Tuesday, December 1, 2009

Baby Care Course 8: Health: Keeping Your Baby Well

Visits to the doctor’s office are expensive, but well worth the money, when they are needed. In this lesson, we will discuss how you can prevent illness, speed recovery, and determine when a doctor visit is necessary, or when home care is adequate. The final section contains a list of parenting resources for further study.

Health Maintenance

Keep your baby well by feeding him good food, by making sure his air and environment are clean, and by following his doctor’s schedule for wellness checkups. Good food, especially breast milk, promotes good health. It prevents illnesses and allergies, reduces infections, and comforts him when he’s sick. Pollutants in his environment can irritate his sensitive breathing passages.

During wellness checkups, request that your baby stay on your lap or in your arms during his exam so that he will be more calm and the exam will be more accurate. You may bring a list of questions to ask. The doctor discusses your baby’s growth and development, nutrition, and illness and accident prevention. Your baby receives a physical exam, measurements are taken, and his hearing and vision are evaluated. He may receive immunizations or lab tests. Immunizations stimulate your baby’s body to create antibodies to disease. (See pages 574 to 580 for more information on immunizations.)

Attached parents often know their child is sick even before he displays symptoms. His behavior may change subtly. More obvious signs of sickness are fever, lethargy, faster breathing, and faster heart rate.

Help him heal from many common illnesses by encouraging him to rest, giving him extra fluids, fresh air, liquid food, and slow-release sugars. Get a doctor’s recommendation before giving medicines. (See pages 584 and 585 in The Baby Book for medicine-giving techniques.)

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 3: Bonding: Building Attachment

Baby Care Course 4: Stages: Growth and Development

Baby Care Course 5: Feeding: Breast and Bottle

Baby Care Course 6: Nutrition: Introducing Solid Foods

Baby Care Course 7: Safety: Babyproofing

Baby Care Course 7: Safety: Babyproofing

Most accidents are preventable. In this lesson, we will discuss how to evaluate the safety of your home and yard from your baby’s perspective–the ground. As your baby becomes more mobile, she may be able to reach higher than you think, and she may develop the ability to climb up onto items before you realize it. Besides preventive measures to avoid your baby’s risk of physical injury, we will also discuss preventive measures to limit her exposure to environmental toxins.

Babyproofing Your Home and Yard

Prevent common accidents and allergies by following these practices:

General: Keep drapery cords out of reach. Pad furniture edges. Cover unused electrical outlets. Remove toxic plants. (See pages 562 to 566 in The Baby Book for information on household plants.) Keep doors, windows, and screens locked. Use safety gates to create play areas. Keep washer and dryer doors closed. Keep floors and carpets clean because allergens, dust, and chemicals settle there. See pages 551 and 552 in The Baby Book for information on fireproofing your house.

Kitchen: Make sure all breakable and sharp objects, and anything poisonous or that could cause choking is well out of his reach. Keep all small appliances unplugged and have a multi-purpose fire extinguisher available. Make sure appliance cords and table clothes don’t dangle over edges. Keep safety latches on cabinet and appliance doors.

Bathroom: Treat medications and cosmetics as poisons and keep them out of reach. Keep safety caps on medicines and dispose of out-of-date ones. Keep scissors, razor blades, and pins out of reach. Place nonskid mats in the tub and shower, and pad tub faucets. Use slipproof backing on bathroom rugs. Keep electrical appliances away from water. Drain water from the tub immediately after use. Never leave your baby unattended. Keep the toilet seat down and latched. Remove the inside lock on the bathroom door. Instead, install a hook high up on the door for privacy.

Bedroom or Nursery: Your baby’s nursery should be well ventilated because he’s vulnerable to the fumes emitted by many products, such as particle board furniture, fresh paint, synthetic carpeting, vinyl products, and the dust mites in matresses and stuffed cushions and toys that may cause him adverse health effects when concentrated in the air. See below for crib safety tips.

If your baby sleeps in your bed, consider the following tips for sharing sleep safely. Don’t sleep with your baby when you are under the influence of drugs or if you are obese. Otherwise, place him on a firm surface between his mother and a guardrail or the wall. A sleeping mother is more sensitive to her baby’s presence than a sleeping father or sibling. Also, being between two bodies may overheat your baby. Make sure the bed is against the wall. Avoid overdressing your baby for bed. Your body heat and light cover is enough to keep him warm. Place pillows on the floor in case he falls out of bed. (See page 319 in The Baby Book for more information on safe sleep sharing.)

Yard: Store away garden hoses. While your baby is playing outside, watch for insects, make sure he doesn’t put poisonous plants in his mouth, and stays away from areas where pesticides or herbicides are used.

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 3: Bonding: Building Attachment

Baby Care Course 4: Stages: Growth and Development

Baby Care Course 5: Feeding: Breast and Bottle

Baby Care Course 6: Nutrition: Introducing Solid Foods

Baby Care Course 6: Nutrition: Introducing Solid Foods

Your baby will be ready to try solids, like all development, according to her own schedule. Generally, this is between four and six months of age when her tongue movements, swallowing skills, and intestines are ready. She will also be getting her first teeth, and she will be able to sit in a high chair at the table with you. She will watch you eat, and may reach for your food. In this lesson, we will discuss her first feeding, and what and how to feed her during her early eating stage from around six to nine months, and during her later finger food stage from around nine to twelve months when balanced nutrition becomes more important.

Six to Nine Month Feeding

Always feed your baby in an upright position. Place his high chair away from hazards, always use the safety belt, and be sure the tray is securely attached. Start with foods that resemble breast milk or formula in taste and texture such as pureed banana or rice cereal. You may mix these foods with breast milk or formula to entice your baby to try them. Make the mixture thin for the first feedings. Dry cereal is more nutritious than pre-mixed cereal. Test the temperature of the food to make sure it’s not too hot. Place a small amount on your finger and put it in his mouth. Let him suck on your finger. Leave the glob on his tongue. If he pushes it back out, he may not be ready for solids. Don’t expect him to eat much at first. Introduce only one new food at a time, at least a week apart. Avoid common allergens such as dairy products, wheat, and soy. Watch for signs of allergic reaction such as a skin rash, diarrhea, vomiting, or nasal congestion. (See the feeding chart on pages 204 and 205 in “The Baby Book.”)

His goal is to learn to eat, not to get a balanced meal. He will still get most of his nutrition from breast milk or formula. Nibbling throughout the day is nutritionally better than eating a few large meals. Feeding your baby takes time. You may have to be creative to get food into him, but never force it. Avoid causing him to laugh while he has food in his mouth to prevent choking. If he chokes, don’t intervene if he can cough or cry. Try to keep him from panicking, and be ready to intervene if necessary. (See pages 653 to 654 in The Baby Book to learn when and how to intervene if your baby is choking.)

Making Your Own Baby Food:

  1. Wash the fruit or vegetable well. Avoid acidic fruits.
  2. Remove tough parts that could cause choking.
  3. You can add a small amount of lemon juice as natural preservative, but don’t add sugar or salt.
  4. Steam the fruit or vegetable to preserve vitamins and minerals. Bake potatoes or squash in their skins, then remove the skins.
  5. Mash and puree the fruit or vegetable.
  6. Pour or spoon the mush into an ice cube tray and freeze.
  7. Place the cubes into freezer bags, label and date. Keep food up to three months in the freezer.
  8. Let a serving defrost in the refrigerator for three or four hours.
  9. Warm and serve.

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 3: Bonding: Building Attachment

Baby Care Course 4: Stages: Growth and Development

Baby Care Course 5: Feeding: Breast and Bottle

Baby Care Course 5: Feeding: Breast and Bottle

Feeding is a time for comforting as well as for nourishing. Whether you choose to breastfeed or bottle-feed, do so with love. In this lesson, we will discuss ways to breastfeed or bottle-feed, and common concerns when doing either.

Breastfeeding

Breastfeeding your baby is her transition from your womb to the outside world. While inside, she was nourished by the umbilical cord, now she’s nourished by your breasts and feels secure in your arms. Your voice and heartbeat are familiar comforts. Your milk, custom-made for her, contains all the nutrients she needs and is easily digested. It protects her from allergies, illnesses, and diseases, and aids in the optimal development of her brain and nervous system. (See pages 118 to 124 in The Baby Book to find out what’s in your breastmilk.)

Breastfeeding your baby is good for you, too. While breastfeeding, you produce a high level of prolactin, the “mothering” hormone, which helps you balance the demanding nature of caring for a baby. Breastfeeding also prevents pregnancy, uses extra calories to help you get back in shape, and protects you from breast and ovarian cancers, urinary tract infections, and osteoporosis.

Take advantage of your baby’s strong newborn sucking reflex by putting her to your breast as soon as possible after birth. If you wait, her sucking reflex may be weak for a couple of days.

Getting Started:

  1. Sit or lie comfortably. Use pillows, footstool, or other props to support your arms, legs, or the baby if neccessary.
  2. Hold your baby at nipple level with her head and body facing you.
  3. Cup your breast with your hand.
  4. Tickle your baby’s lip with your nipple.
  5. When she opens her mouth wide, center your nipple in her mouth above her tongue and pull her toward you so that your nipple is deep in her mouth with as much of your areola in her mouth as possible so she will suck effectively, compressing the milk sinuses to release the milk.
  6. Her chin presses into your breast and her nose touches your breast. If her nose seems blocked, pull her bottom in closer rather than pressing down on your breast.
  7. If you feel pain, stop and start over. Break the seal of her sucking by placing your finger in the corner of her mouth or by pulling back on her cheek.
  8. Nurse her for as long as she shows interest. When she slows and begins to doze, offer her the other breast. At each subsequent feeding, offer her the fuller breast first.

This first breastfeeding experience may feel awkward. Your baby may only nuzzle or lick. Don’t worry if she doesn’t latch on right away. The important thing is to hold her close, talk to her, and comfort her. Correct positioning and latch-on ensures that your baby sucks well, gets plently of milk, and protects your nipples from soreness. (See pages 128 to 133 in The Baby Book for more information on breastfeeding positioning and latch-on skills.)

Your first milk, called colostrum, is an important source of protective immunities against disease. Nurse her often, according to her cues, to develop an adequate milk supply. In the beginning, she nurses from every twenty minutes to every two hours. Her feedings will become further apart as she grows.

After your baby sucks for several minutes, you may feel a tingling sensation as your milk lets down. This occurs several times during a feeding. Even if you don’t feel the let-down, you notice her swallowing more rapidly.

Hold your baby upright after she nurses. This often brings up any air bubbles. Pat or rub her back if she is fussy and seems to need to burp. If she burps, see if she wants to nurse again. If she falls asleep at your breast, it’s not necessary to wake her to burp.

(See pages 184 to 186 in The Baby Book for information on nursing multiple babies; and pages 187 to 191 for information on weaning your baby from your breast.)

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 3: Bonding: Building Attachment

Baby Care Course 4: Stages: Growth and Development

Baby Care Course 4: Stages: Growth and Development

Your baby grows and develops at his own rate. There is a wide variation in what is considered normal. During this first year, his brain grows to sixty or seventy percent of its adult weight. He learns mostly through seeing, hearing, and doing. In this lesson, we will discuss how you influence his development by providing an enriching environment and by responding appropriately to his needs. You help your baby learn by providing him with an environment that he can explore freely, by being dedicated to your own interests, by seeing the world through his eyes, and by encouraging him to be curious, play, and explore his interests.

When viewing growth and development charts, remember that your baby’s progress from one stage to the next is more important than when he meets milestones. (See pages 410 to 413 in The Baby Book to view a development chart, and visit babycenter.com for more information on baby development.) Your baby’s development is observed in four skill areas: gross motor, fine motor, language and social, and cognitive. His gross motor skills determine how he uses his large muscles. His fine motor skills determine how he uses his fingers and hands. This first year is his prelinguistic stage of language development. He learns to communicate by crying and making other sounds before he can say words, so by responding to his signals, you help him learn to talk. By interacting and playing with him, you help him develop social skills. His cognitive skills include his ability to think, reason, and solve problems.

Birth to Three Months

During these first three months, your baby pays a lot of attention to you. She studies your face and listens to your voice. Encourage her by making funny faces and funny noises, and by reading to her. Each day you see more of her personality emerging. By three months, she tracks objects well with her eyes. Try holding a toy about ten inches from her face and move it slowly from side to side and up and down. Try using a rattle or noisy toy to help her locate it. Her eyes may cross as she learns to focus. This is normal. Everything you do with your baby is an opportunity for play and learning. Sing to her while you change her diaper. Name her body parts while you bathe or massage her. All of her senses function well, but she can become overstimulated. Let her relax between different activities.

Your baby will grow and develop better if you hold her most of the time during this stage. Her place in your arms is her transition from her time spent in your womb. She is calmer and learns more when she is in your arms. Let her become part of your daily life. She is biologically compelled to be near you and to observe you to learn about being a human. If she is apart from you, she will cry to let you know that she is not where she belongs.

Monthly Milestones

Newborn to One Month: She lies with her limbs flexed close to her body and her hands fisted. She sucks reflexively, startles, and moves her arms and legs jerkily. She cries to communicate and grins in her sleep. She sees up to ten inches, and recognizes your voice. (See pages 416 to 425 in The Baby Book for more information on your baby’s first month.)

Two Months: Her limbs begin to relax. She swipes at nearby objects, and opens and closes her hands. She may bring her hand to her mouth, and suck her thumb. She studies faces, and smiles. (See pages 425 to 432 in The Baby Book for more information on your baby’s second month.)

Three Months: She stretches her limbs out and opens her hands. She holds her head steady when held in a sitting position. She kicks her legs, and pushes against surfaces. She rolls back to side. She looks at her hands, reaches for objects and places them in her mouth. She recognizes familiar people. She makes vowel sounds, laughs, and cries differently to signal different needs (See pages 432 to 437 in The Baby Book for more information on your baby’s third month.)

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 3: Bonding: Building Attachment

Baby Care Course 3: Bonding: Building Attachment

In recent decades, our culture has moved away from natural human parenting. We are often encouraged to ignore our instincts and follow someone else’s rules for caring for our babies. Companies offer us products that substitute for our presence and care. Your baby can survive on formula, pacifiers, security objects, and playpens, but he will thrive on you. Nature has given you everything you need to care for your baby: arms to hold him, breasts to feed him, and the biological drive to protect and care for him.

In this lesson, we will discuss how you can develop a trusting and affectionate relationship with your baby by learning his nonverbal language, our primal “forgotten” language, and by responding appropriately to meet his needs using your body and your instincts.

Bonding and Attachment

The terms bonding and attachment are often used interchangeably, but there is a difference. One grows out of the other. Bonding is about developing trust, and attachment is about developing affection.

As soon as your baby is born, you begin to bond with her by responding sensitively to her signals. As her attempts at communicating her needs are met with your attempts to understand and meet her needs, she develops trust in you, and in her ability to communicate. She is learning, and so are you. You’re getting to know one another. As she gets better at giving cues, and as you get better at reading them, an affectionate relationship develops between you and her. Your baby regards herself by how you respond to her. For this reason, it’s important to respond to her cries as well as to her more pleasant signals with love and reassurance. Show her that it’s acceptable to express sadness, discomfort, and pain as well as happiness and contentment.

A high-touch and high-interaction style of parenting that encourages attachment is beneficial to you and your baby in many ways. A baby parented in this way tends to develop better intellectually, emotionally, and physically.

Intellectually. Your baby learns best when she is in a state of quiet alertness. Attachment parenting helps her spend more time in this state instead of working hard to get her needs met. More than any educational toy or product, the most important influence on her intellectual development is your responsiveness to her cues.Emotionally. Your baby has trouble regulating her emotions. When you respond to her before her cries escalate out of control, she has an easier time calming herself.

Physically. Your baby releases the hormone cortisol when she is stressed. Too low or too high a level will affect her growth. An insecure attachment to you can cause either problem. Her securely attached relationship with you keeps her cortisol level in balance, so she can use her energy to grow rather than to work hard trying to get you to meet her needs.

Everything you do with your baby is an opportunity for bonding and building attachment. Holding, feeding, diapering, and bathing your baby are all ways of bonding with her. She thrives on closeness and interaction with you. For this reason, it’s important to be cautious in using products designed to substitute for your presence and care. You already have everything your baby needs.

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 2: Newborn Care: Getting a Good Start

You instinctively know how to meet your baby’s basic needs, and there is much you can learn to enrich the bonding experience for both of you. In this lesson, we will discuss ways to build attachment with your baby beginning with the minutes after his birth, what to expect during his first checkup, and how to meet his initial bodily needs. The more time you spend getting to know your baby, the more you will gain confidence in your ability to help him thrive.

Birth Bonding

Stay in bed with your newborn. Hold her against your skin and feed her frequently according to her cues. Breastfeeding, which causes your body to release the relaxing hormone prolactin, is just what you and she need after the birth. If you choose instead to feed her formula, hold her close. This early bonding helps you develop attachment later. Keep her close to your body most, if not all, of the time. This closeness is her transition from being in your womb. She is comforted by your familiar heartbeat and voice. Any time she spends out of touch with you, she will spend in longing.

Look at your baby. Feel the rush of mothering emotions. Her puffy, slitted eyes open occasionally to look at you. They are probably blue or grey in color, but may change. She can see and follow movement, and she can focus on you at about ten inches, the distance from her nursing position at your breast to your face. Her nose is flattened and her head is elongated from her trip down the narrow birth canal. You feel a soft area on her head (called the fontanel) where her skull bones come together. There’s a tough membrane under this soft area so it’s ok to touch. She might have hair, but it may fall out and its color may change. The tops of her ears may be pinned back or folded over. Red pimply patches (called milia) may cover her forehead, nose, and eyelids. They will disappear within a few weeks. Don’t squeeze them. Her neck is obscured by fat rolls.

Touch her. Stroking your baby stimulates her to breathe more rhythmically. Her pink-purple skin may be covered in a white substance, and she may have hair on her shoulders and back. Her hands and feet are wrinkled and bluish. Her arms and legs are flexed toward her chest and abdomen. Feel her quick heartbeat. It’s twice as fast as yours. Her breathing is light and irregular for the first few hours.

Your touch is therapeutic. Babies grow and develop better when they are regularly touched. Massage sessions also help you and her stay connected. (See pages 93 to 98 in The Baby Book for information and instructions on infant massage.)

Talk to her. She recognizes your voice. Her father’s voice may be particularly familiar since lower tones are heard more easily through amniotic fluid.

Respond to her cries. She is trying to communicate a need to you. With practice, your parent-infant communication system of cue and response will get better and better.

Return To Baby Care Course 1

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

During this course you will gain guidance and inspiration for use throughout your parenting journey. We will discuss valuable information on many aspects of baby care including postpartum family adjustments, basic newborn care, bonding and attachment, growth and development, feeding and nutrition, safety, and health. Through creative exercises, you will learn about your child and yourself . Have paper, pen or pencil, and crayons (or other tools for coloring) available. The point of the creative exercises is not to create a polished work of art, but to express your feelings and get in touch with your subconscious. At the end of each lesson, I may also ask you to do additional reading in your text, visit websites, and post responses to questions on the discussion board.

Your recommended text, The Baby Book, by Dr. William and Martha Sears, is a comprehensive baby care book that covers the first two years of your child’s life. Familiarize yourself with the contents and index because this book may well become your baby care bible. I will refer to it often throughout this course. I also recommend The Continuum Concept, by Jean Liedloff and The Wonder of Girls and The Wonder of Boys, by Michael Gurian. At the end of this course, you will find a list of additional resources for further study.

Note: I will address mothers when the subject requires it, but the information is for both parents and other caregivers. I’ll alternate between using him or her in reference to your baby.

In this first lesson, we will discuss ways to successfully adjust to life with your new baby, to maintain your marital relationship, and to develop your own parenting style.

Successful Postpartum Adjustments

Successful adjustment to life with your new baby requires realistic expectations. If things are not what you expected, try to be patient and flexible. The early weeks with your newborn are a time to learn to fit together as a family. You will be giving a lot of energy to your baby in the beginning. If this doesn’t come naturally to you, think of it as an important investment that will pay off in the future. Focus on the good feelings you get when you and your baby are close. Be easy on yourself. Parenting a newborn is hard work, but it is rewarding, as was labor and childbirth.

Your priority is to get to know your baby by learning to read and respond appropriately to her cues. Leave everything else to someone else. When friends and family offer to help, let them do your chores, or just let your chores wait. Don’t be afraid to send well-meaning helpers away. These first weeks can be physically and emotionally draining. Rest and relax.

Many new parents, particularly mothers, experience after-birth depression. Our modern society is baby-centered so new parents don’t always get the support they need. It’s normal for mothers to experience hormonal changes and body fatigue while birth wounds heal; and for fathers to feel left out of the initial mother-baby bonding process. Fortunately, your baby’s high-need newborn period passes, and you settle into a comfortable parenting routine. Until then, think motherly and fatherly thoughts, communicate your feelings, and rest when you can.

If after-birth depression doesn’t subside by the end of the first few weeks when your hormones should be back in balance, or if your depression seems to be getting worse, you may need to seek help. If your depression is noticeable to the people around you, it’s serious enough to warrant a call to your doctor.

New parents are particularly vulnerable to baby advice that implies that they aren’t doing the best for their baby. If you’re confused about what to do, ask yourself what action feels right. Ask for guidance when you need it, but never act against your instincts, because nature has given you all the knowledge you need to appropriately care for your baby.

If you didn’t get off to the start you hoped for, begin again as if it were your baby’s first day. Hold her, look at her, and talk to her.

Baby Care Course 1: New Parenthood: Postpartum Family Adjustments

Baby Care Course 2: Newborn Care: Getting a Good Start

Baby Care Course 3: Bonding: Building Attachment

Baby Care Course 4: Stages: Growth and Development

Baby Care Course 5: Feeding: Breast and Bottle

Baby Care Course 6: Nutrition: Introducing Solid Foods

Baby Care Course 7: Safety: Babyproofing

Baby Care Course 8: Health: Keeping Your Baby Well