Recent advance in brain research has provided great insight into how the brain, the most immature of all organs at birth, continues to grow and develop after birth. Up until the 1990s, it was thought that development was an unfolding of a predetermined genetic map
We know now that brain development is highly dependent on a child’s environmental experiences.
Babies’ brains are immature at birth and it is the brainstem that is responsible for the baby’s survival. The following are windows into how well the brainstem is functioning:
- Primitive reflexes
- Sleep/wake cycles
- Control of digestive system
- Regulation of heart and breathing
Primitive reflexes are survival reflexes; they come from the brain stem and they have to be inhibited for normal development to occur. A baby should develop head control by 2 months, integrate the startle (Moro) reflex by 3-4 months and gain the postural support reflex (bearing weight on legs when pressure is applied against the foot) by 4 months.
It is the development of the higher brain centres that inhibits (or integrates) the primitive reflex. We know that failure to integrate these primitive reflexes, in the normal development windows, is a reliable predictor for further interruption to normal development.
There has been a staggering increase in the incidents of deformational plagiocephaly. The rise has coincided with the 1992 “back to sleep campaign” for SIDS reduction. The interesting thing is that not all babies who ‘back sleep’ develop plagiocephaly. I find that babies that have underlying neck tension have a predisposition for developing flat head syndrome.
Do they grow out of it?
An important study by Speltz and Collett, published in February 2010 in the Journal of Paediatrics, concluded that “the present study provides the clearest evidence to date of neurodevelopment disadvantage amongst infants with plagiocephaly. We recommend that paediatricians pay close attention to the motor development of these infants”.
Many other studies have indicated other issues related to plagiocephaly and development. Miller and Clarren showed that 39.7% of patients with deformational posterior plagiocephaly required an individual education plan, with services such as special education, speech therapy, physical therapy and occupational therapy. Siatkowski and Fortney found changes to visual development.
A study of auditory processing by Balan and Kushnerenko found that “present data suggests that most of the plagiocephalic infants have an elevated risk of auditory processing disorders. The current study we demonstrated, for the first time, that the central sound of processing, as reflected by ERPs, is affected in children with plagiocephaly”.
What can be done?
It is no longer a viable strategy to watch and wait with children who have plagiocephaly or show signs of neurodevelopmental delay. Normal development can be assessed by checking for inhibition of the primitive reflexes and the emergence of motor control, which develops in a head to toe fashion. Early assessment, intervention and correction of structural or functional issues by a properly qualified practitioner are an important strategy in assisting these children.
Neuroplasticity research shows that brains are shaped by environmental experiences. All sensory perception is carried to the spinal cord and brain where it is integrated and the cortical maps of our brains are altered by this experience.
Children who have less interference to their nervous system have a better chance of making sense of their world and their place in it. They have a better opportunity to develop good motor patterns and balance, good emotional regulation and better learning strategies for the future.
- Case-Control study of Neurodevelopment in Deformational Plagiocephaly. Speltz Ml, Collett BR, Stott-Miller M, Starr JR, Heike C, Wolfram-Aduan AM, King D, Cunningham ML. Paediatrics. 2010
- Long Term development outcomes in patients with deformational plagiocephaly. Miller RI, Clarren SK, Paediatrics. 2000
- Visual field defects in deformational posterior plagiocephaly. Siatkowski J, Fortney AC, Nazir SA, Cannon SL, Panchal J, Francel P, Feuer W, Ahmad W. J APPOS. 2005
- Auditory ERPS reveal brain dysfunction in infants with plagiocephaly. Balan P, Kushnerenko E, Sahlin P, Huotilaninen M, Naatanen R, Hukki J. J Craniofac Surg. 2002
One small person in a family is a very different arrangement than two, or more children. When a new baby comes into the mix, dynamics change and everyone needs to shuffle around until new positions are found.
Many parents have heard of bottle propping, also known as prop feeding. And most of us have seen babies sucking quietly away on their own.
Bottle propping is when, instead of the baby being held to drink their bottle, they are on their own. The bottle is supported by a pillow or blanket, even a soft toy so that it’s angled with the milk filling the neck of the bottle and the teat. The baby lies in their cot/pram/on the floor sucking away on their own.
Toilet training is an important stage of childhood development. Most children are ready to start toilet training from around the age of 2 years onwards. However, some aren’t ready for another 6-12 months.
It’s so hard to know if a baby is warm enough, cool enough, too warm or too cool. And if we’re honest, sometimes it’s a bit of a challenge to work this out when it relates to ourselves. One minute we can feel as if we’re overheating and the next, want to reach for a jumper.
One of the joys of caring for a baby is bathing them. But for many parents, bathing is one of those tasks which takes time to build confidence and not feel nerves taking over. Be patient and kind with yourself as you learn what’s involved.