Baby Years

Understanding the Apgar Score

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Published September 14th 2010, in Apgar Score, Development

Your baby receives an Apgar score at one minute and at 5 minutes after birth.  This score determines how doctors will treat your baby from that moment on to ensure that he gets the best medical care possible.

The higher the score out of a possible 10, the better is your baby’s general health condition. The score usually changes from the first to the second rating.  Doctors look at the following:

Appearance/ Color :

  • 0 = blue or pale
  • 1 = body is pink, limbs are blue
  • 2 = completely pink

Respiratory Effort:

  • 0 = absent
  • 1 = slow, irregular, weak cry
  • 2 = strong cry

Heart Rate:

  • 0 = absent
  • 1 = slow, less than 100
  • 2 = over 100

Muscle Tone:

  • 0 = limp
  • 1 = some bending of the limbs
  • 2 = active movement

Reflex Response to Flicking Foot:

  • 0 = absent
  • 1 = facial grimace
  • 2 = cry

A baby who scores 7 or higher on the first scoring is considered in good health. A low score however is not necessarily an indication that your baby is unhealthy, it may just indicate that he needs some immediate special care, for example suctioning. The majority of babies score 7 or higher at the 5 minute scoring.

Remember this scoring is no indication of your baby’s long term health.  It is just a tool for doctors to decide how to treat your baby.

Month 3: Milestones

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Published September 9th 2010, in Month 3

When your baby is three months old, she should be able to:

  • Lift her head 45 degrees when she is lying on her stomach.

She will probably be able to:

  • Laugh out loud
  • Lift her head 90 degrees when she is on her tummy
  • Squeal when happy
  • Bring hand together
  • Smile spontaneously at you
  • Follow an object held about 15 cm above her face and moved 180 degrees, from one side to the other whilst watching all the way.

She may possibly be able to:

  • Hold her head up when lifted up
  • Raise her chest, supported by her arms , when on her tummy
  • Roll over
  • Grasp a rattle
  • Pay attention to very small objects.

She may even be able to:

  • Bear some weight on her legs when held up
  • Reach for a toy
  • Keep her head level with her body when she is pulled into a sitting position
  • Turn her head in the direction of a voice
  • Make vowel-consonant sounds
  • Razz – that is wet razzing sound.

What my Baby Looks Like After Birth

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Published February 25th 2010, in Baby Years, Development, Physical Development

The neonatal phase is the period that stretches from directly after birth and encompasses the first two to four weeks in the life of the child.

Contrary to most parents’ descriptions, newborns are not exactly pretty – they have a swollen bluish and reddish face, a broad flat nose, swollen eyelids and ears that seem somewhat misplaced.  Sometimes the shape of the face is misshapened due to the long path down the birth channel.  The little body is covered in a white substance, vernix caseosa, which protects the baby from infection and dries off in a few days. Some babies are still covered in fine hair, lanugo, which falls out during the first month. Newborns exhibit prominent external sex organs and both sexes’ nipples are swollen due to high amounts of estrogen in the mother’s blood before giving birth.

In addition to these features, the body proportions of newborns differ substantially from the proportion of an adult body.
The head makes up one fourth of the total body in contrast with the eighth of an adult’s. The neck muscles are not able to keep the head up at this point in time.

The average weight of a newborn varies between 2.5 and 4.5kg, with most weighing between 3 and 3.5kg.  Girls tend to weigh less than boys at birth and firstborns tend to be lighter than siblings.

Most parents experience that their infants lose up to 10% of their body weight in the first couple of days in hospital, but will regain it with a week or two once feeding is established. Boys tend to be taller than their counterparts, with the average length being around 45 to 56cm. A newborn baby’s heartbeat varies between 120 and 150 beats per minute, going up when stressed and down when resting.

The apgar-scale is used to evaluate an infant at birth.  This evaluation gets done twice – one minute after birth and again 5 minutes after birth.
A:     Appearance (Colour)
G:    Grimace (Reflex irritability)
P:    Pulse (Heartbeat)
A:    Activity (Muscle tone)
R:    Respiration (Breathing)

Each of these aspects gets scored as zero, one or two, with zero being the worst score and two the best score. The scores get combined with a maximum score of ten.  Most babies score 7 or more.  A score of 4 is indicative of further evaluation and treatment.

What my Baby Should Eat

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Published February 25th 2010, in Baby Years, Breastfeeding, Development, Nutrition

Most of the babies’ awake time is spend on feeding in the first two weeks of his life. Time devoted to feeding differs from baby to baby, but it is commonly between eight and fourteen times a day; giving the mom/caregiver breaks of between 1 and a half and 5 hours at a time.

The debate between breastfeeding and bottlefeeding is ongoing with the proponents of breastfeeding pointing out the following advantages:

  • The anti-bodies in breastmilk provides the baby important immunity against various illnesses like allergies, bronchitis and pneumonia.
  • Breastfed babies tend to have healthier teeth and are less likely as adults to develop arteriosclerosis early in life.
  • Breast milk has the advantage of being easily digested by babies and the fat in mothersmilk gets absorbed almost 100%, while on average only 80% of the fat in formula gets absorbed.
  • The risk of obesity in bottlefed babies is higher than for breastfed babies.    The most commonly accepted explanation being that babies being breast fed stop sucking when they are not hungry anymore, whilst a mom bottlefeeding might believe that the bottle should be emptied.
  • Breastfeeding is more practical – being more economical, always available and at the right temperature. This mother also does not to carry all the preparations necessary for bottlefeeding when leaving the house.
  • Breastfeeding can give the baby an extra sense of security with the advantage of better bonding.


Their counterparts believe:

  • That bottlefeeding can give a similar bond between mother and child and does not hold any negative consequences for social relationships in the future.
  • It gives the mother a feeling of physical freedom which the breastfeeding mother does not have.
  • Substances like tabaco, alcohol and medicines can be transferred to the baby via breastmilk. This will not happen when the baby is bottlefed.
  • Some mothers cannot or do not want to breastfeed.  If these mothers can bottlefeed without the negative association with breastfeeding, the bonding process can continue unscathed.
  • The threat of transferring HIV to an infant should also be considered as a potential draw-back of breastfeeding.
  • It gives the working mother the opportunity to continue with her career, knowing that her child is getting sufficient nutrition.
  • Babies can be affected negatively by certain foods, and may even be allergic, this impacts on the mother’s ability to choose food and can lead to alot of anxiety around food choices.

The group of people supporting bottlefeeding are not by any way saying that  breastfeeding is bad, they would just like more tolerance and respect for mothers who decide to go the route of giving their child formula.

Milestones for Babies

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Published February 25th 2010, in Baby Years, Development, Physical Development

The neonatal phase and baby years are the first two years in a child’s life. It is a period of rapid change physically and psychologically.  The child moves from being completely dependent to becoming more independent.  During this stage a child forms bonds with significant people in their lives – the nature of these relationships have a lasting effect on future social relationships.  During this phase the uniqueness of the individual becomes apparent. Through socialization the child learns that certain actions are acceptable while others are not allowed.

In the first two years of a child’s life he has to master certain tasks:

  1. He learns to walk.
  2. He learns to ingest solid food.
  3. He learns the basics of communication through language.
  4. He starts to learn to use the toilet.
  5. He falls into a routine of sleep, eat and interacting.
  6. He develops an emotional communication with his parents and siblings.

The degree of success attained depends largely on the opportunities the child gets and the help and direction the child receives from significant others.

My Baby's Personality

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Published February 25th 2010, in Baby Years, Development, Social Development

No two children are alike.  As a parent of two daughters, I have noticed just how unique and different children can be, even when the parents and social surroundings stay the same.  Temperament is the result of the combination of genetic and social factors that determine your child’s personality foundation.

Most parents will be able to describe their baby as one of these three temperament types:

  • The Easy Child :  This is the child whose parents walk around with a smile on their faces the whole day long.  These parents cannot fathom why other parents burst into tears from frustration and tiredness, because their baby is such an angel!  This baby is able to easily adapt to her surroundings and is generally in a good mood.  About 40% of parents are lucky enough to report their babies to be “easy children”.

  • The Difficult Child :  These parents basicly sleep walk and have dark rings under their eyes.  They often feel guilty for not enjoying their child and question their parenting abilities. This baby has irregular sleeping and eating patterns, finds it difficult to adjust to a strange environment, reacts intensely to any stimuli and cries alot.  About 10% of parents feel their child is “difficult”.
  • The Slow-to-warm-up Baby :  15% of parents report that their baby falls into this category.  This child is inactive, reacts slowly or little to stimuli and is experienced by the parents as somewhat negative.

The remaining 35% of parents felt their children had a combination of behaviour patterns.

Temperament affects the relationship between the parent and the child and as a result of that also the bonding process between them.  Three different types of bondedness have been identified:

  • Secure Bonding : This baby uses her mother as a security base from which she can discover the world.  When separated from her mother she will show unhappiness and will be delighted when reunited.  She loves physical contact from her mother, and when she comes into contact with strangers she will react positively when her mother is around.
  • Avoidant Bonding : This baby seems unaffected when her mother is around, barely taking notice of her.  She does not become upset when her mother leaves and avoids her when she comes back. She doesn’t explore her world when they are together and seems indifferent to the presence of strangers.
  • Ambivalent Bonding: This baby becomes anxious even before her mother leaves her.  When the mother does leave, she becomes extremely upset. On her return the baby behaves ambivalently – on the one hand she tries to make contact, while on the other hand she cries, kicks and hits her mom.  These babies are anxious and will not dare to explore their environment.  They do not like strangers even when their mother is present.

The way in which you bond with your baby is very important.  This is the first relationship that she forms in her life and it will affect future relationships.  The stronger the bond with the parents, the easier it will be for the child to leave her parents.  Babies also form important relationships with their fathers, siblings, grandparents and other care takers.

During the baby years, parents find themselves constantly scolding their baby and the word “no” seems to be a recurring theme.  This is the process of socialization where parents teach the young one what is right and what is wrong, what is expected from her and what is generally acceptable in their society.   The mother becomes the teacher.

Babies from as young as six months start interacting with their peers – they smile, touch and make little noises to communicate with each other.  These interactions are important in the socialization process.  Interaction between children evolves from being centered on a object like a toy to trying to elicit reactions from the other babies to being able to change roles with each other (for example giving toys to one another).

As parents we should foster our relationship with our baby and encourage positive peer interaction.  This should give her a good basis for future relationships that she will need to form through out her life.

How a Baby Learns to Communicate

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Published February 24th 2010, in Baby Years, Development, Language Development

The ability to communicate with your child through language opens up a whole new world of relationship enriching opportunities to parents.  Parents battle to understand the needs of a crying baby, but through language they can understand exactly what the problem is.  Developing the ability to use language is a complex and creative process that takes time.

Before a baby can speak, they are able to understand language.  In the process of acquiring language, a baby goes through different phases of vocalization:

  • Undifferentiated crying (from birth to one month): During this phase the baby uses crying as a call for attention.  The cry is undifferentiated, because the listener cannot differentiate between a cry indicating hunger, thirst, fear, discomfort or pain.  This tyope of cry is seen as a reflex.
  • Differentiated crying (from about 2 months): During this phase the parents are able to distinguish between the different types of crying.  The baby uses different pitches and sound patterns to indicate their needs.
  • Cooing and Babbling (from about 2 to 6 months): Cooing refers to the throat sounds babies make when they are happy and content or even excited.  Babbling refers to the repetition of simple vowel and consonant-combinations, for example “da-da-da” or “ma-ma-ma”.
  • Seven to Eight Months: The baby repeats words and sounds that he hears. This repetition is accidental or incorrect, but forms a necessary foundation for communication.
  • Nine to Ten Months: This is the phase where you find repetition of words and sounds.  Here the sounds and words are more correct and purposeful.
  • Single word sentences (from one year onwards): During this phase the baby starts saying understandable words.  He uses these words to communicate with others.  Single words are often meant to communicate complex ideas or requests, for instance the word “bottle” can mean “I am hungry” or even “I finished my bottle of milk”.
  • Use of Sentences: This is the final stage of language development.  Two word sentences is the first  sentences used, for example “Baby hungry” or “Mamma gone”.  Baby starts using more words in sentence construction, but often with grammatical mistakes.  Gradually the child becomes able to use more complex sentences to communicate with those around him.

A child of two years generally have a vocabulary of about 300 words.  At three it increases to 1000 words, at five  2000 words and when going to school he can use 3000 words accurately.  Girls tend to acquire language faster than boys, as well as children of higher social economic groups.  Intelligence also plays a role in language development.

Your Baby's Thinking Skills

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Published February 24th 2010, in Baby Years, Cognitive Development, Development

Each stage of development requires that certain tasks are mastered. Piaget, a psychologist and father, observed his own children and identified the following milestones to be achieved in the baby years:

  • Through the first two years in a baby’s life it is important to integrate perception and action. Babies learn how to use visual, auditive and tactile inputs to direct their grabbing and walking.
  • During this period the baby starts to form the concept of object permanence.  This refers to the fact that the child will keep on looking for a toy even if they cannot see it anymore.
  • Children learn to imitate and copy others.  This means that a child develops symbolic thought.

Piaget divided the first two years into 6 stages:

  • Stage 1: The use of reflexes: This period is from birth to one month. Babies respond automatically to people, events and objects in their environment through crying, suckling or grabbing.
  • Stage 2: Month 1 to 4: During this stage the infants learns how to use his inborn reflexes on the basis of experience.  Reflexes turns into learned habits.  The baby is primarly focused on his own body, but have the ability to when he accidentally discovers an action, to deliberately repeat it.The child starts to react to external stimuli and will turn his head in the direction of a sound.  The baby starts to realize there are objects outside of himself.At this stage there is no sense of object permanence, if he cannot see a toy the toy does not exist anymore.
  • Stage 3: Month 4 to 8: At this stage the baby starts incorporating external objects into his behaviour.  If he drops his rattle and hear the sound, he will repeat the action by picking up the rattle and dropping it again.Object permanence develops to the level where he is able to recognize the object even if only part of it is revealed.  If the toy is dropped he will look in the direction of where it fell and if his play with the toy is interrupted, he will return his attention to the toy again.The baby now starts imitating behaviours from others.  These behaviours are however limited to his own observable body parts and actions that he has mastered before.  He will not be able to imitate his mother’s facial expression, because he cannot see his own face.
  • Stage 4: Month 8 to 12: The child now develops the skill to execute goal oriented behaviour.  If for instance there is a bottle between him and his toy, he would be able to push the bottle out of the way and grab the toy.  He combined two actions in order to achieve his goal.Object permanence developed to such an extent that he will search for an object that he cannot see.  He wil go and search first in the place that he is used to retrieve it, even if he saw someone else placing it in a different spot.  This is because he was not responsible for that action, and remembers his previous action.At this stage imitation has developed to the point where he is able to imitate actions like facial gestures.
  • Stage 5: Month 12 to 18: This is a stage of discovery and experimentation.  The child is able to walk and therefore comes into contact with a wider world.  He is able to vary certain actions in order to observe different results.  He will for instance drop a ball from different heights to see how the ball’s bounce is affected. Through this he learns that different objects have different qualities and properties.Regarding object permanence, a child is now able to search for a toy in the place he has seen it being moved to. The child is able now to imitate behaviours that does not form part of his own behaviour repertoire.   The model has to be present in order for him to imitate behaviour.
  • Stage 6:  Month 18 to 24: Children start to develop complex solutions to problems through combining different actions that has been mastered in other contexts, to this particular problem.  They master symbolic representation.They are now also able to copy or imitate behaviour that they have seen previously.  This can be in the absence of the person they are imitating.

The period from birth to toddlerhood, shows immense development – from a child that can only use reflexes to interact, to a child that can solve problems on a concrete level.