baby not standing

Q&A: One Year Old Not Bearing Weight & Not Standing

Tamara GuoChild Development

My daughter is 13 1/2 months old. She was born full term. She is not bearing any weight on her feet. When we try to make her stand, she bends her knees. She never crawled, never moved. Her mind is sharp, and our family physician says everything with her is fine. I am extremely worried if everything is fine, how come she doesn’t bear weight? Is this normal or should we do anything about this?

I would not be concerned if your daughter was not walking yet at age 13 1/2 months, however, the fact that she is not bearing weight on her feet when placed in standing, nor is she crawling or moving about in some way at this age is somewhat concerning. Most babies are able to bear weight on their feet between the ages of 6-9 months and will bounce when their hands are held. I would definitely seek another medical opinion, from perhaps an orthopedist to determine if there is an underlying medical reason as to why she is not yet completing these motor skills and make sure to have her hips checked. I would also look into an early intervention evaluation from a physical therapist in your area so that she can start receiving therapy to help her progress in her motor skills. I was unable to locate a specific resource for early intervention/pediatric physical therapy in your area, however, perhaps if you contact someone at this website link, they can point you in the right direction for resources available to you in the Toronto area.

I would like to provide you with more input. She started sitting at 6 months, and we never ever provided her with support to sit. She decided to sit and started sitting at 6 months without any support. She loves to jump in her jolly jumper. She jumps very well without any help from us. She is not crawling and not moving but tries very hard to reach her toys while sitting and she manages to get her toys.
Her mind is very active and she learns lots from others at her daycare. She follows others words but does not following their walking. When I try to make her stand on my lap, she stands for a second and then bends her knees. Sometimes she jumps as she does in her jolly jumper(but never stands). She never liked tummy time as well. Our physician checked her hips and spine and he said nothing is wrong. She is now 13 1/2 months old and it is very frustrating for me to see her not walking (always very hard for mother). Is there any technique that I can use to encourage her to bear weight on her legs?

Sorry for the delay in getting back to you with a second response. In speaking with our physical therapist, we would again advise you to seek the advice of a pediatric physiotherapist in Toronto so that he/she can do a full motor assessment of your daughter. Perhaps she has hypotonia or in other words, low muscle tone, which could be one reason she is not yet crawling, pulling to stand on her own or walking. Low tone would make it harder for her body to move against gravity to complete motor movements. Also, the fact that she did not like tummy time and perhaps did not spend much time in this position could mean that she simply did not develop the core strength in those muscles which are needed to perform more complex motor movements and she could need some strengthening in this area. Without being able to see your daughter for a “hands on” evaluation, we cannot unfortunately pinpoint any exact reason as to why she is not crawling/walking yet. And, she could also just need more time since some children do not learn to walk until around age 16-18 months and can still be considered within average, even though late in achieving this skill. There are children who never crawl and who go straight to walking, however, from a a therapy standpoint crawling is a very important skill that we do not like children to skip over because it can sometimes leads to later difficulties with sensory issues (from not bearing weight on hands and knees) and even some research has shown later difficulty with reading/writing/visual convergence due to not learning to use arms/ legs independent of one another at this early stage.

You can do some simple things such as bounce your daughter on a large exercise ball, shift her weight on the ball from side to side and back to front while holding her as low as possible at the hips so that she is doing most of the work to “right” her body in space when her weight is shifted. This can help with strengthening. You can use a smaller ball and place her on her tummy and roll it forward and encourage her to place her hands on the floor and bear weight and then roll it back and encourage her to bear weight on her feet or her knees. You can place her in a hand-knee position over your leg and use your hand/body to keep her in a 4 point position and encourage her to play while bearing weight and reaching in this position. Use a small box or tray table and place her in a kneeling position (make sure her bottom doesn’t drop between her feet, her bottom should sit back on the back of her heels if she is not in a tall kneeling position), entice her to come up to tall kneel to play with toys or reach for things. Sit her on a small stool or box so that her feet touch the floor in a flat position, hold her hands and practice coming from sit to stand and back to sit. Use music and singing and mirrors and bubbles and things to make all this fun and not work for her.

I would limit the use of her jumper, baby walkers or exersaucers right now since she needs as much floor time to practice and develop these skills on her own as possible. Many baby items such as walkers, jumpers and exersaucers have been studied and shown to not actually improve a child’s ability to walk, and on the contrary may develop the calf muscles more than the quad muscles (needed for walking) or even lead to later toe walking due to the way a child pushes off in these types of seats. They also inhibit a child’s ability to see their feet while moving and some sling seats hold the child’s hips in a position that is not ideal. Another study from Children’s Hospital of San Diego cited that “The exercise your baby gets in a jumper does not promote the development of trunk and leg control or the balance needed for walking. Additionally, it may limit time your baby spends on his tummy developing the valuable skills for crawling.” Again, we advise seeking the advice of a pediatric physiotherapist, as well as keeping in close contact with your child’s pediatrician to monitor the development of her motor skills.