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Want baby to sleep better at night? Try more tummy time, say researchers

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Long, sleepless nights are perhaps one of the biggest challenges of baby's first year, and sometimes why baby wakes in the middle of the night can be a mystery. After being fed and changed if baby still isn't dozing off, inactivity during the day could be a culprit, according to a new study from Michigan State University (MSU).

The research suggests babies who are less active during the day may also be getting less sleep at night. The study analyzed 22 healthy six-month-old infants and monitored physical activity level and sleep over 24 hours. Researchers found that babies who slept less overall in the monitored 24 hours were significantly less active during the day.

And the researchers say more tummy time during the day could mean more restful nights for baby and mama.

Tummy time refers to dedicated time during the day in which babies are positioned on their stomachs, while supervised, and encouraged to develop motor skills. The research focuses on the effect physical activity, such as tummy time, has on infants.

"While we don't have evidence yet that tummy time directly affects sleep, it increases physical activity and promotes healthy weight gain," says Janet Hauck, an assistant professor of kinesiology at MSU, who specializes in infant motor intervention research. "So, parents who feel their baby isn't sleeping enough could promote tummy time during the day to boost their baby's physical activity level."

According to Hauck, physical activity and sleep influence each other and are strongly associated with growth in older children and adults. "Our findings suggest that this association could emerge as early as infancy, a critical development period," she explains.

Put simply, babies need physical activity too, not just older children and adults. A baby who has exerted themselves physically is likely to sleep more than a baby who isn't as active, according to the researchers.

To improve sleep, Hauck suggests establishing a consistent bedtime routine and encouraging physical activity during waking hours by interacting with baby during floor activities and doing supervised tummy time several times a day.

Tummy time recommendations

Tummy time has come to be a focus of pediatrician recommendations in the last 20 years since putting babies to sleep on their backs became part of the official safe sleep recommendations from the American Academy of Pediatrics (AAP).

While the "Back to Sleep" campaign has reduced the rates of Sudden Infant Death Syndrome (SIDS), it has increased cases of positional plagiocephaly — babies with flat patches on their heads. Tummy time helps to alleviate that risk, and strengthen baby's core and arms, laying the foundation for development of both gross and fine motor skills.

Tummy time can be challenging, however, and it's not uncommon for babies to protest time spent on their stomachs. The American Occupational Therapy Association (AOTA) suggests making tummy time interactive—getting down on baby's level, talking to baby and showing baby toys.

Babies can be positioned on their tummies in short sessions throughout the day, based on baby's tolerance and needs, starting with just a few minutes a day and working up from there as baby gets stronger. Initiating eye contact, talking and singing to baby as well as arranging toys in a circle to promote reaching in different directions are all ways to make tummy time interactive and strengthen baby's core, according to the AOTA.

Placing baby on a blanket on the floor isn't the only way to achieve the benefits of tummy time. One recommendation from the AAP includes positioning baby tummy down across a caregiver's lap lengthwise while providing head support.

Side-lying is another positioning option recommended by both the AAP and AOTA. Caregivers can position baby on a blanket on their side, supporting their back with a hand or using a small rolled blanket. Parents can also start in the hospital by positioning their newborn, while awake, on their stomach or chest, and encouraging eye contact.

Other tummy time tips from the AOTA include:

  • Engage baby's senses by placing a plastic mirror in front of baby or offer differently textured blankets and towels so baby can experience different touch sensations.
  • Get the whole family involved—baby will be encouraged to lift their head, reach and play when they see faces and hear voices.
  • Read to baby during tummy time.
  • Incorporate tummy time into activities you're already doing with baby, such as changing diapers or drying with a towel after bath time.

While increased tummy time doesn't necessarily mean baby will snooze all night long, it's certainly something for exhausted parents to consider, and the benefits of increased physical activity for children of all ages could mean more restful nights for everyone.

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It's 5 pm. You just got home from a busy day at work, dinner is nowhere close to being started, and the afternoon shenanigans have taken ahold of your little ones. They need some time to decompress from their busy day and, let's be honest, you need a few moments to transition into the last part of yours, too.

Your child asks, "Mooooom? Can I watch a show?"

Cue parenting inner-dilemma.

You want to say yes, but you also have fears about technology. How much is too much? Is it bad for my children? Will it isolate my children from me?

Sara DeWitt, the vice president of PBS KIDS Digital, said in her TED Talk that this last question is a big concern for parents. We desperately want to be connected to our children, and for our children to be connected to the world.

Unfortunately, she says, the "fear and skepticism about these devices hold us back from their potential." The truth is, high-quality educational screen time can actually build connections (more on that in a minute). Even more exciting, did you know that the right screen time can help your child develop empathy?

Empathy is a skill, but as a society, we are losing it. A shocking study found that empathy drops by about 40% by the time kids get to college. In a world fraught with inequities, divisiveness and conflict, rebuilding empathy is paramount. Motherly mamas agree. In the 2019 State of Motherhood survey, you told us that your top priority was to nurture kindness with your children.

But how do we do this? Telling our child to "be a kind person" is great, but in order to truly understand, they need to see empathy in context. By using digital content as a prompt for communication and conversation, it becomes one of the many tools we have at our disposal to help guide our children on the path to becoming empathic, kind people.

Enter PBS KIDS.

Raun D. Melmed, MD, FAAP, a developmental and behavioral pediatrician, and author of the Monster Diary series told us that, "our children have unprecedented access to wonderful educational opportunities through digital media. Interactive, nonjudgmental apps can enhance cognitive development (processing and organization, visual-spatial awareness, pattern recognition and even reading), social and emotional awareness, and even moral development."

When we control technology—and not the other way around—the potential is enormous.

The American Academy of Pediatrics says that "media can have educational value for children starting at around 18 months of age, but it's critically important that this be high-quality programming, such as the content offered by Sesame Workshop and PBS."

Researchers looked at the impact of watching PBS KIDS' series, Daniel Tiger's Neighborhood, and the results were pretty inspiring. Children who watched the show for 30 minutes each day for two weeks demonstrated improved empathy, the ability to recognize emotions and increased social confidence.

But, here's the catch: In order to experience this growth, children needed to have recurrent conversations about what they saw with their parents.

Nicole Dreiske, Executive Director of the International Children's Media Center and author of The Upside of Digital Devices: How to Make Your Child More Screen Smart encourages parents to utilize screen time "in the same way that they would use story time: to build trust, emotional intelligence, and empathy." By spending just 10 minutes discussing what happened in a show, children can experience significant benefits.

Knowing the science behind the benefits of screen time is great. But when that afternoon struggle hits, it can be hard to remember exactly what to do, so DeWitt encourages parents to make a plan—here's how.

How to make a screen time plan for your family

Ask yourself the following two questions:

1. What do I want my kids to get out of their digital media time?

Do you want them to have an opportunity to be creative and think outside the box? Pull up PBS KIDS ScratchJr. Is there something going on at home or in school that requires learning about sharing? Share the "Daniel Shares his Tigertastic Car" episode of Daniel Tiger's Neighborhood with them.

Consider your goals, and then choose media accordingly.

2. What do I want my kids to get out of their digital media time? How can it support our family schedule and priorities?

It is okay to factor your needs into the equation, mama. Deriving benefit from your child's screen time is no need to feel guilty. Go ahead and start dinner, or send that email, or yes (gasp), put your feet up and relax for a bit.

Once you've figured out your 'why,' it's time to consider the 'how.'

1. Communicate the plan to your kids (and be clear about limits).

Kids do best with clear boundaries and expectations. This will be especially important if you are implementing changes to how screen time is done in your home.

You could say, "You can play the Wild Kratts game for 30 minutes while I work on dinner, and then we are going to go outside and flap our wings as bats do! Do you think we should eat mosquitos for dinner like they do?!"

Before you start the show, Dreiske recommends planting the communication seed: "Today we're going to notice what we're feeling and what the characters are feeling."

2. Discuss what your kid played or watched.

When screen time is over, strike up a conversation. Dreiske suggests open-ended questions that help to "[create] a special space in which your child feels safe enough emotionally to confide in you about their experiences. Let the child's emotion or feelings 'lead' the talk rather than being obscured by your feelings." You can try the following starters:

  • How did you feel when… ? Why?
  • How do you think that character felt?
  • What if that happened to one of your friends?

3. Find a balance of activities.

Like everything in life, screen time is best in moderation. It is important that children know that screen time is one of the many options they have for activities. Exercise, outdoor play, reading, coloring and more are also incredibly important.

If there is a show or game your child particularly loves, DeWitt suggests finding the non-screen time version of it. "For example, if the kids in Dinosaur Train start a nature collection, suggest a nature walk through your neighborhood after they've watched. If your child likes Ready Jet Go!, use the Ready Jet Go Space Explorer app to look at the stars together and then continue exploring the night sky away from the screen. In other words, we can make digital media as a jumping off point for family fun!"

Sara DeWitt writes, "It helps to remember digital media is simply a tool, just like books, toys and art supplies. As parents, we have the power to decide how and when to use these tools with our kids."

When used thoughtfully, and with love, high-quality screen time is an incredibly powerful way to foster empathy and kindness in the next generation.

This article is sponsored by PBS KIDS. Thank you for supporting the brands that support Motherly and mamas.

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Some women are more at risk than others when it comes to being pregnant. Black moms are up to four times more likely to die from complications of pregnancy and childbirth and another group, Native American and Alaska Native women, are also dying from complications in childbirth at a disproportionate rate.

Native American and Native Alaskans make up just 2% of the total U.S. population but account for the second highest number of maternal deaths in the only industrialized country where maternal deaths, overall, are rising. They are approximately 3.3 and 2.5 times more likely, respectively, to die while pregnant or as new moms than white women are.

Alarming statistics released by the Centers for Disease Control and Prevention (CDC) in May 2019 show that between 2011–2015, black women had the highest maternal death rate at 43 deaths per 100,000 live births, followed by American Indian and Alaska Native women at nearly 33 deaths. Thirteen white mothers died in the same time period.

"Racial disparities in maternal mortality are staggering" 

"More women die in the US from pregnancy-related complications than in any other developed country," the American College of Obstetricians and Gynecologists (ACOG) states on its website. According to the ACOG, the "racial disparities in maternal mortality are staggering…"

According to the CDC, 60% of maternal deaths are preventable. The leading causes of deaths during pregnancy, birth and the first year after childbirth include cardiovascular conditions, infection, and hemorrhage, but preventative strategies—including improving access to care and how it is coordinated and delivered—could save lives.

And in order to save lives, we have to acknowledge that Native American and Native Alaskan moms are dying because the health care system is failing them.

Meet Nicolle Gonzales 

Nicolle Gonzales is a Dine' Nurse-Midwife and the founder of the non-profit Changing Woman Initiative (CWI), in Santa Fe, New Mexico. A Native American-centered women's health collective, CWI aims to improve the health of expectant mothers, but Gonzales tells Motherly that she's been frustrated by a lack of information around native women's health available to medical professionals.

"When I attended conferences where they claimed to focus on Native American women's health, I found them sharing data that did not tell the full story about why our health outcomes were so bad," said Gonzales. "Further, blames seemed to be placed on native women and that it was their behavior that was the cause. I also saw the same old health frameworks being used to address known health disparities and then they would sit back and wonder why the outcomes were still terrible."

Gonzales witnessed many Native American women struggling with navigating the western medical healthcare system throughout her career. She saw assimilation practices from birth and on, that stopped Native American families from "bringing their loved ones into this world in a culturally supported and ceremonial way."

The disconnect helped inspire Gonzales to launch CWI in the fall of 2018.

Prenatal care can be culturally centered and accessible

It's on a mission to renew cultural birth knowledge, promote reproductive wellness, to support healing through holistic approaches and to strengthen women's bonds to family and community. The non-profit organization also provides training to increase the number of Indigenous midwives and encourage policy advocacy related to native women's health.

Gonzales believes some of the reasons behind the higher rates of birth mortality in Native American women are socio/economically and culturally linked. There are longer wait times to see obstetricians and/or midwives in native communities because of the remoteness of some reservations, she explains. Sometimes it's a lack of having a Medicaid card at the time of appointment, having no transportation or not making prenatal care a priority, Gonzales continues.

She believes taking the initial steps to seek medical care are crucial and wants to see moms better supported to do so. "First-trimester prenatal visits are very important. They identify health risks early, genetic screenings can be done sooner, and social circumstances and resources can be brought in," Gonzales says.

According to Gonzales' expertise, native women are at higher risk for adverse birth outcomes due to higher rates of gestational diabetes, hypertension, obesity, blood clotting disorders, drug addictions and limited access to healthcare education.

A less talked about cause of birth mortality rates for Native American women is intimate partner violence, she added. "There are limited places Native American women can go for safety and they are more likely to experience this or die from violence during their pregnancy."

The Changing Woman Initiative

The CWI also provides expectant mothers with access to healthy foods, plants and traditional medicines and time with a traditional doctor commonly called 'a medicine person.' It's a one-of-a-kind approach to a serious problem and the CWI is working to change the statistics from within its own community.

In the next three years, it aims to provide an Indigenous doula and peer counselor training to over 100 women in New Mexico.

The CDC study states that reducing pregnancy-related deaths requires reviewing and learning from each death, improving women's health, and reducing social inequities across the life span, as well as ensuring quality care for pregnant and postpartum periods, and for providers and patients to work together to optimally manage chronic health conditions.

America cannot save the lives of Native mothers if it doesn't understand why they are at risk, and supporting women who can provide culturally appropriate care—and listening to them—is vital.

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In a recent survey shared in the Reproductive Health journal, one out of six women in the United States reported being mistreated while in labor, where mistreatment included, "loss of autonomy; being shouted at, scolded, or threatened; and being ignored, refused, or receiving no response to requests for help."

One out of six.

To make these numbers even more sickening, mistreatment was more common among women of color, women with partners of color, women with lower socioeconomic status, and women under the age of 30.

(And yet people still question the validity of stating that black mothers are at a higher risk of pregnancy and birth-related complications.)

Rarely at a loss for words, I find myself almost unable to speak.

I am a midwife, and I am disgusted.

To be entrusted with the responsibility of caring for a woman giving birth is one of the single greatest honors available in the human experience.

I am not going to lie—it is not easy work. It is stressful and exhausting and sometimes even jading, and there are times when we will question the wisdom of the decision to spend our days doing this.

Yes, we worked incredibly hard to get to where we are today.

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But where we are is beside a woman who is giving birth. It is a gift to nurture and safeguard a woman as she does the profound work of bringing life into this world, and it is a duty to be held with reverence.

Providers. If the day has come that you are too stressed, too tired, too jaded to treat women with respect, then the day has come for you to leave this profession.

You swore an oath. Every time you ignore, or raise your voice to, or disrespect a woman in labor you are breaking that oath because in doing so you are inflicting harm. Birth trauma—and make no mistake, mistreatment in labor is trauma inducing—has very real consequences.

As I have shared previously, "When we give birth, we do so from our core—not just the core of our bodies, but the core of ourselves. We are open and vulnerable during and after birth, and the energy that is around us is the energy that we absorb. It becomes a part of the inner voice that guides us in motherhood."

The eye roll you thought she didn't see when she handed you her birth plan.

That snide remark about her "crazy behavior" while she was in labor.

When you ignored her call-bell because she was "just asking for more drugs."

That time you didn't call the translator service because "she should understand by now."

It mattered to her then and it matters to her now.

I want you to think back to the you who just got accepted to nursing, medical, or midwifery school. Would they be proud of the provider you've become?

I believe that a great many providers out there can answer yes. I believe that most people are trying to do right and be good.

But every single one of us needs to take a very hard look at ourselves and our practice and ensure that we are still deserving of the honor.

To women, I want to tell you three things.

First, you are worthy of respect. You know what? Scratch that. Because the word "worthy" implies that a special quality or effort on your part makes you good enough to deserve respect.

Your very existence calls for respect.

Our culture does a bang-up job of putting medical professionals on a pedestal—and there are some pretty amazing, life-saving ones that quite frankly should be up there. But even the most intelligent, skillful provider is a human, just like you. Yes, they may have a gift. But mama, so do you.

There is no credential, degree or diploma that permits the mistreatment of human beings.

Second, trust yourself.

So often I meet women who say things like, "It felt kind of hostile, but I'm probably just being too sensitive," or, "They kept hurting my feelings, but maybe I'm just hormonal."

If you feel mistreated, it is okay to say so. Yes, misunderstandings happen. But you do NOT have to sweep your feeling under the rug because you think you are "being silly." Your concerns are valid and deserve to be heard.

I also want you to trust that any mistreatment received is not your fault. I don't care if you asked a thousand questions, or cried and yelled the whole time you were in labor or didn't "do what they wanted you to do." Nothing justifies mistreatment, ever.

Lastly, you have rights and choices.

If you feel that you are being or have been mistreated, you have rights and you are not alone. Check with your birthplace and see if they have a patient advocacy department, or contact an attorney or advocate near you that will support you.

For a full list of your rights in childbirth, check out this document from Childbirth Connection.

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News

On Tuesday Connecticut became the eighth state (including D.C.) to pass and enact a paid family and medical leave program when Governor Ned Lamont signed the Paid Family and Medical Leave bill into law.

Today was a win for family leave advocates in Connecticut, as it's been a long road to getting this bill passed. At one point it was even suggested that Lamont would veto the bill, but in the end, lawmakers came to a consensus that it is in the best interest of parents, babies and basically everyone in Connecticut.

"We all agreed on the need to pass this landmark support for working families so they don't have to choose between the job they need and the family they love, or their own health," Lamont said earlier this month.

On Tuesday, he spoke again about how this was a victory for lawmakers and workers.

"Adopting this program means that workers who need to take time off for a new baby or recover from illness are not punished financially, and businesses do not risk losing good workers during those emergencies," he said.

Connecticut's plan is widely regarded as the most generous in the United States because workers will get 12 paid weeks of work to take care of a new baby, sick family member or take care of themselves. The benefits cover 95% of lower wage earner's pay, up to $900 a week.

Oh, and anyone experiencing complications from pregnancy can take an extra two weeks of paid leave to recover from that.

👏👏👏

Workers in the state will be able to start collecting these benefits in 2021 and the plan is funded through a 0.5% payroll tax, much like what other states and countries do.

In a statement to Motherly, Catherine Bailey the Deputy Director or Campaign for Paid Family Leave at Connecticut Women's Education and Legal Fund explained the campaign (a coalition of more than 75 organizations that has fought for paid family and medical leave) applauds the paid family and medical leave plan.

"Paid leave is a critical step forward for women's economic security, especially for low-wage workers and women of color who are an increasing number of primary breadwinners to their families."

She believes the plan will "provide economic stability when women and families need it most - when they need to care for themselves or a loved one, or welcome a new child."

Good job, Connecticut.

[Correction: A previous version of this post said 12 weeks is 4 months, it's not quite 3 months. We regret the error.]

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Trying to get pregnant is an exciting time, but let's be honest—it can be pretty stressful too. We find ourselves continually questioning or critiquing our choices. Is it okay to have a drink? Should we have sex every day or every other day? Should I ask my sperm donor to switch to boxers?

While all this pondering may keep you up at night, the latest findings may just inspire you to try to get some sleep.

According to a study shared at the European Society of Human Reproduction and Embryology conference, it turns out that men who go to sleep before 10:30 pm have sperm that's four times as healthy as men who go to sleep after 11:30 pm.

They also found that men who got eight hours of sleep had healthier sperm than men who got seven or fewer hours of sleep, irrespective of what time they got into bed.

We've known that sleep is important to female fertility. Sleep disturbance can create stress in a woman's body, which in turn may impact how her hormones and reproductive system function.

But it's nice to be reminded that men's lifestyles have a significant impact on fertility too—so often women feel that they have to bear the load, and that's simply not the case.

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(Did you know that fertility issues are split evenly between men and women? Thirty percent of problems arise from the female, 30% from the male (partner or sperm donor), and 30% are from both).

Experts believe that just like in women, a decrease in sleep for men leads to increased stress, which can harm sperm.

I also wonder if we can extrapolate that people who routinely go to sleep before 10:30 pm have healthier lifestyles in general (said as someone who routinely does NOT go to bed before 10:30 pm, ahem).

If you have baby making on the brain, a few other lifestyle tips to consider for your partner or sperm donor include:

  1. Switch from briefs to boxers. Testicles that get more air produce healthier sperm.
  2. Put down the weed. Marijuana negatively impacts sperm's ability to swim, and sperm making in general.
  3. Cut back on caffeine. Caffeine may damage sperm's DNA, decreasing its ability to result in a pregnancy.
  4. And alcohol too. Alcohol can slow sperm's maturation, making it less effective and healthy.
  5. Watch your pockets. Experts believe that keeping a cellphone in your pocket, and therefore near your testicles, can harm sperm.
  6. Beware the bike seat. Bike seats put a lot of pressure on testicles, which can over time decrease their ability to produce healthy sperm.

And as we now know, get into bed early. Insert "rest while you can before you have the baby" joke here 😂.

Good luck!

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