I recommend that parents don’t worry about tummy time until babies are 4 weeks old. The reason for this is because it’s hard enough in the first month to feed, bathe and get babies to sleep without worrying about head contr
Once parents start tummy time, lots of questions come up. How long should it last? How many times a day should we do it? What should we do if our baby cries during tummy time?
No one has studied this scientifically, but I recommend doing tummy time 3 or 4 times a day for about 5 to 10 minutes per session. If your baby cries during tummy time, there are a few things that might help.
- Pull the baby’s elbows in towards the body. This stabilizes the shoulder area and may make it easier for the baby to lift her head.
- Lie on the floor with the baby so when she looks up, she sees your face.
- Put the baby on her dad’s chest while he’s leaning back at a 30 to 45 degree angle. This will make it easier for the baby to lift her head. This can also work on a mom’s chest unless the baby smells the breast and looks down instead of up.
- Babies may be more willing to do tummy time at certain points during the day. A good time to try it is shortly before a feeding when she’s alert, but not too hungry.
Some people recommend that parents ignore the whitish material that accumulates between the labia majora (outside vaginal lips) and labia minora (inside vaginal lips). I prefer that parents clean the area because otherwise poop can get mixed in with the discharge and irritate the baby’s skin.
However, cleaning this area often makes parents nervous. I recommend two things to make this easier. First, you don’t need to remove all of the goo at one time. Second, clean the area by gently wiping with a cotton washcloth in a downward direction. (I prefer washcloths to cotton balls because they have better traction.) Third, if you clean the area with each diaper change, less goo will accumulate and the whole process becomes simpler.
The first stool a baby has is a thick, green, gooey mess called meconium. (For the record, meconium consists of all the stuff babies swallow during his fetal life: skin cells, hair, and other material floating around in the amniotic fluid.) After passing a handful of these sticky poops, a baby has something we refer to as “transition stools.” These poops are runny, green, and foamy. In fact, if your baby has a transitional stool when his diaper is off, you may see it shoot 12 inches through the air! But rest assured, they’re not dangerous and will fade into memory in a couple of days.
When a person’s stomach fills with food, it triggers a reflex that stimulates peristalsis. (Peristalsis is the name for the rhythmic contraction of muscles that push food from the beginning of the gastrointestinal tract to the end.) This explains why adults and older kids often have a bowel movement after eating. However, this reflex is much more active in babies, which is why they often poop while nursing. But the poop that comes out when your baby eats is waste from the feeding that went in hours ago.
It’s hard to see your baby cry, especially when she’s pooping. Parents often assume that babies are constipated if they strain or cry when they poop. Although this is true in older children, babies commonly grunt and strain with defecation because of a reflex that causes them to push when fecal material enters the rectum. However, if this behavior concerns you, be sure to mention it to the doctor at the baby’s next checkup. In rare cases, a baby’s anal opening may be too tight or her anus may be in the wrong position. Although rare, these anatomic variations can make it more difficult to pass stool.
The medical name for a baby’s soft spot is called the anterior fontanel. This is an opening between the bones of the skull that allows the cranium to grow. The fontanel is covered with a very tough membrane so you will not hurt it when you wash your baby’s hair. Although doctors would never recommend poking the fontanel, you can scrub it gently with a hairbrush like the rest of your baby’s scalp.
Umbilical hernias are caused by a weakness in the ring of muscles that surround the belly button. Because of this weakness, abdominal fluid or intestinal contents can push on the skin covering the belly button causing a bulge. The bulge will be more noticeable if a baby is crying or if an older child is standing up.
Umbilical hernias are common and not serious. In the past, parents were told to bind the hernia so it would go away. This does not work and may create a rash on the baby’s abdomen. Fortunately, most resolve on their own by the time children start first grade. If they persist beyond this point, they may need to be repaired surgically.
Umbilical hernias rarely cause harm. Once in my 30-year career, a piece of intestinal fat got “stuck” in the hernia ring had to be fixed on an emergency basis. The way I knew something was wrong was because the area was red and the baby was crying. When I pressed on the hernia, instead of being easily pushed back in, it was hard and tender to touch.
It’s common for toddlers and young children to be afraid of shots. Although I never had to chase my own kids to get them to hold still for a shot, lots of parents have to do this. What I have frequently noticed, however, is that older kids almost always end up being surprised that the shot hurt less than they thought it would. Why does this happen?
Not only do we all have fears, but we also have a tendency to remember our fears when faced with similar experiences in the future. That’s why most people hate going to the dentist even if they’re getting a cleaning instead of having a cavity fixed.
Although young children experience pain when they get shots, older kids are usually not that bothered by the shot itself. However, older kids are often worried about shots because they remember the pain they had in the past.
You may be able to help in this situation if you remind your child that shots haven’t hurt much in the last few years. Another way to deal with this is to have kids write themselves a note after the shot. Then, the following year, you can show them the note, which reminds the child the shot didn’t hurt that much.