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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

In the early days many babies have difficulty dealing with the world outside the womb, and can easily become over stimulated which may result in fussy and colicky behaviour.Your baby needs you to watch for signs of overstimulation and fussing and to calm his environment if need be. To establish a sense-able rhythm in the first few weeks, remember that your baby will most likely not be able to stay awake happily for longer than 40 – 60 minutes before needing to go back to sleep again. Remember to tune in to his signals and offer the appropriate solution. Over-tired signals: Irritability Looking away from you Squirming with frantic movements Arching his back and neck Frowning Hiccups and colour changes around the mouth Gagging and spitting up Crying Solution: Calm his environment and reduce stimulation Hold him firmly and avoid chopping and changing positions Swaddle him tightly with his hands near his face Say “sshh” quietly and rock him gently in your arms, or push him in his pram Let him suck on his or your finger or a dummy Persevere with one strategy for about 2 minutes before trying another 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

Babies cry for a variety of reasons and this article discusses a few of the most prominent reasons and some suggestions on how to deal with it. Tummy talk Hunger may really get your baby worked up so respond to early signs of hunger. Gas and colic can also cause a lot of discomfort, therefore ensure that your baby is well burped and feeding in a relaxed manner. Provide sucking opportunities, which provides comfort and soothing. A clean finger, baby’s hands or fingers or a pacifier works wonders. Nappies Some babies get very upset when wet or dirty, so ensure that she is clean and dry. Sleep and stimulation Tiredness causes fussiness. Newborns need more than 16 hours sleep a day, preferably in a quiet, dimmed sleeping environment.Tone down on stimulation and rather provide gently rocking (swaying) and don’t pat vigorously. Constant, repetitive sounds such as womb sounds, mom’s heartrate or other white noise may be useful to calm your crying baby. Hold me Sometimes babies are just lonely and need closeness or holding. Place your baby in skin-to-skin contact as much as possible - it will keep her warm, snuggled, comfortable and provide feeds if needed. Temperature Ensure your baby is not cold or too hot. A general rule of thumb is to dress your baby in one layer of clothes more than what you are wearing. Do not allow crying to make you anxious. Try to tune in to your baby’s needs and do what your instinct tells you to. By Welma Lubbe Welma Lubbe is a Clinical Nursing Specialist and Educator with a masters degree in Nursing. She is currently busy with her PhD on Neurodevelopmental Supportive Care. Welma is the founder and owner of Little Steps and president of SANITSA.

A baby’s “wind” refers to excess gas trapped in the tummy that causes pressure and discomfort. Babies get wind by swallowing air during sucking. This is often caused by sucking a clogged or blocked nipple or teat, an empty bottle, the thumb or a blanket. Crying also causes babies to swallow air which could cause wind. Using a gripe water can help relieve the discomfort of painful wind and indigestion in babies. They often contain sodium bicarbonate which helps correct the increased stomach acidity in baby’s tummy. Colic affects between 1-3 in 10 babies and is accompanied by continuous high-pitched, inconsolable crying for a few days continuously. Babies suffering from colic may also become flushed in the face, have wind and draw up their legs to their tummies and pass gas. Colic often occurs at the same time of day (usually late afternoon or the evening) and your baby may inconsolably for a period of time. It is not a disease and won’t cause wont baby any long-term harm – but is very stressful for both of you. Administering Paediatric colic drops before a feed may help to relieve the abdominal discomfort that babies feel as a result of excessive gas and bubbles in their tummy. Most colic drops contain an ingredient that causes the small bubbles of gas in your baby’s tummy to join together a larger bubble that can be easily expelled, giving your baby some relief from the bloating and discomfort. Massage, rocking, swaddling or a change of environment may all help to take your baby’s mind off things for a time and offer some relief. Colic usually disappears in babies from about 6-8 weeks. This article is brought to you by Purity; a 2015 Johnson’s Baby Sense Seminar sponsor.

Wouldn’t caring for your baby be so much easier if you understood how your tiny bundle experiences the world? Well, by looking at a baby’s sensory world, we can much better understand and cater for our young baby’s sensory needs. It makes sense that caring for your baby with concern about how he experiences the world will help him both be content and develop optimally. In the same way that your baby is dependent on you for milk (nutrition) and love (nurturing), he needs you to help him cope with and make sense of the sensory environment. In the early days most babies have some difficulty dealing with all the new sights, sounds, smells and feels of the world outside the womb. Many babies become over stimulated with just an average day’s stimulation, resulting in prolonged crying (or colic). Your baby needs you to watch for signs of overstimulation and fussing and to calm his environment if need be. Responding appropriately when your baby is over stimulated and fussing will save you both distress and feelings of desperation that every mother when her baby cries for an extended period. How to respond: Hold your baby quietly and firmly Calm his environment to ensure he does not become further over stimulated Tuck his arms in or swaddle him in a blanket Play some calming music for your baby Put him in a baby sling close to you Give him something to suck such as a pacifier or his hands to help him calm The early days of fussing soon pass and your baby soon becomes more alert and is awake for longer periods but don’t be fooled, babies need an inordinate amount of sleep. The young baby is prone to overstimulation after just an hour and a half of awake time. After six months of age, your baby will manage to happily interact for two and a half to three hours as he approaches his first birthday. Your baby’s growing brain needs stimulation to develop optimally and you can stimulate him via the sense of sight, sound, touch, movement and taste. Give your baby opportunities to explore his world and have a variety of bought and home made toys available for interactions. Talk to your baby lots and use massage to help your baby learn through his sense of touch. Just remember that in the case of stimulation more is not always better. Time stimulation for when your baby can most benefit from the interaction, not when he is tired and irritable. By understanding your baby’s sensory world, you will nurture a baby who is more content but who also learns optimally from his world. Fussing signals Irritability Looking away from you Squirming Arching his back or neck Frantic movements Frowning Hiccups and colour changes around the mouth may be signs of distress Gagging Crying 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

Wouldn’t it be great if your baby came with a manual! One of the hardest tasks of the early days is to understand your new baby’s language. While each baby is unique most babies shared a common unspoken language in the early days. Reflective function or the ability to read and understand your baby and respond appropriately is the most important skill of early mothering. By reading your baby well you will know what he is feeling and thus how to respond. Your baby will feel secure in the knowledge that he is understood and bonding is enhanced. If your baby is feeling happy and ready for interaction, he will make eye contact, coo and smile (if he is old enough). When your baby shows these signals, you know that stimulation and interaction will be well received. In this state, the calm alert state, your baby will be making connections in his brain and learning will occur optimally. Your baby is happy and calm. On the other end of the continuum is the crying state. This signal is obvious and no explanation of what crying sounds like is needed. Your response to the cry will determine how long your baby will cry for. When your baby cries, first respond by asking why: Is he hungry? – feed if three to four hours have passed. Younger babies or those not gaining weight may need more frequent feeds. Is he comfortable? – look at the temperature of the room and whether your baby is appropriately dressed. Is he ill? - if your baby has been the a cheerful fellow and the crying is excessive or out of character, take him to your doctor to rule out illness Is he tired? – babies need to sleep very frequently. Be sure to watch his awake times and put your baby to sleep frequently before he becomes overtired. Reference Baby Sense for how long your baby can be awake between sleeps for his age. Is he over stimulated? – this is the most common cause of crying and requires you to remove him from the stimulating environment and give him down time with calming activities. Long before your baby starts to cry due to over stimulation he will give warning signals that he has had enough. A new born will descend to crying and a toddler to chaos if you miss these signals. By watching for your baby’s signals you can respond before he begins to cry: Sucking hands Looking away and loosing interest in toys Holding hands together in the midline Grizzling or moaning Arching his back Pushing you or a toy away These warning signals are important forms of communication that help your baby keep himself calm and well regulated. When you see these signals, help your baby calm himself by letting him suck on his hands, giving him a dummy or removing him from the busy environment that is stressing him. You baby may also be tired and need to be put down for a sleep. Watch for your baby’s precious signals and respond appropriately, giving him the security that you respond to his needs. By Meg Faure

Crying is a primitive and piercing sound that is bound to get any mom or dad’s attention. When our baby cries, we naturally react to stop the crying. However it is important to understand why our baby is crying as well as responding to stop the crying. When searching for the reason, eliminate basic needs first: hunger tiredness discomfort caused by a dirty nappy, cramps, bloating, reflux, constipation, etc medical conditions When you have ruled out all these possible causes but the crying doesn’t stop, it is understandable that you may begin to feel desperate and at a loss for what to do for your baby. It is important to know you are not alone. In the first 12 weeks of life many babies spend some hours each day fussing and crying. This unexplained crying in the early days has been commonly known as ‘colic’. For many years it was thought that the crying was caused by abdominal discomfort or cramps but recent research shows that it is more a factor of the young brain’s inability to deal with stimulation. Your baby’s ability to filter out stimulation in the world develops over time. In the first two weeks, we hypothesize that your baby’s brain protects him from excess sensory info. During this time your baby is probably an angel, crying very little and sleeping a lot. But at around ten to fourteen days, this protection dissolves and your baby’s brain must start to filter out sensory stimulation on its own. Of course, being immature, it can’t and so your baby reacts to the world with sensory overload. From being that angel who slept all the time, he suddenly is more alert and fusses. He may cry for an hour every evening or as much as three hours day or night. This daily crying usually peaks at around 6 weeks and by 12 weeks the fussy period is over. The best way to prevent excessive crying in the first three months is to limit stimulation and keep your baby’s world calm. So how do you calm your baby who is already crying and unplayable due to overstimulation? Swaddle your baby – the deep pressure and containment provided by a swaddle is the best calming measure. Your overtired baby will then no longer be bothered by his flailing arms and will feel calmer when swaddled Decrease stimulation – do not over stimulate your baby when he is already fractious. Take him to a dim room with quiet lullabies instead of swinging him through the air to make him laugh. Hold your baby and carry him – do not worry about spoiling your newborn, as babies up to four months old do not form habits. However, they do have sensory needs and movement such as that provided in a sling is a great way to calm colicky newborn or fractious toddler alike. Lie with your baby on your chest – when the wheels are falling off, and mum and baby are falling apart, Dad can be a great support. Take your little baby and lay quietly with him on your chest and sooth him with your calmness and gentle touch. White noise – white noise provided by water, a radio tuned to static or a white noise CD/MP3 are wonderful sounds for calming babies. If possible play white noise at the volume of your baby’s cry and he will calm down. By Meg Faure

Almost any mom will admit that she wants her baby to be one of the clever ones - a smart little chap. We know life is easier for bright and clever people. For this reason as parents we invest time and energy in ensuring that our baby develops optimally and is well stimulated. Research is constantly looking at the key influences on intelligence. Timothy Taylor, PhD, in his book The Artificial Ape, published in July 2010, looks at the inventions that changed the course of human development. As we know, human babies are born less mature than almost any other mammal on earth and their survival depends on the mother (or father) to care for the baby 24 hours a day. In prehistoric times, only the stronger and more mature babies would survive. The intelligent but physically weaker babies would simply not survive. The invention of the baby sling over 2 million years ago changed all this. By being carried by their mothers in an ‘artificially lengthened gestation’, human babies had a significantly greater chance of survival and became brighter with more well developed brains. There are good reasons for this: Slings mimic the womb world In the calm world of the womb, your baby is rocked and soothed with movement all day. It is not surprising that many newborn babies fuss when they are put down in the early days. Your baby is signalling that she wishes to be held and soothed by your body’s movements. However, holding a baby can over stimulate them if they are passed from person to person or fiddled with. A better way to hold your baby is with consistent touch, such as that provided by a baby carrier. By imitating the womb world, you can expect a calmer and happier baby. If your baby is calmer more of the time, she will be more available to stimulation and will learn readily from her world. Read more about the womb to world effect on infant calming Slings enhance social awareness Babies who are carried in slings see the world through their mom’s eyes and vice versa. The baby learns from mom’s face and her expressions and is more in touch with language – both verbal and non verbal. Likewise, by having your baby against your chest, you can read her signals and see what she is looking at. This enhances language development as well as social skills, which are a vital part of intelligence. Vestibular stimulation Not only does a content baby learn more from her world in the calm alert state, but in addition, the motion of your body stimulates your baby’s vestibular system, developing muscle tone and enhancing motor development. Sleep Our brains need a certain amount of movement to sleep well for long periods, just think how well you sleep after a good hike or exhilarating run. Babies are no different and it is known that babies who are ‘worn’ during the day sleep better and for longer stretches day and night. A well rested baby is more available to learn from stimulation and can concentrate on activities for longer. Of course there are numerous other tools and activities we do in the first three years of life that encourage our baby to reach her potential, but a sling is such an easy way to encourage your baby’s intelligence and development! So here is to slings. By Meg Faure

In the last trimester of pregnancy, your little one’s sensory systems begin to make connections in the brain and learning starts. However, unlike other mammals, human babies are born relatively immature. Consider the newborn antelope, springing across the African veld, following the rest of the herd only hours after birth. Her ability to keep up with her mother as the herd moves on is essential for the survival of the species but it is also made possible because of her relative maturity at birth. The human babies are born way less mature, with limited ability to act on their world. The human baby can not only not fend for himself and survive without a parent, but cannot even sooth or settle himself, depending on his parents to settle him and sooth his cries. This is particularly so during the first three months of the newborn’s life (the fourth trimester). The easiest way to settle your baby at this time, is to mimic the womb world: Touch - For nine months the only form of touch your baby has experienced is skin to skin – his naked skin against the womb walls, the feel of the cord and the sensation of his own touch. In the labour ward place your newborn baby naked: skin-to-skin on your chest. Cover yourself with a blanket or towel to keep your baby warm. Miraculously, a mother’s chest can increase or decrease by 2 degrees to regulate her baby’s body temperature. This perfectly natural position is commonly called Kangaroo Mother Care and you can aim to ‘kangaroo’ your baby for as many hours as possible in the early days. It is important to know that if your baby is born healthy by caesarean section, he can be warmed up on your chest instead of being removed to a clinical incubator. Swaddling is very important in the early days, as it’s the best way to imitate the tight hug of the womb environment. Swaddling provides deep-touch pressure and also stops little limbs from shooting out when your baby is unsettled, which is a common cause of night wakings in the young baby. A swaddled newborn is a more settled baby and will sleep for longer stretches. For the first nine to twelve weeks, swaddle your baby for all sleeps and when unsettled or colicky. Ensure your baby has some time to kick free of the swaddle when awake. It is important to swaddle your baby’s hands near to his face so he can suck on them to self soothe and regulate his body temperature if becoming warm. Swaddling with the hands by the sides is not a good option as your baby will not be able to self soothe or to regulate his temperature. Smells – Your newborn’s sense of smell is finely tuned at birth. The smells he loves best are the familiar smell of the womb and the sweet smell of breast milk. Do not to wash your baby immediately after birth. Wipe him down if he is a little bloody but do not wash off the vernix. There is evidence that unwashed babies bring their hands to their mouths sooner after birth than washed babies. Sucking on his hands is one of the first, really clever and important strategies a baby will use to self-calm and is important in the development of self-regulation. Aside from vernix, the soothing smells of you is the best olfactory input at this stage. In the early days, keep your new baby’s space free from any scents, as his smell system is so sensitive. An item of clothing that smells of mum or dad in the cot is comforting. Sight - Create a visually soothing space by dimming the labour room’s lights and bringing your baby to your chest, 20-25cm /8 inches from your eyes, which is the perfect distance for him to focus on your eyes. Decorate your baby’s room in muted and clam colours and have a light dimmer switch or a nightlight so that the room can be dimmed when your little one is fractious. A calming sensory space is important, as the visual system is a very powerful system for your new baby. Do not place any toys or mobiles in the cot or crib. The cot must be a calm sleeping space only, not a stimulating play area. For encouraging eye-focus, a few contrasting colour toys or pictures (red, black and white) should be in the room, but keep them near the changing mat where it is appropriate for your baby to be awake and stimulated. Sounds - The newborn is familiar with and soothed by your voice. For a period of time, immediately after birth, your new baby will be calm and alert, listening and focusing well. Talk quietly to your baby to calm him after birth. White noise and womb sounds are calming in the early weeks. Buy or make a recording of white noise or play a CD with tracks of calming music ‘mixed’ with the steady beating of a heart. Movement – Babies are best soothed with movement and rocking. In the early days many babies do not settle unless held. Do not worry about ‘spoiling’ your baby or that your baby is ‘manipulating’ you. The reality is that in the fourth trimester, a baby does not have long-term memory that would create expectations for how he needs to be soothed. Rather, the newborn has a sensory need for the womb and the holding and rocking reenacts the womb space for the new born. A sling therefore is a wonderful tool for soothing fractious newborns and regulating state. The first three months are a period of enormous transition and adjustment for you and your baby. By mimicking the womb world, you can calm your baby effectively. Swaddling, white noise, and carrying baby are just three examples of strategies that imitate the womb world and calm babies in the fourth trimester. References Eliot L. Whats going on in there? How the brain and mind develop in the first five years of life Bantam Books 1999 Faure M The Baby Sense Secret Dorling Kindersley (to be released 2011) Faure M & Richardson A Baby Sense Metz Press 2010 Graven S & Browne J Auditory Development in the Fetus and Infant. Newborn & Infant Nursing Reveiws. Volume 8, Issue 4 2008 Hepper P. Unraveling Our Beginnings: On the Embryonic Science of Fetal Psychology. The Psychologist 18 (8) Aug 2005, published by the British Psychological Society. Hopson J. Fetal Psychology Psychology Today, October 1998 Meisami E. et al Human Olfactory Bulb: Aging of Glomeruli and Mitral Cells and a Search for the Accessory Olfactory Bulb Annals of the New York Academy of Sciences, 1998 Trevathan W. Human birth: An evolutionary perspective. New York: Aldine de Gruyter 1987