Taking Baby Brain Science to the Streets

There certainly seems to be a lot of encouraging activity taking place in the world of early childhood these days – from campaigns such as Let’s Move to efforts dedicated to identifying high quality child care and insuring that it is both accessible and affordable for all. As a pediatrician trained in the so-called “hard” sciences, one of the most intriguing aspects of this activity, in my opinion, is the movement to effectively and impactfully take early brain science to the streets.

Before jumping ahead to some of the exciting and innovative work that’s now being done, it’s worth reviewing (in admittedly oversimplified terms) how we got here. The 1990’s were characterized by a “concerted effort to enhance public awareness of the benefits to be derived from brain research,” earning it its recognition as the “decade of the brain.” In 2000, the IOM released a galvanizing consensus report on the science of early childhood development – representing both a rallying cry and a very big next step in the brain-building movement. Aptly titled From Neurons to Neighborhoods, it served as a broad and firm, evidence-informed foundation for what we are increasingly seeing: direct connections being forged between the burgeoning brain science and what’s being done to directly promote healthy experiences and environments for all young children…on our “streets” and in our neighborhoods, our communities and across the country.

I have found that on the brain science side of the equation, nowhere is the large and growing body of early brain-based research more accessible, compelling and clearly articulated than Harvard University’s Center on the Developing Child, under the leadership of Neurons to Neighborhoods editor, Dr. Jack Shonkoff. Based on a firm believe that the science of early childhood – right down to the developing brain architecture – can be used to develop more effective policies and services focused on building resilience, developing executive function and self regulation skills, and ultimately preventing the potentially neurotoxic effects of poverty, adversity and toxic stress for those most at risk.

Adding to our increasingly deep and detailed understanding of the baby brain is interdisciplinary research being done at places like the University of Washington’s Institute for Learning & Brain Sciences (I-LABS). Headed up by renowned baby brain researchers Patricia Kuhl and Andy Meltzoff, I-LABS is using intriguing modes of dynamic neuro-imaging such as MEG (magnetoencephalography) to not only provide compelling new insights, data and images about the connecting of neurons and the mechanisms for early learning, but also collaborating with people and organizations who can quickly translate this work into real-world applications.

With respect to these “real-world” applications, The First 1000 Days author Roger Thurow captures the importance of translating this science when he states, “If we want to shape the future…we have 1000 days to do it, mother by mother, child by child.” For anyone dedicated to doing just that, it’s heartening to see just how wide a range of brain-building efforts there are now in place across the country – all dedicated to helping all children reach their full potential by directly offering parents and caregivers evidence-based brain-building information, activities and support. Whether bringing the message to families where they live – on their phones, in their inboxes, on their screens or on their doorsteps – the following are a sampling of these brain-building efforts.

Vroom. Vroom’s brain-building message is clear: Shared everyday moments, from mealtime to bathtime, can easily be turned into brain building moments, and that parents have what it takes to become master brain builders. Suggestions for fun, everyday age-specific activities meant to “spark connections” are made easily available via the free Vroom app, along with practical tips, videos and even badges of encouragement. As for future efforts, watch for everyday brain-building messages to make their way on to the packaging of trusted brands. Supported by the Bezos Family Foundation, one look at the Brain Trust behind Vroom and it leaves no doubt that the best in early brain science is at its core.

Thirty Million Words Initiative. With a name based on the 1995 landmark findings of Hart & Risley, who found that preschoolers from families on welfare were exposed to a full 30 million fewer words than their high-income counterparts, Thirty Million Words Initiative is a Chicago-based, parent-directed program that employs the power of home visitation, one-on-one and group interactions, social media, and the use of the LENA word pedometer to study, build relationships, educate and support powerful parent-child interactions and children’s early language development.

Too Small To Fail. Given the foundational importance of early language development and exposure to words, Too Small’s to Fail’s parent-directed Talking is Teaching efforts include direct-to-parent tips and resources focused on talking, reading and singing with young children that are delivered via email and also available on Twitter (@TooSmallToFail). This is a partnership between the Clinton Foundation and The Opportunity Institute meant to improve the health & well-being of America’s children ages 0 to 5 years.

Text4Baby. Text4baby is a free mobile messaging service provided by Zero to Three – an organization dedicated to advancing the proven power of early connections – in partnership with Voxiva. Text4baby provides personalized, evidence-based health information in the form of text messages for moms and babies throughout the critical period of pregnancy and the first year.

Sesame Street. That’s right…when it comes to taking early brain science – complete with its implications for both cognitive and social emotional development – “to the street,” one needs look no further than the beloved Sesame Street. Founded on helping reach all children with life-changing opportunities to learn, a Sesame Workshop – RWJF collaboration is allowing the Sesame Workshop team to study how best to create and directly deliver the brain-building resources we now know are so fundamentally important for young children’s healthy cognitive and social-emotional development. If you aren’t familiar with past contributions of Sesame to this realm, just take a look at what they can endearingly do with key concepts such as self-control (a core component of executive functions skill development) and empathy.

Tending to Tummy Time Troubles & Going Back to Sleep

Back-sleeping and tummy time are common phrases in today’s parenting lexicon. Yet that hasn’t always been the case.

The Back to Sleep Campaign – primarily responsible for the switch to back-sleeping babies and related recommendations for tummy time while awake — was launched in the mid-1990s to educate parents, caregivers and health care providers about ways to reduce the risk for Sudden Infant Death Syndrome (SIDS).

At the time, this represented a big parenting shift. Before this public education campaign, parents had little reason to think twice about putting babies to sleep on their bellies. Generations of parents routinely did so. But with compelling evidence to support the Back to Sleep campaign’s primary message — that placing babies to sleep on their backs reduces the risk for SIDS (sometimes referred to as “crib death”) – great progress was made in helping babies sleep safer.

Just how much progress? It is estimated that since the campaign started, the percentage of infants place on their backs increased dramatically while at the same time, overall SIDS rates decreased by more than half.  As far as public health campaigns go, the Back to Sleep campaign is a hands-down success, and the benefits of raising back-sleeping babies and creating safe sleep environments are as clear as ever.

What isn’t always so clear, however, is how parents and caregivers should go about compensating for all this additional time that babies spend sleeping on their backs. By compensating, I mean tummy time. Encouraging back-sleeping babies to spend awake time on their bellies can help stave off the dreaded “positional plagiocephaly,” more understandably referred to as a flat head.

This all might sound fairly straightforward, but I am routinely asked about, interviewed on, and pressed on the subject of tummy time (and the challenges it seems to pose). How much time should babies spend on their tummies? What can one do to encourage tummy time? Is there a certain position babies should be put in? What if they don’t like it?

My first child was born right around the time that the Back to Sleep Campaign was really taking hold. As a pediatrician-in-training, I was well aware of the recommendations, and my daughter didn’t seem to have any problem following them as she established herself as a very good back sleeper. The problem was that I was far more comfortable with the recommendation for her to spend plenty of time on her tummy while awake than she was. Every time I put her on her belly, she’d squawk, cry, push off with her feet, and convince most everyone around her that she was in great distress. I managed to convince myself that her tummy time displays weren’t truly those of a distressed child, so she did get in a sufficient amount of tummy time. I find, though, many parents find tummy time troubling.

Try the following tummy time tips and tricks to help take the pressure off of you as well as your baby!

  • Tummy timing: The key here is quite simple. Just remember back while sleeping and tummy while awake. Despite what you may have been led to believe, there are actually very few rules about how much time a baby needs to spend on his tummy. There’s no need to set a timer, mark your calendar or otherwise formalize what essentially boils down to a simple concept. Just make sure your baby sleeps on his back, and then I commit to trying to make tummy time your baby’s default for hours when he’s awake.
  • Make tummy time a habit. I’m well aware that this may sound like stating the obvious, but it has been my experience – both in dealing with parents and with child care providers – that laying a baby down on her back seems to be somewhat of a force of habit. That’s great if you’re talking about a baby who’s going to sleep. But if it’s on the floor or a playmat, for example, it can take a conscious  effort to switch to the routine of placing an awake baby on her tummy.
  • Understand the benefits. There’s no magic to tummy time. Simply put, until they  learn to roll, sit and crawl, babies generally spend an impressive amount of their time laying down. If all of this down time is spent with pressure being put on the same spot(s) on the back of their skull while it’s still somewhat soft and not fully formed, it’s bound to make an impression. Tummy time not only takes the pressure off, but also allows babies the ability to strengthen their head and neck muscles.
  • Tummy time entertainment. Not all babies need to be entertained in order to be coaxed into spending time on their tummies. Some are perfectly content to lay there and look around. Feel free, however, to help your baby enjoy this new view of the world by placing toys in front of him, help him prop himself up a bit on his elbows, and even lay down facing him so you can look at, talk to, and even sing face-to-face.
  • Tummy time dissenters. If your baby is a tummy time squawker, as mine was, then don’t be discouraged. Make sure you ask yourself whether your baby’s squawks truly count as cries of distress or rather of effort. While my daughter’s cries certainly had my mother-in-law distressed, in reality my squawking little newborn really wasn’t truly upset, she managed to keep her perfect little round head and build up her tolerance for tummy time while all the while mastering the skill of scooting long before she could even roll, and I have some impressive baby videos to prove it.

Originally posted on Omaha World Herald’s Live Well Nebraska

Coughs, Kids & Vaccines: Why parents are the key to silencing the sounds of pertussis!

You really don’t have to listen very hard to hear the sounds of the season – the rustling of fall leaves, the weekend cheers of husker fans, and lawnmowers out for one last run before being swapped out for snow blowers. But if you ask me, the most noticeable sounds this time of year are all of the coughs, sniffles and sneezes that predictably make their annual show of force during cold and flu season. For parents and pediatricians alike, these are familiar sounds that we learn to live with and treat as needed. This year, however, we are hearing a lot more than usual about another sound – a sound for which we should all be listening carefully: the sound of pertussis.

Perhaps you’ve heard of pertussis – also commonly referred to as whooping cough – from your pediatrician. Some of you may remember reading about it each time you received the standard set of vaccine information sheets describing each of your child’s scheduled immunizations, since the DTaP (the “P” part referring to pertussis) vaccine is routinely given.

Chances are that if you’ve been following the national news lately, however, you may have also heard that there’s a pertussis outbreak in California. In the world of infectious diseases, let me assure you that California isn’t very far away from Nebraska, and this outbreak is not just another news story about an isolated incident hundreds of miles away. The spread of pertussis in California is, in fact, proving to be the worst outbreak in 60 years, having already claimed the lives of 10 infants under the age of 3 months. If that’s not a reason to stop and take notice, I don’t know what is.

The fact of the matter is that pertussis is caused by one of the most contagious bacteria we know. The infection can start out seeming like a common cold, but over the course of a couple of weeks manifests itself as an escalating cough which then turns into coughing episodes sometimes severe enough to result in vomiting or the characteristic “whoop” sound that represents the dramatic effort to draw air back into the lungs.

While adults typically experience weeks (if not months) of a cough that just won’t go away, they don’t often “whoop” like kids do. Neither do babies under 6 months of age – a fact that increases their risk of life-threatening illness or death at a time when they can’t yet be vaccinated (under 2 months) or haven’t developed full immunity (under 6 months of age). Unable to draw air back into their lungs, babies may gasp, gag, or simply stop breathing altogether – making them the most vulnerable at a time when they are also the most at risk.

As someone committed to helping insure the health and well-being of all children, I’ve therefore pulled together some very important facts about whooping cough, who is at risk, and what each of us can do to prevent the spread of pertussis in hopes that we protect all of Nebraska’s children and adults against a sound you never want to hear at any time of the year….the sound of a young child with pertussis.

Make sure your child is up to date on his/her shots. DTap is recommended at 2, 4, 6 and 15-18 months, and again at 4-6 years. The best time to get your child protected against pertussis is the first day your child becomes eligible for each recommended immunization.

Get your adult tetanus booster. Immunity to whooping cough doesn’t last forever. Any adult (or teen) who doesn’t remember getting a pertussis booster shot, or hasn’t had one since they were immunized as a child needs to get vaccinated. The fact of the matter is that babies too young to be protected by the vaccine rely solely on all of us to not expose them. Sadly, an estimated 3 out of every 4 babies with life-threatening pertussis infection got it from a loved one. Prevent this from happening by rolling up your own sleeves, getting an adult booster shot, and doing your part to limit the spread of pertussis.

Be on the lookout for pertussis and contact your doctor or your child’s pediatrician with any concerns. It’s all too easy to mistake pertussis for the common cold at the outset of the infection, and while people are contagious for up to a month, antibiotics are of little benefit after the first week or so. Half of babies with whooping cough end up needing to be hospitalized.

Listen to the sound of pertussis. If my blog hasn’t already convinced you, or you simply want more information, watch my recent pertussis-focused CNN interview with Kiran Chetry on American Morning, go to www.soundsofpertussis.com and let Jeff Gordon of NASCAR fame convince you, or simply listen to what a baby with pertussis sounds like .

Now let’s all commit to doing everything we possibly can to silence the sounds of pertussis.

Originally posted on Omaha World Herald’s Live Well Nebraska