Tongue-tie

Over the last few years, there has been an increase in this diagnosis, which can make it very difficult for baby to breastfeed. I have met heroic parents who have struggled to nourish their baby as they waited to have this condition confirmed. It can be very challenging. But surgery is a serious choice and does not come risk-free. If there is a question of your baby having “oral ties”, I know you will want to do some research. Here are two sources to get you started.

https://my.clevelandclinic.org/health/diseases/17931-tongue-tie-ankyloglossia

Child Abuse Prevention Month

Let’s go a bit further and declare this Celebrate Children Every Month. In my perfect world, the waters would part for the Little Ones. How about:

  • Letting that Mom and baby move to the front of the line
  • Really slowing down through school zones and side streets where kids are playing
  • Watch out for bikes, especially this early in the season
  • Waving back at the child waving to you from the car window
  • Offering to help the parent trying to shop with a melting down toddler
  • Bringing dinner or a treat to a family with a new baby and/or new to your neighborhood
  • Offering to baby sit for friends
  • Organizing a regular play date at the park

Power Point

Hanging out with a one-year-old just a couple days ago, I was impressed with the power of his pointing finger. Pointing left, right and center, it had the adults around him naming objects and colors. His little pointer compelled us to keep the stroller moving when we had paused. That tiny gesture from the littlest in the crowd had all scrambling to please him. The imperial pointer!

I kept thinking about it. Seems like a rather sophisticated coordination of fine motor movement coupled with an awareness of the both near and distant environment and used to convey curiosity as well as command a desire. Turns out, this finger communication is reliably predictive of good language ability. Children at this age who used a finger to point, rather than an open hand, generally had better language skills a year later.

He may be holding court from Daddy’s arms or his stroller chariot, but this little prince was surely ruling his kingdom….and showing promise of strong verbal skills in his future!

Lüke, C., Grimminger, A., Rohlfing, K. J., Liszkowski, U., & Ritterfeld, U. (2017). In Infants’ Hands: Identification of Preverbal Infants at Risk for Primary Language Delay. Child Development, 88(2), 484-492.

Soothing Baby to Sleep

Amongst the most time-honored, parent-proven ways to calm a baby’s crying is the almost-never-fail breastfeeding and this is followed closely by holding and movement ala cradles, swings, car rides. A scientist in Japan, Dr. Kumi Kuroda of the RIKEN Center for Brain Science has looked at this closely. It was a very small study of just 21 infants but the sequence of comforting behaviors that she describes was successful in many of the couplets.

The special sequence is this: Hold baby and walk for about 5 minutes. Most babies settled within seconds. Walk smoothly with minimal abrupt movements. Then sit quietly, still holding baby for at least 8 minutes, allowing baby’s sleep state to lower to a stage where she is less likely to arouse when moved. At this point, there is a good chance that you can gently lower her to bed and she will remain asleep. I think the infants were all less than six months old.

This may sound easy but 5 minutes feels like a long time if your baby is crying or maybe even crying harder. I have not tried this but I would love to know if you have and what your results were.

There is some comparison to this “transporting” technique in other mammals, such as lions and mice, in which it becomes literally a matter of life or death to quiet their young.

I recognize that there is an advantage in simply choosing a specific behavior to soothe a baby and then sticking with it. (once again, easier said than done) Sometimes it takes an infant a bit of time to organize a response and/or to calm down. He might not yet be there when an eager parent may already be trying something new. If he has to cope with quick or multiple changes of position or energetic patting or bouncing or going into/out of the swing and music and toys coming into and out of his visual field, it surely will add to his distress. So whether you choose the walk and sit sequence of soothing or maybe just rocking, whatever you choose, try to sustain the support long enough for baby to trust it and allow himself to relax and recover his equilibrium.

Sweet Dreams!



this and related papers at: pubmed.ncbi.nlm.nih.gov/23602481/

New Law in Colorado

When big people threaten to hit big people, it’s called assault and if they actually do it, it’s called battery. Both are against the law.

Change the size of the person getting hit and the law changes. When big people hit little people, it’s called corporal punishment. Why society sanctions adults hurting children has never made sense to me.

This past year, Colorado introduced HB23-1191 to limit by whom and where children can be “punished”. It passed.

Here is the official summary of the law:

BILL SUMMARY

The act prohibits a person employed by or volunteering in a public school, a state-licensed child care center, a family child care home, or a specialized group facility from imposing corporal punishment on a child. The act defines “corporal punishment” as the willful infliction of, or willfully causing the infliction of, physical pain on a child.

APPROVED by Governor April 20, 2023

EFFECTIVE April 20, 2023
(Note: This summary applies to this bill as enacted.)

Here we are in the 21st century. We take a tiny step forward to protect our little ones.

Screen time: the good, the bad and the ugly

Investigating the original literature that informed a recent American Academy of Pediatrics (AAP) recommendation regarding screen time for infants and children opened a Pandora’s box of studies from multiple countries looking at cognitive, motor, executive function, gender, emotional effects, behavioral changes and more. Earlier, before all this research, it was felt that the downside of screen time for young children was that it simply displaced time that the child would be using to engage with the world, exploring and relating. It did not seem that the screen experience itself was harmful but that it took away from activities that would promote normal development.

Not any more. These studies indicate otherwise. Although researchers have not pinpointed the exact mechanisms by which children’s brains are altered, screen time itself, is associated with some worrisome effects. There have been studies in older children that have shown that screens can be helpful tools in education and we certainly see them everywhere in schools now. But even in these school-age children, caution should be taken as we implement this modality so universally, with minimal information on its short and long-term effects.

Focusing on the young child, it seems very clear that exposure to screens can be deleterious to development. Each hour of television viewed by two-year-olds resulted in a 6% unit decrease in fourth grade math performance. Two hours or more of daily screen time resulted in behavioral problems and poorer vocabulary. Between 6 and 18 months, it led to emotional reactivity and aggression. This is just a sampling of the many studies found at the National Institute of Health’s website: ncbi.nim.nih.gov/pmc/articles/PMC103539471.

The AAP recommends zero screen time for babies 18 to 24 months old, with the exception of video chatting. (So important for keeping connection with family who live far away.) Children who had had daily screen time were more likely to struggle with language and problem solving skills. Those with more than four hours of daily exposure were almost five times as likely to have communication delays.

Babies learn language through interactions with adults. The key component of those interactions seems to be reciprocity in the conversation. Hold baby in your lap, facing each other. Making sensitive eye contact, mimic baby’s sounds and facial expressions. Give her time to respond. Often, when we learn that babies enjoy us, need faces and interaction to thrive, we might be tempted to keep a constant monologue going. This can easily overwhelm a baby and result in baby shutting down. Watch her closely for cues of needing a break in this compelling play.

OK, bring on peek-a-boo, pat-a-cake, eensy weensy spider and where is Thumbkin!! 

For the Love of Men by Liz Plank

Just finished checking out this 2019 book. I share the author’s concern for men. I agree that men have had very limited models of how to be in the world. A variety of current cultural influences have left many men uncertain about their roles.
I only want to comment on two things. First, she mentions a study comparing young men’s responses, supposed to evaluate their level of support for a working wife. She reports that more men in 2014 than the men in 2010 “believe that a woman working outside the home harms preschool children”. Her interpretation of this finding is that men were reverting back into the “male provider/female caretaker model” and less supportive of their working wives. However, I wonder if further investigation is warranted. Perhaps there is another reason or explanation for this finding. The language posed in these questions leaves little room for nuance. Could it be that these fathers believe that a child benefits from having a parent at home? Be it father or mother? This is a very intriguing area of study and I hope to learn more from future studies.
Second, I just have to mention, that she also has a short section on the “gender life expectancy gap” which is something that has long been identified. But from my experience as a NICU nurse (and I believe recent data bears this out), the chance of survival for preterm babies is about equal between girls and boys, given the advances of sophisticated medical interventions. An observation I hope will give parents of boys a bit of equilibrium. In fact, I just read of a 22 week gestation infant, weighing less than a pound, that was going home from a Colorado hospital and yes, it was boy.

Colorado survey for families

The Colorado Department of Early Childhood is conducting a survey of family needs. Any household with children less than six years old is invited to fill out the survey to better inform the state of the current status of young families. Your feedback will direct state services to provide support that is tailored to what parents are experiencing today. If you are interested or know anyone who might be, here is the link:

https://docs.google.com/document/d/1AzlIBwo__agnnVQfCR5j1NWAhB-PRJ_MJfMeQFw7t0I/edit

Photo by samer daboul on Pexels.com

Third Trimester, mother’s internal experience

At this time, the mother’s round belly is more obvious and she may elicit more recognition of her status from casual encounters. She feels proud of her pregnancy and may also really need the special attention and assistance of others during late pregnancy. Individual women will vary in their responses to this solicitous behavior and some women may disdain this attention and then in another situation, may be grateful for the extra care and concern.

But also in this last three months, physical discomforts may increase. And there is also a worry about the health of her child, the safe delivery and her own ability to cope with labor and delivery. The mother may curtail activities outside her home, desiring the safety and quiet of her home. Many mothers report a burst of activity to prepare for her baby’s arrival in the weeks before birth.

The second trimester

As the threat of a miscarriage passes, a mother feels more confident in her pregnancy. These months are generally calm and comfortable, with less nausea and the affirming swell of her body. The highlight of the second trimester is the moment of first sensing baby’s movement, “quickening”. It is recognized at about 20 weeks for the first time mother but may be felt a little earlier with subsequent pregnancies. For many, this is a pivotal moment of connection with their baby and another level of proof that the pregnancy is real.

Concurrent with this heightened awareness of her child, she tends to turn inward. Sometimes misunderstood as being overly sensitive, this introversion is a phase that allows mother to adjust to the changes in her body and her life. It is a focus on herself that helps to generate energy for the strength needed to safely carry this baby through the next months and to prepare for labor, birth, and plan for all the changes involved with the coming of a new little one. During this time of contemplation, she may become tearful without apparent cause and also experience deep joy. A myriad of emotions comes into play, partly fueled by hormonal changes.

A sensitive partner will recognize that this is a normal process and respond with increased tenderness and care as they both integrate the challenges of this extraordinary time.

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