Early Hand Preference in Newborns (Using One Hand Only)
The short answer
Babies should not show a strong hand preference before 12-18 months of age. If your newborn or young infant consistently uses one hand much more than the other, or seems to ignore one hand, it could indicate a neurological concern or birth injury that should be evaluated by your pediatrician. True handedness normally develops between 2-4 years of age.
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By Age
What to expect by age
At this age, hand movements are largely reflexive, and babies should move both arms and hands roughly equally. If you notice that your newborn consistently does not move one arm or hand, or holds one arm differently, this could be a sign of a birth injury such as brachial plexus injury (Erb's palsy) or clavicle fracture. Report any asymmetry in arm or hand movement to your pediatrician promptly.
As your baby begins to have more purposeful hand movements, both hands should be used similarly. Babies at this age should be opening and closing both hands and bringing them to the mouth. If one hand remains fisted while the other opens freely, or if your baby consistently reaches with only one hand, mention this to your pediatrician.
Babies should be reaching for and grasping objects with both hands. They should transfer toys from one hand to the other by about 6 months. Persistent preference for one hand at this age could indicate hemiplegia (weakness on one side) or another neurological condition that benefits from early intervention.
Both hands should be actively used for exploring, banging, and manipulating objects. While some babies may show a slight preference, strong one-handed dominance before 12 months is atypical and should be evaluated. Early identification of one-sided weakness allows for therapy that can significantly improve outcomes.
What Should You Do?
When to take action
- Baby uses both hands roughly equally for reaching and grasping
- Slight preference that varies from day to day
- Both hands open and close freely and have similar movement range
- Baby transfers objects between hands by 6-7 months
- Consistent use of one hand while ignoring the other
- One hand remains fisted while the other opens freely
- Baby does not reach with both hands by 4-5 months
- Your newborn does not move one arm at all, which could indicate a birth injury requiring prompt evaluation
- Strong early hand preference combined with stiffness or floppiness on one side of the body, which could indicate a neurological condition
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Physical Concerns
My Baby Prefers One Hand Too Early
True hand preference should not develop until at least 18 months to 2 years of age. If your baby consistently uses only one hand and ignores or avoids using the other before 18 months, it may indicate that the less-used hand or arm has reduced strength or coordination. This is different from a slight preference and is worth discussing with your pediatrician.
Erb's Palsy (Brachial Plexus Birth Injury)
A brachial plexus injury (Erb's palsy) occurs when the nerves controlling the arm are stretched during delivery, most often during shoulder dystocia. The affected arm may appear limp or have limited movement. The good news is that 80-90% of cases resolve within the first 3-6 months with conservative management and physical therapy.
My Baby Seems to Use One Side More Than the Other
Babies should use both sides of their body fairly equally during the first 18 months of life. While slight preferences can be normal, a consistent pattern of favoring one side - using one arm much more than the other, crawling with one leg dragging, or turning the head predominantly one way - should always be discussed with your pediatrician. Early identification of asymmetry leads to the best outcomes.
My Baby Only Army Crawls
Army crawling (also called commando crawling) is a completely valid and normal way for babies to move. Many babies army crawl for weeks or even months before transitioning to hands-and-knees crawling, and some skip hands-and-knees crawling entirely. What matters is that your baby is independently mobile and exploring their environment.
One Side of My Baby's Body Moves Differently
Babies should generally use both sides of their body equally. If one side consistently moves differently, is weaker, stiffer, or less coordinated, this warrants evaluation. Asymmetric movement can indicate hemiplegia (cerebral palsy affecting one side), brachial plexus injury, or other neurological conditions that benefit from early therapy.
My Baby Crawls Unevenly
While some variation in crawling patterns is normal, consistently favoring one side or dragging one limb while crawling warrants attention. Babies should use both arms and both legs relatively equally when crawling. Persistent asymmetry could indicate muscle tone differences, hip issues, or neurological concerns that benefit from early evaluation.