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Old 08-23-2009, 09:52 PM   #21
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

To answer your question-- no she didn't scoot much... every once in awhile she'd sort of toss her arms forward propelling her forward a little on her fluffy bum. lol.

She also was born with an open sacral dimple, above her anus, that still hasn't closed. She had a spinal ultrasound that didn't show a tether, but it also wasn't completely clear. They'll order more tests if any symptoms show up. So far so good.

The real red flags with sacral dimples, at least I was told, are discharge or hair growing. She has had neither..

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Old 08-24-2009, 03:00 AM   #22
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

OH wow. Has she ever seen a ped? That should have been evaluated immediately, scheduled by her 2wk well baby check. The ultrasounds aren't nearly has accurate past 8wks, and at that point if they've never had it checked, we schedule a MRI.
Tethered cord is definitely a possibility, a strong one. Get in with the Ped ASAP and get it checked and if the tests are okay, then demand a referral to a neurologist.
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Old 08-24-2009, 08:06 AM   #23
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

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OH wow. Has she ever seen a ped? That should have been evaluated immediately, scheduled by her 2wk well baby check. The ultrasounds aren't nearly has accurate past 8wks, and at that point if they've never had it checked, we schedule a MRI.
Tethered cord is definitely a possibility, a strong one. Get in with the Ped ASAP and get it checked and if the tests are okay, then demand a referral to a neurologist.
Sorry to correct but OP would need to get a referral to a ped neurosurgeon, a neurologist is completely different. DD has tethered cord and we've learned a lot about this!
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Old 08-24-2009, 08:08 AM   #24
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

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OH wow. Has she ever seen a ped? That should have been evaluated immediately, scheduled by her 2wk well baby check. The ultrasounds aren't nearly has accurate past 8wks, and at that point if they've never had it checked, we schedule a MRI.
Tethered cord is definitely a possibility, a strong one. Get in with the Ped ASAP and get it checked and if the tests are okay, then demand a referral to a neurologist.

oh momma, you are up so early!! your post was made at 4am my time! (unless you're in a different part of the world?) I hope everything is ok, for you to be up so early?!

Anyway, yes, we take him to all the scheduled Pedi visits. He actually had 2 full newborn exams, the midwife did one when he was born, and then my pediatrician also did one. I work on a maternity floor, and am often present in the nursery to help give reports on the babies when the ped comes in to give the newborn exam....I don't really remember ever seeing a ped look in that area when they do newborn checks, though?
I'm trying to remember when I really noticed the dimples. I think I noticed right away that he had a funny buttcrack. But I don't remember when I noticed the dimples...since they are kind of hidden inside the folds.
I never brought them up, because I thought they were just cute dimples. I never thought anything of it, until one of the babies born when I was working one day had a big hairy patch on her butt. When one of the peds came in to see another baby, we pointed it out to her and asked her if she'd ever seen that before, and she asked if it was accompanied by a butt dimple. It wasn't, and so she said it was fine. But I asked her, "yea what does that mean anyway? My son has those and it's really cute". She said it can be a sign of spina bifida, but when it's just a dimple, they don't really worry unless there is a delay of some sort. I told her my baby wasn't crawling yet (this was when he was 10 months) and she said to give it another month before I even started worrying. Well, it's been another month...now I'm worrying.

Where did you read that about the 8 week thing with the U/S? Did one of your children have to have this?



*ETA- apparently photobucket has decided to remove the pics for being inappropriate Sorry about that everyone

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Old 08-24-2009, 08:15 AM   #25
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

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Sorry to correct but OP would need to get a referral to a ped neurosurgeon, a neurologist is completely different. DD has tethered cord and we've learned a lot about this!
Not if there's not tethered cord. If there is tethered cord a neurosurg would be appropriate. If there's no surgical need, ie no tethered cord, a neuro to find out why the decreased tone and strength is the right person.
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Old 08-24-2009, 08:19 AM   #26
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

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oh momma, you are up so early!! your post was made at 4am my time! (unless you're in a different part of the world?) I hope everything is ok, for you to be up so early?!

Anyway, yes, we take him to all the scheduled Pedi visits. He actually had 2 full newborn exams, the midwife did one when he was born, and then my pediatrician also did one. I work on a maternity floor, and am often present in the nursery to help give reports on the babies when the ped comes in to give the newborn exam....I don't really remember ever seeing a ped look in that area when they do newborn checks, though?
I'm trying to remember when I really noticed the dimples. I think I noticed right away that he had a funny buttcrack. But I don't remember when I noticed the dimples...since they are kind of hidden inside the folds.
I never brought them up, because I thought they were just cute dimples. I never thought anything of it, until one of the babies born when I was working one day had a big hairy patch on her butt. When one of the peds came in to see another baby, we pointed it out to her and asked her if she'd ever seen that before, and she asked if it was accompanied by a butt dimple. It wasn't, and so she said it was fine. But I asked her, "yea what does that mean anyway? My son has those and it's really cute". She said it can be a sign of spina bifida, but when it's just a dimple, they don't really worry unless there is a delay of some sort. I told her my baby wasn't crawling yet (this was when he was 10 months) and she said to give it another month before I even started worrying. Well, it's been another month...now I'm worrying.

Where did you read that about the 8 week thing with the U/S? Did one of your children have to have this?



*ETA- apparently photobucket has decided to remove the pics for being inappropriate Sorry about that everyone
I have pregnancy insomnia. No worries. I"m up half the night. LOL.

I'm a PNP. Have been one for 9yrs and a peds nurse for 2.5 yrs before that. I've seen a lot of these, and I'm extremely conservative in making sure that they are checked because it can have such long term effects. So, any baby that I see with one gets an ultrasound early. It may be overkill by some people's standards, but I wouldn't take the wait and see chance with my baby and I sure wouldn't do it with someone else's baby when it comes to something that can affect their neurological development.
Hope it all turns out just fine for you.
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Old 08-24-2009, 08:34 AM   #27
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

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I have pregnancy insomnia. No worries. I"m up half the night. LOL.

I'm a PNP. Have been one for 9yrs and a peds nurse for 2.5 yrs before that. I've seen a lot of these, and I'm extremely conservative in making sure that they are checked because it can have such long term effects. So, any baby that I see with one gets an ultrasound early. It may be overkill by some people's standards, but I wouldn't take the wait and see chance with my baby and I sure wouldn't do it with someone else's baby when it comes to something that can affect their neurological development.
Hope it all turns out just fine for you.

oh, gotcha. I don't know people on this board well enough yet to know you were a practitioner. Thanks so much for your input. I think it's good to be "over" cautious. I'm just trying to plan for what my ped is going to say about this and recommend to me.... like, will he say to just give it another month? will he just give me a referral to PT? Will he flip out and ask why I didn't bring it up earlier? And I'm trying to prepare myself for my reactions these situations.

So in your opinion, you think an MRI is a definite? So, if he doesn't recommend one to me, or tell me it's unnecessary, this is something I should demand or go find a different ped?
And, if an MRI comes back fine, you think that not crawling at 11 months is definitely reason to take him to a neurologist then? I've tried looking it up, and I haven't been able to find anywhere that says at X many months, you should REALLY start worrying, ya know?

thanks for your input, but I understand if you don't feel comfortable giving any advice (even though I understand it's no substitute for medical advice). I wish I could get opinions from all the peds I work with, but for the same reason, that kind of thing is really frowned down on.

Sorry about the pregnancy insomnia, that's the worst! Have you tried warm teas, progressive body relaxation, etc? I had one of those tapes when I was having troubles, and I never once made it to the end of the tape! Hope you get some rest soon
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Old 08-24-2009, 10:24 AM   #28
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Re: motor delay and sacral dimples, when to worry?

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After having DFS and DD identified by Early Intervention, with what you are describing, I would call your local early intervention in addition to the other things. You can self refer your children. DFS's caseworker referred him, and I referred my daughter. While I like my ped, she wasn't nearly as concerned as I was about my children, and both were identified, even though she thought they would grow out of their issues.

The EI therapy is MUCH cheaper than traditional outpatient centers, they come to your home or daycare, and most states have a monthly out of pocket max depending on your income. The copay is on a sliding scale. My insurance pays for 20 visits a year at $30 a copay, but EI pays for all of them at a fraction of that. Plus, at least in my state, any medical equipment is covered. I paid for DD's PT and her AFOs, and found out later that it all would have been covered by early intervention. Before EI, I didn't really understand what an OT did or how it would benefit my daughter, and definitely would never have sought one out.

The evaluation is free and they come to your house or your child's daycare to do it. In Indiana, they send out an OT and PT, and you go to a pediatric specialist eye doctor. I was completely scared to call, and everyone was incredibly friendly, and nice, and I feel dumb for being scared now. Neither child had any idea they were being evaluated...the therapists just play with the kids. Once the eval is done, you can stop at any time. But it is a really wonderful program.
in Minnesota, EI is free!
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Old 08-24-2009, 10:32 AM   #29
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

My youngest daughter, who is now 4-1/2 months, has a pretty deep sacral dimple. I'd never heard of it before until the doc noticed it when they checked her out after birth. They did call a ped. neurologist to look her over, but they decided not to do an ultrasound because in their opinion it looked like a normal dimple rather than something more serious. However, they told me to be on a lookout for any gross motor delays, but they doubt it is anything at all.

I think a lot of doctors blow things off unless the parents really push it because they are worried. My middle child, and my older daughter, Gracie, was diagnosed with CP at age 4. Doesn't that seem kind of old? She had a lot of gross motor delays, and they basically ignored until finally at age three I took her in and told her doctor that something was wrong. I told her that when I look at Gracie play with other kids she looks like a 1-year old. She could not climb, could not running without falling, and scissor walked (crossed her feet with each stride) along with being a toe walker. She could turn her feet backwards! Crazy girl! Finally after almost a year of physical therapy she was diagnosed with hypotonic cerebral palsy. At that point, however, she had had "issues" with gross motor delays for 4 years! It was not a lightbulb diagnosis that made any huge differences in how she was treated, in fact the day she was diagnosed with CP was the day she was discharged from physical therapy!
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Old 12-17-2010, 06:49 PM   #30
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Re: motor delay and sacral dimples, when to worry? *Pics Added in OP*

hey, I just read your post on your kiddo. I'm not quite sure how long ago you posted it, Re cord tathering. And I wanted to find out how things turned out for you guys? My daughter was born on 08/12/2009 and she did not start crawling untill 12 1/2 months! So a lot of your worrying sounds like what I;ve been going through. She's 16 months now and she's cruising all around my furniture and at times she lets go and she'll stand there for several seconds. She can even stand up in the middle of the room all by herself, but she wont walk just yet, at least not alone. Her pediatrician was worried about her spinal cord being tathered, but once she started crawling the worrying stoped, until now since she's not walking by herself.
When I was changing her I did notice kind of similar dimple around her left butt cheek which I have never noticed before, and all of the times her Dr. has looked there for a dimple she never found one either. I'm a little worried but than again her father didn't start walking untill 18 months of age.
I guess what I am asking is if your little one had to have surgery to repair the tathering, or not?
Thank you for taking time to read this. I know it's a little long.

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