Babies and Strokes

It’s Hemiplegia Awareness Week!

Oftentimes people associate strokes with the elderly.  Kids have strokes too, most often from a brain bleed / hemorrhage either while in the womb, at birth, or afterwards which causes tightness and difficulty using one side of their body, also known as Hemiplegia.
Red flags common for children with a stroke are:
-Inability or difficulty  using one side of body – the baby may hold their arm tightly at their side, fist their hands, or predominantly use one side.
-Early hand preference – Please know that babies are never right- or left- handed, they should not yet have any hand or foot preference.  If they do, it’s important to see a neurologist and be assessed by an OT and / or PT.
-Difficulty feeding, slurry speech,asymmetric facial features such as droopiness on one side of face or a crooked smil
-Stiffness in arms or legs while dressing or bathing
-Reaches with only one arm, head tilts to one side, body bends or cures to one side like a banana
-Delayed milestones
-Seizures
-Abnormal eye movements
-Extreme sleepiness, lethargy

 

I often hear health professionals say a baby with hemiplegia doesn’t need Occupational Therapy till they’re older and using utensils. This is a myth! Babies use their arms from the very beginning to self-soothe, find the breast for feeds, randomly move their body and then to reach for their parent’s face, bring their hands together, put toys in their mouth, push up on their arms or grab their feet. All these developmental experiences require core stability, strength, coordination, sensory awareness and more.  It is NEVER TOO EARLY.  An occupational therapist experienced with babies can help achieve these skills. This is so important because each skill creates a foundational building block for more advanced skills.

 

Infancy is the best time to intensely work with babes with neurologic impairments for several reasons:
1) Brain neural plasticity allows the best chance for change by developing new  neuronal maps and pathways for increased function
2) Develop good alignment and movement patterns from the very start so the baby can learn to roll to both sides, sit straight, crawl, walk with good balance, point, and clap their hands. Then the baby doesn’t need to compensate and only use their unaffected side.
3) Reduce chances of muscles becoming increasingly stiff over time
4) Collaborate closely with parents on handling techniques to encourage bilateral movements and incorporate exercises in a fun way into daily routines

 

The following treatments can help:
1) Baby massage – it’s calming, builds body awareness, and decreases tightness.
2) Neurodevelopmental Treatment / Bobath trained therapist.  Note that some have advanced training for babies which is a bonus.
4) Developmental play approach using therapeutic exercises to achieve milestones, ESP reaping the benefits of rolling and crawling
5) Kinesio taping, splints, orthotics, suits or compression garments to promote good alignment, posture and movement
6) Adapting daily activities and games
7) Sports and hobbies such as swimming, horse riding, gymnastics, yog
8) Baby wearing for many reasons including it’s comforting after a traumatic birth, provides deep pressure and boundaries for body awareness, movement input helps balance and is calming, and better able to promote body alignment.
9) Parent support groups – HemiHelp and HemiChat in the UK.

 

HemiHelp has a fact sheet and video to raise awareness about Hemiplegia here: