Can i hurt my baby in the womb
Can bumping my pregnant belly hurt the baby? | Your Pregnancy Matters
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Your Pregnancy Matters
October 8, 2019
Your Pregnancy Matters
Shivani Patel, M. D. Obstetrics and Gynecology
Your baby bump will probably get bumped while you're pregnant, particularly if you have young children. It is almost always harmless. But if you suffer abdominal trauma, such as getting in a car accident, call your doctor.Patients experiencing their first pregnancies often wonder (and worry) about common questions, such as:
- Am I supposed to feel the baby kicking yet?
- Why can’t I sleep?
- Will having an occasional glass of wine hurt the baby?
Often, talking with a doctor or another mom can relieve these concerns. But one question tends to linger for new and experienced patients alike: Will bumping my belly hurt the baby?
The answer is almost always no. Some abdominal contact is inevitable and typically harmless during pregnancy, from doing daily tasks at work to managing rambunctious toddlers and pets. The rare exceptions usually involve abdominal trauma, such as getting in a car accident.
We’ve put together a run-through of common concerns patients raise, including activities that are generally safe, tips to avoid abdominal trauma, and when to see the doctor.
How protected is the baby in the womb?
In general, women’s bodies are not fragile. Historically, women have worked hard on farms and in factories throughout their pregnancies. Many still do today.
The uterus is a muscular organ that protects the baby from the jostling and bouncing of mom’s day-to-day. When combined with the shock absorbers of the amniotic fluid and the weight you gain during pregnancy, your baby is padded from the effects of most daily abdominal contact.
Abdominal trauma is different. Vehicle accidents, falls, and overzealous lifting can be forceful enough to harm the baby. However, you can take precautions to reduce the risk of abdominal trauma, which we’ll outline below.
Abdominal contact: Safe activities
The following activities are generally safe for women whose pregnancies are not high risk.
Big hugs from toddlers
Not much can beat the feeling of a toddler running to you for a big hug. And, for most patients, the force of a 20- to 40-pound child bumping your belly is not enough to harm the baby. That said, toddlers can be unpredictable, and a hug could quickly turn into flailing arms and legs, which might cause abdominal injury or a fall.
Consider explaining a safer way to hug you. You might say, “Mommy loves when you hug me! But while my tummy is big, please walk to me so I don’t get hurt.”
Extra love from pets
Dogs and cats might jump up on you or plop on your lap when you least expect it. While pets under 40 pounds are unlikely to hurt your baby with pawing or bouncing, they can be a tripping hazard. Make sure you get a visual on your pet when you enter a room to avoid falling.
Pets over 40 pounds can jump or land with enough force to hurt you or potentially harm the baby. Teach the pet not to jump or ask someone to kennel the pet when you are present.
Related reading: Is your pet ready for you to have a baby?
House and yard work
It’s generally safe to mow your lawn, garden, wash the car, and conduct other household chores during pregnancy (sorry to blow your cover!).
That said, listen to your body. If you feel fatigued or sore, take a break. Avoid climbing ladders or working on uneven or slick surfaces to reduce the risk of falling. Also, stay hydrated and avoid heavy lifting.
Abdominal trauma: When to use extra caution
In the following scenarios, consider the suggested precautions to protect your growing baby.
Heavy lifting
While not necessarily related to bumping the belly, patients often ask whether it’s safe to lift babies, groceries, and objects at work during pregnancy.
Heavy lifting and repetitive lifting motions have been associated with pregnancy loss, preterm birth, and maternal injury such as a pulled muscle. The Centers for Disease Control and Prevention note that women in certain professions are at increased risk, including: childcare providers; health care workers; law enforcement officers; service workers; and teachers.
You don’t have to avoid all lifting, but you should follow the guidelines recommended by the American College of Obstetricians and Gynecologists (ACOG). Most non-high-risk patients can occasionally lift people or objects up to 36 lbs through approximately the 20th week of pregnancy. From week 21 on, occasional lifting should be capped at 26 lbs. If your job requires you to lift more than the recommended limits, talk your Ob/Gyn.
Women who lift routinely (every day or several times a week) can lift people or objects up to 18 lbs through 20 weeks gestation and up to 13 lbs from 21 weeks to delivery. If you care for a child or adult who exceeds these weight limits and requires lifting, talk with your doctor. In-home resources are available to alleviate lifting duties during pregnancy.
After delivery, during the post-partum period, follow the 21-week-plus guidelines until your provider clears you to resume regular activities.
Driving or riding in vehicles
Car accidents are the No. 1 reason pregnant patients call our office with concerns about abdominal trauma. Often, they’ve hit their belly on the steering wheel or strained against the seatbelt hard enough to leave marks.
For a safer ride or drive, wear your seat belt properly. Adjust the belt low on your lap, below your belly. Position the shoulder strap between your breasts, which will naturally move it to the side and away from your stomach. To avoid serious injury, ACOG recommends never putting the shoulder strap under your arm or behind your back.
When driving, you might need to adjust your seat back as your belly grows to keep a comfortable length from the steering wheel.
If you are in any vehicle accident, no matter how small, visit your doctor as soon as you can. Injuries that affect the baby or your internal organs might not cause immediate symptoms, and it’s best to find issues early.
Nesting
Nesting, or the urge to get everything ready for the baby’s arrival, can make you feel energized and strong. But don’t give in to the urge to move furniture yourself or haul heavy totes out of storage. Ask for help to move and unload the baby’s things. You can still direct the project.
Working out
It’s important to get exercise during pregnancy, though you will probably need to make some modifications as pregnancy progresses. Your balance will change as your abdomen grows, and the shift will be more noticeable during exercise than during everyday activities.
- On the treadmill: Position yourself toward the middle or back of the belt so you don’t bump your belly against the console. Clip on the emergency stop pulley in case you fall or need to stop suddenly.
- Lifting: Limit the amount of weight and avoid lifting with your back. Also, check your form – balance properly and protect your joints. Also consider using a spotter.
- Hot yoga: Avoid this form of yoga during pregnancy. Research has shown that too much heat can be detrimental to the baby. But feel free to continue doing other types of yoga during pregnancy – it’s a safe, fun way to exercise during any trimester.
When to call the doctor
You can reach out to your doctor any time you are concerned about a belly bump. Call your provider immediately if your water breaks or you experience any of these symptoms of abdominal trauma:
- Reduced or absent fetal movement
- Vaginal bleeding
- Contractions before 37 weeks gestation
Note: Contractions might not be painful. They might feel like cramping or abdominal tightness. If you press on your abdomen and can’t indent the uterus, you’re likely having a contraction.
Even if you don’t experience symptoms after an abdominal trauma, call your provider. The doctor might ask you to come in for an exam to monitor the baby’s movement and heart rate.
With a few modifications, your baby bump doesn’t have to radically change your day-to-day activities. Follow the guidelines and talk with your doctor if you’re unsure – it’s always better to ask than to worry!
Do you need to see an Ob/Gyn? Call 214-645-8300 or request an appointment online.
You may associate post-traumatic stress disorder with survivors of assault, war, or natural disasters. But as maternal-fetal specialist Dr. Shivani Patel will tell you, symptoms of PTSD can weigh heavy on moms who had complex pregnancies. She knows from personal experience.
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How Much Pressure Can a Pregnant Belly Take?
Have you heard stories about when teachers used to send their students home with egg “babies” as a lesson in just how hard it is to keep a fragile little thing safe and protected?
You might have laughed and laughed because it was obviously not the same — except now you’re pregnant, and you’re wondering if waddling around with a baby sticking out from your center of gravity isn’t so different from carrying that egg around all day.
There’s a fragile little one that needs protecting from the big bad world out there, and you’re the only thing standing in the way.
Or are you?
There’s actually a lot of padding between the outside of your stomach and the cozy bubble that baby is floating around in. But your abdomen isn’t bulletproof, no matter how badass growing an entire human makes you feel — there’s a limit to how much pressure and impact it can withstand.
So just how safe is your baby when it’s inside you? Here’s what you need to know.
Admit it: You went home with your egg baby, all confident and carefree, and then before the weekend was over you dropped it on the kitchen floor — because taking care of an egg baby is hard, folks.
Thankfully, taking care of your real baby while they’re in your belly is way easier.
People have been growing and carrying babies for… well, all of life on Earth. Traveling long distances on foot, toiling in the fields, taking care of other children, tending to animals — the pregnant body is actually designed to withstand a lot.
There are a few reasons, specifically, why your body can handle some roughing up without injury to your baby:
- your uterus, aka the strong muscular organ housing your wee one
- your amniotic fluid, which absorbs pressure like a waterbed would
- the extra body weight you’re carrying, which acts like a protective fat layer
One thing to note is that contact (like bumping into a wall) is different from trauma (like a car accident).
Your belly can handle day-to-day abdominal contact. Trauma is a different story, but it’s also much less common.
Because baby is so tiny in the first trimester, there’s virtually no risk to them with abdominal contact or trauma. It’s not impossible to have a negative outcome, but it would be rare unless the injury was severe.
The risk increases a bit in the second trimester, as your baby and stomach start growing more. Even still, the chances of harm to the baby are low.
The third trimester, though, is different. At this point, baby is getting pretty big and filling up a lot of the available real estate in your belly.
This means you may have less cushioning from amniotic fluid and body fat.
It also means you’re at a higher risk of placental abruption, which is most common in the third trimester. Placental abruption isn’t always caused by trauma — but trauma can cause it, leading to bleeding, pain, and even premature delivery.
All these factors combined make the third trimester the most dangerous when it comes to abdominal impact.
Kids and pets
Little kids, dogs, and cats either don’t know or couldn’t care less that you’re pregnant, and their exuberance can result in some uncomfortable leaps into your arms or onto your lap.
For the most part, this won’t hurt your baby; after all, expectant moms have been living with older children and pets forever, mostly without incident.
It does make sense to do some training, though (of your pet and your kid, if necessary!) so it’s not a repeated thing. If your child or pet is over 40 pounds, they could — in theory — accidentally hit you hard enough to cause an injury.
Discourage larger dogs from jumping to greet you and teach your toddler to “hug gently” to avoid any issues.
Fender benders
In general, minor car accidents pose more of a risk to you than to baby. This is especially true in the first and second trimesters. Even in the third trimester, the risk to your baby is low as long as the accident is one all parties can walk away from.
But regardless of how far along you are or how serious (or not) the crash is, always get checked by a doctor right away.
While a little fender bender around the corner from your house isn’t likely to cause any problems, any kind of car accident falls into the “needs medical attention” category of pregnancy impacts.
Housework
Whether you were a klutz pre-pregnancy or not, you aren’t likely to escape those 9 months without banging your bump into doors, cabinets, drawers, and furniture.
Why? Because your center of gravity is all messed up, and you may be in a constant state of distraction thanks to pregnancy brain.
If you’re constantly bumping your belly while you vacuum, wash dishes, put away laundry, or just generally go about your daily biz around the house, you don’t need to worry — baby is nice and safe in there.
Sex positions
The good news is that you don’t have to change up your intimacy routine with your partner very much during pregnancy. There aren’t any sex positions that are actually unsafe.
Some positions might simply be uncomfortable for you, like ones where you have to lie on your back.
Although it isn’t dangerous to be on the bottom for the length of a normal sexual encounter, you might want to try new sex positions during pregnancy that aren’t only more comfortable but maximize the experience for your changing body.
Trips, slips, and falls
Again, your center of gravity isn’t the same as it used to be, so tripping and slipping isn’t unusual during pregnancy. As far as whether these foibles need to be evaluated by your doctor, that depends on if there was any impact to your back or stomach.
In other words, if you trip on a wayward shoe or slip on a patch of ice but don’t hit the floor or ground, you should be good to go.
If you do fall down, though, and it’s hard enough to hurt or knock the wind out of you for a sec, you should give your doctor a call to see what they say. (They might want to examine you or they might just tell you to monitor yourself for signs of injury.)
Any serious falls — like taking a tumble down a flight of stairs or while getting out of the shower — should receive medical attention right away, either with your doctor or through an emergency or urgent care facility.
Lifting
Per the Centers for Disease Control and Prevention (CDC), heavy lifting can not only result in more injuries for you, but could increase your risk for preterm birth.
But what does “heavy lifting” actually mean? Can you carry that box of new baby items up the stairs? Pick up your 5-year-old? Exercise with hand weights?
Well, it depends.
Guidelines published in 2013 suggest that certain factors play into the overall amount you can safely lift. These factors include:
- how far along you are
- how heavy the item or person you’re lifting is
- how often you need to be doing the lifting
To sum it up: The more often you need to lift things, the lighter in weight they should be. Heavier objects can be lifted as long as it’s done infrequently. (And those numbers vary based on whether you’re fewer than 20 weeks or more than 20 weeks pregnant, FYI.)
Also make sure you’re using safe lifting techniques, like bending from the knees and not raising items over your head.
Getting up using your abdominal muscles
If you’re the type who used to jump out of bed first thing in the morning and hit the ground running, you won’t do any harm to your baby with that habit — but you might want to consider a more moderate approach for your own sake.
Repeated abdominal strain during pregnancy can cause or worsen diastasis recti, a common pregnancy and postpartum condition that can be difficult to fully resolve (even with months and months of specialized exercise).
Instead of using your abs to get into a standing position from a prone or seated one, turn onto your side and push off with your arms and legs, or grab onto something — yes, your partner counts — and gently pull yourself up.
Exercises that use your abdominal muscles
You use your core for the vast majority of exercises, even when they’re focused on your arms, butt, or legs.
But there are definitely some exercises, like crunches, sit-ups, and leg lifts, that work your abs the hardest — and these should generally be avoided after the first trimester.
While there’s no direct harm to your baby with these exercises, there are a few reasons why it’s better to skip them.
Lying flat on your back can interfere with your blood flow, and can also cause you to accidentally strain other muscle groups, like the ones in your back, to overcompensate for the weight in your front.
If you want to keep strengthening your core during pregnancy, you can do planks, standing crunches, and yoga poses that position you on your hands and knees.
There are three scenarios where you should call your doctor ASAP, no matter how small they might seem in the moment:
- You’re in a car accident. It doesn’t matter if it’s a head-on collision or a small tap in a parking lot — contact your doctor if you’re involved in any kind of motor vehicle accident.
- You fall. Flat on your face, hard on your butt, turtle-style onto your backside — it doesn’t matter where you land or what you injure. If there’s impact, you should call your doctor.
- You experience an intentional blow to the stomach. There will always be rogue limbs flying when you have a toddler around, and that’s fine. But if anyone hits or kicks you in the stomach on purpose, you should contact your doctor (and if necessary, the police or a domestic violence hotline, depending on the situation).
If you have a minor abdominal strain or impact like the ones we outlined before (e.g., your dog jumped on you or you lifted something unexpectedly heavy), you most likely won’t need to call or see your doctor.
You still should be on the lookout for any concerning symptoms, such as:
- vaginal bleeding or bloody discharge
- consistent pain or cramping
- frequent contractions that don’t get better when you rest
- a decrease in fetal movement
If you notice any of these symptoms, call your doctor, regardless of how mild you think the impact or strain to your belly might have been.
The vast majority of contact your belly has with the outside world every day won’t hurt your baby — they’re very well protected in there!
The risk increases a little during the third trimester, when baby is bigger and the risk of placental abruption is higher. Even then, it takes a traumatic event (not your 5-year-old climbing into your lap) to be cause for concern.
That said, any traumatic event should prompt a call to your doctor, along with any symptoms of pain, bleeding, contractions, or changes to your baby’s movement.
Protecting the tummy? Moms, don't be afraid, the baby is under protection
Quite often, mothers ask obstetricians how dangerous it is to sleep on their stomach, hit their tummy, or get elbowed by fellow citizens in public transport. Will it hurt the baby? Doctors are trying to reassure: the baby is under reliable protection. This does not mean that you do not need to protect the tummy at all, but you should not panic too much and be afraid that the slightest impact can harm the baby. The baby is in the amniotic fluid, which reliably absorb all shocks. So, most of the anxiety is a psychological factor. Any mother instinctively covers her tummy, as if protecting the baby. nine0003
Have a good sleep
Quite often expectant mothers worry about what position to sleep in so as not to harm the baby. Don't worry and trust your feelings. At the very beginning of pregnancy, the uterus does not increase much in size, your baby is still a baby-with-a-nail, so sleeping on your stomach does not interfere or harm either mom or baby. As the uterus grows in size, you yourself will feel that lying on your stomach becomes uncomfortable and will begin to avoid this position. Someone else sleeps on their back for several months, someone immediately rolls over on their side. The position "on the back" also quickly becomes uncomfortable, because in the later stages the inferior vena cava is clamped, and you will feel discomfort. nine0003
In the third trimester of pregnancy, as a rule, the mother intuitively comes to the conclusion that it is uncomfortable to sleep even on her side. Many begin to put a roller from a blanket under the tummy - and this is completely normal. For some it is convenient to lay a roller between the legs - listen to yourself and sleep in a comfortable position. All the same, in a dream, a person changes position involuntarily, so it is very naive to think about the “correct” position for sleeping. Remember that the mattress should not be hard, otherwise it will give you torment. The ideal option is anatomical mattresses that take the shape of the body, but they are quite expensive. Refuse for a while from hard orthopedic beds, even if they helped you to relax before. Sleep on softer. nine0003
Accident
Many mothers are afraid of bumps and falls, which happen quite often, because the tummy protrudes in the later stages. There are myths among the people that an abortion or placental abruption can occur during a fall, and popular television series inform us about this, in which the heroines lose a child from one accidental fainting. In fact, it's not like that at all. Placental abruption occurs with gestosis, abortion can occur from mechanical trauma only if the mother had a threat of interruption in a severe form, in which hospitalization is usually carried out. In general, even in severe car accidents, pregnancy can often be saved. nine0003
However, mother's worries are quite understandable. Therefore, if you are worried, talk to your doctor, describe your symptoms, if he deems it necessary, do an extraordinary ultrasound.
Clothes for the belly
No less myths about how important it is to dress properly. Many mothers, undressing and seeing a trace of an elastic band from panties on their stomach, are already afraid that they have harmed the baby. Yes, indeed, in position it is better to dress in loose clothing. During the day, swelling can occur, and you just feel more useful and comfortable without extra rubber bands. However, it is hardly possible to harm the baby with a belt in the place where the waist used to be. nine0003
Some moms are also wondering if a bandage is not harmful to the baby, which is often recommended to be worn after 23-24 weeks. Of course no. It is designed to redistribute the load on the spine and avoid discomfort and pain, as well as support the anterior abdominal wall to reduce pressure on the lower uterine segment. The bandage is especially relevant for women with weakened abs and for those who give birth not for the first time and have a stretched abdominal wall. However, with good health, sports moms do well without a bandage. nine0003
No less worrisome is the "communication of the older child" aged 1-4 years with the tummy. The baby can jump on the mother, the mother has to carry the child in her arms. And it's not dangerous either. Focus on your well-being: if it’s not difficult for you and your lower back doesn’t hurt, don’t deprive your older child of such pleasure. As you can see, most tummy problems are far-fetched. The baby is safe in his cozy house.
Anna Babina,
Consultant: Tatyana Uletova, obstetrician-gynecologist
Life before birth – Dixion Medical Center in Orel
The author of the article is
Olga Mikhailovna Khoreva,
psychologist of the clinic "Dixion"
In modern society, we no longer treat pregnant women with such trepidation, but at the same time we still know little about the life of a person in the womb of a mother. We have little idea what it feels like to happen. Perinatal psychology reveals these mysteries.
This kind of psychology appeared not so long ago, about forty years ago. This science studies the mental life of a baby in the womb or a newborn, his connection with his mother, the influence of her psychological state on him. nine0003
Many scientists claim that the fetus has a long-term memory and mental life.
The perinatal period has a great influence on the future of a person. It turns out that what happened to him in the womb, as well as during and after childbirth, is stored in his subconscious. In the future, these events affect how a person will become, how he will behave in certain situations.
The events of the perinatal period can be divided into three stages: pregnancy, childbirth and the postpartum period. nine0003
Stage 1: Pregnancy
At this time, a person's life potential is formed, the ability to adapt to various conditions. Dear mothers, learn to love your baby in the tummy, even if his appearance was not a very pleasant surprise for you!
According to scientists, the basic physical and mental potential of the desired child is much higher. Otherwise, children do not sleep well, are easily upset, and cannot calm down for a long time. Often they are physically weaker than desired children. nine0003
The baby in the mother's belly is very sensitive to her mood. He hears, sees, tastes and touches. The child "sees the world" through the eyes of the mother, perceives it through her emotions. Therefore, pregnant women are asked to avoid stress, not to worry.
The child succeeds in all this with the help of hormones that come to the child through the placenta, and with the help of the mother's electromagnetic field. Scientists believe that mother and child communicate by means of millimeter-wave electromagnetic waves. nine0003
It is possible that some of the information is transmitted to the child through the aquatic environment of the mother's body. But the baby still in the womb can show independence. From about the tenth week, the fetus feels touch, that is, it has a sense of touch. From the eighteenth week - begins to distinguish the taste and drink amniotic fluid. At this time, you need to carefully monitor your menu - you can teach your child to eat "not right."
Hearing develops around the twenty-second week, but the children do not hear external noise well. They are disturbed by the sound of the work of the internal organs of the mother. But they hear their mother perfectly. So we recommend expectant mothers to sing songs, read aloud and just talk to your baby. nine0003
This is best done when the baby is awake. This time is easy to determine. Usually during this period the child is actively moving. It will be great if every day during this period you communicate with him like this: touch your tummy and say something, for example: “Hello, baby.” Over time, the conversations will become longer, and the child will respond to touches by pushing. It is advisable to involve older children and dad in this game. Just keep in mind that each family member should have a “own” part of the tummy for touching and their own “sound code”. In this way, the baby's sense of touch and hearing are developed, and it also has a positive effect on the emotional development of the child. nine0003
By the twenty-fourth week, the child's pupils are able to react to light. Some scientists believe that complete darkness reigns in the womb, others that the red part of the spectrum enters the uterus. The baby will learn to distinguish smells only when he is born - being in the womb, he will trust the mother's sense of smell.
Stage 2: Birth
Who will be the child in the "big" life - will he be a "winner" or "victim", how will he fight for a place under the sun - this is determined during this perinatal period. nine0003
Scientists believe that natural childbirth has the best effect on the future of the baby. Stimulation of childbirth has a negative impact on the mother and child - it breaks their interaction, speeds up the process against their will, so it is worth resorting to it only for medical reasons. Despite the fact that with a planned caesarean section, everything happens painlessly for the baby, many scientists believe that in this case your child will not become a fighter, and they do not recommend resorting to cesarean section unnecessarily. nine0003
If you want your child to be a fighter, behave properly when pushing, and then the mouse will become more assertive in the performance of the tasks assigned to him, act accordingly and perceive various situations objectively.
Breathing will help to behave properly during contractions and strains, and it will also help reduce pain. You can learn how to breathe correctly during childbirth on your own or in courses for pregnant women. During childbirth, listen carefully to what the midwife says and try to follow her advice. nine0003
Husband, mother or other close person can provide great support and assistance during childbirth. The so-called joint childbirth has a number of advantages: during contractions, the mother will not be alone with pain, there will be a loved one nearby who can distract her, support and help in this difficult situation; besides this close person is easier to perceive than a stranger, so the words of the midwife, repeated by the husband, will reach your consciousness faster.
Stage 3: Postpartum
According to scientists, at this perinatal stage, a person's attitude to freedom, their capabilities and strengths is formed. Therefore, during natural childbirth, the child is immediately placed on the mother's stomach. He sees his mother, feels her warmth, that is, he feels protected. Immediately after birth, the baby looks at his mother's face - he seems to get to know her again. This process of "gazing" is called bonding.
Psychologists say that during this process a stable emotional bond is formed between mother and child. If the father, whom the baby had only heard before, is next to the newborn and the mother, it will be just great - he will also be involved in the bonding process. It will be great if dad takes the baby in his arms, hugs him, talks to him. The presence of the father is especially important in the case of a caesarean section. While the doctors are "conjuring" over the mother, the baby will be in the hands of the father. nine0003
If it happens that a child cannot be with his mother for a long time after giving birth, then in life independence may become a burden for him. But with good care, breastfeeding for up to a year, tenderness and love, this state of affairs can be corrected.
Breastfeeding is a very important moment that affects both the emotional and physical development of the child.
The composition of breast milk is individual and ideal for just one baby. This composition changes during the day and days of a newborn's life. nine0003
Emotions are the thread that connects mother and child - they still form a single whole, but in the psycho-emotional, and not in the physical plane. The newborn is very sensitive to the mood of the mother. If the mother is upset, then the baby also behaves restlessly.
An important factor influencing the emotional development of a child is the attentive, sensitive attitude of his parents both to him and to each other. You need to spend as much time as possible together, smile, hold the child in your arms more often. nine0003
It has been proven that the baby develops faster if he has a lot of contact with his parents from birth. Of great importance are touches at every change of clothes, bathing, carrying on hands, feeding, massage.