Infant Multiples

/Infant Multiples
­

Pregnancy and Infant Loss Remembrance Day

Today at 7:00 pm in all time zones, families around the United States will light candles in memory all of the precious babies who have been lost during pregnancy or in infancy.  Too many families grieve in silence, sometimes never coming to terms with their loss.

If you or someone you know has suffered a miscarriage, stillbirth or infant loss due to SIDS/SUID, prematurity or other cause, we hope you will join us in this national tribute to create awareness of these tragic infant deaths and provide support to those that are suffering.

More information can be found here.

October 15th, 2017|Infant Multiples, Multiples in the NICU, Preemies|

Fire Safety Exit Strategies: What to do when you have 2 or more Infants

3 girls in firetruckOctober is Fire Safety Month. If you have school age children you may have developed an emergency exit plan with materials from the school. This article focuses on infants and toddlers strategies but has information for all. Resources in English and Spanish are at the end.  Don’t forget to change the batteries in your fire/smoke detectors!

We all know how important it is to have a Fire Safety Plan, including two ways to exit from every room in your home.  But how does that plan change when there are more babies than adults? What if you are alone with 3, 4, 5, or 6 babies?

A good place to start is with prevention and preparation.  Working smoke detectors on every floor of the house and inside and outside each sleeping room are essential. New smoke detectors are available that let you record a mothers voice. They have been shown to be very effective in waking children. Of course fire extinguishers and an escape plan are important too.  Most local fire departments can help you make a family fire escape plan, and may even come out to your home to do a fire safety check.  It is also a good idea to let the firehouse that would respond to your home know how many babies you have.  That way should the worst happen they would  know how many babies need to get out. Depending on where you live, you may also want to contact your EMS or ambulance / rescue squad that an emergency call to your house may involve multiple children. Planning ahead and practicing often can mean the difference between life and death.

Most experts agree that you have less than 3 minutes to exit a burning building, which may not be enough time for many trips.  If at all possible,  carry everyone out in one trip, which we all know is easier said than done.  Here are a few ideas on how to minimize the number of trips, hopefully only one trip!

The Big Grab Method:

For co-bedded infants, who are usually snuggled together anyway, you can probably reach your arms around from either end and grab them all.  They will probably wake up and be upset that they are squished against their siblings, but at least they will be safe.  I know I had no problem picking up three babies with this method and I have pretty short arms.

Laundry Basket Method:

If there is a laundry basket nearby, which there most likely will be, dump out the clothes and fill it with babies.  Drag or push the basket down the hall to stay below any smoke.  If you are on the second floor, back yourself down the stairs sliding the basket of babies down as you go.

Blanket/Beach Towel Method:

Keep a large thick blanket or towel in the sleeping area.  (Fire blankets are available for purchase commercially, but any thick blanket will do.)  The goal would be to provide some insulation from any smoke or fire gases. The blanket would contain some clean breathable air and also act as a filter.  For very small infants you can lay the blanket on the floor, lay all the babies next to, or on top of each other and wrap the blanket up around both sides.  Hold both ends at the top, kind of like how you see “bundles “ hanging from the mouth of a stork.  If there is smoke, drag the entire bundle of babies down the hall to the exit to stay below the smoke.  As soon as you are in fresh air, remove the babies so they can breathe normally.

If you need to go down stairs and they are too heavy to carry (say three or four 6-12 month olds) just drag the bundle down the stairs.  The kids might end up a little bumped and bruised, but they will be alive.

If you just need to get out quick and the air is clear, pick up the whole roll and out you go.  The towel or blanket will keep you from dropping anyone.

Bail Out/Relay Method:

If you are on the first floor, and there is a window, open the window and start passing babies out the window.  Most 0-6 month olds can’t roll or crawl away yet so they will stay where you place them.  If you are alone, think of this as a relay.  First you get the babies all out of the window, then yourself out, then you start moving them away from the house.  Also, as soon as you open the window start screaming for help, hopefully someone will hear you and come running to help shuttle babies away from danger.

Sling Method:

If your nursing sling or carrier is close by, you can put a baby or two in the sling and have your hands free for carrying other babies or directing another child out.  Be careful with this method not to spend too much time getting babies situated in the carrier.  Remember in case of a fire, you only have 3 minutes to escape, so if it takes you 5 minutes to put on and adjust your sling, you will need another method.

Apron Method:

Commercially there are “apron-like” garments designed specifically for evacuating large numbers of babies.  Many hospitals and day care centers have these.  Safe Babies® infant emergency evacuation apron is one product that can carry up to four babies.

Stroller Method:

Of course a stroller can be the quickest mode of transportation, but there are very limited circumstances where this is an option.  How many of us keep a stroller near the bedroom? Also, in the case of a fire, you should never use an elevator, so you could be in for a bumpy ride.  But if you are on the first floor and the stroller is close, don’t over look the obvious.  Throw them in and roll as fast as you can to safety.

You can always combine methods or make up your own.  The most important things is to make sure everyone gets out, and once you are all out, don’t go back in for anything.

Make sure you don’t forget the older children as well.  It is easy to see how a parent would worry first about the children trapped in cribs, or who are unable to walk.  So make sure you teach your older children how to escape on their own.  Children as young as 3 can follow a fire escape plan they have practiced often.  Fire drills are a good way to keep preschool children and toddlers involved.  They also give you a chance to figure out what method will work best for you.  If you are in a two-parent household, run the drill three ways: With Mom Only, With Dad Only, and with Both Parents.  You might be surprised at what method works best in each scenario.

Also be sure to continue to run your practice drills as the children get older.  The bigger they grow the harder they are to carry, so you might need to adjust your plan.  The exit routes in your home will also change with the addition of baby gates, locked doors and toys, toys, everywhere.  Continued practice is key.

If you have doors that must be opened with a key, KEEP A KEY by each door, and REPLACE it when you use it.  Whether it is a child’s room or the front door, you don’t want to have to look for the key.  Hang it on a hook out of the reach of the little ones.  Ideally every door should open without a key, but eventually, babies become toddlers that you may have to lock them in the house to keep them from escaping into traffic without your knowledge.  So, if you have any doors locked, be sure to keep a key by the door or you may have just blocked your best escape route.

If you have babies that require medical equipment, work that into your plan.  I don’t mean that you should try and carry all the babies and all the equipment out in one trip.  Sometimes one baby and a tangle of cords is difficult enough, let alone multiple babies and multiple cords.

If your babies are attached to monitors, oxygen, or feeding tubes, know what you can do without for a few minutes, and how to quickly disconnect to escape and call 911.  When the ambulance arrives, paramedics will be able to monitor/stabilize breathing & heart rates and transport your child to a medical facility equipped with any medical equipment you could have possibly had in your home.  Medical equipment can be replaced, a child can not.

We all hope we will never have to use your escape plan, but it is comforting to know that you have an Exit Strategy should you need it.

 

Resources:

Fire Safety for Kids (interactive games and activities)

Fire Prevention Tips

Fire Safety Coloring Pages

Lista de verificación de la Semana de Prevención de Incendios –

 

Research Participants Needed! Earn $30-50!

Pearson, the nation’s leading provider of educational and clinical assessments, is updating the Bayley Scales of Infant and Toddler Development. The Bayley is used to measure multiple areas of development in infants and toddlers. But before this product can hit the market, Pearson must conduct field testing.  To do this, we are looking for infants and toddlers to help us “test the test”.

We are in need of infants and toddlers between the ages of 2 – 42 months who were born premature at less than 37 weeks gestation. We have a particularly high need for those born at less than 32 weeks gestation.

Time and location are flexible. Pearson will put you in touch with a qualified professional in your area with whom you can schedule a testing time and location that is convenient for you. Depending on your child’s age, testing sessions will last 30-90 minutes. Testing will take place through early 2018.

If interested, please complete the following form: Bayley Study Sign Up

July 12th, 2017|Infant Multiples|

Parent-Led Autism Therapy (PACT) Shows Lasting Benefits

parent-child-playA therapy that focuses on parents’ communication skills may have lasting benefits for young children with autism, a new clinical trial suggests.

Researchers from the United Kingdom found that preschool children who took part in the program had less-severe autism symptoms six years later, compared to kids who received standard autism services available in their local community.

The study is the first to show such lasting benefits from an early childhood program for autism. Experts not involved in the work were encouraged by the findings.

That’s, in part, because the program is considered “low intensity.” Parents had 18 sessions with a therapist over one year, and then took charge from there.

“This study is important in demonstrating that parent-delivered therapy can be used effectively in low-resource communities where there are few trained professionals,” said Geraldine Dawson. She’s the director of the Duke Center for Autism and Brain Development, in Durham, N.C.

The program, dubbed PACT (for Preschool Autism Communication Trial), focuses on parents’ and children’s “social communication.”

Parents are videotaped during different interactions with their child. Then the parents watch the videos alongside a therapist. Parents learn to better interpret their child’s unique style of communication, and respond to it.

To put that into practice, parents are asked to lead “structured tasks” at home for 30 minutes every day.

The approach makes sense and is “very feasible,” according to Jeff Sigafoos, a professor at Victoria University of Wellington, in New Zealand.

In fact, programs that include similar principles are already available in the “real world,” said Sigafoos. He wrote an editorial published with the study in the Oct. 25 online edition of The Lancet.

“All of these programs tend to share a few common elements — such as being home-based, parent-implemented and focused on supporting parents in engaging their child in more social-communication interactions,” Sigafoos said.

The new findings add to evidence that those approaches can help children and parents alike, according to Rebecca Shalev. She is a clinical assistant professor of child and adolescent psychiatry at NYU Langone’s Child Study Center, in New York City.

It’s not “intuitive” for parents to know how to interact with a child who has autism, Shalev said.

Learning how to play with their child and “have enjoyable experiences” benefits everyone, she said.

An estimated one in 68 U.S. children has been diagnosed with an autism spectrum disorder (ASD), according to the U.S. Centers for Disease Control and Prevention. ASD refers a group of developmental brain disorders that affect children’s behavior and ability to communicate and socialize.

The severity ranges widely from one child to the next: Some kids have relatively mild problems with social interactions, while others speak very little and focus on a limited number of repetitive behaviors.

The PACT study involved 152 British children aged 2 to 4 who had relatively serious issues with social communication and repetitive behaviors. On average, they scored an “8” on a standard scale of 1 to 10 — with 10 signifying the most severe symptoms.

The researchers, led by Jonathan Green of the University of Manchester, randomly assigned the children to either the one-year PACT program or the “usual” autism services available in their local area.

Six years later, the researchers were able to re-test 80 percent of the children.

The researchers found that, compared with kids who’d had standard autism services, children in the PACT group were less likely to have symptoms in the severe range: 46 percent versus 63 percent in the usual care group.

And although the program focused on social communication, it also reduced kids’ repetitive and restrictive behaviors, on average.

That’s an interesting finding, according to Shalev. She said it suggests that enhancing parent/child communication has “collateral benefits.”

Sigafoos said, “One take-home message is that it’s important for parents to be highly responsive to their child’s communication attempts. Try to create the need for your child to communicate and watch for any indication of communication on your child’s part.”

He offered one example: “Your child might lead you to the fridge door to request a drink of milk. When you see this, you can acknowledge that the child is attempting to communicate — ‘Oh, I see you want some milk.’ Then try to get your child to communicate in a more elaborate form, ‘Can you say milk?’ ”

Of course, the study is reporting group averages, and not every child showed the same gains. “Simply put,” Sigafoos said, “some children will respond better than others.”

But, he added, in the real world, therapists can adapt an intervention to better suit a particular child’s needs.

Dawson said that, ideally, children with autism would be seeing a therapist directly, along with any training their parents receive.

But, she added, therapists with that expertise are not always available in a community.

It’s also best for parents to learn at-home techniques from a trained therapist, Dawson said. But, she added, there are also some good books with “useful tips.”

Special thanks to our friends at HealthDay

SOURCES: Jeff Sigafoos, Ph.D., professor, education, Victoria University of Wellington, New Zealand; Geraldine Dawson, Ph.D., director, Duke Center for Autism and Brain Development, Duke University Medical Center, Durham, N.C.; Rebecca Shalev, Ph.D., clinical assistant professor, child and adolescent psychiatry, NYU Langone Child Study Center, New York City; Oct. 25, 2016, The Lancet, online

Docs: Infants Should Share Parents’ Room to Help Prevent SIDS

parent-and-infant-handsFrom our friends at HealthDay

Infants should sleep in the same room as their parents — but not in the same bed — to reduce the risk of sudden infant death syndrome (SIDS), new guidelines from the American Academy of Pediatrics advise.

The recommendations call for babies to share their parents’ bedroom for at least the first 6 months of life and, ideally, for the first year.

This could reduce the risk of sudden death by as much as 50 percent, the guideline authors say.

“Room sharing makes a lot of sense,” said Dr. Paul Jarris, deputy medical officer at the March of Dimes.

The rationale is that having the infant within view and reach makes for easier monitoring, comforting and feeding. Because the baby is nearby, parents might notice any potential difficulty, Jarris said.

“If we look at how strong the evidence is, parents will be well advised to adopt room sharing,” Jarris said.

It’s important, however, that infants have their own separate sleep surface, such as a crib or bassinet. They should never sleep on a soft surface like a couch or armchair, the doctors’ group warns.

Nor should babies sleep in the same bed as their mothers, the guidelines say. But, since infants do feed throughout the night, the doctors recommend that mothers feed the baby in bed.

“Babies should be brought to bed for feeding, but following feeding they should be returned to a separate sleep surface,” said report co-author Dr. Lori Feldman-Winter, a professor of pediatrics at Cooper Medical School in Camden, N.J.

“Breast-feeding can reduce SIDS by as much as 70 percent,” added Feldman-Winter.

Because moms may sometimes fall asleep during feeding, the AAP recommends keeping the parents’ bed free of pillows, loose sheets, blankets and other soft bedding that could suffocate the baby, she said.

Each year in the United States, some 3,500 babies die from sleep-related deaths, including SIDS. The number of infant deaths dropped in the 1990s after a national safe-sleep campaign that emphasized placing infants on their back. However, momentum has stalled in recent years, Feldman-Winter said.

Besides room sharing and breast-feeding, the academy’s recommendations to create a safe sleep environment also include the following:

  • Put the baby on his or her back on a firm surface, such as a crib or bassinet, with a tight-fitting sheet.
  • Keep soft bedding, including crib bumpers, blankets, pillows and soft toys, out of the crib. The crib should be bare.
  • Avoid exposing the baby to smoke, alcohol and illicit drugs.
  • Never use home monitors or other devices, such as wedges or positioners, to reduce the risk of SIDS.

Although SIDS risk is greatest from 1 to 4 months of age, evidence shows that soft bedding is still a hazard for older babies.

One pediatric specialist thinks room sharing might be difficult for some parents to accept.

“Room sharing is probably the most controversial recommendation,” said Dr. David Mendez, a neonatologist at Nicklaus Children’s Hospital in Miami.

Parents have strong feelings one way or the other, Mendez said. “Some parents want the baby in the bed right next to them; some parents want the baby to have its own room,” he said.

Mendez said he’s more concerned with other risk factors for SIDS, such as smoking and excess bedding.

“I would rather have the parents put the baby in a separate room if they’re smokers than room share,” he said.

“Having the baby on a firm surface on his back and keeping soft pillows and loose bedding that the baby can get tangled up in out of the bed or crib — those things probably play a much bigger role in preventing SIDS than being in the same room with the baby,” Mendez added.

The new recommendations, published online Oct. 24 in the journal Pediatrics, were to be presented Monday at the academy’s annual meeting, in San Francisco.

SOURCES: Lori Feldman-Winter, M.D., M.P.H., professor, pediatrics, Cooper Medical School, Rowan University, Camden, N.J., David Mendez, M.D., neonatologist, Nicklaus Children’s Hospital, Miami, Fla.; Paul Jarris, M.D., deputy medical officer, March of Dimes; November 2016, Pediatrics