Key developmental milestones

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 What might seem like a little thing is a big thing for your baby!

Hand to feet play – the importance in development

When your child plays with their toes, (including putting their feet in their mouth!) they are actually reaching an important milestone in their development…who would have thought!

Bringing your toes to your mouth requires a number of skills that are really important to master as they are prerequisites to rolling, crawling, walking and hand development.

Your baby should start to reach their knees by the time they are 4 months old and by the time they are 6 months old they should start to bring their feet to their mouth.

What this skill teaches.

  • Awareness of two halves of the body
  • Awareness of left and right
  • Initial activation of tummy muscles
  • Moving legs independently of each other (prerequisite to walking)
  • Stretches hamstrings – needed for walking

Rolling and its importance in development

Watch out! You might have been used to being able to leave your baby on the floor whilst you made yourself a coffee and would be assured they’d still be there when you get back…not any more! Once the skill of rolling is mastered you won’t be able to take your eyes off them!

Typically, a baby learns to roll from their front to back first (there are always the exception to this rule and usually it’s those babies who weren’t a huge fan of tummy time!). Tummy time is important as it helps develop the strength needed around the shoulder joint so that your baby can push up their body to gain the momentum needed to roll.

The first time this happens will be unexpected and accidental but gradually over time as your littlun learns the movement and weight shift needed to replicate the roll again it’ll become easier and easier.  This will (typically) be followed by learning to roll from their back to their front. Again, initially this will be an accidental movement which uses the whole body, but as they get used to the patterning they will refine the movement needed to make it smooth and consistent.

Your baby should start rolling from their front to their back around 5-6 months and rolling from their back to their front at around 6-7 months.

Rolling teaches:

  • Elongation and shortening of trunk muscles needed for crawling
  • Rotation of trunk and pelvis needed for walking
  • Dissociation of two sides of the body
  • Weight shift needed for walking
  • Movement for independent locomotion
  • Exploration of the wider environment

Independent sitting and its relation to eating solids

Independent sitting comes at around 6 months. Often at this point your baby has fully mastered rolling from their tummy to their back and is starting to roll more consistently from their back to their tummy.

Once your baby can sit upright more independently parents commonly start introducing solids into their babies diet but how are sitting and eating solids related?

In order to sit, babies need to activate their tummy muscles, they also start activating their back muscles and instead of sitting with a rounded posture they start being able to sit up taller and more upright. In this upright position their oesophagus is more vertical which makes swallowing easier… I mean, how often do you eat your sandwich lying on your back…never and there is a good reason for it! You cannot easily chew and swallow lying down. Additionally, with the skill of rolling being well established your baby has learnt the skill of rotation. Rotation is important as the rotary movements learnt in rolling are the same skills that are needed in order to chew, hence babies typically will start eating solids once they have established both rolling and sitting.

There are some cases where your baby may be encouraged to wean onto solids earlier but this will be recommended by your health visitor.

Pulling to stand

Before your baby starts standing or walking on their own, a milestone they will meet is pulling themselves up to a standing position at a surface. Often they will start attempting this by pulling up on the sofa or something which is easy to grab, then, as the skill is refined they will be pulling up on anything and everything. But why is this such an important skill? When learning to pull to stand at a surface, your baby is using a lot of different muscle groups and skills. They’re reaching, grasping, pulling, pushing, weight shifting, balancing and ultimately standing! Woah! When they put one knee up and their foot flat they are shifting their body weight, activating the muscles in their bottom and trunk before they push up and activate the muscles in their legs. Once upright their tummy and hip muscles will be working overtime to keep them upright and balanced whilst also gaining weight through their feet to start the development of the arches in their feet.

Your baby should start pulling to stand at a surface around 9-10months, bringing themselves up to standing by pushing up through flat feet.

Pulling to stand teaches:

  • Weight shift
  • Weight bearing
  • Pushing and pulling
  • Trunk control
  • Balance
  • Planning and coordination
  • Arch development in feet

If your baby is delayed at meeting their milestones and you are concerned, our specialist paediatric physiotherapist can assess your child and help them work towards achieving their goal by breaking down all the separate components needed to achieve these skills.

Author: Lucy Pearson I Paediatric Physiotherapist BSc (Hons), APCP
Lucy is highly specialised and knowledgeable in her field of expertise.  She takes an enthusiastic and fun approach to her work, focusing on your child as a whole.  Lucy has worked in both the NHS and overseas at the Starship Hospital, a leading children’s hospital in New Zealand.  She understands the importance of age, growth and the impacts puberty have on treatment and healing times.  She has also completed paediatric specific training in taping, gait analysis and child specific sports injuries

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