Developmental Milestones from 1 Month to 6 Years for Newborn Health Records
Based on American Academy of Pediatrics guidelines, the following developmental milestones should be included in newborn health record books to guide parents in monitoring their child's development 1.
Motor Development Milestones
2 Months
Gross Motor:
- Lifts head and chest when lying on stomach (prone position)
4 Months
Gross Motor:
- Rolls over from stomach to back (prone to supine)
- Supports weight on elbows and wrists when on stomach
Fine Motor:
- Hands are open (unfisted)
- Plays with fingers at midline
- Grasps objects
6 Months
Standardized developmental screening recommended at this visit 1
9 Months
Gross Motor:
- Rolls over from back to stomach (supine to prone)
- Sits without support
- Pulls to standing position
- Comes to sitting from lying down
- Crawls
Fine Motor:
- Reaches for cubes and transfers objects between hands
- Rakes small objects with 4 fingers
- Picks up small objects with 3 fingers
12 Months (1 Year)
Gross Motor:
- Walks independently
- Stands without support
Fine Motor:
- Puts 1 block in a cup
- Bangs 2 objects together
- Picks up small objects with 2-finger pincer grasp (thumb and index finger)
15 Months
Standardized developmental screening recommended at this visit 1
18 Months
Gross Motor:
- Walks backward
- Runs
- Walks up steps with hand held
Fine Motor:
- Scribbles in imitation, then spontaneously
- Dumps small objects from bottle (first with demonstration, then spontaneously)
- Builds tower of 2 cubes
- Puts 10 blocks in a cup
2 Years
Gross Motor:
- Rides on toy without pedals
- Jumps up
Fine Motor:
- Builds tower with 3 blocks
- Builds horizontal train with 3 blocks
2.5 Years
Gross Motor:
- Begins to walk up steps alternating feet
Fine Motor:
- Imitates horizontal and vertical lines
- Builds a train with a chimney using 4 blocks
3 Years
Gross Motor:
- Pedals tricycle
- Climbs on and off furniture
Fine Motor:
- Copies a circle drawing
- Draws a person with head and one other body part
- Builds a bridge with 3 blocks
4 Years
Gross Motor:
- Climbs stairs without support
- Skips on 1 foot
Fine Motor:
- Draws a person with 6 body parts
- Copies a simple cross
- Buttons medium-sized buttons
5-6 Years
Development Focus:
- Early elementary school skills emerge
- Fine motor skills for handwriting develop
- Communication abilities that promote peer group participation
- Feeding abilities mature 1
Critical Guidance for Parents
Important Notes to Include:
- These milestones represent the mean age when most children achieve these skills 1
- Marked delay beyond these ages warrants medical attention but does not necessarily indicate a neuromotor disease 1
- For premature infants (born before 36 weeks), correct for prematurity for at least the first 24 months when assessing milestones 1
Red Flags to Watch For:
- Loss of previously acquired skills (suggests possible progressive disorder) 1
- Development of hand preference before 18 months 1
- Asymmetric motor development (using one side more than the other) 1
- Rolling from back to stomach before stomach to back 1
When to Seek Evaluation: The AAP recommends formal developmental screening at 9,18, and 30 months using standardized tools, in addition to continuous surveillance at all well-child visits 1, 2. Parents should discuss any concerns about their child's development with their healthcare provider immediately rather than waiting for the next scheduled visit.