Tag Archives: stretch

PREMATURE BABIES

MUSCLE TONE IN BABIES

It is helpful to understand how the length of time a baby is carried in the womb prior to delivery may influence the level of tone in her muscles.  The term “muscle tone” can be defined as the balanced level of tension in the muscles.   By “balanced” we mean that the muscles are capable of a range of tension levels, from very contracted which brings the limbs close to the center of the body to very stretched which straightens the limbs out away from the body.  A baby carried to full term usually has balanced muscle tone.  This is evident in the newborn as she is lying on the floor.  Observe that her limbs are bent and rather close to her torso until she learns how to move them on her own.  One she begins to move them through learning the motor skill of kicking, her muscles go through the full range of motion from being flexed and close to her torso to being extended and stretched out.  In babies born premature, muscles usually have lower muscle tone.  This means that baby’s limbs are more stretched out, more relaxed in appearance.  Sometimes the term “hypotonic” is used to describe the muscle tone in premature babies, usually those with very relaxed muscles.  This means the relaxed range of muscle tone is very familiar and the contracted range is a bit difficult to achieve.

MOTOR SKILL DEVELOPMENT IN PREMATURE BABIES

Motor skill development is more challenging for babies born with low muscle tone, because their muscles have to work harder to develop a fuller range of muscle tension.  The baby carried to full term usually has the fuller range of tension already in their muscles.  Premature babies benefit tremendously from a lot of motor skill games and activities.  Their muscles need “extra practice”  for their first year milestones.

SUPPORT FOR PREMATURE BABIES

Due to the relaxed quality of the premature baby’s muscles,  it is easy for the heavy parts of her body to flop backward when you pick her up.  It is very important to fully support her head and neck, as well as the limbs of her body.  Keep a hand behind her head and neck when holding and moving her.  Try to keep her arms and legs from dangling when you hold her by folding them in toward the midline a bit.  Hold her so her spine is a bit rounded rather than straight.  As she develops strength in her muscles she will be able to support her head and move her muscles through the full range of motor activity.

PROPRIOCEPTION AND PREMATURE BABIES

Parents can learn hands-on activities that guide baby to feel the range of motion in various movements, making it easier for baby to find the movements on her own.  For example, a “preemie” may keep her arms fairly straight but through the use of your hands you can show her how to bend and straighten her arm.  These activities improve baby’s proprioception.  They are fun for baby, too.  They guide her toward a clearer feeling of her body and an improved ability to bend and straighten her limbs.  As she learns to feel and move her muscles, they gain strength improving the range of muscle tone.  This is one of the most important developments during baby’s first year.  The motor milestones teach her to use her muscles, support her own body, and to travel from one place to another.


TUMMY TIME TIPS: OPENING THE HIP JOINTS

BABY LEARNS FLEXIBILITY OF THE HIPS

baby learns flexibity in hip joints

Zizu demonstrates how tummy time opens the hip joints.  Zizu learned to enjoy tummy time during her first stellar caterpillar lesson, so it was easy to work with her in this belly-down position.  While she was enjoying holding a rattle, we put our fingers underneath her knee joint and then lifted the knee joint and thigh up toward the ceiling just a little bit.  The elongates the muscles in the front of the hip joints.  Remember our discussion of baby’s in utero position which keeps the hips in a flexed position? This position shortens the muscles of the hip joint.  We lift the thigh a little bit and then bring it back down, a few times.  After the muscles of the hip joint elongate, the bones can move in greater and more efficient range of motion.  This is important for the locomotive skills of crawling, walking, and standing. You can see in the photo that she is quite content to remain in the tummy time position for a while as we work with her.


TUMMY TIME TIPS: MASSAGING THE ABDOMEN

UNCURLING THE BALL

Rochel learns tummy time

Rochel received her first lesson at two months.  In this story, the mother learned from the grandmother the importance of baby experiencing each motor milestone fully, and without rushing!  Lucky Rochel!  She gets to enjoy being on the floor without being forced to stand too soon.  Rochel’s mother asked for tummy time tips, reporting that the baby did not like it very much.  This was no surprise!  Tummy time is usually one of the first topics covered in a newborn’s stellar caterpillar lessons. I explained that prior to birth, for all of those months, the baby is curled up in a ball.  This means that all of the muscles on the front of the body, which we call the flexors, were contracted or shortened.  The abdominal, front of the hip joints, and chest muscles are all contracted!  Lying on the belly comfortably means these muscles have to lengthen.  The front of the body can only lie flat against the floor when these muscles have lengthened, otherwise, the contracted muscles pull the body, specifically the pelvis and torso, up away from the floor.  Once these flexor muscles (abdominal, chest, and front of the hip joints) soften and stretch out, the baby can be comfortable on her belly.

We began to teach Rochel how to lengthen the front of her body. First, we began with gently stroking the abdomen, with long gentle brushing strokes from the top of the chest to the bottom of the abdomen, left to right.  We knew by Rochel’s happy cooing and little smiles that she was quite happy receiving this touch.  Next, we gently assisted the lengthening of her legs by bending and straightening them, one at a time.  Bend and stretch, bend and stretch, bend and stretch, several times with the right leg, then we worked with the left leg.  After working with both legs, we gently rolled her onto her tummy, and there she was with her behind sticking up in the air and her nose pressing down into the floor!  I said smilingly to her mother, “You wouldn’t be comfortable either if your face was smashed into the floor!” In this tummy position I stroked the front of Rochel’s hips to elongate the muscles and allow the pelvis and thigh bones to be flat on the floor, and now she could lift her head and see her mother smiling at her!  Her mother’s face was far more interesting than only the darkness visible to her as her face smashed into the bedspread.  In fact, so interesting was the world around her from this position that Rochel kept her head up a bit more, curiously gazing around the room.  “What a different view from when I am lying on my back looking up at the ceiling,” she thought.

When you look at your baby on her stomach, look at her head and her pelvis.  Is one higher than the other?  Think of a teeter-totter: when one end is up, the other must go down.  So, when the pelvis goes up, the head/face goes down into the floor.  It is very difficult to breathe, lift your head, or look at the world if your face is pressing down into the floor.  We would like her pelvis to stay down flat on the floor so her head is free to lift and examine the world.  First we must uncurl the flexors from that ball-like position she was in for so many months prior to birth,  then a new world curiously becomes visible.  After some practice, Rochel now lays contentedly on her stomach while watching her mother chase her older sister.  And, she still enjoys the abdominal massages, too!