How to make tummy time easier

tummy-timeI 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
ol.

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.
Advertisements

How should you talk to your daughter about puberty?

In my experience, 90% of girls are not excited when puberty starts. And it’s not just their impending period that’s on their mind. Most girls are happy with the body they have and see no reason for it to change. This uncertainty happens because the physical changes of puberty precede the psychological ones. When I discuss this with girls at their 10- or 11-year-old checkups, my goal is twofold. First, I want them to know that they are not alone in their feelings about puberty. Second, I want parents to know that girls may be reluctant to talk about puberty even though moms want to provide them with the benefit of their experience. However, I encourage moms to always keep their “radar on.” If a girl brings up pubertal issues, moms should drop what they’re doing and be open for a discussion.

I also share a story about what happened in my own home when my daughter, now 21, turned eleven. My wife and I bought Molly a copy of the American Girl book, The Care and Keeping Of You, which is a terrific book for girls entering this stage of their lives. Molly looked at the book and literally threw it across the room. We told her that was okay, but added that her mom would be available to discuss anything in the book if Molly wanted to. Over the next six months, we found her occasionally reading the book at night before bed.

My final comment on this subject at checkups is to remind girls that puberty takes years to finish, and I guarantee that they will be happy with their grownup bodies once the process is over.

What’s better, sippy cups or straw cups?

Sippy-cups-vs-straw-cupsNewborns have a sucking reflex that enables them to nurse or bottle feed. This reflex involves opening their mouths and moving their tongues in and out to “milk” the nipple. When babies start solid foods around 6 months of age, they usually push food out of their mouths because that’s what their tongues are used to doing. It takes a week or more for babies to learn how to use their tongues effectively with spoon-feeding, but they continue with the milking action when taking breast milk or formula.

Sippy cups have been around for as long as I can remember. Straw cups are relatively new on the scene. When babies drink from sippy cups, some of them continue to push out their tongues, which could lead to lisps and other speech problems later on. However, with straw cups, they are more likely to keep their tongues in their mouths, which is theoretically better for speech development.

So which type of cup is better for infants and young children? Here’s what Maia Magder, a speech pathologist at NIH, has to say about the matter: “There is no hard evidence that sippy cups cause speech delays, but it’s important to provide infants with opportunities to move their mouths in more advanced patterns to foster feeding and speech advancement.”

Regular “open” cups are the best for speech development, but babies are pretty messy, so many parents aren’t ready for this step until the toddler years. Here is Maia’s take on getting rid of spouts and straws: “Offering an open cup as early as 8 or 9 months helps with jaw stabilization, which is another important factor in speech development. As for the messiness, like other aspects of parenting, think of it as balancing the new with the old. It’s always important to read a baby’s signs and signals when using cups so that your baby doesn’t choke.”

Should you compare your kids?

should you compare your kidsParents frequently hear that they should never compare children to each other. As a pediatrician, I can unequivocally state that this is one of the dumbest things I’ve ever heard. Not only do we compare our children to each other, but we also compare them to other people’s children. Why? Because it’s instinctive for humans to compare things. We compare which apples to pick at the grocery store. We compare which shampoo to buy. We compare which clothes to wear to work.

So where does this “wisdom” come from? I think it’s derived from the difference between comparing and judging. Things can be different without one being superior to the other. When it comes to children, there is never one thing you are comparing. People are more complicated than apples or shampoo so most parents find they appreciate each child for different things. The flip side of this is also true. Namely, each child can make us crazy in different ways.

When this topic comes up in my office, I start by telling parents what I just said. I then expand on the topic by reminding them that what you never want to do is to compare your kids unconsciously and not be aware of it. It’s also a bit perilous to censure one child by invoking the more desired attributes of his sibling.

I have two teenagers who are very different. I horse around with and go to movies with my son, but have intellectual conversations with my daughter. I am proud of both of them, but in different ways. Sometimes I wish my daughter and I could do things like I do with my son and visa versa. That is comparing them, but neither one is a better child than the other. The flip side is that they each annoy me in different ways as well.

Comparing your kids to your friend’s kids is a bit trickier because you don’t have all the facts regarding someone else’s children. You may still find that you like certain aspects of your friend’s children more than your own. Just remember that most kids behave better with people other than their parents.

It’s also very important to remember that children have big ears. They love to eavesdrop on their parents because it’s exciting to hear what grownups have to say when they are alone. If my son heard me saying something comparing him to his sister, I am setting myself up for trouble. I can think it, and I can discuss it with my wife. But this should only be done when all children are accounted for.

Don’t force kids to say they’re sorry

Dont-force-kids-to-say-theyre-sorry-Altercations between young children are common. If parents are around to witness the squabble, they usually ask the aggressor to say he’s sorry. This is a reasonable thing to do because adults are supposed to teach children how to behave in social circumstances. However, most parents have been in the situation where one child does not want to say he’s sorry to the other. What should you do then, especially if your child was the one who wouldn’t say he was sorry?

Not only are you likely to be embarrassed if this happens, but you may also feel a strong sense to force your child to apologize. Encouraging kids to say they’re sorry is logical. Forcing them is not. In some cases, a parent will threaten to take away TV, dessert or other privileges if the child refuses to say he’s sorry.

Although I appreciate the motivation to encourage your child to apologize, if it’s not sincere, it’s not clear that anything will be gained by forcing the issue. My recommendation, in this situation, is to model the appropriate behavior for your child instead of turning it into a showdown. Make eye contact with the victim and say something like this: “I’m so sorry, Henry. We don’t allow hitting in our house, and I don’t know why Ryan did that to you.” You might also consider ignoring your child for a moment and hugging the child who was hurt.

Children learn by experiencing the consequences of their actions. In the above example, you ignored your son and gave positive attention to the child who was wronged. This is only half of the intervention. For the next five or ten minutes, you would watch your son like a hawk so you could give him positive attention for appropriate behavior. Psychologists call this process, “catching them being good.”

Tips for How to Swaddle a Baby

How to Swaddle Baby

Swaddling is a time-honored method to help babies calm down. It helps fussy babies relax during wakeful periods and makes it easier for most newborns to sleep.

Infants respond to swaddling for two reasons:

  1. Newborns have a number in innate reflexes, including the Moro (or startle) Reflex. If a newborn is jostled or surprised by a noise or physical movement, he will typically extend his arms outward and then rapidly flex them in front of his body. A Moro response can be triggered by an infant’s own movements or by actions coming from his surroundings. Either way, the reflex may cause the infant to wake up or start to cry. Swaddling inhibits the Moro Reflex.
  2. Before birth, infants are in the confined space of the uterus. While it is important to be able to move their arms and legs after birth, research has shown that newborns calm down if they are held with their arms against their bodies. This can be accomplished by a reassuring hug or by swaddling them in a blanket.

Like all aspects of parenting, it is important to strike a balance with your baby. It is important for your baby to experience different types of physical interactions. This includes hugs, kisses, skin-to-skin contact, gentle rocking, and massage, etc. So while swaddling can be a real “life saver” when a baby is fussy it is best used when the child is sleeping or for brief periods (around 20 to 30 minutes) while awake.

Two aspects of swaddling are important for you to consider:

  1. The best way to swaddle babies is by keeping their arms at their sides. The reason for this is because most babies will “break out” of the swaddle if their arms are positioned in front of their chest. There are a number of commercial blankets to make this easier to do.
  2. The goal of swaddling a baby is to restrain his arms. The swaddle should not restrict the baby’s legs because it is important for him to be able to flex his knees and hips at all times. The reason this is important is because infants can develop a hip problem (developmental dysplasia of the hip) if their hips are restrained in an extended (straight) position.

Most doctors recommend that parents stop swaddling babies by about four months. At this age, the newborn reflexes that can interfere with a baby’s sleep have disappeared and many babies are starting to roll (and trying to break out of a swaddle). This is also the time when a baby will more actively interact with his surroundings. He will grab objects and explore them with his mouth. He may use a pacifier or suck his thumb for self-soothing purposes.

Teaching children to swallow pills

Learning to swallow pills is difficult for many children. One technique I find helpful is to “hide” the pill in another food before attempting to swallow it. Bread is an excellent choice because it’s sticky and easily encases the pill. Before you suggest the technique to your child, remind her that she swallows large chunks of food all the time. The reason this trick works is because the bread “fakes out” her throat so it doesn’t know a pill is coming. This is how it works.

  • Have your child chew a small piece of bread.
  • Once the bread is gooey, ask him to push the pill into the center of the bread.
  • Next, ask him to move the bread/pill mixture to the back of his mouth and swallow it with a sip of water.
  • Have your child practice with small pieces of candy like tic-tacs. Once this has been mastered, she can graduate to M&Ms and capsule-shaped candy like Mike and Ike.
  • Once your child has done this a few times, swallowing a pill is usually easy.

I use a variation of this technique for children who take time-release capsules, but can’t learn to swallow the pill. Time-release capsules can be opened and their contents can be mixed into pudding or applesauce. To ensure that children don’t chew the beads, I have them practice with candy sprinkles. Once they have done this a few times, they can accomplish the same thing without crushing the granules of their medication.