A blog by Dr Lin Day



A mobile baby is the ultimate game changer

You spend the first few months of your baby’s life giddy with excitement at every development – from grasping something in their hands to that very first wobbly roll – and you eagerly await the moment they take their first shuffly crawl. And then it happens. And your life will never be the same again.

I remember when my daughter (my vivacious, active, energetic, incredibly cheeky 18-month old I’ll simply call Moo for the purposes of this blog – not because she has a particular fondness for cows, but because it’s a nickname we somehow adopted for her since birth!) first started to creep forward on her knees. We were beyond excited, hovering above her with the video camera in our hands at every opportunity. She was unsteady at first, and grew increasingly frustrated as she rocked herself forward on her knees over and over again.

Sometimes she was so frustrated that I had to give her a friendly Time Out and distract her with another quest (oh the wonders of stacking cups). After lots of wobbles, a few tears and some painful nights not sleeping as she tried to master the activity in her cot, she began to crawl. Did I mention that she was only seven months old?

We were ecstatic. I captured it on camera and posted it to Facebook (as you do). My little trouper was on the move.

And about 20 minutes later when she was following me to the kitchen, tugging at my pyjama bottoms and wouldn’t sit still, I realised what this meant. No more “lie here sweetie while mummy gets her coffee” or “just wait one second while I answer the door”. No, none of that existed any more. She was here, there and everywhere.

It’s even harder if you try to leave the house. Seven months into maternity leave and the days of meeting up with friends – at cafes, houses or parks – abruptly came to an end. She was crawling all over the place, trying to get up stairs, behind bookshelves or out of patio doors, picking up everything and opening drawers and cupboards she shouldn’t be.

Or I was trying to stop her crawling because I didn’t think the gravelly terrain of the local playground or the dirty floor of a nearby coffee shop was particularly the place for her to scuttle around on her hands and knees – the same hands she puts everything in her mouth with! Although, admittedly, she won this battle more often than not.

I don’t want to put parents off though. The pride you get from each physical, emotional and mental development is fantastic, and I even remember beaming when I turned up at our first Baby Sensory class post first crawl and she shuffled right across the circle into the middle to watch our lovely leader sing “Say hello to the sun”.

Of course, I then spent every subsequent class slightly jealous of all the other mummies whose babies sat or lay there staring into their eyes as they sang, signed and cooed at their immobile little ones, while Moo was crawling – then walking – all over the place.

That’s right. Within a week of crawling, she was pulling herself up and cruising along furniture. At nine months old, she took her first steps. Again, we captured it on camera. Again, we were over the moon.

But if you thought crawling was difficult, wait till they’re running and you have to chase them everywhere! At least there are some benefits to a fully standing walking child. You can actually take them out – to the park, houses, cafes etc. – without worrying about mucky sore knees. They’re not so frustrated at not being able to reach for the toys they want. And (my favourite) you can hold their tiny little hands as you walk with them side by side.

So, while a mobile baby is a huge game changer in this parenting lark, it’s also immensely satisfying. Your little baby is becoming a toddler, and seeing them grow up happy and healthy is the single most amazing feeling in the world – even if you don’t get to sit still for the next upteen years….

Living with a Colicky Baby

Living with a Colicky Baby

 What is colic?

Colic is defined by inconsolable crying on and off for 3 or more hours a day, 3 or more days a week, and 3 weeks in a month. Your baby may cry or scream at the same time each day, usually in the late afternoon or evening.

Colicky symptoms usually begin in the second week after birth, peak at about 6 weeks, and decline at 3 to 4 months. Colic rarely persists longer than 6 months.

Do all babies suffer from colic?

Colic occurs in approximately 30% of breast and bottle-fed babies, and equally in both sexes. Although first-born babies seem to be affected with colic more than later siblings, they are just as likely to suffer from the condition. Colicky babies gain weight and are otherwise healthy.

What are the symptoms?

One or more of the following may suggest that your baby has colic:

  • Crying an hour or more after a feed.
  • High pitched, intense cry.
  • Incessant, inconsolable crying at a regular time each day or night.
  • Pulling knees to chest.
  • Abdominal bloating.
  • Excessive flatulence.
  • Frequent, explosive, watery stools.

If your baby suffers from chronic constipation, diarrhoea with blood or mucus, a high temperature, vomiting, weak sucking or poor weight gain, see your GP to rule out other illnesses.

 What are the causes of colic?

One or more of the following may cause colic or exacerbate symptoms.

  1. Lactase deficiency.
  2. Intestinal hormone imbalance.
  3. Lack of beneficial bacteria.
  4. Maternal diet.
  5. Formula milk protein intolerance.
  6. Skull misalignment.
  7. Overstimulation.
  8. Lack of exercise or carrying.
  9. Tight clothing.
  10. Parental stress.

Lactase deficiency

Cells lining the small intestine produce the enzyme lactase. Lactase breaks down milk sugars (lactose), which fuel metabolism and promote rapid brain growth. Insufficient lactase production can cause undigested lactose to ferment in the large intestine leading to excessive gas production, flatulence and abdominal bloating.

Foremilk (watery milk at the beginning of a feed) contains more lactose than hindmilk (high-fat milk at the end of a feed). The high-fat content of hindmilk increases the capacity of the intestine to digest lactose. If your baby is unable to nurse long enough during breast feeds, he or she may not receive the high-fat milk needed to aid digestion.

  • Express some foremilk from both breasts before a feed to ensure that your baby receives hindmilk.
  • Let your baby finish one breast before offering the other so that more high-fat milk (hindmilk) is consumed.

When breastfeeding and milk production are fully established, a pacifier can help satisfy the need to suck when your baby is not hungry.

Although it may be tempting to give your baby gripe water or natural remedies to relieve colic between feeds, they may contain potentially harmful chemicals, which can have adverse side effects.

 Intestinal hormone imbalance

Muscular contractions of the intestinal tract are stimulated by motilin, a hormone secreted by cells lining the small intestine.

Motilin in breast milk has a nocturnal peak, which may explain why breastfed babies become colicky in the evening or at night (motilin is also found in formula milk). High levels of motilin can lead to painful muscular contractions. However, close physical contact increases melatonin (a hormone that induces sleep), which suppresses painful intestinal contractions.

Motilin levels also increase when babies are exposed to environmental smoke and/or nicotine in breast milk. Exposure can be minimized by restricting smoking in the home or near the baby.

Lack of beneficial bacteria

Beneficial or ‘friendly’ bacteria in the intestinal tract play a vital role in protecting your baby from harmful microorganisms that cause inflammation and bloating.

Babies born by Caesarean section may miss out on beneficial bacteria naturally passed on during vaginal birth. Bacterial colonisation may also be delayed if your baby has been exposed to antibiotics. This may explain in part, why your baby suffers from colic.

Probiotics (live beneficial bacteria) occur naturally in breast milk. There is some evidence (http://pediatrics.aappublications.org/content/126/6/1217) that formula milk enriched with probiotics may reduce colicky symptoms in healthy bottle-fed babies, but more studies are needed to substantiate this.

Maternal diet

Many breastfeeding mothers have found that excluding cabbage, cauliflower, broccoli, onion, wheat, eggs, soy, caffeine-based foods and drinks, orange juice, and dairy products from their diet reduces colicky symptoms.

Foods not associated with colic include unsaturated vegetable oils, garlic, Brussels sprouts, beans, avocado, bananas, carrots, potatoes, beef, sardines, salmon, and low-fat yoghurt.

 Formula milk protein intolerance

If your baby has been recently introduced to formula and presents the symptoms of colic, an allergic response to one or more proteins in cow’s milk could be responsible. Colic may also be accompanied by other allergic symptoms such as an itchy skin rash, vomiting and diarrhoea.

If an allergy is suspected, formula milk that has been specially treated to change the proteins, or contains no milk proteins, can be given as an alternative on the advice of your healthcare professional. Soy formula milk is just as potentially allergenic as cow’s milk, and there is no evidence to suggest that it reduces colicky symptoms.

 Skull misalignment

Misalignment of the skull due to childbirth can put pressure on the vagus nerve, which passes through the neck and thorax to the abdomen. Compression of the vagus nerve can cause intestinal spasms and pain. Cranial osteopathy has been shown to be successful in treating colicky symptoms (http://www.ncbi.nlm.nih.gov/pubmed/16648084). Treatment involves applying very light pressure to the affected area until tension is released.

 Tight clothing

A snug-fitting nappy can push against your baby’s tummy, especially after a feed. If you cannot easily slide 2 fingers inside the nappy, it may be too tight. Tight clothing can restrict the movement of food through the intestines leading to bloating and discomfit.

Overstimulation

Overstimulation can irritate the nervous system and lead to uncontrollable, high-pitched crying at the end of the day. A daytime routine that includes frequent rest-breaks or naps, and short play episodes when your baby is alert and responsive will help avoid overstimulation.

By the end of the third month, the nervous system has adjusted to environmental stimuli, which is one reason why colic usually stops.

Lack of exercise or carrying

Lack of exercise or overuse of a baby bouncer, car seat or other restraining device may reduce intestinal contractions and lead to bloating. However, regular exercise and tummy time improves intestinal mobility and helps force out excess gas.

“The relative lack of carrying in our society may predispose to crying and colic in heathy babies.”

In many cultures, babies are carried by their mothers, grandmothers or siblings in a sling or pouch on their backs, fronts or hips almost constantly. The baby experiences continual physical comfort and an intimate and secure environment. Colic is rare in babies who are constantly held or cuddled.

Research shows that carrying the baby in a carrier, for at least 3 hours during the day (in addition to feeding), reduces colic in the first 3 months of life by as much as 45%. (http://pediatrics.aappublications.org/content/77/5/641). Close physical contact, carrying and walking are undoubtedly the best ways to comfort a distressed baby. Skin-to-skin contact is especially effective in reducing stress.

Parental stress

Parental tension and anxiety do not cause colic. However, colic can increase parental stress, which in turn leads to increased bouts of fussiness and crying in babies.

Continuous crying and maternal fatigue can have serious implications for the mother-baby relationship. It can also trigger postnatal depression, Shaken Baby Syndrome, and early termination of breast feeding.

Parents with a colicky baby need support, particularly in the early months when it is important to establish a strong bond with the baby. Baby Foundations parenting classes can help by empowering parents with information and practical advice on how best to manage colic (http://www.babysensory.com/en/babyfoundations).

If further help is needed, Cry-sis (www.cry-sis.org.uk) provides support to families with excessively crying, sleepless and demanding babies. The helpline (08451 228 669) is open 7 days a week from 9 am to 10 pm.

By Dr. Lin Day: www.babysensory.com

From one mum to another

‘I’m so happy to welcome Natasha as our first guest blogger. Her posts ‘From one mum to another’ will become a regular feature as she tracks her journey through life with little…well I’m about to say too much already!

Welcome Natasha and I am really looking forward to hearing what life is like as a mum in digital world of 2015!’

Pacifier – Good or Bad?

Pacifier – Good or Bad?

David Beckham hits back at criticism over 4 year-old Harper’s pacifier.

Experts claimed that the pacifier risked stunting her speech and put her teeth at risk of damage. Beckham blasted back saying:

Everybody who has children knows that when they aren’t feeling well or have a fever, you do what comforts them best and most of the time it’s a pacifier. So, those who criticize, think twice about what you say about other people’s children because actually you have no right to criticize me as a parent.”

So should a 4 year-old be using a pacifier? At present, there are mixed opinions as to whether a pacifier in the pre-school years is good or bad. From the child’s viewpoint, the pacifier offers comfort and contentment at a time of need. From the parent’s viewpoint, pacifier use is up to them.

Health professionals argue that prolonged pacifier use may lead to speech delays and dental problems in some, but not all children, if continued after 4 years of age. Problems, if any, depend on the frequency of sucking (how often), duration (how long) and intensity (can you hear it across the room?). However, if the pacifier is taken away too soon, the child will find the fingers or thumb to suck on, which is a much harder habit to break. About 12% of adults still suck their fingers or thumbs.

There isn’t a gold standard in the literature about an ideal age to eliminate pacifier use. Expert opinions also vary greatly (visit:http://www.asha.org/About/news/Press-Releases/2010/pacifier-speech-skills.htm).

Removing the pacifier before your child is ready can create a great source of anxiety. Most children give up their pacifiers on their own, and when they are ready, before they go to school.

 Benefits

 Babies have an innate desire for non-nutritive sucking, but the need for continued sucking can linger for years because it provides the following benefits:

Gives rise to feelings of well-being and contentment.

  • Offers emotional security during periods of isolation or separation from the parent (e.g. during naps and at bedtime).
  • Provides comfort when unwell or distressed.
  • Triggers the calming reflex, which induces sleep.
  • Provides temporary distraction in stressful situations.
  • Prevents finger or thumb sucking.

Sucking on a pacifier is a much healthier means of seeking comfort than eating a packet of crisps! However, pacifiers also have pitfalls. The drawbacks may include:

  • Interference with breastfeeding and milk production in the first 3 to 4 weeks after birth.
  • Night-time crying when the pacifier falls out of the child’s mouth.
  • Increased risk of middle ear infections after 6 months-old (continuous sucking allows secretions from the throat to seep into the middle ear).
  • Skin irritation from excess saliva that may collect behind the base.
  • Contamination by bacteria if not washed or sterilised frequently – latex pacifiers are more significantly colonized with Candida andStaphylococcus than silicone pacifiers.
  • Possible teeth misalignment and/or speech delays from consistent or prolonged use.
  • Dependency on the pacifier.
  • Difficulty in breaking the habit.

In 2006, the International Journal of Orthodontics, and the American Speech-Language-Hearing Association, argued that prolonged use of a pacifier could negatively affect speech skills by interfering with the development of tongue tip movement needed for the production of certain sounds. Instead of making an attempt to use sounds and words, the child may point to objects to have their needs and wants met.

Pacifier use after 4 years-old has been associated with a higher incidence of dental problems (http://www.aafp.org/afp/2009/0415/p681.html). However, thumb or finger-sucking can also alter tongue and teeth positioning. Even slight alterations can affect speech production.

Currently, about 75% of pre-school children in Western countries use a pacifier. Therefore, you can take comfort from the fact that you are not alone. You may wish to consider an orthodontic pacifier, which can help reduce dental problems than a traditional round one (for more information, visit: http://www.aapd.org/assets/1/25/Adair-14-01.pdf).

If you do have concerns, seek the advice of a dental specialist, who will recommend techniques to help your child break the habit. Early orthodontic management may prevent more extensive treatment later on.

Breaking the habit

Methods may include distraction with activities, toys and other objects of affection, putting unpalatable substances on the pacifier, cutting it short to reduce sucking satisfaction, restricting use to bedtime only or stopping the habit abruptly. Social pressure when the child goes to school can also put a stop to the habit. However, the pacifier may be replaced by the fingers or thumb.

Some parents find that agreeing with the child to donate the pacifier to the dummy fairy or to the Christmas elves works best. They will be sure to find a good home with a child who really needs it.

 

By Dr. Lin Day: www.babysensory.com

Baby Foundations classes cover everything you need to know about your baby before and after the birth including pacifier use and alternative techniques to soothe and comfort your newborn baby.

Visit: www.babysensory.com/en/babyfoundations

The Dangers of Baby Containers

Leaving your baby in a bouncer, rocker, or other restraining container for a prolonged period of time can be dangerous….

The consequences of spending too long in a container may include flattening to the back of the head (flat head syndrome) and delayed sitting, crawling, walking and speaking skills. Your child may also develop problems such as clumsiness, poor posture and balance, and reading and writing difficulties when he or she goes to school.

All babies need opportunities to move and explore the world in order to develop physical strength and brain power. Most containers do not provide such conditions. If a bouncer, car seat or other restraining device is to be used, confinement should be limited to short periods of time only.

Although it is essential to put your baby in a car seat when travelling, use should be restricted to car journeys. If your baby is confined in an uncompromising position for a considerable period of time, he or she will become restless, uncomfortable and stiff. Spine and back disorders have been linked to prolonged use when not travelling.

Overuse of a container is a common cause of head flattening, which may also involve bulging of the forehead, fullness of the cheeks and ear misalignment. Any flattening of the soft bones of the skull can put pressure on the nerves, tissues, ligaments and blood vessels of the body and affect feeding and sleeping. It is important to take steps to correct the condition.

 Solutions

Here are a few ways to help your baby’s head round out naturally:

  • To remove pressure on the back of the head, wear your baby in a sling carrier. Your baby will benefit from the extra stimulation of looking around and seeing the world and you will have both hands free to get on with other things. A carrier with a wide girth that places the legs at a 90-degree angle and encourages your baby to bend his or her knees will help prevent hip dysplasia.
  • Regular tummy time during supervised waking hours gives your baby the opportunity to lift his or her head, which promotes neck extension and head turning. Tummy time also gives your baby the opportunity to exercise, which strengthens muscles needed for spinal development.
  • If you do need to keep your baby safe in a container, a head rest, which consists of a soft foam outer core and a central hole, can remove pressure on the back of the head.
  • If skull flattening is severe, a band or helmet may be prescribed when your baby is between 4 and 6 months-old. At this time, your baby experiences rapid brain and skull growth. The band or helmet provides a space or void in the flattened area of the head, which allows the skull to grow into a more symmetrical shape. Treatment generally lasts 4 months or less.
  • Cranial osteopathy, which involves gentle, safe, manipulative movements, can be effective in treating flat head syndrome. Treatment can be started soon after birth or within the first 18 months before the bones of the skull begin to harden and set in place.

What the experts say

In 2008, the term ‘Container syndrome’ was used by health professionals to describe the increased incidence of flat head syndrome and the rise in development and language delays related to the use of bouncers, car seats and other restrainers or containers.

Studies show that babies in the UK and USA spend up to 75% of their waking hours in a container. In less developed countries, more than 90% of time is spent in close physical contact with a care-giver.

A recent publication by the Journal of Pediatrics stated that sitting devices such car seats and bouncers can lead to death if babies are allowed to sleep in them. The study showed that positional suffocation was the cause of death in 46 cases. Of these, 52% were caused by strangulation from the device’s straps. The death of a 3 month-old baby in 2015 in a baby bouncer reminds us of the potential hazards.

The researchers claimed, “It is important to note that an infant in a properly positioned car seat, in a car, with properly attached straps is at little risk from a suffocation injury. However, contrary to popular belief, the restraints and design of infant sitting or carrying devices are not intended for unsupervised sleeping.“
Read more at: http://www.themotherish.com/swing-and-car-seat-dangers/

Staying healthy

To keep your baby’s body and brain healthy, a container should only be used when absolutely necessary. If your baby appears uncomfortable or starts to fuss, then take him or her out and provide close physical comfort.  Alternatively, wear your baby in a sling carrier.

The best way to remove pressure on the back of your baby’s head, and provide opportunities for movement and exploration, is tummy time during waking hours. However, your baby should always be placed on his or her back to sleep.

 

By Dr. Lin Day: www.babysensory.com

Baby Foundations classes cover everything you need to know about your baby before and after the birth from skull development to tummy time, sensory play, feeding, sleep, equipment and development.

Visit: www.babysensory.com/en/babyfoundations