San Diego
Babies and Toddlers From Baby Bump to Toddler Time
Published by
Publisher’s Letter
inside 4 Heads Up, Parents!
Welcome to our third annual baby and toddler digital magazine!
Important safety resources 6 Local Dads Share Parenting Wisdom 8 Choosing a Midwife What to know and questions to ask 12 Maternal Wellness In the third and fourth trimesters 16 When Breastfeeding is Hard
You are now (or almost) a parent—enjoy it! Whether
you’re having your first child or your second or third, San Diego Babies and Toddlers is here to help. Every pregnancy and every baby are different so you are always learning along the way. Health is important, during pregnancy and after. Check out our article on page 12 for tips about wellness in the third and fourth trimesters. If you need help or have concerns, you are not alone and it’s OK to ask for help. Support is available. Have you considered the services of a midwife for pregnancy and birth? If so, see the helpful information and suggested questions to ask on page 8. Dads are so important in the family unit. Don’t be a dad who said, “I missed out”—get involved! You may not know how, but you’ll learn along the way. Hold your baby and play with him. Get lots of great ideas on page 20. Consider a parenting class for moms and dads. Read about breastfeeding concerns, baby sleep and how to cope with crying—all issues that come up for parents of babies. Don’t worry—you will make it through this phase and look back and say, “We made it!”
Common concerns and resolutions 20 The Importance of Dad Involvement Why and how to be an active father 24 Oh Baby! Some of our favorite baby and toddler products 28 How to Cope with Crying Tips, strategies and self-care steps 32 Solving Sleep Regressions Why the baby isn’t sleeping and how to help 36 Isn’t it ONEderful! Tips to celebrate baby’s first birthday
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Heads Up, Parents! Important Safety Resources
Get to know SanDiegoFamily.com, where you’ll discover these articles and a plethora of awesomeness for parents.
Parenting: Pregnancy Doulas 101 How doulas make a difference in childbirth How to Prepare a Child for a New Sibling Dos and don’ts to help the transition
Keep Babies Safe on the Road The Transportation Safety Program at Rady Children’s Hospital San Diego offers parents a plethora of helpful information, including how to choose a car seat, how to properly install a car seat, safe driving habits, considerations for children with special needs and more. Visit www.driventosafety.org for information or to schedule a car seat inspection.
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The Big Reveal! Gender reveal ideas that wow family & friends
Parenting: Baby Pregnancy Nutrition Impacts Baby’s Growth and Development The importance of the first 1,000 days Baby Sleep Challenges Is it time to consider a sleep coach? How to Support Oral Health Caring for baby’s gums; the first dental visit Baby Digestion Issues Common concerns in the first year San Diego Pediatricians, OB/GYNs and Midwives Recommendations by local parents Easy Games that Help Brain Development What to do in the first 12 months How to Transition Back to Work What to do when maternity leave ends
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Get the Latest on Product Safety Sign up to receive alerts via email about child-related product recalls. Safe Kids Worldwide is a nonprofit organization on a mission to prevent childhood injuries. Get connected with their valuable and timely information at www.safekids.org/product-recalls.
Pledge to Prevent Drowning Drowning is the leading cause of injury-related death in children ages 1–4. The U.S. Consumer Product Safety Commission launched a national public education campaign called Pool Safely, which works to inform families of best practices around spas and pools. A few safety tips include: • Never leave a child unattended in or near water. • Teach children how to swim. • Learn CPR.
Get much more information—and take the online Pool Safely Pledge at www.poolsafely.gov.
Stay Connected to Us! San Diego Family Magazine grows with your family from pregnancy through the teen years, so stay connected to us for tons of great parenting information, helpful resources and awesome things to do with your family. Visit www.sandiegofamily.com/parenting/baby to read some of our articles and to sign up for our monthly Baby eNewsletter.
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Local Dads Share Parenting Wisdom
Thank you to these four local fathers, who responded to our call-out on social media for parenting input from a dad’s perspective. They even weighed in on a few article topics throughout the publication.
Mike Collins, Santee Dad to Max (9) and Jack (7 mos.) Knowing what you know now, would you have done anything differently in the first year? I have been extremely fortunate to be home every day with my second son. This pandemic has blessed me with a work-fromhome schedule that allows me to spend more time with him and pick up little nuances that I didn’t experience with my firstborn. Knowing what I know now, I wish I could have been home more during my older son’s first years.
Bradley Johnson, San Marcos Dad to Camden (2) and Danika (6 mos.) Knowing what you know now, would you have done anything differently in the first year? Pay more attention to my wife! Looking back, I could have been more helpful around the house. I underestimated how stressful early motherhood is on a woman’s body and mind. Comparatively, dads have it easy. I still don’t understand how my wife functions on a daily basis with the nurturing expectations on her.
Adjusting to parenthood: It takes time, and it’s OK to learn as you go. Have patience and perseverance and you will be fine.
Adjusting to parenthood: The biggest adjustment has been that there’s no “me” time with two kids under 2 years old. My wife and I do not have nearby family, so it can be a challenge at times. But the activities we do together as a family make it all worth it. I can’t imagine going back to a lifestyle where I have countless hours to myself.
Dad involvement: Spend as much time with [babies and toddlers] as you can. Dads often miss out on this period of time. We aren’t given as much time off after the birth, if any, so make the most out of the time you do get. Derek Restrepo San Marcos Dad to Adrian (3) Knowing what you know now, would you have done anything differently in the first year? I would have stressed out less about schedules. Even though having your child on a routine is great, I wish we would’ve just trusted our gut when it came to what our son needed (even when it wasn’t on schedule).
Mike Cunningham Rancho Peñasquitos Dad to Isa (13), Cadence (5) and Evie (3) What do you wish you had been told before having a baby? Don’t forget about your partner. If you’re frustrated, exhausted, feeling unloved, etc., your partner is probably feeling the same way. Whether you’re romantic with your partner or not, you’re a team and need each other’s support. This not only makes your relationship healthier, but your baby will reap the benefits, too.
Dad involvement: My biggest advice to all new dads is get involved and learn as much as you can from day one. I learned how to change diapers, burp the baby and swaddle alongside my wife. Many dads fall into the trap of “she just does it better” and then never catch up. It’s important to take turns to become just as good at those things as your partner.
Knowing what you know now, would you have done anything differently in the first year? It’s relatively easy to have a child, but it takes a concerted effort to be a good parent. “Good” is subjective, but what I mean is to be present—be mature enough to change your habits to accommodate your child, not the other way around. It took me a while to learn this.
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Allyson Kennett
Choosing a Midwife
What to know and questions to ask When my mom was pregnant with me, there was a series of steps she followed for care—she visited an OBGYN until labor, then checked into our local hospital to deliver. Today, there is a plethora of options for where to give birth and obtain pregnancy 8 • SanDiegofamily.com • Baby Guide 2021
support. Most people have heard the term “midwife” and may know someone who saw one for care, but what exactly does a midwife do and how do you choose one? Midwives are reproductive healthcare providers licensed by the State of
California. While each classification of midwife will have a unique approach to birth, they all follow the Midwives Model of Care. In this model, providers spend at least 30–45 minutes with patients (even during routine checkups) to educate parents-to-be and build trust.
“The pregnant person is the director of their own care. Mother-directed care is the cornerstone of community midwifery,” says Kayti Buehler, a licensed community midwife serving families in San Diego since 2013. Patients are encouraged to research, ask questions and be a participant in making prenatal and labor decisions.
Certified Nurse Midwives A Certified Nurse Midwife (CNM) has attended nursing school and taken additional training to specialize in caring for pregnant individuals. Like all midwives, a CNM focuses on educating the expectant mother, empowering her to research and participate in all aspects of her care and decision making. CNMs often practice at hospitals. San Diego’s Kaiser Permanente, UC San Diego Health, Balboa Naval Medical Center and some Scripps locations have midwives on staff. If you’re intrigued by the midwifery model of care, but nervous about birth without pain medication, outof-hospital births or have a pregnancy with complications, hospital-based CNMs might be a good option for your family. Hospital birth centers combine the Midwives Model of Care with the clinical and technological support of the hospital. Midwives provide prenatal care, support during labor and continue through postpartum care. It’s important to note that since most hospitals are large networks, it is unlikely you will meet your birth team before delivery day.
Community Midwives A community midwife, also known as a Licensed Midwife (LM) or Certified Professional Midwife (CPM), typically attends a school for midwifery and is required to learn about out-of-hospital birth settings. Nursing or other medical backgrounds are not a prerequisite. Community midwives often have smaller caseloads in practices with fewer providers, which leaves more time to build relationships with each family. “Midwifery is a whole family approach, as opposed to a pregnantperson-only approach,” says Buehler.
What about Doulas? You might be wondering where doulas fit into midwifery framework. Doulas are dedicated support people for mothers throughout pregnancy and birth, but they are very different from midwives. While doulas have knowledge of pregnancy, birth and routine interventions, they are not medical personnel or healthcare providers. For more information about what doulas do and how to choose one, read our article “Doulas 101: How doulas make a difference in childbirth” at www.sandiegofamily.com/ parenting/pregnancy.
a community midwife or learning more about out-of-hospital birth, a great place to start is the new San Diego midwife directory: www.seemidwives.com.
How to Choose a Community Midwife When searching for a community midwife, it is a good idea to interview more than one. As midwives place emphasis on relationships and trust building, it is important the person you choose meshes well with you and your support system. Questions to ask: • How many births have you attended as the primary midwife? • How many clients do you take per month? • What do you do if two families are in labor at the same time? • What do you consider “high-risk”?
“We want to incorporate partners, make them feel supported and completely integrated.” Partners and other children in the family are encouraged to attend prenatal appointments. One of the sweetest memories I have of my second pregnancy is my oneyear-old using the Doppler (with the midwife’s help) to find her brother’s heartbeat during a checkup. According to Buehler, what makes midwifery unique from other forms of prenatal care is time. “In prenatal care we provide 30–60 min. appointments, encompassing complete and individualized care, both medical and emotional,” Buehler says. “We spend lots of time guiding, talking about spiritual, emotional and physical discomforts, and how people can find solutions for pregnancy related issues. Even when everything is fine clinically, there is a lot of need for support.” It is common (in community midwifery practices) for parents-to-be to meet all the midwives on staff and know the people attending the birth very well. If you are interested in working with
• What conditions would make you consider transferring care (to a medical setting) during pregnancy? • Are there any induction methods you are comfortable using and when might you suggest them? • What is the most common reason your clients transfer to the hospital? • Have you supported a birth in my nearest hospital before? • Are there any local hospitals you are not comfortable transferring to, and why? Most birth centers and home birth practices require expectant mothers to be pregnant with only one baby, be under age 40 and have very few health risks. These guidelines are required by the State of California in order to remain licensed, but it’s important to note that “health risks” may be defined and addressed differently by practice. v Allyson Kennett is a freelance writer who lives in the South Bay with her husband and three kids. All three of her children were delivered by midwives. She loves supporting her friends through pregnancy and birth. Baby Guide 2021 • SanDiegofamily.com •
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Anne Malinoski
Maternal Wellness
In the third and fourth trimesters It’s not uncommon for maternal wellbeing to fluctuate during the final trimester of pregnancy or the 12 weeks following birth (fittingly known as the fourth trimester). These are periods of intense physical and emotional change. Carefully tending to one or more areas of personal wellbeing during this special time can help new moms feel lighter and more connected as they grow into the next stages of motherhood. Let’s take a closer look at wellness needs during the third and fourth trimesters.
Third Trimester Healthy Eating In the third trimester, continue to choose a healthy variety of foods and drink plenty of fluids. During pregnancy, a woman’s body needs 300 additional calories per day. That’s about the size of a small meal or large snack. Eating a balanced diet while minimizing sweets and fats can help you feel your best during this exciting time. “My recommendation to pregnant people would be to listen to their body and get the nutrients they need,” says Dr. Jaime Friedman of Children’s Primary Care Medical Group. “Pregnancy isn’t a time for a fad diet or to be calorie conscious.”
Exercise and Movement During this stage of pregnancy, exercise can greatly improve a woman’s quality of life. According to the Mayo Clinic, getting enough exercise can improve mood and energy levels. It can help you sleep—and might even shorten labor! Choose an activity that feels good and be sure to get a thumbs up from your healthcare provider.
Skincare According to Kristina Kennett, esthetician and owner at White Rabbit Day Spa in North Park, some women experience flawless, plump and rosy skin during pregnancy. The “pregnancy glow” is a happy byproduct of improved circulation. Unfortunately, fluctuating hormones can cause some unpleasant changes in the skin as well. “It is very common for clients to experience skin sensitivity during pregnancy,” says Kennett. “I recommend using a simple, gentle skincare routine during this time. Intense exfoliating or heavier fragrance may be too much for the skin to handle. Remember to keep it simple and focus on nourishing, healing and protecting your skin.” Kennett and her team offer custom facials, personalized to any stage of a client’s life. They also offer consultations (in-person or virtual) to help pregnant and postpartum women adjust skincare routines. Learn more at www.whiterabbitdayspa.com.
Mental Health It’s normal to feel some anxiety and fear leading up to a big life change. Notice your thoughts and feelings each day and share them with someone you trust. Steady yourself by avoiding other major life changes during this time. It also helps to be realistic about how much you can accomplish in a day and how much rest you need to feel well. If troubling thoughts and feelings are persistent, don’t hesitate to ask a doctor or mental health professional for advice. If it feels hard to talk about, send an email to your healthcare provider, or ask a loved one to make contact on your behalf. Postpartum Health Alliance is an excellent local resource for new parents experiencing mental health changes. Find a crisis line, online screening test and additional support at www.postpartumhealthalliance.org. For immediate support, call the San Diego Access and Crisis Line at 1-888-724-7240.
Community Support This is a great time to foster connections with friends and family, especially those who know how it feels to be pregnant! Spend time with people who make you feel good. Accept help when it’s offered and reach out for help when needed. Research shows that people who feel a strong sense of community experience better mental and physical wellness. So, say yes to the family potluck, and invite those neighbors for a walk. You’ll be glad you did!
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Fourth Trimester A common term for the first 12 weeks after baby is born.
Healthy Eating Postpartum bodies need even more calories per day—about 500 more than before pregnancy. That’s about the size of an extra daily meal. “After delivery, your body is tasked with making breastmilk,” says Friedman. “This means you will need to replace the nutrients your body is taking to give to your baby. Continue to take your prenatal vitamins, get plenty of calcium and drink lots of water.”
Exercise and Movement Your healthcare provider will likely encourage you to wait 4-8 weeks after delivery before resuming a normal exercise routine. Ask about movement that is safe and beneficial in the meantime—like going for short walks or resuming Kegel exercises. Once you get the green light, start slow. Give yourself time to gradually restore your strength. It might help to include your newborn in those early exercise plans. Check out www.sandiegofamily.com/parenting/baby/mom-babyfitness-class-san-diego for our roundup of baby and me fitness classes.
Skincare After baby arrives, skin concerns might arise due to a combination of lifestyle and hormone changes. “After delivery, it is common to experience hormonal breakouts which can last one to two months,” says Kennett. “In some cases, women experience acne until their menstrual cycle balances out again. Breastfeeding can take a lot of energy and nutrients from the body, causing skin to become dehydrated. Lack of sleep is also common, which causes dullness in the skin and dark circles under the eyes.” Be gentle with yourself. It might be a while before you’re ready to devote time and mental energy to a solid skincare routine. In the meantime, keep up the fluid intake and seize those rare opportunities to rest.
Mental Health Mental health changes are common for new parents—both moms and dads. If your thoughts and feelings are concerning, find a way to alert your provider. Help is available and you don’t have to suffer. “If at any time a new parent is feeling extreme fatigue, sadness or disengagement, seek help,” says Friedman. “Any thoughts of harming yourself or your baby are very concerning and should be addressed right away.” Help is available!
Community Support The postpartum period can feel hectic. You might feel like your home is a mess. You might feel like your hair is a mess. Find time for community anyway! “This is where your support system is incredibly helpful,” says Friedman. “Call on people to help with meals or housework so you can get the rest you need.” v Anne Malinoski is a contributing writer and mother of two boys. Baby Guide 2021 • SanDiegofamily.com •
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When Breastfeeding is Hard
In California, about three quarters of women
who begin breastfeeding in the hospital have stopped by nine weeks postpartum. According to Neonatologist and Lactation Consultant Dr. Nancy E. Wight, who is a co-founder of San Diego County Breastfeeding Coalition (SDCBC), women are more likely to meet their breastfeeding goals with the right support. “It takes time for mother and infant to get in sync and there may be early problems: jaundice, hypoglycemia, failure to latch, sore nipples— almost all of which can be solved quickly with appropriate help,” she says. In many cases, breastfeeding is worth fighting for, because it can significantly improve health outcomes for both mother and child. Here is a look at some common breastfeeding problems, and the best ways to solve them.
Sore Nipples It is common to experience nipple discomfort in the early stages of breastfeeding. Remember,
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both mom and baby are new at this. Ensuring that baby has a good latch is the best way to prevent or minimize soreness. To learn what a good latch looks and feels like, call the lactation support line at the birthing hospital, or check out the helpful guides, diagrams and videos at the WIC (Women, Infants & Children) Breastfeeding Support website: https://wicbreastfeeding.fns .usda.gov. If soreness persists, or if nipples are cracked, blistered or bleeding, call a breastfeeding helpline. Be assured that these are common, treatable problems and a professional can help determine the best course of action.
Mental Health Concerns The weeks immediately following birth can be overwhelming for new parents. If breastfeeding feels hard, parents might consider bottle-feeding to improve maternal mental health. But research indicates that persisting with breastfeeding could help even more. “Mothers with depression often feel better when they breastfeed,” says Wight, adding that breastfeedingsafe medications are available to treat mental health symptoms. Postpartum mental health changes are common, but potentially serious. Any concerns should be discussed with a medical professional. Help is available!
Milk Supply Many new mothers worry about the amount of milk they are producing. That worry can escalate to panic without proper education. “In the first three to four days, your baby may get very little milk—this is normal,” says Wight. “It takes time to establish a good milk supply and an easy breastfeeding routine.” Those with supply concerns are invited to visit SDCBC’s website for a printable resource guide, which outlines how to tell if baby is getting enough milk in the days and weeks following birth. The guide also includes a list of local lactation helplines. This resource is free and available at https:// breastfeeding.org.
Misconceptions about Milk Quality Mothers with poor personal nutrition might feel self-conscious about the quality of their milk. These fears are unfounded. “Mothers need to be almost starving before their breastmilk is inadequate for their infant,” says Wight. “You can eat a terrible diet and still make good milk.”
What Do Dads Say? I think it’s important for dads to attend breastfeeding classes. Breastfeeding can be difficult for both baby and Mama, so having an extra person to help out is important to keep Mama confident, comfortable and motivated. – Mike Cunningham, Rancho Peñasquitos I think it’s very important to support your partner in whatever decision she makes when it comes to breastfeeding. I also think it’s important to give her the out if things aren’t working. My wife felt a lot of guilt switching our son to formula. I knew it was important to let her know she was a great mom for prioritizing his needs over her original plan to breastfeed. – Derek Restrepo, San Marcos Furthermore, women who enjoy an occasional drink should not feel discouraged. “You don’t have to be a saint to breastfeed,” she says. “An occasional bottle of beer, glass of wine or even a cigarette are OK—just don’t smoke around the baby!” For information about breastfeeding and drugs call Mother to Baby California at 866-626-6847 or visit www.mothertobabyca.org.
Side-Eye While attitudes are rapidly changing, there are still public spaces in our community that don’t feel breastfeeding-friendly. It is possible that someone in a restaurant or park could offer unsolicited comments about the way a baby is fed. Painful as it is, public commentary is something all parents deal with in the public space. Ignorant comments don’t require a response. If an establishment asks a breastfeeding woman to leave, the law is on her side. In the state of California, a woman may breastfeed her child in any location public or private (aside from the private residence of another) so long as both mother and child are otherwise authorized to be there.
Lack of Role Models Establishing a healthy breastfeeding routine requires a supportive community. If the women in a new mother’s life lack experience with breastfeeding—or worse, feel uncomfortable with the practice— it will be harder to press through challenges. A woman’s partner, family and friends need to know that breastfeeding is important to her. The more they are willing to learn with her, the better the breastfeeding outcome will be. Most lactation professionals are happy to educate the whole family, so a mother can receive essential support from those closest to her.
Breastfeeding Helplines American Red Cross WIC 800-500-6411 SDSU Research Foundation WIC 888-999-6897 La Leche League of San Diego County 858-848-6455 La Leche League Spanish Line 858-792-5009 v Anne Malinoski is a contributing writer and mother of two boys. She breastfed each of her sons for more than 18 months thanks to the support of lactation professionals, a visiting nurse and experienced women in her community. Baby Guide 2021 • SanDiegofamily.com •
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Tongue tie & breastfeeding 5 things you need to know by Jaime Friedman, MD FAAP
Ankyloglossia, otherwise known as tongue-tie, is an anatomical anomaly in which a thin piece of tissue called the frenulum connects the bottom of the mouth to the tongue. The location of insertion on the tongue varies. When the frenulum connects close to the tip of the tongue, the baby’s tongue will look indented or heartshaped. Babies who are unable to protrude their tongue properly may have a hard time breastfeeding. Not every baby with a tongue-tie will have problems breastfeeding. FRENOTOMY Babies with breastfeeding problems and tongue-tie may benefit from a procedure called a frenotomy. A frenotomy is the clipping of the frenulum to release the tongue. Parents should talk to their pediatrician if a frenotomy has been recommended to them. Here are some things to keep in mind before having the procedure.
Symptoms: Babies only need the procedure if they are unable to latch properly,
have trouble transferring milk and thus poor weight gain, and/or if mom is having nipple pain, cracking or bleeding. You may notice your baby “chomping” instead of sucking and you may hear clicking noises with feedings.
Procedure: The procedure is easily done by lifting tongue with a tongue elevator. This protects the base of the tongue and guides the location of the cut. Scissors are used to clip the frenulum. Pressure is applied to stop the bleeding. Babies are encouraged to breastfeed right after. The procedure is best done by your pediatrician or an ear, nose and throat doctor. Many dentists now perform frenotomies using a laser, however often times the laser is not as exact and can cause damage to surrounding tissues.
Risk: The main risks of a frenotomy are bleeding and infection. Babies must have a vitamin K shot to help their blood clot prior to the procedure. Applying pressure and breastfeeding right after also help stop the bleeding. Long term: Babies with a tongue-tie but no issues with feeding do not require frenotomy. Currently, there is not a recommendation to do a frenotomy to prevent future problems with speech, feeding or tongue function. Overall, frenotomy is a relatively simple and safe procedure that can be helpful for infants having feeding issues related to their tongue-tie.
If you have concerns for your baby, speak to your pediatrician.
Follow up care: Families should use gauze on their fingers to sweep under the tongue after each feeding for 1 week following the frenotomy. This will keep the frenulum from re-adhering.
Dr. Jaime Friedman is a pediatrician and the lead physician at the 4S Ranch location of Children’s Primary Care Medical Group.
Jaime Friedman, MD FAAP Pediatrician and mom
The Importance of Dad Involvement
Armin A. Brott
Researchers who study father-child attachment
confirm what active, involved fathers have known in their hearts for years—that the father-child bond is no less important than the mother-child bond. Over 80 percent of studies that have examined father-child relationships have concluded that there’s a strong connection between a father’s involvement and his infant’s well-being. I have talked extensively with dozens of leading experts and studied the research and writings of many more. In preparation for writing several books about fatherhood, I also drew from my own experiences as the father of three, as well as from the interviews I’ve done with hundreds of fathers. It’s my hope that this wisdom and experience will help prepare you for being—and staying—an active, involved father.
Why Get Involved? The big question is, why bother to be involved? Three simple reasons: it’s good for your kids, it’s good for you, and it’s good for your relationship with your partner.
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For your baby. Numerous studies have shown that when dads are actively involved with their infants, they are more secure, confident, independent, and more interested in exploring the world around them than babies who are deprived of quality time with their fathers in the first year. They’re also more comfortable around strangers, handle stressful situations better, and perform better on motordevelopment and intelligence tests. Other studies have shown that toddlers whose fathers took a special interest in childcare were two to six months ahead of schedule on tests of development, problem-solving skills and social skills. For your partner and your relationship. Division-of-labor issues are right up there with money as a top marital stressor. Not surprisingly, the more involved you are and the more you support your partner, the happier she’ll be in her relationship and the better she’ll be as a parent. When your partner is a happy person, you will be as well, which benefits your relationship. For you. Being an involved father will affect you in many ways. You’ll learn to feel, express and manage emotions (positive, negative and everything in between) you never knew you had. You’ll be more empathetic and better able to see things from others’ perspectives. Dads who are actively involved with their children tend to be mentally and physically healthier and are more likely to advance in their careers. It can also change the way you think about yourself. “Fathering often helps men to clarify their values and to set priorities,” writes my colleague Ross Parke, one of the pioneers in fatherhood research. “It may enhance self-esteem if they manage its demands and responsibilities well, or alternatively, it may be unsettling and depressing by revealing their limitations and weaknesses. Fathers can learn from their children and be matured by them.”
How to Get Involved: Interacting with Your Baby Although it may be tempting just to sit and stare at your baby, marveling at every little thing she does, you’ll need to do a lot more than that if you’re going to develop a relationship with her. In the early months, here are some of the best ways to get to know your infant: Hold her (or him). Newborns love to be held and carried around. If you can, take off your shirt—skin-to-skin contact helps warm the baby, and you’ll love it too. It’s perfectly fine for you to lie down on your back and let the baby nap face down on your chest. Note: this is the only time she should sleep on her tummy. Talk to her. Explain everything you’re doing, tell her what’s happening in the news, and so forth—it will help her get to know the rhythm of language. Change her. It doesn’t sound like fun, but diaper changing is a highly underrated bonding experience—a great time to interact with baby oneon-one, rub her belly, tickle her knees, and kiss her tiny fingers. For at least the first month or so, she needs to be changed every two hours—so there are plenty of opportunities. Within two or three years, it’s likely your child will learn to crawl, stand, walk, run, and form one- and twosyllable words. Psychologist Lawrence Kutner likens toddlerhood to a musical fugue in which “the themes of intellectual, physical, emotional, and social development intertwine.” Read all about how to interact with your growing baby in my book The New Father: A Dad’s Guide to the Toddler Years, 12–36 Months.
How Much to Get Involved Being an involved dad means different things to different men. Among the most common definitions are: • Being a teacher, moral guide and role model. • Being there physically and emotionally and being available from the beginning.
• Doing hands-on things (feeding, bathing, changing, reading, playing, running errands, showing affection, etc.). • Being an equal partner in parenting. • Not being stuck in the role of the “wait-till-your-dad-comes-home” disciplinarian. • Being a good provider (financially) and protector (keeping the family safe). Being an involved dad is wonderful and fantastic, but it also takes a lot of time and sacrifice. If you work away from home, the best way to connect with your child is to make sure you’re 100 percent present when you’re together. Mute the phone, take a break from social media, turn off the TV, let the dirty dishes pile up, and eat dinner later, if needed.
A Note for Working Dads Fathers who work away from home benefit greatly from being involved with their kids. Too many men worry that there’s no way to balance their work and family lives, and that taking an active role at home would be committing career suicide. But the truth is that men who put child-rearing high on their list of priorities are, on average, more successful in their careers at midlife than men who focus only on their work. Fatherhood also seems to “promote men’s abilities to understand themselves as adults and to sympathetically care for other adults,” says fatherhood researcher John Snarey. Men who take an active role at home are—by the time their children are grown—better managers, community leaders and mentors. Overall, they’re more concerned about the generation coming up than about themselves. So, take the time—make the time—to get involved with your little ones. It’s the best investment you can make in his or her life, and in the well-being of your whole family. v Armin A. Brott is a nationally recognized parenting expert and the author of the best-selling New Father series and Ask Mr. Dad, a syndicated advice column. Baby Guide 2021 • SanDiegofamily.com •
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You are invited Inside the Red Tent Hosted by
Changing Birth in San Diego One Family at a Time
Communities around the world have been organizing Red Tents as a special place for mothers to share their birth stories, celebrate birth experiences, and heal from traumatic ones. The goal of every Red Tent is to create sisterhood and practice deep listening.
Join our Annual Red Tent Event! WHO WHEN
Women of all ages welcome ~ newborn babies only ~ Saturday, Sept. 8, 2018 Bring something to sit on!
OH,BABY!
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Learning Loveys $15.95; BabyJackAndCompany.com Textured ribbons and fabrics encourage tactile play and help children develop cognitively, socially, and emotionally through sensory interaction. Baby Jack is the only brand that sews ribbon loops shut to avoid injury.
Snuggle Nest Portable Infant Lounger $44.99; BabyDelight.com Creates a comfortable space for baby to lounge and rest at home or on the road. Features two rigid, vented walls lined with soft, breathable mesh. Includes waterproof foam mattress and one sheet. Easily folds for travel. Designed for newborn to 9 mos.
Original Feeding & Infant Support Pillow $40; Boppy.com Provides support while nursing or bottle feeding, props baby up (3+ mos.), supports tummy time for ages 6+ mos. and helps babies sit up (9+ mos). Removable pillow cover comes in 13 designs. Pillow and cover are machine washable. The Very Hungry Caterpillar Grab & Go Keys Toy $10; Amazon.com This charmingly detailed toy from World of Eric Carle includes a travel clip with three plastic keys featuring click-clack rings, textured teether and rattle. Bright colors, various textures and different sounds keep baby engaged while on the go.
No-Snap Infant Clothing $18-$54; PeasyCo.com Infant clothing that has no snaps, buttons, zips, ties, magnets or velcro for no-fuss diaper changes on the go. Peasy is re-defining baby clothing to be efficient for parents, comfortable for kids, and sustainable for the environment. Ethically created with minimalistic design by a mom in Carlsbad, CA.
24 • SanDiegofamily.com • Baby Guide 2021
Petite Keep: Personalized Trunk $254 & up; PetiteKeep.com Store special keepsakes for years in a beautiful, customized trunk. Petite Keeps make a perfect gift for a new baby, milestone birthdays and other celebrations. Customizable with box color, embroidered initials or name, and interior lining options.
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Your Child’s Future
Begins Today
5 TIPS TO PREPARE YOUR CHILD FOR A SUCCESSFUL FUTURE
The first five years of your child’s life are crucial. In these first few years, children develop 90% of their brain. It is critical to talk, read and sing to your baby every day. What we do as parents from the moment a child is born can make a lasting impression. It’s these first experiences and interactions with loving adults that fuel their growth and development.
Here are 5 easy tips that you can do every day to prepare your child for a bright future:
Talking is a brain-building activity. Every time you talk with your baby and have a high-quality interaction, new connections are made in the baby’s brain.
It’s never too early to begin reading to your child. While babies may play with the pages of the book and toddlers may want to read the same book every day, the activity of reading with them encourages a love of books.
The act of rhyming, singing and talking, starting at birth, profoundly influences literacy and language development, which are the foundations for all other learning. Use known nursery rhymes or make-up songs with silly meanings to help build up memory and stimulate motor skills. Warning—singing may turn into dance parties!
Have conversations by narrating the actions you take throughout the day and use a variety of facial expressions. Also, respond verbally to gestures or noises such as cooing, pointing or clapping.
Another fun way to help a toddler connect names and objects with gestures is through games. Playing “Simon Says” is a good example. You can say things such as “Simon says touch your nose,” or “Simon says turn off the light.” These are everyday actions you can take today to ensure your child is ready for kindergarten by age five—the first step toward lifelong success.
First 5 San Diego promotes the health and well-being of young children during their most critical years of development, from the prenatal stage through five years of age. Our goal is to help ensure that every child in San Diego County enters school ready to succeed.
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Anne Malinoski
How to
Cope with Crying
Persistent infant crying is often distressing for new parents. If your baby is going through a period of intense daily crying, know that many have walked this path before you. With a little knowledge and a lot of empathy, you can develop the skills to help your family move through this challenging time. We checked in with local early childhood development and mental health expert Jil Rudolf-Vazquez, who holds an M.S. in child development. She advises parents not to take it personally when babies cry. “In the first couple of months we are still trying to understand all our babies’ cues and once we have figured them out, they often change,” she says. “Always know that your child is trying to communicate something and that it is totally fine if you do not know right away what it is.” Parents of persistent criers often notice more intense crying in the late afternoon. When this happens, babies who seemed fine during the day might experience long bouts of tears, even though all their needs appear to be met. These evening episodes 28 • SanDiegofamily.com • Baby Guide 2021
are sometimes called “the witching hours.” Providers prefer to describe the experience as “The Period of Purple Crying” (see sidebar).
Why is the Baby Crying? Rudolf-Vazquez theorizes that babies might be picking up on caregivers’ emotions in those early evening hours. “If we as adults think about the day, most of us will agree that the hour before bedtime is often stressful,” she says. “People are coming home from work, preparing meals, possibly anticipating bedtime struggles and experiencing general tiredness. So, why would that be different for a baby?” It’s not always possible to know why a baby is crying, but we can certainly look for clues. According to Rudolf-Vazquez, some common reasons for infant crying include: • Development: Babies’ bodies are growing and changing rapidly. They are constantly learning new skills. It’s not easy! During a growth spurt, infants might be fussier and more difficult to soothe.
• Overstimulation: Too much movement or noise can be distressing for little ones. • Tiredness: Babies often cry when they become overtired. • Temperament: One in five babies is highly sensitive. These babies are easily bothered by minimal changes in their environment like sounds, temperatures or textures. They tend to pick up on their parents’ mood and stress more than other children. • Stress: Babies need their parents to help them down-regulate, since they are incapable of calming themselves from a state of heightened stress.
Things to Rule Out While crying is normal and expected, it is important to rule out medical issues. “I can’t emphasize enough: If your instinct tells you something is not OK with your baby, listen to yourself and seek help,” says Rudolf-Vazquez.
• Illness: if you suspect that your baby is ill, always seek help from a health provider. • Teething: Expect teething to begin around 4-6 months of age. The pain might last about 8 days for each tooth. Your provider can counsel you on safe techniques to minimize pain.
What is the Period of PURPLE Crying? Also known as “the witching hours,” it’s important to remember that intense, inconsolable crying is a Period of time (it has a beginning and an end). It is further identified using the PURPLE acronym:
PEAK of crying This type of crying usually begins at about 2 weeks of age, peaks around 2 months of age, and then decreases over the next several months.
UNEXPECTED There is no predictable start or stop to the crying episodes.
RESISTS soothing Baby is difficult to soothe or console. No matter what caregivers do, baby doesn’t stop crying.
PAIN-LIKE face The baby appears to be in pain, though no source of pain can be identified.
LONG lasting Crying can last from several minutes to a few hours each day.
EVENING Baby seems fine throughout the day, but cries for unknown reasons in the evening or late afternoon.
• Colic: Babies who cry very persistently might be labeled as “colicky.” Doctors don’t have a strong understanding about why colic occurs. But according to Rudolf-Vazquez, underlying causes can sometimes be discovered. Possibilities include irritability in the digestive system or feeding problems such as tongue-tie, tongue function or food sensitivity. • Gas: Gas can be extremely uncomfortable for little ones. Always remember to burp the baby after feeding. If breastfeeding, ask a lactation consultant to check baby’s tongue function. Parents who use a bottle should always use the correct-sized bottle and nipple. Techniques that can help with gas include bath time, belly massage, bicycling baby’s feet, or laying baby on her back while gently holding her feet up. It might be helpful to check for food allergies and sensitivities. • Reflux: Although reflux is common, reflux that causes a baby distress is not normal. Baby might outgrow reflux as the digestive system develops, but it can be very uncomfortable in the meantime. Seek medical help if reflux is suspected.
Soothing Techniques When attempting to soothe a baby, the most important thing a caregiver can do is to remain calm and steady. Babies rely on parents and caregivers to help them regulate. “We might not be able to ‘control’ the baby’s crying, but we can control our own emotions, feelings, and the environment,” says Rudolf-Vazquez. “Find ways to be as relaxed and present as possible.” • Movement: Try taking baby for a walk or bouncing gently on an exercise ball. If the movement helps the parent stay calm as well, even better! • Music: While some babies feel overstimulated by music, others find it relaxing. Experiment with
different styles and volumes. Singing lullabies is a time-honored soothing technique. • Environment: Think about ways to create a more relaxing environment. Can baby move to a different, less stimulating room for a little while? Consider noise level, brightness of the room and temperature. • Change positions: Try holding baby in different ways (airplane hold, rest on a parent’s shoulder, baby carrier, etc.). If baby resists one position, gently transition to another until you find what works. • Massage: Infant massage is an excellent technique to reduce stress and help parents bond with baby.
Self-Care Steps for Parents • Delegate: Lean on family and friends to help with household tasks during these hectic early months. • Wellness: Make sure you’re getting enough food and water. Try to exercise if it feels good. Even a short walk can increase energy and improve mood. • Step away: If you are struggling to stay calm during an intense period of crying, it’s OK to take a break. If possible, leave the baby with a trusted caregiver. When that’s not possible, place baby safely on her back in the crib, tell her you love her, and step outside for a few minutes to calm down. Have a bite of dark chocolate (a known mood lifter) or listen to a few bars of your favorite song and then return. v
Your baby doesn’t need you to “fix” her crying, she simply needs you to be with her. Anne Malinoski is a contributing writer and mother of two boys. Her oldest son went through a Period of Purple Crying while her husband was at sea. Baby Guide 2021 • SanDiegofamily.com •
29
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Malia Jacobson
Solving Sleep Regressions Why the baby isn’t sleeping and how to help
First, the good news. Thanks to social distancing and reduced travel, fewer children experienced ear infections, colds, and other minor illnesses over the past year, says Maida Chen, MD, director of the Pediatric Sleep Disorders Center at Seattle Children’s Hospital. Because these illnesses routinely disrupt slumber for babies, toddlers and young children, families may have fewer illness-related sleep complaints. That doesn’t mean everyone is sleeping soundly. More parents are reporting sleep regressions—babies and toddlers skipping or dropping naps, suddenly waking at night, or taking ages to fall asleep at bedtime. With family schedules still in flux, daily routines and sleep routines may be shifting, says Chen. Here’s how to cope. Redefining Regression The term “sleep regression” describes a temporary but troubling return of an undesirable sleep behavior that a parent or caregiver assumed a child had outgrown, like sudden night awakenings, tears at bedtime, or waking at 4 a.m. Although sleep regressions are real, whether or not they’re a problem may be a matter of perception, says Chen. About half the time, a sleep regression is developmentally appropriate; it’s normal for babies to wake more often after they’ve acquired a new skill, like learning to roll over or stand. “A sleep regression is really just a change in sleep that’s perceived as undesirable by a caregiver,” says Chen. “It’s simply a misalignment with our expectations of how a baby should be sleeping compared to what’s happening.” While sleep regressions can happen at any time, they’re common around 4, 9, 12, 18 and 24 months of age and can coincide with developmental milestones. One 2015 study found that learning to crawl temporarily disrupts nighttime sleep between ages 5–11 months. Another study found that nap transitions in toddlerhood can shift melatonin production and delay bedtime.
32 • SanDiegofamily.com • Baby Guide 2021
Sleep regressions can stretch anywhere from a few days to a few weeks or longer, often involving overtired, fussy behavior during the day and long, irritable stretches of light sleep or crying at night. It’s no wonder that parents want to rush through these regressions and get sleep back on track. Why Regressions Seem Worse Lately Childhood sleep disruptions have seemed worse since the pandemic started, despite fewer illness-related sleep complaints from parents, says Chen. But the changes may have more to do with stress than actual sleep problems. “The issue is more highlighted now because we’re spending more time at home and traveling less, and parents have much less time away from their kids,” she says. “When you rely on your toddler’s nap or bedtime so that you can work or have a break, you’re going to be more upset when those regressions happen.” But there may also be disruptions in sleep patterns, like fewer naps or later bedtimes, for a couple of reasons. Spending more time at home might mean that a baby is sleeping later in the morning or taking a longer afternoon nap, two factors that can cause a later bedtime or nighttime awakenings. Families also battle changing of seasons—early sunrises and late sunsets that disrupt melatonin production and delay bedtimes.
How to Help
1
Take inventory of your child’s perceived sleep problems, recommends Chen. “Parents should really do a gut check about what their child is experiencing in terms of sleep, and how big of a problem it really is for the child and the family. Is your child really being affected adversely from a developmental standpoint or is it just the stress of upholding what life is supposed to look like?”
2
Determine your family sleep priorities. If you’re operating in survival mode and just need to nab enough shut-eye to get through the next day, don’t waste a moment worrying
about bringing your toddler into bed with you if it will help everyone get more sleep, says Chen.
3
If keeping your child’s daily routine running smoothly helps keep stress at bay, don’t feel guilty about prioritizing a consistent sleep schedule. “If the family thrives on routine and survival is not the main concern, then this can be a good time to teach the baby or toddler self-soothing skills.” That could mean allowing babies extra time to fall asleep unaided or encouraging toddlers to play alone if they wake too early or aren’t taking a nap.
4
Build in regular times for movement, especially in the morning when light exposure helps regulate sleep patterns and pave the way for a smoother bedtime. Aim for 10 minutes of outdoor time within the first hour of waking up, such as a walk around the block or a game of hopscotch in the driveway. Investing in inexpensive blackout blinds can also help keep sleep routines intact, says Chen.
5
Limit screen time, especially in the final hour or two before bed. “This can be a time to establish family routines that support rest, like taking time at night to unplug as a family and relax,” she notes. “Parents can model healthy habits like taking a break from phones and screens at night.” It’s normal to feel stressed when things seem to fall apart, including a child’s sleep routine, says Chen. But like everything else in babyhood, the change is temporary; children with healthy sleep patterns will nearly always get back on track after a developmental milestone, life change, or seasonal disruption passes. “Right now, what parents need most is to give themselves grace,” says Chen. v
What Do Dads Say about Baby Sleep? My advice is to sleep-train your baby as early as possible. We did sleep-training when our son was 16 weeks old and we always say it’s the best decision we made. We didn’t lose much sleep after that! – Derek Restrepo, San Marcos If you don’t have a king-sized bed yet, buy one. You’ll have lots of slumber parties with your kids. – Bradley Johnson, San Marcos The best advice I can give is to stay calm and help Momma out, whether the baby needs a diaper change, a bottle, or if baby just needs to be held for a while. Remember they won’t be babies forever, and one day you will be able to go back to sleep. – Mike Collins, Santee
Malia Jacobson is a health and sleep journalist, author of Ready, Set, Sleep: 50 Ways to Help Your Baby Sleep So You Can Sleep Too, and host of the Sleep Well Stay Well podcast. Baby Guide 2021 • SanDiegofamily.com •
33
The first 3 years of your baby’s life
are critical.
Is Your Baby Meeting Important Milestones? How your baby plays, learns, talks, acts and moves give important clues to how they are developing. If you have questions or concerns about your baby’s development, contact the San Diego Regional Center for free resources and guidance.
Early Intervention Services are Available.
California Early Start is a state and federally funded program that provides free assessments to infants and toddlers and, if needed, important therapeutic services (free to eligible families) early enough to make a huge impact in a child’s development. Services provided include early intervention instruction; physical, occupational, and speech therapy; medical diagnosis/evaluation. Even with pandemic restrictions, the San Diego Regional Center is open and working to ensure your child has the right services to meet their needs.
Call the San Diego Regional Center at 858-496-4318 or the Exceptional Family Resource Center (EFRC) at 619-594-7416. 858-496-4318 • www.sdrc.org
Se habla español
Keep it simple. Invite family and a couple friends into your backyard to watch the baby smash that yummy cake! ~Melissa Varela, Rancho Peñasquitos I scoured Pinterest in search of ideas for a fun birthday party theme for our twin girls’ first birthday. We chose “Donut Grow Up,” which provides cute ways to use yummy donuts as the “o” in “One!” ~Sandra Page, Rancho Santa Fe For my son’s first birthday we rented a soft play zone for the little ones and had a balloon artist to entertain bigger kids. The play zone was perfect for babies to explore safely. We also like the idea of hiring a “bubble guy” for entertainment. My friend did that for her daughter’s second birthday and it was a big hit! ~Tina Horn, San Carlos
Isn’t it ONEderful! Tips to celebrate baby’s first birthday
Most seasoned parents agree that first birthday parties are
mostly for the adults, but still want a fun, memorable way to commemorate this important milestone. Some parents swear by a cake smash photo session, while others aren’t ready to commit to all that frosting. Some want a pile of gifts, while others say “it’s too much stuff” (maybe start a savings bond?). Whatever side of the baby gate you’re on, you’ll enjoy reading these tips and party themes from moms and dads who have “been there” a couple times already.
36 • SanDiegofamily.com • Baby Guide 2021
I make a photo book every year before my children’s birthdays. I make pages for holidays, events we attended, grandparent visits, etc. I design the last two pages to match the birthday party theme and I have guests at the birthday party write a message/sign it. I’m going to give them all to my kids when they’re older so they can look back on all of their yearbooks. ~Alex Colwell, Ramona Commemorate the first birthday with a photo display of “firsts” (first smile, first tooth, first steps, etc.). ~Sarah B.
First birthdays are best spent indulging in your baby’s favorite things. Think an extended park or beach day, complete with a homemade birthday cake and new toys wrapped in pretty paper that they can rip apart. ~Tia Hutchinson, Point Loma
• If you have older children, include them [in the party] as much as you can. Even though your baby doesn’t know what’s going on, your other children do, and they can get very jealous. Have them help design the cake, put together the menu and select music. Also, let each of them invite a special guest of their own. • After the party, devote time to reminiscing—and taking notes—about your baby’s first year. Write down as many things you and your partner can think of, and try to collect baby-related anecdotes from friends and family. Turn it all into a slideshow, flash drive or baby book. • Once all the guests have gone home, the mess is cleaned up, and the baby is down for the night, pop open a bottle of champagne with your partner and drink a toast to each other. You’ve got plenty to celebrate, too! ~Armin A. Brott, parenting expert and author of The New Father: A Dad’s Guide to the First Year
I would create any of these themes: • This IS My First Rodeo (western décor) • Rollin’ with My Gnomies (gnomes, red and white mushrooms and woodland animals)
Photo credit: Britany Gipson
My husband is from Germany, so for my son’s first birthday, we decided on a “ONE-toberfest” theme. We all dressed for the occasion, decorated in a Bavarian theme, and had beer and bratwurst! ~Brittany Hess, Rancho Bernardo
This year I did a “Wild One” party for my daughter with plenty of animal decor. Our party was three hours long, but we told people to “drop in when you can” so they could arrive late or leave early, depending on their child’s naptime. A schedule is still important; we had cake about 90 minutes into the party so we could catch most guests at once. Activities included a ball pit and sidewalk chalk. I love the idea of a smash cake, but wasn’t ready to introduce the sugar rush, so I made a “cake” using only fruit and whipped cream. In retrospect, I realize I got really excited as a first-time parent. Since I invested in lots of themed décor, I decided to use it for the next couple years (“Two Wild” for her second birthday; “Wild-n-Three” for her third). Boom— planning done! ~Britany Gipson, Rancho Peñasquitos
• Taco ‘bout Uno (Mexican fiesta theme and taco smash cake) ~Emily Dolton, Clairemont
What Do Local Dads Say?
The first birthday party is for the parents. Your baby doesn’t care if there are decorations or streamers or a fancy cake. Baby will be excited just to have extra attention. Please don’t stress about it and feel like you need to spend a lot of money. ~Mike Cunningham, Rancho Peñasquitos Don’t stress out about first birthdays. Your child won’t even remember it. My advice is to invite close friends and family, take some cute pictures and keep it casual. ~Derek Restrepo, San Marcos Photos provided by All Colors Photography (except where noted). IG @SanDiegoCakeSmash
Baby Guide 2021 • SanDiegofamily.com •
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