Monthly Archives: June 2014

Swaddle Products That Confuse Parents

Parents should not be faulted for being totally confused!

Parents should not be faulted for being totally confused!


I found this product at a local big-box store, and my first thought was ” Created by a dad; how terrific!” Then I thought a bit more. How would a parent know when to go sleeveless? Warm weather? Babies who still cry when fully swaddled? Most babies are still crying after you finish swaddling them, even though they calm down after some shushing and swinging. Without the use of the other infant calming techniques (the 5 S’s from The Happiest Baby on the Block) you have served an incomplete meal of comforting. But a new parent would be truly forgiven for thinking that their newborn didn’t like being swaddled with their arms in when they continue to cry.

Newborns are not seeking freedom; after 9 months in a studio apartment, they are most comforted in a smaller space. That is why being cuddled is so wonderful for them. Swaddling firmly prevents those arms from flailing when they are crying. With their arms free, parents will see more of the Moro (startle) reflex and will have to hold them more firmly to replicate that cozy touch that swaddling provides. When put down in a loose or partial swaddle, babies can start crying again. This appears to be a plea to be picked up again, but it is more likely that your baby wants to be firmly held, all the way up through their arms and shoulders.

When is the arms-out swaddle just right? After 3-4 months, babies often have more arm control and less frequent Moro reflex responses. They can sleep well without a full swaddle, and this product makes it easy to wean your baby from swaddling. But nothing in the exterior packaging explained that.

I am thrilled that there are good products out there for parents to choose from. But the most valuable ingredients, knowledge and experience, still seem to be the hardest items to find.

Bumbo Chairs: A Product In Search Of A Problem

The Bumbo chair appeared on my radar in the last 10 years. It seems to me that the manufacturer has solved a problem that does not truly exist.  Get a good high chair, or use a well-designed booster seat that can sit on the floor.  If your child has motor delays, this chair is going to prevent the use of the correct musculature to gain independent sitting.  Whoops!

The Bumbo seems to appeal to parents who want their young infant to sit upright for meals or play as soon as possible. The company’s website does a great job of listing all the benefits of propping up a child who is unable to sit by himself. They are not helping you. They are selling you a product.

If you have a 4-6 month old child who is unable to sit by himself, then congratulations. You have a typically developing child. Make sure your child is spending time lying on his stomach reaching for toys and in your lap learning to balance. Use a high chair that allows you to angle the back to the point at which your child doesn’t fall too far to one side, and use it for short periods at meals and play. Meals at this age are fairly quick and most children want to be free to move.

If you have a 7-10 month old who is unable to sit and reach for toys by himself, then this chair will not assist your child. Using it frequently, instead of building the skills he needs, will probably slow his progress and certainly will not speed up development. It might make him happier if he is frustrated, and might temporarily minimize your concern that he is not developing on schedule. Your pediatrician can review his progress with you if you are concerned. If your child is not able to roll over, and struggles or avoids balancing on your lap at this age, then you may want to carefully review his development with your pediatrician. By this age, those skills should be well established.

All the discussions on the web fall into 2 camps. The first will be families that are certain that this device helped them feed and play with their children, and state that their children loved the chair. Then you have pediatric therapists who, without exception, warn that the position does not promote mature posture and limits the amount of time that a baby can spend in positions that build skills.

The device has been recalled because parents sat children in the Bumbo on tables and beds and children toppled off, injuring themselves. Sometimes severely. Falling out of this chair when it on the floor has been reported and skull fractures have been reported from that position as well. A belt and a warning pamphlet were provided with the last recall, and that action further

A Product That Doesn't Position Your Baby for Success!

A Product That Doesn’t Position Your Baby for Success!

suggests that this chair is not better than a well-designed high chair. It is probably less safe than a good high chair, and suggests less supervision is needed. The opposite is true. Use the Bumbo with the knowledge that is is not solving a problem for your child, and may be creating one.

Tantrum Taming With Special Needs Toddlers

Toddler tantrums are difficult to handle in the first place. The screaming, throwing and hitting can come as a wave of emotion that overwhelms and frightens both the child and the parent. When you have a toddler that may be emotionally age-appropriate but has difficulty expressing thoughts or understanding language, and add trouble handling sensory information, and you have a real problem. These children need our best efforts to help them navigate these waters.

Some special needs children remain at the toddler stage beyond the 18-4 year range. Those children are especially prone to explosions, as some of their abilities race ahead of skill acquisition (language, movement, self-calming) that would help them cope with emotional turmoil.

If you cannot reason with a special needs child who is having a tantrum, what can you do? Although he did not create his techniques for this population, Dr. Harvey Karp’s toddler communication techniques have been very effective for me in my work. He emphasizes gestures/facial expression and use repeated short phrases. Solving the cause of the tantrum comes AFTER acknowledging the child’s feelings. I will not say that every tantrum has evaporated, but I have seen simply amazing results.

The hardest part for me was that his primary technique requires me to sound, well, like a toddler. Communicating with a child in such a simple, primitive way took some practice. But looking incompetent in front of his parents wasn’t so wonderful either.

Dr. Karp’s book “the Happiest Toddler on the Block” has been revised since I first read it, and the new and improved edition is even more user-friendly. If you parent a special needs child or work with one, it is worth learning this compassionate and effective program.

does this look familiar? read on!

does this look familiar? read on!

Water Wow: Summer Pre-writing Fun on the Road

One of my favorite toys for 2-4 year olds is a perfect summer travel item. Melissa and Doug’s Water Wow series is a ring-bound set of 4 pages with a refillable plastic pen with a brush tip. Fill the base with water, twist the top on, and scribble as the water reveals colors and hidden items on the pages.

The size of the pen is just about right to encourage a three or four-finger grasp. Etched lines in the top add traction if fingers get wet. It is the crafty toddler that can figure out how to open the pen, so spills are almost eliminated. Hint: don’t let them see you lock it into position. Divert and distract!

The pages are large enough to include some fun themes, in a range from construction to animals. There are also number and letter books. They dry quickly and are reusable for many, many hours of fun. Some children have scratched the pages in frustration, as the brushes take a minute or two to start releasing the water from the wick inside the top. My current suggestion: have your toddler shake it up and down for a while. They will be having too much fun to get bored or frustrated.

The result? Happy toddlers and clean scribbling that can be repeated all vacation long!

no mess and great pre-writing activity on the go!

no mess and great pre-writing activity on the go!

Father’s Day: Time to Celebrate and Play Rough

The WSJ recently ran a terrific article, “Roughhousing Lessons From Dad”, on the deeper benefits of dads hanging out and physically playing with their kids. Boys or girls, the benefits of having a father that plays with his kids seems quite obvious. This article reminds us that what starts out as a pick-up game during half-time is really a learning opportunity for children. The father that throws his baby up in the air while the baby screams in delight (and a lot of moms cringe) is creating a teaching moment. Apparently learning to do risky things, follow the rules when playing rough, and taking turns being the one in charge are lessons that last a lifetime.

The WSJ article did mention that mothers can and have provided this kind of play, but even though I know many athletic and risk-taking mothers, I have seen very few really embrace the type of play that comes so naturally to dads. Our children just light up when their fathers play wrestle with them, and research supports it.

As an occupational therapist, I recommend this kind of play for children with sensory processing issues. The ability to practice moving and balancing, getting excited about moving and managing that excitement is so valuable. Having all that fun while practicing those skills is, like the ads say, priceless.

Here’s to the unique ways that fathers enrich their children’s lives!

Eating Fish in Pregnancy and Beyond: Eat This/Not That

The FDA has made an additional recommendation to pregnant and nursing women: eat at least 8 but not more than 12 ounces of certain fish for your baby’s health. Don’t eat too much albacore tuna but eat some light tuna. Specific choices they recommend are the fish most likely to have low levels of mercury. Their recommendation is based on a study that correlates higher IQ with greater fish consumption. This is not the same as causation, but they are confident enough to issue the recommendation. Previously they only warned of eating too much fish with mercury. Their new guidelines seem to be a response to the fact that many mothers interpreted the message as “Fish are dangerous”.

Other blogs are filled with questions about whether this is an elitist mandate for people who can afford wild salmon at $20/lb, or a governmental attempt to confuse women at their most vulnerable. No one seems to know why fish is a good idea for health in general. A specific type of Omega-3’s, a lower-fat source of protein, etc all are suspect. It could be that women who eat fish are not eating processed food. Everyone agrees that people are eating less fish in developed countries, and that fresh fish is either expensive everywhere or suspect when caught in local waters due to pollution fears. Vegetarians are eating algae to get the same type of omega-3 benefits.

What is a mother to do? Some take supplements to simplify and eliminate the risk of mercury, but there is no firm indication that supplements provide the same benefits that foods provide. Some carefully monitor every ounce that they eat and source their diet carefully.

The decision is so personal that the best anyone can do is get reliable information and choose a path that seems based in logic and not in fear. We will all be looking for the next government recommendation. Hope it involves chocolate!

Can You Sleep Train a Newborn?

image courtesy of papaija2008/FreeDigitalPhotos.net

image courtesy of papaija2008/FreeDigitalPhotos.net

Sleep training is a hot topic with parents of older babies and toddlers. So many are struggling and bewildered. New parents either pray they will escape this fate or confidently assume they are the exception. It isn’t really the roulette wheel that it seems. Parents are often told that they cannot do much to develop good sleep habits until a child is 3-4 months old. Well, waiting until then may have already set your child up for trouble.

Both the Baby Whisperer series and Dr. Harvey Karp’s Happiest Baby on the Block books describe routines that are loving and sensitive to a baby’s needs. They don’t take sides on the co-sleeping controversy. Both teach families how to read a baby’s cues and create early healthy habits that can survive teething, illness, and growth spurts.

A very young baby can anticipate and can benefit from a routine (not a rigid schedule) that starts in the morning and brings them to nighttime ready to rest and renew. My favorite newborn strategy is the “dream feed”. Waking your baby (yes, waking them up!) to have a filling feed not too long after that initial bedtime nursing or bottle tops them off for a longer period of sleep. A brain that is used to a cycle of naps during the day and a longer sleep at night is ready for the greater demands of the day (and night) at 3-4 months. The child who has no sense of day and night and wakes habitually at all hours is never refreshed. Never mind the state of his parents.

The other strategy that makes a huge difference to families is to understand that bedtime really starts in the morning. If your child’s schedule has been disrupted intentionally or unintentionally, it will make it very difficult to fall asleep. Not responding to those subtle sleep signs will sabotage a very good bedtime plan. If you want to develop good sleep routines,then time, tide and sleep wait for no baby.

The Science Behind Handwriting

The New York Times ran a fantastic story this week, summarizing the scientific research on the benefits of handwriting on brain development. As a pediatric occupational therapist with a specialization in handwriting instruction, it was very exciting to see their conclusions.

I have read the studies they referenced, and they are solid science, not just case studies. Especially interesting are the results regarding recall and knowledge gained from writing notes rather than typing them. Our children will not be able to do that at higher grades if they are not writing legibly at the elementary level. The article fully supports the use of putting the pencil to the paper for all ages from pre-school to college!

“The Science Behind Handwriting”>http://nyti.ms/1kyavGp

Welcome to Your Child’s Brain: Book Review

Ever wonder if all the recommendations and “new” ways to raise your children are based on anything scientific? Well, “Welcome to Your Child’s Brain” will explain the current research behind popular recommendations such as eating fish during pregnancy and teaching your child another language while still in diapers.

Authors Sam Wang, PhD. and Sandra Aamodt, PhD. have written a book that is filled with useful information about brain development from the fetal stage all the way through the teenage years. Ever wonder what your 3-month old really sees? It’s in here. Why does your toddler son enjoy block play so much more than your neighbor’s toddler daughter? It’s in here. If you love science, you will love this book. if you just want to know how to get your toddler to eat spinach or whether watching baby videos will harm your child, you will love this book.

Issues like autism and ADHD are covered, as well as current research on language and math education. This book includes plenty of detail about regions of the brain understood to support all manner of thought, action and emotion. But just when you have had enough of the brain science, they give you a “Practical Tip” section that distills down the research into some information that you can really use today.

“Welcome to Your Child’s Brain” is worth the reading time. You will be amazed at what current neuroscience knows about your child!

Summer Swaddling to Keep Your Baby Cool and Safe

Warm weather has arrived, and with it the question of what to do with a baby that sleeps best swaddled. The answer: dress for the season!

Babies that are too warm when swaddled have hot ears and sweaty necks. Did you know that overheating is one of the risk factors for SIDS (Sudden infant Death Syndrome)? If your baby is too toasty this summer, you may need to change your routine and go shopping.

Try using a thin muslin wrap and just a diaper, and keep a fan or air conditioner going. If that still isn’t enough, then you have to consider no wrap at all. A loose wrap, especially a loose wrap that partially covers the face, is not a safe choice. Use all the other strategies that help babies sleep, including white noise and pacifiers. After you make changes, don’t forget to re-check your baby’s ears and neck to make sure that your strategies worked.

Pleasant (and cooler) dreams tonight!

Nap Nanny Death; A Preventable Tragedy

The infant recliner called the “Nap Nanny” had already been recalled, but another death was reported in NJ this weekend.  The story involves an 8-month old child who was belted in and trapped between the nap nanny recliner and a crib bumper, as per reports in USA Today and other news media.

 Infant recliners are popular and plentiful, but they are not foolproof. Sleepless parents will continue to buy these infant seats and use them in ways that are unsafe due to frustration and lack of awareness. No device is sold with bold warnings about the number of children that die in seats and carriers each year. No parent thinks it will be their child. Until it is.

The American Academy of Pediatrics has clear but poorly publicized warnings about avoiding keeping babies in infant carriers and seats for any extended periods of time. Families need sympathy for the stress they are experiencing, realistic expectations about baby sleep patterns, and specific instruction to avoid placing their babies at risk.
 
There is a two-part solution: position your a baby in a swaddle or in a sleep sack and nothing else in the crib. Learn to quickly soothe and calm your baby. As a Happiest Baby on the Block educator and pediatric occupational therapist, I teach the Happiest Baby protocol, which includes SIDS prevention and support for parents. Direct instruction with the opportunity to ask questions and practice techniques with an instructor can be invaluable.

Babies older than 4 months benefit from Dr. Harvey Karp’s suggestions for older children in “The Happiest Baby on the Block Guide to Great Sleep”.

The pain this family must be experiencing is unimaginable. My heart goes out to them tonight.