Mary Jane sets down the baby's car seat with a noticeable thump. "I’ve had it! I'm giving up breastfeeding," she declares. "I put him on the breast and he eats well. He falls asleep at the breast and seems satisfied," she explains. "But, one hour later he grunts, rolls his eyes around, and puckers his lips," she moans. "I get out of bed and work desperately to get him back on the breast. He finally eats and falls back asleep." Her energy seems to be mounting as she goes on to say, "It starts all over one hour later! - the grunts, his eyes popping open, those mouth movements! I can't go on. Maybe he would sleep better on formula.
The Science: Misunderstanding a baby's body language...
New parents lack information about a newborn's normal sleep cycles. Most newborns, and especially those born early, are still developing clear sleep cycles. As babies mature they develop two clear sleep cycles: still-deep sleep and active-light sleep. Babies "look asleep" in the still-deep sleep cycle. (See DVD Clips of cycles)They are totally still, their breathing is nice and regular, and the baby makes no sounds. However, in active-light sleep a baby will twitch, make mouth movement, open and close his eyes and even make grunting, cooing sounds. But he is still asleep, just in active sleep. If left alone a few minutes, he will often get quiet again and go back to still-deep sleep. Babies spend 40% of their time in still-deep sleep and 60% in active-light sleep.
"Ah-Ha" Moment: How The HUG's information helps this mother...
Mary Jane is interested to learn that some babies "just have noisy, busy active-light cycles." After hearing briefly about these two normal sleep cycles, she promises to let you know how the next few nights go.
She calls back Wednesday with a lift to her voice. "Yep, I just let him wiggle and squirm a few minutes. He really surprised me by going back to that still-deep sleep in only ten minutes. He didn't wake me up to REALLY eat for another one and a half hours!"
And, Mary Jane's still a breastfeeding mom and loving it!
Other helpful resources.
UC Davis Lactation Center offers a helpful article about helping your baby sleep. Give this a look-see.
"Help me! My baby just won't sleep at night!"
Bathing: Getting clean and calming down!
I just completed a wonderful day of teaching baby professionals in Denver about using The HUG with expectant and new moms and dads. Among the many interested things we discussed, we reviewed the common, but sometimes anxiety producing task, of bathing a newborn. A recent article (by Maria Burgio)gives practical advise on bathing a baby: how to check the water temperature, how to hold the baby in the washtub, and how to avoid getting soap in the baby's eyes. However, we discussed another part of the bathing experience: reading the babies body language. The HUG helps parents recognize a baby's SOSs - Signs of Over-Stimulation. These signs include changes in a baby's body (movement, color, and breathing) and a baby's behavior ( "Spacing Out", "Switching Off", "Shutting Down".)
Look at the first baby above. Let's read his body language. See how his forehead is relaxed and smooth, his eye are half closed (looking relaxed), his mouth is loose, and his fist are open. This baby is saying with his body, "I'm enjoying this bath!"
Now look at the second baby. His body is saying something different- he is having a slight SOS. See his forehead is slightly wrinkled, his eyes are wide open, his mouth is open (and you can almost hear a little gasp), his nostrils seem flared, and his fist are squeezed tight.This is a normal stress response to a bath, but a response a parent can respond to.
Some baby's my nature are going to find the bath a bit more challenging that naother baby. However, when a mother recognizes these body changes, she can often respond in ways which will help her baby with this transition. The mother who sees this SOS can lean over and speak quietly in a persistent, calming voice. She might place her hand on the baby's chest for a few seconds or hold his hands against his chest to see if his body starts to say, "I'm ok, Mom!" as the SOS melts away.
The bath is not only good for getting clean, it's a great time for a baby to practice responding to a slightly stressful event with the attentive and loving care of his mother.
Watch for that SOS and get clean! That's really double duty!!
"My C-Section was not a Walk in the Park!!
Tonya had wanted to try a VBAC (vaginal birth after c-section). She had done her homework, read the pros and cons and felt confident that she would do well. Her OB was supportive and reassuring. "We'll be here for you, watching you and the baby carefully. If there is any danger, we can then do surgery."
Unfortunately, her doctor had a family emergency the week before Tonya's due date. On Tonya's last office visit she saw a new physician in the practice. The doctor was unrelenting. "Why would you want to put yourself through all that, he said. "We can be in and out with a c-section in 2o minutes." Tonya saw the diplomas hanging on the wall, the white coat, and the stethoscope around the doctor's neck. "And, wouldn't you feel terrible if something went wrong because of your choice," the doctor added.
The section was planned and executed. And, it was NOT a walk in the park!
Listening to Mothers, a survey just released by Childbirth Connection (http://www.motherfriendly.org/pdf/Lothian_NMSO_2009_CIMS_Forum.pdf), confirms the fact that women are often (or usually) not given accurate and adequate information about the risks and complication of c-sections. Like 1/3 of the women in the survey, Tonya had significant pain at the incision which interfered with breastfeeding. Since 38% of women reported it "too hard to get breastfeeding going" Tonya found out that placing a baby right on an incision site does not help! When the area healed she was left with itching and numbness for two months as were 61% of women in the survey.
Tonya is determined to be a breastfeeding mother. Fortunately, she has a supportive family and a doula next door who keeps checking in on her. Tonya is proud of her persistence, her commitment to do the right thing now! She wants to trust her intuition about parenting more often in the future. Diplomas on the wall matter, but Tonya believes a mother can trust her body and her spirit and know when medical help is needed.
Tonya's son is thriving and Tonya is back to her exercise class. Though busy as a new mom, she takes special time to volunteer to tell her story at a local prenatal class. She helps other moms find their voice and the ability to say to the medical community just what they want and need.
10 Tips to Helping Your Baby Sleep at Night!
Helping a baby sleep at night is a coming together of biology and social learning. New parents need to understand and partner with both forces in order to help their little one learn to sleep at night.
Biology
First, a stomach the size of a walnut cannot hold enough food to sleep all night. This is a simple fact, but one which parents need to remember. Second, a baby’s circadian rhythm is still developing. Melatonin begins moving from the mother to the fetus around 7 months’ gestation. It is not until 6 weeks after a full-term birth that the baby has the “chemistry” to distinguish day from night. Natural sleep cycles affect a baby’s sleep as well. All babies will move between still/deep sleep and active/light sleep about every hour at night. Babies need to group the cycles together without waking up in order to sleep for an extended period of time.
Social Learning
Babies (and grown-ups as well) associate going off to sleep with something: quiet music, a cuddle, a feather pillow bunched to just the right angle. Babies learn to associate going to sleep with suckling the breast, being rocked, skin to skin contact. However, if they ONLY learn to fall asleep under these conditions, they will be unable to get themselves back to sleep once they awaken during the active sleep phase.
1. Recognize (and find comfort in) the fact that you are not alone. You will experience several months of fatigue that all loving, competent parents undergo.
2. Nap during the daytime when your baby naps. Housework can be done for the next 20 years and need not be done now!
3. Make baby’s daytime sleeping and nighttime sleeping environments different: nap in the sunny, family room, and have “bedtime” in the quiet, darkened bedroom. (This helps to establish circadian rhythms.)
4. Learn to distinguish the two sleep cycles: still/deep sleep and active/light sleep. (See www.hugyourbaby.com “sleep”.)
5. When the baby wakes up from active/light sleep after only a short nap, talk quietly to her without picking her up and see if she will return to still/deep sleep. (It is easier to practice this during the day time at first.)
6. If you see her wiggling, smacking her lips, flashing her eyes open, and even making baby sounds – WAIT – and see if this is active/light sleep. Let her squirm a few minutes, and often she will return to still/deep sleep.
7. If it is time for your baby to eat and he does not wake up, wait for him to move into active/light sleep before you use your tricks to rouse him.
8. If your baby falls asleep while nursing, give her a little jiggle when you lie her down. This will help her move briefly back to active/light sleep and let her practice getting herself from this sleep cycle to the still/deep sleep cycle.
9. Notice how your baby contributes to comforting himself: bringing his hand to his mouth, making sucking movements, using the fencing reflex, “Spacing Out.” (See www.hugyoubaby.com “Crying”.) As he practices these efforts to comfort himself, he will be learning the self-regulation needed to sleep at night.
10. Be kind to yourself. Take a bubble bath. Ask for a back massage. Babies notice a mother’s tension, and just a brief “time out” for you can increase your baby’s ability (and yours!) to get a good night’s sleep!
"Help! My Baby Cries All the Time!"
Those huge tears rolling down Latisha’s face say it all. “Antoine cries all the time, and so do I!” this young mother reports. I watch as her new baby seems to wind up for a big one. His face gets red, his hands start to tremble, and his legs stiffen. This mother never imagined how overwhelmed she would feel when her tiny newborn enters the “Rebooting Zone”–fussing or crying. Most normal, healthy babies begin to cry more around 42 weeks gestation, or two weeks after birth (if the baby was born full-term). Babies typically move from crying two hours a day to crying three hours a day by six weeks of age. Then their crying tapers to about one hour a day by twelve weeks of age.
The Science: "Just Tell Me What T.O. DO!"
…Latisha exclaims as her baby cries loudly.
T – Talk to your baby. Lean over and use a persistent, sing-songy voice close to her ear. Give your baby a few seconds to notice and respond to your voice.
O – Observe your baby’s efforts to contribute to his own calming. (See DVD clips) Many parents are surprised to learn that babies have instinctual behaviors that help them calm down. She might bring her hand to her mouth and with your help start sucking her finger or thumb. He may make sucking movements and start to quiet down. Another baby may look like she’s taking up sword fighting (the fencing reflex): her head turns to the side, one arm and one leg extend while the other arm and leg flex (SEE DVD clip). This maneuver helps some babies start to settle down. And finally, some babies use behavioral SOSs (See DVD clips) to turn off the excessive stimulation around them. She may stare into space or appear drowsy then begin to calm down.
DO – If the baby is still crying, your help is needed.
Hold her arms against her chest and continue that quiet, persistent talking. Swaddle the baby or encourage the baby to suck your finger, the breast, or a pacifier (only after breastfeeding is well established). Taking these actions one step at a time, parents discover what is most comforting to their baby.
An "Ah-Ha" Moment for this mother!
Little Antoine starts to cry again. Latisha leans over and speaks quietly into his ear. He looks surprised but continues to cry. He smacks his lips a moment and then quiets right down when Latisha holds his tiny but strong arms securely against his chest. Latisha can’t believe her eyes (or ears!) “Antoine and I are a good team,” she giggles. “We’ll figure this out together!”
"I want to be a good mom...but I don't know what my baby is trying to tell me!"
Becky, a frustrated mother of a one week old, goes on to explain.
"Theo seems so tiny. I can’t tell what will happen next!” she says. "Are you awake or asleep?" "Is it time to eat or time for a nap?" she wonders. “I worry I won’t do the right thing for my baby.”
Though friends, family, and professionals will help, you know that her baby can be her greatest teacher! Help her read her baby's body language, and she'll soon be the expert on her baby!
The Science: Two skills to hlep new parents.
1. Read a baby’s ZONES.
Newborns’ stages of wakefulness and sleepiness (their states or “Zones”) are still developing, which can be confusing to parents. Learning to read what "Zone" a baby is in will help a mom know when to feed her baby, when to play with her baby, and when to help him sleep. There are three “Zones”: the “Resting Zone” (sleep zones), the “Ready Zone” (alert and ready to eat or play), and the “Rebooting Zone” (fussing or crying zone.)
2. See when a baby sends out an SOS (Sign of Over-Stimulation).
All babies are at times over-stimulated by sensations inside of their body or by sounds, sights, and temperature changes outside of their body. There are two kinds of SOSs: body SOS (changes in color, movement, or breathing) and behavioral changes (“Spacing Out”, “Switching Off”, or “Shutting Down.”)
An "Ah-HA" moment for this mom.
Becky was surprised to see how quickly she came to identify what “Zone” her baby was in and to notice her baby’s SOSs. Her baby seems to cry less when Becky responds to an SOSs early on. If Theo has an SOS during feeding, comforting him quietly for a moment makes breastfeeding go better. And Theo’s dad loves to spot an SOS if “play time” gets a little too rambunctious. With keen insight about their baby, this new mom and dad now feel like real pros.
"I love, but do not like, my baby!"
I was rather shocked by the perspective of the young mother referred by my colleague, Gale. "Gale thought you could help me out," the young woman explains.
Eli was Samantha's second baby. He was a planned child, born healthy and full term. Labor and delivery had gone well, breastfeeding was successful, and Mom had two months of maternity leave. What could be that wrong? I wonder.
"He fusses all the time!" Samantha explains as she lays the baby on the exam table. "See, like now! Hear him making all those grumpy sounds!"
Eli is a robust, wide-eyed six-week-old. He is very busy in his movements as he wiggles and squirms on the exam table. His level of activity is a wonder to behold. He seems to wind up a second, then one arm shoots out to the side, both legs kick upward, and he arches his back. He is also very busy with his vocalizing—a grunt here, a groan there, or was that a coo? The activity and sounds coming from his cute little body are normal and even entertaining to me. But his activity level and his vocalizing seem to be off-putting to his mother who thinks Eli is fussing all the time.
"See Sarah there," Samantha says as she points to her four-year-old daughter coloring peacefully on the floor at our feet. "She is so calm and easy to be around. Both my husband and I had alcoholic parents, and we promised each other that we would have a peaceful household. But Eli just keeps on fussing," the new mother remarks as she hands me her baby.
What an opportunity and a challenge this moment is! Can I help this mother see her son through a different lens? As usual, when I feel challenged by a patient encounter, I simply report to the parent on the behavior of the baby (a technique well described by Dr. T. Berry Brazelton). I demonstrate Eli's normal reflexes and get excited when he brings his hand to his mouth and begins to calm down. I pick up the end of my red stethoscope and engage the baby in a little game of following its movement with his eyes. Of course, I finish with the grand finale of having the mother call out the baby's name. Eli hesitates only a moment before he turns toward his mother and—I believe he actually gives her a wink!
Samantha giggles and scoops up the baby from my arms as I discuss this high, but normal, level of activity and vocalizing. We talk about how each baby has a special temperament and style, right from birth. "His body activity and enjoyment of vocalizing are part of Eli's inborn personality," I explain. Mom smiles as she gives him a hug. “I guess he’s just a real go-getter,” she responds.
Eli is three years old now. Every time he and his family come to the clinic to see Gale, they stop by and say hello to me. "Eli's not really fussy anymore," Samantha explains. "But he's still a busy and noisy little guy!" Eli runs down the hall ahead of his mom who laughs out loud as his sister squeals in his pursuit!
My C-section Story: It was not a walk in the park!
Tonya had wanted to try a VBAC (vaginal birth after c-section). She had done her homework, read the pros and cons and felt confident that she would do well. Her OB was supportive and reassuring. "We'll be here for you, watching you and the baby carefully. If there is any danger, we can then do surgery."
Unfortunately, her doctor had a family emergency the week before Tonya's due date. On Tonya's last office visit she saw a new physician in the practice. The doctor was unrelenting. "Why would you want to put yourself through all that, he said. "We can be in and out with a c-section in 2o minutes." Tonya saw the diplomas hanging on the wall, the white coat, and the stethoscope around the doctor's neck. "And, wouldn't you feel terrible if something went wrong because of your choice," the doctor added.
The section was planned and executed. And, it was NOT a walk in the park!
Listening to Mothers, a survey just released by Childbirth Connection (http://www.motherfriendly.org/pdf/Lothian_NMSO_2009_CIMS_Forum.pdf), confirms the fact that women are often (or usually) not given accurate and adequate information about the risks and complication of c-sections. Like 1/3 of the women in the survey, Tonya had significant pain at the incision which interfered with breastfeeding. Since 38% of women reported it "too hard to get breastfeeding going" Tonya found out that placing a baby right on an incision site does not help! When the area healed she was left with itching and numbness for two months as were 61% of women in the survey.
Tonya is determined to be a breastfeeding mother. Fortunately, she has a supportive family and a doula next door who keeps checking in on her. Tonya is proud of her persistence, her commitment to do the right thing now! She wants to trust her intuition about parenting more often in the future. Diplomas on the wall matter, but Tonya believes a mother can trust her body and her spirit and know when medical help is needed.
Tonya's son is thriving and Tonya is back to her exercise class. Though busy as a new mom, she takes special time to volunteer to tell her story at a local prenatal class. She helps other moms find their voice and the ability to say to the medical community just what they want and need.
Alarming new statistics on "non"-natural childbirth!
Sally is a tiny lady with a big, basketball-sized belly. She teaches at the local kindergarden, and her husband, Jeff, our local electrician, had found their way to our hospital's childbirth education class. Sally and Jeff had grown up in a small Eastern Alabama town. They had married right out of high school and now, living in Mobile, were preparing for the birth of their first baby.
Sally was quiet and soft spoken. She rarely raised a question but often jotted down notes as the class went along. When asked, "Why did you decide to take this class?" Sally had said, "'cause I want to birth my own baby. I want to push him out into this big, wonderful world!"
Sally's passion to deliver by natural childbirth is becoming less common.
CIMS - Coalition for Improving Maternity Care offers alarming new numbers on medical intervention at delivery:
"With a staggering 31.8 percent of US births occurring by cesarean section, improved transparency in maternity care has never been more urgent.
The safety of birthing women is in serious jeopardy according to the recently released 2007 US birth statistics. Birth by cesarean section has increased by 50 percent since 1996 and now accounts for 31.8 percent of all US births. While the procedure can be life-saving when used appropriately, it is a major surgery that carries extensive risks for both mother and baby--risks that are not present in a vaginal birth. The 2007 rate is more than double the US Healthy People 2010 and the World Health Organization’s recommended rate of 15 percent. Despite these facts, today’s birthing women have no way of knowing if their local hospitals exceed the recommended rate." http://www.motherfriendly.org/
Sally had heard stories about birth from other ladies at the school. Mary had been told that her "baby seemed too big," so she was induced -- only to deliver a 6 pound, 3 ounce baby boy. Jean's doctor had thought that her pelvis might be too small, so a c-section was done and she delivered a 7 pound, "late premie."
Sally's doctor had already discussed with her "getting an epidural"; he also mentioned that a c-section before the holidays might be "more convenient" for her. But Sally stayed determined. "I bake great sourdough bread," she exclaimed. "It's supposed to stay in the oven for 60 minutes. If I take it out at 50 minutes, it's soft in the middle!"
Sally asked a doula to come to her birth. The three of them made a formidable team, and Jamie was born a healthy 8 pounds, 3 ounces, two days after her "due date."
It's such a big job being a parent. There are challenges such as solving early breastfeeding problems, teaching a two-year-old not to bite his best friend, advocating for a kindergarten child with learning issues, helping a school-aged boy deal with a bully in class or a teen whose friends use drugs. I often wonder what impact we have on the confidence and fortitude of parents from the get-go when such a large percent of women are told they can't even birth their own baby. What does the medical world take from women when we deny them what may be the most empowering experience of their lives?
Sally had it right: "I want to push my baby out into this big, wonderful world." We are lucky when our job is to help her do just that!
[See dangersofcesareanbirth.com]
"My Baby Doesn't Like My Milk!"
"Diane doesn't like my milk!" the young mother declared. "It must not be strong enough for her. I guess it's time for formula."
Her words were a surprise to me. Three-week-old Diane had regained her birth weight in just ten days and was growing at a great, 1/2-ounce-a-day clip. I could see her cheeks beginning to fill out, and she was "filling" her diapers with gusto. Why did this mother think that her breastfeeding was going poorly?
"She just doesn't seem satisfied," Diane's mother said. "Diane doesn't act like she's happy."
As a lactation specialist, I am trained to note weight gain, to identify the sound of milk being swallowed, and to document the number of wet and stooled diapers. Hearing this mother, my suspicion was that Diane's mom was responding to non-feeding infant behavior and projecting those concerns onto her breastfeeding experience.
In addition to noticing the physical signs of breastfeeding success listed above, I also am aware that research shows that a mother will see her baby as "satisfied" when she observes particular newborn behaviors. She wants to see her baby become alert and gaze deeply into her eyes. She wants to calm her baby effectively and doesn't want her baby to appear irritable or difficult to console. Mom wants to enjoy cuddling with her baby and to know that her baby likes to cuddle right back.
Understanding this, I picked up the baby to play some newborn "games." First I swaddled Diane to bring out the best in her ability to play. Next, I swayed Diane gently until her eyes became bright and alert. Then I shook a rattle and watched as Diane followed the toy intently with her eyes. She watched closely as I moved the rattle without a sound. Diane's mom giggled and glowed with the words, "She's really smart, I guess!" With my encouragement the young mother called her baby's name. Diane turned slowly in her mom's direction. With a big grin the mother lifted the baby from my hands and snuggled her face into the crease of the baby's soft neck. One of mom's hands went to her breast to suppress the unexpected let down of milk.
Now Diane's mom is a breastfeeding star and an advocate for other new moms. She comes to our breastfeeding class to discuss the challenges and joys of breastfeeding. "Babies are little people who have special ways of communicating," she says. "Don't just count their pees. Learn to speak their language, and you'll soon know how much they love your milk!"
Overfeeding Your Baby
The young mother is frantic. Her baby never seems quite satisfied. Louise has been committed to breastfeeding, but things just haven’t gone well. Little Becky has lots of those mustard-seed poops and wet diapers, but Louise thinks she doesn't seem very happy. Becky spends a lot of time wiggling and squirming. After eating, her legs and arms shake and bicycle around, she makes one odd face after another, and then she grunts and squeaks. Louise figures all this must mean that Becky is unsettled, unhappy, or discontent. Where are those quiet, cuddly times Louise has always imagined would be a part of being a new mom?
So now Louise is bottle feeding. Every time Becky squirms, Louise gives her the bottle. When the baby sucks the bottle her body seems to get still for the time being. Louise thinks that must mean Becky is at peace. But, all this feeding! Now Becky seems to be spitting up more often and having more painful, gas bubbles. Confused and upset, Louise finally goes off to meet with Angela, the WIC nurse at the health department.
Fortunately, Angela has just completed a special course on preventing overfeeding by reading a baby’s body language. [http://lactation.ucdavis.edu/] It is very common, Angela learns, for moms to be confused by a baby’s body language and “just give the bottle.” A breastfeeding baby can suckle when she is not hungry and be comforted without getting extra calories. However, a bottle-fed baby who sucks a bottle too often will take in unneeded calories and become another statistic--an overfed infant destined to become an overweight toddler, child, and adult.
But Angela helps Louise “read her baby’s body language.” Angela describes Becky's wiggles and squirms as normal movements for some children who exhibit greater motor activity than others. Those grunts, too, are normal vocalizations as a baby plays with the feel and sound of noise making. Those tiny tremors when she is excited or over-stimulated are normal as well. [See video clips of reading a baby's SOS (Sign of Over-stimulation) at http://www.hugyourbaby.com/skills.html] Angela also shows Louise that holding Becky’s hands against her chest, or swaddling her, makes all the difference. Now Becky is thriving.
Louise knows that she will be a successful breastfeeding mother with her next child. And for now, she will feed Becky when she needs to eat, and pay attention to her baby’s amazing ability to say, “Hey, Mom, I’m not hungry! Let’s just play right now!”
Reassuring Parents - a program that helps
Mary Beth tries not to worry, but the harder she tries the more those fears bubble up. “Maybe our child isn’t quite normal.”
Mary Beth has been a teacher of children with special needs for 10 years. She has witnessed the passion and the energy that such parents typically have for doing what is best for their child—as well as the pain that they carry as they wonder about what the future will hold for their children. Though her two-year-old Sammy is now beginning to put two words together (“Mimi -ouse” for “Let’s go to grandma’ house,” and “uce-me” asking for his favorite apple juice), Mary Beth thinks that Sammy is not as chatty as other kids in the childcare center.
A year ago Mary Beth had read an article on early signs of autism. She remembers that as a newborn Sammy would sometimes look away from her face when she talked energetically. At nine months old he liked to play peek-a-boo but did not cackle quite as intently as his cousin next door did. At eighteen months he would bring her blocks to put in his bucket, but Sammy really preferred to watch them clatter to the floor when he dumped them out.
Mary Beth, her husband, and Sammy just moved to Florida and are scheduled for their first well child visit with a new pediatrician. When they signed up for the practice they were given information about the new CHADIS program [http://www.chadis.com/ ]which helps pediatricians care for their patients with just the attention to a child’s development that Mary Beth wants. She enjoys going online to complete the two special questionnaires (Ages and Stages and M-Chat) that will be a part of Sammy’s two-year-old visit. She immediately notices how well Sammy does on the “communication” section of one form and is hopeful her fears will be settled.
Their first appointment goes well. The nurse working with Dr. Mason has a magic touch with kids. Dr. Mason is thorough in her questions and her physical exam. But most important to Mary Beth, Dr. Mason uses these two questionnaires to reassure her about Sammy’s development. She seems to understand that it is normal for this mother to have more than the average level of worries about autism given her work experience. Handouts they are given describing the variation in normal child development are especially helpful. Dr. Mason even refers Mary Beth and Albert to a video clip which shows how normal newborns can momentarily look away from his parent when he is over-stimulated. [http://www.hugyourbaby.com/skills_video.html]
As they leave the doctor’s office, Mary Beth feels that a great burden has been lifted. Her shoulders relax and there is a new bounce to her step. She looks down at Sammy with “new eyes” as if she sees him today as the energetic, engaging, and thriving little guy he really is! Sammy hides behind the trash can and then pops out with a gleeful “me go” as he runs ahead to his dad standing nearby.
