Rethinking milestones—when to relax and when to talk to your pediatrician

Post from Rachel Coley, pediatric occupational therapist with Lovevery and mother of three.

You know the feeling.

The brick in your gut when a fellow parent beams that her 5-month-old is sitting independently, just as you catch your wobbly 7-month-old before they topple over.

Your throat tightening when you see a video of your best friend’s toddler taking their first steps when your same-aged child is just beginning to crawl.

We can’t help but compare our children’s milestones, but is it meaningful? Should we worry if our kids aren’t exactly by-the-book in their milestones? Hands down, the most common question I receive from parents is, “My child isn’t ____ yet, should I be worried?” I also hear from many twin parents who struggle with comparing the different developmental paces of their two.  

Here are some thoughts to consider if you find yourself battling worries over your toddler’s milestones or suffering the effects of child comparisons:

Is my child making progress?

Most new parents have only the big benchmarks of gross motor milestones—rolling, sitting, crawling, and walking—to use as measures of their child’s progress. As a child development professional, I’ve seen firsthand how helpful it is to share with parents some of the more subtle developmental stepping stones that lead up to those big “WOW” moments. 

By recognizing these “baby steps,” you can find reassurance that your little one is indeed making progress, even if it’s at their own rate. And you’ll know what to look for next. When I recommend that a family seek a developmental evaluation for their child, it is most often because these building blocks aren’t being mastered and there is little progress toward the major milestones.

Who am I comparing my child to?

It’s nearly impossible to avoid the tendency to compare when you meet other toddlers and the inevitable “how old is your child?” question comes up. My professional advice: comparing your toddler this month to your toddler last month (and the months before that) is far more valuable than comparing them to your friend’s toddler. In other words, try to measure your child’s progress against their own development, rather than someone else’s.

We can easily fall into the trap of thinking of a milestone checklist as a final exam, a pass/fail, but it’s not that at all—it’s more like a course syllabus. The Lovevery Play Guides help you reframe the way you think about a milestone checklist. The most important thing is to stay tuned in to where your child is now, and understand what kinds of everyday play experiences help them grow and develop. Having a sense of the average age ranges during which various (sometimes subtle) skills emerge can be helpful too, so Lovevery includes those as well. 

When should I worry?

Does this mean I don’t think parents should EVER worry about missed milestones? Not at all, but the vast majority of the inquiries I receive are from parents stressing over an isolated skill that’s emerging more slowly than they would like—even when it falls within the range of “typical” development.

Times to ask questions and consider pushing hard for a specialist evaluation or extra support include:

Regression

Any pattern of lost skills should be attended to. I don’t mean that your baby clapped one day and then you don’t see them do it again for a few days, or a baby who rolled over a few times and then stopped. I mean a child who could consistently sit up and now can’t; a child who babbled or spoke and made eye contact and now doesn’t; a child who looks like they’re losing strength and/or coordination across multiple areas of development.

Not progressing

It’s normal for certain areas of development to take a “back seat” while your toddler pushes hard toward others—typical development often comes in bursts. However, if you truly feel that your child has stalled out in an area of development and is showing no progress for 6-8 weeks, I would seek additional evaluation and support.

Delays in multiple areas of development

A child who is demonstrating delays in multiple areas of development simultaneously should be evaluated by their pediatrician, who can refer you to a specialist if it’s appropriate.

Any significant delay

There are typical ranges for developmental skills. A “wait and see” or “give more time and practice” approach can be right for kids whose skills seem to be emerging on the slower side than you’re expecting. Yet there is definitely a point when experts would consider a skill significantly delayed. If you do have concerns, speak to your child’s pediatrician to see if intervention might be needed.

Talk with a professional

Discussing with your child’s doctor any concerns you might have about their development is important. Child development doesn’t occur according to a neat little chart with exact months for each milestone. 

There is a range of “typical” that is often much wider than parents realize. Your child’s physician should be able to help assess whether there’s anything to be concerned about, make appropriate referrals if needed and, more often than not, reassure you that your toddler is on the right track.

Feeling concerned is normal. Everyone at some point suspects a problem when there isn’t one or makes a mistake about what and when to ask. There’s no need to be shy about asking for outside perspective and help.

If you are worried, take action, talk to your child’s pediatrician, and get the support you need to get to the bottom of your concerns. Get a second opinion and ask more questions. If you don’t feel satisfied with an answer you get, persist until you do.