When Should I See a Paediatric Physiotherapist for My Baby

It can be difficult to know whether your baby is simply developing at their own pace or whether something about their movement or development is worth checking.

Babies develop at different rates, and there is a wide range of typical development. A paediatric physiotherapy assessment isn't just about checking whether your baby has reached a milestone by a certain age. We also look at how your baby moves, how they use both sides of their body, their strength and muscle tone, and how their skills are progressing over time.

If you have noticed something about your baby's movement that doesn't seem quite right, or you simply aren't sure, an assessment can help determine whether they need some extra support or whether their development is progressing as expected.

When should I seek physiotherapy advice for my baby?

It may be worth speaking to a paediatric physiotherapist if you notice that your baby:

  • strongly prefers looking or turning their head to one side

  • has a persistent head tilt

  • has flattening or asymmetry of their head shape

  • finds tummy time particularly difficult

  • isn't lifting or controlling their head as expected

  • consistently uses one arm or leg more than the other

  • seems unusually stiff or unusually floppy

  • isn't progressing towards rolling

  • only rolls in one direction

  • isn't progressing towards independent sitting

  • has difficulty taking weight through their arms or legs

  • isn't progressing towards crawling, standing or walking

  • moves in a noticeably asymmetrical or unusual way

  • frequently stands on their toes

  • has lost a movement skill they could previously perform.

You may also choose to see a paediatric physiotherapist if your baby was born prematurely, has spent time in a neonatal or special care nursery, has an identified medical or developmental condition, or has other factors that mean their development requires closer monitoring.

Importantly, your baby does not need to have a significant developmental delay to benefit from an assessment.

My baby hasn't reached a milestone. Should I worry?

Not necessarily.

There is much more variation in normal development than milestone charts sometimes suggest.

Research from the World Health Organization found broad windows for when healthy children achieved major motor milestones. For example, independent sitting occurred between approximately 3.8 and 9.2 months, while independent walking occurred between approximately 8.2 and 17.6 months in the children studied.

This is one reason we don't assess babies using milestones alone.

Instead of simply asking “Can they roll?” or “Are they crawling yet?”, we also look at the skills developing underneath the milestone.

For example, if your baby isn't rolling yet, we may look at whether they can:

  • comfortably turn their head in both directions

  • reach and play with both hands

  • bring their hands towards the middle of their body

  • reach across their body

  • tolerate tummy time

  • lift and turn their head during tummy time

  • shift their weight from side to side

  • use both sides of their body equally.

Sometimes a baby hasn't achieved a particular milestone yet, but all the building blocks are developing well.

Other times, there may be something relatively simple making the skill more difficult.

What does a paediatric physiotherapist look for?

A paediatric physiotherapy assessment looks at your baby's overall movement and development, rather than focusing on one milestone.

Depending on your baby's age and the reason for the assessment, we may look at:

Gross motor development

This includes skills such as head control, tummy time, rolling, sitting, crawling, pulling to stand, standing and walking.

Movement quality and symmetry

We look at how your baby moves.

Does your baby use both sides of their body? Do they consistently turn one way? Do they reach equally with both hands? Is one leg doing something different from the other?

Small differences can sometimes be more useful clinically than simply knowing whether a milestone has been achieved.

Muscle tone and strength

Some babies have low muscle tone (hypotonia) and may appear particularly floppy or have difficulty maintaining positions against gravity.

Other babies may appear unusually stiff.

We also look at your baby's functional strength and how effectively they can use their body during everyday movement and play.

Head and neck movement

A strong preference for looking in one direction can sometimes be associated with torticollis or restricted neck movement.

Persistent head preference can also contribute to positional plagiocephaly, where one area of a baby's head becomes flattened.

Posture and joint movement

Where appropriate, we may assess your baby's neck, spine, hips, legs and feet, as well as how they position themselves during play.

What if my baby was born prematurely?

Babies who were born prematurely should generally have their development considered using their corrected age, particularly during the first two years of life.

Corrected age takes into account how early your baby was born.

For example, if your baby is 6 months old but was born 8 weeks early, their corrected age is approximately 4 months.

This is important because it would usually be inappropriate to compare their motor development directly with a six-month-old baby who was born at full term.

Many babies born prematurely develop extremely well. However, prematurity can increase the likelihood of some developmental difficulties, particularly for babies born very prematurely or those who experienced complications around birth.

Developmental follow-up allows us to monitor not only when milestones occur but also the quality and progression of your baby's movement over time.

Do I need to wait and see?

Sometimes watching and waiting is completely appropriate.

However, you don't necessarily need to wait until your baby is significantly delayed before asking for advice.

Early assessment can be particularly useful when there is:

  • a persistent difference between the two sides of the body

  • unusual muscle tone

  • restricted neck movement

  • significant head flattening

  • loss of previously acquired skills

  • very limited progression in movement

  • a neurological or developmental concern.

If everything looks appropriate for your baby's age, that reassurance can also be valuable.

What happens if my baby's development is within the typical range?

Sometimes our assessment confirms that a baby's development is progressing well.

In these situations, parents may only need reassurance and some simple ideas about what to encourage next.

We can show you ways to use everyday floor play, toys, positioning and your normal routines to give your baby opportunities to practise their emerging skills.

Not every baby who has a physiotherapy assessment needs ongoing physiotherapy.

What if my baby does need some help?

Physiotherapy for babies should look very different from physiotherapy for adults.

For most babies, physiotherapy involves play, movement and positioning incorporated into normal daily life.

Depending on what we find, this may include helping your baby practise:

  • tummy time

  • reaching and weight shifting

  • rolling

  • sitting and transitions

  • crawling and floor mobility

  • pulling to stand

  • standing and balance

  • walking

  • symmetrical movement and use of both sides of their body.

The aim is to give your baby opportunities to actively practise the movements they are learning, while giving parents practical strategies that can realistically fit into family life.

When should I seek urgent medical advice?

Physiotherapy does not replace medical assessment.

Seek medical advice promptly if your baby loses skills they previously had, becomes suddenly weak or floppy, develops a sudden significant change in their movement, or you have concerns about their general health or wellbeing.

If you are unsure whether a concern is developmental or medical, speak with your GP, paediatrician or child health professional.

Our focus is on early assessment, evidence-based physiotherapy and practical strategies that families can incorporate into everyday life.

If you have noticed something about the way your baby moves or you are unsure whether their development is progressing as expected, you don't need to wait until there is a significant delay before seeking advice.

Evidence & References

World Health Organization Multicentre Growth Reference Study Group. WHO Motor Development Study: Windows of achievement for six gross motor development milestones. Acta Paediatrica. 2006;95(S450):86–95.

World Health Organization. Child Growth Standards – Motor Development Milestones.

Sargent B, Coulter C, Cannoy J, Kaplan SL. Physical Therapy Management of Congenital Muscular Torticollis: A 2024 Evidence-Based Clinical Practice Guideline from the American Physical Therapy Association Academy of Pediatric Physical Therapy. Pediatric Physical Therapy. 2024;36(4):370–421.

Novak I, Morgan C, Adde L, et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy: Advances in Diagnosis and Treatment. JAMA Pediatrics. 2017;171(9):897–907.

American Academy for Cerebral Palsy and Developmental Medicine (AACPDM). Central Hypotonia Care Pathway.

Royal Children's Hospital Melbourne. Clinical Practice Guideline: Congenital Torticollis.

Queensland Health. Child Health and Development Guidance.