If this phrase sounds familiar, you are not alone. It is one of the most common situations we encounter at Physioclem when working with families with small babies.
Holding your baby is natural, conveys security and is part of the bond between parents and children. But when your baby can only rest in your arms and rejects the cot, it is normal for the family to start feeling tired and have doubts: ‘Is this normal?’, ‘Is there something wrong with my baby's body?’, ‘Am I doing something wrong?’.
Why does this happen?
Babies' sleep is very different from that of adults. Their cycles are shorter, much of it is light sleep, and their ability to self-regulate is still developing. Therefore, many babies need external stimuli to be able to transition between wakefulness and sleep. Rocking, warmth, and physical contact are not ‘addictions’: they are instinctive strategies that help the immature nervous system feel safe.
However, when this pattern is very pronounced—when the baby wakes up every time they touch the mattress, when they seem uncomfortable lying down, or when they only relax when held—there may be more than just a ‘need to be held.’
It is common to encounter factors that make it difficult to rest in a horizontal position, such as:
- physiological gastroesophageal reflux in infants
- colic and abdominal discomfort
- tension in the diaphragm, cervical or cranial area
- restrictions acquired during childbirth (whether vaginal or caesarean)
- postural asymmetries or marked preference for one side
All these aspects can lead the baby to seek the lap as the only comfortable position to relax.
How physiotherapy and paediatric osteopathy can help
Through a comprehensive and individualised assessment, we are able to identify tensions, asymmetries or mobility restrictions that may be causing discomfort when the baby is lying down. Using very gentle and safe manual techniques, appropriate for the baby's musculoskeletal and nervous systems, we seek to:
- reduce tensions that interfere with comfort
- improve the mobility of the structures involved
- promote self-regulation of the nervous system
- promote a state of relaxation
- facilitate adaptation to the cot and resting positions
The scientific literature in this area is still growing, but existing studies show consistent results in several aspects related to the baby's well-being. Systematic reviews of manual therapies in babies with colic or excessive crying identify a moderate reduction in crying time and improvements in overall tranquillity, with a high safety profile when performed by qualified professionals. Some studies also point to improvements in physiological parameters, such as breathing patterns or sleep quality, especially when therapeutic touch or massage is integrated into the routine.
One of the suggested mechanisms is the activation of the parasympathetic nervous system - the “calming” system - promoting relaxation and helping the body to come out of the state of alertness that makes sleep difficult. Another possible mechanism is the reduction of physical tension (muscular, fascial or cervical) that makes lying down uncomfortable.
Our method at Physioclem
Every baby is unique, and the work we do respects that individuality.
Our intervention always begins with a complete assessment of the baby's history (birth, feeding, behaviour, sleep, positioning and family routine). We then define a personalised therapeutic plan, which may include:
- gentle mobilisations adapted to the baby
- myofascial release techniques
- very delicate diaphragmatic and cervical work
- simple exercises, such as guided tummy time
- practical guidelines for handling the baby
- strategies to facilitate the transition from the lap to the cot
- suggestions for routine and organisation of the sleeping environment
O nosso objetivo não é tirar o colo ao bebé, o colo é essencial, nutritivo e emocionalmente estruturante. O que procuramos é aumentar o conforto e a capacidade de descanso do bebé também fora dele, para que pais e filhos possam viver esta fase com mais tranquilidade, segurança e descanso.
Na Physioclem, acreditamos que quando o bebé descansa melhor, toda a família descansa melhor. E é exatamente isso que queremos ajudar a construir consigo.
REFERÊNCIAS CIENTÍFICAS
Carnes, D., Plunkett, A., Ellwood, J., & Miles, C. (2018). Manual therapy for unsettled, distressed and excessively crying infants: A systematic review and meta-analyses. BMJ Open, 8(1), e019040. https://doi.org/10.1136/bmjopen-2017-019040
Dobson, D., Lucassen, P. L. B. J., Miller, J. J., Vlieger, A. M., Prescott, P., & Lewith, G. (2012). Manipulative therapies for infantile colic. Cochrane Database of Systematic Reviews, 2012(12), CD004796. https://doi.org/10.1002/14651858.CD004796.pub2
Park, U. J., Jeong, H. I., & Kim, K. (2023). Comparison of effectiveness of manual therapy for infant crying: Systematic review and meta-analysis of randomized controlled trials. Journal of Pharmacopuncture, 26(4), 285–297. https://doi.org/10.3831/KPI.2023.26.4.285
Martínez-Lentisco, M. del M., Martín-González, M., García-Torrecillas, J. M., Antequera-Soler, E., & Chillón-Martínez, R. (2023). Osteopathic manual therapy for infant colic: A randomised clinical trial. Healthcare, 11(18), 2600. https://doi.org/10.3390/healthcare11182600
Lanaro, D., Ruffini, N., Manzotti, A., & Lista, G. (2017). Osteopathic manipulative treatment showed reduction of length of stay and costs in preterm infants: A systematic review and meta-analysis. Medicine, 96(12), e6408. https://doi.org/10.1097/MD.0000000000006408
Schwerla, F., Daake, B., Moeckel, E., & Resch, K.-L. (2021). Osteopathic treatment of infants in their first year of life: A prospective multicentre observational study. Complementary Medicine Research, 28(5), 395–406. https://doi.org/10.1159/000514413
Holm, L. V., Jarbøl, D. E., Christensen, H. W., Søndergaard, J., & Hestbæk, L. (2021). The effect of chiropractic care on infantile colic: Results from a single-blind randomised controlled trial. Chiropractic & Manual Therapies, 29, 15. https://doi.org/10.1186/s12998-021-00371-8
Miller, J. E., Newell, D., & Bolton, J. E. (2012). Efficacy of chiropractic manual therapy on infant colic: A pragmatic single-blind, randomised controlled trial. Journal of Manipulative and Physiological Therapeutics, 35(8), 600–607. https://doi.org/10.1016/j.jmpt.2012.09.010
Rezaei, R., Sharif Nia, H., Beheshti, Z., & Saatsaz, S. (2023). The efficacy of massage as a nightly bedtime routine on infant sleep condition and mother sleep quality: A randomised controlled trial. Journal of Neonatal Nursing, 29(2), 393–398. https://doi.org/10.1016/j.jnn.2022.07.026
Field, T., Gonzalez, G., Diego, M., & Mindell, J. (2016). Mothers massaging their newborns with lotion versus no lotion enhances mothers’ and newborns’ sleep. Infant Behaviour and Development, 45, 31–37.
