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Ask Dr. Sears:

Q. My daughter is 6 and a half months old and she is not rolling over yet. She also hates to be on her stomach. I am getting really worried that she will never crawl. Everyone around me says she will do it when she is ready. Am I overreacting?

A.
Babies' motor milestones are as variable as their personalities. If you lined up ten 7-month-olds for a "race," you would notice a wide array of locomotor skills. Some would crawl, some would scoot, some would roll, but eventually they would all get across the finish line  -- each at her own pace. When it comes to a baby's motor skills, progression is more important than timing. Baby motor development generally unfolds as follows: first, raising her upper body into the push-up position; then sitting; then being on all fours; then crawling; cruising; and finally walking. Nearly all babies progress through this pattern of development, but they do so at their own speed. It may be reassuring to know that of all the motor milestones, rolling over is the most variable and least important. Consider which one of these developmental factors could fit your baby:

Maturity. Babies born prematurely tend to be a month or two behind their full-term peers, but they usually catch up by 1 year of age. The greater the degree of prematurity, the longer it takes a baby to catch up.

Personality. Babies with mellow, laidback personalities tend to be quicker in visual and social development, but a bit slower in motor development. They are more content to look at and study their environment than they are in a hurry to move. These babies are also more cautious when learning to crawl and walk, which factors into their tendency to be a bit behind. But their slow pace can be a perk: They are less accident-prone than their more active counterparts who crawl and walk earlier  -- and therefore get into trouble earlier as well.

Body size. Bigger babies are naturally, and understandably, slower to get off the ground than leaner ones. These babies often don't like being on their tummies for a couple reasons: They probably feel their body is out of balance when they are in this position rather than lying flat on their back, and they may feel disconnected from their caregiving environment because they can't see much more than the floor. One floor exercise that both you and your baby can enjoy, and that will help her get more comfortable being on her tummy and begin crawling, is to put her on her tummy and lie on your tummy in front of her, head-to-head, a few feet away. This will stimulate her to crawl toward you.

When to worry: Every two months, jot down what motor skills your baby has currently achieved, such as sitting, lunging forward, making crawling movements, crawling, cruising, and then walking. If, every month, she is getting more of her body off the ground and her movement is increasing, there is no need for concern. If, on the other hand, she "plateaus" (meaning she isn't showing a lot of progress from one month to the next), you have reason to be worried. Report your observations and concerns to your baby's doctor on her next scheduled checkup. He will then check her muscle tone and do an overall developmental assessment. The most accurate assessments come when babies are in a state of quiet alertness, usually shortly after they have rested and are well-fed. Schedule your baby's checkups for the time of the day when she is likely to be in her best mood (usually in the morning). Let the doctor know your concerns at the beginning of the checkup so that he starts the developmental assessments right away, when baby is in a good mood, rather than toward the end of the checkup, when baby could become fussy.

I always advise my patients to be keen observers and accurate reporters of their baby's development. I then take the clues they report to me and put them together with my own observations to get the right diagnosis.

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