GM.A.6 ON BACK, KEEPS HEAD IN MIDLINE WITH CHIN TUCK

The baby now lies on her back with her head in the midline (an imaginary line running down the centre of her body from head to toe) rather than rolled on the right or left. He chin should be tucked in. This chin tuck is very important. Until now, the baby has been pulling her head back, shortening her neck muscles at the back. To help stabilise herself, she was also hunching up her shoulders. Now, when she lies on her back she has enough control over her front neck muscles to pull her chin in.

If the baby does not learn to do this, it will influence the rest of her development, as she will always have to hunch her shoulders to help stabilise her head and neck. If she does not make progress with the methods described below, consult a physiotherapist. Note that this skill can be taught at the same time as the following skill.

How to Assess

Method: Place your child on her back. Score plus if she lies with her head in the middle, without it rolling to either side, with her chin tucked in.

How to Teach

Lay your child lengthwise on your lap with her head cradled in your hands in the midline position. Gain eye contact and chat to her. The try the same thing without supporting her head. Practise on flat surfaces as well. If you child has difficulty mastering this skill, revise the earlier exercises in this sequence, as these earlier skills are important steps leading up to mastering this skill.

Positioning, Carrying and Playing

Whenever you place your child down to change her, spend a short time practising this skill first. A fun activity, in which the head is cradled in the midline, is ‘having a swing’. Place your baby on a small blanket and, with one person at the baby’s head end and another at her foot end, lift the blanket and swing the baby gently, while chatting to her or singing. Family members should be encouraged to play with your baby, remembering to keep her head in the midline.

Your baby may not be able to manage this skill, because her neck muscles are a little tight, from the days when she hunched her shoulders to hold her head steady, or because she prefers lying with her head to one side. This is easily overcome if you play with your baby lying on your lap, her head near your knees, bottom and legs curled up against your chest, head in midline. Now with your hands cupped over her shoulders, gently but firmly pull down on her shoulders, either alternately or both together. Encourage her to play with her feet while she is in this position, if necessary rounding her shoulders forward for her so she can reach them. It is best to take her opposite foot to the opposite hand.

This exercise should be continued until your baby can achieve a good chin tuck in sitting, and she no longer hunches her shoulders.The way you have been picking up your baby, carrying her and lowering her down again has actually been helping her gain control over her neck muscles. Still continue with the same methods.