Babies and Children
- All Treatments
- Baby Massage
- Hip Dysplasia
- Enuresis / Encopresis
- Neuromotor Delay
Bronchiolitis is the most frequent trouble in babies caused by a viral infection of the lower respiratory system. It has a seasonal pick between ends of October to beginning of March (even if it can appear at any other time of the year).
Its main cause is the RSV (respiratory syncytial virus). 90% of the babies under 2 years old are colonized by this virus and 40% of them develop the disease, which make this affection the most common one at this age.
However, bronchiolitis can have other causes like allergic or environmental factors. For some babies bronchiolitis is only the first manifestation of asthma. Therefore, one of the aims of the baby’s physiotherapist is to determine what cause the bronchiolitis, to develop an appropriate treatment.
How do I know when my baby has a bronchiolitis?
Your baby’s physiotherapists will diagnose a bronchiolitis when there is:
- Respiratory wheezing (mainly during exhalation)
- Running nose
- Sign of respiratory difficulty
How does bronchiolitis progress?
Bronchiolitis commonly starts in the superior airway (nose and back of the throat) and then progress to the lower respiratory system (bronchi and the lung itself).
The first symptom is a dry cough caused by inflammation. Inflammation is a natural protection of our body against external attacks. Inflammatory reaction leads to oedema (swelling of the airway) and bronchospasm (contraction of small muscle inside your respiratory system). The combination of both reduces the diameter of the airway, making it more difficult for your baby to breath.
In a second time, a wet cough appears due to an increase of mucus production. Our lungs produce mucus continuously to clear foreigner cells (bacteria/virus) and other impurity entering our lung. The mucus is then collected in our mouth and swallows to be digested. We do it all day long without noticing it like when we snort…
However, when there is an infection or an inflammation the clearing mechanism is overload and the mucus built up inside our lung. It is problematic for two reasons. First the mucus also reduces the airway diameter, making it more difficult for your baby to breath. Secondly, it increases the risk of developing another infection as bacteria/virus will stay in the lung of your baby.
In absence of treatment, the association of inflammation, oedema and mucus making breathing more difficult force your baby to breathe faster and to use accessory breathing muscles. This type of breathing is really tiring for your baby, who he is often already tired as he sick, eating less and sleeping less…
If this situation persists, your baby will be too tired and won’t be able to keep this fast breathing, reducing the oxygen entering is body. Baby’s physiotherapists call it respiratory distress. It is characterised by:
- High breathing rate (above 50)
- Increased heart rate
- Nose flaring: nostril opening widely (Appear when we struggle to have more oxygen, like when we run)
- Increase throat notch: as we use our accessory breathing muscles of the neck it increase the notch below our Adam’s apple
- Rib cage notch: similarly the use of accessory breathing muscles around our rib cage will create a notch on the side of your baby rib cage
- Sweating: but the skin does not feel warm to touch
- Colour changes: bluish colour around the mouth or on the fingernails, the rest of the skin being pale or grey
- Apnoea of 10s or more: your baby has not enough energy and make long pause not breathing
These symptoms often appear in the above chronological order. However, they can be caused by other medical conditions than bronchiolitis and respiratory distress. In any case, if your baby is presenting one or multiple of the above symptoms call an ambulance or go to the closest A&E
How to treat bronchiolitis?
Medication: your GP or paediatrician can prescribe bronchodilator (to open your baby’s airway) or corticosteroid drugs to decrease inflammation. Another efficient way to reduce inflammation is to nebulise (shop) hypertonic saline water (very salty water).
Baby massage is way to communicate with your baby, to show him/her your love.
It is important to create a secure and comfy environment in this new world he/she would have to discover. Baby massage is a beautiful way to develop a link with your baby thanks to its emotional and physiological benefits.
The physiotherapist will teach you different movements which you will be able to practice under a professional supervision to be able to use later by yourself.
These techniques encompass the whole body, specific hands and feet massage, abdominal massage to prevent colic or constipation, mobilisation of inferior and superior limbs…
It recreates the in utero movement, to feel the maternal contact (skin against skin) and to reach complete relaxation. It is a peaceful moment both for the parent and the baby.
10 good reasons to massage your baby:
- It is a privilege time with your baby to show your love
- To help your baby to relax and sleep better (for you too!!)
- To alleviate constipation and stimulate bowel function
- To alleviate pain and discomfort (gas, colic, crying…)
- To create a time of relaxation for both of you (useful for your whole life)
- To enhance psychomotor development by positive touch interaction
- To develop social interaction through touch
- To enhance GI function of your baby and improve food absorption
- To stimulate cognitive development of your baby
- And obviously to help you and your baby to love each other
There are 2 types of torticolis in children:
- Postural congenital torticollis
- Muscular congenital torticollis
It is the most frequent one and recovers easily by adopting good habits and providing adapted stimulus to your baby.
It is caused by a bad posture/holding of the neck and head. It is present from the birth as it develops during the foetal life. It is often associated to a plagiocephaly (flattening of a side of the head) without muscular reaction.
Initially, it is simply a preferential posture. However, overtime it may have more serious consequences on the orthopaedic system and impair a normal psychomotor development.
As said in the name, a muscular retraction brings the neck in an abnormal and permanent position. The head is blocked side bended on one side and rotated on the opposite side.
It is also associated to a plagiocephaly and to a facial asymmetry.
It is caused by a similar mechanism as the postural torticollis but need a closer attention to have a correct recovery.
Scoliosis is a permanent deviation of the vertebral spine caused by a vertebral rotation. It mainly appears in the childhood or teenage but in some case even during the adulthood. This pathology can be triggered by another disease. However, in most case the exact cause is unknown.
The scoliotic deviation takes place in the 3 different plans:
- Upward or downward
- Left or right
- Forward or backward
The scoliosis is composed of the addition of the rotation of several vertebral levels. Depending of the position of these rotated vertebrae, we speak of thoracic, lumbar or thoracolumbar scoliosis. It give a S shape form to the patient back and often associated with a gibbosity (bump on one side of the back).
Being potty-trained is essential for a good psychomotor and social development of your child. For example, schools do not accept kids who are not clean or need to wear a diaper. At 2 years old normally, your child should be potty-trained. However, it is as difficult as walking to learn, if not more! Furthermore, a lot of taboos are associated with it; therefore, it is a process involving a motor, neurologic and psychologic aspect!
- Nocturnal enuresis is characterized by involuntary and unconscious micturition at night in children older than 5 years old and adults. It is commonly called bedwetting. Enuresis is caused by a deep sleep, a lack of maturity of the micturition reflex or a psycho-emotional trauma. In some rare cases, nocturnal enuresis is a sign of urinary malformation. Nocturnal enuresis is called primer if the child always wet is bed and secondary if there was a period of 6 months without bedwetting. In this last situation, the cause is often a psycho-emotional trauma.
- Encopresis is a form of faecal incontinence. It can appear in children more than 4 years old or in adults. It manifest as the involuntary loss of faeces. It can have a physiologic or psychologic cause.
Rectal problems (constipation or encopresis) are link to diet, psychologic factor, abdominal incompetence and lack of control or weakness of the pelvic floor.
These problems have an impact on child enuresis. Consequently the rehabilitation will be global.
Constipation in babies presents as irregular bowel movement causing period of distress followed by relaxation once the bowel are empty. The abdomen of the baby is often tense and gives a bloated impression.
Gas and digestive dysfunction can also have less obvious repercussion such as lack of sleep, difficulty to fall asleep or inconsolably cry for several hours.
Thanks to Visceral Osteopathy, the therapist will not only target tissue-restricted areas in your baby abdomen and work to bring back their normal motility, but will also use an holistic approach to analyse how the abdominal dysfunction impact the rest of his body with a special interest to his diaphragm.
In the case of cerebral palsy and PMD, the child will have difficulty to learn, to organise his/her posture to initiate movement and to adapt movement amplitude and intensity. It explains their difficulty to hold their head and trunk and movement which are too slow/fast, stiff or brutal.
Our first aim as physiotherapist is to evaluate what are the barriers to development, then, to develop an approach bypassing these barriers in order to allow your child to learn and develop at his/her maximum capacity.
The goal of the rehabilitation is to teach to the child movement which they will automatize and will help them to adapt to normal life issue.
When these leaning difficulties are associated with spasticity , the session start with passive mobilisation combined with other techniques to inhibit the spasticity to create a good environment for learning.
In function of the development stage of the child, the physiotherapist will work on standing, sitting posture, crawling, position change (rolling on the back/front), walking on all four, walking…
Another essential aim of the rehabilitation is the upper limb mobility to develop good prehension skills.
- Pediatrics General Check Up
- Neuro Rehab & Psychomotor Development
Reflux in babies differ from vomiting as the second one is due to a forcefully contraction of your baby muscles whereas the first is stomach contents passively rising up into the oesophagus or mouth.
Even if there are obvious symptoms like your baby “spitting up” whatever they have just swallowed, there also can be more silent symptoms such as:
- Waking often at night
- Weight loss or poor weight gain
- Excessive crying or irritability during or after feeding
- General discomfort or pain when lying down
- Persistent cough
The first cause of these dysfunctions is the immaturity of your baby digestive system. It is why these problems often diminish or resolve after the age of 6 months.
The second cause is his alimentation. Both industrial milk and breastfeeding can lead to constipation and gas. For industrial milk, it can be necessary to try a different brand/type of milk. For breastfeeding, it is mom diet which would be important to modify. Cutting irritant food such as spicy food, vinegar, caffeine, nicotine, chocolate and in some case lactose may reduce or resolve the problem.
Other tips to follow are:
- Burp your baby regularly
- Avoid overfeeding and feed too quickly (try to make break in the feeding)
- Hold your baby upright when and after feeding
Osteopathy can’t solve the roots of the problem (digestive immaturity and alimentation). However, it is very efficient to decrease the symptoms by decreasing diaphragmatic and abdominal tension.
Consequently, osteopathic treatment provides a period of symptoms free during which his digestive symptoms can mature or you can adjust your baby alimentation.
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