Medical Conditions

Signs of Cerebral Palsy in Babies

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published CDC, AAP, NIH guidelines

Editorial policy

Last reviewed:

If your baby has been diagnosed with or you suspect signs of cerebral palsy in babies, here is what the evidence says.

The short answer

Cerebral palsy (CP) is the most common motor disability in childhood, affecting about 1 in 345 children. It results from abnormal brain development or damage to the developing brain, most often before or during birth. Early signs include stiffness or floppiness, delayed motor milestones (not sitting by 9 months, not walking by 18 months), favoring one side of the body, and persistent primitive reflexes. Early diagnosis and intervention with physical therapy can significantly improve outcomes and function.

Key takeaways

  • Cerebral palsy (CP) is the most common motor disability in childhood, affecting about 1 in 345 children. It results from abnormal brain development or damage to the developing brain, most often before or during birth. Early signs include stiffness or floppiness, delayed motor milestones (not sitting by 9 months, not walking by 18 months), favoring one side of the body, and persistent primitive reflexes. Early diagnosis and intervention with physical therapy can significantly improve outcomes and function.
  • Usually normal when: Your baby has slightly increased muscle tone but is meeting all motor milestones on time
  • Call your doctor if: Your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation
  • Varies by age — see the age-by-age breakdown below
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What Parents Should Know

According to CDC, AAP, NIH guidelines, cerebral palsy (CP) is the most common motor disability in childhood, affecting about 1 in 345 children. It results from abnormal brain development or damage to the developing brain, most often before or during birth. Early signs include stiffness or floppiness, delayed motor milestones (not sitting by 9 months, not walking by 18 months), favoring one side of the body, and persistent primitive reflexes. Early diagnosis and intervention with physical therapy can significantly improve outcomes and function. At 0-3 months, very early signs of cerebral palsy can be subtle. Your baby may feel unusually stiff (hypertonic) or floppy (hypotonic) when you pick them up. You might notice that their legs scissor or cross when held upright, or that they arch their back excessively. Some babies with CP have difficulty feeding, with poor sucking or excessive tongue thrust. Persistent fisting of the hands beyond 2 months or a strong hand preference this early (babies should not show hand dominance until 12-18 months) can be early indicators. The General Movements Assessment, performed by a trained clinician, is one of the most reliable early detection tools. It is generally considered normal when your baby has slightly increased muscle tone but is meeting all motor milestones on time. However, you should contact your pediatrician promptly if your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
Your baby has slightly increased muscle tone but is meeting all motor milestones on time
Your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation
Your baby prefers one hand occasionally but uses both hands equally for reaching and grasping
Your baby has sudden onset of weakness, seizures, or loss of consciousness — these require emergency evaluation
Your baby was premature and is slightly behind on motor milestones but steadily catching up when adjusted age is considered
Your baby has severe feeding difficulties with choking, aspiration, or poor weight gain alongside motor concerns
Your baby had a normal brain MRI and General Movements Assessment despite your concerns about stiffness or movement patterns
Your baby seems unusually stiff or floppy compared to other babies, or their muscle tone feels different when you pick them up

When to Seek Immediate Care

  • Your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation
  • Your baby has sudden onset of weakness, seizures, or loss of consciousness — these require emergency evaluation
  • Your baby has severe feeding difficulties with choking, aspiration, or poor weight gain alongside motor concerns

By Age

What to expect by age

0-3 months

Very early signs of cerebral palsy can be subtle. Your baby may feel unusually stiff (hypertonic) or floppy (hypotonic) when you pick them up. You might notice that their legs scissor or cross when held upright, or that they arch their back excessively. Some babies with CP have difficulty feeding, with poor sucking or excessive tongue thrust. Persistent fisting of the hands beyond 2 months or a strong hand preference this early (babies should not show hand dominance until 12-18 months) can be early indicators. The General Movements Assessment, performed by a trained clinician, is one of the most reliable early detection tools.

3-6 months

By this age, motor differences may become more apparent. A baby with CP may have difficulty bringing hands together at midline, may not reach for objects, or may have poor head control. You may notice asymmetry in movements — one arm or leg moving much more than the other. The baby may feel stiff when you try to move their limbs or may have a persistent startle reflex. If "fidgety movements" (the small, continuous movements healthy babies make between 3-5 months) are absent, this is a significant predictor of CP.

6-12 months

Delayed sitting (most babies sit by 9 months) and an inability to bear weight on legs when held standing are important signs. Your baby may roll using only one side, crawl asymmetrically (dragging one side), or not crawl at all. Increased muscle tone (spasticity) often becomes more noticeable during this period. Some babies show dystonic posturing — unusual, sustained postures of the hands or feet. Early referral for physical and occupational therapy is critical, as the brain is most plastic during this period.

1-2 years

Delayed walking is a common reason for CP diagnosis in this age range. Children with CP may walk on their toes, have a scissoring gait (legs crossing), or walk with one arm held in a flexed position. Some children with milder forms may walk on time but with abnormal patterns. By 18-24 months, most children with CP have been identified, though milder cases may not be diagnosed until later. Classification by type (spastic, dyskinetic, ataxic) and by Gross Motor Function Classification System (GMFCS) level helps guide treatment planning.

2+ years

After age 2, the motor pattern of CP generally becomes well established. Treatment focuses on maximizing function through physical therapy, occupational therapy, orthotics, and in some cases medications for spasticity (such as baclofen or botulinum toxin injections). Many children with CP have normal intelligence, and cognitive abilities vary widely. Associated conditions such as epilepsy, vision impairment, speech difficulties, and learning differences should be screened for and managed. With appropriate support, many individuals with CP lead full, active lives.

What to Tell Your Pediatrician

  • Describe when you first noticed signs of cerebral palsy in babies and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby seems unusually stiff or floppy compared to other babies, or their muscle tone feels different when you pick them up.
  • Mention if your baby is not meeting motor milestones — not sitting by 9 months, not standing by 12 months, or not walking by 18 months.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • Your baby has slightly increased muscle tone but is meeting all motor milestones on time
  • Your baby prefers one hand occasionally but uses both hands equally for reaching and grasping
  • Your baby was premature and is slightly behind on motor milestones but steadily catching up when adjusted age is considered
  • Your baby had a normal brain MRI and General Movements Assessment despite your concerns about stiffness or movement patterns
Mention at your next visit when...
  • Your baby seems unusually stiff or floppy compared to other babies, or their muscle tone feels different when you pick them up
  • Your baby is not meeting motor milestones — not sitting by 9 months, not standing by 12 months, or not walking by 18 months
  • Your baby strongly favors one side of the body, using one hand or leg much more than the other before 12 months of age
  • Your baby has persistent primitive reflexes (such as the Moro or ATNR reflex) beyond the expected age
Act now when...
  • Your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation
  • Your baby has sudden onset of weakness, seizures, or loss of consciousness — these require emergency evaluation
  • Your baby has severe feeding difficulties with choking, aspiration, or poor weight gain alongside motor concerns

What You Can Do at Home

  • Keep track of when you notice signs of cerebral palsy in babies — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that your baby has slightly increased muscle tone but is meeting all motor milestones on time — this is generally within the range of normal.
  • At 0-3 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
  • While monitoring at home, seek immediate care if your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation.

My Baby Seems Too Stiff (Hypertonia)

Hypertonia means your baby's muscles feel unusually tight or stiff, making it hard to bend or move their limbs. While some stiffness can be normal during certain movements (like when a baby is startled or upset), persistent stiffness at rest warrants evaluation. Early identification and physical therapy can make a significant difference.

My Baby Seems Floppy (Hypotonia)

A "floppy" baby is one whose muscles feel unusually relaxed and who may slip through your hands when you lift them under the arms. Many cases of mild floppiness improve on their own as your baby grows stronger, but it is important to have your pediatrician evaluate your baby to rule out any underlying conditions.

Low Muscle Tone (Hypotonia)

Low muscle tone means your baby's muscles feel less firm or their body feels "floppy" when you hold them. While it can sometimes indicate an underlying condition, many babies with mildly low tone do very well with support and strengthening activities.

My Baby Lost Skills They Previously Had

Temporary regression in skills can be normal during periods of rapid growth, illness, stress, or when a baby is intensely focused on developing a new skill. However, true developmental regression - the sustained loss of previously acquired skills such as words, social engagement, or motor abilities - is always a reason to seek prompt medical evaluation. This is especially concerning if multiple skill areas are affected simultaneously.

Milestone

Month-by-Month Development

Detailed monthly development guides from birth through 24 months.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is signs of cerebral palsy in babies normal?
Cerebral palsy (CP) is the most common motor disability in childhood, affecting about 1 in 345 children. It results from abnormal brain development or damage to the developing brain, most often before or during birth. Early signs include stiffness or floppiness, delayed motor milestones (not sitting by 9 months, not walking by 18 months), favoring one side of the body, and persistent primitive reflexes. Early diagnosis and intervention with physical therapy can significantly improve outcomes and function.
When should I call the doctor about signs of cerebral palsy in babies?
Your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation Your baby has sudden onset of weakness, seizures, or loss of consciousness — these require emergency evaluation Your baby has severe feeding difficulties with choking, aspiration, or poor weight gain alongside motor concerns
When is signs of cerebral palsy in babies normal?
Your baby has slightly increased muscle tone but is meeting all motor milestones on time Your baby prefers one hand occasionally but uses both hands equally for reaching and grasping Your baby was premature and is slightly behind on motor milestones but steadily catching up when adjusted age is considered
What causes signs of cerebral palsy in babies?
Cerebral palsy (CP) is the most common motor disability in childhood, affecting about 1 in 345 children. It results from abnormal brain development or damage to the developing brain, most often before or during birth. Early signs include stiffness or floppiness, delayed motor milestones (not sitting by 9 months, not walking by 18 months), favoring one side of the body, and persistent primitive reflexes. Early diagnosis and intervention with physical therapy can significantly improve outcomes and function. Common explanations include: Your baby has slightly increased muscle tone but is meeting all motor milestones on time. Your baby prefers one hand occasionally but uses both hands equally for reaching and grasping.
What should I mention to my pediatrician about signs of cerebral palsy in babies?
You should mention signs of cerebral palsy in babies at your next visit if: Your baby seems unusually stiff or floppy compared to other babies, or their muscle tone feels different when you pick them up. Your baby is not meeting motor milestones — not sitting by 9 months, not standing by 12 months, or not walking by 18 months. Your baby strongly favors one side of the body, using one hand or leg much more than the other before 12 months of age.
Is signs of cerebral palsy in babies normal at 0-3 months?
Very early signs of cerebral palsy can be subtle. Your baby may feel unusually stiff (hypertonic) or floppy (hypotonic) when you pick them up. You might notice that their legs scissor or cross when held upright, or that they arch their back excessively. Some babies with CP have difficulty feeding, with poor sucking or excessive tongue thrust. Persistent fisting of the hands beyond 2 months or a strong hand preference this early (babies should not show hand dominance until 12-18 months) can be early indicators. The General Movements Assessment, performed by a trained clinician, is one of the most reliable early detection tools.
Is signs of cerebral palsy in babies normal at 3-6 months?
By this age, motor differences may become more apparent. A baby with CP may have difficulty bringing hands together at midline, may not reach for objects, or may have poor head control. You may notice asymmetry in movements — one arm or leg moving much more than the other. The baby may feel stiff when you try to move their limbs or may have a persistent startle reflex. If "fidgety movements" (the small, continuous movements healthy babies make between 3-5 months) are absent, this is a significant predictor of CP.
Should I go to the ER for signs of cerebral palsy in babies?
Seek emergency care if your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation, or if your baby has sudden onset of weakness, seizures, or loss of consciousness — these require emergency evaluation. When in doubt, call your pediatrician's after-hours line for guidance.
Does signs of cerebral palsy in babies go away on its own?
In many cases, signs of cerebral palsy in babies resolves on its own, especially when your baby has slightly increased muscle tone but is meeting all motor milestones on time. By 2+ years, after age 2, the motor pattern of CP generally becomes well established. Treatment focuses on maximizing function through physical therapy, occupational therapy, orthotics, and in some cases medications for spasticity (such as baclofen or botulinum toxin injections). Many children with CP have normal intelligence, and cognitive abilities vary widely. Associated conditions such as epilepsy, vision impairment, speech difficulties, and learning differences should be screened for and managed. With appropriate support, many individuals with CP lead full, active lives.
CDCAAPNIH

References

  1. [1]Centers for Disease Control and Prevention. What is Cerebral Palsy? CDC, 2024. CDC
  2. [2]Novak I, Morgan C, Adde L, et al. Early, Accurate Diagnosis and Early Intervention in Cerebral Palsy. JAMA Pediatrics. 2017;171(9):897-907. AAP
  3. [3]National Institute of Neurological Disorders and Stroke. Cerebral Palsy. NINDS, 2023. NIH

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Signs of Cerebral Palsy in Babies.

Things to mention

  • Describe when you first noticed signs of cerebral palsy in babies and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your baby seems unusually stiff or floppy compared to other babies, or their muscle tone feels different when you pick them up.
  • Mention if your baby is not meeting motor milestones — not sitting by 9 months, not standing by 12 months, or not walking by 18 months.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Your baby seems unusually stiff or floppy compared to other babies, or their muscle tone feels different when you pick them up
  • Your baby is not meeting motor milestones — not sitting by 9 months, not standing by 12 months, or not walking by 18 months
  • Your baby strongly favors one side of the body, using one hand or leg much more than the other before 12 months of age

Urgent signs to report immediately

  • Your baby has progressive loss of motor skills they previously had — CP does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation
  • Your baby has sudden onset of weakness, seizures, or loss of consciousness — these require emergency evaluation
  • Your baby has severe feeding difficulties with choking, aspiration, or poor weight gain alongside motor concerns

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

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Related Resources

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Bottom line

Most cases of signs of cerebral palsy in babies are normal. Talk to your pediatrician if your baby has progressive loss of motor skills they previously had — cp does not cause regression, so worsening suggests a different or additional condition requiring urgent evaluation.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Related Medical Concerns

My Baby Seems Too Stiff (Hypertonia)

Hypertonia means your baby's muscles feel unusually tight or stiff, making it hard to bend or move their limbs. While some stiffness can be normal during certain movements (like when a baby is startled or upset), persistent stiffness at rest warrants evaluation. Early identification and physical therapy can make a significant difference.

My Baby Seems Floppy (Hypotonia)

A "floppy" baby is one whose muscles feel unusually relaxed and who may slip through your hands when you lift them under the arms. Many cases of mild floppiness improve on their own as your baby grows stronger, but it is important to have your pediatrician evaluate your baby to rule out any underlying conditions.

Low Muscle Tone (Hypotonia)

Low muscle tone means your baby's muscles feel less firm or their body feels "floppy" when you hold them. While it can sometimes indicate an underlying condition, many babies with mildly low tone do very well with support and strengthening activities.

My Baby Lost Skills They Previously Had

Temporary regression in skills can be normal during periods of rapid growth, illness, stress, or when a baby is intensely focused on developing a new skill. However, true developmental regression - the sustained loss of previously acquired skills such as words, social engagement, or motor abilities - is always a reason to seek prompt medical evaluation. This is especially concerning if multiple skill areas are affected simultaneously.

My Baby Was Diagnosed with PVL (Periventricular Leukomalacia)

Periventricular leukomalacia (PVL) is a type of white matter brain injury that occurs most commonly in premature babies. It involves damage to the tissue around the brain's ventricles, which carries nerve fibers controlling motor movements. PVL is one of the most common brain injuries in preterm infants and can range from mild (small focal areas) to more extensive involvement. While PVL is associated with an increased risk of cerebral palsy and developmental delays, outcomes vary widely depending on severity, and early intervention can make a significant difference.

My Baby's Head Shape Looks Abnormal

Many babies develop temporary head shape irregularities that are completely normal. A cone-shaped head from vaginal delivery reshapes within days. Mild positional flattening (plagiocephaly) from sleeping on the back is very common and usually improves with repositioning and tummy time. However, head shape changes involving ridges, a persistently bulging fontanelle, or rapid head growth changes should be evaluated to rule out craniosynostosis.