Among the early blood tests a pregnant woman must endure is the Rh, or Rhesus, factor test which is a test to see if the woman is Rh Negative or Rh Positive, which can be an indicator of hemolytic disease.

When the mother has a negative Rhesus factor and the father has a positive Rhesus factor, it can result in a fetus that is positive Rh factor. Even though the blood systems of the mother and baby are separate while the baby is in the womb, there are times when the baby’s blood can enter the mother’s body. When this happens it can cause the mother’s negative Rh factor blood to naturally create antibodies against the baby’s positive Rh factor blood. This results in the body to treating the baby as it would an infection in the mother’s body, instead of the body recognizing that the baby is supposed to be there.

When the mother and baby have opposite RH factor blood, the mother will become sensitized and her body will begin making antibodies which will attack the baby’s positive Rh positive factor blood, causing the breakdown of red blood cells in the baby which can lead to anemia. In severe cases where this happens while the baby is growing in the womb, it can lead to illness, brain damage and even death of the fetus.

The good news is that, through early blood tests, the dangers of the Rh negative factor in women can be prevented. If a woman is found to have RH negative and the father to be RH positive, the woman can be given a shot of Rh immunoglobulin which is a blood product given through an injection, normally in the buttocks of a woman. The injection suppresses the ability of the woman’s blood to react to the Rh positive red blood cells coming from the baby.

Each shot of immunoglobulin, also known as Rhogam, lasts about 12 weeks. Some doctors will choose to give two shots, one at the beginning of the second trimester and one at the beginning of the third, at about 28 weeks. When the baby is born, if it is indeed has the Rh positive, the mother will be given another shot of Rhogam to help avoid the possibility of her body becoming sensitized to the Rh positive factor in later pregnancies.

Most women will test as Rh Positive, at which point there is no threat to the pregnancy. However, some women will test as Rh negative. If your blood work comes back showing that you are Rh negative, your doctor or midwife will mention it to you. However, if you have questions or are unsure if you fall into this group of women, make sure you ask your provider for the results of your blood work at your next appointment.

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.

In many ways, a fussy baby may be worse than having a colicky baby. At least with a colicky baby you generally know that your baby will be screaming from 6pm to 9pm, or whatever hours you have been “blessed” with, and that there is probably nothing you can do about it. With fussy babies, that isn’t the case.

Fussiness can come at anytime of the day. It can be intermittent or at times last all day. With fussiness guessing what is wrong with your baby and helping them feel better can take hours to accomplish. It isn’t always an easy answer. A fussy baby will generally not cry, but make little and constant growling/groaning type noises. Enough to catch your attention and let you know something is wrong, but not enough to pinpoint the problem after you have learned to understand your baby’s different types of crying.

Reasons Fussiness May Occur
There are many reasons that your baby might be fussy. These include, but are not limited too:

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.