Top Developmental Red Flags for 3 Months Old Baby 

Developmental red flags are certain indicators that health professionals look for in order to identify potential developmental issues or problems that may need intervention. Identifying these developmental red flags early allows you to seek treatment early, which can significantly reduce the impact the issue has on their development, as well as reducing the amount of treatment required to correct it. It’s very important to recognise that the presence of one or more developmental red flags does not necessarily mean your little one has a problem. If you do notice one or more of them, it’s simply an indication that you should seek out professional advice and have a professional assessment done to see if there is cause for concern.

In the first three months of a baby’s life, there are behaviors and signs that are often referred to as red flags that pediatric health professionals look for to indicate that a little one may need a little bit of help. It’s important to know what these developmental red flags are, because if we can identify the difficulties a little one is having early ,and provide treatment early, it can reduce the length of time that little one requires treatment, as well as reduce the potential impact it might have on their development.

As parents, it’s important to know what these red flags are because you are literally with your little one every minute of every day, so you’re in the best position to notice if and when these occur. If you do notice that your little one has any of these red flags, firstly, don’t worry. It doesn’t necessarily mean that there is something wrong. All it means is that they should go and see a health professional for a little bit of an assessment just to be sure. So let’s talk about the red flags for a three-month old. Now, remember if your baby was born prematurely, it’s based on their corrected age, so when they are three months corrected age, not the date that they were born.

The gross and fine motor red flags are:

• Limited head control. 

So if your little one isn’t able to lift their head to 45 degrees or 90 degrees when they’re in tummy time and they’re unable to support their head when you are holding them and providing support around their ribcage.

• Constantly turning their head to one side.

So they have a strong preference to look in one direction.  At three months of age, your little one should be able to easily turn their head from one side to the other. So if you hold a toy above their face and you’d go from one side to the other, they should be able to follow that moving toy. If your little one is constantly looking in the one direction, it may indicate that they have positional torticollis, which is a tightening of the neck muscle. And that’s preventing them from being able to turn their head. Often, if your little one does have positional torticollis, you will notice that their head tilts to the side and their chin tucks down. And you often see this in photos. So you might wanna go back and look at your little one’s photos and see if they’ve constantly got their head in the same position.

If your little one does have a preference to look in one direction and is unable to turn their head in the other direction, then it is important to go get that checked out, because if it’s not treated and it is positional torticollis, it can lead, it can affect their body posture, it can also result in them favoring one side, and it can also lead to a flat spot de

veloping on the back of their head.

• Flattening of the back or side of the head.

At birth, you will notice that your little one’s head is a bit funny, but typically, the unusual shape resolves by six to eight weeks. But if you notice after this point in time that your little one does have a flat spot developing on the back of their head, it’s important to go to a pediatric physiotherapist who can provide some advice on some positioning and assess if there is an underlying reason why that flat spot is developing. It’s also really important to rule out craniosynostosis, which is the early closure of the sutures in the skull. And this can lead to the skull developing an unusual shape, which can then restrict skull growth, and that can impact the developing brain.

• Decreased movement or stiffness on one side of the body or in one arm or leg. 

So typically, at zero to three months of age, your little one will be able to use both hands freely. So they’ll be reaching out with both hands. They’ll also be kicking with both feet. And at three months of age, they’ll be able to turn their head in both directions. If you notice that your little one has increased stiffness in a leg or a arm or they’re not able to move one side of the body or they have a strong hand preference, then it is an indication that you need to go in and check in with their pediatrician to see if there’s a reason for that.

• Little one’s hands are fisted.

So at three months of age, we want those hands to be open and that thumb to be out. So if you notice that your little one’s hand is fisted and that thumb is still resting inside their palm, then you definitely wanna go in and see a pediatric occupational therapist to see if there’s ways that you can get that thumb out. Because if that thumb and that hand doesn’t open, it’s gonna be hard for them to start to grab and play with toys, which they typically do at four months of age.

The social and communication red flags are: 

• Do not cry when they’re uncomfortable or hungry. 

Babies cry to communicate with you what they want and need. They can’t yet use words, but they are very efficient at crying. So if your little one isn’t indicating to you that they are hungry or uncomfortable by crying, then that is a potential red flag.

• Doesn’t notice or respond to loud noises.

Newborns respond to loud noises multiple ways. They might go quiet. They might look for that noise by moving their eyes. And then when they’re able to move in their head in the direction of that noise, they might smile or they might search for you when you start talking. They also respond to loud noises by startling, and that is when they throw back their hands, legs, and their head, and then bring them back into the middle of their body and start to cry.

If you notice that your little one isn’t responding to noise, then it is definitely a time to go and get their hearing looked at.

• Do not look at the caregiver.

By three months of age, you should be able to have a little one look at the carer and sustain that eye contact. And they will also smile or coo in response to that interaction.

• Not smiling or cooing by three months of age.

In regards to a zero to three month’s old vision, there are two things that we want to check. First, we want to make sure that the three month old is able to track a moving toy. So when they’re lying on their back, they should be able to follow a toy from one side of their body all the way over to the other side by following with their eyes and their head.

The next thing you want to look out for is to see if the little one has an eye that is constantly turning in or out. So newborns will have eyes that fleetingly appear cross eyed, but it shouldn’t be constant. If it is, then it is an indication that they need to go and get their vision assessed.

 Feeding red flags are:

• If your baby is choking, coughing, sounds congested, or has any color changes to red around eyes or maybe blue around the lips, those are the things that need to be addressed properly, you need to call your pediatrician. Depending on the severity of the situation, they will make a referral and likely that would be to a speech pathologist specializing in feeding and swallowing disorders. If it’s very severe choking, you absolutely need to call a local emergency, don’t call your pediatrician, call and get some supported services as soon as possible. These are things that we don’t want to mess around with choking, which means the milk goes into the airway, that’s called aspiration, you don’t want your baby aspirating, even if it is on breast milk. The only thing that should go into your lungs is air, you should not have food or your baby’s milk in his lungs.

• Painful latching or painful feeding. Moms will report nipple pain, or when the baby unlatches, their nipple is flattened or misshapen, and that can be because the baby’s oral function is not appropriate. Then we need to look at tongue tie and reflux those types of situations to make sure that they’re not the reason for the baby not using their tongue correctly. And if you’re having painful feedings or misshapen nipples, that means the baby is not functioning correctly with their tongue. Feeding therapy would be very helpful to change those patterns so that breastfeeding is not painful and that your nipples are not misshapen.

In addition, if feeding is stressful for you or for your baby for any reason, talk to your pediatrician about getting a referral for feeding therapy. You should not have stress around feeding, because feeding stress can just get worse, and it can get to the point where your baby’s gonna stop feeding, or refuse to feed, or go on a hunger strike, and those are very scary especially for infants. If things don’t get addressed and your baby sort of just chugs through, those issues are likely going to show up when they’re toddlers, or about six months when they start transitioning from breast milk towards more solid foods. You will see more refusal behaviors, more gags, things like that because the tongue is just not developing appropriately and not functioning the way it should be.

• Difficulty latching or difficulty staying latched. Babies can have difficulty latching because they have some sensory issues. If you ever have sensory issues, you’re going to have motor issues, and if you have motor issues, you’re likely going to have sensory issues. They are so intertwined that it’s very difficult to pull the pieces out. Sensory issue is when the baby tries to latch, they can’t figure out how to organize or get stable enough to actually latch onto the nipple, and if they do try to latch onto the nipple, they may like pull off because they don’t like how it feels on their tongue, or their oral motor patterns are so disorganized that they don’t know how to maintain a latch. And again those are all things that a feeding specialist can help your baby with, so that they can get more effective. One thing that you can try to do if you’re breastfeeding is aim your nipple towards the baby’s top lip, and get their mouth nice and open, and then bring the baby or bring your nipple towards the baby’s mouth, and then help stabilize. Holding your breasts can be very helpful.

• Another one is if the baby is feeding for a really long time. So the baby’s nursing and nursing and nursing for a super long time, and they don’t seem to get full or they just fall asleep.  Those again are issues that their oral function isn’t appropriate and they don’t know how to transfer the milk very well. They’re either just sucking ineffectively, and they don’t mind, they just stay at the breast. But then sometimes those are the babies that lose weight, because you don’t realize that they’re not really transferring anything, or they have short little meals because they only want the let down but they can’t get the high milk. So they get frustrated, because their patterns aren’t functional enough to get that. They have enough pattern to stimulate the letdown from you, but then they don’t know how to get that high milk, and they get frustrated, and then the babies can get pretty irritable, because if they’re only getting that foremilk, there’s a lot of lactose or sugars in that foremilk, and that can make your tummy a little bit upset, and it can make your stools green. Look out for those kinds of things.

• If the baby tires before feeding, you want to look at what’s going on with the feeding. There are certain patterns that you can look for. There Are certain things that you can do to support them, so that they don’t fatigue out, which means they fall asleep before their feeding is done. If you have a baby that seems to be doing that, you definitely want to get some feeding therapy to help the baby be more effective, so they’re not burning so many calories just trying to feed. And then of course that all comes down to that poor sucking pattern.