Baby Time:Feeding, Tongue Ties, and Fussiness

This week, we wanted to discuss how PT may be able to help your infant with feeding difficulties. Recently we have been seeing and treating many infants with difficulties feeding, for example trouble latching, mouth tightness, and trouble getting enough milk! When you bring your new baby home from the hospital, there are so many things to learn and so many things your growing family is experiencing together, whether you are an experienced parent or new parent. If your little one seems to be having trouble feeding and becomes very fussy at meal times, you may start feeling very overwhelmed and exasperated, because all you want them to do is eat to grow big and strong!

A lot of times, babies who are experiencing feeding difficulties also have a lip and/or tongue tie, requiring releases. They also may seem uncomfortable in their bodies and seem fussy a lot of the time. It is often blamed on gas or colic, but there is often more to it. Many new parents are referred to a lactation specialist and/or speech therapist to help with their baby’s feeding difficulties and lip and tongue tie concerns. Both lactation specialists and speech therapists are amazing professionals to have on your team during this fussy, troublesome time. 

What you might not know is that a Pediatric Physical Therapist may be helpful as well, specifically a pediatric physical therapist trained in a special technique called Total Motion Release (aka TMR). This gentle technique helps PTs to look at the whole body of a child, no matter how small, to see if there are any asymmetries in their posture. These asymmetries in their posture are often left over from the infant’s specific positioning in utero.  They make it uncomfortable for your baby to be held in certain positions, which may affect them during feeding or otherwise. They can also contribute to tightness in your baby’s neck, jaw, and inside their mouth, which may affect their ability to feed, as you may be experiencing at home! Funny thing is, the muscles and other soft tissues of the body, specifically in the hips and the trunk, are MUCH BIGGER than the little muscles of the neck, jaw, tongue, and mouth. Because these soft tissues are bigger, they may be adding to the tightness your baby is already experiencing in their mouth, which may be increasing their difficulties with feeding.

If you are thinking this sounds like your little one, breathe a sigh of relief, because these asymmetries are easily worked out with simple and easy positioning techniques, especially if your baby is very little. Here at KidPT, we look at the whole body of your little one and use TMR to do this. Through our TMR lens, we look to see if your baby has any of these soft tissue asymmetries in his or her body. We can talk with your lactation specialist or speech therapist to see what their current concerns are, and as a team we can progress your baby toward ease of feeding, and an overall increase in comfort in their bodies, together! Parents often find that not only does the baby feed better, but they become calmer, happier and sleep better! If you are currently experiencing feeding difficulties with your newborn, and want an experienced pair of hands to see if asymmetries in your baby’s body may be contributing to this, come on in to KidPT for a free Discovery Visit with one of our Physical Therapists! We would love to help you and your little one with our no muss, no fuss approach! 

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Quick Kids:

…It might be more than behavior and attention

By: Dr. Ali

Do you feel like your child never stops moving? Like they are here, there and everywhere, running in between destinations and fidgeting in their chair while eating a meal? Even if you have asked them to take a pause they seem to not listen, or be physically unable to follow the instructions you are giving to slow down, even if they are traditionally a very good listener? Being in constant motion can be related to certain diagnoses, like ADHD. ADHD often presents with additional signs and symptoms, like forgetfulness, difficulty staying on task, trouble listening while another is talking, excessive talking, unsafe and impulsive behavior, and/or trouble with turn taking. Regardless of whether your child has a diagnosis of ADHD or not, there may be another factor contributing to their need for constant motion.

That “thing” is something we PT’s call postural control. Postural control defined as the act of maintaining, achieving, or restoring a state of balance during any posture or activity (1). When someone has a very “fine tuned” postural system, their body, vestibular system (little balance center in the ears), and eyes are telling their brain where they are in space and what position their body has to hold. Then their brain sends signals to the muscles to hold that specific position. In order for all of this to work, the eyes, the vestibular system, and the body have to send accurate signals, the brain has to correctly process this information, and the body must be able to coordinate muscles on all sides to hold the position steady. Phew, even thinking about this long process can make someone tired! 

When there is misinformation, trouble processing the information, or trouble coordinating the body in response to the brain’s signals, it will show in the body. When this happens, the child’s body may sway back and forth while they are trying to sit still in a chair, they may need to continuously move their feet instead of standing still, or they may just keep changing position when the one they are currently in becomes too hard to hold. When children are in constant motion, it often shows us PT’s that they are stuck constantly “restoring” their state of balance, as opposed to “maintaining” as the definition says above. Their body feels like it is always at risk of falling, so they move to catch themselves and prevent this. It may not look like that is what is happening when they are step, step, stepping, but if they are stuck constantly restoring their balance with decreased postural control, this is what their body is telling them is happening. 

When we see kids who show us this constant need for motion, we help them improve their postural control so that they can achieve and maintain steady postures. This is important for so many reasons other than just giving them greater stability. Sometimes when postural control improves, a child has an easier time paying attention to tasks and school lessons, because part of their brain isn’t being used to keep them on balance. All of that brain energy that was being used to signal movement that would prevent them from falling can be allotted to other things, because their balance system is operating on autopilot!

If you see your child having difficulty staying still and want to get another opinion, come in to KidPT for a free discovery visit, and a PT can answer any questions you may have about this topic!

References: 

  1. https://pubmed.ncbi.nlm.nih.gov/10945424/#:~:text=Postural%20control%20is%20defined%20as,change%2Din%2Dsupport%20response.

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St. Patrick’s Day Moves

By: Dr. Ali

This week is St. Patrick’s Day and with all of the green, Leprechaun fun, we wanted to add some fun moves to your family’s festivities! If you need a visual version of these exercises, click above to view the exercises in video form!!

  1. Leprechaun’s Jig: Jump together on two feet, then jump onto one, to two, then to one, and keep repeating this over and over again until you have done 10 one footed jumps total! Look, you’re doing a jig!
  2. Making the Rainbow: Go on your belly to start. Place your hands on the ground and your feet on the ground. Then push your tooshie up into the air and hold
  3. Creeping over the rainbow: Tip toe on a line with a sneaky expression, so you don’t “tip” the Leprechaun off that you are coming. SHHHHH its a surprise, you have to sneak up on him if you want his gold!
  4. Jumping in the Pot of Gold: Jump into your imaginary pot of gold but bringing one knee up close to your chest then jumping onto the leg that is up while bringing your opposite knee close to your chest. 
  5. Give gold coins to your friends: Squat low (because you are still up on the imaginary rainbow) and pass your friends coins by reaching down low. Pass the coins to 10 friends!

We hope you have fun getting JIGGY with it! We know you will all be the best rainbows, pot o’ gold jumpers, jig dancers, and gold coin sharers out there! Happy St. Patrick’s Day everyone!

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School & Private Physical Therapy: Same or Different?

Today’s Frequently Asked Question

Parents often ask us the difference between school physical therapy and private physical therapy.

I mean, why should a parent pay for a service they can get for free at school??!!

I totally get that, so I thought I would explain more in a blog post.  Because If they were the same, you would be right!  There would be no reason to invest in therapeutic care for your child that is being provided for free at school.

Let’s get into how they’re the same and how they’re different beyond their location of services.  

Isn’t Physical Therapy, Physical Therapy?

Physical therapists are all licensed to provide physical therapy and to work with all ages and all settings.  However, not only do goals change depending on the setting and the individual, but the role does too.

The role of physical therapy in the school is to support a child’s access to education.  It is to support their ability to participate in the least restrictive environment and support the motor skills needed at school.  The services are determined by the student’s IEP, Individualized Education Plan, and is a related service based on education law.  

Private physical therapy can look outside of the child’s education to look at the bigger picture of a child’s life today and in the future.  Private physical therapy can focus on goals from all parts of a child’s life, from keeping up with the family at the park to protecting a child’s joints so that they will be strong, healthy and pain-free for the future.  

Many children will benefit from physical therapy services in both settings to help them achieve success at school while also being able to guide the child towards their own personal potential.  

If you have questions as to the best ways to support your child, reach out to us today and one of our physical therapists can hop on the phone with you and chat about your options.  We are here to support you and your child and to help guide you to know your options so that you can best advocate for and support your child on their journey!

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