Newborn
Reflexes: Moro (startle, symmetric extension and flexion), rooting (turns to touch on cheek), sucking, palmar grasp, Babinski (upgoing toes), stepping. Primitive reflexes disappear by 4-6 months (except Babinski, up to 2 years). Newborn assessment: Apgar (heart rate, respiratory effort, muscle tone, reflex irritability, color), weight (6-10 lbs), length (18-22 inches), head circumference (13-14 inches). Fontanelles: anterior (closes 12-18 months), posterior (closes 2-3 months).
Infant Milestones
1 month: lifts head briefly, responds to sound, fixes on face. 2 months: coos, social smile, tracks objects. 4 months: rolls front to back, grasps objects, laughs. 6 months: sits with support, babbles, transfers objects. 9 months: sits without support, crawls, pincer grasp, stranger anxiety. 12 months: pulls to stand, may take first steps, says 1-3 words, waves bye. Red flags: no social smile by 2 months, no babbling by 6 months, no sitting by 9 months, no words by 12 months — refer for evaluation.
Parent Education
Feeding: breast or formula, introduce solids at 4-6 months, avoid honey <12 months (botulism), choking hazards (grapes, nuts, hot dogs). Sleep: back to sleep (SIDS prevention), firm mattress, no blankets/pillows/bumpers, room sharing (not bed sharing). Safety: car seat (rear-facing until 2), choking, fall prevention, baby-proofing (crawling), water safety. Immunizations: per schedule. Development: tummy time (prevent flat head, promote motor skills), reading, talking, singing. Bonding: respond to cries, skin-to-skin, consistent caregivers. Report: parental concerns, missed milestones, developmental regression.
Important Notes
- Back to sleep: place babies on their back to reduce SIDS risk — avoid blankets, pillows, bumpers, and prone positioning.
- No honey before 12 months — risk of infant botulism.
- Rear-facing car seat until age 2 — protects the developing neck and spine in a crash.
Clinical Tips
- Tummy time while awake prevents flat head (plagiocephaly) and promotes motor development — start from birth, increase gradually.
- Introduce solids at 4-6 months, one at a time, watch for allergies — avoid honey <12 months, choking hazards always.
- Primitive reflexes should disappear by 4-6 months — persistence suggests neurological dysfunction.
Summary
Newborn and infant development requires assessing reflexes, tracking milestones (social smile 2mo, sitting 9mo, first steps 12mo), and educating parents on feeding, sleep (back to sleep), safety, and immunizations.
