Time and Space to Move: Encouraging Infant Gross Motor Development

Last week, we reviewed some elements of language development (https://www.mayapeds.com/promote-early-literacy-even-without-books/ ). Today, we’ll discuss some gross motor development and the one key activity all babies can benefit from: time on the floor or other open area. We’ll review some basic development and see why and how free time on the floor is so helpful. Next, we’ll discuss baby “containers,” such as bouncers and high chairs. Some of them have a useful purpose and others should be avoided. Lastly, we’ll go over a practical approaches to make free time more enjoyable for everyone.

This topic was suggested via Instagram (@mayapeds). Please feel free to make your own suggestions, either there or in the comments here. 

Start with Time and Space

When it comes to helping a baby learn, there are a variety of gadgets available. Many claim to help with a baby’s development. And, many imply that a baby cannot properly develop without said gadget. However, for a baby to progress through their gross motor developmental milestones, they actually don’t need much. Time and space is a good start. 

What do I mean by gross motor milestones? We refer to movements with the large muscles of the body. These movements include rolling over, sitting up, crawling, pulling to stand, and walking. As a child gets a bit older, gross motor activities include jumping, hopping, and running. 

Before we go much further, let me emphasize that my expertise is based on a Western education and the American Academy of Pediatrics (AAP). While I learn about worldwide practices and want to eventually share more about what I learn, I’ll be mostly focusing on AAP recommendations today. As I often say, there’s more than one “right” way to raise a child. This post is just one perspective.

Starting as a Newborn

Newborns do a lot of laying around. It may not look like much, but they’re learning and observing. They are also squirming. And stretching. Those seemingly tiny movements are preparing them for literal great leaps in the future. This means babies do need some time to stretch. Temperament influences a lot of how we care for newborns. Some infants really prefer to be bundled up or held most of the time. Being held is crucial and never to be discouraged in these early days. However, I’d like to offer the idea of letting a baby spend some time in a space that allows for more movement. There’s many options: somewhat unbundled on a reclined parent’s chest, in a crib, on the floor, or in a playpen. 

The AAP and World Health Organization  recommend “tummy time,” starting soon after birth. Australia, the United Kingdom, Canada, and South Africa also include tummy time recommendations in their national guidelines. If a baby is awake and on their belly, this usually qualifies as tummy time.

For newborns, this can be done on a parents chest. Those tiny movements of a head lifting or legs kicking are precursors to something bigger. 

Open Space for Older Infants

As they get older, time and space on a parent’s chest may become a limited commodity. When this happens (different for every family, sometimes around 2-3 months), time in an open area is also important. Cribs, playpens, and the floor are excellent options. There is no need to provide intense entertainment like a motorized mobile or a TV screen while a child is in this space. If they’re near the rest of the family, that familial exposure is perfect. By the time a baby is rolling consistently (often by about 6-7 months), this time is even more important. A blanket on the floor is perfectly sufficient. A play yard or playpen can be helpful if the available floor is not clean or safe. In the earlier months, a crib allows enough room.

Let them lift their heads, roll, kick, and reach. They may grunt with the effort.

Babies are driven to learn and progress at their own pace. The pediatrician Dr. Emmi Pikler wrote:

“If we provide enough space and possibilities for moving freely, then the children will move as well as animals: skillfully, simply, securely, naturally . . .

Should we exercise the small child?  Should we teach the child correct movement? What measures could we take to get good results?      

We don’t need to take any special measures.

The question is not how we can “teach” an infant to move well and correctly, using cleverly thought up, artificially constructed, complicated measures, using exercises and gymnastics.  It is simply a matter of offering an infant the opportunity – or, more precisely, not to deprive him of this opportunity – to move according to his inherent ability.”

Excerpt PEACEFUL BABIES – CONTENTED MOTHERS (E. Pikler,1940) via https://thepiklercollection.weebly.com/the-development-of-movement—stages.html

This post goes into more detail about which movements to expect at different ages and more specific ways parents can support typical motor development.

If the Floor is Unavailable

Of course, there are situations where a baby is better off in another place or another position. This is when we think about these baby “containers.” Personally, I’m not a fan of the term “container,” but I use it here for clarity. This refers to swings, bouncers, jumpers, floor seats, exersaucers, car seats, strollers, “loungers,” and high chairs. Containers often get a bad reputation due to effects from prolonged use (abnormal skull shape, for example, as well as the obvious lack of free movement as we’ve discussed). But, some are essential.

Containers for Safety

Safety is always the first priority. Car seats in a moving vehicle is the most obvious and extreme example. There is simply no other safe option. Motor development is not the priority when riding in a car. However, when a baby is no longer in the moving car, it’s best to get them out of the car seat. And, I say this as someone with a baby who slept beautifully in their car seat, so I understand what a big deal it is to transfer them out. 

Bouncers and High Chairs

What about bouncers and high chairs? Sometimes life is just easier using these devices. And, it’s perfectly fine for a few minutes here and there. Ideally, it shouldn’t be the primary place a baby spends their time.

For one example, a mother may have a bouncer in the bathroom for her baby. When this mom needs to use the bathroom, she doesn’t feel comfortable leaving the baby in a crib in another room due to an older sibling also in the house. Older siblings can be a bit unpredictable, right? The bouncy chair allows her to supervise, hands free, while she brushes her teeth. I use this example because it’s another instance where despite my staunch support of babies spending time in an open area, a bathroom floor is not an ideal place to roll around. 

I’m quite sure other families have solved this bathroom dilemma in more creative ways. How parents decide when and where to use these containers depends on many factors.

The most general recommendation I’d like to make is that if there is a safe way for babies to move freely (and happily), go with that. I use the word “happily” just to be clear I’m not advocating for a baby to be left miserable on the floor. Nothing needs to be forced. Even time in an adult’s lap is more “beneficial” than an infant swing because there is still some movement (small shifts in weight), and a lap is unlikely to contribute to changes in a baby’s skull shape.

Two Infant Devices to Avoid

Finally, a word on two devices that can actually do more harm than good. I also discuss these more extensively in my booklet, The First Month , but need to mention them here for completeness.

First, walkers are never recommended. There have been serious accidents as a result of these devices. The walkers I’m referring to have the baby supported in the center and surrounded by wheels at the base. With just a kick of their legs, they’re able to glide across the floor.

Secondly, infants should not sleep in containers not specifically designed for sleep. Lounge pillows, nursing pillows, and rockers all come to mind. If a baby falls asleep in one of these places, they need to be moved immediately to their usual sleeping place. Their usual sleeping place should be on their back somewhere with a firm flat surface and with no surrounding pillows or blankets. This is not a matter of development, but a matter of safety risk. There is an increased risk of suffocation or death if a young infant sleeps in one of these devices.

Make Open Space and Free Time Even Better

Stepping back and looking at the big picture, we see that opportunities to stretch, move, and experiment with muscles are ideal. How to make it even better? Try moving the space to a shady area outside. A blanket on the grass. A playpen under the tree. The natural light is wonderful for developing eyesight. And the gentle movements of nature lend themselves perfectly for a baby’s entertainment. This is an especially nice option if a caregiver has yardwork or another outdoor project. Their baby can safely accompany while also moving freely.

Summary

To summarize, for gross motor development, babies need free time and space to move, ideally some of it outside. Containers can be used if needed, but not for an extended time. As with all guidelines, it’s just information to use as a starting point. Every family has different needs and priorities. The most important thing is that a baby is safe and feels loved. 

Maya M. Mahmood, D.O., FAAP is a board-certified pediatrician and mom. She is passionate about parents having evidence-based information to help their families be healthier.

References

Hewitt, L., Kerr, E., Stanley, R. M., & Okely, A. D. (2020). Tummy Time and Infant Health Outcomes: A Systematic Review. Pediatrics, 145(6), e20192168. https://doi.org/10.1542/peds.2019-2168

Labotz, M. Out of the Container, and Onto the Floor. aappublications.org Journals Blog. May 22, 2020 https://www.aappublications.org/news/2020/05/22/container-floor-pediatrics-5-22-20

Photos by Nathan Dumlao on Unsplash and Luis Arias on Unsplash