Parenting & New Baby Advice Blog

Archive for January, 2008

Your baby might be ready to help feed herself when she sits with stability in her highchair, can put objects into her mouth, has begun some chewing motions, and perhaps holds breast or bottle in her hands while feeding.  Both she and you benefit from her attempts to feed independently.  Though the process may be much slower and is definitely messier than your feeding her, the advantages of letting her try are many.  She feels good making her fingers, body, and mouth cooperate as she attempts to satisfy her hunger.  Feeding herself stimulates all her senses and provides a wonderful learning experience.  She will taste and smell the food.  She will feel the texture and temperature on her fingers as she reaches, chews, and swallows her food.  She will love the click her spoon makes on her dish or on her new teeth.  And she will enjoy the bright colors of the squash and peas.

Transitional Period

At six months, your baby can put objects into her mouth.  She explores her world with her mouth, which makes this time perfect to begin some finger foods.  She can also sit with little support.  By seven months, she may have some teeth and begin to make chewing motions with her mouth.  She can hold a small bottle by herself and may even begin to take liquids from a cup with your help.

While she cannot be expected to feed herself all her foods at this stage, she can participate by feeding herself some foods while you prepare the rest of her meal.  She can also have finger foods for snacks.

Appropriate finger foods during this period include those that dissolve easily in her mouth, such as the following:

• Small pieces of toast.
• Small pieces of cooked vegetables, such as peas, squash, soft green beans, or broccoli.
• Small pieces of very soft meat, such as fish without bones, chicken, or hamburger.
• Small pieces of scrambled egg [unless there is a history of allergy].
• Small pieces of ripe bananas, peaches, and pears.
• Small pieces of soft cheese, such as Monterey Jack. Or Colby [unless there is a milk allergy.
• Cheerios or puffed rice.
• Foods you should avoid include those that may cause choking.  Do not offer the following during the first year:
• Any dried fruits, such as apricots, raisins, dates, pineapple, or coconut.
• Any nuts, such as walnuts or peanuts.
• Popcorn, potato chips, corn chips, or crackers that do not dissolve well.
• Hard candy of any kind.
• Uncooked vegetables, such as carrots or celery.
• Hotdogs and other foods that might be of “windpipe size.”

Bath time is an excellent time to teach your baby to drink from a cup.  She will enjoy the challenge and you will not need to contend with a mess on the floor, or her clothes.  Use a plastic shot glass or a plastic nipple cover as the first cup.  The smaller diameter makes it easier for her to manage with her small mouth.  You can offer her water, breast milk, formula, or juice from a cup.

If you are bottle feeding your baby may enjoy helping you hold her bottle. Let her participate by pulling the nipple in and out of her mouth and adjusting the angle of the bottle.  Avoid putting her to bed with her bottle, though; as she falls asleep, less saliva bathes her teeth and she swallows less often.  Some milk may “pool” in her mouth and support the growth of bacteria, which leads to tooth decay.

Tooth buds for your baby’s first teeth begin to form at about six weeks of fetal life.  Between the fourth and fifth months of fetal life, some tooth buds become evident.  By about the seventh month of fetal life, the tooth buds for all of your baby’s primary [deciduous] teeth are formed.  At birth, the crowns-the portions of the teeth visible above the gums-of your baby’s front  are already formed and contain most of their enamel covering.  The crowns for some of the other primary teeth are partially formed, and the tooth buds for some of the permanent molars are forming.  By the time your child is three years old, the crowns of some permanent teeth will be clearly fairly well formed, and the tooth buds for the last molars will have formed.

As early as three months of age, your baby may begin teething.  Teething is marked by drooling, fretting, and chewing on things in an attempt to reduce the discomfort of sore, swollen gums.  Some babies will exhibit these symptoms for up to four months before the first tooth finally erupts.  If your baby seems uncomfortable, you can help reduce the pain and swelling in her gums by giving her firm, smooth, cool, unbreakable objects to chew.  Massaging the inflamed gums with a clean fingertip may also be helpful.  Medications to numb painful gums are also available.

Don’t be alarmed if your baby seems less interested in the breast or the bottle while teething; sucking increases the blood flow and hence the swelling and pain of the gums.  If she’s old enough, you might try offering her fluids from a cup.

Your baby’s first tooth should appear when she is four to eight months old.  It is not unusual for a child to be ten or more months old before the first tooth appears, though, and occasionally a baby is born with one or more teeth already erupted.  Although most babies will have cut six to eight teeth by their first birthday, some normal babies will have just two teeth or fewer.  If your baby is approaching the age of one year and no teeth are evident [you may see the outlines of teeth before they erupt], you should talk to your baby’s doctor about having a dental examination.

Even though all of your baby’s teeth may have erupted by one and a half to two years of age, you will have to exercise care in the foods that you give her.  A child’s chewing ability is usually not fully developed until about the age of four years.  Children younger than this should not be given such foods as popcorn, nuts [especially peanuts], raw vegetables such as carrots, whole grapes, and hotdogs and round candies.  If these and similar food items are not properly chewed, they may lodge in a small child’s windpipe and cut off the air supply.

Because a baby’s teeth begin to form so early in fetal life, what the mother ate, or did not eat during pregnancy can have an effect on the development of the baby’s teeth.  However, the nutritional needs of the teeth and their supporting bones and muscles are easily met by a well balanced diet; an ample supply of calcium is essential.  After birth, the diet recommended by your baby’s doctor will contain the proper nutrients for baby’s healthy growth and development, including healthy teeth formation.

The change from a microscopic cell to a seven pound baby requires substantial alterations in the body of the mother carrying the baby as well. However, while the baby changes most rapidly in the first few weeks, the mother undergoes her most dramatic changes in the later stages of pregnancy. In the first six weeks, the mother's physical changes are due primarily to alterations in hormone levels. These changes are subtle, and she may not even realize she is pregnant. She may have few symptoms or may easily attribute them to other causes. After this time, the mother's physical changes are partly dependent on the growth of the baby and become more noticeable as the baby gets larger and larger. Although the most obvious changes occur in the uterus and abdomen, almost all of the organs in her body are altered.

When a woman becomes pregnant, her uterus is the part of her body that is affected first and that undergoes the most significant changes. It increases to five or six times its original size, twenty times its original weight, and one thousand times its initial capacity. The amount of muscle, connective and elastic tissue, blood vessels, and nerves increases.

The shape changes from elongated to oval by the second month, to round by mid-gestation, then back through oval to elongate at term. The uterus softens beginning at the sixth week. It changes position as it increases in size, ascending into the abdomen by the fourth month and eventually reaching to the liver. It also becomes more contractile, with irregular, painless, Braxton-Hicks contractions beginning in the first trimester. These contractions may be felt in the last weeks of pregnancy, when they are known as false labor.

Other parts of the reproductive system change along with the uterus, the cervix and vagina have increased blood supply, which causes a darkening in color. This is apparent by the sixth week. The amount of the elastic tissue increases to prepare the way for the stretching that will be required during delivery. Secretions increase, and a mucous plug develops in the cervix. The fallopian tubes, ovaries, and ligaments supporting the uterus all enlarge and elongate. The ovaries, of course, cease to ovulate.

During the fourth month, the uterus will grow into the abdomen, causing the abdominal wall to expand to accommodate it. The connective and elastic tissues are stretched and straitened, creating thin areas called striae [stretch marks]. Unfortunately, while the color of the striae may fade, scars remain after delivery. In fifty percent of women, striae will develop in the third trimester. Late in pregnancy, the internal pressure from the large uterus may even cause the muscles of the abdominal wall to separate.

A woman's breasts must undergo many changes during pregnancy to be able to produce milk. In the first two months, the breasts may feel sore or full. They will increase in size, and veins may become visible on the surface. Striae can develop. The nipples also increase in size and usually darken in color. By mid-pregnancy, colostrums [a thick, yellowish fluid] can be expressed, but milk is not produced until after delivery.

Since the baby is being fed by the mother's blood supply and the mother's enlarging reproductive organs require more blood flow, the amount of blood must also increase. During pregnancy, blood volume expands by twenty-five to forty percent, but the number of red blood cells [the oxygen carrying component of blood] increases to a lesser extent. Therefore pregnant women are generally anemic-that is, their blood's oxygen-carrying ability is somewhat decreased.

To pump an increased amount of blood through the body, the heart must work slightly harder, the heart pumps more blood per beat and beats slightly faster. Heart murmurs attributed to the flow through the heart may develop.

The blood vessels are also affected by pregnancy. The enlarging uterus pressing on veins in the pelvis, increasing the pressure in the veins from the legs. The increased pressure causes the leg veins to enlarge producing varicosities [areas of enlargement]. It may also cause fluid to leak out of the veins and into the tissues, causing swelling of the feet and ankles. Late in pregnancy, the uterus can also compress a major vein, the vena cava, in some women when they lie on their backs; if this occurs, blood is prevented from returning to the heart and a feeling of faintness results.

The enlarging uterus not only pushes forward on the abdominal wall and down on the pelvic veins, but it also pushes up on the bottom of the rib cage and on the diaphragm [the muscle that stretches across the bottom of the chest cavity and assists in breathing]. The rib cage widens, and most women breathe slightly faster. Some feel short of breath.

Urination and digestion are also affected during pregnancy. The urinary tract is changed both by pressure from the uterus and by hormonal influences. The uterus presses against the bladder, which may cause a pregnant woman to urinate more frequently. Hormones cause the ureters [the tubes conducting urine from the kidneys to the bladder] to distend and the flow of urine in them to slow. The sluggish urine flow predisposes a pregnant woman to infection. Hormones, along with the increased blood volume, also causes the kidneys to filter more blood, however, the kidneys may not reabsorb sugar and protein efficiently because of this increased workload, and these substances may spill into the urine. Since the presence of sugar in the urine can also be caused by diabetes and the presence of protein can be caused by infection, most doctors screen the urine frequently during pregnancy and may do other tests if any abnormality is found.

The changes in digestion during pregnancy are well known and frequently kidded about. A pregnant woman craving for pickles and ice-cream has been the premise of many a joke. Women may have unusual cravings, and may also notice changes in the senses of smell and taste, which may cause them to alter eating habits. During pregnancy women often produce more saliva and the saliva will be more acidic, which promotes tooth decay. The gums are more sensitive and may bleed easily. In the first trimester, a woman may have morning sickness characterized by vomiting and a poor appetite. She may also be constipated. One of the pregnancy hormones causes the muscles of the digestive tract to relax, and they therefore pass digesting food more slowly through the intestines. In addition, the uterus can press on the colon, inhibiting passage of feces. Similar mechanisms produce heartburn. The muscles at the junction of the esophagus and the stomach relax and the uterus presses on the stomach from below, causing the stomach contents to flow back into the esophagus. In late pregnancy, the stomach may even be pushed up into the chest, producing a hiatal hernia.

A number of changes are necessary in the structures supporting the uterus to stabilize it as it grows. The ligaments in the pelvis and abdomen stretch to accommodate the uterus, in late pregnancy the upper part of the spine bends backward to compensate for the enlarging abdomen. Hormones loosen the joints of the pelvis in preparation for childbirth.

Hormonal influences are also responsible for changes in the skin. Pigmentation of the nipples, vulva [the external genital organs], the center of the lower part of the abdomen, and the umbilicus increases. Darkening across the face may appear; this is known as chloasma, or the mask of pregnancy. Hormones can also cause reddening of the palms and the appearance of small red spots on the skin; these are nests of blood vessels, which are known as spider nevi or telangiectasias. Sweat and all glands also become more productive.

One of the most important changes during pregnancy is the increase in metabolism, which is necessary to provide nourishment to the fetus .A woman must eat more in order to supply adequate protein, carbohydrates, and fat to the fetus and her own enlarging body. Most women gain about twenty-five pounds, three pounds in the first trimester, and ten to twelve pounds in each of the second and third trimesters. The placenta, fetus and amniotic fluid and the increased volume of blood and breast and urine tissue account for twenty pounds of that weight gain. The rest of the weight is fat and extra fluid. A pregnant woman must also take in more vitamins and minerals for the growing of the fetus. Calcium, which is needed for developing bones, and iron, which is used to make new blood cells, generally needs to be ingested in greater amounts from the fourth month of pregnancy on.

The physical changes during pregnancy are miraculous. Amazingly, though, the physical alterations in the mother reverse after birth, and her body returns to its normal state. For the new baby, however, the process of change that started nine months before has just begun.

Your baby’s social life with his peers will begin just as soon as you see to it that he has opportunities to see other babies.  You can put two babies in a playpen or on a blanket on the grass at three months old, and if they are both in happy moods, they’ll make a picture both families will always treasure.  Cooperative play with other children, the kind most adults consider “real” play, doesn’t start until children are about three, but they all need the companionship of other children long before that.  Of course siblings often make wonderful playmates, but it is important for your baby to be around others who are close to him in age and size.

Finding suitable playmates may or may not be easy, depending on your neighborhood, your own circle of friends, and your personal inclinations and abilities in making new friends.  If there’s a public park near you, you may find this “fresh air playroom” the ideal place both for your child and yourself to take a break from the home routine.  Many lifetime friendships for both parents and children have begun in parks.  The parents socialize and childcare tips as their babies doze in carriages; then later they share supervision duties as their children play on park equipment and learn to get along with others.

Some who have watched their own children or others’ closely as their social lives developed have noted that play progresses in quite predictable stages.  The first stage is not play at all; babies under a year old are watchers.  They examine their toys and everything they get their hands on very closely, and they stare at other people.  You’ll probably notice that your baby is especially interested in other babies and small children and is well aware that they are different from adults.

Toddlers begin what’s called parallel play.  They play side by side or back to back, paying little or no attention to each other.  They like being together and they may occasionally enjoy watching each other play, but most of all each is interested in what he is doing.  When your child is about eighteen months old, you’re likely to see some aggressiveness.  Toddlers don’t really know how to play yet.  They don’t understand sharing, and they haven’t learned that it’s not right to hit and shove and bite other people.  Use common sense when handling a battle between two toddlers; remember that you are the adult.  Of course you can’t stand by and see a child get really hurt, but be careful you don’t teach your toddler that it’s all right to hit others because Mommy will see to it that the others don’t hit back. And be aware that if you spank your toddler for being overly aggressive, you’ll be teaching that the way to stop hitting is to hit.

Associated play, in which children really play together, follows soon.  This is unstructured play; there are no rules, but two children will talk to each other and use some of the same toys.  Both attention spans and tempers are short, and egos are all-important, so you can’t expect the fun to last more than about a half hour in most cases.  You’ll hear the word “mine” often.  If the eyes of to children happen to light on the same toy at the same time, they’ll both reach for it whether or not they really want it.  In fact, toddlers at this age really do want everything they see, unselectively.  Reason won’t solve the problem of contention; these children are not yet old enough to grasp the idea of sharing.  You may be able to make use of a time to set the end of one child’s turn and the beginning of the other’s, but sometimes you may simply have to put a toy away.

Remember that the quarrels that annoy you because they seem senseless help children develop social skills.  If you interfere in any but the most serious, you will be depriving the children of a chance to learn how to get along with others.  At this point, children almost always do best with just one other child, and will get along better and be able to play longer with one than with another.  It is important now that your child sees as many others as possible so as to be able to select the ones with whom she most enjoys playing.

By about the age of three, your child will have become proficient enough at social relationships to begin cooperative play, which involves rules and sharing and turns and fairness-in playing house, the “mother” must act like a mother; it’s not fair for one child to knock down a tower of blocks two have put up together; your child will know that she can’t use the swing while it’s the playmate’s turn.  If you have older children, it’s at about this point that you begin to see the sibling companionship you’ve been waiting for.  While previously the older kids have probably enjoyed playing with the younger one as a sort of living toy, now little brother or little sister has learned enough to make proper responses in play situations and has become much more interesting.  Imaginative role playing-“school,” “house,” “office”-is fun for both the younger and the older kids.

Parents often worry if they see what they think are signs of shyness in their child.  Some shyness is simply the result of a developmental phase; the child will soon outgrow it and become outgoing and friendly.  You can help your shy toddler or preschooler by encouraging non-threatening play with just one or two low-key children, not a crowd of boisterous ones. Be aware that some children are less gregarious than others, just as some adults are.  Don’t push too hard.

After making the dramatic transition to life outside the womb, your baby is faced with the task of learning to survive in his completely new environment.  Fortunately, nature has provided him with many reflexes to maximize his success until he is able to do certain things voluntarily.  Your own instinctual responses will guide you in meeting your baby’s needs.

Just as a mother’s breasts are programmed to provide milk to nourish her newborn, a baby automatically knows how to respond to attempts to feed him.  When you stimulate his cheek, mouth, or lips with the nipple of a breast or a bottle, his head will turn toward it, his mouth will open, and his tongue will move forward.  This movement of his head and mouth is called the rooting reflex and helps him find a source of nourishment.  As soon as the inside of his sensitive mouth is stimulated, he will automatically suck and swallow in a coordinated fashion.

A similar reaction, the hand to mouth reflex occurs if you stroke your baby’s cheek or the palm of his hand.  His mouth will “root” and his arm will flex.  After his hand and mouth find each other, he may suck his fist energetically for several minutes.  This reflex helps babies suck and swallow any mucus that might have been clogging their upper airways [nose and mouth] after birth.

If you slowly pull your baby to a sitting position from his back, he will make a gallant attempt to keep his head upright.  This response is called the righting reflex.  Because his head is heavy and his muscles are not yet strong enough to hold it steady, his head will wobble back and forth.  You will quickly learn to support his head when you pick him up.

For the first few weeks, your baby will lie with one cheek down when on his back.  As his head turns to one side, the arm on the same side straightens and the opposite arm bends.  This posture resembles a “fencing position” and is called the tonic neck reflex.  Lying in this position gives your baby an opportunity to discover his own hand in the weeks to come.  Because it is difficult to turn over on an outstretched arm, this reflex will have to fade before your baby will be able to turn over.

A newborn baby has a very strong grasping reflex.  If you place your finger in his palm, his fingers will curl tightly around it.  The automatic grasp reflex fades over the first two to three months to enable your baby to grasp objects voluntarily.  Gentle pressure against the sole of his foot causes his toes to curl downward.  Stroking the side of his soles will cause his toes to spread and the big toe to extend upward.  This Babinski reflex is the opposite of the normal adult response, in which the big toe turns downward.

Holding your baby upright and pressing the sole of one foot at a time to a firm surface will elicit the stepping reflex.  He will alternately bend each leg as though walking.  This remarkable reflex fades rapidly but reappears months later, as your baby prepares himself for voluntary walking.

Stroking one leg causes the other to bend, cross the first leg, and push away the offending object.  He moves as though to escape from a harmful stimulus.

When placed on his belly, your baby will lift his head and turn it from side to side.  He may even attempt to crawl.  His responses make it virtually impossible to smother when he is lying on his stomach on a firm, flat surface. [For this reason, you need not worry that your baby will have trouble breathing when prone.  You should, however, keep excess bedclothes, toys, and stuffed animals out of the way.]

The most dramatic reflex is the Moro, or startle response.  A loud noise or rough handling will cause your baby to throw back his arms and legs, extend his neck, and cry out.  Then he will bring his arms together in an embrace and flex his legs.  Unfortunately, your baby’s response disturbs him further.  His own furious crying only serves to startle him again.  You can help break this cycle by calmly bringing his flailing extremities close to his body; applying steady, gentle pressure with your hand against his chest and abdomen; or simply holding him securely against your own body.  By three months of age, this reflex will disappear.