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It is empowering for parents to have an idea of what play activities they can incorporate into their daily routines to interact with their baby. Activities that stimulate their vision, hearing, touch and movement, all help them make sense of their world and move towards it. It is important to spend time watching what your baby is doing and what he/she takes an interest in, and then repeating it, providing more of the same. It is in our daily interactions with a loving, consistent caregiver that baby receives the most valuable input. Nurturing daily routines of feeding, bathing, dressing and nappy changing, provide wonderful opportunities for playful interaction. Finding time to be with your babies, to watch them, and to have fun together, is the key to stimulating their development. Remember, YOU are your baby’s first and most important play-mate and play-object. Baby clinics, family or friend groups, and mother-baby workshops are also very beneficial in our learning as parents. Groups give support and sharing as well as help parents understand their babies’ behaviours, stages of development and what activities are best for stimulating sensory and motor development. Here is a guideline of your baby’s development in the first year of life. Having an idea of what your baby is beginning to learn at each stage, gives you an idea of what you can do to encourage their newly emerging skills. Babies are learning to adapt to the new world and organise all the sensory information around them. This is a time of ‘settling in’ as they learn to regulate. Parents and babies learn about one another and parents learn to become familiar with their babies rhythms and signals. At this early age, newborn babies need to sleep, feed, be held, cuddled and talked to. Parents should always respond to their baby’s needs, as this is a time of bonding, developing trust and getting to know one another. Babies learn to focus, maintain eye contact and become very interested in the human face. Right from birth babies are able to mimic facial expressions and this is the beginning of social behaviour. Babies respond to sound from birth. They begin to recognise their caregiver’s voice and can be consoled by the sound of her voice. At 3 months, they begin to turn their heads to the direction of sound. By being touched and by exploring their world through touching, babies become aware of their bodies and how their bodies move. Deep pressure touch is particularly important at this stage to support baby to regulate/calm. Babies are sensitive to movement right from birth. Rhythmical movement and carrying are soothing and comforting for babies. When awake, babies are moving in random wide range movements. As they learn to control their bodies, they bring their hands together in the middle. Babies are learning head control, by lifting their heads up when on their tummies and by holding their heads in the middle when lying on their backs. At 3 months, improved head control can be seen when holding a baby in supported sitting. Parents need to realise that they can over stimulate their babies at this young age. They should be sensitive to their babies needs and read their signals. When a baby looks or turns away, appears fretful or cries, give baby some time and space to regain a calm state. Kate Bailey, Occupational Therapist

What is normal, what is not? Parenting is a mammoth task, and brings with it a lot of uncertainty as to what is actually within the norm, and what may need more urgent attention. I shall therefore attempt to sketch a picture of what is considered normal, with initial focus on the first few months of life, which are particularly panic-provoking! This includes a few words on the dreaded “C-word”…Colic. I shall then go through system by system what may go wrong and when to seek help. As a paediatric allergist, I have a particular interest in allergy prevention strategies, hence shall attempt to dispel a few myths and iron out some truths about what we can do to reduce allergies in the offspring. What is normal in the first few months? The first few months of parenthood are particularly tough as you take full responsibility for a precious but needy little baby, and have to function on minimal sleep. My advice: accept all the help you can, don’t set your expectations too high, and don’t expect your baby to fit into a mould! This is “survival time” for all- the enjoyment of parenthood will come! For the first 3-4 months babies’ brains and tummies are still very immature. This time has been dubbed the “fourth trimester.” The baby is not yet able to manipulate you hence it is not really possible to “spoil” a baby during this time. However, routines can be established from an early age and it is useful to try have a baby in some kind of a routine of sleep, feeding and play by 12 weeks or so if possible. The predictability of a routine helps you as well as other caregivers as well as your baby. Remember to be flexible and especially adaptable at times of travel, sickness and immunisations when the routine may be disturbed for a while. The first few months are vital for establishing a bond with your baby and a relationship of trust- the baby needs to know that “warmth and food and cuddles will come my way when I need them.” Remember that it is normal for a baby to cry as it is its only way of communicating. Crying increases from an average of about 1 hour a day at birth to 2-3 hours a day at 6 weeks, then slowly decreases again to about 1-2 hours a day at 3 months. Remember this “crying curve” when you are tearing your hair out at 6 weeks post birth! Gripes and Groans in the first few months The immature gut during the first 3-4 months means that most babies have gripes and groans to varying degrees. “Colic” by definition is excessive crying of more than 3 hours a day, more than 3 days a week, typically from 2-3 weeks until 3-4 months of age. Truly colicky babies by definition are thriving and usually have a pattern of an unsettled period, typically (but not always) in the early evening, when they cry inconsolably and may draw their legs up in discomfort. Although the specific cause of colic is rather mysterious, the general feeling is that it may be caused by an immature gut and immature nervous system (oversensitivity). Colic does not cause long term harm or distress to the baby. Simple measures such as winding the baby carefully, holding them upright with gentle pressure on the tummy, movement, driving, “white noise”, wind drops and probiotic drops may be useful. More potent colic mixtures can be sedating hence should be used sparingly only for “crisis” times once or twice a day after discussion with your clinic sister or doctor. Individual colic “medications” do not have a great success rate, and each one may work in only about a third of patients. Therefore, if they do not make a difference after a week or 2, stop them. Time is the great healer for colic, but this is hard to accept when you have a little baba crying 24/7! Some cases of excessive crying and discomfort may be caused by reflux of acid and milk into the throat, lactose intolerance and cow’s milk protein allergy. Please discuss concerns of with your clinic sister and doctor, especially if there is excessive vomiting, constant crying, inadequate weight gain, severe nappy rash, or chestiness. On that note, most babies vomit as they have an immature valve at the top of their stomachs which lets milk go up again. This is normal. Vomiting, in fact, only peaks at 4 months. However, if the vomiting seems excessively painful, the baby back-arches a lot, refuses to lie on the back, and is extremely miserable after feeds or fusses excessively during feeds, reflux “disease” should be considered and discussed with your healthcare practitioner. Stools During the first few days of life the baby passes meconium, which is a black or dark green stool of “marmite” consistency. After a few days, stools change. Breastfeeding stools are normally mustard yellow with white “seeds” of curdled milk. Breastfed babies have a wide variety of stooling habits. In the first few weeks they tend to pass stool after most feeds. After a few weeks they settle into a pattern which is widely variable: from 7-8 stools per day to one stool per week- this is all within normal limits. Babies on predominantly formula feeds should ideally pass stool at least once a day. Babies often groan and strain and become red in the face when they are passing stools- this is normal unless accompanied by painful crying. If you are concerned about constipation- (if stools are infrequent or unusually hard or painful to pass) please consult your doctor. Sleep Sleep is always an issue in families with young kids. We won’t go into detail here as every child and family is so different. Don’t expect miracles before 6 months- the young baby is programmed to require night feeds which can be normal until 8-9 months of age. Thereafter, demanding a milk feed is usually not a nutritional issue but a comfort “prop” to help them fall asleep again. Teaching a child to self soothe is an important tool to impart on your young one and can be done from about 4 months of age. They may need a comforter such as a special blanket, soft toy or dummy (or a combination of these) to help them fall asleep. Babies are generally reasonably easy for the first 10 days or so then may become more difficult as colic and wind sets in. Their sleep requirements are high (about 16 hours a day in total for the first few weeks), gradually settling into a pattern of approximately 3 naps per day by 3 months of age. If possible, some naps should be more than 40 minutes long to provide restoring sleep. At night time they will continue to wake 3-4 hourly for feeds for the first few weeks; by 3 months there is often a longer “stretch” of sleep during the night of 5-6 hours. Remember that the safest sleep position for your baby is on the back. The “back to sleep” campaign in the UK has seen the rate of cot deaths halve over only a few years. If the family is really not coping with the interrupted nights, or if there is a sudden change in sleep pattern, it is worth having the child looked at to make sure there is not a physical ailment disrupting the sleep. The routine and feeding pattern should be examined to make sure the daytime sleep and feed requirements are being met. There are a variety of forms of sleep training available, from controlled checking to gentle gradual separation techniques- please discuss with your clinic sister or doctor before embarking on these. If a child is unwell or going through a stage of separation anxiety, it is not a good time to sleep train. Remember that “this too shall pass” and that most children- even the worst initial sleepers- sleep very well by the age of 5 or 6 years. Feeds Initial feeds should be 3-4 hourly during the day, and on demand at night. Some babies only manage 2 hours in between feeds initially- this should stretch once they are able to drink more at one time. Breastfeeding is ideal for babies for several reasons including cost, convenience, allergy prevention and to boost their immune systems. The clinic sisters have vast experience with breastfeeding, please consult them for advice if you are battling. However, not all mothers manage to breast feeds or have insufficient milk- nothing to feel guilty about. There is a vast choice of formula milks and the approximate volume that a baby needs for the first few months is 150 mL milk per kg per day (divide this volume into the number of feeds per day). For example, a 4 kg baby on formula milk who feeds 3 hourly needs approximately 150 x 4= 600 mL per day; ie approximately 75 mL per feed every 3 hours. (8 feeds per day) Some babies need less milk, some need more- the best way to judge is by their weight gain. For this reason we plot babies’ weights on the growth chart regularly to make sure they are not falling off the growth curve. Babies lose weight during the first few days of life- loss of up to 10% of their birth weight is normal. The baby should regain its birth weight by 2 weeks of age. After that, for the first 3 months or so weight gain should be between 150-350 grams per week. After 3 months it slows down somewhat. Solids can be introduced any time from 4 months (17 weeks) onwards. Throughout the first year of life milk is the most important component of the infant’s diet, and even on 3 solids meals a day, during the first year the infant requires at least 450-600 ml milk per 24 hours. After the age of one, milk can be cut down gradually to 300-500 mL per day- overfeeding with milk after a year of age will interfere with an appetite for solids and may lead to problems such as anaemia. From about 14 months or so many toddlers notoriously go through a fussy eating stage-their growth curve naturally slows down and the world around them is SO much more interesting than food! It is therefore important to try and introduce a great variety of foods to the toddler before the fussy stage begins. Developmental Milestones Every baby develops at a slightly different pace, but generally the sequence of development is similar. Stimulation of a baby’s development will be covered by my colleagues. As soon as the baby starts fussing and seems fed up, stop with the stimulating process so that they can calm down in preparation for the next nap. Below are basic milestones typical at different ages. Remember each child develops at a different pace, and individual babies may be advanced in a certain area e.g, grabbing and mouthing yet a bit slower in other areas e.g. sitting/crawling. If your child is lagging behind significantly please consult the paediatrician: the sooner delays are picked up, the quicker we can intervene to find a diagnosis and treatment. Developmental milestones Age Gross Motor Skills Fine Motor Skills Hearing and Language Development Visual Development Personal/Social Birth Very little head control Hands are closed and grasp reflex present Startles to loud noises -Eyes close in response to bright light -Best distance of vision is about 30 cm away -Black and white vision Cries 6 weeks Moderate amount of head control -Can make tight fists -Places hands in mouth -Responds to sounds by calming, startling or crying -Starts making cooing sounds May follow slow moving objects through 90 degrees Begins to smile in response to familiar face or voice 3 months -Very little head lag -Can lift upper body and head when lying on tummy -Leg kicking and stretching -Standing reflex develops (pushes down on a surface with legs when held up) -Hands held loosely -Inspects hands and grasps objects that are place within hands -Can bring hands together -Recognises and responds to parents -Coos and gurgles -Blows bubbles Follows objects moving up to 180 degrees in the field of vision -Smiles spontaneously -Develops facial expressions to show basic emotions -Recognises mother’s face and scent 6 months -Supports head well -Can support upper body with hands when lying on stomach -Sits with support -Can roll over -Reaches for and grasps objects -Places objects in mouth -Transfers objects from hand to hand -Responds vocally when spoken to -Uses sounds such as squealing or laughter to express emotions -Uses repetitive monosyllabic sounds like bababa Can move eyes in all directions Recognises toys 9 months -Sits without support -Crawls on stomach and then on hands and knees -Starts to pull body into a standing position -Can pick up, shake and drop small objects -Grasps food and places in mouth -Holds a bottle Begins to point Starts imitating sounds -Stranger anxiety- Knows and trusts a limited number of caregivers -Recognises own name 12 months -Cruises around furniture -Starts to walk (walking may take up to 18 months) -Begins to throw objects -Good pincer grip -Holds 2 objects and bangs together -Still mouths a lot -Speaks 2-3 words -Makes sounds at toys Picks up tiny things from the ground -Searches for hidden or fallen toys (0bject permanence) -Waves goodbye, - points -Shakes head 15 months -Walks steadily -Starts to climb Stacks 2- 3 blocks Speaks 3-4 words -Has temper tantrums when frustrated -Becomes attached to a soft toy or other object 18 months -Walks steadily. -Runs -throws ball underhand -kicks -Scribbles -Stacks 3-4 blocks -Speaks 6-8 words -May have some 2 word phrases As above -Starts to use fork and spoon -“reads” picture books on his own 24 months -Runs -Jumps with 2 feet -Walks down stairs one foot at a time -stacks 6 blocks -scribbles -may still use both left and right hands to draw -Names at least 6 body parts -Uses 2-3 word sentences -Half of speech understandable -Starts to learn some colours Adult visual acuity -Asks “why?” -Begins to show interest in playing with other children but finds it difficult to share. Play is often in parallel -Helps with dressing -Uses fork and spoon 30 months -Jumps easily -Balances on one foot for a few seconds -Walks down stairs with alternating legs -Draws vertical line and circle -Pencil grip starts to develop -Handedness becomes evidence -Able to name some colours and shapes -2-4 word sentences -Able to recite name -Able to brush teeth with assistance -Washes and dries own hands 36 months -Hops on one leg -Rides a tricycle -Copies a circle -Shows definite handedness -3-4 word sentences -Able to follow 2-3 word commands -Starts to play with other children -can name a friend -Able to help with dressing Dr Claudia Gray, Paediatrician and Allergologist, Vincent Pallotti Hospital and Red Cross Children’s Hospital, Cape Town

Illnesses system by system Most babies contract recurrent minor illness within the first 2-3 years of life when their immune systems are immature and all the bugs they encounter are “new” to their systems. Babies in crèche/daycare and babies with older siblings are exposed to more bugs and tend to get sick more frequently. Do not be surprised if the child has 5-10 minor infections (eg common colds) per year in the first 2-3 years of life. In addition, every cold may last 1-3 weeks so it can feel as if your baby is “always sick.” Remember that children have a higher breathing rate than adults (30-50 breaths per minute can be quite normal for young children, compared with 16-20 in adults); they also have a higher resting heart rate (90-150 beats per minute), which is increased even more when they have a fever. Coughs and colds/Respiratory illnesses Snuffly noses and wet coughs are usually caused by the common cold virus, which lasts 1-3 weeks, and for which there is no specific treatment. Keep the child comfortable with saline nose drops, paracetamol if needed, frequent small feeds and lots of hugs. Children are often “grumpy” or “difficult” when they feel unwell, and often that is the first sign of a viral illness Ask your doctor about doses of fever/pain medication that need to be given. An example of commonly used fever medications are: Paracetamol (eg calpol syrup, panado syrup- NOT infant drops): 0.6mL per kg body weight 6 hourly, eg For a 5 kg child: Panado syrup 3 mL 6 hourly; for a 10kg child 6 mL 6 hourly Ibuprofen (e.g. Nurofen syrup) : 0.3mL per kg body weight 6 hourly. e.g for a 10 kg child: Nurofen syrup 3 mL 6 hourly We do not recommend over the counter cough or flu medicines or sedatives for young children except if advised by your doctor. Not every snuffle needs a doctor’s opinion; however please see your doctor if the child is: - feeding poorly - has a high fever (> 38 degrees in the first 6 months and > 38.5 degrees after that) - is unusually lethargic or irritable - is breathing fast (more than one breath per second/60 breaths per minute; especially if you have already controlled the fever) - has a wheeze when breathing out (often bronchitis or asthma) or a “whoop” when breathing in (usually croup) - is not “getting better” after 5 days or (they may have developed a secondary bacterial infection such as a middle ear infection or tonsillitis). Tummy bugs/Gastroenteritis The most common cause of an upset tummy is a viral gastroenteritis; these viruses are very catchy and often pass through the family. Typically, they present as vomiting for a day or two, followed by diarrhoea for 3-7 days. Of course there can be many variations of this pattern. Keeping the child hydrated is the most important management step, it works best by feeding them fluid little and often. If they are drinking and active despite runny stools, they are coping well. Relax about solids while the child has gastro- fluids are much more important. Commercially available rehydration solutions are best, if your child refuses those try some diluted apple juice or even milk if all else fails. If the diarrhoea lasts more than a week, you may need to try a lactose free diet (eg lactose free formula, reduce dairy in the diet) for the child a week or two while the tummy settles. Consult your doctor if: The vomiting is persistent and the child can’t keep any fluids down The diarrhoea is very frequent (> 10 stools a day) or has blood in it The child looks drowsy or is very lethargic as they may be dehydrated The child has a high fever or a rash. Rashes Rashes are very difficult to self- diagnose so a prompt visit to your doctor is justified if you are not certain of the cause. Some rashes are part of a harmless virus (usually pink spots that fade if you apply pressure to them and are non-itchy); some are the very common, such as seborrhoeic dermatitis (cradle cap) rash in the first few months of life (scaly rash on face and upper body, typically non itchy). Consult your doctor if: The rash is accompanied by a high fever or the child is very unwell The rash consists of red spots which do not fade when you press a glass on them (this may be the dreaded meningitis rash) The rash is itchy (this may be eczema which should be treated promptly) The rash is getting worse with time Other illnesses A child with a high fever and no obvious source of infection (like a runny nose), may well have a flu-like illness (often other members of the family are also unwell), but always seek medical attention if the child is: Very irritable (meningitis and urine infections will need to be excluded) Has respiratory distress or unexplained rashes The illness “Roseola” typically presents with a high fever and irritability for 2-3 days, followed by a rash once the fever settles. Very often the child will have incorrectly be placed on an antibiotic while they have a fever (the throat may also be red), and when the rash appears it gets misinterpreted as a reaction to the antibiotic! Dr Claudia Gray, Paediatrician and Allergologist, Vincent Pallotti Hospital and Red Cross Children’s Hospital, Cape Town

Allergy prevention strategies Allergies of all sorts (asthma, hayfever, eczema and more recently food allergy) have increased dramatically over the past few decades, and we find ourselves in the middle of an “allergy epidemic.” A child without any family history of allergies is now at approximately 15% risk of developing an allergic condition within the first few years; if one parent has an allergic condition, the child is at 40-50% risk of allergies, and if both parents are allergic, this increases to 60-80%. Having a sibling with allergies also carries an increased risk of allergic conditions developing. There are many confusing messages on allergy prevention- the following are the ones with Scientific backing that we currently recommend: During pregnancy Eat healthily and don’t smoke No need to cut out on any food groups for the sake of allergy prevention- it does not reduce allergy in the offspring Try eat 2 or more portions of oily fish per week If you are unable to eat that amount of fish, then consider taking omega 3 supplements Consider taking probiotics in the last trimester if your child is at risk of allergies (ie if there is a family history of allergy in parents or siblings) Feeding the newborn baby Breast milk is best and has allergy prevention properties The Department of Health recommends exclusive breastfeeding until 6months of age. Prolonged feeding over 6 months has no further allergy prevention properties (but of course has other benefits) Continuing to breastfeed whilst the first solids are introduced has some benefit In high risk babies consider giving a daily probiotic and prebiotic for the first 3-4 months (no absolute proof of this yet- but looks promising) Solids introduction Solids should be introduced when the child shows signs of readiness. There is no evidence that delaying solids prevents allergies- in fact it may increase allergies After 6 months you do not need to hold back on anything – you can give dairy, peanut, egg, wheat. Dr Claudia Gray, Paediatrician and Allergologist, Vincent Pallotti Hospital and Red Cross Children’s Hospital, Cape Town

Managing cracked and bleeding nipples This is a common reason for throwing in the towel with breast feeding due to excessive pain and discomfort with feeding. The most frequent cause of cracked nipples is incorrect latching of the baby’s mouth onto the nipple. Thrush (see above) can also cause very painful nipples. Make sure that your baby is latched onto the breast correctly, with both top and bottom lip in a snug seal around your nipple. Your pain level will indicate to you if your baby is latched correctly or not! To release the suction on your beast so that you can take your nipple out of his mouth, insert your finger into the corner of his mouth and gently withdraw your nipple from his mouth, and try to relatch him successfully. Using a nipple shield (available from your pharmacy or baby shop) during feeding gives cracked and bleeding nipples time to heal. Speak to your clinic sister or doctor to recommend a nipple cream to assist with healing. Exposing your nipples to some sunlight also helps to hasten healing (easier said than done!). Expressing breast milk and offering it to your baby from a spoon or a bottle is also a way to let your nipples heal whilst continuing to breast feed. Is my milk strong enough? Don’t listen to old wives tales about your milk being too strong or too weak. It is not the quality of the milk that makes the difference, it is the quantity. Some moms just do not have enough milk to satisfy their baby. This is why it is important to weigh your baby frequently to ensure that she is growing adequately. If your baby is gaining weight, having at least 6 wet nappies a day, and is relatively happy in between feeds which may be very frequent in the early days, lengthening to a few hours after a few weeks; then you can rest assured that you have enough milk. However, your stress and anxiety, a poor diet and inadequate fluid intake all play a part in hampering breast milk production. Make sure you are eating enough protein, such as meat, eggs and beans (you need to increase your protein intake three fold whilst breast feeding), drinking at least a liter of fluid a day and that feeding times are relaxed and calm. The main hormone that ensures adequate milk production (oxytocin) is controlled by emotions, so if you are anxious and upset at feed time, this important hormone will be affected, and you will produce less milk. Managing sore and engorged breasts This typically happens around day 4 after delivery (slightly longer after a caesarian birth). Most new moms are usually at home by now and do not have the support and care of the nursing staff in the maternity units to help them through this difficult time. Your breasts will become full and heavy, and excruciatingly tender to the touch. In some instances, they become rock hard, hot and sore. This is what is commonly known as “milk coming in”. It usually settles after 72 hours. Feed your baby on demand, as normal, and don’t be tempted to express your breasts to make them emptier and softer – all you will do is encourage more milk to be produced! Place cabbage leaves in your bra (they really do work), rub arnica cream or oil onto your sore and swollen breasts, and take an anti-inflammatory medication to help with the pain and swelling (ask your pharmacist, clinic sister or doctor to recommend one that is safe for breast feeding). Applying ice packs also helps with the pain and inflammation. Persevere, it will get better – just give it some time, and don’t expect your breasts to settle down for at least a few days. By Sr Ann Richardson Sr Ann Richardson is the author of Toddler Sense and also co-authored Baby Sense and Sleep Sense. She is a qualified nurse and midwife and has worked in the midwifery and paediatric fields for 30 years. For more information from Sr Ann Richardson go to www.toddlersense.com or email her at info@toddlersense.co.za

Establishing a routine Now that you are parents, every conscious thought seems to be totally ruled by this tiny bundle. You may be feeling anxious about establishing a “routine” as soon as possible but the reality is, that days that fly by (and nights that don’t) in a blur of feeding, burping and nappies have become a way of life. Your baby is obviously dependent on you for nutrition and nurturing, but he needs you to help him make sense of, and manage, his sensory environment in order for his own and unique rhythm to develop. It is out of this rhythm that a routine will develop without any conscious effort on your part. Wouldn’t caring for your baby be so much easier if you understand how he experiences the world? A little stimulation and a lot of calming is essential in the first few months of your baby’s life, so work with your baby’s rhythm for the first few weeks, bearing in mind that his “awake” time (including feeds) will determine when he needs his next sleep. In the early days he can manage to be awake for around 45 minutes before needing to sleep, stretching to about 60 minutes by six weeks of age.By the age of six weeks (even earlier if you are lucky), you have come to know your baby’s own unique rhythm. Some babies are very easy going and settle into their sleep/wake/play/cry cycles quickly and easily, whilst others are not as self-regulated and need longer to settle into their own rhythm. When do I start with a routine for my baby When your baby is about six weeks old, you can instill a basic, but flexible framework of structure to your day, working with what you already know about him. Without even consciously trying, you know when he is awake and happy, when he is hungry and when his sleepy, grumpy and crying times are, and guess what? He has a routine! By Sr Ann Richardson Sr Ann Richardson is the author of Toddler Sense and also co-authored Baby Sense and Sleep Sense. She is a qualified nurse and midwife and has worked in the midwifery and paediatric fields for 30 years. For more information from Sr Ann Richardson go to www.toddlersense.com or email her at info@toddlersense.co.za

You are your baby’s foundation of security and trust, and the solid base from which they will explore the world of social interactions. Your role as primary caregiver is to be your baby’s first and most important, available, attentive and loving social partner. How babies develop and organize their sense of self and how social development unfolds, is dependent on their individual differences together with the unfolding relationship between baby and primary caregiver. A predictable, consistent, loving, ‘tuned-in’ parent creates not only a sense of safety, but also a positive sense of curiosity and confidence to explore new physical and social environments. Individual differences Each baby has a unique sensory processing style, an individual way of perceiving and thus experiencing their world. For a baby who is sensory sensitive, they can become overwhelmed by certain noise, touch, movement, light or too much sensory input. They may have difficulty staying calm and regulated with change in routine, environments, people or experience. These babies may need more time and extra support n order to be ready for social interactions. Informal family gatherings, friend groups and structured baby groups are all beneficial for parents to connect, learn and share their experiences. Introducing babies to new people and social settings when they are ready will encourage them to feel safe and confident with others too. Guidelines for social readiness: In the first 3 months, babies are learning to organise sensations and adapt to being in the world. Caregivers learn to read their babies’ signals, body movements and rhythms. They learn what is overwhelming, what comforts and what helps their baby recover from distress, so they can attain a calm alert state to become available to take in the world. Consistent and predictable care-giving lets babies know that they will be safe and protected at this stage. Trust gives babies a sense of security which allows them to take an interest in the caregiver, their first important social interaction. Between 3 and 6 months, babies are generally more regulated, calm and alert and thus available for engaging. The caregiver and infant take more interest in one another and an emotional bonding occurs. Mirroring of facial expressions, sounds, smiling and gazing at one another becomes part of this growing intimacy and falling in love. This warm relationship gives babies a secure sense of self to prepare them to take interest in the world. At around 6 – 9 months, babies stable head, body and sitting balance enables them to engage with the world. Babies become more purposeful and communicate with body movements, gestures and sounds. Caregiver and baby begin to experience more positive pleasurable interactions as they recognise these familiar patterns of back and forth rhythmical exchange and use them ins ocial play such as peek a boo. Initially, the parent’s lap gives baby a safe and secure platform to gaze outward at the world. The parent is still available to monitor excessive stimulation and be attuned to their baby’s individual signals and needs. The trusting relationship now allows baby to begin to turn his attention to the outside world, with curiosity and anticipation. Babies at this stage take a great interest in family members and other people. Around 9 months, babies soon move from the lap to the floor as they learn to crawl and become more purposeful in exploring their world. This increased distance between baby and caregiver also facilitates the emergence of a sense of self separate from the caregiver. This developing awareness of difference between self and mother leads to awareness of difference between mother and another person. As a result, babies around this age can become vulnerable and wary of strangers which is called “stranger anxiety”. Around 9 to 14 months, the baby’s growing sense of purpose, curiosity and motor competence allows them to crawl or walk away from the secure base of their caregiver. They are growing in independence in discovering their own view of the world. This new feeling of independence can be scary for the toddler and therefore the secure, assuring home base of caregiver continues to be important as they explore their social interactions with others in what we call parallel play where babies play alongside one another, watching, following, exploring and copying one another. Babies’ curiosity and independence prepares them for the next leg of their journey toward confidence and social development. By Kate Bailey, mother of three, Occupational Therapist and designer of the Moms and Babes program.

In the first few months of some babies’ lives (generally under 8 months) they may experience a general scaliness and redness around the scalp area. This condition is known as “cradle cap” and is common in new born babies. It causes scales that are yellow/brown in colour and may also appear as red or slightly pinkish, crusty or flaky patches. It can also occur on a baby’s face, behind the ears, on the forehead or eyebrows and in the diaper area. Cradle cap is caused by the over production of sebum, an oily substance that is needed to keep your little one’s skin healthy. This causes the oil-producing sebaceous glands on the head to become irritated, resulting in inflammation, redness and an irritation that can extend to the face. Although it may look unsightly, it is mostly not serious. For most babies, cradle cap will heal on its own within a few months. The underlying cause of the condition is not well understood. It is thought to be related to levels of maternal hormones in the womb which stimulate the oil-producing glands of the unborn baby’s skin during pregnancy which can lead to cradle cap in susceptible infants. It is a fallacy that shampoo plays a part in causing cradle cap, as gentle shampooing with a mild shampoo has shown to be helpful. There are products that help reduce the length of time and the unsightliness of the condition such as Purity Pedia Kids Cradle Cap Cream. This cream is a special blend of nutritive oils to help alleviate symptoms of cradle cap and reduce inflammation. Purity Pedia Kids Cradle Cap Cream contains a blend of Lavender, Almond, Calendula, Jojoba and Vitamin E to help soften the thick crusty scales of cradle cap and can also be used to help alleviate dandruff as well as dry skin. How to treat cradle cap: Gently massage Purity Pedia Kids Cradle Cap Cream onto the affected area to soften the patches of skin 2 – 3 times a day Use soap-free baby shampoos to wash your little one’s hair and rub off any loose scales Do not be tempted to pick off any scales as your little one’s skin can become infected. If the condition keeps getting worse instead of better despite treatment, consult your healthcare professional for advice. This article is brought to you by Purity; a 2015 Johnson’s Baby Sense Seminar sponsor

We understand that as a mom, there are many aspects to mothering. Here are some tips to make the most of each cherished step along the way: Baby’s first few weeks This is a wonderful time for bonding and getting to know your baby. Bonding is the unspoken connection which develops between you and your little one. This is mainly based on your loving responses to your baby’s gestures, sounds and needs, something which later plays an important role in raising a child who feels good about themselves and who is kind and caring towards others. From the start, your baby is aware of your emotional cues resulting from the tone of your voice, your movements and even your emotions. These are all reciprocated by your baby’s cries, coos and even the copying of your facial expressions. Responding to the cues of your baby, giving him food, warmth and affection reinforces the bond and brings it full circle. There are many ways and cues in which bonding takes place. Here are a few of them: Skin-to-skin: physical contact plays an important role in your baby’s development, making him feel safe and loved. Touch becomes an early means of communication as babies respond to skin-to-skin contact. It's soothing for both you and your baby while promoting your baby's healthy growth and development. Your baby will be able to differentiate between your touch and that of your partner, if both of you hold and touch your little one on a frequent basis. Each of you should also take the opportunity to have "skin- to- skin" with your newborn, holding him against your own skin when feeding or cradling. Cuddle your baby – cuddling is an extended part of skin-to-skin, making your baby know that he is loved. This reinforces your bond and creates a sense of trust between you and your baby. Look into your baby’s eyes: making eye contact reinforces your bond with your baby and encourages them to recognise your face, enabling meaningful communication at close range. Talk to your baby: engaging in talk with your baby makes them respond to your voice. Language is learnt by imitating your sounds, resulting in speech patterns, so that the more you speak to your baby, the faster his speech will develop. How to hold your newborn Always support your baby’s head and neck as newborn babies do not have strong control over their neck muscles. Additionally, at this stage, your baby’s head is very vulnerable, especially around the fontanelles, the soft spots on the top of his head which closes between nine to 18 months. When lifting your baby, support the head by sliding one hand under their head and place the other hand under their bottom, providing adequate support for your little one’s body. Once your baby is firmly in your arms, bring them close against your chest. This makes your baby feel secure. Umbilical cord-care Keeping this area clean is very important. Place some surgical spirits on some cotton wool or a cotton bud and lift up the cord and clean around its base. The base of the cord can become sticky, make sure you clean the area where the cord attaches to the skin. The cord should be exposed to air using a nappy with an umbilical cord cut out. The cord dries out and falls off within around 15 days when it starts becoming blackish/brown in colour. Bowel movements Breastfed babies have bowel movements that are loose and bright yellow with an inoffensive smell. The frequency of bowel movements will vary drastically, from between eight to ten in a day, to one every two or three days. If a baby is -bottle-fed, their bowel movements will appear lighter in colour, semi-formed and will have a stronger smell. These babies can have between four to six bowel movements in a day. Choose a nappy such as Huggies® New Baby that offers a new soft liner which absorbs runny poo and wetness in seconds. This helps to keep baby’s skin dry while gently cushioning baby on soft little pillows which creates a gentle barrier between baby’s skin and mess. What to pack for your first outing with your newborn Make your first outing quick and easy, somewhere close by and where you have been before. If your first trip out is in the car, don’t forget your car seat. Taking your pram with you may help if you would like to walk with your newborn. Take a blanket that’s right for the weather on the day. One of the wonderful benefits of breastfeeding is that your milk is always readily available. If bottle-feeding, make sure you have a sterilised bottle to make-up a feed while you are out. In your bag you will need nappies, wipes, breast pads if you are breast feeding, a changing mat, hand sanitiser and disposable bags for dirty nappies. (If your baby still has its umbilical cord, then don’t forget your cleaning regime.) It is also a good idea to have an extra set of clothes for your baby and a pacifier or some other comfort item, which can make a difference to both of your outing experiences. One of the important points to consider before you leave is to decide how much interaction you want to allow between strangers and your baby. Also be realistic in terms of what you expect to accomplish on your first outing and be prepared to take it easy on yourself if things don’t go exactly according to plan. Taking care of yourself As much as you've longed for your baby's arrival you could end up tired and feeling worn-out after sleepless nights. Remember to make time for yourself. Here are some quick and easy tips: Liquids: drink plenty of water, especially if you are breastfeeding so that you stay hydrated. Drink herbal teas or unsweetened ice teas and avoid drinks with caffeine as these can irritate your baby or prevent him from falling asleep Energy-boosting foods: healthy snacks, fruit, and veggies can help invigorate you with the additional energy needed to care for your baby Try to get enough sleep: This can be a challenging time in terms of finding an opportunity to sleep, making you feel a little edgy as a result. Try and sleep whenever your little one takes a nap. Another option is alternating night duty with your partner, so that each of you is “on duty” for 2 consecutive nights, while the other person gets to sleep through the night. You will definitely feel much better after a good night’s sleep. Don’t be afraid to ask for support: Asking your partner, family or friends to help around the house can make all the difference, easing your load and making you feel supported during this time. Schedule some time away: Although you may feel guilty taking “time out” from your little one, keep in mind that caring for your baby can be very demanding. Take time out for an hour - meeting a friend, going for a walk or putting in time at the gym or at yoga can refresh and re-energise you. This article is brought to you by Huggies; a 2015 Johnson’s Baby Sense Seminar sponso