Pincer grasp: when babies pick up small things and how to help

Most babies develop a pincer grasp, picking up small things between the thumb and pointer finger, at around 9 to 12 months. The AAP says the pincer grasp with index finger and thumb doesn't develop until about 9 months, and picking things up "between thumb and pointer finger, like small bits of food" is on the CDC's 12-month checklist. The CDC lists skills that 75% or more of babies have by each age, so many babies get there sooner.

Before that, babies "rake" food towards themselves with their fingers, which is on the CDC's 9-month checklist. The skill keeps improving after the first birthday: the AAP's 1-year hand skills page says picking up very small objects is still a challenge at 12 months but becomes simple by the middle of the second year.

A neat pincer grasp also means your baby can pick up a dropped coin, a button battery or a stray magnet. This guide covers how the skill develops, the play and finger foods that help, how to keep tiny objects out of reach, and when to ask for advice.

When do babies develop a pincer grasp?

The 6-, 9- and 12-month AAP rows come from the AAP's preemie milestones page, which uses adjusted (corrected) ages. The 6-month CDC row is from its 6-month checklist.

Australia's Pregnancy, Birth and Baby describes the same path. At 9 months babies may use their thumb and fingers to pick up small items and touch food with one finger. At 10 months they may pick up objects using their thumb and forefinger. At 12 months they may pick up small objects with their thumb and finger and release objects on purpose. Its 12–18 month page says toddlers gain the control to pick up very small objects, such as small stones or parts of toys, by about 18 months. Kids Health's 12-month milestones also list picking up small pieces of food with the thumb and forefinger.

How does a baby go from raking to a pincer grasp?

Each step builds on the one before:

1. Reaching and grabbing. By 6 months most babies reach for a toy they want and put things in their mouth to explore them (CDC).
2. Raking. Your baby sweeps food or small toys towards them with their fingers held together. The AAP's hand skills guide says babies start this period clumsily raking things towards themselves.
3. Passing hand to hand. The AAP says babies learn to pass objects from hand to hand and turn and twist them from about 6 to 8 months, and it's on the CDC's 9-month list.
4. Thumb against several fingers. Small things are picked up with the thumb pressed against 3 fingers, which the AAP lists at about 9 months.
5. Thumb and pointer finger. The true pincer grasp. The AAP's hand skills guide says that by the end of this stage babies grasp accurately with the thumb and first or second finger, and practise on anything small "from dust balls to cereal".
6. Letting go on purpose. Putting something into a container, like a block in a cup, is on the CDC's 12-month checklist, and the AAP's 12-month milestones include letting objects go voluntarily.
7. Poking and pointing. The AAP lists poking with the index finger at 12 months, and Pregnancy, Birth and Baby says 9-month-olds may point or poke at objects to show interest. See clapping and waving for how pointing becomes communication.

Why does my baby keep dropping and throwing things?

Once babies can open their fingers when they choose, the AAP says they delight in dropping and throwing things, including flinging toys from the highchair and waiting for you to pick them up. It's practice at letting go, and a lesson in cause and effect.

The CDC's 9-month tips suggest making it a game by handing the item back so your baby can drop it again. If hard things like blocks are flying, the AAP suggests offering softer balls of different sizes and textures instead.

How can I help my baby practise the pincer grasp?

These ideas come from the CDC's 9- and 12-month tips, the AAP and Pregnancy, Birth and Baby:

1. Let them feed themselves. The CDC suggests letting your baby practise feeding themselves with their fingers, sitting with them at meals and expecting mess.
2. Fill and empty containers. Drop blocks into a cup or box together, then tip them out. Pregnancy, Birth and Baby suggests letting your baby put toys into containers and knock down blocks.
3. Offer toys with buttons and strings. Pregnancy, Birth and Baby says babies around 10 months enjoy pushing buttons or pulling strings to hear sounds.
4. Choose toys with moving parts. The AAP suggests wheels that spin, levers that move, hinges that open and close, and holes to poke fingers into.
5. Bang and swap. Banging two things together is on the CDC's 9-month list; offer two blocks or spoons and copy what your baby does.
6. Turn the pages. The AAP lists turning knobs and pages among favourite activities around the first birthday, and thick board-book pages are easiest for small fingers.
7. Hide and find. Cover a toy with a cloth and let your baby pull it off. Looking for hidden things is on the CDC's 12-month list.

Choose toys that are made for your baby's age and too big to fit in their mouth, and stay close during play with anything small.

Which finger foods help babies use their pincer grasp?

Meals are daily pincer practice. The NHS guide to first solid foods says letting babies feed themselves with their fingers helps develop fine motor skills and hand-eye coordination. It suggests starting with pieces big enough to hold in a fist with a bit sticking out (about the size of your finger) that break up easily in the mouth.

As the pincer grasp develops, the NHS says babies of 10 to 12 months should find it easier to pick up small pieces of food and feed themselves. Pregnancy, Birth and Baby's 9-month page suggests small pieces of soft fruit such as banana or avocado, boiled or steamed vegetables such as soft beans or pumpkin, and toast fingers.

Pregnancy, Birth and Baby's 10-month page says small, hard pieces of food should be avoided because they can cause choking. Always stay with your baby while they eat. Our guides to food textures, baby-led weaning and purées and foods to avoid go into more detail, and choking vs gagging explains what's normal at mealtimes.

How do I keep small objects away from a baby who can pick them up?

A baby with a pincer grasp can find the one coin under the sofa. Australia's Pregnancy, Birth and Baby choking guide says, as a general rule, items smaller than a 20-cent coin can choke a child younger than 3 years. The Royal Children's Hospital toy safety page, from Melbourne in Australia, uses a fifty-cent piece as its guide, so the bigger coin is the safer test.

• Keep coins, jewellery, buttons, pen lids, paper clips, erasers, tablets, fruit stickers, stones and broken toy parts out of reach (Pregnancy, Birth and Baby and the NHS safety guide).
• Keep older children's toys away from your baby, as they may have small parts (NHS). The AAP's choking prevention page notes many choking incidents happen when older siblings share small objects.
• Check under furniture and between cushions (AAP), and get down to your baby's level to scan the floor.
• Follow the age labels on toy packaging and check toys for broken or loose parts (RCH).

Button batteries

Melbourne's Royal Children's Hospital in Australia says button batteries are as dangerous as poisons: once swallowed, a chemical reaction can harm the food pipe and airway in just 2 hours. They're found in keys, remote controls, calculators, musical greeting cards, watches, kitchen scales and toys that light up, move or make sounds. Keep these out of reach, make sure battery covers are screwed shut, throw out toys without secure covers and lock spare batteries away. The AAP's battery guide adds taping compartments shut and hanging keys up high, and says lithium coin batteries are the greatest concern because their size is close to a young child's food pipe.

Magnets

The NHS says swallowed magnets can stick together in a child's intestines, and to keep magnetic toys with small pieces away from young children. The RCH advises avoiding keeping small magnets in your house.

If you think your baby has swallowed a button battery or a magnet, call 999 or go straight to the nearest A&E. The RCH says not to wait for symptoms, and its swallowed objects page says not to make your child vomit, which can make a battery burn faster.

The NHS choking guide says not to poke blindly in your baby's mouth, and to get medical help even if the object has come out.

What if my baby was born early?

If your baby was born more than 3 weeks early, the CDC's online checklist says to use their corrected age. The AAP's corrected age guide explains how: take your baby's age in weeks and subtract the number of weeks they were born early. It recommends using corrected age to track development for the first 2 years.

So a 12-month-old who was born 8 weeks early has a corrected age of about 10 months, and may still be using thumb and several fingers rather than a neat pincer. The AAP's preemie page says most premature babies have caught up to the typical range by 2 years.

When should I talk to a GP or health visitor about hand skills?

Call 999 now if your baby

• is choking and can't cough, cry or breathe properly, or becomes unresponsive (Pregnancy, Birth and Baby)
• has swallowed, or might have swallowed, a button battery or a magnet (RCH)
• is vomiting blood after swallowing something
• has difficulty breathing, has blue, grey, pale or blotchy skin or lips, is hard to wake or is having a seizure (the NHS urgent help guide)

Go to A&E now if, after swallowing a small object, your baby

• is drooling or having trouble swallowing
• seems to have pain in their chest, neck or tummy, or keeps vomiting
• has blood in their poo

These come from the RCH's swallowed objects page. After a choking episode that cleared, get medical help today even if your baby now seems fine (NHS).

Talk to your GP or health visitor soon (don't wait for the next check) if your baby

• stops doing something with their hands that they could do before. The CDC says to act early if a child "has lost skills he or she once had", and Pregnancy, Birth and Baby says to see your doctor at any age if your baby stops doing something they had learned.
• seems floppy, or stiff and tense, or doesn't seem equally strong on both sides of their body (Pregnancy, Birth and Baby)

Talk to your GP or health visitor if

The CDC's message is "Don't wait": share your concerns and ask about developmental screening.

What's worth writing down?

Note when you first see raking, passing hand to hand, the thumb-and-finger pick-up and dropping things into a container on purpose. If you're worried, a short video of your baby picking up a soft piece of food from the highchair tray helps your GP or health visitor see exactly what their hands are doing.