Paediatrician's job is to monitor our growth as children.

As a medical student of pediatrics, I recently had the chance to read my mother's personal notes on my and my brother's developments – a book she called "Baby Milestones," where she recorded every detail, measurement, weight and health issues.

When a child grows up and reads his mother’s notes, it creates a lovely bond between parent and child, therefore, I've developed this guide to encourage new mothers to keep a record their observations.

This is a list of the major events that mother might follow to monitor their babies’ development.

When to worry
Most of the time, children who are slow to develop in one area catch up. But sometimes late milestones can signal a problem. The warning signs are
* If your child is delayed in more than one area.
* The delay is two months or more from the norm.

You know your child best, so you're likely to spot any problems - or potential problems - early. Follow your instincts. If you're worried, bring it up with your child's doctor. Look for your child to be walking by 18 months and trying to pull himself up to stand or cruising several months before then. By 12 to 15 months, your toddler should be able to communicate his basic wants and needs, even if he's not speaking actual words yet. For instance, he may grab your hand, pull you to the fridge, and point to the juice. By 15 months he should be able to speak at least a few simple words ("Mama," "Dada," and "up," perhaps), and by his second birthday he should be able to put two words together into a simple phrase or sentence ("Mama go.")

Often vision and hearing problems are hard to spot unless you're a professional, so eye and ear check-ups should be part of every development check.
Some infants are at a high risk for developmental disorders and their development should be monitored more closely. This includes babies with birth defects, genetic disorders (some are identified prenatally), metabolic abnormalities, and neurological problems (such as seizures or feeding problems).

If a delay in a child’s development is suspected, it is important to resist the temptation to wait and see. Early diagnosis and intervention are very important in improving the long-term outcomes for developmental disorders of all types.

• At birth:
Weight: Between 2.5–4.5 kg
Height: Between 45-52 cm
Head circumference: Averagely 35 cm

• By one month:
* Make jerky arm movements
* Bring hands near face
* Keep hands in tight fists
* Move head from side to side while lying on stomach
* Focus on moving objects 8 to 12 inches away
* Prefer human faces over other shapes
* Respond to high sounds by crying or closing their eyes
* Sleep for 19 to 20 hours/day
* Recognize sounds including parents' voices
* Look at their mothers when they speak

* By two months:
* Raise head and chin above the bed while lying on stomach
* Raise head up for a bit when being held upright
* Open and shut hands
* Vocalise sounds (gurgling and cooing)
* Smile

• By three months:
* Support upper body with arms when lying on stomach
* Kick vigorously and try to turn over
* Hold head steady while sitting down (Important)
* Grab and shake hand toys
* Begin to babble and to imitate some sounds (all produce same sounds whatever the nationality)
* Turn head away while having their nose cleaned
* Bring hands to mouth
* Turn head towards sounds
* Follow moving objects with eyes at 180 degree angle
* Enjoy playing with other people
* Recognize mother’s face and scent

• By five months:
* Push up using their arms and arch their back to lift up the chest
* Roll over (stomach to back)
* Laugh
* Reach for objects
* Distinguish between bold colours
* Sleep 16 to 18 hours/day
* Show an interest in mirror images
* Amuse themselves by playing with hands and feet
* Hug Mum and Dad

• By seven months
* Roll over both ways (stomach to back and back to stomach)
* Sit with support
* Support whole weight on legs when held upright
* Transfer objects from hand to hand
* Combines syllables into word like sounds (Ba,Ba-Da,Da)
* Eat crackers on his own
* Enjoy playing peek-a-boo
* Distinguish emotions by tone of voice
* Cough to seek attention
* Develop full-colour vision and mature distance vision

• By nine months:
* Crawl or scoot on their bottoms
* Sit without assistance
* Stand while holding something
* Respond to sound of own name
* Use pincer grasp (thumb and forefinger)
* Put hands on their face to avoid having it washed

• By one year:
* Pull self up to stand
* Stand alone for a couple of seconds, may take a few steps alone
* Say one or more words
* Respond to “no” and simple verbal requests
* Imitate sounds and motions
* Use simple gestures, such as shaking head “no” and waving bye-bye
* Help in dressing self (hands in sleeves, etc.)
* Play ball
* Begin to use objects correctly (drinking from cup, brushing hair)
* Find hidden objects
* Sleep for 13 to 15 hours/day
* Develop Separation anxiety (when parents leave a babies’ sight) and stranger anxiety (reaction of distress when an infant encounters a stranger.
* Easily find hidden objects

Sarah Rikabi is a 5th year Medical student at the University of Damascus

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