What to Expect the First Year (57 page)

In rare cases, the bridge of skin permanently attaches, and a urologist may eventually need to separate the skin and remove the remaining piece of foreskin to prevent the problem from recurring.

“The pediatrician said that my twin boys have inguinal hernias and will have to have surgery. Is this serious?”

Hernias aren't unusual in newborns, particularly boys, and especially those born prematurely (as twins often are). In an inguinal hernia, a part of the intestines slips through one of the inguinal canals (the same channels through which the testes descend into the scrotum) and bulges into the groin. The hernia is often first noticed as a lump in one of the creases where the thigh joins the abdomen, usually when a baby is crying or very active (it often retracts when he's calm). When the section of the intestines slips all the way down into the scrotum, it can be seen as an enlargement or swelling in the scrotum, and may be referred to as scrotal hernia. Should you notice a lump in your baby's groin, report it to the doctor as soon as possible.

A hernia doesn't usually cause any discomfort, and while it must be treated with surgery, it isn't considered serious or an emergency (which means you can relax). Doctors usually recommend repair as soon as the hernia is diagnosed—assuming the baby is strong and healthy enough to undergo surgery. The surgery is usually simple and successful, with a very short (sometimes one day) hospitalization. Only very rarely does an inguinal hernia recur after surgery, though in some little ones, another hernia occurs on the opposite side later on.

If a diagnosed infant inguinal hernia is not treated, it can lead to the herniated section becoming “strangulated”—pinched by the muscular lining of the inguinal canal, obstructing blood flow and digestion in the intestines. Call the doctor immediately if you notice any of the symptoms of strangulation (crying in pain, vomiting, not having bowel movements, and possible shock). If the doctor can't be reached, take the baby (or babies) to the nearest emergency room. Elevating baby's bottom slightly and applying an ice pack while en route to the ER may help the intestine to retract, but don't try to push it back in by hand.

Welcome to the world, baby—a world of sights, sounds, smells, tastes, touches, and textures, some of them comforting, some of them confusing, all of them stimulating to an infant's brand new set of senses. How do you help your little one make sense of those senses—and of the big, sometimes overwhelming world around him or her? Chances are you're already helping plenty, without even trying (or knowing what you're doing—after all, you're new at this, too). Most nurturing comes naturally—which means you'll instinctively give your baby's senses the workout they need to develop to their greatest potential. Just remember, it's a process—one that's just getting started, and one you should never rush or push. Here are a few ways to stimulate your brand new little bundle's brand new little senses. (Also see “Making the Most of the First Three Years,”
here
.)

The sense of taste.
Right now you don't have to go out of your way to stimulate this sense. Your baby's taste buds get a buzz at every meal on breast or bottle. But as your little one gets bigger, “tasting” will become a way of exploring,
and everything within reach (sometimes edible … more often, not) will end up being mouthed. Resist the temptation to discourage this—except, of course, when what goes into your baby's mouth is toxic, sharp, dirty, or small enough to choke on.

The sense of smell.
In most environments, an infant's keen smelling apparatus gets plenty of workouts. There's breast milk or formula, dad's shaving cream, Rover scampering nearby, the flowers in the park, the bagel you're toasting. Unless your baby shows signs of being supersensitive to odors, think of all these scents as yet another opportunity to learn about the environment.

The sense of sight.
Babies can see from the moment they're born—if a bit fuzzily—and are able to learn from their sense of sight right from the start. Through their eyes they learn very quickly to differentiate between objects and human beings (and between one object or human being and another), to interpret facial expressions (mommy's smile!), body language (daddy's open arms!) and other nonverbal cues, and to understand a little bit more every day about the world around them.

What's visually stimulating to your newborn (besides your face)? In general, sharp contrasts and designs that are bold and bright catch a very little one's eyes more than ones that are soft, delicate, or nuanced. Black and white and other strong color contrasts are favored for the first 6 weeks or so, while pastels and other colors become appealing later on.

Many objects, toys among them, can be visually stimulating to your baby. Just keep in mind that more is not more—your baby may become overwhelmed and overstimulated if there are too many toys or other objects competing for his or her visual attention:

• Mobiles. Hang mobiles no more than 12 inches (the distance at which newborns see best) over your little one's face, on one side or the other of baby's line of vision, rather than straight above (most babies prefer to gaze toward the right, but check to see if yours has a preference). Musical mobiles, an age-old nursery favorite, stimulate two senses at the same time.

• Other things that move. You can move a rattle, a stuffed animal, a finger puppet, or other bright toy across baby's line of vision to encourage tracking of moving objects. Position baby in front of a fish tank (or a crib aquarium, or a dream catcher that's caught a breeze). Or blow bubbles for baby.

• Stationary objects. Babies spend a lot of time just looking at things—and that's time well spent. Geometric patterns or simple faces in black and white, hand-drawn or store-bought, are early favorites—but baby will probably also be fascinated by everyday objects you wouldn't glance at twice (like a cut-glass vase shimmering in the sunlight).

• Mirrors. Mirrors give babies an ever-changing view, and babies usually love looking at themselves in one—and socializing with the cutie looking back, even though they have no clue yet who that cutie is. Be sure to use unbreakable, baby-safe mirrors, and hang them on the crib, in the stroller, beside the changing table, in the car. Or place your baby in front of a mirror (or beside it) for tummy time entertainment.

• People. Babies delight in looking at faces close up (especially at that magical 8 to 12-inch range), so spend lots of time getting your face in baby's face. Later, you can also show baby family photos, pointing out who's who.

• Books. Show baby simple pictures of babies, children, animals, or toys, and identify them. The drawings should be clear and sharply defined without a lot of extra (for a baby) detail. Boldly illustrated board books are perfect for this.

• The world. Very soon your baby is going to take an interest in seeing beyond that little button nose. Provide plenty of opportunity to see the world—from the stroller, or car seat, or by carrying your baby face forward once he or she has good head control. Add commentary, too, pointing out cars, trees, people, and so on. Baby's tuning you out? Time to turn off your tour guide mode.

The sense of hearing.
Hear this: It's through the sense of hearing that your baby will learn language, about cadence and rhythm, about feelings (including empathy), about danger—and about much more that goes on in the world around him or her. Let your baby's ears hear all about it through:

• The human voice. This, of course, is the most significant sound in a new infant's life, so use yours a lot—talk, sing, and babble to your baby. Try lullabies, nursery rhymes, silly lyrics you create yourself. Imitate animal sounds, especially ones your baby regularly hears, such as the barking of a dog or the meowing of a cat—or go to town with Old MacDonald's whole farm. Most important, parrot the sounds baby makes to reinforce those verbal efforts. And read to your baby early and often.

• Sounds around the house. They're nothing new to you (in fact, you've probably become pretty adept at tuning them out), but household sounds can be captivating to a young baby: the hum of the vacuum cleaner or the dryer, the whistle of the teakettle or the splash of running water, the crinkling of paper or the tinkling of a bell or wind chime. One sound that baby's better off not hearing around the house: the TV. Try to keep it off when baby's awake.

• Rattles and other toys that make gentle sounds. You don't have to wait until your baby is able to shake a rattle to get rolling. In the early months, you can shake while baby watches and listens, put the rattle in baby's hand and help shake it, or attach a wrist rattle. Coordination between vision and hearing will develop as baby learns to turn toward sound. An activity center that baby can swat or kick at and activate sounds from (if inadvertently) can be entertaining to those ears, too.

• Musical toys. Music is music to your baby's ears, no matter what the source—a music box, a teddy that plays tunes, a musical activity center for the crib, a play mat that makes musical sounds. Toys that do triple duty (make music, provide visual stimulation, and offer practice with fine motor skills), such as a brightly colored toy that plays a sound when squeezed or pushed, are three times the fun, though baby will need your help with the squeezing or pushing for now. Avoid toys that make very loud noises that can damage hearing, and don't place even moderately noisy ones right by baby's ear. Also be sure that the toys are otherwise safe for baby (no strings attached, no batteries that can work their way out of the toy and into baby's mouth).

• Background music. All of life is a sound track for your baby's eager ears, but why not add some background music, too? Play a medley of music in your home—anything from classical to classic rock to country, R&B to reggae, tango to techno—and base encores on what genres baby responds to best. Try tot tunes, too—the more repetition in the choruses (and the sillier), the better. And as you stimulate baby's sense of hearing, protect it, too, by keeping the volume down (if it's too loud to talk over, it's too loud, period).

The sense of touch.
Sight and hearing may get all the buzz, but touch is one of a baby's most indispensable senses—invaluable in exploring and learning about the world. It's through touch that a baby learns the softness of mommy's face and the relative roughness of daddy's, that the dog's ear and the teddy bear's belly feel velvety, that air blowing from a fan feels tickly, that water feels warm and wet, that nothing feels better
than a cuddle, and that those who care for him or her are loving (that's the message you send with every tender touch).

You can provide more varied touching experiences for your baby with:

• A loving hand. Try to learn how your baby likes to be handled—firmly or lightly, quickly or slowly. Most babies love to be caressed and kissed, to have their tummies tickled or razzed by your lips, to have you blow gently on their fingers or toes. They love the difference between mommy's touch and daddy's, the playful way a sibling hugs, the expert ease of grandma's rocking. And skin to skin (kangaroo care) is always in.

• Massage. Preemies who are massaged for at least 20 minutes daily gain weight faster and do better overall than those who aren't. But your baby doesn't have to arrive early to benefit from a loving touch—all babies do. Discover the kind of strokes your baby enjoys most, and avoid those that seem to annoy (
click here
for tips).

• Fabric fun. Try rubbing a baby's skin with different textures (satin, silk, terry cloth, velvet, wool, faux fur, cotton) so he or she can get to know how each feels. Put baby tummy down (while supervised) on surfaces with different textures: the living room
carpet, a towel, dad's sweater, mom's shirt, the wood floor—the possibilities are limitless.

• Toys with texture. Offer playthings that have interesting textures: a plush teddy bear and a coarse-haired stuffed doggie, hard wooden blocks and soft stuffed ones, a rough wooden bowl and a smooth metal one, a silky pillow and a nubby one.