Infants who do not put their feet down to stand

From about the age of 6-7 months most infants will start to put their feet down, stiffen their legs and take some weight when held vertically with their feet on a firm surface.   Some infants seem to really like doing this and prefer to stand rather than sit on a caregivers lap. 

Some infants do not extend the hips and knees in readiness for standing

Here you see how Will (8 months) first bends his legs, then extends them in readiness for standing when he is picked up. 

Picking up 8m.jpg   Picking up 8m 1.jpg   Picking up 8m 2.jpg        

There are a group of infants who do not  extend their lower extremities in readiness for taking weight on their feet.  When you pick them up, they flex the the hips and knees, or hold the LEs straight forwards as if they are sitting on air.  There is no good explanation for why some infants do this and in most cases they eventually start to take an interest in standing on their feet.  

All the infants whom I have seen doing this have been hypermobile, so there may be some link to hypermobility.  And walking has been delayed. 

R 10  asitting on air 2.jpg   R 10m sitting on air 1.jpg

What you can do to encourage an infant to start standing 

Start by practicing sitting on a low step
Start by encouraging the infant to take some weight on the feet when sitting on a low step with the feet on the floor.

Now play games that encourage the infant to lean forwards to retrieve, bang, pull, push or  knock over a toy.

These pictures show how Will at  8 months leaning forwards to grab my hands. You can see how this action brings his weight forwards over his feet.  (Here he is sitting on a 10 cm high high density foam block.)

8m sitting on step and standing up 1.jpg    stand up from step.jpg

Reaching forwards transfers some of the weight over onto the feet and provides the first experience of pressing down on the floor with the feet when in the upright position. 

R 10m sit on step 1.jpg   R 10m stand up low block 27.jpg   

You may need to provide some support to stop the thighs from moving sideways

You can use your hands to do this or let the infant sit between two heavy sandbags that keep the thighs in place. 

Here you see how I am supporting the thighs to stop them moving laterally and also pushing down a little on his feet to get Max used to putting some weight through them. 

T 10m sitting 18.jpg   T 10m sitting 20.jpg

Sitting on a higher surface encourages more weight shift onto the feet
Here you see Max leaning forwards a lot further. Because he is sitting on a higher surface he is getting more weight onto his feet. I am supporting his thighs to stop them from moving laterally.  As I do this I feel him actively pushing against my hands as his hip abductor muscle contract . Because I am stabilizing the thighs, the hip abductor muscle cannot shorten as they contract, imposing an active stretch on them. 

 sitting hip stretch 1_1.jpg    sitting hip stretch.jpg

Initially you may also need to provide some support at the ankles to keep the feet flat on the floor. 

The infant who refuses to put the feet down on a hard surface

If the infant does not like putting the feet down flat on the floor you will need to spend some time desensitizing the feet. Here are some ideas.

1  Start with the infant sitting on a low step. I use a 10-15  cm high very firm foam block.  A couple of telephone books taped together also make a good step.

Sit in front of the infant and support the feet just above the ankles. Now you can play stomping games – stomp the feet alternatively on the floor as if they are marching. Sing a marching song or count in a fun way. 

Try this barefoot or with shoes on, whichever works best for the infant. 

2  You can also try letting the infant sit  with the bare feet on different surfaces such a pillow, soft rug, grass or sand to get the infant used to the feel of these. 

Encourage your infant to be more active sitting on the floor

Infants who move from sitting into crawling and kneeling positions use their feet for leverage and will often put them down flat on the floor. This not only helps to strengthen the LE muscles but get the infant used pushing down on the floor with the soles of the feet. 

The pictures below show two toddlers moving from sitting to positions where he is supporting himself on his hands and feet in different ways.

T 13m sit to kneel 7.jpg   active sitting 4.jpg   active sitting 10.jpg

Infants like to stand up facing a caregiver
Getting up from sitting on a low step is easier than getting up from sitting on the floor and helps to strengthen the LE muscles.

It helps to start with the infant sitting on a step that is a bit higher so that it is easier to stand up. I like to use my leg so that I can give a little bit of a lift in the beginning.

Here you see Roan pulling on me and my clothing to balance in standing. 

R 13m standing up 1.jpg   R 13m standing up 2.jpg   R 13m standing 3.jpg   R 13m standing up 4.jpg

It is best not to help the infant to stand up
Let her do the work all by herself. If you help her she is not learning to coordinate her trunk and leg muscles to get the action right. 

R 13m stand with Pam 11.jpg   R 13m stand with Pam 14.jpg

 

Games that will get your infant reaching and pulling up

Try these ideas when you are encouraging your infant to stand up using you for support. 

  • Put a hat on your head – or any toy that will rest on top of your head.  
  • Put the infant’s clothes on your head – they usually find this funny. 
  • Peek-a-boo games using a scarf over your head.
  • Put a  string of beads around your neck – be sure that they are strong enough not to break when pulled on.