Following the birth of the baby, and the overwhelming feeling we have when we first hold the little one, we soon begin to worry about...pretty much everything.
We want to know the Apgar score (developed by anaesthesiologist Virgina Apgar, also knows as the acronym for : appearance, pulse, grimace, activity, and respiration) and maybe see how the baby compares to other babies. We ask ourselves if our precious gem is getting enough milk, or if he should be opening his eyes by now....
We want to know if our baby is reaching all the developmental milestones as he should be.
We may panic or begin to have anxiety if we fear something is "off", and often feel at a loss when we believe, despite everything we do, baby is still not keeping pace with what we read in that damn article on the internet.
Certainly, there are some delays considered "normal" when it comes to early childhood development. These are delays within the normal parameters established by paediatric associations that can be caused by external and internal factors, related to the environment or the baby's health. When it comes to our baby starting to crawl, and eventually walking, we want to know how much we can push, and if we should push at all.
What are the normal reasons baby's crawling is delayed? How can a parent help? By the same token, what should we be worried about?
Although there is a vivid debate on whether crawling is essential in the baby's development, most experts do agree that if babies skip this phase completely they also miss out on more opportunities to develop strength, and can wind up with weaker upper body muscles.
This is not to say they won't regain that strength later in their development. Felice Sklamberg, a paediatric occupational therapist at New York University's School of Medicine, states, "Crawling helps strengthen the hands, wrists, elbows, and shoulders because babies have to constantly activate them to support their body weight."
There are normal reasons why your baby may not be crawling and that, as a parent you need not worry about. However, there are reasons your baby may not be crawling by a certain age that may require further attention.
15 Baby's Feet Are Curved Inward
There are some things parents should be looking out for before the baby begins the mobile phase, and curved-in feet is one of them.
In some cases baby may be born with feet slightly curved inwards. As a result of being cramped in the womb, babies only begin stretching out gradually over the week and months that follow the birth. Appropriately enough, it is a phase doctors refer to as "unfolding".
If natural extension does not happen by the time he is ready to roll on his belly, it can be discouraging for the baby, and it can impede the little one's regular movements, including the propensity to get up on his knees.
What you can do: Verify if your baby's curvature is within normal limits, askdrsears.com suggests to do the following:
- Pick baby's feet and look at the soles. It’s normal for the front of the foot to be curved in a bit.
- Now hold the heel of baby’s foot with one hand and gently stretch the front of the foot to the straight position.
- If the foot straightens easily with gentle stretching, the curvature is considered normal and it will self-correct within a few months.
- To help the feet straighten, continue with the stretches with each diaper change and minimize sleeping in the fetal position.
If bones are flexible the paediatrician will be able to gently pull the feet into a straight position. In more rare cases the bones can be rigid and may require additional therapy from an orthopaedic paediatrician, or physical therapist.
14 Baby's Feet Are Too Flat
Another physical impediment that may delay baby's crawling and eventually getting up on his feet, also has to do with the shape of the baby's foot. Flat feet in babies are more common than we think, but the "pancake-bottom" feet will not necessarily last long. In fact, children should start forming an arch by the age of three.
Extremely flat feet in your little one may delay crawling because they can make your baby's ankles appear to bend inward as he or she develops.
What you can do: Treatment is rarely needed except in the most severe cases which a doctor will be able to identify. Treatment is also almost never prescribed before the age of three. If a child continues to have extremely flat feet through his toddlers years, a podiatrist may treat him if he notices there is severe pronation (when feet bend inwards). This is usually done with orthotics, from approximately the age of three through seven. The treatment may minimize leg pains as well as reduce the risk of bone and joint deformities in the future.
13 Not Enough Tummy Time
Tummy time is a biggie! In fact, not getting enough of it is considered to be the primary reason why a baby's crawling phase may be delayed.
According to developmental specialists it appears the push to have infants sleep on their backs to reduce SIDS (Sudden Infant Death Syndrome) has lead to babies with significantly weaker back and arm muscles. In fact, this one, life-saving movement, supported by health organizations world-wide, has brought on major changes in the physical development of infants in the past 2 decades.
Due to the "Back To Sleep" campaign, an increasing number of babies never crawl at all and go directly from sitting to toddling.
Studies in the USA from the Eunice Kennedy Shriver Institute of Child Health and Human Development however, have put parents at ease, and paediatricians reassure that "...there seems to be no medical consequence to this developmental change. The babies are normal in every other way, and they sit up and walk at the same time they always did."
A study published in Pediatrics established that while babies who slept on their backs were twice as likely not to crawl, all babies were walking by around their first year, regardless of how they slept or if they had crawled.
What you can do: Keep baby on its back during sleep time, but encourage as much time as possible on the tummy when the baby is awake.
12 Baby Is A Non-Crawler
In light of the reduced tummy-time during sleep and naps parents are encouraged to practice, many babies go directly from scooting, or dragging themselves with their hands, to pulling themselves up when they are ready for further exploration. In addition to this, some babies are simply born as non-crawlers.
The reality is, although occupational therapists consider crawling a corner stone of the baby's physical development, it is not really considered a milestone because not all babies crawl. Some experts will say this phase is essential for the child's gross and fine motor development later in life, and that skipping this phase may cause certain delays in the future.
In truth, it is only considered an issue after a certain age, and only if the baby remains non-mobile throughout.
It can be stressful for parents during a time when there is already so much to worry about, but the paediatrician will only ask a parent to pursue further testings if a child is 10-12 months and not attempting to either crawl or pull himself up. Most doctors will be very reassuring in letting parents know that it is ok if a baby is a non-crawler.
What you can do: Keep a close eye on your baby's mobility, and encourage movement with simple exercises. Contact the paediatrician if you notice your little one is not crawling or attempting to pull-himself up 10-12 months.
11 Baby Is Not Given A Chance To Try
In some cases, we simply don't give our babies the chance to try for themselves, or the opportunity to improve muscle movement and strength.
In a family with older siblings, or grandparents for example, a baby may be picked up more than is actually needed. Baby cries, and he is picked up. Baby sticks up arms and he is picked up. Baby wants a specific toy, and it is handed to him.
Encouraging baby to begin doing the little things by himself will also build self-confidence and the knowledge that he can achieve somethings on his own. Continuing to bring a baby a toy he likes, or continuing to pick up baby for any and all reasons will reduce the chances of him going mobile sooner.
Furthermore, parents are so scared of SIDS that some refuse to put baby on the tummy even during their waking hours. This is also so, because if baby is not used to tummy time, he will cry, and mom will immediately flip him over on his back. Parents become reluctant to force tummy time on their baby, but this can do more harm than good.
Activity centres and swings have further reduced the opportunity for baby to develop muscle strength, as have the hours baby spends in a car seat or stroller.
What you can do: Give your baby supervised tummy time, and reduce the time baby spends in an adult's arms, or in activity centres and swings he cannot move in on his own.
10 Baby's Personality
We all know a mellow and laid-back person right? The one who is always late, or not rushing to get anywhere? The one always holding a book in his hand rather than getting ready to head out the door in the morning?
This is a personality trait we are born with and that will stay with us throughout our adulthood. This we cannot change. These are the babies that start becoming mobile a month or two later compared to babies doctors define as "hyper" or "motor" babies.
On the upside, according to askdrsears.com, these are actually babies who tend to meet their visual and social milestones more quickly.
What you can do: You can not change a baby's character, but you can encourage baby to move by ensuring a safe environment and stimulating activities like, listening to music, as well as with play dates with older babies. You may also mimic crawling moves for your baby.
9 Baby's Weight
A post doctorate study by a student of nutrition epidemiology at the University of North Carolina, published in the Journal of Peadiatrics, concluded that, " [weight...] may delay a baby's ability to roll over, crawl, or conquer other important physical skills." The weight chart used was the U.S. Centers for Disease Control weight-for-length standards.
- Meghan Slining and her team evaluated 215 babies on several occasions up to 18 months old, and of the 152 infants found to be overweight, 20% (31) had delayed motor skills.
- The team also found that 75 babies with high average measures of belly, upper-arm, and upper-back skin fat, 23 percent (17 infants) had delayed motor skills.
- In conclusion: motor skill delays such as an inability to sit steadily for 30 seconds were about twice as likely in overweight and overly pudgy infants than in those with “normal” weight and fat.
It seem logical that babies who weigh more have increased difficulty in mobility as they have more weight to move around and lift off the ground.
What you can do: Encourage baby's movements by playing with baby and placing favourite toys and objects at a reasonable distance from him to move towards.
8 Baby's Clothes Are Uncomfortable
It stands to reason that if you are wearing uncomfortable clothes your mobility will be reduced. Whether this may be a oensie that is too tight, or socks that are too loose, baby will be discouraged from crawling or walking if he does not feel at ease and confident about his movements.
One impediment we rarely think of to limit baby's progress in mobility is the diaper. Why would we? It makes things so much easier, right? Well, according to a study, diapers introduce bulk between the legs, potentially exacerbating infants’ poor balance and wide stance.
The study published by the US National Institute of Health has found a link between infant diapers and the affects they have on crawling and eventually walking development. The study found that, "... diapers cause immediate decrements to infant walking...[but also that] ...the current work cannot address whether these real-time changes have more lasting developmental implications."
The studies goes on to say that babies who wear cloth diapers have shown easier mobility compared to babies that wear disposable ones.
What you can do: Make sure baby is wearing comfortable clothes he can move in with ease and that allow him to grip with his toes. Have baby crawl naked for a few minutes a day to encourage increased mobility.
7 Baby Moves In Other Ways
A common thread in all paediatric findings and published research concerning children's mobility, is that if baby is mobile in other ways different from crawling on all fours, the delay should not be a cause for worry.
In fact, crawling isn't listed on the Denver Development Screening Test, a tool used by paediatricians in the USA to measure children's development.
In the majority of cases there is nothing physically wrong with a baby who crawls by the end of his first year, and the fact is that not all skills develop simultaneously. So if baby is moving in other ways, it should not be cause for worry.
Other ways baby may move instead of crawling:
- sitting up without falling
- scooting on bum with one or both legs
- pushing up from belly (push-up like)
- pulling himself forward with his arms
It could be baby may be stimulated by other things, like figuring out what fingers are for, or seeing what happens if he pushes a ball.
Paediatrician, Dr. Ari Brown, M.D, also author of Baby 411: Clear Answers and Smart Advice for Your Baby's First Year, writes, "By-passing one milestone is not usually a cause for concern, but if a baby skips more than one or seems to only engage one side of his body, then it's important to discuss it with your doctor."
What you can do: If you notice your baby is not mobile at all you may want to stimulate movements with simple exercises like stretching out the legs, support him sitting up, or placing the palms of your hands behind baby's feet when he is on all fours.
6 Baby Was Born Prematurely
An Australian-first longitudinal study by the Royal Women's fund hospital concluded that, "... babies born moderate-to-late premature face much higher rates of developmental and behavioural delays than previously thought, [and that] compared with full-term births, those at 32-36 weeks are three times more likely to result in language and motor delay."
The difference with previous studies is that those mostly focused on infants born before the 32 week mark. This is so because babies born following the 32-34 week period are generally healthier, and less specific studies have been done for the age group.
In fact, the study found, "Compared with those children born full-term, those born between 32 and 36 weeks’ gestation were three times more likely to have delays in their language development, three times more likely to have delays in the development of motor skills, twice as likely to have delays in cognitive development such as ability to perform tasks and follow directions, and were more likely to have difficulty coping in different social settings."
Parents of premature babies know that if you have a 13-month-old, but you gave birth three months early, your baby’s adjusted age is 10 months. In this case, it may take your baby an additional two to three months to learn how crawl, and eventually balance and walk.
What you can do: Follow all suggestions for children born to term, but do not force baby to crawl if he is not physically ready to move, nor compare him to babies born at full-term.
Here are 5 reasons that may be cause for concern if your baby is not crawling:
5 Baby's Legs Are Stiff (Hypertonicity)
Hypertonicity can severely hinder a child from movement. Also known as Stiff Baby Syndrome (SBS), hypertonia, or hyperexplexia, it occurs when muscles are extremely tight. It is a serious matter because it is not only a physical problem, but a nerve and brain issue as well.
Some babies born with Stiff Baby Syndrome are unable to stretch their legs out, or even put their arms over their heads. The only time their bodies are able to relax are when they are sleeping. In more extreme cases of SBS, it also becomes difficult for a baby to swallow.
You may also realize your infant holds his hands in fists, or is unable to relax his legs. Likewise, he may have difficulty releasing an object, and moving from one position to another. Babies with SBS may also cross their legs when picked up.
The good news is, that at this very young age, babies have the capability of re-routing their brains if therapy starts immediately after a diagnosis.
Take note however, that not ALL babies with stiff legs may be affected by SBS, and sometimes daily massages at home may be enough to release tension in the legs.
What you can do: The first thing to do if you suspect your baby to be affected by SBS is call the paediatrician. The doctor will most likely refer the baby to a physical therapist who will work with the baby and the parents. Therapy may last for the duration of the child’s development.
4 Baby's Legs Are Not Toned Or Are Weak
On the other end of the hypertonic spectrum, we can find the hypotonic baby, also know as Floppy Infant Syndrome. In this case as well, it is not solely dependent on the physical strength of the muscles, but is often an underlying issue of the central nervous system, or a genetic or muscle disorder.
In truth, muscle tone has to do with muscle tension, and is not the same as having weak muscles. Whereas hypotonic babies generally have a “floppy” appearance, babies with weak muscles may just have a more difficult time in using their body to move.
It is therefore very possible that your baby may have weak muscles and NOT be hypotonic.
In either case, weak muscles or lack of tone in the muscles, may prevent baby from taking the initiative to move.
What you can do: If you see your baby is having some trouble when he is placed on his tummy, and is unable to come into a table top position, you can initiate simple muscle strengthening exercise for him to do at home. If you suspect the issue is much more serious, or if the child does not progress in his movements, then you should contact the paediatrician, who will then refer you to a specialist.
3 Baby Can't Pull Up
If your little one is unable to pull himself up on his own by the age of 12 months, this too may be due to a lack of muscle strength. Although many babies who pull themselves up are already crawling, it may not always be the case.
In some cases, baby may actually pull himself up BEFORE crawling. Most babies will do so between 9 and 12 months, but it can happen as early as 6 months, when baby can bear some weight on his legs, and bounce up and down.
Although all babies develop at different times, if baby is too weak to be able to pull himself up by the time he turns 1, it can be a sign of a more serious condition like a hip weakness or hip dysplasia, as well as hypermobility or lack of muscle tone.
For example, according the website developmentalgym.com, babies with joint hypermobility or low muscle tone, as well as those born preterm, often have some tightness in the muscles that can cross over the outside of the hips. “An infant with tightness in the hip abductor muscles tends to keep hip-wide apart when kneeling… a position which makes pulling up to standing difficult for the baby.”
What you can do: You can gently help your baby to stand up as early as 5 months WITH your support. You can also place your little one in a sitting position next to a step or sofa where you can leave the toys he is interested in. It may be, he does not have the strength yet, do not force your baby to do so on his own. If you suspect your baby has a problem with the hips make an appointment with the paediatrician so he may refer you to a therapist where the issue can be verified and corrected.
2 Baby Shows No Progression
A parents’ greatest fear following the birth of the baby is noticing he is not developing as he should be in the developmental milestones established by the experts. The important factor to take into consideration in a child’s development however, is progression and NOT timing. So in truth, experts agree that it is not as important WHEN babies meet their milestones, the essential thing is that they are continuously progressing.
Baby should be progressively getting himself off the ground first, sitting up, then crawling, and on to cruising with support. Finally, he should be taking the first steps on his own. If baby does not show any progression over a period of 2 to 3 months it may be something to worry about. Skipping crawling is not a problem if baby is progressing in other ways.
It is also important to take into consideration the other milestones he should be reaching, like fine motor skills, visual and social skills. These also should be acquired progressively.
What you can do: If your baby reaches a developmental plateau where he stays at for over 2 months, make an appointment with the paediatrician for an assessment of his overall progression.
1 Baby Is Late In Other Milestones
If baby has already achieved other physical developmental milestones but is not yet crawling he is most likely doing well. If baby is rolling from stomach to back and back to stomach, if baby is trying to pull up to a crawling position, and then to a sitting position, and possibly standing up first with and then without support, you can probably relax.
But what if baby has not reached these milestones progressively? What are the signs that a baby will not develop normally? Milestones are achieved at different times in a child’s life, but there is cause for concern if the delay is in more than one area:
- gross motor skills (as listed above)
- fine motor skills (grasping and manipulating objects)
- communication and language skills (happen at a later time in the developmental phase-understanding language and speaking)
- self-help skills (happen at a later time in the developmental phase- toilet training and dressing)
- social skills (making eye contact, playing with others).
Dr. Beth Ellen Davis is a developmental pediatrician from Tacoma, Washington. She states that language skills (which generally follow motor skills development) are better markers of developmental delay in babies, "But like it or not, many parents are focused on physical milestones-when they roll over, when they crawl, when they walk.”
Generally speaking, infants with joint hypermobility and low muscle tone, as well as infants at risk for autism, and premature infants, tend to reach the important milestones 2-4 months later than babies without these issues.
What you can do: If you suspect your baby is not reaching other important developmental milestones make an appointment with the peadetrcian.
Sources: NewYorkTimes.com, HealthOfChildren.com, WhatToExpect.com, AskDrSears.com, JournalOfPediatrics.com, nichd.nih.gov, ncbi.nlm.nih.gov, DevelopmentalGym.com