I am on maternity leave #2: Putting your child in the best position to succeed

Hello families! David is 2 months old!

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Watching my little one achieves each milestone has brought me so much joy! The changes I am excited about are not only physical growth but also the development that has occurred in his mind. He started recognizing me and my husband (cognitive), cooing (language), smiling (social), and attempting self-soothing (emotional). These changes can be more subtle than visually obvious physical changes so parents necessitate different ways to recognize and support their attempts as well as achievements in these areas of development. I thought it would be great to share what I have worked on with my husband that has expanded our little one’s development over the past month.


Observing


As I mentioned, these areas of development are more difficult to notice and measure than the changes in a baby’s body. Therefore, my husband and I needed to observe our little one closely. For example, slight changes in facial expression or body movements can mean something.  We may see small hand movements which are his attempt to bat a toy. We may see that he is better at calming himself in a certain position. Also, we may see that he looks away or closes his eyes in order to take a break and have some time to refocus. When we pay attention, we can notice more of his attempts and accomplishments as well as be able to accommodate him better.


Waiting


The responses from babies have a different timeline than us. Their time to respond to their surroundings is expected to be longer than ours. In other words, they require more time to process what is going on and then to respond. For example, our little one is able to track our faces with his eyes, but it takes a few seconds. He is able to respond with cooing when we say, “I love you” but again this would be delayed a bit when compared to communication among adults. We have tried to provide our little one with enough time to process and respond to us.


Responding


When babies initiate interactions by cooing and smiling at us, we can respond back to the baby. This motivates babies to continue to have interactions with us. Then, the interactions between babies and us will be circled. This cycle of back and forth interactions is called, “serve and return” and it is a key foundation piece of healthy brain development. 


Talking to my baby


Talking to babies is very important for language development. Even though they cannot understand what we mean exactly, they learn pre-language skills through facial expressions, gestures, imitations, joint attention, taking turns, etc. When I suggested to my husband to talk more to our son, he told me that he was not sure what to say. Here are two easy ways of how we can continue to carry a conversation with our little one.

  • We describe what we are doing. For example, when I am cooking, I can say, “So now, mommy is going to cut the carrots. Before that, let’s wash them. I am turning on the tap and washing these carrots. I am cutting them in half lengthwise first. Oh, this carrot is pretty hard. I need to use my muscles. I am cutting them across so the pieces can be in half-moon shapes”

  • We pretend that we are having a conversation with our baby. We act like his cooing and babbling means something that is suitable in the context of the conversation. For example, I can ask, “What should we do today?” Like any other typical conversation, I would look at my baby, pause, and wait for his reactions. My facial expression will indicate that I expect his answer. He may coo back to me. Then, I can say, “Yes, that is a very good idea. The weather is very nice so we can walk to the park”


Providing opportunities to master new skills


In order for babies to learn how to walk, they need to try walking countless times. Like physical development, other areas of development also require much practice. The more they are exposed to environments where they can freely experiment with new skills, the sooner they can master those new skills. I have noticed that my baby has started to self-soothe. So, we decided to give him opportunities to practice self-soothing. We have started putting him down when he is sleepy but awake. We started it during his first nap when he is the most sleepy. Now, we put him down when he is still awake and for all of his naps and nighttime sleep. We noticed that he also puts his hands in his mouth to self-soothe. Even though we do not want him to be a finger sucker later-on, right now, we allow him to do it since we believe that practice on how to control his arousal by himself is a more important milestone than preventing him from becoming a finger sucker.


I cannot believe that this little human is already two months old. As new parents, my husband and I encounter new challenges and we are learning every day. However, I appreciate the love my son has brought into our lives and the partnership and strength my husband and I share.

- Minnie

I am on maternity leave #1: The first month

Hello families! Baby David is 1 month old!

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In the past, most of my blog postings have been inspired by my profession - working with children, families, and students who are pursuing their early childhood education licenses. However, this posting will be a lot different since it is based on my own experience as a first-time parent with a newborn. Even though I have nearly 20 years of experience and education related to early childhood, especially with infants and toddlers, starting parenthood is definitely a new experience. Of course, I have had many new parent moments, felt helpless with my crying baby but at the same time, those moments are precious because my own baby is so special to me.

I will share my experiences during the first month based on three categories – Things that have already worked, things that are still in progress, and things that have not worked yet. I would like to emphasize that my child is unique just as yours are. There are countless things that impact a child’s behaviour and development as well as family dynamic. I cannot say that what I have done directly causes the outcomes of my child or my family. However, I thought it would be great to share what I have applied for those who are looking for some experience-based ideas for their newborns.


Things that have already worked


Among the many hats that I wear, baby sleep consulting is certainly one of them – I have helped dozens of parents even prior to being a mother. One thing that I wanted to do from the very beginning was helping my baby understands the difference between day and night. Even though circadian rhythm develops at around 3-4 months, it doesn’t hurt to start helping my baby early on.

What I have done

  • Gone out twice a day (daytime, and evening): I have gone out daily since day 5. During the daytime, I usually go out with a stroller but on a rainy day, I go out with a sling so I can use an umbrella. He is usually sleeping but there were a few days he was so alert. I have not skipped this daytime routine yet. In the evening, my husband joins our outings. It has been such a nice time as a new growing family. We had to skip a few days of this when it was pouring or too late due to other schedules (e.g., guest visits). I could anticipate those occasions and on those days, I go for a longer walk during the daytime. This actually has helped my own recovery and prevented me from being stuck in the house singing the baby blues.

  • Set the mood: When my baby wakes up, I open the window and turn on music. I also turn on a diffuser with diluted sweet orange essential oil which is known for uplifting mood (I also mix with diluted tea tree oil and peppermint that are known for preventing colic). Also, I don’t attempt to limit sound during the daytime. I live in the very busy part of Vancouver so it is almost impossible to block the sound from outside anyways. During the nighttime, naturally, every sensory input subsides. On top of that, I set the mood by dimming the light and turning on unwinding music or white noise. My husband and I also try to use a softer voice.

* There are conflicting arguments regarding the usage of essential oils and only limited numbers of essential oil are safe for babies. Please do your own research and discuss with a healthcare professional before using them.

  • Change his outfits at least twice: I understand it is very easy to let newborns wear a sleeper for the full day because their main job is to sleep. However, I change his outfit at least twice a day (in most of the times, more than twice due to leaking and spitting up) from sleeper to daytime outfit and from daytime outfit to sleeper.

  • Face, hands and bum washing in the morning and full bathing at night: I washed his face, hands and bum with water in the morning and my husband and I give him a bath every night. I believe that these two are very distinguished daily experiences for him. I hope these can be a cue for time to start a day and time to go to sleep. 

  • Vitamin D drops in the morning: It is recommended in Canada that all breastfeeding babies get vitamin D drops. I can't explain this with scientific reasoning, however, based on my own experiences, vitamin D pills made me more alert and awake. Also, when I took it at night, I had a hard time to fall asleep. Therefore, I give vitamin D drops to my baby in the morning.

*I set up the alarm on my phone for this. If you are the mommy who struggles with “mommy’s brain” this helps.

Outcomes

After I got confirmation from my midwife that his weight gain was better than target (30 mg per day. He was gaining for 35 mg per day), I started letting him sleep as much as he can instead of waking him up every two hours. I would like to consider that it has been successful since 3 weeks in, my baby stretched his sleep to an average of 4 hours or more at night and by 4 weeks for 6 hours in a row. I know that it can change in an instant, but I do feel as though we have accomplished this.

 

Since I started maternity/parental leave, I became the main caregiver of my baby. However, from the very beginning, I would like to share this precious moment with my husband so he can develop bonding with the baby. Developing attachment does not just happen. It requires time and effort of a new caregiver as my husband does. Therefore, I would like to encourage my husband and our baby to share more intimate time.

What I have done

  • Daddy and me-time: My husband started a new job just before we brought our baby into the world. As expected, he is super busy. We tried to find any time that he could spend some time with the baby without being rushed. We learned that in the morning before his work, my husband can spend some time with the baby for 30 minutes to one hour (Also, this gives me some time to take a shower and do some tidying up). Also, just before the last feeding at night, there is some snuggle time (skin to skin) between them.

  • Daddy takes care of me: Typical caregiving moments are the best time to develop attachment. When my husband is at home, he is the person who changes baby D’s diapers. He carries the baby around. He goes out for a walk and takes a bath – even inside the tub with him. When I pump, I always give the bottle to my husband (Sometimes I purposely pump for this. It is extra work for me but it is worth it). These attempts have allowed my husband gets to know the baby better and his caregiving skills have improved drastically in order to meet the needs of the baby (good job, hubby!).

Outcomes

Daily daddy routines have been established between my two precious gems. They seem to enjoy these times together. My husband who has never had experience with taking care of newborns is developing a solid relationship with his son. I am very happy and thankful to see that my husband and I are adapting to our new roles as parents and working together as a team.


Things that are still progress


It is important to keep a calm demeanour when taking care of babies. I am confidently able to say that I have been able to deal with crying and behavioural issues related to children in a calm manner for most of my life/career. However, dealing with my own child is different. My logical part of my brain is telling me that he is ok and safe even though he is crying but the emotional part of my brain is telling me to rescue my baby. My stress hits the roof when I hear the sound of my baby crying. This intensified stress makes me lose a bit of my control. There were a few times that I cried with my baby since I felt such pain during the first week.

What I have done

  • Stop, breath, and think through it: Whenever I feel uncontrollable stress due to him crying, I stop and breath. I have to keep reminding myself of the following:

    1) A little bit of crying isn’t going to hurt him

    2) Crying is the the most effective way he can communicate at this point so try to find the reason and resolve it

    3) Sometimes he just cries with no specific reason

    4) The more I can be calm, the quicker he can be calm again

    5) How I feel has intensified due to the hormonal and brain changes that have occurred to me. It does not reflect how he actually feels.

  • Be ready: I knew that the witching hour was going to be difficult but I did not anticipate how frustrated and helpless I would feel. Feeding after feeding (cluster feeding) made me exhausted both physically and mentally. After a few days of struggles, I could anticipate this, and I started preparing myself for this. I also made sure to eat well (sometimes a piece of cake helped me to get through), and hydrated. Also, this applies to when my husband and I are out (Oh man that first doctor’s office visit! We were rushed and soaking wet because of stress sweat). We have learned that it will take way more time to get out of the house. We also need to master how to use new baby-related products such as the stroller and car seat. The better prepared we are, the calmer we can be.

Outcomes in progress

I would put this as a thing that is still progress because we have yet to encounter all the various situations that would require a calm demeanour. I am aware that this may remain as an in-progress task during my entire parenthood.


Things that have not worked yet


First of all, I hope this isn’t misunderstood in that I don’t like to have guests. I do appreciate their kindness and care for our growing family, love to have as many guests as I can and introduce my beautiful baby to them.

Everyone welcomes and wants to meet the new baby. However, having guests does not necessarily follow the needs of the newborn baby. It can disrupt his wake-eat-sleep patterns. He can be overstimulated and become overly tired especially when the visits occur in the evening. We learned it in a hard way. We realized that we cannot say yes to guests whenever they would like to visit. There were two days he woke up more than 10 times at night because we had guests in the evening! Also, this is the time that a new mother must focus on recovery as well and for new parents-baby bonding.

What I have tried

Before I had my baby, I read some postings from mommies groups about rules for guests and did not think about it much. However, after having constant visits from guests, my husband and I realized that we needed something. We tried to set up rules such as the timing of the visit, limiting the numbers of guests at one time, etc. However, we have failed this quite often. It is difficult to say “no” to families and friends who are excited to see the baby. However, my husband and I need to reinforce these rules for the benefit of our baby and ourselves. We just need to remember - Babies cannot accommodate adults. Adults should accommodate babies.


I cannot believe this has already been a month. Time flies and I don’t want these precious moments with my newborn to go away. I hope as my baby gets bigger, stronger, and smarter, my husband and I become more mature and patient for his benefit and ours!

- Minnie

Parental depression and developmental outcomes of their babies

Dear families,

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Depression hurts everyone. Parental depression can disrupt not only parents' own well being but also caregiving and nurturing which leads to negative developmental consequences in babies. The following article explains how parental depression impacts developmental and socioemotional outcomes in developing babies. 

- Minnie

          Babies are born with tremendous abilities to develop relationships with their primary caregivers, mainly their parents (Bowlby, 1958, 1969; Campa, 2013; Kaplan, Bachorowski, Smoski, & Hudenko, 2002).  Their tiny body constantly sends and receives non-verbal signals with their parents which allows parents to meet babies’ physiogical and psychological needs (Browne & Talmi, 2015).  Parental observation, interpretation, accommodation, and adaptation in order to meet babies’ current needs are the foundation for developing infants.  However, many studies (e.g., Aktar et al., 2016; Guyon-harris, Huth-bocks, Lauterbach, & Janisse, 2016 ; (Kaplan et al., 2002) have shown that parental mental health can interfere with their ability to respond their babies.  Consequently, babies’ paths for optimal development can be in jeopardy.  In this paper, a literature review will be drawn upon to explain how parental psychopathology, especially depression impacts developmental and socioemotional outcomes in developing babies.

          Developmental psychologists have tried to introduce human development into several progressive orders.  Many of them agreed that basic physiological and psychological needs should be met first within the relationship with parents in order to achieve a more sophisticated and complex development.  For example, Maslow (1943) believed that there are five different layers of needs.  One level should be fulfilled to pursue the next level.   He explained that the first two fundamental needs are physiological needs, such as food and water, and security needs, such as security and shelter.  These are the foundation for the next step, love and belonging.  Greenspan (1997; 2006) introduced six basic developmental capacities for early childhood.  He (1997; 2006) explained that the first step is developing the ability to regulate their own body as well as attention and focus on the world followed by the second step, mutual engagement and forming relationships and the third step, interactive intentionality and reciprocity.  Winnicott (1960; 1986) also argued that satisfaction when babies’ physical and psychological needs are met through parental care, babies start learning about themselves and the world around them.  Therefore, parental ability to provide a safe environment, read their babies’ signals, and adjust their behaviours to meet their babies’ physical and psychological needs are cornerstones for optimal development in babies.

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          We often only think about parental influence on their babies, not their fetus.  However, the interactions between expecting mothers and their fetus start earlier than the birth of newborn babies.  For example, Feldman (2007) argued that expecting mothers support their unborn babies’ biological rhythms.  In the third trimester, expecting mothers and their fetus synchronize their states, which supports the fetus to consolidate their sleep-wake cycle and the cardiac rhythm, which controls heart rhythms.  However, when expecting mothers are depressed, the development of the fetus can be compromised.

          Field (2011) argued that the evidence of prenatal depression could be found to be 6-38% in the published literature.  There is no clear explanation of the mechanisms underlying the influence of depressed expecting mothers on the development of their unborn child, however, dysregulated hormones among expecting mothers are considered one of the key influencers of developmental consequences (Lewis et al. 2015).  In a literature review, Field (2011) showed that prenatal depression is associated with excessive activity and growth delays in the fetus.

          Other researchers attempted to unveil prenatal maternal depression and the developmental outcomes after birth.  Field (2011) explained prenatal depression could lead to prematurity, low birthweight, disorganized sleep and less responsiveness to stimulation in the neonate.  In addition, Junge et al. (2017) argued that prenatal depression caused high cortisol exposure prenatally which may cause children to be reactive to stress after birth.

          Developmental oddness can be found in older children.  Eichler et al. (2017) investigated that the relationship between prenatal maternal depression and social outcomes among children at four years of age.  One thing that makes this study unique is that children’s social outcomes were measured by trained phycologists, not a parental report to avoid parental bias.  They found that children whose mothers were depressed prenatally displayed more antisocial behaviour symptoms at this particular age.

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          Postpartum depression can be found in 13-20% of new mothers (World Health Organization, n.d.).  Maternal depression interferes with interaction with their babies (Kaplan et al., 2002).  Infant direct speech (ID) is crucial to stimulate babies (Fernald, 1985).  Kaplan et al. (2002) observed the conditioned attention paradigm, ID as a signalling stimulus and smiling as reinforcer among infants whose mothers were depressed and not depressed at four months of age.  Babies of depressed mothers could not attain learning opportunities due to inappropriate maternal support (e.g., withdrawn, negative affect, lower quantity of stimulation, less salient stimulation).  However, the important thing is these children demonstrated attention when other non-depressed females prompted them.  This aligns with the view of capable infants and emphasizes the importance of not only early detection but also support for mothers who are depressed. 

          Synchrony is another key element in the early relationship between mothers and their babies.  Schore and Shore (2008) argued that sensitive parents attune infants’ arousal in order for them to synchronize together to regulate affective states and then, move towards the next emotional state together.  Therefore, in these relationships between mothers and their babies, mothers can support babies’ development of both central (CNS) and autonomic (ANS) nerve systems after birth.  Granat, Gadassi, Gilboa-Schechtman and Feldman (2017) studied the differences of synchrony between three groups of mothers; depressed, anxious and typical, and their babies.  Depressed mothers demonstrated frequent but short gazing to their infants which did not help synchrony between them and their babies.  These babies display social withdrawal (less gaze, aversion) which can lead to an increase in behavioural issues in the near future.  Also, in stressful circumstances, for babies of depressed mothers, the presence of mothers was not effective to reduce negative emotions as an external regulatory agent.  Anxious mothers achieved the highest level of frequency of synchrony.  However, their babies moved to a negative emotional state (anxious) together with their mothers.  Moreover, the intrusiveness of anxious mothers hindered their babies’ opportunity to develop autonomy.  Therefore, a different type of mental illness of mothers requires different strategies to support early relationships with their babies.

          Maternal depression can increase undesirable emotional/behavioural outcomes in older children (Woolhouse, Gartland, Mensah, Giallo, & Brown, 2016).  Woolhouse et al. (2016) measured maternal depression in early pregnancy and at 3, 6 and 12 months postpartum and again at four years postpartum and emotional/behavioural difficulties of children at four years.  Even though any point of maternal depression increased the chance of emotional/behavioural difficulties, children with mothers who were depressed at four years postpartum displayed three times more emotional/behavioural difficulties than children with non-depressed mothers.  This study provides insight into the needs of support for depressed mothers during an extended period.

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          There are many studies about the impacts of maternal depression on child developmental outcomes, but there is a lack of studies related to father influences.  In consideration of the social-ecological systems theory (Bronfenbrenner, 1979) and the transactional theory (Sameroff, 2009), it is important to understand the complex bi-directional, non-linear impact on maternal depression and father contribution.  Fathers can impact a child’s development as well as maternal mental health.  Paulson & Bazemore (2010) found that 10% of fathers suffer from prenatal and postpartum depression and it had a moderate positive correlation with maternal depression. Kim and Kim (2017) compared high-income and low-income families to see the relationship between fathers' indirect influence on children's social/emotional outcomes.  In both groups, fathers' involvement mediated maternal depression and parenting stress, and consequently, children demonstrated better social and emotional outcomes.

          Within the dyad, characteristics or conditions of babies can contribute and influence maternal depression.  For example, the negative temperament of babies is more related to maternal depression (Aktar et al., 2016).  Premature birth also contributes not only to maternal depression (Bakalar, 2008), but also paternal depression (States News Service, 2016).  In fact, maternal postpartum depression is found among as high as 40% of mothers who give premature birth (Vigod, Villegas, Dennis, & Ross, 2010).  Moreover, having a child with developmentally delay is another major risk factor for parental mental health (Alvarez, Meltzer-Brody, Mandel, & Beeber, 2015).  Alvarez et al. (2015) illustrated that depression and anxiety symptoms could be found in as high as 68% and 52 % respectively among these parents.  Therefore, more dedicated support is necessary for these parents whose babies are medically fragile in promoting their mental health as well as the early relationship with their babies.

          Babies are capable communicators (Bowlby, 1958, 1969; Campa, 2013; Kaplan et al., 2002) and their non-verbal communication allows parents to help meet babies’ physiological and psychological needs (Browne & Talmi, 2015).  Parental ability to observe, interpret, accommodate, and adapt are cornerstones for developing infants.  Prenatal depression disrupts developmental outcomes not only in the fetus but also in babies after birth.  Moreover, maternal postpartum depression interferes with the maternal ability to communicate and synchronize with their babies, consequently resulting in undesirable developmental and social/emotional outcomes.  Fathers should also be the centre of our attention due to their own suffering from depression and their influences on child development.  Lastly, the characteristics and conditions of babies can be risk factors to parental depression.  Therefore, those parents whose babies are medically fragile requires more dedicated support to promote their mental health as well as the early relationship with their babies.

References

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Alvarez, S. L., Meltzer-Brody, S., Mandel, M., & Beeber, L. (2015). Maternal Depression and Early Intervention: A Call for an Integration of Services. Infants and Young Children, 28(1), 72–87. https://doi.org/10.1097/IYC.0000000000000024

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Woolhouse, H., Gartland, D., Mensah, F., Giallo, R., & Brown, S. (2016). Maternal depression from pregnancy to 4 years postpartum and emotional/behavioural difficulties in children: results from a prospective pregnancy cohort study. Archives of Women’s Mental Health, 19(1), 141–151. http://dx.doi.org.fgul.idm.oclc.org/10.1007/s00737-015-0562-8