Sitting
Up
by
Robert Needlman, M.D.,
F.A.A.P.
reviewed by
Robert Needlman, M.D.,
F.A.A.P.
Most babies can sit up alone by about seven to nine months. If
a baby is not close to being able to sit by nine months, I think
it's reasonable to discuss this concern with a physician or
developmental specialist.
Sitting up requires a good sense of balance, as well as muscle
strength and control in the trunk and hips. When babies are very
slow to sit, it is usually due to immaturity in one of these
systems. The developmental abilities needed to sit steadily are
also required for standing and walking, so late sitting usually
goes with late walking.
Most of the time, being late to sit only means that a child is on a
slower developmental schedule than his peers; in the end, he does
just fine. It is only rarely that there is some actual illness or
problem underlying the delay.
How sitting develops
Sitting steadily is one step in a developmental sequence. Here are
some of the other steps. The dates are only approximate; many
healthy babies are slower or faster in their motor
development.
Zero-two months.
At birth, if
you hold a baby's wrists and gently pull up on her arms to sit her
up, her head hangs back limply at a dangerous-looking angle. (It
looks terrible, but it actually is not uncomfortable or harmful. I
always try to reassure parents before I do this to their
babies; if I forget, the look of horror on their faces often
reminds me!) If you hold her in a sitting position, her head falls
back or forward. It's not a good idea to leave her this way for
long, by the way, because it's hard for her to breathe in this
position. (This example also reinforces the need to offer young
babies head support at all times.)
Two-four months.
By about two
months, when you do the pull-up-to-sit move, the baby holds her
head in line with her body. Soon after, she actually lifts her head
forward as you tug on her arms, and helps with her abdominal
muscles. If you hold her trunk stable, she keeps her head balanced
for a minute or two, until her neck muscles tire.
Four-six months.
By four
months, when your baby sits in your lap, she holds her head steady
for long periods of time and enjoys looking all around. (Her vision
has improved to the point that she can actually see things across
the room fairly clearly.) By five to six months, she balances in a
sitting position for a few moments, but you have to prop her up
with her legs in front, knees bent, to provide a wide base, and
brace her arms on her thighs.
Six-eight months.
You know that
she is almost ready to sit on her own when she starts to show what
is called the righting reflex: With her sitting, if you hold her
around the chest and tilt her body over, she sticks out a hand as
if to right herself. She has begun to make small, unconscious
contractions of the muscles in her back, needed to keep her
balanced. At first, it takes concentration, but soon, like riding a
bicycle, it is second nature.
Seven-ten months.
At first, she
can only sit if you carefully place her in the right position. If
she tries to reach for something, she topples over. But soon, with
practice, she is moving smoothly from crawling, to sitting, to
crawling again. She can lean way over to get a toy, then easily
straighten back up again. She is an expert sitter.
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