May 22nd, 2012

Best of Babyshrink


Exciting Work — BabyShrink’s Updates

Dr. Heather : April 20, 2011 5:57 pm : Annoying Toddler Behaviors, Babies, BEST OF BABYSHRINK, Developmental Grab-Bag, Preschoolers

Whew, I’ve been busy!

Make sure to check me out all month on ParentsConnect.com, the Nick Jr parenting blog. You know, “We’re not perfect, we’re parents.” We had an awesome connection over my “Good Enough” parenting posts, and it’s exciting to interact with so many of their families. It was all made possible by the fab folks at Learning Care Group — you probably know them by their 1,000+ schools in the US, including ChildTime, Tutor Time, La Petite Academy, Montessori Unlimited, and The Children’s Courtyard. I’ve been blogging for them on the LCG Blog Learning Together too. They have exciting plans for showing off their expertise with kids — and they want my help. I’m honored and thrilled — and I’ll keep you posted as things develop.

I recently spent a bunch of time with the LCG folks on the mainland, creating a series of parenting videos. I’ll post them here soon, and they’ll also be on the LCG website. It was a wild ride, creating top-notch, scientifically-based, but accessible info for parents in the most professional, high-quality, high-tech media environment.

In the meantime, I’m expanding my Parent Coaching practice, and juggling not one, not two, but THREE kids’ basketball team schedules. What the heck — it’s all good experience for my LCG writing — they want to focus on work/life balance in the future, and my house is the perfect crucible to test out some new approaches.

Thanks for your continued support, and I hope you’ll stick around to check out some of my parenting tips!

Aloha,

Dr. Heather
The BabyShrink

2 Comments »

Cool New Gigs

Dr. Heather : February 13, 2011 3:59 pm : BEST OF BABYSHRINK

BabyShrink is almost 3!

Is it possible that BabyShrink is approaching it’s THIRD birthday? This site was launched with much anxiety on my part — and also, great hopes and dreams. Sort of like having a REAL baby. Come to think of it, there are lots of similarities between writing a parenting column and having a baby — the staggering amount of work — 24/7 — being one of them.

So as I was toiling away out here in my island home, pressing the “Publish” button every week and wondering whether anyone would even read my stuff, an interesting thing happened — people DID start reading, and more importantly — enjoying their parenting adventures a little more because of it.

So it comes with a great sense of satisfaction (and even joy) to announce the next step for me — adding the title of “Expert”, in affiliation with some pretty impressive folks. You’ve probably heard Dr. Oz talking about his great new health site, ShareCare, powered by some of the most prestigious names in the country. I’m excited to be on ShareCare — here’s my bio — answering your questions about parenting, child development, and family life. It’s a super user-friendly experience, so I hope you’ll sign up today, along with the 200,000 others who have already jumped on board to Dr. Oz’s Move It And Lose It personalized diet and fitness plan — and countless others looking for real answers to health questions.

I’m also really excited to be featured alongside some awesome names in parenting and family health over at Parents.Com. They have a cool Q and A tool where you can submit questions — and the panel of experts answers for you. Check me out on the same list with gurus like Dr. Harvey Karp (of “Happiest Baby on the Block” fame), Dr. Ari Brown (of the “Baby 411” series), and Dr. Alice Domar, a fellow shrink who’s done tons of fantastic stuff on women’s health at Harvard (among others).

Thanks for all of your support and encouragement — as always, send me your parenting questions. In addition to these cool new ways to reach me,  you can always comment here, tweet me, or drop me an email so that we can arrange some individualized Parent Coaching for you and your family. I’d love to talk with you personally.

Aloha,

Dr. Heather
The BabyShrink

10 Comments »

Dr. Heather in Parents Magazine, August Issue

Dr. Heather : July 14, 2010 6:18 pm : Annoying Toddler Behaviors, BEST OF BABYSHRINK, Developmental Grab-Bag

See me on page 191

See me on page 191

Thanks to Parents Magazine and Sharlene Johnson for giving me the opportunity to be the “Q and A” expert on a

topic we’re all familiar with…The Dawdling Toddler. Pick up a copy anywhere magazines are sold, and let us know YOUR suggestions for getting your toddler out the door in the morning.

Aloha,

Dr. Heather
The BabyShrink

1 Comment »

Pregnant with Baby #4 (and I Just Turned 41)

Dr. Heather : May 11, 2009 8:52 pm : Babies, BEST OF BABYSHRINK, Motherhood

Dear Readers,

This post isn’t an emailed question from one of you. It’s from me, your BabyShrink.

I can finally come out with the news I’ve wanted to tell you for 18 weeks now: I’m pregnant!

This has come as somewhat of a surprise to us, although a very welcome one. Many of you recall we originally went through infertility treatments to get this ball rolling, but needed no help with babies #2, 3, and now 4. So here we are: a 4-for-1 deal!

My age is not the least of it. As an old lady of 41, my OB chart has “Advanced Maternal Age” stamped all over it. I’ve gone through several rounds of genetics screenings, and all the anxiety that goes along with it. I had killer morning sickness (uh, ALL-DAY sickness) for several weeks. But the worst part has been keeping the secret: from you, my coworkers, and even my kids. But we finally feel safe — at least safe ENOUGH — to break the exciting news.

So thanks to all of you for your patience; I’ve been remiss in posting quite as often as I’d like, and my response time to your questions has stretched out a bit. But I’ve been accumulating some heavy-duty experience that I hope will continue to help make BabyShrink fun, interesting and new.

Depending on your interest and questions, I’ll be posting some of the things I’ve learned these past several weeks. I expected to have a CVS (for early chromosomal testing) — and didn’t. Then I expected an amniocentesis — and didn’t have THAT, either. But there are some wild new screening procedures that helped us though that decision-making process, and these are all pretty new. I look forward to your questions about how to decide when, if, and how to make decisions about genetic testing in pregnancy, and all the strong emotions that can go along with the process.

And in the meantime, I’ve discovered that my good-old standby baby bottles — the ones that have gotten us through 3 babies — are no longer considered safe (due to the BPA). So I’ve got to learn about all the newest STUFF out there as well….and I LOVE baby “stuff”. So I’ll need your help in deciding what to buy (and what to skip) this time around.

I’ll also be asking for advice from those of you with large families. Having #4 feels exciting — but daunting. This is uncharted territory in both my family and my husband’s, so we need all the help we can get!

Thanks to all of you for your support and encouragement, and I look forward to going on the rest of this exciting journey with you.

Aloha,

Dr. Heather
The BabyShrink

15 Comments »

Baby’s Sudden Fear of the Bath — Another Hot Topic

Dr. Heather : March 17, 2009 10:45 am : Annoying Toddler Behaviors, Babies, BEST OF BABYSHRINK, Developmental Grab-Bag

One of the FAQs here at BabyShrink is about your toddler’s sudden, inexplicable fear of the bath. Readers Noelle and Dana recently joined in the chorus of parents who are mystified about the radical change in their baby’s bath-time routine. I’ve had plenty of first-hand experience with baby’s bath fears, and I know it can be a hassle (“It interferes with our evening routine, and they NEED that bath!”) and also worrisome (“She never got upset like this before — is this a symptom of something much more concerning?”) But when you understand the normal developmental process driving these fears, a little flexibility — and empathy — can go a long way to restoring your toddler’s enjoyment of the bath.

So thanks for your nice comments about this article, and for making it one of BabyShrink’s most popular posts over the past year.

Click here to check it out!

Aloha,

Dr. Heather
The BabyShrink

1 Comment »

My Most Popular Post

Dr. Heather : March 9, 2009 10:52 am : BEST OF BABYSHRINK, Depression, The BabyShrink Interviews

There’s no way I could do a one-year retrospective without starting with DadGoneMad’s Danny Evans. Danny and his Hot Wife have been there for me from the beginning stages of BabyShrink, and have been endlessly supportive, inspirational and encouraging.

When I was freaking out about my lack of technical abilities, Danny calmed me down. “You’re doing just fine, Heh. This stuff isn’t as difficult as you think it is. It’s going to be awesome!” When I had no confidence in my writing, he was my editor extraordinaire. When I lost my way and wondered if anyone would find my blogging helpful, Hot Wife reassured me, gave me suggestions, and never fed me platitudes. I can always count on Sharon to tell it to me straight.

Danny inspired me to go online with BabyShrink as I saw him struggle with depression, and reveal his inner workings to the world in hopes that he could help others in the process. The note he hits with millions of readers worldwide convinced me that blogging can be a powerful way to help others — and help ourselves in the process.

So if you missed my interview with Danny, here it is. Because of the power of the DadGoneMad readership, and the tsunami of traffic Danny sent me, this is my most-read post ever. Enjoy!

Aloha,

Dr. Heather
The BabyShrink

1 Comment »

A New Post for a New Year

Dr. Heather : March 6, 2009 5:19 pm : BEST OF BABYSHRINK, Older Kids

Those of you who follow me here at BabyShrink haven’t had much to follow lately. The economic crisis has hit my “day job” pretty hard, so like the rest of you, our family is struggling to come to terms with some tough new realities. The end result is — fewer posts.

But that doesn’t mean my dedication has flagged. In fact, this week marks the ONE YEAR ANNIVERSARY of BabyShrink, and I’m taking the opportunity to review the excitement of the past year, and thank you all for the success that this site continues to be.

BabyShrink started as an outlet for me to share my passion for understanding the development of babies, young children, and parents. In my practice, I evaluate and treat (mostly) toddlers whose development has somehow gone awry. Many of these cases involve complex problems like autism, chromosomal defects, trauma, or abuse. But the majority of questions I get about these children have less to do with their complex disorders — and more to do with basic, “run-of-the-mill” child development and parenting issues. Parents in rural areas such as mine have little access to this kind support and information. So I decided to make my parenting suggestions and resources available online.

It’s been a thrill to discover that parents all over the world have found helpful information on BabyShrink. Each day, I eagerly check my “stats” to see what parts of the world my readers are from: Latvia, Australia, Singapore, Turkey, Hong Kong, Trinidad and Tobago, and Canada are on today’s list of visitors. And I’m especially thrilled to give a shout-out to all my American compatriots and readers; today I see you coming in from Yonkers, Berkeley, Des Moines, Anchorage, and a dedicated reader from Cranberry Township, PA who pored over 13 posts this morning. Aloha and mahalo to you all!

Over the next week, I’ll be revisiting some of your all-time favorite posts…you might be surprised (as I am) at my “most-Googled” articles. I’ll also give you a bit of an insider’s glimpse into what it’s been like for a shrink like me to reinvent herself as a blogger, with a shoestring budget and not a lick of technical know-how (all while juggling a marriage, three young children, and my PAYING shrink job). I hope I can inspire you to chase down your own dreams in the process…and continue to encourage you to let “good enough” be GOOD ENOUGH in our efforts to raise our kids.

For a trip down memory lane, I’ve included a link below to my very-first introductory post, published one year today. It’s fun to see that, despite some unpredicted twists and turns, we’ve been able to stick to our goals and interests here. Enjoy!

Welcome To BabyShrink: March 6, 2008

Aloha,

Dr. Heather
The BabyShrink

4 Comments »

MORE on Poop-Smearing: A Complicated Case

Dr. Heather : December 1, 2008 10:48 am : Annoying Toddler Behaviors, BEST OF BABYSHRINK, Potty Training

“What,” you may ask, “is the most popular ‘lurkers’ topic at BabyShrink?” Is there a common theme that brings the most readers to this site?

Yes, there is.

Every day, I check my WordPress “Stats” to see what parents have been reading on BabyShrink. I think it’s hilarious that each and every day I get several Google “hits” from people entering in phrases like this to the search box:

My toddler smears poop everywhere, what do I do?

They end up on this page, which is my all-time most-read post. And if you’ve read the post, you know that I laugh from all-too-knowing experience.

But every so often, I get a question from a reader who needs more help with this problem; it’s progressed past the point of my suggestions. So yes, dear readers, it’s time for yet another poop-smearing post:

Dear Dr. Heather,

My three-year-old daughter has been smearing poop, and it has increased in frequency. Not only does she smear her poop everywhere, but she also has a corner in my living room where she, for the lack of a better term, “marks her territory.” She knows when to pee on the potty and does it fine. But more lately, she will strip off her pull-up and go to that corner to either pee or smear her poop. I don’t know what to do since EVERYTHING I have tried seems not to work. I have had extreme difficulty with her potty training, which her doctor said is normal due to the fact that she is extremely hyperactive and just doesn’t want to stop. He says she is afraid to miss something. I realized that almost a year ago her father stopped coming around, and it has been almost a year since she began this frustrating habit. But it’s gotten worse lately and I don’t know if it’s an outcry towards me because she is possibly mad at me for her father not being around?? Also I am a single mother and although I was able to quit my job and be with her recently i am still not able to give her my 110% attention all the time. I don’t know…all I know is I need help. I can’t handle this…nor can I STOMACH this anymore!! Thank you for your time.

“Tired of Cleaning Up After the Little Stinker”

Dear Tired,

Sounds like you have a complex problem here. If her pediatrician says there is nothing medically or developmentally wrong, you can try using some of these techniques:

First, try some concrete behavioral strategies. Does she have a usual time of day when she poops? Most toddlers do it about the same time each day, and only do it once. If she does, watch her closely until she’s made her poop. Don’t let her wander away from you unobserved until she has pooped. Then you can give her a little more free-reign after you know she’s done for the day. Also, you can dress her in a more restrictive way until she has done her poop. Get a larger size onesie, with perhaps some leggings over it, to put her in until she’s pooped. If she lets you know in advance that she needs to go, fine. You can help her get undressed and to the toilet. If not, it’s OK for now if she goes in her pull-up.

You might also move around things in “her corner”, making it a difficult or unappealing place to spend her time. Experiment with furniture in the room to see if you can re-configure it to “eliminate” that place where she usually goes. Change around the whole room so her association to it is also changed. Make “her corner” a more focal place of the room, so that it’s not a hideaway, and she can’t have any privacy there.

Don’t make a big deal about using the potty right now. She’s giving you mixed messages about being ready, and in that case, the advice is usually to back off from potty training. Let her be in charge of when she uses the potty. But do be clear with her that smearing poop or going on the floor is NOT an option. It’s yucky. Mommy does not like to clean that up. But when she DOES successfully use the potty, make a big deal out of it. Hurray! What a big girl! It’s so nice and clean when you go in the potty! Consider giving her a small treat (one jelly bean, for example) every time she does go to the potty, even if it’s just to pee. And try not to be scolding if she goes in her pull-up. Just be matter-of-fact about it, and clean it up.

I also would not use punishment if she smears poop again. You might remove her from the “scene of the crime”, since you have to sanitize it. Be serious, but neutral. Remind her where she should go, and that poop does not belong on the walls or the floor.

Also, it’s important to give her plenty of opportunity to play with acceptable, squishy, messy things like finger paints, play-doh, even mud pies. She clearly likes the feeling of it; give her ample opportunity to make a mess in an acceptable way. Tell her when you’re playing with messy things, “This is fun to be messy. We can be messy with paints!”

You ask about the impact of her Daddy leaving, and whether that is related. I can’t judge that from here. But you can ask yourself about the impact it has had on YOU. If you have been upset, if things have been very different around the house, you can bet your daughter has picked up on that. But is it related to the poop-smearing? Difficult to say. If you need more input about that, I would suggest talking with a licensed therapist who has a specialty in working with young children. And if you’re having trouble coping, please seek out some help. A little bit of good therapy can go a long way — and help you to trouble-shoot when difficult times arise!

Try some of these strategies, and let us know how it goes!

Aloha,

Dr. Heather
The BabyShrink

16 Comments »

Is “Attachment Parenting” Bad for the Child?

Dr. Heather : November 24, 2008 2:03 pm : Attachment Parenting, BEST OF BABYSHRINK, Breastfeeding, Motherhood

Dear Dr. Heather,

Does breastfeeding past 2 years of age encourage dependency? I know a child who is still breastfeeding and has become very whiny and attached to her mother. The mother is making no effort to wean the child. Is this type of emotional attachment healthy for the child? She still wakes up to nurse during the night and sleeps in the parent’s bed.

Thanks,

Concerned about a child

Dear “Concerned”,

This is a polarizing issue that tends to bring out strong opinions. There is a community that promotes an approach called “Attachment Parenting“, based on the work of well-known pediatrician and author William Sears, MD, and one of they key tenets of this approach says that “extended breastfeeding” (past the age of two years) is recommended and important to the development of a child to promote a solid sense of safety and security. However, their key tenets are only based loosely on well-known child development research, and Attachment Parenting certainly has it’s critics.

One of the things I do like about Attachment Parenting (AP) is it’s understanding of the cultural differences that exist in families around the world, and the promotion of various ways of raising a family that can resonate more fully with various non-Western cultures. For instance, many Asians traditionally — and happily — share a family bed, or a family bedroom, as is suggested by AP. I also like the fact that AP promotes the reliance on the family’s own resources to know what is best for their children; we don’t have to rely on outside “experts” for everything. AP is also well-known for it’s insistence that the attachment between infant and mother is essential to the development of a healthy baby, both physically and emotionally. That message sometimes gets lost, or diluted, in Western cultures.

The problem I have with AP is that it’s adherents often tend to be quite orthodox in their beliefs. I myself have been sternly lectured for simply using a stroller (as opposed to “baby-wearing”, another AP belief), as well as for using a bottle to feed my baby in public. Of course, this is the opposite of the intolerant demagogues who criticize breastfeeding in public — it’s their shared judgmental strictness that bothers me most.

The other concern I have is that it takes a blanket, “one-size-fits-all” approach to all children. Some babies don’t want to be held all the time. Some babies need time without physical contact to “decompress” from all that physical stimulation. Some babies don’t do well breastfeeding either, and many babies sleep better when they’re not disturbed by the direct physical contact of their parents. And your approach to raising your babies has to be dependent, at least partially, on the unique constitution of those babies. You’ve seen me write about sensory differences here at BabyShrink, and I know far too many babies who have these quirks and preferences to be comfortable giving a blanket statement about “baby-wearing”, breastfeeding, or co-sleeping. In our family, only 1 of our 3 children enjoyed being held all the time; the other two needed “time-outs” from direct physical contact in order to look around and “process” all of that physical contact. They (and I) both felt better for a little break now and again, and I used bouncy seats, strollers and cribs regularly for these breaks. It simply isn’t fair to criticize parents who accurately judge the needs of their babies to include a little “down time”, or to make them afraid that they risk their child’s optimal development if they use a stroller or have their crib in their own room.

If you’ve read other BabyShrink posts, you won’t be surprised to hear me say that I strongly support the uniqueness of each individual family to best decide the individual needs of each of their unique babies. And to that end, I say that if it works for a family to have a family bed, or for mom to breastfeed for over two years, I’m not going to criticize that. However, I have met many families who suffer negative consequences of making those decisions, but stick with them in the false belief that it’s what’s best for their children. Often, an AP family will come to see me for a problem related to the development of their toddler. When I start to gather more information, guess what? Mom is exhausted, usually because she has been unable to sleep through the night since the day her baby was born; she’s often still nursing several times a night. And her husband is grumpy because he can’t get any “alone time” with his wife, and he’s sick of being kicked through the night by a toddler who gets bigger by the day. So mom is beyond exhausted, dad is frustrated and distant, and the toddler becomes the focus of the problem. Everyone suffers in this scenario. In this situation, my advice often includes the suggestion to transition the toddler into his own bed, in his own room, to restore some balance in the lives of the couple. The relationship needs attention, too! If the parents don’t have a strong relationship, the development of the child will surely suffer. And if the child needs to sleep in his own bed, and be weaned from breastfeeding, that is a small price to pay if it serves the purpose of bringing the parents back into a more harmonious relationship.

So, “Concerned” reader, I can’t say that “extended breastfeeding” will hurt the development of the child, without knowing all the other factors in the family. It remains the responsibility of the family to determine what’s best for them — and for their child. But I certainly don’t promote Attachment Parenting as the “be-all, end-all” guide to what’s best for your child. Only you can decide that!

Aloha,

Dr. Heather
The BabyShrink


AND MAKE SURE YOU CHECK OUT THE COMMENTS TO THIS POST FOR AN EXTENDED, INTERESTING DISCUSSION AMONG READERS!

AND DON’T MISS ANOTHER ONE OF MY ATTACHMENT PARENTING POSTS HERE

PLUS THIS POST AS WELL — IT’S BECOME A POPULAR TOPIC!!

23 Comments »

How To Handle Masturbation in Young Children

Dr. Heather : June 9, 2008 10:52 pm : BEST OF BABYSHRINK

Dear BabyShrink,

Lately I have been getting very concerned by my 3-year-old daughter’s annoying habit. She lays on the sofa and puts her hands between her legs and does this kind of “bop pushing action”. She sometimes uses objects like her blanky or teddy bear to help her bop between her legs. It doesn’t seem to change her attitude or behaviour any, but I find it annoying. Some people have told me that maybe she is developing sexually too early; and this is very scary for me, can this be true? I am very worried as this is embarrassing and I know to ignore the problem may make it go away, but I would really like to know WHY is she doing this?

Sincerely,

Mama A in Canada

Hi Mama A,

You pose a very interesting and important question. How do we handle the sexual development of our very young children?

Young childrens’ bodies are actively developing in every way. As they develop, they learn that their bodies have different kinds of sensations. It’s a normal part of their own
self-exploration. Young children do experience immature sexual sensations, and masturbation is quite normal. It does not mean that the child is developing sexually too early.

However, it’s a difficult balance to strike, as parents. We want to send the message
that sexual feelings are healthy and normal. But we also want our children to
have a strong sense of boundaries and understanding of what is “good touching”
and what is “bad touching”. We also want them to know that there are appropriate places for self-exploration. For instance, your daughter can feel free to explore her body when she is alone in her room. But it’s not an activity for the living room, or with other kids. It’s
not too early to begin conveying those messages now. You can say, I know it
feels good when you do that. But it’s for you to do in private, in your room,
OK?

We want them to learn to feel comfortable with their bodies and the pleasurable sensations they experience. But we also want them to develop a strong psychological sense of
privacy and safety in experiencing sexual feelings. This is a good time to
start mentioning little facts about her body, and who is allowed to touch whom,
and where.

The emotional message you send about the issue is at least as important as the words you use.

If you feel uncomfortable talking about bodies and sexual feelings, perhaps practice first. You don’t need to give her a big lecture. You should simply mention little facts now and again, such as Oh, you’re wearing a bathing suit now. Who is allowed to touch you under your bathing suit? Only you. Or Mommy, Daddy or your doctor, to make sure you’re clean and healthy.

You also need to talk to your daughter’s pediatrician about it, since little girls can have irritation caused by a urinary tract infection or rash. This may cause itching and the
kind of behavior you describe. So check that out, too.

One last comment about masturbation. Some may worry that their child was sexually abused or somehow learned this behavior inappropriately. But how do you know if that’s true? If your child masturbates excessively, to the exclusion of other usually interesting activities, and can’t keep her behavior to herself privately, you might want to ask your doctor for help. (And don’t feel embarrassed asking about it; your pediatrician hears this question several times a day!)

I hope this helps!

Aloha,
Dr. Heather
The BabyShrink

6 Comments »

The “Good-Enough Mother”: Are Breasts Required?

Dr. Heather : April 21, 2008 8:13 pm : Babies, BEST OF BABYSHRINK, Breastfeeding, Motherhood

Dear BabyShrink,

This ain't wrong.

I fully intended on breastfeeding my first baby. But after trying hard for six weeks, we had to give up. We had 3 lactation specialists, moms, friends, and my doctor helping. But my baby was not gaining weight and crying all the time. I just never made more than a half-ounce of milk at a time, despite pumping and nursing all day (and night). But the specialists all told me to keep trying. That eventually, I would make more milk. I never did, and I could not stand to know that she was hungry. I had to feed her!

Feeding my baby formula felt like a failure as a mom. But she is developing into a wonderful and healthy little girl. Now that I am expecting my second baby, I still think back to that time and I worry about it. It makes me so depressed that I still get teary-eyed every time I think of trying to nurse again. All my friends and my sister were able to nurse. Why not me? People are urging me to try it, but I just can’t go through that again. I was so stressed out at a time I wanted to be enjoying my new baby. Now I will have a toddler to care for as well.

How do I handle this? Any thoughts are appreciated.

Sign me,

Anonymous in Atlanta

Dear, Dear Anonymous Mom,

I asked you if I could post this letter because so many moms out there are experiencing this same thing right now. Terrible guilt and angst because of being unable (or unwilling, for what can be excellent reasons) to breastfeed their babies. Let me say this immediately: as a psychologist, I want you to be as happy and stress-free as possible during the early months with your baby. Your baby’s development and happiness depends very much on YOUR emotional state at that crucial time. If breastfeeding is causing you too much strain and guilt…it’s just not worth it.

OK, I said it! Let the breastfeeding police come and take me away. But it has to be said.

Some of you are about to get angry at me. So before that happens, let me state a few things as fact:

Breastmilk has absolute advantages, nutritionally, over formula

Nursing has been shown to be beneficial in many ways, to both mother and baby

I support the ability of Moms to nurse their kids anywhere at any time

I nursed our four kids

But the pressure to breastfeed can be harmful to many Moms. It’s hurting some of you (and by extension, your babies). While I accept the fact that some Moms simply may not understand the benefits and simplicity of breastfeeding, and I do wish more Moms would at least try it out, I don’t accept the patronizing (matronizing?) attitude that often goes along with judging Moms for their choice not to nurse…or their physical inability to do so.

As a licensed psychologist, I also see many Moms who feel inadequate, uncertain, and self-critical because of society’s pressure to breastfeed. They in turn transmit those feelings to their babies.

Although we are told that virtually all mothers can (and should) nurse their babies, consider the following real-life examples of Moms who simply can’t breastfeed:

The Moms who, like Anonymous above, went through several lactation specialists, medications, and weeks of stress, only to find her breasts simply won’t produce milk (and her baby wasn’t gaining weight)

The Moms who need to take medicine for postpartum depression (or other life-threatening illness) and want to protect their babies from the medication

The Moms who have no breasts, or inadequate breast tissue, either because of an accident, illness, surgery or congenital condition

These are cases where Moms CANNOT breastfeed. Yet in each case, these Moms are criticized and judged by others who have the nerve to ask them, “Why aren’t you breastfeeding?”

But I must maintain that there are also situations where Moms CHOOSE NOT to breastfeed, and that choice must be respected. Who are we to judge the choices other parents make about feeding their babies? Who are we to impose our decisions on them?

I would rather see a happy mom and baby with a bottle of formula than a stressed out mom (and baby) struggling through nursing. To me, the most important thing is that Mom feels comfortable in her decisions as a parent. If Mom is happy, everyone’s happy. I actually stole the term "Good Enough Mother" from one of my shrink heroes, Dr. Donald Winnicott. He was the first to say, "back in the day", that you should not strive to be a perfect parent….just a good enough parent. If you want to get the scoop on him, read more here. (It’s a little technical, but if you’re into psychology, Winnicott is a classic.) 

And it extends to the “I’m a better parent than you” kind of competitiveness that continues beyond the baby stage. Who’s toddler is smarter/cuter/faster/going to the “better” preschool? Who is watching the least TV? Who has the better diet?

Our expectations of being “Good Enough” mothers have gotten completely out of whack. And the very strong pressure to breastfeed our babies does not help.

Again, this is all about expectations. It’s important for parents to have realistic expectations of their parenting. Parenting decisions have to be made with the best interests of both parent and child in mind. Breast or bottle? Your choice is best.

If you’re struggling with this issue and want to talk personally with me about it, I’d love to help you. Hit the “Parent Coaching” button, or email me at BabyShrink@gmail.com to arrange a Skype, phone, or in-person appointment.

Aloha,

Dr. Heather
The BabyShrin
k

54 Comments »

The “Birth Plan”: What NOT to Expect

Dr. Heather : April 19, 2008 8:12 am : BEST OF BABYSHRINK, Depression

There is a strain of pregnancy propaganda out there that sets new moms up for failure. It says that unless you “achieve” some particular kind of delivery perfection, well, then…you haven’t quite made the cut, as a Mom. And that makes me angry.

It’s in all the standard pregnancy books. Something along the lines of, “Create your own birth plan. Be in charge of your delivery. Don’t let that mean, nasty doctor force you to deliver in some way that’s NOT in your plan. Decide in advance if you want to use pain medications for the delivery….or not.”

What they don’t say is that the birth process is usually so unpredictable that your carefully crafted “Birth Plan” gets left at the bottom of your carefully packed “Going To The Hospital Bag”…that got left at home, in a panic, as you rushed to the hospital.

Now, I’m a recovering control freak, so don’t get me wrong. Anything that’s called “a plan” looks fabulous to me. I did it myself, with our first baby. Here were my rules, when I was cluelessly buying into the notion that I could actually control the birth process by planning for it in advance: No induction. Lovely, inspirational music playing in the background. No pain meds. No pitocin. No c-section. (Oh yeah: no binkies or bottles for the baby either, but that was a different lesson for me to learn, for a different post!)

What happened, you ask? Oh, surely you must have guessed by now. I had it coming to me, big time. The control freak gets hammered. The doctor wanted to induce labor, since the baby was getting big, and she was overdue. But oh no, that was not in my Birth Plan. So we waited. And waited. When labor finally did begin, the early stages went well. But when it came time to push…not so well. I pushed and pushed and pushed…and nothing happened. I stood up to push. I squatted to push. I pushed and pushed for hours. The doctor wanted to add pitocin in order to add strength to the contractions, to help me along. No way. Not in the Birth Plan. She wanted to add an epidural, to relax me. No dice, doc. Finally the doctor had to go and do an emergency c-section on another lady. I had some time. The nurse convinced me to have the epidural and the pitocin, and then our baby was finally born. After four solid hours of pushing.

I was so sore after the delivery I had to sit on two huge pillows for weeks, and I still was miserable. Here are some other examples of “Birth Plans” that didn’t “pan” out:

The alternative-medicine-practitioner who swore she’d never use pain meds, who begged for (and got, with huge relief) an epidural after 12 hours of excruciating labor

The Maui-Hippie-type who arranged to have a birthing bath (with doula) brought to her home, only to need an emergency c-section at 34 weeks

My pain-fearing friend who hoped for every drug in the hospital, but delivered in the hallway of the ER while her husband was parking the car

Now, I’m all for planning, to the extent that planning is possible. But I’m really against the notion of feeding new mothers the idea that there is somehow an ideal birthing situation that they should be aiming for…other than the delivery of a healthy baby, with a healthy mother. Because that sets us up for comparisons, judging, and disappointment.
The labor and delivery process is so unpredictable, and so individual and varied, that you really cannot plan for every possibility.

Many of you have expressed sadness, even a sense of failure, because you had to have a c-section. Or if you “caved”, and got an epidural. Unrealistic expectations can lead to big problems. For some, this disappointment can even lead to postpartum depression.

Lamaze Shlamaze; use whatever works.

The breathing techniques I learned in yoga and exercise classes helped me way more than anything I learned in the actual preparation to have a baby. That said, I still pushed for four hours! The only thing that is important in delivering your baby is that both you and baby are healthy. I don’t care if a Martian comes down and performs some kind of weird alien delivery for you, as long as you and your baby are healthy at the end of it.

Did you have any surprises in your delivery? Do tell!

Aloha,

Dr. Heather
The BabyShrink

25 Comments »

Babies and Sleep: Keeping Us Guessing

Dr. Heather : April 16, 2008 10:04 pm : BEST OF BABYSHRINK, Sleep

Dear BabyShrink,

My 8-month-old Lehua is going through a real burst right now, and among other things has just figured out how to get herself up to a sitting position. This is great, but it’s really messing with her naps. Previously, she would fuss for 5 or 10 minutes, and then fall asleep. But now, she’ll push herself up to sit and then seem to get "stuck" there. Fussing turns into sobbing and screaming, and she never gets to sleep. This morning she stayed like that the full hour until we went to get her. This afternoon she dozed off for about 20 minutes and then woke up very fussy but wouldn’t go back down because of the sitting thing. What to do? My instinct is that she needs to learn how to do it herself and we should just tough it out a few days until she gets it. But I don’t know. My mom disagrees of course.

Related question: what to do when she wakes up after only 20 minutes of a nap and is still fussy? Go and get her even though she hasn’t gotten enough rest, or leave her in there fussing until she goes back to sleep? She is taking short naps lately and it is clear she’s not rested. In my experience, it is just so much easier to create good habits than to break bad ones. I think our sleep situation is an example of this, because from the beginning I was super militant about laying down good nighttime habits — never taking her out of her room once we put her down, keeping a regular bedtime, putting her down awake and letting her fall asleep on her own. The goal was for her to be independent in her sleep habits. But I think I dropped the ball on naptime — I’d often let her sleep in the car, in my arms, or in the stroller. Anyway, I’m sure there are other reasons she has more trouble sleeping during the day, but I can’t help believe that was a factor.

Still, it’s good to be reminded of the need to be flexible and have a little "grace period" in times of upset. I’m kind of an uptight person, so when things are getting shook up, I tend to cling even harder to my routines and "good habits." I agree that, while moving in the direction of good habits, you still need to "go with the flow."

I guess the real answer here is what you’ve talked about before — trusting your instincts about what your own baby needs. But it’s hard when you’re not sure what your instincts are telling you!

Ilima
Maui, Hawaii

Dear Ilima,

Wow! I can really relate. Once you have the routine down pat, they go and change on you. I wish I had "the answer". But since this is sort of an unavoidable part of development, all I can do is give you some general information, and you can use your Mommy sense to see what might work for Lehua.

First, yes, sleep is super important. BUT, a few days’ disruption does not make for a "bad habit". I know she’s cranky, but your goal is to gently nudge her back in the direction of sleeping through. In the meantime, one of the things she’s looking for is some comforting through all the wild and wacky changes she’s experiencing. That’s one of the reasons she is waking….to look for you. She is entering a phase where she will be more aware of you, and when you’re gone. Separation anxiety will crop up during sleep, when she is away from you. That’s part of it.

So: what to do when she awakens after 20 minutes, and you know she’s still tired? There are not really a lot a great choices. I say, be guided by practicality. See how you’re feeling that day, and see how she sounds. Is she just a little cranky? Then let her fuss a bit. Is she just way over the limit? Hold her awhile and see if she might go back down. If not….that’s OK. Perhaps an earlier bedtime later that evening is called for. All is not lost. Pick her up and go on with your day, albeit with a cranky girl.

You will also be letting her know that flexibility and adaptation is one important way you will be helping her cope with difficult times. (Lots of my readers have asked about this, and it has been a discussion online here. Can you be flexible….and still have good limits? Yes. Absolutely. More on that topic soon.)

Also, she’s not too young to start talking to her about what’s going on. "Lehua, I know you know how to sleep nicely in your crib. You’re tired! Mommy’s tired! Let’s sleep MORE today, ok? I know you’ll feel so much better when you sleep. Mommy will be here when you wake up today. I know you miss me. You’re safe, we’re here." Just a short little pep-talk is enough. She may not understand 100% of your words, but she’ll start to get the gist, over time. And it will condition you to start talking to her about these developmental challenges, and how you are going to help her get through them.

So much of young babies’ sleep is constitution and temperament, not the environment. That’s a concern I have with some of the popular baby sleep books; the shrinks who wrote them mostly dealt with really severe sleep problems in their practices, and developed their approaches based on those cases. The "run of the mill" cases like yours and mine would just never present to a sleep clinic at a major university. If we generalize to the normal, general public, you get worried and educated parents like you and me thinking that our kids are under-sleeping, developing bad habits, etc.

It doesn’t take much to provide a generally "good enough" environment for sleep for your baby. Anything beyond that is likely to make you nuts, and waste your precious parental energy. And when baby #2 (or #4) comes along? Forget about it! You won’t be able to control the environment very well at all. But those babies still tend to sleep fine. In our house, our third is the best sleeper of the group, and let me tell ya, this house is not a quiet, predictable place!

Your point about independence is well-taken, though, as that certainly is our ultimate goal in child-rearing. But there are developmental capacities that need to be considered. How much independence can be tolerated by the child at each particular age and stage? And how do we allow for the normal, needed regressions in independence that occur regularly? True independence comes out of a solid bedrock sense that one has a strong foundation, and that strong foundation can only be established though reliable dependence in early childhood. Your baby depends on and "borrows" your care, love and strength until those feelings become internalized.
That’s the beginning of true independence.

Good luck, and keep us posted!

Aloha,

Dr. Heather
The BabyShrink

5 Comments »

The Big Kid Bed? NOT!!!

Dr. Heather : April 10, 2008 9:15 am : BEST OF BABYSHRINK, Developmental Grab-Bag, Sleep

Dear Dr. Heather,

When should we switch B to a regular kid bed? She’s 2 1/2 and still in her crib, but hasn’t shown ANY sign of not liking it, or trying to get out. It’s a hassle to lift her in and out, but at least she’s not up and about at all hours of the night (like I think she would be if she was in a "regular" bed).

Katie Kat, Lawrence, KS

Dear Katie Kat,

This is an easy one. WAIT AS LONG AS POSSIBLE. That crib feels awfully cozy and comfy to a toddler who is trying out new (and sometimes scary) things every day.
Some of you have little monkeys who manage to escape the crib. Don’t be fooled; they might be trying to see if they CAN get out, but that doesn’t mean they really WANT to get out. (Or that you really want them to!)

I mean, really, what’s so great about a Big Kid Bed?

I can’t tell you how many stories I’ve heard like this: Toddler escapes crib. Parents assume: AHA! Time for the Big Kid Bed. After highly-anticipated Dora/Diego sheets purchased from “Tarzhay”, Big Kid Bed is initiated. Toddler then proceeds to roam the house freely at night and otherwise wake up the household at all hours. Parents suffer major sleep deprivation (again) until the Monkey gets closer to 3 (or 4), and settles into a Big Toddler sleep pattern. If you have a Monkey, take a look at these crib tents. People  swear by them, and it seems to give that sense of reassurance to the toddler that “your crib is still a safe place for you”.

Really, the crib is not only for keeping the toddler corralled and in the same general location all night. It’s also for providing a sense of safety and containment for them. So don’t worry that you’re somehow making them feel like they’re in “toddler jail”.  And most toddlers don’t even attempt to climb out, not because they can’t, but because they are comforted by the secure feeling of the crib. When we moved our then 2 1/2 year old oldest to a bed, she acted like the bed still had rails. She wanted to be put in and out of the bed, like a crib. I think it freaked her out a little bit to be so "free"!

Really, as long as they are happy in the crib, don’t make yourself nuts. There is no developmental/psychological reason for them to move into a "Big Kid Bed" at 2 or even 3. Wait until it makes sense for the toddler, and the household, to do it. And when you are ready, some kids like the option of having both bed and crib available, if there’s space. Then THEY can make the choice, nightly, for awhile.

For some, the decision will coincide with them trying to stay dry at night, and going by themselves to the potty. So that could be a transition point. But whatever you do, don’t ask the toddler to give their crib up to a new baby. If you must transition the crib for a newbie, make the transition as slowly as possible, and as early as possible. You want to avoid the sense of safety being taken away from the toddler, and given to the new baby. You don’t need to fuel sibling rivalry any more than necessary! Ideally, both toddler and infant would have their OWN cribs. While this isn’t always practical or possible, it does attempt to convey that “you each have your own separate, safe places that nobody will take away until you’re ready.”

That said, many toddlers make the transition to the Big Kid Bed without fuss or difficulties. But it comes down to knowing YOUR kid, being flexible with the transition, and respecting the needs of everyone in the family. (You included!)

Aloha,

Dr. Heather
The BabyShrink

6 Comments »

…And Potty Training?…AS IF!!!

Dr. Heather : April 8, 2008 10:33 am : BEST OF BABYSHRINK, Potty Training

Dear BabyShrink,

What is your take on potty training? Just GO FOR IT, or let the child initiate it all? I have heard (or read) everything from “start at 3 months old,”; to “you can do it in ONE (or three) day(s),”; to “they’ll get it when they are developmentally ready.” We are in the midst of training now, but I feel like we’re just limping along. I want it to be DONE, but I don’t have time to spend 3 days in the bathroom with her (like some books suggest) or plan an entire party around the event (yes, a real suggestion for a “one day solution). I guess we’re doing okay, but it’s just a PAIN IN THE ARSE!

Katie Kat

Lawrence KS

Hi Katie Kat,

This is another issue that triggers tremendous parental guilt, stress and competitiveness. We think, “My kid is SUPPOSED to be fully trained by now….My Mom says I was potty trained at 18 months….He’s gotta be out of Pull-Ups before he starts preschool…The kid down the street has been trained for over 6 months now!”

But first, let me ask you this: What is the definition of “potty trained”, anyway?

For some, it means wearing underwear…except for away from home, pooping, and at night. For others, it means wearing a diaper, but (usually) peeing on request in the baby potty. And for still others, it means different things, on different days! Even most preschools, despite their protestations to the contrary, will actually work with your toddler on this one. So once we realize that there is a whole continuum of potty training (what some call “toilet learning”), we can relax a bit.

The other thing is the grandparent issue. Yeah, I know your parents put pressure on you to get your kid trained yesterday…but the world is really a different place, now. I mean, if THEY had super-duper- absorbent diapers in the super-duper sizes we have now at CostCo, they wouldn’t have been in such a rush either, would they? And let’s face it, there’s nothing grosser than trying to help a tiny tushie balance on a disgusting gas station toilet…isn’t it easier sometimes to just change a diaper?

Forcing a kid to toilet train when they’re not ready is a recipe for disaster. Remember the “anal stage” from your Intro Psych class? Freud was getting at the fact that toddlers are fighting mightily to gain control over their own bodies. When we interfere too much, we start a struggle over power and control that we truly don’t want to win.

So, what to do?

All kids are different. I would suggest trying out one technique at a time, based on how the technique appeals to YOU and your schedule. TALK ABOUT IT with your toddler, using encouraging, simple language (and model it at home too! Dontcha love that?). Read humorous books together, like our current favorite, “Everybody Poops”. But regardless of technique, attitude is the most important thing. Don’t fall into the trap of expectations/pressure/disappointment. Understand that accidents WILL happen, maybe even for months (or years: sorry!) after the initial potty training is “done”. Don’t punish or scold for mistakes, and don’t press for progress when there’s a lull. Know that potty training often does progress in phases: dry at HOME, in the DAYTIME first….but diapers outside and at night. Then dry at night, (or not!) and so on. Some are lucky and it all happens fairly quickly….but for most, not so much! :) But it WILL eventually happen.

Good luck and aloha!

~~Dr. Heather
The BabyShrink

I’d love to hear readers’ potty training stories and suggestions!

29 Comments »

Shhh…I Let My Kids Watch TV!

Dr. Heather : April 6, 2008 2:31 pm : BEST OF BABYSHRINK, Television and High-Tech

Hi Dr. Heather!

I got your link from Dad Gone Mad, and love your site! I think it’s wonderful to have someone sort of “official”; to converse with, as opposed to other moms who are, like me, just guessing at solutions!

My husband and I have a 2 1/2 year old girl, who is basically a VERY sweet, loving, funny kiddo. We are having a lot of fun with her at this stage, but I have a lot of questions. I love being her mom, but parenting is so hard sometimes! So my question is: How horrible is TV, really? I mean, we let her watch in the morning before going to daycare, and at night, but we watch educational stuff (well, mostly… like Little Einsteins or Miss Spider. Okay, sometimes we digress and watch Sponge Bob or Phineas and Ferb… okay, we do that A LOT lately – man, you’re good at getting folks to talk…) :) I’d say it’s maybe 2-3 hours a day, or more on weekends? I feel horrible even admitting this because I’m sure you’re going to tell me I’m a BAD EVIL MOMMY. The TV thing makes me feel so guilty, but, honestly, she likes it and when there’s nothing else to do, it helps me get things done! (Be gentle!)

Katie Kat
Lawrence, KS

Dear Katie Kat,

Your question is great. Don’t worry, no scoldings. In my house, we are All Backyardigans, all the time. (Not really. But plenty.)

“Do you let your kids watch TV?” is one of the most loaded questions we, as parents, ask each other. We hear snippets in the news about TV making kids turn into zombies with no ability to concentrate in school, socialize, or entertain themselves. We hear parents swearing they will not expose their children to TV, and feel ashamed to admit that we can’t imagine life without it! We wonder how the heck to get dinner on the table (or just sit down to think for a moment) without turning on the tube. And really, is Sesame Street so harmful after all?

Your question led me to seek out a television research expert. Frederick J. Zimmerman, PhD, is one of the foremost researchers in the field. He is a Director of the Child Health Institute at the University of Washington, and co-author of The Elephant in the Living Room: Make Television Work For Your Kids. Dr. Zimmerman gave me permission to quote his very interesting book. Page four says, "Parents should not feel guilty, powerless or even indifferent about television, however; its effects need not be adverse, and they are most certainly remediable. Television viewing can be beneficial. It can be entertaining, broadening, and educational. It just has to be used properly." The authors go on to describe the most important issues in TV-watching for kids:

  • What is being watched? Content matters.
  • How much is being watched? Amount matters.
  • What is the context in which TV is watched? The rest of the child’s life and environment matters.

The book also explains that this new age of DRVs and TiVos is terrific for kid TV-watching, since it allows us to zip out the commercials and other negative stuff we don’t need them to see. Here’s Dr. Zimmerman’s website for more useful info.

As far as the BabyShrink’s house goes… we do watch TV, but I am pretty strict about what we watch. I agree that the content of the shows is so important…..and that’s what worries me most, not a Little Einstein or a Super Why or Miss Spider. But the Sponge Bob type stuff is a little too fast-moving, hectic and aggressive for me, and I think it can have an effect on the younger kids, especially. I am all in favor of using TV when you need a break to make dinner (or chat with a friend!), but obviously it shouldn’t be a long-term babysitter. (I know you’re not doing that.) Really, it should be in moderation; make sure they are getting physical outside play every day; the TV content should be as benevolent as possible; and then don’t feel guilty about it!!

Dear Readers: Next time, more from Katie Kat on Potty Training Problems….she had a lot of great questions!

Now go ahead, you know you want to comment about TV-watching and your attitudes about it! I know Katie Kat is not alone in her TV-viewing dilemma. I can’t wait to see what you all have to say about this post! (And don’t be afraid to disagree!)

Aloha,

Dr. Heather
The BabyShrink

25 Comments »

Baby Binky Battles

Dr. Heather : March 26, 2008 9:04 pm : Annoying Toddler Behaviors, BEST OF BABYSHRINK

Dear BabyShrink,

My two-year-old will not cope without his pacifier. He keeps it in his mouth at all times. I am afraid it is delaying his speech as he has quite a few words, but most of the time tries to talk with the button in his face. I have always hated it when I see toddlers running around with plugs in their mouth, and (as Karma always works) I can’t get him to get over his. He won’t go to sleep without it, and if he realizes it’s missing for more than an hour or so, he starts crying and won’t stop until it’s found. This can be very tiring for my mom, who watches him during the day, because very often we don’t know where he lost it. Most of the time it’s found after 30 minutes of searching, buried in the bottom of his toy box, or mixed into the dirty laundry hamper. My question is this? Should he still be so dependent on this silly piece of rubber? If not, how can I get rid of it without him completely flipping out?

Tired of Searching, Las Vegas

Dear Tired,

Yeah, I have one of those at home too. There are different schools of thought about this: we have a pediatrician who tells us to lose the Binky after 6 months, and a pediatric dentist who says “Hey, it’s better than a thumb! Don’t worry about it! Orthodontia is a lot cheaper than psychiatry!” (I swear, she really said this, not knowing I’m a psychologist). I’ve also heard that Binks can delay speech — but I’ve seen too many kids explain the whole storyline of a Super Why! episode with a Binky firmly in place, so I’m not convinced on that front.

Psychologically, there is something to the notion that a toddler is working very hard on independence, and Binkies and other comfort “loveys” are there to help support that independence. There is so much turmoil in a toddler’s life. Things are so out of their control, and a little self-soothing goes a long way. This won’t hurt him psychologically; rather, it tells him that Mom and Dad will support him in his efforts to cope and make himself feel better. He will move on, when he’s ready for the next step, developmentally (which will probably be the annoying preschooler’s habit of: Nose-picking! Betcha can’t wait for that one!)

On the other hand, many kids will be ready to give up the Bink, and won’t put up more than a couple of days of fight about it. It depends on how irritating it is to you, and also how willing you are to pick this particular battle, with this particular toddler, at this particular time.

So what’s a parent to do?

You have 2 choices:

If you’re really sick of it, go for it and decide to spend your precious parental effort, time and sanity on an eliminate the Binky” plan. What worked for us with our oldest (when we still had the time and energy to fight this particular battle) was to, first, have a conversation about it: now that you’re 2 years old, you’re big enough to not have the Binky except for in your crib. The Binky stays in the crib, now for sleep only. Expect protests, and try to have a substitute ready that might (reluctantly) be accepted (blanket, stuffed animal). Then phase out Binky over a week or so, explaining that “you’re big enough now without it, here’s your (blanket, animal) instead.

Stick with the program. Sympathize mightily with the feelings of hurt over the lost Bink, but make a huge deal out of, “Now that you’re such a big boy without a Binky, look at all the cool things you can do now! Only babies have a Binky.” Once it’s over, it’ll probably be over.
binkyla3

(Photo: Little did she know she’d eventually be subjected to the eliminate the Binky plan.)

OR:

Decide that “resistance is futile”, and buy 15 or 20 more Binks to leave around the house, diaper bag, crib, car, etc, etc, so that at least you’re not going crazy looking for them everywhere. That’s actually what we do with our youngest right now. But we are making a concerted effort to talk to him about, the fact that; “The Binky is for the house. Binky does not go to the store. Say “bye” to Binky, we’ll see him when we get back to the car”; getting him ready for the day, closer to the age of2 ½ or 3 (or 4…), when we phase out the Binkster altogether. I really do think that, after that age, there’s no reason the Bink should be kept around any longer.

Good luck, and let us know how it goes!

Aloha,

Dr. Heather
The BabyShrink

20 Comments »

Stefanie Wilder-Taylor: The BabyShrink Interview

Dr. Heather : March 24, 2008 12:01 am : BEST OF BABYSHRINK, Depression, The BabyShrink Interviews

At BabyShrink, we are inclined to believe Stefanie Wilder-Taylor is the long, lost lovechild of Erma Bombeck and Carol Burnett. How else to explain Stefanie’s sharp wit, stunning honesty and widespread public appeal? She is the author of two hilarious books: Sippy Cups are Not for Chardonnay: And Other Things I Had to Learn as a New Mom, and her second salvo, Naptime is the New Happy Hour: And Other Ways Toddlers Turn Your Life Upside Down, which will be released this Tuesday, March 25.

Stefanie will be on the Today Show that day promoting it. It will be her fifth appearance on the show as a parent/humorist/author.

We happen to love Stefanie. We read her blog, Baby On Bored, where she writes about her three daughters (including four-month-old twins!), her experience with postpartum depression, and about life in general, with the superior brand of humor that has also served well in her stand-up comedy pursuits.

We are naturally thrilled that Stefanie agreed to be the subject of the second BabyShrink Interview.

BabyShrink: Why did you start Baby On Bored?

Stefanie Wilder-Taylor: About three years ago, a few months after the birth of my daughter, Elby, I decided to start a blog since I was a writer who was unemployed due to HAVING A BABY. I’d been told how absolutely wonderful it was going to be to become a mother and had been looking forward to "the blessed event" for nine months. But I was in for a rude awakening. Not only did I have horrendous postpartum depression and not know what it was, but I felt unbonded to my baby, overwhelmed, full of regret and ripped off that I’d been sold a bill of goods that didn’t live up to the

{Photo courtesy of Alex Asher Sears Photo, Los Angeles}

expectation.

BS:  You don’t sugarcoat what it’s like to be a mom, and you’ve been very successful in being honest and funny about that.

SWT:  My first book deal came from my blog being seen by an agent and sold pretty straight away. I couldn’t believe that anyone would be interested in my decidedly unromantic take on the early days of my parenting experience but they were. Since the book received such a great response, I’ve found it’s my calling to be honest about everything. I’m feeling safe in the knowledge that others out there feel the same way.

BS: Tell me about your parenting approach.

SWT: Of course, the bonding did take place with my daughter and I love her in an obsessive, crazy, stalker, "mommyish" way. But I refuse to believe that there is one specific way to parent. I do believe that one should treat each child as an individual and parent that individual to the best of our abilities. Yes, you are a parent and you have to suck it up and make sacrifices. But I don’t think you have to live your entire existence thinking of ways to enrich their little minds and ensure they will get into an Ivy League school. Hey, I didn’t even go to college and things worked out okay.

I also believe that all parents lie, so you can’t compare your parenting to what others say. They all let their kids watch TV (otherwise how would you take a shower?). They all let their kids eat cookies (unless they’re completely crazy and controlling), and they all lose their temper once in awhile. It’s reassuring to say the least.

I must also say, I’m in praise of praise! The more the better as far as I’m concerned — this is in response to some articles saying parents overpraise their kids these days.

BS:  You had twin girls four months ago. Knowing you were prone to postpartum depression (PPD), how did you approach this pregnancy differently?

SWT: I did plan to go back on Zoloft the second I gave birth. When I found out my babies were coming early, I wasn’t so sure I would take the meds so fast because I knew I would be trying to pump as much as possible. But, my doctor was fairly insistent that the Zoloft wouldn’t affect my milk enough to warrant possible PPD, so I went ahead and started it. I still pumped for a month while the babies were in the NICU and even the nurses there told me the Zoloft wasn’t a problem.

BS: Has it been different this time?

SWT: It’s been different, yes. My PPD didn’t get nearly as bad in part from the anti-depressant and in part because I knew what I was in for as far as sleep deprivation. The first time around I was paranoid that my horrible attitude would chase my poor husband screaming into the arms of another woman or even another house. But this time, we knew it was just divide and conquer — make it through the first few months and things will get better.  This pregnancy I didn’t mess around and I’m so glad I went back on the medication immediately. With twins, I seriously wouldn’t have had time to be moping around the house all day.

BS:  Did your preparations and advance knowledge help?

SWT: Yes and no. Of course it helps to know that you’ve had another baby and survived it. But, part of PPD is chemical and that can’t be solved by knowing about it in advance. For me, that required meds — pure and simple, and I refuse to feel weak because I need a little something to get me through. Hell, I need meds with or without a baby or three.

BS: Did the twins being preemies and in the NICU make things more complicated, in terms of how you were feeling and recovering? 

SWT: On one hand, I think having the babies be in the NICU made it easier. I knew they were okay and I had a chance to recover from my C-section and fix up the house before they came home. On the other hand, the fact that I went on hospital bedrest and had these babies much sooner than I thought I would, combined with hearing there was a major growth problem with one of the babies, caused an enormous amount of stress. Even though it’s all over, the babies are safe and home and we have help, I realize I’m still recovering from that stress. And it will probably be awhile until things are back to normal.

BS: What can you say to the other moms out there who might also be prone to PPD but are afraid of reaching out to ask for help?

SWT: When I had my first baby, Elby, I thought I was crazy because I was crying inconsolably all day everyday. I felt ashamed that I didn’t feel connected to my child and that instead of feeling blissful I just felt sad and, to be honest, angry. But when, due to my inability to censor myself, I told my doctor exactly what I was feeling, he blew me off and said that "having a baby is a big responsibility" and to basically suck it up. So, not knowing better, I did. It took me 14 months to get the help I needed. It wasn’t until after my daughter was hospitalized for dehydration that I realized I’d felt stressed for months and needed help. I went to a shrink and was put on Zoloft and I suddenly realized that I hadn’t felt normal since my daughter was born. It was like a window opened. Hey, if you’re against pills and think maybe yoga or aromatherapy is going to make a difference for you than by all means do Downward Facing Dog or get a Glade Plug-In. But if you really want to fight fire with fire, I say GET HELP.

To read more of Stefanie’s thoughts, buy her books (linked above) and visit her blog at babyonbored.blogspot.com

14 Comments »

The BabyShrink Interview: Danny Evans

Dr. Heather : March 6, 2008 3:10 pm : BEST OF BABYSHRINK, Depression, Older Kids, Preschoolers, Sleep, The BabyShrink Interviews

I’m thrilled to bring you my interview with Danny Evans (better known to the world by his super-hot blog, Dad Gone Mad), my good friend of 15 years.

Since 2003, Dad Gone Mad has offered a colorful glimpse into bona fide, in-the-trenches fatherhood. With sharp wit and a healthy sense of self-deprecation, Danny plods through the havoc and collateral damage wrought by his two young children. Danny lives in Southern California and is currently writing his first book.

Danny has a lot to say to parents, and especially dads. Becoming a good dad, or at least a “good-enough” dad, isn’t easy. But despite facing the challenges and demons that many of us share, he’s got Hot Wife (one of my best friends) their terrific kids, and a career that is certain to skyrocket beyond even his current success. Danny and I recently spoke about becoming a father, learning lessons from our own parents, and depression.

BabyShrink: Let’s start at the very beginning. Why did you start writing Dad Gone Mad?

Danny Evans: Dad Gone Mad was the lovechild of misery and self-preservation. In 2004 I was working for one of those enormous, Fortune 100 HMOs that everyone thinks so poorly of because their focus in revenue, not health. I hated it. I was a nameless, spiritless corporate drone and I frankly needed to distract myself from those feelings. So I just started writing. About my life, my kids, my marriage, my bowel movements and on and on. Somehow that struck a nerve with people and the site has become what it is now because of their support.

BS: How did becoming a father change you?

DE: It changed everything. Beyond the obvious chaos inflicted on one’s life by a wailing eight-pound shit machine, it thrust me into a period of hardcore self-reflection about my life, my choices, my general readiness to be someone’s dad. I always wanted to be a father, but the moment I became one I wondered if I had what it took to develop this little mass of pink skin and cradle cap into a respectable, confident and driven human being. He forced me to think about the world and the future from the point of view of someone other than myself. That’s an enormous change.

BS: So, you didn’t just start out as a confident father? There were times when you doubted yourself and your ability to be a “good enough” dad?

DE: I don’t think it’s hard for guys to believe they’ll be great dads when the child is just a concept. A fetus. A lot of us are so hard-headed and macho that we think we can do anything if we just decide to do it. We’ll run through a brick wall if we have to. But we’re not a particularly emotional bunch, so I tended to believe that being a good dad simply mean warming up a bottle and installing the car seat and, when the child was old enough, teaching it to burp the national anthem.

That all disintegrates when the concept becomes an actual human life. I was intellectually prepared, but the boatload of emotional and spiritual ramifications that accompany such a drastic change in one’s life can be a bit overwhelming. It brought to the surface issues about my relationship with my own dad, my own aspirations in life, my own priorities and learning to live with the all-consuming love I had for this child. Like I said, it changes everything.

BS: So how did you get past the point where all your self-confidence about being a dad started to disintegrate? How did you build a real, not just intellectual, sense of confidence about being a father?

DE: I think it’s more a function of time than effort. As our son grew older and became more interactive, the bond between us began to solidify. He became human, as opposed to just this crying, screaming, pooping blob of skin. But I want to be clear on the difference between connection and bonding. I was connected to him and completely in love with him before he was even born. But like I said, I didn’t know what to DO about him. The connection came when things like eye contact and smiles and whatnot began to develop. Perhaps it’s a bit selfish to say I needed something back from him before I could feel that bond, but no one ever told me fatherhood was easy.

BS: What do you think society expects in terms of being a “good dad”? How are you different than the way your father was when you were growing up?

DE: I don’t know — or care, frankly — what society expects. I know there are certain standards by which people are judged, and by which their children are judged as well, but the bottom line for me is doing what I feel is right for my kids. That’s not meant as a cop-out or a cliché or as a sign that I think I’m better than other dads — because I certainly do not. But they’re growing up in a much more threatening time than I did and it scares me on their behalf. So I expect that I will do not what is popular, not what the dads on Disney Channel do, but what is right for my kids in their worlds. That’s a big enough challenge, let alone trying to fit into some giant cultural cookie cutter.

I think the father question touches on the most important issue in my life. My dad grew up in an environment where he wasn’t valued or shown love, and that certainly colored the way he fathered my sister and me. My dad and I butted heads a lot, and I always had a feeling that I was being controlled. I can understand that; having no control in his youth, he wanted to have all of it in his adult life. I see the opposite developing in my conversations with my own kids, and the challenge is finding that delicate balance of structure and freedom to explore the world.

BS: How would you respond to those guys who DO feel society’s pressure – whatever that may be – to parent their kids in a certain way? Say, in relation to their boys, and boys’ emotions. Just the other day, we saw a guy yell at his six-year-old son for being a “cry baby” when he fell and hurt himself. This guy really isn’t a jerk; he just was embarrassed that his son was crying. What do you say to guys like that who have a knee-jerk reaction to their kids’ feelings?

DE: I think the scenario you described about your neighbor is actually reflective of the kind of machismo and robotic behavior dads have tried to instill in their sons for generations. Boys aren’t supposed to cry or feel or emote anything but toughness, and if they do they’re labeled a “pussy” or some other such thing. It’s my personal feeling — based on my own experience — that this type of social stereotyping is why male depression has become such an issue in our society. Men are not robots; we DO feel hurt and sadness and disappointment. But because it’s not considered kosher for us to articulate those feelings, we swallow them. And for some, there’s only so much of that you can eat before it overwhelms us and makes us (clinically) depressed.

I’ll be honest: I’m not perfect in this area either. My son tends to cry over a lot of things that aren’t worthy of tears, and it does frustrate me. But I try not to call him names or make blanket statements about his maturity level just because he is prone to tears. I prefer to help him understand why he reacts that way, and to give him alternative tools to deal with disappointment. It’s NEVER easy, but I
think it’s worth the extra time.

BS: I think that’s a really interesting statement you make about men, society, and depression. One thought in psychology is that depression is anger and aggression, turned inward. So as a father, how do you help your son to be appropriately assertive, but not aggressive, without totally thwarting him? What advice can you give other dads who struggle with the same problem – raising confident, strong and happy boys?

DE: I think being a respected and assertive dad requires knowing as much about yourself and your own biases as you do about changing diapers and replacing a detached arm from a Barbie doll. I think a lot of us tend to parent from the perspective of someone who wants to do better with his kids than our parents did with us.
There’s nothing wrong with that idea, but when parenting becomes a competition with our own inner demons, the child is the one who suffers most. I saw those sorts of behaviors in my own fathering early on — the competitiveness and ulterior motivation — and it finally occurred to me that I was robbing my kids of something crucial by behaving that way. Fatherhood is almost never easy, but why make it harder by virtually forcing the kid to be something he’s not.

BS: Yeah, it’s easy to just be reactive to what our parents did: my dad did it THIS way, so I will take a 180 and do it the opposite, just BECAUSE. What do you say to other dads who are struggling with depression? About even recognizing that you had a problem, that this was not “status quo”? About the stigma and shame of getting help, going to counseling, trying meds? How did you get past that barrier?

DE: We talked earlier about the societal norms regarding fatherhood (which I believe to be sort of silly), but it’s obvious that our world’s expectations of men in general make a diagnosis of depression a serious spirit-crusher for men. We learn as boys that men must be stoic, rugged and emotionless. We must ignore pain. On the schoolyard, the boys who performed poorly in sports were labeled a “pussy” or a “faggot”, words intended to convey femininity, which in this context connotes weakness. But we are not emotionless, robotic beings; we are entirely fallible and completely human. We feel sadness, sorrow, fear, angst – but we resist it. It’s shameful.

That’s all BS. The National Institute of Mental Health says six million American men — almost seven percent of the U.S. male population — are stricken with a depressive illness each year. Sadly, it’s in our nature to hide from it through compulsiveness and self-destructive behavior (e.g., alcohol, workaholism, infidelity, etc.). In my personal experience, the only way to get oneself “better” is to accept that we need help and attack the depression with a shock-and-awe type of assault. There are studies that suggest the best possible course of action is a combination of meds and therapy. That’s the path I chose, and I’m glad I did.

If you feel stressed or anxious or irritable, or even if you just think something isn’t right, address it. Swallow your pride and take an honest assessment of your life and your feelings. Contrary to what we most boys learned as kids, there’s no shame in asking for help. The shame comes from ignoring a problem so long that it becomes a detriment to your family.

For more on this and lots of other great stuff, visit Danny online at www.DadGoneMad.com.

21 Comments »

Welcome to BabyShrink

Dr. Heather : March 6, 2008 2:49 pm : BEST OF BABYSHRINK

I’m Dr. Heather. I’m a mom and a psychologist. I specialize in the development of babies, toddlers, and parents. I am a “BabyShrink”.

I created this site to give parents a place where they can better understand the minds of their babies and toddlers. See, babies do weird things. Toddlers do, too. And sometimes that freaks parents out. But you know what? A lot of the weird things kids do are normal. I hope to help you decide what to relax about…and sometimes, when you need to get help. The subject matter we discuss on BabyShrink.com is not the same stuff you read about in baby development books, and not the stuff your (probably overworked) pediatrician might not have time for.

Some examples of what parents like you ask me all the time in my work:

I feel so guilty about going back to work! Is it really ok?

Will my toddler ever stop embarrassing me by biting my friends’ kids?

How can I keep my cool when I haven’t slept since last week Tuesday?

Am I “giving” my child ADHD by letting her watch a Baby Einstein DVD?

What about a Dad’s perspective in all of this?

And your more serious questions:

What about this increase in autism? What’s causing it, and should I worry?

We’re having marital problems. Will this affect the baby?

My baby is developing differently than my friends’ babies. Is something wrong?

I feel down and depressed. Do I have post-partum depression?

We’ll be talking about all these topics and more on BabyShrink. You’re here because you know that taking an active role in your kids’ psychological development can mean all the difference in how she or he turns out. And it’s not always easy to figure out what’s going on in those little minds.Parenting is the most difficult job in the world,but it’s the hardest job you’ll ever love. It will make you feel desperate. It will make you wonder if the latest thing they’re doing is “normal”. We will ask ourselves if we’re screwing them up, despite all our best efforts. And then, in the blink of an eye, those kids will cause our hearts to explode with pride and joy.

You’re here at this site because you care so much about those little munchkins, and you want them to be happy, productive, and well-adjusted. So do I. (My own kids are 6, 4, and 1. I’m living it, right along with you!)

A Pop-Psych-Free Zone

Although we will be discussing some intense issues, I’ll try to keep things light; a little humor can work wonders. You have my word that I’ll endeavor to avoid dry, clinical, confusing “pop-psych” gibberish. We’re all about keeping it real here. I hope to show you how a real person, a real shrink, thinks, lives and works; struggles with family, career and everything else. I hope I can share with you the amazing and interesting lessons that my clients, my kids, and my own hubby-shrink have taught me. (Yes, I know. In our family, we’re two shrinks, raising kids. What pressure, not to mess them up!)

I earned my doctorate in clinical psychology and have been licensed as a psychologist since 1996. I’ve seen thousands of families so far, and I continue to see clients every week.

IMPORTANT DISCLAIMER

This site is not in any way meant to be a substitute for professional evaluation, therapy, treatment, or medical advice. I hope it is entertaining and informative, but I must insist that any significant questions or concerns you have about your kids, your family or yourself be directed to your health care professional.

Let’s get this thing rolling. What questions do you have for me? Click the “Ask Dr. Heather” button at the top of this page to send me your questions!

Aloha,

Dr. Heather
The BabyShrink

13 Comments »

The ABCs of Baby’s Sleep

Dr. Heather : March 3, 2008 5:38 pm : BEST OF BABYSHRINK, Sleep

During the first six months of a baby’s life, when the child’s sleep schedule is virtually non-existent, parents are forced to test the limits of their own stamina. How long can you live without sleep? Do you have what it takes to survive? Fortunately, there are some simple steps you can remember and rely on to get you through the rough times. In fact, they’re as easy as to remember as your ABCs.

A IS FOR AGE
Expectations for your baby’s sleep depend in part on his age. A two-day-old will sleep very differently from a two-month-old, and again from a 10-month old or even two-year-old. Your strategies should vary accordingly (if you can keep your own eyes open long enough to think, which is no guarantee). As your baby goes through developmental shifts and changes, his sleep will likely be disrupted for a short while. Babies working hard on mastering grasping, vocalizing, sitting, or any other skill will likely have this “drive to succeed” break into their nighttime sleep. Reassure them that they can practice in the morning, and that it’s time for sleep. Keep these things in mind:

(Baby Size “Small”, 16-20 weeks):

Don’t count on much sleep, at least during the night. Baby’s rapidly developing brain needs a ton of rest, but this will occur in cycles throughout the day and night, and babies will often need to be fed every two hours or so. As she approaches 12 weeks, her sleep may consolidate considerably, and stretch for longer periods of time. But her memory has not developed to the point that she “counts on” a regular sleep routine as much as she will when she is older. Try to stick to the routine you had before baby was born, but make your bedtime earlier. For your own sanity, take “shifts” during the night with some caring and selfless person (who may or may not be the baby’s Dad, or your mother, or mother-in-law), or at least enough to let Mom get a four-hour stretch of sleep in (which has been shown to make you feel more rested than smaller chunks of rest). Moms, when it is your turn to sleep, really sleep! Use earplugs and an eyeshade, and trust the person you’ve left in charge of the baby. Otherwise, you’ll sleep with “one ear open” and not rest as soundly. Mom…you just need to get through this tough time…it WILL pass!

Baby Size “Medium”, 5-9 months:

Baby has developed enough cognitive abilities and trust in you that she can be taught how to fall asleep – and stay asleep through the night – in her own crib. Start with having baby play when awake and happy in her crib. Or, try placing her in her crib when she’s already asleep, so she can awaken there and get used to sleeping there. Experiment with the use of music, noise, or light machines; some babies love those. Talk to her about sleep, and what you need from her. She may not understand all your words, but she’ll start to get the message. Try this script, using a quiet, serious, but enthusiastic tone: “Baby, we’re all tired around here. Tonight is a great night for you to sleep for a long time in your crib. I’m going to nurse you, turn off the lights, sing a song, and then put you in your crib. I will be here to pat you on your side until you fall asleep. If you wake up, you are safe; you can look around for a while and then go back to sleep. And then in the morning, mommy and baby will feel SO GOOD!” It may take several (hundred?) times to repeat this each night, but you (both) will eventually get in the habit, and it will help. Don’t “push” too firmly until you feel that she has the emotional ability to withstand whatever degree of upset that being left alone to sleep will cause. Some babies will only put up a token protest; others will scream loud and long, but not really “mean it”; others will truly be terrified and need to be supported a bit longer before they can sleep for that long alone. You need to know your own baby, and start to trust your Mommy instincts.

Baby Size “Large”, 9-12 Months:
Now you really have an able little learner on your hands. You can feel assured that most babies will certainly be capable of “going along with the program” by this age. Just make sure YOU know “what the program” is, and be consistent about it.
Fussing and crying, at this age, is usually normal and fine; talk with your pediatrician if you have concerns.

B IS FOR BELLY
Tummy troubles can spell sleep disaster for even the most prepared family. Babies have all sorts of tummy issues throughout their first years. When newborn, they are still adjusting to digestion, and they feel their digestive actions quite acutely. For breastfed newborns, moms can try adjusting their diets. Common causes of tummy troubles in infants include chocolate, dairy, and caffeine in mom’s diet. Check with your pediatrician, then try eliminating these foods from your diet, one at a time, for several days. Formula-fed babies can have trouble with dairy proteins, lactose, or soy. Ask your doctor about trying a new formula. For older babies on solids, think back to see if her sleep problems worsened after introducing a new food. By process of elimination, experiment to see if removing a particular food helps her digestion and sleep.

C IS FOR CONSTITUTION
Constitutional factors are ingrained, probably genetically inherited characteristics, and they have a major impact on the way your baby sleeps. Some of these tendencies affect our personalities, emotions, and behaviors – even from day one. Your baby was born with a whole constellation of these tendencies, and your strategies for dealing with her will depend on those tendencies. For instance, we know that overall activity level is mostly inherited. Highly active babies tend to sleep less and need more interaction. They can’t yet move their bodies around much to burn off their energy, so they crave the mental stimulation of being awake. These babies don’t want to miss anything, and will probably end up being social and outgoing. But the price you pay is less sleep now, and maybe more fussiness. It’s difficult to tell if your baby is fussy because of constitutional personality factors, or if her tummy, or something else is bothering her. Careful observation of her daily reactions and behavior will help you decide what’s what. An active baby needs to have lots of interaction and “play” during the day. Give as much “tummy time” as she will tolerate, to work her little muscles. Engage her attention and go for the laughs; play “peek-a-boo” games, make funny noises, do silly things; whatever brings the laughs. This will both excite her and tire her out for better sleep later. DON’T play with an active baby at night, though; she is never too young to learn that nighttime is for sleep.

Other constitutional factors can interfere with sleep: Babies who are overly sensitive, perhaps to noise, light, skin sensations or body movements can have problems sleeping. Don’t assume your baby needs total quiet to sleep well. Some babies need “white noise” to sleep well; ask your doctor just how loud you can play “white noise”; babies are used to a great deal of noise in the womb and often sleep better with constant noise playing. Babies who are sensitive to the motion of their body often need to be swaddled, even late into their first year. There are new, larger-sized swaddling blankets that make this easy to do. Check out Dr. Harvey Karp’s “Happiest Baby on the Block” for great tips on swaddling and calming babies. (I really do suggest you look at the video rather than the book; it’s quite amazing!) Don’t feel bad about using a baby swing, if it works, at least for the first few months. Neurobiologists think that a swinging motion may actually be helpful in brain development. Although illness isn’t exactly constitutional, it’s worth mentioning. Even a little case of the sniffles can throw off a baby’s sleep. Just support him through his cold, make him as comfortable as possible, and get back with the program when he’s feeling better.

D IS FOR DAYTIME
What does your baby do during the day? Until three months of age, there isn’t much you can do to influence this; babies will sleep where and when they want to. Until this age, they are more influenced by their internal needs and feelings, and less influenced by external stimulation. But after three months, you can try to limit naps and keep her awake more during the day. Keeping her active, interested, and engaged is the best way to wear her out for better sleep at night. Experiment with her nap times and overall amount of daytime sleep. If she naps three times a day, try two longer naps. Don’t let naps run too late into the afternoon. Or awaken her a few minutes early from her naps, to see if she “consolidates” her sleep better at night. But DON’T make the opposite mistake and eliminate naps; this creates an overtired baby, and an overtired baby will sleep LESS at night.

E IS FOR ENVIRONMENT
The environment you provide for your sleeping baby can have a big impact on how well he sleeps. A very young baby (3-4 months) might do better in a swing or a bouncy seat. At that age, my babies tended to sleep better in a bouncy seat, not their cribs; I think the seat provided more cozy support, and having an elevated head helped to clear any possible nasal congestion, as well as being good for reflux or other tummy distress. I moved them from the bouncy into the crib anywhere from 3-5 months.

The right clothing for the right temperature is important too. Don’t make the common mistake of dressing the baby too warmly. It’s easy to assume babies get cold, but often they are too warm. Don’t judgetheir temperature by feeling their hands or legs, but rather their chest. This will give you a better sense of how to dress them for sleep. Dressing them lightly, but fully, for sleep is a good rule of thumb. Babies sleep better if the room is a little on the cool side; they sort of “hibernate” and get cozy for a nice rest. Some babies LOVE little sleep “bags”; my babies hated having their feet and legs restricted. Experiment, experiment, experiment.

Your baby’s sleep can be impacted by other environmental changes you may not have imagined:

~~sleeping in a different room than usual
~~seasonal daylight changes
~~different noise patterns in the house or neighborhood (when I was truly sleep-deprived, I actually thought it would be a reasonable thing to ask the neighbors to eliminate lawn-mowing during nap times!)

If you need to make a major change for a short while (say, a vacation), fall back on what works and plan to get back on track when you get back home. Nothing is permanent, and you can all get back to a good routine with a few nights of getting back in the habit.

F IS FOR FUSSING

I am not a believer in the “cry it out” method that many experts, and one of our own pediatricians, recommend. I cannot stomach the notion of plopping a baby down in bed and closing the door. That being said, however,a little fussing or crying is certainly fine for a baby to tolerate. Some babies “let off steam” from their days in this way. After all, they can’t exactly go for a brisk run to blow off their extra energy; crying is the only way to let it out sometimes, for some babies more than others.

So how do you decide how much crying is enough? First of all, it should be YOU who decides, not some “expert” who says five, or 15 minutes is OK. Some babies can be fine with crying up to an hour at a time; others fall apart after five minutes. You need to know and interpret your baby’s needs. And each of your babies may be different from its siblings. One of mine was a “fusser”. She fussed off and on, much of the day (and night), until she started talking. And she started talking early. This baby just needed to TALK! Once she could start jabbering, she had no need to fuss any longer. HER crying was not really “distress crying” (usually), but rather “talk crying”.

Once you sort out Baby’s sleep needs and habits through the first year, you have new sleep challenges awaiting you in the Toddler years. So pace yourselves, and go grab a nap!

2 Comments »

Is It Autism?

Dr. Heather : March 2, 2008 5:43 pm : Autism, BEST OF BABYSHRINK

*Please note: This post was updated by Dr. Heather on 11/22/2010 .

Autism diagnoses are skyrocketing, but is the incidence of autism really increasing? Are there really more autistic kids out there than there were before?

We don’t know for sure, but one major contribution seems to be the increasing recognition of developmental problems in children by professionals like me. In other words, is it possible that the increase in autism is simply an increase in our diagnosis of the disorder?

Yes.

The single most frequent referral question I get, as a BabyShrink, is: “Is this child autistic?” Often, I see a two-year-old who is head-banging, language delayed, or performing repetitive behaviors. He may already have a speech therapist or other specialist who worries about autism. Or his parents may have seen Jenny McCarthy on Oprah, and say, “my kid does that!”

The New Autism?

When I went to grad school in the 1990s, we learned that Autism was a rare, severe, and life-long disorder of communication and social relatedness. These kids exhibited the most obvious signs of the disorder:

Near complete retreat from communication with others

Hand-flapping and other odd self-stimulatory behaviors

Severe developmental delays and behavioral outbursts

These kids really could not be taught in any regular school setting; They needed support and help in daily living for a lifetime. But as time went on, clinicians started to see less severe forms of these symptoms; we got better at recognizing them in their more subtle forms. As more behavioral health-care professionals were trained, we had more “eyes” looking for the problem. Parent advocacy and special education laws increased pressure on the school systems to widen the array of services for kids with less severe symptoms. Soon, I had parents and teachers asking me to diagnose autism or a related disorder so the child would qualify for intensive, expensive help that was only available under the autism spectrum range of diagnoses.

The pressure is tremendous; here is a child who has communication and other developmental delays. His parents have few resources. The school will only pay if there is an autism diagnosis. Many clinicians admit that they rationalize labeling the child “autistic” if it helps them get the services they need.

Digging Deeper: When Autism Diagnoses Are Misguided

So, back to the typical 2-year-old head-banger referral. A toddler I saw recently already had a new speech and language therapist, and an occupational therapist. They were concerned about his lack of progress in therapy. He had “lost speech”, meaning he no longer used the words he once did. One psychologist had already labeled him “autistic”, after spending just 60 minutes with him….in an office, not the child’s home, where he is most comfortable and most himself. I found a shy little boy who needed a lot of reassurance from his parents with me, a stranger, in his home. But he was outgoing and comfortable with his siblings and cousins on the playground. Later I found a buried note in the records about ear infections and asked about it. Fast-forward two months; after an ear/nose/throat and audiology consult, the child had ear tubes placed to drain the accumulated fluid behind his eardrums. He immediately began speaking meaningful words and his head-banging decreased by 90%; Nobody is worried anymore about him; he is progressing beautifully and is on track to start preschool at age 3.

That child had painful, unremitting ear infections that interfered with his hearing and language development, and caused him to bang his head in an effort to deal with the pain; His “lost speech” was a result of his shyness with the new speech therapist, and his hearing difficulty. He never truly “lost” any speech; he just was too shy to use his words with a new stranger, the speech therapist! And he was diagnosed with autism, and that diagnosis is “counted” in the statistics of the increasing “epidemic”.

I’m not arguing with the possibility that the actual incidence of autism is increasing. But I am not 100% convinced that that is taking place. And I’m worried about the panic and alarm caused unnecessarily to parents.

Misdiagnosed?

I am worried that there are several other distinct disorders being thrown together inappropriately with autism. Children with these disorders deserve to have them studied and understood uniquely, and not just lumped together with other disorders. In particular, there is a large group of children with sensory and motor problems; for example, a baby born with difficulty in tracking her vision. She cannot control her eyes properly so she cannot make eye contact with her parents. She does not learn to communicate well because she cannot make her eyes look where she wants them to go. Her parents think she does not “want” to look at them to communicate. These days, when clinicians hear that a baby does not make eye contact, they immediately think “autism”. But in this case, it is primarily a visual problem – one that, if corrected, will completely eliminate all her delays and symptoms.

Check out the following illustration I found online…(if anyone knows the source, please email me! I have been trying to locate the author but cannot find any information.)

Figure 2. At the age of four months this baby girl turned her head away when an adult tried to interact with her. This was interpreted as a sign of infantile autism. Since two of the older three siblings had esotropia, the infant was referred for an examination. She had normal looking eyes, a refractive error of +1.0 I both eyes and no accommodation to accommodative targets. Therefore +4.0 lenses were placed in front of her eyes to give her a clear image on the retinas. The effect was immediate, the baby looked surprised and a few seconds later showed a normal social smile for the first time.

One thing that health-care professionals seem to agree on is the fact that “Autism” is really a general term for many different disorders, each with different causes and outcomes. We need to work harder at understanding all of the unique disorders that are now being lumped together under one umbrella.

A Word About Vaccines

People are desperate to find a cause for autism. Childhood vaccines protect children from some of the most horrible, deadly, disfiguring, dangerous illnesses that routinely used to kill thousands. Are there dangers with vaccines? Of course. As for all medical treatments, you must weigh the potential risks with the potential benefits. But this problem has been studied extensively by gold-ribbon teams worldwide. Their findings? Vaccines do not cause autism. Not even the older vaccines with thimerosol, a type of mercury. Mercury poisoning by itself does not cause autism either. My kids have all their vaccinations. I have relatives who are survivors of diphtheria, polio and other horrendous illnesses. They don’t want me to lose sight of the misery (and death) that these illnesses inflict. And honestly, when other families choose not to immunize their children, they put the safety of others at risk; especially babies who are too young to have their full complement of vaccines, and other children and adults with compromised immune function. Please do not be misguided by the misinformation out there on vaccines. If you have any questions, please review them carefully with your pediatrician, who will probably agree with what I am saying.

True Autism Symptoms

Now, what does make me worry about autism in a child? Here are the main things I look for when evaluating a baby or toddler. (Remember: each child needs to be seen and thoroughly evaluated in person, preferably in your home, by an experienced professional.) These are some things that should trigger an evaluation, often to simultaneously include the evaluation of developmental psychology, vision, hearing, genetics, neurology, and occupational therapy/physical therapy specialists.

* No eye contact after four-to-five months of age;

* Inability to comprehend any language by 12 months (comprehension of language is far more important than spoken language or speech);

* Lack of gesturing (including pointing) by 18 months;

* Not turning to parents for emotional support/reassurance;

* Exclusively preferring objects to people at any age;

* Lack of imaginative play (make-believe/pretend games) by 18-24 months

There are many other possible, “lesser” symptoms, such as lining up objects compulsively, not responding to the child’s name being called, frequent tantrums, making “strange” sounds, and the apparent “loss” of speech. Often, these symptoms are problems, but are better explained by other diagnoses, such as the visual/motor example above, family stresses and problems, or even complex genetic disorders. And sometimes, these “problems” are simply normal expressions of toddlerhood!

So the bottom line is this: if there are any concerns, get an evaluation for your child sooner, rather than later, since time is of the essence. But make sure you get a comprehensive, thorough evaluation that takes all of the above into account. And if someone does use the word “autism”, don’t panic. These days the word means many different things to many different professionals, and often, the symptoms can be completely ameliorated by the right therapy.

Do you have stories to share about the diagnosis of your child’s developmental delays? Please share!

Aloha,

Dr. Heather

The BabyShrink

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