Occupational Therapy's Role in Infants
As my time dwindles as a student at ProActive Pediatric Therapy, I was asked to reflect on my journey as a student and what I have learned about occupational therapy's role with infants.
I am currently a doctoral student studying occupational therapy at Drake University.
My doctoral capstone experience focused on gaining insight into how occupational therapists can become/use a certified lactation counselor (CLC) by earning a CLC and furthering the knowledge on occupational therapy’s role with infants who have a tongue tie and struggle with breastfeeding outcomes.
Before starting at ProActive Pediatric Therapy, I had solely researched how occupational therapists helped infants, who have a tongue tie, with breastfeeding outcomes. After being here for several weeks, I have learned there is more to look at. It is not just about breastfeeding or a tongue tie, but it’s about function and looking at the whole picture.
We look at
Quality of feeding
Okay, yes your babe is eating, but are they leaking milk out of the sides of their mouths? Is it painful to breastfeed? Is babe clicking or grunting? Does babe fall asleep during feeds? Is babe interested in feeding? Poor weight gain? Do they choke/cough/gag on nipple? These same oral motor concerns then continue as foods are introduced, making it difficult to smoothly and easily transition from bottle/breast to the introduction of foods. It’s not just about weight gain. It’s about pleasurable feeding experiences every time your baby eats. That is what promotes a lifelong love of eating. Quality of movement – Yay your babe is rolling, but what does it look like? Is there lateral righting, equal weight bearing through UE, and is their head elevated to ~90 degrees when lying on their bellies? Are reflexes integrating or are they still present? How easy is the baby achieving these motor skills? Quality of movement now impacts the ease of movement later on
Quality of movement
Yay your babe is rolling, but what does it look like? Is there lateral righting, equal weight bearing through UE, and is their head elevated to ~90 degrees when lying on their bellies? Are reflexes integrating or are they still present? How easy is the baby achieving these motor skills? Quality of movement now impacts the ease of movement later on.
Postural asymmetries
Is babe using symmetry of movements, moving and using both sides of the body equally? Symmetry is key for development!
Head shape
Is there head flattening? Is there a head turn preference, is the babe stuck to one side? Fascial tightness – Is babe using symmetry of movements? Is their head turned to the side? Are they stuck in flexion? Do they avoid certain positions?
Gut motility
Is your babe pooping at least once a day? What does it look like… yellow and seedy? What does their skin look like?
Reflux
Is babe actively spitting up, gassy, has colic symptoms/cries a lot.
Sleep
Do they wake up multiple times throughout the night? What do naps look like? Sleep is critical for optimal growth and brain development.
Airway Patency
Do they snore, have noisy breathing, sleep with their mouth open, or constantly have their mouth open?
Regulation
How quickly can they self-soothe? Do they tolerate other people holding them? Do they have to be swaddled? Do they need a pacifier? Do they like their car seat?
These are all signs that our infants give us to tell us how well their body systems are operating. Our body systems are all interconnected and they give us clues into where support is needed, we cannot separate our systems. We look at the infant as a whole, we are not just looking at whether they have head flattening, but the WHY, why do they have head flattening, what is this infant telling me. We are constantly asking the “I wonder questions.” What is this going to look like in the future? Are these asymmetries going to impact gross motor skills because they don't have a good foundation to start and work from? Infants who are showing these signs need intervention to prevent future difficulties. Early Intervention = Optimal Neurodevelopment.
Thank you, parents, for trusting and letting me be a part of your child’s journey. They have been a part of my learning journey and have left an everlasting mark, it truly has been a gift and an honor.
Marisa