Motor Development in Babies with Heart Defects

During their first 3 months, most babies learn to:

• Turn their head from side to side while lying on their back 

• Wave their arms 

• Kick their legs 

• Lift up on their forearms while on their tummy 

• Roll over from front to back 

• Hold up and turning their head when held upright 

• Put their fists in their mouth 

During their first 3 months, most babies learn to:

• Wave their arms in the direction of an object 

• Grab at an object on purpose with one or two fingers  

• Grab an object on purpose between the palms of both hands 

• Open and flatten their hands 

By the time they are 6 months old, most babies learn to:

• Roll from back to belly 

• Put their feet in their mouth when on their back 

• Push up on their hands with straight arms when on their tummy 

• Pivot from side to side when on their tummy 

• Bear some weight on their feet and “step” when held upright 

By the time they are 6 months old, most babies to:

• Reach for an object in a controlled way 

• Grab and hold an object in one hand 

• Touch their hands together 

• Bring a hand to their mouth 

By the time they are 9 months old, most babies learn to:

• Shake and bang toys 

• Bring an object to their mouth 

• Move objects from one hand to the other 

• Grab objects by “raking” at them with fingers 

• Keep hands open and relaxed most of the time 

Between 9 and 12 months, most babies learn to:

• Crawl on their hands and knees 

• Pull up to standing 

• Cruise on furniture 

• Walk with someone holding one or two hands 

• Stand alone for a few seconds 

Between 9 and 12 months, most babies learn to:

• Let go of an object on purpose 

• Bang two objects together 

• Turn a few pages in a book 

• Put objects in a container 

• Point 

• Hold small objects between their thumb and forefinger (pincer grasp) 

Babies learn by moving and feeling.  They have a strong “motor drive,” which means they want to move for much of the time they are awake. As they practice moving their bodies, babies usually quickly get stronger and better coordinated. However, having a congenital heart defect (CHD) can make it hard for babies to learn motor skills. 

Sometimes, babies do not feel good enough to explore and try new things. Their motor development can be delayed if they: 

• Often feel sick 

• Are in pain 

• Sleep more than usual 

• Have little energy 

• Do not eat enough 

• Are sedated (take medicine that make them sleep or feel sleepy) 

• Are intubated (have a tube down their throat to help them breathe) 

Sometimes, very fragile babies are not allowed to do certain activities.  Their motor development can be delayed if they: 

• Cannot have tummy time 

• Cannot be safely held or handled 

• Cannot be lifted under the arms 

• Wear mittens most of the time 

• Have wires and tubes that make moving hard 

• Are usually in the same place and position 

Babies who receive a lot of medical care spend much of their energy recovering. They often have trouble learning motor skills if they: 

• Are not given the chance to explore objects and places  

• Spend a lot of time in the hospital 

• Have frequent medical procedures 

Some medical conditions make it more likely that babies will learn motor skills slowly.  For example, babies often have trouble learning motor skills if they: 

• Have a brain injury 

• Have a genetic syndrome that affects brain development 

• Have a more serious heart defect such as single ventricle disease 

 Sometimes, babies with heart defects develop motor skills later than babies, or differently from other babies.  With intervention, most babies with heart defects can catch up with their peers. Other babies do not catch up, but intervention can help them to learn skills, get stronger, and feel successful.   

•  When a baby has a motor delay, they might: 

• Roll, sit, crawl, and stand later than other babies 

• Reach, grasp, and pass objects later than other babies 

• Have weak muscles, and tire quickly 

• Resist being on their tummy more than other babies 

• Keep their hands in a fist, with the thumb inside the fist, later than other babies 

• Have legs that turn out at the hip 

• Prefer using one hand or side of their body 

• Prefer to lie with their head to one side, not the other 

If you notice that your baby is struggling in any of these ways, tell your doctor. Remember: every baby can learn, and help is always available.  

If a baby is behind in their motor skills, practice and intervention can help them to make meaningful progress, and usually can help them to catch up with their peers. Parents should always talk with their medical team if they are concerned about a baby’s development. Doctors can help connect families to critical services such as Early Intervention (EI), physical therapy (PT), and occupational therapy (OT). Click the links below for help.

This content was reviewed by staff at Boston Children's Hospital.

Developmental care is best when it is local. Families local to Boston seek developmental support from the Cardiac Neurodevelopmental Program (CNP). Other feeding care is available through the programs listed below. Families from other regions can use the link below to find their care team.