Baby’s first big milestone: Head control

  • September 15, 2017

Head control is essential because all of the following motor milestones depend on it.

Your baby can not roll, sit, crawl or stand without head control. Babies who have difficulties with head control will either need professional help, or they will learn to hold their head with compensation.

This compensation could affect the whole body, the developing movements, and skills.

mama with newborn baby

MILESTONES OF HEAD CONTROL: STAGE ONE
DAY ONE TILL THREE MONTHS OF AGE

YOUR FULL-TERM NEWBORN BABY

Your full-term newborn baby’s whole body is in a “flexion pattern” which means that the head, shoulders, arms, back; legs are all in the bent/forward position.

When you place your baby on her belly, she will not be able to straighten her arms, legs or back. This makes it a bit challenging to lift her head up.

Learning of motor skills and being out of the womb will help your baby’s flexion pattern disappear by the age of ~two months.

Full-term newborns have a reflex that helps when learning head control. If you place your full-term baby on her belly, – face forward onto the mattress – your baby will turn her head to one side to assist herself breathing easier.

This reflex will help your baby learn to lift her head up. 

More...

newborn flexion contracture

YOUR PREMATURE BABY

Premature babies generally do not have the above-mentioned flexion pattern, or it is milder. The reflex could be weak or missing as well.

Because of these and other possible factors, it is critical to monitor and assist your premature baby with positioning and eventually exercises to ensure overall gross motor development starting with good head control as a foundation.

premature baby sleeping on his back

 THE BEGINNING STAGES OF GOOD HEAD CONTROL


WHEN YOU HOLD YOUR BABY UPRIGHT:

  • Both, baby’s trunk and head needs to be supported at all times. One hand on her head, one head on her body.

  • Slight tilt to any direction would make your baby’s head fall to that direction.

  • The baby is “head heavy,” meaning where the head goes the body follows helplessly.
mama supporting head holding baby

WHEN YOUR BABY IS LAYING ON HER BACK OR PARTIALLY ELEVATED:

  • Her head will be turned to the side, alternating sides.
  • For a brief moment, your baby will hold her head in the middle.
  • While your baby keeps her head in the mid-line, she looks into your eyes. This eye contact at first is a split second to a few seconds long. Your face has to be a few inches away from her face.
twin newborns sleeping


When your baby is laying on her belly:

  • She keeps her head to the side. Your baby cannot turn her head from one side to the other.
  • When your baby is laying face-down, she can and will turn her head to one side. In the beginning, she will prefer to turn to the same side. 

newborn in flexion contraction

DEVELOPMENT OF GOOD HEAD CONTROL


This is not a chronological list. When I work with a baby, I look for the completion of all skills within the given time-frame regardless of the sequence of achievement.

WHEN YOU HOLD YOUR BABY UPRIGHT:

  • You will support her head less in several forms: - your hand holding her head will cradle the head more loosely and - will move closer to her neck - eventually, both of your hands will hold her trunk only - and your hands will move lower on her back

  • If you tilt your baby, it is visibly noticeable that she is attempting to keep her head up. However, without your support, the baby's head would still fall over.

  • Your baby slowly becomes less and less “head heavy.”

WHEN YOUR BABY IS LAYING ON HER BACK OR PARTIALLY ELEVATED:

  • Your baby starts holding her head in the mid-line more often and/or for longer periods of time.

  • Your baby will turn her head from side to side more often and with noticeable, easy/grace in the movement. This movement becomes second nature for her.

  • Your baby keeps eye contact for longer periods of time and more often. You could enjoy her gaze from few seconds to a few minutes eventually.

  • Your baby starts tracking your face and some objects.


When your baby is laying on her belly:

  • Face down; your baby turns her head easier to the side. During these turns, she lifts her head higher and higher. She also starts turning her head to both sides.

  • Laying with her head turned to one side, you notice that she is attempting to turn the head to the other side regularly. These efforts by the end of this stage will result in her ability to turn her head from side to side.
2 month old lifting head on belly

HOW TO TEST YOUR BABY’S PROGRESS?


Every baby develops differently. Your baby could complete the milestones in a different order, or a bit faster/slower. Three months of age is an average age.

Fifty percent of babies complete the above milestones of head control by three months thus the medical society chose this number to represent average. Some baby’s reach this stage by 2+, some by 4+ months.

When I work with a baby, my first test is to see if the flexion-pattern and reflex mentioned above are present. If they are missing, I recommend physical therapy.

My second way of testing for possible challenges is to see that the baby is alert and there is visible progress in overall development on a weekly or biweekly basis.

My third, only the third test is to compare the baby’s progress against the developmental charts for that particular milestone.


CHECKLIST OF GOOD HEAD CONTROL
BY THE END OF ~THREE MONTHs

WHEN YOU HOLD YOUR BABY UPRIGHT:

  • she holds her head pretty well on her own – but you might keep your hand close to her to catch an occasional bigger wobble of her head

  • her head wobbling is significantly less

  • you can pick her up with both of your hands on her trunk; she holds her head pretty steady, you might put your fingers on her neck
3 month old held up in air

WHEN YOUR BABY IS LAYING ON HER BACK OR PARTIALLY ELEVATED:


  • she holds her head in the mid-line and keeps it there for a minute to several minutes

  • she turns her head from side to side with ease

  • she loves looking at you and keeps a good eye contact with you, sometimes even for a couple of minutes

  • she is tracking your face and some objects


When your baby is laying on her belly:

  • she lifts her head; her shoulders are off the mattress

  • her arms are next to her shoulder; sometimes she forgets her arms straight down by her body

  • she puts some weight on her arms when lifting her head; sometimes she lifts them up

  • she is tracking your face and some objects
3 month old lifting head on belly


POSSIBLE HEAD CONTROL CHALLENGES

Remember, the information presented here CAN NOT substitute medical evaluation, medical diagnosis or medical treatment.

Always follow your doctor's advice. The contents of this blog is informational only. It CAN NOT be used to substitute proper medical care.

  • When placed on her belly, - face forward onto the mattress - your newborn full-term baby will not turn her head to the side.

  • When placed on her belly, - face forward onto the mattress - you see that she attempts to turn her head but with no results.

  • When placed on her belly your newborn full-term baby lays straight. There is no “flexion pattern” present, or it is mild.

  • Baby prefers to hold her head only to one side (all positions).

  • No, or minimal eye contact.

  • By the end of the three months, no changes or minimal changes in her head control are noticed.

  • When placed on her belly your baby holds her head up to high. When held upright she appears to be arching her neck and back. She attempts to hold her head without your help.

I repeat, this blog is for informational purposes only. However, knowing the nature of us humans, you might try things described on this blog with your baby. I can not stop you from it. If you harm your baby, it is solely your responsibility!

Remember, the information presented here CAN NOT substitute medical evaluation, medical diagnosis or medical treatment. Always follow your doctor's advice. The contents of this website are informational only. It CAN NOT be used to substitute proper medical care!


Reading, using, sharing the “Contents” of the Baby’s Milestones Website, FB pages, Instagram and other social media sites, you agree that they are for informational purposes only.

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