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.

Importance of Communication Development in Early Years

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.

Speech Milestones by Age

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:

Newborn (0-3 Months)

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:

• Smiles in response to your appearance.
• Cooing sounds.
• Quiets or smiles when spoken to.
• Your voice.
• Different cries for specific needs.

Upto 6 Months

By six months, babies start experimenting with sounds and use their voice to play. Major developments include:

• Making gurgling sounds during play.
• Babbling with different sounds.
• Vocalizing likes and dislikes.
• Responding to the change in tone of voice.
• Turning eyes toward sounds.
• Showing interest in music and sound-making toys.

Till 12 Months

By the first birthday, there are some significant communication milestones that have been achieved:

• Trying to imitate speech sounds.
• Speaking basic words like "mama," "dada," or "uh-oh."
• Responding to simple commands, such as "Come here."
• Recognizing common items by name, like "shoe."
• Turning toward sounds and voices.

Upto 18 Months

In this stage, children learn to understand and use words in a consistent manner. Some of the important milestones are:

• Knows the names of people, objects, and body parts.
• Responds to simple commands with gestures.
• The child says up to 10 words.

End of 24 Months

By two years of age, children usually have more developed communication skills:

• Using simple sentences, like "more milk."
• Asking one- to two-word questions, such as "Go bye-bye?"
• Following simple directions and answering simple questions.
• Saying 50 or more words.
• Being understood by family members at least half the time.

Ways Parents Can Support Development

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.

When to Seek Medical Attention

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

The Food Safety and Standards Authority of India (FSSAI) has issued notices to Zydus Wellness, Nestlé India, Abbott Healthcare, Nutricia International and Mead Johnson Nutrition over advertising claims involving children's nutritional drinks and infant formula products.

The regulator has asked these brands to provide scientific evidence to support their claims about growth, immunity, concentration, and digestion, and questioned the promotion of infant milk substitutes on social media.

The notices, which were shared on social media on October 21, also named an Instagram influencer, Ira Fathima, over sharing a Reel recommending infant formula products. The action concerns compliance with food advertising rules and laws regulating the promotion of infant milk substitutes.

FSSAI Questions Complan's ‘2X Faster Growth’ Claim

FSSAI has asked Zydus Wellness Products to provide evidence for claims made on Complan's packaging, including “2X Faster Growth”, “Supports Concentration and Memory” and “Pro Immunity+ 34 Vital Nutrients”.

The regulator also questioned their promotional statements like “Grow Taller, Faster”, “Clinically Proven 2X Growth” and “Growth Comes in 4 Flavors”.

It said the claims appeared to violate the Food Safety and Standards (Advertising and Claims) Regulations, 2018, and sought scientific justification for the advertised benefits.

Zydus Wellness has maintained that Complan complies with applicable regulations and that its claims are supported by scientific evidence. The company said it had submitted a detailed clarification to the authorities.

Also read: FSSAI Proposes No Added Sucrose Or Fructose In Foods For Babies Up To Six Months: How Can It Affect Infant Health

Nestlé Asked To Substantiate Infant Formula Claims

FSSAI has separately questioned claims on two Nestlé India products, Lactogen Pro 1 Powder and NAN Excella Pro Stage 1.

For Lactogen Pro 1, the regulator asked to provide evidence supporting the claim that whey protein in the product is “easy to digest”.

On NAN Excella Pro Stage 1, FSSAI flagged the claim “5 HMOs helps support the normal immune system”.

The regulator said the statement could imply that the product supports a certain physiological condition, which may not comply with rules restricting such claims unless specifically permitted.

FSSAI also sought scientific substantiation for the whey protein digestibility claim appearing on NAN Excella Pro Stage 1.

Nestlé India said it had already submitted a detailed response to the regulator regarding the product-label issues.

In a statement dated September 18, the company said its products and labels had been approved by FSSAI's expert committee and that the statements were supported by scientific evidence.

Also read: Red Bull Vs FSSAI: Beverage Giant Can Retain The 'Energy Drink' Label; What Are Its Health Risks

Infant Formula Promotions On Social Media Also Under Scrutiny

In a separate notice, FSSAI flagged an Instagram Reel posted by Ira Fathima in which she recommended five infant formula products - NAN Pro 1, Aptamil Premium 1, Similac Advance 1, Enfamil A+ Stage 1 and Dexolac 1.

The Reel spoke about benefits of these products like balanced nutrition, stronger immunity, brain development and easy digestion to the products.

The regulator alleged that the promotion violated the Infant Milk Substitutes Act, 1992, as amended in 2003, and the Food Safety and Standards (Foods for Infant Nutrition) Regulations, 2020. These rules govern the advertising, marketing and promotion of infant milk substitutes.

The notices also named Abbott Healthcare, Nutricia International and Mead Johnson Nutrition India over their promotional content.

Abbott said it was neither involved in nor aware of the Instagram content before receiving the notice, and did not endorse the claims made in the Reel.

Should Parents Be Worried?

Parents should pay attention, but they do not need to panic. FSSAI's notices raise questions about particular advertising claims and infant formula promotions. They do not mean that the named products have been declared unsafe.

For Complan, the regulator has questioned claims like “2X Faster Growth” and “Supports Concentration and Memory”. Even though this does not establish that Complan is harmful, parents should not assume a drink will make their child grow twice as fast or improve memory based on advertising alone.

For infant formula, the notices is against claims about digestion and immunity, and promotional practices. They are not a blanket warning against using infant formula. If your baby needs formula, don't stop or switch it abruptly. Discuss these concerns with your paediatrician.

Digital technologies have transformed how children learn, communicate and access information. But concerns about mental health and online safety have prompted governments worldwide to consider restrictions on children's social media use. In India, Karnataka has announced a social media ban for children under 16. Other states, including Andhra Pradesh, Goa and Bihar, are considering age-based restrictions.

On October 15, the Supreme Court held that “the right to access and use the internet is a fundamental right of every individual.” A bench of Justices J B Pardiwala and K V Chandran added that children, “irrespective of their age, enjoy the same rights,” and that “the safety of our children and their freedom are not at odds with each other. Our children are entitled to both.”

The debate is not just about screen time. It also concerns how digital platforms are designed, how algorithms shape what children see and how these factors may affect their health and well-being.

A recent three-paper Series in The Lancet examines these issues through the concept of digital determinants of health: the digital systems, business models and design choices that influence health outcomes.

In an exclusive interview with HealthandMe, Dr. Salman Fitrat Khan, a member of the Youth Advisory Group for The Lancet Series on Digital Determinants of Health and a co-author of its umbrella review, “Associations of digital media use with health, behavioural and developmental outcomes in children and adolescents: an umbrella review and meta-analysis,” discusses how governments can protect children's mental health while safeguarding their digital rights.

Also read: Over 2 Hours of Daily Screen Time Linked to Depression, Obesity In Young People: Lancet

Q. What does this Lancet Series mean for children and adolescents in India, where smartphone and social media use is rising rapidly?

Dr. Salman: India has the world's largest youth population, with about 65% of its people under 35. Digital access and media use are also expanding rapidly. At this scale, even modest adverse effects of digital media could add up to a substantial public health burden.

India has an evolving regulatory framework for digital technologies and child protection. Existing safeguards include the Digital Personal Data Protection Act, 2023, which provides for verifiable parental consent for children, and the Protection of Children from Sexual Offences (POCSO) Act.

However, enforcement remains uneven, and requirements for child-friendly platform design and systemic risk assessment are less developed than in some other jurisdictions. Restrictions on social media use by children under 16 are also being considered at national and state levels.

Generative AI is already part of Indian children's lives. One consulting report found that 77% of children older than 10 had used it for schoolwork, although this is not a peer-reviewed finding.

A major challenge is the lack of research from low- and middle-income countries. Very few studies we reviewed came from these settings. Locally led research is therefore crucial to understanding how rising smartphone and social media use affects children and adolescents in India.

Q. Are parental screen-time limits enough, or should countries regulate platform design and recommendation algorithms? What measures do you suggest?

Dr. Salman: Parental limits alone are not enough. Current approaches place much of the responsibility on young people and families, even though many risks arise from systems largely beyond their control. No single measure, including age limits, is sufficient.

The Series identifies device screen-time limits as an example of “technological solutionism” and proposes a broader approach:

• Safer platform design: Require age-appropriate defaults, safeguards for high-risk features and assessments of potential harm before new features are widely rolled out.
• Protection from commercial exploitation: Ban behavioral advertising and commercial profiling of minors.
• Platform accountability and transparency: Require companies to assess and mitigate mental health risks associated with recommendation systems and engagement-driven design. Improve algorithm transparency and provide vetted researchers with secure, legally protected access to platform data.
• Age restrictions with safeguards: Design age-based limits that prevent exclusion and avoid broad identity-verification requirements.
• Ongoing evaluation: Assess interventions continuously and adapt them as evidence emerges, including to address unintended consequences.

Support for parents remains important through caregiver resources and digital literacy. However, these measures should complement structural reforms rather than substitute for them.

Read More: Social Media Bans for Kids Gain Ground Worldwide: Will They Work?

Q. Which digital features pose the biggest concerns for young people's mental health?

Dr. Salman: The Series does not rank these features, noting that platform design remains largely invisible in current research. However, it highlights several areas of concern:

• Engagement-maximizing design: Infinite scrolling, autoplay and hyper-personalized algorithms can encourage habitual use and have been linked to effects on attention, sleep and emotional regulation.

• Engagement metrics and recommendation systems: Likes and follower counts may fuel anxiety, while recommendation systems can lead users into increasingly narrow content streams.

• Notifications: Frequent notifications can interrupt attention and encourage reward-seeking behavior.

• Appearance-focused content: Such content may contribute to depression, anxiety and body dissatisfaction, particularly among girls and young women. The Series' umbrella review found an association between body-ideal content and poorer well-being.

• AI companions and generative AI: AI companions raise concerns about emotional manipulation, while generative AI can produce images of young people that may be used for exploitation and abuse.

• Data-driven advertising: Children's data can be used for commercial targeting, including advertising unhealthy products.

These concerns do not mean that every child will experience harm or that every feature has the same level of evidence behind it. The Series highlights the need for better research into how platform design affects young users.

READ: Is India Set To Implement A Social Media Ban For Children?

Q. How should parents distinguish normal digital use from problematic use?

Dr. Salman: The Series defines problematic digital use by its pattern rather than the number of hours spent online. It involves loss of control, preoccupation and continued use despite harm. There is no universally consistent definition of problematic use in research.

Warning signs include digital use that disrupts sleep, schoolwork or relationships, or displaces physical activity and face-to-face interaction. Late-night use can also be a concern.

Heavy use, however, can be entirely normal for teenagers, including when they communicate with peers or explore their identities. Some forms of digital engagement can be beneficial, particularly moderate, socially oriented use. For young children, educational content watched alongside a caregiver was associated with better outcomes.

Parents should avoid treating problematic use solely as a child's failing. This can overlook the role of platform design in shaping behavior. The Youth Advisory Group also described doomscrolling as a response to platform environments rather than simply a personal choice.

Q. What would you want policymakers and technology companies to change first?

Dr. Salman: Technology companies should prioritize two steps:

• Assess new products for potential harm before release.
• Share data and internal research with vetted researchers.

For policymakers, the Series recommends treating digital determinants of health as a core public health responsibility. This includes:

• Designating focal points within health ministries to coordinate with education and data protection authorities.
• Prohibiting third-party tracking of minors in publicly funded health and education systems.
• Auditing school platforms, youth health apps and major social media platforms used by adolescents.
• Involving young people as partners in policymaking, not merely as consultees.

Where regulatory capacity is limited, practical starting points include incorporating digital risks into school health surveys and adolescent health programmes.

Pennsylvania’s health department has issued a health alert on congenital measles for the first time in decades as cases rise among pregnant women and newborns.

As of October 19, Pennsylvania had reported 1,286 measles cases across 42 counties, with 247 hospitalizations and six reported deaths. At least 50 pregnant women have reportedly been affected.

At least one death has been linked to congenital measles. The first death reported in the current outbreak was that of a newborn boy who died immediately after birth while his mother was severely ill with measles.

The health department said the outbreak had raised concerns about congenital measles, which has not been identified in the state for decades. The alert provides clinical guidance on managing measles during pregnancy and in newborns.

Decades of MMR vaccination meant many doctors had never encountered such cases. However, declining vaccination rates have allowed measles to spread in under-vaccinated communities.

Nationwide, 4,410 confirmed measles cases had been reported as of October 15, according to the US Centers for Disease Control and Prevention (CDC). Of these, 96% were in unvaccinated people.

Also read: What Happens After Measles Infection? The Hidden Risks That Can Last For Years

What Is Congenital Measles?

Congenital measles occurs when a pregnant woman contracts measles and transmits the virus to her fetus through the placenta.

According to the American College of Obstetricians and Gynecologists (ACOG), newborns with clinical or laboratory evidence of measles within the first 10 days of life following exposure in the womb are considered to have congenital measles.

Historical reports suggest that transmission occurs in approximately 25% to 30% of cases when the mother develops measles in the days before delivery, although data are limited.

What Happens to Babies With Congenital Measles?

Congenital measles can range from an asymptomatic infection to severe disease and death, according to ACOG. Symptoms may include fever, rash and jaundice. Complications can include pneumonia, low platelet counts and neurological problems. The rash may appear late, look different or be absent.

Can Congenital Measles Be Fatal? What To Watch For In Newborns?

Read More: Measles Cases Are Rising in US—Who Should Get A Booster Shot?

Before immune globulin became widely used, congenital measles mortality was reported to be as high as 30%.

Affected newborns also face an increased risk of subacute sclerosing panencephalitis (SSPE), a rare, fatal brain disease that can develop months to years after infection.

ACOG advises considering newborns at risk of symptomatic, transmissible measles if they are born after maternal symptoms begin and up to 14 days after the mother's rash onset.

Asymptomatic newborns who initially test negative may be considered for repeat testing on day 10 of life to check for infection acquired in the womb.

How Can Parents Protect Their Babies From Measles?

MMR vaccination before pregnancy is the best way to prevent measles during pregnancy and reduce the risk of congenital measles.

Women without evidence of immunity should receive at least one MMR dose in non-outbreak settings and two doses at least 28 days apart during outbreaks.

Because MMR is a live vaccine, it should not be given during pregnancy. Women should avoid pregnancy for 28 days after vaccination.

Pregnant women who may have been exposed to measles or are unsure of their immunity should promptly contact their healthcare provider.