New Babycare

DR. miriamstoppard

& ed ed vis at re pd u

new babycare A practical guide to the first three years

new

babycare

new

babycare DR.miriam

stoppard B9;G8E

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www.dk.com

EgZ[VXZ I’ve learned a lot about babycare in the last five years or so. The lessons have come from my children (four sons), my stepchildren (two daughters), my daughters-in-law, and my 11 grandchildren. The basics of child development and the principles of baby and child nurturing change little, but there’s room for progress and improvement in all sorts of subtle ways. Some of these just nudge us in a different direction while others seem so fundamental we ask ourselves what took so long. I’m grateful to all the new members of my extended family for all of them have taught me something useful—even the youngest, Maggie and Evie, my identical twin granddaughters. It’s been thrilling to listen to, observe, note, learn, and inwardly digest the hundreds of small things that have refined my thinking about baby and childcare. They’re all reflected in this new edition of one of my favorite books.

 8dciZcih 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Introduction The newborn Equipment Clothing Holding and handling All about diapers Bathing and hygiene Feeding Bowel and bladder function Sleeping Crying Physical development Intellectual development Social behavior Playing Outings and travel Home safety Home medicine

8 20 32 40 50 58 70 86 132 142 158 178 206 236 264 282 292 308

Index Acknowledgments

344 352

>cigdYjXi^dc There must be parents who feel nothing but joy at the news that they are expecting a baby, but they are few and far between. Once the initial excitement is over, most parents would confess to having mixed feelings about the prospect of having a baby.

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INTRODUCTION 15 [dXjheZg[ZXianlZaaViVY^hiVcXZd[-·&% ^cX]Zh'%·'*XZci^bZiZghVcYi]Vi¼h l]ZgZndjg[VXZVcYndjg]VcYhh]djaYWZ ^[ndjlVcindjgWVWnidgZXd\c^oZndj VcYlViX]ndj#7VW^ZhgZhedcYidh^\]ih! hdjcYh!hbZaah!idjX]Zh!XdckZghVi^dch! VcYVbW^ZcXZhVhhddcVhi]ZnZciZgi]Z ldgaY#>[eVgZcihgZVa^oZi]^hVcYiV`Zi]^h [VXihZg^djhan^iejihi]Zb^cV]^\]an gZhedch^WaZedh^i^dc#>ibZVchi]Vii]Zn! VcYcdiiZVX]Zgh!VgZgZhedch^WaZ[dgV X]^aY¼h[^ghiaZVgc^c\# Ndjl^aacdidcanWZiZVX]ZgWji eaVnbViZ!XdjchZadg!ZYjXVidg!VcY Y^hX^ea^cVg^Vc#Ndjg^c[ajZcXZl^aaWZe^kdiVa# 6X]^aYaZVgch[gdb^iheVgZcih¼[g^ZcYh]^e VcY]dhi^a^in!]Vee^cZhhVcYhVYcZhh! XdciZciVcYY^hXdciZci¸i]ZWajZeg^ci[dg V adk^c\gZaVi^dch]^eVcYi]ZVgX]^iZXijgZ d[VXdckZghVi^dc#>cYZZYVWVWn^h XdckZgh^c\^cVhh]dgiVi^bZVhildlZZ`h hdndjcZZYid`cdl]dlidgZXd\c^oZ eg^b^i^kZWVWnXdckZghVi^dc#6aai]ZZVgan h`^aah¸lVa`^c\!iVa`^c\!hdX^Va^o^c\!VcY ^ciZaaZXijVaYZkZadebZci¸VgZVWhdajiZan ^ci]ZeVgZcih¼]VcYhVcYcddcZZahZ^h XjaeVWaZ ^[i]^c\h\dlgdc\#I]^hbZVch i]VibdYZgceVgZcih]VkZidWZVXi^kZ! ^ciZgZhiZYeVgZcihl]diV`Zi]Z^ggdaZh Vh iZVX]ZghhZg^djhanVcYl^i]YZY^XVi^dc! [gdbi]ZbdbZcii]ZWVWn^hWdgc#

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INTRODUCTION 19

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Soon after delivery, your baby will be examined and his weight, head circumference, and length will be measured in order to form a baseline against which his future development will be assessed. Don’t try to compare your baby with others; doctors and midwives don’t. The only comparisons that should be made are with himself at different stages. The average birth weight is 5 pounds 8 ounces–9 pounds 12 ounces (2.5–4.5 kilograms), but if your baby is smaller, don’t worry. The normal range varies according to genetics, race, and nutrition. The average length of a new baby is 19–20 inches (48–51 centimeters), but again big variations are common.

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WVWn¼hgddbViVXdch^hiZciiZbeZgVijgZ! VgdjcY+*·+-à;&+·'%à8#7ajZbVg`hVahd XVaaZYBdc\da^Vchedih!l]^X]add`a^`Z Wgj^hZh!d[iZcdXXjgdci]ZadlZgWVX`h d[WVW^Zhl^i]YVg`h`^cidcZhcZVganVaa 6[g^XVc!=^heVc^X$AVi^cd!VcY6h^VcWVW^Zh ]VkZi]Zb#I]ZnVgZXdbeaZiZan]VgbaZhh VcY[VYZVlVncVijgVaan# Jaundice BVcn]ZVai]ncZlWdgc^c[Vcih YZkZadeha^\]i_VjcY^XZ¸VnZaadl^h] Y^hXdadgVi^dcd[i]Zh`^cVcYi]Zl]^iZh d[i]ZZnZh¸dcVWdjii]Zi]^gYYVnd[a^[Z# I]^h^h`cdlcVhe]nh^dad\^XVa_VjcY^XZ! WZXVjhZ^i^hcdiVY^hZVhZ#>igZhjaih[gdb i]ZWVWn¼hWaddY]Vk^c\V]^\]XdciZcid[ eg^b^i^kZgZYXZaah!l]^X]VgZWgd`ZcYdlc V[iZgW^gi]#L]ZcgZYXZaahVgZWgd`Zc Ydlc!dcZd[i]Z^gXdchi^ijZcieVgih!i]Z nZaadle^\bZciXVaaZYW^a^gjW^c!^cXgZVhZh^c i]ZWaddYVcYXVjhZhi]Zh`^cVcYZnZhid Xdadg#E]nh^dad\^XVa_VjcY^XZh]djaYXaZVgWn i]ZZcYd[i]Z[^ghilZZ`!Vhadc\Vhi]Z WVWn^h[ZZY^c\lZaa#

The umbilicus >bbZY^ViZanV[iZgW^gi]i]ZjbW^a^XVaXdgY ^h XjiVWdji(·)^cX]Zh-·&%XZci^bZiZgh [gdbi]ZWVWn¼hVWYdbZc#EgZhhjgZ^h ZmZgiZYdc^iWnVXaVbeVcYi]Zhijbe h]g^kZahVcYYgdehd[[l^i]^c&%YVnhdghd# HdbZWVW^ZhYZkZadejbW^a^XVa]Zgc^Vh hbVaahlZaa^c\hcZVgi]ZcVkZa!Wjii]ZhZ cZVganValVnhXaZVgjel^i]^cVnZVg#>[ndjg WVWn]VhdcZVcY^iZcaVg\ZhdgeZgh^hih! X]ZX`l^i]ndjgeZY^Vig^X^Vc#

The breasts 7di]bVaZVcY[ZbVaZWVW^ZhXVc]VkZ hldaaZcWgZVhihViW^gi]0i]ZnbVnZkZc ]VkZVha^\]iY^hX]Vg\Zd[b^a`#I]^h^h XVjhZYWni]ZegZhZcXZd[bViZgcVa

24 THE NEWBORN ]dgbdcZh^ci]ZWVWn¼hWdYnVcY^i gZhdakZhcVijgVaan#CZkZgignidhfjZZoZVcn d[i]Zb^a`dji#I]ZhlZaa^c\l^aahjWh^YZ l^i]^cVXdjeaZd[YVnh#

The genitals I]Z\Zc^iVahd[Wdi]WdnhVcY\^gahVgZ cVijgVaanaVg\ZgViW^gi]i]Vci]ZgZhid[ i]Z^gWdY^Zh#I]ZhXgdijbdgkjakVbVn ZkZcadd`gZYVcY^c[aVbZY#I]^h^hV cVijgVadXXjggZcXZVcY^hXVjhZYWni]Z bdi]Zg¼h]dgbdcZhXgdhh^c\i]ZeaVXZciV ^cidi]ZWVWn¼hWaddYhigZVb#I]ZhZ ]dgbdcZhbVnVahdXVjhZVXaZVgdgl]^iZ Y^hX]Vg\Z^c[ZbVaZWVW^Zh!VcYZkZcV hbVaaVbdjcid[ kV\^cVaWaZZY^c\#DcXZ V\V^c!i]^h^heZg[ZXiancdgbVaVcYl^aaXaZVg

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Stools 6WVWn¼h[^ghihiddahVgZjhjVaanYVg`\gZZc VcYhi^X`nVcY]VkZkZgna^iiaZhbZaa#I]^h^h WZXVjhZi]ZnVgZbV^canbZXdc^jb!l]^X] ^hY^\ZhiZYbjXjh[gdbi]ZbjXjh\aVcYh ^ci]ZWdlZa#>i^hi]Zdcan`^cYd[bdi^dc ndjgWVWnl^aaeVhh[dgi]Z[^ghiild dgi]gZZYVnh#
COMMON BLEMISHES Birthmarks Quite commonly there are small red marks on a baby’s skin, particularly on the eyelids, on the forehead, and if you lift up the hair, at the back of the neck just under the hairline. They result from the enlargement of tiny blood vessels near the surface of the skin and are traditionally called stork bites. Both of my sons had them and they disappeared, as they do in most children, by the time they were six months old. In some babies, however, these marks may not disappear until they are about 18 months. Another common birthmark is the so-called strawberry mark. This appears after a couple of days but fades before the child is three years old. If you’re at all worried by your baby’s birthmark, ask your pediatrician for advice and reassurance. Pimples It is not unusual for a baby to have small white pimples over the bridge of the nose, called milia. These pimples are not abnormal so never, ever

squeeze them. They are caused by a temporary blockage of the sweat glands and sebaceous glands that secrete sebum to lubricate the skin. They nearly always disappear after a few days. Rashes Many babies develop a skin condition called FSZUIFNB
UPYJDVN. The baby’s skin becomes red and blotchy, with small white bumps that appear and disappear quite rapidly. The whole rash only lasts for a couple of days and will disappear without treatment. If you’re in any doubt, you should talk to your pediatrician.

Body hair Babies are born with varying amounts of hair, called lanugo, on their bodies. Some babies have only a soft down on their heads, others are covered in very coarse hair over their shoulders and down their spines. Both are quite normal, and the hair usually rubs off soon after birth.

NEWBORN BEHAVIOR 25

Newborn behavior >[ndjXdcXZcigViZdcndjgWVWnVcY dWhZgkZ]^bXVgZ[jaandkZgi]Z[^ghiilddg i]gZZYVnhd[a^[Z!ndjl^aaWZXdbZ[Vb^a^Vg l^i]cdgbVa^c[VciWZ]Vk^dgVcYl^aa\Zi VXXjhidbZYidndjgWVWn¼h^Y^dhncXgVh^Zh# >i ^hZhhZci^Vai]VindjaZVgcidjcYZghiVcY ]^hh^\cVah0hiVnl^i]]^bVhbjX]Vh edhh^WaZ!idlViX]]^b!cjghZ]^b!VcY eaVnl^i]]^b# >[ndjdWhZgkZ]^bXadhZanndjbVn cdi^XZi]Vi]ZYdZhhZkZgVajcZmeZXiZY i]^c\h/]ZbVnh]^kZgfj^iZhjYYZcan[dgcd gZVhdc0]ZbVnbV`ZhdbVcnhcj[[a^c\ cd^hZhi]VindjldcYZg^[]^hcdhZVcYV^g eVhhV\ZhVgZWadX`ZY0]ZbVnZkZchide WgZVi]^c\Vaid\Zi]Zg[dghZkZgVahZXdcYh# CdcZd[i]ZhZWZ]Vk^dgh^hVWcdgbVa#>ci]Z [^ghilZZ`hd[a^[ZndjgWVWnl^aaWZ\^kZcV ]ZVg^c\hXgZZc^c\iZhiWni]Z]dhe^iVa#

Sounds Breathing6cZlWdgcWVWn¼hajc\hVgZ hbVaaVcYWgZVi]^c\l^aahZZbh]Vaadl l]ZcXdbeVgZYiddjgh#L]Zcndj[^ghi \didndjgWVWnndjbVnWZjcVWaZid YZiZXii]Vi]Z^hWgZVi]^c\#9dc¼iWZ [g^\]iZcZYWni]^hWZXVjhZi]ZWgZVi]^c\ l^aa\Zihigdc\ZgZVX]YVn# 6aacZlWdgcWVW^ZhbV`ZhigVc\Z hdjcYhl]Zci]ZnWgZVi]Z#HdbZi^bZh i]Z WgZVi]^c\^h[VhiVcYcd^hnVcYVidi]Zg i^bZh^ibVnWZ^ggZ\jaVg#NdjgWVWnbVn hcj[[aZl^i]ZVX]WgZVi]^cVcYdjiVcY ndjbVni]^c`]Z]Vh\diVXdaY#I]^h^h cdicZXZhhVg^anhd#>cbdhiWVW^Zh^i^h WZXVjhZi]ZWg^Y\Zd[i]ZcdhZ^hadl! VcY i]Zhcj[[a^c\cd^hZ^hXVjhZYWni]ZV^g ign^c\id\Zii]gdj\]i]ZkZgnhbVaacVhVa

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26 THE NEWBORN VcYVgZVh^\ci]Vii]ZbjhXaZh^ckdakZY^c gZhe^gVi^dc¸i]dhZWZilZZci]Zg^Wh!i]Z Y^Ve]gV\b!VcYi]ZVWYdbZc¸VgZ\Zii^c\ higdc\ZgVcYign^c\idldg`^c]Vgbdcn#

Reflexes and movements 6aacZlWdgcWVW^Zh]VkZgZ[aZmZh!l]^X] VgZ^chi^cXi^kZbdkZbZcihYZh^\cZYid egdiZXii]Zb#I]ZhZgZ[aZmZhaVhijci^a kdajciVgnbdkZbZcihdcndjgWVWn¼heVgi iV`Zi]Z^geaVXZ!\ZcZgVaanVgdjcYi]gZZ bdci]hdaY#Ildd[i]ZbdhiZVhngZ[aZmZh idZa^X^iVgZi]dhZi]ViegdiZXii]ZZnZhVcY i]dhZi]VibV^ciV^cWgZVi]^c\/ndjgWVWn l^aaXadhZ]^hZnZh^[ndjidjX]]^hZnZa^Yh VcYl^aabV`Zhigj\\a^c\bdkZbZcihl^i] ]^h]VcYh^[ndj\Zcian]daY]^hcdhZ WZilZZcndjgi]jbWVcY[dgZ[^c\Zg# The rooting reflex>[ndj\Zcianhigd`Z ndjgWVWn¼hX]ZZ`ndjl^aa[^cYi]Vi]Z ijgch]^h]ZVY^ci]ZY^gZXi^dcd[ndjg [^c\ZgVcYdeZch]^hbdji]#=ZbV`Zhi]^h gddi^c\bdkZbZcil]Zc]Z^hhZVgX]^c\

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28 THE NEWBORN

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30 THE NEWBORN

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34 EQUIPMENT

CHANGING AND BATHING EQUIPMENT New baby • Changing unit with storage drawers • Padded changing mat • Changing bag for going out, with a folding changing mat • Baby bathtub • Cotton balls • Baby wipes • Baby oil • Barrier cream • Large soft towels • Washcloth or sponge • Baby’s hair brush • Blunt-ended scissors • 4 packs disposable diapers or • 24 cloth diapers Diaper liners Diaper pins Plastic pants 2 diaper buckets

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Older baby • Toothbrush • Bath seat and/or nonslip mat for big bath • Potty • Steps for reaching the sink

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CHOOSING EQUIPMENT 35

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FEEDING EQUIPMENT New baby/breast-feeding • Nursing bra • Breast pads • Breast pump if you need to express milk • Bottles or breast milk storage containers for expressed milk New baby/bottle-feeding • Bottles • Nipples • Formula • Large pot for boiling bottles and sterillizing the nipples • Bottle brush Older baby • Plastic bowls • Baby spoons and forks • Trainer cups • Blender or liquidizer • Bibs • Highchair and/or booster seat • Safety harness

36 EQUIPMENT

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SLEEP EQUIPMENT AND ACCESSORIES New baby • Baby carrier • Waterproof sheet to protect mattress (tie-on sheets are good) • Cotton sheets • Cotton cellular blankets • Fleecy blanket • Baby monitor Older baby • Full-size crib with foam mattress • Crib comforter (for babies over 12 months)

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Additional equipment :kZcndjc\WVW^Zha^`ZidhZZl]Vi¼h\d^c\ dcVgdjcYi]ZbVcYVWdjcX^c\WVWnX]V^g ^hjhZ[ja[dgVWVWnWZ[dgZh]ZXVch^i# 6alVnheaVXZi]ZX]V^gdci]Z[addgVcY bV`ZhjgZh]Z^hhV[ZanhigVeeZY^c# 6ai]dj\]bVcneZdeaZ[^cYeaVneZch gZb^c^hXZcid[VWVWneg^hdc!hdbZ[^cY i]Zb^ckVajVWaZ#>[ndjYZX^YZidWjndcZ ndjgX]d^XZl^aaWZWZilZZcVXdaaVeh^WaZ cnadc"bZh]ZYeZcVcYgV^a!dgVhfjVgZ lddYZceZc0Wdi]]VkZVeVYYZYWVhZ#

CARRYING EQUIPMENT • Front-carrying fabric sling with neck support for newborns. Make sure it’s washable.

• Backpack for an older baby. • Carriage with solid body and collapsible fabric hood, or • Carriage with removable carrier, or • Folding stroller that reclines for a young baby (there are many types available, ask other people which they prefer), or • Carriage/carrier combination—can be used as a carrier on wheels for young baby and converts into a stroller. There are combinations called travel systems that include a car seat, or • All-terrain, three-wheeler stroller. • Sunshade for summer. • Waterproof cover for stroller. • Rear-facing car seat for baby up to 20 pounds (9 kilograms). • Front-facing car seat for older child—this is compulsory in many states, up to various ages and weights. Check your local regulations • Changing bag to carry spare clothes/diapers.

38 EQUIPMENT

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BASIC FURNISHINGS • Baby carrier and stand. • Crib (you can put a baby carrier in the crib to begin with). • Changing area with storage for diapers and other items. • Storage for clothes and toys. • Baby monitor so you can hear her if she wakes or cries. • Low chair where you can sit when feeding. • Thick curtains or good blinds to keep the room warm and dark. • Dimmer switch to provide low levels of light for night changing or feedings. • Shelves for books and toys. • Mobiles hung over the crib and changing area. • Pictures on the walls and on a bulletin board in her room. Change the pictures regularly to keep her interested.

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ADAPTING A ROOM FOR A TODDLER • Nonslip rugs to make wooden floors cosier to sit on.

• Bedside table for nightlight and drinks; make

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sure she can’t pull on cords. • Low table and chair where your toddler can sit and draw and play. • Low hook where she can hang up her coat. • Bulletin board for her special pictures. • Toy boxes on wheels.



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All parents take great pride in their new baby’s appearance and it’s very tempting for you and your family and friends to rush out and buy lots of clothes for him. It’s up to you what you choose, but there’s absolutely no need to spend a lot of money. Remember that your child is going to grow rapidly during these first years, and he will grow out of clothes very quickly. As far as your baby is concerned, he doesn’t mind what he wears as long as it is soft and comfortable and can be put on and taken off without too much trouble.

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BASICS FOR A NEW BABY • 6–8 T-shirts/undershirts or Onesies • 6–8 one-piece stretchies/pajamas • 2 cardigans/sweaters (4 for winter babies) • 2–3 pair of socks and padders • 2 pair of mittens • 2 nightgowns (choose one with drawstring

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bottoms to keep feet warm)

• 1 blanket or shawl • Protective clothing and sunhat for sun protection

• One-piece snowsuit for winter

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42 CLOTHING

BUYING CLOTHES FOR A NEWBORN • Whatever sizing system the manufacturer uses, make sure you buy a size that will last until your baby’s at least two months old. He won’t be uncomfortable if his clothes are slightly too big. It’s more practical than buying the newborn size, which he’ll quickly grow out of. • Buy only machine-washable, colorfast clothing for your baby. • Make sure any clothing you buy allows easy access to the diaper, so there’s the minimum of undressing involved. One-piece stretchies with snaps in the crotch or down the front and legs are the easiest to put on. • In the early weeks, you may find it simplest to use nightdresses that can just be lifted up to get at the diaper. • Clothes that open down the front or have wide necks are the best because babies hate having their faces covered. • Clothes that fasten up the front also mean you don’t have to turn your baby over when you’re dressing him. • Material should be soft and comfortable with no hard seams or rough stitching; check the neck and waistband before buying. Buy terry cloth, cotton, or pure wool clothes; if you buy clothes made of man-made fibers check that they feel soft and comfortable. • Buy nonflammable clothing. • Avoid lacy shawls or cardigans—your baby’s tiny fingers can easily get caught in the holes. • Avoid white—it gets dirty quickly and needs more care when washing. Babies look as nice in bright colors as in the pastels traditionally specified for them. • If you buy a hat, either buy one with a chinstrap, or sew some ribbon on it. Many babies hate wearing hats and pull them off unless they’re tied on under the chin.

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DRESSING A BABY—BIRTH TO 1 YEAR 43

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44 CLOTHING

PUTTING ON A STRETCH SUIT

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DRESSING A BABY—BIRTH TO 1 YEAR 45

UNDRESSING A NEWBORN

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DEALING WITH STAINS Vomit/feces

Use an enzyme-containing detergent after you’ve removed the vomit and rinsed the garment with cold water.

Milk

Remove milk stains by rinsing the clothing thoroughly in cold water and then using an enzyme-containing detergent.

Egg

If there is an egg stain on clothing, soak in cold water for an hour before laundering in the usual way.

Fruit and chocolate

Douse tough stains such as chocolate or grape juice with seltzer, rub until the discoloration has gone, then wash as usual.

Blood

Soak bloodstains in cold water for thirty minutes. If they don’t come out use an enzyme-containing detergent. If this fails, try a few drops of ammonia on the stain.

Lipstick

Dab stain with a soft white cloth that’s been dipped in rubbing alcohol; or use a pre-wash stain stick, then wash as normal.

Grass

Remove grass stains with alcohol if they are resistant to laundering.

Chewing gum

Soften the gum with paint thinner before gently pulling the gum away from the fabric, or freeze the garment and scrape it off.

46 CLOTHING

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CHOOSING CLOTHES—1 TO 3 YEARS 47

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MAKING CLOTHES LAST • When foot pajamas get too short for comfort, cut off the feet for an extra month’s wear.

• Reinforce the knees on the inside of new jeans with the extra fabric you trim from the bottom of the legs, or use iron-on patches. • Make summer shorts from long winter pants that are too short or have gotten worn at the knees. • When your child outgrows an expensive jacket, you can cut out the sleeves and let her wear it as a vest. • Run a dark blue crayon, indelible pencil, or a fountain pen filled with blue/black ink over the white line when jeans have been let down.

48 CLOTHING

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CHOOSING CLOTHES—1 TO 3 YEARS 49

CHOOSING SHOES FOR TODDLERS There’s no need to put your baby into shoes until he’s walking. The bones in your baby’s feet are soft and pliable—so pliable that even the pressure of tightly fitting socks can misshape toes if your baby wears them regularly. When it’s very cold, or when he starts to crawl, you can put on socks or booties, but make sure there’s plenty of room for his feet to move around. When buying shoes, go to a reputable shoe store and make sure the assistant has been trained to measure and fit children’s shoes. She should always measure the foot for width and length before bringing any shoes for your child to try on. Once the shoes are on, she should press the joints of the foot to check that the foot is not restricted in any way and be sure that the buckle or laces hold it firmly in place and don’t let it slip. Ask your child to walk around in the shoes to be sure the toe doesn’t crease up and hurt when he’s walking and to double-check there’s no slipping. The type of shoe you buy will be determined by when and where it is to be worn. Your child will need a sturdy, well made pair of leather shoes once he is running around and playing outdoors, and 6QQFST
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HANDLING YOUR BABY—BIRTH TO 1 YEAR 53 In a sling I]ZgZ^hcdgZVhdcViVaal]n ndjgcZlWdgch]djaYc¼iWZXVgg^ZY^cV ha^c\!Vhadc\Vh^iegdk^YZhVYZfjViZ hjeedgi[dgi]ZWVWn¼hcZX`VcY]ZVYVcY ZckZadehi]ZWVWn¼hWdYnhdh]ZXVc¼iha^e djid[Z^i]Zgh^YZ#I]ZWZhi`^cYd[ha^c\^h i]ZkZgnhd[i!edjX]a^`ZdcZi]ViVaadlh i]ZWVWnidgZhi^cXjgaZYedh^i^dc#Bdhi eVgZcih[ZZa]Vee^ZhilZVg^c\i]Zha^c\dc i]Z^gX]Zhil]ZgZi]ZnXVchZZVcYXjYYaZ i]ZWVWnZVh^anVcY\ZcZgVaanegdiZXi]Zg bdgZZ[[ZXi^kZan#

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AVOIDING BACK STRAIN Babies and toddlers inevitably require lots of lifting and carrying, not to mention the carriages, strollers, and other equipment that go along with them. It is important for the protection of your back that you learn a lifting technique that avoids injury and strain. Don’t lift with straight legs and curved back, because this puts strain on your back. Instead, keep your back straight, bend your knees, and lift, using your powerful thigh muscles to take the weight.

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Until your child starts to use the potty, probably some time during the third year, he will have to wear diapers both day and night. During the first few months life may seem like an endless round of diaper changing. But don’t despair. As your child grows and gains more control over bowel and bladder muscles, he will go for longer without excreting and urinating and the number of diapers you need to change will decrease. By about two and a half, he will probably become aware of wanting to go to the bathroom. It is at this point, and not before, that you should start toilet training.

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DISPOSABLE DIAPERS—BIRTH TO 1 YEAR 61

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62 ALL ABOUT DIAPERS

HOW TO PUT ON A DISPOSABLE DIAPER

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CHOOSING DISPOSABLE DIAPERS There are many different types of disposable diaper to choose from and they come in a variety of sizes to fit the age and weight of your baby. When trying them, consider the following: • How absorbent is the diaper and does it keep your baby’s bottom dry? • Is it comfortable around the legs and does it fit around the body well? Check for any hard edges that might irritate your baby. • You’ll need to balance price against efficiency. Buying cheaper diapers might be a false economy if they are not as absorbent or effective as a more expensive brand.

64 ALL ABOUT DIAPERS

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DIAPERS AND ACCESSORIES Here is a selection of reusable diapers and equipment. Provided your baby is changed regularly he will be happy in any style.

PLASTIC COVER

FFABRIC DIAPER LINER

FABRIC DIAPER WITH VELCRO FASTENER

LINERS AND SAFETY PINS

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HOW TO PUT ON AN ALL-IN-ONE CLOTH DIAPER

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Diaper washing routine

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TIPS FOR USING CLOTH DIAPERS • Use a disposable inside a cloth diaper for extra absorbency at night. You can also use this method when you’re traveling and want to avoid an awkward change. • Use stretch fabric covers over plastic covers— they look neater than plastic covers on their own. Frilly and patterned plastic covers are also available if you want something prettier. • Always keep your fingers between the diaper and the skin if fixing with a pin. • When you’ve put on the diaper run your fingers around the legs to be sure it’s not too tight. • To save time, fold all the diapers ready for use and put the diaper liners in position. • Make sure that the diaper fits snugly around your baby’s body. It gradually gives, so if it’s too loose it will slide down.

Tips for washing fabric diapers • Keep plastic gloves near the sterilizing bucket for lifting diapers out; or use plastic tongs. • If you use powder sterilizer, always put the water in before the powder. Otherwise the powder spreads through the air when you add the water and you may inhale it. • Both drying in the open air and in a tumble drier keep the fabric softer. Drying on the radiator tends to harden the fabric. It’s better to invest in a rack to place over the bath or use a pull-out clothesline if you can’t dry outdoors or in a tumble drier. • Keep any diapers changed at night in a separate bucket, or in a large plastic bag, and add them to the new day’s solution the following morning. • Some buckets have special holders for air fresheners. If yours doesn’t, hook a piece of wire through a freshener and attach it above the waterline.

68 ALL ABOUT DIAPERS

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DIAPER RASH CHART Appearance

Cause

Treatment

Redness and broken skin in the leg folds.

Inadequate drying after bathing.

Meticulous and thorough drying. Do not use powder.

Rash that starts around the genitals rather than the anus. Strong smell of ammonia.

Ammonia dermatitis.

General diaper rash treatment, above. If this doesn’t work, seek medical advice.

Spotty rash all over the genitals, bottom, groin, and thighs, which eventually leads to thick and wrinkled skin.

Extreme form of ammonia dermatitis.

Seek medical advice if rash persists after trying general treatment, above, first.

Rash that starts around the anus and moves onto the buttocks.

Thrush.

Get medical advice. You will probably be given nystatin cream and medicine.

Brownish-red scaly rash on the genitals and buttocks and anywhere the skin is greasy.

Seborrhoeic dermatitis.

Ointment for rash, prescribed by your doctor. You might also get a special lotion if the scalp is very scaly and sore.

Small blisters all over the diaper area.

Heat rash.

Don’t use plastic covers, and leave off the diaper as much as possible.

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Part of your daily routine is to keep your baby clean. This will be reasonably easy when she’s very small, but as your baby becomes more active you’ll find that you will not only have to clean her more often, but also that the daily bath will require more effort. By the time she’s two she may want to try washing herself.

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TOPPING AND TTAILING A YOUNG BABY This means cleaning your baby by washing her face, hands and diaper area, without undressing her completely. Remove her clothes, leaving her

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GIVING YOUR BABY A BATH It is important that your baby doesn’t get cold when being bathed, so make sure the room is warm and free of drafts, and that you have everything you

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GIVING YOUR BABY A SPONGE BATH If you’re nervous about giving your baby a bath, or if she really hates being undressed, give her a sponge bath. Get everything you need ready. Sit her

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76 BATHING AND HYGIENE

BATHTUB BATHING TIPS • Always run cold water first. If you start with hot water, the bottom of the tub may be too hot and could burn the baby. • Cover up hot faucets with a washcloth or towel so there’s no risk of scalding. • Don’t pour more hot water into the tub while the baby is in it—she could be scalded. • Make sure that you put your baby in the tub (and lift her out of the tub) with your back straight, taking the strain with your thighs. • Don’t let your baby stand up in the tub without your support—she could slip and fall. • If your child starts to jump up and down in the tub—no doubt rejoicing in a newly found skill —be very firm about making her sit down again, or she could easily topple over. • Don’t be tempted to see if your baby can sit unsupported. She could easily tumble under the water and get a bad scare—bad enough to put her off baths for a while. • Never, ever, leave your baby alone in the tub. Even if you turn around for a moment she could slip under the water and drown. • Don’t let the water out while the baby’s in the tub. She may be frightened by the disappearing water and by the noise. • Don’t dust your baby with talcum powder after a bath—it’s very drying to the skin and can cause irritation. • If you’re at work during the day, make the most of bathtime—it can be a great time to play and relax with your baby. • Have some toys exclusively for use in the tub, to make bathtime a special treat.

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78 BATHING AND HYGIENE HdbZWVW^ZhYZkZadejbW^a^XVa]Zgc^Vhsee p.23#I]ZncZVganValVnhXaZVgjel^i]^c VnZVgdgild#>[ndjgWVWn]VhdcZVcY^i ZcaVg\ZhdgeZgh^hih!hZZ`bZY^XVaVYk^XZ#

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Possible bathtime problems W^gi]id&nZVg Fear of undressing BVcnndjc\WVW^ZhWZXdbZZmigZbZan Y^higZhhZYl]Zci]ZnVgZjcYgZhhZY# 7VW^Zh ]ViZi]Z[ZZa^c\d[V^gdci]Z^g WdY^Zh!egZ[Zgg^c\^chiZVYi]ZhZXjg^ind[ WZ^c\[jaan Xadi]ZYdgi^\]ianlgVeeZY# L]Zcndjg WVWn^hkZgnndjc\!ndjXVc\Zi VgdjcYi]^hWnidee^c\VcYiV^a^c\ or \^k^c\ Vhedc\ZWVi]see pp.72–74#

Fear of bathing >[ndjgWVWn^hVWhdajiZaniZgg^[^ZYd[]Vk^c\ VWVi]!h`^e^i[dgVXdjeaZd[YVnhVcY i]ZcignV\V^c!kZgn\Zcian!jh^c\dcanV a^iiaZlViZg^ci]ZijW#Jci^andjgWVWn^h gZVYnid\dWVX`^cidi]ZWVi]ijW!\^kZ hedc\ZWVi]hdgideVcYiV^a# >[!V[iZghdbZi^bZ!h]Zhi^aaYdZhc¼ia^`Z WZ^c\WVi]ZYVcY^hhi^aa[g^\]iZcZYd[

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WASHING YOUR BABY—BIRTH TO 1 YEAR 79

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WASHING YOUR BABY—BIRTH TO 1 YEAR 81

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82 BATHING AND HYGIENE

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WASHING YOUR TODDLER—1 TO 3 YEARS 83 dg\gVWi]ZhdVedgh]VbeddVcY\Zi hdbZ^c]ZgZnZh#8dkZg^c\i]Z[VjXZih l^i]VidlZa^hV\ddYlVnidhd[iZcVcn [VaahdgWVc\h#

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84 BATHING AND HYGIENE

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WASHING YOUR TODDLER—1 TO 3 YEARS 85 NdjXdjaYbV`ZV\VbZdjid[]V^g lVh]^c\#>il^aaWZXdbZbjX]bdgZ[jc[dg ndjgX]^aY^[ndj\Zi^cidi]ZWVi]ijW!idd! VcYlVh]ndjgdlc]V^gVii]ZhVbZi^bZ# G^chZ^il^i]V eaVhi^XXdciV^cZgd[lViZgVcY h]dl]Zgi]Vi^i¼h[jcedjg^c\lViZgdkZg ndjg]ZVY# >[ndj]VkZVcdaYZgX]^aY!ndjXVc egdkZ^iYdZhc¼i]jgiWnaZii^c\i]Zndjc\Zg X]^aY]ZaendjlVh]]Zgh^Wa^c\¼h]V^g#DcXZ ndj¼kZaVi]ZgZYi]Zh]Vbedd!]daYi]Z [g^\]iZcZYX]^aYVcYaZi]ZggjWWdi]d[]Zg ]VcYhi]gdj\]i]ZWjWWaZh#>[edhh^WaZ!aZi ]Zgid]Zaeedjgi]Zg^chZlViZg!idd#Ndj XVcVahdlVh]VYdaa¼h]V^g^ci]ZijWl^i] ndjgidYYaZg¼hVhh^hiVcXZ#AZindjgX]^aY ]Zael^i]i]Zh]VbeddVcYg^chZ!i]Zc hj\\Zhii]VindjYd^iid]Zg]V^g#L^i]Vcn ajX`h]Z¼aaiV`Zi]^hVheVgid[i]Z\VbZ# NdjXVcZcXdjgV\ZndjgX]^aYidlZi]Zg dlc]V^gl^i]VlVh]Xadi]!i]ZcejiVi^cn W^id[h]Vbedd^cid]Zg]VcYhhdi]Vih]Z XVceji^idc]Zg]V^g# 6cdaYZgX]^aY^hVahdjhZ[ja^cegdk^c\ i]ViVlZi[VXZ^hc¼ijceaZVhVci#;dg ZmVbeaZ!ndjgdaYZgX]^aYbVnWZegdjYd[ ]daY^c\]ZgWgZVi]jcYZglViZg#DcXZndjg idYYaZg^hVWdjii]gZZ!h]Zb^\]ilVciid _d^c^ci]^h\VbZ!ZkZc^[^ibZVchdcan ejii^c\]ZgcdhZVcYbdji]jcYZgi]Z hjg[VXZl]^aZndjXdjciid[^kZ#

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GETTING HER USED TO WATER Another way of getting your child used to water on her face is to take her swimming. Once she’s got used to splashing and getting her hair wet, you’ll be able to start hair washing. This is especially easy if you take a shower after swimming in the pool. You can then gently and deftly introduce the idea of having a shampoo in the shower, using a nonsting baby shampoo: a quick shampoo should only take a couple of minutes. You can also use the shower attachment at home, encouraging your child to play with the spray, playing it up to her shoulders and eventually onto her hair and face. When she’s used to wet hair, you can then quickly shampoo and rinse it. If she likes swimming in a pool, take advantage of any swimming classes that you can attend with your child where you do most of the teaching (with help from an instructor if you need it). Being able to swim may save your child’s life. If possible, it’s a good idea to make sure that she has learned to swim before she starts school.



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The main aim of infant feeding is to provide adequate nutrition. It helps to bear in mind that while breast-feeding is undoubtedly best if, for any reason, you don’t breast-feed your baby, he’ll still thrive on bottle feeding. Don’t feel guilty if you make this decision; concentrate on the needs of your baby. The love and affection that you give your baby while you’re feeding is as important as any milk. And once he’s on solids, the important rule to remember is to take your lead from your child; as long as you offer a wide variety of foods he doesn’t have to have “essential” foods every day. Remember, above all, that food is a pleasure.

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88 FEEDING

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MILK SUPPLY AND DEMAND FEEDING All mothers are anatomically equipped to feed their babies and there is no such thing as mother’s milk that does not suit a baby: the milk the breasts produce is the baby’s natural food. • There is no such a thing as a mother physically incapable of feeding her baby: the size of your breasts bears no relation to the amount of milk that you can produce, although breast enlargement or reduction surgery can affect your ability to breast-feed. • Milk is produced in deeply buried glands, not the fatty tissue of the breasts, so don’t worry if your breasts are small: they BSFF adequate. The amount of milk that you produce is dependent on how much your baby takes, on the principle of supply and demand. For example, if your baby’s appetite is not very great then your breasts will not produce very much milk because they’re not being stimulated by your baby to do so. If your baby is an eager feeder, your breasts will respond and produce more milk. The amount of milk available for your baby will fluctuate throughout the whole time that you breast-feed, according to how much your baby takes. • If your baby is hungry half an hour after being fed, don’t worry. Your breasts will have produced some milk for your baby to feed on, and they’ll soon build up a supply for his new needs. When the need for more food slows down, the breasts will produce less. • A newborn needs 2–3½ fluid ounces (60–100 milliliters) of milk per 1 pound (500 grams) of body weight, so a 7 pound 11 ounce (3.5 kilogram) baby needs 14–24 fluid ounces (400–650 milliliters) daily. Each breast produces 1½–2 fluid ounces (40–60 milliliters) of milk in three hours so a daily output of 24– 35 fluid ounces (700–1000 milliliters) is ample.

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COLOSTRUM During the 72 hours after delivery, the breasts don’t produce milk. Instead, they manufacture a thin, yellow fluid called colostrum. This fluid is made up of water, protein and minerals and it takes care of all your baby’s nutritional needs during the first days of his life before your breast milk comes in.

Benefits of colostrum Colostrum contains invaluable antibodies that protect your baby against diseases like polio and influenza, as well as intestinal and respiratory infections. It has an additional laxative effect that stimulates the excretion of meconium (TFF
Q). It’s important to give your baby the breast regularly in the first days, both to feed on the colostrum and to get used to latching on to the breast (TFF PQQPTJUF). Every time your baby cries in the early days you can give him your breast, but for only a couple of minutes each side at first so that the nipples don’t get sore. Giving your baby the breast also helps the uterus to contract.

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BREAST-FEEDING—BIRTH TO 1 YEAR 91

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BREAST-FEEDING TIPS • You may find that because your let-down reflex is too efficient, your milk pours out too quickly and chokes the baby as soon as he sucks. You can slow the flow down by expressing a little milk first (TFF
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BREAST-FEEDING—BIRTH TO 1 YEAR 95 jhZi]^hVhVcZmXjhZid_jhi^[n\^k^c\jedc WgZVhi"[ZZY^c\#EaZVhZYdc¼ihjXXjbWid i]^hegZhhjgZ0gZh^hi^iZkZc^[ndjgYdXidg bZci^dch^iidndj!VcYXZgiV^can^[[g^ZcYh VcYgZaVi^kZhYd# :kZgnldbVcXdbZhZfj^eeZYl^i] i]Z bZVchVcYXVeVX^inid[ZZY]ZgWVWn# 7gZVhihgZhedcYidi]ZYZbVcY[dgb^a`Wn egdYjX^c\^i!hd^[ndjgWVWn^hcdiiV`^c\ Vaandjgb^a`^ci]Z^c^i^VahiV\Zhndjh]djaY ignidZmegZhhi]ZgZhihdi]ZYZbVcY[dg b^a`[gdbndjgWgZVhih^h`Zeije#Bdhi WgZVhihgZhedcYidi]^hVeegdVX]l^i]V \ddY[adld[b^a`# 6hndjgX]^aY\ZihdaYZgVcYeZg]Veh ]VhWdjihd[Xgn^c\!hdbZdcZl^aacjY\Z ndjVcYhVni]ZWVWn^h]jc\gn#NdjbVn ]VkZ_jhi[ZYndjgWVWn!^cl]^X]XVhZ]Z bVnh^beanWZi]^ghin#I]^hdXXjgh!d[ XdjghZ!VhhddcVhndjhiVgib^mZY[ZZY^c\ WZXVjhZ[ddYcZZYha^fj^YidY^ajiZ^iVcY idWZY^\ZhiZY#Hd^c^i^Vaan!ignndjgWVWn l^i] [aj^YdjcXZ&*b^aa^a^iZghd[eaV^c! XddaZYWd^aZYlViZgidfjZcX]]^hi]^ghi# :kZgncZlbdi]Zg^hldgg^ZYVWdji ]dllZaah]ZXVc[ZZY]ZgWVWnVcYbVn [ZZaVegZhhjgZidjhZhjeeaZbZciVgn WdiiaZh#I]ZViigVXi^dcd[i]ZWdiiaZidVc Vcm^djhbdi]Zg^hi]Vih]ZXVchZZ^chiVcian ]dlbjX]b^a`i]ZWVWn]VhiV`Zc¸Vc VhhjgVcXZcdiVkV^aVWaZl]ZcWgZVhi" [ZZY^c\#7jiignidWZad\^XVaVcYgVi^dcVa VWdji^i!VcYVWdkZVaa]VkZXdc[^YZcXZ^c ndjgVW^a^inid[ZZYndjgWVWn#GZbZbWZg i]ViVWVWniV`Zh-%eZgXZcid[i]Z[ZZY^c\ ^ci]Z[^ghiildidi]gZZb^cjiZhdcZVX] WgZVhi#Hdi]dj\]i]ZWVWnbVnWZXdbZ WdgZYl^i]WZ^c\VindjgWgZVhi!^[]Z]Vh WZZchjX`^c\[dgViaZVhi[^kZb^cjiZh!]Z ]VhVabdhiXZgiV^can]VYZcdj\]b^a`id hVi^h[n]^h]jc\Zg#

ENSURING A GOOD MILK SUPPLY • Rest as much as you can, particularly during the first weeks after the birth of your baby. This is a time when you should sit rather than stand, and lie rather than sit. • Your milk flow will be affected if you are tense, so go through your prenatal relaxation routine and make sure that you have a period to yourself every day when you can lie down. • Go to bed as early as you can. You will be very tired anyway since your sleep patterns will probably be broken by your baby. • As far as the house is concerned, let the housework go. Don’t do anything but the most urgent things. • Make sure your diet is well balanced and protein-rich. Don’t eat a lot of highly refined and processed carbohydrates (cakes, cookies, candy, or chocolates). • You may need iron supplements and possibly some vitamin supplements; ask your doctor. • Drink about 5 pints (3 liters) of fluid every day while you’re breast-feeding; some women find they need a drink near them while feeding. • Most of your milk is produced in the morning when you are rested, so if you constantly rush around or become tense during the day you’ll find by evening that your supply is poor. • If your baby doesn’t take all the milk available in the early feedings of the day, express the remainder. This will ensure that the supply is restored up throughout the day. • Get help and support from everyone around you who is positive and optimistic. TTalk to your pediatrician, lactation consultant, or nurse practitioner; speak to friends who’ve had babies and get advice from them. • If you are unable to give your baby a feeding because you’re away or because you’re ill, express the milk off to keep the supply going.

96 FEEDING I]ZgZbVnWZi^bZh!hjX]Vhl]Zcndj ]VkZVWadX`ZYYjXidgVkZgnhdgZc^eeaZ! l]Zc^i^heV^c[jaidWgZVhi"[ZZY#=VgYVh ^i^h!^i¼hWZhiidVkd^Y\^k^c\ndjgWVWn [dgbjaVYjg^c\i]ZhZeZg^dYh^[ndj edhh^WanXVc#I]ZgZVgZiddbVcnWZcZ[^ih idndjgWVWnWZ^c\ZmXajh^kZanWgZVhi"[ZY [dgi]Z[^ghih^mbdci]h^[^i¼hedhh^WaZ# L]Zc[ZZY^c\^heV^c[ja!bVcnbdi]Zgh egZ[ZgidZmegZhhb^a`[gdbi]ZV[[ZXiZY WgZVhiVcYjhZ^i^cVWdiiaZ#<^k^c\ hjeeaZbZciVgn[dgbjaV[ZZY^c\hXVc jcYZgb^cZi]ZegdYjXi^dcd[WgZVhi"b^a`# 6WVWnl]d]VhWZXdbZjhZYid ndjgc^eeaZbVnY^ha^`ZeaVhi^Xc^eeaZh# Jc[dgijcViZan!^iXVcWZY^[[^XjaiidiZaa l]Zi]ZgndjgWVWn_jhiY^ha^`Zhi]ZWdiiaZ! dg^hcdi]jc\gn#>[ndjeZgh^hi!]Z¼aa ZkZcijVaan\ZijhZYidi]ZWdiiaZ!Wjindj bVni]Zc[^cYi]Vi]ZYdZhc¼ilVciid\d WVX`idi]ZWgZVhi#>[ndjgWgZVhihVgZkZgn hdgZ!ign\^k^c\ndjgWVWnZmegZhhZYb^a` [gdbVhiZg^a^oZYheddcdgXje#

Expressing milk 7diiaZhd[ndjgdlcZmegZhhZYb^a`XVc WZ \^kZcidndjgWVWnl]ZcndjVgZ^aa! ZmigZbZani^gZY!dgVgZaZVk^c\i]ZWVWn l^i]hdbZdcZZahZ#:megZhhZYb^a`XVcWZ `Zei^chiZg^aZXdciV^cZgh^ci]ZgZ[g^\ZgVidg [dgjeid)-]djgh!dg[gdoZcVcY`Zei^c i]Z[gZZoZg[dgjeidh^mbdci]h#I]^hl^aa ZcVWaZndjgeVgicZgdgWVWnh^iiZgid[ZZY ndjgWVWnl^i]ndjgb^a`#6ahd!WZXVjhZ WgZVhihegdYjXZb^a`^cgZhedchZid YZbVcY!ndjbVncZZYidZmegZhhb^a`^c dgYZgid`ZZendjghjeean\d^c\¸^[ndjg WVWn^hegZbVijgZVcYXVc¼inZiWgZVhi" [ZZY![dgZmVbeaZ# B^a`XVcWZZmegZhhZYWn]VcYdgl^i] VWgZVhiejbe#:aZXig^XejbehVgZbdgZ ZmeZch^kZWjiZVh^ZgidjhZi]Vci]Z bVcjVa`^cY#I]ZnXadhZan^b^iViZVWVWn¼h cVijgVahjX`^c\XnXaZVcYVgZWZhi^[ndj cZZYidZmegZhhd[iZc#:kZc^[ndjjhZV ejbe!^i^hldgi]aZVgc^c\i]ZiZX]c^fjZd[ ]VcYZmegZhh^c\^cXVhZndjcZZYidjhZ^i#

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EXPRESSING TIPS • Expressing milk should never hurt. If it does, you’re not doing it correctly. Stop immediately.

• Every piece of equipment and all containers should be sterile; your hands must be clean.

• If you’re worried about your baby not going back to breast-feeding after a feeding from a bottle, try giving the expressed milk from a cup, with a spoon. They should both be sterilized. • Milk must be stored correctly otherwise it will spoil and make your baby ill. As soon as you’ve expressed your milk, put it into the refrigerator until it is needed; it will keep for 48 hours. You can freeze the milk for up to six months; the expressed milk should be put into sterile plastic containers that can be sealed. Don’t use glass; it might crack.

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98 FEEDING

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Startled babies BdhiWVW^ZhVgZZVh^anhiVgiaZYWnhjYYZc! adjYcd^hZhdgk^daZcibdkZbZcih^ci]Z^g [^ghi[ZllZZ`h#L]Zcndje^X`ndjgWVWn je[dgV[ZZY^c\!]daY]^b[^gbanVcYiVa` id]^bhddi]^c\an#AdlZgndjg]ZVYidlVgY

BREAST-FEEDING—BIRTH TO 1 YEAR 99 ndjgWVWnhdndjg[VXZVcYZnZhVgZVaa]Z hZZh#BV`ZhjgZi]Zgddb^hfj^ZiVcY i]ZgZVgZcdY^hijgW^c\cd^hZhVgdjcYndj VcY!^[edhh^WaZ!e^X`ndjgWVWnjeWZ[dgZ ]ZhiVgihidXgn#

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Anxiousness on your part >[ndjbZZiVb^cdgdWhiVXaZhjX]Vhndjg WVWngZ[jh^c\id]VkZV[ZZY^c\!igncdiid \Zildg`ZYjeVWdji^i#CZgkdjhcZhhbVn aZVYidbdgZY^[[^Xjai^Zh!l]^X]l^aabV`Z ndjbdgZY^hXdjgV\ZYVcYbVnZkZceji ndjd[[WgZVhi"[ZZY^c\eZgbVcZcian# CZgkdjhcZhhbVnVahdV[[ZXindjgb^a`# 6h[VgVhndjgWVWn¼h]ZVai]^hXdcXZgcZY! ZkZcV[ZlYVnhd[XdadhigjbVcYWgZVhi" b^a`\^kZV\ddYhiVgiida^[ZVcYVgZWZiiZg i]VccdcZViVaa#Ndjh]djaYcZkZg\Zi ldgg^ZYVWdjindjgWVWn\d^c\l^i]dji [ddYWZXVjhZndjXVcValVnh[VaaWVX`dc WdiiaZ"[ZZY^c\#9dc¼iaZihbVaaegdWaZbh aZVYndjid]VhinYZX^h^dch#NdjbVnWZ iZVg[jaVcYZVh^anjehZiYjg^c\i]Z[^ghi lZZ`dghdV[iZgYZa^kZgnVcnlVn!VcY^i ldjaYWZVh]VbZid\^kZjeWgZVhi" [ZZY^c\l]ZcndjVgZ^ci]^hjchZiiaZY hiViZ#IgnideZghZkZgZ!VcYVh`ndjgYdXidg [dgVYk^XZ# >[ndjVgZldgg^ZYVWdjiWgZVhi"[ZZY^c\! bV`Z^iVhZVhndcndjghZa[VhndjXVc#>[ ndjVgZZbWVggVhhZYVWdji^i!bV`ZhjgZ

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IF YOU’RE ILL As long as you feel like breast-feeding, continue to do so—even if you have to go to the hospital. You may have to make special arrangements with the nursing staff, but if this is what you want, argue firmly for it, and don’t be dissuaded. • If you have to have an anesthetic you will not be able to breast-feed—not only will you be too groggy afterwards, but the drugs you have been given will have passed into your milk. • If you have advance warning of an operation, try to express and freeze your milk. This way the baby will not miss your milk, even if he misses the pleasure of feeding from you. • If you are confined to bed with a bad cold or flu, you can express your milk so your partner can feed the baby if you feel too weak. • If you’re too ill even to express milk your baby will have to be given formula milk by bottle or by spoon. He’ll probably protest at first, but will acquiesce as he becomes hungrier.

100 FEEDING

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CARE OF YOUR BREASTS 101

BREAST PROBLEMS Problem

Prevention

Cure

Cracked nipples Shooting pain when the baby suckles.

Feed little and often in the first few days. Keep the nipples dry by using disposable breast pads or clean hankies.

Keep feeding if at all possible. If necessary, express the milk by hand (not by pump), and feed the baby by bottle or spoon.

Engorgement Extremely full and painful breasts with a swollen areola.

Feed your baby frequently and try to encourage him to empty your breasts regularly.

Have a hot bath and gently express some milk, or encourage it to flow by massaging toward the nipple.

Blocked duct A hard red patch on the outside of the breast where the duct lies. This can often occur as a result of engorgement or if your bra or clothes are too tight.

Same as for engorgement. Wear a properly fitting bra and keep feeding the babyy in different positions throughout the day.

Frequent feeding, offering the breast with the blocked duct first so that it is properly emptied. Express the breast if necessary.

Mastitis Acute infection of the milk duct resulting in a pusfilled lump.

Same as for a blocked duct.

Antibiotics prescribed by your doctor. If this fails it will have to be drained surgically. You can, however, continue to feed, even if you need an operation.

Breast abcesses This infection, which results from an untreated blocked duct, can make you feel feverish; you may have a shiny red patch on your breast.

Same as for a blocked duct.

Same as for a blocked duct. You will probably be prescribed antibiotics by the doctor. Unless instructed otherwise, you can continue to feed your baby from the affected breast.

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102 FEEDING

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HYGIENE AND PREPARATION TIPS • Always wash your hands before sterilizing, preparing, and feedings.

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CLEANING EQUIPMENT

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104 FEEDING

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MAKING UP A POWDER FORMULA Bottles must be mixed strictly in accordance with the powder-to-water proportions recommended by the manufacturer or by your doctor. Make bottles

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when you need them. Bacteria can multiply fast in bottles of warm formula, so don’t make up bottles in advance and store them.

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BOTTLE-FEEDING TIPS • Don’t feed your baby when he’s lying flat; it is very difficult to swallow in this position and your baby may gag or even be sick. • Never leave your baby with the bottle propped up on a pillow or cushion. Not only is it very dangerous because your baby could choke, but he could become very uncomfortable if he has to swallow a lot of air along with his formula because of the angle at which the bottle’s been propped. Moreover, your baby misses out on the cuddling and affection that he should enjoy while he nurses. • Don’t try to force your baby to finish the bottle after he has stopped sucking: he knows when he’s had enough. • Even if you think the formula isn’t right for your baby, don’t change it without consulting your pediatrician or nurse practitioner. It is very rare for a brand of milk to be responsible for a baby not eating well. Sometimes a baby is allergic to cow’s milk, and may have to have a hydrolized (broken down so it’s more easily digested) formula. Always ask your doctor for advice. Never change to a substitute formula without checking with your pediatrician.

108 FEEDING

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110 FEEDING

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TIPS FOR NIGHT FEEDS

Reducing night feedings

• Feed your baby in bed so that you are warm

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and comfortable, but always put him back in his crib afterward. • If you’re very tired, and you are breast-feeding, express enough milk for the nightfeeding and put it into a sterile bottle, so your partner can give the baby the bottle. • Keep some diaper-changing necessities in your bedroom so you can feed and change your baby with minimal disturbance. • It’s easy to get cold sitting up in bed so have a sweater or robe handy. • Have a drink by your bedside in case you get thirsty while feeding. • If your baby’s in another room and you’re concerned about not hearing his cries, invest in a baby monitor.

INTRODUCING SOLIDS—6 MONTHS 111

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112 FEEDING

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TIPS FOR FEEDING • Give your baby only one new food at a time and then wait for several days to see if there’s an adverse reaction. • Use dry infant cereals that you have to make up rather than ready-mixed cereals; they contain more iron and are more nutritious. • Only give cereal once a day. • If your baby doesn’t like taking food from a spoon, dip a clean fingertip into the food and let him suck it off. • If you find it difficult to feed your baby on your lap, put ]^b in a baby seat on the floor. • Keep plenty of paper towels nearby to mop up any mess. • Even early solids, especially banana, can stain clothes, so put a small cloth bib on your baby.

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ESTABLISHING SOLIDS—6 MONTHS TO 1 YEAR 113

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FOOD INTOLERANCE AND ALLERGY Don’t worry too much, but take sensible precautions with the foods you give your baby —especially if you or your relatives have allergies. • Don’t give your baby foods containing wheat flour or gluten before he is seven months old since he may find them difficult to digest. • Avoid giving your baby soft-boiled eggs until he is about one year old. • Don’t give a baby under one years of age honey; it can cause infant botulism, a rare but serious disease. • Don’t give your baby very high-fiber breakfast cereals as they are too difficult to digest. • Avoid unpasteurized cheese until your baby is at least two years old. • If your baby has a relative who suffers from an allergic condition, avoid giving him peanuts, or foods containing peanuts, and shellfish until he is at least three years old.

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TIPS FOR FOOD PREPARATION • Before steaming and puréeing fruit, peel, remove

• Use cast-iron cooking pots. A little iron will be

the seeds and any parts that may choke the baby and cut up into small pieces. Do the same for the vegetables. • Give your baby meat, cooked any way you like and then puréed. Don’t forget fish, chicken, and chicken livers, which are cheap, quick, and easy to prepare. Thin down the puréed meat with vegetable water or soup. • Always choose the freshest-looking vegetables (not wrinkled or dull-looking ones), and cook them as soon as possible. • Handle fruit and vegetables gently. Don’t cut them until you have to and don’t crush and bruise them because this destroys the vitamin C in them. • Cook vegetables and fruit in as little water as possible, with a tightly fitting lid on the pot, so they are steamed rather than boiled. This helps to retain the vitamins. • Cook soft-skinned fruit and vegetables in their skins because this helps to retain the vitamins and will also give your child fiber. You may have to remove the skin if it’s very tough and likely to choke your baby.

absorbed into the food and helps to boost your child’s iron supply. • Always make the food a suitable consistency for your baby’s age. For example, a thick milk for your six-month-old baby; a thicker cream for your seven-month-old baby; and a slightly chunky mash for a nine month old. • Don’t use copper pans for green leafy vegetables as copper breaks down vitamin C. • Don’t cook canned foods for too long or you will destroy the vitamin content. • Don’t add salt or sugar to your child’s food; the immature kidneys can’t handle a heavy salt load and you will be doing your child a favor if you don’t encourage a sweet tooth. • Avoid using too many saturated fats in your cooking—use safflower or corn oil instead. • Don’t prepare vegetables or soak them in water a long time before you cook them or you will destroy the vitamin content. • To discourage bacteria from growing, put your baby’s food into the refrigerator as soon as it has cooled to room temperature.

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READY-PREPARED FOODS • Check the list of ingredients on the can or jar.

• • •

•

They are listed in order of concentration, so never buy anything in which water is listed first. Make sure that the jar is vacuum sealed when you open it, otherwise it may be contaminated. Don’t buy “mixed dinners;” they usually contain a lot of thickener. If possible, buy meat and vegetable dishes separately and then combine them if you want a “mixed dinner.” Don’t keep opened jars in the refrigerator for longer than two days. Throw them away after that.

• Don’t buy anything that has added salt, sugar, modified starch or monosodium glutamate (MSG). • Never store food in opened cans; put it into a dish or bowl and keep it covered in the refrigerator. • Don’t heat the food up in the jar—it could crack. • It is very unhygienic to feed the baby from the jar then keep the rest for a second meal, since it will have become contaminated with saliva. It’s all right to feed your baby from a jar if he’s going to eat it all or if, for example, you’re on the move and you don’t mind throwing away what’s left when he’s had enough.

ESTABLISHING SOLIDS—6 MONTHS TO 1 YEAR 117 ;dgi]^X`Zc^c\!jhZ\gdjcY!l]daZ"\gV^c XZgZVahhjX]Vhl]ZVi\Zgbdgg^XZ!XdiiV\Z X]ZZhZ!nd\jgi!dgbVh]ZYediVidZh#>[ndj [ZZandjcZZYidhlZZiZc[ddYh!jhZ cVijgVaanhlZZi[gj^i_j^XZdgYZmigdhZ#CZkZg jhZgZ[^cZYhj\Vg¸Wgdlcdgl]^iZ#Djg WdY^ZhYdc¼icZZYid]VkZ^i!^i¼hWVY[dgdjg iZZi]!VcY^idcanZcXdjgV\ZhVhlZZiiddi]#

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WEANING YOUR BABY ON TO A CUP When he’s six months old, introduce your baby to drinking from a cup as part of the process of weaning from breast or bottle. The best times to use a cup are at the lunchtime and late afternoon feeding when he’ll probably be eager to eat solids. Give him solids first and then try the cup. There are a variety of special cups available. Cups with spouts are best at the beginning because they let the liquid drip out and the baby has to half suck and half drink to get anything. Hold the cup yourself and offer only a few sips of milk at first, but release it as soon as he wants to take it from you. As he gets more dexterous, he can use a two-handled cup; the kind with slanted lips are ideal because they don’t have to be tipped far before the liquid comes out. Some babies, however, prefer an open cup. Your baby will gradually wean himself off the morning feeding. He’ll still want a breast-feed or bottle before bedtime until he’s at least a year old—more for comfort than for food.

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SELF-FEEDING TIPS • Tuck a few tissues under the neckline of your baby’s bib to keep his neck from getting wet as he practices drinking. • If a baby won’t wear a bib, put a colored scarf round his neck to protect his clothes. • If your baby is going to sneeze, get out of the way or you will get covered in food. • Fit a kitchen towel holder on the back of the highchair or near it. • Keep the highchair well away from your walls—your baby will be quite capable of throwing food by now. • Get a nonslip bowl if you can since it will stay in place while your baby is trying to get food onto his spoon.

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FINGER FOODS If self-feeding with a spoon seems to frustrate your baby, but his appetite is good, try finger foods. Your

baby will be able to handle them easily, and even if the food is hard he will suck it.

Fruit and vegetables • Any fresh fruit that is easy to hold, cut into a slice, without the skin or seeds, e.g. bananas • Any cooked vegetable that you can make into a stick or a shape that is easy to grasp, e.g., carrots • Mashed potato

Protein • Cubes of low-fat cheese • Macaroni and cheese • Pieces of cheese on toast • Hamburgers cut into small, easily held pieces • Scrambled eggs • Cottage cheese • Any kind of meat, preferably white, in pieces that are easy to pick up • Chunks of firm fish, taken off the bone • Sliced hard-boiled eggs—only give him yolk until he’s aged one year

Grains and cereals • Small pieces of sugarless dried cereal • Little balls of cooked rice • Whole-wheat bread (without the complete grains) • Whole-wheat crackers (without complete grains)

120 FEEDING

SAFETY TIPS • You should be careful not to give your child a piece of food that might stick in his throat or be inhaled, so you should avoid nuts, fruit with stones and seeds, unpeeled fruit with tough skins, and raw vegetables. • Don’t ever leave your child eating or drinking alone in a room. If he gags, chokes, or vomits, he needs immediate help (TFF
Q).  • Don’t be obsessive, but be careful with mealtime hygiene. Use clean utensils, a clean highchair, and a clean bib. • When you are storing food in the refrigerator, cover containers with plastic wrap, and never put cooked with uncooked meat together.

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FOOD AND EATING—1 TO 2 YEARS 121

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DON’T GIVE YOUR CHILD: • Popcorn • Whole nuts or very rough whole-wheat bread, with pieces of whole grain

• Small pieces of raw fruit or vegetable • Fruits with stones or pits, such as plums • Unpeeled fruit with thick skins • Highly spiced dishes, unless he enjoys them and specifically requests them

• Salty foods • Sugary drinks

122 FEEDING

FOOD GROUPS Food group

Food

Content

High protein

Chicken, fish, lamb, beef, pork, offal, eggs, cheese, legumes

Protein, fat, iron, vitamins A, D, B

Milk and dairy products

Milk, cream, yogurt, ice cream, cheese

Protein, fat, calcium, vitamins A, D, B2

Green and yellow vegetables

Cabbage, sprouts, spinach, kale, green beans, squash, lettuce, celery, zucchini

Minerals, including calcium, chlorine, chromium, cobalt, copper, manganese,, potassium, and sodium

Citrus fruit

Oranges, grapefruit, lemons

Vitamin C

Other vegetables and fruit

Potatoes, beets, corn, carrots, cauliflower, pineapples, apricots

Carbohydrates, vitamins A, B, C

Breads and cereals

Whole-wheat bread, noodles, rice

Protein, carbohydrates, vitamin B, iron, and calcium

Fats

Butter, margarine, vegetable oils

Vitamins A, D

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FOOD AND EATING—1 TO 2 YEARS 123

SAMPLE DIET FOR A 14-MONTH-OLD CHILD Day 1

Day 2

Day 3

Breakfast 1 egg, scrambled, ½ slice buttered whole-wheat toast

Breakfast 1 cup diluted orange juice, 5 ounces (25 grams) yogurt, 2 tablespoons baby muesli, with wheat germ, 1½ fluid ounces (50 milliliters) milk, ½ banana

Breakfast 2 ounces (50 grams) cereal plus milk, 1 cup diluted fresh orange juice, ½ banana

Mid-morning 1 cup diluted orange juice, 1 apple

Mid-morning 1 cup diluted fruit juice, 1 cookie

Mid-morning 1 cup water, 1 apple

Lunch 2 ounces (50 grams) white fish, ½ whole-wheat bread roll, 1 tablespoon green beans, 1 cup diluted fruit juice

Lunch 1 cup milk, 1 cup water, 2 fish fingers, 1 tablespoon peas

Lunch Egg florentine, (2 tablespoons spinach, 1 egg, 1–2 ounces/25– 50 grams cheese), 1 pear, 1 yogurt (sugar-free), 1 cup milk

Mid-afternoon 1 cup water

Mid-afternoon 1 cup water

Mid-afternoon 2 cups diluted apple juice, 1 oatmeal cookie

Dinner 6 ounces (150 grams) beans, 2–3 ounces (50–75 grams) potatoes, 2 ounces (50 grams) cheese, ½ banana, 1 cup milk

Dinner 1 egg omelette with 1 ounce (25 grams) cheese, tablespoon fresh green beans, 1 cup milk, ¼ slice whole-wheat bread

Dinner Ham sandwich with wholewheat bread, cubes of cheese, raw carrot, cubes of melon

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FOOD AND EATING—1 TO 2 YEARS 125

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TIPS FOR FEEDING TWO-YEAR-OLDS • Always make sure that a meal contains at least one food you know your child likes.

• Always serve small amounts and allow second helpings. A full plate is intimidating to a child.

• Keep foods simple. Children like to see what

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they are eating: they don’t like messy foods.

• Always offer a variety of foods to guarantee a balanced diet.

• Liven up your toddler’s meal by using colorful food.

• Until your child is going to school, include a finger food in a meal when possible.

• Include foods that are fun to eat, like jelly, oven-baked potato chips, or an ice cream cone.

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MAKING MEALTIMES FUN As with all feeding, the key word is flexibility. You and your child should enjoy yourselves, so give a little thought to making mealtimes entertaining for all of you. • Ice cream cones don’t have to be used just for ice cream. Fill one with cheese and tomato chopped together or tuna fish salad. This allows you to give your three-year-old a snack on the move. • Encourage your child to “build” his meal from sandwiches, cubes of cheese, vegetables, and dried fruit. He can build a house, a car, or a boat, and when it is finished, eat it.

• If he wants to use a knife, give your child a plastic or blunt-ended one.

• Let your child use a straw for drinking sometimes. So he won’t tip the drink over, cut the straw off so there is no more than 2 inches (5 centimeters) above the cup, or use a flexible straw. • Be open to innovation and occasionally serve your child’s meal on a doll’s plate or on a flat toy. • Fill a cake pan with lots of different finger foods, like cubes of cheese, pieces of cold meat, raw vegetables, fruit, and tiny sandwiches, and let your child pick what he wants.

128 FEEDING

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130 FEEDING

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134 BOWEL AND BLADDER FUNCTION

Stools of the breast-fed baby

Changes in bowel movements

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BOWEL MOVEMENTS—BIRTH TO 1 YEAR 135

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136 BOWEL AND BLADDER FUNCTION 9^Vgg]ZV^cndjc\WVW^Zh^hValVnhhZg^djh WZXVjhZi]Z^ciZhi^cZhVgZcdi\^kZc hj[[^X^Zcii^bZidVWhdgWi]ZlViZg ZhhZci^Va[dga^[Z!VcYhZkZgZYZ]nYgVi^dc XVcYZkZadefj^iZgVe^Yan#I]ZgZ^hcdcZZY idWZXdcXZgcZYVWdjii]ZdYYaddhZhidda ^[ndjgWVWn^hVXi^c\lZaa!ZVi^c\cdgbVaan VcY^h]Veen#=dlZkZg!^[ndjgWVWn]Vh kZgn\gZZc!hbZaan!VcYlViZgnhiddah! gZ[jhZh[ddY!]VhV[ZkZgd[&%%•;(-•8 dgbdgZ!]VhWaddYdgejh^ci]Zhiddah! VcY^ha^hiaZhhVcY]VhYVg`g^c\hjcYZg]Zg ZnZh!XdciVXii]ZeZY^Vig^X^Vc^bbZY^ViZan# >[ndjgWVWn^hkZgnndjc\jcYZg[djg bdci]h!\didi]ZeZY^Vig^X^Vcdg]dhe^iVa ZbZg\ZcXngddbVhhddcVhedhh^WaZ#L^i] VcdaYZgWVWn!i]Z66EgZXdbbZcYhV gZ\jaVgY^Zi!Vaadl^c\ndjgWVWndgX]^aYid ZVil]ViZkZgVeeZVah#>[h]Z]Vh^hkdb^i^c\ VhlZaa!VcZaZXigdaniZhdaji^dchjX]Vh EZY^VaniZ^hhj\\ZhiZY#>[ndjgWVWn]Vh]VY Y^Vgg]ZV[dgfj^iZV[ZlYVnh!Vkd^Y^c\b^a` dgb^a`egdYjXihbVnWZgZXdbbZcYZY

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GAINING CONTROL—1 TO 2 YEARS 137 ]ZgY^VeZg#NdjgX]^aY¼hVlVgZcZhhd[]Vk^c\ V[jaagZXijbVcYV[jaaWaVYYZgl^aa egdWVWandXXjgViVWdjii]ZhVbZi^bZ!Wji ]ZgVW^a^inidYZVal^i]i]ZildhZchVi^dch l^aaWZY^[[ZgZci#

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138 BOWEL AND BLADDER FUNCTION

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TIPS • Let your child develop at her own pace. There is no way that you can speed up the process. You can only be there to help your child along. • Let your child decide whether to sit on the potty. You can suggest that she does but you should never force the issue. • Treat your child’s feces in a sensible manner, and never show disgust or dislike for them. They’re a natural part of your child and initially she’ll be very proud of them. • Do not delay once your child has signaled she wants the potty, since control is only possible for a short time. • Always praise your child and treat her control as an accomplishment.

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140 BOWEL AND BLADDER FUNCTION

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GAINING CONTROL—2 TO 3 YEARS 141

TIPS • Whenever you travel, make sure that you have

• Let your child accompany you to the bathroom at

a potty with you so that your child can go under any circumstances without having to wait. Put the potty on the floor in the back of your car so that you can stop anywhere along the road instead of having to worry about finding a public restroom in a hurry. • If she sits down and can’t do anything, turn on the faucets; this works for babies as well. • If you keep star charts for different accomplishments, keep one for each success. • If you have a potty in the bathroom, you and your child can go to the toilet at the same time.

an early age so that she can learn from watching you. This works particularly well with boys. • Tell your child quite firmly and sympathetically that accidents will always be ignored and forgiven, and that she should not worry about them. • Get a potty well before you think your child will need it. You can explain why it is there and that when she is old enough she’ll be able to use it. This may give your child an incentive to try. • Be wary of flushing the toilet when your child’s with you—many are frightened by the noise, and by the fact that “part of them” is being taken away.

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WHAT BEDDING TO USE

What your baby should wear Ndjc\WVW^ZhYdc¼ia^`ZWZ^c\X]Vc\ZY!hd ^ci]ZZVganlZZ`h!l]Zc]Z¼h\d^c\id cZZYX]Vc\^c\[gZfjZcian!ndj¼aalVci hdbZi]^c\i]Vi\^kZhZVhnVXXZhhid]^h Y^VeZgWjiXVjhZhi]Zb^c^bjbd[ Y^hijgWVcXZ#C^\]iYgZhhZhVgZjhZ[ja ^c^i^Vaan!WjidcXZndjgWVWn]VhhZiiaZY Ydlc!egdWVWanl^i]^cVbdci]!dcZ"e^ZXZ ¹higZiX]^ZhºVgZZfjVaanegVXi^XVa# L]ZcndjgWVWn¼hVWdji[djgbdci]h daY!ndjbVnlVciidjhZVhaZZe^c\WV\! ZheZX^Vaan^ci]Zl^ciZgsee p.36#Ndjg

BED-MAKING TIPS • Your baby will be most comfortable wrapped in sheets and blankets made of natural fibre— cotton is ideal. • Do not use blankets with fringes—he may suck on them. • Avoid lacy, openwork shawls because your baby’s fingers might get stuck in the holes. • You can use your own old sheets, cut to the correct size, in addition to new ones. The more you have, the less frequently you’ll have to do the wash. • Use a pillowcase as a sheet—just slide the mattress into it. When one side gets dirty just turn the mattress over.

T Temperature

What to use

57ºF (14ºC)

Sheet and four blankets or more

60ºF (16ºC)

Sheet and three blankets

65ºF (18ºC)

Sheet and two blankets

68ºF (20ºC)

Sheet and one blanket

75ºF (24ºC)

Sheet only

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ALL ABOUT SLEEPING—BIRTH TO 1 YEAR 145

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146 SLEEPING

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SLEEPING TIPS • Keep pre-bedtime as happy and pleasant as

• Play a musical mobile. Many babies are fascinated

possible. • Try giving a comfort suck from the breast or the bottle just before he’s put to bed. • Develop a routine and stick to it. Don’t put your baby straight to bed: work out a routine of play, then bath, bed, story, song, and then goodnight. But don’t leave the room; quietly tidy up so that your baby learns that he can drift off to sleep without actually “losing” you. • Let your baby develop comfort habits (see above). • Rock your baby’s crib if he finds that soothing.

by the movements they make and are soothed by the sound. • Don’t take your older baby out with you in the evenings, even if you used to do this earlier with no problems. He’ll be used to his own routine and his own room and will be frightened by being moved somewhere else. • When he does cry, always go back but don’t pick him up immediately. See what’s wrong first—he may just need you to change his position or adjust the temperature in the room.

ALL ABOUT SLEEPING—BIRTH TO 1 YEAR 147

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ALL ABOUT SLEEPING—1 TO 2 YEARS 149 Older babies >ci]ZhZXdcY]Va[d[i]Z nZVgndjgWVWnh]djaYhaZZei]gdj\]i]Z c^\]i#=dlZkZg!i]ZgZbVnWZdXXVh^dch l]Zc![dgl]ViZkZggZVhdc!]ZlV`Zhje# Igni]Z[daadl^c\/ ™ 8]ZX`i]VindjgWVWn^hcdiidd]di0^[]Z ^h!gZbdkZhdbZXadi]^c\dgWaVc`Zih# ™ BV`ZhjgZi]Vi]Z¼hcdiiddXdaYV[iZg `^X`^c\d[[]^hWaVc`Zi#:^i]ZgjhZV haZZe^c\WV\see p.36dgbdgZWaVc`Zih! dgaZVkZVhV[Zin]ZViZg^ci]ZWVWn¼h gddbidegdk^YZVXdchiVciiZbeZgVijgZ# ™ 8]ZX`i]Vi]ZYdZhc¼i]VkZY^VeZggVh]# >[]ZYdZh!i]ZY^hXdb[dgid[^iXdjaY lV`Z]^bje#IgZVii]ZgVh]see p.68# ™ 9dc¼i\d^cidi]ZWVWn¼hgddbXdchiVcian idX]ZX`i]Vi]Z¼hhaZZe^c\lZaa¸ndjg Vcm^Zinl^aaWZbdgZd[VY^hijgWVcXZ# ™ >[]Z¼h]VYVc^\]ibVgZ!egdk^YZXdb[dgi VcYhiVnjci^a]Z¼hVhaZZeV\V^c#>[^i ]VeeZchdcbdgZi]VcdcZc^\]i^c hjXXZhh^dcadd`[dghdbZZmiZgcVa

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HELPING YOUR TODDLER TO SLEEP During the day • Make up a nap time box for your child with favorite toys and books that he can look at as he gets sleepy before a nap. Don’t include good or expensive books—they may get ripped up. Use board books or old books. A good alternative is to make up your own books by pasting interesting pictures from magazines onto cardboard and then covering them with clear plastic. • Give your child a occasional treat by letting him take a nap in your bed, or somewhere near you. • If your child won’t take a nap, make sure that he has a rest time where he is calm and quiet. • If your toddler won’t go to sleep, put on a longplaying tape or CD. Teach your child that the rest time is not over until the music stops.

In the evening • Don’t put your child to bed immediately after an exciting game or rough-and-tumble—he will have great difficulty settling down, which will be frustrating for you. Give him 10–15 minutes to quiet down, sitting with you watching TV or looking at a book. • Even a small child likes to look at a book in bed so, if your baby is quite happy, leave him with a favorite, nonscary book. • Put a dab of your perfume or aftershave on your child’s pillow and suggest that he breathe it in deeply. Deep breathing is relaxing and calming and will help your child get to sleep. • Give your toddler a bath before bedtime and follow this with a warm drink and a story in bed.

ALL ABOUT SLEEPING—1 TO 2 YEARS 151

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152 SLEEPING

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TIPS FOR EARLY WAKERS • Put a pile of cloth or board books at the bottom of the crib or bed for early morning “reading.” Make sure that there is enough light to see by; if there isn’t, leave on a low-wattage nightlight when you put your toddler to bed. • Put a soft box or plastic bucket at the side of the bed or crib with small toys, crayons, paper, bits of

cloth, or interesting household articles in it, so he can play with them. • Leave a paper bag with some fresh fruit or bread at the bottom of the bed; never put the food in a plastic bag for safety reasons. • Leave a drink of water in a plastic cup within reach of your child.

ALL ABOUT SLEEPING—1 TO 2 YEARS 153

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™ 7Z[aZm^WaZVWdjiWZYi^bZ#AZ[iid i]ZbhZakZh!bdhiX]^aYgZc\didhaZZeVi VgdjcYhZkZcdgZ^\]id¼XadX`^ci]Z ZkZc^c\!l]Zi]Zgndjejii]ZbidWZY dg cdi#L]nh]djaYi]ZnWZjc]Veen^cV gddbdci]Z^gdlc!^chiZVYd[]Veen^c ndjgXdbeVcn4 ™ <^kZndjgX]^aYVcZVganZkZc^c\WVi]# I]^hd[iZcgZaVmZhX]^aYgZcVcYbV`Zh i]ZbhaZZen# ™ >[ndjgX]^aY^hegdk^c\Y^[[^Xjaiid\Ziid \didWZY!ejidc]^heV_VbVhWZ[dgZ]Z¼h Wgdj\]i^cidi]Za^k^c\gddb#>[]Z[Vaah VhaZZe!ndjldc¼i]VkZidlV`Z]^bje V\V^c#NdjXVceji]^bhigV^\]i^cWZY# ™ >[egdWaZbheZgh^hi!iVa`idndjg eZY^Vig^X^Vc!l]d^higV^cZYidhjeedgi eVgZcihXde^c\l^i]XdbbdcWZ]Vk^dg egdWaZbhVcYh]djaYWZVWaZidhj\\Zhi ]Zae[jahigViZ\^ZhVcYiZX]c^fjZh#

Rapid-return technique >[![dghdbZgZVhdc!ndjgWVWnhiVgihid \Zidjid[WZYZkZgnc^\]idgXVaah[dgndj XdchiVcian!Xg^Zhl]ZcejiYdlc!VcYldc¼i hZiiaZ^c]^hWZYVic^\]i!igni]^hiZX]c^fjZ# >iXVciV`ZV[Zlc^\]ih!Wji^iYdZhldg`# ™
154 SLEEPING

All about sleeping 'id(nZVgh 7ni]Zi^bZndjgX]^aY^hildnZVghdaY!]Z jhjVaancZZYh&']djghd[haZZeVic^\]i VcYVWdjidcZdgild]djghd[cVee^c\ Yjg^c\i]ZYVn0i]ZVXijVaVbdjcil^aa YZeZcYdci]ZX]^aY#>c\ZcZgVa!i]ZcVedg gZhii^bZl^aah]dgiZcYjg^c\i]ZnZVg!Wji WZYi^bZl^aajhjVaanhiVni]ZhVbZ#I]Z Vbdjcid[i^bZndjgX]^aYhaZZehVic^\]i ldc¼iYZXgZVhZjci^a]Z¼hVgdjcYh^mnZVgh daY!l]Zc]Z¼aagZYjXZ^i]Va[Vc]djgViV i^bZ!eZgnZVg# 6gdjcYi]ZV\Zd[i]gZZ!bVcnX]^aYgZc hide]Vk^c\cVeh!Vai]dj\]i]ZbV_dg^in hi^aacZZYVgZhieZg^dY^cYddghV[iZgajcX] jci^ai]ZnVgZVWdji[^kZdgh^m#

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TIPS FOR MAKING BEDTIMES EASY • Mark bedtime with an alarm or a timer, so that you can give your children five minutes warning. • For a young child, have a toy clock next to the real clock and set the hands of the toy clock to bedtime. When the hands of the real clock match up with the toy clock, it is time for bed. • Keep a child’s bedtime as near the same time as you can every night to help establish regular sleeping patterns. • Children are often not sleepy at their bedtimes. They like the time to slow down just lying in bed looking at a new toy, reading a new book, or chatting to one another. It is a good idea to have

children who are near each other’s own age sharing a bedroom until they require privacy. • Once your children get into a bed, lie down with them before you leave them to go to sleep. It is very nice for them; it warms up the bed, and their last memories are of your closeness. It is also very relaxing for you: I did it with my children and I nearly always found that I dropped off before they did. It was a tradition we started when they were young but continued after they went to school.

ALL ABOUT SLEEPING—2 TO 3 YEARS 155 /JHIUUJNF
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Bedroom rituals BdhiX]^aYgZca^`ZVWZYi^bZg^ijVa#B^cZ ValVnh]VY]Va[VYdoZc[Vkdg^iZhdc\h i]Zna^`ZYbZidh^c\!VcYVhidgnWdd`i]Zn

156 SLEEPING a^`ZYi]Z^g[Vi]ZgidgZVY#L]ZclZlZgZ ]dbZid\Zi]ZglZldjaYh]VgZi]Z WZYi^bZgdji^cZ/iZcb^cjiZhl^i]bZ h^c\^c\VcYiZcb^cjiZhl^i]]^bgZVY^c\ VhidgnWdd`#LZldjaYWdi]hiVn^ci]Z WZYgddbVcY!h^cXZi]ZgZlZgZi]gZZ X]^aYgZc\d^c\idWZY!WZYi^bZhlZgZ XdbbjcVa!l^i]i]ZX]^aYgZch^ii^c\dgan^c\ dcZVX]di]Zg¼hWZYh#>ilVhV[Vb^ani^bZ# Bn]jhWVcYldjaYa^Zdci]ZWZYl]^aZ >hVc\i]Zhdc\h#>hiVnZYVcYaV^YdcVWZY l]^aZ]ZgZVYVhidgn# L]Zci]ZhidgnVcYhdc\hlZgZdkZg!^i lVha^\]ihdji!ZmXZei[dgVadlc^\]ia^\]i!

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Many newborn babies cry a lot, so be prepared for it. If you expect your baby to cry, and treat it as normal when she does, you’ll find it easier to cope with. If your baby is one of the few who doesn’t cry much, think of it as a bonus. In order to understand why your baby is crying, and how you can provide comfort, bear in mind that what upsets a baby, and what comforts her, changes as she develops. A new baby may cry when she’s undressed for a bath; a one-year-old may cry when you leave the room. The new baby will be comforted by being snugly wrapped up in a towel; the one-year-old will be comforted by the sight of you returning.

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160 CRYING

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ALL ABOUT CRYING—BIRTH TO 1 YEAR 161 aZVgc^c\VWdjiadk^c\]jbVcWZ]Vk^dg#I]Z bdYZa[dgi]^hWZ]Vk^dg!l]^X]h]Z¼aagZiV^c [dga^[Z!^hi]Vi^bedgiVciZVgangZaVi^dch]^e l^i]]ZgeVgZcih# L]VilZiZcYidXVaahed^a^c\^hWdi] VcVijgVagZhedchZd[Vbdi]ZgidV Y^higZhhZYX]^aY!VcYi]ZcVijgVacZZYd[ i]ZWVWn#6bdi]Zg¼hWZ]Vk^dg^h¹Wj^ai^cº _jhiVhbjX]Vhi]ZWZ]Vk^dgd[i]ZWVWn# 6bdi]Zg^h\ZcZi^XVaanegd\gVbbZYid gZhedcYid]ZgWVWn¼hXgn^c\!Vai]dj\]h]Z bVnhjeegZhh]Zg^chi^cXi^kZgZhedchZl^i] VaZVgcZYgZhedchZi]Vi^ciZg[ZgZhl^i] ]ZgcVijgVaYg^kZh¸l]^X]VgZide^X`je! hddi]Z!VcYcjghZ]ZgXgn^c\WVWn#HdX^Zin ]Vhhj\\ZhiZYi]Vih]Zl^aahed^a]ZgWVWn ^[h]ZYdZhi]^h!VcYhdh]Z^hidgc#H]Z h]djaYcdiWZ0h]Zh]djaY[daadl]Zg cVijgVa^chi^cXih#I]ZegdiZXi^kZ^chi^cXi^c Vbdi]Zgl]^X]^hl]Vih]Z^hY^heaVn^c\ l]Zch]Ze^X`hjeVcYig^Zhidhddi]Z]Zg Xgn^c\X]^aY^hi]ZWVh^hd[]ZgbViZgcVa ^chi^cXi!VcYZhhZci^Vaid]ZgW^dad\^XVa [jcXi^dcVhVbdi]Zg#7VW^ZhgZfj^gZi]^h e]nh^XVaXdciVXil^i]Vhd[i!lVgb!adk^c\ ]jbVcWZ^c\#I]ZcZZY[dgi]^h^hhdhigdc\ i]Vi^iVabdhidkZgg^YZhi]ZcZZY[dg[ddY#

The mother’s response 8gn^c\!VcYndjgegdbeigZhedchZid^i! jcYdjWiZYaneaVnVc^bedgiVcieVgi^ci]Z lVnndjgWVWnWZXdbZhViiVX]ZYidndj# :kZgnX]^aY^cV[Vb^anl^aaWZXdbZViiVX]ZY idWdi]eVgZcih!Wjii]ZfjVa^ind[i]Z ViiVX]bZciYZeZcYhdci]ZhZch^i^k^ind[ i]Zbdi]Zg#>i^hi]ZegdbeicZhhVcY Veegdeg^ViZcZhhd[i]Zbdi]Zg¼hgZhedchZ idi]ZX]^aY¼hY^higZhh¸^cdi]ZgldgYh]dl bjX]h]Z^hViijcZYid]ZgX]^aY!l]^X]^h i]Zbdhi^bedgiVcieVgid[i]^hhZch^i^k^in# >i^hXg^i^XVa[dgi]ZYZkZadebZcid[VhiVWaZ

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Crying spells HeZaahd[Xgn^c\VgZa^`Zanid\ddc[dg i]gZZ![djg!dgZkZch^mlZZ`h!l]^aZndjg WVWnWZXdbZhVXXa^bViZYidi]Zdjih^YZ ldgaY#L]Zch]Z]VhYZkZadeZYVgdji^cZ i]ViiV`ZhVXXdjcid[]Zga^`ZhVcYY^ha^`Zh! i]Z[gZfjZcXnd[Xgn^c\jhjVaanYZXgZVhZh# :kZgndcZ[^cYh^i]VgYZgidXdeZl^i] Xgn^c\Yjg^c\i]Zc^\]i#L]ZcndjghaZZe^h ^ciZggjeiZY!ndjl^aa[ZZa!a^`ZZkZgndi]Zg eVgZci!V]^\]YZ\gZZd[^beVi^ZcXZ#Ndjg [ZZa^c\hVgZc¼iVWcdgbVa0ZkZgndcZ]Vh i]Zb#9dc¼ieVc^Xl]ZcndjgWVWnhiVgihid Xgn#>i^h^cZk^iVWaZi]Vih]Zl^aa!VcYndjg iZchZcZhhl^aadcanbV`ZbViiZghldghZ# >[ndj[ZZai]VindjgWVWnhZZbhidWZ Xgn^c\Vadi!ndjXVciV`ZXdb[dgi^chdbZ gZhZVgX]i]Vi]Vhh]dlci]ViWVW^ZhbVn Xgnfj^iZ^cYZeZcYZciand[VcnY^hXdb[dgi i]ZnbVnWZ[ZZa^c\dgd[i]ZZ[[ZXi^kZcZhh d[i]ZXdb[dgindj\^kZ#;dg^chiVcXZ! WVW^Zhl]dlZgZWdgcV[iZgVadc\aVWdg! dgl]dhZbdi]ZghlZgZ\^kZcYgj\hYjg^c\ aVWdg!lZgZbdgZa^`ZanidXgn[gZfjZcian VcYhaZZe^ch]dgiWdjih# Bdi]Zghl]dlZgZ]^\]anVcm^djh Yjg^c\egZ\cVcXniZcYid]VkZbdgZ ^gg^iVWaZVcYY^[[^XjaiWVW^Zh#>i^hVahd lZaa`cdlci]VibVaZWVW^ZhVgZbdgZ kjacZgVWaZidhigZhhVii]Zi^bZd[W^gi] i]Vc[ZbVaZWVW^Zh!VcYViaZVhidcZ 6bZg^XVchijYn]Vhh]dlci]ViWdnhVgZ bdgZ^gg^iVWaZVii]ZV\Zd[i]gZZlZZ`h i]Vc\^gah#

162 CRYING

Causes of crying W^gi]id+bdci]h Hunger I]^h^hi]ZbdhiXdbbdcXVjhZd[Xgn^c\ ^cndjc\WVW^Zh!VcYeVgZcihhddcaZVgc idgZXd\c^oZ^i#HijY^Zh]VkZXdc[^gbZY l]VieVgZcih`cdl¸WVW^ZhXgnbdgZ WZ[dgZ[ZZY^c\i]VcV[iZg#:meZg^bZcih ]VkZh]dlci]Vi^i^hi]ZVXijVa[ZZa^c\d[V [jaahidbVX]i]ViWg^c\hi]ZbdhiXdb[dgi! cdiWZ^c\]ZaY!hjX`^c\!dghlVaadl^c\#

GENERAL CRYING CURES If your baby still seems fretful, try some, or all, of the following remedies as part of your crying cure. Most babies are soothed by movement and sound, and many parents find it relaxing, too.

Movement • Rock your baby—rocking chairs and swings are ideal for this. • Walk or dance with your baby. • Bounce your baby gently in your arms or on a bed or in the crib. • Put your baby in a bouncy seat, and rock it gently for her. • Take your baby for a ride in the car, or a walk in her carriage, stroller, or sling, even at night. • If you are on your own, put your baby in a sling and just let her cry. Keep doing whatever you want to do and try to ignore the crying. Sound • Talk, sing, or croon to your baby. • Put on the radio or television. • Put on the vacuum cleaner, or let a faucet run forcefully into the sink for a few minutes. • Give your baby a noisy toy. Shake and rattle it. • Play tapes or CDs of calm music.

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CAUSES OF CRYING—BIRTH TO 6 MONTHS 163

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IF CRYING IS DIFFICULT TO COPE WITH One of the things you should be aware of is that every parent at some time or other contemplates doing something physically violent to her or his children. Most mothers with newborn babies who are exhausted and trying to pacify a screaming baby will confess that they have thought of doing anything to stop the baby crying. It is not abnormal to think such things. It’s only abnormal to do them. A crying baby can be particularly difficult to handle before your period. Mothers who are ideal parents—very loving and caring, sympathetic, and patient for the rest of the month—can find the few days prior to menstruation a challenging time. Most mothers are aware when they begin to lose hold of themselves and are able to control violent

behavior against their children. But if you feel yourself sliding down a slippery slope, you should seek help, first from your partner, or from a friend, but also from your doctor.

Get help if necessary If you ever find yourself hitting or shaking your baby, don’t feel that it is an admission of failure to seek help. You must do so immediately, both for your child’s sake and your own. Don’t stand by and let your partner injure your child either: try to make him or her see that what he or she is doing is wrong. If he or she is impervious to your pleas, seek help on behalf of both of you. Contact your doctor, or the police immediately.

164 CRYING

COLIC This term describes unexplained recurrent bouts of crying usually in the late afternoon or evening, though they can occur any time. The crying may be intense and brief or last for hours, and is not generally pacified by the usual remedies. The baby’s face gets red and she draws her legs up. Many causes have been suggested, such as overfeeding, underfeeding, gas, being picked up too much or too little, indigestion and tension. It has always seemed to me that tension is the most likely cause. You’re busy in the evening and it’s likely that your baby picks up on the tension and responds by crying. Since your baby is likely to cry every night for 12 weeks, I’m against using medicine to prevent it. Of course, try to soothe your baby, but don’t expect her to respond readily. Take comfort from the fact that these colicky spells come only at night and usually only last for three months. Colic generally stops without you doing anything and is rarely serious.

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THE CAUSES OF CRYING—6 MONTHS TO 1 YEAR 165

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ALL ABOUT CRYING—1 TO 2 YEARS 167

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170 CRYING

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TIPS FOR MAKING SEPARATION EASIER Separation anxieties Children over the age of three still dislike being separated from their parents, even if they are only going to spend the evening out of the house. Up to the age of five or six it is quite normal for a child to shed a few tears until she is reassured about some of the details of the evening. One of the most difficult separations for a child of this age is when her mother goes into hospital for the birth of a new baby. In addition to the jealousy that most children feel at this time (TFF
Q), there is the upheaval of being separated from the mother. Prepare your toddler well in advance of the birth by talking about the new baby, about your going into hospital, and about who will take care of her while you are away. Ideally it should be someone she knows well who understands her routine and can ensure that it continues while you are away. Try to let her visit you as often as possible while you are in hospital.

Making separation easier • Always spend a few minutes with your child quietly doing something nice before you leave. Never rush off without a proper goodbye. • If you make a promise that you will be back by a certain time, keep it and, when you go, remind your child that you will always come back. If you are delayed, call to explain why. • Have a goodbye ritual—tell a story or play a game, give a hug, blow a kiss as you get into the car, wave to your child as she stands on the step. • Think up a few games—kiss a child’s palm and fold her fingers around it. Tell her if she needs a kiss from you while you’re away there is one for her in her hand. • Never keep the fact that you’re going out a secret from your child. Talk about it ahead of time. • If you are going to have a babysitter, ask her to come a half hour before you leave so she can start a game with your child before you go.

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172 CRYING

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DEALING WITH INJURIES You don’t want your child to grow up being babyish about minor injuries, but you should never underestimate one, especially if you can see the damage. There is no point in saying that a small scratch doesn’t hurt, because the sight of blood will scare your child and she will use pain as an excuse for your attention. Whenever your child comes to you with an injury give sympathy and support and use placebos whenever you can. The best possible placebo is a kiss and a cuddle and a gentle word. Next, try a favorite drink or snack, then suggest a small treat—perhaps your child’s favorite food for the next meal, or having a tea party in the garden. Always keep your “magic” ointment handy. In our house it is a simple antiseptic that can be used for all cuts and abrasions. It is very soothing and if your child believes that an ointment will work and take away the pain, you are halfway there.

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BREATH HOLDING As your child gets older she may try holding her breath and her face might become quite blue during them. In this instance, try any of the following tips: • Blow gently on your child’s face. • Sprinkle a few drops of cold water on your child’s face or apply a cold cloth. • Gently pinch your child’s nostrils together for a second or two.

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FAMILY CONFLICT Your children have to grow up knowing the facts of life, one of which is that adults disagree occasionally, get angry, and have quarrels, but for heaven’s sake, don’t let them be frequent.

Don’t argue in front of the children If your partnership is going through a difficult period, don’t fight in front of the children. Children, of course, want their parents to inhabit an ideal world where there is no arguing, no anger, and no acrimony, and they get very insecure when the people they love most don’t seem to love each other. The greatest deterrent to having a quarrel with my husband came when my second-youngest

son, at four-and-a-half years old, snuggled up next to me right after we had had an argument, looking very doleful. When asked what was wrong he said, “I don’t know, but the world doesn’t feel right.” Most children have an instinct to be peacemakers; mine certainly did. As soon as they heard a raised voice or an opinion vehemently expressed, they’d start diversion tactics like, “Do you want a cup of coffee, mom,” and then actually interject with, “Please don’t get in a woos,” their term for getting upset. It is very hard to lose your temper when a child is pleading with you to stay calm. Remembering the damaging effect that witnessing a argument can have on a child is a great deterrent.



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Watching your baby grow and develop is one of the most exciting aspects of being a parent, and during the first year you’ll be astounded by how quickly your child changes. With each passing week, he’ll gain control over the various muscles in his body so his coordination will improve, and with this improved coordination he’ll be able to sit, crawl, stand, and, eventually, walk and run. His manipulation abilities will improve and gradually, over the months, he’ll develop fine control over his movements.

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180 PHYSICAL DEVELOPMENT

MILESTONES: BIRTH TO 6 MONTHS Month

Milestone

Birth

• Head control when on his back If you grasp your baby around the upper chest and lift his body from the mattress, his head will be so heavy and floppy that it will just hang back. This is why it is so important to support his neck and head carefully. • Sitting Your baby won’t be able to sit up at all without support. If you hold him in a sitting position his back will be round and his head will loll forward. He’ll be very wobbly, and will collapse immediately unless supported. • Crawling Your baby will be born with a crawling reflex (TFF
Q),  but will lose this as soon as his body uncurls from the fetal position.

1

• Mobility Your baby will have lost his newborn appearance, but his legs will still be bent. He may lift his head. • Manipulation Your baby’s hand will be held in a tight fist; he’ll reflexively grasp anything put in his palm. • Head control when on his stomach Your baby will lie with his head to one side, with his bottom pushed up in the air, and his knees slightly bent underneath his body. • Sitting Your baby’s back will still be rounded and he’ll only be a little steadier. However, he’ll try and hold his head up for a second or two when held by you.

2

• Mobility Your baby continues to stretch himself. When lying on the floor, he can lift his head to a 45-degree angle and hold it for a few moments. • Manipulation He’ll hold his hand open more often and his grasp will become voluntary. • Head control when on his back If you lift your baby from the mattress by holding on to his hands, he’ll be able to hold his head in line with the rest of his body for a second or so. • Head control when on his stomach Your baby’s body will be more fully stretched out and he’ll be able to lift his head from the mattress for a moment or two.

3

• Mobility Your baby’s body will be completely uncurled and his legs will be extended. He’ll hold up his head. • Manipulation His hands will generally stay open although he may not be able to grasp anything for long. • Head control when on his back If you pull your baby up from a lying position by his hands, he will keep his head up in line with the rest of his body without additional help from you. • Head control when on his stomach He will now lie quite flat and be able to raise his head and hold it in this po time. He’ll begin to take the weight of his sho slightly outstretched forearms. • Standing Once your baby can support his head, he’ll enjoy being held facing you with his feet touching your knees. Lift him up and down so he feels his feet in contact with your legs and learns the sensation of taking his weight. AT THREE MONTHS

GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 181

Month

Milestone

4

• Mobility Your baby should be able to roll from side to side and on to his back. He’ll support himself on his forearms. • Manipulation Your baby will have discovered his own hands, which he’ll suck and play with. • Head control when on his stomach Your baby will be able to raise both legs off the mattress. He’ll be able to support his chest and head by propping himself up on his forearms. This way he’ll be able to see what’s going on around him. • Sitting If you hold your baby in the sitting position, he will be able to sit with his head held up; the lower part of his back will still be rounded, but the upper part will be almost straight.. • Crawling Your baby will probably raise chest and legs off the floor while making swimming movements with his arms.

5

• Mobility When placed on his stomach, your baby will push his head off the mattress. He’ll roll from back to side. • Manipulation Your baby will be able to grasp objects between his hands and will love sucking his own feet this way.

6

• Mobility Your baby will be able to twist in all directions and may sit briefly unsupported. • Manipulation Your baby will be able to hold an object between finger and thumb and may be able to rotate his wrist. • Head control when on his back Your baby’s head and neck will be so strong and well-controlled that he’ll be able to raise his head from the mattress and look at his toes. • Head control when on his stomach Your baby will be able to take the weight of his head, shoulders, and torso on his outstretched hands, and roll from his back to his side. • Sitting Your baby will be able to sit up without support, but only for a few seconds. • Crawling Your baby will be able to support the top half of his body on outstretched arms,, and you may see the first signs of crawling when he bends his knees up below his body. Although he’s moving into the crawling position he probably won’t yet have got the hang of it, the result of which will be his rocking back and forth. • Standing By now he’ll probably make jumping movements by bending and straightening his knees and hips whenever he’s held in a standing position.

AT SIX MONTHS

182 PHYSICAL DEVELOPMENT

MILESTONES: 7 MONTHS TO 1 YEAR Month

Milestone

7

• Mobility Your baby’s ability to sit will improve, although he may have to bend forward to balance himself. • Manipulation The finger and thumb become completely opposable. Your baby will hold an object in each hand and can transfer small objects from one hand to the other. • Sitting He will be able to sit alone but will be very unsteady. His back will still be rounded and he will have to support himself with both arms, probably by placing them in front of his body as a kind of brace. However, in this position he won’t be able to move his hands in any way because he’ll be relying on them for balance. Any movement will result in his tumbling over. • Crawling Probably within a month of the previous stage your baby will have begun to take his body’s weight on one outstretched arm when he wants to. • Standing He may start a sort of dancing movement instead of jumping and he’ll also start to hop from one foot to another. Babies quite often place one foot on top of the other then pull out the underneath foot and repeat the whole movement over and over again.

8

• Manipulation Your baby’s dexterity will improve and he’ll use a pincer movement to grasp small objects. • Sitting Your baby will be able to sit up completely unsupported and will be able to turn around. He will still be a bit unsteady so always make sure that he is surrounded by soft cushions in case he topples over. • Crawling Your baby will have begun to pull himself forward on the floor with his head held erect, making kicking movements. • Standing If he hadn’t started his dancing movement instead of jumping, this will begin about now and he’ll start hopping from one foot to another. He may also start standing on one of his feet, pulling out the lower foot and repeat it endlessly.

AT EIGHT MONTHS

GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 183

Month

Milestone

9

• Mobility Your baby will make determined efforts to crawl and may be able to support himself on his hands and knees. • Manipulation Dexterity continues to improve. He begins to poke his index finger into holes in toys. • Sitting Your baby’s balance will be so well-developed that he’ll be able to swing his torso to look around and will be able to reach forward without losing his balance. • Standing He can take his full weight on his feet, but can’t balance yet. If you support your baby firmly underneath the arms, he will be able to take his weight on his legs and will try to move one foot in front of the other. Supported on your lap, he will try to take a step or two forward. At this stage, you must support your baby very securely to take most of the weight, because his balance is still primitive.

10

• Mobility Your baby will be able to crawl with both his arms and legs straight. He’ll pull himself to a standing position. • Manipulation Your baby will be able to hold two objects in one hand. He’ll be a little clumsy in releasing them. • Standing The muscle control of his knees and feet will have improved and he will begin to pull himself up to a standing position on furniture, despite the fact that his balance is still far from good.

11–12

• Mobility Your baby will probably be able to toddle when supported but will “cruise” along furniture by himself (TFF
Q).  • Manipulation Your baby will be able to hold crayons, feed himself, and give and take objects. Coordination will improve daily.

AT TEN MONTHS

184 PHYSICAL DEVELOPMENT

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Helping your baby to sit up Cdli]Vindj`cdl]dlVWVWnaZVgch idXdcigda]^h]ZVYVcYidh^ije!ndjXVc ]ZaendjgWVWnWneaVn^c\h^b^aVghdgihd[ e]nh^XVa\VbZhVhi]dhZeaVnZY^ci]Z[^ghi bdci]hd[a^[Z#I]ZhZ\VbZhl^aa^cigdYjXZ ndjgWVWnidi]ZjhZd[i]ZbjhXaZh]Z cZZYh[dg\gVhe^c\!ejaa^c\!VcYejh]^c\#

Propping your baby up ;gdbVhZVganVhh^mlZZ`hndjgWVWn h]djaYWZ^cXajYZY^cl]Vi¼h\d^c\dc# Egde]^bjel^i]Xjh]^dch^c]^hXVgg^V\Z dg^cVWdjcX^c\X]V^g#L^i]Vaad[bn X]^aYgZc>[djcYi]ZWdjcX^c\X]V^gi]Z WZhilVnd[egdee^c\i]Zbje#I]ZX]V^g

SAFETY TIPS WHEN PROPPING YOUR BABY UP • At about five to six months old, most babies learn to roll over from their back to their sides and then from their front on to their back. Once your baby acquires this skill, he must never be left lying anywhere except on the floor, in a space that you’ve cleared of all hard or sharp objects. You should never leave your baby alone anywhere. • When your baby is propped up, surround him with cushions. By the age of six months, when only his lower back needs support, he should still be padded around the bottom with cushions.

• Never leave him propped up on a chair or bed —he should always be on the floor.

• At about seven months old, when your baby will start to sit up, but topple over many times while attempting to do so. You must surround him with cushions or pillows so that he does not get hurt. • Beware of leaving lightweight cribs, furniture (chairs, for example), or carriages within his reach. Your baby could easily pull them over by grabbing the side of something unstable and attempting to pull himself upright.

186 PHYSICAL DEVELOPMENT ^hhd[iVcYbdaYhidi]ZWVWn¼hgdjcYZY h]VeZ0^iXVcWZhV[ZaneVYYZYl^i]hd[i e^aadlhVcYXjh]^dch#7jii]ZWVWnbjhiWZ hV[ZanhigVeeZY^cid^iidegZkZci]^b[gdb ha^ee^c\!VcY]^h]ZVYbjhiWZhjeedgiZY l^i]VXjh]^dcdge^aadl#7ZXVjhZi]ZX]V^g ^hhdheg^c\n!^igZhedcYhidndjgWVWn¼h _Zg`nVgbbdkZbZcihVcY`^X`^c\!hd]Z^h ZcXdjgV\ZYidignidbV`Zi]^c\h]VeeZc [dg]^bhZa[#CZkZgejiVWdjcX^c\X]V^gdc ViVWaZdgdi]ZggV^hZYhjg[VXZ^cXVhZndjg WVWn¼hbdkZbZcih¹WdjcXZº^id[[#

SAFETY TIPS • Never leave your baby alone. • Remove furniture with sharp edges and corners. • Remove anything breakable from a surface that is less than 3 feet (1 meter) from the floor. • Don’t leave wires trailing across the floor. • Cover sockets with safety plugs. • Make sure that there are no electric switches less than 3 feet (1 meter) from the floor. • Put safety gates across doorways and at the bottom of the stairs. • Try to keep the floor clear of small, sharp toys. • Make sure all fireplaces are guarded. • Don’t leave any cloths hanging from tables, which a baby could reach up and pull. • Make sure that all furniture is sturdy and fixtures are safely attached to the wall. • Never leave anything hot on the table in the same room as your baby. • Make sure that stair balusters are not wide enough apart for a child to squeeze through. • Make sure that all cabinet doors are closed firmly and that the handles are out of a crawling baby’s reach; if they aren’t, lock them or seal them with masking tape. • Make sure that all containers of poisonous substances are locked away or out of reach.

Crawling 7Z[dgZndjgWVWnXVcXgVla!]Z]VhidWZ VWaZid\Zi^cidi]Zg^\]iedh^i^dc#=Z]Vh idWZVWaZidhigV^\]iZc]^hWdYnhdi]Vi ]^haZ\hVgZdjihigZiX]ZY#=Z]VhidaZVgc VYZfjViZXdcigdad[]^h]ZVYVcYcZX`# =Z]Vhid]VkZi]ZhigZc\i]idejh]je dcWdi]d[]^hVgbhhdi]Vi]^hX]ZhiVcY ]ZVYVgZXaZVgd[i]Z[addg# >i¼hY^[[^XjaiidheZX^[nViZmVXianl]Vi V\ZVWVWnl^aahiVgiidXgVla!hdndj h]djaYgZ\VgYi]Zi^bZhdceV\Zh&-&·&-( VhhiV\ZhbdgZi]VcV\Zh#L]Vi¼hbdgZ! ndjh]djaYc¼ildggn^[ndjgWVWnh]dlhcd ^ciZgZhi^cXgVla^c\#HdbZWVW^Zh]ViZan^c\ dci]Z^gijbb^ZhVcYi]ZnVgZjhjVaani]Z dcZhl]dadkZhZZ^c\l]Vi¼h\d^c\dc VgdjcYi]Zb#I]Znl^aaegdWVWanaZVkZ XgVla^c\idVaViZghiV\Z0^cYZZY!hdbZ WVW^ZhcZkZgaZVgcidXgVlaViVaa!Wjihi^aa lVa`eZg[ZXian#

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GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 187 jhZVaa]^hdlcgZhdjgXZh!^cXajY^c\]^h YZiZgb^cVi^dc!id\Zi^i# ™ 7VW^ZhaZVgcWnb^b^Xgn[gdbVkZgnZVgan V\ZhddcXZ]ZhiVgihign^c\idXgVla^i¼h cdiVWVY^YZV[dgndjid\ZiYdlcdc i]Z[addgndjghZa[VcYXgVlal^i]]^b# ™ Ha^eeZgn[addgh!Vai]dj\]jhjVaan YVc\Zgdjh!XVcWZZcXdjgV\^c\[dg XgVla^c\WVW^ZhWZXVjhZZkZci]Z ha^\]iZhibdkZbZci^hgZlVgYZYl^i] [dglVgYbdi^dc#

Shuffling IdbdkZ[dglVgYndjgWVWn]Vhid XddgY^cViZ]VcYbdkZbZcihVcY`cZZ bdkZbZcih#>c^i^Vaan]ZbVn[^cYi]^h Y^[[^XjaiVcYbVnYZk^hZVjc^fjZh]j[[a^c\ bdkZbZciidegdeZa]^bhZa[[dglVgYVcY WVX`lVgY#I]^hXVcWZVcni]^c\[gdbV h^YZlVnhXgVW"a^`ZbdkZbZciidV`^cYd[ h]j[[a^c\dc]^hWdiidbl^i]dcZaZ\ ijX`ZYjcYZgcZVi][dgaZkZgV\Z#>iYdZhc¼i bViiZgl]VihinaZd[bdkZbZcindjgWVWn VYdeih¸VaaVgZVXXZeiVWaZ#I]Z^bedgiVci i]^c\^hi]Vi]Z¼hbVhiZgZYi]ZVgid[ bdk^c\0^i¼hV\gZViVX]^ZkZbZci!VcY]Z h]djaYgZXZ^kZVadid[egV^hZ[dgYd^c\hd# 9dc¼iY^hXdjgV\ZndjgWVWn[gdbVcndYY bdkZbZcih]ZbV`Zh!WjigVi]ZgaZi]^b Y^hXdkZg]dlidXdcigdaVcYbdkZ]^hWdYn ^c]^hdlceVgi^XjaVglVn#

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188 PHYSICAL DEVELOPMENT ]Z\V^chXdc[^YZcXZ^ci]ZbdkZbZci#Ndj XVcVahd]ZaeWncdi\Zii^c\Vc\gnl]Zc ndj]VkZidYd^idkZgVcYdkZgV\V^c#

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HELPING YOUR BABY STAND • Don’t put socks or shoes on your baby’s feet. He

• Don’t play tricks on your baby by suddenly

has much better grip and balance when his feet are bare. If your house is cold, put booties with suede soles on your baby’s feet. Make sure that all your baby’s clothing is loose so that movement isn’t restricted. • All the furniture in the room should be heavy, firm, and stable so that there’s no risk of it toppling on the baby as he holds onto it. • Resist the temptation to hurry your baby with standing or walking. He’ll do it in his own good time and nothing you do can rush the process.

removing your support. This will give your baby a bad fright and could damage his trust in you, because until that moment you were the one thing he could rely on. • Don’t start to use sleeping bags for the first time now—your baby will try to stand and will fall. If he’s used to one it’s all right to continue with it. • Make sure that all wires and cords are tucked away or firmly tacked down. He may start by cruising around furniture, but a cord may seem an ideal “hold” once he’s on the move.

GENERAL DEVELOPMENT—1 TO 2 YEARS 189

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Physical milestones At 13 to 15 monthsNdjgWVWnh]djaYWZ VWaZidhiVcYWn]^bhZa[VcYiV`ZdcZdg ildhiZehidgZVX]Vhjeedgi#=dlZkZg!]Z ldc¼iWZVWaZid\Zije[gdbi]Zh^ii^c\id i]ZhiVcY^c\edh^i^dcl^i]djihjeedgi [gdbndjdgWn]daY^c\dcid[jgc^ijgZ# At 15 to 18 monthsNdjgWVWnl^aaWZ VWaZidgV^hZ]^bhZa[idi]ZhiVcY^c\edh^i^dc jcV^YZY#=Zl^aaegdWVWanWZ\^cidlVa` l^i]djiVcnhjeedgi^ci]ZZVganedh^i^dcd[ [ZZil^YZVeVgiVcYZaWdlh]^\]#EgVXi^XZ bdgZaZ\bdkZbZcihl^i]ndjgWVWn!jh^c\ VaVg\Zhd[iWVaai]Vi]ZXVcignid`^X`id ndj#I]^hVahd]Zaeh]^hWVaVcXZ# At 18 to 20 monthsLVa`^c\l^aaWZXdbZ hiZVY^ZgVcY]^hVgbhl^aaYgdeYdlcid]^h h^YZ#NdjgidYYaZgl^aaVabdhiXZgiV^can lVciidlVa`jehiV^gh# At 21 to 24 months NdjgidYYaZgl^aaWZ VWaZidbV^ciV^c]^hWVaVcXZl]^aZ]Z WZcYhdkZgide^X`hdbZi]^c\jeVcYl^aa cdi[VaadkZg#9VcXZl^i]]^bid]Zae]^b egVXi^XZVl^YZgVc\Zd[bdkZbZcih#

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HELPING YOUR CHILD WALK • Arrange the furniture around the room so that he can go down one side, across, and up the other. • Initially, spaces between furniture should be no bigger than the width of your baby’s arms so that he can hang on to something with one hand and stretch out the other to reach the next support easily. If the gaps are too big, your baby won’t be able to reach the support that will enable him to cross the space. • While your baby is learning to walk, make sure that the floors aren’t slippery—one bad bang may keep him from walking for several weeks.

• Make sure the room is baby-proofed, with no cords or objects that can be pulled over.

• He doesn’t need shoes or socks; bare feet are safer not only because there’ll be no risk of malformed feet but also because he’ll be able to grip well and get used to the sensation of weight. • A useful aid to complement cruising and your baby’s first steps is a pushing toy or cart. Make sure it has a stable wide base so it won’t topple over. Don’t use a baby walker. • Always stay nearby when your baby is taking his first steps.

WALKING—1 TO 2 YEARS 191

SAFETY TIPS • Remember that once your toddler can walk

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he’ll also be able to climb, so install childproofing devices on all windows: either bars or special fasteners that allow the window to be opened only a few inches. • Keep possible hiding places like cabinets or chests securely locked so that your baby can’t disappear and get locked in. • Door locks must be out of reach. • Do not allow your unsupervised child into a backyard with access to the street. Teach the street-training drill as soon as possible. • Teach your toddler how to negotiate stairs properly, by sitting on the top stair, putting his legs down to the one below, and then following with his hands. • Keep all the handles of pans turned away from the front of the stove. • Never leave anything hot lying where your toddler can reach it. Keep it out of his reach until it is absolutely cold. • Glass doors should never be so clean that your toddler bumps into them. Put colored paper or stickers on the glass to make them visible. • Keep all medicine in a medicine chest, high up and always locked. Never carry medicine around in your purse. • Move cleaning products out of reach or store them in a locked cabinet. • Don’t put rugs on polished floors unless they are backed with double-sided tape or carpet grip to stop them from slipping. • Don’t let your child near anything that is small enough to be swallowed or pushed up his nose or into his ear. • Keep all sharp instruments, including kitchen equipment, out of your child’s reach. • Never leave sewing materials or tools around. • Never leave your child alone near water.

192 PHYSICAL DEVELOPMENT

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GENERAL DEVELOPMENT—2 TO 3 YEARS 193

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194 PHYSICAL DEVELOPMENT

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COORDINATION—BIRTH TO 1 YEAR 195

HAND–EYE COORDINATION Month

Skill

How to help

Up to 2

Until he is about eight weeks old your baby will not have learned to use his hands. He’ll be learning to focus; the maximum distance at which he’ll be able to focus will be about 8–10 inches (20–25 centimeters).

Your baby will try to focus on anything that is moving, for instance a colorful mobile. However, your face will be the most interesting object in his life, so make sure he sees it often and close. Hang interesting objects in his line of sight, no further than 10 inches (25 centimeters) away.

2–2½

Your baby will have opened his hands and will watch them with fascination. Focusing distance is not much more than 12 inches (30 centimeters) so he’ll bring hands and fingers up to his face so he can watch them moving.

As soon as your baby’s hands are open, they are ready to have things put into them. The most interesting toys are the ones that make a noise, like a rattle. They are also useful because your baby starts to make a connection betweenn what his hands are doing, what his eyes are seeing, and what he can hear.

2½–3

Your baby will watch his hands very carefully and with a lot of concentration. When he does this you’ll know that he has made the connection between seeing and doing. At about this age your baby may make a clumsy movement with either hand to get near an object.

Your baby is learning to judge distances and to move his hands to where his eyes think something interesting is happening. Put a string above his crib or carriage with lots of interesting objects hanging from it. Let them swing freely so that your baby can reach up and touch them and see them move as a result of his action.

3–4

Your baby will touch everything in sight, and will be learning how to measure distances using his hands and eyes. He’ll look at an object and then confirm the distance by trying to reach it. Instead of using an open hand, he will try to make a fist before he connects with it.

Your baby will now be too old for swinging things. If something goes out of reach it will only frustrate him because he wants to grasp it. Instead of having objects dangling from a string, secure them to the sides of the crib. You can hold out an object so that he can try to get hold of it. Always wait until he’s touched it before handing it over.

4–6

Your baby’s hand–eye coordination will be developing rapidly, so he judges distance well and his eyes will be mature enough to focus on objects at any distance. He will also be learning to grasp, so when he reaches out and touches an object he’ll open his fingers and curl them around whatever he wants to hold.

Your baby really needs lots of practice at reaching out and grasping things; he’ll also have a great deal of fun doing it. You can encourage him to do this by holding out the most interesting objects you can find, for example, anything that makes a noise or is an interesting shape. It could be a plastic bottle, a ball of wool, or car keys.

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COORDINATION—1 TO 3 YEARS 197

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198 PHYSICAL DEVELOPMENT

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TEETH—BIRTH TO 1 YEAR 201

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HOW THE TEETH COME IN The first to erupt are usually the lower front incisors, then the two upper incisors. The two upper lateral incisors come next, followed by the lower ones. After this, the first upper molars erupt and then the first lower molars. The upper canines come in next, one on each side, followed by the lower ones. The second molars erupt first in the lower -BUF F 'JSTU
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Help toddlers with tooth brushing

VISITING THE DENTIST

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Take your child for his first dental check-up before his third birthday, and make sure that this visit is as relaxed and pleasant as possible. Take your child for this visit when his teeth are healthy rather than waiting for signs of problems. Get your child used to the sight of the instruments and the smell of the surroundings by taking him with you when you go for your own checkup. If he can be trusted, and if your dentist has no objections, sit the child on your lap and let him watch while the dentist examines you. He’ll no doubt be fascinated and will be delighted to copy your example. Just before your child’s visit, play a game of going to the dentist and look into each other’s mouths. Then, when you actually get to the office, prearrange for the dentist to look at your mouth before he looks at your child’s.



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Your baby is the most responsive and rewarding pupil you will ever meet. She wants to do more things, explore more areas, and widen her horizons more than anyone else you know. She also wants to please you, and the combination of these qualities gives her an appetite for learning that should thrill you. One of the most important things to remember is that she is never too young to learn, though you’ll have to tailor the way you introduce her to new experiences or the ways you try to teach her. Don’t set her tasks that are beyond her capabilities, as this will only lead to frustration. Guide her in all things, but never try to force her.

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208 INTELLECTUAL DEVELOPMENT

WHAT YOUR BABY UNDERSTANDS Newborn baby Your baby will concentrate on your face if you bring it close to her, and she can distinguish your voice from other people’s. When she hears your voice her eyes will move in the direction of your face and she will try to follow it if you move your face close to her. She can recognize your face if you place it about 8–10 inches (20–25 centimeters) away from the time she’s 36 hours old. Four weeks If your face is close enough for her to focus on, she’ll watch you while you are talking and she’ll mimic your talking by opening and closing her mouth. She may stop crying when you pick her up because she knows you are a source of comfort. She imitates the movements of your face: she can use the right muscles to smile and grimace. Six weeks She will smile back at you and her eyes will follow a moving toy. Eight weeks If you hold something brightly colored above her head, she will take a few seconds to focus on it and will then follow it as you move it from side to side. Three months She will immediately see a toy held above her. She will smile when you speak and

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will squeal and gurgle with pleasure. There will be obvious signs of curiosity and interest in what is going on around her. Four months At feeding times, she will show signs of excitement. She will laugh and chuckle when played with. She will love being propped up because she’ll be able to see what is going on; she will turn her head in the direction of sounds. Five months She’ll be aware of strange situations and can express fear, disgust, and anger. Six months Your baby will become very interested in mirrors and in seeing herself in one. Eight months She will know her name and will understand the word “No.” She will probably have developed little sound signals like a cough to attract your attention when she reaches out for something she wants. She’ll probably want to feed herself at around this time. Nine months She’ll show a will of her own and may stop you when you try to wash her face. She will concentrate very hard on toys and games and will even turn a toy over in her hand so that she can examine it carefully. When an object is hidden under a cloth, she’ll lift the cloth up to see the object. Ten months She’ll probably be able to clap her hands and wave bye-bye. She’ll show that she understands a small number of words, and very short, simple statements. Eleven months She’ll know, and will enjoy, simple games like “Peek-a-boo.” Her other favorite game will be dropping things and having you pick them up. She’ll become very noisy and will want to shake and bang anything that makes a noise. Twelve months She will do anything to make you laugh and will repeat it over and over again. She’ll enjoy “reading” simple books with you and will help you undress her by lifting up her arms when you take off her clothes. She may know a few simple words like bottle, bath, ball, and drink.

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212 INTELLECTUAL DEVELOPMENT

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INTELLECTUAL DEVELOPMENT 12 months Your baby likes looking at simple books with you and loves a joke—she will repeat anything that makes you laugh. She’ll understand that she should hold up her arms when you dress her and she knows the meaning of simple, frequently used words like shoe, bottle, and bath. She may even say one or two intelligible words. 15 months She will show you that she wants to brush her own hair. She’ll know what kissing means and will give you a kiss if asked. She’ll be very thrilled by any new skill and will want to help you with household chores like dusting. Even though she doesn’t understand individual words she can understand quite complex sentences. 18 months When you are reading together she will point to things, like a dog, ball, or cow. She will recognize a cow and say “Cow.” She’ll know the

different parts of her body: if you ask her where her foot is she will point to it, and to her hand, her nose, her mouth, and her eyes. She’ll know the difference between her nose and Mommy’s nose. If you ask her to fetch something she will. 21 months She will come to you, attract your attention, and take you to things that she is interested in or has a problem with. She’ll love scribbling with a pencil. She’ll begin to understand and obey simple requests and questions. 2 years She likes her own company and will play happily on her own. Instead of just scribbling with a pencil, she will make up-and-down strokes in imitation of writing. She knows the names of many familiar objects and toys and will use the words with meaning. Once she learns the meaning of a word she may repeat it continuously.

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218 INTELLECTUAL DEVELOPMENT

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INTELLECTUAL DEVELOPMENT 2 years and 3 months She will try to build houses and castles with blocks and will repeat new words when you encourage her. She knows who she is and can say her name. She’ll begin to pit her will against yours, and may become negative. She’ll say the word “No” more often and won’t always conform to your wishes. 2 years and 6 months She loves helping you and will help with chores, putting things away, and bringing things to the table. She’ll know both her first name and last name. She can draw horizontal lines and vertical lines and can name several common objects. A boy will notice that his sex

organs stick out from his body wheras those of his mother, and of his little girlfriends, do not. 2 years and 9 months She’ll begin to ask questions. She’ll know the difference between boys and girls. She’ll learn nursery rhymes and will be able to repeat them. She’ll begin to understand numbers. She’ll try to draw a circle but won’t be able to complete it successfully without help. 3 years She’ll like to play with other children. She’ll know more nursery rhymes and will almost be able to draw a circle. She’ll know the difference between words such as on, under, and behind, and will be able to form complicated sentences.

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EARLY READING Some children have a natural inclination toward reading early and writing before their peers. If yours is one of them, encourage and help but never push. Your child can only master these advanced skills when the brain and intellect are sufficiently developed. You are not able to know whether your child’s brain is capable of reading (and later writing), so take your lead from her. Until this happens, simply continue read to her, point out and name objects in books, and encourage her to repeat them. I’m against using “flash cards” when your child finds it onerous and boring. In this instance you’re only doing it for your own satisfaction and pride. This should never be the reason for making your child do anything. But if your child is eager to learn words and gets pleasure from remembering flash cards, do encourage her as much as you can. Don’t try to make her read. When she’s ready, she’ll start pointing out words. Only then should you start to help her.

224 INTELLECTUAL DEVELOPMENT

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SPEECH—BIRTH TO 1 YEAR 227 Eleven to twelve months NdjgWVWnl^aa egdWVWanhVn]Zg[^ghi¹gZVaºldgYhhdbZ i^bZYjg^c\i]^hbdci]#I]ZZbZg\ZcXZd[ i]ZhZ[^ghildgYh^hVhbjX]XdcigdaaZYWn ndjgWVWn¼he]nh^XVaVW^a^inidVgi^XjaViZ VcYbV`ZheZZX]hdjcYhVh^i^hWn]Zg ^ciZaaZXijVaVW^a^inidbV`ZXdccZXi^dch WZilZZcdW_ZXihVcYaVWZah#I]ZldgYhh]Z X]ddhZhl^aaVabdhiXZgiV^canWZi]ZcVbZh d[i]^c\hi]ViVgZ^bedgiVciid]Zg/eZdeaZ a^`ZbVbV!YVYV!Vc^bVahYd\!XVi!VcY dW_ZXihXje!WVaa#

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BILINGUALISM Children thrive on having two languages to learn. When young babies are learning to talk, they can make all linguistic sounds. They find a new language much easier than adults do. It also seems to be easy for them not just to learn them, but also to think and speak in two languages. I remember watching my young godchild looking from her French mother who was speaking French, to her English father, who was speaking English. She was just two-and-a-half years old, but she replied to her mother in French and her father in English. I would encourage exposing children to more than one language.

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SPOTTING IF SOMETHING IS WRONG Don’t worry if your baby doesn’t speak in her first year. As in everything else, children develop speech at different rates. But if your child is still not combining words by age two, you need expert help. If hearing is deficient, it’s crucial to have the faults attended to before she starts school. If you are concerned about your child’s speech, discuss the issue with your pediatrician, who may refer you to a speech therapist or developmental specialist. Many problems can be corrected if identified early enough.

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SPEECH—1 TO 2 YEARS 229

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230 INTELLECTUAL DEVELOPMENT

THE FIRST SENTENCES Some time before your child’s second birthday she’ll start to string words together. This is an important milestone because it shows that she’s aware of the relationship between objects. Your baby’s first sentences will be limited in meaning. They’ll probably explain something that has just happened or describe what someone is doing. Her sentences will be concerned with: What’s happening

Me run Cow go moo Truck bump

Who possesses what

My dolly Mommy dress Grandma bag

Where things are

Doll in box Daddy in backyard Ball in bath

Repetition

Me more milk Play again

Where something’s gone

Drink all gone No more toy

Her sentences won’t follow adult grammatical rules—that develops later—but they have a logic of their own. She’ll learn fairly early that certain words are used together. She’ll repeatedly hear “Pick up,” “Put on,“ “Go out,” and will continue to use them as one word even when joining them to others. So she’ll have “Car pick up,” “Door go out.” She’ll make the past tense by adding “d” to anything—“I wented”, “You goed,” “I gaved.” To make words plural, she’ll add an “s” to the end—”Look, fishes,” “Mouses,” “Gameses.”

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SPEECH—1 TO 2 YEARS 231

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SPEECH—2 TO 3 YEARS 233

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234 INTELLECTUAL DEVELOPMENT \Zii]ZldgYhid\Zi]Zg!ndjXdjaYed^ci ]Zg^ci]Zg^\]iY^gZXi^dcWnhVn^c\!¹L]Vi Y^YndjbV`Z^ci]ZhVcYWdm4ºdg¹=dl Y^Yndj\ZiYdlc[gdbi]Zided[i]Z Xa^bWZg4º¹L]ZgZY^Yndj\ddcndjg ig^XnXaZ4ºNdjXVcegdbei]ZggZhedchZhWn Vh`^c\!¹L]Vi]VeeZcZYcZmi4º DcZd[i]Zi]^c\hVaabnX]^aYgZc Zc_dnZY^cVXdckZghVi^dc!lVh[dgbZid aZVkZVWaVc`i]Vii]ZnXdjaY[^aa^cl^i]i]Z

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HELPING WITH GRAMMAR As your child begins to understand the more complicated aspects of grammar, you can help, as before, by simply repeating what she has said in the correct form. As she starts to apply the constructions more and more widely, help her to use them in the correct way with new words and expressions.

Negatives With your help, your child can learn to put the negative where it belongs. By listening to you, she learns to use won’t, can’t, wouldn’t, hadn’t, wasn’t. Your child says, “I not eat biccit.” You say, “You didn’t eat your biscuit.” Your child says, “No candy left.” You say, “Oh, dear—there isn’t any more candy.” Questions In the same way, you can teach her how to ask questions correctly and to use the appropriate words that precede questions. Your child says, “Go out?” You say, “Where shall we go?” Your child says, “More?” You say, “Would you like some more ice cream?” Your child says, “Coat on?” You say, “Why do you put your coat on?” In this way, your child learns to use the “wh” words, such as what, who, which, where, and why.

Adjectives One of the best ways to teach your child about adjectives and the relationship of one object to another is to do it by opposites. If your child says, “big ball,” you can look around for a smaller ball and then introduce her to the concept of opposites like big and small. You will be able to show her that compared to each other, one is bigger than the other and one is smaller than the other. Similarly, you can introduce other concepts to your child, such as wide and narrow, thick and thin, deep and shallow, heavy and light, hard and soft. Always demonstrate with the appropriate objects and, if possible, make it into a kind of game. Possessive pronouns Your child says, “I bring book here,” and you can say, “You were over there and you brought your book to me here.” Your child says, “I hate this biccit.” You say, “Then I’ll eat your biscuit and you can eat my biscuit.” Your child says, “This Jennifer coat, that Mommy coat.” You say, “Yes, that is your coat, Jennifer, and this is my coat.” This way your child learns how to use the words “my” and “yours.”

SPEECH—2 TO 3 YEARS 235

Asking and answering questions

Always answer truthfully

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LISPING This is common speech defect in children who are just learning to talk. It occurs because the child simply has not mastered all the sounds needed to speak, so she substitutes a similar sound that she can make. The child may be copying another child with a lisp. This can become a habit, however. Neither of these is anything to worry about and usually stops without treatment. Lisping may indicate a more serious underlying problem though. It may be caused by a degree of deafness, a cleft palate, or a faulty action of the tongue. Although these possibilities should have been excluded at your child’s regular developmental checkups, if you are at all concerned about a child’s persistent lisping, consult your pediatrician so that speech therapy can be started if necessary.



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238 SOCIAL BEHAVIOR

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PERSONAL DEVELOPMENT—BIRTH TO 1 YEAR 241 dc!VcYl^aaWZkZgnZV\ZgidaZVgc# LV`Z[jaWVW^ZhVgZjhjVaankZgnhdX^VWaZ VcYV[[ZXi^dcViZ#6ai]dj\]]ZbVnZm]Vjhi ndj!]Z¼aaWZkZgngZlVgY^c\# Jci^andjgWVWn¼hdaYZcdj\]id ZciZgiV^c]^bhZa[!ndjVcYndjgeVgicZgl^aa WZ]^hhdaZ[dgbd[ZciZgiV^cbZci!VcY]Z bVnYZbVcYndjgViiZci^dcViVaa]djghd[ i]ZYVnVcYc^\]i#>[ndjYdc¼ildg`dji hdbZhdgid[h]^[ihnhiZbl^i]ndjgeVgicZg! ndjbVnWZXdbZhd[Vi^\jZYi]Vindj XVccdiXVggndc#9dc¼iWZgZhZci[jad[ndjg WVWn¼hlV`Z[jacZhh0ignidVXXZei^iVcY iV`ZegVXi^XVahiZehidbV`ZhjgZi]Vindj \ZiZcdj\]haZZe# ™ 8Vggni]ZWVWnVgdjcY^cVha^c\# ™ L]Zcndj¼gZVi]dbZ!iV`Zi]ZXg^Wdg XVgg^Zgl]ZgZkZgndj\d!VcYeaVXZ^i hV[ZandcViVWaZdgldg`hjg[VXZhdi]Vi ndjgWVWnXVc]ZVgndjgkd^XZ# ™ =VkZeaZcind[e^XijgZhVcYbdW^aZhdkZg i]ZXg^Whdi]Vi]Z¼aaWZdXXje^ZY# ™ Egde]^bje^cVWdjcX^c\X]V^gdg^ci]Z XVgg^V\ZdghigdaaZgl^i]higVehdc[gdb VWdjih^mlZZ`h# ™ @ZZei]ZWVWn¼hgddblVgbWZXVjhZi]^h hdbZi^bZhZcXdjgV\ZhhaZZe^cZhh#

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242 SOCIAL BEHAVIOR

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BOUNDARIES—BIRTH TO 1 YEAR 243

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244 SOCIAL BEHAVIOR [V^ajgZl^aaWZkZgnYZbdgVa^o^c\#L]Zc ndjgWVWn^h^ci]^h`^cYd[bddY! Wjaan^c\VcYegZhhjg^c\l^aaXVjhZbdgZ hijWWdgccZhh#7ZiVXi[ja!]jbdgdjhZkZc! VcYVa^iiaZYZk^djh#>[ndjaZindjgWVWn [ZZai]Vi]Z^hiV`^c\Xdcigda!ndj¼aa[^cY i]Vi]ZkZgnd[iZcVYVeihidl]Vindj lVci#>chiZVYd[hVn^c\¹9dc¼iºidndjg WVWn!l]d^hi]gdl^c\eaVhi^Xbj\h ZkZgnl]ZgZ!bV`Zi]ZXaZVc^c\je^cidV \VbZ#H^iYdlcVcYhj\\Zhii]Vi]Zignid e^X`i]ZbVaajeWZ[dgZndjXdjciidiZc#

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Possible concerns W^gi]id&nZVg BVcnldbZcWZa^ZkZi]Vibdi]ZgadkZl^aa WZijgcZYdca^`ZViVeVhhddcVhi]Z^g WVWn^hWdgc#>iXVcXdbZVhgVi]ZgVh]dX` l]ZcV[iZgZkZcilddgi]gZZYVnhi]Zn Ydc¼i[ZZaVcni]^c\[dgi]Z^gWVWni]Vi gZhZbWaZhadkZ#I]ZnbVn[ZZaiZcYZgcZhh VcYegdiZXi^kZcZhhidlVgYi]^hi^cncZl WZ^c\l]d^hYZeZcYZcidci]Zb!Wjii]Zn Ydc¼i[ZZaVhigdc\!W^cY^c\adkZ# I]^h^hkZgnXdbbdcVcYcdiViVaa VWcdgbVa#AdkZjhjVaanYdZhYZkZade V[iZgdcZdgildlZZ`h#Jci^a^iYdZh! XdcXZcigViZdcZc_dn^c\ndjgWVWn e]nh^XVaan/i]Z[ZZad[ndjgWVWnV\V^chi ndjgh`^c0]^hhbZaaVhndjejindjgcdhZ

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Postpartum depression BdhildbZc]VkZ[ZZa^c\h`cdlcVhi]Z WVWnWajZhV[iZgX]^aYW^gi]#I]ZhZVgZ XVjhZYWni]ZYgVbVi^XYgde^c]dgbdcZ aZkZah!VcYjhjVaanhddceVhh#6Wdji&% eZgXZcid[bdi]Zgh!]dlZkZg!YZkZade edhieVgijbYZegZhh^dc!l]^X]^hbdgZ hZg^djhVcYXVcV[[ZXindjggZaVi^dch]^e l^i]ndjgWVWn#GVe^YbZY^XVaViiZci^dc ^hcZZYZY¸i]Zadc\ZgedhieVgijb YZegZhh^dc^haZ[ijcigZViZY!i]Zadc\Zg^i

BOUNDARIES—BIRTH TO 1 YEAR 245 XVciV`ZidgZhdakZ#EdhieVgijbYZegZhh^dc ]VhbVcnhnbeidbh!VcYldbZc ZmeZg^ZcXZi]ZhZ^ckVgn^c\XdbW^cVi^dch# 6hlZaaVh[ZZa^c\hhjX]Vh]deZaZhhcZhh VcYYZhedcYZcXn!hj[[ZgZghXVcZmeZg^ZcXZ aZi]Vg\n!Vcm^Zin!iZch^dc!haZZeY^[[^Xjai^Zh! adhhd[^ciZgZhi^chZm!dWhZhh^kZi]dj\]ih! [ZZa^c\hd[\j^ai!VcYaVX`d[hZa["ZhiZZb# >[ndj]VkZVcnd[i]ZhZhnbeidbhYdc¼i WdiiaZjendjg[ZZa^c\h¸hZZ`]Zae#
Antisocial babies ?jhiVhi]ZgZVgZVYjaihl]d`ZZe i]ZbhZakZhidi]ZbhZakZh!hdbZWVW^ZhVgZ h^beanVW^iVci^hdX^Va#I]ZnYdc¼ihb^aZ bjX]!i]ZngZhedcYa^iiaZidWZ^c\iVa`ZY id!i]ZnhZZbcdiidZc_dneaVn^c\\VbZh! VcYi]ZnbVncdia^`ZWZ^c\XjYYaZY#Dc i]Zdi]Zg]VcY!i]ZnXVcWZXdbZjehZi^[ aZ[iVadcZ^cVhigdaaZgdgXg^W#I]ZnXVcWZ gVi]Zg^gg^iVWaZVcY\ZijehZiZVh^an#I]Zn iZcYidXgnVcYVgZhadl![jhhn[ZZYZgh# L]ZchjX]VWVWn^hi^gZY]Z^h[gZi[ja WjiYdZhc¼i\didhaZZe#NdjgWZhiZ[[dgih [V^aidbV`Zi]^h`^cYd[WVWnhjccn!VcY ndjbVn[ZZandjVgZaVk^h]^c\adkZida^iiaZ Z[[ZXi#7jiYdc¼iWaVbZndjghZa[¸hdbZ WVW^ZhVgZ_jhia^`Zi]^h0ndjVgZcdiVadcZ# 6WVWnl]dhb^aZhVadiVcYZmjYZh _dn\Zih[g^ZcYh]^e!adkZ!XdbeVc^dch]^e! VcY]Zae^cgZijgc#I]ZWVWnl]dVXih b^hZgVWaZdgl]d_jhihiVnh^ccZjigVa\Zih aZhh^cgZijgc#A^[Z^hcdiVheaZVhVci[dg ]^b!hd]ZbVn\gdljeidWZVigdjWaZY ^cY^k^YjVa#6hVeVgZcindjbVn]VkZid ldg`]VgYid\ZindjgX]^aYidWZbdgZ edh^i^kZ#6ai]dj\]ndjbVn[^cY^iY^[[^Xjai! ndj]VkZidignndjgWZhiid\ZindjgWVWn

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Babies with disabilities 6aaWVW^ZhYZkZadeViY^[[ZgZciheZZYh! [gdb kZgn[VhiidkZgnhadl#>iXVcWZ Y^[[^Xjaiid_jY\Zl]Vi^hcdgbVaVcY l]Vi^hcdi#>[ndj[ZZai]VindjgWVWn^h cdi`ZZe^c\jel^i]i]Z\ZcZgVahdX^Va b^aZhidcZhsee p.238!Xdchjaindjg eZY^Vig^X^Vc#=dlZkZg!b^cdgegdWaZbh bVncdih]dlje[dghZkZgVabdci]h!hd ValVnh[daadlndjg^chi^cXih#>[ndjhjheZXi i]VindjgWVWn^hcdiYZkZade^c\cdgbVaan! hZZ`ZVgan]Zae#I]ZZVga^Zgndj\Zi]Zae! i]Z\gZViZgi]ZX]VcXZndj]VkZd[YZVa^c\ l^i]VcVWcdgbVa^in# >[ndjgWVWn]VhVe]nh^XVaY^hVW^a^in! ^i¼h d[iZcXdb[dgi^c\VcY]Zae[jaidiVa`id eZdeaZ^ch^b^aVgh^ijVi^dch!hdXdciVXiVcn gZaZkVciV\ZcX^Zh#

HEAD BANGING Toward the end of the first year, some babies begin to bang their head against the end of the crib. This is rarely a sign of abnormality, and there’s little risk of brain damage; most babies grow out of it quite quickly. However, minimize the risk by padding the ends of the crib with a quilted fabric, and by buffering the crib and the wall if it causes an irritating banging noise. Try giving your baby a relaxing bath at bedtime and an extra long cuddle—some psychologists think that such children may need more physical attention and stimulation. Music may also be soothing. If your baby continues to bang his head for several months, talk to your pediatrician.

246 SOCIAL BEHAVIOR

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Likes and dislikes 6X]^aYWZ\^chidh]dlVaa`^cYhd[ VhhZgi^kZcZhhYjg^c\i]^hnZVgVcY^i^h cVijgVai]Vi]Zh]djaYYZbdchigViZ egZ[ZgZcXZhYgVbVi^XVaan#=Z^hkZgnZV\Zg id\gdljeVcYidh]dli]Vi]Z^h\gdl^c\ je#=Zcdadc\ZghZZh]^bhZa[VhVb^ggdg ^bV\Zd[ndj0]ZcdlhZZhi]Zildd[ndj VhhZeVgViZeZdeaZ!VcYi]ZgZ[dgZ[^cYhcd gZVhdc[dgYd^c\ZmVXianl]VindjlVci# =Zl^aaWZYZiZgb^cZYidZmZgX^hZ]^h ^cYZeZcYZcXZVcYl^aagZ[jhZd[[Zghd[ ]ZaeVcYh]gj\d[[ndjgVhh^hiVcXZ!ZkZc l]Zc]ZgZVaancZZYh^i# NdjgX]^aY^hYZkZade^c\a^`ZhVcY Y^ha^`Zh!VcY]VhVkZgnhigdc\jg\Zid[ja[^aa ]^hdlcYZh^gZh!ZkZci]dj\]i]ZnbVncdi WZi]ZhVbZVhndjgh¸VcYnZii]ZXdc[a^Xi i]^hbVnWg^c\XVcbV`Z]^b[ZZakZgn jc]Veen#NdjgX]^aY^hidgcWZilZZci]Z kZgnhigdc\Yg^kZidZmZgi^cYZeZcYZcXZ VcYi]ZYg^kZidWZadkZYWnndj# :kZcl]Zc]Z^hign^c\idl^cV WViiaZl^i]ndj!]ZcZZYhndjg]ZaeVcY Zbdi^dcVahjeedgiWZXVjhZ]Z^hidd ^bbVijgZidbVcV\Zl^i]djii]Zb#

Balancing his needs Ndjg_dW^hidiV`Zi]Zb^YYaZgdVYVcY ignidWVaVcXZndjgX]^aY¼hcZZY[dg ^cYZeZcYZcXZl^i]i]ZcZZY[dgadkZVcY egdiZXi^dc#>i^hc¼iValVnhZVhn#Ndjg idYYaZg¼hi]^c`^c\^h^bbVijgZ!]^hbZbdgn ^hh]dgi!VcY]^h_jY\ZbZci^hjcgZa^VWaZ# =ZXVc¼ii]^c`V]ZVYVcYbVnWZ^beVi^Zci l]Zci]^c\hYdc¼i\ZiYdcZ^bbZY^ViZan# 6ii]ZhVbZi^bZ!ndjgX]^aY^hZV\Zg idXdcigdaVcYYdb^cViZi]ZldgaYVgdjcY

PERSONAL DEVELOPMENT—1 TO 2 YEARS 247

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248 SOCIAL BEHAVIOR

Personality NdjgX]^aY^hWdgcl^i]]^hdlceZghdcVa^in! l]^X]h]dlh^ihZa[l^i]^ci]Z[^ghi[Zl lZZ`hd[a^[Z#=dlZkZg!i]ZgZVgZXZgiV^c hdX^Vah^ijVi^dchi]Vil^aaYZkZadeVX]^aY¼h eZghdcVa^inYjg^c\ZVganX]^aY]ddY#I]Zn XVcWg^c\djiWdi]i]Z\ddYVcYWVY VheZXihd[]^heZghdcVa^in!hdignidbV`Z hjgZi]Vii]Z\ddYigV^ihVgZVXXZcijViZY VcYi]ZWVYdcZheaVnZYYdlc#

THE TIMID CHILD Some children are naturally shy; they keep to themselves, and speak very little. Don’t immediately think that your child has problems and become overanxious and overprotective. A child who is talkative on home ground may be completely silent and withdrawn in a strange place or when confronted with strangers. This happens in many children around the age of one. In a new situation, don’t increase your child’s difficulties by insisting that he join in immediately. Allow him to sit quietly on your knee or to stand by your side while he takes in what everyone is doing and becomes familiar with it. After half an hour or so, when you can sense that he is feeling more comfortable, gradually encourage him to join in your conversation. Even a shy child, if encouraged in this gentle, slow way, will join in with new friends and new games after an hour or so. But remember to introduce new experiences slowly and allow your child to get used to them before moving on to other ones. If your child is very timid and shy he may become very upset if you try to leave him with a babysitter. You must try to understand your child’s feelings and still give him your love no matter how irritating the situation is. He’ll grow out of this clinginess with your help, but he’ll need to gain a sense of security first.

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250 SOCIAL BEHAVIOR XVciZVX]]^bVWdjih]Vg^c\WnhVn^c\i]Vi ^[]Z]Vh]^h[g^ZcY¼hidn!]Zbjhi\^kZdcZ d[]^hidi]Z[g^ZcY#6X]^aYd[ild^h jhjVaanVWaZidjcYZghiVcYi]Z_jhi^XZd[ i]^hgZX^egdX^in# Ndj]VkZidYZVal^i]h]Vg^c\^ckZgn h^beaZiZgbh!WZXVjhZ^ciZaaZXijVaanndjg

ONLY CHILDREN Although only children undoubtedly benefit from the constant love that they receive, and grow up feeling very close to both parents and friends, there are few who don’t confess to having wanted brothers and sisters at some stage in their lives. This is rarely a serious problem, but one of the things you can do to mitigate any possible problems is to introduce your baby to other babies of the same age. As your baby reaches the sociable age, around 18 months to two years, make a real effort to find friends for him and invite them to visit you at home.

Try not to overindulge It’s easy for parents to overindulge an only child and to make him feel too important. You’re going to have to curb your desire to give him all that he wants and, just as important, all your attention. It’s important that he learns to accept that he can’t have everything he wants and be the permanent center of your world, just as a child in a larger family has to (TFF
Q).  It may be tempting to be possessive and overprotective. This can be bad for you and your child. You’ll feel bereft when he becomes independent and needs you less, but your child will lose out on a sense of curiosity, adventure, and independence and may become clingy. You mustn’t shy away from disciplining your child either. Like any other child, he has to be shown the right way to behave if he’s to grow up able to mix with others.

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BOUNDARIES—1 TO 2 YEARS 251

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252 SOCIAL BEHAVIOR

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BEHAVIOR GUIDELINES Learning the rules of social behavior and learning self-control takes time; it doesn’t take months, it takes years. Don’t expect him to remember what you said last time. He isn’t necessarily defying your previous instruction, he may simply have forgotten it. A child of two has a very short memory, so be forgiving and repeat your instructions. Words never mean as much as actions, and you really do have to show your child how to behave. Here are some of the things that you can do. • Have as few “rules”—those instructions that cannot be broken under any circumstances—as possible. “Don’t” is a very negative word and if you are not careful, by the time your child is two, you could be prefacing everything you say with “Don’t.” “Do” is a very positive word so reinforce with positive “dos” and cut down the “don’ts.” • Don’t give vague instructions; try to be very clear. Instead of saying “Don’t be naughty,” tell him exactly what you don’t want him to do. • If you give your child instructions, always give a reason why. If you tell your child that his tricycle has to be put away when he’s finished using it at night, explain that otherwise it may get rusty in the rain and not work. Try to avoid saying “Because I say so” when he asks you why.

• Always reward good behavior with praise and affection, possibly even with a treat if your child has accomplished something difficult. You can help him distinguish between good and bad behavior just by withholding praise and rewards from acts you don’t approve of. • There is no better way to get your child to do something than to show that you do it, too. If you want your child to take off his dirty shoes at the door, show him that you do it, too. • Be consistent. Don’t let your standards slide and give one instruction on one occasion and the opposite on another (although you can show that under certain circumstances you are prepared to be flexible). There is no reason why your child shouldn’t have a lot of ice cream on his birthday, because he knows that that day is special, but he should learn not to expect the same on the following day. • Always admit your mistakes to your child, no matter how young he is, and always be generous when you do something wrong. It makes your child feel that the world is fair and just. Don’t be afraid to say, “naughty Mommy,” or “Mommy shouldn’t have done that,” or “You are right. I won’t do it again.”

BOUNDARIES—1 TO 2 YEARS 253

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254 SOCIAL BEHAVIOR

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STUTTERING Nearly all children of this age have jerky speech that, on occasion, may turn into a real stutter. This may be because your child has so many ideas in his head that he thinks more quickly than he can speak. It may also be that he is very excited and simply can’t articulate properly. Stutters can also appear for a short time and then disappear again. Stay calm and don‘t draw your child’s attention to the stuttering. Don’t jump in with the word that you think your child is looking for. Simply accept his speech. Making your child feel nervous and self-conscious about the way he talks will only increase his tendency to stammer.

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BOUNDARIES—1 TO 2 YEARS 255

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256 SOCIAL BEHAVIOR

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258 SOCIAL BEHAVIOR

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PERSONAL DEVELOPMENT—2 TO 3 YEARS 259

Answering children’s questions 8]^aYgZcl]dVgZZcXdjgV\ZYidVh` fjZhi^dch!VcYl]dVgZ\^kZcZmeaVcVi^dch! iV`Z[dg\gVciZYi]Vii]Z^geVgZcihl^aa a^hiZcidi]Zb#I]ZhZX]^aYgZc\gdljeid WZ]Vee^ZgVcYaZhhVji]dg^iVg^Vci]Vc X]^aYgZcl]dhZfjZhi^dchVgZ^\cdgZYVcY l]dVgZgVgZanhjeea^ZYl^i]ZmeaVcVi^dch# EVgZcihl]diV`ZcdiZd[l]Vii]Z^gX]^aY hVnhVgZh]dl^c\i]Vii]ZnXdch^YZg]^bVc ^cY^k^YjVal^i]hdbZi]^c\jhZ[jaidhVn# >[ndjg[Vb^anWZa^ZkZhVcYdeZgViZh^ci]^h [gZZVcYZVhnbVccZg!^i¼h\d^c\idWZV bjX]]Vee^Zgjc^i# >ci]ZZVgannZVgh!ndjgX]^aYgZ\VgYh ndjVhdbc^hX^ZciVcYl^aacVijgVaanijgcid ndj[dgVYk^XZdcbdhihjW_ZXih#>[ndj gZbV^cVeegdVX]VWaZVcYlZaXdbZ fjZhi^dch!ndjgX]^aYl^aa\gdlje[ZZa^c\ i]Vi]ZXVciVa`idndjVWdjiVcni]^c\# 9^hXdjgV\^c\ndjgX]^aY[gdbVh`^c\ fjZhi^dchl]Zc]Z¼hndjc\VcYjc^c]^W^iZY l^aadcanbV`ZVcn^c]^W^i^dchldghZVh]Z \ZihdaYZg#>[ndjlVciidWZi]ZXdc[^YVci d[ndjgX]^aYgZc!^i^h^bedgiVciidignid `ZZei]ZX]VccZahd[Xdbbjc^XVi^dcdeZc ViVcnXdhi# Ndjh]djaYcdiVkd^YVchlZg^c\ fjZhi^dch!ZkZc^[i]ZnZbWVggVhhndj#>[ ndjVgZXdcXZgcZYVWdjil]ZcidiZaandjg X]^aYVWdjihZm!i]ZVchlZg^hndjZmeaV^c i]Z[^ghii^bZ]ZVh`hndj#6X]^aY¼hXjg^dh^in h]djaYValVnhWZbZiWnndjgl^aa^c\cZhh idVchlZgigji][jaan#>i^hbjX]WZiiZg^[]Z aZVgchVWdjihZm^cVcVXXjgViZ!bViiZg"d[" [VXilVn[gdbndji]Vc^cVhZXgZi^kZ! bZadYgVbVi^XlVn[gdb[g^ZcYhl]dbVn lZaa]VkZhdbZd[i]Z^c[dgbVi^dclgdc\# ;gdbVWdjii]gZZnZVghdclVgY!VX]^aY XVc]VcYaZViaZVhieVgid[i]Zigji]VWdji hZmjVafjZhi^dch!Vai]dj\]^i^hcdijci^a]Z

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HANDLING GENITALS Babies usually become aware of their genital organs toward the end of the first year, but handle them without any obvious pleasure. Handling eventually does bring a pleasurable sensation, and then fondling becomes more like real masturbation. Most children of both sexes masturbate, and it’s simply unreasonable to expect them not to. Despite the myths, it will not lead to blindness or insanity. It is perfectly normal for a boy to handle his penis. After all, he handles every other part of his body that sticks out. In young children, this is rarely done for any length of time or for any purpose. The pleasure it brings is more general than sexual. It is not until children are much older that they feel sexual excitement.

Don’t scold your child There is no reason to discourage a child from handling genitals, nor should you stop him from masturbating. That will only cause furtiveness, and worse, it may stop your child from discussing anything about genital organs in later life. Unless masturbation is an obsessional means of escaping from reality, the best way to treat it is by paying no attention to it at all. If by accident it happens in public, distraction is the best course of action, but never, ever, scold your child for it.

260 SOCIAL BEHAVIOR

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BOUNDARIES—2 TO 3 YEARS 261

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Shyness HdbZX]^aYgZcVgZh]nWncVijgZ!VcY hijY^Zhh]dli]VijeidiZceZgXZcid[ ^c[VcihVgZWdgcl^i]VcZgkdjhhnhiZbi]Vi egZY^hedhZhi]Zbidh]nWZ]Vk^dg#HjX] X]^aYgZch]dli]Z^gh]ncZhhWn\^k^c\ Zk^YZcXZd[Y^ha^`^c\cZlZmeZg^ZcXZh0ZkZc l]ZciV`ZcidV[Vb^an\Vi]Zg^c\dgeVgin! i]Znl^aaheZcYbdhid[i]Zi^bZXa^c\^c\ idi]Z^gbdi]Zgh¼aZ\hdg]^Y^c\i]Z^g[VXZh#

STEALING Most young children are used to taking things that belong to others—their mother’s makeup, a sibling’s toy, or their father’s keys—just because they want to play with them, and at home this isn’t usually a problem. However, young children are incapable of understanding the “property rights” of others, and you may discover that your child has taken something while you were out shopping or visiting a friend’s home. If this is the case, explain to the child that this is stealing, and that stealing is not allowed. Eventually, your child will get the idea. It isn’t necessary to have the child accompany you when you return the object, unless the habit has become persistent and you feel that extra enforcement is necessary. Most children feel penitent enough on being found out.

262 SOCIAL BEHAVIOR

“HABITS” Nail-biting, thumb-sucking, and carrying a comforter are not abnormal in a young child. Don’t try to stop them, and certainly never by force, ridicule, or deprivation. They are nearly always caused by tension of some kind and they happen in about half of otherwise normal schoolchildren. For the most part, they are unconscious, nervous habits and are best cured by encouraging pride in appearance. For example, the majority of children stop nail-biting when they become more concerned about their appearance and become interested in the opposite sex. At this age, social considerations begin to outweigh personal habits. I don’t believe in discouraging these habits. As they get older, children sense what is acceptable, impose self-control, and only indulge in their habit in private No one can persuade me that

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Play has a vital role in your child’s development and provides a platform for learning, especially about becoming sociable. To learn to become sociable, a child has to have contact with children of the same age, and these contacts will mainly be made through play. Parents now know that for their children to be healthy and happy and to grow up well adjusted, they need to be given liberty to play for as long as possible. To this end, parents provide their children with all sorts of play equipment and toys, with an emphasis on their educational value.

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TOYS AND GAMES FOR BABIES Never in a baby’s development is play more synonymous with learning than in the first few years of life. She is learning to see properly and discovering how to use her hands and how to master hand-eye coordination (TFF
Q).  She may learn quite a lot simply by watching and moving her own hands, but she’ll practice and perfect her new skills with any toys you give her.

Suitable toys • Mobiles • Rattles • Mirror • Music boxx • Large/ small balls • Soft toys • Squeaky toys • Bendy toys • Activity center • Books • Cooking utensils

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SAFETY TIPS • Make sure the toys you buy are for the appropriate age group.

• Never give your child anything to play with that is so small that she might swallow it by accident or gag on it, or push it up her nose or into her ear. • If you buy an second-hand painted toy make sure that the paint is leadfree. Young children put everything into their mouths and children have been known to get lead poisoning from toys covered with paint containing lead. (This applies to second-hand furniture, too.) • Never leave your baby alone while she is playing, not even in a playpen. • Always provide nontoxic crayons and pencils. For your own sake, make sure that the crayons, pencils and felt-tips markers you provide will wash off surfaces and fabrics. • Don’t buy toys made from thin rigid plastic. They break easily and leave sharp edges. • When you buy soft toys, check for a safety label. If there’s no label, make sure that there are no sharp pieces of wire used to hold any pieces on, and check that eyes and noses are firmly secured to the fabric.

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268 PLAYING

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PLAY—BIRTH TO 1 YEAR 269

BABY MASSAGE Massage is a wonderful way to express your love for your baby; in the early days it helps the bonding process between you and your child—it helps to calm an unsettled baby and can help an anxious mother come to terms with handling her precious new baby. Older babies and toddlers also benefit from massage; it is an effective way of soothing a

fretful baby and can help an overexcited toddler relax. Work from the head down, with light strokes, ensuring that both sides of the body are massaged symmetrically. Use sweeping strokes and do each part two or three times. On small areas, use only your fingertips. On some parts of her body you will need two hands and on others one.

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270 PLAYING

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TOYS AND GAMES FOR TODDLERS

Playing with paint

Your toddler’s coordination will improve greatly this year, as will her manipulative skills. Toys that make use of both of these will provide the most enjoyment, but be prepared for your child to be a bit clumsy at first and give her large items. Household objects will continue to be popular, but other toys may stretch coordination and mental processes further.

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Suitable toys • Shape sorters • Stacking blocks • Building blocks • Hammering table • Push/pull toys • Dolls • Cars • Crayons and felt markers • Paints and brushes • Blackboard • Books • Modeling clay • Sandbox • Wading pool • Slide • Swing • Climber frame • Wagon

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272 PLAYING

PAINT TIPS • Keep paint in small plastic jars, preferably the nonspill variety that have a hole in the top for the paintbrush. • Plastic egg cartons make a difficult-to-spill artist’s palette for your child. • Children love making their own paint, so make up a little liquid starch in a small container and provide some bottles of food coloring. Children can add the food coloring until they have the color they require. • Cleaning up is easier if you add a little bit of detergent to finger paints. • You can make a paint that will stick to a shiny surface like glass or aluminum foil by mixing a few drops of food coloring, an egg yolk, and powdered detergent. However, if you are using egg, make sure your that the child is not allergic to eggs. • If you buy your child felt-tip markers or crayons, make sure they’re the fat, chunky ones because they’re easier to hold. Make sure they are washable, too. • Take a fairly large block of synthetic foam rubber and cut different-sized holes in it. Stand up all your child’s bottles, brushes, and jars in it so they won’t fall over. • A utensil tray makes very good storage for bottles, jars, and paintbrushes. • Put drawing paper on a paper towel dispenser and attach it to the wall in your creative corner. • Keep your old newspapers for floor covering, or use a large plastic tablecloth.

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CREATIVE MATERIALS Glue Mix 8 ounces (250 grams) flour with a teaspoon of salt in a pan. Add 20 fluid ounces (600 milliliters) water slowly until it’s absorbed into a paste. Simmer for five minutes then cool and refrigerate in an airtight container until required. Modeling dough Mix three parts of flour to one part of salt, then stir in one part of water. Color with food coloring and store in an airtight container. Mock play dough Mix together equal parts of salt and flour. Add a little oil and then add enough water to mix to a stiff dough. Knead until soft and stretchy.

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SAFETY TIPS • Keep her far away from any kind of pool containing water. No matter how small or shallow it is, even if she can swim, she should never be left unattended. • Any game that involves metal implements is potentially dangerous, for example, metal buckets and spades or toy pistols. So is any game with sharp or pointed instruments, such as bows and arrows or toy knives. • Never let your toddler go anywhere near or handle fireworks or matches.

276 PLAYING

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STORAGE TIPS

CLEANING AND PREPARING TOYS

• Save plastic containers with lids for storing blocks

• Always buy machine-washable stuffed toys. • You can use a vacuum cleaner clean stuffed toys

or other small toys. Those made for ice cream or margarine are ideal. • Use brightly colored labels for easy identification of what’s inside your containers. • Large glass jars are good for storage because you can immediately see what’s inside them. • Never throw out any shoe boxes—they make good beds for dolls as well as houses or barns. • Loop a plastic mesh basket over the faucets in the tub to store all bathtub toys. • Use a flat-topped chest for storing larger toys. This can double up as a table. • Your child’s toys are bound to get strewn around your home. Try to keep a basket in each room to make for quick and easy neatening. • Keep a special bag or box of toys in the car.

in between washes.

• Try to buy plastic toys that can be put into the dishwasher when they are dirty.

• If plastic toys have got out of shape, you can soak them in hot water and then re-mold them with your fingers. • Clean and deodorize smelly toys by sponging them with a cloth that has been soaked in a solution of baking soda. • You can dry clean your child’s soft toys by shaking them in a bag containing a generous amount of baking powder.

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TOYS FOR 2- TO 3-YEAR-OLDS Children of this age are gaining steadily in independence, control of language, and new skills. They like to build things up and knock them down, and they love “let’s pretend” games.

Suitable toys • Large-piece jigsaw • Modeling clay • Plastic building bricks • Scissors (blunt-ended) • Glue • Carriages and strollers • Tea sets • Toy washing machines, cooking utensils • Playhouse • Tricycle • Cars and trucks • Jungle gyms

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TELEVISION Some babies are introduced to television while they are still in their cribs. Their parents see television as a built-in babysitter to keep children amused. For a lot of children television is more popular and consumes more of their playtime than all other play activities added together. Here are some of the reported facts about television: • Television is at its least useful when a child is left to watch it alone. Even if she’s watching a highly educational program she’ll get less out of it if she watches it in an entirely passive way. But if she watches with other children who comment on it, or with an adult who asks questions and makes observations, the program can act as a springboard for ideas and discussion. • Some parents let television interfere with the usual eating and sleeping routines, leading to upset digestion and tired children. • Watching television can curtail other activities, especially outdoor play and playing with other children; it may leave little time for creative play. • Television often presents information in a more exciting and dramatic way than schoolbooks and schoolteachers. Children therefore often find books and schoolwork boring. • Television cuts down on conversation and other social interactions in the family.

• Characters on television are often presented as exaggerated stereotypes and children come to think that people in a given group have the same qualities as the people portrayed on the screen and this influences their attitude toward them. • If a child watches too many programs portraying crime, torture, and cruelty, this may blunt a child’s sensitivity to violence so that she accepts violent behavior as normal. • Two groups of children were studied for the effects of violence on television. One group saw violent programs, the other did not. The studies showed that the young children in the group who watched the violent programs were noticeably more aggressive, both with other children and with their toys, than those children who had not been exposed to the same programs. • Children are great imitators and as the lawbreakers often seem more glamorous than the heroes, children tend to identify with the villains. • Television can present models for the behavior of the different sexes and for life roles and careers. This in turn gives rise to similar expectations in children that are not always the best. • If children are really interested in programs they have seen they may want to find out more by reading or asking grown-ups about the subject.

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No baby is too young to take on an outing. In fact, with a young baby you can go just about anywhere and, provided he can look around, he’ll enjoy the change of scene even if he doesn’t understand quite what’s going on. Planning ahead is the secret, and the younger your baby the more carefully you need to plan. If you are well organized, outings with your baby can be a great joy, and the sooner that you start after bringing your baby home from the hospital, the better. Looking after a baby doesn’t preclude parents from resuming the active life that they had before. One word of warning, though: don’t be too ambitious or undertake very long trips at first.

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WHAT TO TAKE FOR A YOUNG BABY • A changing surface (that can be a fold-up plastic mat or a cloth diaper)

• Disposable diapers • Baby wipes • Breast pads if breast-feeding • Bottle and milk powder if bottle-feeding • Hat (sun hat for summer, warm one for winter) • Sweater • Toys for distraction • Plastic bag for dirty diapers

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Using a baby sling

Using a stroller

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WHAT TO TAKE FOR AN OLDER BABY • A changing surface • Disposable diapers • Baby wipes • Baby food and spoon • Non-messy snacks • Feeding cup and some water • Bib • Hat • Sweater • Toys for distraction • Plastic bag for dirty diapers

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Using a backpack

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TIPS FOR STROLLERS • Never leave your baby unattended. • Always make sure that the stroller is fully extended and that the frame is locked in position.

• Never let go of the stroller for a moment without putting the brakes on first.

• Always put the safety harness on your baby. • Never, ever, put shopping on the handles of the stroller; it could tip over backward.

• From an early age, teach your child to keep his fingers away from the wheels.

• One disadvantage of strollers compared to carriages is that in cold weather your child is more exposed. If you don’t have a padded chair cover, lay a blanket over the stroller seat before you put the baby in. Wrap the blanket around him. • If your baby falls asleep before you get home either put the stroller down into the lie-back position or tuck him up comfortably with pillows. • If you have an older child and a baby, fit a stroller board onto the stroller to save the toddler’s legs.

LOCAL OUTINGS—BIRTH TO 1 YEAR 285

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TIPS FOR SHOPPING WITH BABIES • When you’re carrying your child in your

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backpack remember your child’s grasping fingers can reach bottles and cans in a store. • When you take your child into the supermarket, keep him supported and under control by using your own harness to strap him into the cart. • For emergencies keep a few disposable diapers, wipes, and plastic bags in the glove compartment of the car for quick changes. • Shopping seems to make children hungry and therefore fretful. Avoid this by taking a snack. • You can use the opened trunk of the car, with a blanket laid over it, as a surface on which to change your child.

286 OUTINGS AND TRAVEL

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SHOPPING WITH TODDLERS • Encourage your child to become familiar with shopping. Give him the wrappers or boxes of things on your shopping list and suggest he find them for you by matching them up with products on the shelves. • Toddlers can get lost in stores. Dress yours in an easily spotted coat or hat in a bright color. • As soon as possible, teach your child his name, address, and telephone number. In the meantime, insert a label with this information inside his coat in case he does get lost. • I used to use a referee’s whistle on a string around my neck to summon my children. We had a code: one whistle—come quickly; two whistles—run; three whistles—emergency. • Any outing can be a lesson in disguise. In the supermarket you can teach your child about healthy eating (that beans are better than spaghetti) or bargains (that buying large cans works out cheaper than getting small ones). • It’s a scary prospect but you can make sure your child could find his way alone when he’s near home by giving the same running commentary as you approach your house. “And here’s that big tree on the corner, now we turn right, past the mailbox, and here’s our street, and our house, the fourth one on the left.”

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LOCAL OUTINGS—1 TO 3 YEARS 287

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288 OUTINGS AND TRAVEL

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CAR TIPS • Never leave your child alone in the car. • When the temperature is very hot, avoid heat exhaustion and heatstroke by only taking your baby on essential short trips early in the morning and at night when it is cooler. • Secure a blind or piece of thick cloth on the car window to protect a baby from the sun. • Remove all loose objects from the back ledge in case of accident. • Always keep a bag with spare diapers and changing equipment in the car. • Have a blanket or crib quilt to put over the baby when he falls asleep.

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CAR TRIPS—1 TO 3 YEARS 289

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PREVENTING CARSICKNESS Some children are more prone to carsickness than others. Most grow out of it as they get older, but there are ways to minimize the risks: • If your child gets carsick, ask your pediatrician to suggest a suitable medicine. • Keep your child occupied. • Don’t give your child rich or greasy food within a few hours of leaving. • If your child wants a snack during the trip, give him dry cookies or a candy. • Don’t become overanxious. Children quickly pick up on their parents’ moods and this can make them apprehensive and more prone to carsickness. Excitement and apprehension play a part, and children tend to suffer more on the outward trip than on the return one. • If your child gets very pale or very quiet, stop the car. Provide a plastic bag or bowl to be sick in, if necessary. • Keep a supply of plastic bags in the car, baby wipes to clean your child up, a change of clothes, and something to take away the taste.

290 OUTINGS AND TRAVEL

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WHAT TO TAKE WITH YOU

Making the best of plane trips

• Child’s passport and immunization record,

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if necessary. • Lightweight bag for baby’s equipment. • Folding travel crib, if crib unavailable. • Stroller, carrier, backpack, or sling. • Plastic mat for diaper changing. • Bouncing chair if used. • Pack of disposable diapers; buy supplies at destination. • Diaper changing equipment. • Potty if needed. • Plastic bags for dirty diapers. • Thermos flask for days on beach. • Bottle-feeding equipment if required. • Nonspill cup, plastic dish, and spoon if weaned. • Toys and games. • Comforters if used. • Quick-drying, noncrease clothes. • Sun hat, if necessary. • Long-sleeved shirts and long-legged pants.

AIR TRAVEL—BIRTH TO 3 YEARS 291 idnh!WjidcanWg^c\i]ZbdjidcZViV i^bZVcYVi^ciZgkVahi]gdj\]i]Zig^e# ™ 9dc¼iignidZVidgYg^c`]di[ddYl]^aZ ndj¼gZ]daY^c\i]ZWVWn# ™ AZindjgWVWneaVnl^i]Vaai]Z^c"[a^\]i Zfj^ebZci¸heddchVcY[dg`h[gdbi]Z [ddYigVn!eaVhi^XhV[Zin^chigjXi^dch[gdb i]ZhZViedjX]!]ZVYe]dcZh[dgi]Z bdk^Zhdg[dgbjh^X#

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SAFE SUN TIPS Keep babies in the shade at all times. Do not expose them to the sun. Babies have little skin pigment so they have much less protection from the sun than adults, and exposure to the sun’s ultraviolet rays can lead to skin damage and skin cancer in later life. • In very hot weather, avoid taking your baby out in the sun between 11 a.m. and 3 p.m. when the sun is at its highest. • Dress your baby in a wide-brimmed hat and loose, light clothing that covers her shoulders and neck, such as a shirt or dress with sleeves and a collar. • Be aware that your baby is still at risk on cloudy days. • Make sure the carriage or stroller has an adjustable sunshade to shade your baby. • Be particularly careful near snow and water where reflected light is strong. • Apply sunblock of at least SPF 30 to your child before he goes out and reapply often. Use waterproof sunblock when swimming.

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Accidents in the home cause a large percentage of deaths of children between the ages of one and four. Most of these incidents are avoidable, so take the time and care to minimize the chances of anything happening in your home. Most accidents are caused by a chain of events rather than a single occurrence—for example when someone is ill or tired, or when something unusual is happening.

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RISK FACTORS The chances of an accident happening are increased by the following factors: • If your child is tired, ill, or hungry. • If parents are tired or ill or if the mother is premenstrual or pregnant. • When there’s great excitement in the home, such as when you’re going on vacation or expecting the arrival of a new baby.

• If your child is considered hyperactive. • If you and your partner aren’t getting along, or if you’re actually fighting. • If your child doesn’t have anywhere safe to play. • If correct safety precautions haven’t been followed. • If the equipment you use for your baby doesn’t comply with safety standards.

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294 HOME SAFETY

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ROOM-BY-ROOM SAFETY 295

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296 HOME SAFETY

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298 HOME SAFETY

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ROAD SAFETY It’s never too early to teach your child the safety code for crossing the street. Whenever you want to cross the street, always go to a pedestrian crossing if possible or find the safest place to cross—one where you can see clearly in all directions and drivers can see you. Stop by the curb, hold your child’s hand or her harness, look in both directions for traffic, and listen. If traffic is coming, let it pass. Look in both directions again and when nothing is coming, walk across; don’t run. Continue to look and listen as you cross. Keep up commentary about what you’re doing, looking for, and listening for. ,FFQ
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EMERGENCY FIRST AID 299

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ST

RECOVERY R POSITION For a baby under one year Cradle your baby in your arms with her body facing slightly toward you. Keep her head lower than her body to help keep the airway open. For a child An unconscious child who is breathing should be placed in the recovery position to keep her airway open and to allow liquids to drain from her mouth. Roll your child over onto her side with the uppermost leg

bent and the lower leg straight. Make sure her lower arm is clear of her body. Bend her upper arm at the elbow so that it supports her body, place her upper hand under her cheek to help keep the head back.

302 HOME SAFETY

Chest compressions for a baby under one year

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Warning • Do not give your child anything to eat or drink. If she’s thirsty, simply moisten her lips with water. • Do not warm her with a hot-water bottle or electric blanket; it takes blood away from the vital organs.

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304 HOME SAFETY

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• Don’t put lotion or fat on the area. • Don’t cover a burn with an adhesive dressing. • Don’t cover the burn with a “fluffy” dressing or any cloth that sheds lint.

• Don’t remove anything that is sticking to the burn: you may cause further damage to the skin or tissue and introduce infection. • Don’t overcool your child; it could cause hypothermia.

EMERGENCY FIRST AID 305

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306 HOME SAFETY

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EMERGENCY FIRST AID 307

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Warning • Never shake your child to check his level of consciousness. • If your child is unconscious, assess his condition. If he is breathing, place him in the recovery position (TFF
Q); if he’s stopped breathing, begin resuscitation.

FIRST AID KIT Always have a first aid kit in your home (and a separate one in the car). Keep it out of reach of your

children in a cool dry place. Check the contents regularly and restock as necessary.

• Sterile gauze squares in various sizes for

• • • • •

• • • • • • •

cleaning wounds. A box of adhesive dressings in various sizes. Sterile dressings with bandages attached in various sizes. Small and large roller bandages such as gauze or crêpe bandages. A roll of 1 inch (2.5 centimeter) hypoallergenic adhesive tape. A sterile eye pad with bandage attached. 2 triangular bandages Safety pins

Blunt-ended tweezers and scissors Disposable gloves Protective face mask for rescue breathing Antiseptic cream Calamine lotion

Other useful items • Children’s acetaminophen and/or ibuprofen liquid • Insect repellent • Antihistamine syrup • Sunscreen with the highest protection factor • Digital thermometer



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All parents are worried when their child is sick. The difficulty can lie in not being able to identify what’s wrong with the child (especially when he’s too young to tell you how he feels) and in not knowing how serious the ailment really is. All children get sick at some stage, but modern medicine is so efficient that few illnesses now pose the threat that they once did. Health care professionals can identify and prescribe for the ailment; it’s the parents’ job to provide the essential nursing and comfort. Sometimes it’s difficult to know when to ask for help, but if you’re worried, it’s always best to seek medical advice.

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310 HOME MEDICINE

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USING A THERMOMETER—BIRTH TO 3 YEARS 311

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TYPES OF THERMOMETERS AVAILABLE Never use a mercury thermometer in your child’s mouth; he may bite it and swallow mercury, which is poisonous. Digital thermometers are harder to break and easy to use with children of all ages and can be used in the mouth, under the arm, or rectally. A baby’s temperature should be taken rectally for the most accurate reading. To take the mouth temperature, ask your child to open his mouth and raise his tongue. Place the thermometer under his

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tongue and ask him to place the tip of his tongue behind his lower front teeth to hold the thermometer in place. Ask him to close his lips, but not his teeth, over it. Wait until the thermometer beeps and read the number in the window. Ear thermometers are accurate and give a reading in seconds. Strip thermometers are less accurate than the others, but simple and safe to use. Always wash a thermometer after use in soap and cold water.

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312 HOME MEDICINE

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GIVING MEDICINE TO A BABY OR CHILD If you are using a syringe or a plastic measuring spoon to administer medicine to your child, measure out the dose before you start. Make sure that you have understood your doctor’s instructions if you’re giving a prescription medicine and follow them precisely. When giving overthe-counter medication, read the directions on the package very carefully. If you are at all unsure, check with your doctor or pharmacist. You’ll need to hold your child securely. It’s best to hold his hands gently out of the way to prevent him from knocking the medicine out of your hand.

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GIVING MEDICINE—1 TO 3 YEARS 313

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ADMINISTERING DROPS TO A BABY OR CHILD

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314 HOME MEDICINE

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COMFORT AND RECUPERATION TIPS • Give your child treats. If he has a sore throat give

• Make a worktable by cutting a semi-circle out of

him ice cream. • Cool cotton sheets are soothing to a feverish child. Change the bed regularly. • When your child is vomiting, always be there, and support his forehead with the palm of your hand. Give him some water to rinse his mouth with, and perhaps a mint to suck afterward to take away the bad taste. • Put a table next to the bed for his toys, books, fruit juices, or water.

an inverted cardboard box. This can be placed over your child’s lap. You could also support a sanded wooden plank on two chairs placed either side of the bed. • Buy some new toys for your child. Don’t give them to him all at once, but one at a time. • If your child isn’t feeling too sick you could try wrapping the toys up so that you can play a game together. Ask him to guess what’s in the packages by feeling them, then let him tear off the paper.

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N

Blisters

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N

Bruise

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N

Burns

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N

Congested or runny nose

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N

Chicken pox

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N

Colds

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N

Cold sore/Herpes simplex

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N

Colic

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N

Conjunctivitis

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N

Coughing

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N

Cradle cap

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N

Croup

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Cuts and abrasions

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N

Diarrhea

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N

Drowsiness

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N

Earache

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N

Eczema

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N

Epilepsy

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N

Eye discharge

6hi^X`nZnZ^h[V^ganXdbbdc^ci]Z[^ghi lZZ`dghdV[iZgndjgWVWn^hWdgcVcY^i ^hcZVganValVnhXVjhZYWnVa^iiaZWaddYdg Vbc^di^X[aj^Y\Zii^c\^cidi]ZWVWn¼hZnZ Yjg^c\W^gi]# What to do I]ZgZ^hValVnhi]Zedhh^W^a^in i]Vii]Zhi^X`nZnZ^hXVjhZYWnVWVXiZg^Va ^c[ZXi^dc!hdhZZ`bZY^XVaVYk^XZ_jhi^c XVhZ#=dlZkZg!jhjVaanVaai]Vi^hcZZYZY^h XVgZ[jaXaZVch^c\l^i]VXaZVcXdiidcWVaah hdV`ZY^chiZg^aZlViZg#L]ZcndjlVh] ndjgWVWn¼hZnZ!ndjh]djaYValVnhYgVl i]ZhlVW[gdbi]Z^ch^YZXdgcZg!cZVgi]Z cdhZ!idi]ZdjiZgXdgcZg!VcYi]Zci]gdl ^iVlVn#>i¼h^bedgiVciidjhZVhZeVgViZ hlVW[dgZVX]ZnZ#

N

Fever

I]ZgVc\Zd[cdgbVaWdYniZbeZgVijgZ^h .+#-·.-#+•;(+·(,•8#6cni]^c\dkZg &%%#)•;(-•8^hV[ZkZg!Vai]dj\]i]Z

]Z^\]iViZbeZgVijgZgZVX]Zh^hcdi cZXZhhVg^anVcVXXjgViZgZ[aZXi^dcd[i]Z hZg^djhcZhhd[i]Zh^X`cZhh#6[ZkZg^hcdi ^c^ihZa[Vc^aacZhhWjiVhnbeidbd[dcZ# 6eVgi[gdbVcn^aacZhh!ndjgX]^aY¼h iZbeZgVijgZl^aagZ[aZXii]Zi^bZd[YVn VcYVXi^k^inaZkZa/6[iZgVhigZcjdjh\VbZ d[hdXXZg![dgZmVbeaZ!i]ZiZbeZgVijgZ XdjaYiZbedgVg^anWZdkZg&%%#)•;(-•8# 6iZbeZgVijgZd[dkZg&%%#)•;(-•8 XdjaYWZhZg^djh^cVWVWnjcYZgh^m bdci]hdaY#>[i]ZiZbeZgVijgZgZbV^ch ]^\]!i]ZgZ^hVahdVha^\]ig^h`d[V[ZWg^aZ hZ^ojgZsee p.332# What to do >[ndjhjheZXii]VindjgX]^aY ]VhV[ZkZg!iV`Z]^hiZbeZgVijgZ!i]Zc X]ZX`^iV\V^c^c'%b^cjiZhidhZZ^[^i]Vh kVg^ZY#Lg^iZYdlcZVX]gZVY^c\# EjindjgX]^aYidWZYVcYgZbdkZbdhi d[]^hXadi]^c\!ZkZc^[i]Zgddb^hXdda# 6X]^aYl^i]V[ZkZgcZZYhidWZXdkZgZY dcanWnVa^\]iXdiidch]ZZi#<^kZX]^aYgZc¼h a^fj^YVXZiVb^cde]Zc^ci]ZgZXdbbZcYZY YdhZid]ZaeWg^c\Ydlci]ZiZbeZgVijgZ# >[i]ZiZbeZgVijgZ^h]^\]!\^kZVaiZgcViZ YdhZhd[VXZiVb^cde]ZcVcY^Wjegd[Zcid gZYjXZ^c[ZkZgVcYi]ZcidXdcigdai]Z iZbeZgVijgZ#CZkZg\^kZVhe^g^cidVX]^aY jcYZg&+nZVghd[V\ZVh^i]VhWZZca^c`ZY idi]ZYZkZadebZcid[GZnZ¼hhncYgdbZ# :cXdjgV\ZndjgX]^aYidYg^c`VhbjX] a^fj^YVhedhh^WaZWnd[[Zg^c\]^bhbVaa Vbdjcihd[[aj^YVigZ\jaVg^ciZgkVah#6h` [dgbZY^XVaVYk^XZegdbeian^[/ndjgX]^aY^h jcYZgh^mbdci]hdaY0ndjgX]^aY]VhV hZ^ojgZ0]Z]Vh]VYVhZ^ojgZWZ[dgZdg hZ^ojgZhgjc^ci]Z[Vb^an0ndjgWVWn]Vh V[ZkZgi]ViaVhihbdgZi]Vc')]djghdg i]gZZYVnh^cVX]^aY0ndjVgZldgg^ZY VWdjiVcnd[i]Zdi]Zghnbeidbh#

328 HOME MEDICINE

N

Fingers caught in door

Jci^andjgWVWnaZVgch]dlYddghldg`! i]ZgZ¼hValVnhi]Zg^h`i]Vi]^h[^c\ZghbVn WZXdbZigVeeZY# What to do >[i]Zh`^c^hWVYanWgd`Zc VcYi]ZgZ^hVcnhZg^djhWaZZY^c\!iV`Zndjg X]^aYidi]ZcZVgZhiZbZg\ZcXngddb ^bbZY^ViZan#>[i]Z[^c\Zg^hWaZZY^c\ egd[jhZan!egZhhdci]ZeaVXZl]ZgZ^i^h WaZZY^c\VcY]daYndjgX]^aY¼h]VcYje^c i]ZV^g#L]Zci]ZWaZZY^c\hideh!ejidcV Ygn!XaZVc!cdc[aj[[nYgZhh^c\^[edhh^WaZ VcYejindjgX]^aY¼hVgb^cVha^c\[dgi]Z ig^eidi]Z]dhe^iVa#

N

Gluten sensitivity/celiac disease

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jcY^V\cdhZY^cndjc\\^gah^iXVcaZVYid VYZaVn^ci]ZdchZid[bZchigjVi^dc# >c^ihkZgnVYkVcXZYhiV\Z!\ajiZc hZch^i^k^in!dgXZa^VXY^hZVhZ!egdYjXZh VWcdgbVaWdYnXdc[^\jgVi^dc#I]Z VWYdbZcWZXdbZhY^hiZcYZYl^i]]VgYan Vcn[Vidci]Za^bWhdgWdYn!i]ZbjhXaZh d[i]ZaZ\hVcYVgbhWZXdbZlVhiZY!i]Z idc\jZWZXdbZhhbddi]!VcYi]ZgZbVn WZhlZaa^c\d[i]ZVc`aZh#I]Z]V^gl^aaWZ i]^c#=dlZkZg!\ajiZchZch^i^k^in^hcdikZgn XdbbdcVcYi]Z[VXii]Vi^i^hXVjhZYWnV kZgnXdbbdc[ddYhij[[h]djaYcdibV`Z ndjjccZXZhhVg^anlVgndgdkZgVcm^djh VWdjindjgX]^aY¼hY^Zi# What to do DcXZVY^V\cdh^h]VhWZZc bVYZ!ndjgX]^aY]VhidWZ\^kZcV\ajiZc" [gZZY^Zi!l]^X]bZVchi]Vil]ZVi!gnZ! WVgaZn!VcYdVihl^aa]VkZidWZZmXajYZY# NdjgX]^aYl^aa]VkZidgZbV^cdcV\ajiZc" [gZZY^Zi[dga^[Z# I]Z[^ghii]^c\i]Vindjl^aacdi^XZ^h Vc^begdkZbZci^ci]ZbddYd[ndjgX]^aY# I]^hjhjVaanVeeZVghl^i]^cV[ZlYVnh!VcY ^h[daadlZYWnV\gZVian^begdkZYVeeZi^iZ VcYXdchZfjZcilZ^\]i\V^c#Ndjl^aai]Zc cdi^XZVX]Vc\Z^ci]ZVeeZVgVcXZd[i]Z hiddahVcYi]Z[gZfjZcXnd[WdlZa bdkZbZcih!Vai]dj\]i]^hbVniV`ZlZZ`h# 6[iZgWZ^c\dcV\ajiZc"[gZZY^Zi[dgh^m bdci]hidVnZVg!ndjgX]^aYh]djaYWZ l^i]^ci]ZcdgbVagVc\Z[dglZ^\]i! Vai]dj\]]^h]Z^\]il^aaiV`ZVWdjiild nZVghidgZXdkZg#

N

Hay fever

=Vn[ZkZg!dgVaaZg\^Xg]^c^i^h!^hh^b^aVg idVhi]bVZmXZeii]Vii]ZVaaZg\^XgZVXi^dc dXXjgh^ci]ZbjXjhbZbWgVcZhd[i]Z cdhZVcYZnZa^Yh!cdii]ZX]Zhi#

MEDICAL INDEX 329 I]ZXdcY^i^dc^hVahd`cdlcVhVaaZg\^X g]^c^i^hVcYXVjhZhhcZZo^c\!VgjccncdhZ l^i]XaZVgY^hX]Vg\Z!VcY^iX]n!lViZgn! gZY"g^bbZYZnZh#>ibdhiandXXjgh^cheg^c\ VcYhjbbZgVcY^hjhjVaanXVjhZYWnV gZVXi^dcideaVciedaaZc#=Vn[ZkZg^h igdjWaZhdbZ!Wji^hcdijhjVaanhZg^djh# What to do >[ndjgX]^aY^hhcZZo^c\Vadi! X]ZX`]^hiZbeZgVijgZidbV`ZhjgZi]Vi ]Z^hc¼i^aal^i]Vc^c[ZXi^dchjX]Vh ^c[ajZcoVdgVXdbbdcXdaY#9^hXdjgV\Z ndjgX]^aY[gdbgjWW^c\]^hZnZh0i]^hl^aa bV`Zi]ZbldghZ#7Vi]Z]^hZnZhl^i]Xdda lViZgidZVhZi]Z^gg^iVi^dc#HZZ`bZY^XVa VYk^XZVhhddcVhedhh^WaZ^[ndji]^c`ndjg X]^aYbVnWZhj[[Zg^c\[gdbVbdgZhZg^djh ^c[ZXi^dc!dg^[i]Z]Vn[ZkZg^hbV`^c\ndjg X]^aYb^hZgVWaZ#>[ndjgX]^aY¼hXdcY^i^dc^h hZkZgZ!]ZbVncZZYidhZZVcVaaZg\^hiVcY ]VkZVhZg^Zhd[iZhihidigVX`Ydlci]Z VaaZg\Zci]Vi^hXVjh^c\]^hhnbeidbh# I]ZgZVgZkVg^djhbZVhjgZhndjXVc iV`Zidignidb^c^b^oZi]ZhZkZg^ind[ ViiVX`h#LViX]i]ZedaaZcXdjciZVX]YVn VcY!^[^i^h]^\]!Y^hXdjgV\ZndjgX]^aY [gdbeaVn^c\cZVg[gZh]anbdlc\gVhh![dg ZmVbeaZ#JhZhnci]Zi^Xhij[[^c\[dgndjg X]^aY¼he^aadlhVcYYjkZi!gVi]Zgi]Vc [ZVi]Zgh#@ZZendjg]djhZVhYjhi"[gZZVh edhh^WaZ#:kZc^[ndjgX]^aY^hc¼iVaaZg\^Xid Yjhi!VYjhinVibdhe]ZgZValVnhbV`Zh ]Vn[ZkZgldghZ# EgZeVgZVcZbZg\ZcXneVX`[dgdji^c\h# >ih]djaYXdciV^ceVeZgcVe`^ch!ZnZYgdeh idgZYjXZi]ZZnZ^gg^iVi^dc!Vbd^hiidlZa idhddi]ZndjgX]^aY¼hZnZh!VcYl]ViZkZg bZY^XVi^dc]VhWZZcegZhXg^WZY#Ndjg YdXidgbVnWZegZhXg^WZVhiZgd^YcVhVa hegVndgVcdgVaVci^]^hiVb^cZid]Zae gZa^ZkZi]ZXdcY^i^dc#

N

Hives (see Urticaria)

N

Infectious fevers (TFF
Q) 

N

Measles

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330 HOME MEDICINE kZgn]jc\gnl]Zc]Z¼h[ZkZg^h]!Wji bV`ZhjgZi]Vi]ZYg^c`hVYZfjViZ Vbdjcihd[a^fj^YWnegdk^Y^c\hbVaaWji [gZfjZciYg^c`h#HZZ`bZY^XVaVYk^XZ ^bbZY^ViZan^[ndjgX]^aY]VhVcnd[i]Z [daadl^c\/V]^\]iZbeZgVijgZ[djgYVnh V[iZgi]ZgVh]]VhVeeZVgZY0ZVgVX]Zdg aVWdgZYWgZVi]^c\0Ve]aZ\bnXdj\]0dg ^[]ZWZXdbZhhZb^"XdchX^djh#

N

Meningitis

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N

Mumps

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N

Nettle rash (see Urticaria)

N

Nosebleeds

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MEDICAL INDEX 331 WaddYi]Vi^hhlVaadlZYXVc^gg^iViZi]Z hidbVX]VcYXVjhZkdb^i^c\#I]^h^cXgZVhZh i]ZWaddYegZhhjgZ^ci]Z]ZVYVcYXgZViZh ViZcYZcXn[dgi]ZcdhZidWaZZYV\V^c# 6eean\ZciaZegZhhjgZl^i]ndjgi]jbW VcY[^ghi[^c\ZgdcZ^i]Zgh^YZd[i]ZcdhZ jci^ai]ZWaZZY^c\]VhhideeZY#I]^hl^aa jhjVaan]VeeZc^cilddgi]gZZb^cjiZh#>[ cdhZWaZZYhdXXjg[gZfjZcianhZZ`bZY^XVa VYk^XZ#NdjgX]^aYbVnWZgZ[ZggZYidV heZX^Va^hi[dgXVjiZg^oVi^dcd[i]ZYZa^XViZ VgZVh^ch^YZi]ZcdhZ#

N

Pertussis (whooping cough)

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N

Pin worms

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N

Pneumococcal infection

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332 HOME MEDICINE

N

Pneumonia

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N

Rashes

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N

Roseola infantum

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N

Rubella (German measles)

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MEDICAL INDEX 333 [dgZ]ZVYWZ[dgZbdk^c\Ydlcidi]ZWdYn! VgZeVaZVcY[aViVcYVgZcdiVhXadhZ id\Zi]ZgVhi]dhZ^cbZVhaZh#I]ZndcanaVhi [dgildidi]gZZYVnh#I]Z\aVcYhdci]Z WVX`d[ndjgX]^aY¼hcZX`l^aaVabdhi YZ[^c^iZanWZhldaaZcVcYi]ZnbVnhiVna^`Z i]^hV[iZgi]ZgVh]]Vh\dcZ#I]Zhnbeidbh jhjVaanaVhiVWdjiiZcYVnh# What to do 
N

Scarlet fever

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N

Seizures

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N

Sleepwalking

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N

Splinters

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N

Sprains

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N

Stings

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Strabismus

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N

Stys

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N

Sunburn

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N

Teething

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N

Tonsilitis

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N

Toxocara

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N

Urticaria

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N

Vomiting

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N

Warts

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IMMUNIZATION 339

Immunization >bbjc^oVi^dc^hdcZd[i]ZbdhihjXXZhh[ja [dgbhd[egZkZci^kZbZY^X^cZVcY]Vh ]ZaeZYidZgVY^XViZbVcn[dgbZganaZi]Va Y^hZVhZhi]gdj\]djii]ZldgaY#=dlZkZg!

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AGE

V CCINATION VA A

HOW GIVEN

REACTION

Birth– 1 month

• Hepatitis B

One injection

Generally well tolerated, reaction at injection site possible, but rare

2 months

• Pneumococcus

One injection

Possible redness and swelling at injection site, mild fever

• Diphtheria, tetanus, pertussis

One injection

Slightly raised temperature; sickness and/or diarrhea, small lump at injection site that will disappear in a few weeks

• Hepatitis B

One injection

Generally well tolerated, reaction at injection site possible, but rare

• Diphtheria, tetanus, pertussis

One injection

As above

• Hepatitis B

One injection

As above

• Pneumococcus

One injection

As above

• Diphtheria, tetanus, pertussis

One injection

As above

• Hib

One injection

As above, fever; rash; generally unwell/malaise

• MMRV (measles, mumps, rubella,

One injection

As above

• Pneumococcus

One injection

As above

• Hib (if not given at 12 months)

One injection

As above

18 months

• Hepatitis A

One injection

As above

2 years

• Hepatitis A booster

One injection

As above

4–5 years

• Diphtheria, tetanus, pertussis

One injection

As above

One injection

As above

(whooping cough), polio and Hib 4 months

(whooping cough), polio, and Hib 6 months

(whooping cough), polio, and Hib Around 12 months

and chicken pox) 15 months

(whooping cough), polio

• Measles, mumps, and rubella (MMR) or MMRV

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COMMON CHILDHOOD INFECTIOUS DISEASES Disease

Incubation period

Symptoms

Measles TFF
Q

10–14 days

Runny nose, cough, inflamed eyes, fever, vomiting, diarrhea, Koplik’s spots on the inside of the cheeks at first then after four days a rash behind the ears, then on the face, then on the body.

Rubella (German measles) TFF
Q

14–21 days

Slight temperature, enlarged glands at the back of the neck, rash behind the ears then on the forehead, then the rest of the body. Rash lasts three days.

Roseola TFF
Q

4–7 days

A high temperature with slight cold symptoms; a pink rash after three days when temperature goes down.

Chicken pox TFF
Q

10–21 days

Dark red, irritating groups of spots that emerge every three or four days. Initially look like blisters then scab over.

Pertussis (Whooping cough) TFF
Q

Around 7 days

Slight temperature, runny nose, slight cough then a convulsive cough followed by whooping breath, vomiting, cyanosis (blue coloring to skin) during coughing spasms, then exhaustion.

Mumps TFF
Q

17–21 days

Swelling and soreness of the glands at the sides of the face, and in front of the ears, painful swallowing, and dry mouth. Fever and generally unwell.

Scarlet fever or Scarlatina TFF
Q

2–5 days

Sore throat, lack of appetite, fever, vomiting, swollen glands, tiny red spots, scarlet facial flushing, and strawberry-colored tongue.

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Treatment

Complications

Immunity

Prevention

No specific treatment other than children’s acetaminophen to reduce the fever. If secondary infection of the ears or lungs occurs antibiotics will be necessary.

Ear infection, pneumonia encephalitis, gastroenteritis.

Lifelong

Immunization combined with mumps and rubella vaccine around 13 months and 4 years.

No specific treatment.

None to your child but fetal damage could occur in a pregnant woman.

Lifelong

Immunization combined with measles and mumps vaccine around 13 months and between 4 years.

No specific treatment.

Rarely infantile convulsions.

Usually lifelong

None

Relive itching with calamine lotion.

Encephalitis, pneumonia.

Lifelong

Varicella vaccination at 12 months, booster at 4–6—may be combined with MMR.

Antibiotics must be given early to be effective; fresh air. Possibly raise your child’s head in bed to make breathing easier.

Possibility of seizures, bronchitis, or pneumonia.

Lifelong

Immunization at 2, 4, and 6 months, with booster at 15–18 months and then at 4 years.

Plenty to drink, soft food if chewing is painful.

Meningitis, inflammation of the testes.

Lifelong

Immunization combined with measles and rubella vaccine around 12 months and between 3½ and 5 years.

Penicillin with bedrest as long as fever lasts.

Rheumatic fever.

Lifelong for each strain

None

342 HOME MEDICINE

Immunization and traveling abroad >[ndjVgZeaVcc^c\idiV`ZndjgWVWndg idYYaZgVWgdVY!^i^hk^iVai]Vindj[^cYdji WZ[dgZ]VcYVWdjii]Z]ZVai]g^h`h^ci]Z Xdjcignndjl^aaWZk^h^i^c\VcYi]Z egZXVji^dch!^cXajY^c\kVXX^cVi^dch!i]Vi ndjbVncZZYidiV`Z#NdjXVc\Zii]Z ^c[dgbVi^dc[gdbndjgigVkZaV\Zci!i]Z ZbWVhhnd[i]ZXdjcignndjVgZ\d^c\id k^h^i!i]Z9ZeVgibZcid[=ZVai]!dgi]Z 8ZciZgh[dg9^hZVhZ8dcigda#I]Z898 ejWa^h]ZhVcZlZY^i^dcd[i]Z Yellow Book: Health Information for International TravelZkZgnildnZVgh!\^k^c\je"id"YViZ l ^c[dgbVi^dcdc]ZVai]g^h`hi]gdj\]djii]Z ldgaY!VcYndjh]djaYXdchjai^ilZaa WZ[dgZndjgYZeVgijgZYViZ#I]Z Yellow BookXVcWZdgYZgZYi]gdj\]i]Z898 k lZWh^iZ!Villl#XYX#\dk$igVkZa0WjibjX] d[i]Z^c[dgbVi^dc!^cXajY^c\jeYViZh!^h VkV^aVWaZdci]Z898h^iZ# NdjgX]^aYh]djaYWZXjggZci[dg]^h V\ZdcVaakVXX^cVi^dcha^hiZY^ci]Z ^bbjc^oVi^dchX]ZYjaZsee p.339#>[ kVXX^cVi^dc^hgZfj^gZY!ndjh]djaYhZZndjg YdXidg!dgeZY^Vig^X^Vc!ViaZVhiildbdci]h WZ[dgZYZeVgijgZWZXVjhZhdbZkVXX^cZh iV`Zi^bZidWZZ[[ZXi^kZ!VcYhdbZXVccdi WZ\^kZcVii]ZhVbZi^bZVhdi]Zgh#Di]Zg kVXX^cZhVcYbZY^XVi^dch!l]^aZhV[ZWn VYjaih!h]djaYcdiWZVYb^c^hiZgZYid egZ\cVcidgWgZVhi"[ZZY^c\bdi]Zgh!dgid X]^aYgZc!WZXVjhZi]Z^ghV[Zin[dgi]Z[Zijh! WgZVhi"[ZZY^c\^c[Vci!dgX]^aY]VhcdinZi WZZcYZiZgb^cZY#NdjXVcdWiV^cheZX^[^X ^c[dgbVi^dc[gdbi]Z898lZWh^iZ gZ\VgY^c\i]ZkVXX^cVi^dch[dgigVkZaidVcn eVgi^XjaVgVgZV!VhlZaaVhdjiWgZV`hd[ Y^hZVhZhi]ViVgZgVgZ^ci]ZJH#

Vacation health precautions First aid kit 7ZhjgZidiV`ZV[^ghiV^Y`^i! l]^X]h]djaYXdciV^cVeVX`V\Zd[ VY]Zh^kZYgZhh^c\h!hiZg^aZcZZYaZh!^chZXi gZeZaaZci!Vci^hZei^XXgZVb!lViZg hiZg^a^oVi^dciVWaZih!VaXd]da"WVhZY]VcY hVc^i^oZg!X]^aY"hV[Z]VcYl^eZh!Y^VeZggVh] d^cibZci^[Veegdeg^ViZ!dgVagZ]nYgVi^dc hdaji^dcDGHhVX]Zih!VcYVcnbZY^X^cZh i]Vi]VkZWZZcegZhXg^WZYWnndjgYdXidg# Water safety>[ndjdgndjgX]^aYlVcih idhl^bl]^aZdckVXVi^dc!WZVlVgZi]Vi i]ZadXValViZgbVnWZXdciVb^cViZYVcY eVgVh^i^X^c[ZXi^dchXVcWZe^X`ZYje^[Vcn lViZg^hhlVaadlZY#>cVgZVhl]ZgZ h]^hidhdb^Vh^hdgdi]ZgeVgVh^iZhVgZ Xdbbdc!YdcdiVaadlndjgX]^aYidhl^b ^cjcX]adg^cViZYlViZg# Water 7VW^Zh¼[ddYh]djaY!d[XdjghZ!WZ b^mZYl^i]Wd^aZYlViZgVhjhjVa# Di]Zgl^hZ!jcaZhhndj`cdli]Vii]ZadXVa lViZg^hhV[Z!jhZWdiiaZYlViZgdghiZg^a^oZ ^iWnWd^a^c\dgjh^c\hiZg^a^oVi^dciVWaZih# I]^hVeea^Zhcdi_jhiidYg^c`^c\lViZgWji Vahdidi]ZlViZgndjjhZ[dgXaZVc^c\ iZZi]dgg^ch^c\i]Zbdji]dji# Food 7ZlVgZd[gVlkZ\ZiVWaZh!hVaVYh! jceZZaZY[gj^i!XgZVb!^XZXgZVb!^XZXjWZh! jcYZgYdcZbZVidg[^h]!VcYjcXdd`ZYdg gZ]ZViZY[ddY#

Taking medicines abroad >[ndjcZZYidiV`ZVcnegZhXg^WZY bZY^X^cZh[dgndjgWVWndgidYYaZgl^i] ndj!ndjh]djaYX]ZX`^[i]ZgZVgZVcn gZhig^Xi^dchdciV`^c\Ygj\h!egZhXg^WZYdg dkZg"i]Z"XdjciZg!^cidi]ZXdjcignndjVgZ k^h^i^c\#>i^hVYk^hVWaZid]VkZVaZiiZg[gdb

IMMUNIZATION AND TRAVELING ABROAD 343 ndjgYdXidgl^i]YZiV^ahd[VcnbZY^X^cZh egZhXg^WZY!idVkd^YegdWaZbhl^i]8jhidbh#

Traveling restrictions 8]ZX`l^i]i]ZIgVchedgiVi^dcHZXjg^in 6Yb^c^higVi^dclll#ihV#\dkdgndjg V^ga^cZWZ[dgZndjaZVkZ]dbZidZchjgZ i]Vindj]VkZ[daadlZYVcnhZXjg^ingjaZh XjggZcian^c[dgXZ#>cVYY^i^dc!bV`ZhjgZ

i]VindjgWVWn]Vh]^hdlceVhhedgi¸ bVcnXdjcig^ZhcdlgZfj^gZi]ViZkZgn eZghdc!gZ\VgYaZhhd[V\Z!]VhVeVhhedgi#

Travel insurance L]ViZkZgXdjcig^Zhndj^ciZcYidk^h^i!^i^h kZgn^bedgiVcii]VindjiV`ZdjiVYZfjViZ eg^kViZbZY^XVa^chjgVcXZ!ZheZX^Vaan^[ndj ]VkZVegZZm^hi^c\bZY^XVaXdcY^i^dc#

DISEASE AND PRECAUTIONS Disease

Risk Area

Vaccination

Cholera

Africa, Asia, Middle East, especially in conditions of poor hygiene and sanitation.

None available in the United States. Cholera is contracted from eating or drinking contaminated food or water.

Malaria

Africa, Asia, Central and South America; possibly southern Europe and United States (check before traveling).

None, but antimalarial pills must be taken before, during, and for a month after your trip.

Polio

Everywhere except Europe, North America, Australia, and New Zealand.

Given as a routine to babies in the US.

Rabies

Many parts of the world, including Europe.

Not routine, but ask for advice because it may be more common in remote areas..

T Tetanus

Occurs worldwide, but greatest risk in areas where children are not immunized.

Given as a routine to babies in the US.

TB

Africa, Asia, Central and South America, some poorer inner-city areas elsewhere.

Skin test and injection, preferably three months before travel. Not necessary for short visits and when staying in modern hotels, but advisable for longer visits if you will be living or working closely with the local population.

T Typhoid

Everywhere except Europe, North America, Australia, and New Zealand, in conditions of poor hygiene and sanitation.

TTwo injections, 4–6 weeks apart. Typhoid is contracted from drinking contaminated water.

Yellow fever

Africa and South America.

One injection at least ten days before traveling. Infants under nine months should not be vaccinated, and should not be exposed to the disease.

344 INDEX

Index A VWhXZhhZh!WgZVhi&%& VXZiVb^cde]Zc'%'!(&+ VYkZcijgdjhcZhh&.V\\gZhh^dc'*(!'+& V^gigVkZa'.%·& VaaZg\^Zh Vhi]bV(&[ddYVaaZg\n&&)!&'-·. \ajiZchZch^i^k^in(',·]Vn[ZkZg('-·. jgi^XVg^V((, Vae]VWZi!aZVgc^c\'-%·& Vc^bVah W^iZh(&. ]n\^ZcZ-( Vci^WdY^Zh!^cWgZVhi"b^a`-- Vci^hdX^VaWVW^ZhVcYX]^aYgZc ')*!'+& Vcm^Zin see [ZVghVcY Vcm^Zi^Zh VeeZi^iZ!adhhd[&''!(&% Vhi]bV(&ViiZci^dc"hZZ`^c\')+

B WVWWa^c\''+!'', WVW^Zh see cZlWdgcWVWn WVX`eVX`h(+!**!'-)·* WVX`higV^c!Vkd^Y^c\** WVX`nVgYh!hV[Zin'., WVaVc^i^h(&. WVh`Zih!WVWn(+!&)( WVi]^c\,%·-* WVi]ijWh,)·*!,.·-% W^gi]id&nZVg,%·-& Zfj^ebZci() &id(nZVgh-'·* hV[Zin,)!,+!-'·(  see also lVh]^c\ WVi]gddbh!hV[Zin'.) WZY"lZii^c\&)%·& WZYY^c\&))

WZYgddbh(-·. hV[Zin'.+ WZYh(+ bdk^c\[gdbXg^W^cid&*& h^X`X]^aYgZc(&) iV`^c\X]^aY^cideVgZcih¼ WZY&*' WZYi^bZgdji^cZh W^gi]id&nZVg&)'·(!&), XVjhZhd[Xgn^c\&+-·. &id'nZVgh&*& gZVY^c\Wdd`h&**!&+.! '%.·&% 'id(nZVgh&*)·+ WZZhi^c\h(() WZ]Vk^dg cZlWdgcWVWn'*·, see alsohdX^VaWZ]Vk^dg W^a^c\jVa^hb'', W^Wh(*!&&W^XnXaZhZVih'-+ W^a^gjW^c'( W^gi]bVg`h') W^iZldjcYh(&. W^i^c\!VcYWgZVhi"[ZZY^c\.. WaVYYZgXdcigda)+!+.!&('! &(-·. Vic^\]i&(.·)% WZY"lZii^c\&)%·& aViZYZkZadeZgh&)% gZ\gZhh^dc&)%·& WaZZY^c\ XjihVcYVWgVh^dch(') cdhZWaZZYh((% hZg^djhWaZZY^c\(%' Wa^hiZgh(&. WaddY!^chiddah&()!&(+ WdYniZbeZgVijgZ WVW^Zh&)) XVjhZhd[Xgn^c\&+( [ZkZgh(&*·&+!(', ]ZViZm]Vjhi^dcVcY ]ZVihigd`Z(%*

]nedi]Zgb^V(%* i]ZgbdbZiZgh(&& l]ZcidXVaai]ZYdXidg(%WdcY^c\&+!&.!'-·(&!.' WdcZh!Wgd`Zc(%+ WdgZYdb!Xgn^c\&+* WdiiaZ"[ZZY^c\&%'·. dcXVg_djgcZnh'-Zfj^ebZci[dg(* [gZfjZcXnd[[ZZY^c\h&%, bV`^c\jeWdiiaZh&%) c^\]i[ZZY^c\h&&%!&)c^eeaZh&%'!&%) egdWaZbh&%-·. hiZg^a^o^c\WdiiaZh&%'·( hjeeaZbZci^c\WgZVhi" [ZZY^c\.)·+ lZVc^c\&&& WdjcX^c\X]V^gh(,!&-*·+ WdjcYVg^Zh W^gi]id&nZVg')(·* &id'nZVgh'*&·* 'id(nZVgh'+% WdlZaXdcigda)+!+.!&(' &id'nZVgh&(+·,!&(-·. 'id(nZVgh&(.!&)% WdlZabdkZbZcih see hiddah WdlZaegdWaZbh&(*·+ Y^Vgg]ZV(')·* WgV^c ]VcYZYcZhh&.+ k^h^dc'%& WgVh!WgZVhi"[ZZY^c\.(!&%% WgZV`[VhibZcj&'( WgZVhi"[ZZY^c\--·&%& VYkVciV\Zh--·. WgVh.(!&%% dcXVg_djgcZnh'-VcYXdcigVXZei^dc-. Zfj^ebZci[dg(* ZmegZhh^c\b^a`.+·, [gZfjZcXnd[[ZZY^c\h.) b^a`hjeean-.

INDEX 345 c^\]i[ZZY^c\h&&%!&)- edh^i^dch.(·) egdWaZbh.-·. hjeeaZbZciVgnWdiiaZh.)·+ il^ch.) lZVc^c\&&& WgZVhieVYh&%% WgZVhiejbeh(* WgZVhih XVgZd[&%%·& ZmZgX^hZh&%% cZlWdgcWVWn¼h'(·) egdWaZbh&%& WgZVi]^c\ Vhi]bV(&WgZVi]]daY^c\&+-!&,+ Xgdje(') cZlWdgcWVWn'* gZhXjZWgZVi]^c\(%& l]ZcidXVaai]ZYdXidg(&% Wgd`ZcWdcZh(%+ Wgj^hZh(&.·'% Wgjh]Zh!eV^ci^c\',' Wjaan^c\'*(!'+& Wjgch(%)!('% Wjge^c\&%-·.

C 8ZhVgZVchZXi^dc.) XVadg^Zh&'&!&'+ XVgWd]nYgViZh-,!&'% XVgg^V\Zh('!(+!(,!&)) XVgg^Zg(+!&)( XVggn^c\WVW^Zh*'·* XVgh XVg_djgcZnh'--·. XVghZVih('!(,!'-- XVgh^X`cZhh'-. gdVYhV[Zin'.XViVgg]('% XZa^VXY^hZVhZ('XZgZVah&&.!&''!&'+ X]Vc\^c\Zfj^ebZci() X]ZhiXdbegZhh^dch(%' X]^X`Zcedm('%·&!()%·& X]d`^c\&&-!'..

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XgVla^c\&-+·, ¹XgVla^c\ºgZ[aZm'+!', XgZVi^kZeaVn'&+!',(!',*·+ Xg^WWjbeZgh(+!&)* Xg^WYZVi](+!*'!&)* Xgdje(') ¹Xgj^h^c\º&--!&.% Xgn^c\&*-·,, W^gi]id&nZVg&*-·++ Xde^c\l^i]&+( Xgn^c\heZaah&+& XjgZh&+' ¹Y^[[^XjaiºWVW^Zh'(.·)% aZVk^c\WVWnidXgn&+% c^\]ilV`^c\&)- &id'nZVgh&+,·. gZhedcY^c\id&*-·.!&+& 'id(nZVgh&,%·, XjYYa^c\**·+ Xjeh!lZVc^c\dcid&&, XjihVcY\gVoZh(')

D YV^gnegdYjXih&''!&'+ YVg`![ZVgd[&*+·,!&,& YVncjghZg^Zh''* YZVi]!Xg^W(+!*'!&)* YZ]nYgVi^dc&(+!(&* YZaVn^c\iVXi^Xh!WZYi^bZ egdWaZbh&*+ YZciVa]n\^ZcZ'%)·* YZci^hih'%* YZgbVi^i^h+Y^VeZgh W^gi]id&nZVg*-·+, WaVYYZgXdcigda&(- dcXVg_djgcZnh'-X]Vc\^c\Zfj^ebZci() Y^VeZge^ch+) Y^hedhVWaZY^VeZgh+&·' [VWg^XY^VeZgh+)·*!+, a^cZgh+)!+* &id(nZVgh+. lVh]^c\++·, Y^VeZggVh]+*!+-·. Y^Vgg]ZV(')·*

346 INDEX W^gi]id&nZVg&(*·+ idYYaZgY^Vgg]ZV&)& l]ZcidXVaai]ZYdXidg(&% Y^Zi see[ddYVcY[ZZY^c\ ¹Y^[[^XjaiºWVW^Zh'(.·)% Y^ccZgbZcj&'( Y^e]i]Zg^V^bbjc^oVi^dc((. Y^hVWaZYWVW^Zh')* Y^hX^ea^cZ&*!')(·*!'*&!'+% Y^hXdciZciZYWVW^Zh')& Y^hZVhZh ^c[ZXi^djh()%·& igVkZa^c\VWgdVY()( Y^ha^`^c\ndjgWVWn'))·* Y^hdWZY^ZcXZ'** Y^hedhVWaZY^VeZgh*YdXidg!l]ZcidXVaa(%-·&% Ydaah'&+!''% Yddgh!adX`ZY&*, YgVl^c\h'&+!','·( YgZVbh&*, YgZhh^c\ see Xadi]Zh Yg^c`h ^cigdYjX^c\hda^Yh&&, h^X`X]^aYgZc(&* lZVc^c\dcidVXje&&, Ygdlh^cZhh('* Ygj\h see bZY^X^cZh Yjbb^Zh&++ YjkZih(+

E ZVganlV`Zgh&),·-!&*' ZVgh XVgZd[,, ZVgYgdeh(&( ZVgVX]Z&+)!('*·+ ]ZVg^c\egdWaZbh''ZVi^c\dji'-* ZXoZbV('+ ZaZXig^Xh]dX`(%( ZbZg\ZcXn[^ghiV^Y'..·(%, Zbdi^dch- _ZVadjhn'*( eZghdcVaYZkZadebZci'*+ Zc\dg\ZYWgZVhih&%&

Ze^aZehn('+·, Ze^h^didbn.) Zfj^ebZci('·. ZmZgX^hZh!WgZVhiXVgZ&%% ZmegZhh^c\WgZVhi"b^a`.+·, ZnZXdciVXi!l^i]cZlWdgc WVWn'-!'%. ZnZh XVgZd[,, Xdadg'' Xdc_jcXi^k^i^h(''·( Y^hX]Vg\Z''!(() ZnZYgdeh(&( ]VcY"ZnZXddgY^cVi^dc&.)! &.* cZlWdgcWVWn&*!'' hi^X`nZnZ''!(', higVhW^hbjh''!((* hinh((* k^h^dc&..·'%&

F [VWg^XcVee^Zh*-!+)·, [Vb^an WVWnVheVgid[')' Xdc[a^Xi^c&,, ^c]^hidgn&%·&& [Vi]Zgh&' WdcY^c\l^i]WVWn&. WdiiaZ"[ZZY^c\&%' c^\]i[ZZY^c\h&)[Vih ^cY^Zi-, [ZZY^c\idYYaZgh&''!&'[ZVghVcYVcm^Zi^Zh d[WVi]^c\,-·-% WZYi^bZegdWaZbh&*+ VWdjiWgZVhi"[ZZY^c\.. XVjhZhd[Xgn^c\&+*·+ d[i]ZYVg`&*+·,!&,& YZVa^c\l^i]&,&·( ZcXdjgV\^c\hZXjg^in'*^ggVi^dcVa[ZVgh&,'·( c^\]ibVgZh&*, d[eVgZci]ddYe]dW^Vh&,+·,

egZhX]ddacZgkZh&,( d[hZeVgVi^dc&+,!&,% d[i]jcYZg&,& d[jcYgZhh^c\,d[lViZg-* [ZWg^aZhZ^ojgZh(&+ [ZXZh see hiddah [ZZY^c\ see WdiiaZ"[ZZY^c\0 WgZVhi"[ZZY^c\0[ddYVcY [ZZY^c\ [ZkZg(', igZVi^c\(&*·&+ l]ZcidXVaai]ZYdXidg(%- [^c\Zg[ddYh&&. [^c\Zgh!XVj\]i^cYddg(', [^gZ!Xadi]^c\dc(%) [^ghiV^Y ZbZg\ZcX^Zh'..·(%, [^ghiV^Y`^i(%, [aZVh-( [ajdg^YZiddi]eVhiZ-,!'%(! '%)·* [dciVcZaaZh'%·'!,* [ddYVcY[ZZY^c\-+·&(& Wjn^c\[ddY&&*·&+ Xdd`^c\VcYgZ]ZVi^c\&&+ ZhiVWa^h]^c\hda^Yh&&(·'% [ddY[VYh&'* [ddY^cidaZgVcXZVcYVaaZg\n &&)!&'-·. ^cigdYjX^c\hda^Yh&&&·&' cjig^i^dcVacZZYh-+·, &id'nZVgh&'&·+ egZeVgVi^dc&&* gZVYn"egZeVgZY[ddYh&&+ hV[Zin&&'!&&) hZa["[ZZY^c\&&-·&. h^X`X]^aYgZc(&)·&* hcVX`h&(%·& hidgV\Z&&*·&+ 'id(nZVgh&'+·. see alsoWdiiaZ"[ZZY^c\0 WgZVhi"[ZZY^c\ [dgZh`^c!XVgZd[,- [gVXijgZh(%+ [gZZo^c\[ddY&&*·&+

INDEX 347 [gZh]cZhh'+'·( [g^ZcYh'*, [gj^i [^c\Zg[ddYh&&. &id'nZVgh&'&!&'' 'id(nZVgh&'+ [gjhigVi^dc VcYWVYWZ]Vk^dg')(·) XVjhZhd[Xgn^c\&++!&+eaVn'&+ iZbeZgiVcigjbh&,*·+

G \VbZh W^gi]id&nZVg'++·, ^b^iVi^kZ\VbZh',,·[dgbVc^ejaVi^dc',-·. &id'nZVgh'&*!'&+ \ZcZgdh^in!ZcXdjgV\^c\'*% \Zc^iVah XVgZd[,- ]VcYa^c\'*. cZlWdgcWVWn')
H ¹]VW^ihº'+' ]V^g Y^ha^`Zd[lVh]^c\-%·&!   -)·* cZlWdgcWVWn') iVc\aZh-) lVh]^c\,*·+ ]Vaah!hV[Zin'.+·, ]VcYa^c\WVW^Zh*%·* ]VcYa^c\X]^aYgZc**·, ]VcYh XddgY^cVi^dc&.)·-

]VcYZYcZhh&.+ lVh]^c\-'!-(!&&) ]VgcZhhZh! ]^\]X]V^gh(*!&&[dglVa`^c\'-, ]Vn[ZkZg('-·. ]ZVY [dciVcZaaZh'%·'!,* ]ZVYWVc\^c\')* ^c_jg^Zh(%, cZlWdgcWVWn'%·' ]ZVg^c\iZhih!cZlWdgc'* ]ZVg^c\egdWaZbh''- ]ZVgi!X]ZhiXdbegZhh^dch (%' ]ZViZm]Vjhi^dc(%* ]ZVihigd`Z(%* ]Zgc^V!jbW^a^XVa'(!,- ]ZgeZhh^beaZm('&·' =^W^bbjc^oVi^dc((. ]^XXjeh'*·+ ]^\]X]V^gh Wjn^c\(*! jh^c\&&-!&'(·) ]^kZh see jgi^XVg^V ]daY^c\WVW^Zh*%·* ]dbZhV[Zin'.'·, ]dgbdcZh!VcYWdcY^c\(% ]dhe^iVah!X]^aYgZc^c(&, ]djhZ]daYdW_ZXih!\VbZh l^i]'+,·- ]jc\Zg!VcYXgn^c\&+' ]n\^ZcZ WdiiaZ"[ZZY^c\&%( [ddYhV[Zin&&'!&&) `^iX]Zch&&)·&* eZih-( idYYaZgh-( ]nedi]Zgb^V(%*

I ^YZci^[^XVi^dc!eZghdcVa YZkZadebZci'*+ ^aacZhh(%-·&, VcYWgZVhi"[ZZY^c\.. ^bbjc^oVi^dc((.·)(

^c[ZXi^djhY^hZVhZh()%·& ^bV\^cVgn[g^ZcYh'&+ ^b^iVi^dc \VbZh',,·eZghdcVaYZkZadebZci'*+ ^bbjc^oVi^dc((.·)( ^c[ZXi^djhY^hZVhZh()%·& ^c_jg^Zh WaZZY^c\(%' Wgd`ZcWdcZh(%+ Wjgch(%) XjihVcYVWgVh^dch(') YZVa^c\l^i]&,' ]ZVY^c_jgn(%, h]dX`(%( ^chZXjg^in&)+!&+,!')- ^chjgVcXZ!igVkZa()( ^ciZaaZXijVaYZkZadebZci '%+·(* VWhigVXi^YZVh'''·( W^gi]id&nZVg'%+·&& XaVhh^[^XVi^dc'&*!''.·(% [dgb^c\XdcXZeih''&·' Wn^b^iVi^dcVcY ^YZci^[^XVi^dc'*+ aZVgc^c\[gdbZmeZg^ZcXZh '&-·&. aZVgc^c\hejgih'&%·&& b^aZhidcZh'&'!'&cjghZgnhX]dda'')·* &id'nZVgh'&'·&, VcYeaVn^c\'&)·&,!''%·&! ',.·-& 'id(nZVgh'&-·')

J _VjcY^XZ!cZlWdgcWVWn'( _ZVadjhn'*( _^\hVlejooaZh',. _d^cih!hegV^ch((( _jbenWVW^Zh')&·'

K `^iX]Zch ]n\^ZcZ&&)·&* hV[Zin'.)·*

348 INDEX

L aVc\jV\Z see heZZX] YZkZadebZci aVcj\d') aVjcYgnhZgk^XZh!cVee^Zh+, aZVgc^c\ see ^ciZaaZXijVa YZkZadebZci aZ[i"]VcYZYcZhh&.+ aZiiZgh!aZVgc^c\'-%·& a^\VbZcih!hegV^ch((( a^\]ic^c\![ZVgd[&,& a^`ZhVcYY^ha^`Zh')+ a^eWa^hiZgh!cZlWdgcWVWn'' a^he^c\'(* a^k^c\gddbh!hV[Zin'.+ adkZ [dgWVWn-!&+!&.!(%·& daYZgX]^aYgZc*+ ajcX]bZcj&'(

M bVaVg^V()( bVc^ejaVi^dc XddgY^cVi^dc&.+ \VbZh',-·. b^aZhidcZh&-.!&.( idnh[dg',% bVhhV\Z!WVWn'+. bVhi^i^h&%& bVhijgWVi^dc'*. bViigZhhZh!Xdi(+ bZVai^bZh&'(·)!&'+·, bZVhaZh('.!()%·& ^bbjc^oVi^dc((. bZXdc^jb')!&('!&() bZY^X^cZh VcYWgZVhi"[ZZY^c\&%& \^k^c\'&( hV[Zin'.' igVkZa^c\VWgdVY()'·( bZc^c\^i^h('.·(% ^bbjc^oVi^dc((. bZcjh![dgidYYaZgh&'( bZhhnZViZgh&') bZhhneaVn'&,

b^aZhidcZh ^ciZaaZXijVaYZkZadebZci '&'!'&e]nh^XVaYZkZadebZci&,.· -)!&-.!&.( hdX^VaWZ]Vk^dg'(-·. heZZX]YZkZadebZci''+·, b^a^V') b^a` WdiiaZ"[ZZY^c\&%'!&%)! &%* WgZVhi"[ZZY^c\--·.!.* ZmegZhh^c\WgZVhib^a`.+·, [ZZY^c\idYYaZgh&''!&'^cigdYjX^c\hda^Yh&&&!&&(! &&, b^a`YjXih!WadX`ZY&%& b^a`iZZi]'%'·(!'%) b^cZgVahcZZYZY-+·, BBGK^bbjc^oVi^dc((. bdYZa^c\Ydj\]'&*!',( Bdc\da^VcWajZhedih'( BdgdgZ[aZm',!*% bdi]Zg^c\^chi^cXih(&!&+&! ')* bdji]!cZlWdgcWVWn''·( bjbeh((%!()%·& ^bbjc^oVi^dc((. bjh^X WZYi^bZgdji^cZh&**!&+. bjh^XVa^chigjbZcih'&+ h^c\^c\'.!&**!&+.!'&+ bjha^chfjVgZh+)

N cV^ah W^i^c\'+' XVgZd[,, cVeh&),!&).·*%!&*) cVj\]inX]^aYgZc'** cVkZa'( XVgZd[,,·- cZZYh d[X]^aY&(·&) d[eVgZcih&) cZlWdgcWVWn

VeeZVgVcXZ'%·) WZ]Vk^dg'*·, WdcY^c\l^i]'-·(& WdiiaZ"[ZZY^c\&%'·. WgZVhi"[ZZY^c\--·.. Xadi]^c\)%·* Xgn^c\&*-·+* Y^VeZgh*-·+, Zfj^ebZci[dg('·. ]VcYa^c\*%·* ^ciZaaZXijVaYZkZadebZci '%+·. c^\]i[ZZY^c\h&&% cjghZgn(-·. cjig^i^dc-+·, haZZe^c\&)'·+ idYYaZghVcY&,%!'*( k^h^dc&*!&.. lVh]^c\,%·- c^\]i WaVYYZgXdcigda&(.·)% Xgn^c\egdWaZbh&+&!&+-·. ZhiVWa^h]^c\Vgdji^cZ&)'·( [ZVgd[i]ZYVg`&*+·,!&,& c^\]i[ZZY^c\h&&%!&)c^\]ia^\]ih&*+!&*,!&,& c^\]ibVgZh&*, c^\]ilV`^c\&)-·.!&*&·( c^\]ibVgZh&*, c^eeaZh WdiiaZ"[ZZY^c\(*!.+!&%'! &%) WgZVhi"[ZZY^c\.' c^eeaZh]^ZaYh&%& hdgZc^eeaZh.'!&%& ¹Cd!ºhVn^c\')) cdhZ XVgZd[,, XViVgg]VcYgjccncdhZ('% cdhZWaZZYh((% cdhZYgdeh(&( cjY^in'*cjbWZgh!aZVgc^c\VWdji'-& cjghZgn egZeVg^c\(-·. g]nbZh'&+!'('

INDEX 349 iZbeZgVijgZ'(!(cjghZgnhX]dda'')·* ^cigdYjX^c\X]^aYgZc&,(·* cjgh^c\h^X`X]^aYgZc(&)·&, cjig^i^dcsee[ddYVcY[ZZY^c\

O dWZh^in&'*·+!&'DcZh^Zh)% dcanX]^aYgZc'*% djiYddghV[Zin'.- dji^c\h'-'·, dkZg^cYja\ZcXZ'*%!'*)!'+( dkZg[ZZY^c\ WdiiaZ"[ZZY^c\&%-!&%. WgZVhi"[ZZY^c\.. dkZgi^gZYcZhh!Xgn^c\&,( dkZglZ^\]i WdiiaZ"[ZZY^c\VcY&%- idYYaZgh&'*·+!&'dmnidX^c-.

P eV^c XVjhZd[Xgn^c\&+) l]ZcidXVaai]ZYdXidg(&% eV^ci^c\',%·' eVcih eaVhi^X+)!+,!+-·. igV^cZg+. eVeZg!eV^ci^c\',' eZc^h WVaVc^i^h(&. XVgZd[,- X^gXjbX^h^dc,]VcYa^c\'*. eZghdcVaYZkZadebZci W^gi]id&nZVg'(+·)' &id'nZVgh')+·*% 'id(nZVgh'*+·. eZghdcVa^in')eZgijhh^h((& ^bbjc^oVi^dc((. eZih!]n\^ZcZ-( e]dW^Vh&,+·, e]nh^XVaYZkZadebZci&,-·'%*

W^gi]id&nZVg&,-·-XddgY^cVi^dc&.)·- b^aZhidcZh&,.·-)!&-.!&.( &id'nZVgh&-.·.' iZZi]'%&·* 'id(nZVgh&.( k^h^dc&..·'%& lVa`^c\&.%·' e^beaZh!cZlWdgcWVWn') e^cldgbh((& eaVX^YWVW^Zh')% eaVhi^XeVcih+)!+,!+-·. eaVn\gdjcYh!hV[Zin'.eaVn\gdjeh''* eaVn^c\'+)·-& W^gi]id&nZVg'+)·. VcYaZVgc^c\'&)·&,!''%· '&!',.·-& &id'nZVgh',%·+ hV[Zin',* VcYh]Vg^c\').·*% h^X`X]^aYgZc(&+·&, 'id(nZVgh',,·-& l^i]]djhZ]daYdW_ZXih'+, eaVneZch(, ecZjbdXdXXVa^c[ZXi^dc ((%·& ^bbjc^oVi^dc((. ecZjbdc^V((& ed^hdc^c\(%+ eda^d--!()( ^bbjc^oVi^dc((. edhieVgijbYZegZhh^dc'))·* edii^Zh ^cigdYjX^c\&(, igVkZa&)& ediinigV^c^c\ seeWaVYYZg Xdcigda0WdlZaXdcigda egV^hZ&)!')-!'*' egZbVijgZWVW^Zh*%!.- egdee^c\WVW^Zhje&-*·+ egdiZ^c W^gi]id&nZVg-+!&'% &id'nZVgh&'&!&'' 'id(nZVgh&'+ ejWa^XigVchedgiVi^dc'-*

ejbeh!ZmegZhh^c\WgZVhi"b^a` .+ ejc^h]bZci'*' ejooaZh!_^\hVl',.

R gVW^Zh()( gVe^Y"gZijgciZX]c^fjZ! haZZe^c\egdWaZbh&*( gVh]Zh((& X]^X`Zcedm('%·& Y^VeZggVh]+-·. ZXoZbV('+ bZVhaZh('. cZlWdgcWVWn') gdhZdaV^c[Vcijb((&·'! ()%·& hXVgaZi[ZkZg((' jgi^XVg^V')!((, l]ZcidXVaai]ZYdXidg(%- gZVY^c\ WZYi^bZg^ijVah&**!&+.! '%.·&% aZVgc^c\aZiiZgh'-%·& aZVgc^c\idgZVY''( ididYYaZgh'(&·' gZXdkZgnedh^i^dc(%& gZ[aZmZh'+·,!&-)!&.) gZ\gZhh^dc!WdlZaVcYWaVYYZg Xdcigda&)& gZ]ZVi^c\[ddY&&+ gZhXjZWgZVi]^c\(%& gZhiVjgVcih'-* gZhjhX^iVi^dc(%%·' g^\]i"]VcYZYcZhh&.+ g^c\ldgb-( g^ijVah VibZVai^bZh&'+·, ViWZYi^bZ&**·+ gdVYhV[Zin'.gdaZbdYZah&*·&+ gddi^c\gZ[aZm'+ gdhZdaV^c[Vcijb((&·'! ()%·& gjWZaaV(('!()%·& ^bbjc^oVi^dc((.

350 INDEX

S hV[Zin&-+ WVi]^c\,)!,+!-'·( XVg_djgcZnh'-[ddY&&'!&&) ]dbZhV[Zin'.'·, djiYddghV[Zin'.eaVn^c\',* ejh]X]V^gh'-) hVn^c\¹Cdº')) hZa["[ZZY^c\&'% hjcegdiZXi^dc'.& idYYaZgh&.& idnh'++ hVabdcZaaV&&) hVcY!eaVn^c\l^i]'&*!',) hXVaYh(%) hXVae!XgVYaZXVe,*!('(·) hXVgaZi[ZkZghXVgaVi^cV(('! ()%·& hX]dda ^cigdYjX^c\X]^aYgZc&,(·* cjghZgnhX]dda'')·* egZhX]ddacZgkZh&,( hZWdgg]dZ^XYZgbVi^i^h+hZXdcY"]VcYZfj^ebZci(' hZXjg^in eZghdcVaYZkZadebZci'*- hZXjg^indW_ZXih&)+ VcYhaZZeegdWaZbh&)+ idYYaZgh**·+ hZ^ojgZh(&+!(('·( hZa["[ZZY^c\&&-·&. hZa[^h]cZhh'+( hZeVgVi^dc egdadc\ZY&+. hZeVgVi^dcVcm^Zin&+,!&,% hZmjVa^in'*-·. h]Vbedd,*·+!-& h]Vg^c\!eaVn^c\VcY').·*% h]^ZaYh!]V^glVh]^c\-&!-) h]dX`(%( ZaZXig^X(%( h]dZh!idYYaZgh). h]dee^c\'-*!'-+!'-,

h]j[[a^c\&-, h]ncZhh')-!'+&·' h^c\^c\'&+ WZYi^bZg^ijVah&**!&+. idcZlWdgcWVWn'. h^ii^c\Ydlc&-,·- h^ii^c\je&-)·+ h`^c WaZb^h]Zh') Wa^hiZgh(&. Wgj^hZh(&.·'% WjgchVcYhXVaYh(%)!('% XjihVcY\gVoZh(') Y^VeZggVh]+-·. ZXoZbV('+ cZlWdgcWVWn'(!,+·, hea^ciZgh((( hjcegdiZXi^dc'.& hjcWjgc(()·* lVgih((- see also gVh]Zh haZZe"lVa`^c\&*,!((( haZZe^c\&)'·*, W^gi]id&nZVg&)'". Yjg^c\WgZVhi"[ZZY^c\.Zfj^ebZci[dg(+ cVeh&), VcYc^\]i[ZZY^c\h&&% &id'nZVgh&).·*( hV[Zhiedh^i^dc&)* haZZenWVW^Zh')% 'id(nZVgh&*)·, lV`Z[jaWVW^Zh')%·& haZZe^c\WV\h(+!&))!&-ha^YZh',) ha^c\h!jh^c\(+!*(!&+'!'-( hbVX`^c\'*' hbZaa!hZchZd['. hb^a^c\'%. hcVX`h&'(!&(%·& hcZZo^c\'* hcj[[a^c\'* hdVe,+!-' hdX^VaWZ]Vk^dg'(+·+( WdjcYVg^Zh')(·*!'*&·'! '+%

\j^YZa^cZh'*' b^aZhidcZh'(-·. eZghdcVaYZkZadebZci '(+·')'!')+·*%!'*+·. edhh^WaZXdcXZgch'))·*! '*(·*!'+&·( hdX`h),!). hda^Y[ddYh ZhiVWa^h]^c\&&(·'% ^cigdYjX^c\&&&·&' hdjcYh!cZlWdgcWVWn'*·+ heZZX]YZ[ZXih''-!'(* heZZX]YZkZadebZci W^a^c\jVa^hb'', W^gi]id&nZVg''*·. XdckZghVi^dch'(( ZmeVcY^c\kdXVWjaVgn'(%! '((·) \gVbbVg'() ]Zae^c\ndjgWVWn'',·. a^he^c\'(* b^aZhidcZh''+·, &id'nZVgh'&'·&)!''.·(' egdWaZbh''fjZhi^dch''(!'(* hZciZcXZh'(% h^bea^[n^c\ldgYh'', hijiiZg^c\'*) 'id(nZVgh'&.·'%!''(! '((·* jcYZghiVcY^c\VcY'(& he^ii^c\je&%.!((, hea^ciZgh((( hed^a^c\WVW^ZhVcYX]^aYgZc &+!&*-·.!&+%·& hedc\ZWVi]h,) hegV^ch((( hiV^cgZbdkVa)* hiV^gh!hV[Zin&*,!'.+·, hiVcY^c\&-,!&-hiVgiaZgZ[aZm',!*% hiZVa^c\'+& hiZg^a^o^c\ WdiiaZh&%'·( Y^VeZgh++ [ZZY^c\Zfj^ebZci&&'!&&)

INDEX 351 hi^c\h(() hiddah d[WdiiaZ"[ZYWVWn&() WdlZaegdWaZbh&(*·+ d[WgZVhi"[ZYWVWn--!&() X]Vc\Zh^c&() [gZfjZcXnd[&(' cZlWdgcWVWn')!&() hidgV\Z ^cWVWn¼hgddb([ddY&&* idnh(.!',+ higVW^hbjh''!((* higZiX]^Zh)%!))·* higdaaZgh(+·,!'-(·)!'-+ hijiiZg^c\'*) hinh((* hjX`^c\gZ[aZm'+!&%+ ¹hjX`nºWVW^Zh.- HjYYZc>c[Vci9ZVi] HncYgdbZ(+!*'!&)* hj\Vg dkZglZ^\]iidYYaZgh&'iddi]YZXVn&(&!'%) hjcegdiZXi^dc'.& hjcWjgc(()·* hjeZgbVg`Zih'-* hlVaadl^c\gZ[aZm'+ hlZZih&'' hl^bb^c\-* hl^c\h',)

T iVa`^c\ see heZZX] YZkZadebZci iVc\aZh!^c]V^g-) iVcigjbh&+-!&,*·+!'*) I7ijWZgXjadh^h()( iZZi]'%&·* Wgjh]^c\'%'·(!'%* XaZVc^c\-( YZXVn&(&!'%) iZZi]^c\'%&·'!'%)!((* iZaZk^h^dc'-& iZbeZgiVcigjbh&+-!&,*·+! '*)

iZbeZgVijgZ WVWn¼hgddb'(!(-!&)( d[WdiiaZ"[ZZY^c\h&%* iZiVcjh()( ^bbjc^oVi^dc((. i]ZgbdbZiZgh(&& i]^ghi.* i]gZZ"Y^bZch^dcVak^h^dc&.. i]gjh]+- i]jbWhjX`^c\&++!'+' i^b^YX]^aYgZc')-!'+&·' i^gZYcZhh!VcYXgn^c\&+*!&,( idYYaZgh WZYgddbh(-·. WdlZaVcYWaVYYZgXdcigda &(.·)& XVg_djgcZnh'-. Xadi]^c\)+·XddgY^cVi^dc&.,·- Xgn^c\&+,·. Y^VeZgh+. Y^Vgg]ZV&)& [ZZY^c\egdWaZbh&'*·+! &'-·. [ddY&'&·+ ]VcYa^c\**·+ aZVgc^c\'&'·&,!'&- VcYcZlWVW^Zh&,%!'*( eaVn^c\',%·+ hV[Zin&.& h]dZh). h]dee^c\l^i]'-, haZZe^c\&).·*( hcVX`h&(%·& heZZX]YZkZadebZci ''.·(' iZZi]'%)·* k^h^dc'%& lVa`^c\&.%·' lVh]^c\-'·( id^aZiigV^c^c\seeWaVYYZg Xdcigda0WdlZaXdcigda id^aZih&)% idc\jZ"i^Z''·( idch^a^i^h((+ iddi]eVhiZ-,!&(&!'%(!'%*

idee^c\VcYiV^a^c\,' idjX]!^bedgiVcXZd[&+·&-! *+ idmdXVgV((+·, idnh ^cWVi],* W^gi]id&nZVg'+)·+ VcYXgZVi^k^in',* [dgZVganlV`Zgh&), aZVgc^c\egdXZhh'&* &id'nZVgh',%·+ eaVn^c\l^i]dji'&, hV[Zin'++ h]Vg^c\').·*% hidgV\Z(.!',+ 'id(nZVgh',, igV^cZgeVcih+. igVkZa V^gigVkZa'.%·& XVg_djgcZnh'--·. [dgZ^\cigVkZa()'·( l^i]cZlWdgcWVWn(+·, edii^Zh&)& ejWa^XigVchedgiVi^dc'-* il^ch*, WgZVhi"[ZZY^c\.) ine]d^Y()(

U jbW^a^XVaXdgY,, jbW^a^XVa]Zgc^V'(!,- jbW^a^Xjh'( jcXdchX^djhcZhh(%%·' jcYZg[ZZY^c\..!&%jcYZgh]^gih)( jcYZglZ^\]iidYYaZgh&'+ jcYgZhh^c\ XVjhZd[Xgn^c\&+( [ZVgd[,- cZlWdgcWVW^Zh)* jg^cZ WVW^Zh&(' Y^VeZggVh]+-·. see alsoWaVYYZgXdcigda jgi^XVg^V((, jgi^XVg^VcZdcVidgjb')

352 INDEX

V kVXVi^dch'.&!()'·( kVXX^cVi^dchsee^bbjc^oVi^dc kZ\ZiVWaZh [^c\Zg[ddYh&&. &id'nZVgh&'&!&'' 'id(nZVgh&'+ kZgc^m'( k^daZcXZ!dciZaZk^h^dc'-& k^h^dc&..·'%& k^iVb^ch-+·, k^iVb^c9-+!'%) kdb^i^c\((,·XVgh^X`cZhh'-. [dgX^WaZkdb^i^c\&%. l]ZcidXVaai]ZYdXidg(&% he^ii^c\je&%.!((,

W lV`Z[jaWVW^Zh')%·& see also c^\]ilV`^c\ lVa`^c\&.%·' ¹Xgj^h^c\º&--!&.% ¹lVa`^c\ºgZ[aZm'+·, lVgih((-

lVh]^c\ W^gi]id&nZVg,%·-& Xadi]^c\))·* Y^VeZgh++·, ]V^g,*·+!-%·&!-)·* eaVhi^XeVcih+, hedc\ZWVi]h,) idYYaZgh-'·( idee^c\VcYiV^a^c\,' see also WVi]^c\ lVhehi^c\h(() lViZg Yg^c`^c\&&,!&'& [ZVgd[-* lViZgeaVn'&*!',( lVm!^cZVgh,, lZVah!cZlWdgcWVWn') lZVc^c\&&&·&' lZ^\]i\V^c&,-·.!&-. lZ^\]iegdWaZbh!idYYaZgh &'*·+!&'- l]dde^c\Xdj\]seeeZgijhh^h l^cY!Wjge^c\&%-·. ldg`^c\bdi]Zgh&&·&' ldgbh-(!((+·, ldjcYh

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Acknowledgments Medical consultants for new edition: 9g#L#?d]c;nh]B77H;G8E;G8E8=0 9g#6k^kVHX]Z^cB9# Cooling Brown would like to thank: 8dchiVcXZCdk^h[dgegdd[gZVY^c\0=^aVgn7^gY [dgi]Z^cYZm# Picture library: GdbV^cZLZgWadl I]ZejWa^h]ZgldjaYa^`Zidi]Vc`i]Z [daadl^c\[dgi]Z^g`^cYeZgb^hh^dcid gZegdYjXZi]Z^ge]did\gVe]h/ Corbis:8VbZgdc'.0Getty Images:

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This book provides a wealth of practical advice on looking after your baby, but above all I hope it will give you the confidence to trust your own instincts as you respond to your baby’s needs. Remember that no one knows your baby like you do.

“A comprehensive book that should solve your problems.” —PARENTS MAGAZINE

 Reassuring,up-to-date guidance

for the first three years of life from this best-selling parenting author

 The complete picture on feeding,

sleep, crying, bathing, home medicine, hygiene, first aid, and more

 Features a stage-by-stage guide to

your baby’s physical, emotional, and intellectual development

DR. miriamstoppard Discover more about Miriam Stoppard’s books at www.dk.com/miriamstoppard and from Miriam herself at www.miriamstoppard.com

Jacket images: Front and spine: Photolibrary: Marina Raith. Back: Author portrait: Carolyn Djanogly for DK; PunchStock: Brand X Pictures.