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Keeping an eye on your baby's growth and development

Parent-held records

After your baby’s birth you’ll usually be given a personal child health record or parent-held record for your baby. This is a way of keeping track of your child’s progress. It makes sure that, wherever you are and whatever happens to your child, you’ll have a copy of the records for your own information and for health professionals when and where you may need it.

To start with you’ll want to use the records mainly to record your child’s height and weight. Then you can add information about immunisations (see pages 102–8), childhood illness and accidents.

You may find that when your child is reviewed, the doctor or health visitor will not formally ‘test’ your child but will ask you questions about what he or she can or can’t do.

It is therefore helpful if you record these details in your child’s personal child health record and complete the questionnaires in the book before your child has a review. Don’t forget to take the book with you when you take your child for a review!

Development reviews

Your GP and health visitor will offer you regular development reviews. The review gives you, the parents, an opportunity to say what you’ve noticed about your child. You can also discuss anything at all that may concern you about your child’s health and general behaviour. Not just the big things, but the kinds of worries and niggles that every parent has but feels unsure about taking to a doctor or nurse.

The review programme

Development reviews will usually be carried out by your health visitor, a doctor, or both. They may be carried out at a regular clinic session or in your own home. The aim is to spot any problems as early as possible so that, if necessary, some action can be taken. So, even if you think your child is doing fine, it’s worth having the review. Your health visitor will tell you when it’s due but, if you’re concerned about something at any other time, don’t wait. Ask to see someone. You can usually expect to be invited to a development review when your child is:

  • 6 to 8 weeks old
  • 6 to 9 months old
  • 18 to 24 months old
  • 3 to 31/2 years old
  • 41/2 to 51/2 years old (before or just after your child starts school).

In some parts of the country, the age that your child is reviewed may vary slightly to those given above, especially after the age of three.

Height and weight

Your child’s height and weight are a very useful guide to general progress and development. You can have your baby regularly weighed at your child health clinic or doctor’s baby clinic. Older children should be weighed and measured as part of other health checks. Babies vary in how fast they put on weight, but usually weight gain is quickest in the first six to nine months, and then it slows down.

  • Most babies double their birthweight by four to five months.
  • Most babies treble their birthweight by one year.

Some weeks your baby will gain weight; some weeks he or she will not gain weight. This doesn’t matter. What’s looked for is a general weight gain over a period of weeks.

Understanding your child’s height and weight chart 

Your child’s growth will be recorded on ‘centile’ charts so that his or her progress can be easily followed.

Boys and girls have different charts because boys are on average heavier and taller and their growth pattern is slightly different. This page shows an example of a boy’s height, weight and head size centile lines for babies up to one year old; page 38 shows a girl’s height and weight centile lines for children from one to five.

The centile lines printed on the charts show roughly the kind of growth expected in weight and in length. On each of the charts the middle line (shown as a red line in this book) represents the national average for white British babies. For example, if 100 babies are weighed and measured, 50 will weigh and measure more than the amount indicated by the red line, and 50 will weigh and measure less.

Most babies’ and children’s weight and height will fall between the two centile lines coloured blue in this book. Only four out of every 100 babies and children will have weights and heights that fall outside these centiles.

As these data are based on the average heights and weights of white children, it’s worth bearing in mind that if you’re of Asian origin your baby will on average be lighter and shorter. If you’re of African-Caribbean origin your baby will on average be heavier and longer.

Your child’s height and weight (and head size if under a year) will be plotted as a curved line on one of these charts. This makes it easy to see how your child is developing.

Whatever weight and length your baby is at birth, he or she should have a fairly steady growth, resulting in a line curving in roughly the same way, and usually inside, the centile lines on the chart. During the first two years of life it is quite usual for a baby’s line to cross the centiles on the chart from time to time, but if at any time your baby’s weight line suddenly goes up or drops (and it may drop, for example, because of illness), talk to your health visitor or GP about it.

You should also talk to your health visitor or GP if, after the age of two, your baby’s height curve does not follow a centile line or starts to veer upwards or downwards from it.

Remember that, even if your child’s development is satisfactory at one review, development is a continuous process. It is therefore important that you continue to observe your child’s development, attend all the reviews and talk to your health visitor or GP if you have any concerns about your child between these reviews.

General development 

Some health visitors may ask your child to do little tasks such as building with blocks or identifying pictures. Others may simply watch your child playing or perhaps drawing, and get an idea from this observation, and your comments, of how your child is doing. If you look at the development chart on page 31 you’ll have an idea of the kind of physical and verbal skills they’re looking for. 

If your child seems slow in one particular area of development you’ll have the opportunity to discuss what the reason may be. And to see whether there’s anything useful that needs to be done to speed things up.

If you don’t speak English 

If your first language is not English, or your child’s first language is not English, you can have help from an interpreter, linkworker or health advocate who can speak your language. Ask your health visitor about this help if you need it.


A baby should be able to see from birth. Eyesight develops gradually over the next six months.

By the first review, you’ll have noticed whether or not your baby can follow a colourful object held about 20 cm (8 in) away with his or her eyes. If this isn’t happening you should mention it.

At birth a baby’s eyes may roll away from each other occasionally. If a baby is squinting all, or much, of the time tell your health visitor and your GP.

If your baby is squinting you’ll need to be referred to an orthoptist or ophthalmologist who specialises in understanding children’s eyes.

Hearing and talking

Hearing and talking are linked. If your child can’t hear properly he or she will have great difficulty learning to talk and may need to be taught other ways of communicating. So the sooner hearing problems are discovered the greater the chance that something can be done.

It isn’t only hearing that is important though. Babies don’t learn to talk unless they’re talked to, even if, at first, the conversation is limited to making noises at each other. By learning to take it in turns to make babbling noises, your baby is learning what a conversation feels like. Most parents quite naturally join in babbling sessions with their babies and so they’re very often the first people to notice if there’s a problem.

If you’re ever worried about your child’s language development, talk to your GP or health visitor. Your child may be helped by referral to a speech and language therapist.

Your baby’s hearing may be tested at birth in the hospital. No baby is ‘too young’ for a hearing assessment. You should expect a hearing assessment at six to nine months. If there’s no apparent problem, but you’re still worried, ask for another appointment. If a problem is found, your baby will need to have a follow-up assessment because hearing loss may be temporary, due to a cold or a passing infection.

If your child doesn’t seem to hear properly at the second appointment, or you are still worried, ask for a referral to a specialist.

For some families, everything is not ‘all right’. Sometimes what begins as a worry does turn out to be a more serious problem or disability.

If this happens to you, your first need will be for information about the problem and what it’s likely to mean for your child and for you. You’ll have a lot of questions. Put them all to your GP, your health visitor and to specialists to whom you are referred. You may find it easier to make a list.

Be determined and persist if you need to. Not all health professionals talk easily or well to parents. And you yourself may find it’s difficult to hear and take in all that’s said to you first, or even second, time round. Rather than live with unanswered questions, go back and ask again for the information or opinion you feel you need. Or you could take along a tape recorder. If, in the end, the honest answer is ‘I don’t know’ or ‘We’re not sure’, that’s better than no answer at all.

Tips for helping your child learn to talk

  • Start talking to your child right from birth – say what you are doing about the house, as they happen e.g. when unpacking shopping.

  • Start looking at books with your baby from an early age. 
  • Point things out when going for a walk e.g. ‘there’s a bus, the bus is red’.
  • Have fun singing nursery rhymes and songs, especially those with actions.
  • Encourage your child to listen to different sounds.
  • Gain your child’s attention when you want to talk together.
  • Increase vocabulary by giving choices e.g. ‘do you want an apple or a banana?’
  • Give your child opportunities to talk.
  • Don’t have the television on as a background noise.
  • If your child says something incorrectly, say it back the right way. Do not make your child repeat it.

Bilingual children

Children who are growing up in a family in which more than one language is spoken don’t usually have problems. A few develop language more slowly. The important thing is to talk to your child in whatever language feels comfortable to you. This may mean one parent using one language and the other using another. Children usually adapt to this very well.

We are indebted to Health Promotion England for their help in compiling this section.