Tag Archives: newborn

PREMATURE BABIES

MUSCLE TONE IN BABIES

It is helpful to understand how the length of time a baby is carried in the womb prior to delivery may influence the level of tone in her muscles.  The term “muscle tone” can be defined as the balanced level of tension in the muscles.   By “balanced” we mean that the muscles are capable of a range of tension levels, from very contracted which brings the limbs close to the center of the body to very stretched which straightens the limbs out away from the body.  A baby carried to full term usually has balanced muscle tone.  This is evident in the newborn as she is lying on the floor.  Observe that her limbs are bent and rather close to her torso until she learns how to move them on her own.  One she begins to move them through learning the motor skill of kicking, her muscles go through the full range of motion from being flexed and close to her torso to being extended and stretched out.  In babies born premature, muscles usually have lower muscle tone.  This means that baby’s limbs are more stretched out, more relaxed in appearance.  Sometimes the term “hypotonic” is used to describe the muscle tone in premature babies, usually those with very relaxed muscles.  This means the relaxed range of muscle tone is very familiar and the contracted range is a bit difficult to achieve.

MOTOR SKILL DEVELOPMENT IN PREMATURE BABIES

Motor skill development is more challenging for babies born with low muscle tone, because their muscles have to work harder to develop a fuller range of muscle tension.  The baby carried to full term usually has the fuller range of tension already in their muscles.  Premature babies benefit tremendously from a lot of motor skill games and activities.  Their muscles need “extra practice”  for their first year milestones.

SUPPORT FOR PREMATURE BABIES

Due to the relaxed quality of the premature baby’s muscles,  it is easy for the heavy parts of her body to flop backward when you pick her up.  It is very important to fully support her head and neck, as well as the limbs of her body.  Keep a hand behind her head and neck when holding and moving her.  Try to keep her arms and legs from dangling when you hold her by folding them in toward the midline a bit.  Hold her so her spine is a bit rounded rather than straight.  As she develops strength in her muscles she will be able to support her head and move her muscles through the full range of motor activity.

PROPRIOCEPTION AND PREMATURE BABIES

Parents can learn hands-on activities that guide baby to feel the range of motion in various movements, making it easier for baby to find the movements on her own.  For example, a “preemie” may keep her arms fairly straight but through the use of your hands you can show her how to bend and straighten her arm.  These activities improve baby’s proprioception.  They are fun for baby, too.  They guide her toward a clearer feeling of her body and an improved ability to bend and straighten her limbs.  As she learns to feel and move her muscles, they gain strength improving the range of muscle tone.  This is one of the most important developments during baby’s first year.  The motor milestones teach her to use her muscles, support her own body, and to travel from one place to another.


HOW TO CARE FOR A NEWBORN: SUPPORT THE HEAD

a baby is placed on the floor with her head supported by the teacher's hand

 NEWBORN BABIES AND neck CONTROL

 Newborn babies do not have head control, the ability to lift and move her head on her own.  It is a motor skill that develops with plenty of tummy time.  With the early gross motor skill of lifting the head, baby develops strong neck muscles.  The action of lifting the head strengthens baby’s neck muscles so she can eventually hold her head up on her own.  Until she can hold her head up all by herself, her neck muscles are weak and she needs support.  When you hold her or move her from one place to another, please use your hands and forearms to provide extra stability for her. Young babies need support to prevent their heads from falling to the side and over stretching ligaments or muscles.  For a more detailed explanation about why babies need neck support please read our post on baby head support.

WHEN CAN BABY HOLD HEAD UP?

Often babies learn to hold their heads up for long periods of time on their own by about 5 or 6 months of age.  At this time you can hold them upright and baby can manage her own neck control.  However, even at this stage it is a good idea to put a hand behind baby’s head and neck to support her as she goes down toward the floor.  Often the action of putting baby down on the floor moves her through a backward motion which can be stressful on the neck.  We recommend putting your hand on the back of baby’s head and allowing your wrist and forearm to cross in back of her neck and upper back.  This puts her head, neck, and torso in one piece as you move it so no part can unsafely dangle.  When she is on the floor, roll her a bit to one side and place your hand behind her head and then roll her back onto your arm before picking her up.  Observe baby Zizu (5 months) in the above photo receiving some extra support as she is picked up from the floor.

PARENTING TIPS FOR NEWBORN BABIES

  • Always support baby’s head when holding and moving her.
  • Avoid playing the game of tipping her head backward (even if she seems to like it).  It over stretches ligaments.
  • Learn to roll her to the side to place your hands in the best place for her to feel your support.  This includes behind her neck.
  • When baby is able to hold her head up on her own in a few months, continue supporting her head as you put her down for naps or floor time.


BOOK REVIEW: “THE HAPPIEST BABY ON THE BLOCK”

Parenting book "The Happiest Baby on the Block"

What is colic?  Colic is a term used to described babies who cry loud and for long periods of time with no explanation.  Often their faces are twisted as if they are in pain.  Parents think they may have gas and a trip to the doctor reveals everything is normal, yet baby continues to spend a large portion of daily awake time crying at the top of her lungs.  Parents often feel at a loss as to what to do for these babies.  Dr. Harvey Karp, a respected pediatrician, researched this dilemna and began working with parents of babies with colic.  The result is his book The Happiest Baby On The Block.  

The Happiest Baby On The Block addresses the question “How Can I Calm My Baby?” by looking at the top five actions parents have taken across cultures over thousands of years.   Now a national bestseller, Dr. Karp’s book presents “the 5 S’s”:  Swaddling, Side Position, Shhh Sound, Swinging, and Sucking.”  Dr. Karp’s theory is that babies respond to the 5 S’s when used in combination because they provide an experience for baby that closely resembles the experience of the womb.  Soon, with these techniques, even the fussiest baby learns to be calm.  Dr. Karp  presents the “5 S’s” in a simple manner so parents can try them at home and quiet baby’s cries.

The Happiest Baby On The Block:  by Harvey Karp, M.D.  (New York:  Bantam Books, 2002).


WHAT IS SWADDLING ?

YouTube Preview Image

SWADDLING DEFINED

The technique of securely wrapping a blanket around  baby to keep her arms and legs secure is called swaddling.  The blanket is folded in a precise way to be rather snug and keep the arms and legs of a newborn baby from flailing around.  The Mayo Clinic website demonstrates one technique for swaddling a newborn.  This often is calming to the baby.  Sometimes babies are swaddled to keep them warm or to transport them more easily.  Mothers around the world have swaddled babies for these very same reasons for thousands of years.  Just think of the images you have seen of  babies swaddled and put into a papoose which is carried on the mother’s back in Native American tribes or of baby Jesus lying in the manager.

swaddling THE NEWBORN BABY

One of the most popular reasons for swaddling babies is to quiet their crying.  When nothing else seems to work, swaddling is often helpful in quieting a crying baby.  Dr. Harvey Karp, pediatrician and author of The Happiest Baby on the Block, demonstrates the swaddling technique in the above video from thehappiestbaby’s youtube channel.  Dr. Karp teaches that swaddling a newborn is one of the key elements to inducing a more calm and quiet state.  Some babies are swaddled just for sleeping at nighttime so they do not startle themselves as they move.

SWADDLING AND MOTOR SKILL DEVELOPMENT

Newborns sometimes startle themselves when they move an arm or a leg.  They have been in a watery environment in the womb and the sensation of ones body moving in water is much different than when moving out of the water.  When in water there is more pressure against our limbs.  They have not yet developed much muscle control of their limbs.   Swaddling keeps them from flailing their limbs and provides a clear feeling of their body because of the snug wrap of the blanket.  The development of proprioception is very important for motor skill development during baby’s first year.  Because baby’s movements are sometimes sudden and unexpected at this early age the swaddling also keeps her from falling out of mommy’s arms.  It is important not to swaddle too tightly as well, which will be discussed in a future post.  When you ask ‘Why swaddle?” just remember the benefits listed below.

BENEFITS OF SWADDLING

  • Keeps babies warm
  • Helps quiet baby
  • Makes baby easier to carry
  • Keeps baby safe
  • Improves baby’s feeling of her own body


BABY HEAD SUPPORT: BABY ANATOMY LESSON

baby with head and neck supported

HEAD & NECK SUPPORT IN POSITIONS AND TRANSITIONS

One of the most commonly-needed supports for baby is that of the head and neck.  This is often easy to do when holding the baby in one’s arms but challenging to do when picking baby up or putting her down.  It is the transition from picking her up off of the floor and putting her back down again that brings moments when her head lacks the necessary support.  Parents should learn how to hold and transition baby from one place to another while keeping her head and neck supported.

BABY ANATOMY:  EXTENSION VS. HYPEREXTENSION

In the above photos, Donna demonstrates head support with Zizu (about 5 mos. old).  The hand can be placed in back of the head so it is cradling the head while the wrist of the same arm crosses in back of the neck and upper back.  This prevents the head from tipping backward beyond the position of extension.  Extension of the neck is the position of the head when we sit up straight and look forward.  Hyperextension is when we sit up straight and look up toward the sky. The latter should be avoided with baby.  To complete our anatomy lesson we should also mention that flexion of the neck  is the action of looking down toward the floor from a sitting position.  When baby is lying on her back in your arms or on the floor, extension exists when her spine and head make a straight line that is parallel to the floor.  Hyperextension, which we want to avoid, exists when the head tips backward from the point of extension.  This causes great strain on the developing muscles and ligaments of the neck.

THE PERIOSCOPE OF THE 5 SENSES

The great range of motion that is possible with the head and neck exists because we need that mobility to look around us.  The somatics pioneer Dr. Moshe Feldenkais referred to the head as the “perioscope of the senses.”  You can imagine a submarine with the perioscope moving around to observe what is happening, to determine which way to go, and to steer clear of potential danger.  That is what we are basically doing with our head and senses as we move.  Thus, we need greater mobility in the neck region of the spine than we do the lower portions such as the middle of the back.  The mid-back had less range of motion because it is part of the ribcage which protects vulnerable organs like the heart.  The need here is for stability and protection.

TUMMY-TIME FOR BABY NECK STRENGTHENING

Babies develop strong neck muscles through motor skill development.  Tummy-time is one of the most important activities for developing this strength.  Tummy-time for babies teaches the gross motor skill of lifting the head.  By putting baby on her stomach two or three times a day while supervised, she will learn to lift her head very high.  At first, begin with only a few minutes on the tummy and gradually increase the time as her strength and comfort improves.  This activity develops the strength in her neck and back muscles so she can eventually hold her head up on her own.  Remember that it takes  time, maybe 2 or 3 months, to develop this strength.  Continue to support baby’s head until she can hold her head up on her own for a long time while on her tummy.


UNIQUE BABY SHOWER GIFTS

I am frequently asked, “I have a baby shower to go to, is there a book you would recommend?”  or “My niece just had a baby, is there a toy or rattle you could suggest for a baby gift?”  With the abundance of books, rattles, toys and baby gear on the market and the millions of dollars in marketing promoting them, choosing gifts wisely has probably never been more difficult.  Today we share:

5 Unique Baby Shower Gift IDEAS

1.  Stellar Caterpillar Lessons (private, class, or virtual):  What an original baby gift for a new mother to gain a few tips on how to best guide baby’s motor skill development!  We coach mothers on buying developmental gear and toys  and how to cultivate a strong self-image for baby through movement.  A private lesson, group class, or virtual lesson also offers mom playful activities to try at home with baby.  Contact Donna to customize a baby shower lesson gift.

2.  Infant Swimming Lessons:  Is there a pool in your area that offers swimming lessons for baby?  This is the fun baby shower gift that probably no one else will think to get.  Parents will love taking baby into the water for a fun outing.  Read our post “Can Babies Swim?” to know what to look for in a swim school.

3.  Developmental Rattles (a single rattle or a set):  Read our posts on “Best Baby Rattles” to learn how to choose one that a tiny baby can learn to shake. Add in a few more spanning a developmental time period or offering a range of sounds.  One of the best baby shower gifts is a set of 5 rattles ranging from a tiny one for a newborn to a larger squeaky one for a 9-month-old.  Think simple in shape and construction and interesting in sound. That is all she needs!

4.  Baby’s First Library:  A dear friend, a literary agent, shared with me her creative baby gift.  Choose a selection of board books from our Amazon Listmania “Best Books for Babies” list.  Favorites for the newborn include “Pat the Bunny,” “Goodnight Moon,” “Black on White”/”White on Black,” “Moo, Baa, La La La,” and “The Very Hungry Caterpillar.”

5.  Books for Mom:  “Diary of a Baby” & “What’s Going On In There?”:  A shower gift of these two books provide some of the best information for moms on development.  “Diary of a Baby” is a quick and easy-to-read book on emotional and physical development that can be read at various stages.  “What’s Going On In There?” makes a great reference book, as it spans five years of baby’s development.  Both are listed on the “Best Books for New Parents” Amazon Listmania list.