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  • Writer's pictureDr. Kristen Mitteness

Why Milestones Matter (and my favorite ways to get there)

The CDC changed their milestone guidelines in 2022. This caused quite an uproar among many, especially the elimination of crawling, but regardless, there are reasons babies do certain things in certain orders: it wires the brain for functional development. Given ample opportunity to properly develop, children grow to be well adjusted and functional adults. Certain milestones will help integrate their pediatric reflexes, which were originally required for birth and early survival and others will help develop new reflexes and movements. These skills "stack" on each other. The old idiom, you have to walk before you can run, holds true. You can't beat nature. While this isn't an exhaustive list of milestones and activities, and some kiddos will meet them a bit earlier or later than I have listed, it's worth going through each of them to reach the next stage. And there are many things caregivers can do to foster this development. These little ones are fully reliant on adults at first! Remember, they are the future. It's worth the time and effort to ensure they develop fully and properly. The more effort you front load with your littles, the less you will need to do in the future (it comes fast!).

Things to do throughout the first year:

  • Respond to your baby's cues. Babies aren't manipulative and you can't spoil a baby. If baby is crying, attention is needed. Even if it's a quick "I'll be there in a second!" You aren't responsible for stopping your baby from crying, you are simply responsible to ensuring they are being responded to. Baby is learning to communicate and crying is the first way they know how.

  • Get outside. Nature is so healing and great for sensory development, even for babies. It allows their eyes to see beyond the distance in the house which is important for vision development. It exposes them to different sounds, smells, textures and temperatures in just the right amount. Fresh air is good for anyone and everyone. It can help regulate circadian rhythm. It can help make sleeping at night easier. It's amazing what getting outside can do for a fussy baby. Find appropriate outdoor gear and get outside! This blog post has lots of fun ideas. More time outside may even help integrate reflexes more efficiently and help your baby reach their milestones. You can't beat nature. Balanced and Barefoot by Angela Hanscome does a wonderful job of explaining the benefits of outdoors on children, even before the age of 1.

  • Unrestricted floor time. Babies need freedom to move around as much as possible in order to develop their mobility skills. This doesn't mean you just lay them on the ground and can just leave them (although sometimes you can). You get on the floor with them. Prop them up, if they need it, play with toys. On their bellies, backs and sides at first, until they are able to sit up and stand up. I know it's easier to strap a baby into a seat, rocker or stroller, but it restricts their movement and slows down their progressions. Please, please, please try to limit restricted movement (car seats, high chairs, swaddles, anything with straps really, or things you put them in to hold them in positions they cannot hold themselves) to two hours or less a day. I know there will be days you are in the car longer than that, but if you can average less than two hours in these containers, the better off your babe will be.

  • Skin to skin, tummy to tummy time. Does it feel like your baby wants to be constantly held? That's okay and totally normal! The more we resist it, the more they will want it. Your baby only knows you and is learning the world. Having your comfort is what they need to learn independence. It won't always be like this! But giving a baby quality time and comfort early on can foster healthy attachment in the future. A good carrier makes this much easier.

  • Read out loud. Read books, signs, labels, anything! The more we talk and read to our babies, they more language they are exposed to. This is great for vocabulary development and encourages interaction with your baby, especially when you don't know what else to do? It doesn't matter if they seem to be paying attention or not. Exposing children to books and spoken word is excellent for brain development.

  • New people, places and things. As much as you are comfortable with, expose your little one to new people, places and things. This will also stimulate their senses and activate their brain in ways you simply can't by living groundhog day at home. Hopefully you are at places where there are extra hands to help and it may give you, not only another person to talk to, but someone else to share your baby with! This is especially helpful when they are crawling or running around every where. And may even help improve sleep. These don't have to be "baby appropriate" places. Live your life with your baby - groceries, post office, friend's house, etc.

0-3 months

  • Starts smiling - it's really hard to not smile at a baby. Exposure to facial expressions will help them learn to smile, too. Laughing isn't too far behind!

  • Watches you and follows objects - hold black, white and/or red objects or cards within 2 feet of baby's face and slowly move them so they can track them. Baby's eyes might not look like they're working together yet, but this will get better the more you do it. Toys with sounds can also be fun!

  • Moves arms and legs - Freely moving arms and legs is the first step in baby building their core muscles which will be required for absolutely every movement in their future. You can move their arms and feet around, too, so they learn and feel the movement. Bringing the opposite hand to the opposite foot (right hand to left foot and left hand to right foot) helps to begin signalling to their brain the cross crawl movement required for crawling.

  • Pull to sit - Using baby's grip reflex to your (and her) advantage by having her hold your index fingers or thumb (you can hold onto her for extra support) and gently pull from laying down into a seated position and back. Baby's are capable of way more than we give them credit for! Babies need to strengthen their neck and core muscles to be able to do all other movements (and life - we can learn from them as adults!).

3-6 months

  • Babbling - by now, your little one should start making sounds.

  • Bringing hands to mouth - A lot of the milestones from 3-6 months are getting baby ready to eat. This is a skill they will eventually be able to do on their own and the more practice they get the better! As they start putting things into their mouths, they are slowly moving their gag reflex back which will enable them to eventually swallow food efficiently.

  • Rolls from back to belly - I am more concerned about a baby being able to roll from their back to their belly, then from their belly to their back. A human is vulnerable if they can't roll from their back. From their belly, we typically start to push up to stand, so rolling from tummy to back, I'm less concerned about. Help them to practice rolling by gently turning their hips and guiding them with toys. Notice if they only roll to one side and help them practice rolling to the other so they can equally use their muscles. It's not uncommon for them to favor one side.

  • Pushes onto all fours, plank and precrawling - The more free floor time baby gets, the more inclined he'll be to start exploring. This means he'll push up into his hands and start extending arms, eventually push onto toes and knees and even start inch worming or precrawling. Precrawling may include moving in circles or backwards. This is all normal. He'll even eventually push himself up to a seated position - this is more important that placing him into seated position. Have the ability to get in and out of a seat will often go hand in hand with crawling.

  • Pull to hang - Once baby masters pulling to sit, you can move onto pulling to hang. Babies who are ready for this, love this! It helps to develop their rib cage and diaphragm, improving breathing and lung capacity. It also helps strengthen their shoulders and upper body helping to prevent future injuries. This also improve their future ability to pull to stand on their own and catch themselves when they lose balance.

6-9 months

  • Crawling - With lots of floor time, crawling will come naturally to your little one. They want to go get things and be mobile, they simply need the time and space to get there. Two great ways to get babies moving their limbs while on their belly is to place them tummy down on an exercise ball and to roll them a bit and getting in a pool. They often naturally want to doggy paddle when they are tummy down in the pool. Use these to your advantage and get baby ready to crawl!

  • Pulling to stand and furniture walking - Being able to stand means baby can see much more of the world. This is another reason she loves being carried by you - the view! Don't feel obligated to place baby in a standing position. Let her lead the way. She'll get there! She needs the upper bodt strength to pull up and catch herself when she falls - if we put baby into a standing position before she is ready, she is a more risk of injury. Just another good reason to practice hanging and giving her lots of floor time freedom.

  • Passes things between hands - This skill is much more practical than you may realize. We pass things between our hands all day long. It also means both sides of our body are communicating well with each other. When baby has something in his hand, give him another toy and see what he does! He'll eventually figure out how to hold two things at the same time by moving things between his hands.

  • Responds to name - Chances are, you naturally use your child's name all of the time. If not, start saying it! It took me a while to stop calling my daughter, baby, and actually using her name. By now, if hearing is normal, she should be responding to her name.

  • Makes varying sounds - Screaming, babbling, screeching, blowing raspberries, sticking a tongue out - the more sounds and mouth movements baby is exposed to, the more he will do! This is also a fun way to get baby out of a whiney state - new and weird noises are distracting. I use this one to make diaper changes less of a wresting match.

  • Can get into and out of a seated position - All of that core strength is required to move in and out of a seated position. Just another awesome skill baby learns as long as she is given lots of floor time and freedom.


9-12 months

  • Waves hello or bye - You have been probably waving hello and goodbye to your little one for a while now, especially in the mirror (they love mirrors!). This is a new way for them to use their limbs in a purposeful way. The motion will continue to become more precise and lead to more intentional uses of their arms, hands and fingers.

  • Intentionally uses names - Whether it's mom, dad, the family pet, milk or food, this is often the time when babies start to talk and use names or sounds for specific things. Reading a variety of books, especially ones with lots of differnet sounds (we love Mr. Brown Can Moo, Can You? And Moo, Baa, La La La) will continue to expose them to words and sounds. There is a wide range of "normal" when it comes to talking. Late Talking Children by Thomas Sowell really opened my eyes to this.

  • Uses pincer grasp - You may notice this one when he is eating or when he's trying to eat something in the yard. Fine motor skills are coming and this one is very helpful for every day life. Just watch out for those choking hazards!

  • Prewalking - Bear crawling, furniture walking, independently standing and pushing toys all lead to the next step - walking! Don't feel like you have to encourage walking. Children who have all of the prewalking skills will eventually get there. And spending extended time crawling does great things for brain development.


With the right exposures and stimuli, children will develop at the pace that is right for them. The more opportunities we give them to move, grow and learn, the more they will take advantage of these opportunities. If you're unsure, feel free to reach out to a well trained chiropractor, physio, PT or OT with questions. Or even ask other parents! We have much to learn from other families - living in silos has really removed us from understanding what's "normal" when it comes to child development. Also, trust your gut - as a parent, you know what's right and what's not for your little one. Don't hesiate for second, third and fourth opinions. And also, trust your child. They function on instinct. You've got this!

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