Every baby develops differently but it helps to watch out for these Warning Signs of a Physical Developmental Delay in Your Baby so you can act early.

Every parent longs for the day when their little one takes their first step, or says ‘Mama’ for the first time. There’s something magical about hitting milestones – it shows your baby is growing into his or her own person, and is developing normally. That’s why hitting every milestone gives a parent so much joy, but the opposite is also true. Few things can stress a parent out like their baby not reaching their developmental milestones on time.

Generally speaking, babies’ physical development proceeds from top to bottom, in this manner: Head and neck control->Control on hands and upper body->Control of the feet and legs->Control of the bladder and bowel. Following this pattern, babies roll over first, then sit, then pull themselves up with support, stand without support, walk with support and then without support.

Yet, this is a very generalized pattern, and many babies deviate from it. Some babies may skip a milestone, or some may mix up the order. The time at which each milestone has to be achieved is also quite broad, and babies can reach their milestone anywhere within that time frame. Every baby is different, and it makes no sense to compare any two babies – not even siblings.

That said, it’s important to be aware of developmental delays. Physical developmental delays are also referred to as early motor delays, and they occur when a child shows a significant delay in achieving a certain milestone during the first few years. Knowing which delays to watch out for can keep parents alert in case of a serious delay, so that it can get medical attention immediately. The earlier developmental delays are tackled, the better the chances of recovery so the baby can catch up with his or her peers.

Here is a complete list of warning signs of a physical developmental delay in babies, sorted by age. If your child shows any of these signs, it’s recommended to have a consultation with your child’s doctor.

Warning Signs of a Physical Developmental Delay

0-2 Months

• Muscles feel stiff
• Strains body when being held
• Becomes stiff or crosses legs when being picked up
• Doesn’t react on hearing loud noises
• Doesn’t look at objects as they move
• Does’t bring hands to mouth
• Cannot hold head up when being picked up from a lying position
• Cannot support head when pushing up from a tummy down position

3-4 Months

• Cannot support head properly
• Doesn’t grasp or reach out for objects
• Doesn’t put things in mouth
• Cannot move one or both eyes in different directions
• Does not watch things moving
• Doesn’t smile at people or make cooing sounds
• Does not push down with legs when placed on a stable surface
• Exhibits Moro reflex even at 4 months – extends arms, legs and neck when falling backwards, and quickly brings limbs together and cries

5-6 Months

• Muscles seem floppy or stiff
• Doesn’t bring things to mouth
• Doesn’t reach out for objects
• Does not react to loud noises
• Does not smile or make cooing sounds
• Doesn’t seem to have any affection for primary caregivers
• Cannot roll over in any direction
• Can’t sit up with support
• Reaches out with only one hand and keeps the other in a fist
• Has asymmetrical tonic neck reflex even by 6 months – when the head turns to a side, the arm on that side straightens while the opposite arm bends upwards

7-9 Months

• Has tight or floppy muscles
• Doesn’t have good head control in a sitting position – head flops to a side
• Doesn’t reach out for objects or reaches out with only one hand
• Cannot transfer objects from one hand to the other
• Has difficulty putting things in the mouth
• Does not look in a particular direction
• Does not respond to his or her name being called
• Does not seem to identify or show affection for primary caregivers
• Cannot sit with support by 7 months
• Cannot bear weight on legs when pulled into a standing position
• Can’t sit without support by 9 months

10-12 Months

• Does not crawl, or crawls with one hand and leg, dragging the opposite hand and leg
• Cannot stand with support by 12 months
• Does not point to objects
• Can’t say basic words like mama
• Cannot wave or shake head

13-18 Months

• Does not point to things
• Cannot push a toy with wheels
• Cannot hold objects with pincer grasp by 18 months
• Does not recognize familiar objects or people
• Does not mimic others
• Has vocabulary of fewer than 6 words
• Cannot walk normally by 18 months, or walks only on toes

19-24 Months

• Cannot take spoon to the mouth
• Cannot walk in a stable manner
• Unable to stack four rings by 2 years
• Has difficulty using common objects like brush, spoon
• Does not mimic others
• Cannot follow simple instructions
• Grows less than 2 inches per year after second birthday

25-36 Months

• Has trouble with simple actions like turning a handle, putting a peg in a hole
• Can’t work with smaller objects
• Does not make eye contact
• Cannot follow simple instructions
• Has difficulty playing with other children
• Drools or speaks in an unclear manner
• Falls frequently
• Can’t climb stairs

3-4 Years

• Has difficulty in pretend play or games with other children
• Does not respond to strangers
• Cannot scribble
• Speaks in an unclear manner
• Has trouble with daily activities like dressing, using the potty
• Cannot follow instructions with 2-3 steps
• Cannot differentiate between ‘you’ and ‘me’
• Cannot jump in place

4-5 Years

• Cannot say own name
• Does not exhibit a range of emotions and is usually extreme
• Is not active and does not engage in pretend play
• Has trouble brushing teeth, washing hands or getting dressed
• Has difficulty focusing on a single activity
• Does not draw

Besides these, here are a few general signs of a physical developmental delay:

1. Seems very clumsy
2. Has trouble handling objects
3. Has trouble eating
4. Tends to favor one hand or one side of the body
5. Loses skills she once had
6. Involuntary reflexes have more control over voluntary actions

To know how your child is doing, you can check out a physical developmental delay tracker created by The American Academy of Pediatrics (AAP).

There are many reasons children can have a physical developmental delay. One reason is prematurity – children who are born premature reach their milestones later than full term children born on the same day. They may also show delayed muscle development compared to others. Other underlying medical conditions that can affect physical development are ataxia, myopathy or cognitive delays. It is important to see your child’s doctor at the earliest to rule out any of these conditions.

In the mean time, you can encourage your baby at home with a few simple tips. Use brightly colored toys to catch her attention. Get moving toys with wheels that will encourage the baby to move towards it. Prop baby up with pillows or a baby chair. Make sure baby gets enough tummy time and floor time, as well as time walking bare foot. Massage baby regularly to stimulate her muscles.

Most importantly, trust your instincts and don’t let the stress get to you. With early detection and proper management, most of these physical developmental delays can be overcome and your baby can lead a full, healthy life like everyone else.