Cherishing Your Child

"Everybody's got a hungry heart."
-Bruce Springsteen

"…the precondition for giving is receiving… It is natural to say 'That is a well-cherished child' or 'There is a child who wants cherishing.' We think of cherishment as the emotional equivalent of nourishment. Soul Food."
-Elisabeth Young-Bruehl and Faith Bethelard

Humans are born ready to love, and to be loved. All parents recognize the adoration reserved especially for parents, the small arms reaching up, the joy of infant and parent in their cocoon of mutual delight. Babies expect to be cherished.

This cherishing, this affirmation of the infant from head to toe, teaches the baby who he is. In interaction with the parents, the baby learns "Yes, these are my toes, how good they feel when Dad kisses them!" and "Mom makes that happy noise when I smile at her!" The baby also learns "Mom and Dad love to bathe me, to nurse me, to care for me: I am worth taking care of. I am lovable."

Cherishing our babies is natural, if we listen to our instincts. It is our secret weapon, the nourishment that helps them grow inside, the source of self esteem, the foundation on which their ability to love and be loved rests.

This expectation of being loved is what allows our children to learn so quickly, to risk bumps and scrapes and hurt feelings: the security of knowing that someone who adores them is watching out for them, supporting their growth. Cherishment is the security of unconditional love.

For the parent, cherishing is reveling in being this baby’s parent, being grateful even in the middle of diapers and sleeplessness and colic that this baby was sent to these arms.

But if we have not been cherished ourselves, cherishing can be challenging. When we have been frustrated in our attempts to love and be loved, we may find it difficult to revel in our new baby. We may find ourselves annoyed rather than delighted by her need for our attention, angry rather than sympathetic when he howls. We may avert our eyes from her adoring gaze. We may become uncomfortable when engaged in reciprocal play with our baby and interrupt it without really noticing what we are doing, or even our discomfort.

Often, parents who have not been cherished themselves are envious of the attention the baby receives from others. These parents may insist that the baby adapt to their needs, by, for instance, refusing to adequately babyproof and then becoming angry when the baby persistently attempts to explore the VCR or the stack of magazines.

And for the baby, what happens when this need to cherish and be cherished is frustrated? Frustration, of course, is anger. Lack of being cherished creates an angry child.

Some parents are conditionally accepting. They might adore the baby, for instance, but find it difficult to deal with her when she's angry. What happens? The baby simply rejects the parts of herself that haven't been accepted. The ability to love herself is compromised, shadowed with self hatred; she is not, after all, good enough to evoke what she needs and wants most: cherishing. As she rejects parts of herself, her emotional growth is compromised. (See the Attachment Research for more about the Resistant-ambivalent response.)

The need for cherishing, like all survival needs, doesn’t vanish when thwarted. It goes deep underground. We defend ourselves against this dangerous need that would make us vulnerable; we ward it off with anger, which eventually turns into bitterness.

In extreme cases, the hope of being loved becomes too painful, and the child defends against it by consciously expecting rejection. We all know these children, who become experts at soliciting dislike. In very extreme cases, these can become the kids who are capable, one day, of taking a gun to school and opening fire. The famous researcher Rene Spitz said it most succinctly:

"Infants without love…will end as adults full of hate."

Luckily, virtually all of us get enough cherishment that we don't end up as killers. Few of us, though, get enough of this "soul food" that we don't end up with a heart that is, at times, more hungry than we would like. That hunger, those unmet needs, are what drive all "bad behavior" on the part of our children. Kids whose needs for cherishment are met become cooperative kids. Sure, they'll have times when they're overwhelmed by emotion, or have a hard time regulating their behavior. But these kids WANT to cooperate to please their parent.

Want to raise a happy, cooperative, responsible child? Cherish your baby.

What's Wrong with Pacifiers?

I received a question from a reader recently:

"Should a natural mama ever consider using a pacifier?"

I know there are experts who disagree with me, but the short answer is Yes. Every baby is different and some simply have very strong comfort sucking needs. Most of the time, those needs are met by breastfeeding, but there are plenty of breast-fed babies who still need to suck their thumbs. And while a thumb is definitely a more “natural” choice than a pacifier, there is one clear way in which a pacifier trumps a thumb. But I’m getting ahead of myself.

Pacifier manufacturers were given a blank check recently when the American Academy of Pediatrics released a recommendation that babies be given pacifiers at naptime and bedtime through the first year of life because studies show that pacifiers decrease the risk of SIDS.

The recommendation specifies that pacifiers should not be introduced until after one month of age in breastfeeding infants, when, presumably, nursing is well established and the pacifier won’t cause nipple confusion. The artificial nipples of both bottles and pacifiers are easier for a baby to latch onto than breast nipples, which may undermine an infant’s ability to correctly latch onto the breast. In addition to giving mom sore nipples, babies can get so frustrated and upset they refuse to nurse.

Are pacifiers necessary to protect against SIDS?

However, many breastfeeding experts are challenging the AAP recommendation. Their argument? SIDS is thought to result from an infant falling into too deep a sleep before his body has gained the ability to regulate its own arousal. Sucking on a pacifier while sleeping keeps the baby from sleeping as deeply, thus guarding against SIDS. However, Mother Nature has already designed the perfect way to help babies regulate their arousal systems during the early months of life: waking frequently at night to nurse, and sleeping near Mama. In fact, co-sleeping and breastfeeding have both been shown to have a protective effect against SIDS, because the baby’s physiology is kept at a higher level of arousal. His sleep cycles even parallel his mother’s. SIDS was probably unknown before separate bedrooms and cribs were invented, and as both co-sleeping and breastfeeding have increased since 1992, SIDS has decreased.

Given that pacifiers do not offer any particular benefit against SIDS for babies who are already breastfeeding, most breastfeeding experts continue to advise against pacifiers, even after nursing is well established. Why? Frequent nursing is the best way to create a good milk supply, which remains a necessity long after the first month. Babies drink 1/3 of their daily food intake during their night feedings, so using a pacifier to calm a crying baby at night can lead to poor weight gain as well as plugged ducts, mastitis, and a decrease in milk supply. In other words, pacifiers can easily sabotage nursing.

Bonding experts also worry that a baby’s cry is meant to initiate connection, and pacifiers could take the place of love. From a bonding perspective, nursing is not just about feeding a baby, it's about emotional nurturance, or just plain comfort. When a baby cries, she needs to be held and comforted.

In answer to the worry that the baby is just "using the breast as a pacifier," most natural mamas would retort “Isn’t that how nature designed humans? Which would you rather your baby see as her source of comfort: You, or a piece of plastic?”
So if a pacifier is a risk factor for breastfeeding and can even undermine mother-child bonding, why do I say that a natural mama might consider a pacifier?
Simply because I think being dogmatic and judgmental is a disservice to mothers. We know that every baby is different. Some babies need much more comfort sucking than others. Even some breastfed-on-demand babies suck their thumbs or fingers. In fact, some infants suck their thumb or fingers in utero and come out ready to find their thumbs again.

You might argue that a thumb is more natural than a pacifier, and I would have to agree. I would also point out that in the middle of the night, a baby can always find his thumb, when he almost certainly will not be able to locate his pacifier by himself. Toddlers who suck their thumbs are famously the best sleepers. However, neither thumb nor pacifier should be used past the age of five, when the arrival of the permanent teeth nears. And that’s where the pacifier trumps the thumb.

The pacifier habit is far easier to break than the thumb habit, simply because it doesn’t stay on your child’s hand, beckoning. Pacifiers get thrown away, the child mourns, has a tough week, and goes on with her life. But the siren song of the thumb is always there, leading to feelings of shame and anxiety as the poor child tries hard to please her parents, peers and the dentist by giving up her comfort habit.

Of course, there are many kids who give up their thumbs easily. I personally remember doing so, and I would absolutely choose a thumb over a pacifier for my own children. (I breastfed each child well into toddlerhood, and early on with each I rooted for them to find their thumbs, but they never did.)

What is the pacifier made of?

If you’re considering offering your baby a pacifier, there’s one other critical element we haven’t discussed. What is the pacifier made of? Many pacifiers have BPAs in them, although I predict their rapid extinction given all the recent publicity. But other pacifiers aren’t necessarily safe, either. Latex pacifiers leak low levels of nitrosamines, a known carcinogen. Some pacifiers are still made with diisononyl phthalate (DINP) or phthalate esters, which can be released during sterilization. Silicone pacifiers were considered safe for a long time, but are now highly suspect. The only safe pacifier on the market seems to be Natursutten’s rubber pacifier, which has no synthetics or additives, but the instructions say they have to be replaced every five to seven weeks to stay safe, which is costly and inconvenient. And while the Natursutten is currently claimed to be safe, there’s always the problem that what's considered safe today might not be considered safe tomorrow. After all, most of us hadn't heard of BPAs a few years ago.

Author,

Dr. Laura Markham.

Helping Your Baby Get To Sleep

Most new parents are shocked by the constant interruption of their sleep that a newborn brings to the house. But there are ways to be there when your baby needs you, and still get some rest.

There are basically three schools of thought on this issue.

The first, made popular by the book authored by pediatrician Richard Ferber, advocates teaching babies over the age of three months to sleep through the night in their own cribs, by letting them "cry it out" for increasingly longer periods of time. While most babies eventually give up and fall asleep, the process is often traumatic for parents (and we can assume for the baby), and frequently needs to be repeated following any disruption in routine. Critics point out that Ferber has no psychology training and question whether letting babies cry it out has permanent, harmful effects. More on Ferber.

The second school of thought, practiced by advocates of the Family Bed, says that infants are hard-wired to sleep with their mothers, and nurse at night, for many months, probably until toddlerhood. They point out that babies who sleep with their mothers are less likely to die of SIDS (Sudden Infant Death Syndrome), and that the mothers get much more sleep. My personal experience is that the family bed was heavenly. Critics of this method express concern that parents might inadvertently roll on their babies in the night, and point out that babies who sleep with their mothers and nurse on demand take much longer to sleep through the night. They also wonder why any self-respecting toddler who is accustomed to sleeping with his parents will give that up for a new, lonely, "big-boy-bed." Dr. James McKenna is one of my favorite resources on safe cosleeping.

The third school, perhaps best represented by No Cry Sleep Solution author Elizabeth Pantley, understands that parents may desperately need some sleep and agrees with Ferber that babies need to learn to fall back asleep on their own, but argues that this can be accomplished without the trauma of letting babies cry it out. More on Pantley's No Cry Sleep Solution.

My own view

There are safe ways for you to get more sleep, without leaving your baby to cry, and without necessarily sharing a bed. You can even start encouraging an infant in that direction but ONLY if you listen to the infant when he tells you he's hungry or needs you to hold him. In other words, this is a gentle, gradual process. See #8, below, for how to begin this process. 

Fair disclosure: I attempted Ferbering once when my son was nine months old and failed, having given him an ear infection from crying (and having nearly given myself a nervous breakdown.) After that, we went back to the family bed, which we all loved. However, once nursing my toddlers no longer helped them fall back asleep for long, I found myself walking the floor with them and spending many long hours in the middle of the night helping them to fall back to sleep. After substantial research, and working with many parents, I've come to the conclusion that many little ones who are helped to sleep by parents (nursing or rocking), simply can't put themselves back to sleep when they re-awaken during the night. If they're nursing, they may well awaken to nurse, but then will need to nurse again every time they re-awaken a little at night. Eventually, if they don't figure out how to fall back asleep on their own when they awaken at night, they will need our loving help to learn how to fall asleep without rocking or nursing.

Is this a problem? Not necessarily. Some moms are able to nurse at night as long as their child wants. However, I often speak with moms who are ready to stop night-nursing their little one, but find the prospect of night-weaning upsetting.

Does that mean we should always put babies down awake so they can learn to put themselves to sleep when tiny, so they won't develop bad habits? Since almost all newborns fall asleep at the breast (or bottle), that would be impossible. It is completely appropriate to nurse babies to sleep. Nursing to sleep is no more a "bad habit" than peeing in a diaper. As they get older, the time will come when they can learn to fall asleep themselves, just as they will eventually give up diapers.

Does that mean that a time will come when to teach our baby or toddler to fall asleep, we can leave him to cry? Never, in my view, if you want an emotionally healthy child.

But then how do kids learn to fall asleep on their own, without nursing back to sleep? They learn in the safe comfort of your arms, once they're old enough. For more on teaching your child to learn to fall asleep without nursing or rocking, click here.

Sleep is, of course, a very personal decision. I believe that

There is a sleep solution that fits every unique family, from co-sleeping to baby bunks that attach to the parents' bed, to baby hammocks, to cribs.

Of course you want your children to know from the earliest age that they can always ask for and get help. That said, we all need sleep to function and be good parents. My recommendations are biased in favor of keeping your infant close so you can get more sleep. But this is a very individual choice. Read as much as you can, and then lose the guilt. Do what works for you and your baby.

How can you get some sleep, 

when your infant is still waking up to eat?

1. Sleep whenever and wherever you can.

Keep your baby near you while he's still nursing at night, so you don't have to get out of bed. Breastmilk is designed to be given every few hours. It simply cannot hold a baby for much longer. Rats, on the other hand, give their baby food much higher in fat, so that the mother rat can leave the babies for eight hours while she’s off foraging. Baby humans could not survive predators if they were left for long periods, so nature has designed them to require their mother's presence fairly constantly. That means your baby needs to be nursed at night, for a minimum of six months and probably until she is a year old.

2. Afraid of rolling over on your baby?

Unlikely, since mothers are designed not to (unless her natural warning system has been interfered with by drugs or alcohol). There is actually evidence that babies who sleep with their mothers are less likely to die of SIDS because the co-sleeping babies' sleep cycles are in sync with their moms', and her presence stimulates him not to fall into such a deep sleep. There are experts who say that a father could suffocate a very young baby, especially if he's had a drink before bed, so most safe co-sleeping checklists say to position the baby between mom and the wall rather than between the parents. However, the fathers I hear from tell me they're very conscious of their baby, even while asleep. We know that Dads do have a hormonal response to becoming fathers, which includes a natural protectiveness toward the baby, so Paternal Instinct is as real as Maternal Instinct. I personally think that any Dad will be a better father if we honor his paternal instinct and give him the opportunity to sleep snuggled with his baby, but that's an individual decision. In any case, make sure you set up your bed for safe cosleeping, don't start without reading this detailed checklist for safe co-sleeping.

3. If you don't feel comfortable with your baby in bed with you, try a “Moses basket,” cradle or baby bunk within arm's reach.

Some moms are such light sleepers that they just can't get any sleep at all if the baby is in their bed. There are wonderful baby bunks that can be anchored to your bed, at the same level, and opened so that the baby has his own space but you can roll him into your bed with you to nurse.

4. Learn to nurse lying down so you can sleep while he feeds.

It may take a week, while you get the hang of nursing, but learn to nurse lying down, so you can doze, and you'll feel much more rested. Just wedge pillows behind you and between your knees for support, and put a folded blanket under Baby if necessary to raise him to the level of your breast so neither of you is straining to reach. He should be on his side, facing you.

5. Help your baby set her metabolic clock.

She doesn't know it's night and she should sleep. She'll learn, eventually, but you can help your little night-owl adjust faster to the world outside your womb by making sure she doesn't sleep all day. Take her out in the sun. Go for walks. Let her feast her eyes and ears on the wonders of the world. All humans really do sleep better at night when they've been exposed to fresh air and sunshine during the day. Also,you should know that babies who sleep with their moms end up synchronizing their REM sleep cycles, which means she's more likely to treat night as sleep time and day as waking time. And of course, keep things dark and quiet at night. Nurse her when she wakes, and change her if you must (not all babies are sensitive enough to require changes at night), but don't make it into playtime.

6. Take a long maternity leave, so you can nap when your baby naps during the day.

This is the golden rule. Forget the shower, who cares? Go for the nap.

7. If your partner can take the baby in the morning to let you sleep in for an hour, it can make all the difference in the world.

Don't feel guilty about it. Eight hours of sleep with interruptions to feed your baby is not the same as the eight hours you used to get. You need lots more now.

8. Go to bed early.

When you were pregnant you did it. Don't feel bad about it, this is not the time to resume an active evening life. You have the rest of your life to stay up late.

9. Encourage sleep associations that your baby can control.

As your infant gets a bit older -- say three months -- you can begin encouraging her to learn to fall asleep without sucking or being held. This is a gradual, gentle process. Here's a whole article on how to encourage good sleep habits as your baby grows.

Breast or Bottle?

Research shows unequivocally that breastfed babies are healthier and smarter, and that the longer babies are nursed, the healthier and smarter they are. Because the nursing mother experiences hormonal changes that influence how she perceives and relates to her infant, many experts feel that the mother who nurses bonds more strongly with her baby, resulting in a better relationship over time.

1. PLAN to nurse.

Not "If it works out." But "I will do this." And you will. There are lots of times in history when infant formula wasn't available, as, for instance, in London during World War 2. Records show that every mom who gave birth during that time was able to breastfeed her baby successfully -- because there was no alternative.

2. Be Prepared.

The classic nursing hold is to cradle your baby's head in the crook of your arm, turn her whole body to face you so you're belly to belly, and move her to your breast so she can "latch on." That means she needs to be at the level of your breast, which means on a pillow, not on your lap. Many nursing moms say that a good nursing pillow, the kind with the circular cut-out for your belly, is hugely better than an ordinary pillow, which slides around and isn't necessarily the right height or firmness. You don't need most of what they sell for baby (I didn't use changing tables or cribs, for instance, or strollers in the early months), but a nursing pillow is a smart purchase.

3. Know Your Technique.

Good basic technique can tremendously lessen sore nipples, prevent clugged ducts and mastitis, and make the difference in whether breastfeeding works or not. A few helpful rules:

• Be sure your baby opens his mouth wide and gets not only the nipple, but most of the aerola in. This stimulates the full milk let-down as well as preventing sore nipples. Can't get him to open wide enough? Trigger the "rooting reflex" by tickling his mouth or cheek with your nipple.
• Be sure your baby is facing you so he doesn't have to turn his head to nurse.
• Be sure your baby is at breast level so you don't have to hunch over. You can relax better, insuring better milk let-down, and you don't get a sore back and neck.
• Don't know if he's in the correct position? His tongue should be slightly visible between his lower lip and your breast. If not, dis-engage him, tickle his cheek so he opens his mouth wide, and and let him latch on again.
• To save your nipples, dis-engage by inserting your finger at the side of his mouth and breaking the suction so he pops off. (Usually he will fall asleep nursing and the breast will fall out of his slack mouth, that is also fine.)
• Change holds and rotate the baby's position from feeding to feeding. This better drains the breasts and avoids clogged ducts, as well as protecting the nipples from soreness. For example, use the football hold (Baby's feet pointing behind you, hold his head in your hand) or try nursing lying down (prop yourself well with pillows, and if necessary put a folded blanket under baby so neither of you strains).
• Be sure you drink LOTS of water. Just drink water constantly.
• Change your bra daily so any leaked milk (even tiny amounts) doesn't cause a breast infection.
• Wait to introduce a pacifier or bottle until nursing is well-established.

4. Get a good start.

We don't grow up watching moms and aunts nurse their babies, and it isn't second nature to us, so sometimes it isn't as easy to get started nursing as we expect. It's easy to get unbearably sore nipples in the very beginning, or for the baby to have a hard time latching on. And very occasionally, babies are born with a challenge, such as being tongue-tied, which requires a quick snip under their tongue by a doctor.

While you're pregnant, arrange lactation support for that first week. It's a good idea to call your local La Leche chapter in advance just to have a couple of breastfeeding consultants' names handy. Such an expert often makes all the difference in the world. It is absolutely not worth the anxiety of muddling through when one session with an expert can put you and your baby on track.

5. Cultivate family support.

Make sure your partner understands your reasons for choosing to breastfeed. A little education goes a long way to overcome prejudices. Most men, with their wife's encouragement, find breastfeeding a miraculous act, especially once they understand how important it is for their baby. Your partner's support will be critical to your success.

6. Pick a pediatrician who supports breastfeeding.

Virtually all new breastfeeders worry about whether their child is getting enough milk. Most pediatricians are nursing advocates. Get him or her to help you as much as possible.

7. Remind yourself of all the advantages to you.

No middle of the night fixing of bottles. No sterilizing of bottles. No formula expenses. No formula allergies. As much ice cream as you want to eat, while the pregnancy pounds melt away. Diminished chance of breast cancer later. A delay in how soon your period resumes. Pride in the amazing ability of your womanly body.

8. Find other Moms who are breastfeeding to hang out with

...through La Leche or other groups. It makes all the difference in the world.

9. Resist the impulse to supplement with formula.

If you want your baby to take a bottle, pump your milk and have your partner offer it in a bottle once nursing is well established. (Don't wait too long or your baby may turn up her nose at this fakery!) Remember that the answer to too little milk is always to increase the demand by more nursing and/or pumping. Supplementing with formula -- even in an attempt to be sure your baby gets enough -- ALWAYS decreases your milk supply. If your baby needs more food, feed her more often!

10. Take a six month maternity leave

...if at all possible. Then, when you return to work, your child will be ready to supplement his morning and evening feedings with solid food during the day.

11. Relax. Enjoy. And don't be in a hurry to wean.

Don’t worry, she won’t be nursing in high school.

"Well, since you brought it up, when should I plan to wean? When I go back to work?"

 

Many studies confirm that breast milk changes in nutritional value to remain appropriate for babies as they grow into toddlers, maintaining its many health benefits. The National Association of Pediatricians recommends breastfeeding at least until age one, preferably longer. The average age of weaning around the world is four years old. So you might want to plan to nurse for at least a year, maybe two or three. (I'm biased here, I nursed both my kids till they were three. And I was back at work, in both cases, well before they weaned, but not for the first six months.)

So why do most mothers bottlefeed or, at best, wean in the first year?

 

Cultural pressures certainly influence many women. If no one around you is nursing a baby, it may be hard to envision yourself nursing. If your own husband -- or even complete strangers -- begin to chastise you for nursing an eleven month old who is learning to walk, you will probably begin to feel uncomfortable nursing, especially if you don't have support to continue.

But for most mothers, even those convinced of the benefits of nursing for their child, going back to work means the beginning of the end of breastfeeding. Most maternity leaves in this country are disgracefully short, averaging 6 weeks at 2/3 pay compared to an average of a year at full pay in most European countries. Fully half of all American women are not entitled to ANY paid maternity leave!

"Well, I do have to go back to work. What can I do?"

 

Wait as long as you can, so breast-feeding is well-established. By six months, your baby can supplement with solid food while you're gone. Remember that any reduction in demand will reduce your supply, so nurse her as much as you can when you're together, and pump at work.

Parenting Your Newborn

Congratulations! You have a new baby! Now what?

Welcome to Planet Parenthood, where the sleep is scarce but the love will blow you away. In this section, you'll find your baby's developmental tasks, your priorities, and a simple Parents' Gameplan, all set up to make your life easier when you've only had an hour of sleep and you've got two minutes to read.


Your Newborn's Primary Developmental Tasks:

Learning to eat

Learning to sleep at night

Learning to handle lots of stimulation

Development of trust

Rapid physical and brain development

6. Settling into his body



Your Challenges:

Learning everything about your baby when he was delivered without an owner's manual -- and as soon as you figure it out, he changes!

Renegotiating your entire life.

Getting some sleep.

Your Top Priorities

Learning to feed your baby

Learning how to comfort her

Getting some sleep

Learning how to relax and enjoy the moment (Don't sweat the small stuff -- and it's almost all small stuff.)

Gaining the confidence that you really are the perfect parent for this baby!

Your Strategy:

1. Wear your baby.
She'll cry less. You'll be more in touch with her cues. Babies are designed to be held.

2. Breastfeed.

He’ll be healthier, have a higher IQ, and cry less. You’ll be happier in the middle of all that unfolded laundry. (The hormones that get released when you nurse are similar to those released after orgasm.) Nurse on demand, not on schedule. Get whatever advice you need to get nursing established. As soon as your baby can handle it, nurse at night lying down, so you can doze while she nurses; you won't be so exhausted the next day from night feedings.

3. Sleep whenever and wherever you can.

For me, the family bed was the only way to get any sleep at all. It makes some people anxious. There are now great options, like a baby bunk, that connect right up against your bed so you can't roll on the baby accidentally. Or a baby hammock positioned near your bed, which lets your baby sleep in womblike comfort right next to your bed. My advice is to read as much as you can, and then lose the guilt. Do what works for you and your baby.

4. Plan for the baby to be with Mom or Dad as much as possible for at least the first year.

An infant needs to be with an adult who is crazy about her. That’s too much to expect from a paid caretaker. Not to mention that if the paid caretaker IS crazy about the baby and leaves your employ – and the chances of turnover are very high – your baby will experience it as a tremendous loss. HE doesn’t know this isn’t a second mother. In fact, if he spends most of his waking hours with her, he doesn't know it isn't his primary mother.

5. De-prioritize everything else,

except eating, sleeping and loving, for yourself and the rest of your family. This isn't just for moms. It's amazing how many dads assume their lives can go on as usual when there's a new baby at home.

6. If you stay home with a baby, don’t let yourself get isolated.

At the very least, get out of the house every single day and go for a walk. (No one cares if your hair doesn't look its best, I guarantee.) Or get together with other moms or dads and talk babies. Or politics (For instance, why the U.S. is one of only five countries of 168 studied that doesn't mandate some form of paid maternal leave, putting us on par with Papua New Guinea, Lesotho, and Swaziland!)

10 Must-Know Baby and Toddler Nap Facts.

We’ve written quite a bit about baby and toddler naps here on the blog, so if you’ve been following our site for awhile, you’ve had the chance to read a lot of baby and toddler nap tips and tidbits. But, some of you are new moms  and we strive to educate all of our parents on the importance of good sleep and how to achieve it!

Today, we’re presenting you with 10 must-know facts about your baby’s or toddler’s naps. Think of it as your nap “cheat sheet”. ??

10 Things You Need To Know About Baby and Toddler Naps

The first nap of the day is the most important. This isn’t to say that other naps aren’t also important. But the first nap of the day tends to be the most restorative, setting the tone for the day, and it’s generally the one that produces the best sleep for babies and young toddlers.

Most babies don’t transition to one nap at 12 months; most transition to one nap between 15-18 months. There seems to be a prevailing opinion out there that at the one year mark, babies should suddenly transition from two naps to one. And some will, with no problem. But we’re here to tell you that making the 2-to-1 nap transition at 12 months isn’t the norm for most babies. In fact, most babies aren’t ready to move to one nap a day until 15-18 months.

Most 6 month old babies aren’t ready for just 2 naps per day; most still need 3 (or even 4). Just as there’s a misconception that all 12 month old babies are ready to transition to one nap per day, there’s also a misconception that 6 month old babies are ready to transition to just 2 naps each day. We think this misconception is at least party due to a recommendation that Weissbluth makes in his book Healthy Sleep Habits, Happy Child. In the book, Weissbluth states that only 16% of babies need a third nap after 5 months. Keep in mind this statistic came from a study of a limited number of children.
We are not discounting Weissbluth’s studies, but we do take it with a grain of salt, since all babies vary in their ability (particularly mood-wise) to stay awake for long periods of time. In our extensive work with families, we’ve found that far more than 16% of babies appear to need 3 naps at 6, 7, even 8 months of age. Therefore, we usually tell parents not to rush into a 2 nap schedule with their 6 month old babies. Doing that increases the chances that their 6 month olds will become overtired, which will in turn affect their night sleep. We’ve found it’s better to stick to a 3 nap schedule (or even a 4 nap schedule) and then gradually transition to a 2 nap schedule around 8 months.

Your child’s nap needs will change greatly between birth and 18 months. Greatly. This just makes sense if you think about it — newborns nap pretty much constantly during the day, while an 18 month old needs just 1 nap. That’s a lot of change during a relatively short period of time!
So, how many naps does your baby or toddler need in the first 18 months of life? You can read this article for detailed information, but here’s the short version:

*1-3 MONTHS — 4-5 naps per day, depending on how long his naps are and how long he can stay up between naps.

*3-4 MONTHS — 4 naps.

*5-8 MONTHS — probably 3 naps (though some will need 4 until after 7 months). A few babies will only have 2 naps at a very young age, but those naps are usually long.

*9-15 MONTHS — 2 naps. Some babies will transition to 1 nap at 12 months, but that’s not common.

*15-18 MONTHS — 1-2 naps. The transition from 2 naps to 1 usually happens in this window of time.

*18 MONTHS-4 YEARS — 1 nap. The age to transition away from all napping varies a lot, from 2 to 5+ years old, but the average age is between 3 and 4 years old.

If your baby or toddler sleeps well at night, that doesn’t necessarily mean she’ll nap well during the day. Remember, nap sleep is different than night sleep. Naps happen during daylight hours, when the sun’s up and when it tends to be noisy and busy. External factors like that can make it hard for a baby or toddler to nap well. And many families struggle with keeping a consistent daily nap routine in place — because life tends to get in the way! That, too, can make it hard for a baby or toddler to nap consistently. Contrast that with nights — it’s dark, it’s (usually) quiet, and everyone is (usually) at home. That at least partly explains why many babies and toddlers who sleep just fine at night struggle with their naps.

On-the-go, “moving” naps aren’t as restorative as naps that happen at home, in bed. This might come as a bit of a surprise, but it’s true — naps that happen “on the go” (in a moving car, for example, or in a moving stroller or shopping cart) aren’t as restorative as naps that happen on a non-moving surface (like a bed). They aren’t as long, for one thing, and during a “moving” nap, your baby’s or toddler’s sleep won’t be as deep. The occasional on-the-go nap isn’t a big deal, of course; sometimes, you gotta do what you gotta do. But if the majority of your baby’s or toddler’s naps are happening in the car, or in a stroller, you may need to rethink your daytime routines and schedule.

It’s possible for your baby or toddler to nap too much. Yes, we realize that this particular “problem” doesn’t plague most of you. ?? But it’s true; some babies and toddlers nap too much, and it negatively affects their nighttime sleep. How much nap time sleep is too much? You can check out this article for details, but here’s a fast breakdown:

*INFANT STAGE (birth – 4 months) — newborns will sleep 14-18 total hours during the day. To maximize nighttime sleep, limit naps to two hours, and try to keep your baby awake for 30 minutes between naps. (Need help with newborn sleep? Take a look at our newborn e-Book.)

*BABY STAGE (4-12 months) — babies need 13-15 total hours of sleep during the day. 2-4 of these hours should be naps (depending on how much sleep your baby is getting at night.)

*TODDLER STAGE (12 months – 3 or 4 years) — 1-3 hours of total naptime is considered normal and healthy.

Educate yourself on when common nap transitions occur, and how to manage them. Nap transitions are likely to occur at the following times:

*3-4 MONTHS — baby transitions from 5 naps to 4.

*5-6 MONTHS — baby transitions from 4 naps to 3.

*8-9 MONTHS — baby transitions from 3 naps to 2.

*15-18 MONTHS — toddler transitions from 2 naps to 1.

As for how to handle these nap transitions? We have loads of resources on that very topic in our Members Area – keep reading for details!

If a nap just isn’t happening, know when to give up and try again later. We end up dispensing this advice quite often to our consultation clients who we are working on nap training: don’t waste too much time trying to make a nap happen. No sense in spending 3 hours trying to force an afternoon nap to happen — at that point, you’re probably closer to bedtime than you are to naptime!

When your toddler is finally done taking naps, consider replacing nap time with “rest time”. It’s always a little sad when your toddler finally ages out of his naps. Gone are those one or two hours of peace, when mom or dad could get some work done, catch up on chores, or take a nap themselves! However, the end of nap time doesn’t have to mean the end of your afternoon peace and quiet. Simply replace nap time with rest time.

BONUS NAP TIP: We like you so much, we’re squeezing in a bonus tip for you! This one deals with short naps, an all-too-common problems for the parents in our Baby Sleep Site® community. The fact is, short naps are normal for newborns and young babies, but by about 6 months of age, most babies are able to take longer naps. Want all the details on why short naps happen, and how to fix the problem? Check out this article on short baby naps.

These are not the top child health problems

Childhood obesity, bullying, and drug abuse are the top child health problems, according to respondents to a national survey for Mott’s Children’s Hospital in Michigan.The survey participants got it wrong on two of those priorities.  Their responses are more a reflection of what’s been getting media attention, rather than the real problems affecting America’s youth.

I was glad to see that childhood obesity, listed by 60 percent of the participants, achieved the number one ranking.  It’s hard to overemphasize the serious medical and mental health implications of this epidemic.However, those who listed bullying (58 percent) and drug abuse (53 percent) as the most serious child health problems got it wrong.Bullying is an important issue, but the prevalence is not increasing, and may in fact be declining. Schools are taking this problem very seriously, and many states have laws that help insure that our kids can go to school in an emotionally safe environment.

While drug abuse is a serious issue, it’s more of a symptom of underlying problems.If I was completing the survey, I’d list child abuse and neglect as the second most serious health problem for our kids. The overall rates of neglect, physical abuse and sexual abuse remain alarmingly high.  This is a safety issue that demands our focused attention.

I’d rate stress as the third most significant health issue, one that is related to so many other problems identified in the survey.Childhood stress is difficult to comprehend. Most of our kids are privileged, entitled and raised in financially secure environments. They have economic advantages unknown to any other generation. With so many benefits, why is stress such a serious health issue?

I’d list stress as one of my top priorities because we are raising a generation of entitled and overprotected kids who are horrible at dealing with life’s problems. When confronted with difficulties, they respond by abusing drugs, smoking, bullying or developing mental health issues.

These problems are symptoms. We don’t need more education to teach kids that bullying, taking drugs, and smoking are bad. Instead, we need to teach our children better ways to deal with unpleasant feelings, difficult people, failure and frustration.

What kids are calling “stress” today was once viewed as just a normal part of living that kids figured out how to manage.

The solution is for parents to stop solving problems for their kids, and start teaching them how to deal with difficulties on their own. Your job is to do more coaching and less controlling, helping our kids to be strong and independent, not victims of life’s normal pressures.

Using a Mother’s Microbes to Protect Cesarean Babies

The first germs to colonize a newborn delivered vaginally come almost exclusively from its mother. But the first to reach an infant born by cesarean section come mostly from the environment — particularly bacteria from inaccessible or less-scrubbed areas like lamps and walls, and skin cells from everyone else in the delivery room.

Photo

The transfer of the maternal microbiome occurs naturally after (a) a vaginal birth. After a (b) C-section, researchers transferred the neonatal microbiome from the mothers with a (c) gauze treatment.CreditKim Caesar/Nature Publishing Group

That difference, some experts believe, could influence a child’s lifelong health. Now, in the first study of its kind, researchers on Monday confirmed that a mother’s beneficial microbes can be transferred, at least partially, from her vagina to her baby after a C-section.

The small proof-of-principle study suggests a new way to inoculate babies, said Dr. Maria Gloria Dominguez-Bello, an associate professor of medicine at New York University and lead author of the report, published on Monday in Nature Medicine.

“The study is extremely important,” said Dr. Jack Gilbert, a microbial ecologist at Argonne National Laboratory who did not take part in the work. “Just understanding that it’s possible is exciting.”

But it will take further studies following C-section babies for many years to know to what degree, if any, the method protects them from immune and metabolic problems, he said.

Some epidemiological studies have suggested that C-section babies may have an elevated risk for developing immune and metabolic disorders, including Type 1 diabetes, allergies, asthma and obesity.

Scientists have theorized that these children may be missing key bacteria known to play a large role in shaping the immune system from the moment of birth onward. To replace these microbes, some parents have turned to a novel procedure called vaginal microbial transfer.

A mother’s vaginal fluids — loaded with one such essential bacterium, lactobacillus, that helps digest human milk — are collected before surgery and swabbed all over the infant a minute or two after birth.

An infant’s first exposure to microbes may educate the early immune system to recognize friend from foe, Dr. Dominguez-Bello said.

Friendly bacteria, like lactobacilli, are tolerated as being like oneself. Those from hospital ventilation vents or the like may be perceived as enemies and be attacked.

These early microbial interactions may help set up an immune system that recognizes “self” from “non-self” for the rest of a person’s life, Dr. Dominguez-Bello said.

In the United States, about one in three babies are delivered by C-section, a rate that has risen dramatically in recent decades. Some hospitals perform the surgery on nearly seven in ten women delivering babies.

An ideal C-section rate for low-risk births should be no more than 15 percent, according to the World Health Organization.

Dr. Dominguez-Bello’s study involved 18 babies born at the University of Puerto Rico hospital in San Juan, where she recently worked. Seven were born vaginally and 11 by elective C-section. Of the latter, four were swabbed with the mother’s vaginal microbes and seven were not.

Microbes were collected on a folded sterile piece of gauze that was dipped in a saline solution and inserted into each mother’s vagina for one hour before surgery. As the operations began, the gauze was pulled out and placed in a sterile collector.

One to two minutes after the babies were delivered and put under a neonatal lamp, researchers swabbed each infant’s lips, face, chest, arms, legs, back, genitals and anal region with the damp gauze. The procedure took 15 seconds.

Dr. Dominguez-Bello and her colleagues then tracked the composition of microbes by taking more than 1,500 oral, skin and anal samples from the newborns, as well as vaginal samples from the mothers, over the first month after birth.

For the first few days, ambient skin bacteria from the delivery room predominated in the mouths and on the skin of C-section babies who were not swabbed, Dr. Dominguez-Bello said.

But in terms of their bacterial colonies, the infants swabbed with the microbes closely resembled vaginally delivered babies, she found, especially in the first week of life. They were all covered with lactobacilli.

Gut bacteria in both C-section groups, however, were less abundant than that found in the vaginally delivered babies.

Anal samples from the swabbed group, oddly, contained the highest abundance of bacteria usually found in the mouth.

The results show the complexity of labor, said Dr. Alexander Khoruts, a microbial expert and associate professor of medicine at the University of Minnesota. “It cannot be simplified to a neat, effortless passage of the infant through the birth canal,” he said.

As the month progressed, the oral and skin microbes of all infants began to resemble normal adult patterns, Dr. Dominguez-Bello said. But fecal bacteria did not, probably because of breast or formula feeding and the absence of solid foods.

The transfer fell short of full vaginal birth-like colonization for two reasons, Dr. Dominguez-Bello said. Compared to infants who spent time squeezed inside the birth canal, those who were swabbed got less exposure to their mother’s microbes.

And all infants delivered by C-section were exposed to antibiotics, which also may have reduced the number and variety of bacteria colonizing them.

A larger study of vaginal microbial transfer is underway at N.Y.U., Dr. Dominguez-Bello said. Eighty-four mothers have participated so far.

Infants delivered both by C-section and vaginally will be followed for one year to look for differences in the treated and untreated groups and to look for complications. Thus far the swabbing has proved entirely safe.

The procedure is not yet recommended by professional medical societies, said Dr. Sara Brubaker, a specialist in maternal and fetal medicine at N.Y.U. Until more is known, physicians are hesitant to participate.

“But it has hit the lay press,” she said. “Patients come in and ask for it. They are doing it themselves.”

Dr. Brubaker is one of them. When her daughter was born three and a half months ago, she arranged to have her baby swabbed.

Zika virus: Study supports link to microcephaly

In what experts describe as another piece of evidence linking Zika with the risk of birth defects, researchers on Wednesday reported finding the virus in the amniotic fluid of two pregnant women whose foetuses were diagnosed with microcephaly.

 

In a study in the Lancet Infectious Diseases journal, the scientists said their finding suggests Zika virus can cross the placental barrier, but does not prove it causes microcephaly, a condition in which babies are born with abnormally small heads.

 

More research is needed to understand the link, they said.

 

"This study cannot determine whether the Zika virus identified in these two cases was the cause of microcephaly in the babies," said Ana de Filippis, the doctor who led the study at the Oswaldo Cruz Institute in Rio de Janeiro, Brazil.

 

"Until we understand the biological mechanism linking Zika virus to microcephaly, we cannot be certain that one causes the other."

 

Many scientists believe Zika, a mosquito-borne disease that is currently sweeping through the Americas, may be a risk factor for microcephaly in newborns, as well as for a serious neurological disorder in adults called Guillain-Barre syndrome.

 

The World Health Organization has declared the Zika epidemic spreading from Brazil a global public health emergency and called for urgent studies to establish with its association with rising number of cases of suspected birth defects can be proven.

 

De Filippis' study noted that the number of suspected cases of babies with microcephaly in Brazil in 2015 has increased twenty-fold compared with previous years. At the same time, Brazil is reporting high numbers of Zika virus infections.

Babies born with microcephaly are at risk of incomplete brain development.

 

The condition has previously been linked to a range of factors including genetic disorders, drug or chemical intoxication, maternal malnutrition and infections with viruses or bacteria that can cross the placental barrier such as herpes, HIV, or other mosquito-borne viruses such as chikungunya.

 

For this study, de Filippis' team investigated the cases of two women, aged 27 and 35, from Paraiba in northeastern Brazil.

The women had symptoms of Zika infection - including fever, muscle pain and a rash - during their first trimester of pregnancy. Ultrasounds taken at approximately 22 weeks of pregnancy confirmed the foetuses had microcephaly.

 

The researchers took and analysed samples of amniotic fluid at 28 weeks of pregnancy. While the women's blood and urine samples tested negative for Zika, their amniotic fluid tested positive for the virus genome and for Zika antibodies.

"Details of the Zika virus being identified directly in the amniotic fluid of a woman during her pregnancy suggest ... the virus could cross the placental barrier and potentially infect the foetus," de Filippis wrote.

Jimmy Whitworth, a Zika expert and professor of international public health at the London School of Hygiene & Tropical Medicine, said the findings "strengthen the body of evidence" pointing to Zika as a cause of microcephaly in Brazil.

 

But he noted that while studies of this sort can show associations, they can't show direct causation.