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| |    Sitting Up by Robert Needlman, M.D., F.A.A.P. reviewed by Laura Jana, M.D., F.A.A.P. Most babies can sit up alone by about seven to nine months. If a baby is not close to being able to sit by nine months, I think it's reasonable to discuss this concern with a physician or developmental specialist. Sitting up requires a good sense of balance, as well as muscle strength and control in the trunk and hips. When babies are very slow to sit, it is usually due to immaturity in one of these systems. The developmental abilities needed to sit steadily are also required for standing and walking, so late sitting usually goes with late walking. Most of the time, being late to sit only means that a child is on a slower developmental schedule than his peers; in the end, he does just fine. It is only rarely that there is some actual illness or problem underlying the delay. How sitting develops Sitting steadily is one step in a developmental sequence. Here are some of the other steps. The dates are only approximate; many healthy babies are slower or faster in their motor development. Zero-two months. At birth, if you hold a baby's wrists and gently pull up on her arms to sit her up, her head hangs back limply at a dangerous-looking angle. (It looks terrible, but it actually is not uncomfortable or harmful. I always try to reassure parents before I do this to their babies; if I forget, the look of horror on their faces often reminds me!) If you hold her in a sitting position, her head falls back or forward. It's not a good idea to leave her this way for long, by the way, because it's hard for her to breathe in this position. (This example also reinforces the need to offer young babies head support at all times.) Two-four months. By about two months, when you do the pull-up-to-sit move, the baby holds her head in line with her body. Soon after, she actually lifts her head forward as you tug on her arms, and helps with her abdominal muscles. If you hold her trunk stable, she keeps her head balanced for a minute or two, until her neck muscles tire. Four-six months. By four months, when your baby sits in your lap, she holds her head steady for long periods of time and enjoys looking all around. (Her vision has improved to the point that she can actually see things across the room fairly clearly.) By five to six months, she balances in a sitting position for a few moments, but you have to prop her up with her legs in front, knees bent, to provide a wide base, and brace her arms on her thighs. Six-eight months. You know that she is almost ready to sit on her own when she starts to show what is called the righting reflex: With her sitting, if you hold her around the chest and tilt her body over, she sticks out a hand as if to right herself. She has begun to make small, unconscious contractions of the muscles in her back, needed to keep her balanced. At first, it takes concentration, but soon, like riding a bicycle, it is second nature. Seven-ten months. At first, she can only sit if you carefully place her in the right position. If she tries to reach for something, she topples over. But soon, with practice, she is moving smoothly from crawling, to sitting, to crawling again. She can lean way over to get a toy, then easily straighten back up again. She is an expert sitter.
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