As pediatric nurses and private baby nurses, we spend a lot of time focused on milestones. Yes, meeting milestones is a crucial way to measure development, but is it that important? Is it the only thing we should be worried about? Does every baby and child develop at the exact same rate?
The simple answer to these questions is no.
Just as much time we spend assessing current milestones met, we also spend counseling a worried parent on an unmet milestone. We try to explain to parents that experts have determined these milestones as ways to assess when a child might be off. These milestones are set in place to help us identify potential issues, not for definitive diagnoses.
“Developmental milestones are intended to be guidelines interpreted with the understanding that kids develop at variable rates”, says Damon Korb, MD, developmental and behavioral pediatrician, author of Raising an Organized Child, and director and founder of The Center of Developing Minds. "They don't predict what will happen later," he says. "They're just an indicator of where we're at now, and that we're moving through the stages and aren't stuck."
Just when we think we have reassured an anxious parent, one of their parent friends will give their opinion about milestones being related to parenting and the anxiety cycle starts all over again! While parenting and activities can help develop children faster, most times it has nothing to do with parents. We have seen neglected babies in the hospital soar past every developmental milestone, and we have seen great parents struggle with their child’s milestones. We see siblings with the same parents develop at vastly different rates. It is variable.
Late development doesn’t always mean there will be issues later in life, either. I was walking at eight months! I was walking laps around my cousin. Who ended up being the athlete? My cousin! When you hear that a child is "supposed to" take their first steps by a year old, what that milestone really says is: This is the age by which most children take steps. In reality, variation ranges anywhere from about 8 to 18 months.
"In my practice, I get a lot of referrals for evaluating a child's development, and I see such high levels of anxiety among parents," says Mona Delahooke, PhD, child psychologist and author of Beyond Behaviors: Using Brain Science and Compassion to Change Children's Behavioral Challenges. "When you get feedback that your child is delayed in hitting a milestone or is missing a milestone, it can be so anxiety-provoking, but it's really needless because a child's development is always changing."
Milestones aren’t always linear, either. We have many babies who begin walking at nine months, then seemingly forget at ten months, then pick it back up at twelve months. This understandably worries a parent who is focused on milestone markers. This is okay, and this can be normal.
The great variability in milestone development has led many experts in the field to want a change in terminology. Many physicians and experts are wanting to start saying “journey” or “process”. We are on board for this change!
Our point to all of this is: be easy on yourself. You are a good parent. You want what is best for your child. You are going to help your child live their best life. Breathe! Your pediatrician will help you closely monitor your baby’s milestones. If your baby requires intervention on a slow milestone development, it does not mean you are a bad parent. Take it from a pediatric nurse!
We hope this helps relax some anxieties about milestones. As always- like, comment, and share!
Jeri Ford, RN, BSN, CPN
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