Episode 17
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[00:00:00] Welcome to the Create Thriving Families podcast. I'm your host, Lisa Peterson. I'm a doctor of chiropractic, and I've been in private practice for 20 years, seeing mostly women, babies, and children. The Create Thriving Families podcast is a place for us to have a conversation about how we can help our children become the healthiest, most vibrant, and aligned version of themselves, the full expression of who they came here to be.
The quality of our lives and the quality of our relationships is dependent on the quality of our health, and I believe that the greatest gift any of us could give to our children is the best start possible when it comes to their own health. I can't wait to see where this journey takes us. Let's get started.
Okay. Welcome to part two of a [00:01:00] two-part miniseries, which is within the new developmental series, which will be eight podcasts in total, two podcasts for the zero to three-month window, two podcasts for the three to six-month window, and so on, up to 12 months. For this episode today, what I will be talking about is what you, as a parent, should be seeing in your baby's first three months, from zero to three months old.
My hope for this podcast series is to give new mothers the full guided tour of their baby's neurology during the first year of life. But I wanna split it up in a way that hopefully is practical and actionable and tells you what you need to be doing to support each of these phases and what you should be seeing, and hopefully try to split it up in a way that can keep it a [00:02:00] little bit interesting and relevant for the age that your baby is in.
So again, today we're gonna be talking about what you should be seeing in your baby's first three months. And I'm hoping that by the end of this episode, you have a map of what should be unfolding, ways that you can be supporting development, what's normal to be seeing, what is worth taking a closer look, and some practical things that you can be doing in case you need to be talking to a clinician about your baby's development.
And also, I hope that this episode gives mothers confidence in knowing what they're seeing, because those first three months with a new baby, that's one of the hardest... It's a hard time for many reasons, especially when it's your first baby, but the first three months is hard regardless of how many babies you've had.
And I, I [00:03:00] hope that this gives all mothers a little bit of clarity and a little bit of confidence and a little bit of peace during a time that can be pretty taxing. So if you listened to part one, which was episode 16, you now have the picture of what's happening under the surface in your baby's first three months.
That episode was all about what's actually happening developmentally in a newborn's brain and nervous system. Today, I wanna bring it up to the surface, because once you know what you're looking at, the day-to-day with a newborn becomes a different experience. And when you can read what your baby is doing instead of just having to react to it all day long, you- You stop guessing.
You start trusting both your baby's development and your own instincts, and that's where we are going today. [00:04:00] There is, just to give you a little bit of an overview of what we're gonna be talking about today, I've sort of split it up in nine different sections. I wanna talk about state regulation, nervous system state regulation in real life, what's happening when your baby is awake, what's happening when they're crying, what's happening when they're sleeping, what's happening when they're feeding.
In part two, I wanna talk about the social engagement system in action, why things like eye contact and smiling and talking to your baby and listening when they're starting to make some noises and use their voice is really important. Part three is all about the primitive reflexes, which reflexes you should be seeing and what they actually mean.
Part four is all about movement milestones, the things that you should be seeing them be able to do, and the progression that you should be seeing from zero to the end of the three-month [00:05:00] period. Part five is all about sensory soothing, what helps to calm a zero to three-month-old, and why does it work.
Part six is all about their head shape and a little bit more about looking at things like symmetry in their movements. That's some of the things that I see a lot in my practice. Part seven is about the development of the visual system and things that you as a mother will actually see during this time.
Part eight is sort of if there are any red flags or things that you maybe need to be looking for outside help with, when you need to ask for help. And part nine is just putting all of the pieces of it together and looking at some, again, practical things that mothers can be doing in the everyday during these first three months.
So if we come back to the first part, the [00:06:00] talking about nervous system state regulation, it sort of can look a little bit messy. It can look a little bit like chaos during these first three months. It feels very unpredictable as a mother. You really feel like you're not sure what to expect. You don't know when everything seems fine until suddenly it's not, and there's crying, or everything seems okay and then suddenly, somebody's overtired and there's, the whole thing is falling apart.
And if you're looking at what your baby is actually doing during this period of time and thinking that your job is less about constantly needing to fix their- fussiness, your job is helping them rehearse in their nervous system while they are learning how to move between [00:07:00] states, if we put it plainly. I, in the first episode in this series, I explained that I have a few...
I have a list of references of both books and research articles and helpful people that I think can be relevant for some of the information that I have in these episodes, and I have listed all of those in a reference list that you can have, you can click on in the show notes and have access to that in case you're more interested in looking up any of the specific people that I talk about during these episodes.
But I want to mention some of the actual science behind the things that I'm talking about here. There is a pediatrician named T. Berry Brazelton. He developed the Neonatal Behavioral Assessment Scale, which defined the six newborn states that every baby [00:08:00] cycles through every day: deep sleep, light sleep, being drowsy, being quiet but alert, being active and alert, and crying.
And the capacity to move smoothly between these states is one of the clearest signs that the lower part of the brain, the brain stem, which is really the only part of the brain that is fully functioning at birth, is organizing itself well. You need to think that when your baby's born, they're born with a very primitive brain, and their experiences and their, what they go through during the first year of life really builds the brain that is going to be the foundation that they're gonna have for the rest of their life.
So in the first three months, they're building the capacity in this lower [00:09:00] part of the brain and learning how to move more smoothly between these six states that T. Berry Brazelton talked about. And your job during that piece of time is to be helping them rehearse that dance, moving between the states.
There's another man that I've referenced a lot out, in other podcasts and also in the, the first part of this series, and that's Stephen Porges. And Stephen Porges, his work adds to our understanding of the autonomic layer of the nervous system. So- The capacity that a baby has to drop from active, being active but and alert into quiet and alert, or their ability to come back from crying into a more regulated state, and that their ability to [00:10:00] do this depends on developing vagal tone.
We talked more about this in part one. And every co-regulated soothing experience is training that capacity. Every time your nervous system is helping your baby's nervous system to come back from being dysregulated or crying or being upset or being fussy into a regulated state, you're training and helping your baby's nervous system to be able to do this more efficiently on its own in the future.
This is something that takes a lot of time and a lot of practice, but that's what's happening. And Stephen Porges is a very interesting source to be looking more into if you're interested in learning more about it. So at home with a newborn, this sort of looks like going in cycles of your baby feeding and sleeping and [00:11:00] being alert and crying, and nothing is really following a schedule or a clock yet.
A lot of babies during this window of time are cluster feeding. They're feeding a lot in the evenings and needing a lot of skin-on-skin time or closeness to their parents for co-regulation. And you're looking... During those first three months, you're looking for a baby who can briefly be quiet and alert, and then often you'll see dysregulation or being fussy or crying and, and that they will need help getting back into that quiet but alert state of being in their nervous system.
So those periods of time are, can be short, but you should start to see that they are more and more able to have longer periods of time as they go from being newborn to the first three months. [00:12:00] And you'll also see short, fragmented stretches of sleep that during the first three months of their lives are gradually starting to get a little bit longer, a little bit more predictable, a little bit less fragmented.
So, uh, a brand-new baby doesn't have a schedule yet, and the, the cycles that they're doing between all of these states of nervous system awareness, the deep sleep, light sleep, being alert, being, you know, crying, this is something you're gonna see your baby cycle through every single day. When you have those periods of time where they are quiet and alert, this is, uh, this is the golden state of the newborn period.
This is where you and your baby can be ha- spending some time looking at each other, starting to engage with each other, starting [00:13:00] to engage with the world. So when you have those windows, try to protect them. Get the most out of them. And if your baby is crying, it's, it's not the system failing, it's just one of the six states.
So what matters is whether your baby can be brought back from being upset or crying or being fussy into a state of more regulation with your help. So things that you should be watching for, again, the length of time where they are quiet and alert should be increasing over the first three months, and you should start to be seeing a little bit of more predictable rhythms emerging.
Your baby's not on a clock yet. There's not a schedule yet, but maybe a little bit more predictability to times of the day when they sleep, times of the day when they need more contact, times of the day when they are feeding for longer periods of time, cluster feeding. A lot of times [00:14:00] cluster feeding will be tapering off by the end of the second month or within the third month for most babies, not all.
And you should start to be seeing longer stretches of sleep at night with, of course, there will be individual variation, but better sleep and longer sleep when they're three months old than you saw in the newborn state. So things that you wanna think about as a mother, you wanna be responding to your baby based on the state that they're in, not the time on the clock, and you wanna be noticing and protecting those periods of time when they're quiet but alert.
This is when connection happens. This is when you can be f- having face-to-face engagement and gentle playing, and that's when you'll get the most out of those times where you're really building the connection between the two of you. [00:15:00] And think about soothing your baby when they are dysregulated or crying as that's sort of the work of that, those first three months.
Every time you co-regulate with your baby, you're training their nervous system to come back to baseline, and this really teaches your baby's nervous system how to handle stress for the rest of their lives. And another thing that I think is important to say is to lower the bar for what productive looks like during this window.
You're helping a tiny human being practice state regulation all day. So during those first three months, it is completely normal that you look around your house at 4:00 in the afternoon and you think, "It's been eight hours and I have nothing to show for it." You know? The laundry is still not folded. The [00:16:00] dishwasher that I was going to empty is still not done.
I was-- my cup of coffee that was warm this morning at 8:00 in the morning is still full and standing on the counter ice cold. Um, it's very normal to look around and think, "Where have the last eight hours of my life gone?" And not be able to remember anything specific, because you've been working on practicing state regulation, and it takes time, and it's not something that you can...
You can't make it more effective, and you can't make it go faster, and you just sort of have to take each day for, for what it is. So if we talk a little bit more about the social engagement system, somewhere between about four and eight weeks, your baby's social engagement system starts to become more obvious in a way that you can finally see.
Eye contact becomes more frequent, and [00:17:00] they can h-hold eye contact for longer periods of time. A lot of times, that's the period of time that you'll see the first real social smile happen, and that really, that's something that all parents can remember, that period of time when their baby starts to smile when they see them, and you can see their face light up, and they're recognizing and they're responding to seeing you or seeing, seeing their parents, seeing the people that they know.
There is some research by a man named Edward Tronick, and his research showed that even very young babies are very exquisitely tuned into the emotional engagement of the caregiver. Long before they can speak, they are-- babies are reading your face. They're listening to the tone of your voice, the timing of your, how you're talking, and your responsiveness to them, and they're using that information to organize [00:18:00] their own state of their nervous system.
And in those first three months when your baby starts to be smiling more and able to hold eye contact and be really observing you and things that are close by in their environment, those are visible signs that the system is doing its job. Two men, Alan Schore and Daniel Siegel, also talk about this same concept using a little bit different language maybe, and what they're talking about is that the right brain is- developing primarily more prominently during this first year of life, the right side of the brain, the right hemisphere of the brain.
And the right brain in your baby is being shaped by the right brain in you. So the way that you make eye contact, the timing of [00:19:00] your smile to them, the level of warmth in your voice, these are the inputs in the system that are helping their, your baby's right brain to develop. So seeing that they are making more contact with you, making more eye contact, responding to your voice and your smile, it's-- these are, again, all signs that the inputs, the growth in the brain is working.
And so at home, it looks like eye contact during feeding and eye contact during the periods of time when they are quiet but alert, uh, seeing them start to smile, seeing them start to respond to your face more and more from about six to eight weeks, a longer window of time where they're able to hold eye contact and to be observing you when you are looking at them.
And the [00:20:00] early sounds of them starting to use their voice, starting to coo, and starting to make noises with their voice, usually during when you're face to face and being in contact with them. And, and so you'll start to hear that their, their mouth starts moving, and they're starting to make noises and starting to engage more.
So what you wanna be, again, watching for eye contact that's lengthening and deepening during these first three months, that they are starting to smile by about six to eight weeks, that they're starting to make some sounds by about the second and the third month, and that you have a baby who is lighting up in response to seeing familiar faces by the time they're about three months old.
You can build these face to face moments in your day. They don't need to be long periods of time, but [00:21:00] they need to be repeated often. And when your baby starts making sounds and making noises and starts cooing, you wanna respond to that as if it's a real conversation. You listen, and you smile, and you coo back, and you are wiring into their brains that back and forth that we, the rest of us as adults have in conversation.
And when your, when your baby's holding eye contact with you and they look away, that's, that's them regulating the intensity of the connection. So that's okay. Let them break the gaze and come back, and that's the rhythm of it. And also during this period of time, you really, and this is the first few years of life, but especially these first months, you wanna limit screens during these face-to-face windows.
The right brain of, your baby's right brain is wired by another right brain, not by a screen. So if we go through a little bit [00:22:00] about the primitive reflexes, the ones that you will notice and the ones that, and what, what they mean. Again, these primitive reflexes are automatic reflexive movements that babies have during the first year of their life, and some of these primitive reflexes are there from birth, and some of them develop a little bit later on throughout the first year of life, and they are...
I describe them, uh, sometimes as training wheels for the nervous system. They're reflexive movements that help to build more complex, more sophisticated movement patterns, and they help your baby develop everything from balance, coordination, and bigger, more complex motor skills. Uh, it helps with visual training.
So these primitive reflexes are something that we see right from birth, and as your baby's brain and nervous system grow and develop, [00:23:00] these primitive reflexes are no longer necessary because your baby has built the ability to move and to coordinate their movements in a, in a more sophisticated way. And so these reflexes become integrated or are controlled by the higher centers of the brain that, that are seeing these m- these primitive reflexes as no longer necessary if it's happening the way that it should.
So Sally Goddard Blythe has several books, and her work really gives us a clear map of which of the primitive reflexes are most observable in the first three months and what each one is teaching the brain. So knowing what they are turn what looks like random movements into being able to read the picture of what's happening in their, in their developing nervous system.
Harold Blumberg, h- h- his clinical experience [00:24:00] also reinforces that the most important thing that a parent can do for these primitive reflexes during the first months is make sure that your baby has the freedom to move. The reflex is the baby's training program, and the movement is the training So the reflexes that you'll see during the first three months of life, you'll see the Moro reflex, which is the startle reflex.
You'll see their arms throw out to the sides. You'll hear them a lot of times gasp or take a deep breath in, and then the arms will come back in. And it should be these, their arms jerking out to the sides should be on both sides, symmetrical, and already present during the first weeks. You'll see the rooting and the sucking reflex, which is them turning...
If you touch, stroke your baby's cheek, you'll see them turn to that side where you are stroking them, and it will [00:25:00] activate their sucking reflex. And that should also be present from birth, and it should be on both sides and well coordinated between the right side and the left side. You'll see the palmar grasp reflex, which is your baby gripping your finger when you stroke the inside of their palm.
It should be strong, and it should be on both sides. You should also see the stepping reflex, which is if you hold your baby upright with their feet on the, on a surface, they will make stepping motions like they're trying to walk. And this will, this is normal, should be there early, and it will usually be lessened as you're getting to about the third month or so.
But it should be present in the beginning. The two final reflexes that you should see are the asymmetric tonic neck reflex, which is when your baby's head turns to one side, the arm and the leg on that side extend. They go out to the [00:26:00] side. And the arm and the leg on the opposite side, so on the side they've turned away from, comes in toward the midline.
And this is a reflex that's teaching the eyes and the hands to find each other. It's teaching eye-hand coordination. The spinal galant reflex, the final reflex, is if you are stroking down one side of your baby's lower back, just to the side of their spine, they... you'll see reflexive movement where they curve toward that side.
And this is a reflex that helps with the birth process, and it also is preparing them for crawling later on in life. So these primitive reflexes are important to see in the beginning, and they are important to follow up during the first three months. You wanna look again for symmetry. Each reflex should be roughly equal on both sides of the body.
You wanna look for strength of the reflex. It should be clearly [00:27:00] present in those first weeks. And you should easily be able to see these reflexes. It should be clear in the first three or four times that you try to bring the reflex forward. So for example, with the spinal gallant, if you're stroking down one side of your baby's lower back, it should be very clear and very easy that you see their muscles tensing and jerking them a little bit over to the side.
So they're curving over to the side that you are stroking them on. This is, if you repeat the reflex three, four, five times, a lot of times you'll see that it becomes less and less. It's not as prominent every single time that you do that. That's normal. But it should be very clear and easy to see these reflexes the first few times that you do that.
So you want to, during this period of time, you want to give your baby as much unrestricted floor time as you can. We talked a lot about this in the last episode as well, [00:28:00] but having a space where they can be on the floor and move unrestricted, it's all homes pretty much in Scandinavia have hardwood floors.
And so it's really hard for a baby who's wearing clothing to be able to move themselves around on a hardwood floor. You slip and slide everywhere. But if you have some kind of a mat or some kind of something that they can be on, and if it's warm enough on the floor, taking off their pants and taking off their socks so that they get a little bit of a grip on the floor so they can actually be moving around, just setting up a space that they have to be able to have unrestricted movement.
You want to be, from the very beginning, giving your baby supervised and short periods of being on their tummies from the very first weeks. And this can be laying on the floor on their tummies. It can also [00:29:00] be laying on their tummies up on top of your chest. And that's a good way to also be practicing having eye contact and talking and singing and all kinds of things, getting them to exercise lifting their heads.
You want to hold and carry your baby in different positions throughout the day so that they are getting a variation of how they're being held and carried. That also helps for their motor and their sensory system so that they're getting a lot of different kind of sensory input from the balance systems and movement throughout the day.
If you see one of the primitive reflexes that is very asymmetrical, it's weak on one side and it's strong on the other, or if you see that there's anything that you are wondering about whether what you're seeing is normal or not Find a clinician who is trained in [00:30:00] neurodevelopment in your area. Find a chiropractor who can check primitive reflexes or an occupational therapist who is trained in neurodevelopment.
Find someone who can help you do an assessment on the primitive reflexes if you are wondering if there's-- if you're looking at something that's normal and the way that it should be or not. That can be... It can be hard sometimes if you're not used to checking them. If we look at our next section, which is movement milestones, by the end of the first three months, you should be seeing some real progress in head control, how long your baby is able to be laying on their tummy, and just the smoothness of overall movement.
Not as much head bobbing, not as much where it looks like they're really having to fight for having control of a very big head on a very tiny neck and starting to see a little bit more of a smoothness to the way that they're [00:31:00] moving. There's a woman, Mary Sheridan, she has done a lot of work on milestones and the framework for milestones, and she gives us the, maybe the simplest map of what to expect month by month in the first year.
And so for the, for the zero to three-month window, the biggest sort of milestones in terms of gross motor movement are seeing that they're having better head control, seeing that they're able to be on their tummies more, and starting to see the appearance of m- being more midline with their hands, which means the hands are starting to be able to meet each other in the middle of the body, and the first sort of signs of them reaching for things intentionally.
So they see something that's exciting or interesting, and they're reaching to grab it or to touch it. Two women who I also have on the reference list, Esther [00:32:00] Thelen and Karen Adolph, who talk a lot about milestones as well and reminding us that milestones are not switches that flip on. They happen gradually through hundreds of small, imperfect attempts.
So you wanna think about giving your baby unrestricted time on the floor is all about allowing them the time and the space to practice these motor movements. And the more rehearsal, the more practice time that a baby gets, the more smoothly the milestones should unfold. So during those first weeks, you will see their, your baby will be able to briefly lift their head during tummy time.
Their head will be able to be turning to both sides. symmetrically in those first weeks. By about six weeks of age, you'll see that they're getting more [00:33:00] skilled and able to hold their head for a longer period of time. They can turn their heads, both laying on their tummies and laying on their backs, for more sustain, for longer periods of time, and that their hands, again, are starting to meet each other more at the midline of the body.
By about two months, you should see more strength and better control of the head when they're laying on their tummies, and their hands starting to find each other, and their hands starting to find their mouth. And you'll also see that their eye movements are tracking more across the midline of the body.
And about 12 weeks or three months, they should be holding their head pretty well when they're laying on their tummies. They should be having, starting to support their weight more on their forearms, having their hands together often, and really beginning to reach for things and grab for things and, and being able to have better control when they're holding up their own heads [00:34:00] when they're sitting supported by you.
Obviously, no three-month-old is sitting on their own let yet. But being able to hold their own head more stable when you are supporting them in a sitting position. So you wanna think that your baby is not going to wake up one day and have control of their head. They are going to wake up every day and try a little bit more than they tried yesterday, and slowly you will start to see the m- better strength, better coordination, um, better control take over.
So starting early with having them laying, spending time on their tummies, a lot of, uh, babies will be... You need to have, uh, good mood on your side. You need to... It's better to be doing it after they've slept a little bit, and, and there will definitely be big differences in how long they are interested in being on their tummies in that first, those first three months of time.
But [00:35:00] if you have a baby who really hates being on their tummies, they really are having a hard time lifting their head, they really, they're crying, they're not interested in being put on their stomachs, that could be something that is worth looking at. If finding a clinician who can help you to find out if there's a reason, if there's, if there's something that they're having pain when they're in that position or having a hard time lifting their head, it's important to check that.
So you should be seeing, again, progress in head control during these first three months, increased tolerance and increased competency when they are on their tummies, symmetrical movement on both sides of the body Their hands are starting to come more to the middle of the, this, the middle of the body, and their hands are starting to come up to their mouths by about the end of the third month.
So you wanna be thinking at home about putting them on their tummies every day. Start early on. Being on to- laying on their tummies on, on your chest [00:36:00] is fine, uh, especially in the very beginning. And frequency, doing it often, matters more than duration. You wanna vary positions across the day, how you're carrying them, carrying them on their backs, carrying them on their sides, having them laying on their tummies, having them be up on your shoulder, having them facing outward, facing forward.
You wanna really try to give them as many different inputs into their vestibular system, their balance system, as you can, and giving them a range of movements throughout the day. And so if you see your baby really preferring turning their head to one side, you're seeing that your baby is really having a hard time laying on their tummy, or they're not progressing in head control and strength as they would during the first three months, again, find a clinician, find a chiropractor who is trained in [00:37:00] pediatric chiropractic or another clinician who is trained in neurodevelopment.
This, the wait and see method, I talk about it on almost every podcast, but I am not a fan of the wait and see method because if there's something that you're observing during the first three months, it is so important to find out if everything is working properly and, and nothing is... They, they don't have an area of their spine that is not able to function the way that it should be doing.
They don't have an asymmetry in the, the musculature or the, the strength of their muscles, and somebody who is able to check whether the primitive reflexes that should be present and symmetrical are present and symmetrical. So you will never regret finding someone who is in your area who is skilled and capable and able to help you to do an assessment of your baby if there's something that you're seeing that feels like it could be off.
The next section is all about [00:38:00] sensory soothing. What calms a newborn, and why does it work? The... Anything that, when your baby's upset, anything that feeds the vestibular or the proprioceptive or the tactile systems. And the vestibular and the proprioceptive and the tactile systems are all about the balance or the, your baby's ability to be registering when they're moving in space and the baby's ability to be, you know- have control or have input on where their body is in space without looking at it.
So we have sensors in all of our muscles and our joints that tell us where our hands are when we're not looking at them and where our feet are when we're not looking at them. And these things, these systems are developed, uh, and very immature in the beginning, but these systems are something that are [00:39:00] present also in the womb.
And so when you are rocking your baby or bouncing your baby or swinging, you know, your baby or doing, touching them, these kinds of input are something that your baby will recognize from the womb. And so that will very often help to soothe and calm their nervous system. There are two women who are foundational in this area of sensory soothing, uh, a woman named A.
Jean Ayres, and more recently a woman who has updated her work. Her name is Lucy Jane Miller. And they give us a, a simple framework, and that is that the inputs that calm a very young baby are the inputs that feed these foundational senses. So deep, even pressure feeds the proprioceptive [00:40:00] system. You know, touching, being really not too hard, obviously, but keep having deep, even pressure when you're touching your baby.
Things like massage or touching their skin or massaging their feet or having touch on the, your baby is really important for their proprioceptive system. Slow, rhythmic movements feed the vestibular system or the balance system. And warmth and contact feed the tactile system. White noise, which a lot of babies can help with sleep, is something that sort of approximates the constant noise and sounds that are in the womb.
So all of these things that you're doing to soothe and to calm your baby are helping the autonomic nervous system to develop and to grow. There's a woman called Mona Delahooke, and [00:41:00] she takes the polyvagal framework, which is Stephen Porges' work, and turns it into practical advice for parents. And her core point or her, one of her core messages is that behavior is downstream of state.
So if your baby is dysregulated, if your baby is upset, if your baby is crying, the answer to that is not to manage that behavior, but it's to support the state With looking more at bottom-up sensory input that helps the nervous system come back to baseline. So this act of co-regulation that we've talked about where your baby is not born knowing automatically how to go from dysregulated into regulated.
They need help from a caregiver or from [00:42:00] an adult to regulate their nervous systems and to be brought back into a baseline, calm, regulated state. And so trying to manage the behavior of your baby being upset, uh, you know, in best case is something that's gonna be a long, arduous process, and worst case, it's gonna, it's gonna increase the amount of time that the nervous system is using to learn how to find that calm, regulated state later in life.
So r- thinking about co-regulation, letting your baby borrow your nervous system, being in that calm, regulated state yourself so that your baby has something to model or to mirror is really important. So what does this look like at home? If you have a baby who [00:43:00] calms down when they're held against the body, and again, it's okay to h- to hold onto them a little bit tightly.
It's okay to use a little bit of pressure. You want to... When you hold them tight against you, that's sending a lot of proprioceptive and tactile input to their brain. You're, uh, you know, seeing a baby who quiets when they're being carried or they're being rocked or they're being... Or you're swaying your body, not swinging your body, but swaying your body back and forth, that is sending input to the vestibular system.
That's mimicking the movement that they had when they were in the womb. A baby who you see who calms down with white noise or with shushing or... I had a patient who her s- her son only slept with the vacuum cleaner on next to him, so she turned the vacuum cleaner on every time he was going to sleep. Some babies who fall asleep as soon as you turn the shower on.
Some kind of an auditory input [00:44:00] that feels like they recognize from being in the womb. And a lot of babies who are really soothed with having a pacifier, having a, something that they're sucking, that is also the autonomic nervous system being stimulated. So there's a reason why your baby calms down when you hold them.
It, this is not, you're not, um, training bad habits in your baby. You're not spoiling them. You are giving them sensory input By holding them, by rocking them, by soothing them to help them train their nervous system to be able to do it for themselves later on in life. And again, like I say every time, this is a process that's trained over time.
It doesn't happen automatically. But actively being responsive to a baby who is dysregulated or upset or crying helps them to train their nervous system to be able to do it faster and better themselves in the [00:45:00] future. If your baby is dysregulated, the... It's very rare that the answer is going to be to let them work it out.
The answer is give their system sensory input that their s- system can recognize, and be a calm, regulated parent who is doing the work. And it's not gonna be perfect every single time, but that is the recipe for how to help to train their nervous system during these first three months of life. So you should be seeing during these months that you're catching on to what your baby likes, what soothes them, and what doesn't.
Some babies hate to be held in certain positions. They hate it when you are, if you're sh- do- using, you know, shushing motions. They hate having white noise next to them, and some love it. But you don't know until you try to figure it out. So [00:46:00] you should be starting to see a pattern of what soothes your baby, and when you figure that out, do it often.
Do it more. You're, s- you're finding the key to how to help them regulate their nervous system. You should see that it's easier to do this, that they're having an increased capacity to be soothed by the end of those three months, that they're coming back to baseline more easily than they did in the, in the very beginning.
And you should see y- sensory preferences emerging. Some babies need more movement. Some need to be held tightly and more of that deep pressure, and some need more quiet. So you should start to be able to recognize a little bit more what it is that your baby needs and what works. So if you're at home, you can be building your sensory toolkit.
This could be having, if your baby is using a pacifier or not, if you notice that when you [00:47:00] sing to them, that that soothes them, or when you s- talk to them in a low voice, uh, that works to soothe them. If, if being skin to skin is something that can soothe a lot of babies, being rocked, being b- b- being in a s- in a, in a baby, um...
being in a, a carrier where they're c- where they're close to your skin, close to your body. So try things, see what works, and listen to the feedback that your baby's giving you about what's working and what isn't working. And try to match this, how you're soothing them to the moment. If you have a really tired baby, sometimes bouncing them all over the room is not going to work very well.
A lot of times an overstimulated baby, they need a little bit more quiet. They need a little bit, um, [00:48:00] they need to be held tightly. They need to be held close. If you have a baby who is not overtired and not overstimulated, they can us- but just fussy, they, a lot of times they can handle more movement and more noise.
Um, when things are getting hard, if you're in a rough spot, try to lower the sensory load. Try to dim the lights. Try to move yourself and your baby into a room where there's not a whole lot of people talking or loud music or TVs or a lot of voices. Um, th- you know, when there's sensory overload, getting handed around to everybody in the room who wants to hold them is not always the key to regulating a nervous system.
So trust your instincts. The mother of the baby usually can read exactly what the baby needs much more accurately than anyone else, and then you just have to be an advocate for whatever the situation is and what [00:49:00] your baby needs and be clear about that with the people around you. Everybody means well, but the mother is the one who can usually read what's actually going on and what her baby needs, so.
If we talk a little bit about head shape and asymmetry in the shape of the head, I wanna just say that I have a full podcast on plagiocephaly, which is an flattening of the head, and I think if this is something that you are seeing in your baby, I think having a little bit more information, I will link that podcast in the show notes so that you can find it.
But if we're just gonna go a little bit into head shape and asymmetry here. During the first three months, it's really important to be noticing and looking at how your baby is holding their head, where they prefer to look, if the shape of their head is changing during those first months. These are all signals from the developing nervous system.
So [00:50:00] Looking at what it looks like, how their movement patterns are, you should have a baby who is equally interested and able to turn their head as far in each direction. You shouldn't be seeing an asymmetry of movement. There's something going on if that's the case. There's a, there's a German, a man named Heiner Biedermann.
He is a pediatric manual therapist, and he gave a name to a cluster of symptoms or presentations that he calls KISS syndrome, K-I-S-S, kinematic imbalance due to suboccipital strain. And if we're gonna put that into plain language, this describes babies who, due to a position in utero or the birth process or both, end up with a strong preference for turning their head to one side.
Usually, that shows up with feeding difficulty, irritability, [00:51:00] disrupted sleep, and the head shape changes that follow that because they're laying with their head more turned to one side than the other for prolonged periods of time. His work is widely known in manual therapy work, and he gave a name and a framework to what a lot of pediatric chiropractors and osteopaths and a lot of us who are working with the function of the spine and the cranium see every single day.
You wanna see that a baby, your baby is equally turning to both sides. What can be a little bit harder to pick up on sometimes is the babies who... Sometimes you'll have a baby, it's very clear because they cannot turn their head to one side. They'll get to the midline, and they just can't turn their head or won't turn their head in the other direction.
Then it's very obvious to know that you, to see that you have a baby who's got a reduction in function, typically in the, one of the upper cervical, the upper neck, where they've got a, what chiropractors term a subluxation of [00:52:00] a misalignment of one of the vertebral bones that is impinging the nerve function and impinging the muscle's ability to help turn the head in both directions.
But the part that's more tricky is if you have a baby who spends a lot more time with their head turned in one direction, but they're able to, on their own, turn their head in the opposite direction. Those can be a little bit harder to see as parents, and it can take longer time to notice. But you wanna see a baby who's spending most of their time equally distributed between having their head straight forward and having their head turned to the left and having their head turned to the right.
So if you're seeing anything that looks asymmetrical, it's worth finding a clinician again who you can have do an assessment of your baby's spine and see if everything is in the position that it should be in and everything is working the way that it should. If you're seeing a flat spot developing on one side of the back of the head or directly in the back of the head, if there's, you have a baby who feeds really well on one [00:53:00] side and really struggles on the other, also worth finding a clinician who can find out if the reason why they're having a hard time feeding, you know, it affects the baby's ability to turn their head fully in the other direction.
If they have an impingement in the way the nervous system is functioning on one side, they will often have a decrease in the sucking reflex or their, the strength in the mouth or the throat or their tongue. They're not able to use the muscles as efficiently, so they're not able to feed as efficiently or effectively on the side that is hard to turn towards.
So if you're having a baby who there's a big difference in how they're feeding from one side to another, then I think that it's really time to have your newborn assessed by a pediatric chiropractor. Um, if you have a baby who is really irritable when they are handled in certain positions and there's no obvious reason for why they would be upset by that or crying from that, if you can [00:54:00] see that it looks like they're upset or something is maybe hurting them when they're in certain positions, that's also a case where I think it's worth finding someone who can do an assessment.
And if you have really disrupted sleep that doesn't seem to, they're not hungry or there's not an obvious reason, but they're having really disrupted sleep or really short periods of time when they're sleeping and being waking frequently, again, there's not much of a pattern in the very beginning, but if that's something that you're still seeing throughout the second and the third month, I think again, it's worth finding someone who is trained in pediatrics and neurodevelopment and having them do an assessment.
I think you want to think that it's worth having a closer look when you're seeing asymmetry of movement that isn't changing, if they have a head preference when turning their heads, a preference to be in one side or the other, if they're developing a flat spot in the back of the [00:55:00] head, if feeding is easier on one side than the other.
These are all things that are really hard to know as a parent what to do with, and a lot of times you need help from somebody who does this. So address those things early. I really think it's important to be finding someone in your area who's good and taking your baby early to be assessed instead of waiting and watching to see what happens.
That is rarely the best approach if there's a pattern that's in front of you. It's easier to fix in the zero to three month window than it is later on. So You want to see an even, full head shape, no developing flat spots, equal feeding ease on both sides, a sense of comfort in different positions.
They're not clearly being upset by being placed into a certain position, and that their head is turning to both sides equally. They are themselves able to turn their head equally to both sides. [00:56:00] So things that you can do at home, you want to again be varying their positions throughout the day. Alternate the sides that you are carrying your baby on, the direction they sleep in when they're sleeping in the, their cot or sleeping in the bed, the side that you're feeding from.
If you are bottle feeding, you still want to be holding them, alternating the sides, the arm that you're holding them with, uh, when from each time that they're feeding. Having daily tummy time from the very beginning is one of the most protective things you can do and preventative things you can do for head shape.
Limiting the time that you have your baby in containers, which is everything from car seats, bou- obviously when they're in the car they need to be in a car seat, but car seats outside of the car, bouncers, swings, things that contain your baby and hold their head against a flat surface, you want to be limiting their time in that.
And if you see a strong, persistent preference, again, we [00:57:00] talked about this, of developing a flat spot, feeding asymmetry, you want to find a clinician who is trained in pediatric assessment. If this is a chiropractor or an osteopath or a physiotherapist who has experience with newborns, but somebody who knows what they're doing and can help you to find out if this is something that needs attention.
The last couple of sections here, if we talk about the development of the visual system, your baby's vision really changes in the first three months, and probably more so than it does during any other window of their life. And so if you know what to expect during this time, it lets, you don't have to worry about what's normal, and you can be just observing the development, uh, and see what's unfolding.
So- I referenced Mary Sheridan earlier. Her framework, again, gives us a picture of what vision looks like during the first three months. The newborn [00:58:00] can see best at about eight to 12 inches, which is about the distance from where they are when they're breastfeeding to their mother's face. So if that's not proof of nature knowing what it's doing, I don't know what is.
And they prefer, babies in the beginning prefer high c- looking at high contrast things and looking at human faces. And then over the first weeks, they're able to, their focus sharpens. They can track with their eyes a little bit more. You'll start to see that they can, their eyes will converge more when they're looking at things in the middle of their body.
And by about three months, you'll see that they are tracking, following much more clearly, and they are looking at objects that they wanna get ahold of before they're actually reaching with their hands. You wanna be thinking about, in those first weeks, that your baby's gonna be having a briefly focusing on faces that are about eight to [00:59:00] 12 inches away and s- and beginning to track movement of faces or objects.
But by six weeks, you'll see much longer windows of focus and that the eyes are starting to follow across the midline of the body, and that you'll see them start to be smiling in response to your face. By two months, eight weeks, you'll see even better tracking, eyes that meet yours and can focus and stay there so that they're holding eye contact, and that they are increasingly interested in things in their, that are around them that have high contrast and patterns.
And by three months, you'll see them, they're exploring the room. They're looking around. When they're held upright, they're looking at their own hands. They're starting to reach for things. They're starting to try to... The first signs of sort of swatting at objects that they can see in their visual field.
So in the very beginning, your baby has vision [01:00:00] that is designed for looking at your face. And as the time progresses, as they get to the end of this three-month window, they are, the brain is learning more how to use both of their eyes together and how they're starting to see, they're able to see more, have a little bit more depth perception and see a little bit more, a little bit farther, and being able to track things in their visual field.
And that they are more able to track almost with their eyes than they are with their hands. So you'll see their eyes moving towards something that they're interested in and that they would be, like to get ahold of, and that's more clear than their ability to grab ahold of those objects with their hands.
That, that usually takes a little bit more time and a little bit more Coordination. So you wanna see that they are using both of their eyes m- mostly equally, uh, no consistent crossing of the eyes. Sometimes you will see their eyes cross, [01:01:00] but you wanna see no consistent crossing of the eyes or wandering of one of their eyes.
You wanna see that they are more visually interested in the world around them and more tracking what's happening in their environment by about three months. So in the very beginning, things that you as a mom can do, you just hold your baby at, up to your face. Let them study your face. There's no better visual input than this.
Have as much natural light in your home or wherever you are as you can. The visual system is, it's so much easier with natural light than you having a lot of bright or artificial lights in their environment. You wanna also, again, be limiting screens in the visual field for a young baby. Screens flatten depth perception.
Things on a screen move way faster than babies are able to track, and they, they bypass the [01:02:00] input that you're trying to, that the visual system is trying to learn. If you notice consistent eye crossing, one eye that's wandering, or you feel like there's a lack of visible engagement, by the end of the third month, you wanna be bringing that up to your clinician.
That's some, those are some things that you wanna have some help with taking a look at to see what's going on. So if we think about looking at, again, what is... Because all babies are different, they're never gonna follow the textbook exactly, and sometimes it's important to think there's a difference between normal variation and a signal of something that's worth looking at more closely or getting some help with looking at.
So Robert Melillo, who is both a, a chiropractor and a researcher, I have referenced his work so much, and I've s- done a, so much, so many hours of training [01:03:00] with him on, um, functional neurology and child development and neurological developmental disorders. And his framework really emphasizes that asymmetry and delays in those first months, these are things that are worth taking seriously.
Not because every single asymmetry or delay means that there's a problem, but because Looking at these things, having someone look at these things early and having early intervention is so much more effective than trying to fix things later on when they've been more hardwired, uh, into the system. So the earlier that the developing brain and nervous system gets help, the easier that help is.
And obviously there's a normal range and there's sometimes a wider range, and the point is not to panic at every variation, but to know which things that you're [01:04:00] seeing that are worth getting some help on, and we've talked about a lot of those. So the things that you can be reassured by is your baby's feeding, they're growing, they're gradually moving more toward better nervous system regulation.
They have longer periods of quiet alertness. They're looking at your face. They're noticing things in their visual field. They're better able to hold their head upright. They have more smoothness in their movement patterns than they did when they were a newborn. They're more... They're able to engage and to have eye contact.
And, and if you're seeing things that are, things that you wanna be-- w- that are worth taking a closer look or having a clinician take a closer look, those are things like we've talked about with having a preference for turning their head to one side over the other that's, it's not improving or it's not changing, um, very asymmetry when it comes to feeding, that there's a difference [01:05:00] between the sides.
If you're not seeing visual engagement by the end of the third month, if you feel like their head control isn't progressing, they're not getting stronger, their movements are not getting more smooth, if you're not able to-- if they're not being startled by sounds, if they have a very high muscle tone, if you feel like your baby is really stiff and rigid in their body, or if they have a very low muscle tone where you feel like they're floppy and not building strength and engagement, better b- better coordination and better strength in their muscles at the end of those three months, that's something that you wanna have a clinician take a look at.
If you feel like there's asymmetry in the primitive reflexes or if you feel like you're seeing, again, flattening in the back of the head, or if you have a baby who is just really distressed and dysregulated in a way that's very hard to soothe [01:06:00] and that isn't matching up with they're not hungry and they're not tired, and you're not seeing that that ability to soothe them quicker and more efficiently as the three months goes by, that's also something that's worth getting a clinician to, to take a look at.
And so these are things that you... If something is nagging at you and it's on your mind, g- get a second pair of eyes on it. A lot of times, all the time, mothers are right when something doesn't feel right. So if your intuition is telling you that there's something that you need to get looked at, get it looked at.
And early intervention in this window really has a high yield. This, the system is, the brain and the nervous system are so plastic. They're so, they're developing, they're so responsive to input during this window of time. So if you have some really well-targeted help, it can go a long way. So trust your instincts.
If [01:07:00] something is, again, nagging at you, don't wait and see. Find a clinician who's trained in pediatric neurodevelopment, not just the basic routine well child checks. You need somebody who can really look at their development and is trained to see the early signals. So that's the person that you wanna find.
And, uh, at the same time, you know, the more that you know, the entire point of this is that the more that you know about what normal development looks like, the more you will understand that there's some variation is definitely normal, and that you just wanna be seeing these changes, developing the signs of growth and the signs of development over these three months.
So to wrap it up here, these are long episodes, these, this series, but my hope, again, is to give you as much information and as many tools as I can so that you've got it for these, this first year of life. You wanna think [01:08:00] about building a daily rhythm around your baby's state, not around the clock. You wanna be really generous with the amount that you're holding and carrying your baby and having skin-to-skin contact.
Think that all of these things are helping to develop their brain and their nervous system, not spoiling them to be... You hear, there's, you can still hear people say that sometimes, that if you're, you'll spoil your baby if you're holding them too much. That's not what's happening. You're helping them build their brain and their nervous system by being very generous in these first months by holding, carrying, skin-to-skin contact, a lot of, as much engagement as you can.
You wanna have a lot of, as much time as your baby will agree to on being on the floor and being able to move in a way that's unrestricted and being on their tummy Daily, several times each day. [01:09:00] Spend a lot of time having, being face-to-face and having conversations, listening to them when they are making sounds and noises and cooing and, and doing the same back.
Um, giving a lot of sensory input that sort of matches where your baby's nervous system is. So if they need low stimulation, if they need things to be quiet, and your voice to be low, and the timing and the stimulation to be as low as possible, if they're in a more awake and alert state and can handle a little bit more sensory stimulation, be trying to match their nervous system, and that's something that you learn.
It's really hard in the very beginning with a newborn, but as the first three months progress, it'll be easier and easier for you to read what it is that they need. You wanna really have tight limits on screens and on having them in containers or things that are keeping the back of their head against something for too long at a time.
And remember that [01:10:00] being, having your own nervous system as regulated as you can is the best support that you can give to your baby's nervous system. So hold them a lot, let them move a lot, let them be on the floor a lot, soothe them a lot , slow down a lot. Everything else is just not, not as important in this very, in this very first window.
And again, having as... When you need a break, when you as the mother need a break and need help and need support for your own nervous system, get really good at asking for it. It's the most powerful brain-building tool that your baby has, is your regulated nervous system, and it's so taxing in those first three months.
You really need help, and you need to get good at asking for that help. So overall, first three months of [01:11:00] life, you wanna have an overall sense that your baby is becoming more of themselves, more responsive, more present, more organized, more regulated across these three months. You w- wanna see that you yourself are becoming more confident.
You can read your baby better. You trust your instincts more. You're second-guessing yourself less. You wanna see these windows of your baby being quiet but alert are getting longer, and that being able to soothe them becomes faster and easier, and that you are starting to really trust yourself in knowing that this, the development is happening and unfolding just as it should.
You wanna- Think about protecting the conditions around your baby. Having a rhythm, how you hold them, having them on the floor, having a lot of face time, being good at soothing them, having low stimulation so that they're not constantly being overstimulated by too much sensory input. Read what your baby is doing [01:12:00] instead of trying to read the clock and what time it is.
Your baby is the source and is telling you from minute to minute what they need. And among everything else, you know, really this is just honoring the magnitude of the work during this time. You are right inside of, just in the thick of one of the most important developmental windows in your child's entire life.
And so having the, just the, the, s- just slowing down and having the patience and having the understanding of what's actually happening. Because when you're sitting in it, you're thinking to yourself, "I'm never again going to be able to take a shower that lasts more than 30 seconds," or, "I'm never again gonna be able to eat breakfast before 2:00 in the afternoon."
I mean, you're r- you... I remember all of those thoughts with both of my kids, 'cause when you're sitting in it, [01:13:00] it's so all-consuming, and it's so taxing, and it's so full-on that you think to yourself that you're never gonna get on the other side of it and have a normal life again. But I promise you are.
And those three months goes by so fast, but the days can feel really long when you're inside of it. So if this series, I hope that you will go back, if you haven't listened to the first part of this zero to three-month series, I hope you will, and I hope that you will... I hope it gives you a new way of seeing your newborn.
I hope you'll share it with another mother who maybe has a baby in this zero to three-month window. I think that the information in these episodes is the kind of thing that's important for new mothers to know, and important information for them to have. And I hope that you will follow the show so that you don't miss the next episode.
There are two more episodes coming up about [01:14:00] the three to six-month window, two episodes after that about the six to nine-month window, and the last two episodes that are about the nine to 12-month window. So I hope that you will come back and join me for those. And again, thank you very much for being here and spending time with me today.
Thank you again for joining me today for this episode. I hope you found something valuable in the time we spent together, and I hope you'll join me again next week on the Create Thriving Families podcast. Until then, be well.
