Updated baby milestones and your role in spreading the news

Did you hear? New Developmental Milestone Guidelines for babies and children 2 months to 5 years are out. Since the American Academy of Pediatrics (AAP) introduced them in 2004, it has not updated the milestone checklist. So, yes, an update was overdue.

What even is a developmental milestone? Basically, it is something that most babies can do by a certain age. They show if a baby is developing as expected. 

The new updates are designed to help parents, caregivers, and doctors identify autism and developmental delays/disorders so families can get the support they need earlier. The sooner the intervention and support begin, the better. 

Hopefully, these updates will offer some peace of mind to families and help them feel confident about their baby's development. The new milestone guidelines have removed vague language such as 'may,' 'can,' 'should, 'begins,' which will likely reduce parental/caregiver confusion and increase discussions with their doctors and nurses.

The Center for Disease Control and Prevention (CDC) has a resource-laden website  with free materials for families and those who serve them. They also have an app that's easy to download and allows caregivers to track their baby's milestones, capture notes of concern or questions and then email to themselves or their doctor/nurse. The Tracker app seems designed to encourage caregiver/doctor communication. The app moves seamlessly from English and Spanish, which should help to reduce misunderstanding. Ideally, more languages will come soon. It's a start, at least. There are printable resources in other languages on the website.

I highly encourage you to explore the website. 

The new guidelines now align with the recommended well-child visits that occur from 2 months to 5 years. If you need a refresher, that's two months, four months, six months, nine months, one year, fifteen months, eighteen months, two years, thirty months, then again at three, four, and five years old. 

The milestones are divided into a few main domains. 

Social/Emotional - how babies interact with others and show emotion
Language/Communication - how babies express their needs, their thoughts, and that they understand you.
Cognitive - how the baby learns, thinks, problem-solves
Movement/ Physical Development - how babies move their bodies. Maybe the most well-known.
And, of course, some milestones overlap domains.

Why does this matter to you? You're a babywearing educator and consultant and not a doctor after all. 

If you're in contact with new caregivers, then you are in an ideal place to alert them to the resources, including the app, that are available for free. You will draw their attention to how babywearing can help them monitor their child's development and identify potential delays. 

Do you think it's rare for a child to have a developmental problem? The CDC estimates that 1 in 6 children in the USA has a developmental disability.1 The long-term risks of missing early developmental disorders are high - children are at increased risk for poor school performance and health problems. However, about half the children's delays are not caught until school-age, and a window of opportunity has been missed.2 Early treatment is essential to reducing the long-term impact on the child and their family. 

You probably discuss how the major milestones are assisted by babywearing, and these new updates mean you will have more precise and less vague guidance. To give you an example - let's say you're meeting with a family whose baby is three months old to help with their baby carrier. 

Now, let's say you know the expected milestones for a four-month old baby. As you are working with the pair, you can point out what you see: 

"Oh, I love how your baby smilies to get your attention!"  

Perhaps they're not doing that yet. It might be a tad early, right? The baby is only three months old. 

Maybe you notice the baby turns its head toward its caregiver, or the baby finds its hand super fascinating. You see the baby reach their arm towards a toy. 

Once you see a milestone, you could mention it - you're not a doctor and should never 'diagnose' a baby, of course (unless you are a doctor) - then ask, "Are you using a milestone tracker?" You are planting seeds by the simple act of asking if they do and mentioning a milestone. Even if you are the 100th person to ask them if they track their baby's milestones, likely no one else can frame their baby's milestones as they relate to babywearing. 

How might you do that specifically? Ok, let's dig into that more. The CDC has a list of tips and activities for parents and caregivers. I will choose a few from there. (LINK) I will use the first one; "Talk, read, and sing to your baby. This will help them learn to speak and understand words later." ³

"When you use a baby carrier, it is easy to talk and sing to your baby while you go about your day!" 

Singing can be done softly and used to share a private moment between baby and caregiver. The baby can hear the voice resonate in the chest of their caregiver and hear the nuances of the song. Parents can narrate their actions and name things for babies as they move about their day. 

You can read to a baby while wearing too; however, some things are easier if the baby is sitting in your lap, and reading is perfect for that. 

Another tip from the CDC: "Let your baby have time to move and interact with people and objects throughout the day. Try not to keep your baby in swings, strollers, or bouncy seats for too long." ⁴ 

The baby carrier gives the caregiver a lot of freedom to move themselves and the baby throughout the day. The baby is closer to eye contact with other people, and many objects are easy to pick up to let the baby explore as the caregiver narrates and names what is happening. I find many caregivers do this instinctually. It's a beautiful way to move through life. 

I could keep going, but hopefully, you see how easy it could be to begin mentioning the updated milestones and the tracker app while sharing how babywearing can be an essential part of meeting those goals. Ideally, you will also take the time now to learn about the early intervention programs in your area or take a moment to check that your resource sheet is up to date. Plus, spend some time exploring the new guidance.

References
1. Boyle CA, Boulet S, Schieve LA, et al. Trends in the prevalence of developmental disabilities in U.S. children, 1997-2008. Pediatrics 2011; 127: 1034-42.
 2. Dawson, G. (2008). Early behavioral intervention, brain plasticity, and the prevention of autism spectrum disorder. Developmental Psychopathology, 20, 775-803. 
3, 4. https://www.cdc.gov/ncbddd/actearly/milestones/milestones-4mo.html#tips

Links
AAP announcement
https://publications.aap.org/pediatrics/article-abstract/doi/10.1542/peds.2021-052138/184748/Evidence-Informed-Milestones-for-Developmental?redirectedFrom=fulltext

CDC Material and Website
https://www.cdc.gov/ncbddd/actearly/index.html