Monday, April 10, 2006

The Case for Tummy Time

My wife and I are lucky enough that we live within 40 minutes of both sets of grandparents. They are also excited enough about our little Squirt that they will alternate being our daycare. We are truly blessed. They visit often, bring goodies and give us needed respites. As baby novices we've tried to glean some tips from those that have weaned us. I mean we turned out okay didn't we? What we've realized is what they were taught flies in the face of what we read in the baby books now. They are all about formula and were floored when my wife popped her hulking mammaries into Squirts mouth. They keep pulling him out of swaddles and undoing his wrapped hands, so he can be free. They wanted to sleep him face down.

This information coupled with the stories of our friends leads me to a bold prediction. Our friends have one year olds who with the flat hammerhead syndrome from laying in one position all the time and who can't crawl or sit up because they are always on their back. I speculate in 10 years, the American Academy of Pediatrics will recommend side sleeping or maybe suspended animation sleeping (Mike Jackson's chimps are ahead of their time.)

Don't get me wrong I still sleep Squirt on his back, although he always ends up on a side. It just seems to me that so-called baby experts know a lot less than they pretend. Take Dr. Karp with his 5 S'S - cute marketing gimmick. I have the book and watched the DVD more times than Do the Right Thing, my favorite movie. I practiced the 5 arts and feel pretty adept at them. But he wraps so tight that I'm sure earlier generations would call it being bound and tied. His head jiggling as shown in the DVD would amount to shaking for other pediatrians. His shushing in the ear is comes pretty close to I'm going to blow off your eardrum until you shutup. And then my ultimate question is yes, I can usually quiet my baby with his techniques - but then what? It NEVER puts him to sleep - just in this dazed/what the hell is going on/deer in headlights calm that lasts at most a matter of minutes. The same thing happens in his video.

So I've decided on serious tummy time for our munchkin: on my tummy, on the bed, in his pack n play, and his crib. He struggles and will eventually cry but you can see him get stronger and smarter as he tries. I'm all about physical activity - I see too many of my middle school students live on a diet of flaming hot cheetos and Code Red Mountain Dew. The back is just preparing him for the couch. The couch is a carb(thanks KP). Formula from a bottle prepares him for the the fast food nation. Work that nipple honey, go get it. So when he's out grown the breast, I'm just gonna spray some milk on the table and he'll go lick it up.


thisislarry said...

with our first, we were back sleepers all the way, straight down the AAP path. It was horrible. He just could not get comfortable, and suffered from night terror as he got older.

with our second, we said 'screw the AAP' and went tummy down. bliss. well, as much bliss as you can get with an infant.

now our 2nd is much more comfortable sleeping than our first is. How much is personality and how much is sleeping positions I dont know (and how much is anal-retentive asian parenting aimed at the first-born?)

papa2hapa said...

My recommendation for anyone with a newborn is co-sleeping. Don't believe any of the "omg don't do it you'll roll on top of the baby" crap. The only cases have been with people who were seriously overweight (so if you are, reconsider) or people who were drunk.

Since I'd imagine most of us here are fairly responsible daddies I'd recommend co-sleeping. You can make a little nook in your bed, or put the crib next to the bed so both mattresses are level. This way, if you breastfeed (I highly recommend) you don't have to wake up in the night to feed the little one. Also, since the time it takes you wake up, to respond to the baby if the baby is in the other room, you'll actually be letting the baby sleep longer and more soundly. The baby won't have to wake up to cry as much to get you to notice she needs something.

The whole back sleeping thing is a mystery to me. The Noodle slept tummy down all the time and is fine. A lot of kids lay on their backs and are have to do what works for you.

La doctora said...

Since the education campaign to put babies "Back to sleep" started in the mid80s, the rate of Sudden Infant Death Syndrome has been cut in half (see this reference This lower rate of SIDS is partially why this generation of parents may not know what the deal is about sleeping on the back-- it works-- don't take chances. If you support "Breast is Best" then the evidence should lead to believe that "Back is Best" too.

papa2hapa said...

I agree that the SIDS campaign has helped in reducing the risk of SIDS, but back sleeping is not the only reason why the rate of SIDS is in decline.

As per more recent article:

Medical examiners, coroners and others charged with determining cause of death have been classifying more of the mysterious infant deaths as by suffocation or from unknown causes rather than from SIDS, which itself is a general term for unexplained infant death.

“There’s been this general feeling out in the community of pathologists and people who certify deaths (of) reticence to assign SIDS as the cause of death,” study author Dr. Michael Malloy of the University of Texas Medical Branch in Galveston said in a telephone interview.

the study, which was published in the academy’s journal, Pediatrics, concluded the reported 9 percent decline in SIDS deaths between 1999 and 2001 -- the last year for which data was available -- may not be valid.

During the same three-year period the overall infant death rate remained stable while deaths attributed to suffocation or unknown causes rose, indicating blame was shifted away from SIDS, Malloy wrote.

The other steps they tell people to take is not to smoke, not to allow stuffed animals in the bed, to not allow soft materials in the bed, to have tighter fitting pajamas, and to keep the temperature cooler.

Therefore, we can't assume, nor can we not assume, that back sleeping is the only way to go. I'd say that half the time the Noodle slept on her back, she'd eventually roll over and get on her tummy.

papa2hapa said...
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papa2hapa said...

Another interesting article of note from the American Academy of Pediatrics.

Our interest in whether breastfeeding in the bedsharing environment might reduce vulnerability to SIDS stems in part from the unexplained observations that SIDS rates can be much lower in societies or cultural groups that practice forms of parent-infant cosleeping often with breastfeeding such as in Hong Kong,1,2 Japan,3 and areas of London in which recent Bangladesh immigrants continue the custom of cosleeping.4-6 Moreover, that close proximity to parents during sleep contributes to these low SIDS rates in these countries is suggested by the New Zealand study cited by Hauck and Kemp in their critique. Infants who slept in a room alone were nearly four times as likely to die from SIDS as infants who shared a room with adult(s), but this protective effect did not generalize to room-sharing with siblings.7 This suggests that an active role by an adult caregiver is necessary before cosleeping (and/or bedsharing) can be beneficial, a finding consistent with our hypothesis.8,9

Furthermore, the recent increase in SIDS rates in Japan, which has been paralleled by a shift from a tradition of social sleeping to solitary sleeping, also supports a potentially protective role of parental proximity during sleep.10 Amongst the Pacific Islanders, who commonly bedshare, SIDS is lower than any other group in New Zealand, further suggesting that at least under some circumstances proximity to the parent(s) during sleep may be protective, as we are proposing.

daddy in a strange land said...

I think by the time a baby is physically able to roll around in its sleep to change postion (from on the back to on the front, say), we're talking about a different developmental stage. The anti-SIDS back-sleeping recommendations, from my layperson's understanding, are first and foremost about the initial time when the baby basically stays in the position you put her/him in. This is not the same for all, and I'm sure some of you have infants who thrashed about from the get-go, but The Pumpkin definitely had a period when she stayed where she was put. And discomfort from acid reflux or whatever was alleviated, at that stage, not by putting her on her stomach but by elevating the mattress under her head. (And none of this is to discount in any way the personal choice to co-sleep, but that's a different issue from solely the back-sleeping one.)

Davita said...

I've never experienced the flat head thing. Both of my kids were put to sleep on their backs. We're all about back sleeping, breastfeeding, co-sleeping (in the bed and in a bedside cosleeper), and tummy time. You do what is best for you. There are studies out there to support any parenting theory that you may believe in. The bottom line is that doctors can say this warn that but it is you that has to live with the endng result. Whether or not you put the baby to sleep on his back, you should still give him tummy time during the day. I think a lot of parents miss that tummy time is extremely important. I can't quote anything (it's been awhile) but I remember reading from multiple sources that on the tummy has the greatest sensory in take. It is key to neuron development and somewhere I read about autistic parents reporting a lack of tummy time during infancy.