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Friendly nursing versus the reality of everyday life!

Date: 2022-08-31

I meet parents of toddlers on a daily basis in shops, during strolls, in the corridor of the foundation where I work, at sling consultations, or while visiting friends.

Future parents are taught in antenatal classes how to pick up their babies, put them down, change their diapers, pass them along, and put them in the car seats... However, as I continue to observe other parents, I see it is all insufficient. Learning using dolls in the antenatal school or the first sessions with the midwife are not enough, way not enough...

Why? Because parents do not know why they should do it (sic!). All the acquired knowledge loses its meaning when you have an emergency situation on board. Suddenly all the knowledge and nursing manoeuvres you know fly away, hands get tangled, the child is uncooperative and wriggling. You start thinking – I have to react quickly! What is the point of complicated tricks, when it is easier to take the crying baby in your arms in your own natural way formed by your own habits, one that is comfortable for you!

Exactly! The position might be comfortable for you, but is it also comfortable for the little one who was just born?

Before birth, the foetus had comfortable conditions: warm, tight, and dark. Everything around it was muffled by the foetal waters, and its movements were FLUENT! Let’s stop here for a second. Fluent motions mean that a baby is accustomed to slow changes of position, thanks to which his or her nervous system fine-tunes itself, and has time to gather stimuli from the environment and organise his or her body.

A baby that comes into the world still has immature defensive reactions. Rapid movements are unnatural for the newborn. At this stage of life, if you lift your baby rapidly, he or she will experience a rollercoaster effect. The Moro reflex will be activated, which affects the biochemical reactions of the brain and a significant release of the stress hormone cortisol. In order to allow babies to properly gather stimuli from the environment and process them at their own pace, you can introduce nurturing daily habits that will positively influence the newborn’s adaptation to the world. It is called neurodevelopmental care. It includes a) positioning the infant for feeding, sleeping, resting, playing, and post-feeding burps; b) proper and safe positioning in the car seat; c) position changes like lifting, putting down, carrying, and passing from person to person; d) all care routines such as changing, dressing, and bathing. Fostering selfregulation skills is also important, which is crucial for the child’s emotional development and for building a relationship with the parent during grooming. A key prerequisite for appropriate care is to take into account the current developmental stage of the toddler. This means that all activities should be closely tailored to the child’s abilities to avoid limiting the child’s developmental potential!

A child’s development is determined by the level of maturation of the nervous system. At the beginning, the nerve cells in the brain form connections at the level of the lower parts of the central nervous system. Over time, the higher levels of the brain mature until the brain controls the body at the cortical level by entering a more conscious state. Involuntary reactions quiet down and reflexes integrate. The child feels hunger, the need to sleep, and is able to signal his or her needs by crying, facial expressions, and displaying distress. With time, the baby’s motor skills and communication with the environment allow for improved functioning. A young child’s motor development is very dynamic, from week to week he or she achieves new skills but your support while building independence during this time is crucial. Be vigilant and observe your little one. If the toddler has not been controlling the head yet and you start to see the first attempts, offer support but also let the baby do the work. Let them exercise the head movement in lateral positions, carry them in lateral positions, and use their potential until you feel that it is enough to stabilise the shoulder girdle, and the baby is performing the task perfectly.

The care of the baby should be adapted to his or her developmental stage. A newborn baby is born with an embryonic position, he or she has no head control. During lifting and putting down the parent should stabilise the head. It is different for a six-month-old baby, who already has head-to-body adjusting reactions, the motor skills are more conscious and when lifting, it is enough to just hold the child firmly by the trunk. Hence, care should be flexible, and tailored to the baby’s abilities, to pave the way for his or her development and not restrict it.

What happens if you do not apply neurodevelopmental care? The child’s development is programmed by the nervous system. If you do not apply the above-mentioned care, and, at the same time, do not interfere with natural growth, the baby will progress naturally according to the development of the nervous system. The motivation to learn about the world will be the main driver for such advancement. Our grandmothers and great-grandmothers did not have a clue about neurodevelopmental care, and yet they passed on various baby care tips among themselves. Today we know that not all of their tips have a beneficial effect, e.g. tightly wrapping the entire baby can adversely affect the development of the hips, and immobilising the hands hinders self-regulation.

Primum non nocere – above all do no harm :)

Nursing practices can have a negative effect, e.g. if you support the baby’s head for too long and make the baby lazy, you delay the acquisition of head control skills. For a long time, physiotherapists, midwives, promoters of a healthy start, and baby-nursing advisers have been stating that lifting a baby by the armpits does not support the development and, instead, has a detrimental impact. And yet, that is exactly how parents lift crying toddlers.

Make sure that nursing is baby-friendly by empathising with their needs :).

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