Nine years ago, when I had my first baby, infant physical therapy wasn't even on my radar - it just wasn't something being talked about, especially not the way it is now. So I sat down with Dr. Brita DeStefano, founder of Progress Through Play in Denver, a mom of two and an infant physical therapist who's spent the last seven years specializing exclusively in that first year of life, to change that for you. We get into what infant PT actually is (spoiler: it's so much more than "my baby isn't rolling yet"), and Brita breaks down how womb positioning, delivery, and even reflux can all show up in your baby's body as tension - impacting everything from feeding to tummy time to sleep. We talk about torticollis, head flattening, and her favorite at-home "boomerang test" that can help you catch tightness before your pediatrician might even notice it.

Join The Breastfeeding Blueprint: www.thelabormama.com/breastfeeding & use the code PODCAST to save 20%

What I loved most about this conversation is how Brita reframes the whole thing - it's not about parents needing to be on high alert, it's about approaching your baby's body with curiosity instead of worry. We also get real about the accessibility side of things, because I don't think we talk enough about how frustrating it is that this kind of proactive, whole-body care isn't always covered by insurance or easy to access. If you've ever wondered why your lactation consultant is asking questions your pediatrician isn't, or you've just felt like something's a little off with how your baby is feeding or sleeping and couldn't put your finger on it, this episode is going to hand you the language - and the confidence - to advocate for your baby.

More from Dr. Brita DeStefano:

Visit ptpdever.com

Follow her on Instagram @progressthroughplay

Helpful Timestamps:

• 00:00 Meet Dr. Brita, Infant PT
• 05:47 Why Infant PT Matters
• 09:33 Feeding Referrals and Early Support
• 15:29 Curiosity Over Anxiety
• 20:44 Womb Position and Birth Tension
• 26:37 Torticollis Signs and Screening
• 29:49 Flat Head Prevention Tips
• 33:35 Reflux Digestion and Movement
• 40:50 Resources

About your host:

Lo Mansfield, MSN, RNC-OB, CLC is a registered nurse, mama of 4, and a birth, baby, and motherhood enthusiast. She is both the host of the Lo & Behold podcast and the founder of The Labor Mama.

For more education, support and “me too” from Lo, please visit her website and check out her online courses and digital guides for birth, breastfeeding, and postpartum/newborns. You can also follow @thelabormama and @loandbehold_thepodcast on Instagram and join her email list here.

For more pregnancy, birth, postpartum and motherhood conversation each week, be sure to subscribe to The Lo & Behold podcast on Apple Podcasts, Spotify, or wherever you prefer to listen!

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Opinions shared by guests of this show are their own, and do not always reflect those of The Labor Mama platform. Additionally, the information you hear on this podcast or that you receive via any linked resources should not be considered medical advice. Please see our full disclaimer here.

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It wasn't until I struggled with my first who had tongue ties and reflux and colic and all of the things that finally I ended up down a rabbit hole I couldn't dig myself back out of to really look at that whole baby.

If a baby's body feels really good and is functioning well, the things that they need to do and the things that they need to learn will come easier to them

Motherhood is all-consuming Having babies, nursing, feeling the fear of loving someone that much Then there's this baby on your chest, and boom, your entire life has changed

It's a privilege of being your child's safest space and watching your heart walk around outside of your body

The truth is, I can be having the best time being a mom one minute, and then the next, I'm questioning all my life choices

I'm Lo Mansfield, your host of the Lo and Behold podcast.

Mama of four littles, former labor and postpartum RN, CLC, and your new best friend in the messy middle space of all the choices you are making in pregnancy, birth, and motherhood.

If there is one thing I know after years of delivering babies at the bedside, and then having, and now raising those four of my own, it is that there is no such thing as a best way to do any of this, and we're leaning into that truth here.

With a mix of real life and what the textbook says, expert insights, and practical applications, each week we're making our way towards stories that we participate in, stories that we are honest about, and stories that are ours.

This is the Lo and Behold podcast.

Before we started chatting, I told today's guest to treat me as if I know nothing.

Essentially, I said, " I want you to talk to me and almost tell me why I would need you," and certainly why you guys would need them, too.

Because nine years ago, when I had my first baby, she works in a field that I was not even considering, that in my opinion, was barely being talked about, and certainly not on social media in the ways that it is now, which is a great thing, and we'll get to that.

So I have Dr. Britta DeStefano with me.

She is an infant physical therapist.

She's a mama of two, and she is the founder of Progress Through Play.

We'll talk about that a little bit more, but it is a Denver-based practice, so she and I are nearly neighbors, that supports babies and families from day one with, let's say, babies' movement and all the other things we're gonna talk about, too.

Britta specializes in newborn development, feeding, movement like I just mentioned, hands-on therapies as well.

Her whole philosophy is really simple, and she definitely speaks to that so beautifully in this conversation.

Babies deserve to feel good in their bodies, just like you do, so they can eat, sleep, poop, and play with ease, right?

That's what we want for them, and so that is what her practice is all about, and that is what her work is all about.

Her passion is helping you, helping parents understand your baby so that then you can spend less time worrying about them and just more time enjoying them in that first year of your guys' life together.

Britta, thank you so much for being with me today.

Why don't you go ahead and give us your, bio intro?

Not, like, the more fun one.

The more straight from you one.

Dr. Brita: Sure.

I am first and foremost a mom of-- my kids are getting big, but a 12 and a 10-year-old, and then a practice owner.

I own a pediatric physical therapy practice in Denver, and we specialize in infants.

So we really look at that first year of life from birth up until they take their first steps and all of the things that they need to do, which is a lot of things, in that first year.

And, you know, I have many titles, Baby Whisper, Baby Poop Whisper.

All the things that, help parents feel a little bit more confident and comfortable in understanding what's going on with their babies in the first year of life.

Okay.

Perfect.

Can I ask you, how long have you been doing this?

'Cause I have a follow-up question to your answer.

Dr. Brita: I've been a pediatric physical therapist for my whole career, which is over 15 years, and I've been specializing just in infants for about the past seven years.

Okay.

So my question to that or the follow-up to that is, do you feel like people are more aware of what you do now than they used to be?

And there's more of-- 'cause obviously it's not like, oh, suddenly we have pediatric physical therapists as of two years ago.

But it does sometimes feel like we have more awareness and probably you even maybe have more clients like, "I know what you do." They came to you intentionally, like, all of that as well.

do you think that's true or you're seeing that in practice?

How are you gonna say that?

Dr. Brita: Absolutely.

And I think social media is partially Part of what has brought more awareness to what we do.

I think also I have just seen a shift in the way that a lot of us practice in the field of pediatrics of just being more niche, more specialized, in the sense that when I started, a lot of us really were generalists and seeing, you know, all the patient populations from birth to 18 years old, which is a lot, and a lot of people are still really great at that.

I myself prefer to really niche down and be an expert in one specific patient population, and there is a huge trend in just the past seven years since I started specializing, in that population of more and more pediatric physical therapies kind of joining that, practice model.

And so with that, there's building awareness of what we can do-

Yeah

for babies.

Yeah, definitely.

Okay.

Perfect segue into the next question, which I had told you before we started is, I want… Like, talk to me almost as someone who is a little bit more of the like, "Wait, what do you actually do?" Like, why would I end up in front of you?

So what would you say is the reason, if there is one, and this might be pretty spread out across a couple different reasons, that parents do end up in front of you and kind of as a, a side-on question to that, it a proactive step that parents are taking in to get in front of you or more a, "Oh, shoot, we're go-walk- we're working through this, and now we know that someone like you can help us"?

Dr. Brita: Great question.

A little bit of both.

Again, kind of tying in with that building awareness, I think there are a lot of parents that are just a lot more proactive because they're aware that the services are out there.

I would say even, like I said, my oldest is 12, and completely different access that parents have these days than even I did with my experience then.

And what I tell people typically to give them, like, the umbrella version of what we do is babies have bodies just like we do.

Their bodies go through a lot during, pregnancy and during delivery, and then there is a lot expected of those bodies pretty quickly.

They have to kinda hit the ground running from birth until that walking stage that I talked about that we specialize in.

And our philosophy is that if a baby's body feels really good and is functioning well, the things that they need to do and the things that they need to learn will come easier to them.

That includes breast and bottle feeding, learning how to do tummy time, and all of their milestones, but also, like, digestion and sleep and all the things that parents do kind of stress about in that infant stage really come under the umbrella of just how well is their body working the way it should?

Is their nervous system regulated well so that they can be in a space to do the learning that they need to do?

And so we just kind of say that we are specialists in all the things that your baby's body needs to do in that first year of life.

So do you feel like you do have more come into you because they're like, "Oh, breastfeeding is not going well.

This must be attention issue." You know, someone's probably guided them around, and so they land there. Or is it like, " We're worried about milestones," and so they end up in front of you 'cause they're not meeting milestones?

Or do you just feel like it's actually truly all over the board with how people end up in front of you?

Dr. Brita: I think probably an equal split.

What we have here, at least built up in Denver over the past seven years, is just a lot of really excellent providers that can recognize very early on before it does snowball into a really big issue that like, "Hey, we are seeing these signs right now.

Your baby's six days old.

We're gonna go ahead and plug you in with the resources to help get this support as early as possible." Because it, it is true, I mean, there's tons of research on the benefit of intervening early when it comes to anything supportive with children, and with babies especially.

I don't want parents to be spending their whole, you know, infancy in physical therapy.

I would like for them to come in and see me as early as possible, in which case we can often work through these struggles much quicker and get them back to enjoying their baby.

And so I think what we're seeing is more and more of those providers who really are great at that collaborative care and getting their patients the full spectrum of support that they know that they deserve.

And so we do see a lot of families, like you said, struggling with breastfeeding.

Their lactation consultant is there for, you know, an hour and a half really listening and hearing the things that we want them to be listening for, and then plugging those parents in with the resources they need.

Do you feel like it does come a little more from a lactation consultant?

Because obviously for all of us, like, feeding this baby is, like, the big deal these first weeks and onward.

So do you feel like it's pediatricians noticing things?

Or often it may be some feeding stuff, and that LC or the IBCLC is saying, "You know, I think you could benefit from XYZ, what you do"?

Dr. Brita: Yeah.

I think the lactation consultants are the ones that are referring the earliest because they are in there day one.

Yeah.

Pediatricians are referring a little bit later for things like head flattening, delayed milestones.

You know, this baby's not rolling over.

They're having a hard time with tummy time.

So we do see both because- There's a spectrum of all these different things that we can help babies with, but we really do value those lactation consultants who are just in there from the get-go and really get to know the families.

And what I didn't realize early on in my career as a pediatric physical therapist was how much Breast and bottle feeding is a full body experience for babies.

When I first started, I was doing nothing related to how they were feeding.

I was trying to work on tummy time and movement, not realizing how interconnected that was with everything that their body needs to do in order to feed optimally.

And it wasn't until I struggled with my first, who had tongue ties and reflux and colic and all of the things, that finally I ended up down a rabbit hole I couldn't dig myself back out of to really look at that whole baby and understand that absolutely physical therapists can play a role in helping families have a successful feeding journey in collaboration with their lactation consultants and whoever else they're working with.

But it's really rewarding when, like you said, feeding this baby is like my number one job.

And when- Mm-hmm … it doesn't go smoothly, that's a huge stressor on families, and to be able to help with that is one of the best parts of my job.

Absolutely.

I had asked because, you know, you mentioned earlier intervention when there is an issue is better, right?

We know that.

That's pretty, like, much universally true- Well studied … right, for all of us.

But there's also this postpartum truth in the United States where it's like you're not really in front of anybody.

It's the ped, right?

But they're probably not… Typically, that pediatrician's not quite as invested in the way a lactation consultant would be, and so that idea of like, "Well, I want to make sure we're on the right track, but really there's not that many people around me checking in," I just think that can be such a hard line for parents to walk sometimes.

You know, where you're, "I want to trust my intuitions. I want to trust this provider. Should I have another provider?" And you probably know this as well, but the advice a lot specific to feeding is have a lactation consultant in your corner immediately, right?

And so as you're sharing this idea of, you know, often they're the ones who see things the earliest related to feeding and the body, that's just to me, I'm like, "Oh, that's just another reason-" Absolutely

"to really have a lactation consultant in your corner." Even if you're like, "Oh, it's gone well three times," you know, whatever that might be, like, just having them because they are often those first ones to catch, in my opinion, Gab… I guess what I'm hearing from you as well, to catch some of that earlier stuff that can get you kind of on track, or send you to someone like yourself who can help get you on track before we tumble a little bit farther down this road than, than we want to.

Dr. Brita: Yeah.

Yeah.

And what we hear a lot is families- Potentially having questions that maybe are not, to a pediatrician, sounding like a giant red flag yet.

Y- you know, they'll say, "Oh, but it's fine because my baby's gaining weight," right?

So everything else is dismissed because from the medical side of things, they're tracking, you know, checking off the things that the pediatrician needs to check off.

But then we zoom out a little bit and say, "Okay, outside of that bare minimum weight gain that we're looking for, what's the quality of the feeding? Is it sustainable the way that you're feeding this baby? Or if we fast-forward a couple months, are you gonna be.. It's unsustainable for you to keep putting forth this much effort."

And so we look at how much effort the baby's having to put forth to get fed, 'cause a lot of babies are working way harder than they need to.

They're fatiguing, and they're not transferring well, and those sorts of things.

It's trickling down into their digestion.

They're, they're fussy and uncomfortable.

And so we want it to be effortless for the parents to feed their babies, and also effortless for the babies to feed.

And so sometimes we do have to kind of look a little deeper and make sure that family really does feel fully supported in their feeding journey beyond, you know, kind of that surface level, are they gaining weight or not?

And granted, obviously, there's babies who are not gaining weight, and we definitely get to see those ones 'cause those ones have more of the red flags that get the referrals.

But a lot of times, parents will kind of say, "Oh, we don't, we don't need help." And when I start asking questions, I'm like, "Oh, no, you deserve this support, too.

Like, you're working really hard.

It doesn't have to be that hard.

We could definitely make this easier for everybody." And they're like, "Oh, really?" So-

It's like, "That would be great. I'll take anything easier in this postpartum period."

Dr. Brita: Yeah, and I kind of… I had one of each, right?

Mm-hmm.

Like, the really checked all the symptoms baby, and then the one that kind of flew under the radar.

And so I'm pretty passionate about making sure that those ones don't get missed, the ones that are a little bit less obvious, maybe compensate really well, and so you don't notice that they're struggling until later.

And then these babies who are obviously are really high-needs babies, and they're really struggling.

I really like to make sure that parents realize that they deserve support no matter where they are on that spectrum.

Okay, so I have a follow-up question that goes along with that, and I wanna answer this before we get into some specifics about, like, what you do and what parents can be looking for and stuff like that.

how do you tell parents, or even if you were to go back and tell yourself with all you know now, too, how do they balance the, we don't want you constantly looking at your child, wondering what's wrong and how can I correct it and, and trusting, you know, this intuitiveness or we're feeling good.

Like, I'm just gonna trust that we're doing really well together.

'Cause I feel like with these kind of milestone-y early conversations about what our babies, I'm air quoting here, like should be doing, sometimes then we can end up in this place of fear or constant vigilance when really you're both doing beautifully, you know, or as beautifully as someone does at fourteen days postpartum or whatever.

So how do you kind of help parents navigate that and/or, like, what would you say to someone who's at the beginning of this listening and they're thinking, " Oh man, this is like another thing that I need to, to be on the watch for," if you will?

Dr. Brita: Yeah, I would say we see a lot of those anxieties pop up around what your baby's doing at really any stage.

And what we tend to try and do is talk about approaching things with curiosity.

So we're not concerned, we're curious about how your baby's body works, what their strengths are, what can they do, and being able to kind of give parents the tools, like how to observe and look for all those exciting things that are happening in between the big ones.

You know, they're waiting, they're like, "Why is my baby not rolling yet?

My friend's baby's crawling and mine's not." Well, if we look outside of just those big milestones that get all the attention, it gives parents more to celebrate and be engaged with of, you know, purposeful play because my baby is, learning how to reach and learning how to shift their weight and rocking on their hands and knees, and all these other things that we as physical therapists get equally as excited about as those, the big ones, because we know how important every single one of those little steps is.

So I think when we can help parents understand that there's so much more going on, then it, it takes the anxiety away from those big things because we're not, you know, tunnel vision.

We can see everything else.

And so that's one way that we can kind of help like ground the parents into like look at what they're doing right now.

You know, we're not worried about this thing in the future.

We're looking at this baby today.

And I think it's normal for parents, even those of us who are in this field, to still worry because-

Yeah Yeah.

Well, sometimes I feel like I'm sitting here listening to you, and I'm thinking, "Oh, my gosh. Was I, like, missing one of my babies compensating and struggling?"

And, 'cause I can also have the tendency to be the opposite of what I just kind of described and was questioning about of like, everyone stop worrying.

Like, they're fine.

Everybody thinks there's always something wrong, and we just need to, like, let them be, right?

And that's not always gonna be super helpful either because we do need to be curious.

I actually love that part of your answer, of just remaining curious doesn't mean the same as, like, being anxious, but just not ever thinking something is, "Oh, this is, like, absolutely true, and we don't have to question this anymore." Just having that little bit of curiosity, and then I think, like you said as well, knowing the little things in between the big things is such a sweet way for us to kind of gauge, we're making progress, or we're doing well, or this is a good sign, too.

And it kind of goes back to that idea of pediatricians, and this is, like, a blanket generalization, right?

But if it's like, oh, they're worried about wet diapers and poopy diapers and gaining weight, great.

It's like, no, there's so many little things in between.

Pediatricians are also paying attention to those as well.

So I think as parents just recognizing there's these big benchmarks a lot, and those are valuable, and we can know what they are.

But like you said, knowing the many milestones in between, the many things that people are looking for, and asking your provider, "Hey, what are some of those in-betweens?"

And, like, getting knowledgeable about that.

I do think that can really help with that, just curiosity and confidence as you kind of grow with them, I guess, to some degree.

Yeah.

Dr. Brita: Yeah.

And I think one of my favorite things, because we do have these nice long, hour-long appointments with the families that come in to see us, is that I spend that whole hour teaching them about their baby's body and how it works- Yeah

and what they're doing and why they're doing it, and this reflex and how that reflex helps with this next milestone.

And I really, really enjoy doing that and having the parents leave with all this, you know, empowerment and knowledge about their specific baby, not just, like, babies in general, you know, milestones in general, but, like, this little baby in front of us.

This is what they're going through right now, and this is, you know, what they're really excelling at, and here's where they need a little extra support.

And I think that's also super, super helpful for parents to be knowledgeable about their own baby and not comparing it to, you know, this-

Definitely

Dr. Brita: chart.

Definitely.

Okay, let's get into some of kind of these specifics or things that do end up in front of you.

When we were first starting, you mentioned something about how womb positioning, how baby is in during pregnancy can kind of impact some movements, probably tens- different things that can be true of them post-birth.

So can you, I guess, talk to us about- If you're a parent and maybe you know your baby's in a certain position, or maybe you're seeing something really early, like, what some maybe links are there between how they are during pregnancy and then what might be true once they're here?

Dr. Brita: Absolutely.

Well, we know for sure that obviously babies are in a confined space for nine months, and towards the end, getting pretty smooshed up in there, and that obviously is gonna have an impact on their bodies as it's growing and developing.

Now, most of the time, their bodies are designed to be able to, to bend and withstand and mold their heads through the birth canal, and it's, it's amazing the ways that our bodies are meant to do these physiological processes.

But there's obviously times in which, that positioning is limited because of a short umbilical cord, you know, nuchal cord, or baby's breech for a long time, or we see there's defined risk factors for babies that have a diagnosis called torticollis, or it's tightness on one side of their, their neck.

They have a hard time turning their head to one side.

And it's larger, longer babies, firstborn babies- Boys typically because they tend to be a little bit bigger, multiples, because all of those things are risk factors for a baby being more confined, right?

Is

firstborn because the womb hasn't, like, stretched out prior?

Okay.

I was like- Mm-hmm … I can't figure that one out, but I got it.

Yeah,

Dr. Brita: exactly.

Makes sense.

'Cause if any of you've ever had more than one baby, you know that we're a little

more relaxed.

My womb is

Dr. Brita: probably very floppy.

Yeah.

Um, so that's what we, we know for sure from, from studies.

We know that breech babies are more at risk for having hip dysplasia, right?

'Cause the hip joints aren't aligned in the same way as if baby is head down.

So there's those defined things that we know for sure that put babies at risk for having, you know, what we call tension, tightness in their body.

I did your air quotes, too.

But then really anything that their body goes through during that pregnancy or during delivery can influence how their body is feeling.

Those really crazy fast precipitous labors, lot of times those babies come out and are a little stunned.

Stunned.

They get a little tense from that flying out.

Sometimes their reflexes aren't quite activating the way they would if they had a nice flow, you know, delivery.

On the flip side of that, if we are in that birth canal for a really, really long time, obviously those babies are also being put through quite a lot during that process.

And so I kind of describe it to parents the best way I feel like I can, in the sense that there's plenty of babies that are born that do not need any type of physical therapy.

However, it's a spectrum, and so there's some babies that are, very, very tight, and that tension in their body is going to impact their ability to feed or be comfortable doing tummy time or turn their head from one side to the other.

And it's like when you sleep funny and have, like, a kink in your neck, and a lot of times you go about your day, you can just kind of massage and go to sleep, and the next day and you wake up and it's fine.

Those are the babies that come out, and they kind of move and unwind themselves and don't need any assistance.

And then there's those times where you've slept funny on your neck.

It is not getting any better.

You say, "I've got to get to the, my massage therapist or the chiropractor or the PT or whatever, because this is beyond my capability of just working through naturally with some stretching" or whatever you would typically do.

So the same for babies.

There's plenty of babies that were confined in the womb, went through whatever birthing process, and are able to naturally stretch out through the movement that we do with them just in a day-to-day routine, and then there are babies that are gonna need that extra assistance, and- Yeah

those are the ones that end up in our office.

Yeah.

Okay, quick pause for a second.

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All right, let's get you back to your episode

Okay.

Talk to me a little bit more about torticollis.

You mentioned it a couple times, but I, I feel like that one is one that maybe parents would be the ones to notice because of the way the baby's feeding or whatever.

So can you just kind of lay out a little bit what that might look like, what a new parent might notice when they're trying to feed if they are, you know, tight, have that tension or whatever that is kind of inhibiting baby's movement and feeding?

Dr. Brita: So torticollis is a diagnosis primarily focused on the neck and neck range of motion, so we're looking at whether or not a baby can turn their head fully from one side to the other side.

However, I've treated babies with torticollis for 15-plus years.

Every single one of them also has other things going on besides just one tight muscle in the neck because our bodies are all connected.

There's no way to look at one muscle in isolation.

It works along with their jaw and their trunk and the rest of their body.

So we almost always find other patterns of things that we can help support these babies with.

But what we really want parents and pediatricians and any other providers who are working with these young babies to do is screen for it and watch for the signs early.

This is one of the most researched diagnoses that we have, and actually, the American Physical Therapy Association has clinical practice guidelines that recommend that every single baby that's born is screened for torticollis within the first three days of their life, which I don't think is happening.

What does

that screening look like?

No.

Yeah.

I mean, not that I'm aware of.

Dr. Brita: Yeah.

So it, I mean, they're mainly geared towards those first pediatrician visits that they see, and screening for range of motion of the neck, making sure baby has, full rotation to both sides.

But as a physical therapist, I think what gets missed is looking at that range of motion of the rest of the body because a lot of times when babies don't have head control yet, you miss the fact that they can't really actively move side to side because they're not doing a lot of independent movement, and what we find shows up even more than maybe like a head turning preference- Is one side of their body feeling tight, which makes it difficult for them to be comfortable, like nursing on one side because it's getting stretched out.

Or if you lay your baby down, you see that, like, C curve to their body, always to the same side.

It's, like a side bend in towards that tight side.

And so sometimes that head turning preference isn't the first thing that a parent might notice, but they might see some of those other signs, like really struggling with latching or feeding on one side or seeing that C curve to their body.

Now, they might also notice every time I put them down to sleep, their head is always facing this one direction, and that's obviously one of our big indicators and something that, again, we're wanting to be proactive about because that head turning preference is what puts babies at risk for having head flattening.

And that's something we also can be proactive about treating so that it, again, it doesn't snowball into a bigger issue.

Well, that was just, again, a perfect segue 'cause I would like you to talk to me about the head flattening as well, 'cause I know… Again, like you said, torticollis is one that I think obvi- sounds like, you know, we're aware of it in the healthcare field, research about it, like, it is prevalent.

I feel like the flat head one is as well, where parents are like, "Oh, yeah, how do I also help, help with that?" So the two are connected is what I'm hearing from you.

Is there, again, anything parents could be looking for or even, you know, I've seen little tips like lay them down on different sides of their cribs or their bassinets so that they're, you know, orienting in different ways.

What, what would you say for us for that?

Dr. Brita: Absolutely.

So because their heads are so soft and moldable to make it through the birth canal, and because we put them on their backs to sleep, then it does again kind of put them at risk for having prolonged pressure on one side or one area of the head if they do have kind of that restricted range of motion.

And, you know, we have more and more instances of head flattening since we began that Back to Sleep campaign.

Prior to that, babies were in a lot of different positions for sleep, and so there wasn't quite the rates that we see now.

But the best thing a parent can do, this is my favorite easy screener for parents, is do a test where the next time you go to put your baby down for a nap or bedtime, whatever it may be, pay attention to what side their head is turned to.

So this time I'm putting you down for a nap with your head turned to the right.

Take a look at them, you know, after a few minutes or halfway into their nap, look at the monitor or go check in the room and make sure that they could comfortably stay with their head in that position.

The next time you put them down, try it to the other side.

So put them with their head turned to the left side, check in on them again, make sure that they are comfortable and that they can keep their head in that direction.

If you notice that, I'm gonna give it hypothetically, the example that when you put them down with their head facing to the left, you came back to check the monitor, and they had scooted it all the way back over to the right side.

And then the next time you do that for a nap, they do it again.

I call that the boomerang effect, where tightness in their body is pulling that head back over to what is their preferred side.

Because if there's tightness on one side and we try to make them sleep with their head to the other side, it's like sleeping whilst doing a hamstring stretch.

Like nobody, nobody's gonna be comfortable in that position.

So your baby's body is saying, "I need to go relieve some of that tension by turning my head back to the easier side." And so if you notice that boomerang effect happening consistently, that would be an indication that that's one of those babies that couldn't quite work out some of that tension from the womb or delivery and needs some assistance from a physical therapist.

So that's just like such an easy screener for all parents to do even before maybe their pediatrician would notice something.

And so that's a great way for us to catch a lot of those cases earlier than maybe they would be

Would you say that babies that end up with the flatter head or maybe do need the helmet and need the care for that as well, that there's always an underlying tension as well?

Or can that just happen because we lay them on their backs to sleep all the time, and they are on their back 12 hours a day?

Maybe they're a great sleeper.

I don't know.

Can just that alone cause the flat-headedness, or do you feel like typically, no, there's underlying tension as well, and we can, we can work on that too, or even treat the root cause, right, type conversation?

Dr. Brita: Yeah.

There's typically something else going on.

You know, it could be torticollis.

We see sometimes it's babies that are really refluxy, really archy.

kind of those uncomfortable babies will posture in a way to relieve GI discomfort, and so it wasn't the tension that potentially initiated that positioning, but baby's trying to get comfortable.

Maybe they're really gassy or, you know, again, spit-uppy, and so they are choosing a specific position just to relieve something else going on in their body.

But again, that's something that kind of goes back to- The beginning of what I said where we really want babies to feel good in their bodies so that these things can be easier for them.

So that's an instance where we would say, yeah, we need to look at their digestion, their feeding.

And again, earlier in my career did I understand how intricately connected a baby's digestion was for their movement patterns?

No.

That's, again, part of that rabbit hole that I went down, understanding that

If a baby's really gassy and has that distended belly, they are gonna, again, posture their bodies in certain ways.

It's gonna make them potentially uncomfortable in certain positions that they need to get into for their development.

And, you know, we see that kind of trickle down into how they feel about doing the things they need to do in order to meet their milestones.

And we can actually, rewind back and see that this all kind of started with that reflux that they had in the beginning.

So at the end of the day, it's all connected, and we do wanna get to kind of the puzzle pieces that all need to work together for that baby's body to do all the things that it needs to do.

So-

It's interesting as I'm listening to you kind of chat through this, part of me just thinks like, well, you've al- obviously said multiple times it's all connected, right?

But typ- my brain's going, okay, if we could just get all of them in infant PT, we could make sure that everything works so that, like, something doesn't cause something else, right?

' Cause I think a lot of times as parents, we're, we think, my baby has reflux, we're treating the reflux, right?

But then there could be some tension issues, right?

Or I know we just keep using the word tension, but there could be something going on that's causing the reflux, or the reflux is then gonna cause something else.

Or maybe they're not feeding well because they feel horrific all the time.

And so it's like, gosh, if we could just get in there like, obviously, like you're saying, yeah, exactly, and stop it before that trickle down because it is str- So interconnected, just, I mean, what a gift, right?

Practically speaking, a lot with that actually, do you…

This is taking us totally into more of a financial conversation.

Are your services typically something for parents to expect would be covered with insurance?

Or is it something that if they get a referral it could be, or there needs to be a diagnosis?

Like, how does that work for families if they're thinking, "This sounds great, but I have bad insurance," or whatever.

What would that look like for them?

Dr. Brita: Yeah.

Our practice specifically, I had to kind of create in a way that allowed us to be as proactive as we want to be, which unfortunately in the United States, our healthcare system is not built for.

So there are definitely avenues to go see a pediatric physical therapist, you know, covered by insurance.

We have direct access in Colorado, and every state in the US has some degree where you can just walk into a physical therapist office, you can book an appointment, you do not need a referral from your pediatrician.

Whether the insurance company requires it, that's a whole separate thing.

But I don't ever need, you know, that prescription from a physician for somebody to come in and see us.

However, we want these families to feel like, you know, I noticed that nursing hurts on one side when my baby was three days old, and we got an appointment two days later.

So for our practice specifically, we stay outside of that insurance realm, so we don't have wait lists, and people can come in and see us as quickly as possible.

But we, do everything we can to give families the paperwork they need to try and get reimbursed from their insurance companies, 'cause we believe obviously this should be something that they should be able to get reimbursed for, but there's a long way to go with, unfortunately, our healthcare system to get to that point.

But for us to be able to get people in with us quickly and then out and done with their therapies as quickly as possible, it works the best for us to not contract and deal with the insurance companies.

Yeah.

I'm sure that's true for a lot of people.

I ask because the conversation, you know, where I was just like, "Gosh, I wish we could just like get in there before we have, you know, these multiple things going on," just makes me think of the postpartum conversation of like pelvic floor PT, right?

And again, there's that like, why can't we just all have that so we then don't have all these other things?

And, and as you and I both know, that's not how it works here.

But I hate that parents can listen to an episode like this, follow along with someone like you, and think, "I would love to have that or want it," and then to know that finances could potentially, hinder that ability to, what I would say care for yourself really well and care for your child really well.

It's just so frustrating.

Not that you have not that there's a question in that, but it's so frustrating.

Dr. Brita: It's really frustrating to me because in, I'm just speaking to my community specifically here in Denver, there's plenty of families that say, "You know, I, I recognize this. We do need support. For us personally, we need to go through someone who can accept our insurance," which obviously I then want to help them find that person that they can go see.

And it's pretty frustrating for me as a provider too to even have referrals because the places that I can send them might have excellent therapists for them to see but have an eight-week-long wait list because- Yeah … again, just working within

this- Which

Dr. Brita: doesn't serve anyone.

Yeah … within this system, that's just the way that they end up having to operate.

And again, like if you have a newborn and you're struggling to feed them or they're really fussy and uncomfortable, we want help today.

Mm-hmm.

Not eight weeks from now.

Mm-hmm.

Eight weeks from now, that baby's a completely different baby.

So I am, I'm very frustrated with the lack of accessibility For what I do, and, you know, again, we, we keep fighting for that, in the US

A conversation for another podcast- Yeah

I guess.

We're

Dr. Brita: not there yet.

So- Sorry, guys, we ended on a real downer right there, didn't we?

Yeah.

But I just feel like that question has to be asked in these conversations because it's, it's such a big part of how people decide what they can do or… yeah, I just, it's like, oh, I wanna empower these families with all this information, and then we also have to acknowledge the practical realities of, you know, the country we live in or the insurance system that we have or whatever, and it's just tough to do that sometimes.

But, but thank you for your answer.

Yeah.

And that's- We- … not a very fun place to stop.

Dr. Brita: As much as we can, too, 'cause, like, my favorite thing is we go out in the community, and so we will speak at lactation support groups.

We will teach tummy time classes at, you know, mom events.

We host a free support group here in our clinic for families dealing with tongue-ties and oral ties and that sort of stuff.

And so, we really are trying to at least get the information out there as many ways as we possibly can, you know, on Instagram, through our online resources, and then all those community touchpoints because, to your point, like, yes, there needs to be so much more accessibility for it.

Well, I know that you're a great follow 'cause I've been following you along.

We're basically neighbors, in case any of you wanted to know that.

We live quite close to each other.

I've been following you along for a while.

Why don't you actually tell everyone where they can find you, whether that be your practice or online as well, and then the free stuff that you offer both online, and then some of these classes I think are so great.

I'm like, man, I didn't even… We didn't even talk about ties and oral ties and tummy tie.

But obviously, yes, you can share more of them online, so where can, where can they find that too?

Dr. Brita: Absolutely.

Progress Through Play is my practice, and so we're on Instagram under that handle.

And we pretty much put all of our resources there.

You can find everything.

Our website is ptpdenver.com.

But yeah, if you are local, we do infant massage classes, baby play classes, the, the Tongue Tie Support Group.

Our newest one, which I think is so much fun, is a class specifically for dads and babies, and it's a rough and tumble play class, so it's teaching dads how to safely do that kind of dad play with a young baby.

So that has been one of our favorite new offerings that we've

I love that.

'Cause the number of times I've looked at my husband and been like, "Can you please not do that with him?" And I, I don't think I'm typically anxious about that kind of stuff.

I'm like, yeah, you know, we're built to play, but I'm also like, "What are you doing?

Do you know what you're doing?" Yeah. So I love that. And then But it's fun … we all mom and say, "Well, the

Dr. Brita: physical therapist told me it's okay."

Exactly.

He would… That's what he would do.

He'd be like, "This is fine. I went to my class." Yeah.

It's really, really fun.

I love that idea.

Okay, last question I ask everybody before they leave me.

What is one thing in your life right now that's just bringing you a ton of joy?

Dr. Brita: Oh my goodness.

I think it's the realization of how much I am enjoying parenting bigger kids.

As someone who spends all my time with babies and would say I'm a huge baby person, I, I love that stage, I have just had so much fun seeing the growing independence and, like, my son's going into seventh grade this fall, and them just blossoming and being surprised at how much I enjoy seeing them turn into these cool kids was a super fun experience as part of this parenting journey for me.

I love hearing that, 'cause I'm someone who maybe feels like you did or still does now, where I'm like, "I love this baby stuff. I'm really good at this stuff. I feel really nervous about what's ahead of me," right?

And everyone's like, "Oh, the best years are the little years," and you're like, "Well, there's still so much more.

Don't say that to me." So it's so encouraging for me to hear anyone just even a little bit ahead of me saying, "No, no, no, no, it's so cool." So I love hearing it.

Dr. Brita: I am kind of the one in a lot of my friends' groups that has older kids, and I think I didn't hear enough when I was in that baby toddler stage how cool it is to parent older kids.

And I think more people need to talk about it, and, more parents in that early stage need to hear that.

I agree.

So thanks.

That just, like, blessed me and encourages me 'cause, man, it's hard around here sometimes with, with my little kids too, so you're like, "Oh, I need some… Yeah, I want some stages to look forward to ' cause this one feels hard," so, so I'll take it for sure.

Well, thank you so much for your time.

I feel like we should've just met in person and somehow done it in a coffee shop, but I appreciate you and I do, I've loved, just following along with you the last couple of years.

Like you said, information access is just so valuable to us parents 'cause this is a space where, I mean, I was not really learning anything about it when I had my first nine years ago.

So I'm grateful to you for putting stuff out there for us, for me, and for parents too, so thank you.

Dr. Brita: Well, right back at you.

Same for you.

Thanks, Freda.

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