Ah, the milestone of milestones. Walking is often used as a turning point whereby our little ones go from babies to toddlers. This usually happens around the first birthday, but not always. It is common for some babies to walk at around 9 months, and others around 15 months. It is all about the baby, and is not something we as parents have much choice over. I think it’s safe to say that, by now, we all know that nothing in this baby world do we seem to have much control over.
From a personal ‘therapist’ perspective, I believe kids who crawl for longer periods of time develop better shoulder and hip strength from being in the 4-point position for longer. This advances them greatly at a later stage with regards to fine motor skills. Please see my post on crawling if you would like more information regarding how this happens. If your baby did start walking earlier, that isn’t of great concern, as long as the period of crawling was around 3-4 months.
That being said, here is my list of ways to help facilitate the development of walking:
There is still the endless argument of the use of a walker/walking ring to aid the development of walking. Sure enough, some babies will learn to walk sooner from using these, others will walk much later because of them. The main problem with using a walker is that the core muscles are fully supported, and the legs are not taking weight in the correct angle, straining their ligaments in the hip, knee and ankle. So whilst they may have learnt to walk sooner, the consequences will be evident later in low muscle tone, poor core strength, difficulty coordinating gross motor movements as well as poor fine motor strength due to less time spent crawling. Please see my article on why walkers and exersaucers may hinder development.
If your baby has not started walking by 18 months of age, it is recommended that you consult a doctor or therapist to determine why this may be, and also to provide you with assistance in developing the necessary skills your baby needs to walk. Please remember that each child is an individual and this is only a guideline based on typical development. Please feel free to comment or email me if you would like some more advice or ideas specific to the development of your child.
A sensory board is a lovely thing to make for a baby. Young babies are explorers, they learn through exploration, especially when all senses are involved. This is why most toys involve noise with lights and colours, as well as different textures. Babies use their hands, feet, mouths and almost anything they can to explore with different things in their environment. At this young age, the ability to interpret and perceive tactile perception is actually best when done through sensory receptors in the mouth as opposed to the hands, as it is in adults.
It is important to remember that mouthing toys and objects is normal, and to ensure that whatever you are exposing your baby to, that there is no safety risk. Remember to make sure you use non-toxic glue when sticking things onto a sensory board, and ensure any ribbons or string are not long enough to pose as a choking hazard. Small objects should be carefully stuck down and babies should be carefully supervised when playing with a sensory board.
What objects are stimulating to the senses?
· Shiny, metallic objects (keys, coins, foil, wrappers, mirrors, stickers, glitter)
· Bright colours with high contrast images (polka dots, stripes, big bold images)
· Noisy objects (crinkle paper, wrappers, packets)
· Rough textures (pasta pieces, cork, rock, wood, grass, Velcro, sandpaper, corn)
· Smooth textures (pebbles, beads, silk, ribbon)
· Soft textures (felt, cotton wool, gel beads, pipe-cleaners, feathers, sponge)
· Patterned textures (cupcake liners, bubble wrap, zips rows of straws)
It is important to ensure a variety of senses are stimulated, but also to ensure the baby or child is not over-stimulated by limiting the number of sensory objects on the board. For younger babies, try use a board with 6-8 objects. As the child gets slightly older, add a few objects and see how they cope. You should be able to tell if your child is over-stimulated by watching how they interact with the objects. If the baby avoids interaction, he is probably overwhelmed and it might be best to consider removing some objects.
Here are some ideas of sensory boards:
I really love this idea using old wipes packets to create a peek-a-boo sensory board.
Have fun crafting, and enjoy watching your little explorer play!
If we compare the generation of our parents, and their parents, with the generation of today, there is so much we can say is different. For starters, look at all the technology available to us today. We have modern gadgets all over the place - and that has shaped and changed the way we raise our children.
One of the biggest differences seems to be that we have both parents now working full time, or a mom working at least half-day, to make ends meet. Things are much more expensive, and we somehow just need so much more of everything. We no longer have all friends, family and a workplace within a 5 minute radius of our homes as well. We travel longer distances to spend longer hours doing a job that pays just enough to make ends meet. And so we work even longer hours and travel even further distances to make more money so that our children can have more expensive toys and go to a more expensive daycare. It just seems never-ending, and whilst its often unrealistic to expect mothers (or fathers!) not to work, we get so caught up that we forget the little things.
I have seen far too much of this. And I have seen the effect it is having on our children. 10 minutes of TV time turns into an hour, and before you know it, the whole afternoon. They say with everything that moderation is key - whilst this is true, there is no standard, set criteria for moderation. My version might be half an hour in the exersaucer, yours might be 3 hours a day. Moderation is subjective. And this is my biggest concern when the media are throwing the word around - for the food we eat, the exercise we do, the bad habits we have. It seems like everything is okay, as long as it is done in moderation. But there comes a point as a parent, when you stop and look at what your children are doing, and wonder whether these few minutes or hours every day could be spent in a far better way.
When it comes to parenting, none of us like to hear that we are doing things wrong. We defend our choices and our actions because, lets be honest, we actually are trying our best! There are things we don't know and things we are not aware of, but regardless of the circumstances, we are trying to be good parents and give our babies and children the best we possibly can.
So my advice for today is this:
1) turn the TV off.
2) put away the electronic toys.
3) take your child out of the entertainment stations - the exersaucer, the jumper and the walker.
4) turn the computer, tablet and mobile phone off.
And do these instead:
1) use an activity gym to allow for movement that is natural and free, like rolling or transitional movements. Use a boppy pillow to support sitting with toys around your child for him to play with.
2) bring out toys that captivate your child and allow for the development of cognition, problem solving and decision making - like shape sorters, stacking rings, blocks, mirrors, rattles, rainsticks and musical toys. Give him toys that he has to figure out and that require effort. Not electronic toys that play an entire tune at the light touch of a button.
3) play with your child, on your lap, on your hip, on the floor or on the bed. Wherever you are, bring your child with you. Show them what you are doing. Point and name things around you. Talk to him, and let him learn about the environment he lives in. Play peek-a-boo, blow bubbles, sing nursery rhymes and just interact with one another!
4) facilitate some sensory play. Children learn by using all of their senses to explore with things. Give them things to touch, to smell, to taste, things to hear and things to look at. Use ball ponds, sand pits and allow for outside play on a blanket (in the right weather, of course). Make a sensory board with things that you have lying around the house, just remember to ensure the safety of your children with all objects they come into contact with.
Let them feel, move and explore. Let them learn.
Crawling is a milestone often overlooked, despite it being one of the most important. It usually develops after independent sitting has been established, and before standing and walking occurs. Most children crawl from month 8/9, until walking at around month 11/12, on average. This gives a baby a solid foundation of 2-3 months on their hands and knees. So, why is this important, if we almost never have to crawl again in life? Why is walking not the main focus of development instead?
The answer is this – crawling makes use of all of our limbs, in a coordinated manner, incorporating the use of the trunk, and requires much control and strength. Not only this, crawling demands great levels of accuracy when it comes to our physical movement, and the planning thereof. We need to judge and perceive distance in order to accurately get where we want to, working on our visual perception too. We use these skills in walking too, but the physical demands are actually less (aside for the balance aspect, that is) since all four limbs are required to move in a sequential manner that coordinates arms with legs as well as left with right.
Due to the nature of crawling, and the position the body is in – called four-point kneeling, and the incorporation of our arms, we are able to develop greatly in terms of proximal stability, which is the strength and stability of the shoulder and pelvic girdles, in order to assist in the maintenance of postures. As adults, we still find long periods of time in four-point kneeling challenging, and the weaker you feel your core strength may be, the chances are, the more you’ll struggle maintaining a weight bearing position through your arms, like ‘planking’ or doing push-ups.
So, why do we need strong arms and shoulders? Most of us are not planning to be heavy-weight champions, right? So we think upper limb strength shouldn’t be too important. But this is so wrong! We take our shoulder strength for granted, and those of us who have dislocated a shoulder or broken a clavicle may understand just how difficult things are without that strength. A task like cutting requires the use of both hands, and in doing so, both arms generally need to be lifted off of the table to cut properly. For a child, this means a few minutes of elevated arms, which, for their small bodies is really no easy task, considering their core is working hard to hold their seated posture correctly at the same time. Add a weak core to this mix, and we have so many more problems. I can think of so many bilateral activities requiring both arms elevated – mixing something in a bowl, pouring a glass of juice, carrying a heavy object, reading a book whilst sitting/lying, throwing and catching a ball, lacing and threading beads – all tasks we expect our school-going children to be able to do.
For this very reason, a weak core and weak shoulders is something most often picked up when children start school and these tasks are expected of them. Tasks requiring fine motor skill like writing and colouring become really messy because children with weak shoulders fatigue easily. In OT we have a golden rule called ‘proximal stability before distal dexterity’ – which means a strong core is essential for adequate and effective function of the limbs and hands. So when a child has a weak core, it’s often most evident in poor fine motor skills or even gross motor skills, depending on how weak the core really is.
A child with a weak core – often termed low muscle tone, also slouches and fatigues very easily. This is a child rocking on his chair in class, hooking his feet around the legs of the chair, resting on his hands, slumped over the desk, fidgeting and shifting positions frequently. He might even compensate by getting up and walking around. It’s an effort to sit up straight and they are exhausted by the end of the day. Paying attention in class is difficult when they are so busy trying to sit properly. A tired body makes for a distractible mind! It is quite common for these children to be misdiagnosed with ADD/ADHD because of this.
So yes, whilst we are not all training to be weight lifters or professional swimmers, a strong set of shoulders is really a big deal to a young child. A well developed core allows them to develop in many other ways, and when these muscle groups are not well-developed, some serious issues can arise.
Another question I get asked is why children do not crawl. In my eyes, a child bum shuffling across the floor is considered as ‘not crawling’, as is a child who leopard crawls (moves on their tummy). These do not have any components of crawling – no four-point kneeling, no weight bearing through the arms or hips and no use of tummy muscles. So essentially, there is no advantage or development in those kinds of movement. These happen when a child has a weak core and is reluctant to get into the correct position because it may be simply too difficult for him to achieve it, and he comes up with his own means of mobility. We then get the parent who claims “my child was so advanced he just skipped crawling and went straight into walking” – however, your child was probably too weak to crawl, and his fine motor abilities will really be affected, making him struggle through first and second grade. That is definitely not considered advanced and having a child unwilling to crawl is cause for concern. It is an indicator of weakness from an early age – please do not ignore it, address the problem there and then!
A common link has been found between non-crawlers and the use of exersaucers, walkers and jumpers. These prevent core strengthening due to the support they provide. They also remove most motivation for mobility,
1) because my toys are always right here in front of me, and 2) I can move around while I am in the walker, and bounce or rock in other devices, which is much easier and way more fun – that crawling thing is hard! As humans we are naturally taking the easy way out – and babies are very much the same. Why learn to crawl if you can get what you want through other means? So yes, these devices are so much fun, our babies do love them for that reason. But they also cause laziness, delayed (or even skipped) milestones and problems later on with other areas of development.
Other areas in which crawling has advanced development – are in our visual perceptual abilities. We use these skills everyday in all our movement patterns, and fine motor skills, as well as accuracy in tasks. We need visual perception to build puzzles (visual closure), find something in a cluttered draw (figure ground perception), copy off the blackboard in class (visual motor integration), organize things in rows, columns, left and right (spatial relations) and pay attention to detail in order to find the differences in things (visual discrimination). When we crawl we use depth perception in order to identify where objects are in our environment – so that we can judge, plan and adapt our movement patterns using this visual feedback. Crawling babies are seen to develop mostly in their spatial relations skills and visual motor integration abilities, as well as motor planning skills. Children need these skills in writing, cutting, threading, building puzzles, doing a pegboard activity, and even when matching and copying.
The ability to coordinate movement is also a very important aspect of development. We learn to move one side at a time (unilateral movement), and we then learn to coordinate both sides moving together at the same time (bilateral symmetrical coordination), in tasks like holding a bottle and drinking from it. It then advances to moving both sides in a sequence, at different times of the body (asymmetrical bilateral coordination), as in crawling, walking, skipping etc. It is a very important skill because it teaches us to sequence and time our movements in order to move in an accurate and controlled manner, which is essential in things like catching a ball or even hopping. One needs to know where to place his feet, legs and arms, in an instinctual, instant manner. When these require more planning than normal, children are slower in these areas, often missing the ball when thrown to them, missing the ball when trying to kick it, cutting uncontrollably, and colouring outside of the lines.
It is important that we, as parents, see milestones for what they are – stepping stones paving a way for development. Imagine walking along a path and there is a big gap where a stepping stone should have been – you will need to take one large leap and might lose your balance and stumble for a few of the following steps. Our children need to achieve these milestones in order to prevent limitations or difficulties in future development. We wouldn’t let them miss a milestone important as learning to read, and it is essential we understand and identify crawling as a milestone with just as much value!
Crawling is essential for development, and advances your child in so many ways – and the longer the crawling phase, the better. Ideally, 2-4 months of crawling before walking is best. If your child learns to walk soon after crawling, this is okay too. We don’t want to delay walking or prevent a child from walking in order to crawl for longer, but it is advised that children with a shorter crawling phase do upper arm strengthening activities to compensate for this. These include climbing a ladder, climbing up a rope, doing monkey bars, throwing and catching balls (weighted balls are better for older kids), or wheelbarrow walking.
Non-crawling, or even incorrect crawling should never be ignored!
I decided to make a list of gifts for babies aged 0-6 months, since it can be such a difficult age to know just what toys to get in order to facilitate the most development in this age band, since there is so much happening!
Our little ones are far too young to understand the concept of Christmas or gifts – but that doesn't mean we can’t spoil them already! I bought my little girl presents that we have already opened and started using, just so that we could get the full use of them and she could develop in the meantime. The gifts she will receive on Christmas will be those that she should be able to use soon after the day!
Some of these gifts are suitable from birth, others closer to 4-6 months, but all should be of use to you before the 6 month mark. The milestones we want to achieve in these early months are as follows:
· Tracking or following an object with the eyes
· Locating sounds not within the visual field
· Head control in an upright position, and in prone (on tummy)
· Swatting at and reaching toward toys
· Bringing hands together in the mid-line and up to the mouth
· Supported standing / weight bearing through legs
· Grasping large toys
· Kicking legs into the air, holding onto feet and bringing feet to mouth
· Rolling over – first from tummy to back, and then from back to tummy
· Initiation of sitting independently (some may achieve this only after 6 months)
· Identification of self in the mirror
The list of toys I have compiled are things I found to have more than one purpose, and something that could be of use for a long time, to help with achieving more than just one milestone. It is important to remember that younger babies are able to see strong contrasts better, so black and white stripes or patterns, often with one bold color, are ideal. Those pretty pictures with detail are lovely to look at, but all our little ones really see at this stage is a big blur of a picture. There needs to be a bold contrast, and you will be able to see a difference in just how much your baby likes to look at these rather than pretty patterns and colors. Many toys I have selected have aspects of bold contrast for this young age, but also have more complex pictures so that as the baby grows and his vision improves, he can still use them.
It is also important to remember that from 4 months onwards, our little ones may start teething and this causes them to drool everywhere, over everything. They also have better developed tactile sensory abilities in their mouths as opposed to their hands, which is why they use their mouths to touch and feel toys as a form of exploration. The toys baby uses should be something you are able to easily wash and sterilise, since he will be putting them right into his mouth! Electronic toys are no good when it comes to being sterilised or being covered in drool! Wooden toys are lovely for teethers because of their hard, rough texture – but to sterilise? Such a pain! The same can be said with soft toys like teddy bears, unless they can go through the wash, but they are generally dust collectors and cause vast amounts of allergies! Always consider this when buying toys for your baby.
So here is my list, in no particular order!
An activity gym! Probably my favourite piece of furniture in the house at the moment – if only the colour scheme matched the living room! I prefer the ones where the sides fold up. These can be used as a type of play-pen and also, when she is big enough, a ball-pit she can climb in and out of! I have the Tiny Love Gymini Developlace, simply because it has an arch at the top that I have been able to use to put high contrast pictures onto, and because it becomes a crawl-through tunnel and a play-station (not the electronic gaming device!) she can sit and play in. It also comes with many different places to hang toys, and comes with a high contrast toy to use with newborns. There is a peek-a-boo hole on one of the sides as well. It is adjustable and easy to use, and my little one will use it up until she starts walking – which makes it very cost effective.
A tummy time mat! I used to believe that a rolled up blanket or feeding cushion would do exactly the same thing as the cushion the tummy time mat comes with. But for some reason, she tolerates this cushion, and nothing else! The density of the foam and height of the cushion provides the right amount of pressure and lifts the tummy off of the ground slightly, without making the floor too far for the forearms to reach. I have seen ones (unfortunately not available in South Africa) that have an inclined play surface at the front of the mat to help babies with head control. The standard mats have toys flat on the floor, which does not encourage them to look up and around, so you need to do more entertaining or use other toys. This brings me to my next toy.
A small standing mirror! A mirror that can be placed up in front of your baby to encourage head control. I find that the 0-3 month old babies are only really captivated by a mirror, not so much bright and colorful toys – probably because they aren’t able to grab them and figure out what they do, where the mirror provides constant visual input. A mirror is so useful in teaching a baby how to coordinate and control his movements, because not only is he moving, he is able to watch himself move and get visual feedback, something we all use when doing a new skill (we can look at the area, but with limited head control and poor body awareness, a baby cannot physically look at himself when doing a new movement, so the mirror helps him to do that). Try to find a mirror that is of good quality and doesn’t distort the reflection – imagine seeing yourself for the first time as a blurry, distorted version of yourself and developing body awareness this way!
It is also a nice way to begin teaching your baby to vocalise and babble, by pointing to the mirror and saying “baba!” every time he sees himself he can then associate that with who he is. He will also be able to explore with different facial expressions and the emotions associated with them. I often hold my baby girl while looking in the mirror and we make faces in the mirror, she can watch me and herself. Most of these mirrors can be clipped onto the side of the crib or hung from an activity gym, so they are really useful!
Wrist rattles! These are little rattles and bells that can be strapped onto the wrists, hands or feet that jingle when baby moves. The aim of this is to develop his body scheme as well as cause and effect (if I do this, it makes a noise!). Since he is only going to be fully grasping at around or after 4 months, this is a fun way of letting him explore with sounds before that milestone happens. It also draws his attention to his hands and feet, making him more inclined to explore with them by looking at them, touching them and bringing them to his mouth. These can be used when he is a bit older too – I often use them with little ones when I put them into a ball pond, so that even though there is no visual feedback of their arms and legs moving since they are covered with the balls, they can feel the balls against the skin (tactile input or touch) and also hear them moving (auditory or sound), to help them develop that ever so important body scheme I am constantly talking about.
A clutch cube! I actually have two of these toys – one by Lamaze, and one by Tiny Love. We haven’t started using them yet but when we do, I’ll be sure to let you all know which one I prefer. One came in a gift pack of 3 toys and the other was a new toy on the market I just had to try out. The Lamaze clutch cube has a hook to hang from an activity gym or car seat, which is really useful. The Tiny Love Flip Cube seems to have more elements of fine motor control, which makes it something she can use until a much older stage of development. Both are focused on exploration and senses! There are different textures, pictures, mirrors and sounds associated with the cubes. The Lamaze cube has different things on each side, where the Tiny love has the ability to open up and reveal more toys inside, and is completely reversible. A small baby won’t be able to coordinate opening this and flipping it, but there are definitely more aspects to look at and explore with because of this feature, and it makes it something that can be useful until she is well over the age of 1 year!
A fold out book! I have the Tiny Love Princess book. The reason why I prefer the fold out book to the normal flip-through one is because babies younger than 4 months can use it without having to hold it, or have mom hold it for them. I like this one because it is double sided, one side for younger babies, the other for older babies who are able to visually process pictures and colours better. It also can stand if placed correctly, since it is super rigid! It also has little strings to tie it to the crib! I use it during tummy time and I have even placed it in the arch of the Gymini Developlace, as well as around the car seat. This is one of my favorite toys because it can be used in so many ways and is so portable as well! The colorful side has different textures and things to explore with too!
A fold-up stroller arch! This is my portable Activity Gym that can be clipped onto anywhere – the car seat, crib, bassinet or stroller. It can even be clipped onto the actual Activity Gym at home! I like the Tiny Love Woodland Arch, because it folds up really nicely and the toys it comes with are good too. My baby girl still prefers to look at us when she is in her stroller though, so we will probably start using this when she starts grasping and showing more of an interest in toys. It comes with a teether attached to it too!
Soft baby blocks! Very similar to the clutch cube, aimed at exploring with different textures, sounds and pictures. These are nice because they can be stacked at a later stage when she starts wanting to construct things, and also have numbers and letters and pictures for when she begins to learn concepts. They require a larger grasp than the clutch cube (since that has smaller “handles” to hold onto), which are nice to develop hand strength. They make great stocking fillers!
A sit-to-stride activity walker! This is advanced for the 0-6 month age band, since it helps with sitting, but it is multipurpose and goes all the way up to walking age. This is a type of walker that really does teach a baby how to walk since there is no support provided on the trunk, he has to learn how to balance and displace his weight on his own and in the most natural way. Taller babies should be observed with these because we don’t want them to almost lean over if the height of the toy is too low, and the same with babies who are too small to learn to walk, holding the handles when they are not the right height affects the arch and angle of the hips to the spine and affects the way we walk. A toy like this is useful to encourage sitting, especially when it can easily be moved to their side to encourage rotation of the trunk (a skill we learn so that we can crawl, and also use to move from sitting into the crawling position called 4-point kneeling). It is similar to the new crib activity centres that clip onto the crib and baby can sit and play there, but I personally want to keep the crib for sleep time, not associate it with play time. For this reason, I also don’t have a mobile over her crib – it is a stimulatory toy, which contradicts why we put them in the crib to begin with – to sleep!
And there you have it, perfect gifts for our perfect babies! This is a nice article to share with friends and family who want to buy your baby a gift but aren't so sure what to get for this age. I hope it proves useful in choosing some gifts that will last and ensure many hours of fun for your little one! I'll be sure to post this off to Santa from Peyton!
Happy playing, but most of all - I hope you all have a fantastic (and safe!) Festive Season!
Body scheme, body scheme, body scheme! I’ve said it a million times, and I’ll say it again. As an OT, I feel as though this is one of the most important concepts a child needs to develop. We have established that our tiny humans have no dysfunction in any sensory areas (that we know of!) at this stage. You know he can see and hear, is touching things, tasting things and smelling, so now we can start using his ability to process that information and develop his body scheme.
If there are some problems with his sensory organs, if your baby has problems hearing, seeing or even serious skin conditions preventing him from interpreting tactile sensation or touch, this is going to impact on his development in other ways, and I can address that with you on a more personal and individual level. Feel free to email me through my contact page if this is the case.
So what is a body scheme? Let me start off by doing a little exercise with you all.
Close your eyes. Picture your house. Picture where the rooms are in relation to one another. Picture where each piece of furniture is. Imagine walking through the house with your eyes closed. Most of us do this for night time feedings already, and have that coffee-table-dodge manoeuvre down.
Your body scheme is your brains’ ability to visually map out and know the ins and outs of your body, down to the tips of your pinky fingers and toes. It allows us to walk up stairs without having to carefully watch each and every step we take. It’s also why when walking into an unexpected hole or down a step we forgot existed, we have to do a complete once over of what just happened. Of course, we need the sensory feedback from the environment (the feel of the ground under your feet, wall against your arm) to make sure we move around as accident free as possible, but imagine having to watch your feet press the pedals of your car when you drive? Or when you run? This is why our brains have developed that ability to know where your body is in relation to other body parts, so that movement can be coordinated and accurately timed. It ties in with the proprioceptive and vestibular sensory input I mentioned in one of my other posts.
We aren’t born with this map of our body. It has to develop. It does start to develop in the womb as we tumble around and kick, receiving both vestibular and proprioceptive input. But there is only so much development that can happen in here, the rest happens in the big world outside of the womb. This is why as babies, we struggle to coordinate movements and our movements have almost no accuracy or control. But once it does develop, it helps us to control our arms and legs so that we can reach for that toy, shake it around, and put it back down where we need to. This kind of development works in a similar fashion to how our strength develops – from the core outward. Our hands and feet are the last to develop, but yet the most important. You will notice a baby be able to accurately place his arm in the direction of the toy he wants, but not yet be able to open his hand to take it and close it once in his hand. That comes with time and practice and as our body scheme improves, so do our movements and milestones.
This is an important skill, not only for babies to develop milestones, but for children too. They need to develop refined skills like cutting and writing, balancing on a beam, putting clothes on, climbing a ladder, kicking a ball, riding a bicycle – all things that need to be done through knowing where my body is and what my body parts are doing. It is common for children with a poorly developed body scheme to be very clumsy, and compensate for this with their visual abilities. This is exceptionally tiring for anyone to do, let alone a small, active child, who might start to avoid gross motor play or fine motor activities because they are so draining, and because he has identified that others are much better than he is, or perhaps he has even injured himself from being quite clumsy.
So we want to make sure this is a skill he develops well. We want confident, busy little bees who can dominate on the playground and in the classroom. How do we get there? We start now, and we don’t ever stop!
As I mentioned before, vestibular and proprioceptive input are quite essential in the development of body scheme, so please read the post “Super Seven Senses” if you haven’t already! We need to use all of his senses together in order to advance the development of his body. Remember to watch for signs of overstimulation!
Here are some nice activities to do with your baby to incorporate his senses and help him identify and map out his body:
Baby Massage. Nothing complicated, nothing fancy, just a little massage here or there with some cream or baby oil. Try not to provide pressure on the stomach, focus on the limbs, chest and back, and pay attention to tiny hands and feet. You want to try massage with movements in one direction because this is easier for the brain to process then an up-down or circular motion. And the movement should be from the core outwards (shoulder to hand, hip to foot). Try not to lift your hand in between a stroke of an arm or leg, go from the shoulder, and slide down to the hand and fingers, then only lift your hand up and start at the shoulder again. You can vary the pressure and speed, but a nice deep (yet gentle) pressure is best, and slower is better to help calm baby down. Pick a nice quiet time to do this. No toys or noises or stimulatory things happening. After a bath is usually a perfect time or when baby is about to go down from a nap, since you are going to be calming him down with the massage. Try to use a natural oil or cream that isn’t strongly fragranced, which will only stimulate him. I use the Johnson’s Bedtime Bath Oil.
Joint traction and compression. Ah, fancy words. Don’t be fooled, they aren’t as complicated as they sound, and you are probably already doing these. Any time there is pressure through a joint, this is joint compression. Weight bearing with arms straight during tummy time provides joint compression through the elbow, wrist and shoulder. Standing with legs straight provides joint compression through the ankle, knee and hip. Kicking against something is also really nice for joint compression. So we want lots of play time on the tummy and in standing. The kicking activity mats are really nice too. Joint traction is the opposite of this – it is the bones and joints pulling apart when resistance is applied. I often do this when I massage my little girl, as I rub her arms and legs, I gently pull them as well. Not so hard that her whole body moves, just that the arms and legs are getting a bit of a stretch. We can do the on the spine in both directions during play time – on the tummy, the vertebrae are pulling apart at the front of the bones as they arch their backs upwards. On their backs, when their legs come up, the vertebrae are being stretched at the back of the bones. When on his back, you can lift his feet up and touch his nose to give a nice quick stretch of the spine. Which brings me to the next activity.
Playing with hands and feet. Whether baby learns to do this on his own, or you do it with him, it is essential for him to explore with these body parts, and that means putting them in his direct visual field and also into his mouth – an area better developed at interpreting tactile sensory input at this age! It’s nice to do this when baby is naked after a bath, during a bath or even when he is being changed. Make sure he is warm though! Take his hands and bringing them to his feet, crossing the left hand to right foot, and vice versa, as well as left hand to left foot. Let the hand just touch the foot, and if he can grasp it, even better! Now is your turn to play with his hands and feet. Take his feet together and touch his nose and lips with his toes. Hold his feet and clap the soles together. Give his feet lots of tiny kisses. Blow air against them. Let him kick against you, blow out your cheeks and use his feet to slowly push the air out! Do all of these while he watches you! Do the same with his hands (fisted or flat). Pretend to eat his hands, let them touch your face, let them feel the vibration of your cheeks as you talk or hum. Clap his hands together. Bring his hands up to his eyes and cover them, touch his nose and his mouth. Verbalise what he is touching, and try to let his hands do the feeling, so hold the palms or the wrists and let him use the fingers to feel. You can also use wrist and ankle rattles to draw his attention to the hands and feet. Have a look at my post titled “Legs in the air!” as well for helping him interact with his feet.
Mirror play. I mentioned in my previous post on Christmas gifts about how useful a mirror is in obtaining feedback and watching yourself move. It is really important for babies to watch themselves in the mirror as often as they can. Not only do they love it, it helps them identify and understand how they are moving and what they look like when moving. Please use a good quality mirror and make sure it isn’t going to harm him in any way at any point in time!
Sensory play. Find things around the house with different textures – feathers, silks, wools, cellophane. Use them to touch your baby in the same way you give him a massage, provide a bit of pressure (we don’t want to just tickle him), and make sure movements are in one direction, starting from the core and moving outwards. Obviously be cautious of his face and never fully cover his nose and mouth. Make sure he can see the object you are using, bring his hand to touch it where he can see what it is as well! Describe the feeling to him and talk to him, tell him where feathers come from and what we use silk for! You can also use something like shaving foam, while sitting in front of a mirror, place the foam on the mirror, take his hands and squish it all around, draw patterns with it. You can also use sugar or sand on a tray or in a box, put his hands in and let him feel the texture, take his hands and make patterns in the sand. Trickle the sand over his legs and arms. Make sure to wipe down and clean him after activities like this – we don’t want him putting these things into his mouth when on his hands. When he is able to sit independently, we can use a ball pond and sand pit and when he learns to crawl, we can use tunnels to develop his body scheme as well.
Swaddling. Try limiting the swaddle to night time, since play time should involve as much freedom to move as possible. You also want to swaddle with his hands in the middle, not at his sides. It is not comfortable for anyone to sleep like a soldier, please don’t make your baby sleep this way either. Having his hands up and in the middle allows him to put them in his mouth to begin to self soothe and to develop a milestone called hands-to-midline, which is a very essential and important skill. It teaches him that he has two sides to his body and they can work together – coordination. It is also not a functional position to have his arms hanging at the sides of his body, and he will not learn their existence if this is how he constantly lies! A swaddle blanket should have flexibility to stretch so that he can receive proprioceptive input when moving, and so that he is able to wiggle and move without big startling movements that may wake him. Small movements are normal and allow him to get comfortable as well as for his blood to circulate. Knowing your body boundaries is a soothing feeling, which is why massage and swaddle are calming techniques we use for babies.
Also remember that eliminating body parts from his field of vision is only going to delay his ability to learn about them – especially when giving him one sensory input in that area – for example standing in an exersaucer, receiving proprioceptive input through the legs but having no vision of them whatsoever during the weight bearing, which is really not helping him to learn that they are there. Once he knows where his feet are and what they do, he won’t need to look at them when standing or walking!
Try not to limit movement by placing him into a Bumbo, bouncer or anything similar. Lying against a surface provides tactile input and allows for learning. But sitting and being unable to actively move body parts is a very limiting thing to do for his development, physically and from a sensory point of view. Reward his free movement by giving him cause-and-effect toys to kick, touch and grab at. Something that moves and makes a noise just encourages him to move and play in a controlled and accurate manner.
Please be careful of over-stimulating him. This is the first time he is getting exposed to or feeling some of these things, so give him time to learn and be patient. When he starts to fuss, he has had enough and you can try again later!
Happy playing to you all!
Our senses are so important for us for any kind of development. It is so vital for us to use all senses in order to improve in aspects and develop and acquire skills. Even as adults we rely greatly on our senses – not just one or two, but all of them combined, to do most of our everyday activities, and especially the new or novel tasks. Many of us don’t actually know that we have 7 different types of senses. We learn about the common 5 – sight, smell, touch, taste and sound. But those other two? That's what I'm here to tell you about.
These senses are as follows:
Sense number 6 – Proprioception
This is something you use in motor skills. It is the ability of your muscles and joints to send signals to your brain, describing what you are doing (whether the muscle is relaxing or contracting, flexing or extending, how the ligaments are working and overall movement). This input is constantly happening, but you are more aware of it at times than at others. This sense allows you to feel the floor when taking a step, and to know what pressure is required based on the surface you are standing on. A child who does not have a well developed ability to process this, will often compensate by stomping or jumping harder than necessary, dragging feet, and will seem to not know their body boundaries too well.
This is a sense that goes well with the ability to sense touch – but works from deeper within the muscles and joints, where touch receptors are more localised in the superficial skin layers. This sense helps us to coordinate and control our movements, because it allows us to understand where our limbs are in relation to our body, and to know what they are doing. It also allows the brain to identify the need for muscle development and strengthening in the areas of higher demand.
If you close your eyes, get someone to take your foot, and move it in certain directions, each time asking you to tell them where and how they moved your foot – you would be able to tell them, right? Your proprioceptive input is what allows for this to happen. When explained this way, Im sure you can see just how important this is. However, imagine an unstable, unsupported joint with weak muscles. Would one be able to make sense of movements that happen with these? It is much more difficult, since you are also trying to focus on keeping your body upright and movements controlled.
So why is this important in my baby? Well for starters, he does not have a body scheme or the ability to know his body boundaries yet. He has low muscle tone and weak joints. But we put his body into weight bearing positions and place pressure on the joints regardless, when we know he is clearly not ready? And being a sense – it is quite easy to over-stimulate and overwhelm him because of that. He is not only processing the world, but also those bright colors, loud noises, funny smells, soft blanket and all that movement happening. It is very easy to overwhelm him and we end up doing it all too easily.
We also tend to take some positions for granted. Take tummy time, for example. Your baby first needs to learn to prop himself up onto his forearms, and then push his body up by straightening his arms. The only sense allowing him to understand and control this is his proprioception. Later on, he will be able to climb a ladder or catch a ball, without having to think about where his arms should be and when. He will already understand his physical boundaries and muscle movements. A movement like rolling is giving him enough proprioceptive input at this stage - we take it for granted but he is doing it because that is all his body can handle right now. If it could process the information and handle the pressure from birth, he would be born and start walking straight away. It develops with time. Putting him in positions and devices he is not yet ready for physically, only negatively affects the ability to process this sense too.
So how do we develop the ability to process proprioception in our children? The most important thing to remember is natural movement. We are born with our limbs kicking and arms flailing, and the second a slight resistance is placed on those movements, we start to learn more and more about them. It is therefore essential to allow your baby to move as much as possible through his normal ranges. Swaddle blankets are also ways in which we have pressure on our limbs and develop proprioception. Standing, weight bearing through the legs, arms, even forearms, helps to develop this sense. It becomes very limiting when movement is not free or natural and is limited to smaller ranges – which is exactly what happens when a baby is placed in most entertainment stations – a swing, a bouncer, an exersaucer, a Bumbo, even a car seat or carrier.
The best thing for them at this stage is an activity gym, no matter whether it’s tummy time, side lying, or playing on his back, his kicking and pushing and movement is not limited to certain movements or ranges. Standing and being supported. Sitting and being supported. All help to allow movement and sensory input through the body. When he is older, a ball-pit or sand-pit will be useful in identifying body boundaries too. Let them move!
And then we have our last sense:
Sense number 7 – the Vestibular system
This is a very complex sense that again comes from deeper within, so complex that it is a whole system. Inside of our ears, we have tiny granule-type organs that are able to move as the head moves and tilts. When these move, a signal is transmitted to the brain that tells us how the head is situated in relation to the space around it as well as to the rest of the body. Pretty incredible, right?
It is quite an advanced sensory input that takes years for us to learn to appropriately process, but works to help us balance and to coordinate movement. Most of us have already started developing this sense with our children without actually realizing it. Swings, rockers and car rides all have motion to them and enable the development of this sense. This is why we easily overwhelm a baby when moving and playing with him too much, or changing movements too rapidly. A crying baby will almost never soothe if you chop and change from bouncing to rocking to swinging in the space of a few minutes. Each time you change a motion, he has to process it and understand what it is you are doing, before he can actually be soothed by it.
The key? Consistency and timing. Doing one motion repeatedly until he calms before trying another is best, and when changing motions, keeping him still for a rest period in-between. What we might see as soothing and calming, is a new and overwhelming sensory input to a baby. It is also not recommended to tilt your baby so that his head is below his body or upside down, because of just how overwhelming a sense this can be!
It is important to develop this sensory system, but cautiously and with time. Your baby needs natural movement as well, to develop this. Something like rolling over moves the head and tells him something is happening and his body position is changing. Babies who are big enough thrive from time outside at the park because this sense develops well with the swing, round-about, see-saw and slide. Movement is everything, the more free and natural, the better. Limiting him to a confined space and position is only limiting his ability to understand his body and his movements, and therefore his ability to improve these.
My recommendation is this:
Be aware of the movement and position of your child. Look at where his body is receiving pressure, and where he is able to move and how he is able to move. If you see things blocking his ability to move, you see something holding back his ability to develop. Try limit time spent in chairs or bouncers. Let your child lie on his side, back, tummy, let him stand on you, roll him across the bed, gently swing him, bounce him on a ball. Teach him about the movements and watch his face as he feels them. Don't limit his ability to explore with a movement or motion by distracting him with a big shiny toy. Encourage his movement by not carrying him all the time, and when he is old enough, challenge him to fetch toys and to move as much as he physically can. Placing a toy in his hand to play with provides very little opportunity to learn and develop.
Be aware of all of his senses so that you know when he has had enough and is over-stimulated. Make a big deal out of a movement by verbalizing things “wow, look at you standing!”, “now we are bouncing, up and down, up and down!” which helps him to learn the concept of the movement. It’s all about playing with him and letting him play on his own, no limits and no restrictions! He who moves most, learns most!
This is just a new activity for you all to try! You can start doing it with your baby when he has adequate head control, to be able to move his head to get comfortable. When you see your baby looking at and lifting his legs, this is definitely a good time to try this exercise with him!
I got my baby girl a tummy time mat recently, and it came with a small arc shaped cushion. I use it now for something completely different too! I have used this exercise with many children in therapy, and both the babies and moms love it! Its something we do for body scheme development, as well as coordination, mid-line crossing, rolling back to tummy and also (but mostly) tummy muscle strengthening!
An activity like this is also very good for babies with low birth weight or premature babies, as they weren't able to gain as much sensory input through the feet when kicking in-utero, since they had more space than term or bigger babies. This helps to learn about the feet - something that advances them when learning to walk or stand!
You place baby on his/her back with the small cushion/blanket/towel under just the bum, stopping at the hips. Make sure it lifts the bum cheeks up but doesn't cause strain on the neck by making too high of a head/trunk angle. It is basically playing whilst lying on the back, but by raising the hips we created more of a flexed position, encouraging leg kicking, and working tummy muscles. Babies who just lie flat on their backs find it harder to bring their legs into the air, so this gives them a view of their feet to motivate them to do this - and makes it easier to move the legs up and down!
What this should help baby do is bring his legs up first straight out and then after some time bent and close to the body. If you put yourself in this position, move your legs up and down and feel just how much your tummy muscles are working! Encourage him to look at and touch his knees and feet, with opposite hands to feet and also the same side foot to hand. He probably wont be able to get a firm grasp on the foot yet but now he's just learning that there is a foot there to begin with. You can also take both feet together and lift them up to touch his face but don't hold this position for long. Get baby to look at his feet when he is barefoot, and you can also put brightly colored socks on his feet to look at. Some socks have small bulging animals and rattles too, these are also good for this type of exercise!
You can also hold his body flat, bend his legs at the knees and stretch the hips by moving the legs from side to side (bent legs only with body flat on floor). This stretches the tummy rotator muscles involved in rolling and the hip joints!
Just a tip for moms with babies who spit up and reflux a lot - wait half an hour to an hour after feeds to do this activity.
My baby girl has a little bell toy hanging from her activity gym that she kicks while in this position and she loves it. Happy playing all!
I was busy holding my little girl this morning, standing on my lap/tummy while I lay on the couch and I started to analyse just how good this is for her, so I thought Id share it with you all!
This is aimed at young babies who have just started to bear weight through the legs (around 2-3 months of age).
Here's my list of reasons why babies should stand when supported by you, rather than on the floor or in various forms of entertainment stations:
1) here the pressure through the feet is on a soft but dense surface, which helps with arch development and provides support for the entire sole of the foot. Something hard (like the base of an exersaucer or the floor) cant move under the foot nor can it support the entire surface area of the sole, causing stretching of unsupported muscles and ligaments. A soft pillow doesn't have the density our bodies do, so it isn't quite tough enough to fully support the foot either.
2) here they have the ability to bend and straighten legs with their own control (and mostly this happens through reflexes) which helps to develop strength an coordination. When positioned in a seat they aren't able to bend and straighten their legs in this way, and the seat is giving the hips full support so it limits normal movement of the legs.
3) her entertainment station is my face - which is also coincidentally about 30-40cm away from her, and perfect for her current visual capacity development. I pull faces at her and talk to her constantly, I taught her to pull her tongue out at me and she can focus on my face and learn emotional expression (something like this cannot be gained from a colorful toy which, to be honest, she wouldn't really be able to grasp yet or explore with anyway, and would probably overstimulate her). In an exersaucer, they are too small to stand in such a way that allows their hands and arms to move in order to reach and try grasp things, and most of them sit with their tummies against the front of the seat anyway, so they really can't move much at all.
4) I can choose where to provide support when she seems to tire out. I often hold her at the hips initially. This frees up her hands and she tries to grab at and touch my face. At times I hold her hands only, which gets her tummy muscles working really hard, and other times i hold her around the middle for support when she is just enjoying standing and looking at me. She sometimes looks down at her legs and feet too, which she wouldn't be able to do in an exersaucer.
5) When she gets tired, I bend my knees and let her sit and rest lying on my legs. From this position i can hold her hands and she can pull herself up into sitting, and from there up into standing (my favorite exercise, its like baby sit-ups!)
I love the quality of the time spent with her in this position and i get a workout too - she stands on my tummy and I have to activate my muscles so that she balances and is upright! Win-win situation, right?
Just another reason to play with your baby instead of giving them something to play in!
Where I live, we still have something called a walking ring or walker, and up to date therapists have had much debate regarding the use of one. Walking rings are actually banned in Canada, and for good reason. There is a safety concern around a walker, which brings babies to a height at which they might be able to reach objects on counters, touch stoves, pull things onto themselves, or tip over, sometimes even down a flight of stairs. No only for the safety concerns, they too are really bad for physical development and motor skill acquisition.
Have a look at the images in the post before and after reading this. Initially you see smiling, happy babies, but after reading the post, have a good look at everything other than the smile!
So here it is, my list of the problems I find with Jumparoos/Walking Rings/Exercaucers:
1) the seat is often quite rigid and too wide for babies' hips causing them to bend outward at an angle. They then weight bear through this position with low muscle tone and weak ligaments, causing them to stretch and you end up with stiffness when moving the leg in other directions because some ligaments are then shortened and some lengthened. Add the force of bouncing on these joints in a Jumparoo and you make things infinitely worse. The muscle tone is not ready to support the joint and the ligament and this can cause improper development seen when a baby begins to crawl and walk. The way they coordinate the gait and the movement of the hip, knee and ankle can often be abnormal, and they tend to 'lock' the joints as a compensatory technique caused by a lack of strength and support.
2) the absence of looking at their own legs and feet. We use all senses to learn to move and walk. If you cannot see your feet and legs, how do you develop what we call a body 'scheme'? A baby explores with his body through vision and touch. We aren't born with an understanding or even acknowledgement of our limbs - the further away the body part, the longer it takes us to understand its existence and purpose. It takes practice and exploration through touch for a baby to develop his understanding of his body. Not using vision to develop a motor skill will often end in a sensory compensation technique - where he will seek input in the legs and feet through other means, in order to improve his body awareness. Some children will not compensate for this and will struggle with body awareness, being quite clumsy and uncoordinated for some time. It is almost impossible for a child to adequately learn to stand or walk with no visual input from their legs or feet, much like expecting him to tie his shoelaces for the first time with his eyes closed.
3) the height of the 'floor' in relation to the baby - since all babies are different heights, you either get babies learning to stand on their toes (and then the same thing happens to ligaments as i mentioned in point 1), or their feet are placed flat and the arches of the foot, which are not ready to develop, and then receive more pressure than they can and the foot develops with limited arches and this results in poor flexibility of foot muscles. The sole needs full support from a dense surface, which is why a pillow is not supportive enough, and a hard, flat surface only provides support to some areas of the sole. A child who stands on their toes will have overdeveloped, tightened calf muscles and can often develop toe-walking, a habit I have learnt takes many months to break since it is a physical problem with the legs and a sensory problem with the feet. Much like my previous point, the sole receiving pressure allows us to develop an understanding of what it is and its purpose. Receiving that input but limiting it to our toes will cause a problem with our awareness of the rest of the foot, and therefore improper use of the foot when standing or walking.
4) the support and posturing - I often explain to moms that our bodies work on a demand and supply basis. If there is a need for muscles of the trunk to develop, they will. We would be born with a full set of well-developed muscles if this wasn't the case! If you have a look at babies who are in hospital for extended periods of time, they lack basic skills like head control, because there is no actual demand for this to develop when lying flat in a bassinet and receiving support when being held and fed. In a supportive seat like the seat in a Jumparoo or Exersaucer (which often comes way above the hips and even supports the middle), the body receives the message that there is enough support and the muscles do not need to develop yet, despite demanding strength and control from the legs. The seats force the pelvis into the wrong tilt and without trunk control their bodies are forced forwards with the back and neck arched in order to maintain an upright position of the head. Having his trunk forced forwards against the seat limits any movement of the arms in order to reach or grasp a toy. The low muscle tone also means that the vertebrae do not receive adequate support in this position and extended use can cause spinal deformities and abnormal posturing. Limiting activation of the tummy muscles stops him from developing postural control - a basic strength that we need to do absolutely everything. It is often most evident in children who start going to school and are expected to perform fine motor skills like writing or cutting. Keeping an elevated posture is hard work for these children and they end up rocking and swinging on classroom chairs and constantly fidgeting, all due to a lack of postural control.
5) the lack of interaction with the rest of the environment - babies in an Exersaucer/Jumparoo are only able to play with the toys directly in front of them, most of which, in these devices are electronic and have one simple purpose. Should something captivate your baby just outside his exersaucer/jumparoo, how will he be able to interact with it since it is now out of reach? You inhibit normal movement and normal exploration, and his desire to crawl and move to fetch a toy is then lost. I often see children with no motivation to crawl or transition from one position to another, like moving from sitting to standing, because when placed in his exersaucer, everything is done for him and there are no demands placed on him to do things for himself.
As in most cases, there are babies who may actually develop faster or normally in these. There are also babies who develop slower because of them. And then there are babies who develop abnormally and have serious problems caused by them. Each baby is different. What we don't realize is that babies don't need these gadgets to develop, yet parents rely on them to keep the baby busy so that they can do laundry or cook or tend to other children, and the media provides an unrealistic idea that your baby will be actually be advantaged whilst in these. It's not that way at all.
Babies need furniture to pull themselves up into standing, to hold while cruising, to fetch toys they want. Make your living room a safe place and let your baby go wild by putting toys everywhere you can and getting him to fetch them.It saves you a lot of money not buying these and your child will be better off for it. If you do intend to use one in order to cook dinner or do laundry, 15-20 minutes in them wont harm your baby, but doing this more than once or twice a day is going to have an impact on their development, and it becomes easier and easier as time goes on to let them spend more time entertained in them, rather than entertaining them yourself or allowing them to move on their own, which is definitely bad for them and hinders their development.
Parents should play with their babies more, and use gadgets far less. Let them move on their own, let them explore, and don't fall into the trap of letting the entertainment stations do your job as a caregiver!
If you have a look at the images after reading this, what do you notice about the posturing and leg position of the babies?
Ive edited this post to add a section for parents who are still dead-set on using an exersaucer. This isnt me advocating for one or saying that you should get one - this is me suggesting when and how to use it if you are going to do so anyway. I really hope that you will consider this advice.
Since I pointed out that being in an exersaucer or jumparoo takes away the motivation for a baby to crawl and perform transitional movements (sit to stand, sit to crawl, etc.), I would strongly suggest waiting until your child is a well established and active crawler. Once he has started crawling, he has shown that his hips and legs are quite strong and move within a wide variety of ranges. His muscle tone has developed greatly, and allows his joints to be stable when he is positioned in 4-point kneeling, or the puppy position of crawling. He also should, by now, have adequate trunk strength to keep himself upright should you support him at the hips or hands, but cannot yet coordinate pulling himself up to stand or hold himself in a steady standing position to play without your support. This is a gap where, instead of you supporting his hips so he may play in standing, he can use an exersaucer to stand and play in a safe and secure way without needing your support.
However, if he is placed in here too often and crawling time is neglected, the impact lies on his shoulder strength and bilateral coordination of all limbs, something that can be evident when he is older and fine motor skills are in high demand. If placed in these devices too long, it will also delay his ability to pull himself into standing or to stand and hold the furniture and cruise along it, since he will not have the opportunity to practice these from within the device. Once he has learnt to crawl, you should ideally place toys on higher surfaces, just out of his reach, to encourage him to stand up to retrieve them on his own. Limit exersaucer time to when you are truly busy and cannot support him. From my personal perspective, this is the only gap at which I see no abnormalities or serious delays arising if baby is placed in an exersaucer, but like always, moderation is still a must.
Another recommendation, which mamaOT.com has also made, is to use the toys of the exersaucer, and the exersaucer itself, as a surface which baby can use in place of a table, and play with from outside - not sitting inside the exersaucer. Many moms have asked if they can adapt their devices to make them better - and I strongly encourage this if you are going to use one. All babies are different shapes and sizes, which makes it hard for manufacturers to ensure children will not develop abnormally when using these. Please feel free to email me with photos of your baby inside one of these devices if you would like my assistance or advice in altering or adapting it to prevent complications if you are still going to use one.