This post includes excerpts from my post on the Iowa City Babywearers website in Feb. 2018. In the full post, I describe a specific case and how ICBW assisted a mother who wanted to safely “wear” her CP toddler, click here to read.
About Cerebral Palsy
There is no cure for cerebral palsy. While symptoms become more noticeable with age the disease is not progressive. Preterm births, twins, and infants who experience difficult births, or head trauma during or after birth are most likely to have cerebral palsy. In some cases, it is caused by infection or environmental toxins during pregnancy and in very rare (2%) of cases, the cause is genetic. Nearly 80% of people with cerebral palsy have structural problems in the area of the brain that control movement, balance, and posture; and some will experience seizures.
Babies born with cerebral palsy may seem like any other newborn, with signs of the condition not becoming noticeable until they miss sitting and crawling milestones around 6-10 months of age. However some newborns with the condition may be extra floppy or too stiff, and some may already show signs of scoliosis. Infants and children with cerebral palsy tend to experience chronic, localized pain in over-strained joints and muscles; this may make them more fussy and difficult to get to sleep. Toddlers may not be able to walk, may have trouble with drooling and swallowing– the combination is a choking hazard– and they may have trouble communicating. Non-mobile children with cerebral palsy may have weak bones, as bone density is determined by how much stress is put on growing bones, which puts them at risk of low-stress fractures.
There are subtypes of cerebral palsy which indicate most noticeable symptoms, including spastic for stiff muscles, ataxic for poor coordination, and dyskinetic or athetoid for involuntary writhing movements; individuals may experience a combination of these types. Some may have bone or joint deformities, including scoliosis. Treatment may include physical therapy, speech therapy, braces and assistive technology, muscle relaxers, and (in extreme cases) surgery to lengthen muscles or to cut overactive nerves. In the future, stem cell therapy may be beneficial. No two individuals with cerebral palsy will have the same constellation of symptoms or treatments.
Benefits of Babywearing for kids with Cerebral Palsy
Communication can be limited for people with cerebral palsy, lack of coordination of the muscles of the face, tongue, and throat may make speech impossible and the same is true for sign language. But one of the biggest hurdles is preventing learned helplessness and passive communication exclusively with caregivers. Babywearing may encourage both the child and the public to engage in communication with each other simply by proximity. Even in neurotypical infants and children, being in a carrier nearer the heads and faces of people (as opposed to lower down in a stroller or carried car seat) helps children hear and see other people engaging in conversation and using body language.
The movements of being in an infant carrier may help with bone density, at least when compared to smoothly rolling in a stroller or wheelchair, as the jostling of the caregiver going about their day puts some healthy stress on the bones of the infant. We already know that the movements of a babywearing caregiver help neurotypical infants and children develop core strength and coordination (Karasik 2013, 2015; Suskind), it may, in some cases, be beneficial for children with cerebral palsy. Babywearing may encourage caregivers to get kids outside more regularly, without concern for where the wheelchair can or can’t go. We know the benefits of being in nature for everyone’s well being (adults and children alike) and the dose of vitamin D (even on a cloudy day) is beneficial for bone development.
The chronic pain and sleep disturbances may be reduced with the comforting physical contact of a caregiver. Simply the body warmth provided by the caregiver can help soothe achy muscles and joints– some infant crying may be a reflex to increase body heat, much like shivering (Hofer). Additionally, there is transport response, which soothes crying infants as they are carried during a walk (Esposito), the analgesic properties of skin-to-skin (Gray), and for CP infants who can safely breastfeed, nursing may be easier with the added support of an infant carrier (some parents can nurse hands-free using a carrier). The crying associated with lack of sleep and chronic pain, may be reduced by carrying (Hunizker), however, more interesting is the caregiver’s perception of crying when their baby is frequently carried. Babywearing parents tend to be more sympathetic about and recall less crying than actually occurred, whereas parents who didn’t carry reported more feelings of resentment and frustration about their infant’s crying (Elliot). For CP infants with reflux that prevents them from sleeping well, the upright position of most carriers can reduce reflux and allow infants to sleep.
It is important to emphasize that every child with cerebral palsy has unique symptoms and needs. When babywearing is safe and comfortable for a child with cerebral palsy, it may improve the quality of life for parents and caregivers– and for the children themselves.
If you have experience babywearing a child with special needs, I’d love to hear your story!
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Sources & Further Reading on Cerebral Palsy:
Elliot, Ruth, et al. “The Effect of different soothing interventions on infant crying and on parent-infant interaction.” Infant Mental Health Journal 23:3 (2002) 310-328.
Esposito, et. al. “The Calming Effect of maternal carrying in different mammalian species.” Frontiers in Psychology 6:445 (2015)
Gray, L. et al. “Skin to Skin contact is analgesic in healthy newborns.” Pediatrics 105:e14 (2002).
Hofer, MA. “Infant crying: An evolutionary perspective.” New Evidence on Unexplained Early Infant Crying: Its Origins, Nature, and Management. Ed. RG Barr, et al. Johnson and Johnson Pediatric Institute: Skillman, New Jersey (2001) 59-70.
Hunziker, Urs, et. al. “Increased Carrying Reduces Infant Crying: A Randomized Controlled Trial.” Pediatrics 77:5 (1986)
Karasik, Lana B. et. al. “WEIRD Walking: Cross-Cultural Research on Motor Development.” Behav Brain Sci. 33:2-3 (2010) 95–96.
Karasik, Lana B. et al. “Places and postures: A cross-cultural comparison of sitting in 5- month-olds.” J Cross Cult Psychol. 46:8 (2015) 1023–1038.
Suskind, Diana, et. al. “The Effect of the Young Child-Carrying Practices of Nigerian Women: on Gross Motor and Language Development in Young Children.” (1998)