Big Babies – The Curse of (mis) Diagnosing a Macrosomic Infant Part.1

Thousands of women are diagnosed with suspected big babies (or ‘macrosomia’ to use the medical terminology) every year, but this one simple label can have a profound effect on their birth.
Obstetric consultants often take the results of growth scans as gospel, scheduling elective C-Sections or inductions as a result of them, but how accurate are these estimates? and does early induction or elective C-Section really prevent problems if a baby is extra large? – you might be surprised at the answer!
…and even IF the baby is big, what’s to say that the mother will have problems giving birth? Some women have a great deal of trouble giving birth to a small six pounds baby, whilst others, like myself, can birth an eleven pound baby with ease. Then there is the issue of the nocebo effect – the creation of a medical problem when there was none initially, in short if you go looking for problems with ‘a big baby’, you dent the mother’s confidence, you induce her before her body and baby are ready and keep her immobile by monitoring constantly throughout her labour – the chances are her birth will be problematic, not because of the size of her baby – but because of the management of her labour. Yes the nocebo effect is particularly strong in modern day obstetrics.
So, even if the growth scan estimate is accurate how can anyone possibly know how YOU will birth? The only sure thing is that nobody knows how much your baby will weigh until it is placed in the scales after birth, or how your birth will go until after the event. I heard a great analogy from an obstetrician once, that likened trying to predict the size of a baby before birth, by ultrasound, to trying to guess the weight of a man, sitting in a bath full of water, in the room next door by measuring his waist and thigh bone. When you look at it like that it really does become apparent how ludicrous these gross measures we use are!
So How Accurate are Ultrasound Estimates of Foetal Weight?

Ultrasound is widely believed to be the most accurate method of estimation of foetal weight. Yet in 1988, Miller, Brown, Khawli, Pastorek & Gabert in “Ultrasonographic identification of the macrosomic fetus” found that the typical mean error ranges from 300 to 550g (11.6 to 19.4 oz). That’s around a WHOLE POUND! In 1992 Chauhan, Lutton, Bailey, Guerrieri & Morrison In “Intrapartum clinical, sonographic, and parous patientsestimates of newborn birth weight” found that ultrasound was the least accurate of the three methods, i.e: it was less accurate than the educated guess of the obstetrician or mother!  In their study “Pregnancy outcome following ultrasound diagnosis of macrosomia” Delpapa & Mueller-Heubach found that “In 66 of 86 women (77%) delivering within 3 days of ultrasound examination, estimated fetal weight exceeded birth weight. In only 41 of these 86 women (48%) were the estimated fetal weights within the corresponding 500-g category of birth weight” – That’s quite some difference!

Limitations in the sensitivity and specificity of ultrasound have been observed in many other studies but sadly despite these well documented limitations, health professionals continue to incorrectly believe that ultrasound is an accurate way of predicting macrosomia, this also despite the UK Government’s CESDI (Confidental Enquiry Into Stillbirths & Deaths in Infancy) report stating that “the inaccuracy of ultrasound estimates have been well documented. Indeed, it is possible that estimating fetal weight by late ultrasound may do more harm than good by increasing intervention rates”.
I’m sure many people can recount a story of a friend or relative who has been told their baby would weigh 10lbs only to birth a perfectly average sized 8lber, or those, as myself with my first baby (who subsequently weighed 10lbs) who were told “it’s completely average, a 7lber” only to find they were expecting a whopper. As a general rule of thumb growth scans are quite good at plotting the growth rate of a single baby over a time period following several scans, but as a one off, arbitrary measure, research suggests that “mother’s intuition” is more accurate!
So What to Do if You are Offered a Growth Scan?
If you are offered a growth scan (note you do not “have to have” one) you could ask what the results will be used for? For instance, will the results be used to benefit you and your baby? You could ask how accurate they are at predicting birth weight? Or you could ask if they have any negative effects or risks attached to them? (such as leading to unnecessary inductions or C-Sections). Some people also believe that Ultrasound scans themselves carry risks. Above all else, how will YOU feel about the result, how will you feel if you are told your baby is big? will it dent your confidence and potentially inhibit your labour? remember – the scans are being offered to you, as such you can politely decline them after carefully assessing the risks and benefits of them.
Why Are Some Babies Much Bigger Than Others?

If you believe the media you will probably think it is because we all eat too many chips. In reality there’s an awful lot more to it than that. It is true that women who develop Gestational Diabetes are more likely (a twofold risk in fact) to give birth to a larger infant, however this site is interested in those women who have not been labelled with any medical disorder and who seem to “just make big babies”. There are several known risk factors, aside from Gestational Diabetes, which can highlight certain women who are more predisposed to birthing a macrosomic baby, these are:
  • Multiparity (not your first baby)
  • Birthing a previous macrosomic baby
  • A prolonged period of gestation
  • Carrying a male baby
  • Parental Stature
  • Excessive weight gain during pregnancy
Genetics does seem to play a role though and often women will give birth to a very large baby with none of the above risk factors – in fact according to Boyd, Usher & McLean and their report “Fetal macrosomia: prediction, risks, proposed management” – 34% of macrosomic babies are indicated to be born to mothers with NO risk factors! similarly very obese women are just as likely to deliver smaller infants. Finally even with TWO of the above risk factors present, women are only 32% likely to have a macrosomic infant.
Why are We So Terrified of Birthing a Big Baby?
The female pelvis is PERFECTLY designed for birth… matter the size of the baby… is designed to open up to make more space for the baby…….and a baby’s head is PERFECTLY designed to gently mould, to make it smaller, so that it passes through the female pelvis with ease. Babies know how to get into a good position for birth, tucking their head tightly so that the smallest part presents first.
But when a women reduces her pelvic capacity, by being immobile on a bed, perhaps due to an induction – for a “big baby” or an epidural, because of the pain caused by the induction, or the fear caused by the constant “big baby” conversations everything gets a lot harder, words like”cephalopelvic disproportion” (CPD) – where the baby’s head is too big to pass through the pelvis and “shoulder dystocia” – where the baby’s shoulders get stuck – get used – needlessly.

If a woman enters labour free from fear and anxiety oxytocin (the hormone of labour) will be free to flow, her uterus will contract efficiently, endorphins (natural morphone like pain relievers released during labour) will flood her body, adrenaline will be kept to a minimum ensuring that her uterus is well oxygenated and making her as comfortable as possible. She will move instinctively into positions which freely open her pelvis, such as a squatting position (where the pelvis is said to have up to 30% more capacity) or perhaps on all fours – both superb positions for birthing a big baby.

The size of a baby then in a normal, physiological birth – where anxiety and “big baby” talk is not present – is largely irrelevant, it doesn’t make it more painful and it doesn’t make it harder! The following article, by midwife Gloria Lemay, is a MUST read for anybody worrying about birthing a large baby and wondering whether their pelvis is “big enough” Pelvises I have known and loved.




So, Is an Induction of Elective C-Section Not Necessary for a Suspected Big Baby Then? 

You may have been advised that it would be best for you and your baby if you are induced early? or perhaps an elective C-Section has been advised. You might have been told that you baby is much more likely to get stuck (also known as “shoulder dystocia”), but does the research agree?

Actually the vast majority of research into Macrosomic babies indicates that elective C-Section and induction for just a suspected large baby is a bad idea, deeming it unneccessary, needlessly expensive and not effective at preventing birth trauma to the mother or baby. When looking at induction the research is in fact even more scathing, with many suggesting that early inductions only serve to raise caesarean section rates without altering outcomes for the mums or babies.

Finally, just suspecting a macrosomic baby can lead to problems, with one study indicating that the risk of cesarean section was substantially higher (52 versus 30 percent) in pregnancies in which macrosomia was suspected, even after controlling for birth weight and other confounding variables. More importantly, the difference in the cesarean section rate was attributable to a greater proportion of failed inductions for the macrosomia in the group in which it was suspected.

Lets take a quick whistle stop tour of clinical research into suspected foetal macrosomia and birth outcome. Lets start with my favourite, a Cochrane Review looking at “Induction of labour for suspected macrosomia”, April 1998 suggested that elective C-Sections and inductions for a suspected big baby was a bad idea. The summary of the review is as follows. Important points have been highlighted:

“Babies who are very large (macrosomic – over 4500 g) can sometimes have difficult and, occasionally, traumatic births. One suggestion to try to reduce this trauma and to reduce operative births has been to induce labour before the baby grows too big. However, the estimation of the baby’s weight in utero is difficult and not very accurate. Clinical estimations are based on feeling the uterus and measuring the height of the fundus of the uterus, and both are subject to considerable variation. Ultrasound scanning is also not accurate. Induction, if undertaken too early, can lead to babies being born prematurely and with immature organs. The review of trials, assessing induction of women when it was suspected that their baby was above 4 kg, found three trials involving 372 women, none of them with diabetes. There was no evidence of any benefit in terms of caesarean section or instrumental births, or in outcomes for the baby. However, these studies were too small to be sure of the outcomes. Further research is in progress.”

The results section of the Cochrane Review also states: “Perinatal morbidity was not statistically different between groups (shoulder dystocia).”

In the Archives of Gynecology & Obstetrics, September 2008. Sadeh-Mestechkin, Walfisch, Shachar, Shoham-Vardi, Vardi & Hallak, in their study entitled “Suspected macrosomia? Better not tell” noted that:  “Our ability to predict macrosomia is poor. Our management policy of suspected macrosomic pregnancies raises induction of labor and cesarean delivery rates without improving maternal or fetal outcome.”

In 1994, in The Chinese Medical Journal, Yan, Chang & Yin, in their article “Elective cesarean section for macrosomia?” studying the births of 207 macrosomic babies concluded that: “Elective Cesarean section on macrosomic infants to prevent dystocia is not recommended because most of them can be delivered vaginally.”

In 2000, in the European Journal of Obstetrics, Gynecology & Reproductive Biology, Mocanu, Greene, Byrne & Turner studied the births of 828 macrosomic babies born over a 5yr period in their report entitled “Obstetric and neonatal outcome of babies weighing more than 4.5 kg: an analysis by parity” they concluded that:  “The poor antenatal predictability of macrosomia, the high rate of vaginal delivery and the low incidence of shoulder dystocia would not support the use of elective caesarean section for delivery of the macrosomic infant either in primigravidae * or multigravidae.”

* Editor’s Note: Primigravidae = First Time Mother, Multigravidae = Second or More time mother.

In april 1995 in Obstetric Gynecology in their research “The outcome of macrosomic infants weighing at least 4500 grams: Los Angeles County + University of Southern California experience” looking at 227 births of macrosomic babies, Lipscomb, Gregory & Shaw noted that:  “Vaginal delivery is a reasonable alternative to elective cesarean for infants with estimated birth weights of at least 4500 g, and a trial of labor can be offered.”.

In 2006 in the American Journal of Obstetrics & Gynecology, Chauhan, Grobman, Gherman, Chauhan, Chang, Magann and Hendrix reviewed the evidence for performing an elective ceasarean or an induction for suspected macrosomia, in their article”Suspicion and treatment of the macrosomic fetus: a review.” they noted that:  “Due to the inaccuracies, among uncomplicated pregnancies suspicion of macrosomia is not an indication for induction or for primary cesarean delivery.”

In 1996, Rouse, Owen, Goldenberg, Cliver, in “The effectiveness and costs of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound” published in JAMA 1996.  estimated that “to prevent one case of permanent brachial plexus injury, 3,700 women with an estimated fetal weight of 4,500 g would need to have an elective cesarean section for suspected macrosomia at a cost of $8.7 million per case prevented.

Hmmm – perhaps that early induction isn’t looking like such a good idea after all? What are your birth options then? READ ON – to see part two – Birthing a Big Baby.


Why it’s Good to Stop Saying ‘No’ To Your Toddler

I have just bought a new camera and whilst looking through an old SD card I found this shot of my daughter, taken when I think she was about 14 months old. She had emptied out an entire shelf of my kitchen cupboard, carried it all, bit by bit, into the hallway and then she started to experiment. First she emptied out all of the stock cubes and built a tower with them before unwrapping them and crumbling a few and mixing with a whole pot of dried herbs. Then she emptied the whole pot of salt out on the floor and began to make patterns with the (expensive Denby!) cup, mug and cinnamon jar in the spilt salt. Slightly out of shot is the empty packet of custard powder emptied before the salt and the open packet of pasta that had been crushed/thrown around and discarded. I don’t think she’d started on the vinegar by this point.

Look at how pleased she looks with herself, to my mind she’s thinking “hey I did good mum – look at this pattern I made and I did it all by myself!”

She is child number 4. If this had been child 1, 2 or even 3 the child in question wouldn’t have been smiling and I most certainly wouldn’t have been taking a photo congratulating her on her masterpiece. I would have been cursing, shouting and quite possibly crying and asking why she had done this to me? why did she have to be so naughty? why did she do these things when I was most tired or busy?

…..but by number 4 I had learnt to stop fighting with my toddlers, by no. 4 I had learned to understand them and learnt how wrong I had been with my others. For my daughter wasn’t naughty – she was like any other perfectly normal toddler – inquisitive, eager to learn, enthralled with the world – there was no malice, no selfishness, no lack of empathy, no plotting against me, no bad manners and no feralness – all things I had thought about my previous three for far lesser acts of toddler experimentation!

What did I say to her after taking this photo? “look at the circle shape you made with the salt, it’s nearly time for dinner now – do you want to help me tidy this away and put it back where it should be?”. Why would I tell her off? if anybody did anything wrong here it was me, for underestimating her dexterity at scaling kitchen cupboards!

Further searching through my SD card revealed 3 more pictures of my daughter that wouldn’t have appeared in my albums of children 1, 2 or 3, like the one where she learnt about the sticky consistency of suncream and how it felt cold and wet (and I guess good judging by the amount she put on) when emptied on her skin and turned anything else she emptied it onto white:

Or the time she found my very expensive Estee Lauder lipstick and decided to copy mummy and put on her own make up (on the whole of her face, hands, clothes, wall and mirror):

and my favourite – the summer she discovered how good it felt to pick her nose at the age of  15mths – oh what a love affair she had with her nose that summer – almost every picture of her we took on our holiday that year featured her in deep though, a finger searching every tiny mm of the inside of her nostrils.

What would you tell your toddler if you caught them in any of the shots above? how many times had I reprimanded her brothers for being NORMAL, for being little scientists, for having a healthy appetite for the exploration of their world.

I remember my lightbulb moment well, it was about 5yrs ago, I was walking my then 2yr old son to preschool. I was tired, I was busy, we were late. My son was walking at the speed of a snail and an elderly one at that. The half a mile journey took us around an hour, why? because he stopped to look at *EVERYTHING* we passed – leaves, rubbish, birds, worms, drain covers, broken bits of pavement – it was all fascinating to him. I started off in my impatient adult tone “come on darling, we haven’t got all day, hurry up” and after a while I got it, I hadn’t noticed the fruit on that bush before – who knew we had a wild damson tree close to our house? and that worm, how fascinating it was when it looped and curled around itself, the dew on the leaves sparkling like little gemstones….and I realised how much I was missing as an adult and I realised how fascinating our world really was and how mean of me it was to pull my little boy passed everything he wanted to see/touch/smell/hear telling him to “hurry up”. I realised how utterly frustrating I must have been making life for him. I realised something had to change….


So next time you tell your toddler “stop”,  ”no” or “hurry up” – take a little time and ask yourself why?


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What Rod? Our Experience of BedSharing to Age 4.

When my firstborn, arrived in 2002 Gina Ford frenzy was in full force. You weren’t a good mother if your baby didn’t sleep through by 12 wks and didnt have a routine you could set your watch by and you especially weren’t a good mum if your baby didn’t self settle to sleep in his black out blinded room.

I wasn’t a good mum.

My NCT class friends were good mums, their babies did what they wanted and what Gina said made them contented. Mine would only sleep at the boob/in my arms. If I put him down he wailed. They were good mums. I had failed.

So we tried controlled crying, I cried as much as my baby did. Then we moved onto Tracey Hogg. She made me feel a bit better, but not much. Every night we would try to get him to self settle, we would hold his hand/stroke his head through the bars of his £1000 handmade walnut cot that meant we couldn’t afford a holiday that year. Then we would slowly sneak out when his eyes closed trying not to creak the floorboard which made him wake and yell if we weren’t still holding his hand.

How I wish I had followed my instincts and let him sleep where he wanted and where I most enjoyed having him….but “good mums” didnt do that, good mums ensured they created confident children by making them independent as soon as possible at night.

My son is now almost a teenager and if he ever reads this will be mortified when I tell you he is desperate to sleep in bed with us as much as possible. He hates sleeping alone, has no confidence, is painfully shy and clingier now than he was as a newborn, when he hugs me I can feel the desperation and need in it still.

…..and then there was my daughter. She arrived 5 years after my first (with 2 more brothers in the middle). Five years of confidence, five years of wisdom, five years of regret. From day one (of her arrival in our own home) she slept in my arms. I gave her as much of me as she wanted and she I.

When she was 3 months we had her Christened. My Godmother rocked her to sleep whilst I fed and watered our guests. I bumped into her cradling my baby at the bottom of my stairs looking perplexed “where’s her cot” she asked me. I smiled. “She doesn’t have one”. “but where does she sleep?”………”with me”………”oh”. The silence spoke volumes. I knew what it meant……………

For 4 years 1 month and 14 days my daughter slept in my arms….and then it happened. One night she was fidgeting so much I couldn’t sleep. So I asked her to please keep still in our bed and suggested if she didn’t want to she could sleep in her bed (she has always had a bedroom and a bed that remained unslept in). It was 1am. She got up said “OK mummy” – walked across our hallway in the pitch black, got into her bed, pulled up the duvet and went to sleep.

The next night she announced “I want to sleep in my room tonight”. She took herself up, found her PJs and changed into them by herself and got into bed “reading” a book. I popped in to check and ask if she wanted me to read the story to her “no” she said, I asked if she was sure she wanted to sleep in her room “yes” she said. I asked if she wanted a hug “no” she said “but I want a kiss”. We kissed, said our “I love yous and God blesses”. She turned off her lamp and I left. With a tear in my eye.

She has spent every night since in her own bed. Our co-sleeping journey is over, a bittersweet ending of pride and letting go. How I miss her warm, small, soft body curled into mine. She gave me a gift  in those 4yrs of joy and I gave her one in return. The gift of true confidence and independence.

The NEWLY UPDATED Gentle Sleep Book – out now! If you would like to understand and learn how to improve your baby, toddler, or pre-schooler’s sleep WITHOUT cry-based conventional sleep training, this is the book for you!


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Motherless Mothers – Mothering Without a Mother Figure

I am a motherless mother.

My mother died from breast cancer when  I was 21 and she 52 , 5 years before my firstborn child arrived. My journey as a mother has been bittersweet, I have loved finding a new dimension to myself,  I have loved viewing life with new eyes but I realise now how much I have lost, for it is only now I realise the true depth of feelings my mother had towards me, how much of herself she sacrificed for me and I wish I could say “thank you”.

I wish I could ask her about my birth, I wish I could ask her how I was fed, I wish I could ask her what I was like as a baby, what she enjoyed the most and what she found the hardest. I wish I could share her wisdom, I wish I could share her stories. I wish she could meet my daughter (and of course my sons) and pass down that feminine knowledge another generation. Although I often say I now feel complete since having children,  in many ways I feel far less than a whole, I am a mother now, a wife, a friend and more, but I am no longer a child to anybody (my father died 3yrs after my mother) and only now do I realise the importance of that dynamic and the sharing of parenting wisdom through generations. I guess the saying is often true “you don’t realise what you had until it’s gone”.

Please let me add here though, I am not writing this post for pity –  do not need any, I had 21 years of wonderful closeness and I know I am lucky. I am also not writing this to be about me. I am writing because I realise now how society has lost value in mothers, how we have lost value in Grandmothers, in great grandmothers and in those feminine feet who walked in our footsteps before us, how we have lost value in female knowledge and the family in the raising of a child. Our society now is so masculine, so materialistic, so authoritarian. We have lost our way, we *need* a maternal influence, whatever our age, whoever we are.

I realise that many mothers may feel too that they are motherless in a way, even though their parents still remain alive, as I have said already, I feel incredibly lucky for the close relationship I had with mine when she was still here, I had 21yrs of closeness  and sharing with her, some I know spend their whole life seeking that closeness from a mother, still alive, who is for some reason or other unable to give it.  I have often seriously thought about “adopting a granny” for my children, an older, wiser feminine influence. I feel too their life is not wholely complete without one.

I’m sure many of you have read “The Red Tent” and thought wistfully of a society so masculine and blood thirsty and yet quietly run and steered by a deep feminine and maternal presence. Of such sisterhood and understanding and acceptance. How do we return to this ethos? how do we once again hold the matriarchs dear and close at the head of society? much like this:

The Jamaican matriarch is the center of our society. Women here have long been leaders in their homes, churches, and communities – and now they are becoming the engineers, computer programmers, architects and, yes, prime ministers of our future. It is the natural next step.

~Mercedes Dean

Think how different society could be if we truly valued motherhood once again? think how different our own experiences of parenting could be if we returned to a time with tribal matriarchs, whether they share our DNA or not, who could support a new mother through her own transition. I think in many ways being motherless is what has steered me on my path, in many ways I do act in a maternal way towards new mothers who attend my classes, by passing on what I lack helps me to feel whole and I hope helps them too.

In many ways today in our society we are all “motherless”.

I do hope I live to see the day that it changes, the day modern society realises what they have lost from their past in their quest for the future.


Why do Mothers Judge Each Other?

Bear with me, this is going to be a bit of a ramble,  I’m not quite sure what I want to say – or how to say it and I certainly don’t have any stats or science to back me up here, but this has been bothering me an awful lot lately.

Why do mothers judge other mothers?

and no, I didn’t say ‘Why are mothers judged’ – that’s a whole other blog post!


I bet some of you are thinking “but I don’t judge other mothers”, but honestly, I think *all* mothers judge other mothers in some ways, some far less consciously and far less vocally than others, but I truly don’t think there is a mother out there who has never judged another – why? because I think it’s a vital part of becoming a mother, of learning about ourselves, testing our mothering skills and hopefully, ultimately, gaining confidence in ourselves.



1 [mass noun] the ability to make considered decisions or come to sensible conclusions

I know I have judged other mothers, but when I really think about who I’ve judged, the who doesn’t really matter – when I think about the why, now that gives me answers.

Why did I judge that mother when she trained her baby to sleep through the night? (answer: because I didn’t feel secure in my decision not to do it even though I wasn’t happy with my baby’s sleep and the hour it took us to get him to sleep at night, because her baby *did* genuinely seem more ‘contented’ than mine).

Why did I judge that mother who breastfed a one year old, surely that was weird and must be more about her than her baby’s needs? (answer: because I gave up breastfeeding at 6months and everytime I saw her feed, as well as the small intake of breath at the oddness of it I felt a stab of regret that I wasn’t still doing it and that her baby was benefitting from her milk in ways mine never would from his ‘follow on’ milk).

Why did I judge that mother who breastfed until 6mths? (answer: because I breastfed a four year old and there was a small part of me that wasn’t strong enough to cope with the dirty looks, the clearing rooms and the ‘shouldn’t you have stopped that ages ago’ comments – *should* I have stopped it ages ago? maybe they were right, maybe it was all about ME and not my daughter).

Why did I judge that mother with her forward facing pram, chatting away to her friend and ignoring her baby? (answer: because I was uncomfortable in the sling, my son was crying and I felt like crying too, struggling with my bags of shopping and wishing I had a buggy to hang the bags from).

Why did I judge the mother whose baby slept in his own cot in his own room from 12 weeks? (answer: because  I was desperate for a night’s sleep without a foot in my back laying on the meagre 5 inches of mattess that was left for me, wondering when my daughter would ever decide to leave our bed).

Why did I judge the mother who dieted and regularly visited the gym when her baby was only 6 weeks old? (answer: because I felt self conscious about my body and my appearance).


“Criticism of others is thus an oblique form of self-commendation. We think we make the picture hang straight on our wall by telling our neighbors that all his pictures are crooked.”  Fulton. J. Sheen.

Why did I judge? because I was insecure.

Why did I judge? because I was not truly confident in my decisions

Why did I judge? because in a way that judgement was self talk, self directed, a maternal hypothesis you might say. I was weighing up the issue, trying to decide which way to fall, which path to take.

“People hasten to judge in order not to be judged themselves.”  Albert Camus.

Judging others helped me to test my maternal hypotheses, judging others helped me to feel confident with my choices, judging others helped me to be secure – judging others was ALL about me. The judgement was never about the other mothers, it was all about me and the more upset I got at others? well actually the more whatever they were doing unsettled me and the true issues were with myself. The more I think about it though, the more I think that this judgement is a necessary part of the adjustment to motherhood. I’m not condoning judging out loud – far from it, ideally it will all be internal chatter only.

What do you think?


How to Create a BirthFriendly Calm Birth Environment – Wherever You Are!

I am a huge homebirth advocate, all of my children were planned homebirths (only 2 of the 4 were actually born at home though – that’s a whole other blog post!), but the more I work in the birth field the more I am becoming convinced that it is not the actual *place* of birth that matters. It’s *what* and *who* is in the place that has the strongest influence. I have been at some homebirths that felt anything but relaxed and ‘homely’ and I have been at some hospital births that have been amazingly relaxed.

Whenever I work with a couple antenatally I always suggest they put a lot of time and effort into planning their birth environment as much as possible and most importantly they focus on a portable birth environment, no matter where they are planning to have their baby, because we all know what happens to the best laid plans……homebirth transfers, midwife shortages, birth centre closure….sadly none of these are uncommon. The following is a list of multi sensory tips that I discuss with expectant couples with the hopes that they can birth in the calmest environment possible, wherever the physical location may be.

1. Think about Lighting – Sight

Hardly any rooms (home or hospital) have truly oxytocin/melatonin friendly lighting. Bright light is a huge inhibitor of labour progress, hence why most women prefer a dimly lit environment to birth in, the light source too is nearly always natural: sunlight, moonlight, starlight, firelight, candlelight…How best then to replicate this ambience in a room with bright electric ceiling lights and nothing else? and often a room where you are unable to light candles (compressed gas!) or plug in lamps to the mains. I am a huge fan of battery operated fairy lights and LED candles. I have a huge selection of battery operated lights in my doula bag, the majority of them came from cheap pound shops, my favourite though are my colour changing tea lights, bought from Amazon about 5 years ago they’re still going strong after numerous births and no battery changes! dotted around the birthing room they create a beautiful relaxing vibe. To add a little more light I use a Wonderbulb on the floor in the corner of the room (underneath a chair to diffuse the light). The combination of the wonderbulb and tealights gives just enough light to a room at nighttime. I also have some waterproof colour changing spa lights which are great stuck onto the side of a birthing pool, gently lighting the water in rainbow colours.

For daytime births I always suggest mums pack a pair of big sunglasses, which have 2 uses 1) sheilding the mum from bright daylight if the room she is in has inadequate blinds/curtains and 2) giving the mum much needed privacy due to the lack of eye contact.


To me, lighting is the most important part of the birthing environment, it can have such a big impact on the mum’s oxytocin levels and is so easy to rectify!

2. Think about Scent – Smell

Our sense of smell is our sense most closely related to our memory. This can work either for or against us. The smell of medical equipment, the smell of antiseptic, the smell of hospitals, the smell of latex gloves……can all bring up unpleasant feelings for us, most often triggering the release of adrenaline (which in turn can slow labour and increase pain levels). Whereas the smell of nature – plants, flowers, the ocean, the smell of our home, the smell of chocolate, vanilla, baking cakes….can all encourage us to relax and feel good. I find the easiest way to scent a room during labour is to use aromatherapy oils. I always suggest mums to be ignore advice for ‘good oils to use during labour’ and instead go to a shop selling a large array of oils and find a smell that reasonates with them. For the mums I have worked with this has ranged from vanilla to orange oil and frankincense to lavender, it’s rare that mums pick the same scents, though lavender and clary sage do crop up lots (interestingly both on the ‘recommended for labour’ list!). The important thing then is to use that oil, build up a connection with it (check it’s safe to use during pregnancy!), use it whenever you relax: in the bath, when you go to sleep, during a massage….and really build up that conditioning. So many forget the importance of this, expecting a ‘labour oil blend’ to work magic on the day, the real magic though comes from the conditioning of the oil before labour!


The best way I have found of scenting a room during labour (bearing in mind you need to avoid naked flames in hospital!) is to use a battery operated aromatherapy diffuser such as this aromafan – which really is as good as using an oil burner, I have had my trusty fan for many years now and it has served me well at many births – with massive impact for little outlay. After birth it’s also great to use to help children fall to sleep at night and particularly when they have a cold or stuffy nose (with ravensara oil for little ones).

3. Think about Music – Sound

Lots of mums to be make a ‘labour playlist’ containing their favourite songs. It’s amazing how many of these songs however are fast paced. Ideally the perfect labour soundtrack will be composed of 60-70 beats per minute (BPM) – the same as a healthy resting pulse rate – which can help the brain enter into a relaxed state, also known as ‘alpha state’. It is possible to purchase special ‘alpha music’ – such as that by famous composer John Levine.

ImageAgain – just like the smell section above this music needs to be conditioned, spend some quiet time each day relaxing with your music, condition it to relaxation and slow breathing, if you have a massage, facial or reflexology take it along with you and ask the therapist to play it whilst you relax. On the day a well conditioned piece of alpha music can have strong relaxation results, even better if you pack some headphones to drown out external noise too!

4. Think about tactile objects – Touch

Not just touch from another person, here light stroking can often be more beneficial than a heavier massage, the sort of stroking we are so familiar with and is already deeply conditioned with relaxation and often heavily conditioned to calming from our own mother, but think about anything else that may be touching your skin. My whole family are like Linus from Snoopy with his favourite blanket – we love to curl up on the sofa with our soft throws and blankets. My youngest son and I each have a fake fur throw that instantly relax us, whereas my daughter loves her knitted baby blanket. Also – my own pillow means instant relaxation to me, taking my throw and my own pillow into hospital with me massively helped me to relax and has done for many of the mums I have supported during labour.

The last point I would like to add here is that of water. Much is written about waterbirth, but the other benefits of water are less so: showers aimed on the back of a labouring mum, a water feature gurgling away in the background, a deep bath (even better with some waterproof spa lights – see above!) – all of these can have powerful effects even if access to a birth pool is not available!


5. Think about Food and Drink – Taste

I always suggest couples pack a labour feast, not just to munch on during labour (if they feel like eating), but for afterwards too instead of the obligatory toast! I think it’s really important here to remember the birth partner, what is he or she going to eat and drink? and where is it going to come from? if it’s to be purchased on the day it means the mum is going to have to be left, or more often it means the partner goes without as they don’t want to leave the mum. I always suggest partners pack themselves lots of (not loud crunchy or smelly!) food and drink as well as packing snacks for the mum.

On this note it’s really important that the birth partner thinks about all of the above too, what will he or she do to stay comfortable? what will he or she do to stay relaxed? what will he or she do to not get bored? This last one is vital! I have seen too many bored dads pacing the floor and asking “how much longer?”!! So always suggest partners may like to pack newspapers/magazines and yes – even games consoles/laptops and IPhones to play games on!

I hope this list helps you to prepare for your birth, always remember you can control most environments and make them as birth friendly as possible, whatever and wherever your original plans – it is always possible to retain some control over your birth environment.

Do let me know any tips you have for creating a good portable birth environments! Happy BIRTHday!


5 Reasons Why Your Birth Can Affect Your Baby and Your Parenting

When I meet a new mum, dad and baby  for the first time at a consultation for colic and sleep I always start with the same question:

“tell me about your birth”

Mostly it’s met with confusion, wrinkled eyebrows and exchanged curious looks, very often they ask me “why?” straight back. After all they haven’t come to see me to talk about their birth, they’re here to see me to work out why their baby cries so much. To me though the two are so inextricably linked it is impossible to understand the issues they are having with their newborn unless we go back to the beginning (sometimes the cause goes even further back – I’m very aware of that!). So, here’s why I ask that question and why I believe that any professional working with new parents MUST consider the baby’s birth in order to really help:

1) The birth can have lasting physical consequences for the baby

If a baby is born by C-Section, ventouse or forceps my ears always prick up immediately, especially if the labour has been long and involved malpresentation. I work very closely with a local chiropractor who specialises in working with new babies and over the years I have learnt an awful lot from her. Imagine if your head had been crooked at an unusual angle for several weeks, then imagine that somebody was pushing your head into that position even harder for a whole day, you’d have a headache and neck ache right? I have seen babies in obvious discomfort, several with torticollis unable to turn their head – aside from the discomfort this can also have an effect on feeding – several mums have said “he just won’t feed from that side and cries whenever we try” – they hadn’t considered it might be painful for their baby to turn their head to do so. Also when you start delving into the world of cranial nerves even more the whole issue becomes more complex. During labour the baby’s cranial bones move and overlap (think of a cone headed newborn!), this is normal and the bones usually return to their normal position over a few days after the birth, mostly via the process of the baby sucking (and the movement of the upper and lower jaw) which stimulates the base of the skull via the palate. Sometimes however things don’t return to normal and often abnormal skull compression becomes noticeable via the baby’s feeding habits and need to suck much more than usual. If the baby’s vagus nerve (the nerve directly linked to digestion) is compressed this can also have noticeable effects on a baby’s digestive system causing pain. All of this is more likely to happen if the labour is long, the baby is malpresented (I often notice babies who laid in an asynclitic presentation during labour are more fussy) or is born via emergency section, forceps or ventouse. Visiting a good chiropractor or cranial osteopath can make a profound difference for some new parents and babies. I believe in this so passionately I believe it should be available on the NHS, after all we check a baby’s hearing after birth – why not his skull and spine?

2) The birth can have lasting physical consequences for the mother.

Again, in my utopian world  all new mothers would be visited by a chiropractor or osteopath. Having suffered from hideous SPD (now known as PGP) during pregnancies 1 and 2 it wasn’t until no.3 I discovered that – hey pregnancy didn’t have to hurt! I was literally  changed woman. I was lucky in that I only suffered during pregnancy, but I have known plenty who continued to suffer after the birth, this affected their posture, but standing and seated and the constant discomfort slowly begins to erode into the psyche, along with the discomfort experienced whilst breastfeeding, often meaning babies are latched poorly – and we all know where that leads. It’s not just the pelvis and spine that matter though. I have met too many women suffering with perineal trauma, poorly stitched episiotomies and the like which not only cause great physical discomfort, but emotional too – which naturally has a knock on effect long after the event.

3) The birth can have lasting psychological consequences for the baby

Even those that have gone supposedly “well” or have been “natural”. The two big culprits to look out for here are the use of exogenous oxytocin (aka syntocinon/pitocin depending on where you’re reading from!) and what happened immediately after birth. Let’s start with the  artificial oxytocin. It’s impossible to talk about this without mentioning Michel Odent. In his article “If I were the baby: questioning the widespread use of synthetic oxytocin” Michel discusses the blood flow from mother to baby via the placenta and states the permeability is higher in the mother-foetal direction than vice versa (i.e: blood travels from the mum to baby via the placenta easily – so too therefore does whatever substance is travelling in the mother’s blood), Michel’s concern is the “oxytocin-induced desensitization of the oxytocin receptors”. “In other words, it is probable that, at a quasi-global level, we routinely interfere with the development of the oxytocin system of human beings at a critical phase for gene-environment interaction”. What does this mean in reality? well we know that when artificial oxytocin is put into the maternal blood stream during labour so to it enters the babies and can have profound and lasting consequences on the neurophysiology of the baby for the rest of their life.

Michel goes on to say “we now have scientific evidence that explains how the capacity to love develops through a complex interaction of hormones, hormones that are secreted during many experiences of love and close human interaction including sexual intercourse and conception, birth, lactation, and even sharing a meal with loved ones. The role of oxytocin, the “love hormone,” is particularly important. Natural oxytocin delivered by human touch, but not synthetic oxytocin delivered by an intravenous drip, has important effects on many organs in the body, including the brain. “  Those important effects, Odent theorises, can cause the baby to grow with damaged oxytocin receptors which he links to raising levels of autism, anxiety, stress and disturbed ”self loving” – including higher levels of anorexia, drug and alcohol dependency.

Not to mention on another level how traumatising birth is for babies – and here I am not implying birth needs to be traumatic for babies, when I trained in baby massage with Peter Walker he said to us “what if the process of birth was the very first massage we receive? what if birth is a pleasurable experience for the baby?” this really made me think – it’s what they are born into that is more traumatic – bright lights, rough handling, scratchy towels, cold instruments, latex gloves, cord clamps, silly hats and scratch mits, injections or bitter tasting oral drops. It’s no wonder babies cry when born!

I was intrigued to learn of the importance of amniotic fluid in calming babies. When you think of this more deeply it’s kind of obvious – a baby spends 9mths in amniotic fluid – it is what you might  call “a constant”, naturally then the scent of the fluid on their skin (and that of their mother) after birth will be calming to them, reminding them of home you might say – yet, what do we do? we wipe it off, dry them and wrap them up in a rough towel – despite the fact there is sound scientific evidence to suggest this is the wrong thing to do – babies whose amniotic fluid is not wiped off after birth cry significantly  less (ref: H. Varendi et al., “Soothing effect of amniotic fluid smell in newborn infants,” Early Hum Dev (Estonia) 51, no. 1 (Apr 1998): 47-55) – and this is without even discussing skin to skin to contact (which we’ll do below).

4) The birth can have lasting psychological consequences for the mother.

On a continuation of the above theme. We know that the blood brain barrier prevents artificial oxytocin from entering the brain – this may not seem important when you are told that you need an oxytocin drip to “speed up” or even start your labour – or when you are told it’s best you have an injection to deliver your placenta and prevent blood loss (all of which contain synthesised oxytocin) – but when you understand that this results in a direct lack of oxytocin circulating the maternal brain we begin to realise quite what catastrophic effects the usage off these supposedly “safe” chemicals can have upon the bonding of mother and child and the initiation (and even long term succcess)  of breastfeeding. We know oxytocin is the hormone of love and if we are depriving mothers of this in their brain it doesn’t take a rocket scientist to work out how we may be  damaging the love process between mother and baby. So often I work with new mothers ashamed to admit that they still dont know if they really love their babies or that it took them a long time, that there was no instant “rush of love”. I have experienced it both ways. My first two births were syntocinontastic, the first one I had “failed to progress” (or they had failed to wait – you decide!) and thus it was deemed my failure of a body couldn’t get my baby out without a drip to ramp up my contractions, I was then injected with syntometrine against my consent (i.e: I wasn’t even asked for consent – “I’m just giving you the injection for the placenta now dear” – jab and in it went before I had a chance to say anything) – my second birth was an induction for pre-eclampsia and I was told I HAD to have syntometrine because I was ill/had been induced (yes I know – I was young and naive, I know a lot more know and only wish I could turn back the clock!). Did I get that instant rush of love with those babies? Was breastfeeding easy? No. My last two babies were dramatically different though. My third son arrived at home, in a birth pool, in my dimly lit living room with an incredibly respectful midwife who didn’t touch us at all. Nobody, but me, laid hands on him until he was 3 days old. Oh my goodness now I knew what they meant by “love at first sight”. within 30 minutes of his birth (still in my arms in the pool) I would have died for  him – it was as if I was a bubble of golden, warm love. I have never felt so high, drugged or drunk in my life. THIS is how it should be and this was how it was for my last baby too, a birth very similar to my third.  The love was chemical and instant. I look at photos of my first two births and I can see shadows of the pain and indignity I had suffered, the trauma I had endured and the sheer relief it was over. Those same feelings of inadequacy, grief and confusion that lasted for years after the event. Is it any wonder why so many new mothers find it hard to bond with their baby? hard to interpret their cries? hard to hear their instinct? we strip so many mothers of the chemical euphoria they should experience and pay no attention to the after effects. If you can identify check out THIS article for some tips to help you to recover. You could also get in touch with Birth Crisis who are fantastic.

5)  The birth can have lasting psychological consequences for the father.

All too often we forget about the dads, but birth can be – and is – an immensely emotional event for the father, both positively and negatively. Nobody seems to care about the dads though, nobody holds their hand and tells them they are doing well, nobody hugs them and listens to their worries or tells them “it’s OK” to cry. We expect them to be a tower of strength and support – yet where is their support? the sooner we catch onto this the better. As a doula I now firmly believe my role is 10% supporting the mum (if birthing women are left alone they pretty much don’t need help from me or anyone else) and 90% support the dad, it’s funny but a lot of expectant fathers are reluctant when it  comes to the idea of employing a doula, the mothers are  often much, much keener and the dads worry that they will feel left out. In reality it couldn’t be further from the truth and research indicates at  births with a doula present the partner is more supportive and more involved. Anyway, I’m starting to digress, my point here is that when birth goes well it can be  an amazing high for the dad too – it can help him bond with his baby almost as instantly as the mum, but when it goes bad……….oh when it goes bad….I have been at a couple of ventouse births and episiotomies now, sitting at “the business end” and sometimes the visions and noises still haunt me – how must it feel to see your partner in distress – being cut or having a baby pulled out of her with great force? and then being sent home, alone, 2 hours later if your baby was born outside of visiting hours, yet we don’t seem to understand how traumatic witnessing a birth such as that can be for a dad – and the impact that can have upon his transition to fatherhood. Indeed we know when dads are supportive of breastfeeding the mother is much more likely to be successful and feed for longer, the birth can have a big impact on the  dad and thus impact on the support he is able to give to his partner.

There is so much more I could write here, but I’m wary that I’m up to 2500 words already so I’ll revisit this some  other day.

What do I do with the information that is given to me about the birth from the new parents? most of the time, nothing (sometimes I’ll suggest a visit to a chiropractor, breastfeeding counsellor or birth afterthoughts midwife or a telephone call to the birth trauma association but rarely) – I listen and I listen some more. For that mum or dad it may be the first time somebody has listened and never underestimate the impact that feeling listened to can have on somebody’s state of mind.

Next time you meet a new mum with a colicky baby – think about asking her about her birth.


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The Fourth Trimester – AKA Why Your Newborn Baby is Only Happy in Your Arms

“My baby is only happy in my arms, the minute I put her down she cries”

“He sleeps really well but only when he’s laying on my chest, he hates his moses basket”

“She cries every time we lay her on her play mat”

“He hates going in his pram, he cries the second we put him in it”.

If I had a pound every time I heard  these from a new parent I’d be a very rich lady by now! What amazes me though is that society in general doesn’t get it, they don’t get why so many babies need to be held by us to settle and what perplexes me even more is that we do spend so long trying to put them down! We spend more than time though, the ‘putting babies down’ industry is  worth millions, rocking cribs, battery swings, vibrating chairs, heartbeat teddies and the list goes on………………having been a first time parent who bought all four of the items listed above I am embarrased to admit now it honestly didn’t enter into my head that perhaps the answer was to *not* put my baby down and I certainly didn’t consider why these things might help. It took me a long time to understand and empathise with my baby, to see the world through his eyes so to speak.

“Empathy: the intellectual identification with or vicarious experiencing of the feelings,

 thoughts, or attitudes of another.”

To empathise with our newborns feelings we need to put ourselves in their place, to imagine experiencing their world – but which world? The world they have spent most of their life in, their ‘womb world’ or the world they are in now – our world. To fully understand we must appreciate the enormous transition they have made – a concept known to many as ‘The Fourth Trimester’ -some make the womb to world transition easily, others less so and it is this latter group in particular “the clingy babies” we can learn so much from through this concept.

“Birth suddenly disrupts this organization. During the month following birth, baby tries to regain his sense of organization and fit into life outside the womb. Birth and adaptation to postnatal life bring out the temperament of the baby, so for the first time he must do something to have his needs met. He is forced to act, to “behave.” If hungry, cold, or startled, he cries. He must make an effort to get the things he needs from his caregiving environment. If his needs are simple and he can get what he wants easily, he’s labeled an “easy baby”; if he does not adapt readily, he is labeled “difficult.”” – Dr. William Sears.

So lets quickly compare the two different ‘worlds’ your baby has lived in:


Pretty different huh? On top of this the big thing to understand is that in utero the baby’s world was constant, each day was the same, the stimulation didn’t change, but now they are born each day is different – ever changing,  ever stimulating!

The concept of the fourth trimester helps us to understand the transition a newborn must make over their first few weeks earthside and once we understand we find so many ways we can help – but to me the most important facet of the fourth trimester is parental understanding and empathy, once that exists everything else will flow naturally.

Here are some common newborn calming techniques that tend to work quite well, but remember each and every baby is different, if you don’t already know, you will soon learn what your baby likes best and that’s what matters, that it is unique to *your* baby. Prescriptive ‘do this/don’t do this’ baby calming lists don’t help anybody – because they forget they are dealing with individuals – both parents and babies! Some things on this list will be inappropriate for you and your baby, some simply won’t work, some you won’t like – and that’s OK! because really it isn’t about these tips it’s about you and your baby getting to know each other!


The womb is a constantly moving space, Braxton Hicks would squeeze your baby at the end of pregnancy and each time you moves your baby was wobbled around inside. Imagine how walking upstairs feels for a baby in utero! Babies tend to love movement but so often we put them down somewhere completely still. You could try dancing, swaying from side to side, going for an exaggerated quick walk or bumpy car ride.

Skin to Skin Contact

Such a brilliant baby calmer! Being in contact with your warm, naturally (un)scented, skin is heaven for a baby, it helps to stabilise their body temperature, heart rate and stress hormones and stimulates the release of oxytocin – the love and bonding hormone – in you both. Topless cuddles, shared baths, baby massage and bedsharing are all great skin to skin experiences for your baby and you.


Sharing a bed with your baby is an amazing way of getting more sleep for everyone, babies are generally much calmer and sleep more easily if they sleep with you in your bed, yet it is such a taboo topic and although 60% of parents will share a bed with their baby at some point it’s a subject that makes society very uncomfortable, but…it is an *amazing* baby calmer!  It’s really important that you think about how bedsharing will work and follow some important safety guidelines HERE.

For more on bedsharing and other ways to improve your newborn’s sleep, watch my free webinar here:


Imagine how snug your baby was at the very end of your pregnancy inside of you – now imagine how strange it must feel to them after they have been born and have so much space around them! The absolutely best thing you can do is to envelop your baby in your arms, but for times when you don’t want to or indeed can’t then swaddling is an option. Swaddling is becoming increasingly popular, however there are important safety guidelines to be followed if you choose to swaddle your baby, if you are breastfeeding please make sure feeding is established before swaddling and take care not to miss your baby’s hunger cues if you are feeding on demand:

  •  Never swaddle over your baby’s head or near his face
  • Never swaddle your baby if he is ill or has a fever
  • Make sure your baby does not overheat and only swaddle with a breathable/thin fabric
  • Only swaddle your baby until he can roll over**
  • Always place your baby to sleep on his back
  • Do not swaddle tightly across your baby’s chest
  • Do not swaddle tightly around your baby’s hips and legs, his legs should be free to “froggy up” into a typical newborn position.
  • Lastly start to swaddle as soon as possible, do not swaddle a 3 month old baby if he has not been swaddled before.

** The American Academy of Paediatrics recommends swaddling for babies 0-14wks.


Wearing your baby in a sling is one of the ultimate ways to keep them calm and happy. It increases the time a baby spends in a state of “quiet alertness” – a time of contentment when they learn the most. When a baby is in utero they spend 100% of their time in physical contact with us – yet the moment they are born this is estimated to drop to only 40%! Babywearing also means 2 free hands!

Choose your sling carefully. A good sling will be easy to use and will support both yours and your baby’s spine whilst not placing any pressure on your baby’s growing hips – newborns should always be carried facing inwards with a “frog leg” pose, not a crotch dangle pose so commonly used by commercial baby carriers. Also seek to carry in an ‘in arms’ position – i.e: how your baby would be held if you were holding them! This great picture from JePorteMonBebe highlights this newborn hold position perfectly.

Babywearing is a great way for dads to bond with babies!

It is quite common for a baby to cry once placed in a sling, this does not mean that they hate the sling – it just means that you need to move, so get dancing! As with swaddling,babywearing is becoming increasingly popular, however there are important safety guidelines to be followed, the TICKS acronym below neatly sums them all up:



The “tiger in the tree” position below, taken from baby yoga, is often magical, stopping a crying baby in an instant!

Babies love sound, but for many not the sound you might think. For many babies a hoover is much more calming to a baby than a lullaby. A special white noise recording, such as THIS,  can be played on loop whilst your baby sleeps to help keep them calm.


If your baby is hungry nothing will calm him, so watch for his hunger cues. Feeding is always better if it is baby led, not led by a routine – whether you are breast or bottle feeding. Remember as well that your baby may not always be hungry for a full feed, they may want a quick drink, a quick snack or just some comfort sucking. Babies also find sucking the ultimate relaxation and comfort tool. Sucking helps a baby’s skull bones to return to their normal position after birth as well as providing them with comfort and security. If you are not breastfeeding you might find your baby will relax when given a dummy/pacifier.

Deep Bathing

The womb is a wet, warm place. The world as we know it is dry and cold! Sometimes a nice deep, warm bath can stop a baby’s tears in seconds – even better if mummy or daddy goes in the big bath with baby too as skin to skin contact is a wonderful baby calmer.


If all else fails many babies stop crying the minute they hit the open air – I’m not sure if this is because we are usually moving (e.g.: walking over cobbles with the buggy/ bouncing in a sling and the drone and movement of a car) or because of the change in air – but it works!

What have you found calms your newborn?

The NEWLY UPDATED Gentle Sleep Book – out now! If you would like to understand and learn how to improve your baby’s sleep WITHOUT cry-based conventional sleep training, this is the book for you!


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