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.
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.
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.
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 - (email@example.com) and/or Jan Tedder, HUG Your Baby President - (firstname.lastname@example.org)
- Brazelton, T. & Nugent, K. (2011). Neonatal Behavioral Assessment Scale. London: Mac Keith Press.
- 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.
- Gardner, M., Deatrick, J. (2006). Understanding interventions and outcomes in mothers of infants. Issues in Comprehensive Pediatric Nursing, 29, 25-55.
- 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.
- Neifert, M. & Bunik, M. (2013). Overcoming clinical barriers to exclusive breastfeeding. Clinical Pediatrics of North America 60(1), 115-145.
- Nugent, K., Petrauskas, B., Brazelton, B. (2009). The Newborn as a Person. Hoboken, NJ: John Wiley and Sons, Inc.
- 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.
- Tronick, E. & Beeghly, M. (2011). Infants’ meaning-making and the development of mental health problems. Am Psychol 66(2),107-119.
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 see and hear what Malaysian Lactation Consultants think about incorporating HUG Your Baby into their work with young families.
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!|
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.
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 email@example.com Read about The HUG in Australia.
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 firstname.lastname@example.org. 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 email@example.com Read about The HUG in Italy!
Japan's Director of HUG Education and Research: Yoko Shimpuku, 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 firstname.lastname@example.org 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 email@example.com 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 firstname.lastname@example.org Read about The HUG in South Korea.
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 email@example.com.