2025 – PAGE 184 – DEVELOPMENTAL MILESTONES & ANTICIPATORY GUIDANCE
SURVEILLANCE MILESTONES – 2 MONTHS OF AGE
| AGE | LANGUAGE &
COMMUNICATION |
MOVEMENT & PHYSICAL | COGNITIVE | SOCIAL &
EMOTIONAL |
| 2 mo | Makes sounds other than crying (e.g., “ooo” and “aah”); responds to loud sounds | Holds head up while prone; moves all four extremities; briefly opens hands | Fixates and watches your movements; views toys for several seconds | Able to be calmed when held or spoken to; looks at faces; appears happy to see a caregiver approaching; social smile when talked to |
MNEMONICS: A 2-month-old tracks or watches in TWO directions (TWO sides or 180º at “1.8 mo”).
MNEMONIC STORY: Imagine a two-month-old baby who loves camping. He is always such a happy camper and APPEARS HAPPY TO SEE YOU APPROACHING. He gives you the cutest SOCIAL SMILE as he LOOKS AT YOUR FACE. You excitedly shout to him that you’re taking him on an adventure to go on a camping trip! He RESPONDS TO YOUR LOUD SOUND and starts to cry, but he can be CALMED WHEN HELD BY YOU. As you’re holding him, he stops crying and starts to MAKE OTHER SOUNDS BESIDES CRYING. Since you need to start packing for the camping trip, you lay him on his belly on the floor. He HOLDS HIS HEAD UP WHILE PRONE and WATCHES YOUR MOVEMENTS as you pack. He sees you packing his favorite toys and VIEWS THE TOYS FOR SEVERAL SECONDS. When you get to the campsite, you pick him up and strap him into your custom-made hiking backpack carrier that has a special seat just for him. He starts squirming around and MOVING ALL FOUR EXTREMITIES. As you start hiking into the woods together to start your new adventure, he BRIEFLY OPENS HIS HANDS with excitement.
MNEMONICS FOR CRYING BY AGE: By three months of age, babies cry approximately 1 hour/day. Use 1-2-3 and 3-2-1 to remember that at months 1, 2, and 3, babies usually cry a maximum of 3, 2, and 1 hours per day.
PEARL: (DOUBLE TAKE) Colic is defined by LOTS OF THREES! The infant will have a normal exam and normal lab values. Look for a baby who has been crying > 3 hours/day at least 3 times/week for at least 3 weeks. The age should be between 3 weeks and 3 months. This should resolve by 3 – 4 months of age. Recommend that the parents recruit help from family/friends so that they can get breaks.
PEARL: If a child presents like this after 4 months of age, do an aggressive workup.
MNEMONIC: Remember the “3’s”: > 3 hours per day, > 3 times per week, > 3 weeks and resolves by 3 months of age.
2-MONTH-OLD MILESTONES TO KEEP ON YOUR RADAR
| AGE | LANGUAGE | GROSS MOTOR | FINE MOTOR | COGNITIVE | SOCIAL | RED FLAGS |
| 2 mo | Partial head lag (45°) with pull-to-sit at 2–3 mo | Unable to fixate; poor visual attention |