When we think about physical therapy, most of us imagine a clinical setting or a gym with lots of
equipment and people being herded through a series of exercises. It’s something you do after an
accident or injury. Certainly not something your newborn needs, right?
Actually, your baby could benefit greatly from physical therapy. But not just any PT! I recently talked
with Dr. Aleta Naujunas, the lead physical therapist at Tulip Therapy about the benefits of pediatric PT.
What is Pediatric Physical Therapy?
Physical therapy is something that we as postpartum doulas constantly talk to our clients about. But it is confusing to many why we would refer them to physical therapy. What exactly do they do, and how is it different from other services they may be getting, like chiropractic care and lactation consulting? “We treat kids from birth up. We work a lot with babies that are struggling with tummy time. It doesn’t have to be struggle,” Dr. Aleta says. If tummy time or feeding is a struggle, there is usually a reason, and physical therapy can help to identify and correct the issue. “It usually doesn’t even take that much, it’s just kind of identifying what’s holding it up. Our biggest thing is we empower families with an exercise program, so you’re not coming here three times a week. We usually see babies once a week or every other week, sometimes even less frequently,” she shared.
Understandably, the thought of driving all over the state with your newborn is not a pleasant thought for new parents. Tulip Therapy has two convenient locations in Newington and Manchester. Unless your baby’s case is particularly complex, you won’t need to come in super frequently. “We work on some of that muscle balancing, both in terms of relaxing those muscles and strengthening them. We love working on the peanut ball! We get babies up on the peanut just to work on some of the strengthening and releasing tension in a happy way, especially if they don’t love tummy time,” Aleta explained. “We’re very hands on, in a warm way. We don’t want your baby to cry though their session. We try to make it as positive as possible.”
What are some of the reasons why someone would bring their baby to see you?
“We get a lot of babies that have tongue ties, and we love to see them before a release if possible.
Especially if they have a neck rotation preference as well,” Dr. Aleta answered. She then explained how
to spot a neck rotation preference. “If you look at your baby and you see them looking one way more
often or if you scroll through your pictures and they’re always looking like this,” she said, turning her
head to one side, “some of these muscles can get tight in their neck.” Muscle tightness can impact your baby’s ability to feed comfortably, especially breast feeding, because it is hard for them to relax on one side. If you’ve noticed your little one feeds better on one breast over the other, it may be the result of muscle tension. Physical therapy can also be an early intervention to treat head shape asymmetries. Although some pediatricians will recommend waiting, ideally addressing it earlier is better. “You can fix it without a helmet! To put a percentage on it, probably 99% of the time if you are coming in at one or two months,
you can fix it without a helmet,” she explained. She went on to explain it is faster and easier to fix early on. “You really gotta address it before six months, because six months is the point at which you’re not going to make as much of a change. So, four months is not too late, but one to two months is like the sweet spot where we’ll measure and we’ve had some dramatic changes.”
I asked if there are some things that would make a baby predisposed to head asymmetry? Dr. Aleta shared some research behind it. “It is more likely in first born males and twins. The exact reasoning why is not super well known, but there is a higher incidence in first born males and twins. Sometimes we have tiny moms who have ten pound babies and that baby had to fit in there somehow, so they might have been [scrunched up]. They can actually come out with flat spots. Also vacuum assisted births and forceps births too, sometimes with the pressure.” She added, “I always joke that maybe they found like a really comfortable organ and they’re like ‘this kidney is a nice pillow!’ and they just hung out there.”
Muscle tightness or a flat head sometimes just happens, and it’s nothing the parent did or didn’t do. What is it like when families come to see you? Do people need a referral?
Dr. Aleta explained that no referrals are needed. Even if your pediatrician doesn’t feel like it is necessary, trust your gut if you feel your concerns aren’t being heard. “We never make it an awkward situation with a primary care provider. You don’t need a referral; you can just come see us and we can address those concerns,” she said. Unlike some other therapies, such as Birth to 3 programs, physical therapy is very hands on. “I’m also trained in craniosacral therapy. It’s very gentle, very gentle modalities. Your body wants to heal itself, so
it’s helping the body heal itself through gentle manipulation of tissues and bones and joints. Getting everything to be where it should be so that the body can work right,” she said. She encourages a full evaluation and incorporates craniosacral therapy into her treatment plan. “That works on loosening the tension, but then I also want to work on the functional strength too. It’s nice to put things where they should be, but then you got to have the muscle strength to keep it there,” she explained.
Dr. Aleta emphasized the difference between pediatric physical therapy and adult physical therapy. “Babies are not mini adults. Especially with the tongue tie factor too, that’s something that, as far as I know, we are the only pediatric PT/OT specialty process that actually focusses on that in the entire state. So, it’s something that we are really passionate about- getting babies the right care. Because then, they usually only need a couple of visits and then they’re off and running.”
As you can see in the pictures, the offices of Tulip Therapy are designed to be comfortable and relaxing for both parents and children. “We have our little baby and changing room. Some families will drive 30 or 40 minutes to get here and then they need some time. We’re not going to rush you out the door,” Aleta said.
How can parents tell if they should see a pediatric physical therapist?
Your baby should be relaxed. If you are having difficulties with breast feeding, tummy time, or you notice that their body is tense, a consultation with pediatric physical therapy may be helpful. “When in doubt, we have people who come in and make an evaluation appointment. Some of them don’t need to come back, we’re like ‘hey, here’s some things to work on, but this might be within the typical range.’ It’s not a lifetime commitment,” Dr. Aleta shared.
As a postpartum doula, I often see babies at one to two weeks turning completely to the side with the newborn curl. I asked Dr. Aleta when that should stop. She explained “babies are born in what we call physiologic flexion. They have to be flexed to fit in. Usually within the first two to three weeks, I want to see less of that immediate roll over. Your baby should not roll before three to four months. If they are on their belly or on the changing table and they are early rolling, that’s usually body tension. I always say it’s like tension plus gravity, not actual muscle strength.”
If you have noticed that your newborn is rolling early, or seems to prefer one side over the other, contact Tulip Therapy to schedule an evaluation. No referrals are needed, and most insurances are accepted. “We try to empower families to feel like they can provide the best care they can for their babies,” Dr. Aleta said. That is a sentiment that we at Tiny Miracles Care agree with. We want to help you get off to the best start with your precious newborn. We hope you will let us be a part of your family soon. You can watch the whole interview with Dr. Aleta here.