Post on 06-May-2015
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A/Prof. Varsha Atul Shah, Senior ConsultantSingapore General HospitalVisiting ConsultantDept. of Child DevelopmentK. K. Women and Children Hospital
Raising Happy and Healthy Babies
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What is Raising? Happiness? Healthy? Baby?
Raising - Parenting
Happiness - Pleasure, enjoying, showing joy, contentment
Healthy - Disease free, possessing good wellbeing
Babies- Very young child, an infant , from birth to 1st birthday
Consider ‘Evolution of life’-Young abandoned at birth!
Flies Worms Butterflies Frogs Turtles Cuckoos Rattle snakes Crocodile
Mammals
They give birth to live young All female mammals nurse their young with
milk Mammary glands secretes milk for newborns
Foal, Calf, Puppy
Baby dogs, cats, horses, and elephants all walk within a short time of being born
All stand immediately after birth But Human baby stand after 1 year, are
helpless
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Why Human babies are helpless after birth?(1/2)
Is virtually immobile Not capable of independent functioning Cannot creep, walk, or speak Cannot hold on to or cling to his mother.
(unlike other primates) Must be carried if he is to go from one place to
another or feed Cannot continue to survive without the efforts
of another human
Human baby have only 25% of their adult brain size
Apes, our closest mammalian relatives, are born with 45% Human babies reach 45% brain growth at end of
their first year when are crawlingAn appropriate human gestation period should last
at least eighteen months--nine months in and nine months out of the womb
Be like Kangaroo (KMC) 9 months outside womb
Why Human babies are helpless after birth?(2/2)
Why happiness is important for babies?
Psychologists - happiness is a learned condition Unhappiness in 1st year = Unhappy adults A happy child is a healthy child Feeling safe and well looked after Having all the basic things he needed Full of confidence and sense of security Happy baby grow up to be positive adults Emotionally intelligent baby (High EQ)
How do you measure happiness?Happiness scales
Gross national happiness(Bhutan)Happy Planet Index The Global Kids Happiness Index
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Bhutan
Lot of physical touch, emotional bond, attention given and attachment parenting
Taking care of their feeding and pee and pooAnd many more things…described later
What make baby happy?
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Why 1st year is critically important?The brain typically grows to 60% adult size by 12 monthsDoubles weight in 1 yearOptimal brain and body development, for intellectual, social and emotional intelligence
Why 1st year is critically important?
During this teensy-weensy period in her life baby forms:The attitudesPersonality traitsDisposition characteristics that will be with
her foreverSelf esteem and confidenceEQ
To do list for happy baby
“Not to do list” for happy baby
Must do list for Babies
While you are pregnant-Happy mumAfter birth
-touch-Skin to skin contact at birth-Room in-Infant massage-Breastfeeding
Attachment parenting Bonding with babyPlay time
Happy babies
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Minimize stress Unborn is sensitive to music, emotion in his
mother’s voice and the meaning of her wordsMake up songs just for the baby and sing
them lovingly when you’re alone in the house or car
While you are still pregnant!
Have fish oil, chocolates since omega-3 fatty acids helps brighter babies and a lower risk of postpartum depression
Keep yourself stress free and happyModerate exercise is helpful, yoga etc.A well-balanced, healthy diet, with fruits,
vegetables, whole grains, sea food and fish(When mother is happy, baby is happy; when mother is anxious, baby is too)
Fit Pregnancy, Happy Baby
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After birth…
Placental detachment after birthMom and babe structurally separatedNot physically or emotionally separatedInside, you gave your blood; Outside, you give your milk, eyes, hands, and voice--your entire self
After birth
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http://lisamccourt.com/webgift/101WAY.pdf
Bonded baby is a happy baby=Confident adultBonding = falling in loveHold, caress, and love himlisten to themRespond immediately to their babies‟ cues, wear
their babies, breastfeed, and sleep with their babiesSpend time, even co sleepBonds like that develop through shared
experiences with your babyTrying to read baby, communication easy
1. Get attached! Do not separate!Treat them like Baby Kangaroo, Why?
RIGHT STARTWELCOME YOUR BABY WITH HUG, SKIN-TO-SKIN CONTACT AT BIRTH!
BENEFITS KEEPS BABY WARM AND CALM INITIATES BREASTFEEDING AND SPECIAL
BONDING
SO HOLD YOUR BABY CLOSE TO YOU TODAY!
Fall in love at first siteHelp start for breastfeeding and bonding Regulates warmth, sugar, heartbeat, breathing
in babiesCalms baby/relaxes motherLikely to breastfeed exclusively for longer time
Benefits of skin-to-skin contact after birth
Allows you to identify baby’s hunger cues Get to know her baby faster, establish BFReduces baby’s stress and cryingLess cross infection
Benefits of 24 hour rooming-in with baby
Exclusively breastfeeding for at least 6 monthGold StandardBreastfeeding is the healthiest thing you can
do for your baby
2. How will you feed your baby?
Breast milkBreast milkBreast MilkBreast milkBreast milkBreast MilkBreast milkBreast Milk
Feed your baby’s body and soul
Help contract uterus reduces postpartum bleeding
Relaxes mum and promote bonding with babyFacilitate weight loss (average 500 Cal lost per
day of BF), less osteoporosis and anemiaLower risk of breast, ovarian, uterine cancerCost saving/Sense of pride for mum to
breastfeed
Benefits of breastfeeding-to Mum
Only perfect, natural, organic, easy to digest, healthy food for babies
Promotes emotional wellbeing and bondingLess risk of allergy, wheeze, obesity, diabetes,
cancer Immunity to fight infections like diarrhea, ear,
chest infectionEnhance brain and cognition with higher IQ
Benefits of breastfeeding-Babies
Skin to skin contact immediately after birth24-hour rooming-in and baby led cue feedingHelping mothers position and attach babies Building mothers’ self-confidence No supplement/teats/ dummies * Baby Friendly Hospital Initiatives
Hospital practices to successful breastfeedingBFHI*accredited hospital
Strangely prevalent notion that letting a baby cry alone (We do not spoil them by picking them up)
Nine months inside the womb and nine months of intensive mothering outside the womb are required to prepare a human infant adequately to spend any time alone
Close mother-baby contact, responding promptly to crying, and breastfeeding until at least the age of two
Picking up a baby when he cries teaches him that someone responds to his needs, whether those needs are for food or merely for the physical sensation of being held
3. Pick up your baby!(1/2)
Babies just feel bad sometimes and long for human contact and loveCrying is the only way a baby can
communicate
3. Pick up your baby!(2/2)
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Eat when hungrySleep when tiredLess likely to develop eating disorders later in life Less likely to develop sleep disturbances
4. Ditch the schedule-Give demand feeding
Talk RespondRead Sing and play musicPraise and give loving attention.Cuddling and holdMake them feel cared for and secure
5. Play with your baby(1/2)
Play when she’s alert and relaxed. Watch for signs of being tired or fussyDistract your baby with toys if touching unsafe
5. Play with your baby(2/2)
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Do not ignore crying babyNotion that babies are trying to control usIgnoring a crying baby only makes frantic and
insecure May eventually stop crying thinking he is not worth his parents ‘time and attention’!You can only “spoil” a thing by neglecting it
6. Ignore anyone who tells you your baby is manipulating you!
You can often soothe a crying baby by just walking out your front door and outdoor
Include baby by wearing your baby, in all your activities wherever you go or work at home
Use sling over pramWear your baby on your body(Baby wearing)
7. Don’t make baby a shut-in, go out door, Bring baby everywhere you go
Make your own baby gear!
Sleep deprivation biggest causes for post-partum depression
New mother is biologically programmed to sleep next to baby
You may think that you will get more sleep by sleeping apart from baby, but the reverse is probably true
Both baby and mum sleep better when they are together
8. Don’t turn into a Mommy-Zombie.
Baby want is to feel included and connected in the lives of their caregivers
Babies like action love being involved in your cookingcleaning, shopping, walking, and laundry foldingExercise with baby!Try Baby Crunches, The Baby March, The baby push ups
when baby can sit wellTalk to him about all the things you see as you pass them
9. Involve baby in all activities.
A child whose needs are met Who has a strong attachment to his parentsWill develop a foundation of trust that will
allow him to become independentMore love from parents, the more baby are
able to love themselves
10.Let baby develop independence naturally, not by training
Parents love to compare milestoneBaby’s personality and interests affects
developmentSome may build block towers before he learns
to walk or talk or vice versa Don't rush and don't compare!
11.Respect the rate at which baby’s abilities develop
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Responding promptly to baby’s cues Will give her the message that her wants
and desires count
12. Help your baby to become emotionally expressive!
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13. Make them feel special
Under two years old no benefit much from TV Babies don’t hear radio and television wordsTelevision will sound like background noise to
a babyThey hear real spoken words better
14.Turn off the TV
Infancy represents a mere 2% of our lifespans, yet 80% of brain growth in 1st year
Brain growth is directly proportional to how much stimulation it gets
Constant flow of sensory input not only makes him happy; it makes him smart!
Moment spent in contact with you is a moment Is being stimulated and getting smarterMoment spent alone in a container is a opportunity
lost forever
15.Make baby smart while you make him happy
Loveys are the security blankets, tattered stuffed animals, or other objects that so many children form strong attachments to
It trains the child to bond to things instead of bonding to people
The infant in arms, at breast, and in mom and dad’s bed receives security and fulfillment from personal relationships.
(Dr. Sears Attachment Bonding)
16. Skip the loveys, inanimate attachment (½)
Humanly attached infant -have better peers relationship -have deep intimacy with a mate as an adultChild left in crib and play pan risk for developing -Shallow interpersonal relationships -Becoming increasingly unfulfilled by a materialistic world.”
16. Skip the loveys, inanimate attachment(2/2)
Mothers - Typically nurturers who make a child feel safe - Unconditionally accepted Dads - Encourages their children to do their best- Stretch their limitations, and succeed in achieving their goals
17.Don’t underestimate the value of Dad! (½)
Dad needs to invest time to develop his own bond with baby
Touch is a more powerful bonding tool than sustenance (Harry Harlow, 1950)
17.Don’t underestimate the value of Dad! (2/2)
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Most babies can understand “no” by about eight monthsWhen baby must be stopped in his tracks or headed for major mischief, avoid NOUse alternatives like “Stop!” Call baby’s name in just the right tone of voice - can be more effective than the standard ‘no’ Follow it up with a distraction, distraction and
distraction
18. Don’t be a “no” machine!(1/2)
You know likes of your baby, use as distractionKeep a mental list of the things he loves You can always direct his attention to a favorite activity, song, or toy
18. Don’t be a “no” machine!(2/2)
When toddler gets stuck eg between sofa,- the natural inclination is to rush to the rescue
Instead, size up the problemAnalyze if Is it one she could handle alone? If it might be, try encouraging her verballyRescue if cannot, but say, “Mommy will help
Emily,” not “Mommy will do it for Emily.”
19.Know when to encourage and when to rescue
Babies laugh by four months old- early laughs are usually in response to joyful feelings - Pleasant physical sensations - rather than a reaction to something that strikes them as
funnyBabies loves:- unusual noises, - funny faces - quick, silly movements
Sense of humor may start to develop near his first birthday
20.Share laughs with baby(1/2)
Sharing laughter with your baby:- is a tremendous bonding toolReally healthy too:- laughter actually strengthens the immune system- enhances cardiovascular flexibility - increases intellectual performance and information
retention- rebalances the chemistry of stress hormones in
your bodyRef: Annette Goodheart, Ph.D., author of Laughter Therapy
20.Share laughs with baby(2/2)
At 1 yearno button in the house is safe from pushing, no knob is safe from turning, no switch is safe from switching. Babies love to imitate their parents and your toys
are likely to attract him much more than his own-Televisions, stereos, phones, car-key remotes, light-switches, computer switches, brief case closures…the list of manipulative that are irresistible to tiny hands is endless
21.Give the button-pusher plenty of buttons(1/2)
They like real toysGive themAny defunct gadget—like phones that are no
longer in use, calculators, or computerized address books--could become treasured possessions as baby hones those fine-motor skills
Baby-proof your home to make sure that he doesn’t hurt himself or damage anything valuable
21.Give the button-pusher plenty of buttons(1/2)
Poor behavior is the direct result of poor self-esteem
Every day, good parents, in an attempt to teach their kids to be better, make disparaging remarks about them.Do not dismiss their children’s interest in or
curiosity Do not nag them, discourage them,
disrespect them
22.Be your baby’s biggest fan!
Child will see himself as the Parent describes him--flawed, wrong, not fast
enough or smart enough Not good enoughLow self esteemPraise them, encourage them
22.Be your baby’s biggest fan!
Babies are exceptionally good at making you angrySometimes make you want to scream, but DON’T
do itBabies are sensitive to the emotions of their
parents even not visible angerif you are often angry, seek helpGet counseling; take up yoga; meditate; hire a
mother’s helper; but DO SOMETHING to break the pattern.
23.Handle your anger like a grown-up. (1/2)
Think for a moment about how you act when you have fallen in love with someone?If you feel that same level of admirationConnectednessEmpathyawe for your childSame longing to please her and be near herTHEN YOU ARE, WITHOUT DOUBT, RAISING A HAPPY BABY
24.Stay in love forever(2/2)
25.If you can’t be there, find the best care for your baby
NutritionTummy timeImmunizationFeeding and weaning, dietWatch growth and developmental milestones
Healthy Babies
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NutritionBreast milk - First 6 months of lifeBetween 6 and 12 months of age- Weaning
diet- Baby led weaning-learn about new tastes and textures -Breast milk continued-Feed your baby slowly and patiently-Encourage your baby to try new tastes but without force
24. Healthy Bodies
25.Tummy Time
Any time baby is supervised and positioned on the stomach for play, that is considered tummy time!
Recommended by The American Academy of Pediatrics
Supervised playtime on the stomach to promote growth and development
Prevent flat spots from forming on the head and motor milestone delay
What is Tummy Time?
Daily Tummy time leads to the mastery of important motor
milestones• such as rolling over• pulling up• Crawling
Why Tummy Time?
Start EarlyStart GraduallyBolster TimeLap TimeDistract BabyFace to Face TimeMake as routine family time
Quick Tummy Time Tips
Even when in hospital Position your newborn on your stomach or
chest while you lie in a reclined position on a chair, bed
Will encouraging eye contactRock your body from side to side
Quick Tummy Time Tips
15 seconds of tummy time on the first attempt
Goal is to eventually work up to at least 30 minutes over weeks
Stop if your infant begins to cry in protest
Quick Tummy Time Tips
Make a small bolster by rolling up a thin towel or blanket and place this under baby's chest
Quick Tummy Time Tips
Make a small bolster by rolling up a thin towel or blanket and place this under baby's chest
Quick Tummy Time Tips
Lap Time
http://www.tummytimetips.com/includes/images/tip-pic-9.jpg
Quick Tummy Time Tips
If your baby dislikes being on her stomach, remember this: distract, distract, distract
Play music, sing, shake toys, and clap your hands, keeping baby occupied
Quick Tummy Time Tips
Lie down on the floor facing your baby during tummy time
Sibling can also participateVoice and expressions should be animated
Quick Tummy Time Tips
Causes of crying
Normal cause of crying
Colic Emotional distress (loneliness or fear) Environmental discomfort Full or wet diaper Hunger Mild, transient discomfort (that goes away on its own) Need for affection, need for stimulus Teething Thirst Tiredness
Pathological cause of cryingIT CRIES mnemonic for infant crying
I – Infections (unwell child, herpes stomatitis, urinary tract infection, meningitis, osteomyelitis, and so forth)T – Trauma (accidental and nonaccidental), testicular torsionC – Cardiac (heart failure etc)R – Reflux, reactions to medications, reactions to formulasI – Immunizations, insect bitesE – Eye (corneal abrasions, ocular foreign bodies)S – Surgical (obstruction, inguinal hernia) – Strangulation (hair/fiber tourniquet)
Colic-Expressive crying
Colic
Colic starts in the first weeks of life and resolves by around 4 months of age
Crying most often occurs in the late afternoon or evening
The baby draws its knees up to its abdomen, or arches its back when crying
GOALS of treatment
To provide strategies to help soothe a crying baby
To reduce parental anxiety and stress Exclude pathological cause
What can you do?
Holding the baby through the crying episode If intolerable, it is best to put the baby down somewhere
safe (e.g. their cot) and take a few minutes' 'time out' Gentle motion (e.g. pushing the pram, rocking the crib) 'White noise' (e.g. vacuum cleaner, hairdryer, running
water) Bathing in a warm bath Go for a drive I Love U massage on tummy Colic drops
BCG and Hepatitis B at birth4 weeks- Hepatitis3 months and 4 months- DTP, HiB, Rotavirus
and pneumoccocal6 months –DTP, HiB, hepatitis B12 months-MMR and Pneumoccocal, Chicken
pox15 months-MMR18 months- DTP, Hib,Chicken pox
Immunisation
Follow health booklet milestonesChart Weight, length, head circumference on
percentile chartsFormal Denver Developmental screening
Test(DDST) at 9 months, 36 months
Growth and development screening
DEVELOPMENTAL MILESTONES CHRONOLOGICALLY
Milestones What you can do
NEWBORN -Day 1, can listen, alert.-Day 3, can respond when spoken to. -By the end of first month, respond to sound - by swiveling his eyes or head - Will even twitch his mouth when his mother speaks
-Answer all signals -Make sure your baby sees you when you nod your head, or sees you move your mouth when you speak. -His range of sight extends to just a foot, so bring your face, fingers or colorful things as near as possible. -Stimulate by talking, singing and showing him bright things.
Milestones What you can do
4 weeks -Try to speak by opening and closing his mouth
-Respond to your voice by changing his behavior
-Quiets when you speak soothingly
-Become distressed when you speak loudly or roughly
-Laugh a lot, speak in sing-song fashion or sing lullabies to feed his sense of rhythm
-be more physical with him, hold him, rock and sway him or use a rocking chair and cradle
-If his head shows some steadiness, you may even want to try a little "dance" with him to some music
Milestones What you can do
6 weeks -May start smiling at you and nod his head when you talk to him.
-Able to make small throaty noises in response.
-love looking at faces! you can make funny faces and funny noises
-Look at the baby, when baby look at face intently, looking for facial clues
-Move fingers or toys in and out of his vision to capture his interest-Speak from both sides of the face to learn to recognize voices coming from different directions.
Milestones What you can do
2 months -Smiling becomes a greater habit
-Start showing an active interest
-looking at the source of sounds
-Staring at objects and looking as if he is trying to get a hold of them with his eyes
-Prop him up on cushions to see more things around the room
-Allow him to see bright, colorful objects and soft toys
-Show him his hands
-All of these will stimulate his interest in his surroundings
Milestones What you can do
3 months -Starts to develop an awareness of his own body
-Often look at his fingers and move them at will (hand regards)
-Respond with exaggerated movements and sounds
-Play single games like tickling his feet, pulling at his leg and arms, or bending his knees
-Give him toys of different weights and textures for him to grasp and feel.
Milestones What you can do
5 months -Enjoy simple games, like splashing in the bath
-looks at himself in the mirror
-Turns his head towards sounds
-Moves his arms and legs to attract attention
-Respond to your baby when you are "called"-Move towards him and make eye contact so that baby will understand when you are responding to his requests-You are his source of help and comfort -Introduce strangers to your baby-Use his name as much as you can
Milestones What you can do
7 months -He can recognize his own name
-Puts his arms out to be picked up
-Tries to feed himself, showing the first signs of independence
-Will imitate simple things you do and anticipate repetition.
-Show your baby his reflection in the mirror
-Repeat sounds that your baby makes, to demonstrate simple cause-and-effect to him.
Milestones What you can do
1 year -Repertoire of emotions-show interest in his favorite book, points pictures/favorite passages -Say a few words with meaning-Can understand simple questions-Shake his head for "No"-Will repeat tricks that make you laugh
-Teach names of objects and parts of his body-Do actions he can imitate-Praise, reward all responses-Describe routines -Read him short stories with abstract ideas. -To show affection by kissing or hugging you or patting his toys-Describe anything you do for him, e.g. putting on his clothes, sitting him in a chair-Finally - Celebrate his first birthday!
DEVELOPMENTAL RED FLAGS (1 TO 3 MONTHS)
Doesn't seem to respond to loud noises Doesn't follow moving objects with eyes by 2 to 3 months Doesn't smile at the sound of your voice by 2 months Doesn't grasp and hold objects by 3 months Doesn't smile at people by 3 months Cannot support head well at 3 months Doesn't reach for and grasp toys by 3 to 4 months Doesn't bring objects to mouth by 4 months Doesn't push down with legs when feet are placed on a firm
surface by 4 months Has trouble moving one or both eyes in all directions Crosses eyes most of the time (occasional crossing of the eyes is
normal in these first months)
DEVELOPMENTAL RED FLAGS (4 TO 7 MONTHS)
Seems very stiff, tight muscles Seems very floppy, like a rag doll Head still flops back when body is pulled to
sitting position (by 5months still exhibits head lag)
Shows no affection for the person who cares for them
Doesn't seem to enjoy being around people One or both eyes consistently turn in or out Does not respond to sounds around them
DEVELOPMENTAL RED FLAGS (4 TO 7 MONTHS)
Has difficulty getting objects to mouth Does not turn head to locate sounds by 4 months Doesn't roll over (stomach to back) by 6 months Cannot sit with help by 6 months (not by themselves) Does not laugh or make squealing sounds by 5 months Does not actively reach for objects by 6 months Does not follow objects with both eyes Does not bear some weight on legs by 5 months
DEVELOPMENTAL RED FLAGS (8 TO 12 MONTHS)
Does not crawl Drags one side of body while crawling (for over one month) Cannot stand when supported Does not search for objects that are hidden (10-12 mos.) Says no single words ("mama" or "dada") Does not learn to use gestures such as waving or shaking
head Does not sit steadily by 10 months Does not show interest in "peek-a-boo" or "patty cake" by 8
mos. Does not babble by 8 mos.("dada," "baba," "mama")
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