November 2022 – Baby Shastra

Vision: The Art of Seeing

November 20, 2022 babyshastra

VISION: THE ART OF SEEING

Vision is constantly relied on to get information from the environment. Learning about our surroundings like colors, shapes, objects, people and their respective significance daily life is primarily based on vision in the first 2 years of life. It is also used as an ingredient for complex interactions like eye-hand coordination, eye-foot coordination, depth and distance perception and anticipatory protective responses, especially during sports.

During the first year, visual recognition of objects helps to build up visual-perceptual skills. These skills are essential in academics and daily skills like driving or organizing your home.

These are:

Form consistency: Ability to recognize the same shape in any context. This helps with learning colors, shapes, numbers and alphabets.
Discrimination: Ability to identify differences in a group of objects. This skill is useful for knowing the difference between zero and ‘o’ or finding matching socks in the drawer.
Figure-ground perception: Ability to differentiate between foreground and background. Extremely important for stairs and threshold that are not well demarcated.
Visual memory: Ability to remember what you have seen. This is used in our daily life to recognize directions based on neighborhood landmarks, people we have met a while ago or even where you’ve last put your keys!
Visual sequencing: Ability to put a sequence based on visual cues. This is how reading sight words and spelling are learned.
Visual closure: Ability to complete the rest of the picture based of a partial visual cue. Helps in speed reading as you fill in words by looking at some important ones only.
Visual-Spatial relation: Ability to understand position of the object in relation to the environment. Useful in following directions like “bring the socks from the second drawer on the left” or “your shoes are under the red chair.”

Given the tremendous reliance on vision, let’s look at some strategies to help vision along.

0-3 months:

Holding the baby close to rock, sing and cuddle are prefect times for the baby eyes to learn how to focus on your face and recognize facial features
Since contrasting colors grab more attention in early months, mobile toys with black and white or red colors are useful.
Allowing hand to mouth exploration is also part of the large eye-hand coordination process as this exploration leads to hand awareness and builds coordination in the arms.

3-6 months:

This is the peak time for eye-hand coordination development. Providing hanging toys like crib mobiles or on play mats is a good option to strengthen this skill.
Babies are also tracking and following people and objects in their vicinity. Tracking skills are building blocks for object permanence.
Mirrors can be used gradually around this time though cognitively recognizing a reflection comes a little later.

6-9 months:

Allowing play with objects of daily use and associating them with pictures in books is a good way to start building up visual memory.
Action songs so baby can imitate your hand/body movements.
Creeping and crawling to stimulate depth perception

9-12 months:

Games like pee-a-boo, rolling ball and finding hidden toys are great ways for visual scanning of the environment.
Naming and pointing objects
Doing obstacle courses, crawling up and down stairs are great ways to develop visuo-perceptual skills.

12- 18 months:

Ball games- rolling, catch, throw, kick.
Shape sorters, building blocks, simple one piece puzzles.
Sequencing stories from books or daily life.

18-24 months:

Games that incorporate eye-hand, eye-foot coordination like soccer, cricket.
Involving child in their daily routines like finding their own pair of socks or getting their spoons out of the drawer will improve their visual- perceptual skills.
With sufficient independence in fine motor skills, some simple crafts and coloring great ways to improve visual-perception.

Our eyes are the most used sensory organ and we rely on our vision not just for interaction with the environment but also at times to trust our instincts. We are very quick to believe in something visible! But seeing is just the starting point of believing, right?

“The only thing worse than being blind is having sight but no vision.” – Helen Keller.

Puja

19/1/2015

Baby Development 1st year, Play, Sensory-Motor

Tummy Time: 3,2,1 Blast-Off!

November 20, 2022December 4, 2022 babyshastra

TUMMY TIME: 3,2,1 BLAST-OFF!

Tummy time has become a hot word over the last few decades as a reaction to the “Back to Sleep” campaign started for SIDS prevention. In developmental terms though, tummy time is like the number “zero”- of highest significance but somehow not given its due. In this post, we are going to look at how tummy time is the foundation for a holistic development.

What is tummy time?

Tummy time means having the baby lying on their belly to play. On our support group a lot of new parents confuse the process with the end result. Tummy time is a position in which the process of strengthening is occurring and the end result of tummy time is the ability of the child to push up on their arms while holding the head freely.

By doing tummy time from early days, we are expecting this against gravity strengthening to trigger sensory processing, visual development, balance responses and upper back (shoulder) strengthening for reaching at 3-4 months. It also helps in maintaining head shape and preventing torticollis (twisted neck)

When should you start tummy time and for how long?

It is recommended that babies sleep on their backs but they can be put on their tummy for play with adult supervision. Doing this consistently, a few minutes a day, a few times a day will help the baby develop muscles in their neck, back and trunk.

Tummy time can be started as soon as the stump of the umbilical cord falls off. The typical rule of thumb is at least 5 minutes per month of life. So a one month old can be on their tummies for at least 5 minutes and a two month old would need at least 10 minutes. If you have started tummy time consistently from the first week or so of life, there are high chances of the infant not resisting tummy time and enjoying the position for longer duration.

Click Here for a video of a mother talking about her experience with tummy time for her two sons.

How should tummy time be done?

Ideally, tummy time is done on the floor on a firm mat. The hard surface gives the right feedback and allows baby to push against gravity with full force.

Clink Here for a video showing five easy ways of doing tummy time.

Click here for a handout you can print and put up to remind all family members to do tummy time with the baby whenever awake.

The first picture is my son at 4 weeks old, tummy time during massage before bath. We started tummy time on day 13, once the umbilical cord fell off. We barely managed a minute or two in the first month because of the long sleep cycles. After about 2 months, the duration was increased as per his needs. (Second picture at 2.5 months)

Why is tummy time so important?

Sensory: When the body is in prone, the body weight on shoulders, chest and arms is the first step to body awareness and mapping. The position also stimulates the calming center of the brain. Most of you must have experienced as mothers that holding the baby close with arms and legs curled up and rocking calms the babies down faster. Even as adults, when we get really upset, we tend to cross our arms or curl up in bed. On the back, gravity doesn’t allow for that fetal position.

Motor: Most of the movements babies develop in the first year are initiated from prone position. Also, strengthening of muscles in infants and toddlers occurs when there are repeated movements against gravity. For strong core and neck muscles (which provide support for posture and fine movements later on) the against-gravity position is on their tummy. A strong core is essential for any motor skill and coordination.

Vision: Tummy time helps with strengthening eye tracking muscles. It also helps with initiation of depth perception which is needed later for crawling, reaching, walking, stairs climbing, playground activities and academics.

Fingers: The ONLY time an infant gets to develop a basic strength in their palm + finger muscles is when they are trying to push themselves off the floor. All the other fine motor development like playing with toys in sitting, feeding with spoon, writing, craft skills are only developed well if there is basic strength in your fingers. Latest research is showing increased number of students with hand-writing problems.

Overall brain development: Tummy time leading to prone activities and movements are instrumental in developing coordination between the 2 halves of the brain. This connection is super essential for life skills. In social context when the skill of understanding body language when talking to someone or understanding sarcasm and other subtle language nuances stems from integration of both sides of your brain. Higher level functions like analysis of data, planning out chess strategies or musical aptitude are also part of bilateral integration. Not to forget all sporting activities and some daily activities when we multi-task!

Head shape and neck muscles: Getting pressure off the back of the head allows for good head shape to form. Also allows both side neck muscles to elongate proportionally preventing head shape defects. (Common terms are torticollis or plagiocephaly)

Muscle tone: Being on the back increases extensor tone leading to babies possibly arching their backs off the floor.

Other: Prone helps to relieve gas from the stomach.

Given the benefits of tummy time, I would definitely encourage parents to try as much as they can. Starting earlier does in fact help the baby like and enjoy the position but having parents engaged while doing it is a great bonding time for you as well.

Puja

22/1/2015

The website for more resources and handouts is www.pathways.org

Expert opinion, Preterm Infants

Advocate for your baby in the NICU

November 20, 2022November 20, 2022 babyshastra

ADVOCATE FOR YOUR BABY IN THE NICU

The NICU is one of the most intimidating places for a new parent. It is filled with beeping technology, wires and multiple professionals all of whom seem to be using words you do not understand, not to mention the heartbreaking and scary experience of having a child in NICU.
An NICU is a very controlled environment, a lot of the time parents don’t feel like they can voice an opinion or ask a question. The professionals around them seem to be too busy and seem to know what baby needs better than the parent! However a parent is the best advocate for any child, no one can do that job better than you. Here are some tips on communicating with professionals in the NICU:

Do not be afraid of asking questions during daily counseling sessions. If the professional on the team uses a term/jargon you do not understand ask them to elaborate and explain what it means.
Make lists, you will come up with questions or have doubts when the doctor is not around. It helps to write things down so that you don’t forget to ask them when you do get the opportunity. It also helps to prioritize concerns, so that you can bring up these concerns in the beginning of the appointment.
Make notes during the appointment, so that you can convey accurate information to your partner if he/she is not present during the conversation. These notes will also help you keep track of what the medical professional thinks should be the outcome of an intervention, that way if a intervention is not working as it should you can quickly advocate for your baby.
If you feel your concerns have not been addressed, state this clearly. You can go over the details again or ask for more information from your doctor. If necessary ask for a second opinion.
Ask your doctor if your baby is stable enough to do kangaroo care (skin to skin contact between parent and child), kangaroo care has been shown to have a lot of benefits for low birth-weight and premature babies including improved cardiorespiratory and temperature stability and better sleep, in addition to being beneficial to the breastfeeding relationship.
Ask for help with breastfeeding, try to find a lactation consultant who can help you latch baby or pump for baby. Breast milk will help your baby’s tummy mature and help fight infections. Breastfeeding is also automatic skin to skin! In situations where the mother is unable to breastfeed or pump for baby ask if the hospital has a milk bank.
Premature babies develop differently than full term babies. It is important that parents advocate for their children and ensure that regular developmental screens are conducted so that any delay can be caught early. Ask your doctor for referrals when it is time to take baby home from the hospital.

Parents of preemies share your tips here: What questions did you ask? What questions did you wish you had asked? Did you take a list of questions with you? What to expect on the first visit? What to do if the professional is using too much medical jargon?

Happy Parenting

Lalitha Acharya

11/25/2015

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We would like to thank Lalitha Acharya for writing this post. Lalitha is mother to a 2 year old and a psychologist with a M.S in Clinical Psychology from the US. She has experience working with traumatized children and their families and running groups for individuals diagnosed with severe mental illnesses in both inpatient and out patient setting.

Expert opinion, Preterm Infants

My experience as an early intervention therapist for preterm babies

November 20, 2022November 20, 2022 babyshastra

Having worked with preemies babies straight out of the NICU, I can endorse the facts that there is so much more complexity to preemie development than any other. In many countries around the world, preemie babies are given special status, which means that they are automatically eligible for monitoring of development till they are at least 2 years old.

As an early intervention therapist and service coordinator in the US, I have followed many babies as soon as they come home from the NICU. Support for families include discussing how to take care of the baby within the home and family environment, how to inform other family members about the many do’s and don’ts associated with a preemie baby, how to create a development friendly environment and what to expect from preemie babies.

All families were followed by a service coordinator once a month and all five areas are tracked using parent questionnaires. As soon as a concern is noted or observed, simple environment changes are suggested to see if the baby will respond differently. If there is further need for intensive hands-on strategies, then services are provided accordingly. This system is put in place so we can monitor and track all at-risk babies and prevent any long term delays.

Families who are diligent from the beginning had higher chances of not needing any additional support after 3 years. A lovely family I worked with had twin preemie boys. As usual, both babies were regularly screened and we picked up a delay in one of twins at the 3 months screen. There was a distinct lag in head control and we started with regular therapy sessions. At the 9 month check, this baby was at par with his peers. In fact, I remember that he walked 2 weeks before his brother did!

On the other end of the spectrum, I distinctly remember a child we were following right from the time she came home from the NICU. The family, for various reasons, decided not to pursue regular services after 6 months. At 2 years, when the child needed help with speech and problem solving skills, they came back to the program. If they would have remained within the regular monitoring system, there is a good chance that we would have picked this up sooner and the child would have shown some progress.

There are many possible outcomes of development in a preemie baby and it is impossible to make a guess of what will happen unless development is tracked closely. There could be multiple outcomes ranging from all perfectly okay to a diagnosable condition in a few years. Since there is no way of predicting it, all we can do is keep a close watch and try prevention.

If there is one thing parents can take away from all of this, please remember to track your preemies development, not only growth. Growth is measured by height and weight while development is measured using milestones and skills.

While there is a general lack of awareness to track development in India, families with premature babies are hit the hardest! During NICU stay, families are overwhelmed by the medical aspects and bringing your preemie baby home in itself feels like a huge victory.

Please do remember that this is just the beginning to their beautiful lives. Track their milestones based on adjusted age and know that premature birth come with certain developmental risks that are visible later in life. Be aware and educated so IF there is need, you know what to do and where to go.

Happy Parenting

Puja

11/20/2015