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Paediatric Osteopathy, osteopathy Michelle Sherriff Paediatric Osteopathy, osteopathy Michelle Sherriff

Movement Milestones at 3 months

At three months, your baby's motor strength continues to develop. They will reach for small toys and try to shake or put them in their mouth. You'll notice better head control and lots of kicking and pushing down when their feet are on a hard surface.

Developmental movement Milestones

At three months, your baby's motor strength continues to develop. They will reach for small toys and try to shake or put them in their mouth. You'll notice better head control and lots of kicking and pushing down when their feet are on a hard surface. Here's a quick checklist of baby's Movement Milestones at 3 months​​​​​​​

  • Raises head and chest when lying on tummy​​​​​​​​

  • Supports upper body with arms when lying on tummy ​​​​​​​​

  • Stretches legs and kicks out when lying on tummy/back​​​​​​​​

  • Opens and shuts hands ​​​​​​​​

  • Brings hands to mouth ​​​​​​​​

  • Swipes at objects/toys with hands ​​​​​​​​

  • Grasps and shakes small toys ​​​​​​​​

  • Pushes down on legs when feet on firm surface ​​​​​​​

Movement milestones Red Flags

If you notice your baby isn't meeting one or more of the following movement milestones, contact your healthcare provider to discuss your concerns​​​​​​​​

  • Can't support his/her head well by 3 months​​​​​​​​

  • Doesn't reach for and grasp toys by 3-4 months​​​​​​​​

  • Doesn't bring objects to his/her mouth by 4 months​​​​​​​​

Osteopathy and Babies

How can your osteopath help? ​​​​​​​​
Osteopaths take a detailed history and assessment to identify areas of tension or restriction in the musculoskeletal system. We assess: ​​​​​​​​

  • Primitive reflexes and neurological evaluation​​​​​​​​

  • Orthopaedic and osteopathic evaluation​​​​​​​​

  • Developmental milestones​​​​​​​​

Osteopathic treatment aims to restore normal function and optimise healthy development for your baby ​​​​​​​​(Read more about osteopathy and babies).
Dr. Michelle Sherriff works in conjunction with general practitioners, maternal health nurses and lactation consultants and can make a referral when indicated. ​​​​​​​​

osteopathy near me

Dr. Michelle Sherriff consults at Portland Osteopathy and Wellness Group,

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Infant Torticollis

Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck.

INFANT TORTICOLLIS​​​​​​​​

Does your baby lie with their head positioned to one side or is unable to feed from both sides equally?​​

The word torticollis is derived from the Latin, "tortus" meaning twisted and "collum" meaning neck. Torticollis is usually related to tightened muscles on one side of the neck. ​​​​​​​​

Torticollis in infants is common and is reported to be as frequent as 3 in every 100 babies. It is usually diagnosed within the first month of life. ​​​​​​​​

You may notice the following signs with your baby: ​​​​​​​​

  • Baby’s head tilts or rotates to one side. More specifically; the head and ear are tilted towards the affected sternocleidomastoid muscle and the chin points to opposite side ​​​​​​​​

  • They prefer looking in one direction​​​​​​​​

  • They prefer breastfeeding on one breast only or have more difficulty on one side ​​​​​​​​

  • Limited range of motion in head and neck ​​​​​​​​

  • Asymmetry in baby’s head and face (plagiocephaly) ​​​​​​​​

  • A small lump in your baby’s neck​​​​​​​​

​​​​What causes it? 

Your baby may have been born with torticollis (congenital) or it may present after birth (acquired torticollis) ​​​​​​​​​​​​​​​​

CONGENITAL (Muscular or postural type) ​​​​​​​​

Symptoms and signs may not become obvious until your baby is 6-8 weeks old and gains more head and neck control. The most common type of torticollis is muscular. ​​​​​​​​

The sternocleidomastoid muscle attaches from the sternum and inner clavicle to the mastoid process of the temporal bone. When it becomes shortened it pulls your baby’s head into a tilt and/or rotation. This muscle can become tight and contracted due to the following factors ​​​​​​​​

  • Abnormal uterine position, for example breech position ​​​​​​​​

  • Injury during birth ​​​​​​​​

  • Forceps or vonteuse delivery ​​​​​​​​

  • Abnormalities related to the cervical spine. ​​​​​​​​

  • Rarely, it may result from a congenital disease affecting the nervous system​​​​​​​​

  • Babies diagnosed with infant torticollis should also be assessed for Developmental Dysplasia of the Hip (DDH)​​​​​​​​

  • Acute onset or torticollis diagnosed after 6 months (acquired) requires urgent further investigations ​​​​​​​​

​​​​​​​​What you can do? 

If your  baby's head tilts to one side, they prefer looking in one direction and have difficulty breastfeeding on both sides equally,  there are several things you can do to help your baby: ​​​​​​​​

Osteopathy: Make an appointment with your osteopath to address any underlying strains or restrictions related to uterine position and/or birth trauma ​​​​​​​​

Feeding:  When feeding your baby, encourage them to turn away from their favoured side by bottle/breast positioning ​​​​​​​​

​​​​​Sleeping: When putting your baby to sleep, position them facing the wall so they need to actively turn their neck to the restricted side to look out into the room. ​​​​​​​​

​​​​​​​​Playing: Encourage neck rotation to the restricted side with toys, sounds and singing. ​​​​​​​​

​​​​​​​​

EXERCISES 

Two exercises for infant torticollis are tummy time and guppy pose. ​​​​​​​​

TUMMY TIME: position your baby so their head is turned away then encourage your baby to turn towards you by talking or singing ​​​​​​​​. (Tummy Time blog)

GUPPY POSE: support baby on their back over your lap and allow their head to extend backwards, allow the chin to move away from the chest Encourage rotation to the restricted side. This pose releases tension through the front of the neck, and chest. ​​​​​​​​

 How can an osteopath help 

An experienced osteopath who works with babies will assess for any cranial or facial asymmetries related to torticollis, they’ll assess for restricted cranial articular motion, cervical spine and rib dysfunction. They will palpate the sternocleidomastoid and scalene muscles for any lumps and tightness. 

As torticollis may have an impact on the vestibular system and can affect the visual system, your osteopath will also check your baby’s visual tracking.

It’s really important to treat infant torticollis as early as possible. If left untreated, it can lead to functional restrictions of the spine, plagiocephaly and it has also been associated with thoracic scoliosis. 

osteopathy near me

Dr. Michelle Sherriff use a very gentle form of osteopathic treatment for babies called Biodynamic Osteopathy to treat infant torticollis.  This type of treatment allows your baby to come to a point of stillness, allowing an unwinding and rebalancing of their system. Osteopathic treatment aims to restore normal function, optimise healthy development and assist your baby’s own innate capacity to heal and restore balance naturally. 

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Tummy Time

Tummy time involves placing your baby on their stomach while they are awake. It’s important for your baby because it helps build strength through the upper body, shoulders and neck. It also helps your baby develop head control.

Tummy time involves placing your baby on their stomach while they are awake. It’s important for your baby because it helps build strength through the upper body, shoulders and neck. It also helps your baby develop head control. 

Babies spend a lot of time sleeping on their back to reduce the risk of sudden infant death syndrome (SIDS). Tummy time helps prevent areas of flatness on the back of the head (positional plagiocephaly) related to this sleeping position 

This position also promotes motor skills and helps your baby reach developmental milestones such as sitting up, rolling over, crawling, standing and walking. 

When to start 

Tummy time can be started safely from birth for 1-2 minutes in the first few weeks and gradually building up to 10-15 minutes a day by approximately 4 months of age. 

Start with laying your baby across your lap on their tummy.  As your baby gets stronger, tummy time can move to a blanket or playmat on the floor. 

How to do it

  • Your baby should be happy and alert for tummy time. After a nappy change or nap is recommended. 

  • Put some age-appropriate, safe toys close to your baby.  Move the toys in front of your baby’s face to encourage head lift and rotation 

  • Lie down next to your baby on the floor, turn pages in picture books to develop visual strength 

  • Place a non-breakable mirror in front of your baby so they can see their reflection. 

  • Make it safe, fun and interesting. Sing to your baby during tummy time. 

  • It doesn’t have to be inside. Take a rug outdoors on a nice day for a change of scenery. 

How often: 

Set a goal of two to three times a day.

What to do if your baby dislikes tummy time 

Babies with big heads or were born prematurely can find tummy time difficult and may need more time to build their strength up.  Babies who experience reflux/silent reflux generally dislike tummy time. For those babies, avoid it straight after they have fed as it may cause vomiting or discomfort. Wait until they have been burped, had their nappy changed and are reasonably content before placing them in this position.

Try a different approach for babies who dislike tummy time.

  • Chest to chest with the parent seated in a chair

  • Chest to chest on the floor: try laying down on your back and placing your baby on your chest for a few minutes 

  • Over your lap, parent seated on a chair or on the floor 

  • Over your arm, parent seated 

  • Over a rolled towel, place the towel under the baby’s chest with their arms forward 

  • Over a gym ball (with support from the parent) 

  • Always supervise your baby during tummy time. As your baby develops you’ll need to keep the area clear and safe.  

See your osteopath

If your baby is experiencing any of the following issues:

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Plagiocephaly

When a baby is born with an asymmetrical head it is called plagiocephaly, from the Greek “plagios” meaning oblique and “kephale” meaning head. A true plagiocephalic head will resemble a parallelogram when viewed from above.

When a baby is born with an asymmetrical head it is called plagiocephaly, from the Greek “plagios” meaning oblique and “kephale” meaning head.  A true plagiocephalic head will resemble a parallelogram when viewed from above. 

Newborn skulls are cartilaginous and membranous which allows them to be soft and malleable through the birth process. Birth strains usually resolve quickly or by six weeks post birth.  “As the twig is bent so shall the tree incline” is a well known phrase from the founder of osteopathy, Dr. Andrew Taylor Still. Early osteopathic treatment is recommended to address cranial and facial strains related to plagiocephaly. When left untreated, plagiocephaly may contribute to postural imbalances and delays in early milestones,

There are two types of plagiocephaly; primary and secondary.  Primary plagiocephaly is present at birth and may be related to the following factors:

Through pregnancy:

  • abnormal uterine positioning or strong moulding forces in the uterus 

  • Primiparity, first child

  • Twin pregnancies, less space

  • Intrauterine constraint

  • Low amniotic fluid or premature engagement of the head and pelvis

  • Premature baby, the skull is still very soft and malleable

  • Torticollis related structural anomalies, for example congenital fusion of cervical vertebrae.

The birth process:

  • A difficult or lengthy labour

  • Assisted delivery (especially if ventouse or forceps used)

Secondary plagiocephaly appears several weeks to months after birth. Causes include: 

  • Torticollis where plagiocephaly develops secondary to torticollis.

  • Dysfunction of C1 causing fixation of the head

  • Positional flattening, baby spends too much time lying on their back

  • Restricted position of newborns

ON EXAMINATION 

You may notice a flat spot at the back or side of your baby’s head as well as bulging, called “bossing” at the front of their head on the same side.  Your baby may have difficulty turning their neck to one side, prefers resting their head in one position or to feed from one breast. You may notice you baby’s eyes and ears are not symmetrical. 
Your osteopath can inspect and palpate (feel) the cranial bones, suture and fontanelles to diagnose plagiocephaly. 

OSTEOPATHIC TREATMENT 

Early and frequent osteopathic treatment is important to treat any intraosseous restrictions and strain patterns of the cranial base and resolve any membranous and fluid strains. Treatment of the cervical spine is indicated if torticollis is related. Dr. Michelle Sherriff utilises a very gentle form of osteopathic treatment for babies called Biodynamic Osteopathy in the Cranial Field. This type of treatment allows your baby to come to a point of stillness, allowing an unwinding and rebalancing of their system.

WHAT YOU CAN DO

  • Make an appointment with your osteopath for early and regular treatment

  • Face Time, when you baby is awake play with them face to face

  • Tummy Time, place them lying down on their tummy (when awake) or on their side from from 1-2 weeks of age.

  • Encourage your baby to turn their head to the restricted side with toys, rattles or positioning cot so your baby turns to look at you.

  • Vary the position of your baby’s head when putting them down to sleep to avoid the flat spot

  • To reduce risk of SIDS babies must always be placed on their back to sleep

  • A helmet may be an option if the deformation is moderate or severe and persists beyond 6 months.

  • A more serious condition called craniosynostosis must always be excluded before plagiocephaly is treated conservatively

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