Picking up a baby under the arms is safe when you do it correctly, but the technique matters more than most people realize. Done right, your hands support the baby’s torso and head simultaneously. Done wrong, you risk straining the baby’s joints or letting the head fall backward. Here’s how to do it properly at every stage.
The Basic Technique
Place both hands around the baby’s ribcage, with your fingers wrapping toward the back and your thumbs resting on the chest. Your hands should be high up under the armpits, gripping the torso firmly rather than hooking under the arms themselves. This distributes the baby’s weight across your palms and fingers instead of putting pressure on the shoulder joints.
For babies under about 4 months old, you need to add one critical step: support the head. You can do this by spreading your fingers wide so that both index fingers (or index and middle fingers) reach up behind the baby’s neck and the base of the skull. This keeps the head from flopping backward as you lift. Once the baby is up, immediately transition to a hold that supports the head, such as cradling them against your chest with one hand behind the head and neck.
The lift itself should be slow and smooth. Scoop the baby up and bring them toward your body in one fluid motion rather than holding them out at arm’s length. Babies feel more secure when they’re brought close quickly, and it’s easier on your back and wrists.
Why Head Support Is Non-Negotiable at First
Newborns have almost no control over their neck muscles. During the first few weeks, caregivers need to support the head every time they lift, hold, or move the baby. By around 2 months, most babies can briefly hold their head steady when held upright. But true head control, where a baby actively stiffens the neck and trunk muscles when being picked up, doesn’t reliably develop until 3 to 4 months of age.
You’ll notice the shift when it happens. A younger baby is essentially dead weight when you reach for them. An older baby with good neck control will tense up and participate in the lift, holding their head in line with their body as you raise them. Until that milestone arrives, every pickup under the arms needs a hand or fingers behind the head. For premature babies, use the corrected gestational age: 4 months from the original due date, not the actual birth date.
What Not to Do
The most common mistake isn’t the under-arm pickup itself. It’s grabbing or pulling a baby upward by the hands, wrists, or forearms. This puts traction on the elbow joint and can cause a painful injury called nursemaid’s elbow, where a ligament that holds the forearm bones together slips out of position. The result is sudden pain and a child who won’t move or rotate the affected arm.
This injury is surprisingly easy to cause. It doesn’t take much force. Pulling a toddler up by one arm to prevent a fall, swinging a child by the arms during play, or yanking a reluctant toddler forward by the wrist can all do it. The ligament that holds the elbow together is loose in young children, which makes the joint vulnerable to even brief, sharp pulling forces. Once it happens once, it’s more likely to happen again.
To avoid this, always lift from the torso. Hands go under the arms and around the ribcage, never pulling upward from the hands or wrists. This keeps the force on the sturdy trunk of the body rather than on small, vulnerable arm joints.
Picking Up From Different Positions
From Lying on Their Back
Slide one hand under the baby’s head and neck, and the other under the bottom. Lift gently so the baby is horizontal, then bring them to your chest and shift into a comfortable hold. You can transition to an under-arm grip once the baby is close to your body, but for the initial lift off a flat surface, the head-and-bottom method gives better control, especially for young infants.
From Lying on Their Stomach
Slide one hand under the chest (so your fingers support the chin and neck area) and the other under the hips. Roll the baby gently toward you as you lift. Tummy-down babies sometimes startle when flipped quickly, so keep the motion gradual.
From a Sitting or Upright Position
This is where the under-arm technique works best. Face the baby, place both hands around the ribcage with thumbs on the chest, support the head with your fingers if needed, and lift straight up toward your body. Once the baby is against your chest, settle them into whatever hold you prefer.
Adjusting as Your Baby Grows
The under-arm pickup becomes much simpler after 4 months, when most babies hold their heads up independently. You no longer need to worry about supporting the neck with every lift, and the baby will often reach toward you or lean into the pickup, making the whole process feel more natural.
As babies get heavier (most double their birth weight by 5 months), the ergonomics shift for you too. Bending at the knees rather than the waist protects your lower back, and keeping the baby close to your torso during the lift reduces strain on your arms and shoulders. Get in the habit early because it matters a lot more when you’re picking up a 20-pound toddler multiple times a day.
For toddlers, the under-arm lift remains the safest method. Even though they’re sturdier, their elbow ligaments are still loose enough for nursemaid’s elbow to occur through age 5 or so. Continue lifting from the torso, and avoid swinging or jerking them upward by the arms during play.