The American Academy of Pediatrics suggests waiting to start solids until your baby is 4-6 months old. What many people do not realize however is that the four months is meant more for formula fed babies while the six months is meant more for the breastfed babies. Why do they say wait and what are the pros and cons of starting your baby on food other than breast milk and formula?

Breast milk is full of iron unlike formula so it gives a baby the full amount of iron that they need while they grow for a longer amount of time. Because formula lacks as much iron, a baby who is formula fed should start on baby food at about four months old, in order to supplement and get more iron. Breast milk is so amazing because it changes as your baby grows giving your baby exactly what he needs, when he needs it, including the right amount of iron. This is why breast milk is best for the first year. Because your baby gets the iron from breast milk that he needs he doesn’t need baby food for at least six months.

Is your baby ready for solids? There are many ways you can tell from your baby’s development whether or not they are ready to start solids. A baby’s weight and development are very important. Can they sit, can they pick up objects? These are all very important to consider. For more on introducing solids, please click here.

There is really no reason to rush your baby into starting solids. There are some parents that choose to wait till nine months or closer to a year before they start their baby on food other than breast milk. Baby food is meant to help get babies acquainted to other flavors and learn how to eat food, however until they are a year old breast milk or formula should still make up at least 3/4 of their diet. Don’t feel pressured to start your baby on solids. If you are concerned about whether or not you should or your baby’s health, ask your pediatrician at your baby’s next well-check.

After you have your baby, while in the hospital your doctor or the pediatrician in the hospital will tell you to schedule a well-check for your baby either at one week or two weeks of age. Many first time moms however do not know what a well-check is, when their baby should be seen, or why it is important.

Well-checks are what pediatricians refer to when a healthy baby comes into see them for a normal checkup. As your child gets older you might only take them to the doctor when they are sick, but as an infant until age two they should be seen much more regularly. The first visit is normally within a couple of weeks of birth, but in some cases may be at one month. Generally, most visits are very similar and routine, and in most there will be immunizations given. To see the current recommended immunizations schedule click here.

2-4 Weeks
At this first visit to the pediatrician your baby will be weighed and measured so that the doctor can see how they are growing since birth. It is important for your baby’s doctor to do this because some babies have allergies to breast milk or the formula they are on, has reflux, or other problems that keep them from gaining weight. Finding this out early is the most effective way to make sure that your baby is healthy. He will also start your baby’s growth chart at this point so that you can both keep track of how your baby is growing. If you have any questions or problems now is a good time to ask. Your next well-check will probably be scheduled around your baby’s two month birthday.

Two Months
During this visit your baby will once again be weighed and measured to check his growth. The numbers will be added to his growth chart so that you can see progress. Where your baby is on the growth chart is normally NOT a big deal, as long as they are being consistent in their growth. If you have a concern about your baby’s growth however, be sure to ask your doctor.

Your baby will also get his first series of immunizations at this visit. In most cases your baby would have received a Hep B shot in the hospital before you took him home. In rare cases where he did not, he will be given that shot now. Other shots your baby will probably get include DTaP, Hib, IVP and PCV. Some doctors will also give your baby the vaccine for the Rotavirus which is a liquid given by mouth. Your next well-check will probably be scheduled around your baby’s four month birthday.

Four Months
Your baby’s growth chart will be updated again and it becomes fun to see the pattern in their growth. Many parents look forward to finding out their baby’s height and weight since your baby is probably in either his second or third set of clothes by this point. The pediatrician will probably start talking to you about giving your baby on baby food. He will also go over any milestones that your baby has reached and the milestones he might reach before your next visit.

Your baby will get another round of immunizations at this visit. These include a second Hep B, DTaP, Hib, IVP and PCV. Ask your pediatrician about giving your baby Tylenol to help with the pain he may be feeling. If you are breastfeeding, plan on feeding your baby immediately after the shots as it may provide comfort to him. Your next well-check will probably be scheduled around your baby’s six month birthday.

Six Months
Your baby is a half a year old! Time has probably flown by. As a general rule, your baby has probably doubled his birth weight by this time, however if he hasn’t don’t worry about it. Check with your pediatrician if you are concerned. Your baby’s growth chart will once again be updated during this visit. Once again you will discuss milestones your baby has reached and talk about what milestones might be reached over the next three months.

Every visit seems to include immunizations. This time around your baby will once again get the DTaP and Hib vaccine. They will probably get the final dose of Hep B as well. He may get another dose of IVP, however this dose can be given between now and two years so your pediatrician may choose to wait. If it is the season for it, your baby can also now get the influenza shot which is recommended for children over the age of six months. Your next well-check probably won’t be scheduled until your baby is either nine months old or possibly at a year.

Nine Months
It has been up to three months since your last well-check and your baby has probably grown and changed quite a bit. Your pediatrician will go over milestones that your baby has reached over the last few months and answer any questions you might have. At this point your baby has probably been eating baby food daily so you will be able to discuss any problems you are having with that at this visit as well.

If your baby is seen during this month, he may or may not receive immunizations. The latest schedule from the American Academy of Pediatrics does not show immunizations at this time so it will be up to you and your baby’s doctor on what shots to give or not give. You next well-check will be around your baby’s first birthday.

One Year
Your baby has turned one! Where has the time gone? Does it seem possible that a year ago you were holding a tiny baby in your arms? This is a big appointment for your baby as you get to see exactly how much your baby has grown over the past year. The pediatrician will update the growth chart and go over your baby’s diet at this appointment. In most cases you will be told to go ahead and start giving your baby whole milk instead of formula, or in addition the breast milk if you are still breastfeeding.

Once again there are immunizations scheduled for this visit. If your baby did not get the fourth Hep B at six months, he may get it now. Other immunizations he may get include the Hib, IVP, MMR, Varicella, PCV and if it is that time of year, the Influenza vaccine. These can all be given at different times during the next six months so discussing the time frame with your pediatrician is a good idea. The next well-check will be at 15 months.

15 Months
Your pediatrician will update the growth-chart and will discuss with you any problems you are having. If your baby did not get Hib, IVP, MMR, Varicella, PCV or the Influenza shots at your last visit you will get them now. Your baby may also get the fourth DTaP immunization. Your next well-check visit will be at 18 months.

18 Months
At this point your baby is probably running around and growing more in inches than in weight as he burns extra calories. You may see a change in the height level on the growth chart but not much of one in the weight. Your pediatrician will go over any questions you have and make sure your baby is healthy.

DTaP, IVP and the Varicella vaccines are what your baby might get at this visit if they haven’t had it previously. Also, if it is winter now the Influenza vaccine might be in order. In most cases these shots finish off your child’s immunizations until they reach school age, between 4-6 years old. In some cases your pediatrician may have skipped a dose or pushed one back. If that is so your baby may get shots at his next well-check, at two years.

Two Years
Unless there is a problem this will be your baby’s last well-check until he turns three. He should be speaking, walking, and probably in the terrible two’s by now. If you have any concerns about his development you should talk to his doctor at this time. His growth chart will be filled out by now and a nice curve should be seen. If your child missed any of his immunizations he may be given some at this appointment in order to get caught up. There shouldn’t be any more after this until he is 4-6 years old.

All babies have them! The small, circular, soft spot on top of your newborns head, which is actually called the fontanel. What you may not know is that there are actually two fontanels on your newborn. The anterior fontanel is on top and the posterior fontanel is at the back of the head.

Soft spots are placed where the skull has not completely closed at birth. The anterior fontanel is about two inches wide and may not be closed completely until your baby is 18 months old. The posterior fontanel is only about a half inch wide and will be closed by the time your baby is three months old, much earlier than the anterior soft spot.

Soft spots are present for several different reasons and are very important in terms of your baby’s health. First and foremost, having a gap in the skull allows the head to change shape making it easier for your baby to come down the birth canal. This is why some babies are born with a cone shaped head.

Second, the soft spots allow room for your baby’s brain to grow during the first year of life. During this time your baby’s brain will grow very rapidly and it needs to have somewhere to grow. If the skull was closed there would be no way for the skull to stretch and expand.

Another use of soft spots by doctors is to check your baby’s hydration level when your baby is sick. Most of the time the fontanel will expand and move when your baby laughs, cries and breathes. When your baby is sick however and get dehydrated his fontanel will sink into his head. If your baby has a depressed fontanel, call your pediatrician and ask him what you should do.

There is nothing special you have to do to take care of your baby’s fontanel. You mainly have to make sure that you are careful around that spot since there is in essence, no protection covering your baby’s brain in that spot. Wash it gently and be sure not to let any older brothers and sisters accidentally push on it while playing with their new “toy”.

If you think there is anything wrong with your baby’s soft spots, or feel that they might be closing too soon, be sure to ask your pediatrician at your baby’s next well-check, or call your pediatrician to ask him. Most of the time everything will be fine, but it is better to be safe than sorry, and that is what he is there for.

One of the most common causes of severe diarrhea among infants and children is a virus that most mothers have never even heard of…the Rotavirus. Until my first son got it, and was hospitalized because of it, I had never heard of it. After that experience I made sure that my second son received the vaccine at his two month well-check.

What is the Rotavirus? It is a virus that not only most children get by the time they are 3 years old, but most people get it every year. However, the symptoms range for each person. For a child, generally the most severe is the first time it is contracted. For adults it is likely to just cause a little diarrhea or stomach ache, which most would hardly notice. It is estimated that 70,000 children are hospitalized, and another 150,000 are brought into emergency rooms each year. Approximately 100 children die each year from Rotavirus complications.

Rotavirus has an incubation period of about two days and the symptoms of Rotavirus include diarrhea, fever and vomiting. Some experience severe abdominal pain as well. Rotavirus also as a distinct odor to it — many say that once you have smelled it, you will never forget it. Rotavirus can last anywhere from three to nine days. Once you have it you can become immune to it, however like the common cold there are many different strains in the world that you can be infected by.

Rotavirus in its’ worst form can also be the cause of severe dehydration in infants and children. Signs of dehydration include dry, cool skin, sunken eyes, dry mouths, absence of tears when crying, and lethargy. It is important to watch your baby for these symptoms and try to keep him hydrated so that you can avoid hospitalization.

There is very little treatment for Rotavirus once it has been contracted; however they now have a new vaccine available for an infant that is taken orally. It is very contagious and is often transmitted from fecal to mouth when children do not wash their hands after using the bathroom. If you have older children and an infant in your home, it is very important to teach your older children how to properly wash their hands in order to help avoid your infant from catching the virus.

If your baby is sick and you think he might have the Rotavirus, call your pediatrician and have him seen. Your pediatrician might have suggestions to help keep your baby hydrated or more comfortable.

Ear infections are terribly painful and in a baby who can’t tell you what is wrong, they can easily go undiagnosed. Many times parents do not know that their baby has an ear infection until they take them to the pediatrician either while their baby is sick, or possibly during a well-check. Some babies will seem happy and cheery, showing no signs, while others will cry and be fussy, leaving mom pulling out her hair wondering what is wrong.

There are simple steps you can take to help avoid the possibility and occurrence of ear infections in your baby. There is no guarantee that your baby will not get an ear infection, but if you at least know you tried your best, it can help lessen the guilt you might feel.

Don’t Smoke
Smoke is a respiratory irritant that makes the Eustachian tubes swell and not function appropriately in both the smoker and household members exposed to them. Even if you smoke outside or in your car when your baby is not with you, second hand smoke is still on hand and gets into your clothes, which your baby can then breathe in.

Cold and Flu Season
Good hand washing and flu shots for the whole family are helpful. Getting the PREVNAR vaccine (pneumococcal) may help limit the number of ear infections as well. With the increased risk of colds and respiratory problems floating around during the winter months, keeping your baby in and away from other children as much as possible can help limit their chance of getting sick and getting an ear infection.

Feeding Positions
Feed your baby in an upright position. Milk can get into the Eustachian tubes if the baby is lying horizontally while eating. This may be hard when you are breastfeeding. When your baby gets big enough try having him sit in your lap as you feed him, instead of lying across your lap, lying in bed with you, or being held in the football position.

Avoid Pacifiers
There is scientific data to suggest that the prolonged sucking on a pacifier can cause an infection in the ear since the mouth and ear tubes are all connected. Some people go as far as to wean their babies either from the breast, the bottle or both by the first birthday.

Child Care
Reconsider your child care options. Kids in daycare settings get more viral upper respiratory infections (colds) which lead to the ear infections. If your baby is getting a lot of ear infections and is in daycare, look into having a friend or family member who has no other kids in their home watch your baby for you while you work.

One of the hardest things for a new mom to go through is watching her baby get sick and not being able to do anything to make it go away. Whether it is a simple cold, or something more serious it is very hard to watch your baby feel bad, cough, sneeze or run a fever and be able to do little to make him feel better. It is not easy to look in a face that clearly doesn’t understand WHY he feels so bad and sit idly by. So how do you know when your baby has just a little bug, or it is something more serious and you need to take him to the doctor.

When in doubt it is never wrong to call up your baby’s pediatrician to ask for advice. Sometimes a simple call may help you feel more relaxed, or the nurse may have a hint to help relieve your baby’s discomfort. In the end it is important to remember that your doctor is not only there for well-checks, but also for sick baby calls.

Colds
Little coughs, a hardly heard sneeze, watery eyes and a runny nose can hit your baby as hard as it hits you. There are several different things you can try to do to help relieve your baby’s discomfort. First, ask your doctors what medicines you can give your baby. There are several items on the market made specifically for babies. Make sure you ask your pediatrician first however, and follow dosing instructions precisely. Second, invest in a humidifier. Often changing the air around your baby can help clear his head and chest. Third, make use of the “bulb” you are given in the hospital that they use to suction out your baby’s nose. They are too young at this point to understand how to blow their nose, so the only way to help them clear their sinuses is the bulb. As much as your baby may hate it and cry, it is a great tool for you.

Fever
When is your baby’s fever too high? There is no “right” answer to this question. A lot of it depends on your baby’s health since birth. Was he full term or premature? Has he been sick a lot or healthy for the most part? At your baby’s next well-check be sure to ask your pediatrician what degree of temperature he would suggest you call his office about. Some doctors will say 100 degrees, others may say to wait till it is a minimum of 102 degrees or slightly above. It is best to find out the answer to this question before you need it. Also, be sure to ask your pediatrician what medications he thinks is ok for you to give your baby when he spikes a fever.

Hospitalization
Occasionally your baby will get an illness that will cause him to be hospitalized for anywhere from a few hours to possibly several days. This is hardest on parents especially if there are IVs and tubes involved. It is best to remember during this time to ask a lot of questions and not to be afraid to ask for a second opinion. In most cases a hospital will allow at least one parent to spend the night at the hospital with your baby. If your baby is breastfed or you co-sleep with him, don’t be afraid to ask the hospital to get you a real hospital bed so that you can curl up next to your baby and help him get the most rest possible. Babies are very intuitive and yours will know when you are upset, scared, sad or happy. Try not to panic in front of your baby. Keeping a calm hospital room will help your baby stay calm and relaxed as well.

Remember, your baby getting sick is a part of life. He will have many more healthy days than he does sick days, but the sick days will come. Try to keep your wits about you, don’t be afraid to call the doctors, and give your baby some extra cuddles while they get better. Luckily, your baby is too young to remember being sick and will forget about it much sooner than you will.

Life is a series of discoveries for a little baby. From the time they are born they are discovering the nipple, discovering mom and dad, discovering siblings, discovering toys and discovering body parts such as their hands and later their feet. Babies have a natural instinct to suck from inside the womb, and can often be seen sucking their thumb in an ultrasound during pregnancy. Sometimes this will continue on outside of the womb.

A baby can first discover his hands at a couple of months old. Or, it may be later when he starts teething and drooling. You may see your baby try to stick his fist in his mouth, or frantically try to gnaw on it while he is drooling. Finding his fist, may lead to him finding his thumb, or in some cases finding a finger, or two. Some babies, when they find their thumb realize that they can suck on it for comfort.

There are babies, both breastfed and bottle fed, who need to suck and who find comfort and are lulled to sleep by sucking. Sometimes these babies can calmed with a pacifier, while other times they can not. Many times it is the mother’s nipple that takes the brunt of the sucking, as it is the only thing that calms down and puts her baby back to sleep.

When a baby finds his thumb however it might mean relief for mom, and more free time to get other things taken care of around the house. Maybe it is the warmth of the thumb or fingers, but some babies who like to suck find comfort in sucking on their thumb. This can worry some parents though.

Some parents are afraid of creating a habit with their baby that they have a hard time of breaking. Others are afraid about damage being done to their baby’s teeth. Statistics show however that most children quit sucking their thumb by the time they are 4 years old, before their baby teeth fall out and their adult teeth start coming in. Thumb sucking is simply outgrown by most children.

It is extremely difficult to stop your baby from sucking his thumb. It is especially hard to keep your babies thumb out of his mouth, and keep it out when your baby is asleep. You can offer the pacifier, which is much easier to take away if your baby will take it. If you breastfeed, you can try to discourage it by nursing more often or nursing your baby to sleep so that he doesn’t search out his thumb for sucking.

If your baby is sucking his thumb and it bothers you but there is nothing you can do about it, ask your pediatrician to see if he has any suggestions for you. With as many babies and kids that your pediatrician see’s it is likely that he has heard stories from other mom’s that worked, and he might have tips for you.

When you have water in your ears, or you feel that you need to clean them you will generally grab a q-tip and dig in. Many parents would think the same goes true for their baby. However the motto of many pediatricians now is, “If I can’t see in your baby’s ears, I will clean them out myself.”

86 the cotton swabs
Cotton swabs can be quite traumatic to the ear canal. More often than not the cotton swab forces old skin, wax and debris closer to the eardrum. The same goes true for other tools you could use to dig into your baby’s ear.

Your pediatrician will have a device that looks similar to a knitting needle that she uses in conjunction with her ear scope to gently pull out any wax buildup that your baby may have. This may be necessary to do during well-checks or if you take your baby in for a sick baby check up.

There are at home methods you can try as well after you get the okay from your pediatrician. A combination of half-and-half white vinegar and rubbing alcohol purges the old skin, excess wax and debris, and controls residual moisture.

You can apply the vinegar-alcohol solution while bathing your baby. Tilt your baby’s head to either side and apply two to three drops in each ear. After about two to three seconds, tilt your head in the opposite direction to empty the excess waste. Residual moisture will evaporate.

Be sure you okay this process with your baby’s pediatrician before you try it and make sure you only use a small amount of solution. If you have been told that your baby has a hole in his eardrum, don’t use the solution. Opt to let your pediatrician handle the wax.

By Elizabeth Pantley, author of Gentle Baby Care

Choosing your baby’s doctor several months before her expected arrival is a good idea. This way, you won’t feel rushed and can take the time to make the right decision. During the first few years of life, your baby will have frequent visits for routine checkups and illness; so selecting a healthcare professional you trust is important.

Decide which type of healthcare provider

Different types of healthcare professionals are qualified to care for your baby:

A pediatrician is a medical doctor with specialized training in caring for children from birth through adolescence.

A family physician or general medical practitioner (GMP) is a physician who is educated and trained in family practice, which is medical care that covers every member of the family for well and sick care. You already may have a family physician for your own healthcare.

A nurse practitioner (NP) is a registered nurse (RN) with advanced education and training. Nurse practitioners often work in partnership with a licensed physician.

Once you’ve determined what type of professional you would like to consider, find prospective doctors through these sources:

• Recommendations from friends who have children
• Your obstetrician
• Your local hospital’s referral service
• Medical schools and medical directories
• The American Board of Pediatrics

Determine your insurance company’s requirements

Check out the rules of your insurance policy prior to choosing your baby’s doctor. You may have to designate your baby’s doctor for your health insurance carrier, or you may be required to have your selection approved in advance. Many health plans have strict rules about which doctors you can visit, so it’s important to determine if your choice of primary care physician also decides which specialists and which hospitals you will be able to use if your baby should need specialized care, since oftentimes these are linked together by the rules of a health plan.

Consider your parenting philosophy

Choose a doctor who has a similar philosophy with regard to important parenting issues, since most parents turn to their pediatrician for advice and guidance on more than just health-related issues. While this similarity in outlook is not crucial, it certainly makes for a more complete and enjoyable relationship that allows open conversation and precludes the need to avoid topics on which you disagree. A like-thinking pediatrician understands your starting point when advising a particular course of action, and is more likely to prescribe one that suits your ideals. An easy way to find out what a doctor’s opinion is to ask open questions, such as, “What are your recommendations about breastfeeding and bottlefeeding?”

Here are just a few of the important topics you should consider:

• Feeding – Does the doctor support your goals for breastfeeding, bottle-feeding and weaning?
• Sleep – What is the doctor’s opinion on sleep-related issues, such as co-sleeping and letting the baby cry herself to sleep? Are her views similar to yours?
• Immunizations – Will the doctor provide you with ample information to make decisions about various vaccinations? Do his standard recommendations suit you?
• Discipline – Does the doctor believe in the same approach towards discipline as yours?

Take the time to interview prospective doctors

Most medical professionals are happy to provide a brief interview meeting at no charge. This gives you an opportunity to meet the doctor and ask questions. Here are a few tips to make this a productive event:

• Make an appointment.
• Arrive early and observe the waiting room, staff and other patients. Is the staff helpful? Is the atmosphere child-friendly? Is the office clean and tidy? How long do people wait for their appointments?
• Be prepared with a brief list of questions.
• Stick to your most important topics.
• Refrain from small talk or lengthy explanations.
• Remember that your main purpose is to listen, not to talk.

Before your interview

If you do a little research and handle the technical details before your appointment, you can use your time with the doctor to obtain answers to your most important questions.

You can obtain information about a doctor, such as certifications and residency background, from:

• The American Board of Pediatrics
• American Academy of Pediatrics
• The American Medical Association
• Royal College of Physicians and Surgeons of Canada

You often can get information from a receptionist or secretary at the doctor’s office. First, ask for a brochure or other written information about the doctor and the practice. If the following information isn’t covered, then call the office and ask for the following:

1. The background and experience of the doctor. (Asking for a verbal answer from the doctor during your upcoming appointment may well take up a large portion of your meeting.)
2. What are office hours? Are there evening or weekend hours?
3. How is billing handled?
4. What insurance is accepted?
5. What are your after-hours and emergency procedures?
6. What hospitals is the doctor affiliated with?
7. How do you handle questions by telephone?
8. Will my doctor personally see us for every scheduled appointment?
9. If he is unavailable, who will see us?
10. How many doctors share this office?
11. Do you have a special waiting room or a separate entrance for sick children, or how do you separate them from others?
12. Do you have a lactation specialist in the office? If not, can you recommend one?

Interview questions

Arrive at your appointment to interview a medical professional with your list of questions. Don’t ask about issues that sound good but don’t really matter to you; the meeting likely will be short, maybe five to 15 minutes (ask in advance how much time you will have).

Stay focused on your own priorities. Relax and be friendly, but stay on track. Here is an assortment of sample questions to help you create your own list:

1. Can you explain how we will work together during our baby’s first year?
2. Will you examine our baby at the hospital (or at our home) directly after birth?
3. What is your typical advice to new parents about… Circumcision? Breastfeeding? Bottlefeeding? Sleeping through the night? Immunizations?
4. Can we come to you with questions about non-medical issues, like feeding or behavior?
5. What do we need to know about our newborn’s health and care?

After your interview

Consider the answers to these questions to help you make your final decision:

• Is the office conveniently located for you?
• How long did you have to wait in the waiting room?
• Did you feel good about the office and staff?
• Did the doctor listen thoughtfully to your questions?
• How willingly and thoroughly did the doctor answer questions?
• What was his attitude when he answered them?
• Do you feel comfortable with the doctor’s specific child-rearing philosophy?
• Did you feel that you could freely ask questions?
• Did the doctor appear knowledgeable and current with his information and advice?
• Would you feel comfortable bringing your baby to this person for care?
• Would you feel confident having this doctor handle an emergency with your child?

Copyright Elizabeth Pantley. (McGraw-Hill, 2003)

About the author

Elizabeth Pantley is the author of several books, including Gentle Baby Care : No-cry, No-fuss, No-worry — Essential Tips for Raising Your Baby, The No-Cry Sleep Solution: Gentle Ways to Help Your Baby Sleep Through the Night, Kid Cooperation (with an introduction by William Sears, MD), Perfect Parenting, as well as her latest The No-Cry Sleep Solution for Toddlers and Preschoolers and is also president of Better Beginnings, Inc. She is a popular speaker on family issues, and her newsletter, Parent Tips, is seen in schools nationwide. She appears as a regular radio show guest, and has been quoted in Parents, Parenting, Redbook, Good Housekeeping, American Baby, Working Mother, and Woman’s Day magazines.

Visit Elizabeth’s web site http://www.pantley.com/elizabeth.