Your Baby and You

Bonding is the name of the important relationship a parent has with their child. It’s that feeling of love and warmth parents often describe when they talk about the way they feel about their child.

Attachment is a description of a child’s relationship with their parent, their need to be close to the parent in order that they can feel safe and secure in the world – and so that as they get older they can begin to explore the world away from their parent.

You begin to bond with your baby by responding sensitively to her signals.

As she tries to communicate her needs and you try to understand and meet her needs, she develops trust in you and becomes attached to you. You’re both learning and getting to know one another. As she gets better at letting you know what she needs, and you get better at responding to those needs, a connection develops between you both and your baby learns to see herself by how you respond to her.

For this reason, it’s important to respond to her cries as well as to her smiles with love and reassurance. This shows her that it’s OK to express sadness, discomfort, and pain as well as happiness and contentment.

"I don’t think I fell completely in love after the baby was born, I think it grew, and it grew, and it grew" - Rachel, Mum to Sade

Your baby’s brain

Babies are born with millions of brain cells. They have many more brain cells than they need, but they cannot be used until they are connected to each other.

These connections are made when the baby has an experience e.g. hears, sees, touches something. If the same connection is used often it will become permanent. If a brain connection isn’t used then that connection will die away. So, the more good experiences a baby has in the first three months, the more positive brain connections it will keep.

Important experiences that help a baby to make brain connections are being spoken and sung to, touched, stroked, rocked, fed, cuddled, and comforted.

If you are doing all of these things with your baby, not only are you well on your way to developing a healthy relationship with him, you are also helping his brain to develop.

The benefits of forming a healthy relationship in the first few months of life include:

• Resilience in later life, an ability to cope with life’s problems
• Protection against mental health problems, such as anxiety and depression
• Increased self-confidence and self-esteem; the ability to see yourself as a worthwhile person
• Increased general optimism - an ability to see your future in a positive way
• Improved ability to maintain healthy relationships with other people
• Fewer behaviour problems in childhood
• Better and faster language development
•  A reduced likelihood of post-natal depression in either parent

In pregnancy

During pregnancy there is lots you can do to help your baby feel soothed and secure, and to help her make a link between the inside and outside world: talking, singing, playing music, gently stroking your tummy, moving around, rocking, dancing.

Research has shown that babies are aware of sounds, touch and movement in the uterus and will recognise familiar smells and sounds as soon as they are born. You may also have learned things about your baby before he is even born. For example, that he likes music, that he is active, that he moves more when you are in the bath.

Making preparations for your baby, getting ready for his arrival, changing your routines, keeping him in mind when you make plans for the future, all these things are how you begin to develop a loving relationship with your baby even before he is born.

Try playing music that you enjoy and see how your baby responds in the womb.

What kind of personality do you think s/he may have?

At birth

Babies are born ready and primed to be sociable and interact with you right from birth. There is often a period immediately after birth when babies are particularly alert and eager to meet you. This is the start of you both getting to know each other. As long as you are both well, you will be offered an opportunity straight after the birth to have skin-to-skin contact with your baby. This is a time when you may want to just look at your baby and see him gaze back, talk to him, touch, smell and stroke him and give your baby the gentle welcome he needs.

During this time the physical contact you have with your baby will stimulate your production of the hormone oxytocin. This hormone will help you feel calm and relaxed and will help you to bond with your baby. Already babies can see 22–30cm (9–12 inches) to your face, can hear and are able to recognise their parents’ voices and their birth parent’s smell from being in utero. These familiar sounds and smells will be soothing to a baby born into an unfamiliar world.

You may have heard this time referred to as ‘the golden hour’ and although this is considered important immediately following birth, skin to skin can be offered any time - and as frequently as feels right. It can be a useful way to soothe your baby or encourage feeding during baby’s early months. Skin to skin is a great way for a second parent or care-giver to meet and welcome the new baby too.

If you don’t feel like you want to, or aren’t able to do this immediately after birth, don’t panic. Bonding doesn’t happen instantly like super glue. It’s a gradual process and can be started when you and your baby feel ready.

This may be a good time for a partner or another family member to become involved in getting to know the new baby.

Babies’ states

• Deep sleep
• Light sleep
• Drowsy or dozing
• Quiet, alert
• Fussing
• Crying

Part of learning about your baby is recognising when your baby is ready to play, sleep, cuddle, rest, and feed.

All babies have different levels of wakefulness throughout the day. Learning how to recognise your baby’s ‘state’ will help you to know how to respond to your baby at different times.

Quiet, alert

You will know that your baby is feeling alert when:

• He has wide bright eyes
• He is able to focus and show interest in a face, voice or object
• His body is still
• He looks for eye contact with you
• He smiles and babbles

This is time for chatting and playing with your baby.

TIP: Use this time to have fun with your baby and to show him how important and enjoyable he is. Remember that a baby can only maintain this state for short periods, minutes or even seconds, and will let you know when they need a rest (see time out signals).

Drowsy or dozing

You can tell that your baby is in this state when:

• Her eyes are open but glazed or heavy lidded
• Her eyelids are fluttering
• Her movements are smooth
• She will react to noise, touch and movement

During this time your baby will move from this state to either light sleep or to an alert state.

This is a time to watch, wait and see what your baby will do.

Light sleep

You can tell that your baby is in a light sleep when:

• Her eyes are closed or fluttering, there may be rapid eye movement under her lids
• There may be some body or face movements
• Her eyes may open briefly at times
• Her breathing may be more irregular
• She is easy to wake

This sleep is important for brain growth.

TIP: During this time you may want to keep noises and disturbances to a minimum if you want her to continue sleeping, as she may be easily disturbed.

Deep sleep

You will be able to tell that your baby is in a deep sleep when:

• His breathing is steady and regular
• His eyes are closed with no eye movement
• He is quite still apart from occasional startles, jerks or sucking movements
• He is difficult to rouse

Deep sleep is important for babies; it’s when they grow, rest and develop.

TIP: Try not to wake a baby in deep sleep, even for eager visitors. Instead use the time to catch up on your own rest. Sleep is just as important for parents.

Fussing

You can tell that your baby is in this state when:

• She becomes active, moving her arms, legs and head
• She may make more noises and fuss
• She may become extra sensitive to noise or movement

When your baby behaves in this way she is telling you that she needs something to change.

TIP: You need to slow things down, change what you are doing or change her position – maybe she is bored, hungry, tired, or overwhelmed.

Crying

Your baby will at times cry loudly and intensely and it might feel difficult to know how to respond.

• There will be lots of body movements
• He will grimace and may have his eyes closed tight

When your baby cries she is letting you know that she needs something different just now.

Babies cry for a number of reasons, it is their most effective form of communication. By getting to know your baby, and through trial and error, you can figure out what he wants. Once he reaches 4-6 weeks the amount of crying will reduce.

It is important to know though that you cannot spoil a baby by responding to his crying.

When you respond promptly and soothingly you are teaching him that you can be relied upon, that he is important, and that his world is a safe place. Because of this he will begin to cry less and sleep more at night.

All babies cry. They cry as a way of letting you know that they need something. As you get to know your baby it will become easier to work out what he needs, but at first it can be very difficult to know what to do.

Trial and error is the only way to deal with it. As you become more familiar with what your baby is trying to communicate to you when he is crying, you will be able to work out what he needs sooner. He will then learn that he can trust you to respond to him. You will also both learn that your baby’s upset is not the end of the world and that all will be well soon.

Some of the reasons why your baby may cry include hunger, pain, over-stimulation, boredom, loneliness, misjudging his mood, feeling too hot or cold, being undressed, and simply not liking what’s happening at that time.

If you can work out what your baby needs and you can give it to him, then life will be much more comfortable for both of you. If you are not sure what your baby needs – and you won’t always know what’s wrong – then your baby needs you to be there to soothe and reassure him. This can be really difficult, as hearing your baby cry can be almost as distressing for you as it is for him.

Try to keep calm and know that your baby is not crying to punish or reject you, he just has no other way of communicating his upset. Physical contact with your baby helps your baby to regulate, so cuddling your baby may be all he needs.

Comforting your baby won’t spoil him, and you won’t be creating a ‘rod for your own back’.

In the next section you’ll find ways you can help to soothe and settle your baby. Try them, and you will soon see which he prefers and what works for him (although don’t be surprised if what works this time, doesn’t next time).

It’s important for your baby to know that you are there and that you are responding to how they are feeling. Your baby can also benefit from learning ways to calm herself, and sometimes you can find opportunities for this.

You might find these ideas helpful to try – think about choosing a time when both you and your baby are feeling resilient and fairly cheerful, but you notice your baby beginning to become unsettled. If your baby is really upset and unsettled, they probably just need you to pick them up straight away, and comfort them in the way that you know usually works.

It’s important to remember that if your baby is crying for long periods and you feel concerned that they may be unwell, you should access advice from a health professional.

Stages of consoling

• First try to soothe your baby by letting him know you are there, let him see your face and hear your voice. You may have to speak quite loudly in order to be heard over the crying.
• If this doesn’t help, then try placing your hand gently on his tummy, in addition to talking to him.
• If that’s not enough, then try holding his hands and arms gently across his body.
• If your baby is still upset, then try picking him up, holding him still or rocking him in a rhythmic way, all the time talking to him in a soothing voice. Try holding him in different positions. It may also help to wrap him loosely in a sheet to help him feel more secure.
• Encourage your baby to use his hands to suck on, or a dummy if you are not breastfeeding and are happy to use one. In order for a baby to be able to soothe himself, he will need to be able to suck on his hands, for this reason the wearing of scratch mitts is not recommended. If you are concerned that your baby may scratch his face, ensure that his nails are kept short by using a soft emery board.
• Some parents like to use a sling to keep their baby close to them and find this closeness helps to soothe their baby. Others find that a trip in the pushchair or car works, when nothing else will. Try not to use these as a first resort though, as this will reduce your baby’s chances to use and become skilled at soothing himself. Whatever you try, give your baby time to respond. Changing things too quickly can be unsettling for a newborn.

If you feel you cannot cope with your baby crying any longer, then put your baby in a safe place and walk away. Stay within earshot so that you will know if she settles. Do not leave her for more than 5 minutes without going back to her. Talk to someone you can trust about how you’re feeling – your family, midwife, health visitor or GP. Ask for help and support from your family, friends, or trusted neighbour, so that you can take a break.

Remember your baby needs you to take care of yourself, so that you can take care of her.

Cry-sis offer support for parents who are experiencing problems with their crying and sleepless babies, you can call the Cry-sis helpline on 08451 228 669

BABYBUDDY. Text BABYBUDDY to 85258 for free, anonymous support via text message, any time of day or night.

ICON provides information about infant crying and how to cope: iconcope.org

You may also find online information on the ‘Period of PURPLE crying’ useful. This explains the scientific reasons why babies cry more between 2 weeks and 3-4 months more than any other time.

You may have noticed that your baby already has his own personality and even his own agenda! Understanding that your baby is a tiny person separate from yourself, with his own thoughts, feelings and intentions is an important skill called Reflective Functioning.

We can think of this as head, heart, hands.

Head

Focus on your baby, and think about their thoughts, you start to see the world through their eyes and from his point of view. You may then begin to understand that their thoughts, ideas and intentions are separate from your own.

Heart

Imagine what it is like to be your baby and feeling their feelings. Through doing this, you may begin to recognise their feelings are separate from your own. Take some deep slow breaths if you notice that your baby’s feelings are making you feel upset or overwhelmed.

Hands

In response to head and heart whilst interpreting your baby’s thinking and feeling, you may then find you progress to doing and saying things at the right time, which are sensitive. This lets him know you are trying to understand him.

If you can, spend a few minutes each day just sitting back, watching your baby and practising head, heart, and hands – it can really strengthen your relationship with your little one.

You are your baby’s favourite toy

He will love to look at your face, feel your skin, taste you, cuddle with you, be gently rocked, moved around and held by you. He will particularly enjoy having you spend time talking with him.

This may feel a little awkward at first but the enjoyment and interest he shows will be a big reward. If you’re not sure what to say or feel uncomfortable, then start with giving a commentary on what you are doing or copy whatever sounds or expressions that your baby makes. Copy his facial and body movements and be sure to put plenty of expression in your voice and face to attract your baby’s attention.

Make sure that you allow time for baby to respond to you and take his turn, he can’t respond as fast as you can. As he gets used to these special times with you, he will want to join in more and you will be able to let him lead the play sometimes.

Babies love to hear people sing to them or say rhymes

The different rhythms will keep his attention and help him to develop his own speech. Don’t worry if you don’t know children’s songs, any song will do. Use whichever language you feel most comfortable with.

All babies have different ways of showing that they are overwhelmed, tired or stressed. Watching your baby will help you to learn when she needs a break.

If you notice these behaviours in your baby, think about what might be overwhelming her and allow her to take a break. Slow down the pace or stop the activity you are doing with her, or move her to a quieter, calmer area. Or perhaps baby is ready for a sleep or a feed.

After a short break your baby may be ready to join in the fun again. But remember that interacting takes a lot of energy and concentration, so don’t expect her to be able to do it for more than a few minutes at a time. As she gets older, she will become more skilled and the more she practices the longer she will want to play for.

Signs to look out for are:

• Sneezing
• Yawning
• Hiccupping
• Turning away
• Closing eyes
• Bringing up a bit of milk
• Skin colour change
• Sudden sleeping
• Crying, staring, and holding their fists tightly or their body tensely

Knowing when to feed your baby can be difficult to work out. But as you get to know her you will learn how she signals that she’s hungry.

These signals are called feeding cues and can start even before she wakes – your baby may become restless in her sleep. If her hand is near her face, she may begin to turn towards it, and even try to suck it or anything else near her mouth.

If these early cues are missed, your baby may begin to make noises and smack her lips. Eventually she will work up to a full cry to let you know she’s hungry, however, feeding before she gets to this point will be easier for you and for her.

Keeping your baby close to you in the early weeks helps your baby to feel safe and secure, supports brain development and helps bonding. It helps with feeding, giving you the opportunity to watch for feeding cues and it also helps increase your milk supply if you choose to breastfeed.

It’s important when you feed your baby that you are both in a position that lets you see each other’s faces. Make sure you are both comfortable and well supported.

If you are finding breast or bottle feeding harder than you expected, or your baby is fussing a great deal, it might help to go along to your local infant feeding support group. Your midwife or health visitor will be able to give you the details.

Feeding isn’t just about getting food into your baby; it’s a special time in the early weeks, and in the months ahead as well, for you and baby to spend time together. It’s a chance to be completely focussed on each other. So try and forget about all the other things you need to be doing, make a drink, put on some music, and relax.

During pregnancy, and the first years of your baby’s life, you or your partner may experience mental health symptoms which can feel unexpected or worrying.

Having a new baby can be completely overwhelming; doing everyday tasks can feel like climbing a mountain when you are struggling with your mental health. Mental health difficulties are common around the time of having a baby and help is available. Being a parent isn’t always easy. Whether you are struggling a little or a lot, with the right support you can prevent things from becoming more difficult.

Symptoms can take away energy, motivation, concentration, interest, and confidence. Simply managing unpleasant symptoms can take a lot of energy. It is important to change your expectations and let go of what you don’t need to do.

Accept what is good enough

Conserve your energy for the important needs of yourself and your baby and be flexible about what you think ‘should’ be done. Often it can help to talk to other people – family, friends, other parents, and professionals. Let other people do anything possible to support you – run you a bath, take baby for a walk in the pram, do some laundry for you, or cook you a meal. If you don’t have people around you who you can ask for help, this can make things feel more stressful.

Speak with your health visitor who can link you into local peer support services.

You are not alone

Many parents with mental health conditions are able to give their babies safe and loving care, without their babies being affected in any way. You can find out more about the local support available at the back of this booklet. Alternatively speak with your midwife, health visitor or GP and they can support you in accessing the help that is right for you and your family.

There are various treatments that you may be offered, including talking therapies, and for some, medication may be offered.

If you or your partner are living with a long term mental health condition you may wish to contact your care coordinator, especially if you feel like symptoms are worsening.

Together, you will be able to consider a support plan which is right for you and your family.

Read more about perinatal mental health.

"I guess the biggest piece of advice I would give to any parent is don’t be scared to ask for help" - Mike, Dad to Atlas

Written by Spoons

Some babies may require neonatal care after birth and we know that this can be a stressful time for parents.

The neonatal unit may initially feel over-whelming and the environment can take a little getting used to. There is a lot to take in and you won’t be expected to remember everything you are told. The neonatal unit staff will talk you through any machines or medical equipment that your baby might need and encourage you to ask as many questions as possible. You will also be given the opportunity to talk to the medical team caring for your baby.

You may have concerns about bonding with your baby, but they will recognise your smell and voice and will be comforted by you being as close as possible. You and your partner will be encouraged to spend as much time as possible with your baby on the neonatal unit and there are lots of things you can do to feel closer to her. The neonatal unit staff will support you and your partner to be as involved as possible in caring for your baby. Being hands on in caring for your baby on the neonatal unit has lots of benefits for both you and her and can have a positive impact on both parent and infant mental health.

Neonatal care can sometimes feel a little isolating for parents but there are organisations who can support you through your neonatal journey.

For more information on neonatal care in the Greater Manchester area, visit the North West Neonatal Operational Delivery Network website.

For more information on support for families who experience neonatal care in Greater Manchester, visit the Spoons Neonatal Family Support website.

Greater Manchester is currently developing mental health services for neonatal babies and their parents.

You may find the resources below a helpful start to getting the support you need:

Infant parent services - Support growing relationships with your baby. Discuss accessing this service via your GP, midwife, health visitor or neonatal nurse.

Greater Manchester specialist perinatal community mental health team - Support for women who experience complex mental health problems during and after pregnancy, and for their infant up to the age of 2 years. Speak to a healthcare professional to discuss a referral. Call 0161 271 0188.

Talking/psychological therapy (IAPT) - Access your local IAPT service via your healthcare professional.

Pregnancy and early childhood resources

Home–Start - Support and friendship for families.

Brazelton Centre - Learn more about your baby’s language

Maternal mental health service - Work therapeutically with parents who are experiencing significant distress as a result of trauma and/or loss during their maternity or neonatal journey. Call 0161 271 0188 (option 4)

Gingerbread - Single parent support.

Proud 2B Parents - A service for lesbian, gay, bi and transgender (LGBT) parents to be, LGBT parents, and their children.

Spoons - A range of support services for families both in neonatal units and within the community. Call 0300 365 0363.

Cry-sis - Support for parents with crying and sleepless babies. Call 08451 228 669.

ICON - ICON provides information about infant crying and how to cope.

Basis - For parents who wish to make informed choices about infant sleep and night-time care.

Dad Matters UK - Offering education and peer support services for new dads and dads to be across Greater Manchester.

BABYBUDDY - Text BABYBUDDY to 85258 for free, anonymous support via text message, any time of day or night.

Finding Rainbows - Bereavement support charity who offer one-to-one counselling, group sessions and more. 24/7 Helpline 0161 312 8924

You can also ask your community midwife or health visitor for information about local support.

This Your Baby and You information is also available as a booklet for families across Greater Manchester.  Ask your midwife, health visitor or neonatal nurse for a copy. If booklets are not available locally, you can order one by emailing Tameside and Glossop early attachment service on: pcn-tr.eas@nhs.net

A special thank you to all the parents and babies of Greater Manchester who shared such precious insight and content included in the current and original resources.

The content and media footage are a refreshed version of the original ‘Getting it Right from the Start’ resources produced by Tameside and Glossop early attachment service.

Thank you to the Greater Manchester perinatal and parent infant mental health programme, the original and the current contributors who assisted in the production.

This has been funded by Greater Manchester for the perinatal and parent infant mental health programme.