When we look at how babies develop we know that they learn at slightly different speeds but there are key time points where we expect to see them achieving certain movements e.g. rolling by 5 months. Learning to move is a complex process, it relies on many systems working together.  Some children may learn slower as they have been exposed to risk factors during pregnancy or in the first few months of life.  Infants who are born premature (>36 weeks), having a low birth weight, their mother had an infection whilst pregnant (listeria or toxoplasmosis), there was reduced placenta health, can increase the risk of them having a neurological concern or cerebral palsy.  However, we are lucky with current research and international collaboration of specialists within the area of child development as we now know what we should be looking out for. What are the red flags or movements that we see in the baby that means we should be taking a closer look?

So what are these “early warning” signs?

  • Is your baby showing a hand preference before 1 year?
  • Are they older than 6 months and they cannot get their feet to their mouth or their legs feel stiff and are hard to bend?
  • Are they older than 4 months and keep their hands closed tightly (fisted/ clenched) most of the time?
  • Are they not able to hold their head in line with their body when pulled up to sitting (older than 4 months of age)?
  • Are they Can they sit by themselves



Advice for new school parents

Your baby is all grown up and off to school.  You most likely have a looong list of things that they need. A school bag would definitely be on the list.  Your child might already have a back pack that they used for kindy or childcare but is it right for school? How they will use their school bag is likely to be different. We need to ask ourselves; is it the right size for their height? Is it big enough to carry what they need? Will they be wearing it for a long time e.g. walking to school, waiting to catch the bus? And is it comfy? It is important to consider these points and what the ‘tradeoffs’ are for each on the ‘health’ of your growing child’s back.


If you drive past a school take a minute to look at the kids walking to or going home with their heavy school bag. If they are wearing both straps these are often loose with the bag hanging below their back.  Initially when they set off they may look ok, but with each step their posture is changing and their body is adapting to the load.  Their chest muscles are shortening whilst their back and shoulder muscles are being lengthened, their spine is being stressed and they are changing the messages from their brain to their muscles which will reinforce the bad posture.


Changes to their posture

  • shoulders are rounded and pulled forward affecting the arm position in the shoulder joint
  • head is pulled forward in front of their body
  • spine alignment affected- neck curve is flatter and the mid-back curve has increased
  • smaller steps taken as body positioned forward- affecting the muscle in their hips, knees and ankles
  • natural arm and opposite leg swing is reduced which is important for cross patterning
  • decreased walking efficiency


If they are wearing only one strap- shortening of back and neck muscles on the same side and lengthening of the other.  



Over the years there has been an increase in children having neck and back pain. This is down to a number of factors such as our kids being less active, poor posture sitting watching TV or looking at other handheld devices but also due to schools having fewer lockers or permeant desks and carrying more in their bag’s. Therefore adding a poorly fitted, poorly packed, thin strapped and too big a school bag to the mix isn’t going to help. As a result your child may experience back or neck pain or complain of ‘tingling’ or their arms feeling ‘funny’ from the pressure of the straps pressing on blood vessels and nerves that supply their arms.


There are numerous medical studies that have investigated back pain in children.  The research shows that most children start to experience pain at around 11 years of age around the time they start to hit puberty.  Other risk factors identified are being female, carrying a heavier weight, a bag that is too big (in proportion to the child) and increasing age.  Interestingly they found that wearing one shoulder strap was the same as wearing two.


Unfortunately we can’t stop them growing up or change if they are a girl so we can only influence the bag’s Size and Weight.  The curves in our spine are developed to enable us to carry greater weight than if it was straight.  When we wear a heavy backpack it pulls our shoulders forward and we lose these natural curves and this is true for children, teenagers and adults although as adults we are less flexible in our joints and hopefully our muscles are stronger. This flattening of our spine puts uneven pressure on our vertebrae (bones) but also on our discs (cushions between our vertebrae) which long term uneven pressure can cause them to bulge and press on our spinal cord (called a herniated disc).


It is recommended that children carry no more than 10 % of their body weight. For most 5 year olds with an average weight of 20 Kgs this is 2 Kgs only.


How much is 2 Kgs?

2 Kgs = Lunch box (cheese sandwich (2 slices of bread), apple, yoghurt, banana, 2 biscuits), empty drink bottle (500 ml), pencil case, 2 x 1B4 exercise books, P.E shoes, jumper.



Tips when selecting a school bag

  • Choose a bag that is proportional in size – when the straps are fitted the bottom of the bag should sit at the level of the hips
  • Shoulder straps should be well padded and wide to help spread the weight and fitted to reduce excess movement
  • Teach your child how to adjust their shoulder straps and place heavy items close to their back
  • Encourage them to use their locker or their desk to leave things they won’t need for the rest of the day
  • Full their drink bottle at school and empty it before leaving (if they are old enough to do this)



Reducing the risk of your child developing back pain will help ensure your child goes into adulthood with a ‘healthy back’.  ??


Babies have been swaddled or wrapped for thousands of years and it is enmeshed in many cultures around the world. It is designed to provide containment and mimic being in the womb. More recently in New Zealand swaddling was promoted with the introduction of the back-to-sleep campaign. Back sleeping is not an instinctive position for babies, but this combined approach helped them go to sleep and made an incredible difference to sudden infant death syndrome rates. However recently in some regions in New Zealand, there has been a move away from teaching new mothers how to swaddle. This intrigued me, so I went on a search to find the scientific evidence for the change in practice.

What does the research say?

Key findings: Tight, full-body, heavy fabric swaddling can cause significant issues

  • Swaddling that is tight with arms bound to their side (elbows straight) has been found to increase chest (respiratory) infections compared to non-swaddled babies
  • Tight swaddling around the hips and legs has been linked to hip development problems (hip dysplasia)
  • Heavy synthetic fabrics have been found to raise an infant’s body temperatures beyond the normally accepted temperature.

However there is nothing about how it might be beneficial for infants or parents if done correctly (hands up near their faces, loose around their hips, or not include their hips with a breathable light cotton fabric).

  1. If you recall your antenatal ultrasound scans, you may have seen your baby’s hands up by their face or busily sucking on their thumb or fingers. Developmental swaddling which encourages their hands up by their face can help maintain this familiar and comforting position.
  2. In neonatal units, supportive positioning is common practice as they are born with low muscle tone. Containment swaddling or nesting helps prevent over-stretching of chest muscles from the effects of gravity, provides good alignment of shoulder blades, and improves the baby’s energy expenditure. As a developmental therapist, there are noticeable differences in arm and body posture in non-swaddled term babies too. They tend to have tighter shoulder blade muscles and longer chest muscles making bringing their hands together and reaching up harder. It is visible when they are learning to roll and in sitting
  3. Containment can help babies learn self-regulation, their ability to self-settle in the first few months after birth. If you are a new parent, you would be familiar with this period called the fourth trimester. During this time, parents are encouraged to support their babies to learn this skill which helps them go to sleep and return to sleep if woken after a sleep cycle.
  4. I have heard the rumor babies who have not been swaddled lose their startle reflexes faster. In my experience, this is not the result of swaddling but the baby’s ability to control their arms. This voluntary control of their arms and legs is learned at around the age of two to three months.  If we are comparing babies who are swaddled all the time during their awake periods then yes but I am recommending developmental swaddling for sleep only.
  5. Good sleep is important to both parents and babies. For infants, good quality REM sleep is when they lay down their new learning for the day (motor learning) and this will help them learn the voluntary control discussed earlier as well as promote weight gain, growth, and stabilization of hormones compared to overtired upset babies.


When should I stop swaddling?

When your child starts showing signs of rolling from their back to their tummy is a good time to stop. For most babies, they learn to roll consistently at 4 to 5 months of age. Some babies roll earlier than this. If they have accidentally rolled over they might have demonstrated this skill once or twice then stop for a few weeks this is normal at 2 to 3 months of age.

I would recommend weaning the swaddling off. Start with no swaddling for day sleeps then progress to no swaddling for night sleeps after a few days of practice. The Love to dream range has a progression suit that allows you to zip off the arm covers to help them slowly get used to the change in sleep support.

Steps to Developmentally Swaddle

  • Hands up by their shoulders
  • keep it loose around hips and legs
  • use lightweight fabrics and do not overdress your baby
  1. lay wrap with a point at one end – like a diamond
  2. fold the top corner down around 1/3 of the wrap
  3. lay baby on the wrap with fold line at the level of their ear lobes
  4. tuck one hand into the “pocket” created from folding down the corner, pull the end across to the opposite side of their body, and tuck under
  5. repeat with their other hand as in step 5
  6. fold up the bottom of the wrap loosely fitting around their waist.

Watch the video to learn how to developmentally swaddle your baby. Check out the link here

I don’t want to developmentally swaddle my baby.

I would recommend providing opportunities to counter the muscle imbalance changes through play if you do decide to not use developmental swaddling. Encouraging more side-lying play, using body slings, and supporting their arms together during cuddles and feeds will help.

Thank you for taking the time to learn more about developmental swaddling.

Hopefully, this has answered a few of your questions and also allowed you to work out what is best for you and your baby when it comes to swaddling. If you stick to the developmental method of swaddling with breathable light fabrics it can be a great way to ensure a successful night’s sleep. But if you find it stressful or challenging then swaddling may not be for you.



  1. Patricia FrancoNicole SeretJean-Noël Van HeesSonia ScailletJosé GroswasserAndré Kahn. Influence of Swaddling on Sleep and Arousal Characteristics of Healthy Infants, Pediatrics 
  2.  Bregje E. van SleuwenAdèle C. EngelbertsMagda M. Boere-BoonekampWietse KuisTom W.J. Schulpen and Monique P. L’Hoir. Swaddling: A Systematic Review,
  3. Nelson, Antonia M. RNC-MNN, PhD, CNE, IBCLC Risks and Benefits of Swaddling Healthy Infants, MCN, The American Journal of Maternal/Child Nursing: July/August 2017 – Volume 42 – Issue 4 – p 216-225 doi: 10.1097/NMC.0000000000000344


It is likely that you have tried turning their head to the other side when they are asleep.  You have tried more tummy time. You have placed the toys on their non- favorite side but back their head goes. Although these are fantastic starting points to help with torticollis or head-turning preference, they are often not enough. If you are getting head shape changes then this just makes it even harder for your baby to turn their heads as often they have a lump or ridge that they have to get over.  At Auckland Children’s Physio this is something that parents are reaching out for us to help with. Starting early to address this means fewer appointments and faster results. The best results we have seen this past year had have been from the babies who are 6 weeks old at the time of their assessment. They have only needed 2- 3 sessions and they are able to turn their heads equally and easily from side to side and can be discharged. We want this for all babies as we don’t want it to drag on and affect how they use their hands, their rolling but also the associate visual and face changes we see in the more severe cases.


Is your child anxious about standing? or walking with their leg turned after their fractured leg has healed? These exercises will help. 

Some young children need a little helping hand to start walking after they get the “all clear” from the doctors. It doesn’t need to take a few weeks of them struggling to walk or need you to continue to carry them around. Unfortunately, not all children are able to be seen by a hospital children’s Physio when their cast has been removed but not to worry.  I have put together a FREE booklet of exercises that you can start with your child to help speed up their progress. Try these exercises if you find they are walking with their foot turned out, finding it hard to bend their knee, or walking like they have a ‘peg leg’. Download a copy here or email us at to get your free copy.

Download FREE booklet here: Lets get playing again!




High quality research is showing babies exposed to pain as new-born’s or infants have altered long term pain responses to those who aren’t exposed when they are older. Unfortunately stopping your baby experiencing pain can be unavoidable or be the greater of two evils e.g. newborn testing, 6 week immunizations. But we as parents can help. Evidence shows that babies that are getting skin to skin cuddles and breastfed prior and during the painful procedure will have a lower stress response, shorter crying duration and lower stress hormones than those babies that do not. This is more effective then medication even! So if you are soon to be a new mother ensure you are getting skin to skin and breastfeeding (likely to be just initiating) at birth whilst your baby has their vitamin K injection. When you take them for their 6 week and 3 month immunizations set yourself up to provide a cuddle (skin to skin ideally- try having a shirt that you can unbutton so your baby can snuggle in or you can give a breast feed to) and let your GP or practice nurse know the reason why. They can review the literature that supports this practice via the Cochran library or can get in touch and I will happily discuss the evidence further.

Below is a lovely summary that was created by professionals who are passionate at improving new-born babies pain experiences to help set them up for a happier future.


Our practice philosophy is to promote strength and development through play and exercise. We provide a holistic and comprehensive approach that is backed by clinical experience. We can create a tailored individual program to be implemented at home, childcare or school to help meet your child and family’s goals.

Copyright by Auckland Childrens Physio 2020. All rights reserved.