Are sleeping problems common?

You’ll probably be relieved to know that they are very common and a lot of parents are in the same boat.  Between a fifth and a third of all families report they have some kind of sleeping problem during the pre-school years (Messer and Richards, 1993).  

Source: lullaby

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

How much sleep is needed ?

Baby Sleepy

Parents are often concerned that their baby may not be sleeping enough, whilst others voice their concerns about their baby sleeping too much. I think it may be useful for parents to know the amount of hours that the average baby sleeps at different ages.  However, it is important to remember that there is a  huge variation that exists from one baby to the next.  Some newborn babies sleep 21 out of the 24 hours per day.  Others only need as few as 8.  The test to see if your baby is getting enough sleep is to examine if she is waking happy and alert.  If so she is getting enough sleep.  If she wakes and is irritable or tired, she may need to sleep longer.

Baby Sleeping Timing

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

What New Parents Fight About

When you're disoriented, sleep-deprived, and cranky from acclimating to life with your baby, it doesn't take much to set off a big fight with your partner. 

Below, find the top five comments that make a new parent's blood boil — and how to keep the peace instead.

 

 

 

"Can you get up with the baby? I'm exhausted."

With a baby's arrival, sleep suddenly becomes a thing to be shared, taken in shifts, and negotiated. This can be a shock to your system as a couple.
"What stands out to me the most was how possessive of sleep we got. We argued a lot about who deserved it more," remembers one mom.

Keep the peace: Try to stay away from the "I'm more tired than you" competition. "No one can say who's more tired, because neither of you really knows. The reality is, if you're both feeling exhausted, you both need help," says Carolyn Pirak, a licensed clinical social worker and director of Bringing Baby Home, a program that focuses on relationship building for new parents.

If you can afford a babysitter, consider hiring someone on a short-term, regular basis so that you and your partner can catch up on rest. Or accept assistance from family members or close friends. There's no shame in getting help so that you can both get more sleep. In fact, it's a responsible thing to do because it's good for the overall health of your family.

To avoid arguments over whose turn it is to get up, set up a "sleep trade-off" with your partner. For example, you could each get one weekend day to sleep in, take four-hour shifts throughout the night, or — if your baby is taking bottles — do one night on, one night off.

If one parent is working and the other is staying home with the baby, you may choose to arrange things so the working parent gets more sleep on weeknights but picks up the slack on weekends, when the stay-at-home parent can sleep later, sleep longer stretches, or take naps.

Remember that sleep deprivation can make people irritable, depressed, and more likely to argue. A few hours of extra slumber can make a surprising difference in your mood and outlook.

"Here, the baby wants you"

If your partner tensely asks you to take the screaming baby after just a few minutes, you may struggle not to let loose with a few screams yourself. "As soon as our son needs something or starts crying, my husband hands him off to me," says one mom. "He'll only spend time with him when the baby's happy."

Keep the peace: Remind yourself that your partner isn't necessarily trying to shirk baby duty. As one father explains, "I want to comfort my child. But it's kind of hard when she's screeching as though I'm the devil."
Work with your partner to develop routines with your baby. This will cut down on the screaming-for-mommy phenomenon.

"My job was to give our son his bath," says Charles Neuman, a father of three. "Since it was my job, there was no discussion of it. I knew what to do, I always did it, and my son was used to having me do it."

Develop a routine for the baby hand-off, too. "If you meet your partner at the door and immediately give him the baby, it can be a setup for failure. The transition is too abrupt," says Pirak.

Instead, spend some time together as a family. Then calmly take your leave. If you do this on a regular basis, your baby learns to expect it and is less apt to protest.
Many fathers find that using a sling, carrier, or other babywearing device, which holds a baby close and snug to their body, can help ease mommy hunger.

But there are times when babies keep crying despite a parent's valiant efforts to soothe. That's okay. Encourage your partner to hang in there with your screaming baby. It's good practice and, in the long run, may help your baby accept him as a comforter.

"What do you do all day, anyway?"

Babies have only a few basic needs — but meeting those needs can easily fill your days. Dishes pile up in the sink, laundry remains unwashed, errands go by the wayside. The fact that a tiny baby can wreak such havoc on adult schedules is one of the biggest surprises of new parenthood — and it can be difficult for a parent who's away from home all day to understand.

"My wife would come home from work and immediately begin marching around the place, picking things up. She'd finally blurt out, 'What do you do at home all day, anyway?'" says Cary Levine, a father of two who stays home with the kids one day a week.

"It's true that the house was a mess — but after spending the last nine hours trying to feed and entertain a 6-month-old, the last thing I needed was a lecture."

Keep the peace: Getting defensive is a natural response, but it only makes things worse. "I'd immediately rattle off an array of excuses for why the house was messy, finally resorting to the 'How many fathers do you know that stay home?' line. We'd end up arguing," says Levine.
Instead, use "I" statements to tell your partner how this makes you feel. For example, "I feel defensive when you ask me that question." This can help defuse things until you have time to talk, says Pirak.

Wait until your child is asleep and you can have a calm, solution-focused discussion. This worked for the Levines: "I agreed to pay more attention to what needed to get done during the day, and my wife agreed to accept that the house might not be in tip-top shape when she walked in," he says. "Of course, after a month or so, we'd lapse into our old ways, but we'd just have another sit-down and refocus."

"But I cleaned up last week!"

A new baby means new chores — like diapering and feeding — as well as more of the old ones, like cleaning, shopping, and laundry. In fact, according to Pirak, caring for a new baby creates about 350 separate chores per week!

It's no wonder that parents feel overburdened and unsure of how to divide up the work in a way that feels fair to both partners.

Keep the peace: Don't fall into the trap of expecting your partner to read your mind and then feeling resentful when it doesn't happen. Instead, explain how you're feeling, once again using the good old "I" language. For example, "I'm feeling overwhelmed and burdened because of all the household chores."

Explain that you need help. Get down to the nitty-gritty specifics. Instead of a vague "You need to clean up more," try "Can you fill the dishwasher while I run a load of laundry?"
Setting up a regular system for chores can be particularly effective. "I'm in charge of vacuuming, dusting, and dishes," says Neuman. "My wife, Erika, is in charge of cooking, general straightening, cleaning the bathrooms, and the children's laundry."

"I'll be right back!"

"I'm just going to check something on the computer," says your partner, ducking into the bedroom. When he emerges 45 minutes later, he can't understand why you're fuming. Or she goes out to do a "quick" errand, which somehow turns into a series of super-errands.

"My husband would take off for hours," says one mom. "He'd go shopping for something, wouldn't be able to find it, go to another store...and all I knew was that he was gone while I was stuck with the baby. I got mad about it a lot."

Whether on purpose or by accident, "the great baby escape" happens when new parents desperate for "me time" steal a few moments — or hours. But for the parent left behind, it's anything but minor.

Keep the peace: Using "I" language again, express your feelings to your partner. For example, "When you spend time on the Internet while I'm caring for the baby, I feel left out and like I'm being taken advantage of." Present your concern as a problem to be solved, rather than as something your partner has done wrong and should feel guilty about.

Then come up with a plan — together — so that you can both have time to pursue your individual interests.
The Levines tackled this issue by making a calendar to track and schedule their time spent at work, doing childcare, being together as a family, and doing things alone.

"Scheduling family time seems silly, but it preserved the notion of having time when we were all together and really focusing on the kids, as opposed to trying to multitask, which is always a disaster," says Alyse Levine.

Additional tips for keeping your post-baby relationship strong

Don't supervise: If it's your turn to take a break, take it! Don't use the time to advise your partner on how to handle the baby. Remember, there are lots of ways to soothe and entertain — and if your partner's style is different than yours, all the better for your child's flexibility.

Have a date night: Sure, you love your baby. But it's important to have some couple time too.

Show appreciation: A little acknowledgment can go a long way. So express your gratitude for things your partner does, like taking out the trash, making the baby smile, or bringing home the bacon. It will make him feel good — and will likely have a boomerang effect.

Get professional help if you need it: Couples counseling can be extremely helpful. Some insurance companies will help cover the cost, or try your place of worship or local social service agencies for low-cost or free counseling.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Massaging your Baby

Many traditional cultures believe that massaging the new born baby is an absolute must, and even modern child rearing practices now highlight the several reasons why infants can benefit from massage:

Bonding with your new baby

The new baby’s senses are not very finely attuned; but they do love being touched.
A mother’s soothing hands and familiar voice are a source of delight for a small baby who is bewildered to be out of the embrace of his mother’s safe and warm womb and out into a world of light, noise and all manner of unfamiliar sights.

Massage is one way for a new child and mother to bond in the most basic way that there is; by touch. Looking into your baby’s eyes as you massage his lovely new skin the baby recognizes and learns to love the most important face in his tiny world.

He finds comfort in the beloved voice of his mother that he has known from before his birth and in the firm touch of her warm hands as they massage him.

It will Ease baby’s Discomfort

If a new born suffers from colic or distention of the abdomen, massage will greatly relieve his discomfort and perhaps cause him to pass gas so that his fretfulness will be eased. A restless, wakeful baby will likely be tired out by a massage and this will help him sleep better.
As the mother massages the baby she engages with him by murmuring to him, singing to him or laughing with him; thereby keeping him amused and entertained and diverting his mind from any discomfort he may be in.

Good for Baby’s soft skin and Circulation

While it is not a good idea to use aromatherapy oils that an adult would typically use, most pediatricians recommend the use of an unscented olive oil for use on a baby’s skin that will keep the baby’s skin soft and moisturized.
Olive oil is also unlikely to cause any kind of allergic reaction or rash to develop on the baby’s sensitive skin.  Massage typically aids and improves circulation even among adults and using the proper technique to massage your baby will have just such a beneficial effect on your baby’s circulation.

Improves Growth and Development

According to some studies, premature babies who are regularly massaged, have been seen to gain weight at a faster rate. They also showed better growth and development.  They also seemed more alert and active and were able to leave hospital earlier than other premature babies.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Top Ten Worries of New Parents

You already know that worrying is part of the parenting turf. (You'll find it listed in the job description right after guilt.) What you may not realize until after your baby arrives, however, is just how many things there are to worry about-and how normal it is to drive yourself crazy by panicking about every little thing.

Believe it or not, you will probably find yourself obsessing about the very same things that your parents worried about when they were raising you-and that their parents fussed about a generation earlier. 

While child rearing philosophies and infant feeding practices have changed dramatically over the years, worrying about your new baby never quite goes out of fashion.

Here is a list of the top ten worries of new parents. 

 

1. Will my baby die?

There's no doubt about it: if there's one thing that tops the new parent worry list, it's the possibility that your baby could die. The first time he sleeps through the night on his own, you awake in a panic, wondering if he's alright.

The fear of losing a child to Sudden Infant Death Syndrome can be particularly strong for new parents, notes Dr. Tiffany McKee-Garrett, an assistant professor of pediatrics at Baylor College of Medicine in Houston, Texas. The good news on the SIDS front is the fact that SIDS deaths are relatively rare, occuring in just one or two of every thousand live births.

2. Will I be able to protect my baby from harm?

The world can suddenly feel like a very scary place when you're entrusted with the task of caring for a newborn. Fortunately, newborn babies aren't nearly as fragile as they look, and common sense and parental instinct enable most parents to keep their babies safe from harm.

3. Is my baby "normal"?

Something else that most new parents worry about is whether or not their baby is developing normally. McGee-Garrett spends a lot of time reassuring worried parents that their babies are well within the normal range in terms of their development. "I try to remind these parents that there is a large variability in the timing of when babies do things," she explained. "In the vast majority of cases, despite the parents' concerns, the baby is developing just fine."

4. Is my baby getting enough to eat?

While parents of formula-fed infants may also fret about whether their babies are getting enough to eat, feeding-related worries tend to be more of a concern for parents who are breastfeeding. Part of the problem, of course, is that it's impossible to measure the amount of liquid that a breastfeeding baby is consuming--other than counting the number of wet and soiled diapers that the baby produces over the course of a day. Fortunately, most new mothers grow more confident in their bodies' ability to provide for the needs of their breastfeeding babies once they and their nursing babies gain a little more experience.

5. Is my baby crying too much?

Many new parents are shocked to discover how long and how often newborns cry, and may worry that the crying could be a sign of a more serious problem. McKee-Garrett tries to reassure the parents that she works with that crying is perfectly normal infant behavior, and that as long as the baby looks well, the crying is unlikely to do him any real harm. And to parents of colicky babies, she offers these reassuring words: "This too will end. Your baby will grow out of the colic by age three months-age four months if you're really unlucky."

6. Is my baby sleeping too much-or too little?

If your baby sleeps through the night right away, you may worry that he's not eating often enough. If he's not sleeping through the night by the time he's six months, you may worry that you're setting him up for a lifetime of bad sleeping habits by failing to teach him to sleep through the night. Fortunately, most newborns settle into more adult-friendly sleep patterns by the time they reach three to six months-good news for parents who can't imagine anything more satisfying than a good night's sleep!

7. Will my other children learn to love the baby?

Parents who are expecting their second or subsequent child frequently worry about how their firstborn will adjust to the arrival or a new baby or sister. While there can be some rough spots on the road to sibling acceptance, most older children do learn to welcome-or at least accept-the new baby.

8. Will life ever be the same for my partner and I?

Another worry at the top of the list for many new parents is how they will manage to stay connected with their partner when baby makes three-or four-or more! While it's hard to find much "couple time" when you have a newborn around, most couples take solace in the fact that the exhausting newborn phase only lasts for a short time. Once the baby is sleeping through the night-or at least for a couple of hours at a time-most couples are able to find the time and energy for romance again. 9. Will I be able to provide for this child financially? Another big worry-especially for first-time fathers-is money. It's a concern that Harriet Lerner, Ph.D., bestselling author of The Mother Dance, has heard time and time again from men: "New fathers feel tremendous pressure to earn, earn, earn."

Despite what many panicked first-time fathers fear, babies don't have to cost the earth. Borrowing as much as possible from family members and friends and shopping secondhand are two excellent ways of reducing your baby's bottom line.

10. Will I be a good parent?

One of the most common worries of new parents-particularly of new mothers-is about whether they are up to the challenges of parenting.

Given society's extraordinarily high standards of mothers, new mothers have good reason to be scared, says Lerner. "Society has expectations for mothers that even a saint couldn't meet."

While this particular worry never disappears entirely, most new mothers resolve their Madonna complex by learning how to accept their imperfections on the parenting front.

While there are plenty of things for new parents to worry about during their baby's first few months of life, most parents discover that their anxiety level begins to decrease a little as time goes on.

That was the case for Laura Augustine, 31, whose son, Sam, recently turned one. "I was pretty paranoid when we first brought Sam home from the hospital," she recalled. "I can't believe how much easier it is now."

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Breast Compression

The purpose of breast compression is to continue the flow of milk to the baby when the baby is only sucking without drinking. Drinking (“open mouth wide—pause—then close mouth” type of suck—) means baby got a mouthful of milk. If baby is no longer drinking on his own, mother may use compressions to “turn sucks or nibbling into drinks”, and keep baby receiving milk. 

 

Compressions simulate a letdown or milk ejection reflex (the sudden rushing down of milk that mothers experience during the feeding or when they hear a baby cry—though many women will not “feel” their let down).

The technique may be useful for:

1. Poor weight gain in the baby

2. Colic in the breastfed baby

3. Frequent feedings and/or long feedings 4. Sore nipples in the mother
5. Recurrent blocked ducts and/or mastitis
6. Encouraging the baby who falls asleep quickly to continue drinking not just sucking
7. A “lazy” baby, or baby who seems to want to just “pacify”. Incidentally babies are not lazy, they respond to milk flow.


Compression is not necessary if everything is going well. When all is going well, the mother should allow the baby to “finish” feeding on the first side and offer the other side. How do you know the baby is finished the first side? When he is just sucking (rapid sucks without pause) and no longer drinking at the breast (“open mouth wide—pause—then close mouth” type of suck). Compressions help baby to get the milk.

Breast compression works particularly well in the first few days to help the baby get more colostrum. Babies do not need much colostrum, but they need some. A good latch and compression help them get it.

It may be useful to know that:

1. A baby who is well latched on gets milk more easily than one who is not. A baby who is poorly latched on can get milk only when the flow of milk is rapid. Thus, many mothers and babies do well with breastfeeding in spite of a poor latch, because most mothers produce an abundance of milk. However, mother may pay a price for baby’s poor latching—for example sore nipples, a baby who is colicky, and/or a baby who is constantly on the breast (but drinking only a small part of the time).

 
2. In the first 3-6 weeks of life, many babies tend to fall asleep at the breast when the flow of milk is slow, not necessarily when they have had enough to eat and not because they are lazy or want to pacify. After this age, they may start to pull away at the breast when the flow of milk slows down. However, some pull at the breast even when they are much younger, sometimes even in the first days and some babies fall asleep even at 3 or 4 months when the milk flow is slow.


Breast compression - How to do it

1. Hold the baby with one arm.

 
2. Support your breast with the other hand, encircling it by placing your thumb on one side of the breast (thumb on the upper side of the breast is easiest), your other fingers on the other, close to the chest wall.

3. Watch for the baby’s drinking, (see videos at www.drjacknewman.com ) though there is no need to be obsessive about catching every suck. The baby gets substantial amounts of milk when he is drinking with an “open mouth wide—pause—then close mouth” type of suck.

4. When the baby is nibbling at the breast and no longer drinking with the “open mouth wide—pause—then close mouth” type of suck, compress the breast to increase the internal pressure of the whole breast. Do not roll your fingers along the breast toward the baby, just squeeze and hold. Not so hard that it hurts and try not to change the shape of the areola (the darker part of the breast near the baby’s mouth). With the compression, the baby should start drinking again with the “open mouth wide—pause—then close mouth” type of suck. Use compression while the baby is sucking but not drinking!

5. Keep the pressure up until the baby is just sucking without drinking even with the compression, and then release the pressure. Release the pressure if baby stops sucking or if the baby goes back to sucking without drinking. Often the baby will stop sucking altogether when the pressure is released, but will start again shortly as milk starts to flow again. If the baby does not stop sucking with the release of pressure, wait a short time before compressing again.

6. The reason for releasing the pressure is to allow your hand to rest, and to allow milk to start flowing to the baby again. The baby, if he stops sucking when you release the pressure, will start sucking again when he starts to taste milk.

7. When the baby starts sucking again, he may drink (“open mouth wide—pause—then close mouth” type of suck). If not, compress again as above.

 
8. Continue on the first side until the baby does not drink even with the compression. You should allow the baby to stay on the side for a short time longer, as you may occasionally get another letdown reflex (milk ejection reflex) and the baby will start drinking again, on his own. If the baby no longer drinks, however, allow him to come off or take him off the breast.

9. If the baby wants more, offer the other side and repeat the process.

10. You may wish, unless you have sore nipples, to switch sides back and forth in this way several times.

11. Work on improving the baby’s latch.

12. Remember, compress as the baby sucks but does not drink. Wait for baby to initiate the sucking; it is best not to compress while baby has stopped sucking altogether.

In our experience, the above works best, but if you find a way which works better at keeping the

baby sucking with an “open mouth wide—pause—then close mouth” type of suck, use whatever works best for you and your baby. As long as it does not hurt your breast to compress, and as long as the baby is “drinking” (“open mouth wide—pause—then close mouth type” of suck), breast compression is working.

You will not always need to do this. As breastfeeding improves, you will be able to let things happen naturally.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Alanis Morissette gives birth to a Boy

Meet Alanis Morissette’s Son Ever Imre!

Amazing, indeed. Alanis Morissette Tweeted a photo Tuesday of her and her husband enjoying a moment of joy with their 6-week-old son, Ever Imre. Morissette summed up the photo in a single word on Twitter. “Amazing,” she wrote.

The Canadian singer-songwriter, 36, and husband Mario ‘Souleye’ Treadway welcomed Ever on Christmas Day. Days after his birth, she Tweeted that she was “moved beyond words and so grateful” and “so in love with my new nuclear family.”

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Infant Reflux

All babies spit up, some more than others. 

They have immature digestive systems 
and sometimes the muscle at the top of
the stomach isn’t yet strong enough to 
stop the stomach contents coming back 
into the gullet or even the mouth (reflux). 

When reflux begins to get painful and frequent, you may be dealing with gastro-esophageal reflux disease (GERD).








When Luke was two weeks old, he was already showing the typical symptoms of gastro-esophageal reflux disease with constant vomiting. “It was incredibly stressful,” says his mom, Naomi. “It wasn’t just the milk in his stomach coming back up, it was also the acid, which made him scream. He would arch his whole body back in an attempt to lessen the pain.” Refusal to feed is common in babies with severe GERD. “He’d cry because he was hungry, but when he tried to feed it hurt him too much. I began to dread breastfeeding.”

HAPPY SPITTERS AND SCRAWNY SCREAMERS
If a baby is otherwise well, happy and gaining weight, most parents and health practitioners consider the reflux a laundry problem rather than a medical issue. But if a baby is showing symptoms of GERD, it’s time to seek help. “We’d go through six changes of clothes on a good day. It was frustrating, but we could cope. However, Luke’s breathing was affected by his reflux. He’d scream constantly. He developed a chronic cough, and we were constantly worrying if he was getting enough milk.” After referral to a pediatrician, a barium swallow test showed Luke had severe reflux with esophageal scarring.

It’s important to see your doctor if your baby isn’t gaining weight, there is blood in the vomit, or there is persistent coughing or chest infections due to stomach fluids getting sucked into the lungs. Usually, no tests will be necessary to diagnose GERD, although a 24-hour ph-Probe study is considered one of the more definitive tests. (A thin flexible probe is inserted to sit just above the stomach to test the amount of acid.)

Once a diagnosis of GERD has been made, there are various medications that can be used to treat it. Antacids are usually tried first and work well with mild cases. Drugs that neutralize acid such as Zantac have been used effectively for more than 20 years, and a newer development is the use of drugs like Prevacid that actually stop acid production. Motility drugs can sometimes be prescribed to help the stomach empty quicker. “Luke was put on Zantac,” says Naomi. “It took a couple of weeks to see the difference and we often had to adjust the dose as it was very weight-specific, but it made such a change to all our lives. Seeing him learn to love food was just the best.”

The great news is that ultimately it’s something 98 percent of babies grow out of, and surgery is necessary only in
the most extreme cases. “Luke was on medication until he turned two, but he’s finally over it and symptom free. We called it the reflux roller coaster.”

WHAT YOU CAN DO TO HELP:

• Minimize spit-ups by keeping your baby as upright as possible, particularly after eating.
• Keep the head-end of the crib propped up at a thirty-degree angle to reduce reflux episodes.
• Breastfeed. Breast milk is digested more easily, so empties out of the stomach quicker.
  Plus, breastfed babies take in less air when feeding.
• Give small, regular feeds.
• Once babies are on solids, gravity does a great job of keeping the food in the stomach.
• Remember that most babies outgrow reflux.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Labor and Birth with Twins

Giving birth is always amazing. The process for giving birth to twins is doubly amazing. Here are some of the things that a twin mom will need to consider when giving birth to her twins.

Babies Positions

The position of the babies will largely determine how the twins are born - vaginally or by cesarean. About 40% of twins are both head down (vertex) at term, another approximately 30% see the first baby (Twin A) vertex and Twin B breech. Both of these positions are acceptable to consider a vaginal birth.

Other positions of the babies like two breeches, two transverse or Twin A breech and Twin B vertex are usually delivered via cesarean surgery. This is usually known ahead of time with ultrasound technology. However, even twins can change positions late in the game and even into labor. This is particularly true of Twin B after the birth of Twin A.

Vaginal Birth

More than half of twins will be born vaginally. Whether this option is the right one for you and your babies is a discussion that should be discussed with your doctor or midwife. The good news is that even though you have two babies - you only have to labor once!

Once the cervix is open, each baby will have it's own pushing stage (second stage). This means you will have to push twice, but the majority of the time the second twin is born much more easily than the first. This is because the first twin has paved the way, so to speak.

The average time between the birth of the first and second baby is generally about 17 minutes. However, as long as the second baby is doing well (they will still be monitoring this baby), there isn't much need to speed things along. Sometimes during this phase of waiting, you will have an ultrasound to confirm the position of the second twin and your practitioner will decide how it is best to deliver him or her.

Sometimes, the second twin simply comes down head first like Twin A, this is handled in exactly the same manner. If Twin B is breech, your practitioner may decide to allow the baby to deliver breech, to turn the baby externally or internally or even do something called a breech extraction (pulling baby out by the feet).

Cesarean Birth

While having twins does increase the risk of you having a cesarean, fewer than half of twins are born this way. While positioning of your babies will play a large part in the decision as to what type of birth you will have, there are also all of the normal reasons for cesareans. These include, placenta previa, placental abruption, maternal indications like PIH, active herpes, and labor complications like fetal distress, etc.

If you give birth by cesarean prior to labor, the date will most likely be set between 37-40 weeks. If you go into labor prior to the scheduled date, your cesarean will likely happen then. There is no real difference in the surgery or recovery from a cesarean with twins.

Combined Vaginal/Cesarean Birth

This is actually not as common as you might believe. One baby being born vaginally with the second twin being born via cesarean occurs in only about 3-4% of all twin births. Usually this is done for an emergency with Twin B, like a cord prolapse (This is where the cord comes out with or before the baby, thereby cutting off the baby's oxygen supply.), severe malpresentation (like a transverse baby that cannot be moved by internal or external forces), placental abruption (This is where the placenta tears away from the wall of the uterus prematurely.), etc.

Prematurity

More than half of twins will be born prior to 37 weeks. This can also impact how your babies are delivered. Talk to your practitioner about staying healthy and maintaining adequate hydration, rest and nutrition to care for your growing babies and body.

Hospital Concerns

Some hospitals require that all twin mothers give birth in the operating room, even if they have a vaginal birth. You might also ask about the use of epidural anesthesia, as it is also sometimes a requirement, even if there are no medications placed inside the tubing. This allows immediate anesthesia should it become necessary. There may be other concerns you have like rooming-in or breastfeeding two babies. Be sure to talk to your hospital at length about issues you may be concerned about with your babies.

No matter how your twins come into the world, be prepared for a sudden change. Be willing to accept help when offered and take the time to get to know each of your new little bundles.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Scratching Face

How To Stop Baby From Scratching Their Face

Babies can do all sorts of things without knowing. Sometimes babies will scratch their faces with their tiny nails as they touch their faces and sleep at night. The last thing you want is a baby with a face full of little scratches so it's your job to prevent them from injuring themselves. All you have to do is a take a few precautions.

Instructions

Things you'll need:

1. Swaddler

2. Mittens

3. Nail clippers

4. Medical tape

• Clip your baby's nails with specialized baby clippers. It is often easier to do this when the baby is asleep. Clip the nails weekly so they stay nice and short. Be very careful not to clip them too short though as it will cause your baby discomfort and they may try to bite their fingers and actually end up hurting themselves.

• Put mittens on the baby's hands after cutting their nails. There are several kinds of lightweight cotton mittens that will cover their hands and thus prevent them from being able to scratch themselves.

• Put the baby in a swaddler when putting them down for a nap. The swaddler is meant to mimic the womb and thus holds their hands down at their sides in a tight cloth that wraps all the way around their bodies. It's not only good and comforting for your baby but it also prevents them from touching their faces and scratching themselves.

• Tear off little bits of medical tape and wrap them around the baby's fingertips. This will cover the nails and stop the baby from hurting themselves if they touch their face or body often. Replace the tape daily and make sure to buy hypoallergenic tape that won't irritate the skin.

 

 

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Squint (Strabismus) in Children

The medical name for squint is strabismus. It is a condition where the eyes do not look in the same direction. Whilst one eye looks forward to focus on an object, the other eye turns either inwards, outwards, upwards or downwards. Most squints occur in young children. A child with a squint may stop using the affected eye to see with. This can lead to visual loss called amblyopia, which can become permanent unless treated early in childhood. This treatment involves patching the good eye, to force the use of the affected eye. Sometimes surgery is needed to correct the appearance of a squint.

 

 

 

What is a squint?

A squint is a condition where the eyes do not look together in the same direction. Whilst one eye looks straight ahead, the other eye turns to point inwards, outwards, upwards or downwards. Squints are common and affect about 1 in 20 children. You might even spot that your baby has a squint. Most squints develop before preschool age, usually by the time a child is three years old. Sometimes squints develop in older children, or in adults.

This leaflet only deals with childhood squints.

Understanding the eye muscles

The movement of each eye is controlled by six muscles that pull the eye in specific directions. The lateral rectus muscle pulls the eye outwards. The medial rectus muscle pulls the eye inwards. The superior rectus muscle is mainly responsible for upwards movements, whilst the inferior rectus muscle mostly pulls the eye downwards. Finally, the superior and inferior oblique muscles help to stabilise the eye movements - particularly for looking downwards and inwards, or upward and outward movements.

For example, to look left, the lateral rectus muscle of the left eye pulls the left eye outward and the medical rectus of the right eye pulls the right eye inward towards the nose.

A squint develops when the eye muscles do not work in a balanced way and the eyes do not move together correctly.

Are there different types of squint?

Yes, there are different types of squint. Squints can be divided into different categories:

• By the direction of the squinting (turning) eye:
  • An eye that turns inwards is called an esotropia.
  • An eye that turns outwards is called an exotropia.
  • An eye that turns upwards is called a hypertropia.
  • An eye that turns downwards is called a hypotropia.
• Whether the squint is present all the time (constant), or comes and goes (intermittent).
• Whether the affected eye turns when the eyes are open and being used (manifest squint) or whether the eye turns only when it is covered or shut (latent squint), but looks fine when the eyes are open.
• Whether the severity (angle) of the squint is the same in all directions or not:
  • A concomitant squint means that the angle (degree) of the squint is always the same in every direction that you look. That is, the two eyes move well, all the muscles are working, but the two eyes are always out of alignment by the same amount no matter which way you look.
  • An incomitant squint means that the angle of squint can vary. For example, when you look to the left, there may be no squint and the eyes are aligned. But when you look to the right, one eye may not move as far and the eyes are then not aligned.
• By age of onset. Most squints develop sometime in the first three years of life. Some develop in older children and adults. Squints that develop in children usually have different causes to those that develop in adults.
• By the cause.
  • In many cases of childhood squint, the reason why a squint develops is not known.
  • In some cases of childhood squint (and most cases of adult squint), the squint occurs because of a disorder of the eye, the eye muscles, the brain or the nerves.

What are the types and causes of squint in children?

About 4 in 100 children aged five years old have a squint. It is quite common to notice a brief squint when tired or daydreaming. Babies sometimes cross their eyes - it is quite normal for this to happen occasionally, especially when they are tired. Some squints are much more obvious than others. You might notice your child has an eye that does not look straight ahead. Another sign of squint is that your child might close one eye when looking at you, or turns his or her head on one side.

Congenital squints of unknown cause

Congenital squint means that the child is born with a squint, or it develops within the first six months of life. In most cases, the cause is not known. (The eye muscles are not balanced but the reason for this is not known.)

In most cases one eye turns inward. This is called congenital esotropia (sometimes called infantile esotropia). This common type of squint tends to run in some families so there is some genetic component to this type of squint. However, many children with congenital esotropia have no other family members affected. In some cases the eye turns outward (congenital exotropia). Less commonly, a squint of unknown cause may result in an upward or downward turn of the eye.

Squint related to refractive errors

Refractive errors include: short sight (myopia), long sight (hypermetropia) and astigmatism. An astigmatism is a vision problem where the surface of the eye (the cornea) or the lens, is more oval-shaped, rather than round. This leads to problems with focusing. These are conditions that are due to poor focusing of light through the lens in the eye.

When the child with a refractive error tries to focus to see clearly, an eye may turn. This type of squint tends to develop in children who are two years or older, in particular in children with long sight. The squint is most commonly inward looking (an esotropia).

Other causes

Most children with a squint have one of the above types of squint, and are otherwise healthy. In some cases, a squint is one feature of a more generalised genetic or brain condition. Squints can occur in some children with cerebral palsy, Noonan's or Down's syndrome, hydrocephalus, brain injury or tumour, retinoblastoma (a rare type of eye cancer) and several other conditions.

What problems can be caused by a squint in a child?

Amblyopia

Amblyopia is sometimes called a lazy eye. It is a condition where the vision in an eye is poor and it is caused by lack of use of the eye in early childhood. The visual loss of amblyopia cannot be corrected by wearing glasses. However, it is usually treatable (see below).

If amblyopia is not treated before the age of about seven years, the visual impairment usually remains permanent.

To understand how amblyopia occurs, it is helpful to understand how vision develops. Newborn babies can see. However, as they grow, the visual pathways continue to develop from the eye to the brain and within the brain. The brain learns how to interpret the signals that come from an eye. This visual development continues until about age 7-8 years. After this time, the visual pathways and the 'seeing' parts of the brain are fully formed and cannot change.

If, for any reason, a young child cannot use one or both eyes normally, then vision is not learnt properly. This results in impaired vision (poor visual acuity) called amblyopia. The amblyopia develops in addition to whatever else is affecting the eye. In effect, amblyopia is a developmental problem of the brain rather than a problem within the eye itself. Even if the other eye problem is treated, the visual impairment from amblyopia usually remains permanent unless it is treated before the age of about seven years.

A squint is the most common cause of amblyopia. In many cases of squint, one eye remains the dominant focusing eye (the one that sees). The other, turned eye (the squinting one) is not used to focusing, and the brain ignores the signals from this eye. The turned eye then fails to develop the normal visual pathways in childhood and amblyopia develops in this eye. (See separate leaflet called 'Amblyopia' for more information.)

How the squint looks

A squint can be a cosmetic problem. Many older children and adults who did not have their squint treated as a child have a reduced self-esteem because of the way their squint looks to other people.

Impaired binocular vision

With normal eyes, both eyes look and focus on the same spot. This is called binocular vision (bi- means two, and ocular means related to the eye). The brain combines the signals from the two eyes to form a three-dimensional image. If you have a squint, the two eyes focus on different spots. In children with squint this does not usually cause double vision. As described above in the amblyopia section, in children the brain quickly learns to ignore the signals and images coming from the turned (squinting) eye. The child then effectively only sees with one eye. This means the child does not have a good sense of depth when looking at objects. As a result, he or she cannot see properly in three dimensions.

(Adults who develop a squint often have double vision as their developed brain cannot ignore the images from one eye.)

How is a squint diagnosed and assessed?

It is important to diagnose a squint (and amblyopia) as early as possible. Routine checks to detect eye problems in babies and children are usually done at the newborn examination and at the 6- to 8-week review. There is also a routine preschool or school-entry vision check.

Some newborn babies have a mild squint that soon goes. However, any squint that is present after the age of three months is usually permanent unless treated. So, even if your child has had routine eye checks, tell your doctor if you suspect that a squint has developed.

A baby or child with a suspected squint is usually referred to an orthoptist. An orthoptist is a health professional who is specially trained to assess and manage children with squint and amblyopia. If necessary, an orthoptist will refer a child to an ophthalmologist (eye surgeon) for further assessment and treatment.

Various tests can be done to check a child's vision (even if they are unable to read yet). Sight tests can even be done for babies. Tests to find a squint can involve covering and uncovering each eye in turn. This often shows which eye has the squint, and how it moves. The pupils of the eye can be checked with a torch, to check they become smaller (constrict) with light, and widen (dilate) when the light is removed. An ophthalmoscope is a special torch used to examine the back of the eye (the retina). Very occasionally, if another cause of squint is suspected (other than a congenital squint or one related to refractive errors), a scan of the eye or the brain may be needed.

What are the treatments for squint?

Treatment typically involves the following:

• Treating amblyopia (visual loss) if this is present.
• Wearing glasses to correct any refractive error, if this is present.
• Surgery is often needed to correct the appearance of the squint itself, and may help to restore binocular vision in some cases.

Treating amblyopia (lazy eye)

The main treatment for amblyopia is to restrict the use of the good eye. This then forces the affected eye to work. If this is done early enough in childhood, the vision will usually improve, often up to a normal level. In effect, the visual development of the affected eye catches up. The common way this is done is to put a patch over the good eye. This is called eye patching.

The length of treatment with an eye patch is dependent on the age of the child and the severity of the amblyopia. The patch may be worn all or most of the day, every day. Treatment is continued until either the vision is normal or until no further improvement is found. It may take from several weeks to several months for eye patching to be successful.

Your child will be followed up, usually until about eight years of age, to make sure that the treated eye is still being used properly, and does not become amblyopic again. Sometimes, further patch treatment (maintenance treatment) is needed before the vision pathways in the brain are fixed and cannot be changed.

Occasionally, eye drops to blur the vision in the good eye, or glasses that prevent the good eye from seeing clearly, are used instead of an eye patch. Both these methods also force the amblyopic eye to see.

Vision therapy can be used as a treatment to maintain the good work achieved by eye-patching. This involves playing visually demanding games with a child to work the affected eye even harder - like eye training.
Note: some people wrongly think that eye-patching is a treatment to correct the appearance of a squint. Eye-patching and other treatments for amblyopia aim to improve vision, and do not correct the appearance of a squint.

Correcting refractive errors

If a child has a refractive error (long or short sight, for example), then glasses will be prescribed. This corrects vision in the eye. It may also straighten the squinting eye, if the refractive error was the cause of the squint.

Surgery

In many cases an operation is advised to make the eyes as straight as possible. The main aim of surgery is to improve the appearance of the eyes. In some cases, surgery may also improve or restore binocular vision (this means that the two eyes are working together).

The exact operation that is done depends on the type and severity of the squint. It may involve moving the place where a muscle attaches to the eyeball or, one of the muscles that moves an eye may be shortened. Sometimes a combination of these techniques is used.

Botulinum toxin

Botulinum toxin (also know as Botox®) stops muscle cells from working (it paralyses them). It is used for a variety of conditions where it is helpful to weaken one or more muscles. In recent years, injections of botulinum toxin directly into eye muscles have been used as a treatment for certain types of squint, particularly for squints that turn inward (esotropia). This treatment may become more popular as an alternative to surgery - but only for certain types of squint.

What is the outlook (prognosis)?

For amblyopia (if it develops)

As a rule, the younger the child is treated, the quicker the improvement in vision is likely to be, and the better the chance of restoring full normal vision. If treatment is started before the age of about 6-7 years then it is often possible to restore normal vision. If treatment is started in older children then some improvement in vision may still occur but full normal vision is unlikely ever to be achieved.

For improving the appearance of the eyes

Squint surgery usually greatly improves the straightness of the eyes. Sometimes, even after an operation, the eyes are not perfectly straight. In some cases, two or more operations are needed to correct the squint. It is possible that several years after successful surgery, the squint may gradually return again. A further operation is an option to restraighten the eyes.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Pinkeye

About Pinkeye

Conjunctivitis, commonly known as pinkeye, is an inflammation of the conjunctiva, the clear membrane that covers the white part of the eye and the inner surface of the eyelids.

While pinkeye can be alarming because it may make the eyes extremely red and can spread rapidly, it's a fairly common condition and usually causes no long-term eye or vision damage. But if your child shows symptoms of pinkeye, it's important to see a doctor. Some kinds of pinkeye go away on their own, but other types require treatment.

Causes

Pinkeye can be caused by many of the bacteria and viruses responsible for colds and other infections, — including ear infections, sinus infections, and sore throats — and by the same types of bacteria that cause the sexually transmitted diseases (STDs) chlamydia and gonorrhea.

Pinkeye also can be caused by allergies. These cases tend to happen more frequently among kids who also have other allergic conditions, such as hay fever. Triggers of allergic conjunctivitis include grass, ragweed pollen, animal dander, and dust mites.

Sometimes a substance in the environment can irritate the eyes and cause pinkeye; for example, chemicals (such as chlorine and soaps) and air pollutants (such as smoke and fumes).

Pinkeye in Newborns

Newborns are particularly susceptible to pinkeye and can be more prone to serious health complications if it goes untreated.

If a baby is born to a mother who has an STD, during delivery the bacteria or virus can pass from the birth canal into the baby's eyes, causing pinkeye. To prevent this, doctors give antibiotic ointment or eye drops to all babies immediately after birth. Occasionally, this preventive treatment causes a mild chemical conjunctivitis, which typically clears up on its own. Doctors also can screen pregnant women for STDs and treat them during pregnancy to prevent transmission of the infection to the baby.

Many babies are born with a narrow or blocked tear duct, a condition which usually clears up on its own. Sometimes, though, it can lead to conjunctivitis.

Symptoms

The different types of pinkeye can have different symptoms. And symptoms can vary from child to child.
One of the most common symptoms is discomfort in the eye. A child may say that it feels like there's sand in the eye. Many kids have redness of the eye and inner eyelid, which is why conjunctivitis is often called pinkeye. It can also cause discharge from the eyes, which may cause the eyelids to stick together when the child awakens in the morning. Some kids have swollen eyelids or sensitivity to bright light.
In cases of allergic conjunctivitis, itchiness and tearing are common symptoms.

Contagiousness

Cases of pinkeye that are caused by bacteria and viruses are contagious; cases caused by allergies or environmental irritants are not.

A child can get pinkeye by touching an infected person or something an infected person has touched, such as a used tissue. In the summertime, pinkeye can spread when kids swim in contaminated water or share contaminated towels. It also can be spread through coughing and sneezing.

Doctors usually recommend keeping kids diagnosed with contagious conjunctivitis out of school, day care, or summer camp for a short time.
Someone who has pinkeye in one eye can also inadvertently spread it to the other eye by touching the infected eye, then touching the other eye.

Preventing Pinkeye

To prevent pinkeye caused by infections, teach kids to wash their hands often with warm water and soap. They also should not share eye drops, tissues, eye makeup, washcloths, towels, or pillowcases with other people.

Be sure to wash your own hands thoroughly after touching an infected child's eyes, and throw away items like gauze or cotton balls after they've been used. Wash towels and other linens that the child has used in hot water separately from the rest of the family's laundry to avoid contamination.

If you know your child is prone to allergic conjunctivitis, keep windows and doors closed on days when the pollen is heavy, and dust and vacuum frequently to limit allergy triggers in the home. Irritant conjunctivitis can only be prevented by avoiding the irritating causes.

Many cases of pinkeye in newborns can be prevented by screening and treating pregnant women for STDs. A pregnant woman may have bacteria in her birth canal even if she shows no symptoms, which is why prenatal screening is important.

Treatment

Pinkeye caused by a virus usually goes away on its own without any treatment. If a doctor suspects that the pinkeye has been caused by a bacterial infection, antibiotic eye drops or ointment will be prescribed.

Sometimes it can be a challenge to get kids to tolerate eye drops several times a day. If you're having trouble, put the drops on the inner corner of your child's closed eye — when the child opens the eye, the medicine will flow into it. If you continue to have trouble with drops, ask the doctor about antibiotic ointment. It can be applied in a thin layer where the eyelids meet, and will melt and enter the eye.

If your child has allergic conjunctivitis, your doctor may prescribe anti-allergy medication, which comes in the form of pills, liquid, or eye drops.
Cool or warm compresses and acetaminophen or ibuprofen may make a child with pinkeye feel more comfortable. You can clean the edges of the infected eye carefully with warm water and gauze or cotton balls. This can also remove the crusts of dried discharge that may cause the eyelids to stick together first thing in the morning.

When to Call the Doctor

If you think your child has pinkeye, it's important to contact your doctor to learn what's causing it and how to treat it. Other serious eye conditions can mimic conjunctivitis, so a child who complains of severe pain, changes in eyesight, or sensitivity to light should be examined. If the pinkeye does not improve after 2 to 3 days of treatment, or after a week when left untreated, call your doctor.

If your child has pinkeye and starts to develop increased swelling, redness, and tenderness in the eyelids and around the eye, along with a fever, call your doctor. Those symptoms may mean the infection has started to spread beyond the conjunctiva and will require additional treatment.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Infant botulism

Infant botulism is an illness that can occur when an infant ingests bacteria that produce a toxin inside the body. The condition can be frightening because it can cause muscle weakness and breathing problems. But it is very rare: Fewer than 100 cases of infant botulism occur each year in the United States, and most babies who do get botulism recover fully.

Infant botulism is treatable, but because of its severity, it's important to learn the symptoms so you can recognize it early. Also know that honey is a known source of the bacteria spores that cause botulism. For this reason, honey shouldn't be given to babies under 12 months of age.

About Infant Botulism

Infant botulism can occur when a child ingests spores of Clostridium botulinum bacteria, which are found in dirt and dust and can contaminate honey. This illness typically affects babies who are between 3 weeks and 6 months old, but they're susceptible to it until their first birthdays.

These bacteria are typically harmless to older kids and adults because their mature digestive systems can move the spores through the body before they cause any harm.

But very young babies haven't developed the ability to handle the spores yet. So once an infant ingests them, the bacteria germinate, multiply, and produce a toxin. That toxin interferes with the normal interaction between the muscles and nerves and can hamper an infant's ability to move, eat, and breathe.

Two other types of botulism tend to affect older kids and adults: wound botulism occurs when the bacteria infect a wound and produce the toxin inside of it; food-borne botulism is usually caused by eating home-canned foods that contain the toxin.

Signs and Symptoms

Symptoms of botulism appear between 3 to 30 days after an infant consumes the spores. Constipation is often the first sign of botulism that parents notice (although many other illnesses also can cause constipation). Call your doctor if your baby hasn't had a bowel movement in 3 days.

Other symptoms can include:

• flat facial expression
• poor feeding (weak sucking)
• weak cry
• decreased movement
• trouble swallowing with excessive drooling
• muscle weakness
• breathing problems

Infant botulism can be treated, but it's important to get medical care as soon as possible. Call your doctor right away if you see any of the warning signs in your baby.

Treatment

Infant botulism is treated in the hospital, usually in the intensive care unit, where doctors will try to limit the problems the toxin causes in the baby's body. The toxin can affect the breathing muscles, so doctors may put the infant on a ventilator. Because the toxin can affect the swallowing muscles, they may give the baby intravenous (IV) fluids to provide nourishment.

An antitoxin is now available for the treatment of infant botulism called Botulism Immune Globulin Intravenous (BIGIV), which should be given as early in illness as possible. Babies with botulism who have received BIGIV recover sooner and spend less time in the hospital.

With early diagnosis and proper medical care, affected infants should fully recover once the effects of the toxin wear off.

Prevention

Like many germs, the Clostridium botulinum spores that cause botulism in infants are everywhere in the environment. They're in dust and dirt, and even in the air. Experts don't know why some infants contract botulism while others don't.

One way to reduce the risk of botulism is to not give infants honey or any processed foods containing honey (like honey graham crackers) before their first birthday. Honey is a proven source of the bacteria and has led to botulism in infants who've ingested it. Light and dark corn syrups were thought to be a source of spores, but no proven cases of infant botulism have been attributed to ingesting them. However, check with your doctor before giving these to an infant.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Dressing your Baby

Tips For Putting Clothes On Baby

Because newborn baby's body is soft, his head is bigger and cannot be straight, coupled with the fat arms and curving legs, these problems bring parents a great difficulty to put the clothes on baby. Therefore, when parents dress clothes for baby, they should pay attention to the following matters:

1. Change clothes for baby only when it is necessary
If baby often sick up milk, you can put a large bib on baby, or use wet towel to clean up the dirty part. It is unnecessary to change a suit from head to foot each time.
2. Be careful when the clothes cover baby head
Before cover the clothes on baby's head, mother should open the neckline with hands to avoid the collar hurt baby's ears and nose. At the same time, in order to avoid baby's fear of darkness when his line of sight covered by clothes, you can talk to him to distract his attention.
3. Choose a complante to put clothes on baby
It is better to choose a complanate place to put on clothes for baby and try to prepare some toys or light music. At the same time, you may turn the dressing time into parent-child conversation or game's time.
4. Proper room temperature and humidity for putting clothes on baby
When dress clothes for baby, the room temperature for newborn baby should be maintained at 22 to 24 degrees Celsius, the humidity should be maintained around 60%-65%. The room temperature is too low can affect baby's metabolism and blood circulation, too high the room temperature will cause the fever; The proper humidity makes people skin feel comfortable and breath smoothly without dry, it is not conducive to the floating dust.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Burping your Baby

Feeding a baby is an exciting experience for any new parent. It can also be a little intimidating, especially if you don't know what to expect. So here's a quick guide to an important aspect of feeding — burping.

Burping helps to get rid of some of the air that babies tend to swallow during feeding. In some babies, not being burped frequently and too much swallowed air can lead to spitting up, crankiness, and gassiness.

How to Burp Your Baby

When burping your baby, repeated gentle patting on your baby's back should do the trick — there's no need to pound hard. To prevent messy cleanups when your baby spits up or has a "wet burp," you might want to place a towel or bib under your baby's chin or on your shoulder.

Try experimenting with different positions for burping that are comfortable for you and your baby. Many parents prefer to use one of these three methods:

1. Sit upright and hold your baby against your chest. Your baby's chin should rest on your shoulder as you support the baby with one hand. With the other hand, gently pat your baby's back. Sitting in a rocking chair and gently rocking with your baby while you do this may also help.
2. Hold your baby sitting up, in your lap or across your knee. Support your baby's chest and head with one hand by cradling your baby's chin in the palm of your hand and resting the heel of your hand on your baby's chest (but be careful to grip your baby's chin, not throat). Use the other hand to pat your baby's back gently.
3. Lay your baby on your lap on his or her belly. Support your baby's head and make sure it's higher than his or her chest. Gently pat your baby's back.

If your baby seems fussy while feeding, stop the session, burp your baby, and then begin feeding again. Try burping your baby every 2 to 3 ounces (60 to 90 milliliters) if you bottle-feed and each time you switch breasts if you breastfeed.

If your baby tends to be gassy, spits a lot, has gastroesophageal reflux disease (GERD), or seems fussy during feeding, try burping your baby every ounce during bottle-feeding or every 5 minutes during breastfeeding. If your baby doesn't burp after a few minutes, change the baby’s position and try burping for another few minutes before feeding again. Always burp your baby when feeding time is over.

For the first 6 months or so, keep your baby in an upright position for 10 to 15 minutes (or longer if your baby spits up or has GERD) after feeding to help prevent the milk from coming back up. But don't worry if your baby spits sometimes. It's probably more unpleasant for you than it is for your baby.

Sometimes your baby may awaken because of gas — simply picking your little one up to burp might put him or her back to sleep. As your baby gets older, you shouldn't worry if your child doesn't burp during or after every feeding. Usually, it just means that your baby has learned to eat without swallowing excess air.

Babies with colic (3 or more hours a day of continued crying) might also have gas from swallowing too much air during crying spells, which can make the baby even more uncomfortable. Using antigas drops has not proven to be an effective way to treat colic or gas, and some available medications can be dangerous.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.

Bonding With Your Baby

Bonding is the intense attachment that develops between parents and their baby. It makes parents want to shower their baby with love and affection and to protect and nourish their little one. Bonding gets parents up in the middle of the night to feed their hungry baby and makes them attentive to the baby's wide range of cries.

Scientists are still learning a lot about bonding. They know that the strong ties between parents and their child provide the baby's first model for intimate relationships and foster a sense of security and positive self-esteem. And parents' responsiveness to an infant's signals can affect the child's social and cognitive development.

Why Is Bonding Important?

Bonding is essential for a baby. Studies of newborn monkeys who were given mannequin mothers at birth showed that, even when the mannequins were made of soft material and provided formula to the baby monkeys, the babies were better socialized when they had live mothers to interact with. The baby monkeys with mannequin mothers were more likely to suffer from despair, as well as failure to thrive. Scientists suspect that lack of bonding in human babies can cause similar problems.

Most infants are ready to bond immediately. Parents, on the other hand, may have a mixture of feelings about it. Some parents feel an intense attachment within the first minutes or days after their baby's birth. For others — especially if the baby is adopted or has been placed in intensive care — it may take a bit longer.

But bonding is a process, not something that takes place within minutes and not something that has to be limited to happening within a certain time period after birth. For many parents, bonding is a byproduct of everyday caregiving. You may not even know it's happening until you observe your baby's first smile and suddenly realize that you're filled with love and joy.

The Ways Babies Bond

When you're a new parent, it often takes a while to understand your newborn's true capabilities and all the ways you can interact:

• Touch becomes an early language as babies respond to skin-to-skin contact. It's soothing for both you and your baby while promoting your baby's healthy growth and development.
• Eye-to-eye contact provides meaningful communication at close range.
• Babies can follow moving objects with their eyes.
• Your baby tries — early on — to imitate your facial expressions and gestures.
• Babies prefer human voices and enjoy vocalizing in their first efforts at communication. Babies often enjoy just listening to your conversations, as well as your descriptions of their activities and environments.

Making an Attachment

Bonding with your baby is probably one of the most pleasurable aspects of infant care. You can begin by cradling your baby and gently stroking him or her in different patterns. If you and your partner both hold and touch your infant frequently, your little one will soon come to know the difference between your touches. Each of you should also take the opportunity to be "skin to skin" with your newborn by holding him or her against your own skin when feeding or cradling.

Babies, especially premature babies and those with medical problems, may respond to infant massage. Because babies aren't as strong as adults, you'll need to massage your baby gently. Before trying out infant massage, be sure to educate yourself on proper techniques by checking out the many books, videos, and websites on the subject. You can also contact your local hospital to find out if there are classes in infant massage in your area.

Bonding also often occurs naturally almost immediately for a breastfeeding or bottle-feeding mother. Infants respond to the smell and touch of their mothers, as well as the responsiveness of the parents to their needs. In an uncomplicated birth, caregivers try to take advantage of the infant's alert period immediately after birth and encourage feeding and holding of the baby. However, this isn't always possible and, though ideal, immediate contact isn't necessary for the future bonding of the child and parent.

Adoptive parents may be concerned about bonding with their baby. Although it might happen sooner for some than others, adopted babies and their parents have the opportunity to bond just as well as biological parents and their children.

Bonding With Daddy

Men these days spend more time with their infants than dads of past generations did. Although dads frequently yearn for closer contact with their babies, bonding frequently occurs on a different timetable, partially because they don't have the early contact of breastfeeding that many moms have.

But dads should realize, early on, that bonding with their child isn't a matter of being another mom. In many cases, dads share special activities with their infants. And both parents benefit greatly when they can support and encourage one another.

Early bonding activities that both mom and dad can experience together include:

• participating together in labor and delivery
• feeding (breast or bottle); sometimes dad forms a special bond with baby when handling a middle-of-the-night feeding and diaper change
• reading or singing to baby
• sharing a bath with baby
• mirroring baby's movements
• mimicking baby's cooing and other vocalizations — the first efforts at communication
• using a front baby carrier during routine activities
• letting baby feel the different textures of dad's face

Building a Support System

Of course, it's easier to bond with your baby if the people around you are supportive and help you develop confidence in your parenting abilities. That's one reason experts recommend having your baby stay in your room at the hospital. While taking care of a baby is overwhelming at first, you can benefit from the emotional support provided by the staff and start becoming more confident in your abilities as a parent. Although rooming-in often is not possible for parents of premature babies or babies with special needs, the support from the hospital staff can make bonding with the infant easier.

At first, caring for a newborn can take nearly all of your attention and energy — especially for a breastfeeding mom. Bonding will be much easier if you aren't exhausted by all of the other things going on at home, such as housework, meals, and laundry. It's helpful if dads can give an extra boost with these everyday chores, as well as offer plenty of general emotional support.

And it's OK to ask family members and friends for help in the days — even weeks — after you bring your baby home. But because having others around during such a transitional period can be uncomfortable, overwhelming, or stressful, you might want to ask people to drop off meals, walk the dog, or watch any of the new baby's siblings outside the home.

Factors That May Affect Bonding

Bonding may be delayed for various reasons. Parents-to-be may form a picture of their baby having certain physical and emotional traits. When, at birth or after an adoption, you meet your baby, reality might make you adjust your mental picture. Because a baby's face is the primary tool of communication, it plays a critical role in bonding and attachment.

Hormones can also significantly affect bonding. While nursing a baby in the first hours of life can help with bonding, it also causes the outpouring of many different hormones in mothers. Sometimes mothers have difficulty bonding with their babies if their hormones are raging or they have postpartum depression. Bonding can also be delayed if a mom's exhausted and in pain following a prolonged, difficult delivery.

If your baby spends some time in intensive care, you may initially be put off by the amount and complexity of equipment. But bonding with your baby is still important. The hospital staff can help you hold and handle your baby through openings in the isolette (a special nursery bassinet) and will encourage you to spend time watching, touching, and talking with your baby. Soon, your baby will recognize you and respond to your voice and touch.

Nurses will help you learn to bathe and feed your baby. If you're using breast milk you've pumped, the staff, including a lactation consultant, can help you make the transition to breastfeeding before your baby goes home. Some intensive care units also offer rooming-in before you take your baby home to ease the transition.

Is There a Problem?

If you don't feel that you're bonding by the time you take your baby to the first office visit with your child's doctor, discuss your concerns at that appointment. It may be a sign of postpartum depression. Or bonding can be delayed if your baby has had significant, unexpected health issues. It may just be because you feel exhausted and overwhelmed by your child's arrival.

In any event, the sooner a problem is identified, the better. Health care providers are accustomed to dealing with these issues and can help you be better prepared to form a bond with your child.

Also, it often helps to share your feelings about bonding with other new parents. Ask your childbirth educator about parenting classes for parents of newborns.

Bonding is a complex, personal experience that takes time. There's no magic formula and it can't be forced. A baby whose basic needs are being met won't suffer if the bond isn't strong at first. As you become more comfortable with your baby and your new routine becomes more predictable, both you and your partner will likely feel more confident about all of the amazing aspects of raising your little one.

Respected Readers: Need your help to keep the site up and running. please donate ! Any help is appreciated.