SENSE-ABLE BABYTM                                                                                                                               

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                                                            ALERTNESS LEVELS:
Alertness levels change throughout the day. Sometimes we are drowsy and sometimes we are active. When adults are drowsy during the day, they are likely to move around or drink caffeinated beverages to "perk up", whereas when adults are drowsy late at night, they go to bed. Babies also change from being drowsy to active. Yet, they are dependent upon parents and caregivers to know when to put them down for a nap, or when to change the surroundings or their interactions to better help the baby "perk up" or calm down. Babies give us signals that they are tired such as rubbing their eyes, fussing, or sucking their fingers. They also give us signals that they are over-stimulated and may need us to help calm them down. Below is a list of behaviors a baby may exhibit when over-stimulated. However, these symptoms may also occur at other times and do not always mean the baby is over-stimulated, requiring the adult to analyze each particular instance. 

-Hiccups, sneezing, yawning, gagging, or spitting up
-Frowning, grunting, or grimacing the face
-Squirming, arching back, pushing self away, turning head away, or gazing away 
-Disorganized movements with limbs and/or tongue thrusting
-Zoning out due to "shutdown" or suddenly falling asleep even in a noisy environment
-Crying inconsolably which may or may not stop when noise lessens, the baby moves locations, or is held tightly
-Changes to vital signs: breathing irregularly, panting, fast heart beat, sweating, color change (flushing or paleness)

               INFANT SLEEP & WAKE STATES:

  • Movement of body and eyes are still, yet may startle or have bursts of sucking
  • Only responsive to stimuli if it is very intense
  • Breathing is regular


  • Some movement of the body
  • Eyes may flutter (REM- rapid eye movement)
  • May suck, smile, or fuss for a short time
  • More able to respond to stimuli, then change to a more awake state
  • Breathing is irregular


  • Startles mildly and activity level varies in body and facial muscles
  • Eyes may open and close with a "heavy" or glazed look
  • Yawns, rubs eyes, or kicks legs in an uncoordinated manner
  • Responses to stimuli are slow but state often changes to be more awake or more asleep
  • Breathing is irregular


  • Movement varies from little to alot with eyes open wide
  • Able to focus with attention span at its best
  • Face seems bright and happy
  • Best time for learning and interaction
  • Breathing is regular



  • Alot of movement and may be fussy
  • Eyes open but not as focused and bright
  • May get overwhelmed or too sensitive to stimuli such as noises
  • Less attentive and easily distracted
  • Breathing is irregular



  • Alot of movement with facial grimacing, crying, and eyes tightly closed or open
  • Very responsive to stimuli perceived as unpleasant
  • Flailing, may scratch or claw own skin
  • Breathing is irregular
  • Babies can alter from each sleep and wake state with stimulation that is either alerting or calming
  • When a baby is in that "just right" quiet alert state, additional stimuli can push him into a crying state just as minimizing stimuli can alter the infant into a calmer state


  • Noises, then short rhythmic cries may indicate hunger
  • Fussing/ whimpering, then a soft cry building up to a long and hard cry may mean that he is tired or over-stimulated
  • Fussing/ whimpering beginning with noises before the cry may mean he needs a change of scenery, is bored,or may need a nap
  • Sharp, high-pitched cry may mean gas or pain (teething, ears, belly) whereas loud bursts of crying may mean discomfort, and this cry is not as shrill as the pain cry
  • Loud cries with quivering or slightly blue lips may mean he's cold whereas a cry with fussiness with squirming and sweating may mean he's hot
  • Short cries that follow cooing and then stop when picked up may indicate him missing his parent/ caregiver or just needing a hug or cuddle
  • Irritable or quick, fussing cries after a meal with spitting up may mean he has reflux, was overfed, or pain from the spitting up
  • Crying followed by grunting, especially when the child stops drinking from the bottle or nursing, squirms, or holds breath, may mean he's pooping, and even if the baby is not constipated, he may put alot of effort into the bowel movement
  • Some babies fuss, squirm, and cry when they have a dirty diaper whereas others don't mind the wet, warm feeling
  • Colic may be a reason for crying, and baby's cries may differ for this, but by definition it lasts for 3 hours a day for at least 3 days of the week.  Often, this cry is similar to the pain cry
  • End of the day rhythmic crying also known as the "witchy hour" crying occurs due to having been over-loaded throughout the day, and the baby is just "winding down", and this may be mistaken for colic
  • Grunting followed by fussing and short cries may happen when the baby is frustrated or needs help such as before he can crawl to grasp for toys out of his immediate reach
  • Night-time crying may happen while the baby is in a light sleep, and then if left alone the baby may fall back into a deeper sleep or soothe self to fall asleep.  But babies who can't self soothe  may cry loud and long for a parent to pick them up or help put them back to sleep, and this is often mistaken for hunger.  Waiting 5 minutes to pick the baby up helps differentiate, because a hungry baby will not go back to sleep until fed
  • Most healthy babies may cry from 1-4 hours total within a day. This is how a baby communicates his needs.  However, if the baby cries solidly for 2 hours without a break, then contact the child's physician especially if accompanied by a fever or vomitting.

All babies can benefit from calming strategies at different times such as prior to bedtime or after attending a loud party.  Babies who tend to over-respond to sensory input can especially benefit from calming strategies.  Overall, predictable interactions and routines are calming for the baby. Greeting him in a similar way each time you enter his bedroom after he has napped is calming, just as feeding him in the same location each time can be calming. The following are strategies within each sensory system that may be calming to a baby. However, each baby is an individual, therefore what works for one baby may not for another.

       AUDITORY (Hearing):  

  • Take the baby to a quieter room
  • Turn down volume or turn off television, radio, or music
  • Take away the noisy toys or turn off the volume to the toy
  • The human voice is soothing to most babies, but talk to baby in a soft, monotone voice versus using inflection or squealing with excitement
  • If baby is over-stimulated, play music without words in the song, such as soft or classical music with a predictable beat
  • Hum to the baby
  • Hold the baby to your bare chest for him to hear your heart beat
  • "White noise" machines or put him near a rhythmic, repetitive background noise such as the washing machine or a ceiling fan


  • Decrease clutter of the room
  • Go to a less crowded room
  • Use natural or dim lighting, without glare
  • Turn off the television
  • Remove toys with flashing and blinking lights
  • If outside, put him in the shade or wear a hat to limit the direct light in his eyes
  • If baby is over-stimulated, limit getting too close to his face &/or limit direct eye-contact, yet some babies calm when looking at your face
  • Close the blinds or hang up curtains that block out light
  • Paint the walls in pastel shades, or blue/green

    TACTILE (Touch):    

  • Swaddle him in a blanket or tuck his arms in to his sides; use a special swaddling blanket
  • Hold the baby firmly to cuddle and remain quiet or limit talking
  • Let him hold your finger
  • Put him in the "football hold" or across your chest as you rub him or pat him gently on the back
  • "Kangaroo care" in which the unclothed baby lays on your bare chest 
  • Hold him or touch him in a steady position, as the "off-on-off" pattern of hands touching him can be over-stimulating
  • Infant massage with strokes that are rhythmical, slow, and medium-to-firm pressure; use the whole hand including the palm, not just the fingers. Light touch is more alerting than firmer touch 
  • Change the dirty diaper, as the wet feel may be bothersome
  • Provide neutral warmth with layers of blankets
  • Use soft cotton fabrics with sheets and blankets as opposed to polyester or scratchy fabrics
  • For an older baby with over-responsiveness to touch, provide opportunities for resistive touch such as pushing or pulling wheeled toys and climbing over large cushions

        MOVEMENT (Vestibular & Proprioception):

  • Rock slowly side-to-side (sway) as you stand to hold the baby
  • Rock the baby while holding him in a rocker or glider chair
  • Walk with the baby and try various postures to hold him in: when upright-face him away or toward your shoulder, to the front of you face baby away or toward you, and on your hip. In sidelying, can be to the front of you 
  • Take the baby for a ride in the stroller as you walk
  • Take the baby for a car ride
  • Limit or stop bouncing baby up and down while he's over-stimulated as this alerts him more
  • If holding the baby or having him in a baby sling you are wearing, be aware of your motions in different directions: walking can be calming whereas bending over, going up stairs, or spinning can be alerting
  • For older babies who are very active, resistive movements can have a calming effect. Ideas: pushing and pulling wheeled or ride-on toys, climbing over large cushions, climbing up a staircase (supervised!)
  • Any motion that is predictable and/or repetitive is more calming than an unpredictable motion. Swinging at the same pace is calming, whereas swinging at different paces (e.g. when pushed by sibling) is alerting. Motions that are performed in the front-back (e.g. rocking horse, swing) and side-to-side directions tend to be calming (e.g. swaying)


  • Allow him to suck on a pacifier or his fingers (NNS-non nutritive suck). If he can't hold the pacifer or find his fingers by himself, then help him
  • Offer teething toys and help the baby to learn to hold them so he can bring them to his mouth 
  • Don't stop a young infant from sucking his thumb as this is not a predictor of a child who will still suck his thumb once he is older; sucking is a strategy babies need for calming
  • Breast-feeding can be calming, yet be aware if the baby is using the breast as a pacifier even when he is not hungry
  • Feed him low-taste (bland) baby and snack foods such as crackers or bananas


  • Do not wear strong perfumes or body spray, since the natural scent of the parent/caregiver is calming
  • In the crib, let the baby cuddle with a T-shirt that has recently been worn by Mom or Dad that still has their scent     
  • Lotions with neutral or lavendar scents   



Many babies could benefit from strategies that alert them or "get their engines started" such as those who tend to fall asleep during a feed or those who under-respond to sensory input. The following are strategies within each of the sensory systems that may help your baby to be more alert and "perk up". However, each baby is an individual and what works for one baby may not for another. Be careful to not over-stimulate the baby which may then lead to fussing and crying.

      AUDITORY (Hearing):

  • Use an excited voice or talk "motherese" with inflection
  • Sing songs with words or with words and motions


  • Brightly colored toys (red, yellow, blue, green)
  • Contrasting colors such as black and white checkered fabric on a blanket or toy
  • Set toys out on floor or in baskets within sight
  • Brightly colored wall decorations or items dangling from the ceiling
  • Hang a mobile above the crib or diaper changing table
  • Fluorescent lighting
  • Toys with lights that flash, twinkle, or blink

      TACTILE (Touch):

  • Stroke the baby's cheek or head with your hand
  • Infant massage with strokes that vary in speed and pressure, and vary using the fingers versus the whole hand including the palm. Light touch is more alerting than firm touch
  • Tickles
  • Stroke the back of his neck and spine to keep him from falling asleep during a feed
  • Blow air on his face   
  • Water play: cold water is more alerting than neutral or warm/hot temperature


         MOVEMENT (Vestibular & Proprioception):

  • Bounce the baby on your lap, making sure his head is well supported
  • Dance or swing the baby in the air while holding him firmly 
  • "Rough" play
  • Offer a variety of toys that encourage movement such as wheeled toys that are meant to push or large balls to chase after while crawling, tunnels to crawl through, or a rocking horse to ride on
  • Motions that are performed at an unpredictable pace are more alerting than rhythmical motions. Spinning/ rolling, up/down, and upside down motions are also alerting. Bouncing the baby on an adult's lap at an unpredictable pace and then tilting him backwards is more alerting than just bouncing him up/down 

         TASTE & ORAL MOTOR:

  • Feed him high-taste foods such as tart fruits or mixed flavors
  • Massage gums with finger or infant toothbrush


  • Since most smells are alerting, especially foods, let the child play with the baby food before eating or smell trace amounts of breast milk or formula before taking a bottle    

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