Posted tagged ‘development’

Can sitting or standing hurt a young baby’s bones?

May 2, 2016

The Pediatric Insider

© 2016 Roy Benaroch, MD

Desiree wanted to know: “Is it true that putting an infant (2-4 month old, before they can sit unassisted) in a sitting position can damage their spine? I’ve read posts by people about this but don’t know how much truth there is. Assuming child can hold head up enough to be able to ‘sit’ on someone’s lap or on a sitting device for relatively short periods of time? Is there a limit to how long this should be or that it becomes dangerous?”

Little babies love to master new things. And they have fun doing it, too—their eyes sparkle when they learn to stand in your lap, or when they sit up with a little help to see the whole world. When they’re lying down on the floor or their bed they can only see the ceiling. Where’s the fun in that?

Their little minds and bodies are made to grow and develop and try new things. Spending time on their tummies helps babies develop muscles in the front of their chests, and helps practice the coordination to lift their heads and look around. Time sitting up exercises different muscles, too. And bones themselves grow and develop based on the stresses and loads that they feel—so, yes, standing up is a good thing to help babies grow stronger and more confident of their skills.

A few caveats – keep a little common sense in mind. Those gizmos that help babies sit up are fine, but not if you put them on top of a table or counter. They can still topple out of them, so never use them on a raised surface. Also, a baby has to be able to hold his or her head up unsupported to stay in an upright position.

Is there a limit to how long babies should try these new positions? Sure – let the babies tell you. If it starts to hurt, they’ll get upset, and that’s when you’ll pick them up or move them or try a new activity. If bones are being “damaged” by the stress of a new activity, they’ll hurt, and you’ll know it. That’s why people feel pain when they should stop doing something. Babies are very good at telling you when something hurts.

They’re also very good at telling you when they’re happy. So help your baby learn new things and try new ways of standing, sitting, and getting around. Have fun!

This is a baby

Just say no

October 14, 2009

The Pediatric Insider

© 2009 Roy Benaroch, MD

Here’s a request from Rhonda: “I was wondering if you could post something about negativity in children. I am sure I can’t be the only parent dealing with a child who can’t help himself from constantly complaining and using negative talk all day long. It’s exhausting to live with someone who sees the glass as always half empty.”

Negativity is a behavioral “rut”—a way of looking at things or doing things that tends to reinforce itself over time. If you or your child acts negative and says negative things often enough, soon you’ll find that a negative outlook is the “automatic” response.

I’ve written about one good approach to getting out of a negative rut before, a method I call “The Greenies.” That works best for ages 3-7 or so, and can be a great way to develop positive habits for both parents and children.

Also, look at your own way of communicating. Are you saying “no” a lot to your child? Parents of toddlers probably say no hundreds of times a day, and kids will pick up on that and begin to imitate it. If your response is usually “no”, your child will get very used to saying that, too.

You want to teach toddlers to communicate without whining and begging. A great way to do this is to train yourself to try to always say yes to any safe request—IF it’s asked in a reasonably nice way. What constitutes “nice” depends on the age—a friendly-sounding point and grunt is pretty nice for a 13 month old, but you ought to require a four-year-old to say “please”. Silly requests are fine (as long as they’re safe). This is a great age for kids to go to The Home Depot dressed as Bob the Builder, or draw on the walls of the shower with pudding or shaving cream. On the other hand, you must ignore any request that isn’t asked nicely. Whining, cajoling, begging, repeating, tugging, nagging—all of that gets, well, nothing.

Ask multiple-choice questions rather than yes/no questions. Instead of saying “Do you want to wear the red shirt?”, ask “Do you want the red or the blue shirt today?” Too many choices can be overwhelming, and you shouldn’t pepper your child with questions all day long, but try to phrase the questions you do ask in a way that makes “no” not an answer.

There may be particular times when negativity is strongest. Children may be more likely to act whiney when they’re hungry, or tired. It may be best to “steer clear” of your child during those rough times, to give him a chance to sort it out. You can also offer some affirmation and sympathy–“I know it’s hard to smile when you first get up. I’ve got breakfast ready for you when you’re feeling up to coming downstairs.” Don’t expect the best behavior all of the time.

When your child does whine and complain, you ought to ignore it. Don’t argue or try to talk him out of his negative mood. The interaction with you will reinforce negativity. Even a punishment is at least some interaction with mom, and that’s what kids crave. Instead, look for times when your child is positive (or at least vaguely less negative), and make sure to pay plenty of attention to him then. Reflect a positive attitude back, and you’ll get more of that positive attitude in the future.

Talk with your children

October 6, 2009

The Pediatric Insider

© 2009 Roy Benaroch, MD

Language skills are fundamental to success, and speech skills learned in early childhood are strongly associated with later cognitive development. There are many products available that claim to give a child a “leg up” on learning—special videos, interactive toys, flashcards—but a recent study supports an old notion that the best way to help your children learn to speak is to simply talk with them.

In the 2009 study, published in Pediatrics, researchers used small digital recorders worn by about 275 children to determine how many words they heard each day, how much television they listened to, and how many interactive conversations they had with adults in their lives. They also measured each child’s language performance. On average, the children in the study heard about 13,000 words each day.

The number of words spoken to the child was strongly associated with improved language skills, but an even stronger effect was seen with conversational turns—that is, the number of times adults spoke with the child, taking turns in a conversation. Television was a negative predictor of language skills. More time listening to TV correlated with fewer conversations, and poorer speech development.

Speaking to your child is good; speaking with your child is better. Tell stories, interrupt yourself for questions, and allow your child to make up the next few sentences. Encourage back-and-forth conversations. Give your child time to think and respond, and show with body language and patience that you want her to ask questions back. You’ll get some laughs, you’ll learn about your child’s world, and you’ll help your child grow.

Subtle developmental clues

November 4, 2008

A post from Day: “Dr Roy, what is considered “normal range” for a one year old’s speaking ability? My 13 month old doesn’t speak yet and this concerns me. He might babble “gagaga” but it has no meaning. I stay at home with him and every day I try to teach him words such as momma, daddy, bye bye, cat etc and he isnt learning to say them. His pediatrician told me this would be something we would address at 15 months(my pediatrician was not worried at all that he wasn’t speaking) but as a mom who sees other 12 month old’s ability I am worried. Also, he 100% understands what I am saying. I can say simple commands such at ‘lets eat’ and he knows to go to his high chair so I know he understands me. Thank you!”

From my point of view, how many words a 13 month old is using really isn’t a useful marker of how well the child is developing. Some normal 13 month olds have 4 words, some fewer; some have no words at all. There’s a lot of variability there, and concentrating on word count at this age can create a lot of unnecessary worry.

A neurologically normal 13 month old should do all or almost all of these things:

  • Follow simple directions.
  • Use gestures like waving or nodding.
  • Point to things he wants, or point to things he wants you to look at.
  • Look at things you point at.
  • Bring things to show you.
  • Show off—that is, do cute things, then look to make sure you’re paying attention.
  • Combine sounds with a melodic quality, similar to speech. Even if words don’t make sense, the overall “sound” of his babbling should sound like a monologue, with pitch and speed changes and pauses.

The easiest “milestones” to talk about and compare between children are things like when they start walking, or how many words they say at a certain age. However, the subtle things like the ones I’ve listed are far more important, and offer far more insight into how a child is developing.

Late-talking twins

May 1, 2008

Holly posted this on the suggestions thread: “My 21-month-old b/g twins were 6 weeks early, but have hit big milestones (eating solids, crawling, walking, etc.) generally on target. They are, however, a little slow on speech. We have always spoken/read to them as adults, and their speech comprehension is very good. Both have had some struggles with ear infections, and my daughter is scheduled for an adenoidectomy soon. I have read in various twin literature that speech delay is not unusual with twins, but at what point would you recommend having them tested for speech delay?”

It’s true that at least mild speech delays seem to be more common in twins—some believe they have each other to “talk to,” and don’t need to learn Mommy’s language! I’m not sure that’s necessarily true, but you should certainly see if your children are in the usual range of speech skills for their age.


She’s too young! Is puberty starting early?

April 5, 2008

I saw a ten year old girl in fifth grade for a check up this week. Her mom mentioned that she had started to develop breasts about a year ago. When I started talking about the girl’s first period, mom’s jaw dropped open. Mom had been 13 when she started—could her daughter be about to have her first period in elementary school? Why?