We encourage families to resume life as usual once you leave the clinic with your baby’s new accessory! Although this may sometimes be easier said than done. Your baby gets their helmet at critical times in development, typically anywhere between 4-15 months. Many parents wonder how this may impact their daily routine. Today let’s look at some developmental milestones that your baby will be cruising through during these months.
“Play is often talked about as if it were a relief from serious learning. But for children. Play is serious learning. Play is really the work of childhood.” – Fred Rogers
Development From Birth to 3 Months
Babies are working on building neck strength and improving head control. At about 3 months there is enough control to independently move the head from right to left and briefly hold their head up off the ground. They transition from a mostly closed hand position to opening up their hands in order to reach for objects and bring hands together, typically they can also hold onto objects for a few seconds at a time.
This age is also the introduction of tummy time, which can begin as soon as your baby comes home from the hospital! Babies learn new skills through play. Tummy time is one of the most important forms of play. This play strengthens the neck, back, arms, and legs while allowing for the development of depth perception, visual motor skills, and fine motor skills. Generally, it is best to start with short periods of tummy time, around 15-20 seconds multiple times a day and build up to 20-30 minutes each day.
Helmet Considerations Prior to 4 months
When incorporating the helmet remember it is light, 4-6 ounces or about the weight of a small box of crayons. It should not interfere with tummy time once your baby has met these milestones. If your little one is still building neck strength and tummy time has been difficult, this play time can be done without the helmet until this skill is mastered.
While we do helmet prior to 4 months of age, it is usually not recommended. Typically, pediatricians and insurance companies prefer families to attempt repositioning off of flattened side for 2 months prior to diagnosing plagiocephaly and pursuing helmet therapy.
Reasons for helmeting prior to 4 months of age include:
Severe asymmetry or flattening
Extended hospitalization
Developmental delay
Two months of positioning without improved cranium or difficulty repositioning consistently
Severe reflux or allergy
Anticipated worsening of cranium due to torticollis or other underlying medical condition
Macrocephaly (Head is much larger than average)
Shunt placed
Development From Months 4-6
Moving into month 4, with all that head control your baby starts to push up onto extended arms raising their head and chest high. They will begin short periods in supported sitting and begin tracking objects with improved control. They can now move their eyes independently of their head and begin to explore the world around them.
But what do I do with my hands? During play time they are exploring hand eye coordination trying to reach for their favorite toys and bang them together or pass them from hand to hand.
By the end of month 6, simple hand skills are mastered and your baby starts working on isolating fingers to improve dexterity. '
During this time, babies typically start to master rolling from tummy to back and back to tummy giving them their first means of independent movement! They now can roll around the room to reach their favorite place and further investigate. In tummy time, they can now shift from side to side and pivot around in a small circle. This mobility makes tummy time that much more exciting and with improved strength in this position incorporating the helmet should be much easier.
Helmet Considerations 4-6 Months: Helmets are never meant to interfere with development. In our experience, we actually see babies take off developmentally once they get their helmets. The helmets provide a round surface to roll from and also block the peripheral view. This encourages movement and further strengthens their little neck muscles. If your baby seems to have trouble with tummy time in the helmet, talk to your practitioner about it! Tummy time is important and the helmet should not interfere with this important play activity.
Generally, after adjusting in the first week of wear, your baby is a natural and should be moving through play time with little awareness of the helmet. If your baby seems to frequently be pulling at the helmet or has increased irritability with the helmet on, it may be time for an adjustment!
4-6 months of age is ideal; for starting the helmet process. Babies are growing quickly and adapt easily to the helmet at this age. The helmets are also made to change with growing babies. At our clinic, we never anticipate baby will need more than one helmet and can make any adjustments necessary in house.
Development +6 Months
Now we are at month 7 where your baby is starting to master unsupported sitting and is working on moving from laying down to sitting all by themselves. They will be attempting to come up on their hands and knees and rock back and forth to start preparing to crawl. During play time babies will start imitating simple movements such as shaking a rattle and throwing toys. Hand control is also improving and your baby may show an interest in turning book pages and picking up smaller objects with their thumb and index finger, this will be leading up to finger feeding which may not be mastered until 12 months of age.
By the end of 9 months it will be hard to get your baby to stay in one place as they are now independent explorers. Babies will be rolling, crawling around, cruising on furniture, using furniture to pull up into supported standing, and be able to transition efficiently into a seated position. Your baby is also improving control of motor movements and will start imitating more complex gestures such as clapping, waving, and pointing.
Months 10-12 focus on refining motor movements and building the balance, strength, and coordination required for walking. In addition, your baby will be working towards finger feeding and becoming more independent in this life skill. Once your baby gets to 15 months they are walking, improving coordination by using utensils for messy feeding, scribbling on paper, and developing speech by using a few words during play.
Helmet Considerations +6 Months:
Yes we can absolutely helmet over 6 months of age! Many of our babies don't come see us until after their 6 month check up with their pediatrician and that is perfectly fine. Most research states that if the head is still at a certain severity by 6 months of age, it is unlikely to correct on its own. This is because repositioning these little movers shakers is nearly impossible and why 6 months of age seems to be the bench mark for starting helmet therapy.
Some babies over 6 months of age tend to be a little more opinionated about the scanning and helmet process. They do typically adjust to the wear schedule in the first week and go on to get full correction. Sometimes is can take a little longer for correction because alot of cranial growth has already occurred. Remember that the helmet works by shaping your baby's growth so correction is dependent on growth. In some cases where baby has a larger head, we have to wait for more growth to get full correction.
"Older babies" also start to start sleeping on their tummies. This can give parents quite a shock to see their babies face down in a helmet. According to the "Safe Sleep and Your Baby" handout from the American Academy of Pediatrics:
Babies up to 1 year of age should always be placed on their back to sleep during naps and at night. However, if your baby has rolled from his back to his side or stomach on his own, he can be left in that position if he is already able to roll from tummy to back and back to tummy.
If your baby regularly flips to their belly and back in their helmet, they are safe to sleep in their helmets and turn onto their bellies. Helmets should never be rotating to cover the babies face in anyway during wake or sleep time. If your helmet is shifting and waking baby or you have concerns about how your baby sleeps in the helmet, speak with your helmet practitioner.
If you are interested in more details about your baby’s development during those first months and beyond, we have included some resources for our families below!
https://pathways.org/growth-development/4-6-years/milestones/
Retro Baby by Anne H. Zachry, PhD
Author Katherine Ann OTD
Editor Kaitlin Ploeger OTD
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