A few years ago, my friends and I started a book club in hopes of expanding our minds and having stimulating conversation. As the years have gone by, and we have gotten married and had babies, the topic has moved away from characters and plot lines, and gone more towards weddings, travels, and babies. While I do not have a baby of my own, I am able to hold my own with the baby conversations because of my experience as a pediatric physical therapist.

At last week's "book" club meeting, the conversation turned to developmental milestones, specifically crawling, after one of my friends said, "My pediatrician said that crawling is no longer a milestone." Now, without immediately jumping on my pediatric PT soapbox, I calmly addressed why I don't love that statement. Let me start by saying, I DO understand why pediatricians are relaying this information to parents. If your child is delayed in crawling or skips it all together, this is not necessarily a red flag for a possible underlying medical condition or cause for immediate concern. But I DON'T believe we should write off crawling all together.

So, you may ask, why would my pediatrician say that? With the decreased time babies are spending on their stomachs due to the "back to sleep" campaign to reduce SIDS in combination with more time spent in carriers such as swings and bouncy seats, they are missing out on all the benefits of being on their stomach. If they were rarely on their stomach prior to crawling, there is a decreased probability that they are going to use crawling as a means of getting places.

And why do I believe crawling is important? Crawling is an important stage of a baby's life when so many of the body's systems work together to enhance development and set them up for future success. Crawling on hands and knees in an alternating pattern helps to develop four major areas: movement, manipulation, postural control, and balance.

Movement: While moving forward, babies increase use of their right and left sides of their body and cross over sides of their body with their arms and legs. This helps to stimulate both sides of the brain and set them up for bilateral coordination tasks (jumping jacks, skipping) as they grow up. Also, since their hands are moving forward, babies have a whole new perspective of their eyes following hand movement, setting them up for good hand-eye coordination tasks in the future (throwing and catching, and following words on paper when reading). This movement also improves their social skills as well. Now they are learning about personal space and moving outside of their restricted area when sitting or in their carrier. They are able to engage more socially, seek out more experiences, and learn their limitations on where they are/are not supposed to crawl.

Manipulation: Crawling is the only time in a baby's life when they are going to take body weight through their hands. With this weight bearing and movement of the hands, a baby is developing the muscles of the hand to create their arches, increase strength, and increasing stability around their joints of fingers, wrist, elbow, and shoulders, which are all things that relate directly to manipulating objects such as toys, crayons, typing, etc., These are skills that they will use for the rest of their lives.

Postural control: Good postural control requires muscle strength and muscle stability to maintain the body in good alignment. On your hands and knees, muscles from your whole body
are engaged from hands to shoulders to core to legs. As your child grows, these muscles need to stay strong and work together to keep good alignment of your muscles and bones and prevent orthopedic issues (like back pain or knee pain) in the future.

Balance: In order to balance, your vision, proprioception (where you are in space), and vestibular (inner ear) systems work together to hold your body in place. When rocking and crawling forward on your hands and knees, these systems are working together in a whole new space and position. More time spent in crawling over a variety of services will require these systems to work together and continue to develop. This will set you up for more challenging balance situations in the future like walking over changes in surface, riding a bike.

So, how are you going to get your baby to crawl? Stay tuned for several helpful tips!