Nurturing Your Baby’s Development: Positioning (Part Two)

Welcome to part two of how to nurture your baby’s development through positioning! Last post, we talked  about tummy time, back time, and sidelying. All of those positions are related specifically to FLOOR time.  Now, let’s talk more about upright positions that your baby will begin to explore as they grow and get  older. 

Sitting 

Sitting is best practiced after your baby achieves good head and neck control in other developmental  positions, typically between 3.5-4 months of age.  

Pros of sitting include 1) strengthening your baby’s core and hip muscles, 2) challenges balance against  gravity, 3) opens the door to learn transitions and let your baby explore their environment more, 4) helps  prepare your baby for upcoming skills such as pulling to stand, and 5) allows for more free play with both  hands to improve coordination. 

Sitting can be practiced in a variety of ways. Most babies start out with their feet touching in front of them  (like a ring), but other sitting positions to practice include short sitting (like sitting in a chair) and side  sitting (both feet pointed in one direction).  

Kneeling/Hands and Knees 

Kneeling is a position where your baby sits on their feet, with their feet directly under their hips (also  called short kneeling). Tall kneeling is when your baby lifts their bottom off their feet and “stands” on their  knees. Hands and knees is the typical crawling position.  

Pros of these positions include 1) building strength in the bottom muscles and hips, 2) building shoulder  and hand strength, 3) improves coordination and planning of movement 4) gives your baby more freedom  of movement to explore their environment, and 5) prepares your baby for skills like climbing, crawling, and  pulling to stand. 

While kneeling is a wonderful position for babies, it is important to remember that W-sitting (when your  baby’s feet are outside the hips) is less recommended as it can apply more strain to the knee and hip and  limit the need for your baby’s core to keep your baby upright. 

Standing 

Finally, standing is best practiced after your baby’s hips are more developed and able to accept weight  safely and their core is strong enough to keep them stable, typically around 7-8 months of age.  

Pros of standing include 1) building strength in the hips, knees, and ankles, 2) challenges balance in a  very functional position, 3) prepares your baby for skill such as cruising and walking, 4) improves bone  density/strengthens bones, and 5) improves endurance (muscular and cardiovascular).  

With all of these positions, consequences can occur if one position is used too frequently or your baby is  unable to transition between a variety of different positions independently. Try encouraging your baby to  change positions frequently through toy placement and modeling the movement to help your baby build  an appropriate balance of skills. 

How Specialized Physical Therapy Can Help 

If your baby is struggling with any of the positions mentioned above, it may be helpful to seek out  assistance from a specialized healthcare professional(s) to assess the specific reasons why these  particular positions are more difficult and provide education to help your baby continue to progress at  home. Your provider will be trained to evaluate and address the specific needs of you and your baby with 

targeted exercises and an individualized home program to help make these positions easier and more  comfortable. 

For more information on if your baby would benefit from individualized physical therapy treatment, feel  free to reach out to us.

Our team of clinicians are pediatric  physical therapists and certified breastfeeding specialists, and we are here to help! Year One Wellness  offers virtual consultation everywhere and in-person consultations in and around Austin, TX.