Kacie Demetros, MS OTR/L CEIM, is a pediatric occupational therapist at the Inova Loudoun Hospital Outpatient Specialty Rehabilitation Center. She is a member of the rehabilitation team for the hospital’s NICU Follow-Up Clinic.

Rolling over. Grasping a toy. Sitting up without help. Babies experience amazing developmental milestones in their first year, each at their own unique pace. Still, some babies need a helping hand as they grow and develop.

Is your baby meeting the milestones? Here are some signs to watch for, and what you can do to support your baby’s growth and development.

Baby Milestones

It’s easy to keep tabs on the big milestones, like the first time your baby rolls over, crawls or takes her first steps. But some of the clues that your baby might need extra support can be more subtle:

  • Side preference. In newborns, you might notice your baby looks to one side most of the time. As babies get older, they may always roll toward the same direction or always reach with the same hand. A preference for right or left hand won’t emerge until your child is a toddler. In the first year, she or he should be using both hands equally.
  • Feeding difficulties. Younger babies might have trouble breastfeeding or taking formula from a bottle. Older babies might have trouble swallowing purees or solid foods. These can signal problems with muscle development or swallowing disorders that can be treated and managed.
  • Not progressing with milestones. If your baby isn’t reaching his or her developmental milestones on schedule, it may signal a developmental delay. By 6 months, for example, most babies will begin to manipulate toys with both hands, push up on their arms when on their tummies, sit with support, and roll over from front to back and back to front. Treatment by specialists such as occupational therapists, physical therapists and speech-language pathologists can address any delays.

How to Support Baby’s Development

As a parent or caregiver, there is a lot you can do to help support your baby’s healthy growth and development. Try these activities with your little one:

  • Tummy time. Give your infant plenty of supervised playtime on his or her belly. Tummy time helps babies develop the strength that will one day help them roll and crawl. And playing with you and other adults provides important social interaction. (While awake tummy time is important, medical professionals recommend putting babies to sleep on their backs.)
  • Equal sides. Encourage your baby to use both hands and to turn his or her head in both directions. This can be as simple as offering toys and food from the right and left. If you notice the baby prefers the right, for example, make an effort to offer toys from the left side.
  • Infant massage. Gentle massage is a great way to connect with your baby. It provides healthy stimulation for the baby’s nervous system and can also promote calming and sleeping. (Infant massage classes are available at the Inova Loudoun Hospital Outpatient Specialty Rehabilitation Center.)
  • Visual stimulation. Stimulating baby’s sense of sight is important for development. Very young babies like to look at high-contrast objects, such as toys and books with black-and-white color schemes. As they get a bit older, many babies are drawn to mirrors and brightly colored toys. 

How Therapists Can Help

If your baby isn’t reaching his or her developmental milestones on schedule, there are professionals who can help. The right specialist depends on the situation:

  • Pediatric occupational therapists work with babies to improve their physical, cognitive, sensory and motor skills. This includes things like working to develop fine motor skills and hand-eye coordination. We can also help when there’s an issue with a baby’s sensory development. This often happens when a baby is born prematurely, and can result in a baby who has strong reactions to things like taking a bath or having a diaper changed.
  • Pediatric physical therapists monitor a baby’s large motor skills and offer therapy to help develop these abilities. Physical therapists often address things such as gaining head control, rolling over, tolerating tummy time, sitting up, crawling, walking and climbing. Physical therapists also treat conditions such as torticollis, a fairly common condition in which tight neck muscles cause the baby’s head to be tilted in one direction. 
  • Speech-language pathologists diagnose and treat speech and communication difficulties in older babies. They are also experts in swallowing disorders, and can also play an important role in helping to solve infant feeding problems.

Help for Developmental Delays

Babies born prematurely are especially likely to need extra developmental support in their first two years. At Inova Loudoun Hospital Outpatient Specialty Rehabilitation Center’s NICU Follow-Up Clinic, occupational therapists, physical therapists and speech-language pathologists work together closely to monitor and support babies who arrive early. My colleagues and I also provide services to full-term babies who need extra help as they grow.

If you have concerns or questions about your baby’s development, talk to your pediatrician. If she diagnoses a developmental delay, she can refer you to specialists such as the team at the Outpatient Specialty Rehabilitation Center.


For more information about the Inova Loudoun Outpatient Specialty Rehabilitation Center’s (OSRC) NICU Follow-Up Clinic, please call 703-858-6667.

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