Baby steps to walk­ing

Some ba­bies take much longer than oth­ers to learn how to walk. When should you worry? Lib­bie Jou­bert con­sulted the ex­perts

Your Baby & Toddler - - Contents -

THOSE FIRST WONKY steps are prob­a­bly the most ea­gerly an­tic­i­pated mile­stone in a baby’s life. It is the mile­stone that says, “I’m not a baby any­more – I’m a tod­dler!” And boy, do some ba­bies make us wait…

Ac­cord­ing to Paarl pae­di­a­tri­cian Dr HP van der Merwe, about half of all ba­bies be­gin walk­ing at 12 months, but the nor­mal range is con­sid­ered to be any­where be­tween nine and 18 months. There are many fac­tors that play a role in ex­actly when the big mo­ment ar­rives; even genes and tem­per­a­ment have an in­flu­ence. A placid child will of­ten walk later as he is sat­is­fied to play in a more static po­si­tion for longer. Such chil­dren sim­ply feel no ur­gency to take part in all the ac­tion – they are happy to ob­serve.

Very busy ba­bies, on the other hand, are in­clined to walk ear­lier, says Lizanne du Plessis, an oc­cu­pa­tional ther­a­pist from Som­er­set West.

Lizanne says the on-the-go ba­bies show a great in­ter­est in their en­vi­ron­ment. Their lit­tle brains and bod­ies are con­stantly seek­ing out more stim­u­la­tion.

More fac­tors that con­trib­ute to when your baby walks is how strong they are, what stim­u­la­tion they re­ceive and if they are ex­posed to an older sib­ling. If your lit­tle one shows no sign of walk­ing by 18 months, it is def­i­nitely a good idea to have him eval­u­ated by a doc­tor, es­pe­cially if some of his other mile­stones are also lag­ging be­hind, says Dr van der Merwe.

Some­times the qual­ity of the move­ments your baby makes is more im­por­tant than the age at which he makes them, says Anro-mari Co­hen, a phys­io­ther­a­pist from Vre­den­dal. On its own, the in­abil­ity to walk is not al­ways an in­di­ca­tion of a prob­lem. But cer­tainly seek help if your child is be­hind with other mile­stones as well, such as rolling over, sit­ting, crawl­ing and pulling up against fur­ni­ture.

“It is worth es­tab­lish­ing whether other ar­eas of devel­op­ment are also de­layed, for ex­am­ple speech, so­cial in­ter­ac­tion and fine mo­tor skills. An unusu­ally stiff or unusu­ally floppy baby could also in­di­cate a prob­lem,” says Co­hen.

WHY ARE SOME SLOWER?

Here are some of the most typ­i­cal rea­sons why some ba­bies are late walk­ers: • The part of the brain that is in charge of move­ment con­trol is de­vel­op­ing slower than the rest. • The child was pre­ma­ture. • After birth they suf­fered from a virus or an in­fec­tion, or there was a short­age of oxy­gen. • There could have been prob­lems dur­ing the preg­nancy, such as ill­ness, smok­ing or al­co­hol abuse. • There could have been com­pli­ca­tions dur­ing the birth, such as lack of oxy­gen, a birth in­jury or early sep­a­ra­tion from the pla­centa. • Chronic ear in­fec­tions can also play a role. This can lead to baby’s bal­ance be­ing thrown off and this causes a de­lay in walk­ing. • Your child’s in­her­ited body type could even play a role. Small, del­i­cate ba­bies of­ten walk sooner than their larger coun­ter­parts who re­quire more strength to come up­right. • Your child’s con­tented na­ture could mean that he is happy for longer to just en­joy crawl­ing.

IS EAR­LIER BET­TER?

Nope! Chil­dren who started walk­ing be­fore nine months don’t have bet­ter co­or­di­na­tion or sport­ing abil­i­ties later in life. They also aren’t more in­tel­li­gent than ba­bies who walk later, says Van der Merwe. Ul­ti­mately there is no dif­fer­ence in the skills and abil­i­ties of a child who started walk­ing at 12 months com­pared to a child that started at 15 months. Walk­ing early does not mean your child will grow to be a great ath­lete and learn­ing to walk later does not doom him to a life of clum­si­ness either.

Re­sist the urge to try to en­cour­age your child to walk ear­lier than he wants to. Chil­dren who start at nine months mostly didn’t crawl at all or not for very long. This could lead to poor devel­op­ment of shoul­der sta­bil­ity. This in turn can lead to prob­lems with fine mo­tor devel­op­ment much later on, when they’re six years old or so.

WHEN IS THER­APY NEC­ES­SARY? If, by six months of age, your baby shows no in­ter­est in try­ing to sit, you should have her eval­u­ated as she is al­most cer­tain to be a late walker. All the de­vel­op­men­tal mile­stones such as sit­ting, crawl­ing and pulling up pre­pare your child to walk one day.

The doc­tor or ther­a­pist will look at the big­ger pic­ture of your child’s over­all devel­op­ment. Has she reached all her mile­stones? At which age did she lose her prim­i­tive re­flexes? She will be ex­am­ined or­thopaed­i­cally and neu­ro­log­i­cally and if ev­ery­thing is nor­mal, you can re­lax.

Co­hen says the fol­low­ing are red flags that could in­di­cate prob­lems: • Your baby can­not sit in­de­pen­dently at

nine months. • By 12 months she does not bear any

weight on her legs. • She does not walk after 18 months. • By two years she can’t run yet. • By three she can’t climb stairs yet. • She walks on her toes most of the time. • Her mus­cle tone is very stiff, or

unusu­ally floppy. WHAT CAN A THER­A­PIST DO? A ther­a­pist will take down a com­plete his­tory, start­ing with many ques­tions about your preg­nancy, the birth and the child’s devel­op­ment after the birth.

She will eval­u­ate your child phys­i­cally and rec­om­mend a num­ber of ses­sions for ther­apy.

You will also get ex­er­cises to do at home. Part of the eval­u­a­tion is to es­tab­lish how strong your child’s back and tummy mus­cles are, be­cause good trunk sta­bil­ity and trunk ro­ta­tion are im­por­tant for walk­ing.

Pay at­ten­tion be­fore your first visit to whether your child uses both sides of the body equally. Can he move in and out of dif­fer­ent po­si­tions, for ex­am­ple from sit­ting to kneel­ing, or sit­ting to stand­ing. Does he stand on both legs, with his feet flat on the ground?

Your child will most likely spend a lot of time on a physio ball and bench and get swing­ing ex­er­cises to do. The ther­a­pist will also use bal­anc­ing equip­ment where your child will first be seated, then kneel­ing and then stand­ing.

The plan is to im­prove your child’s mus­cle tone, teach her brain to carry out cer­tain move­ments, build mus­cle strength and al­low cer­tain body parts to be­come more sta­ble. WHAT NOT TO DO Be wary of walk­ing rings. They in­ter­fere with nor­mal gross mo­tor devel­op­ment. They strengthen the lower part of your child’s limbs, but her thigh and hip mus­cles re­main weak, while these are the most im­por­tant mus­cles for walk­ing. Walk­ing ring ba­bies also of­ten have short­ened Achilles heels.

Rather let your baby play on the mat and let her de­velop at her own pace, go­ing through all the phys­i­cal mile­stones. YB

BE WARY OF WALK­ING RINGS. THEY IN­TER­FERE WITH NOR­MAL GROSS MO­TOR DEVEL­OP­MENT

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