Delayed Milestones (Delayed development)

Let’s understand this by example. If you happen to travel by train, you know estimated time of arrival of train at every station so one can, say it is arriving at right time and hence if arrives late then it is delayed. So, in babies also while growing they have to achieve certain targets at that particular age which if not achieved at that expected age is known as delayed milestones.

Q. How can I identify if delayed milestones are serious?

If a child is delayed in two or more domain at expected appropriate age it is considered to be serious. It is usually diagnosed by child specialist as although noticed by parents or grand parents it can be ignored most of the time as normal process.

Q. When to consult doctor?

It’s always better to err on excess in children so slight doubt in delay of milestones can be indication to consult your paediatrician rather than to ignore. So, delay in smiling, holding, crawling, walking, speech etc make you suspicious enough to have an appointment with child specialist.

Q. Causes of delayed milestones?

It can be due to many causes, common among those are environmental, metabolic, genetic, complications during pregnancy or at the time of birth and post birth. The most common neurosurgical cause to rule out is when delayed milestones are associated with increase in head size.

Q. Investigations for milestones.

Usually screening and charting of milestones is sufficient enough to diagnose delay in milestones. Further causes can be ascertained by blood tests, metabolic screening, genetic analysis and MRI of brain, USG abdomen, hormonal profile etc. after discussing with doctor.

Q. Treatment

R. Surgical treatment in the form of CSF diversion procedure will be required in case of increase in head size and hydrocephalus. Most of the rest of the causes need supportive and occupational therapies.