Medically, any baby who is born before 37 weeks of pregnancy is a premature baby.
Premature babies have different levels of prematurity levels, the risks being higher for an earlier birth.
Babies born before 26 weeks of pregnancy are at the highest risk and are also referred to as micro preemies.
Special care coupled with lots of positivity and attention is essential to give your baby the best chance of surviving a premature birth easily.
Children born prematurely are often deprived compared to children born on time. Long hospitalization, innumerable amount of medical procedures/treatments has often an effect on psychological and physical development of the child.
The stress parents experience due to frequent visits to various specialists, does not help to improve the situation.
1) When should we need to start physiotherapy of premature baby?
Premature babies go through a “difficult period” inside the incubator due to many medical treatments, stress and anxiety of what is happening to their body.
The physiotherapist job is to carefully observe the behavior of the prematurely born child, spontaneous movements of the baby as well as how it reacts to the people, how it's fed, how it sleeps, whether it's calm or irritated.
Psychomotor delay in premature child is called a "multisystemic immaturity".
This means that it takes time for the body of the child to get used to the surroundings(home environment, parents and people around them). In another words, the child needs time to develop the motor abilities it was deprived of at the moment of the premature birth.
Observation of baby motor development is essential from the very beginning.
Base on observation the physiotherapist will recommend the physiotherapy for the baby.
There is no reason to delay a physiotherapy assessments. Often an overlooked first symptom e.g. hyper/hypotonia, can develop further into baby positional asymmetry.
It is not a rule but an attitude like “perhaps it will go away or it will get better with the time” may be misleading and the child without help of a physiotherapist may not be able to reach milestone such as rolling , crawling or sitting up. Not every preemie requires such an approach, some children will develop properly without any involvement from physiotherapist and will develop properly.
Every child has an individual development and the worst thing that can be done is to generalize symptoms and aggregate all the possible indications into one bag. Let’s be vigilant! It’s better to react earlier and obtain a professional opinion.
2) Parents often ask about increased/decreased muscle tension in children,where it comes from,the causes and how does it manifest in a child?
The complications during the pregnency can be caused by many factors such as infections, illnesses, medications taken during pregnency .
All can have an effect on the development of the fetus, often this is when the "control and self-regulating system"responsible for the proper muscular tension in children develops.
Development of society,the environmental pollution, chemicals used on food and in agriculture as well as stress creates challenges for us as children are born weaker and weaker.
Studies have shown that just several years ago it was more difficult to get a diagnosis of the child.
Nowadays due to the advancement of neurodevelopmental methods such as NDT-Bobath, first irregularities of the nervous system can be observed in just a few days of child's life.
Based on the child's movement we are able find out if the “movements” are correct or not.
However before consulting with a physiotherapist or neurologist,parents can observe the behavior of baby themself.
Whether baby prefers certain positions over others e.g. not tolerating tummy time, prefers one side of the body over other, using one hand only to grab toys, the child presents with fisted hands, does the baby cry incessantly and refuse to calm down, has the baby got eating problems (sucking, swallowing) or if the child excessively spill their food.
These may but not necessarily be indicative signs of muscular disorders in children (hypertonia/hypotonia).
In my clinic parents will obtain professional help and advice. By good knowledge of the principles of an infant’s motor development we promote the child’s proper development through natural games.
Let’s remember that the earlier the irregularity is noticed and diagnosed in a child, the higher the chances are for an improvement in the functioning of a baby.