Postpartum Doula Discovers the Magic of The HUG!

Heather Smith is a Postpartum Doula in Cary North Carolina. She describes her introduction to, and experiences with, becoming a Certified HUG Teacher.

I first heard about HUG Your Baby from Marcia Thuermer, who also instructed the DONA Postpartum Doula workshop I attended.  Marcia spoke very highly of Jan Tedder and the HUG Your Baby approach to teaching new parents about their new bundle (or bundles!) of joy.  After hearing testimonies from parents who used the HUG, I had to get in on this!

My first experience sharing the HUG was with a close friend (also a first time mother of a 2 week old preemie).  "Mason" was born at 37 weeks (mom was induced and received an epidural and IV pain medication).  When Mason was born, his latch was not sufficient enough for successful breastfeeding, but Susie and her husband had taken several breastfeeding classes before Mason was born and were adamant he would be a success story.  Mason had to stay in the NICU for a few days for monitoring so Susie was not able to practice breastfeeding with him as much as she would have liked to.  But Susie pumped and saved all of her precious liquid gold for that little fellow for when she was not able to breastfeed.  

When Mason was discharged, his latch had improved and Susie's milk had come in.  They were ready for "normalcy..."
When I arrived to meet Mason for the first time, he was crying.  Susie was already so exhausted from the labor/delivery and visiting Mason in the NICU; she was almost at her wit's end.  She cried too, saying that the absolutely wonderful nurses and lactation consultants had provided so much support and education in the area of breastfeeding that she forgot to ask about anything what to do when he won't stop crying!  

I gave her a big hug, then I gave her another kind of hug...  I told Susie about what "normal" crying was like for newborns around 1 week old (Mason had now reached his due date and his adjusted age was 1 week old) and that typically babies cry for 2-2.5 hours the first two weeks.  I suggested that Susie (and her husband Phil) try to keep track of how long Mason cried for over the course of the next 24 hour period, and when he cried.  They were certain he was crying over 6 hours a day for no clear reason at all.  When I came back two days later, we were all amazed.  Mason had only cried for a total of 2 hours throughout a 24 hour period...Susie couldn't believe what the chart said!  Susie and Phil also made notes of when Mason cried.  It seemed that Mason cried when Phil tried to "play" or interact with him.  Of course, Phil was worried that Mason didn't like him.  And Susie was also starting to doubt her idea of the breastfeeding success story as she was having a really hard time waking him up to breastfeed.  

I was excited to tell them there were answers to their concerns, that being HUG Your Baby.  I explained to them about the three zones (resting, ready and rebooting) and demonstrated what they looked like.  Luckily enough, Mason was able to help demonstrate the rebooting zone for us!  While Mason was in the rebooting zone I asked Susie to quietly speak to him in her loving motherly voice.  Mason was still upset.  I told Susie that sometimes babies need a little more help and showed her what she needed to "do."  I held little Mason's arms to his chest and he started to settle.  The sighs of relief were evident across the room.  Mason's movements started to become more controlled as well as his breathing.  Phil then spoke to Mason in a calm soft voice...and Mason looked at him!  Phil said that was the first time Mason ever did that!  Susie and Phil were overjoyed and were instant believers in the HUG.  As I could tell both parents were enthralled with what they were able to do for Mason, I stepped out. 

My next visit was a few days later and I remembered Susie was having a little bit of a hard time with breastfeeding as Mason was a "sleepy" baby.  I arrived when Mason had been asleep for about 20 minutes (his last feeding was about 2 hours before).  Susie was pretty set in her feeding schedule of every 2 hours and wanted to wake Mason up to breastfeed.  Before she attempted to wake this sweet sleeping baby, I quickly went over the active/light and still/deep sleep cycles.  Mason was very still and quiet; I told Susie he was in the deep sleep cycle and babies are very hard to wake during this time.  I also told her that typically babies will transition to the active sleep cycle 30-60 minutes after falling asleep (newborn babies fall asleep and enter the deep sleep cycle first).  We waited a few more minutes and watched as Mason started to stir and make a few grunts.  She then picked him, gently unswaddled him and got him in her favorite breastfeeding position.  She couldn't believe it, he was cooperating and breastfeeding well!  Susie realized she had been trying to wake him up to breastfeed when he was still in deep sleep. 

My next visit I plan to go over what do to when Mason appears to be "waking up" after a short nap and it is not time to eat. 

Childbirth Educator Knows that Expectant Parents Need The HUG!

Alisa Perozo-Dickerson is a registered nurse from St. Louis, Missouri. She recently had a baby boy of her own, and has decided to find a way to work less while raising him. She has begun her own Childbirth Education business and is integrating HUG Your Baby into her newborn classes.

I am so excited to be able to offer a class on "newborn behavior" to my clients. So often you see classes that go over basic care, hygiene, and the "how-to's" of baby care- but they lack the explanation behind the baby's behavior. It's interesting, because I began certifying as a HUG Teacher right when my own baby was six weeks old. This course actually has helped my husband and myself tremendously! I remember watching my husband (a first time daddy) play with our son, and the baby would keep looking away from him. I saw the disappointment in my husband's face as he continued to look for that eye contact. He actually said, "I don't think he likes me as much as he likes you. He won't even look at me." It was amazing to witness first hand how much one simple SOS could affect how a parent views himself! I quickly explained the "switching off" SOS and now my husband regularly uses the terminology, "he's over-stimulated."
I also recently came across a question on a local community forum asking if a baby should be evaluated for autism- for the very same reason! The baby was not making eye contact and was looking away from his mother, and the mother was extremely concerned. I was very glad to be able to explain that the behavior was not only normal, but expected!

This program is so vital and important to new parents, so that parents can form strong attachments with their babies from the beginning, instead of making negative inferences about themselves or their babies due to normal newborn behavior. I am looking forward to being able to help new parents accomplish this, using the HUG Your Baby program.

Parents As Teacher Benefit from HUG Your Baby Training!

Robin Roberts, Parents As Teachers (PAT) State Coordinator in North Carolina initiated research to evaluated the benefit (or not) of HUG Your Baby's training and resources for PAT professionals. She recruited parent educators from across the state who wanted to enhance their care of newborns and their families.  

(Partial) Review of Literature:
Research confirms that when mothers receive effective parent education they experience increased confidence, increased sensitivity to their babies, enhanced maternal-infant interactive skills, and a more positive perception of their infants (Fulton et al., 2012; Nugent et al., 2009). Parents who understand and respond effectively to changes in a baby’s states and to stress responses increase that newborn’s ability to eat, play, and learn, and decreases the baby’s shutting down response (Neifert & Bunik, 2013; Brazelton & Nugent, 2011; Tronick et al., 2011; Papousek et al., 2008). Therefore, new parents need information that helps them read their baby’s body language and recognize their baby’s capabilities (Karl & Keefer, 2011). Furthermore, parent learning is enhanced when information is demonstrated rather than simply described (Gardner et al., 2006) and is offered in language that is familiar to parents.

PAT Study:
Eighteen parent educators participated in this pilot program.  They completed HUG's online courses: "Helping Parents Understand their Newborn" (Part I) and "HUG Strategies and Skill Building" (Part II). Participants then utilized The HUG 20-minute parent education DVD and their HUG skills with their clients.

A Pre- and Post-Test confirmed that professional participants significantly increased both their knowledge about newborn behavior and their confidence to teach young parents.
  • The average pre-training score was 51.2% correct.  The average post-training score was 73.5% correct.   The difference in the means of the pre and post training scores is significant at the 95% level.  (See Figure 1)
  • The average pre-training confidence score was 2.5 (on a 4-point scale from Strongly Disagree to Strongly Agree).  The average post-training score was 3.6.  Ten of the fifteen items were significantly different at the 95% level; three were so at the 90% level, and two items were not significantly different. 
What PAT professionals had to say about HUG Your Baby training and resources:
Overall, participants were very satisfied. Following are some comments by these professionals. 
  • "HUG works great with teens."
  • "...incredible to see parents learn and understand the stages of development."
  • "...easy to use this online course."
  • "Easy to use the HUG DVD to enhance parent visits..."
  • "Practical tool to use with families."
  • They gained knowledge about their baby
  • They could articulate at least one specific area of learning
  • Even second and third time parents had much to learn from HUG Your Baby

Parent’s response to HUG teaching:
Forty-seven of forty-eight (98%) parents provided substantive answers to an open-ended question about what they learned. Forty-four of 48 (92%) answered that HUG Your Baby could improve their parenting by giving them information about and skills to: better understand their baby, understand their baby’s sleep and crying cycles, get their baby to the best state for eating and playing, and appreciate their baby’s ability to pay attention. They reported feeling more confident as parents and would recommend The HUG to others.   

Contact information:
HUG Your Baby looks forward to collaborating with national PAT leadership about the possibility of making HUG resources and training available to the larger PAT community.

For more information contact: Robin Roberts, NC State Coordinator -  ( and/or Jan Tedder, HUG Your Baby  President - (

Partial bibliography:
  1. Brazelton, T. & Nugent, K. (2011). Neonatal Behavioral Assessment Scale. London: Mac Keith Press.
  2. Fulton, J., Mastergeorge, A., Steele,J. & Hansen, R. (2012). Maternal perceptions of the infant: Relationship to maternal self-efficacy during the first six weeks' postpartum. Infant Mental Health Journal, 33(4), 329-338.
  3. Gardner, M., Deatrick, J. (2006). Understanding interventions and outcomes in mothers of infants. Issues in Comprehensive Pediatric Nursing, 29, 25-55.
  4. Karl, D. & Keefer, C. (2011). Use of the Behavioral Observation of the Newborn Education Training for teaching newborn behavior. JOGNN Jan. 40(1),75-83.
  5. Neifert, M. & Bunik, M. (2013). Overcoming clinical barriers to exclusive breastfeeding. Clinical Pediatrics of North America 60(1), 115-145.
  6. Nugent, K., Petrauskas, B., Brazelton, B. (2009). The Newborn as a Person. Hoboken, NJ: John Wiley and Sons, Inc.
  7. Papousek, M., Schieche, M. & Wurmser, H. (2008). Disorders of Behavioral and Emotional Regulation in the First Years of Life. Washington, DC: Zero to Three Press. 
  8. Tronick, E. & Beeghly, M. (2011). Infants’ meaning-making and the development of mental health problems. Am Psychol 66(2),107-119.

Congratulate Newly Certified HUG Teacher in Malaysia

Ning Desiyanti Soehartojo, MD, IBCLC, is a mother of four and a physician in Shah Alam, Malaysia, where she has provided primary care to families for many years. Since becoming an IBCLC in 2009 Ning has focused her practice on supporting breastfeeding women and is now eager to incorporate HUG Your Baby into the care she provides. She volunteers as a Peer Counselor Program Administrator responsible for training breastfeeding peer counselors in Malaysia. Ning shares the following story with us today.

Annie came for a lactation consult because she wanted to relactate and, if possible, learn to breastfeed her baby. Annie’s prolonged labour left her exhausted and too sedated to initiate breastfeeding immediately after birth.
Adam was a sleepy baby for the first few days, and Annie’s “flat nipples” made it difficult to get breastfeeding off to a good start in the hospital. As a result, Annie bottle-fed Adam with formula milk.

“It has been a month now, and I still can’t figure him out. He sometimes wakes up with a start and cries. When I picked him up to feed, he would either fuss and push me away or fall back to sleep.” I took the opportunity to explain a baby’s two types of sleep – active sleep and deep sleep – and how baby cycles between these two every 30-90 mins.

Adam was in Annie’s arms. I used The HUG's "See, then Share" approach. I described that Adam was in deep sleep now: his arms were floppy, his breathing deep and regular, and his eyes shut tight. Annie mentioned that it’s difficult to get Adam to wake for feeds when he’s in deep sleep. I explained that it will be easier to rouse Adam from active sleep than from deep sleep. Annie went on to undress Adam, called his name, tickled his feet, smothered him with kisses – “I do this every morning, to wake him for his bath.”

As Adam was transitioning from the Resting Zone to the Ready Zone, he showed signs of overstimulation. His limbs jerked and tremored, his face turned red, and he clearly was not happy. I pointed out this SOS, helped Annie notice how her son was entering the Rebooting Zone, and then guided Annie to decrease stimulation while increasing support. She quickly but quietly cuddled and held him close, swaying him gently.

Responding to his mother's comforting measures, Adam gradually settled. Annie sighed with relief.  “I understand now. Less is more.” As the first step towards transitioning Adam to the breast, Annie plans to do lots of cuddling and skin-to-skin contact when he is in his Ready Zone.

“I wanted so much for Adam to breastfeed. But each time I put him to the breast, he fussed, cried and refused to latch. I felt he was pushing me away and didn’t need me. With the help of The Hug approach, Annie learned to pay attention to Adam’s cues and behaviours. “When I understand which Zone Adam is in, I can respond to his needs better”. 

Adam transitioned from full bottle feeding to breastfeeding on demand by 3 months old. He's definitely a star, thanks to mummy Annie's patience and determination and a bit of guidance from me and The HUG!

CLICK HERE to read about HUG Your Baby in Malaysia!
CLICK HERE to see and hear what Malaysian Lactation Consultants think about incorporating HUG Your Baby into their work with young families.

New Certified HUG Teacher Incorporating The HUG into Home Visits

Beth Cooper, from Apex, North Carolina, is incorporating HUG Your Baby into her work as she makes a transition in her work life. She shares how becoming a Certified HUG Teacher has benefited her.

 The HUG helped me understand and guide families as I moved into a new career path. I have been working in Early Intervention for over 30 years, doing 1 hour weekly home visits with families of birth to three year olds that have developmental needs. I have training in Touchpoints as well as NIDCAP  (developmental care for premature babies) and the Brazelton Newborn Exam, so felt competent observing the behavior of infants.  

Beth and one of the lucky mothers she serves!
I am now starting to work as a baby nanny and will get trained as a post partum doula, specializing in premature and other medically fragile or special needs infants and toddlers. So, instead of brief visits with families I will be spending most of the day with them.  My ideal is to work with mom’s that are staying at home with their children, so that I can support the whole family rather than taking care of the child(ren) while the parent(s) work.  I am delighted that becoming a Certified  HUG Your Baby Teacher has given me language to share a baby’s behavior with parents and enhanced my ability to help parents read their baby’s cues.

Doula Integrates HUG Your Baby into Her Services

Holly Phelan is a labor and postpartum doula in Jupiter, Florida. She is delighted to have integrated HUG Your Baby into her work with young families and shares her experiences with us today!

As a labor and postpartum doula teaching and using the HUG techniques has been such a benefit to my practice. Watching a new Mom's face go from confusion to understanding after learning new information is so rewarding. I often do my postpartum visits with new moms around the 2 week mark and this provides me the great opportunity to go over normal newborn crying patterns. Most recently I met with Anna and her baby boy. Because of what I learned in the HUG I start my visit by simply observing mother and baby and letting her talk. Baby boy began to fuss and cry and immediately Mom sprung into action, she spoke loudly trying to get his attention, she bounced him around, tried everything to get him to look at her and became tense and distressed as he only began to cry louder. This gave me the perfect opportunity to talk to Anna about normal crying, newborn zones, and SOS's. I saw a lightbulb go on over her head as she realized this was exactly the behaviors her baby was showing and I saw her confidence build as I showed her how to swaddle, speak softly and sway baby boy until he calmed down! She had a few breastfeeding questions that we went over and I gave her the "Roadmap to Breastfeeding success." I directed her to the HUG blog so she would know what to expect over the coming months! When she hugged me and thanked me over and over as I was leaving it reaffirmed why I do what I do! 

My favorite part of learning the HUG has been teaching classes in my community. During the first class I taught one mother exclaimed, "I think this is the best information anyone has given me about my baby yet!" I love empowering women in birth as a doula and now new families as a HUG teacher! My husband and I recently found out we are expecting our first child and couldn't be more excited. I can't tell you how happy we are to have discovered the HUG before we embark on our parenting journey. It has given us a confidence that we would not of had otherwise and the comfort that we will be able to meet our babies needs. 

Home: But The HUG Keeps Going!

This week Jim and I reflected on our year abroad as we prepared for our flight back to Raleigh-Durham. (Click here for a glimpse at these reflections.) As we flew past an amazing North Carolina sunset, I was struck with such excitement and appreciation about those who have agreed to keep those HUGs going in their home country and to enhance the work of HUG Your Baby internationally. It is with great delight that I write my final HUG Your Baby's International Teaching Tour blog and introduce you to those who are making a difference in the world!

HUG Your Baby International Country Representatives
(in alphabetical order)
Australia's HUG Your Baby Distributor: Barb Glare, IBCLC, is a lactation consultant with decades of experiences at a large rural hospital in Victoria, Australia. She was one of the early leaders of the Australian Breastfeeding Association and is currently Director of Breastfeeding Conferences, a company that produces conferences for midwives, lactation consultants and nurses in Australia and New Zealand. Having hosted many international leaders in the field of lactation, Barb has a pulse on issues that impact breastfeeding mothers around the world. Barb brought HUG Your Baby to numerous cities in Asia-Pacific and is a distributor for HUG resources. Contact Barb at  Read about The HUG in Australia.

Holland's Director of HUG Education and HUG Distributor: Elly Krijnen, RN, IBCLC, has decades of experience caring for young families and training nurses, midwives, lactation consultants and kraamverzorgenden (similar to postpartum doulas) in Holland. As a mother of three (now grown and thriving) NICU babies, she is especially attentive to the concerns of families with premature babies. Formerly the owner and manager of a maternity center in Amsterdam, Elly now works as a private lactation consultant and is co-owner of "Baby en Borst" (Baby and Breast), a charming store and educational center in Almere. Contact Elly at Read about The HUG in Holland. 

Iran's Program Director of HUG Your Baby and HUG Research Advisor: Maryam Mozafarinia, RN, MSN, CHT, recently completed a Master's degree in Neonatal Intensive Care Nursing from Teheran University School of Nursing, where she became the first Certified HUG Teacher in Iran. She currently lives in Canada with plans to complete a DNP with a focus on neonatal nursing. Maryam translated The HUG materials into Farsi and published research on using The HUG to teach fathers of infants in a NICU. In the process she developed the HUG for Iran website. Contact Maryam at Read about Maryam's research in Iran.

Italy's HUG Your Baby Distributor: Benedetta Costa, founder of the Italian Association of Infant Massage (A.I.M.I.), distributes the Italian HUG DVD through Infant Massage srl. Benedetta founded the A.I.M.I. decades ago to help parents learn the power of infant massage to connect with their newborn. She has worked tirelessly to grow this program to its current 4,000-person membership. Contact Benedetta at  Read about The HUG in Italy!

Japan's Director of HUG Education and Research: Yoko Shimpuku, RN, CNM, PHN, PhD, CHT, has worked clinically as a nurse midwife in both hospitals and birth centers in Japan. She earned her PhD from the University of Illinois at Chicago. Yoko's work has been published in peer-reviewed journals and presented at international conferences. She conducts research in Tanzania for the education of pregnant women, adolescent girls, and local midwives. A former intern with the WHO, Yoko's international efforts have been recognized with multiple research grants and awards. Yoko is Assistant Professor at the School of Nursing, St. Luke’s International University, Tokyo. She created the Japanese HUG website and Facebook page. Contact Yoko at  Read about The HUG in Japan.

Malaysia's HUG Your Baby Distributor: Ning Desiyanti Soehartojo, MD, IBCLC, is a physician in Shah Alam, Malaysia, where she has provided primary care to families for many years. More recently, she has become an IBCLC and is now focusing her care on supporting breastfeeding women in Malaysia. Ning is becoming a Certified HUG Teacher and wants to integrate this information into the care she provides. Contact Ning at  Read about The HUG in Malaysia.

South Korea's Director of HUG Education and Research: Min Sung Kwon, RN, MSN, received her Master's degree in mental health nursing from the University of Sydney in 2013 with a thesis focusing on postpartum depression. (Click here to see an interview about this work). Min is currently studying and working in Australia at breastfeeding clinics as she prepares to become an IBCLC. Contact Min at  Read about The HUG in South Korea. 
Thailand's HUG Your Baby Distributor: Meena Sobsamai is a nurse-midwife and lactation consultant (IBCLC) in Bangkok. She has decades of experience providing prenatal, delivery and antenatal care in Thailand and has contributed to the leadership team for the Childbirth and Breastfeeding Foundation of Thailand and Thailand's WHO Baby-Friendly Initiative. She developed "BirthaBaby," a company that educates parents and professionals and markets beautiful, hand-made childbirth teaching materials. Meena will soon be distributing the Thai HUG Your Baby DVD. Contact Meena at  Read about The HUG in Thailand.

HUG Your Baby's Child Development Consultant: D. Camille Smith, MS, EdS, CPD, is an educational psychologist who was trained in the Brazelton NBAS exam and its counterpart for premature babies, the APIB. She initially worked with new families and babies transitioning from the NICU to home and then for years at the Centers for Disease Control (CDC), where she designed curriculum for interventions with parents. Camille is the co-author of the Essential Package of Health and Developmental Services (EP) – an HIV parenting intervention resource used internationally. She is thrilled to be recently certified as a postpartum doula and looks forward to sharing her experience with young families and to helping professionals integrate HUG Your Baby into their work. Contact Camille at 

HUG Your baby Trainers:
Gale Touger, BSN, FNP, CHT, is the first HUG Your Baby Trainer. She has worked professionally with families for more than thirty-five years and more recently excels as "Grandma Par Excellence" (shown here). Gale studied at Boston University, Duke University, and UNC-Chapel Hill. She was honored as the NC Nurse Practitioner of the Year, received the Barbara Bennett Peer Assistance Award, and is a member of Sigma Theta Tau Nursing Honor Society. Gale is certified in Brazelton's Touchpoints and the Brazelton Center's CLNBAS teaching exam (now known as the NBO) and integrates The HUG into her work as a nurse practitioner in Beaufort, SC. As a HUG Trainer Gale teaches local professionals, helps to study and develop the HUG curriculum, and joins Jan in "Giving a HUG" to parents and professionals across the USA. She is currently completing research on the impact of teaching The HUG to professionals in outpatient settings. Contact Gale at

Barbara Hotelling, MSN, WHNP, IBCLC, CHT, has worked for decades as a postpartum home visiting nurse, nursing instructor, doula, and childbirth educator. She has published in numerous peer-reviewed journals and spoken internationally on issues related to providing evidence-based birth and parenting care. Barbara has served and led the birthing community as President of both Lamaze and DONA, and as a CIMS site evaluator. She has been honored by Sigma Theta Tau International Honor Society of Nursing (2006), Nurses’ Education Funds Scholarship (2005), Mother-Friendly Nurse Recognition-ANACS (2003), Elisabeth Bing Award-Lamaze International (1998), Who's Who in American Nursing (1996), and Who's Who in American Women (1996). Barbara is currently a clinical instructor at Duke University School of Nursing, where she was named the "Clinical Instructor of the Year" (2014). Contact Barbara at

Vice President and Director of "HUGs for Dads"Jim Henderson, PhD, brings skills to HUG Your Baby as a teacher, editor, journalist and administrator with experience in public relations, publishing, and fund raising. He earned degrees at Gettysburg College (BA), Columbia University (MA), and Duke University (PhD). For thirty-two years Jim worked as a teacher and administrator at Carolina Friends School, where he gained day-to-day experience with innovative and effective approaches to developing the hearts, minds, and spirits of the next generation. A lifelong musician, Jim has performed professionally for six decades and wrote and performed (with colleague, Tony Bowman) the HUG Your Baby theme song. Jan, Jim and Tony are currently writing, arranging, and recording HUGs Around the World: Lullabies to Calm Babies and Empower Parents. For more than a decade Jim worked to compose, write, and produce Ariel's Way (a modern musical adaptation of William Shakespeare's The Tempest), which deals theatrically with timely themes of parenting and forgiveness. He is currently creating "HUGs for Dads," a program to help prepare fathers-to-be for the journey ahead.