Q&A: Preeclampsia Baby Not Rolling Over

blockquote_bgMy child just had her nine month check-up. My husband and I have been concerned as her gross motor skills are developing slowly. I had preeclampsia during pregnancy and spent the last two months on my side. My doctors kept her in my womb until she had neutral blood flow. At that point, they decided it was time for me to have her via c-section. She was born 6 weeks and one day early. She weighed 3 lbs. 5 oz. Because of her prematurity, we have been monitoring her gross motor development based on what her due date would have been if she was full term. Even given this though, she is developing slowly. She did not require any oxygen when she was born nor were there any complications other than what one might see in a normal preemie. For the last 2 months, she will roll from her back part way onto her stomach (will not remove the arm under her), and she tends to sleep like this. She will not roll over all the way from back to stomach.
She will not even really attempt to roll over from stomach to back. It is as if she does not recognize that she can use her arms when she is on her stomach. While she has been able to hold her head steady for a couple of months, she is not making much progress on sitting up without support. If she is leaning against something, she can balance for a few minutes or longer depending, but she does not sit up on her own without support. She mostly just seems very content to lay on her back and play. We have tried to work with her both on her stomach and back but have made little progress. Her doctor did not have many recommendations although her did recognize that her gross motor skill development is delayed. My questions regarding this are: Should we be concerned and seek other opinions? If so, do you have a recommendation as to whom? (i.e., help me grow, another specialist, etc.) Are there more things that we should be doing as parents to facilitate gross motor skill development?

I would recommend contacting your local early intervention provider for a physical therapy evaluation for your daughter. From your description of your daughter’s motor skills, it sounds as if your daughter would definitely qualify and benefit from physical therapy services to help her continue to progress with rolling, sitting and crawling. Since she was a preemie, it is certainly fine to keep in mind that she may need an extra month or two to develop skills similar to her same age peers, however, by 9 months she should be rolling in both directions and starting to sit on her own. Continue to give your daughter as much play time as possible on her belly on the floor and encourage her to roll to secure toys that are placed just out of her reach. You can help her if her arm continues to get stuck as you mentioned. If you place her on a small blanket and tip the blanket upwards while she is on it, it will give her some extra momentum to roll. You can also place her over your lower leg, tucking her knees under her, to get her used to weight bearing on her knees and encourage her to place her hands on the floor over your leg to bear weight in this position (a skill she will need for crawling).

You can use a boppy pillow or a pile of regular pillows around her on the floor to encourage her to practice independent sitting. Place toys to her left and right sides and not always directly in front of her to encourage her to pivot and reach for things when she is on her belly and while sitting. After each diaper change you can work on helping her into a natural sitting position by (instead of just picking her straight up) by rolling her to her side, and placing on of your hands on her hip and your other hand on her opposite shoulder and rotating her up into a sitting position. This will help her to learn to achieve a sitting position on her own, and as she gets stronger she should be placing her hand on the floor and helping push herself upwards. You can also sit her on an exercise ball and gently bounce her, tipping her gently from side to side and encouraging her to “right” her body back into midline. This may help increase her core strength needed for more complex motor skills. You can lie her on her belly on a small playground ball and roll her forward encouraging her to place her hands on the floor and then rolling her back again into her knees. Limit her time spent in bouncy seats, exersaucers, walkers, etc. A physical therapist will be able to give you many more suggestions on how to work on her motor skills during playtime. You can consult with your local Help Me Grow program, seek out a private physical therapist through your insurance or this is a link to early intervention services in your area: Clark County Board of MR & Developmental Disabilities: Early Intervention Services 2430 Van Buren Avenue, Springfield, OH 45505-2555 Phone: (937) 328-2680.