Category Archives: Infant Health & Safety

Sitting and Playing at 7 – 8 months

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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.

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.

 

Fine Motor Play Ideas from Six to Nine Months

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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

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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!

Diaper Surprise! 12 Freaky Things to See in Baby’s Diaper during the first year

Breastfeeding, Feeding, Infant Health & Safety, New Moms, solids

Changing your baby’s diaper may feel a bit like unwrapping a surprise gift or delicately defusing a small package bomb. You’re never quite sure what’s inside until its too late, and the contents may shock you, amuse you, or make you run for Dr.Google.

Don’t underestimate the fascination you may have with your baby’s diaper contents. Embrace this stereotypical new parent obsession, though do try to limit detailed diaper discussions to other new parents, and those who feign polite interest without turning white or audibly gagging.

Surprise! Here are 12 freaky things you might find in your baby’s diaper during the first year:

Day 3: Brick dust (uric acid crystals) – a rust or pinkish colored residue staining the front of the diaper. This resolves as baby’s urine becomes more dilute.

Week 2: Gel crystals. These look like oversized grains of sugar stuck to your baby’s genitals. Don’t panic – they’re not coming from your baby! Instead, they’re from the absorbent lining escaping from tiny tears in a disposable diaper.

Week 6: Green spinachy-looking poop. Like the occasional random projectile vomit, these bizarre baby things sometimes happen, possibly on days when baby is nursing more than usual. Unless it’s frequent, frothy, with mucus and blood, don’t worry about occasional green poop in the diaper.

Month 3: Nothing. No poop. Nada. Perhaps several days or even a week may go by with nary a stool. Perfectly normal for breastfed babies, as long as baby is content and pee is plentiful. No need to intervene. What goes in will eventually come out (and usually at the least opportune time and in abundance), so be fully prepared for a poop explosion.

Month 4: Containment Failure or Blow Out. When baby is in a seated position (car seat, bouncer, baby carrier) there’s really only one place for poop to go, and that’s UP. Tell-tale sign of the Blow Out is a yellowish wet spot located at the small of the baby’s back. Usually involves a complete change of clothes, bath optional. For both of you.

Month 5: Mom’s hair (because it’s falling out everywhere). Tip: Time to get a short, sassy hair cut. Hint: Beware the Hair Tourniquet.

Month 6: Slimy mucus in poop when baby has a cold. Swallowed mucus isn’t absorbed by the GI tract and will pass through unchanged into the diaper with poop.

Month 8: Little black threads which look exactly like tiny worms. These are from baby eating fresh bananas (not jarred). They’re just like the little black strings you see in homemade banana bread. Mmm. Banana bread.

Month 9: Gas-mask worthy smells. The strongest odors yet are typically from introducing more protein foods. Whew. Just. Wow.

Month 10: Bits of paper are likely from the tag she was chewing in the store or cardboard from gnawing on the corner of a board book. Paper is one of the four basic food groups of mobile babies. Bonus points if you can still read a letter or word.

Month 11: Easily identifiable bits and pieces of food. Oh, there’s a blueberry! Hey, look, a lima bean! Tip: If you want to know how long it takes for food to make it through your baby’s digestive tract, feed baby some corn. My estimation is you’ll see it again in about 18 hours.

Month 12: Poop that looks (and smells) just like big-people poop. If it’s not too squashed, you can shake it into the toilet instead of sealing it up in the diaper. The more solid food your baby eats, the more their poop will start to look more “familiar”.

Bonus – 18 months: Brightly colored flakes – from that crayon you needed to pry out of your toddler’s mouth. Makes for some pretty poop, though!

Help! Baby Won’t Take Bottle! and IBBM Method

bottles, Breastfeeding, Feeding, Infant Health & Safety, New Moms, ,

Hello,
Since you’re here, you’re probably pretty stressed. Sorry about that. I’m here to help with resources and support. I have a pretty good track record on this – which is why you’re here 😉
Hang in there.

Please READ:
Won’t Take a Bottle
Selecting Bottle Nipple
Bottle Feeding the Breastfeed Baby

Please WATCH:
Help, Won’t Take Bottle.

Please TRY IBBM 2x/day for 5 days.

Personalized Support – Home and Phone Consults

Changes in Routine over the Holidays

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It’s easy for everyday routines to be disrupted over the busy holiday weeks. Travel, visitors, parties, new decorations, and changes in childcare or playgroup routines , plus alterations in meals, nap and bedtime routines may result in both excitement and stress for infants, toddlers and parents.

Some simple steps may help to maintain a sense of security and routine during these busy days:

Keep mealtimes as regular as possible, or offer healthy snacks if a family meal is being held later than your child might like. Most toddlers have a short attention span in the highchair, so bring along some appropriate diversions to keep a child content at the table a little longer, or allow him to play with quiet toys on the floor next to the table if appropriate.

When traveling overnight, bring along some favorite toys, books, music and blankets and try to keep to your regular bedtime routine, even if it’s a little briefer or later than usual. If you usually bathe, read, rock, sing with your little one at bedtime, follow that pattern. Your baby will recognize the familiar rituals, even in a new environment. White noise may help mask unfamiliar city or party sounds.

Unfamiliar faces or crowded rooms at parties may take your child some time to get used to. Sometimes visitors are so eager to see the baby that they want to rush in and envelop the baby in a hug. Explain to visitors and relatives that most young children need some time to acclimate to new places and people (even grandparents, if it’s been awhile since their last visit). Hold your child and let her watch you interact with friends and relatives first. Wait until she seems more relaxed and shows a willingness to explore the environment or be held by someone new.  Using a sling or frontpack is a great way for relatives to see and interact with the baby, while parents are still able to maintain a sense of safety and security.

Keep extra-vigilant at holiday gatherings and parties when there are many adults and children present. It’s often assumed that someone else is watching a child, when in fact the toddler may be unobserved exploring an area that is unsafe or mouthing a potential choke-hazard. Sometimes a well-meaning relative may give a baby or toddler a food or plaything that is unsafe or not age-appropriate. Party foods (including candy, nuts, chips and baby carrots), festive decorations and toys for older children are all tempting and potential hazards for a crawling baby or young toddler.