DS not meeting physical milestones - is something wrong?

[zen1]

I don't know whether this is the right place to post or not, but I thought at least I might get the benefit of other people's experiences / advice.

My ds is 11 months old and is still not really able to sit. He will sit momentarily (sometimes for up to 2 minutes) if really focused playing with a toy in front of him, but most of the time after a few seconds he falls backwards. He has a very large, heavy head which seems to pull him back. He hates being on his stomach and rolls over if I try to give him tummy time. Basically, he just likes being on his back. He moves around on his back by using his legs to propel him.

I am very reluctant to seek health professionals' opinions because...I don't know really. I feel there's nothing wrong with him in any other area. He seems bright and happy, understands a lot, can clap, wave etc. What do you think? He is 2 months outside the "norm" so I am getting a bit concerned. Thanks

[kcartyparty]

I wouldn't worry too much. I have looked after babes that were still not walking at 13 months old.

Some babes choose not to eat solids until they are 12 months old.

All are different.

He has found his way of getting around and is happy with that.

As for sitting up... try keeping his back against something solid (sofa), and have pillows around his hips. He will learn how to sit eventually.

If you are concerned speak to your HV am sure she will be able to help

[zen1]

thank you got your reassuring words. When HV noticed he wasn't sitting at 9 months, she said if he's still not doing it at 1 yr (3 weeks away) he will need paed referral.

I know you are right about babies all being different (one of my other ds's didn't walk till 22 months). It's just that sitting seems so fundamental to learning other gross motor skills. I sat him on a swing today and he looked like a 6 month old.

[kcartyparty]

when you sat him in the swing was he floppy, or did he sit quite upright?

It is not unusual for a babe to lean to one side whilst in the swing

[zen1]

He looked scared and was a bit wobbly, before sliding down inside the swing so the crotch bar was supporting him.

[HairyMaclary]

I'm sorry I am going to disagree with kcartyparty and say that you should go to your GP or HV, but pref GP, and ask for a referral to a developmental paediatrician. I say this for 2 reasons, firstly if there is nothing wrong they will put your mind a rest, you obviously have concerns and these should be listened to. Physical delay does not mean delay in other areas.

The second reason is that some of the things you say he does sound familiar. My DS has cerebral palsy - we have always known this so have not been expecting a 'normal development'. However the sitting thing, if he is struggling and sitting so the crotch bar is supporting him in a swing then he is finding it hard to sit properly on his pelvis. This is exactly what my DS did.
The propelling around the floor - is this done by him tipping his head back and using his heels and the back of his head. This is also something that rings bells for me, mostly because we were told never ever to let DS do it! Eventually DS learnt to crawl and now he is walking a bit.

I am not diagnosing anything at all, and it may be that your son is developing in his own way and that is fine. However please go and see your GP, early itervention makes all the difference and physiotherapy can really help if you catch the child when they are young.

Good luck and come back and ask lots of questions if you want - there are lots of us here who can talk to you.

[zen1]

Thank you hairymaclary. I will give it a couple of weeks then I will see someone. When I last saw my hv, she asked me to pick ds up and hold him in front of me. She said she was watching to see if he drew his legs up to his hips (which he did). She said if babies don't do this, it is a possible indicator for a problem.

I am curious, why were you told never to let your ds move around on his back? My ds just refuses to go on his front.

I should say that I have 2 other ds's. Neither of them crawled (both bottom shufflers!) and neither moved at all till after a year. Ds1 could not roll over till 9 months and ds2 didn't walk till 22 months. Infact DS2 was way outside the accepted norm for a lot of physical things (only learned to jump when he was 3). However, you wouldn't know it now. I am really hoping ds3 is just incredibly slow with the sitting.

[HairyMaclary]

I didn't meant to alarm you - sorry - but in my experience the early intervention is so so important to any long term outcome that I am very keen on getting things checked out! If you hold him up does he weight bear on his feet? Does he want to stand or not really?

My DS has spastic cerebral palsy which means he likes to go stiff and straight - like an ironing board - although when he was little it was most obvious is the throwing himself backwards that he did when held. Therefore if he moved around on his back using his feet to push he was using the stiffness of his muscles, all our therapy was and is concentrated on allowing him to relax his muscles and use them properly. Scooting on his back encouraged the wrong patterns of movement - but once set in they are very very difficult to shift!

Ds hated going on his front too because he found it hard to hold his head up when in that position. Unfortunately (for him) because he couldn't roll he couldn't get out of it! So He stayed there despite his screams, he started with less than 30 seconds and built up time. Lots of interaction from me and lots of toys, mirrors etc all helped. We were guided by this from his physio and OT as we knew it was very important for his to learn to crawl properly. Which he did eventually at about 20 months.

[minervaitalica]

Zen1, a referral could really put your mind at rest, but are you scared of how you would feel if your boy needed some help (which by the way, a lot of kids need at some point or another!)?

I am saying it because I felt exactly the same when we were referred to the physio because DD could not roll. I did not want to go because I was worried that my fears would be confirmed - and to some extent they were, but then we got loads of help and she eventually managed. It really was a good outcome, and I probably stressed myself more than was necessary!!!

[WavesTheWhiteFlag]

HairyMaclary sorry to gate crash this thread, but my ds (5mths) sounds very similar to yours, although we dont have a diagnosis yet. I just wondered how your ds was diagnosed. So far we see a physio to combat the stiffness in his limbs and floppyness of his torso and neck. Im convinced that we will eventually get a CP daignosis but of course no docs are mentioning it. Be great to pick your brain

[madwomanintheattic]

wwf - sounds like dd2

she has v low tone core and some spasticity in limbs. she was originally dx spastic quad just before 2 (but re-dx at 4 to athetoid as limb tone had improved so dramatically).

she was 'developmental delay' until the first official dx, but as an ex-scbu/ hie baby discharged with full physio/slt support we pretty much knew we were headed for a cp dx by 6 mos, despite the silence of all the profs, who continued to treat her (cp) without naming names. (law suit anyone? )

dd2's arms were v tight and hands fisted, tucked up under chin - lots of physio means that she has pretty functional fine motor these days (she's 6 now) although obv not age-appropriate. our consultant told us that the physio would be the most important person in her life during the early years - he was so right!

dd2's tone has changed such a lot she was tiny - most people don't believe she is the same child. how often do you see the physio? are you happy with the support you are getting?

zen1, apols for hijack!
the fact that your other dcs have been later or atypical developers is of course v reassuring. if you are concerned (and i suspect if you are posting in special needs you might have subconscious concerns that you aren't admitting to yourself ) then ask for a developmental paed referral. nothing to be gained by waiting - and potentially if intervention is required, it can be started sooner. hope it all goes well!

[pumpkinpasties]

i so agree that early intervention is really important, a babies brain learns more effectivly before they turn 2.
As he can sit for a short perion, if it is cp i would think it would be quite mild, but see your gp and insist on a paed referal.
ds has cp but was hie at birth so we were expecting as least something, like madwoman he has been dx with spastic quad, but his muscle tone is changing so rapidly even now, i'm expecting a re-diagnosis at some point in the future. ds has had physio intervention from day one and it relly has helped.
not wanting to scare you or anything but the sooner things get said the sooner it will sink in and your ds will get the right help

[HairyMaclary]

WWF - DS was born prem, 11 weeks early, so he has always been in the system. At 5 days old he had an ultrasound that showed a bleed. We were told what this may mean but kept being told that he seemed ok or 'at the upper limits of normal'!! It only slowly began to dawn on us the extent of his problems and CP wasn't officially diagnosed until after and MRI at 1, but he had been treated from the beginning.
Once we moved to this area when DS was 13 months and still not sitting we had Physio, Ot and SAlt weekly and then joint visits from phyiso and OT at home every other week on top of that. We really needed that from the beginning but moved countries when he was 6 months old!

I have been told that DS has typical premature CP with stiffness in legs more so than arms and low trunk tone.

Ask any more if you want!

Zen - sorry to hijack too.

[yomellamoHelly]

Used to be of the all-babies-develop-at-their-own-pace crowd, but ds2 (2 3/4 y) has cp and has only competently sat for the last couple of months. Now I would say ask for a referral. If your ds does sit by the time the appointment comes round you can cancel no harm done and if not you'll start the process of dicovering what's going on with your son. In the meantime I would be forcing him to do as much tummy-time as possible by laying him on his front and placing my leg across his hips / top of his bum (so he can't flip over) and trying to get him to push himself up (still a very relevant exercise for ds2). Placing a roll under his chest at armpit level would make this slightly easier for him if it's a complete no-go.

[Scottie22]

It does sound like his trunk may be weak - our consultant said that many babies who bum shuffle have a weak trunk so it could be in your family if your other children were late with gross motor milestones?
My dd could just about sit unsupported by 9 months but needed cushions behind until after age 1. Her most obvious difficulty is a weak trunk although she has slightly fluctuating tone in her limbs too.
dd didn't walk until 20 months and has been unsteady but improving lots with exercise/swimming etc. Physio and OT have been helpful.

[anonandlikeit]

Echo what the others have said, chances he is just doing things his way BUT no harm done asking for a referal & you may have to wait a while before you get the appt, if needed.

Hairy, SNAP! my ds2 has typical prem CP too (spastic dip)

[zen1]

No worries about thread hijack! It's interesting to read of others' experiences. I know you guys are right about the early intervention thing - minervaitalica, I suspect you might be right when you questioned how I might feel if ds did need some help. It's silly really. I am at my in-laws at the moment and when I mentioned my concern to mother-in-law, she thinks he's just slow and should be given time.

HairyMaclary, don't worry about alarming me - I appreciate your honesty. Ds can weight bare on his legs and can stand holding on for a few seconds. Also, when he rolls over from front to back, he does one big push up and then uses the weight of his head to roll himself over.

I don't know much about CP, but I always thought it was caused by lack of oxygen to the baby during birth - is that the cause?

[zen1]

yomellamo, I will try more with the tummy time, but he is very against it! He can push up quite high with his arms to roll himself.

Scottie, that's very interesting what your consultant said about a lot of bum shufflers having weak trunks (I was a bum-shuffler too and didn't walk till 18 months) Insidently, your dd sounds just like my ds2. He only just sat at 9 months, and as I said didn't walk till 22 months and has done other things much later like climbing and jumping. I didn't consult anyone about him though as late walking is on both sides of our family. What sort of exercises can improve trunk muscles?

[anonandlikeit]

There can be any number of events or causes but basically there is an injury or trauma to the brain. This can be before, during or after birth.
It can range hugely from being barely noticable to severely disabling.

[anonandlikeit]

zen, what is your ds's head control like, if you pull him to sitting (like row, row, row the boat) does he have a head lag at all.

[zen1]

His head control is quite good (considering it's so big - was born above the 99th centile!). He keeps his head parallel with his body when doing row row etc and doctor said it was ok at 8 wk check. It just seems to weigh him down after a bit though, which is why I think he likes to lie on his back.

[cory]

I'm going to chime in with the get-him-a-referral crowd.

I know it's stressful for you, and quite likely he would develop on his own, but I have had the experience myself of not picking up on a disability and having to live with the fact that permanent damage has been done; dd would have been a lot happier if intervention had been earlier.

My dcs do not have CP, but hypermbolity syndrome/Ehlers Danlos syndrome, which also results in a weak body/lack of control, though not in spasticity; it's more of a connective tissue thing than a brain thing (though there may be some problem with transmission of nerve signals to the brain). Earlier intervention would have been better.

[WavesTheWhiteFlag]

We had been seeing physio once a week, but now once a fortnight. She is really pleased with his development. Starting to lift head when on tummy and do what she called anti-gravity movements with his arms, guess that means he is starting to bash things!!. He is also getting a bit better when sitting supported, doesnt just flop back but if you leave go he does still crumple. Cant complain at all about physio, the difference in just a few weeks of going was immense, we have now been going for over 2 mths.

Just been refered to SALT for weaning, but there is a big backlog so dont know if she will see him before he needs solids!!

Someone asked how you improve core strength, the best way Ive been told is to sit them up as straight as you can as often as you can. We were given a special corner chair, but lots of cushions would work. Start off just a couple of minutes. It helps if you can put a tray or something under their arm pits so they can easily reach toys etc. Of course tummy time is the best way to improve all round strength. My ds loves looking at a mirror angled so he can see it when lying down.

I can say from experience that although its worrying to not know what is going on with your lo, if you are at all worried seek help straight away. Babies learn so fast when they're little that early intervention is fantastic and can change things so much. Your HV should be able to refer you to a physio and Peads. Dont waste anymore time

[zen1]

Dh's aunt is a hv, and she has offered to come and see ds this w'end (we're staying at in-laws) to give her opinion on his physical development. I am suddenly worried, though ds did sit up well for a couple of minutes tonight. Tried to put him on his tummy again this evening, but this time he drew up his legs, so I couldn't lay him flat - then rolled straight over.

WWF, when my hv saw ds for 8 month check, he had not eaten a thing (point blank refused solids from 6-10 months, despite me trying twice a day every day) and she asked if I wanted him to be referred to a SALT as he wouldn't tolerate any food or a spoon in his mouth, despite chewing every teething ring going. I didn't take her up on it because I had read that a baby's ability to digest solids was related to their ability to sit up (or stomach muscles). At the time he was very wobbly and used to slide sideways in the highchair at every meal. When he reached 10 months though, he suddenly stayed upright and that coincided with him wanting to eat. He still won't take anything out of a cup / beaker so the only fluid he has is from me b'feeding.

[feelingbetter]

I'm going to jump on the bandwagon too and tell you to get a referral. If there is nothing wrong, you'll be reassured.

He could be just a bit slow on the physical stuff, but it's worth checking out.

Like Madwomanintheattic, my DS is globally delayed according to the Dr.s who are dancing round the CP diagnosis, even though we know its coming.
he is 16 months old, learned to roll over at 10ish months and we are now working on sitting up. His head control is good but his trunk control is poor and he sounds much like your DS in the 'slouching' department . Not meant to scare you at all (he is older and will not sit unaided for long time yet) but I honestly believe we would not have got this far (he has waaaayyyyy exceeded all initial expectations) without the input of an ace physio, who he has seen since 10 weeks. We don't see her that often (and....sniff....will say goodbye soon as she is a neonatal physio) as it hsa been a slow process, but her help and guidance has been invaluable.

DS does see a SALT as he has a small problem with his swallow and cannot drink from a cup or beaker. He cannot tolerate anything in his mouth except for a spoon (covered in food) which is fine. He takes fluids from a bottle and has his drinks thickened.
Does your DS have teeth? Does he tolerate them being brushed? My DS STILL only has 2 teeth and he hates themm being brushed, but hates it slighty less after some tips from his SALT

Honestly, if you are at all worried - get the referral. There is help avaialable, even if it is only for a short time.

[zen1]

thanks feelingbetter. Dh's aunt (hv, but will give objective advice) is coming round later to see ds and give an opinion.

In the tooth dept, yes ds3 has 10 teeth and will allow them to be brushed. Think he quite likes having his gums massaged as he seems to have been teething since he was 6 weeks .

What made the drs say your ds is globally delayed? Just wondered how they knew and could start physio at 10 weeks? I am just wary of my ds being labelled with something (I know he is obviously slow) when it could be nothing. If the paeds had assessed my ds2, I'm sure they would have come up with something (he didn't roll till after a year, but could sit).