toddler pulls himself to standing on with couch
Health

The Latest On Baby Developmental Milestones

words by Dr. Rachael Carreon
Baby Development And When To Seek Help From A Specialist

As a pediatric physical therapist here in Charlottesville, I specialize in infant feeding, oral motor development, and early gross motor milestones. Throughout my work, I’ve seen firsthand how closely those areas connect. A baby struggling with reflux or tension during feeding, for example, may also find tummy time difficult or have a harder time learning to roll or sit.

I want to share a breakdown of typical milestone windows from birth to age three, along with some guidance on when it might be time to reach out for support.

Baby Development In the First Three Years

Before we dive into milestone timelines, I want to preface this by saying: every baby develops on their own timeline. 

Milestones aren’t deadlines. They’re more like windows. Most babies reach certain skills within a general range. If a child falls outside that window, or struggles in multiple areas, that’s our cue to take a closer look.

For example, when I talk with families, I remind them that early movement patterns can look a little funky. Many infants start with movements like one-sided rolling, army crawling with one leg tucked, or using one hand more than the other. 

Babies are experimenting, and that’s great! It’s also completely normal. I usually give about a two-week grace period for those patterns to even out before we start worrying about asymmetries.

Developmental Milestones in Infancy (0-12 Months)

Here’s what to look for when watching your new baby develop.

Mother is playing with her little baby on the bed, baby is just getting teeth in

Baby Milestones 0–3 Months

Motor: Babies are working hard to gain head control. In tummy time, they should start lifting their head and eventually hold it parallel to the ceiling for short bursts. Movements shift from jerky to smoother.

Feeding/Oral Motor: Babies should be able to latch and coordinate a rhythm of suck-swallow-breathe. Feeding may still be a little messy at first. By 2–3 months, most babies develop a rhythm that allows them to gain weight steadily.

Social/Communication: First social smiles appear around 4-6 weeks. Babies start cooing and responding to your voice.

When To Seek Help

If you notice a strong preference for which direction your baby turns their head (such as only looking in one direction in the car seat or while sleeping), or a flat spot on their head, reach out early to address this. 

It’s also a good idea to check in with your pediatrician if your baby:

  • Is always red-faced and frustrated in tummy time 
  • Has difficulty lifting their head or pushing through their arms
  • Has a ton of reflux or spit up
  • Has ongoing feeding struggles, such as coughing/choking, lengthy sleepy feeds, or refusing the breast or bottle)
  • Isn’t making eye contact/smiling by 2–3 months

Baby Milestones 4 – 6 Months

Motor: Babies should be reaching for their knees, then grabbing their feet. This is an important precursor to rolling. We expect babies to start rolling anywhere between 5-8 months. Rolling tummy to back usually comes first, but some babies surprise us!

  • Babies can lift their head easily in tummy time, prop on forearms, then extend arms fully during tummy time closer to 6 months. 
  • Sitting with support is expected around 5-6 months, but I usually don’t start getting concerned until 8 months of age. 

Feeding/Oral Motor: Interest in mouthing toys ramps up and often has parents thinking those first teeth are on the way. But this is an important developmental mini-milestone. It’s practice for learning how to manage solid foods later!

Communication: Babis should be babbling and laughing. They will show increased responsiveness to voices around them as well.

 When To Seek Help

Talk to your pediatrician if your baby: 

  • Is still not tolerating tummy time
  • Isn’t showing any inclination to reach for or grab their feet
  • Seems very stiff/floppy
  • Shows no interest in mouthing toys
  • Has feeding struggles (gagging/choking on a bottle or refusing feeds)

Baby Milestones 7 – 9 Months

Motor: Sitting independently should be steady by 8 months. Many babies pivot in circles on their tummy to reach for toys. Oftentimes, babies will begin army crawling or scooting backwards on their belly before mastering forward army crawling. They may also start rocking on their hands and knees. Crawling often emerges here, though some babies wait until closer to 10 months.

Feeding/Oral Motor: Starting solids means exploring new textures. Babies should mash foods with their gums and begin developing a rudimentary pincer grasp to self-feed.

Social/Communication: Babies should respond to their name, understand “no,” and engage in interactive games.

When To Seek Help

Talk to your pediatrician if your baby: 

  • Can’t sit up independently by 9 months
  • Is having trouble pushing through their arms in tummy time or while maintaining sitting balance
  • Isn’t using both hands or side of their body equally
  • Has ongoing trouble managing solids (only tolerating very thin purées, choking frequently).

Baby Milestones 10 – 12 Months

Motor: Babies should be working on and mastering transitions, including transitioning in and out of sitting independently. They may begin pulling into standing with caregivers or on horizontal surfaces (think couches, coffee tables, chairs, the bathtub), cruising along furniture or walls, and may even take those long-awaited first steps. Crawling should be reciprocal (opposite hand/leg moving together), not just scooting on their bottom.

Feeding/Oral Motor: Finger foods should be in full swing, and chewing skills should progress beyond just letting foods dissolve.

Communication: First words, waving, clapping, and imitating sounds and actions.

When To Seek Help

Talk to your pediatrician if your baby: 

  • Isn’t transitioning and moving toward mobility (not crawling, scooting, getting in and out of sitting, or pulling to stand)
  • Isn’t using hands to self-feed or still can’t manage anything beyond purées

I usually don’t get concerned about those first steps until babies are about 16 months, especially if they’ve had other delays or difficulties with previous milestones. 

Developmental Milestones in Toddlerhood (1 – 2 Years)

I usually don’t get concerned about first steps until babies are about 16 months, especially if they’ve had other delays or difficulties with previous milestones. 

A cute little boy is playing and having fun with an educational Montessori toy while sitting on the floor at home. The parents are lying on the floor and smiling at their smart son.

Toddler Milestones 12 – 18 Months

Motor: Walking independently is the big one, though falls are still very frequent. Toddlers should be getting in and out of standing without external assistance from furniture or a caregiver. We’ll also see them squatting to pick up toys and standing back up without support.

Fine Motor: Using utensils (with spills!), stacking 2–3 blocks, and pointing to things and people they see.

Feeding/Oral Motor: Toddlers should be chewing more effectively, biting into foods, and managing a wider range of textures.

Communication: Most toddlers have 5–15 words by 18 months, respond to simple directions, and gesture to communicate.

When To Seek Help

Talk to your pediatrician if your toddler: 

  • Is not walking by 16–18 months
  • Is not pointing/gesturing 
  • Doesn’t use a few words
  • Refuses solids or still gags on food frequently 

Toddler Milestones 18 – 24 Months

Motor: Running becomes (a bit) smoother, climbing is nonstop, and kicking/throwing balls emerges. Toddlers may even play around with jumping and ascending stairs using a handrail instead of crawling up stairs. 

Fine Motor: Builds towers of 4–6 blocks, starts using a spoon more accurately, and scribbles with crayons.

Feeding/Oral Motor: Toddlers should manage a variety of textures and finger foods.

Communication: Vocabulary explodes in these ages! Expect 30+ words and some two-word phrases.

Social/Play: Parallel play emerges. This means playing near peers, not necessarily with them.

When To Seek Help

Talk to your pediatrician if your toddler: 

  • Isn’t walking independently
  • Can’t transition on/off furniture
  • Has no words or gestures by 18 months
  • Still eats only a very limited range of foods

Developmental Milestones in Early Childhood (2 – 3 Years)

Children learn, grow, and change so much in early childhood! You may have trouble keeping up with everything new they are doing and exploring.

Early Childhood Milestones 24 – 30 Months

Motor: Toddlers should be jumping with both feet together for takeoff and landing, ascending and descending stairs with a handrail, and kicking a ball. They may begin riding a balance bike, scooter, or other wheeled toy with assistance.

Fine Motor: Toddlers can pages in a book. They start imitating vertical and horizontal lines when drawing.

Feeding/Oral Motor: Toddlers should be using an open cup well, chewing efficiently, and feeding themselves with increasing independence. (But i’ll be honest, it’s probably still a mess)

Communication: You’ll notice 2–3 word sentences, and toddlers will start using pronouns.

Social/Play: Pretend play takes off! Toddlers will start feeding dolls, cooking, managing a construction site, or pretending to drive.

When To Seek Help

Talk to your pediatrician if your child: 

  • Isn’t using simple two-word phrases
  • Struggles to chew/swallow
  • Isn’t jumping/climbing confidently

Early Childhood Milestones 30 – 36 Months

Motor: Young children walk up/down stairs alternating feet consistently. They begin balancing briefly on one foot.

Fine Motor: Children can copy a circle, dress with some help, and use a fork or other utensils consistently. 

Communication: Vocabulary surpasses 150-200 words. Children will start participating in short conversations.

Social/Play: Children these ages start playing with peers, not just beside them. They express a WIDE range of emotions. 

 When To Seek Help

Talk to your pediatrician if your child: 

  • Isn’t combining words
  • Avoids play with peers
  • Struggles with utensil use
  • Isn’t climbing/jumping/running confidently by 3 years old.

How Pediatric PT Supports Development

It truly takes a team to support a child’s development. Physical therapy, occupational therapy, and speech therapy each bring unique strengths to that process.

All these different types of therapy also offer Parent Guidance. This includes practical, play-based strategies to use at home, so progress continues long after each session ends.

When all three disciplines work together, the results can be transformative. Babies feed more comfortably, move more freely, and interact with joy and confidence. 

The goal isn’t just checking off milestones – it’s helping your child feel calm, coordinated, and capable in their body and their world.

Infant physical therapy session with specialist in rehab center. Little boy patient with muscle weakness doing treatment exercises standing in knees near sport mat

What Is Pediatric Occupational Therapy (OT)? 

Occupational therapy often focuses on the fine-tuned, everyday skills that help babies and toddlers interact with their world. 

This is often fine motor development, like grasping, self-feeding, and early handwriting foundations. It can also include sensory integration, which helps little ones process and respond to touch, sound, and movement in a way that feels safe and organized. 

An OT might work on helping a toddler tolerate different textures at mealtimes, improve attention and play skills, or build the coordination needed for dressing and feeding independence.

What Is Speech-Language Pathology (Speech Therapy)? 

Speech therapy supports both communication and feeding. Speech therapists help babies develop the oral motor control needed for safe swallowing, efficient bottle- or breastfeeding. Later, it helps kids manage a variety of food textures. 

Speech therapists are also experts in early language development. They can help toddlers understand and use words, gestures, and sounds to express themselves and connect with others.

What Is Pediatric Physical Therapy (PT)?

Physical therapy focuses on the foundations of movement and body function. These make all those other skills possible! For infants and toddlers, that includes:

  • Gross Motor: Building strength, balance, and coordination for milestones like rolling, crawling, sitting, walking, and jumping.
  • Breastfeeding & Oral Motor: Supporting jaw and tongue movement in breast and bottle feeding, and addressing body tension, reflux, or postural asymmetries that make feeding uncomfortable or inefficient.
  • Body Tension & Posture: Helping babies who feel stiff, tight, or floppy move comfortably and develop balanced strength for future skills.

When To Seek Help With Baby Developmental Milestones

No two babies develop exactly the same way. That’s part of what makes this stage so amazing! One baby might roll early but take a little longer to crawl, while another goes right from crawling to walking. The important thing is that your baby is comfortable in their body and steadily making progress.

Still, if you think something feels “off,” don’t worry that you’re being overly cautious. You’re being a tuned-in parent. You know your baby best, and your gut instinct is one of your greatest parenting tools. 

If you’re in the Charlottesville area and wondering whether your baby’s development is on track – or just want peace of mind – I’d love to connect. At Foundations Pediatric Therapy and Wellness, I help families navigate those early months and years with calm, confidence, and expert guidance.

You don’t have to figure it out alone. There are experts out there who will work together to help your little one thrive.

Resources To Guide You Through Pregnancy & Beyond:

Life with little ones keeps changing, and we love supporting Cville kids at every stage. Find resources on how baby learns, finding a daycare or preschool, choosing pediatrician, and fun first outings with your infant in Central Virginia. 

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DR. RACHAEL CARREON is a pediatric physical therapist in Charlottesville and the owner of Foundations Pediatric Therapy & Wellness. She specializes in infant feeding, oral motor development, and early gross motor milestones.