GROWING UP GREAT! Series developed by Dr. LORI RAPPAPORT

 

BIRTH TO THREE MONTHS

 

Ø   Healthy Sleep Habits

Ø   Baby’s Cry: What Does It Mean?

Ø   Colic Or The Evening Fussies?

Ø   Make Sure Baby’s Home Is A Safe Place

Ø Your Baby’s Development

 

 

 

Healthy Sleep Habits

 

The first few days of life, it is often difficult to tell whether your baby is awake or asleep at any given moment.  But how quickly that seems to change, usually the first night you bring them home from the hospital!  Whether your baby sleeps quite well or restlessly the first few days after birth should not be considered an indicator of things to come.  Newborn infants do not have regular sleep patterns and it usually takes six to ten weeks for them to develop a twenty-four hour schedule, that is, with their days and nights matching yours!

      Most babies begin to show a sleep pattern in the first few weeks of many naps varying in length from ten minutes to six hours distributed across the day and night.  Some babies sleep so well they may need to be waked for a feeding, but this is more unusual.  Although most babies will develop a twenty-four hour schedule on their own, there are several things you as a parent can do to instill good sleep habits from the start.

 

How often should baby eat? Newborn babies need to be fed every two to six hours.  If you are using a feeding on demand schedule remember, not all cries are hunger cries.  A full term baby does not need to eat every hour even though he may seem hungry at these times and eats when you offer him the breast or bottle.  Hourly feedings are exhausting for the mother, unnecessary for the baby and interferes with the baby’s ability to develop a normal schedule.  This does not mean when your baby cries one hour after a feeding that you ignore her.  But helping your baby to develop healthy sleep habits may include your having to tolerate some crying and be creative in finding ways to comfort her other than feeding. Babies are often soothed by walking, rocking, or being talked to for a while, and may then drift off to sleep without a feeding.  

 

 Developing a schedule. Once you begin to notice your baby’s emerging schedule, it will become easier for you to anticipate his needs.  By three to four months, most babies will be sleeping for their longest period during the night, anywhere from five to 9 hours at one time.  Although your baby may not cry for a feeding, he may be ready to eat at a predictable time, and if offered, may nurse eagerly.  Similarly, she may be ready for her nap even though she does not appear fussy.   By providing a consistent routine from day to day, you can help your baby to stabilize and maintain her twenty-four hour cycle.  If the times of baby’s feedings. play, bath, bedtime and other activities are constantly changing, the more likely his sleep patterns will too.  Of course, it is not always possible to keep baby’s schedule exactly the same, day to day, especially when she has older siblings with their own schedules!  But the more predictable your baby’s schedule, the easier it is for you to have one of your own.  Many parents find it helpful to be able to count on a period of the day when they know they will have a few hours to themselves while baby sleeps.

 

The importance of bedtime rituals. As your baby gets older, you will develop certain bedtime rituals, for example a bath, reading a book, a song or some quiet time before going to bed.  Bedtime rituals differ from family to family and from child to child.  For the most part, the importance lies in having some type of ritual or signal that it is time to go to sleep.  It serves as a transition between the activities of the day and bedtime.  Some routines are better than others in that they are more likely to promote good sleep habits in your baby while others may be setting him up for problems in the future. 

      Bedtime rituals include not only the activities that take place as you prepare your baby for bed, but those that occur while he falls asleep.    Many parents rock, nurse, or rub their infant’s back until they fall asleep, then place them into their crib.  This is fine in the first few months when you do not expect your baby to sleep through the night.  However, as your baby gets older you will expect that he develop a sleep cycle much like that of his siblings and parents.  Everyone, even adults, has normal periods throughout the night when they wake up, and then roll over and go back to sleep within a minute or two.  When a baby wakes up during the night, provided it is not for a feeding, he will also fall back to sleep if the same conditions exist as when he fell asleep at the beginning of the night.  What does this mean?  It means if baby learns to fall asleep while nursing, then he will look to be nursed again to fall back to sleep.  He does not think that it is 3am and mom is sound asleep but rather that he needs the comfort of nursing (or rocking, patting, or a pacifier, or whatever the routine may be) to settle back down to sleep.  While you may not consider this a problem at 10pm or even midnight, you may feel differently at 2am and 5am.   It is in everyone’s best interest, both baby and parent, to have uninterrupted sleep, or the least interruptions as possible.

 

 Promoting positive sleep habits.  When you put your baby to sleep, make sure that he is still awake when you put him into his crib.  Although he may cry for a brief period, he will learn to fall asleep on his own, and in turn, when he wakes periodically through the night, he will know how to fall back to sleep without your help.

         In addition, be aware of the associations your baby has with falling asleep.  Try to avoid things that require your presence, such as rocking, nursing, patting and even pacifiers, as young infants need you to help them find them in the middle of the night.  Instead, help your baby to learn to fall asleep on her own, perhaps listening to some music   or other sounds, with a special blanket or toy, or something else, which she may find comforting.   While they may not be as comforting as mom or dad, in the long run it will help your baby—and you—to sleep well at night

 

                         

Baby’s Cry: What Does It Mean?

 

Babies cry to communicate their needs and feelings, and like adults, they have more than one.  At first, it seems impossible to distinguish between a “wet cry” and a “hungry cry” but with time, you will become an expert!   When your baby cries, you might run down a list of possible reasons such as is she wet, cold, hot, tired, or hungry?  Could this be a signal for teething, fever or a cold?  Or is he trying to tell you she is lonely and wants the physical closeness and comfort of being held?    Too often parents try food, usually a bottle, as their first course of action.  While the baby may take it and quiet down, hunger may not have been their chief complaint.  Babies who are offered a bottle whenever they cry learn to use food to comfort unrelated needs such as tiredness, frustration or physical discomfort.   To avoid this, try to keep track of your baby’s feeding schedule, so you will have a better sense of when it may be close to feeding time.  When your baby cries, before offering him a bottle, try a few other things like changing his diaper, swaddling and rocking him, burping him, a change of scenery (even babies get bored!), singing him a song, adding a blanket for warmth or taking one away, taking him for a walk, etc.   Be creative!  Babies can be comforted in many ways, and it’s a challenge to discover those that work best for your baby.

 

 

Colic Or The Evening Fussies?

 

Most babies go through daily crying sessions, which can last anywhere from 15 minutes to an hour.  These crying spells usually occur in the evening, the most hectic time of day, with dinner to be prepared, parent(s) coming home from work, and other children if any, needing attention.  For some babies, all the commotion is more than they can handle; for others, after a busy day of taking in all the sights and sounds of their new environment a good cry helps them to unwind.  Colic differs from ordinary crying in that the baby seems inconsolable, cries for three to four hours or more all throughout the day and night.  These episodes of crying are unpredictable, though they usually seem worse in the evening.  Colic usually begins during the second or third week of life and occurs in all cultures, in both bottle and breast-fed babies.  No one knows what causes colic, and unfortunately there is no known medication that will completely cure colic.  Some parents find their babies get relief from simethicone drops, sold over the counter as Mylicon drops, which have an anti-gas ingredient.  While there is no evidence that the cause of colic is gas, many infants who have colic do seem gassy.  Colic usually is as bad as it’s going to get by six weeks, and many babies outgrow it by three months, with some continuing through the fourth or fifth month.  It may decrease gradually, with some good and some bad days, or abate all of a sudden.   Although it may seem that this period will never end, the good news is that colicky babies thrive just as well as other babies, and having colic doesn’t predict future personality. 

 

SURVIVAL TIPS:

1. Relax; you are not doing anything wrong!  Try to cope with your baby’s crying as calmly and rationally as possible.

 

2. Make sure your baby’s crying is not due to a simple cause such as hunger, fatigue, wet diaper, too cold or too warm. 

 

3. Take a break.  A colicky baby takes its toll on even the most patient parent, not to mention their relationship with their spouse.  Try to catch a break at least once a week, daily if possible during the baby’s crying time by either hiring a helping hand if you can, or asking a friend or relative to help out.    Even a short break from the crying can make you feel recharged.

 

4. Walk the floor with your baby.  Many babies are soothed by rhythmic rocking, or walking back and forth, either in your arms, in baby carrier (snugli) or in a sling.  The closeness, along with the movement, soothes some babies.  If this works for your baby, you may find that “wearing” him in the snugli several hours a day gives you a break from the crying as well as two free hands.

 

5. A warm bath may be soothing to your baby but only if he likes the bath.  Some babies scream more as soon as they are out into the water,

 

6. Give the baby a break from you.  If you’ve tried several different tactics to calm baby down and it hasn’t worked, put him down in his crib or bassinet for a while.  It will not hurt him to cry in his crib for ten or fifteen minutes while you take a break to either go to the bathroom, lie down, make a phone call or grab a bite to eat. 

 

7. Take baby for a walk in the stroller.  If she is still crying, try to tune her out.  Earplugs work well to lessen her wails and that may help you to relax a little bit. 

 

8. If you continue to have difficulty with your baby’s crying, consult your baby’s doctor.

 

Make Sure Baby’s Home is a Safe Place

 

Baby’s home should be a safe place, especially her crib.  Infants have no use for pillows, stuffed animals or duvet cover or comforters, all of which pose the risk of suffocation.  These things are particularly dangerous in the first four months, as the baby will not have sufficient head or body control to move off of or out from under a pillow or comforter.  In these early months, thin blankets (receiving blankets) or those that do not have much loft (or “fluff”) are best.

      Whether you use an infant carrier or an infant/toddler car seat, both should be rear facing until your baby is 20 pounds.  The safest place for baby is in the back of the car, in the middle seat.  Remember, baby should never be placed rear facing in the front passenger seat if it is equipped with an airbag. 

      Never leave your baby alone on the changing table, bed, or other high surface.  Although in the first few weeks your baby will not know how to roll over, it is difficult to predict when she will learn.  Better to get in the habit of being safe right from the start. 

      One of the most useful pieces of baby paraphernalia is the bouncer seat.   It not only provides soothing motion (especially the ones that vibrate) but it gives baby a place to sit and view the world around him.  Just make sure his view is from the floor, and not on a table or other high surface.  Small children as well as adults make knock baby off the table accidentally.  Surprising as it may be to parents, many a baby has rocked his way to the ground.  If you are not sitting right next to baby it is a good idea to place him on the floor.

      If you are using a microwave to warm or thaw a bottle remember to shake it well and let it sit for a minute before testing.  Hot spots can occur as it has a tendency to heat unevenly.

            For safety when bathing baby with the tap water, turn your hot water thermostat down to 125 to 130 degrees.  This is also a good way to prevent burns in young children who use the faucet on their own.

 

Your Baby’s Development

 

The first few months, the best entertainment you can provide your baby with is you.  At one month, baby likes to listen to your voice, whether that be talking, cooing or singing.   Babies can make out a face at about eight to twelve inches away and love to stare intently at them.  A mobile hung above the crib or changing table is stimulating.  Black and white designs also interest babies and you can find cards with preprinted designs, mobiles and small toys at most baby stores. 

      The first month, baby spends a large amount of his time sleeping.  When he is awake he seems to be either “half awake” or “half asleep.  As baby moves into her second month the difference between sleeping and waking becomes more defined; she is much more active and alert.   When you dangle a bright colored object over her, her eyes pick up the movement.  His head no longer lies limp on your shoulder, but he lifts it from time to time in a bobbing motion.

 

At Two Months Babies Like to:

· listen to sounds

· look at their hands

· hold head up and follow moving objects with their eyes

· smile and be smiled at

 

Give Your Baby:

· Soft safe toys to feel and scratch

· An opportunity to develop head control by frequently placing her on her stomach

· squeak toys and things to look at

· a rattle placed in his hand

· your voice

· your smile

 

      Around three months baby becomes quite social.  She coos and smiles as you approach her. It is quite a love affair!  When you lean over her and talk to her, she responds by smiling and gurgling.  Baby’s hands are no longer tightly closed, but have started to relax.  If you place a rattle in her hand she will hold it and even glance at it.  If supported in a sitting position, he will have a good deal of head control. When an object is within reach she will look at it and wave her arms, sometimes coming into contact with it, but she cannot yet reach for and grasp it. 

      When placed on her tummy she lifts her head, holds it strongly, and props her chest up with her forearms. 

      This is also the age when baby begins to put things in his mouth.   Small, easy to grasp objects such as plastic keys and rattles are appreciated.

 

At Three Months Babies Like to:

· Wave and watch his hands

· Bring objects to his mouth to explore them

· Listen to the sound of his voice     

· Kick at an object

 

Give Your Baby:

· A mirror to view himself

· Wrist and ankle bells

· A patterned sheet on his crib

· Music

· A mobile

· Appropriate sturdy toys to explore with her mouth

· The great outdoors

· Play-time with you

Lori Rappaport, Ph.D. is a  Licensed Clinical Psychologist specializing in child and family issues.  Dr. Rappaport has over 15 years of experience working with children and families experiencing chronic and life threatening illness.  She is a consultant to the Jenna Druck Foundation which provides support to families that have lost a child (www.jennadruck.org).  
In addition, Dr. Rappaport has a private practice in Del Mar, CA.
  (858) 481-2188.
 
www.growingupgreat.com