How to handle difficult babies

I am currently doing my paediatric placement at a child development centre. Here one of the main areas focused on is the assessment and treatment of Plagiocephalies. When a child presents with this condition they are usually around the age of 4-5 months and the assessment consists of observing the baby in supine, prone, sidelying and sitting postures. To do this there is quite a bit of handling and facilitating of the baby to move between these positions. We also have to assess active and passive neck ROM. So as you can see there is quite a bit of hands on with the baby. Now most of the babies I have seen so far have tolerated being handled by me and the PT quite well until I came across a 4/12 baby whose mother reports that her baby does not tolerate strangers very well at all and tends to “lose it” when first handled by a new person. Now as most of you might know when a baby decides to throw a fit it takes a fair while to settle them back down if even at all.

So after the subjective I gave picking the baby up a go and just as the mother said the baby did absolutely lose it and so after my failed attempts to calm her down I had to give her back to her mother so she could settle her. After a few minutes when she had settled the PT tried but also failed to keep her calm while handling her and again had to pass her back to her mother. So since it looked like only the mother was going to be able to handle the baby today the PT looked at me and challenged me to come up with a solution to still complete the objective assessment without handling the bub.

First of all I tried simply talking the mother through what I wanted to do but after the first few tests it was clear she didn’t really understand what I wanted of her and so the aim of the test wasn’t being achieved. Now I was back to square one. The next thing I tried was a went and found a doll and so I sat opposite the mother and demonstrated exactly what I wanted her to do and explained the aim of the activity. This seemed to work very well and allowed me to complete the assessment enough as to determine the extent of the problem and then prescribe management strategies.

When reviewing the session my supervisor said that what I did was very acceptable and she commended me on the way I handled my first screaming baby.

So I was wondering if anyone else has had to deal with babies who don’t tolerate being handled by strangers very well and if so how and what did they do to get around it and complete a successful session.