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Buy This…Not That: Books

by Wendi McKenna Infant Development, Parent Strategies, Toys/Equipment

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!

Tracking Tummy Time to Prevent Plagiocephaly and Torticollis

by Wendi McKenna Infant Development, Movement, Prevention, Tummy Time

The importance of tummy time play cannot be overstated. Since the introduction of “Back to Sleep” in 1994, many published studies have cited an increase in medical diagnoses such as plagiocephaly, brachycephaly and torticollis*(see below for descriptions) and developmental delay of gross motor milestones. Though this program successfully cut in half the rate of Sudden Infant Death Syndrome (SIDS), the rise of other mostly-preventable diagnoses illustrate some of the unintended consequences of “Back to Sleep.”

Many parents are anxious or even fearful about the tummy down position because of its connection to SIDS. Just because an infant is awake, that anxiety does not dissipate, so parents often avoid placing their infants on their tummies from the start. In addition, parents are not aware of the importance of tummy time when babies are awake, so there is little reason for them to even try.

Tummy time is important for many reasons. Babies are often positioned in utero in asymmetrical positions, and many stay in the same position for most of pregnancy. These asymmetries do not disappear overnight after babies are born. They need to be worked out with babies’ spontaneous movements against the floor and gravity. Babies need to have plenty of time to move freely on the floor, to be out of containers such as car seats, infant seats, swings, and strollers. The position of choice when putting an awake baby down should be tummy down. Newborn babies do not have the strength to lift their heads for sustained periods of time. They rest their head on the floor with their cheek in contact and their neck turned 90 degrees. As long as they position themselves looking both directions, gravity and the floor provide a long, low-load stretch on the SCM and other muscles implicated in torticollis. Tummy time also eliminates any pressure on the back of the head, preventing flatness or allowing any flat spots to round out.

Parents should look at their baby from head to toe after birth to look for any asymmetries in baby’s preference for turning his head or flexing his body one direction or another. Parents can also take pictures of head shape over time to ensure that any flat spots round out. Keeping a photo diary or a log of activity over time helps parents to determine patterns that either exacerbate or alleviate any asymmetries present at birth.

I looked at a few different smart phone applications that would help me do just this after my son was born. I settled on iBabyLog, which is a great tool to track nursing, diapering, sleeping, and activity schedules (many other categories are also available for tracking). I can customize my comments, take photos, and easily look at patterns over time to track progress. For example, when putting my newborn son down for sleep, I make sure that he looks to the left one time and then to the right the other. When working on awake tummy time, I also track the time he looks left versus right. With the ability to track and summarize positions and alignment over the day and the week, it is easy for parents to notice any asymmetries that are present. And, at this very young age, parents have the power to fix asymmetries early with great results.

Using iBabyLog or other tracking tools to document positions during sleep and awake times can help parents to be more aware of their baby’s alignment. Proper alignment is a crucial foundation to symmetrical movement, which is essential for baby to properly achieve motor milestones. By being aware and tracking some of the foundation elements of movement, parents can intervene early and prevent medical problems in alignment and movement from ever occurring.

*      Plagiocephaly is a misshapen head secondary to abnormal and asymmetrical forces placed upon the skull as an infant’s head is growing. It causes a diagonal asymmetry with flatness on the back of one side of the head and protrusion of the opposite forward side. It affects the shape of face, position of eyes and ears, and shape and symmetry of joints of the jaw and cervical spine. Since “Back to Sleep” began, the incidence of plagiocephaly has increased from 1 in 300 to 1 in 15. Though many pediatricians state that misshapen heads are merely a cosmetic issue, there are two very important joints that articulate with and are affected by skull shape: the jaw (TMJ) and the upper cervical vertebrae (OA). Atypical alignment in any joint, but especially those that require simultaneous action of two sides, increases abnormal wear and tear, leading to premature joint breakdown, arthritis and pain. Though this is a well-known and accepted medical phenomenon, because the first “Back to Sleep” babies are only 18 years old, long-term consequences of this specific malalignment due to misshapen heads have not yet been documented in medical literature.

*      Torticollis is a shortening of the sternocleidomastoid (SCM) muscle on one side of the neck. Other neck muscles can be involved as well, but this muscle is most often implicated because of its long ropelike and very superficial location. When this muscle is short/contracted, your baby will have a head tilt to the same side, rotate to the opposite side, and prefer to extend head backwards rather than tuck his chin. Babies often avoid turning their head in the other direction and cannot achieve midline orientation of the head. Torticollis can be congenital, most often due to position in utero, or acquired, often due to asymmetrical head shape and positioning, such as with plagiocephaly. These two diagnoses frequently present together.

*      Brachycephaly is a flatness on the back of the head that is more symmetrical from left to right, but causes protrusions laterally on both sides, making the face and head wider than otherwise would be. It reduces the space for the cerebellum to grow and decreases the distance between the back of the head and spinal cord, possibly placing the spinal cord at greater risk for injury with any head injury. It also changes the orientation of jaw and cervical spine joints. Brachycephaly is due to constant pressure on the back of the head from sleeping and positioning in infant “containers” such as car seats, infant seats, strollers, and swings.

What I DIDN’T Expect The First Year . . . or the Second & Third Year!

by Wendi McKenna Infant Development, Sleep

My boys are now 3 months and 3 years old.  I find myself obsessed about the same thing with both of them, something I didn’t expect to be so obsessed with, something that I try and ensure that my boys get enough of each day.  Can anyone guess?  The “word on the street” (as I steal a phrase from Sesame Street) is SLEEP!!!

As most first time preggo mommies do, I devoured many a book when I was pregnant with #1 but did not even think to look into “sleep books.”  Isn’t that what babies do – eat, SLEEP, poop?  It’s simple – feed baby then baby sleeps peacefully in the super fancy crib in the super cool nursery you designed!  For many, this is how the story goes and the family travels happily down the proverbial sleep road.   In our case, it was different.  When baby #1 was about a month old and our lives had settled a bit, I was wondering why sleep was so tough for him.  I was obsessed with Googling (that’s got to be a word now) everything about infant sleep.  I was bonding (and continue to) with other new moms over this exact same topic at play dates, play gyms, and parks.   Early on, I relied on Dr. Harvey Karp’s “Happiest Baby on the Block” book and the 5 S’s.    As baby #1 got older, sleep (getting him to do it for a long period of time by himself) continued to be challenging.  By the time my first was 10 months old, I had read about sleep everywhere, gotten all of the advice I could stomach, and finally hired an online sleep consultant.  The sleep consultant was to advise me with MY child’s/family’s specific needs and to keep me accountable to follow through with changes that I knew would be extremely hard.  Since then, we have had waves of good and bad sleep – making it through sleep regressions, teething, and now, working through being scared of the dark.  Best advice: sleep begets sleep.  No matter how many times I try and trick the “system” and have my son stay up later so he sleeps later, it is an epic fail!!!

When Baby #2 came, I thought I was prepared.  I was armed with my “I am not going to do it like I did with Baby #1” sleep plan.  Well, at 3 months, it is better but not perfect!  This time, I have tried to get a routine/rhythm sooner.  This is out of pure necessity of needing time to take care of my 3 year old and take care of life.  The routine that I found most helpful is Tracy Hogg’s “The Baby Whisperer” EASY.   E = eat, A = activity, S = sleep, Y = You Time! The hardest part: the YOU time since I am trying to be “super mom!” The best part — knowing the general flow of what to “expect” in terms of how long baby should be awake at certain ages.  For example, at 3 months, Baby # 2 should be awake about 80 minutes before going back down for a nap and should nap about 3 or 4 times per day.  All babies follow similar sleep stages: I should look for yawns, and have him all but in the co-sleeper by yawn #3!!!  It doesn’t always work but it is better.  Best advice: even at a young age, there is a “flow” (if baby is healthy medically).

So, why this blog now?  Because there was one bump in the road that blind-sided me and, it is coming up again!  DAYLIGHT SAVINGS . . .November 4th . . .  there is no stopping it.  For those of you that have kiddos that can easily adjust, Yay for you and cheers to your extra hour of sleep.  For those that have babies and little kiddos that still struggle with the change,  the baby sleep site is always helpful to me.  “Falling back” is the hardest because even if we are “sleeping in” until 5.30 – that means a crazy 4.30 wake time soon.  Time to start preparing.

More reviews of our preferred baby books/references is coming soon to this blog but I simply wanted to share my “real life” reflections and obsessions.  I am still so amazed by my children and their development.  I have a 3 month old who is just learning about himself and his world, that his smile makes mommy smile, that his voice makes sweet sounds too, and that he has hands and they are cool.  I have a 3 year old whose hands are busy all day building, writing, coloring and who likes making things “dis-pear” by saying “abracadabra,” spending time in his pretend schools, forts, zoos, and oceans, and talking himself to sleep!   I can imagine a time soon when both boys will be difficult to wake (like their daddy) and I will be Googling “ways to wake up your teenager.”  Until then, I will keep traveling along this sleep road hoping that the gets easier.  Even though I am sleep-deprived and sleep-obsessed, I am blessed!  Sweet Dreams and Sweet Sleep for All!

~ Rachel

Tummy Time, Part II: Newborn to Four Weeks

by Wendi McKenna Infant Development, Movement, Tummy Time

The tummy down position for newborns looks awkward to adults. Babies have their little tushies in the air like a beetle, their legs tucked underneath them, and all their weight pushed forward on their upper chest and face. To most of us, that position looks like torture. To others, it may remind them of the yoga “child’s pose” that is meant to relax and center us, bringing our spirit back to a state of equilibrium. This position is actually exactly what a newborn infant needs to help calm and give them the opportunity to learn how to self-soothe. When newborns are on their tummy, the floor provides support to counteract the ballistic movements that are typical and can disorganize babies’ states of consciousness. Their arms are tucked underneath them with their hands conveniently close to their faces and mouths. Newborns frequently get their hands to their mouths when in this position. However, when on their back, they do not have the motor control to easily reach their hands to their mouths. The floor provides that support.

Full term, healthy newborns can turn their head each way and effectively clear their airway when awake and placed on a firm surface, so there is no need to be concerned about suffocation when baby is in this position. They drag their faces, including cheeks, lips, and chin across the floor, which provides rich sensory information to those parts of the face. Again, conveniently, these are the parts that are essential for feeding; the extra sensory information provided by the floor causes more frequent firing of neurons in this part of the brain, and strengthens the pathways that are needed to reinforce successful feeding.

In regards to vision, newborn infants see best 8-12 inches from their face. When on their tummy, parent and caregiver faces and voices (the best toy around) can easily be positioned in that precise spot so you can marvel, talk to and bond with your baby where they see you best. It also gives the parent an opportunity to lie down: Something all new parents need to do!  Also, if babies’ hand happens to move a bit away from their face, they can visually regard it and start learning about self-discovery: Wow, that is MY hand!

You can also start working on the coordinated connection/integration of auditory and visual information with behavioral/motor responses. By positioning yourself on the opposite side of way baby is facing and softly calling to your baby, they will first hear and then listen, locating your voice and the hearing sound of their name, responding with motor movements to try and turn their head the other direction in order to SEE the source of what they heard. This simple game helps to connect sensory information with motor output AND ends with an amazing gift to both you and the baby: They get to see your smiling face! Added bonuses are that they 1) crossed midline in the process, which strengthens the integration of right and left sides of the brain, and 2) practiced looking both directions, increasing mobility, length, and strength of joints and muscles on both sides of the body. It truly is amazing how a simple game can positively affect so many systems and contribute to their development and maturity.

One of the best ways to ensure that your baby likes tummy time is to start at birth. If your baby is still not tolerating this position well after consistently practicing throughout the day for a couple of weeks (such as short times after each diaper change), there are many ways to modify the tummy-down experience to make it easier and more successful. Try chest to chest tummy time, lap soothe tummy time, and tummy down carrying. If you are still struggling to help your baby enjoy this time, live workshops and individual consultations are available in the San Diego area and online video consultations are available for those further away!

A recent search for online videos of infants on their tummies highlighted a misconception that many parents have. Despite the very calm, happy babies that were on the floor on their tummies for minutes at a time, parent’s voice-overs indicated they thought they were torturing their babies, that they were doing this merely to follow doctors’ orders to force their babies to “workout.” Rather than interpreting what your feelings would be in this position, take the time to read your babies’ expressions. This position is one that calms and nurtures our newborns’ immature systems; it provides rich sensory and motor experiences that no other position provides; and it allows the opportunity for babies to build foundations in these domains that will positively contribute to development for the weeks, months and years ahead. Enjoy this position with your baby; it is one of the easiest and least expensive ways to support your babies’ development.

Tummy Time, Part I: Why are we talking about this?

by Wendi McKenna Infant Development, Tummy Time

The “Back to Sleep” program, introduced by the American Academy of Pediatrics after comprehensive research from multiple continents, was one of the most successful public relations campaigns. From 1994 to 2006, the frequency of babies placed on their backs to sleep increased six-fold while at the same time the SIDS rate was reduced by 50%. However, there have been many unintended consequences. Before the back to sleep program, infants had a combined awake and asleep time on their tummies of at least 18 hours per day. We are lucky these days if infants experience even 30 minutes per day. That is a lot of time lost in a position that is imperative for proper development in many domains and body systems. Research has repeatedly shown that a lack of tummy time contributes to gross motor delays such as lifting head up/head control, rolling over, pushing up and crawling. However, tummy time is imperative not only for gross motor development, but for the foundation skills required for fine motor, oral motor, body awareness, vision, and self-soothing skills. This series will address the importance of tummy time from birth to seven months, provide benchmarks for each stage and the developmental importance of tummy time for many domains and body systems.

A parent’s anxiety about tummy time can negatively affect how their infant perceives and experiences this important position. SIDS is a scary thing, but parents feel they have a strong, effective tool to help combat the likelihood of it happening to their child: by placing their infant on their back to sleep. Unfortunately, even if a parent understands that it is during sleep time that the back position is important, it is difficult to turn off that anxiety about the tummy time position even during awake hours.  In turn, when a baby fusses or cries while on his tummy, parents swoop in to rescue them versus calmly trying to modify the situation to truly figure out why the baby is upset. Babies have great instincts and they figure it out quickly that the tummy is a position that should cause anxiety. Thus, many babies do not tolerate it well.

There is much parents can do to help babies develop happy routines on their tummies. The easiest way to start is at birth when a baby is used to being “smashed.” A full term baby’s house is very small before birth when she is most often supported in a “fetal position” by the uterine walls. After birth, the floor can also provide that kind of comfort barrier. Because it is more difficult for babies to remain in a flexed position on their back, often nurses and families choose to swaddle to contain them as if still in utero and to support them before their muscles really have had a chance to first stretch out and then learn to move efficiently and with control against gravity.  The tummy down position after birth is comforting. If it is repeated frequently and consistently everyday, trying it first whenever you place your baby down, it remains a very comfortable position and a place where your baby can happily learn to move, play and grow.

For a photo essay and general description of what to expect the tummy position to look like from newborn to seven months, see blog post, Madeline’s Tummy Time Journey: Birth to Seven Months. Future blog posts will also describe this journey in greater detail to explain why your baby’s posture and movement changes as she matures. Stay tuned!

Independent Sitting: How to Get There!!

by Wendi McKenna Infant Development, Movement

Independent sitting is an empowering milestone for your baby to reach, usually around six months. Baby is upright and sees the world from a completely new perspective. Baby has two free hands to reach, grab and manipulate and explore objects. AND, parents have a baby who can more easily entertain himself for a while without worrying about him crawling away…yet.

The sitting position is also very new from the perspective of posture control. For the first time, baby will control a position where his body and head cannot immediately contact, lean or rest on the floor or other surface. This requires balance with finely graded muscle control, strength and endurance in the neck, trunk, and leg muscles.

Usually baby wants to be upright before he can safely stay there independently (they often fall backwards when first trying to learn to sit up). Before you use props such as the very popular Bumbo chair, please make sure baby’s alignment is appropriate: 1) legs out in front on a flat surface rather than tucked underneath him or propped or in a wide butterfly position; 2) pelvis and back straight rather than rounded in a C-curve; and 3) head in midline rather than tilted one direction. Babies younger than five months usually do not have enough strength or control to practice sitting upright by themselves, even in a propping device. If they do sit in a propping device, they will more than likely be leaning heavily into the support barrier rather than trying to move away from it. However, if sitting alignment is good and baby is just learning the finer points of control before he achieves full independence, feel free to provide a safe environment for him to practice.

Three options (of many):

1. Place baby between your legs as you both sit on floor in long sit (legs in front, knees straight and knees/feet pointing up or slightly outward). Provide contact to the sides of baby’s hips with your legs and have baby reach for toys in front and slightly to the side. You can also rock side to side to provide sensory input about weight shifting, an important foundation of movement. As he develops more control, increase the space between your legs and baby’s hips so there is a wider gap and a larger space for him to control. Place toys in different places in front and to the side (first just outside one foot, and progressing backward closer to hip). The more baby has to reach outside the immediate base of his legs, the more control he needs to contact and grab the toy and return back to the middle to play. Also, the further back the toy is placed from toe to hip to behind the hip, the more he has to weight shift over his hip and rotate his whole body, making the movement more complex. Just remember that the baby’s goal is to get and play with the toy, not necessarily to learn to sit independently. So please let baby play with the toy once he gets it rather than taking it away and having him practice the move again.

2. In a small open box that is stabilized so it won’t tip over, baby can sit with legs in front and toys placed inside box, on walls or dangling above. You can also cut a few holes in side of box for baby to discover and explore. The walls are close enough to provide a barrier so when he does lose his balance, he falls into the side wall rather than all the way to the ground. The walls should be close enough to the baby so that he can push off them and recover back to the middle by himself. The box walls are also close enough and high enough so the impact from the “fall” is distributed across more of his body and the velocity of the hit is very slow, keeping him safe from injury. As he improves, you can use a bigger box so there is more room for him to move, make mistakes and learn from them. Finally, transition baby to an open space on the floor with baby surrounded by pillows or other soft objects, just in case he loses his balance and falls completely. In this case, you will probably need to help him get back into sitting. The box option (as long as it is stabilized and won’t tip over), allows baby to safely practice sitting without you being immediately present as in option #1.

3. Part of sitting independently is being able to control getting into and out of sitting independently. Babies typically master independent sitting when placed in the position by a parent before they can get there by themselves. However, if you practice the transition from sitting to floor and floor to sitting every time you set baby down or pick them up (even starting at birth), they will start to get the idea of how to move in and out of the position and have an easier time learning it. See “Moving in Gravity” blog post for more detailed information.

Most of all, have fun helping your baby achieve this wonderful motor milestone.

Moving in Gravity

by Wendi McKenna Infant Development, Movement

As adults, we take for granted movement in an environment dictated by gravity. We lie down, sit, stand, walk and run all with assistance from a surface beneath us. We are grounded.

Babies, however, are not. When born, they are dealing for the first time with the concept of gravity. They have independent movement, but not independent mobility. It takes them months to figure out how to move in a controlled manner through space, first by rolling on the floor, then transitioning to sitting, crawling, pulling to stand, cruising along surfaces, and finally, walking! We know that the foundations of movement for these motor milestones are best developed when baby is placed on his tummy from the start, but there are other ways to introduce and practice these essential basics.

When we move our babies through space, picking up and placing, picking up and repositioning, picking up and handing off, we often don’t think about how this feels. If we put ourselves in our babies’ “shoes,” however, one can imagine that this might feel a bit overwhelming, where you don’t have much control, and that gravity that held you down in one spot all of a sudden disappeared. Adults don’t jump or fly from one position to another, but yet, that is exactly what we are imposing upon our babies. Imagine instead introducing the concept of a controlled weight shift, which IS how we move. Combine this with talking about the movement you are doing with them and you have provided a rich, multi-modal, experience of movement. You teach them what movement is supposed to feel like and you’ve drawn attention to parts of their body and what they are doing in the present moment. These strategies are especially useful for young babies that are more sensitive or that tend to startle with changes in movement and position.

An example of this kind of handling is when placing baby down for diapering. Rather than just placing baby down on her back when changing her diaper, try to have the first point of supported contact on the table, pad, or bed be her bottom and legs, as if sitting. Then slowly shift her over one hip and lower her down to her side, finally rolling her onto her back (the next time you place her down, transition over the other hip). If this is difficult to imagine, perform the transition yourself as if you are going from a sitting to a lying position in bed, then help your baby do the same movement. She will not help you at first, but you are providing the sensory experience of movement that will eventually be the way she does it independently. Practicing both sides will help develop symmetry. If you perform this movement every time you change her diaper, she will expect it, anticipate it, respond better and start helping you more. You have given her an opportunity to explore her own independent movement rather than only relying on you. You can reverse this transition to then pick her back up from the table.

Now, think of other times during the day when you pick up and place your baby. How can you alter these experiences to mimic more closely what she will do when moving independently? In our somewhat sedentary culture, it’s never too early to introduce independent movement and provide positive and happy experiences associated with movement to start instilling the value of active play!

Madeline’s Tummy Time Journey: Birth to Seven-Months

by Wendi McKenna Infant Development, Tummy Time

This series of photos and captions follows one baby girl, Madeline, from six days old to seven months in order to illustrate the typical progression and development of posture and movement skills while on the tummy. Disclaimer: Rather than choosing to use infant seats and other containers, Madeline was placed on her tummy first every time she was put down on the floor. She practiced tummy time regularly and usually enjoyed more than 60 minutes per day from birth and more than 90 minutes per day after three months of age.

At six days old, baby Madeline shows appropriate physiologic flexion and is supported by the floor happily in tummy time! The floor helps to prevent startles and providers her the opportunity to see her hand and get it to her mouth to start learning self-soothing skills. The floor serves as a soothing confinement, similar to the sensory experience of being in the womb. Though she occasional works to lift her head away from the surface, she is content to relax into the surface.
At 27 days old, baby Madeline’s legs are more extended at her hips and knees, allowing her pelvis to drop and weight to shift backwards a bit. Her arms at the shoulder and elbow are also stretched out more, allowing them to come away from her body, though her elbows are still behind her shoulders. She can lift her head higher, but total clearance from the floor as she rotates side to side is not a regular occurrence. VISION is a key driver to help “right” the head so her eyes approach the horizon. This natural drive to reach the visual horizon is essential for development of head control.
At six weeks, Madeline is more disorganized in her postures and movements than when she was birth to four weeks because she has had sufficient time for flexor muscles to relax and stretch out, but not enough time to develop active, controlled contractions against gravity. Head lifting while on tummy is typically unilateral so that her head is slightly rotated one way or the other rather than controlled in the middle. Babies can lift head to 45 degrees briefly, but there is still a lot of head bobbing.
At eight weeks, Madeline’s pelvis continues to drop because hip flexors are stretched out more and head lifting is easier because of 1) increased mobility in cervical/neck and thoracic spine; 2) increased strength in extensor muscles against gravity; and 3) a strong desire to lift head because of vision and vestibular/inner ear righting reactions that work to maintain eyes on the horizon and nose on the vertical. Postures are still asymmetrical, elbows tend to be behind shoulders, and there is inconsistent weight bearing through the arms.
At eleven weeks, Madeline demonstrates more extension in the spine and, finally, the ability to get the elbows in front of the shoulders for more effective weight bearing on the arms. Babies at this age to three months should hold their head steadily at 90 degrees, maintain midline position and rotate each direction.
At 14 weeks, Madeline can easily hold her head up to 90 degrees with elbows in front of shoulders. She shows great symmetry between left and right sides on tummy and all other positions. By this age, babies should spend at least 90 minutes per day on their tummies.
At four months, Madeline is starting to play with the swimming position where head and all limbs are extended off the floor. She will alternate between swimming and bearing weight, which is important to develop co-activation and symmetry between the front and back muscles.
At five months, Madeline is far more proficient moving around on her tummy, pivoting, shifting, turning, and dragging or pushing herself around. She controls lateral weight shifts because there is now symmetry between the flexor muscles and the extensor muscles of the body. Madeline is showing elongation on the left weight bearing side and shortening on the right non-weight bearing side. Those side tummy rolls say it all. 🙂
At six months, Madeline is performing a straight-arm plank, challenging herself to discover what her body can do! She moves easily around on her tummy, rolling, scooting, and pivoting independently. She sits independently when placed and is working on the transition from floor into sitting as well as the transition to hands and knees and rocking back and forth…getting ready to crawl! At this point, tummy time is usually a position for transition rather than the end product because she is independent balancing in upright positions. She has more access to her environment, people, and toys when sitting, where both her hands are free to explore and manipulate objects.
At seven months, Madeline shows us ultimate control of her body while on her tummy. She has shifted her weight over her right side, balancing without falling while reaching her left hand across her body. Movement like this requires precise balance and control of muscles on the front, back, right and left, all working in coordination with one another. Her body is active from her head to her toe. At this time, Madeline is capable of getting onto hands and knees and transitioning from her tummy to sitting by herself.

 

Practicing best practice

by Wendi McKenna Infant Development, Tummy Time

It has already been 4 weeks since Baby #2 arrived!  We have gone from the newborn “shock” and calm from leaving the comfy, cozy womb to truly being more awake, alert, and aware.  I have also had 4 weeks of working to practice what we preach in our Tummy to Play Everyday Classes.  I am a second time mom and now work to manage (aka juggle) a 3 year old, a newborn, a household chores/errands, and, oh yes, trying to “sleep when baby sleeps”!

I think that I now have a unique opportunity to blog about the reality of implementing much of what is presented in our classes . . .  when life happens.  So, here it goes . . .

  • Start Tummy Time Day 1:  Check!  Have done it every day.  One of our favorites is tummy to tummy.  It is so peaceful to watch a little one sleep but I sure would love some too!  We have managed to do true tummy time on the floor one time each day.  He is not always happy and begins to fuss after a while.  BUT, I do change his position or modify something before picking him up (ie. Put him on his side, eye level smile, sing, pat his back, etc.).  It definitely helps for a short time.
  • Leave the Carseat in the Car: I have ventured in to the doctor and the grocery store using the Sleepy Wrap only.  I find it much easier to go “car seat free” in public when with just the baby.  It is much easier to chase after the older one because “his listening ears weren’t turned on” while pushing a stroller vs. having a newborn in a carrier.  The car seat does stay in the car when we come home – a tremendous change from Baby #1.
  • Container Culture:  Hello, my name is Rachel and I use a container with my baby!!  My first son really only wanted to be held or be in a carrier – which became quite exhausting!  With Baby #2, we have more variety: held in arms or a carrier or being in the Co sleeper, pack and play, and the bouncy seat.  This baby still has yet to enjoy the swing.  The bouncy seat has been so useful for short periods of time for mommy to grab a shower, a peaceful meal, and also gives him a different view of the world!
  • Making Movements Meaningful:  Another tip that has been difficult to implement ALL the time: meaning all diaper changes, all transfers between caregivers, etc.   Yet, I find myself doing it more automatically than 4 weeks ago and definitely more automatically than with Baby # 1.
  • Symmetry:  Wow!  This has been the toughest one!  I am a physical therapist that works with children, have had one baby already, and still find it difficult and awkward to switch to my right side when carrying, bottle feeding, etc.  I didn’t realize just how difficult it would be.
  • Bonding: I love this part!!  My favorite times are our tummy to tummy play and snuggles, when baby is fast sleep in the carrier making cute baby sleepy noises; talking to baby about what he is doing, what I am doing, what we are doing together; making faces and imitating sounds; and kissing every sweet baby part on that lil monkey (cheeks, fingers, belly, toes . . you know).

I will continue work daily to practice what I preach and love the knowledge that I have gained by doing these Tummy to Play Classes.   Let’s continue on this journey together as our children move, play, and grow!

Rachel

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.