When should a baby start walking?

What is the normal age range for walking?

Walking is a milestone with a wide normal range. As part of the WHO Multicentre Growth Reference Study, 816 healthy children in Ghana, India, Norway, Oman and the USA were assessed regularly between 4 and 24 months 1. The window for walking alone, from the 1st to the 99th percentile, was 8.2 to 17.6 months 1.

Walking alone had one of the widest windows among the six milestones studied, which shows how much normal variation there is 1.

What milestones come before walking?

In the WHO study, the windows for achievement were 3.8 to 9.2 months for sitting without support, 4.8 to 11.4 months for standing with assistance, 5.2 to 13.5 months for hands-and-knees crawling, 5.9 to 13.7 months for walking with assistance and 6.9 to 16.9 months for standing alone 1.

About 90 per cent of children achieved five of the milestones in a common sequence, and 4.3 per cent did not crawl on hands and knees at all 1. Skipping crawling is therefore not necessarily a concern.

Why do some babies walk later?

Temperament, body size, opportunities to practise, premature birth and family patterns can influence when a child walks. Premature babies are usually assessed against their corrected age, based on their due date, in the first years.

Late walking can also be a sign of developmental delay, low muscle tone, neuromuscular conditions, cerebral palsy or hip problems, particularly when other signs are present.

When should a late walker be assessed?

A child who is not walking independently by about 18 months, which is later than the range seen in healthy children in the WHO study, should be assessed by a health professional 1. Earlier assessment is advisable if the child is not sitting without support by 9 months, the upper end of the WHO range for that milestone 1, is not bearing weight on the legs, or has stiff or floppy muscles.

Loss of skills at any age, uneven use of the arms or legs, or delays in other areas such as speech, social interaction or hand use also need prompt evaluation.

How can parents encourage walking?

Provide plenty of floor time, safe spaces to cruise along furniture and opportunities to push stable toys. Holding toys slightly out of reach encourages standing and stepping.

Barefoot walking indoors helps babies feel the ground and develop balance. Baby walkers are not recommended because they can cause injuries and do not help children learn to walk.

What should parents look out for besides the age of walking?

The overall pattern of development is more important than a single milestone. Health professionals look at whether a baby is gradually gaining new skills in movement, hand use, communication, play and social interaction.

Signs that deserve attention at any age include stiffness or floppiness, always using one side of the body more than the other, lack of interest in people or surroundings, or losing skills that the child previously had.

What happens if my baby needs physiotherapy?

A paediatric physiotherapist assesses how the baby moves and then gives parents playful activities to encourage sitting, standing and stepping at home. Therapy is usually built into daily routines such as nappy changes, bath time and play.

Parents are central to therapy because babies learn through frequent practice. The physiotherapist reviews progress regularly and works with other professionals if further assessment is needed.

What happens at a developmental assessment?

A health professional reviews the child's history and milestones and examines muscle tone, strength, reflexes, hips, feet and overall development. Vision and hearing may also be checked.

If needed, the child may be referred to a paediatrician, physiotherapist or other specialists. Early support helps children develop skills and helps identify any underlying condition.

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