Head Control – A developmental milestone

Developmental milestones reflect the growth and integration of the central nervous system in the child.
Head control is the ability to maintain the head and the cervical spine in an upright position. Head control is a developmental powerhouse! It’s the precursor to moving the entire body, which starts with rolling over and goes on to sitting up, crawling, cruising, and walking. It’s the gateway to the world of food because it prepares your baby to handle purees. And, it gets your baby ready to speak and introduces her to the wide world of language.

At what age do babies hold their head up?

At birth, your baby has little control over his head because his motor skills and neck muscles are fairly weak. He’ll develop this crucial skill, which is the foundation for all later movement – such as sitting up and walking – little by little during the first year of life.

Your baby will probably be able to lift her head when she’s about a month old, and hold it up when placed in a sitting position at around 4 months. Her neck muscles and head control should be strong and steady by 6 months.

How do babies learn head control?

your baby will rely on you to support his head and neck for at least the first month or so. Perhaps it’s nature’s way of making sure you have lots of time to gaze into each other’s eyes and bond as you cradle your baby in your arms.

1 to 2 months
By the end of his first month, your baby should be able to lift his head briefly and turn it from side to side when lying on his stomach. At around 6 to 8 weeks, if he’s especially strong and coordinated, he’ll raise his head while lying on his back.

When you carry him on your shoulder, he’ll have enough control to hold his head up shakily, but not for long. He’ll also be strong enough to hold up his head while sitting in a car seat or front pack. Wait until he can hold his head up steadily without any support from you to use a jogging stroller or a backpack, though. If you carry your baby in a sling, make sure his face is visible since he can’t yet move his head to breathe easily.

3 to 4 months
You’ll notice a definite improvement in head control by this time. Your baby will be able to raise his head to 45 degrees while on his tummy and keep it up steadily.

For a fun game that also develops his neck muscles, places your baby on his back and slowly pulls him up by his hands to a sitting position. Slowly ease him back down, and repeat.

At this age, he should be able to hold his head in line with the rest of his body as it’s pulled up. You can probably carry him in a backpack now.

5 to 6 months
By 6 months, your baby will be able to hold his head steady and erect, and he’ll flex it forward when he’s pulled into a sitting position. He may be ready for a jogging stroller at this point.
How to help your baby learn head control?

You don’t have to do much to encourage the development of head control, but you do have to be careful until it’s well established. For the first few months, especially, you’ll need to cradle your baby’s neck and head when you lift him, hold him, or carry him. Although your baby should always sleep on his back, put him on his tummy frequently while he’s awake – lifting his head and chest to see you or his toys will strengthen his neck muscles.

From 3 to 6 months, you may want to prop your baby in a sitting position – in a safe place, with plenty of neck and head support. Use pillows, or set him on your lap, with his back against you. Have him sit in different spots around your home so his view changes. Never leave him sitting unattended, though, because he could topple over.

If you’re a runner, avoid taking your baby out with you in a jogging stroller until he masters head control. When you think he’s ready, pick a jogger with a five-point harness, which offers the most support.

What to do if your baby doesn’t hold his head up?

Pulling to sit can work on a baby’s head control as well as develop their core muscles such as their abs.  When they are lying flat on their back this will be the hardest position for them to control their head and neck muscles because they have to work fully against gravity.  In order to make it a little easier for them, you can start them on an angle, such as your lap with your knees bent.

When you go to help them sit up using the pull to sit method you want to make sure they engage their whole body to help with the process.

If your baby seems to struggle to lift his head up even slightly at 3 months, mention it at your next doctor visit. Babies develop skills differently, some more quickly than others, and head control is no exception. Premature babies may reach this and other milestones later than their peers – check with your child’s doctor if you’re worried.

CAUSES For Poor head control:

Hypotonia is a medical word for low muscle tone. If your baby has it, she will likely feel limp in your arms, like a rag doll. That’s why it’s also called floppy infant syndrome.

Poor muscle tone tends to signal a problem with the brain, spinal cord, nerves, or muscles. But physical therapy and other treatments can help your child build stronger muscles and better coordination.


Most babies enter the world with good muscle tone. It lets them flex and flail their little limbs. Newborns with hypotonia won’t have a strong arm and leg movements.
As they get older, “floppy” babies will miss important milestones, like being able to lift their heads when they’re on their tummies. Other common symptoms include:

Poor head control. When your baby can’t control her neck muscles, her head will fall forward, backward, or to the side. Feeling limp, especially when you lift her. If you pick her up with your hands beneath her armpits, her arms may raise without resistance — as if she could slip through your hands. Arms and legs hang straight. Babies usually rest with their arms and legs flexed — there’s a slight bend in their elbows, hips, and knees. But children with hypotonia don’t.

Sometimes, the condition can cause problems with sucking and swallowing. Also, your child’s joints may be extremely flexible, as if she is double-jointed.

Many Possible Causes

Floppy infant syndrome can happen for no clear reason — what doctors call benign congenital hypotonia. But more often, it’s related to another health problem. There are many possible causes. A few are:

Brain damage due to lack of oxygen right before or after birth Problems with the way the brain formed in the womb Disorders that affect nerves Down syndrome Prader-Willi syndrome Tay-Sachs disease Achondroplasia (a form of dwarfism)Spinal cord injury Cerebral palsy Severe infections

Hypotonia isn’t always a sign of a major problem. When babies are born too early, they may have poor muscle tone because their bodies haven’t had enough time to develop properly. In this case, things should get much better as weeks and months pass. You just need to make sure your baby is meeting milestones and getting any treatment she needs.

Getting the Right Diagnosis

because many things can cause hypotonia, it may take some time to figure out what’s behind your child’s condition. The doctor will want to learn about your family’s medical and genetic history and give your baby a physical exam. He may check here:

Motor skills Sensory skills Balance Coordination Mental status


Once the doctor figures out the cause of your child’s hypotonia, he will try to treat that condition first. For example, he can prescribe medicine to treat an infection that caused her muscle problems. But sometimes, there’s no cure for the problem that causes hypotonia. If an inherited condition, like Down syndrome, caused it, your child will have that condition for life.

No matter the cause of hypotonia, your child can have therapy to strengthen her muscles and improve coordination. There are many options, including:

Sensory stimulation programs: These help babies and young kids respond to sight, sound, touch, smell, and taste. Occupational therapy: This will help your child get fine motor skills, which are (or will be) essential for daily tasks. Physical therapy: Like occupational therapy, it can help your child get more control of her movements. It can also improve strength and muscle tone over time. Speech-language therapy: Helps with problems breathing, speaking, and swallowing.

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