Recently I had the pleasure to meet with Marsha Podd, R.N., C.L.E. author of Secrets of a Baby Nurse. We met up because of a mutual interest in infant sleep and well being. During our conversation we discussed sleep training. Marsha works with parents of newborns on sleep training. She and I discussed our personal belief in infants learning to sleep on their own. Learning to self-soothe and self-regulate is an important skill that can be learned as early as 6 months old.

Marsha also mentioned a study that was done that followed up with children at six years of age that participated in sleep training. What they found is that 'controlled crying' and other sleep training methods had no adverse behavioral or emotional affects as compared to those who had sleep problems, but received no training. In fact, the study comments' "without intervention, sleep problems are more likely to persist into childhood, potentially leading to behavioral and cognitive problems including aggression, anxiety and attention and learning difficulties". You can read more from Murdoch Children's Research Institute here. 

Do any of these terms sound familiar: Night Nanny, Baby Nurse or Newborn Care Specialist?  Each of these terms has been used interchangeably in the past, but in reality there is vast difference in their duties. A Night Nanny is simply a person who comes into your home at night and gets up with your newborn when he/she awakens. She is not educated in newborn issues and will do only what the client instructs her. At times it can be like the blind leading the blind.

A Baby Nurse is a registered RN or LPN who comes into your home and cares for your newborn’s medical issues. So what is a Newborn Care Specialist?

Newborn Care Specialist (NCS) is an extensively educated, skilled person who has a well-rounded knowledge in formula and breastfeeding, understands how to effectively set up a routine that fits the family’s lifestyle, is able to interpret and adequately respond to a baby’s needs, establish healthy sleep habits, knows about diaper rashes, circumcision care, reflux, colic, swaddling, soothing techniques and how to effectively set up the family for success. She will be experienced in preemies, multiples and special needs babies.  She will generally come in for one week to three months relieving the parents at night and educating them while she is there. Most Newborn Care Specialists are also available for day duty or round the clock duty. Her goal is to work herself "out" of a job by the time the baby is 3 months old and typically sleeping from 7 PM to 7 AM without waking.

Once a baby reaches 12 weeks or 12 pounds he/she should be sleeping all night without waking. A Newborn Care Specialist is trained to help a baby accomplish this using gentle no cry methods.

A great schedule is the key to a happy baby.  Implementing a good sleep, feed, and wake schedule can be the key to a peaceful home and baby.  A baby with a good schedule will also sleep better at night.   A Newborn Care Specialist can help set that up.

A trained Newborn Care Specialist is an expert in swaddling and can show new parents how to become experts also.  Many new parents do not realize that when proper swaddling techniques are used, the benefits will be a baby who sleeps longer and more peaceful.

Bring home baby is not as simple as it is cracked up to be. You can read the books and go to the classes but when that sweet little bundle arrives in your home, all your learning can go out the window. There is so much to know about babies and a Newborn Care Specialist is a person who is ‘in the know’.

While doing your search for a newborn care, we would strongly suggest that you make sure the Newborn Care Specialist you hire is certified by a qualified agent.  The Newborn Care Specialist Association is the certifying agent for the Newborn Care Specialist and can be researched at www.ncsainfo.com . Certified individuals  carry the initials CNCS (Certified Newborn Care Specialists) behind their name. Many individuals call themselves Newborn Care Specialists but not all are qualified to be doing that job, causing countless problems you will be calling a certified NCS to fix.

Summary

Arriving home with your newborn, a Newborn Care Specialist can be a wonderful asset to your family and to Mom’s recovery. Her services are priceless when she leaves 12 weeks later. Your baby should be sleeping through the night, and your evenings are yours to share with your other children or your spouse. You will feel more confident in your newborn care skills and you will be well on your way to a well- integrated family structure. Even if you decide to gift yourself with only a couple of weeks of help, the education you will receive and the rest you will get for those two weeks will have your friends envious.

Nancy Hamm is a Certified Newborn Care Specialist with over 35,000 hours of on-the-job experience.  She owns Exclusively Baby Nurses www.exclusivelybabynurses.com  a professional placement agency, The Baby Nurse Directory www.TheBabyNurseDirectory.com  a free referral network for new parents; she does sleep consulting, and is available for night-time work.  She can be reached at 800-337-0650.

Natalie went on to tell me that there is much more to it than that. In addition to feeding, changing and keeping watch over baby, she provides parent education, including sleep training. Natalie starts with swaddling, a pacifier and a sound machine. She may also recommend positioning, including elevating the crib for infants with reflux. (See Natalie's review of Baby Stay Asleep).

What is her infant sleep training philosophy? She uses bits and pieces from different sleep training methods. She feels that sleep is essential for newborns - "it is the center of who they are". Therefore, it is important to develop healthy sleep habits. She believes babies should sleep in a familiar surrounding. The sounds from the sound machine are similar to the sounds in the womb and therefore familiar to the baby. She also believes they should sleep in their own crib - to learn that this is their "sleep space" – and is not opposed to some crying. Waiting too long to have baby sleep in their own space can make it difficult to transition later on.

Natalie's services are invaluable to new parents! The combination of getting some sound advice and sound sleep can make for one happy family!



Me: What are the benefits of swaddling?

Tamara: Swaddling has several benefits.
- keeps them warm
- helps them sleep longer
- provides relief from colic and fussiness
- helps baby sleep on his back, which reduces the risk of SIDS
- keeps the startle reflex in check.  babies that sleep on their backs
tend to startle themselves awake.
- it's soothing and reminds them of the closeness, comfort and warmth of
the womb.

Me: When would you swaddle?

Tamara: It all depends on the baby.  Personally, I swaddled my two youngest at the
hospital and for probably their first few days.  I didnt swaddle either of
them much until around the age of 5-6 weeks old when their startle reflexes
really kicked in.  At that point they had to be swaddled to stay asleep for
more than a few minutes at a time.  I would swaddle for naps and nighttime.
I continued to swaddle them for naps and bedtime until they were old
enough that I began to worry they might roll over while swaddled.

I'd also swaddle any time they seemed especially fussy.  A crying baby
with arms flailing can be calmed by wrapping them up and holding them
close.

Me: How do you swaddle?

Tamara: Again, it depends on the baby.  Some are perfectly content wrapped up in a
blanket.  Some are little houdini's that can break out a traditional
swaddle in 2 seconds flat.  The preferred position according to Dr. Harvey
Karp in "Happiest Baby on the Block" is to have their arms at their sides.
If you watch the nurses in the hospital, you'll see them put baby on the
blanket, pull the arm down to the side, wrap that half of the body and tuck
the blanket around the back. Then the pull the next arm down to the side
and wrap the rest of the blanket around the entire body.  This method works
great until baby can get their arm bent and their hand up near their face.
At that point it becomes a wrestling match with the blanket, trying to get
that arm out and that's when the grunting and fussing starts.

Me: How does your product work?

Tamara: My products work by wrapping baby's arms to keep them at their sides.  I
use a knit fabric, which stretches, so their arms aren't completely
immobilized.  They can move their arms, but they aren't able to get that
elbow bent all the way to a 90 degree angle, which would allow them to
break out of the top.  I have three different designs.  One is an accessory
piece makes any ready-made swaddle or just an ordinary receiving blanket a
bust-proof swaddle.  Another is designed so that baby can be safely buckled
into a swing or bouncy seat while swaddled.  It would also work perfectly
with your sleep positioner!  The last one is like a traditional ready-made
swaddle, but it's design makes the leg pouch is impossible to kick out of.

If you want to provide sensory input that stimulates and enriches your infant’s development, think variety. Touching is a key sense for infants. Books and toys that have rough, smooth, bumpy and crinkly parts are great to use. For all babies, infant massage has many benefits.Just simply being held has tremndous benefits.

 Movement is a struggle for some infants, while some crave it, others are frightened by it. Rocking, bouncing and swinging are all activities that can be introduced gradually to help overcome sensitivity to movement. Wearing or carrying your baby while going for walks or doing light chores can provide movement, deep touch pressure and sound (your heartbeat) all together!

Infants also need a variety of visuals to look at. Infants respond to bold patterns and bright colors at first. Point things out in your home, the community or in nature. People’s faces are another fascination for babies. Hold your baby's gaze during feeding time and speak softly to capture her attention.

Music and singing can be combined with all of the above activities. White noise or ocean waves are soothing while drums and high-pitched sounds are alerting. Mimic your baby’s sounds back to them to encourage language development. By combining sensory inputs you are further enhancing their development. However, recognize that "multi-sensory” input can be too much for infant’s that are sensitive or at certain times of the day (i.e. when tired or hungry).

Why is tummy time so important?

The experience of being on their tummy helps babies learn to push up, roll over, sit up, crawl, and pull to a stand. These are all important developmental milestones in a baby’s first year.

How can we help babies to get the experience of tummy time?

Once you place your baby on his stomach, distraction can help until he gets used to it. Join your baby on the floor. Get face to face and encourage him, sing to him, shake his rattle, make funny faces and play peek-a-boo. You could place a favorite toy or new toy within reach or use a tummy time gym with mirrors, lights, music and toys attached. Another option is to lay your baby tummy-down on your tummy, either on the floor, in a recliner, or even in the bath.

If your child has some neck strength and head control (usually by age 3 or 4 months), try propping him on a rolled towel or nursing pillow. Place the towel or pillow under his chest and armpits, with his arms in front of it. Another idea is rolling your baby on a big exercise ball. Hold him on it tummy-down while you gently rock the ball back and forth.

For safety reasons, be sure to supervise your baby during tummy time.

More Tummy Time Tips

Tip: Make sure your child's sitter or daycare provider knows about the importance of tummy time when your baby's awake as well as the importance placing your baby on his back to sleep.

Tip: Make sure your baby isn't hungry or tired when you set him on his tummy. On the other hand, don't place him on a full belly, which might be uncomfortable or worsen reflux. When he starts to cry — even if it's only been a minute — try to coax him a bit longer by talking with him or playing with him. When he's had enough, pick him up and try again later. His tolerance for tummy time is likely to increase gradually with experience and a bit of coaxing

Tip: Try to figure out if there's anything in particular about tummy time that your baby finds distressing. Maybe his blanket gets too scrunched under him or the carpet is too scratchy. Maybe it's too cold on the floor, or too slippery. Maybe he needs his thumb, hand or pacifier to suck on.

What are your tummy time ideas? Please share!

Recently, a few parents have asked me how to swaddle their baby while using the Baby Stay Asleep. There are many benefits to swaddling a baby for sleeping. It helps a baby feel warm and secure; it can help prevent a baby from throwing his arms up and waking himself, or even scratching his face. Swaddling is an old and common practice. It is mentioned in the popular parenting book "The Happiest Baby on the Block" which I would also recommend!

Anyways, the product I came across is called the SwaddleBuddy Suit. I have not tried this product myself, but it looks like it solves the problem of how to swaddle your baby while using the Baby Stay Asleep. So check it out!



So, I was really caught off guard when Luke refused to get out of the car and cried and told me he was not going to like this school! Talk about unexpected! I took a deep breath and tried to reason with him, that did not work. So I tried humor- what we call in our house “the-upside-down-tickle-treatment” and thankfully that did work! I ended up staying at school for two hours before leaving him. I went back to the car and cried myself. At that moment I wanted to go back to New Hampshire, back to what was comfortable. I had underestimated the impact this move would have on my son and on me. I am happy to report that when I picked him up in the afternoon, he told me he liked summer camp. 

Six years ago, I had also underestimated my transition to motherhood. I was someone who had always worked with kids of all ages. I thought – I’ve got this motherhood thing, no problem! Well, I was so wrong when a few weeks after my son was born, he was crying all the time, not sleeping well and not eating well. He was finally diagnosed with infant acid reflux. Talk about unexpected! You can read more about my experience as a mother bonding with a newborn with reflux in a previous blog. 

When to start? It most often recommended to start at 6 months, although some pediatricians will recommend as early as 4 months. Sometimes pediatricians may recommend putting baby cereal in your baby’s bottle to help with reflux. This has not been shown to be effective and some babies are actually sensitive to rice or oatmeal cereal causing gas, bloating, or constipation, which will further contribute to their discomfort. 

How do you know they’re ready? Your baby can sit up with support, can hold his/her head steady when sitting and shows interest in your food. It is often recommended to start with cereal. However, there is no reason not to start with fruits or vegetables. Try introducing one new food every 4 – 7 days. Look for signs of food sensitivity or intolerance, such as eczema, increased fussiness, rash, diarrhea or constipation; or signs of a food allergy, such as hives, swelling or difficulty breathing.

If your baby seems not to like a food – don’t give up! On average it takes introducing a new food 10 times for a baby to get used to it.  Remember to have fun with them- babies learn through play!

Finally, I wouldn’t expect all babies to eat large quantities. Most babies with reflux and children with reflux will eat small, frequent meals. My five-year still does!

 For more information: 

Introducing Solid Foods to a Baby with Reflux

Babies and Solid Foods: What to serve when

Food Allergies