Positional Plagiocephaly

Positional Plagiocephaly, commonly referred to as “infant flat head” is a condition in which a baby’s skull develops a flat spot, often on one side. 

What causes plagiocephaly?⁣

• Often, plagiocephaly is the result of positioning. Babies’ skulls are very soft and easy to mold. As a result, if a baby spends too much time lying on their back or in a piece of equipment, such as a car seat, they can develop a flat spot on the back of their head (called brachycephaly). If a baby has a preference to look in one direction only, they can develop a flat spot on the same side as the preference⁣

• Torticollis (tight neck muscle) can play a role as well.  If a baby has reduced range of motion, the back of the skull becomes flat on the same side the baby prefers to rotate towards. ⁣

In more severe cases, you may also see changes in the appearance of the baby’s face. The ear may shift forward, the cheek appears larger, and the eye may appear smaller on the same side as the skull fattening. ⁣

It is important to note that plagiocephaly does not impact brain development. However, a positional preference or torticollis can impact acquisition of motor skills. ⁣

Treatment for plagiocephaly often involves: ⁣

• Counter-positioning exercises to address a preference and prevent continued pressure on the affected side. Back to sleep is recommended as it is safest for baby, making tummy time so important when baby is awake. Scroll a few posts back for some hints on making tummy time more enjoyable! ⁣

• Stretching and strengthening of the neck muscles if torticollis is a contributing factor. ⁣

• An orthotic helmet may be considered. More information on orthotic helmets for plagiocephaly coming later this week!⁣

If you have a concern about your baby’s head shape, or notice that they prefer to look in one direction, speak to your doctor or physiotherapist for an assessment (you don’t need a referral). The earlier a positional preference or plagiocephaly is identified, the easier it is to treat. ⁣ 

Baby Carriers + Baby Wearing

Baby-wearing is beneficial for both the baby and caregiver. That being said, it is important to keep a few safety considerations in mind when using a carrier.

• Hip position is key! The baby’s legs should be bent so that their knees are slightly higher than their bottom, with their tights spread around their caregiver and well supported. This will result in their legs creating an “M” position.

• Your baby’s face should be in view at all times. You should not need to remove fabric to check on them.

• Ensure your baby is not resting with their chin against their chest. This may restrict their airway. There should be at least one finger width under your baby’s chin.

• The carrier should provide appropriate support for the baby’s neck and back. Remember that an infant’s back is naturally rounded. Do not use a carrier that forces the baby to straighten his/her spine.

• Remember that the carrier should be safe and comfortable for the wearer too! Look for carriers/slings that evenly distribute the baby’s weight across the wearer’s body.

Happy baby wearing!

Disclaimer: This information is not intended to replace manufacturers’ recommendations.

Swaddling

Swaddling your newborn is a common practice that may provide comfort to your infant. It is important to remember that care must be taken to ensure healthy hip development.

Your baby’s legs should be able to bend up and out at the hips. They should not be tightly wrapped straight down and pressed together.

This position places the hip joints in a vulnerable positioning and may lead to damage of the soft cartilage of the socket.

If you choose to use a sleepsack specifically designed for swaddling, please ensure it has a loose pouch/sack for your baby’s legs and feet.

Developmental Dysplasia of the Hips

Developmental Dysplasia of the Hips, or DDH, is a condition that affects the head of the femur (thigh bone) as it develops in the hip joint (acetabulum). DDH affects ~1 in 1000 babies, is more common in girls, babies who are breech, and those with a family history of DDH. 

Symptoms of DDH can vary, with some young babies showing no symptoms all. An ultrasound of the hip joint is often used to diagnose DDH.

Symptoms may include: 

• Hearing or feeling a "clunk" when moving the hips, during a diaper change for example

• Difficulty moving the thigh outward at the hip (hip abduction)

• Leg length discrepancy; the affected leg may appear shorter than the other

• Asymmetrical (uneven) fat fold (rolls) around the groin or buttocks 

• Limping or changes in gait in older children

•   A curve in the spine in older children

When detected early, DDH can be effectively treated with the Pavlik Harness, and less than 1% of children affected may require surgery. 

If your child has any of the above risk factors for DDH, or you have concerns with how your child’s hips move or feel, speak with your doctor.

For more information on DDH, visit:

https://www.aboutkidshealth.ca/Article?contentid=944&language=English

Toe-Walking

While it can be FUN to walk on tip toes during play, some children walk up on their toes all of the time. This pattern normally disappears within a few months of learning to walk, however if it persists past a child's third year, there may be a need for therapeutic intervention.

A physiotherapist can address any muscle tightness, joint stiffness, and muscle weakness that may be caused by toe walking through a FUN exercise program to prevent further impact on gross motor development.

If you are concerned, please contact us for an initial assessment, regardless of your child's age: info@fundamentalspt.com or through our website.

Side Sitting

Side sitting is one of our favourite seated positions, not only for infants, but children (and adults) of all ages! What is so great about side-sitting, you may ask? ⁣⁣

• It encourages a more upright posture than cross-legged or ring sitting⁣⁣

• It is an important developmental position for transitions (i.e. for a baby to get from sitting to 4-point)⁣⁣

• It optimizes hip mobility without putting the joint at risk⁣⁣

• It engages the core and trunk muscles ⁣⁣

• Facilitates cross-body movements ⁣⁣

⁣Perhaps the next time you and your child sit on the floor you might try this one out! Just remember to practice both sides to prevent any asymmetries.⁣⁣

Hands to feet

Around 3 months of age you will likely notice that your baby discovers their feet! Little ones love to explore their feet with their hands (and sometimes mouth), which is so cute to watch, but also a FUNdamental skill. Hands to feet:

• Encourages cross-body exploration when the opposite hand reaches the foot

• Provides early opportunities at grasping

• Engages the core to keep the legs up against gravity

• Stretches out your baby's hamstrings

• May initiate rolling from back to side or tummy

If you have any questions or concerns about your baby's gross motor development please reach out to info@fundamentalspt.com or through our website to book an appointment!

The Importance of Climbing

Not only is climbing really FUN, it is also a powerhouse FUNdamental skill for kids of all ages. Climbing improves upper and lower body strength, while also helping to build core strength which is essential for gross motor skill development, including co-ordination and balance. Visiting your local park or participating in a community gymnastics class is a way to encourage whole body strengthening through climbing.

Questions or concerns about your child’s gross motor development? Please book an appointment so that we can have FUN together!

Crawling

Crawling opens up a FUN new world for your little one and allows them to explore their surroundings. It also makes parents’ lives a lot busier! Crawling is a key FUNdamental milestone that helps to develop:

• Shoulder stability

• Hip strength

• Weight-shifting

• Pelvic mobility

• Trunk rotation

• Body awareness

• Interaction with the environment; optimizing social and cognitive development

Children typically start to crawl between 8-10 months. Is your child “bum scooting” or “commando” crawling? This can be perfectly normal, but sometimes these styles of crawling can indicate weakness or a delay in motor skill development. Crawling on hands and knees is key milestone in development and we always want little ones to master this movement, even if they have jumped ahead to other skills like cruising or walking.

If you have any questions or concerns about your baby’s gross motor development, please reach out to info@fundamentalspt.com or through out website. to book an appointment.

Tummy Time

Placing your baby on their tummy while they are awake and supervised is FUNdamental to their healthy development. Tummy time helps to develop core, upper extremity strength, and neck control, which are the foundation for rolling, crawling, sitting, and walking.

Here are some tips to help make tummy time enjoyable for you and your baby:

• You can start with just a few minutes of tummy time several times a day – for example after each diaper change. Work up to longer stretches as your baby feels more comfortable.

• Give your baby lots to see and look at while on their tummy; toys, a mirror, you!

• A roll placed under your baby’s chest can help them to feel more supported and comfortable when starting tummy time.

• Help your baby to get into a better position on their tummy by gently placing their hands under their shoulders

• Having your baby lie on a caregiver’s chest, either when sitting in a chair or lying down, is a great way to make your baby feel more comfortable on their tummy.

If you have any questions or concerns about your baby’s gross motor development, please contact us at info@fundamentals.ca or through our website.