While controversy remains around the physical manipulation of infants and young babies, physiotherapists provide a trusted and safe option for parents whose babies do require intervention for numerous reasons.

“The list of conditions in infants that may include physiotherapy care is quite long,” says chair of the APA National Paediatric Group, Nicole Haynes.

“Some physiotherapists may be working in relation to breathing difficulties, sensory system impairments, musculoskeletal and orthopaedic conditions, infants born with a diagnosed or suspected neurological or chromosomal conditions.

“In a private practice clinic, the most common reasons a parent may think to take their child to the physio if they are concerned about their motor development or they are concerned about a physical presentation such as constantly looking to one side, a flat spot on the back of the head or an odd position of the feet.”

Physiotherapists are trained to work from neonates upwards, and can complete further training to specialise in paediatric physiotherapy.

“There will usually be a physiotherapist working in maternity hospitals who is trained to see neonates in the special care nursery from the first day after birth,” says principal physiotherapist Alison Wroth.

“This is particularly the case with pre-term babies, or babies born unwell or with a disability.”

Developmental coordination disorder/developmental delay, developmental dysplasia of the hip, gross motor development, idiopathic toe walking, infant headshape, talipes, torticollis, neurological conditions, gait assessment, rehab after surgery and respiratory conditions are all able to be treated by a physiotherapist.

“For babies with head and neck asymmetry problems, they should see a physio ASAP - the sooner this is assessed and managed, the better the outcomes for babies,” says Ms Wroth.

“For delays in gross motor issues, sometimes it is a matter of doing an assessment and reassuring the parents, plus giving some strategies to encourage development at home, rather than any urgent need to intervene or have intensive therapy. 

“On other occasions, if there is a significant delay in development, this is best identified early as early intervention management programs tend to result in better outcomes for the baby.”

Ms Wroth says physiotherapists base their interventions and treatments on the highest possible available scientific evidence, and never perform treatments that are deemed to be unsafe or risky. 

In addition, physiotherapists are regulated by the Australian Health Practitioner Regulation Agency (AHPRA).

“This means that physio have to maintain their education, training and registration on an annual basis in order to keep practicing; physios are accountable to AHPRA for their conduct when with patients.”

Physiotherapists complete an undergraduate degree in which rigorous assessment takes place in order to ensure competency in key clinical areas, which includes paediatric theory and practical components. 

Following graduation, some physiotherapists choose to specialise and/or undertake further education and training to work in the area of paediatrics. 

“Physios can choose to work in an organisation or clinical setting which focuses on paediatrics/babies and follow a clinical pathway, supervised by more senior clinicians, in order to gain experience and knowledge in this area; they can also choose to undertake postgraduate study at university to further their skills in this area,” says Ms Wroth.

Physiotherapy treatment includes advice and education to parents in relation to the condition, positioning and handling techniques, gentle exercises and stretches along with active play ideas to promote the recovery of musculoskeletal conditions in infants.

Furthermore, physiotherapists are well-equipped to help parents understand the reasons behind the condition that prompted the investigation, and will educate parents rather than treat babies unnecessarily.

“Physios can often identify any issues and refer on as required, or provide reassurance to new parents that their baby is developing typically,” says Ms Wroth.

“Parents may not think of taking their baby to a physio for unsettled behaviours, however physios have expertise in analysing movement and physical behaviours in babies and may be able to contribute to better understanding of the underlying cause for their baby being unsettled.”

Individual assessment forms the basis for any treatment program, which usually includes educating and instructing parents in management strategies and play-based therapy for the home environment.

“A typical assessment may take one hour, however the baby spends the rest of that day in a different environment so physio treatment tends to focus on supporting and upskilling the caregivers, who are with their baby most of the time.”

More than 450 physiotherapists have completed the Paediatric Physiotherapy Level 1 course, says Ms Haynes, while in 2018, the Australian Physiotherapy Association paediatric group had 638 group members, 28 titled members and 2 specialist members.

“There are many options to pursue a career in paediatric care,” says Ms Haynes.

“Seeking out these opportunities and ensuring they are well supported roles with mentors, supervisors and a team of colleagues is the first step and then continuing to develop your knowledge through formal and informal learning throughout your career.”