INFANCY

I'm Afraid Natalie Might Break!

Natalie is Susan and Jacob's first baby. They are the first among their friends to have a baby. They have no family members living nearby. Susan brings Natalie in to see Dr. Fuentes for her 6-month health supervision visit, and the physician notices that Susan handles Natalie like a china doll. Natalie exhibits very little head and trunk control. When placed on her stomach, she fusses and raises her head only to see what's in front of her. When a toy is placed in front of her, Natalie looks at the toy but doesn't reach for it. Dr. Fuentes determines that Natalie's height and weight are normal. She is alert and happy. However, her motor skill development is lagging--most noticeably in head and trunk control.

Dr. Fuentes asks Susan how she and Jacob interact with Natalie. Susan admits that she and Jacob are not very sure of themselves when it comes to holding and playing with Natalie. Susan discloses that she is afraid Natalie might "break" if she lets her move around too much. In fact, Natalie spends most of the day in her infant seat or crib.

Dr. Fuentes asks Susan to show her how she carries, undresses, and bathes Natalie. The demonstrations confirm that Susan is gentle and extremely careful--so much so that Natalie remains passive. With as much gentleness as Susan exhibited, Dr. Fuentes picks up Natalie. However, Dr. Fuentes encourages Natalie to sit while he holds her firmly under the arms. Dr. Fuentes carefully moves Natalie from side to side to show Susan how she can move Natalie without hurting her.

The secret, Dr. Fuentes says, is to encourage Natalie to move independently. "Natalie's head and trunk are almost two-thirds of her weight, and she has to learn to control them. You and Jacob need to give Natalie opportunities to strengthen her muscles and her brain's connections to the muscles, while offering support if she needs it. Tonight, spend some time with Natalie sitting on your lap facing you; hold her gently but firmly, and let her sway back and forth and side to side. Make it a game. Talk to her and encourage her. As long as you are gentle but hold her firmly, she won't break."

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