What to Expect the First Year (113 page)

BOOK: What to Expect the First Year
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Think twice about that early boarding.
If the airline you're flying does preboards for families, think twice before you take advantage. Yes, boarding first allows you to snag much-needed overhead-bin space and gives you some extra time to negotiate those tight aisles with baby and baby gear. But early board can equal early bored, since it means about an extra half hour on the plane—probably not something you want to endure voluntarily with a squirmy baby who needs constant entertainment.

Find a friendly flight attendant.
If you're alone, don't be shy (but do be nice) about asking the flight crew for help. After all, it can be nearly impossible to lift a bag and put it in the overhead bin while holding a baby. So ask a flight attendant (or fellow passenger) for a hand.

Don't expect to be fed.
Food on domestic flights has just about disappeared in coach (you may still find it on international flights)—the best you can expect is usually a snack for purchase, if that. Call ahead to find out exactly what will be served and if baby meals are available for purchase (or for free on international flights). Sometimes a snack means nothing more than a beverage and a bag of snack mix, which, as a choking hazard, is off-limits for babies. And no matter what food's been promised, don't ever board without your own supply of baby-appropriate (and approved) snacks. Takeoff delays can result in mealtime delays, food service carts can move at a maddeningly slow rate down the aisles, and special meals sometimes don't show up at all (plus, let's face it—they're not all that special).

Bring extra supplies.
Bring as many toys as you can fit into your carry-on luggage and twice as many diapers as you could possibly need, endless wipes and hand sanitizer, at least one change of clothing for your baby, and an extra t-shirt for you (forgetting the last item guarantees you'll be spit up on, thrown up on, spilled on … or all of the above). Don't forget an extra layer of clothes for your baby—it can get cold on a plane. Toss in a small blanket, too, since blankets on planes (if you can find one) are often used by many passengers between washings.

Put safety first.
If your child is occupying a seat, plan to bring aboard a car seat that's FAA-approved (not all are), and know how to install it without the base. Babies should ride in a rear-facing position. Even if you didn't buy a separate seat for baby, bring the approved car seat with you to the gate, just in case there's an extra seat next to you on board. If there isn't, the flight attendants will gate check it for you. This should limit the amount of handling—and tossing around—the car seat might encounter during regular baggage checking (you can also purchase a bag for some car seats as extra protection). If your baby is on your lap, do not belt him or her in with you—serious injury could result from even a mild impact. But do secure your belt around yourself and then hold your baby around the waist with your hands, grasping your wrists during takeoffs and landings. Don't allow your baby to crawl around alone in the aisles or to sleep or play on the floor in front of you because of the risk of injury if the plane should suddenly hit an area of turbulence.

Also carefully review the information on oxygen masks and find out where there are extras in case your baby doesn't have a seat (and therefore a mask) of his or her own. There's usually an extra mask provided in every row or section of seats. Remember, just like they say in the preflight safety video, you should put on your own mask first and then attend to your child's. If you try to do it the other way around in a low-oxygen emergency, you could lose consciousness before you manage to get either mask on.

Clean up before you take off.
Use sanitizing wipes to clean around areas that baby might touch or mouth (and that many passengers have handled before)—the seat back, armrests, tray table, and window shade.

Mind those ears.
Changes in altitude and air pressure are tough on little ears. Drinking during takeoff and landing can help by encouraging swallowing, which helps release the pressure that builds up in the ears (start as the plane starts speeding down the runway and again when the pilot announces the initial descent). Let your baby drink from a bottle, a sippy cup, or a cup with a built-in straw. Nothing to drink? A paci or feeder bag could do the trick if your baby sucks on it enough to require saliva swallowing—and as a last resort, you could try squirting water into baby's mouth with a medicine syringe. Though always comforting, breastfeeding during takeoff and landing isn't recommended for safety's sake.

If all else fails and your baby screams all the way up and all the way down, ignore the dirty looks from other passengers (you're likely to see a lot of sympathetic faces, too). At least the screaming will help reduce the pressure on your baby's eardrums and ease the pain.

Have a baby with a stuffy nose, and a ticket to fly? It's a good idea to visit the doctor first for clearance, since congestion can block Eustachian tubes and make in-flight ear pain much worse. You can also try relieving some of the congestion by placing saline drops in baby's nose before takeoff and landing.

Traveling by Train

Not in a rush? Take your time and take a train. You'll save yourself the wear and tear of driving—and the drag of airport hassles. Plus, baby will have more freedom of movement, plenty of distractions (with nobody
driving, everyone can be in entertainment mode), and an always-changing view. Your family train trip will be easier if you remember to:

Book in advance.
Ordering train tickets in advance (online or over the phone) allows you to arrive at the train station with tickets in hand, so you won't have to wait in a long ticket line. If it's possible to make seat or compartment reservations, do this in advance, too. Remember, however, that for most U.S. train reservations in coach, you are guaranteed a seat for each ticket, but not that those seats are together.

Be timely.
Peak travel times can be very crowded, especially during holiday seasons, so avoid them if you can. A late-evening train may be a good option if your baby is likely to sleep during the trip.

Pack appropriately.
For overnight train travel, your carry-on bag should also be an overnight bag, packed with extra clothes, diapers, and all those baby-care basics. This should make digging into your neatly packed suitcases unnecessary. Better still, it may make it possible to check your heavy baggage through, giving you less to lug and more room in your compartment or at your seat.

Arrive early.
Check ahead to find out what time the train ordinarily arrives at your station. If there is a 10- or 15- minute gap between arrival and departure, try to get there before the train arrives rather than just as it's about to leave. The goal: a better chance of seating the family together. If there are two adults, send one ahead, as soon as the platform number is announced, to save seats for all while the other struggles down the platform at a snail's pace with baby. If you can, grab a window seat (plus the aisle one) so your little one can watch the scenery go by.

Don't pass on the redcap.
If uniformed redcap service is available, take it. For a minimal tip, a redcap will take your bags and escort you down to and onto the train so you don't have to lug anything but your little one. Redcaps also have the inside track on which platform a train will be arriving on before it's announced, which means you'll be on your way there before the crowds descend.

Derail boredom.
Your baby will enjoy watching the scenery for only so long. So tote those toys, books, and crayons—and lots of them.

Take advantage of longer stops.
Even a 15-minute stop gives you and your baby a chance to get off the train for a stretch, and possibly even wander down to see the engine that's been pulling the train (just be sure someone is watching your luggage and that you reboard in time).

Bring your own.
Even if there's a dining or snack car on board, there's no guarantee your baby will be willing or able to eat what they're serving. So, just as you would when traveling by car or plane, bring your own snacks and drinks.

Chapter 19
Keeping Your Baby Healthy

If there's anything sadder-looking than a sick baby—it's a sick baby's parents. Even a little bout of sniffles in their little one can hit mommy and daddy hard, especially if it's the first sniffles in a first baby. Add an elevated temperature—even if it's only a slight rise—and parental anxiety can soar. Questions multiply with every passing minute, with every symptom (was that a cough?): Should we call the doctor? Should we wait for the office to open in the morning or on Monday (babies always seem to get sick in the middle of the night or on weekends), or call right away? Should we give baby medicine to bring down that fever while we're waiting for the doctor to call back? Will the doctor ever call back (it's been only 5 minutes, but it already feels like forever!)?

Fortunately, infant illnesses are usually mild—a few extra cuddles, and it's back to baby business as usual. Still, it makes sense to prevent as many as possible—to keep your baby healthy through healthy eating, healthy habits, and on-time delivery of scheduled well-baby visits and childhood immunizations. Of course, even the best prevention isn't always a match for determined germs, which is why it's important to learn what to do when your baby is sick: how to evaluate symptoms, how to take and interpret a baby's temperature, what to feed a sick child, what the most common childhood illnesses are, and how to treat them.

What You Can Expect at Checkups

If you're like most parents, you'll look forward to well-baby checkups—a lot. Not only to see how much your baby's grown, but also to get answers to the dozens of questions that have come up since the last doctor's visit (at least, the ones that you managed not to frantically call about already—there will be plenty of those, too). Make sure you keep a list of these questions and bring them along to appointments … and don't forget to ask them.

Baby will usually have his or her very first doctor's visit within several days of being released from the hospital. The schedule for the rest of the year will vary from office to office and baby to baby (depending on individual health needs and concerns), but most doctors recommend well-baby visits at 1, 2, 4, 6, 9, and 12 months of age.

Though every well-baby visit will be a little different, the doctor will be looking at your little one's growth, overall health, and development. You can expect most of the following at each visit, but keep in mind that you may not notice some of the physical checks, since the doctor will move through them quickly:

• A chance to ask all the baby-related questions you've collected since the last visit

• Questions from the doctor about how you and baby are doing, and about baby's feeding, sleeping, and development

• Measurement of baby's weight, length, and head circumference (which will be plotted on a growth chart to see baby's progress)

• Vision and hearing assessments

• A physical exam that will include all or most of the following:

• A check of your baby's heartbeat and breathing with a stethoscope

• A check of baby's belly by gently pressing on it to feel for anything out of the ordinary

• A check of baby's hips to make sure there's no dislocation (the doctor will rotate your little one's legs)

• A check of baby's arms, legs, back, and spine to make sure they're growing and developing normally

• A check of the eyes (with an ophthalmoscope and/or a penlight) for normal reflexes and focusing, and for tear duct functioning

• An ear check (with an otoscope)

• A peek in the nose (also with an otoscope) to make sure the mucus membranes are healthy

• A quick look into the mouth and throat (using a tongue depressor) to check for color, sores, and bumps

• Feeling the neck and underarms to check on the lymph glands

• A check of the fontanels (the soft spots on the head)

• A check of the genitals for hernias or undescended testicles (and while the doctor's at it, he or she will also check the femoral pulse in the groin, for a strong, steady beat)

• A peek at the anus to check for cracks or fissures

• A check of umbilical cord and circumcision healing (when applicable)

• An overall assessment of baby's skin color and tone, and a check for any rashes or birthmarks

• A quick look at reflexes specific to baby's age

• As baby grows, an assessment of his or her overall movement and behavior and ability to relate to others

• Advice on feeding, sleeping, development, and infant safety

• Immunizations, if they're scheduled and there's no medical reason to postpone them (
click here
). These are typically scheduled for last so that baby's crying won't interfere with the exam.

When you get home, record everything (baby's weight, length, head circumference, blood type, test results, birthmarks) in a permanent file, a baby book, or an app.

First Test Results

During baby's first well-baby visit you'll probably get the results of neonatal screening tests (for PKU, hypothyroidism, and other inborn errors of metabolism), if they weren't given previously. If the doctor doesn't mention the tests, the results were very likely normal, but do ask for them for your own records. If your baby was released from the hospital before these tests were performed, they will probably be performed at that first visit. Some states have specific protocols about when testing should be done. Ask your pediatrician whether any of your newborn's metabolic screens will have to be repeated after discharge, based on your state's protocol.

For Parents: The Pediatrician's Role in Postpartum Depression

Sure, the pediatrician is your baby's doctor, but a mom's well-being affects her baby's in so many ways. Postpartum depression (PPD) can keep a new mom from nurturing her little one, which can lead to slower development (babies of depressed moms are less vocal, less active, make fewer facial expressions, and are more anxious, passive, and withdrawn). And since pediatricians have many more opportunities to interact with new moms than do ob practitioners (PPD sometimes doesn't start until after that 6-week postpartum visit and sometimes begins well before it), they're considered the first line of defense in fighting PPD. That's why the AAP recommends that pediatricians screen for PPD at babies' 1-, 2-, and 4-month visits by asking new moms to complete a short checklist called the Edinburgh Postnatal Depression Scale—basically 10 questions designed to reveal whether a new mother is struggling with PPD. If you think you or your partner might have symptoms of PPD, ask the pediatrician for a screening if it's not offered (and don't wait for the next appointment if the symptoms are serious enough to interfere with functioning—call for help right away). A prompt diagnosis and the right treatment can make all the difference in helping a new mom enjoy her new life with her new baby.

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