Why do some babies need Physical Therapy?
I have found that most people don’t have ANY idea why a baby would need physical therapy. When I tell people that I’m an infant physical therapist, I’m often looking back at a confused face…so let me take this chance to explain what infant physical therapists like me do, because it is actually quite a lot!
I’m a list maker, so let’s start there. Here is a list of the most common reasons I would work with a baby (not in any particular order):
torticollis (head turn preference)
plagiocephaly (flat head syndrome)
increased body tension or discomfort
delayed motor milestones
before and after a baby has a frenectomy (tongue tie release procedure)
breast or bottle feeding challenges
developmental education
Torticollis
You can read more about this diagnosis in a previous blog post. Torticollis is a fairly common diagnosis that affects a baby’s posture with a peristent preference to look to one side. This might not seem like a big deal, but for babies that spend a lot of time on their backs, this can make exploring their world, and meeting their next milestone very challenging. Neck tightness is uncomfortable, and can be related to feeding challenges. Untreated torticollis often also results in changes to a baby’s head shape, sometimes leading to plagiocephaly.
Physical therapy helps babies with torticollis by getting them to find midline head position, helping them move their head and body with symmetry, and educating parents.
Plagiocephaly
This is a BIG fancy medical term for “asymmetrical head shape.” I also wrote in-depth about plagiocephaly in a previous blog post. Young babies are at risk for plagiocephaly because their skulls are so soft, and they spend a lot of time lying on their backs. The good news is that physical therapy is super effective in treating plagiocephaly, especially when started early (like, BEFORE 2 months old).
Physical therapy helps babies with plagiocephaly by educating parents about play, teaching symmetrical movement, and strategic positioning to reshape their child’s head.
Increased Body Tension/Discomfort
There are lots of reasons why your baby might seem “uncomfortable.” Often, it is difficult to tease out the root cause, as their can be so many contributing factors, and unfortunately, babies can’t let us know how they are feeling in a straight-forward way. Torticollis or tethered oral tissues (TOTs) are often big culpits when it comes to infant discomfort. Feeding challenges can also cause discomfort, especially if your infant is gassy or demonstrates reflux symptoms.
Physical therapy can help reduce discomfort by addressing range of motion restrictions, assisting your baby in finding movement that feels comfortable, and releasing tension with manual techniques.
Delayed Motor Milestones
Infant physical therapists are skilled at helping babies achieve their next motor milestone. Each important skill builds on the next, so it is always best to address any concerns as soon as possible. Physical therapists assess infants for tightness, weakness, or asymmetry that often contributes to motor delays. Motor challenges are often first noted during tummy time, where your baby might have difficulty picking up their head, or immediately get upset in a belly-down position. Read about ways to make tummy time easier here.
Individualized physical therapy can provide you with specific exercises, positions, and playful activities to get your baby rolling, sitting, crawling, and walking. I love celebrating each of these exciting milestones with the families I work with!
Before and After a Frenectomy (tongue tie release procedure)
A frenectomy, or tethered oral tissue (TOTs) release procedure, is a surgical procedure that is not without risks. It should not be an immediate response to the identification of a tongue, lip, or cheek tie(s). The presence of a frenulum is only one contributing factor in making this big decision. What is most important is how your baby’s tongue is functioning. Physical therapists that are trained in the treatment of tethered oral tissues (TOTs) are uniquely qualified to look at tongue mobility, tongue function, feeding position tolerances, and whole-body movement patterns that all are important for your infant’s feeding success.
Physical therapy for your baby with a possible tongue tie should happen BEFORE you consider a frenectomy. Often, with physical therapy treatment, surgical procedures can be avoided. If it is determined by your team of providers that a frenectomy is the best choice for you baby, you will see the best outcomes when you seek out visits with a physical therapist BEFORE and AFTER the procedure.
Breast and Bottle Feeding Challenges
It is my opinion that your babies first motor milestone is feeding! It requires strength, coordination, and functional mobility to achieve the wide latch and strong suck required for successful feeding at the breast or bottle. Breastfeeding can be especially challenging (and painful for Mom!) if your baby does not have full tongue mobility and/or increased oral tension. Initially, some of the necessary movements for breastfeeding are reflexive, or automatic, but this natural assistance fades with time. If you feel that your infant could use extra help, please reach out. There is so much we can work on, and infants usually make quick progress with focused exercises. Babies that move better, feed better!
Developmental Education
I love educating families about the “magic” of developmental milestones. It is amazing to me how each skill truly builds on the next, and that skipping a skill might not seem like a big deal at the time, but often causes future issues (i’m looking at YOU, crawling). One the best parts of my job is giving parents the tools to help their little one succeed in achieving their next milestone. I do this education in my one-on-one sessions, and in my motor play workshops, which I host weekly on Monday mornings at Wellness Village NH.
Hopefully, (if you made it this far) you are feeling extra educated about what it is that an infant physical therapist does. I would love to answer any additional questions on your mind, and as always, I’m here in southern NH to provide direct services to your babies from birth through walking. Reach out today for a FREE consultation so we can talk specifics about what is going on with your baby.
