Elsa has come a long way since the first therapy appointment at only a month old. She barely moved her eyes, just small finger tips sporadically twitching when awake. While asleep she was so motionless I would check to see if she was breathing. Now at 9 months she is rolling around the living room finding her brothers spider-man figure to soothe an aching gum line.
For a child with special needs or a even an infant with motor delays, the smallest head bobble is a victory to be celebrated. It’s too easy to get caught up in what’s next, or how far behind a child is compared to the norm, but don’t forget to rejoice in the small steps our children make. Each day is filled with graceful moments that I deliberately have to look for because it’s too easy for me to get caught up in the process of improvement to take a moment to be in the here and now.
So, looking to the here and now I’ve thought of a few ways to add physical therapy into the day so it’s not too overwhelming. If we get stuck with the idea that PT has to be a scheduled half hour session it’s never going to fit. Spread out into our daily lives is where it’s best placed to see improvement in the long run. Of course, regularly scheduled PT appointments is a must but the homework can be a daily easy activity with you and your child. Below is a short video of simple holding positions that can be helpful in developing head control in infants.
Prone: With one hand supporting your babies head and chest and the other under their belly, hold them facing the floor. Most babies like a bit of rocking in this position for comfort. You can start with small increments of time here or just hold them throughout the day to get them used to tummy time.
Sidelying: This is a great way to develop trunk stability as well as head control. One hand is under the head and rest on your babies stomach. The other hand is under the top leg and resting again on the stomach. With the arm under the head, you can gently lift your elbow to provide more of a stretch to one side of your babies neck or encourage them to lift their head up. This will improve your babies head righting skills. (Fancy term for keeping the head upright in sitting and eyes level to the surface.) Don’t forget to switch sides. If your baby has torticolis (shortening of one side of the neck muscles) holding them longer on the side that has the shortened neck muscles will give them a nice stretch and improved the condition quickly.
Upright, forward facing: In this position, your baby is trying to hold their head in midline. This is the easiest position for a baby to maintain because it is within a small range of motion and it is aligning the spine in a natural position. It’s working all of the neck muscles as well as the shoulder girdle to improve stability of the head while upright. Hold your babies legs under both knees as if to pull the knees to the chest. With your other hand support the front of the babies chest or use your hand as a guide to allow them to lift their head off your chest for brief moments.
Upright, facing mom: For anterior (front) neck strength this is great to encourage your baby because they are facing mom. They can look at you the whole time and work on the pull to sit motion of keep the chin tucked into their chest when coming up to sitting. To do this, hold your baby facing you with their legs straddling your stomach. Slowly bring your baby away from your chest with one hand supporting gently behind the head. You can use a small amount of movement to bring encourage your baby to pull towards you leading with their head. This can take time but it will happen, and with mom’s face in front they’re even more encouraged to pull forward. In this position it is easier to do a pull to sit movement than from a lying down position. But you can work towards that by starting here.
Honestly, I never thought about the way I held my older boys. It was easy and natural. With Elsa, I wanted to protect at the beginning. But too much protection will not challenge Elsa to improve. Constant, small, reachable physical challenges make big improvements overall. With each position you hold your baby, change it to their specific needs. Ask your PT how to modify these positions and don’t be afraid to ask questions! You know your baby best.