Midwife Adds The HUG to Her Parent Education

Doreen Lawton, practicing in Chattanooga, Tennessee, has been a midwife for over 10 years and has taught childbirth classes and newborn parenting to many couples. She also has worked as an early interventionist with families who have special needs babies with sensory impairments. In addition Doreen has had 6 children of her own and felt that she knew a thing or two about babies! However, HUG Your Baby has significantly enhanced her ability to teach parents and grandparents. Doreen has frequently heard from second-time parents, "Boy, where was this information when we had our other children?" Here is what Doreen wants to share:

I recently had the privilege of teaching The HUG to a family about to welcome a newborn through adoption. The adopting mother, father and grandmother were in attendance during the first session. We met again once the baby had come home and they had a few days to get to know one another. Mom had lots of questions and concerns about normal newborn behavior and how to meet all the baby's needs. During the first session, the family was very excited to learn the different newborn zones, how to tell them apart, and what TO DO when the baby needs support to reboot. Of greatest concern to this mom, as with most, was what to do when baby cried. "How do I know when she needs to eat or sleep or when she is just bored?" After discussing normal newborn behavior, zones and SOS's and watching the DVD, the family said they felt much more prepared and learned a lot. Since their baby was not yet born, we used a doll and role playing to facilitate learning the calming techniques. We agreed to meet again after the baby came home. 

When we met for the second session, the baby had been home with them for about a week and was 2 weeks old. Though she had not given birth, it had been an emotional journey for this new mother and she felt every bit as overwhelmed as a mother who had physically given birth! I was happy we had already planned this second session and were able to build on previous information. 

This baby was not crying much, but was a very sleepy baby and difficult to wake to feed. (Isn't it funny how sometimes the thing we most fear doesn't happen, while the thing we had not anticipated does?) Because the baby had been born a little early, the mom had been instructed to wake her every 2 hours to try and feed her. This was proving almost impossible as it often took over an hour just to wake her, and then she would fall quickly back to sleep after drinking what mom perceived as a very small amount. Though she had been given information in the hospital NICU as to how much baby needed, she had anticipated that babies, especially small ones, needed more than that. After sharing the information from the HUG on the size of a newborn's stomach and how much they actually need, and given how well baby was gaining weight, she was able to relax a bit and accept the baby's not finishing a bottle. Seeing the PowerPoint picture of the number and amount of newborn "poos" that are normal, her confidence in her daughter's feeds was restored, since she knew her daughter was producing even more poos then shown in the picture. 

We went over the sleep stages again, as well as when and how to try and wake her. The baby cooperated beautifully by moving into active sleep as we were discussing this. I was able to demonstrate how to calmly and gently stimulate her to wake more fully, and get into the Ready Zone to eat, by unwrapping her, holding her upright, and talking to her in a calm, soft voice. Mom was amazed at how alert she became after few minutes of this and how well she ate right after. She even stayed awake for a bit after feeding and was able to show off her talents of turning to her mother's voice which brought tears as she realized that this baby recognized HER as her mother!! What a powerful moment to share with this sweet family!!

Soon I will be relocating and am excited to bring The HUG with me to share with parents and families. I also plan to include The HUG in my childbirth classes and to offer a follow-up refresher class after a baby comes, since many pregnant couples are so focused on the upcoming birth that the information presented on newborn care is often not remembered. I have encouraged many of my colleagues in the birth professions to take The HUG course and to offer its excellent information to their families as well. I'm a believer!!!

HUG Your Baby in The Netherlands

Anita Spiegels van de Ven is a pediatric nurse and lactation consultant from The Netherlands. She works in a hospital and has her own practice making home visits. The HUG helps her parents learn the behavior of their baby and understand how they can better support their child.

Marijn is a healthy, 5-month-old, breastfeeding baby. From 3 months, her parents have chosen to add eating and sleeping structure into the baby’s life as described in the book, Baby in a Dream Rhythm. The parents made this decision as the mother prepared to return to work. Mother describes Marijn as an active baby.

Because of difficulty with his sleep, the parents took Marijn to see an osteopath. The parents described that the doctor found “tension in the diaphragm.” After this osteopathic treatment Marijn seemed more settled and quiet.  Mother has taken more efforts to help calm her baby including baby massage and swaddling with one hand free. Marijn is sleeping in his own room in a crib.

When I visit this family, the mother has returned from a walk with the baby, who is asleep in the stroller. Within a few minutes there is stirring in the stroller, and Marijn moves into a quiet, awake state. The mother leans over and enjoys face-to- face time with her baby, who looks at her with wide open, bright eyes. I enjoy seeing how this mother told her baby what she was doing, such as,“Mama is going to put a clean diaper on you.”

As Marijn breastfeeds, his mother and I discuss The HUG Zones and SOSs, how to calm a baby, how to help her baby sleep well, and how to play with her baby so that he can grow and learn.

The next day I receive the following email from Marijn’s mother: “I have been searching the Internet for information about my baby. Then I found you! Your experience and positive approach was wonderful for me. You had only just left when Marijn lay in bed and fell asleep almost immediately. My husband was amazed! Now we are watching our baby and letting HIM tell us what to do! Thank you so much!

HUG International Teaching Tour begins with "Eye-Ball" Exercises

This week is the anniversary of the beginning of our first international HUG Your Baby Teaching Tour. Though I energetically chronicled our travels during that year, I later learned that many of you were unaware of the blog I was keeping. I thought I'd take you on our trip again by posting some of my favorite blogs. This trip informs the work I do every day and continues to be such a blessing in my life.  So indulge me as I re-step our journey and reflect on how HUG Your Baby and YOU can make a difference to babies and their parents in our world!

“Eye-ball exercises” is a HUG Your Baby technique that we teach in order to see more of a baby’s behavior, to notice more of a parent’s interaction, to “Gaze and Engage” more intentionally with the lives before us. I am hopeful that my own vision will sharpen as my husband, Jim Henderson, and I travel from country to country this year and meet young families.

As Jim and I begin our travels, it seems prudent to read of the experiences of my greatest mentor, Dr. T. Berry Brazelton, in his new memoir, Learning to Listen: A Life Caring for Children. As we fly toward Kona, Hawaii, I am delighted to read how Dr. Brazelton practiced what I call “eyeball exercises” while he and his family visited with Mayan (Zinacanteco) families in Chiapas, Mexico, in the early ‘70s. His fourteen-year-old daughter, Kitty, facilitated Dr. Brazelton's access to the lives of mothers and babies in a culture that restricted visits by non-family males to order to protect their child from a potential “evil eye.” Enjoying the local fashion in dress and head gear, Kitty was her father’s “ticket” into these home.

There he witnessed a Zinacantecon birth—along with sixteen relatives, chickens, and dogs, all “there for” the laboring mother. The mother was completely quiet, but with each labor pain, the attendants, and animals, all groaned, howled and crowed through each contraction. A healthy baby boy was born.

With intention to keep a newborn calm, the baby was put to the breast with every wiggle—up to 90 times in a day! The goal of a docile baby was further reinforced by being held in close proximity to the mother for several months and later wrapped in a robozo (effectively swaddled) for several more months to protect him “from losing his soul.” The Zinacantecon children had REMARKABLE alerting ability and sensitivity to visual and auditory stimuli. With muscle activity restricted, Dr. Brazelton could get a newborn to visually follow a moving toy or his face for a full 30 minutes—a feat he had never experienced with a North American baby.

Of course I must avoid making general assumptions from unique observations. But appreciating what behaviors are noticed by a parent, how that parent responds to her baby, and what those behaviors mean in different cultures will be of interest to Jim and me as we set eyes on foreign lands and engage with the families we will encounter.

(Learn more about HUG Your Baby's International outreach.)

Why Delay Solids until Baby is Six Months Old

Over the past few years, the American Academy of Pediatrics and other international pediatric leaders have changed their recommendations for beginning solids from four months to six months. The following immunological and developmental considerations prompted this change in recommendation[i]:

A baby’s intestines are still developing.
During early infancy the intestines secret only a small amount of IgA, an immunoglobulin protein that coats and protects the lining of the intestines. Fortunately, breast milk contains a lot of IgA that offers this protection while the intestines are developing. Between four and seven months the intestines go through a developmental process called “Closure”. This process causes the intestines to be more selective about what is allowed to pass through. If breast milk is reduced and solids are added before this closure occurs, the baby’s immune system can be triggered to begin an inflammatory, allergic-type response to proteins that leak through the intestine. It is now believed that this process can initiate life-long allergies and asthma and may be a component of a child’s later developing autoimmune illnesses such as diabetes.

Babies less than four months have the tongue-thrust reflex.
This reflex protects the baby from choking. When food is placed on the tongue, the tongue pushes the food out rather than drawing it in.

The baby’s swallowing mechanism is still immature.
Between four and six months babies develop the ability to move food from the front of the mouth, to the side for chewing, and then to the back of the throat for swallowing.

By six months most babies have developed the ability to sit.
Being upright obviously facilitates the eating of solids and a baby’s ability to participate actively in the process.

Older babies love to imitate their loved ones.
By six months a baby may grab mother’s spoon or the cracker from a sibling’s hand. This imitating of behavior not only increases a child's ability to self-feed, but also contributes to the baby’s developing cognitive, social and intellectual skills.

[i] http://www.askdrsears.com/topics/feeding-eating/feeding-infants-toddlers/starting-solids/6-reasons-delay-introducing-solid-food

Calming Down - But, Not Just the Breast

Breastfeeding is magical for many reasons! It saves babies lives, it protects mother from serious illnesses, it saves families money and it enhances bonding and mother-child interaction.

But . . . sometimes babies need something MORE than the breast.

This statement is considered controversial, if not hieracy, to the lactation world where professionals (rightly) claim that breastfeeding provides the best nourishment and the best nurturing. But, I have additional experience with mothers who are stressed with the fact that their babies only calms down when on the breast. Could this behavior indicate a potential problem with self-regulation? Can we help active, energetic babies learn other ways to calm down and will this help encourage mothers to keep breastfeeding? I think so.

Consider Romono, a thriving, robust, active 6 month-old. I meet him when 3 weeks old when even then his parents could see that sucking was his only way to settle down.  Now Romono is six months old and is always on the go! He babbles consonants, rolls over with great zest and is beginning contralateral movement - the first step to learning to crawl. He  is distracted during breastfeeding as he constantly seeks to explore and engage with the world around him.

And, now he is up 8 times at night! (See paragraph below on why this baby is awake so much at night.) He can only nap when in his Mobi and mom (and his nanny) dare not move once he goes to sleep. Though mom is dedicated to breastfeeding, this behavior is exhausting and worrisome to her.

Today we explored and practiced ways to enhance Romono's ability to contribute to settling himself. When he showed tired signs, Mom put the baby to the breast.  Though she usually nursed the baby down to deep sleep, today she took him off the breast when he started flutter nursing. She held him securely a few minutes then put him on the bed. He initially wiggled and vocalized but mother used her voice to "shoosh" the baby and held his hands to his mouth so he could suck his finger. After a bit he settle down but moved to an alert, contented state. After about 10 minutes of contented self play (exploring hands, bringing hands and toe to mouth, babbling) he began to fuss a bit. Mom assumed he "was hungry again" and was ready to put him back to the breast. But with encouragement, she returned to the comforting activities just practiced. The baby immediately calmed again without needing the breast.

The plan is to practice these calming behaviors when putting down at night, add a lovey to the settling process and see is comforting without additional breastfeeding will help with nighttime awakenings. (Click here for more information on use of a lovie.)

More frequent awakenings:
See previous blogs on Touchpoints - a surge in a baby's developmental which causes a temporary disruption in eating, sleeping or general behavior. If breastfeeding mothers do not understand and anticipate these changes, they will add more frequent nursing at night.

HUG Your Baby in The Netherlands!

Anita Speigels is becoming a Certified HUG Teacher in The Netherlands (Holland). She has begun translating some of our HUG teaching material into Dutch.

Giving a Bigger "HUG" -- by Becoming a Certified HUG Teacher!

Nancy Winn works as a Childbirth Educator and Case Manager for a non-profit child abuse prevention agency in Salida, California. Though she has years of experience serving young families, she is completing the Certified HUG Teacher program to better prepare these men and women for parenthood. She shares her efforts and this journey with us.

As part of my CAPPA childbirth educator training, I took Part 1 of the HUG training.  I was immediately anxious to learn more about HUG Your Baby and become a Certified HUG Teacher so that I could teach The HUG tips and techniques to the new the families I serve.  I hoped that adding this class to my childbirth education series, would prepare new families to understand newborn behaviors and be more confident in meeting the needs of their infants.

It is easy for new parents to become overwhelmed with advice from well- meaning friends and family.  But, The HUG approach is fun to teach!  Describing the HUG Zones and SOSs (Signs of Over-Stimulation) and teaching calming techniques helps to enhance the bond these new parents have with their child. 

Recently I met with a mom and her 3-week-old baby. This breastfeeding baby had regained her birth weight and was steadily growing an ounce a day.  When I arrived the baby was initially fussy, turning red in the face, crying and showing SOSs and signs of beginning to Reboot.  Mom attempted to calm the baby by swaddling her and then putting baby to breast.  The baby wouldn’t latch. Mom sighs, “she keeps doing this. I thought she was hungry, but I guess she's not. Am I doing something wrong”?    

I talked with mom about the HUG Zones. Practicing the HUG Strategy, "Gaze and Engage" (I learned in HUG's Part II course), I observed the baby and the mother's reaction to her child's behavior. I then discussed the SOS signals the baby was sending out.  I was then able to show mom different calming techniques and how to get the baby from the Rebooting to the Ready Zone. Using The HUG approach of swaddling, talking softly and swaying the baby was all the baby (and the mother) needed. Giving this mother skills to calm her fussy baby was an important step to helping her continue to breastfeed and to enhance her confidence as a new mother!

CLICK HERE to read more stories by Certified HUG Teachers.

Japanese Certified HUG Teacher Helps a Mother Avoid Giving Formula

Yasue Ota has been a registered midwife in Japan for about 10 years and is now teaching maternity nursing and midwifery at Juntendo University in Chiba. Yasue discovered The HUG website and was attracted to the words, ‘Baby Zones and SOSs’. Yasue thinks that “HUG Your Baby Zones and SOSs” are such a wonderful and easy tool to help new parents understand their baby.

Read the exciting account, below, of how using The HUG kept one Japanese mother from giving formula!

I visited Maya when she was 2 weeks old. That was just 1 week after leaving the hospital. Her mother, Tomoko, told me that Maya cries all the time. Tomoko felt that perhaps her breast milk is not enough for her baby. So Tomoko was wondering if her baby might need a little formula. I shared with Tomoko the following ideas about a baby’s crying:

Most normal, healthy babies begin to cry more around forty-two 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.

I explained some easy-to-remember tips to Tomoko, who says what all new parents holding a crying baby say: “Just tell me what TO DO!” Sharing HUG Your Baby concepts, I told Maria:

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.

Maya was crying loudly while I talked to Tomoko. We paused to observe Maya’s efforts to calm herself. We were delighted to see Maya bringing her hand to her mouth, sucking her finger, and starting to quiet. Tomoko was surprised to learn that babies have instinctive behaviors that help them calm down.

I added another tip to DO (to calm the baby): If the baby is still crying, hold her arms against her chest and continue that quiet, persistent talking—and encourage the baby to suck your finger or the breast, or swaddle her safely.

Maya started to cry again and Tomoko leaned over the baby and spoke quietly into her ear. When Maya continued to cry Tomoko waited a moment and then noticed that the baby smacked her lips. The baby then quiets right down when Tomoko holds her tiny but strong arms securely against her chest. With a smile on her face, the mother then brought the baby to the breast for a good feed. “Now I see how I can work it all out without any formula!” Tomoko tells me.

I really feel pleasure in seeing the "ah ha" moments parents have when I use The HUG ideas and teaching strategies as they relate to their individual baby. I think HUG Your Baby is such a useful tool for facilitating breastfeeding, fostering mother-baby bonding, and enhancing parent confidence.