What Causes Delayed Walking in Babies?

Reviewed on 6/16/2021

When do babies begin walking?

There many conditions that may cause delayed walking in toddlers.
There many conditions that may cause delayed walking in toddlers.

Most toddlers begin walking between 11 and 16 months of age, although some don't start until 18 months. Remember that most walking issues with toddlers resolve on their own. If, however, your child is unable to stand, support themselves, or walk by the age of 18 months, this should prompt attention from a pediatrician. Below are a few common conditions that a pediatrician may evaluate to determine the cause of delayed walking.

What causes delayed walking in babies?

Neurological disorders

  • Certain neurological disorders such as cerebral palsy or Down's syndrome may delay the phase of walking altogether. Picking up on the cues also helps address the underlying problem and start the treatment early.

Muscular dystrophy/muscular issues

Vitamin D deficiency

Rickets

  • Studies have reported a link between rickets and delayed walking.
  • However, if the condition has not progressed to an advanced stage, it is reversible, and timely treatment can help the child walk upright.

Hypothyroidism

Motor skills and walking

  • Some children have delayed motor skills, causing them to walk a little later than others. There could be many other reasons for the delay that simply have to do with their personality.
  • Some children would rather wait until they feel confident or are just unsure.
  • Hypotonia is a condition where people have less control over their bodies. It can affect walking in children who have or exhibit symptoms of hypotonia. This condition might be caused by brain damage. It could also be caused by muscular disorders, the nerves that supply the muscles, or an infection.
  • In other motor skill areas, some children have a learning disability causing a delay in walking. This is where a top physical therapist can help teach those skills and build strength to start walking.

Familial maturational delay

  • One or both parents may have a history of delayed walking during their early childhood period.
  • In such cases, there is a possibility that some of their children may have the same condition.
  • This does not constitute a disease but rather a maturational delay due to some genetic or familial influence.
  • There should not be any unnecessary concern, particularly if they started to walk by 2 years of age.

Prematurity

  • A baby who is born prematurely is expected to have some degree of developmental delay, the extent of which may depend on the prematurity level.
  • Therefore, a delay of 2-3 months from expected milestones, including delay in walking, may be tolerated as long as the affected baby is showing good overall progress and does not demonstrate any abnormal muscle stiffness or posture.

Other reasons

  • High muscle tone (very tense muscles)
  • Stiff limbs or poor balance
  • Baby is carried everywhere and not given the opportunity to try walking
  • Intellectual disability

What are early indicators for delayed walking?

  • Baby cannot sit without support by 9 months
  • Baby is not standing with support by 12 months
  • Baby is not walking steadily by 16 to 23 months
  • Baby is consistently toe walking (walking on tiptoes)
  • Baby is consistently late progressing through common developmental milestones (lifting head, rolling over, and sitting up)
  • If a baby is not walking by 16 to 23 months, a medical examination should be conducted to check their muscle strength, range of motion, and joint flexibility. Delayed walking could be an initial warning sign for cerebral palsy, muscular dystrophy, or other genetic conditions. A physician can rule out some of the aforementioned common disorders.

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References
Chaplais, J. de Z., and Macfarlane, J.A. "A review of 404 'late walkers.'" Archives of Disease in Childhood 9 (1934): 177-188. <https://adc.bmj.com/content/archdischild/59/6/512.full.pdf>.

Willacy, Hayley. "Delay in Walking." Patient.info. Apr. 26, 2019. <https://patient.info/doctor/delay-in-walking>.

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