by Bette Lamont
She is here at last! He has finally arrived! Nothing in a family is more exciting than the arrival of the new baby. Here, nestled in your arms is a being so complete and perfect, yet so unfinished. All the potentials of the adult are in evidence, but the distinct qualities of this large-eyed, physically limited, dependent, angelic being trigger many questions. Foremost among those questions is: “What can I do to help this child reach its potential?”
The purpose of this article is to consider deeply the fact that the newborn infant has everything it needs to organize a brain and body to its full potential. We also want to consider how we, as parents and other adults in the child’s life can learn to create the best possible environment to support this child’s unfolding mind and complex brain.
The magic of the human baby is that it is full of reflexes that have as their ultimate purpose the organization of their own brain and body. What was formerly considered a passive period of life, the first months, is in fact filled with movement and sensory experiences that are critical to growth. With the exception of the random burp or hiccup, it appears that every activity of infancy has an important role in this growth. Across every culture, in every country in the world, infants who are neither impeded nor impaired will, if given the opportunity, do the same motor activities at approximately the same ages.
The primary role of the adult, beyond loving, bonding with, feeding and clothing the baby, is to create an environment that supports the baby’s access to sensory and motor activities for the distinct purpose of activating and organizing reflexes in the brain.
A health baby as young as one month, put on its tummy on a smooth surface, will wiggle arms and legs in a random fashion that cannot propel them off the spot. The head lifts and falls again as the baby tests his mettle against the forces of gravity. The grunts and occasional cries that accompany this challenging activity are merely sounds of a hard worker learning about his body and the world in which it lives. The infant is beginning to establish, by the lifting of the head, the cervical and lumbar alignment of the spine. Postural reflexes that are developed at this age set the stage for good upright posture in the older child.
The wiggling arms and legs are going to find a pattern of organization that will ultimately lead to propulsion. The movement of the arms and legs against the stability of a torso locked, for the moment, on the floor, will create range of motion in the hip sockets and shoulders (known as the “proximal” joints). The awkward bear-like walk of children who have not had tummy time as infants can be directly attributed to this developmental gap.
Between 2 and 7 months this infant will develop and perfect the art of tummy crawling*: arms and legs work together in a smooth pattern, moving forward, that may be described as “horizontal rock climbing.” All of this activity in the “proximal joints” will lead to better stability and mobility (or “organization”) of those joints. The baby who has lots of time to explore crawling will, by the fact that there is much stimulus to the pelvic area, be more likely to toilet train at a reasonable age. In our work with children who continue to wet their pants through preschool and up until as old as eight, we found nearly all had skipped the tummy crawling stage of development and had poor overall awareness and organization of their lower body.
As the baby crawls, its posture and coordination are not the only skills that are enhanced. The baby also begins to control the horizontal tracking of its eyes, create some of the rotation in the arms that will support emerging fine motor skills, and other critical sensory and motor skills.
In light of the fact that the Back to Sleep campaign initiated in the 1980s by the Surgeon General has saved lives, we have to be more strategic in our plans to give baby appropriate tummy time. We have seen a rise in learning and behavior issues that directly parallel the cultural shift toward putting all babies to sleep on their backs. We believe that this is an unintended consequence of a health policy that can be addressed by consciously creating time for babies to be on their tummies. Between the ages of 2-1/2 and 7 months, the default position for all infants should be on their tummies when not otherwise engaged in nursing, sleeping, or receiving physical comfort and contact with a parent. This will go a long way towards countering the negative effects of back sleeping. A firm but soft mat is the ideal environment. Toys scattered about on the mat, many just out of reach, can provide an incentive to mobility.
For those parents who are anxious about ever putting the baby on its tummy during the first year of life, a good option is to move the parent’s deskwork to the floor. Write letters, make lists, read, balance a checkbook while lying on the floor where you can see and interact with your baby. Become part of the baby’s world rather than bringing the baby up into a seated position to be part of your world. The seated position is not more stimulating, but is rather a passive, observer role during a time that the baby needs to be working on trunk and limb control, mobility, posture, and myriad other skills triggered by tummy crawling.
Sometime in the early months of the first year, grandparents, friends, or neighbors invite us to explore the joys of various containment devices such as walkers, exersaucers, jumpy chairs, and one of the most insidious new containers, the Bumbo baby sitting chair*. These devices certainly make our babies more convenient by making them immobile and since the babies seem content in them, they appear to be good for the child emotionally, seem to stimulate vision because they are looking out at the world, and are able to play with toys on a tray.
However, this is the point at which the natural infant, unimpeded and unimpaired, makes a leap in motor skills. This child is ready to get up on hands and knees to spend the next several months creeping**. This hands and knees activity now brings in the balance factor. Conquering gravity is one of baby’s first major accomplishments. The balance that is developed at this time is the foundation for balance through the lifespan. Knees and feet begin to line up with hip sockets in preparation for walking***. The constant looking up and down, focusing on objects at different distances as they propel forward begins to trigger visual convergence. These, among other benefits, ensure the baby of the best possible developmental foundation.
Containment devices, on the other hand, have been found to be associated with gaps in coordination, midline awareness, and have been implicated in dyslexia, impulse control, even violence in older children – not because of what they do, but because of what the children do NOT do when in them.
Recent reports of research in both Britain and in the United States concluding that babies do not need to do these activities and that those who don’t crawl or creep will develop normally need to be examined in much greater depth.
Don’t be misled by this short-sighted research. The weight of evidence in our files at NeuroDevelopmental Movement® Consultants demonstrates clearly that when crawling and creeping are skipped, critical functions are compromised. We have observed that these floor activities influence the child’s ability to focus, store and retrieve information, observe detail, coordinate right and left, and sequence, among a multitude of other skills. We have watched older children belly crawl and creep on hands and knees, among other activities, in a therapy program, and experience improvement in visual motor skills, tracking, balance, impulse control, anger management, reading and attention.
Ultimately, deficits in the primitive skills usually acquired in the early months of life compromise cognitive functions. As a result, we assess and treat hundreds of children and adults who are bright but unable to perform at the level of their potential. The evidence is overwhelming: CRAWLING DOES MATTER. FLOOR TIME IS CRITICAL.
The best option for your newborn will, we know, ultimately be proven to be activities that have been coming naturally to infants for tens of thousands of years.
“It’s Tummy Time!”
* Baby containment devices that contain the infant in an immobile sitting position only interrupt the natural movement processes by which the infant acquires postural reflexes and spinal stability. Babies will sit with better posture and at appropriate age naturally if they are given tummy time. An infant forced into the sitting position too early can develop acquired scoliosis. Resist the urge to purchase this kind of physically and neurologically damaging equipment.
** For those of you confused about our terminology, please know that MOST EVERYONE IS! Our terms come from a distinction made in the 1950s by the US military. This government body referred to the tummy down activity as “crawling” and the hands and knees activity as “creeping.” Thus, our terminology was adopted – sorry!
*** If you are, for any reason, interested in having a baby that walks early (which we don’t advise) let them do it in their own time. The best way to achieve “on time” walking is to promote lots of creeping. Research has shown that babies who spend time in walkers between 7 and 12 months actually walked slightly LATER than babies who were not in walkers at all.