Physiotherapy for babies

When is it time to consult a physiotherapist about your baby’s progress?

Every baby is different and each baby develops at his or her own particular pace. Some babies develop some skills very early and are slow at achieving other milestones.
And some babies seem to get stuck with delays in learning to sit, crawl and walk. These delays may frustrate the baby who is keen to explore and get about. The baby starts to miss out on important opportunities for exploring and learning and getting fitter.
It can be useful to see a physiotherapist to check why your baby is not progressing and what you as a parent can do to get the baby moving a little faster.
There are many different reasons why a baby might be slow in reaching the major motor milestones.

• The baby’s hips or shoulders may be a little stiff this is a particularly common problem in premature babies
• The neck and trunk muscles may not be as strong as they should be. This is often why the baby appears to have low muscle tone.
• The baby might just be very cautious and not want to try anything that seems difficult or dangerous.
• Babies with very flexible joints (double jointed) often have difficulties stabilising themselves against the ever present downward pull of gravity.
• Very big babies are sometimes a bit lazy and need extra encouragement to develop the muscle strength needed for getting up and moving about.

When does a baby need a bit of extra help to get moving?

The table shows the range of ages at which babies reach different milestones. The column on the right indicates when physiotherapy intervention may be needed to help the baby along. If your baby was born prematurely, use the baby’s corrected age.

MILESTONE BABY NEEDS NUDGING WHEN HE/SHE: Rolls onto tummy 7-9 months Is not rolling over onto tummy at 10 months. Sits without support and reaches for toys 6-8 months Cannot sit without support even for short periods of time by 8 months. Not sitting securely and reaching for toys at 9 months. Lies on tummy and pushes up on arms 4-6 months Does not push up on arms by 8 months. Moves around on floor on tummy 6-8 months Is not able to turn around or push self backwards when lying on the tummy by 9 months. Pushes up onto hands and knees 7-9 months Does not even attempt to push up onto hands and knees by 10 months. Crawling 9-13 months Does not start to crawl by 14 months. Pulls up into standing 8-10 months Cannot pull self up into standing from sitting on the floor by 12 months. Stands with support 8-10 months Is not able to stand supporting on one hand only and reach with the other by 12 months. Walks sideways along furniture 9-13 months Has not started to walk sideways along and between the furniture by 15 months. Stands without support 10-13 months Is not able to stand without support by the age of 15 months. Walks alone 11-14 months Is not walking alone by the age of 16 months.

You can find more detailed information about how babies develop flexibility, strength and coordination for achieving the major milestones at: www.skillsforaction.com

Preemie Developmental Support Programme

Pamphlet produced by Pam Versfeld Physiotherapist
41 Alpina Road, Claremont – E-mail: pam@skillsforaction.com – Cell: O84 945 6575

Bibliography
Piper MC and Darrah J (1994) Motor Assessment of the Developing Infant. WB Saunders Co.
Pin, Tamis W, Bev Eldridge, and Mary P Galea. 2010. “Motor trajectories from 4 to 18 months corrected age in infants born at less than 30 weeks of gestation.” Early human development 86:573-80.