Postpartum Insights- interview with Pediatric Occupational Therapist Sarah Czarnecki

In our concluding segment of the “Postpartum Insights” series, we have the privilege of conversing with a local Pediatric Occupational Therapist, Sarah Czarnecki. Operating her private practice right here in Hoboken, Sarah brings her wealth of experience to the table. She delves into a range of topics, encompassing tummy time suggestions and adeptly guiding parents through the intricacies of caring for babies who might have sensitivities to touch and repositioning.

Sarah’s journey spans a diverse spectrum - from her tenure at Blythedale Children's Hospital in New York, where she dedicated herself to medically fragile children with a variety of complex rehabilitative needs, to her involvement with New Jersey early intervention (EI). Today, she stands at the helm of her own private practice. In addition to her impressive resume, Sarah is a recent mama of two, wife, and lover of music and adventures. I’m excited to pick Sarah’s brain and have her shed some light onto how an occupational therapist can help parents navigate their particular child.

Sarah Czarnecki, OTR

pediatric occupational therapist

Sarah, welcome! I’d love to start off with what a pediatric occupational therapist is, for those who don’t know.

Hi! I’m happy to be here, thank you so much for having me! Pediatric Occupational Therapists work with children 0-18 to improve their function and independence, due to disabilities, injuries, or illnesses. 

I collaborate with children and their families to maximize abilities and gain independence in everyday activities. In my previous role at a children’s hospital, that looked like working with newborns who had a traumatic birth or who were born with a disability. In my private practice work, it looks like supporting parents at various stages of the child’s life. For newborns and babies (0-12 months) I can help those who have trouble regulating or self-soothing when touched or repositioned to helping to improve body symmetry through movement and vision (when babies favor one side). In addition, I often work to improve baby’s tolerance to tummy time through facilitation and modifying and adapting the home environment. For specific needs for children older than one year, you can reach out to me directly via my website.

In what ways does Pediatric Occupational Therapy differ from Pediatric Physical Therapy?

This is a good question, and one that comes up a lot as you can imagine. Physical therapy is most often used to improve gross motor developmental milestones (how to move their body) whereas occupational therapy is used to help the child improve their day-to-day activities. I focus on neuromotor function including gross and fine motor skills, visual motor skills, sensory integration, and cognitive/play skills.

For the babies in my private practice, this often looks like helping parents with newborns who are labeled as ‘fussy’ or ‘colicy’ in the sense that they are particularly sensitive to their environments. They often don’t tolerate physical touch well, have an intense Morrow reflex, or startle reflex, and have trouble regulating once they’re repositioned. I work with these families to improve tolerance and integrate sensory systems. 

Babies often prefer and favor one side of their body, where it is noted that they focus or rest looking in one direction. This can cause flattening and asymmetry to their skull and can lead to Plagiocephaly. I offer environmental changes and visual intervention that often result in improvement, in addition to hands-on facilitation to improve the muscles of the head, neck, and shoulder girdle.

“Tummy time” is a phrase and type of positioning that gets a lot of attention from parents of newborns. Tummy time is important for building muscle strength, which is the foundation of baby’s movement (sitting, crawling, walking) and posture (which leads to the ability to eat solids). That being said, a lot of babies struggle with tummy time and parents can become overwhelmed or frustrated. If your baby is having trouble tolerating tummy time, I incorporate vision, play, and sensory strategies in addition to motor facilitation to help improve time spent in this position.

I know you have a soft spot for working with young children and their parents. When would a family reach out to you for care, assuming they don’t have an indication from their pediatrician?

This is a great question. Pediatricians see such a small snippet of your baby in an unnatural environment and you know your baby best. If you have any concerns with your baby's sensory tolerance (handling, touch, reflexes), visual system (focusing on objects/family, scanning the environment, and tracking objects), body symmetry, or tolerance to tummy time, it wouldn’t hurt to seek out a consultation. I often begin with a consult session where I connect with the family for a more in-depth conversation regarding concerns and my own clinical observations and then provide family education and strategies/suggestions. If more intervention is needed or wanted, I work with families to set a timeframe and frequency depending on clinical implication and recommendation.

As a recent mom of a newborn for a second time, is there anything else you want to say to new parents navigating the postpartum time?

Every baby is different with their own unique qualities. There is so much questioning and second guessing when navigating the early days. Don’t hesitate to get some advice and suggestions from experts– a little can go a long way!

When my second was born, I found her to be very sensitive within the first week of life, in comparison to my first. She wasn’t tolerant of being placed in the bassinet, had a very big startle reflex when changing positions, and didn’t like diaper changes. I used my skill set in sensory techniques to focus on improving her overall experience and making her more comfortable in her new world outside of the womb. 

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If anything from this interview resonated with you, you can reach Sarah via her website to schedule a consultation for her services. Sarah is experienced in working alongside your child’s existing care team and welcomes a collaborative environment to set you and your family up for success. She is currently on leave with her newborn, but will be back up and running her private practice this fall! 

Andrea Yates at Caring for You Doula is a postpartum doula based in Hoboken, NJ, serving families across northern NJ- Hudson, Essex, Bergen, and Union Counties. She is passionate about nutrition for new moms, the postpartum period, and helping parents navigate this time with confidence and ease. Contact her today to set up a free consultation on how she can help care for you and your family during this amazing time.