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In this article I'm taking a look at flat spots, torticolis and abnormally shaped heads.

Flat spots on a babies head are on the rise. How do they become so misshapen and what can we do to avoid or reverse the damage once it has occurred?  These are some of the questions I would like to look at in brief in this article.

When a baby is born it has a very soft, pliable skull which enables them to pass through the birth canal.  This soft skull can and is easily moulded by its surroundings as with a baby who was constricted within the womb such as a breech baby whose head is wedged under the mother’s ribs.   These babies are often born with a very abnormally shaped head.

Some of these babies may also have torticollis, a tight muscle on one side of their neck causing a pulling to one side. These babies tend to favour looking and lying with their head on one side. Other babies may just choose to favour one side or lie with their head straight, looking up. All these babies, due to their still developing soft skills, are at risk of developing a flat spot on their heads.

These days a flat head may be a combination of one or more of the above mentioned problems and not enough time off their backs. Many babies sleep, play, sit and travel on their backs this can causes or exacerbate the problem.  When a baby continues to lie in the same position over several weeks’ even months the pressure on the soft skull causes it to flatten out.

Prevention and assistance in correcting the problem:

Encourage Tummy Time
To help prevent a baby from developing a flat spot. Alternate which side his head rests when sleeping but more importantly give your baby lots of supervised time on his tummy. When he is awake and after the feed time put him on his tummy not on his back. If this is done from birth you will find baby will not resist. If your child is older and complains about the length of time he spends on his tummy then start with small sessions and work up to longer sessions so that eventually he will have from 60-80% of his awake time, when not feeding, no his tummy.

If your baby has a flat spot or is showing signs of torticollis, encourage baby to turn away from the direction they favour by attracting their attention to the other side with toys, sounds, movement or by sitting on the opposite side which will encourage them try to turn to look at you. (see Articles on play and learning - How Important is Tummy Time for Your Baby?)

During Sleep Time

To prevent a baby favouring holding his head on one side, alternate which side his head rests. To help him, turn his head either to the left or right. With an older baby who is aware of their surroundings you can assist baby by alternating which end of the cot your baby sleeps. Babies tend to look towards the direction from which their caregiver comes. They will look towards the door where you enter. Therefore changing his cot position from one end of the cot to the other will help him to turn his head from one side to the other.

Things to avoid
Avoid tea-tree mattresses as they form a hollow into which baby's head rest this may cause flatness on one side.
Avoid putting baby into a rocker, bouncinette or Frazer chair where they are lying on their backs. It is also advisable no to leave your child, for long periods, in the car capsule or pram for the same reason.

Although sitting upright will keep your baby off their backs it is not wise to leave a child sitting for long periods of time as it is not beneficial for their development and may cause stress on their developing backs. Limit unsupported sitting until baby is able to put himself into and out of a sitting position himself.  This includes equipment such as jumping or sitting rings where baby needs to sit. A child who has limited tummy time often doesn't learn to crawl. Tummy time is the best exercise to develop all the muscles for rolling, crawling, sitting, standing and walking. It also helps develop special awareness and coordination.

Signs to look for are:

• Baby is holding his head tilted to one side.
• A flat spot on the back or side of baby's head.
• Baby is unable to turn their head or favours looking in one direction.
• Very round face with flattened back of the head.
• Non-symmetrical head, eyes or ears differing in size. 
• If you notice any of these signs I suggest you contact your Early Childhood Nurse or Doctor.

If you are concerned

If there is no improvement or if you child has had this problem for some time you will need to see a physiotherapist who will be able to show you some exercises to help stretch tightened neck muscles.

Also read our article on Flat Spots on Baby's Head by Alti Vogel, who is an Orthotist at the Children's Hospital Sydney.

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips. Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

How Cradle 2 Kindy Can Help

Cradle 2 Kindy can help you with other health concerns for children from birth to five years old. Call and see how Cradle 2 Kindy's can assist you with your concerns.

Cradle 2 Kindy 1300 786 101

Also see: What happens at a Coaching session?

More Articles on Health

Disclaimer: Article on our website are for education purposes only. Please consult with your doctor to make sure this information is right for your child.

All articles on this website have a copyright. The use of any material must have permission from Cradle 2 Kindy Parenting Solutions.

For the first few months of a baby’s life your baby has three basic needs - feeding, sleeping and love.  A well fed baby is generally a happy baby.  ‘Nutrition’ then is the first and most important need of a baby, for without it you will not succeed in accomplishing the second which is ‘sleep’.  Right from the beginning we need to put into place good eating habits. 

Some Facts

• If your baby feeds well, they will generally sleep well.  
• Feeding a baby to sleep is not a good idea, as they begin to associate feeding as a technique to get them to sleep. It is also a very hard habit to break when they are older.
• You may also find that your baby will fall asleep on the breast or bottle and not complete a feed.  This will cause them to be hungry quicker and usually leads to catnapping and snacking.  Try to keep baby awake during and after the day feeds as this encourages baby to sleep for longer periods between feeds and feed well when it is feed-time this in turn leaves time to play before going back to bed.  Keep to the guidelines of – feed, play then sleep.
• ‘demand-feed’ Many mothers fall into a trap with demand-feeding because they believe demand-feeding means feeding their child every time they cry.  A well-fed baby will, of its own accord, begin to ‘demand-feed’ every 3½ - 4 hours within the first few weeks of birth.

Ask Yourself the Following

• Is my baby crying because they are hungry or is there some other reason for their cry?
• Is he/she unsettled because they are over tired, over stimulated, uncomfortable or in pain, or have they woken and just needs to be resettled?
• When was the last feed?  Even breastfed babies will go 3 - 4 hours between feeds.  Calculated the time from the beginning of the last feed to the start of the next feed.   If your baby wakes after having less than an hour’s sleep, it is advisable to resettle him/her.  
• How long did baby nutritively feed for?  A breastfed newborn may take up to 45 mins to feed well.  If baby falls asleep on the breast, wake them up by tickling the toes, undressing them, or using a wet cloth on their face.  As baby gets older, they will become more efficient and quicker to feed.   Bottle-fed babies usually take a shorter time to feed, but they too should not be given small feeds regularly but should be fed their full quota every four hours.   (The amount baby is needing goes on their weight not on their age as indicated on many of the formula tins)

Baby’s Sleep Cycle

Understanding baby’s sleep cycle will help you understand why they wake and when to resettle.  The sleep cycle of a baby is usually thirty to forty-five minutes.  During each sleep cycle we have Rapid Eye Movement (REM) sleep and non-REM sleep, which is when we enter our deep sleep.  Every baby’s progression Non-REM is different, with some it takes as long as twenty minutes to enter a deep sleep.  Others reach their deep sleep quickly and stir after twenty minutes.  We all wake briefly after our deep sleep; this is where many of the difficulties of resettling begin.   Most of us do not even remember waking; others such as light sleepers, will wake and resettle themselves.  A baby may stir, and even cry, as he/she wakes.  If parents are not aware that their baby needs to be resettled at this time, they are often picked up, offered a feed or encouraged to have time up.  This pattern repeated day after day will reinforce to the child the need to wake up and stay awake after only a short nap instead of learning to self settle. 

Why is Sleep so Important?

Sleep is a basic physiological need.  It is crucial for our health because when we sleep, our body repair and restore themself.   Lack of sleep for babies therefore hinder growth, robbing their body of the vital rest needed for energy to grow.  More than at any other period of our lives the first five years is crucial for physically development therefore the need for large blocks of solid sleep.  This growth is also seen in the development of our brains.  Consequently sleep deprivation in children may hinder physical and mental development.  Not only does sleep effect baby’s growth and development but a child who sleeps well tends to be happier, more settled, healthier and easier to manage both day and night.  

Parental sleep is also important.  During the night, if your child sleeps soundly in between feeds, you are more likely to be able to cope with waking to feed them.  A rested parent has a happier frame of mind and can manage the challenges of parenthood.  An unsettled child, who wakes several times during the night to be settled or fed, can cause sleep deprivation which affects the whole family.  Older children in the family may also be affected either directly through disturbed sleep, or indirectly through lack of attention and irritable parents.   Parents who are up during the night may need to sleep or rest during the day to catch up on their sleep.  This can be difficult if you have more than one child. 

Some Myths Regarding Sleep for Babies

During my practice as a mothercraft nurse I have heard of many beliefs and myths surrounding sleep for babies and toddlers.  Here are some of them.
Myth:  Not all babies and toddlers need to sleep during the day.  
All babies and toddlers need daytime sleep but amounts of sleep vary depending on their age

• Myth:  Babies that sleep well at night don’t need long sleeps during the day.
• Some babies catnap during the day and fall asleep exhausted at night sleeping sometimes six to eight hours.  This often changes.  A baby who has not learnt to self-settle during the day often begin to wake several times during the night and demand assistance to resettle.  
• Myth:  Catnaps and night waking are just ‘phases’ babies/toddlers outgrow.
• Some babies and toddlers need to learn how to sleep.  If they develop a bad sleeping pattern, it may become a lifetime habit which can affect them even as adults in the form of insomnia.  
• Myth: Changing from breast to formula or starting your baby on solids will help them to sleep better and longer.  
• There is no guarantee or evidence that either will work if a child has never learnt to self settle.    
• Myth:  Babies need to be picked up in they are unsettled as they may need their nappy changed or to be burped.  
• Babies were born out of a wet environment are not disturbed by wet or dirty nappies.   Wind doesn’t disturb a baby. It is not wind that causes discomfort otherwise why is it that a baby, who isn’t crying, can have a huge burp after being picked up from a sound sleep? It is usually something more than just wind that unsettles a baby.
• Myth:   All babies have an unsettled period ‘the witching hour’ or ‘arsenic hour’.  
• I disagree with this as parents who have kept their babies to a good sleep routine do not have an unsettled period unless there is something upsetting the baby such as over handling, poor feed, reflux, teething, an infection or they have never learnt how to self settle.

Signs of a Possible Sleep Problem

• Sleeping for less than an hour or “catnapping” during the day.
• Frequent night waking.
• Needing external assistance to go to sleep - nursing, cuddling, rocking or feeding to sleep or a dependency on a dummy or pacifier is often a sign of a sleep problem.
• Frequent waking with small feeds - often just snacking or comfort sucking.

So wrapped up in our doting love for our baby is the understanding that they need to feed well and be encouraged to sleep well.  When you have these elements right you are on the right track to having a contented baby.

This article was written by mothercraft nurse Sally Hall from Cradle 2 Kindy Parenting Solutions.  If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

Disclaimer: Article on our website are for education purposes only.  Please consult with your doctor to make sure this information is right for your child.

All articles on this website have a copyright the use of any material must have permission from Cradle 2 Kindy Parenting Solutions.

Ask yourself the following questions and if you answer any with a "YES"
then your child is probably experiencing sleep problems.

• Do you have an baby who sleeps less than an hour?
• Are you feeding your baby every two to three hours?
• Do you have difficulty getting your baby or toddler off to sleep?
• Is your baby irritable or unhappy at a particular time most days?
• Is your baby dependent on an outside influence to help him/her get to sleep? (Nursing, rocking, patting, dummy, sleeping with someone, breast or bottle).
• Has your baby’s daily routine been upset due to sickness, travel or teething or has the environment changed causing him/her to be unsettled?
• Do you have an infant (over 3 months) who sleeps less than eight hours at night?
• Do you have a toddler who is constantly waking at night?
• Does your child sleep in your bed or constantly get out of bed and you would like him/her to learn to stay in his/her own bed?
• Would you like to teach your child to go to bed earlier or without an argument or to sleep longer than 5 am in the morning?

If your situation has been mentioned or you would like to avoid any of the above, we have the program to help you.

Before commencing on a settling program:

• check baby/child isn't sick.
• check baby/child's temperature.
• check with your doctor that baby/child doesn't have a ear or urine infection.

If your baby/child has been checked and cleared by your doctor yet continues to be unsettled you may like to try the following relaxation tips before enrolling our services:

• relaxation music
• a warm relaxation bath.
• a walk in the pram with a cover over the pram to encourage baby to sleep.

If the behaviour continues call Cradle 2 Kindy for an appointment on: 1300 786 101 

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

All articles on this website have a copyright any use of any material must have permission from Cradle 2 Kindy Parenting Solutions.

Irritable babies

As a mothercraft nurse I visit many homes with unsettled babies.  Parents pacing the floor, pulling their hair out having tried every remedy and potions family and friends have suggested with little or no improvement.  The nightmare some families go through with their babies often results in shattered confidence, mental and physical exhaustion which can lead to postnatal depression, family feuds and marital breakdowns.

So why are these babies so unsettled?  

There may be several reasons why a baby is unsettled one of which may be what is commonly called 'colic'.  So what is 'colic' any way?  Good question.  The pharmacies shelves have been filled with remedies for colic, special bottles and teats and liquids.  So is it colic or something else that is causing so many babies to be unsettled?  And if it is colic why aren't these remedies working as well as they should?  Someone said it may be reflux but my baby doesn't vomit. 

What is the difference between colic and reflux?

'Colic' is an unsettled baby with lots of wind.  Reflux babies also have a lot of abdominal wind.  If you look at the symptoms of colic they are similar if not the same as those of a baby with reflux.  So what is the difference between reflux and 'colic'?   I, and many health professionals will agree with me, believe that colic as it was commonly known is today known as 'silent reflux'. 

A word from a Paediatric Gastroenterologist

Dr Bryan Vartabedian in his book Colic Solved says”..colic has evolved into one of our culture’s greatest urban legends – a mythical explanation meant to explain the seemingly unexplainable.”  He goes on to say “I’m always amazed at the number of paediatricians who approach me after my presentation and comment, ‘I didn’t know that some of these symptoms pointed to reflux. For years we’ve been calling this colic.’...They’re well-trained practitioners who were never taught that inconsolable screaming, arcing, and pulling from the nipple where symptoms of anything other than colic.  Like the babies suffering with this condition and the parents who try to console them, they’re victims as much as anyone else, trying to catch up with the advances in medicine that are now giving us explanations and answers.”

In otherwords Colic is now known to be Reflux.

What is reflux?

Reflux occurs when the acid content of the stomach rises into the oesophagus causing discomfort and burning. This understandably causes a baby to be very irritable.  Babies may be seen to raise their legs, back arch and/or to cry inconsolably.  Gastro-oesophageal reflux (GOR) is common in babies but often goes undiagnosed as many think it is colic.  If untreated reflux can cause complications such as increased risk of SIDS, ear and respiratory infections, ulcerated oesophagus.

There are two types of reflux -

1. Frank reflux  - where a baby will regurgitate frequently sometimes in large amounts.
2. Silent reflux - when a baby rarely regurgitates but is very unsettled. This type of reflux is rarely picked up and often goes undiagnosed.  It may start from birth or it may develop later from three weeks or three months. 

What to look for:

When visiting a family I look for things to determine whether a baby has a sleeping, feeding or a physical problem. 

1. Does your baby snack or cliuster feed? (often falling asleep at a feed or have frequent short feeds, feeding under 3 hrs)
2. Is your baby hungry due to your low supply? Do you need to incurease your supply or tip baby up after a feed?
3. Is your baby difficult to settle or has an unsettled period during the day or night?
4. Is your baby able to self settle after the initial 30-45 mins cat nap?
5. Are you over handling your baby?
6. How long is your baby awake and how long do they sleep is it according to their age appropriate needs? (See our FAQ Questions relating to Sleep)
7. Does your baby have an infection - urinary, ear or chest infection?

Depending on your answers you may have a baby who suffers from reflux, hunger or one who just need to be taught how to sleep and how to self settle.  Many babies have a degree of reflux.  Not all babies suffer from acid reflux, some vomit frequently but are not bothered by it other babies don't vomit at all but are in terrible pain. 

An irritable, unsettled baby if encouraged to sleep well between feeds and not cat nap may quickly become a more settled baby but if their irritable periods continue and they refuse to sleep they may be suffering from acid reflux.  If you suspect your baby has reflux take a look at questions listed below. 

How does one detect reflux

1. Firstly look at your family tree.  Ask your parents on both sides if you or any of your siblings has 'colic' or were very unsettled or vomity babies. These are typical signs of reflux.  If the answer is yes or maybe it is more likely that your child may also have reflux.
2. Is your baby very unsettled at a certain time of the day more than any other? Often in the 'witching' or 'arsenic' hour between 2 pm and 9 pm. Take into consideration whether they are over tired, over handled or possibly just hungry. 
3. Is your baby often unsettled from one feed to the next? Dozing between bouts of uncontrollable crying? 
4. Does you baby prefer sleeping in a rocker, over your shoulder,in a pouch or in an upright position?
5. When asleep are their periods where he/she wakes suddenly and cries out seemingly in distress? or is grunting in squirming in their sleep?
6. Does you baby back arch, pull their legs up, fight their wrap and generally look uncomfortable?
7. Do you use a dummy to help pacify your baby during these unsettled periods?

If you have a family history of unsettled babies and you answered yes to most of the above then read on to see if your baby has any other symptoms of reflux.

Some symptoms that can indicate reflux including silent reflux are:

• irritability and pain
• poor sleep habits typically with frequent waking
• grunting, squirming and wriggling during sleep
• arching their necks and back during or after eating or at sleep time
• gulping, coughing or re swallowing hours after a feed
• teary eyes when gulping
• mouth filling with saliva, spit, frothing, excessive drooling
• frequent hiccups
• sinus congestion
• rattle wheezy chest
• reoccurring unexplained croup
• food/oral aversions
• constantly needing to suck
• swallowing problems, gagging, choking, coughing
• gagging themselves with their fingers or fist (sign of oesophagus)
• bad or acid breath
• flatulence
• running or blocked nose
• sneezing
• hoarseness
• frequent red, sore throat without infection present
• neck arching (Sandifer's Syndrome)
• vomiting or projectile vomiting (seldom in silent reflux)
• irregular, infrequent, watery or firm stool
• pulling legs up as if in pain

If reflux is untreated it may lead to:

• refusing food or accepting only small amounts despite being hungry or the exact opposite requiring constant small meals or liquid
• poor weight gain, weight loss, failure to thrive
• respiratory problems—pneumonia, bronchitis, wheezing, asthma, night-time cough, aspiration
• anaemia
• frequent ear infection
• chronic hoarse voice
• erosion of dental enamel
• sinus infections
• ulcerated esophagus

Tips: Reflux babies are often happier when held upright and therefore sleep well on your shoulder or in a pouch this is not encouraged as long term sleeping problems usually follow. 

Remember:  Many reflux babies are unsettled only at certain time ‘the arsenic hours’ and sleep well after this time but if left untreated they may become unsettled all day which may eventually become all night as well.  

If you would like more information on this and other similar topics our E-books are packed full of practical parenting tips.  Down load an E-Book specifically related to your child's age group through Publications at Our Shop.

How Cradle 2 Kindy Can Help

Cradle 2 Kindy coaches are trained to recognise signs of reflux and have many tips that will help you through this difficult time.  Give us a call now to book a visit so that we can assist you with all your concerns.  

Cradle 2 Kindy 1300 786 101

Also see: What happens at a Coaching session?

More Articles on Health

Disclaimer: Article on our website are for education purposes only.  Please consult with your doctor to make sure this information is right for your child.

All articles on this website have a copyright any the use of any material must have permission from Cradle 2 Kindy Parenting Solutions.