Babies can be baffling, and there is certainly no shortage of confusing literature when it comes to raising them. Tummy time or not? Ferber or co-sleep? Spoon-feed or baby-led weaning? With so much (often contradictory) information out there, it’s best to get a professional opinion about whether your baby is doing just fine or if they could use some help.  

Dima Alsakka is an Occupational Therapist who is passionate about working with babies and young children. Her work is based in various areas of childhood development, including motor development, sensory regulation, attachment theory, and cognitive developmental theory. She will be presenting this month as part of the 4 Trimesters: Pregnancy, Birth & Postpartum Conference taking place October 27. We chatted with Alsakka about infant development, the pressure to hit milestones, and when to actually be concerned. 

SDTC: What is important to keep in mind regarding baby development during the first year?

DA: Establishing positive attachment and healthy co-regulation skills between you and your baby is essential during this time. It can have a tremendous long-term impact on the baby. Attachment can happen through many daily living activities (like feeding, bathing or playing), and I’ll be talking about that during my workshop.

Should we worry if our little one is not hitting age-appropriate milestones?

You should definitely consult with your pediatrician or family physician if you feel your baby is not reaching cognitive or motor milestones, or if you observe an atypical pattern of development, such as only using one hand to reach and grasp items, or only attending to sounds coming from one side of the body.

Keep in mind that sometimes delays are just perceived to be delays by well-meaning caregivers. For example, parents often worry that their child hasn’t learned to sit, crawl or walk yet; however, when I complete an assessment, the child’s gross motor skills look typical. The baby may just be taking a bit longer to achieve that milestone.

If we are worried we aren’t doing enough to stimulate growth and development, what are practical ways we can incorporate these activities into daily life?

Great question! My answer to this for parents of typically developing babies is always the same: provide them with time for free, unstructured play. There really is no need for any fancy high-tech toys, equipment (e.g., swings, bouncers, playpen) or technology (baby videos and tablet games). In fact, research has shown that “low-tech,” unstructured play is actually the most stimulating for motor and cognitive development and provides the richest learning experience.

I always ask parents and caregivers to find an area in their home that can be a designated “safe space” for the baby to play and explore on the floor with age-appropriate toys. If they want to play with their child, I recommend that they sing, play and read to their baby in that space. They can also observe and verbalize what the baby is doing (e.g., “I see you like the red car…it goes vroom vroom“).

I also love sensory play, and there is a lot of evidence that it can support the development of healthy sensory-regulation skills (e.g., being able to manage noisy environments or bright lights). This can be incorporated into unstructured play-time.

What do you wish more parents knew about infant development?

That the spectrum of typical development is very wide. For example, typically developing children can take their first steps as early as nine months or as “late” as eighteen months; nonetheless, I always tell parents to trust their gut feeling and seek help if they are concerned.

What are the biggest developmental issues you are seeing in your practice?

I have been seeing a lot of clients for feeding and oral-motor issues in babies as young as six months. I meet a lot of parents who struggle getting their babies to transition to table foods, to accept new textures or flavours, and to establish positive mealtime routines. Some of these children have a diagnosis for a developmental disorder (like Autism Spectrum Disorder), but many of my clients are typically developing children too. We all assume that children will just figure out how to eat and chew on their own; however, after about four to five months of age, oral-motor skills are no longer reflexive (like a newborn suckle). They are learned behaviours.