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 UK today began the first phase of its flu vaccination program, offering jabs to millions of children and pregnant women ahead of winter.

Nearly 19 million people received their flu jab in England last year, helping prevent an estimated 104,000 hospitalizations.

Why Do Early Flu Vaccinations Matter?

Flu season typically peaks in December and January. Starting vaccinations earlier for children and pregnant women aims to protect those most vulnerable to serious illness and limit the spread of the virus before it circulates more widely.

Starting vaccination in September gives children and pregnant women time to build protection before flu begins circulating more widely. As per the NHS, the children’s flu vaccine can take up to 14 days to work.

Who Gets the Flu Jab First?

Children and pregnant women are among the first groups offered vaccination because they are more vulnerable to serious illness from flu.

Most school-aged children will receive their vaccine, via nasal spray, at school.

Parents of two- and three-year-olds, as well as children in clinical risk groups, will be invited to arrange vaccination through their GP practice.

Pregnant women can receive the flu jab at any stage of pregnancy through their maternity team, GP practice or participating pharmacy.

NHS teams are also taking vaccines into local communities, including through high street pharmacies and mobile vans.

Why Are Young Children and Pregnant Women More Vulnerable?

Flu can be much more serious than a bad cold. Every winter, thousands of children require hospital care because of the virus, while pregnant women also face a higher risk of serious illness.

Flu can spread quickly among younger age groups, which means vaccinating children can also help limit transmission to people who may be more vulnerable, including babies, grandparents and pregnant women.

Vaccinating pregnant women can also help protect their newborn babies in their first weeks.

“Flu can really knock you for six, and for some children and pregnant women it can mean becoming seriously ill or ending up in hospital. Getting vaccinated only takes a few minutes, but it can make a real difference – helping protect you and the people around you from getting seriously unwell,” said Dr Amanda Doyle, National Director for Primary Care and Community Services at NHS England.

When Will Other Groups Get Vaccinated?

From 1 October, flu vaccinations will be offered to other eligible groups, including:

• People aged 65 and over
• Adults with some long-term conditions
• Care home residents
• Carers
• Close contacts of people who are immunocompromised
• People experiencing homelessness
• Frontline health and social care workers

Parents of two- and three-year-olds will also be able to book appointments at participating community pharmacies through the National Booking Service from October.

NHS Expands RSV Vaccination Program

The NHS’s year-round RSV vaccination program is also expanding from today to include people aged 65 to 74 with a weakened immune system or certain long-term lung conditions.

RSV can make babies and adults with long-term lung conditions seriously unwell and increase their risk of hospitalisation.

Eligible people can receive the vaccine through their GP practice or, in some areas, a participating pharmacy. Those eligible should expect an invitation from their GP.

Pregnant women can also receive RSV, whooping cough and flu vaccines to help protect their newborn babies in their first weeks.

“Vaccinations play a vital role in protecting those most at risk from flu and they are also crucial for relieving pressures on our NHS over the winter months,” Secretary of State for Health and Social Care Yvette Cooper said.

“Everyone who is eligible for a free vaccination will be notified through their phone or in the post,” Cooper added.

A US woman has naturally conceived and given birth to a healthy set of triplets, a rare pregnancy that medical professionals described as an uncommon occurrence.

Nyla Craft from South Bay region in Los Angeles, already a mother of two — a daughter and a son — gave birth to three boys: two identical twins and a third who is their fraternal sibling, said chief of neonatology Dr Rohit Passi at Kaiser Permanente South Bay Medical Center, as reported by the Los Angeles Times.

“This is a very rare pregnancy and a rare outcome,” Passi said.

Triplets Conceived Naturally

The triplets were conceived naturally, Passi said, which happens in only about one in 10,000 pregnancies.

They were carried for 36 weeks, which is considered a good gestational period for triplets. All three were born at a healthy weight, with a combined weight of about 19 pounds — around three pounds short of the reported world record total weight for triplets, according to the Guinness Book of World Records.

Also read: Scottish Toddler With Rare UV Disorder Gets UV-Safe Home: All About Inherited XP

Pregnancy Was Physically Demanding

Craft said she first learned she was expecting triplets during a doctor’s appointment earlier this year.

“Earlier this year, I went to the doctor and I saw like two different sets,” she said. “I was like, oh my goodness, I’m having twins. And she was like, no, there are three. And I was like, oh my gosh, triplets.”

Craft said the physical demands of carrying the triplets were unlike anything she had experienced before.

When she learned the three babies weighed a combined 19 pounds at birth, the figure put her difficult pregnancy into perspective, ABC7.com reported.

Rare Combination Of Identical And Fraternal Twins

Quynh Vo-Hanser of Kaiser Permanente South Bay said the pregnancy was especially unusual.

“This is a really rare event,” Vo-Hanser said. “This is what we would refer to as a mixed triplet. This is a spontaneous pregnancy, which meant that it was achieved naturally. And within this triplet set, there’s an identical twin set, and then the fraternal sibling.”

Vo-Hanser emphasized the rarity of the birth. “Within the United States, there are 3.5 million deliveries and about 2,400 are triplets,” she said.

Hospital Assembled Larger Delivery Team

Read More: Fournier Gangrene: Woman Develops Rare Flesh-eating Infection After Bikini Shave, Herbal Application

The rare delivery on August 18 required a larger-than-usual medical team to care for both the mother and the three babies.

There were three NICU nurses, one for each baby, along with two doctors caring for the babies and additional doctors and nurses looking after Craft. “There were about 15 people in the delivery room when we normally have about five,” Passi said.

Triplets Came Close To Reported World Record

The trio’s combined birth weight of about 19 pounds also put them close to the reported world record for the heaviest set of triplets at birth, which stands at 22.7 pounds.

The combination of a naturally conceived triplet pregnancy, an identical twin pair and a fraternal sibling, all born at 36 weeks and of the same sex, made the delivery particularly unusual, according to the medical team.

A fever in an infant or young child is often dismissed as a routine infection. However, recurrent or unexplained fever could sometimes point to a urinary tract infection (UTI), which, when associated with an underlying abnormality, may put the kidneys at risk. Identifying UTIs early is particularly important in infants and toddlers who cannot communicate their symptoms.

When Fever May Signal a UTI

Unlike older children, infants and toddlers cannot explain symptoms such as pain or burning while urinating. A UTI may therefore present only as fever, poor feeding, reduced milk intake or irritability.

Whenever a child has a febrile UTI, we should look for an underlying cause. One such condition is vesicoureteral reflux (VUR), where urine flows backwards from the bladder towards the kidneys.

How Reflux Can Affect the Kidneys

When bacteria are present in the bladder, this backward flow can carry infection towards the kidneys. Repeated kidney infections can cause renal scarring, particularly in young children.

Repeated scarring can affect kidney growth and function and, in severe cases, contribute to chronic kidney disease later in life. This makes timely evaluation and management important.

Also read: No Washrooms for Women: The Shocking Health Risks of UTI, Hyperuricemia & More

Not Every Child Needs Surgery

After a documented febrile UTI has been treated, children may require evaluation for an underlying cause based on their age, history and clinical findings. If VUR is identified, treatment depends on its severity. Not every child with reflux needs an operation. Management depends on the grade of reflux and the child’s clinical condition.

VUR is graded from 1 to 5. Low-grade reflux, particularly Grades 1 and 2, can often be managed through monitoring and, in selected cases, antibiotic prophylaxis. Many children may outgrow the condition as the urinary system matures.

Higher-grade reflux, especially when associated with recurrent infections or renal scarring, may require intervention. Options include minimally invasive Deflux injection or laparoscopic and robotic-assisted surgery in selected cases.

Also read: AIIMS Performs Second Dual Kidney Transplant Using Organs From 70-Year-Old Donor: How It Can Expand Donor Pool?

Prevention Goes Beyond Antibiotics

Constipation, bowel and bladder dysfunction, and improper toilet habits, which can contribute to recurrent UTIs, should also be given attention. Encouraging children to void regularly and managing constipation can help reduce infections.

In the present era, urinary abnormalities may be suspected during an antenatal ultrasound (TIFFA scan) allowing early postnatal evaluation and monitoring.

Early Detection Can Protect Kidney Health

The message for parents is simple: recurrent fever in a young child should not always be dismissed as a routine infection. Identifying a UTI and investigating an underlying problem such as VUR at the right time can help prevent recurrent infections, reduce renal scarring and protect kidney health in the long run.

By Dr. G. Ravindra Varma, Managing Director and Senior Consultant Urologist, Andrologist, Uro-Oncologist, Laparoscopic and Robotic Surgeon, AINU, Visakhapatnam