Happy New Year!

Happy New Year! We'd like to welcome you back to our blog! We took some time off for the holidays, but now we are back. For those of you new to our blog, welcome! We would like to start the new year off with a little tutorial about how our blog works and where you can find "The Basics" of Baby Behavior, which is a great series of posts to start with if you are new, or if you haven't been around here in a while. You can 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!

Baby Language Quiz - Answers!

Here are the answer's to this week's quiz:

Typically, how old are babies/toddlers when they:
1. Consistently respond to their own names?

Around 6 months. At the same age, babies will look longer at people who are named, showing that they have linked names with people like "mommy," "daddy," and other close relatives.

2. Start to use a few words consistently with meaning (not just understanding but saying the words themselves with obvious meaning)?

Around 12 months. You'll notice that your baby understands words much earlier than he says them. He will first understand then use new words (often mispronounced) at an amazing rate as his first birthday passes. Remember to pay attention to what words your baby hears from you or any other source. Babies are sponges, soaking everything up including words you wouldn't want shouted out at a family gathering.

3. Use cooing and other noises specifically to attract your attention?

As early as 3 months, your baby will be using sounds that she knows will attract your attention. Remember, your baby loves looking at your whole face and listening to your voice. She is trying to learn as much as she can from you. If you respond to her softer sounds, she'll have less reason to resort to shrieking.

4. Start to combine words into short noun-verb sentences?

Around 20 to 24 months, your baby will start to use sentences and combinations of words. Even though your baby might still shorten or mispronounce words, you'll notice that he seems to follow basic grammar  rules in that he is using words in a specific order, like "I go."

5. First recognize friendly or angry tones in others' voices.

Around 6 months, your baby will respond more positively to friendly voices and negatively to angry ones. She's been watching and learning from you and has learned to prefer nicer tones of voice. Keep in mind that your baby might become upset if she is nearby when people are arguing even if she doesn't understand what is being said.

Resources:
Infant Development 2nd Edition, Volume 1: Basic Research. Bremner and Wachs (Eds). Wiley-Blackwell. 2010.

Stamm, J. Bright from the Start. Gotham Books, 2007.

In the News: Babies Teach Social Emotional Learning

We recently read an article about a school-based program called Roots of Empathy that helps children learn about emotions by having them spend time with babies.  This news story reported that through this program, children in the classroom are encouraged to observe the babies’ development and label the babies' feelings. They then discuss those feelings and relate them to their own. Sounds a bit like reading cues to us! So, how does social emotional learning (SEL) work?

Social emotional learning is “the process of acquiring core competencies to recognize and manage emotions, set and achieve positive goals, appreciate the perspectives of others, establish and maintain positive relationships, make responsible decisions, and handle interpersonal situations constructively.”  (Durlak 2011) SEL programs help children develop healthy behaviors related to self-awareness, self-management, social awareness, relationship skills and responsible decision making.

Special school-based programs, like Roots of Empathy, teach social emotional learning in two ways. Students learn how to process and apply social and emotional skills, such as labeling and understanding emotions, appropriately. These skills are taught by modeling and practice so that the children can apply them in real life situations.

How does all of this fit with baby behavior education?

Learning how to recognize and respond to baby cues improves babies' relationships, but it doesn’t have to end there. Teaching siblings or other children about baby behavior, how to understand the baby’s emotions and needs, is not just helpful for parents and babies; it may also be beneficial for the older child as well.

SEL programs are associated with lower levels of problem behaviors and emotional distress, improved academic performance, improved attitudes about self and others, and increased positive social behaviors such as sharing and helping others.

Incorporating SEL at home

If you have older children, teach them about the cues that your baby uses to communicate. Encourage your children to use the cues to “play detective” to see if they can figure out what the baby needs. They will love the challenge and enjoy feeling helpful. Your older child will feel more in control as you teach him or her how to tell when baby needs a break from playtime and your baby will be happier because of it! As your child begins to identify cues and emotions of your baby, talk with them about their own emotions. By helping them label their baby brother or sister’s cues and feelings, they will become more aware of their own feelings. 

References

Roots of Empathy Program: http://www.rootsofempathy.org/

Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students' social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev 2011;82(1):405-32.

Baby's (and Toddlers) Day at the Zoo - Part 2

Last week (after my adult daughter and I had spent a day at the San Diego zoo), we shared some tips to help you plan your own trip to the zoo with your baby or toddler. In this post, we'll share more of our experience and offer some Baby Behavior-related suggestions to help you have more fun and less stress during your day at the zoo.

On the day of your trip...
1. Be ready to play games in the lines. My daughter and I saw many parents waiting with their children in the long lines at the gate. The happiest groups were prepared with plenty of age-appropriate distractions for the kids. Their older kids were playing "eye spy" and the babies and toddlers were playing peek-a-boo or looking nearby for shapes and colors. Games played in lines don't have to be elaborate. Repetitive games that encourage your baby or toddler to use her senses and mind work best.

2. Support safe exploration. Zoos and large parks are wonderful but potentially dangerous places. Many parents worry about their children getting lost in public places. We know that you'll take care to keep your toddler close to you but you'll need to keep a close watch on everything your toddler is doing. Healthy toddlers will actively explore the world around them. That's how they learn. In zoos, there are non-stop opportunities for your child to pick things up off the ground, fall on uneven surfaces, slip on wet pavement, or get knocked over by a crowd straining to see an animal exhibit. We saw a couple of little ones get pressed up against the window by a crowd at the lion enclosure after their parents pushed them forward to get a better look.We don't want you to be paranoid about it, we just you to recognize that someone's eyes are going to need to be on your toddler nearly all of the time. In a big zoo, it is best to bring other adults so you can take turns watching the kids.

3. If you use a backpack, remember that your baby needs "face time." We saw many parents carrying babies and toddlers in backpacks. Obviously, carrying your baby on your back can make your trip much easier, but your baby needs you to be part of her learning. We saw excited happy babies in backpacks pointing around the park while another adult (often mom or grandma) talked to them about what they were seeing. Unfornately, we also saw a few parents carrying their unhappy and frustrated babies without ever talking to the children or looking back at them. It didn't take long for their babies to lose interest and glaze over. Remember, even the most exciting zoo sites won't be fun if you aren't involved in your baby's experience.

4. Watch for your baby's cues. Your baby will let you know when he's had enough of the sounds, sights, and smells at the park. Watch for cues that your baby is getting overwhelmed or tired. Just taking a break in some quiet shady spot or letting your baby nap in your arms can make a huge difference. You can stop the meltdowns before they get started.

5. Tell park staff right away if your baby drops or throws anything into an enclosure. When we were looking at the giant tortoise, an excited preschooler threw a cap from a soda bottle into the enclosure just as his group moved away. He didn't really know what he was doing and his parents (busy with other children) didn't notice what he had done. We stopped a park volunteer and let her know what happened and they took care of it right away. These things can be embarrassing but the park staff understand that young children will be impulsive. Even small pieces of plastic can be dangerous for animals, so let someone know.

6. Some exhibits require children to be quiet, so be realistic and think twice about standing in long lines. The San Diego zoo has a world famous giant panda exhibit that is well worth seeing. The animals are so popular that the wait time in line to see them can be 45 minutes or more. Because Pandas have such sensitive hearing, the staff must ask visitors to be quiet when they are close enough to see the animals. If your child is too young to keep from squealing, screaming, or shouting, you might want pass on exhibits that require quiet visitors. It is not a matter of discipline or parenting; babies and toddlers have very limited ability to control themselves. Just be realistic; you know your child best.

7. Give your child time to get emotionally ready to leave the park. We saw many toddlers who were very upset when they had to leave the park. While it is hard for any child to give up having fun, most do much better when they have some warning. Some children are fine with a moment or two, others need 10 or 20 minutes to get used to ending a fun activity. The difference isn't a matter of discipline, its temperament. You are likely to know how long your baby needs to adjust to change. Don't forget the simple step of letting your child know ahead of time when you are ready to leave the zoo.

8. Get your baby/toddler ready for the gift shop, before you go in. Zoo gift shops are chaotic places. Even if your baby or toddler is able to understand what she can and cannot have, she may be overwhelmed by all the noise and excitement. Let your child know what is ok and not ok before you go inside and be sure to watch for cues. If your child does have a meltdown, having another adult who can stand in line for purchases while you step outside can be a big help.

Zoos are wonderful places to take children no matter what their age. We hope you use your knowledge of your baby's behavior to make the day more enjoyable for both of you.

(Photo Credit: Adrienne Heinig)

Baby's Day at the Zoo - Part I

Recently, my adult daughter and I had an opportunity to visit the San Diego Zoo. It is an amazing place and we had a wonderful day. As you might expect, we were surrounded by families from all over the world, many with babies and toddlers. Zoos and large parks are great places to take children, especially when you've done your homework and made a plan well ahead of time. In today's post, we'll share some tips to help you plan your zoo-day. Next time, we'll share some of what we learned on the day of our trip that might help make your experience as safe and as fun as possible.

Before you go....
1. Consider the cost (including admission, shows, food, water, and souvenirs) given that your baby or toddler may not be able to stay through the entire day or enjoy all of the activities. Even a stroller can get hot and uncomfortable, so don't count on one to get you through to the next exhibit after the meltdowns begin.

2. Create a realistic schedule/plan for your day that allows for meals, breaks, and rest time (for you and your baby). Go during the part of the day when your baby is most likely to be happy and alert. Large zoos take a long time to get through. If your baby is very young, you might want to concentrate in one area or choose a smaller zoo.

3. Prioritize the animals/sites you want to see. Even if your toddler can stay awake through most of the day, he might get overwhelmed by all the new sites and sounds. By mid-afternoon, we saw more than a few miserable parents with fussy babies and cranky toddlers. Most zoos have maps you can see online. If your toddler is old enough to help, make a list of your favorite animals together!

4. Speaking of maps, make sure you know the layout including distances, hills, and bathrooms! Find the routes that work best for your situation and fitness level. We saw a lot of tired parents pushing double strollers up steep hills!

5. Bring a crowd, or at least a couple of helpful adults to help. Excited children can wiggle away in an instant. It's always best to have more than 2 eyes or arms in such an exciting and potentially dangerous place. We were happy to see a lot of extended family members, especially with toddlers. Just make sure that every one knows who is watching your child at all times.

Next time, we'll share what we observed and learned during our time in San Diego to help your day at the zoo be more fun for you and your child.

Learning to Talk Takes a Team Effort

It is amazing how quickly babies change. They grow so fast, learn so much, and gain some control over their bodies so quickly during those first few months. Before you know it, your baby is using words!  Learning to talk becomes one of your baby’s most important jobs as he becomes a toddler.  We’ve shared how babies develop their ability to communicate starting with basic cues and words during the first year that lead to a vocabulary explosion in the second year.

But did you know that you play an important role in your baby’s progress in learning how to talk? Babies don’t learn language on their own, they rely on the people who care for them to help them know what words mean and how and when to use them. Here are some language experts' “lessons learned” from the research on how babies learn to understand and use language.

1. Repetition, repetition, repetition.

Developmental scientists have found that the most important factor influencing a child’s vocabulary is the “language environment.” Babies learn the words that they hear around them (keep that in mind when you stub your toe). Babies first learn the words they hear most often – such as their own names, and words used for clothing items and household objects.  When your baby is able to point to objects, you’ll find that your baby seems to want to play the “name game “all day long. This is a very important process. Not only will your baby point at things for you to name but your baby will look at your face to see how you “feel” about the object.  Your baby is learning a lot more than words; your baby is learning about safety and context and where things and people fit in the world.

2. Babies understand language before they can use it.

For a long time, researchers thought that understanding language occurred much later than it actually does for most babies. That’s because scientists had to rely on tests that required that babies demonstrate some use of language (like naming objects or following directions). But, many babies didn’t do well on the tests because they were still learning to make consistent sounds with their mouths and to control their bodies. Newer tests show that babies can understand many words and even the structure of language far before they can use words to communicate. That means that for a while, you’ll have to play “translator” for your baby, figuring out what she needs and communicating those needs back to her and to others.

3. Learning and using language relies on multiple skills and different parts of babies’ brains.

The use of language (not just words) takes a lot of brain power. Babies need to use their sensory, memory, analytical, motor, and social skills all at once to communicate with the world. That means that many parts of their brains are used when they are learning and using words.  You play a very special role in this process.  Your baby needs you to be on “his team” to make it all happen.  Let your baby explore, hear you talk, see your face, and watch your emotional responses to objects and experiences. Make sure that your baby has plenty of chances to see how you interact with other people in positive ways. Support your baby’s efforts as he tries to communicate with you and others. Take the time to see how your baby uses his whole body and brain to interact with his world. It’s an exciting and fast paced process as your baby will double his usable vocabulary between 18 and 21 months and again from 21 to 24 months.   Go team!

Source:

Hollich G. Early Language. In: Infant Development. 2^nd Edition. Volume 1. Basic Research. JG Bremner and TD Wachs (Eds.). Wiley-Blackwell, 2010.

New Research: How Carrying Calms Babies

It’s almost instinctive; parents around the globe have walked their infants up and down halls in their efforts to calm them. Now research confirms that this time tested calming ritual works!  A recent study shows that carrying your baby (defined as holding and walking at the same time), has more of a calming effect than holding alone.

Carrying Effects on Babies

Carrying causes 3 things to happen; it decreases voluntary movement of the infant; it reduces babies' heart rate, and it decreases crying. Why? Carrying actually calms the baby’s nervous system (if you want a really technical explanation of how this works, read the full journal article referenced below).

Carrying is Repetition to Soothe

Over the years, we’ve promoted “repetition to soothe” as a tool to calm your crying baby. Carrying is a perfect example of this. It both brings baby close to your body and involves repetitive movement.

How to Use Carrying as Repetition to Soothe

Anytime your baby cries, first you want to try to find out why he is crying. Check for the obvious reasons first, like hunger, discomfort, or a dirty diaper. Then check less obvious things like overstimulation (lights, noises, people, etc.) If your baby is still upset after you’ve fixed everything, then try repetition to soothe. Hold your baby close and repeat a calming action or words over and over. This is where carrying can be incorporated! You may be wondering though just how you are supposed to know if you’ve taken care of the reason for the crying, if it’s not completely clear. If there is an underlying issue (like pain or hunger), crying will continue after the carrying stops.

Slings and Soothing

Slings or other baby carriers are a great way to carry your baby and save your arms! Remember, the key to calming is the repetitive motion, so don’t stand still! For more information about slings, click here. Remember to follow all manufacturer directions to ensure safety when using any baby carrier.

What are some other examples of how you use repetition to soothe with your baby?

Reference
Esposito G, Yoshida S, Ohnishi R, Tsuneoka Y, Rostagno Mdel C, Yokota S, Okabe S, Kamiya K, Hoshino M, Shimizu M, Venuti P, Kikusui T, Kato T, Kuroda KO. Infant Calming Responses during Maternal Carrying in Humans and Mice. Curr Biol. 2013;23(9):739-45.

Sightings of Savvy Parent Travelers

Yes, we're back out on the road again. From San Diego, California to Chapel Hill, North Carolina, we're sharing ideas and hearing what others are doing to support babies and their families. Usually, we would post a photo and tell you that we'll be back soon. But this week, I was fortunate to observe some parents that have clearly done their homework when it comes to traveling with their babies and I wanted to share some of their great ideas with you.

1. Tag Team Security
With two kids, a stroller, baggage, and today's security screening requirements, parents typically are struggling and juggling all the way through the TSA line. But this last weekend, I saw two parents of an infant and toddler work through a closely choreographed routine that looked almost effortless, handing off kids, belts, shoes, bags, in perfect step and at just the right time to get everything through security with a minimum of stress. Several fellow passengers stopped to watch the "dance" and once we were through security, I asked them if they had practiced it all at home. "Oh yeah!" said the proud dad, "only about 100 times."

2. Baby Yoga at the Gate
On my second trip of the weekend, I arrived at the gate to find a young couple and a baby close to the windows doing yoga together. While dad stretched out, mom gently moved and stretched the babies arms and legs. She also sang a song and smiled at her alert and happy baby. After a few minutes, dad kept the baby busy while mom went through a few poses. The mom told me that they always stretched during layovers. She said, "Makes sitting in planes and car seats easier when we take these breaks."

3. Toddler Take Off
Even though I couldn't see them, I heard a young mom talking to her older toddler. "What does the plane do?" The baby made a rumbling sound and mom made a rumbling sound. I heard her say again, "What does the plane do?" The toddler laughed while mom said "Zoooooommm!" They repeated this game several times before the plane actually took off and just as the plane lifted into the air, I could hear the baby laughing and making the rumbling sound as loud as he could.

4. Aisle Stroll
One of my flights was nearly 4 hours long, and as soon as the fasten-seat-belt sign went off, I noticed a dad, holding a young baby, pacing back and forth in the aisle. As flight attendants and fellow passengers moved around the cabin, he kept closer to their seats, but he kept walking for about 40 minutes. The baby was alert, relaxed, and looking around as they passed by my seat several times. When someone commented on what a "good baby" he had, the dad said that the walking made a big difference in keeping the baby happy, even if the baby didn't fall asleep. I didn't hear his baby cry at any time during the flight.

Obviously, these parents had a lot of experience traveling with young babies and toddlers. Given the press in the past about parents' struggles with their kids on planes, I really wanted to share some stories of parents who really do it right. So, how about you? What do you do to make air travel with your baby a little easier?

Bottles at Bedtime for Older Babies and Childhood Obesity

It’s possible that putting your baby to sleep with a bottle could have long term effects on your child’s health, according to a recent study.

Over 8,000 children who were part of the US Early Childhood Longitudinal Study were included in a recent study about feeding and obesity risk. Researchers, from Brigham Young University in Utah, found that putting an older baby to bed with a bottle could increase his or her chance of childhood obesity by 36 percent. How can this happen? Researchers hypothesized that when older babies are fed a bottle at bedtime on a regular basis or as part of their bedtime routine, babies become used to this and will take the bottle whether they are hungry or not. It can become a pattern. The problem is that this can discourage babies from being able to self-regulate their intake and result in their taking bottles at bed and naptime out of habit rather than when they need the calories. If babies eat more calories than they need every day, they gain too much weight.This pattern of needing to eat before sleep may continue into childhood or adulthood.

Research Meets Reality

We know that many families give bottles at bedtime and understand why you do. Nine percent of breast fed babies and 40% of formula fed babies were “put to bed with a bottle” at 9-months of age according to this study. However, it is unclear whether that means that these babies were given a bottle at bedtime by the parent or given a bottle to self-feed in the crib. It’s also not specified in this study whether or not these babies were put to bed with a bottle of breast milk or formula and breastfeeding to sleep is not mentioned at all. Therefore, we think these study findings need to be interpreted with caution since the question asked the parents in this study was vague.

But, the study findings are straightforward, bottles at bedtime increase older babies' risk of becoming obese. So, what are you supposed to do if bedtime bottles are already a habit?

Helpful Tips if You Do Put Your Baby to Bed with a Bottle

The problem is not the bedtime feeding itself but the excess calories. You want your older baby to learn to eat when he is hungry, not out of habit after he has had enough to eat during the day. The researchers recommended including feeding before bed only if the baby is showing hunger cues and to stop feeding when baby shows fullness cues. They also recommend not forcing your baby to finish the bottle so that he will sleep longer. Overfeeding past the baby’s fullness cues can also cause the baby to override his own body’s hunger cues making it easy for your baby to gain too much weight. 

Alternatives to the Bottle at Bedtime

If you do decide to stop giving a bottle at bedtime, we know that you may be worried that changing your feeding pattern will negatively affect your baby’s sleep. You will need some new tools to help your baby get used to sleeping without a bottle! A consistent bedtime routine will help your baby get to sleep and stay asleep more easily. Babies need help to relax and rest at the end of the day. Bedtime routines can be used to help your baby get so sleepy and calm that she can get the rest she needs. For examples of how to start or change a routine, click here. It’s also helpful to wait until you see signs that your baby is tired before starting your routine; that way she will fall asleep more easily.

AAP Recommendations on Weaning

You may be wondering when your baby should be off of the bottle completely. The American Academy of Pediatrics (AAP) recommends weaning your baby from the bottle before 18 months of age. This is important not only to prevent tooth decay but also to limit the amount of milk your child is drinking. It’s probably a good idea then to start weaning your baby off the bottle as soon as they are eating enough solid food at dinner time so that they don’t need milk at bedtime for nutritional purposes. For most babies, that's around 1-year of age.

We hope that we have provided you with enough information to be able to make an informed decision about feeding at bedtime. We know that this is a challenging topic and hope that the alternative tools we provided above are helpful if you do decide to change your bedtime feeding practices.

References

Gibbs BG, Forste R. Socioeconomic status, infant feeding practices and early childhood obesity. Pediatr Obes. 2013 Apr 2. [Epub ahead of print]

AAP Statement on weaning from the bottle

Our Top 10 Posts!

If you are new to our blog, or even if you’ve already done some exploring, we wanted to welcome you by sharing a countdown of our 10 most popular posts. We hope that you’ll find them as useful as the thousands of parents who have come to our blog in the past. The page views keep coming; today, we’ll top 1.9 million! Thanks to all of our loyal readers who continue to spread the word. It is probably not surprising to any of you that most of these posts are related to infants' waking and crying. Here's the countdown:

10. With just under 6000 page views, our 10th most popular post was: Tips for Coping with Persistent Infant Crying

9. The next post, coming in at number 9, was read about 6500 times: Tips for Dealing with a Waking 9-Month-Old

8. Our 8th most popular post, read about 6800 times was: What the Recent Research on "Cry it Out" Doesn't Tell Us

7. More than 7100 visits placed The Science of Infant Sleep Part I: The First 6 Weeks in our top 10.

6. At number 6, one of our earliest posts Baby Behavior Basics Part 3 – Learning and Creating Your Babies Special Language got more than 21,500 page views.

5. A post about puzzling stranger anxiety comes in at number 5, with just under 65,000 page views: When Stranger Anxiety Isn't Only For Strangers

4. We must have some cranky sleepy babies out there! Why Do Some Babies Hate Being Drowsy? is our 4^th most popular post with about 69,000 page views.

3. Even in the womb, an active baby is a healthy baby is the most recent post in our top 10, receiving 97,600 page views since 2012.

2. In second place, with about 103,300 page views was one of our posts about infant development at different ages Infant Development 4-5 months: Distractions, Distractions!

1. Finally! In first place, with just under 275,500 page views: Babies’ Development from 6 to 8 Weeks: Changes, Challenges, and Social Smiles.

That’s it! Our top 10. Which are your favorite posts?

Right-handed or Left-handed? How Early Can You Tell?

Being a lefty, I know all about the inconveniences of being one of the 10% (or so) of adults who are left-handed. Of course, I know there are stories about “lefties,” specifically, how our brains work differently than those of our righty brethren. The stereotype lingers that lefties are creative but a bit scattered, illogical and spacey. Ok, the spacey part might work… But, how do babies become right- or left-handed and how soon can you tell which hand your baby will prefer? In this post, we want to share some of the research in this area.

How Do Babies Become Right or Left Handed?

Scientists do not fully understand how babies end up favoring one hand over the other. A few ideas have been tested related to babies’ positioning in the womb. Because of the limited space and the position of maternal organs, developing babies end up looking to the right more often than to the left. This means that they are more likely to see and become familiar with their right hands. Another idea relates that there is more likely to be space in the womb to move the right hand versus the left. If one hand is easier to move around, it may end up as the preferred hand. Some scientists have focused on factors influencing handedness after the baby is born. Typically, newborns do look to their right more often than their left and they will work to move the hand they see. This may result in earlier voluntary movement of the right hand. Another theory relates to the fact that babies watch and learn from their parents. Babies notice which hands are used to feed them, play with them etc. This theory may partly explain why left-handedness tends to run in families.

So, the current thinking is that most babies become right-handed because of several circumstances that slightly but consistently increase in the likelihood that they will see, explore, and use their right hands both prenatally and postnatally. We lefties either didn't have these experiences or reacted to them differently (perhaps that's where the brain differences come into it).

How Early Can you Tell if a Baby will be Right or Left Handed?

Many parents start to imagine that their baby is left- or right-handed based on the percentage of time their 4- or 5-month-old reaches awkwardly with one hand or the other for an object that is held in front of them. But simple one-handed grasp actions are easy to do with the non-dominant hand (you do this every day) so trying to identify the preferred hand so early isn’t likely to be very predictive (at least not of left-handedness because nearly all babies end up right-handed). Handedness becomes more predictable when babies start to use both hands to explore objects. Older babies will use one hand to grasp and the other to keep objects steady or to manipulate them. When they start to play with toys in more complex ways (stacking, pulling them apart, putting them in and out of containers), they are more likely to use a dominant hand. Babies tend to be older (18 to 24 months) before handedness becomes more consistent. No matter what age your baby starts to prefer one hand over the other, there are a couple of things you should know. First, handedness is really a continuum, meaning that most babies can use both hands but they tend to use one hand more effectively than the other. Some people rely on the preferred hand for nearly everything, others can use both hands for most tasks. Handedness in adults and older children seems absolute only because of habits and more practice doing daily activities like eating and writing with one hand. Second, researchers have found that babies are less likely to show hand preference when they are learning new skills. That means that you might see your baby using one hand much more often than the other until he starts doing something new (like standing) and then he might use both hands equally until he masters the new skill.

References

Fagard J. The nature and nurture of human infant hand preference. Ann. NY Acad. Sci. 2013; 1288: 114-123.

Michel GF, Babik I, Sheu CF, and Campbell JM. Latent classes in the developmental trajectories of infant handedness. Dev Psychol. 2013; June 17 Epub.

Nelson EL, Campbell JM, Michel GF. Unimanual to bimanual: Tracking the development of handedness from 6 to 24 months. Inf Beh Dev 2013; 36: 181-188.

Revisiting Teething: Part 3

Alternative medicines to relieve teething pain?

By Karolina Gonzalez, MAS

Note: We are not medical doctors. We are providing this information based on articles published in research journals. You should talk to your own doctor before you give any medications or remedies to your child.

As a mom, I totally understand parents have concerns when trying to help their children deal with teething discomfort. I’ve heard a lot of them telling others which of the alternative medicines available today are the best. But I’m sure many parents out there are wondering about how effective those options are. Do they really work? We want you to make an informed decision regarding the product you choose to relieve your child’s teething discomfort. So let’s take a look at what the scientific evidence tells us!

First of all, it is important to point out that even though many parents might think that “natural” options are safer than “drugs,” that is not true. There are, for example, highly toxic natural substances. You should also know that while the U.S. Food and Drug Administration (FDA) regulates "conventional" foods and drug products, it regulates dietary supplements under a different set of regulations, per the Dietary Supplement Health and Education Act of 1994. Manufacturers of dietary supplements, including herbal treatments, are not required to prove a product is safe and effective before it reaches the consumer. For example, there’s insufficient evidence to support the use of any herbal teething remedy as an effective method for treating teething discomfort (McIntyre & McIntyre, 2002). However, herbal compounds such as Chamomile (Matricaria Chamomilla) are still popular among certain communities to relieve infants’ teething pain.

Homeopathic teething tablets and gels, another type of alternative medicine, are also marketed to soothe pain, reduce inflammation and ease irritability associated with teething. Homeopaths treat disease using very low dose preparations administered according to the principle that “like should be cured with like.” The remedies are prepared by a series of dilutions and vigorous shaking. The more you dilute it, the greater is its strength (Vickers & Zollman, 1999).  

Homeopathic remedies are also regulated by the FDA. For example, Hyland’s Teething Tablets were voluntarily recalled by its manufacturer on 2010 to ensure all the lots of the product contained equal amounts of the ingredients. The product was re-introduced with a new formula in July 2011 when all concerns were addressed. According to the National Center for Complementary and Alternative Medicine (NCCAM) parents can safely use the tablets as well as the gel with young children. But there is currently insufficient evidence that homeopathy is clearly effective for any single clinical condition, including teething pain in infants (Ernst, 2010).

Amber teething necklaces are a traditional European remedy for relieving teething pain and widely available today. It is important to stress that these necklaces are designed to be worn, not chewed. They supposedly help to reduce teething pain due to an analgesic compound in the amber that is absorbed into the body through the skin. But according to research, there is currently no scientific evidence suggesting that such necklaces are effective for treating teething discomfort (Markman, 2009).

From my own experience, I can tell you that an extra dose of loving care and attention has been the most effective method for “treating” my now 11 month-old teething baby. But no matter which method you choose, remember to talk with your doctor before giving your child any medication. And feel free to tell us about your experience!

References:

FDA. Dietary Supplements. Available at: http://www.fda.gov/food/dietarysupplements/default.htm

McIntyre GT & McIntyre GM. Teething troubles? British Dental Journal. 2002;192: 251-255.

Vickers A, Zollman C. ABC of complementary medicine: Homeopathy. BMJ. 1999 October 23; 319(7217): 1115–1118.

National Center for Complementary and Alternative Medicine. Homeopathy. Available at: http://nccam.nih.gov/health/homeopathy#sideeffects

Ernst E. Homeopathy: What does the “best” evidence tell us? Med J Aust. 2010;192(8):458–460.

Markman L. Teething: facts and fiction. Pediatr Rev. 2009;30:e59-64.

 

 

Revisiting Teething! Part 2.

By Karolina Gonzalez, MAS
Some time ago we shared information about common ways parents may "treat" their teething infants. We discussed the pros and cons about the use of teething toys, pain medications and mouth gels. New information is available about the latter two, so we decided to share it with you today!

We want to remind you we are not medical doctors and we are not recommending the use of any medication, pharmaceutical or natural. We are just reporting what research tells us about those options, to help you to decide which of these methods, if any, to use with your own infant. Please consult your doctor before giving your child ANY medication.

Common Teething Medications
Acetaminophen: Pediatricians often recommend acetaminophen products, such as Tylenol, for infant and toddler teething discomfort. Until quite recently, there were two suspension strengths: one for infants (80 mg/0.8 mL) and one for children (160 mg/5 mL), which resulted in the potential for confusion, as well as the potential for an accidental overdose. In response to recommendations from an FDA Advisory Committee Meeting, since 2011, some manufacturers have changed the amount of acetaminophen in these medicines to one standard amount to help reduce dosing errors that can lead to accidental overdoses (Krenzelok, 2009). Infant drops, which contain 3 times more medicine than the children’s liquid, are being phased out and will no longer be available. You need to be aware that the dosing amounts are different depending on the concentration they are using. And please remember, even though teething pain might affect some children on-and-off for several months, acetaminophen is not appropriate for long-term pain-management.
Mouth gels: Even though teething gels have been popular, on April 2011, the FDA warned the public that the use of benzocaine, the main ingredient in over-the-counter (OTC) gels and liquids applied to the gums or mouth to reduce pain, is associated with a rare, but serious condition. This condition is called methemoglobinemia and results in the amount of oxygen carried through the blood stream being greatly reduced. In the most severe cases, this condition can result in death. Analysis of the incidence of adverse reactions to benzocaine and dose required to produce an adverse reaction revealed 132 cases of methemoglobinemia between November 1997 and March 2002. Only 69 of the reported events specified the dose used, but of those, 37 indicated use consistent with package directions (i.e. appropriate dosing) (Moore et al, 2004). As of today, the FDA recommends that benzocaine-containing gels and sprays not be used on children younger than 2.

References:

Krenzelok. The FDA Acetaminophen Advisory Committee Meeting – What is the future of acetaminophen in the United States? The perspective of a committee member. Clin Toxicol (Phila). 2009 Sep;47(8):784-9.

U.S. Food and Drug Administration. FDA Drug Safety Communication: Reports of a rare, but serious and potentially fatal adverse effect with the use of over-the-counter (OTC) benzocaine gels and liquids applied to the gums or mouth. Available at: http://www.fda.gov/Drugs/DrugSafety/ucm250024.htm Accessed on May 27, 2013.

Moore et al. Reported Adverse Event Cases of Methemoglobinemia Associated With Benzocaine Products. Arch Intern Med. 2004 Jun 14;164(11):1192-6.

Additional resource:

American Academy of Pediatrics. Fever and Pain Medicine: How Much To Give Your Child. Available at: http://www.healthychildren.org/English/safety-prevention/at-home/medication-safety/Pages/Fever-and-Pain-Medicines-How-Much-to-Give.aspx  Accessed on May 26, 2013

Revisiting Teething! Part 1

By Karolina Gonzalez, MAS

 

Is your little one too fussy? Always consider the “big picture” before blaming those tiny pearly whites

As a new mom I’ve already been there! When my baby starts getting fussy and irritable in the grocery store, there appears that helpful advice from an empathetic woman: “He must be teething! Have you tried this? And what about that?” Everywhere you go and your baby starts showing any disengagement cue, together with the excessive drooling and the desire to chew on something hard, someone shares with you a popular treatment to help him soothe his tender gums, right?

Parents and caregivers attribute a wide variety of signs and symptoms in young children to teething. Excessive drooling, runny nose, diarrhea, fever, and sleep problems are just a few examples. A few days ago I even heard a mom saying she was sure her baby gets constipated when teething.

Such parental beliefs are consistent worldwide, across all education levels, and for both first-time and experienced parents (Markman L, 2009). We’ve already mentioned in previous posts though, that results from research studies indicate that no symptoms are linked consistently with tooth eruption in all children. However, those popular beliefs might lead parents to try possible solutions that will not always help and in some cases, may even pose a risk for their children’s health.

Remember that young children are exposed to a wide variety of environments, illnesses and situations that may cause episodes of congestion, diarrhea or fever; and that local symptoms may occur, but systemic (whole body) symptoms are not caused by teething. This perspective will help you avoid using the “teething diagnosis” to explain either normal baby behavior or a serious illness that should be treated right away.

My baby’s first two lower teeth appeared when he was 7 months old. And even though we noticed one of his upper teeth coming in a few weeks ago, we can’t say more teeth have appeared yet at almost 10 months. I must say, though, as first-time parents, learning everything from scratch and getting to know our baby day by day, we’ve considered teething pain as the cause for him being pretty irritable at times!

Next time, we’ll continue with this series about teething, sharing an update regarding common over-the-counter medications used to treat teething pain in infants. Stay tuned!

References:

Markman L. Teething: facts and fiction. Pediatr Rev. 2009;30:e59-64.

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:

• For general tips, try our 10 Tips for Traveling with Your Baby.
• On your own with your baby? Check out these specific tips. 
• Planning a plane trip with your toddler? Here are some things you need to know.
• Visiting friends? Here are some tips for making the visit less stressful.
• Finally, read this post for tips to keep your baby or toddler from becoming overstimulated despite all the excitement, fun, and stress that comes from traveling during the holidays.

We wish you all safe and peaceful travels this holiday season.

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!

The Very Best Baby Gift

Now that the big gift giving holidays are nearly over, some of you have boxes of new toys, games, and super hero jammies pushed back into corners while the favorite gifts (of the moment) are being fully explored. Others have just a few new things unwrapped under the tree or already being worn and played with. As we all settle back into the post holiday routine, we'd like to remind you that there is one gift that your child will cherish more than any other, no matter what his or her age.

There is no greater present you can give a child than your undivided caring interest and attention. Whether you are playing peek-a-boo with a young infant, clapping with joy as your little one takes her first steps, listening with rapt attention to a 3-year-olds' never ending stories, or sharing the triumph of a first successful (if not haphazard) attempt at shoe tying, your loving acceptance and attention will spark memories that will outlast all of the latest gadgets. So, if there wasn't that much money left to spend on gifts this year, you need to know that it really doesn't matter.

Baby science tells us that your presence and affection are the most important gifts your baby will receive. The special moments you share together directly influence how your baby develops, now and in the years to come. So, let the dishes soak and turn the cellphone off, remember how fleeting the stages of your child's life can be and take the time to enjoy each one.

Dining Out with Babies: Making it Easier for Others

Last time, we shared some tips for parents to make dining out with their babies a little less stressful. We wanted to follow that up with a post on what you might do if you found yourself in a restaurant (as I did) near to a baby old enough to sit up at another table. As a fellow diner, it is easy to make dining out with babies easier for parents. Not being rude is a great start. But, we know you want to do more than that.We know that our readers can astonish others by “reading” the universal signals used by babies. There is no better time to use that skill than when you find yourself in a restaurant with a baby.

Here are a few things you can do:

1. Make it clear that you welcome the baby. Smile knowingly, stay relaxed and if you get an opportunity, say something nice about the baby. This may sound obvious but you may be the only one in the room who is welcoming.

2. If the baby is alert and looking around, try to catch the baby’s eye. The baby (as long as she is old enough) will be looking for a friendly face and once the baby sees you, the baby will take a good long look. You’ll see how hard the baby will work to figure out where you fit in the world. After all, the baby has no idea whether or not you are a relative or likely to be someone they will see again and again. If you maintain eye contact with the baby and the baby is old enough, you’ll see the baby “refer” to mom or dad to see if you are on the “approved faces” list. I hope you are. If not (sadly, some parents are very suspicious of everyone), just let it go and enjoy your meal.

3. Let the baby be the guide for any further interaction. Babies love attention and if you are making eye contact while their parents are busy looking over the menu, the baby is likely to try to engage you in some way. The baby may smile, open his eyes wider, or stare at you intently. Many babies will start a game of peek-a-boo by looking at you then burying their faces in their parents’ shoulders, then looking at you again. Here’s some fun “across the table/room” games to play.

a. Peek-a-boo – there are many variations of this game but the gist is that the baby looks at you, then stops looking at you and then looks at you again. Thrilling, eh? Well, if not for you, definitely for babies. If you look away when she looks at you or hide behind your hands or your menu, the baby will at first watch you closely then start to play as soon as she figures out that she has a new playmate. The excitement for the baby comes from being able to predict that she will see your happy face again.

b. Mirror games – babies love it when you repeat their actions. If baby shakes her head and then you shake your head, she’ll smile and do it again. The more you do it, the better the baby is able to predict what you’ll do, the more the baby will be amused and laugh. Clapping is another great activity for mirroring. Remember that the baby must always be the leader.

c. Pointing games – babies love to point at things and have their parents talk to them about what they are pointing to. When you are a little farther away, you can make it clear that you are interested in what they are pointing to by looking in the direction in which they are pointing. If you are close enough and it is acceptable, you can talk to the baby about what you see. If not, you can change your facial expression enough that the baby knows you are paying attention. Looking surprised or pleased to see what the baby is showing you will keep the game going.

There are two things to remember that will help your game playing be more fun for everyone. First, always let the baby lead the games and actions. When baby is in charge and predicting what will happen, the baby will be gloriously happy. Second, watch for disengagement cues. These cues will let you know if the baby is getting overstimulated. Playing with a stranger can be hard work! While I‘ve shared several ideas for playing, these games don’t have to make you miss your dinner. Most babies stay interested in strangers for only a few moments and by playing, you’ve given a clear message to the parents and others around you that you value the baby and the opportunity to interact. Bon Appetit!

Tips for Taking Your Baby to a Restaurant

Recently, I was in a restaurant seated next to a large extended family that included a baby who was about 7 months old. The room was not crowded and the baby had a clear view of our table. Being a big fan of babies, I caught the baby's eye and for a few minutes, we played little follow-the-leader games across the room. As the family was leaving, mom and baby waved good-bye and the mom thanked me for entertaining the baby during the meal. Smiling, I thanked the mom for bringing the baby. By her surprised look, I could tell that it was not a typical experience for her. It made me sad to think that taking a baby to a restaurant has become such a stressful event. In this post, we'll share some ideas to help make this experience easier on you and your baby. Next time, we'll talk about what you can do to make things easier for another family if you find yourself in the position I was in, as a fellow diner near a family with a baby.

Choose Wisely
When you have a choice about where you're going out for a meal, choose the place that will be the least stressful to you. The type of restaurant can make a big difference. Consider your baby's capacity for stimulation. How busy will it be? What is the noise level? How many other children or babies are likely to be there? If you are new to taking your baby out, you might want to stick to casual places where there are likely to be other children. You might also consider finding out if there is a covered area outside where you (or someone else) can take your baby for a walk as needed.

Be Prepared
I'm sure that anytime you go out with your baby, you pack the diaper bag with everything that you might possibly need. Before going to a restaurant, you also should take the time to create a "game plan" with your partner or family members to deal with any challenges that may arise. Before you go, decide who will do what if something loud, embarrassing, or smelly happens!

If your baby is less than 2 months old, there is no way of knowing when your baby will be awake, sleeping peacefully, or hungry. You'll need to be prepared for all 3. Older babies are more likely to be more predictable and it may be wise to time your outing to increase your chances of having a contented baby.

What to Watch For
Your baby is very likely to be interested in all the sights and sounds that you encounter in the restaurant. Healthy babies want to explore their surroundings. But that means you need to be vigilant to make sure that anything potentially breakable, messy, or dangerous is moved out of your baby's reach. Relatives and friends will want to play and entertain your baby and that's great too. Take advantage of their willingness to entertain your baby to get something to eat! But, you'll also want to keep an eye on your baby to make sure that he doesn't become overwhelmed or overtired. It is common for friends and relatives to ignore the early disengagement cues until your baby becomes fussy. Trying to help, they might continue to stimulate the baby with keys, toys, or games. While these distractions may work in the short term, you'll start to see stronger and more frequent disengagement cues and your baby may become very upset. It is better to respond to the early disengagement cues with reduced stimulation (as simply as holding your baby closer to you and turned toward your body) and/or some repetitive sounds and movements until your baby seems ready to play again or falls asleep.

Take Things in Stride
The most important thing to remember when you go out in public with your baby is that you cannot control or predict what your baby will do anymore than you can control who else will be in the restaurant when you arrive. Your baby may suddenly have a fussy period or you may be greeted with exasperated looks from your fellow patrons before you even sit down. Your baby may have a huge diaper blow out just as your meal arrives. These things happen and are part of parenting. Someday, you'll look back on these experiences and laugh. Should anything unexpected happen, stick to the plan that you made before you left (i.e. whoever has eaten more leaves the table to change the diaper or settle your crying baby) and keep your sense of humor. While it is important to be considerate of your fellow diners, you shouldn't berate yourself about things that you can't control. Being prepared, vigilant, and accepting will help your restaurant adventures be much more relaxing and fun for you and your baby.