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Plagiocephaly and torticollis are two commonly occurring conditions in infants and young children. Plagiocephaly is characterized by flattening or deformity of an infant’s head shape. Torticollis is a form of a head tilt where the child’s head or neck is twisted or held in an abnormal way.
Tummy time should be introduced as soon as an infant has longer periods of alertness where he or she can be placed on their tummy while awake to prevent plagiocephaly. Babies slowly begin to lift their head and neck with some support from parents. Tummy time gives the back of their head a break from constant pressure of laying and sleeping on their backs. Tummy time should only be done under direct observation from parents. Infants should never be left unattended while on their bellies.
If head flattening does occur, it is often benign and reversible with active repositioning at home. Physical therapy may be recommended if repositioning is not effective enough once plagiocephaly occurs. In severe cases, helmet therapy is initiated by a craniofacial specialist to help correct the abnormal head shape.
Torticollis is often seen in conjunction with plagiocephaly. Some babies favor a side when they are sleeping or playing and the neck muscles begin to tighten in that particular direction. Placing toys or yourself on the opposite side forces them to look the other way and stretch out the neck muscles which can prevent a head tilt. They may need help moving their head and neck at first. Gentle neck stretches multiple times per day help loosen the tightening of the neck muscles if a head tilt starts to develop. Parents can perform these neck exercises with diaper changes so it’s an easy (and frequent!) reminder to do them. Similar to plagiocephaly, physical therapy may be recommended if torticollis is not responsive to at home exercises.
If you have any concerns about your baby’s head shape give us a call in the office.
Even before you are pregnant, your body practices getting ready for infant feeding with each menstrual cycle – under the influence of the monthly hormonal changes, the ducts grow and branch out, and then return to their pre-cycle state.
Once you are pregnant, this milk making capacity starts to expand. Pregnancy hormones cause the areola and nipple to grow and possibly darken. The ducts that will bring the milk to the baby and the glands that will make the milk proliferate. Fat tissue is stored and blood flow increases – so your breasts may look larger, feel heavier and have more prominent blood vessels.
By 16 weeks of pregnancy, your body is already making colostrum – the first milk your baby receives. Some women leak a little colostrum in pregnancy, and some women don’t. Both are normal.
Once the placenta is delivered after birth, a sudden shift in hormones signals your body should start full production. This happens slowly over the first few days. Your milk will typically “come in” two to five days after birth. If you’ve had a cesarean birth, this may take an extra couple of days. While you’re waiting for your milk to come in, colostrum is the perfect food for your baby. Think of colostrum in teaspoon-fuls not ounces – frequent, small feedings are perfect for your newborn.
The more milk that’s removed from the breasts in the early days, the better your milk supply will be over time. It’s normal for your baby to nurse every hour or two in the early weeks. If your baby isn’t nursing well, you should be pumping to keep the milk moving and the production going as you work on getting your baby nursing well. If you aren’t removing milk – with baby or with pump – production slows and eventually ends.
You will know your newborn is getting enough if:
Your baby may initially lose a little weight, with the lowest weight tending to be on day 4 or day 5. Weight loss between 7% and 10% is a red flag that something is going astray with feeding. Working closely with your baby’s pediatrician and a lactation consultant is important to be sure your baby is adequately nourished. Your baby should gain ½ ounce to 1 ounce per day and be back to birthweight by 7-14 days.
You may feel engorged when your milk first comes in. Frequent feeding (or pumping if your baby isn’t feeding well) is the best way to keep yourself comfortable. Breast swelling normally lessens at about 7 to 10 days after birth and is NOT a sign of decreased milk supply. Around 4 to 6 weeks postpartum, your milk supply will even out to more accurately match your baby’s needs. Again, this is also NOT a sign of decreased milk supply.
If you need to increase your milk supply, the key is more frequent milk removal, either by nursing your baby more often or by adding pumping in addition to frequent feedings. Stop pacifiers and bottles, and meet all of baby’s sucking needs at the breast. If supplements are needed, consider using an at-breast supplementer to provide them. A lactation consultant can be a great resource during this time.
Knowing what to expect from the start with breastfeeding will help you to have a successful experience feeding your baby!
Contact our office at any time if you have breastfeeding questions. Our lactation consultant and other providers are excited to help you make breastfeeding a wonderful experience for you and your baby.