Parenting & New Baby Advice Blog

Archive for February, 2008

Many of the ways you can save time center around good organization. Of course, definite scheduling of your time is impossible now; you can’t be sure exactly when or how often your baby is going to need you. Every plan you make that involves other people or a specific time must be expendable of have an alternative. This way, you can shift gears at a moment’s notice when your baby requires an extra feeding or when some other normal but unanticipated takes place. At the very least, you’ll want to consistently allow more time than you think you’ll need for everything. Experienced parents have found many ways to save themselves time and confusion as they go about the business of life with a new baby. Here are some of their ideas:      

• Keep shopping lists, lists of chores that must be absolutely done, and lists of thank-you notes to be written for baby presents. By writing everything down, you free yourself of having to remember details at a time when you are most apt to be forgetful and preoccupied.
• At night, do as much as you can to get ready for the next day. Set the table for breakfast, lay out clothes for yourself and the baby, pick up the newspaper. Any nuisance chores and decisions you can handle ahead of time will make the day start that much better.
• Cut down on time consuming trips around town by banking by mail and shopping by phone or through catalogs whenever you can. Try to do several errands when you are out, and plan them so you waste the least possible amount of time driving around.
  Practice doing two things at the same time: make out a grocery list or do your stretching exercises while you talk on the phone; fold the laundry as you watch television; or clean the bathroom as the tub fills.
• Above all, do not rush, "Haste makes waste" is a cliché, but it is as true today as it was when it was first uttered by someone who knew that the faster he or she tried to do something, the more likely it was that there would be an accident.

You’ll probably feel a little awkward and clumsy the first few times you diaper and dress your baby, but with a little practice, you’ll be handling him with ease and confidence. Use a waist high table of some kind even for a tiny baby so you won’t have backaches. An old dresser with a pad on top will now, but modern changing tables have built-in safety straps to hold your baby when he is old enough to squirm and resist. If you use disposables, diapering is almost automatic: lay the baby on the diaper, fold the front half of the diaper up over the baby and fasten it with the convenient attached tapes. [Those tapes sometimes tear, instead of throwing a diaper away, mend it with masking tape.] To keep wetness from soaking into outer clothing, use disposables with elasticized legs and turn the plastic top of the diaper to the inside. A cloth diaper can be given a figure eight twist at the crotch for both double thickness and a tighter fit. Pin the back of the diaper over the front, slipping one or two fingers between the cloth and the baby’s skin to keep the pin from sticking the baby. Use a pincushion or bar of soap to hold diaper pins [do not use ordinary safety pins, and keep them out of the baby’s reach] Never hold pins in your mouth. Whichever kind of diaper you use, lay an extra one over your baby boy to avoid being squirted while you change him. 

The kinds of clothing you select for your baby will reflect your own taste and inclinations. Some parents are willing to spend the extra time necessary to iron natural-fiber, woven- fabric because they like the look of a dressed up baby; others opt for simple knit clothing that needs little care. Whichever kind of clothing you prefer, look for garments that will be easy for you to put on and take off the baby-those with few, if any buttons, necklines with large enough openings to fit easily over the baby’s head, and sturdy crotch fasteners that make diaper changing easier. 

Over the years, a commonly accepted immunization schedule has evolved. Most doctors follow it, although there are some acceptable variations. The schedule is designed to give your child the maximum protection available as soon as possible. The reason some shots are not given earlier is that the child’s own defense system hasn’t matured enough to develop immunity. For example, a number of years ago, the measles, mumps, and rubella vaccine were given to infants at twelve months. It was discovered that many of these infants didn’t develop protection against these illnesses because their own defense systems weren’t able to react to the vaccine correctly. The date was changed, and now the vaccine is much more effective.

Immunization and Testing Schedule

• 2 months - DIP and TOPV
• 4 months - DIP and TOPV
• 6 months - DIP
• 9-12 months - TB test
• At least 15 months - MMR
• 18 months - DIP and TOPV
• 2 years - HiB and TB test
• 4-6 years - DIP and TOPV

DIP [diphtheria-tetanus-pertussis vaccine]: This immunization is given as a shot, usually in the thigh. Many children have no reaction to it. Some have swelling and redness at the injection site, as well as some fussiness.

TOPV [trivalent oral polio vaccine, also called the Sabin vaccine]: Your child is given a small amount of liquid to swallow. Side effects from this vaccine are very rare.

MMR [measles, mumps, and rubella vaccine]: This vaccine is given as a shot. Your child needs only one shot to have lifelong protection from all three viruses.

TB Test [tuberculosis test]: Some doctors feel that routine tuberculosis testing is necessary and do it on all children. Other doctors feel that this testing is not needed and do it only when they believe the child is at risk of exposure to this disease.

HiB [hemophilus influenza type B vaccine]: This relatively new vaccine protects children against developing several types of infections including one type of meningitis [infection of the coverings of the brain and spinal cord]. This meningitis is more common in children two to six years old who are exposed to a number of other children, such as in day care centers, or who stay with babysitters who care for four or more children. Although this type of meningitis isn’t common, if your two to six year old child is in day care or with a babysitter, you should discuss the HiB vaccine with your doctor.

Boosters: After your child has his childhood shots, he’s all set unless he is going to be traveling in certain foreign countries or until he turns twelve. The tetanus shot provides protection for five to ten years.

Smallpox: The immunization used to be routine, but it has been discontinued because the risk from the vaccine itself is greater than the risk of getting smallpox. This disease has almost been wiped out worldwide.

With goodwill and a sincere desire for communication, you may very well be able to take the best that your parents and other older relatives have to offer and tactfully teach them the best of what you know, without lowering your standards or sacrificing your values. First, use the many available resources to back up your opinions. We all tend to believe what we read, and women of the older generation held doctors and experts in high regard, so show Grandma the passages in books and magazines that reinforce your opinion. Quote your pediatrician to her. Share with her the literature you have from organizations such as the La Leche League (International, USA,

Canada) and the National Childbirth Education Association. Tell her what you’ve learned from people whose opinion she respects-you neighbor, whose children she always admires, or your sister or sister-in-law. Sometimes simply stalling is a good technique. Thank her for her advice, and say and do nothing more about the matter. Or “forget” to try her method, or tell her you’ll probably “start soon.” With good humor and consideration, you can probably work things out with Grandma so you at least approach the ideal relationship, in which you are working together for the benefit of your child and in which the child is more important to both of you than each other’s opinions about child care are. Bear in mind that the ultimate benefits of your rapport with Grandma will go to your child, whose relationship with her is priceless.

 The bottom line in dealing with Grandma or anyone else is that you are the parent, an intelligent and well informed person, and you have the right to determine what is best for your child and to raise him or her as you see fit. In the end, if you have to, you can remind these people that they chose their ways and you will choose yours. Of course, all this is easier with acquaintances or strangers, who will perhaps surprise you with their audacity in telling you what to do or asking you impertinent questions about the way you are caring for your child. You do not need to justify your actions to such people; you can avoid confrontations by simply thanking them politely for their interest and going your way. Do be sure that you are actually being criticized before you react. Remember that the more insecure we are, the more we tend to infer criticism when none was intended, and that we all tend to overreact to situations in which our children are concerned. There are few issues important enough to force confrontations with relatives and friends.

Being pregnant doesn't mean being fat. It doesn't have to mean being tired all the time, nor does it mean looking dumpy and saggy as a new mother. The way you feel [terrific or fatigued] and the way you look [sleek or bulgy] depend to a great extent to what actions you take during pregnancy regarding diet and exercise. By eating a wide variety of wholesome foods and by exercising aerobically on a regular basis, you can maintain or improve your fitness and health during this time of extra demands on your body.

Decide how you want to look and feel after delivery. Then accept the challenge of making necessary changes in eating and exercise. That's the first step. Look at your schedule and make changes to include sensible eating and an exercise program. The two go hand in hand. Just because you are pregnant doesn't mean you're fragile. Give your exercise program top priority. Plan your day around your exercise program, not the other way around.

This section describes a safe and effected fitness program for pregnant women at any level of fitness. The emphasis is on aerobic exercise, with some discussion of the other important components of a complete fitness program- stretching and strengthening exercises.

Starting an Exercise Program for the First Time

Becoming fit during pregnancy requires safe, regular, sustained, moderate exercise-not embarking on a new sport or doing strenuous workouts. Even if you have never exercised regularly before, you can safety begin a workout program during pregnancy. The safest and most productive activities during pregnancy [especially for the woman exercising for the first time] are swimming and brisk walking. They are best because can usually be continued until almost the day of delivery, and carry little risk of injury that would prevent further exercising. All you need before beginning is a sound program, appropriate clothing, and a health clearance from your personal physician.

Guide for Safe and Effective Exercise

For anyone engaged in an exercise program, it is important to know if you are under or overworking your heart. If you under work your heart muscle, you won't build stamina or endurance. If you are overworking your heart, you could become short of breath, dizzy, nauseated, or faint.

During pregnancy, it is especially important not to overwork. There are many internal body changes taking place that require oxygen and energy. In addition to the fact that you are growing a whole new person! That is why you should learn how to measure your body's responses to exercise.

One sign of overworking aerobically is shortness of breath. If you are working at just the right pace, you should be able to carry on a normal conversation while exercising [the" talk test"]. But, to be more accurate, you can learn to use your own pulse to tell you exactly how your body is responding to exercise.

Taking Your Pulse

Your pulse varies according to your activity level. It is lowest when you are least active. It also varies to response to illness and emotions. Your pulse can tell you about your physical fitness level, too. The more fit you are, the lower your resting pulse rate. Most women have a resting pulse rate of seventy-two, to eighty beats per minute [bpm], but this may decrease as their level of fitness improves. During pregnancy, the resting pulse normally varies within the same day and from day to day. As pregnancy advances, the pulse rate increases just slightly.

There are many pulse locations you can use, including the ones at your temples, your wrists and inside your upper arms. Do not use the carotid artery, [the pulse at the side of your throat]. Pressing this artery often alters the pulse beat, giving an inaccurate reading. Also, if you should accidentally press too hard or "massage" your neck trying to locate the pulse [especially during a workout], you may alter or decrease blood flow to the brain, making yourself feel faint or dizzy. Never take your pulse with your thumb. There is a pulse in your thumb and it is easy to confuse that pulse with the one in the artery you are trying to measure.

For practice, try to find the pulse in your wrist right now. To locate it, look on the thumb side, just below the small round bone on the side. Press firmly with your index and middle fingers. You should feel it beating. If not, get up and move briskly around the room for a couple of minutes and try it again. Practice several times during non-exercise times to become proficient at locating and counting your pulse.

Pulse Monitoring During your Workout

Three or four times during your workout, monitor your pulse. If you are attending an aerobic dance or exercise class with an instructor, monitor your own pulse whether or not the instructor has the entire class doing it. You should check your pulse after each aerobic dance or exercise segment, approximately every four minutes. After a while, you will be able to' read your body" and will know when your pulse is at the right level. You will then be able to check your pulse less frequently. But at first, be consistent in checking your pulse often.

Try to keep moving while you check your pulse. It will take practice at becoming proficient at doing this, but it is very important. Each time you stand still to take your pulse, it drops or changes. At the same time, the blood has a tendency to pool in the lower part of your body, affecting the blood pressure, and you may become dizzy or lightheaded. So keep moving to get an accurate pulse. [Of course if biking is your aerobic activity, you will have to stop to take your pulse. "No- hands" biking is not a good idea! Try jogging in place to keep your pulse rate up.

The most precise way to count your pulse is with a digital watch turned face up on the inside of your left wrist. Place the index and middle fingers of your right hand on your left wrist, finding your pulse beat. Keep moving as you begin counting [to yourself] how many times you feel the beat. The first beat is called zero, then one, two, three, and so on. For six seconds count each beat. Then simply place a zero after the number of your count. For example if your count is twelve your pulse is 120 bpm.

Finding Your Target Heart Rate Zone

Which pulse range is right for you? In order to improve your heart muscle and receive the other benefits of exercise, you must keep your pulse within your individual "target" heart rate zone. This target zone [in pregnancy and until approximately twelve weeks after delivery] is achieved when the heart is beating at between sixty and seventy percent of your safe maximum attainable heart rate [SHR].

A formula is used to determine each person's target zone. 220 [which is considered the highest pulse] minus your age equals your SHR Multiply that by sixty or seventy percent to get the limits of your target zone. The chart that follows contains the target zones for pregnant women and new mothers of all ages. Use it to determine your own target zone. If you cannot carry on a conversation in your target zone, you should reduce your activity, lowering your pulse to the level at which you are able to converse comfortably.

Use your target zone to help you regulate your activity during exercise. If your pulse is below your target zone, you need to work harder. If it is above your target zone, you are working too hard for your fitness level; you need to slow your activity to slow your pulse down to your target zone.

Target Heart Rate Zones for Pregnant Women and New Mothers

Age	Target Heart Rate [bpm]
15	123-140
20	120-140
21	119-139
22	118-138
23	117-137
24	117-137
25	116-136
26	115-135
27	115-135
28	113-134
29	113-133
30	113-133
31	112-132
32	111-131
33	110-130
34	110-130
35	109-129
36	108-128
37	108-128
38	107-127
39	106-126
40	106-126
41	105-125
42	104-124

*Target heart rate is calculated at sixty percent to seventy percent of the safe maximum attainable heart rate. In pregnancy, maximum heart rate should never exceed 140 beats per minute.

Stamina and endurance are achieved sooner by working at the lower end of your target zone, nor the higher. Therefore, don't try to rush yourself to fitness by overworking, because it doesn't work and could cause harm.

Remember that your target zone is just for you. If you haven't exercised regularly before, you may have to do very little to zoom your pulse up. The more fit you become, the harder you will have to work to get your pulse in the target zone. Do not compare yourself with others; there is no norm to achieve. Each pregnant woman should work at her own individual level.

Memorize the low and high numbers of your target zone. If you are above the high number, you need to slow yourself down-by walking, pedaling your bicycle more slowly, or reducing the vigor of your arm and leg movements. Unless you believe you are going to collapse or faint, do not stop moving or sit down. Keep yourself moving until your pulse drops to your target zone and you are ready to resume exercising.

If at any time during exercise you begin feeling faint, dizzy, lightheaded, nauseated, clammy or cold even though you are sweating or extremely fatigued, stop exercising, but walk around for a while and then have a seat. If you are in a structured class, talk with the instructor before leaving-let her know you are feeling unwell. She may want to keep her eye on you for a bit, or she may want to help you seek medical assistance. Also, see your physician before resuming exercise. These are warning signs. Listen to your body. There may be a very simple cause or one that is complicated and serious. Your physician, not your fitness instructor, or you should determine the cause.