Baby Handling - The Do's & the Don't's

At Active Living, we treat a lot of babies for various concerns and general wellness. Complaints we see most often in the clinic for babies include:

• Baby is restless and irritable

• Not sleeping well

• Crying often

• Baby is happy when moving

• Difficulty digesting

  • Digestion appears to be painful

  • Long period of time between bowel movements

  • Gassy

  • Reflux

• Baby doesn’t like certain positions e.g. – will only sleep when held, doesn’t like car seat, won’t sleep on back, etc

• Baby will only turn head or rest head to one side

• Not latching &/or only nursing on one side

• “Curved” body shape

• Various other complaints

While most babies respond well to treatment in the office, parents are often concerned what they are doing at home may be contributing to the symptoms their baby is experiencing.

A large part of our treatment plan follows a developmental kinesiology and DNS (link) approach; in early childhood our movement pattern is automatic, predictable, and genetically formed as the nervous system matures. An infant does not need to be taught when and how to lift it’s head up, grasp a toy, roll over, creep, or crawl. All these movement patterns or muscular synergies occur automatically in a specific developmental sequence throughout the course of CNS (Central Nervous System) maturation; enabling the infant to control posture, achieve erect posture against gravity, and to move purposefully through muscular activity.

The positions we place our babies in and the way we are handling our babies can contribute to their symptoms! It can also inhibit the natural developmental movement patterns our babies should be developing.

Ideally, we never want to put the baby in a position he can’t achieve on his own. We want to give them a surface they can feel the support on (usually the ground) to develop up-righting of the spine – eventually around one year to a bipedal (walking) gait.

Here are a few tips and guidelines for baby handling and positioning based on Developmental Kinesiology:

Newborn Phase:

• The position of your baby depends on external help – you! It is important, even at this stage that your baby spends time on his/her back, front (tummy time), and side-lying.

  • Tummy time can be on your chest! Baby needs to feel support from the surface she is on to be able to activate the proper muscles to lift her head

• Placement of toys (play mats are great for this stage):

  • While baby is lying on back – toys should be placed hanging over tummy (baby’s field of vision with a neutral spine) and not in a position where he would extend the head to look at toys behind.

  • When baby is in tummy time, toys should be placed in-front and within or just out of reach of his hand. Get on the ground with your baby here, face to face! It’s a great place for your body to feel support as well! You can also make it a fun way for your other kids to play with the baby!

• Positioning of the baby in bassinet or crib – If the bed is next to a wall or beside where you are sleeping, regularly change the position of the baby (head at one end one night, flip to head at other end next night) to motivate head turning to both sides. This will help reduce the likelihood of Plagiocephaly (flattening of the cranial bones on one side)

• Touch should be calm and light – your baby still has reflexes which makes him/her startle easily. These reflexes will disappear with age.

• If lifting from a supine (baby on his back) position, don not lift the baby by the shoulders and try not to let the baby go into extension if lifting from the chest. Control the head position and try to keep the torso and spine neutral. Rotational handling can be very helpful for development. Ask us how!

• Changing diapers – try to keep the spine neutral/straight. Side-lying position can be used, although may be more difficult for the person changing!

As baby develops, consider these points :

• Frequent passive sitting at a time when baby is not ready yet may result in abnormal spinal development

• Toy placement – if toys or objects are placed too high, there is excessive trunk and head extension. The baby is also not able to use both hands to manipulate the toy. Proper placement of the toy or object allows for proper posture, the baby can use both arms for support and toy manipulation

• For baby to eventually become/achieve an upright position, proper hand SUPPORT is critical for posture during the verticalization process. If the arm support is too high, it will result in too much truck and head extension as well as abnormal foot position. Poor support.

• Never put the baby passively in a position which he/she cannot get into themselves

  • If the baby can’t get into the position (e.g., sitting or standing) voluntarily, he/she is not ready to be in that position passively. Putting the baby in these positions passively is too challenging and overloads the ligaments and joints. This can cause abnormal skeletal development (link to previous blog post)

• Don’t teach your baby to walk holding them by their hands. Until the baby walks spontaneously (and he will!), he is not ready for such a challenging activity. Proper posture is only possible when muscle coordination patterns are adequate!

Car Seats:

• Only use for transport. Babies often like to fall asleep in car seats, but they are not designed for long term sitting. They are designed to keep your baby safe while in the car. Whenever possible, transport your baby to another position (crib or bassinet, floor) where he can lay on his back in is free to move. Prams (bassinet attachment) are great for the stroller at the newborn stage.

• Check baby’s head and body position in car seat. If head is slouched to one side, ask us how to correct this!

Baby Carriers:

• It is important to consider the neurodevelopmental age and ability of the baby.

  • A newborn can’t control their head position, so if carrying it is better to use a horizontal position. A sling can help keep the baby in a horizontal position.

  • Wraps or Soft-structure carriers – bum should be lower than hips. Avoid lordosis of the lumbar spine and anteversion of the pelvis (you can ask us what this looks like!), elevated shoulders and asymmetry of the head (ask us how)

We hope you’ve found these tips helpful. If you have any questions or concerns, please reach out!Dr. Melanie Brandt