Parenting - Prenatal to preschool/Parenting_PrenatalToPreschool.bin/dp/0020/00206.txt

Text File | 1993-06-25 | 41KB | 706 lines

$Unique_ID{PAR00206}
$Font{NP}
$Pretitle{}
$Title{Birth to 6 Months:  Safety and Health}
$Subtitle{}
$Author{
Editors of Consumer Guide
Mendelson, Robert A
Mendelson, Lottie M
Meyerhoff, Michael K
Ames, Louise Bates}
$Subject{Birth to 6 Months Safety Health mobility unattended crib bath
hazardous walkie-talkie intercom monitor siblings sibling hostility jealousy
pets dogs cats accidents car seat restraints airplane airlines fly flying
flight child-snatching strangers stranger fires emergencies prevention
protection smoke detectors fire extinguisher sickness illness 100 DEGREE
TEMPERATURE rectal thermometer acetaminophen drops cool-mist humidifier
saltwater nose drops cold contagious illnesses vaccinations vaccination
reaction immunized immunizations vaccine reactions smokes cigarettes
secondhand smoke upper-respiratory infections ear infection Colic infant acne
zits teething teeth teethe tears tear duct obstruction birthmark birthmarks
stork bites Cradle cap yellow scales dandruff shampoo vaginal drainage vagina
bloody mucus maternal hormones crowds Circumcision circumcised hiccups vision
sight hearing deaf bowed legs telephone PHONE NUMBERS CPR cardiopulmonary
resuscitation first aid Sudden Infant Death Syndrome SIDS IMMUNIZATION
SCHEDULE}
$Log{
Taking a Rectal Temperature:  Steps 1, 2, and 3*0020603.tif
Taking a Rectal Temperature:  Step 4*0020604.tif
Taking a Rectal Temperature:  Steps 5 and 6*0020605.tif
Coping with Colic*0020607.tif}

The New Parents' Question & Answer Book


Birth to 6 Months:  Safety and Health


     Since she won't be able to get around much on her own, how much trouble
can my baby get into during this period?

     It's easy to get lulled into a false sense of security by your baby's
relative lack of mobility during this period.  However, it is important to
realize that even a newborn is not a totally stationary creature.  When upset,
a baby only a few days old can propel herself a short distance by repeatedly
digging her heels into a soft surface and thrusting her legs.  As she gains
more control over her body in the next few months and can sit up, roll over,
etc., a baby becomes increasingly capable of moving herself at least a short
distance from where she was left.  Therefore, right from the start, it is
never a good idea to leave your baby unattended for more than a moment unless
she is in her crib; and never do so when she is on a high surface, in the
bath, or near something hazardous.  And, of course, you always have to be
careful about the things that are in your baby's immediate environment,
especially once she has learned to use her hands under the guidance of her
eyes and starts reaching for objects regularly.  This includes items you use
in caring for her, such as diaper pins and baby powder.  Don't assume she is
safe in her crib unless you've first read the crib-safety question in
"SELECTING TOYS AND EQUIPMENT" (the last section in this age group) and
checked to make sure the crib you use meets or beats the requirements.


     I can't be with my baby all of the time, especially during the night.
How do you suggest I "keep an eye on her" when she is in her crib?

     This is one area where today's mothers and fathers have a big advantage
over parents from previous generations.  Babies have always been able to
summon help with a loud cry.  However, various problems that affected their
breathing, and thus prevented them from vocalizing loudly, often went
unnoticed in the past, sometimes with tragic results.  And many naturally
nervous parents used to spend the first several weeks of their child's life
getting up every couple of hours and going into the nursery just to make sure
everything was okay.  Now, however, it is possible to purchase relatively
inexpensive walkie-talkie or intercom-type devices that allow you to monitor
what's going on in the nursery from any other room in the house.  Making an
investment in these new electronic devices will give your baby added security
and increase your peace of mind enormously.


     My baby's two-year-old brother loves to play with her, but sometimes he
doesn't seem to know his own strength.  Should I keep him away from her?

     It is very normal and natural for a two-year-old child to feel fairly
intense jealousy and hostility toward a new sibling, and you can expect those
harsh feelings to get worse as the months go by and the baby begins to demand
more and more immediate attention.  Many parents have difficulty accepting the
fact that their older child is upset over the presence of their younger child,
and they interpret acts of violence as situations where the older child
"doesn't know his own strength" or some other comparatively benign
circumstance.  The fact of the matter is that you have to be very careful
about your baby's safety whenever she is in the presence of a closely spaced
older sibling.  Because their feelings are so strong, and because they really
don't understand the extent of their own capacities and the potential
consequences of their actions, slightly older siblings have been known to
cause very serious damage to small babies.  Even if a two-year-old sibling is
relatively accepting of the baby, his curiosity may get out of hand and
significant harm may result.  Therefore, while you should not keep her brother
from getting to know his sister, you should make sure that he is well
supervised whenever they are together.


     Do pets present a problem?

     It is difficult to say because dogs and cats, like people, have unique
"personalities" and react differently to various situations and circumstances.
Some pets, particularly if they were around a long time before the baby
arrived, display almost siblinglike jealousy toward the new object of their
owner's attention.  Others are quick to warm up to the new arrival and can
even become very protective toward the baby.  Therefore, it is wise to wait
several weeks before you leave your baby alone near a pet so that you can get
a clear sense of how they will get along.  In general, it also is a good idea
to be on the lookout for inadvertent accidents triggered by pets.  For
example, a friendly but overly eager dog may jump up on a stroller or high
chair, causing it to topple over.  And an otherwise harmless cat may decide
that the baby's crib is a warm and cozy place to sleep, possibly in a position
that can cause serious problems for the occupant.


     Getting my baby into and out of her car seat is time-consuming and
tiresome.  Won't she be safe if I just hold her?

     Holding your baby in your arms when she's in the car may seem like a safe
thing to do, but in the event of a collision--even at very low speed--it
provides virtually no protection for her at all; her momentum will tear her
free and send her flying toward the dashboard or windshield.  Car seats can be
a tremendous inconvenience at times, but the statistical evidence is
overwhelming that they do save lives.  The substantial increase in the chances
that your baby will survive even a major accident certainly make the
investment of a little extra time and effort well worth it.  Furthermore, the
use of child restraints for children in this age group is now required by law
in every state, so not strapping your baby in can get you into trouble as
well!  (See the question in "SELECTING TOYS AND EQUIPMENT," the last section
of this age group, for advice on purchasing a suitable, safe car seat.)


     Is it safe to take my baby on an airplane?

     It certainly is, even more so now that most airlines will permit parents
to place their babies in suitable car seats during takeoff and landing.
Perhaps the only thing to be particularly concerned about is ear discomfort as
a result of sharp increases or decreases in cabin pressure during landing and
takeoff.  Because the eustachian tubes in their ears are narrower and more
prone to collapse with altitude changes, little babies are especially
susceptible to such problems.  Therefore, avoid taking your baby on a plane if
she is congested or has an ear infection; if she must fly, make sure your
pediatrician has examined her and okayed the flight.  Also, have your baby
nurse or suck on a pacifier during ascent and descent to promote swallowing
and reduce pressure on the ear canals.  Since a hungry baby will suck more
vigorously, make sure that she has not been fed shortly before takeoff or
landing.


     Is there anything I should be concerned about when taking my baby to the
supermarket or shopping mall?

     Unfortunately, in this day and age, parents must be aware of the
possibility of child-snatching in such situations.  The chances of your baby
being taken are not nearly as great as the impression you may have received
from the sensational news coverage that this phenomenon receives.  Still, the
fact of the matter is that it can happen and that parents need to be careful.
Particularly during this period, if convenient, it is a good idea to carry
your baby in a backpack or sling so that she is in contact with you at all
times.  If you put her in a carriage or stroller, make sure she is securely
harnessed, and never leave her unattended.  Also, to the extent possible, try
to plan your trips for times of the day when the stores are likely to be
relatively uncrowded.  Even if you keep your baby close to you, the pushing,
shoving, and jostling that takes place during peak periods can cause problems
which it may be just as well to avoid completely.


     When strangers admire my baby, they sometimes ask if they can hold her.
Is it safe to let them?

     This is a personal decision that has to be made on a case-by-case basis.
While caution is always appropriate whenever your baby is in the presence of
people you don't know, you can make yourself crazy by assuming that every
stranger is getting ready to run off with your child.  Therefore, if you feel
comfortable with the circumstances and have a good feeling about the person,
you shouldn't feel as if you have to abide by a policy of never allowing
anyone other than family members to enjoy your baby.  However, particularly
during this period, you have to make sure that whoever picks up and holds your
baby--stranger, friend, family member, or whatever--knows what he or she is
doing.  Not everyone may be aware that your baby needs proper neck and head
support when held at this age, so a well-meaning but uninformed person may be
unintentionally but distinctly hazardous.  In addition, avoid allowing anyone
who has symptoms of a contagious illness to hold the baby.


     What can I do to protect my baby from fire and other household
emergencies?

     The best way to protect your baby from such things is to prevent them
from happening.  Especially during this period, when she has absolutely no
capacity to remove herself from harm's way, and when her ability to ask for
help is severely limited, your baby is very much at risk in such situations.
Therefore, this is a good time to purchase and install smoke detectors, a
fire extinguisher, and other such equipment; and if you already own these
devices, double-check to see that they are in good working order.  In
addition, you should obtain a special window decal for the nursery so that
fire fighters and other emergency personnel will be able to find your baby
quickly.  Finally, always remember to remove your baby from the house before
you try to deal with any emergency yourself.  If you fail and the situation
gets out of hand, it may be too late to redirect your efforts toward finding
your baby and getting her to safety.


     How will I know if my baby is getting sick?  When should I call my
pediatrician?

     Parents rapidly become expert and accurate assessors of how their baby
feels.  When does cranky or out-of-sorts become a sign of illness?  If your
baby is crying more for no apparent reason, and the cry sounds like she's in
pain, investigate.  If her diaper is dry, there are no pins sticking her, and
you can find no reason for her distress, consider how she's been feeding,
sleeping, and acting.  Any sudden or distinct change in your baby's
personality or demeanor can be a sign of illness.  Has she been wetting a
larger or smaller number of diapers than usual?  Have her stools been
unusually loose and more frequent?  Has she vomited?  Does her skin feel warm
or moist?  Does she look pale or flushed?  Is she acting lethargic or
withdrawn?  Does she have a fever? (CALL YOUR PEDIATRICIAN RIGHT AWAY IF YOUR
BABY IS LESS THAN SIX MONTHS OLD AND HER TEMPERATURE IS ABOVE 100 DEGREES
FAHRENHEIT.)  Is she coughing?  Does she have a stuffy or runny nose?  Does
she seem to have trouble breathing?  Do her eyes look clouded, glassy, or red
rather than clear?  If you answered yes to two or three of these questions or
even to one that concerns you, call the pediatrician.  Your pediatrician may
suggest that you wait and see or may feel confident after consulting with you
that it's not necessary to see the baby at this point.  On the other hand,
your pediatrician may advise you to have the child seen immediately.  There
are times when you may feel that your questions sound stupid.  Ask them
anyway.  An important part of the pediatrician's job is to be a resource for
parents.  A parent's concern is a very important reason for calling the
pediatrician.


     My doctor believes in taking the baby's temperature rectally, but I'm
afraid I'll hurt her.  Can I use a thermometer strip or just feel her forehead
instead?

     If and when you think it's necessary to assess your baby's temperature,
the method of choice is still by the old-fashioned rectal thermometer.  Moms
have been feeling foreheads for generations, and it's a lovely Mom thing to
do, but it's not accurate.  And while the strips are much easier to use, they
do not have the accuracy of a rectal thermometer.  Taking your baby's
temperature rectally does not hurt her.  If you've never taken a child's
temperature rectally before, ask for guidance when you are at your
pediatrician's office.  Be sure you know how to find and read the mercury
level as well.  You can also refer to the illustrated directions on Taking a
Rectal Temperature.  With proper instruction and practice, you'll be an expert
in no time.  Remember, too, that it's not necessary to take the baby's
temperature unless you think she's ill.  A fever is only one symptom of
illness, so be sure to pay attention to how your child is feeding and acting
as well.  However, if your baby is less than six months old and has a
temperature above 100 degrees Fahrenheit, call your pediatrician immediately.


     What medications and equipment should I have in the house in case my baby
gets sick?

     At this age, the most important piece of equipment to use in case your
baby gets sick is the telephone.  It is essential to consult with your
pediatrician whenever you think your baby is sick.  In addition, you'll need a
rectal thermometer, and you'll need to know how to use it properly (see
illustration:  Taking a Rectal Temperature).  You may also want to keep some
acetaminophen drops on hand in case your pediatrician advises you to give them
to your baby to relieve discomfort or bring down a fever (if your baby
develops a rectal temperature over 100 degrees Fahrenheit during the first few
months of life, immediately call your pediatrician for instructions).  Another
very useful item to have on hand is a cool-mist humidifier to help make your
baby more comfortable during respiratory illnesses.  Finally, a bottle and
dropper filled with saltwater nose drops (see recipe below) is useful to help
clear your baby's nasal passages when she has a cold.


     I have a cold, and I'm afraid my baby is going to get it.  Is there any
way to prevent this?

     Unfortunately, among the many things a family shares are cold viruses.
As far as prevention goes, if you wash your hands frequently, throw used
tissue in the garbage, and try not to sneeze on the baby, there's little else
you can do to protect her from your cold.  Some parents use surgical masks
(which most likely frighten the baby), but by the time your cold symptoms are
"full blown," you've already exposed the baby.  You're far better off trying
to stay in optimum health yourself and to avoid exposing yourself to people
who have contagious illnesses.  Unfortunately, as yet, we do not have a
vaccine that can prevent you or your baby from catching a cold.


     What do I do if my newborn gets a cold?

     Treatment of a cold in an infant varies a little from the way it's
treated in an older child or an adult.  Most babies (especially those that are
breast-fed) handle colds well.  Still, your baby's smaller nasal passages can
more easily become blocked, and this can be troublesome since she must be able
to breathe through her nose to feed successfully If the stuffiness interferes
with her appetite, it may be helpful to use a humidifier (cool-mist type) in
her room and to apply a homemade saltwater solution as a nasal flush (see
recipe below).  Do not give your infant any prescription or nonprescription
medication without first checking with your pediatrician.  Likewise, if your
baby develops a fever over 100 degrees Fahrenheit or stops eating, contact
your pediatrician.


     My husband is worried about the possibility of our infant developing a
serious reaction to childhood vaccinations.  How can I convince him that our
infant should be immunized?

     Congratulate your husband upon becoming a parent at a time in the history
of mankind when you can prevent your baby from getting most of the life
threatening, crippling, and debilitating communicable diseases of childhood.
Proper immunization will protect your child from diphtheria, tetanus, whooping
cough, polio, mumps, measles, and rubella.  The latest vaccine in the arsenal
against disease is HiB.  Hemophilus influenza type B was once the major cause
of meningitis in young children.  Many of those afflicted died; others
suffered significant hearing loss.  A chicken pox vaccine is also currently
being developed.  Although chicken pox is usually not a severe disease, there
are occasionally complications that can be life threatening, especially to a
child with a compromised immune system.  The side effects or reactions from
these immunizations usually include minimal discomfort, a slight fever, and,
sometimes, irritability for up to 48 hours.  The severe or unusual reaction
you hear about may happen once in 300,000 children, and many of these are not
documented sufficiently.  In other words, the child in question was likely
developing or exhibiting a preexisting condition.  Parents of today are indeed
fortunate to be able to promise their children a healthier future free from
all these diseases.  What's more, while you're convincing your husband about
the necessity and privilege of immunizing your child, inform him of the
necessity for all adults to get a tetanus/diphtheria booster every ten years.
Ninety-seven percent of recent cases of tetanus occurred in adults.  MMR
(measles, mumps, and rubella) reimmunizations are recommended for adults born
after 1956 unless they have a record of having received a second immunization
or have had a case of measles that was documented by a physician.  If you had
the immunization before your first birthday, it should be repeated.


     My husband smokes cigarettes.  I've told him it's harmful to the baby,
but he thinks that if he smokes in the adjoining room, it's okay.  Is it?

     Your baby can be inhaling smoke from her environment even if it's not
directly in her face.  Many studies provide us with statistical proof that
secondhand smoke definitely does affect the number of upper-respiratory
infections and middle-ear infections in children.  Children of smokers have
more colds, ear infections, bronchitis, and pneumonia, and they show reduced
pulmonary (lung) function.  More recent research has indicated that the
occurrence and severity of colic and coliclike conditions in babies can be
related to secondary smoke.  For many years, secondhand smoke has been a known
factor in the severity of asthma in children.  Studies investigating croup
show tobacco smoke to be a contributing factor here, too.  We could go on, but
these reasons should be more than enough to convince responsible parents that
they need to provide their children with a smoke-free environment.  If your
husband can't quit, have him do his smoking outside.


     What is colic?  Do all babies get it?

     Colic means different things to different people, even to pediatricians.
In general, colic refers to repeated episodes of inconsolable crying in a baby
who previously was not especially fussy.  The episodes of crying usually begin
a few weeks after birth and occur during the day and at night.  Nothing the
parents do makes any difference.  After what seems like forever (but is
usually less than two hours), the baby calms down or sleeps and is back to her
usual self.  This pattern may be repeated several times daily.  Most babies do
not get colic, but those who do can try the patience of even the best parents.
There have been many theories about what causes colic, but we still really
don't know.  The important thing to remember is that no matter how bad it
seems, colic disappears as quickly as it appears, usually when the baby is
about three to four months old.  To determine whether your baby has colic,
think about other factors that may be making her fuss.  Is she hungry,
thirsty, or uncomfortable?  If she is breast-fed, did her mother eat anything
unusual that might be causing the baby abdominal discomfort?  Does the baby
have any other signs of illness, such as vomiting, loss of appetite, fever, or
diarrhea?  If the answers to these questions are negative, then you're
probably dealing with colic (see Coping With Colic, below).


     What is infant acne?  What can be done about it?

     There are two times in life when children develop acne.  We all know
about the teen years, but many are not aware that the same type of rash can
occur in the newborn.  In response to withdrawal from maternal hormones, some
babies develop a mini version of acne on the face, neck, upper chest, and
back.  The lesions look just like a small version of teenage acne and appear
in the same places because they involve the same oil-producing glands.  The
good news is that in a few weeks these "baby zits" will gradually go away
without any kind of treatment.  Although they can be upsetting to parents,
they don't bother the baby at all, so it's best to leave them alone.


     How will I know when my baby is teething?  Will it make her sick?

     Babies get their teeth at different ages and at different rates.  On the
average, babies begin to teethe at about six to eight months of age and erupt
about one tooth per month until they have 20, which is the total number of
deciduous or "baby" teeth.  Many babies begin to drool at about three months
of age and fool their parents into thinking that they are teething.  Actually,
the drooling is from the salivary glands, which are just becoming active.
Babies have no symptoms from teething until a tooth is about to erupt (break
through the surface) and the area of the gum around the tooth begins to swell
or bulge.  Although many babies erupt teeth without any symptoms, teething may
cause fussiness, soreness of the gums, drooling, runny nose with clear mucus,
slightly elevated temperature (rarely over 100.4 degrees Fahrenheit), and
slightly loose bowel movements.  You can help make your teething baby more
comfortable by letting him chew on cool, firm teething objects and by using an
appropriate dose of acetaminophen drops (not aspirin).  Check with your
pediatrician, however, before giving your baby any medications.


     My two month old always has tears coming from her left eye.  Sometimes
the discharge is yellow and thick.  Is something wrong?

     Tears (the natural lubricant of the eye) are produced by a gland on the
outside of the upper eyelid; from there, they flow across the eye.  They are
picked up by a tiny duct on the medial (nose side) of the lower lid, and drain
into the nose.  If you look carefully in the inner part of your lower lid, you
will see a tiny opening through which the tears drain.  Occasionally, this
duct is blocked at birth, so the tears well up and spill out of the eye and
onto the face.  This is by far the most frequent cause of tearing from one eye
only in a young baby.  In most cases, the tear duct will open by itself, and
the unusual tearing will stop.  Sometimes, however, a mild infection occurs
because of the obstruction.  This can result in the tears becoming yellow and
thick.  Applying warm, wet packs to the closed eye may help get rid of the
infection; if it does not, contact your pediatrician.  You may be instructed
to use some antibiotic eye drops or ointment and/or to use a massage technique
to help encourage the duct to open.  In a very small number of infants, the
duct does not open by itself and must be surgically opened, usually during the
end of the first year of life.


     My baby was born with pink-red birthmarks on her forehead, her eyelid,
and the back of her neck.  Will they go away?

     The type of birthmark you describe usually fades with time, often several
years.  Unless there is a family history of similar marks on the face and head
that are permanent, these "stork bites" are of only minor significance.  They
are most often found on the back of the neck, on the hairline above the neck,
on the eyelids, between the eyebrows, or on other parts of the face.  They
require no treatment.


     What is cradle cap?  How should it be treated?

     Cradle cap is best thought of as infant dandruff.  It consists of oily,
yellow scales, which can be thick or thin and may be patchy or involve most of
the scalp.  It often starts after the first few weeks of life and may last for
months if not treated.  The scales can even become so thick that hair can't
grow through them, resulting in temporary bald spots.  Cradle cap is not
contagious, but it can be a real nuisance.  The best treatment is to lather
your baby's scalp with a mild baby shampoo, and gently scrub the scales off
with a soft brush or your fingernails.  Don't worry about touching the
fontanels (soft spots).  While it may feel like the skull is open beneath
them, there is actually a tough, protective membrane under the skin.  If the
cradle cap persists after several days of daily shampooing, switch to a
dandruff shampoo and use the same technique.  The scales will loosen and come
off.  It may be necessary to continue the vigorous shampoos throughout the
first few months of life, after which the cradle cap will become less of a
problem.


     My breast-fed newborn girl has been having drainage from her vagina.  Is
this normal?

     Whitish vaginal drainage and even a small amount of bloody mucus is
normal in female infants, especially those who are breast-fed.  It is a
response to maternal hormones.  It causes no symptoms and is self limiting,
usually lasting only a few weeks.  It requires no treatment and is definitely
not a reason to discontinue breast-feeding.


     My breast-fed newborn son has noticeable swelling under both nipples that
seems to be increasing.  It doesn't seem to bother him, but it looks and feels
like he has little breasts.  Is this normal?

     What you are describing is a normal variant that occurs in some infant
boys and girls.  It seems to occur more often in breast-fed babies, but may
occur in those on formula also.  It appears to be a response to maternal
hormones in the baby's very sensitive breast tissue.  It will resolve itself
without treatment and without a change in feeding method.  Occasionally, there
is even a tiny amount of whitish fluid that comes from the enlarged breasts.
This is also a variant of normal and should not cause concern.


     Is it dangerous to take my newborn into a room that's crowded with
people?

     Whenever possible, you should avoid exposing your newborn to crowds of
people because of the possibility of her catching a contagious illness.  If it
is necessary to take her into this kind of situation, you'll want to take a
few precautions.  Ask anyone who has any symptoms of illness to please refrain
from coming near the baby.  Limit the number of people who hold her, or better
yet, show her off while you're holding her.  If necessary, use some excuse for
not passing her around, such as "She's very fussy," or "She's been spitting up
a lot today."  Tell people that your pediatrician doesn't want her to be
handled too much and that kissing spreads germs.  On the other hand, you can
put her down in a room away from everyone else and have a sitter or close
relative watch her for a while.


     Should I have my newborn boy circumcised?

     Circumcision (a partial removal of the foreskin of the penis) is a
procedure that may be done in the first few days of life.  In certain
cultures, it is done routinely as a religious ritual.  Most parents of newborn
boys have to make the decision about whether or not to circumcise as soon as
they know their newborn is male.  We recommend that parents-to-be take the
time to decide this issue prior to the birth and that they take the following
information into consideration.
  1. Most pediatricians will support whatever decision the parents make, so it
     is up to the parents to make an informed decision.

  2. The American Academy of Pediatrics has recently issued a revision of
     their previous policy statement regarding circumcision.  In it, the
     Academy points out that infant males who are not circumcised have a very
     small chance of developing a urinary tract infection in the first year of
     life.  Aside from this issue, there is no true "medical" reason to have a
     baby circumcised.

  3. Most mothers agree that it is easier to clean and care for a circumcised
     penis.

  4. There is some pain involved during the circumcision.  The baby, however,
     quickly recovers from it.  Some physicians who perform circumcisions
     prefer to use local anesthesia, while others feel that it is not
     necessary.

  5. There is an extremely low incidence of complications from the local
     anesthesia and from the circumcision itself.

  6. It is important to some parents that their son look like his father,
     brother(s), and other boys his age, whether circumcised or not.
     Therefore, you may want to take the circumcision rate in the community
     into account.

     Remember that as long as you inform yourself about the options, there is
no wrong answer in this matter.  Whatever is decided, discuss the care of your
son's penis (circumcised or not) with your pediatrician.  If your newborn son
has not been circumcised, do not attempt to retract the foreskin and clean
beneath it.  The foreskin separates gradually during the first few years of
life.  Forcibly retracting it at this age may cause pain and bleeding and may
harm the penis.


     Why does my baby have hiccups all the time?

     Hiccups are brief spasms of the diaphragm (the structure which separates
the chest cavity from the abdominal cavity); they occur frequently in young
babies.  Many moms who frequently felt their babies hiccupping in the womb
often note the same tendency during the first few months after birth.  Many
babies hiccup when they are hungry, perhaps as a result of the empty stomach
pulling down on the diaphragm.  Hiccups are also common at the end of a
feeding; burping may help to relieve these.  Perhaps the most important aspect
to note here, however, is that hiccups are normal and self limiting.  In most
babies, they cause no distress or other behavioral changes.  If hiccups do not
bother your baby, don't let them bother you.


     How can I be sure that my baby is seeing normally?

     At birth, a baby's vision is not fully mature, but it does improve
rapidly in the early months of life.  By about four months of age, your baby's
color vision will be almost fully mature, and she will be able to focus on
distant objects as well as those that are nearby.  To get an idea of whether
your baby is seeing normally, check to see that she follows the movements of
your hand or face or a brightly colored object with her eyes.  Make sure her
eyes move together as she does so.  Also check to see that when she is facing
a light source--such as a sunny window or a lamp--the reflection from the
light falls at exactly the same spot on the colored portion of both eyes.
After the second or third month of life, if you feel that your baby is not
following this developmental pattern or you notice that one or both of her
eyes seem to wander when she looks at an object, discuss it with your
pediatrician.  Since your child learns more through her eyes than through any
of her other senses, it is important to try to make sure that her visual
abilities are normal for her age.


     How can I tell if my baby is hearing properly?

     From the moment of birth, you can tell if your baby is deaf by noticing
whether or not she startles when exposed to loud sounds.  Fortunately,
complete deafness is mercifully rare.  On the other hand, mild to moderate
hearing loss--due to congenital defects or infections--is difficult to detect
and can have serious consequences in terms of understanding and learning how
to use language.  Starting at about four months of age, you can--and
should--screen your baby regularly for possible problems in this area.
Because she should be able to orient accurately to the source of sound at this
point, you can test her hearing ability by standing a few feet behind her and
quietly calling her name.  Even if she is occupied with something, she should
turn, look at you, and smile.  Repeat this process from several different
vantage points, gradually decreasing the loudness of your voice until you're
nearly whispering.  She should still turn, look, and smile in response.  If
your baby repeatedly fails this "whisper" test over the course of several
days, don't hesitate to get her to your pediatrician and insist that the
problem be investigated and taken care of as soon as possible.


     My baby likes to stiffen her legs when I hold her in a standing position.
Can it hurt her legs to stand this way?

     Most babies, starting at about four to five months of age, like to bear
weight on their feet and even bounce while being held in an upright position.
Many babies are also noted to have bowed legs at about fifteen to eighteen
months of age.  These two facts are probably responsible for the myth that
this early weight bearing causes bowed legs later in life.  This just isn't
the case.  The desire to bear weight on the legs in early life as well as the
usually temporary appearance of bowed legs in the second year of life are
normal and expected.  They are in no way related.  If your baby enjoys bearing
weight on her legs and bouncing on her feet, indulge her.


IMPORTANT PHONE NUMBERS TO KEEP READILY ACCESSIBLE

     It is obvious that obtaining outside assistance immediately is very
important in an emergency, but parents sometimes fail to realize how foggy
their thought processes can become in a crisis situation.  Therefore, in order
to ensure your baby's safety, it is critical to keep a list of appropriate
phone numbers posted clearly next to every phone in your house.  When a
serious accident happens, you don't want to be rummaging through drawers or
flipping through notebooks in a desperate attempt to find the information you
need.  The list should contain phone numbers for the fire department, the
police, the poison control center, the paramedics or an ambulance service, and
the nearest hospital emergency room.  There should also be explicit
instructions regarding the fastest route to that hospital.  The phone number
of your personal pediatrician should be included as well, and if you may not
have access to a car, the number of the local taxi service should be written
in, too.  Less critical, but often convenient, are phone numbers for a local
pharmacy, your dentist, nearby friends or relatives who might be able to lend
a helping hand, plus the gas company, the electric company, a locksmith, etc.
By the way, it is also advisable to post the information that emergency
service providers are likely to ask for, such as the exact birth date of your
baby, any allergies she may have, the inoculations she has received, etc.  You
may be unpleasantly surprised by how much basic information you simply can't
recall under stress.  Finally, in preparing your list, always leave room for
additional numbers that may become important later on.  It is a rare list of
more than a few months old that doesn't include the numbers for a baby-sitter
who is usually available on short notice and a pizza place that delivers, too.


WHAT YOU NEED TO KNOW IN CASE AN ACCIDENT HAPPENS

     Although it is not necessary for you to become an expert on all health
and medical procedures pertaining to babies--that is what pediatricians are
for--it is advisable for you to take the time to become familiar with certain
basics so that you can help your baby before expert help arrives in times of
emergency.  Your local chapter of the Red Cross, the Heart Association, or
other such organization, or your local hospital, health clinic, day-care
center, or other such agency probably can help you to acquire essential
training in first aid and CPR (cardiopulmonary resuscitation) for babies.
Even if you have had similar training before, taking an update or refresher
course certainly wouldn't hurt.  And you should note that providing first aid
and CPR for a baby involves many considerations and techniques that are
significantly different from those that are applicable to older children and
adults.  Choking, poisoning, head injuries, cuts, burns, etc. all need to be
handled at least slightly differently with babies.  By the way, if at all
possible, responsibility for learning these first aid and CPR procedures
should not be relegated to just one parent.  The more people who have this
information--including close friends, relatives, and baby-sitters, as well as
both parents--the more likely your baby is to receive proper treatment when an
unfortunate incident occurs.


SUDDEN INFANT DEATH SYNDROME

     Sudden Infant Death Syndrome (SIDS) refers to the sudden, unexpected, and
unexplained death during sleep of a seemingly normal and healthy baby.  The
victim is usually between the ages of one month and one year, with the peak
incidence at two to three months of age.  SIDS is very rare prior to two weeks
of age or after six months of age.  The incidence of SIDS is highest in black
and American Indian babies; in babies of young, single mothers; in babies
whose mothers have abused drugs during pregnancy; and in babies who were born
prematurely.  If you fall into one of these high-risk groups or if there is a
history of SIDS in your family, discuss this with your pediatrician.  It is
important to remember that SIDS can occur without any warning or any past
history.  In these cases, the parents must be advised that nothing that they
did or did not do caused the loss or could have prevented it.  Often, the
emotional scars that these parents carry because of guilt can be as severe as
the loss of the baby.  Most cases of SIDS cannot be prevented.


RECIPE FOR SALTWATER NOSE DROPS

     Mix half a measured teaspoonful of salt with one-and-a-quarter cups (ten
ounces) of water.  Pour the solution in a dropper bottle, and use as a nasal
flush to loosen thick mucus and to help clear your baby's clogged nasal
passages.


RECOMMENDED IMMUNIZATION SCHEDULE FOR CHILDREN

Age                           Immunization

Birth                         HB
Two months                    DTP, oral polio, HbCV, and Hb
Four months                   DTP, oral polio, and HbCV
Six months                    DTP and HbCV
Nine to 12 months             Tuberculin test (may be repeated at one to two
                              year intervals; consult pediatrician)
12 months                     HbCV and HB
15 months                     DPT, oral polio, MMR, and HbCV
18 months                     DTP and oral polio
Four to six years             DTP and oral polio
12 years                      MMR
Every 10 years                Td

DTP = Diphtheria, tetanus, and pertussis (whooping cough) vaccines given as
      single injection
HB  = Hepatitis B
HbCV= Haemophilus b conjugate vaccine
MMR = Measles, mumps, and rubella vaccines given as single injection
Td  = Tetanus-diphtheria booster