Tuesday, April 23, 2013

Babies' Firsts: When Babies Begin to Stand

A few weeks ago, we asked our readers to share information about when their babies learned to stand (click here to go to the original post). Specifically, we asked:
  • How old was your baby when he or she first tried to pull up to stand? 
  • What did you baby use to pull up on (for example, furniture, toys, etc)
  • How long did it take for him or her to stand alone, without holding onto something?

Today, for part 2 of this Babies’ Firsts topic, we want to share what the research shows about how and
when babies learn to stand!

As we've mentioned many times, babies develop and master new skills at different ages. The children of our staff at the Human Lactation Center illustrate this fact perfectly! My oldest daughter, Olivia, didn't stand until about 11 months, but my younger daughter, Charlotte, first stood at 6 ½ months. Jen G’s daughter Lily stood at around 9 months and our newest edition, Karolina’s son David first pulled to stand at 7 months.  

Our experience with our children perfectly represents what has been shown in the developmental research! Studies show that 50 percent of babies can pull themselves up to standing with support at 8 months and 90 percent of babies can by 10 months old. 

When learning to stand, your baby will need to use his arms to hold himself up on something and may be standing wide legged on his tip toes until he gets into the swing of things. During this time your baby will begin to use less arm support and may begin to shift his weight from side to side. He will need to get used to moving and controlling his body in this new position.  Soon he will be able to rotate his body around and use one arm for grabbing objects. He will also be able to reach down from a standing position to grab items off the floor.

By 13 months 90 percent of babies will be able to stand without support but still need to practice staying balanced. They will begin cruising around, that is holding on to furniture and moving sideways. Very soon after cruising, babies will begin taking unassisted steps.  They may still fall often, but don’t worry, their brains are hardwired to keep practicing until they get it right!

When your baby starts showing interest in pulling up to stand, it is very important to make sure he practices in a safe environment. Pulling up on things that move easily could be dangerous, so we encourage you to get down on his level and look for unexpected dangers. For example, when Charlotte started to pull up, she crawled over to her sister’s dollhouse and, before I could get over to her, she had tried to pull up on it. The plastic dollhouse was not sturdy enough to hold her weight and it scooted across the floor while she fell forward. Luckily, it scooted quickly so she did not hit her face on the pointed roof, but she could have easily gotten hurt. Small furniture, laundry baskets, and anything with wheels should be kept out of reach until your baby gets better at standing on his own.  At 14.5 months old, 90 percent of babies can independently squat from standing and shortly after they will be able to stand up directly from the floor without having to pull themselves up on something.

Pulling up to stand is a big milestone! If your baby is just learning to stand, Congratulations! Soon he’ll be running around you’ll be trying to catch up!

Thursday, April 18, 2013

“My baby does not like being in a sling!” Tips for parents that want to babywear

Some babies like being worn in a sling or other baby carrier only in specific situations or they just may not want to be in it all the time. This is normal! Your baby-wearing experience may also be very different from one child to the next. It’s also normal for babies to love sleeping in the sling but then want to be out of the sling once they awaken, especially as they get older. Here are some tips to try to help your baby enjoy baby wearing.

·       As your baby gets older she will have motor drives that push her to practice motor skills. This could explain some of her frustration while she is awake and in the sling. She wants to be on the ground practicing crawling, sitting up, pulling up, etc. Giving her enough time to practice these skills on the ground will probably help her enjoy sling time more.

·       Try different positions before you give up. It may be the hold that she is uncomfortable with. Many babies do not like the traditional cradle hold and may prefer a hold where they can move their arms and legs more freely. They are learning all about the world around them and so may want to face out at times so they can explore.

·       Overstimulation can occur when you are out and about, even if your baby is in the sling. If your baby is fussing while in the sling, pay attention to your surroundings and if it seems you r baby may be overwhelmed, turn her to face you to help  limit her visual stimulation.

·       As the weather turns warmer, think of how your baby is dressed in the sling. Is she too hot? That alone could make her fussy. It can take time for your baby to get used to a sling. Try it for a few weeks before giving up!

·       Make sure your baby feels comfortable and snug (and that the sling fits you well). If you are uncomfortable in the sling, your baby might be too.

·       Try different carriers. Don’t give up until you find one that works for you and your baby. Sometimes you can borrow different types from a friend or family member to “try before you buy” or find a store that lets customers practice using the sling with their babies.

·       Move, move, move! It’s pretty common that babies like you to be moving while they are in the sling.

·       Disengagement cues are not specific. If your baby gets upset in the sling, it may not be the sling that’s upsetting her. Your baby may be reacting to loud noises, strong smells or other things in her environment.  Sometimes changing the environment will help while other times taking her out of the sling is what she needs.

Baby wearing can be a great experience for both parent and baby. Hopefully the tips above will help make your baby more comfortable and happy in whatever carrier you choose!


Friday, April 12, 2013

Successfully Breastfeeding After a Rough Start: Part 2

By Karolina Gonzalez, MAS

Last time, I shared the exciting news that my baby, David, was born and that my goal to breastfeed him exclusively was more difficult to achieve than I had expected.

After meeting with the lactation consultant on day 4 postpartum, I felt someone was actually supporting our breastfeeding goals. More than anything, her words were amazingly encouraging! I started using the breast pump to stimulate milk production and the nipple shields to be able to nurse the baby as often as he wanted to. However, two days later David’s weight gain didn’t improve at all.
On day 7, I noticed his tongue was not moving forward enough for him to effectively breastfeed. The tongue plays an important role in breastfeeding! In order to extract milk from the breast, the baby needs to move his tongue forward to cup the nipple and the areola. When he draws his tongue back, he presses the tissue against the roof of his mouth. This compresses the ducts behind the areola and allows the milk to move into the baby’s mouth. Babies with ankyloglossia, commonly known as tongue-tie, might have difficulty latching onto the breast and the mother may experience nipple pain and/or trauma. These conditions can lead to other breastfeeding problems, such as slow weight gain and/or failure to thrive in the baby and ultimately a poor maternal milk supply and untimely weaning (Ballard JL et al, 2002).

Everything indicated to me that some level of ankyloglossia could have been the cause for David’s low weight gain and constant fussiness, as well as my sore nipples and perceived low milk supply. Researchers have also reported that inadequate milk supply may be rooted in decreased ejection reflex as a result of maternal nipple pain or in suppressed lactation as a result of the infant’s inability to drain the breast (Ballard JL et al, 2002). I had already heard about that while pursuing my Master’s Degree in Maternal and Child Nutrition, but now looking back, I think sleep deprivation and pain prevented me to take that into consideration in the first place!

We left to the hospital again to discuss my observations with the lactation consultant. She agreed with me and scheduled a procedure to get his tongue clipped that same day. It was a fast and I think painless procedure, since the baby didn’t even cry! Right after that, I put him to the breast and everything was different! From then on his feedings were short but he seemed satisfied and not fussy anymore. This indicated to us that before having his tongue clipped, he needed to stay at the breast longer to get some milk. He was probably nursing more because his suck was less efficient. Over the next few days, my milk started flowing much more easily and breastfeeding was not painful at all! And the most important result was that, David achieved a normal rate of weight gain within 2 days after the procedure. Our efforts were definitely worthwhile! We were successfully breastfeeding!

I really hope sharing this experience will help those moms who want to breastfeed their babies to keep on trying despite the obstacles you might face at the beginning. For those moms-to-be who are still waiting for the baby, my advice would be to keep in mind all the resources you have at hand once you leave the hospital. And make sure those around you know about them, so they can act proactively when needed! Also, by clicking here, you can read some tips to get through your baby’s first week of breastfeeding...successfully, that we published some time ago.

Ballard JL, Auer CE, Khoury JC. Ankyloglossia: Assessment, Incidence, and Effect of Frenuloplasty on the Breastfeeding Dyad. Pediatrics. 2002;110:5, e63.
For more about tongue-tie, click here.

Monday, April 8, 2013

Successfully Breastfeeding After A Rough Start: Part 1

By Karolina Gonzalez, MAS
You might remember I was expecting a baby last summer. David was born in mid-July on a beautiful sunny morning after 4 hours of labor. It was a very fast non-medicated delivery. Everything happened so rapidly that our midwife still insists the baby almost was born in the car on our way to the hospital! But I clearly remember (and laugh about) my husband asking my mom whether or not to have coffee and toast before leaving at 4 am, while I was already opening the garage door and turning the car on. I knew we had to leave soon!

After David’s birth, both of us were very alert and he latched onto my breast as soon as he was next to me! I felt so fortunate and so in love with my little baby! Since everything with baby and mom was fine, we came back home the next day. We were all delighted with the baby, but I was really struggling with breastfeeding. On day 3, we met with the lactation consultant. The baby seemed to have a good latch and he was making sounds as if he was swallowing colostrum, but he was consistently losing too much weight. Even though I was determined not to use supplemental formula, on day 4, I was advised to do so by the pediatrician.

During the next two days and despite using the breast pump to stimulate milk production and the nipple shields to be able to nurse the baby as often as he wanted to (I was very sore), his weight didn’t improve. I was sleep deprived, tired and engorged, conditions that together increased my doubts about being able to deal with what sometimes seemed too much. However, I was determined we both could keep on learning how to do this! In the next post, I'll explain how we learned what was wrong and what was done to help David and I to breastfeed successfully.

It’s amazing how fast babies grow up! David is now a very active and joyful 8-month-old who moves as if he wanted to jump and run, even though he is just taking small steps with the help of his parents. Now, I realize I should cherish every moment with this beautiful energetic little boy, since in a blink of an eye he’ll become a grown-up! And yes, he is still a breastfed baby!