Updated: Aug 21, 2018
What Successful Crawling Looks Like, and How to Get There.
There is nothing more exciting to a parent when their child starts that little rocking motion while on all fours. To think of them becoming mobile is a very big milestone. As chiropractors to these little ones ready to explore, it is vital we do our best to properly analyze and ensure that the baby is developing correctly to become successful crawlers!
What Crawling should look like:
There are so many forms of crawling that include: the army crawl, the bear crawl, the one-leg push crawl, or the butt scooting, however these are not good for the baby. Although these can look quite adorable, there is only one ergonomically correct crawl that also indicates to us, as the babies chiropractor that the infant is growing and developing at a healthy pace. A normal or correct crawl will be with an infant up on all fours, using one arm to move forward while the opposite leg also moves forward, similar to a proper walking gate. This is termed Cross-Crawl.
A proper crawl foundation will give the infant depth perception, proprioception, find motor skills, balance, neurological balance which assists in frontal lobe development, and right left brain integration which will help them develop and strengthen both sides of their body. A proper crawl for no less than 3 months will prepare the child to now appropriately gain standing balance and begin stepping. Never accept another cute but incorrect crawl again, step in and assist your patient to gain proper structure and function.
To get started, take a look at the early stages of life. If the child comes in as a newborn or just prior to any mobility milestones like rolling have been reached, start by asking the parents if they are giving the baby adequate tummy time. This will encourage them to learn to push their chests up with their arms and to roll. While learning to push up, they are also teaching their eyes to be level with the horizon, learning depth perception, working on their secondary cervical curve and also when babies begin to synapse their right and left sides of their brain. This is called right/left brain integration. During this important neurological development, the infants brain goes from solely depending on the brain-stem, primitive reflexes and cranial nerves to creating synapses and utilizing the right and left sides of the brain (providing control of their extremities vs. their newborn spontaneous movements) and developing the frontal lobe.
We have all learned about cross-crawl exercises to use with our patients or ourselves with exercise or rehabilitation. Well, from the start of our development as humans, the idea of cross-crawl is needed to ensure that our right and left brains learn to integrate to properly develop the frontal lobe, balance and coordination, and proprioception. As chiropractors it’s imperative that we assess their right and left brain integration prior the crawling phase. If care hasn’t been established early on in infancy then we need to know how to remediate any deficits in order to correct the dysfunctional patterns and get the child back on track for optimal growth and development.
If you see a child that has already developed an abnormal crawl, what can you do? First check the primitive reflexes. Primitive reflexes need to be present in all newborns and through most of infancy, but not in older children and they phase out as the infant gets to crawling age (7 months to a year old). I talk about primitive reflexes a lot because when caring for pediatric patients they are very important to know, check and remediate. Whether the reflex is not present and should be or if the child should have outgrown but it is still present, it is a deficiency and will need to be remediated. I find that the remediation is usually very quick for little ones.
As a chiropractor we need to most importantly thoroughly assess their spines and adjust where subluxations are found. Specific areas of restriction often found with crawling deficits are the sacrum, the upper cervical spine, and the lower extremity. When assessing the upper cervical do not discount the occipital placement, whether it is in flexion or extension as well as all of the cranial bones and sutures. Remember we need to first correct the spine, allowing for proper nervous system function, so our remediation and other exercises can be successful.
Remediations and Exercises:
I personally encourage stomach sleeping, especially when I see that the baby is able to lift its head and move it from side to side. For parents that aren’t comfortable with night time tummy sleeping, then encourage them to at least nap them during the day on their stomachs when they can check up on them and get the sense of security with the baby stomach sleeping. Most babies do not care for tummy time by means of crying while on their stomach. When parents just can’t bare letting their little ones cry during tummy time, we can show them other ways. I like to encourage tummy on tummy, the babies are much happier while practicing their tummy time on mom or dads chest or stomach as well. Also, using a pillow like the Boppy or my favorite is by Leachco that can firmly hold their bottom halves in place form sliding while allowing their chests to be lifted from the ground. Another way to give tummy time to smaller infants is to hold them on your forearm, cupping their chin in your hand, tummy along the forearm and legs on either side of the elbow. Then you can support their bodies with the other hand and slowly and securely move them up and down or side to side, providing the tummy time exercise benefits.
Primitive reflex remediation’s can be quite simple and fast. As part of my remediation process I use a small paintbrush and advise the parent to perform the reflex test 30 times 3 times per day on the effected side. For example, for a positive Babinski’s, you’d have the parent gently stroke the brush from the heel up to the ball of the foot 30 times consistently, no fast. Eventually they will see the toe flaring stop. As reflexes are remediated, we are helping their neurology function as it developmentally should. Along with reflex remediation’s, provide cross-crawl exercises in order to assist the child to learn right and left brain integrations. A great way to work with infants on cross-crawl is at each diaper change, simply have the parent bring opposite hand and foot to each other 3times per side. So, you’d stretch the right arm for instance up over the head, while stretching the left leg down, then bring them together and back down, repeat with the opposite arm and leg. This is subconscious cross-crawl activity. Another one to do with infants is to place their belly on a small exercise ball, I use a small balance ball for kids, and begin with them on their feet, and roll them over the ball until their heads almost touch the ground, but not touching. Here, we want them to learn to bring their arms up to stop their heads from touching the ground.
Providing your patients with not only the knowledge but the tools to successfully crawl you will gain their trust as a physician and you will earn referrals. Be confident in your knowledge, practice, take courses on pediatric care, you cWant to add a caption to this image? Click the Settings icon. an assist in providing a healthy future for these children. Please remember, if you are not confident in the proper care of a child or expectant mother in your office, please get to know a local chiropractor that is certified to care for them properly, gain a relationship so you can co-manage and give each patient the best care they deserve.