Tips from a Pediatric Physical Therapist

Normal child development is something most parents might worry about when they have a newborn baby.

All of us that are parents know that having a newborn means not just sleepless nights and diaper changes but also many doctor appointments. Those appointments with the pediatrician have many purposes, including:

1. To make sure your child is healthy
2. To receive vaccinations (if you choose to do that)
3. Ensure your child is growing and developing correctly

Most babies will progress properly with the help from their parents and older siblings. But how do you know your child is developing normally? How do you help them grow? And what do you do if they are not? 

In the case of your child’s development, the pediatrician will usually give a handout of what activities your baby should be doing at that point but not how you can help them. I am going to go through the major developmental milestones your child should reach at certain ages and how you should be helping them. 

1 month old: 

• Lifting head briefly in tummy time and sitting
• Following toys but not through full motion of the neck

How do you assist your child?

1. Tummy time is very important to help the child in strengthening their neck and back muscles. Put them on their tummy whether on the floor (after the umbilical cord falls off) or on your chest at an angle (the angle will help take pressure off of their stomach if they do still have the umbilical cord)
2. Hold them in an outward facing position close to your chest so they can look around and use their neck muscles
3. In different positions (laying on their back, on their tummy, while being held in outward facing position) use light up or noisy toys to have them follow those toys. 

2-3 months old: 

• Pushing up on elbow while on stomach
• Rolling side to side and tummy to back
• Likes to kick
• Holds head upright for few seconds in supported sitting position
• Puts little weight through the legs in supported standing

How do you assist your child?

1. Hold them in sitting and standing to strengthen muscles throughout the body
2. Keeping up with tummy time!

4-5 months old:

• Pushing up on hands in tummy time
• Pivots to reach toys while on stomach
• Rolling both directions
• Puts full weight through legs in supported standing
• Grasping and releasing toys

How do you assist your child?

1. Put them on their tummy to play and put toys just slightly out of reach or to the side, force them to turn to the object.
2. Assist with rolling (if not already rolling) by bringing one leg over the other, initiating the roll for them.
3. Hold them in a standing position while playing
4. Put toys in their hand 

6-7 months old:

• Sitting by themselves
• Able to get to sitting position by themselves
• Moves objects between hands

How do you assist your child?

1. If not sitting independently, continue to place them in that position. Place your hands on their thighs to stabilize them and release your hands as they become better.
2. Give them toys to play with in sitting position.

8-9 months old:

• Crawling 
• Cruising (walking along furniture) 
• Pulls up to standing position at furniture
• Moves from sitting to crawling
• Points at objects

How do you assist your child?

1. Put them on all fours. This will help them put weight through their legs and arms to gain the strength to begin to crawl.
2. Stand them up at the couch or coffee table and move a toy just out of reach, forcing them to take steps towards it.

10-11 months old:

• Will briefly stand without support
• Walks with hands held

How do you assist your child?

1. This may be pretty obvious but walk with them. Get them a walker or push toy (this will give them the support they need to take steps.

12-15 months old:

• Walks Independently
• Throws a ball while sitting
• Builds a tower with blocks

How do you assist your child?

1. Show them how to place the blocks together and take apart. Do this yourself and put the block in their hands.
2. Show them how you throw a ball.

16- 24 months old:

• Walks upstairs with hand-held assist, both feet on one step
• Throws ball in standing
• Beginning to jump (closer to 24 months)

How do you assist your child?

1. Walk up and down stairs with them
2. Hold their hand as they try to jump or have them step down from a step in slight jumping motion

Please remember these are just guidelines. If your child is behind by a couple of weeks: DO NOT FREAK OUT. Babies all develop on their own pace, as I am sure you have heard before. The time to speak to your pediatrician or PT would be if your child is behind by more than 2-3 months.