Baby Care: Glimpses from my book

Zero to One: Growth and Development

CONGRATULATIONS!

You are now the proud parents of a healthy, cheerful and lively baby. I can imagine how you must have struggled through the past nine or ten months to bring this “bundle of joy” into your family! Believe me, there is no happiness greater than creating a new life. However, much of this happiness can swiftly turn into disappointment and disillusionment for parents who have not prepared for the hard work and the perseverance that is required to nurture the baby.

There are several issues that are of abiding concern for would be parents as well as those of you who have just drunk from the fountain of parenthood. Most of these concerns are as old as human history itself, and must have existed even in pre-recorded era. They revolve around issues like the baby’s growth, development, immunisations (vaccinations), breast feeding and weaning and management of day to day common illnesses. I shall attempt to discuss some of these concerns here in broad detail.


GROWTH AND DEVELOPMENT

A “Biopsychosocial” model of development and growth has replaced the earlier models where the argument was between “nature” and “nurture” alone. As per this model, biological factors (or genetic endowment) continuously interact with psychological and social factors to bring about net growth and development. For example, a baby endowed with genes for an eventual height of say, five feet ten inches, may not achieve this final height because of lack of love (psychological factor) or because of poverty and lack of food (social factor). Conversely, with proper nurturance and care, an orphan child may also reach almost 90 to 95% of her genetic potential.

Hence, while it may not be possible to artificially increase a baby’s height or intelligence with tonics or love even, it will always be feasible to help the baby attain her full genetic potential by properly looking after her needs and by continuously showering her with love and nurturance.

The Newborn:

Immediately after birth, the newborn baby has a quiet state of alertness. She looks around, and responds to her mother’s touch by making pleasurable sounds and slow back arching movements. If offered the breast, she will root for the nipple and begin to suck her mother’s milk. This quiet alert state lasts nearly 40 to 45 minutes, and as a mother, you are advised to feed the baby if possible during this phase. After this, the baby goes to sleep. Later on, she will be found in different states of alertness and wakefulness all through the first month.

The baby has amazing capabilities at, or soon after birth. She can see, hear and feel things around her. Her vision is 6/60, which is very poor by adult standards (a mere 10%), but with this vision, she can see her mother’s face very clearly as she suckles on the latter’s breast (a focal distance of 9-10 inches). She has a preference for seeing a human face (a roundish moving structure with two eyes and a talking mouth) and for hearing and recognising her mother’s voice and lap too.

During the first week, the baby may lose 10% of her birth weight owing to various reasons; this weight is then regained over the next seven days. After this, the baby is expected to put on 28-30 grams daily for almost the next 45 days. During these early months, she may add up to 3.5 cms/month to her body length.

Sleep patterns may be such that during the first month or two, babies may be sleeping almost twelve to sixteen hours everyday. This may consist of a long sleep of nearly eight hours, plus 3-4 naps of 40-50 minutes each in between. As the baby grows, the night time sleep may be almost constant at 7-8 hours, but she will take fewer and shorter day-time naps. Even during the night time, she may wake up for feeds, and this is perfectly normal.

Crying without any apparent reason is why most mothers get poor sleep and rest during the baby’s first three or four months. While many such crying episodes are due to what has been called “infant colic”, some babies will cry in spite of being properly fed and burped. Crying activity peaks - at almost 3 hours of crying per day - by about 6 weeks of age, and then gradually declines to 1 hour or so by three months of age. On the other hand, involuntary smiling is also seen in one-month olds.

Sensory achievements include recognition of mother’s voice, smell of mother’s milk, gazing pleasurably at mother’s face while suckling and conveying the felt feeling of “trust” in the mother’s ability to look after her urgent (hunger, wet nappy)as well as non-urgent (desire to be cuddled or burped or just carried in the arms) needs. The moment the baby sees her mother approaching her, her crying ceases and she will look expectantly, awaiting her needs to be satisfied.

Age 2-6 months:

The emergence of a voluntary smile and increased eye contact with you will mark a watershed change in your feelings for your baby. You will feel as if she is returning your love back to you. During the next 3 to 4 months, the baby will achieve many movement, cognitive and social milestones.

Between 3 to 4 months, the growth rate will slow down to about 20 grams per day. Her length will also grow less rapidly, say about 2.0 cms. / month.

The baby will begin to see objects hanging before her and will try and reach out for them, albeit imprecisely. Rolling over from the tummy down (prone) to the back down (supine) position becomes possible at around 4 months, while the reverse roll is achieved a little later at 4 ½ to 5 months of age. Head control improves, so that the baby can be made to sit up in your lap to allow her to either feed from a cup, or to look around her. At the same time, her vision has improved too, and she can see a larger field as well as more depth.

Sleep patterns are almost the same as before, though the day-time naps may be reduced in frequency and/or length.

Socially, the baby is beginning to appreciate things outside the field of her mother, and gets distracted easily while feeding. The baby tries to communicate by smiling, makes cooing sounds and often laughs loudly (the so-called “belly laugh”) when tickled on her belly. She tries to “engage” an adult in a “conversation” and will try to lure the adult back to her if the former looks away.

Self-exploration is also seen from this age onwards. The baby will often “play” with her face, hands, feet or genitals. Finally, the baby will begin to exhibit emotions like anger, sadness, joy, etc., but these will get further refined after about 7 to 8 months of age.

Age 6 – 12 months:

The child’s growth slows down further, to about 15 grams/day of weight and 1.5 cms. / month of length during this period. She will begin to sit up by 7-8 months, stand with support by 8-9 months, stand unsupported by 10-11 months, and finally begin to take steps by the year end. Increased mobility means increased opportunities for exploration, increased risk of injuries and disinterest in feeding or other activities.

Around 6-7 months, the first tooth (usually the lower central incisor) erupts, and then the other milk teeth erupt over the next two years or so. Tooth development goes hand-in-hand with skeletal growth.

Your baby has now begun to clearly pick up any object within the range of her hands, and will put that object immediately into her mouth. Before doing so, she may inspect the object, pass it from one hand to the other, bang it, drop it, etc. What appears to be purposeless activity is actually a learning process for her, and will advance her understanding of the offered object(s).

By the age of nine months, the infant knows that an object that is not “visible” may actually be “hidden” and she will “uncover” the object from under a towel, or cup or whatever else may have concealed the object (such as a coin, or a marble). At the same time, she will begin to differentiate between familiar and unfamiliar people, and stranger anxiety may cause her to cry inexplicably when, for example, your US returned brother asks to hold her in his arms. She will scream for no reason, and will not quieten till you take her back from his hands.

Finally, your baby will begin to assert her independence by asking to be allowed to hold her own glass or spoon while feeding, and so on. Tantrums may also be seen as she tries to become autonomous.

Speech is in the form of babbling syllables like ma, ba, da etc. without actually knowing their meaning. Some inflections may reflect your native tongue, like aai for mother. One or two specific words may also appear and you will find them used with a specific person or object.

At this age, picture books provide an ideal context for verbal language acquisition.


See the next entry for information pertaining to the second year gowth and development!