What babies need

Four legs good, two legs better!

Four legs good, two legs better! (Photo credit: dullhunk)

Dr Howard Chiltern, an experienced paediatrician from Sydney, was recently interviewed by Margaret Throsby on ABC-FM. He has written books about babies, and gives regular talk to parents, grandparents and anyone else who is interested, about how to look after babies in the first 12 months of life.

He starts with the interesting claim that human babies are born “premature” –  we stand erect, our pelvis is twisted, the hip joints need big buttresses, and so the pelvis is narrowed compared to other animals. This is an adaptation to walking erect as bipeds. It means that babies come out immature, with only 25% of their brain formed – so we need a tribe of people around to look after us.

A baby is not an independent little person who can make a decisions – there are all sorts of myths about teaching the baby what to do and not reinforcing undesirable behaviour, but the baby at birth is a foetus – and therefore should be kept in a fetal environment. You can’t teach him to sleep on his own and change has feeding times to fit in with you. 25% of the baby’s brain is formed at birth – the other 75% is the connections made between the neurones – which develop rapidly. The weight of the brain doubles in the baby’s first year of life, and this is all in the connections between neurones.  A lot of this depends on the environment.

Crying is their only means of communication  – it doesn’t mean they’re miserable – it is always a form of communication.

When the baby is crying, a parent goes through a checklist of things that might be wrong. Babies cry because of anything that threatens a baby’s survival – hunger, being lonely – which is a survival matter – and they want to be warm.

It is a myth that picking up a baby when it is crying reinforces crying, and you will creating  rod for your own back. It is the opposite. Picking the baby up quietens the baby and helps the baby eventually to individuate and become independent.

The most common reason they cry is because they are stressed. The main cause for stress is too much stimulation. Babies are not happy about coming out of the womb.

Babies are not all alike at birth. Temperament is on a normal distribution curve. 20% of babies are self-soothing. These are the ones whose parents say they are good babies, sleeping through the night – “isn’t yours?” At the other end of the spectrum, are the 15% of babies who are super sensitive. Others are in the middle of the distribution – for 2 or 3 days a week he’s a bit ratty. Parents learn to soothe the baby by seeing his signs and responding to them. That’s the essence of good parenting.

With 2nd babies parents are more relaxed. Parents treat their 1st baby as if it was made of crystal. Babies are as tough as old boots. They really are well adapted to dealing with the world.

There is no such thing as colic. At 4 – 6 weeks of age babies get upset and look like they are in pain. They cry and draw their legs up, as if they have a stomach pain. It’s nothing to do with pain. If you can calm the baby down, they will be OK. The pain lies with the mind not the gut. If you settle the baby down, he will settle. If you just cuddle them they will take time. You have to down-regulate it gradually. They have high cortisol levels, which take time to come down. “Bore your baby to sleep.” Don’t take him out into the living room in front of his brother or TV. Wrap the baby up, go into a quiet room, place the baby’s ear against your heart. Other things like going in car don’t calm them. Try to replicate life in the womb. Full flexion, swaddle, primitive reflex – startle – fling arms out – put against heart beat, put arms in, feed them if they are hungry or let them smell you. Create something like the environment inside the womb – reduce the visual stimulation level. They don’t have the off switch. They develop it at around 3 months They learn to switch off. Stick to plan for 3 to 5 days. It takes time to down-regulate. It needs an intense calming regime.

Sleep with mother because mothers sleep in a protective way, do not go into deep sleep – sleep with an awareness of baby – fathers sleep more deeply and are unlikely to be aware of the baby, although they can learn.

Women are nurturing, but for most women, nurturing doesn’t go any further than babies and partners, but does not extend to self. Women should do like the cabin staff tell them – first fit your own mask, then fit your child’s. Look after yourself first. Of course you have to get up when babies wake, even though you are tired, but many mothers lose themselves and become martyrs. Do not be the best mother you can be. Be the best woman, then mother. The best thing that grandparents can do is look after the mother, not the baby. We are designed to have grandparents. Baby’s first year is absolutely critical for the baby’s mental health. First 6 to 12 months is important. There can be other carers than the mother. In prehistoric times there were others caring for babies. If the child has carers, they must be loving, involved and interested in the child and keep the baby calm.

There are a lot of innate attractants to the breast. In developing countries the majority of babies are breast fed. Why are there so many mothers whose babies have trouble breastfeeding in the West?  If a baby is left between the mother’s legs after the birth, babies will take 100 minutes to crawl up the body to the breast. Encourage babies to latch. Give them baby-led latching. Do not do it by placing them. Mothers don’t have personal confidence about breast-feeding.

What about controlled crying in order to get into a routine? Controlled crying has a place after 1 year but totally inappropriate in first 6 months or 9 months. Crying is an evolutionary mechanism. If the baby is crying and the mother doesn’t come, crying extinguishes, the baby becomes silent, or you will be taken by a sabre tooth tiger. If crying, the baby has a high level of stress hormones, which remain high if the baby silences.

Co-sleeping – no alcohol, no drugs, no fatigue, so will drop into deep non-protective sleep. There must be a big bed, no toddlers, not too many covers, pick them up when they cry. Will create a nice confident reliable child who knows and trusts you.

Howard Chiltern’s latest book is Baby on Board (Finch publishing Sydney).

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