Calling all parents again

Dear parents,

I am back again after a long break. Did I sleep too long? Sorry for that.

Just to pick up the strings where we left them, I have re-posted my first letter again. New mothers and fathers can go through it too.

Is your baby now 3 months old now? Then this letter is for you!

The  newborn has now grown into a 'smiley face' 3month old infant. 

He is now learning to turn over, hold his head up, look around, search his mother’s face, cry when hungry or uncomfortable, and then smile meaningfully. He looks at dangling colourful toys, tries to reach out and finally grasps it at around 4 months.

Now he can laugh aloud with pleasure! Infants at this age also begin to explore their own bodies and a sense of self emerges. How does that happen? Let's try to explain with an example. The little infant wiggles his hands in-front of his face and also touches a dangling toy. Each time he can see his fingers moving and realizes they are fully under his control, he realizes that they are his own. Those hands will touch the toy whenever he wants it to. On the other-hand, when he cries, most often he sees the known smiling face (mom’s face), but not ALWAYS. So that is not his self. In this way slowly the 'self' versus 'non-self' concept evolves in the little one's brain.

Four-month-old infants seem to be "hatching" socially, as he starts taking more interest in the outer world. During feeding, infants no longer focus exclusively on the mother but become distracted.

In another few months he can sit up and crawl. He notices small objects, tries to pick them with a ‘pincer’ grasp with 2 fingers and put it in his mouth. By now, he is making a lot of sounds and trying to communicate with those around. He loves to play with whatever is around by holding, dropping, poking and mouthing whatever he can lay his hands on.

 His attachment for his parents becomes intense and the preference is also very clear by 4- 5 months. The primary emotions of anger, joy, interest, fear, disgust, and surprise appear in appropriate contexts as distinct facial expressions by 4-6 months.

As he progresses along the development ladder, he is always banking on new stimulation and responses. Each new endeavor is backed by a cause and effect analysis in the little brain. So, an enriched environment ensures growth while stressful experiences can impede proper blooming. As a parent we need to pick up the little one’s cues and respond appropriately and consistently. Every cue from the baby is like a service at the tennis court, the vigilant player/parent timely returns every single serve/cue.#serve and return technique.

Babies develop attachment right from birth to the primary care-giver, most often the mother. Her touch, her smell, her voice and her face evokes a special response in the newborn baby and he responds by looking into her eyes as she feeds him, or by calming down when held and caressed by her. This attachment increases as the baby grows and the love and care is reciprocated by the parents. This reciprocation generates stability in the baby. Parents who are emotionally available, sensitive, perceptive, and effective at meeting the needs of their infant throughout the early months of life are likely to have securely attached infants. Parents who are affectionate and responsive to the child’s physical and emotional needs, who provide adequate stimulation, carry a positive attitude, and give adequate emotional support see their babies grow into stable and sociable individuals. Children’s secure attachment to caregivers also is associated at a later age with more effective coping with stress and better performance at school.

During these early months, just as the baby is developing an attachment, the parents are also getting to understand their baby and his needs. It is a two way bonding, each strengthening the other. By 3 months of age, the child and parents achieve a synchronized reciprocation through vocal and affective exchanges. A happy, smiling interactive parent evokes smiling, cooing, and playfulness in the infant. This is the seed laid down for effective social reciprocation in later life. Good attachment with parents provides a secure base, which allows infants to explore their world with confidence.

This little infant has begun to bloom and is just learning to explore her immediate environment. Her tiny grip on your finger, her winning smile, and her squeals will win your heart. What does this little angel want from you? Your active presence and your milk. So, go ahead with breast feeding on the baby’s demand and play with her, enjoy her company. She now has a definite bonding with you and enjoys every smile, every caress every glance you give her. The more active stimulation she gets in the form of handling, caressing, feeding, smiling, laughing and singing, the more responsive she will be. And it is so much fun to see her do something new almost every other day!

The baby, by now can express his basic emotions, as we have discussed earlier. He also seeks reciprocation of his expressions.  The infant makes face-to-face behavioral expressions, which reveal his ability to share emotional states, the first step in the development of communication. If the parent does not respond, he tries to draw her attention and engage her and cries angrily if he fails to evoke the required attention. If this lack of response perpetuates, infants gradually make lesser efforts to re-engage. Rather than anger, they show sadness and a loss of energy when the parents continue to be unavailable. This is often seen in infants of depressed parents or abandoned infants.

Now a busy mother might repent that she is unable to be with her baby as much as she wants to. No fear dear, babies will accept separation provided it is predictable and Baby realizes that Mom will be back. It is consistent availability that matters, not necessarily constant availability. Little babies are unable to handle unpredictable circumstances and get frustrated. It is the quality time that she demands. So please remember the golden rule to be Consistent, Responsive, Predictable and Comforting (CRPC). Your lively, animated presence will spark the expressions in the little one and help her develop newer skills.

For most parents, this is a very happy and rewarding period of parenting. Don’t you agree?

Enjoy nurturing God’s special gift for you....and if, in the process, you have any questions for me, mail me at udbhaas@gmail.com
I will be back for the baby turning 7 months.
Bye for now,
Dr N Chatterjee
Paediatrician, Udbhaas

#child development  #parenting tips  #serve and return

Calling all Parents

An Open Letter for all Parents

Dear Parents,
It is such a pleasure to see you all so happy with your children. As I close my eyes I see children of all ages, from newborns to teenagers, clinging to their parents, sometimes happy & merry, sometimes sad and crying, some healthy, some sick, some content and pleasant, some irritable and cranky. But one thing is common in all the parents-- their eagerness to help their children. Every parent has numerous questions to ask pertaining to better child care. As a paediatrician I have been responding to these questions for long many years. But now when I look back I feel, much has remained unspoken and unexplained. So in this open letter I will try to address the parental queries that I can recollect.
Newborn -2 months
Let’s start with the young mother with her newborn baby, who is ready to give all for her baby but just doesn’t know what is best. Dear Mom, don’t waste time, start breast feeding as soon as possible and feed her as frequently as she wants, holding her close. The best gift you can give her is your milk and your lap. This will provide not only nutrition and warmth, but also sense of security and gratification.

As the baby grows in your lap, look into her eyes, smile at her and talk with her. Very soon she will start to recognise you and reciprocate with her own cues. This is the beginning of social interaction. Whenever the little baby cries to express any need, respond immediately. This pacifies the baby and gives her a sense of control over her environment. She learns the meaning and impact of her own cry. This is her first exposure to the cause and effect phenomenon.
We must remember that the newborn baby can see, hear and feel too, just like us adults; they are not inert! They can also express their feelings and needs with their cry, their gestures and body movement. It is for us to honour their senses and pay attention to their cues...and the mother is the best at it. Strong or flickering lights, loud noise, harsh touch, hot or cold temperature...all these irritate a baby, whereas he/she is soothed by soft music, soft light and soft, warm touch. This is why the little one is so peaceful and comfortable when mama holds him in her arms, humming a lullaby.
Even a newborn can see and they preferentially focus on human faces. So you will notice that in a few days the baby is looking at your face as you feed him. Look back with a wide, warm smile. Here, we must remember, during the first six weeks of life the baby is much like a demanding, grumpy old man, either feeding, sleeping or showing discontent. He will need frequent feeds and a lot of sleep but doesn’t seem to pay heed to your smiles. Don’t lose heart, your efforts aren’t lost. He feels the comfort of your lap and warmth of your smile and is developing an attachment, though still unable to express happiness.

• Come 6 weeks and he will start showing responses. As you look into his eyes, he will stare back and gradually a smile will appear anytime between now and 2 months. This ‘social smile’ implies that he is beginning to understand human behaviour and can win your attention with his smile. This is the beginning of his communication skills. Your consistent and animated response will boost his confidence and self control. He will learn that his feelings are important and he can affect his environment.

A lot of things you see the baby do during these early days may seem unnatural and problematic. He may want to feed almost every few minutes, he may pass watery stool with yellowish granules upto 8-10 times a day, or, not pass stool at all for a week, there may be peeling of skin all over, big blue patches on his back, a baby girl may have bloody discharge from her vagina, there may be a blister on the upper lip or maybe a tooth or two...these are all normal variants. Do not panic, but consult your doctor to make sure.
Enjoy nurturing God’s special gift for you....and if, in the process, you have any questions for me, mail me at udbhaas@gmail.com
I will be back for the baby turning 3 months.
Bye for now,
Dr N Chatterjee
Paediatrician, Udbhaas

#child development #parenting #serve and return