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The Defense of Tummy Time

Just yesterday, as most days, a colleague at Kids Unlimited posted an excerpt talking about the importance of tummy time. Some responses offered an alternative article written on the RIE/Janet Lansbury blog highlighting the case against tummy time. I would like to directly respond to this article. There is much of RIE, Resources for Infant Educarers, I love and respect and use on a daily basis with my patients, clients and children. However, I do not agree with their beliefs on tummy time.

To Sit…Or Not to Sit: Developing Functional Sitting Skills in Babies

A celebrated developmental milestone is when a 6-month-old baby (give or take a few weeks) can sit up independently. But, what does that mean? The reference books say independent sitting is when a baby is placed in sitting on the floor and can remain there without help from caregivers, other supportive props or gear, or the use of their own hands for balance. But, is this independent sit functional for baby and why does it matter?

Play: 9 to 12 months

Babies at 9 to 12 months are really moving and grooving! They are in to almost everything and will likely be pulling to stand, cruising along furniture, and preparing to take those first few wobbly steps! This is also a bittersweet time for many parents (myself included) as you see your little baby vertical – even if holding on to something! Typically, by 9 months, babies are sitting unsupported and reaching for toys, crawling (tummy up or down) and by the end of this stage, babies are creeping, pulling to stand, cruising, and some may even be walking. Their ability to move in new ways (crawl, stand, even walk) makes it easier to explore and helps them make new discoveries.

Is My Baby’s Head Normal?

Today, many more babies have flat spots on their heads than 20 years ago. In fact, it is now common to see babies out in public wearing orthotic helmets and to hear stories about their courses of physical therapy. Diagnosis of positional plagiocephaly/brachycephaly and often-concurrent torticollis, two mostly preventable conditions, is on the rise. What can we as parents, caregivers, and medical practitioners do to reduce the risk of these diagnoses?

Play: 6 to 8 Months

Babies 6 to 8 months continue to move, play, and grow at an amazing rate!  At times, it seems as though they are learning something new every day!   Many of the same principles that we discussed in the post about play with your 4 to 6 month old continue to apply.  Here are 5 new tips to consider:

SAFETY:  A moving baby who puts everything into his mouth needs to be watched all the time because he can quickly swallow small objects or creep into unsafe places. Babies are not able to understand about danger. Lock away unsafe objects or put them high out of reach.  Many experts advise to use the TP Rule: if an object can fit through the hole in a toilet paper tube, then it is too small for a child 3 and under to play with.  If there are older siblings in the home, please teach this to them as well so they can be an active participant in determining what toys can be out when baby is playing.  PLEASE ENSURE THE SAFETY OF YOUR BABY by childproofing!  Get down on the floor, crawl around, and see what your little explorer could find!

Social: Time for play dates!  Start early – this is as much for you as it is for your baby!  People are much more interesting than things and babies love to see other little people that look like they do!  You and baby will also create lasting friendships.

Stranger/Separation Anxieties: Expanding baby’s social circle is important but be aware of his sensitivity when around strangers and when separating from mom (stranger anxiety and separation anxiety).  If you do have to leave, make sure you still say good bye and explain that you will be back.

Simple: Babies don’t need fancy toys!  They can be happy playing with a set of measuring cups, exploring plastic bowls or a spoon, etc.  The main point to remember is offering varying sizes, shapes, colors and textures.  Remember, baby is not impressed by labels or price tags!

Sun, Sand, Snow:  It’s time to get outdoors!   Baby is now old enough to be outside with baby safe sunscreen so spend time enjoying it.   Watch the trees moving in the wind and try to find birds, flowers, doggies, and other people.   Talk about you are finding as you explore the environment!  Baby loves to hear the sound of your voice and the more you speak in a happy, sing-song voice, the more your baby will listen, engage, and learn.  Try and make some of the sounds that you hear.   This is also a great time for more walks in the stroller or in the carrier.  Don’t forget other fun activities like crawling on the grass, putting feet in the sand, playing with bubbles, to name a few.

Take time to truly marvel this amazing stage of development . . . it will be gone before you know it!

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Play: 4 to 6 Months

Play starts getting more fun since your baby is more alert and begins to become an explorer and investigator versus a passive play mate.  At this age, baby starts to move too and, from here on out, won’t stop!

A 4 to 6 month old baby is quite a charmer!  He loves to smile, make silly noises at you (or anyone for that matter), to babble, and starts using his voice to get a reaction!  This is also the time when physical development gets “rolling” at an amazing rate.  Baby begins to prop sit (with arms or support), push up more on arms in tummy time and begins to roll purposefully.  Reaching becomes more and more accurate since eye hand coordination has improved.  Baby will reach for anything (ask any older sibling) and likely put most any object into his mouth to explore it.  Moving an object from one hand to the next will soon follow.   Around this time, most babies begin to sleep better so parents get to come back from the land of Sleep Deprivation (even if it’s short-lived).  With so many big changes, how can you maximize your play with this amazing little one? Below are a few ideas organized by thinking of baby’s senses!

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Touch:  Baby will love to experience different textures on his hands, face, and body.  Try introducing toys, blankets, stuffed animals with different textures.  Try putting on simple white gloves and washing your baby at bath time.  It provides a different sensation and helps you hold on to a slippery baby!  Continue with naked baby time and body exploration.  Try playing games like “where are your toes?” and then touch his toes (either with your hands or his) and say “Toes!”

 

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Sight:  Baby is ready to check out all of the new colors he can now see.  He now distinguishes between new and familiar faces which may mean a bit more clinginess to his primary caregiver.  Make sure you point out things and talk about the environment surrounding him, encouraging exploration by holding him up on your shoulder.   Mirror Play in a variety of positions (tummy, supported sitting) to let him see himself is always fun.  Try “Baby, Do What I do!”  Make various facial expressions (open mouth wide, puff cheeks out, stick out tongue) and see if he tries to imitate you.  Peek-a-boo is a great game to play with you, siblings, toys, etc.  Baby will need help initially but, pretty soon, he will have this tricky game all figured out!

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Sound:  Rattles, maracas, and very simple cause and effect toys (with your help initially) will be quite fun for baby.  Shake a rattle behind your baby’s head and let him or her turn and grab it.  Baby still loves YOU the best so use your voice!  Make silly sounds and mimic his sounds . . . the sillier the better!  One of the cutest things I get to see these days are baby and his older brother “talking”! Make sounds for your baby.  Clap your hands (help him clap his too because this will happen very soon) and help baby bang two objects together.  Play music too.  What about “zerberts”?  Isn’t blowing on your baby’s chubby baby tummy the best?  In our house, that crazy sound always gets a laugh!  Remember, many sounds in the environment will be new and novel like a dog barking, bell ringing, music, etc.  so be respectful!

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Movement:   Dance with baby.  Hold your baby in different ways (tucked in front, tummy, side) than your standard and dance away, sing, smile – in front of a mirror is even better!  Or, make it a movement activity for the entire family!  Always check on baby every 30 to 60 seconds by “freezing” or “waiting.”  This gives your little one a break to let him process the new information and reset himself in a way.  Give baby plenty of time on the floor each day.  I know this can be difficult but this floor time is one of the most essential parts of development.  It is the perfect surface and the perfect time for baby to spend time on his tummy, back, supported sitting, rocking on hands and knees all to build strength and skill to progress toward rolling, crawling, and walking.   As this stage progresses, try and have baby equal time on all four sides of the body.

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Other Helpful Hints: To help your baby focus, put out only one or two toys at a time.  Be respectful of all that baby is learning and balance stimulation with plenty of quiet time.  And, of course, be respectful of baby’s cues that he needs space or a break.  Can you imagine having to learn so many things in such a short time?  So many things are new as they move, PLAY, and grow!

Enjoy the magic and the wonder!

Play: 2 to 4 Months

Continuing with the play theme, your 2 to 4 month old baby is definitely more alert, more interactive, and more interested in initiating exploring his world. You just need to give yourself permission to linger, to observe and to marvel. It will still take a while for him to organize purposeful movements, sounds, smiles, and coos, but if you linger it will happen. And then you will be addicted and do everything in your power to see him do it again!

A 2 to 3 month baby smiles and coos, holds his head more steadily in midline, and controls gross shoulder movements to reach his arm in space towards something interesting. His favorite toy is still YOU, but you can also introduce bold colored or simply patterned books or toys (or safe Christmas ornaments). His gross reach into space will be more like a punch with a closed fist (no controlled grasp with hand yet), but when his hands are closer to his body and face or on an object, they will open and scratch at the surfaces.

I caught my husband playing with Kellan on the changing table, giving and receiving “body blows” with right and left jabs and hooks. I LOVED seeing this because Neil entered Kellan’s world. He observed what Kellan was doing and gave meaning to it. Kellan’s blows knocked Neil a few paces backwards or to the side, and with every repetition, Kellan understood more and more that his movements were affecting his environment. He was in control! Smiles and coos followed. No laughs yet, but we are waiting to hear Kellan’s first giggle!

A 3 to 4 month baby definitely exhibits more control, keeping body symmetrical right and left, top to bottom. Reaching is more refined and, when body is supported, head control is great with very little wobbling! This all translates into more refined play. Baby will turn his head to your voice, follow you with his eyes, reach for and briefly grasp objects. Expect more cooing and smiling. And his favorite toy…..YOU! Faces fascinate baby, but if you need to step away, try placing baby near a mirror so he can see himself!

Babies at this time are busy exploring all that they see. Because head control is greatly improved, eyes have the opportunity to fix themselves on different objects to study them. You will find baby staring at you and if in the right position, different parts of his own body (which he considers to be completely separate from himself). Though he can’t yet do it by himself, if you bring his feet into view, he will study them like they are the most amazing phenomena ever. This often elicits gross reaching and swiping at them. Self-discovery is so important, and this age is a perfect one to start “naked playtime.” Take his clothes and diaper off and in a warm room on a blanket or floor mat, place him on back, tummy and side and let him move around and explore in the buff. He will get his hand-to-hand, hand-to-chest, hand-to-face/head/mouth. If your house is just too cold, linger a little longer in the bathtub for the same experience.

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Other ideas include music and singing, starting peer time in playgroups (babies LOVE other babies…and it’s a great time for moms/dads to get together), reading (never to early for this), and lingering with the daily tasks. Your play will come naturally if you really observe your baby, enter his world and help him make sense of it. Be respectful of his needs and follow his cues, whether he wants more intense sensory experiences or to calm down a bit. Sometimes it can be a challenge to read your baby and know what they need, but through daily play and interaction, you will continue to know your little guy and love him that much more!

What are some of your favorite play activities at this age?

Play: Newborn 0 to 2 months

Once established that your newborn baby (0-2months) is in an active-alert, ready to learn, ready to play state, what on earth are you supposed to do with her!?!?! In a one word answer, LOVE her! Touch her, hold and hug her, cuddle with her, sing to her, whisper sweet nothings, give LOTS of kisses all over. But…let’s also be realistic. Newborn babies are not awake that often, and when they are they are usually eating, pooping, burping, spitting up, being changed and/or bathed, changed again, and changed again. Is there time for all this LOVE? YES! Because the love happens during all the awake duties. Don’t think about it being extra, think of it as being a part of each task. Love is a journey, not a destination!
So, slow down, don’t rush through all the tasks, take time to observe and interact with your baby during all of it. Changing at our house routinely takes 15-30 minutes because of all the play on the table. Before you know it, playtime is over and it’s nap time again! And, please, though we all know that moms and dads are super-heros, try to take a nap when your baby sleeps. These first several weeks are often about survival, especially when up many times during the night. We also know if this isn’t possible…but give yourself permission and try :-). Always good to shoot for the stars, and have someone ELSE clean the house, do laundry and make dinner too :-).

Extra ideas to play with your newborn:
– Sing nursery rhyme songs or recite rhyming poems (from memory, refresh, or learn new ones).
– Talk about what you are doing at that moment in time, or tell a story about what happened during day or the plans for rest of day. Get VERY detailed. It will take a long time!
– Observe your baby’s facial expressions and copy them. Especially the mouth/lips/tongue. You will be amazed at what your baby can “say” to you through her mouth and you will start to learn so much about her.
– Read books and show pictures, black and white work best, but you can throw in some red too. Start with simple pictures and slowly get more detailed.
– Move slowly as you work around baby so she has a chance to see and track you from side to side with her eyes.
– Tummy time!! Near and dear to our hearts at Move Play Grow. Try chest to chest with you propped up closer to vertical than horizontal at this age. OR get down on floor and lay next to your baby about 10 inches away so she can see you best.
– Wear your baby and go for a walk to get out.
– Be quiet and still. Being awake, babies are taking in even the most mundane things that we take for granted. No need to over stimulate by shaking rattles and toys in their faces, moving and bouncing all the time. Allow some “down” time too.
– Mix it up.

Most importantly, get to know your baby: observe, learn, internalize, journal (write stuff down…you think you will remember everything, but you won’t), and love her. There is NO ONE else in the world like your baby and definitely NOTHING like the unique relationship you have with her. Cherish it!

Buy This: All About Timing

Timing of gifts are as important as the gift itself. The ages stated on toys are both for safety and for children’s cognitive abilities. Buy one too early and you might frustrate your child; buy one too late and they’ll be bored. This is another reason to purchase toys that appeal to all ages, inspire creativity and imagination, and can be played with differently as your child grows and matures. This post discusses Stacking Cups and Push Toys.

A toys that works at most ages: Stacking Cups

– 4-6 months: watch parent spin them on floor, reach for them as grasp emerges, mouth them
– 6-7 months: Bang two together with one in each hand
– 7-8 months: Passing single cup hand to hand
– 10 months: Container to put things in
– 12-14months: Rolled on floor, picked up from floor, playing hide and seek for the cup, using as a container to put things in AND dump them out
– 15-17 months: Stacking
– 17+: Stacking higher and higher and KNOCKING it over in fun, novel ways :-), sorting, more complex games! Watch your child play with them to give you ideas how to jump in, join THEIR world and help expand it.

A toy that should be delayed before introduced: Push Toy

A push toy often has 12 months of age associated with it, but that is assuming your child is walking. A push toy should NOT be introduced before your child is walking independently. Many people believe that it can be a walking aide that teaches a child to walk. In fact, it encourages movement compensations that impede independent walking and encourages taking forward steps with heavy leaning on hands. Walking with a push toy before independent walking is also a safety hazard because the child cannot control the speed or direction of the toy, which can get away from them. Their protective extension (arms forward to break a fall) is not yet fast enough to always help them catch their inevitable fall.
However, once a child is walking well, push toys are FABULOUS! Small grocery carts can be filled and emptied and transported place to place. Parents can make the cart heavy by placing gallon cartons filled with water into the basket (or allowing kids to use many small water bottles so they can do the heavy lifting), requiring stronger pushing and pulling. Obstacle courses can be set up to steer in, out and around, encouraging problem solving with the inevitable crashes (and, unbelievably, providing a foundation for prepositions in language!). It is also a great core workout–just think how much your abs need to work to steer those wayward grocery carts in the store! And of course, it allows your little one to do a “mommy/daddy” job and trains them for using the “customer in training” carts at the stores!

Timing is key when first introducing toys. Appropriate expectations for play will help you to make smarter selections. Kids are always drawn to novel things, so rotating toys every few weeks will rekindle interest in old toys and give you an opportunity to see how they approach their toys differently. Ultimately, engage with them in the play: first observe what they are doing, join in to be with them in the moment and then help them expand OR be amazed as they push YOUR limits!

Have fun! Play lots! Be SILLY!

Guest Post: YOU are the BEST Toy

Christmas is nearly here! Soon, you and your little ones will likely be knee deep in toys, wrapping paper, and fun! As we bring our Buy This/Not That Series to a close, we have a guest post from a wonderful speech and language therapist. In this special post, Miss Lori reminds us all of something very important, a message that can carry us throughout the years.

When thinking about what toys to pick for your child, keep in mind that it is not the toy itself but what YOU do with it that brings the magic to the play. Ultimately YOU are the best toy for your child. From the very beginning stages of development, it is the relationship YOU create with your child that supports the development of his or her creative mind. YOU bring the play to life whether cradling your baby in your arms, banging on a pot with him while singing your favorite tune, or all dressed up as a princess in her favorite castle. IT is YOU that helps your child make connections, build experiences and help get the ideas flowing. With time, you will start to see your child bring in their own ideas from their own experiences and begin the process of thinking, learning and creating.

Here are just a few ideas for toys/household items that will facilitate the fun, creative play above:

Infant: Laundry basket, Books, Stackers/nesters, any time/anything that supports face to face interactions with your child! Get down and view the world from their eyes!

Toddler: Pots/Pans, Hats, Buckets/Balls, Bubbles, Bowls, Beads, Blankets, YOU!

Preschool: Tents, Puppets, Plush Toys, Boxes, Dress Up (be creative with what you have!), YOU!

Embrace the magic of your child and see the world through their eyes! Thank You Miss Lori for this reminder!

By: Lori Jenkinson, SLP-CCC

Buy This…Not That: Infant “Chairs”

Buy This: Bean Bag! For positioning infants who are NOT rolling yet! Here’s why:

Our babies are born with the innate desire to be upright, mostly driven by vision. However, for the first several months they do not have the postural control to hold themselves up against gravity. All the work they do on the floor, being carried, transitioned from position to position, getting diapered and clothed provide opportunities for their bodies to respond and react and, eventually, to anticipate and initiate. These daily activities provide the foundation for postural control and eventually independent sitting, standing, and walking.

Despite not having control, sometimes babies want to be upright out of DESIRE to see more or NECESSITY to digest the latest meal without spitting it all back up. And though we love to cuddle with our babies, we can’t always be there to hold them in supported positions. We have to do laundry, make meals, SLEEP, take showers, make phone calls, answer emails, etc. We then have three options: put them on the floor on tummy or back, wear them, or put them in some sort of container. Though the floor is a position of choice and one that we advocate to try first, it does not resolve the issues stated above.

The market has attempted to answer this call with myriad products: swings, infant seats, bouncers, walkers, standers, jumpers! All are designed to position your infant in a place that he can’t get to by himself, often relying on postural control that is not there yet. We’ve all seen the infant in their seats, sliding down to the base, falling down to the side, held up only by small straps that protect them from falling out, but doing NOTHING to help align the baby and protect his body and joints while in the seat.

Enter Bean Bag: thought of as a suitable chair for toddlers, preschoolers and up, but rarely considered for an infant, especially a young, 0-4 month baby who is not yet rolling. Just make sure baby is awake and being watched closely.
-Bean bags are portable: they can be carried in a single hand and squeezed through narrow places. They don’t have metal legs or corners that slam into your leg or twist your wrist as they are transported place to place. They can be placed in front of a large mirror, right next to your chair by your computer, in front of the bath tub as you bath your other children, or in a “circle time” reading group with siblings before bed.
-Bean bags are moldable: you can manipulate them to precisely fit your baby in order to support whatever position you want. You can change the angle your baby sits in, tilt the baby slightly left or right to keep pressure off the back of the head or to help aid digestion (RIGHT side). You can even mold them to hold a book!
-Large bean bags are secure for a baby who is not yet rolling: Once baby is positioned and supported, you can push up the sides, top and bottom to create a barrier.
– Bean bags with a blanket (especially ones with waterproof backing) laid over the top are EASY to clean after the inevitable leaky diaper or spit up. No wrestling to get covers off frames that then leaves your seat useless until the laundry is done. Just throw first one in hamper and place another blanket down!
-Finally, bean bags are far less expensive than most infant seats and other containers and are functional pieces of “furniture” for your entire family! They grow with your child

Bean bags are an ideal answer when your pre-rolling infant needs to be in a more upright position compared to the floor. However, bean bags are not a surface that encourages a lot of body movement. Because the head and body are supported well, this is a good place to work on eye gaze and visual tracking as well as reaching with arms/hands. Note of caution: Once baby is rolling and trying to sit up, they can fall off of bean bag unless they are secured down with a strap and buckle. Watch for a future post about sitting options for infants who are moving more but not yet sitting independently.

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In the meantime, we would love some feedback or stories about how you use bean bags in your family!

“Not That: An Infant Chair to Avoid.”

Most infant chairs out there are okay to use in small doses with your pre-sitting baby, especially if you use towel rolls or a Snuggin’ Go  to help align your baby. Remember, though, straps in chairs are for safety only, they do not help align your baby properly. Most infant chairs are okay because they provide full support of the back and head in a reclined position.

However, there is one chair that we do not recommend: the Bumbo. This chair is designed to have your baby sit upright before she has the capacity to do so, and there is minimal if any capacity to modify it enough to provide good alignment because it does not support the entire back or head. A baby often sits with a rounded back, and leans on the sides, relying on the chair to hold her up. Undo stress and strain are placed on joints and muscles are unable to accommodate because they are not developed enough.

Parents often believe this chair is okay because it simulates the position of upright sitting parents often facilitate by placing their hands on baby’s trunk. However, the crucial difference is that your hands are directly on your baby, providing dynamic support that responds to your baby’s needs to stay in the middle. The Bumbo is a static plastic chair that does not move, respond or accommodate. It allows your baby to lean into a surface to remain upright, which in addition to placing stress on joints teaches them through practice how to be upright without turning on core muscles. We want our babies to spend this precious, short amount of pre-sitting time developing foundations for movement, not compensation strategies that can affect development of more advanced motor skills.

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So, we therefore recommend that you save your money with this product. For other strategies to help teach your baby to sit independently, see our recent blog, Independent Sitting: How to Get There.

 

 

Buy This…Not That: Books

Books are a wonderful gift! This post will focus on babies up to 12 months but my 3 year old still enjoys many of these – at a different level.

By 6 months, vision is developed enough for baby to recognize some images and to begin understanding that pictures represent objects. Baby starts to prefer certain pictures, pages, or even entire stories read over and over! While you read, your baby will respond by grabbing for the book and vocalizing. By 12 months, your child will start to help turn pages, pat or start to point to objects on a page, and repeat your sounds.

Buy This: for this age, look for board books that are sturdy, that can be propped, and small enough for baby to try and hold – and taste! Babies love books with photos of babies, bright colors, textures, flaps and familiar objects. Also look for simple content with language that is short and repetitious.

Some Favorite Books in Our Home: Baby Faces, Colors, Giggle Baby, Peek-a-Who. Some Favorite Authors: Karen Katz (Where is Baby’s Bellybutton?), Sandra Boyton, and Eric Carle. A small plastic photo book with familiar faces is another great idea!

What are your family’s favorite books/authors?

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Yesterday we covered “Buy This: What to look for in Books for Babies.” Today is “Not That: Things to Avoid in Books for Babies.”

Avoid books that are too wordy. You can always reword some parts, skip parts, etc. but remember you will be reading some of these books A LOT! The book on the left shows a great starter book – one color and one picture. The book on the right introduces many images, some of which baby may not even know (eggplant, beet).

Avoid books with fragile pop ups and paper pages. Choosing durable books in the early years will allow your child to explore the book, attempt to turn pages without the risk of tearing/ripping.

Avoid books that are too long. Attention span can be quite fleeting when babies start to move since that becomes quite a focus. Be okay with reading only a page or two!

Avoid the same type of book: Provide a variety, limit books that are too repetitive and look for those that rhyme! Babies seem to love those!

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Here are some great Do’s and Don’ts when reading with your baby. It is so important to remember that it isn’t always about the content but about the actual act of reading. Speed up, slow down, point at pictures, make different sounds, etc. Realize that you won’t always finish every book, that your baby may lose interest. Have books throughout your home, in your car, diaper bag, etc. as an easy tool for distraction. Take the time to snuggle your little one and read the book through the eyes and heart of your child!

And to complete our “books” topic, check out this link called “Love Books!” It is a collection of many different blog posts of book reviews and corresponding activities! How cool is that — especially for our older kiddos! Can’t wait to check some of them out!
Happy Reading!

Disclaimer
The content on this website is based on Wendi’s personal and professional experience and general research. It is not meant for individual medical diagnosis or treatment. If you are concerned about your child, please consult with your primary physician and/or therapist.