Parenting & New Baby Advice Blog

Archive for December, 2007

At birth, babies prefer high contrast.  Black and white designs provide the most contrast.  At first, babies prefer geometric patterns with stripes and angles.  Soon they will shift their preference to circular patterns, such as bull’s eyes.

Within three weeks, the most exciting image in his visual field is the human face.  Because your hairline and your eyes offer the most contrast, he will at first concentrate his gaze between your nose and your forehead.  Between four and eight weeks, your baby may break into his first social smile while studying your face.  At three months, he will be able to distinguish your face from a stranger’s.  By rewarding you with a special smile, he lets you know that he recognizes you.  By four months, his vision has matured.  Like you, he enjoys looking at things that are colorful, novel, and in motion.

How do you know when your baby finds something visually interesting?  An alert, calm, baby will respond to a pleasing object in his visual field by brightening his face and moving his arms and legs rhythmically.  An active baby will stop moving and carefully scan the object with his eyes.  He will signal to you when an object doesn’t interest him or when he has had enough stimulation by turning away and withdrawing.

Avoid bombarding your baby with visual input during the first two months of his life.  During this time, while he’s getting settled, all stimuli should be low key.  In these first weeks he is becoming familiar with his hands and should not be exposed to a lot of jazzy stimuli that will distract him from that familiarization process.  Later, when he has begun to master basic visual skills and has gained control over his head and hand movements, he will be ready to explore his visual environment.  As always, take your cues from him.Things That Stimulate Visual Development

• Black and white geometric patterns.
• Your face.
• Toys with faces.
• Out of reach mobiles [remove them when the baby can sit to avoid entanglement].
• Mirrors [choose stainless steel mirrors he can’t break].
• Being carried about by you.
• Being placed in an infant seat [always fasten the lap belt and never leave him unattended].

Social behavior begins very early in the lives of human beings.  Infants respond to people almost from the moment of birth.  In fact, if you began the bonding process with close skin contact immediately after your baby was born; you probably felt that she was definitely aware of you, reaching out to you.  Newborns are attracted to human faces and they like the sound of human voices, especially female voices.  Soon your new baby’s eyes will follow your movements in a room, then her head will turn to watch you.  At three or four months, your baby will respond happily to smiling people, then will smile at the sight of any approaching face.  The baby will smile-you will smile-her smile will broaden.  Thus, social interaction begins; the baby has learned to get a reaction from another person.  She will even try to mimic you when you stare, stick your tongue out, or make faces.  One day, you will notice that your baby quiets if you speak or sing as you come near the crib.  It won’t be long until she will make a sound in response to your voice.

At five to eight months old, your baby will probably be learning how to be “cute,” how to get your attention by pretending to cough or doing something that has made you laugh before. She will know the difference between familiar people and strangers and may show fear of strangers.  When your baby is somewhere between the ages of eight months and a year, you’ll be getting cooperation in the singing games and finger plays with which you’ve been entertaining her.  Soon she will adore having an audience and will delight in performing the “bye-bye” ritual and any others that get attention.

Between the ages of one and three, your child will be ready to branch out socially.  Though learning to actually play with other children effectively will take a while, she will want to be around them, if only as an observer.  She will learn a great deal from this observation.

First Social Set: The Family

The immediate family-mother, father, siblings, and a care-giver, if the baby has some kind of daycare-is your baby’s first social set, a select and fortunate group.  All of you will outdo yourselves to entertain and please the baby, and your greatest thrills will come when he responds and reciprocates.  Remember, though, that the key word in all human behavior is unique.  Your baby is as different from all the other babies in the world as each snowflake is different from all others.  Antics that sent your older child or your highboy’s child into paroxysms of giggles and gurgles may very well make this baby cry and pull back.  Take your cue from your child, if he startles easily or seems frightened by your loud noises, funny faces, or sudden actions, ease up.

At about a year, your child will be extremely sociable.  He will love being part of any and every family gathering and will obviously adore everyone.  Your baby will happily go on your rounds of shopping and errands with you, pay and receive social visits with you, and thoroughly enjoy just being with you around the house.  Anything goes, in fact, as long as a family member is close at hand.

Unfortunately, things will change.  The push toward independence you’ve read and heard about become reality, and at a point somewhere around eighteen months, your baby will appear to have outgrown any need for you.  He will barely acknowledge your presence in daily life, except to say no a great deal.  Walking, running, climbing stairs, exploring, and satisfying curiosity about everything and anything will be all engrossing.  There will be occasional reversions to the old baby ways of love and play, but in general the child of this age is concentrating so hard on self and environment that adults seem to exist for no reason other than to satisfy his desires.  The exception to this behavior will be when there’s trouble, no one but mommy or the primary, daily caregiver can handle a cut or a bruise or make a stubborn toy work the way it should.

Sociability will return in time, but by the time it does, your baby’s social set will include playmates and others outside the family.  You will never again be as all-important to your child as you were for the first year, which is as it should be.  Learning to let go is among the most important of parents’ lessons.

You should be checking your baby’s mouth on a periodic basis even before the first tooth erupts.  This will give you an idea of the normal appearance of your baby’s mouth.  Teething may be preceded by whining, crying, or drooling more than usual.  Other common signs of teething are changes in feeding habits, trouble in sleeping, and increased irritability.  If your baby’s gums are red and swollen or if you can see or feel the tip of the tooth, teething probably is causing these changes in your baby’s behavior.  However, if your baby also has a fever or a rash or is vomiting, something else may be wrong.

Your baby will have a strong urge to chew at this time and should be given a teething ring, or dry toast to chew on.  Babies will vary in their need for help at this time.  Check with your baby’s doctor or dentist before using any of the commercial preparations to ease teething discomfort.  To help soothe your baby’s gums, wipe a dampened gauze pad over them, two or three times a day.

After your baby’s teeth begin to appear, clean them daily with a dampened gauze pad or clean washcloth until your baby is old enough to begin using a toothbrush.  When your baby is one and a half to two years old, purchase a child-sized toothbrush.  At least once a day-preferably after meals-let your child “brush” her own teeth; this will consist mainly of chewing on the toothbrush.  At this age, make no attempt to try to teach your child tooth brushing techniques.  It is more important to establish a pattern of dental care, and even chewing on a toothbrush helps clean the teeth.

Never give your baby a bottle of milk, juice, or a sweetened beverage when you put her to bed, and never put honey, syrup, or another sweetening agent on your baby’s pacifier.  These practices may help comfort your baby, but they can cause severe destruction of your baby’s teeth.  Nursing decay syndrome, or nursing or nursing bottle caries [dental cavities], can result from such practices.  When your baby is awake and sucking on a bottle, the liquid is rapidly diluted with salvia and swallowed.  However, if your baby falls asleep while nursing and swallows less often, the bacteria normally present in her mouth have time to turn to sugars in these liquids into acids that attack the tooth enamel.  Sweetening agents on a pacifier also permits the sugars to remain in the mouth too long.  The teeth most severely damaged are the upper incisors, and it has been necessary to remove teeth destroyed by this type of decay in children as young as eighteen months old.

Other practices that are just as destructive are putting sugar in a piece of cloth and using this as a pacifier or using a piece of bread as a pacifier.  The starches in the bread are quickly converted to sugars in the mouth, which can then serve as a food source for decay-causing bacteria.

Dental decay is the most common diseases affecting children, and it is the most preventable.  Eating a well balanced diet low in sugars, drinking fluoridated water or using fluoride supplements, tooth brushing after meals, and visiting the dentist at recommended intervals can help prevent most caries or catch decay at an early stage.  Caries in the primary teeth must be taken care of to relieve your child’s pain and to help maintain the teeth until they are ready to be replaced by the permanent teeth.

Inflamed, bleeding gums are not normal but are a sign of dental problems.  Even a young child can have gum disease, which needs the attention of a dentist.  Dental decay in primary teeth or gum disease that is not taken care of can lead to infection or other problems that mat affect the permanent teeth,

Young children exploring their world by crawling, toddling, and attempting to stand alone may fall or bump into things that may injure their teeth and mouths.  Any mouth injury that results in excessive bleeding or a chipped, loose, or displaced tooth needs to be evaluated by a dentist.  If a tooth is knocked out, put the tooth in a cup of water and take it and your child to the dentist as soon as possible.

Thumb sucking is a natural and satisfying behavior for babies and young children.  Most children outgrow this activity by four or five years of age.  It should not be a cause for concern in young children.

As the family grapples with the serious illness and perhaps the imminent death of the baby, the infant must also cope with the consequences of their ill health. An infant’s need to be cuddled is just as great as her requirement for food. She thrives on consistent care from her parents. A baby quickly comes to know and love these special people.

Separations, such as hospitalizations, can be very distressing for an infant.

Parents of children of chronic diseases can sometimes arrange to care for the child at home with or without the assistance of a nurse. Should parents decide to bring their dying baby home, many communities have resources to assist them during this period [such as visiting nurses, home care nursing, and hospital care].

During necessary hospitalizations, most hospitals allow parents unrestricted visiting privileges and often provide facilities for parents to room-in with the sick infant or child. These arrangements give parents the opportunity to participate in the care of their sick baby. Caution must be exercised not to spend so much time with the ill child that the well-being of the parents and other members of the family suffer.

Things to do that can help you cope with an ill or dying baby includes the following:

• Tell the physician and other hospital staff about your needs and the particular needs of your baby.
• Provide the hospitalized baby with her favorite toys and food. Display pictures of the family where she can see them. The entire family should visit the baby as often as is feasible.
• Obtain counseling with a skilled professional.
• Read about the subject. Most bookstore and libraries have many books for all age groups about coping with the illness or death of a loved one.
• Search out support groups, which exist for many types of chronic illnesses of childhood. There are also support groups to help parents adjust to the death of an infant.
• Allow siblings to visit the sick baby in the hospital.
• Attending funeral services that are brief and not morbid will help all family members to understand and except the finality of their loss.
• Keep lines of communication open between family members. Families that can share their feelings and console each other learn that even an enormous loss can be mastered.

Your pregnancy involves very many people besides yourself and your new baby. Your family, of course, is affected. You may have a Lamaze teacher and an exercise instructor. And you will certainly have a doctor; your obstetrician is a partner in your pregnancy. He or she will have the responsibility for you and your baby's health, so you want to be sure the doctor is qualified and competent. In addition, he or she will intimately participate in a very special event in your life-you want someone with whom you can cooperate and feel comfortable.

Finding the right obstetrician may take some work. You may need to talk to people and visit a few doctors before you are satisfied. You can get recommendations from many different sources. Friends and relatives may suggest their obstetricians. Another doctor, such as your internist, may provide a name. Maternity nurses, or obstetrical residents [doctors in training], at your local hospital often know which obstetricians in the community are good. You can ask the department of obstetrics and gynecology at the nearest university hospital for the names of graduates, or faculty members who work n your area. If these avenues fail, try contacting a childbirth education group, such as the International Childbirth Educational Association, or a local Lamaze instructor.

When you have the name of an obstetrician who sounds promising, your next step is to find more information about her. To be sure she is a competent doctor, check out her training. An obstetrician should have completed an obstetrics residency at a registered hospital and should be certified by the American Board of Obstetrics and Gynecology.

Next, find out which hospital she is affiliated with the hospital should be accredited by the Joint Commission on Accreditation of Hospitals [JCAH]. Find out whether the hospital is a teaching institution. If it is, be sure you understand how residents will participate in your delivery. The hospital should be covenant for you, and it should have the facilities you want or need for your delivery. Some hospitals have only the traditional separate labor and delivery rooms. Others have elaborate birthing centers. If you are at risk for having problems during pregnancy or delivery, the hospital should have an infant intensive care nursery.

Find out about the people the doctor works with. If she works with a group of doctors, they probably take turns being on call at night, if you go into labor on a night your doctor is not on call, will she come in or will one of her partners perform the delivery? If one of her partners may deliver your baby, you will have to be sure that you are comfortable with the other members of the group and that they have the same attitudes towards childbirth as your doctor. Otherwise, the delivery you so carefully planned may be changed at the last minute. Some obstetricians employ nurse practitioners or midwives to do checkups or even perform uncomplicated deliveries. If this is the case, be sure you understand and are comfortable with the arrangement.

Finally, don't be afraid to ask about finances. Be sure your insurance will cover the doctor's charges and find out how and when payment is expected. Find out what happens to the charges if there are any complications.

When you have collected your information, you are ready for your first meeting with the doctor. It is a good idea for Dad to accompany you so he can ask questions and form an opinion of the doctor as well. If you haven't been seeing an internist or gynecologist regularly, it is a good idea to choose an obstetrician before you conceive; arrange a pre-pregnancy appointment to make sure there are no medical conditions that make pregnancy inadvisable at the time. If you have been receiving regular medical care, your first appointment should occur as soon as you think that you are pregnant, usually two weeks after the missed period. During the first visit the doctor will take a complete medical history including discussion of past and present illnesses and past pregnancies. A complete physical exam, not only a pelvic exam, should be done. You should have an opportunity to discuss with the doctor issues about your pregnancy and delivery. Be prepared for this part of your visit. Make a list of questions you want to ask. The obstetrician should be willing to answer any questions and discuss the type of care you will receive. She should be flexible about issues that are important to you, but if she feels that something you want will compromise your care, she should be willing to explain to you why.

You will want to talk about pregnancy and delivery. Important issues during pregnancy include nutrition, exercise, illness, and monitoring the baby's development. Discuss with the doctor what you should eat. How many more calories will you need? How does she feel about you drinking coffee or other caffeinated beverages? What about alcohol consumption? She will probably recommend vitamins and calcium supplements. Discuss with her how much exercise you should get. Would she recommend an aerobics class? Find out what you should do if you become ill. What medicines can you take and what should you avoid? An obstetrician can monitor a pregnancy with blood tests, urine tests, ultrasound studies and amniocentesis. What does she think is appropriate for you?

There are many decisions regarding delivery that should be made beforehand. You need to decide where you want to give birth-in a regular delivery room or in a birthing center. If you want your husband or other children there, be sure your doctor agrees. If you have strong opinions about the medical treatment during labor and delivery, be sure to discuss them with your doctor. For example, some women do not want an intravenous line, anesthesia or an episiotomy [a surgical incision to enlarge the external opening to the birth canal and make delivery easier]. Fetal monitoring is another topic you wish to inquire about. You may want to find out your doctor's opinions about inducing labor and cesareans. Ask her how many cesareans she performs. If her rate is high, try to find out why. Does she have a high risk population or is she just quick to operate?

By the time you are finished discussing all of these topics, you should have a good idea how well you like the obstetrician. Do you feel at ease with her? While you may not agree on very subject, you should feel confident that you can develop a working relationship and that you can discuss a problem and reach a compromise that will be satisfactory for both of you.

Finding an obstetrician may be easy, or it may require an extensive search. Because the doctor plays such an important role in your life at this time, it is worth the effort to find someone you like as well as trust. Only in this way can you be sure that your pregnancy and baby delivery will be as safe and as joyful as possible.