What to Expect the First Year (69 page)

Thin Baby

“All the other babies I see are roly-poly, but mine is long and thin. The doctor says he's doing just fine and I shouldn't worry, but I do.”

Though they might not win as many diaper commercial roles as their roly-poly peers, slender babies are usually just as healthy—sometimes healthier. As long as he's content, alert, and otherwise thriving—and his weight, even if it's at the lower side of average, is keeping pace with his height—your lean little one is likely following his genetic blueprint, and in mommy and/or daddy's slimmer footsteps.

If you sense that your baby's not gaining enough because he's not getting enough to eat—and the baby's doctor confirms your hunch—you'll need to step up your feeding efforts so he can step up his weight gain. If you're breastfeeding, try the tips
here
. If you're bottle-feeding, the doctor may
suggest diluting the formula a little less, or adding a small amount of extra powdered formula or rice cereal to the mix (don't try this without doctor's approval, and be sure to follow directions on measurements precisely). Once solids get the green light, focusing on foods that are denser in calories and nutrients (e.g., avocado) can also help fill out your Slim Jim.

Also make sure that your little guy is feeding frequently enough—he should be eating a minimum of 5 times a day (more if he's breastfeeding). Some babies are too busy or too sleepy to demand regular meals, and others skimp on feeds because they're just as content to suck on a pacifier. If your baby is a mealtime slacker, you'll have to take the initiative to make sure he brakes for feedings—even if that means cutting short a marathon daytime nap, interrupting a fascinating encounter with the crib gym, or unplugging the paci. If he's easily distracted, try feeding in a dark, quiet space.

Heart Murmur

“The doctor says my baby has a heart murmur but that it doesn't mean anything. Still, it sounds scary to me.”

Hearing the words “heart murmur” can definitely make a new parent's heart skip a beat—and that's understandable. But happily, it's also unnecessary. The vast majority of heart
murmurs are completely harmless and clinically insignificant. Most, in fact, do mean absolutely nothing … and that means that they're absolutely nothing to worry about.

So what is a heart murmur, and why is it not worrisome? It's abnormal heart sounds caused by the turbulence of the flow of the blood through the heart. The doctor can often tell if an abnormality is likely responsible for the murmur by the loudness of the sounds (from barely audible to almost loud enough to drown out normal heart sounds), by their location, and by the type of sound—blowing or rumble, musical or vibratory, for example.

Usually—and it sounds as though the doctor has already found this to be the case with your baby's—the murmur is the result of normal turbulence of blood flow due to the shape of the heart as it grows. This kind of murmur is called “innocent” or “functional,” and is usually picked up by stethoscope at a routine doctor's visit. No further tests or treatments or limitations of activities are usually necessary. More than half of all babies will have an innocent murmur sometime during their lives, and it is likely to come and go throughout childhood. But the existence of the murmur will be noted on your baby's record so other doctors who examine him at a later date will know it has always existed. Very often, when the heart is fully grown (or sometimes earlier), the murmur will disappear.

Occasionally, the pediatrician will ask a pediatric cardiologist to double-check that a baby's murmur is normal, which it's most often confirmed to be.

Black Stool

“My baby's last diaper was filled with a blackish BM. Could that means she's having a problem with her digestion?”

More likely she's been having an iron supplement. In some children, the reaction between the normal bacteria of the gastrointestinal tract and the iron in a supplement causes the stool to turn dark brown, greenish, or black. A change in poop color (usually to a dark green) can also happen if you recently started your breastfed baby on iron-fortified formula. There's no medical significance in this change, and no need to be concerned by it. If your baby has black stools and isn't taking a supplement or hasn't recently switched from breast milk to formula, check with her doctor.

ALL ABOUT:
Playthings for Baby

Walking into a toy store (or browsing toys on a baby store site) is like walking into a carnival in full swing. With every aisle or page bombarding the senses with its selection of eye-catching playthings for your bundle of joy, it's hard to know where to start and when to stop. So how can you make sure you don't succumb to the prettiest packages and the most alluring gimmicks, and end up with a huge collection of the wrong toys for your baby? Check out the following before you head to the checkout:

Is it age-appropriate?
The right toy will help your baby perfect skills already learned or help develop new ones just
about to be tackled. How will you know if it's the right toy for your little player? Take a look at the toy's package. Those age-appropriate recommendations are there for two good reasons: first, to help you meet your baby's developmental needs, and second, to keep your little one safe. So while you might be taken in by that darling dollhouse, best to hold off until all that itty-bitty furniture no longer poses a choking hazard (and your baby has the manual dexterity to have fun playing with it). Giving your baby toys before he or she is ready for them has yet another disadvantage: It's possible that by the time baby is actually developmentally ready, the toys will be yesterday's boring news.

Is it stimulating?
Not every toy has to bring your baby one step closer to that college acceptance letter—after all, babyhood (and childhood) are times for just plain fun, too. But your baby will have more fun with a toy if it's stimulating to the senses: sight (a mirror or a mobile), hearing (a music box, a rattle, or a bear with a bell in his belly), touch (a baby gym bar or activity board), or taste (a teething ring or anything else that's mouthable). As your baby grows, you'll want toys that help him or her learn hand-eye coordination, large- and small-motor gross- and fine-motor control, the concept of cause and effect, color and shape identification and matching, spatial relationships, and those that stimulate social and language development, imagination, and creativity.

Is it safe?
Toys are responsible for more than 100,000 injuries a year, so when choosing playthings for your baby, you'll want to make safety tops on your list. In general, do your toy shopping at reputable stores and sites and choose toys that have been made recently by reputable toy manufacturers. Avoid “antique” or vintage toys (the kind that you might pick up at a garage sale or flea market, or discover in grandma's attic) and noncommercial toys (say, made by craftspeople and sold at a farmers market or local shop)—or put them out of baby's reach until he or she is old enough to play with them without mouthing them or pulling them apart. Bargain stores may also sell imported toys that are unsafe (and often imported from countries where regulations are nonexistent). Specifically, look for:

• Age guidelines. Follow the recommendations from the toy's manufacturer on age appropriateness. These guidelines are there for safety reasons, not for educational readiness. If the toy you've bought used (or received handed down) has no packaging, check the age guidelines on the company's website. If it's so old that it's now off the market, play it safe: Don't let your baby play with it.

• Sturdiness. Steer clear of a toy that breaks or falls apart easily—it's an injury waiting to happen.

• Safe finish. Be sure that the paint or other finish is lead-free and isn't toxic. Keep up to date on toy recalls (
cpsc.gov/recalls
) to make sure you don't have unsafe toys in your house.

• Safe construction. Toys with sharp edges or breakable parts are unsafe.

• Washability. Bacteria love to put down roots on toys that can't be washed—and that could be a big problem for your little one, who likely puts everything (including bacteria-laden toys) in that adorable mouth. So look for toys that can be washed and disinfected.

• Safe size. Toys that are small enough to pass through a small-parts tester or a toilet paper tube, or that have small removable parts or parts that can be broken off, present a serious choking hazard. Ditto toys with pieces that can be chewed off once teeth have poked through.

• Safe weight. Got a toy that's heavy? Keep it away from your lightweight. Heavy toys can cause an injury if they fall on your baby.

• No strings attached. Toys (or anything else) with strings, cords, or ribbons longer than 6 inches are a strangulation risk. Attach toys to cribs, play yards, and elsewhere with plastic links, which have the added bonus of being bright and fun to play with. Or buy toys that attach with velcro.

• Safe sound. Loud sounds can damage baby's hearing, so look for toys that have gentle sounds rather than sharp, loud, or squeaky ones, and ones that can have the sound lowered or turned off completely.

For more on choosing developmentally-appropriate toys for your baby, go to
WhatToExpect.com
.

Suitable for Cuddling

Nearly every stuffed animal your baby will encounter will be lovable and huggable. Here's how to make sure those teddies, giraffes, bunnies, and doggies are as safe as they are cute:

• Eyes and noses on animals should not be made of buttons or other small objects that could fall off (or be pried or chewed off) and pose a choking hazard. Screen for buttons elsewhere, too (such as on a teddy bear's suspenders).

• No wire should be used to attach parts (such as elephant ears). Even if the wire is covered with fabric, it could be chewed off or worn off and pose a puncture hazard.

• No strings should be attached—that goes for bows around the bunny's neck, a leash on the dog, a string on a pull toy, and so on—that are longer than 6 inches.

• Look for sturdy construction—seams and connections that are tightly sewn. Check periodically for wear that could allow stuffing to come out (which would pose a choking hazard).

• All stuffed animals should be washable, and should be washed periodically so germs don't collect on them.

• Never place stuffed animals in baby's bassinet or crib—they can pose a suffocation hazard.

Chapter 10
The Fifth Month

Your little one's the life of the party these days—and you're invited to enjoy every moment. And what's not to enjoy? During the fifth month, your baby continues being endlessly entertaining company, picking up new crowd-pleasing tricks almost daily, never seeming to tire of social interaction—especially with his or her favorite companion, you. Even better: With a (relatively) longer attention span, the interaction's a lot more dynamic than it was even a couple of weeks ago. Watching that little personality unfold is fascinating, as is baby's growing captivation with the expanding world around him or her. Baby's doing more than looking at that world now—he or she is touching it, too, exploring everything that's within reach with those hands, and everything that can fit (and many things that can't) with that mouth … possibly including those feet. Foot in mouth? That's standard practice for still phenomenally flexible babies.

Baby Basics at a Glance: Fifth Month

Sleeping.
Your baby will still be sleeping 15 hours—on average—each day. Those hours will likely be split between daytime naps (3 to 4 hours over two to three naps) and nighttime sleep (around 10 to 11 hours each night—though baby's likely to wake up once or twice during those 10 hours).

Eating.
Baby is still on a liquid-mostly diet. (Though some parents choose to begin solids during the fifth month, most doctors recommend waiting until the half-year mark.)

• Breast milk. Count on an average of 5 to 6 feeds a day—though some babies nurse lots more than that. Baby will be drinking somewhere between 24 and 36 ounces of breast milk a day.

• Formula. You'll be bottle-feeding an average of 5 times a day, around 6 to 8 ounces of formula per bottle for a total of 24 to 36 ounces of formula a day.

• Solids. Most doctors recommend starting solids at 6 months. But if you're spooning up solids sooner, remember that baby doesn't need much more than 1 tablespoon of baby cereal mixed with 4 to 5 teaspoons of breast milk or formula once or twice a day, or the equivalent in fruit or vegetables if you've started with those foods. Breast milk or formula should still be the mainstay of baby's diet.

Playing.
Baby's discovered how much fun his or her hands can be, both as playthings themselves and because they can manipulate objects and toys. So give baby toys he or she can grasp, mouth, and eventually, pass from hand to hand. If baby's still horizontal (not sitting), the play gym will still be fun, though try to switch out some of the dangling toys for interest. Activity bars on your little one's infant seat will provide loads of fun, as will squeaky rubber toys that can be squeezed, banged against the floor, or mouthed (especially when baby starts teething). Soft stuffed animals may become baby's favorites at this age, so be sure to provide your cuddly cutie with some cuddly cuties of his or her own. And as baby spends more and more time on his or her tummy, a fun activity mat can still provide lots of entertainment.

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