To sit…or not to sit: Developing functional sitting skills in babies

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!

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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.

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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!

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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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LPP_1005Wendi 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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23 thoughts on “To sit…or not to sit: Developing functional sitting skills in babies

  1. thank you for this post, my daughter turned 6 months on the 18th and does not sit. I have tried a few times and she falls back right away, only occasionally leaning forward using her hands for support for mere seconds before falling back. Based on your article, should I not bother with attempting assisted sitting with her (i have propped up pillows and supported at hips) and just do tummy and other floor time, she will progress when she is ready?

  2. Hi Tara. Thank you for taking the time to comment. The short answer is “yes.” You do not need to practice sitting in order for her to progress to independent sitting. Floor time/tummy time is the best place for her to continue to develop the foundation components of movement that makes sitting possible. That said, she should be very functional, independent, confident and competent on the floor with pushing herself up, pivoting around, rolling in both directions, reaching for toys, scooting short distances etc. If she is not moving around a lot on the floor, then we can have a different conversation. Remember, though, she can still be in sitting to enjoy a more upright position, but the best place right now is on your leg or lap where you can provide her the dynamic support she needs. It sounds like she needs too many artificial props around her in floor-sitting for it to be really fun for her. Her main goal is to interact with the people and world around her. If she is spending too much mental capacity trying to keep her balance (sometimes unsuccessfully), she doesn’t have enough reserve to really take in her surroundings and learn. Hope that helps! ~Wendi

    • Hi Wendi,

      Thank you for this information. She does push herself up, pivot, roll in both directions and reach for toys. She has not started scooting on her belly. She does on her back, pelvic thrust and kick her legs to get around, she crawls on her back, I don’t let her do that often though, I usually will return her to her belly. My pediatrician said he has never seen that before and once a baby learns to get around they will focus on that and not always attempt to learn a new way to move so to encourage her to scoot I put her on her belly and place toys a little farther away from her reach.

      Thank you again for your information about sitting, I do sit her in my lap often so we will do more of that so she isn’t always in a supine/prone position.

      • I have seen a few babies do the back crawl thing. Just as you are doing, try and limit that pattern. It utilizes too much extension whereas crawling is a more balanced use of flexion with extension. Babies (and all of us) use the path of least resistance to move. For some reason, she found the back crawl to be easier…probably because she really feels comfortable with extension (does she have a history of spitting up?). Try and work on flexion activities such as reaching for her feet and toes, playing with them, placing them in her mouth, rattles on ankles or using her legs to kick at dangling things while on her back (keeping legs in air rather than slamming down to the floor). When she’s on her back, try and have all the interesting things to get and look at (including you) be in the direction of her feet, not above her head.
        When on her tummy, have her try play with things that are placed to the side, so that she has to shift her weight to one side of her body to free up the other side to play. She will actually be closer to a sidelying position. See other information below in reference to my comment following another reader’s question that was submitted a couple days ago.
        Hope this helps!

    • Hello,

      Thanks for this post… very helpful! What do you recommend for a 5 month old with a flat spot. I do as much tummy time as possible but I do use the bumbo when I need my hands free and it’s not safe to wear baby (i.e. cooking dinner) to avoid other baby gear that puts pressure on the head.

  3. Wendi,

    My daughter is almost 9 months old and has been sitting (when placed) independently since she was 5 months old. She army crawls, mostly in a circle, to get around some, but mostly prefers to sit up and play. She does not push up on her knees and rock at this point, but she will transition from sitting to her belly, occasionally. She does roll both ways, but I don’t feel like she takes advantage of this skill while she is playing. I am concerned that she should be crawling at this point, and that she may skip crawling entirely and go straight to walking. She also pulls herself up to standing when she sees something within reach to do so. Should I be concerned and what can I do to encourage her to crawl, besides continue to place her on her belly? Thanks.

  4. Hi Jennica,
    Thank you for your thoughtful and detailed question! The great news is, it sounds like your daughter has some strong foundation skills on the floor, and given the opportunity to spend more time there, she will progress nicely. The difficult part is that sitting and standing already exist in her repertoire, and comparatively, the floor is a more limited venue. So her tummy time might be short-lived and frustrating for her. IF she tolerates tummy time, my first recommendation would be to place her down on her tummy as much as possible rather than in sitting. And if she is in sitting, try to keep her away from surfaces that she can pull up on. She should have to work to get there…:-).

    I don’t know what your daughter looks like on the floor, but from your description, it sounds like she does not bear weight on her hands with straight/extended elbows very much…that she is most likely spending time on her forearms. She may also lack the control to truly weight shift into and control a sidelying position, an important foundation skill that allows one side of the body to be the stable weight bearing side against the floor and the other side to be the moving, reaching, interacting side in space. These two skills are essential for transitions up to sit and for crawling on hands and knees.

    Disclaimer, I think all babies should crawl…for many reasons, and I will be blogging about that shortly. That said, in order to help teach her transitions to and holding/moving in hands and knees position to get her ready for crawling she needs to first learn to control her body weight on extended arms with hands in contact with the floor…not just her forearms. A few ways to accomplish this are:

    1. When baby is on her tummy, manually lift her upper chest slightly off the floor and bring her weight backwards a little bit (your direction of the lift should be up and back toward feet on a diagonal…not just straight up). You should expect arms to reach down to the ground and hands to make contact with floor, and for hips and knees to flex/bend so she is on hands and knees. If her knees are wider than her hips or slip out to the side, then you kneel behind her and sandwich her little pelvis between your legs to keep her in line (gentle squeeze for support). If she kicks her legs out behind her, you will probably need to try #2. You can then lessen your support as she takes more control. You can do this in front of a toy that she wants to reach for, you can add some rhythmic rocking to a song you are singing, or you can simply use this as an opportunity to teach her to get into sitting…Once on hands and knees, baby can shift weight back further and to one side or the other, move pelvis over a leg that is planted into the floor and get into sitting. She will typically use a hand on the ground for support and an extra push. If this does not make sense, then you perform the transition tummy to sitting on yourself so you know what is needed.

    2. When baby is on tummy, shift her weight to one side so she is fully weight bearing on one side and the other is free. She should be able to keep her head off the ground. Help her to flex the free (upper/non-weight bearing) leg up toward her tummy so that hip and knee are bent and her upper thigh is close to or almost touching her tummy. Then help her shift her weight back onto that flexed leg. This should help her to hoist her pelvis up, freeing the other leg to come up and requiring that she push up on her arms in order to be in line with her hips and pelvis. Again, you can provide some support under her chest if she can’t come up.

    3. When baby is sitting, you sit behind her and straddle her so you are making contact on one side of her body with your thigh. Entice her with a toy, your voice, a sibling, another parent, etc to try and reach over your leg. As she reaches, roll your leg with her movement and allow her to rotate up into a hands and knees position, her hands on one side of your leg and knees on the other. Your leg acts as a bolster to keep her tummy off the ground, so that she will be supported on hands and knees. She can then rock back and forth, reach for things, etc. Again, the goal is to get her comfortable bearing weight on her hands with arms extended while also on her knees.

    There are many ways to help a baby learn to be on their hands and knees, but I hope these ideas are good to get you started. Try them out and keep this conversation going. I think it might help a lot of people!

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  6. Hello! Thank you for the fabulously informative article! My daughter is just about 3 months old and is far from a “container” baby; she is constantly held or worn in carriers and spends time playing on the floor quite often. She tolerates tummy time for about 5 minutes at a time but we do this many times a day. She has great head control. My question is this…over the past 2 weeks she has shown a preference for sitting up, assisted. We hold her in our laps or up on the floor sitting and she seems to love looking around like this. Is it detrimental to her becoming an independent sitter to hold her like this? Also, our high chair has an infant insert which would enable her to sit up in the chair. Should we avoid using the high chair to sit her upright for short periods during the day (at the table with us while we eat, for example)?

    • Hi Jennifer,
      Great questions and I’m so glad to hear about all the floor time she is getting. The easy answer is, the more time your daughter has on the floor, experimenting with her own independent movements, the more she will develop those essential foundation skills for mobility on the floor, transitions, and the tools for more upright postures. That said, ALL babies love to be upright; that is what drives them to work to get up. And that magical 3 month milestone is when their cognition kicks up another level: “The floor is still tough for me to move around on, and I know how to “tell” mom and dad that I like to be up.” They know the difference because of all the time you are carrying them around. There is so much more to see, point out, touch and feel, etc.
      However, their muscle/postural control system is not developed enough to support them there independently. Some experts go as far to say babies shouldn’t be supported upright at all until they can get there independently, however, I take a softer and more realistic approach.
      If your daughter is sitting up with you, please make sure you have your hands or forearms around her trunk, supporting her spine. Do not just prop her bottom down and lay her back on you. This way you can respond to her movements, changing your support of her as you need to.
      As for the high chair, I would delay putting her in it until she can sit independently (this goes for a stroller too), even with the infant insert, because she most likely will not be properly aligned and even the slightest movement will tilt her in the wrong way because she doesn’t have the postural control to correct her body back to midline.

      Socially, however, being at the table with you is very important. You have a few options. You can wear her while you eat (which is awkward at best); hold her upright on your lap one hand/arm wrapped around her spine to support it; have a few more picnic lunches and dinners on the floor with her until she can be at the table (this is fun); or….(and ONLY if you have a safe enough table/counter top with sufficient width/breadth and sturdiness and you promise to be in arms length away from her at ALL times) you can put her play mat on table surface and have her be your centerpiece in tummy time, facing you. We did this often with our 3rd baby and they were always the most fun dinners.
      I hope this helped! Let me know how it works out for you.
      Warmly, Wendi

  7. Thanks for the helpful response! We will avoid the high chair for now. We did try a stroller 2 times before I realized it’s much easier to wear my daughter (and I love having her close to me!) I was worried about always placing her on the playmat as I didn’t want her laying on her back too much and getting a flat spot on her head but I’m realizing that when she is on her playmat, she is in constant motion and moves her head and body all over. Thanks again for the advice, my husband and I love holding her on our laps when we are not wearing her so we will make sure she is supported by our arms as you mentioned. We are still doing tummy time, despite her protests, in multiple short periods. She rolled from tummy to back yesterday for the first time, very exciting! Thanks again!

  8. I love this article! I have read it multiple times as it really does sum up a lot of my beliefs about physical development (not that I have any education or training in this area). But, I really do think that we are instinctively built to acquire certain skills provided we’re given the opportunity.

    The educator in me knows that all children develop at their own pace, but the mama in me is starting to get more anxious than usual. My daughter is just 8 months and doesn’t seem to be anywhere close to functional sitting. She spends most of her time on the floor, and like Tara’s little one, she rolls in both directions, pivots, and even pulls herself forward sometimes–especially, if she can grab onto something. She can manage a sitting position if sat up, but will eventually let herself fall back. She is obsessed with feet, mine, her dad’s, her own, etc. She will pull off her shoes and socks, and suck on her toes whenever she gets the chance. You asked Tara if her LO had a history of spitting up? She still spits up all the time when I sit her on my lap or on the floor, even sometimes when I’m holding her. She almost always pushes herself away and arches her back. We always assumed it was just because she wants to look at EVERYTHING! Could her diapers have anything to do with this as well? We do cloth and they are bulkier than disposables. More naked tummy time maybe? That’s a lot of questions, but I’m starting to feel lost.

    • Hello Auria,
      So sorry it has taken so long to respond to your thoughtful question. I hope your daughter is doing well!
      My first thought, not knowing your baby is that her spitting up/reflux may be a contributing factor in why she is limiting her mobility. She sounds like she prefers extension to flexion, which will impede development of control moving side to side and with rotation. Only after extension and flexion are balanced can baby really exhibit true lateral motion; and then rotation. They go through the sequence of front/back; side/side and rotation in each position (floor, sitting, standing), so baby might rotate on the floor but be just working on forward/backward in sitting.
      There is a big difference in the emotionality of pushing away/backwards and looking backwards. The first is an attempt to get away from something…typically discomfort or the feeling of something coming up the esophagus from the stomach; the second is based on basic curiosity and is often a game babies play. The first is a sign that not all is right; the second is a normal behavior.
      I used cloth diapers for a long time and stopped because they are so bulky and actually impair a lot of movement. Definitely engage in lots of naked tummy time/floor time.
      The one thing you should watch for is how easily your daughter can control movement side to side. She should be able to lay on her side with her head up without rolling all way to back or tummy. If this is challenging for her, there are lots of ways you can assist and teach her, but what I would recommend depends on the baby…and I don’t know enough about her.
      Let me know how it’s going now. If you are still concerned, we can set up an internet consultation
      Thanks
      Wendi

      • Thank-you so much for taking the time to respond, Wendi.

        Most of what I’ve observed of my daughter lying on her side, her head is usually down. She will lift it in transition to tummy/back, but I can’t remember specifically if she can lie on her side with her head up. I tried to see if she would do it, but if I try to lift her head while she is lying on her side, she immediately transitions to a roll. (She is currently at the end of a viral infection which resulted in some swelling in her ear and I’m not sure if this is a factor at the moment.)

        If I put her in a sitting position, she will lean forward, and rotate, but she is hesitant to lean to her side. She will reach out her arm at a toy next to her, but she will not lean over to touch it.

        We have a doctor’s appointment in a week and I’ve already noted gross motor and reflux as something to bring up. Thank-you for all your support and advice. I’m going to keep my eyes open for the side lying and head thing, and I’m sure I’ll be in touch again soon!

        Auria

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  10. Hi Wendi,
    Great article!
    My son is 8 months old and he resists sitting, even when assisted. Since his birth, he always hated tummy time and when placed on his tummy, would immediately roll over to his back and prefers to be held. Now, he does however like to stand up, turn and jump with assistance. When we make him sit on our lap, he arches his back and tries to stand up. We started feeding him on high chair for the past two weeks. He seemed to like it initially but now, for the past three days, resists to be seated in it. He tries to arch his back and get out of it by pushing himself up. He does that with car seat too, sometimes. One thing he enjoys while on the floor is to put his feet into his mouth.

    He has mild reflux like symptoms (seems very similar to silent reflux from what I’ve read on internet), which has greatly reduced after we introduced solids since his 7th month. He doesn’t spit up, except occasionally but burps a lot.

    I’ve been concerned and trying to research a lot on this and fortunately stumbled upon your article. Please let me know if I should be worried and how I can encourage him to sit and meet his developmental milestones.

    Thank you.

  11. Very informative article! I have a question though…. my little one is just a few days shy of 5 months now. One side of her head has a flat spot…. not horrible but significant enough that we have asked pedi about it. He told us to do as much as we can to keep her off her head and back (except of course for sleeping) We put her on a mat on the floor for tummy time as much as possible throughout the day. Luckily she does very well, and often tolerates it for more than 30 mins at a time! She rolls more now, so when she goes to her back I keep putting her back on ber tummy. She can’t stay on either side for even a few seconds. I am so worried about her flat spot getting worse, so we got a fisher price “sit me up floor seat”. This seems like a more natural position than a bumbo, and it allows her to be off head, as she can’t be on her tummy or carried by me all day long! I put her in this when she’s tired of tummy time or I can’t hold her.
    Is using this seat really that bad for her sitting development? What should we do?

    • If you are worried about the flat spot on your daughters head, and are only considering a positioning program at this time, the best thing to start would probably be a Tortle beanie hat by Dr. Jane. This is a beanie hat that has a built in bolster. You place the bolster over the flat spot and it prevents baby from laying on the flat spot. This can be used any time that baby is awake.
      I would not advise limiting your babies exploration just to stay off a flat spot. Sitting up is fine with immediate supervision and support for interactive play as long as she is properly supported in good alignment. However, any container will limit baby’s overall movement, her exploration potential, and her practice with learning the foundations of more coordinated movements. Please contact me if you have more questions about any of this. I would be happy to help.

      • Hi Wendi, thank you so much for your response! I will look into the tortle beanie hat. I’m surprised this was not mentioned to us by the plagiocephaly doctor we recently saw. Thanks again for your help!

  12. Hi
    I just wanted to say thank you for an excellent article. I studied OT but worked in adults and remember learning that the milestones for baby development was rolling, sitting , crawling. When I had my first baby it just didn’t make sense to me from a developmental point of view to have to prop him up to play with all the support needed. so all my kids played on their tummies until they learnt to crawl at 6 months and sit independently at 9 months. I had a lot of comments from the ‘older’ generation about how I was depriving them of important playtime by not promoting sitting. Thanks explaining this so clearly.

So, whadya think?