BABY MOVES #6

NOTE: Most guidelines are built for “birth at 40 weeks”. If your baby came early – it is recommended to “correct” or “adjust for due date”, specifically in movement. *Learn more about corrected age HERE.

More complex and coordinated movement patterns are building every day now. Here are a few new and review tools for the movement toolbox.

Try This

Baby Sit Up Progression

This is the mastery leg of this progression (scaffold)… the end game. With baby on their back, offer your fingers/hands. Once baby has a good grasp of them, do not pull the baby to sit – instead allow the baby some time to pull on their own. This is like tummy time for the arms and truck. It may take a while to get a full self powered pull to sit up, but it teaches the brain about an important transition.

Progression Recap: It started with the fully supported sit up, then the support lessened (but the encouragement stayed high). From there the sit up progresses toward no support, and finally the self powered pull, while you assist to sit, is achieved. Don’t worry about the timing or the rate – every baby goes through this at their own pace, but progress is connected to having the option to practice regularly.

Finding Feet

This is about the time that babies can explore their full bodies. Assist baby in bringing their feet and hands together in front of their body, and also their feet up to their mouth. Talk about the experience. Repeat with a toy in hand or on foot. This can also be done with baby on their side.

Variation: Gently hold and move the legs and hands in various places of contact (ex: moving the arm via the wrist, or mid arm, or near elbow). This provides additional proprioceptive input (see description below) at these different contact locations on their body. The body uses all movement in understanding how their body parts move. This variety of contact gives additional signals for the brain to learn from. Scientists call this “stimulating neuromuscular development”.

Visual Tracking

Just because the head may be moving well doesn’t mean it’s done. Get their attention from different angles in front of and behind the baby, and from various distances. Look specifically for eye tracking – both with the eyes only and with the head and eyes. Think of the head as what points the eyes in a direction of attention, and then the eyes do the finer adjustment. Your baby should be able to track objects with eye movement only when an object is within the visual field. Do this whenever the opportunity arises – in tummy time, son side, while baby is in supported sitting (support as needed), etc.

Reaching and Grasping Progression

Continue to offer objects of various shapes, colors and sounds, handing them over from different positions to promote visual guidance before reach/grasp. Also offer objects from positions across the baby’s body (bilateral coordination). You can gently stroke the baby’s hand with the toy then move it away slowly to stimulate the baby to use that hand to reach.

Tummy Time, Etc

Keep the tummy time going. Encourage grasping and reaching in the tummy position. Reaching in this position builds strength to push up onto the elbows and hands, which builds into skills for crawling.

Trying stroking the back and the inner thighs (shown) during tummy time to get the feet and chest to lift – like a little sky diver!

The “safely drag and spin around the room on a blanket” is fun modification. The blanket or towel can then be used for assisted rolling.

Keep the variety up with rolling in and out of tummy time. For supported standing, you may start seeing some interest/reaction in a little up and down bounce motion.

Proprioception

Proprioception is our body’s ability to sense where it is in space, and where one’s own body and body parts are in relation to each other. Hold your hand out in front of you. Now bring it closer to you quickly, and then slowly. Your ability to move quickly and slowly and not hit yourself in the face is proprioception. Proprioception also lets you do things like touch your finger to your nose while your eyes are closed. Go ahead try it. Now try it while standing on one foot.

Proprioception is important because it helps us move our body efficiently and safely in space. Every time your baby moves, they are getting feedback about the position of their body and they are wiring that in the brain. Coordinated movements like reaching and grabbing, rolling and twisting are developed by how the brain senses how muscles move the arms or legs in order to accomplish a task. The more we move with variety, the more wiring for this important sense.

AND how is your proprioception? A fun game to play alongside baby (or to break up some sitting) is doing things like standing on one leg for a few seconds, walking backwards, or generally moving in a way you don’t normally move. You can go simple or you can get advanced with training programs like this [YouTube, 2min 20sec]. Working this alongside the baby has an added benefit – the more the kiddo sees you exercise / move around, the more likely they may be to adopt that as part of their lifestyle.

Speaking of Dad Moves…

DAD MOVES #3

We have to mention it. Consult your physician before changing your physical activity.

This progression further develops awareness, coordination, and control of the diaphragm with Fill-the-Balloon breathing [YouTube, 4min10sec]. This is accomplished by training the ability to consciously control diaphragm activity through how we inhale and exhale.

With practice, we can activate a greater percentage of the muscle while increasing its range of motion (mobility). This unlocks the ability to bring more air into the lungs and it also increases core strength. And if you are not sold – poor diaphragm health is a component of chronic low back pain. Diaphragm strength, control, and mobility is an important component of pain free movement.

Of the 6-14 breaths you breathed in the last minute, how many were you aware of? Luckily, training the diaphragm is easy and can be done anytime and anywhere. All you have to do is breathe.

For reference

1) Getting the Diaphragm Moving [YouTube, 1min 52sec]
2) 4 Zone Expansion Progression [YouTube, 5min 26sec]
3) Putting it all Together, full progression [YouTube, 10min]

A Note on Growth Charts and Milestones

The why here goes a bit deeper. It’s not just about the science of how important movement is to humans, but rather in the how and why humans are educated about it – via milestones and growth charts. They are often confusing and misleading, can cause stress, and don’t tell the entire story.

Growth Charts

“My baby is 95 percentile in height and 89% in weight”
“My baby is 46 percentile in height and 4% in weight”

Height and weight, but what is missing?
-> Health.
Growth tracking is meant to tell a pediatrician if a baby is within a band or range from one measurement to another. It’s a fairly useless metric if you only have one data point – yet many parents anchor on the measurement itself and not what the measurement can inform. When we look at growth, the goal is to understand if the baby is developing on a healthy curve – along some expected, healthy, trajectory – regardless if they look like a tiny kid or a huge baby.

The same goes for measurements specific to height, but these databases generally smooth the curves so that we see what percentage of a population is a certain height. In the chart below for adults in the US – we can see a middle, or average height, for women and a middle, or average height, for men.

But the issue is in the smoothing of these curves and in how the data was put together. A more accurate distribution of height of US men vs women looks like this:

This gives more detail and context. This is important to know, especially when it comes to “milestones”.

Milestones

Milestone charts take many forms these days. They have a lot of opinions attached to them as well.
They are often misleading in how they are presented and what they mean, and this can often lead to stressors in the form of comparisons – such as Nancy’s kid down the road that’s “only 8 months old, is walking, and reciting poetry”. The bulk of this comes from motor/movement milestones, since they are the most visible and easiest to “assess”.

This is the motor milestone chart from the World Health Organization. It’s the data set that most milestone charts are built from (or should be built from). This is one of the best charts to look at major milestones.

This chart gives a window in which certain motor skills are normally achieved in typically developing children. “Normally” is the key word, but it doesn’t show the order (some kids skip), and it doesn’t show the distribution. If we attempt to add in a distribution, by showing when “most” (90%) of kids reach a milestone, then the chart looks like this.

But here’s the thing. Every single day they are moving forward and every single experience finds its own place in development. The charts don’t tend to cover what influences development – genetics, culture, home environment, parental involvement, etc.

Many research communities are working to understand how to gather better data and create better metrics in order to better understand a child’s unique development vs a wide general range that lacks context. It will be a long time before that is available. The point here is to not worry so much about the kid down the street or what your kid is doing in terms of a milestone chart that lacks context. The main use of milestone charts is to identify when a child is past the 90% date and hasn’t shown forward development.

If you are interested in learning more, THIS is one of the best, science based, write ups on this topic – and comes from Dr Gwen Dewar.