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Raising Happy and Healthy Baby By Dr. Varsha Atul Shah


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Raising Happy and Healthy Baby By Dr. Varsha Atul Shah

  1. 1. A/Prof. Varsha Atul Shah, Senior Consultant Singapore General Hospital Visiting Consultant Dept. of Child Development K. K. Women and Children Hospital Raising Happy and Healthy Babies 1
  2. 2. What is Raising? Happiness? Healthy? Baby? Raising - Parenting Happiness - Pleasure, enjoying, showing joy, contentment Healthy - Disease free, possessing good wellbeing Babies- Very young child, an infant , from birth to 1st birthday
  3. 3. Consider ‘Evolution of life’- Young abandoned at birth!  Flies  Worms  Butterflies  Frogs  Turtles  Cuckoos  Rattle snakes  Crocodile
  4. 4. Mammals  They give birth to live young  All female mammals nurse their young with milk  Mammary glands secretes milk for newborns
  5. 5. Foal, Calf, Puppy  Baby dogs, cats, horses, and elephants all walk within a short time of being born  All stand immediately after birth  But Human baby stand after 1 year, are helpless 2
  6. 6. Why Human babies are helpless after birth?(1/2)  Is virtually immobile  Not capable of independent functioning  Cannot creep, walk, or speak  Cannot hold on to or cling to his mother. (unlike other primates)  Must be carried if he is to go from one place to another or feed  Cannot continue to survive without the efforts of another human
  7. 7.  Human baby have only 25% of their adult brain size  Apes, our closest mammalian relatives, are born with 45% Human babies reach 45% brain growth at end of their first year when are crawling An appropriate human gestation period should last at least eighteen months--nine months in and nine months out of the womb Be like Kangaroo (KMC) 9 months outside womb Why Human babies are helpless after birth?(2/2)
  8. 8. Why happiness is important for babies?  Psychologists - happiness is a learned condition  Unhappiness in 1st year = Unhappy adults  A happy child is a healthy child  Feeling safe and well looked after  Having all the basic things he needed  Full of confidence and sense of security  Happy baby grow up to be positive adults  Emotionally intelligent baby (High EQ)
  9. 9. How do you measure happiness? Happiness scales Gross national happiness(Bhutan) Happy Planet Index The Global Kids Happiness Index 3
  10. 10. Bhutan
  11. 11. Lot of physical touch, emotional bond, attention given and attachment parenting Taking care of their feeding and pee and poo And many more things…described later What make baby happy? 5
  12. 12. Why 1st year is critically important? The brain typically grows to 60% adult size by 12 months Doubles weight in 1 year Optimal brain and body development, for intellectual, social and emotional intelligence
  13. 13. Why 1st year is critically important? During this teensy-weensy period in her life baby forms: The attitudes Personality traits Disposition characteristics that will be with her forever Self esteem and confidence EQ
  14. 14. To do list for happy baby
  15. 15. “Not to do list” for happy baby
  16. 16. Must do list for Babies
  17. 17. While you are pregnant-Happy mum After birth -touch-Skin to skin contact at birth -Room in -Infant massage -Breastfeeding Attachment parenting Bonding with baby Play time Happy babies
  18. 18. Page 26
  19. 19. Minimize stress Unborn is sensitive to music, emotion in his mother’s voice and the meaning of her words Make up songs just for the baby and sing them lovingly when you’re alone in the house or car While you are still pregnant!
  20. 20. Have fish oil, chocolates since omega-3 fatty acids helps brighter babies and a lower risk of postpartum depression Keep yourself stress free and happy Moderate exercise is helpful, yoga etc. A well-balanced, healthy diet, with fruits, vegetables, whole grains, sea food and fish (When mother is happy, baby is happy; when mother is anxious, baby is too) Fit Pregnancy, Happy Baby
  21. 21. Page 29 7
  22. 22. Page 30 After birth…
  23. 23. Placental detachment after birth Mom and babe structurally separated Not physically or emotionally separated Inside, you gave your blood; Outside, you give your milk, eyes, hands, and voice-- your entire self After birth 8
  24. 24.
  25. 25. Bonded baby is a happy baby=Confident adult Bonding = falling in love Hold, caress, and love him listen to them Respond immediately to their babies‟ cues, wear their babies, breastfeed, and sleep with their babies Spend time, even co sleep Bonds like that develop through shared experiences with your baby Trying to read baby, communication easy 1. Get attached! Do not separate! Treat them like Baby Kangaroo, Why?
  27. 27. Fall in love at first site Help start for breastfeeding and bonding Regulates warmth, sugar, heartbeat, breathing in babies Calms baby/relaxes mother Likely to breastfeed exclusively for longer time Benefits of skin-to-skin contact after birth
  28. 28. Allows you to identify baby’s hunger cues Get to know her baby faster, establish BF Reduces baby’s stress and crying Less cross infection Benefits of 24 hour rooming-in with baby
  29. 29. Exclusively breastfeeding for at least 6 month Gold Standard Breastfeeding is the healthiest thing you can do for your baby 2. How will you feed your baby?
  30. 30. Breast milk Breast milk Breast Milk Breast milk Breast milk Breast Milk Breast milk Breast Milk Feed your baby’s body and soul
  31. 31. Help contract uterus reduces postpartum bleeding Relaxes mum and promote bonding with baby Facilitate weight loss (average 500 Cal lost per day of BF), less osteoporosis and anemia Lower risk of breast, ovarian, uterine cancer Cost saving/Sense of pride for mum to breastfeed Benefits of breastfeeding-to Mum
  32. 32. Only perfect, natural, organic, easy to digest, healthy food for babies Promotes emotional wellbeing and bonding Less risk of allergy, wheeze, obesity, diabetes, cancer Immunity to fight infections like diarrhea, ear, chest infection Enhance brain and cognition with higher IQ Benefits of breastfeeding-Babies
  33. 33. Skin to skin contact immediately after birth 24-hour rooming-in and baby led cue feeding Helping mothers position and attach babies Building mothers’ self-confidence No supplement/teats/ dummies * Baby Friendly Hospital Initiatives Hospital practices to successful breastfeeding BFHI*accredited hospital
  34. 34. Strangely prevalent notion that letting a baby cry alone (We do not spoil them by picking them up) Nine months inside the womb and nine months of intensive mothering outside the womb are required to prepare a human infant adequately to spend any time alone Close mother-baby contact, responding promptly to crying, and breastfeeding until at least the age of two Picking up a baby when he cries teaches him that someone responds to his needs, whether those needs are for food or merely for the physical sensation of being held 3. Pick up your baby!(1/2)
  35. 35. Babies just feel bad sometimes and long for human contact and love Crying is the only way a baby can communicate 3. Pick up your baby!(2/2) 9
  36. 36. Eat when hungry Sleep when tired Less likely to develop eating disorders later in life Less likely to develop sleep disturbances 4. Ditch the schedule-Give demand feeding
  37. 37. Talk Respond Read Sing and play music Praise and give loving attention. Cuddling and hold Make them feel cared for and secure 5. Play with your baby(1/2)
  38. 38. Play when she’s alert and relaxed. Watch for signs of being tired or fussy Distract your baby with toys if touching unsafe 5. Play with your baby(2/2) 10
  39. 39. Do not ignore crying baby Notion that babies are trying to control us Ignoring a crying baby only makes frantic and insecure  May eventually stop crying thinking he is not worth his parents ‘time and attention’! You can only “spoil” a thing by neglecting it 6. Ignore anyone who tells you your baby is manipulating you!
  40. 40. You can often soothe a crying baby by just walking out your front door and outdoor Include baby by wearing your baby, in all your activities wherever you go or work at home Use sling over pram Wear your baby on your body (Baby wearing) 7. Don’t make baby a shut-in, go out door, Bring baby everywhere you go
  41. 41. Make your own baby gear!
  42. 42. Baby wearing technique
  43. 43. Sleep deprivation biggest causes for post-partum depression New mother is biologically programmed to sleep next to baby You may think that you will get more sleep by sleeping apart from baby, but the reverse is probably true Both baby and mum sleep better when they are together 8. Don’t turn into a Mommy-Zombie.
  44. 44. Baby want is to feel included and connected in the lives of their caregivers Babies like action love being involved in your cooking cleaning, shopping, walking, and laundry folding Exercise with baby! Try Baby Crunches, The Baby March, The baby push ups when baby can sit well Talk to him about all the things you see as you pass them 9. Involve baby in all activities.
  45. 45. A child whose needs are met Who has a strong attachment to his parents Will develop a foundation of trust that will allow him to become independent More love from parents, the more baby are able to love themselves 10.Let baby develop independence naturally, not by training
  46. 46.  Parents love to compare milestone Baby’s personality and interests affects development Some may build block towers before he learns to walk or talk or vice versa  Don't rush and don't compare! 11.Respect the rate at which baby’s abilities develop Page 57
  47. 47.  Responding promptly to baby’s cues Will give her the message that her wants and desires count 12. Help your baby to become emotionally expressive! 11
  48. 48. 13. Make them feel special
  49. 49. Under two years old no benefit much from TV  Babies don’t hear radio and television words Television will sound like background noise to a baby They hear real spoken words better 14.Turn off the TV
  50. 50. Infancy represents a mere 2% of our lifespans, yet 80% of brain growth in 1st year  Brain growth is directly proportional to how much stimulation it gets  Constant flow of sensory input not only makes him happy; it makes him smart! Moment spent in contact with you is a moment Is being stimulated and getting smarter Moment spent alone in a container is a opportunity lost forever 15.Make baby smart while you make him happy
  51. 51. Loveys are the security blankets, tattered stuffed animals, or other objects that so many children form strong attachments to It trains the child to bond to things instead of bonding to people The infant in arms, at breast, and in mom and dad’s bed receives security and fulfillment from personal relationships. (Dr. Sears Attachment Bonding) 16. Skip the loveys, inanimate attachment (½)
  52. 52. Humanly attached infant -have better peers relationship -have deep intimacy with a mate as an adult Child left in crib and play pan risk for developing -Shallow interpersonal relationships -Becoming increasingly unfulfilled by a materialistic world.” 16. Skip the loveys, inanimate attachment(2/2)
  53. 53. Mothers - Typically nurturers who make a child feel safe - Unconditionally accepted Dads - Encourages their children to do their best - Stretch their limitations, and succeed in achieving their goals 17.Don’t underestimate the value of Dad! (½)
  54. 54. Dad needs to invest time to develop his own bond with baby Touch is a more powerful bonding tool than sustenance (Harry Harlow, 1950) 17.Don’t underestimate the value of Dad! (2/2) 12
  55. 55. Most babies can understand “no” by about eight months When baby must be stopped in his tracks or headed for major mischief, avoid NO Use alternatives like “Stop!” Call baby’s name in just the right tone of voice - can be more effective than the standard ‘no’  Follow it up with a distraction, distraction and distraction 18. Don’t be a “no” machine!(1/2)
  56. 56. You know likes of your baby, use as distraction Keep a mental list of the things he loves You can always direct his attention to a favorite activity, song, or toy 18. Don’t be a “no” machine!(2/2)
  57. 57. When toddler gets stuck eg between sofa, - the natural inclination is to rush to the rescue Instead, size up the problem Analyze if Is it one she could handle alone? If it might be, try encouraging her verbally Rescue if cannot, but say, “Mommy will help Emily,” not “Mommy will do it for Emily.” 19.Know when to encourage and when to rescue
  58. 58.  Babies laugh by four months old - early laughs are usually in response to joyful feelings - Pleasant physical sensations - rather than a reaction to something that strikes them as funny Babies loves: - unusual noises, - funny faces - quick, silly movements  Sense of humor may start to develop near his first birthday 20.Share laughs with baby(1/2)
  59. 59. Sharing laughter with your baby: - is a tremendous bonding tool Really healthy too: - laughter actually strengthens the immune system - enhances cardiovascular flexibility - increases intellectual performance and information retention - rebalances the chemistry of stress hormones in your body Ref: Annette Goodheart, Ph.D., author of Laughter Therapy 20.Share laughs with baby(2/2)
  60. 60. At 1 year no button in the house is safe from pushing, no knob is safe from turning, no switch is safe from switching. Babies love to imitate their parents and your toys are likely to attract him much more than his own -Televisions, stereos, phones, car-key remotes, light-switches, computer switches, brief case closures…the list of manipulative that are irresistible to tiny hands is endless 21.Give the button-pusher plenty of buttons(1/2)
  61. 61. They like real toys Give them Any defunct gadget—like phones that are no longer in use, calculators, or computerized address books--could become treasured possessions as baby hones those fine-motor skills  Baby-proof your home to make sure that he doesn’t hurt himself or damage anything valuable 21.Give the button-pusher plenty of buttons(1/2)
  62. 62. Poor behavior is the direct result of poor self- esteem Every day, good parents, in an attempt to teach their kids to be better, make disparaging remarks about them. Do not dismiss their children’s interest in or curiosity  Do not nag them, discourage them, disrespect them 22.Be your baby’s biggest fan!
  63. 63. Child will see himself as the Parent describes him--flawed, wrong, not fast enough or smart enough Not good enough Low self esteem Praise them, encourage them 22.Be your baby’s biggest fan!
  64. 64. Babies are exceptionally good at making you angry Sometimes make you want to scream, but DON’T do it Babies are sensitive to the emotions of their parents even not visible anger if you are often angry, seek help Get counseling; take up yoga; meditate; hire a mother’s helper; but DO SOMETHING to break the pattern. 23.Handle your anger like a grown- up. (1/2)
  65. 65. Think for a moment about how you act when you have fallen in love with someone? If you feel that same level of admiration Connectedness Empathy awe for your child Same longing to please her and be near her THEN YOU ARE, WITHOUT DOUBT, RAISING A HAPPY BABY 24.Stay in love forever(2/2)
  66. 66. 25.If you can’t be there, find the best care for your baby
  67. 67. Nutrition Tummy time Immunization Feeding and weaning, diet Watch growth and developmental milestones Healthy Babies Page 79
  68. 68. Nutrition Breast milk - First 6 months of life Between 6 and 12 months of age- Weaning diet- Baby led weaning -learn about new tastes and textures -Breast milk continued -Feed your baby slowly and patiently -Encourage your baby to try new tastes but without force 24. Healthy Bodies
  69. 69. 25.Tummy Time
  70. 70. Any time baby is supervised and positioned on the stomach for play, that is considered tummy time! Recommended by The American Academy of Pediatrics Supervised playtime on the stomach to promote growth and development Prevent flat spots from forming on the head and motor milestone delay What is Tummy Time?
  71. 71. Daily Tummy time leads to the mastery of important motor milestones • such as rolling over • pulling up • Crawling Why Tummy Time?
  72. 72. Start Early Start Gradually Bolster Time Lap Time Distract Baby Face to Face Time Make as routine family time Quick Tummy Time Tips
  73. 73. Even when in hospital Position your newborn on your stomach or chest while you lie in a reclined position on a chair, bed Will encouraging eye contact Rock your body from side to side Quick Tummy Time Tips
  74. 74. 15 seconds of tummy time on the first attempt Goal is to eventually work up to at least 30 minutes over weeks Stop if your infant begins to cry in protest Quick Tummy Time Tips
  75. 75. Make a small bolster by rolling up a thin towel or blanket and place this under baby's chest Quick Tummy Time Tips
  76. 76. Make a small bolster by rolling up a thin towel or blanket and place this under baby's chest Quick Tummy Time Tips
  77. 77. Lap Time es/tip-pic-9.jpg Quick Tummy Time Tips
  78. 78. If your baby dislikes being on her stomach, remember this: distract, distract, distract Play music, sing, shake toys, and clap your hands, keeping baby occupied Quick Tummy Time Tips
  79. 79. Lie down on the floor facing your baby during tummy time Sibling can also participate Voice and expressions should be animated Quick Tummy Time Tips
  80. 80. Causes of crying
  81. 81. Normal cause of crying  Colic  Emotional distress (loneliness or fear)  Environmental discomfort  Full or wet diaper  Hunger  Mild, transient discomfort (that goes away on its own)  Need for affection, need for stimulus  Teething  Thirst  Tiredness
  82. 82. Pathological cause of crying IT CRIES mnemonic for infant crying I – Infections (unwell child, herpes stomatitis, urinary tract infection, meningitis, osteomyelitis, and so forth) T – Trauma (accidental and nonaccidental), testicular torsion C – Cardiac (heart failure etc) R – Reflux, reactions to medications, reactions to formulas I – Immunizations, insect bites E – Eye (corneal abrasions, ocular foreign bodies) S – Surgical (obstruction, inguinal hernia) – Strangulation (hair/fiber tourniquet)
  83. 83. Colic-Expressive crying
  84. 84. Colic  Colic starts in the first weeks of life and resolves by around 4 months of age  Crying most often occurs in the late afternoon or evening  The baby draws its knees up to its abdomen, or arches its back when crying
  85. 85. GOALS of treatment  To provide strategies to help soothe a crying baby  To reduce parental anxiety and stress  Exclude pathological cause
  86. 86. What can you do?  Holding the baby through the crying episode  If intolerable, it is best to put the baby down somewhere safe (e.g. their cot) and take a few minutes' 'time out'  Gentle motion (e.g. pushing the pram, rocking the crib)  'White noise' (e.g. vacuum cleaner, hairdryer, running water)  Bathing in a warm bath  Go for a drive  I Love U massage on tummy  Colic drops
  87. 87. BCG and Hepatitis B at birth 4 weeks- Hepatitis 3 months and 4 months- DTP, HiB, Rotavirus and pneumoccocal 6 months –DTP, HiB, hepatitis B 12 months-MMR and Pneumoccocal, Chicken pox 15 months-MMR 18 months- DTP, Hib,Chicken pox Immunisation
  88. 88. Follow health booklet milestones Chart Weight, length, head circumference on percentile charts Formal Denver Developmental screening Test(DDST) at 9 months, 36 months Growth and development screening
  90. 90. Milestones What you can do NEWBORN -Day 1, can listen, alert. -Day 3, can respond when spoken to. -By the end of first month, respond to sound - by swiveling his eyes or head - Will even twitch his mouth when his mother speaks -Answer all signals -Make sure your baby sees you when you nod your head, or sees you move your mouth when you speak. -His range of sight extends to just a foot, so bring your face, fingers or colorful things as near as possible. -Stimulate by talking, singing and showing him bright things.
  91. 91. Milestones What you can do 4 weeks -Try to speak by opening and closing his mouth -Respond to your voice by changing his behavior -Quiets when you speak soothingly -Become distressed when you speak loudly or roughly -Laugh a lot, speak in sing- song fashion or sing lullabies to feed his sense of rhythm -be more physical with him, hold him, rock and sway him or use a rocking chair and cradle -If his head shows some steadiness, you may even want to try a little "dance" with him to some music
  92. 92. Milestones What you can do 6 weeks -May start smiling at you and nod his head when you talk to him. -Able to make small throaty noises in response. -love looking at faces! you can make funny faces and funny noises -Look at the baby, when baby look at face intently, looking for facial clues -Move fingers or toys in and out of his vision to capture his interest -Speak from both sides of the face to learn to recognize voices coming from different directions.
  93. 93. Milestones What you can do 2 months -Smiling becomes a greater habit -Start showing an active interest -looking at the source of sounds -Staring at objects and looking as if he is trying to get a hold of them with his eyes -Prop him up on cushions to see more things around the room -Allow him to see bright, colorful objects and soft toys -Show him his hands -All of these will stimulate his interest in his surroundings
  94. 94. Milestones What you can do 3 months -Starts to develop an awareness of his own body -Often look at his fingers and move them at will (hand regards) -Respond with exaggerated movements and sounds -Play single games like tickling his feet, pulling at his leg and arms, or bending his knees -Give him toys of different weights and textures for him to grasp and feel.
  95. 95. Milestones What you can do 5 months -Enjoy simple games, like splashing in the bath -looks at himself in the mirror -Turns his head towards sounds -Moves his arms and legs to attract attention -Respond to your baby when you are "called" -Move towards him and make eye contact so that baby will understand when you are responding to his requests -You are his source of help and comfort -Introduce strangers to your baby -Use his name as much as you can
  96. 96. Milestones What you can do 7 months -He can recognize his own name -Puts his arms out to be picked up -Tries to feed himself, showing the first signs of independence -Will imitate simple things you do and anticipate repetition. -Show your baby his reflection in the mirror -Repeat sounds that your baby makes, to demonstrate simple cause-and-effect to him.
  97. 97. Milestones What you can do 1 year -Repertoire of emotions -show interest in his favorite book, points pictures/favorite passages -Say a few words with meaning -Can understand simple questions -Shake his head for "No" -Will repeat tricks that make you laugh -Teach names of objects and parts of his body -Do actions he can imitate -Praise, reward all responses -Describe routines -Read him short stories with abstract ideas. -To show affection by kissing or hugging you or patting his toys -Describe anything you do for him, e.g. putting on his clothes, sitting him in a chair -Finally - Celebrate his first birthday!
  98. 98. DEVELOPMENTAL RED FLAGS (1 TO 3 MONTHS)  Doesn't seem to respond to loud noises  Doesn't follow moving objects with eyes by 2 to 3 months  Doesn't smile at the sound of your voice by 2 months  Doesn't grasp and hold objects by 3 months  Doesn't smile at people by 3 months  Cannot support head well at 3 months  Doesn't reach for and grasp toys by 3 to 4 months  Doesn't bring objects to mouth by 4 months  Doesn't push down with legs when feet are placed on a firm surface by 4 months  Has trouble moving one or both eyes in all directions  Crosses eyes most of the time (occasional crossing of the eyes is normal in these first months)
  99. 99. DEVELOPMENTAL RED FLAGS (4 TO 7 MONTHS)  Seems very stiff, tight muscles  Seems very floppy, like a rag doll  Head still flops back when body is pulled to sitting position (by 5months still exhibits head lag)  Shows no affection for the person who cares for them  Doesn't seem to enjoy being around people  One or both eyes consistently turn in or out  Does not respond to sounds around them
  100. 100. DEVELOPMENTAL RED FLAGS (4 TO 7 MONTHS)  Has difficulty getting objects to mouth  Does not turn head to locate sounds by 4 months  Doesn't roll over (stomach to back) by 6 months  Cannot sit with help by 6 months (not by themselves)  Does not laugh or make squealing sounds by 5 months  Does not actively reach for objects by 6 months  Does not follow objects with both eyes  Does not bear some weight on legs by 5 months
  101. 101. DEVELOPMENTAL RED FLAGS (8 TO 12 MONTHS)  Does not crawl  Drags one side of body while crawling (for over one month)  Cannot stand when supported  Does not search for objects that are hidden (10-12 mos.)  Says no single words ("mama" or "dada")  Does not learn to use gestures such as waving or shaking head  Does not sit steadily by 10 months  Does not show interest in "peek-a-boo" or "patty cake" by 8 mos.  Does not babble by 8 mos.("dada," "baba," "mama")
  102. 102. gBNI P84 Pp8