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First Steps

  1. Hold baby as much as possible.
  2. Do infant massage.
  3. Rock with baby in rocking chair.
  4. Use a Baby Bjorn or infant carrier as much as possible and take walks with the baby.
  5. Place the baby on the tummy as much as possible.
  6. Consider passively moving his hands and legs.

Infant Massage

One thing I think that we need to be on top of for the little babies is making sure that they are getting the physical stimulation that they need. Our little guys don’t roll around and can’t nurse and are really sort of boring when they aren’t being a lot of work. So, I think that we need to go overboard making sure that they get the touch that they need. The abstract below indicates that touch is important to stimulate the vagus nerve, which promotes growth and emotional development. Other things that touch can do:

- stimulates gastric motility

- stimulates weight gain

- improve social engagement

- improve attention

- improve facial expressions(affect)

- improve vocalizations

When Kian was born we got at this by:

- doing daily infant massage

- taking daily baths with him (skin on skin)

- Holding him constantly and rubbing his hands and feet

- Having him in the Baby Bjorn all of the time

- Letting the puppy lick him J

Infant Behav Dev. 2008 Sep;31(3):361-73. Epub 2008 Mar 4. Links

Vagal activity, early growth and emotional development. Field T, Diego M.

Touch Research Institutes, University of Miami School of Medicine, United States; Fielding Graduate University, United States.

A review of the research on infant vagal tone suggests that vagal activity is associated with both infant growth and infant socioemotional development. Vagal activity has been noted to increase following the stimulation of pressure receptors as in massage therapy. Vagal activity, in turn, stimulates gastric motility which mediates weight gain in infants. Vagal activity has also been notably elevated during synchronous mother-infant interactions and positive affect, providing confirmatory data for the Porges "social engagement system" model. In contrast, low vagal activity has been noted in prenatally depressed mothers (and prenatally angry and anxious mothers) and their infants, as well as in children with autism. These studies highlight the relations between vagal activity and the social behaviors of attentiveness, facial expressions and vocalizations.

Passive Movement

  • We met a wonderful physical therapist (PT) in the NICU who explained to us that putting a baby on your chest (head up) and rocking actually provides the baby with an opportunity to learn about its place in space and make micro adjustments of its body to compensate for the movement. It promotes neck strength.
  • She also encouraged us to pretend as if our baby was not sick and create the same movement and sensorial input that you would for any baby. Imagine that your PWS baby is cranky and fussy. Rock him and dance him and pat him and do all of the things that he would demand of you if he could.
  • The Baby Bjorn also provides an opportunity for bonding and improved neck control. The baby receives the stimulation of your movement, feels your body, and is included in your actions. We did not use a stroller for the first 6 months of our baby's life. Instead, we tried to take a daily walk with him in the Baby Bjorn.

One Mom's Story

I have to tell you how I made it through Danielle's first year and how I wish that I had enjoyed it more now that she's grown into such a grown-up girl.

I loved snuggling with her and reading to her and we still read two books each night before bed. She's starting to read now and that is very exciting! I tried to treat her as if she were normal, meaning that I learned to read her tiniest expression to know what she was thinking and feeling. When she would get a little frown, I would treat it as if she was having a temper tantrum. I would put on soft classical music (Baby Genius is great) and walk with her, holding her and soothing her as if she had colic or something. I wanted her to know that I was there for her just as I would have been if she were screaming her head off.

We got one of those baby gyms so that she could see and play with the toys while she was laying on her back. I got a really good bouncy seat so that I could have her with me while I did dishes just as if she were sitting on the floor playing with measuring cups, which is what my son loves too.

I would dispair that she couldn't hold any toys. I bought some of those wrist rattles and cursed them for being so heavy! I learned to buy toys for their weight and ease of activation vs. if they were a best seller.

Danielle's three favorite toys: The first thing we got her that really worked, even before she could hardly move, was a Fisher Price Sparkling Symphony Mirror ( ). The rolly thing on the bottom activates the lights and music. I'd get it so that it was so so close to activating and hang it in the bassinet (it's actually a crib toy) so that her arm was next to it. At the slightest movement it would activate. I figured that it would show her that she could have an effect on her environment.

When she could hold something, a Bee Finger Puppet was her favorite (see it at but this is a Europe URL, we got ours at our local Backyard Bird Shop). It is very light-weight, has the stringy legs which she would suck on, the filmy wings which she would rub, and the nose to chew on! I've kept it in her baby box because it was the first time she was able to really play with something.

The most long-term favorite toy we got her was a tiny horsey from Manhattan Toy Company. It was only 2 - 3" high and very light. I can't find it on the Net and we got it at a horse show. The closest thing I can find is at . This is also in her baby box. I even have a video of her playing with it in her bouncy seat that I emailed to In-Laws in case you'd like to see. I'm a proud mama and I'll subject anyone I can to my files and files of pictures and videos!!!

She went through a shoelace and ribbon phase where she would just let them run through her fingers over and over. I was afraid that it was the start of OCD. We'd find our shoes with no laces in them all the time. But it did help me out sometimes because it would keep her occupied for a good 15 minutes or more. Then after a while she moved on to other things and now David (16 mo) is taking our shoelaces out - so who knows?!?!

Let's see, she held her head up at 6 mo. Sat up very wobbly at 10 mo I think, started rolling _everywhere_ (too cute) and then crawling at around 12 mo, walked at 18 mo.

Now that Danielle's older, she loves puzzles (of course) and does 100 pc puzzles designed for 7-10 year-olds. A while back, I went into her room to see what was keeping her so quiet . . . she was doing the 100 pc puzzle _upside down_ so that it would take her longer!

My biggest thing to remember is that, most mom's say their childs stages go so quickly. WE get the priviledge of watching our children grow and learn in a bit of slow motion. She did everything, but it took her into her 2nd year instead of getting it all done in the first year.

Research on the value of a rich environment

Ment Retard Dev Disabil Res Rev. 2004;10(2):91-5. Related Articles, Links

Environmental complexity and central nervous system development and function.

Lewis MH.

McKnight Brain Institute and Department of Psychiatry, University of Florida, Gainesville, Florida 32601, USA.

Environmental restriction or deprivation early in development can induce social, cognitive, affective, and motor abnormalities similar to those associated with autism. Conversely, rearing animals in larger, more complex environments results in enhanced brain structure and function, including increased brain weight, dendritic branching, neurogenesis, gene expression, and improved learning and memory. Moreover, in animal models of CNS insult (e.g., gene deletion), a more complex environment has attenuated or prevented the sequelae of the insult. Of relevance is the prevention of seizures and attenuation of their neuropathological sequelae as a consequence of exposure to a more complex environment. Relatively little attention, however, has been given to the issue of sensitive periods associated with such effects, the relative importance of social versus inanimate stimulation, or the unique contribution of exercise. Our studies have examined the effects of environmental complexity on the development of the restricted, repetitive behavior commonly observed in individuals with autism. In this model, a more complex environment substantially attenuates the development of the spontaneous and persistent stereotypies observed in deer mice reared in standard laboratory cages. Our findings support a sensitive period for such effects and suggest that early enrichment may have persistent neuroprotective effects after the animal is returned to a standard cage environment. Attenuation or prevention of repetitive behavior by environmental complexity was associated with increased neuronal metabolic activity, increased dendritic spine density, and elevated neurotrophin (BDNF) levels in brain regions that are part of cortical-basal ganglia circuitry. These effects were not observed in limbic areas such as the hippocampus.

Review Nature Reviews Neuroscience 7, 697-709 (September 2006) | doi:10.1038/nrn1970

Enriched environments, experience-dependent plasticity and disorders of the nervous system Jess Nithianantharajah1 and Anthony J. Hannan1 About the authors

Top of pageAbstractBehavioural, cellular and molecular studies have revealed significant effects of enriched environments on rodents and other species, and provided new insights into mechanisms of experience-dependent plasticity, including adult neurogenesis and synaptic plasticity. The demonstration that the onset and progression of Huntington's disease in transgenic mice is delayed by environmental enrichment has emphasized the importance of understanding both genetic and environmental factors in nervous system disorders, including those with Mendelian inheritance patterns. A range of rodent models of other brain disorders, including Alzheimer's disease and Parkinson's disease, fragile X and Down syndrome, as well as various forms of brain injury, have now been compared under enriched and standard housing conditions. Here, we review these findings on the environmental modulators of pathogenesis and gene–environment interactions in CNS disorders, and discuss their therapeutic implications.

J Neurophysiol. 2006 Aug 16

Early Experience Determines How the Senses Will Interact.

Wallace MT, Stein BE.

Hearing and Speech Sciences, Vanderbilt University, Nashville, Tennessee, United States.

Multisensory integration refers to the process by which the brain synthesizes information from different senses in order to enhance sensitivity to external events. In the present experiments animals were reared in an altered sensory environment in which visual and auditory stimuli were temporally coupled but originated from different locations. Neurons in the superior colliculus developed a seemingly anomalous form of multisensory integration in which spatially disparate visual-auditory stimuli were integrated in the same way that neurons in normally reared animals integrated visual-auditory stimuli from the same location. The data suggest that the principles governing multisensory integration are highly plastic and that there is no a priori spatial relationship between stimuli from different senses that is required for their integration. Rather, these principles appear to be established early in life based on the specific features of an animal's environment in order to best adapt it to deal with that environment later in life.

It is an animal study and hard to read, but it emphasizes the importance of early stimulation to help the nervous system grow to be ideally suited to a given environment.