Magical Milestones for Healthy Baby Development

Breinoefeninge om die ouderdom te stuit
April 11, 2017
STIMULATION – The Goldilocks principle
July 20, 2017

By Dr Melodie de Jager

{Wherever he or him is used to refer to a baby, she or her is also implied}

Milestones – An overview

Motor milestones are beacons of progress; they show moms and dads if their baby’s senses (of touch, smell, taste, hearing and sight as well as the inside senses) and the muscles are developing in sequence like nature intended it to be. If the senses and muscles are wired well and integrated to form a detailed and functional map of baby’s body, baby will reach each milestone in sequence, and within the appropriate time frames. If the pregnancy progressed without a glitch and baby’s birth went smoothly, then it is up to mom, dad and caregiver to provide baby with enough freedom of movement and stimulation to meet each motor milestone with great excitement!

There are many other kinds of milestones: emotional milestones, social milestones, language milestones and cognitive milestones, but this article will focus on motor milestones. All the other milestones are equally important, but the developmental priority from conception until 14 months is physical development, and motor milestones fall within this wonderful window of opportunity.

Sensory development is equally important, but due to a baby’s limited ability to tell mom, dad and the paediatrician what he can feel, smell, taste, hear or see, measuring sensory progress is a bit more difficult.

To move appropriately is a sign of development – Mollie Davies

Milestone tips:

  • Milestones are beacons of progress
  • The order in which milestones are reached is important
  • Reaching milestones earlier is not better
  • Physical development should be optimised between 0-2 years.

If one looks at the graph you will see that the brain grows rapidly from conception to 2 years, investing time in baby’s development is now a huge priority.

Breastfeeding

Feeding is life saving and even though it is seldom viewed as a motor milestone, it actually is baby’s first motor milestone after birth. A sucking baby is content, because the rhythmic pressure of his tongue on his palette is soothing and helps baby to relax and dissolve the overdose of stress hormones, especially when he gets startled or stressed. Sucking for nourishment is called suckling. Sucking with an ‘l’ – suckling, is much harder than sucking because baby needs to grasp moms breast firmly with his lips, his tongue needs to cup around the nipple and he needs to suck in such a way that he creates enough suction to get milk out of the breast (also called latching). At the same time baby needs to establish a harmonious rhythm between suckling, swallowing and breathing. All of this happens in the first hour after birth!

  • Sucking is for nurturing (to feel good)
  • Suckling is for nourishment (food)

WHAT BabyGym® CAN I DO TO ENCOURAGE BABY TO FEED WELL?

  • Gently simulate contractions around the crown of the head by rhythmically and gently applying and releasing pressure before a feed (and even during a feed when he is about to fall asleep).
  • Gently draw the outline of the lips with your finger, a cotton bud or a finger toothbrush/ gum massager.
  • Use your finger to outline the inside of the mouth; this helps to close baby’s lips and promotes suckling.
  • Massage the hand and firmly apply pressure to the palms of the hands.
  • When bottle feeding, remember to hold baby in your arms, make eye contact and swop arms mid-feed so that baby learns to turn his neck to both sides.

Strong neck

A baby that suckles with ease is a happy and growing baby, but growth alone is not enough, baby also needs to develop. Development happens from top to bottom (cephalo-caudal), ‘top’ refers to his neck and ‘bottom’ refers to the core muscles of his back and tummy. We can see baby is developing when he starts to turn his head (from side to side), holds his head upright for longer periods (to see further), and starts to notice the world around him. Once his head is stable, the tummy and back muscles can strengthen to enable baby to become mobile.

Once baby has repeatedly fought the pull of gravity (by attempting to raise and turn his floppy head while enjoying tummy time), his muscles will have strengthened enough to want more. His neck and shoulder muscles follow suite and soon baby is no longer satisfied to only engage his environment through the senses of touch, smell, taste and hearing, baby’s curiosity now calls on the eyes to work together too. To enable baby to see further afield, his eyes need to work like a team of horses pulling a cart.

The core muscles include the neck, tummy and back (abdominal) muscles, as well as the stabilising muscles that prevents baby from falling to the side. The shoulder-, arm- and hand- as well as the hip-, leg- and feet muscles can only develop once the core has become strong and stable. Core stability is needed before a baby can roll over, sit, crawl, self-feed, or walk.

A strong neck and a stable head leads all physical development – Dr Melodie de Jager

Rolling – Developing the left and the right brain

Rolling over happens effortlessly when a baby spends hours playing on a rug, exploring his range of movement while lying on his back or tummy, that is why we refer to back and tummy time collectively as ‘rug time’. When a baby explores the range of his arm- and leg movements freely, he becomes aware of his environment, and he becomes curious to explore.

Baby’s left brain controls his right arm and leg, while baby’s right brain controls his left arm and leg. Stimulating his left brain is important because it develops the mechanics and wiring needed for language development, logical reasoning, planning and organisation, attention to detail and the ability to store (or memorise) facts in an orderly manner. Stimulating his right brain is important because it wires baby’s brain to be flexible and a creative problem solver. A stimulated right brain also means baby can grow up to be a lateral thinker, with great spatial skills and the ability to see the bigger picture. Due to the different functions of the left and right parts of the brain, rolling over in both directions is important.

WHAT BabyGym® CAN I DO TO ENCOURAGE BABY TO ROLL OVER?

  • Make sure that your baby suckles well, develops strong neck control and has strong tummy and back muscles by allowing sufficient rug time. Baby will moan, but encourage rug time by placing a colourful toy (on a plain rug) just out of baby’s reach. Sit alongside baby and encourage baby to reach for the toy; move the toy to both the left and the right sides of baby’s body.
  • Make sure baby is not wearing tight or restrictive clothing, bulky, sopping wet- or scratchy nappies, as this can also limit movement.
  • If your baby finds it difficult to roll, you can help him to roll until he gets the hang of the movement: Place him on his back, lift the one leg and bring it across his body so that he rolls onto his side, allow him to roll the rest of the way by himself. Repeat to the other side. Repeat for a few days until baby starts to roll-over by himself.

Rolling over is a precursor to crawling and later to reading and writing with ease. It is worth the effort to encourage baby to roll to the left and to the right. Pack away the pram, supporting chair and walking ring, and unroll the rug!

Sitting – Developing muscle tone

When a baby starts to roll, it is cause for great celebration because the rolling milestone says: “My neck and core muscles are strengthening and stabilising, and I am nearing readiness for the upright posture”. Tummy time prepares a baby for the upright posture, and the ability to sit upright with a straight back.

The sitting milestone  says: “I have defied the pull of gravity, look, my back is straight!”

  • Balance develops when a baby is able to senses where ‘up’ is and moves his head in that direction.
  • Muscle tone develops when baby is able to lift his weight off the ground, fighting the pull of gravity.

There are two kinds of balance:

  • Static balance – to hold a posture without support, like when you are sitting or standing; in other words being upright without moving around.
  • Dynamic balance – to hold a posture while moving around in a coordinated way, for instance while crawling or walking.

Maintaining the upright position while standing develops first, and is a result of a baby’s stable neck, strong core and ability to rotate the trunk (to twist the shoulders separately from the hips, which develops while a baby is rolling over). Maintaining the upright position while moving develops later when a baby becomes more mobile: crawling, self-feeding, cruising and walking.

The ability to STOP is the ultimate balancing act – Cozette Laubser

WHAT BabyGym® CAN I DO TO ENCOURAGE BABY TO SIT?

  • Enough rug time allows a baby to roll over; and with time, space and practice, baby will start to support himself on his forearms.
  • After some more practise he will start to push up, supporting his weight with open hands and extended arms, while opening up his legs to create a stable base.
  • A strong core will enable baby to bring his body upright, into a sitting position.
  • While in the sitting position baby might at first lean forward to support the upper body with both hands, but with time and practice his balance and coordination will improve and he will learn to sit without support.

Grasping – Developing early speech

Sitting is an important motor milestone because it is from the upright sitting position that a baby observes his world in a new way. Baby’s view now includes more dimensions and invites baby to move and explore. It is baby’s growing sense of curiosity that sparks the need to reach out, grasp, and develop eye-hand coordination. Eye-hand coordination starts when the eyes spot an object worth exploring, and the hand reaches out to touch it.

Grasping starts out with swatting: During the first few months baby will learn to swat at a swinging toy, and then one day (mostly by chance), baby manages to grab hold of the toy. With further practise he will learn to deliberately reach for the toy (rather than reflexively grasping it) and bring the toy to his mouth. Mom and dad can encourage grasping by presenting a variety of exciting items to baby. Introducing different items with varying colours and textures one by one, will draw out the ‘grasping-game’ over months. Continued reaching and grasping will help baby to develop smoother shoulder-, arm-, hand- and finger movements, enabling baby to move with more control and accuracy.

Sitting with a upright posture enables baby to engage socially and to develop the all important eye-hand coordination that is necessary for self-feeding, playing, and later on: drawing, reading and writing.

Creeping and crawling

Crawling is an advanced baby milestone because it collects sensory-motor information from all the previous milestones (head control, suckling, rolling and sitting), and integrates it. Rug time offers endless development opportunities and when an advanced milestone like crawling follows, skills like postural control, balance, locomotion and manipulation are effortless. But, mastering crawling implies that crawling for a day or two is not sufficient. Research has indicated that it takes more or less 50 000 repetitions of a specific movement to complete the necessary brain and body wiring (sensory-motor integration) and insulation (permanence).

Mom, dad and caregiver, use your ingenious games to keep baby on his knees for as long as possible, because we all know: you need to crawl before you can walk.

Locomotion means to move, and crawling is baby’s first experience of moving forward. He has been rolling to the side, but he has not moved forward yet. Crawling teaches baby to move forward.

While crawling, baby becomes aware of the left and right sides of his body and crosses the midline between these two sides. The crawling on all-fours action crosses the midline of the body, and very importantly- the brain! This happens naturally when the eyes (and therefor the head) moves across the midline from one hand to the other, as baby crawls.

Children who battle to cross their midline tend to draw or write on one side of the page and then pass the crayon, or pencil, over to the other hand to continue on the other side of the page. The same problem can be observed in different ways:

  •  A child can read, but stops mid sentence when they reach the midline
  • A child can write, but starts to reverse letters and numbers as soon as they cross the midline
  • A child turns the book sideways to write.

Problems crossing the midline very often originate from a skipped baby milestone like crawling, because crawling on all-fours develops teamwork between both eyes, both ears, both hands and both feet, the core muscles on both sides of the body, the left- and the right brain hemispheres, and all four lobes of the brain: the frontal lobe, the parietal lobe, the occipital lobe, and the temporal lobe.

Crawling also teaches baby about directions like ‘in and out’, and ‘over and under’. When a baby experiences direction with his body i.e. when he needs to crawl over the carpet and under the table and out of the passage and into the kitchen, it prepares his brain for abstract symbols like letters and numbers which all work with direction. Math uses symbols or directions like: above, below, before, and after, and letters use direction like: ‘the letter b faces right’ and ‘the letter d faces left’.

Isn’t it magnificent to see that every home already has everything needed for optimal development in the first 14 months? Mom and dad, your home and the experiences you offer your baby, creates a mini map of the entire world!

Creeping and crawling not only helps children to cross the midline, but it also activates both hemispheres of the brain in a balanced manner – Carla Hannaford

WHAT BabyGym® CAN I DO TO ENCOURAGE BABY TO CRAWL?

To ensure baby is going to crawl, pull out the checklist and double check:

  • Did baby suckle well?
  • Does baby turn his head with equal ease to the left and to the right?
  • Can he lie on his back and vigorously kick with both legs?
  • Does baby roll to both sides?
  • Does baby have strong enough core muscles to push himself up with extended arms?
  • Does baby have strong enough core muscles to pull himself up while grasping with his hands?
  • Can he move into a sitting position by himself?
  • Remember to allow rug time!

When a baby is ready to become mobile, he starts to moan, push and shove – a very good sign because moaning is ‘early talking’ and sparks the brain into action. The necessary brain wiring takes a while to develop, which means that baby will continue to moan, push and shove until all the necessary muscle strength, coordination and control has developed to push him up into an all-fours position.

A word of caution: mom, dad, granny and caregiver, stop yourself (and each other) from continually coming to baby’s ‘rescue’, it may just rob his senses, brain and muscles from the opportunity to synchronise this very complex process.

  • Place a toy out of reach to stimulate the desire to become mobile.
  • If your baby shows no signs of starting (or wanting) to crawl, fold a tea towel or towel nappy into a rectangle. Place the rectangle on the floor and place baby over it on his tummy with the ends sticking out on both sides. Pulling the ends upwards will automatically raise baby’s body into the all-fours position. Gently rock baby forwards and backwards. Do this daily until baby starts to move by himself.
  • Pedalling action/ bicycle ride: Place baby on his back and take his ankles in your hands and push the ankles upwards one at a time to bend the knees one after the other as though baby is riding his bicycle while keep the ankle, knee and eye in line. Move the legs slowly as though going up a hill and then fast as though going downhill. Create a story while exercising the legs to team listening skills and gross motor movement.

Standing, cruising, walking and talking

While baby is not mobile, baby is totally dependant on mom, almost like an extension of mom, but all of this changes once baby becomes mobile. The moment baby can pull himself up and stand upright, baby becomes his own person. Standing, cruising and walking marks a monumental shift from ‘me’ to ‘we’. Up until now baby has learnt about his body and what it can sense and do, but once baby can stand, cruise and walk, the focus shifts from ‘me’, to discovering ‘we’ – the environment, objects and people.

Baby can now see further, reach out, and enlarge his territory to discover a stimulating new world. Now his three-dimensional map is complete: he saw the table from underneath while enjoying rug time; he saw it from the sides as he sat and crawled around it, and now he can finally see it from the top too! Voila, his three-dimensional map of the table is complete!

New objects mean new words and baby’s vocabulary grows rapidly. This is a time of discovery and nothing is perceived as out of bounds. Ensure your home is child-safe!

‘Bare feet’ are the ‘best shoes’ a baby can wear- the feet can bend, straighten and arch; the toes can ‘grasp gravity’, and the skin is uncovered, free to explore textures! – Dr Melodie de Jager

Mom and dad, your response to baby’s efforts determine a great deal: The more you protect and restrict, the more baby hears you say: “I don’t think you can do it”. The more you encourage baby to explore freely and discover his own competencies the more baby hears you say: “I believe in you, I know you can do it!”

WHAT BabyGym® CAN I DO TO ENCOURAGE BABY TO WALK?

  • If baby doesn’t pull himself up yet, place him in a kneeling position in front of a low table. Raise his one knee and put his foot flat on the floor. Gently lift baby in such a way that he will shift his weight onto the foot. Slowly raise baby into an upright position. Repeat a few times over a couple of days.
  • Push toys, kiddies’ strollers and boxes provide superb opportunities to practise walking while baby feels that he is still being supported.

Baby no longer just responds to others, he now starts initiating contact with others by calling out, extending his arms to be picked up and wants to play games like peek-a-boo, catch me if you can, etc. Baby now also follows mom and dads every move, so that he can learn from you. Baby also starts imitating mom and dad’s speech and it is at this stage that simple repetitive sounds like “ma-ma”, “da-da”, and “ta-ta” emerge. At the end of baby’s first year mom, dad and baby have built a rich repertoire of ways to communicate, and that instinctively assures baby that he is loved and accepted. It is from this secure and warm ‘nest’ that baby ventures onwards to make friends and to become a friend himself.

{If you are in doubt about your baby’s motor milestones, rather ask for help and guidance from a professional person such as a qualified BabyGym Instructor, Neurodevelopmental Physiotherapist, or an Occupational Therapist who specialises in Sensory Integration. Raising your little one is teamwork, you don’t need to know everything, you just need to know whom to ask.}

Bibliography

Ayers, J. 1994. Sensory integration and the child. Los Angeles: Western Psychological Services.

Davies, M. 2008. Movement and Dance in Early Childhood. London: SAGE Publications Ltd.

De Jager, M. 2008. BabyGym – brain and body gym for babies. Cape Town: Metz Press Publishing.

De Jager, M. 2011. Brain development milestones and learning. Johannesburg: Mind Moves Institute

Hannaford, C. 1995. Smart moves. Virginia: Great Ocean Publishers.