Learn about some common developmental red flags for infants that we use to identify developmental delays and other problems.
If there’s one thing we’re sure of (as moms and as professionals), it’s that child development and developmental milestones don’t always unfold in a perfect, linear way. There is a range of what’s considered “typical” development and all kids develop at their own pace.
While this is true, there are certain markers or developmental red flags that we therapists might notice that can point to possible developmental concerns that may warrant a referral for early intervention services. What are red flags for infant development?
Thanks to Wendi McKenna, DPT, PCS, C/NDT from Move Play Grow for helping us compile the detailed list below…
0 – 3 Months: Developmental Red Flags
1 || Feeding difficulties, especially when accompanied by irritability
2 || Preferring to turn head to one side more than the other
3 || Showing a strong preference for a specific posture or position, seldom moving out of a specific position (e.g. head tilted to one side, head turned to one side, arched back, or back arched to the side)
4 || Flattening of the back or side of head
5 || Decreased movement on one side of body compared to the other
6 || Excessive arching of back/body, or excessive stiffness or floppiness
7 || Significant birth history (trauma, medical complications at birth)
*Note: During the second month, babies’ movements are marked with increased asymmetry. Because of this, it can be challenging to discern subtle motor problems at this age. Pay close attention to strong movement preferences, noticeable stiffness or “floppiness”, and head shape.
By the third month of life, babies should start to organize to midline and adopt more symmetry with their posture and movements. They should be able to hold their head in a midline position and bring both of their hands to the mouth and body.
During this age range, babies begin to explore their bodies using their hands, beginning the process of developing body awareness and body mapping in the brain.
Vision also becomes more organized by the third month, because babies’ heads are more stable. Tracking (looking from side to side), divergence and convergence (perceiving objects that are near or far), and downward visual gaze (looking at something below the level of the eyes) become easier and more established.
Also, by three months, babies begin to show decreased frustration and increased tolerance for tummy time (as long as they’ve had lots of practice) and should be able to actively bear weight on their forearms during tummy time.
4-6 months: Developmental Red Flags
1 || Arching the body backward in any position
2 || Keeping one or both hands tightly clenched all the time
3 || Shifting weight and/or reaching only to one side during play
4 || Difficulty with initiating and maintaining sidelying position (at 5-6 months)
5 || Lacking variety in movements on the floor
6 || Consistently falling forward or extending backward when placed in sitting (at 6 months)
4 months
Babies that are 4 months of age are experimenting with active movement against gravity. They use their hands to touch their faces, bodies, and knees when lying on their back.
Arm and hand movements are usually symmetrical (the right and left hands moving in unison) and babies’ hands should be able to open and close easily. During tummy time, 4-month-old babies alternate easily between a superman position and a forearm propped position.
5 months
Babies in the 5 month age range begin to actively shift their weight from side to side, using this movement for stability (pushing one side of the body into a surface) and mobility (reaching out into space to interact with surroundings).
In tummy time, babies at this age can push up onto their hands and begin experimenting with scooting, rolling, and pivoting in a circle. They also begin to explore and play in a side-lying position, helping them differentiate between and coordinate the two sides of the body
6 months
Babies become masters in training on the floor by 6 months – rolling, scooting, and pivoting on their tummies and even starting to army crawl. They can stop and start any movement they want – even mid-movement, which means that they are using control rather than momentum to get from point A to Point B.
At this age, babies can use rotational movements and often you will see one segment or part of the body facing one direction while another is facing the opposite direction. 6-month-old babies are reaching, grasping, and crudely manipulating objects…and of course bringing everything to their mouths for further investigation.
Head control is complete by this age and babies can roll in both directions while keeping their heads off the ground.
At 6 months, babies can sit when they are placed in this position, with a slight forward lean, but without needing to prop on their arms and without a rounded back. They are likely to fall over backward or sideways, and this is normal.
Babies at this age can’t get into a sitting position by themselves yet, so it’s not a safe position to leave them in without close supervision.
7-9 months: Developmental Red Flags
1 || Scooting on back or bunny hopping on legs instead of crawling
2 || Inability to bring hands together at midline
3 || Inability to sit unsupported
4 || Difficulty bearing weight on hands and arms
5 || Limited desire to move, explore, or climb
6 || Asymmetrical use of the sides of the body
7 || Sitting with very wide legs or W-Sitting
7 months
7-month-old babies are experts when it comes to transitioning in and out of positions on the floor. They roll, pivot on their tummies, push up onto hands and knees, and even up onto their hands and feet like a bear.
They are learning to crawl, trying to get up into a sitting position, and even pulling to stand.
Quality and refinement of movement come into focus during the 7th month. A baby’s ease and desire to move demonstrate that they have a strong foundation in basic movement skills and movement patterns.
Babies will all learn to move (no matter how they choose to do so), but if the foundation isn’t solid, compensations will begin to emerge and will get stronger over time. This can lead to future challenges.
8 months
8-month-old babies are becoming more and more active, exploring and transitioning between positions. They can get from the floor into a sitting position independently and may begin to crawl.
They begin to pull to stand and may want to climb onto low furniture and up stairs. They find all small objects on the floor, putting everything into their mouths.
In a sitting position, if babies use very wide legs or a w-sitting position, it can be an indication of decreased postural control. These positions limit movement and muscle activation.
9 months
9-month-old babies are on the go! They are crawling, climbing onto furniture and up and down stairs with help and supervision, and pulling up to stand at various surfaces. Climbing, while scary for us as parents, is essential to the development of spatial awareness.
Through climbing, babies learn about heights, distances and space how their body moves in space.
10-12 months: Developmental Red Flags
1 || Lack of variability in movement
2 || Lack of desire to explore using movement
3 || Strong preference for using one side of the body
4 || Consistent asymmetrical movement patterns
5 || Cruising only in one direction
6 || Consistently standing, cruising, or walking on tiptoes
7 || Having a general demeanor of “learned helplessness” – wanting and waiting for an adult to do everything for them
8 || Struggling with grasping and releasing objects
10 months
At 10 months, babies are very busy practicing skills and experimenting with new things. They love the concept of “in and out” and use it to put their bodies in and out of spaces, and to put toys in and out of containers.
Babies at this age are also starting to imitate gestures and interactions more easily (e.g. waving bye-bye, interactive games like peek-a-boo), showing signs of social development by interacting with familiar people.
11 and 12 months
At 11 and 12 months, babies become independent with standing. They gain more control of grasp and release with small items, play pat-a-cake, and love to bang objects together.
At this age, babies really pay attention to toys in their hands, exploring properties by feeling and looking rather than always going straight to the mouth.
Babies at 11 to 12 months are crawling, climbing, standing, and even starting to take a few steps by themselves. It’s amazing what can happen in one year!
By 1 year, all babies have a good understanding of their bodies and what they can and cannot do. Foundation skills and movement experiences over the previous several months ensure the development of efficient movement patterns and a huge repertoire of movement options to access.
Variety and variability are the hallmarks of healthy development!
They will adopt movement patterns and preferences based on the strength of their foundations, so more varied practice throughout the first year will ensure they have a gigantic repertoire of movement options to access. Variety and variability are the hallmarks of development.
Other concerns and indicators for higher risk of developmental delays
-Low birth weight
-Alcohol and other substance use during pregnancy
-Sudden or noticeable regression in developmental skills
If you are concerned about your baby’s development, it is best to speak with your pediatrician and arrange a consultation with a pediatric therapist. The earlier we can detect challenges and provide prevention in the form of early intervention services , the better the outcomes will be.
Resources for Infant and Toddler Development
Learn more about developmental milestones for infants, toddlers, and preschoolers here!
Learn more about primitive reflexes and how the persistence of primitive reflexes impacts childhood development?
Check out these development-boosting activities for babies!
Be sure to grab our Developmental Milestones Handbook and our Developmental Milestones Printable Handout Pack!
Find out more about the 2022 CDC Milestone Updates!
Latest posts by Wendi McKenna DPT, PCS, C/NDT (see all)
- The Most Common Developmental Red Flags for Infants - May 17, 2017
- Protected: Infant Developmental Red Flags (Members Only) - June 6, 2014
Foundation skills and movement experiences over the previous several months ensure the development of efficient movement patterns and a huge repertoire of movement options to access. Thanks for your information! Great article!
So glad you enjoyed it! I loved creating it with Lauren and Claire! Thanks, Wendi
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Sorry if I’m being really dense but one of your red flags for 4-6 months is arching of the back. I cannot see that it goes on to say why? My baby is almost 6 months and has just started arching or pushing his stomach out when standing on you. After seeing this is classed as a red flag I’m in a bit of a tizzy but am none the wiser as to why its concerning.
Thank you for your question and I’m sorry that the red flag caused any angst. If a baby is repeatedly arching their back and not balancing it out with a neutral spine or flexion, there are several reasons why that can be happening. The hallmarks of typical development are movements that are variable, flexible and adaptable. If baby overuses one movement direction compared to the opposite, they are developing an asymmetry in their foundation. If your baby is ONLY arching when standing but not in other positions, that’s probably nothing to worry about. But if the arching occurs in all the different positions (e.g. superman on tummy, but not planking, pushing head into the floor to roll rather than lifting and turning it) to the exclusion of using the front side abdominal muscles, they are compensating for weaknesses that could have several reasons. Email me so we can chat further.
Thank you for making me realize this. It’s great.
This article is great. I like it very much. Thank you.
Should I be worried that my 8 week old sometimes curls his right wrist inwards?
My just turned 4 month old arches her back but she doesn’t do it as much anymore. What worries me is she arches her back during tummy time and she will not use her hands to push her head up just holds her head up from arching her back. Also it is quite obvious she prefers to turn her head to a certain side. While holding her up right she prefers to look and turns head to her left also while she sleeps her head will always turn to her left.
I am a little concerned about it as these are red flags on your list. What could be the problem?
Regards Daniel
Shortened or tight muscles can be a cause. Often the infant will be very distressed when belted up in a car seat and May prefer one side when breastfeeding. Often times the cause can be due to physical trauma during delivery. A osteopath who specialises in infants will be able assess the child and correct the issues. A series of treatments is usually required but improvement will be noticeable almost immediately. Osteopaths treat the whole body skeletal, muscular/ligaments etc. Their adjustments are very gentle and suitable for infants.
I am wondering about scooting on the back in 7-9 months old babies. Why is it considered bad? My baby was premie so do I look at her age as per due date to determine her milestones?
I don’t want anything to be considered “Bad.” It’s all just information. If a baby chooses to scoot on their back, it’s because side to side motion has not entered their repertoire. Sometimes they figure it out, other times they continue to make compensation to make due. Not to worry, if there are some holes in the development foundations, they can be filled in with intentional and committed practice.
Wonderful article. Can you please offer additional insight on the red flag of “consistently falling forward or extending backwards when placed in sitting position at 6 months”? I am noticing my 6 month old doing this along with beginning to arch back when placed in sitting position. Thanks so much.
My 5 months old lifts his bum always up high and archs his back some times…when I make him to sit on my lap he ll arch his back and comes down to lying position I m not understanding what is happening he rolls tummy to back n back to tummy
I missed this comment from a few months ago. How is he doing now? Often times when kids overuse extension, it’s because they haven’t figured out how to control side to side motion/weight shifts. This can manifest in all the later milestones as well, such as choosing to scoot on bottom instead of crawl, crawling with a hitch (one foot up, one knee down), overusing one side vs the other, or maintaining a really wide base of support in positions that block movement. Let me know if you would like more information based on what your son is doing now.
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Hello! I am in infant teacher (10+ years) and I have a four month old in my class who is developmentally behind. The most profound is the arching and trying to almost back flip using his head. He flails and half turns and it looks very uncomfortable. I’m in the process of ASQing him, but to be perfectly honest, his parents don’t care. I’ve had numerous conversations with them about a handful of concerns and they brush me off, or just completely walk away mid conversation. I would love any advice about how to bridge this topic with them because I know he needs help. I have seven other babies in my class, so realistically I can’t also be his physical therapist (although the expectations for early education providers ASTOUND ME and are never ending). Please help.
Best,
Nell
Hi Nell, This can be a real challenge and my experience is that parents care SOOOO much that the idea of anything being a red flag or a problem is toooo big to handle. I emailed you. I think it best to jump on the phone and I can help coach you through some possible scenarios.
Wendi
Hi Wendy, I just read Nell part and your response. I have a 3 month old and he is always arching his back with his head pulled back and sleeps on one side (left) also I try to put his head straight but he tilts to an angle, another thing I try to do tummy time and he tends to arch his back and can’t push his head up with his arms. Any help or advice you can give me please
It’s hard to tell just from your response, but there Or a few things that could be going on. I will send you an email and we can do a consult on the phone.
Thank you for writing about developmental red flags in infants. It’s a great read and very informative. I have been scouring the Internet for information and advice on developmental delays in infants and am so glad I found your website. Our 6mo has been showing a preference to grabbing items with his right hand over his left and seems to have only recently “found” his left hand. Up until about a month ago he kept his left hand mostly shut and wouldn’t even try to reach for anything using it. I admittedly wasn’t doing enough tummy time or letting him just lay on his back and play until recently, and I think that had a huge effect on him developing one side more than the other. I could be mistaken but we have noticed in improvement in the movements on his left side since increasing the time spent on tummy and back. We have also been placing toys on his left side and playing with that hand more to try to encourage him to use it. He does push up with both hands during tummy time but still likes to move his left hand backwards and reach for toys with the right hand. Do you have any recommendations or activities we could do to develop his left side gross motor skills?
When you say Preferring to turn head to one side more than the other, preference to one side, scooting on back, do you mean red flag for autism or with their motor skills? Thank you.
Your article is very valuable, thank you
This was a great read but has made me worried, I have a 5 month old who was 5 weeks early, he doesn’t roll or try to move onto either side. He does do tummy time and will teach for toys with both hand though mostly his right. He plays on this activity mat and reaches for toys and is able to get them into this mouth. He leans slightly to the left when I put him in his chair and can’t sit unaided he will fall front, back or to the side but he does show signs of wanting to sit and his head doesn’t lag when I aid him into a sitting position. Should I be concerned?