What to expect when you're expecting (133 page)

Cleft lip or other mouth deformities that interfere with sucking. Though the success of breastfeeding depends somewhat on the type of defect, with special help, nursing is usually possible. (Babies with cleft palates won’t be able to breastfeed but will still be able to be fed pumped breast milk.)

Very rarely, the milk supply isn’t adequate, perhaps because of insufficient glandular tissue in the breast, and breastfeeding just doesn’t work—no matter how hard mother and baby work at it.

If you end up not being able to nurse your baby—even if you very much wanted to—there’s no reason to add guilt to your disappointment. In fact, it’s important that you don’t, to avoid letting those feelings interfere with the very important process of getting to know and love your baby—a process that by no means must include breastfeeding.

F
INALLY. THE MONTH YOU’VE BEEN
waiting for, working toward, and possibly worrying about just a little bit is here at long last. Chances are you’re at once very ready (to hold that baby … to see your toes again … to sleep on your stomach!) and not ready at all. Still, despite the inevitable flurry of activity (more practitioner appointments, a layette to shop for, projects to finish at work, paint colors to pick for baby’s room), you may find that the ninth month seems like the longest month of all. Except, of course, if you don’t deliver by your due date. In that case, it’s the tenth month that’s the longest.

Week 36
Weighing about 6 pounds and measuring somewhere around 20 inches tall, your baby is almost ready to be served up into your arms. Right now, most of baby’s systems (from circulatory to musculoskeletal) are just about equipped for life on the outside. Though the digestive system is ready to roll, too, it hasn’t really gotten a workout yet. Remember, up until this point, your baby’s nutrition has been arriving via the umbilical cord—no digestion necessary. But that’s soon to change. As soon as baby takes his or her first suckle at your breast (or suck from the bottle), that digestive system will be jump-started—and those diapers will start filling.

Week 37
Here’s some exciting news: If your baby were born today, he or she would be considered full term. Mind you, that doesn’t mean he or she is finished growing—or getting ready for life on the outside. Still gaining weight at about a half pound a week, the average fetus this age weighs about 6½ pounds (though size varies quite a bit from fetus to fetus, as it does from newborn to newborn). Fat continues to accumulate on your baby, forming kissable dimples in those cute elbows, knees, and shoulders, and adorable creases and folds in the neck and wrists. To keep busy until the big debut, your baby is practicing to make perfect: inhaling and exhaling amniotic fluid (to get the lungs ready for that first breath), sucking on his or her thumb (to prepare for that first suckle), blinking, and pivoting from side to side (which explains why yesterday you felt that sweet little butt on the left side and today it’s taken a turn to the right).

Your Baby, Month 9

Week 38
Hitting the growth charts at close to 7 pounds and the 20-inch mark (give or take an inch or two), your little one isn’t so little anymore. In fact, baby’s big enough for the big time—and the big day. With only two (or four, max) weeks left in utero, all systems are (almost) go. To finish getting ready for his or her close-up (and all those photo ops), baby has a few last-minute details to take care of, like shedding that skin-protecting vernix and lanugo. And producing more surfactant, which will prevent the air sacs in the lungs from sticking to each other when your baby begins to breathe—something he or she will be doing very soon. Baby will be here before you know it!

Week 39
Not much to report this week, at least in the height and weight department. Fortunately for you and your overstretched skin (and aching back), baby’s growth has slowed down—or even taken a hiatus until after delivery. On average, a baby this week still weighs in at around 7 or 8 pounds and measures up at 19 to 21 inches (though yours may be a little bigger or smaller). Still, progress is being made in some other areas, especially baby’s brain, which is growing and developing up a storm (at a rapid pace that will continue during the first three years of life). What’s more, your baby’s pink skin has turned white or whitish (no matter what skin your baby will ultimately be in, since pigmentation doesn’t occur until soon after birth). A development that you may have noticed by now if this is your first pregnancy: Baby’s head might have dropped into your pelvis. This change of baby’s locale might make for easier breathing (and less heartburn), but could also make it harder for you to walk (make that to waddle).

Week 40
Congratulations! You’ve reached the official end of your pregnancy (and perhaps the end of your rope). For the record, your baby is fully full term and could weigh in anywhere between the 6- and 9-pound mark and measure anywhere from 19 to 22 inches, though some perfectly healthy babies check in smaller or bigger than that. You may notice when your baby emerges that he or she (and you’ll know for sure at that momentous moment which) is still curled into the fetal position, even though the fetal days are over. That’s just sheer force of habit (after spending nine months in
the cramped confines of your uterus, your baby doesn’t yet realize there’s room to spread out now) and comfort (that snug-as-a-bug position feels good). When you do meet your new arrival, be sure to say hello—and more. Though it’s your first face-to-face, your baby will recognize the sound of your voice—and that of dad’s. And if he or she doesn’t arrive on time (choosing to ignore the due date you’ve marked in red on your calendar), you’re in good—though anxious—company. About half of all pregnancies proceed past the 40-week mark, though, thankfully, your practitioner will probably not let yours continue beyond 42 weeks.

Weeks 41–42
Looks like baby has opted for a late checkout. Fewer than 5 percent of babies are actually born on their due date—and around 50 percent decide to overstay their welcome in Hotel Uterus, thriving well into the tenth month (though you may have lost that “thriving” feeling long ago). Remember, too, that most of the time an overdue baby isn’t overdue at all—it’s just that the due date was off. Less often, a baby may be truly postmature. When a postmature baby does make a debut, it’s often with dry, cracked, peeling, loose, and wrinkled skin (all completely temporary). That’s because the protective vernix was shed in the weeks before, in anticipation of a delivery date that’s since come and gone. An “older” fetus will also have longer nails, possibly longer hair, and definitely little or none of that baby fuzz (lanugo) at all. They are also more alert and open-eyed (after all, they’re older and wiser). Just to be sure all is well, your practitioner will likely monitor an overdue baby closely through nonstress tests and checks of the amniotic fluid or biophysical profiles.

You may experience all of these symptoms at one time or another, or only a few of them. Some may have continued from last month; others may be new. Still others may hardly be noticed because you are used to them and/or because they are eclipsed by new and more exciting signs indicating that labor may not be far off:

A Look Inside

Your uterus is right under your ribs now, and your measurements aren’t really changing that much from week to week anymore. The top of your uterus is around 38 to 40 cm from the top of your pubic bone. Your weight gain slows down or even stops as D-day approaches. Your abdominal skin is stretched as far as you think it can go, and you’re probably waddling more now than ever, possibly because the baby has dropped in anticipation of impending labor
.

Physically

Changes in fetal activity (more squirming and less kicking, as your baby has progressively less room to move around)

Vaginal discharge becomes heavier and contains more mucus, which may be streaked red with blood or tinged brown or pink after intercourse or a pelvic exam or as your cervix begins to dilate

Constipation