agree to and enforce the same rules that you do.

The key is to remember that toddlers cannot be reasoned with, but learn by getting attention from you for a behavior – this is called reinforcement. There are two kinds of reinforcement: positive reinforcement is praise and attention for wanted behavior. Therefore, be sure to “catch your toddler being good”, and be sure to praise your toddler when he uses his words to express frustration rather than screaming, biting, or hitting. Negative reinforcement occurs when you give attention to bad behaviors: this might including bribing or negotiating with your child to get them to stop a behavior, or getting upset or angry yourself when your toddler is misbehaving.

So, what should you do if your toddler breaks an important rule, or acts out by hitting or biting? First, reprimand the child immediately with a firm but calm voice so that he knows what he did wrong. Next, try a time out, especially for “dangerous” behaviors like biting and hitting – time-out removes your child from his bad behavior and gives him a chance to cool off. Usually 1 minute time-out for each year of age is sufficient. Time out should be boring, with minimal interaction and eye contact, and should end while your child is still calm, quiet and still (that is, before he starts acting out again!).

If your child seems unusually aggressive, if you are worried about safety, or if you can’t cope on your own, talk to your pediatrician – She can help you sort out other strategies or supports to help your toddler learn to handle their frustration.

Does my toddler need to play with others?
How much sleep do babies (children) need?

Babies and children need LOTS of sleep! Most babies do not have a regular sleep schedule until they are around 6 months old. Newborns will sleep in 1-2 hour increments for up to 18 hours of the day and may be equally alert or sleepy during the day or night. Usually by 1 month of age, infants will consolidate some of their sleep for longer stretches, and by 2-3 months, many infants will settle into a 3 nap per day plus overnight schedule. By 6 months infants will sleep approximately 14 hours per day, while 1 year olds sleep just under 14hours per day. Toddlers will often resist going to sleep – they don’t want to miss anything! Having a set nighttime routine with consistent bedtime can help your toddler get the rest they need.

When do children start to read?
Is television bad for kids?

Let's face it, television is a part of our culture and difficult to avoid. Not all television is bad, and some programming can be educational. Parents should closely monitor what their children are watching, and the American Academy of Pediatrics recommends no more than 2 hours of "screen time" (TV, video games, computers, etc.) per day. Televisions should not be placed children's bedrooms where it is difficult to monitor and can cause difficulties with sleep.

What are normal bowel movements?
What is normal urination?

Most infants urinate 8-10 times per day, and this slows down as they age. Once bladder control is reached, most children urinate 4-5 times per day.

How would I know if my child has asthma?
How would I know if my child is diabetic?

Signs of diabetes are excessive thirst and urinating more than usual. A child who has been toilet trained for a while may also start to have accidents with urination if they have diabetes. Other signs include weight loss and vomiting.

When can my child sit in the car without a booster seat?
How would I know if my child has a learning disability?

A learning disability can present with difficulty keeping up with peers in school or not reaching academic potential, and may be subject specific, such as isolated reading or math difficulty. There are many other issues that can cause a child to have problems in school, such as ADHD, depression, anxiety, sleeping disorders, etc. If you suspect that your child may have a learning disability it is important to talk to your child's teacher and principal, since the school system is responsible for performing evaluations for learning problems. Your pediatrician can also look into other issues that can cause problems in school.

Do we need to use sunscreen on children?
How can I discipline my child without her thinking I’m an ogre?

As a parent, it is your job to discipline your children so they grow up knowing what is right and what is wrong. Discipline should be done in a loving environment, and should not include corporal punishment. Time-out for younger children, and taking away privileges for older children can be helpful. Also, remember to praise your children when they do something good! This way, your child is hearing positive reinforcement from you, so you will not always be the "bad guy". Discipline involves praising good behavior as well as discouraging bad behavior.

When does teasing turn into bullying?
How would I know if my child is gifted?

Some signs of a gifted child include high verbal and reasoning skills, ability to learn quickly and absorb large amounts of information, and very good memory skills. They may also be able to read well above their grade level. Keep in mind that just because a child is gifted does not mean that they could not also have a learning problem such as dyslexia or language problem, and gifted children may become bored in regular classes which could cause behavioral problems.

How would I know if my child is depressed and what should I do about it?
What are the signs of puberty and how long does it last?

Puberty begins in girls with breast development and in boys with enlargement of the testicles. Other signs of puberty include pubic and underarm hair, acne, body odor, physical growth, and periods (in girls). Girls begin puberty between 8-13 years of age, and boys begin puberty between 9-14. Puberty lasts until it is over! It can take from 2-5 years to progress through the physical stages of puberty.

How would I know if my child has mono?
What are the best ways to maintain open lines of communications with sullen teenagers?

It might be difficult to get your teenager to start talking. Parents should try to be available and be honest. Let teens know that you are there to talk, and you are willing to talk about anything. Take advantage of time driving in the car or time at the kitchen table to ask questions. And remember to listen!

How do you punish a kid who’s way bigger than you?

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