Tuesday, December 25, 2012

Happy Holidays!

Happy Holidays to all of our Secrets readers. We're taking some time off to be with our families but we'll be back with new posts in 2013!

Wednesday, December 19, 2012

Tired of Looking Through our Blog for the Basics?

Several months ago, we were asked if we had a book that included (in one place) all of the most important baby behavior information that new parents need. Realizing that new parents don't have time to read a long book, we created a short E-book that includes all the basics and a special section on newborn behavior. No surprise, it's called The Secrets of Baby Behavior! The booklet costs less than $5 and any sales will go to support our work here at the center. Our blog is not changing and we look forward to answering your questions and sharing new studies with you into the new year and beyond.


To get more information (and even take a peek inside the book) search for Secrets of Baby Behavior on Amazon.com or click here

We'd like to thank all of our readers who've inspired the nearly 350 posts we've published over the last 3 1/2 years. 

Tuesday, December 11, 2012

Does "Back to Sleep" Delay Babies' Rolling Over?

By Jennifer Goldbronn, RD, MAS

The Back to Sleep Campaign, now known as the Safe to Sleep Campaign, educates parents about ways to decrease SIDS risk, including putting babies on their backs to sleep.

There has been some controversy in the past that this campaign has actually decreased the total time babies spend on their tummies not just during sleep but while they are awake.  There was some concern that less time on the tummy would delay some motor skills such as rolling over, sitting up or crawling. What followed was a campaign to promote “tummy time” during awake time.

Studies then followed looking at whether or not specific developmental milestones were delayed since inception of the Back to Sleep Campaign.

Some studies found slight delays but results were still within developmental norms.  Other studies showed that the age of rolling tummy to back was older and that babies were reversing which milestone they hit first, rolling back to front first instead of front to back. For information on the age at which babies roll over, click here.

Thus, a new study aimed to see if there really was a difference in the developmental milestone (rolling over) before the Back to Sleep Campaign compared to now, 20 years later. Current data were compared to the AIMS (Alberta Infant Motor Skills) data set, a measure of normal infant motor abilities, collected 20 years ago. The current data set used the same assessment guidelines and age ranges as the AIMS data set, and the proportion of infants passing each of four items (immature and mature front to back rolling and immature and mature back to front rolling) by 36 weeks of age was assessed.

What did they find? Infants in both groups achieved the milestone of rolling over at almost the same age. The order with which the infants reached the four milestones (passing each item) was the same in both the pre-campaign and post-campaign groups. The age at which 50% of infants could perform each milestone was also the same in both groups.

The results of this study show no significant effect of the Back to Sleep Campaign messaging on infants’ ability to reach the "rolling over" milestone. The authors of the current study will continue to assess the effects of the Back to Sleep Campaign on other motor skills such as crawling, sitting and walking. Stay tuned for the results!

For more information about making tummy time easier for your baby, click here.

We also clarified some common misconceptions about tummy time in this subsequent post.

Reference

Darrah J, Bartlett DJ. Infant rolling abilities- the same or different 20 years after the back to sleep campaign? Early Hum Dev. (2012) [Epub ahead of print]

Wednesday, December 5, 2012

We'll Be Back Next Week

We're finishing up a tricky and important project and its taken up all our brainpower! We'll be back with a new post next week.

Wednesday, November 28, 2012

Getting Ready for Holiday Travel

It's that time of year again! Families everywhere are packing suitcases  and heading out to highways or airports for holiday trips to see friends and family members. Some of you are uneasily making checklists and hoping that you haven't forgotten anything important for your baby's first big trip. Others have taken so many family trips that you have a special patented system for fitting 7 bags and the portable sleeper in a space where the uninitiated could only squeeze 2 suitcases and a diaper bag.

This time of the year, we traditionally share our tips for traveling with your infant and/or toddler. So here they are:
We wish you all safe and peaceful travels this holiday season.

Wednesday, November 21, 2012

Happy Thanksgiving - We're Taking a Rest

We're taking the week off to spend with our families. We hope that you are doing the same thing! Happy Thanksgiving!

Friday, November 16, 2012

Reader question: Marathon Running and Breast Milk Production


By Jennifer Goldbronn, MAS, RD

We recently received the following question from a reader: Could you post info on marathon training and how it impacts milk production? A mom says she has seen her pumping output cut in half since beginning her training.

To be honest, there is not a lot of evidence out there looking specifically at intense long-term exercise and its effects on breast milk production. However, a past post of ourslooked at a few related studies on the topic concluding that exercise doesnot affect breast milk production or infant growth. Below, we’ve provided a few more details of the studies reviewed in our past post and added a couple of other related references.

Intense Exercise

In a 1990 study, intense exercise (≥45 minutes per day, 5 days per week for at least the last 6 months prior to the study) did not affect milk volume or composition. Many women in this intervention were involved in competitive sports, one even training for a triathlon. Researchers found that study participants compensated for increased energy expenditure through exercise with increased food intake. Researchers also noted that while there was no increase in nursing frequency in this study, there could be in other situations where there was a large calorie deficit from exercise and/or dieting. The limitation of this study was the very small sample size (8 women in the exercise group and 8 in the no exercise group). This makes it difficult to draw conclusions based on this study alone. (Lovelady 1990)

Moderate Exercise

In a follow-up study, Lovelady (2000) found that moderate exercise (45 minutes per day for 4 days per week) combined with energy restriction (500 kcal per day) in healthy, previously inactive, breastfeeding mothers did not harm the growth of their infants.

One additional study (Dewey 1994) found no difference in both the volume and composition of breast milk or in the infants’ weight gain with moderate exercise (4-5 times per week for 45 min., beginning at 6-8 weeks postpartum and lasting for 12 weeks.) This study was also conducted with previously inactive women and had a small sample size with only 18 women in the exercise group and 14 in the no exercise group.

Short-term Diet or Exercise

Two other studies (Strode 1986, McCrory 1999) showed no change in milk volume with short-term energy restriction (by diet or exercise), but the studies were no longer than 7-11 days in length. Further research needs to be conducted to see if there are changes in milk volume after the first week.

Conclusions:

More research needs to be completed to truly show how long term intense exercise effects breast milk production. We can only infer from the above studies that moderate exercise does not negatively affect breast milk production or infant growth. As mentioned in the previous post, separation of a mother from a young breastfeeding baby may effect milk production if feeding on-demand is interrupted. Also, if the mother was feeding on-demand and begins to pump to allow for longer workout sessions, breast milk production may be negatively affected because the breast pump is not as effective as the baby at removing milk. If less milk is removed, then less milk is produced by the mother’s body.

References

Strode MA, Dewey KG, Lonnerdal B. Effects of short-term caloric restriction on lactational performance of well-nourished women. Acta Paediatr Scand 1986;75:222-9.

McCrory MA, Nommsen-Rivers LA, Mole PA, Lonnerdal B, Dewey KG. Randomized trial of the short-term effects of dieting compared with dieting plus aerobic exercise on lactation performance. Am J Clin Nutr 1999;69:959-67.

Lovelady CA, Lonnerdal B, Dewey KG. Lactation performance of exercising women.Am J Clin Nutr. 1990 Jul;52(1):103-9.

Lovelady CA, Garner KE, Moreno KL, Williams JP. The effect of weight loss in overweight, lactating women on the growth of their infants. N Engl J Med. 2000 Feb 17;342(7):449-53.

Dewey KG, Lovelady CA, Nommsen-Rivers LA, McCrory MA, Lönnerdal B. A randomized study of the effects of aerobic exercise by lactating women on breast-milk volume and composition. N Engl J Med. 1994 Feb 17;330(7):449-53.

Wednesday, November 7, 2012

Babies' Firsts: When babies learn to sit up


A few weeks ago, as part of our Babies’ Firsts series, we asked our readers to answer these questions:
  • How old was your baby when he or she was first able to sit up on his or her own?
  • How did playtime change once your baby could sit up? 

We’ve gotten several comments from readers, so first we’d like to thank everyone who responded. Each of their babies started sitting up on their own right around 6 months! Not surprisingly, playtime didn’t change much for these babies because they had been sitting up with help, but they were able to play more independently and were showing more interest in toys than they had in the past!

Today, we would like to share what developmental research says about the ages babies tend to learn to sit up. As always, remember that all babies are different and they develop at their own pace. We will provide ranges, but if your baby does not fall in the range, don’t be alarmed. If you are unsure about your baby’s developmental progress, talk to your pediatrician!

Sitting with Support
More than 90% of babies are able to sit up while being held (at the chest/waist) by a caregiver by about 1 month old. In the beginning, the neck muscles are not developed enough to keep the babies’ heads from bobbing around while held in the sitting position, but within the first few months, their necks get stronger and they are better able to control their heads while being held in a sitting position.

Sitting with Propped Arms or Arm Support
Before being able to sit fully upright on their own, many babies can sit while using their arms to support their weight. According to the research, 50% of babies can sit this way by 2.5 to 3 months of age and 90% can sit this way by 4.5 months. This type of sitting shows off babies’ flexibility because they often look like they are folded right in half when sitting this way! Between 4.5 and 6.5 months, their arms get stronger and they are able to sit up higher with their arms closer to their bodies.

Sitting without Arm Support
The age range for the ability to sit without any arm support is much wider. Between 4.5 and 6 months, babies usually begin sitting without their hands or arms on the ground, but as you can imagine, they aren’t able to sit fully upright right away and need to be closely watched to make sure they don’t fall and hurt themselves. As they gain strength, they are able to straighten up more easily, and by 8 months more than 90% can sit up well enough to be left alone in a sitting position.  

Sitting and Moving Around
Once a baby has mastered sitting independently, he or she won’t  sit still for long. Fifty percent of babies can twist and rotate around to reach for things by 7 months and 90% can do this by 8.5 months.  Between 8 and 12 months, they start moving from sitting to lying on their tummies (50% around 8 months and 90% around 12 months), which is an important step to prepare for crawling!

Safety is key!
So, no matter when your baby starts sitting up independently, the most important thing is to keep them safe.  Even when they have been sitting for a while and seem to have mastered the skill, be cautious when sitting them down. Never leave your baby alone on a couch, chair, or bed and keep the floor around your baby clear when he’s playing. For more information on baby proofing, you can review some of our previous posts (click here).

Tuesday, October 30, 2012

Wow! More Than One Million!

A big thanks to all of our loyal readers for spreading the word! Not only did we cross the mark of more than one million pageviews (1,016,500 as of today), we've had more than 115,000 hits in October alone! We've come a long, long way since we started in June of 2009.

We encourage all of our new readers to start with the basics before moving on to other topics. You may want to begin with our overviews on your baby's cues, crying, and sleep patterns.
Everything else we've posted is available to you and there are a few ways you can find what you are looking for.
  • On the left side, in the section titled Blog Archive, you can find links to every blog we've posted (the titles of each blog are listed with the most recent at the top).
  • If you have a specific topic you are interested in, you can use the keyword links, in the Labels section, to find related entries.
  • If you just want to browse full entries, you can use the older posts link at the bottom right of the page. This link will take you through the posts, beginning with the most recent.
We hope that you find the information we've provided useful. If you don't find what you are looking for or if you have any questions, please send us a comment. We love to answer our readers' questions and are always accepting new ideas for future posts!

Tuesday, October 23, 2012

Babies' Firsts: Sitting Up


Last year, we started a series of 2-part posts we called “Babies’ Firsts.” In the first part, we ask our readers to answer a few questions about the first time their babies did something exciting. Then, in the second part, we explained when and how babies tend to achieve the highlighted milestone.

So far, we've covered smiling, crawling, and rolling over, but it’s been quite a while since we've posted a new topic.

Today, we’d like to continue the series by asking you these questions:

  • How old was your baby when he or she was first able to sit up on his or her own?
  • How did playtime change once your baby could sit up? 

Send us a comment with your answers and watch for part 2, where we’ll share more information about how babies learn to sit up!

Wednesday, October 17, 2012

What the Recent Research on "Cry it Out" Doesn't Tell Us

A few weeks ago, the news was full of stories about a long-term follow-up study that was used to see if a sleep intervention, started when infants were about 8 months old, had long term-effects (positive or negative) on babies, moms, or their relationship with each other. The authors' conclusion was a simple one; there was no long term effect on any of their measures. Hardly earth shattering stuff. But in this case, the lack of an effect was big news. In the original study (published in 2007), the authors reported that mothers in the intervention group reported fewer infant sleep problems and had better scores on a common depression scale (used at 10 and 12 months postpartum). Given that their study found no evidence of harm to the child 5 years later, the authors and the press concluded that "cry it out" methods of sleep training were safe and beneficial for parents who want to use them to get more sleep.

Our loyal readers already understand our bias. We don't like sleep training and we have certainly heard from those of you who do! Ok, so you're thinking who is right here? Which point of view does this research support? Unfortunately, neither. In this post, we'll take a closer look at this work and discuss what it does and doesn't tell us.

The Original Intervention

Maternal child health nurses in Melbourne, Australia were trained by the authors to provide sleep management support for mothers who reported sleep problems in their 7-month-old infants. Mothers were randomized (based on which clinic they attended) when their babies were 8-months-old into an intervention group that received the sleep management support or a control group that received standard care. The sleep management support included an assessment of the mothers concerns and an individualized sleep plan (education, handouts, and a choice of behavioral methods including "controlled crying" or "camping out"). Using "controlled crying" meant that babies were put in their cribs and allowed to cry until they fell asleep but parents were encouraged to go in periodically and console their babies, gradually increasing the intervals in between visits. Using "camping out," meant that the parents sat with the baby until the baby fell asleep but gradually reduced the time in the room over 3 weeks. Of the 174 families in the intervention group, 60 or about 34% chose to use one of these "cry it out" methods. At 10 and 12 months, the mothers were asked to answer a questionnaire about their babies' sleep and to fill out a screening tool used to identify depression.

Moms in the intervention group were less likely than moms in the control group to report that their babies had sleep problems at 10 and 12 months and they had better scores on the depression screening questionnaire (meaning they were at lower risk for depression). Follow up studies at two years showed that those depression scores were still better in the intervention moms even though there were no longer differences in the perception of sleep problems in their toddlers. After 5 years, the authors found no effect (good or bad) of the intervention on any measure.

What Have We Learned?

Reporters picking up on the story reported that this research proved that cry-it-out methods were effective and safe for babies (because they had no effect 5 years later).  And many parents who had used one of these methods (and people who make their living sleep-training) were deeply relieved. But there is another perspective...while the cry-it-out methods were part of this intervention, the researchers were really testing the benefits of health nurses offering invidualized sleep plans for parents who perceived their 8-month-old babies were having sleep problems. Only about a third of the families used the cry-it-out methods but 93% of the moms reported that it was very helpful to have someone to talk to about their concerns. Because of the study design, the real finding is that health nurses' support was safe and beneficial to the families, at least in the short term. By the time the children were 5-years-old, there was no difference between groups. We need to keep in mind that the families had other options to choose from for their indidualized plans (including using routines) and they received education on what could be expected as normal. Because the authors used the mothers' perceptions of sleep problems rather than objective measures of infant sleep, the explanation of what was normal could have in itself influenced this measure and reduced the mothers' stress. These were important features of the intervention that didn't show up in the news.

So what does all this mean? In our view, this study confirms that families need support throughout the first year (and beyond) in dealing with the stressful parts of their babies' behavior. Importantly, it also shows that moms who are not supported may be more at more risk for depression. But, this study does not provide evidence one way or the other specifically about cry-it-out methods since there was no randomization of those methods to one group or the other. We know that this is a passionate issue for a lot of families. Whatever your feelings about sleep training, we hope that we've helped you better understand what this recent work does and does not teach us.

References: 

Hiscock H, Bayer J, et al. Improving infant sleep and maternal mental health: a cluster randomised trial. Arch Dis Child 2007; 92: 952-958.

Hiscock H, Bayer JK, et al. Long-term mother and child mental health effects of a population-based infant sleep intervention: cluster-randomized, controlled trial. Pediatrics 2008; 122: e621.

Price AMH, Wake M, et al. Five-year follow-up of harms and benefits of behavioral infant sleep intervention: randomized trial. Pediatrics 2012; 130: 643-651.

Wake M, Price A, et al. Does an intervention that improves infant sleep also improve overweight at age 6? Follow-up of a randomised trial. Arch Dis Child 2011; 96: 526-532.

Tuesday, October 9, 2012

An Unexpected Reaction: Clarifying what we mean by “tummy time”


A few weeks ago, we posted a response to a reader’s question about how to make tummy time easier for her baby. We provided a few suggestions and asked other readers to share things they found useful for making tummy time enjoyable. We got some great tips from readers, like laying baby tummy down on mom’s chest or lap, and holding or wearing baby in a sling. After seeing a few of the comments and emails from our readers, we were a little surprised to see what people think about tummy time. I was curious, so I scrolled through a few popular parenting websites and found that many more parents expressed the same perceptions. Today, we’d like to clear up some misconceptions about what we mean when we refer to “tummy time”

Perception: Tummy time needs to be scheduled into the day. This was probably the most common misconception I saw during my search. Maybe it is because the term “tummy time” implies that it should be done at a certain time of day or for a certain amount of time. Or maybe it’s because many of the sources of advice suggest spreading it out over the day and aiming to get in some tummy time each day.

Clarification: Regardless of the reason for the confusion, we’d like to assure you that we are not suggesting that you pencil tummy time into your calendar or to do list. The term “tummy time” was made popular during the Back-to-Sleep Campaign, a nation-wide effort to reduce deaths from Sudden Infant Death Syndrome by teaching parents to put babies down to sleep on their backs (click here for a previous post campaign). As a way to help parents remember to put their babies down on their tummies while awake (but not asleep), health care providers used the term “tummy time” and slogans like “back to sleep, tummy to play.” It is possible that some parents found that incorporating tummy time into a routine helped them remember, but there is no evidence that babies need to be put onto their tummies at the same time every day and we found no recommendations for the number of “tummy times” or total minutes babies absolutely need.

Perception:  The tummy time recommendation is the only physical activity recommendation. Several of our readers seemed to think that we were suggesting that tummy time was the only alternative to being in a car seat, bouncy chair, or stroller.

Clarification: Just like adults, babies need to move to be healthy (see one of our early posts, For Babies, A Little Playtime is a Great Workout).   After being confined to their mom’s bellies for so long, even just stretching is great exercise for your baby. Babies need a lot of time to stretch, not just on their tummies, but on their backs too. Car seats are great for car rides and strollers are great for walks, but having their arms and legs free to move and stretch, being able to turn and raise their heads, and wiggling and twisting their bodies is how they get stronger and prepare for more complex movement.  

Perception: Tummy time is not necessary if a baby is carried in a sling. Some of our readers mentioned that wearing your baby in a sling provides the same benefits as tummy time and therefore, “baby wearing” could replace tummy time all together.

Clarification: First, I’d like to mention that the similarity between tummy time and baby wearing was new to us, so we searched for studies to share with our readers. We didn’t find any research articles, so if you have any you’d like to share with us, we’d love to take a look and possibly write a future post on them.  There is no question that holding your baby, in a sling or just in your arms, is very important (click here and here for a 2-part series on slings). Having close contact is beneficial for mothers and babies. But, like we mentioned before, babies need to develop their muscles, and to do that, they need to be able to move around in a variety of different positions. While many slings allow some flexibility for the baby to move around, some do not, and when it comes to muscle development, free movement is key.   

Perception: Tummy time is only good for preventing the “flat head”

Clarification:  Studies show that tummy time has several benefits. It does help to prevent plagiocephaly, the technical term for “flat head syndrome,” but it also strengthens muscles in the jaw, neck, shoulders, chest, and arms.  Also, health professionals have observed an increase in motor development delays corresponding to a decrease in the amount of time babies spend on their tummies.

We’d like to thank everyone who emailed, commented, or posted on Facebook in response to our tummy time post. We hope the information above provides a clearer picture of what tummy time means and why it is important. We recognize that every baby (and family) is different but the bottom line is that babies need time and space to stretch, push, twist, and turn. No baby should be bundled up, buckled up, or on his back or on his tummy all the time. Just like adults, babies need a variety of movement to stay strong and healthy.  

References:



Friday, October 5, 2012

Reader Questions: What we can and cannot answer


Over the last few weeks, we have been getting more and more comments and emails from our readers. While we always encourage questions, feedback, and topic ideas, we want to take a few minutes to remind everyone about what kinds of information we can and cannot provide through this site.

We CAN:
  • Answer questions about general infant behavior and development (including sleep)
  • Provide evidence-based answers to questions about how babies communicate (like cues and crying)
  • Provide tips and resources for parents looking for support
We CANNOT:
  • Provide medical diagnoses
  • Provide one-on-one counseling for very specific feeding, sleep, or crying problems
  • Advertise other websites or products
We would like to help our readers in any way possible, but we feel it is important not to provide information that we are not qualified to give. We are not medical doctors, we are researchers. Also, there are many issues that require in-person consultation, which is not possible given that we have readers all over the world.

If you have a question and are unsure if it is something we can help with, please send us an email. If we can provide answers and support, we will. If it is something that we feel needs more personalized or medical attention, we will let you know. Whenever you are concerned about your baby's immediate help, call your medical provider.

Thank you for your continued support of our blog and, as always, we look forward to hearing your thoughts and questions!

Friday, September 28, 2012

New Around Here?

For those of you who are new to our blog, we'd like to welcome you! Since we began over 3 years ago, we've posted more than 335 entries to help families better understand their babies. We encourage all of our new readers to start with the basics before moving on to other topics. You may want to begin with our overviews on your baby's cues, crying, and sleep patterns.
 
Everything else we've posted is available to you and there are a few ways you can find what you are looking for.
  • On the left side, in the section titled Blog Archive, you can find links to every blog we've posted (the titles of each blog are listed with the most recent at the top).
  • If you have a specific topic you are interested in, you can use the keyword links, in the Labels section, to find related entries.
  • If you just want to browse full entries, you can use the older posts link at the bottom right of the page. This link will take you through the posts, beginning with the most recent.
We hope that you find the information we've provided useful. If you don't find what you are looking for or if you have any questions, please send us a comment. We love to answer our readers' questions and are always accepting new ideas for future posts!


Friday, September 21, 2012

Reader question: Help! My baby hates tummy time!


Over the years, we have mentioned the importance of “Tummy Time” several times (for a few examples, click here and here).  Tummy time is when your baby is put down on his or her stomach, while awake, and is important for muscle development (for information about tummy time from the AAP, click here).

Recently, we got an email from a reader with this question:

I need help! I know my baby needs to spend time on his tummy when he is awake, but he HATES it! Every time I put him down, he fusses and gets upset. What should I do?

As I have mentioned before, my youngest daughter Charlotte did not like tummy time much when she was little (to read more, click here). To answer this reader’s question, I put together this list of tips I learned with Charlotte:
  • Start slow. Limit tummy time to just a few minutes at a time to start. Even this short time is helpful for muscle development and you can increase the time gradually once your gets comfortable.
  • Get down to your baby’s level.  It is good to get down there and make sure there isn’t anything making the baby uncomfortable, like a scratchy rug or blanket, the sun shining in through the window, or a draft from the air conditioner.
  • Provide entertainment. The best entertainment for a young baby during tummy time is your face. As we mentioned in our post Mothers and Babies: Face to Face and Heart to Heart, your baby loves to look at your face, so get down there with him and let him look at you. You will be able to distract him from his new position and help him feel safe and secure with your nearby.  Siblings can be great entertainment too and older babies like to look at toys and even begin trying to reach for things as they get older!
  • Consider the timing. Before putting baby down, consider what has happened just before or what might happen soon. Did your baby just eat? Having a full tummy might be more uncomfortable. If he is tired or has been playing for a while, he might get frustrated faster.
  • Keep it calm and quiet.  Consider what is going on around him. Is there a lot of noise or movement nearby? It may be unsettling to sense things going on above when he is facing down.  Keeping it calm and quiet may make him a little more comfortable.
  • Be patient. Even if your baby doesn’t like it the first few times, keep with it. It is important for muscle development and it will come in handy when he learns to roll over (click here to read about how babies learn to roll over). By starting with short sessions several times a day, you will be able to respond to him quickly if he gets upset. He will get used to it over time and be rolling over before you know it!

We hope these tips help and we’d love to hear from readers whose babies seemed to dislike tummy time too! Send us your comments. 

Tuesday, September 18, 2012

Baby Behavior in the News: Infant Bather Recalled

By: Jennifer Goldbronn


With so many baby gadgets, toys, and accessories in our busy world, how do we make sure they are all safe? Today, we’ll share a recent recall you may have seen in the news and provide a few tips to help you stay up to date with the latest product safety information for your baby.


Recently, an infant bather was recalled due to fall and head injury risk. The bather brand is “Summer Infant” and the product was sold between September 2004 and November 2011. Seven injuries have been reported. For more information on which model numbers were recalled, please check the CPSC (Consumer Product Safety Commission) website at http://www.cpsc.gov/.

Safety tips
Obviously, this is not the only recall out there related to baby products. Just since the writing of this post many other products have been recalled. So how do you keep up with it all? Try the following tips:
  • Register the products that you buy so that the company can contact you if there is a recall. Many products come with registration cards and/or have online registration.
  • Sign up for regular emails about product recall and safety information from the CPSC at https://www.cpsc.gov/cpsclist.aspx.
  • Report unsafe products or incidents to the CPSC on their website.
  • When buying used products, check for safety recalls on the CPSC website before using with your baby.
  • Follow the use instructions and never use products in ways they were not intended.
  • Keep you baby close by. 


Other News Stories
Are you interested in other baby behavior “in the news” topics we’ve written? Check out the posts below.










Thursday, September 6, 2012

We're Getting Ready for School!

Fall quarter begins very soon at UC Davis. We're spending this week getting ready. We'll be back next week with a new post!

Thursday, August 30, 2012

Visiting a New Baby? 5 Tips to Do it Right

Are you planning a visit to a new baby in your life? While we are sure that the  new parents want to share their joy, visitors can sometimes be a source of stress. We know our readers don't want to be the kind of visitors who parents would rather avoid. So in this post, we share some tips to make your new-baby visit a more positive experience for everyone.

1.     Visit only when invited.

New babies are exciting for friends and family and everyone will want to rush in to see the new little bundle of joy. That means that exhausted, confused, and stressed new parents may be dealing with a parade of visitors even before they leave the hospital. Of course, they want you to see their baby as soon as possible but unless you've been specifically asked to come to the hospital, wait until the baby gets home. If you haven't heard from the happy mom or dad after a few days at home, connect with them in an unobtrusive way (isn't technology wonderful?) and ask when you might bring a meal or run an errand for them. If you don't hear back, don't be offended and don't drop in. Give it a few days and try again.

2.     Keep it brief.

New parents love to proudly show off their babies but they are not likely to be ready for long visits. Unless you're asked to help with the baby while the parents nap (and I hope you are), keep your visit to an hour or less. When you arrive, tell the parents you want them to rest and that you are staying only a short time. If you really want to help, several short visits spread over a few days are easier on parents than one long one. If you get a chance to hold the baby, remember that a little stimulation goes a long way with newborns. Watch for disengagement cues and do your best to make sure that the baby doesn't get overstimulated.

3.     Don’t bring a crowd. 

Hospital rooms are not designed for large groups, too many people in a hospital room can be tough on babies, moms, and medical staff. If the parents have asked you to visit in the hospital, plan to wait in the lobby so they can keep visitors to no more than 2 or 3 adults at once. Common sense should be used in deciding whether or not to bring children to the hospital. Give the parents some time between groups of visitors and make sure that you watch out for mom, dad, and baby so they don't get overtired. The baby's parents may think it is rude to ask visitors to leave, so it will be up to you to be sensitive to their needs. Once home, short visits that include the whole family may be fine but the bigger the group, the shorter the visit should be.

4.     Genuinely offer to help in specific concrete ways.

All new parents need help with everything from meals to dishes to laundry to mowing the lawn. If you show up and offer to help in a general way, it is likely that the parents will be too tired to figure out what you can do. If they are loyal readers, they would have organized all their helpers before the baby was born. But if not, you can make things much easier for them if you offer specific ways to help. So, don't ask "how can I help?" Say, "After I set the table for the food, I'd like to get those dishes done for you and then water the plants. Is that ok?"

5.     Don’t add more work. 

We've heard stories from parents who end up with 20 people in their living rooms two hours after they get home from the hospital. The TV gets turned on and everyone settles in for a game. New moms and dads or their closest supporters end up getting snacks and drinks for everyone. This is an extreme example but it is easy for parents to get into "host" mode and offer to entertain their guests. Don't let this happen to your loved ones. New parents need support, not more work. Don't bring food that requires complicated preparation or lots of dishes to serve, don't bring the baby gifts that require complicated set up or clean up, and don't assume that the new family wants to host a party.

We hope that these tips help you become the most welcome visitor to the new baby in your life. If you are, you'll know by the look of relief that you see on the faces of the new parents when you arrive.

Tuesday, August 28, 2012

Is safe infant sleep information accurate on the internet?


By Jennifer Goldbronn

With 59% of the population using the internet to search for health information it’s important that accurate information is available. A recently published study evaluated the accuracy of safe infant sleep information on the Web. The researchers wanted to see if a particular set of search terms led to accurate information defined as consistent with the AAP safe sleep recommendations.  A total of 1300 Web sites were reviewed using 13 key search terms about safe infant sleep.  (Chung 2012)

What did they find?
Results showed that less than half (43.5%) of the Web sites provided accurate information, 28.1% provided inaccurate information, and 28.4% were not relevant. Accuracy was the highest among government Web sites and organizational Web sites (Web sites ending in “.org”). About 80% of governmental Web sites were accurate and nearly half of all educational websites (those ending in “.edu”) were categorized as accurate. Web sites with the least accurate information were retail product review Web sites, blogs, and individual Web sites. These sites often promoted products not endorsed by the AAP.

The right information
When you’re looking for sound information on the Web, the key is to consider the source:  
  • When possible use government and organization Web sites.
  • Look for the Web site’s sources. Do they provide references or indicate where the information came from? Is it a source you trust? 
  • Check to see when the site was last updated. Is it recent information?
  • Discuss your questions/concerns with a healthcare professional, such as your baby’s pediatrician.
  • As always, be skeptical. There is a lot of advice out there and you should never do anything that makes you feel uncomfortable. 


We will always try to bring you the latest information about infant sleep! For links to past posts about safe infant sleep, click here.

To view the full AAP report: SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment, click here.
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf+html

Other trustworthy Web sites noted in this article include:

References
Chung M, Oden RP, Joyner BL, Sims A, Moon RY. Safe Infant Sleep Recommendations on the Internet: Let's Google It. J Pediatr. 2012 Aug 3. [Epub ahead of print]

The full AAP report: SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment, click here.
http://pediatrics.aappublications.org/content/early/2011/10/12/peds.2011-2284.full.pdf+html

Friday, August 24, 2012

In the News: Antibiotic Exposure and Obesity Risk


Over the last few days, you may have seen or heard headlines like Could Antibiotics Be A Factor In Childhood Obesity?  and Antibiotics Too Soon May Set Babies Up for Obesity. These headlines are referring to research findings published this week in the International Journal of Obesity. (Trasande 2012) In today’s post, we’ll breakdown the study results and explain what it means for you and your baby.

Study Details
The data in this report were part of the ALSPAC study, a large, long-term health study in the United Kingdom. In the early 1990’s, more than 14,000 pregnant women were recruited and since then, the researchers have been monitoring their children’s health and development. For this report on the relationship between antibiotic use and weight status, the researchers used data from 11,532 children, excluding children who were under 5.5lbs at birth and those without antibiotic exposure data.

The researchers were interested at examining how exposure to antibiotics during 3 different age ranges (0-6 months, 6-14 months, and 15-23 months) was related to body mass over the first 7 years of life. They asked the parents of the children about antibiotic exposure in surveys that were mailed to their homes. To determine the children’s weights, the researchers used weight-for-length measurements at at approximately 2, 10, and 20 months of age and Body Mass Index (BMI) at 38 months and 7 years of age. They also considered other factors that could influence weight status and factored those into their analysis to help highlight the relationship between the antibiotic exposure and weight status.
Study Results
Here is a list of the major study findings:
  • About 32% of the children received antibiotics before 6 months of age, increasing to almost 75% by 23 months of age.
  • Children who were never breastfed or had mothers who smoked during the first trimester of pregnancy were more likely to be exposed to antibiotics before 2 years of age.
  • After accounting for other risk factors, children exposed to antibiotics before 6 months of age were 22% more likely to be overweight at 38 months.
  • No consistent association was shown between overweight and antibiotic exposure from 6-14 or 15-23 months.
How does exposure increase risk of obesity?
Although this study was able to show a relationship between early antibiotic exposure and risk of obesity in a very large group of children, this is one of the first studies to look at this relationship, so more studies are needed to confirm the findings. Furthermore, the study was not set-up to determine why the association exists, so it is not possible to explain how exposure to antibiotics increases obesity risk. Using what is known about how the digestive tract develops and data from studies of antibiotic exposure in farm animals, the authors suggest that it is possible that the antibiotics change how the young infants’ intestines develop, but more research is needed to determine how and why this relationship occurs.

What does this mean for you and your baby?
While the study findings suggest that babies who are given antibiotics before 6 months have higher risk for overweight, the increased risk is relatively small and the connection between antibiotic exposure and overweight is inconsistent. If other studies confirm this finding, this would mean that early exposure to antibiotics might be a factor (among other factors) contributing to the increases in childhood obesity over the last decade. Since the researchers could not identify why antibiotic use was related to childhood obesity, they don't know if other important things (like why or how long the antibiotics were given) might make a difference. Antibiotics used to be given to babies more often than they are today and your doctor may not think your baby needs them for common illnesses. If your doctor does recommend antibiotics for your baby, take time to discuss your concerns so you can make a decision together that you feel comfortable with.

Reference: 
Trasande L. et al. Infant Antibiotic Exposure and Early-Life Body Mass. Int J Obes (Lond). 2012 Aug 21.  [Epub ahead of print] 

Tuesday, August 21, 2012

Reader Question: Variation in Breastfeeding Frequency

Recently, a reader asked us why her 8-week-old baby was still nursing every 2 hours when her friend's baby (just a couple of weeks older) began nursing every 3 to 4 hours around the same age. Both babies are healthy, nursing well, and gaining the right amount of weight. In this post, we'll share some information about differences in how often moms breastfeed even when babies are the same age and size.

Differences in Moms and Babies

Because most breastfeeding moms don't see how much milk their babies get, they don't know how much milk volumes can vary from one mom to the next or even from feed to feed. Moms may assume that their babies take about the same amount of milk as their friends' babies but there can be big differences even when babies are about the same age. For example, breastfed babies take an average of about 27 oz per day from 1 to 3 months of age but that amount can vary from mom to mom by as much as 25%. Why so much difference? There are a few reasons why:
  • Moms vary in how much milk they can "store" in their breasts. The amount is limited by the milk producing structures that are in her breasts after lactation is established. Studies in Australian showed that this "storage capacity" can vary from just under 3 oz to over 20 oz! Moms also can have different storage capacity in one breast versus the other.
  • The fat content and the calorie content of milk also varies from one mom to the next. While the type of fat in mom's milk is affected by diet, the total fat and calories in milk are not. Total milk fat content is related to mom's biology and tends to be the same for all of her children. So, some moms make "2% milk" and some moms make "whole" milk and others are in between.
  • Babies vary in how much milk they need to take each day. Some grow very fast and some a little slower, some healthy babies are very big and others are smaller.
  • The amount of milk that babies can drink all at once also varies quite a bit. While all young babies have tiny stomachs, some are physically able to take more than other babies and others a little less.
Moms and Babies Work Together

When moms are responding to their babies' cues when feeding, most babies are good at taking as much milk as they need to get enough calories to be healthy and grow. But, since moms are also part of the picture, babies will differ in how often they need to feed based on mom's storage capacity and the calories in her milk. If a mom has higher fat milk, a big storage capacity, and a baby who can take a lot of milk at once, she can go longer between feeds (like the 3-4 hours for the friend in the story above). But, if she is a mom with a lower storage capacity, lower fat milk, and a smaller baby, she's going to need to feed more often so that her baby gets all the calories she needs (like every 2 hours). As babies get bigger, they will be able to take more milk at once and get closer to moms' capacities. They also build their own "storage" (baby fat) that helps them go longer between feeds.

If you are a worrier, you might be thinking that you'll end up with low fat milk and a small capacity combined with a bigger baby who can't take much milk at once. While that is possible, it's not common. Even then, a baby who nurses a lot gets a lot of practice and with a lot of practice, babies get very efficient (and quick) at nursing so the total time spent nursing may not differ much from moms who don't have to nurse as often.

References:
R.A. Lawrence. Breastfeeding: A Guide for the Medical Professional. Saunders, 2010.

Daly SE, Kent JC, Huynh DQ, Owens RA, Alexander BF, Ng KC, Hartmann PE. The determination of short-term breast volume changes and the rate of synthesis of human milk using computerized breast measurement. Exp Physiol. 1992;77:79-87.

Friday, August 10, 2012

A Question for the Dads out There

In gathering background for a short series on dads, I ran across a paper on a study that focused on dads of breastfed babies. The study included measures of the support and help that the dads had received since they had become fathers. The researchers reported that 83% of the participants reported that they "did not find the help they received in recent weeks to be helpful." Even more, none of the dads in the study reported that the help they received was very helpful. None. While I would hope our readers are getting the help that they need as they learn about their babies and their new roles, I really have no idea. So, I want to ask our dads out there, what kind of help do you most need? What action, knowledge, or support would be most helpful to you?

Leave us a comment and let us know.

Wednesday, August 8, 2012

Dealing Realistically with Postpartum Sleep Deprivation Part 2.

In our last post, we shared information about why young babies need to wake at night. Of course, if your baby is awake, that means that you are awake too (yes, research studies have actually been done to tell us that). Rather than being frustrated and stressed trying to find ways to get your young baby to sleep longer, we want to encourage you to look at the problem differently and look for ways to cope with having to wake up so much. Since adults’ sleep cycles (including both dreaming and non-dreaming sleep) are about 90 minutes long, new parents have reported feeling more rested when they are able to get 90-minute blocks of uninterrupted sleep several times per day. Focusing on getting these “chunks” of rest may make those first few weeks a little easier. Even if the baby is not cooperating and still feeding every two hours, parents can take turns and trusted friends and family can help make sure the baby is cared for between feedings. So "sleep when the baby sleeps" really is great advice. Right? Well, ok, we know it isn't always that simple.

Barriers to Sleep

Here's some more research that won't surprise you: many parents don’t “sleep while the baby sleeps” even if they try. Parents have a hard time finding time to sleep, falling asleep, returning to sleep, and staying asleep even though they are exhausted. If you are dealing with any of the following problems, you may be wondering what you can do to get more sleep.  

Hormone Shifts

Hormone shifts in the first days and weeks after delivery can leave moms feeling hot, cold, exhausted, wired, and moody 24-hours a day. These hormone shifts typically last only a short time and you should start to feel better and be more able to rest after the first couple of weeks. Talk to your doctor if you have any concerns.

Worry

First-time moms are more likely than experienced moms to suffer from sleep disturbances (including difficulty in falling and staying asleep) because of higher stress levels. First-time moms are more likely to be nervous and unsure about baby care. New dads worry too. You might find yourself wide awake wondering if you're a good parent. You might even stay awake worrying about getting enough sleep! Talk to your experienced friends and get tips to build your confidence, read this blog, share your concerns with your doctor, partner, and supportive friends and family. When you talk about your feelings, you might find a new perspective and learn that many parents feel the same way.You may find that it helps to follow a short routine and listen to soft music every time that you lay down to rest so those worrisome thoughts don't get a chance to get going. 

Other Responsibilities

Another common reason that parents said they couldn't get to sleep (when they had the chance) was that they worried about keeping up with household chores and other responsibilities. Some parents reported that they didn't even try to sleep because they were too busy with visitors and housecleaning. I know it is easy for someone like me to say “just let the chores go.” There can be many reasons why that can be very hard to do. But if you can’t let things go, you are going to need some help. You may feel that you should be able to handle it all but that's just not realistic; we are not meant to raise our children alone. Remember that whole “it takes a village” thing? It’s true. We have some posts to help you arrange to get some help when you need it. If you are ok with letting things go (and we hope that you are), just make sure the chores get done that are directly related to safety (you don’t want to trip and fall or give yourself food poisoning).

Believe us, we know what it is like to be in that early postpartum fog. We hope that these tips help you to get through it. Remember, more sleep is just a few weeks or months away.

References:
1. McQueen A, Mander R. Tiredness and fatigue in the postnatal period. J Adv Nurs 2003; 42: 463-469.
2. Coo Calcagni S, Bei B, Milgrom J, Trinder J. The relationship between sleep and mood in first-time and experienced mothers. Behav Sleep Med. 2012; 10:167-79
3. Insana SP, Montgomery-Downs HE. Sleep and sleepiness among first-time postpartum parents: A field- and laboratory-based multimethod assessment. Dev Psychobiol. 2012 May 2. doi: 10.1002/dev.21040.
4. Hunter LP, Rychnovsky JD, Yount SM. A selective review of maternal sleep characteristics in the postpartum period. J Obstet Gynecol Neonatal Nurs. 2009;38(1):60-8.