Welcoming Mothers to Breastfeed

By Cindy Wickham, TLC Educational Services Manager

Did you know that breastfeeding helps reduce SIDS, illness, ear infection, and upset tummies in babies? And that despite all of the health benefits of breastfeeding for both infants and their mothers, it can still be challenging for a mother to find a safe, welcoming environment in which to breastfeed or pump?

TLC welcomes breastfeeding and pumping mothers, and is undergoing Breastfeeding Friendly training to further improve our ability to accommodate mother's with nursing infants who are part of our infant & toddlers childcare program.

Breastfeeding Friendly, in addition to HEAL (Healthy Eating, Active Living) training, is part of a center-wide initiative to develop an implementation plan and clear policies regarding healthy eating in our classrooms, educating families about the benefits of quality nutrition on healthy child development, and welcoming breast feeding parents and staff into our facility.

Materials to make TLC a Breastfeeding Friendly site include books and toys to help children understand what breastfeeding is, why it is important, and to normalize seeing it.

Why Breastfeeding Friendly?

By becoming Breastfeeding Friendly certified and implementing HEAL, TLC will be able to better impact positive development in children through increased nutritional intake beginning at birth, and through monitored obesity prevention by classroom teachers, aides, and therapists. Healthy development impacts a child’s behavior in the classroom on a daily basis, as well-nourished minds and bodies are able to focus and learn better.

The Benefits of Breastfeeding and Creating a Space for Breastfeeding

Babies don't need water or cereal, as all the liquids and nutrients they need are provided in their mother's milk. Introducing solid foods before six months of age can replace the nutritional and caloric content provided by a mother's milk, and should be avoided. A newborn’s brain is only about ¼ the size of an adult’s, and grows to be 80% of adult size by age three, and 90% by age five, the age when a preschooler graduates from TLC, making their time at TLC one of the most critical periods in their development for adequate nutrition acquisition, which starts in infancy. Poor nutrition contributes to delays in intellectual development by causing brain damage, illness, and delays of motor skill development. Early shortages in nutrients and exercise can reduce cell production; later shortages can affect cell size and complexity. Nutrient deficits also affect the complex chemical processes of the brain and can lead to less efficient communication between brain cells, potentially crippling a child’s cognitive potential for life.

By giving mothers who are able to breastfeed the space to do so during the day (both breastfeeding and pumping), whether on their lunch break from work, or before dropping off or picking up their child, we are helping mother's build a solid nutritional foundation for their child. This foundation is built upon in our classrooms when TLC teachers help establish healthy eating habits and food preferences.

Infant Feedings at TLC

TLC infant room staff respond to hunger cues from infants in their care. Research shows it is best to feed a baby when it is hungry, not on a strict schedule. Babies have fluctuating appetites as they grow, and may receive different amounts of calories each time they feed, resulting in a need for more or less milk at alternating variables. Cue-feeding has been shown to help babies grow better, stay calm for feedings, and learn to eat when they are hungry, which can prevent over-eating and obesity as they grow. Cues for hunger in infants include opening mouths, sticking out tongues, or moving head side to side. Hand sucking can also be a sign of hunger, and turning away from a breast or bottle a sign of fullness. Infant room staff can store both breast milk and formula on site, and mothers are welcome to come during the day and feed their infants at any time.

Advice on Breastfeeding & Child Nutrition from Boulder County Health

The recommended minimum amount of time to breastfeed an infant is for the first six months. In this time, it is recommended to exclusively feed babies breast milk. Babies don't need solid foods before they are six months old. Solid foods are difficult to digest before this time, and foods like cereal in a bottle can hurt baby's teeth, upset tummies, and interrupt sleep. Mothers are encouraged to breastfeed through the child's first birthday, and for longer if the mother wishes to do so.

A variety of positive food experiences and activities promote good eating habits and development in children. Focusing on programs about child health, breastfeeding, and healthy habits can improve a child's cognitive development early on, and thus impact their mental processing and performance throughout life, and improve a child’s ability to make healthy choices that positively impact their own well-being. TLC's programs for infants, toddlers, and preschool children, including the implementation of Breastfeeding Friendly, help build life-long healthy habits in kids.

"TLC" Means Excellence for ALL Children

By Greg Ludlow, Vice President of TLC Board of Directors, Finance Committee member

TLC is One of the BEST Childcare & Preschool Centers for All Kids

The Tiny Tim Learning Center was founded many years ago by a dedicated group of parents of children with special needs. My step-daughter, Casey, was one of the early enrollees.  She is 41 today, lives on her own, and is largely self-sufficient, thanks to her involvement with places like Tiny Tim (now called TLC) and the wonderful people who worked there throughout her young life.

Casey in preschool while attending Tiny Tim

When she entered Longmont High School, attending a few classes with typical children was called "mainstreaming."  Today, having children with special needs in a class with typical children is referred to as an "inclusive classroom."  The world is a better place today because of inclusive classrooms like those at TLC, where special kids like Casey aren't locked away from their peers at a young age. This was the driving philosophy behind the founding of Tiny Tim, and remains the mission of Tiny Tim, called TLC, today: Kids with special needs and kids with typical development should learn side-by-side in inclusive classrooms to benefit both the children with special needs, and the children with typical development.

Candidly, TLC has little issue with attracting children with special needs to enroll in its programs. TLC's long-standing reputation as a wonderful early childhood education program for children with special needs is just as well-deserved today as it was when my step-daughter attended. Even though the name has changed from "Tiny Tim" to "TLC," the mission, the standard of care, and the quality of the education and services to families remains the same. Because of TLC's reputation and word-of-mouth referrals, TLC almost always has a wait-list for children with special needs to enroll in its classrooms.

The wait-list stems from TLC's commitment to classroom ratios of 6:4, meaning classrooms are comprised of 60% children with typical development, and 40% children with special needs. This is a research based best-practice ratio to ensure each child receives the maximum attention, care, and service needed to build kindergarten-readiness.

TLC classrooms and teachers help ALL children learn positive behavior, learn critical early-learning concepts, grow up healthy, make friends, and become kindergarten-ready

Despite TLC's ability to prepare EVERY child for success in kindergarten and beyond, enrolling the typical child has proven to be a difficult task for TLC. TLC's most common feedback is that families don't know TLC serves typical kids as well as kids with special needs. This misunderstanding is disappointing, in that TLC can only enroll more children with special-needs when there is a sufficient enrollment of typical kiddos to create the 6:4 ratio in every classroom.

Thus, the recent name change from The Tiny Tim Learning Center to TLC Learning Center. It is the Board of Director's and the staff's hope that the name will decrease the misconception that TLC doesn't serve typical children with the high-quality education they need. TLC absolutely serves typical children with research-based curriculum, outstanding and caring staff, and carefully monitored progress of skill acquisition and development using the Teaching Strategies GOLD assessment portfolios.

Beginning in 2013-2014, TLC teachers switched from paper portfolios to virtual portfolios, so all preschool student achievement and growth data was collected online, making it easy for data to be shared with kindergarten teachers after students graduate from TLC.  The Educational Services Manager, Cindy Wickham, collected data on TLC students for the Board in August, 2014. The data included:  percentage of TLC students leaving for kindergarten who were “kindergarten ready” based on Literacy and Math (achievement), and the number and percentage of students who were meeting or were above the expected growth. This growth data was aggregated by age (3-4 year olds, and pre-kindergarten/4-5 year olds). The growth data was collected in each of the following areas: social-emotional, physical, language, cognitive, literacy, and mathematics. The results are highly indicative of TLC's success in preparing ALL children for success upon entering kindergarten:

Achievement data: Of the eleven students who left TLC at the end of 2014 to enter kindergarten, 94% were “kindergarten-ready” based on math and literacy data collected in GOLD portfolios.

Growth data:  In the 3-4 year old group, the percentage of students meeting or exceeding growth expectations was between 87% (language) and 96% (social emotional). In the 4-5 year old group, the percentage of students meeting or exceeding growth expectations was between 94% (literacy & mathematics) and 100% (cognitive and social-emotional).

These results are especially noteworthy, when one remembers that TLC's classrooms are not 100% typically developing children, but include 40% children with special needs.

Infant & Toddler Care at TLC, and Preschool Open Enrollment

The Board and staff's desire to better share with the community our work with typical children also triggered our interest in launching Infant & Toddler childcare.TLC now provides inclusive, high-quality, Four Star Qualistar Rated Infant & Toddler childcare five days a week to better serve families, and to create a continuum of care for children from birth to five.

This is why I am writing this article. We need your help letting the community know that we serve typical children as well as special needs children, all while maintaining our same mission to provide comprehensive early childhood education and therapeutic services to assist each child in reaching his or her highest potential. Please take a moment and think of parents with newborns or infants and refer them to us, either by calling (303)776-7417 or by emailing Cindy Wickham at CWickham@LearningWithTLC.org.

While TLC is a 501(c)3 non-profit, it operates as a business in order to be able to fulfill our mission. As with any other business, operating at full capacity would allow us to both operate more efficiently and offer more children the opportunity to grow, learn, and become better prepared for entering grade school.

TLC's Impact on My Family

Casey and her brother, Tom

And if I might make it more meaningful by sharing a personal experience, please keep reading.  Cathy and I met and blended our existing families in 1983. She had Casey, and I had two daughters. Shortly thereafter, our son, Tom, announced his pending arrival. Fast forward to Tom's first day of kindergarten at Hygiene Elementary. Cathy was a panic stricken mother-bird when he did not get off the afternoon bus. Tom called her a short time later to say his friend, who was born with a cranial birth defect, was being teased on the bus by some older boys, and Tom was afraid to get off and leave him alone with those boys. So Tom rode the whole way home with his friend.  I have been proud of my son many times in his life, but never more so than that day. He learned to be such a sensitive and caring person in large part by being raised with an older sister with Down syndrome. This is the type of compassionate behavior children with typical development learn in addition to literacy and math skills, by being in classrooms alongside children with special needs.

Don’t you want that same thing for your child, grandchild or just a young neighborhood kid?  That is what an inclusive classroom setting offers, among many other positive learning experiences for typical kids.

Telling the community what we do and who we serve to help us enroll more typical kids helps not only the typical kids, but the special needs kids we can take off our wait list and enroll in a classroom because of the balanced ratios created when typical kids enroll.

Could you help us spread the word?

Casey, Tom, and Tom's wife, Lindsay today

Flu Season & Enterovirus 68 in Preschools

By Katie Dueber, Pediatrician & TLC Board Member

As a mom of two young children and a pediatrician, this time of year always makes me nervous. As kids head back to school, they are eager to see their friends and teachers, catch up from the summer, and share their germs. Now, this may not be the first concern on everyone’s mind, but it certainly is at the forefront of mine. Being well-aware of germs is especially true this year, as we are seeing an early spike of a particularly potent respiratory virus.

Enterovirus 68 (EV-D68) is making headlines as it clears out classrooms and fills pediatric intensive care units. Its victims include our youngest patients as they are always more susceptible to respiratory illness, and also asthmatics. Kids with even mild asthma are really struggling with this illness and these are the kids that are often requiring hospitalization for supportive care. This virus is causing severe cold symptoms, cough, and in some patients, wheezing and respiratory distress.

This virus is not new, but the effect it is having on children this year seems to be. There has been a lot of media attention around this virus, adding to parental concern but also increasing awareness about the virus and precautions to take against it. The largest numbers of reported cases seem to be in Kansas City and Chicago, but Colorado certainly seems to be seeing its share. There are more than 100 types of enteroviruses and they typically cause mild diseases that are spread through the oral-fecal route. EV-D68 is also spread by mucus and droplets in the air.

Asthma is a risk factor for more severe illness. If your child is on a preventive asthma medication, please make sure that he or she is using it. If your child uses Albuterol, even occasionally, start it with any symptoms of cough or illness. Even if you child does not have asthma, this virus can make your child ill. Prevention is the best medicine, but if your child does get sick, use over the counter medications as instructed by your physician, encourage fluids, rest and keep your child at home.  This is a virus, which means antibiotics will not help, so do not expect your doctor to prescribe them, but have your child seen if he is not improving. And have him seen right away if he is having any difficulty breathing.

EV-D68 is not the same virus as influenza, but we will likely be seeing that all too soon as well! To help prevent the spread of respiratory illness, wash hands often with hot water and soap, drink plenty of fluids, keep your child home if she is sick, avoid others when they are sick and get your flu shot!

Sophia washes her hands with soap in her preschool class to help prevent the spread of germs

Early Intervention & Occupational Therapy


By Shari Karmen, TLC Therapeutic Services Manager & Occupational Therapist

I believe in Early Intervention; I don’t believe in the motto “wait and see what happens in a year." Parents should trust their gut feeling when worried about their child’s development because parents know their children best. Early Intervention and screening for developmental delays and disabilities can make all the difference in setting a child on course for healthy growth.

Helping kids and their families screen for delays and address areas of concern to build strong, happy kids is what I love to do. I want all parents to know what Early Intervention is, and how it can benefit their child.

 My son, K, as a baby

When I think of the successes of Early Intervention in children I've worked with, so many faces come to mind. I remember when a little girl with a serious heart condition ate her first cheerio without choking, a huge feat for a toddler with a history of feeding difficulties and poor weight gain. I remember another little girl who was sent home from her long hospital stay with bottles and nipples from the hospital that were not available to the public. Her mom was panicked, but we worked together to find the right combination and a comfortable feeding position. Together, we were able to help the little girl move to a commercially available bottle and nipple. Her mom was overjoyed, and the little girl was able to eat a healthy amount and gain weight at a healthy pace, and that made me smile. I have so many stories like these.

I also have a personal story. My son, K, was delayed. I was probably the nightmare mom – the one who knew just enough to drive the doctors nuts. I brought my son in to the doctor's at four days old and said he had low muscle tone. Of course at the time he was crying his eyes out and stiff as a board, making the process of observing him more difficult. But my pediatrician believed me when I voiced my concerns, and referred me to the Early Intervention program in Tucson.

K is truly an Early Intervention success story. We started Physical Therapy for his low muscle tone at six months, followed by Occupational Therapy, and then Speech Therapy. With help building his strength and muscle tone, K was able to sit upright, as well as crawl a crooked path at nine months. He walked at 18 months. He did not use verbal language, but learned some sign language between 12-18 months. He was very sensitive to movement, noises, and touch, which made car rides, going to the grocery store, and getting dressed a challenge. Our therapists worked with K and us on each of these difficulties.

My husband and I followed through with every recommendation and exercise demonstrated by our therapists, working with K at home following appointments. My son graduated from Physical Therapy, then Speech Therapy (speaking in full sentences), and lastly, Occupational Therapy within three years. I am happy to report that today he is a talented, soft spoken, and loving 18 year old, getting ready to leave the nest to pursue degrees in classical piano performance and music education. We couldn't be prouder parents.

I know not everybody’s story is the same, but in all of my years working, I can honestly say that I always see positive changes with Early Intervention services. I was friends with my son’s therapists, and now I have made friends with my client’s families, and I love seeing the progress their children make long after they've graduated from Early Intervention therapies.

So, what is Early Intervention?

Commonly referred to as EI, Early Intervention is a nationwide system that helps identify, and then helps treat babies and toddlers with developmental delays or disabilities. EI focuses on five areas of development:

  • Physical (rolling, crawling, using hands to play with blocks)
  • Cognitive (problem solving how to get to a toy, playing peek-a-boo, figuring out a toy)
  • Communication (babbling, talking, following directions)
  • Social/Emotional (feeling secure, smiling, playing with other children)
  • Adaptive (eating, dressing, sensory processing)

Eligibility for EI services is determined by an evaluating team. If eligible, EI services can be put in place from birth up to a child’s third birthday.

Anyone can refer a child to EI. If you as a parent have a concern about your child’s development, you can call a center like TLC (a pediatric therapy office specializing in EI services and physical, occupational, and speech therapies for children up to 12), the local Child Find office through your school district, or the Part C agency in your county. Physicians and daycare providers are also great referral sources.

Early Intervention services include:

  • Physical Therapy – to address gross motor skills such as rolling, crawling, and walking, issues with balance, strength, and coordination.
  • Occupational Therapy – to address fine motor skills, sensory processing, self help skills (feeding, dressing), and play skills.
  • Speech and Language Therapy – to address understanding of language, expression, social communication, and speech intelligibility.

EI is based on routines. That means that we, the therapists, help you, the parent, to provide therapeutic activities during your child’s daily routine. EI therapists can see children in the hospital, in homes, in childcare settings, and out and about in the community.

If you have any concerns about the development of your child, don't hesitate to have your child screened. It's easy, and can make a world of difference in helping your child be the happiest and healthiest baby it can be. I'm proud to say, Early Intervention works!