Every parent knows the feeling - you stare at your child for hours, analysing every gesture, every smile, every head movement. On the one hand, you are happy that he is growing and developing so quickly; on the other, doubts arise. "Why does he always look to one side?", "Is it normal for him to bend into a C?", "Maybe it's just my imagination, but something doesn't add up here...". It's natural to want to make sure that everything is going correctly and that no asymmetry in infants appears, for example.
Symmetry in child development is more than just "nice body positioning". This is the foundation for correct motor development, balance and coordination. Therefore, it is useful to know when parents' observations are just a simple concern and when they can be the first sign of asymmetry, requiring consultation with a specialist.
Diagnosis of asymmetry
Recognising asymmetry for parents is very difficult. However, more and more parents are coming to our Kids Medic therapy centre in Warsaw who say they have a feeling that something is wrong. Sometimes it happens that the father or grandmother has doubts, whether the child's development is normal - mums are not the only ones who are alert. And again, I must admit to you, dear parents, that your intuition is unfailing.
Sometimes the asymmetry is large, obvious and the doctor will have no doubt that the child should be referred for rehabilitation. There are also times when the asymmetry is discreet, or only visible during the child's activity, such as when moving around.
It is worth knowing that the longer the asymmetry in a child persists, the more difficult it is to deal with it and more serious may be its future health consequences.
What is the assessment of symmetry?
We assess the child on a firm surface, such as a foam mat, rather than on a soft mattress. When looking at a symmetrical child we can see that the head is aligned with the spine, the auricles are equidistant from the shoulders. The shoulder and hip rims are parallel to each other. It is important that the child turns the head in both directions.
We assess symmetry not only in the static, but also in the child's spontaneous dynamics. We check whether the month-specific skills are symmetrical, whether qualitatively and quantitatively the child presents symmetry.
As paediatric physiotherapist in Warsaw I assess, for example, whether the child turns from back to stomach through both sides and, if so, whether he or she does so correctly. The child can turn only through one side. He or she may also rotate through two sides, but through one side in the correct way and through the other side in an incorrect pattern. Parents usually notice that the child bends the body into a "C" shape.
Is asymmetry something to worry about?
You may now ask yourself - what difference does it make when it comes to child development? The answer is: very large. Overlooked asymmetry in infants very often has consequences in his later years of life.
Effects of asymmetry in children:
- scoliosis
- flat feet
- back pain
- hip pain
- deformities of the head and face
- balance and coordination problems
- abnormal occlusion
- visual impairment
Where does asymmetry in infants come from?
The causes of asymmetry may vary. It can be a consequence of positioning in fetal life. The small amount of foetal water or the rapid descent of the baby low into the birth canal means that the baby has limited movement in the mother's abdomen. It can happen that it is positioned asymmetrically for a long time and presents the same positioning after birth.
Sometimes the asymmetry will be a consequence of a difficult birth. There are also cases where asymmetry in infants is acquired through incorrect care of the baby, e.g. putting the baby to sleep on one side only, carrying the baby on one arm only, feeding or putting the baby to sleep always in the same position.
Babies with colic or reflux are more prone to asymmetry.
Red flags, or what should we be concerned about?
- the child's head always or almost always points in the same direction
- inclination of the head to one shoulder
- flattening of the back of the head
- strong preference for looking in one direction
- placing the body on one side
- grasping toys with one hand only
- body arrangement in letter C
- body sinking to one side
- difference in the size of the eyes or cheeks
- performing activities to one side, e.g. sitting down, turning, creep using only one arm or leg
What does asymmetry therapy look like?
The important thing is that asymmetry can be "cured". Very often it is enough to show parents the correct care for their child, 2-3 home exercises and there is no trace of the asymmetry.
If a child comes to us with established or very severe asymmetry, the therapy takes longer. It consists of exercises with a physiotherapist at our centre and the continuation of selected exercises at home by the parents. In extreme cases, rehabilitation is combined with stunting therapy.
Asymmetry in infants is not the end of the world
If you see the right specialist, he or she will examine your child thoroughly, draw up a therapy plan together with you and make you quickly forget about the asymmetry. The effects are often quick and parents are glad that they did not wait to see a specialist such as the NDT Bobath physiotherapist or Vojta.
We look forward to hearing from you! We will be happy to answer your questions and help you determine whether the asymmetry in a child is physiological or whether therapy needs to be implemented.
Photo source: Freepik.com
Anna Bernaś
Paediatric physiotherapist
