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Your Baby is: Three Months Old

Managing Expectations: Neurodevelopment at Three Months Old

The "wait and see" in HIE, as our community calls it, isn't a matter of waiting to intervene; it's learning about your child, what you can do to help them reach their unique potential, and give you tools of empowerment to hopefully decrease your anxiety, increase your confidence, and bring more joy to your journey.

While you may sometimes feel anxious about waiting to see what their development looks like, we hope this information will decrease that anxiety. As always, we are here for you every step, every inchstone of the way.

Three Month Visits

Your follow-up schedule may vary depending on where you live, your access to healthcare, what types of services and providers your child may need, and other factors. Whether it's with a family doctor, pediatrician, neurologist, or another developmental provider, we want to help you feel prepared, empowered, and secure in knowing you're not alone.

Know Before You Go

One of the hardest parts of this journey of unknowns is knowing what questions you may want to ask or things you "should" be doing. Here are a few different questions to think about as you prepare for a six-month visit with either your child's medical team:

Development

If applicable, collect information (therapy reports or daycare concerns) to bring to this appointment.

  • What is typical or atypical about my child's development in [area]?
  • What are the short or long-term impacts in this developmental area?
  • I'm finding it surprising that...
  • I am worried that...

Feeding

  • My child is having trouble with (fill in the feeding concern.)
  • What are the appropriate next steps?

Seizure Risk

  • What do they look like? How should I report concerning movements?
  • What are infantile spasms? What is the risk factor for them? When are they likely to occur?
  • Is there a need for future EEG/MRI?
  • What should I know about AEDs?

Take Your Time

Clinical visits can be overwhelming - whether you have to travel far, you may be understandably nervous, anxious, or worried about your baby and their development. Know that your child's team is there to help you and your child. It's okay to ask for clarification on how to reach your team in between appointments and their concerns, as well as time to process new information or to repeat information you've heard.

History

  • This is how your provider gets to know you and your child!
  • The provider will ask you questions about interval development, feeding, abnormal movements, and any major changes that have happened since you were last seen.

Exam

  • The provider will perform a thorough neurologic exam and will look for expected vs. atypical findings in the developmental areas listed below.

Debrief

  • The provider will review and discuss findings from the neurologic exam.

Next Steps

  • The provider will leave time for you to ask questions, discuss your concerns, and celebrate victories.
  • Ask about the next steps: recommended therapies, early interventions, equipment needs, and recommended educational resources.

Back Home & Next Steps

You've made it through the visit, and you may feel many ways - relief, sadness, frustration, confusion, hope, joy... some, all, or none of the above! It's very normal to feel like you forgot to ask certain questions, and this is the time when, in between appointments, you can feel once again like you're back in the wild. You're NEVER alone. We have some tips below, and we are always here to provide support.

Follow-Up

  • Ask for clarification on the follow-up schedule with the provider (this may vary depending on the provider.)
  • Create appointments for the referred or recommended therapies and early interventions.

Monitor

  • Take notes and videos, or monitor your child’s progress to share with your provider, therapy, or early intervention specialists.
  • Monitor for seizures, loss of skills, or lack of developmental progress.

Seek Resources

  • The provider will give "anticipatory guidance," including milestones to focus on, what to expect, what to look out for, and when to call.

Neurodevelopmental Guide: Three Months Old

Many families wonder what is typical and what may be considered a concern in their child's development. We've worked to try to break down this information into easy-to-understand tools that you can use to learn more and build better relationships with your child's team.

The neurodevelopmental guide below shares the following:

  • Neurotypical expectations: What the average three-month-old is typically expected to be doing from a development perspective

  • Clinical notes: These are findings that may be outside of those expectations

  • Recommended interventions: These are things that can be worked on either at home, with early intervention therapies, or by referrals to additional specialists or team members who may address certain areas of concern.

Clinical Exam

In addition to the above developmental areas, the clinician/provider will also give your baby a clinical exam, from head to toe (and they are really cute toes), and in between! They look for specific markers in growth and development during this part of the visit.

Developmental Resources

Everyone has their favorite resources, and these come recommended by our Medical Advisory Board, Staff, and Community of Families:

Disclaimers:

  1. If at any point the child has signs or symptoms more than expected for the course, then additional workup may be recommended.
  2. This information does not substitute the guidance and recommendations of your healthcare provider.
  3. This information is general and not personalized medical advice; for specific concerns, please reach out to your healthcare provider.
  4. The development presented is based on typical developmental milestones based on normative data, CDC / AAP (2022). Your provider may use a subset or a different developmental screening, too.

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