It’s the wee hours of the night, you’re wiping your eyes and you’re delicately typing into the search bar all things pertaining to your baby -
“Is it okay if my baby does…?”
“When does my baby…?”
“What is the best way to help my baby…?”
The list goes on.
As a new parent, I get all those leading questions. I see you. And - even as a physical therapist with years of working with infants and children of all ages - I, too, have fallen victim to Google searches with the desire to do best by my child. Thankfully, a good deep breath, a little reminder to trust the process, and refocusing on what is truly important helps settle my mama-mind.
We all know the Google search cycle is ineffective, but your thoughts are well-intended. So what do you do?
Maybe your questions are related to how to get your baby to lift their head during tummy time.
Maybe you’re wondering if keeping their head to one side is normal.
Maybe you’re thinking they should be sitting by themselves by now.
Maybe your baby is still not rolling or crawling no matter how hard they try.
Maybe they are eager to take their first steps, but it’s just not working out quite right for them yet.
Whatever the thought, seeking the help from a skilled physical therapist and trusting the process will lead to peace of mind, confidence in an active plan, and - ultimately - the sure success of your child.
You’re doing great parent. Sometimes a little nudging in the right direction is all a little baby needs. Sometimes it’s more, and that’s okay - PT can help! Below we’ll discuss:
What even is infant physical therapy?!
Why would my baby need physical therapy?
What goals does physical therapy typically focus on for infants?
What can me and my family expect from infant physical therapy?
What even is infant physical therapy?!
Infancy is defined as the period of life from 0 to 12 months of age. During this time, your child is rapidly growing and prolific development occurs. The way your child moves and the sensory information provided both in their environment and through their relationships shapes the manner in which they navigate the world. More than pure attainment of milestones, the quality and frequency of a baby’s movement is influenced by and impacts their muscle strength, range of motion, postural control, balance, and coordination for years to come.
Infant physical therapy focuses on addressing challenges in these areas and promoting optimal movement patterns to maximize the functional potential of babies. This is done through a playful and gentle approach appropriate for infants using person-to-person engagement; toys; and play equipment (mats, balls, therapist’s lap, etc.) for motivation, postural support, and resistance to challenge your child.
*For more information on pediatric PT as a whole, please see our physical therapy section under the services tab.
Why would my baby need physical therapy?
The first year of life is a time of rapid growth and development and with each month comes new skills and a changing view of the world. The brain grows to 80% of its maximum size by the time your child is 3 years old. (1) But while change and growth are consistently happening beyond the first year of life, studies have shown that the brain more than doubles in size from the time your child is born to their 1st birthday. (2) Physical therapy can help improve motor function at any age, but this time of infancy is especially critical to create the neural pathways necessary for upcoming skills as your child grows and lays the foundation for the future. As Tamis-LeMonda put it in reference to Esther Thelen’s mountain stream of development metaphor: “Like a river that carves its course, the active infant navigates the social and physical environment and generates rich inputs that propel learning and development.” (3)
Indicators that your baby may need PT:
Muscle stiffness
Generally floppy; low muscle tone
Lack of movement during tummy time
Arms and/or legs remain flat on surface when on back
Hip popping/clicking noises
Poor posture in sitting
Not accepting weight through both feet
Preference for tilting or turning their head to one side
Not rolling belly-to-back and back-to-belly over both right and left sides with frequency and ease by 6 months
Uses a wide base of support in sitting or w-sits as the dominant sitting position
Not transitioning in and out of sitting independently by 7 months
Uses a “janky crawl,” scoots on bottom, bunny hops, or commando crawls to get around; lacks reciprocal creep on hands and knees
Not pulling up to stand by 10 months
Inability to stand on flat feet by 11 months
Not cruising both directions by 12 months
Movement appears tiring for baby; they must put forth a lot of effort in order to move
Physicians often recommend PT for infants for the above presentations and for conditions such as:
torticollis & plagiocephaly
delayed gross motor skills
hip dysplasia, clubfoot, and other orthopedic conditions
cerebral palsy
other neurological and genetic conditions.
What goals do physical therapists typically focus on for infants?
Improving range of motion
Strengthening muscles
Promoting more symmetrical and efficient movement patterns
Achieving independent transitions between positions
Controlling postural reactions
Increasing balance
Improving coordination
Attaining age-appropriate gross motor developmental milestones
What can me and my family expect from infant physical therapy?
A physical therapy evaluation for an infant should involve assessment of the baby’s behavior and common movement patterns during play. The physical therapist will observe and assess your baby’s posture in tummy time, on their back, in sitting, and in standing as well as how frequently they move. They may also gently move your baby’s head, arms, and legs at different speeds. This information helps the physical therapist understand your baby’s range of motion, strength, muscle tone, and postural and motor control. In turn, this helps them to determine a plan of action and prioritize and tackle your child’s biggest obstacles to movement.
Depending on your child’s needs, a typical treatment session might include:
Gentle stretching and massage-like techniques
Activities on a therapy ball or bolster or even the therapist’s lap to elicit postural righting reactions, head/trunk control, and/or specific muscle activation
Hands-on techniques to facilitate certain muscles for more optimal posture and efficient movement patterns
Assistance for transitional movements between positions (such as rolling in certain directions, getting in/out of sitting, pulling to stand, preparing for walking, etc.)
Practice of important developmental milestones
Therapeutic activities and exercises for infants might look like play - and that’s a good thing! Movement should be motivating! Littles ones learning to move in new ways can be tricky sometimes, but your child does NOT have to struggle - and YOU do not have to settle for the perpetual cycle of pondering and midnight Google-searches. From this new mama to you, take a good deep breath, reach out to a professional and trust the process. Then you can refocus on what is truly important - your child’s well-being. A skilled pediatric physical therapist can help your baby move efficiently and joyfully - maximizing their functional potential and setting a solid foundation for their future.
If you have any questions or concerns about your baby’s posture, movement, or overall development, call or email our clinic today to schedule an evaluation or free consultation with our physical therapist!
You’re doing great parent! Keep up the amazing work.
by Melissa Lam, PT, DPT, c/NDT
References:
Bethlehem, R.A.I., Seidlitz, J., White, S.R. et al. Brain charts for the human lifespan. Nature 604, 525–533 (2022). https://doi.org/10.1038/s41586-022-04554-y
Gilmore JH, Langworthy B, Girault JB, Fine J, Jha SC, Kim SH, Cornea E, Styner M. Individual Variation of Human Cortical Structure Is Established in the First Year of Life. Biol Psychiatry Cogn Neurosci Neuroimaging. 2020 Oct;5(10):971-980. doi: 10.1016/j.bpsc.2020.05.012. Epub 2020 Jun 9. PMID: 32741702; PMCID: PMC7860052.
Tamis-LeMonda CS. The mountain stream of infant development. Infancy. 2023 May;28(3):468-491. doi: 10.1111/infa.12538. Epub 2023 Mar 24. PMID: 36961322; PMCID: PMC10184132.