Exactly when babies can hold their head up varies between children, but it generally happens around 4 months of age. At birth, a baby’s head will flop backward if unsupported. Over the next several months, though, their muscles will develop and they will stretch and strengthen their necks until they can finally hold their heads up independently, sphinx-style, around 4 months old. “Infants at this age have the upper body strength to hold their head and neck up at a 45-degree angle,” explains Pierrette Mimi Poinsett, MD, a pediatrician and health advocate consultant for Mom Loves Best. Different babies develop at different rates, but they generally follow the same succession of milestones. First, they’ll try to lift their heads for short periods of time and later they’ll be able to hold them up for extended periods. Later they’ll progress through other milestones, like sitting up unsupported and ultimately starting to walk. By about 3 months old, most babies will be able to raise their head and chest up when lying on their stomachs. Around 4 months your baby will likely have full head control and by about 7 months be able to sit up unassisted. Sometime after that toward the end of the first year, your baby will learn to get themselves up into a sitting position without any help.
Why Supporting Your Baby’s Head Is Important
Before babies can hold their own heads up, it’s important to support the head and prevent it from flopping backward. “Not supporting the baby’s head can lead to unintentional injury,” notes Georgia Agganis DNP, RN, CPNP, a pediatric nurse practitioner and adjunct faculty at Regis College. In addition to leading to future milestones, being able to hold their heads up also offers babies a protective benefit. While the neck muscles remain weak and the head heavy, babies are at risk for positional asphyxiation. This means that while they are asleep, if they are propped up at all, their head may lull forward, compressing their windpipe and preventing them from breathing. Positional asphyxiation can lead to death, even if a sleeping baby is under direct adult supervision. The sooner they develop head control, the better. To protect your baby from positional asphyxiation before they have head control, always put them down on their back on a flat firm sleeping surface, such as a crib, bassinet, or play yard, whether for the night or a nap.
How to Help Babies Develop Neck Strength
You don’t have to explicitly teach your baby to hold their head up—they will naturally learn this skill as they become physically and developmentally ready. However, you can and should support your child’s progress by positioning them on their stomach frequently. Incorporating time spent on their stomach into your baby’s day is important for their physical development. Start with 3-5 minutes per day and slowly build up when your baby can tolerate it. “You will notice that newborns can slightly push their heads up for a brief amount of time,” says Dr. Poinsett. “As they get older, infants can hold their heads up for a longer period of time. Their head, neck, and shoulder muscles get stronger over time until they can hold their head up with their chest off the floor.” Mindfully scheduled tummy time is particularly important because babies should be placed on their backs during all sleep times, for safety reasons. Spending so much time on their back prevents them from exploring movement and developing strength in their necks, so it is important to make up for this by intentionally incorporating tummy time into your baby’s day.
Tummy Time Tips
Try to do a little tummy time after each diaper change, starting from birth. This helps you get into the habit. It may help to position yourself so that your face is close to your baby’s face at the start. As your baby grows, they can see longer distances and focus on colors and other details. They will likely still enjoy observing human faces, and they may also like to look up at a high-contrast picture. Opening a board book in front of your baby may help encourage them to lift their head during tummy time. If your baby gets fussy every time you try placing them on their stomach, try laying them across your lap or lie down with your baby on top of you. You can also curl your knees towards your stomach and position the baby on your shins (keep a firm hold of your baby if you try this one). Babies may feel more comfortable when they are physically in contact with their primary caregivers.
When to Speak With Your Pediatrician
Babies will develop at their own rates, but too much of a lag with milestones may indicate a problem. “We look at head and neck control starting from the first visit,” explains Agganis. “We assess head lag, and by two months of age we assure the baby can lift their head when on their tummy.” If your baby cannot support their head well at 3 months, speak with your baby’s healthcare provider. They may need some additional support.
