Optimising your baby’s development 

Intro
Welcome to Sense by Meg Faure the podcast that’s brought to you by Parent Sense, the app that takes guesswork out of parenting. If you’re a new parent, then you are in good company, your host, Meg for is well known OT Infant specialist and the author of eight parenting books. Each week, we’re going to spend time with new mums and dads, just like you to chat about the week’s wins, the challenges and the questions of the moment. Subscribe to the podcast, download the Parent Sense App and catch Meg here every week to make the most of that first year of your little one’s life. And now meet your host.

Bailey: Hello and welcome to everyone to joining us for another episode of Sense by Meg Faure. I’m Bailey Georgiadis, I’m a mom and podcaster, and I’m here with parenting and baby expert, Meg Faure to talk about something that I know all of you listening have thought about, worried about, lost sleep over, and that is your child’s development. I think I speak for lots of moms and even dads when I say there is enormous pressure on parents to ensure that their babies are ahead. We even just on track developmentally and you know what I mean? You’re at the park or a birthday party or at a class with a friend and your little one is there with their little one. And you just start comparing who baby rolled over first? Who’s crawling? Who’s the cleverest? Who can count to 10 and three different languages? Okay, now I’m kidding on the last part. But all sorts of things we know deep down we shouldn’t compare because each baby is unique and individual, but we can’t help but wonder is our baby going to be a genius or are they on track developmentally. And it can actually drive most of us crazy.

And if you are already struggling with a little bit of anxiety, it is a necessary added anxiety that just goes with it. Meg, we have a lot to talk about today. We really do need to unpack this very hot topic. And I’m always so glad to have a front row seat with you. So thank you. How are you doing?

Meg: Yeah, really well, Bailey, it’s good to connect with you again. It’s been a couple of weeks and it’s always good to have a little bit of in-depth dive into a topic that’s a little bit meaty. And of course, as you have mentioned, this one is hotly contested and very meaty.

Bailey: Yeah. Now, before we begin, just a quick reminder that we really want to hear from you. Look out for the posts on Meg Faure and Parent Sense Facebook and Instagram and ask those burning parenting and baby questions. Meg will answer them right here, and just remember there is no such thing as a silly question. Meg, are you ready? I think we are absolutely dying for a bit of perspective on this subject.

Meg: Absolutely. Yep.

Bailey: When we talk about optimal development, what exactly do we mean?

Meg: Yeah, so I think first of all, we all have this kind of benchmark in our head of, as you’ve said, having these absolutely brilliant kiddies and developing them optimally from the get-go. But when we start to think about development, we need to think about what are the criteria and the foundations for this optimal development. So the reality is that your baby comes with their own set of raw materials, the raw ingredients for optimal development. And those raw ingredients as it were, are made up of primarily two things. The first one is their genetic code.

So the first perspective, or the first aspect of optimal development is the genes that your baby’s born with. Now, those genes will come from you and your partner, and as that sperm and egg fuse, it comes together to create this little gourmet that then becomes the human baby. And pretty much all your baby’s potential is laid down in that moment. Now, prior to that moment, there were a couple of things that you could do to alter things and to make, to create an even more optimal space. And that is to make sure that you have a really good diet and that you are avoiding certain drugs and certain types of toxins and substances prior to pregnancy. So prior to pregnancy, that sperm and that egg can actually be impacted on by what’s going on in the environment, particularly the sperm. The sperm is kind of built on demand, whereas the eggs have been in your body for, you know, since you were a baby. So you don’t have as much impact on the genetic code there, but you certainly do with the sperm. So that’s the thing, egg and sperm come together, create the possibility for this human life.

The second big thing that happens to create this, these raw ingredients is of course pregnancy and what goes on in pregnancy. And that is really speaking to how stressed are you? What are you eating in pregnancy? And what’s your lifestyle like? You know, how what’s your nutrition like and much supplements are you on your on? And so there’s a certain amount of nurture that actually already impacts the nature part of the debate or what your baby’s born with, right from the get go. But basically kind of by halfway through your pregnancy, you’ve pretty much better done the opportunities and the raw ingredients for your baby. What comes afterward is how you can max this on how you can really optimize development. But as a kind of baseline, and as a foundation, it all comes through from genes and from very early pregnancy experiences.

Bailey: I mentioned milestones earlier because they are such a big deal to parents of babies and little ones. I mean, I’ve even completely wrapped up in it, baby is six months old and should be able to do X, Y, and Z, so why isn’t h? Or whatever the case is. And I think a lot of us become so obsessed with milestones. So what is, and I know you can’t see me because it’s a podcast, but I’m going to do it inverted comers, what is normal?

Meg: So, you know, I think that that’s where the pressure comes is that parents don’t want their baby to develop atypically. They don’t want to have anything go wrong, and so we start to obsess over these milestones. So as an example, I mean, every baby’s going to learn to walk. 99% of babies are going to learn to walk. And that becomes an example of a milestone that parents will really obsess about. And it can become quite a significant obsession, where if you have a baby who only walks at 18 months, and you know that all your friends who’ve got babies develop at the same age, then are walking at 12 months, it becomes a huge area of concern for you.

So milestones are thing that we see, I guess the word milestone is great because you see a milestone is, is kind of a stone that was placed every mile along a path, and that’s what it is. It’s kind of a stone or a marker as your baby develops. And so your milestones are things that we can see very obviously in babies and it that you get gross motor to milestones, you get fine motor to milestones, you get language milestones, you get emotional milestones. We can, we can actually unpack all of them as we go along. But the bottom line is that the human baby develops along a very specific trajectory. And that then kind of creates an expectation for what we call normal milestones. So we know that ex X percentage of babies will walk between 14 and 16 months as an example. So that becomes the milestone for walking. The milestone for walking is 14 to 16 months. Of course, you’ve got the babies who walk earlier than that. And you get the babies who are going to walk later than that. But generally as parents, we start to hang our hat on, right, this is when it should be happening.

Bailey: Yeah.

Meg: The problem with normal is that it’s actually is a very wide range. So anybody who is using the parent sense app, if you go into the play section of the app, which is the pink section, and you actually have a look at your baby’s milestones, which is a little pink line in that app that actually says, you know, your milestones, you’ll see that there is an incredibly wide range of normal for every single milestone. So I don’t narrow down too much. And the reason for that is that I think that when milestones are too narrow, it creates expectations that makes parents very, very anxious. So I like parents to think about milestones in a quite a broad sense. So, as an example, if you look at the cuing milestone, you’ll see that it happens from 8 to 12 weeks. That’s a very broad range, it’s four weeks. And rolling can happen from 21 weeks to 30 weeks, and that’s a nine-week window. So instead of talking about what’s normal, we should talk about what does that window look like? Because it’s a much more constructive way. Yes, we can then measure whether or not our baby’s approximately within the norm, but we don’t get fixated on it. When we should get fixated on it is a whole other question because parents then go, okay, well, window, I need to worry, you know. So I’ve spoken about ‘normal’ being a wide range.

Bailey: That’s going to be the next question, actually.

Meg: Exactly. There you go. So when is it that actually we should worry? And one of the things that I say is that if your baby has got a cluster of milestones that are outside of the normal range, then you need to have a look at it. So let’s have a look at that one. Your baby’s typical age for smiling is around about six weeks. So anywhere from four to eight weeks would be typical for, for babies to smile. But let’s say your baby smiles at 10 weeks, and then you look back at the eye contact milestone, and the eye contact milestone needs to happen in the first couple of days and weeks. And that didn’t happen until four weeks. So now you’ve got, eye contact was late, smiling is late. Another milestone in that trajectory would be cooing as an example. So that didn’t happen when we thought it would’ve now happens closer to six months. And the next one for instance, is let’s say speech and speeches only happened at 22 months. Okay, so they’re toddlers. And when you look back, you’ve got significant delays in one single milestone track. And that milestone track is the social track, because smiling, speaking, cooing, that’s the social track. And so when those milestones tend to fall outside of the norm, all in one track, then you can say, hold on, there’s something going on there.

And so when a mom phones me as an example, and she says to me, my baby’s 22 months and hasn’t spoken a word yet. I always go, right, what age do they make eye contact? When did they smile? When did they start to coo? Okay, this is late. We need to look into it. And so I would refer her to whoever I think thought the time was correct. Likewise, we can do the same with gross motor skills. So your gross motor track would be, for instance, tummy time, lifting your head, rolling, sitting, crawling, walking and running. So walking typically happens by 16 months, sometimes as late as 18 months. But if you were very late on walking, but so your baby only walked at and at 18 months, and by the way, one of my nephews did that. And when you look back at the milestones, all the others were on track. He’s probably absolutely fine. He’s just decided to be a really good crawler and out of interest, that particular nephew of mine is the most skilled cricketer in our family.

Bailey: That’s amazing.

Meg:  So there you go. His sporting abilities absolutely phenomenal, but he took a very long time to consolidate walking. So, you know, there are milestones that I just wouldn’t worry about being normal. They times when there’s a significant cluster of them, then you go, hmm, this is a little bit of a warning sign.

Bailey: Okay. It’s good to know. There seem to be, and I know this might generalize, but there seem to be two types of parents when it comes to this kind of subject, those who take a far more relaxed approach and let nature to take its course than others who are far more hands on and believe that it any skill or ability can be nurtured. So let’s talk about this, the nature verse nurture debate.

Meg: It’s a big one. It’s certainly a big one. So nature, as I mentioned is really your genetic code and your pregnancy. So those two things set up your baby’s nature essentially, and they give you a platform, so that on the birth day, your baby’s born, they’re a blank state, but they’ve got all the potential. Their brain cells are all ready to be wired, they’re in the right place, and so that nature is critically important. So for instance, if a baby has a chromosomal deficit in pregnancy, so already at a chromosomal level, one of their genes is either multiplied at, or is cut off. You know, that immediately changes that child’s trajectory, and it doesn’t matter how enriched that environment is. It doesn’t matter how wonderfully enriched the nurture is, the nature has coded for a certain thing.

So the nature has coded. And I mean, an example of nature would be the color of your hair. Bailey your hair is blonde, you are never going to have black hair just growing out of the top of your head, it’s coded in your genes. So nature is hardwired, it’s coded, and it really doesn’t shift a lot. What happens on top of that though, is this nurture. And this is the home that to grow up in, how much stimulation you get exposed to. And this nurture debate actually came up in the mid-1900s where a group of researchers had gone to a Romanian orphanage, and there were children that on a nature level were completely equipped to become properly awesomely, developing little ones, you know, sort of with, with all the genes that would set them up for success in life. And they then got put into cots and never touched. So they were, all that they were doing is given food and they were never held, touched, handled or stimulated. And by the time the researchers came into the orphanage, these children had irreparable brain damage.

And really, I mean, and it became one of those kind of, and there’s been lots of research done subsequently on it, but it’s become one of those incredible pieces of research where we realized actually it didn’t matter how incredible the next kind of three years of their life were, the damage was done because that’s what nature does. Nurture is actually bringing out the potential within the nature. And so at that point, of course, the debate is then said, oh, well, of course nurture’s much more important. So it’s, you know, it’s critically important, it’s more important than nature. What we now understand is that it’s really an interplay between the two. So you bring your genes, your genetic code on top of that, your parents nurture you in a way that then give you the opportunities. And then what’s quite interesting and this is more recent research is that your genes can actually be turned on and off by this nurturing environment, by nurture. And that’s a scientific theory called epigenetics. And so you can have genes actually being turned on for certain things that actually wouldn’t be if they weren’t in the context of a certain nurturing environment.

So as an example, if we think about high levels, very, very high levels of stress, which is actually part of the nurture debate. It doesn’t sound like you’re nurturing somebody if they’re highly stressed, but right essentially it’s the nurture part of the debate. It’s what the environment brings. So if you can think about nurturing environment and relationship. So environment and relationship is highly stressed, very toxic, just not conducive to a little one really flourishing. That little one’s nature, what they were born with in terms of how quickly they would respond to stress can be completely and meaningfully shifted by being in a toxic world. So that little one might have been a little one who wouldn’t over respond to stress, but because they’re born into, let’s say a poverty situation, which we know is one of our biggest risk factors into a world that has high levels of violence, a huge amount of care, maybe a chaotic relationship, and maybe a mother who can’t give them what they need, because she’s in a stressed relationship, let’s say. So that’s what toxic stress looks like.

What happens to that little one who was wired for a low level of stress in life? It actually really just starts to create a very smooth pathway in the stress part of the brain. And so when that little one is faced with a small stressor, when they’re eight years old, now they’ve got to separate from mom or somebody shuts in an environment that immediately says to them, whoa, I’m in a very, very dangerous world. And that toxic stress pathway gets reignited in their brain, and so their in instant response to a small stress in life becomes exacerbated and they then become stressed human beings. So you can see how on a nature level, they maybe weren’t even wired for that, right? On a nurture level, we’ve managed to change their response to the world. And actually it now becomes a hardwired response in them that they are very stressed in response to small things. And the interesting thing about epigenetics is just it takes it a step further is that that person’s genes can actually be changed through that. And so when that person has a baby, the genetic code they pass on would be more to be towards being stressed rather than not stressed. Even if that child actually wasn’t in a stressed world. So epigenetics is a very, very interesting area of science that’s being developed and so it kind of adds another veneer on top of the nature-nurture debate.

Interlude

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Bailey: I feel like every time we chat, I learn something new, and I just love it. I’m so fascinated by this, so thank you. I want to explore social and emotional development with you. When does that start? And, and how will parents know that their little ones have even started to develop this way?

Meg: Yeah, so I think that this is the most important area of development because at the end of the day, our super skills as human beings is to be social and emotional and to engage with other human beings. It’s so critically important. And I often think back in that I think about, you know, what would be the worst disability to have to deal with in a child. And there are, if you’re a parent dealing with any disability, you would have grounds to be able to say that what you’re going through is probably the trickiest. But for me, it was to have a child who didn’t socially engage and wasn’t emotionally involved. And you know, that’s classically seen with autistic population children where they just don’t engage on a social-emotional level. And so I really have always highlighted the social, emotional development. I think it’s so critically important. And it was probably about 10 or maybe more years ago now, I attended a course in Washington DC by, Stanley Greenspan, who was a psychiatrist and really probably at the forefront of the social-emotional development. And he was really the thought leader at the time on autism as well. And so I had attended these courses and we started to look at the social-emotional growth chart with him. Social-emotional development is so fascinating because just like we can watch a baby go from lying, to rolling, to crawling, to sitting, to standing, to walking and so on. And it follows a very straight trajectory. Well, what’s fascinating is that social-emotional development does as well.

Bailey: Really?

Meg: It’s incredible. And you know, it starts to develop on the day a baby was born, like literally on day one. And that very first milestone is just making eye contact and just being still and calm. And after a baby’s born, particular baby born by vaginal delivery, they will be very still and very focused. We call it the calm alert state, and it’s a state that allows you to kind of connect with another human being. So that’s, I would say is one of the first milestones you would look for. The next very important milestone that he talks about is the ability to stay calm in the context of stimulation. So that’s a social, emotional milestone of actually staying calm when there’s a lot of chaos going on and babies learn that in the first three months of life. The next milestone I would be looking out for, which happens in that period is eye contact. So really looking for you when you enter a room to actually make eye contact and to look at you in the eyes, is a social-emotional milestone. Because if you avoid eye contact, you’re going to battle to connect emotionally. So there are babies, and we see this with autistic kiddies and some other kiddies that they actually do avoid eye contact. But it’s a very important milestone.

The next social milestone that I would be looking for, and it’s one of my favorites is smiling and smiling happens. It’s fairly hardwired, for most babies, it happens at six weeks, some a little earlier. So you can see that by the time the babies hit three months, they’ve got a cluster of little foundations for lifelong social-emotional development. What happens next in social-emotional development is that they now need to move on to next level of actually connecting with another human being. So in the early days, those are the early signals, but the next step, which goes for about the next six months is to really fall in love with another human being. So Stanley Greenspan’s second big milestone was falling in love. And falling in love, happens from about three months to six months and obviously a little longer. And in that period babies have to believe that they are, are completely the center of the world. And I mean, I’ve done podcasts on primary maternal preoccupation, people can go back and have a look at it, but it’s that absolute obsession that a mother has with her baby that tells her baby that you are the most important human being in this world. And so that awareness that I’m so critical and that I’m the center of the world is actually am an emotional milestone.

And then the next social emotional milestone will happen in the second six months of life, which is when the baby actually realizes, hold on, I’m actually separate to my mother. And just because I’m feeling this doesn’t mean she’s feeling this or my father. That separation from the object permanence often creates a lot of anxiety for little ones because up until that point, they thought that that if they were hungry, mom was hungry or dad was hungry, they didn’t have a sense that they were different person. But this separation of persons and this what we call mind mindedness. So that they’re understanding that I’ve got a mind and you’ve got a mind. It is absolutely critical, because that leads us onto the next step in social-emotional development. And that is that if I’ve got a mind, I need to use some sort of form of communication to be able to let you know what’s in my mind. And that leads us onto the next step, which is to be able to start the foundations for communication, which could be pointing or clapping or waving, and then eventually, speak. So you can see how the human baby goes all the way through these trajectories of being the center of the world. Having to stay calm with stimulation, starting to engage socially with things like smiling, having a relationship with another human being and then eventually communicating what is in their mind to another human being.

And when you move through these milestones in the first 12 months of life, that’s when you come out the other side as a toddler, who’s ready to start to assert yourself, to develop your personality, to develop autonomy, which is of course the next stage of emotional development. So for me, it’s such a fascinating trajectory in some ways, much more interesting than gross motor foundations as an example,

Bailey: You actually just brought in the magic again of parenting and what an absolute privilege it is to be a part of someone’s so small’s world and create hopefully that nurturing environment. Because yes, you’ve had a little hand to do with the nature part, but the nurture part is where you can really get involved. And so what can we do you to safeguards social-emotional development?

Bailey: That’s such a great question because there are things that the baby comes with in their genetic her. So some babies are just born calmer than other babies. So we spoke a few podcasts ago about the sensory personalities and if mums, who haven’t listened to that they must go back and listen. So some babies are born just a whole lot calmer, some more sensitive, so they bring that. So that’s what the baby brings, and it’s a lot about their sensory profile. What the mom and dad brings are a couple of things, number one, a parent has to be able to calm their baby in the early days, and that’s important for the baby to feel calm in the presence of stimulation and to learn to calm themselves.

So that’s one piece parents have to bring, and that entails using techniques like swaddling or white noise.

Bailey: I was actually just going to say that you also have to go back and listen to the podcast on the fourth trimester because it all now starts to make sense. It’s like this big train of things, but sorry, carry on.

Meg: Exactly. Yes, exactly. And this is what happens in the fourth trimester is that one of the first things that parents do to be able to develop up the social-emotional world is to calm their babies, so they do need to listen to that episode. So calming your baby is the first thing you do. The second thing you do is you’ve got to be completely and utterly obsessed with them. And you know, I think sometimes we’ve spoken about bonding and this was in one of my episodes with Kirsty. Bonding, doesn’t always happen naturally for parents, but telling your baby and giving them the signals that they’re very important in your world is actually important as a foundation. So, I think it is important for parents if they’re not feeling connected, if they’re not feeling in love with their babies to actually go on and have a look at what’s going on for their emotionally themselves, because connection’s important.

And then the next thing that’s important is turn taking and serve and return. And so that’s kind of responding to your baby. So they make a coo, you coo back, you make a coo, and then they coo back. Then you’re just silent for a bit and allow them the opportunity to coo if they want to. So all of those pieces are part and parcel of helping them to develop social-emotional development. So it’s a lot around bonding. It’s a lot around time and space. I guess one of the things that’s important for parents to understand is that, and I’m sure that their parents who are listening that might feel a little guilty right now. Like, gosh, I’m just not getting this right, and I’ve done so many things wrong, but actually there’s lots of research that told us that actually getting things wrong is also important. Because that helps babies to develop their social-emotional world. So, you know, if you’re not getting it right hundred percent of the time, as long as you repair it, then you’re actually okay and you are giving your baby the opportunity to develop socially-emotionally.

Bailey: But also remember as a parent, no parent ever sets out to do an average job, we all want to do the best that we can. And sometimes we need to give ourselves some slack, you are doing the best that you can. And that’s why listening to these podcasts are so important because they give you the added tools that we didn’t know that can help us become even better moms and dads. So don’t put so much pressure on yourself.

Meg: Exactly. And you know, I love Donald Winnicott’s work, and he always spoke about the good enough parents, like all the good enough mother. And he said, you know, you don’t have to be perfect, in fact, preferably not. Perfect mothers are generally actually messing up because they are creating a world expectation for their baby that isn’t realistic. So if you don’t get it right all the time, it’s spot on, it’s probably better for your baby.

Bailey: It is question time. And I love this because it gives you real access to Meg. So this question came from a dad, we’d love to hear from the dads. He says that his two-year-old babbles all the time, but it’s really difficult to pick out any actual words. He still points and gestures when you want something, but him and his wife are wondering if there’s more that they can do to encourage their toddler’s language skills.

Meg: Yeah. So I think, you know, when your baby hits two years old and isn’t saying any words, every parent gets concerned and that’s because you’ll get some babies to actually say words at 10 months already. And most babies are saying a few words by 14 months. So when you get to two years old and your baby’s not saying anything, it’s obvious that their parents would be worried. So a couple of things here go back, first of all, and have a look at all the so social and emotional milestones and the language milestones, like was your little one smiling around about the right age, babbling it around the right age, that type of thing. So that’s your first thing, or is this really a global delay? If it’s a global delay in language, then you want to maybe just have a look at hearing. So I would just take them for a hearing test, just make sure that that’s all sorted, because if your baby can’t hear, they’re not going to learn language very well.

And even something like blue ear or recurrent ear infections can actually affect the way that a baby actually hears sounds and therefore can impact on language. So those would be my first things. I always like to rule out the basics before I start to get a little deeper. And then other than that, let’s say hearing’s fine, pointing and gestures, which is what the dad says that the little one is doing are all fine, but just not the words themselves. I actually wouldn’t worry too much. I’d probably give it another three months before I started to worry. But what I would do is I would stop all television and screens completely, go cold Turkey on that. And the reason is that we know from research, the children who watch screens under the age of two, definitely do have delayed language, so stop with any screen use, number one.

Number two, speak your mother tongue, so that’s important. So whatever your home languages and your wife’s home language was when you were babies speak that language because mother tongue is something that is really, really important for conveying emotions. So do that and speak a lot, like a lot, a lot, a lot. Describe everything that you do, describe it all the time, talk through everything and then see whether or not that improves. And if by the age of kind of two and a half, two years, three months, there’s still absolutely no words. Then probably a little visit to speech therapist just to check it out would be a good idea. But as I said, if it’s in the context of all other milestones being normal, plus your little one is gesturing really nicely and babbling really nicely and understands everything. I forgot to mention that. As long as they’re following through on instructions, then I wouldn’t be as panicked as potentially you’re feeling right now. And I would relax a little bit and just give it a couple more months.

Bailey: Fantastic. Thank you, Meg. As always, your wisdom has been incredible. I absolutely love learning from you. So thank you very much and parents just remember you are never alone. This is why make us here to take the guesswork out of parenting. Thank you so much for listening to this podcast and we’ll chat again next week.

Meg: Thanks Bailey. Cheers.

Outro
Thanks to everyone who joined us. We will see you the same time next week. Until then, download Parent Sense App and take the guesswork out of parenting.