All posts by Nancy Holtzman

Sitting and Playing at 7 – 8 months

Infant Health & Safety, ,

Once your baby has mastered a solid sitting position, you’ll find that he is able to remain sitting upright and stable for longer periods of time. He is able to make subtle balance adjustments and may begin reaching for objects further out of reach.

Now that he doesn’t need to focus as much on keeping his body from falling, he can shift his attention to the important work of baby play. Like a little scientist, your baby will study his toys, how they feel, taste, look and sound.

Your baby will still mouth everything, but no longer is that his primary way to investigate an object. Instead, he’ll inspect toys carefully, using wrist rotation to turn it in different angles, and hold it with one hand to manipulate it with the other. Learning to use two hands in a coordinated fashion is a developmental task at this stage: watch your child stabilize the toy in one hand, and use the other hand spin, poke or explore the object. Using both hands differently to accomplish a goal is new and exciting.

In addition to more complex rattles, your baby is ready for more complicated developmental toys now. Stacking cups, nesting boxes, Tupperware containers and small blocks are excellent toys for this age group. Try placing an assortment of small but baby-safe toys or household objects in a plastic bowl or shoebox for your baby to explore. He’ll likely spend time removing objects one by one to empty the container. Show him how to put them back “IN” and take them “OUT” again. Your baby will also enjoy holding two objects, one in each hand, and banging them together. He may intentionally drop one object to pick up another and experiment with the different sounds he can make banging first one and then another object against another or against the floor or table.

Select open-ended safe developmental toys, meaning that you can play with them in different ways during different developmental stages. For example, your baby may not yet be ready to place blocks through the lid of a shape-sorting set, but he will enjoy using the blocks in other ways or just taking them out of the container. Keep your toy areas “fresh” by preventing your baby from being overwhelmed by a big pile or baskets of toys. Instead, put out a small assortment, and rotate the selection every few days. Have baby safe books available (washable fabric books or plastic “bath books” are good choices if your child tends to chew on board books) and keep board books handy in every room so you always have a book in reach to read to your baby when the opportunity arises.

Baby’s Sleep Environment

Baby Sleep

Your Baby’s Best Sleep happens in a room that is Cool, Dark and Quiet

Use light and dark to reinforce sleep and wake cycles. Keep lights dim for the 30 minutes before sleep, and during nighttime soothing, feeding or diaper changes. Light is a significant biological driver of the circadian rhythm, and can be used to help reset sleep and wake times in babies once sleep has consolidated, from about 5 months onward. Research suggests that exposure to light will suppress melatonin, the sleep-inducing hormone, just as darkness encourages release of melatonin, which encourages sleep.

Keep the lights dark from the desired bedtime, to the desired morning wake up time, to help reinforce the sleep cycle. If your child is waking too early, true room-darkening shades are important. Early morning light creeping in will encourage an earlier wake up time. If there’s enough light in the room to read by, it’s too light. Avoid gaps at the sides of shades that allow a strip of light at the edges. Using aluminum foil on the windows to block light may not be attractive, but it’s certainly effective.

Continuous White Noise is an underused sleep aid. Not just any white noise, but continuous white noise is essential because it helps muffle random sounds at the most vulnerable times: during light sleep stage. Rather than sound machines that shut off after an hour, make sure it plays all night. Position your sound machine between the baby and the noise. Determine if you’re most concerned about outside sounds, or household noises. When a baby is in a deep sleep, he might be oblivious to even a loud sound. When he is in a light sleep, even a quiet sound like a sneeze or a toilet flushing in another room might be enough to rouse him. Continuous white noise also serves as a sleep association that is easy for anyone to replicate and can travel when you do.

A Cool, Ventilated Room 
A cool, dark and quiet room works best. When the season has warm days and cool nights, it’s reasonable to open the windows for fresh evening air. However, with the windows open, the birds and outdoor sounds will be even louder at 5 AM. A fan in the room to help circulate air is a good option if the windows are closed. Keep the room temperature at 64-69°F for sleep. During cooler months, keep feet warm at night. Remember:  “warm feet for better sleep”. Don’t worry if your baby’s hands or face feel cool to the touch. Slip your hand under your baby’s shirt: if his tummy and chest are warm, he’s warm enough.

Gross Motor Play for Babies

Infant Health & Safety, New Moms, ,

Gross Motor Play for Babies about 5 to 8 months old

Once your baby is enjoying more “Floor Time” and finding new ways to move his body, incorporating new “gross motor” activities will create fun new ways to challenge his skills.

Always keep safety in mind: stay nearby (or provide hands-on “spotting” if needed), make sure all toys and materials are child-safe and choke-hazard-free, and provide an appropriate surface for the expected occasional tumbles such as carpet or foam-flooring.

Try any of these ideas from about six months onward.

Tunnel Play: a collapsing tunnel is a fantastic play environment that offers many different uses over the coming months and years. Before your baby is crawling, try placing a sheet folded into a long strip all the way through the tunnel. Then, give your baby a “ride”, pulling him slowly through the tunnel, first on his back, and next on his tummy. Once your baby is crawling, he’ll crawl through the tunnel with your smiling face encouraging him at the  other end. Later still, he’ll crawl after a ball or pull toy you roll through the tunnel. And after that, a tunnel can become part of a more complex “obstacle course” set up for your toddler. Best still, when not in use, your tunnel collapses flat and can be tucked in a closet or under a bed.

Rody and Gym Ball play: With your hands-on assistance, your baby will enjoy practicing bouncing on these objects, and tilting from side to side. Slide your hands down to your baby’s hips (rather than holding him under the armpits) to allow his own trunk muscles to work on balance. If you are using a gym ball, you can sit him on top for some activities, and lay him tummy down on the ball for others. Facing a full-length mirror is fantastic when possible.

Bouncing on parent’s lap with songs and rhymes. Your baby is ready for exciting “rides” with bigger rises and (controlled) falls and swoops! Three favorite active bounces to try:

Trot-Trot to Boston
Trot-trot to Boston, Trot-trot to Lynn. Look out little Baby, that you don’t FALL IN!
Bounce baby on your lap and while holding securely, allow your baby to either tilt back or drop through your legs at the end.

Noble Duke of York
Oh, the Noble Duke of York, he had ten thousand men.
He rode them UP to the top of the hill, and he rode them DOWN again!
And when you’re UP, You’re UP. And when you’re DOWN, you’re DOWN.
And when you’re only HALFWAY UP, you’re neither UP nor DOWN!
Sit baby straddled across your leg like a horse and bounce baby rhythmically, raising and lowering baby to the up and down cues of the song. This is a truly a favorite!

Pop! Goes the Weasel
All around the cobbler’s bench, the monkey chased the weasel.
The monkey thought it was all in fun, then… POP! Goes the weasel!
Bounce baby on your lap to the rhthm of the song and while holding securely, do a big lift up at the “POP!”

You may find it a little tiresome singing the same songs over and over, but your baby thrives on the repetition, and begins to anticipate the movements and exciting finish! This familiarity helps him be an active participant in the activity.


Baby Ball Pit
Take one package of Ball Pit Balls and dump the balls into your pop-up travel crib/play-yard. Presto! Easy ball pit!

This is an easy activity and can provide many hours of play when used selectively. The balls are easy to put away and bring out on special occasions when you need a diversion. Meanwhile several balls at a time can be used for other activities such as dropping in and out of a bucket, rolling down a makeshift ramp, playing “catch” by rolling back and forth with caregiver while sitting on the floor, and as your child grows, for “indoor bowling” or counting and sorting by color.

 

Music and Baby Development

Uncategorized

Another Reason to Turn Off the TV and Turn On the Music!

Babies love to share music with others. They use sounds, movements and expressions to interact with others and connect with their own feelings. Music often becomes the first form of creative expression for infants and toddlers. It can also give them a way to connect and bond with the caregivers around them. Music can also be a powerful way to connect babies to their own heritage or culture or another language.

Music has so many developmental benefits. There is no doubt that babies and young children seem to love music, but what are they really getting out of it? What does dancing, bouncing and clapping really have to do with development?

Familiar, soothing sounds.
Many parents play an instrument or sing to their babies long before they are born and some babies respond to music played to them in utero by becoming more active. Infants also can recognize songs or sounds familiar from pregnancy, and make a distinction between a song that a mother sang during her pregnancy, and one that they have never heard before.

Young children are attracted to musical patterns and structure. Research has shown that music helps children build early mathematical skills by teaching spatial properties, one-to-one correspondence, sequencing, patterning and early counting. Babies seem to have a natural affinity for rhythm. Babies follow the beat of music playing and move their body to the tempo naturally when parents sing to them.

Benefits of steady beat. Patting the beat of a song on your baby’s legs, or bouncing to music rhythmically helps your baby “feel” the steady beat. Steady beat also has similar brain relationships to the coordination needed for other rhythmic skills like marching and running.

Finger Plays help fine motor skills. Infants and toddlers learn imitation, fine motor and language skills through the hand motions that accompany many songs for young children. Most songs we sing with infants and toddler include clapping at the end of songs or special finger plays for special parts, like the mama duck quacking in “Five Little Ducks” or the wheels turning on “The Wheels on the Bus.”

Language Development. As older babies begin experiencing rapid language growth and their ability to distinguish between spoken sounds exponentially increases, so does their ability to distinguish between musical sounds, note and tones of instruments. Music development and language development support each other and support the baby’s sense of making himself understood in the world.

Feel the Music! Music is an outlet for energy, emotions and creativity. Music can be joyful and exciting, and it is impossible to sing silly songs to a child without a smile on your face. Music can also be soothing and calming, like a lullaby that is shared at the end of the day, or the tender humming while walking a newborn to sleep.

Music helps to establish routines and transitions. A familiar song will help a baby feel safe and secure in an unfamiliar setting, just like a lovey or familiar toy. Music plays an important role in establishing routines. The same song for bedtime becomes part of the transition from awake to drowsy, or a clean-up song becomes the transition from playing to tidying up for dinner.

Fine Motor Play Ideas from Six to Nine Months

Infant Health & Safety, New Moms, , ,

Midway into the first year, your baby will be busy learning and experimenting with how her hands and body work, and how the world works.
There are many easy and fun “fine motor” activities you can incorporate into every day play.

These interactive activities incorporate thinking and learning skills: how to use the hands in a coordinated fashion to achieve a goal, “motor planning” to position the fingers and hands, arms, trunk and body more intuitively to complete a task efficiently, cognitive skills by observing and learning by “cause and effect”, and the satisfaction that comes as your baby anticipates a result and sees it occur as expected.

Some fun toys and activities to add to your play:

Pull toys with string: A classic toy and way for your baby to learn cause and effect and how she can impact her environment. Show her how to pull the end of the string and draw the toy closer to her. Similar activities can be created by placing a folded receiving blanket near your baby and placing a toy or object on the far end. Show your baby how she can slowly pull the edge of the blanket in toward her body to bring the toy into closer reach.

What’s Inside, #1? Take some random objects or toys safe for exploring, and wrap each one in material that will be safe for your child to unwrap: a scarf, a receiving blanket, tissue paper, gift wrap. Let your baby practice unwrapping the packages to discover what is hidden inside.

What’s Inside, #2? Take a baby-safe toy or rattle and place it inside a clean sock, initially with an edge of the rattle exposed. Show your baby how to work to pull the sock off the object, or take the object out of the sock, and cheer when she succeeds. This can be made more challenging over time depending on the item “hidden” in the sock. Try a small safe ball. That’s hard!

What’s Inside, #3? Use safe containers like a cardboard shoe box with lid or a purse for your child to investigate. Place a stuffed animal or several small safe toys inside. Demonstrate how to take items OUT, place them back IN, and close the lid or top. Ask, “Where is it?” and show that it’s still in there where you put it.

Ball Ramp: Take a long cardboard tube and cut it in half. Use this as a ramp to roll a baby-safe small ball or car down the tube. Initially, your baby will probably be on the receiving end, catching the ball as it rolls down the ramp, but soon, she will have the skills to place the object at the top of the ramp and let go so down it rolls!

Large Knobbed Puzzle: A chunky wood “beginner” puzzle will be of interest now, even if your baby initially is more interested taking the pieces out, tasting them and banging them against the table. By modeling how the pieces fit back into the frame, your baby will soon try to imitate that action as well. Hint: secure the frame of the puzzle to the table surface with painter’s tape to reduce frustration from the frame sliding around or falling off the table.

Quick Tip: Too many toys piled up can be overwhelming. Instead, put out a small selection of toys at a time, and rotate new ones in and out of the mix every few days to keep things fresh and stimulating/ Of course it’s fine to leave favorite items that are frequently used.

Bronchiolitis and Croup

Infant Health & Safety, New Moms, Uncategorized

Bronchiolitis: A common respiratory illness during a baby’s first year

Your baby will (unfortunately) contract six colds, on average, during his first year. Most colds will have upper respiratory symptoms (runny or stuffy nose, perhaps a cough, possibly a fever). Most colds will last for 5-10 days (yes, it takes longer for babies to shake a cold than an adult. Also, the baby’s symptoms are much more obvious since they cannot blow their nose, and they let you know when they are not feeling their best).

Occasionally, some colds have a “Stage Two” attached.
There are three common “Stage Two” parts of colds: some babies will get an ear infection after a cold (due to physiologic anatomy and nasal congestion), some cold viruses will result in a body rash (“viral rash”) one or two weeks after the cold virus has resolved, and finally, some colds will travel lower in the baby’s respiratory tract and continue on into a Croup or Bronchiolitis. Croup is more common in 1-2 year olds. Bronchiolitis is more common during a baby’s first year.

So, think of bronchiolitis as “part two” of a cold. The cold virus unfortunately has moved lower in the baby’s respiratory tract, to the smallest of the airway branches, called the bronchioles. An adult typically gets “bronchitis” from a chest cold (inflammation of the bronchi), but an infant gets “bronchiolitis” – inflammation of the smaller branches of the respiratory system.

These respiratory infections are unique in that they typically impact infants and toddlers, but not adults. However, the very same virus that may cause a basic cold in anyone, a “head cold” or “chest cold” for others in the home, may result in croup or bronchiolitis in an infant or toddler. It’s not the virus itself that causes the bronchiolitis (or croup, or ear infection), rather, the virus causes the infection, and the infection progresses to a symptom in the bronchioles (or middle ear).

Bronchiolitis is an infection of the respiratory tract that affects the smallest airways of the lung. The swelling and obstruction of these tiny airway passages creates shortness of breath, wheezing or whistling noises. You might notices an infant with bronchiolitis is working harder, with rapid, shallow breathing, with neck or chest “accessory muscles” moving with the breathing efforts.  You’ll likely notice more irritability or crankiness, restlessness and decreased appetite as the body’s efforts must go into breathing and oxygenation rather than eating and nutrition.

Since the virus that causes bronchiolitis is often the same virus that causes the common cold, you may see cold symptoms including a runny or stuffy nose, cough and fever. Bronchiolitis or croup may start with a common cold, but progress to the lower respiratory tract.

Even if your baby doesn’t seem to be struggling to breathe, restlessness may be a sign of low oxygen levels in an infant, so it’s worth a call to your pediatrician if your baby has a fever, congestion, is breathing rapidly and seems very unsettled or unhappy. It’s better to call and be told what to watch for, than worry about if you should call or not!

Bronchiolitis is most common in the winter and spring but may occur at any time. It is most common in babies under a year old, boys are more commonly affected and exposure to smoke, daycare or older siblings makes a baby more likely to get more frequent colds, so also increase the risk or rate of bronchiolitis. Avoiding obviously sick people (hard to do in daycare where seemingly 75% of children appear to have some stage of a cold!) and good hand washing are always good practices to reduce risk of catching a cold or virus.

RSV (respiratory syncytial virus) is the most common viral cause of bronchiolitis (though the flu virus or a regular rhinovirus – the common cold virus – may also result in bronchiolitis in an infant). Premature and other vulnerable infants are more susceptible to RSV, or may have a harder time managing RSV illnesses, so some higher-risk babies may receive a vaccine to prevent RSV.

Your pediatrician will diagnose bronchiolitis by listening to your baby’s chest, checking a pulse oximetry oxygen level and perhaps ruling out pneumonia or another diagnosis by requesting a chest x-ray. Presense of the RSV virus may be confirmed using a nasal swab in the pediatrician’s office.

Treatment for bronchiolitis will depend on your baby’s specific symptoms and severity. Most bronchiolitis cases are mild and will be cared for at home by offering fluids, anti-fever medications, and using a humidifier and saline nose drops to keep breathing more comfortable. Occasionally “nebulizer” breathing treatments may be done in the doctor’s office or at home. Rarely, a baby may need to be briefly hospitalized for breathing treatments or extra oxygen but this is not typical at all. Antibiotics will not help bronchiolitis, which is the infant’s respiratory response to a virus similar to a cold.

School of Hard Knocks: Babies and Everyday Bumps

Infant Health & Safety,

Your baby inches his way under the coffee table and bumps his head on the leg. He rolls over on the play mat, and lands right on top of a plastic toy. He’s working on sitting, but tilts sideways or sometimes even backward when he loses his balance. All before breakfast.

Chances are good that over the coming weeks and months, he’ll have a dozen minor bumps, falls and mishaps before his first morning nap. Your mantra can be: “Oh well! You’re Okay!” Bumps happen. It’s a sign of healthy development!

Minor bumps and tumbles are part of becoming mobile and learning about the world. Healthy, active babies get their bodies into some uncomfortable predicaments and learning how to fall is just as important as learning balance. Your baby needs to be able to explore his safe environment freely (though supervised). Yes, having a baby-safe environment is essential, but even so, you’ll never be able to protect your baby from every bump and bruise.

Practice your UNDER-reaction. 
If you gasp with fear each time and rush to his rescue each time he takes a little tumble, it’s going to be a very long few years for you both.

Even when you’re wincing inside, try to keep your expression neutral or positive, and ignore any bumps or tumbles your baby doesn’t react to. You’ll be amazed that he takes his cues from your own reaction. Babies will often take what seems like a scary or painful tumble, and then continue on as though they hardly noticed.

Of course you should offer comfort (and then distraction) if your baby seems upset or scared, and soothing if he is hurt. But most of the time, your baby will topple over from sit, or roll over and flop his head on the floor or bump his head under the table, and may look to you as to how to react. If you can foster an attitude of: “Oh well! You’re okay!” it’s likely that he will, too. Save the scooping up, attention and comfort for the times when he is clearly is hurt. Unfortunately there will be plenty of those opportunities as well. (Remember, minor bumps and bruises are a sign of healthy development 😉 )

Floor Time for Babies

Infant Health & Safety, , , , , ,

Your baby’s gross motor development occurs along predictable Cephalo-Caudal principles. As a reminder, this means that your baby develops motor strength and muscle control starting from from the top (Cephalo, Latin for “Head”) toward the bottom (Caudal, Latin for “tail”). This principle of development means that first, your baby works on achieving head and neck control, then upper body strength in the arms, shoulders and upper torso, then lower abdominal strength, and finally, leg strengthening and balance for walking.

For this context, think of the first year of life for a human child as a timeline from birth, essentially laying flat with very little muscle control, to one year, when a baby is now upright, standing and moving independently (cruising, crawling or walking).
The mid-way point, six months, the baby is halfway there. During the sixth month, most babies will be working on sitting upright, and on finding some way to move. Here’s how tummy time plays a critical role in building strength for these skills. Tummy time doesn’t go away, it evolves into “Floor Time”.

Between 2 – 4 months, babies (hopefully!) are working on tummy time, beginning to push up on bent arms and support their head, neck and eventually shoulders and upper body (pushing their chest up off the floor to the nipple level, even) for increasingly longer periods of time. What the 2 month old found frustratingly hard work when placed on his tummy, the 4 month old effortlessly performs: remaining propped up on his bent arms for much longer periods of time.

At five months, he’s ready for a new challenge: rather than resting on his bent forearms during tummy time, he may push straight up on extended arms, getting almost all his chest off the floor down to his belly button. After doing this for a week or two, you’ll begin to see some fancy developments: he’ll start pivoting in a circle and then moving (creeping) backward. Using some combination of pushing off with his arms, typically these earliest movements will take your baby sideways and backwards. These fun efforts mean that your baby will creep backward until he’s halfway under the couch or coffee table. You’ll watch him get stuck many times over, often to your amusement.

To encourage him to pivot (which strengthens his upper body) yet to lower his frustration (Frustration Tolerance – another skill) place a few tempting toys around him in a circle. This way, when his efforts take him away from the object of interest in front of him (because early movements tend to take babies sideways and backwards!) there will be a new and rewarding item that catches his attention.

This activity is called “Floor Time”. Unlike Tummy Time, where you may have needed to use a prop, position your baby carefully, and a receiving blanket was all that was needed, Floor Time requires more space. Your baby needs some space to begin to explore how his body can move, and motivation to investigate his environment. Months before he can crawl and even though he may not yet be able to roll, he’ll still figure out ways to somehow scooch, creep, wiggle or otherwise inch and arch himself a few feet in one direction or another.

A clean area rug or foam matting makes a perfect surface for floor time. Blankets and quilts tend to get bunched up under your baby’s efforts to move. When possible, bare feet is best for sensory input and for traction. Watch those little toes flex and dig into the surface to get leverage to push off with!

By six to eight months, your baby will figure out some version of movement. Though it may not be what you think of as “crawling”, most babies in this age group have some way of getting a few feet away from where you left them. HOW they move matters less than having the motor strength to move, and the cognitive desire to explore. Some babies will use their arms to pivot and creep backward, others will “commando crawl”, using lots of effort with their upper body to drag themselves forward. Some will use an amusing combination of rolling, shimmying or scooting to get around!

Time to Baby Proof!