TID BITS & TIPS

FREQUENTLY ASKED QUESTIONS

Is there anything I can do about my baby's "flat head?"


YES! You can improve your baby's head shape with repositioning, including "Tummy Time," positioning off of flat spots and avoiding “containers” for positioning during sleep. "Containers decrease your baby's opportunity to relieve pressure points on their head, lending to flattened areas where they have long durations of pressure. We suggest limiting to at most 10 minutes when awake, just a couple times per day; this includes inclined baby sleepers, infant swings, and infant carriers. Baby should sleep on their back, on a flat surface, in a crib or bassinet. Physical therapy is also considered the first method of treatment for head shape deformities. Your PhysioBaby PT can provide you with guidance on severity of head shape and provide referral recommendations for head shape assessment and treatment.




What is Torticollis?


Torticollis is a condition of the neck in which the child’s head tilts toward one shoulder and often the chin rotates toward the opposite shoulder. It occurs when muscles in the child’s neck, most often the Sternocleidomastoid (SCM), is tight.This postural condition may be caused by any number of factors, including the baby’s position in the uterus, trauma to the SCM during birth, or positional preference after birth. Torticollis is often accompanied by a head shape asymmetry. Physical Therapy for Torticollis: Physical Therapy plays an important role in individualized treatment of torticollis, including stretching, strengthening, motor skill development, myofascial release, visual motor development, and overall postural symmetry. A therapist guided home exercise program is a critical part of your child’s improvement with therapy. The sooner baby starts Physical Therapy, the greater opportunity for improvement.




Tummy time? When, where, and how?


YES! "Tummy Time" plays an important role in typical development in newborns and infants. "Tummy Time" helps babies to develop postural muscle strength and control while promoting typical head shape and muscle symmetry. "Tummy Time" will help your baby build the strength and coordination needed for rolling, sitting, crawling, and eventually walking.

"Tummy Time" starts right after birth; newborns should be introduced to "Tummy Time" during supervised, awake times and can include modified positions such as on your chest, across your lap, or "airplane carry."

"Tummy Time" should be done often throughout the day, when Baby is awake; aim for at least 5 times per day, 20 minutes on and off of tummy time, to baby's tolerance. No, baby should not cry it out for 20 minutes while on their tummy. We want baby to learn that being on their tummy is a new way to look at the world and explore new things.

"Tummy Time" can be fun! Your baby may enjoy laying on a play mat with interactive toys that light up or make sounds, interacting with you, and exploring their own appearance looking into a mirror. Baby may need a small prop when they are new to this skill; you can use a small pillow or rolled up blanket under their chest.

Just like anyone else starting a new exercise, your baby may need occasional rest breaks but can return to the "Tummy Time" activity once rested.




How long will my child need physical therapy?


Each baby has different therapy requirements, based on their unique presentation. I aim to optimize each session so that fewer sessions are necessary. The goal for each baby is to progress gross motor skills at an age appropriate rate with optimal postural alignment and a good variety of movement patterns. This will depend on your babys muscle tone, strength, motor planning, range of motion, and most importantly your level of participation in a home program. We want your baby to graduate from physical therapy as soon as possible but we also will not let them go too early - this may mean decreasing frequency over time, after initially starting physical therapy at a higher frequency. The caregiver will always be a part of creating this plan and what works best for the entire family.




My baby has a flat head, should baby still sleep on their back?


Yes, back is still best, even in the presence of plagiocephaly!

The American Academy of Pediatrics (AAP) recommendations on creating a safe sleep environment include:

· Place the baby on his or her back on a firm sleep surface such as a crib or bassinet with a tight-fitting sheet.

· Avoid use of soft bedding, including crib bumpers, blankets, pillows and soft toys. The crib should be bare.

· Share a bedroom with parents, but not the same sleeping surface, preferably until the baby turns one but at least for the first six months. Room-sharing decreases the risk of SIDS by as much as 50 percent."

Sleeping on a flat, firm surface actually optimizes an infants opportunity to rotate their head and thus relieve pressure points when compared to use of an incline sleeping device or swing. These positioning devices "contain" the baby in a position which limits their opportunities for neck rotation and pressure redistribution, increasing the pressure on baby's flat spot. Additionally, sleep devices also often reinforce poor postural alignment (torticollis) due to decreased opportunities for typical movement.




How can I make sure that my child gets the most out of each session?


In order to optimize outcomes of each session, the following tips are useful: - Try to be ready on time, with a fresh diaper if appropriate. - Set up a soothing and comfortable environment: a blanket over soft or carpeted surface where your baby is comfortable. - Have on hand two to three of your baby's favorite toys (light up, musical, or textured). - Minimize sounds from t.v. or other devices. - Put beloved pets in a secure space, away from therapy. - It is expected that baby may need to stop to nurse, take a bottle, or just receive comfort from their caregiver during the session; this is completely supported and will incorporated into baby's therapy session.




How does telehealth work for physical therapy?


Telehealth is not a supplement or replacement for traditional physical therapy care, however, it is a useful resource that provides additional options for patients to access therapy.

The critical component of a physical therapy assessment of a baby's motor skills, head shape and postural alignment is observation of movement patterns in various positions, only requiring the caregiver to follow instructions for how to place the infant. A physical therapist is able to obtain a comprehensive perspective of how your baby moves and their postural alignment by watching your baby via telehealth. Subsequently, the most important part of any therapeutic program is a home positioning and exercise protocol. Provision of a home protocol with discussion and demonstration can be successfully achieved via telehealth.

Patients receiving Complete Decongestive Therapy (CDT) for lymphedema and related diagnoses are ideal for telehealth services due to the extensive education nature of treatments.




What is a CLT and how do they work in the pediatric population?


A CLT "certified lymphedema therapist" has the highest level of expertise in treatment of patients with vascular anomalies, including lymphedema, venous malformations, arteriovenous malformations, and other impairments of the vascular system. A LANA certified therapist has demonstrated continued education and professional growth by passing the North American Certification Exam. While vascular anomalies are rare in the pediatric population, they do occur and require management through a multi-disciplinary team including a certified lymphedema therapist. A therapist with expertise in pediatric vascular anomalies has the ability to incorporate physiologic developmental principles with vascular anomaly management in order to achieve optimal function. Catherine has developed a passion for this niche of therapy and collaborates with many advanced specialists providers to improve the lives of patients with vascular anomalies.




Do you take insurance?


Please inquire with us about your plan coverage. We provide support with most private insurance companies to get your child the therapy they need at an affordable rate.





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Tel: (832) 308-0381

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