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29 Mar

0028aLike other gross motor milestones, rolling over is full of fuel for your baby’s development. It’s his first experience moving his entire body, and continues to strengthen his muscles, balance, and coordination. It’s a big step in his sensory development as he builds an internal sense of his body and how he can move its parts to achieve a goal. Rolling helps him learn to interact with his environment as he is exposed to new textures, temperatures, sights, smells, tastes and sounds. Language learning widens as he begins to purposefully explore his surroundings and seek out interaction with you.

When do Babies Roll Over?

Babies start to roll from front to back around 4 months. They usually master rolling from both front and back around 6 months. Like all milestones, this is based on averages. If you’re concerned about your baby’s development, you can always check in with your pediatrician.

Pediatric Physical Therapist Dr. Andrea Hayward, MSPT, DPT says that often, babies roll over for the first time by accident. They’ve spent many weeks on their tummies lifting and moving their heads, strengthening their muscles, and leaning from one side to another. One day they lean far enough to one side in the right position and boom!

After that, driven by vision and curiosity, your baby will roll to explore his environment.

Rolling Over and Movement

Rolling over is your baby’s first experience with full-body, independent, purposeful movement. It uses and strengthens all of his muscles. Especially important are the pelvis and trunk muscles, which he will soon use to pull himself up to sitting. Also important for sitting up are the arms, which he will use to push against the floor, prop himself up, and catch himself if he starts to fall over.

Rolling Over and Sensory-Motor Integration

Sensory-motor integration is what allows us to use our bodies without thinking about it (knowing how high to lift our leg to step out of the tub, for example) and being able to move in a balanced and coordinated way.

Pediatric Occupational Therapist Natasha Bravo, M.S., OTR/L explains that rolling helps develop two important senses involved in sensory-motor integration: Vestibular (a sense of our body in space) and proprioceptive (a sense of our body parts and how they work together). Rolling helps your baby understand where his body parts are in relation to the ground, to each other, and to objects around him. These “internal” senses help him navigate his environment and adapt to information he receives through his “external” senses (touch, sight, smell, taste and sound).

Our environment is full of external sensory information, which would be overwhelming if we hadn’t learned to understand and respond to it as babies. Movement milestones gradually introduce your baby to sensory information and what to do with it: He rolls from a soft blanket onto a wood floor, feels that it is hard and cold, and rolls back onto the blanket. Or he rolls into a spot of sunshine, notices the light has changed, and closes his eyes against the brightness. In these ways, he becomes accustomed to taking in, organizing, and using information from the environment.

Rolling Over and Language Development

Curiosity-driven play, within the context of meaningful interactions, is the main driver of language development for your baby, and will be for much of his childhood. Pediatric Speech-Language Pathologist Mandy Alvarez, M.S., CCC-SLP says that rolling over is an important milestone for play because you can begin to follow your baby’s lead as he explores a whole new world. He will seek out things that interest him and you can follow along, labeling and talking about them. He will love this interaction with you, and it will motivate him to continue exploring and connecting with you. These interactions also teach him about expressing himself (I want that toy), cause and effect (I shake this toy, you laugh), and non-verbal communication (you’re smiling, that means I should keep doing this).

The more your baby rolls around, the more he will learn, so try to keep him on the ground as much as possible! Remember to baby-proof rooms and keep an eye on him (or he may eat the dog food). If you’re outside, bonus! Rolling on grass offers a great sensory experience for ba-bies. Check out our BabySparks app for over a dozen activities you can do with your baby to encourage this important milestone.

14 Mar


0024aPicture this: You’re finally getting out of the house with your new baby. Your pediatrician gave you the thumbs up to take her out in public, and after weeks of round-the-clock breastfeeding and fewer showers than normal, you pull up to a department store. You click her carseat into the stroller and walk into the store. You feel great. You’re wearing a cute nursing top and even brushed your hair! After a splendid 30 minutes a woman approaches you, smiles, and speaks quietly near your ear, “Listen,” she says. “You’re leaking. Do you know where the nursing pads are? If not, I’ll show you.”

You look down and realize you’ve been cruising the store with two big, wet circles on your shirt. A few minutes later in the nursing aisle, you toss one, then two boxes of nursing pads into your cart and thank the woman profusely. “Oh,” she says, “I’ve been there.”

Breastfeeding is wonderful, but when it’s hard and even exhausting, these awkward moments can offer some comic relief:

The Loud Eater

Some babies are chuggers. They latch on, suck hard, and swallow like an athlete at the end of a triathlon. If you’re out in public, everyone within a small radius will get to hear the sucks, sighs and glug-glugs of your baby thoroughly enjoying her feeding. Just smile and carry on, mama.

The Forceful Letdown

Some women have “overactive letdown” (milk that comes out really quickly, usually due to an oversupply of milk). It’s a tricky issue that a lactation consultant can help you manage, but it will likely leave you with some funny memories—like your baby pulling off your breast when your milk lets down, and it sprays all over the room, or the wall, or (oops) the legs of the man sitting next to you on an airplane.

Your New Accessory: The Pump

Ah, The Pump. It comes in several makes and models, with endless choices of cute carrying cases. You can even buy a special bra for hands-free pumping, so you can pump and, say, cook dinner at the same time! And, nothing brings excitement into a partnership quite like the nightly pumping session, when you sit next to your loved one with a pump dangling from your chest, the loud, rhythmic whir of the motor drowning out the sound of the TV.

The Search for a Breast On Someone Else’s Chest

There might be a day when someone else, like your brother in-law, is holding your baby and she starts rooting around his chest for a breast. “Sorry, sweetie!” you might say, a little too loudly, as you scoop her up. “No milk there!”

Flashing: It Happens

Some women are comfortable nursing without a cover, and others are more modest. No judgment here. But if you’re on the modest end of the spectrum, there will inevitably be a time (or times) when you flash someone. It’s usually only embarrassing for a few seconds, unless it’s your father in-law. Just cover up and start talking about the weather.

It’s All Worth It at the End of the Day

You’re rocking and nursing your baby in the dark, while everyone else in the house sleeps. It’s quiet except for the noises of her sucking and swallowing. You notice the warmth of her body, the way she smells, and the tininess of her hand on your chest. There will be a moment (or many) like this, maybe on an early morning around 3 a.m. You’ll be wearing one of your forever milk-stained tops and you’ll be tired, but you’ll know that it’s all worth it at the end of the day.

10 Mar

23aGreat news! Your sweet baby has graduated from the NICU and is now home. This means he can breathe, eat, regulate his body temperature, and is maintaining a healthy weight.

In a full-term baby (40 weeks), all organ systems are mature and fully functioning when he is born. This includes his brain, lungs, heart, eyes, ears, bowel and muscles. When a baby is born earlier than 37 weeks, these systems must develop outside the womb, which means your baby will need your help.

Below are ways to support your baby’s development in three important areas: Muscle tone and strength, gastrointestinal (GI) tract, and sensory system (auditory, tactile, smell/taste, and vision).

MUSCLE TONE & STRENGTH

Premature babies tend to be weak and hypotonic (low muscle tone), especially through the trunk. It’s difficult for them to bring their hands to their mouths and keep them there, which is important because when babies bring their hands to their mouths they are learning to cross the midline (the middle of the body). Crossing the midline is integral to things like coordination and balance.

It’s also hard for them to stay in flexion (curled up). They will try to gain a sense of control by stiffening their muscles. They may arch, stick their limbs out straight, make fists, or point their toes. Your baby will start to relax these movements as he gains strength and control through the trunk.

How to Help

  • Keep your baby in flexion. Full-term babies inside the womb are in flexion and pushing against the uterus, which builds muscle tone. You can help your premature baby by swaddling him or keeping his limbs bent and tucked in when you position or carry him.
  • Adjust your baby’s positioning in the following areas: Behind the head—keep his chin tucked to his chest. Behind the shoulders—bring his arms forward and his hands to his mouth. Along the hips—bring his legs together. Under the knees—keep his knees bent.
  • Focus on midline. Keep his head in the middle, facing forward, and bring his hands to his mouth.

In the beginning your baby will need continuous support. As he gains strength and control over his body, he will need increasingly less help.

GI TRACT

It’s often difficult for premature babies to pass stool. Even though their stools are not hard, they may appear constipated or strain during a bowel movement. This is because their abdominal muscles are weak. It takes a lot of abdominal strength to move stool!

How to Help

  • Swaddle your baby. Swaddling pulls your baby’s body in towards the abdominal muscles, which turns them on and helps them get stronger.
  • Do GI massage. Your pediatric physical therapist can show you how to massage your baby to manually help move stool through his body.
  • Do appropriate abdominal exercises. Your pediatric physical therapist can also teach you exercises to help him move stool.

SENSORY SYSTEM

Because premature babies have trouble integrating the information they receive through sound, touch, smell/taste and sight, they can easily become fussy or lethargic. Your baby will give you cues to let you know if he wants to interact, or if he needs a break.

Cues that he wants to interact: He is quiet and alert, with his eyes open and focused. His body is relaxed. His arms and legs are tucked in. His hands are at his mouth. He is smiling (around 6 weeks corrected age), or cooing.

Cues that he is overstimulated and needs a break: He is looking away. He appears stressed. His body is limp or stiff. He is yawning or sleepy. He has hiccups or is spitting up.

How to Help

  • Bonding touch. Touch, when your baby is showing you that he wants to interact, can help calm and regulate your baby. Provide calming, firm pressure, as soft strokes can be overstimulating. Skin-to-skin touch is also helpful. Lay your bare baby on your bare chest and cover him with a blanket.
  • Infant Massage. Studies show that for premature babies, regular massage can lead to better growth and development, better intake of oxygen, and a slowed heart rate during and after massage. Ask your pediatric physical therapist to help you learn this skill.
  • Swaddling. A firm swaddle with your baby’s arms and legs tucked nicely creates a sense of security, and helps him regulate sensory information he receives from his environment.

These tips should get you off to a great start with your little one. For more ideas, our BabySparks app includes over 100 activities designed specifically to support the development in babies 0-3 months.


Morgan Bryant, PT, DPT has a doctorate in physical therapy, practice owner of Matrix Rehab, LLC visit www.matrixrehab.net, wife and mother of 2.

08 Mar

22You might have thought breastfeeding would be a breeze. What could be easier than feeding your baby as nature intended, right? The truth is that breastfeeding can be tricky, and for many mothers and new babies it takes practice to get into a groove. Here are some of the top tips to help you get started.

Feed frequently, especially at the beginning. Because new babies have tiny tummies and seek closeness, yours will likely want to breastfeed often. Frequent breastfeeding also helps establish your milk supply because it sends a message to your body to make more milk. Many experts recommend that for at least the first month you feed your baby on-demand (whenever he is hungry). Others, like Tracy Hogg, author of the “The Baby Whisperer”, say you can start a feeding routine as early as 4 days old. Some mothers and babies are better suited for routine, and feeding every 2-2.5 hours works well. Others do better with feeding on-demand. The important thing to remember is that if you try a routine, you should still feed your new baby if he shows signs of hunger before the next scheduled feeding. Signs of hunger include rooting for the breast, sucking on his hand, restlessness, and crying.

Pay attention to positioning. There are several ways to position yourself and your baby for breastfeeding. Here is a great slideshow on nursing positions you can try. Check to make sure you are comfortable and your back and feet are supported; you are not feeling any pain; and your baby is supported, latched on well, and feeding efficiently (more on latch and efficient feeding below). A nursing pillow (like the Boppy or the My Brest Friend) can also help you position your baby.

Make sure your baby is latching on correctly. Latching refers to the way your baby places his mouth and establishes suction on your breast. Poor latch is a common source of breastfeeding woes, like inefficient intake of milk and ongoing nipple soreness. It is normal for nipples to be sore, and even cracked, for the first few weeks (you can rub breastmilk or nipple ointment on them), but if breastfeeding remains painful it might be due to poor latch. For a good latch, you want your baby to open his mouth wide and place his mouth around your areola, not your nipple. To get your baby to open wide, tickle or gently pull on his chin and then guide your breast into his mouth.

In some instances (if you have flat nipples or your baby is born early, for example) getting a good latch can be difficult at first. Temporary use of a nipple shield can help your baby learn to latch on (and save you from ongoing nipple soreness).

Listen for an even suck/swallow rhythm. One sign of proper latch and efficient breastfeeding is the sound of a suck/swallow rhythm. This indicates that your baby is getting a steady flow of milk.

Stick to one breast per feeding. Throughout a feeding, the consistency and fat content of breastmilk changes. It starts out thinner (foremilk) and becomes thicker towards the end (hindmilk). Hindmilk is higher in fat and is important for your baby’s weight gain. To ensure that your baby is getting hindmilk, stick to one side until it’s empty. If your baby wants to continue, switch to the other side. If he’s satisfied, start with the other side at the next feeding.

Share a room with your baby. When you are feeding your new baby frequently at night, having him in a bassinet next to your bed will make nighttime feedings less disruptive for you.

Keep track of diapers. After your baby’s first week of life, he should have 6 or more wet diapers in a 24-hour period. His stool will be yellow, seedy, and loose. This, along with normal weight gain, are indicators that he is getting enough breastmilk.

Take care of yourself. Try to eat well, drink plenty of fluids, rest when you can, and make sure any medications you take are breastfeeding-approved. Also, ask your pediatrician if you should give your baby vitamin D supplements, as many exclusively breastfed babies do not get enough through breastmilk alone.

Ask for help! Lactation consultants are trained professionals who can help answer breastfeeding questions and troubleshoot any bumps in the road. The hospital where you gave birth, your pediatrician, or even an internet search can help you find a lactation consultant in your area.

If breastfeeding is difficult but important to you, don’t give up! It can take a few to several weeks to get into a groove, and challenges can pop up from time to time after that. But, with some troubleshooting and/or professional help, you can get on track and enjoy this special time with your baby.

02 Mar

21As any adult who’s had trouble sleeping knows, the habits around sleep (like winding down before bed and creating a comfortable sleeping environment) play a big role in falling and staying asleep. Good sleep habits are lifelong skills that you can start teaching your baby from day one. These habits can also set the stage for successful sleep training, which many parents turn to when their babies are around 4-6 months old.

Below are common tips for instilling good sleep habits for your baby, separated into two age groups, since babies younger than 3 months have different needs than older babies.

Sleep Habits for Babies 0-3 Months

Although opinions differ about every aspect of baby sleep, most child development experts advise that until 3 months of age you go with your baby’s flow. He will need to eat frequently both day and night, and he will seek comfort as he adjusts to the world after months of being in a cozy womb. Even though it might be too early for a schedule at this age, you can still do the following to promote good sleep:

  • Keep daytime bright and gently active. In the morning, open the curtains and let light into the room. Give your baby tummy time, sing, play, do your BabySparks activities with him, and take him outside for fresh air. We say “gently active” because babies at this age can easily become overstimulated. They also need lots of cuddles!
  • Avoid an overtired state. When we are overtired, our brains produce the stress hormone cortisol, which wakes us up. Watch your baby for signs that he’s tired, like yawning or rubbing his eyes, and help him fall asleep before he becomes overtired.
  • Keep nighttime calm, dark, and quiet. Close the curtains and use a soft voice. When it’s time for sleep, consider using a white noise machine to drown out sounds (like loading the dishwasher or still-awake older siblings).
  • Create a comfortable sleeping environment. Soft pajamas and sheets and a moderate temperature in the room can help.

Sleep Habits for Babies 3+ Months

At this age, babies are typically ready for more routine. You can set feeding, nap, and sleep schedules. While it’s generally not an issue to feed newborns to sleep, many experts agree that by 3 months it might be good for babies to learn to fall asleep by different means so they do not become dependent on nursing or bottle feeding. Here are things you can add to promote sleep when your baby turns 3 months old:

  • Develop a schedule. Set a regular wake-up time, mealtimes, nap times, and bedtime. This can help your baby prepare for sleep at predictable times.
  • Follow a bedtime routine. A bedtime routine (bath, book, lullaby, for example) both calm your baby down and condition him to prepare for sleep. Routines can be brief and simple or long and elaborate, depending on how much time you have. The important thing is to do similar things in a similar order at a similar time each night.
  • Replace feeding-to-sleep with another activity. To avoid your baby becoming dependent on nursing or bottle-feeding to fall asleep, try feeding him at the start of your bedtime routine. As the last step, try rocking or gently bouncing your baby until he’s sleepy but still awake, then put him in his crib to finish falling asleep on his own. When babies start getting a majority of calories from solid food (by 12 months or so), you can consider dropping the before-bed nursing or bottle altogether. Your pediatrician can help you determine when that’s appropriate for your baby.
  • Give baby a chance to settle on his own. Sometimes babies wake up, make noise or even cry, but quickly settle on their own. If your baby fusses in the night, try waiting a minute before you respond to see if he really needs your help.

The key to maximizing good sleep habits is to stay as consistent as possible. These habits will help ease changes like traveling or switching from a crib to a bed, and will serve your child for a lifetime.