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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

Twins bring double the joy and with that, double the work. Sleep deprivation with one child is bad but do twins spell double the sleep problems too? It is a well-known phenomenon that we are seeing more and more twin births these days, mostly because of infertility treatments. With in-vitro fertilisation up to five eggs may be implanted into the uterus at the same time, which greatly increases the likelihood of twins. About one in 80 pregnancies are multiple pregnancies. Two thirds of twins come from two separate eggs being fertilised. These become non-identical twins. Identical twins are created when one fertilised egg splits into two separate cells, and so the foetuses originate from the same cell. Once your twins are born, there are definitely much more work involved, and a strong structure and routine will be the only thing that gives you sanity in those hectic first six weeks. Don’t even think about demand feeding – you will run yourself into the ground! Get help, whether that’s your mom moving in with you or hiring a nanny. This is important, especially if you have a toddler as well. One twin may be more demanding than the other, which may throw you a bit, but once you know how to handle each baby, respond to their individual signals and work around that, life will start settling into a routine of sorts. It is possible to breastfeed twins. Some moms like to feed simultaneously with one on each breast, while some prefer to feed them straight after each other, a few minutes apart. You can also alternate their feeds; breast milk for one feed and formula for the next feed. Your body should be able to supply enough milk, but this depends on how much feeding stimulation your breasts get (either by your babies latching and sucking, or effective expressing) as well as your health. Many twins are born prematurely, which may cause some initial feeding problems. Persevere though, and you will be amazed at how quickly they “toughen up” ! If your babies are bottle fed, it is possible that they may need to be on different formulas! The same applies for solid food and meal planning. Remember they are two individuals, and may have digestive systems that function differently. Their nervous systems may also function differently. One twin may need more sleep than the other, and one may cope better with prolonged stimulation than her sister or brother. Remember to look at each baby as an individual. Routine is the key to keeping a structure that will ultimately lead to happier, more rested babies and a more relaxed mom. Set feeding times strongly. Do not demand feed Let them sleep together. They were together in the womb and being together can be comforting. Try to get them synchronised into the same routines of sleep, wake and play (even if the meals and activities may be slightly different), so that their body clocks and biorhythms are as similar as possible, but if they are very different, accept that they may be “out of synch” for some periods of time. Separate them from sleeping together if one is sick, if they keep very different awake and play times, or if you are trying to sleep-train one of them. Keep a log of all feeds and sleeps, as it is really easy to get confused about which twin has done what! Remember to still treat them as individuals, especially if one has sleep problems – it is impossible to sleep train both twins at once. If you have to do some controlled crying, separate them so that they don’t disturb one another. Enlist some support in the form of a night nurse or a family member who can take care of the “other twin” whilst you are sleep training. there will always be a stronger twin who will be “leader of the pack”, and who may be more advanced in certain developmental stages, and have a stronger character. If this is the case, it doesn’t mean that the other twin in “the weak one” – remember they are individuals – please treat them as such. Leaving the house with your twins in tow means that you will look a bit like a travelling circus! You will have lots of paraphernalia to carry with you, and will need to decide on things like whether you will have one or two nappy bags, and countless other variables. Make decisions that are the most practical and work for you. You may become a little socially unacceptable after the birth of your twins. A mother of multiples becomes an entourage with your two babies, and if you have toddlers even more so. Don’t fret! Find similar moms through an organisation like SAMBA (South African Multiple Birth Association on 0861 432 432 or www.samultiplebirth.co.za ) with whom to swap war stories, learn what to expect and engage in twin or triplet-friendly activities. Some Tips: Establish a structure and routine. Be organised by being one step ahead of them Get help Join a support group Treat each child as an individual. Don’t try to be super mom. Involve your husband and other family members. By Ann Richardson

There is no better incubator and home for a fetus to develop than within his/her mommy’s tummy. However, sadly for some babies who are born too early, technology needs to play a role in keeping a baby warm and creating a space to continue developing. Even full term babies born by caesarean section are placed in incubators to warm them up. Kangaroo Mother Care (KMC) reminds us of how marsupials or kangaroos take care of their young. The infant kangaroo is always born prematurely. When the little kangaroo is born, it crawls into the maternal pouch where it receives warmth, safety and food, until maturation. Similar to the kangaroo mother, the human mother provides a safe, warm environment and frequent feeding opportunities for her premature baby, when she cares for her using the KMC method. This can be seen as the continuation of a pregnancy that has been disrupted. KMC is an innovative method of taking care of premature babies. It can however also be used for full-term babies until they become uncomfortable in the KMC position. KMC has a list of benefits and is a relatively simple and novel method of caring for premmies. KMC refers to the continuous nursing of a baby skin-to-skin on the mother’s or father’s chest. The baby is dressed only in a nappy and then placed on the mother’s naked chest between her breasts with the head underneath her chin. Continuous KMC is skin-to-skin care practiced for 24 hours, day and night. The baby is removed from the position, only when the mother takes a bath. Alternatively, intermittent KMC can be practiced. The baby is held skin-to-skin for a shorter period of time when the mother or father is unable to be with their infant for 24 hours. In this case parents can practice KMC for a few hours per day and still experience the benefits of skin-to-skin contact. KMC and birth A mother’s temperature rises by one degree Celsius during pregnancy. If her baby is cold when placed onto her mother’s chest, mom’s temperature will rise by another two degrees Celsius, and if the baby is too warm her temperature will drop by one degree Celsius, to help cool her baby. Amazingly, this is even evident in twins – when twins are placed in skin-to-skin, each breast will change temperature to suit the temperature needs of the baby on that breast. Unfortunately, dads do not have this temperature regulating ability, but the baby on dad’s chest will help regulate her own temperature by extending a limb to cool herself. For dad’s skin-to-skin care is a great way of bonding. Other effects of KMC Benefits to the baby include maintenance of adequate body temperature, less crying, more quiet sleep periods, less energy consuming movements resulting in satisfactory weight gain, better milk supply and sleep synchrony, as well as less infection. KMC babies can also be discharged to home sooner. Babies born by caesarean section or who came too early may suffer from breathing difficulties and skin-to-skin care is the most effective technique used to decrease the baby’s oxygen needs, stabilises heart rate and breathing and even blood pressure. Benefits to the parents include an increased sense of bonding with their baby, an increased confidence in caring for their baby, continuation of the interrupted nurturing role as a mother and the empowerment to become the primary caregiver again. Skin–to-skin care also enables both fathers and mothers to participate in their infants’ care; the closeness improves bonding between parents and their infants. Kangaroo discharge refers to the fact that many low birth-weight babies can be discharged earlier. Discharge irrespective of weight is possible once the infant is feeding satisfactorily and weight gain is maintained. KMC is continued at home until the baby reaches a weight of 2 - 3 kg or when the baby becomes restless and protests when tied in the KMC position. KMC at home Even older babies can be cared for in skin-to-skin as long as she finds it comfortable. This is especially helpful if you take your baby home during the winter and need to help her control her temperature. Try to KMC your baby for 90 minutes at a time, allowing her to cycle through the sleep states and enjoy a longer period of sleep. In preemie babies, to have the most benefit from skin-to-skin care, it should be practiced as often as possible for as long a period as possible. If you could not start at birth, start as soon as possible thereafter – it is never too late. Some parents continue with skin-to-skin care even until toddler age, which is great for parent and child. By Welma Lubbe; Nursing sister specialised in Neonatal ICU care

Everyone hopes their pregnancy will be uncomplicated and free from emergency. Few people consider the possibility that their baby could be born many weeks before the due date and need to be given special care for the first few days, weeks or months after birth. However, the reality is that around 15% of babies are born sick or premature each year in the SA. What to expect If you are shocked when you walk into the neonatal unit, you are not alone. It is very likely to be different from almost any other place you have been, and you may have just experienced one of the most traumatic episodes of your life. The room is full of monitors, high-tech equipment and the frequent sound of alarms. But all of the staff knows that you are under stress and are there to help you as well as your baby. Many of the babies in the neonatal unit are extremely tiny and immature. The equipment that surrounds them is designed to keep them warm, to monitor many of their body’s functions and to support their breathing. Depending on how early your baby is born or how unwell he or she is, you may be shocked when you see him or her for the first time. Premature babies may appear thin with little body fat and look different from most term newborn babies that you may have seen before. This is simply because they are at an earlier stage of development as they were born early. If your baby is very premature, he or she may only be the length of your hand and may well sleep for almost 20 hours each day. Breastfeeding The fact that your baby is in a neonatal unit (NICU) will have come as an enormous shock to you. However, the good news is that you can still do many things you planned including breastfeeding. Even if you have decided against breastfeeding, you could express your milk for a little while. Giving this to your baby will help to protect him or her from many different illnesses. If you choose to breastfeed, you should express your milk as soon as possible, and it can be stored in a fridge on the unit until your baby is ready to feed. Preemie Sense The womb world is most certainly the ideal place for the human foetus to develop. Thrust into the harsh world of the NICU, your preemie is missing out on a great deal of the soothing sensory input of the womb world. While your baby is medically fragile in the unit, the medical team will focus on the medical needs and keeping your baby stable. But once your baby is medically stable you can ask the NICU team if you can start some sensory care for your baby by enacting the womb world: Touch: Kangaroo mother care (KMC) or skin to skin is a great way to give your baby calming touch and has a great effect on weight gain and bonding. Visual: The womb is a muted space visually. Cover your baby’s incubator with a towel or sheet to keep the area darker. Try to start differentiating dark and night by keeping the space darker at night than during the day. Sounds: Keep the NICU as quiet as possible and turn down the alarms to quieter but still safe, noticeable levels. Do not place bottles and other objects onto the roof of the incubator as the sound resonates through to your baby’s ears. Movement: A tough one and probably best replicated when wearing your baby in KMC Help and support www.SANITSA.org.za www.littlesteps.co.za Discussing your feelings with other parents can also help. Many neonatal units run a group where parents meet to share their experiences or simply have a coffee and a chat. Your GP may be able to refer you to a counsellor. You could also ask a member of staff at the neonatal unit if there is a counsellor or psychologist available to talk to parents and offer support. By Meg Faure