Building Your Baby From the Ground Up
I meet with a wide range of patients—from factory workers to athletes, young families to the elderly. Yet there is something particularly special about working with infants. Reaching and wriggling as they yearn to discover the world, their reflexes and seminal movements are nothing short of awe-inspiring.
Upon birth, babies begin a developmental journey that transforms them from immobile infants to bipedal toddlers within 12 to 18 months. This crucial window is their opportunity to move in innate, prescribed ways in a sequence optimized for building neuromotor coordination. With this highly evolved pattern, infants gain sustainable stability, coordination, and subsequent mobility that lays the foundation for their biomechanical future.
Informed by the models of the Vojta Method and Dynamic Neuromuscular Stabilization, the foundational concept that infants are soft-wired to develop in a predictable way has shaped my clinical lens and illuminated to me the critical importance of proper movement during infancy.
In my clinical practice, I examine and check infants with developmental delays. Although I enjoy this work, it is difficult to see parents’ frustration and overwhelm at a child’s atypical movements, not to mention the developmental setbacks for the infants themselves. I can’t help but ask, “How can we prevent the problem before it begins?”
That question has led me to realize that there is a troubling lack of knowledge about how to best support an infant on his or her biomechanical developmental journey. Some foundational concepts have yet to reach mainstream consciousness.
To simplify my clinical recommendations, I give my patients, friends, and family these three pieces of advice: forgo all infant orthotic devices, get on the floor, and educate your village of caretakers.
Avoid Infant Orthotic Devices
This recommendation is the one that surprises people the most: to forgo implements designed to contain or artificially support infants. The kind of devices I’m referring to include common registry gifts like fixed-foam infant seats, walkers, ExerSaucers, jumpers, and oversize pillows used to prop up infants. I call such items Infant Orthotic Devices, or IODs. Though such products are common, bolstered by claims from manufacturers that they “help” infants learn to sit and walk, I advise parents to forgo them entirely.
Most noticeably, IODs restrict an infant’s natural movements and compromise the developing neck and spine. With aberrant stress placed on their joints, ligaments, muscles, and bones, babies are less able to act out the predictable neurological movements described by Vojta. Infants in IODs are also deterred from receiving the right sensory input at the right time, and may experience misordered sensorimotor input. This lack of coordinated sensory input and motor output may cause them to develop altered movement patterns that could follow them as they grow.
Research shows that infant walkers, in particular, can cause developmental delays, altered motor patterns, or at the very least do not help the child. In fact, the American Academy of Pediatrics has gone so far as to recommend a ban on the manufacture and sale of mobile infant walkers because of safety concerns. In addition, in an interview with the Chicago Tribune, Mary Weck, clinical coordinator of physical therapy at Children’s Memorial Hospital in Chicago, states, “No equipment enhances a child’s motor development.”
Nevertheless, manufacturers of infant orthotic devices continue to make widely-accepted claims that such devices benefit infants by “helping” them learn to sit and walk. Remarkably, infants don’t need any help in this process, and by “helping” them with an IOD, we may be altering their natural progression.
“Baby’s development is like the opening of a flower bud. It gradually unfolds,” as Marianne Hermsen-van Wanrooy so poetically states in the introduction to her foundational book, Baby Moves. “If we open its petals unnaturally, we interfere with the growing process and the flower becomes distorted.”
What we must remember is that motor development must be allowed to be a gradual process. It takes a typical infant 12 to 18 months to be able to walk. I encourage you to see and celebrate the micro-milestones, as well as the big ones, once the child has reached them on his own.
Get on the Ground
In light of research linking IOD use to motor developmental delays, I urge my patients, friends, and family to forgo these devices altogether and opt instead for something that is free and commonly available: the ground.
When infants spend time on their backs and on their tummies, they benefit from the opportunity to move naturally— and that alone propels them to eventually crawl, sit, and walk. It is in this process of moving in reaction to the sensory input of being on the floor that appropriate coordination of movement and muscular co-activation occurs. Without each link, occurring in sequence, the chain of motor development becomes skewed and altered patterns are more likely to occur.
Like skipping a chapter in a book, using IODs makes an infant jump ahead in their development. In so doing, however, a child will miss the important storyline of their developmental journey.
Educate Your Village
More research is needed to investigate the effect of IODs on infant motor pattern development. In this article, we extrapolate the existing research on infant walkers to include other pieces of equipment that provide artificial support to infants’ limbs and spine. Acknowledging the gap in research, I stand by this extrapolation because I have observed and cared for the dysfunction caused by these devices in my own clinic.
Whether it’s turning in the direction of a sound, reaching for an object, or taking a first step, these soft-wired neuro-sensorimotor sequences require no technological intervention, only free-range interaction with a flat surface in a safe environment.
Give your baby the benefit of a nurturing developmental environment wherever she or he spends time. You can find educational materials and posters on our website (building yourbaby.com) to share with your village of caretakers.
The old-is-new, less-is-more approach I propose here maintains that a minimalistic and evolutionary model of infant motor pattern development is best, and that the less technology we use to help our children walk, the better and stronger they will be.
As a father and as a clinician, I understand the desire to see a child thrive. That is why it has become my mission to educate and empower parents, clinicians, and caretakers to set their children up for biomechanical developmental success.