If you’ve spent any time looking for baby advice online, you’ve probably noticed something confusing.

One person says to do one thing. Another says to do the exact opposite.

Sometimes they’re both pediatric physical therapists.

So who’s right?

The answer is often: both of them (or neither of them. Or maybe just one of them).

The challenge is that good advice is usually meant for a specific situation. When that context gets left out, parents are left wondering what they’re supposed to do.

I was recently reminded of this during a therapy session.

A father had seen a pediatric physical therapist on Instagram demonstrate a simple trick for babies learning to crawl. The therapist wrapped a soft headband around the baby’s thighs while the baby was on their hands and knees. The idea was to keep the knees from sliding apart.

His son was just beginning to learn this position and like the baby in the video, his knees would slide outward.

“Should we try that?” he asked.

For his baby, my answer was no.

Not because the idea was bad. Because it solved the wrong problem. The therapist wasn’t wrong. She was likely thinking about a different kind of baby than the one sitting in front of me.

As we brought him up into hands and knee position, he tried to move forward immediately. Wrapping a band around his legs may help keep his legs together, but it would also make it harder for him to experiment with movement.

Instead, I suggested that the parents sit behind him with their own legs gently supporting the outside of his knees. As he tried to crawl forward, they could easily adjust their position while still allowing him to move freely.

The goal for this child wasn’t simply to keep his knees together. We wanted to support his movement without getting in the way of it.

Now picture a baby with a different challenge. 

Some babies have much lower muscle strength. They work hard just to stay on their hands and knees as their legs slowly slide apart. This type of baby needs help to allow them to stay in the position.

For this baby, a headband around the thighs might be helpful. By giving a little extra stability, it allows the baby to stay in the position and build the strength it needs.

I don’t know the therapist who made the video, but I’d be willing to bet she usually works with this type of baby. 

I think what makes it hard for parents to decipher all the available information is that most of the advice is good advice for a specific circumstance. That’s why it often makes sense when you hear it but then doesn’t work out the way you expected.

I used to collect advice from almost anyone who was willing to give it. Sometimes it helped. Often time it didn’t. Eventually I realized the problem wasn’t the advice itself. I simply wasn’t playing the same game as the person giving the advice.

Over the last couple of years I have gotten better at figuring this out. First, I realized that I needed to understand the person’s perspective for giving the advice. I would suspect that the person in the Instagram video had worked with several kids who were very weak and thus did not have much desire to move out of the hands and knees position because they were working so hard just to maintain it.

This perspective is different from the circumstances of this particular child who is typically developing and very motivated to move.

The second thing I figured out has more to do with people close to us who give advice. The people who love us most are incentivized to give safe advice. If we dream big we might get disappointed. We might fail.

So if a loved one seems to be talking you out of your dream, know that it comes from a place of love. Listen to their objections because they may have some valid concerns, but ultimately make the decision that best fits your circumstances and goals rather than their perspective.

Whether you’re trying to help your baby crawl or trying to make a big life decision, I’ve found it helpful to ask the following questions:

What experiences led this person to give this advice?

What incentives do they have to give this advice?

Once you understand the perspective behind the recommendation, it’s much easier to decide whether it fits your situation.

Good advice isn’t universal.

It’s contextual.

FAQ

Why do experts sometimes give different advice about babies?

Babies may look similar while struggling with the same skill, but the underlying reason they’re struggling can be very different. One baby may need more support to build strength, while another simply needs room to move and experiment. Good therapists often recommend different approaches because they’re solving different problems. Asking good questions to understand why the advice was given will help you understand whether the advice applies to you and/or your baby.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

If a baby spends a lot of time with pressure on the same part of their head, that can contribute to flattening. This is one reason parents are often encouraged to give their baby tummy time, vary positions, and avoid too much time in car seats, swings, bouncers, and other containers.

But there is another reason flat surfaces matter.

It is not just about the shape of your baby’s head. It is also about the small movements your baby makes when their body is not being molded by a device.

The American Academy of Pediatrics recommends that babies sleep on their backs on a firm, flat, non-inclined surface, such as a crib, bassinet, or portable play yard with a fitted sheet. They also recommend avoiding routine sleep in seating devices like swings and car safety seats, except while riding in the car.

That recommendation is primarily about safety.

But as a pediatric physical therapist, I also think about it from a movement perspective.

Here’s what’s going on:

A flat surface gives your baby’s body more reason to make little adjustments. A container gives your baby’s body more reason to relax into the shape of the device.

That may sound like a small difference, but for a baby, small movements matter.

Containers quiet your baby’s body

A container is anything that holds your baby in place.

Car seats, swings, bouncers, strollers, infant seats, and similar devices all do this in different ways. They support your baby’s body. They often curve around your baby. They may keep the hips, trunk, shoulders, and head in a fairly fixed position.

That support can be useful. It can keep your baby safe while you do something necessary. It can give you a needed break.

But the same support that makes a container useful also changes what your baby’s body has to do.

When your baby is held by a device, the device does some of the work for them.

Their trunk does not have to adjust as much. Their head may settle into one spot. Their shoulders and hips may be held in a certain position. Their body has less reason to make the tiny adjustments that happen when a baby is resting on a flatter, more open surface.

A container does not just contain your baby. It shapes your baby’s body and reduces their need to respond.

Think about a big bear hug

Imagine someone gives you a big bear hug.

At first, you may wiggle a little. But if the hug is firm enough, your body eventually gives in. You stop trying to move as much. You relax into the pressure because there is not much else to do.

A baby container can work in a similar way.

The seat curves around the baby. The straps hold them in. The padding supports them. The baby’s body settles into the shape of the device.

It is different from resting on a flat surface.

On a flat surface, the baby’s body is not being hugged into one shape. There is more room for small shifts. The baby may turn their head a little. They may adjust their shoulders. They may move their arms or legs. They may subtly change how their trunk rests against the surface.

Babies move even when they are resting

When we think about baby movement, we usually think about the obvious milestones.

Rolling. Sitting. Crawling. Pulling to stand. Walking.

But babies are also developing through tiny movements that are easy to miss.

A baby lying on a flat surface makes small adjustments with their head, neck, shoulders, trunk, arms, and legs. Even when resting, their body is still receiving information from the surface underneath them.

These little movements help a baby get to know their body better. It makes bigger movements possible.

A container reduces these movements.

In a car seat, swing, or bouncer, the device gives the body more external support. The baby does not have to respond as much to gravity, the floor, or their own position. The device holds them in a more fixed shape.

That does not mean every moment in a container is harmful.

It means containers should be used sparingly.

Flat surfaces ask more from your baby’s body

A flat surface does something very helpful: it gives your baby’s body a more neutral place to rest and adjust.

When your baby lies on a firm, flat surface, their body has more freedom. Their head is not tucked into the same curved seat. Their trunk is not molded into the same shape. Their shoulders and hips have more room to settle naturally.

This allows for small, natural movements. Your baby may not look like they are doing much. But their body is still working in quiet ways.

This is one reason I like babies to have plenty of time outside of containers.

They need time to respond to the world instead of being shaped by the device.

Why this matters during sleep

Most parents think about container time when their baby is awake.

That makes sense. Awake time is when we think about tummy time, reaching, rolling, kicking, and playing.

But sleep position matters too.

Even when your baby is asleep, their body is still responding to its environment. That surface they are on is either giving them room to settle naturally, or it is molding them into a specific position.

A car seat, swing, or bouncer often places a baby in a curved or semi-reclined position. The head may fall to one side. The trunk may stay rounded. The shoulders may stay forward. The hips may stay flexed.

A flat sleep surface gives the baby’s body a different experience.

It does not wrap around them in the same way. It does not hold them in the same curve. It gives their body more room to make small adjustments.

That is the part many parents do not think about.

Sleeping in containers is not only about head shape.

It is about how much the container conforms to the baby’s body and how much movement that conformity discourages.

What about babies who sleep better in containers?

Many babies seem to sleep better in a car seat, swing, or bouncer.

They may settle faster. They may like the snugness. They may like the incline. They may like the motion. They may feel held.

A container can feel calming for the same reason a bear hug can feel calming. It gives support. It reduces freedom. It quiets the body.

It’s okay if a baby falls asleep in a container from time to time, but it is best if we can move them to a flat surface to finish their nap.

Car seats are for the car

Car seats are essential.

Use them every time your baby is in the car. A properly used car seat is one of the most important safety tools you own.

But car seats are designed for travel. They are not designed to be your baby’s regular bed.

This distinction helps parents avoid unnecessary confusion.

If your baby falls asleep while you are driving, that is normal. You do not need to panic.

But once you are home or at your destination, the better habit is to transfer your baby to a flat sleep surface when it is safe and practical to do so.

The American Academy of Pediatrics’ parent guidance says that if a baby falls asleep in a car seat, stroller, swing, infant carrier, or sling, they should be moved to a firm sleep surface on their back as soon as possible.

That does not mean you need to panic over every car nap.

But it does give you a good default habit:

Car seat for travel.

Flat surface for sleep.

Where head shape fits into this

If a baby spends a lot of time with pressure on the same part of their head, they can develop flattening on one side or the back of the head. If they often rest with their head turned one way, they may also develop a preference for that direction. This can lead to developmental problems down the road.

Containers can contribute to this because they reduce variety and make it easier for your baby to settle into one preferred spot.

A flat surface gives your baby more variety of positions and an easier time changing to a different position. These factors make it less likely that your baby’s head will develop a flat spot.

Practical takeaway

Containers are useful because they support your baby. But that support is also the reason they should not become your baby’s main resting place.

A container holds your baby in one shape. A flat surface gives your baby more room to make small adjustments.

Those little movements may not look impressive, but they matter.

They help your baby experience their body, shift position, turn the head, settle differently, and avoid being molded into the same posture over and over again.

FAQ

Is it okay if my baby falls asleep in the car seat?

It is common for babies to fall asleep in the car seat while riding in the car. The car seat should always be used for travel. But once you are out of the car, it is best to move your baby to a firm, flat sleep surface on their back as soon as it is safe and practical.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

When I was at the park this week, I was reminded of something I think many parents do not think about.

There was a baby sitting in a car seat while her mother sat on a bench and read. Her toddler brother was climbing on the playground.

That is very normal. Most of us think about taking toddlers and older kids to the park. They need space to run, climb, swing, slide, and get their energy out.

But what about babies?

I like parks for babies too.

The experience is different, of course. A baby is not going to run across the grass or climb the ladder to the slide. But a park can still be a very helpful place for your baby’s development.

Here’s the simple idea:

A park visit does not have to be a “playground” visit for your baby. It can be a floor-time visit in a new place.

For young babies, that may mean tummy time on a blanket.

For older babies, it may mean rolling, reaching, crawling, or pulling to stand near the edge of the playground.

And for you, it may simply mean getting out of the house, breathing fresh air, and resetting the day.

Why I like park visits for babies

Sometimes you and your baby just need a change of scenery.

The house can start to feel small. The same toys, the same rooms, the same floor space, and the same routine can get old for both of you.

A walk to the park can help.

You can put your baby in a stroller, carrier, or wrap and head outside. Even before you “do” anything developmental, the walk itself gives your baby new things to see, hear, and feel.

The light is different.
The air is different.
The sounds are different.

That may seem simple, but simple experiences matter for babies.

Babies are constantly learning about the world through their bodies. What seems commonplace to us, may be a cherished first experience for our baby.

What do you do with a baby at the park?

Start with a blanket.

That is the easiest way to turn a park visit into something useful for your baby without making it complicated.

For a young baby, lay the blanket on a flat area of grass and place your baby on their tummy. Then lie down across from them and make faces, talk to them, sing, or simply let them look around.

You do not have to turn it into an exercise session.

You are just giving your baby a new place to be on their tummy.

That alone can be helpful.

Some babies who fuss with tummy time at home will tolerate it a little better outside because there is more to look at. The trees move. Other kids run by. Dogs bark. Leaves blow. The light changes.

There is a lot going on.

If your baby likes looking at faces, your face may be enough. If you want a little more help, bring a baby-safe mirror and set it in front of them. Many babies will spend extra time on their tummy when they can look at themselves.

And if you want a small break, you can sit nearby and read while they watch the mirror or look around.

For babies who are rolling

Once your baby is starting to roll, the park blanket becomes a little more interesting.

Bring a few toys your baby likes and place them just out of reach to the side.

This gives your baby a reason to turn, reach, and roll.

We often think of baby play as putting toys right in front of the baby. That is fine, but babies also need practice reaching to the side, turning their body, and moving toward something they want.

A blanket at the park gives them a nice little space to practice.

You can place a toy to one side and let your baby roll toward it. Then move the toy to the other side and let them roll back.

It does not need to be formal. You are simply using the park as a new place for the same good floor play your baby needs at home.

For babies who are crawling

Once your baby starts crawling, the park becomes even more interesting.

You can let your baby start on the blanket and then give them the space to move off the blanket and feel the grass.

This is where parents sometimes hesitate.

And I understand why.

Grass is pokey. The ground may be uneven. Your baby may try to eat leaves, dirt, or bark. You will need to watch them, of course.

But this is also part of how babies learn.

The floor at home is predictable. Grass is not. It feels different on their hands, knees, feet, and legs. It changes how they move. It gives them new sensory information.

These small experiences help your baby build a bigger understanding of the world.

For babies who are pulling to stand

As babies get closer to standing, they often become very interested in the playground equipment.

They see older kids climbing, stepping, sliding, and running. They want to be part of it.

This can be a great time to let your baby pull to stand at a safe, low part of the playground structure.

They might hold onto a step.
They might stand at the edge of a platform while you support them.
They might cruise along a low rail.
They might simply stand and watch the bigger kids play.

This is not about pushing your baby to be advanced. It is about letting them participate at their level.

A baby who is pulling to stand does not need to go down the slide or climb the structure. But they may love feeling like they are part of the playground.

That sense of participation matters too.

Babies are social. They watch other kids. They learn from what is happening around them. Sometimes the motivation to move comes from wanting to join in.

What about the baby swing?

Baby swings can be fun, and there is nothing wrong with using them when your baby is ready and well-supported.

But I would not make the swing the whole park visit.

The swing is still a container. Your baby is strapped in and supported by the seat. They may enjoy the movement, but they are not using their body in the same way they do when they are on the ground.

That is why I like the blanket and grass so much.

The bigger purpose of a park visit

For a toddler, the park is often about movement and energy.

They run. They climb. They slide. They swing. They come home tired.

For a baby, the purpose is different but still important.

A baby gets new tactile, visual, and movement experiences.

They feel grass, wind, sun, shade, and uneven ground.
They see trees, dogs, bikes, birds, and playground equipment.

They get inspired by older kids.
They hear new sounds.
They move their body in a new environment.

These experiences help your baby learn about the world around them.

And the more chances they have to explore safe, varied environments, the more they have to build on later.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

Sometimes a small movement detail tells you a lot about how a baby is learning to use their body.

This week, I worked with two babies who reminded me how often babies pull when they would benefit from learning to push. It sounds like a small difference, but it can change how they crawl, climb, stand, and eventually walk.

Here’s what’s going on: when babies pull with straight legs, they often rely on the muscles behind their thighs instead of learning to push through bent hips and knees.

That may not sound like a big deal, but pushing helps babies build strength, balance, and control.

The baby who scooted on her bottom

One little girl I worked with scooted on her bottom instead of crawling.

Bottom scooting can be very effective. Babies who do it often get around quickly, keep their hands free, and look very clever doing it. But when a baby scoots instead of crawling, they may miss some of the strengthening and coordination that comes from being on hands and knees.

To help this baby change her movement, we used a cushion from a Nugget play couch as a low obstacle.

At first, she tried to climb onto it from a sitting position. She put both feet on the cushion and pulled with her legs. Her legs stayed fairly straight, and she was trying to drag herself forward instead of getting onto her knees and climbing up.

Once she figured out this wasn’t going to work, she opened herself up to different ideas. Her mom and I were able to help her get onto her hands and knees, and she climbed right up.

Ah, the power of a small obstacle to help change a child’s movement pattern.

The baby who climbed onto the couch

Another baby I saw was standing but not yet walking.

He loved climbing onto the couch. His strategy was to put one foot up on the couch and pull himself up with his knee almost straight.

To help him change this pattern, I gently bent his knee and held it against the couch. This made it easier for him to push through. Sure enough, he started pushing his knee into the couch to climb up instead of using his leg to pull himself up.

Why pushing matters

Pulling is not bad. Babies need to pull too.

They pull to stand. They pull toys toward themselves. They pull on furniture, people, blankets, and anything else they can reach.

The issue is when pulling becomes the main strategy and pushing does not develop well alongside it.

When babies primarily pull with their legs, they may overuse their hamstrings, the muscles on the back of the thigh. They may avoid using their glutes, hips, and trunk muscles as much as they could.

Pushing through bent knees and hips helps babies build a stronger foundation.

It helps with:

• Getting onto hands and knees
• Crawling over obstacles
• Climbing safely
• Moving from the floor to standing
• Squatting
• Walking with better control

Pushing also teaches the body how to organize movement from the ground up.

When a baby bends a knee, puts weight through the foot or leg, and pushes, they are learning how to use strength and balance together. That pattern matters far beyond one single milestone.

What to watch for

You may notice this pattern if your baby:

• Scoots on their bottom instead of crawling
• Has trouble getting into hands and knees
• Climbs by pulling with a nearly straight knee
• Seems strong but uses awkward or effortful movement strategies

This does not mean something is automatically wrong.

Babies experiment. They problem-solve. They use the easiest path available to them.

But if your baby avoids pushing, it may be worth giving them more opportunities to practice.

What you can try at home

You do not need fancy equipment.

A couch cushion, your leg, a firm pillow, or a low step can all give your baby a chance to practice pushing.

The goal is not to make the obstacle too hard. The goal is to make it just challenging enough that your baby has to shift weight, bend a knee, and push.

You can gently help by:

• Encouraging hands-and-knees play
• Placing toys on a 6-12″ step and have them kneel as they play
• Supporting your baby’s knee so they can push through it when climbing
• Letting your baby work through obstacles instead of lifting them over the obstacle

The most important idea is this:

Help your baby push from a bent knee and hip instead of pulling with a straight or nearly straight knee.

You are not trying to correct every movement. You are helping your baby discover a different, helpful pattern.

When to get help

If your baby strongly resists hands-and-knees play, always scoots instead of crawling, seems unusually stiff, uses one side more than the other, or has trouble progressing toward crawling and walking, it check in with your baby’s physical or pediatric physical therapist.

A good therapist can help you understand whether your baby just has a preferred movement habit or whether there is a bigger reason they are avoiding certain positions.

Either way, the goal is not to make you worry.

The goal is to help your baby build more options.

FAQ

Is bottom scooting always a problem?

No. Some babies bottom scoot, grow out of it, and no one would ever know the difference.

Bottom scooting can be a sign that a baby is avoiding hands-and-knees movement, pushing through bent legs, or using both sides of the body together in a balanced way.

If your baby bottom scoots but is also able to crawl, climb, get into hands and knees, pull to stand, squat, and move in a variety of ways, it may not be a concern.

If bottom scooting is their only way of getting around, you see differences between how they use their right and left sides, or they seem stuck in that pattern, check in with a professional.

Pushing is one of those small movement skills that can make a big difference.

When your baby learns to push through bent knees and hips, they are building strength, coordination, and confidence for the next stage of movement.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

Let’s talk about containers.

A “container” is anything that holds your baby in place. That includes car seats, baby carriers, strollers, infant seats, bouncers, sit-in walkers, swings, high chairs, and play standers.

Containers are not bad. They can keep your baby safe. They can give you a few minutes to take a shower, make food, help another child, or simply breathe.

The problem comes when babies spend too much of their day in containers and not enough time moving freely.

Here’s what’s going on: babies learn to move by moving.

When a baby spends too much time held in one position, it can limit the little movements that build strength, coordination, head control, rolling, reaching, and crawling. Over time, too much container time can contribute to what is sometimes called Container Baby Syndrome.

A question I heard from parents this week

Yesterday, a family asked me about a play stander they had just bought for their baby.

It had toys attached to it and gave their baby a safe place to play for short periods of time. Their baby had recently started rolling and moving across the room. The parents were excited about this, but it also had them a little concerned. If one parent was home alone and needed to take a shower or prepare a meal, they needed somewhere safe to put the baby.

They were worried that even these short times in a container might harm their baby’s development.

I told this specific family not to worry.

Why?

Because they were coming at it with the right mindset.

They were not using the play stander as the baby’s main place to spend the day. They were using it as a helpful tool for short periods when they needed the baby to be safe and contained. Their baby was also getting lots of time to move freely, including at least 60 to 90 minutes of tummy time spread throughout the day.

Containers are useful tools. They become a problem when they become the default.

What is Container Baby Syndrome?

Container Baby Syndrome is a phrase used to describe movement and development problems that can happen when a baby spends too much time in devices that restrict movement.

This does not mean one stroller ride, one stretch in a carrier, or a few minutes in a play stander will harm your baby.

It also does not mean you should feel guilty for using baby gear. My wife and I used containers for short periods of time with our girls.

However, when babies spend a lot of time in containers, they are at greater risk for:

• Delays in movement development
• A flat or misshapen head
• Tightness in the neck
• Trouble turning the head equally both ways
• Favoring one side of the body

The reason is simple: containers reduce variety.

A baby in a car seat, swing, bouncer, infant seat, or play stander is being supported by the device. Their body does not have to make as many small adjustments. Their head may rest in one position. Their arms and legs may have less freedom. Their trunk does not have to work as much.

Babies need chances to use their bodies in lots of different ways.

Containers should be the exception, not the home base

One of the easiest traps with baby gear is that it becomes the default place to put the baby.

The baby goes into the car seat. Then into the stroller. Then into the swing. Then into the bouncer. Then into the high chair. Then back into the car seat.

None of those things are wrong by themselves.

But when you add them up, a baby can go through a large part of the day without much freedom of movement.

The floor is one of the best places for your baby

For babies, the floor is the best “developmental gym.”

It does not need to be fancy. You do not need expensive toys. You do not need a perfect setup. Just a blanket on the floor.

On the floor, your baby can:

• Turn their head both directions
• Practice looking toward sounds and faces
• Kick their legs
• Bring hands to mouth
• Reach for toys
• Roll toward something interesting
• Push up during tummy time
• Shift weight from side to side
• Learn how their body works

These little movements matter.

They are the foundation for bigger skills later, like sitting, crawling, pulling to stand, cruising, and walking.

A simple way to think about container time

You do not need to track every minute.

Instead, think about the pattern.

Are containers helping you get through real-life moments?

Or are containers where your baby spends most of the day?

That distinction matters.

A few minutes in a play stander while you shower is very different from a baby spending most of the day moving from one device to another.

A walk with a stroller is different from using a stroller as the main place your baby hangs out.

A baby carrier can be wonderful for closeness and connection, but your baby still needs time outside the carrier to move freely.

The goal is not to eliminate every container.

The goal is to make sure your baby gets many chances each day to move without being held in one position.

What about car seats?

Car seats are necessary for safe travel. Use them every time your baby is in the car.

The concern is not normal car seat use during travel. The concern is when the car seat becomes a place where the baby spends lots of extra time outside the car.

This is especially easy to overdo with car seats that are designed to hold a baby outside of the car. When it is easy to unsnap the car seat and carry the baby to another location, it becomes easy to give that baby too much time in their container.

What if my baby hates tummy time?

This is one reason container time can sneak up on families.

If your baby does not like tummy time, it is very easy to avoid it. Then the baby spends more time on their back or in containers. Then tummy time stays hard because they are not getting enough practice.

You do not have to force long stretches of tummy time.

Start small.

It’s okay if your baby only tolerates 30 seconds (or less) at a time. Just consistently give them 30 seconds at a time and increase the number of times on their tummy each day. With this consistently they will build the strength they need to work up to the 60-90 minutes of tummy time they need.

Signs your baby may need more free movement

You may want to look more closely at container time if your baby:

• Is not rolling, reaching, or moving as much as expected
• Spends much of the day in seats, swings, carriers, strollers, standers, or other devices

These signs do not automatically mean something is seriously wrong. But they are worth paying attention to.

Often, the first step is simply more floor time, more position changes, and more opportunities to move.

Practical takeaway

Use containers when they help with safety, travel, meals, connection, or your own sanity.

But try not to let containers become your baby’s main place to spend the day.

A helpful rhythm is:

Container when needed. Floor when possible. Held when wanted. Variety throughout the day.

Your baby does not need a perfect routine. Your baby needs chances to move, explore, and use their body in different ways every day.

FAQ

Will short periods in a baby container hurt my baby’s development?

Short periods in a container are usually not a problem if your baby is also getting lots of time to move freely. The concern is when containers become the main place your baby spends the day.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

I recently evaluated a baby in my physical therapy practice who had just started moving forward on his hands and knees—but not in the way most people expect.

He would get into the hands-and-knees position, but instead of moving one arm and the opposite knee forward, he slid both knees forward at the same time.

At first glance, it looked unusual. But it also told me something important:

He wanted to move.

That matters more than many parents realize.

Curiosity, exploration, and the desire to move independently are all positive developmental signs. Before worrying about how a baby moves, I first look at whether they are motivated to explore their environment.

In this case, he absolutely was.

So the question became:

Should we change the movement pattern?

Here’s What’s Going On

Some babies discover creative ways to move that are different from the classic crawling or creeping pattern.

(Technically, physical therapists often use the word creeping to describe moving on hands and knees with alternating arms and legs, but most parents simply call this crawling.)

This baby had figured out that sliding both knees forward worked well enough to get where he wanted to go.

The good news was that he had already mastered the difficult parts:

• He could get into and maintain the hands-and-knees position
• He had enough core strength to support himself
• He was motivated to move and explore

Those are big developmental wins.

Now we just needed to help him refine the mechanics.

Why Crawling Patterns Matter

When babies crawl by moving one arm with the opposite leg, they are practicing an important coordination pattern called reciprocal movement.

This pattern becomes foundational for later skills involving coordination between the two sides of the body.

I’ve evaluated older children who skipped crawling entirely and later struggled with movements like jumping jacks, skipping, or other coordinated activities in school.

That doesn’t mean every baby who crawls differently will have future coordination problems. Development is never that simple.

But when we can gently encourage a more efficient movement pattern early, it often helps support future coordination and strength.

The Core Strength Piece

There’s another reason I wanted to help this baby shift away from sliding both knees together.

That movement pattern relied heavily on the rectus abdominis—the “six-pack” muscles many adults think of as the core.

But true core strength is much broader than that.

The core includes many smaller stabilizing muscles around the spine and pelvis, including the obliques and multifidi muscles. These muscles help babies stabilize and rotate their bodies during movement.

Alternating arm-and-leg crawling naturally strengthens those stabilizers because the body has to shift weight from side to side while maintaining balance.

Sliding both knees forward at once reduces some of that challenge.

As I discuss in Tummy Time to Walking, babies build the best strength through normal movement and exploration—not through isolated exercises.

Before Helping a Baby Move Differently, I Change the Environment

One thing I’ve learned as a pediatric physical therapist is this:

Often the easiest way to change a movement pattern is to change the environment.

Before I place my hands on a baby or try to physically guide a movement, I first ask:

“What in the environment is encouraging this pattern?”

In this case, the answer was simple.

The baby was on a slick floor.

Hardwood, tile, and linoleum create very little resistance. Sliding both knees forward becomes an efficient solution.

Babies are smart.

Why lift one knee at a time if sliding works just fine?

Try a Rug or Carpet First

Sometimes simply placing a baby on a rug or carpet changes the movement pattern immediately.

The extra resistance makes sliding both knees together harder, which encourages lifting one knee at a time.

Sometimes babies will instantly switch to a more typical crawling pattern.

Other times, they stop moving forward altogether because the new surface suddenly feels much harder.

That’s okay too.

If that happens, let your baby continue exploring in the way they currently can. Then gradually reintroduce the rug or carpet during play.

Often they figure it out naturally over time.

The Blanket Trick That Helped This Baby

For the little guy I evaluated, the rug alone wasn’t enough.

So his mother and I tried something simple.

We placed a blanket in front of him and scrunched it slightly so it created small ripples and bumps.

When he moved toward a toy he wanted, he suddenly needed to lift one knee high enough to get over the edge of the blanket.

That tiny environmental change encouraged the exact movement pattern we wanted.

The first few times, we helped hold the blanket down so it wouldn’t slide or bunch up too much. He wasn’t lifting his knees very high yet, and we wanted him to succeed instead of getting frustrated.

Within a short time, he started bringing one knee forward more naturally.

One of the Best Parenting Tools: Changing the Environment

I always enjoy moments like this because they remind me of something important:

Sometimes the best way to help a baby learn is not by constantly correcting them, but by changing the environment around them.

When the environment supports the skill, babies can practice more independently without an adult constantly stepping in.

And honestly, parenting already involves enough moments where you have to say “no” or become the obstacle to what your baby wants.

It’s nice when the environment can do some of the teaching instead.

Practical Takeaways

If your baby crawls by sliding both knees forward:

• First, celebrate that they are motivated to move and explore
• Try practicing on carpet or a rug instead of slick flooring
• Use small obstacles like a scrunched blanket to encourage lifting one knee at a time
• Keep practice playful and frustration low
• Remember that movement variation is common, especially early in learning new skills

Most importantly, remember that babies are trying to solve movement problems the best way they can with the environment they are in. Sometimes a small change to that environment is all it takes to help a new skill emerge naturally.

FAQ

Is it bad if my baby crawls differently?

Not necessarily. Many babies experiment with unusual movement patterns while learning mobility skills. What matters most is whether your baby is continuing to explore, gain strength, and develop new movement abilities over time. However, if your baby continues to use different movement pattern, please discuss it with the pediatrician or pediatric physical therapist.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

“How was your night last night?”

If you’re in the season of waking up every couple of hours with a baby, that question can feel loaded. Maybe your baby woke up crying three times. Maybe they only settle when you hold them. Maybe you’re exhausted and wondering how long this phase is going to last.

When you’re in the middle of sleep deprivation, it can feel endless.

Here’s what’s important to know: it won’t last forever. And one day, surprisingly, you may even miss parts of it.

When the Nights Feel Never-Ending

There was a two-year stretch in our family where we had a couple of foster babies in a row who struggled with sleep and fussiness.

I’m a lighter sleeper than my wife, so I was usually the one getting up in the middle of the night to feed them, rock them, and help them settle back down.

At the time, waking up every few hours felt like a burden that would never go away.

If you’re in that season now, you probably understand that feeling. The nights blur together. You’re tired during the day. You start measuring time in naps, feedings, and wake-ups instead of weeks and months.

And when you’re exhausted, it’s easy to think:
“Will this ever get better?”

Here’s What I Remember Most

What surprises me now is not how hard those nights were.

It’s how short they were.

In some ways, time felt frozen during those sleepless stretches. But when I look back now, the strongest memories are not frustration or exhaustion.

I remember closeness.

I remember holding a baby in a dark room while the house was quiet. I remember the feeling of being needed. I remember the connection that formed during those long nights.

And that connection lasts.

When I tell my daughter stories about what she was like as a baby, she lights up. She takes pride in being part of our family story. The love and trust built in those ordinary moments continues to show up years later in ways I never expected.

That doesn’t mean you have to enjoy every sleepless night.

You don’t need to pretend exhaustion is magical.

But sometimes it helps to remember that these difficult moments are also deeply human ones. You are building relationship and security, even when it just feels tiring.

Time Moves Faster Than You Think

Our youngest is now 8 years old. Next year, she’ll be too old to attend the school where my wife works. Our 12-year-old is only a few years away from driving and high school graduation.

It feels like such a short time since ago they were so incredibly small.

When you have a baby, the days can feel incredibly long. But the years move unbelievably fast.

One day your baby will sleep through the night consistently.
One day they won’t need to be rocked.
One day they won’t fit on your chest anymore.

And someday, you may find yourself wishing you could go back for just one more middle-of-the-night cuddle.

Here’s What’s Going On

If you’re overwhelmed by broken sleep right now, that doesn’t mean you’re failing.

Babies wake frequently for many reasons:

• Hunger
• Comfort
• Immature sleep patterns
• Growth and development
• Illness or teething
• Needing connection and regulation

Frequent waking is extremely common in infancy, even though it can feel isolating when you’re living through it.

This season is temporary, even if it doesn’t feel temporary today.

Practical Takeaways for Exhausted Parents

If you’re struggling through sleepless nights right now, here are a few things worth remembering:

• You do not have to love every moment to value this season later.
• Exhaustion can coexist with deep connection.
• Your baby is not “giving you a hard time.” They are having a hard time.
• Small moments of comfort and consistency matter.
• Accepting help when possible is healthy, not weak.
• It’s okay to simply survive some seasons of parenting.

Sometimes the goal is not mastering the perfect sleep routine.

Sometimes the goal is just getting through this week with gentleness toward yourself and your baby.

FAQ

Is it normal for babies to wake up often at night?

Yes. Frequent night waking is very common during infancy, especially in the first year. Babies wake for feeding, comfort, development, and regulation. While every baby is different, disrupted sleep is a normal part of early parenting for many families.

However, if you have concerns about it, please check in with your pediatrician.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

A dad joked with me recently that his son was “a head first kid.”

It was a pretty accurate description. This little boy was fearless, fast-moving, and completely uninterested in caution. He had started crawling down stairs and launching himself off couches head first. No hesitation. No reverse gear.

Unfortunately, babies who always go head first usually discover gravity the hard way.

Helping a baby learn to climb down backward is not just about preventing falls. It is actually an important developmental skill that teaches the brain how to move safely without relying entirely on vision.

Here’s what’s going on.

Why Babies Prefer Going Head First

We are visual creatures. We naturally want to see where we are going.

That is why many babies try to crawl forward off a couch or down a stair. They can see the floor in front of them, but they cannot yet trust the information coming from the rest of their body.

Going down backward requires something different.

Your baby has to:

• Feel where their hands and knees are
• Shift weight without seeing the landing spot
• Coordinate movement using body awareness instead of vision

This ability is called proprioception.

Proprioception is the brain’s ability to sense where the body is in space through information coming from muscles and joints. It is one of the hidden foundations of coordinated movement.

A Simple Example: Learning to Type

My 12-year-old daughter wants to learn how to touch type.

Right now, she still looks down at her fingers while typing. That is normal. Vision is helping guide the movement.

To improve, she recently started covering her hands with a piece of paper while practicing. Without seeing her fingers, her brain has to rely more on feel and repetition.

That process is very similar to what babies experience when learning to climb down backward.

They are learning to trust what their body feels, not just what their eyes can see.

How to Teach Your Baby to Get Down Safely

The best way to teach this skill is through repeated practice with your help.

If your baby is trying to get off the couch or approach stairs head first, gently turn them around and guide them through the movement backward. Put your hands on them as little as possible so that they feel only what is necessary for their movement.

Give them lots of practice. The simply need lots of repetition.

Over time, your baby’s brain starts recognizing:

• where their legs are
• how far they are from the floor
• how to shift weight safely
• how to coordinate movement without using their eyes.

Eventually, your baby will automatically turn around feet first before climbing down.

That is a huge developmental win.

What This Skill Builds Beyond Safety

Learning to descend backward helps build:

• body awareness
• coordination
• motor planning
• balance
• confidence with movement

It also helps babies become more adaptable movers instead of relying only on visual input.

This matters later for:

• climbing playground equipment
• navigating uneven surfaces
• sports and physical play
• general coordination and confidence

Sometimes a simple everyday movement teaches much bigger developmental lessons.

What If My Baby Refuses to Go Backward?

Some babies resist this skill for a while, especially adventurous ones.

That is normal.

Many babies need lots of guided repetition before they independently turn around to climb down. The key is staying calm and consistent.

Instead of repeatedly saying “No!” when your baby goes head first, focus on physically helping them experience the safer movement pattern again and again.

The brain learns through doing.

FAQ

When should babies learn to climb down backward?

Many babies begin learning this skill sometime during the crawling stage, especially once they start exploring furniture, stairs, or playground structures. The timing varies, but repeated practice and supervision help the skill develop naturally.

One Chapter That Never Made the Book

In the first draft of Tummy Time to Walking, I actually included an entire chapter on helping babies climb up and down couches, stairs, and household obstacles.

My editor encouraged me to cut it to keep the book shorter.

I still think the topic matters.

If enough parents are interested, I may dig up that rough draft, clean it up, and turn it into a future blog post. If you’re interested, email me and let me know. I may not reply quickly, but I read every email.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

A few weeks ago, I saw a baby who had just turned 6 months old.

He strongly disliked tummy time and had spent much of his first few months on his back. As a result, he had developed a significant flat spot on one side of his head.

At his previous visit, I encouraged his mom to ask their pediatrician about a referral for a reshaping helmet to decrease the flat spot.

That recommendation surprised her a little.

Most of the time, I do not recommend helmets. In most cases, a baby’s head shape improves with positioning changes, increased tummy time, and natural development over time.

But this case was different.

His flat spot was more significant than what I typically see, and tummy time was still very difficult for him. I was concerned that waiting too long would reduce the window where a helmet would be most effective.

At the next visit, I asked Mom what the pediatrician had said.

She told me the pediatrician wanted to wait and continue with physical therapy for now. If things were not improving enough by around 9 months, they would reconsider a helmet at that point.

Mom was understandably unsure.

Two professionals were looking at the same baby and arriving at different recommendations.

Here’s What’s Going On

Situations like this are more common than most parents realize.

Healthcare professionals often have access to the same information, research, and treatment options. But we do not always prioritize that information the same way.

Different professionals:

• see different patient populations
• have different clinical and treatment experiences
• weigh risks differently
• communicate uncertainty differently
• have different thresholds for when intervention feels necessary

In this case, both the pediatrician and I understood the same basic facts:

• helmets can be helpful in certain situations
• they are a significant commitment for families
• they are typically worn about 23 hours per day
• they are most effective earlier in infancy
• there is still some effectiveness later on, though generally less than earlier treatment

The “what” was the same.

The difference was in how we each interpreted the situation and prioritized the risks of waiting versus acting sooner.

Because I work with babies with torticollis and plagiocephaly every day, I may have been weighing those risks differently based on my experience with similar cases.

That does not automatically make one professional right and the other wrong.

But it does make things harder for parents trying to make decisions for their baby.

What To Do When Professionals Disagree

One thing that makes these situations difficult is that healthcare conversations can sometimes sound more certain than they really are.

But many medical and developmental decisions are not purely black and white. Often there are multiple reasonable paths forward, each with different tradeoffs.

When you encounter conflicting advice, here are a few things that can help:

1. Ask More Questions

Sometimes the disagreement is smaller than it first appears.

Try asking:

• “What’s the downside of waiting?”
• “What’s the downside of acting sooner?”
• “What makes you lean toward this option?”
• “If this were your baby, what would you be thinking about most?

These questions often reveal that two professionals may agree on the big picture while differing only on timing or priorities.

I also know that asking questions can feel uncomfortable for some parents. Many parents worry they will seem difficult, questioning, or disrespectful.

And to be fair, some professionals are more comfortable with questions than others.

But a good professional should want you to understand the reasoning behind a recommendation, especially when the decision affects your child and your family’s daily life.

2. Understand the Assumptions Behind the Advice

Recommendations are shaped by experience.

One professional may be more focused on avoiding unnecessary intervention.

Another may be more focused on avoiding missed developmental windows.

Neither perspective is inherently unreasonable. Understanding the “why” behind the recommendation is often more helpful than simply comparing the recommendations themselves.

3. Think in Probabilities, Not Certainties

One of the most helpful ideas I have learned comes from professional poker play, Annie Duke. In her book Thinking in Bets, she talks about asking people about the probability of possible outcomes.

This kind of conversation often leads to more honest and useful discussions because it moves away from “Who is right?” and all-or-nothing thinking.

It allows you to consider the other person’s reasoning in a way that is often hard to assess otherwise.

Parenting Often Requires Decision-Making Under Uncertainty

One of the hardest parts of parenting is realizing that there is not always a perfectly clear answer.

Even experienced professionals sometimes see situations differently.

That does not necessarily mean someone is wrong.
And it does not mean you are failing as a parent.

It simply means there are multiple reasonable paths forward, each with different risks, benefits, and priorities.

If you stay curious, ask thoughtful questions, and seek to understand the reasoning behind the recommendations, you can make decisions with more confidence and less fear.

FAQ

Does a flat spot always require a helmet?

No. Many babies improve significantly with positioning changes, tummy time, and natural development. Helmets are usually considered when head shape asymmetry is more significant or when improvement is limited despite conservative treatment.

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.

A few weeks ago, I started working with a 17-month-old who was not yet walking.

That was concerning on its own. But something else caught my attention even more quickly:

He used his right leg much more than his left.

When he crawled on his hands and knees, his right knee came farther forward. When he pulled to stand, he always led with his right foot. When he pushed a toy walker, his right leg did most of the work.

His parents hadn’t noticed it before.

That’s very common.

Most parents aren’t watching their baby’s movements with the same level of detail a pediatric physical therapist does. And honestly, you shouldn’t have to. But sometimes small movement patterns can tell us important things.

Here’s What Was Going On

Young babies and toddlers should move fairly symmetrically.

Before age 3, most kids should:

• reach with either hand
• crawl with equal effort on each side
• pull to stand with either leg forward
• walk up stairs leading with either foot
• explore movement in a balanced way

It’s normal for preferences to slowly emerge later.

But when a younger baby strongly favors one side, it’s worth paying attention.

In this case, I noticed a click in the baby’s left hip during my examination. That can sometimes be associated with hip dysplasia, so I referred him back to his pediatrician for further evaluation.

Hip dysplasia is a condition where the hip joint does not develop normally. Some babies with hip dysplasia may avoid using one leg because it feels unstable, stiff, or uncomfortable.

Whether or not that ends up being the cause, one thing was clear:

His movement was becoming increasingly one-sided.

Why It Can Be Hard to Change a Movement Pattern

This baby was extremely good at pulling to stand.

He moved quickly and efficiently using his right leg. Any attempt to encourage the left side caused immediate resistance.

That makes sense when you think about it from the baby’s perspective.

Imagine someone trying to make you do something in a slower, harder way when you already know an easier method. Just like you and me, babies prefer the movement pattern that feels strongest and most familiar.

The Unexpected Solution: Stairs

At home, the family had a staircase with a baby gate across it. The baby was excited to explore stairs for the first time. As he climbed, he naturally led with his right leg; his left mostly followed behind.

So on the next step, I gently shifted his weight to the right and encouraged him to lead with the left leg instead.

He resisted briefly, then figured it out. We practiced a few more steps before his mom took over.

That was it.

No complicated exercises.
No battles.
No forcing repetitions for thirty minutes.

Just a new skill that created a new opportunity.

Why New Skills Work Better Than Correction

Two weeks later, his mom proudly showed me how well he could climb the stairs. But something else had changed too.

He was now voluntarily lead with his left leg when pulling to stand.

Instead of constantly fighting his old movement pattern, we had introduced a brand-new activity where he had not yet developed a strong habit.

That gave us room to guide the movement the way we wanted it. Since he didn’t have experience with this activity, he didn’t have a preference of how it should be done.

This allowed us to work on strengthening his weaker side which lead to him to get more comfortable using his left leg in all his movement.

Sometimes the best path forward is not pushing harder through the old pattern.

Sometimes it’s finding a different activity that helps the body practice the missing skill in a more natural way.

What Parents Can Watch For

If your baby consistently:

• uses one hand or leg more than the other
• prefers looking or feeding in one direction
• crawls unevenly

…it may be worth discussing with your pediatrician or pediatric physical therapist.

It does not automatically mean something is wrong.

But asymmetry can sometimes give us early clues that a baby may need additional support.

One Simple Idea You Can Try

If your baby resists using one side, try introducing the skill in a completely different context.

New activities often create more flexibility and curiosity than correcting an old pattern directly.

That might look like:

• climbing cushions
• crawling over obstacles
• creeping up stairs with supervision
• reaching in different directions during play

Sometimes the key to unlocking your child’s potential is by introducing a new skill.

FAQ: Is It Normal for a Baby to Favor One Side?

Small differences can occur, especially during periods of rapid development.

But strong or consistent one-sided movement in babies and young toddlers is worth paying attention to, particularly if it affects feeding, crawling, standing, cruising, or walking.

If you are concerned, be sure to ask your child’s pediatrician. The pediatrician or a pediatric physical therapist can help determine whether it needs closer attention.

Want More Help Like This?

If you found this helpful, I write a short, weekly newsletter for parents who want to better understand their baby’s development—without overwhelm or alarm.

Each week, I share:

• Simple ways to support your baby’s movement
• Real stories from my work as a pediatric PT
• Practical ideas you can use right away

You can sign up here (and receive the first chapter of my book):

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Dr. Trevor E. Carlson, PT, DPT
Pediatric physical therapist, author of Tummy Time to Walking, and founder of InfantPT.com.

I help parents better understand their baby’s movement and development with practical, calm, experience-based guidance.