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Many videos make you panic because your baby skipped crawling or didn’t get enough tummy time today. Social media can make motor milestones scarier than they need to be. I sat down with Jena Schultz, a pediatric physical therapist and mom of two to cover tummy time, crawling, W sitting and toe walking. Jena also shares two areas where she says don’t wait, act early. My hope is that you walk away calmer and more confident in your mom gut. 

We discuss:

• Why fear-based posts spread so fast online

• How pediatricians and therapists can work as a team

• Where tummy time came from and why Grandma never did it

• Army crawling, butt scooting and the slippery floor favor

• Head flattening and why early referral matters

• Why development happens in a sequence, not a stopwatch

• How to tell your intuition apart from fear

To connect with Jena Schultz follow her on Instagram @drivingdevelopment and check out all her resources at ⁠https://www.drivingdevelopment.org/⁠ 

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00;00;27;11 – 00;00;52;19

Dr. Mona

Welcome back to the show. Remember, if you are tuning into this conversation before October 15th, 11:59 p.m. Pacific Standard Time, you need to pause this episode and go vote for the Stock Talk podcast because we are nominated for a Signal Award, which is an award for podcasts, and we are nominated in the family and child raising category. All this will be so huge.

00;00;52;19 – 00;01;11;27

Dr. Mona

If I win, I get a trophy. Like I haven’t gotten a trophy since like high school. Okay, but you know what you need to do? Go vote. Voting ends at 1159 Pacific Standard Time. But I want to get into this amazing conversation today. Have you ever set a timer for tummy time and felt like a failure when your baby screamed at minute two?

00;01;11;29 – 00;01;33;04

Dr. Mona

Has a post ever told you that skipping crawling means something is wrong with your baby and suddenly you’re up at night replaying every wiggle and scoot? I want to share why this conversation today means so much to me. As a general pediatrician, I’m trained to care for a wide range of issues like allergies, asthma, eczema, ADHD, autism, and to know when a child needs a specialist.

00;01;33;06 – 00;01;56;23

Dr. Mona

But my focus where I’ve spent the most time and heart is child development and parenting. Sleep feeding behavior, milestones, all of it. Doing that well means learning from specialists, listening to parent concerns and opinions that differ from mine, and looking at the data, including data that reflects all kinds of families. Then I put it together with my clinical experience and what families tell me.

00;01;56;25 – 00;02;19;00

Dr. Mona

That focus is intentional, and I’m honored to do this work. But it’s not easy. And then I became a mom. My son Ryaan had a stroke and seizures, and development became my entire life. I watched him like a hawk for any sign of concern. That was also when I was newly active on social media as PedsDocTalk, right in the middle of the pandemic, and a lot of accounts started popping up for parent education.

00;02;19;03 – 00;02;37;25

Dr. Mona

And some of them truly stress me out. Even as a pediatrician, in trying to educate. They made it sound like missing one skill automatically meant a red flag. And that went against everything I knew as a pediatrician and everything I wanted to feel as a mom. And that’s why I wanted to have this conversation. Today’s guest is Doctor Jenna Shultz.

00;02;37;25 – 00;02;57;02

Dr. Mona

Jenna holds a doctorate in physical therapy and is one of only about 1% of physical therapists who are board certified in pediatrics. In 2020, she started driving development as a side project, and it grew into a busy pediatric clinic in North Texas. She also created Thrive Screen, a course that helps parents focus on what matters in their baby’s first year.

00;02;57;04 – 00;03;19;23

Dr. Mona

And she’s a mom of two who brings the research and the real life chaos to the same table. We’re chatting about why fear spreads so fast online, why Jenna thinks tummy time gets a little too much hype, and what to focus on instead, and whether skipping crawling is really a red flag. We also cover sitting and talking. Plus the two things Jenna says are worth acting on early.

00;03;19;29 – 00;03;43;09

Dr. Mona

Flat spots on the head and head turn preference. If you’ve ever felt like your baby is behind because of something you saw while scrolling on the internet, you are not alone. Make sure you’re subscribed on YouTube. Download this episode wherever you’re listening and share this conversation on social by tagging PedsDocTalk, the PedsDocTalk podcast and driving development so we know it landed for you.

00;03;43;11 – 00;03;53;18

Dr. Mona

Okay, so scoot on over and let’s get into this amazing, important conversation.

00;03;53;20 – 00;03;57;00

Dr. Mona

Thank you so much for joining me today, Jenna.

00;03;57;02 – 00;04;03;20

Jena Schultz

Thank you, Doctor Mona, for having me. I’m so excited to be, here with you and, man, what an inch. Yeah, that was awesome.

00;04;03;23 – 00;04;21;21

Dr. Mona

Oh, yeah, I love it. I like making it like a talk show or like you’re coming into, like, a ring of, like a fighting ring, you know, like, here we go for the first time. Let’s do this. I’m really excited. I’m really excited to have you on. You know, I we have we have connected on social. This podcast episode was actually recorded in its entirety many months ago.

00;04;21;21 – 00;04;46;06

Dr. Mona

And then we had tech issues, so I had to have Jenna come back on. So we are getting the second round with a little more questions, because we’ve grown in our careers and obviously through social media. But before we get into this, you know, milestones, myths, especially about motor milestones, introduce yourself. What, drove you to get on, social media to start educating and also start your practice as well?

00;04;46;09 – 00;05;15;01

Jena Schultz

Yeah. So, it’s it’s funny because, yeah, a lot has happened since we last recorded. And, you know, I initially started driving development in 2020, as we all did with a little side quest. And it it blew up into, this entire business that I’m so grateful to have. And so I see patients here in North Texas and, provide one on one care, but also provide information online.

00;05;15;01 – 00;06;02;05

Jena Schultz

And so one of the things I’m very passionate about is, sharing information in a, not fearful way, in an offering way. And proactive education. I feel, especially over the course of the time since we last spoke to has become a lot more, based in fear and anxiety. And and yeah, I actually, took, about a year off of social media, so you’ll see it a year gap there where, you know, I was I was noticing all these things online and trying to build this community, and, was just getting really disgruntled with all of the, the fear based messaging there.

00;06;02;05 – 00;06;30;19

Jena Schultz

And so, took a year off because I was like, man, I don’t want to add to this noise. Yeah. But I found in taking the year off, I still treated patients. And in that year, they were still hearing the noise. The noise was stop. And so, I decided to come back, and instead of kind of looking through the lens of adding to the noise, which I wasn’t doing, but I had convinced myself I was, going to create our own music cure.

00;06;30;19 – 00;06;37;19

Jena Schultz

So I’m back on social media sharing, doing all the things. And, yeah, I’m excited to be back.

00;06;37;22 – 00;06;56;25

Dr. Mona

Well, thank you for being back. And I completely resonate with that sort of noise that can become all too consuming in our brains and our hearts. Especially when we’re trying to provide that evidence experience based combo, which I think is so valuable. Right. It’s taking both and putting it together the way we listen to our patients and learn from them and say, you know what?

00;06;57;00 – 00;07;16;19

Dr. Mona

That’s a little bit wrong. That’s right. Maybe I can do something differently. And I see you do that as well. And I’ve mentioned this. You are one of the only parts of, speech therapist that I follow. You know, there are many, but I try to choose 1 or 2 in the specialties because one then just gets a lot of like, noise in my mind.

00;07;16;24 – 00;07;40;00

Dr. Mona

But also I want to follow creators like yourself that are very balanced and centrist in how they educate. You know, fear is always going to sell more. Fear is always going to get more clicks. And I understand that from a social media model, but it doesn’t have to be that way, especially when we talk about various things, you know, and you are seeing the same thing I have on social media.

00;07;40;01 – 00;08;03;01

Dr. Mona

Lots of anxiety around things like sitting, crawling, tummy time schedules, toe walking, and sometimes the nuance gets lost. And honestly, some of it is push just to sell something like a course or something like that. And you know from your perspective, what trends or messages have you noticed online that concern you the most?

00;08;03;04 – 00;08;30;09

Jena Schultz

Yeah. So, so and that’s so important, doctor Mona, first off, I’m honored that, you chose me to trust with that information. I definitely, am one of the few that I feel embraced that gray area. And speaking of the things that worry me the most, it’s, really that black and white education. And you had alluded to it already that fear gets more clicks, it gets more engagement, it sells more.

00;08;30;14 – 00;09;14;06

Jena Schultz

And, you know, it’s if I were to come on and say that, if your baby doesn’t crawl, there’s something wrong with them that invokes fear. Yeah. That fear is going to lead to comments and likes and shares and more engagement. And at the end of the day, I what parents are seeing is more divisive information at the top of their feeds and, further and further from embracing that gray area and that nuance and something I found, especially in my time off on the sabbatical, was that, that gray area, gray area is where we really allow our babies to become their unique selves.

00;09;14;08 – 00;09;51;19

Jena Schultz

And, one of my favorite quotes, local artist here in DFW put this quote together and it’s, you’ll never fit inside their boxes. They’re much too small for all you are. And I have it on our playroom wall. But I like to use it as a metaphor in this sense for social media consumption. So a lot of the times when we are taking in information online, we’re looking at that black and white, and we’re trying to put our babies into those boxes that we’re seeing on people’s social media feeds.

00;09;51;19 – 00;10;19;04

Jena Schultz

So we’re scrolling and scrolling and there’s literal boxes of information on their feeds. And I just want to challenge parents when they’re going through that. Are they trying to put their baby in the boxes that people are putting their on their feeds? Or are you taking that information and applying it to your baby’s own unique journey? And, that’s where you embrace that gray area instead of that divisive black and white.

00;10;19;09 – 00;10;44;22

Dr. Mona

I, you know, I really resonate with that. I think, general pediatricians get a lot of flak, for, you know, some of the things that we may recommend and I agree that we could do a better job. And I say we as an entire profession of, you know, recommending early intervention or support when needed. I know you’re a big advocate on play, Josepha, which is flattening of the head and I think many times not myself.

00;10;44;22 – 00;11;00;07

Dr. Mona

But there are colleagues of mine that are like, yeah, I don’t do much like it’ll go away. Just, you know, put them, give them tummy time that it but there’s really not a good level of education on here’s more things that we can do to maybe prevent helmets if that is a possibility. And I love that, you know, I love that it’s.

00;11;00;10 – 00;11;24;13

Dr. Mona

This isn’t about. We don’t care about anything that. Oh, don’t like dismissive. This is about there are certain things that I don’t want you to lose sleep over, but here are some tools that you need to better support your child. Right. That’s what this is about. And I think that’s what you do as well. But then it becomes like the fear on one side, like if you if you don’t give your child tummy time for ten minutes a day, multiple times a day, they’re going to have a flat head and you’re a bad parent.

00;11;24;13 – 00;11;29;13

Dr. Mona

Like that’s what that feeling is. Versus don’t worry about it. No, it has to be somewhere in the middle.

00;11;29;15 – 00;11;46;21

Jena Schultz

Right? 100%. Like we have to embrace that gray area. And, you know, we can we can act early without overreacting. And, that’s that’s really the core of kind of what I like to preach to parents.

00;11;46;23 – 00;12;07;25

Dr. Mona

Yeah. And you know that there’s a phrase that goes, sometimes you can’t see the forest for the trees. Yeah. And sometimes some specialist. Right. And when I am, you know, OTS, speech therapists, they can sometimes get mad at us general pediatricians because we are looking at that big picture. Right. We are looking at how maybe one domain relates to another domain.

00;12;07;25 – 00;12;26;11

Dr. Mona

Right. So if a child’s not speaking we’re also looking at cognitive development. We’re also looking at motor development and gestures. You know it’s all connected for us. And so sometimes I get that feedback that why didn’t you see this. Or you know you need to refer for one thing. But a lot of us, I’d like to be honest, are looking at that big picture.

00;12;26;11 – 00;12;46;20

Dr. Mona

And that’s how I approach development, you know, and so I may be, you know, a little less conservative than someone else to be like, you know what? We can watch this because I’m seeing something that is really protective or good that warrants that. I don’t think you need someone at this point like a specialist. But of course, I know because I’ve done development enough to say, you know what?

00;12;46;27 – 00;13;04;15

Dr. Mona

Now is the time to see somebody. But that being able to see the forest for the trees and look at that big picture is something that we are trained for. And then it’s also important for us as general pediatricians to know, okay, now there is minutia here that I need to address. And the best person for that would be a physical therapist.

00;13;04;15 – 00;13;06;26

Dr. Mona

If it’s a motor skill like we’re talking about.

00;13;06;29 – 00;13;34;17

Jena Schultz

Yes. Yeah. And so often I feel like we, we find the, the rhetoric where we’re butting heads with other professionals, and it’s like our word against theirs. And, I’m a little frustrated with how the conversation has gone. A lot of people online have been like, oh, you know, like, all pediatricians don’t really refer. They don’t use refer appropriately.

00;13;34;17 – 00;14;03;22

Jena Schultz

And it’s just closed that lane to us having the open communication to better serve our, our patients and, yeah, being able to work and I’ve found some phenomenal ones here in my area that being able to work together and trust each other is the, the biggest thing. And so, I love that you mentioned that obviously, knowing when to refer knowing, having those open lines of communication so important.

00;14;03;25 – 00;14;25;08

Dr. Mona

And I would love to get into some nitty gritty. Of course, there’s many different motor milestones and things that we could talk about, but I wanted to focus this on tummy time. And then things like w sitting, crawling to walking. So first let’s get into tummy time. You know, tummy time feels like one of those buzz word milestones that stresses parents out, especially when it comes to you got to do it for this amount of time.

00;14;25;08 – 00;14;37;24

Dr. Mona

And here’s my program that make sure you do it this amount of time. As a pediatric physical therapist, what do you want parents to really know about tummy time? How to get it done? The basics of that so that they’re not stressing themselves out but understand the importance of it.

00;14;37;29 – 00;14;57;29

Jena Schultz

Yeah. So, I think we can start with like, a little short, objective history of tummy time. So, you know, tummy time came about, because of the Back to Sleep campaign, which is very important. Help, you know, safe sleep and everything, but it was a, movement to make sure that babies were still getting time on the belly.

00;14;57;29 – 00;15;27;28

Jena Schultz

And so, you know, development. But, you know, that’s why maybe your grandmother might be like, we never did tummy time. Well, that’s because they probably didn’t. It wasn’t like a thing that they really had to lean into. But with that said, over the course of the last, you know, year, few years, a couple decades since that came in, I personally have an opinion on tummy time that, might be a little, I don’t know, rock the boat a little bit.

00;15;27;28 – 00;15;49;26

Jena Schultz

And, I think that tummy time is overrated. And I would say, like, don’t hear it. I’m not saying it’s still, like, rated like it’s important. But it’s just not the only thing. And telling parents that they have to do, like a certain amount of time and all of this, it only creates stress. And really, it’s the very first milestone that we see.

00;15;49;26 – 00;16;21;21

Jena Schultz

And then like from the get go, we are telling parents to not trust their instincts to try to hit this exact quota and all these things. And yes, it’s important, but I don’t tell parents to count time, time. I tell them to, count variety. And so, what that means is like giving your baby variety and how they’re playing, back lying side lying tummy time, holding them and bonding.

00;16;21;21 – 00;16;48;08

Jena Schultz

I mean, it’s all important. And when we focus too much on one thing, it can become imbalanced. And so what that looks like is I like to allude to like, let’s say you go to the gym and you just work out your biceps all the time. Yeah, just that’s it. Just your biceps. One position. You have a tricep, you have muscles every planning your body.

00;16;48;08 – 00;17;17;07

Jena Schultz

Yeah. And so if we are just focusing on one position, we are not looking at the rest of the big picture. And so, yeah, I think that, you know, obviously we can work in tummy time and work it in, you know, naturally and how it feels good to. But stressing about the minutes and having it be the one thing when we need to be looking at back lying so they can bring hands to midline and side lying to prep for rolling all of those.

00;17;17;10 – 00;17;24;09

Jena Schultz

It’s really just just a little overrated in my opinion.

00;17;24;11 – 00;17;52;13

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show. Oh yeah, I love how you said it’s rated, but not overrated, right? Because of course it’s useful for the muscles that it’s doing. And I, I love because I feel the same way that you mentioned about the time, because when I see people and it’s it’s happening, I mean, my fellow clinicians do it online, you know, physical therapists or developmental therapists about the you’re going to do this schedule.

00;17;52;15 – 00;18;07;20

Dr. Mona

What parent, especially in the first three months, is going to be able to do anything on a schedule and like it’s a blur, like I and I think about like, parents who can’t even give the vitamin D drops. Right? And I’m like, even that. I already have my own opinions and I’m like, don’t really panic about it.

00;18;07;28 – 00;18;30;03

Dr. Mona

But same thing here, right? You’re going to get these moments by laying on your chest. You’re going to get these moments if you, you know, try to minimize the the containers. Right. What I mean by that is that putting your kid in a container for five minutes isn’t going to break their brain. And they’re, you know, and their back, but like, okay, so when you’re when you’re able to have them and play with them, take them out, put them on a mat like let them be on their bed, let them be on their side.

00;18;30;03 – 00;18;55;05

Dr. Mona

And I love you brought that up because my philosophy, like yours, is that I want people to have to think about less. And when we’re thinking about, okay, now I got to get this ten minutes of tummy time and it’s just not going to happen when it’s right. Rather than doing that, make it just part of your life and routine and like, have them lay on you when you’re awake and like all that stuff, you know, it’s going to be so much better and so much more practical to get done.

00;18;55;07 – 00;19;12;05

Jena Schultz

Oh yeah. And also chest to chest tummy time, especially in those early months, 100% counts. And I have people ask me if it counts, like if you have your baby laying on your chest and tummy time, it’s the best tummy time you’re bonding. You could get skin to skin. Yeah, all of it.

00;19;12;05 – 00;19;32;09

Dr. Mona

I’m like the social emotional connection with motor like hello like that is whenever we can match two domains together. It’s like the developmental dream. You know, I love that. Yeah. No, I really appreciate that. And I love this, you know, the time thing that you mentioned, and in terms, you know, of course, if people are looking for strategies on tummy time, things like that, I know, Gina has resources.

00;19;32;09 – 00;20;01;03

Dr. Mona

I also have a video as well. But I wanted to just kind of go through the basics here of like, myths, not to freak out what to do. And so thank you so much for answering that. Now, the next one is about crawling. And as you know, crawling was removed from the CDC milestones and it caused a big uproar because there are many physical therapists and many developmental specialists who feel that if a child doesn’t crawl, it’s an automatic huge red flag.

00;20;01;03 – 00;20;10;19

Dr. Mona

And these are not my words. These are other people’s words. So what are your thoughts? Is crawling a critical milestone, or is the lack of crawling a red flag?

00;20;10;21 – 00;20;45;06

Jena Schultz

Yes. So the crawling debate, it’s a it’s a hard one. So some objective history to here is that crawling used to be a CDC milestone and they had taken it off just like you had said. But there is so the reason why people are upset about this as pediatric PTSD is that there is something that we know where it’s if there is a child that has a condition already, they may have a harder time crawling.

00;20;45;08 – 00;21;10;02

Jena Schultz

But they also have a harder time meeting all of their other developmental milestones. Right. So it’s correlation, not causation, where, yes, a child may not be able to get into hands and knees and coordinate in actual crawl, but it’s because there could be underlying things if there is a diagnosis already.

00;21;10;04 – 00;21;11;01

Dr. Mona

00;21;11;03 – 00;21;35;26

Jena Schultz

A child that skips crawling but is on track with all other milestones. There are no other red flags. We need to be looking at the new labs here. There are, there are kids that I have had in clinic where the parents have the, the crawling to be at the their fingertips online, and they come in and they’re so worried that they’re skipping crawling.

00;21;35;29 – 00;21;54;20

Jena Schultz

But this little one is so advanced in terms of like trying to follow their like they’re on top of it. They’re like starting to say words and they’re like chasing around for other. And really, they are about to start walking.

00;21;54;24 – 00;21;55;01

Dr. Mona

Right?

00;21;55;02 – 00;22;26;27

Jena Schultz

And so I tell the parent that if we were to delay this child’s self-directed, self-motivated walking and say, no, don’t do that and just keep them on the floor and hands. And yes, it is doing a total disservice to them because we’re taking them away from listening to their body and their intuition. Now, this doesn’t mean that, like, there’s anything wrong with them or that like they won’t be able to crawl or have any of these things down the line.

00;22;26;29 – 00;22;29;27

Jena Schultz

You can always work on crawling, crawling tunnels, all of these things.

00;22;29;27 – 00;22;30;10

Dr. Mona

Yes.

00;22;30;15 – 00;22;32;24

Jena Schultz

You and I could get down do it right now.

00;22;32;26 – 00;22;38;11

Dr. Mona

But let’s do it, girl, we need to. Brain motor. Motor movement is good for dopamine. Let’s do it.

00;22;38;13 – 00;23;05;11

Jena Schultz

I love it. But yes, it’s just that. That correlation. Because, yes, we know that a child with cerebral palsy or a child with muscular dystrophy may have a harder time doing these activities. Doesn’t mean that a child who has skipped crawling and gone to walking, or is choosing a different form of mobility, is having a red flag or a big issue.

00;23;05;18 – 00;23;15;27

Jena Schultz

So that’s where the big confusion comes from. But, you know, there’s a lot of people that have some, some strong, opinions on, I.

00;23;15;27 – 00;23;39;24

Dr. Mona

Think, like more than strong. I mean, I feel like the narrative that I’ve heard also, and if you want to explain, if there is a reasoning behind this, is like people who don’t crawl are going to have a harder time cutting using scissors because of their inability with fine motor. Like there’s also people saying that there’s going to be problems down the line with basic hand movements and tasks, and maybe explain where that may come from or if there’s validity to that.

00;23;39;27 – 00;24;09;07

Jena Schultz

Yeah, it’s it’s similar in that we know that if a child is crawling, they’re getting the sensory input to their hands. They’re getting, strengthening in their hands. They’re getting that, you know, sensory feedback and all of these things that can build the intrinsic hand muscles. So, yes, it’s true that that does happen, but it’s not if they don’t get that, they aren’t going to have strong hands.

00;24;09;07 – 00;24;31;07

Jena Schultz

Correct. It’s like there are other ways that they can get that strengthening and that in this one little thing is not going to be the hiccup to their entire development down the line. There are other ways for them to get those experiences and that strengthening. And I just, I it just feeds into that fear based messaging.

00;24;31;14 – 00;24;55;06

Dr. Mona

Well, this is a prime example of you explaining being able to see the forest for the trees. Right? I meaning like you are looking at that big picture, which I have been in those offices many times, which is why when there’s an uproar, I’m like, what are we talking about? Like if I, as a pediatrician who is very into child development, saw a pattern of my antique crawlers, that’s not I guess that’s the term I’m going to use my my crawling, defiant children.

00;24;55;06 – 00;25;20;23

Dr. Mona

Okay. If I saw my crawling, defiant children go on. Because I’ve seen these kids now for like eight years at my current practice. Go on to have issues right, with whatever fine motor skills, issues with anything when they were meeting all those other milestones. And of course I’m going to sound the alarm and say, hey, but like you said perfectly, this is all about looking at the other domains and other domains, not only in, you know, speech and cognitive and social emotional, but other motor milestones.

00;25;20;23 – 00;25;41;28

Dr. Mona

And many of my patients bypass the crawling and go straight to walking. And I tell the family I’m like, they got to keep up with their siblings. Like, look at them go. And they’re coordinated and they’re early walkers. And I’m like, they are probably doing what evolution has taught them to do, right? You think about evolution and like the caveman, I’m pretty sure no one was worrying about crawling because they got to go.

00;25;42;02 – 00;26;03;10

Dr. Mona

They got to go hunt. They got to go move. So the baby probably figured out early. Well, you know what? I can walk much faster than I can crawl. Let’s get this ship moving here. And so I joke about that, because it is something that I think about when I think of motor and development. Right. I think a lot about evolution, and I think a lot about how these are very primitive things that we’re learning how to do.

00;26;03;11 – 00;26;19;13

Dr. Mona

Like, it makes sense for us to want to walk. Is there any red flag on the type of crawling, you know, meaning like parents often ask me about the army crawl or like the butt scooting and like, you know, them having to drag their butt like anything there? Or is that more of a big picture? Look as well.

00;26;19;15 – 00;26;41;18

Jena Schultz

And it’s so funny because I feel like I’ll just sound like a broken record, but it’s all that gray area. Yeah. So it’s there. There are certainly children who, you know, are having difficulty as they age with fine motor skills and also had a history of skipping, crawling. And again, that correlation, not causation. It doesn’t mean that that’s going to happen.

00;26;41;20 – 00;27;12;11

Jena Schultz

But also when we go back to the crawling style, same thing if there is a child that has a history of, let’s say, torticollis or, some sort of diagnosis that made them asymmetrical and they have a asymmetrical, all type of crawling pattern, it could be that the torticollis isn’t fully resolved. Torticollis is essentially a diagnosis for those who don’t know of a, one sided tightening of the neck.

00;27;12;13 – 00;27;29;16

Jena Schultz

That is a small case. And this is just like an example of how it’s so case to case because there’s also children that I have seen that are bottom scooting because they are. The flooring that they’re on is very slippery.

00;27;29;18 – 00;27;30;00

Dr. Mona

Yeah.

00;27;30;00 – 00;27;38;29

Jena Schultz

They have hardwoods in their house. Anytime they go to crawl in there and they like slip. Exactly. And so.

00;27;39;05 – 00;27;40;23

Dr. Mona

Like yeah, exactly.

00;27;40;27 – 00;28;01;22

Jena Schultz

So that they, they scoot on their bottom around and I’ll tell parents. Yes, if you notice that there is like a they’re scooting on their bottom, but there’s also like delay and other milestones. Are there other concerns we can listen to that intuition and talk to our provider about it. But it’s not an immediate red flag.

00;28;01;22 – 00;28;19;22

Jena Schultz

And I would say for the little ones that, skip crawling that come into my clinic, more often than not, I am reassuring parents that there is nothing wrong with their little one. But we are. They want to get the check in just in case. Yeah, and you know what? That’s always an option. You can always get a check in just in case.

00;28;19;22 – 00;28;26;10

Jena Schultz

Just make sure you’re going to someone who is not going to fear monger into selling services with just.

00;28;26;12 – 00;28;42;02

Dr. Mona

Yes, it is tricky, and I love that we’re talking about this because we got to look at an intent. Obviously, as a general pediatrician, I don’t get anything more by telling you that your child’s okay, right. Like meaning I want your child to develop and thrive on their own accord. So for me telling you, hey, I’m not concerned.

00;28;42;04 – 00;28;58;01

Dr. Mona

You know, let’s look at this. Let’s watch this. Of course, I’m very into development, so I end up giving some guidance like, hey, here’s what we can do. Here are some resources. I want to see you back in X amount of time to see how they’re doing with whatever, you know, milestone. That may be a little on the lesser end of the range.

00;28;58;01 – 00;29;15;12

Dr. Mona

That’s, typical, but it’s so important that we do that. And the next questions are probably going to be nuanced as well. Or maybe not is about something I hear parents ask a lot about is w sitting and talking. So what do you want parents to know about for these two things? And when are they concerning.

00;29;15;12 – 00;29;17;24

Dr. Mona

And and rather just being normal development.

00;29;17;26 – 00;29;42;22

Jena Schultz

Yes. So w setting got a, kind of bad rap because it, it with certain children that have, conditions. Again, they will have difficulty with their trunk control. And so they sit in the W set to lock out their hips so that they can have more stability and setting. Yeah. So that setting is essential. And you can look it up, you’ll see pictures.

00;29;42;22 – 00;30;07;06

Jena Schultz

But essentially the knees come in, the feet go wide. And it just creates a more stable base of support. And sitting. Now again correlation not causation a child may sit that way. And it could be the only way they sit because they are lacking trunk control. If it is the only way that they can sit and they can’t sit any other way, and there’s other delays, of course we can look at it as being an issue.

00;30;07;06 – 00;30;30;05

Jena Schultz

However, w sitting is just a normal variation in developmental sitting for most children. And I like to give the metaphor of like, let’s say you’re you’re standing up and you have chosen to lean on a wall. It’s one of the ways you can choose to to stand. Yeah, you can lean. You can, you know, put a foot up.

00;30;30;05 – 00;30;53;00

Jena Schultz

You can, stand on your own. You can, you know, there’s a million different ways that you can stand. But if that is the only way that you can stand by leaning on the wall, then that’s going to be a red flag. So if the said as the only way that a child can sit and there’s other concerns emerging, then we want to look a little deeper and, and.

00;30;53;00 – 00;30;55;13

Jena Schultz

Yeah. So, oh for the toe walking.

00;30;55;16 – 00;31;16;21

Dr. Mona

Yeah. Before we go into talking. So the, the you know, obviously I share my kids on social. This is a very personal decision that my me and my husband came up with together. I mean, everyone has their own opinions, but part of the negative of sharing your kids on social is that everyone always has a comment about the random, little nuanced things that they’re doing right, and so many people are very kind about it.

00;31;16;21 – 00;31;33;14

Dr. Mona

They’re like, because both my kids are intermittent sitters, meaning especially not like they sit other ways, like you said. So I’m not worried about it. But when they are sitting w sit and then I post a cute video of them playing, oh, Doctor Mona, like I’ve heard about w sitting is that okay? And I’m like, do I need to another video on this?

00;31;33;14 – 00;31;47;04

Dr. Mona

Like, yeah, it’s okay. But I love that you explain that sort of balance and that analogy with the standing, you know, because sometimes you stand with your hips like this or you pop it out. But if I see, like old grandpa always walking out with a popped hip, something’s up, you know. So.

00;31;47;04 – 00;31;48;00

Jena Schultz

Right.

00;31;48;02 – 00;32;04;05

Dr. Mona

Yeah. Like that example. Yeah. It’s true. I mean, I’m not worried in the slightest because they can get in and out of it. They are able to sit in other positions. They they are able to do like planks with me when I work out. I’m not worried about their core. Like, you know, it’s it’s that again, looking at that nuance and big picture.

00;32;04;08 – 00;32;11;16

Dr. Mona

But yeah. So tell me about to walking because that’s another one that I think there is nuance here as well.

00;32;11;18 – 00;32;17;13

Dr. Mona

Now let’s take a quick break to hear from our sponsors who support helps us keep bringing you this show.

00;32;17;15 – 00;32;40;29

Jena Schultz

Oh yeah. And I have kind of a fun story about working too. So in, 2022, I got like a bunch of followers off of a post that had about like 10 million views and, it was a video of my son. I had put one of those, like, gosh, like suction cup toys up on the top of one of our glass doors.

00;32;40;29 – 00;33;01;03

Jena Schultz

And he, intentionally so that he would elevate up on toes and reach for it. And it went viral and it went viral because of what we were talking about with the controversy, so many people took to the comments, this is bad for their development. It’s going to cause toe walking. It’s all of these things. And like, like, let’s think of this objectively.

00;33;01;03 – 00;33;30;08

Jena Schultz

So inability to elevate on toes is just as much of an issue as constant walking. So the nuance here is that, elevating on toes is just like a normal type of exploratory development. It is something that kids should be able to do. They should be able to elevate on toes. It’s a precursor skill building for jumping because those, you know, those muscles in the back of your legs get stronger.

00;33;30;10 – 00;33;53;16

Jena Schultz

Now it does become an issue when it’s again in the first two years. The only way that a child can walk elevated up on toes. And even then we’ll kind of look at what else is happening, you know, is there any sensory issues? Is it along other delays after the age of two is kind of where if it’s persisting, we’ll look into it a little bit deeper.

00;33;53;16 – 00;34;21;01

Jena Schultz

But again, only if it’s almost all the time, 50 to 75% over that amount of time. And if it’s just habitual, it’s it’s worsening and we’re noticing it with other delays and other diagnoses. It’s one of those things that has gotten a bad rap, I think, from fear. A lot of people get fearful that it is diagnostic of something.

00;34;21;05 – 00;34;21;22

Dr. Mona

Yes.

00;34;21;22 – 00;34;42;26

Jena Schultz

And it is not diagnostic at all. It is just a way that your body is supposed to explore through movement, elevating up on toes. And I have a lot of people that reach out to me in DMs. Doctor Mona, that art like like sending videos. And just a reminder, please don’t do that because I can’t do.

00;34;42;27 – 00;34;48;14

Dr. Mona

Any one of us. Please. Yeah, as much as we love you all, we can’t do it. It’s not. It’s not legal. Yeah.

00;34;48;16 – 00;35;09;12

Jena Schultz

Exactly. And but I, you know, I’ll, I’ll see them and be like, oh, you know, I can’t diagnose or treat or anything, but a lot of these videos are like, my child is cruising along the couch, just learning to walk, elevating up on toes. And they’re like, something’s wrong, something’s wrong. And I have to reassure, like you here, I can’t, you know, diagnose sampling.

00;35;09;14 – 00;35;28;29

Jena Schultz

Again, don’t send me videos or pictures, but reassure you here that when a child is first exploring and starting to walk and do those things, they’re going to do some weird things. They’re going to elevate up on toes. They’re going to find their feet in space. It’s not diagnostic. It doesn’t mean that anything is wrong.

00;35;29;02 – 00;35;53;04

Dr. Mona

I love that. Yeah I mean there’s a lot you brought up the fear thing and that’s what I get too. And I a lot of the fear is that this means and I get this a lot that this means autism. This means like and not to say that an autistic child can’t have, you know, talking, but a lot of it could be sensory related, like you said, which we know that there’s a crossover between sensory differences and autism, but it is that, you know what else is happening with the child.

00;35;53;06 – 00;36;08;27

Dr. Mona

And then from a motor, you know, from a muscular standpoint, if a kid is talking, everyone’s like, I get the comment of like, well, their muscles are very tense. And, you know, could this be a sign of like a muscular dystrophy? And I’m like, listen, a muscular dystrophy would be much different than a child just wanting to go on tiptoe.

00;36;08;27 – 00;36;29;03

Dr. Mona

It’s like there’s a lot more going on. There’s a lot more weakness or hyper, you know, being hypertonic, which means that there’s more tone there. So definitely bring it up to your clinician, to your, you know, if you want to see a physical therapist about it. But it’s really important to again, know that middle ground. And I know you know me and you, Jenna, we’ve talked a lot, a lot about middle ground things, right?

00;36;29;03 – 00;36;46;20

Dr. Mona

We’ve always talked about the tummy time, the crawling, the you know, w sitting and the toe walking. Is there anything in the work that you do or maybe something that you see so much that you just want to give a message on? Like, hey, this is actually where I want to throw a little more nuance out the window and say, hey, do this.

00;36;46;20 – 00;36;48;27

Dr. Mona

Don’t do this. In regards to motor development.

00;36;49;00 – 00;37;15;02

Jena Schultz

Now, I love this. So it’s it’s, I love that you brought this up too, because there’s there are a few things that I’ve seen in the last decade where I’m like, gosh, like, we just we’re doing this again, like we don’t have a thing. But then also there are a few things where I’ve been a little frustrated that like when there isn’t, there really should be early intervention and an easy fix.

00;37;15;02 – 00;37;41;17

Jena Schultz

So to speak. And so it is one of those things that you brought up when it comes to play GSF early. So, I am a strong believer that if there is a head flattening that we notice in the first few months of life that we refer to someone who can help with the head shape. And that’s just because, we are able to fix it through strategic repositioning without a helmet.

00;37;41;19 – 00;38;01;29

Jena Schultz

If we get them early enough. And, you know, I think the frustration is just seeing that not happen and then have the parents have to go through the whole process. And helmets are so helpful when they’re needed and all of those things. But, they can get costly. Not all, you know, insurance is cover uncertain. So that’s one of those things I feel strongly about.

00;38;02;01 – 00;38;11;24

Jena Schultz

It really isn’t a gray area where if I see the flattening, it’s like, let’s go ahead and refer. It’s just in everyone’s best interest. It’s less expensive or less things.

00;38;11;26 – 00;38;28;11

Dr. Mona

And I mean, I mean, yes, the I like you said, they’re amazing and beautiful in terms of the work that they can do, but they’re also 23 hours a day and they are very itchy. And my I have patients have eczema that are like struggling with it. So of course we’re trying to reduce it but not upset if we ended up having to go that route.

00;38;28;11 – 00;38;31;20

Dr. Mona

But like again, there are things that we can do hopefully before it happens.

00;38;31;22 – 00;38;51;27

Jena Schultz

Yes. Exactly. Like and it and like I said, I’ve had many patients be with them and use them and and have great outcomes. But again it’s one of those things where we can avoid. The other thing is with torticollis and early head turn preference. So if a child has a head turn preference one way or the other, huge clinical practice guidelines.

00;38;51;27 – 00;39;14;03

Jena Schultz

I’m a research person, came out for torticollis and for head turn preference in early babies that, the sooner we get them in, the faster the outcomes, the better the resolution. So it’s like if we see them in the first month or two of life with that had turned preference, we can, correct it up to 98% of the time within a month or two.

00;39;14;06 – 00;39;38;27

Jena Schultz

And then as if we don’t see them until 4 to 6 months, that therapy can extend out 6 to 9 months. And the percentage of us being able to fix it goes down by about 30 to 40%. So yeah, that’s where the early intervention, those are my two things. And it’s just because I’ve seen it over the last decade where earlier has been better and it has made a big difference.

00;39;38;29 – 00;39;52;02

Dr. Mona

Oh, I know we talked about at the beginning, but that is an area that I’m I’m a stickler for head shape. Like I’m literally in the visits. And you know, I think I train my residents to, you know, I have residents that I teach and I’m like, this is how you’re going to look at the head. Like, you can’t.

00;39;52;02 – 00;40;14;22

Dr. Mona

You have to look from above. Like you got to look at the where the ears are placed. Like I’m teaching them that because I think it’s so important because, like you said, if I’m finding that an infusion, it’s going to be at the the one month visit, right. Because it’s like for that head shape, of course, if we see it before then it’s an even bigger red flag because are we dealing with something like, the sutures of the skull fuzing to, to early and for everyone?

00;40;14;22 – 00;40;32;10

Dr. Mona

I have a video on my YouTube about play Joseph Foley versus something called cranial anastomosis, which is more of a red flag of when the sutures are closing too early. But really important to look at that. Look at Jenna’s resources as well. She’s obviously I’m doing a lot more of the when do I want you to go to a physical therapist?

00;40;32;10 – 00;40;49;03

Dr. Mona

And she’s doing what happens when you go to a physical therapist, you know? Yes. The the teamwork makes the dreamwork. But it is something that, you know, clinicians, I believe on my end, it need to do a better job of looking at that at every visit, especially in that first four months, to six months, just because that is that critical time.

00;40;49;10 – 00;41;06;24

Dr. Mona

And I’m a big believer that, yes, let’s go to physical therapy, let’s do that. The therapies that are going to help reduce that risk. And if we’re going to need a helmet, it’s always better to do that before that, like for me before the six month, but definitely before the nine month. Like it’s going to have better outcomes if we started earlier.

00;41;06;27 – 00;41;22;11

Dr. Mona

But we won’t know unless we bring it up. And I don’t see a lot of parents bring it up to me. It’s me bringing up to the parents a lot of the times, which is wild, like I’m like, and I don’t scare them. I’m like, hey, I just want you to know that I am seeing a little bit of flattening on this side.

00;41;22;15 – 00;41;38;14

Dr. Mona

So here’s what we’re going to do about it. And even if it’s so minor, because the way the brain is so soft or the skull so soft, if you don’t take care of it, it snowballs. And so I think it’s so important that parents know that you there are preventative ways. It’s not a guilt filled thing. It’s not like anything you did wrong.

00;41;38;16 – 00;41;41;02

Dr. Mona

Some baby’s heads are just really soft.

00;41;41;02 – 00;41;56;24

Jena Schultz

Yeah, that can happen. Yeah. Yeah it can happen from position in utero. I mean, like, nothing anyone did. Yeah. I mean, if anyone could avoid it, it was me. And my second one had a flat head that we fixed with repositioning and firm position in utero. So.

00;41;57;01 – 00;42;03;09

Dr. Mona

And I love when we share our own, you know, journeys of like, you know, how we we became the mom on the other side. Yeah.

00;42;03;13 – 00;42;04;01

Jena Schultz

Exactly.

00;42;04;09 – 00;42;23;15

Dr. Mona

Like, well, here we go. I talk about this all the time for me. You know, the irony, I it’s the irony of being in these helper positions. But for me, being someone who is so obsessed with child development and then having a son who had a stroke and seizures, who, you know, obviously that greatly impacts development. And watching those milestones like a hawk being a little bit too obsessive about the milestones.

00;42;23;15 – 00;42;49;16

Dr. Mona

And I’ve, I’ve spoken about that’s my story and that I was like, especially with speech. I was so obsessed with him talking that I wouldn’t even pause and let him talk. It would be like, right, see red see ball, see it’s him, mama. And he’s like, what the fuck is going on? It’s probably like, mom, chill. But no, I mean, it’s so important to know what you’re bringing to the table when it comes to milestones and how our own insecurities or worries can can translate into how we interact with them too.

00;42;49;20 – 00;43;15;14

Jena Schultz

Yeah. No. Exactly. And I, you know, just telling parents too, that, oh, the number one thing that I tell them is just that development happens on a continuum in a sequence, not on a stopwatch. So. And not on like a hard deadline. So, you know, a lot of times when you go to the pediatrician, you’ll get things, that are like, Miles, I don’t know if they do this anymore, but they used to.

00;43;15;16 – 00;43;38;24

Jena Schultz

You get milestone charts and it’ll be like at this age we’re checking. Are they rolling? Are they sitting? Yeah. And I just want to remind parents, that development and those milestones are met on age ranges. So it’s like rolling can typically happen anywhere between like 3 to 7 7 to 8 months and still be within normal range.

00;43;38;26 – 00;43;48;04

Jena Schultz

Yeah. And so all of these have ranges. And so just kind of taking a breath knowing that there’s that great space there.

00;43;48;10 – 00;44;04;02

Dr. Mona

Oh, this is so great. I love chatting with you. What a great conversation. And I, you know, a lot of the stuff I already had felt, but hearing it from a physical therapist who’s doing the work that you do, is very validating. And I know a lot of our listeners are going to feel the same way. What would be your final uplifting message for them?

00;44;04;02 – 00;44;08;08

Dr. Mona

You’ve given so many nice pearls, but what would that be?

00;44;08;10 – 00;44;41;11

Jena Schultz

Yeah, I just, I, I want parents to know that education and this is power, but we can have education without having fear. And so, really choosing intentionally who you engage with on social media is important if you’re listening to who you’re getting your information from. And, and, just asking yourself if there is something that is making you feel off with your baby, is it coming from a place of intuition, or is it coming from a place of fear and a place of anxiety?

00;44;41;11 – 00;44;58;20

Jena Schultz

So, I really am a a true believer that deep down we know our baby’s best. And listening to that intuition is important. And so, yeah, just just remember to take you into that and try to drown out the noise, so to speak, so you can make your own music.

00;44;58;26 – 00;45;17;00

Dr. Mona

Here, here, I love it. Second time’s the charm with this episode. Jenna, I adore you and thank you so much for all of your insight. This is such a awesome conversation. Where can people go to stay connected? For all of your resources, new resources you have launched this year? All of that, please let us know.

00;45;17;02 – 00;45;38;29

Jena Schultz

Yeah. So you can find me, on Instagram at Driving Development. That’s my OG. But, and I’ll see patients here in North Texas if you’re a local, I would love to see you. I also have a program called Thrive Screen, and you can learn more about that. It’s a five module course that gives you a foundational framework for what actually matters.

00;45;38;29 – 00;45;59;08

Jena Schultz

Basically everything we are talking about here. And this first year, we dive in on kind of like the head shape, the head term preference, the stuff that I’m just like, these are my non-negotiables. Let’s just look at them. Let’s knock them out. But then it’s a lot about listening to your intuition and, you know, engagement with your baby and how important that is.

00;45;59;08 – 00;46;21;20

Jena Schultz

And there’s a whole community we launch in cohorts so that you’re going to be, with other parents that are your babies, that are babies, your babies same age. And, yeah, there’s daily developmental things. It’s just a five minute check in if you want to do it. It’s a little developmental tip just so you can feel proactive and empowered.

00;46;21;23 – 00;46;34;07

Jena Schultz

But it’s really, you know, my act of rebellion against the, the noise by creating our own music. So thrive screens my own music there. Check it out. We’re enrolling new core cohorts every 3 to 4 months.

00;46;34;09 – 00;46;44;11

Dr. Mona

I love it. I will be attaching that resource. Thank you again. Jenna. This was so awesome. And I’m so glad to connect. And I know this won’t be the last time that you come on my show. Are we connected another way?

00;46;44;13 – 00;46;47;18

Jena Schultz

Yeah. Thank you. Doctor. Man, I love this. Thank you for having me on it.

00;46;47;21 – 00;47;12;11

Dr. Mona

Thank you. And thank you for calling me doctor Mona. I didn’t even tell you that. You didn’t have to say that. You could just go. We’re we’re we’re besties. Okay. Like, that’s totally fine. You’re so sweet to do that. But thank you. Jenna. I really appreciate this. Okay. Second time really was the charm on this one. Like I mentioned in the convo, we had to record this a second time because of technical difficulties after the recording, which is a podcast host nightmare.

00;47;12;17 – 00;47;36;14

Dr. Mona

But Jenna is amazing and I loved this conversation. My biggest takeaway? We can act early without overreacting. A flat spot on the head or a strong head turn preference is worth getting checked soon because early helps make a real difference. A baby who skips crawling but is sitting, scooting, pulling up, and chasing their siblings around. That baby is showing you a lot of what you need to see.

00;47;36;16 – 00;47;58;10

Dr. Mona

We tend to make things so black and white, but the next time a post makes your stomach drop, pause and ask yourself what Jenna asked, is this worry coming from my gut or from fear? You know your baby and if something feels off, ask if it’s the scroll taking. Give yourself permission to put the phone down and speak with a trusted professional.

00;47;58;13 – 00;48;24;19

Dr. Mona

And remember, if that professional says everything seems fine and your gut is telling you something different, you can ask them for a referral. You can suffer for yourself too. A specialist advocacy is also so important and it can feel so hard, especially as a new parent. Send this episode to the friend in your group chat who just asked why their baby isn’t crawling it, or the new parents setting tummy time timers on their phone because they need this conversation.

00;48;24;21 – 00;48;51;05

Dr. Mona

And remember, if this was the old you, meaning you are past the stage but you had this anxiety of milestones. Please share this episode. Tag the pizza talk talk podcast pizza talk talk and driving development. When you share it. It helps us bring conversations like this to more people. And one last thing. If you’re hearing this before October 15th at 1159 Pacific Standard Time 2026, go vote for us in the Signal Awards family and child raising category.

00;48;51;09 – 00;49;01;20

Dr. Mona

The link is in our caption. I still can’t believe were nominated and every vote counts. Thank you for being here. I’m Doctor Mona and I’ll chat with you all next time on the PedsDocTalk podcast.