Pediatric Series, #2 – Developmental Milestones

Is your child hitting developmental milestones on time? Let’s go over what your child should be demonstrating at various months before turning 1 year old.

Keep in mind that you should be considering your baby’s corrected age when making comparisons, if he or she was born a preemie. Children develop at different speeds and your child may be 1-2 months ahead or behind “schedule”.

If significantly behind, address your observations with your baby’s pediatrician. Your child may require physical therapy if there is concern for an untypical delay.

At Rebound, we will use objective tests to determine how behind your child is and create a treatment plan to help your child reach important milestones.

1 – 2 Months

Your baby can start to turn his or her head when lying on the back and belly. He or she will be able to briefly lift his or her head up during tummy time.

You will notice random arm and leg movements. Your little one can see objects 8-10 inches in the distance and will be most interested to look at your face and highly contrasted auditory toys, such as a black and white rattle.

3 Months

Baby should be tolerating tummy time for at least 60 minutes a day.

While on the tummy with forward forearm prop, he or she will be able to keep his or her head more upright and visually track objects to each side with head rotation.

He or she will be able to move arms and legs more symmetrically; i.e. bring both hands to mouth or body and straighten both legs.

4 – 5 Months

Neck muscles become strong enough to keep the head up against gravity when you pull your baby up to sitting by his or her hands.

Your baby will start to reach his or her hands to knees and feet.

He or she will be able to roll from tummy to back and begin to roll from back to belly, over both sides.

6 – 7 Months

Your baby will start to look steadier sitting independently; he or she may play with a toy while sitting and will put hands forward to prevent loss of balance.

He or she will prefer to be on his or her belly and will roll easily to do so when placed on his or her back.

You may start to notice your baby pivoting around on his or her belly or push up on hands and knees.

8 – 9 Months

Baby is on the move! You might observe your baby scooting on his or her bottom and/or belly to explore.

Crawling, getting into and out of sitting, kneeling, and pulling up to stand will also occur during this time.

10 – 12 Months

Cruising along furniture will happen before independent walking. Parents may have the notion that their child should start walking by 12 months old, and if not, believe there may be something wrong.

But typical babies may walk anywhere between 9 to 18 months old.

Pediatric Series, #1 – Torticollis

What is torticollis and does your child have it? We will discuss what the word means, what to look for, how is it caused, and how to get help for your little one.

What is Torticollis?

Torticollis in Children

Torticollis is a neck deformity where the head constantly tilts or rotates to one side, or a combination of both.

This coincides with a stiff neck where there is muscle tightness on the side of the tilt and a decrease in range of motion in the opposite direction of the tilt and rotation.

In infancy, if the torticollis remains untreated, “plagiocephaly” or skull and facial deformities may develop.

The Causes of Torticollis

There are multiple causes which further classify pediatric torticollis into “congenital torticollis” and “acquired torticollis”.

Congenital torticollis means your baby was born with the torticollis due to either shortened and tight muscles on one side of the neck from positioning in the womb, known as “muscular torticollis”, or Klippel-Feil syndrome (much less common).

Klippel-Feil syndrome is a genetic phenomenon where two or more vertebrae in the neck are fused during fetal development.

Acquired torticollis occurs after birth and may result from several situations.

One such situation being imbalanced positioning during the first few months of life when your baby does not have the strength to correct her head positioning against gravity.

If your baby is unknowingly and consistently being placed in a position where her head is leaning to only one side, that side with eventually tighten and she will have developed ‘muscular torticollis’.

A second situation may be lymph node swelling from a cold or an ear infection, in which case your child may hold her head in a position of comfort in response to inflammation and pain.

In this case, the torticollis should resolve itself after your child gets over the illness.

Another situation may be head or neck trauma. Again, your child may position the head away from midline for comfort. In this last case, be sure to determine the method of injury and ask your child’s doctor about any concerns to rule out more serious injury.

If my child has it, what do I do?

If your baby presents with congenital torticollis, typically the pediatrician will catch this early on, during your baby’s wellness first few visits.

Your baby’s doctor will be able to determine whether the torticollis is due to shortened neck muscles, or another cause.

If your child has muscular torticollis, the pediatrician may show you some stretches and recommend physical therapy.

Here at Rebound Hawaii, we treat muscular torticollis through stretching, positioning, and strengthening.

We also educate parents and equip them with a therapeutic program to carry over treatment at home to optimize success.

It is important to address torticollis early to reduce the appearance of plagiocephaly and prevent compensations related to vision, posture, muscle imbalance, and gait pattern.

If you have any questions, do not hesitate to contact us!