Changing Colors: The Blog of Spectrum Pediatrics

April 5, 2017

Is Baby-Led Weaning Right for Your Child?

By: Heidi Liefer Moreland, MS, CCC-SLP, BRS-S, CLC

Baby Led Weaning is becoming more popular as an option for transitioning children onto solid table foods.  This involves introducing the child to bigger pieces of foods that they are allowed to pick up independently and bring to their mouths.  Initially, they develop the ability to pick up large “graspable” pieces and accurately find their mouth.  As they become more skilled, they mouth the food, and eventually learn to manage small broken pieces that break off inside their oral cavity.  Once the food is in their mouth, they develop safety skills to protect their airway, including gagging and pushing pieces out with their tongue. With time and practice, they develop the control to hold the pieces still for biting, mashing, and early chewing.  Finally, their skills are mature enough to move the bites back in the mouth for swallowing.  As they develop the skills to control the smaller pieces of food orally, their hand abilities are also becoming more refined.  These increasing fine motor skills allow them to accurately pick up smaller pieces of food, which are more easily chewed and swallowed when their mouths have become ready for them.

As a therapist, I believe there are a number of factors that indicate this is developmentally appropriate method to help children learn about the properties and management of solid foods.  These factors are typically emerging or present at the age of approximately 6 months, which is when this process is recommended to begin. Of course, it is always important to discuss this with your pediatrician, as well.  The factors to consider are discussed below:

  1. Infants develop the hand control to pick up bigger stick-shaped foods before they develop the pincer grasp to pick up smaller foods or to self-feed with a spoon.
  2. Infants are experiential learners that are self-motivated, and will continue working with tasks that remain interesting and meaningful, until they appear to be mastered.  They are not designed to learn from a “teacher” or through adult-directed learning, which is what happens when an adult feeds them.
  3. Infants have reflexes and drives that facilitate this process that are no longer present at a later age.  These reflexes include:
      • Predominant oral exploration drives the child to bring things from hand-to-mouth, rather than banging or flinging.
      • Gag reflex remains at the front of the mouth at earlier ages, and this allows for important safety responses.
      • Tongue thrust is present, which helps them expel foods that are unsafe for swallowing.
      • Lateral tongue movement to stimulation is present, which will be used to develop control of the food.
      • Brain development takes place as neural connections are made during functional multi-sensory activities.  Therefore, the learning that happens on a banana pieces may be slightly different than learning that takes place on a teething toy.
  4. Brain development for motor skills also requires fine-tuning that happens with repeated   experiences that allow for on-line adjustments.  An example that many adults may remember is the experience of learning to ride a bike.  The only way to really learn balance while pedaling is to wobble around while the body learns to anticipate and adjust for the rolling and tipping movements of the bike.
  5. Because babies are “in charge” of the process, they control how much they eat.  This is consistent with the self-regulation of hunger and satiety that is developed during nursing, and has been found to be a positive influence in the prevention of obesity.
  6. Because the baby is exploring at their own pace, children frequently become less resistant and afraid than those who are presented with foods at the pace and interest of the feeder.

 

baby eating riceAlthough this approach is likely consistent with the way infants were fed long before the development of prepared baby foods, modern child-rearing dictates that we need to investigate a process, before it is recommended to ensure that it is safe and appropriate.  There is a study that is available through the National Institutes of Health (NIH).  In this study, it looked at developmental skills and available evidence of baby-led weaning, and it indicated that this is a feasible process for children who are learning to eat.

As with many child-rearing strategies, your supervision and judgment is crucial in determining readiness and to keep the process safe.  Your child is ready when he or she is able to sit with upright head control and be stable in a chair with supports.  Although the following considerations should be addressed for all children, those with developmental delays or motor deficits may require further assistance in these areas, or might need more time to develop complete readiness.

  1. Sitting stability – If your child is very unstable, you need to wait until he is a little more steady, or make sure he is well supported.  Imagine drinking from an open cup while walking a tightrope.  It is hard to develop aim and fine oral control if you are trying hard to keep your body stable.
  2. Hand to mouth control – If your child has significant difficulty with other refined hand movements (such as reaching for objects, picking up and dropping toys, or opening and closing their hands with appropriate timing), they will likely have the same difficulty with learning self-feeding skills.  Wait until their motor control is mature enough to be a little more accurate and consistent
  3. Oral control – It is important for your child to be responsive to items in their mouth in a timely fashion, so they can expel big pieces, rather than choke.  If their motor responses are over- or under-reactive, the same is likely to be true of food items in their mouth.  Giving breakable solid foods too soon will result in a greater risk for choking, which is an obvious problem.  Additionally, too many fearful experiences with food is likely to result in more refusal later as a self-protective mechanism.
  4. Allergy precautions – If there is a high likelihood of allergies, discuss food exposure with a physician or nutritionist to determine which foods are more likely to cause allergic reactions, so you can be wise in the order of presentation.

 

child with food on faceImportant considerations in food selection:

  1. Look for foods that hold together well enough to be picked up, but are soft enough to easily fall apart in the mouth (such as baked sweet potato logs)
  2. Never leave your child alone with food items.  They are still learners, and they must be supervised.
  3. Avoid foods that become sharp when broken (such as potato chips).
  4. Avoid foods that are too sticky to be easily controlled (such as a big spoon of peanut butter).
  5. Avoid hard foods that require teeth to break down (Raw apple pieces or small raw carrots are the most frequent culprits in food related choking incidents).
  6. Avoid foods that are too slippery to be easily controlled by an immature eater (such as canned peaches).
  7. Be familiar with infant and child CPR, and to look for that in a child care provider.  It is recommended for children learning to eat solids, but also because food is not the only thing kids put in their mouth!  Here are some links for CPR information:

Looking to learn more about Baby Led Weaning? This website continues to discuss the benefits and even shares a few great recipes for your child!

Sources:

  1. How Feasible is Baby Led Weaning as an Approach to Infant Feeding? A Review of the Evidence.
  2. Web summary from book author
  3. Video
  4. Glasgow Study Reviewed

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March 27, 2017

Everything Sprouts in Spring: Yoga

By: Krystina Burke, MS, CCC-SLP

The spring season is a great time to get outside and get moving as a family! As we have mentioned here before at Spectrum, yoga is a fun activity that children of all ages and their parents can do together! We all know yoga is great for the body and mind but did you know yoga can benefit and boost the language skills of little ones, too? Yoga poses rely on the skills of physical imitation and attention which are foundational language skills. In addition, doing springtime yoga poses as a family can also secretly target higher language skills such as spatial relationships and opposites for the older children in your family!

Children ages 4-5 are beginning to understand words for order such as “first, next, and last” and can follow longer directions containing multiple steps more easily! Opposites like up and down and big and little also start to have meaning and can be used to further clarify a child’s message.

Yoga poses are often taught using step-by-step instructions in combination with physical modeling. This is a perfect and natural place to add order words! Some of my favorite springtime poses are tree pose, sun, bird, and planting a garden. Here is one way to teach tree pose to the little ones in your life: “First, stand on one leg, then bend your opposite knee, next place the bottom of your foot on your inner ankle or thigh (depending on the comfort and balance of the child) lastly, balance and sway in the wind like a tree”.

You can make this more challenging by asking children to be big or little trees or have their trees move up and down in the wind! Once you feel like your child has mastered a pose, have them try and “teach” the pose to someone else. Now they have the opportunity to use order words and opposites to explain a more complex direction to someone else!

Check out some more springtime yoga poses here!

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March 27, 2017

Mealtime Stress: Traumatic Stress

By: Heidi Moreland, MS, CCC-SLP, BRS-S, CLC

Most children and families with a child who has had a life-threatening illness or prolonged medical intervention have experienced a significant amount of stress. Everyone copes with these experiences in different ways. Those coping strategies make changes in the brain that will affect the way you react in future stressful situations. Some families are able to move beyond the initial crisis. They may continue to worry, but are able to develop new thought patterns and behaviors without getting stuck in the same cycle of worry.

However, other parents and families experience symptoms of Traumatic Stress which continue long past the time of the initial crisis. Traumatic Stress is a set of psychological and physiological responses of children and their families to pain, injury, serious illness, medical procedures, and invasive or frightening treatment experiences. These responses are often more related to the person’s own perception of how traumatic the event was, rather than how medically traumatic the event would appear to be to a medical professional or to others involved.

Having a reaction to stress is normal, but it is not helpful if the symptoms persist once the crisis is over. In fact, those symptoms can impact the ability to develop new healthy patterns of coping that are more appropriate for a non-crisis situation. Not everyone experiences on-going symptoms, but those who do tend to fall into a few different categories.

  • Re-Experiencing: Thoughts and feelings pop in your head, you get upset over reminders, or feels like it is all happening again.
  • Avoidance:  You try not to think of those things, or avoid any reminders of them. Sometimes busyness and list-making are functional ways to help you distance yourself from those thoughts and feelings.
  • Increased Arousal:  You always fear that something bad is going to happen, or you remain on constant alert in order to prevent it. You are jumpy and easily started. This can lead to difficulty sleeping and concentrating.
  • Dissociation:  You distance yourself physically or emotionally, or even have difficulty remembering all of it.

Information from the National Child Traumatic Stress Network reports that about 20% of families whose child suffered a traumatic event or illness showed symptoms of Traumatic Stress that were significant enough to impact treatment for the child. It is more often mothers who are affected, and the consequences can be seen months or years after the initial crisis is over. We have also found that about 20% of our families would benefit from treatment specific to dealing with trauma. There isn’t a lot of information to predict who will experience Traumatic Stress that lingers, or why some people are able to move past it, while others’ get “stuck,” but we do know that seeking treatment is extremely helpful.

Many parents, especially mothers, would rather focus on their child’s treatment and don’t want to spend time or resources on themselves. In this case, though, treating your own symptoms will actually make it easier for you to help your child and the outcome is actually better. If you are experiencing any of the symptoms above, or realize that you are having trouble getting past your child’s early medical history, it is possible that you are impacting your child’s recovery process, as well as the relationships around you. Treatment is usually not long-term, and can be extremely helpful to both you and your child.

For more information click here or talk to your child’s pediatrician or your own primary care provider. You can also look for counselors, psychologists, or social workers with experience in dealing with Traumatic Stress, particularly medical stress if possible. Consider providers who utilize telemedicine if there are no providers near you, or if child care is a problem.

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March 21, 2017

Bike Riding 101

By Colleen Donley, PT, DPT

Here are a few tips to remember while picking out a bike:

  • Kid’s bike sizes are determined based on the wheel size, not the seat height- wheel sizes include 12, 16, 20, and 24-inches.
  • A child should be able to dismount and straddle the frame while standing flat-footed.
  • When riding, the knees should not be scrunched up under the handlebars or straight out at the lowest position. There should always be a slight bend in the knee.
  • There are different types of brakes- rear-coaster brakes and hand brakes

Before you get into the standard “big kid bike,” there are different styles to help get your child prepared. Here are some explanations of different styles to help you choose where to start and which is right for your child.

  • Pedal and push bikes let your child sit on the seat with their feet on or off the pedals while you push them along. As your child gets accustomed to the feel of movement on the seat and begins to push the pedals on their own, you can gradually fade out how much you push them along. Most of these bikes come with removable handles to convert into a toddler bike.
  • Tricycles have three wheels and serve as great starting points to help your little one develop the coordination to pedal. Moving the pedals requires moving the right and left leg in a reciprocal manner, a skill that many children actually have to learn! Kiddos steer tricycles by using the handlebars only and not by leaning their weight to one side or the other.
  • Balance bikes have no pedals. They let your child develop their sense of movement, momentum, and balance while learning how to steer without the added complexity of a pedal. Many like balance bikes as a first step as they allow the child to keep their feet on or close to the ground for extra stability while they learn to control their body on the bike.
  • Training wheels have become more of a contentious point as the popularity of balance bikes has grown. Training wheels widen the base of support in the back of the bike to eliminate the need for balance while your child masters the coordination of moving the pedals and steering. Many say that training wheels teach the child how to unbalance the bike, as the child will lean their weight against the outer support of the wheels. Then when the training wheels come off, the child has to unlearn to lean against this leverage. So for a child that has already mastered balance on a balance bike, it might be worth skipping the training wheels.

Before beginning to ride, don’t forget the helmet!! Be sure to get the right size by measuring the circumference of your child’s head one inch above the eyebrow. A properly fitting helmet should be placed on top of your child’s head and remain in place as they shake their head yes and no. Head out to an open parking lot or empty tennis court to give your kiddo lots of open space to explore and experiment with speed and steering. Have fun!

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March 21, 2017

Mealtime Stress: Why Can’t I Stop Worrying? How Do I Make it Stop?

By: Heidi Moreland, MS, CCC-SLP, BRS-S, CLC

Worries and anxious thoughts can sneak in like smoke under a door, coloring everything in the room. They can be disruptive to relationships and experiences, but also SO difficult to stop. Even in the middle of worrying, we have a sneaking suspicion that the anxiety isn’t healthy. The problem is that worry can also feel protective. That it means you are a good parent, a conscientious person and that you care. If you want to stop worrying, you need to give up the belief that worry is productive and that it serves a positive purpose.

Telling yourself to stop doesn’t work. Most of us have tried it, but it can even make the anxiety stronger because now you are focusing even more energy on those thoughts! Here are a few tips from HelpGuide.org, which is a mental health website that is affiliated with Harvard Health Publications.* We have found these tips to be incredibly helpful in our own lives and in working with families of children who struggle with eating.

1. Learn to postpone worrying. Write down thoughts as they occur to you, remind yourself to think about it later. It will break up the constant worry, and allow you to begin control your thoughts rather than allowing them to control you.

  • For current concerns, you can allow yourself a period of time every day to think about them, but limit the thoughts to that window of time. Set a timer if you have to!
  • For concerns about the future, you need to recognize the limitations of fretting in the present about a future problem.

2. Ask if the problem is solvable.

  • If it is, start a plan and take action. Ask the doctor specific questions or start a treatment process to address your feeding concerns.
  • If it is too far in the future to start a plan, write it down to worry about later. Logistical problems for the first day of Kindergarten can’t be resolved while your child is only 6 months old.
  • If it isn’t, accept the underlying emotions, such as fear or anger that lurk beneath the worry. For example, “if my child fails, everyone will believe that I am a bad mother.” Accept those emotions as part of being human and being a parent. Because worrying also protects you from feeling those emotions, embracing the emotion can help you create a better balance between your intellect and your emotions.

3. Challenge the anxious thoughts. Are you making the world or the situation more dangerous than it really is? The way in which you view a situation discredits you and your child’s ability to handle life’s problems and assumes that neither of you will be able to rise to the occasion and conquer new situations. These thoughts are called cognitive distortions, and can actually result in shielding you or your child from an opportunity to learn and mature. Take a look at your thought patterns to see if any of these seem familiar:

  • All-or-nothing thinking – looking at things in black or white categories, with no gray middle ground. “If my child isn’t eating all healthy foods in a meal, he is eating nothing.
  • Overgeneralization – generalizing from a single negative experience. He only ate two bites at breakfast, he doesn’t ever eat enough.
  • The mental filter – focusing only the negatives. Our parents often report their concern when their child didn’t eat their brussel sprouts, forgetting that he tasted them, which he has never done, AND he ate a bigger lunch than he has ever eaten before!
  • Diminishing the positive – Coming up with reasons that the positive doesn’t count. Yes, he ate a whole serving of ice cream, which is the most he has ever eaten, but it’s ice cream, not broccoli. Plus, he ate ice cream last year at the beach.
  • Jumping to conclusions – Making negative assumptions without the facts. The doctor didn’t call me back in an hour, I’m sure there is something seriously wrong with the tests.
  • Catastrophizing- Expecting the worst-case scenario to happen. This is especially difficult for families when there has been traumatic illness and difficult things did happen.
  • Emotional reasoning – Believing that your emotions reflect reality. “I am really scared about the doctor’s phone call. That must mean that he has bad news.”
  • Should’s and should not’s – making a list of what you should and shouldn’t do, and being upset with yourself if you break the list. For many of our parents, that can reflect some of the beliefs you made on how you were going to parent. “I wasn’t going to allow my child to have any sugar.” That can make it difficult to feel successful if one of your child’s first desired foods is flavored yogurt.
  • Labeling – Labeling yourself completely on your mistakes or on your shortcomings. “I can’t do this myself, I am a failure.”
  • Personalization – Assuming responsibility for things outside of your control. “I should have stopped the doctors, or asked more questions about the feeding tube before they put it in.” Realize that you made the best decision you could at the time, based on the facts that you had, and move forward.

4. Accept uncertainty – Worrying can feel like you are predicting the future, which will allow you to prevent any unpleasant surprises and control all the outcomes. Too bad that doesn’t actually work! Thinking about things endlessly doesn’t stop them from happening. At the very least, it can ruin the present. In some situations, especially with children and eating, it can actually cause the problem you are so worried about avoiding!

5. Be aware of how others affect you – Anxiety is incredibly catching and sneaky. In fact, we make sure that each staff member has another clinician to consult with during treatment. It helps to have someone who is not in the situation to de-escalate anxious thoughts and ground decisions in reality. Choose the people that you discuss your child’s eating with carefully.

6. Practice mindfulness – Acknowledge your thoughts, instead of trying to push them away. Don’t try to control them, hang on to them or analyze them endlessly. Engaging in those thoughts is what leads to being stuck in that cycle. Stay focused in the present.

Dealing with anxiety takes practice, so don’t be discouraged if your thought patterns don’t change overnight. Some people need help with changing these thought patterns so they don’t become more destructive. Next week, we will talk about the signs and symptoms of Traumatic Stress, and when to seek professional counseling.

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March 21, 2017

Trick of the Trade from Jamie Hinchey, MS, CCC-SLP

Welcome Spring: Picture It!

Now that it’s spring, it’s time to get outside and enjoy the nice weather! As a speech therapist I am always looking for fun and creative crafts to do during my therapy sessions. I love when the seasons start to change, especially from winter to spring. This is a great time to work on sequencing and concepts during my therapy sessions. This “Picture It” craft uses a trick of the trade we have talked about previously: cameras.

For this activity you will need:

  • A camera (on phone or your “old school” camera)
  • Colored pencils or crayons
  • A large piece of white construction paper

With spring, usually comes beautiful days outside. Before going outside, it is helpful to talk to your child about the different seasons and explain now that winter is going away, spring will be next. By using these sequence words (first, next, then, etc.) you can work on time concepts with your child. It may be helpful to talk about what spring means and what you might start to see outside as the seasons change. A book can also be a great way to introduce new concepts, there are a lot of books focusing on spring or outdoor activities. See our previous post on spring books here!

Once you have gone over this with your child, take them outside and take a picture of them in the environment. This could be in the flowers, under a tree, laying on the grass, or at the playground. If possible, print out your picture and use it when you start your “Picture It” craft. If you are unable to print it out, have the picture out so your child can reference this. Ask your child to identify what they see in the picture and draw their own picture of what “spring” looks like to them. To challenge your child, you could also talk about what you might hear or taste on a nice day! This craft can target all areas of development. For fine motor skills, have your child draw with different types of writing utensils or even cut out pieces of paper and glue. For gross motor and attention, work on your child sitting in a specific spot at the table or floor and attending enough to complete the activity. For language development, have your child tell you about what they did outside or retell what happened in a book you may have read about Spring! There are so many fun crafts, but try to use the beautiful Spring weather as a way to get your child outside!

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March 21, 2017

Everything Sprouts in Spring: What makes a good book?

By: Brianna Craite, MS, CCC-SLP

Recently, the therapists at Spectrum Pediatrics had a discussion on “What makes a good book?” We know how important book routines are to develop strong early literacy and pre-reading skills. Books can also help foster hand eye coordination while turning pages. You can practice supported or independent sitting while reading.

Walking into the book section in any store or browsing the library can be overwhelming with the wide selection. Here are a few things our therapists’ thought of especially when looking at the pictures that may ease your search:

  • Bright simple pictures
  • Pictures that include early vocabulary themes like body parts, animals, toys etc.
  • Pictures “tell the story”

As children get older we suggest books with words or phrases that repeat to practice early literacy skills. Check out the list below and you’ll see some of my book choices for the upcoming spring season!

Toddler

Board books are easy for early readers to turn the pages. It is important to look for interactive flaps, bright colors, and spring vocabulary. As a speech therapist, I often recommend that parents label the pictures they see in the book while allowing their child to explore the interactive parts of the book. Using books with interactive flaps can help increase your child’s attention on the book.

Preschool/Kindergarten

While looking for books for preschool age, focus on books that have repetitive words such as I see Spring. The repetitive words are great for early readers. The Tiny Seed by Eric Carle is one of my favorite books for Spring. After reading this book, try planting seeds of your own for an interactive activity to go along with the story! And Then it’s Spring by Julie Fogliano is a great book for early readers, especially when focusing on teaching the concept of changing seasons. Spring is Here by Will Hillenbrand is a wonderful book for introducing spring vocabulary and learning about friendship!

Enjoy your books!

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March 15, 2017

Technology Tuesday: Hello Spring

We found an app that we had to include in our “Everything Sprouts in Spring” series! The “Hello Spring: Preschool Games” mobile application is available on both your phone or iPad. This app is a great way to “Welcome Spring” with your child. The free version of this application allows you to explore the different things you may see out in nature when spring arrives. This includes growing trees, blossoming flowers, and a rabbit that helps guide your child around the screen. By using your finger to point to different areas on the screen, your child can help the rabbit feed baby birds, give water to the flowers, and help dig with a shovel to grow food in the garden. This is specifically designed for preschool and kindergarten children. For $2.99 you can buy in-app purchases that allow your child to design different animals (bees, birds, etc.), learn about where fresh produce comes from, and take care of baby birds to help them grow.

To learn more about the app or to purchase it click here!

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March 14, 2017

Mealtime Stress: What if It’s Me?

By: Heidi Moreland, MS, CCC-SLP, BRS-S, CLC

Although children with health and developmental challenges are at a higher risk of developing feeding problems, all children are susceptible to mealtime pressure. Last week’s post discussed the fact that mealtime pressure or a focus on healthy eating can actually backfire by creating more stress around mealtimes and food intake, resulting in even greater discord around food.

However, it is also a parent’s job to provide healthy foods and develop appropriate limits and expectations for their children. Navigating that balance can be extremely difficult. Here are a few questions to ask yourself to determine if you are bringing greater stress to the table.

1. Do I talk about anything besides food and eating at mealtimes?

2. Do I have a mental tally of the number of bites my child has eaten during the meal or over the day?

3. Do my childrens’ books and toys tend to focus on food and healthy eating?

4. Do I spend more time looking for recipes or foods to tempt the picky eater(s) at my table than I do reading them stories or playing with them?

5. Do I find myself saying “take a bite,” or “eat your food” more than 5 times per meal?

6. Do I bribe my kids to eat or to eat certain foods?

7. Am I the only one who can feed my child “the right way”?

8. Do I cheer or clap at every bite to encourage them to eat another?

9. Do I focus so much on intake that I don’t allow other people to enter the room, talk, or do anything that might “disrupt” the flow of eating?

10. Do I know the calorie and nutrition information of any food that makes it to the table?

If a number of these sound true for you, it is likely that you are contributing to the mealtime stress. This week, take a look at your mealtime behaviors and put yourself in your child’s place. Does it feel like you are trying to sell something? Would you want to listen to you if you were seated together at a dinner party? Too much focus on food, even praise, can have a negative effect. If you can’t stop thinking about it, it probably shows. Next week we will look at some things you can do to protect your child from your stress about food.

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March 13, 2017

New Sleep Guidelines: What are they?

By Tracy Magee, MEd, CCC-SLP

In October 2016, the American Academy of Pediatrics AAP released new recommendations regarding safe sleep for babies up to 1 year of age. Here are some of the suggested guidelines:

1. Remember your “ABCs”:

  • A is for Alone. The baby should sleep alone in a crib or bassinet.
  • B is for Back. The baby should always be put to sleep on his/her back.
  • C is for Crib. The baby should always sleep in an uncluttered crib (no loose blankets, no bumpers, etc.).

2. Sleeping Environments:

  • Research shows that it is safest for a child to sleep in his/her parents’ room. The guidelines recommend at least 6 months to a year. It is suggested that sleeping in a bassinet or co-sleeper (and not in the parents’ bed) is safest.
  • A baby should never sleep on a couch, as the cushions are not firm enough to keep the baby safe. The baby can easily fall or get wedged in between the cushions.
  • Make sure the child is sleeping on a firm surface/mattress.

3. Other ways to keep your baby safe during sleep:

  • Using a pacifier during naptimes and bedtimes
  • Keeping a fan on in the room during naptimes and bedtimes
  • Limiting baby’s exposure to secondhand smoke and adults that have been using drugs or alcohol

One of the newest developments with these guidelines is that fact that the AAP recognized that many parents could be so exhausted that they might fall asleep when feeding their baby. The organization suggests that the parent should sit on his/her bed with no loose bedding if they feel there is a chance that they may fall asleep. This is the safest location for the child if this scenario were to happen. Of course, as soon as the parent wakes, the baby should be placed in a crib or bassinet.

At Spectrum Pediatrics, we recognize that the choices about where your child sleeps are very personal to your family. Please take these recommendations when speaking with your pediatrician. Together, the doctor and your family can determine what is the best sleep setting for your specific child!

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