Eczema Blues

This was originally posted as a 4-week series which had since been combined into a single informative post. I met Heidi in Singapore, during the Rise and Shine Expo where I got the front seat to her workshop “What to Expect in the First Year”. Heidi had kindly reviewed the Q&A before I published the 4-week post series.

Baby Feeding

Q1: How do Mothers who Breastfeed know that their babies are getting enough milk?

Heidi: Breasts don’t come equipped with ML mark – but fortunately healthy babies usually know exactly how much they should eat.  Breastfeeding is based on demand and supply – babies demand what they need to grow, breasts supply it.  Still, many moms worry that their babies are not getting enough to eat.  Since you can’t determine exactly how much is going in – best way to tell if baby’s getting enough is by checking how much comes out.  If baby’s pooping plenty and peeing plenty – and most breastfed babies do plenty of both.  Also keep in mind that babies are very good at what they do – feeding from a breast.  They’re better at extracting breastmilk than a pump is.

Also remember, whether you’re pumping or feeding from the breast, make sure each breast gets drained before you move on to the next.  That way you’ll be sure your baby’s getting both the foremilk (the thirst quencher, which is thinner) and the hindmilk, which is creamier, full of more fat and calories and which helps a baby feel full and satisfied.  Wonder if baby will get enough as he or she grows?  No need to – as baby grows and his or her appetite grows, too – your breastmilk supply will increase to keep pace.

Q2: How can Dads help out in Feeding?

Heidi: First of all, dads can help by being supportive of breastfeeding efforts.  Research shows that when dads are supportive of breastfeeding, it’s much more likely to succeed.  But also keep in mind that moms don’t have a monopoly on nurturing a baby. In fact, here’s an interesting father fact: Dads-to-be and new dads experience a drop in testosterone and a surge in esterone – most likely nature’s way of bringing out their nurturing side.  And those hormonal changes work.  There’s nothing (besides breastfeeding) that a mom can do that a dad can’t do equally well if not better, given the chance. Like a mom, dads can talk to, sing to, hold, rock, cuddle, and hug their babies. And while they can’t breastfeed, they can feed bottles of supplemental formula or expressed breastmilk-and do so with their babies snuggled bare skin-to-skin, to nourish and nurture their babies at the same time.  Can’t find a teat your baby will take? Ask around and shop around-different babies like different styles of nipple. Just make sure it’s slow flow so that it takes more effort, like a breast nipple does.

Q3: Should a 6-month old baby prefer solids to milk, is it ok to provide only solids and milk at night?

Heidi: Breastmilk or formula is still the main source of nutrition for a 6-month old – and will continue to be for most of the first year.  While some babies will take more, about 24 ounces per day is considered the right amount of formula (or if you were expressing your baby’s milk, breastmilk) for this age.  Solids, at least in the first few months of introduction (which should happen at about 6 months) are less for the nutrition, which formula or breastmilk has covered, and more for the experience…getting used to taking different textures and tastes.  But again, solids enough won’t give baby everything that he or she needs at 6 months.  Sometimes babies who don’t take enough milk are drinking too many other calories in the form of juice – so skip the juice altogether, or limit to no more than 4-6 oz a day.

Q4: When should the baby be weaned?

Heidi: You’re actually starting to wean a baby from the very first moment you offer solids.  Start a cup by age 7 months (sooner if baby seems eager to try and is sitting well), but you can continue the bottle until the first birthday – at which point best to graduate to a cup full time.  In the meantime, so baby will be ready for this momentous transition, make sure your little one becomes a sippy or straw cup pro.

For teething babies, sucking on a feeding or teething bag filled with frozen banana, mango, or peaches or chilled avocado can be soothing – but also a great way to feed a fussy baby.  Chilling spoon-fed foods (or even formula or expressed breastmilk) can also spell relief for teethers.

Baby Sleep

Q1: What is a suggested Bedtime routine?

Heidi:  Bedtime routines are a relaxing way to unwind at the end of the day for both parent and baby – and allows an older, active baby an opportunity to brake gradually for bed, instead of trying to go suddenly from 100 to 0 gradually. A bedtime routine should last about 30-45 minutes and should include a bath, massage, jammies, snack or milk, brushing teeth (if there are any), story time, cuddles and with good night ritual of saying ‘good night’ to family members, toys, animal friends. Keep lights low and music soft (no TV in the background) during the bedtime routine.  A snack of complex carbohydrates and protein can help keep a little one’s blood sugar even through the night, which can result in sounder sleep. Most important advice on bedtime routines: keep them consistent…same time, same amount of time, same order.

Q2: How to encourage afternoon naps?

Heidi:  First watch for your little one’s sleepy cues (yawning, rubbing eyes) and catch them before baby goes from sleepy to overtired (an overtired tot has a tougher time settling down for sleep).  Use a modified, shortened routine for naps – without the bath. Naps are as important for a baby or toddler as nighttime sleep – and in fact babies who don’t nap are less likely to sleep well at night.  Plus, babies do some of their most important developing during sleep, including naps – and it gives little ones a chance to recharge their batteries.  Just make sure the nap doesn’t come so late in the day that it interferes with nighttime sleep.

Q3: What about a baby who keeps waking up in the night?

Heidi: The problem isn’t waking during the night – we all wake during the night, but we’ve learned (hopefully by now!) how to fall back to sleep on our own.  That’s an important life skill that all babies eventually have to learn.  While feeding a baby during the night is fine for younger infants, by 4-6 months, they no longer need those nighttime feeds…they’ve just become a habit.  To help your baby learn how to fall back to sleep on his or her own, look at how he or she is falling asleep at bedtime.  That’s a child’s “sleep association”.  Feed or rock or cuddle your baby to sleep, and he or she will come to expect that same crib-side service at 2 am.  Best to put a baby down for the night drowsy but still not asleep, so he or she can fall asleep on his or her own – and know how to fall back to sleep on his or her own.  Bedtime routines are also a consistent, predictable transition to sleep – a positive sleep association: bedtime routine means I’m getting ready to sleep.

Falling back to sleep is an important life skill that all babies eventually have to learn.

Q4: What about Co-Sleeping?

Heidi: Sleeping with a baby in the same bed generally isn’t recommended by doctors, simply because it can be less safe and has been linked in research to a higher risk of SIDS (sudden infant death syndrome).  If you do want to sleep in the same bed with your baby, there are safety precautions you must take, such as sleeping without pillows of fluffy blankets, not putting baby against a wall or near any headboard that baby might become entrapped in (or entrapped between mattress and headboard).  Better and safer is to keep baby in the same room with you (being close to you but not in the same bed actually reduces the risk of SIDS), but in a safe sleeping space (crib or bassinet).  SIDS can also be prevented by not over-bundling the baby in heavy clothing (baby should be dressed lightly and the room should be comfortably cool), not putting anything in the crib but the baby (no pillows, blankets, plush toys, or bumpers), and keeping a fan on, circulating air. Also, use a pacifier (if your baby will take one) during sleep.

Do keep this in mind if you share a room (and doctors recommend that you do): babies are noisy sleepers (‘sleeping like a baby’ isn’t really as restful as people think).  They make a lot of noises, they move around a lot in their sleep.  So parents who co-sleep may actually find themselves sleeping less restfully, too, and may pick their babies up more often than necessary.  To avoid this, wait until your baby’s actually awake and crying to offer comfort or a feed.

What to Expect for Babies

Q1: Is it OK for baby to suck fingers?

Heidi: Babies are born suckers, and in fact many suck their fingers or hands before they’re born.  Sucking is a strong reflex in babies – and it’s their go-to habit for comforting themselves (and that’s a very good thing).  So no harm in baby sucking his or her thumb or fingers – in fact, it’s the most convenient comfort habit your baby could settle on (fingers are attached to their hands – no dropping them in the middle of the night, like a pacifier).  Let your little sucker suck away for now – there’s no likely to be harm to teeth until much later in the preschool years.  If thumb sucking is interfering with talking and socializing, occasionally use your little one’s hands to play finger games or clapping games or anything else that engages them.  If later on the dentist says it’s time to pull the plug on that finger, a positive reinforcement campaign – instead of pressure or scolding – will work best.  Say, a chart with stickers for sucking-free days.

When to schedule that first dental appointment?

While some pediatric dentists believe it should take place sometime after the first birthday, it’s probably safe to wait until the third birthday if there are no signs of decay or other dental issues, you’re brushing and flossing consistently, and the pediatrician is checking your baby’s teeth at each visit.  Also, wean baby from the bottle at a year to avoid tooth decay, and limit sippy cup use (sippies allow juice or milk to pool in the mouth).  Instead, as soon as your little one is able, switch to a straw cup, which is safer for teeth.  Another reason to break the bottle habit at a year: babies who drink their bottles lying down (as when falling asleep) can be more prone to ear infection.

 Q2: When should parents start baby-proofing the home?

Heidi: A lot of parents assume they’re safe (or, that their home is safe from baby and their baby safe from their home) until their little one is walking, or at least crawling well.  But it’s safer to start sooner – usually around 5 or 6 months – since you can never underestimate the resourcefulness of a curious baby.  In fact, it’s always safer to overestimate you’re your baby can reach/get into/climb to/manage to open or grab.

Q3: How much should parents clean the home?

Heidi: No need to put your baby into a bubble – and of course, that’s not practical. Neither is keeping your home white glove clean or laboratory sterile. Regular weekly cleaning is plenty, as long as you’re also sticking with the most important hygiene habits, like handwashing. In fact, research shows that some exposure to everyday germs actually boosts a baby’s immune system – making them less suspeptible to illness later on. Babies who attend day care or have siblings bringing germs home from school have fewer illnesses later on, too.  Same holds true for exposure to furry friends – studies show that young children who have dogs are less likely to suffer from allergies.

Q4: How many times is a child expected to fall sick in the first year?

Heidi: There aren’t any set number of infections a baby can be expected to come down with.  Some babies, especially those in day care or with older siblings, have more frequent colds and other viruses, others never get a single one.  Breastfeeding boosts the immune system, so breastfed babies are less likely to become sick and when they do, are more likely to recover faster.  And of course, making sure your baby gets all necesssary vaccines (and making sure anyone who spends time with your baby, including you, daddy, and grandparents and other babysitters does too) will help him or her stay well. And hands down, handwashing is the best way to prevent illnesses of any kind.

Q5: How to select a good stroller?

Heidi: The right stroller is the one that best fits your needs.  A travel system can be convenient, especially when the baby is young, but those strollers are often very heavy.  If you’ll be doing  a lot of stroller pushing, also make sure the one you choose folds up easily (particularly important if you’ll be in and out of the car with it or on and off trains and buses).  And make sure the height of the stroller is comfortable for you to push.  A good alternative to the stroller for shorter trips is a sling or other baby carrier, which allows you to go mainly hands-free and keeps baby snuggled close to you.  Try before you buy, since every mom, dad, and baby is will find different models comfortable.  And if you’re thinking about buying one while you’re expecting, be aware that your bump will definitely get in the way!.

Q6: What are the causes of colic?

Heidi: Colic is really a catch-all phrase that covers any kind of extended crying in a young baby.  It’s usually defined loosely by the rule of 3’s: at least 3 hours of hard-to-console crying at least 3 days a week, starting at about 3 weeks and tapering off by 3 months – but of course, many babies cry much more than that. There are plenty of theories to explain colic, but the top ones are gas (babies have immature digestive systems, so gas happens…a lot) and overstimulation.  Babies at 3 weeks lose the abillity to block out extraneous stimulus in their environment – so by the end of the day they’re often at stimulation overload, and just need to unwind with a good cry (and by good…of course I mean, long).

Q7: What about sex?

Heidi: The answer is YES.  Staying intimate is one of the best ways, of ocurse, of staying connected – especially in that first year as parents, when there are so many baby-focused distractions. Try to remember that the most important relationship in your life, even once baby comes on the scene, is the one with your partner.  Babies should and often do take priority, but try not to put your twosome on the back burner – be a couple, not just a couple of parents.  A weekly or monthly date night, even if it’s just snuggles and movies on the sofa.  Scheduling in sex – or being spontaneous (baby’s napping?  Get busy!).  And taking the time for quick hug or a kiss.  When it does come to the main event, delivery can leave you quite sore, even if you didn’t tear or have stiches, and postpartum hormone changes can make your vagina uncomfortably dry.  So make sure you get all the warming up you’ll need, and don’t skimp on the lube – use it liberally until your own juices are flowing again.

Try to remember that the most important relationship in your life, even once baby comes on the scene, is the one with your partner

Q8: You have written “What to Expect when You’re Expecting” close to 30 years ago, has what to expect change?

Heidi: There is definitely a lot more information available now, and also more empowerment to women. Husbands and doctors now understand the role and importance of moms. Also parents can turn to online communities and social networks for support.

Thank you Heidi for helping so much for the past four weeks; as you all know, I’m passionate about childhood eczema and looking forward to have more experts on board and a community to especially help new moms with eczema babies.

This was originally a two-part series (combined into a single post), live coverage of Dr Thomas Armstrong’s workshop in Rise and Shine Expo, Singapore. His workshop was titled 8 ways of teaching: How to teach practically anything using multiple intelligences.

Multiple Intelligences

The theory of multiple intelligences was first developed in 1983 by Dr. Howard Gardner, professor of education at Harvard University. He took a broader interpretation of intelligence other than just linguistic and logic/mathematical intelligence that still remain as the main focus in schools today. A society requires more than word smart and number smart people, for instance, professions such as designers, artists, musicians, dancers play an important role. The concern of a narrow definition of intelligence is that children who are actually intelligent in other ways become labelled as “learning disabled”. Furthermore, teaching the same concept in different ways allow not word or number inclined children to learn the concepts and also reinforces learning for children who are.

8 Multiple Intelligences

Linguistic Intelligence

Linguistic intelligence (“word smart”) – This intelligence refers to being good with words, and children who are word smart may love reading books, telling stories, good at spellings and taking tests and good at writing. Parents can help these word smart children by bringing spoken/written words into learning.

Logical-Mathematical Intelligence

Logical-mathematical intelligence (“number/reasoning smart”) – This means being good at numbers and logic/reasoning. Children who have more of this intelligence are typically good in science, mental calculation, patterns and taking number-related tests. Parents can help number smart children by thinking of ways to use numbers or patterns into learning.

Spatial Intelligence

Spatial intelligence (“picture smart”) – This means being good with pictures and images. Children who have more of spatial intelligence are usually creative, loves arts, doodles, legos and video games. Parents can help these children by using visual aids, colour, art and metaphors.

Bodily-Kinesthetic Intelligence

Bodily-Kinesthetic intelligence (“body smart”) – This refers to being good with the body and hands, such as children who are hands-on, loves to act, moves, sculpts and athletic. Learning for these children can be aided by involving the whole body and hands-on experiences.

Musical Intelligence

Musical intelligence (“music smart”) – This refers to being good with tone, rhythm and timbre and such children are often good in instruments, singing, rhythm and remembering music. Parents can help these music smart kids learn better by including music and rhythm into the learning experience.

Interpersonal Intelligence

Interpersonal intelligence (“people smart”) – This intelligence deals with being good at social interactions and these people smart children are natural leaders, street smart, good at mediating or persuasion. Learning for these children can be aided in peer to peer sharing, co-operative learning or large group simulation.

Intrapersonal Intelligence

Intrapersonal intelligence (“self smart”/ personal reflection) – This refers to being good at knowing oneself and these children are independent learners, confident, good at setting goals for themselves and reflecting. These self smart kids learn well when they are given choices or from forming associations with their personal experience.

Naturalist Intelligence

Naturalist intelligence (“nature smart”) This intelligence is for children who learn best using nature, who loves animals, have a green thumb or loves outdoors. Bringing learning for these children to nature or relating to nature can help their understanding of concepts.

For parents who want to assess which areas their children (or themselves!) are the strongest in, see this slideshare by Dr Thomas for the multiple intelligence inventory listing.

September 28, 2013 Singapore – Eight Ways of Teaching (Handouts) from Thomas Armstrong Ph.D.

Identifying Multiple Intelligences in your Child

Dr Thomas shared that there are many ways parents can gather which intelligence their child is better at, and the best is by observation. Trips to art exhibits, zoos, parks, museums, libraries, music events and different environments can help parents to know what their child is interested to explore. Parents can document their observation using a scrapbook and observe over time what their child is better at. They can also go to the child’s school, ask the teachers and review the work done during school. A sparkle in the child’s eyes is the best indication!

Parents’ Questions on Discovering Child’s Multiple Intelligences

Q1: What if the parent is not strong in the intelligence that the child is good at? How can the parent then help the child to learn using this area of intelligence?

Dr Thomas: Parents can take the effort to learn and strengthen the intelligence in the particular area, and turn to other parents/tutors/technology to learn (both for themselves and for their children). One point to note is that every child is good at an area, it is not possible that a child is not intelligent in any area.

Q2: How to build a child’s intelligence and know that they have improved in it?

Dr Thomas: Parents should worry less about testing and think more about creating stimulating environments as a family, for instance, playing games, reading, stories, taking walks and visiting new places. Avenues to learn are already embedded in everyday life – for instance, questioning about why nature is as such, get them thinking instead of opting for an intensive learning program. Flash cards are not recommended as even if the child can get it right, flash cards do not encourage deeper understanding – some parents do it to feel good about themselves!

Multiple Intelligences/ Learning for an Eczema Child

I can’t resist the urge to sneak a question in for an eczema child. A child with eczema suffers from poor sleep, may lack concentration from lack of sleep or the itch be taking much of their mind. Dr Thomas, I wonder if there are certain areas to help these children in class (apart from treating the eczema so that the child can get proper sleep and not feel like scratching in class).

For instance, will it be even more important for parents to figure out other ways to help the eczema child learn apart from linguistic and logic as these require more sitting (leading to chances to scratch)?

My baby started learning her words using sign language, which helps as she has to sign and not scratch (her experience).

Dr Thomas:  I think any activity that involves hands-on learning would be good for the same reason as sign language:  the student’s hands will be involved in learning and not scratching.  Some examples of hands-on learning include:  fingerpainting, building with legos, working with math blocks, playing with clay, making a collage, creating a diorama (a three-dimensional model of a scene from a book, for example), and woodworking.  These, of course, are excellent for all children, but have this added benefit for children suffering from eczema.

Thank you so much Dr Thomas Armstrong for helping with the questions above and offering a very enlightening workshop for parents during the Rise and Shine Expo.