Tuesday, July 19, 2011

Do you know someone "At Risk"?

During some reading time today, a question came to mind that just kept popping back up ... do you know someone "at risk". Thinking this through I considered how many women, children and families there are who have situations placing them at-risk, particularly in this poor economy. I thought I should put some of these scenarios out there, in hopes it will inspire at least one person to reach out to someone in need. 
At-Risk Situations for a Mother, Family or Newborn Baby Include:
* teen mother and teen father
* history of physical or sexual abuse
* poverty, poor prenatal care, poor nutrition, homelessness
* additions (past or present)
* mental illness or mental retardation (current or family history)
* preterm birth
* traumatic birth
* congenial problems or malformations
* genetic problems
* maternal depression postpartum
* lack of social support postpartum
* perfectionist and overly conscientious parents
For those families who have never had to deal with any of these circumstances, may you cherish your blessings and support others who may have to work through these difficult situations.

Monday, July 18, 2011

Prenatal & Postnatal Attachment, and Behavioral Outcomes

For most infants, the bond with his or her mother begins while the infant is still in the womb.  Prenatal attachment theory emphasizes that a mother's relationship with her unborn child is extraordinarily powerful and important to her future role as a parent. In most cases, the prenatal attachment is obvious just by talking to the woman - her body language, actions and excitement about the baby in utero communicate she is already forming an incredible bond.
Immediately after birth, the infant is united with his mother outside the womb. When the infant cries, the mother responds with attention, comfort, feeding and changing. Immediately, the baby learns to trust and expect that his mother will meet all of his needs. Infant-mother attachment forms largely within the first six months of life. Research has shown us that children who are adopted after six months of age are less likely to develop secure attachments and are at higher risk for behavior problems later in life.  
As the infant growns older he will begin to venture out on his own. Using his mother as a secure base, the child may crawl into another room or toward another child. However, when he is unsure or afraid, the infant will return to his mother, his safe haven, for comfort. No matter how far or how frequently the child ventures out, he will attempt to maintain a certain proximity to his mother. If this proximity is not maintained, the child will experience separation distress until he is reunited with his mother. Proximity maintenance is one of the most important characteristics of attachment, especially when considering the evolutionary advantages.
Mary Ainsworth's "Strange Situation" from the 1970's greatly expanded upon her own theory of attachment as briefly described above. Her research demonstrated profound effects of attachment on behavior. She theorized there are three major styles of attachment: secure attachment, ambivalent-insecure attachment, and avoidant-insecure attachment. Since the 1970's, ongoing research has continued to support Ainsworth's attachment theory. You may be wondering now, what are these styles of attachment and how do they affect my child's behavior?  
Secure attachment can be seen when a child becomes moderately distressed by their parent's absence yet reassured upon their return. The child feels secure and trusts that his mother will return. When frightened, these children seek parental comfort and rely on them for support in meeting their needs. Securely attached children have higher self-esteem, develop strong relationships and the ability to self-disclose to others. These benefits last throughout the entire lifespan.
Ambivalent-Insecure Attachment can be seen when a child becomes very distressed by their parent's absence. These children are not secure nor trusting that their mother will return. She can be counted on for parental comfort or support in meeting needs. This is thought to affect 7-15% of children in the US.
Avoidant-Insecure Attachment can be seen when a child avoids parents or caregivers. He does not prefer the mother over a caregiver or stranger when offered a choice. Because this often results from abusive or neglectful parenting, the child internalizes the punishment he receives for relying on his parents and has learned to avoid seeking their help or support.  
Attachment style can negatively impact future behavior. We see from research that children who do not form secure attachements are more frequently diagnosed with oppositional-defiant disorder, conduct disorder and post-traumatic stress disorder.

Montessori At-Home Activities

For some great Montessori At-Home Activities, check out my post on "Montessori in the Home"

Wednesday, July 13, 2011

a quote about Infant Massage

"We know now that infant massage helps growth and development. Babies who are massaged gain more weight, they sleep better, they are less irritable, they are more responsive, they have better interactions with their parents and they show superior mental and motor development."
-Tiffany Field, PhD.
Director, Touch Research Institute

Friday, July 8, 2011

SIDS & Helmets - a complicated issue

I've been reading a lot about this complicated issue and thought I'd share my findings...
In 1992, the American Academy of Pediatrics (AAP) proclaimed that infants should be placed on their backs to sleep to prevent SIDS deaths. This inspired the state of Texas Minimum Standards for Licensed Childcare Facilities to require training in this for all employees. (This is why we only allow infants to sleep on their tummy after they've developed enough strength and coordination to roll from tummy to back.) Since 1992, SIDS deaths have been reduced by 40%!
Also, since 1992, there has been a major increase in a condition called plagiocephaly (some medical studies report the increase going from 1 to 400 babies.) Positional plagiocephaly is the most common type which literally means asymmetrically shaped head. However, there is another type called craniosynostosis which is the premature fusion of the cranial bones. For the rest of this post, I'll only be focusing on the positional plagiocephaly.
Infant brains grow phenomenally in the first six months after birth and the cranium expands to accommodate it. But because babies spend most of their time sleeping, the head of a baby who sleeps mostly on his back can develop a depression. Twins and multiples are more likely to get plagiocephaly because of constraint in the womb and prematurity requiring the infant to be on a ventilator, lying flat during the first days after birth.
There are some thing which can be done to prevent positional plagiocephaly.

Prevention Do's
  • Increase supervised tummy time
  • While the infant sleeps on his back, you could gently rotate his head to face the right or left
  • While nursing, consider different angles that would be comfortable for you and your baby and also vary the infant's head position in your arms
  • When changing the baby, try approaching him from different angles to vary his gaze on you
  • Move mobiles around so the infant is turning his gaze in varying directions
  • Move light sources occasionally

Prevention DON'TS
  • Never poke, push or apply pressure on the infant's head, no matter where on the head but especially near the top
  • Never prop the infant's head, the infant's body or his crib. Propping the infant or the crib is dangerous and should never be attempted no matter how small of an incline.

If the prevention strategies are not enough you will most likely notice asymmetry between 3-6 months. There is treatment which includes a specially fitted helmet prescribed for the infant to wear for about 23.5 hours per day for up to 6 months. This helmet is used to shape the infant's growing skull. How it works - the doctor will first measure and make a plastic mold of the infant's head. These will be used in creating the individual helmet. Once the helmet is ready, the idea is that it will fit firmly on pronounced areas while leaving room for the other areas to grow, letting them "catch up" to those that are more pronounced.


Correcting plagiocephaly vs. not correcting plagiocephaly
The research is more clinically based which relies on individual trial & error cases rather than an experimental and control group.
Pros 
  • No research has shown harm from correction with a helmet
  • Reduction in future emotional stress or self-consciousness
  • The practice is not new as it can be seen in Asian & ancient Egyptian cultures.
Cons 
  • Not always paid for by health insurance as it can be considered cosmetic (For example, Aetna pays for the treatment only in moderate to severe cases)
  • The infant can get used to the helmet and when it's removed it takes some time for him/her to get used to life without it
I hope this information finds someone in need. I have a very sweet story of a little boy who did have the helmet and I observed him the first morning he got it off ~ the link is here.

Wednesday, July 6, 2011

A story about Baby Helmets

Cosmetic helmets are sometimes used to move & mold the infant's cranial plates before they harden into their permanent shape. I've posted more detailed information about the why's and how's of helmets which can be found here, but for this post - I just have a sweet story. :) So, I recently had an opportunity to observe an infant who had been wearing one of these helmets for a few months - and today he got it off! While I was observing this little boy in the infant community, it was so beautiful to watch the discovery of his actual head (instead of feeling the helmet). He was sitting up looking at a cloth book when he raised his arms and put them on his head (actually on the sides of his head as infant arms are shorter and don't reach the top). Puzzled for a moment, he paused then started rubbing just above his ears. He rubbed in a couple small circles and realized there was something fuzzy - his hair! He rubbed, twirled and gave it a little tug. But with no success of pulling it down to eye level and see what it was, he moved his hands around a little more and found his left ear! Again, his little fingers explored the ear... pushed it, bent it and then of course pulled on it. He didn't seem to mind he couldn't pull the ear down to eye level in order to see it though - he just looked up and gave a huge grin before going back to looking at his cloth book. Reflecting on this, I continue to be amazed at the joy of discovery babies feel each and every moment.

Language & Sensorial Development - Prenatal through the First Year

To my readers, I found this wonderful article discussing language & sensorial development. The perspective covers the prenatal aspect through the first year of an infant's life. It's about five pages long and I've included the link for you here (Languae & Sensorial Development - Prenatal through 1st Year).
Please do enjoy ~ happy pregnancy & happy parenting!