The first year is characterized by rapid physical growth. A normal baby doubles its birth weight in six months and triples it in a year. During that time, there is great expansion of the head and chest, thus permitting development of the brain, heart, and lungs, the organs most vital to survival. The bones, which are relatively soft at birth, begin to harden, and the fontanelles, the soft parts of the newborn skull, begin to calcify, the small one at the back of the head at about 3 months, the larger one in front at varying ages up to 18 months. Brain weight also increases rapidly during infancy: by the end of the second year, the brain has already reached 75% of its adult weight.
Growth and size depend on environmental conditions as well as genetic endowment. For example, severe nutritional deficiency during the mother's pregnancy and in infancy are likely to result in an irreversible impairment of growth and intellectual development, while overfed, fat infants are predisposed to become obese later in life. Human milk provides the basic nutritional elements necessary for growth; however, in Western cultures supplemental foods are generally added to the diet during the first year.
The newborn infant sleeps almost constantly, awakening only for feedings, but the number and length of waking periods gradually increases. By the age of three months, most infants have acquired a fairly regular schedule for sleeping, feeding, and bowel movements. By the end of the first year, sleeping and waking hours are divided about equally.
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