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Question & Answer - Development

What should parents consider when preparing for their child's birth and early development?

September 2015


The following is a series of interviews with Diane Bahr, MS, CCC-SLP, CIMI (International Presenter on Feeding, Motor Speech, and Mouth Development) by Cintia Saporito (Journalist in Argentina).

Questions from Cintia Saporito (CS)

Answers from Diane Bahr (DB)


CS: What are the key aspects every mother “to be” should consider when planning her maternity leave?

DB: In my opinion, every mother should have a systematic but flexible plan for her maternity leave which includes good and appropriate preparation for feeding her infant. Feeding therapists see many newborns with subtle but problematic mouth development and feeding concerns that frustrate parents. I wrote a blog for Kids in the House discussing these issues.

CS: What should be considered when choosing a daycare?

DB: Look for a daycare that supports a baby’s social-emotional and physical health during mealtimes, play time, rest time, and diapering. A lot of development is occurring in the first year of life. It is important that daycare personnel interact with babies by getting them out of seats, swings, and bouncers and into appropriate other body positions throughout the day. Daycare providers need to communicate with (e.g., talk to the baby, read the baby’s signals) and feed the baby in an appropriate manner without television in the background. They also need to comply with their country’s guidelines to avoid SIDS (Sudden Infant Death Syndrome).

CS: How concerned about work should mothers be?

DB: Many mothers need to work to help support their families. A mother’s concern about work will be based on her individual situation and her personality. I would love for mothers and/or fathers to have the option to stay at home the first year if they choose, but this is frequently not reality.

CS: Why is maternity leave beneficial or important for the mother (and her baby)?

DB: Maternity and paternity leave is important for bonding as well as the social, emotional, communication, and feeding development of the child. Maternity leave is particularly important for mothers who choose to breastfeed. Breastfeeding is the best feeding method for the health and development of a child if a mother can do this. It also has many benefits for the mother.


CS: What things should a mother consider when preparing her birth plan?

DB: When preparing for a baby’s birth, a mother should think about how she wants to feed her baby at birth and after birth. Based on research, breastfeeding is the best feeding method for a baby’s mouth development as well as overall health and development. It is also the best feeding method for the mother’s own health and recovery after birth. The value of breastfeeding vs. bottle feeding can be found in my book Nobody Ever Told Me (or My Mother)That! Everything from Bottles and Breathing to Healthy Speech Development (Chapter 2).

CS: Who would be the best choice to be with the mother during birth? What are the aspects involved in birth that the future mother must know? And, how should they be handled?

DB: It is important for the mother to speak with the doctor or midwife who is delivering her baby to discuss whether the baby can be put to the breast right after birth. Babies placed on their mothers’ bellies immediately after birth can usually find their way to the breast. It would be wonderful if a lactation consultant, doula, nurse, or doctor who knows about breastfeeding could be available to help the mother begin to breastfeed the baby right after birth.

CS: Is there any additional information you would like to add?

DB: If a mother decides to bottle feed her baby, I have written directions for appropriate bottle feeding as well as information about troubleshooting during breast and bottle feeding in my parent-professional book. I recognize that in our modern world some mothers and fathers do not choose breastfeeding for their children, so I want those parents to know the best bottle feeding methods possible. Here are two additional articles on our website about feeding a baby during the first two years of life:

-Feeding 101: What Baby Food Jars Don’t Tell You (AKA: What do parents need to know when feeding their children from birth to 12-months of age?)

-Sippy Cups, Bottles, and Straws, Oh My! Feeding 201 (AKA: What do parents need to know when feeding their children from 12 to 24-months of age?)


CS: How can a mother manage nerves and anxiety when having to leave her newborn to go back to the office?

DB: It is truly anxiety provoking for a mother to go back to work. I saw this when my own daughter returned to work, and her baby was only 6-weeks-old. In my opinion, the best approach for a mother returning to the office would be to have a systematic plan for this process. I would suggest that she write this plan, so she can see what she needs to do. She can then see that the process is probably not as overwhelming as she may think.

CS: What would it be best in terms of daycare, nanny, a family member looking after the child?

DB: The person with whom the mother leaves the baby while at work should be determined according to what makes the mother, father, and baby most comfortable. As part of a systematic plan for returning to work, I would suggest that the mother and father explore all of their options to discover the best fit for their baby. The baby needs to be with a person who can care for and nurture the baby because a lot of important growth and development is happening during the first year of life. Prior to returning to work, the parents can try each viable situation/option with the baby to see which one is best for the baby.

CS: What arrangements should the mother do to keep breastfeeding the baby or to move onto formula?

DB: A feeding plan for the baby will be crucial when the mother returns to work. If the mother is breastfeeding, she will need a quiet, comfortable, and private location where she can pump her breast milk during the day while she is at work. She will also need a place to store the breastmilk (e.g., refrigerator or insulated container with a cold pack).

Prior to returning to work, the mother will need to introduce the baby to breastmilk in the bottle, so the baby knows how to take a bottle. Bottle feeding and breast feeding are very different processes in terms of how the mouth works. I suggest that the mother think about introducing the bottle after the baby is breastfeeding well. The father and other family members can give the baby the breastmilk from the bottle at home to help the baby learn the bottle feeding process.

In choosing a childcare situation, it would be important for the mother and the father to observe care provider(s) feeding and caring for the baby to be sure there is a “good fit” between the baby and the care provider(s). If the parents are supplementing the baby with formula, formula can be given to the baby from the bottle by the caregiver. Switching completely from breastmilk to formula may be problematic for some babies because formula has a completely different taste and smell than breastmilk. Breastmilk is reported to be sweet and salty. It has different food tastes based on what the mother eats. Formula smells and tastes medicinal. In fact, formula is a medicalized way of feeding a baby, and many babies have some digestive difficulties with formula. This is the reason parents often change formulas based on their pediatricians recommendations.

CS: Do you have any additional information you would like to add?

DB: Here are some additional interviews on this topic if you are looking for more ideas:

-How can child care providers best support breastfeeding mothers? What can daycare providers expect when a client is breastfeeding and you are caring for their infant?

-Infant Care Tips for Child Care Providers Part 1 and Part 2.

About the Interviewer

Cintia Saporito is a Journalist and Sociologist from Buenos Aires, Argentina. She has contributed as a writer to different media and editorials in her country, as well as collaborated in the writing process of books specializing in subaltern movements and economic history. Cintia is also a Human Studies and Communications Middle School Teacher and is now in the process of getting her degree in Psychology.

Here are the articles written by Cintia as a result of her interviews with Diane Bahr:

-Saporito, C. (2015, May). Maternity Leave is Over, What Now? (Text in Spanish).

-Saporito, C. (2015, May). Tips to Make Your "Birth Plan" (Text in Spanish).

-Saporito, C. (2015, Mar. 18). Preparing for Maternity Leave (Text in Spanish).

About Diane Bahr

Diane Bahr, MS, CCC-SLP, CIMI is a certified speech-language pathologist and infant massage instructor. She has practiced speech-language pathology since 1980 and has been a feeding therapist since 1983. Her experiences include teaching graduate, undergraduate, and continuing education courses; working with children and adults who exhibit a variety of speech, language, feeding, and swallowing disorders; and publishing/presenting information on oral sensory-motor function, assessment, and treatment. She is the author of the textbook Oral Motor Assessment and Treatment: Ages and Stages (Allyn & Bacon, 2001). She has also written a book for parents entitled Nobody Ever Told Me (or My Mother) That! Everything from Bottles and Breathing to Healthy Speech Development (Sensory World, 2010).


Question & Answer - Development

I have a 5-month-old baby who screams when placed on her tummy. She also is not rolling. I am concerned that she is behind in her gross motor development and that this will affect her other development. Should I be concerned?

QUESTION FROM: Ann in Maryland

June 2013


Answer from Diane Bahr, MS, CCC-SLP

This is a common problem for today’s parents, and it seems related to lack of infant experience. However, first check with your pediatrician to see if your baby has any physical or medical concerns that may cause her discomfort when she is on her belly. Once you determine the problem is not physical or medical, you can teach your baby to spend time on her belly and to roll.

Why Do So Many Babies Dislike Tummy Time?

While pediatricians recommend “back-to-sleep” and “tummy-to-play,” babies do not seem to be getting enough belly time. In past generations (when children slept on their bellies), they had some natural tummy time as they moved in their sleep and when they woke up. However, today’s children sleep on their backs, and many are swaddled to help them sleep (which limits movement). Additionally, today’s parents are “on the go,” so babies go from crib, to car seat, to baby seat, to swing, etc. Today’s babies often spend so much time in some type of apparatus that they have been called “container babies.”

Babies (who spend too much time in containers) do not have enough opportunities to move and develop the muscles in their bodies. When placed on their bellies, they likely find that tummy time is hard for them (because they feel weak in this position). No one likes to do things that are difficult.

“Belly time ... provides the foundation for the development of breathing, postural control (e.g., sitting and standing), and movement (e.g., rolling, crawling, walking, eating, drinking, and talking). The muscles in your baby’s head, neck, upper spine, shoulder girdle, chest, and abdomen develop through belly time and movement” (Bahr, 2010, p. 56).

Therefore, you are correct to be concerned about your baby’s motor development if she is resisting belly time and not rolling. However, typically developing babies usually “make up for lost time” with the right help and encouragement.

How Parents Can Encourage Tummy Time and Related Motor Development

Today’s parents need to make a concerted effort for their babies to have adequate tummy time. Parents can accomplish this by placing the baby’s belly against the parent’s belly as they recline and relax together. It is important that the parent remain awake and alert during this time.

Parents may also get on their own bellies (on the floor or bed) with the baby on her belly. For younger babies, parents can make eye-contact, talk, and smile. For older babies they can look at toys and picture books together. Pack N Plays or a blanket on the floor can also be good areas for tummy time as long as babies have supervision and no one will step on them.

If belly time seems too difficult and/or stressful for a baby (at first), parents can provide support by:

  1. Placing small towel rolls under the baby’s arms or
  2. Positioning the baby on a wedge, so she does not have to bear her full weight

However, we want to keep babies “on track” in their development. 

What to Expect at 5 to 6 Months of Age

Here are the skills we want to see in a 5-month-old baby when she is on her belly (Bly, 1994):

  1. Good head control, and she can move her head from side-to-side easily
  2. Weight-bearing on her forearms and hands, and she can reach forward for toy

With regard to rolling, a 5-month-old baby should roll from her back to her side on her own. When she is on her side, she should be able to bring her hands together and to her mouth. By 6-months, a baby should actively roll from her back to her stomach (Bly, 1994).

Parents can play a game to help a baby learn to roll from her back to her side at 5 months.  Place your hand under the baby’s shoulder or hip, and gently help her begin to roll to her opposite side. You may gently guide her arm or leg across her body, but do not pull on them (to avoid dislocation of the joints). This gentle rolling game can be fun for the parents and the baby.

Thank you for asking this very important question, as many parents are likely experiencing this very same problem. You are not alone.


Bahr, D. (2010). Nobody ever told me (or my mother) that! Everything from bottles and breathing to healthy speech development. Arlington, TX: Sensory World.

Bly, L. (1994). Motor skills acquisition in the first year: An illustrated guide to normal development. San Antonio, TX: Pearson.

This Q & A has also been printed with permission from Diane Bahr on Own A Daycare.