📏 Children's Health

0–5 years

Child Growth and Developmental Milestones

Is your child growing and developing normally? A practical guide for Nigerian parents.

Every child develops at their own pace, but there are important milestones that most children reach by certain ages. Missing milestones may indicate a developmental problem that benefits from early intervention. Regular growth monitoring at clinic visits is one of the most important aspects of children's health in Nigeria.

⚠️ Go to Hospital IMMEDIATELY if your child has:

🚨 Loss of a skill the child previously had (e.g. stops talking, stops walking) — regression is always concerning

🚨 Child cannot see or does not follow faces by 3 months

🚨 Child is not responding to sounds at any age

🚨 Seizures or uncontrolled movements

🚨 Child appears extremely small or thin for age — possible severe acute malnutrition

🚨 Child has very large head or very small head compared to growth chart

Signs Parents Notice

• 0–3 months: smiles socially, tracks faces with eyes, holds head briefly when on tummy

• 4–6 months: rolls, reaches for objects, babbles, recognises familiar faces

• 6–9 months: sits with/without support, transfers objects between hands, responds to own name

• 9–12 months: crawls, pulls to stand, says "mama"/"dada" meaningfully, waves

• 12–18 months: walks, says 5–10 words, follows simple instructions

• 18–24 months: runs, 2-word phrases, uses spoon, symbolic play (pretend play)

• 2–3 years: 3-word sentences, follows 2-step instructions, asks questions

• 3–4 years: dresses with help, pedals a tricycle, plays with other children

• 4–5 years: tells stories, uses scissors, knows name and age, counts to 10

Home Care — What You Can Do

Monitor weight and height at every clinic visit

The Road-to-Health chart (child welfare card) shows your child's growth trajectory. A child who was on the 50th percentile and drops to the 10th over months needs assessment, even if they look "okay".

Stimulate your child's development

Talk to your baby constantly — narrate your activities. Read to them from birth. Allow supervised tummy time from day 1. Let toddlers explore and play. Limit screen time under 2 years — it delays language development.

Feed appropriately for age

Exclusive breastfeeding for 6 months. Introduce complementary foods at 6 months while continuing breastfeeding. By 12 months, family food (mashed) 3 times a day plus 2 nutritious snacks.

Ensure regular immunisations

Follow the Nigerian immunisation schedule — vaccines protect against diseases that can permanently impair development (meningitis, measles).

When to Seek Medical Help

SoonAny missed milestone — particularly language delay (no words by 12 months, no 2-word phrases by 2 years), motor delay (not sitting by 9 months, not walking by 18 months).

SoonConcern about child's hearing — not turning to sounds, inconsistent response to voices.

SoonChild's weight falls across two or more percentile lines on the growth chart.

RoutineRegular clinic weight and height checks — every month for under 1 year, every 3 months for 1–5 years.

Common Mistakes to Avoid

🚫 Do not compare your child's development rigidly to another child's — there is a normal range
🚫 Do not dismiss concerns about development as "he is just a boy" or "she will catch up" — early intervention for delays is far more effective
🚫 Do not leave developmental concerns until school age — the earlier intervention begins, the better the outcome
🚫 Do not deprive a child of stimulation — children learn through play, conversation, and exploration

Tests Your Doctor May Order

Weight, Height, and Head Circumference Plotting

Plotted on growth charts at every clinic visit — the most important monitoring tool for child growth.

Hearing Screen

Newborn hearing screen should be done before hospital discharge. At-risk children (family history, premature birth, neonatal jaundice) need formal audiology assessment.

Vision Screen

Red reflex examination at birth detects congenital cataracts. At 3–4 years, visual acuity can be formally assessed.

Developmental Screening Tool (ASQ)

Ages and Stages Questionnaire — a parent-completed tool used at 9, 18, 24, and 30 months to systematically screen for developmental delays.

How It Is Treated

Early Intervention for Developmental Delay

Physiotherapy for motor delay, speech and language therapy for language delay, occupational therapy for fine motor delay. Early intervention — before age 3 — has the best outcomes because the brain is most plastic.

Nutritional Support for Growth Faltering

If weight gain is inadequate — dietary assessment, iron and vitamin D supplementation, treatment of underlying infections or worm infestation, and sometimes therapeutic feeding.

Deworming

Routine deworming every 6 months from age 1 — intestinal worms significantly impair growth, iron absorption, and cognitive development. Mebendazole or albendazole.

Vitamin A Supplementation

Every 6 months from age 6 months to 5 years — protects against vitamin A deficiency (a major cause of preventable childhood blindness and increased infection severity).

Frequently Asked Questions

My toddler is not talking much — should I worry?

By 12 months: at least 1 meaningful word. By 18 months: 5–10 words. By 2 years: 2-word phrases. Not meeting these benchmarks warrants a hearing test and developmental assessment. Boys often talk later than girls, but significant delay should be evaluated, not waited out.

My baby was premature — how do I adjust for age?

Use the corrected (adjusted) age — subtract weeks of prematurity from their chronological age. A baby born 8 weeks early should be assessed against the developmental milestones for their corrected age until age 2.

Is screen time harmful for young children?

For children under 18–24 months: screen time (except video calls) is associated with delayed language development. For 2–5 years: limit to 1 hour per day of high-quality content, watched together with a parent. The issue is not the screen itself but replacement of talk, play, and reading.

My child was normal then stopped talking — what does this mean?

Regression — losing a skill that was previously acquired — is always a red flag requiring urgent developmental assessment. It can be the presentation of autism spectrum disorder, hearing loss, or rarely a neurological condition.

What is malnutrition and how do I know if my child has it?

Malnutrition in Nigeria is common and includes stunting (too short for age), wasting (too thin for height), and micronutrient deficiency. A child plotted below the 3rd percentile for height or below -2 standard deviations for weight/height needs nutritional assessment.