Few periods of parenting bring as many questions as the first three years.
Is my newborn eating enough? Sleeping too much? Sleeping too little? When should tummy time start? When will they smile, roll over, sit up, crawl or walk? How many words should they be saying? Is it normal that another child the same age is doing something mine is not and vice versa?
And as babies become toddlers, the questions change just as quickly. Is this much separation anxiety normal? Why are tantrums suddenly so intense? Should they be playing with other children yet? Is picky eating just a phase? What should I be watching developmentally at this age?
For new parents, the questions can feel almost constant because development during this period is remarkably fast. A baby can seem entirely different from one month to the next, and just as soon as parents begin to understand one stage, their child moves into another.
That is part of what makes the newborn and toddler years so extraordinary. It is also what can make them overwhelming.
Developmental milestones give families and pediatricians a helpful framework for understanding what is changing and what may come next. But they are not a checklist every child follows on the same schedule. Children develop at different rates, and one skill rarely tells us everything we need to know about how a child is progressing.
What Do We Mean by Development?
When pediatricians talk about development, we are looking at several areas that grow and influence one another throughout infancy and early childhood.
Gross motor development includes larger body movements such as gaining head control, rolling, sitting, crawling, walking, running and climbing.
Fine motor development involves increasingly precise movements of the hands and fingers, from reaching and grasping to feeding with utensils, stacking, scribbling and manipulating small objects.
Language and communication begin well before a child says a first word. Eye contact, facial expressions, cooing, babbling, gestures, pointing, understanding language and eventually speaking are all part of communication development.
Cognitive development includes the ways children explore, remember, solve problems, understand cause and effect and make sense of the world around them.
Social and emotional development includes attachment, interaction with caregivers and other children, emotional expression, play, independence and the gradual development of self-regulation.
A child may make rapid progress in one area while another develops more gradually. That is one reason we look at patterns and progress over time rather than judging development by any single milestone.
Birth to 3 Months: Learning Each Other
In the earliest months, much of family life revolves around feeding, sleeping, diapering and soothing. It can be easy to overlook how much development is happening at the same time.
Your newborn is learning the sound of your voice, studying faces and beginning to focus more effectively on the world around them. Movements that initially appear almost entirely reflexive gradually become more controlled. Head and neck strength improves. Periods of alertness become longer and more interactive.
This is also when parents begin seeing some of the first clearly social behaviors. Babies increasingly make eye contact, respond to familiar voices, begin cooing and, during these first few months, offer that much-anticipated social smile.
Parents often wonder:
➤ When should my baby start smiling at me?
Those little smiles you see in the earliest weeks are often reflexive. Typically at about 6-8 weeks of age, babies begin smiling socially in response to faces, voices and interaction.
➤ How much tummy time should we be doing?
Tummy time can begin early in the first few weeks of life when your baby is awake and supervised. Short, frequent opportunities are often easier than trying to keep an unhappy baby on their tummy for one long session. However, if your baby likes tummy time, there is no such thing as too much as long as they are awake and supervised. Tummy time helps develop the neck, shoulder and upper-body strength needed for later motor skills. Tummy time should take place on a firm surface (the floor/carpet of your home) rather than a softer surface like a cough or a bed.
➤ Should my newborn be on a schedule yet?
In the early weeks, feeding and sleep patterns are still developing. Some predictability gradually emerges, but young newborns generally are not ready for a highly structured schedule.
➤ Am I doing enough to stimulate my baby?
New parents sometimes feel pressure to provide constant enrichment. Your newborn does not need a curriculum. Your face, voice, touch and responsiveness offer an enormous amount of age-appropriate stimulation.
Supporting development
Talk to your baby during feeding and diaper changes. Look at them when they are alert. Read aloud. Sing. Tell them stories about your day. Offer supervised tummy time. Respond when they make a sound and allow space for them to respond again.
These simple back-and-forth exchanges are important. Researchers sometimes call them “serve and return” interactions: a baby looks, vocalizes or gestures, and a responsive caregiver answers. Those repeated interactions help support early language, social development and the developing brain.
3 to 6 Months: Becoming More Engaged
By the middle of the first year, babies often seem to shift from observers to enthusiastic participants.
Their bodies are becoming stronger and more coordinated. Head control improves considerably. Reaching becomes more purposeful. Hands that once seemed to move almost randomly begin grabbing toys, exploring objects and bringing nearly everything within reach toward the mouth.
Many babies begin rolling during this period. They may push up more strongly during tummy time and begin working toward sitting with support.
Communication becomes more social as well. Babies laugh, squeal and experiment with different sounds. They recognize familiar people and may work surprisingly hard to attract and hold your attention.
Parents often wonder:
➤ Should my baby be rolling yet?
There is variation in when babies begin to roll, and some learn one direction well before the other. Infants typically roll between 3 and 6 months of age, but we look not only at whether a baby has achieved a particular skill, but also at strength, symmetry, muscle tone and continued progress.
➤ Why does everything go into their mouth?
Mouthing is an important way babies explore texture, shape and sensation. It is developmentally appropriate, although this growing curiosity also makes keeping choking hazards out of reach increasingly important.
➤ Do I need to practice sitting or standing with my baby?
Babies benefit greatly from opportunities to move freely on a safe surface. Lots of different body positions are the goal. Floor play allows them to strengthen their bodies and practice coordinating movements without needing to rush them into the next position. Once they have consistent head control at about 4 months of age, practicing standing and sitting with them are good core strengthening activities.
➤ Why is my baby suddenly so distracted while feeding?
Their world has become much more interesting. A sound across the room, a sibling walking past or even a nearby light can suddenly compete for attention.
Supporting development
Offer plenty of safe floor time. Place toys within reach and allow your baby to work toward them. Talk back when they vocalize. Read books with simple pictures. Play simple social games.
Repetition is valuable at this age. The same songs, books, faces and little games help babies recognize patterns and anticipate what comes next.
6 to 12 Months: Exploration Takes Off
The second half of the first year brings some of the most visible changes of infancy.
Babies become increasingly skilled at controlling their bodies and manipulating the objects around them. Sitting becomes more stable. Fine motor skills become more precise. Mobility may progress through rolling, scooting, crawling, pulling to stand and eventually moving along furniture.
But babies do not all follow an identical sequence.
Some crawl on hands and knees for months. Others scoot or use another method of getting where they want to go. Some spend relatively little time crawling before progressing toward standing and walking.
Communication is changing just as quickly. Babbling becomes increasingly complex. Babies begin understanding familiar words and routines long before they can verbally respond. Gestures become more meaningful, and many begin waving, reaching and pointing.
Cognitive development becomes easy to see, too. Drop the spoon and someone picks it up. Press the button and a toy responds. Hide an object and go looking for it. Babies are beginning to experiment with cause and effect, memory and problem-solving.
Parents often wonder:
➤ Does my baby have to crawl before walking?
Not every child follows the same pathway to independent walking. We look at a child’s overall motor development rather than treating crawling as a required box to check.
➤ When should my baby respond to their name?
Recognition and responsiveness develop over time. We consider response to name alongside hearing, eye contact, vocalization, gestures and broader social engagement.
➤ My baby isn’t saying words yet. Should I worry?
Communication begins long before recognizable speech. Babbling, gestures, imitation, shared attention and understanding language are all meaningful parts of communication development during the first year.
➤ When should we babyproof?
Earlier than most families think. Babies have a habit of mastering new skills before anyone has quite prepared for them.
As mobility increases, take another look at your child’s environment from floor level.
Supporting development
Give your baby safe opportunities to explore without directing every moment of play. Put an interesting object slightly out of reach. Play peekaboo. Name the things your child is looking at. Respond when they point, babble or try to get your attention.
That back-and-forth matters. Conversation starts long before either participant is using many actual words.
12 to 18 Months: Welcome to Toddlerhood
Around the first birthday, the developmental landscape shifts again.
Your child is becoming more mobile, more communicative and increasingly aware that they are their own person with their own ideas.
Walking tends to receive most of the attention at this age, but there is much more happening.
Toddlers are building receptive language, meaning the words and directions they understand. They communicate more intentionally through combinations of sounds, words, facial expressions and gestures.
Pointing is an especially meaningful developmental skill. A child may point because they want the banana on the counter. But they may also point simply because they spotted an airplane and want you to see it too. That desire to share attention and interest with another person is called “joint attention” and is an important part of social and communication development.
Toddlers also learn by watching and imitating. You may find them pretending to talk on a phone, brushing a stuffed animal’s hair or wiping a table because they have watched you do it.
Parents often wonder:
➤ My child isn’t walking yet. Is that okay?
There is a range in when children begin walking independently. We look at the complete motor picture, including strength, balance, symmetry, pulling to stand and how a child is getting around.
➤ How many words should my toddler have?
Parents understandably focus on word counts, but language development is more than a number. What does your toddler understand? Are they communicating wants and interests? Do they gesture and point? Are new sounds and words emerging?
These details help us understand the broader communication picture.
➤ My toddler understands so much more than they say. Is that normal?
Receptive language, what a child understands, and expressive language, what they can communicate verbally, do not always develop at exactly the same rate. We follow both.
➤ Why has separation suddenly become so difficult?
Separation anxiety is common during infancy and toddlerhood. Your child has developed a strong attachment to familiar caregivers and a greater awareness of when you are there and when you are not. They do not yet have an adult’s understanding that a separation is temporary.
Supporting development
Narrate ordinary life without feeling that every interaction needs to become a lesson: “We’re putting on your shoes.” “There’s the dog.” “You found your cup.”
Read together and let your toddler participate by pointing, turning pages and choosing familiar books. Give simple directions. Provide safe opportunities to walk, climb and carry.
And give them time to try. A little manageable frustration while fitting a shape into a toy or figuring out how to reach something can be an important opportunity for problem-solving.
18 to 24 Months: More Words, More Independence and Much Bigger Feelings
The second year brings remarkable cognitive, language and social growth.
Toddlers understand increasingly complex language and become more effective at communicating their own wants and ideas. Vocabulary can expand quickly, and words begin coming together into short phrases.
At the same time, toddlers are discovering independence.
The catch is that the desire to be independent develops much faster than patience, impulse control, language and emotional regulation.
A 2-year-old can know exactly what they want while having very few tools for coping when the answer is no, the banana breaks in half or the blue cup is somehow the wrong blue cup.
That developmental mismatch explains a great deal about toddlerhood.
Parents often wonder:
➤ Are all these tantrums normal?
Tantrums are common during this stage. Toddlers are still developing the ability to manage frustration and other strong emotions. Hunger, fatigue, overstimulation, transitions and difficulty communicating can all make them more likely.
➤ Why does my toddler say no to everything?
Discovering that you are a separate person with preferences is powerful. Testing limits and asserting autonomy are part of development. Toddlers still need calm, predictable boundaries, but wanting some control is entirely understandable at this age.
➤ Should my toddler be talking more?
Language often progresses substantially during the second year, but children do not all acquire words at the same pace. We consider vocabulary along with understanding, gestures, social interaction, speech sounds and continued progress.
If speech or language development is concerning you, bring it up with your child’s pediatrician. You do not need to wait until a particular birthday to ask.
➤ Should my toddler be playing with other children yet?
Toddlers may be very interested in peers but still spend a great deal of time in parallel play, playing near another child rather than organizing a truly cooperative game together. Interactive play develops gradually.
Supporting development
Keep reading and talking. Expand on your toddler’s language. If they say “dog,” you might answer, “Yes, that’s a big brown dog.”
Offer limited choices when either answer is acceptable: the red shirt or the blue one, banana or yogurt.
Predictable routines can also help toddlers manage transitions. And during a meltdown, remember that a highly upset toddler is not in a particularly receptive state for a lengthy explanation. Calm boundaries and simple language are generally much more useful.
Ages 2 to 3: Language, Imagination and a Growing Sense of Self
Between ages 2 and 3, children often seem to become more recognizably themselves.
Vocabulary expands. Sentences grow. Conversations become more reciprocal. Questions arrive in abundance.
Children begin talking not only because they need something, but because they want to tell you what they saw, what happened or what they are imagining.
Pretend play also becomes increasingly sophisticated. A block becomes a phone. A stuffed animal needs a checkup. A cardboard box becomes a boat.
This type of play is doing important developmental work. Children use it to practice language, relationships, problem-solving and emotional skills.
Physical development continues as well. Running becomes more coordinated. Children climb, jump, throw, scribble and participate more independently in dressing, eating and household routines.
And you may hear some version of “I do it myself” many, many times.
Parents often wonder:
➤ How much of my toddler’s speech should I understand?
Speech clarity develops gradually. Parents and familiar caregivers often understand a toddler before unfamiliar listeners do. We pay attention both to the amount of language a child is using and to how speech clarity is progressing over time.
➤ Why does my toddler insist on doing everything independently?
Because independence is one of the major developmental projects of toddlerhood. When it is safe and practical, allowing children to attempt age-appropriate tasks supports confidence, problem-solving and self-help skills.
➤ Is pretend play really important?
Yes. Pretend play is a meaningful part of cognitive and social development and creates natural opportunities to practice language, imagination and interaction.
➤ Why is my toddler suddenly afraid of things that never bothered them before?
As imagination develops, children can begin thinking about possibilities they were not capable of imagining as babies. New fears can emerge along with this growing awareness.
Supporting development
Give your child meaningful opportunities to participate in everyday family life. They can carry something light, place clothes in a hamper, help put toys away, use a spoon, attempt parts of dressing or help with another simple household task.
Continue reading together. Talk about the pictures and ask simple questions. Encourage pretend play without feeling the need to direct the story.
And make room for conversation. Your toddler is learning not only from the words you use, but from taking turns, being listened to and discovering that what they communicate has meaning.
What Your Pediatrician Is Watching Along the Way
Parents understandably remember development through its big firsts: the first smile, first roll, first word and first step.
At well-child visits, we are looking more broadly.
We consider development across gross motor, fine motor, communication, cognitive, social and emotional skills. We want to know what your child is doing now, what new skills are beginning to emerge and whether development continues to move forward.
Developmental surveillance is part of routine well-child care. Your pediatrician will typically ask developmental questions during the checkup to get a sense of how your child is progressing. If you have concerns or questions, ask them!
The American Academy of Pediatrics recommends formal developmental screening along with autism-specific screening at 18 and 24-30 months. Screening may also be appropriate at any age when a parent, caregiver or pediatrician has a concern.
A developmental screening is not a diagnosis. It is one tool that helps us identify children who may benefit from closer evaluation or additional support.
And your observations matter. Pediatricians see children at intervals. You see your child every day.
When to Bring Us a Concern
Development naturally comes with questions, and your child’s well visits are a good time to talk through what you are noticing. If something concerns you about the way your child moves, communicates, responds to sounds, plays, interacts with others or continues to gain skills, bring it up.
You do not need to know whether what you are seeing represents a developmental delay. Sometimes the answer is reassurance and continued observation. Other times, it may make sense to look more closely or consider additional support.
A loss of a skill your child previously had is always important to discuss with your pediatrician.
Depending on the concern, next steps might include a hearing evaluation, speech and language evaluation, physical or occupational therapy, developmental assessment or referral to an early-intervention program.
When additional support is needed, identifying it early can give children access to services during an especially important period of growth and development.
Supporting Development at Home
Healthy development is supported in many of the ordinary moments that make up a child’s day.
Talking during a diaper change, reading a familiar book, singing a favorite song, going for a walk, offering safe opportunities to move and explore, or giving a toddler time to try something independently all contribute to learning and development.
These everyday interactions help build language, motor skills, problem-solving, confidence and connection. They also give parents countless opportunities to notice new skills as they emerge.
There is no single activity, toy or routine that determines how a child will develop. What matters most is ongoing interaction, opportunities to explore and a responsive relationship with the adults caring for them.
And when questions come up, bring them with you. Development changes quickly during these first three years, and pediatric visits are an important opportunity to talk through what you are seeing, what may be coming next and anything that is causing concern.
Trusted Resources for the Newborn and Toddler Years
When questions come up between visits, reliable information matters. These are good places to begin:
HealthyChildren.org: Ages & Stages
Published by the American Academy of Pediatrics, this extensive resource covers infancy and toddlerhood as well as feeding, sleep, behavior, safety and other common questions throughout childhood.
HealthyChildren.org: Milestones Matter
An overview of developmental milestones, developmental screening and when to discuss a concern with your child’s pediatrician.
HealthyChildren.org: Language Development in 2-Year-Olds
Helpful information for families trying to understand the rapid changes in receptive and expressive language during toddlerhood.
Center on the Developing Child at Harvard University: Serve and Return
A useful explanation of the science behind the simple back-and-forth interactions between young children and their caregivers that support early brain, language and social development.
ZERO TO THREE: Resources for Families
Practical, research-informed resources on development, behavior, play, relationships and parenting from birth through age 3.
Infant & Toddler Connection of Virginia
Virginia’s early-intervention program for infants and toddlers from birth through age 3 who have developmental delays or disabilities or a condition that may affect development.
More from South Riding Pediatrics and Farrell Pediatrics
Caring for Your Newborn: An A to Z Guide
Our practical guide to feeding, attachment, crying, sleep, tummy time, pediatric visits and many of the questions that arise during the newborn period.
An Overview of Newborn Safety
Guidance for families on creating a safe environment for a new baby, including sleep, car safety and other important considerations.
And remember that your pediatrician is one of your most valuable developmental resources. Well visits give us the opportunity to follow your child over time, answer the questions that come with each new stage and help you understand your child’s individual development.
