FAQs with a Pediatrician :: Part Two - Tummy Time and Headshape, and Feeding and Growth
Dr. Laine Racher is a pediatrician who loves taking care of babies. She ran a full-scope pediatrics practice for over a decade, has experience working with the Headshape Clinic at the Alberta Children’s Hospital, and also has a passion for working with transgender teens. When she set up her practice at Ensemble she narrowed her focus to supporting families with babies up to a year of age.
Her practice has a lot of variety, from well newborns in for their check-ups to medically complex babies navigating multiple health issues. Not surprisingly there are certain questions from parents that come up regularly during her clinic visits, so she thought it would be helpful to compile answers to some frequently asked questions.
Dr. Racher sees families by referral only (information can be found here), and she facilitates a session on Newborn Development and Headshape as a part of our Postpartum Group Program. You can learn more about her here and here.
Tummy Time and Headshape
Why do I need to do tummy time with my baby?
It is important to give your baby opportunities to strengthen their posterior chain muscles, which run from the back of the skull down to the pelvis.
This does not necessarily mean putting your baby on their belly on a mat on the floor! Any position that encourages head elevation counts, such as lying on a parent's chest or being in a carrier and looking up at you.
Can I check to see if my baby has issues with their headshape?
Our babies spend a lot of time on their backs - sleeping on their backs to decrease the risk of Sudden Infant Death Syndrome (SIDS) and hanging out in their car seats and bouncy chairs. Since their skulls are still forming and very malleable this can lead to them developing a flat spot on the back of the skull.
A lot of babies prefer to look to one side over the other, often the right. This means that the flattening of their skull can happen on one side rather than at the back.
While we do this at all well baby checks, you can assess your little one’s head shape by looking at their head from above. Ideally you want to see that their ears are in alignment, without one being further forward than the other, and that their forehead is symmetrical, without one side protruding more than the other. Discuss any concerns you may have with your baby’s healthcare provider.
Feeding and Growth
How can I tell if it’s time to start solid foods?
Most babies are ready to move beyond breastmilk/formula between 4-6 months.
A key sign to watch for is that baby has the oral motor skills to swallow solid (albeit mushy) food. This means that they have the ability to move food from the front of the mouth to the back. You can test their ability to swallow by putting a small amount of food on the tip of their tongue and watching to see what they do with it. If they leave the food there, without moving it to the back of their mouth and swallowing, you can wait another couple of weeks then try again.
Other signs that baby is ready to start eating solids are:
Head and neck control that allows them to sit up. Being wedged with supports in a high chair counts!
An interest in food. If your baby is watching as the kids and adults around them eat, and they are even reaching to try to get in on the action, then those are good signs that they are getting ready to try solid foods.
Does the order of new foods that I offer to baby matter?
A few important tips to keep in mind:
The iron stores that baby is born with start to run low around 6 months, so it is important to start iron-fortified cereals and/or other iron-rich foods by 6 months.
It works well to introduce new foods every 1-2 days.
Highly allergic foods should be introduced one at a time at least 2 days apart. This includes: eggs, peanuts, tree nuts, dairy, soy, and shellfish.
Avoid honey in the first year of life.
Otherwise, I encourage families to keep it simple by pureeing whatever foods the other family members are eating as they offer baby an increasing variety of different foods.
How can I make sure my baby is growing well?
The best way to track your baby’s growth is by following their percentile weight at your healthcare visits. Don’t focus on which percentile they are tracking along, it’s more important that we see consistency around the same percentile. In other words, don’t worry if your child is on the 3rd or 93rd percentile, as long as they continue to follow that trajectory month after month.
Having said that, watch for a growth pattern shift around 2-3 months when babies transition from the influence of their mother to their genetic potential. In other words, they can shift up or down to a different percentile trajectory after 3 months, when the influences they were under in pregnancy are no longer there, and their growth becomes dependent on their own unique genetics.
Are there any resources you recommend to parents?
I have compiled a number of resources on my website. You’ll find feeding information here, and a resource guide on headshape here.