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Babies' first words are often seen as a important and precious moment in their development, marking the beginning of their journey into verbal communication. For instance, when the baby looks at his or her parent and says "mama" for the first time, it brightens up the parent's face with joy but it is a meaningful connection in their bond that is growing. For parents, these are some sources of pride and joy. But how do you determine whether your child's speech and language are progressing?
Understanding the communication milestones will help monitor a child's development and spot potential issues before they become more serious. The milestones serve as benchmarks to guide health care providers on whether a child needs further assistance.
The first five years of a child's life are the time of massive growth and brain development at an incredible speed. All domains of development find their roots within this period, including communication. From the day they were born, babies start crying to communicate, and within weeks or months, they begin to babble, imitate sounds, and eventually words. Communication is not only important to express needs but also for understanding the world and building relationships. It is an important tool that supports cognitive, emotional, and social development.
Babies learn communication skills at their own pace. General milestones can, however serve as a guideline for typical development. Let's go through these milestones by age:
At this point, the babies communicate mostly through crying. They give cues as to their needs by responding with actions like smacking the lips when hungry or arching the back when they feel overstimulated. At the end of three months, you may also observe:
By six months, babies start experimenting with sounds and use their voice to play. Major developments include:
By the first birthday, there are some significant communication milestones that have been achieved:
In this stage, children learn to understand and use words in a consistent manner. Some of the important milestones are:
By two years of age, children usually have more developed communication skills:
Parents can be very supportive in developing the communication skills of their child. Here are some effective strategies:
1. Pay Attention to Hearing: Ensure your child responds to sounds and voices. Notice if they react to noise or look at you when spoken to. If you suspect hearing issues, consult your pediatrician promptly.
2. Engage in Conversation: Respond to your baby’s coos and babbles. Talk to them frequently about daily activities, like “Mommy is making breakfast,” or “We’re going to the park.”
3. Imitation Training: Teach your baby to imitate actions and gestures of others, such as clapping, waving, or peek-a-boo. These activities encourage her to understand turn-taking and even nonverbal communication.
4. Animals Sound: Learning time must be fun. Train your baby to imitate an animal's sound, "A cow says 'moo.'". This encourages sound production along with word association.
5. Read and Sing Together: Reading stories and singing songs expose your child to language patterns and rhythm. Make it a daily habit to promote vocabulary growth.
6. Use Your Native Language: Speak to your child in the language you’re most comfortable with. Early exposure to rich language environments helps babies learn effectively.
7. Strengthen Their Attempts: Cheer every time your child tries to speak. Repeat the words and sounds and gently correct as needed. A little "baby talk" is okay but clearly say simple words for them to imitate.
Though every child develops at his own rate, there are some delays that point toward professional intervention. Talk with your child's health care provider if:
- Doesn't turn toward sounds or his name.
- By 12 months, he isn't babbling, and by 18 months, he has not spoken a single word.
- Uses speech in a peculiar manner or shows delayed speech.
Your pediatrician can refer you to some specialist who could be an audiologist or speech-language pathologist for more extensive testing. In the case of a bilingual child, he will also be evaluated by a bilingual speech-language pathologist.
Communication milestones form a kind of roadmap in understanding how your baby develops. This means through conversation, play, and learning activities, you could be able to enhance language skills while promoting your child's development. When concerned about delay, consult professional help, as this might make all the difference by having communication skills set up to meet a great future for your child.
Communication Milestones: Birth to 1 Year. American Speech-Language-Hearing Association
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Childhood allergies rarely present as isolated issues. While one child may experience itchy skin and rashes, another may complain of a perennial runny nose and some wheeze a lot with infections, and yet others present with food-related symptoms. Although these are distinctly different manifestations, they could have a single root cause.
Childhood allergies are basically an inappropriate immune response towards a substance that usually presents no harm, be it a food item or an allergen in the environment. However, it is not always easy to pick out what is causing the allergic response. The child's medical history as well as the nature and accompanying circumstances of the reaction, play a pertinent role in picking out what is precipitating the problem.
Two children may present with similar complaints but have different underlying allergic conditions. Understanding the pattern of the disease helps decide what investigations are needed and how best the condition can be managed.
Also read: In-Toeing In Children: When It Needs Assessment
Allergic diseases can affect multiple body systems. The most common are the skin, upper respiratory tract and the lower respiratory tract. Skin allergy manifests as atopic dermatitis or urticaria, upper respiratory tract can cause allergic rhinitis and conjunctivitis and lower respiratory tract can manifest as asthma.
There are also food allergies which could present with gastrointestinal symptoms or even more serious reactions. A child may also face multisystem involvement and this can sometimes be life-threatening like in a case of anaphylaxis.
Allergic disorders may present with multisystem involvement due to the fact that type 2 inflammation is a key driver in the pathology. Cytokines such as IL-31, IL-13 and IL-5 are integral to the formation of IgE antibodies and the activation of eosinophils. Genetic predisposition, skin barrier dysfunction, environmental exposure and the gut microbiota also contribute towards the development of allergies.
There is usually an evolution of allergic diseases as a child grows older. This is commonly referred to as the atopic march. It is common for a child to present with atopic dermatitis and then develop food allergies, allergic rhinitis or asthma later on in life. However, this is not always the case, and an allergic disorder cannot be extrapolated to the presence of any other based on this association alone.
Awareness to these associations can help parents and doctors to watch out for developing conditions and ensure early and appropriate intervention. For example, in a child presenting with persistent eczema, investigation for associated allergic disorders is vital if the history supports it. Early diagnosis and management can also help the parents identify red flags and seek help sooner.
A thorough clinical history is an extremely valuable tool when it comes to diagnosing allergies. It is important for the doctor to know what the likely allergen was, how soon after exposure the symptoms cropped up, whether similar symptoms have occurred before, and what body systems are involved.
The timing of the reaction and whether it is a one-off or recurrent episode is important. A reaction occurring minutes after ingesting a certain food is very different from a food that causes symptoms after days of consumption.
Skin prick tests and specific IgE blood tests are commonly used to screen for sensitisation to common allergens, but these are just pointers. A positive test does not necessarily signify a clinically relevant allergy. The symptoms and exposure history must always be taken into consideration.
Testing for specific IgE to a panel of foods without a clear indication is not only misleading but can also be harmful. Parents may unnecessarily eliminate food groups from the child's diet based on a positive test, thereby affecting nutrition. Similarly, total IgE levels are not helpful in diagnosing a specific allergy.
The treatment varies from managing acute symptoms (with antihistamines or steroids) to controlling chronic conditions (with regular inhaled steroids for asthma). Avoiding the allergen where possible, and treating flare-ups appropriately are the cornerstones of management. Immunotherapy with allergen extracts may be indicated in selected patients with respiratory allergies. Biologics may be considered in certain conditions under specialist supervision.
Children at risk of anaphylaxis should have a personalised action plan and an epinephrine auto-injector available at all times.
Childhood allergies should not be managed in isolation. The focus should be on the child as a whole rather than a single presenting complaint. Awareness and management of any associated conditions can help prevent potentially serious complications.
By Dr Gargi Mathur, Senior Paediatrician, Shalby International Hospitals, Gurugram
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Parents may notice that a child’s feet point inward while walking or running. This is called in-toeing. It is common in young children and, in most cases, reflects normal development of the foot or leg bones. Many children improve naturally as they grow, without treatment.
However, it is not always helpful to dismiss a persistent or troublesome walking pattern as “just a growing phase.” The child’s age, the cause, whether the pattern is worsening, and its effect on movement all matter.
In-toeing usually comes from one or more of three areas:
1)Foot: The front of the foot curves inward, a condition called metatarsus adductus. Flexible cases often improve naturally.
2)Shin: The shin bone turns inward, called internal tibial torsion. This is common in toddlers and usually improves with growth.
3)Thigh: The thigh bone turns inward, called femoral anteversion. It may become more noticeable when a child begins running or walking with the feet turned in.
The appearance of the feet alone does not always reveal the cause. A clinician can assess the child’s walking pattern and examine the hips, knees, shins and feet.
Also read: Hailey Bieber Opens Up About PMDD After Childbirth: What Is It And How Is It Different From PMS?
An occasional inward-pointing step, without pain or difficulty, usually needs observation rather than treatment. Arrange an assessment if the child:
The clinician will ask when the in-toeing began, whether it is changing, and whether it affects daily activities. They will observe the child standing and walking, and assess foot flexibility, hip and leg rotation, balance and function.
X-rays are not routinely needed when the history and examination fit a typical developmental pattern. They may be considered if there is pain, trauma, unusual examination findings or concern for another condition.
No. For typical, painless developmental in-toeing, reassurance and observation are usually appropriate. Special shoes, braces and orthotics do not correct the usual rotational causes. Physiotherapy may help when there is a separate issue—such as weakness, balance difficulty or impaired coordination—but it does not generally change the underlying bone rotation.
If in-toeing is severe, persistent and causing substantial functional difficulty, a paediatric orthopaedic specialist can advise whether further evaluation or treatment is appropriate. Surgery is rarely needed and is generally considered only for older children with severe deformity and significant functional problems.
A practical message for parents: Most children with in-toeing walk and play normally, and their alignment improves as they grow. The aim is not to make every child’s walking look identical; it is to ensure the child moves comfortably and safely. Seek an assessment for pain, limping, sudden change, pronounced asymmetry or meaningful difficulty with everyday activities.
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Model and entrepreneur Hailey Bieber recently opened up about her postpartum journey, shifting focus on one of the least-discussed aspects of women’s health: premenstrual dysphoric disorder (PMDD).
Hailey said that she experienced PMDD after the birth of her son, Jack Blues Bieber. It is a menstrual health condition that can cause intense emotional and physical symptoms.
In an interview with Women's Wear Daily, Bieber spoke about how motherhood drew her towards women's health, especially considering the challenges she faced after childbirth.
"After I had my son, I struggled with [PMDD] a bit, and there's just not a lot of conversation or research around it," she said.
Bieber, who welcomed her son with husband Justin Bieber in August 2024, had previously discussed her diagnosis during an appearance on the SHE MD podcast in March 2026. She said she was diagnosed approximately six months after giving birth.
Although she had experienced premenstrual syndrome (PMS) before pregnancy, she noticed that the emotional symptoms leading up to her period had become much more intense.
"I was like, 'This just feels way more intense than before,' like, the lead-up to getting your period," she said.
She said she experienced overwhelming emotions, adding, “Why does it feel like my whole entire life is gonna end? Like, I don't understand.”
Bieber said her symptoms gradually improved over time. She also highlighted how speaking about her experience helped her feel less isolated. "Conversation, for me personally, makes me feel less alone," she said.
Also read: 8 Signs Of 'Pregnancy' That Are Likely PMS
Premenstrual dysphoric disorder is a severe form of premenstrual syndrome (PMS) that causes intense emotional, mental and physical symptoms during the days leading up to menstruation.
By Dr Sushma K, Obstetrics, Gynecology and Reproductive Medicine, Apollo Hospitals, Seshadripuram, Bangalore told HealthandMe, "It is a chronic medical condition related to the menstrual cycle. It affects approximately around 3 to 8 percent of the women who are menstruating. So it not only causes physical symptoms, like premenstrual syndrome, it also causes emotional and psychological symptoms. It typically occurs one or two weeks before menstruation starts."
Unlike premenstrual syndrome, PMDD can significantly interfere with a person's ability to work, relationships, social life and other daily activities. When it comes to symptoms, patients can have sudden onset of sadness, increased sensitivity, or tearfulness, sudden spells of crying, severe irritability, anger, depressed mood and anxiety.
Dr Sushma said, "These emotional symptoms can also have physical manifestations. For example, decreased interest in going to school, office, and difficulty concentrating. Some may resort to overeating. Some may have excessive sleepiness or some may face insomnia. Some also experience restlessness, discomfort, joint swelling, muscle pain, and abdominal bloating.”
Also read: The Menstrual Cycle and Nutrition: Does Your Body Really Need Different Foods at Different Times?
PMS and PMDD are both caused due to hormonal changes in the menstrual cycle. However, the intensity of symptoms and their effects on daily life distinguish the two conditions.
Dr Sushma said, "PMS is a mild to moderate condition and it can be easily managed. It comes with physical symptoms like bloating, breast pain, tiredness, and mood changes. It also does not interfere with people’s daily routine and relationships. It occurs in almost around 75% of the people who are menstruating."
PMDD symptoms can be more severe, especially depression, anxiety, irritability and emotional distress. These symptoms can disrupt work, relationships and everyday functioning.
She added, "But PMDD is more severe. It will impair daily life. It also causes more intense psychological and emotional symptoms than physical symptoms."
So PMDD is not just an extreme version of a bad premenstrual week. It is a recognised health condition that may require medical treatment.
Experts say that the exact cause of PMDD is not fully understood yet. But they believe it may be due to an increased sensitivity to normal hormonal changes during the menstrual cycle.
After ovulation, levels of hormones like oestrogen and progesterone fluctuate. In some individuals, the brain may respond differently to these hormonal changes, affecting mood regulation and other bodily functions. Serotonin, a neurotransmitter involved in regulating mood, sleep and appetite, may also play a role.
Dr Sushma explained, "PMDD is a very severe depressive disorder. Patients may have panic attacks, depression, and thoughts of self-harming. So these are the key main important differences. PMDD may happen because of disrupted dysfunctions in the central nervous system during the menstrual cycle. That is because of how the central nervous system reacts to the normal estrogen and progesterone levels during the menstrual cycle.”
Hailey Bieber's experience has sparked conversation about PMDD risk after childbirth. Pregnancy, childbirth and the postpartum period involve significant hormonal and physical changes.
However, PMDD is linked to the menstrual cycle and its recurring hormonal fluctuations. The return of menstrual cycles after childbirth may make premenstrual symptoms intense. However, there is limited evidence establishing that childbirth directly causes PMDD.
Dr Sushma said, "New mothers may not face premenstrual dysphoric disorder because there is no ovulation. The lady is not menstruating because she is lactating. But once the ovulation starts, the symptoms of PMDD will return. These symptoms can worsen because the mother is sleep deprived or she faces a lot of hormonal changes. There is also a newborn. So the baby’s care-giving also adds to the stress. So PMDD may get aggravated in new mothers."
PMDD should also not be confused with postpartum depression. Postpartum depression can occur after childbirth and is not restricted to the days before menstruation.
The doctor explained, "Postpartum depression is not cyclical. Whereas PMDD will come in a cyclical manner, mostly 10-12 days before periods, which is usually in the luteal phase. Also, it may resolve after the bleeding starts.
Whereas postpartum depression is not related to the menstrual cycle."
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