The baby’s development during the first year is fascinating to watch. As a new born there is no postural control, no purposeful movements and very little awareness of the surroundings. The development of a healthy baby is hard-wired in the Central Nervous System (CNS) and is therefore automatic and follows the maturation of the CNS. We usually don’t have to teach babies to change their supporting zones, to start turning, sitting and finally stand up and walk. It is, however, quite common that the baby for different reasons skips some stages of the predetermined development process. The developing baby regularly changes its support zones and thereby its posture which alters the muscle-pull on the bones resulting in shaping of bones and joints. Missing key mile-stones will therefore alter the stabilization and posture in all of the following stages of development. This often leads to insufficient stabilization and may create varying degrees of sub-optimal formation of bones and joints.
It is essential to recognize non-ideal patterns & postural disturbances and influence them as early as possible; before they become fixed and the individual keeps the incorrect patterns throughout their adult life. In adults the patterns often cannot be changed, so emphasis is put on finding ways for the brain to overcome the dysfunctional patterns.
Awareness and encouragement of the developmental milestones is important to ensure that the baby goes through the developmental process as close to ideal as possible.
Some of the most fundamental stages of the baby development are:
- Elbow support when lying on the stomach- Starting from approximately 6 weeks the baby will support itself on the forearms, and by 3 months the medial epicondyle of the Humerus becomes an important support point- which facilitates stabilization and proper positioning of the scapulae. Good stabilization of the scapulae allows for straightening of the spine with proper lifting and movement of the head and neck. As the support improves the baby will be able to support on one arm while reaching and playing with the other arm. Single arm support is enabled by support from the inside of the opposite knee. This is one of the most important reasons babies need plenty of stomach time.
- Lifting the legs when lying on the back- Lifting of the legs is an important feature of the baby’s development. Starting with short attempts from 6 weeks old, from about 3 months the baby should be able to lift and hold the legs in a raised position. By 4.5 months the legs are completely lifted and the baby supports itself on the Thoraco-lumbar junction. This stage is very important in the development of sagittal stabilization (core stabilization), where the oblique abdominal chains get activated. The baby should be able to touch the knees at 5 months, hold the feet by 6 months, and put the feet in the mouth by 7 months of age.
- Turning from the back with the legs lifted- After the sagittal stabilization has been developed at approximately 4.5 months the baby starts preparing for turning. Turning with the legs lifted at 90 degrees is a good sign that proper activation of the oblique abdominal chains has been activated. It is not a normal physiological pattern for the baby to turn with straight legs, so if that is the case the parents are taught how to facilitate proper turning patterns. Babies often favour turning towards one side but they should be encouraged to turn both ways.
- Crawling - Crawling follows the supporting patterns developed when lying on the stomach, and is important in the development of scapular and hip stabilization. The crawling phase is initiated by the baby bringing the knee up above 90 degrees thereby allowing push off with the inside of the knee to lift the hip. This is a very important step in the facilitation of hip stabilization. When crawling one arm and the opposite leg should be supporting diagonally while the other two limbs move to a position where they take over the supporting function. The supporting and moving forward of the limbs should be symmetrical and simultaneous, with no movement of the spine and pelvis sideways, and only a rotational torque along the spine. A proper crawling pattern moves one arm and the opposite leg while the other limbs provide support with minimal movement of the spine and trunk.
Paying attention to these basic stabilization and movement patterns between a baby’s 3-7 months will be rewarded in the development of functional movement patterns later on, as functional shoulder, hip and core stabilization is crucial in all our movements.