Monday, October 29, 2012

Breastfeeding a Toddler

GI is 13 months old and "still" breastfeeding. It's not as if I expected him to suddenly stop when he turned one. I also don't have any intention of cutting him off at some arbitrary and magical age. He and I will both know when he's ready to taper off and stop. What this means is that I am now officially breastfeeding a toddler. And that is a whole new ballgame. He's no tiny baby anymore!

Toddlers have some very clear ideas about their world. They want what they want when they want it, and they will let you know in no uncertain terms if they are unhappy with your response. And when they want to nurse, you'll know about it.

Toddlers are not newborns. They don't need to nurse on demand. They can eat solid foods, drink from a cup, and feed themselves (messily, to be sure). GI can be just as happy sitting in his high chair with some finger foods as cuddled in my arms nursing. Well, almost as happy. If he's hungry, though, food will suffice for him if it's not a good time to nurse him, or if I just don't feel like it. The only time it's nurse or bust is when he's tired and wants to fall asleep, and then I'll lay down with him in bed and let him nurse until he drifts off. Sometimes it's even that simple.

Toddlers are little people whose brains are developing at an incredible rate. One of the things they start learning is the difference between need and want. At the same time, they're learning to understand an incredible number of words. You'll notice your little one start to be able to follow directions, identify body parts, look at named people, point to pictures of objects and animals you name, and so on. This is called "receptive" language, and it develops much more quickly and earlier than "expressive" language. Expressive language is talking. A baby and toddler can understand an instruction or word much earlier than he can say it. This is frustrating, because he wants to tell you something, knows there's a way to do it, but can't make his mouth cooperate.

This is where teaching him some simple signs or syllables to express his need can be very powerful. When a baby or toddler can ask for what he wants and know that you understand his desire, his frustration evaporates. When a toddler can express his need, both of you can be on the same page. Pick a few basic expressions for your toddler to use first. I imagine "nurse" or "breastfeed" will be high on the list of frequently-requested items. I recommend the following three words: nurse, eat, and more. Those three words seem to satisfy most of my toddlers' basic requests.

So, when GI started trying to pull my shirt off whenever he wanted to nurse, I knew it was time to really start to work with him on using a hand sign or word instead. I had been trying to teach him the ASL word for "more," which is a simple sign that most toddlers can manage some form of. It looks like this:

I wanted him to use this sign when he wanted more of something, instead of grunting and whining or shrieking. Whenever he seemed to want "more" of something (especially food!), I'd first ask, "Do you want MORE?", emphasizing the word "more" and making the hand sign at the same time. When he would tentatively make the sign, I'd heap on the praise ("Very good! You want MORE! You signed MORE!"), repeat the sign, and then give him more. He eventually started to catch on. He then decided that "more" meant eating, which was fine. This evolved to his making the sign for "more" whenever he wants to nurse. But that's also fine. I understand it. He understands it. And he doesn't pull on my shirt collar anymore. Instead, he signs. It's really amazing. He even signs when he's half asleep and wants to nurse back to sleep! 

I will continue to work with him on differentiating signs, using "more" in context, as well as introducing "eat" (bringing the fingers to the mouth) and "nurse" or "milk" (opening and closing the hand as if milking a cow). The other day, he learned "water" with just a few repetitions; now that he understands that making a sign is communicating a need, he is very receptive to learning more signs. The ASL sign for water is sort of making a "W" with your fingers and tapping your index finger against your mouth. His version is to tap his mouth with one finger, but he's very clear about it. Toddlers can't really make a "W" with their fingers, so you may have to modify certain signs to make them easier. You can also make up your own signs, as long as you're consistent about how you form it and when you use them. I'm very excited to have made the first step, which is encouraging a behavior I prefer and discouraging a behavior I don't like (i.e., signing a need is preferable to shrieking).

In general, if your toddler has a nursing behavior that irritates you, you don't have to put up with it. You can talk to him, tell him that you don't like what he's doing. End the nursing session if he continues. When he behaves nicely while nursing, praise him. "I like how calmly you're nursing. Mommy likes cuddling with you like this." Or whatever. When saying "no" to something, use short, simple phrases. "No bite! Hurts Mommy!" The more words you use, the less they hear.

Toddlers are notorious for "nursing gymnastics." They don't stay in one place while they nurse. Their whole body moves, except for their mouth, attached to your nipple. Toddlers will nurse in weird positions, roll around, kick, fiddle with anything they can get their hands on (like, say, your other breast), and crane their neck to see something blocked by your body. Nursing a toddler can be uncomfortable and annoying. I'm not gonna lie.

The best way to make nursing your toddler more enjoyable is to teach nursing manners. Just as you would teach him to say please and thank you, not to hit or pinch or bite others, and to share his toys, you can teach him not to bother you while he nurses. Give him something to do with his hands, like hold a blanket or toy, or wear a nursing necklace. End the nursing session if he begins a behavior you are trying to eliminate. Toddlers are smart. They'll catch on quickly that they don't get their nursies if they pinch Mommy.

If and when you do decide to wean, having already set limits will help. You can get your toddler used to your saying "no" sometimes to nursing, to being offered food or drink instead, and to limiting the length of the nursing session. You can designate a special place in the house for nursing, such as your bed or his, or a special chair, and only nurse there. Or, you can start limiting when they nurse, such as only for naps and bedtime, or only when it's light outside, or only when brother is sleeping. You can decide what methods work best for you. I'm not saying it's going to be easy, but if you give it time and move slowly, weaning can be relatively painless, with the occasional tantrum or screaming jag. But that's true of anything when it comes to toddlers! 

I have found that I can tolerate or even enjoy nursing my toddler more when I know I have a choice about it, and when I have gained some control after a year of nursing on demand. It's certainly okay to nurse your toddler on demand, if you want to or feel he still needs it, but let's admit that it's not always practical. And I'll let you in on a little secret: once your toddler figures out he can ask for it, he'll ask for it constantly. So you'll probably need to say no once in a while!

Nursing a toddler is not weird. It is not exceptional or extraordinary or "out there." It's not unusual. It's not harmful to you or him (quite the opposite, in fact!). Nursing a toddler is worthwhile. It is rewarding in a way different from nursing a younger baby. Nursing a toddler is magic for soothing a booboo or calming a tantrum or distracting. Nursing a toddler is normal, and you should feel comfortable nursing your toddler whenever and wherever you and he want to.

Thursday, October 25, 2012

Car Seats are a Nuisance

I hate my car seats. I hate using them. I hate the buckle-fest that goes on every time I have to take my kids anywhere. I hate waiting for them to climb in or wrestling my toddler into his seat. I hate moving car seats. I hate playing around with them to find the best fit. I hate that we own upwards of seven car seats for three kids. I hate that I can't just hop into someone else's car with my kids unless I lug around 50 pounds worth of car seats, too.

There, I said it.

I hate it. It's a PAIN IN THE BUTT.

But you know what would be worse?

My kid being paralyzed because he was forward-facing at too young an age.
My kid being ejected from his seat because he wasn't buckled properly.
My kid suffering internal organ damage because the seat belt didn't sit across his hips and collarbone like it was supposed to.
My kid dying because I was too lazy to use his car seat properly.

The worst words I could ever imagine hearing would be, "If he had been in a five-point harness, he would have survived." The best words I could imagine hearing in the face of a terrifying car accident would be, "If she hadn't had him buckled safely in a good car seat, he probably would have been killed."

I was talking to my mom about how I never really knew heart-stopping, gut-wrenching fear until I had kids. Just the other day, I saw a discussion about kids wrapping their seat belts around their necks out of boredom and then being choked by the belt because the seat belt locked and they couldn't unwrap it. Later that same afternoon, I looked in my rear-view mirror to see my six-year-old playing with his seat belt, and my heart just about leaped up into my throat. How timely that I had just read all about this kind of tragedy!

The thought of my baby's sweet, pudgy neck being broken because I was impatient for him to face forward means I will spend those hours finding just the right car seat with just the right fit. The thought of my three-year-old's body being flung through the windshield because I didn't take the time to tighten his harness properly means I will always double-check that he is buckled correctly. The idea that my robust six-year-old could be killed by the very seat belt that was supposed to save him means I will find a way to fit his booster seat between his brothers' car seats, or let him sit in the third row, even though it's a pain to choose between trunk space and seating in my car.

So, yes, car seats are a nuisance. They are annoying. I'm a bit sick and tired of the whole car seat era (which will be going on for quite some time, yet!). But, really, I think it's a small price to pay to keep my kids safe in the car, don't you?

Monday, October 22, 2012

Happy Birthday, NJ!

It is my oldest son's sixth birthday today. The past week or so, I've been reflecting on the last six years and how dramatically my life has changed. On this blog, I talk a lot about the impact of a child's birth, about choosing whether to breastfeed, about sleep training and car seats and other aspects of infant care, and sometimes I think it's not obvious that NJ is a big boy now. He's six. He doesn't need breastmilk or formula. I haven't just given birth to him. He's been out of diapers for years. He is still in a booster seat. And, now that my child is turning six, why do I still dwell on these six-year-old details?

After all, he doesn't remember how he was fed as an infant. He doesn't know how he was born. He doesn't know how I cried over not breastfeeding him, how I wrestled with the decision to attempt a VBAC with his brother, how my experiences with him have shaped my life. Six years have put me in a completely different place, a different mindset, and a different role than I ever imagined for myself.

At six, NJ eats regular solid foods, sleeps through the night in his own bed, showers and dresses himself, brushes his own teeth, is reasonably healthy, goes to school every morning, and talks a mile a minute. You can't tell, looking at my six-year-old, that he was formula fed. You can't tell that he was born by c-section. You won't see that I spent months of his infancy struggling with PPD because of the mode of his birth and my perceived "failure" at breastfeeding.

I remember baby NJ, and I remember giving him bottles, the pain of the c-section. But, as for him, you don't see a formula-fed baby when you look at him today. You don't see the perfectly round head of a baby delivered by c-section. You don't see the bottles or the cans of formula. That's not what makes a person. That's a year or two lived in the blink of an eye. That's not what you see when you look at my six-year-old.

What I hope you will see is a boy who knows he is loved, a boy who loves his parents and his brothers, a boy who is concerned for his family's well-being. What I hope you will see is a tall, handsome, red-headed boy full of curiosity and ideas about the world, optimistic and enthusiastic. What I hope you will see is an affectionate and talkative boy, a bright boy, an outgoing and uninhibited boy.

And he is a boy now.

He is no longer a floppy, perfect newborn.

He is no longer the charming infant.

Or the inquisitive toddler.

Or the bright preschooler.

Now he is a big boy. A first-grader. A grade-schooler, through and through. 

A few weeks ago, I watched him walking out of class with a friend, chatting about who-knows-what, backpack on his back, with no teacher ushering him from one place to another, unconcerned with looking for me at the gate, and I realized, he really is growing up. He's a boy, with his own ideas and interests, his own view of the world. He can come up with his own conversation topics and share his interests with friends. He is in charge of his own head, and while he still needs me to teach him right from wrong and how to behave, his opinions are his own (the occasional "right, Mommy?" tacked on to the end of a sentence notwithstanding). 

One day, I will watch this incredible child don the cap and gown and march proudly down the aisle to receive his high school diploma. One day, I will (G-d willing) see him wed under the chuppah. One day (G-d willing), I will weep tears of joy at holding his own little red-headed baby, who will look just like that tiny baby he once was. 

And, judging from how fast these first six years have gone, I have the feeling that it really won't be long at all.

Will I, 20 years from now, still ruminate about his birth? Probably. Though long ago in the great scheme of things, the facts will never change. I will always wonder what impact the circumstances of his birth and infancy had on his health, his personality, and my bond with him. I will always wonder what might have been different. I will always feel a twinge of guilt that his brothers have gotten something that I couldn't give him. Does it mean I love him less? No. Does it mean he's not as smart as he could be? I don't see how. Does it mean he's not as healthy as he could have been? Maybe. But we can't forget to keep looking forward. Thinking about the past is only helpful if it influences how we handle future decisions. I hope that I make good choices for NJ as he grows, and I know that I will be able to provide him with the support he needs when, one day, G-d willing, he is ready to enter this scary and unimaginably rewarding adventure of parenthood.

Happy birthday, my first born. Happy birthday, my dear, dear boy. May you always look forward and take the lessons you've learned and put them to good use. May I merit to see you called to the Torah as a bar mitzvah, wed under the chuppah, and grow into a mensch.

Monday, October 15, 2012

Car Seat Rule #2: The Whys and Hows of Rear-Facing

For the second in my sometime series on Car Seat Rules, let's talk a little bit about rear-facing. (Rule #1 is here.)

What is "rear-facing"?

We hear this term a lot. "Extended rear-facing." The AAP recommends "rear-facing" for at least two years. Use a "rear-facing" infant or convertible car seat.

It's simple, really. Rear-facing means that the child will ride facing the back of the car.

What is "extended rear-facing"?

"Extended" just implies that you keep your child rear-facing longer than the law requires. In most states, the law requires that your baby be rear-facing until at least 20 pounds AND one year old. Most convertible car seats also state that you should not turn the car seat to face forward until your child is 20 pounds AND one year of age. "Extended rear-facing" means that you keep your child rear-facing well beyond the 20-pound/one-year minimum. Most organizations interested in child safety, such as the NHTSA and the AAP, recommend you keep your child rear-facing until at least two years old, or as long as he or she fits within the height and weight limits of the rear-facing car seat.

Why is rear-facing safer?

Facing backwards is safer than facing forwards because, in a crash, inertia will cause everyone in the car to continue moving forward. (The car stops, but the people inside will still be moving forward at whatever speed the car was going when the crash happened.) The occupants of the car will be held in place (hopefully) by their seatbelts or their car seat harnesses. This puts stress on the neck, shoulders, and spine of forward-facing passengers, because the shoulders and body are held back by the restraint, but the head and arms are free to continue their forward motion. In a child, this can cause severe neck and spine injuries, shoulder injuries, and even death, as the weight of a child's head traveling forward with the force of the crash can stretch the spine as much as two inches and may break the child's neck.

By contrast, if a child is facing backwards in a car seat, the whole body will be pressed back into the seat, distributing the crash force over the body and the car seat itself, which is built to withstand these forces. The child's body will be cradled by the seat and held in a normal position, instead of the head being flung forward, as it would be when facing front.

In other words, to put it harshly, rear-facing versus front-facing can be the difference between your child's escaping unscathed or being killed in a crash.

How do I install my car seat rear-facing?

  1. You may use either LATCH or the car's seat belt (but NOT BOTH). 
  2. Find the rear-facing belt path or LATCH path by consulting your car seat manual. It should also be clearly marked on the car seat itself. Make sure the LATCH strap is fed through the right path, is not twisted, and is under the car seat padding. Locate the LATCH connectors in your car in the crease where the seat and seat back meet. (There should be a little LATCH symbol on the seat where the hooks can be found. )
  3. Make sure your seat is at the appropriate recline angle, as designated by the car seat manual. 
  4. Connect the LATCH or feed and buckle the seat belt as shown in the manual. 
  5. Tighten. If using LATCH, lean your knee or hand with as much weight as possible into the seat and pull tight the LATCH straps. If using a seat belt, pull the belt all the way out until it locks, then allow it to retract as far as you can. Put some weight into the car seat and pull that seat belt tight. 
  6. With LATCH and with seat belt, make sure the straps are not twisted at any point. 
  7. Your seat is installed when you cannot wiggle it more than one inch side-to-side or forward-and-back while grasping the seat at the belt path with your stronger hand. (In other words, the seat may still move a little bit, but it shouldn't move back and forth too much. One inch of movement in any direction is the maximum.)
Where should the straps of the harness go?

Unless you have a car seat that can be adjusted while installed (such as the Britax Boulevard or Pavilion), sometimes marketed as a "no re-thread harness", then adjust the straps before you install the car seat. Recline the seat and sit your baby or child in the seat. Find the strap slots that are closest to your child's shoulders but still BELOW them. Having the straps at or below the shoulders prevents the child from sliding up the back of the seat in a collision. Unhook the shoulder straps from the metal clip at the back of the car seat and pull them out of the slots, then thread them through the correct slots. Make sure the straps are not twisted or folded. Reconnect the straps to the metal hook. Then install the car seat. As your child grows, you will need to re-thread the straps occasionally to keep up with him, so learning this process will be helpful.

How do I buckle my child in?

  1. Sit your baby or child in your correctly-installed and adjusted seat. 
  2. Make sure his bottom is all the way back against the seat. 
  3. Put his arms through the straps and pull the crotch strap up between his legs. 
  4. Fasten the buckles of the harness and tighten the harness* until you cannot pinch and hold a fold of the strap at the child's collarbone. The straps should be tight, like a hug, but not uncomfortable. If the straps are too loose, your child could be ejected from the seat or not be restrained properly in a crash. 
  5. Now buckle the chest clip (if your seat is equipped with one - nearly every seat on the market in the U.S. has one; European seats do not). Place the chest clip in line with your child's armpits. (See Car Seat Rule #1 for more information on using the chest clip.)

*For most modern car seats, you tighten the harness by pulling on the long strap that comes out of the front of the car seat. To loosen the harness, press the button or pull the lever near where this pull strap emerges from the seat and tug on the harness to loosen it. Consult your car seat's manual for instructions on tightening and loosening the harness. Most car seats are similar and straightforward when it comes to tightening and loosening the straps.

How long can my child rear-face?

A child can stay rear-facing until he reaches the height or weight limit of his car seat. Many, many convertible car seats these days have a rear-facing weight limit of 40 pounds or more. My 3.5-year-old, who is above the 50th percentile in height and weight, is only 33 pounds, to give you an idea of how long that could be. A seat is outgrown by height for rear-facing when the top of the child's head is within one inch of the top of the car seat shell when seated in it properly.

Don't worry about your child's legs being "scrunched" or "squished" up against the back of your vehicle seat. Legs bend. Children will adapt, by crossing their legs, resting their feet up high on the back of the seat, or draping their legs over the sides of their car seat, and be perfectly comfortable. And even if, G-d forbid, you are in a crash and your child's leg breaks, a broken leg is a much less severe injury than a broken neck. For the record, there are no documented cases of a child suffering leg injuries as a result of being rear-facing in a car accident.

This YouTube video clearly (and tragically) illustrates the dangers to a baby's neck and shoulders if front-facing in a car accident.

Friday, October 12, 2012

Sleep: 13 Month Update

I thought I'd update you once in a while on GI's sleep patterns, in the hope of creating a sort of historical record of sleep his evolution. My previous sleep posts regarding NJ and SB (part I, part II, part III) were based largely on my own fuzzy memories and the occasional LiveJournal post I had made when in the moment and wanting to scream (or rejoice).

A couple of things I know for sure are different this time:
1) SB was O-U-T out of my bed around 12 months. And then back in. But also out. His crib was in NJ's room, and I at least attempted to get him to sleep in there for the first part of the night.

GI, on the other hand, is still sleeping with me every night. His crib is snugged up right next to my bed, with the side off, because I had intended to at least try to scoot him over into his own space after nursing him. That...didn't work, but moving the crib or putting the side back on or any other option just seemed like too much trouble. At least it acts as a safety net should he roll off in that direction. It also acts as an excellent place to store clean laundry, hang wet things, and toss various items into when I don't have anywhere else to put them.

2) SB and NJ both had a bedtime by this age. We had a bedtime routine, I was consistent about bedtime, and both were down and out before 8:00 p.m.

GI, by contrast, hasn't settled into a predictable sleep routine, despite my efforts. He participates in the bedtime routine, including having a nightly bath, being with us while we read books and do the bedtime Shema, and he happily waves "night-night" and comes to my bed to nurse. This does not always translate to falling asleep, though. He seems to have an alternating schedule that goes something like this:

a) He's tired in the morning and takes a one to two-hour nap around 10:00 a.m. He is then extremely tired by 4:00 or 5:00 p.m., and my choice is to either put him down for a second nap or lose my mind because I have an overtired toddler following me around and screaming. I usually choose the former, and he sleeps for about 45 minutes and is up to eat dinner with us around 6:00. He is then not tired until after 10:00 p.m., but goes to sleep very easily at that point. On these nights, he usually sleeps reasonably well (comparatively, of course), and so I tend to think this is supposed to be his sleep rhythm right now. However...

b) If he goes to sleep after 10:00 p.m. he sleeps past 7:30 a.m. and then isn't tired for a morning nap. This means he goes down for a nap closer to lunch time, or even after lunch, and usually sleeps for about two hours. This means he's tired around 7:30 or 8:00 p.m. and goes down for the night right after I finish putting his brothers to bed. This is great! He's in bed by 8:00 or 8:30! Unfortunately...

c) If he's asleep by 8:30, then he sleeps more fitfully (I don't know why) sometimes, and then is up before 7:00 a.m. This means he's tired for a morning nap around 10:00. And back to (a).

I don't quite know what to do about this strange cycle, except to force him to stay up and take just one mid-day nap. I feel like 13 months is too young to be on a one-nap routine, although it would make my life easier if it works. The problem is that if he gets overtired, he's just impossible to deal with and I can't get anything done. I have to decide between having a happy and rested baby during the day so I can get work done while he's awake (and get him down for a morning nap and work while he sleeps) or having an overtired baby at 10:00 and just deal with him until I'm comfortable with him going down for a nap. I'm leery of messing with his sleep needs just yet. I'm leaning toward giving it a few more weeks or months and seeing if it resolves itself. He may just be in a transition period going from two naps to one, and he certainly will get there on his own soon enough.

It is better than it was. For about three or four weeks in September/October, GI was sleeping just horribly. He would wake to nurse, nurse for a minute, roll away, then start saying "eh eh eh," roll back to nurse some more, pop off, "eh eh eh," nurse, pop off, etc., ad infinitum, all night long. I was losing my mind with exhaustion. And then, just as suddenly, he's back to his old ways, waking two or three times to nurse, nursing for a finite amount of time, and going back to sleep. This, I can handle. I can deal with it. I'm used to it. Sure, I'd love an uninterrupted night's sleep, and that will come eventually, but at least I know what I'm up against now.

My number one piece of advice for parents with complaints about their kids' sleep is, "Give it a few weeks." If it doesn't improve on its own after three to four weeks, then you probably want to look into making some changes, but I've found that with babies, you get about four to six weeks of decent sleep habits, then four to six weeks of horrendous sleep, then four to six weeks of okay sleep again, typically. Just when you think you can't take it anymore, it gets a bit better. And just when you think everything's great, it gets worse. So, give it a few weeks, and hang in there.

If the situation is completely intolerable, however, and your baby is over a year old, sleep "training" is always an option, but it's up to you how much "training" you can and are willing to do. There's the old "cry it out" standby, or there are gentler methods.

My plan is to slowly work for improved sleep conditions over the next year, as I did with SB.

The first step will be to get him sleeping in his own bed, in another room. To that end, we are going to get bunk beds for NJ and SB (NJ is turning six, so it seems an appropriate time) so that GI can sleep on a twin bed in their room. A twin bed, because then I can go in and lay down to nurse him at night, which won't change immediately. He's used to sleeping in a bed, not a crib, so I think the transition will work well for him.

The next step will be for him to learn that he can fall asleep without a boob in his mouth. This worked well with SB around 16 months and took only about three nights for him to understand. I will nurse him until I'm sure he's just comfort nursing, and I will talk to him about falling asleep without nursing and that he can do it. Then I will do whatever is necessary to get him to fall asleep without nursing. This may involve some controlled crying. I plan to try this around 16 months, as that seems to be a magic age, and that's when I was able to do it with both NJ and SB.

Finally, night-weaning. Once he knows he can fall asleep without nursing, I'll have to make sure he's getting enough to eat during the day that he won't need to be hungry at night. Then I'll simply have to refuse to nurse him at night. He will probably still wake for comfort a few times a night for a while, but, eventually, he should start sleeping through the night. I will have to wait and see whether this comes at the same time as full weaning or if he will still nurse during the day.

I expect that by the time he's two, he will be mostly sleeping in his own bed at night, and will hopefully be night-weaned. This is a yearlong process for me, but the ultimate goal is that everybody gets to sleep at night and that bedtime is not stressful or scary.

Monday, October 8, 2012

The Daycare Dilemma

I had a woman ask me if I felt there was a difference between kids who stay home until they are old enough for preschool or kindergarten and kids who are in daycare from infancy or toddlerhood. It was a friendly and sincere discussion, not at all judgmental, and she confided that she likes to ask other mothers' opinions because, in a way, she wants to justify to herself her decision to keep her kids home with her until they're three.

My oldest, NJ, has been in some form of daycare or school since he was four months old. My other two have never been in any kind of daycare or school, except for the four weeks SB spent in a preschool summer program in this past July. I hire the occasional baby-sitter or mother's helper, but, for the most part, SB and GI spend their lives, morning, noon, evening, and nights, with me.

I can't speak much for GI yet, because he's just 13 months. But I can talk about the older two. NJ and SB are very different people. They play well together and love each other and each has traits from both parents, but their personalities are really quite different. NJ is more like his dad, while SB seems to be taking after me. Both are bright, verbal, funny, and enthusiastic. Both love to learn, are curious, like to experiment and figure things out, and like playing with friends. Both are cuddly and affectionate. NJ is less self-driven, more dependent, and likes to be in control. He talks a lot and is fidgety. He asks a lot of questions and insists on being right. He jockeys for attention, likes to be in charge, but also strikes me as a little bit insecure. SB is more independent, more likely to go off and find something to do. He's confident but not bossy. He has trouble sharing (but what 3-1/2-year-old doesn't?). He tells stories and speculates aloud about things. He has more self-control and is less talkative than NJ, unless he's competing with NJ for attention. He has fewer playmates but craves their contact ("Can we go to S's house? Can I play with Y?").

How much of these differences are simply their personalities, what G-d gave them and what they inherited from us, and how much are due to their school/daycare experiences?

I don't know.

I think NJ would be more secure in himself and be able to play more independently if he had been at home with me and had had to entertain himself more. I think SB would know a lot more and have had more stimulation and be less bored if he were in preschool. On the whole, though, I'm not sure that it made a huge difference in their development.

I think the difference lies in me. I think I am different as a parent.

When NJ was a baby and toddler, he was out of the house for a good chunk of my day. I had the house to myself and could get work done and run errands easily by myself. I didn't have to deal with a fussy baby or a whiny toddler most of the day. But, when he was home with me, on a day off from daycare or when he was sick, instead of knowing how to enjoy him and spend time with him, I resented his interference in my daily routine. I didn't know how to balance work and baby, and it was hard for me to let go of the need to produce in my day job.

By contrast, SB was with me all the time. I had to learn to balance work and baby, because I had no choice. It wasn't easy, and I found myself in the same cycle of resentment, where the baby would be fussy and clingy and needy right when I had tons of work to get done. NJ was still at daycare, so I only had one child to deal with, but it was definitely an adjustment. Slowly but surely, I got better at letting go, working at odd times, and simply spending time with my baby.

The result is, I think, that I know SB and GI better than I know NJ. I understand them, I understand their needs and how to handle them. And they have the stable foundation of always having Mommy to run back to.

So, do I think there's a difference between "daycare kids" and "stay-at-home" kids? Yes. But I don't think one is "bad" and the other "good." I don't think there's a "right" choice and a "wrong" choice.

I think it's very healthy for kids to be home with a parent when they are young. They learn that they can depend on you, they learn your values, they learn how you spend your day. They learn important life skills.

I also think it's healthy for kids to be in a setting where they have contact with peers. A child isolated at home with a parent will be bored, will not learn to play nicely with others, and will crave stimulation that he's not getting. It's important to take advantage of a young child's desire to learn and ability to absorb information and establish a foundation of knowledge for when they do eventually start school. I think a parent who is overwhelmed by being with her kids all the time will not parent effectively, will be burned out and jaded, and might not give her child everything he needs.

There are extremes, of course, of parents who never see their kids or kids who only ever see their parents. Neither is of these situations is healthy. A balance is important. If a child is home all day, then it is the parents' responsibility to find some kind of group situation, such as a playgroup, class, or part-time preschool or daycare program, or to set up playdates with the child's friends. If a child is typically in a daycare or preschool situation all day, then it is the parents' responsibility to spend as much time as possible with them in the mornings and evenings and on the weekends and holidays so that the child learns he can depend on his parents and so that the parents understand their child.

Now that SB is approaching four years old, though, I can see his need for more stimulation that I can give him. He craves knowledge, and I can't teach him everything he needs and wants to know. And now that NJ is approaching six (his birthday is in two weeks!) and is in school all day, I can see that he needs me more, for grounding, stability, and discipline. I can't meet SB's needs all by myself any more, but I can - and must - be there more for NJ.

Looking forward to when GI is three or so, I can see that he, too, will need more than just Mommy all the time, but I can also see that, right now, Mommy is his greatest need. I hope that as he grows, I will be able to find that balance with him and that NJ and SB can benefit from it as well.

Friday, October 5, 2012

Guest Post: On Raising a Special Needs Child - "Welcome to Holland"

For this second in what I plan to be a series of guest posts, Aysha Tapp writes about the challenges and triumphs she faces in raising her son, who has cerebral palsy. It is hard for those of us with "typical" or "normal" children to understand what it's like to know that your child isn't going to develop along the same timeline as your friends' kids. Aysha describes the highs and lows of parenting a child with disabilities and shares a poem at the end that she feels best expresses how her life has changed since the birth of her son.

Raising a child with a disability is one of the most difficult and most rewarding things a person can ever go through. 

My son is two and has cerebral palsy. He got stuck during birth and lost oxygen. After what seemed like forever, but was probably only 2-3 minutes, the midwives had broken his clavicle and pulled him out. He wasn’t breathing, was a whitish-purple, and had a very weak heartbeat. For the first thirty minutes we did not know if he was even alive. After two days, we were told that, on a scale of 1 to 10, where 1 was completely normal and 10 was in a wheelchair unable to eat or speak, he would be an 8. We were devastated. We had spent nine months preparing to have this perfectly healthy baby boy. My husband dreamed of playing baseball and soccer with him; I dreamed of helping him with his first steps and playing with all of his other friends. All of those dreams came crashing to a halt in a matter of minutes. We felt so alone and devastated. We had friends tell us that “all babies develop on their own time scale,” and it frustrated us. I wanted to scream, “How can you say that?  How can you possibly understand?” It became a white elephant in the room isolating us from our friends, and we knew they were tired of us talking about it. Since then we have worked very hard, through therapies and surgeries, to get him to be able to do the things we were told he would never do. He started eating when he was 2 months, started pulling himself up at 2 years, and can say two or three words as well as saying about 10 in sign language. 

He is still nowhere near “normal” though. We had to get a handicapped sticker for our car because, even though he is only two, and a lot of other parents carry their two-year-olds, he cannot stand or sit on his own, and there IS NO putting him down while I do something else. We had to get a handicapped stroller for him, which looks like a wheelchair but without the giant wheels. As happy we all are that he has it, it’s still one more thing that makes us different, and it’s one more piece of hope gone.

The hardest thing to deal with is the obviousness of his disability as he gets older. When he was a year old it wasn’t so unusual that he wasn't walking yet. At two years, it feels pretty bad. He gets really frustrated when we are around other kids because he wants to be doing the things they are doing, but he can’t. He can’t play on a playground or slide down a slide without my help. He can’t get on a riding toy, or off a riding toy, or continuously on and off a riding toy, without my help. I have to be there for him in order for him to play with anything that isn’t on the floor. It is frustrating for him and frustrating for us as parents.

One of the awesome things is what the brain does in a situation like this. When faced with an injury where parts of the brain are severely damaged, the brain overcompensates in other areas. He is smart - like, really smart. He is testing cognitively as a three year old while his motor skills are stuck at 12 months or less. For example: He figured out how those singing greeting cards work after he intentionally took one apart (he was 16 months at the time). That was annoying. His brain is working to figure things out, but his hands and body won’t do what he wants them to do. He. Gets. So. MAD. So mad. A lot. As his mother, I am not sure how to help him. I don’t want to overcompensate by doing things for him, but at the same time I still want to help him. Where is that line, and have we already crossed it?

As difficult as it can be, I honestly believe people who do not have the experience of having handicapped children are missing something special. They don’t know what it’s like, on top of everything else a normal person does in a day, to go through hours of therapy every day so your child can do a simple task. You learn to celebrate the little things that most children breeze through. When our son drank from a straw for the first time we cheered and just about threw a party!! After three months of intensive therapy, bribing him with milkshakes and other yummy treats, he finally got it, and we could move on to the next thing. It was so beautiful! We have a bottle of champagne set aside for the day he walks on his own, which we probably won’t be opening for a few years, but I know it will happen someday. We have to know he will, because we can’t show him how to doubt.

It’s not easy having a disabled child. You break down, you feel hopeless, you blame yourself, and you isolate yourself from your friends. You get inducted into a new group of people who are thrown together through unfortunate events. When A was first born, someone I knew sent me a poem. It’s the best way I have found for describing what it feels like to be a parent of a disabled child. It still makes me cry. I'd like to share it with you.

Welcome to Holland
By Emily Perl Kingsley

I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this......

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."

"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."

But there's been a change in the flight plan. They've landed in Holland and there you must stay.

The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."

And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.

But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.

If you would like to write a guest post for Jessica on Babies, please email Jessica at jshaham (at) gmail (dot) com with your topic. See this post for subjects we'd especially like to see covered and for additional information on guest posting. You retain all rights to your article and may repost or re-publish in other venues if you desire. Posts will be proofread and edited only for minor grammatical and spelling errors or for clarity.

Tuesday, October 2, 2012

What Did the Cave Babies Do?

Whenever I watch a baby working on a new skill - crawling, pulling up, walking - or imitating the behavior of the people around them - pretending to talk on a phone, pressing buttons on the remote control, taking the car keys and waving bye-bye - I try to imagine their "cave-baby" ancestors in the same stage of development. (By "cave babies," I mean the babies of humans living in more primitive times or in earlier stages of evolution.) Cave babies didn't have little carts with wheels to push around when learning to walk, but I bet you they pushed something around to learn to walk. I like to picture a little naked cave baby pushing a log or something around, or hanging onto their parents' legs or fingers and taking hesitant steps. I imagine a cave baby bear-walking across the cave to a big boulder or stack of firewood and pulling up to standing while his parents look on and applaud. Or what about the little cave toddler waddling about with a miniature spear or bow or collecting basket? How cute is that image?

We have all these modern devices to help babies develop. We have walkers and jumpers and sleep positioners. We have ball popper toys to entice them to run around and catch things. We have knee pads for babies who don't like to crawl on hard floors. We have videos and CDs intended to help babies' brains develop. We have special potty seats and training pants for helping them learn to use the bathroom. It's not that I'm saying that some of these aren't great inventions (although I don't think all of them are great inventions), it's just that sometimes I wonder, how in the world did babies in more "primitive" times ever learn to walk, talk, play catch, or develop skills they'd need to live, without all these modern devices?

When GI takes my car keys and waves bye-bye, I imagine his cave-baby counterpart grabbing his mother's digging stick and poking holes in the dirt. When GI pushes a chair around the house, I picture little cave-baby-GI toddling around pushing a storage basket. When GI proudly holds a vacuum cleaner attachment up in the air, I see the cave toddler happily hoisting aloft his daddy's spear.

Babies will figure out how to get where they need to go. The stages of development are hard-wired. They'll learn to walk and talk and play. They'll imitate their elders, dabble in various skills, and make mischief no matter what kinds of modern devices or boulders and spears we provide them with, as long as they have people to follow around and imitate. (Not that I'd let my baby play with a spear, obviously.) People worry so much about how to teach their babies to do what they already want to do. Assuming they're typical babies, they'll learn to sit and roll over and walk and talk without the need for any kind of fancy devices, specially designed toys, things with buttons that "encourage" babies to talk, things with wheels that help babies walk, or things that dangle bright objects enticingly out of reach to excite babies into rolling over. Sure, these items are fun to have, and someone invented them for a reason, but, really, what did the cave babies do? Did they not learn to roll over, sit up, crawl, walk, and talk? They must have, since they grew up and had babies of their own, or we wouldn't be here!

I like the notion of mischief-making cave toddlers, finding a basket full of freshly-collected vegetables and pulling them all out, trying to put mommy's foot coverings in the fire, burying the rabbit intended for dinner, hiding in the bushes when out gathering, trying to climb into the collecting basket... all the types of things today's toddlers do, but with a cave-baby twist. I think all babies are in some ways the same, and they have probably gotten into some of the same kinds of trouble since time immemorial.

What amazes me is how babies really do imitate what they see. While the cave babies may have mimicked their parents making a fire or skinning a rabbit, today's babies are learning modern skills by copying their parents' activities. A baby whose mom is on her cell phone a lot will pretend to talk on a cell phone. A baby whose parents watch TV a lot will sit and stare at the TV, remote in hand. I suppose this is really a lesson for all of us, that if babies will imitate their parents' behaviors, we probably want to make sure we're behaving in a way we'd want to see them emulate.