Q&A: 5 Month Old with Brachial Plexis Injury Not Rolling Over

CME WebsitesChild Development, Infants 3 - 12 Months

blockquote_bgMy daughter is 5 months and 1 week old. She is seeing a therapist for brachial plexus injury. She is doing well and is showing a full range of motion now. However, she is not rolling over even one way yet. When we put her on her belly she will reach for her toys but that is all. Should I be concerned? We don’t see her therapist for another month.

First of all it is great that she has full range of motion already. Although she should be rolling, the fact that she had the brachial plexus injury would make it much more difficult for her to do so as reaching is a part of rolling. It would probably be a good idea to increase the frequency of her physical therapy to take advantage of her new range of motion.

In the mean time you should work on her rolling from back to belly. Encourage her to reach across her body to grab toys when she is laying on her back. Do this to both sides. Help her if needed with the side that had the injury. If she is unable to bring her hands together at midline, then begin with her laying on either side and encourage playing with toys with both hands in the middle. It is easier to reach when laying on your side as gravity is not working against you. Once she is able to play easily at midline in right or left sidelying then progress to her playing with toys at midline in supported sitting or laying. If she has trouble with this, help her  to bring her shoulders forward either by cradling her in sitting or putting small rolls (burp cloth or thin blanket) lengthwise at each shoulder while she is laying on her back. Bringing her shoulders forward will help her to reach against gravity.

Progress to her reaching in sitting or laying without the rolls or assistance to bring shoulders forward. Once she has mastered playing at midline (and she may already be there) then work on her reaching across her body. Once she can do that, then take it a step further by slowly moving the toy behind her head. She should continue to reach for it and follow it with her head. You can help her at her hips to roll onto her side if needed and then to complete the roll. Practice going right and left. Give her a chance to do as much as she can on her own then help her as needed. Babies tend to accidentally learn how to roll from belly to back however you can encourage her to do so by having her reach for toys with either hand when on her belly then move the toy behind her. If needed, help her to put her head down and roll over the non-reaching arm.