Development of head control when supported upright

The ability to hold the head steady and  to turn in different directions allows infants to connect with their surroundings. Over the first months typically developing infants also learn to hold the head steady and erects as they are lifted and moved and when they are carried and held erect when sitting on a caregivers lap. 

Learning these abilities is an essential prerequisite for learning to sit, creep and crawl and pull up to standing and walk. They are also needed for using the hands to explore, grasp and manipulate objects and use the hands for communication. 

Earlier maturational theories of development ascribed the emergence of  head control to maturation of  righting rand other postural responses. Modern developmental systems thinking about postural control emphasize the role of experience and infants' strong motivation to interact with the social environment and physical environment as drivers of infants' emerging control of head position and movements. 


Before you start

  1. Think about a child you have seen with poor head control due to developmental delay , CP. or other movement disorders. 
  2. How is the child's ability to function and participate in everyday routines and interaction with caregivers and other family members affected by poor head control?
  3. After reading this article, do you perhaps have any new ways of thinking about improving a child's head control? 

Head control when supported upright, being lifted and carried

When supported with the trunk upright, the newborn infant has the ability to briefly lift the head upright by extending the neck. . 

Within a few weeks infants are able to extend the neck for more extended periods when support around the the upper thorax and the tipped forwards or sideways. 

Infants' willingness to put effort into lifting the head is large driven and motivated by their interest is looking at people, interesting things and events in the environment.  

Max 9w handling 1.jpg

Video: Max at 9 weeks (3 weeks CA)



Over the next 1-2 months learn to extend the neck for more extended periods when support around the the upper thorax and when tipped forwards or sideways.

At 10 weeks Will can turn his head to the side as he inspects the environment. This position provides him with a new and different view of his surroundings. 

W 10w handling 1.jpg    W 10w handling 2.jpg

Video Will 10 weeks 



Head control when being lifted 

The action that occur during the everyday handling of the infant, such as being picked up from supine, provide the repeated experience needed to acquire the coordination and strength needed to support the head against gravity and adapt to the changing direct of the forces action on the head. 

These images show Max at 6 weeks (CA) keeping his head steady as something in the environment engages his interest. 

Max 9w picking up from supine 1.jpg      Max 9w picking up from supine 2.jpg     Max 9w picking up from supine 3.jpg    Max 9w picking up from supine 4.jpg

Infants who are carried in baby slings or wraps also have an opportunity to practice keeping the head erect as the caregiver moves around and bends forwards. 

Supporting the head when tipped backwards takes longer to develop and whe the infant is lifted forwards the head needs to be supported for the first months. 

Head control when supported in sitting 

From a 2-3 months care givers may also support the infant in sitting on the lap. Caregivers adjust the level of support provided around the chest depending on the infant's abilities to keep sustain extension of the neck and upper  thoracic spine.  

Max 10w supported sitting 3.jpg         Max 10w supported sitting 2.jpg

Head control when being lifted from supine

This series of images illustrates how a caregiver can adjust her support to allow an infant to control the position of the head as he is lifted from supine. 

Max 10w pciked up 2.jpg    Max 10w pciked up 3.jpg    Max 10w pciked up 4.jpg    Max 10w pciked up 5.jpg


To put Max down  again in prone, tip him forwards and lower him to the supporting surface.  Notice how he is able to maintain the neck extensions and he is head is moved through space. 

Max 10w pciked up 5_1.jpg   Max 10w pciked up 8.jpg

Video Max  5 weeks (CA) lap sitting and being lifted

This video clip nicely illustrates the effort infants need to expend in order to keep their head upright when supported in sitting. After a while he tires and his head drops forwards, but quickly lifts it up again. I without without really thinking too much about it adjust my hands to provide more support. 

Towards the end of the clip you I lift Max up from supine, and then put him back down in prone.