Q. My daughter is almost 10 months old, and she's not yet able to bear her full weight on her legs. (She can put her feet down only for a second or two.) Her hips have been checked twice now, and everything seems to be fine -- but I'm not so sure! She just started to sit on her own and is not yet crawling. She was also born breech. Could this be a factor?
A. It sounds as if you know your daughter very well and your mothering instincts are telling you to be concerned. I once had a patient whose developmental issues were similar to your daughter's. The patient's mother said to me, "I'm going to camp out in your office until you find out what's wrong with my baby." Her statement really got my attention -- she truly believed there was something wrong with her child. Her conviction pushed me to keep searching until we found the right diagnosis. I encourage you to listen to your instincts and to take the following steps:
Keep a developmental journal. It's wise to chart your baby's development, especially in regards to her muscle strength, so that her doctor can compare each month to the last. Progression is more important than timing -- this is the golden rule of infant development. When your baby achieves a skill is not as important as her normal progression from sitting up to crawling to standing. If your daughter plateaus, showing little change in development over a two-month period, there's true cause for concern, but if she's simply slower than other babies in her age group, there's not. Although your daughter is not yet crawling, the fact that she is now able to sit up on her own (in contrast to last month) indicates that her infant motor development (the ability to get more and more of her body off the ground) is progressing.
Evaluate total baby development. Take note of your baby's other skills. Is her fine motor movement normal? Does she reach and grab for objects, transfer them from hand to hand, and pick things up with her thumb and forefinger? Is her visual and social development normal? Does she vocalize and babble, follow you around the room when you walk by, and wave her arms to mimic you? Even if her inability to bear weight on her legs is an isolated finding (meaning the rest of her development is normal), it's still an important observation.
Consider your baby's temperament. Babies with an easy temperament develop social skills earlier, but motor skills later. They're more content to lie around and observe their surroundings than to crawl around. Hyper babies tend to be motor babies, and are quicker to sit up, crawl, and walk. Body type also plays a part: leaner babies tend to sit up and crawl sooner than babies who have a big and round body type, although there is still wide variation in this observation.
Consult a developmental specialist. Ask your doctor to refer you to an infant development specialist who can perform a thorough neurological and developmental evaluation. The specialist will examine your baby's social, visual, fine motor, and large motor development. To make the most of this evaluation, bring your journal along: The specialist will want to know what your baby's developmental milestone progression has been over the last few months.
Check out baby's hip development. Breech babies are prone to dislocated hips, also called developmental hip dysplasia. This is because the breech position can prevent the ball-and-socket hip joint from developing properly. Dislocated hips can usually be diagnosed during a routine pediatric exam, but sometimes it's difficult to tell just by maneuvering the hip joint. I strongly advise you to ask your pediatrician to order an X-ray or MRI of your baby's hips to ensure the hip joints are developing normally.
Enjoy your baby. You can encourage your daughter's development simply by playing with her. Lie down on the floor next to her, head to head: This encourages her to raise her head and shoulders off the floor. Crawl around on the floor next to her: She'll be enticed to mimic you. Encourage her to bear weight on her feet by holding both of her hands. Give her toys to transfer from hand to hand. My book, The Baby Book, is a useful resource for interacting with your baby. You'll find activities you can do with her that will encourage her social, visual, and muscular development at every stage.