Friday, July 17, 2020

Preparing Baby for Daycare


Transitioning a baby to daycare doesn't begin when you hand your infant off on the first day to your provider. It starts waaaaay before then. 

For your peace of mind, your child care provider's ability to provide quality care, and your infant's emotional and physical comfort, there are several things that need to be accomplished long before that first day of child care.

For a successful transition:
  • Baby must be bottle trained
  • Baby must be able to nap well in the crib or pack-n-play your provider uses
  • Baby must be used to safe sleep practices
  • Baby must be able to fall asleep on own
  • Baby must be able to spend time not being held
  • Baby should be able to self-soothe to some degree by 4 months
It is very easy while on maternity leave, especially with your first child, to breast feed exclusively, hold your baby all the time, let your baby fall asleep on the breast, and hold your baby while sleeping. You want that closeness and to spend as much time as possible with your infant. 

Unfortunately, all these things set your infant up for having a very rough transition to a daycare situation, and possibly the loss of your daycare position. Even if you have a wonderful and attentive provider, they have other children to take care of as well. Lunch must be made, diapers changed, altercations mediated, learning taught. One infant can not consume 100% of a provider's time and attention. 

A parent and infant that expects or demands that, will need to find a provider willing and able to accommodate those needs. Since sleep practices are regulated by licensing, that can mean needing an in-home nanny who is not under the same regulations, or an illegal provider. A quality licensed provider will not be placing an infant at risk, even at the parent's request.

BOTTLE TRAINING

The earlier you introduce the bottle, the better the result. As soon as good breastfeeding is established, the introduction of a bottle a few times a week will help your infant transition to day bottle feeding during child care much easier. Introduction just a few days or even weeks prior to going into daycare, will be a struggle. I currently have a 15 week baby that took more than 3 weeks of daily 3 bottles a day training to even BEGIN to take the bottle with any level of success. She was exclusively breastfed while mom was home. She had never had a bottle and refused that plastic nipple even being near her mouth. Quite vocally. Starting earlier is easier. For everyone, including your baby. 



Baby should be taking a bottle on the same schedule as they will at daycare, at minimum, the last two weeks before transitioning into care. If there will be no option for you to come breast feed, there shouldn't be any option of that at home those last two weeks, either. 

Even if you plan to breastfeed every feeding at your child care provider's, your baby should still be bottle trained unless you can GUARANTEE that you will be able to make those feedings. No meetings that go over, no late phone calls, no car accidents or bad traffic in your commute, etc. You can't leave a hungry baby screaming with your provider with no way for them to accommodate your child's needs. 

Keep in mind that exclusive breastfeeding also means your baby will have a very difficult time if you get sick or in an accident, they get sick and need to go into a hospital, you want to go out for an evening or go away for a weekend, you need to take certain medications if you get sick, or would like to have alcohol every once in a while and be able to pump-and-dump for 24 hours afterward. 

Very few infants have "nipple confusion" after breastfeeding is established at about the 4 week mark. They want their mom connection and the taste and feel of the breast, and will go between bottle and breast with little fuss once trained. 

Once baby is old enough to have an opinion, it can be difficult to bottle train. There are some tricks:
  • Provide a nipple that mimics mom's breast and nipple size OR
  • Provide a nipple that is similar to their pacifier if they use one
  • As with a binky, begin by just having them play with it in the mouth
  • Have dad or someone else give the bottle
  • Give the bottle in a position other than the one for breastfeeding
  • Give the bottle when you know baby is hungry
  • Try holding a shirt or blanket with mom's smell next to baby's head
  • If baby refuses to take breastmilk from a bottle, try formula. If formula works, gradually mix it with breastmilk in increasing quantities until baby is back to taking breastmilk exclusively.
  • Make sure bottle is warm enough, it needs to be body temperature
What causes problems: 
  • Not starting early
  • Not starting early enough to have it completed in time for care
  • Liking that baby only wants mom, not fair to baby
  • Not pumping prior to care to know how much can be produced and creating a back up supply of frozen breast milk
  • Assuming baby will take a bottle from the provider, in a new environment with new sights, sounds, smells and people, when baby is already stressed from starting at a new place
Most providers require infants to be bottle trained prior to starting care.

HOLDING

I hold my infants to 4 months as much as possible. I have a lot of experience and am able to do almost everything with an infant in my arms. When not in my arms, the infant is in their carrier, pack-n-play or bouncer right next to me. I am able to talk and interact with the baby at all times. However, I can't hold them the entire time. They must be okay with the separation and just being close, seeing my face and hearing my voice.


 

Your baby needs tummy time and to spend time near, but off, of you. Holding an infant 24/7 is fine for the first weeks, but they need to build the muscles for rolling and that takes time down on the floor. They need to know that not being held is not being abandoned and to be okay with it.

Over 5 months, a baby should be on the floor most of the time. Spending time on the floor with a constantly changing variety of toys and sensory items is what builds physical strength, proprioception sense, vestibular balance, crossing-the-midline ability, cognitive connections, resiliency, cause/effect understanding, visual acuity, and so many more developmental markers. Being held, sitting in a stationary exersaucer, and using any other contraption that holds an infant in a fixed position is detrimental to their growth and development. It is vitally important for their physical, mental, emotional and cognitive growth that they be allowed to spend time alone on the floor exploring and moving. 


What causes problems:
  • Hold 24/7
  • Expect provider to do the same
  • Expect baby to be okay with not being held exclusively once in care, even though they are not okay with it at home [we are not magicians]
  • Not providing tummy time and other physical growth opportunities so that once in care, baby is not developmentally able to perform at an age-appropriate level

SLEEPING

Legally, providers must practice safe sleep practices. Infants must be placed on their backs in a pack-n-play or crib to sleep with nothing more than a plain pacifier. Period. Sleeping in a carrier, bouncer, baby hammock or even in the arms can place the infant in danger of positional asphyxiation

If a baby is allowed to sleep on a parent's chest, laying face down for naps, the transition to care is going to be VERY difficult. You've got a level of warmth, heart beat sound, face-down position, smell and body feel all to overcome before the infant can sleep in a daycare situation. This is SO far outside of how the infant will need to be taking naps at daycare, that it is very difficult to overcome once this becomes the baby's norm. 

NOOOOooooo!

Establishing your care situation as early as possible, you can find out if your future provider will be using a crib or pack-n-play, which music or white noise they use, level of light in the nap area, etc. so that you can mimic those factors as early as possible to get your infant comfortable with how they will be sleeping in care.

We often can't take the time to rock them to sleep, and we can't allow them to fall asleep on the bottle. We need to be able to place them in their crib or pack-n-play, on their back, and have them go to sleep with reassurance and soft touches.

Even the most chill daycare will have crying babies, screaming toddler drama, bickering preschoolers. Add in some banging, music, chatter, etc. and daycare is NOT a quiet place. Infants, especially for morning nap, must be able to sleep through noise. Putting them down in a quiet room by themselves all the time is setting them up for sleep problems at daycare. At minimum, have music or TV playing while they sleep in the morning and go about your regular activities. My infants sleep through the vacuum, dogs barking and all the other noises that go on here.  

What causes problems:
  • Letting baby fall asleep on the breast or bottle 
  • Holding baby in any manner while sleeping
  • Not putting baby to sleep in a crib or pack-n-play as will be required at daycare, especially for naps, while at home
  • Not practicing safe sleep practices/back-2-sleep
  • Swaddling beyond 2 months when daycare can't
  • Using a white noise your provider can't replicate
  • Using a Wubbanub, blanket, or other lovey for sleep time that can't be used at daycare for sleep
  • Having baby sleep in a quiet environment
SELF-SOOTHING

Parents, especially new parents, are quick to pick up and soothe at every peep their infant makes. Soothing is not at all bad, but when infants associate any little discomfort or irritation with being held, cuddled, rocked, cooed and entertained, it doesn't allow the natural progression of self-soothing. "Babies who can self-soothe sleep for longer periods and have longer total sleep times at night." Infants should begin to learn to self-soothe at 3-4 months and a 6 month old should have the ability.

A child care provider may be dealing with another child when baby starts to fuss, and unless the infant is in emotional distress, the infant may have to wait their turn.


Helping with self soothing:
  • Give the opportunity for your infant to self-soothe by not immediately jumping in to "fix" the situation
  • Watch for self-soothing behavior and only step in if the baby seems to be escalating in need for assistance
  • If necessary, soothe with sounds, words and soothing touch [gentle pats, back rub] rather than holding, rocking  and full physical contact when possible
What causes problems:
  • Respond with soothing to every little peep their infant makes
  • Soothing with breast/bottle feeding
  • Soothing immediately with picking up rather than sounds, words or touch first
SCHEDULE

I've seen mom blogs say that you need to get your baby on a schedule before they go into care. I disagree. A good provider is aware of developmentally appropriate practice and one of those practices is that infants are allowed to eat and sleep on demand. Especially until 6 months. At 6 months babies generally navigate into a regular schedule. However, this will always be at the whim of teething, gas, growth phases, changes in family schedule, any time away from parents or in a new environment, changes to routine, etc. Never get complacent with an infant schedule. As soon as you do, it will change.

The rhythms of a daycare setting are very different from the ones at home, and while a general schedule of morning nap, eating every 2-3 hours and afternoon nap are in play, schedules are never meant to be rigid for infants. Even older children often have different sleep needs when in a growth phase. I had a 5 year old who hadn't napped in a year suddenly start needing one when he took a massive growth spurt of an inch in a month. Your provider will want to know what the general schedule has been at home will try to accomodate that to some extent. More so, the provider will look to your baby for cues of hunger and tiredness and respond accordingly. 

Forcing your infant to stay up, go hungry, or pushing your baby to eat when it is full, is not appropriate. Babies need what they need when they need it. 

CONCLUSION

When all of these things are in place, your infant and provider can focus on building an emotional bond, a trust bond. Your infant can focus on becoming familiar and comfortable with the new environment in a state of being well rested with a full tummy. Having those basic needs met with little to no issue, will make the transition a MUCH easier one, on your baby, your provider, and YOU.

When in doubt, ask yourself, "Would I be doing this if I had six children?" 

If your answer is no, and you plan for your baby to go into daycare, then your parenting should, at least most of the time, help your baby prepare for a child care setting.

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