Introduction
The study of human body movement assists in understanding different biomechanical, psychological, and physiological mechanisms of the body. Taking care of a newborn from the time of birth to the age of about twelve months requires the mother or the caregiver to understand some concepts necessary for the survival of the baby. According to Davis, Cladis & Motoyama (2011), the breathing pattern of newborns from up to the age of six months is purely diaphragmatic (abdominal), hence; the need to understand various positions that allow the infant breath effectively. Understanding diaphragmatic breathing patterns acts as one of the major clinical practice techniques that help improve the baby’s thoracoabdominal movements and promote the desirable respiratory system. The following paper discusses various diaphragmatic positions and how they influence breathing in newborn during the first year after birth.
Breathing patterns and postures in newborn
Safe and efficient respiratory strategies developed through the understanding various breathing patterns of a newborn are essential for the growth and development of an infant. The infant’s first breathing immediately after birth transforms from liquid to air-filled lungs. The transition acts as the most significant physiological adaptation that defines the survival of a newborn (Hillman, Kallapur, & Jobe, 2012). Making the infant’s lungs absorb adequate air for respiration during the early stages after birth may be difficult, hence; the need to establish specific positions that allow total circulation of air to the diaphragm region for easier breathing (Tes Pas, Davis, Hooper, & Morley, 2008). To allow continuous flow of oxygen into the infant’s body, the mother or the caregiver should maintain recommended postures and diaphragm positions during different periods of growth as recommended by the pediatric. An effective breathing takes place when there is a larger end aspiratory volume (EIV) and end expiratory volume (EEV) in the infant’s diaphragm.
At 3 months
At three months after birth, the baby needs to achieve an optimal stabilization pattern that is ideal for the coordination of breathing in the abdominal section of the body. The mother positions the infant on his or her back holding the legs in an upward a position referred to supine. In the supine position, the baby utilizes the upper part of gluteus muscles, the back, and the nuchal line for support. Moreover, the position allows coordination of activity between the diaphragm, the abdominal wall, and the pelvic floor allows free movement of respiratory air from the outside environment through the nose to the diaphragm (Huston & Ward, 2016). The supine position is highly recommended for infants at three months because it helps in lengthening the diaphragm during tidal breathing leading to bigger EEV and EIV.
On the other hand, at three months the infant could be placed lying down on his or her belly while holding the head against gravity in a position referred as the prone. The infant supports the body using pubic symphysis and elbows. The position helps in stabilizing the upper thoracic spine through achieving a balanced contraction between extensors and the deep neck. Additionally, the intra-abdominal pressure created through co-ordinate activities of the diaphragm stabilizes the lumbar spine and lower thoracic allowing easier circulation of air from the abdomen into the lungs and consequently, less diaphragm activities. According to MacLean, Firzgerald, & Waters (2015), exposure to the external environment 2-3 months after birth is characterized by abrupt changes in the neurotransmitters systems that help in controlling the ventilator system. However, experts argue that the prone position causes diaphragm shortening during breathing leading to the diaphragm doing more work. The position makes the diaphragm work rapidly and harder due to shorter EEV and EIV that may end up compromising the infant’s ability to respond to changes in environmental air (Rehan, Nakashima, Gutman, et al., 2000).
At 6 months
At six months the infant is ready to start taking another diet apart from the breast milk. Between six to eight months the baby sits independently. The normal sitting position acts as the most effective in allowing proper circulation of air in the diaphragm. The sitting position helps in increasing the strength of lumbar muscles and increase diaphragmatic breathing (Tecklin, 2008). The infant's ability to move from the sitting position to other movements such as turning sideways demands more energy that calls for more air circulation in the body. The ability to change positions at six months allows the baby to shift from the supine to prone positions easily. Changing positions willingly encourages variations in thoracoabdominal motions that allow more air to circulate in the diaphragm leading to an increase in EIV and EEV. According to Oliveira, et al. (2009), improved thoracoabdominal synchrony through alternating prone and supine positions leads to proper breathing patterns in infants.
At 9 months to 12 months
The baby’s lungs develop fully between nine to twelve months. The mother or the caregiver should utilize specific diaphragmatic positions to allow proper circulation of air to the lungs. Both the supine and prone positions are highly recommended during this period because it prevents upper airway obstruction and ensures the baby breathes in the fresh air. On the other hand, the position allows the easier blood flow in veins without any constriction that may limit the amount of oxygen flowing into the infant's lungs. On the other hand, the diaphragm length increases as the infant approaches one year of age. Therefore, an effective mechanism capable of taking care of diaphragm volume changes should be adopted to keep the baby healthy. The upright position ensures helps gravity help the infant in diaphragmatic breathing. The two positions cater for the increased lung volume and help keep the body well ventilated (Rehan, Nakashima, Gutman, et al., 2000). Moreover, infants between 0 to 9 months require an adequate supply of oxygen to ensure proper abdominal respiratory movements while sleeping. According to Horemuzova, Katz-Salamon, and Milerad (2000), improper sleeping positions lead to the obstruction of upper airways through a condition referred to as Hypoxemic episodes.
Conclusion
Diaphragmatic breathing exercises find more application in the clinical practice today because they promote pulmonary ventilation in the independent zone of the newborn's lungs by ensuring proper displacement of the abdominal compartment responsible for respiration during the young age (Vieira, Mendes, Elmiro et al., 2014). The lack of adherence to recommended diaphragmatic breathing positions at different stages of infant growth causes risks associated with the inadequate distribution of oxygen in the newborn's body. The infant should be placed in a position allows the abdomen to breathe without any strain. Moreover, the baby’s abdomen should lie against a soft base (Anonymous, 2012).
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