What are the key developmental milestones for babies in their first two years. How do babies typically progress in physical, cognitive, and social skills. When should parents be concerned about their baby’s development.

The Incredible Journey of Baby Development: First Month to First Birthday

Watching a baby grow and develop is a truly remarkable experience. From those first precious moments to the exciting milestones of the first year, every day brings new discoveries and achievements. Let’s explore the fascinating journey of baby development, focusing on the key milestones from the first month to the first birthday.

First Month Marvels: Setting the Stage for Growth

In the first month of life, babies are already making significant strides in their development. They begin to make sense of the world around them, using their senses to explore and learn.

• Arm movements become more controlled, with jerky, quivering motions
• Hands are often kept in tight fists and brought near the face
• Head movement from side to side while lying on the stomach
• Visual focus improves, with babies able to see objects 8 to 12 inches away
• Preference for human faces and high-contrast patterns emerges
• Hearing is well-developed, with recognition of familiar voices

Are newborns able to recognize their parents’ voices. Indeed, research suggests that babies can recognize their mother’s voice from birth and their father’s voice shortly after.

Third Month Triumphs: Increasing Awareness and Interaction

By the end of the third month, babies show remarkable progress in their physical abilities and social interactions.

• Improved head and upper body control when lying on the stomach
• Stretching and kicking of legs becomes more pronounced
• Hand-eye coordination begins to develop
• Grasping and shaking of toys
• Enhanced visual tracking of moving objects
• Babbling and imitation of sounds commence
• Smiling in response to parents’ voices
• Increased enjoyment of social interaction

Why do babies start babbling around this age. Babbling is an important precursor to speech, helping babies practice the mouth movements needed for forming words and experimenting with different sounds.

Mastering Motor Skills: The Journey from Rolling to Crawling

As babies approach the middle of their first year, their motor skills develop rapidly, leading to increased mobility and exploration of their environment.

Seventh Month Milestones: A World of Movement

Around the seventh month, babies typically achieve several significant physical milestones:

• Rolling over in both directions
• Sitting up without support
• Reaching for and grasping objects
• Transferring objects between hands
• Supporting body weight on legs when held upright

How does rolling over benefit a baby’s development. Rolling over is crucial for building core strength, improving spatial awareness, and preparing for more advanced movements like crawling and walking.

In addition to physical developments, seven-month-old babies also show significant cognitive and social advancements:

• Full-color and mature distance vision
• Vocal expression of emotions
• Response to their own name
• More complex babbling
• Ability to distinguish emotions in others’ voices
• Increased object exploration using hands and mouth
• Enjoyment of games like peek-a-boo
• Interest in mirror images

The Crawling Conundrum: When Do Babies Start Exploring on All Fours?

Crawling is a major milestone that typically occurs between six and nine months of age. However, it’s important to note that not all babies crawl in the traditional sense, and some may skip this stage altogether.

Why do some babies skip crawling. Some babies prefer alternative methods of locomotion, such as bottom-shuffling or rolling, which still contribute to their physical development and spatial awareness.

First Birthday Breakthroughs: Walking, Talking, and More

As babies approach their first birthday, they achieve a multitude of exciting milestones that showcase their growing independence and cognitive abilities.

Physical Milestones at One Year

• Sitting without assistance for extended periods
• Getting into a hands-and-knees position
• Crawling proficiently
• Pulling up to stand using furniture
• Cruising along furniture and possibly taking a few independent steps
• Developing a pincer grasp (using thumb and forefinger)

When do most babies take their first steps. While some babies may take their first steps around their first birthday, the average age for independent walking is between 12 and 13 months.

Language and Cognitive Developments

• Saying “dada” and “mama” with intention
• Using simple exclamations like “oh-oh!”
• Attempting to imitate words
• Responding to “no” and simple verbal requests
• Using basic gestures such as waving goodbye
• Exploring objects in various ways (shaking, banging, throwing)
• Beginning to use objects correctly (e.g., drinking from a cup)
• Finding hidden objects with ease
• Recognizing named images in pictures

How many words should a one-year-old say. While there’s a wide range of normal, most one-year-olds can say between one to three words. However, they usually understand many more words than they can say.

The Second Year: Rapid Growth in Skills and Independence

The second year of a child’s life is marked by significant advancements in physical abilities, language skills, and cognitive understanding. Let’s explore the key milestones typically achieved by the second birthday.

Physical Achievements

• Walking independently with improved balance and coordination
• Beginning to run
• Kicking a ball
• Climbing on and off furniture without assistance
• Navigating stairs while holding onto support
• Scribbling with crayons, showing improved fine motor skills

How can parents support their toddler’s physical development. Providing safe spaces for exploration, offering age-appropriate toys that encourage movement, and engaging in active play together can all support a toddler’s physical development.

Language and Cognitive Leaps

By their second birthday, most children experience a language explosion and significant cognitive growth:

• Using several single words (typically by 15 to 18 months)
• Forming simple phrases (usually by 18 to 24 months)
• Constructing two- to four-word sentences
• Following simple instructions
• Recognizing names of familiar people, objects, and body parts
• Beginning to sort objects by shapes and colors
• Engaging in make-believe play
• Imitating behaviors of others

What is the average vocabulary size for a two-year-old. While there’s considerable variation, most two-year-olds have a spoken vocabulary of about 50 words and can understand many more.

Understanding Developmental Variations: Every Child is Unique

While developmental milestones provide helpful guidelines, it’s crucial to remember that every child develops at their own pace. Some may excel in certain areas while taking more time in others.

Factors Influencing Development

Several factors can impact a child’s developmental timeline:

• Genetics
• Premature birth
• Environmental factors
• Individual temperament
• Opportunities for practice and exploration

How does premature birth affect developmental milestones. For premature babies, it’s important to adjust expectations based on their corrected age (calculated from their due date) rather than their actual birth date.

When to Seek Professional Advice

While variations in development are normal, there are times when parents should consult a healthcare provider:

• Significant delays in reaching multiple milestones
• Loss of previously acquired skills
• Lack of response to sounds or visual stimuli
• Persistent difficulty with feeding or sleeping
• Extreme reactions to sensory input

What should parents do if they’re concerned about their child’s development. It’s always best to discuss concerns with a pediatrician or healthcare provider. Early intervention, if needed, can make a significant difference in a child’s developmental trajectory.

Nurturing Your Baby’s Development: Tips for Parents

Parents play a crucial role in supporting their baby’s development. Here are some strategies to encourage growth and learning:

Creating a Stimulating Environment

• Provide age-appropriate toys and books
• Ensure safe spaces for exploration
• Limit screen time, especially for children under 18 months
• Expose your child to a variety of sensory experiences

Encouraging Language Development

• Talk to your baby frequently, describing activities and surroundings
• Read books together daily
• Sing songs and play word games
• Respond positively to your baby’s attempts at communication

Supporting Physical Development

• Provide plenty of tummy time for infants
• Engage in active play and outdoor activities
• Offer opportunities for both gross and fine motor skill practice
• Create safe spaces for crawling, walking, and climbing

How much tummy time should babies get. The American Academy of Pediatrics recommends supervised tummy time 2-3 times daily for 3-5 minutes, gradually increasing duration as the baby grows stronger.

The Role of Nutrition in Baby Development

Proper nutrition plays a vital role in supporting a baby’s rapid growth and development during the first two years of life.

Breastfeeding and Formula Feeding

The American Academy of Pediatrics recommends exclusive breastfeeding for the first six months, followed by continued breastfeeding along with complementary foods until at least 12 months. For those who cannot or choose not to breastfeed, iron-fortified infant formula is an appropriate alternative.

Introducing Solid Foods

Around 6 months of age, most babies are ready to start solid foods. This process, often called weaning, should be gradual and tailored to the individual baby’s needs and readiness.

• Start with single-ingredient purees or soft foods
• Introduce new foods one at a time, waiting a few days between each new food
• Offer a variety of flavors and textures
• Continue milk feeds (breast milk or formula) alongside solid foods

When can babies start eating finger foods. Many babies are ready for soft finger foods around 8-9 months, but it’s important to watch for signs of readiness and consult with your pediatrician.

Key Nutrients for Baby Development

Certain nutrients are particularly important for baby development:

• Iron: Crucial for brain development and preventing anemia
• Omega-3 fatty acids: Important for brain and eye development
• Calcium and Vitamin D: Essential for bone growth
• Protein: Necessary for tissue growth and repair
• Zinc: Supports immune function and growth

How can parents ensure their baby gets enough iron. Breastfed babies may need iron supplements starting at 4 months. For formula-fed babies, choose iron-fortified formula. When starting solids, include iron-rich foods like fortified cereals, meats, and legumes.

The Impact of Sleep on Baby Development

Adequate sleep is crucial for a baby’s growth, learning, and overall development. Sleep patterns change significantly over the first two years of life.

Newborn Sleep Patterns

Newborns typically sleep 14-17 hours per day in short bursts of 2-3 hours. Their sleep is divided almost equally between rapid eye movement (REM) and non-REM sleep.

Sleep Changes in the First Year

• 3-4 months: Many babies begin to develop a more regular sleep-wake cycle
• 6 months: Some babies can sleep for longer stretches at night, though frequent night wakings are still normal
• 9-12 months: Many babies are capable of sleeping through the night, though individual variations are common

When do babies typically start sleeping through the night. While some babies may sleep through the night (6-8 hours) by 3-6 months, others may not do so until after their first birthday. It’s important to remember that night wakings are normal and often related to feeding needs.

Creating Healthy Sleep Habits

Establishing good sleep habits can support your baby’s development:

• Create a consistent bedtime routine
• Provide a safe sleep environment
• Put your baby to bed drowsy but awake
• Respond to your baby’s needs, but avoid overstimulation during night wakings
• Ensure your baby gets enough daytime sleep (naps) appropriate for their age

How many naps should a baby take. The number of naps varies with age. Newborns may take 4-5 naps a day, while by 12 months, most babies take 1-2 naps daily.

Understanding and supporting your baby’s development is a rewarding journey filled with incredible milestones and precious moments. By providing a nurturing environment, responding to your baby’s needs, and offering opportunities for exploration and learning, you can help your little one thrive during these crucial early years. Remember, every baby is unique, and the joy is in celebrating each individual step along the path of growth and discovery.

Developmental milestones for baby | March of Dimes

During the first year of life, your baby will grow and develop at an amazing speed. 

Her weight will double by 5 to 6 months, and triple by her first birthday. And she is constantly learning. 

Major achievements—called developmental milestones—include rolling over, sitting up, standing and possibly walking. And your heart will likely melt at the sound of her first “mama” or “dada.”

No two babies are exactly alike. Your baby will develop at her own pace. Most babies reach certain milestones at similar ages. However, it’s not unusual for a healthy, “normal” baby to fall behind in some areas or race ahead in others.

The following milestones are only guidelines. Your baby’s health care provider will evaluate your baby’s development at each well-baby visit. Remember: Always talk to your child’s health care professional if you think your baby is lagging behind.

If your baby was born prematurely (before 37 weeks of pregnancy), you need to look at the milestone guidelines a little differently. The age at which your baby is expected to reach various milestones is based on her due date, not her birthday. So if your baby was born two months early, she will most likely achieve milestones two months later than the guidelines below predict.

By the end of their first month, most babies:

• Make jerky, quivering arm movements
• Bring hands near face
• Keep hands in tight fists
• Move head from side to side while lying on stomach
• Focus on objects 8 to 12 inches away
• Prefer human faces over other shapes
• Prefer black-and-white or high-contrast patterns
• Hear very well
• Recognize some sounds, including parents’ voices

By the end of their third month, most babies:

• Raise head and chest when lying on stomach
• Support upper body with arms when lying on stomach
• Stretch legs out and kick when lying on stomach or back
• Push down on legs when feet are placed on a firm surface
• Open and shut hands
• Bring hands to mouth
• Grab and shake hand toys
• Follow moving object with eyes
• Watch faces closely
• Recognize familiar objects and people at a distance
• Start using hands and eyes in coordination
• Begin to babble and to imitate some sounds
• Smile at the sound of parents’ voices
• Enjoy playing with other people
• May cry when playing stops

By the end of their seventh month, most babies:

• Roll over both ways (stomach to back and back to stomach)
• Sit up
• Reach for object with hand
• Transfer objects from one hand to the other
• Support whole weight on legs when held upright
• Develop full-color vision and mature distance vision
• Use voice to express joy and displeasure
• Respond to own name
• Babble chains of consonants (ba-ba-ba-ba)
• Distinguish emotions by tone of voice
• Explore objects with hands and mouth
• Struggle to get objects that are out of reach
• Enjoy playing peek-a-boo
• Show an interest in mirror images

By their first birthday, most babies:

• Sit without assistance
• Get into hands-and-knees position
• Crawl
• Pull self up to stand
• Walk holding onto furniture, and possibly a few steps without support
• Use pincer grasp (thumb and forefinger)
• Say “dada” and “mama”
• Use exclamations, such as “oh-oh!”
• Try to imitate words
• Respond to “no” and simple verbal requests
• Use simple gestures, such as shaking head “no” and waving bye-bye
• Explore objects in many ways (shaking, banging, throwing, dropping)
• Begin to use objects correctly (drinking from cup, brushing hair)
• Find hidden objects easily
• Look at correct picture when an image is named

By their second birthday, most children:

• Walk alone
• Pull toys behind them while walking
• Carry large toy or several toys while walking
• Begin to run
• Kick a ball
• Climb on and off furniture without help
• Walk up and down stairs while holding on to support
• Scribble with crayon
• Build tower of four blocks or more
• Recognize names of familiar people, objects and body parts
• Say several single words (by 15 to 18 months)
• Use simple phrases (by 18 to 24 months)
• Use two- to four-word sentences (“want snack”)
• Follow simple instructions
• Begin to sort objects by shapes and colors
• Begin to play make-believe
• Imitate behavior of others
• Show growing independence

Your Baby’s Development Milestones at a Glance

It’s so exciting to watch your baby’s development, but it’s easy to worry if they’re not rolling, sitting or crawling at the ‘right’ time.

Here’s roughly what developments to expect and when.

At a glance

• Most babies start crawling between six and nine months




• The average age to start walking is 12-13 months




• Some babies are saying ‘mama’ and/or ‘dada’ around nine months, and the average age for a first word is 10-11 months

If there’s one thing we know about babies it’s that they’re all different and do things at their own pace. Particularly with baby milestones, it’s easy to get concerned your baby hasn’t reached a stage when another child has at the same age. Development anxiety is common for parents, but try to remember your little one is an individual and will get there in their own time. 

Below is our rough guide to what you can start to look out for and when.

Rolling over

Some babies can do this at three months, but most are nearer to five or six months. Some haven’t mastered it by seven or eight months. All are completely normal.

Sitting

Most babies can sit without cushion props somewhere between five and seven months. By nine months almost all can do this pretty well.

Crawling

The word crawling covers a multitude – bottom shuffling, commando crawling (on the tummy) and crawling backwards. Most babies start it between six and nine months, but others are closer to 12 months. Some don’t crawl at all and go straight from sitting to cruising then walking.

Walking

There’s an absolutely huge variation in the age babies/toddlers walk –and how early they start is not necessarily a sign that they will be more physically capable in later life. The average age to start walking is 12-13 months, but there are plenty who don’t take their first steps until 16-18 months. If they aren’t walking by 18 months it is officially classed as ‘delayed’, but it’s still nothing to worry about if your health visitor is happy with their development.

Teeth

Very occasionally, babies are born with teeth, but most babies get their first tooth, usually one of the bottom front ones, between four and eight months – the average is six months, but it’s quite possible to reach their first birthday and still have no teeth. By aged two and a half to three they will all have their 20 milk teeth.

Talking

Some babies are saying ‘mama’ and/or ‘dada’ around nine months, and the average age for a first word is 10-11 months. However, lots of babies/toddlers don’t take much of an interest in talking until after their first birthday, some nearer to 18 months. As long as you’re talking to them lots and they seem to understand you, don’t worry – talking will come.

Remember!

All babies are unique and develop at different paces – don’t forget, they haven’t read the baby books! But if you’ve got concerns – especially about their sight or hearing – do talk to your health visitor or GP.

Read more about Baby Development Anxiety .

You can also see more about your baby’s development with our milestones chart. 

what is it in simple words, benefits and harms for a child, where to listen for free

Problems with children’s sleep are familiar to almost all parents. Sometimes the child is difficult to put to sleep, then he wakes up every 20 minutes, or refuses to sleep in the crib. In fact, it takes a lot of work to get a newborn to sleep, but a baby can really be taught to go to bed at eight o’clock in the evening, fall asleep without a breast and sleep all night, 10-12 hours in a row.

But in this article we will talk about white noise, which can be a helper for parents trying to improve their child’s sleep. Let’s take a look at how white noise can help kids and adults, and how safe it is to use.

What is white noise for newborns

As adults, you yourself have probably fallen asleep to white noise more than once. For example, to the sounds of the road, when the window is open, or a fan running in the apartment. This is white noise – background sound, in which there are high, medium, and low frequencies, they are evenly distributed and sound at the same volume, without any drops. In our life, we encounter such noise all the time. This is the rumble of the crowd, the sound of rain, a waterfall, the murmur of a river, the sound of a working hair dryer, vacuum cleaner, air conditioner, crackling fire and others. But if such noise does not always have a calming effect on adults, and sometimes even vice versa – it interferes with falling asleep, then for a newborn, a monotonous sound is more familiar than silence, and helps him calm down.

The explanation is simple. All the time while the baby was in his mother’s stomach, he was not in absolute silence. He heard mother’s heart beating, how she breathes, how blood runs through her vessels, the noise of the intestines, as well as many sounds from outside: conversations, music, etc. All these sounds were constant and measured. The kid is used to such a background, so the silence in which the parents are trying to put the child to bed can scare him, especially at first. By the way, many mothers themselves imitate white noise when they rock the child, saying “shhhhhhh.” Also, often babies sleep well in a stroller for a walk – just under the white noise of the street.

Benefits of white noise for newborns

— Studies have been conducted on the safety of using white noise in newborns and infants. The effectiveness and safety of white noise has been proven not only in relation to a child’s sleep, but also in infantile colic as the main non-pharmacological method, says Tatyana Stetskaya, PhD, neurologist, member of the Russian Society of Somnologists . – White noise can work during a child’s daytime sleep and nighttime sleep, if you want to “mask” extraneous sounds. Its use is most effective in the first 12 weeks of the newborn, but studies have not revealed any age restrictions on its introduction. Simply put, if you haven’t introduced your child to white noise before six months, it’s never too late to try.

So, let’s take a look at the benefits of white noise for a newborn and his parents.

• Helps the child to calm down. If the baby cries for a long time, and the mother fails to calm him down either by motion sickness, or by breastfeeding, or in other ways, then turning on white noise can help. Perhaps you have noticed how the child suddenly calms down when he enters the bathroom, where water runs from the tap.
• Accelerates falling asleep. The sooner the excitement of the baby, obtained after a fun game or walk, goes away, the sooner he will fall asleep. This is where white noise can help.
• Improves the quality and depth of sleep. When using white noise, the newborn does not wake up every 20 minutes, which parents often complain about. The problem of fragmentation of sleep is being solved, it becomes longer, the baby sleeps better.
• Helps to mask extraneous sounds. This is especially familiar to parents who already have grown-up children, who often prevent the younger one from falling asleep with their games. Repairs at the neighbors, loud noises from the street or guests in the next room – all this also does not allow the newborn to fall asleep peacefully. Turning on white noise will mask these sounds and help solve the problem.
• Helps parents relax and unwind. With better quality white noise sleep, adults have more time for themselves to do household chores or just relax. In addition, parents themselves can fall asleep easier under such noise after a hard day.

Harm of white noise for newborns

Photo: pixabay.com

Some parents of babies fear that white noise can be addictive, form a clear association for sleep, and then the child will not be able to fall asleep without it. Or it can somehow affect the still immature nervous system of the baby.

— In fact, there is no need to be afraid of white noise, — says our expert Tatyana Stetskaya. – Conducted studies on the safety of using white noise have proven that it does not have a detrimental effect on the central nervous system, provided that the basic safety rules are observed: the sound volume should be no higher than 50 dB (this is approximately the level of a calm conversation between two adults – ed.), distance – not less than 1 meter from the baby’s crib.

There is one more nuance. Often, parents use the so-called sleepy toy as a source of white noise. They have been gaining popularity lately. The soft toy reproduces several types of white noise, turns off when the baby falls asleep, that is, lies motionless for a certain time, and turns on when the baby starts tossing and turning. Moreover, manufacturers say that you can use such an assistant to fall asleep from birth. But not all experts approve of such a gadget.

“Kids fall asleep really well to white noise, but I don’t see the point in these toys, may the manufacturers forgive me,” says Tatyana Stetskaya. – And it is simply not safe to use it from the first weeks of life. The American Academy of Pediatrics categorically does not recommend the presence of pillows, blankets, toys, and even bumpers in the crib of a newborn due to the risk of developing suffocation, sudden infant death syndrome. In addition, the source of white noise should be located at least a meter from the baby’s crib. And in my personal experience, the sound that such toys generate is not as effective as the sound of a real hair dryer or an audio program from a special application.

Reviews and opinions of specialists

Many parents leave positive feedback about white noise. They assure that the newborn really calms down, falls asleep faster, the duration of sleep can also be longer.

“I noticed the effect of white noise on the baby on the second day after returning from the hospital, although I didn’t know anything about it then,” says Irina Moiseeva. – My son cried a lot, and somehow I went into the bathroom with him, where the water tap was open. He suddenly began to listen and after a few seconds calmed down. At first I resorted to this method to calm him down, and then I read about white noise, downloaded the application, and used it constantly when laying down.

“I have two children,” says another mother, Svetlana Barkova. – When the youngest was born, the eldest was not yet three years old, and it was impossible to explain to the child that the youngest should be quiet during sleep. She made noise, played, constantly woke up her sister. White noise helped, I always turned it on when I put the child to bed. He drowned out the sounds from the next room and the baby quickly fell asleep.

White noise really works, but it’s worth remembering that it is only a helper for parents, and not a salvation from all sleep problems.

– In general, white noise really helps the child to calm down and fall asleep. But it is a mistake to think that this is a panacea, – says Tatyana Stetskaya. – Parents should understand that if the baby has poor sleep hygiene, there is an incorrect rhythm of the day, physical discomfort, pronounced associations for falling asleep in the form of rocking or feeding, systematic overwork and lack of sleep, white noise alone will not help. Comprehensive work on a child’s sleep is important.

Where can I download and listen to white noise

You can easily reproduce white noise at home by turning on a fan, hair dryer or shower. But this is not entirely convenient, especially since the time of its use is not 1-2 minutes, but much longer.

The easiest way is to download an app that plays white noise on your phone. There are many of them today, choose according to your taste, read the reviews of those who have already used the programs. The most popular today: applications “Bayu-bay” (this is the Russian version of Sound Sleeper), Baby Sleep Instant, White Noise, Relax Melodies. The advantage is that you can turn on white noise wherever you need, you don’t need the Internet for this, but only a charged phone.

There are also many sites on the Internet that offer to download or listen to white noise online. But, unfortunately, they are not always of high quality and meet all parameters. So be careful if you’re looking for white noise there. Pass by dubious sites that offer a lot of different content, it is better to stop at resources that are dedicated specifically to sleep problems. Before you turn on white noise for your baby, listen to it yourself, evaluate the quality.

Popular questions and answers

Consultant for breastfeeding, sleep and child care Liliya Khusainova answers questions about white noise .

What is the risk of excessive use of white noise for newborns?

Qualitative studies on this topic do not exist, we cannot speak with full confidence about either the harm or the benefits of white noise. The only recommendation that is scientifically proven is not to use noise louder than 50 dB.

There is definitely evidence that the use of white noise above 50 dB is harmful, anything lower is relatively safe. It is important that the device that makes the noise is not in close proximity to the child.

Until what age can white noise be used?

There are no clear age restrictions, but I want to note: the less the baby gets used to special conditions for falling asleep, be it white noise, absolute silence, blackout curtains or a spy toy, the easier it is to put him to bed in other conditions.

This allows parents to lead a more active lifestyle: they are not tied to a place to sleep, they can go out to people, go to visit, go to a cafe. If it is possible not to use white noise, it is better to do without it.

And this is possible if you understand the real needs of the child during falling asleep. In fact, white noise is a “crutch” that helps parents put the child to bed, switch his attention.

If your child is having trouble sleeping, they probably have unmet needs and white noise distracts from them. It is better to solve the original problem, find and satisfy the need, and not mask it.

Can adults use white noise for newborns?

Of course, you can use white noise for adults with the same volume restrictions. But for an adult to sleep well, white noise is not necessary, it is more important to observe sleep hygiene: go to bed at physiological time, put away gadgets an hour before bedtime, do not overeat before bedtime – these are more effective ways to combat insomnia.

Why is it so important for us to talk about the loss of a child

Why is it so important for us to talk about the loss of a child?

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• Why is it so important for us to talk about the loss of a child

Why is it important for us to talk about the loss of a child

WHO/M. Purdie

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The loss of a child during pregnancy due to miscarriage or stillbirth is still a taboo topic around the world, which is associated with condemnation or a sense of shame. Many women who lose a child during pregnancy or childbirth continue to receive neither the proper care nor the respect they deserve. In this material we want to share stories told by women from different countries.

Miscarriage is the most common cause of pregnancy loss. Estimates of the prevalence of this phenomenon vary somewhat, although according to the March of Dimes Foundation, an organization dedicated to maternal and child health, the prevalence of miscarriage in women who knew they were pregnant is 10-15%. Different countries around the world use different definitions of pregnancy loss, but as a rule, the death of a child before 28 weeks of gestation is considered a miscarriage, and death at or after 28 completed gestational weeks is considered a stillbirth. There are 2.6 million stillborn babies born each year, and many of these deaths could have been prevented. However, even in developed countries, miscarriages and stillbirths are not systematically recorded, so the actual figures may be even higher.

Worldwide, women’s access to health services varies by country of residence, with hospitals and outpatient facilities very often under-resourced and understaffed in many countries. As varied as the experience of bereaved women, stigma, guilt and shame are common themes around the world. Women who have lost their children have shared personal experiences that they felt they had to keep their grief quiet, either because miscarriages or stillbirths remain common or because people perceive them as inevitable.

Jessica Zucker, Clinical Psychologist and Writer, USA

“I am a clinical psychologist specializing in mental health issues related to reproduction and motherhood. I have been doing this for over ten years. But when I myself had a miscarriage at 16 weeks, only then could I truly feel that heartache, that re-experienced feeling of grief and loss that my patients have been telling me about for so many years.

Jessica’s story

All this has an extremely hard effect on women. Many women who lose a child during pregnancy may develop mental health problems that last for months or years, even if they later have healthy children.

Cultural and social views on the loss of a child in different parts of the world can be very different from each other. Thus, in sub-Saharan Africa, the prevailing opinion is that a baby can be born dead because of witchcraft or the machinations of evil spirits.

Larai, 44, pharmacist, Nigeria

“I took everything that happened after my miscarriage very hard. This was greatly facilitated by the medical workers themselves, despite the fact that I am also a doctor. Another issue is cultural representations. Here, the loss of a child brings shame to the woman, because there is a perception that if a woman has lost a child several times, something is wrong with her, and that she may have had extramarital affairs, and the loss of a child
in that case, God’s punishment.

Larai’s story

Miscarriages or stillbirths have many possible causes, from fetal abnormalities, maternal age, and infections, many of which (such as malaria and syphilis) are preventable, although identifying the exact cause is often difficult.

General recommendations for preventing miscarriage include a healthy diet, physical activity, avoiding smoking, drug and alcohol use, limiting caffeine intake, managing stress, and maintaining a normal body weight. This approach focuses on lifestyle factors, and in the absence of specific explanations for what happened, this can lead to women feeling guilty that it was their behavior that caused the miscarriage.

Lisa, 40, Marketing Manager, UK

“I’ve had four miscarriages. Every time this happens, a part of you dies. The first time was the hardest. It was my very first pregnancy. We were so happy that we will soon have a baby. But when we went to our local hospital in the southeast of England at week 12 for a routine ultrasound, I was told that I had a miscarriage, or miscarriage, which meant that my baby had died long ago, although I did not feel no signs. ”

Lisa’s story

As with some other medical topics, such as mental health, which remain a huge taboo, many women report that, regardless of their cultural background, education and upbringing, their friends and families don’t want to talk about their loss. Apparently, this is due to the general tradition to surround any grief with a veil of silence.

Susan, 34, writer, USA

“I’ve been dealing with infertility for almost five years now. After I decided to try IVF, I actually managed to get pregnant, but after a few weeks the baby stopped growing. It took doctors two and a half weeks to confirm this. It took another two weeks before I had a miscarriage that lasted 19days. I could not imagine that it could be so painful, for so long and with such heavy bleeding.

Susan’s story

Stillbirths occur later in pregnancy, namely after 28 gestational weeks, as defined by WHO. About 98% of stillbirths occur in low- and middle-income countries. Lack of proper care and supervision during labor results in one in two stillbirths occurring during delivery, many of which could have been prevented with quality care and proper supervision of the woman in labour.

Better care during pregnancy and childbirth could prevent more than half a million stillbirths globally. Even in high-income countries, non-compliance with standards of care is an important cause of stillbirths.

There are clear ways to reduce the number of children who die during pregnancy, namely: improving access to antenatal care (in some parts of the world, women do not see a health worker until they are several months pregnant), introducing models of continuous care, provided by midwives, as well as community care where possible. Integrating infection management during pregnancy, fetal heart rate monitoring and birth monitoring into a comprehensive care package could save 1.3 million lives of otherwise stillborn babies.

Emilia, 36, shopkeeper, Colombia

“When my baby was stillborn at 32 weeks, we already gave him a name. The doctor referred me for an ultrasound examination, during which he told me that the child was not showing signs of life. I knew right away that my baby was dead. I know this could have been avoided. If from the very beginning I had been told everything about my condition in more detail, if the doctors had treated me more attentively during the critical periods of my pregnancy, my child could have been saved.

Emilia’s story

The attitude towards women during pregnancy is related to the extent to which their sexual and reproductive rights are generally realized; many women around the world do not have the ability to make autonomous decisions in this area.

In many parts of the world, the pressure of public opinion is forcing women to become pregnant when they are not yet physically or psychologically ready for it. Even in 2019, 200 million women who want to avoid pregnancy do not have access to modern methods of contraception. And when pregnancy does occur, 30 million women are forced to give birth outside of health facilities, and 45 million women do not receive adequate antenatal care or no antenatal care at all, greatly increasing the risk of complications and death for both the mother and the mother. child.

Cultural practices, such as ritual female genital mutilation and child marriage, cause great harm to girls’ sexual and reproductive health and the health of their children. Having children at a young age can be dangerous for both mother and child. Adolescent girls (aged 10–19 years) are significantly more likely to have eclampsia or intrauterine infections than women aged 20–24 years, increasing the risk of stillbirth in this age group. In addition, babies born to women younger than 20 are more likely to have low birth weight, prematurity, or severe health problems in the first month of life, which also increases the risk of stillbirth.

Female genital mutilation increases a woman’s risk of protracted or difficult labour, bleeding, severe tears and increases the frequency of instrumental use in childbirth. At the same time, children of such mothers are much more likely to need resuscitation during childbirth and increase the risk of death during childbirth or after birth.

Putting women at the center of care is critical to creating a positive pregnancy experience—the biomedical and physiological aspects of health services need to be complemented by social, cultural, emotional and psychological support.

However, many women, even in developed countries with access to the best health care systems, do not receive adequate care after the loss of a child. Even the language used by medical professionals in relation to miscarriage and stillbirth can be traumatic in itself: the use of terms such as “cervical failure” or “dead gestational sac” can be painful.

Andrea, 28, stylist and singer, Colombia

“When I was 12 weeks pregnant, I had a scheduled appointment with the doctor, where I had an ultrasound. The doctor told me that I was not doing well, but did not specify what exactly was wrong. The next day, when I woke up, I noticed blood stains on the sheets. I didn’t get any information about why I had a miscarriage. My doctor was very kind to me, but he didn’t explain anything to me. But the nurses were completely indifferent and unfriendly and behaved as if I had undergone an ordinary medical procedure, and nothing more. No one gave me any support.”

Depending on the rules of the particular medical facility, stillborn bodies may be treated as clinical waste and incinerated. It happens that when a woman learns that her child has died, she is forced to continue to carry the dead baby for several weeks before she can give birth. Even if this delay may be clinically justified, this situation is excruciating for both the woman and her partner. Even in developed countries, women may be forced to give birth to their dead babies in maternity wards, surrounded by women who have healthy children, which is very difficult from a psychological point of view and reminds the woman of her loss.

Not all inpatient or outpatient health facilities can adopt a new care strategy or provide more services.