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Health and Environmental Issues for Children Under Six

Promoting Normal Growth & Development

Growth and Development

The first five years of life are a time for rapid development and growth. Infant, toddler, 3-year-old, 4-year-old, 5-year-old: at each age, children are growing, trying out new abilities, and learning from the people in their lives. Caregivers should learn about normal growth and development. This means knowing what to expect at each stage of early childhood. How much should a baby gain in weight during the first year? When will the baby stand up? How many words does a typical 2-year old use? How do toddlers play?

All areas of children's development are important: physical health, language, learning to walk and run, emotional health, social skills, and learning ability. It is important to remember that each child has his or her own personality and abilities. Each family has their own way of living. Caregivers can do much to promote young children's growth and development, by being sensitive to the unique needs of the child and his family.

Here are some internet sites that provide interesting, up-to-date information on a wide variety of child development and health topics for parents and caregivers.

The "National Network for Child Care" is at . This website is provided by the United States Department of Agriculture Cooperative Extension System. It has articles by child development experts on many topics in child development. It also has brochures and fact sheets that describe normal growth and development . There are articles on specific ages and stages of development.

The Bright Futures website is . Bright Futures has attractive and easy-to-read publications on health, nutrition, family issues, oral health, physical activity and mental health. It provides good advice on children's growth and development. This website is provided by the United States Department of Health Resources and Services Administration, Maternal and Child Health Bureau, and the National Center for Education in Maternal and Child Health.

The KidsHealth internet site can be reached at . KidsHealth was developed by the Nemours Foundation. It provides information on a wide variety of child development and health topics for parents and caregivers. There are articles on what to expect at different ages and stages of development.

Brain Development

Babies are actively learning about their world from the day they are born. Very young children learn from every encounter with their parents and caregivers. Early brain development is rapid. The baby is building the basic structure of the brain by using his senses of sight, hearing, touch, taste and smell. That is why good nutrition, loving care, a safe and stimulating environment, and protection from diseases and trauma are so important for young children.

Some tips to support early brain development:

  • Listen to the baby for clues about what he needs.
  • Turn off the television and the radio.
  • Read to the baby.
  • Play with the baby.
  • Control your emotions - don't get mad at the baby.
  • Never hit or shake a baby. A single blow or shaking can cause lasting damage to a baby's brain!

For more information about early brain development, please visit the BrainWonders internet site, which can be reached at BrainWonders was developed by the Boston University School of Medicine, the Erikson Institute and the Zero to Three National Center for Infants, Toddlers and Families. This website provides interesting, up-to-date information on early brain development for parents and caregivers.


Infants do not sleep on the same time schedules as adults or older children. It is important for parents and caregivers to understand how newborns sleep and the changes in sleep patterns that happen during the first two years.

Newborn babies sleep up to 16 hours per day, but for only a few hours at a time. This pattern is related to feeding, as babies must eat every three to four hours throughout the day and night. While most parents want their babies to sleep through the night, this is not the baby's usual sleep pattern for the first three months. Parents should expect to get up at night to feed and change their babies, and then soothe them back to sleep. Caregivers should provide quiet areas, free from distractions, to promote sleep during the day.

Sleep safety

  • Place the baby on his back to sleep.
  • Remove pillows, thick comforters, stuffed toys or objects with strings or cords.
  • Have a crib that meets safety standards with no wide spaces between bars and sides that can not suddenly fall.
  • Do not bring a baby into bed to sleep with you.

Establish a routine for naps and bedtime.

  • Keep a positive attitude.
  • Have regular patterns of feeding, changing, playing, and reading.
  • Pick up a crying baby and take care of his needs, including cuddling or carrying the baby for awhile.
    You cannot "spoil" an infant by paying attention to her!

Crying and Colic

Do not be surprised if the baby has a "crying time" in the evening, from about five to seven o'clock. There is often a lot going on as parents come home from work, baby comes home from child care, and older children come home from school. Everyone can feel restless, hungry and fussy at the same time. Try to put the baby's needs first and remember that things will settle down.

Many babies have colic, which is a period of continued crying for three or more hours.

  • Check to see if the basic needs are met (hunger, dry diaper).
  • Try consoling the baby by carrying him around, rocking, using a baby swing, or riding in a car.
  • Get another adult to help for a while.
  • Try to stay calm: the crying will end.
  • Seek help and advice from a doctor or nurse if colic if frequent or if the baby shows signs of illness.

Sleep patterns change as a baby becomes a toddler. Between the ages of one and two, a toddler will need about 10 to 12 hours of sleep each day. Many children nap for several hours. Young children may still wake up during the night, for a variety of reasons like teething, dreams, or being wet or hungry.

Safety is very important.

  • There should be no large items in the crib that the child could stand on to climb out.
  • There should be no items with cords or strings in reach of the child.
  • It may be time to get a bed for the child, especially if he or she is ready to climb out of the crib.

Useful Internet Sites

For more information about sleep, please visit the KidsHealth internet site, which can be reached at KidsHealth was developed by the Nemours Foundation. It provides interesting, up-to-date information on a wide variety of child development and health topics for parents and caregivers.

At DHEC, contact Dr. Max Learner at 898-0748 or email to