The first two years of life are some of the most crucial ones, especially in regards to growth and development. Since we want to make sure your child is doing well in these two areas, we would like to see him often for well check-ups in the first 24 months.
When it comes to growth, we look at weight, length & head circumference. The key thing we assess is steady growth. So, your baby may be 15% for weight (which means out of 100 babies he would be smaller than 85 other babies his age) or 50% (which means he is right in the middle), but both numbers are fine if that is what his percentile usually is at each visit. Now, if your baby was usually in the 50% & now is 15%, there may be a concern that he is not growing well, which is something your doctor may want to look into. Length & head size generally follow the same rules, but notably, head size does not have to correlate with weight & height. For example, you baby may be 50% for weight & length but only 15% for head size, but if he is always around 15%, then that's normal.
Along with evaluating growth, we also look at how your child is developing physically, mentally & socially. Here the key thing we assess is progression. For example, babies start to smile at others after several weeks. From there, we expect to see them gradually progress from laughing to babbling to saying "mamama" to actual words. The same goes for walking. Your child should progress from keeping his head up to rolling over to sitting up to cruising along furniture to standing on his own to walking. One thing to appreciate when looking at developmental milestones is that they occur over a range of time. So, you don't always have to worry if your 12 month old is not walking while your friend's child has been walking since 10 months. Though it can be earlier, walking is a actually a 15 month milestone!
Of course, we see your child for only a snapshot of time every few months while you're with him all day every day, so if you have concerns about his growth or development, please ask your doctor. We want to be partners with you in ensuring your child's well-being.
Written by Tony John, MD, FAAP of Hometown Pediatrics