There are many ways to encourage development. Talking and playing with babies are two of the most important things parents and caregivers can do to help them develop. These recommendations are general and not all inclusive. The recommendations provide strategies to help promote gross motor skills, fine motor skills, early language development, and socialization.
- Gross motor skills include big movements such as rolling, crawling, standing or walking.
- Fine motor skills include hand movements such as reach and grasp.
- Early language development includes cooing, babbling, and a baby’s first words.
What is the Neonatal Follow-Up Clinic?
The Neonatal Developmental Follow-Up Program is a specialized clinic for children who had medical complications related to, or immediately after, their birth. This clinic assesses gross-motor skills, fine-motor skills, social development, language and learning ability at specific ages to determine if the child is developing as expected.
The majority of patients seen in the Neonatal Follow-Up Clinic are referred from a Neonatal Intensive Care Unit (NICU) or a Cardiac Critical Care Unit (CCCU). Babies who have been admitted to the NICU or CCCU may be at risk for developmental issues due to medical problems before delivery, during delivery or after birth. These recommendations may be used to encourage development in babies who have not spent time in the NICU or CCCU, but still require care in the Neonatal Follow-Up Clinic. Talk to your child’s doctor to see if you should be following these guidelines with your baby.
Babies and toddlers are assessed at specific ages in the clinic and are given recommendations that parents and caregivers can refer to at home to help their baby achieve their maximum potential. These recommendations are for corrected age, as some of the babies followed in the clinic were premature at birth. If your baby was premature at birth, these recommendations apply to them starting at six weeks corrected age.
If you are concerned about your baby’s development, speak with your primary health-care provider.
Neonatal follow-up clinic recommendations at six weeks
Gross motor
- Practice tummy time for a few minutes at a time, multiple times per day to improve head and trunk control. Practice when baby is awake and settled (not crying or fussy).
- Tummy time can be across your lap, lying on your chest or on the floor.
- Encourage side-lying position for play (left and right side-lying). A rolled towel can be placed at your baby’s back to prevent them from rolling over.
- If your baby is demonstrating right or left-sided preference, present faces, toys, objects, and other stimulation to the opposite side your baby favours.
- Practice floor time for play as much as possible. The bed is NOT a safe place for your baby to play. The floor provides a safe and firm surface for your baby to practice and learn movement.
Fine motor
- Encourage your baby to bring hands and toys to their mouth to promote orientation to the midline (middle of the body).
- Encourage open hands by stroking the back of your baby’s hand.
- For babies with thumbs held across the palm, encourage holding thicker, round rattles or squishy toys.
- Offer toys that allow two-handed exploration and play.
- Use supported and reclined sitting to encourage early reaching and grasping of toys at the midline.
- Present a variety of objects with different textures, shapes, and sizes for exploration with hands and mouth.
- Give your baby toys that are black and white or have high-contrast colours, as well as ones that rattle, to help promote hand-eye coordination.
Communication/Social
- Be face to face with your baby and be animated. Use lots of gestures as you interact.
- Respond to communication; smile and engage when your baby makes sounds.
- Play social communication games (i.e. peek-a-boo).
- Repeat any sounds your baby makes.
- Crying is a baby’s way of letting you know they need your attention, so respond by interacting with your baby to promote healthy attachment.
- Sing and read books to your baby daily.
- Electronic media use by children younger than two years old is not recommended. This includes phones, television, computers, and tablet devices.
Growth
- Continue regular visits to your family doctor/paediatrician to monitor your baby’s growth.
- Head re-shaping — position baby on their side, lying off of the flattened side of their head.
Sleep
- Start a bedtime routine (e.g. low lights and reading to baby before bedtime).
- Practice safe sleep habits: position your baby on their back to sleep on a separate firm, flat surface in your room, at least for the first six months.
For more information on neonatal neurodevelopmental recommendations at different ages, please see the links below:
Parental mental health and well-being
All caregivers are encouraged to have ongoing discussions about their mental health and well-being with their family doctor. There are free community services available to promote coping and resilience for caregivers. Consider learning more about the following supports and interventions.
- Healthy Babies Healthy Children Ontario: Free home visiting program that supports all pregnant mothers and families with young children up to age six.
- Connex Ontario: Provides service information for mental health supports by phone, online chat or email.
- Ontario 211: A useful tool to search for community and government services in the greater Toronto area.