Baby and Toddler Basics: Expert Answers to Parents' Top 150 Questions

mommy.

Introduction

As a physician, I have been answering parent questions for 20 years. That’s why I wrote Baby and Toddler Basics for parents, grandparents, and caregivers, to keep this book on your nightstand or in your baby bag so when something comes up, whether a cough, a fever, a diaper rash, or a stomachache, you’ll have the answer you need in a simple, concise, accurate, and easy-to-read format.

Baby and Toddler Basics focuses on your child from birth through age 3 years and includes parents’ top questions on breastfeeding, nutrition, crying, sleeping, illnesses, and child care. Baby and Toddler Basics is meant to answer not only the questions you have today, but those you are likely to have at 3:00 am tomorrow morning! Baby and Toddler Basics provides practical information, advice, and important tips and tells you when you need to call your pediatrician. Best of all, it fits in your baby bag! So before you pick up your smartphone to call or e-mail your pediatrician, check out Baby and Toddler Basics for your answer.

In pediatrics, situations change dramatically, depending on the specific age of the child, so it’s no surprise that the answers to many common questions will vary by age. Therefore, in this book, babies aged birth through 1 month are called newborns; babies aged 1 month through 1 year are called infants; and children aged 1 through 3 years are called toddlers. As .

The information and advice in this book apply equally to children of both sexes, except where noted. To indicate this, the use of masculine and feminine pronouns is alternated throughout the book.

I hope you find Baby and Toddler Basics helpful, but don’t forget that you know your child best. You will undoubtedly come up with questions not addressed in this book. That’s the nature of having kids! If ever you find yourself with unanswered questions, no matter how small or silly they may seem, go ahead and ask your pediatrician. And whenever you have more serious concerns, remember that no book, Baby and Toddler Basics included, can ever take the place of direct medical advice, you should never hesitate to call your pediatrician. After all, that’s what we’re here for—even at 3:00 am!

CHAPTER 1

Basic Baby Care

If you’re reading this book, congratulations on your pregnancy! Chances are you’re getting a good head start in anticipating what lies ahead with your new bundle of joy. Admittedly, some days may be more joyful, or at least more peaceful, than others. Whether you’re trying to figure out why your baby is crying (is she hungry, wet, or tired?) or you’re attempting to get her dressed and out the door for her first doctor’s appointment (don’t forget that new diaper bag), you will quickly realize that your life has now changed . . . forever.

Even though you’ve eagerly awaited and geared up for this wonderful addition to your life and family for the past 9 months (if not more), you are likely to find yourself still needing some guidance, now that you are going to become a parent. In the hospital, you will have lots of help from the nurses, lactation consultants, and doctors—all at your fingertips. You may still be reading all the must-have parenting books and spent many evenings on the phone with your mother and girlfriends talking about all the details. You think you are prepared. But nothing can ever completely prepare you for the crazy but exciting ride ahead. Most new parents have questions—usually lots of them! Here are some of the top questions parents have.

(If it is sleep, feeding, poop, fever, or skin-related answers you’re looking for, rest assured that these very important newborn topics are covered in their own chapters.)

After Delivery

1.What happens in the delivery room?

If this is your first baby, it can definitely be an overwhelming experience. But don’t worry—there will be doctors, nurses, and other specialists around to help you and your little one through. There will be monitors on your belly to keep track of you and your baby throughout the whole process. Whether you are having a vaginal delivery or a C-section, there will be designated nurses and doctors ready to assist you and your newborn during the delivery.

After delivery, your doctor will dry and rub your baby’s back until there’s a good cry to make sure those lungs are working. Crying is a wonderful sound after delivery because it means your baby is likely strong and healthy. These are your baby’s first breaths, and crying helps the lungs expand and makes residual fluid in the mouth and airway come out. Then, your baby may be placed on your chest skin to skin for that first moment of mother-baby bonding. Your baby may even search for your nipple for her first attempt at breastfeeding.

If your doctor or nurse feels that your baby needs some extra attention, she may be brought over to a warmer (in the same room) so that they can take a closer look. This will happen either immediately after delivery or after a short period of mother-baby bonding. Either way, please let the nurses and pediatricians do their job as they are quickly trying to ensure that your baby is healthy. Their priorities will be to check that the heart is beating well and the lungs are expanding properly. A spouse or family member may be asked if they want to cut the umbilical cord. This is optional but simple and may be a nice moment to remember. The nurse or doctor will show him or her exactly what to do (and they may even take a photo for you if you ask). After the initial minutes of going down the checklist, the nurses may weigh and measure your baby before bringing her back to you (often bundled up with a hat for warmth).

2.Should I give my baby vitamin K and eye ointment?

Yes. The vitamin K injection is one of the most important things you can do for your baby at birth because it reduces the risk of life-threatening bleeding in the first few weeks of life. Vitamin K is one of the essential clotting factors in the blood. All babies are born with a low amount of vitamin K due to immature organs, such as the liver and intestines, which take a few weeks to months to mature. If the vitamin K is not replaced, it puts newborns at a high risk of serious bleeding. The injection is easily given in the thigh and recommended by the American Academy of Pediatrics (AAP).

The erythromycin eye ointment is an antibiotic ointment that prevents a bacterial eye infection that could be spread from the process of delivery. Your baby may be at low risk for an infection, but the antibiotic is harmless—and it is always better to be safe than sorry, since it can prevent eye damage and blindness.

3.How can I bond with my baby?

There are many ways you can bond with your baby. Bonding is a natural process that will happen with time. It’s okay if you don’t feel a strong bond right away—as long as you are attending to all of your baby’s needs, she will be fine. Part of the bonding process includes your baby getting to know you, in addition to you getting to know your baby. Breastfeeding is a perfect time for this, as you learn to recognize your baby’s body language and facial expressions. She will learn that you are a source of comfort, and nursing will build that trust (see chapter 2 for more tips on breastfeeding). If you are bottle-feeding, these mealtimes are just as important for bonding and building a loving relationship. All parents can have skin-to-skin contact with baby, so she will feel your warmth and get used to your smell. Touching is also important, and infant massage and bath time are also great ways to calm and connect to your baby. Carrying your baby in a baby carrier or a sling across your body is also a great way to help you bond and walk around easily with your baby (see the next section on when and how to go out and about).

Baby’s Bedroom?

(Or Room Share, Don’t Bed Share)

Your baby doesn’t necessarily need her own bedroom right now. Actually, the AAP recommends that your baby sleep in the same room as you, but in her own safe sleep space—such as a crib or bassinet. Any flat, solid surface for your baby is acceptable. Sometimes, bassinets are preferred for the first few months because they may be more mobile. Otherwise, just remember that the bassinet or crib should be bare, which means that no toys, bumper pads, pillows, or bedding should be in your baby’s crib. And, always place your baby to sleep on her back! If you want to decorate the room and hang items for your baby to look at, that is great—as long they are not right next to your baby at sleep time.

4.I’m feeling a little overwhelmed and down since I had my baby. Why am I not super happy, and is this normal?

It is normal to have mood swings and baby blues feelings after having a baby. Up to Eighty percent of women report having some degree of the baby blues after the birth of a child, so you’re not alone. A new mom may feel a little down, tired, anxious, not able to sleep (even when baby is sleeping), not as hungry as usual, or weepy—or she may cry for no apparent reason. The exact cause is not fully understood, but it’s thought to be due to hormonal changes and situational and emotional changes that cause a new mom to feel down or depressed. It’s important to remember that you are not alone. Look for a new-mom support group in your area.

The best way to feel better is to take care of yourself. Ask your friends and family for help with your baby. Or, ask them for help with the housework and cooking meals (or, if possible, hire a postpartum doula or baby nurse). Remember that it’s important to eat a balanced diet, get some fresh air, keep a journal, and do something you love to do. Don’t hesitate to talk to a therapist, counselor, or your doctor if you, your family, or your physicians feel it might help. There are many experts specially trained in helping moms with baby blues and postpartum depression.

Other things that are known to help are

Light to moderate exercise

Drinking plenty of fluids

Some experts recommend taking omega-3 fatty acid, folate, magnesium, and calcium supplements (with your doctor’s permission, of course)

Avoiding caffeine and alcohol

Lack of sleep can also put you over the edge. I remember after 4 or 5 days without sleep, I couldn’t stop crying for any reason at all! Asking for help so you can get a few hours of shut-eye can really make a difference.

I also tell breastfeeding moms’ partners that their job is to get up and change the baby’s diaper in the middle of the night. Or, simply handing the baby to mom for a feeding and then putting the baby back in the bassinet after feeding can help mom get a little more rest, while also feeling supported.

If your feelings of being overwhelmed or down since the birth of your baby 3 weeks ago seem to linger, you need to call your Ob/Gyn or primary care physician right away. Or, if these feelings have lasted more than 2 weeks straight and don’t just come and go, you need to reach out to your doctor for help. In such cases, intense therapy and possibly even medications may be needed. Don’t be shy about asking your family and friends for help—the birth of a new baby is a special time for everyone, and they will often be more than happy to contribute.

Out and About

5.When do I need to bring my baby in for a checkup?

In general, it’s a good idea to see your pediatrician within 2 days of leaving the hospital. In decades past, longer hospital stays allowed babies to be observed for about a week after delivery. This also gave parents more time to gain some hands-on newborn experience. Nowadays, the first checkup is typically scheduled soon after discharge from the hospital (within your baby’s first week) to make sure your baby is feeding, peeing, and pooping well; isn’t jaundiced (see question 101, on page 182); and hasn’t lost too much weight. All babies initially lose weight after they are born, and most regain their birth weight by around 2 weeks of age. This early visit is especially useful because most babies spend only 2 to 3 days, at most, in the hospital after birth. That’s certainly a lot to learn in a short time. How your baby is feeding, pooping, growing, and behaving will dictate how often he needs to be seen by the doctor in the first few weeks.

Remember that after being sleep deprived for 72 hours, you may barely remember your name, let alone the questions you thought of in the middle of the night—so write them down as you think of them. Allow plenty of time to pack up (see the following Dr. Tanya’s Tip: Baby Bag Essentials), get out the door, and arrive at your appointment—it can take some time to get used to moving about with a newborn!

Dr. Tanya’s Tip

Baby Bag Essentials

Babies need lots of stuff—all the time. So prepare an extra baby bag…or two. Give one to anyone else who will be caring for your baby. That way, all the necessities will be available if an outing takes longer than expected. A well-stocked diaper bag should include the following:

Five diapers (at least)

Changing pad

Baby wipes

Diaper cream

Plastic bags for dirty diapers or clothes

Formula, bottle, and nipple (if formula feeding); sippy cup for an older baby

Burp cloths

Bottle of water (to mix formula, clean up messes, or drink yourself)

Change of clothing (for your baby and for yourself) in a sealed bag

Blanket

Pacifier (if your baby uses one)

Acetaminophen (Tylenol)

Hand sanitizer

Rattle or toy

List of important information —pediatrician’s phone number, recent weight of baby (including the date), allergies (if any), and immunization records. Better yet, save this information in your smartphone so it’s always at your fingertips.

Don’t forget to restock items as they are used, so you’re always ready to go anywhere, anytime!

After your hospital follow-up visit, your pediatrician may recommend that you come in for a weight check appointment or two, but then regular well-baby examinations for the first year are usually scheduled at 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months. Of course, this schedule varies slightly from doctor to doctor. It may seem like you are always on your way to the pediatrician, but every well-baby examination is important. Your doctor will examine your baby from head to toe, check his growth, evaluate his development, look for signs of illness, and provide advice for keeping your little one healthy, happy, and safe. In addition, there may be specific tests and immunizations (see chapter 9, Vaccines) recommended, depending on the age of your baby at each visit.

You can always schedule an additional appointment for your baby at any time if any specific problems or concerns arise between well-child examinations.

6.When can we take our newborn out?

Whether you’re thinking of going outside, inside, or high up in the sky, a good rule of thumb is to stay away from crowds of people until your baby is 6 to 8 weeks of age, if at all possible. This is because a newborn’s immune system is still maturing, which leaves her more susceptible to catching colds, as well as becoming seriously ill very quickly. Avoid any closed areas where your baby could be exposed to lots of people who may be sick, such as grocery stores, malls, movie theaters, parties, or airplanes. Especially during the winter, it’s best to assume that everyone is contagious—some people may not show outward symptoms but can still spread germs! Whenever possible, don’t let anyone who is obviously ill get near your baby. Try to keep young children away because they tend to be even less able to keep their hands and germs to themselves. And, try to decrease the number of people who touch, breathe on, and cough on your baby.

Now that you know what to avoid, going outside is totally fine. Dress your baby appropriately (see the following Dr. Tanya’s Tip: Is My Baby Too Hot or Too Cold?) and go for a walk in your neighborhood or enjoy a stroll outside.

Dr. Tanya’s Tip

Is My Baby Too Hot or Too Cold?

You can’t really know—unless you carry around a thermometer everywhere you go (which isn’t realistic or recommended)! This is because babies don’t always sweat or shiver when you might expect them to, and they can’t yet tell you how they feel. The general rule is that babies should wear as many layers as you are wearing. It’s all right to add one more layer if it makes you (or seems to make your baby) more comfortable. It’s not necessary to drastically change the thermostat in your house just because you have a newborn (since parents always ask, 69 to 72 degrees is a good normal range)—just dress her appropriately. If it is a hot day and you are only wearing a T-shirt and shorts, your baby should be okay in a onesie. If it is cooler out and you need a sweater and jacket, dress your baby the same. A hat is always a good idea—if it stays on!