Infant Milestones: Worth stressing about?

 

Welcome back to The Movement Team blog and thanks to everyone who has been reading our team’s weekly entries. We are seeing more and more children and babies at the clinic and that has been especially true over the school holidays. It’s great then that today’s blog is focusing again on Paediatric Physiotherapy.

Does this sound familiar to you?

Especially in the first two years, parents are very often on the receiving end of the ‘how are they?’ and ‘are they doing x yet?’ double. Instead of x, insert any key milestone or achievement. Are they rolling yet? Are they sitting yet? Are they talking, crawling, eating, smiling, walking, or drawing yet? 

Often these questions are asked by a well meaning health professional, a caring family member, an interested friend, or maybe even by a not-so-secretly competitive fellow parent. Either way, early childhood is one of the very few times in life that we compare everyone against a set of population wide standards. There are many good reasons for doing this, however this tendency to compare our babies abilities to an age related chart of achievements definitely has its traps. 

The concept of developmental milestones (movement milestones particularly… think rolling, sitting, crawling etc) comes from the early scientific pioneers who first began to study how babies learn things. When comparing and observing how thousands of babies are developing, the most obvious thing to notice and document are the similarities. Most babies roll around this point, most babies sit at this age, most babies crawl on hands and knees. These observations are all correct and useful, however they are not how babies learn.

Some of the common movement milestones curtesy of the Alberta Infant Motor Scale.

Some of the common movement milestones curtesy of the Alberta Infant Motor Scale.

Milestones should be viewed as the outcome of learning to move, not the method. The ability to sit is not a pre-programmed pattern lodged in a child’s nervous system waiting until a baby is old enough to be initiated. 

Sitting as an Example

The ability to sit is something the baby learns to do for a purpose. Amongst a large range of benefits, learning to sit allows a baby to use both hands to interact with toys and allows them to easily view the world around them. The ability to sit is simply the thing the baby has learnt to do in order to play better. Play, exploration, interaction and curiosity are the reasons, sitting is just the means to an end. This reasoning is exactly the same for why we learn any movement or posture.

We 'borrowed' this image from google... credit seems to go to 'School Time Snippets'

We 'borrowed' this image from google... credit seems to go to 'School Time Snippets'

Learning to move then is all about problem solving. Learning a movement skill is quite specific to what you have actually practiced. For babies, this means that variety is the key. Learning to sit in a high chair is not the same as learning to sit independently on the floor, and learning to walk down a slope isn't exactly the same as learning to walk on the flat ground. To learn any skill you have to have had both a reason to do it and regular opportunities to practice it.

This is where parents come in...

For parents, this all means that motivating and challenging your child is key. However it can often be hard to find a balance between these two factors. If the challenge is too great (like putting a baby flat on their tummy too early or for too long), a baby will use their developing communication skills (crying!) to object. 

There is some great research emerging about the power parents have to influence their babies development. There are a few articles referenced below, though they are targeted at health professionals so might not be super interesting for those not used to reading scientific publications. I am definitely not writing this in order to scare or put pressure on parents, rather I am trying to remove some of the mystery of learning to move and point out how valuable the little things you do on a daily basis actually are! Little habits can really make a big difference for your baby. For example, practicing regular tummy time (see a previous blog post here), playing with easy to grab and interesting toys, avoiding excessive use of positioning equipment and just having fun engaging and playing games with you baby are all powerful influencers on your baby's development. 

Sometimes you just have to trust yourself!

Remember that while health professionals might be experts on certain conditions, areas of development or illnesses, you are the expert on your baby. Your baby is changing all the time, so you are also learning all the time what motivates them, what is too easy, what is too hard and what help they need to be able to play and explore their environment. 

Knowing the next milestone might be useful in order to help you understand where your baby is heading, however try to avoid making unhelpful comparisons and instead focus on having fun with your baby. A large variety of awake positioning and play experiences is key! So get creative! 

Finally if you are worried that your baby isn’t doing things when they should or that they are doing things that are odd or different, don’t worry in private, see your GP or a health professional with paediatric training and voice your concerns! This is true even if part of your brain thinks the concerns might be a little silly!

A child very happy to reach his milestones!

A child very happy to reach his milestones!

 

A few interesting articles:

Enhanced Handling and Positioning in Early Infancy Advances Development Throughout the First Year Lobo et al. 2012

Learning to Move Adolph, K. 2008

 

 

Tim

 

TIMOTHY EFFENEY

PHYSIOTHERAPIST

B.Phty (Hons), G.D. Paed. Neuro. Rehab.

Tim has 8 years of Physiotherapy experience and is an expert in Paediatric (Baby’s and Children’s) Physiotherapy. Tim’s the person to see if you have any concerns about your baby or child’s movement skills or development.

Tim is co-owner and director of The Movement Team. Tim also holds an Advanced Physiotherapist position within a Child Development Service in the public health sector.

Tim has worked across the breadth of paediatric health (acute hospital, disability care, developmental, community and private clinics) and has completed numerous national and internationally recognised education courses in topics including developmental orthopaedics, high risk infant management, respiratory functioning and infant movement.

Tim's formal training consists of:

Bachelor Physiotherapy (Hons) - University of Queensland

Graduate Diploma Paediatric Neurological Rehabilitation - University of Western Australia

Tim additionally holds the following positions and memberships:

Chairperson of the Queensland Paediatric Physiotherapy Clinical Network 2013 - present

National Paediatric Group Member - Australian Physiotherapy Association

 

 

The clinical information included in this article is of a general nature and might not apply to every family. Please see your local health professional for individualised developmental advice.