Sunday, December 12, 2010

Tummy Time for Baby | Articles | Babies Today

As a pediatric occupational therapist I have a few soap boxes that I step onto frequently and one of them in particular is putting babies on their tummies as they are lying on the floor (or another firm surface) while supervised. Many parents do place their infants in this position, but some do not. And even the ones who do place their babies to ly on their tummy, it is often not done for long enough. This article has some good suggestions on tummy time strategies:

Tummy Time for Baby | Articles | Babies Today

Because so many of the babies I work with have endured medical problems including heart surgery, I have to be creative in helping to build the infant's endurace for the tummy time position. Sometimes it has to start with the baby lying on top of the parents chest as the parent lies back in a reclining chair at a 45 degree angle. Other times it is just as simple as getting down on the floor and talking to the baby or shaking a rattle near them to distract them from the disliked position. Whatever the strategy, it needs to be done on a regular basis (daily) or the child will not become tolerant. Unfortunately, when tummy time is not emphasized the child is at risk to be delayed with rolling over, crawling, and sitting skills. I even see older toddlers and preschoolers who have delayed fine motor skills with drawing and manipulating small toys because they don't have the upper body strength...yet had they got in tummy time they may have had stronger shoulder girdles to support fine motor control in the fingers. :(

Wednesday, September 8, 2010

Infant Vision:
Birth to 24 Months of Age | American Optometric Association

Even if you don't suspect that your baby has problems with his or her vision, it is wise to take your baby to see the optometrist as soon as 6 months of age; sooner if you suspect any problems.

Infant Vision: <br>Birth to 24 Months of Age | American Optometric Association

Pediatric optometrists (OD) and opthalmologists (MD) have tools and techniques to evaluate babies and non-verbal children, so don't let that keep you from going! Vision is important for all areas of learning: communication so that he baby can look at your face as you are speaking; motor skills so that the baby can look at his hands and feet as those body parts are moving and interacting with toys; social skills so that he can see all of the people within his environment and read social cues given by the other persons facial expressions; cognitive skills so that he can use his eyes to problem solve such as with puzzles; and self-help skills such as to watch the bottle, spoon, or bowl as he is feeding himself. If you are ever concerned about your child's visual skills, no matter the child's age, please take them to see an eye doctor!

Saturday, July 31, 2010

When should my baby stop using a pacifier? | BabyCenter

My kids both quit taking a pacifier early on (3 months of age), probably because they were breastfed. But it is a great question to want to know how old is too old to use a pacifier.

When should my baby stop using a pacifier? | BabyCenter

The American Academy of Pediatrics suggests using a pacifier for the baby's first year of life. Just remember that when you take it away, you need to provide another way for the baby/toddler to self-calm. It might be thumb sucking, holding a fuzzy toy, or listening to soothing music.

Thursday, July 1, 2010

Car Seat Crying (Child Development Institute)

Great article on helping keep a young child busy during a car ride, and the suggestions also help to develop the senses.

Car Seat Crying (Child Development Institute)

Would love to hear comments on what you do to help make car rides more fun for a young child!

Thursday, June 24, 2010

The Importance of Touch for Newborn Development

It seems like I can't go to work even one day and not be reminded of how IMPORTANT the sense of touch is, and how its development can be hindered by developmental disabilities and/or premature birth. It is interesting how the sense of touch has pathways that connect to soooo many parts of the brain, therefore any brain damage at all typically results in some sort of tactile dysfunction. Sometimes that means the child being overly sensitive to touch such as not wanting to be held or only wanting to be held a certain way; this can impact attachment and bonding to caregivers and motor skill development. Sensitivity may be less obvious such as grouchiness when being clothed in aversive fabrics like lace or polyester. Tactile dysfunction may also impair the infant's ability to discriminate touch input. This might show with poor sucking and feeding skills or body awareness needed for rolling, sitting, crawling, reaching, and walking because if the tactile information is not detected then these skills are hindered. Kids with severe impairments with discrimination may not detect pain or detect it less than typical. I've had parents report that some of these children break a bone and don't even cry, so the parents don't even realize it until the body part swells and turns blue! The following link describles the sense of touch and ideas to promote it.

The Importance of Touch for Newborn Development

I personally am a big fan of infant massage for many reasons including promoting the development of the sense of touch. A few years ago when I became an infant massage instructor, I first had to do lots of studying and "homework". I learned that it has quite a bit of evidence that it improves attachment, bonding, digestion, and body awareness as well as some other areas of development. I use it a lot to help calm the baby prior to a bottle feeding, especially with premature babies who have poor sucking/swallowing skills as well as a poor ability to calm down and get "organized." So what's your favorite way to promote the sense of touch in infants?

Friday, February 26, 2010

Simple Strategies to Help with Plagiocephaly

Plagiocephaly is a fancy word for mis-shapen head. It can happen for many different reasons in a small infant, especially since their heads are malleable and change shape easily.

My now 20 month old son had a slighly flat spot on the back of his head because he was positioned upright and reclined which put pressure on his head. We had to position him like that due to his severe reflux. I think the flat spot would have been worse had I not put him in "tummy time" so much of his waking hours. Of course, I couldn't lay him in this position until at least 45-60 minutes after a feeding or he would vomit. Once he got around 5-6 months of age, he would roll over and sleep on his tummy. By 7 months he was crawling. These things in addition to all of the reflux medications he was on contributed to a better head shape by 8-9 months of age. His head shape was never severe enough for a helmet. But I explained his situation to indicate how easy it is for a child's head to get mis-shapen and back to being okay.

Often, a baby with torticollis or neurological damage is prone to plagiocephaly. Also, babies with medical problems who aren't able to move age-appropriately, such as preemies, those with heart defects, and babies who have had multiple surgeries. Another reason can be being a multiple (twins, triplets, or more) or a large baby born to a petite mom; this is because there isn't as much wiggle room and they may get stuck with the neck and head in an awkward position.

If your child has been diagnosed with plagiocephaly then hopefully he/she is getting occupational and/or physical therapy services. Therapy can help with neck/trunk strength, stretches, and massage as well as helping with any necessary adaptive equipment to help reposition the baby.

Some simple strategies to help when the head is mis-shapen on the left or right side:

-switch the way the baby is carried, sometimes over the left shoulder and sometimes over the right

-switch the way the baby is held when being fed, sometimes on your right side, other times to your left side

-when using a changing table for diapering, alternate which end the baby's head is at, this helps the baby to look in different directions

-move positioning equipment within the room: bouncy seat, bouncers, swings, etc. so that the view is not always the same for the baby

-when approaching the baby as he/she is in a device or on the floor on a blanket, come from different directions to help the baby look to each side as well as overhead and to the front

-don't sit the child in a Bumbo (R) seat or standing bouncer before he/she has the trunk control to be in it. This is also the case with Jumparoos (R) and Johnny Jump Ups (R). If the baby doesn't have enough trunk or head control, then he will lean to the side which only perpetuates the asymmetry of the head

-offer the baby toys to each side of him wherever he is: swing, floor overhead gym, carseat, on tummy on blanket on floor, etc.

-get down on the floor and play with the baby, sometimes be on his right side, other times on the left or to the front

-infant massage indirectly initially such as to the belly or legs, and then if tolerated to the chest, neck, and arms

-follow through with all exercises/stretches given by the PT and/or OT. Be careful about getting aggressive stretches off of the internet, because depending upon the etiology of the plagiocephaly these stretches could be hurting the baby

Final thought: if your child's doctor prescribes a helmet to help with head shape, then by all means get a helmet and use it the suggested wearing schedule (usually 23 hrs a day). I have seen some amazing changes in head shapes of babies with helmets.

To see pictures of plagiocephaly and helmets, visit