Why tummy time is important for your baby’s development



Since 1992, the American Academy of Pediatrics has recommended that infants be placed on their backs to sleep at night and during naps. The Back to Sleep and Safe Sleep campaigns have contributed to a 40 percent decrease in sudden infant death syndrome in the U.S.

Pediatric experts around the world also recommend babies spend time on their tummies – when they’re awake – to help them develop strong muscles and good motor skills. Studies show only 30 percent of parents follow these recommendations.

Jade Elliott spoke with Dr. Lindgren, a pediatrician with Intermountain Healthcare about the importance of tummy time on this episode of the Baby Your Baby Podcast.

“When babies are on their tummy, they start trying to lift their neck, move their arms and legs and work their core abdominal muscles, which helps them develop motor skills and better balance,” says Peter Lindgren, a pediatrician with Intermountain Healthcare.

Spend 3-5 minutes a few times a day interacting with your baby on their tummy. Place baby on your chest to talk and play, but don’t let baby sleep there. And don’t fall asleep with baby on your chest. Place baby in a safe place on the floor where you can watch and play with your baby for a few minutes. Some babies might not like being on their tummy at first, but gradually work up to 30 minutes a day of tummy time.

Fun ways to help your baby exercise during tummy time

  •  Place a toy just out of baby’s reach, to see if they’ll move their head or arms.
  • Place several toys in a circle around baby to encourage baby to roll over, scoot or crawl.

Place babies on their back to sleep until their first birthday

Babies should be placed on their backs to sleep at night and for naps until they reach their first birthday.

“Once baby can roll over both ways, from back to tummy and tummy to back, you do not need to return your baby to the back position,” says Dr. Lindgren.

“Nothing else should be in an infant’s crib. Do not put blankets, pillows, bumpers or soft toys into the crib.”

Dr. Lindgen says pacifiers are ok, but you may want to delay their use for the first two to three weeks after birth if you are breastfeeding. Make sure there is nothing that could cover a baby’s mouth or nose while sleeping.

If baby falls asleep in a car seat, stroller, swing, infant carrier or sling, move them to a firm sleep surface on their back as soon as possible.

Vary baby’s position to help prevent a flat spot on the back of their head

“It’s also very important to spend time holding your baby and bonding. Varying baby’s position can help reduce the risk of developing a flat spot on the back of their head. Limit the time baby spends in car seats, swings and bouncy chairs. And don’t forget to change the side you hold your baby during feeding,” added Dr. Lindgren.

For more information visit intermountainhealthcare.org

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Three ways to improve your toddler’s manners



Toddlers can say the sweetest things, the most outlandish things – and things that could be considered rude. Such moments can make parents feel awkward, and maybe not know how to respond.

So how can you help teach good manners to your toddler? And what should you do when your toddler’s actions are rude?

Jade Elliott spoke with Dr. Peter Lindgren, a pediatrician with Intermountain Healthcare about improving your toddler’s manners.

“Good manners in the early years often start with children behaving in appropriate ways, such as kindness to others, sharing, or taking turns,” said Dr.  Lindgren. “Modeling these behaviors, and giving children the right kind of attention and reinforcement, help to build these behaviors in young children.”

Here are three ways you can help improve your child’s behaviors and manners, according to The American Academy of Pediatrics (AAP).

1. Model good manners. Point out good manners among adults. Example: “Daddy is sharing his treat with mommy. Good job, sharing, Daddy!”

“Children watch everyone around them, including siblings and especially, parents. So as parents, you’re in a great position to show them the behaviors you’d like them to adopt, and help them practice good manners,” Dr. Lindgren said.

Use manners in your interactions with your children and others. When giving your child directions, remember to use “please” and “thank you.”

2. Give children positive attention throughout the day. Parents can start by gently touching the child in a loving way. The AAP recommends parents give children at least 50 brief, loving touches every day, as simple as a touch on the shoulder or the back.

Another way to show positive attention is to spend quality time with children – if even a few minutes at a time.

This could be in reading a book together, or playing with your child when you return home from work. Let the child guide the play, and comment on what they’re doing, such as “You’re working hard to color that picture!” You can also use the opportunity to praise them for putting their crayons back in the box when finished.

3. Reinforce positive behaviors. Pay attention when your child is behaving, and remove attention when she’s misbehaving (except in cases when the behaviors are dangerous or will result in harm), according to the AAP.

“Often, when kids are quiet or behaving, we don’t give them much attention – until they misbehave. And rude behavior often gets adults’ attention very quickly,” Dr. Lindgren said. “But paying attention only to misbehavior can create more misbehavior.”

Pay special attention to your child when he’s behaving, and praise a specific action. For example, you might say, “Great job listening the first time” or “Good job waiting patiently for your turn” to reinforce these behaviors.

“This is a habit parents can build, and start to build at any time,” Dr. Lindgren says. “The more you practice, the better you’ll be at noticing and praising positive behavior.”

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Water safety



Families are flocking to swimming pools in the summer heat. Primary Children’s Hospital has some tips on how to keep tots safe around water.

“Bringing babies and toddlers to pools or beaches is a wonderful experience for families and children,” said Jessica Strong, community health manager at Intermountain Primary Children’s Hospital. “These are cherished memories in the making. That’s why is so important to keep kids safe around water, and remember to remove hidden hazards around your home.”

Jade Elliott spoke with Strong about tips for keeping your children safe around water on this episode of the Baby Your Baby Podcast.

In Utah, drowning is the second leading cause of preventable injury death for children under age 14, Strong said.

A good way to protect children from tragedy is through planned supervision, Strong said.

“Have a dedicated water watcher who is solely focused on watching the children, and won’t be distracted by a phone call, text, or side conversation,” Strong said. “This is a duty that can be rotated in a group, in 15-minute shifts, for example. Some families choose to wear a lanyard with a water-watcher card as a reminder — to the water watcher and others — of who’s on shift.”

Here are some other tips to keep tots safe at the pool or lake:

  • Teach children to swim.
  • Have children wear Coast Guard-approved life jackets instead of water wings, which can deflate or fall off a child’s arms. Many public pools offer lifejackets to rent or borrow.
  •  If you have a pool, keep a locked gate around it at all times.
  •  If a child is missing, always check nearby water first.
  • Teach children to stay away from water while hiking or camping.
  •  If a child falls into rushing water, call 911. Don’t jump in after them.
  •  Learn CPR.

Strong also recommends parents and caretakers check their homes and yards for hidden water hazards. Kiddie pools, bathtubs, or even buckets with a little water can be hazardous.

“Toddlers are top-heavy,” Strong said. “They can fall in head-first to these containers — and may not be able to get out of the water by themselves.”

When not in use, Strong recommends draining kiddie pools and other containers and turning them upside-down to prevent injury.

More information is available at primarychildrens.org/safety

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


How hospital caregivers help your baby transition to life outside the womb



As you prepare for childbirth, there’s such a focus on labor and delivery and getting your baby here. It’s so important that delivery happens safely. But many moms may wonder about what happens at the hospital after birth.

Jade Elliott spoke with Taylor Hanton, a neonatal nurse practitioner with Intermountain Healthcare,  about the special newborn care and bonding and the important screenings for your baby that are offered at the hospital after birth .

The first hour after a baby is born is a very special time that neonatal providers like to call the golden hour as your baby transitions from living in the womb to living in the world and begin bonding with mom and her partner.

Why is the first hour of a baby’s life called the golden hour?

It’s a time for mom and baby to bond and ensure baby is adapting well to their new environment as well as making sure mom recovers from the delivery of her baby.

What happens right after birth?

The labor and delivery nurse is frequently in the room during the first couple of hours checking on mom and making sure she remains stable after delivery. The nurse will also assist mom with breast or bottle feeding and monitor vital signs on both mom and baby.

Skin-to-skin

Right after an uncomplicated vaginal delivery or even caesarean birth, the baby is placed on mom’s chest, to encourage skin-to-skin contact, bonding, keep baby warm, and help regulate newborn breathing. This can happen even before the umbilical cord is cut. If you have a Caesarean section, skin-to-skin is delayed due to the location of the surgery, but often can occur prior to mom leaving the OR.

Apgar scores help measure your baby’s general condition and how well your baby is adapting to the new world outside the womb and if assistance is needed. They can be done with your baby still on your chest. Apgar assess your baby’s heart rate, breathing, muscle tone, reflex response, and color. Apgar scores are assigned at one minute after birth and again at five minutes.

Most newborns have an Apgar score greater than 7. Few babies score a perfect 10, since babies are born blue and it take some time for their entire bodies to turn pink.

Approximately 5-10 percent of newborns will require some degree of resuscitation. This may include assistance with removal of oral secretions, drying and/or tactile stimulation to increase the baby’s heart rate, and to facilitate effective breathing and consequently oxygen delivery to the body.

Only about one percent of newborns require extensive resuscitation at birth. If you are delivering in a hospital, the staff is skilled and prepared to perform all resuscitation interventions on your baby if needed. Neonatal caregivers can help baby breathe with an oxygen mask or a tube placed in the windpipe, and fluids and medications may be administered through a blood vessel in the umbilical cord. If Apgar scores are still low, your baby may be transferred to the neonatal intensive care unit (NICU) for further care.

What’s the difference between a well-baby nursery and a NICU?

Well baby nurseries are typically for babies 35 weeks and above, however some rural nurseries only care for newborns 37 weeks and above. Newborn intensive care units are for babies that require extra monitoring and care, including all babies born less than 35 weeks gestation. It’s important to know the level of care available at your delivery hospital and if you will need to go somewhere else if you go into early labor. This will help you and your newborn receive care at the same hospital and not be separated.

What advice do you have for parents during that golden hour?

It’s a time to make sure the baby is adapting to life apart from the protection of the womb. The newborn caregivers make sure the baby is breathing comfortably and does not need any assistance or additional oxygen as well as make sure the baby can maintain a normal temperature.

It’s not the best time for a lot of visitors to be in the room. Babies need a low stimulation environment as they continue to clear fluids from the lungs and use their calories to work on feeding and maintaining a normal body temperature. Newborn transition is often interrupted in babies who are overstimulated (for example being held by multiple people, loud voices, or being unwrapped). These babies often become worn out and are not able to feed as well, become cold, and/or start to work harder to breathe.

The Golden Hour is a special time for mom and partner to have some time alone with the baby and to help the baby make a successful transition to his/her new world. This is also an important time for your baby to have a positive feeding experience and receive the appropriate nutrition to continue the transitioning process. In fact, newborn baths are even delayed to not interfere with this important process.

What newborn screenings are offered at the hospital to check baby’s health?

Many newborn screenings are required by state law. Here are some screenings routinely provided in Intermountain hospitals.

A screening for critical congenital heart defects or CCHD test helps identifies babies that are born with a heart defect that could put them at risk for delivering blood and/or oxygen to the body. The screen evaluates the amount of oxygen in your baby’s blood by sticking pulse oximeter sensors to your baby’s skin. If your baby does not pass the CCHD screen, an echocardiogram (an ultrasound to look at pictures of your baby’s heart) may be performed to further access the heart anatomy and function. Early detection and treatment for CCHD can be lifesaving.

Newborn screening is the first step towards a healthy start for your baby. Neonatal screening is a state requirement to help detect specific conditions in infants who would benefit from early detection and treatment. The Utah Newborn Screening Program checks for more than 40 disorders, such conditions include hormone abnormalities, inborn errors of metabolism, immunodeficiency disorders, red blood cell abnormalities, and cystic fibrosis. Early identification of disorders, provides an opportunity for treatment that can lead to significant reductions in morbidity and mortality. This is a simple blood test that requires just a few drops of blood collected from your baby’s foot. The first screening is obtained 24-48 hours after birth and the second is performed 7-16 days after birth.

Click here for the Baby Your Baby Podcast on newborn screenings.

A hearing screening checks for hearing loss. For this test, tiny earphones are placed in your baby’s ears and special computers check how your baby responds to sound. It is not unusual for a newborn to fail one or both ears since there is often fluid still in the ear canals. If this happens, a repeat test is scheduled shortly after discharge.

Bilirubin screening is done to check for high levels of bilirubin which can cause jaundice. Mild jaundice may go away on its own, but higher levels may need treatment with special lights. This blood test is usually done at 24 hours after birth, but is may be done sooner if your baby is at a higher risk for developing jaundice.

Administering vitamin K. Babies are born deficient in Vitamin K. Giving them this important vitamin helps prevent dangerous bleeding or intercranial hemorrhage. It is best given through a shot in the thigh within three hours of birth. Administration of oral Vitamin K is less effective than the shot due to erratic absorption from the gastrointestinal tract and must be given weekly until your baby is three months of age.

Administering erythromycin eye ointment. Erythromycin eye ointment is administered within three hours of birth to treat ophthalmia neonatorum. This is an infectious and potentially blinding conjunctivitis transmitted to a neonate by exposure to maternal chlamydial or gonococcal infection during birth. These infections can cause corneal scaring, ocular perforation, and blindness as soon as 24 hours after birth. This treatment is recommended by the American Academy of Pediatrics and CDC for prophylaxis against newborn conjunctivitis.

What about vaccines and follow-up care?

Hepatitis B vaccine is given to newborns at the hospital. It’s important to follow up and take your child to their well-child visits with their provider starting a few days after discharge. During these visits, the newborn provider will check the baby’s growth, ability to orally feed, evaluate for jaundice, and listen to heart and lung sounds. Additional well-child check-ups are important to assess continued growth and development and provide additional vaccines to prevent childhood diseases.

Do caregivers teach you about taking care of your newborn?

Women and newborn caregivers will teach you about how to care for your baby. They will show you how to care for the umbilical cord, and how to hold, bathe, diaper, swaddle, nurse or bottle feed, and burp your baby. They will also provide you with information on when to call your baby’s provider for other concerns such as diarrhea, vomiting, and fevers.

For a schedule of well visits go to intermountainhealthcare.org

For more information about newborn screenings in Utah visit Utah.gov. Outside of Utah, visit your state’s website or marchofdimes.org

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Swaddling: How to do it safely and when to stop



Newborn babies often sleep better when swaddled. But how babies are swaddled, and through what age, can make a difference in their long-term sleep patterns — and help reduce the risk of Sudden Infant Death Syndrome (SIDS), said Rachelle Rigby, RN, pediatric medical and surgical services director at Intermountain Primary Children’s Hospital.

Jade Elliott spoke with Rachelle Rigby, RN, Intermountain Primary Children’s Hospital, about how to swaddle and when to stop.

“Newborn babies love to be snuggled up tight because that’s how they were developing inside mom, and they like that feeling,” Rigby said. “But parents should wean babies from swaddling around the third month, and make sure they’re swaddling correctly so their faces don’t end up covered by the blanket when the baby moves.”

Rigby recommends swaddling baby in one thin blanket, just below the neck area. Baby’s arms can be inside or outside the swaddling, largely depending on preference.

“If in every ultrasound the baby was seen with their arms up, leave their arms out of the swaddling blanket! They might like it better,” Rigby said.

To swaddle baby, place a thin blanket on a solid surface, and the baby on top. Fold one side over the baby, fold up the bottom, then fold the other side over the baby and tuck it in.

Be sure the blanket is below the neck to keep the blanket out of the face when the baby wiggles.

Using a thin blanket helps prevent overheating, which has been linked to Sudden Infant Death Syndrome (SIDS), Rigby said. Placing a fan in the room can help prevent overheating as well, she said. Babies also should sleep on a firm crib mattress or bassinet in a separate sleeping area in their parent’s bedroom, and never in the same bed as the parent.

“At three months, it’s good to start using footed pajamas or a sleep sack instead of swaddling. While this may disturb the baby’s sleep temporarily, this is also an opportunity for the baby to learn to self-soothe, which is a critical part of their development,” Rigby said. “Self-soothing skills will pay off in the long run for the baby, and help parents get the sleep they desperately need.”

More information: Primarychildrens.org

The Baby Your Baby program provides many resources for all pregnant women and new moms in Utah. There is also expert advice from the Utah Department of Health and Intermountain Healthcare that air each week on KUTV 2News.


Sharon Lechter



Dan Clark sits down with Sharon Lechter, co-author of Rich Dad Poor Dad, and the founder and CEO of Pay Your Family First.

 

(Recorded: July 14, 2020)