1. SAFETY: CAR SEAT USE AND MISUSE Alaska Injury Prevention Center Sept 11, 2012 Mary Pomeroy, PT Abilitypt.mary@gmail.com www.abilitypediatricpt.com Ability Pediatric Physical Therapy 566-5660

2. AAP: Car Seat Alert SAFE SLEEP  Not safe for sleeping  Car safety seats are not stable on a crib mattress or other elevated surfaces.  Contributes to positional skull deformities  American Academy of Pediatrics: OCT 2011

3. Car Seat: Suffocation Alert!!  “Infants who are younger than 4 months are particularly at risk, because they might assume positions that can create risk of suffocation or airway obstruction.”

4. “Bucket Babies” Developmental Consequences and Their Prevention  AGENDA Who are the Bucket Babies? Etiology  Prevention  Safety

5. DIAGNOSIS: BUCKET BABIES

6. “Baby Buckets”

7. Motor Delay/Asymmetry, Plagiocephaly and Torticollis  Motor delays extending to 15 mo. of age (J Ped 2006)  Plagiocephaly (deformational): 1 in 60 live births (Petisch, Keefer, LaBrie, Mulliken. Pediatrics 2002; Graham 1999))  Torticollis (positional): 17% of babies with torticollis (Kordestani, Pate., et al)

8. Plagiocephaly

9. The prone-reluctant baby  Look for developmental and health concerns  Observe for asymmetrical skill development: limbs, torso, head  Consider PT referral

10. Tummy Time Tools from Children’s Healthcare of Atlanta  www.choa.org/tummytim etools www.choa.org/tummytim etools  404-785-3229

11. Head tilt, asymmetric rotation: so what?

12. Age 6: SCOLIOSIS

13. PREVENTION of BUCKET BABY TRIAD THROUGH EDUCATION  Before baby arrives: childbirth class/health fairs  Car seat / misuse education  Well baby checks

14. Parent Education: Newborn Nursery and Health Care Office  Prone time education: flip the pancake  Feeding and diapering positions  Carrying in arms, not “bucket”  Appropriate use not Misuse

15. Thanks!

16. References Available upon request.