Baby milestones: How to handle skill development anxiety

 “Parents will often email me or message me and say, ‘Hey, my baby’s not doing this. Should I be worried?’ And I always respond, ‘No, I don’t want you to be worried, I want you to be curious, I want you to pay attention.’”

Rachel Coley, Pediatric Occupational therapist

Host Jessica Rolph is joined by Rachel Coley in this episode of My New Life, a Lovevery podcast, to discuss the common anxiety parents share about their children reaching milestones and comparing to other children’s progress. Does it help? Does it really matter?

Rachel Coley is a Pediatric Occupational Therapist and the mom behind a super informative website called CanDo Kiddo. Rachel prefers to focus on what she calls “mini-milestones”, which are all the tiny steps a baby takes to reach their objective. Tune in to learn what to do if your baby doesn’t like tummy time, how baby containers are getting in the way of natural development, and why the floor is the best place for your baby to be. 

Key Takeaways:

[2:51] Technology is shaping what kind of toys we are putting in front of our babies.

[4:22] Why do babies need to be on the floor?

[6:25] Is swaddling beneficial for a baby?

[7:14] Tummy time is the baby’s first opportunity to interact with gravity.

[11:15] Thinking about tummy time as a position for play is really helpful.

[13:54] Milestone anxiety vs staying curious about mini-milestones.

[15:30] How parents can help babies build the strength necessary to roll over.

Mentioned in this episode:

CanDo Kiddo 

Transcript

I remember being on the floor with my baby. He was doing the tummy time thing, and started to wobble, tipped over and rolled for the first time! The look on his face was so unforgettable, he looked scared and surprised all at once.  

He was 6 months, and wasn’t really into rolling over much after that, and it got me wondering, how does my baby stack up? I’ve since discovered I’m not the only parent out there with milestone anxiety. It feels as though we can’t help but compare our babies’ milestones, but does it help, does it matter? 

I was so excited to discover today’s guest, Rachel Coley. She is a pediatric Occupational Therapist and mom behind the super-informative website CanDo Kiddo. 

Rachel prefers to focus on what she calls mini-milestones: all the steps it takes a baby to get to that photo-worthy moment.

Rachel shares with us everything from how we can help babies who don’t like tummy time, how baby “containers’ are getting in the way of natural development and why the floor is the best place for your baby to be. She also talks about how googling into the night can be detrimental, and why milestones are not pass / fail for your baby. 

Without further ado, here’s our conversation.

Pediatric Development

Do Babies Develop Naturally?

Jessica: So we hear this a lot from parents, ‘Don’t babies just develop naturally?’ Why is there this big focus on all the baby gadgets and all this parenting information? 

Rachel: Yeah. Parenting has changed and babyhood has changed so much over the past, say, 20 years. So, as parents, we are marketed to with a lot of devices and gadgets and apps and things that are really getting in the way of what our babies truly need to develop; and we’re doing it through no fault of our own, it’s just a lack of awareness and information. And so as a professional, that’s my heart and my mission, I know it’s yours, too, to spread just that intentionality of parenting that we want to be aware of. 

For example, how much time our babies are spending held and restricted in this little device, whether it’s the car seat carrier, or the bouncy seat or the swing or even sleeping in some of those devices. Suddenly the hours of the day start to add up, that our babies are not getting a full opportunity to move unrestricted.

Technology’s Effect on Babies

Rachel: Another factor is all the technology. And that’s shaping, I mean, you know, it’s shaping what kinds of toys we’re putting in front of our babies and it’s closing down the opportunities for open-ended creative play and exploration of the physical world. And so we just need to be mindful of how much tech is getting in the way of our babies just really playing in the ways that they’re hardwired to do to develop. 

And then, of course, the phones get a lot of bad press. Phones are awesome because they help us feel connected, especially as new moms when we feel isolated, but we’re also interrupting this really natural flow of back-and-forth with our baby; we call it ‘bids for attention’. And so, for example, I’m guilty of this, but when you’re feeding your baby, the distance between your face and your baby’s face is optimal for your baby’s vision, for your baby’s tuning into you and responding.

And so nature and biology has sort of hard-wired that to be an opportunity for back-and-forth eye gaze and communication and facial expression; and we are interrupting it because so often, myself included, we’re scrolling and we’re texting, and we’re just distracted from that time. And not to say that you have to tune in every minute of a baby’s waking day, but the pendulum has swung, I feel, too far in the other direction.

Jessica: It’s so true, We just all need that reminder, every parent needs that reminder to be just more tuned in and more connected. 

The Developmental Impact of Tummy Time 

Jessica: I’m so intrigued by what you talked about with babies needing to be on the floor. Why do they need to be in a flat position? What is happening with them developmentally? And can you tell me more about what this looks like?

Rachel: Yeah. So one of the first things that our babies do before they even start intentionally moving, is that they have to unwind from this position that they’ve been in, and it’s not just that they were in that position, held for so long, curled up in a womb, but that’s actually how they grew. So, they have never had an opportunity to stretch out of that position fully. And so that’s one of the first tasks, once they’re born. And when we continue to put them in devices that are so soft and so cuddly and hold them in that comfy womb position, we really are undermining some of their first developmental work, which is to stretch out of that position.

And gravity is a big piece of what does that, just laying flat on the floor, gravity is helping to stretch them. Or when they’re in their tummy time, with their cheek down, which is super valuable, newborn tummy time, it’s actually stretching their neck into new positions. So, being on the floor provides that unrestricted movement. And one of the things that I get really excited about and like to point out to parents is that, especially in the early weeks, something that we take for granted, like lifting your arm, is huge muscle work for a baby! Just the weight of their arm is significant for them, and so they’re strengthening their shoulder muscles, for example. And so all those little wiggles they do on the floor in the beginning, it’s really important work that we don’t give enough credit to. It’s a beautiful process, but we’re kinda, like I said, getting in the way of it by continuing to hold the baby in the curled up womb position for a lot of their day.

Tummy Time vs. Swaddling

Jessica: It reminds me of my husband, who was an expert swaddler, and I feel like it was part of his kind of connection with our first baby, to swaddle him. And I remember him being in the swaddle so much, and my intuition was saying that he needed more time to stretch out. Can you tell me more about how we should think about swaddling, and in addition to all the baby seats and strollers and car seats?

When to Stop Swaddling Your Baby

Rachel: Swaddling can be really useful for sleep and for soothing a baby to go to sleep. Some babies don’t need it, but most babies do; because of their startle reflexes, it does help with sleep, but we wanna think about when baby’s awake, get that swaddle off. They usually do a really adorable stretch when they come out of the swaddle, and then they’re ready to have some interaction with you, and we just want to be mindful to stop using the swaddle once the baby doesn’t need it anymore. We have all these suits and gadgets and big, puffy things that keep babies sleeping better, but sometimes the objective ultimately is not to have them sleep 12 hours through the night. Some movement is normal during sleep, and so we don’t wanna restrict that more than we need to.

The Benefits of Tummy Time

Jessica: There’s this big focus from public health experts about the need for babies to have tummy time. Can you talk about the overall benefits of tummy time and just why we’re hearing about this as being such an important part of babyhood?

Rachel: So, it’s sort of the antidote to what I was talking about with babies being on their back in this curled up semi-reclined, cushioned position that’s cosy and comfy, but is not allowing them full movement; tummy time is the antidote to that. That’s really the baby’s first opportunity to interact with gravity by starting to lift the head. And so that interaction with gravity, and learning to master it, that’s a lifelong skill. And in a way that’s really difficult for parents to connect, it’s really the underpinning of some of the milestones, even like walking. Because through that tummy time experience, the baby is learning to lift the head and getting a lot of movement input through the inner ears. 

So, we have three-dimensional babies, right? They’re not just made to lay in one position, so we wanna make sure that they’re in all positions, even on their sides, on their bellies, on their backs, on their backs with their head turned fully to each side to look at something. So we just want to always keep the baby’s position diverse and changing throughout their day.

How To Do Tummy Time 

Jessica: Tell me about how you do tummy time with a newborn.

Rachel: Tummy time with a newborn, for a healthy, full-term newborn, is really snugly a lot of times. Most babies need a person that they know and love to regulate, which means stay comfortable and happy. And so a lot of tummy time in the beginning is going to be on an incline, warm, fuzzy surface, and that’s a parent; so that’s where I like to start, and then we start moving towards a floor surface or a flat surface. And it’s okay if the baby’s cheek is down for the most part, that’s the way it looks in the beginning, is that head turned to the side, cheek down, and that is still really valuable tummy time. The goal is not always to be head-lifting. And then as the baby gets more used to that, then they can start to lift the head and do some more prolonged head-lifting. But in the beginning, it’s really short duration, it’s lots of responsive tuning into your baby. And when they’re done with tummy time, you give them a break, you roll them out of it. I like to say, “You bring them back to their happy place,” which is right there with you, you do whatever you know comforts and soothes your baby, and then you try it again.

Jessica:We all kind of feel like we have to check this box, and it’s like there’s some pressure to this tummy time thing. And oftentimes, our babies don’t really like it, so I love what you talk about at CanDo Kiddo about doing kind of small, bite-sized pieces of tummy time. Can you talk about that a little bit more?

Rachel: Yeah. So I like parents to think about tummy time like reps and sets in a gym. So the rep would be: You have the dumbbell in your hand and you’re gonna do it, lift it over and over. You’re going to take a break, and then you’re going to lift it a few more times, then take a break; and then the set is when you walk away from that exercise. And so when we do tummy time, it’s not one and done. I hear from parents a lot, “He can only do one minute of tummy time,” or “two minutes of tummy time”, and I say, “Great, that’s where he is. So let’s do one minute, roll him out when he gives you those signs that he needs a break, and then give him a break, get him happy, engage in that googley-eyed connected play and then roll him back in and do another minute.” I mean, it’s okay if the duration of those reps is really short.

For some babies, who are more dis-regulated and maybe have reflux or something, where they’re really struggling to get comfortable in tummy time, I like to say, “They’re still learning to be comfortable in that position,” it can even be 30-second reps. 

And so I say, “Do as much as your baby is comfortable.” Try to default to floor time instead of devices, do as much floor time as you can before you opt for the baby seat or the bouncer, or the swing. And then do as much tummy time as your baby is comfortable. And as long as it’s progressing, I want your baby to be doing more tummy time on average this week than they did last week because we want them to be building on that endurance and strength.”

Jessica: That’s great, and it’s so inspiring, it feels doable when you say it that way. 

How to Help Babies Enjoy Tummy Time 

Jessica: What ideas do you have for babies that don’t like tummy time? You’ve talked about newborn tummy time and how they can be on you, and that counts as tummy time, which I love. What about like a two, three-month-old? What kinds of things can we do, how can we think differently about tummy time so that our babies can start to enjoy it?

Rachel: I think thinking about it as a position for play is really helpful because sometimes we think, “Oh, tummy time is the activity, so let’s put him in tummy time and then let’s see how long he goes,” but I like to encourage parents to just think about that as the position. Now, what are we going to be doing in tummy time? What is the baby going to be looking at or touching with his hands? And so I really like to tap into the senses.

For a younger baby, they’re not going to be grabbing and holding anything in tummy time, so we really want to think about the senses of vision and touch and hearing. And so we’re just engaging the baby in opportunities to engage with the world around them. Facetime; for babies who are not regulated in tummy time, who don’t, so to speak, like it, we want to do lots of face-to-face time because that’s one of the biggest comforts for a baby, your face and your voice, or other trusted caregivers; face, voice, smell, and touch. Those are babies who are oftentimes, I will have a parent just keep a hand on the baby during tummy time.

Also, we can incline the tummy time, we can actually make tummy time easier for babies by lifting their chest so that they’re at more of an angle, and you can do this tons of ways. One of my favorites for babies who hate tummy time is actually to hold them in your arms in tummy time, and that way you can lower them closer to flat. And then when you get the signal that they need a break, you can lift them up to be more on an incline, so that does make it easier. So, it’s a break, but they’re still in tummy time. And they’re right there with you, and you can be moving around the house and dancing and singing, or standing in front of a mirror so you can talk to them.

Tummy Time Activity Ideas

Jessica: Some other ideas that you’ve shared on your website are an exercise ball tummy time, doing tummy time over your legs, including fun things, like sensory herbs or a tray of, a pan of water, if you’re supervising your baby. There’s some really fun ways that you can make it interesting. So, I definitely encourage people to look at CanDo Kiddo and Lovevery for more ideas for how to keep tummy time fun.

Rachel: Yeah. And I will say, too, when you start to shift how you think of tummy time, instead of it being like, “Oh, I’m gonna set the timer and put baby on the floor and see how long he lasts,” if you kind of think of it as more like, “Oh, this is just a natural position,” it starts to play into this idea of getting babies out of the devices. So, for example, when you go meet your friend for coffee and you have your baby in the car seat carrier, or in the stroller, getting them out of the stroller is going to help them. And then since you have a baby on you anyway, just lay them across your lap and maybe pat their back while you’re talking to your friend. And so without a whole lot of fanfare, you have just knocked out two huge ways to help your baby’s development. So you’ve gotten them out of the restricted car seat and they are now in tummy time.

Pediatric Milestones

Jessica: There’s so much focus on milestones these days, and I do kind of wonder about this broad range of when children start to crawl, when babies start to crawl, somewhere between six and 10 months, and it’s usually actually in the latter end of that period is, on average, when babies start to crawl. How do you think about milestones and how they’re progressing? How can we feel confident as parents that our babies are moving forward in the right ways?

Rachel: Yeah, I think we get really focused on these big milestones and we don’t have benchmarks along the way to tell that our baby is moving towards those milestones. So that’s what I like to help parents to see, is what I call the mini-milestones. So parents will often email me or message me and say, “Hey, my baby’s not doing this. Should I be worried?” And I always respond like, “No, I don’t want you to be worried, I want you to be curious, I want you to pay attention. So what is your baby showing you, for example, with crawling? Are they showing you some signs that they’re moving towards that milestone? And if they are, I am not concerned. They are doing great, they’re just taking their own time with it.” And so some of those, like for crawling, for example, I often ask a parent, “Well, first of all, are they rolling both directions? Because if they’re not, maybe we need to step back and work on that, because that’s one of the ways they’re gonna build their tummy and back muscles that are going to support the crawling.”

But I also like to ask things like, “Is your baby lifting one arm in tummy time to reach and to grab things?” And if they’re not, that’s telling us about their arm strength, that they’re not yet able to bear all of their weight on one arm to reach the other arm. So I just like to teach parents some of those little signs that baby’s on the right track because then there’s less focus on just a pass/fail, “Are they crawling yet?”

How To Help Your Baby Develop New Skills and Milestones

Jessica: Yeah, and you talked about rolling over. What can we do, as parents, to help our babies just build the strength to be able to roll over?

Rachel: Yeah, I mean, the biggest recommendation for all milestones, is basically more time on the floor. And then once baby’s on the floor, when they’re on their backs, for example, you can really encourage lots of kicking and lots of leg movement, because that’s going to help the baby gain a lot of abdominal strength and core strength. 

And then I always like to remind parents about side-lying play, because lots of them forget to put babies on their side, and that’s a great place to practice just that cause and effect of, “Wow, if I crunch my body up like a little jelly bean, I roll forward onto my belly. But if I stretch out, I roll onto my back.” And, obviously, it’s not a cognitive, conscious process like that, but that is the experiment that a baby is subconsciously doing when they’re on their side and they accidentally flip back onto their back.

Are Baby Milestones Important?

Jessica: This is so valuable to just hear about what the stages of development are and milestones, but can we get too caught up in milestones? How do you think about milestones?

Rachel: Oh, absolutely. I, myself, have gotten too caught up in milestones with my own kiddos. There is a range for all of these milestones. And even if your child is at the end of what the baby book might say for that, that end of that range does not necessarily mean, “Oh, there’s a huge diagnosis coming in. You should be worried,” it’s just a sign that maybe your baby needs a little extra help in that area.

I’d much rather a parent back up and think, “Okay, so let me get curious about how I can support this milestone through play.” So, things like, “Maybe I have been busy and I haven’t put my baby on the floor as much recently,” or, “Maybe I could just make more space for the baby to be on the floor when we’re upstairs and I’m folding laundry. I hadn’t thought about that before. I always put him in the swing, but maybe I could create another play space upstairs that’s just a little safe spot on the floor for the baby.” 

Combatting Milestone Anxiety

So, just helping babies to make progress towards milestones, and not view those milestones as this scary checkbox that is gonna indicate something horrible.

And I always like to tell parents, and I am totally guilty of doing this, but I like to tell parents that if you find yourself searching the internet for answers a lot, then that’s a red flag for you as a parent that something’s going on internally. So, the dark corners of the internet are not going to help you if, deep down, you’re really worried about your baby, they’re only going to feed that worry and anxiety. So, just shutting down the computer or the phone and sitting back, and really just thinking for a minute, “What’s going on with my baby, what’s going on with me, how can I better support what my baby needs to be working on?”

Jessica: I love that, Rachel. Thank you so much for being with us.

Rachel: Yeah, no problem, thanks for having me.

3 Episode Takeaways for Parents

OK, so let’s review some of Rachel Coley’s tips around how to observe your baby’s progress and build their strength:

1. Create Opportunities for Your Baby to Be on the Floor

All those baby-containing devices; the stroller, the swing, and carriers can get in the way of the best place for your baby to be, the floor. Just laying flat on the floor allows gravity to encourage your baby to build their muscles. So next time you need to get something done consider putting your baby down on the floor instead of in the bouncer seat. 

2. Consider Your Baby’s Mini Milestones

There are a lot of little steps/ mini progressions that lead up to those big milestone moments, and every baby has their own path. The healthy window for rolling over, sitting up, crawling and walking is much longer than you might think. If you want to know more, sign up for weekly stage-based emails at lovevery.com

3. Incorporate Play Into Tummy Time

If your baby doesn’t like tummy time, think about tummy time more like a position for play. What can your baby look at, touch, and hear during tummy time? How can you engage their senses? Think about tummy in reps and sets. When your baby gets fussy, you can give them a quick break then try again a minute later. Learn more about “The Tummy Time Course Pack” with Lovevery’s new The Course Packs.

“Swimming” in tummy time yet?

4 ideas for no-floor, less fussy tummy time