Wow! This Baby IS a Handful!

A young mother, worried about her breast milk, enters the WIC office with her three-week-old baby, Sumi. Carolyn, the WIC counselor, reviews Sumi's chart. After a full-term birth, Sumi has regained her birth weight by 10 days of age and is now gaining between 1/2 to one ounce a day. In addition, mother's careful records show that the baby has 6-8 yellow stools and several wet diapers per day. Why, Carolyn wonders, is this mother worried about her milk supply?

The mother explains that her baby is easily upset; she wiggles and squirms constantly whenever she is lying down. "I just can't figure out what Sumi wants most of the time," the young mother sighs.

Sumi is in peaceful sleep inside her car seat as the mother and counselor chat. After only a small stir, Sumi suddenly arouses with a full, hardy cry. Mother swoops down to pick up the baby, who is already red in the face and whose hands reach out with a wide, jerky movement. The baby wiggles frantically in mother's lap as she attempts to open her blouse to breastfeed. Once brought to the breast, the baby sucks a couple of times then falls off to sleep.

Wow, Carolyn, thinks. This baby IS a handful!

As Carolyn listens carefully to this mother's story, she hears familiar characteristics of a more challenging baby: high activity level, unpredictable schedule, and frequent state (or Zone) changes. Sumi is struggling with Zone regulation issues, which puts this mother at risk for giving up breastfeeding.

A baby exhibiting effective state (or Zone) regulation will transition from one state to another rather slowly, might bring her hand to her mouth, or assume the fencing pose to calm herself down. That baby feels easier to understand and more predictable to the mother.

When Sumi begins crying again, Carolyn leans over and speaks to the baby with a sing-song voice. Surprisingly the baby slows down her crying. Then Carolyn encourages the mother to gently hold Sumi's hand to the baby's chest. The mother is delighted to see Sumi stop crying and look up at her.

Carolyn reviews Sumi's WIC record, which indicates that breastfeeding is going great and that this baby is thriving on her mother's milk. Carolyn demonstrates several more tips for calming a crying baby and reminds mother that babies this age cannot be spoiled. "Spending a little more time with the baby skin to skin and 'baby wearing' will also settle Sumi as she adjusts to being out in the world," Carolyn says. Finally, Carolyn invites the mother to a New Mothers meeting the next day and encourages her to ask for a bit of help at home.

A follow-up phone call a week later reveals that this mother and her baby duo are doing much better. The mother is proud to be a breastfeeding mom and is confident that the support and encouragement of other mothers--and her WIC counselor--will help her meet her breastfeeding goals.