Katherine:

I would agree with all you wrote about working with infants who arch their
backs and necks, and the need to postition them with their hips flexed.
Infants can't eat any better than adults with their necks hyperextended
because of the intricate interplay with  the neck muscles that support the
jaw, cheeks, head, larynx, etc that also coordinate with the sucking and
swallowing muscles. Studying these muscle groups sometimes reminds me of a
delicate ballet. Putting these high toned infants to sleep in a car seat is a
great idea. I also warn parents who have infants like this not to burp them
in the up-over-the shoulder position, which also encourages arching. Often,
parents will say "Look how well he/she is holding up his/her head!" when what
the baby is doing is hyperextending their neck  to balance it on their
shoulders. A better position for burping this type of baby is sitting on the
parent's lap, with the baby leaning forward on the parent's hand. ( I am
using the word parent because this is an activity that a grandparent or
father can participate in!) There is a very wide variety of "normal" tone and
postures, both in adults and in infants, and infants frequently move through
different types of tone and postures as they grow and mature. I would be
concerned, however, with an infant older than 3-4 months who is still
exhibiting excessive or constant arching of the trunk/neck, which may
interfer with development. All babies need to be assessed as a whole baby,
not just on one or two developmental tasks. When in doubt, get another
opinion.


Debbie Rabin, OTR, CLC
Los Angeles, CA