What Every Parent Needs to Know About: Rolling
Rolling is an exciting milestone because it is one of the first ways baby can change positions on their own! It is also the start of their mobility journey and it is exciting to watch them initiate movement and explore their world!
When do babies roll?
As a pediatric physical therapist I look for independent rolling between 4 and 6 months. Wether they roll back to belly or belly to back first can be influenced by how much they enjoy tummy time, the balance of extensor vs flexor muscles in their trunk, and their proportions. As long as baby is trying to roll both directions by 6 months I am generally not concerned. Some babies will roll belly to back at an early age, even before 4 months, and then stop. This is super common, and I get many calls from worried parents that their baby forgot how to roll! Babies have large heads in proportion to their bodies, and when young babies are in tummy time even just looking to the side can cause the weight of their head to roll them over. As they get more strength and control during tummy time, they stop this accidental rolling. After a period of time they learn how to shift their weight and use their strength to initiate a voluntary roll from belly to back!
Pre-rolling skills to watch for and support:
Visual tracking (being able to follow an object with their eyes, expected 2-3 months)
Plays in side-lying with or without support (allows practice for hands to midline play and activation of different trunk muscles, you can start supported side-lying play from birth!)
Reaching (reaching one, then both hands away from the body when on their back, expected 2-5 months)
Grabbing their feet babies need those wrong abdominal muscles to roll, expected 4-5 months)
Head righting (being able to lift their head is important to complete the roll from side-lying to belly, emerges at 2-3 months and strengthens until 6 months)
Fully lifts head and shifts weight side to side in tummy time (allows baby to initiate a controlled roll belly to back, expected 4-6 months)
How to work on rolling: (include pictures or videos for each)
Practice the parts before the whole! Work on back to side, or side to belly before practicing the whole roll.
Use a toy for motivation! We learn the best when we are working towards a goal, and for babies the goal is play. Have them track a toy as you move it to their side and in an arc so it ends up over their head (for rolling back to belly.) For rolling belly to back, use the same idea with having them track a toy to look to their side and then over their shoulder.
Help at the hips! Once baby is trying initiate rolling on their own, help at their hips to allow them to practice clearing their head and arms on their own.
Use gravity to assist! Practice rolling down a small incline to let gravity help them get over (always assist you baby for safety)
Practice, practice, practice! To master any new skill babies will practice it hundreds of times so give them lots of opportunities to practice
Why might a baby have difficulty with rolling?
While there are many reasons, here are some of the common concerns that I see.
Excessive arching or increased use of extensor muscles along the back of their trunk (this can lead to muscular imbalances and difficulty with coordination the movements needed for rolling. This can be seen more commonly in babies who were premature, have increased muscle tone, or have reflux.) (link to prematurity blog)
Weak abdominal muscles (a baby with weak abdominal muscles might not kick their legs, lift their pelvis, or reach their arms. This can be seen more commonly in babies with low muscle tone, or babies who have difficulty with floor play and/or tummy time.)
Retained ATNR reflex (present from birth, the ATNR reflex causes baby to move their arms into a “fencing” pose when they turn their head to the side. It weakens and then disappears around 4-5 months, but if it does not go away it can limit rolling since every time baby tries to start the roll their arm ends up blocking them.)
Torticollis and/or Plagiocephaly (if baby has any issues moving their head or has a strong preference to turn their head to one side, they often learn to roll only over their right or left. While they still roll on their own, if they only roll to one side this can lead to muscular imbalances and difficulty with coordination that leads to problems with symmetry of skills later on.)
When to seek support from a pediatric physical therapist:
Your baby is 4 months and not visually tracking, starting to reach, or kicking their legs
Your baby is 6 months and is not initiating rolling, or needs a lot of help to roll
Your baby is 7 months and not yet rolling independently both back to belly, and belly to back
Your baby at any age has a hard time turning their head to both sides, holds their head in a til to one side, or has a strong preference to turn to one side over the other (link tort blog)
Your baby has a flat spot on one side of their head, or flattening along the back of their head (link plagio blog)
You have any concerns or questions about your baby’s development!
If you have any concerns about your baby or question on how to support their rolling contact us today at (520) 633-2687 or visit our online scheduling portal to find our soonest opening!
The information provided in this blog post is for educational purposes only and not intended to be medical advice. Consult a medical professional or healthcare provide for diagnosis and treatment.