The infant will typically demonstrate inutero positioning for there first 3 to 4 weeks following birth. It is important at this early age to already place their head so they get equal amount of time with the head positioned to the right and to the left both when on their stomach and their back. For the infant with a favorite side, you may need to be persistent and eventually hold the head to the side. When the navel is healed, it is time to start tummy training.
When the head is turned to the side while lying on their back, they should assume the Fencer positioning. This reflex is seen clearly by 6 weeks, often earlier, it is named after the sport. It is important they do this on both the right and the left sides. Doing this with the infant is a part of daily training. In the pictures below you see the Fencer reflex when Arlo is looking to his right. It is not as well developed on the left, so this would be something to work with. You would position the arms correctly in the Fencer position and eventually use vibration to strengthen the response.
When the infant is old enough to follow your face, (this is usually between 6 weeks and 2 months), you get their attention and have them turn there head to the side by following you or a toy and help them into the Fencer position. To couple another important reflex once the assume the Fencer positioning, roll them, hips and shoulders simultaneously, to the side they are looking towards. If they do not do the Fencer reflex, help them by putting them in the correct position. The video down below demonstrates this.
Tummy training in the 2 month old is with the elbows in close to body in line with the shoulders. Hold the elbows, pressing lightly on the inside of the elbow. If the baby loses shoulder support on one side (see Arlos’s right shoulder in the middle picture) you can work with the baby in different ways. Begin by pressing the elbow slightly up towards the shoulder, so the baby has good support, ‘proud shoulders’. The other alternative is to use pressure on the pelvis gently tipping it so the pubic symphysis is in contact with the floor. For the baby that leans with the head to the side, you can give the baby a sense of neutral positioning by using your finger to correct the head tilt.
In persistent cases where the shoulder is not supporting the body, use your hand to position the shoulder in neutral. In the infant with a favorite side to position the head, the opposite side of the neck will be weaker. Here are some pictures of how to work with the weaker side of the neck. First you hold around the chest of the baby and start to lift from sidelying. You want to see them engage the neck muscles. If they are unable to activate the neck muscles, you can use you hand and lift the head up to the side. Because the left side is weaker and the infant does not use the left arm in the same way, you can use vibration on the arm. You can use vibration instrument on you hand (not trigger gun which is percussion) as an indirect way to stimulate the non-dominant side. If you use an electric toothbrush, you can place it directly on the arm.
In the early months, think about the infants day as sleep, feed, play. They should be in tummy first where they may more easily burp or spit up. Spitting up is common in the early months and unless excessive, it is nothing to get excited about, burp clothes are a necessity. Have them look to right and left. Lie them on each side with contrast images or colorful things to look at. When the infant reaches three months, there is a major change in how the brain functions. This is a time when you will see new milestones and training should take that into consideration. At this point you assess their age based on their due date. We expect to see hand-hand, hand-mouth and foot-foot activity. For the infant with asymmetry, they usually prefer to activate the same side they look to. It is crucial for their motor development to help them find the non-dominant side. You see in the pictures how to bring both the right and left hand to the mouth. Once the infant starts bringing the hands to the mouth, and everything else they can grab onto, they typically drool more. This is to help keep their mouth free from germs. the hands should not be clenched all the time now. You can use vibration to help them relax the hands.
At 3 months the infants job is to find stability lying on the stomach with a triangle of support. The elbows are slightly forward and wider compared to the shoulders and their weight is balanced on the pubic symphysis.
The video below shows how you would have your training session with the 3 month old infant.
The infant should be now solid in the three month skills. They should be stabile on the stomach with proud shoulders, looking side to side. They should be able to lie on the sides with out tipping, You can use a towel to prop them if the start pushing on to their back. They should lie on the back performing the Fencer reflex as they look side to side.
At around 4.5 months to 5 months the infant should develop a new set of skills. The infant should when lying on the stomach be encouraged to shift the weight to one side to be able to lift the opposite hand to grab for a toy. You can help them by stabilizing the right knee and the left shoulder, introducing a toy so he lifts the right arm. The weight shift should be clearly to the left side of the body. They should be able to do this on both sides.
