Building Fine Motor Skills Through Play - Infants
When a baby spends a great deal of time in the hospital early on with many altered sensory experiences, it may lead to delays in oral and fine motor skills. It is essential to give your CDH baby a lot of sensory experiences and work on building up strength in their hands to combat any potential delays they may have. If you start noticing delays, you should discuss them with your pediatrician, who will refer you to an occupational therapist if necessary. However, there are many wonderful things you can do at home to get ahead of the game!
Tummy time: One of the best things you can do for your CDH baby is to give ample amounts of tummy time. The American Academy of Pediatrics (AAP) recommends that babies begin tummy time the very day they come home from the hospital. In the beginning, newborn tummy time should consist of two to three 3-minute sessions daily. According to Nationwide Children's Hospital, as they get stronger, you can gradually increase the length of time, working up to a total of 90 minutes a day by 4 months. Tummy time can be done on a mat on the floor or lying on your chest. If your baby dislikes tummy time, try sneaking it in for one or two minutes after a diaper change and gradually increase over time- turn it into part of your normal play, not a chore. If your baby is on oxygen, talk to your child's doctor about whether or not your child might need increased oxygen support while doing these activities. Remember that tummy time activities right after eating might not be very comfortable for your baby and might result in a return of their food.
Feeding Time: At around 6 months, you will likely be able to introduce your baby to eating solid food (always check with your pediatrician before introducing solids). During this fun stage, place tiny pieces of food on their tray and allow them to hand-feed themselves. This will work on their fisted grasps and eventually their pincer grasp. If solids are not recommended, you can also use small toys such as marbles, beads, water beads, etc. but always watch closely to ensure these non-food items are not put in the mouth. Using an empty egg carton, you can put one small piece in each opening and show the baby how to pull them out one at a time.
Exercise Ball: An exercise or yoga ball is great for building up muscles in the hands, arms, and neck as they push up on the ball while on their tummy. They also help with spatial awareness, balance, and core strength. There are lots of YouTube videos that explain how to do these various exercises safely with your baby. If your baby has significant head control and neck strength, you can also try sitting them on the ball and bouncing them slightly while holding their core steady. Slight movements up and down or side to side can significantly improve muscle tone in various parts of the body.
Playtime: Be sure to allow your baby plenty of opportunities to be down on the ground playing with toys independently. The less you use restrictive bouncers and seats, the more your baby can explore. Placing your child on a play-mat with toys overhead or just out of reach will encourage grabbing, holding, and passing toys back and forth. You can also switch up the textures and sounds of the toys to help with sensory integration. Always stay nearby just in case your baby hurts themself or needs help moving away from danger.
Oral Motor: In these early months, many babies will start to put objects in their mouths. This provides a great deal of sensory input and allows them to explore their world using their senses (specifically taste and touch). However, often babies with CDH will be oral averse and refuse to mouth objects. In this case, using an oral motor brush can help. This brush vibrates to stimulate the muscles in the mouth, which allows the muscles to develop in the ways needed for talking and eating solids. This activity requires significant parent attention to assist with massaging the mouth and cheeks while ensuring safety.
Every baby is different. Some will love one activity while others may not. Experiment with involving various toys, music, or singing to help make it more fun. You can also try increasing or decreasing the movement involved – sometimes, just the smallest movement side to side can feel like a major exercise to a young baby. The most important part of all these activities is to have fun! If your baby senses you are having fun, they will be likely to enjoy them as well.
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