Milestones and Tummy Time with "The Baby Movement Coach" | Sarah Richards, Pediatric PT, DPT | DE
Updated: Apr 6
I learned so much from my conversation with Pediatric PT, DPT, Sarah Richards (aka The Baby Movement Coach). As The Baby Movement Coach, Sarah provides tummy time and milestone support to families through virtual and in-home wellness sessions. She also offers an array of community classes to support new parents and babies on their journey towards rolling, sitting, crawling, and walking. I had the recent pleasure of attending one of her New Castle County, Delaware in-home wellness sessions. During which she gave the parents peace of mind (what a gift!) by providing professional, actionable advice, baby gear recommendations, and creative ideas for incorporating purposeful play into their family's daily routine. Her passions for early screening and intervention were evident as she listened to the families concerns, observed their baby in his natural play environment, and ultimately empowered them with the knowledge and insight to confidently navigate their child's early motor development. I hope you enjoy our conversation-- let's get into it!
Can you start by sharing a little bit about yourself and what you do?
Sure! I am a Pediatric Physical Therapist. I’ve been a Physical Therapist for almost 8 years & have worked almost exclusively in Pediatrics since 2017. Most of my time in Pediatrics has been with the state’s Early Intervention Program which provides therapy services to children & their families from birth - 3 years old. I’ve also worked in Home Health pediatrics which provides physical therapy for children through age 21.
Pediatric Physical Therapists are experts in baby movement milestones & help children with movement challenges reach their highest potential with mobility & participation in peer/family activities. I’ve worked with children with genetic syndromes, torticollis, flat head syndrome (plagiocephaly), developmental delays, cancer, cerebral palsy, mitochondrial disorders, developmental coordination disorder, autism, major multiple traumas & everything in between.
In 2021, The Baby Movement Coach upgraded from just an Instagram account, where I share free information & resources for parents wanting to know how to best support their baby’s natural development to an official LLC. The Baby Movement Coach has always been a wellness-focused adventure, aiming to give parents the early education they deserve in hopes of either identifying an early need for therapy or possibly preventing the need for therapy altogether. The Baby Movement Coach, LLC now provides in-home & virtual Tummy TIme & Milestone Support in addition to several Community Classes & Developmental Playgroups.
What did you want to be when you grew up? You are so passionate -- did you always know that Physical Therapy would be your calling? How did you come to specialize in Pediatric PT?
I actually knew early on in High School that I wanted to become a Physical
Therapist. I had to rehab two serious knee injuries as a Freshman & Sophomore and after going through those experiences, I couldn’t see myself doing anything else. I have always had a fascination with the human body & how it works along with a strong desire to help people. Fun Fact: My mother & sister are also therapists – but occupational therapists. Working with children is something I’ve always been passionate about & prior to deciding to become a PT, I thought I may go into education.
For many parents that haven’t studied early childhood development, or grown up around lots of babies, we often learn “on the job” as our children grow. What are the important motor development milestones that babies achieve during their first year of life?
The timeline for motor development is variable for each baby but also predictable. Most babies should achieve rolling (4-7 months), sitting without support (4-9 months), crawling (in some form between 6-12 months) and standing with assistance (5-10 months) in the first year. Walking without support has a wider range of “normal” and can occur anywhere between 9-18 months. Lots and lots of babies don’t walk before their first birthday & that’s completely fine. If there are no signs of emerging independent walking by 15 months, then I usually encourage a PT evaluation at that time.
There are lots of “mini-milestones” along the way so it's important to take time to observe & enjoy all the things your baby will do on their journey towards the major milestones. The other thing I really look for in my tiny friends is for some form of functional belly mobility (pivoting in circles, scooting, etc) or purposeful rolling to get places by 6ish months. Early independent mobility is like a key that unlocks the door for all other areas of development because it allows our babies to explore their environment in new ways & have a multitude of new, more meaningful interactions with caregivers.
As parents, we are all told of the importance of tummy time, and “Are you doing tummy time with your baby?” is a question that is asked at every doctor’s checkup right after “Do you have a car seat installed in your vehicle?” and “Is your house baby proofed?”. You have an awesome downloadable resource on your website that instructs parents on how to get started with tummy time. Can you give us a quick overview of what tummy time is, why it is so important for our baby’s development, and how much tummy time we should aim to give our babies each day?
Sure, Tummy Time is awake, active time that your baby spends on their belly. It exists to combat the motor delays that were observed by pediatricians following the initiation of the Back to Sleep or “Safe Sleep” program in 1994. Research supports that back sleep positioning is correlated with delays in prone (belly) mobility skills such as rolling and crawling. Clinicians have also seen an increase in pediatric musculoskeletal diagnoses such as Torticollis (tight neck muscle with a head tilt) and Plagiocephaly (flattened area of the head) over the last 30 years, since the Safe Sleep Campaign began. Almost 46% of babies now have a flat spot by 4 months of age!
Answers to the “How much Tummy Time question” are all over the place. Generally, parents should start off in the early weeks with just sprinkles of a couple minutes throughout the day & gradually progress until your baby is doing 10-15 minute (or more) spurts by 4-5 months for a total of at least 30 minutes a day.
I know, from first hand experience, that it can be pretty distressing for parents when their babies start to fuss when placed on their tummies. How do you determine if an infant is truly upset or just complaining during a therapy session? And how do you encourage parents to make tummy time more enjoyable if their babies are not tolerant?
Tummy Time is a “no-cry” zone. If your baby is crying, then they aren’t learning & it’s our job to respond when they are communicating with us that they need something. “Complaining” is like your baby is a bit annoyed or frustrated that they don’t know what to do & they get happier as you engage in play with them. This happens more with older babies, 3-4 months and up. You know your baby & you know what a true pain cry sounds like & we never try to work through that during play. Play should always be fun, engaging & facilitate bonding. I help parents learn their baby’s cues so that they can play during their baby's most happy, active times and end play time before the tears ever start.
What are some ways that parents can encourage purposeful movement in their daily routine?
I encourage parents to start with trying to bring what they can down to the floor. This means folding the laundry, answering emails, eating a snack & spending time together as a family down on the floor with your baby. This allows your baby to learn that the floor is a safe space. Prioritize floor time over time spent in “containers” - things like bouncer seats, loungers, baby seats, exersaucers, baby walkers, jumpers, etc. - by always offering the floor first, especially earlier in the day before your baby gets tired.
Being held by you, babywearing or being held by another caregiver always trump utilizing baby positioning devices, although in our modern world, they have a time & place to be used without shame or judgment. Try to have a small safe space in a few different locations in your home where you can put your baby down safely for floor time. Sometimes utilizing a small portable pack n’ play can be helpful in areas that are otherwise unsafe.
Many of the toys and playthings you bring along to therapy sessions seem to be Montessori in nature. Can you elaborate on ways that you incorporate the Montessori method into your wellness sessions?
Oh, so we utilize a Montessori-inspired parenting style in my own home that I’ve only been learning about since my oldest daughter was about 12 months old. Montessori principles that I’ve learned along the way have naturally flowed over into my practice as a physical therapist. This generally looks like encouraging parents to create a “prepared environment” which looks like setting up purposeful opportunities for babies to learn how to move their bodies in age appropriate ways. An example would be having a small shelf that’s the right height for a baby learning to pull to stand to pull up on & access their toys.
I try to guide parents towards developmentally appropriate toys & gently explain the difference between loud, musical, sometimes overstimulating multipurpose toys & toys that are simple, engaging and meant for your baby to learn one skill with that they practice over and over again. Less is very much more for a baby learning how to explore their environment & play independently.
There is also a big emphasis on observing & following the child in Montessori inspired parenting. This looks like taking time to quietly watch what your child is doing without interrupting them & then providing opportunities for them to practice the skills they are interested in. We are often so quick to help as parents & Montessori encourages parents to wait for the child to ask for help & only step in when absolutely necessary. In my wellness sessions, I spend a lot of time quietly observing the baby & pointing out to parents all the small things their baby is doing that they may not even notice. I’m then able to direct parents towards developmentally appropriate activities & toys based on their child’s skill level and interests. I could talk forever about how Montessori has inspired my parenting & practice as Pediatric PT but I will leave it at that.
There is a lot of misinformation out there surrounding early childhood development. Can you do some quick myth busting for us?
Sure! Some of the most common myths I hear are
Babies should walk by their first birthday - The age range of “normal” is 9-18 months. 50% of babies walk by 12 months. 95% by 15 months so many, many babies learn to walk between 12-15 months.
Seated baby walkers help babies learn to walk - Overuse of baby gear, including seated baby walkers can actually delay independent walking.
Toe walking is normal & your baby will grow out of it - Toe walking can be a really normal part of development as babies explore new movement patterns. Unfortunately most don’t grow out of habitual toe walking & it should be addressed by a Pediatric PT if your baby has been walking independently > 6 months, toe walks more than 60% of the time and if they toe walk in a coordinated, balanced, efficient way in all directions and with running.
Just do more Tummy Time & your baby’s flat spot will correct itself - Unfortunately also false. Your baby’s head needs appropriate counter pressure for extended periods of time in order to “round out”, especially if the flattening is moderate or severe. Tummy Time will help prevent it from worsening but it won’t correct it.
Letting your baby stand in your lap will make them bow-legged. - An old wives’ tale! Babies are born “bow-legged” due their positioning in the womb. Their legs straighten out as they learn to stand & walk. It may look worse in an early walker but should correct itself by 1.5-2 years old.
What are some red flags indicating developmental delays that parents should watch for? And how can early referral be a game changer for infants exhibiting these symptoms?
I actually have a list of “Signs to Seek Support” for ages 1, 3, 5, 7, 10, 12 and 15 months in my Parent Guide to Motor Milestones & Development. That list includes red & yellow flags. Red flags indicate that your child should be immediately referred to a pediatric physical therapist. Yellow flags are things that may need a referral, but should be monitored closely first. Two big red flags are a persistent head tilt or head turn preference past 10 weeks or a flattened area on their head at any age. Other things to watch for are if your baby feels extra “floppy” or “stiff” when you hold them or if they are unable to bring both of their hands together at their chest & mouth by 4 months. I’m also a big advocate for an immediate Pediatric PT referral if babies aren’t tolerating Tummy Time well by 5-6 months or if they aren’t showing signs of emerging independent walking by 15-16 months. Early referrals result in less time and money spent on therapy & improves long term functional outcomes for your baby.
What is your position on the Bumbo or other similar infant seats?
If you find yourself needing a baby seat, I usually recommend The Upseat. It puts your baby in much better alignment for reaching, looking around the room, socializing, feeding & playing. It also places your baby's legs in an optimal alignment to promote healthy hip development. The Original Bumbo seat puts babies in a slouched position with their legs closer together. It really restricts their movement & doesn’t allow them to use their postural muscles very well. It’s not a great position for feeding, reaching or playing. Babies also usually outgrow a Bumbo seat very quickly. The Upseat will last several months. I usually recommend that parents minimize time spent in infant seating devices until their baby is starting to show signs of sitting upright themselves, usually around 6 months.
I have always been of the mind that it is much easier for babies to learn to walk barefooted. Let’s talk about baby feet and whether or not babies should be wearing shoes for their first steps.
Yes! Barefoot is “best” for babies learning to walk. Allowing your baby to be barefoot allows their foot to feel the floor, strengthening their tiny foot muscles & allowing them to develop appropriate balance reactions. Shoes aren’t needed unless your baby is walking in a space that’s unsafe to walk barefoot. Shoes provide protection. First shoes should be flexible but have a sturdy heel cup, a wide area for toes, grippy soles & straps or laces for tightening. Avoid slide on or stiff shoes. Stride Rite is one of my favorite first walker shoe brands.
Tell me more about your Little Baby and Big Baby Movement Classes.
The Baby Movement Coach currently hosts Little Baby Tummy Time one Saturday morning each month at The Center for Airway & Facial Development (office above The Birth Center). This class is for parents & their babies from 0-6 months.
Little Baby Movement Class is an 8 Week Series that I host twice a year outdoors at local parks. Each week goes over a different developmental topic. Some of those topics include: Tummy Time Basics, How to Play with My Newborn, Container Baby Syndrome & Baby Gear for Little Babies, Torticollis & Flat Head Syndrome (Awareness & Prevention Strategies), Purposeful Play for Rolling, Purposeful Play for Sitting, Purposeful Play for Crawling, Movement Milestone Myths, Babywearing and Developmental Toy Ideas for Every Stage. After class, moms usually take the opportunity to walk the park together & make friends with other moms who have babies the same age. Expert special guest speakers may also be present for some Classes during the session.
For our “big” babies, I currently host Baby Cubs at Evolution Karate Studio in Middletown. This class is for our almost crawlers through early walkers. I’ve partnered up with Kama Porcelli (More Than Words Physical Therapy) to offer this Class. She hosts several other toddler & preschooler gross motor classes.
Look for more Tummy Time and pop-up Milestone Classes in the near future at new locations!
How is your business different from other typical physical therapy private practices?
The Baby Movement Coach is focused on wellness & prevention. My goal is to prevent your baby from ever needing physical therapy by giving parents the knowledge & tools needed to set their baby up for developmental success from the very beginning. I strive to give parents easy-to-implement everyday strategies & the confidence to support their baby’s natural development through Tummy Time & Milestone Coaching Sessions. Parents don’t know what they don’t know & there’s no one else to show them how to be successful with Tummy Time, what toys are developmentally appropriate & how to set up their baby’s play space to nurture development. I want parents to be able to feel the joy watching their baby grow & learn new ways to move their body for play instead of letting anxiety take over.
The other side of this is that I get to screen & refer babies to therapy who truly need it, sooner than ever before. Early identification & early referral are critical for decreasing duration of treatment & money spent on treatment & maximizing functional outcomes of treatment. The Baby Movement Coach helps parents avoid getting stuck in the outdated, yet still pervasive “wait & see” model of care that our healthcare system thrives off of.
What are the benefits of in-home pediatric therapy sessions for babies compared to traditional clinic-based therapy?
In-home sessions tend to be more convenient for families, especially for families with newborns & younger babies, when getting everyone packed up & out of the house can be trying. They tend to be more intimate, allowing for more family involvement & they allow me to see your baby playing in your baby’s natural environment which is where they will learn best & generally feel most comfortable. We can more easily work together to come up with strategies that you’ll be able to implement since we tend to use things you already have or I’m able to make suggestions that make the most sense for your family & your home. A traditional clinic-based therapy setting is generally busier, louder, brighter and more overwhelming for babies & families.
Do you still provide physical therapy services in addition to wellness sessions?
Yes, I still provide physical therapy services as an independent contractor with a local Early Intervention agency. Babies have to be evaluated through the State “Birth to Three” program to qualify for those services. The Baby Movement Coach is also partnered with a local private physical therapy company (More Than Words Physical Therapy) to provide outpatient pediatric physical therapy services in client homes & daycares specifically for babies with Plagiocephaly, Torticollis &/or Delayed Milestones. These babies may or may not qualify for the State’s Early Intervention program. Insurance & private pay options are available.
Who would benefit most from wellness sessions vs who would need PT?
Wellness sessions are designed for parents with a newborn or baby who is not yet walking. They are perfect for parents struggling to implement tummy time & play in to their baby’s routine. They are great for parents who have questions regarding “normal” baby development & when to seek a physical therapy evaluation. I often work with parents who have NICU graduates (or babies with other health histories that put them at risk for developmental delays) who want to make sure their baby is “on track” to catch up with peers. I also frequently work with parents in wellness sessions whose baby is at the later end of what’s considered normal for mastering milestones. Ideally, I would love to see your baby as a newborn for Tummy Time and then again for rolling, sitting, crawling & walking as needed.
Babies that would require physical therapy services are babies that have head tilts or a head turn preference, a flattened area on their head or a baby who has missed several skills or presents with one or more of the “red flags” that I mentioned earlier.
How can people get in touch with you?
Head to my website:
& fill out the contact form, or email me at
If you’re on Instagram,
for lots of developmental information & play tips.
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