Don’t Skimp On The Nap
May 18, 2017 · Posted in Infant Development, Parenting, Preschoolers, Sleep, Toddlerhood · Permalink · Comments Off on Don’t Skimp On The Nap

The data just keeps pouring in on the importance of children’s sleep. Perri Klass MD, highlights the impact of daytime sleep for young children in her NYT article, “A Child’s Nap Is More Complicated Than It Looks” 

“Dr. Monique LeBourgeois, a sleep scientist at the University of Colorado at Boulder, and her colleagues recently conducted the first study on how napping affects the cortisol awakening response, a burst of hormone secretion known to take place shortly after morning awakening. They showed that children produce this response after short naps in the morning and afternoon, though not in the evening, and it may be adaptive in helping children respond to the stresses of the day.

By experimentally restricting sleep in young children, and then analyzing their behavior in putting puzzles together, Dr. LeBourgeois’ group also is quantifying how napping — or the lack of it — affects the ways that children respond to situations. “Sleepy children are not able to cope with day-to-day challenges in their worlds,” she said. When children skip even a single nap, “We get less positivity, more negativity and decreased cognitive engagement.”

At least two naps a day for the first year, at least one nap a day until age three, and for some children, even up to age five is critical. Children experience a “pressure to sleep” and need to have the opportunity to release that pressure with regular naps. Remember this when choosing between a nap and baby class. The best thing for your baby’s brain development is sleep.

 

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The Pump, The Scale And Other Interferences To Nursing
October 17, 2016 · Posted in Breastfeeding, Feeding, Infant Development · Permalink · Comments (6)

pexels-photo-235243Recently I had the chance to see first hand how easily a new mother and her breastfeeding can be undermined. A dear friend’s younger sister Sarah had her first baby two weeks ago. Four days after the birth I received a frantic call from my friend in Connecticut. I arrived to find an exquisite and healthy little girl and a broken down distraught new mother.

“I called the lactation consultant and she was here yesterday with her her scale. She watched Eliza eat and said she wasn’t an ‘efficient sucker’. She told me to feed her for 5 minutes on one side and then she weighed her. She said she wasn’t getting enough and that I had to increase my milk production. I am supposed to feed her until she falls asleep – then wake her and supplement with formula and then pump as much as I can.” Tears streaming down her face she sobbed, “Look at my nipples, they are shredded.”

I hate this story and unfortunately we are hearing ones like it more and more over the past few years. Breast feeding is the process of a mother and her baby’s bodies, newly separated at birth, learning to get back in sync in a new way. It is a process that takes time, patience and faith. Ideally new mothers will be supported by veteran breast feeders who, rather than focusing on milk production and weight gain, will help them tolerate and accept the often painful and slow process.

“We are going to forget about everything you’ve heard so far and start from scratch, so get those boobs out and let’s start,” I said.

For the next four hours I had the pleasure of tending to Sarah, bringing her warm compresses and lots of water as we dished over family gossip and carefully watched Eliza. I taught Sarah the critical importance of recognizing signs of hunger and of fullness. As simple as this sounds it is the key ingredient in the healthy feeding of your child. During this time she had two feedings with 3 hours of sleep and big blue-eyed wakeful periods in between. Sarah was amazed that her baby was full after only ten minutes of nursing and really did not need to eat for another three hours. Yes, she needed attention: rocking, swaddling, pacifier and even to be left alone and to sleep. Turns out Eliza is a very efficient sucker. What her mother needed was reassurance that the two of them together had everything they needed. We banished the pump and the scale. I taught Sarah to not read every squeak and squirm as a sign of hunger. Two weeks later mother and baby are thriving and Sarah owes me big time – just kidding.

In our fast-paced, product-oriented society, nursing a baby has become yet another human process that is driven by perfectionistic anxiety. Because so many new mothers are alone and isolated from other women, the practice of calling on professionals to help has become the norm. Unfortunately, it is hit or miss as to whether the consultant supports or intrudes and so derails the unfolding process with it’s inevitable pain and the leap of faith it takes to trust your body. (We know how easy that is for women!)

This article first appeared in A Child Grows in Brooklyn

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Ode To A Bath
July 29, 2015 · Posted in Infant Development, Parenting, Toddlerhood · Permalink · Comments (5)

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One of the sweetest and most treasured memories of our children’s early childhood is the nightly bath. Although tired and spent from the long day, it is a time to sit down and enjoy the wonderful world of a child in water. Pretend play, bubble fun, talk and laughing not to mention the pleasure of watching your child’s beautiful naked body swim around and get squeaky clean .

The never-ending  domestic duties of parenthood – bathing, feeding, bedtime, dressing, walking to school, running errands, giving snacks, refereeing fights,  all can seem repetitive and mundane. And in truth, these jobs are all of these things–monotonous, hilarious, boring, tender, frustrating, and gratifying. One  rarely gets a thank you or any kind of recognition.  These are the jobs that are tempting to put in a category of custodial, and therefore not  important.

Society in general, and parents in particular, need to value the importance of these tasks. They are the  very fabric of the intimate relationship with your children.  During the bath, the walk to school, or home from ballet or karate, relationships deepen, values get transmitted and children feel cared for and known.  In our busy world “quality time” has become synonomous with special activities. These every day routines are special activities and our involvement with them is  meaningful to our children. We are not  advocating that any one person should have to do all of this with no help from other people, hired or otherwise. But  we are reminding us all that these are not just the tasks to be “outsourced”.  They matter and will have a lasting impact.

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The Baby Brain: Wired for Connection
October 22, 2014 · Posted in Infant Development, Parenting · Permalink · Comments Off on The Baby Brain: Wired for Connection

We all are amazed at how babies are brilliant little creatures. Now brain research is able to look inside the infant’s brain to see the actual mechanisms that underlie their amazing abilities. A study published in Current Biology used functional magnetic resonance imaging (fmri) of the brains of three to seven month old infants to assess brain activity in relationship to sound. They found that the infant brain attends to human voices and emotions even more than familiar environmental sounds. These babies’ brains showed more activation when they heard emotionally neutral human sounds, such as coughing, sneezing, or yawning, than when they heard familiar non-human sounds like their toys or running water. We are wired for connection from birth.

Another interesting finding was that these babies showed greater response to sad sounds versus neutral ones. This makes sense from an evolutionary perspective–to be more alert to a bad situation is probably adaptive for a baby. This may be a part of understanding why we all tend to remember and focus on the negative rather than the positive experiences in life.

Adaptive capacity or a design flaw is debatable, interesting never the less.

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Sleep Training “What If’s”: Part One
September 11, 2014 · Posted in Infant Development, Parenting, Sleep · Permalink · Comments Off on Sleep Training “What If’s”: Part One

Tips from our book, A Mothers Circle:

Parents often second-guess why their baby is crying. They feel guilty and, looking for an out, they imagine that their baby is sick or teething or hungry. Here is the first of a three-part series answering frequently asked sleep training questions.

“What if he is hungry?”

The specter of a miserably hungry baby crying out in the night hangs over most parents on the eve of their sleep work. Parents are somehow not reassured upon hearing again that a three-to-four-month-old baby who weighs at least twelve pounds can get through an eleven-to-twelve-hour period of nighttime sleep without a feeding. They have become so accustomed to feeding their baby at regular intervals through the night that this seems incredible to them.

If your baby is only taking one night feeding you might be ready to cut out that feeding completely. If your baby is like Leslie’s, needing only a minute of nursing before falling back to sleep, it is easy to see that he is not actually hungry. But if your baby has been taking eight ounces of formula or nursing for ten to fifteen minutes several times a night, he has without doubt grown accustomed to refilling his belly throughout the night. In this case, we do not recommend doing sleep work all in one fell swoop, particularly if your baby is only three to four months old. Rather, you can first help your baby to learn the skill of falling asleep on his own at bedtime. Then you can gradually cut down on his night feedings.

Some parents choose to wake their babies for one night feeding before they go to bed themselves. Having slept from 7:00 or 8:00 p.m., babies typically are so soundly asleep at eleven or twelve at night that they wake up only partially, then fall directly back to sleep after a feeding. Even though he is still getting this one night feeding, the fact that you are waking him up instead of the other way around makes your message consistent. Once your other goals are accomplished, you can eliminate this late-night snack.

Another option is to respond with a feeding only once during the middle of the night, but do it when your baby awakens on his own. Then do not feed the baby until morning. This done over a week-long period will teach your baby to fall asleep on his own and to only wake once for a nighttime feeding. After this is firmly established you can move on to eliminate the nighttime feeding completely.

Babies are creatures of habit. And they are smart. On the first night without his middle-of-the-night feeding your baby probably is a little hungry and is expecting to be fed. He cries because he knows he will be fed. But he doesn’t need to eat. Giving up the middle-of-the-night feeding is not easy for your baby; it is stretching him. But almost immediately he will naturally begin to eat more during the day and he will not be hungry at night.

Some parents prefer to gradually train their babies to expect less during their nighttime feedings. They continue to feed their babies when they cry at night, but diminish the number of ounces, or minutes on each breast, until a feeding is so minimal that it is clear their baby no longer needs it.

“What if he wakes up soon after he goes to sleep?”

Sometimes a baby will awaken forty minutes to an hour after he has fallen asleep at bedtime and parents can misread this short sleep as an early evening nap. Treat it as a night waking, not as a nap.

“What if he is teething?”

Parents regularly invoke teething to avoid sleep training. The truth is, babies are teething throughout this entire period. Unless your baby’s tooth is actually just cutting the gum, or his gums are inflamed, there is no need to interrupt or forestall sleep work. If the erupting tooth is obviously giving your baby pain, consult your pediatrician about options for relieving your baby’s discomfort.

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Media in Moderation
June 1, 2014 · Posted in Infant Development, Media, Parenting, Technology, Toddlerhood · Permalink · Comments (1)

 

Media and Children– From The American Academy Of Pediatrics

 

Media is everywhere. TV, Internet, computer and video games all vie for our children’s attention. Information on this page can help parents understand the impact media has in our children’s lives, while offering tips on managing time spent with various media. The AAP has recommendations for parents and pediatricians.

Today’s children are spending an average of seven hours a day on entertainment media, including televisions, computers, phones and other electronic devices. To help kids make wise media choices, parents should monitor their media diet. Parents can make use of established ratings systems for shows, movies and games to avoid inappropriate content, such as violence, explicit sexual content or glorified tobacco and alcohol use.

Studies have shown that excessive media use can lead to attention problems, school difficulties, sleep and eating disorders, and obesity. In addition, the Internet and cell phones can provide platforms for illicit and risky behaviors.

By limiting screen time and offering educational media and non-electronic formats such as books, newspapers and board games, and watching television with their children, parents can help guide their children’s media experience. Putting questionable content into context and teaching kids about advertising contributes to their media literacy.

The AAP recommends that parents establish “screen-free” zones at home by making sure there are no televisions, computers or video games in children’s bedrooms, and by turning off the TV during dinner. Children and teens should engage with entertainment media for no more than one or two hours per day, and that should be high-quality content. It is important for kids to spend time on outdoor play, reading, hobbies, and using their imaginations in free play.

Television and other entertainment media should be avoided for infants and children under age 2. A child’s brain develops rapidly during these first years, and young children learn best by interacting with people, not screens.

 

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#!*+!%!&$@!*
June 16, 2011 · Posted in Infant Development, Media, Parenting, Sleep · Permalink · Comments Off on #!*+!%!&$@!*
“The windows are dark in the town, child/The whales
huddle down in the deep/I’ll read you one very last book if you
swear/You’ll go the —- to sleep.”
Yay! A sense of humor about parenting! I haven’t come across a parent who hasn’t thought a variation of “Go The #!+%! to Sleep”, let alone said it out loud. Not that I am condoning it, of course! The immediate buzz about the picture book by Adam Mansbach was like a collective laughing sigh of relief.
In Pamela Paul’s article about the book, Raising Children is Heck in the NYT, she writes that
“Barbara Jones, director of the office of intellectual freedom at the American Library Association, reminds us that parents have long appreciated that message, even in (somewhat) child-friendly formats. “Down will come cradle, baby and all?” Ms. Jones said pointedly. “That’s for parents. That’s about please — go to sleep already!”


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How Much Do I Need To Play With My Baby?
March 24, 2011 · Posted in Infant Development, Parenting, Play · Permalink · Comments Off on How Much Do I Need To Play With My Baby?

max_400-1Many mothers feel like they are an entertainment center. They feel responsible for stimulating their babies all day long. Parents often comment that they feel guilty or lazy when they are not involved in talking, singing, shaking rattles and playing peek-a-boo. They worry that a baby sitting in a bouncy seat or laying on a blanket just looking around is a neglected child or an under stimulated one. Not so.

When you think about the world from the perspective of your baby, everything is new and therefore, interesting. From the play of light on the wall, to the sights on the street to just sitting in the kitchen. Learning and growth happens as a natural part of existing in your environment. So it is not necessary for you to work so hard at playing and talking the entire time your baby is awake. Just coexisting quietly is important too.

Of course, it is important to carve out a couple blocks of time each day where you can be totally tuned in to your baby and take part in playing with him in a focused way. Listening to music, exploring toys together, clapping hands and waving bye bye, being tickled and kissed. You are showing him the world and the world of relationships. Remember that babies can easily become overstimulated, so you want to be watchful not to introduce too many new things to him at once, and to tone down the interaction if he appears to look or pull away, cry or fuss. These are all signs that he may be overstimulated.

Your most important job is teaching your baby how to be in a relationship, the give and take, the ebb and flow, teaching him he is adored. All the other learning happens very naturally just from being in the world.

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Starting to Set Limits
March 1, 2011 · Posted in Discipline, Infant Development, Parenting, Toddlerhood · Permalink · Comments Off on Starting to Set Limits

Responsive parenting is an ever-teetering balance between offering comfort and figuring out limits. Though limit setting is not the emphasis of parenting in the first year, it’s share of the pie increases over time. When your baby innocently pulls her father’s chest hairs or swipes at your face with sharp fingernails, or bites you while nursing, the very change in the tone of your voice when you say “Ouch!” conveys a message of displeasure. Then when you add “Gentle, gentle!” or “No, no!” this introduces the concept of limits. Here is some insight into setting limits that will help make the process smoother.

NO IS NOT A BAD WORD
The belief that “no” is a bad word is one of the legacies of overly permissive parenting. Important behaviors including restraint, self-control, and caution are learned by hearing the word “no.” Children will learn to say “no,” and need to be able to say it, regardless of whether they hear it from their parents. In the latter half of the first year the word, “no,” followed by a brief explanation such as “hot!” or “ouch!” or “you have to be gentle” teaches your child about the world of objects and relationships. Language is just developing at this time but the word “no” is best used when coupled with an action to reinforce the lesson. So if your baby bites your nipple, or pulls the cat’s tail, say “no” and gently remove her from the situation, take her off the breast, or move her away from the cat. Then after you’ve said a clear “no” and moved the baby, give a more gentle explanation, like “no pulling, that hurts lulu’s tail,” or “no biting mommy, that hurts!” Over time your baby internalizes these everyday lessons.
spoiling

All children go through difficult periods as they grow. All children will appear “spoiled” at some point. Stages when a child has difficulty waiting and sharing, when she is especially clingy, whiny, and demanding are all typical of normal child development. However, chronically demanding, objectionable, whiny behavior usually indicates either that a child has received far less attention than she needs or that she has never been stretched in her ability to wait, to use her own resources, or to soothe herself. For parents who felt restricted, misunderstood, and unfairly reprimanded as a child, it is common to offset their baby’s frustration and anger with understanding and permissiveness. Discipline and authority often become synonymous with the words punitive and mean. The key is to see that setting limits is important.

You can be a close, loving, devoted parent and a figure of authority at the same time. When used judiciously, saying “No” will not crush your child’s spirit. In fact, limits are critical for her sense of security and self-worth. Limits do not simply shut a door. They stretch a child, teach her about the world, and let her know she is protected. Limits also help a child to learn about self-control, respect and empathy for others. They are a necessary and important part of parenting.
When the time comes, many parents are deeply ambivalent about setting limits, especially with older children. More psychologically minded than their own parents, the current generation wants to be sensitive to their babies’ needs and feelings and nurturing to their children’s egos, but loving and limit setting are not mutually exclusive.

TOLERATING YOUR CHILD’S NEGATIVE REACTIONS

It can be frightening and upsetting to have your baby get angry or cry out because of something you impose or withhold. In fact, one of the most difficult challenges a parent faces is tolerating a child’s discomfort—be it illness, fatigue, pain, frustration, disappointment, or anger. It will not always be possible, or even advisable, to take away those feelings. It will be important, though, for you to let your child express them. Your baby’s consistent experience of your attempt to understand her needs is critically important to her sense of self and of relationships.

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How To’s of Sleep Training
February 8, 2011 · Posted in Infant Development, Sleep · Permalink · Comments Off on How To’s of Sleep Training

You and your partner have decided that you are ready—or desperate enough—to try to teach your baby good sleeping habits. After endless nights of broken sleep, a new logic has emerged: This is not good for our baby or for us. So now what?

❍     Enlist each other’s support
Sleep work is best when both parents are actively involved. Talk openly about your feelings and plans and lean on each other for support and encouragement when you are faltering.
❍     Clarify your motivations
•    Write down your goals and the reasons behind them. You may well be turning for reassurance to these ideas at a weak moment in the middle of the night. For example
•    We can’t go on like this. The baby is always cranky.
•    I am overtired.
•    My husband and I are fighting.
•    The baby could be waking up every night like this until he is two or three years old.
•    Other babies sleep well. So can ours.
•    This is in our baby’s best interests.
❍     Select a day to start
A Friday or Saturday night is a good choice because you will not have the pressure of a workday hanging over you. Don’t make other plans for the evenings during the first week of sleep work. Make your baby’s sleep training your only commitment.
❍     Talk to your baby
Tell your baby about what will be happening. Keep it simple.  For example, as you sit to rock him and give him his last feeding say, “Tonight you’re going to learn how to fall asleep on your own. Mommy and Daddy will be right here and we are going to help you sleep better. We’ll see you at morning time!” The tone of your voice can convey to your baby that something new is going to happen and that he is still safe.
❍     Get your sleep chart ready
You can use the chart in the appendix of A Mother’s Circle or you can use your own to keep track of the minutes and intensity of your baby’s cries, as well as how long he sleeps.
❍     Take a deep breath and begin
This is a commitment. Recognize that it will require some unusual discipline and strength from you.
❍     Put your baby in his crib before he is asleep
On the first night sometime between seven and eight at night it’s bedtime as usual. Use your baby’s now-familiar bedtime routine to ready him for the night. Carefully watch your baby to be sure he does not fall asleep in your arms or at your breast. Put him in his crib when he is drowsy but not fully asleep. Even if your baby does not appear tired, put him in his crib. Say goodnight in a loving manner.
❍     Look at the clock when your baby begins to cry
Make a note of the time your baby begins to cry on your sleep chart and keep track of the duration and intensity of his cries. Pay attention to the intensity so you can determine whether it is escalating or calming down. This chart can be helpful. You can see your baby’s progress, however slight.
❍     Note what time the crying stops
Wait until the baby is quiet and note the time that he stops crying. If there is a pause in your baby’s cries and then he resumes, begin timing anew.
❍     Repeat with every waking
Even though this seems like a lot of work in the middle of the night, it is short-term work for a long-term goal of uninterrupted sleep. It may seem easier to just go in and nurse for four minutes and get your baby back to sleep, but in the long run you will be waking up in the night indefinitely if you approach sleep this way.
❍     To check or not to check
There are differing ideas about whether or not interval checking in on babies when you are sleep training is helpful or not. While checking in on the baby may be helpful to a small group of babies, our experience has been that the vast majority of babies over four months old become more agitated when their parents go and see them in the midst of crying. Babies are smart but not sophisticated enough to be soothed by your presence without the whole package of holding, rocking, or nursing that they are used to. It’s like a tease to them. We have found that while it reassures parents, it infuriates babies.
❍     Support one another
If it is the middle of the night and one of you is still sleeping, rouse your partner. Both of you should be fully awake so that you can support each other during the difficult process. If either of you feels yourself faltering, remind each other of your goals.
❍     Listen to your baby cry
Parents respond differently to this difficult task. You may decide you need to listen intently to every cry and gasp your baby makes. Alternatively, you may decide that you need some emotional distance from your baby’s crying. If the sound of your baby crying becomes too painful for either of you, have that person take a break: take a walk, a shower, or listen to music on headphones.
❍     Pay attention to your reactions
Make it a point to try to understand what the crying elicits in you. Is it fear? Is it anxiety? Discerning your own response can shed light on how you project your past onto your baby’s cries.
❍     If you feel you must check in
If the intensity of the experience feels overwhelming and you feel you need to check in on the baby then keep it short—no longer than one to two minutes.
❍     Be consistent
Although many families falter a few times during sleep training, try to remember that if you do give in and feed or rock your baby to sleep after a prolonged interval of crying, his crying has been for naught. As the nights continue you should see a great reduction in crying time and night wakings. New self-soothing behaviors like thumb sucking, holding a cloth blanket or small toy, or a new favorite sleep position will emerge. Anticipate, though, that on the fourth or fifth night there may be a regression, more crying or wakings. This is the night when parents typically give up and feel that their efforts are not working. However, this is the most critical night to hang in there and proceed. There will be a significant positive change after this night.
❍     Designate a wake-up time
Choose a definitive time before which is “night” and after which is “morning.” Try to stay consistent. In other words, if 6:00A.M. is your designated “morning,” any wake up before then is considered a night waking.

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