Birth, Baby!

The information provided on this podcast is for general information purposes only and is not intended as a substitute for professional medical advice, diagnosis or treatment.

Always seek the advice of your qualified health provider with any questions you may have.

Never disregard professional medical advice or delay in seeking it because of something you have heard on this podcast.

Reliance on any information provided here is solely at your own risk.

Thank Welcome, this is Birth, Baby.

Your hosts are Ciarra Morgan and Samantha Kelly.

Ciarra is a birth doula, hypnobirthing educator, and pediatric sleep consultant.

Samantha is a birth doula, childbirth educator, and lactation counselor.

Join us as we guide you through your options for your pregnancy, birth, and postpartum journey.

Today, we have Doctor Kristi Hammerle of Year One Wellness with us to share her knowledge of what to expect in the first year in terms of milestones.

Doctor Kristi Hammerle is a pediatric physical therapist and certified breastfeeding specialist.

She's the owner of Year One Wellness, an infant specialty practice in Austin, Texas, where her team works with babies with milestones and other things that may come up in the first year.

One of her passions is educating the community on the benefits of optimal development for all babies.

So you can join her at local baby play classes where she'll share activities and strategies to promote purposeful play, healthy communication and motor development throughout Year One and beyond.

We're so glad to have you here with us today, Doctor Hammerle.

Thank you.

And thank you for inviting me on Birth, Baby.

How are you guys?

Good.

It makes me laugh when I say Doctor Kristi Hammerle only because like we've met you, like you're just a normal person, but doctor sounds so fancy.

And I think if I had doctor in front of my name, I would want people to call me Doctor Ciarra all the time.

Yeah, I get that question a lot.

It's funny because that's my professional title, but I go by Kristi for the most part, and especially being in pediatrics, most kids call adults Miss Kristi, or the parents are used to just calling me Kristi.

So, you know, whatever comes up, I feel like I have about four different names that I go by.

So, I think it's a Southern thing.

I think like Doctor Kristi or Miss, like the kids, my kids' friends call me Miss Ciarra.

My husband hates it.

He's like, you're Mrs.

Morgan.

I'm like, no, I'm not.

Southern thing.

Yeah, it's too formal for me.

Anyways, okay, that's not what we're here to talk about.

I know, and you know, babies can't talk anyway, so it's whatever the parents want to call me.

That's right.

They just like gurgle, it's fine.

They shouldn't be reaching that milestone yet.

They shouldn't be able to talk yet.

They're just checking.

You know, full on sentences, maybe not yet, but I have some cooing and babbling I'm here for.

But like Doctor Kristi Hammerle, maybe that's a little much to expect of your infant.

Okay, okay, good to know.

Good place to start.

So tell us what exactly is Year One Wellness and what do you specialize in other than titles?

Yeah, so Year One Wellness right now is an infant specialty practice comprised of a group of pediatric physical therapists that specialize in working with infants.

All of us have some kind of advanced certification in breastfeeding or are currently working towards that.

So for example, I'm also a certified breastfeeding specialist.

So we help babies with breastfeeding difficulty.

We collaborate with IBCLC lactation consultants for that.

We help babies who have a condition called torticollis, which we can get into, but basically it's like a neck or body tightness due to uterine positioning.

Babies with head flattening.

So in a lot of cases, we can help babies avoid helmets if they get started with therapy early enough.

And then also babies with the typical milestone delay, babies having trouble with tummy time, rolling, sitting, crawling, walking and other things like that.

All right, this was not on our list.

Here I go going off of the thing already.

But you said something that really sparked something in me because when you said due to uterine position, it's funny, I have this struggle between, yes, our bodies are made to do this and this is what we're supposed to do and it's perfectly designed and all of these things, but babies can still come out a little wonky, a little off kilter and needing some adjustment and balance in their body and I think that's really hard for people to have both sides of that that they can believe is that it's all perfectly designed and your baby may need some help once they're outside of your body.

And we didn't know about all of this stuff way back when.

So do you think that this is something that is new, things like torticollis, or is it just that we now know about it and we're able to improve physical function because we know about it and have these tools?

That's a great question.

I think it's a little bit of both.

What I'm seeing is that there is much more awareness and knowledge about how babies are supposed to typically develop.

There is a general typical progression that babies should be doing when they come out.

So there's more knowledge about that.

With social media, social media can be helpful or it can be a bit much sometimes, but there really is, you know, it's a platform for us to share what we know.

And I think through social media, we've been able to share, hey, this is what we do with babies.

This is kind of what you can expect to see from specialists like physical therapists that do work very, very closely with movement and motor development.

So on the one hand, I think that some of these things have always been there.

There's just more of an awareness now.

And then on the other hand, there was an uptick in babies needing physical therapy and other therapeutic supports with the back to sleep, safe to sleep recommendations that started in the 90s.

And they're amazing recommendations because we really have seen a decrease in SIDS, but on the flip side, as far as motor development is concerned, these babies are being so swaddled and contained for much longer throughout the day than they used to be.

They are laying on their backs, which any kind of neck tightness or body tightness, muscle tightness that they were born with isn't being worked out like it would if they were belly sleeping.

And then we're also seeing a way higher rate of head flattening because of the amount of time babies are spending on their backs and on the back of their heads.

So I really think it's kind of a mixture of both, but I would say infant physical therapy, infant therapy has definitely increased in the more recent years.

So interesting because I never even put those together that, you know, with the Back to Sleep campaign, isn't it interesting how sometimes we fix one problem, which is the bigger problem, right?

We want the babies to stay alive.

So clearly that's the bigger problem, but then we end up creating another problem by accident that's less severe, but does need to be addressed.

And for the specifically like for head flattening, what is the problem with that?

So like, so what, so what if their head is flat?

Like what problems does that cause in the future?

Yeah, great question.

So with head flattening, there's kind of this big, you know, is it, is it just cosmetic?

Is it not cosmetic?

When do we need to intervene?

When do we just say, hey, all of us have some kind of flattening?

And I think with everything, you know, in the birth world, everything with babies, it's not so black and white, it depends.

And so when head flattening is more cosmetic, it is contained to purely the back of the head.

And when it maybe shifts into the realm of being not so just cosmetic and maybe being something we do want to address is when there's been more shift of other cranial facial bones.

And I'll kind of explain that a little bit more.

The way that heads are shaped and formed after birth is through pressures on the head.

And because infant skulls are so malleable, especially in that newborn zero to three months, wherever a baby has pressure on their head, wherever that part of the head is contacting the surface it's laying on, it basically stunts in growth or doesn't grow in that exact spot while it's contacting the surface they're laying on.

So say you have a baby that doesn't have any neck tightness, they're looking right, they're looking left, about 50% of the time book directions, the head, the skull kind of gets stunted, essentially an equal amount and you don't really realize it and the head is nice and round.

But when a baby has a head term preference, maybe because of torticollis or a neck tightness, there's not excessive pressure, but there's more prolonged pressure on one spot on the head, the back of the head and that can cause flattening.

What happens because the craniofacial bones are so interconnected is when there's flattening on one side of the head, it pushes the bones around that spot out.

So say you have a flat spot on the back side of the right side of your head.

Well, it's gonna push the right ear and the bones around the right eye and cheek and jaw forward if it gets flat enough or severe enough and that's when you start to see some jaw shifts, some asymmetrical jaw alignments, it messes with the bones around the nasal cavity and the palate and that's when you really can start to see some interference with say, latching or chewing or breathing.

And so where something may start out a little less severe, you do wanna recognize it early, that way we can intervene and kind of prevent the latter, if that makes sense.

And I imagine if like, if bones are starting to shift, you would start to see eventually that kind of like, traveling down the body as well, and maybe like going into some, you know, spinal stuff eventually someday too, which would be a problem later in life as well.

That's interesting.

Yeah, symmetry is the name of the game for babies.

We all have a little bit of asymmetries, but for the most part, we want babies in their first year to develop very symmetrically, develop the muscles on both sides of their bodies evenly, that way they're set up with the best foundation for more advanced skills like walking, running, jumping, skipping, and things like that.

So if someone wanted to come see you, would they need to have a referral from a medical provider or can they just come in without a referral?

This is specific state by state for physical therapists.

So in the state of Texas, you don't need a referral to visit a physical therapist and you don't need one for 10 to 15 business days after you have that first initial visit with your physical therapist.

After that, we do need a referral on file to continue practicing.

That's just what our state board requires of us right now.

And I know as a pediatric physical therapist, I love parents being able to call me directly and us being able to get in right away because a lot of the diagnoses I help babies with are very time-sensitive, but I'm always reaching out to the pediatricians immediately and just letting them know what's going on because I think with babies especially, with everyone, but babies especially, it's just so important to have that collaborative care team.

So even though you don't need one, I still like to give the pediatricians a heads up.

And usually they're great with babies seeing PT.

Is this an insurance thing?

Like if people use insurance, do you like do most physical therapy?

I mean, you can't probably answer for most physical therapists, but I guess for you and the ones that you know, do y'all take insurance or is this more of an out of pocket deal?

With a lot of infant specialty practices, it's out of network right now.

And that's because of a lot of different things.

One is insurance reimbursement rate.

One is the restrictions that insurance companies place on practice, especially with infants.

So many of these infant services, even if we decide to take insurance, insurance wouldn't cover for them.

And sometimes the amount of time it takes for an insurance company to approve services, that's precious time that we really need with these infants to get started.

So we're an infant specialty practice.

We're out of network with insurance companies.

So what we do is provide super bills after every visit to everyone.

And it has all of the medical and treatment codes on it needed to be reimbursed by insurance.

So you can submit to your insurance.

They can take a look and decide, yeah, we'll go ahead and cover this or no, it's not in your plan to have out of network services.

That's helpful.

Yeah, it's difficult.

I mean, even with us, we don't take insurance either.

And we do something kind of similar.

So I always tell people, we're not judging you that you don't take insurance.

I'm just asking because people ask us all the time about what types of services will.

So what are some of these milestones that people should be looking for in the first year of life?

Let's get into the meaty, gritty part of it that I'm sure people are listening in for.

Yes, I would love to talk about that.

I'm gonna talk about the major milestones first.

And then we can chat about something called mini stones or mini milestones.

What we're really seeing, it used to be considered that tummy time was kind of the first major milestone, the first thing your babies are doing.

But now as we're really looking more at babies, really breastfeeding is the first movement milestone.

Breastfeeding, feeding in general, but breastfeeding specifically does require a set of appropriate feeding and postural and gross motor skills to be put together to allow a baby to successfully eat at the breast or chest.

And when it's difficult for a baby to do that, it gives us a little bit of a clue on something.

Something might not be working exactly like it should, or we might be able to intervene to help a baby in this certain way.

So many of the babies that are having certain feeding challenges are also having tummy time difficulties and vice versa.

So I really like to consider breastfeeding that first movement milestone.

Then you've got tummy time.

Everyone's encouraged to do lots of tummy time these days because of those back to sleep recommendations.

So tummy time can be very telling if a baby is having trouble lifting their head or turning it side to side.

There might be some tightness.

There might be something going on there that could be worked out.

Then how babies develop is really from head to toe.

So if you think about it, the first thing that they're doing as little newborn babies is lifting their head from tummy time and maybe tracking back and forth or turning their head side to side.

So those first skills kind of start at the head and neck.

Then babies start to push up onto their arms and tummy time.

So now we're moving down to the shoulders.

As we gain strength in the neck, it moves down to the shoulders.

Then they start to roll.

And so now we're moving down to the abs and they develop all the strength and coordination there.

Then we move into sitting and crawling.

That's the hips and legs.

And then kind of end with standing and some advanced walking and movement skills.

And that's the legs.

So you can see how having that really good foundation from day one really builds upon and can help create a good foundation for toddlers even.

Laughing at myself right now, have you seen the little saying that's going around?

It's like, I was today years old when I learned that blah, blah, blah, blah, blah.

Well, I was today years old when I realized like, I mean, yeah, it goes from the head down to the toe.

Like that was so cool how you just explained that.

And I'm sitting here, nobody can see my face because we're on a podcast.

Well, y'all can, but.

And I'm like, my face is just like a surprise.

Okay, yeah, that totally makes sense.

And if any one of those steps is kind of missed along the way, it can see how it would be a hindrance to the next step.

So that is so cool.

I love how you just broke that down and explained that.

Yeah, it kind of goes back to what you said.

You know, like we are all kind of designed to move in a certain way and to have things work out.

And that doesn't mean things can't pop up, but generally there is kind of a process, you know?

There's a method to the madness here.

Yeah, that is really interesting because it does happen.

I mean, even with breastfeeding itself, like when they do that breast crawl right at birth, it starts with the head and then you start seeing it kind of moving through their body all in those first few moments.

So it makes sense that as their development continues, you see that happening as well.

That's really interesting.

I like that.

And I do wanna also just mention that just because a baby might've had trouble with something at a certain stage, it doesn't mean that they won't be able to progress or to do another skill with good quality.

And there's always those basic foundational skills that are created, say, in tummy time, there's always ways to work on that later in those later stages, just in more developmentally appropriate ways.

So just, you know, I don't wanna instill any anxiety or panic in anyone if their baby did have trouble breastfeeding or tummy time.

There's ways to address that with play and movement later on down the line.

100%.

Every baby is different just because we have this set of, and I tell this to parents all the time, and even in pregnancy, just because we have this set of expectations, it doesn't mean that everybody is gonna do it in the exact same order, and it's not gonna look the same for everybody.

So it's okay that your baby is doing things differently.

All those guidelines just exist to give you an idea of what we would generally expect to see for the average, but there's gonna be some who are below and some who are ahead, and that's okay too.

I remember my son was, he was pushing up on his little hands so early, and he had the strongest neck, and he was doing all that from days old.

And then my daughter was just completely happy to not do that in the slightest bit.

And it's just different kids do things differently.

Different kids, we all have different bodies, we all have different genetics and muscle tones, and every kid thrives in a slightly different way, and that's really so true.

Yeah, absolutely.

So, if someone's baby isn't meeting these milestones, how do they know if they should intervene, or will it correct on its own?

So, you know, the only way to really know why a baby isn't meeting a milestone at the time that they might not be is getting assessed by a specialist in that particular area.

There is a range of typical development for each milestone.

So, for example, crawling typically is achieved between 8 and 10 months.

So, you know, say it's 8 months and your baby isn't crawling yet.

Maybe you give it a little time just to see if, hey, that's their body, they just need an extra month or two.

It's still within that typical window.

Maybe you're approaching 10 months, and it starts, and great.

I would say, you know, move on, move on with your day.

Keep on keeping on.

But maybe you're getting into month 11, you're noticing your baby isn't really moving out of sitting or they just kind of, you feel like they've plateaued.

You feel like you've just got that gut instinct that something isn't right.

That's when maybe some intervention is needed.

And when you get assessed, you know, your therapist can figure out why isn't that baby crawling.

Is there some tightness in the hips that just needs to be addressed?

Is there, you know, a fear, a sensory or vestibular reason why crawling might not be happening and a little bit of fear of movement there?

Is there just maybe some shoulder weakness?

Maybe your baby didn't spend a lot of time in tummy time and they just haven't developed those shoulder muscles and they don't feel confident enough to support themselves on hands and knees.

Your therapist can help figure out what the root cause is and then just target that specific root cause in a play-based way.

Help your baby pick up those skills and move on with their developmental progression.

All right, well, you mentioned mini stones.

What are mini stones?

I've never heard that term before.

Yes, mini stones.

So everyone typically thinks about milestones as the big stuff, sitting, rolling, crawling, walking.

And the mini stones are all of the little activities between those big milestones that are just as important in giving a baby all the tools they need to really explore their environment.

For example, when a baby is younger and rolling between their back and belly, they're going to start reaching, reaching for toys on their back.

That would be an example of a mini stone.

When they're on their belly, they're going to start pivoting or moving in a circle on their belly.

That would be a mini stone.

Transitioning up and down from sitting and crawling or sitting in the floor position is a mini stone that you might not think of initially, but that are very important for your baby to be able to independently explore and practice movement.

So there's just, it's just all those little things in between the big stuff that should be happening.

One that people ask me about all the time, because I'm a sleep consultant as well, is when is my baby gonna know how to put their pacifier back in their mouth?

I was like, well, they can learn before they would naturally learn if you want to like actively help teach them during tummy time.

I was like, spread a bunch of little pacifiers around and kind of play with them, not tease them in a mean way, but kind of work it back and forth with them so that they can learn how to put it in on their own.

And then you just hack the crib with a bunch of pacifiers so they can find one in the middle of the night.

Would putting a paci back in kind of be a mini stone?

That kind of hand to Mel?

Yeah, absolutely.

It's a combination of recognizing an object, being able to coordinate reaching out for it, grab it with your fingers, bring it to your mouth in the appropriate orientation.

So absolutely, I would consider that a milestone.

And just like you said, that's exactly what I recommend to parents, setting up the environment to give the baby success with their abilities, their normal development.

So putting a bunch of pacifiers around in areas that they can reach and then just having them figure it out for themselves over time, along with helping them if they need help.

But setting up that environment is really important too.

Yeah, so since a lot of these things that we're talking about can be done during tummy time, like turning around in tummy time and rolling back and forth and all that, how important really is tummy time?

Because you said earlier that we really kind of only do this because of the Back to Sleep campaign, making it so that we need to do more of this.

So how important is it and what kind of things qualify as tummy time?

Because I think people might have a really rigid view of what tummy time looks like.

Tummy time is very important.

As a physical therapist, I definitely do believe that.

But there are different ways to support babies in tummy time.

You know, before the Back to Sleep campaign, I think the term tummy time wasn't really as much of a thing because since most babies were sleeping on their belly, they just naturally got in a lot of tummy time.

You know, they'd gradually wake up, play on their belly, until they got fussy, and then parents would come in and pick them up.

And they just got all of that good strengthening.

So what happens in tummy time is your baby develops hand-eye coordination, visual spatial skills, shoulder girdle strengthening, pectoral and abdominal strengthening, the ability to practice their feeding reflexes by mouthing and sucking on their hands, you know, neck and back strength.

It's just so good for everything.

And other positions are too.

Back play is very important for motor muscle development as well, as well as sideline play.

But tummy time is a big one because it's done the least nowadays.

So that's why people really push it.

When you're in that newborn stage, tummy time is going to look a lot different than when a baby is four or five months.

And tummy time in that newborn stage might look like laying on your chest, picking up their head a little bit.

It might look like rocking a baby in tummy time on an exercise ball, which is one of my personal favorites.

It might look like putting a little blanket roll under their arms to give them a little extra support or doing it over a boppy.

And then, you know, as a baby gets stronger in those positions, maybe around, you know, two months or so, you start doing more direct floor or on a tummy time mat play.

It's very safe.

It's very appropriate to put babies directly on a flat surface right after they're born, but they might last a little bit longer in some of those alternative positions like on your chest or on a ball.

I love that.

Yeah, tummy time, I get asked about that a lot, and I always tell, you know, my clients who have newborns, because that's when I mostly see babies is right, you know, a couple days after they have them, I always tell them, you know, tummy time, you don't have to be rigid about it, but you do need to do it.

Tummy time for a newborn can look like you laying on the couch with your newborn on your chest and looking at each other because that's encouraging your baby to hold up their head and start using some of those muscles, and it encourages them to do those things without, you know, screaming their little heads off because sometimes babies just do not enjoy being put on a cold, hard ground with nobody nearby.

No, absolutely not.

It's just like us.

Sometimes throughout the day, sometimes we're more motivated and ready to work out, and sometimes we're just not, we're not having it.

It's just like that, too.

So one of the number one questions...

Feeling that real hard right now.

Yeah, yeah, all of us.

The colder weather is making me really...

It makes it hard.

It makes it hard.

One of the major questions I get as a physical therapist is, tell me how many minutes of tummy time I'm supposed to do.

And I like to do that.

I mean, I like, I empower parents to just read their baby's cues.

I like to encourage parents to every daily wake cycle, try to, you know, when baby's happy, fed, changed, try to do a little tummy time, whether that's on your chest or on a tummy time mat, stay with them, you know, lay down in front of them or maybe put them up on the ottoman so you can sit in front of them if that's more comfortable, so you can be face to face, sing to them, rub their back.

And if they're only good for two minutes, cool, roll them out of it and try again a little later or try it the next week cycle.

If they happen to stay there for 10 minutes or even like rest their head and start mouthing their hand, but they're okay, just leave them there.

They're chill, they're happy.

So it's fluid, it's flexible, it isn't such a rigid thing.

You're just kind of monitoring baby's response to all of that, gradually increasing the positive association with tummy time.

Yeah, 100%.

I love it.

So what about crawling?

We hear this one a lot.

I hear moms and mom groups even just talking about this.

Like, oh my gosh, is my baby going to crawl?

And then you see all the conversations like, oh, babies don't have to crawl before they walk.

That's not a real milestone.

And then you hear the others like, no, it's absolutely a milestone.

So settle it for us as a PT.

Is it a milestone?

What happens if they don't do it?

I will for sure.

Before I do that, what do you guys think?

As you're in the birth world, you're in the baby world, but, you know, you're not sure.

You're both moms.

What do you think about crawling?

Oh, sure.

Who's interviewing who?

I'll go first.

I think that it is really important to learn how to crawl, but I don't know how important the order is.

I feel like even if a kid learns how to walk first, they're eventually going to learn how to crawl.

I know my daughter for a long time was like pulling up and trying to take steps, even though she didn't succeed before she crawled.

So she seems all right.

Yeah, I think I agree.

I don't think that the order necessarily matters, but I will say having a nine-month-old that's walking is absolutely terrifying.

And I like crawling for that reason.

It's creepy.

It's so creepy.

My daughter walked it nine months.

It's really creepy.

Sorry for anybody listening with walking.

I'm allowed to say it.

Here you are.

But I don't know.

I remember when my son, my first born, when he started walking, it was horrifying watching him walk.

I wanted to buy a helmet for him because I was terrified that he was just going to smack his head every time.

And he did.

He smacked his head so many times.

And my husband was like, this is just what babies do.

It's fine.

He's fine.

But I wanted to buy a helmet for him because I was so scared.

And then when my daughter started, it felt a little, I don't know, because I'd been through it before, it felt a little bit different.

But she did the rolling thing.

She didn't really crawl a whole lot.

She did the rolling thing and would happily just roll her, like just this little child rolling herself all around the house.

And she did that forever.

I think she really only crawled for like a couple of weeks before she started walking because she was just so content to roll.

That's right.

And some kids do the little leg drag thing where like it's one leg.

It's almost like they move scoot.

Like they scoot, yeah.

That's my favorite one.

Yes.

There's so many variables around crawling.

And your baby that rolled everywhere probably developed amazing abdominal control and strength doing that everywhere.

Oh, totally.

She's a rock star.

I love when babies do that.

Yeah.

So here's the thing about crawling and the controversy and the mix up.

Is it important?

Is it not?

Is your baby going to be fine?

I think that with a lot of things related to babies, there is so much shame to parents.

Is your baby meeting this milestone by this age?

What do they look like, you know, comparing one baby to another?

And I think that, first of all, of course, I think crawling is an important milestone, and I'll explain why.

But I think that, you know, there was this such heavy push on crawling maybe at first, and then, you know, what does that mean for the babies that didn't crawl?

You know, it doesn't mean that they're any less.

It doesn't mean that they're not going to be athletes.

It doesn't mean that they're not going to be intelligent or worthy.

And so I can see why there's this push back in that regard.

If you think about the benefits that crawling does give, there's a reason that it's an important part in the developmental progression.

When a baby spends time on their hands and knees and they're doing a nice, good, reciprocal crawl, which means opposite arm and leg movements, both knees down, ideally, there is that janky crawl and other crawl patterns that can mean different things.

And we can talk about that if you guys want.

But, you know, there's so much coordination happening between the right and left sides of the brain and the right and left sides of the body.

There is, again, all that shoulder girdle strengthening.

There is development of the hand arches, which is really gonna help with handwriting in the future.

A lot of your balance and postural reactions and coordination that help with walking and help with skipping and riding a bike and some of those more advanced motor skills are really developed when babies crawl.

Now, say a baby skips crawling and starts walking.

Yeah, just get back down and start doing crawling later on.

When they're a little bit older, get a tunnel.

When their toddlers have them do lots of crawling through tunnels and climbing, and they're gonna develop those important skills that they would have had they crawled before walking, too.

I don't think it's so black and white, personally.

I want to see that those skills are being incorporated into play somehow, like you guys said, if a baby crawls first, it maybe delays that walking a little bit, and so when they do start walking, it's a little less scary.

So that's my view on crawling.

I definitely think it's important.

Is your baby gonna be any less if they don't crawl before they walk?

No, just practice those skills at some point, you know?

I love it.

That makes sense.

We like balance.

For sure.

We're all about balance here.

So you said a couple of things, a couple of times you've said, and we can get into that, or we can talk about that if you want to.

Girl, we have you here.

We're going to use you for all you want to give us.

So if you have extra knowledge you want to drop on us, do it.

Yeah, I will.

I could talk about this stuff forever.

So, you know, you can cut me off if there's any catches.

So there is a more preferred method of crawling, and it is both hands and knees on the ground, both, you know, right and left movements happening when a baby gets up and down from the floor, they're kind of going over their right and left hips about evenly.

And that goes back to in the first year, we want all of the muscles to be developing as symmetrically as possible on both sides of the body.

That way there's less postural asymmetries down the line, there's less compensatory movements, you know, our right side being so much stronger than our lefts, et cetera.

When a baby crawls with an asymmetrical pattern, which might look like one leg up or like one leg falling behind or one foot on the ground, it usually does indicate either some kind of hip restriction or some kind of weakness, either in the abdominals or the hips that's causing them to keep a leg up or to keep their weight shifted on one side of their body.

And I mean, if you get down and crawl with one knee down, one foot up for a while, you're gonna feel that one side of your muscles are getting worked a lot more.

And we just, we want it to be balanced because again, we want to give babies as good of a foundation as possible.

And again, if your baby crawled like that, there's other ways to work on strengthening and doing other things like manual therapies to make sure all any of that tightness or weakness is worked out later on.

It's all about symmetry, right?

Like we want to be all lined up, just like what you said in the beginning.

That's huge.

I feel like we talk about this stuff in labor or pregnancy too.

We're always like, do spinning babies, do the three balances, you know, having each side of your, like, can we do only do one side of the side lying release?

No, you have to do both because we want balance in your body.

So it goes all the way, you know, to your baby and then throughout life.

It really does.

It really does.

Yeah, I know.

I was just just like, I always get the question or comment, Oh, my baby's going to be right handed or or when does my baby show handedness?

It's really not until closer to between two and four years.

So if there is a significant preference of your baby using one hand or one leg, it might be a little bit more of a either joint tightness or muscle weakness kind of thing going on.

Oh, that's interesting.

That's not something I've ever even thought about.

Yeah, because people might just think it's because they have a preference for that side due to coordination of like mind and body brain sort of stuff.

So that's really cool.

So is there anything we missed?

Anything else you want to talk about before we let you go?

Let's see.

We could talk to get about a good deal about milestones.

I will say with head flattening, that's a pretty popular topic in infancy these days.

Head flattening and helmets.

And if you start therapy early enough and address the root cause of head flattening, which is typically tight neck or tight body, you can avoid a helmet.

If we get in there and loosen up those muscles and we do very strategic repositioning strategies to help keep the pressures on the parts of the head that we want to help round it out.

You can absolutely avoid a helmet, but you do have to start young.

And by young, I mean about three months and younger.

And really parents are the best people to recognize these things if they know what to look for because they are seeing their baby's postural preferences much more than, you know, your pediatrician, any other provider just because they're the ones spending all the time with the babies.

So if you do notice your baby has a head turn preference early on, look at the head from the top down.

If you feel like one side is getting a little bit flat, reach out to someone.

If you'd like some help before you kind of get to that four or five month window, you still need to get the root cause addressed.

But at that point, it's much harder to correct the head shape and you're probably going to have to go to the helmet route if you're not happy with your baby's head shape.

So I just always like to empower parents and doulas and lactation consultants and anyone seeing babies early on that there is a window of optimal opportunity here because I know a lot of parents are disappointed when they don't know that.

Yeah, I have noticed just from being educated by you and the other people in our community that when I go to even a postpartum follow-up meeting, if I see a baby is turning their head to one side pretty significantly, not really moving to the other side, I'll even kind of test it.

I'll be like, let me see, we'll try to move the baby to the other side and they flip right back.

So it's something that I mentioned to parents too, because a lot of times parents are thinking about so many other things in those early days that they don't even notice.

Or their baby has a preference for only being on one breast and then the other breast they have to do football hold because they can't get their baby to latch without a football hold.

I'm like, do they not want to turn their head that way?

You might want to go get an assessment to see if that might be what's going on because that could fix the issue.

So you inspired two new questions in me about that.

One is what age are babies generally when people are saying, oh, my baby needs to get a helmet or that's being recommended.

And then the other question with that is you were saying it's good to start three months and younger with these exercises with the PT.

Is this something that also you need chiropractic care for?

Is that something like do people do both or is PT sufficient for this?

So I was so to your first question, I would say in my experience, I am noticing that a lot of babies, the torticollis and the head flattening is getting noticed at the four month pediatrician appointment, the four month well check, because typically at that point, it's advanced enough to where it's very obvious.

If a family is lucky, it'll get recognized at the two month or earlier.

If they're really lucky, and they will be recommended to start therapy now.

I don't know that every professional, healthcare professional out there knows that physical therapy can make such a difference in head shape and movement and mobility.

And so they might not be getting recommended to start physical therapy.

So it's definitely something that I would encourage you to bring up to your pediatrician.

Usually they're very receptive when parents bring up those kinds of concerns early on.

And then tell them, hey, I would like to see a physical therapist.

Can you write a referral?

Or hey, I'll be reaching out to one myself, just FYI.

And that can really, really start.

Because the well checks are early on and then two months and four months.

And so if it's not caught at two months, it's not really being looked at again until four months.

So just being aware and advocating for yourself and your baby.

And then as far as chiropractic care and other therapies, chiropractic care is typically a manual passive therapy.

Physical therapists do manual therapy as well, but I think any form of manual therapy helps.

So it's totally up to you.

If you want to get physical therapy and chiro, if you want to get physical therapy, chiro and cranial sacral, more power to you.

I do think that the functional component of physical therapy, so once we loosen up those tissues in the muscles and the joints and the fascia, whatever it is that's needed, we follow it up with functional retraining, which is a really important piece to help it stick.

For example, after we loosen up a baby's neck, we're going to play with that baby in tummy time, we're going to make sure they're tracking both ways, we're going to make sure they're turning their head to either breast so they can actually use the new range they have, and that's really what makes a good new movement pattern stick.

But all the therapy, I mean, really, the more the better.

It's not always easy to get to everyone, but yeah, the more the better for sure.

Yeah, absolutely.

I mean, we always tell people, I think that all of these things are great, and if you can do it all, then do it all, because that is what's going to get things done the fastest and help your baby the most.

But in the long run, we can't all afford to go do all the things, both financially and just time-wise, and emotionally, that's a lot.

So kind of figuring out what works best for you and what's working for your baby too in those situations.

Maybe some things are going to be more effective than other things.

So kind of picking and choosing.

So with that, how can people find you if they want to learn more or get services with you?

So pretty much on all socials, you can find me at Year One Wellness, and that's one spelled out O-N-E.

And then you can also visit my website yearonewellness.com.

And then if you are local to Austin, you can come see us at our monthly Blooming Baby Play Classes where we have different classes for babies from 0 to 18 months that I host with a speech therapist.

And we talk all about motor development, play, language.

We build community.

We do social activities.

And we also chat with everyone individually in case they have more personal concerns that they want to chat about.

So, that's in Central Austin.

We would love to see you.

I love it.

And we'll link all of that in the show notes for everybody so you can go find that and connect with Kristi easily.

Thank you so much for coming on.

I think all of this was really great information.

I learned a lot today.

Me too.

And I'm excited to share this so everybody else can hear as well.

Yeah, thank you so much.

Yeah, and thanks for letting me come on and geek out about baby development.

And congrats to you guys too on your amazingly successful podcast.

Thank you.

I know everyone in the Austin birth community feels so lucky to have you guys sharing this information.

And you guys are just also really fun to hang out with.

So that's all we asked for.

We just want to be cool.

Thank you for joining us on Birth, Baby.

Thanks again to Longing for Orpheus for our music.

You can look him up on Spotify.

Remember to leave a review, share and follow wherever you get your podcasts.

See you next week!