Shortly two days before his tenth month birthday, Mattie gave us a big surprise by showing us he can sit by himself! After all the grunting, panting, bumps, and countless rollovers, he finally propped his arms, lifted his shoulders, straightened his back, and balanced himself sitting! This was surely a really hard workout and a huge feat. This kid deserves all the praise he can get, as this is definitely a remarkable milestone!
Down Syndrome and Low Muscle Tone
Mattie has Down syndrome. Down syndrome is a genetic condition that resulted from having the presence of one extra chromosome in some or all of the body’s millions of cells. Instead of having two copies of the twenty first chromosome, Mattie has three. As a result Mattie has a total of 47 chromosomes instead of the usual 46.
One of the physical problems associated with Down syndrome is hypotonia or low muscle tone. This means that Mattie’s muscles appear relaxed and feel very floppy. When I first held Mattie in my arms, I literally felt that I would break his body into pieces. He was so frail, his limbs were so thin and limp, and his joints so loose that I felt that one wrong move I make could dislocate his shoulder or snap his neck.
Due to low muscle tone, Mattie’s gross motor skills such as rolling over, sitting, standing, and walking get hampered. He will still reach these milestones but a lot later compared to regular babies. When other babies reach their milestones automatically and with ease, Mattie needs to little by little strengthen his muscles on his neck, arms, legs, trunk, stomach, lower back, middle back, and upper back. Before he could learn how to sit, he must learn to master simple skills like putting his head and hands in the center, lift his head and neck, put his legs together and move and kick them, practice different positions such as side lying, back lying, stomach lying, prop on elbows, rolling, supported sitting, and the list goes on. He is literally like a ragdoll, only constant repetitions and practice of exercises can increase his muscle strength.
Physical Therapy
We’ve started Mattie on physical therapy since he was three months old. His therapist would start his session with a massage - massaging his head, down to his shoulders, arms, legs, and back. Then they would do pull ups (like sit ups for abdominal work out), and back extensions. Mattie will also have a work out on the vestibular ball for further strengthening of core muscles and balance. After this they would start working on sitting, crawling, while reaching objects like rattles, balls and squeak toys for added stimulation. Mattie hated his therapy at first. He would always cry 90% of time during his one-hour sessions with the therapist. As Mattie cries, mommy would cry 90% of the time too. I feel sad that my three-month-old baby has to work his body out when at this age he should just enjoy being a baby. But as he gets used to his therapy sessions, his crying got less and less and soon he learned to enjoy it. I guess it also helps a lot that we got a really good therapist who has a heart for babies like Mattie.
Here’s a picture of Mattie crying during first few therapy sessions.
Working on Sitting
I try to give Mattie his exercises everyday, especially on the days that he does not have sessions with his PT. Unlike therapy sessions where we try to give all the exercises in a span of an hour, I give Mattie his exercises little by little by inserting an applicable activity during playtime. This way I get him excited and motivated to do his exercises!
As Mattie’s muscle strength improved, it got a lot easier to handle him as we worked on his sitting skills. Sitting exercises would include: 1) sitting on a corner with cushions, 2) sitting on a bumbo seat, 3) sitting with hands propped on the floor, 4) sitting with hands propped on his thighs, 5) sitting unsupported, and 6) moving in and out of sitting. We would make him try to tolerate sitting positions from 5 seconds to 1 minute, then 5 minutes and longer periods to develop his strength and balance. Less and less support is given until such time he can sit on his own.
One of the key exercises that I think made him confident about sitting on his own was when we made him lay his arms on something just about the height of his chest. The perfect toy that did the trick was this Chicco talking cube. This toy was a hand me down from one of my nieces. It had just the right height where Mattie can put his arms on as he practices sitting. It has five sides, each with different buttons that offer various activities and songs to encourage language and fine motor skills. Mattie was so fascinated with the sounds that came out each time he accidentally pushed the buttons. This kept him entertained as he strengthened his sitting skills.
We also tried to make him a put his arms on his crib while we entertained him with peek-a-boos and songs.
We made him play with an activity center that we put on a small box so that it would be just the right height on which he can maintain his balance at the same time play with his toy. A boppy pillow also hugged his legs for extra support in case he falls on his back. The pillow also made it easier for him to go back to sitting in case he falls down on his sides.
Another crucial exercise that helped him to sit was his pull-ups. Mattie hated this! Imagine the dreaded crunches you do in the gym for that abdominal workout. This is exactly the same thing. His pull-ups include pulling to sit from back lying using both hands, and pulling to sit by pulling with one arm and propping on the other arm as he moves from back lying to side lying and then to sitting up. These exercises really helped strengthen his stomach muscles.
Mattie is just so ecstatic with his new skill. He’ll flash a big smile as he works his way from lying on his tummy to pushing his arms and legs into sitting. He also loves the attention we give him as we praise him on a good job he’s done!
Make sure your babies are supervised at all times. Since they are still working on their balance, there’s a great chance that they will fall on their backs or hit their toys and possibly hurt themselves. Also make sure you consult with your therapist for the exercises you would do on your babies.
Happy Sitting!
Mattie is just so ecstatic with his new skill. He’ll flash a big smile as he works his way from lying on his tummy to pushing his arms and legs into sitting. He also loves the attention we give him as we praise him on a good job he’s done!
Make sure your babies are supervised at all times. Since they are still working on their balance, there’s a great chance that they will fall on their backs or hit their toys and possibly hurt themselves. Also make sure you consult with your therapist for the exercises you would do on your babies.
Happy Sitting!
Mattie's Mom
