Archive for October, 2009

Settle your crying baby with a snug swaddle!

Tuesday, October 27th, 2009

swaddlebabyI love a good swaddle! Settling your crying or fussy baby can be difficult and swaddling (tightly wrapping) helps.  I know wrapping to be a wonderfully effective tool for parents and babies in the first few months of life and I share this with new parents in hospital. Many other health professionals do, as well.

Swaddling is an age-old child care practice that has been used across countries, continents, cultures and communities. Even the infant Jesus Christ was wrapped in ‘swaddling cloths’. There is a great deal of medical research and evidence that proves the benefits of swaddling, including:

·         Swaddled babies wake up less and sleep longer

·         Swaddling keeps sleeping babies on their backs and reduces the risks of SIDS

·         Swaddling helps babies feel safe, secure and calm

Babies can be swaddled from birth until the time when they can roll over independently (usually between 4 and 6 months of age), so it is a useful tool for those early, unsettled months. Swaddling has calming and soothing effects on babies and promotes a feeling of warmth, safety and security. It has the capacity to do this for several reasons:

·         Swaddling mimics the confined womb environment (remember, your new baby is used to a pretty confined space in the womb!)

·         Swaddling reduces arousal from the startle reflex (Moro reflex) and external stimulation. (Babies often wake themselves with sudden jerking movement of their arms and legs. Swaddling helps keep things all together!)

·         Swaddling reduces your baby’s irritability and crying. (In medical studies, swaddling has been associated with significant reduction irritability and crying and was shown to be more soothing than massage or sucking.)

·         Swaddling results in better sleep for your baby – and then for you! (Experience and research clearly demonstrates that swaddled babies arouse less and sleep longer.)

A common misconception of swaddling is that it should not be too tight. Not true! Feel confident to swaddle your baby very snugly to ensure the wrap does not come undone. To be sure that your wrap is just the right tightness, a good rule to follow is to think of sliding your hands inside your jeans pocket. Your baby’s wrap should be firm, fitting and secure, just as your hand feels when inside the pocket of your jeans.

Answering recent concerns, the hot off the press editorial To Swaddle or not to Swaddle, from the reputable Journal of Paediatrics, looks at the currently available information on swaddling. It concludes that the advantages of swaddling outweigh the risks, if any.

When combined with recognising your baby’s tired signs swaddling is one of the easiest and most rewarding of settling strategies. Together with sound and movement, swaddling will not only helps your baby, but it will give you confidence as well. When you can successfully calm and soothe your baby with a swift, snug swaddle; take a moment to congratulate yourself!

Intuition rules…

Thursday, October 15th, 2009

harry1I see hundreds of parents every year with young babies. Many of those parents are sleep deprived and exhausted. They look for rules in the attempt to find much needed sleep.

 

As health professionals we can give reassurance whether or not everything is okay in a health assessment. However, I am concerned that parents are being put under added pressure of UNDERSTANDING their baby’s cries and reading every conceivable publication to find the rules on what to do about it.

 

As a Paediatrician (and a dad of 4 who has been there!) I suggest parents trust their intuition more and expect less of the brain strain of processing a plethora of information. Don’t expect your head to translate responses that your instinct can do better. Follow your heart.

 

Sure, take in the interesting stuff presented in books, magazines and the media. If it strikes a chord within you, there is probably something relevant to you and your baby. It is good to identify and reflect, but not berate and feel pressed to absorb more. Experience and intuition will help you as much as all the information.

Seek guidance from a health care professional who you trust when you need to. Listen to guidance that is offered, but remember they are only guideposts. Nothing in parenting is concrete. Just when you think you have it worked out, something will change – baby’s illness; holidays; back to work; crises, both minor and major.

 

You will need to adjust and readjust your parenting barometer. To do this you need to trust your intuition. Yours…as a mother or father. You have known your baby 9 months longer than anyone else. Take a breath and feel confident in your understanding of what is right for you and your baby. But don’t flog yourselves with the imperatives, must-do’s and essential knowledge. You know your baby.

 

Parenting is an evolution from embryo to baby to child to adolescent and into adulthood. There are common threads of understanding and community norms, but no one rule or language. Trust your instinct during that evolution of physical, social, emotional, cultural needs. Trust that what feels right for you and your baby is the right way.

 

Intuition rules.

Dads and Depression

Tuesday, October 6th, 2009

dadbaby1Wonderful again this morning to have the opportunity to speak out about Dad’s and Post Natal Depression thanks to Today.

 

As I’ve previously blogged, it seems we have understated the effect of birth on fathers. Click here for the recent blog on new fathers and fussy babies.

 

So far just about all of us have heard of maternal postnatal depression (PND). However, we have little awareness and recognition of paternal stress and depression. My survey results highlighted the anguish and pain for fathers (as well as the delight, joy and love).

  • The incidence of maternal PND is around 14%    Men may suffer from psychological distress after childbirth and birth-related PND is not a rare condition. Research findings here.
  • The incidence of paternal PND is around 8%   
  • We also know that in families in which mum has PND; fathers have about a 1/3rd likelihood of being depressed as well. Not a good combination!  
  • PND can be serious. Even life threatening.   
  • Dads generally don’t understand maternal PND (nor do mothers if it remains undiagnosed). As a result it can be difficult for dads to be appropriately supportive. Even the best fathers/husbands can become critical and judgmental of their depressed partners
  • Dads like fixing things. They don’t get that PND can’t be fixed immediately. Dads feel powerless and helpless
  • Crying, colicky, irritable babies feed in to this  cycle, causing frustration, loss of self confidence, and sleep deprivation   
  • Dads don’t know how to deal with the unsettled, crying baby. If the baby is breast fed, what can the dad do to help?  

There are a number of tools out there and solutions are available:

  • for us all to be aware of the problem. Research supports including fathers in strategies related to infant settling. An intervention/prevention approach to infant behaviour problems should include fathers
  • the Australian Government has shown awareness of maternal PND with a $55 million 5 year program, including routine and universal screening.
  • Information and awareness – October is Beyond Blue’s Anxiety and Depression Awareness Month
  • better family and community supports with higher recognition of the issue of PND  
  • less stigma associated with negative  parental-baby experience/depression  
  • even better training of, and awareness by  Obstetricians, Midwives, Paediatricians, GP’s, Child Health Nurses   
  • strategies and tools (dads love tools!) to settle a crying baby.   Research supports including fathers in strategies related to infant settling. A simple tool, Sounds for Silence can help mothers and fathers settle their baby. Demonstrated here and here.
  • good non-judgmental individual or group counseling   
  • medication

Dads’ distress and powerlessness has always concerned me. I’m pleased to  continue to highlight PND and fathers. The task of making life easier for parents should never be abandoned!