Health Warning about Baby Wearing

Baby wearing has been gaining in popularity over the last few years as a good way to maintain closeness and reassure your baby while leaving you with hands free for other things. This practice has been something both mum and baby enjoy but recently there have been a number of babies who have died while mum was out walking with her baby "safe" in a fabric sling.

The slings concerned are the soft fabric ones which do not have frames and are designed to carry baby in a lying down position rather than being held upright. The greatest risk, it is suggested, is to premature babies or babies with a low birth weight, babies from a multiple birth or babies with respiratory conditions.
The suffocation risks are linked to incorrect positioning of baby;-

1) Either the baby is in the C position with their chin tucked into the chest blocking their airway.
                                                               OR
2) The baby's nose and mouth is covered by the fabric itself.

Over the past 20 years 13 babies have died in the USA while being carried in a sling. 12 of them were less than four months old. The majority were premature or were experiencing breathing problems or had a cold.

The safety advice is as follows;-
Be sure your sling is tight
The adult "wearing baby" should be able to look down and see their baby's face.
The adult can kiss baby's face by tipping their head forward.
The baby should never be curled up so their chin is forced onto their chest as this restricts breathing.

The simple mnemonic is TICKS
Tight
In view at all times
Close enough to kiss
Keep chin off chest
Support back

Taking baby swimming.

Learning to swim is a survival and a life skill and can be a lot of fun. Many pools offer classes to young children. Here are some things you should know;-

•  Your baby does not need to have had any vaccinations, or to have completed a vaccination schedule before you take them for a swim. When live Polio virus was given, this was the recommendation but since the Polio vaccine is no longer live this is no longer a risk.
• Babies should wait one hour after feeds before a swim.
• If your baby has had a tummy bug wait two days after  the first solid poo before going swimming.
• Babies with ear infections should not swim until they have completely recovered.
• Avoid changing diapers by the pool side.
• Dress toddlers in close fitting swimsuits to contain any poo.
• Reduce the risk of "accidents" by taking frequent toilet breaks.
• Don't rinse your hands in the pool after a nappy change, use soap and water.

The temperature of the pool and the changing area are really important. A baby cannot control their body temperature. Pool water should be at least 30 degrees C. Taking a towel to the poolside so that you can wrap baby for the return to the changing room is comforting and keeps baby warm. A babies skin and eyes are more sensitive than an adults and the chemicals used to sterilize the pool can irritate the skin and eyes of some babies, so building up time in a pool can be helpful in letting baby adapt to these. Showering baby immediately after a swim will also reduce the effects of these chemicals.

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Simple ways to move to drinking from a cup

When infants are born they are able to nurse and to suck milk from breast or bottle. As they grow they move to drinking from a cup or beaker. Usually this is started at about 6 months, or when the infant can sit unsupported. This does not mean that it becomes immediately safe to leave a little one with a cup or beaker any more than it is safe to leave them alone with any foodstuff or bottle. There is still a risk of choking.

Using a standard paper cup you can make an appropriate drinking solution when out and about.

Mark the paper/plastic cup leaving a small container to hold the liquid.

In this case the rim has been left intact to keep the structure rigid, but removing this part of the rim is OK it just makes the cup more "bendy".

Now you can easily see how much fluid is heading to baby's mouth and can avoid rushing this experience and ending up with some fluid going into your little one's nose!

In these pictures a doll has been used to demonstrate this, but the principal is the same when adapting a paper cup for a child who can sit unsupported.


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Milk, Formula and other "baby milks"

 Accepting "breast is best" for infants we have also to recognise that not every mother chooses to breast feed. There are many manufacturers of different formula milks for parents to choose from. These are well researched and often aimed at particular issues. You can find "Anti Reflux" milks, "Comfort" milks, first second and growing up formulas. The choices can be bewildering. 

Recently some mothers have been talking about using Rice milk to avoid lactose intolerance or allergies. Rice milk is contraindicated for children under 5 years. Arsenic is present in the soil where rice is grown and cultivated, so rice milk may contain very small trace amounts of arsenic. This arsenic can build up in the child's body and is a poison, so, rice milk is not recommended.

Soya/Almond and Oat milks can be used in cooking but are not recommended as a main drink for infants as these are usually very low in calories. When milk is the main food the calorific content is as important as the vitamins and minerals which are generally added to formula milks. Once a child is two years old these can be used  and, by two years of age, semi skimmed milk can also be used.

Alpro have brought out a soya milk which is suitable for children from 1 year of age because it has added fat, calories and vitamin D. This milk is called Alpro+1.

When a child reaches a year of age, they should be offered pasteurized full cream milk. This contains the right amount of calories and fats. Once a child is drinking less than 500mls of formula per day they should be given a daily vitamin supplement, containing vitamin D and this should continue until they are 5 years old.

From the time your little one starts on semi solid diet they should be having about 300mls of milk daily. This includes yoghurt, milk based deserts and drinks. It is good to encourage children to drink water rather than fizzy drinks and sweetened diluting juices. As the child starts on a semi solid diet fluids should be offered in a beaker or cup rather than a bottle. Many parents keep the last drink at night in a bottle for a little longer and until family diet is established. Dummies/comforters and bottles can stop your child talking properly making their speech unclear which is frustrating for both parent and child.

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Weekdays and weekends....

Parents often ask if their child can learn the difference between week days and weekends. This is usually asked because there is some thought that perhaps this little person could learn to sleep longer at the weekend. Unfortunately children don't learn to alter their sleeping pattern depending on the day of the week, until they are teenagers. At that time there are other forces in play.

Routines are very important to children. These are the touchstones of a child's life. Having some certainty that meal times and play times are regular events help the child to understand what the adults expect and desire of them. If we look at our own lives we have some routines which may not be recognised as such, but which make our lives easier because they add to our own understanding of the world.

Yes, children can often recognise that on one or two days of the week parents are not away at work, that there is family time, and that at the weekend the day runs along different lines. They don't know that this is Saturday and Sunday. The basis for a good sleep pattern cannot be adjusted and then readjusted in so short a time frame.

Family time can be positive for those who have difficulties with food refusal or fussiness. At weekends there is usually more time and children who have demonstrated food refusal or fussiness can be involved more in the preparation of foods. There is more time to spend exploring textures and tastes and this can be a positive re enforcement of the enjoyable and sociable aspects of food.

Simple things like teaching a child to spread butter, applestrop, or cheese on bread encourages them to explore texture and taste and encourages a level of independence. Helping to set the table at meal times, to wash the vegetables, and to see how cooking is done and how that changes the food being cooked ,can help develop an interest and make it more acceptable to try a new taste or even experience a familiar one.

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Lullabies and their importance in childhood.

Parents have always sung songs to their children. These songs can be the precursors to developing language, learning about cadence and rhythm. Even very  young infants who have heard a song repeated, will start to repeat the cadence and rhythm of the end of the verse. This is also true of the nursery rhymes we tell our children. If they are repeated regularly from infancy, by a few months the child will replicate the last part of the verse.

The songs you choose to sing are not as important as the sound of your voice.

Dr. John Lind, professor emeritus at Karolinska Institute in Stockholm, Sweden, discovered that children who have parents with rather poor singing voices still grow up to love to sing, and are able to sing on key (Fletcher, 1981, p. 26). It is more important that parents sing to their babies than that they sing well. Authorities like Lind and Hardgrove (1978) remind us, “It is not the quality of the voice that matters, it is the connection....It is not the on-key, smooth mechanical perfection that brings joy to infants as well as adults. The joy comes in the rendition, and the example of this intimate parent-to-infant message encourages the child to sing”

 Although singing lullabies comes naturally to many people, some may need a few tips on sharing them with infants. Infants’ interest in a world of sound can be enhanced in different ways and through different qualities of tones and pitches, rhythmical movement, and songs.

Suggestions for Singing Lullabies to Infants 

Build a repertoire of favorite lullabies. If possible, memorize them. This is important, as many of today's young parents have no memories of lullabies being sung to them, and are not familiar with the most beautiful lullabies from around the world. There are excellent lullaby books on the market. There is also a wide variety of good lullaby compact discs (CDs) and cassette tapes available.  

• Note: Tapes and CDs should be used only as accompaniment or as an aid when learning new songs. The parent's or teacher's voice should always be present.
• Some infants prefer one lullaby over another; however, don't limit your singing to only music considered to be lullabies. Try singing contemporary songs and show tunes. Infants enjoy variety and change of pace.
• As you securely hold and gently rock an infant, smile warmly and look directly into the infant's face and eyes. This kind of "bonding" brings contentment and security to the infant.

As your child grows action songs become more interesting because the actions encourage play and make the music even more interactive. Singing can lift the spirits even on a grey day when the world seems to be against you, making time to make music with your little one is an intimate connection that will live on and probably be replayed with their own children. Lullabies can be a lifelong gift carried through generations like family histories.

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What controls the circadian rhythm in babies and when is it developed?

At 6 week old baby has no idea about day or night, and has no 24 hour rhythm. By 60 days, to 3 months (12 weeks) this rhythm is developed or developing.  Hormones are beginning to shape your baby’s day and night. This internal biological clock is controlled by a part of the brain called the hypothalamus – in a small section known as the SCN. The SCN receives information from the eyes, from temperature, social cues and food availability.

Natural dawn light is white/blue light which encourages us to wake up by cueing the release of Cortisol, the wake up hormone. As the day passes to night natural light becomes orange/red light, encouraging the brain’s release of Melatonin, the hormone of sleep. Using electric white/blue light when attending to your child at night, is stimulating the release of “wake up” hormone. Using a low level red/orange light is going to naturally be less disturbing,

If food is always available from 7pm to 7am, you are training your baby to regularly be awake at night expecting food.  Again, this disrupts the body clock. Few children, from 9 months old, physically require feeding at night. These late night milk feeds have other physiological effects on babies. When babies consume milk, their bodies produce insulin in response to this. Insulin secretion has actually been shown to block the production of melatonin the sleep hormone.

These lowered levels of melatonin are what then create a fitful night’s sleep for your baby, who then struggles to get into a nice deep sleep cycle without enough of this hormone. This is why, if you resisted that feed after midnight, your baby would eventually settle until morning – even if you heard them wake and re-settle a few times.

Night time feeding also delays the production of another hormone called ghrelin, this hormone helps control appetite. Studies show as the number of hours of sleep increase, ghrelin concentrations decreases, thereby reducing appetite. This reduced appetite allows your baby to sleep for longer period without waking hungry.

So not only are there hormones disrupting his sleep, an excessive fluid intake can cause him/her to wake up wet and uncomfortable, and the milk in the digestive tract is sending information to tiny little biological clock controls, to tell baby to wake up, as food available = day time!

Each time your baby sees your beautiful face at night contributes to disruption by sending messages to that SCN in the brain that this is a social time of day and not a time to be sleeping. This further confuses your baby’s circadian rhythm. This is the  truth behind the strict “no eye contact no smiles at night” that parents are encouraged to follow. Eye contact and using a name is encouraging the possibility of a prolonged interaction, play or negotiation. Night time is sleep time and this should not be negotiable.

If you would like help and support to alter your child's sleep behaviour;-
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