Your Baby's First Year

Fifth Edition

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The guide to every aspect of infant care that’s most recommended by pediatricians and trusted by parents, with over four million copies sold—now in a completely revised and updated fifth edition!

From the American Academy of Pediatrics, the nation’s most authoritativename in childcare, comes the definitive all-in-one resource Your Baby’s First Year. Featuring new and expanded content, including the latest reports on cutting-edge research into early brain development, the fully illustrated fifth edition of Your Baby’s First Year includes 

• Guidelines for prenatal and newborn care, with spotlights on maternal nutrition, exercise, and screening tests during pregnancy
• Milestones for physical, emotional, social, and cognitive growth, as well as visual, hearing, language, and movement milestones
• Cutting-edge research on early brain development and how babies and young children think.
• A complete health encyclopedia covering injuries, illnesses, and congenital diseases
• An in-depth discussion on breastfeeding, including its benefits, techniques, and challenges
• Revised nutrition recommendations, including the importance of early introduction of allergenic foods and obesity prevention tips
• Tips for choosing childcare programs
• Updated safety standards: the very latest AAP recommendations, from CPR instruction, safe sleep, and immunizations, to childproofing tips, car safety seats, and toy safety
• Safety checks for home, including bathing, preventing drowning, poisoning, choking, burns, and falls
• And much more

Comprehensive, reassuring, and up-to-date, Your Baby’s First Year is an indispensable guide for parents everywhere.

Under the Cover

An excerpt from Your Baby's First Year

Chapter One

Preparing for a New Baby   

Pregnancy is a time of anticipation, excitement, preparation, and, for many new parents, uncertainty. You dream of a baby who will be strong, healthy, and bright—and you make plans to provide her with everything she needs to grow and thrive. You probablyalso have fears and questions, especially if this is your first child, or if there have been problems with this or a previous pregnancy. What if something goes wrong during the course of your pregnancy, or what if labor and delivery are difficult? What if being a parent isn't everything you've always dreamed it would be? These are perfectly normal feelings and fears to have. Fortunately, most of these worries are needless. The nine months of pregnancy will give you time to have your questions answered, calm your fears, and prepare yourself for the realities of parenthood.  

Some of your initial concerns may have been raised and addressed if you had difficulty becoming pregnant, particularly if you sought treatment for an infertility problem. But now that you're pregnant, preparations for your new baby can begin. The best way to help your baby develop is to take good care of yourself, since medical attention and good nutrition will directly benefit your baby's health. Getting plenty of rest and exercising moderately will help you feel better and ease the physical stresses of pregnancy. Talk to your physician about prenatal vitamins, and avoid smoking, alcohol, and eating fish containing high levels of mercury. 

As pregnancy progresses, you're confronted with a long list of related decisions, from planning for the delivery to decorating the nursery. You probably have made many of these decisions already. Perhaps you've postponed some others because your baby doesn't yet seem "real" to you. However, the more actively you prepare for your baby's arrival, the more real that child will seem, and the faster your pregnancy will appear to pass.

Eventually it may seem as if your entire life revolves around this baby-to-be. This increasing preoccupation is perfectly normal and healthy and actually may help prepare you emotionally for the challenge of parenthood. After all, you'll be making decisions about your child for the next two decades—at least! Now is a perfect time to start.  

Here are some guidelines to help you with the most important of these preparations.      

Giving Your Baby a Healthy Start    

Virtually everything you consume or inhale while pregnant will be passed through to the fetus. This process begins as soon as you conceive. In fact, the embryo is most vulnerable during the first two months, when the major body parts (arms, legs, hands,feet, liver, heart, genitalia, eyes, and brain) are just starting to form. The chemical substances in cigarettes, alcohol, illegal drugs, and certain medications can interfere with the developmental process, and some can even cause congenital abnormalities. For instance, if you smoke cigarettes during pregnancy, your baby’s birth weight may be decreased. Even breathing in smoke from the cigarettes of others (passive smoking) can affect your baby. Stay away from smoking areas and ask smokers not to light up around you. If you’re a smoker, this is the time to stop—not just until you give birth, but forever. Children who grow up in a home where someone smokes have a greater risk of sudden infant death syndrome (SIDS), more ear infections and more respiratory problems during infancy and early childhood, and even an increased risk of childhood obesity. They also have been shown to be more likely to smoke when they grow up.

When preparing for your baby, you may decide to paint and add new furniture to the nursery. It’s important to have good ventilation in spaces you’re painting, to avoid inhaling large amounts of fumes. New furniture can harbor chemicals and you should allow it to ventilate before placing your baby in or near it. Exposures do not only happen in the home; workplaces may have chemicals in use that, when inhaled, can result in harm to you and your baby. Your employer should provide you with personal protective equipment or other task assignments if you are exposed to chemicals or dust in the workplace.

You should avoid all medications and supplements except those your physician has specifically recommended. This includes not only prescription drugs you’re already taking, but also nonprescription or over-the-counter products such as aspirin, cold medications, and antihistamines. Even vitamins can be dangerous if taken in high doses. (For example, excessive amounts of vitamin A have been known to cause congenital abnormalities.) Consult with your physician before taking drugs or supplements of any kind during pregnancy, even those labeled “natural.”

Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids. They can be an essential part of a balanced diet for pregnant women.

However, you should be aware of the possible health risks from eating fish while pregnant. Avoid raw fish, as it may contain parasites such as flukes or worms. Cooking and freezing are the most effective ways to kill the parasites. For safety reasons, the US Food and Drug Administration (FDA) recommends cooking fish to an internal temperature of 140 degrees Fahrenheit (60 degrees Celsius). Certain types of cooked sushi such as eel and California rolls are safe to eat when pregnant.

The most worrisome contaminant in fish is mercury (or more specifically, methylmercury). Mercury has been shown to be damaging to the fetus’s brain and nervous system development. The FDA advises pregnant women, women who may become pregnant, nursing mothers, and young children to avoid eating shark, swordfish, king mackerel, and tilefish (from the Gulf of Mexico) due to high levels of mercury in these fish. According to the FDA, pregnant women can safely eat an average of 8–12 ounces (two to three average servings) of a variety of other types of cooked fish each week. Five commonly eaten fish low in mercury are shrimp, canned or packaged light tuna, salmon, pollock, and catfish. Albacore tuna can be high in mercury, so canned chunk light tuna is a better choice. If there are no local health advisories about fish caught in your area, you can eat up to 6 ounces (one average meal) per week of local fish, but don’t consume any other fish during that week.

While no adverse effects from minimal caffeine intake (1 to 2 cups of caffeinated coffee per day, or about 200 mg of caffeine) have yet been proven, you may want to limit caffeine to the minimum needed when you are pregnant. Remember, caffeine is also found in many soft drinks and foods such as chocolate.

Another cause of congenital abnormalities is illness during pregnancy. Take precautions against these dangerous viral infections:

German measles (rubella)
can cause intellectual disability, heart abnormalities, cataracts, and deafness, with the highest risk occurring in the first twenty weeks of pregnancy. Fortunately, this illness can be prevented by immunization, although you must not get immunized against rubella during pregnancy. If you are unsure whether you’re immune, your obstetrician can order a blood test. In the unlikely event that you’re not immune, you must do your best to avoid sick children, especially during the first three months of pregnancy. It is then recommended you get immunized after giving birth to prevent this same concern in the future.

Chickenpox (varicella)
is particularly dangerous if contracted shortly before delivery. If you have not already had chickenpox, avoid anyone with the disease or anyone recently exposed to the disease. You also should receive the preventive vaccine when you are not pregnant.

Herpes is an infection that newborns can get at the time of birth. Most often, it occurs as the infant moves through the birth canal of a mother infected with genital herpes. Babies who get a herpes viral infection may develop fluid-filled blisters on the skin that can break and then crust over. A more serious form of the disease can progress into a severe and potentially fatal inflammation of the brain called encephalitis. When a herpes infection occurs, it is often treated with an antiviral medication called acyclovir. For the last month of pregnancy, your doctor may advise taking preventive medications like acyclovir or valacyclovir to reduce the risk of an outbreak. If you have an outbreak or feel symptoms of one coming on during your delivery time, you should notify your obstetrician, and a Cesarean section (or C-section) may be recommended to decrease the risk of exposure to the baby.

- About the author -

The American Academy of Pediatrics is an organization of 66,000 primary-care pediatricians, pediatric medical subspecialists, and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.

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