You already brought your baby home or you are still waiting for this great moment? Are you taking care of your will be taking care of the baby? You are the first one who can observe the starting problem in the baby. You are the person with whom the baby spends the most of the day. Only you have the babies health fully in your hands. I do not doubt, that you know how to prevent illnesses. There are many articles and books written about healthy nutrition, allergies, cold etc. However the informations how to control the physical development of the child are less known. I will try to give you in the following articles a simple key to the control of your child’s psychomotor development. (Introduction to the psychomotor development of the child)
HOW TO DO THE CHECK UPS?
Entry position I
When do we evaluate: it is ideal to have the baby undressed (for example when you are about to bathe the baby). You can easily check the body.
What do we evaluate: Evaluate in which parts ofthe body does the baby lean on the most against the mat, how does the baby turn or lift up the head and trunk, in what position are the feet etc. this is the type of evaluation where clothing would cover the small details (wrinkles or skin fold etc).
Goal of this evaluation: you observe the quality of the movement.
How often to observe: do the check up once in 2 - 4 weeks.
Entry position II
When do we evaluate: you can evaluate the psychomotor development even during the day, when your baby is dressed.
What do we evaluate: you can observe how often does the baby turn from one side to another, and whether it is turned with head more to one side than the other, how does does the baby turn over, does the baby crawl or walk.
Goal of this evaluation: the evaluation is differing according to how old the baby is. In this rough context evaluate more what is the baby capable of doing - maximum performance, skills of the child (quantity of movements).
How often to observe: check up on in 2 - 4 weeks.
NEWBORN BABY (PERIOD 0. TO 4 WEEKS)
Testing on the back:
You can observe, how the child goes into asymmetric position.
What should the baby be capable of?
If the head is turned for example to the right, the abdomen will be also turned to the right. The head is slightly tilting back, and the pelvis as well.
This asymmetric position is typical for children up to the 3rd month.
Testing on the stomach:
Observe, whether the baby lies on the chest and it bottom is outstretched upwards. Hands and legs are somewhat beneath the body. Baby is still keeping the crooked position, which it had in the mother’s belly.
What should the baby be capable of?
The baby should be able to turn the head from one side to another. But it doesn’t have to lift the head too high. Hands are for the most of the time clenched in fists with thumbs hidden inside the fist. However the fists should not be held convulsively, and the baby should be able to open the hand for at least short amount of time by itself.
The newborn child is for most of the time under the effect of reflexes. Reflexes enable the child to survive (breathing, heart activity, but also searching for food and being fed). Newborn reflexes should be during regular checkups evaluated by a pediatrician, alternatively neurologist.
EVALUATING THE REFLEXES
You can test some of those reflexes by yourself, without the help of pediatrician or neurologist. That way you can reveal the possible discrepancy in the development of the right or left side of the body, alternatively the extremities.
1. Reflexes on the extremities
Reflexes evaluated on all the extremities (arms and legs) should be equipped (by visible) on born extremities with the same intensity.
If the baby is on one of the sides reflexively more equipped and on the second side not at all, alternatively if one side is equipped more intensively, there is a high probability that it is a neurological problem.
2. Spinal cord reflexes
Spinal cord reflexes will disappear during the maturation of the CNS (central nervous system).
If the equipment of the reflexes are persisting even long time after it should be gone, you should visit your pediatrician on the discrepancy in the development of your child.
ATTENTION! Do not be discouraged by the thought that the pediatrician in the field of musculoskeletal system knows everything.
It is not always like that. You are the only person that has to stand for the rights of your child’s health.
Get involved into testing reflexes of your baby your partner as well or younger siblings of the child and make from it entertaining game. Thanks to these tests you can reveal in time the deviations in child’s development and inform your pediatrician about it.
HOW TO TEST THE REFLEXES?
How to do it: hold the baby firmly by the body, and place it somewhat on its legs. The left leg will during the contact with the ground get a grip, and right leg will make a step forward. If you tilt the baby to the right, the right leg will stretch out against the ground and left leg will step forward.
When do we observe that: This reflex is activated between 4 and 6 week of life.
How to do it: if you place your finger to the mouth corner, the baby will search it with its tongue.
When do we observe that: it should be activated up till 3 months.
How to do it: if you place your finger into the mouth, you will feel how the baby is trying to suck on the finger.
When do we observe that: it is activate till 3 month. Older children of course have this reflex as well, but it is already conscious, it means it can suck by itself, it doesn’t need the reflex anymore.
Palmar grasp reflex
How to do it: place your finger into the open hand of the baby, so that you would touch the palm of the baby. The baby will immediately grasp you firmly.
When do we observe that: it is activate till the 5th month of life. Older children are already able to hold toys consciously and play with it.
Plantar reflex in the feet
How to do it: place your finger on the open foot of the child, so that you would touch the the upper part of the foot sole. The child will immediately clench the toes.
When do we observe that: this reflex is active till 9 month, when the child starts to learn to stand.
Previous reflexes are fading out with growing age. But there are two reflexes which will continue to protect the child’s eyes against mechanical damage its whole life.
1. Reflex for eye protection
How to do it: if you move your hand abruptly close to the face of the infant, the baby should blink.
When do we observe that: it is active after 3 month of life.
2. Reflex for eye protection
How to do it: if you clap your hands, the baby should blink again.
When do we observe that: it is active after 5 month of life.
NEWBORN BABY (PERIOD FROM 4 TO 8 WEEK)
In these weeks you can observe, that your baby is watching you, the baby can focus on you. But the eye contact is only short for time being. The the eye contact means that your child is mentally healthy. Mentally healthy child has the need to observe someone or something, and this need grows in later age to reach for a toy, in order to play with it.
Testing on the stomach
What should the baby accomplish?
The baby should be able to lift its head above the ground, by moving the neck upwards. The baby therefore should not lift the head by bending in the cervical spine, but if the baby lifts the head correctly it activates the muscles on the throat (including deep muscles on the front side of the cervical spine).
How does the hand work?
The hand and its fingers are starting to be more loose. Usually the baby is able to open up its hand where the thumb is most of the time outside the fist.
Generally, the baby is starting to get relieved from the crooked position similar to the position the baby was in mother’s womb.
We wish you, that your baby would make you only happy. Protect your child from bad influences and protect its health. The baby wouldn’t be here without your care, and the child will repay you that with first look and smile. Every new thing, your baby will do, will be thank you for being there.
Published in magazine Uzlíček, no: 3/2007
Author: Mgr. Iva Bílková, FYZIOklinika fyzioterapie Ltd, Prague, Czech Republic