12 - 48 Months

Baby’s First Steps: Walking and Other Milestones

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 “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.’”

Dr. Giselle Tadros
pediatric physical therapist, In-Home Pediatric Physical Therapy

Few milestones in a baby’s life are more memorable than their first steps. It feels like a major accomplishment — for baby and parent! But what comes after those first steps varies greatly from child to child, something Dr. Giselle Tadros constantly reminds her patients. She’s a pediatric physical therapist, founder of In-Home Pediatric Physical Therapy, and the guest on today’s episode of My New Life.

Giselle discusses how long it takes most babies to switch from crawling to walking as their primary mode of locomotion. Got lots of gear to help your kid with that transition? If so, you’re in good company. But you may be surprised to learn that baby walkers are not legal in many countries outside of the US!

Key Takeaways:

[1:40] What is the most common reason a parent of a toddler goes to a physical therapist for help?

[2:42] What does Giselle consider late for walking? When should a parent seek help? 

[3:52] What can parents do to help their children develop the core strength needed to be physically active toddlers? 

[6:10] What do jumpers do for children?

[7:27] Giselle explains why she promotes baby wearing.

[8:35] What are signs of core weakness in a child?

[10:03] Why some children need support with balance.

[10:43] How long does it take for a child to become good at walking? 

[12:04] What are some ways to encourage muscle development in toddlers in a natural way so that they become really active kids?

[13:35] What are some ways to replicate outdoor play inside? 

[14:40] Giselle talks about what she likes to see in an 18-month-old toddler in terms of gross motor skills.

[15:25] Giselle discusses the milestones of a typical two year old, from a gross motor development perspective.

[17:46] Jessica reviews the highlights of her conversation with Dr. Giselle Tadros.

Mentioned in this episode:

In-Home Pediatric Physical Therapy

#inhomepediatricpt on Instagram

Script:

Jessica: Hi, Giselle

Giselle: Hi, Jess.

Jessica: I love following you on Instagram. It’s so fun to get to talk to you today.

Giselle: Well, thank you. It’s such a pleasure to be here.

Why Babies Struggle to Walk

Jessica: I’d love for you to share from your expertise, what do you see as the most common reasons a parent of a toddler comes to you for help? 

Giselle: So I’ve seen kids that maybe are late walkers. Sometimes kids take a little bit more time to figure out how to walk. Some kids that can be toe walkers as well so they are walking, but they’re up on their toes and not going all the way down. Some kids that have frequent falls, or falling often, and also kids that have some core strength delays and that shows up in toddlers as balance issues so those are the kids that are a little bit more clumsy or falling often when you compare them to their peers.

And some kids that just aren’t running around like you’d expect them to, that are sort of a little bit more inactive. And these are the ones that we always worry about when mom say, “Oh, they’re awesome. These kids don’t bother me. They sit down at home and they mind their own business,” and for us as a therapist, that’s a big red flag for us ’cause toddlers need to be busy and running around and you can’t keep your eyes off them for a second.

When Do Babies Walk?

Jessica: There are so many things to worry about. Let’s just go with walking for a first. What do you consider late for walking? When should a parent seek help? What are the signs? 

Giselle: Generally, what I say is a child should take about four months to go from crawling to walking. If your child was a late crawler, I wouldn’t be surprised if they didn’t walk immediately at that 12-month mark. I had one of my children had a little bit of lower tone, but she still managed to walk at 10 months and then I had my other kid that I thought was a beast and really strong, and he didn’t walk till 14 months so there’s definitely variation, just based on so many different things that sometimes I don’t even know the answer, but I would say that isn’t walking after 18 months, then I would seek out some kind of help or intervention.

Sometimes it’s something really simple, like targeting the core and getting them more confident in their standing, and then they can just take right off. Some kids are 15 months and they’re just a little bit timid and shy, and once you give them that confidence, they’re able to walk really well.

Jessica: And then what can you do as a parent, if your child has been crawling and you think that they’re progressing normally, but what can we do to help our children develop that kind of, that core strength and all that they need to be physically active toddlers? 

Are Walkers for Babies Good or Bad

Giselle: I always say just the way that you position different things in the home can really help them to get that kind of strength. So, kids need a lot of just practice to squat, to bend down, to pick things back up. That’s a great core exercise. 

So I love some kind of a setup where there’s something that’s a little bit higher up and then something else on the floor. So they could take a ball and put it up in a basket or just lots of up and down movement is really gonna help them build all the muscles that they need to get up and walk.

I also say to get your kids out of those walkers. So those walkers, in fact, in the US, we are the only civilized country that still allows walkers because they’re so dangerous and they actually are very bad for a child’s joints, and they delay walking because they don’t allow the right muscles to kick in.

So if you’re using a walker, hoping that your baby is going to learn how to walk, it’s actually preventing the whole process, which I… Parents always find fascinating.

So a couple of years ago, one of my cousins who lives in Toronto called and said, “Hey, I can’t find any walkers, those baby walkers in the local store. Do you mind just bringing me one from Walmart?” And I said, “Yeah, sure, no problem.” I already know I don’t love them, but I try not to get too physical therapy with my family and so I got one and we packed it in the car, and we were driving and we get to the border, and they asked us to pop the trunk and the board of Patrol says, “What is this?” And I was like, “I have no idea what he’s talking about.”

It turns out that the walkers are actually illegal in Canada and that’s why she could never find one. And it was just such a great liberating moment for me because I know that they’re so bad for kids and just to hear that they’re not allowed was so great. And then I went and I did a bunch of research and found that apparently, the US is the only place where they’re legal so they’re really, really bad for the kids and most other countries have figured it out, and hopefully, we will too, at some point.

Jessica: Oh, that is fascinating. And what about those jumpers? So, you hang something in a door jam and then the baby kind of bounces up and down and jumps. What are those doing for a child? 

Giselle: Honestly, they’re not really doing much. Again, it can be fun and it’s something that you can put your child in, but if your child’s feet are not planted flat on the ground and they’re just kind of using their momentum to go up and down, it’s not really strengthening anything so I always recommend to use it very sparingly, like 10-15 minutes, if you need to be making dinner or whatever it is and you just sort of need your baby to be somewhere safe, then it’s okay to use. 

But in terms of them getting any kind of strength or developing the skills that they need for walking, again, it’s more delaying the process rather than helping.

Can Gear Help My Baby Hit Pediatric Milestones? 

Giselle: I always just say to minimize gear. Kids don’t need a ton of different things to be in all the time, just a safe place on the floor to play. With kids, you give them a spoon and Tupperware and they’ll find something to do. They’re so creative and so curious, and I find that just leaving them to be is always the best way to get those muscles activating.

Jessica: And what about baby carrying? Do you encourage baby carriers carrying your baby on you and your toddler, is there any research from an OT’s perspective or from your kind of, professional background that would support or not support caring your baby? 

Giselle: I absolutely love baby-wearers, in fact, I recommend them to almost everyone that comes in here, as long as it’s fitting mom very well so that she’s not having any kind of pain and her alignment is good, so her shoulders are stacked over her hips, which are stacked over her knees and she’s nice and upright and not sort of hunched over or arching her back too much, and the baby is sitting comfortably. 

It’s actually a great way to build muscle because the baby isn’t really just slumped, but he’s actively up and looking around and twisting. He’s getting a lot of movement so I actually really like baby-wearers and I encourage moms to use them.

What’s Normal Milestone Development for Babies? 

Jessica: I love hearing that. That’s really encouraging and very consistent with what we’ve been hearing, too. So you were talking about toe walkers and balance, how do you know if your child is doing something that might be, maybe not as healthy for them, whether that’s toe walking or their balance might be an issue. How can you tell what’s normal and then when you need to seek help? 

Giselle: One of the things that is usually a sign that there’s some kind of a core weakness is something called W-sitting, and I’m sure that you’ve heard about this all over because it’s becoming more and more popular. And W-sitting is basically, when a child is sitting with their bottom on the floor and then their knees are bent and their feet are positioned outside of their hips so if you’re standing from above them, you would see that their legs are shaped like a W. 

And in and of itself, it’s not a bad position, but children will move in, move out of this position and that’s okay as long as they’re not staying there for long periods of time, and as long as it’s not the only way that they choose to sit. There are risks with W-sitting for sitting for long periods of time or if that’s their go-to position. It’s not good for their hips, and of course, it definitely prevents that core strength and stability that I was talking about because that wide stance of their legs make it easier to just keep the body upright. 

And so they’re not using all of the other muscles of their abdomen, their back, their pelvis, to develop the strength as they would if they were sitting in other positions. So W-sitting is always a sign that there could be some kind of weakness going on.

Jessica: Tell me about balance. How can you tell if your toddler is just just learning to walk or might have some other deeper underlying issues and need support with balance? 

Giselle: You’ll see kids that have some trouble balancing and a lot of it, again, comes from that core. I will always do lots of lots of balance work with any child that comes to me because it just helps generally. With a toddler, they love being up and walking, I love holding a hand, walking along a narrow curve, that’s a great way to work on balance. And you have to slow down and let them sort of take their time to do it.

Jessica: Some children can walk and stand without help, but then still choose to crawl, is this normal? How long does it take for a child to become good at walking? 

Giselle: I get this question all the time on Instagram, tons of DMs. My daughter took her first steps, but she’s still trying to crawl around and so we have to remember that that is their muscle memory. 

So, a baby’s go-to for their muscle memory is the fastest and the easiest way to do things so when they’re still learning to walk. It’s not that they’re not necessarily interested, but they’re so focused on whatever it is that they wanna get that they will go to their quickest and fastest way to get something. So, it usually takes, I would say, six weeks of just practicing in a very low stress environment of taking steps before it becomes their primary mode of locomotion.

I always tell parents, don’t freak out, just let them do it. Just give them time to get up and walk, and fall and get up, and walk and fall, couple of steps here and there, but don’t expect it to be their go-to the minute they take their first few steps. And always without fail, they’ll come back to me and say, “You were so right. I didn’t need to do anything except be patient.”

Jessica: Yes, isn’t that so much in parenting? 

Giselle: Yeah.

How to Encourage Muscle Development in Toddlers

Jessica: Patient. So, older kids are generally less active than they were a generation ago, so how about thinking about toddlers. What are some ways to encourage muscle development in our toddlers in a natural way so that they become these really active kids? 

Giselle: What I always like to do is empower parents. I say that you are your child’s greatest teacher because you understand your child the very best and you can create opportunities for learning through play that are fun.

 One of the first things that I love doing, and this is, if you remember Jessica, when we were kids, we used to always go outside and play tug of war with our friends. So, you’d have a long piece of cloth, or a rope, or whatever it was, and we’d all stand on opposite sides, pulling and pulling and pulling and that’s really actually hard work for our body because you’re engaging so many different muscles. I do this at home with my son where I take a scarf or the other night we did it with a pair of his pajama pants actually.

And I was sitting down on my knees and he was standing up and I said, “Let’s play tug of war, you pull and I’ll pull too,” and we each just sort of pull in our own direction. And you know, you let them win a little bit and then you tug and pull and they’ll come forward, and it was just this back and forth of a couple of minutes where there was tons of giggles, so much fun. And we were both sweating by the end.

Jessica: Oh, I love it. It’s so simple, but what if I’m gonna play that tonight, that is such a fun classic game, but I never would have thought of it. Now, it has so much more purpose in building core strength.

Giselle: That’s right, that’s right.

Jessica: So, that’s such a fun idea. What are some other ways to replicate outdoor play inside? It’s raining today. I’m just trying to think about how I can engage my kids inside. Do you have any ideas? 

Giselle: Absolutely. What I always say is take all the pillows off of the couch, throw them on the floor and let them build a fort and you, A, get to see just all of their curiosity and creativity juices start to flow, so they will make forts. And I always give them the little throw blanket that I have so they create tunnels and they do all kinds of stuff. 

And of course, with a toddler, you can help them create those things, but then at that moment they’re climbing, they’re going down, they’re squatting, they’re jumping up, they’re coming through, they’re peeking out. You can also put chairs as well, and again, they can climb over them and through them, and under them and just create tons of different movements all the time.

Gross Motor Skills for One Year Olds

Jessica: I love that. And so thinking back on what gross motor skills one-year-olds are working on. So many of your activities you just described you are working on these kind of core skills by 18 months, what do you like to see from a gross motor perspective? 

Giselle: So by 18 months I definitely want a child to be walking. I want them to be able to start and stop and turn without falling, maybe even starting to run a little bit, starting to be able to manipulate a ball if it’s rolled to them. I want them to be able to pull a toy behind them when they’re walking and to start running a little bit on some level surfaces, and to be able to carry a large toy across the room or a basket without falling over.

Jessica: I just love imagining all of those things, especially the basket without falling over, it’s so cute when they’re just towing around with their containers. What about two-year-olds? What do you like to see in a two-year-old from a gross motor development perspective? 

Giselle: So by two years old I definitely want a child to be able to run without falling. I want them to be able to start jumping with both their feet in the air, actually leaving the ground, and I want them to be able to start climbing up and down the stairs while holding onto a handrail or holding on to a parent’s arm. Those are all sort of really important things to be able to do by the time they’re around two-ish.

Jessica: Those first jumps are so sweet. I remember reading a checklist kind of like this and being like, “I don’t know if my child can jump at two,” and so I remember just seeing like, “Let’s see. Let’s see if she can do it.” It’s very helpful to hear those average ranges and kind of what you like to see from your professional perspective.

Giselle: Yeah, and I don’t like to cause stress by these things, but it’s just stuff for you to look out for and to try. You could take your two-year-old, if you haven’t seen them jump, put them on the bed or the couch and hold their hands and just start singing, “Five little monkeys jumping on the bed,” and just bounce a little bit with them and they’ll be jumping in no time.

What I always say is, just have fun with them. You wanna be active, you wanna enjoy time as a family. The numbers are that you want a child to be active for 60 minutes a day, and you also don’t want them to be idle for more than 60 minutes a day. 

So just encouraging that active movement is the greatest predictor of preventing sort of adult obesity later in life. And just daily exercise is really the key to being fit in general. So I say, just do things together. Let your kids help you wash the car. In the winter, shovel the snow, even if they’re not doing it well, but just have them doing these things with you. 

Raking leaves and jumping, and then planting and caring for a vegetable garden, doing stretches and exercises if you’re doing yoga. So, just lots of activities together because your toddler is really looking up at you and copying everything that you’re doing and so they’re learning and their muscles are getting stronger, and they’re also just looking to you as a role model for being physically active and fit and strong in the years to come.

Jessica: Giselle, it has been so fun being with you today. Thank you so much for all of your expertise, it’s great to talk to you.

Giselle: Thank you so much. It’s been so much fun being here.

3 Episode Takeaways for Parents

Play is such a great vehicle for skill development! Physical and mental.

Walking Takes Time

After the first steps, it usually takes a child around 6 weeks to transition from crawling as their primary way of getting around, to walking. Place objects on a low table just out of crawling reach and your soon-to-be toddler will be more motivated to pop up. 

Playtime Can Build Muscle

Try playing tug of war with your toddler — it engages all kinds of muscles. No need to find a rope; a blanket will do. It builds core strength and will certainly get a lot of giggles.

Indoor Play is Important for the Core, Too

Blanket forts are a great way to replicate outdoor play inside. Empty boxes work magic too. Fort building involves lots of sitting, standing, crawling, and peeking. All of these build core strength: the key to an active, healthy life in the years to come.

You can find more tips to get your toddler moving on the Lovevery blog

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Kate Garlinge

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Posted in: 12 - 48 Months, 9 - 10 Months, 11 - 12 Months

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