You could be forgiven for thinking that, apart from being adorable, babies’ feet are the same as an adults. We’re all humans after all with the same bones, muscles and physical makeup. However, babies’ feet have not yet developed and have a lot of growth and change before they start to resemble ours. Usually it is not until around 3 years of age that a visible arch will form and bones have developed. You might be surprised to know that by caring for your babies feet you can help prevent major foot problems in later life.

It is for this reason that, as a parent, you must be very careful with what you put on your baby’s feet. Their feet are easily moulded into shape and if your dress them in poorly fitting shoes or even socks that are too tight, you can mould their feet into the wrong shape.

As your baby goes through their key developmental milestones i.e. learning to crawl, pulling to stand, cruising along furniture, it is best that they remain barefoot to allow sensory feedback from the floor and improve their grip as they start to try more challenging movement patterns. Being barefoot also allows the small muscles in their feet to develop and strengthen.

It is only once your baby is taking steps independently that you may want to consider buying them their first pair of shoes. The stage at which your baby is taking independent steps indoors is a sign that they are just starting to find their feet and by providing them with a flexible, lightweight shoe to help protect their feet and give them some grip, you will prevent them from slipping and increase their confidence in their new upright position. Avoid anything with a hard sole. They do not need a hard sole at this stage and anything too rigid will inhibit the normal growth of the foot. Allow them some time out of their shoes as well. This will help the muscles of their feet to develop in the correct way.

The exciting time for buying shoes is when your baby starts walking both indoors and outdoors. At this stage they are ready to have their first pair of proper walking shoes. It is important that you get your baby’s feet correctly measured by a shoe fitter. Try well known companies such as Clarks, Start-Rite and Schuh (this post is not sponsored by these companies) they have specially trained fitters with knowledge on the best shoe for your baby. Always check with your child’s physio if you are unsure.

To ensure you get the correct shoe. some key features to look out for are:

• that the heel is well supported and held securely
• the foot does not easily slip out of the shoe
• there is no rubbing
• no alteration to your baby’s balance

A semi rigid sole, with some flexibility, is appropriate for this stage of your baby’s development. You should be able to bend and twist the sole at the middle of the shoe without much force or effort. Make sure there is enough room inside the shoe for your baby to flatten all their toes. At this stage you will find your baby grows very quickly, so it is important to get their shoes checked regularly. It is recommended they have a fitting every 6-8 weeks.

Remember, if you have any questions or concerns relating to finding the right pair of shoes, The Children’s Physio will be able to advise.

Have you noticed that your baby tends to tilt their head down to one side? Is the shape of your baby’s head becoming more asymmetrical or flatter on one side? These are signs of a Torticollis, which you will need to get looked at by your health professional sooner rather than later.Torticollis is a relatively common, easily treated, condition in babies. If you know what to look out for, the first signs of a torticollis can be picked up and treated in the first few weeks of life.

A torticollis is where there is a shorter sternocleidomastoid muscle on one side of your baby’s neck compared to the other. The Sternocleidomastoid is a neck muscle that connects the base of your skull to your collar bone. You have one on either side of your neck and in some people, especially in new born babies one side can be shorter than the other. This will cause your baby’s head to tilt down and turn towards one side. There is often a small benign lump on the muscle of the baby’s neck which is an indicator of Torticollis.

With treatment this muscle will stretch and grow and the problem will resolve. However, if left untreated it can cause permanent changes to the shape of your baby’s skull, have a detrimental effect on their development, restrict their normal movement patterns and cause a permanent limitation of your baby’s neck.

There are several reasons that a Torticollis can occur in babies, it is thought that the most common cause is a lack of space for the babies head in the mother’s uterus. Babies can often stay in one position for a long period of time without any space to move their neck. This means that as the baby grows their Sternocleidomastoid muscle can become under developed, stiff and tight on one side and over stretched and weak on the other.

If left untreated a Torticollis can begin to effect the shape of your baby’s head. In fact, a flattened head shape is often the first sign picked up by parents that something maybe wrong and it is only weeks, months down the line when an assessment of the head is done that the Torticollis is found to be the main issue.

The bones in a babies skull are not fully formed until approximately 12 months old, until this point they are thin and flexible to allow the head to grow and mould into shape. Due to the muscle shortening caused by a Torticollis, your baby will naturally tilt their head down to one side and have reduced ability to turn their heads. This means that only one side of your baby’s head is ever in contact with a surface and has al the weight going through it, preventing the head from being moulded into a well rounded shape.

1. Normal head shape
2. Plagiocephaly – flattening to one side
3. Brachycephaly – flat back of head

Do not panic if this is the case with your baby. The head shape continues to be mouldable until approximately 12 months old and the altered head shape does not, in any way effect your baby’s brain development. You still have a perfectly healthy baby, there are just a few things you made need to do to help the head shape correct. Seeing your child’s health professional or a Children’s Physio as quickly as possible, is the best thing you can do if you have concerns about your baby’s head shape.

How can you help?

*The following advice is provided by “The Children’s Physio” a highly specialised, fully registered paediatric physiotherapist based in London United Kingdom- The information provided is guideline advice only and not a suggested treatment of a Torticollis. A full assessment of your child is recommended prior to carrying out these exercises to determine the cause of the Torticollis and guide you with appropriate treatment.

Your baby needs to be encouraged to turn their head to the opposite side that the Torticollis is puling them towards.

• When your baby is in their cot, position them so that al the environmental stimuli is on the side they avoid turning to. So that when you walk into the room they have to turn the way they normally avoid in order to see you.
• When cuddling your baby, carry them on the opposite shoulder to the side of their Torticollis. So if they favour looking to the right, carry them on your left shoulder and vice versa.
• Remember Tummy time is important. It strengthens your baby’s neck and allows the back of their head to have a break from being in contact with surfaces. If you have problems with encouraging tummy time, speak to a Children’s Physio to help give you ideas to help your baby enjoy tummy time!
• Be mindful of how you handle your baby when feeding them. If you always feed from the same side you will be inadvertently encouraging a preferential head turn.
• play with your baby from both sides, encourage them to look around, turn their head and seek out objects out of their direct line of vision.

If you have any questions or concerns about either your baby’s head shape or neck movement, don’t hesitate to contact The Children’s Physio for advice or for a convenient home visit appointment.

Does your child complain of having achy legs? Are they often kept up at night by the same kind of restless throbbing pain? Have you tried to soothe your child’s pain but are unsure whether or not you need to see a doctor or give them medicine?

If this sounds familiar then your child may have growing pains. We have all heard of growing pains but what are they? When should you, as a parent, become concerned and how can you help your child?

What are growing pains?

Growing pains affect up to 40% of children at some point in their childhood. They usually start in early childhood around ages 3-5years and then reoccur later in childhood at around ages 8 -12 years old. There is no evidence that bone growth is the cause of growing pains, so it is common for these pains to occur with or without a period of growth. It is considered that these pains are most likely related to activity. Children are often playing and exercising in ways that put a high demand on their bodies. This can cause discomfort and aches later in the day or even the following day.

Growing pains are crampy, dull, muscle pains that effect children’s legs predominantly in the late afternoon and evenings. The severity of these pains is variable but can sometimes be so severe they disrupt your child’s sleep.The pains are focused in the muscle not the joint and most children will report of pain in their thighs, calves and behind their knees. Growing pains do not cause any redness or swelling of the joints, this could be a sign of something more serious, so do go see your doctor if the pain focuses in the joints and they appear red, hot or swollen.

When should you seek medical advice?

Your GP, Paediatrician or children’s physio can help diagnose and treat growing pains. There are some signs and symptoms to look out for that may mean the pain your child is experiencing is something more serious. Look out for the following:

• Fever
• Pain post injury
• Long lasting, constant pain
• Pain first thing in the morning
• Redness, heat, swelling at a joint
• Limp
• Rash
• Poor appetite
• Unexplainable weakness and tiredness

The above list are not signs relating to growing pains so it is important to be aware and see your health professional if required.

Even though growing pains are not serious they can still have a big impact on your child and the pain experienced can be very upsetting. Sometimes because the pain has gone by the morning, people can assume that the pain is not real. This is not the case and its important you offer support and reassurance to your child when they are in pain, and help them learn to cope with pain in a healthy non life limiting way.

How can you help?

The pain experienced with growing pains is a dull, crampy muscle ache. This kind of pain responds well, to touch. Massage the area, teach your child some easy stretches they can do to relieve the crampy sensations. Use heat* to reduce pain and muscle tightness. a warm bath, heat pads and hot water bottles are a nice way to provide relief. Avoid using medications as these are often ineffective with muscle pain and can have harmful side effects for your child. Use pain coping strategies like relaxation tapes and guided visualisation, especially at night if it is stopping your child falling off to sleep.

*Always use due care and caution when using heated products with your child.

If you have any concerns about your child’s pains or want some advice on how to massage and stretch to relieve pain

A good nights sleep is crucial to your baby’s health and development, not to mention the importance of a good nights sleep for you as their parent. If a child’s sleep is disrupted, they aren’t the only ones feeling tired. According to a recent study, the average parent will have lost six month’s worth of sleep by the time their child is two years old! So it is no wonder that one of the most frequently discussed topics around parenting and child health is sleep.

The most important thing to remember when thinking about a child’s sleep, is that no child is the same. Some babies are born with an in built ability to self soothe and enter into the land of dreams with ease, whereas other babies can really struggle to settle and sleep. You can have the same parents use the same routines but all their children will sleep differently.

Newborn Babies

At this stage your babies sleep is interlinked with feeding. I am sure you will all recognise the dozy, milky state that occupies your newborns life. Your baby has not yet developed its awareness of night and day and their “body clock” is non existent. Few babies settle well at this stage and crying is common as it can be very difficult to notice your babies subtle cues for sleep. By the time your baby is crying they are already over tired. Lots of babies cannot go longer than 90 minutes without sleep so look out for cues such as yawning, rubbing their eyes, or staring off into space.

12 Weeks

Now the “fun” starts and by fun I mean the bedtime routine. At around 12 weeks old babies start to produce the sleep hormone melatonin more. This is naturally produced in the body, and helps us to distinguish between night and day. Produced in the evening, melatonin production triggers drowsiness. It is at this stage that you can start to introduce a bedtime routine to regulate your baby’s sleep pattern.

Self soothing and the ability to fall asleep without you or any props is key. That way if they wake during the night they will be able to get back of to sleep without disturbing you. Bear in mind that many factors can impact on a sleep routine and do not be disheartened if it takes a while to establish one. Illness, teething, change of sleeping environment are all examples of factors that may disrupt even the most established routine.

34 Weeks

It is around this age that babies develop a sense of self and an awareness that they are a separate entity from their mothers. As a result separation anxiety is common and can disrupt sleeping patterns. Stay vigilant with your routine, the disruption is not a sign that it is failing it is appropriate and expected at this age, sticking to your familiar routines will help get you through this disruption and help restore a better sleeping pattern once this stage has passed.

Useful Tips and Tricks to Help Your Child Sleep…

1. Shhhhhhh! As much as is possible, keep things quiet at night, keep the lights low and help your baby start to learn the distinction between night time and day time.
2. Don’t fall into the trap of doing things for the sake of it just because your baby is awake. Only change their nappy if it is very wet and soiled.
3. Wake your baby for regular feeds during the day, every three hours or so is advised. This way they will wake less for feeds during the night. Make sure you are not putting your baby off to sleep at night hungry, especially when weaning.
4. Establish bedtime rituals. Feed, bathe and then bed. In that order so that your baby doesn’t start to use the feed as a prop for getting off to sleep. from 6 months establish night time cues in the early evening, tidy away toys and turn of stimulus such as the radio or television to help them wind down.
5. Be aware of the bedroom temperature and make sure it is neither too hot or too cold. Ideal temperature is 18 degrees Centigrade.
6. Take your baby outside for walks late in the afternoon. This will help them to learn and get used to the difference between night and day.
7. Comfort Vs Leave to cry. Its a controversial topic but there are many studies to show that attending to your baby when they cry helps with the development of neural pathways in the brain that lead to feelings of security and safety. Both are essential for anyone to drift off to sleep successfully.
8. Once you baby is over 12 weeks you can start the gradual “retreat technique”. When your baby cries start by comforting them with rocking and then putting them back into bed. Work this down each time, next time they cry give them a brief cuddle and put back into bed, next time just go to the cot and stroke their head, then just go near to the cot and finally just enter the room.

How much sleep do children really need?

Here is a rough guide of how much sleep your child needs. These are just guidelines, if you have concerns about your child’s sleep then consult your paediatrician. There are many healthcare professionals such as The Children’s Physio, cranial osteopaths and occupational therapists who can help with sleep disorders in children.

• Birth to three months – Seven hours in the day and eight and a half hours at night.
• Three to six months – Three and a half hours in the day, eleven hours at night.
• Six to nine months – Three hours in the day, eleven hours at night.
• Nine to twelve months – Two and a half hours in the day, eleven hours at night.
• Twelve months to two years – One and a half hours in the day, eleven and a half hours at night.
• Two to three years – As above but daytime nap will reduce and maybe dropped.
• Three to four years – Twelve hours at night.
• Four to five years – Eleven and a half hours at night.

With the February half term looming just around the corner, give yourself and your little one a giant pat on the back and let out a big triumphant breath! You have made it through half the school year already and summer is within sight. Time Flies!

Half term is a great time to let your children have some fun, be more active and generally let loose after a busy school term. But what happens when the holidays are over? Here at The Children’s Physio we often hear how difficult it is to keep your children active whilst they are in school and doing long days and with ever increasing busy schedules how can you ensure your child is getting the right amount of exercise?

It is recommended that children aged 5-18 years should be doing 60 minutes of exercise every day to stay healthy and keep fit. An hour on top of an already hectic school routine can be hard to find the time for, but exercising everyday doesn’t have to be a chore. Here are some ways you can encourage your child to keep active and exercise during the school day, whilst still having fun…

1) Getting to School

Avoid the dreaded school run! Instead of taking your child to school in the car or on the bus, encourage your child to walk or cycle to school. You could even talk to other parents who live close by and start a group so you can all stay fit and active and get to school together. After eating a healthy breakfast, exercising before school will help to stimulate brain cells and get your child alert and ready to learn.

2) School Bags

Here at The Children’s Physio we are often giving out lots of advice re the correct school bag for your child’s height and age. School bags filled with heavy books are often a major cause of back pain and fatigue in children. Do a quick check of your child’s school bag to make sure it is no bigger than your child’s back and that it has wide, adjustable straps. Make sure your child is only carrying what they need for each day to reduce the weight of the bag, you would be surprised how things can build up over time.

3) Posture

Being active keeps muscles fit and strong and protects your child’s joints. Weak muscles can lead to poor posture, and poor posture can cause severe back pain. In school encourage your child to sit upright in their chair with a straight back. Not only will this help them stay more alert in lessons but it will prevent them getting stiff and sore.

4) Make the most of Lunchtimes

Lunch breaks should be fun and a chance for your child to take their mind away from the classroom. The complicated maths class or confusing science lesson does not need to be dwelled on during lunch. Getting active and doing some fun activities can help them relax and refocus ready for the afternoon. Ask your child’s teacher what options there are during lunch breaks and encourage your child to take part.

5) Sports Clubs

Sports Clubs are a great way of keeping active, having fun, increasing self confidence and making friends. See what kind of clubs your school offers and sign your child up.

6) Outdoor games

Get ready to become temporarily unpopular and insist your child turns off the TV, puts down the computer game and goes outdoors to exercise. The outdoors will help keep your child fit and active, refresh their minds, improve their sleep and they can have fun with friends.

7) Movement breaks

Speak to your child’s teacher. It is advisable your child gets up to move and stretch during long lessons, this can help improve energy levels and prevent your child experiencing pain and stiffness.

Keeping your children fit and healthy can be more fun than you think. Do you have any suggestions that you have found work for you and your child? If so comment below and let’s get sharing ideas to keep children fit, healthy and happy!

There are certain moments in life that stand out, ones we look forward to with excitement and anticipation and then treasure in our memory for a lifetime. Watching your baby smile for the first time, seeing them begin to play and interact with the world around them and being there for your baby’s first steps are just a few of those precious moments. So it is no wonder that we worry when these things do not happen as we expect.

It can be so easy to look around at other people’s children in playgroups and compare your child’s development to others. When should your child start walking? At what age should you become concerned and seek professional advice if they are not yet sitting or crawling? There is so much conflicting information out there, not to mention all the, not so helpful but well meaning “do gooders” offering unsolicited advice and reasons as to why your little one isn’t rolling compared to their child of the same age, who just happens to be crawling already.

Being a new parent is stressful enough, so to help take away the stress of your child’s development, here is an approximate guide to some of the gross developmental milestones of a child in the first 3 years of life. Please do remember these are only guidelines and every child is unique in their development so if you have any concerns or queries just ask your children’s physio for a developmental assessment.

• 6 weeks: Sits with back curved and support. Head control is starting to develop.
• 6 months: When puling your child from lying on their back, up into sitting, your child maintains their head control and brings their head up with them.
• 9 months: your baby can get into the sitting position independently. Can sit unsupported and pivot in sitting. Your child also crawls at this age. (Age of crawling varies widely and some babies never crawl. If you have concerns re crawling ask your children’s physio).
• 10 months: pulls themself up to standing and stands holding onto surfaces.
• 12 months: your baby can stand and walk holding one hand. May start standing alone briefly. May begin taking their first steps.
• 18 months: walks well. Climbs stairs holding onto rail. Runs. Seats self in chair.
• 2 years: can go up and down stairs on their own (two feet per step). Kicks a ball.
• 3 years: climbs stairs one foot at a time. Able to stand on one foot and balance for a few seconds.

Most children take their first steps somewhere between 11-15 months, but the rate of development is variable and unique to each child. Even if your child takes longer than expected it is not a sign of any long term implications. Walking is considered delayed if it has not been achieved by 18 months.

If you have any questions about childhood development or any concerns about the rate of your child’s development do not hesitate to get a developmental assessment by your children’s physio. Whilst your GP or paediatrician may be able to do a developmental assessment, a children’s physio is an expert in development and can assess and commence treatment to help your child on their way.

What have you found useful to aid your child’s development? Do you have any anecdotes or thoughts about a babies development? Please leave any comments or queries in the comment box below….

It is common to think of Physiotherapy as something only required by professional athletes or the elderly. When you imagine a physio you will probably have images of someone being massaged pitch side or struggling to learn to walk again after a severe accident, injury or illness. However, physiotherapy is crucial in the treatment of children and you may be surprised by all the different ways physiotherapy could help your child.

Here are ‘6 signs your child may need physiotherapy’, and if you relate to even just one, you might want to consider how you can help your child’s body grow and heal in the right way:

Pain that won’t go away – Often dismissed by many health care professionals as “growing pains”. If your child is suffering from joint or muscle pain, often worse at night or after activity then there’s no reason to suffer in silence. Often pain comes and goes so it is easy to ignore initially but if your child has been complaining of the same pain for a while, it may be time to ask a physio to assess your child. A children’s physio can assess your child’s joints and muscles and will often find a treatable reason for this pain and teach you and your child how to change their body and fitness to reduce the pain.

Balance and coordination – Would you describe your child as “accident prone “or “clumsy”? Are you constantly receiving calls from school about your child falling over in the playground? You are not alone; many children have poor balance and coordination and as a result frequently fall over. Children’s physio can retrain your child’s body to move without falling over. Poor balance can be caused by a multitude of underlying issues, not only can a physio can work out what the root of the problem is they can also challenge the body and improve specific muscle strength to help you tackle this issue. No more grazed knees, torn trousers and holes in tights!!!

Reduced stamina and fatigue – Ever thought your child was unusually tired after the school day? Have you noticed they find it hard to keep up with the rest of the family on family days out? Even when doing fun activities that you know they enjoy such as birthday parties and trips to the theme park do you notice that your child is struggling to take part? Tiredness and fatigue are a common complaint of many children, but not something that has to start limiting your child’s function. If tiredness becomes an issue for your child a children’s physio can help address the issue and teach you and your child ways of managing fatigue and gradually increase fitness and stamina to help them live a full and active lifestyle.

Unexplained pain in other areas – Sometimes the point of injury is not the point of pain. Your child might have initially injured or had some weakness in one part of their body, only to find that a different part of them suffers, or becomes susceptible to pain and lack of mobility. Sometimes pain can occur without any original injury whatsoever. If your child has pain in their body that cannot be attributed to a specific incident or accident, it is worth seeking a children’s physio to assess for any imbalances and discrepancies in the muscles and movements of your child’s body and advise on how best to move forward.

Disturbed sleep – If your child is struggling to sleep through the night, waking up in pain or complaining of restless legs then you’ll know how significantly a lack of sleep can affect your child. A lack of sleep can often be a result of that discomfort. Sleep patterns are a good indicator of what is going on inside your child’s body. If your child has problems getting to sleep, suffers with restless nights, or simply does not wake up feeling fully rested, one cause could be pain and mobility problems. Seek an assessment from a children’s physio to make sure the discomfort isn’t being caused by something you can easily treat, if shown how.

Delayed milestones – Is your child struggling to master rolling from front to back, are you finding it frustrating that other children in play groups are up and cruising whilst your child is only just sitting. A children’s physio is an expert in the development and movement of children. They are highly skilled in teaching you and your child subtle ways to strengthen and progress their movement patterns so that any delay in development is corrected and your child can reach its milestones with their peers. That way your child won’t only develop physically but they also won’t miss out on all the social development and fun with other children their age whilst trying to catch up.

Do you want to find out more about what children’s physiotherapy can do for you and your child? If you can relate to any of the above points you won’t regret seeking some advice from the professionals to help your child live a full, happy and healthy life.