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
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