My baby has a hand preference, is that normal?

Recently in clinic, a family presented with their 11 month old baby with concerns that she was mostly using her right hand and only when a task requires two hands, would she then use her left hand to assist her right hand. Mum had noticed a hand preference since 6 months old but had trouble convincing her GP that this was an issue. In fact, she had also noticed that baby’s left foot was stiffer than her right. Her GP repeatedly reassured her that its normal and she would grow out of it. A few months later, as it was not improving, she again persisted in asking her GP to refer them to a Paediatrician. The family eventually saw 2 Paediatricians and a Neurologist, before they were referred to Physiotherapy.

When I assessed baby, it was evident that she had a right-sided preference, and slight increased tone in her left arm and leg. Her left hip was stiffer and did not open outwards as easily as her right hip for nappy change, a sign picked up also by the 2nd Paediatrician. As a result, baby required a hip X-ray to rule out any hip dysplasia, and she is awaiting a brain MRI ordered by the Neurologist to determine if there is any change in the brain that has caused the increased tone in one side of her body. Physiotherapy assessment of baby’s gross motor skills revealed that baby is delayed in her gross motor skills, as she was not yet moving from sitting to tummy, not yet crawling, and not yet able to stand upright with equal weight bearing on both feet.

Regardless of the diagnosis, physiotherapy will be essential to assisting baby in developing her gross motor skills. We made a treatment plan for baby, and we will work towards helping baby achieve her gross motor milestone by 18 months old. Based on my professional experience, I believe it is possible to achieve this goal, although it will require a lot of hard work and commitment on the family’s part.

As we concluded the session, baby’s mum voiced her thoughts of how she tried for a few months to get help for her baby, and the thought that it took her 4 months before baby could get access to early intervention upset her tremendously. She had told her GP repeatedly that baby had an obvious hand preference at 6months old, but was told it normal. “ Is that normal? “ she asked me. So this triggered a conversation with the family, which I thought would be useful to share with everyone. To be fair to the GP, this baby’s left-sided weakness is very subtle and I can appreciate how it was overlooked by someone who is not specifically trained in infant motor development.

Is it normal for baby to have a hand preference?
The short answer is no, it is not normal for baby to have a hand preference. Hand preference usually starts to develop between the ages of 2 to 4 years old, however it is common at this stage for children to swap hands. Between the ages of 4 to 6 years old, a clear hand preference is usually established.

So babies under 2 years old should not have a clear hand preference. If you notice your baby having a clear hand preference, it is important to have baby assessed.

Some causes for a hand preference in babies include:

• Erbs Palsy

This is a condition where by the brachial plexus ( nerves to the arm ) was damaged at birth during a traumatic delivery.

• Cerebral Palsy
Cerebral Palsy is a broad term used to describe a group of disorders affecting the way a person moves. It is due to damage to the developing brain either during pregnancy or shortly after birth. Cerebral Palsy affects each child differently, and can affect one side of the body, the lower half of the body or both arms and legs.

Some unusual symptoms that may be of concern:

  • Fisting of the hands at rest and not opening the hands to reach for toys;
  • Stiffening of the elbow with the arm by their side;
  • “Ignoring’ one side of the body, and not using one arm to reach even when the toys are closer to that side of the body;
  • One arm appears uncoordinated when trying to reach for toys, while the other arm easily reaches for the same toy;
  • Tendency for baby to always roll to one side or reach to one side, or to sit up from one side only,
  • Crawling with unequal arm or leg use on one side of the body.

If you notice any of the above symptoms in your baby and it concerns you, then it is important to seek expert advice for your child. If you know of a mother who has expressed her concerns about her baby, please do share with her the above information. If we can empower parents with information and knowledge to seek medical advice and access to Paediatric Physiotherapy for Early Intervention, we would save another parent the heartache of feeling that they had missed out on valuable time for their child.

Early Intervention
Research has shown that the developing brain is very plastic, which means we can influence the brain to change and learn new movement patterns. Most of the skills development occurs from birth to 3 years old, and motor development begins to develop when babies are still in the womb and continues through the first 5 years of life.

So time is of essence, the sooner babies get access to early intervention, the better the gross motor skills development they achieve and the better the quality of life they have in terms of participation in life and independence.

If you or someone you know has been wondering, “Is it normal for my baby to have a hand preference?”, and would like some help for baby, call our practice on 02 9790 4233 to speak to our Paediatric Physiotherapist today!