Wednesday, July 18, 2012

5 Tips For Infant Massage

Babies grow super fast. This is no secret. But often in the hustle and bustle of each day sometimes it can be easy to forget what this means for your baby. Imagine if you were going to the gym every day, for around 8-10 hours. No heavy impact, but lots and lots of Pilates style aerobic exercise, weight lifting, and yoga. Just think about how exhausted and sore you would be. Then as you rest, the pain of bone growth would set in. Maybe this isn't exactly how babies feel, but as one who has observed babies over and over again during their first few months, I think it is pretty close sometimes. This is just one reason why I'm such a strong believer in baby massage. Another is that as a mother of an extremely premature son I relied on the calming and relaxing effect of infant massage very often. In this post I will cover some of the best massage strokes for a calming and soothing effect on your baby.

1. Arms and legs

Starting near your little Yogi's hands, gently wrap your hand around his forearm. Then, with minimal pressure, slide your hand toward the shoulder/armpit area. To keep your baby's arm extended as you do this, you can hold your baby's hand with one of your hands, while your other hand executes the massage stroke. Repeat this stroke about 5-10 times on each limb, or as many as feels right and relaxing for you and your baby. When using this stroke on your baby's legs, hold the foot with one hand, start the stroke at the ankle, and slide until you reach the hip.

2. Chest and stomach

There are a lot of strokes that are recommended for a baby's stomach and chest. My favorite for the chest is to start with your hands together each covering one side of her rib cage. Then slowly fan your fingers out toward your baby's sides starting with your pinky fingers until your hands are splayed out across her chest. Then smoothly continue the motion down the sides of your mini-buddha's belly all the way down to her hips. Repeat this stroke between 5-10 times, or as many as feels right and relaxing to you and your baby.
On the stomach the most basic soothing stroke is a circular one that moves in a clockwise direction around your little one's belly-button. Be careful not to get too close to the belly-button, you want to be a minimum of 1-2 inches (2.5-5 cm) away from it at all times. This is clock-wise from YOUR perspective, meaning if you start on your babies right side (the one most easily reached by your left hand) you should first move up and over your baby's belly button, then down and under it, until you end up right where you began. The pressure should be minimal, and you can leave your baby's clothing on if it is more relaxing to do so. This stroke is best used at a minimum of 20 minutes after a feeding, and can be used as much and as often as your baby seems to enjoy it (though the first 20 minutes after eating is not the best time).

3. Back and shoulders

With your baby laying on his stomach, you can use this basic gentle stroke to help calm, and move gas out his lower exit. Starting with one hand over each shoulder blade using gentle pressure slide the heels of your palms down both sides of your little athlete's back at the same time until they reach the diaper line. Put no pressure on his spine, and be aware of trying not to tickle your baby in this position. While tickling will not hurt him, it can be counter-productive when your goal is relaxation. This stroke can be repeated anywhere between 10-20 times, as long as your baby is enjoying it and it is relaxing for both of you.
For the shoulders it is not important for your baby to be laying on his stomach, or back. Either position is fine as long as he is comfortable and relaxed. This is more of a hold than a stroke, as you cup your hands around each of your baby's shoulders and gently pull down toward his hips. I recommend you pull both shoulders at once, but you can do one at a time as well if your baby seems to like it better. No kneading or rubbing is needed for this, just gently pull, and hold for about 20-30 seconds, then release. You can repeat this hold a few times if your baby seems to be particularly calmed by it, but using it too often can cause tension, so trust your instincts and watch your baby for cue's.

4. Feet and hands

Though an open-palm massage is often soothing for an adult, infants often find it too stimulating, and even ticklish. It is much more calming for your baby to have your hand cover her fist and  gently squeeze it while it is closed. Just a small amount of pressure as you cover her fists is enough to release the clenching that she normally has to do herself, and is normally very calming. This hold can be maintained for about 20-30 seconds, and repeated as often as it is comfortable and relaxing for you and your baby.
Similarly, when massaging your little sweet-peas toes you want to avoid tickling her. So softly cover the toe-end of her feet from about the arch and all around the top and bottom at the same time. Then you will move in four directions. First up, gently stretching the toes slightly up toward her knees, then down subtly pointing her toes away from her body like a little ballerina. Next, you will rotate her feet slightly counter clockwise, very gently, and watching her for any signs of discomfort. Follow this by rotating her feet in exactly the she gentle way clockwise. The timing for this part of the massage should be about 2-5 seconds for each direction that your move her toes. When I'm doing this massage, I think to myself: "Up-two-three, down-two-three, twist left-two-three, twist right-two-three, release." Though you can repeat the foot massages often as you and your infant are finding it to be relaxing.

5. Face and ears

Massaging your baby's face can be quite soothing, but it is easy to cause stress if you are not careful where you touch. I recommend this stroke as a way to avoid most of the trigger points for feeding instincts. Starting directly above your little snuggle-pop's eyebrow on the end nearest to the nose, run your fingertips softly along the length of the eyebrow, then across the temple and around the outer edge of of his ear. Not on the ear, but on his head behind his ear. If it is easy for you to do both sides at once, this is more relaxing, but if you find it easier to stroke one side then the other, do that instead. Repeat this stroke as often as you like, using very soft pressure, and slow soothing motion.
Your baby's ears are soft, and sensitive, so vigorous massaging of any kind will most likely not be very soothing. However gently holding the large outer edge and lifting it slightly away from his head can be very soothing indeed. Again, I think of this as more of a "hold" than a stroke, and no kneading or pulling is necessary. Just a gentle grasp and lift should be enough to do the trick. Only maintain the hold for about 5-10 seconds, unless the baby seems to be especially enjoying himself. This hold, and face massage, are best used when your baby has just come in from an overly-stimulating walk, or just after leaving a noisy room with bright lights.

Though it is always important to be in tune with your little bundle's needs, when giving an infant massage it is also very important to be relaxed and grounded yourself. Listen to your instincts, watch your baby's reactions to the different strokes and holds, and if something seems to be causing stress or discomfort, discontinue it at once. Soft music, a warm room, a gently scented hypo-allergenic organic massage oil, all of these things are nice, but not essential to your ability to give an effective and relaxing infant massage.
If you have found these tips to be helpful, please share them with any new or expecting parents you know. Comments, questions, and requests are always welcome. I am working on illustrating this post, and hopefully will have something up soon. Happy parenting!

There is a NEW post from NAOMI up today! Check it out HERE.

Tuesday, March 6, 2012

5 Tips For Baby Milestones 0-3 Months

The sheer volume of developmentally significant moments in the first three months is a bit overwhelming. It can be hard to know which milestones are more important to watch for than others. The tricky thing when looking at milestones at any point in your baby's development is becoming too focused on when your baby should be able to start doing something. Milestones are developmental moments that we watch for to make sure nothing is out of the ordinary. For example, infants can start laughing as early as 3-4 months old. But if your baby doesn't start laughing until she is 5-6 months old there is still nothing out of the ordinary. This milestone is only important when the normal span of time for it to occur has passed. So if your baby still hasn't laughed by 9-12 months, there might be something wrong. There are very few things that must happen in the first three months in order to be sure that your baby is developing on schedule. Five of them are listed here.

1. Turns head toward sounds.
The acknowledgement of hearing sound and expressing curiosity about where the sound came from are very important. Your baby can start to show this interest right away, or it may take a few weeks. However, if your little Sherlock is showing no interest in sudden sounds that are coming from outside their range of vision by the age of three months, there might be something seriously wrong. If your baby does not meet this milestone, it could be caused by a number things, including deafness, and neurological issues, so bring it to your pediatrician's attention right away.

2. Eyes follow your face.
This is called "tracking", and it is a social instinct that teaches your baby how to communicate. Although babies don't speak, or even learn to use sign language for several more months, they are learning to interpret your expressions, your tone of voice, and your physical cues from the first couple of weeks. If your baby isn't showing any more interest in your face than in a random toy or mobile by three months this could be indicative of a serious issue. Though the particular cause is best left for your pediatrician to sort out, it is something very important to watch for.

3. Resists when arms or legs are pulled or pushed.
The instinct to pull or push with arms and legs is essentially your baby's built-in personal trainer. Your baby has to grow new muscles and continually strengthen existing muscles constantly from the moment they are born. Her body is growing so fast, and getting heavier , so nature made sure she would be born with a need to push and pull, kick, and grab, twist and wiggle, constantly. If this instinct hasn't kicked in, or seems to be barely there, it could cause many physical development delays and result in years of physical therapy. As well as being a sign that there might be something seriously wrong. But it is easy to test, just give a little tug on your baby's hand while she is awake and alert. If she pulls away, she is fine.

4. Tries to suck on things that brush the cheeks.
This instinct normally kicks in within minutes of birth. However, it can sometimes take a bit longer. The urge to turn his head and start suckling is of course one of your little kissy-face's most basic survival instincts. It is there to help him figure out how to eat. Though you can still feed a baby who does not have this instinct, it is important to bring it to your pediatrician's attention, as it could be a sign of something more serious.

5.Grasps an object with purpose.
Now this skill does take just a bit longer to kick in. At first your baby will just swat at things or nudge them with her hand, but after a month or two, she should be able to grab something within her reach that she is looking at. Though she won't learn to let go for another month or two, learning to grab, on purpose, is something that demonstrates the normal development of curiosity, independence, and physical coordination. If this skill is late in showing up, even if the cause is not a very serious one, it could point to a particular type of challenge that your diaper-dweller will have to face. Such as the need for help with fine-motor skill development, or being encouraged to explore and ask questions, or needing extra encouragement to try new things. Of course your pediatrician will help in determining how serious the cause of missing this milestone is. And guide you in the proper direction to give your baby the help she may need.

Always remember, milestones aren't there to promote competition, it doesn't matter in the least if your baby started doing something two weeks or a month before another baby. And it doesn't matter if it takes your baby a month or two longer to master a skill like rolling over or sitting up than other babies you see of the same age. The most important thing about milestones is to be sure that your baby will have the earliest possible care for any issues that could have an effect on his development. If you have found these tips to be helpful, please forward them to any new or expecting parents you might know. And as always, your questions, comments and suggestions are always welcome. Happy parenting!

Wednesday, January 18, 2012

5 Tips About Your Baby's Spit-Up

Many of us parents worry about our baby spitting-up milk and/or formula. Sometimes it can seem like our little regurgitators don't keep anything down at all! I often get asked questions about this constant concern, and in my recent poll it was voted the topic of most interest to you. However, since many of the questions I am asked don't have to do with how to minimize spit-up, I decided to take this opportunity to simply answer some of the most common questions many parents have on the topic.

1. Is spit-up dangerous during sleep?
Laying your baby on his back to sleep is considered the safest position. But this obviously leads to the concern that your infant may choke on his own spit-up. This is not a common problem for most babies. Most babies will turn their head slightly to the side during sleep, and even if they don't they have reflexes that help them avoid choking on their spit-up. If you have ever dripped water on your little splasher's face during his bath, you might have seen him arch his head and body backward while waving his arms. This reflex is to help your baby roll onto his side if any thing obstructs his breathing. He will do the same thing, even while asleep, if his airway is not clear. Even swaddling will not keep your baby from arching his back and turning his head. The only time when night-time spit-up might be dangerous is if your baby has a cold that is producing a lot of mucus. If your baby is having trouble breathing anyway, there is a chance some spit-up could be sucked into the lungs on accident. There are some dangers that this could cause, so if you suspect that this has happened I would contact your pediatrician right away. Signs that your baby might have inhaled some spit-up are, excessive coughing, coughing while crying, and a rattling sound to their breathing between coughing.

2. Why does my baby spit up when laying down?
Many babies have trouble keeping their food down when laying flat, because there is a valve that is often under developed or not yet very strong at the top of the stomach that is meant to keep food down once swallowed. When this valve is so underdeveloped that it hardly functions it causes the condition known to most of us parents as "infant reflux". Even if your baby doesn't have reflux, when there is still liquid in her  belly and you lay her down, the food will sometimes leak back into her throat (which can be painful because there will probably be some stomach acid mixed in) and stimulate the gag reflex, which causes spit-up. It helps clear food out of the airway before it is accidentally inhaled into the lungs, but also causes a bit of a mess. Most of the time digestion of breast milk and formula is pretty fast, and almost all of your baby's food will be gone within 10-15 minutes after a feeding. However, every baby is different, and as your little one grows she will change as well. Sometimes this means that digestion will take longer, or that there is something about the feeding that disagrees with your finicky nibbler's tummy, and there may be a bit more left to toss back up the pipes than normal. As a good rule of thumb, try to keep your baby's head elevated a few inches above her stomach for at least 20 minutes after feeding to try and ensure that most of the food has been digested before you lay her down flat.

3. Is white chunky spit-up normal?
There are several different types of spit up. The most common is fairly watery with a few chunks of white cheesy-creamy stuff in it. This kind is usually seen pretty quickly after a feeding, and most often in infants that are having a bit of excess drool. The reason the spit-up is watery with little white chunks is usually because the spit-up was triggered by a burp which brought up both bits of partially curdled milk (curdling is a natural reaction to your baby's stomach acids, and is part of the digestion process), and mixed it with the excess saliva that was both in your baby's throat, and in his mouth. Another common kind is a large amount of milky-white chunky stuff. This usually comes right up from the tummy, and is often the result of a strong gag reflex getting triggered accidentally by a burp (...or a finger, or a toy, or a pacifier). It can also be caused by a bit too much horsing around too soon after eating. And, more rarely, it can be caused by nausea from a sickness. In general, white chunky spit up is absolutely normal. Other common types of normal spit-up are mostly milky (few chunks) and mostly watery (no milk or curdled milk chunks).

4. Is my baby spitting-up too much?
Almost always the answer to this question is "no". If your baby is eating regularly, having a normal number of wet and dirty diapers, and is continuing to gain weight, then she is getting enough to eat. It can seem like your baby is spitting up an awful lot, but it is extremely rare for a baby to spit up an entire feeding. The reason for this is, that digestion begins as soon as your baby swallows her first mouthful. And for a baby who is 3-4 months old digestion proceeds at an average rate of 1 ounce (30 ml) every 10-15 minutes. So if your baby eats approximately 5-6 ounces (150-180 ml) and a feeding lasts around 15-25 minutes, a great deal has been digested by the time your adorable little lactarian has finished. Even if your baby occasionally empties everything left in her stomach within 5-10 minutes after eating, the most that would come up would be around 2 ounces (60 ml). Now, don't get me wrong, 2 ounces (60 ml) can seem like an awful lot when poured down your neck, but as far as it being a sign that your little tulip isn't getting enough nutrition, it is unlikely. However, trust your instincts, and if you feel like something is really wrong with your baby, always check with your pediatrician.

5. How can I tell if my baby's spit-up is not normal?
In some cases there are conditions that cause strange spit-up. Some signs that you should immediately bring to your pediatrician's attention are:
  • If your baby's spit-up is discolored (Yellow, green, red, blue, etc).
  • If your baby spits up something that looks like coffee grounds.
  • If your baby is not gaining weight appropriately.
  • If your baby is forcefully expelling spit-up type fluid (projectile vomiting) frequently.
  • If your baby resists feedings and is still spitting up large amounts.
  • If your baby spits up constantly throughout every feeding.
  • If spitting up seems to be causing your baby sharp pain (screaming and crying immediately after spitting up on a regular basis).
 Unless you see one of these strange types of spit up, your baby's spit up is probably normal.

Although there are many things to worry about with your new baby, generally spit-up shouldn't be one of them. The worst thing about spit-up for most parents is the inevitable spoiling of a favorite shirt, or getting some splattered on  your face. If you have found these tips helpful, please forward them to any new, or expecting parents you know. As always questions and comments are always welcome! Happy Parenting!

There is a NEW post from NAOMI up today (9/5/14)! Check it out HERE.