Babies need tummy time

Putting infants on their backs and stomachs promotes full development


Jill S. Browning


Spotlight - October 2006 Tyler Roney recently was mistaken for a superhero. The 15-month-old from Tinley Park was out shopping with his mom, Jennifer Roney and twin sister, Megan, when a little girl approached them and asked if Tyler was Spiderman. His unique headgear had attracted the girl's attention.

In fact, Tyler was wearing a medical device called a DOC (dynamic orthotic cranioplasty) band to correct his deformational plagiocephaly.

Plagiocephaly means that a baby's head is misshapen and flat on one side or in the back due to too much pressure being applied on the soft skull.

Since 1992, when the American Academy of Pediatrics began advising parents to put their babies to sleep on their backs to prevent sudden infant death syndrome, there has been an increase in the number of babies with plagiocephaly, from 1 in 300 births in 1979 to 1 in 50 today.

If a baby has low muscular tone and control (due to weak neck muscles or being constrained in utero, both of which apply in Tyler's case), he might be more prone to developing plagiocephaly, says Mary Kay McGuire, a clinician at Cranial Technologies in Oakbrook Terrace, which provides physical and occupational therapy to children.

Back sleeping and spending time in a car seat, bouncy seat or swing exacerbate the problem, because the baby's head remains pressed against a flat surface.

A cosmetic matter?

While experts debate the long-term impact of plagiocephaly, many studies link it to developmental problems. For example, some babies with the condition might not meet the early major milestones of gaining head control, sitting up or crawling.

McGuire says she sees kids who didn't spend time on their stomachs strugging later, in kindergarten, with fine motor skills, unable to use crayons or scissors properly. In addition, experts suspect that a baby's visual perception may be affected by asymmetrical features caused by a lopsided head.

Roney's pediatrician told her not to worry-that Tyler's misshapen skull eventually would round out on its own. She was told to do some "aggressive repositioning," which involved rotating the baby's head, doing some stretching exercises and giving him adequate "tummy time." But when Tyler's head stayed flat and he continued to favor one side, she took matters into her own hands and contacted Cranial Technologies.

The earlier children start therapy, the better results they will have, says McGuire. The best time to start the band phase of treatment is when children are 4 to 6 months old.

Treatment consists of a lightweight band that applies gentle pressure to the malleable skull in order to reshape and round it out. Typically, a baby wears this band 23 hours a day for three to four months.

Roney is thrilled with the results from the band, which she says is easy for her son to wear and has reduced the flatness of his head. "It's so important to not let a lackadaisical doctor get in the way of treating your baby in a timely fashion," she says.

Lisa Geiger, Downers Grove mom of 18-month old Andrew, agrees. A friend who is an occupational therapist persuaded her to take Andrew for an evaluation. Today, he sports a round head and symmetrical face after a brief stint of wearing the DOC band.

McGuire wishes that the message about plagiocephaly was as "in your face" as the "Back to Sleep" campaign. Roney says that the phrase "tummy time" doesn't adequately communicate the importance of the activity. "It sounds like something that's fun and entirely optional," she says, "but it's not."

Jill S. Browning is a writer and mother of triplets in Downers Grove.

Supervise your baby on his tummy at least two to three times per day, from the time he comes home from the hospital.

Take him out of the car seat, bouncy seat and swing. Rest him face-down on your chest or legs to strengthen his neck muscles.

Roll up towels and position him on his side with toys and objects in front of him.

Don't be discouraged if he's displeased: Keep it up.

While he sleeps on his back at night and for naps, turn his head in different positions. Alternate which end of the crib you put his feet; this will cause him to naturally turn toward light or objects in different positions.


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