Birth to Four Months

In the first months following birth, babies change and grow quickly. Even when babies are born early or with medical concerns, they quickly begin to show the desire to learn about and interact with the world. Newborns learn by seeing, listening, and touching the things that surround them. They begin to communicate their needs and preferences, and they develop a sense of attachment and security through relationships with their caregivers.

An important first step in development for newborns includes organizing their body functions. Their bodies must learn to control systems that were controlled by their mothers during pregnancy, such as breathing, skin color, temperature, and digestion. Overall, it may take weeks and sometimes months for babies to keep body functions steady, especially when they are born early or have medical complications. Parents should note if their baby has several wet diapers a day and at least one dirty diaper. Although it is common for newborns’ breathing patterns to be somewhat irregular at times when sleeping, babies should not have a pause in breathing longer than 10–15 seconds, and their breathing should become increasingly even and effortless in the weeks following birth. Many babies are sensitive to loud sounds, bright lights, or activity, and they may suddenly throw their arms out to the sides when startled. These are normal responses as the baby develops the ability to adjust to new experiences and to being touched, moved, and handled.

Newborns spend much of their first weeks sleeping, though it may take a few weeks to many months to establish regular sleeping patterns. In the first few months, look for newborns to begin sleeping 3–4 hours at a time, especially at night. Babies should increasingly be able to go to sleep on their own when they are sleepy and tune out regularly occurring sounds while sleeping. Eventually, babies learn to wake up without crying. They may wake up when it is time to eat. As they spend more time awake, looking at parent’s faces and listening to voices, infants build the foundation for later learning.

Newborns need some time to become acquainted with their bodies and learn how to smoothly move their limbs. Initially, babies tend to keep their arms and legs tucked into their bodies most of the time and may be more comfortable being swaddled in a blanket. Gradually, babies learn to reach out and touch their own head, body, hands, and arms. They learn to adjust their posture for comfort and snuggle into a caregiver’s body when being held or fed. Babies who are born early, or who spend an extended time in the hospital, may move differently or use body positions that are different from those of babies who were not born early. When babies are awake, caregivers should offer a variety of positions, such as in their caregiver’s arms, on their shoulder, and on the baby’s back, sides, or stomach. This promotes body movement and acquaints babies with different postures.

Interactions with parents and other caregivers are important experiences for young babies. Emerging research suggests that infants as young as two months old are beginning to use their sense of touch and imitation to begin building connections to others. These early interactions between infants and their parents and other caregivers establish a foundation for resiliency and positive social-emotional functioning. Moreover, responsive caregiving is important for brain development. Research suggests that parent-child interactions have a significant impact on how the brain develops and adapts to adversity and trauma. Furthermore, these interactions provide important opportunities to engage in back and forth conversations that significantly impact language development.

Relationship-building experiences like holding, cuddling, and feeding teach babies that they will be protected, cared for, and loved. Listening to voices and looking at faces are also important for the social and emotional development of newborns. Parents can help build skills and trust with their babies simply by looking at them warmly and quietly when they are awake. Babies will begin to follow their parents’ faces with their eyes, later moving their head, and they may copy facial expressions in response to a parent’s voice or smile. Interaction with young babies should be tempered to match the baby’s level of interest and their ability to take in sounds and actions. Some newborns may easily become overwhelmed and need a quiet place to relax.

Eating is a complex skill for newborns to acquire. Learning to attach to the breast or suck from a bottle, while also swallowing and breathing, takes some practice. When babies are fed, all of their senses are stimulated. They not only taste and smell food, they also must handle being moved and interacting with the person who feeds them. Parents can help babies learn to enjoy and anticipate eating by keeping eating times calm and predictable. Parents and caregivers must observe the infant’s behavioral cues that they are hungry or full and respond as quickly and predictably as possible to support infants in developing self-regulation. Babies provide cues to caregivers when they are hungry. Early cues are stirring or stretching with waking, mouth opening and turning their head as if to seek a nipple, or putting hand to mouth. Crying, agitated body movements and turning red are late hunger cues. Newborns often find it difficult to stay awake when eating, but their ability to stay alert will increase as they become used to regular eating and waking times. Young infants will often grasp or explore with their hands while eating. They will begin to anticipate being fed by showing excitement and turning their head toward bottle or breast and opening their mouth. Babies will also often look at their caregiver while eating, and so feeding provides an opportune time for baby and parent to share eye contact and feel close to one another.

A key skill for newborns and infants to develop is the ability to self-sooth or regulate their emotions. Young babies need help from their caregivers to protect them from overstimulation, including loud sounds, bright lights, and too much handling or activity. When babies become overwhelmed, parents should step in and help by removing them to a quiet and soothing atmosphere. As they grow, babies develop strategies to better manage stimulation and soothe themselves, such as sucking on their hand or grasping a blanket. Infants who can calm themselves are better able to manage stress and adapt to new experiences. Parents and caregivers can help infants develop self-soothing skills by observing what causes distress and what techniques or strategies soothe them. Newborns will change and develop quickly given a nurturing environment. Parents and caregivers should consistently respond to infants’ needs and give them close attention. Babies respond positively to environments that are organized and consistent. Caregivers can help babies develop a sense of trust and security by providing consistent routines that help them know what to expect. They can help them feel secure by doing some things the same way each time, such as feeding and changing. Caregivers should notice how a baby reacts to different situations and respond accordingly. Caregivers should talk with a health care provider about any questions or concerns about their child’s development.