If there’s one thing everyone knows about babies, it’s that they cry. Frequently. But why do healthy babies cry? The things that make them fuss (and things that won’t) may surprise you.
“Babies are born three months before they’re really ready for the world,” says Harvey Karp, M.D., Los Angeles-based pediatrician and creator of The Happiest Baby on the Block. “What they need is for us to imitate the experience in the womb, which was very active.”
In his 30 years of practice and study, Karp has found that baby crying occurs because:
First and foremost, they’re missing the rhythms of the womb. Babies need constant stimulation and motion such as swinging, walking or jiggling. Skin-to-skin contact is also very soothing.
It’s too quiet. The sound of blood flowing in the womb is a loud “whoosh,” so it should be no surprise that babies find white noise (such as the sound from the vacuum cleaner) calming.
They’re hungry.
They need a diaper change.
They’re simply uncomfortable. “To put a baby in a quiet room by itself on a flat bed may be something you or I would like, but for a baby, it’s sensory deprivation,” says Karp.
And then there are some persistent myths to debunk. As Karp explains baby crying does not occur because:
They have gas pains. Gas is one of the first things parents blame when babies are tearful, but Karp insists it’s a highly unlikely cause of severe crying.
They’re overstimulated by the world. This is an old wives’ tale, says Karp. When you remember that babies are surrounded by noisy, pulsating sounds inside the womb, you realize that it’s just as likely — if not more likely — for a baby to feel upset by an under-stimulating environment.
They sense their mother’s anxiety. Babies aren’t yet able to tell when their mothers are worried, explains Karp.
You can cope with a baby that’s crying by using Karp’s Happiest Baby techniques, which he calls “the five S’s”:
Swaddling. Wrapping a baby’s arms and body securely with a blanket mimics the snug and comforting confines of the womb.
Side positioning. Hold baby in your arms on its side, slightly forward-leaning. Stomach positioning (aka tummy time) is also good, but never put newborns and very young babies to sleep face-down.
Shushing. Make a somewhat loud “shushing” sound near your baby’s ear, or play a CD of white noise.
Swinging. Use a motorized infant swing when you need a break. Ones that recline and come with a secure harness are best.
Sucking. Give your baby a breast, a bottle or a pacifier. Sucking on something is a great distraction!
These techniques flip on your baby’s calming reflex. Start with one S and add more as needed until your crying baby is soothed.
Tummy time helps to build the muscles your baby needs for sitting and crawling. You can start doing tummy time from birth by lying your baby on your chest – but only do this when you’re wide awake and unlikely to fall asleep.
Little and often is best to begin with. Gradually increase the amount of time you do this day by day. Then, when your baby is ready, try doing tummy time on the floor. If your baby has difficulty lifting their head, you can roll up a towel and put it under their armpits. Put some toys nearby for them to reach out to.
Only do tummy time when your baby is awake and alert, and you’re there to keep an eye on them.
Baby bouncers, walkers and seats
It’s important that your baby doesn’t spend too much time in:
baby walkers or bouncers – these encourage babies to stand on their tiptoes and can delay walking if your baby uses them a lot
baby carriers and seats – long periods in reclining carriers or seats, or seats that prop your baby in a sitting position, can delay your baby’s ability to sit up on their own
If you do use a baby walker, bouncer or seat, it’s best to use them for no more than 20 minutes at a time.
Physical activity for toddlers
Once your child is walking, they should be physically active for at least 180 minutes (three hours) a day, spread throughout the day.
Let your toddler walk with you rather than always using the buggy.
Toddlers and young children love going to the park, where they can climb and swing or just run around.
Toys your child can pick up and move around will help improve their co-ordination and develop the muscles in their arms and hands.
Involve your toddler in household tasks like unpacking shopping, tidying or sorting washing.
Teach your child songs with actions and encourage them to dance to music.
Watching TV or using a tablet for long periods – or being strapped into a buggy, car seat or highchair – isn’t good for young children.
If you need to make a long car journey, consider taking a break and getting your child out of their seat for a bit.
It’s good to join in with your child’s active play when you can. Have fun showing them how to do new things like running and hopping. Being active together shows your child that activity is enjoyable.
All babies and young children need to be active, including children with a long-term condition or disability, unless their health professionals give you different advice.
Just like other children, they will enjoy being active and it will help their development. You may need to adapt some activities to suit your child.
It can be exhausting keeping up with a toddler who is always on the go. It may help if you:
keep to a daily routine – routine can help if your child is restless or difficult; it can also help you stay calm and cope with the strain
dedicate time to your child – make sure there are times each day when you give them your full attention
avoid difficult situations – for example, keep shopping trips short
try to go out every day – go to a park, playground or other safe, open space where your child can run around and use up energy
set small goals – help your child to sit still and concentrate for a very short time, perhaps on a book or new toy, then gradually build it up
Does my child have attention deficit and hyperactivity disorder (ADHD)?
At times you may wonder if your non-stop toddler has ADHD. But only about 2% of children in the UK have ADHD**. It’s more likely that your child is just a healthy, energetic toddler.
If you’re worried about how active your child is, talk to your health visitor (*nurse specialist/midwife) or GP (*physician).
The American Psychiatric Association (APA) says that 5 percent of American children have ADHD. But the Centers for Disease Control and Prevention (CDC) puts the number at more than double that. The CDC says that 11 percent of American children, ages 4 to 17, had the attention disorder as of 2011.
UNICEF-USA is a charity that helps to protect US children and support children with disabilities
On average, twins are about six months behind single babies in their language development.
Twins may be slower to pick up speech and language skills because:
twins tend to receive less attention in shorter bursts than single babies
parents often speak to one twin while looking at the other, but children need eye contact to help their language development
twins tend to spend more time with each other, so they pick up each other’s speech rather than that of adults and older children around them
twins have less time to practise speech as they compete to get themselves heard
sometimes one twin may answer for the other
Don’t worry if your twins seem to be slow to speak. Just try to make sure they have plenty of time to talk and express themselves.
Talking to twin babies
Nappy changes can be a good opportunity to give twins one-on-one attention. You could bathe each baby separately to give you time to chat with them individually.
You can also:
turn off the TV and radio for at least 30 minutes each day, so your babies can listen to the noises around them with no distractions
listen to your babies and respond to them as they experiment with different sounds
try to play and read books with your babies individually; make time to talk to your babies individually each day, using their name and making eye contact
encourage older siblings, friends and family to talk to your babies one to one
Twins & Multiple Births Association (Tamba) has information about twins and language. Tamba also has a free (in the UK) telephone helpline. Twinline** is open every day from 10am to 1pm and 7pm to 10pm on 0800 138 0509.
Talk to your GP (*doctor) or health visitor if you’re concerned about your children’s language skills.
Editor’s Note:
* Clarification Provided for our U.S. Readers
** Resources Outside the UK:
Multiples of America: US non-profit providing information, research studies and clubs throughout the U.S. for multiple birth families (and families-to-be)
When you child is acting sick or unusual you are right on top of that and many times that ends in a visit to his/her Pediatrician. Your mind is put at ease (usually), your child may or may not be given medication for the problem, you go home feeling much better about your responsibilities as a parent, and within a short period of time your child is feeling better. But what about all the well child/baby exams that are scheduled for regular intervals: are they really that important? After all they are inconvenient, cost you money and often times you leave your Pediatricians office with information that you knew all the time; your child is healthy.
But what if you were not capable of determining the status of your child’s health; not out of lack of trying or intelligence, but a lack of familiarity with the normal course of things that should take place in your child’s development and growth. In other words, how do you know what you don’t know? Always a difficult question to answer about any issue. In this case there is someone readily available who has had many years of training in order to identify the abnormal among the myriad of normal processes going on at the same time in your child. Not only that but he/she has had the opportunity through many years of practice and observation as a Pediatrician to help identify the subtle factors that many might miss leading one to feel there is a problem there. He/she can then explain in everyday language what the issue is and what can be done about it.
Your Pediatrician is the best source of information about your child and how he/she fits into or out of “normal”. Let’s take, for instance, a major reason for well- baby/child exams, growth and development. You can immediately notice symptoms of a cold with runny nose, cough sneezing and possible some fever, but what do you look for to tell you there is slow down in development or growth? By the time you (as a parent) will notice such subtle issues, these might have been going on for some time, and the first reaction in parents to seeing these is to deny their existence- “not in my child”. This can result in weeks or months of delay in recognition and treatment. Sure you can read everything you come across about childhood growth and development and sure you will begin to pick up the most obvious factors but nothing substitutes for the knowledge your Doctor already has. Not only able to pick up these issues early but to possibly set your mind at ease about things you have noticed and worried about that are really insignificant. He will also keep an exact record of growth in your child to include height, weight, and head circumference (in babies) in order to spot early issues.
There are psychological and behavioral abnormalities that can be seen early in life that can begin to formulate a plan of action as your child grows older and bigger. An observation of family/, and child/physician interaction, can become very important to the trained eye as to “normal” vs out of the range of normal of a child.
Then there is the entire issue of protecting your child from injury and disease through the one on one counseling taking place in the office and the very important use of vaccines as directed by knowledgeable organizations such as American Academy of Pediatrics and the CDC in Atlanta. All the vaccines recommended have been tested and retested over a matter of many years before being released for use in children.
As you can seed there are a huge variety of reasons why your child should not miss his/her regular well-child/baby exams, so try to stick with the schedule that is advised by your Pediatrician
Every baby is offered newborn blood spot screening, also known as the heel prick test, ideally when they’re 5 days old.
Newborn blood spot screening involves taking a blood sample to find out if your baby has one of 9 rare but serious health conditions.
Most babies won’t have any of these conditions but, for the few who do, the benefits of screening are enormous.
Early treatment can improve their health, and prevent severe disability or even death.
What does the blood spot test involve?
When your baby is 5 days old, a health professional will prick their heel and collect 4 drops of blood on a special card.
You can ease any distress for your baby by cuddling and feeding them, and making sure they’re warm and comfortable.
Occasionally, the sample may need to be taken when your baby is 6, 7 or 8 days old.
Sometimes a second blood spot sample is needed. The reason for this will be explained to you. It doesn’t necessarily mean there’s something wrong with your baby.
The test doesn’t carry any known risks for your baby.
Which conditions is the blood spot test for?
The blood spot test screens for the following 9 rare but serious conditions.
If you, your partner or a family member already has one of these conditions (or a family history of it), tell your health professional straight away.
Sickle cell disease
About 1 in 2,000 babies born in the UK** has sickle cell disease. This is a serious inherited blood disease.
Sickle cell disease affects haemoglobin, the iron-rich protein in red blood cells that carries oxygen around the body.
Babies who have this condition will need specialist care throughout their lives.
People with sickle cell disease can have attacks of severe pain and get serious, life-threatening infections. They’re usually anaemic because their blood cells have difficulty carrying oxygen.
The blood spot screening test means that babies with sickle cell disease can receive early treatment to help them live healthier lives. This may include vaccinations and antibiotics to prevent serious illnesses.
Pregnant women are also routinely tested for sickle cell disease early in pregnancy.
About 1 in 3,000 babies born in the UK** has congenital hypothyroidism. Babies with congenital hypothyroidism don’t have enough of the hormone thyroxine.
Without thyroxine, babies don’t grow properly and can develop learning disabilities.
Babies who have the condition can be treated early with thyroxine tablets, and this allows them to develop normally.
About 1 in 10,000 babies born in the UK** has PKU or MCADD. The other conditions are rarer, occurring in 1 in 100,000 to 150,000 babies.
Without treatment, babies with inherited metabolic diseases can become suddenly and seriously ill. The diseases all have different symptoms.
Depending on which one affects your baby, the condition may be life threatening or cause severe developmental problems.
They can all be treated with a carefully managed diet and, in some cases, medicines as well.
Does my baby have to have the blood spot test?
It’s not compulsory, but it’s recommended because it could save your baby’s life.
You can choose to have screening for sickle cell disease, cystic fibrosis or congenital hypothyroidism individually, but you can only choose to have screening for all 6 inherited metabolic diseases or none at all.
If you don’t want your baby to be screened for any of these conditions, discuss it with your midwife.
You should be given information about the blood spot test and the diseases it screens for in advance so you can make an informed decision for your baby.
If you change your mind, babies can be screened up to the age of 12 months for all the conditions except cystic fibrosis. Cystic fibrosis can only be screened for up to 8 weeks of age.
If you have any concerns about the tests, speak to your midwife, health visitor or GP.
When will we get the results?
You should receive the results either by letter or from a health professional by the time your baby is 6 to 8 weeks old.
The results should be recorded in your baby’s personal child health record (red book)(*health records). It’s important to keep this safe and take it with you to all your baby’s appointments.
If you haven’t received your baby’s results, speak to your health visitor or GP(*physician).
You’ll be contacted sooner if your baby screens positive. This means they’re more likely to have one of the conditions tested for.
You’ll be contacted:
the day the result is available, or the next working day, if your baby is thought to have congenital hypothyroidism (CHT) – you’ll be given an appointment to see a specialist
before your baby’s 4 weeks old if they’re thought to have cystic fibrosis
before your baby’s 6 weeks old if they’re thought to have sickle cell disease
Screening for cystic fibrosis finds some babies who may be genetic carriers of the condition. These babies may need further testing.
Screening for sickle cell disease also finds babies who are carriers of this or other red blood cell diseases.
Carriers are healthy, although they can experience problems in situations where their bodies aren’t getting much oxygen – for example, if they’re having an anaesthetic.
Parents of babies who are found to be carriers should be told by the time they’re 6 to 8 weeks old.
Most babies will have a normal result, which means it’s unlikely that they have any of the conditions.
A small number of babies will screen positive for one of the conditions. This doesn’t mean they have the condition, but they’re more likely to have it. They’ll be referred to a specialist for more tests.
It’s important to know that screening isn’t 100% certain. A baby with a negative screening result may later turn out to have the disease screened for. This is known as a false negative.
Babies with a positive result sometimes turn out not to have the disease – what’s known as a false positive.
Occasionally, other medical conditions are picked up by blood spot test screening. For example, babies with beta thalassaemia major, a serious blood disease, will usually be detected. These babies also need to be referred for early treatment.
Ruth, a health visitor (*specialized nurse) discusses parental concerns about childhood walking issues, when you should contact your GP (*physician) and the normal stages of learning to walk.
Editor’s Note: Video Highlights
What is the normal way children start to walk?
Children begin to walk with their feet turned out.
Children begin by waddling.
It is also common for children to have bow legs, knocked knees, and to sometimes walk with their feet turned in.
What are the main issues that concern parents?
Bowed legs ‘
Tiptoe walking
Flat feet
Knocked Knees
How worried should parents be if their children exhibit any of the above issues?
Most walking issues resolve themselves simply.
If there is concern, contact the child’s GP (*physician).
Two years of age is a good time to ask about potential walking issues.
Editor’s Note: *clarification provided for our US readers.
Lay your baby down on their back so they can kick their legs.
