What to Expect the First Year (44 page)
Read What to Expect the First Year Online
Authors: Heidi Murkoff
“We've heard a lot of different opinions about vitamin supplements. Should we give our baby one, and what kind should we give him?”
When it comes to deciding whether or not to give your baby a vitamin supplement (and which kind to give), it's the pediatrician's opinion that matters most. That's because your baby's doctor will take into account not only the ever-evolving research and recommendations on vitamin supplements, but your little one's unique needs.
If your little one is exclusively or partially breastfed, he'll be getting most of the vitamins and minerals he needs from breast milk (assuming you're eating a good diet and taking a daily prenatal vitamin or one designed for breastfeeding moms). But he'll definitely fall short on vitamin D, which is why pediatricians recommend that breastfed babies get 400 IU a day of vitamin D in the form of a supplement (probably A-C-D, which combines vitamins A, C, and D), starting in the first few days of life. And while he'll score enough iron from your breast milk in the first 4 months, levels can diminish after that pointâwhich is why the pediatrician is likely to add an iron supplement to the mix (1 mg/kg per day, probably in an A-C-D supplement with iron added) at least until iron-rich solids (like fortified cereals, meat, and green vegetables) are introduced. As an added precaution, the pediatrician may suggest that your little one stay on an iron supplement throughout the first year. The added benefit of combining iron with vitamin C (either in a supplement or with food): The vitamin C helps with iron absorption.
If your little one is exclusively bottle-fed, chances are he's getting most of the nutrients he needs through formulaâthough he may fall short on vitamin D until he's consistently drinking enough to meet his daily quota (he'd have to down a minimum of 32 ounces, something he's not likely managing yet). To fill the gap, the pediatrician may recommend giving your baby a vitamin D supplement (probably in the form of A-C-D drops) at least in the short term. Later, once your baby gets serious about solids and starts drinking less formula, the doctor may suggest adding iron as well, again probably in an A-C-D with iron formula.
Ask the pediatrician for recommendations on what supplements your baby needs (if any), and when. Happily, most infant vitamin drops are tasty, and many (though far from all) babies have no problem taking them. It might be easier to give the drops right before a feed, when your baby's apt to lap them up (from hunger)âor you may find him more receptive after a feed. A tasteless powdered supplement can be substituted for the drops if your baby takes a bottle (you mix them right into formula or breast milkâjust make sure your baby drinks the whole bottle to get the full dose). The powder can also be mixed with solids once they're started (but again, only if you can count on baby finishing that bowlful).
If your baby has health problems, was premature, or if you're breastfeeding and think your diet might be lacking some important vitamins and minerals (say, if you're a vegan and you're not getting enough B
12
, zinc, or calcium), the doctor might recommend additional supplements for your baby. Preterm infants who are breastfed will likely be prescribed an iron supplement of 2 mg/kg daily, starting at 1 month of age and continuing until their intake of iron-rich foods fills the requirement for this essential mineral.
What about fluoride? Babies under 6 months don't need fluoride supplementation, and older babies need it only if there isn't adequate fluoride in the water supply or if they don't drink tap water (bottled water doesn't contain it). Ask your baby's doctor for specific recommendations. Keep in mind that with fluoride, as with most good things, too much can be bad. Excessive intake while the teeth are developing in the gums, such as might occur when a baby drinks fluoridated water (either plain or mixed with formula) and takes a supplement, can cause fluorosis, or mottling (“chalk marks” appearing on the teeth). Excessive intake can also occur if excessive amounts of fluoridated toothpaste are used.
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Take the responsibility of caring for a newborn baby for the first time. Add in the days and nights that seem to blur together as one endless feeding. Plus a few too many visitors, a generous helping of postpartum hormonal upheaval for mom (and some for dads, too), and, possibly, a fair amount of home clutter accumulated during your stay in the hospital or in the last days of pregnancyâwhen you could barely move, never mind clean. Throw in the inevitable mountain of gifts, boxes, wrapping paper, and cards to keep track of. It's only natural to feel that as your new life with baby begins, your old lifeâwith its order and cleanlinessâis crumbling around you.
As hard as it may be to believe now, your inability to keep up with both new baby and house during the first weeks or months in no way predicts your future success at the juggling act called parenthood. Things are bound to get better as you get more sleep, become more adept at all those baby-care tasks, and learn to be a little more flexible. It will also help to:
Get help.
If you haven't already arranged for household helpâpaid or unpaidâand taken steps to streamline housekeeping and cooking chores, now's the time to do so. Also be sure that there is a fair division of labor (both baby care and household care) between parents, if there are two.
Get your priorities straight (before you straighten up).
Is it more important to get the vacuuming done while baby's napping or to put your feet up and relax? Is it really essential to clean out the fridge, or would going for a stroll with the baby be a better use of your time? Keep in mind that doing too much too soon can rob you of the energy to accomplish anything well, and that while your house will someday be clean again, your baby will never be 2 days, or 2 weeks, or 2 months old again. In other words: Stop (cleaning) and smell the babies.
Get organized.
Have a million to-do's floating through your sleep-deprived head? Write them down. First thing every morning (or before you crash every night), make a list of what needs to be done. Divide your priorities into three categories: chores that must be taken care of as soon as possible, those that can wait until later in the day, and those that can be put off until tomorrow, or next week, or indefinitely. Assign approximate times to each activity, taking into account your personal biological clock (are you useless first thing in the morning, or do you do your best work at the crack of dawn?) as well as your baby's (as best you can determine it at this point).
Though organizing your day with lists doesn't always mean that everything will get done on schedule (in fact, for new parents it rarely does), it will give you a sense of control over what may now seem like a completely uncontrollable situation. You may even find, once you've made your list, that you actually have less to do than you thought. Don't forget to cross off or delete completed tasks for a satisfying
feeling of accomplishment. And don't worry about what's not crossed offâjust move those items to the next day's list.
Another good organizational trick of the new parent trade: Keep a running list of baby gifts and their givers as they're received. You think you'll remember that your cousin Jessica sent that darling blue-and-yellow onesie set, but after the seventeenth onesie set has arrived, that memory may be dim. And check off each gift on the list as the thank-you note is sent, so you don't end up sending two notes to Aunt Karen and Uncle Marvin and none to your boss.
Get simplified.
Take every shortcut you can find. Make friends with frozen vegetables and healthy frozen entrées, your local salad bar, the pizza delivery guy, online grocery and diaper shopping.
Get a jump on tomorrow tonight.
Once you've bedded baby down each night and before you collapse, summon up the strength to take care of a few chores so that you'll have a head start on the next morning. Restock the diaper bag. Measure out the coffee for the coffeepot. Sort the laundry. Lay out clothes for yourself and the baby. In 10 minutes or so you'll accomplish what would take you at least three times as long with the baby awake. And you'll be able to sleep better (when your little one lets you) knowing that you'll have less to do in the morning.
Get out.
Plan an outing every day with your little oneâeven if it's just a walk around the mall. The change of pace and space will allow you to return to Casa Chaos somewhat refreshed.
Get to expect the unexpected.
The best-laid plans of parents often (actually, very often) go awry. Baby's all bundled up for an outing, the diaper bag is ready, your coat is on, and suddenly the distinct gurglings of an explosive poop can be heard from under all baby's gear. Off comes coat, bunting, diaperâ10 minutes lost from an already tight schedule. To allow for the unexpected, try to build extra time into everything you do.
Get the joke.
If you can laugh, you're less likely to cry. So keep your sense of humor, even in the face of total disorder and utter clutterâit'll help you keep your sanity, too.
Get used to it.
Living with a baby means living with a certain amount of mayhem most of the time. And as baby grows, so will the challenge of keeping the mayhem in check. No sooner will you scoop the blocks back into their canister than he or she will dump them back out again. As fast as you can wipe mashed peas off the wall behind the high chair, your baby can redecorate with strained peaches. You'll put safety latches on the kitchen cabinets, and your one-baby demolition derby will figure out how to open them, covering the floor with your pots and pans.
And remember, when you finally pack your last child off to college, your house will be orderly once againâand so empty and quiet that you'll be ready to welcome the pandemonium (and even the dirty laundry) they bring home on school vacations.
Tired of separating your baby's laundry (especially because the loads, like the clothes, are so tiny)? Here's a happy laundry alert: Most babies probably don't need their clothes washed separately from the rest of the family's, with special baby laundry soaps. Even the high-potency detergents that really get clothes clean, eliminating most stains and odors (the kind babies are very good at generating), aren't irritating to most infants when well rinsed. (Rinsing is most thorough, and stain-fighting powers are most effective, with liquid detergents.)
To test your baby's sensitivity to your favorite laundry detergent, add one item that will be worn close to baby's skin (such as a t-shirt) to your next family load, being careful not to overdo the detergent or underdo the rinse. If that tender skin shows no rash or irritation, go ahead and wash baby's clothes with yours. If a rash does appear, try another detergent, preferably one without colors and fragrances, before deciding you have to stick with a baby laundry formula.
Love the smell of baby laundry detergent? Go ahead, make your dayâand your whole family's laundryâsmell baby fresh.
“My baby spits up so much that I'm worried she's not getting enough to eat.”
Although it seems as if your little one is literally losing her lunch (and breakfast, and dinner, and snacks), she's almost certainly not. What looks like a lot of spit-up probably amounts to no more than a tablespoon or two of milk, mixed with saliva and mucusâcertainly not enough to interfere with your baby's nourishment. If your baby's growing well, peeing and pooping plenty, and thriving, there's no need to cry over spit-up milkâor to worry about it.
Doctors are fond of saying that spit-up is a laundry problem, not a health problem. It's smelly and messy, but it's normalâand so common. Most babies spit up at least occasionally, and many spit up with every feeding. The reason for this malodorous mayhem? Newborns have an immature sphincter between the esophagus and stomach, which allows food to back upâeven more easily, since they spend most of their time lying flat on their backs or semireclining. They also have excess mucus and saliva that needs to be clearedâand up and out is the most effective way for an infant to ship that goop out. Often, they spit up because they eat too much (especially if they're bottle-fed and mommy or daddy is pushing more ounces than a tiny tummy can handle), or because they're getting too many air bubbles with their milk (particularly if they were crying before the feed or didn't get burped enough during it). Later, teething babies often gag and spit up thanks to all the drool they're producing.
Most babies stop spitting when they start sitting, usually at about 6 months. The introduction of solids (also at about 6 months) can help limit spit-up, tooâafter all, it's easier to spit up an entirely liquid diet. Until then, there's no sure way to stop the spitting up (though a bib for your baby and a burp cloth for you should prevent some of the mess), but you can cut down on the frequency:
⢠Keep bubbles at bay by minimizing air gulping during mealtimes (don't feed her when she's crying, and try to calm her down before feeds).
⢠Put gravity in your corner by feeding her with her upper body elevated (as upright as is comfortably possible).
⢠Tilt bottles so that the liquid (not air) fills the nipple, or use bottles that don't allow air to enter the nipple.
⢠Avoid bouncing her around while she's eating or just afterward. You'll be less likely to bring up the works if you keep her relatively still.
⢠Break for burps often enoughâat least once, halfway through her feedings (if you wait until the end, one big bubble can open the floodgates). If she's a slow eater or seems fussier than usual, break more frequently.
⢠Keep her upright as much as possible after meals.
Most babies are “happy spitters”âin other words, the spitting doesn't bother them in the slightest (though the same probably can't be said for their parents), and it doesn't affect weight gain or growth. Some babies may have discomfort with spittingâor may be gassy or have other signs of reflux without spittingâand the doctor might diagnose it as gastroesophageal reflux disease or GERD (
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