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Tag: tummy time

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

baby helmet

Helmet Heads!

Helmet Heads!  Shaping Baby Inside and Out

Putting your baby in a helmet is a difficult decision for parents to make, but more often parents are choosing to put one on their baby. Are helmets necessary and why are so many babies wearing them? An explanation of why, when and how little melons are getting shaped by helmets. 

A Helmet is Not Just For Vanity!

The Cranial Orthosis (CRO) or helmet does help your baby look their best by giving them a more symmetrical head, eyes, ears and even jaw. But, the CRO does so much more than making pretty babies! The skull holds and protects our baby’s most important organ, the brain. When the skull is misaligned, so is the brain. The helmet allows the skull to serve and protect allowing for the best position and shape for optimal neurological development. Sensory input from the outside world is organized in the brain. For example, if the eyes are misaligned this fires misinformation to the brain which is also misaligned and that is less than ideal for our baby’s development. 

Why is Head Shape Important? 

 A baby’s face, ears, eyes, mouth and head should look symmetrical on both sides. Asymmetry caused by a head tilt (torticollis) or any other asymmetry noted on a baby’s noggin should be evaluated by a pediatric physical therapist. These small asymmetries now can cause big delays later. Gross and fine motor milestones and other coordination skills can be affected down the line, like playing sports, playing instruments or keeping up with their peers. 

 

What is Plagiocephaly and What Causes It?

Plagiocephaly is a term to describe a misaligned head shape. Other names used are brachycephaly and scaphocephaly. Each of these terms describes a particular head shape deficit which is a flattening on one or more sides of the head. Sometimes a bulge is present as bones pushed on one side will cause a protrusion to another. 

There are many known and unknown factors that can cause a misalignment of cranial bone plates. Here are some known reasons: 

  1. Lack of Tummy Time: Back to sleep and tummy to play! Tummy time will reduce the risk of flat spots.
  2. Torticollis: A preference to turn to one side can cause a flat spot. Increased tummy time is recommended for torticollis.  
  3. Sleep Preference: “Back to sleep” campaign to reduce Sudden Infant Death Syndrome (SIDS) has been successful at saving lives but has caused an increase in flat heads. 
  4. Containers: Too much time in car seats, bouncy seats, or other soft bottom containers restrict babies ability to turn and move naturally.
  5. Medical Conditions: Premature or medically fragile infants required to spend more time in certain positions early on for their safety.  
  6. Multiples or Intrauterine Constraint: Inability to move in the mother’s womb can cause muscle imbalances during development.  

When Is the Best Time to Get a Helmet?

Baby’s head doubles in size within the first year! Ideally, it is recommended that a baby has a helmet between 3-6 months of age. Sometimes it is recommended earlier than 3 months depending on the child. Typically, the earlier the helmet goes on the less time they have to wear it due to the speed of head growth in the first few months. A helmet may not be recommended after 12 months because the head growth slows down which in turn slows down the changes the helmet can make. Physical Therapy is recommended before, during and after helmet treatment for exercises, positional changes and stretches can improve asymmetries and progress motor skills. 

Parents Don’t Regret Getting a Helmet but Do Regret Not Getting One

This is a common phrase physical therapists hear from parents. Parents often forget their baby had a helmet until they look at old pictures because it is on and off so fast. Baby helmets have a small window of opportunity to make big changes that will last a lifetime!

Be sure to ask your PT who they recommend to evaluate and be fitted for a custom cranial orthosis. Schedule a free screening with a physical therapist at BDI Playhouse if you have any questions about the shape of your baby’s head!  

Written By: Dana Bukala, PTA

 

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

 

Why Tummy Time is Important

Why Tummy Time is Important

Tummy time is important for your baby’s development. Here are the top 7 reasons why you should be incorporating tummy time into your baby’s routine.

1.  Strength

Spending time on her belly is important because it strengthens the neck, back, shoulders, hips, arms, and hands.  It will help to increase the range of motion / stretch tight muscles in the neck, hips, and abdominals. 

2.  Coordination and Body awareness

Your baby will learn about her body in a different position and experiment with how to work with and against gravity.  She will learn to pivot (reaching and pivoting are precursors to crawling), balance, and increase postural control.  By increasing coordination and body awareness, your baby will also initiate hand-eye coordination with reaching, hand grasp and release.

3.  Prevention of flat spots

The more your baby is on their tummy, the less likely the back of your baby’s head will develop flat spots (positional plagiocephaly).

4.  Acquire gross motor skills 

The more waking hours spent on their tummy, the earlier babies will roll over, push up on arms and crawl (Dr. Karen Adolph, director of the NYU Infant Action Laboratory). Tummy time also strengthens extensor muscles which will lead to better sitting skills and postural control of your baby. 

5.  Sensory exposure 

Lying on their tummy lets babies feel different textures on their arms, hands, and cheeks.  This helps grow their touch sense and helps develop movement and balance (vestibular sense).

6.  Vision 

Your baby will experience the world from a different perspective during this time.  It allows your baby to see things both near and far.  It also helps them develop eye and hand coordination.

7.  Aids in digestion and reflux.

Sometimes despite your best efforts, babies continue to resist spending time on their tummy. History of reflux, a slightly misshapen head, muscle asymmetries such as torticollis, and other challenges may require additional problem solving to improve tolerance to being placed on the tummy.  Don’t give up! This position is critical to developing and achieving motor and cognitive milestones. We can help you figure out how to improve tummy time. Try our free Infant Massage Classes or call for a free screening to see if there is more we can do to promote healthy infant mobility. 

If your child resists tummy time, is developing a flat spot, is unusually fussy, often looks to one side, or holds his head to one side, or you have any other questions about development, don’t hesitate to give us a call.  BDI Playhouse Children’s Therapy offers free screenings and consultations through Telehealth or at one of our child-friendly therapy gyms in Orland Park and Aurora, IL

 

Fixing a Flat (baby head): What is Plagiocephaly and what can I do to correct it?

What is Plagiocephaly (pronounced play-jee-oh-sef-uh-lee)?

Sometimes infants are born with or develop plagiocephaly or brachycephaly, a flat spot on the back or backside of their heads that is noticeable and may raise questions or be a cause of concern. 

Understandably, you may ask:

  • Will my baby’s head shape stay like this?  
  • Is there anything I can do to prevent or fix this?  
  • Will this affect my baby’s brain growth or development?

In the early 90’s the American Academy of Pediatrics advised parents to put babies to sleep on their backs to reduce the risk of SIDS.  This increased the time spent with increased pressure on the baby’s head from the surfaces they rested on. This also increased the incidence of plagiocephaly (a.k.a. “flat head syndrome”).  In addition, there are dozens of baby positioning “containers” such as infant car seats, swings, and bouncy chairs that keep babies resting for longer periods on the back of their heads. Flat spots can make it challenging for babies to keep their heads in midline and they can develop a preference to turn or face toward a particular side.  These babies may be resistant to or even refuse tummy time because lifting their little heads up against gravity can seem difficult and stressful. Although this will not typically cause problems with brain development, babies that have a flat spot may experience movement preferences to one side, may not latch on for nursing as well as expected, will experience reflux or digestive issues, and may be extra fussy, colicky or more difficult to calm.  

How can I tell if my baby has a flat spot?

No two babies have the same head shape but asymmetries or flat spots are usually easy to detect if you know what to look for. Most areas will round or even out as a baby moves her head side to side, up and down, and begins to roll over in the first few months.  Take a look at the baby’s head in several positions. If Baby has a lot of hair it is good to do this while the hair is wet, such as after a bath.  

  • Look at your baby “face to face.”  Are both eyes the same size or is one wider or narrower than the other? Is one cheek puffier than the other? Does the back of his head appear unusually wide or does the head slant sharply upward from his forehead to the back of the head? Do you notice that one ear is higher or in front of the ear on the other side?  
  • Look at the baby’s head shape from behind while supporting him in sitting.  This is often the first place a flat spot is detected. Are the ears level? Does the head tilt to one side? Is the top of the head very wide compared to the area just above the neck?  
  • Now, look at the baby’s head from the top.  Is one side of the forehead more forward than the other? Can you see one cheek puffing out more than the other? Is one ear significantly positioned in front of the other?  
  • Finally, look at the baby’s head from the side.  Is there a slope from the forehead that rises to a point in the back?   

Notice if your baby’s head is moving freely with his body or is the head “planted” on the surface?  Is he beginning to lift his shoulders and arms off of the surface and is the baby beginning to bring hands or toys to his mouth?  Does the baby constantly only put one hand in his mouth or does he turn his head to mouth a toy instead of bringing the toy toward his middle.  When Baby is on his belly, can he lift his head easily up in the middle or does he usually turn it fully to one side or the other to lift it up.  These are all signs that there may indicate a muscle imbalance or be present as a result of the flat spot on a baby’s head. While none of these seem particularly alarming, they can keep your baby from developing movement and visual motor patterns that will advance him more naturally toward rolling, crawling, walking and gross motor play.

What Can I do if I notice a flat spot?

  • Provide lots of opportunities for Tummy time.  
  • Limit time in baby carriers, car seats, bouncers, swings, and containers
  • Carry baby when you can but change positions often to keep hips healthy
  • Alternate the ends of the crib for sleeping so baby will face stimulating sights or light during waking times
  • Provide visual stimulation in front of the baby that moves side to side 
  • Consult your pediatrician or a pediatric physical therapist if a flat spot persists for more than a few weeks.  A baby’s head shape can change quickly from birth to 6 months.  

What if the flat spot won’t go away?

If your baby’s head is held unusually still, he has a distinct head-side or position preference, he is having difficulty nursing, bottle feeding is stressful, or he is resisting positions like tummy time contact your pediatrician or a pediatric physical therapist who specializes in treating infants.  It is best not to take a “wait and see” approach because most of a baby’s head growth happens between birth and 6-8 months and this is the best time to make big changes in head shape and mobility.  Most consultations are free and professionals can offer advice and solutions that can help you and your baby.  

BDI Playhouse Children’s Therapy offers free screenings and consultations through Telehealth or at one of our child-friendly therapy gyms in Orland Park and Aurora, IL

Written by Sheri Ireland-Berk, PT
Physical Therapist