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Tag: infant

Torticollis

Torticollis is a condition most commonly diagnosed in infancy in which the baby’s head is consistently tilted or turned to one direction. It is often present beginning at birth, but is typically noticed at 1-2 months of age as the baby’s head control improves. The most common cause is tightness in the neck muscles due to a variety of potential factors. 

Torticollis risk factors:

  • Positioning in utero
  • Delivery in breech position or use of forceps for delivery 
  • Multiples birth (twins, triplets, etc.) 
  • Reflux (GERD)
  • Vision concerns
  • Genetic factors and syndromes 

Signs of torticollis:

  • Baby or child consistently tilts head towards one side in most positions
  • Baby or child consistently turns head (rotates) or looks in one direction  
  • Baby has difficulty bottle feeding or breastfeeding on one side noted
  • Baby has a flat spot on the head
  • Baby has asymmetries in the head and facial region

Torticollis can be treated by a pediatric physical therapist (PT). Your PT will work with you and your baby to create an individualized plan of care including stretching and strengthening activities for your baby’s neck and trunk. Improvements in strength and head position are typically noted within the first few months of physical therapy with a good prognosis to completely resolve the torticollis, especially if treated early. If left untreated, torticollis can impact the following areas of development: rolling, sitting, pulling to stand, crawling, standing, walking, balance, vision, bottle feeding and breastfeeding, and eating. 

Conditions associated with torticollis:

It is never too early to intervene and to treat torticollis. Schedule a free screening with a physical therapist at BDI Playhouse if you have any questions about your baby’s head position or head shape. So worry not, our BDI Playhouse therapists are experts in this area and we are waiting to answer any questions you may have! 

Written by: Cassidy Bannon, PT, DPT

Pragmatic Language

The Power of Pragmatic Language

Social Language Milestones

Pragmatics is the way we use our language in social settings. For example, how to start a conversation, interpreting body language, understanding different perspectives, and using sarcasm. Pragmatic language is typically learned incidentally (learned through experience) but with some children, it may need to be directly taught. Pragmatic language begins to develop as an infant and continues to grow and form until the high school years. Below is a list of “milestones” to expect along with activities/strategies to enhance social language. 

Infant (3-12 months)

  • Starts making eye contact
  • Reaching 
  • Participates in parallel play (playing next to caregiver, sibling) 
  • Participates vocal turn taking
  • Uses vocalizations to request, protest, express feelings 

Activities: Peek-a-boo, stacking blocks, waving, songs, nursery rhymes

Toddler (12-36 months) 

  • Imitates routines
  • Imitates other children
  • Uses words (12 months)/phrases (18 months)/sentences (30 months) to request, protest, express feelings
  • Asks questions
  • Begins at 18 months
  • Initiates pretend play (ex: playing in toy kitchen, pushing trucks/cars, playing with baby doll)
  • Begins at 18 months
  • Takes two turns in conversation
  • Begins to describe/retell events 
  • Begins to return/initiate greetings by waving 

Activities: Ask questions during pretend play (“What’s baby doing? Where are they going?”), “sabotage” by putting toys out of reach, shared reading activities, scrapbooks to encourage retelling 

Preschool (3-5 years)

  • Uses language for teasing, joking, fantasies 
  • Starts to share with others
  • Joint play with peers (participating in others play schemes, including self in play) 
  • Theory of Mind: Understanding that others have different beliefs 
  • Begins at 4 years
  • Produces narratives as “chain”
  • Takes 4-5 conversational turns 
  • Improves describing skills to repair communication breakdowns
  • Begins to inference/predict 
  • Participates in turn-taking games

Activities: Sequence 3-4 pictures and retell story, give simple riddles (i.e., “This is an animal that lives on the farm and says ‘Moo’”), play “Go Fish” or “Bingo”

School age (5-11 years)

  • Invites others to play 
  • Initiates conversations with familiar topics (ex: school, weather, weekend) 
  • Problem solving (individually and in a group) 
  • Begins 6-8 years old
  • Gives and responds to compliments 
  • Tells and understands jokes of greater complexity 
  • Politely interrupts 
  • Responds to and uses facial expressions (ex: smiles, frowns, looks of surprise) 
  • Recognizes spatial boundaries 

Activities: Practice multiple meaning words, Apples to Apples, Emotion charades, Red Light Green Light 

Middle/High School (11-18 years)

  • Recognizes if listener is interested or bored 
  • Shifts topics during lulls in conversation 
  • Understands difference between friends/acquaintances
  • Engages in collaborative discussions 

Activities: Would You Rather questions, book club, Let’s Talk Conversation Starters

If you notice delays in the way your child is using social language such as having difficulty making friends, understanding body language, or maintaining age-appropriate conversations, schedule a screening with an SLP at BDI Playhouse today!

 

Sleeping in crib

Sleeping Safe Baby

It’s getting chilly out there! Are you wondering how to keep your baby warm and safe while sleeping? Here is a quick guide on how to keep your baby safe while sleeping in warm and cold weather!

4 simple steps

1. Place your baby on their BACK during naps and at night.

2. Use a firm mattress in a safety approved crib.
3. No bedding, pillows, bumpers, toys, and stuffed animals in the crib.

4. Baby can share your room but NOT your bed.

sleep arrangement

These simple steps are recommended for any season and time of the year by the CDC and National Institute of Child Health and Human Development.

Always remember! BACK to sleep & TUMMY to play! Click here for more information about the importance of Tummy Time!

Can my baby sleep in a swing or car seat?

Consumer Reports states, “car seats are safe for travel, not prolonged sleep. Parents and caregivers should feel confident that using an infant car seat is essential in a car, but a baby shouldn’t be left unattended in a car seat, it shouldn’t be your baby’s primary sleep space.”
If your baby falls asleep in their car seat, swing, bouncer or any other place that is not a flat firm surface, it is recommended to gently remove your baby from the “container” and place them in a safe sleep space. This allows your baby to move naturally which is essential to typical development. “Container” sleeping is not only unsafe for prolonged sleeping but linked to primitive reflex integration deficits, torticollis, visual deficits, plagiocephaly, toe walking, and delayed milestones.
 

Is my baby warm enough?

To determine if your baby is too warm or cold, feel their chest or back of their neck. They should be warm, not hot, clammy or sweaty. Babies have poor circulation so hands, feet, cheeks, and ears can be cool to the touch during sleep and does not necessarily mean they need more layers. The ideal temperature for a baby’s room to sleep in is between 68-72F (20-22C).

Can my baby wear a hat, socks or mittens?

No, it is not recommended for baby to have any clothing that can come loose to avoid suffocation. Hats are not necessary if baby is dressed appropriately for temperature. Mittens should be avoided as babies use their touch to learn and self soothe. You can clip or file nails often to avoid scratches. Footy PJ’s are a great alternative to keeping baby toes warm.

Can my baby have a blanket?

No. To reduce risk of suffocation avoid using blankets or ANY soft items in the crib. Instead use a sleepsack which is a blanket that baby wears. Be sure to look at the TOG rating of the garment to assess which sleepsack should be used depending on the room temperature. Remember to dress baby for the room temperature and not the temperature outside. It is suggested that you get a room thermometer because baby monitor temperatures can be inconsistent. What is a TOG rating? Thermal Overall Grade (TOG) is a standardized unit of measurement that calculates the thermal insulation of warmth of a textile. Keep in mind every baby is different and always check your baby for warmth with touch as described above. This chart is a general reference of how to dress baby with a sleepsack depending on the temperature.

According to the CDC, In 2019, there were approximately 1,250 deaths due to SIDS, approximately 1,180 deaths due to unknown causes, and approximately 960 deaths due to accidental suffocation and strangulation in bed.  Take these simple steps are the best known ways to reduce the risk of SIDS and allow baby to sleep safely and comfortably.  If you are concerned about your baby’s sleep, tummy time, feeding or any other infant development reach out to your pediatrician and your local pediatric therapists. Have questions?  Schedule an appointment with a pediatric therapist for a free infant screening at BDI playhouse!
Written by: Dana Bukala, PTA
Infant Massage

Infant Massage

Benefits of Infant Massage

Massage has benefits at any age, but for babies it can be extra helpful! The best time to massage your baby is when they are awake, but alert. It doesn’t have to last long to get these benefits. You don’t need much, a comfortable room, something soft to place baby on, and some oil (here are some suggestions to pick out what works for you)!

Improved development 

Massage can improve circulation, improve muscle tone, and provide increased awareness of a baby’s body parts. It’s also a great time to talk to your baby which will help their speech and language.

Improved sleep

Daily massage can help babies build tolerance to handling and different input. This can help them learn to calm and relax their bodies on their own which can help them The relaxation linked to massage can help baby fall asleep on their own. 

Improved digestion

Babies occasionally experience difficulties with pooping or have increased gas. There are specific massage techniques that can help move gas bubbles and poop along. 

Parent and child bonding

Massage is a great way for parents, caregivers, and grandparents to bond with their baby. Babies respond differently to different strokes. It’s a great way for parents to pick up on the babies cues. It’s also a great excuse to get some 1:1 quiet time with baby. What a great way to break up that witching hour!

Improved body awareness

Body awareness helps babies start interacting with their environment. They get input when they recieve massage. This can help improve their awareness of where their body is in their environment. If your baby has a preference for using one side more than the other it can be a great way to help them be more aware of the side they don’t use as much

 

If you would like to learn how to massage your baby , BDI Playhouse offers Infant Massage classes in clinic and virtually. Trained therapists will help you find the best way to ready your baby’s unique cues to get the most out of massage! 

 

 Written By: Andrea Turnell, PT, DPT

 

Engorgement

Breast Engorgement

What is the best way to prevent engorgement while breastfeeding?  Frequent feedings!  Feeding your baby 10-12 times per 24 hours and making sure your breasts are emptied each feed should reduce your risk of experiencing engorgement.  However, if you are experiencing that painful fullness here are a few tips

Strategies to reduce engorgement

Before Breastfeeding

  1. Hand express or pump the breast for 1-3 minutes prior to feeding
  2. If you can get milk to flow use moist warm compresses to increase milk flowing
  3. If you cannot get milk to flow use cold pack on breasts
  4. Warm shower with back to water, taking a “breast bath” in warm water, and/or applying wash cloths that are moist and warm

While Nursing

  1. If the breasts or areola are too swollen for baby to latch pump or and express for 1-3 minutes to soften breast before feeding. 
  2. Apply light to moderate pressure (REVERSE PRESSURE SOFTENING) to move fluid around nipple and to make it more latchable.

Between Feedings

  1. Use cold compresses, over a protective layer of fabric, on your breasts, chest, and under arms to help decrease swelling.
  2. Wear bras that are not too loose and not too tight.

Engorged breasts can make your breastfeeding experience tough.  The best way to treat engorgement is to prevent it!  However, if you are experiencing persistent engorgement and would like additional help, schedule a free screening with one of our lactation counselors.

Written by Jessica Keenan, MA, CCC-SLP/L, CLC