The More Ya Know: A Chat with Dr. Courtney Disterhaft-Zumer, Pediatric Physical Therapist.

As a physical therapist (PT) myself, I thought it was only fitting that I have a blog post featuring a Pediatric PT regarding all things related to physical development (and sleep of course)! With that being said, let me introduce Courtney Disterhaft-Zumer.

Dr. Disterhaft-Zumer is a Pediatric Physical Therapist with areas of expertise treating pediatric patients for: torticollis/plagiocephaly, neonatal care, positioning programs, developmental delay, sensory integration, sensory processing disorder, autism, flat feet, toe walking, Cerebral Palsy, Down Syndrome, Juvenile Rheumatoid Arthritis, aquatic therapy, concussion recovery, strengthening and endurance during cancer treatment, and sports-related injuries. She currently works at Fox Valley Physical Therapy, which is a private practice in Oshkosh, WI. She has a 5-month-old son, Maverick, which has recently enhanced the care that she gives to her patients.

One of the main things I think about when it comes to physical therapy in the pediatric population is milestones! What are the ages baby's should be rolling by? Sitting, etc.? Dr. Disterhaft-Zumer says that there is some wiggle room to each milestone, but if you ever have concerns regarding your child's physical development, to reach out to a Pediatric PT and/or your baby's Pediatrician. Please see below for her breakdown of milestones:

Rolling & reaching with both arms: 4-6 months

Sitting up without support (this can include hands on the floor or on their legs): 6 months

Pulling up to stand: 10-11 months

Standing without support: 11-12 months.

Walking: Around 12 months

How might this impact or interfere with sleep? You can tell that many of the above listed milestones correspond with when the dreaded sleep regressions typically seem to occur. Especially at the 4-6 month mark. This is the point in time where your baby's sleep cycle starts to mature, they gain a new sense of awareness from being a newborn, and start to actually become more mobile. Allowing your baby to play as much as possible during the day is one way to help with a regression.

At the 10-12 month age bracket, babies might be start sitting up in bed and pulling themselves up to a standing position. It is important to remember that we need to keep our babies safe! This means that by this age, crib heights should really be lowered to one of the lowest (if not the lowest) position.

What are some common conditions you see in infants that might be preventable?

Developmental delay due to infants not liking tummy time or having enough floor time. Difficulty turning the neck to one side or flatness in the skull due to inappropriate positioning and lack of neck strength.

Tips on how to prevent developemental delay, or a flat head?

Tummy time, tummy time, tummy time. Avoidance of using swings, positioners, and excessive time in carseats. Also choosing the "wait and see" option and choosing not to seek the help of a Pediatric PT right away.

Like you just stated, tummy time is so important! BUT most babies do not enjoy tummy time. What are some ways to make tummy more enjoyable? Dr. Disterhaft-Zumer says:

A lot of younger infants are not fond of tummy time. My advice is to use a prop (boppy or rolled up towel), or a peanut ball in order to help with the enjoyment factor. Infants really like black and white images, mirrors, or musical toys. If none of these suggestions work, you can try tummy time over a parent's bent knees, lay your infant on your chest, or hold them on their tummy with your arm under them. If it seems like they are unable to lift their head, a Pediatric PT evaluation would be extremely helpful!

What are some things parents can do during tummy time? Or just in general to help keep their infants entertained during wake windows?

Looking at black and white images with contrast; giving them a brief break and laying them on their back and letting them try to grab for objects, face-to-face time with caregivers, singing, going for walks, and so much more. I'll be honest-- Pinterest is your friend when it comes to looking for ideas for infant enrichment.

A question I have started to get asked by some parents is if using swaddles can hinder or slow an infant's development. My thoughts are, as long as a swaddle is being used appropriately for short periods of soothing and during periods of sleep, it should not interfer with their physical development. What are your thoughts on this question? She says,

"Swaddling helps promote physiological flexion, or the "newborn scrunch." This position helps the infant feel safe and decreases the startle reflex. This helps with a deeper and better quality of sleep."

So far we have mostly talked about physical development when it comes to infants. But let's talk some about older kiddos who have special needs or different health conditions including but not limited to: ADHD, autism, Downs Syndrome, etc. A lot of these children can struggle with sleep. And a lot of these children's parents can struggle with creating a concrete bedtime routine for their children to follow. It can be hard for parents to make a good routine because their children probably struggle with change. If your child is struggling with change, Dr. Disterhaft-Zumer reccomends,

"Try to change only one thing at a time. Try to make it as fun as possible (use hand made story books, sticker charts, etc.). New habits and routines can be established, but children sense anxiety in parents. So be confident in the decisions you are making for your child!"

I want to thank Dr. Disterhaft-Zumer for taking some time out of her day for this discussion. Lastly, as a newer mom and pediatric PT, are there any final last words of advice that you would like to share?

If something doesn't feel right, ask for help right away. Don't just accept this as the "new normal." If you have any questions or concerns, please contact me at my clinic, 920-235-8966 and ask for Dr. Courtney. We can work out a way to schedule a virtual or in-person visit to help with any concerns you may have.