Monday, October 31, 2011

Happy Halloween!

Boo! We hope all of you have a happy and safe Halloween! We'll be back with a new post on Friday.

Friday, October 28, 2011

Swaddling Safely: Reducing Risk for Hip Dysplasia

By Jennifer Goldbronn, MAS, RD

Swaddling can be an effective tool for helping newborns to rest because they have so little control over their sometimes flailing arms and legs. However, a possible adverse effect of swaddling that has gained attention recently (though it has been known for centuries) is the increased risk for the development of hip dysplasia related to swaddling with the baby's hips and legs extended. Today we’ll explain what hip dysplasia is and how it is related to swaddling, and share tips for hip-healthy swaddling.

What is Hip Dysplasia?

Hip dysplasia is simply looseness or instability of the hip joint, which in its severe form results in hip dislocation. About 1 in 20 infants are born with some hip instability, though most (about 90%) are mild and resolve over time with normal development. Tight swaddling of the legs, however, is one factor that can interfere with the hips developing normally.

How are Hip Dysplasia and Swaddling Related?

Young babies’ hip and knee joints naturally flex into the fetal position (curled with legs and arms pulled toward the body) from their time spent developing in the womb. After birth, normal development of these joints will allow their legs to straighten over time. However, when a baby’s legs are not free to bend and flex, there is an increased risk of abnormal development of the hips. This is where tight swaddling of the legs can impact hip health. A 2007 review showed that the incidence of hip dysplasia is highly associated with “traditional” swaddling techniques that force extension of the hip and knee. (van Sleuwen 2007) Studies show that cultures using cradleboards, which force the hips and knees into full extension, have higher incidences of hip dysplasia.

Recommendations for “Hip-Healthy Swaddling”

Here are a few tips for swaddling that promote healthy joint development (based on American Academy of Pediatrics (AAP) and The International Hip Dysplasia Institute (IHDI) recommendations). When swaddling your baby:

• Do not straighten your baby's legs or bring them close together

• Make sure the blanket is loose around your baby’s hips and legs; your baby’s legs should be able to bend up (flex knees) and out

• Always make sure your baby is placed on his back to sleep and that there are no loose blankets near him

Keep in mind that other parents and caregivers who swaddle their young infants may not have information about safe swaddling techniques. Please pass this on! For more information about healthy swaddling and hip dysplasia explore the resources below.

References and Resources

The International Hip Dysplasia Institute Web site:,

The American Academy of Orthopaedic Surgeons Web site:

Van Sleuwen BE, Engelberts AC, Boere-Boonekamp MM, Kuis W, Schulpen TWJ, L'Hoir MP. Swaddling: A Systematic Review. Pediatrics. 2007;120: e1097-e1106.

Tuesday, October 25, 2011

Reader Question: Starting Daycare with a Sensitive Baby

Recently, a reader asked us a question about her 3-month-old daughter. She was worried about starting daycare because the baby didn’t like people other than her parents to hold her. Our reader also was worried that her baby would be afraid because she was too young to understand that her mother was coming back at the end of the day. In this post, we'll review some of the ideas we've shared in the past about sensitive babies, separation, and how babies learn what is safe and what is not.

Sensitive Babies and Daycare

All of us have felt the pull of wanting to be with our babies when we are at work. We know how hard it is to leave babies with other caregivers however much we love and trust those caregivers. But, we also know that babies are born with a desire to learn and socialize with many people, not only their parents. Because your baby cries routinely when held by others, your baby may be quite sensitive to differences in how she is held and to overstimulation. Because your baby is so young, it is unlikely that separation anxiety is happening yet. We’ve provided tips for helping babies deal with separation in an earlier post.

As your baby gets older, she will have more tolerance for being with others, especially those who are familiar to her. Visiting the day care with the baby before the baby starts may be an option to help the baby be more familiar with the surroundings. While your baby might be fussy when you drop her off at daycare, she is likely to settle down quickly and be very excited when you return. Sometimes, she might also let you know that she was not happy that you left (but just for a short time). It will get easier once the routine is established.

Your Baby is Watching You

An important thing to consider is how you feel about your baby’s caregiver. It is important that you find someone that you trust so that you are confident that your baby will be happy with her new caregiver. Remember our posts about “social referencing?” Your baby will look at your face to see if people are “safe” or not. Having a happy, confident look when dropping your baby off, even if your baby becomes a little upset can be an important way to help your baby adjust to daycare and feel safe. Your understanding smile will let your baby know that while she is upset right now, you know she’s about to have a great day.

Friday, October 21, 2011

Baby Behavior in the News: Mother and Crying Baby Asked to Leave Bus

A few days ago, this headline caught my attention: Oregon bus driver accused of berating mom, crying baby. Although the details are unclear and the investigation is still in process, news articles in papers across the country have covered the event that happened a few weeks ago in Portland, Oregon. Apparently, the bus driver pulled over after a baby had been crying for quite some time, despite the mother’s attempts to keep her baby calm. The driver walked back to speak with the mom; meanwhile other passengers urged the bus driver to keep going, saying that the baby was not bothering them. After the conversation with the driver, the mother took her baby off of the bus even though it was dark and she had not reached her destination. Although the exact sequence of events is still being determined, video footage shows that, over the next several minutes most of the passengers left the bus to stand with the mother and baby. For more information about the incident, you can refer one of the articles referenced below.

If you’ve read our blog posts in the past, you know that babies cry as a way to communicate their needs. We don’t know why this baby was crying, but it’s likely that the baby could have been tired (it was nighttime) and/or overstimulated from the environment, among other things. When babies cry, it’s hard for all adults to hear, but it’s important to remember that there is a reason that crying sounds terrible - it makes adults act to meet the baby’s needs. Other passengers reported that the mother had been “cradling and cooing” the baby a long time; a perfect example of using repetition to soothe.

We want to note that, after the incident, the bus company noted that their rules prohibit “vulnerable riders from being abandoned” and the driver has been put on leave until the investigation is complete. Also, the mother has not been identified and has not provided her side of the story. Regardless of the exact details, this is a clear indication of the need for increased understanding about normal infant behavior, not only among parents but in our society as a whole. (This is something we’ll keep in mind for future posts!)

What would you have done if you were this mother or another passenger on the bus with her? Have you ever been in a situation with a crying baby where you felt discriminated against? If you’d like to share a story with us, send us a comment.


Tuesday, October 18, 2011

Baby-Wearing Hula: Movement with your Baby

Picture this: a circle of women, babies worn in various types of slings or carriers on their mothers’ chests, all swaying to the beat of a Hawaiian tune. What am I describing? Baby-wearing hula!

I was fortunate enough to travel to Hawaii to teach baby behavior to staff of the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) in Hawaii. As my flight took off, I was flipping through the pages of the in-flight magazine and came across an article about baby-wearing hula, a weekly mother-baby class offered at a small hula studio, in the very town I was visiting. In a past post we talked about the benefits of baby-wearing, noting the benefits and risks of using baby slings and reporting on studies showing that wearing your baby improves infant attachment and reduces crying.

Baby-wearing hula is a great example of combining exercise, bonding, soothing and baby-wearing. What I found most interesting about the description of the class was that the instructor was not focused on how many calories the mothers would burn, like so many other fitness classes, but on the babies themselves. The class allowed the babies to direct how much and how fast the class would go. Sounds to me like they are probably paying attention to some baby cues! Slow dancing with your baby is also a great example of repetition to soothe .

There are other mother-baby (or daddy-baby!) classes that may be offered in your area that would have similar effects. Mother-baby yoga classes are quite popular and beneficial to both parent and baby. There are even some exercise videos out there that are made especially for baby-wearing parents. When my daughter was a baby I used to do a really fun baby-wearing video with Latin dance moves. My daughter loved the music and moving with the rhythm.

Multitasking moms will also appreciate that you can combine bonding time with healthy movement. We encourage you to watch your baby’s cues to see when he or she is getting tired or over stimulated in the new environment. Taking a short break may help. You can always return to the activity once your baby is ready to engage again. Experiment with the direction your baby faces and see what he likes best. If he gets tired, you may want to face him in toward your body to minimize his stimulation. Read steps to help prevent overstimulation here. If he shows engagement cues, wanting to interact and play, face him outward to engage with other babies in the room. For more information about how babies use cues to communicate their needs, click here.

How do you incorporate movement into your life with your baby in tow? We would love to hear your ideas.

Friday, October 14, 2011

Babies' Firsts: How babies learn to crawl

In a previous post, we asked our readers to share stories about when and how their babies learned to crawl. Several readers responded and the comments provided an excellent example of the most important information about crawling – all babies are different and there isn’t a set age or way that all babies learn to crawl. When someone describes a baby who is crawling, most people imagine a baby on her hands and knees, but some babies never crawl this way. In fact, some babies never crawl at all and are content to roll or scoot around until they learn to walk.  Our readers’ children learned to crawl at all different ages, ranging from 6 to 12 months and each had their own way of moving that worked for them. For example, one of our readers explained that because they have hardwood floors in her house, her baby moved backwards first and even after she learned to crawl on her hands and knees, it was easier for her to army crawl.

Today, we’ll describe the different types of movements that can be considered crawling.  As you are reading, keep in mind that babies don’t necessarily use each of these types of movement to get around and that the ages provided are just averages. If you have concerns about your baby’s physical development, contact your pediatrician.

Pivoting is just what it sounds like – turning the body with the tummy on the ground. When pivoting, a baby will have her head up and her legs stretched out and she’ll use her arms and legs to pivot while curling her body. Some babies begin pivoting around 4 months of age and 50% and 90% master this ability by 6 and 8 months, respectively.

Four-Point Kneeling
Four-Point Kneeling is when a baby is able to support her weight on her hands and knees. While this is more of a stationary ability that needs to be mastered before learning to crawl on the hands and knees, babies in this position may rock back and forth and  even fall forward if they rock with enough momentum.  Fifty percent of babies can hold themselves up in this position by 7 months and 90% by 9 months. Although they may be unsteady at first, within about a month they become much more stable.  

Reciprocal crawling
In our house we call it the army crawl, moving forward by putting weight on one arm and the opposite leg and then switching to the other arm and leg, but not lifting the entire body up off the floor. Fifty percent are able to crawl this way at 7.5 months and 90% are able to by about 9 months.

Reciprocal Creeping
Reciprocal creeping is what most people consider crawling; the baby’s weight will be on hand and opposite knee and she’ll move by shifting weight from one hand and leg to the others. Fifty and 90% are able to crawl this way by 8.5 and 11 months, respectively.

Just like our readers, our children all had their own ways to move. Jen G’s daughter, Lily, mastered crawling on her hands and knees at 8 months, and Olivia, Jen B’s oldest daughter, army-crawled until 12 months. Charlotte (Jen B’s youngest daughter) started crawling army-style at 5.5 months, was up on her hands and knees one week later, and has recently (at 10 months of age) began moving around on her hands and feet. No matter how your baby learns to get around, one thing is for sure, once they start moving, it’s hard to keep them still!

Reference:  Piper M, Darrah J. Motor Assessment of the Developing Infant. Philadelphia PA:W.B. Saunders Company 1994.

Tuesday, October 11, 2011

Your Baby's Senses: The Magic of Touch

In prior posts in this series, we've talked about your baby's senses - taste, hearing, sight, and smell. Last but certainly not least, we'll turn to a sense that has a powerful influence on your baby's behavior, touch.

The sense of touch (the somaesthetic system) is the earliest to develop of all the sensory systems in the body. While the skin's sensitivity to touch, pressure, temperature, or pain is only part of the somaesthetic system, it is the part that most people think of when they hear the word "touch." From the first moments after birth, our instincts tell us to gently touch our babies, often starting with just a light stroke along their tiny arms or legs with our fingertips. We seem instinctively to understand that our touch plays a powerful role in our babies' lives. And so it does. The research into babies' somaesthetic system is filled with some older animal studies, dark circumstances in orphanages, and more recent and ongoing work. The findings are clear, a caregivers' touch is important for babies' growth and development.

Touch As A Basic Need
In the 1950s, a psychologist named Harry Harlow conducted a very dramatic (and likely unethical by today's standards) experiment with baby rhesus monkeys. He took the baby monkeys away from their mothers and put them into cages with 2 fake "mother monkeys" made of wire mesh, one bare and the other covered with terry cloth. The wire mother monkeys each had a bottle pushed through the wire so that the baby monkeys could feed. At the time, scientists thought that babies bonded with their mothers solely because mothers were a source of food. It was a surprise when all of the monkeys spent as little time near the bare wire monkey as possible and all their time clinging to the terry cloth covered mother monkey. Harlow revolutionized child care at the time, concluding that babies needed more than something to eat, they also need soft familiar touch. Tragically, human babies who have been removed from conditions of neglect (like in overcrowded and understaffed orphanages) struggle to function, socialize, and communicate. While the lack of touch is not the only reason for these children's problems, it is considered by developmental scientists and as a powerful contibutor.

Touch Plays a Role in Communication
Touch has been shown to be a way that caregivers and babies communicate. When mothers use touch as part of games that they play with their babies (like tickling their tummys or gently touching their noses), they are rewarded with bigger smiles and more playtime.Most parents understand that a light tickling touch or a firm stroke on baby's back communicate different messages. Using touch, parents can help babies stay alert and encourage their babies to explore their world. A restraining touch can also be used as a warning and to  prevent babies from hurting themselves.

Touch Can Help Calm Babies
When babies cry, adults instinctively want to hold and touch them gently. We somehow know that while we can reassure our babies with our words, touch plays a special role in helping babies feel safe and loved. Repetitive touch (like rubbing a baby's back) is a common part of parents' efforts to calm babies and babies who are touched spend less time being fussy. An interesting side effect - when parents calmly stroke their babies' backs, they tend to become more calm themselves.

The study of babies' sense of touch is relatively new. While the research into the need for touch goes back more than 50 years, today's researchers are learning the role that touch plays in the development of babies, physically, emotionally, and socially. Stay tuned and we'll talk more about touch in future posts.

1. Harlow HF. The nature of love. American Psychologist, 1958: 13: 673-685.
2. Provence S and Lipton RC. Infants in institutions. New York; International Universities Press, 1962.
3. Stack DM. Touch and physical contact during infancy: discovery the richness of the forgotten sense. In: Infant Development (2nd Ed), Wiley-Blackwell, 2010.

Friday, October 7, 2011

Our Growing Family

As most of you know, the "Secrets of Baby Behavior" is written by the staff of the UC Davis Human Lactation Center. We started this blog over 2 years ago because our research had taught us that many parents were missing important information that scientists had learned about babies' behavior. We hoped that creating a commercial-free research-based blog (written by moms) would provide an objective resource for parents amidst all of the conflicting messages floating in cyberspace. We're so glad that so many thousands of readers have joined us along the way.

Of course, we have continued our research and trainings. We've been working hard to support medical and public health professionals who want to share baby behavior messages with patients and clients. Recently, we realized that professionals could benefit from a blog targeted specifically for them. So, next Monday (October 10), we'll be launching a new blog called "Baby Behaviorist" at We'll still be posting here on the Secrets blog and this blog will stay focused on parents' interests and questions. But, we know that some of our Secrets readers are professionals - doctors, nurses, dietitians, lactation consultants, and public health staff. We encourage those readers (and interested parents too) to check out "Baby Behaviorist" next week!

Tuesday, October 4, 2011

Question for our Readers: Crawling

In our last Babies’ Firsts post, several readers shared stories about when their babies rolled over for the first time. This time, we want to hear about crawling! While rolling over is typically (but not always) the first form of mobility, having a baby who can crawl is a whole new experience. So, think back (or if you have a hard time remembering, like I do, check the baby book or baby blog) and send us a comment telling us:

  1. What type of pre-crawling movement did your baby begin with (army crawl, rocking, scooting etc)
  2. Was there anything peculiar or funny about how your baby crawled?
  3. How long did it take before he or she realized she could get anywhere and everywhere?

We can’t wait to read your comments and we’ll share our stories and some information about how babies learn to crawl!