A Solution to Infant Developmental Challenges

The “Back to Sleep” protocol, while intended to reduce SIDS, has led to some unexpected issues for infants. It might be causing delays in reaching developmental milestones and leading to skull deformities or torticollis. These problems often need correcting through physical therapy or helmet therapy. Unfortunately, these treatments may come too late, missing crucial times for brain development and failing to "fix" misshapen skulls or delayed motor skills.

On the flip side, tummy time is a simple, effective, and cheap method for all infants, especially those with plagiocephaly and torticollis. It means placing an awake baby on their tummy while a grown-up watches and interacts with them. Doing this two to three times a day for about three to five minutes each, and gradually increasing the time, can help as the baby gets stronger. The best results happen between birth and six months old, so it's key that parents learn about it early on. Many new parents haven’t been properly informed by healthcare providers, leading to confusion about how to do tummy time correctly.

Purpose

This capstone aimed to use early check-ups with pediatricians to teach parents about the importance of tummy time right from birth. Pediatricians need to be trained to guide families on how to position their babies early on. They should also know when to refer families to physical therapy if the baby struggles with tummy time. Just like there are clear guidelines for SIDS prevention, tummy time education should also be a priority to help make it a regular part of an infant's routine. This might help reduce future resistance to the prone position.

Plan

This project gathered feedback from pediatricians about their knowledge and views on tummy time. Parents were also surveyed to get their take on current tummy time practices. After looking at the survey results and literature, we decided to create an evidence-based flyer. This flyer includes a timeline for tummy time progression and correct alignment tips as the baby develops motor skills. Pediatricians can give this flyer to parents starting at birth and follow up during each well-baby visit. We also made a PowerPoint to introduce the flyer and discuss related research with pediatricians.

Outcomes from the Literature Review and Surveys

1. The surveys and literature review showed that while pediatricians and parents know tummy time is important, they lack specific details like duration and alignment.
2. Pediatricians are willing to spend time educating parents about tummy time during well-baby visits, starting from birth. They’re open to discussing it and handing out the flyer.
3. Parents need to be reminded that tummy time should always be supervised, especially in families with lower socio-economic status.
4. If after trying tummy time for 6 weeks the baby still struggles, they should be referred to a physical therapist, especially if there are head shape issues too.

Clinical Relevance

Doing tummy time right helps the musculoskeletal, visual, social, cognitive, and sensory systems work together to promote motor skills development.

Lower physical activity levels in kids contribute to rising childhood obesity rates. Getting babies moving through tummy time might help boost overall activity levels in children.

Even though plagiocephaly and torticollis are often seen as cosmetic, they’re linked to higher risks of ear infections, dental issues, and vision problems. Tummy time is a non-invasive way to help shape the baby’s head correctly, especially if started early.

The flyer was designed considering various factors that affect tummy time positively and negatively. This project could help future research on how to encourage tummy time, improve motor development, increase infant activity, and provide better recommendations for parents and healthcare providers.

Practice Recommendations

• Recommendation 1: Pediatricians should provide early tummy time education along with SIDS prevention, starting at birth.
• Recommendation 2: Pediatricians should follow up on tummy time education at each well-baby visit until the baby is at least 4 months old, emphasizing correct alignment.
• Recommendation 3: If a baby struggles with tummy time for the recommended durations and has head shape or symmetry issues, pediatricians should refer them to a physical therapist around 6 weeks of age.