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BABY ACES: When we consider the traumas that qualify as ACEs, babies need their own list.

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Babies are obviously very different from older children developmentally, including their ability to understand and process trauma. Indeed, a baby may be completely unaware of an actual ACE— say, the incarceration of their father— which a middle schooler would be painfully aware of. Yet at the same t…

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Kathryn Stagg on baby brain development and responsive parenting

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Kathryn Stagg on baby brain development and responsive parenting

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Did you know that when you are cuddling, feeding, responding and playing with your baby, you are actually growing their brains? Babies are born with an immature brain and the majority of brain structure and function develops outside of the womb. Every interaction a baby has will help make those brain connections.

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Research on the link between breastfeeding and cognitive development:

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Research on the links between breastfeeding and cognitive development
Impact of breastfeeding on intelligence, educational attainment and income at 30 years of age in Brazil
This prospective, population-based birth cohort study assessed whether breastfeeding duration was associated with IQ, years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists.

The authors found that durations of total breastfeeding and predominant breastfeeding were positively associated with IQ, educational attainment, and income. They also identified dose-response associations with breastfeeding duration for IQ and educational attainment. Participants who were breastfed for 12 months or more had higher IQ scores, more years of education and higher monthly incomes than did those who were breastfed for less than 1 month. The results of this mediation analysis suggested that IQ was responsible for 72% of the effect on income.

The authors conclude that breastfeeding is associated with improved performance in intelligence tests 30 years later, and might have an important effect in real life, by increasing educational attainment and income in adulthood.

Victora et al (2015). Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth cohort study from Brazil. Lancet Glob Health, 3: e199-205
Notes

This is a ground-breaking study builds upon previous research as it links breastfeeding with improved cognitive, economic and social outcomes into adulthood

The results of this study are particularly important as the study design (prospective, population-based) means that the findings are likely to be robust

This study was carried out in Brazil during the 1980s when mothers from all social classes breastfed, so socioeconomic biases sometimes found in breastfeeding studies were absent in this case

It is unclear whether the effects noted in this study result from the nutritional content of breastmilk itself, or the nurturing behaviours breastfeeding encourages, or a combination of both of these.

Response to study suggesting that breastfeeding has little impact on early life intelligence and cognitive growth
In response to this 2015 study exploring the links between breastfeeding and IQ, we would like to refer our supporters to this statement, published by First Steps Nutrition, outlining the reasons why the study's findings should be discounted from any future systematic reviews.
Read First Steps Nutrition statement
Original study: Von Stumm S, Plomin R (2015) Breastfeeding and IQ growth from toddlerhood through adolescence
Breastfeeding and intelligence Horta, B. L. et al (2015). Breastfeeding and intelligence: a systematic review and meta-analysis. Acta Paediatrica, Special Issue: Impact of Breastfeeding on Maternal and Child Health. Volume 104, Issue Supplement S467, pages 14-19. Impact of Baby Friendly accreditation on breastfeeding rates, cognitive outcomes and maternal mental health
This study systematically reviewed evidence of the association between breastfeeding and performance in intelligence tests. It was found that breastfeeding is related to improved performance in intelligence tests.

Using data from the UK Millennium Cohort Study, these researchers found that women giving birth in hospitals that participated in the Baby Friendly Initiative (BFI) were up to 15 percentage points more likely to initiate breastfeeding and between 8 and 9 percentage points more likely to breastfeed exclusively at 4 and 8 weeks than comparable mothers giving birth in non-participating hospitals. Mothers from low income families, and with low levels of education, were more responsive to the BFI programme than highly educated mothers in more affluent families.
Del Bono E, Rabe B. Breastfeeding and child cognitive outcomes: Evidence from a hospital-based breastfeeding support policy. ISER Working Paper Series: 2012-29 Breastfeeding and child development outcomes
They then compared the outcomes of children who were breastfed as a result of the BFI program with those of otherwise similar non-breastfed children. They found significant effects of breastfeeding on cognitive outcomes throughout childhood, and in particular between ages 3 and 7. In contrast to the previous literature, researchers found no statistically significant impact of breastfeeding on a number of health outcomes, but saw an improvement in child emotional development and maternal mental health.
Huang, J., Vaughn, M.G. & Kremer, K.P. (2015). Breastfeeding and child development outcomes: an investigation of the nurturing hypothesis. Maternal and Child Nutrition, DOI: 10.1111/mcn.12200 Long-chain polyunsaturated fatty acids (LC-PUFA) in colostrum, and infant mental development
This study investigated whether the nurturing hypothesis - that breastfeeding serves as a proxy for family socio-economic characteristics and parenting behaviours - accounts for the association of breastfeeding with children's academic abilities. Results from the study suggested that breastfeeding may not be a proxy of socio-economic characteristics and parenting behaviours, as proposed by the nurturing hypothesis. The mechanism of breastfeeding benefits is likely to be different from those by which family socio-economic background and parenting practices exert their effects. The authors call for greater clarity in understanding the mechanisms behind breastfeeding benefits, to facilitate the development of policies and programs that maximise breastfeeding's impact.
Guxens M, Mendez MA, Molto-Puigmarti C et al (2011) Breastfeeding, Long-Chain Polyunsaturated Fatty Acids in Colostrum, and Infant Mental Development. Pediatrics. Published online doi: 10.1542/peds.2010-1633 Breastfeeding and reduced risk of epilepsy
This Spanish study of 657 pregnant women during pregnancy and 504 of their children at 14 months found that a high percentage of breastfeeds during the first 14 months was positively associated with child mental development. Maternal education, social class, and IQ only partly explained this association. LC-PUFA levels seem to play a beneficial role in children's mental development when breastfeeding levels are high.
Sun Y, Vestergaard M, Christensen J, et al. Breastfeeding and risk of epilepsy in childhood: a birth cohort study. J Pediatr. Epub 2011 Jan 14; doi:10.1016/j.jpeds.2010.11.035 Breastfeeding associated with higher test scores at age 9
An observational study of 69,750 infants born in Denmark found that breastfeeding may decrease epilepsy in childhood. Researchers observed a dose-response like pattern; for example, children breastfed for 3 to 5, 6 to 8, 9 to 12, and >13 months had a 26%, 39%, 50%, and 59% lower risk of epilepsy after the first year of life, respectively, compared with children who were breastfed for <1 month.
C McCrory and R Layte. The effect of breastfeeding on children's educational test scores at nine years of age: Results of an Irish cohort study. Soc Sci Med 21 Mar 2011 The effect of breastfeeding on children's cognitive development
This Irish study of 8,226 9 year-old children explored the impact of breastfeeding on educational test scores. After confounding for a range of child, maternal, socio-economic and socio-environmental factors, children who were breastfed were found to have a 3.24 percentage point advantage on reading scores and a 2.23 percentage point advantage on mathematics scores using standardised reading and mathematics tests. Any amount of breastfeeding was associated with significantly higher test scores than no exposure, but evidence of a dose-response relationship was weak.

This research examined the effect of breastfeeding on children's cognitive outcomes, as measured by test scores in reading, writing and mathematics measured at ages 5, 7, 11, and 14. Authors found that breastfeeding had an effect on a child's cognitive outcomes that could not be entirely explained by a mother's socio-economic background. Controlling for a wide range of factors, children breastfed for four weeks or more did better than children breastfed for less than four weeks by about one tenth of a standard deviation (slightly less at younger ages, and slightly more at older ages). This loosely translates to a difference of about 3 IQ points. The effect was found across English, maths and science scores, and it persists at least until age 14.
Breastfeeding and academic achievement at 10 years
Iacovou, M, (2010), The effect of breastfeeding on children's cognitive development. Institute for Social & Economic Research, Working Paper No. 2010-40 (full text)
Wendy H Oddy, Jianghong Li, Andrew J O Whitehouse, Stephen R Zubrick, and Eva Malacova (2010) Breastfeeding Duration and Academic Achievement at 10 Years. Pediatrics, Dec 2010; doi:10.1542/peds.2009-3489 Breastfeeding is associated with improved child cognitive development: evidence from the UK Millennium Cohort Study
This Australian study of 1,038 children found that 10-year-old children who were predominantly breastfed for 6 months or longer in infancy had higher academic scores than children who were breastfed for less than 6 months. The effect of breastfeeding on educational outcomes differed according to gender; boys were particularly responsive (in mathematics, spelling, reading, and writing) to a longer duration of breastfeeding.
Quigley MA, Hockley C, Carson C et al (2009) Breastfeeding is associated with improved child cognitive development: evidence from the UK Millennium Cohort Study. J Epidemiol Community Health; 63(Suppl_2):8 Breastfeeding and child cognitive development
A total of 11,801 children were assessed according to their gestational age at birth and also according to breastfeeding status. At age five the children were tested using a validated tool - the British Ability Scales (BAS) test. The researchers found that the mean BAS naming vocabulary score decreased with prematurity. After adjusting for confounders, ever breastfeeding was significantly associated with a higher mean BAS naming vocabulary score in children born at term with a stronger effect in children born moderately preterm or very preterm and this also increased with each additional month of breastfeeding. A similar effect of breastfeeding was observed when using other BAS tests such as pattern construction and picture similarities scales.
Kramer MS, Aboud F, Mironova E. (2008) Breastfeeding and child cognitive development: New evidence from a large randomized trial. Arch Gen Psychiatry 2008: 65; 578-584. Evidence confirms breastfeeding link to higher IQ
A Belarusian Promotion of Breastfeeding Intervention Trial (PROBIT) study followed up 13,889 children from its original cohort at 6.5 years of age to assess whether prolonged and exclusive breastfeeding improves children's cognitive ability. The researchers measured IQ scores and teacher evaluations of academic performance in reading, writing, mathematics, and other subjects. The experimental intervention led to a large increase in exclusive breastfeeding at age three months and a significantly higher prevalence of any breastfeeding at all ages up to and including 12 months. The experimental group had higher mean scores on all of the Wechsler Abbreviated Scales of Intelligence measures for IQ. Teachers' academic ratings were significantly higher in the experimental group for both reading and writing. The researchers conclude that their results demonstrate that prolonged and exclusive breastfeeding improves children's cognitive development.

A team of scientists have looked at the DNA profile of more than 3,000 children involved in two long-term studies in the UK and New Zealand (NZ). In the UK, the study had followed a group of over 2,000 twins with IQ measured at age 5, whereas in New Zealand 1,037 children were studied, with IQ measured every other year from age 7-13. The researchers were able to eliminate a series of confounding variables which have been considered to impact upon intellectual development: intrauterine growth, social class and maternal cognitive ability. The retention rates were very high at 97% and 96% respectively.
Caspi A, Williams B, Kim-Cohen J, et al (2007) Moderation of breastfeeding effects on the IQ by genetic variation in fatty acid metabolism. PNAS; 10.1073. 0704292104
The study found that in the presence of a particular gene in the child, FADS2, breastfeeding can raise IQ by an average of 7 points. FADS2 is closely involved in the way the body processes fatty acids in the diet and has two genotypes - C and G. Some 90% of people carry the C version of the gene, which the scientists found was associated with better IQ scores in breastfed children. Breastfeeding had no effect on the IQ of the 10% of children who had G versions of the gene; however their outcomes were made no worse by breastfeeding.

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Research on Brain and Cognitive Development - Baby Friendly Initiative

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Impact of breastfeeding on intelligence, educational attainment and income at 30 years of age in Brazil This prospective, population-based birth cohort study assessed whether breastfeeding duration was associated with IQ, years of schooling, and income at the age of 30 years, in a setting where no strong social patterning of breastfeeding exists.

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Center on the developing child at Harvard University

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Center on the Developing Child at Harvard University

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Three Core Concepts in Early Development

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This video series depicts how advances in neuroscience, molecular biology, and genomics give us a better understanding of how early experiences are built into our bodies and brains.

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How human brains are built

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What mother rats can teach us about parenting and brain development

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What mother rats can teach us about parenting and brain development

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From 'The Hormone of Closeness - The role of oxytocin in relationships' by Kerstin Uvnäs Moberg:

"Canadian research Michael Meaney, from McGill Unversity, demonstrated that some mother rats interact more than usual with their offspring by licking them, lying next to them and warming them during their first week of life. When these offspring became adult rats, they were less fearful, interacted more than other rats and were better able to handle stressful situations. When these rats, in turn, became mothers, they were particularly caring and social towards their own offspring. This behaviour is then repeated in subsequent generations. Initially, it was believed that this behaviour was due to a genetic difference between rats that licked and interacted more and rats that interacted less. But Michael Meaney has carried out experiments where he has shown that this may not be the case. He showed that if the offspring born to a mother who devoted herself to them and interacted and licked a lot was taken from their real mother and instead raised by a mother who didn't lick or nurture them as much, the offspring adopted their 'foster-mother's' characteristics. They became more scared, less social and less stress resistant. Neither did they become more nurturing towards their own offspring when becoming mothers themselves. In the same way, it could also be shown that the offspring born to a mother who didn't lick as much, when raised by a more nurturing mother who licked a lot, adopted the 'foster-mother's' characteristics. From these results, it was concluded that there was no real genetic difference between the rats that lick a lot and those that lick little. Instead, it was all about a character trait was that established in the first week of life and was dependent on how nurturing their mothers were and how much they licked their offspring during this time. The more licking and tactile interaction a rat pup was exposed to during the the first week of life, the more interactive and the calmer the rat because as an adult. It was the high amount of tactile stimulation that transformed them."

What does this have to do with human babies you might wonder? Well, babies respond to being kissed, cuddled and stroked in a very similar way to rat pups: loving touch causes the release of oxytocin (a feel-good hormone) in their brain, and this generates positive brain development. How parents respond to their baby's needs shapes their developing brain, programming the way they will respond to stress and manage their emotions. Being in the arms of a loving adult regulates a baby's heart rate, breathing and body temperature, and calms and relaxes them. When a baby's needs are met on a regular basis by a person who loves them deeply, they develop secure attachment, and this forms the basis of future physical and psychological good health. Feeling safe, secure and loved will, over time, give a child the ability to regulate their own emotions, develop self-confidence, and over the course of several years, become more social and independent.

The vast majority of new parents want nothing more than to respond lovingly to their baby's requests for comfort and closeness, but unfortunately, many parents are warned by friends, family or even health professionals, that their baby will become spoilt and demanding if given too much attention. This is a myth: you can't spoil a baby because their needs and their wants are the same.

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From 'The Hormone of Closeness - The role of oxytocin in relationships' by Kerstin Uvnäs Moberg: "Canadian research Michael Meaney, from McGill Unversity, demonstrated that some mother rats interact more than usual with their offspring by licking them, lying next to them and warming them during their first week of life.

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Author, Speaker, Researcher supporting new parents through pregnancy, birth and caring for babies

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This week (7- 12 June) is Infant Mental Health Awareness Week and the theme is '20:20 vision: Seeing the world through babies' eyes'. The Week is led by the Parent-Infant Foundation (PIF) and the First 1001 Days Movement, a collaboration of relevant organisations with the PIF as secretariat, which is being launched during the week.

What is infant mental health? It is the emotional wellbeing of babies. The Movement's vision is that 'every baby has loving and nurturing relationships in a society that values emotional wellbeing and development in the first 1001 days, from pregnancy, as the critical foundation for a healthy and fulfilling life.'

What babies want is what they need and these needs are basic. As obstetrician Grantly Dick-Read wrote in the mid 20 th century:

"The newborn has only three demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three."

They do also need to receive attention from other humans. If their needs are usually met, babies can form secure relationships (attachment) with their caregivers. Usually, there is one primary caregiver, most commonly the mother. Attachment theory was developed by the psychoanalyst John Bowlby in the 1950s. An attachment figure who cares responsively for the infant provides a secure base. It is believed that behaviours by the infant to stay close when separated, like screaming and clinging, have been reinforced by natural selection (see What is attachment theory).

Babies are vulnerable - as Donald Winnicott, paediatrician and psychoanalyst, among his other insightful quotes, stated:

'There is no such thing as a baby, there is a baby and someone'.

However, infants are not passive as they communicate by giving cues to their needs, such as the rooting reflex when hungry. If their needs are not responded to quickly, they become upset. Dr. Edward Tronick's 'still face' experiments in the 1970s showed the importance of human connection for an infant. If the parent's face is still and unresponsive to her baby, the baby looks confused and then becomes distressed. The experiments also showed that ruptures in a relationship like this are easily repaired. Parents do not need to respond perfectly.

However, when there is repeatedly no response to a baby's distress, as in sleep training where the baby is left alone and expected to adapt, it was found that the babies' behaviour changed so that by the third night they were no longer crying but their cortisol (stress hormone) levels were still high so there was a mismatch between behaviour and physiology; instead of learning to self-soothe it seems as though they were giving up so in despair.

The significance of the care babies receive is that their experiences, starting before birth, influence the neural connections that are formed in the developing brain - the 'wiring'. A parent who is emotionally not really available to the baby (so not attuned to their needs) will find it difficult either to respond or to respond appropriately, providing an unintentional 'still face' or angry face. The parents could be ill, depressed, addicted, suffering domestic abuse, desperately worried about their financial situation, overloaded with responsibilities.........It is therefore crucial for a society to care for parents so that they can be emotionally available to their children.

Feeding is a crucial part of nurturing care and breastfeeding facilitates the process.There is considerable evidence that not being breastfed is linked to poorer physical health in infants (Lancet, 2016). Breastfeeding provides personalised nutrition. Antibodies and other components in breastmilk reduce the chance and severity of infections. Oligosaccharides in breastmilk feed and thus favour beneficial bacteria in the infant's gut and this helps the development of a healthy immune system. It is difficult to allow for confounding factors in studies on breastfeeding but reviews show it is linked with better cognitive performance, which is likely to be due to the fatty acids in breastmilk. But what about any impact on emotional development? There are studies which suggest that being breastfed is associated with paying more attention to positive emotions in others. Breastmilk contains the calming hormone oxytocin, which stimulates social interactions, and which is further released through touch and suckling, so the moods of both mother and baby benefit. Several studies indicate that mothers who are breastfeeding tend to touch their babies more, are more responsive and tend to gaze at them more, all of which will help the infant's emotional wellbeing. The Unicef UK Baby Friendly Initiative leaflet, Building a Happy Baby, provides practical suggestions for parents to support their baby's brain development and addresses myths and realities.

Jones found that breastfeeding helps to protect infants from the harmful effects of maternal depression.

Mothers who stop breastfeeding before they want to are at greater risk of postnatal depression ( Borra et al 2014) so mothers need easy access to breastfeeding support to help them continue, thereby benefitting their babies physically and emotionally. Sadly, there are barriers to breastfeeding throughout society, as outlined in the WBTi UK report.

Parents and carers urgently need more support, especially during the stresses and isolation of lockdown and the COVID19 pandemic. We call on government to make infants and their families a high priority during the pandemic and in our plans to rebuild a stronger society.
Photo used with permission

Patricia Wise is an NCT breastfeeding Counsellor and a member of the WBTi UK Steering Group

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This week (7- 12 June) is Infant Mental Health Awareness Week and the theme is '20:20 vision: Seeing the world through babies' eyes'. The Week is led by the Parent-Infant Foundation (PIF) and the First 1001 Days Movement, a collaboration of relevant organisations with the PIF as secretariat, which is being launched during the week....

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How a child's brain develops through early experiences

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Article by Prof Amy Brown

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A full night's sleep will be near the top of many parents' wish lists. Sleep deprivation is no fun and many parents find themselves turning to baby care books that promise to train their child to sleep through the night.

These books promote a range of ideas. At the more extreme end, extinction - often known as " cry it out" - involves putting the baby to bed and ignoring their cries (sometimes checking periodically to make sure they are not unwell or in danger). A modified version of this, often known as "controlled crying", suggests parents should ignore cries for a set amount of time, before responding briefly to reassure their baby, gradually increasing the amount of time between checks. The idea is that babies will eventually realise no one is going to come - and sleep instead.

But there are two main issues with both variations of this sleep training. Babies can become distressed during longer periods of crying, with raised levels of stress hormones. In addition, not responding to a baby's cries goes against everything we know about building positive attachment relationships. Babies who learn that someone will respond to their needs, in a loving and appropriate way, typically go on to have better social, emotional and educational outcomes.

Shutterstock/MonkeyBusinessImages

The research explained

Research into these methods has shown mixed results, mainly because many parents find leaving their baby to cry too distressing. This is unsurprising. Parents are hardwired to want to respond to their baby's cries. Other research suggests that such techniques may only work temporarily or only work for some babies.

In one study that examined whether mothers implemented sleep training advice in books, the advice only worked for around 20% of babies. Most struggled to follow the guidance or it had no impact, leaving them feeling frustrated and even like a failure.

One reason why sleep training might not work is because waking at night is developmentally normal for most babies throughout their first year. Even adults sometimes have difficulties sleeping through the night and insomnia is a common complaint. But, unlike babies, adults are able to meet their own needs. If we do wake, we can get ourselves a drink, pull the covers back or rationalise our thoughts.

In addition, some parents may be getting confusing advice, as research headlines don't always give the full picture. One trial randomised mothers who felt their baby had a sleep problem to either behavioural sleep training techniques or "usual care". Those in the sleep training group reported better mental health and fewer sleep problems at one year. But those mothers were also taught about normal infant sleep and given an opportunity to chat to a nurse about their worries and ideas for self-care.

At the end of the trial, mothers rated "having someone to talk to" as the most useful thing. Is this evidence that rather than trying to teach babies to sleep, there should be more support for new families instead?

So what does work?

If you are reading this as a sleep-deprived parent, do not despair. There are gentler ways to help your baby sleep better that do not involve listening to your baby cry. And the good news is that responsive sleep support can be just as effective and less stressful for everyone.

First, understanding the sleep needs and circadian rhythms of the baby can go a long way towards optimising sleep. There are two sleep regulating mechanisms in the human body. The first is the Circadian rhythm, or body clock. This is regulated by exposure to light, noise, activity and social cues at the right time of day. Getting outside in the daytime and having a predictable darkening of the room one to two hours before bedtime can really help. Some parents find a predictable routine that signals bedtime helps (having a bath, getting changed and maybe a soothing story or song).

The second regulating mechanism is something known as " homeostatic sleep pressure ". The drive to sleep (when your eyes start drooping) builds during wakeful hours. The younger we are, the less time we can manage awake. So, understanding how to support babies to take regular naps to prevent them from becoming overtired makes a big difference.

Shutterstock/MonkeyBusinessImages

This is easier to achieve when you learn to recognise your baby's sleep, feeding and other cues. Understanding these cues helps parents to spot when their baby is ready for sleep, before they become overly tired and frustrated. It also helps deepen the bond between parent and child. Being able to accurately interpret a baby's need for more action, quiet time, food, cuddles or sleep will mean that parents are more in tune with them. No book can tell a parent what their baby needs right now. This can only be learned through observation and trial and error.

Read more: Babies don't need sleep coaches - but sometimes their parents do

Finally, decreasing parental stress can make a huge difference to sleep. The more we worry about sleep, the worse it gets. Little things like accepting what's normal, taking time for self-care and accepting offers of help, not only make it easier to feel more rested and able to cope, but can also rub off on the baby. Babies are masters at responding to emotional states, so parents will probably find that their baby is easier to settle and sleeps better when they take care of their own emotional well-being.

And if you are one such sleep-deprived parent, please remember: your baby will not be like this forever - they will sleep one day.

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Sleep-training and babies: why 'crying it out' is best avoided

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A full night's sleep will be near the top of many parents' wish lists. Sleep deprivation is no fun and many parents find themselves turning to baby care books that promise to train their child to sleep through the night. These books promote a range of ideas.

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College of Human and Health Sciences, Swansea University

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Why you might want to put the baby books down...

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Benefits of skin to skin last for decades:

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Benefits of skin to skin last for decades:

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When you become a parent for the first time, there is an undeniably steep learning curve. Add to that the struggle of sorting through fact and fiction when it comes to advice and- whew -it's enough to make you more tired than you already are with that newborn in the house.

Just like those childhood games of telephone when one statement would get twisted by the time it was told a dozen times, there are many parenting misconceptions that still tend to get traction. This is especially true with myths about bottle-feeding-something that the majority of parents will do during their baby's infancy, either exclusively or occasionally.

Here's what you really need to know about bottle-feeding facts versus fiction.
1. Myth: Babies are fine taking any bottle
Not all bottles are created equally. Many parents experience anxiety when it seems their infant rejects all bottles, which is especially nerve wracking if a breastfeeding mom is preparing to return to work. However, it's often a matter of giving the baby some time to warm up to the new feeding method, says Katie Ferraro, a registered dietician, infant feeding specialist and associate professor of nutrition at the University of California San Francisco graduate School of Nursing.

"For mothers returning to work, if you're breastfeeding but trying to transition to bottle[s], try to give yourself a two- to four-week trial window to experiment with bottle feeding," says Ferraro.
2. Myth: You either use breast milk or formula
So often, the question of whether a parent is using formula or breastfeeding is presented exclusively as one or the other. In reality, many babies are combo-fed-meaning they have formula sometimes, breast milk other times.

The advantage with mixed feeding is the babies still get the benefits of breast milk while parents can ensure the overall nutritional and caloric needs are met through formula, says Ferraro.
3. Myth: Cleaning bottles is a lot of work
For parents looking for simplification in their lives (meaning, all of us), cleaning bottles day after day can sound daunting. But, really, it doesn't require much more effort than you are already used to doing with the dishes each night: With bottles that are safe for the top rack of the dishwasher, cleaning them is as easy as letting the machine work for you.

For added confidence in the sanitization, Dr. Brown's offers an incredibly helpful microwavable steam sterilizer that effectively kills all household bacteria on up to four bottles at a time. (Not to mention it can also be used on pacifiers, sippy cups and more.)
4. Myth: Bottle-feeding causes colic
One of the leading theories on what causes colic is indigestion, which can be caused by baby getting air bubbles while bottle feeding. However, Dr. Brown's bottles are the only bottles in the market that are actually clinically proven to reduce colic thanks to an ingenious internal vent system that eliminates negative pressure and air bubbles.
5. Myth: Bottles are all you can use for the first year
By the time your baby is six months old (way to go!), they may be ready to begin using a sippy cup. Explains Ferraro, "Even though they don't need water or additional liquids at this point, it is a feeding milestone that helps promote independent eating and even speech development."

With a complete line of products to see you from newborn feeding to solo sippy cups, Dr. Brown's does its part to make these new transitions less daunting. And, for new parents, that truly is priceless.
This article was sponsored by Dr. Brown's. Thank you for supporting the brands that support Motherly and mamas.

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It's science: Skin-to-skin time benefits your baby-even 20 years later

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If the feeling you get when you snuggle a baby could be bottled and sold, this world would probably be a better place-research basically proves. Between the way those snuggles release heartwarming oxytocin to the benefits they have on babies' growing brains, let's all agree there really is no such t...

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Before we get into different types of slings and carriers, benefits of babywearing and so on, a bit of biology to start with.

Babies like to be carried and to be close to their caregivers. Put a baby in a cot and while she might be happy for a while, she will soon start fussing. Pick her up- happy again. Ever wondered why that happens? It's really quite simple.

Humans are mammals, right? We like to think about ourselves as unique and somewhat separated from animal kingdom, but truth is we are not so much different. Each mammalian species has a specific way of taking care of its young, so let's look at some broad categories and see where we fit. The following distinction is by Nils Bergman:
Cache mammals
These include the deer and the rabbit. Cache mammals are mature at birth. Their mothers hide their young in a safe place and return to them every twelve hours. Consistent with this behavior, the milk of cache animals is high in protein and fat. It sustains the young animals for a long time, because the babies are fed infrequently.
Follow mammals
The giraffe and cow are follow mammals and like others of this group, are also mature at birth and can follow their mothers wherever they go. Since the baby can be near the mother throughout the day and feed often, the milk of the follow mammal is lower in protein and fat than that of a cache mammal.
Nest mammals
These include the dog and the cat. Nest mammals are less mature than cache or follow mammals at birth. They need the nest for warmth and remain with other young from the litter. The mother returns to feed her young several times a day. The milk of nest mammals has less protein and fat than cache mammals. But it has more than follow mammals, who feed more frequently.
Carry mammals
This group includes the apes and marsupials, such as the kangaroo. The carry animals are the most immature at birth, need the warmth of the mother's body, and are carried constantly. Their milk has low levels of fat and protein, and they are fed often around the clock.

So where do humans belong? Humans are the most immature of all mammals at birth so that would put us in either nest mammals or carry mammals category. But, since human milk is very low in fat and protein and high in carbohydrates, it becomes clear that we are carry mammals.
What does it mean? It means that babies EXPECT to be carried, to be close to parents and to be touched often. It's hardwired and cannot be changed. If they are not carried or are separated from mother, they express their dissatisfaction by fussing or crying. Carrying your baby is the biological norm. As Meredith Small says in her book Our Babies Ourselves: During 99% of human history the pattern of infant eating, sleeping and contact was that human infants were carried all the time, probably slept with their mothers and fed frequently throughout the day.

What we currently see as the "normal"- baby sleeping separately from parents, placed in a pram and expected to eat every 2-3 hours, is really our very strange attempt to fool Mother Nature. Is it successful? I guess it depends how we define success.

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Before we get into different types of slings and carriers, benefits of babywearing and so on, a bit of biology to start with. Babies like to be carried and to be close to their caregivers. Put a baby in a cot and while she might be happy for a while, she will soon start fussing....

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The Secret Life of the Brain, a David Grubin Production, reveals the fascinating processes involved in brain development across a lifetime. The five-part...

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Child Development Core Story, Part 3: Stress

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University of Minnesota Institute of Child Development, video by Cliff Dahlberg and Vox Pop Video. For Project for Babies, Jane Kretzmann.

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Center on the Developing Child at Harvard University

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2. Serve & Return Interaction Shapes Brain Circuitry

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One of the most essential experiences in shaping the architecture of the developing brain is "serve and return" interaction between children and significant adults in their lives. Young children naturally reach out for interaction through babbling, facial expressions, and gestures, and adults respond with the same kind of vocalizing and gesturing back at them.

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Center on the Developing Child at Harvard University

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The basic architecture of the brain is constructed through a process that begins early in life and continues into adulthood. Simpler circuits come first and more complex brain circuits build on them later. Genes provide the basic blueprint, but experiences influence how or whether genes are expressed.

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Cognitive and social development in a newborn:

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Cognitive and social development in a newborn:

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Cognitive development is associated with acquiring knowledge in the broadest sense. This includes the development of memory, perception, and judgment as well as the accumulation of facts. For a general discussion of newborn cognitive development, including the nature vs. nurture debate and an explanation of so-called normal development, keep reading.

Your Baby's Cognitive Development

In the seventeenth century, English philosopher John Locke described the infant mind as a tabula rasa, or blank tablet, waiting to be written upon. Two hundred years later, William James said the infant is so heavily "assailed by eyes, ears, nose, skin and entrails at once" that he sees his surroundings as "one great blooming, buzzing confusion." As recently as 1964, one medical textbook claimed not only that the average newborn was unable to fix his eyes or respond to sound, but also, "consciousness, as we think of it, probably does not exist in the infant."

Now we know better. In the last 15 years, the number of studies of infant cognition have increased enormously. There are many disagreements about various findings, but researchers definitely agree the newborn comes into the world not as a passive receiver, but as a participant, ready and eager to interact with the environment. For example, although by adult standards the newborn has extremely poor vision, he can still discriminate between light and dark and focus on objects from 8 to 12 inches away. Babies' intellects are working, and working very well, long before they can talk. They perceive a great deal, and they have decided preferences as well.

From the beginning, your baby prefers to sleep in one position or another. By eight weeks, your baby is able to differentiate shapes, liking faces more than inanimate objects, and sees colors, reacting especially strongly to the bright primary colors red and blue. Your baby can distinguish the sweet taste of sugar water and prefers the smell of bananas to that of shrimp. Infants prefer higher-pitched sounds, and within a few weeks, your baby recognizes and responds to his mother's voice. In short, the senses participate in the developmental process from the moment of birth. As a Yale University psychology professor who has studied infants for more than 40 years has said about the newborn's zestful approach to life, "He's eating up the world!"

Genetics Versus Environment

Infants vary tremendously in their capabilities, just as adults do. Some of this variation can be traced to inherited differences. Recently, in fact, geneticists have postulated that, in addition to controlling skin, eye, and hair coloring, genes may control behavior under certain environmental conditions. No matter what a baby's genetic inheritance, though, her environment must supply warmth and nourishment, both emotional and physical, if the baby is to reach her full developmental potential.

A great deal of conflict exists over the degree to which intelligence is inherited. It does seem clear that intelligence is not fixed at a rigid level at birth, and many environmental factors can affect the level of a child's intelligence throughout her development. Some cognitive psychologists today believe that while perhaps the outer limits of intelligence are fixed at birth, a child's environment can make a difference of as much as 40 points in her IQ (intelligence quotient, the number indicating the level of a person's intelligence as shown by special tests). This figure is staggering when one considers it is the same as the range between the value for borderline mental retardation (80 IQ points) and the value for the average college graduate (120 IQ points). Other psychologists who have conducted classic studies of identical twins separated at birth have been more conservative, saying environment can cause a difference of as much as 20 IQ points.

Theories about the genetic inferiority or superiority of certain ethnic or racial groups cannot be proved. The differences among the environments of home, nation, tribe, and culture make genetic comparisons of entire races or ethnic groups scientifically unverifiable. Given the tremendous differences among human beings, the best we can do is speak of developmental potential when trying to gauge intelligence in a young child.

"Normal Development"

Remember: Everything you read or hear about normal development for a child at a certain age refers to what is expected of the average child. But keep in mind that the "average baby" does not exist in reality. Every baby at some time probably will be "ahead" of other children the same age in some ways, and "behind" in other ways.

Whatever his individual differences from the norm, you can expect your baby to develop at an incredible rate during the first year of life, in a head-to-toe direction: He gains control over his eyes, neck, and hands before learning to use his legs for walking. In the beginning, your infant is very much mouth-oriented; the sensations of sucking and mouthing give the most pleasure. Soon, the ability to use the hands develops. At about five months, your baby grasps toys, and his learning is related to the ability to manipulate. By about ten months of age, your baby recognizes and smiles at familiar people and may display anxiety when strangers are present. At about the same time, the baby becomes expert at crawling -- and at getting into everything. At about one year, he begins to walk alone, a true milestone in his development.

In the second and third years, toddlers become increasingly independent and curious, a combination that makes them dangerous to themselves and everything about them. You will have discovered the necessity to carefully childproof your home by the time your baby can crawl, but the hazards increase dramatically as your child becomes more agile and more investigative. During the second year, your child's rapid increase in the ability to communicate through language represents a big breakthrough. "No" becomes a favorite word, and temper tantrums may be frequent as he encounters frustration over boundaries you must set.

As your child grows and changes, you will probably notice his development seems not to occur steadily, in an even line, but rather in spurts.

Parental Expectations

Comparing your child's development with that of the children of your friends and neighbors is futile and unproductive. A common failing of parents is to exaggerate a bit as they try to show their children in the best light, and what you hear is not always the truth. The most glowing (and the most overstated) accounts of babies' accomplishments are likely to come from parents whose children are long past the stages about which they speak. You will hear that one friend's baby slept through the night at two weeks, another's walked at nine months and spoke complete sentences at 18 months, and still another's was completely toilet trained at a year. If you worry that your child isn't living up to standards set by others, you will upset your own tranquility and find it impossible to enjoy and appreciate your baby. In addition, you set your child up for a life of low self-esteem and an endless struggle to meet your impossible expectations.

Even the most accurate and realistic of developmental schedules worked out by pediatricians and psychologists after their observations of thousands of children cannot tell you exactly what your baby should be doing at any given period. These schedules are helpful if not taken too literally, but you should use them only as guides to give you a general idea of what to expect from your child. Every baby develops at a different rate, and if yours is slow to roll over or build a tower of blocks, it doesn't mean he is less intelligent than your friend's or neighbor's child or than the average baby profiled on the development charts.

A child's maturity level may be more likely than his IQ to determine the rate of development. Some children are late bloomers; they simply mature more slowly than others, but often their accomplishments ultimately equal or surpass those of others. Some children develop at an average or above-average rate in one area, such as motor skills, and at a below-average rate in another, such as language. You may wish to take the sex of your child into consideration, too. In general, girls mature more quickly than boys. They usually walk earlier, talk sooner, show more early interest in intellectual skills such as printing and drawing, and become toilet trained earlier.

Promise yourself from the beginning you will respect and love your baby as a unique individual, different from any other, with his or her own beauty and charm. Constantly practice the art of accepting your child as is, without ranking or comparing her with others. Be aware that while the environment you provide is, of course, important, genetics control certain facets of a child's potential. It is not your fault if you do not rear a genius nor is it entirely to your credit if you do.

As stated above, it is believed that the nurture aspect of a baby's existence can do much to enhance her abilities. On the next page, learn about what you can do to promote your baby's development so she can reach her full potential.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

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Understanding Cognitive and Social Development in a Newborn

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Cognitive development is associated with acquiring knowledge in the broadest sense. This includes the development of memory, perception, and judgment as well as the accumulation of facts. For a general discussion of newborn cognitive development, including the nature vs. nurture debate and an explanation of so-called normal development, keep reading.

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Building A Happy Baby: the importance of responsive parenting and feeding: 

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Building A Happy Baby: the importance of responsive parenting and feeding: 

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The development of the brain is influenced by many factors, including a child's relationships, experiences and environment. Learn more about the crucial role you play in building your baby's brain, get your questions answered, and find some fun "brain-building" activities to share with your little one.

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The development of the brain is influenced by many factors, including a child's relationships, experiences and environment. Learn more about the crucial role you play in building your baby's brain, get your questions answered, and find some fun "brain-building" activities to share with your little one.

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Prepared by Judith Graham, Extension human development specialist. Revised by Leslie A. Forstadt, Ph.D. Child and Family Development Specialist.
For information about UMaine Extension programs and resources, visit extension.umaine.edu.
Find more of our publications and books at extensionpubs.umext.maine.edu.

Like constructing a house, brains are built upon a strong foundation. This starts before birth, and is very important during the first three years of life. Brain cells are "raw" materials - much like lumber is a raw material in building a house, and a child's experiences and interactions help build the structure, put in the wiring, and paint the walls. Heredity (nature) determines the basic number of "neurons" (brain nerve cells) children are born with, and their initial arrangement.

At birth, a baby's brain contains 100 billion neurons, roughly as many nerve cells as there are stars in the Milky Way, and almost all the neurons the brain will ever have. The brain starts forming prenatally, about three weeks after conception. Before birth, the brain produces trillions more neurons and "synapses" (connections between the brain cells) than it needs. During the first years of life, the brain undergoes a series of extraordinary changes.

In the brain, the neurons are there at birth, as well as some synapses. As the neurons mature, more and more synapses are made. At birth, the number of synapses per neuron is 2,500, but by age two or three, it's about 15,000 per neuron. The brain eliminates connections that are seldom or never used, which is a normal part of brain development.

"Windows of opportunity" are sensitive periods in children's lives when specific types of learning take place. For instance, scientists have determined that the neurons for vision begin sending messages back and forth rapidly at 2 to 4 months of age, peaking in intensity at 8 months. It is no coincidence that babies begin to take notice of the world during this period.

Scientists believe that language is acquired most easily during the first ten years of life. During these years, the circuits in children's brains become wired for how their own language sounds. An infant's repeated exposure to words clearly helps her brain build the neural connections that will enable her to learn more words later on. Language can be learned a multitude of ways, like casual conversation, songs, rhymes, reading, music, story telling and much more. Early stimulation sets the stage for how children will learn and interact with others throughout life. A child's experiences, good or bad, influence the wiring of his brain and the connection in his nervous system. Loving interactions with caring adults strongly stimulate a child's brain, causing synapses to grow and existing connections to get stronger. Connections that are used become permanent. If a child receives little stimulation early on, the synapses will not develop, and the brain will make fewer connections.

Stress can become toxic when a child has frequent or prolonged experiences like abuse, neglect or poverty without adult support. When adults are present to support a child's experiences and help the child's stress levels come down, stressors may be tolerable. Examples of tolerable stress include loss of a loved one, illness or injury, or poverty when a caring adult helps the child adapt. Some stresses are also thought of as positive stress, such as when there is a small amount of fear or sadness, or everyday challenges. In experiences of positive stress, the system can return to a calm state in a relatively short period of time. When children are faced with physical or emotional stress or trauma, the hormone cortisol is released when the brain sends a signal from the hypothalamus to the adrenal cortex, which is a gland above the kidney. High levels of cortisol can cause brain cells to die and reduces the connections between the cells in certain areas of the brain, harming the vital brain circuits. In other words, the wiring of the house can be severely damaged or miswired if a child is exposed to repeated and longtime stress with out the assistance of a caring adult. Babies with strong, positive emotional bonds to their caregivers show consistently lower levels of cortisol in their brains.

Brain Structure

The brain is part of the central nervous system, and plays a decisive role in controlling many bodily functions, including both voluntary activities (such as walking or speaking) and involuntary ones (such as breathing or blinking).

The brain has two hemispheres, and each hemisphere has four lobes. Each of these lobes has numerous folds. These folds do not all mature at the same time. The chemicals that foster brain development are released in waves; as a result, different areas of the brain evolve in a predictable sequence. The timing of these developmental changes explains, in part, why there are "prime times" for certain kinds of learning and development.

Different parts of the brain control different kinds of functions. Most of the activities that we think of as "brain work," like thinking, planning or remembering, are handled by the cerebral cortex, the uppermost, ridged portion of the brain. Other parts of the brain also play a role in memory and learning, including the thalamus, hippocampus, amygdala and basal forebrain. The hypothalamus and amygdala, as well as other parts of the brain, are also important in reacting to stress and controlling emotions.

The basic building blocks of the brain are specialized nerve cells that make up the central nervous system: neurons. The nerve cells proliferate before birth. In fact, a fetus' brain produces roughly twice as many neurons as it will eventually need - a safety margin that gives newborns the best possible chance of coming into the world with healthy brains. Most of the excess neurons are shed in utero. At birth, an infant has roughly 100 billion brain cells.

Every neuron has an axon (usually only one). The axon is an "output" fiber that sends impulses to other neurons. Each neuron also has many dendrites - short, hair-like "input" fibers that receive impulses from other neurons. In this way, neurons are perfectly constructed to form connections.

As a child grows, the number of neurons remains relatively stable, but each cell grows, becoming bigger and heavier. The proliferation of dendrites accounts for some of this growth. The dendrites branch out, forming "dendrite trees" that can receive signals from many other neurons.

Connections among Brain Cells

At birth, the human brain is in a remarkably unfinished state. Most of its 100 billion neurons are not yet connected in networks. Forming and reinforcing these connections are the key tasks of early brain development. Connections among neurons are formed as the growing child experiences the surrounding world and forms attachments to parents, family members and other caregivers.

In the first decade of life, a child's brain forms trillions of connections or synapses. Axons connect to dendrites, and chemicals called neurotransmitters help send messages (called "impulses") across the resulting synapses. Each individual neuron may be connected to as many as 15,000 other neurons, forming a network of neural pathways that is immensely complex. This elaborate network is sometimes referred to as the brain's "wiring" or "circuitry." As the neurons mature, more and more synapses are made. At birth, the number of synapses per neuron is 2,500, but by age two or three, it's about 15,000 synapses per neuron. This is like going from 100 to 600 friends on Facebook, and each of those friends in turn, is connected to 600 more people! The neural network expands exponentially. If they are not used repeatedly, or often enough, they are eliminated. In this way, experience plays a crucial role in "wiring" a young child's brain. Brain development does not stop after early childhood, but it is the foundation upon which the brain continues developing. Early childhood is the time to build either a strong and supportive, or fragile and unreliable foundation. These early years are very important in the development that continues in childhood, adolescence, and adulthood.

Sources: Shonkoff, J.P., & Phillips, D.A. (Eds). (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development National Academies' Press. Retrieved from http://www.nap.edu/catalog/9824.html

Shore, R. (1997). Rethinking the Brain: New Insights into Early Development. New York, NY: Families and Work Institute, pp. 16-17.

Day-to-Day Care of Young Children's Brains

Research on early brain development and school readiness suggests the following guidelines for the care of young children:

Ensure health, safety, and good nutrition: Seek regular prenatal care; breast feed if possible; make sure your child has regular check-ups and timely immunizations; safety-proof the places where children play; and use a car seat whenever your child is traveling in a car.

Develop a warm, caring relationship with children: Show them that you care deeply about them. Express joy in who they are. Help them to feel safe and secure.

Serve-and-return: Like a tennis match, how you respond to a child's cues and clues makes a world of difference in their learning. Notice their rhythms and moods, even in the first days and weeks of life. Respond to children when they are upset as well as when they are happy. Try to understand what children are feeling, what they are telling you (in words or actions), and what they are trying to do. Hold and touch them; play with them in a way that lets you follow their lead. Move in when children want to play, and pull back when they seem to have had enough stimulation.

Recognize that each child is unique: Keep in mind that from birth, children have different temperaments, that they grow at their own pace, and that this pace varies from child to child. At the same time, have positive expectations about what children can do and hold on to the belief that every child can succeed.

Talk, read, and sing to children: Surround them with language. Maintain an ongoing conversation with them about what you and they are doing. Sing to them, play music, tell stories and read books. Ask toddlers and preschoolers to guess what will come next in a story. Play word games. Ask toddlers and preschoolers questions that require more than a yes or no answer, like "What do you think...?" Ask children to picture things that have happened in the past or might happen in the future. Provide reading and writing materials, including crayons and paper, books, magazines, and toys. These are key pre-reading experiences.

Encourage safe exploration and play: Give children opportunities to move around, explore and play (and be prepared to step in if they are at risk of hurting themselves or others). Help them to explore relationships as well. Arrange for children to spend time with children of their own age and of other ages and support their learning to solve the conflicts that inevitably arise.

Use discipline to teach: Talk to children about what they seem to be feeling and teach them words to describe those feelings. Make it clear that while you might not like the way they are behaving, you love them. Explain the rules and consequences of behavior so children can learn the "why's" behind what you are asking them to do. Tell them what you want them to do, not just what you don't want them to do. Point out how their behavior affects others.

Establish routines: Create routines and rituals for special times during the day like mealtime, nap time, and bedtime. Try to be predictable so the children know that they can count on you.

Become involved in child care and preschool: Keep in close touch with your children's child care providers or teachers about what they are doing. Occasionally, especially during transitions, spend time with your children while they are being cared for by others. The caring relationships they form outside of the home are among the most important relationships they have.

Limit television: Limit the time children spend watching TV shows and videos as well as the type of shows they watch. For very young children, there is no research evidence suggesting TV helps children learn. For older children, make sure that they are watching programs that will teach them things you want them to learn.

Take care of yourself: You can best care for young children when you are cared for as well. Learn to cope with your stressors so that you can help your child learn too. Your child's well-being depends on your health and well-being.

Source: Shore, R. (1997). Rethinking the Brain: New Insights into Early Development. New York, NY: Families and Work Institute, pp. 26-27.

Gopnic, A., Meltzoff, A., Kuhl, P. (1999). The Scientist in the Crib: What Early Learning Tells Us About the Mind, New York, NY: HarperCollins Publishers.

Nash J. M. "Fertile Minds." Time, February 3, 1997, pp. 48-51.

Newberger, J. J. (1997). "New Brain Development Research: A Wonderful Window of Opportunity to Build Public Support for Early Childhood Education." Young Children 52 (4), pp. 4-7.

Reis, H.T., Collins, W.A., & Berscheid, E. (2000). The relationship context of human behavior and development. Psychological Bulletin, 126(6), 844-872.

Shonkoff, J.P., & Phillips, D.A. (Eds). (2000). From Neurons to Neighborhoods: The Science of Early Childhood Development
National Academies' Press. Retrieved from http://www.nap.edu/catalog/9824.html

Shore, R. (1997). Rethinking the Brain: New Insights into Early Development. New York, NY: Families and Work Institute, pp. 26-27.
Information in this publication is provided purely for educational purposes. No responsibility is assumed for any problems associated with the use of products or services mentioned. No endorsement of products or companies is intended, nor is criticism of unnamed products or companies implied.
© 2001, 2011
Call 800.287.0274 (in Maine), or 207.581.3188, for information on publications and program offerings from University of Maine Cooperative Extension, or visit extension.umaine.edu. The University of Maine does not discriminate on the grounds of race, color, religion, sex, sexual orientation, including transgender status and gender expression, national origin, citizenship status, age, disability, genetic information or veteran status in employment, education, and all other programs and activities. The following person has been designated to handle inquiries regarding non-discrimination policies: Director, Office of Equal Opportunity, 101 North Stevens Hall, Orono, ME 04469, 207.581.1226, eoinfo@umit.maine.edu.

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Children and Brain Development: What We Know About How Children Learn

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Prepared by Judith Graham, Extension human development specialist. Revised by Leslie A. Forstadt, Ph.D. Child and Family Development Specialist. For information about UMaine Extension programs and resources, visit extension.umaine.edu. Find more of our publications and books at extensionpubs.umext.maine.edu. Like constructing a house, brains are built upon a strong foundation.

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"He sleeps really well but only when he's laying on my chest, he hates his moses basket" "She cries every time we lay her on her play mat" "He hates going in his pram, he cries the second we put him in it".
If I had a pound every time I heard these from a new parent I'd be a very rich lady by now! What amazes me though is that society in general doesn't get it, they don't get why so many babies need to be held by us to settle and what perplexes me even more is that we do spend so long trying to put them down! We spend more than time though, the 'putting babies down' industry is worth millions, rocking cribs, battery swings, vibrating chairs, heartbeat teddies and the list goes on..................having been a first time parent who bought all four of the items listed above I am embarrased to admit now it honestly didn't enter into my head that perhaps the answer was to *not* put my baby down and I certainly didn't consider why these things might help. It took me a long time to understand and empathise with my baby, to see the world through his eyes so to speak.
"Empathy: the intellectual identification with thoughts, or attitudes of another." or vicarious experiencing of the feelings, "Birth suddenly disrupts this organization. During the month following birth, baby tries to regain his sense of organization and fit into life outside the womb. Birth and adaptation to postnatal life bring out the temperament of the baby, so for the first time he must do something to have his needs met. He is forced to act, to "behave." If hungry, cold, or startled, he cries. He must make an effort to get the things he needs from his caregiving environment. If his needs are simple and he can get what he wants easily, he's labeled an "easy baby"; if he does not adapt readily, he is labeled "difficult."" - Dr. William Sears.
To empathise with our newborns feelings we need to put ourselves in their place, to imagine experiencing their world - but which world? The world they have spent most of their life in, their 'womb world' or the world they are in now - our world. To fully understand we must appreciate the enormous transition they have made - a concept known to many as 'The Fourth Trimester' -some make the womb to world transition easily, others less so and it is this latter group in particular "the clingy babies" we can learn so much from through this concept.

So lets quickly compare the two different 'worlds' your baby has lived in:

Pretty different huh? On top of this the big thing to understand is that in utero the baby's world was constant, each day was the same, the stimulation didn't change, but now they are born each day is different - ever changing, ever stimulating!

The concept of the fourth trimester helps us to understand the transition a newborn must make over their first few weeks earthside and once we understand we find so many ways we can help - but to me the most important facet of the fourth trimester is parental understanding and empathy, once that exists everything else will flow naturally.
Movement
Here are some common newborn calming techniques that tend to work quite well, but remember each and every baby is different, if you don't already know, you will soon learn what your baby likes best and that's what matters, that it is unique to *your* baby. Prescriptive 'do this/don't do this' baby calming lists don't help anybody - because they forget they are dealing with individuals - both parents and babies! Some things on this list will be inappropriate for you and your baby, some simply won't work, some you won't like - and that's OK! because really it isn't about these tips it's about you and your baby getting to know each other!
Skin to Skin Contact
The womb is a constantly moving space, Braxton Hicks would squeeze your baby at the end of pregnancy and each time you moves your baby was wobbled around inside. Imagine how walking upstairs feels for a baby in utero! Babies tend to love movement but so often we put them down somewhere completely still. You could try dancing, swaying from side to side, going for an exaggerated quick walk or bumpy car ride.
Bed-Sharing
Such a brilliant baby calmer! Being in contact with your warm, naturally (un)scented, skin is heaven for a baby, it helps to stabilise their body temperature, heart rate and stress hormones and stimulates the release of oxytocin - the love and bonding hormone - in you both. Topless cuddles, shared baths, baby massage and bedsharing are all great skin to skin experiences for your baby and you.

Sharing a bed with your baby is an amazing way of getting more sleep for everyone, babies are generally much calmer and sleep more easily if they sleep with you in your bed, yet it is such a taboo topic and although 60% of parents will share a bed with their baby at some point it's a subject that makes society very uncomfortable, but...it is an *amazing* baby calmer! It's really important that you think about how bedsharing will work and follow some important safety guidelines HERE.
Swaddling
For more on bedsharing and other ways to improve your newborn's sleep, watch my free webinar here:

Imagine how snug your baby was at the very end of your pregnancy inside of you - now imagine how strange it must feel to them after they have been born and have so much space around them! The absolutely best thing you can do is to envelop your baby in your arms, but for times when you don't want to or indeed can't then swaddling is an option. Swaddling is becoming increasingly popular, however there are important safety guidelines to be followed if you choose to swaddle your baby, if you are breastfeeding please make sure feeding is established before swaddling and take care not to miss your baby's hunger cues if you are feeding on demand:
** The American Academy of Paediatrics recommends swaddling for babies 0-14wks. Babywearing

Never swaddle over your baby's head or near his face

Never swaddle your baby if he is ill or has a fever

Make sure your baby does not overheat and only swaddle with a breathable/thin fabric

Only swaddle your baby until he can roll over**

Always place your baby to sleep on his back

Do not swaddle tightly across your baby's chest

Do not swaddle tightly around your baby's hips and legs, his legs should be free to "froggy up" into a typical newborn position.

Lastly start to swaddle as soon as possible, do not swaddle a 3 month old baby if he has not been swaddled before.

Wearing your baby in a sling is one of the ultimate ways to keep them calm and happy. It increases the time a baby spends in a state of "quiet alertness" - a time of contentment when they learn the most. When a baby is in utero they spend 100% of their time in physical contact with us - yet the moment they are born this is estimated to drop to only 40%! Babywearing also means 2 free hands!

Choose your sling carefully. A good sling will be easy to use and will support both yours and your baby's spine whilst not placing any pressure on your baby's growing hips - newborns should always be carried facing inwards with a "frog leg" pose, not a crotch dangle pose so commonly used by commercial baby carriers. Also seek to carry in an 'in arms' position - i.e: how your baby would be held if you were holding them!

Babywearing is a great way for dads to bond with babies!
Position
It is quite common for a baby to cry once placed in a sling, this does not mean that they hate the sling - it just means that you need to move, so get dancing! As with swaddling,babywearing is becoming increasingly popular, however there are important safety guidelines to be followed, the TICKS acronym below neatly sums them all up:

The "tiger in the tree" position below, taken from baby yoga, is often magical, stopping a crying baby in an instant!
Feed
Noise
Babies love sound, but for many not the sound you might think. For many babies a hoover is much more calming to a baby than a lullaby. A special white noise recording, such as , can be played on loop whilst your baby sleeps to help keep them calm.
Deep Bathing
If your baby is hungry nothing will calm him, so watch for his hunger cues. Feeding is always better if it is baby led, not led by a routine - whether you are breast or bottle feeding. Remember as well that your baby may not always be hungry for a full feed, they may want a quick drink, a quick snack or just some comfort sucking. Babies also find sucking the ultimate relaxation and comfort tool. Sucking helps a baby's skull bones to return to their normal position after birth as well as providing them with comfort and security. If you are not breastfeeding you might find your baby will relax when given a dummy/pacifier.
Outside
The womb is a wet, warm place. The world as we know it is dry and cold! Sometimes a nice deep, warm bath can stop a baby's tears in seconds - even better if mummy or daddy goes in the big bath with baby too as skin to skin contact is a wonderful baby calmer.
What have you found calms your newborn? The NEWLY UPDATED Gentle Sleep Book - out now! If you would like to understand and learn how to improve your baby's sleep WITHOUT cry-based conventional sleep training, this is the book for you! p.s: Come and chat with me on Facebook, Twitter and Instagram Or watch my videos on YouTube You can also sign up for my free parenting newsletter HERE.
If all else fails many babies stop crying the minute they hit the open air - I'm not sure if this is because we are usually moving (e.g.: walking over cobbles with the buggy/ bouncing in a sling and the drone and movement of a car) or because of the change in air - but it works!

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The Fourth Trimester - AKA Why Your Newborn Baby is Only Happy in Your Arms

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"My baby is only happy in my arms, the minute I put her down she cries" "He sleeps really well but only when he's laying on my chest, he hates his moses basket" "She cries every time we lay her on ...

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Sue Gerhardt's address to the European Parliament

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Faculty of Medicine, University of British Columbia

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The amount of close and comforting contact between infants and their caregivers can affect children at the molecular level, an effect detectable four years later, according to new research from the University of British Columbia and BC Children's Hospital Research Institute.

The study showed that children who had been more distressed as infants and had received less physical contact had a molecular profile in their cells that was underdeveloped for their age - pointing to the possibility that they were lagging biologically.

Although the implications for childhood development and adult health have yet to be understood, this finding builds on similar work in rodents. This is first study to show in humans that the simple act of touching, early in life, has deeply-rooted and potentially lifelong consequences on the epigenome - biochemical changes that affect gene expression.

"In children, we think slower epigenetic aging could reflect less favorable developmental progress," said Michael Kobor, a Professor in the Department of Medical Genetics who leads the "Healthy Starts" theme at BC Children's Hospital Research Institute.

The study, published Nov. 22 in Development and Psychopathology, involved 94 healthy children in British Columbia. Researchers from UBC and BC Children's Hospital asked parents of 5-week-old babies to keep a diary of their infants' behavior (such as sleeping, fussing, crying or feeding) as well as the duration of caregiving that involved bodily contact. When the children were about 4 ½ years old, their DNA was sampled by swabbing the inside of their cheeks.

The team examined a biochemical modification called DNA methylation, in which some parts of the chromosome are tagged with small molecules made of carbon and hydrogen. These molecules act as "dimmer switches" that help to control how active each gene is, and thus affect how cells function.

The extent of methylation, and where on the DNA it specifically happens, can be influenced by external conditions, especially in childhood. These epigenetic patterns also change in predictable ways as we age.

Scientists found consistent methylation differences between high-contact and low-contact children at five specific DNA sites. Two of these sites fall within genes: one plays a role in the immune system, and the other is involved in metabolism. However, the downstream effects of these epigenetic changes on child development and health aren't known yet.

The children who experienced higher distress and received relatively little contact had an "epigenetic age" that was lower than would be expected, given their actual age. A discrepancy between epigenetic age and chronological age has been linked to poor health in some recent studies.

"We plan to follow up on whether the 'biological immaturity' we saw in these children carries broad implications for their health, especially their psychological development," says lead author Sarah Moore, a postdoctoral fellow. "If further research confirms this initial finding, it will underscore the importance of providing physical contact, especially for distressed infants."

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bc children s hospital research institute

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Holding infants - or not - can leave traces on their genes

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The amount of close and comforting contact between infants and their caregivers can affect children at the molecular level, an effect detectable four years later, according to new research from the University of British Columbia and BC Children's Hospital Research Institute.

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The science behind responsive (on demand) feeding: 

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The science behind responsive (on demand) feeding: 

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© 2017 Gwen Dewar, Ph.D., all rights reserved

The infant feeding schedule reconsidered

In the past, Western "baby experts" often instructed parents to feed their babies at regularly-spaced intervals of 3- or 4-hours.

But today, official medical recommendations have shifted in favor of letting babies decide.

Why the change?

There are a number of reasons, but the simple answer is this: When we let babies determine the timing and the length of their own feeds, they are more likely to get what they need: Not too little, and not too much.

Interfering in this process -- by imposing an infant feeding schedule -- doesn't help babies develop their own intuitions about food (Tylka et al 2015). And it may lead to problems.

For instance, newborns should be fed frequently, and whenever they show signs of hunger -- ideally, before they start to cry. Otherwise, newborns are at higher risk for dehydration and underfeeding.

Moreover, frequent feeds help breastfeeding mothers establish a good milk supply, and feeding on cue can help breastfed babies adjust for natural variations in milk quality (Institute of Medicine, National Academy of Sciences 1991).

Feeding on cue may also help bottle-fed infants avoid overfeeding. And of course all babies go through growth spurts. All babies experience fluctuations in their energy requirements. Feeding on cue makes it easier for infants to increase or decrease their intake as needed ( Tylka et al 2015).

Finally, there may be benefits that extend beyond addressing a baby's hunger and thirst. Babies fed on cue may have an easier time coping with stress. They might even enjoy a cognitive advantage. There are hints that imposing an infant feeding schedule could have a negative impact on cognitive development.

So it seems that the best infant feeding schedule is the one that babies devise for themselves. But what is the evidence? Let's take more detailed look.

The infant feeding schedule in evolutionary perspective

Mammal babies everywhere begin life on a diet of milk. But they don't all time their feedings in the same way. In some species, mothers "park" or "cache" their young in nests, and leave them there. It's a strategy that allows the mother to go foraging without the fuss of a tag-along infant. But it only works if there's a way to keep the babies from starving during those long separations. How do they cope?

The solution is two-fold.

1. Mothers produce milk that is high in fat, and high in protein -- what we might call super-fuel.

2. Infants have the ability to suckle very fast and efficiently when they finally get to feed.

Together, these elements permit babies to "tank up" on a highly-concentrated food--enough to last them for many hours.

Mammals that follow this strategy are called "spaced feeders," and their milk is very rich indeed. A good example of a spaced feeder is the rabbit, which produces milk that is 18.3% fat and 13.9% protein (Jenness 1974).

By contrast, other mammals keep their babies with them as they forage. Exactly how they do this varies from species to species. Some, like monkeys, carry their babies. Others, like cows, have their infants follow them around on foot.

But regardless, the babies stay close, and along with proximity comes frequent meals. Babies tend to initiate feedings, and suckle at a more leisurely rate. They don't need to tank up on a super-fuel, and so their mothers don't make one. The milk is less caloric, more dilute.

A good example of a continual feeder is a cow, which produces milk that is typically 3.7% fat and 3.4% protein (Jenness 1974).

What about humans?

In some modern, industrial societies, humans act like spaced feeders. Babies are "parked" in cribs or cradles and get fed after intervals of 3-4 hours. But were we designed for this strategy? Does the biology of human breastfeeding have the earmarks of spaced feeding? The answer is no because

human milk is relatively low in fat (3.8%) and protein (1%), and

human infants suckle at the slow pace typical of continual feeders.

So our basic physiology gives us away. We don't produce super-fuel, and our infants lack the spaced-feeder's knack for super-fast milk extraction. And that's consistent with the behavior of other members of our family tree. Continual feeding is the strategy of choice among all of our close relatives -- including bonobos, chimpanzees, and gorillas.

It is also the strategy observed among human beings living in traditional societies. In hunter-gatherer societies, babies aren't just nursed on cue. They are also nursed very frequently -- about 2-4 times an hour (Konner 2006). In other traditional societies, parents don't match this extreme pace, but feedings are nonetheless initiated by the infants. In a survey of non-industrial societies (which included nomadic pastoralists and settled agricultural peoples) anthropologists found that "on demand" feeding was the rule. In every society for which information about the infant feeding schedule was available (25 out of 25), people fed their infants on cue (Severn Nelson et al 2000).

This, then, is our basic physiology and our evolutionary heritage. But how much does it matter? Is this something we can work around?

Mightn't we be able to keep babies equally happy and healthy using a strict infant feeding schedule? Perhaps it's just a matter of tweaking the timing of feeds.

It sounds straightforward, but there are stumbling blocks.

Babies vary in their needs -- from individual to individual, and from day to day

Different babies have different needs, and the same baby experiences fluctuations in energy requirements over time. What if your baby has the urge to be more active, and needs more food to fuel her activities? What if your infant needs more fluids because it's hot, or because he's coming down with a virus? What if your baby is in the middle of a growth spurt?

It isn't merely that you need to adopt a schedule that is individualized to your baby's current needs. You also need a schedule that keeps changing in response his or her future needs. That's pretty hard to do unless you are paying attention to your baby, offering meals when you observe signs of hunger. And if you are doing that, you aren't imposing a strictly-timed infant feeding schedule. By definition, you are feeding on cue.

Moreover, the baby's need for food and fluids is only one side of the equation -- the demand side. There is also the supply side of the equation. If your baby is on formula, it's easy to figure out what your baby is being supplied with. You can read the label, and know your baby is getting the same formulation from one feed to the next.

But breast milk doesn't work that way. Human breast milk is roughly similar in composition from one woman to the next, but there are significant differences. Not only does breast milk vary between individuals. It also varies between milk samples produced by the same woman at different points in time.

Breast milk varies in caloric content

When Shelly Hester and her colleagues analyzed 22 published studies on the metabolizable energy content of breast milk, the researchers were able to estimate the calories found per serving: About 65 calories per 100 milliliters (mL) of breast milk.

But hang on. That estimate is the average for milk expressed between 2 weeks and 6 weeks postpartum (Hester et al 2012).

Milk produced earlier is substantially less caloric. Colostrum, the milk produced during the first few days, has only about 53 calories per 100 mL. Then, between approximately 6 and 14 days postpartum, the caloric density increases slightly, averaging 58 calories per 100 mL (Hester et al 2012).

And milk produced later -- after the 6 weeks postpartum -- becomes increasingly caloric as time goes by. That's because the fat content of breast milk tends to increase the longer a woman continues to nurse. When researchers have tracked lactating mothers over time, they've found that the fat content in milk produced at 6 months is higher than it is at 3 months (Szabó et al 2010).

That's a lot of variation already, but we've only scratched the surface because individual mothers vary substantially in the energy content of their milk. Studies indicate that individual woman may range widely in the fat content of their milk -- from 2 grams per 100mL to 5 grams per mL ( Institute of Medicine, National Academy of Sciences 1991).

And other research has identified some of the causes of this variation: Diet, body mass index, maternal age, socioeconomic status, and even smoking habits have been linked with differences in the amount of fat in breast milk (Innis 2014; Rocquelin et al 1998; Argov-Argaman et al 2017; Al-Tamer et al 2006; Agostoni et al 2003).

So it shouldn't surprise us if there is no "one size fits all" infant feeding schedule that's going to serve every baby equally well. Babies vary in their needs, and different breastfed babies may be receiving very different types of breast milk. Some get milk that is richer than average. Others get milk that is much lighter.

And since babies can only drink so much before their stomachs are full, the fat content of milk is going to make a substantial difference in the calories they obtain from any given feeding session. Some babies will need more frequent feedings than other babies do, simply because their milk has fewer calories per serving.

Just as important, milk from the same mother can fluctuate in quality from day to day, and even from hour to hour (Khan et al 2013). So it's possible that an infant feeding schedule that works pretty well one day might leave a baby dissatisfied on another.

Finally, it's worth noting that the quality of breast milk changes during the course of a feed. At the beginning of a feeding session, when the breast appears full, the milk that is released is relatively diluted and low in fat. Then, as the session continues, the breast takes on a softer, emptier appearance, and the milk changes. The earlier "foremilk" gives way to a more concentrated, fattier "hindmilk" (Woolridge 1995), and you can see the difference in this photo.

The foremilk looks watery and bluish. The hindmilk -- produced by the same breast, but later in the session -- is ivory in color, and thicker.

Thus, if the adult terminates the breastfeeding session too soon, or forces a baby to switch breasts too soon, the baby will miss out on hindmilk (Woolridge and Fisher 1988). Babies in this situation will fill up on a low calorie meal, and require more frequent feedings to obtain the energy they need. In addition, they may be at higher risk for symptoms associated with consuming low quality milk. As breastfeeding expert Michael Woolridge (MD and PhD) has pointed out, low-fat milk can contribute to colic, vomiting, diarrhea, and flatulence in infants (Woolridge 1995).

What about formula-fed babies? Don't they need us to impose restrictions -- so they won't overfeed?

You may have heard about research linking formula-feeding with rapid infant growth and an increased risk of childhood obesity. The links have been replicated in many studies, have prompted concern. Why are formula-fed babies more likely to become overweight?

One answer is that formula might be too energy-dense for some babies (Hester et al 2012). But it also appears that the delivery system -- drinking from a bottle -- is a contributing factor.

For example, in one study of 1250 American infants, researchers found that bottle-feeding in early infancy was associated with a tendency to eat everything on offer, regardless of whether the babies consumed formula or breast milk. The more frequently babies drank from bottles during their first 6 months, the more likely they were to become big eaters later. As toddlers, they were more likely to completely drain any bottle or cup given to them (Li et al 2010). A smaller study conducted in the United Kingdom reports similar results (Brown and Lee 2012).

It's not clear what this means. Infants can extract milk more quickly from a bottle than they can from a breast. Perhaps the fast pace leads to consuming more during a feed, so babies become accustomed to taking in bigger meals.

But whatever the underlying cause, it invites the obvious question: Isn't this a good reason to impose an infant feeding schedule? Aren't bottle-fed babies better off if we restrict the timing of their meals?

The evidence suggests not.

For instance, experimental research indicates that babies are sensitive to internal cues of hunger and satiety. When allowed to feed on demand, both breastfed (Woolridge and Baum 1992) and formula-fed (Fomon et al 1975) infants adjust their intakes in response to the caloric content of their milk or formula.

And when researchers have tracked infant development over time, they haven't found that feeding restrictions -- including timed feeding schedules -- reduce the risk of a child becoming overweight.

On the contrary, most studies either report no link, or a positive correlation between restrictive feeding and higher body weights (Gubbels et al 2011; DSantis et al 2011b; Dinkevich et al 2015; Gross et 2014). For example, in one study, researchers found that formula-fed babies were more likely to experience rapid weight gain. But they also found that scheduled feeding was a risk factor in its own right (Mihrshahi et al 2011).

Such observations are consistent with studies of older children. Intrusive, restrictive rules about eating may interfere with the development of self-regulation. They may actually increase a child's tendency to engage in emotional overeating (Jani et al 2015; Rodgers et al 2013), and lead to excessive weight gain (Tylka et al 2015).

So researchers suspect that imposing restrictions -- like a strict infant feeding schedule -- are counterproductive for preventing obesity. Kids might learn to ignore their own hunger cues, and eat in response to social cues ("it's time!") or emotions ("I've been denied -- now it's time to make up for that"). By allowing infants to initiate feedings, we may be helping them develop a more healthy relationship with food.

Other considerations: Do the effects of an infant schedule extend beyond matters of nutrition and energy regulation?

That's an interesting question.

From birth, infants get distressed when their signals to nurse are ignored. And studies indicate brief, token acts of feeding can help newborns bounce back from stress.

Newborns cry less and show signs of reduced pain when they receive small amounts of milk, formula, or sucrose (see review by Shaw et al 2007; also Blass 1997a; Blass 1997b; Blass and Watt 1999; Barr et al 1999). The act of suckling is itself an analgesic (Blass and Watt 1999). And breastfeeding may be a painkiller and stress-reducer.

In one study, newborns subjected to a painful blood collection procedure cried much less if they were permitted to breastfeed (Gray et al 2002). They cried just 4% of time total procedure time, versus 43% for infants in a control group.

Babies who fed during the procedure also showed markedly reduced rates of grimacing (8% v. 50%), and their heart rates increased less (6 beats per minute v. 29 beats per minute).

Some of these differences may be attributable to the extra skin-to-skin contact that the breastfed babies got. But in a follow-up study, the researchers confirmed that breastfeeding was more soothing than skin-to-skin contact alone (Gray et al 2000; Gray et al 2002). And the authors noted that babies who were held without being fed tended to get frustrated, and required much more time to settle down (Gray et al 2002).

So what might happen to a baby who finds her signals for quick comfort are routinely ignored?

While I've found no studies that bear directly on this question, responsive care has been linked with development of better stress regulation skills -- even among highly irritable, "at risk" babies.

Moreover, a variety of studies suggest that sensitive, responsive parenting contributes to secure attachment relationships and better child outcomes.

And there is intriguing research regarding cognitive development.

In what is perhaps the largest study yet to investigate the effects of an infant feeding schedule, Maria Iacovou and Almudena Sevilla (2013) tracked the development of more than 10,000 British children -- breastfed and bottle-fed alike -- from birth to age 14.

There were no experimental manipulations. The researchers merely noted whether babies had been fed on schedule or on demand, and then followed their cognitive and academic progress. And the results favored feeding on demand:

At every age, kids who'd been subjected to an infant feeding schedule performed more poorly on standardized tests. Moreover, their IQs were, on average, 4.5 points lower.

Correlation doesn't prove causation, of course, and this is just one study. It needs to be replicated.

But it's interesting to note that the study's results remained much the same even after controlling for a variety of potential confounds, like parents' education levels, economic factors, health, breastfeeding, maternal smoking, and the children's exposure to negative discipline tactics. There wasn't any obvious reason for the difference between groups. Just the distinction between feeding on cue and following an infant feeding schedule.

Summing up: What do we really know?

As with most science, we still have a lot left to learn. We don't yet understand all the determinants of breast milk quality, or why the composition of breast milk changes over time. We don't yet understand all the causes of increased obesity risk in formula-fed and bottle-fed infants. And it isn't yet clear how much impact an infant feeding schedule might have over the long term.

In particular, we need more research on the possible effects an infant feeding schedule might have on stress regulation and cognitive development.

We also need more research regarding physical growth rates. When researchers analyzed the growth records of 48, one-year-old babies, they found no "pervasive" effect of feeding style on infant weight gain during the first six months postpartum (Saxon et al 2010). However, this study relied on retrospective reports from mothers (asking them to characterize their feeding styles 12 months before), which introduces some uncertainty. And the study didn't control for breastfeeding, which differed between groups.

That's important, because -- as we've seen -- imposing an infant feeding schedule could have opposite effects on weight gain depending on whether a baby is breastfed or formula-fed. It may help breastfed babies avoid being underfed, and help formula-fed babies avoid excess weight gain. By lumping together all babies fed on cue, we lose the ability to detect these opposing, but potentially important effects. Future, carefully controlled studies can help us resolve the question.

Meanwhile, what we do know is that human beings exhibit the characteristics of continual feeders, and it's a sure bet that relatively frequent, "on demand" feedings have been the historic and evolutionary norm for our species.

It's also clear that breast milk can vary substantially in fat composition and caloric density, so that babies will benefit from being able to schedule the timing of their own feeds. And all babies -- whether they consume breast milk or formula -- experience fluctuations in their needs for fluids and energy. When we are responsive to their cues of hunger and thirst, we're more likely to meet these needs.

More reading

How can you tell if a newborn is hungry? Find answers to this and other questions in my article, "The newborn infant feeding schedule: A review of the evidence against regimented feedings."

In addition, you can read more about this topic in "Breastfeeding on demand: A cross-cultural perspective." And for more information about the composition of breast milk, read this review.

References: The best infant feeding schedule

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Brown A and Lee M. 2012. Breastfeeding during the first year promotes satiety responsiveness in children aged 18-24 months. Pediatr Obes. 7(5):382-90.

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Shah PS, Aliwalas L, and Shah V. 2007. Breastfeeding or breast milk to alleviate procedural pain in neonates: a systematic review. Breastfeeding medicine 2:74-82.

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Tylka TL, Lumeng JC, Eneli IU. 2015. Maternal intuitive eating as a moderator of the association between concern about child weight and restrictive child feeding. Appetite 95:158-65.

Ventura AK, Inamdar LB, Mennella JA. 2015. Consistency in infants' behavioural signalling of satiation during bottle-feeding. Pediatr Obes. 10(3):180-7.

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Woolridge MW and Baum JD. 1992. Infant appetite-control and the regulation of breast milk supply. Children's hospital quarterly 3:133-119.

Woolridge MW and Fisher C. 1988. Colic, 'Overfeeding,' and Symptoms of Lactose Malabsorption in the Breast-Fed Baby: A Possible Artifact of Feed Management. Lancet 13: 382-384.

Note: Portions of this article, "Jettisoning the infant feeding schedule: Why babies are better off feeding on cue," are taken from an earlier Parenting Science article, "The infant feeding schedule: Why babies benefit from feeding on demand." The material here has been updated and substantially revised.

For more references pertaining to the infant feeding schedule, see my article on breastfeeding on demand.

Image credits for "The best infant feeding schedule"

Friend with mother nursing infant - US Dept. Agriculture (creative commons license)

Grandmother, infant, and mother - Philippe Parr / flickr ( creative commons, no derivations)

Image of mother nursing outdoors - Aurimas Mikalauskas /flickr (creative commons)

Breast milk by Azoreg / wikimedia commons (creative commons license)

Baby bottle by nerissa's ring / flickr ( creative commons license)

Newborn sleeping by Jason Barles / flickr ( creative commons license)

Content of "The best infant feeding schedule" last modified 3/2017

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The best infant feeding schedule: Why babies benefit from feeding on cue

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© 2017 Gwen Dewar, Ph.D., all rights reserved The infant feeding schedule reconsidered In the past, Western "baby experts" often instructed parents to feed their babies at regularly-spaced intervals of 3- or 4-hours. But today, official medical recommendations have shifted in favor of letting babies decide. Why the change?

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Here's the new UNICEF leaflet for health professionals on bed sharing. 

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Here's the new UNICEF leaflet for health professionals on bed sharing. 

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This paragraph is particularly important: While some young babies settle easily in a cot or Moses basket between feeds, others do not. Some parents who choose not to co-sleep may decide to encourage their baby to learn to sleep independently using the controlled crying method, which is not recommended. This approach can be distressing for the parents and their baby, be detrimental to the baby’s growth and development and can undermine breastfeeding.

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New research into the importance of responding sensitively to babies’ distress: 

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New research into the importance of responding sensitively to babies’ distress: 

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Parents, no pressure, but the success of our future society depends on you!

New research points to cuddled children growing up to be healthier, less depressed, kinder, more empathetic, and more productive adults.

According to a WSBT report, "snuggles matter."

The new research from Notre Dame Psychologist Darcia Narvaez studied more than 600 adults and found those who were cuddled as children grew into more well-adjusted adults with less anxiety and better mental health.

The study found that, along with cuddling, a positive childhood with lots of affection and quality time also led to healthier adults with better coping skills.

The research will soon be featured in the journal Applied Developmental Science.

Much research has already been done on the effects of how cuddling helps preemies, and now that researchers are seeing benefits all the way up to adulthood, it just goes to show what the Beatles knew all along - all you need is love.

This research also puts an end to an age-old debate - you may now tell your mother-in-law that you can't "spoil" your baby by picking them up when they cry.

In fact, Narvaez tells WSBT that not only is it impossible to spoil a baby, you will actually "ruin" the baby's development by letting it cry.

"What parents do in those early months and years are really affecting the way the brain is going to grow the rest of their lives, so lots of holding, touching and rocking, that is what babies expect. They grow better that way. And keep them calm, because all sorts of systems are establishing the way they are going to work. If you let them cry a lot, those systems are going to be easily triggered into stress. We can see that in adult hood, that people that are not cared for well, tend to be more stress reactive and they have a hard time self calming," said Narvaez.

So, parents, snuggle away! Your child - and the world - will thank you later.

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New research ends an age-old debate: Will you spoil your baby if you pick it up each time it cries?

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Parents, no pressure, but the success of our future society depends on you! New research points to cuddled children growing up to be healthier, less depressed, kinder, more empathetic, and more productive adults. According to a WSBT report, "snuggles matter."

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A thought-provoking article about nappy changing: 

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A thought-provoking article about nappy changing: 

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We are conflicted about nappy changing these days. As a society, it makes us uncomfortable. It is distasteful, involving dirty, smelly bodily substances. It is anxiety provoking, requiring the exposure of babies' genitals. It is inconvenient, necessitating a pause in the midst of whatever other activity a parent has underway. And it frequently emotional, with babies refusing to lie still or staring intently into their caretaker's face.

For all these reasons, nappy changing is something we don't usually talk about in polite circles. It may be a necessity of life with a baby, but it's not exactly a subject for the dinner table, is it? It might therefore seem too inconsequential a topic for a whole article, especially when you consider that other pieces in this blog series have focused on 'serious' subjects, like terrorism and abuse and brain development.

Yet, to my mind, that is exactly the reason for writing a piece on nappy changing. Babies' brains grow more rapidly during the period of life during which they need their nappies changed than will ever be the case again. Approximately 1000 synaptic connections are formed every second during this period. Astounding. And it is the emotional experiences that babies have over and over again that build the most robust neural pathways. Nappy changing is undoubtedly an activity that babies encounter repeatedly. Indeed, over just the first six months, there are approximately 10 changes per day, each lasting, say, 5 minutes. That's 9000 minutes or 540,000 seconds, and thus half a billion synapses.

So nappy changing isn't quite as inconsequential as we might at first have thought. It has an impact on babies' brain development. More specifically, the emotional experiences that caretakers give babies whilst changing their nappies are being built into babies' brains.

I thought, therefore, that it would be interesting to reflect on the ways in which modern society encourages us to approach the task of nappy changing. This is an appropriate moment for such reflection, given that Real Nappy Week is taking place this very week in London. Most people won't have any idea there is a group of committed individuals who want to celebrate the benefits of real cloth nappies. This article is my way of supporting their efforts.

So what are some of the big messages we get about nappy changing in today's society?

One message is that nappies are disgustingly funny. Take, for example, the videos that regularly travel the web that show fathers wretching whilst changing nappies. In August 2015, a tattooed, uniformed father gained international attention when the video of him vomiting as he soldiered on with nappy changing went viral, featuring eventually on television and in newspapers.

Why is it always Dads? I know that we regard ourselves as having 'moved on' as a society, because once upon a time fathers never changed nappies at all. But this humiliating form of humour says something darker about the way we frame modern masculinity. We are either laughing at dads' incompetence - or turning them into heroes for coping with something ordinary. Indeed, if you want a gag gift for new fathers, you can buy a 'doodie apron', which comes complete with nose peg, face mask and gloves, all designed to help a father keep the disgusting productions of his baby's body at bay.

I know it's supposed to be funny. And I know I sound like I need to get a life if I'm not laughing at the innocent joke. But I find myself wondering about the baby's experience. Is the baby scared when confronted with Dad clad in a face mask? Does the baby feel ashamed when Dad looks disgusted in reaction to the substances that her body produces? Does the baby feel embarrassed when parents start laughing whilst filming 'poo faces' to send to Pampers as part of an advertising campaign?

Here's my point: we feel okay about all this laughter because we think it's only about the adults. We don't think it matters to the babies. We wouldn't laugh at older people with dementia who are pooing, because we would think that was disrespectful. But when it comes to babies, we think they don't notice. That why the joking seems innocent and can't do harm to anybody.

Except it's not true. Babies are born with a connected brain. That means they are already aware of and attuned to and reading other people's emotions, facial expressions and behaviour. Babies learn about themselves by the way we treat them. This includes the way we treat them during activities as 'inconsequential' as nappy changing. If we react often enough to babies' bodies with disgust, then they start to see themselves as disgusting. It is ominously fascinating to realise that we can build a sense of shame into our child's brain by the way we treat them during nappy changing. As parent, we can do that without ever realizing or intending to. And modern society makes it more, not less, likely that we will do just that.

What's another message that we get in today's world about nappy changing? How about this one: the less it happens, the better. Pampers and Huggies make disposable nappies d esigned to last 12 hours without the need for a change. The idea is that parents don't have to be interrupted in the midst of other activities with their wee ones. Babies can remain strapped into car seats and strollers and carry cots. They don't have to risk being woken at night.

Modern society creates more and more devices that reduce babies' opportunities to feel their parents' touch. Of all the senses, touch is the most important for babies. It is the first sense to develop in the womb and the most developed at birth. Skin is our largest organ, and the sensations that skin sends to the brain are so powerful that they act as pain relief. In our evolutionary history, babies spent much more time experiencing touch, strapped as they were to a parent's body during the day and sleeping next to a parent's body at night. Modern babies experience an extremely different type of infancy than did our forebears.

Yes, babies adapt to the modern world. Skeptics will reply that babies are clearly surviving in today's world of nappies, transport devices and sleeping arrangements. I agree, they are. But I also know that without sufficient touch and physical attention, babies die. That was one of the points to come out of studies of Romanian orphans. Infant humans depend on the physical presence of another human being in order to survive.

Could the decreasing amount of touch that modern babies receive be one of the reasons that our society is witnessing an increase in behavioural problems associated with emotional regulation? The most fundamental pathways that the brain is forming during the early years are the ones that enable to us to cope with - that is, regulate - our emotions.

So maybe it would be better if disposable nappies weren't quite so efficient? Maybe it would be better for babies' emotional health if nappy companies could find ways to inform parents about the crucial importance of touch and cuddling and feeling Mum's warm fingers on your skin - even while they search for ways to keep urine from reaching a baby's skin.

That's one of the aims of Real Nappy Week. The celebrations aren't designed only to highlight the value of non-disposable nappies, but to get us as a culture to rethink the whole business of nappy changing.

So what's one final modern-day message to which we might pay attention? How about the way in which our fear of sexual abuse now overlaps with nappy changing?

Many nurseries now have a policy that requires two members of staff to be present when nappies are changed, in order to guard against the risk of inappropriate touch. We are scared that the people who have been vetted to take care of our children might harm them, and nakedness makes nappy changing seem a particularly vulnerable setting.

Videos that instruct new parents on how to change nappies are frequently shot from an angle that avoids revealing babies' genitals, or are edited so that the genitals are blurred out. How ironic that the very parts of the body that generate the need for a nappy change cannot be shown on film. In our struggle to come to terms with the very real risks that children face of being sexually abused, we have further sexualised our youngest children.

In the run-up to Real Nappy Week, my team released our brief film 'dance of the nappy'. The film is excerpted from our longer feature-length film, 'the connected baby', first released in 2011 with funding from the British Psychological Society. We estimate that the longer film has now been viewed by 100,000 people, but this is the first time we have released an entire segment for public viewing on YouTube.
The film shows the intricate emotional dance that goes on between a 5-week-old baby and his mother during an ordinary nappy change. The baby's emotional responses to his mother's movements and facial expressions are so nuanced that it would be easy to miss them. That's why we wanted to make the film: because such moments of connection are happening for babies across the world, but it is easy for parents to overlook them because they are so subtle and fleeting. Video footage makes it possible to slow everything down and reveal what is not apparent to the naked eye.

After filming that session, I realised the baby's genitals were in full view. The mother realised it too. She commented on it at the time, whilst we were filming. Later, during editing, she confirmed that she was comfortable with retaining the footage. But I had to ask myself: was I comfortable with it? Was it appropriate in today's society to show a 5-week-old baby's genitals on a movie screen? What would I say if someone challenged my decision? What if, later, when the baby is grown, he resents having had his bum shown off to the world? What if I was accused of encouraging inappropriate touch because his genitals appear briefly but undeniably?

My decision was not to change anything. I decided that real-life nappy changing means exposing and cleaning baby's genitals. I decided that merely alluding to that, by editing out that footage, actually feeds our modern day fear that genitals are inherently sexual, even those of a 5-week-old baby. I decided that I was making a film that was trying to show how connection is possible at all points in a baby's day, including during an activity as 'disgusting' as changing a pooey nappy. Because that's exactly what the film shows - not just a Number One, but a Number Two. And the interaction between the mum and her baby is still loving and affirming. The baby gets no sense that his bodily excrement is shameful to her. After weeks of fretting, I decided I could defend such a scene to the world.

This week, I was reminded about my early worries. Since our public release on YouTube last week, I have received queries from three people, expressing unease that the film shows 'everything'. I was relieved to realise that I now welcomed such debate, rather than feared it. Those weeks I had spent agonizing had been valuable, for they enabled me to articulate the position I take in this debate.

And here is my position: Something is emotionally askew in our modern society. On the one hand, the global company Pampers can make an award-winning film that is intentionally designed to make us laugh at babies' unease and discomfort when they poo. On the other hand, we can be made uncomfortable by a film that shows the real poo and the parts of a baby's body that produced it. Something is awry in our reasoning.

I like the idea that a scene of something as tediously ordinary as a pooey nappy can become a radical act. A baby boy's bum can make us reflect in new ways on our own humanity.

So, to the grown man of the future who was once that baby boy, let me offer my thanks and my apologies now. It was your bum that offered us this gift of reflection. Your mother says in the film: "One day you might really hate that I did this in front of the camera." I hope you don't. Because every time I show this film, I offer you a silent, grateful thanks for the trust you placed in us that day.

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Changing nappies is as much about babies' brains as their bottoms

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We are conflicted about nappy changing these days. As a society, it makes us uncomfortable. It is distasteful, involving dirty, smelly bodily substances. It is anxiety provoking, requiring the exposure of babies' genitals. It is inconvenient, necessitating a pause in the midst of whatever other activity a parent has underway.