Today I am excited to welcome pediatric physical therapist Wendi McKenna, DPT, PCS, C/NDT! Wendi is here to talk to us about how to help our babies become independent, functional, confident sitters. (Spoiler Alert: It’s not by putting them in a Bumbo seat.)
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A celebrated developmental milestone is when a 6-month-old baby (give or take a few weeks) can sit up independently. But what does that mean? The reference books say independent sitting is when a baby is placed in sitting on the floor and can remain there without help from caregivers, other supportive props or gear, or the use of their own hands for balance. But is this independent sit functional for baby and why does it matter?
Any time a new skill emerges, there is a period of chaos where trial and error is the name of the game. Babies persistently work to lift their heads during tummy time; they persevere through many failed attempts to finally roll over; and they wear the signs of trial and error all over when starting solid foods. All the hard work they put into mastering each new skill serves as a foundation for tackling the next developmental milestone on the horizon. Babies’ inherently strong level of motivation helps them to continue on this arduous journey, constantly facing new challenges and overcoming them on a daily basis. The subsequent development that occurs during the first year of life is nothing short of a miracle.
So why, after months of floor time/tummy time practice when our babies finally gain functional mobility skills, does our society promote placing them in sitting: a position they have no idea how to get to or, more importantly, how to safely get out of?
Watching a 6 month old on the floor is wonderful. All of the floor time (especially tummy time) they received starting from birth built the foundation for the function we see at 6 months. After all that practice, they get it…they’ve practiced a lot and it’s a place they are comfortable. They can roll from point A to point B; they explore every inch of their body; they access toys out of reach by pivoting around or inch-worming; and they bring that toy back to play while lying on the floor on tummy, back or side!
The best part is, as long as they are in a safe space, they really can’t get hurt because they are already on the floor. There is no falling. Babies rely on parents for many things, but they are also incredibly self-reliant when given the opportunity. Though they love playing with you (and there should be a lot of that), they can and should practice independent exploration and play in positions that allow them to move and be functional…on the floor! This easy practice builds a strong foundation in sensory and motor development for all milestones and skills yet to come.
This takes us back to functional sitting. When babies are independent AND functional sitters, they have the ability to get into sitting by themselves and the knowledge of how their body works in space to help them safely get out of it. Functional sitting is mobile sitting with controlled weight shifts left, right, forward and backward, and on all the diagonals in between. These weight shifts allow for transitions down to the floor, across onto hands and knees, or up to kneeling. Weight shifts also allow for long, stretched-out reaching to grasp a toy with a controlled return to sit for play.
Below is a four-photo sequence depicting independent weight shifts and transition into sitting…functional sitting!
Functional sitting comes after the trials and errors trying to get to sitting independently; every failed attempt and subsequent problem solving tactic exposes babies to ALL the moves necessary to later control or stop a fall when they lose their balance in sitting. Functional sitters are immediately safer and more confident sitters than babies placed in sitting by a caregiver because babies who are placed in sitting have not yet practiced those moves that will help them maintain balance or control falls. Placed sitters often fall without trying to slow it, and even forcefully extend backwards because they haven’t learned how counterproductive (and dangerous) that is. Emotionally, functional sitters know where they are and how they got there, reducing anxiety and increasing their sense independent accomplishment (true self-confidence). And, it’s never too early to provide opportunities for your baby to build self-confidence…from the ground up!
Though I’m advocating for more time on the floor (tummy, back, side) until baby is a functional sitter, there is a time and place for sitting baby upright. When your baby can sit upright without the need for propping by baby gear or with their own hands, it is safe to have supervised independent sit time on the floor. You can also support your baby in sitting on your lap, engaging in fun play and movement games. And who doesn’t love a game of “timber” on the bed?!?!? All of this is good fun and safe. But when placing your baby down, rather than setting up padding 360 degrees around your independent (but not yet functional) sitter, consider placing him on the floor where he is safe, mobile without anxiety or risk for injury, and free to move, explore, play and learn.
At the top of this post is a video of Kellan getting up into sitting for the 2nd time. (I missed the first time by 30 seconds). He is 7 months, 3 weeks and though he sat independently when placed at the typical 6-month mark (yes, we tested him), we chose to keep him on the floor on tummy, back or side whenever we placed him down. This confident, proud and functional sitter is our reward: a baby who, once in sitting, automatically had the confidence to move around, risk falls, actually lose his balance and fall with control and then go right on playing happily.
Sitting Summary + Tips:
* The independent transition to sit typically takes place between 7 and 8 months rather than the 6-month mark for placed independent sitting.
* When not wearing or carrying your baby, provide floor time on tummy, side or back rather than placing them in sitting. Let them find their way independently…you can always coach them with your words as they move (a great play and bonding experience).
* If you must sit your baby, please avoid using plastic containers/props and gear that are specifically designed to sit pre-sitters upright/vertical before they are ready (there are popular products out there that do this). A four month baby is not ready to be sitting upright with gear, but can be upright on a caregiver’s lap where dynamic and responsive support is provided to maintain proper alignment.
Now that you’ve done all this reading…Here’s to Moving, Playing and Growing!
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Wendi McKenna is a pediatric doctor of physical therapy and owner/founder of Strides Physical Therapy, Inc. After 13 years of practice and ever-increasing referrals for preventable diagnoses associated with flat head (plagiocephaly), torticollis and general developmental delay, Wendi created a prevention-based baby wellness program with colleague, Rachel Griffin, called Move Play Grow. Her hope is to empower parents with knowledge about their babies’ sensory and motor development to give parents more confidence as they make decisions, work, and play with their babies every day. Happy tummy time is a primary goal with all classes taught, which even after one class any baby can achieve.
Wendi has an amazingly supportive and loving husband, and three crazy wonderful children, ages 7, 5 (girls) and 8 months (little man)! When not treating patients or teaching classes, she is always with her family, enjoying all the little moments, joy and laughter that life brings.
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In addition to being mama to two sweet little boys and wife to a crazy awesome husband, Christie is a Registered & Licensed Occupational Therapist (OTR/L). She holds a B.A. in Psychology with a Minor in Education from the University of California Los Angeles (UCLA...Go Bruins!), and an M.A. in Occupational Therapy from the University of Southern California (USC OT). She has experience working as a pediatric OT in early intervention (birth to 3), clinic-based, and school-based settings. Her mission with MamaOT.com is to encourage, educate, and empower those who care for children. Christie loves that she gets to PLAY when she goes to work, is hopelessly addicted to Kettle Corn, and is known for being able to turn virtually anything into a therapeutic tool or activity, from empty food containers to laundry and everything in between. Learn more about Christie and what inspired her to become an OT.
Occupational therapy (OT) is a holistic profession that helps people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities, also known as “occupations”. Some OTs help people diagnosed with disability, injury, or disease. Others help prevent disability, injury, or disease. Because of occupational therapy, people of all ages are able to say, "I can!" no matter what their struggle. Isn't that amazing?!
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