The one guide pediatricians most recommend—now completely revised and updated!
From the American Academy of Pediatrics, the nation’s most trusted name in child care, comes Your Baby’s First Year, the definitive all-in-one resource that provides authoritative advice on every aspect of infant care. Featuring new and expanded content, including the latest reports on cutting-edge research into early brain development, the fully illustrated fourth edition of Your Baby’s First Year includes
• Guidelines for prenatal care, with spotlights on maternal nutrition, exercise, and screening tests during pregnancy
• Growth and developmental milestones through the first twelve months of a child’s life, including physical, emotional, and cognitive development
• An updated chapter on developmental disabilities
• A complete health encyclopedia covering injuries, illnesses, and congenital diseases
• Breastfeeding discussion, including its benefits, techniques, and challenges, as well as nutritional needs and vitamin/iron supplementation
• Recommendations for choosing child care programs
• Updated safety standards: the very latest AAP recommendations, including immunizations, childproofing, and toy safety
• Safety checks for home, including bathing, preventing drowning, poisoning, choking, burns, and falls
• Car safety, including information on car safety seats
• And much more
Comprehensive, reassuring, and up-to-date, Your Baby’s First Year is an indispensable guide for parents everywhere.
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Steven P. Shelov, M.D., M.S., F.A.A.P., pioneered and developed several of the parenting publications for the American Academy of Pediatrics, including Caring for Your Baby and Young Child, The First Year of Life, and A Guide to Your Child’s Symptoms, now published as The Big Book of Symptoms. In 2002, he was presented with the Lifetime Achievement in Education Award by the AAP, its highest award for pediatric education. In 2009, Dr. Shelov received the Clifford G. Grulee Award, recognizing his outstanding service to the AAP. He is currently Professor of Pediatrics at the Stony Brook School of Medicine and Associate Dean for Medical Student Education at the Winthrop University Hospital Clinical Campus of Stony Brook.
The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists, and pediatric specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
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 beinga 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 bestway 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 ofpregnancy. 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'tyet 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 decisionsabout 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. Chemical substances such as those in cigarettes, alcohol, illegal drugs, and certain medications can interfere with the developmental process and with later development, and some caneven cause congenital abnormalities.
Take smoking, for instance. If you smoke cigarettes during pregnancy, your baby's birth weight may be significantly decreased. Even inhaling smoke from the cigarettes of others (passive smoking) can affect your baby. Stay away from smoking areas and asksmokers not to light up around you. If you smoked before you got pregnant and still do, this is the time to stop--not just until you give birth, but forever. Children who grow up in a home where a parent smokes have more ear infections and more respiratoryproblems during infancy and early childhood. They also have been shown to be more likely to smoke when they grow up.
There's just as much concern about alcohol consumption. Alcohol intake during pregnancy increases the risk for a condition called fetal alcohol syndrome (FAS), which is responsible for birth defects and below-average intelligence. A baby with fetal alcoholsyndrome may have heart defects, malformed limbs (e.g., club foot), a curved spine, a small head, abnormal facial characteristics, small body size, and low birth weight. Fetal alcohol syndrome is also the leading cause of mental retardation in newborns. Alcoholconsumption during pregnancy increases the likelihood of a miscarriage or preterm delivery, as well.
There is evidence that the more alcohol you drink during pregnancy, the greater the risk to the fetus. It is safest not to drink any alcoholic beverages during pregnancy.
You also should avoid all medications and supplements except those your physician has specifically recommended for use during pregnancy. _This includes not only prescription drugs that you may have already been taking, but also nonprescription or over-the-counterproducts 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 [existing from birth] abnormalities.) Consult with your physicianbefore 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 fatty acids called omega-3's. They can be an essential part of a balanced diet for pregnant women.
At the same time, you should be aware of the possible health risks from eating fish while you're pregnant. You should avoid raw fish during pregnancy because it may contain parasites such as flukes or worms. Cooking and freezing are the most effectiveways to kill the parasite larvae found in fish. For safety reasons, the U.S. Food and Drug Administration (FDA) recommends cooking fish at 140 degrees Fahrenheit. The fish should appear opaque and flaky when done. Certain types of cooked sushi such as eel andCalifornia rolls are safe to eat when pregnant. The most worrisome contaminant in both freshwater and ocean fish is mercury (or more specifically, a form of mercury called methyl mercury). Mercury in a pregnant woman's diet has been shown to be damaging to the development of the brain and nervous systemof the fetus. The FDA advises pregnant women, women who may become pregnant, nursing mothers, and young children to avoid eating shark, swordfish, king mackerel, and tilefish due to high levels of mercury in these fish. According to the FDA, pregnant womencan safely eat an average of 12 ounces (two average meals) of other types of cooked fish each week. Five of the most commonly eaten fish that are low in mercury are shrimp, canned light tuna, salmon, pollock, and catfish: Albacore tuna tends to be high in mercury,so canned chunk light tuna is a better choice. If local health agencies have not issued any advisories about the safety of fish caught in your area, you can eat up to 6 ounces (one average meal) per week of fish you catch from local waters, but don't consumeany other fish during that week.
While no adverse effects from minimal caffeine intake (one cup of caffeinated coffee per day) have yet been proven, you may want to limit or avoid caffeine 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. You should take precautions against these dangerous diseases:
German measles (rubella) can cause mental retardation, heart abnormalities, cataracts, and deafness. Fortunately, this illness now can be prevented by immunization, although you must not get immunized against rubella during pregnancy. If you're not surewhether you're immune, ask your obstetrician to order a blood test for you. In the unlikely event that the test shows...
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