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UPCOMING ISSUES |
BABYQuelling baby’s cries |
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------ Quelling baby’s cries Babies are a mystery for most new parents. They don’t talk, and the only way they can communicate is to cry. The trick for new parents is to try to unlock the mystery—to figure out how to soothe and comfort their babies. Holly Klassen knows all about trying to soothe a crying baby. “Literally from the moment he was born, he cried and screamed constantly,” says Klassen. “My husband and I were exhausted, both physically and emotionally.” Firstly it is important to recognize why your baby is crying or is discontented. Here are just a few of the possibilities.
But remember it’s not a science and remember as the weeks go by you will start to recognize your baby’s different cries. If your baby cries inconsolably for long periods every day, he may have ‘colic.’ Babies with colic will cry for several hours a day, usually in the evenings. No one knows what causes colic. It usually lasts up to about four months of age. 7 Soothing Solutions: 2. Check the ‘necessaries’: Is her diaper wet? Is he too hot or too cold? Is he comfortable or in an awkward position? It is important to check some of the obvious, easy to fix problems. 3. Hold your baby: No matter the reason for the cry, being held by a warm and comforting person offers a sense of security and can calm a crying baby. 4. Swaddle your baby: During the first three or four months, babies feel comforted if you can re-create a tightly contained sensation. 5. Get your crying baby moving: Babies enjoy repetitive, rhythmic motion like rocking, swinging or swaying. 6. Use white noise: The womb was a very noisy place. White noise is continuous and uniform, like a heartbeat, rain or your vacuum. 7. Sleep Baby Sleep: “Newborns sleep an average of 14 to 18 hours a day. By the age of six months, a baby requires 11 hours of uninterrupted sleep at night and approximately three-and-a-half hours during the day.” says Dr. Heather Pizzo, a baby sleep coach. Sleep is essential for everyone’s health, physical development, emotional well-being, and cognitive growth. Dr. Pizzo says before the age of four months, a baby does not have the cognitive ability to soothe itself to sleep. Babies need to be taught how to fall asleep.” Therefore, a parent should do whatever it takes to get their babies to sleep. After the age of four months, babies should be taught to soothe themselves to sleep, recommends Dr. Pizzo. Dr. Pizzo says it’s important to remember infant and toddler sleep problems do have an effect on parental mood, marital satisfaction, and parental stress level. More concerning, she points out, sleep problems have even been linked to Sudden Infant Death Syndrome (SIDS) and Attention Deficit Hyperactivity Disorder (ADHD). “The worry and stress of having a baby that cries all the time and won’t sleep is physically and emotionally draining and isolating,” says Klassen. She and her husband struggled to find information when they’re son was inconsolable. That’s when Klassen started their own website offering advice, support and resources to parents. Many people define successful parenting as having a happy baby. When babies cry and are fussy, parents may feel their definition of themselves as good parents is being challenged. Remember, just because your baby cries, you are not a bad parent. ------ Sleep solutions for newborns Congratulations on the birth of your new baby. This is a glorious time in your life—and a sleepless time too. Newborns have very different sleep needs than older babies. This article will help you understand your baby’s developing sleep patterns, and will help you have reasonable expectations for sleep. Read, learn, and beware of bad advice When you have your facts straight, and when you have a parenting plan, you will be able to respond with confidence to those who mean well but offer contrary or incorrect advice. So, your first step is to get smart! Know what you are doing, and know why you are doing it. Read books and magazines, attend classes or support groups—it all helps. The biology of sleep Newborn babies have very tiny tummies. They grow rapidly, their diet is liquid, and it digests quickly. Although it would be nice to lay your little bundle down at bedtime and not hear from him until morning, this is not a realistic goal for a tiny baby. Newborns need to be fed every two to four hours—and sometimes more. Sleeping “through the night” What’s more, some sleep-through-the-nighters will suddenly begin waking more frequently, and it’s often a full year or even two until your baby will settle into an all-night, every night sleep pattern. Falling asleep at the breast or bottle Therefore, if you want your baby to be able to fall asleep without your help, it is essential that you sometimes let your newborn baby suck until he is sleepy, but not totally asleep. When you can, remove the breast, bottle, or pacifier from his mouth, and let him finish falling asleep without it. If you do this often enough, he will learn how to fall asleep without sucking. Waking for night feedings Here’s a tip that is important for you to know. Babies make many sleeping sounds, from grunts to whimpers to outright cries, and these noises don’t always signal awakening. These are what I call sleeping noises, and your baby is asleep during these episodes. Learn to differentiate between sleeping sounds and awake sounds. If your baby is awake and hungry, you’ll want to feed him as quickly as possible so he’ll go back to sleep easily. But if he’s asleep—let him sleep! Help your baby distinguish day from night Have your baby take his daytime naps in a lit room where he can hear the noises of the day. Make nighttime sleep dark and quiet, except for white noise (a background hum). You can also help your baby differentiate day from night by using a nightly bath and a change into pajamas to signal the difference between the two. Watch for signs of tiredness Make yourself comfortable Excerpted with permission by McGraw-Hill/Contemporary Publishing from The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night by Elizabeth Pantley, copyright 2002. www.pantley.com/elizabeth ------- Infant massage: connect with touch Infant massage plays an important role in helping parents and babies cope with discomforts like colic or digestion problems, but many parents find out that there is a deeper layer of benefits. Communication = confidence as a parent Bonding Stress relief For the ‘working’ parent Eczema Adoption A safe place Top 3 reasons to massage baby Improved Sleep Colic Digestion & Growth 10 tips for massaging your baby ------- Coping with a colicky baby It’s 3 o’clock in the morning. The dark of night has enveloped most of the neighbourhood. A sliver of light peaks through the curtains. It’s the flicker of the television. You have been sitting in the same spot, rocking back and for what seems like forever but it’s more like half an hour. You have done this for every night for weeks now. Then sleepy silence. Baby is finally sleeping. And then the silence is broken. The loud and desperate screams of a baby with colic. Another night of rocking, feeding, walking, a few tears and no sleep. Sound familiar? Then no doubt you are living or have lived with a colicky baby. And the numbers show you are not alone. Colic may affect as many as one in five babies. It usually starts a few weeks after birth and usually gets better by age three months. Some struggle with for longer. Colic ends by about nine months for about 90 percent of babies. Dr. Michelle Ponti is a pediatrician who has seen her share of colicky babies and concerned, exhausted parents. “It is a diagnosis of exclusion, meaning that if a doctor has examined the baby and there isn’t any other underlying reason for the baby to be fussy,” says Ponti. She says your baby must be feeding, growing and developing well despite being irritable to be considered colicky. We all know every baby cries, but colicky babies do more than just cry. Colicky babies cry or even scream persistently, for anywhere from two to four hours continually. The exact underlying cause of colic is not fully understood. Some theories point to gas, while others indicate hypersensitivity to stimuli. Christine Sachse knows colic all too well. It happened with her first child, Sophie, who is now four years old. “She came out screaming and literally never stopped,” recalls Sachse. “I didn’t realize it was abnormal that she screamed.” It was a similar story for Stacey Dunseath. Her son Roan, also her first, struggled with colic. Dunseath remembers the experience like it was yesterday, even though her baby is now 18 months old. Dunseath noticed there was a problem by about four weeks. “The crying just wouldn’t cease. The nights were awful. It lasted for almost seven months,” says Dunseath. “He would wail like a banshee. Clearly he was in pain. Legs up, face grimaced. He was very difficult to calm even when I was carrying him.” Dunseath just described many of the classic signs of colic. Erin Arnold and her son Keagan are right in the thick of it. Keagan is two months old and has been crying from almost the first day he was born. “I feel like we have tried everything that the books and doctors have recommended,” says Arnold. Learning to comfort a colicky baby can be a frustrating thing. “There is no evidence-based standard of care treatment for colic,” says Dr. Ponti. “There are a lot of theories and what works for one family or infant may not work for another.” Sachse says they went through a whole list of things: different holds, swings, carriers and drops. “My philosophy became just to ride it out, otherwise I was going to become frustrated,” says Sachse. But there has been some promising research on a treatment for colic. In a January 2007 study, research into probiotics appeared to soothe colic in some babies. Probiotics are substances that help maintain the natural balance of good bacteria in the digestive tract. Scientists at the University of Turin studied 90 babies between April 2004 and May 2005. They found crying decreased in infants who received daily doses of a particular probiotic. But many doctors agree, more research is needed. Dr. Ponti stresses one very important point. “There isn’t a magic bullet. There is no magic cure out there.” But the bigger question is how to survive weeks and weeks of a screaming, inconsolable baby with everyone coming out happy and safe in the end? “First piece of advice is don’t hurt your baby,” says Sachse. “Put the baby down and walk away. That we had to do a few times.” Dunseath says the biggest thing, for her, was family. “Try and rely on your family as much as you can. Other than my mother-in-law, the big grace was…a moms’ group [that I joined],” says Dunseath. “These were all fantastic, supportive women.” Erin agrees that mom-and-baby groups have been a lifesaver. “And there is one locally in the Vancouver area that is kind of a therapeutic group. We’re talking about identity, and our feelings,” says fellow mom Erin Arnold. “I feel safe to talk about how I am really feeling.” While colic is not considered a serious medical problem, it can take a heavy emotional toll on the entire family, especially on Mom. Dr. Ponti says reaching out for help is an important aspect for families trying to cope with colic. Having a strong support network around you can really help. “ It won’t change the pattern of the colic but it will definitely change how that mom is able to cope,” says Dr. Ponti. “It does end and that’s an important point to highlight. It’s not going to change or predict the child’s outcome or personality and maternal-infant bond because it does end around the three-month mark so it’s relatively short-lived. It may not feel like it at the time.” Sachse acknowledges something that most moms of colicky babies feel. “I expected this immediate bond with her that I should love her and I didn’t.” “I definitely feel isolated ” says Arnold. “It’s hard to feel connected to your partner. You have all these ideas of what it’s going to be like.” Sachse and Dunseath their children have all come through colic. Everyone is happy and healthy now. And Dunseath and her son have a great relationship. “It took a while for me to heal from him. Now we really have a connection; we have a strong relationship,” Dunseath says. ------- Circumcision: both sides of the great debate Circumcision is the surgical removal of the foreskin that normally covers the head of the penis. There are many studies intended to help parents find the right answer regarding circumcision. One would think that the abundance of information is beneficial to the indecisive mind, but these studies are often inconsistent and confusing. Or, even worse, they have conflicting results. Why do it? There are several arguments that advocates of circumcision bring forward in the pros and cons debate. According to the proponents of circumcision, there are potential benefits associated with infant circumcision, including fewer urinary tract infections, a reduced risk of cervical cancer in female sexual partners, lower risk of cancer of the penis, and a lower risk of HIV infection and other STDs. According to a study published in October 2005 in the Public Library of Science Medicine, circumcision provides a degree of protection against HIV, equivalent to a very efficient vaccine, the authors said. Therefore, they said, the operation may provide a way to prevent the spread of the dreadful disease in sub-Saharan African countries. Cervical cancer (see sidebar) is one of the most common cancers that affects a woman’s reproductive system, with various strains of the human papillomavirus (HPV) causing most of the cases. A study published in 2002 in the New England Journal of Medicine concluded that male circumcision is associated with a reduced risk of penile HPV infection. Also, the study reported, the risk of cervical cancer for women who had male partners with a long sexual history was lower if men were circumcised, when compared to women who had foreskin-intact partners. The pain associated with the procedure, proponents say, is reduced considerably by using local anesthetics such as EMLA cream (EMLA cream is not recommended for infants under one month of age, due to complications such as methemoglobinemia (blood cells are unable to transport oxygen and carbon dioxide, resulting in cyanosis of the baby, which is a sign of hypoxia), dorsal penile nerve block (DPNB), and the subcutaneous ring block, which was associated with the lowest risk of complications, and sugar pacifiers. In its statement regarding neonatal circumcision however, the Canadian Pediatrics Society says that the most effective and least risky type of anesthesia or analgesia remains to be determined. If parents opt for circumcision, they should search for an experienced practitioner who will use the required topical analgesic and perform the operation as to ensure a low risk of complications. Why not do it? Circumcision has been recommended in order to prevent phimosis (inflammation of the tip of the penis), cancer of the prostate and penis, as well as cancer of the cervix in women. According to a recent study published in June 2006 in Urologic Nursing, there are better ways of treating phimosis than circumcision. The application of steroid topical cream, the authors say, is a painless and more economical method of treating phimosis. The study points out that since medical professionals see more boys with an intact foreskin, it is important that the public is educated regarding physiologic phimosis, as well as the available options for persistent nonretractile foreskin and/or pathologic phimosis. Other sources have recommended circumcision for aesthetic reasons and because the circumcised men will experience more pleasurable sensations during sexual intercourse. The latter argument is flawed by the scientific evidence that almost half of the specialized nervous centers contributing to optimum sexual sensitivity happen to be in the foreskin that is removed during circumcision. Interestingly, circumcision was initially performed in English-speaking countries as a way to prevent masturbation. A number of reports incriminate an intact penis to be responsible for a variety of infections, starting with urinary tract infections (UTI) especially during the first six months of life, followed later in life by penile cancer. While most physicians admit that some of these studies are partially right, one major argument against circumcision is that the risk of penile cancer in a population is very small to begin with – approximately 10 men in a million are diagnosed with this type of cancer. Cancer of the penis can be prevented by a rigorous hygiene and access to clean water. As for the UTI risk during the first year of life, the truth is that circumcised boys are less likely to develop the infection (1 in 1,000 compared to the rate of uncircumcised 1 in 100 boys). However, at the same time, the overall risk is low and good hygiene helps prevent such infections. The AAP has cited breastfeeding as a way to reduce the incidence of UTI, due to the protective properties of the breast milk on the baby’s mucosal tissues. Urinary tract infections, which can affect young boys and are said to occur less in circumcised ones, can be prevented by rigorous hygiene. In a recent statement released by Doctors Opposing Circumcision (DOC), a group of physicians, medical professionals and others who oppose non-therapeutic neonatal circumcision, it is stated that methycillin-resistant Staphylococcus aureus infections are at an all-time high and there is a dramatically increased risk for circumcised newborn boys. The circumcised wound, the statement says, is a portal-of-entry for the S. aureus, as reported by several scientific papers. Therefore, DOC advises doctors to act in the best interest of the child-patient and decline performing circumcision, even when that means opposing parental requests. Up until 1986, most medical practitioners were convinced that infants cannot feel pain, which is why operations such as circumcision were performed without anesthesia. Today, even though circumcisions are performed using local analgesics, infants still experience extreme pain, opponents say. Pain aside, being strapped down is enough to shock a newborn, they say. As for transmission of sexual diseases, while circumcised males are at a slightly lower risk for contracting STDs later in life, according to a study published in Pediatric Clinics of North America in 2001, patient education and the practice of low-risk behaviour are far more important in preventing HIV and HPV transmission. The bottom line? ------ How new babies measure up: what doctors look for after birth Our assessment of the newborn starts long before the birth. Assessing the baby in the uterus alerts us to conditions at birth. What do we look for in the unborn fetus to assess health? What do we watch in labour? As the baby is born we also assess the condition of the fetus carefully. We listen to the fetal heart rate and assess the position of the baby (facing up or down). Is there a cord around the neck? That is common and seldom a problem. We carefully observe the baby’s response to birth. What do we assess at birth? At birth we quickly assess the baby’s gestational age, heart rate, breathing, muscle tone, response to our touch, and skin colour. For a quick and standardized assessment there is a scoring system – the Apgar score. It is a numerical scoring system done at 1, 5, and 10 and sometimes 20 minutes of age. The perfect score is 10 and few babies ever receive that score. A low (< 5) one-minute Apgar score has little significance. However a five- and 10-minute Apgar score < 5 alerts us to watch the baby carefully but does not necessarily indicate permanent problems. At birth most babies are blue. Therefore an excellent Apgar score is 9 out of 10 (they lose one for colour). A great Apgar score is 8. Often they score 2 for heart rate, respiratory effort, and tone but only 1 for response to stimulation and colour. Many mothers and fathers are shocked by the blueness of the newborn. They must be reassured that this is normal. The baby’s circulation at the moment of birth is completely re-routing to adapt to breathing air. Within a few minutes the baby will “pink up” but the extremities often stay blue for a while. At birth a baby may cry, but may not. This is not a bad sign. Some babies are quietly looking around and blinking, breathing well and “pinking up” without crying. We no longer try to make babies cry at birth if they are showing signs of health. If there has been meconium (baby poop) we carefully suction their mouths as their head is born in hopes of preventing the poop from getting into the lungs. Once born, we may also look down their throat with a special instrument – a pediatric laryngoscope. If poop is in the airway we suction it out so they do not breathe it into the lungs and get sick. We listen to their heart (at birth there normally can be a murmur). We listen to their lungs to make sure air is entering in both lungs. We check their responses to stimulation (are they jittery, do they have normal reflexes). We also check the number of vessels in the cord (there should be three), watch baby’s body temperature (babies can get sick from being cold; a high temperature suggests infection). If the baby looks pale we check for anemia. We also look for bruising (their heads and faces can get quite bruised from the trip down the birth canal. We also check for congenital abnormalities. Approximately three percent of babies have a birth defect but often it is minor like a skin tag or extra finger. If there is a concern at birth a pediatrician is called if not already present. The pediatrician would then do a very complete examination from head to toe to check every system to assure that it is normal. If there is no immediate concern a complete examination is done by the baby’s caregiver (family doctor, midwife, obstetrician). This includes: general appearance, signs of gestational age, sex, skin colour, head shape (many are cone-shaped or molded at birth; this usually disappears in one to two days), ears, nose, throat, lungs, heart (rate, murmur, rhythm, pulses present), abdomen (no masses or distension), spine (any sign of spina bifida), hips (any sign of hip dysplasia), neurological tests (limp, jittery, normal reflexes), genitalia (undecended testes, hypospadias), anus (open or closed i.e. imperforate). After the initial examination, all babies continue to be watched. We watch their adaptation to life outside the uterus. We watch them breathe, eat, and observe their colour. Many babies become jaundiced after a few days. This is a normal development resulting from the breakdown of the old type of hemoglobin they used to “breathe” while in the uterus. They need a new type of hemoglobin to breathe air. The breakdown product is called bilirubin and its level can be measured with a blood test. Sometimes the levels can go too high especially in pre-term infants. If high enough then they must “go under the lights.” The special lights cause the bilirubin to be converted to a form that is easily excreted. We also check weight gain, urine output (wet diapers), and bowels (dirty diapers). Before they go home babies get a blood test for thyroid and PKU, a protein metabolism problem. Both of these tests are for rare conditions, which if not detected, can cause permanent harm to the infant – harm that could have been prevented. Like their parents we want to be attain the best health for the baby. We carefully and gently do the tests we must, to look for any problems that we can prevent or correct. -------- The Bottom Line: How to solve the diaper dilemma For Jody Turner there are no two ways about it. She loves disposable diapers. “I am not organized enough I guess, to always a have a fresh supply of cloth diapers and I find the disposables really convenient,” Turner says. Like almost 85 percent of the Canadian parents, Turner opts for disposable when is comes to diapering her children. At the other end, there are parents who gave cloth diapers a try and decided to stick with it. As parents of babies and toddlers we are immersed in diapers. We diaper for at least the first two-and-a-half years of our child’s life. Finding the right diaper has never been easier. And harder, at the same time. There is a vast selection when it comes to diapers, from disposable diapers that come in all shapes and sizes, to cloth diapers that are nothing shy of fashionable. According to Environment Canada, in the first two years of life, a baby will use probably somewhere between 5,000 to 7,000 disposable diapers. It is estimated that in Canada alone, the number of discarded disposable diapers reaches and goes well beyond four million. Daily. Environmentally conscious groups make parents aware of the strain these disposable diapers put on the landfills, since they take several hundred years to decompose. That is not to say that cloth diapers don’t burden the environment. They have to be washed regularly, sometimes dried with a dryer, and thus, they create part of the greenhouse gases we are trying to steer clear from. Here are the pros and cons for both alternatives. Disposable Diapers Disposable diapers would probably look less appealing if all parents would take the time to clean the poop inside before disposing of them. It may seem an obvious thing to do, yet not a lot of parents do this dirty job. As a result, the raw sewage accumulates in the landfills, which become breeding grounds for bacteria and live pathogens such as the polio virus, for example, coming directly from vaccinated babies’ diapers. According to Environment Canada, the landfill sites – which are not designed to handle human waste – threaten the health of sanitary workers, water supplies and wildlife. According to most environmental groups, disposable diapers represent one of the most threatening items in the landfill, making composting diapers look like a decent alternative. And although several trials have failed at composting diapers, help is on the way, with one company operating in Toronto and another in California. Also, all brand-name and store-brand disposable diapers nowadays have a polyacrylate filling. When the urine, or any other liquid for that matter, comes in contact with the polyacrylate particles, they swell up and transform into gel. The gel can sometimes break free of the diaper and get onto the baby’s skin, especially when dealing with wiggly babies and active toddlers. According to some independent studies performed in United States using rat models, the chemicals used to bleach diapers might cause asthma-like symptoms in some sensitive babies. There is a more natural alternative to regular disposable diapers, and it comes as close as possible to cloth, says Carla Van Messel, owner of store HipBaby in Vancouver. They are usually made of cotton and have no polyacrylate filling. Diapers like Tushies or TenderCare are soft and yet very absorbent, so they keep both parents and babies happy. They are usually less loaded with bleaching chemicals so they provide convenience in a healthier and environmentally-friendly combination. Cloth Anyone? Money-wise, cloth diapering is the most viable option, even more so if you decide to do the laundry yourself. Not only that, you can reuse the diapers on your second baby. And third. When it comes to the waterproof cover, one may consider hanging them to dry in order to make them last longer. Most toddlers are potty trained between two and a half and four, but cloth diapered babies tend to do it earlier, says Van Messel from her own experience. One explanation is the wet sensation that “cloth babies” have after they go in their diaper. Although the latest models are very absorbent and designed to ensure that baby’s bottom stays dry longer, they are still made of cloth. Are cloth diapers bad for the environment? Well, they are not exactly harmless either, since according to Environment Canada, home laundering of cloth diapers produces greenhouse gas and other emissions from energy consumption in the dryer. The latter energy problem can be solved easily by hanging the diapers to dry. But washing a load of diapers once or twice a week, they say, is roughly equivalent to flushing a toilet five times a day for a week. Not too bad, considering that solid matter gets treated as sewage, instead of ending up in the landfills. As for the detergent, yes, it can be a burden for the environment, but many parents today opt for natural, biodegradable detergents. Disposables are a real threat to the environment, they contain many unhealthy chemicals, and manufacturing them means sacrificing trees and polluting waters. Cloth diapers are not exactly the most convenient choice for the on-the-run parent, but they do their share when it comes to saving trees and not exposing babies to potentially allergenic chemicals. What to choose? ------ Teach baby the ABCs of reading Confidently sitting in her bath, my daughter, just shy of her first birthday, holds her prized new bath book, Circus McGurkus. She appears serious and contemplative, turning the slippery pages, running her finger along the text and pointing to the familiar characters. She is mimicking the behaviours of a reader. Already she has gained pre-literacy skills, which will help her become a better reader and ultimately a more successful learner. Toddlers are primed for learning, their brains twice as active as adults, synapses developing rapidly. Caregivers can make a dramatic influence on their child’s future reading skills. Now is the time to create an engaging and positive literary experience for your child. Begin by focusing on six main literacy skills. Motivation Phonological Awareness (the ability to hear sounds in words) Building Vocabulary Print Awareness (book mechanics) Letter Knowledge (learning your ABCs) Narrative Skills Empower your child by giving them one of the greatest gifts they will ever receive from you – the ability to read. Erin Peters is a freelance writer and a mom living in Vancouver. ------ Tune in to Baby The relationship you and your baby create from the womb through the first years is profoundly important for your baby’s development. The nature of this earliest relationship shapes baby’s preverbal knowing that they have a right to exist as the person they are. It also shapes baby’s capacity to trust, to deeply connect with themselves, to discover their own rhythms and needs. How you relate with your baby establishes his basis for knowing what a relationship is. This deep, cellular learning about himself and significant others is a template he will carry into future relationships. The seeds of self-worth, self-confidence and trust are sown now. Recent research in neuroscience and developmental psychology shows that the infant’s experience in the early years largely determines how baby’s brain develops. Early experience and, in particular, the parent/baby relationship impacts how the brain is actually wired. If baby’s experience is chronically inadequate, the neural networks of the prefrontal cortex, the seat of our most advanced human functions may be damaged, producing an enduring vulnerability to psychological problems. If appropriate, the child will be wired for health. Given this information, it is clear that the quality of attention and focus you bring to being with your baby in these earliest times has a huge ‘pay-off’ for your baby. Your attuned and responsive connection with your baby is an immense and far-reaching gift for baby and yourself. Ways to Tune In to Your Baby Here are some simple but profound ways you can tune in to your child. These ideas come largely from the work of Magda Gerber, the founder of Resources for Infant Educarers (www.RIE.org). For decades she has helped parents and infants learn how to treat each other with respect. 1. Observe Gerber, in her book, Your Self-Confident Baby, suggests, “As you observe your baby, relax and focus on what you see and hear. Look at your child. Look at her face, her arms, her legs. What is her body language saying? See what she responds to. See what holds her interest. See what bothers her.” In order to observe, you need to be able to still yourself. If you are anxious or agitated, you are not in a space to observe well. Quiet yourself. Notice your breathing. Bring yourself into your own body and senses. Clear your mind. Come into the present moment and then into relationship with your baby. Whether you are diapering him, holding him, feeding him, or bathing him, use these taking-care-of routines as a special time to be wholeheartedly present with your baby. Often we tend to do several things at once. See what it is like for you and your baby if you give him your undivided attention. Often this will ‘fill him up’ for the times when he is not with you and he will be able to separate from you with greater ease. 2. Talk Gerber describes the process, “When doing taking-care-of routines, explain and show your infant what you are doing step by step. Allow your baby to follow and become involved in the process, to make eye contact with you, to study your face, vocalize, initiate play, follow your actions and respond to you, and you to him.” For example, rather than picking up your baby unexpectedly or from behind, tell him, “I’m going to pick you up now.” Reach out to him and see if he will respond; perhaps a subtle change of expression or a movement of the eyes, arms, or legs. Initially, and with very young babies, they may not show any visible response. But you are establishing a habit of two-way communication and mutual responsiveness. Talking to your baby and listening to his response will help the two of you come into deeper attunement. Trust builds. Respect for each other grows. 3. Slow Down Step into ‘baby time.’ See what your baby can teach you about slowing down and smelling the roses. It may be difficult at first. Many of us live our lives at a fast and furious pace. Slowing down may seem impossible, boring or uncomfortable. But if you weather those feelings, you may find that tuning into your baby’s rhythm and pace brings you into a deeper and more satisfying connection with your baby and yourself. It’s Not About Being Perfect Dr. Thomas Verny, in Tomorrow’s Baby, states, “Most developmental psychologists now agree that repairing an interaction gone awry is a linchpin of healthy infant development.” The knowledge that breakdowns in communication will generally be repaired allows children to move out into the world carrying a sense of confidence and power because they can count on intimacy being re-established. The ability to repair relationships when they are out of sync, to come back into attunement after missing each other is what Carol Gilligan, in The Birth of Pleasure, calls the tidal rhythm of relationship: the “finding and losing and finding again.” She notes, “Trust grows when babies and mothers establish that they can find each other again after the inevitable moments of losing touch.” The job of parenting; of fathering and mothering is one of the most mundane, commonplace and revolutionary tasks a person can do. How we are with our children shapes the future of the world. As important as the work is, it is not about being perfect. It is about being human. It is about deepening our connection with ourselves and with our children through tough and tender times. It is about making “a safe house for love.” Shari Bender, M.A.Sc., R.Psych., is a registered psychologist in private practice in Vancouver. If you have questions, you can reach her at 604.221.9053 or sjbender@telus.net. ------ Potty Talk: when is baby ready to toilet train? There’s nothing like hindsight to keep a parent sane. I like the definition of the word found in Miriam Webster’s dictionary: “the perception of the nature of an event after it has happened.” Things seem so obvious looking back on them. With my first child, I was without this critical parenting tool. Every anticipated milestone was analyzed, measured, compared against this chart or that data. Take toilet training for instance. Having never “trained” someone to “toilet” before, I looked for information and was met with a dizzying blur of parenting experts in books and magazines. Throw in unsolicited tips from family, friends, neighbours, and well-meaning strangers – how could I know which was the ‘right’ approach? Different toilet training methods even have their own vocabularies – potty training, toilet learning, elimination communication, natural infant hygiene. Their views conflict on issues such as when to start the process, how to determine the readiness of the child, whether to heap praise and rewards or to be matter of fact … and much more. But their outcomes are identical – helping our children master the skill of peeing and pooping in the toilet. They also agree that for the process to be most successful, it must be relaxed, positive and non-punitive. Parents: bring lots of patience, humour, more patience, and be willing to accept setbacks. Conventional wisdom adjusts to change. What was accepted practice in Canada a generation ago isn’t considered a good fit with current lifestyles. Think about how many moms now work outside the home, how absorbent and convenient disposable diapers have become, and how squeezed for time family members are as they move from one activity or meeting to another. Times have changed. Today it is widely promoted that most children are ready to start toilet training between the ages of two and three, sometimes later. Watch for these signs. Your child may be ready to begin potty training if he: • stays “dry” for several hours • lets you know if he has to go, or is going • is uncomfortable in a diaper that needs changing • can pull his pants up and down • understands the value of putting things where they belong • likes to imitate your behaviour (cooking, shaving, shopping) Invest in a child-size potty or special seat that fits onto the regular toilet. Some families have a few strategically placed in and around the house – even in the car for when they go on outings. Let your child explore the seat by sitting on it fully clothed, then barebottomed when he’s ready. Visit the toilet with him routinely throughout the day. When he produces something, praise him genuinely. When he has an accident (and he will probably many) handle it gracefully. Let him know that accidents are okay and carry on. Mastering the many steps of toilet training can take a long time, or it can happen very quickly. Did I mention patience? Once you’ve started the process, try not to stop. Choose a time that works for the whole family, when you can focus on the task at hand as consistently as possible. A less visible and quietly growing toilet training movement in Canada and other western cultures is Infant Potty Training, also known as Natural Infant Hygiene. Saltspring Island’s Ingrid Bauer, author of DIAPER FREE! The Gentle Wisdom of Natural Infant Hygiene writes that this method is a “gentle, compassionate and practical way to care for a baby’s elimination needs from infancy. Rather than teaching a baby to eliminate into his or her most intimate clothing and cleaning up after the fact, mothers and fathers learn to listen and respond in the present moment to the baby’s needs and communication … parents can lovingly meet their baby’s needs, deepen their communication, and significantly reduce diaper use. This gentle and ancient practice is the most common way of caring for a baby’s hygiene needs in the non-Western world.” The Vancouver chapter of Diaper-Free Baby, a network of free support groups promoting Infant Potty Training, boasts 14 members since its inception earlier this year. Its goal is to help “people find ways to integrate the practice into their modern lives and homes.” Ancient wisdom is conventional to those who practice it. Worth exploring. I now have two kids, both out of diapers. They walk, talk, tell “knock-knock” jokes and peel their own oranges. They even sort of sleep through the night most of the time. And they each learned all this in their own way. I can say with authority and the grace of hindsight, that the right approach is the one that works for your family. Factor in your lifestyle, cultural traditions, stresses and realities. Gather information. Trust your instincts. ------- Toddlers gone wild: how to make sense of toddler’s outbursts Half a year ago, a national newspaper stated in big letters that toddlers are “the most violent people on Earth.” Unfair? Most likely, yes. According to Kathy Lynn, parent educator, “violent is too harsh a word to be applied to toddlers. They are most likely the most frustrated group of people but by no means the most violent. They don’t know how to communicate their needs, so they get frustrated.” Almost every toddler will display signs of aggression at some point. Hitting, pushing, biting – they are all there. What’s a parent to do? Why does it happen? Some blame the parenting style. Some blame the circumstances. Some blame the rough-housing. “Parents should never bite, kick, smack, slap, or punch their children playfully. Children do not have a perspective of what is too much; they generalize behaviour and copy it... Whoever is playing with the child should be very gentle, controlled, and modelling appropriate behaviour,” says Gloria Burima, registered psychologist in Victoria. When the parents playfully bite or punch, the child gets the wrong message and he might end up doing the same to other children because to him that’s playing! Parents need to identify any possible sources of frustration. Maybe the daily schedule needs to be changed, or maybe they are just not able to accomplish as much. As Lynn explains, the more there is that toddlers cannot do, the more frustrated they get. If toddlers who attend daycare start displaying signs of aggression, rather than labelling the child as violent, parents should observe the child in that particular environment. Most times, they can identify the things that set their child off. Whether the child is being picked on by other children or he doesn’t like that particular daycare, parents should spring into action and either change the daycare provider or find a way to resolve the conflict. Punishment vs. discipline Nope, they are not the same. Parents should opt for disciplining rather than punishing the child. “Development psychologists try to help parents understand that it is preferable to focus on discipline – a suitable and meaningful consequence for something that should stop or not be repeated – to help the child learn not to repeat undesirable behaviours,” says Burima. Toddlers as young as 14 months understand from their parents’ expression that some of their actions are wrong. Disciplining them though, should be an act of kindness and understanding, as they lack social skills. And even if they seem to understand they’ve upset the parent, the real consequences of a particular action elude them. Their curiosity and desire to explore make them repeat the same thing. It’s hard to call that misbehaviour but it is a mistake to ignore it hoping it will go away. Start disciplining a child early. If your baby pulls your hair or pokes you in the eye, let him know it hurts and remove his hand. If you smile while you tell him it hurts he’ll take it as a game and do it again. If you put on a serious face, he’ll get the idea. Eventually. Your words and behaviour speak volumes. Establishing a good disciplining relationship early on with your child will help prepare you both for the future. New challenges arise every day. Help is on the way There is no universal cure for your little one’s temporary quick temper. But here are some suggestions that could make your toddler less frustrated and more understanding of the fact that aggression is not acceptable. • Teach your toddler how to communicate his frustrations: Allow her to cry, offer warm hugs and let her know it is alright to feel sad and angry sometimes. “Toddlers should be able to express and identify their feelings, but they need a lot of help labeling how they feel. Anger masks a lot of other feelings – fear, apprehension, exasperation, frustration, disappointment, sadness, loss. Therefore it is important to help the child to identify feelings in themselves and others as soon as possible” says Burima. • Time-out? It depends. Some parents do not believe in time-outs, while some do. “Time-outs could make a child even more mad and frustrated. Instead, parents should keep the children close and calmly explain to them why hitting, pushing and biting is not acceptable” advises Lynn. Together, parent and child can look for a quiet place to calm down and discuss about what happened. Older children should be taught to calm down and think about their actions in a quiet spot where they feel comfortable. Whether you want to call it time-out or not, the idea is to discipline the child with love and understanding. If you opt for time-outs, Burima’s advice is to keep them short – no longer than five minutes, even less that that – and keep your toddler within sight. You can hold your little one on your lap and calm them down. Explain to them that hitting or pushing hurts others. Since you are trying to teach your child respect and understanding towards others, remember that you teach best by example. • Accept the fact that they might not be ready for the activities that you plan for them. Toddlers have a different view of the world: They don’t understand why they have to share and they get tired during a play date. “Developmentally, toddlers are not ready to share their toys yet. When hosting a play date, they should be allowed to put away their favourite toys before the guests arrive so they won’t have to share them,” says Lynn. If there are obvious signs of aggression during play dates, consider putting them on hold for a while. There are many other activities your toddler will enjoy. • By letting your toddler know what he will do next, he’ll feel more secure and less frustrated. “Parents should try to make their little ones’ lives as seamless as possible,” says Lynn. Some children are more temperamental than others and parents need to respect that and tailor the day’s schedule according to the child’s needs. • Consider signing up for a parent participation music class at your local community center. These classes provide a good environment for your toddler to get used to having playmates and enjoy their company. If you want to take it to the next level, here’s a challenge: Set up a short play with finger puppets and talk about nice behaviour. You’ll be surprised by your child’s responsiveness. • Ask for help. “Parents should be concerned about aggressive toddlers when their attempts to control and change these behaviors are not effective,” suggests Burima. It is not unusual for parents to overlook more subtle causes for the child’s aggressive outbursts so contacting the pediatrician for a referral to a child therapist might be a good idea. • Last but not least, remember to keep your calm. Since you are teaching empathy and kindness, your child should always get the first example from you. And if some days you feel like you are losing it, don’t feel bad, nobody is perfect. Just make sure you apologize and talk to your child about it. “This too shall pass...” There will be days when no matter how hard you try, your toddler will be as wild as they come and constantly looking for trouble. Take heart and remember that children have different temperaments. Since this is the age where their personality comes out forcefully, it is our job as parents to teach them good behaviour, while nurturing their budding individuality. ------ How to create a nursery that grows From the moment I learned I was pregnant I had many visions on how to decorate the nursery. Ideas for adorning our baby’s nursery went off like firecrackers of pink and blue. Baby chicks, bunnies, and an assortment of characters came to compete as the possible nursery theme. The contenders ranged from the soft and delicate water coloured drawings from the glossy vanilla pages of Beatrix Potter books to the blue collar charm of Bob the Builder and his squadron of steely sidekicks. Flawless nursery spending and splendor would start with the perfect West Coast Saturday morning. After a good night’s sleep under our crisp white duvet, it was time to head downstairs for a quick flip through an inch thick Weekend Sun, a piping hot cup of French Roast in hand and the oversized bistro plate of eggs and smoked salmon my hubby made for me. When the kitchen was spotless, once again, it was time to shower and don my fall uniform; North Face puffy bomber, buttery soft Levi’s and my Marc Jacob moon boots, a sassy replacement to the overexposed usage of Uggs. Hubby and I jump would then jump in the car and head off to the shops. Miraculously we will find a primo parking spot at each stop. Just before we are ready to interlock our wedded hands and skip down the aisles with a wallet full of ‘skies the limit’ credit, I wake from the land of NOT – and go shopping with my other best pal. My mom. The Lower Mainland might be full of husbands and fathers-to-be that love to shop for nursery do-dads but I am not married to one. I do have one who is supportive and he’s found out that if I’m happy, he’s happy. As we refused (twice) to learn the gender of the growing bump in my belly I let the pink and blue butterflies in my tummy duke it out for territory. How I wanted to decorate the nursery was split between frothy yard after yard of raspberry and cream toile and a vibrant emerald green and sapphire blue tartan fashioned into curtains and a wee duvet to honor my Scottish heritage, my a-ha! moment came with the decision to embrace the ‘Convertible Nursery’. With the exception bubble gum pink, you can choose just about any paint colour for your nursery and with the right fabric and accessories it will suit your babe. Be it a boy or girl. What will your nursery be to you? For first timers, be willing to accept the wisdom from other Moms and Dads, they will tell you what they know from their first hand experience. Getting up for those multiple feedings and diapering during the night can be a lot less taxing if the baby is close by. With both my sons they spent their first year in our principal bedroom. Close enough to scoop up to nurse and within hand-holding distance from my bed to their crib, when it was me who suffered from a little separation anxiety. The space should reflect your taste as well. You will spend a lot of time in that room and the space you create will colour your recollections of an incomparable experience. The term “Convertible Nursery” is picking up speed and it’s one I use frequently. In that glorious state of bliss uncertainty and awe, although it seems your baby will be a newborn forever, they develop at high-speed. Those miniature clothes that look so small in a baby dresser will soon be spilling out of those shallow dresser drawers, cupboards and vanities. Picking furniture pieces and a nursery theme or style that will give you time to catch your breath before you have to decorate all over again or hear the pitter patter of sibling feet, is quite simply, smart. Divide your nursery into three convertible areas; Furniture, Layette, and Design. Convertible Furniture The crib will be the most expensive and important piece. This is where your babe will sleep (if you’re lucky). A convertible crib is designed to transform into daybeds or full beds and will change with the age of your child. Typically this means when your infant grows into toddler and is ready for a big boy/girl’s bed they can sleep in the same piece, just in a different format. This will save you money and you won’t need to buy two separate beds as your child grows. Buy adult-sized dresser drawers; new or used. If you’re a DIY kind of gal (like myself) scour the newspaper for yard sales, estate sales, thrift shops and the like. That dark 70’s piece can be transformed. Suppose shabby chic philosophy of pioneer Rachel Ashwell, everything old is fresh again with a couple coats of white paint. I would choose glossy white for a girl’s and flat white for a boy’s room. Hardware for the drawers is the ideal convertible. Determine what you might like and tally up the total number of pieces you’ll need, you might find that it is often very costly to change out hardware, despite the spin they toss out on reno home shows. If you want to decorate with jovial kiddy designs, chose durable and inexpensive ones made of plastic and resin. When you are ready to convert to a more sophisticated look, let your mouth water over the selection at Restoration Hardware. Convertible Layette Toiletries and supplies for your layette; creams diapers, breast feeding equipment and stuff for Mom can be stored in a plastic toy box. Mine is bright and cheerful in primary colours, has three deep drawers and cost in the region of $30 at Canadian Tire. Once I can move the toiletries back to the bathroom, I will have a place to store the dozens of HotWheels® accumulating under my bed. Changers can often be spruced up with fabric panels and removable rails to accommodate books and toys. Convertible Décor Paint might still be the most inexpensive way to decorate, however it does take time and you might just opt for some sleep in a year ~ or two. Do yourself a favour and try one of the useful virtual painters online. If you can’t find the urge to paint gender specific colours like pinks and blues, be willing to expand your interpretation of pink and blue. From Pepto-Bismol to Blush, from Robin’s Egg to Cobalt. The range of colours is colossal and you might be surprised at what you thought you liked and what you end up choosing for the nursery. The following websites all have virtual painters, paint calculators and ideas for the self taught designer www.benjaminmoore.com, www.behr.com, www.sico.ca. Accessorize with personal items you buy and receive as newborn gifts. When I had my boys I was lucky enough to have several crocheted blankets, handmade stuffed toys and quilted blankets. Our nursery is now doing double duty for baby and toddler. Each boy has his own area with shelving up high (away from curious hands) that is unique to each alone. The cherished heirloom pieces made by my mother, family and friends won’t be on display forever, Agree to let the nursery convert when you’re all ready. A nursery is a special place. But even more so, a special time. Hang on to every moment. The good, the bad and the everything in between. ------- The
news on baby's first shots If you have a baby, your child's doctor may have told you that there are a few new vaccines that are now funded by the provincial government. You probably have lots of questions about these vaccines. Here is what you need to know. Additions
to standard vaccinations Pentacel (also known as "5 in 1"). This five-component vaccine provides protection from pertussis (better known as whooping cough), H.flue (a cause for meningitis, skin infections, pneumonias among other illnesses), diphtheria (now a very rare cause of severe illness that is no longer seen in Canada), tetanus, and polio. Recombivax. This vaccine provides protection from hepatitis B. This used to be given to children in grade six, but is now part of the newborn series. MMR. This three-component shot provides protection from measles, mumps and rubella (also known as German measles). Both measles and mumps are rarely seen in North America, thanks to our excellent vaccine programs. Rubella, however, is still seen. While it can cause a relatively mild illness in young children, it becomes a problem when these young children pass it on to pregnant women who are no longer immune to it. It can cause devastating disease in the fetus, as well as deafness and brain damage. Both the pentacel and recombivax are offered routinely at two, four, six and again at 18 months of age. A booster is offered before entry into kindergarten (ages four to six). It is the same as the pentacel but does not include the H. flue component, as this bug does not tend to cause serious disease in this age group. The MMR is offered at 12 and again at 18 months. For more information about these immunizations, visit the Canadian Pediatric Society website at www.CPS.ca and click on immunizations. What's
new? Prevnar
The Prevnar vaccine was licensed in Canada in 2001. If your baby was born before July 1, 2003, you would have had to pay up to $360 for the vaccine including the boosters. What are the side effects? In a large study of 17,000 children, there were no serious adverse effects. Some redness or swelling at the site of the shot, fever, irritability or rash may occur. Prevnar is now part of the two-, four-, and six-month immunizations with a booster at 18 months. If you're keeping count, that means three shots at each appointment (ouch!). If you give your baby acetaminophen (Tylenol or Tempra) before the visit though, he probably won't mind too much. Meningococcal
C vaccine The vaccine is very safe, with no serious adverse effects reported. Common side effects include redness and swelling at the site of the injection, fever, and irritability. Once again, acetaminophen is your child's friend. Happy first birthday! The bad
news The cost for this vaccine is about $80. It's a great first birthday gift that Grandma can give to your baby. More bad news. If your baby was born before July 1, 2003, the Prevnar vaccine is not funded and there's no "catch-up" program planned. If your baby was born before July 1, 2002, the Meningococcal C vaccine is not funded. However, some children will qualify if they have certain chronic health conditions or if they're aboriginal. Check with your child's doctor. Otherwise, you'll have to pay out of pocket for the shots. If you have extended health coverage, your plan may cover some of the cost of the vaccine. Many parents wonder if the many vaccines that children now receive, can overwhelm the immune system. This is simply not the case. There doesn't appear to be a limit to the number of vaccines with which the healthy immune system can work. -------- Dreaming
of sleep Deep in the night my baby is crying. Again. Awake and in need of sleep, we both resume the dance of new parent, new child. Rocking, snuggling, feeding, yawning until the peaceful cadence of breath is the only music heard. In darkened households everywhere, these ancient rhythms are repeated over and over until the weary sunrise. Welcome to the reality of "sleeping like a baby." As we prepare for the birth of our child, new and expectant parents tune in to advice, solicited or not, about feeding, holding, diapering, nurturing, teaching, protecting. Gathering information is a big part of the nesting instinct. Yet somehow, in all the facts and old wives' tales, the science of babies and sleep is often neglected. Only when the baby is born does the notion of a "good night's sleep" seem naïve. We start looking for answers. In the last four decades, sleep has moved from centuries of myth and curiosity to science. We can measure brain activity during slumber, what's connecting, growing, or dormant. How sleep affects moods, growth and learning. "Sleep needs" are charted. REM and deep sleep, individual temperament, stimulation levels, all make up an equation with no definitive answer. What we do know is that chronic sleep deprivation impacts our ability to be creative, patient and even loving parents. For babies, interrupted and insufficient sleep affects their emotional, intellectual and physical development. What hasn't been discovered is a singular solution to help babies to sleep better. From "crying it out" to Ferberizing, scheduling to attachment parenting, sleep theories are varied and often conflicting. Letting a baby "cry it out" has been a common approach to sleep training for decades. Basically, once baby no longer needs night feedings, he is put in his crib for the night. The door is closed and the he is left to cry until he finds a way to self comfort. Not for the faint of heart, this method challenges the parents' instincts to respond to their distressed child. But after about one week, the theory goes, the baby will learn to fall asleep on his own. The most popular variation of "crying it out" is the slightly softened approach of Dr. Richard Ferber, author of Solve your Child's Sleep Problems. Known as "Ferberizing", this technique recommends that parents not leave their child "cold turkey" but that they periodically comfort baby without picking him up. After a kiss goodnight, parents leave the room and, if baby cries, wait a predetermined amount of time before going back in to check on him. Most parents start with five-minute intervals the first night, 10 minutes the second and so on. Comfort and speak to baby, pat him gently, but don't pick him up. Leave the room and repeat this again until baby falls asleep. Dr. Penelope Leach and Dr. T. Berry Brazelton both agree on the importance of letting babies fall asleep on their own. Their methods are still gentler than Ferber, but follow the same premise: the baby must be left in his crib after the bedtime routine. When he cries, go into his room to comfort and reassure him, then leave. Leach writes, "You may have to repeat this over and over again, but it is the only sure way eventually to convince (him) both that you will come and that you will not get (him) up." Brazelton suggests you let baby fuss for a few minutes to see if he will settle on his own before you go in to quietly soothe him. On the opposite end of the sleep expert spectrum is Dr. William Sears, author of Nighttime Parenting and many other parenting books. Dr. Sears is an advocate of attachment parenting and the "family bed," encouraging parents to sleep with their children. According to Sears, co-sleeping is a way for babies to learn that sleep is a pleasant state to enter. When baby falls asleep with a parent, he sleeps better and for longer, and tends to develop healthier sleeping patterns than babies who are left to "cry it out." Dana Obleman, creator of Sleep Sense Seminars in Vancouver, understands how confusing all this can be for new parents. Armed with first-hand experience of new baby sleep stress, a background in education and psychology and a passion for promoting the importance of sleep, Obleman leads seminars that help make sense of such divergent information. The goal? To develop a customized "sleep plan" that works for your family. "Sleep is crucial to everyone's happiness, health and well-being," says Obleman. "We need to value it, put it as a priority in our lives." This is not always easy in a fast-paced world where sleep is viewed by some as an annoying interruption in their busy lives. "Why waste the night just sleeping?" chimes the TV ad for whiter teeth. Waste indeed. We all feel better with a good night's sleep. It's a fact. Finding the best way to help your baby and entire family sleep well is a personal journey. It calls on your instincts as a parent, and a deep understanding of your child's needs. Writes Obleman, "The only approach that will be successful for you is one that you feel comfortable with." Now that's a theory I can agree with. How these
local moms got sleep: "I soon came
to realize that rushing around doing household chores while the baby napped
was not the way to go. I would nap while the baby napped." "Jordie was
a terrible sleeper and a colicky baby. Scott and I would take turns in
the night and...having naps during the day if we'd had a particularly
bad night...Nina was a dream. I just let her sleep with me for the first
few months and we were all well rested!" "How did
I get sleep? While nursing, cooking, driving, talking to my husband. Really?
I tried to sleep when the baby slept, but found it hard to ignore my competing
impulses to clean my chaotic house or have a bath. I went to bed early
and basically had no life beyond mothering until the haze of infancy lifted
and toddlerhood dawned." "With Isaac,
I would put on a video, place Jacob on the couch between my legs, have
Nathan...in my arms, Isaac in the bassinet next to my head...while I napped.
Amazing enough it worked. I could sleep well knowing the boys were close
and safe." -------- Childcare
options: who will care for baby? In today's busy world, parents are working harder than ever to meet their obligations. And as working parents, they want to feel confident that their children are receiving the best care possible. Children receive care in a variety of settings including their homes, the homes of neighbours or relatives, and family or group childcare settings. Each option has advantages and disadvantages. A parent's choice is dependent upon lifestyle, budget, personal preference and available options in their location. Here is a rundown on the most popular types of childcare and their advantages and disadvantages. Family
Child Care Family childcare programs that are not licensed through the Provincial Community Care Facility Act and Child Care Licensing Regulation can provide care for up to two children (unrelated to the caregiver). Licensed family childcare programs can provide care for up to five children (plus two of school age) aged from infancy to 12 years. The cost of this type of care ranges from $500 to $800 per month depending on the age of the child, location of the program, qualifications of the caregiver and whether or not the facility is licensed. The primary disadvantages of this type of care can be the restricted hours and the preparation, time and energy that are required in transporting the child to and from the caregiver's home. Some parents also find the caregiver-to-child ratio too high for an infant. Group
Day Care Different licensing requirements exist for the two categories. Group daycare centre hours are sometimes up to 13 hours a day, offering parents more flexibility for drop-off and pick-up times. Staff are required to have training in Early Childhood Education from an approved institution or college. These centres often offer an excellent preschool education program thus improving the transition from day care to elementary school. If a centre is located near an elementary school it will often offer drop-off and pick-up service for children needing half-day care while enrolled in kindergarten. Full-time care in this type of facility will cost between $500 to $750 per month. The disadvantage to this type of care is that some children have a difficult time adapting to the larger environment of a group daycare. Also children with special needs or behavioural problems sometimes need more specialized care. As with family childcare programs, group day care may not be economical when two children from the same family require care. Nannies
The disadvantage for many is economic. The cost of a nanny can be beyond the means of working families: between $1300 and $2500 per month. The salary range is dependent upon the job description and the nanny's experience. Even if parents can afford a live-in overseas nanny, they may not be able to provide the accommodation required, or may not feel comfortable having someone outside their family living in their home. Nanny
Sharing The main disadvantage to nanny sharing is that it can be tricky for two families to arrange a workable situation. Employers should be sure they agree on a reasonable work schedule, vacation dates and monetary division of statutory holidays. When searching for appropriate childcare it is important to research all the alternatives. Your final choice will depend upon your lifestyle, budget, preferences and the available options in your neighbourhood. A good place to start looking is the childcare resource and referral programs in the Lower Mainland. They are an excellent resource for both parents and caregivers. Janet MacDonald is the owner and operator of Optimum Childcare and Nannies Inc, a nanny recruitment service that has been in business for more than 14 years. For further information you can contact her through her website: www.opti-mum.com. -------- Waterbabies:
why teach baby to swim? Waterbabies, laughter and learning to swim ... an unbeatable combination! The benefits of baby-friendly infant/toddler swimming are unique and uplifting, and contribute to the positive development of the whole child. Researchers have documented that the stimulating effect of child-paced infant and toddler swimming lessons has the potential to increase intelligence, concentration, alertness, and perceptual abilities. Improvement in social, emotional and physical development has also been published. Of course, the manifestation of such inspired cognitive, personal and motor development takes time, patience and repetition. Through the soothing medium of water, children are able to experience its caressing and stimulating effect. Water's buoyancy is like an invisible helping hand. Zero gravity allows for freedoms that do not exist on land. The water provides a special time and place for you and your child. Early swim lessons set a positive foundation towards a lifetime of participation and enjoyment in a variety of water sports. With Mom and Dad as co-teachers in the pool, baby can learn to relate to the water with ease and confidence. Infants as young as six months can begin to rediscover the liquid environment they left behind in the womb. 8 reasons
to teach baby to swim 2. Babies can exercise more muscles in water than on land. They are less restricted by gravity and their ability to sit or stand. This increased strength often manifests itself in early acquisition of physical skills such as walking. 3. Early mastery of water movement gives children a head start in learning the basic swimming skills. Stroke instruction can begin as early as three years for children who have had the proper preparation. 4. Water helps to improve coordination and balance by allowing babies to move bilaterally to maintain their equilibrium. 5. Warm water, combined with gentle exercise, relaxes and stimulates babies appetites. They usually eat and sleep better on swim days. 6. Babies flourish in the atmosphere of focused attention that their parents lavish on them during swim time. Parents often confess that the lessons provide the only time they can spend 30 pleasurable, uninterrupted minutes with their babies. Swimming provides babies with lots of skin-to-skin contact with their parents. That, psychologists say, deepens the bond between parent and child. 7. As babies learn how to maneuver in the water on their own, their independence and self-confidence blossoms. This is evident by the ear-to-ear grins stretching across their faces. 8. Learning to swim is not only a fun-filled and healthy activity, but it can save a life. All children should learn how to swim to greatly reduce their chances of a water accident and to prevent the paralyzing effects of fear and panic if they fall into the water. -------- Plagiocephaly
and baby Have you noticed babies with flat heads? Babies who lie in one position for long periods of time can develop a flat area on their head, as skull bones are soft until about one year of age. The medical term for this flattening of one side on the back of the head is "positional plagiocephaly." The baby may develop one ear that sticks out and facial changes on the "flat side" of the head. (*Remember: A baby should sleep on its back on a firm surface!) When can
plagiocephaly develop? How to
help prevent the condition: How to
check if your baby has a "round" head shape: What to
do if your baby gets a flat spot on the head: Tummy
Time: 1. What is
tummy time? 2. Where
should my baby have tummy time? 3. What do
I do when my baby has tummy time? 4. What can
I do if my baby doesn't like tummy time? -------- Ear
infections and baby: why they occur, and how to prevent and treat them
Otitis media, or ear infections, are the most frequent complaints when a child is brought to a doctor. Over 80 percent of children are expected to have a least one ear infection, and almost 50 percent will have it by age 3. Toddlers are much more prone to ear infections for many reasons, and certain factors increase their chances of getting an infection. Ear infections are associated with colds and other infections, and can be partially caused by them. A typical ear infection occurs when a virus or bacteria ascends the Eustachian tube connecting the throat (oral pharynx) to the middle ear. When the reflux, or "back wash" of relatively common viral and bacterial mucous from the throat goes up the tube and is not drained, swelling, pain, pressure and finally an ear infection and fever can result. Anatomy of the throat and ear, immunity to viruses and bacteria, and total exposure to these infections account for the high rate of infections. The young child has a narrow, short, and easily accessible Eustachian tube, which allows infections to go up from the back of the throat to the middle ear. For the first six months of life, a child is immune to many infections passed on from mother during pregnancy, But after this, a child must usually build up immunity to fight off infections. As a baby becomes mobile, he/she puts his/her hands and mouth on everything. At the same time, baby's exposure to other children, viruses and bacteria increase. All of these factors influence the chance of infections. Upper respiratory infections, such as the common cold, are frequent throughout the first few years of life and can sometimes lead to ear infections. Acute Otitis Media (AOM) should be suspected if your child has pain, fever, or discharge from the ear. Ear pain, usually caused by the sudden and high pressure from the mucous and bacteria in the middle ear, against the ear drum (tympanic membrane) can be displayed by pulling at the ear, irritability, or even decreased appetite or energy. High fever (above 38.5ºC or 101ºF) is another good indication of infection. Thick, smelly, green or yellow discharge from the ear is less common, but sometimes present, and should be distinguished from harmless, thin, brown or reddish-brown ear wax. Medical evaluation of AOM includes a history of all these factors, and physical signs. Physicians look for fever, ear discharge, and visual changes of the tympanic membrane. The movement of the tympanic membrane when air is pushed into the canal is the most reliable way to diagnose AOM. Treatment of infections should be aimed at quick, safe relief of symptoms. Tylenol and or Advil/Motrin should be used alone or in combination to give relief from pain and temperature. Decongestants are helpful when AOM is associated with colds or upper respiratory congestion. Antihistamines can be used when allergies are present. Because 50 to 80 percent of all ear infections clear without the help of antibiotics, they should be reserved for specific conditions. These include infections with severe pain, high fever, or infections lasting more than three days. For children under two years old, because severe complications may occur, antibiotics should be used to decrease the chances of the development of these complications. Finally, in children with frequent infections, spontaneous resolution is less likely, and antibiotics are needed. Prevention of AOM is the most important and possibly the most effective way to eliminate pain and suffering. A vaccine against S. pneumoniae, a bacteria that causes 40 percent of all ear infections is now readily available. Prevnar is now part of the routine immunization schedule for children born in BC after July 2003. It gives immunity against the seven most common types of S. pneumonaie, and the majority of subtypes that cause AOM. It can also be given to children under five, who do not benefit from the new schedule, at a cost. Along with immunization and infectious control (such as hand-washing, decreased contact with other sick individuals and surfaces like toys, that contain respiratory secretions) are effective in decreasing chances of ear and other infections. When ear infections occur, symptomatic treatment with over-the-counter medications are sometimes the only treatment needed. When symptoms are severe, prolonged or frequent, or displayed by a child less than two years old, medical treatment should be sought. -------- Flying
with baby I first took my son on an airplane when he was barely four months old. I remember having just said goodbye to my husband and feeling awfully scared. How was I going to manage with a baby on the plane? Alone! What if my baby starts crying inconsolably? Sixteen months later I can tell you one thing: I survived. And yes, travelling with a baby can be fun. With bit of planning ahead you'll get the best out of it, guaranteed! Planning
the trip "Priority for the bassinets goes to babies weighing less than 12 lb," says Zelma Demeter, a travel consultant from Vancouver. The bassinet seats have enough room to accommodate you and your baby paraphernalia. The bulkhead seats have more leg room but the armrests are fixed, so even if there are empty seats next to you, you can't lie down. Many people decide to purchase an extra seat and bring along the car seat. Safety-wise, this is preferable but paying for an extra seat can put a strain on the budget (usually half the price of the adult fare). Your baby might even refuse the car seat given the new setting. You can easily hold the baby on your lap and save a load of money. If the flight is not fully booked chances are you'll get a courtesy seat. Travel pros recommend that you travel during off-peak times. That means avoid the weekends and opt for mid-week travel. Book a night flight, if possible: your baby is more likely to sleep and you may catch a wink, too. If it's a short flight, aim for nap time. Small
stuff (to pack) o Diapers: enough to get you by and them some. If you like a certain brand, load up. Leaking diapers are not worth the stress. Take plastic bags for soiled diapers and the best wipes you can possibly find: all natural, no fragrance, and with the shortest list of ingredients. This is particularly important if you'll have a long flight. Delicate baby bottoms can easily get rashes when travelling. Word to the wise: Changing diapers in the tiny airplane bathroom can be cumbersome; take a toy along to entertain the baby and work quickly. The transparent plastic cups were a real hit with my son. o Clothing: take enough clothing to face any mishap with dignity. Accidents happen, babies throw up and no diaper is seal-tight. o If you are exclusively breastfeeding, make sure you eat and rest well before your trip so that your milk supply will not be affected by the stress of getting everything ready. Start packing early so you'll avoid the craziness of the last-minute preparations. If your baby is bottle-fed consider buying enough cans of ready-to-feed formula instead of dealing with messy powder. In any case, bring along some disposable bottles to make things easier. o If your baby is too young for an umbrella stroller (you can take these on the plane), a regular stroller can sometimes be stashed in the cabin. o Your favourite baby carrier. Of all the things I took with me, there was one I couldn't do without: my sling. Baby carriers are invaluable for soothing crying babies and helping them fall asleep. Not to mention getting around the airport. o Some pain medication, either homeopathic remedies or Tylenol in case of unexpected pain. o Baby blankets, wash cloths and favourite toys completed my list. Yours can be longer but you should keep in mind that your diaper bag should fit in the luggage compartment. Up we
go! Whispers
in the air... Ultimately, keep in mind that your little one feels your distress and acts accordingly. Be calm and your chances of having a content baby will definitely increase. My husband's words in response to my travelling worries were: "All he needs is you. He feels safe with you no matter where you take him." Needless to say, those words have become my travelling mantra. -------- How
to choose the best stroller Next to a crib and car seat, a stroller is likely the most essential piece of equipment you'll buy for your baby. With so many brands available - and prices ranging anywhere from $50 for an umbrella stroller to more than $600 for a tandem model - choosing a stroller can be almost as painful as childbirth itself. Okay, well not exactly, but the wrong choice may prove to be an uncomfortable ride for both your baby and your pocketbook. What makes an ideal stroller? According to the Safe Start program at BC Children's Hospital, the most important feature is safety. Among babies under one year of age in Canada, strollers are the fifth leading cause of emergency visits due to falls and the number one cause outside the home. Stroller-related injuries are generally the result of harness misuse (or non-use), tip-overs and equipment malfunction. Most first-time buyers have no clue as to what the advertised 'bells and whistles' mean to them. Beyond safety, the type of stroller you choose will depend a great deal on your lifestyle. Here are some guidelines to help you find your ideal stroller. Stroller
Safety Features Stability. The stroller should demonstrate good maneuverability on turns and should not easily tip sideways or backwards on inclines. Storage. There should be a bottom storage basket to discourage hanging bags and purses on handlebars. Mechanical soundness. Folding mechanisms and wheels should be secure. Ideally the spokes/wheels should be inaccessible to little fingers while in motion. A five-point harness. This is the only harness type that will prevent a toddler from standing up in the stroller or reaching down to the wheel mechanisms. Price can be a limiting factor in buying new. If you choose to buy a second-hand stroller make sure you first check the brand and model number for potential safety recalls. Your best bet is to buy a stroller from a friend or relative whom you trust and who can point out any flaws. Jogging
Strollers Here are some features to look for in a jogging stroller: Tires. 12" to 16" tires are fine for walking and hiking but are not recommended for running; look for 20" tires and an aluminum frame if you plan to run with your jogger. Maneuverability. Many 'look-alike' joggers have a swivel front wheel that makes maneuvering in tight spaces easy. Swivel wheels are not intended for running. Some newer models feature a front wheel lock to give you both options. Recline feature. This is an essential feature on joggers intended for infants. Take the jogger for a test run to make sure the fully-reclined seat does not interfere with your legs when in full stride. Brakes. There should be a locking/parking brake and break-away strap to prevent the stroller from getting away from you. Handlebars. Handlebars should have sweat-resistant grips. As well, two-parent families (where one parent is significantly taller than the other) can prevent back strain by choosing a stroller with a height-adjustable handlebar. Even with a fully-reclined seat, Safe Start does not recommend jogging on rough terrain or gravel until your baby is at least one year of age. The jostling and bouncing can stress an infant's very weak neck muscles. At jogging speed, you may have difficulty stopping in time to avoid a driver who doesn't see you. So avoid high-traffic zones. For the same reasons, never jog at night without wearing retro-reflective material that can easily be seen by oncoming motorists. Parents'
Picks Compatibility with major brands of infant car seats. Many all-in-one stroller combinations last only as long as your child uses an infant car seat. Children move out of their infant seats when they reach 9 kg (20 lbs), which means that if you buy an all-in-one you'll likely be shopping for another stroller in about eight months. Newer strollers have built-in holders to accommodate most infant car seat brands and convert to lightweight or full-featured strollers later on, thus stretching their value. Portability. Parents who constantly lift strollers in and out of their vehicles will tell you that jogging and full-featured strollers are not all they're cracked up to be. The favourite companion of a seasoned 'chauffeur' is a no-frills, lightweight stroller (preferably with a canopy) that can be easily folded and stored in their vehicle. Drink/bottle holder and snack tray. Parents like built-in cup holders because they free hands for steering. Snack trays provide a place for toys and teethers so they don't get dropped on the floor. To prevent scalds, keep a lid on hot tea or coffee. Safe Start does not recommend using cup holders and other handlebar accessories that are not part of the original stroller. Air-filled tires. These have better shock absorption than hard plastic tires, for a more comfortable ride. Two-way handlebar. With this, you can reassure your baby in the early months and then flip the handlebar to the other side when he/she is ready to face the outside world. Stroller
match-maker The lightweight stroller. Pros: it weighs much less than a full-featured stroller, is easy to fold and fits into any vehicle and is a great choice for frequent travelers. Cons: it is not always suitable for newborns as not all models have a full-recline feature. Most lightweights are not as stable as full-featured strollers and won't stand up as well to prolonged use. The umbrella stroller. Pros: it is lightweight and easy to fold. Cons: the umbrella stroller is notorious for tip-overs, especially in cases where items are suspended from handlebars or users ignore recommended age/weight guidelines. Recommended as a back-up rather than a full-time stroller. The jogger stroller. Pros: air-filled tires and heavy-duty design make this the best choice for outdoor enthusiasts, as long as it has a full-recline feature for infants. Cons: beware of look-alikes that may not have the correct safety features for jogging. Parents must take extra precautions to shield their infants from sun and cold temperatures. Check the manufacturer's instructions to make sure the stroller is designed for your needs. For detailed stroller ratings, visit Consumer Search, one of North America's leading independent ratings sites, at www.consumersearch.com. For product recall information on second-hand strollers, visit the Consumer Product Safety Commission online at www.cpsc.gov. More infant and toddler safety information can be found on Safe Start's website at www.cw.bc.ca/safestart. Anne Williams manages the Safety Station at BC's Children's Hospital. It is Canada's only hospital-based safety information centre and fundraising shop. Proceeds support the hospital's injury prevention program. -------- Bring
music to your child's ears It was overwhelming. I was a new parent and the message I was getting was that if I didn't have my baby registered in some program to stimulate his brain, he would be forever damaged. I was panicking. Everywhere I looked there were videos, books, CDs and flashcards available for purchase. Who was this "Baby Einstein" guy anyway? After I calmed down and realized that the only thing my baby wanted to do for the first few months was sleep and eat, I began to explore the exciting options that were available for my little one. My husband and I decided on a music program. The class we chose began in the fall and, like a school year, ran until June. My son, by now eight months old, blossomed with each successive class, shaking his little egg and eagerly taking his turn playing the drum. Imagine my surprise and delight when one day he hummed along with the violin as we danced around with scarves in class! Children
& Music As their first teacher, we play a major role in our children's early learning by providing them with opportunities to reach their full potential. Early environmental stimulation makes a huge difference in our children's growth according to Gordon Well, professor of Education at the Ontario Institute for Studies in Education. Since the 1970s, strong evidence has emerged that suggests that activity, experience, and stimulation can alter brain development. "Music classes nurture the bond between children and parents using music and movement. It gives parents an opportunity to spend quality time with their child in a fun and stimulating environment," says Louise Leroux, an early childhood music educator. "Music can enhance a child's language and cognitive development. It also helps develop their social skills, self-esteem and creative expression when they can learn in a positive and encouraging way." What to
look for in a music class The Next
Mozart/Einstein? Research at the University of California, Irvine shows that giving three-year-olds piano and group singing lessons, dramatically improved their spatial-temporal reasoning, which is important in understanding math and science. An American group of music educators, the National Association for Music Educators, published a review of studies about music education as it plays a part in the development of children. The report indicates that students participating in musical education activities are more likely to have higher self-esteem and do well in school both academically and socially. It's important not to place pressure on your baby or toddler to participate in class. Each child is different and will develop at his own pace as he becomes comfortable with his surroundings or the activity. What's important is spending special time with your baby or toddler in the company of other parents and infants. Now three years old, Devon has a little brother who also attends music classes. It's a family affair and I look forward to becoming music's version of a "soccer mom." Aside from all the scientific research, the most important aspect in all of this is my kids are enjoying music for music's sake. The fall can't come soon enough for us when our classes begin again. -------- Understanding
your baby's cries Everyone from professionals to your mother has opinions about why your baby cries and what you should do about it. And, whether or not we are the baby's parents, a crying baby often stirs up strong feelings in us: frustration, anxiety, irritation and helplessness. It is easy to be overwhelmed and confused by the intensity of emotion and the often contradictory opinions. In this article I will talk about a particular way to understand baby's crying. Although I, too, have an opinion as to how to respond to your baby, I would encourage you to connect with your deepest knowing of yourself and your baby and do what feels like the best match for your situation. Crying
as communication There are different kinds of messages or needs that your baby communicates by crying: 1. Physical
needs 2. Emotional
needs 3. Expressing
emotions 4. Releasing
tension & stress Another source of tension and stress, especially for babies born prematurely, is over-stimulation. A trip to the mall, a walk in the park, a family get-together is loaded with stimulation. Babies can be easily confused and overwhelmed by what they see, hear, sense and feel. During the first few months it is not unusual for babies to have a crying spell at the end of an eventful and stimulating day. They may be crying even though their immediate needs have been met because crying allows them to release body tension and stress. Babies may also release tension and stress from past events. It is not uncommon for stress to have accumulated from the baby's time in the womb and/or during the birthing process. Birth can be a frightening and painful process for babies. It can also be traumatic, not only for parents but also for the baby. Dr. Aletha Solter, developmental psychologist and author of several books on babies and crying, states, "Researchers have found that babies whose mothers were extremely stressed during pregnancy or whose mothers experienced a difficult delivery, cried more and awakened more frequently at night than babies who did not have these traumatic experiences." How events become traumatic and how birth events can be traumatic for baby, mother or father is a topic for another day. However, studies show that crying releases hormones that reduce tension and the arousal level of the nervous system. Vimala McClure, author of Infant Massage: A Handbook for Loving Parents, says crying "is an inborn stress-management and healing mechanism." Listening
to babies Over the last 100 years, professional advice has swung from letting baby cry it out alone to responding promptly to baby's crying by rocking or nursing them. However, as McClure points out we continually miss the point. Babies cry because they have needs and once immediate needs have been met, they may need to cry to express their emotions or release stress. She states, "We should begin to accept crying as simply another way we humans can cleanse our hearts of negative feelings and stress. We can acknowledge that it is okay to cry sometimes, and that everyone eventually stops crying and finds relief, especially if their family and friends allow them to express their feelings, and love and respect them all the more for doing so." How to
listen to your baby Then go to your baby. Make eye contact if she is willing. If not, you could hold her or place your hands gently and firmly on her and connect to her through your hands. Let your love go to her. Talk to her. Let her know you are there and interested in what she has to say. Take whatever action is necessary to meet her needs (e.g. feed her, carry her with you for a while). If her immediate needs have been met, then remember she may need you to listen to her expressing what she is feeling or be with her while she releases built up tension. Be with your baby while she cries. Listen and observe her body language and facial expressions. Watch her mouth and what she is saying with her eyes. Notice how she moves her arms and legs. When you listen to your baby in this way, you are fulfilling their psychological needs in these early weeks and months. The underlying messages that you are communicating to your baby are, "You are loveable and worthy of respect just the way you are. You have a right to express your emotions and to ask for what you need. I will stay in contact with you even when you are upset." You are deepening the bond and strengthening your attachment with your baby. You are building a solid foundation from which your child can grow into the world feeling secure, safe, worthy and loved. -------- Your
child's eye health Research estimates that 80 percent of learning is perceived through our visual system. For a growing toddler, clear binocular vision is necessary for experiencing the world around him, learning how to read, and for proper eye-body coordination. Early detection and treatment of any vision problem will enhance your child's ability to learn and succeed in future years. When your baby is born, his visual system is not yet fully developed. A newborn has little control of his eye movements or focusing. Newborns can see shapes and patterns of dark and light, but not detail. Most babies are born hyperopic (farsighted); this decreases as they grow. By three to four months of age, their ability to see farther increases. Colour vision also develops. By six months, the eye muscles have become better coordinated, and depth perception improves. Before this age, it is not unusual to see the baby's eyes wander around or appear crossed, but if it persists past this time, there is a possibility of strabismus (misaligned or crossed eyes). Strabismus may result in poor depth perception and amblyopia (lazy eye) if not corrected early. A toddler's visual system is integrating with other systems to develop better coordination. Toddlers are very physically active and test their environment by touching, throwing, and walking. Repetition in these movements stimulates the systems' development and allows for better eye-body coordination and greater depth perception. Drawing, painting, and building with blocks further stimulate their visual development. Reading to toddlers not only helps stimulate their verbal skills, but also helps them visualize and prepare for reading. A child's visual system continues to develop until about the age of eight or nine. If there is any misalignment, high refractive error, or disease (such as congenital cataract), then the brain learns to ignore the weaker eye and uses only the good eye. The development in the suppressed eye becomes stunted if it is not provided with a clear image. Very often a parent can't tell that there is a problem, and the child does not notice any problem either, since what they see is normal to them. Because of this "plastic period" where the eyes are still developing, early intervention is key to improving any impairment. Vision therapy with glasses or eye muscle exercises helps stimulate the lazy eye. Strabismus surgery on the eye muscles will align the eyes and improve vision and depth perception. Visual impairment is common, affecting 5 to 10 percent of preschool age children. If left untreated, it may result in learning, reading or even behavioural problems at school. In later years it may lead to poor vision if the better eye is ever injured. The Canadian Association of Optometrists and the Canadian Ophthalmological Society recommend that a child's first eye exam be performed by the age of three. The exam should be done by age one if the baby is premature, the pregnancy was difficult, if there is a family history of poor vision or eye disease, or if there is any neurological disease. The first eye exam can be overwhelming for the toddler. The experience should be as fun as possible, but also provide the eye doctor with enough information to ensure the visual system is developing normally and the eyes are healthy. Sometimes it is helpful to examine the parent first, so the child can see what is involved. This time also allows the child to acclimatize to his surroundings. The child can even sit on the parent's lap for added emotional comfort during the exam. The exam typically involves looking at many pictures. The doctor will test for visual acuity using a picture chart both up close and in the distance. Depth perception is tested by using 3D glasses and pictures of animals, and muscle coordination is tested by having the child follow a picture of a familiar object. The doctor will perform a retinoscopy to look for any high prescriptions or focusing errors that may interfere with visual development. Often the child is asked to look at pictures or bright, noisy toys at the end of the room while the doctor is looking at the ocular health. Although rare, eye diseases in children can be sight threatening and in some cases, life threatening. Children should then have their eyes tested on an annual basis. Yearly eye exams are covered by MSP until age 19. You can contact your optometrist directly for an eye exam without a doctor's referral. If you do not have an eye doctor, your family doctor may be able to suggest an optometrist or refer you to a pediatric ophthalmologist. For more information, visit www.whatcouldbemoreimportant.com, or contact the British Columbia Association of Optometrists at 1-888-393-2226. -------- Reducing
the risk of SIDS Every new parent rejoices in their heart the first time that their baby sleeps through the night. Most parents would also admit that they rush to the baby's bedside to make sure that he is still breathing for fear of SIDS. SIDS, or sudden infant death syndrome, refers to the unexplained sudden death of an apparently healthy infant under the age of 12 months. It is the most common cause of infant death outside of the immediate newborn period. There are approximately three SIDS deaths in Canada every week. Most SIDS deaths occur between two to four months of age and nearly all occur before six months of age. Male infants are affected 30 to 50 percent more commonly than females. While SIDS often occurs in infants with no known risk factors, there are many things that a parent can do in order to reduce the risk of SIDS. Since the recommendation of back sleeping, the incidence of SIDS has reduced considerably. It's not entirely clear why back sleeping is associated with a decreased incidence of SIDS, but it may be due to decreased deep phase sleep when compared with prone (tummy) sleeping. Placing an infant on his side places the baby at an intermediate risk between back and prone sleeping. Neither prone nor side sleeping is recommended in infants except for very specific medical reasons. One of the strongest risk factors associated with SIDS is cigarette smoking. Both prenatal as well as post-natal smoking place the baby at risk of SIDS. If other family members smoke in the baby's environment, this also places the baby at an increased risk of SIDS. Bed-sharing, particularly with other siblings or with an individual who is over-tired or under the influence of alcohol or drugs can put the baby at risk for SIDS. Recent evidence suggests that bed-sharing with a mother who is a smoker is riskier than bed-sharing with a non-smoker. In addition, co-sleeping with an infant on a soft or confining surface such as a sofa increases the risk. Infants who sleep in cribs with pillows, stuffed animals, loose bedding and bumper pads also are at higher risk of SIDS, presumably due to the risk of suffocation. Over-heating is also a potential cause for SIDS. It is recommended that infants sleep in a room that is at a comfortable temperature and that only a light blanket be placed over the infant. Pacifier use has been shown to be protective against SIDS. The mechanism for this is not known. It is likely that over the next few years, more information will be available to provide some guidance around the use of pacifiers as a protective device against SIDS. There is some evidence to suggest that breastfeeding may be protective against SIDS. The evidence is not strong. Breast feeding is recommended for the other benefits it offers to both mother and baby. Home apnea monitors have been marketed to the public as a way of preventing SIDS. There is no convincing evidence to suggest that these monitors are protective against SIDS. While not every case of SIDS is preventable, there are many things that can be done in order to lessen your baby's risk. Don't smoke during your pregnancy or after the delivery. Breastfeed your baby if possible. Have the baby sleep in a crib with a firm mattress with no stuffed animals, bumper pads or fluffy loose blankets. Keep the room slightly cool and always make sure that you place him on his back for sleep. If you do choose to sleep with your infant, make sure that pillows and soft bedding are removed. Don't sleep with your baby if you are exhausted (this is may be easier said than done) or have had any alcohol or other sedatives. A pacifier at bedtime may be protective although it may increase the risk of breastfeeding difficulties or ear infections. -------- Small
bugs, big troubles: preparing your child for cold season Your child's first cold. A runny nose, fever and crankiness are no fun. But with an ounce of prevention and good care, there is less reason to worry about during cold season. Facing the 'enemy' The two most prevalent respiratory infections are the common cold and the flu (influenza). Both are caused by viruses and have similar symptoms but the flu usually starts abruptly and is more severe. When they have a cold, children experience a stuffed nose and cough, but no high fever or severe tiredness. Colds cannot be treated with medication, but there are remedies to ease the symptoms. According to Jonathan Damonte, Classical Homeopath at Vancouver's Be Well Now Centre, if the child is older and has no history of a depressed immune system "a cold should be let to run its course before intervening with classic or homeopathic remedies, unless there is a high fever or any other complication". Possible complications are ear and sinus infections. "Almost two-thirds of children will get an ear infection during infancy and childhood," says Dr. David Scheifle, Pediatric and Infections Specialist at BC Children's Hospital. Flu, on the other hand, comes with high fever, body and muscle ache, runny nose, irritated red eyes, general fatigue and weakness. Complications are serious and include pneumonia and bronchitis. If your child has the flu, keep him hydrated and treat the symptoms while monitoring the temperature. "The flu is more dangerous," says Dr. Scheifle, "because the virus can start growing in the breathing tubes." Keep in mind that flu is highly contagious and usually occurs in epidemics peaking during the winter months. Hot issues
Dr. Glenda Laxton, ND from West Coast Naturopathic Clinic in Vancouver, advises parents to relax. "First year in preschool is rough for young children, but that is a good thing because they are building a strong immune system by being exposed to a lot of germs," she says. In time, each infection a child goes through will help the immune system cells become "smarter." They will recognize the attacker much quicker, which means the disease-causing bugs will be killed faster. "Overdressing the children during the cold season will not help them fend off viral attacks," says Dr. Koelink, a family physician from Vancouver who explains further. "Viral respiratory infections are self-limiting and result in symptoms like fever, runny nose, fatigue and productive cough, that peak on the third day and then gradually settle down." Parents should closely observe the sick child, advises Dr. Koelink who says that if the symptoms do not improve after the third day and they get worse, the child should see a doctor right away. One of the symptoms for the viral respiratory infections is fever. Parents fear fever more than anything, but fever is an indication that the body is fighting the disease by killing the germs. "The typical pattern for fever is that it goes up in the afternoon and evening and then at night it goes down so the child is able to get a good night's rest," says Dr. Koelink. If the temperature is 39°C or higher and the child starts being lethargic or has glossy eyes, parents should head for the emergency room immediately. What parents
can do As children affected by respiratory infections experience an appetite loss, they shouldn't be forced to eat but rather offered favourite foods to choose from. What's important is to keep them hydrated. Breastfed babies should be nursed on demand until the symptoms disappear. 2. Good hygiene. Toddlers should be taught good habits from early on. Small children have no control over touching another child after they just rubbed their runny noses or put their fingers in the mouth, so the best way to prevent colds from spreading is to wash hands, big and small alike. Colds can be transmitted through direct as well indirect contact. Sharing toys is a great way of developing social skills but make sure you wash them carefully every once in a while. Cold germs can live on objects for hours. One safe bet to reduce the occurrence of respiratory infections is to avoid crowded places from November to March. 3. Supplements. Are they needed or not? According to Dr. Laxton, "children should get their vitamins from natural sources, organic if possible and less from pills." For the older children though, some form of supplementation is necessary especially if they are picky eaters and attend childcare regularly. Naturopathic health practitioners recommend that children get immunity-boosting essential fatty acids (EFA) in form of cold pressed flax oil or hemp oil, which can be mixed with food. They contain omega-3 fatty acids which strengthen the immune system. 4. Vaccination. There is a lively debate over flu vaccines. While alternative health practitioners are cautious when it comes to flu vaccines due to possible side effects, pediatricians strongly recommend the flu vaccine for young children. For the first time this year, says Dr. Scheifle, Health Canada's National Advisory Committee on Immunization, recommended that healthy children aged 6 to 23 months get the flu shot. "They are as likely to end up with complications as people in the age group of 65 and older," explains Dr. Scheifle. "For healthy children two and older, a flu vaccine is not routinely recommended as they have a better immune system and can cope easier with the flu symptoms." 5. Rest. Last but certainly not least, babies and toddlers need to rest well in order to stand a better chance in the war against the winter bugs. Good nutrition and sleep are the key ingredients for a stronger immune system, says Dr. Koelink. Parents should be especially cautious when administering their children decongestants to help with the cold symptoms, explains Dr. Koelink, because children might experience "paradoxical reactions" like crankiness and hyperactivity, hence they are unable to settle down and rest properly. When all has been done to prevent a virus from entering and wreaking havoc into your little one's body, remember that catching a cold or the flu is a natural thing. Each virus attack will leave your child stronger and better prepared for future encounters. Cold season or not, allow your little ones to enjoy the outdoors as much as possible. Chilly air, rain and snow will not give your children a cold or the flu no matter how cold their noses and feet get. Daniela Ginta, M.Sc. is a freelance writer from Vancouver, BC and proud mother of a two-year-old boy. She writes on numerous family and natural health topics. ------- How to care for baby’s pearly whites Most of us think that plaque causes cavities. In fact, it’s not only plaque but also how frequently children eat and drink that contributes to tooth decay. The more often your child drinks, especially between meals, the more likely tooth decay will develop. Unsweetened juices like apple and orange and even milk can cause decay. Water and diet drinks don’t cause decay. Your child’s teeth are covered in plaque most of the time. When plaque meets sugar from juice, milk, breads, cereals and other foods, an acid is created that leaches calcium from tooth enamel. Cavities start when teeth begin losing more calcium than they take in. Unfortunately, eating and brushing habits that contribute to cavities can start well before a child’s first visit to the dentist. In one study undertaken by public dental health staff of 37,369 children in BC, more than 1 in 10 kindergarten students was found to have tooth decay on their top front teeth. Decay often starts behind the front surface of the baby teeth so it is difficult to see. The department of pediatric dentistry at BC Children’s Hospital has these tips for preventing early tooth decay. Tooth Care Tips: Start brushing your baby’s teeth when they first appear. Gently wipe them clean using terry cloth or a baby toothbrush. A baby toothbrush is the best and more effective at removing plaque than a cloth. Help with brushing to make sure teeth are cleaned thoroughly, until your child has the manual dexterity to brush properly (when he or she is coordinated enough to tie a shoelace, for example). Children should be able to brush and floss by themselves somewhere between five to seven years of age. Use fluoride sparingly Children’s developing teeth need fluoride. However, today’s enticing flavours and colours of toothpaste can lead children to assume it is safe to eat, and they could run the risk of ingesting too much. Until your child is three years of age, use only a pea size of children’s toothpaste with a minimal amount of water to reduce the likelihood of swallowing. Encourage children older than three to use only a pea size amount, and supervise them while brushing. Never give oral rinses or mouthwash to children under six years of age unless advised to do so by your dentist. Educate your child care expert or nanny In some cultures, caregivers soothe children by providing them with bottles of juice or milk, or pacifiers dipped in honey. However, this practice is a major cause of cavities in young children. “Concentrated juices and milk are high in sugars,” warns Dr. Doug Johnston, head of pediatric dentistry at BC Children’s Hospital. “Constantly bathing a child’s teeth in these liquids every day, or night, will lead to decay.” Make sure that your caregiver or nanny knows to avoid giving snacks or sugary liquids throughout the day, and instead stick to regular mealtimes. Otherwise, the caring attempts to soothe a infant may inadvertently cause dental nightmares. Sugar containing drinks are more likely to cause decay if the child drinks from a bottle or a sippy cup. If a baby or toddler is thirsty and asks for a bottle, it is acceptable to provide him or her with one containing water instead of juice. Take your child to the dentist Early teeth guide permanent teeth into place. If baby teeth – especially back teeth – are lost or removed due to tooth decay, new teeth are more likely to emerge out of position. Repositioning the teeth can be a very expensive proposition. For more information on dental care for children, visit the Association of Dental Surgeons of BC at www.adsbc.bc.ca or the Canadian Dental Association at www.cda-adc.ca. ------- Celebrate your unique baby After months or even years of anticipation, your bundle of joy has finally arrived. And while at first it may feel like it’s all you can do to make it through each day – changing diapers, feeding, wiping up – you may decide to hold a celebration to honour the birth of your child. Whether formally or casually, as a small group of family members or with a larger group of friends and relatives, there are countless ways to welcome baby. For thousands of years, the human race has performed rituals that recognize the birth of a child and mark the inclusion of that child into his or her community. Many of these rites are rooted in religious or cultural tradition, however, most can be altered to suit your values and wishes. The Christian ritual of christening (baptism ceremony symbolizing initiation into the faith); Jewish bris (circumcision ceremony) for boys and simchat bat (naming ceremony and celebratory party) for girls; African Yoruba and Akan baby naming ceremonies (when the baby is formally recognized as a member of the community); and the traditional Chinese custom of “doing the month” (where the mother, believed to be vulnerable, remains indoors and refrains from eating certain foods) followed by a “full month” celebration (welcoming the baby into the family and the mother back to regular life) are examples of religious and cultural birth traditions. This may be a time when you choose to embrace the traditions of your heritage. But if you’re looking for something a little different, there are secular celebrations to suit every taste. Resisting the temptation to show off their little treasure, many new parents choose to spend the first days after birth simply bonding with their new child. With all the excitement of the birth, these moments spent together as a new family can be tender and meaningful. Some parents invite friends and family to participate in a short, informal ceremony followed by a celebratory party, either in their home or at a special venue. Parents may affirm their love for and commitment to their child, and their hopes for the child’s future health and happiness. Some people include poetry or prose readings and music. Instead of godparents, who were traditionally chosen for the strength of their religious faith, people often choose relatives or close friends to become “guide parents,” or mentors. They may also choose to add a few words to the ceremony. Looking for something a little less structured? Ask friends and family to contribute to a journal or other blank book. Their special messages will be read and treasured by the child in later years. Or, you could record a video using a similar concept. Plant a “birth tree” to grow along with your child. Fruit trees are especially nice because the child can later eat from his or her special tree. And, if you plant when your child is a baby, the tree will be ready to climb by the time he or she is nine or 10. Know your baby’s destined to be a star? The Star Registry (starregistry.com) will let you close the deal. For just $54, you can by naming rights for a real star. It’s a great way to see your baby’s name in lights, and later, introduce them to astronomy. The Registry will send a certificate with the star’s name, coordinates and a personalized star chart. Making a donation to charity in your child’s name is also increasingly popular. Contact your favourite charity, or, choose one that helps needy local children, such as Canuck Place (canuckplace.org), BC Children’s Hospital Foundation (bcchf.ca), the Adoptive Families Association of BC (bcadoption.com) or Variety – The Children’s Charity (variety.ca). Or, choose to sponsor a child in a developing country (fosterparentsplan.ca). |
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