Bringing Your Toddler to Holiday Parties

By Jennifer Goldbronn

Last time, we shared some tips for making it easier for you and your baby to deal with the hustle and bustle of holiday gatherings. What about older babies and toddlers? What can you do to help them stay calm and happy? Here are some ideas to keep in mind.

1. Older babies have great memories! They remember if Aunt Rita always tries to take them away from you for that big hug. Family members are often very excited to see your baby! This can come across a bit scary to a baby that has someone rushing up to them and excitedly clapping or talking to them in a high pitched voice. Babies also remember how their parents reacted to certain family members. If you tense up when Aunt Rita comes running toward you, your baby will see your tension and learn that you think that Aunt Rita is scary too!

2. Toddlers learn about their world by creating scripts in their minds for common occurrences (like bedtime or getting dressed) and by assigning “jobs” to the people in their lives (i.e. every night Dad gives me a bath, mom reads me a story). For people that your baby does not see very often, babies may be more apprehensive with them because they don’t know what their job is.

3. As older babies gain the ability to move away from their caregiver (crawl, walk, etc.), they also develop an instinct that tells them to stay close to their caregiver. This is important for their safety but can also make family gatherings challenging when everyone wants to hold your baby.

Tips for navigating holiday gatherings

Now that you understand why older babies behave the way they do in these types of situations, we want to share some tips to help you through the upcoming holiday season!

·         Explain what you know about your baby and set boundaries with family members. Make sure they give your baby time to warm up first.

·         Watch your own facial expressions and body language. If you are worried that a particular family member will rush up and try to grab her from you before she is ready, your baby will know! You may be nervous or frustrated for other reasons and these feelings show as well. If you enter a party rushed and stressed, your baby will see it in your face and may become upset when introduced to people right away. So, try to smile and relax when introducing your baby to people!

·         Create a routine for when you see family members and talk her your toddler though it. Tell her what she is about to see and do. Your family members might think it is odd, but they will get used to it after a while. For example, whenever you get to a new party, sing the same song before you go in the door and introduce your child to everyone in the same way.

·         Change your expectations. Knowing your baby’s normal development at this age, don’t be surprised if he or she wants to stay near you the whole time! It’s OK! If others want to hold her, have them stay close by so that your baby can still see you. Given time and familiarity, your toddler eventually will calm down and enjoy the party too.

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

Part 2: Tips to Ease the Transition of Baby into Her Own Room

Charlotte, 5 1/2 months

In our last post, we wrote about current practices and recommendations for sleeping locations of infants. It doesn't matter if you are a first time mom or an experienced mom, or how old your baby is, transitioning your baby into her own room will be an adjustment for the whole family Today, we have a few tips that may help make the process easier!

• As with any transition, change takes time. Don’t expect your baby to fall asleep easily in your room one night and just as easily in his own room the next night. Being patient as your baby gets accustomed to his new space is important!
• Take small steps toward a gradual transition into the new location. For example, if your baby sleeps on a sleep surface other than a crib, like in a bassinet, start by moving your baby’s crib into your bedroom and having him sleep there. After your baby gets used to sleeping in his new crib in your room, then move the crib into his room. Another option is to start the transition by having your baby sleep in his new room for daytime naps only. After that is going well for a while, try having him sleep in his room for bedtime too.
• Keep in mind that any change in routine (and transitioning to a new room is a big one!) can affect your baby’s sleep patterns, potentially causing more night awakenings for a short time.
• Be consistent; older babies like routines! It’s important to be consistent with your baby’s bedtime setting as well as his bedtime routine. For more about routines, click here.
• While you are trying to be consistent, it’s also important to be realistic. Things will happen that will be out of your control. Your baby may get sick and be in your room for a few days until she is feeling better. That’s okay! You can get back to your usual routine when she is back to feeling better.
• It’s not unusual for older infants to wake more than usual once in a while. She may have separation anxiety or be conquering a new physical milestone. For a list of reasons why older babies may wake more sometimes, click here.
• It’s not uncommon for some older babies to resist being placed back to sleep in their cribs after awakening during the night. For an explanation of why this happens, click here. For solutions, click here.
• Wait until your baby is in quiet (deep) sleep before transitioning her from one sleeping place to another, such as from your bed or your arms to a crib. Older babies can enter deep sleep more quickly than younger babies, but always look for signs of deep sleep before lying your baby down to sleep.

We hope this information has been helpful! Making a big change, like moving your baby into her own room, is a big milestone and it is important to do what is best for your family. We’d love to hear your stories and tips about how YOU transitioned your babies into their own rooms too!

Tips for Dealing with a Waking 9-Month-Old

Last time, we shared some reasons why a 9-month-old may wake and refuse to go back to his crib. In this post, we promised to share some tips to help the tired parents with older infants. Some of you may be expecting us to produce sure-fire ways to get that baby back into the crib, sleeping through the night - sweetly, quietly with no tears or stress. Well...most of you will know that we can't do that, because we tell you the truth.

Our reader asked:
"My 9-month-old often refuses to let my husband put him back in his crib at night. I have to go in and nurse him every time he's up in order for him to go back to bed and sometimes even then he doesn't want to go back in his crib!"

Since the beginning of our blog, we've had many posts about sleep. You can read through some of them by clicking here. These posts always seem to attract strong opinions and we realize that each family manages the night time hours in their own way. For some of our readers, "sleep training" may seem to be the logical answer to a baby's refusal to go back to sleep. We've already shared our reasons why that would not be our first choice. Other readers would tell any mom waking with an older infant to sleep with the baby. You may have noticed that we haven't talked about co-sleeping, which the American Academy of Pediatrics opposes. Co-sleeping is both a simple act and a complicated issue and we believe that others are better at examining the pros and cons of that practice and that our readers can make their own informed decisions. So, we'll stay focused on understanding, and working with, the baby's behavior (that's what we're here for after all).

It is important to understand that it is not unusual at all for a 9-month-old to wake once at night. Many mothers find the infrequent night nursing is fine for them, others search for ways to phase the night nursing out of their lives. This is a process that takes a little time.

Some ideas:

1. We're going to assume that this baby is growing well, feeding well, and not showing any hunger cues when he wakes at night. Growth spurts can cause babies to feed more frequently for a few days (even at night) so you might want to give it some time and see what happens. Some older babies may be uncomfortable and wake while teething. If you have any concerns about your baby's health, growth, or development, you should talk to your baby's doctor.


2. During the day, give your baby as much opportunity as possible to practice new physical skills, like crawling, pulling up, and climbing over things. The drive to practice these skills can cause older babies to wake. Make sure that the day time naps aren't stretching out so that you can get more done. It is easy to let that happen but you'll be up more at night that way.


3. Keep up a regular bedtime routine. Follow the same pattern of activities each night, ending with your drowsy (or sleeping) little one in the place where you would like him to sleep.


4. Trying leaving something small in the place your baby sleeps (like a burp cloth) that you've been handling or wearing (nothing big like a blanket or pillow - those objects aren't safe for babies). Sometimes anxious babies can be calmed by something that smells like mom (or dad) or other familiar objects.


5. Check the room for blinking lights or other changing sights or sounds that might stimulate your baby in the night. Consider a soft steady night light (turned on during the bedtime routine) and some low level white noise to cover any little sounds that might disturb your baby during periods of lighter sleep.


6. Your baby may want to nurse to go back to sleep because he is anxious or having difficulty calming himself. This would be quite normal for older babies because they don't yet have the skills to understand or control their emotions. While nursing may be both familiar and effective in helping him relax, it is not the only way to calm your baby (if you would rather not nurse). You or your husband can use "repetition to soothe" techniques like stroking, rocking, talking softly or singing to your baby. Your husband can establish a new calming routine that he uses at night when needed. Your baby will not like the change at first (so you might want to start the process when you've had a chance to get some rest or don't have to wake up early the next day) but if you gently persevere, your baby will adapt to the new routine.

Next time: JenB Returns!

Let's Talk About Twins (Triplets, Quads, etc.) Part 2: Bonding with Multiples

My mom grew up as a twin and has shared fond memories (and the usual stories of sibling rivalry) with me as I grew up. Though my mom is a fraternal (not identical) twin, she has many similarities with her sister and shares a special closeness with her to this day. Growing up, each sister knew when the other one was in trouble or hurt. When my aunt married and left the house before my mom did, my mom’s heart broke over the separation. There is no doubt that twins and multiples share a special bond, and that this connection begins in the womb. In this post, we will talk about the unique bond between twins and multiples as well as the bond between caregivers and multiples. We’ll also share some ideas to help parents of multiples bond when their attention is divided among multiple babies.

The “Womb-Mate” Bond
After being “womb-mates” for approximately 9 months and coming into the world together, multiples have forged a strong attachment to each other. Several studies have shown that multiple’s have the ability to comfort each other. In one study, researchers observed the interaction of twins in utero. They found the twins’ movements and behaviors to be in synchrony 94.7% of the time! Ultrasounds have also shown that womb mates touch each others’ faces and even suck on each other’s hands in utero. When multiples are born, and leave the safe confines of the womb, they are sometimes separated. This separation can be stressful because they are so used to each other’s presence. Keeping twins or multiples close to each other after birth can also help regulate their breathing and heart rhythm. (Robin 1996)

Development of the Parent-Infant Bond in Families with Multiples
While multiples develop a distinct bond with each other, they also develop a special bond with their caregivers. For primary caregivers of multiples, this bond can be more challenging to develop simply because of the time and work it takes to care for multiple babies. External factors, such as each baby’s health status, can also affect the development of the mother-baby or caregiver-baby bond. Oftentimes multiples will come home from the hospital at different times based on their health and feeding status. This can be challenging for parents because they have a baby (or babies) at home to care for and a baby (or babies) at the hospital to visit and care for as well. Thus, it makes perfect sense that parents would forge a bond with each baby at a different pace. (Robin 1996) Be patient, the bond will form, it just may take longer than you planned it to.

Forming an individual bond with each of your multiples can be challenging. Before you can form individual bonds with each baby, you must recognize them as individual children. “Collective Mothering” occurs when a mom responds to the infants as a group rather than as individuals. In a study of mothers of multiples, researchers found that when mothers were fatigued they were less likely to provide individualized care for their babies. (Robin 1996)

Caring for Multiples
To cope with the overwhelming burden of caring for multiples, caregivers develop patterns or routines to curb the chaos. While we recognize that routines are important , this study showed that sleeping and feeding routines were carried out uniformly in 80% of the families by one year after birth, without consideration of the children's individual needs or patterns. (Robin 1996)

There are several ways for parents to individualize the care of their multiples and create a special bond with each baby. Here are some tips to do just that:

Allow yourself time with each baby one-on-one
After delivery, allow other close family members or friends to spend one-on-one time with each child. This will not only allow them to create a special bond with each baby, but it will allow you to spend time with each baby individually as well. (LaMar 2004)

Accept help from others
I know this is a common recommendation on our blog, but help is essential when caring for multiples. In one study, almost ¼ of mothers of twins refused help after their babies’ birth. (Robin 1996) Coping with different sleep, feeding and crying patterns in 2 or more infants can be overwhelming and exhaustion is common. We know sometimes it’s hard to ask for help, but keep in mind that levels of depression and fatigue are higher in caregivers of multiples. (Thorpe 1991) Developing a support network will be invaluable.

Watch for each baby’s individual cues
Recognizing and responding to each baby’s individual cues will help your babies feel safe and happy. Remember, babies get better at communicating their needs to caregivers when they get practice giving cues and having their caregivers respond appropriately. For more details about responding to infant cues, click here.

We hope this series on twins and multiples has been helpful to those of you out there parenting (or preparing to parent) these special little ones. For the rest of you, let us know what other topics would be useful to you in your own parenting journey!

Next Time: We’ll share a short series on easing the stress of separation from your baby.

References

Robin, M, Corroyer, D, Casati, I. Childcare Patterns of Mothers of Twins during the First Year. J. Child Psychol. Psychiat. 1996; 37(4): 453-460.

LaMar KL, and Taylor CR. Share and share alike: incidence of infection for cobedded preterm infants. Journal of Neonatal Nursing. 2004;10(6): 6–9.

Thorpe, K. Golding, J, MacGillivray, I. & Greenwood, R. (1991). Comparison of prevalence of depression in mothers of twins and mothers of singletons. British Medical Journal. 1991; 302: 875-878.

Repetition in Baby's Daily Life: The Power of Routines

As human beings, we rely on our daily biological rhythms to know when to wake, to work, to eat, and to sleep. These rhythms are controlled by internal things (like hormones) and external things (like light/dark cycles and alarm clocks). Babies are born with somewhat "flexible" rhythms that are influenced by the environment as they grow and develop. This flexibility allows babies to adapt to their parents' world. Most parents don't believe it, but they have enormous influence over their babies' daily rhythms. Routines are an important tool to help parents and babies get in synch.

Right away, I need to clarify that routines are not the same thing as "schedules" that might be forced on babies. Routines refer to patterns of actions, doing the same thing in the same order (as in dance or gymnastic routines). Schedules usually refer to actions that are dictated by the clock rather than the baby's needs.

Predictable daily routines help babies develop rhythms that are just like mom and dad's. As a side effect, they also help babies build trust, social skills, and self-control. Most parents instinctively settle into routines at bedtime, bathtime, and when feeding their babies. Because babies love repetition (see our last post), routines can help babies feel calm and secure. For example, let's pretend that your 3-month-old shows signs of being drowsy. You might take the following steps to lead the baby gently to sleep.

1) Hold the baby close and start using the same words over and over to tell the baby that it's time for nap.

2) Change the baby's diaper and clothes, close to the place where she takes her nap, maybe while singing a special nap time song.

3) Put her down on her back to sleep and gently rub her tummy while still singing or saying the same words over and over.

4) As the repetition lulls her into feeling more and more sleepy, you can step away and let her fall asleep on her own.

To reinforce a routine, you need to repeat these steps before every nap. Routines can be used for most of baby's daily activities. Once babies are older than 2 1/2 to 3 months, they start to develop their own rhythms and even settle into their own loose schedules, sleeping and eating at similar times each day.

I'll be honest, routines won't always make your baby sleepy or happy. But if you keep using them with your baby, your routines eventually will become familiar "dances" and you'll both know all the steps. Routines can be especially helpful for busy toddlers, but that's another post...

Next time: We'll share some fun ways to communicate with older babies.