[Blog] Ep 47. 0-1 Year Baby Milestones: Development & Delays

ft. Dr. Megha Arora, Pediatric Physiotherapist

Milestones Matter: How to Support Your Child’s Growth Journey

As modern Indian parents, we’re constantly surrounded by developmental timelines, baby comparison videos, and milestone charts. But how do we sift through it all and focus on what really matters for our child’s growth? In a powerful episode of The Modern Indian Parent podcast, host Sanchita Daswani speaks with Dr. Megha Arora, a pediatric physiotherapist and founder of Mommy Theories, to demystify developmental milestones and help parents feel confident about supporting their children.

What is a developmental milestone?

Milestones are a way to track the growth and development of children. According to Dr. Megha, they are observable behaviors or skills that children typically achieve within a certain age range.

• Physical milestones include both gross motor skills like rolling, sitting, and crawling, and fine motor skills like grasping a toy or using a spoon.

• Communication milestones cover babbling, saying simple words, or making eye contact.

• Cognitive milestones involve problem-solving abilities—like playing peek-a-boo or stacking toys around 9 to 12 months.

Dr. Megha emphasizes that while not all children follow the exact timeline, these benchmarks help identify delays and allow for early interventions.

How do we know when there is a developmental delay?

Every milestone comes with a range, typically a 3–4 month window.

• Sitting up can happen between 4–9 months; if there’s no sign by 9 months, it’s considered delayed.

• Crawling may begin as early as 6 months but can extend to 12 months.

Megha recommends watching for the end of the timeframe. If you approach the limit without progress, it’s time to step in. Early intervention is key in preventing the child from skipping foundational milestones.

Should milestones be reached on their own or do we help as parents?

There’s a common belief that kids should develop naturally without interference. But Megha disagrees.

• “You have to help them initially,” she says. Newborns need support due to reflexes and weak muscle tone.

• Activities like tummy time and assisted sitting are not optional—they're essential tools to help kids progress.

Megha emphasizes that active parental involvement determines not just milestone completion, but long-term physical and cognitive outcomes, including academic performance later in life.

When should you start tummy time and for how long?

Tummy time doesn’t need to wait, it should start as early as the first week after birth.

Dr. Megha explains that because babies now sleep on their backs to prevent SIDS, their back muscles tend to get overused while the front muscles are neglected. Tummy time helps balance this out by working on neck, shoulder, and core strength, laying the foundation for rolling, sitting, and more.

Megha recommends:

• Start small. Begin with 1–2 minutes during diaper changes or while doing skin-to-skin on your chest. That counts as tummy time!

• Follow your baby’s cues. If they fuss, roll them back. Gradually build their tolerance.

• Make it interactive. From the second month, place high-contrast cards or crinkly toys in front of them while they’re on their tummy. Sit at eye level and talk to them.

• Do it often. Aim for one active tummy time session during every wake window. As babies grow, these sessions can last 5–15 minutes.

Tummy time doesn’t mean you need to place your baby flat on the floor right away. You can ease into it with your lap, your chest, or assisted tummy time on soft surfaces. It’s about building strength gently and consistently in those crucial early months—especially before rolling begins, since once they can roll, it gets harder to keep them on their tummies!

How to encourage a baby to roll over?

Tummy time helps but side lying play is the unsung hero here.

• Side lying reduces gravity’s resistance and helps babies understand the mechanics of rolling.

• Start early with a supported side lying using towels or your leg.

• Use rattles or contrast flashcards to keep the baby engaged.

Megha recommends alternating sides to not only help rolling but also support even skull development, preventing conditions like flat-head syndrome.

This approach doesn’t need to wait. As early as the newborn stage, you can begin assisted sideline play. Dr. Megha recommends supporting your baby with a rolled towel or even your own leg to help them stay comfortably on their side. From the second month onward, you can introduce short sideline play sessions with rattles, crinkly books, or contrast flashcards to keep your baby engaged. Just five to six minutes per side is enough to make a real difference.

Do babies need pillows?

The answer is a firm no.

• Pillows, especially head-shaping ones, pose a suffocation risk.

• They don’t offer the same benefit as side positioning, which applies gentle and natural pressure for skull shaping.

• Head massages and oil rituals are also myths, and could be dangerous when applied over soft spots.

Megha shares that even pediatricians often downplay flat spots, but her own experience as a mother and physiotherapist showed her how they can lead to muscle imbalances and developmental issues like scoliosis later.

Make sure milestones happen on both sides

Drawing from her own experience, Megha shares how her daughter developed a flat spot on one side of her head, which gradually led to tight neck muscles, a preference for one side, and asymmetrical crawling. As a physiotherapist, she noticed these early and corrected them, but she also realized that most parents might not even know to look for such patterns.

Megha recommends:

• Encourage your baby to roll both ways- left and right.

• Make sure they crawl symmetrically on hands and knees, not just dragging or scooting.

• Observe if they’re cruising (walking while holding furniture) in both directions.

This emphasis on bilateral movement supports balanced muscle development, proper posture, and even long-term spinal health. It might seem like a small detail now, but ensuring your child uses both sides of their body equally helps set the stage for smooth transitions into walking, coordination in school activities, and even avoiding chronic pain later in life.

Why your baby must sit up before starting solids

Before introducing solids, there’s one crucial readiness sign parents often overlook: the ability to sit up with minimal support.

• Good head and neck control indicate that digestive muscles and enzymes are ready too.

• Feeding while reclining or in a bouncer is a choking hazard.

• Babies need to be able to reach, grab, and self-feed to some extent.

Sanchita and Megha agree that sitting before solids supports both nutritional and physical development.

The takeaway? Wait until your baby can sit up with minimal support, usually around six months, and never rush the process. As Sanchita gently reminds us: “They’re going to be eating their whole lives. There’s no need to hurry.”

What do we need to do to help our kids sit up at the right time?

Sitting doesn't happen overnight, it’s built on earlier skills.

• Tummy time → Rolling on both sides → Supported sitting.

• Start supported sitting after baby can roll.

• Use mirrors, suction toys, and gradually reduce support.

Megha suggests using an exercise ball to improve balance, and always turning sitting practice into fun play.

Why practicing sitting up will not hurt their back

A major myth is that early sitting strains the spine.

• Megha assures parents that this fear is unfounded. The sitting position mimics the natural fetal C-curve.

• Avoid standing babies too early, but supported sitting post-head control is safe.

She also emphasizes that waiting for “functional sitting” before offering support might actually delay development.

Do baby seats help with sitting?

No, baby seats are developmental containers, not facilitators.

• Bumbo seats, bouncers, and jumpers limit free movement and reduce active muscle engagement.

• They often delay sitting and crawling because the child isn’t learning to balance or move on their own.

Megha recommends a thick foam floor mat and open playtime instead. Let babies explore, fall, and build strength naturally.

Why Crawling Shouldn’t Be Skipped

Crawling may seem like just a transitional phase, but Megha makes it clear—it’s essential, not optional.

She explains:

• Crawling helps build upper body strength by putting weight on the shoulders, arms, and hips.

• It supports brain development through cross-body coordination—opposite hand and leg movements activate both sides of the brain.

• These neurological connections support later skills like writing, using tools, and self-feeding.

• Crawling also improves balance, posture, and spatial awareness.

Parents sometimes see skipping crawling as a sign of advancement. But Megha warns that it’s usually a sign of muscle tightness, weakness, or early encouragement of the next milestone (like standing or walking) before the child is ready.

Her advice is simple: Don’t treat crawling as optional, it’s a foundational skill with long-term benefits.

How to encourage a baby to crawl?

If your child is walking but hasn’t crawled, it’s not too late.

Megha recommends:

• Use tunnels, obstacle courses, and crawling games, even for toddlers.

• Focus on three play positions: side sitting, high kneeling, and all-fours supported on your thigh.

• Encourage crawling for a few minutes daily, even during play, to build shoulder and core strength.

Why are there delays in walking?

Walking can happen anytime between 12–18 months. Delay is only a concern if there’s no standing attempt by 15 months.

Megha suggests:

• Ensure your baby gets enough safe floor time.

• Provide stable furniture to pull up and cruise.

• Avoid walkers—they can delay walking by developing compensatory patterns.

Instead, try:

• Parent-to-parent walking practice across a room.

• Building confidence through supported cruising.

Do we need to worry about toe walking?

Megha assures parents that toe walking is normal up to a point.

Here’s when to worry:

• If your child is over two years old and toe walks more than 80% of the time.

• If there’s no ability to walk on heels.

• If the pattern persists for more than four weeks.

Otherwise:

• Keep your baby barefoot indoors to help develop foot muscles and arches.

• Shoes should only be used outdoors after two months of confident walking.

Final Thoughts

Dr. Megha Arora’s advice is clear, science-backed, and deeply empathetic. As parents, our job isn’t to rush our children through milestones, nor is it to sit back and wait. It’s to be active participants in their journey, providing the right environment, the right tools, and the patience to let them grow at their own pace.