Category Archives: 2. The Infant

From newborn to 17 months.

My Dear Crying Baby

By Tamara Parnay

Newborn babyMy dear crying baby,
Don’t worry
I see through…
Just beneath your upset, tear-streaked face
Lies pure innocence
Just beneath your urgent, heart-rending cries
Lie complete and utter trust and dependence
Just beneath your immediate suffering
Lies relief
Just beneath my anxiety and fear
Lies joy
Just beneath my anger and resentment
Lies gratitude
Just beneath the challenge of this moment
Lies peace
Just beneath it all
Lies love
I see through all the way through
To love
I love you
My dear crying baby
I am here for you
Always

Love, Mama

Discuss this topic with other API members and parents. Get advice for your parenting challenges, and share your tips with others on the API Forum.

The Importance of Skin-to-Skin Contact

By Jack Newman, MD, & Teresa Pitman

Editor Rita Brhel doing Kangaroo Care with her premature daughterWe now have a multitude of studies that show mothers and babies should be together, skin-to-skin (baby naked, not wrapped in a blanket), the baby’s neck extended slightly so his head is in “sniffing position,” immediately after birth – and they should spend as much time together skin-to-skin as possible in the days that follow. The baby is happier, the baby’s temperature is more stable and more normal, the baby’s heart and breathing rates are more stable and normal, and the baby’s blood sugar levels are better.

Not only that – skin-to-skin contact immediately after birth allows the baby to be colonized by the same bacteria as the mother. This, plus breastfeeding, are thought to be important in the prevention of allergic diseases. When a baby is put into an incubator, his skin and gut are often colonized by bacteria different from his mother’s and studies show that the baby is much more likely to adjust to his new world, metabolically speaking, when he is skin-to-skin with the mother than if he is in that incubator.

We now know that this is true not only for the baby born at term and in good health but also for the premature baby. Skin-to-skin contact and Kangaroo Mother Care can contribute much to the care of the premature baby. Even babies on oxygen can be cared for skin-to-skin, and this helps reduce their need for oxygen and keeps them more stable in other ways as well.

From the point of view of breastfeeding, babies who are kept skin-to-skin with the mother immediately after birth for at least an hour are more likely to latch on without any help, and they are more likely to latch on well, especially if the mother did not receive medication during labor or birth. Putting mother and baby skin-to-skin can also be a valuable first step in solving any breastfeeding difficulties they are having.

There is no reason that the vast majority of babies cannot be skin-to-skin with the mother immediately after birth for at least an hour. Hospital routines, such as weighing the baby, should not take precedence. Of course, there is also no reason a baby cannot be back skin-to-skin with the mother immediately after the hospital routines are done.

The baby should be dried off and put on the mother. Nobody should be pushing the baby to do anything; nobody should be trying to help the baby latch on during this time. The mother, of course, may make some attempts to help the baby, usually in response to the baby’s behaviors showing some interest in going to the breast, and this should not be discouraged. The mother and baby should just be left in peace to enjoy each other’s company. The mother and baby should not be left alone, however, especially if the mother has received medication. It is important that not only the mother’s partner but also a nurse, midwife, doula, or physician stay with them – occasionally, some babies do need medical help and someone qualified should be there “just in case.”

The eye drops and the injection of vitamin K can wait a couple of hours. By the way, immediate skin-to-skin contact can also be done after Cesarean section, even while the mother is getting stitched up, unless there are medical reasons that prevent it.

Studies have shown that even premature babies as small as 1200 grams (2 pounds 10 ounces) are more stable metabolically, including the level of their blood sugars, and breathe better if they are skin-to-skin immediately after birth. The need for an intravenous infusion, oxygen therapy, or a nasogastric tube, for example, or all the preceding, does not preclude skin-to-skin contact. Skin-to-skin contact is quite compatible with other measures taken to keep the baby healthy.

Of course, if the baby is quite sick, the baby’s health must not be compromised, but any premature baby who is not suffering from respiratory distress syndrome can be skin-to-skin with the mother immediately after birth. Indeed, in the premature baby, as in the full-term baby, skin-to-skin contact may decrease rapid breathing into the normal range.

Even if the baby does not latch on during the first hour or two, skin-to-skin contact is still good and important for the baby and the mother for all the other reasons mentioned.

I have heard of a few cases where a mother had planned not to breastfeed but was still urged by hospital staff to hold her baby skin-to-skin. After doing this for a short period of time and seeing her baby gravitate to her breast, these mothers decided to breastfeed after all. The effects of this simple technique are powerful! In fact, one could say that skin-to-skin contact is even more important if the mother does not breastfeed so that the mother and baby have this special opportunity to “fall in love with each other.”

The Case for Skin-to-Skin Contact Between Mother and Baby, Whether Full-term or Premature
In summary, skin-to-skin contact immediately after birth that lasts for at least an hour has the several positive effects. These babies:

  • Are more likely to latch on, and to latch on well.
  • Have more stable and normal skin temperatures.
  • Have more stable and normal heart rates and blood pressures.
  • Have high blood sugars.
  • Are less likely to cry.
  • Are more likely to breastfeed exclusively longer.

Excerpted from The Latch and Other Keys to Breastfeeding Success by Newman, J., and Pitman, T. (2006) Amarillo, TX: Hale Publishing. (pp. 9-12) www.ibreastfeeding.com

Babywearing is Good for Babies

By Marie Blois, MD, member of API’s Board of Directors

Babywearing momBiologically, babies need to be carried in order to thrive. Studies have shown that otherwise well-nourished and cared for infants who are deprived of human touch fail to thrive and can even die. Good things happen when baby is carried. Research shows that babies who are held often:

  • Cry less — Studies have shown that the more babies are held, the less they cry. The long-term consequences of letting infants cry without responding are just beginning to be understood. One study found that letting babies cry permanently alters the nervous system by flooding the developing brain with stress hormones. Responding quickly to your crying baby is an investment: the less she cries now, the more peaceful the upcoming year. It’s well worth your effort.
  • Are more calm and content — Carried babies have a more regular respiratory rate, heart rate, and steady internal body temperature. Even very tiny premature babies can be carried safely in a sling without danger of compromised breathing or heart rate. Regularly carrying a baby encourages baby to feel secure and content.
  • Sleep more peacefully — Keeping baby close helps organize his sleep-wake cycles. Naptimes are spent in constant motion, close to mother’s heart and nighttime is dark and still with a loved parent nearby. One study of premature infants found that babies had longer intervals of quiet sleep when they had skin-to-skin contact with mother.
  • Develop better — Babies who are held experience human touch and movement. This stimulation has been shown to have a positive effect on baby’s development. Carrying baby enhances motor skills by stimulating the vestibular system (used for balance). Carrying baby naturally limits the time baby spends in hard plastic carriers, such as car seats, automatic swings, and such. Holding baby while moving counts as “tummy time.”

Our babies are clever. They are born knowing how to signal their biological needs. They root when they need to nurse, smile when they need vital eye contact for optimal brain development, and they love to be held. There are good biological reasons for these behaviors: they help babies survive and thrive.

Excerpted from: Blois, M. (2005). Babywearing: The benefits and beauty of this ancient tradition. Amarillo, TX: Hale Publishing. www.ibreastfeeding.com.

Breastfeeding Helps to Offset Early Disadvantages

From the University of London

BreastfeedingBreastfeeding may be particularly important to the educational and emotional development of children from single-parent and low-income families, new research suggests.

Previous studies have reported that the high nutritional content of breast milk can increase a baby’s IQ. Other research has found that breastfed children are at an advantage because their mothers are, on average, better-off and more articulate.

However, a new study from the Institute of Education, London, which involved 1,136 mothers, strengthens the argument that breastfeeding is also associated with more positive parenting practices that can continue beyond infancy.

Breastfeeding Strengthens Mother-Baby Attachment

Researchers who analyzed the behavior of mothers reading a storybook to their one-year-old children found that, on average, those who breastfed made more effort to engage their infants in the book than mothers who bottle-fed. In general, mothers with more positive attitudes towards breastfeeding also appeared to have a warmer relationship with their babies.

The greatest differences in behavior were between two groups of single and low-income mothers — those who breastfed for six to 12 months, and those who bottle-fed. Poorer women who breastfed interacted with their babies during the book-reading exercise almost as well as more advantaged mothers did. However, low-income mothers who bottle-fed their babies tended to communicate with them much less well than other mothers, the researchers say.

Marital status had no effect on the quality of a mother’s interaction with her child, provided she had breastfed for six to 12 months. In fact, single mothers who had breastfed for this period made slightly more effort than other mothers to explain the storybook to their child.

A repeat experiment four years later found that mothers who had been on a low income when their child was one, but had breastfed for more than six months, had a higher quality of interaction with their five-year-old than other mothers. They also made more effort to engage their child in the book-reading exercise than mothers who had not breastfed. By contrast, breastfeeding appeared to have no lasting effect on the parenting behaviors of married and higher-income mothers.

Study Author: Breastfeeding Especially Important for Single and Low-Income Parents

The report’s principal author, Leslie Gutman, research director of the Institute’s Centre for Research on the Wider Benefits of Learning, says that the age five findings underscore the “protective” influence of breastfeeding for lone parent and low-income families.  Future studies should investigate the processes behind the findings, she suggests. Researchers should attempt to establish, for example, whether skin-to-skin contact forms stronger bonds between breastfed infants and their mothers which, in turn, lead to more positive parenting practices.

Report Indicates a Need for Change in Government Policy, Improvement in Education

Gutman also says that the findings provide support for government policies that encourage breastfeeding, particularly for more disadvantaged mothers. “Mothers in such challenging circumstances may face more obstacles to breastfeeding, especially for a longer period of time,” she points out. “They may lack role models and encouragement, or they may be under greater pressure to return to work when their child is still very young.”

If a mother works on a short-term casual basis, or is an agency worker, she may not qualify for maternity leave, and if she earns less than £90 per week, on average, she does not qualify for Statutory Maternity Pay. This may act as an incentive to stop breastfeeding and return to work as soon as possible, the study says.

“New mothers, particularly in deprived communities, may therefore require more than information leaflets,” the researchers comment. “Rather, interventions that offer early and ongoing support and encouragement to manage breastfeeding may be needed: this may come from financial support in order to enable a delay in return to work and/or workplace nurseries where mothers can visit and breastfeed their babies during the day. Meanwhile, campaigns such as ‘Be a star’, run by Blackpool Primary Care Trust (PCT) and North Lancashire Teaching PCT to provide role models for young mothers, may be a way of highlighting the issue.”

The Institute of Education research, which was funded by the Department for Children, Schools and Families, is based on a new analysis of previously unreported data that were originally collected as part of the Avon Longitudinal Study of Parents and Children in the mid-1990s.

Report Also Shows Social Mothers as Having Stronger Attachments with Their Babies

Gutman and her colleagues also found that mothers with extensive social networks interacted with their infants more positively, on average, than mothers with more limited social circles. “At a community level, the finding implies that the networking and social interactions that go on between parents in children’s centres, early-years settings, community groups and many other community venues,  such as libraries, and health and leisure centres, are of great value,” they say.

Efforts to improve maternal health could also help to build parenting capabilities as postnatal depression impairs communication between mother and child, the researchers add.

For More Information

“Nurturing Parenting Capability: The Early Years,” by Gutman, John Brown, and Rodie Akerman, can be downloaded at www.learningbenefits.net.

Parenting Style Changes Gene Expression

From API’s Communications Team

DNAResearch has, for many years, shown that the way a child is parented will physically shape his brain — that each interaction, good or bad, will create pathways within the brain as a reflection of the emotions surrounding that interaction. And that a pattern of neglect or abuse will shape the brain differently than will a consistently loving, attachment-promoting relationship.

Now, a new study published in a February 2009 issue of Nature Neuroscience — as reported in the The New York Times article, “After Abuse, Changes in the Brain — shows that, in addition to shaping the brain, patterns of interaction change the way a person’s genes are expressed.

Researchers at McGill University in Montreal, Quebec, Canada, have found for at least ten years that affectionate mothering alters the expression of genes in animals. These changes in the genetic code are then passed on to the next generation. For the first time, there is direct evidence that the same happens in human DNA. McGill researchers report that people who were abused or neglected as children had genetic alterations that made them more biologically sensitive to stress.

McGill teamed up with the Singapore Institute for Clinical Sciences to compare the brains of 12 people who had difficult childhoods before  committing suicide with the brains of 12 people who did not suffer abuse or neglect as children.

When humans are under stress, the hormone cortisol circulates and puts the body in a state of anxiety. One way the brain reduces this response is to make receptors on brain cells that help clear the cortisol, reducing the feeling of distress and protecting neurons from the damaging effects of extended exposure to cortisol.

Researchers found that the genes that code these receptors were 40 percent less active in people who had difficult childhoods than those who did not.

There is still speculation as to why some people with difficult childhoods are able to regulate stress more easily while others are not. Possibilities include individual genetic differences or an individual’s ability to connect with other people who help stabilize his stress response.

To read this entire article, go to: www.nytimes.com/2009/02/24/health/research/24abuse.html?emc=eta1.

Nutritional Deficiencies in the Mother May Affect Her Attachment with Her Baby

From API’s Publications Team

Healthy diet essential for mothersNutritional deficiencies in mothers can affect her mental health and lead to inconsistent patterns of mother-child interactions, which in turn increases the likelihood of creating an insecure attachment between the mother and child.

The effect can be two-way, since insecure attachment can lead infant depression which often leads to a repressed appetite in the baby. The resulting nutritional deficiencies in the baby can prolong childhood mental illness.

These theories will be discussed in a March issue of The American Journal of Clinical Nutrition article by Purdue University, “Models Linking Nutritional Deficiencies to Maternal and Child Mental Health.”

How to Play with Your Baby

By Maathangi Iyer, staff writer for The Attached Family

Baby's playYour child is naturally imaginative — all children are. Most theories of child development view young children as highly creative, with a natural tendency to fantasize, experiment, and explore their physical and conceptual environment.

Having said that, the role of a parent in developing, stimulating, and nurturing the child — with respect to his emotional, cognitive, and language development — cannot be over-emphasized. Based on analysis by “Early Childhood Longitudinal Study’s Birth Cohort (ECLS),” 31 percent of American parents know very little about the pace of a typical infant’s development, such as when a child should start talking or begin potty training. Lack of knowledge can be a detriment to a baby’s development, whether it’s expecting a baby to be able to do something he’s not developmentally ready for or ignoring the child’s need for playful learning.

Even very young babies enjoy playing with their parents, and as the baby grows, so does her need for exploring and learning. The first few years of your child’s life is an exciting time for you and her, as it is this stage that the growth and development of her young brain are the fastest in her life. The day-to-day experiences are responsible for shaping the brain. Your baby’s experiences are what she sees, hears, feels, tastes, and smells — and each experience triggers electrical activity in the brain, enabling it to form these connections and grow. Continue reading How to Play with Your Baby

“Giving the Love that Heals,” an interview with attachment therapist Harville Hendrix

Happy Valentine's DayDear Readers,

Click here to download your free gift from API.

As promised in the Winter 2008-09 Healing Childhood Wounds issue of The Journal of API — as a followup to the article “The 11th Commandment” — this free audio download is the full version of API Co-founder Barbara Nicholson’s interview with Imago Relationship Therapy Founder Harville Hendrix.

The author of Giving the Love that Heals, Harville’s words are inspiring and motivating — a true reminder that everyday should be Valentine’s Day. You do not want to miss this interview!

Happy Valentine’s Day from API…

~ Rita Brhel, editor of The Attached Family publications

(If you have trouble downloading the file, contact me at editor@attachmentparenting.org.)

Separation without Anxiety

By Grace Zell, staff writer for The Attached Family

Grace Zell and her children
Grace Zell and her children

About a year ago, a friend convinced me to do something good for myself and join the local gym. She would leave her two-year-old daughter in the gym’s nursery and enjoy a nice exercise class. Up to this point, I had only left my 18-month-old daughter, Katie, with my mother at our home, or with a trusted babysitter who my daughter warmed up to after a few times with me present. Unfortunately, the babysitter was back at college and my mother lives three hours away, so I figured the gym nursery would be the next best thing to get some “me time.”

I was nervous as I signed up for a gym membership, thinking that this whole enterprise hinged on my daughter being able to tolerate the nursery. The staff of the nursery seemed attentive but not overly warm or concerned about anything other than the safety of their wards. Luckily, on our first day, my friend dropped her daughter off at the same time. Katie was preoccupied with playing with her friend, and I snuck away after telling her that I would return after I was done riding the bike.

Not Yet Ready

After ten minutes, I was paged to the nursery. Katie’s preoccupation with her friend’s presence had worn off, and she noticed that she was alone with a roomful of strange children and adults. She was crying and looking for me at the door. The nursery staff followed a policy of not allowing any child to cry for longer than ten minutes before paging the parent to come, but they advised me to continue leaving her at the nursery while I was exercising — that eventually Katie would be able to stay without crying. Continue reading Separation without Anxiety

Every Parent-Child Interaction Shapes the Brain

By Amber Lewis, staff writer for The Attached Family

Pathways in the brain created by neurons
Pathways in the brain created by neurons

Humans all begin the exact same way. We start our life out as a zygote, the fertilized egg in our mother’s uterus, 46 chromosomes that will determine everything from eye color to height and that help to influence our intelligence and who we are individually. By the fourth week of pregnancy, the zygote has turned into an embryo and will begin developing what will become its brain.

The brain begins as the ectoderm, which is the top layer of the now three-layered embryo, and will develop into the neural tube which will close by week six. At ten weeks gestation, the new brain will begin forming neurons at the rate of 250,000 per minute, according to the article “Fetal Development: What Happens During the First Trimester?” on Mayoclinic.com. At the 16th week, the fetus’ eyes are becoming sensitive to light, and at week 18, the fetus can hear. By the 28th week, the fetus’ eyes open.

Parenting Begins In Utero

Why does this matter? Many mothers believe that their interactions with their unborn child can have an impact. Some parents even go so far as to parent in utero — reading and talking to their unborn child, already loving their baby deeply before even meeting him face to face. Research now shows what these parents already knew; parents influence their child’s psychological development from very early on. Continue reading Every Parent-Child Interaction Shapes the Brain