A Therapists Guide to Fix the Developmental Delay of Baby Milestones

holding up head is hard for a big babyI was recently contacted by a mom who wanted to know how to get her baby to stay in the propped position. It seems that he could hold the prop position briefly, but very quickly his head dropped down to the floor. The mom’s observation was that he had a very big head. In fact, she said his head circumference was in the 98th percentile.

Believe it or not, a big head can cause big developmental delays.

Other potential delay causes include very big babies, cute fat babies and low tone babies. While none of these issues are considered to be a disorder, they can be very problematic to the developing baby. The goal is to have your baby accomplish her developmental milestones within the normal time frame. If you have read my other posts, then you understand that delays can mean that your baby does not realize her potential.

Here is the reason why the above problems can cause developmental delays. Everything we do relies on body mechanics and gravity.

In reality, it all boils down to physics. So when a baby’s head is very big, the weight of her head relative to her developmental progress is disproportionate. Her neck and other muscles cannot hold the head up against gravity. The same problem applies to heavy babies or very large babies. Their weight exceeds their developmental ability. If the child is low tone, then she doesn’t have sufficient strength to move up into gravity and skills don’t emerge on time. The problem snowballs because the older the baby gets, the bigger or heavier she gets as well. When the initial milestones are missed, the subsequent ones are harder and harder to achieve. Progress slows and eventually the baby is substantially delayed. Is there anything actually wrong with these babies? No, there isn’t. But they will end up delayed nonetheless. And physical delays impact cognitive development – which is the primary issue for most moms and caregivers.

There are many things you can do at home with your baby without getting therapy services. If you recognize the problem, you can help to eliminate it before it gets too bad.

The best thing to do is review my videos which give some tips for helping to improve trunk control. No matter what the issue, improving trunk control can help all babies.

Today I am going to provide you with a terrific exercise which can help with back, head and neck control for a baby as young as 3 – 4 months.

Before you try this, please be sure there are no issues with the spine (ligaments, tendons, bones, etc). Because the head weighs so much in relation to a baby’s body, this can strain the neck muscles too much if the baby has very low tone or neurologic weakness. If you are confident that your baby can tolerate work on the neck muscles, then you can try this. Start by picking up your baby under her tummy and bringing her up to your waist. Bend your elbow and position her so that she is draped over your forearm and tucked against your lower abdomen. Your forearm will hold her up and at the same time it will hold her legs against your lower abdomen and thighs. Make sure her legs say straight. This is very important. She should be bent at a 90 degree angle or more with her head hanging down toward the floor. Don’t hold her too tight, but apply enough pressure to keep her legs straight. If she keeps bending her knees then use your free arm and place that forearm over her knees to keep them from bending. I emphasize this because babies cheat with this exercise by bending up their legs and pushing off your tummy with their feet. That helps them to extend their spine and lift up. It looks good, but it is cheating BIG TIME. They all try and cheat, so I am alerting you ahead of time.

So now she is bent over your forearm, pressed gently to your abdomen and knees and legs are straight. Using the arm that she is resting over, give a very slight rotation to your arm and an equally slight but firm pressure upward. Don’t actually raise your arm. You might move it about an inch or so, but no more. Just apply a firm pressure as if you want to lift up your baby higher, but without executing the actual lift. Then wait. Hold the pressure and wait. Be patient. We are waiting for the head righting reflex to kick in. What you will see if this is done properly is that your baby will extend her neck and start to raise her head up. She may arch her back a little and pull her shoulder blades back and up as well. The goal of this exercise is to get her to bring her head all the way up to your chin area by extending her neck and back muscles. Babies who are strong enough and have really good reflexes can straighten up all the way in a fairly quick amount of time. Heavy and low tone babies may only initiate the movement and extend their head a little. That is okay to start. The back muscles are big and get strong fast. Doing this exercise a few repetitions a couple of times a day should yield great results.

If you have followed the directions and don’t see any attempt to bring up the head, here is a little trick you can try. You will have to let go of blocking the knees temporarily to do it. Take your thumb and first two fingers and place them at the base of the spine. Then press in and down toward the buttocks. It is actually a firm pressure in and down. The fingers move very slightly. You are only adjusting the position of your fingers rather than moving them. So start the pressure directly in toward the spine and then alter the pressure so that it is more toward the tushie. This little bit of facilitation works on the tendon reflexes at the spine and helps trigger the spinal muscles to contract – which is what we want anyway.

Over the years I have shown moms how to do this exercise and all of them learned it very quickly. It is quite easy to do but amazing to watch.

 All babies respond to this facilitation technique. Some have a better response than others, but all do well with this when it is done properly. I do want to mention that you also need to be strong enough to do this. You will be supporting the weight of your baby on your forearm. When she attempts to straighten, it can be hard not to lose your grip position. It is important that you keep as motionless as possible other than exerting the pressure as directed. Do not lean backward in an attempt to help. You might feel the urge to nudge things along. Resist the urge and maintain an erect posture. When administering therapy, it is important to allow the baby to do the work with the appropriate muscles. Any kind of assistance or positional changes can affect the outcome.

I hope that this exercise works for you. This is the best one I know that can help a baby strengthen her back and neck muscles. By three or four months of age, a baby should be able to prop on elbows. If she can’t because of a big head or weak muscles, she won’t get the necessary input into her arms and shoulders that will help her later on to crawl and use her hands for fine motor skills. Now is a good time to start to help by trying this exercise.

2 Responses to “How to help your baby gain head, neck and back strength”

  1. Thirzah says:

    This sounds exactly the kind of aid I was hoping to find for my baby, but I am having a hard time following the instructions – any chance of some pictures to show the holding positions? Thanks xx

  2. I am sorry but I don’t have a photo. Try this. Hold your baby up straaight against your trunk with the baby’s back to your stomach. Bend your right arm and place it across the baby’s hips/tops of thighs. Hold your arm firmly in place. Drop the top half of your baby over your arm as if you are folding her in half (her head to her toes). Then slightly rotate your fist so your thumb rolls toward your stomach and slightly pressure your arm up (don’t really lift). Hold. Your baby should attempt to straighten up. Brace her at the knees if you feel she pushes off of you with her feet (keep legs from bending). this really works. Sometimes you have to experiment with where you place her over your arm. If you are too much on her tummy, nothing will happen. Pull her higher so your arm is near the top of her thighs.

Leave a Reply