Gratitude as We Bring The HUG Back Home

"Seeing and Sharing" a baby's
behavior in Brunei

Jim and I have been traveling for thirteen months. We’ve taken thirty-seven flights to share HUG Your Baby and learn about the care of babies and young families around the world. I made sixty-nine presentations in thirteen countries! Jim's played music for princes and for farm animals, and with musicians on four continents. We’ve written blogs and lullabies, taken photos and videos, and worn out our shoes and clothes.

Now we are headed home. And how are we feeling? Happy. Sad. Satisfied. But, most of all, we feel grateful.

Jim gets a flue lesson in Thailand

Travel reveals new ways of living and being, but only when travelers find local people willing to accommodate and guide them. Jim and I are exceedingly grateful for all we’ve seen and learned this year. Above all we are grateful for the many remarkable people who, by extending themselves to us, made this journey a joy, a revelation, and an inspiration.

"Giving a HUG" at the Bokko
Birth Center, Kagawa, Japan

We hoped that our passion for parenting and babies, and for music and the arts, would attract new friends in faraway lands and make our travel more than tourism. We are grateful that our trip was such a success in this regard. Not only did we learn more than we imagined we could, we met so many generous, caring, creative and wise people who embraced us and shared with us their family lives and professional lives, their loves and hopes and dreams.

Our sons and partners (who managed our
home and The HUG in Durham)
joined us in Bali for Christmas

We are also grateful for family and friends at home who managed our affairs there, who followed our journey with love and interest, who came to visit us abroad, and who took us in when we passed through North America.

As this year of travel draws to a close, we cannot stop thinking of the many wonderful people we met and relied upon and connected with, and of the many remarkable experiences we had through and with them.

In addition to the many good people we met as we traveled, we also want to express our gratitude for the many good things that made this trip both possible and enjoyable: 

Barbara Hotelling and I chow down
at La Belle Mere Postpartum Care
Center, Seoul, So Korea

We are grateful for our good health . . . no accidents and
only a few, mercifully short
bouts of illness.

We are grateful for our security . . . no robberies, thefts, or losses of anything hard to replace.

We are grateful for the weather . . . seldom too hot or too
cold, and often ideal.

HUG's "Roadmap" -
making ends meet in Australia

We are grateful for where we’ve been . . . so many lovely places to treasure.

We are grateful for staying on budget . . . no big surprises or retirement-ending disasters!

We are grateful for simple, well-designed and durable travel gear . . . that kept our traveling simple and safe.

Sisters-in-law, Nancy and KB
"Scoot" with me around England

We are grateful for the success of the TravelScoot . . . that showed us living with a disability is a challenge to be overcome not only with the right attitude and the right support, but also with the right equipment.

We are grateful for electronic resources (Blogger, Facebook, flip camera,
Tripit, Google calendars) . . . that made our trip possible, manageable, and share-able.

Finally, we are grateful for each other and for the love that continues to grow between and around us. We may have gotten sick of each other’s
clothes on this trip, but not to be sick of each other, after thirteen months of daily togetherness, is perhaps the most amazing gift of all!

In Tasmania

With thirty-six years of married life behind us,
Jim and I still wonder what’s next. We find
ourselves most grateful, at journey’s end,
for the love and commitment that keep us
dreaming, working and growing together!

Holland: Final Stop on International Teaching Tour!

On some days, giving A HUG seems quite magical. Today was one of those days, when a room full of highly experienced lactation consultants joined me in Almere, Holland. Learning and teaching is always a two-way-street. Today there was much give and take about the "hot spots" for LCs (swaddling, pacifiers, and sleep issues) as well as important conversations about the critical importance of helping parents understand a baby's behavior. 

The group was especially engaged with the HUG Strategy, "See and Share (the baby's behavior)." We practiced "Broadcasting" and "Commentating," using role-plays with a baby doll. Then we were delighted to be joined by a charming, first-time mother and her baby. How wonderful to see this little one demonstrate the competencies of "Spacing Out" or "Switching Off" to manage an over-stimulating environment! It is always clear that these normal behaviors can be misinterpreted by caring parents. A little bit of education about these concepts is often reassuring to mothers, as it was today. 

Elly Krijnen, Holland's
HUG Your Baby
country representative!

Ninety percent of the Lactation Consultants in today's workshop signed up to complete the Certified HUG Teacher program. Elly Krijnen, RN, IBCLC, and co-owner of Baby en Borst, hosted the workshop. Elly, who has decades of experience in maternity care, parent education and professional training, also agreed to serve as the Holland country representative (and distributor) for HUG Your Baby. Dutch parents will enjoy getting The HUG from Elly and from the passionate and competent professionals she knows and serves.

The HUG Your Baby community is thankful to celebrate this final, and glorious, day of sharing HUG Your Baby with parents and professionals around the world! Thank you to the Dutch lactation consultants (pictured below) who joined us on our last day of taking The HUG out into the world!

Holland: Learning from the Dutch

This blog was written by Jim Henderson, Ph.D., Jan’s husband, HUG Your Baby’s Vice-President, and developer of The HUG for Dads.

Travel lets us appreciate how cultures have developed in different ways to meet shared human needs. During the HUG Your Baby International Teaching Tour, Jan and I have enjoyed sampling each country’s amazing variety of food, music and visual art. We’ve also been fascinated to learn about the different customs cultures have evolved for welcoming babies to the world and for preparing moms and dads for parenting.

Home 

Though Jan and I generally try to avoid judging or ranking cultural practices, when it comes to the various national systems of health care we have encountered it is hard NOT to compare them to what America offers. By most measures (using both international standards and our own impressions), America comes off pretty poorly in comparison to the systems of health care that most other developed countries have evolved—especially with regard to care provided for babies and mothers.

Jan and Elly

In The Netherlands we were particularly impressed by how the Dutch health care system has evolved to offer excellent maternal-child care. We learned a great deal from chatting with our host in Holland, Elly Krijnen, a nurse, IBCLC, educator, mother of three, former owner of a maternity center in Amsterdam, and currently co-owner of “Baby & Borst” in Almere.

For centuries, midwives (vroedvrouwen, or “wise women”) have been at the center of Dutch health care. During the last century, as medical science advanced, Dutch midwives held their ground as a distinct, and powerful, group of practitioners. To this day midwifery is the standard of care in Holland (as it is in many European countries, as well as in Australia and New Zealand). Dutch women who do not have medical complications give birth in the hands of midwives.

At a home birth in Holland

A generation ago the majority of Dutch women gave birth at home. Today about one-third of babies are born at home in Holland. Women can choose either a home or a hospital birth. In either case, midwives do the delivery, unless there is an emergency, a medical complication, or some other special indication. But excellent midwifery care is just the beginning of the benefits that are guaranteed to Dutch citizens through the basic health insurance premiums of $140/month that everyone is required to pay.

Kraamverzorgenden provide
8 days of care, 3-8 hours per day.

Beginning in the 1950s the specialized profession of “Maternity Nurses” (kraamverzorgenden) evolved. To this day, new Dutch mothers receive, according to their needs, either three, five or eight hours per day of “maternity nurse” care during the first eight days after their baby is born. 

Kraamverzorgenden not only participate in labor and delivery. They educate their clients, one-to-one, about baby care—and also will cook, clean up, provide care for other children, or do whatever the family needs during their daily home visits.

In a Dutch Consultation Bureau

New mothers receive sixteen weeks’ paid maternity leave, time that typically begins four or six weeks before delivery. Beyond this, parents may elect to take another six months of non-paid “family leave,” during which time their jobs are guaranteed. Dads get just two days of “paternity leave,” but they may also exercise their option to a portion of the family’s total leave time.

Mothers in Holland have the right to breastfeed at work. Either a work place must provide an approved lactation room, or the employed woman may take off up to 25% of her work time (paid, for nine months) to accommodate breastfeeding. Holland has done the research and concluded that the benefits to both society and business justify this arrangement. Furthermore, lactation consultations are paid for by most insurance companies in Holland.

Beginning with the third week of life, Dutch families receive well child care, and parenting guidance, from the Consultation Bureau, where they see a nurse and then a doctor (on alternating visits) once a month during the first year of life.

As America, at last, begins to move toward justice in public health, American citizens, insurance companies, and policy makers are wise to embrace or adapt policies and practices that have proven effective in other countries. Wouldn’t the USA be a better, healthier country if it treated its mothers and babies as they are treated in Holland? Jan and I—and HUG Your Baby—think so!

China: Barbara Hotelling Takes HUG Your Baby to China

This post was written by Barbara Hotelling, MSN, IBCLC, CHT, a HUG Your Baby trainer, Duke University clinical instructor, and past President of Lamaze International and DONA International.

It was my privilege and honor to be invited to bring HUG Your Baby to the 3^rd anniversary celebration of AIMA Maternity Hospital in Hangzhou, China. Vivien Li was my hostess and  translator as we traveled from Hangzhou to Wenzhou and Taizhou to make presentations to professionals and parents at three maternity hospitals.

Tours of the three hospitals were so interesting. Parents take birth classes and get prenatal, birth, postpartum, and breastfeeding care at the maternity hospitals. The nurses serve as doulas and are trained in Brazelton’s sleep/wake states and how to calm a fussy baby so they can educate parents as they care for them. Parents may stay in the postpartum care center for a week or two and receive help with breastfeeding and parenting questions. After birth in the hospital and discharge from the hospital, babies can enjoy the baby spa, where they get a swim in the tub followed by infant massage.

Support from family and friends is huge in these three Chinese cities. New parents rarely suffer from depression as their needs are met, allowing them to be present with their newborns. 

Professionals – nurses, lactation consultants, and physicians – attended a full HUG Your Baby training in Hangzhou. At times we have mothers with their newborns attend the HUG classes for professionals as a way to demonstrate a baby’s behavior and use of the HUG Strategies. 

However, since no mothers were available for this particular class, my life-like baby doll, Audree, was used to demonstrate HUG techniques for calming a fussy baby and showing parents the amazing talents of the newborn. Parents later came to a special parent session, where their babies demonstrated various Zones, feeding cues, engagement/disengagement cues, and how well they recognized and responded to their own parents’ voices (compared to mine).

In Wenzhou and Taizhou, professionals attended an introduction to The HUG and parents attended information sessions where they learned HUG information to use with their infants.

Enthusiasm for HUG Your Baby information warmed my heart, and Chinese travel and hospitality warmed my soul. 

"See, then Share" the Baby's Behavior

The HUG Strategies are described in depth in the Part II HUGYour Baby course. Because the HUG Strategy, “See then Share” the baby’s behavior, is so critical to effective lactation support, we must take a moment to review this concept.

“See then Share” the baby’s behavior means to become an expert at observing the behavior of a child and then to be intentional about sharing that information.

Many times lactation specialists make general statements to new mothers. “Your baby is so cute.” “You are such a good mother.” “Your baby looks very peaceful.” While these statement might initially seem like a compliment, they suffer from two problems. First, such a statement can seem so general that a mother might think, “She probably says THAT to everyone.” Secondly, the statements do not provide the mother with any information about her baby or her mothering.

It can be helpful to think of two ways to share information. We can either “Broadcast” or “Commentate” the information. In the sporting world, a "Broadcaster" is a person who simply describes EXACTLY what the athlete does. “He caught the ball in his right hand, spun to the left and scored with a jump shot.” A “Commentator” is the person at half-time who explains the significance of certain moments of action.

You will discover that the use of these two approaches in describing a baby and mother’s behavior will not only enhance lactation but will also promote the parent-child relationship.

Imagine you enter the room with a new mother and practice “Broadcasting” the baby’s behavior. “Oh, I noticed that when you spoke to me your baby hesitated in his suckling and looked up at you.” “It was lovely that you spontaneously reached down and rubbed her head as if to reassure her that all was well.”

Before you start asking questions about breastfeeding you might start by noticing and “Broadcasting” what the mother is doing correctly. “I see that you are holding her belly to belly and that her lip is nicely flared outward.” “When she starts to wiggle and squirm, I see that you release suction on the nipple before you move her to the other breast.”

These statements both compliment the mother AND give her information about what she is doing well. This feedback seems personal, just for her! You are also affirming her as the expert on her child (a strategy Dr. T. Berry Brazelton promotes).

But, of course you may need to give additional information. You might use a “Commentating” statement that does not disempower the mother: “Some mothers find that putting a drowsy baby skin to skin will help her to wake up for breastfeeding.”

I ALWAYS “Broadcast” at least three statements before I offer advice or correct a behavior. It is amazing to see a mother who might have been resistant to feedback, then smile and join me in admiring her remarkable baby. "Broadcasting" keeps the baby's behavior in focus and creates a special bond between me and the mother.

Why delay solid foods until 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