Go read the Disclaimer again. I am not a doctor. This is not medical advice. Seriously.
Health care providers at well baby visits will, in addition to measuring, checking physiological development and reflexes, ask a bunch of questions about what your baby does. Some of these will be about sleeping, eating and child care arrangements. The rest can be considered under the catch-all term Developmental Milestones.
There are many lists of developmental milestones. You can find them in any child care bible, and on numerous web sites (google developmental milestones, with or without baby, infant, etc.). These lists can give you ideas of games to try playing with your baby, and may explain otherwise surprising dramatic changes in your baby (there really was a day when Teddy's distance vision improved or, at any rate, he suddenly got interested in small things that were further away).
A close look at any of these lists reveals their cultural bias. Elements like "helps hold bottle while feeding", for example, aren't relevant for a baby still exclusively breastfeeding at the breast. Nor, for that matter, are "drinks from a cup" or "uses a spoon". Furthermore, because formula is so damaging to infant development, developmental milestones -- created and tested in an era when formula feeding was so dominant -- do not accurately describe normal breastfed infant development.
The three large criteria are: gross motor skills, fine motor skills and language. Other categories may include (in order of frequency that I've seen them): social/emotional, cognitive, self-help.
Within each category are a bunch of things a baby might be able to do.
Normally, each item is accompanied by an age by which some, many or most babies that age can do that thing. Some of these things (babbles, smiles, walks) are absolutely universal. A baby in any culture which never did one of these things would be regarded in any culture as, at least, a little unusual. However, some of these things vary wildly in when they happen across culture, and some things never happen for some or all babies in some cultures (holds bottle). These lists get even wackier as babies become children (pedals tricycle is one of my favorites, particularly since climbs trees is not on any list I've seen. Ditto for tripod pencil grasp, without, say, threading a needle or hammers accurately).
In addition to the culturally specific problems, the age is also culturally determined. For instance, in many cultures, babies acquire many of the early gross motor skills (walking) much earlier than in the US. This is not unexpected simply on the basis of prevalence of breastfeeding in the US at the time standards were set here, versus prevalence of breastfeeding in other cultures at the time the anthropologists recorded their findings.
Child rearing ideology also plays a major role. In the US, mothers are trained, in ways subtle and coarse, to play with their babies in a very verbal way. This is not universal; in some cultures, babies are never spoken to directly (and yet they learn language just fine, because they experience it in their environment). They are discouraged from playing physically with their babies, and in some cases, discouraged strongly from assisting their babies in attaining certain gross motor skills. For example, La Leche guidelines (an organization which provides admirable support for breastfeeding, but otherwise has quite conservative ideas of child rearing), both advocate tummy time (which, until a baby can roll to and from her tummy, is a very exhausting, trapped position to be in) and specifically prohibit teaching a baby to walk. Yet many other cultures view teaching infants to walk as part of ordinary child rearing.
Montessori dogma asserts that babies must learn to pull up by themselves with no assistance from other people, mamas or otherwise. They seem to think that a low bar or a wagon is a much more natural way to pull up and learn to "cruise" than, for example, mama's hand held steadily, or her leg as she sits beside her baby.
Both La Leche and Montessori are adamant that children must learn to walk before they crawl, otherwise all kinds of horrible maladjustment will ensure. Yet crawling is very cultural, and really quite strange, probably an artifact of flooring, exacerbated by putting babies to sleep on their stomachs and leaving babies alone (the latter two would motivate the babies to move, and the first would cut down on the mortality to a point where mamas would allow it). Crawling may also be declining with the back to sleep campaign.
Ignoring, for the moment, the cultural dependency of the items on the list and the timing of attainment (if ever), the lists cause other problems as well. Because many, inconsistent lists exist (in these not-official examples, note that peekaboo shows up at month three here and at month seven here), depending on which one you look at, you could either panic, or chortle at how brilliant your baby is.
Earlier, I described how pregnancy and childbirth can spark competitiveness among women on a variety of fronts. While we all know it's bad to take our offspring's Little League prowess as our own (good or bad), a lot of people still do it. These lists provide endless opportunities for this kind of competition, breeding endless worries for new parents, damaging relationships between parents (so they don't trust each other for information) and put the pediatrician (and other listmakers) in the position of advice-giver and judge on the quality of one's child and child-rearing choices.
A lovely essay on the same topic, by a lovely woman from Lagos.
Babies which are carried a lot, and which breastfeed after the first few months, start to show a lot of skill at climbing around on mama (and any other adult they spend a lot of time with). Here are some possible milestones:
Those who have read Boucke's book on Infant Potty Training might be able to think of a few more: can be held by thighs to pee or poop; sits on mama's feet for elimination; walks to appropriate potty location and so forth. Adapted for our potty arrangement, one might be: thumps at diaper to indicate wetness or need to go to the potty; can sit without support on potty.
Because our potty is on the counter between the wall and light switches and the sink, we have also noticed when our baby stopped trying to turn the light on and off and started succeeding. Ditto for opening the medicine cabinet and adjusting the water faucet.
Even leaving aside breastfeeding and elimination communication, it would be nice to see a milestone for "light's up in recognition of the arrival of another familiar caregiver, even when in mama's arms".
It seems ludicrous that my proposed milestones might one day replace the current milestones, and, indeed, they will not. The list probably needs to be pared back a lot (smiles, babbles, walks are still sure things). But because even some of the culture-free milestones have cultural influences on when they are attained (dangerous environments lead people to delay children walking), in an ideal world, the whole idea of milestones would be replaced with a great deal of trust in the on-the-spot caregivers sense of the baby. Alternatively, those who assess babies could make an effort to account for childrearing practicies and how those affect development.
I do not expect this to happen any time soon, if at all, if only because it would make it so much harder for parents to compete.
Copyright 2006 by Rebecca Allen.
Created March 7, 2006 Updated March 8, 2006