DAY 5

YOUR BABY

If your baby’s nose and head were misshapen from birth pressures, they’re now starting to look more normal. His umbilical cord is beginning to dry up, and if he was circumcised, his circumcision scar should be showing signs of healing.

Your baby will be changing almost daily as he gains better control of his body and becomes more self-regulating. In the meantime, it’s normal to have some squalls and storms along with the sunshine. In the months ahead, your baby will develop more elaborate ways of vocally communicating with you besides crying.

At first, your baby’s feeding and going to sleep will be intertwined with each other. Your baby sleeps, wakes up, feels hungry, and you feed him; then he stops momentarily to stare around, you diaper him and rock him, feed him again, and he falls back to sleep.

And just when you think you’ve got your baby’s routine figured out, it may change. A baby who was sweet and passive in the hospital may suddenly transform into a hard-to-console screamer. A baby who slept for many hours every night in his early days may start waking up and demanding to be fed at all hours of the night and day, especially when there are growth spurts.

Meanwhile, there’s no need to race to your baby’s side every time you hear a murmur in the night. Young babies make lots of weird noises when they sleep (and if you bought a baby monitor, you may have the urge to throw it out the window). Babies snort, wheeze, grunt, make sucking motions with their mouths, and may fuss briefly when they’re moving from rapid eye movement (REM) sleep into deep sleep. You’ll see your baby’s eyes darting around under his closed eyelids. Pause to make sure your baby’s fully awake before you race in for the rescue.

YOU

Even if your delivery was normal and uncomplicated, you probably have a strong urge to tell the story over and over. As with weddings and deaths, talking about what’s happened is a constructive way to process a powerful life-changing event so you can put it in perspective and then move on.

Some moms find themselves obsessed with thoughts that things went awry during labor and birth. If something happened to the baby during labor and birth, you may have nearly overwhelming feelings of shock, anger, or sadness as you struggle to make sense of your experience.

If you’re having any of those experiences, it’s very important to spend time talking things out with a trusted friend; a psychologist or counselor; or your pastor, priest, or rabbi. Trying to suppress such strong, but unexpressed feelings can interfere with your caring for your baby and could drive a wedge between you and your partner.

Try keeping a journal of your thoughts and noting down any questions about what happened. For gnawing questions that you can’t answer yourself, it may be useful to obtain a photocopy of your medical records from the hospital records department to discuss with your doctor or midwife. You may find reassurance that any complications weren’t your fault, and that your caregiver or the staff did the best they could to help you and your baby through the process. If there was a serious mistake made, you can decide how you want to proceed from here.

The brain thing

Since each baby has different experiences, no two babies’ brains are wired exactly the same, even in identical twins. And no two babies develop on the same schedule, either. Each unfolds in his unique way.

Different circuits in your baby’s brain will become sensitized at different stages of development in the months ahead. The development of your baby’s body skills and mastery of movements, which began before birth, will continue for years to come.

The part of your baby’s brain that controls emotions, vision, ability to relate socially, and language skills already began to form before birth. The part that allows your baby to recognize objects and that affects eye-hand coordination will activate during his second or third month.

The frontal lobe, the area of the brain that controls higher mental abilities, like reasoning and speech, will develop gradually over the last part of your baby’s first year. Ripeness for learning skills, like mastering foreign languages and learning math and music, will activate over the next three years.

Over time, your baby’s brain will develop a complex series of neural connections to help him make sense out of sounds, including the intricacies of speech and music. Expressions and experiences in his waking life that are repeated and reinforced will help to forge strong brain connections. On the other hand, the “nerve vines” in your baby’s brain that aren’t reinforced by his experiences will eventually wither and die.

That doesn’t mean you need to exhaust yourself (and your baby) with a constant barrage of stimulation, or expose him to music, printed words, and pictures to make him smarter. The things you do naturally, like talking to your baby, holding and nursing him, walking with him, and the sounds and motions you make to comfort him when he cries are exactly right actions for encouraging baby brain growth. And babies, just like grown-ups, need down time just to relax, pause, and gaze around without stimulation.

Your baby’s doctor

Even though your baby’s first checkup took place in the hospital, you also need to schedule an appointment for his first office visit with your family physician or pediatrician.

If you haven’t chosen your baby’s health-care provider yet, ask your obstetrician, midwife, or the hospital where you delivered for the names of well-respected pediatricians who are accepting new patients. The chief pediatric resident or nurses in the newborn nursery at the hospital where you gave birth are also a good source for finding the best pediatricians. Your local pharmacist may have ideas, too. (The American Academy of Pediatrics, www.aap.org, also lists pediatricians by location.)

Plan to interview a few doctors until you find the one with whom you feel the most comfortable. It’s important that you like and trust the skills of the person you pick to be your child’s doctor—after all, you’re going to be seeing a lot of him or her, especially in the first year, and you might have to deal with him or her, during some scary moments.

Here are some other things to remember when choosing your baby’s doctor:

• Location. Is the doctor’s office a reasonable distance from your house? If your baby’s sick or has a seizure, you need to be able to get there quickly.

• Insurance. Is the doctor affiliated with your insurance plan? How much will the copayments for office visits cost? Is full payment required for each visit, or will your insurance company be billed first? If you aren’t covered by insurance, how much will routine and sick-child visits cost?

• Credentials. Is the doctor board certified through the American Board of Pediatrics and a member of the American Academy of Pediatrics? That indicates that he or she has had additional years of study in pediatrics and periodically passes recertification exams.

• After-hours coverage. Who will be on call for your child’s doctor during hours when the office is closed, and how are you supposed to reach him or her? If you’re going back to work, are there evening and weekend office hours?

• Baby’s appointment schedule. How many well-baby visits does the doctor recommend, and how far in advance should you schedule visits?

• Nonemergency calls and e-mails. How are phone-ins for routine baby questions handled? Does your doctor reply to e-mail queries, and, if so, will there be a charge for that?

• Bill paying. How does the office handle financial matters? Do you have to pay at the time of your visit, or will you be billed? What credit cards does the office accept?

If you can’t afford health insurance for your baby, look into your state’s health-care programs. All states have federally funded programs to provide health insurance for children whose parents have moderately low to low incomes. Some states supplement federal funds with their own, and parents may be able to make $20,000 or more annually and still qualify. Your baby may also be eligible for Medicaid. If so, your baby’s checkups may be free. Contact your local social services or health department to learn more. (The U.S. government citizens’ hotline is: 1-877-KIDS-NOW).

  Tip

Some doctors want babies to come in only a few days after birth, others are willing to wait longer. If your baby seems healthy and breastfeeding is progressing well, ask about postponing the exam until you’re feeling up to it.

Your baby’s second “gestation”

While chimpanzees are born with 65 percent of their adult brain capacity, only 25 percent of the human brain is functional at birth. That’s why human babies are so dependent. Like kangaroo babies in pockets, they’re primed to go through a second stage of development in someone’s arms after they’re born.

It will require just about as long as your pregnancy took for your baby to move out of your lap and become mobile on his own. Brain growth doesn’t stop then, though. It will continue to form complex neural connections over the next 12 years. That’s what makes good nutrition and being responsive to your baby’s other physical and emotional needs so important.

Beyond nursing, your baby’s biggest physical task at the moment is to master control of his head since it is so much heavier in proportion to the rest of his body. If you gently pull your newborn up into a sitting position using his arms, his head will lag behind. Your baby’s ability to support his head will show gradual changes almost every week until he’s able sit erect by himself at about month six. Babies must ride with their car seats facing the rear of the car because of this need for extra head support.

Until your baby’s neck and back muscles are stronger, it’s important that you firmly support your baby’s head with your hand or arm, and that you move slowly to prevent straining yourself.

The importance of motion

Although your baby needs loving touches to get to know you, motion has been found to be even more effective than touch, your voice, interesting toys, or visual stimulation when it comes to helping him to calm down during a crying jag.

   WARNING! Don’t Shake Your Baby

“Shaken Baby Syndrome” is similar to severe whiplash and usually occurs when a person becomes exasperated by a baby’s crying and shakes the baby in frustration. Your baby’s brain is very vulnerable and still immature and poorly protected, so it only takes less than 4 to 5 seconds of shaking to injure it. Shaking a baby can lead to serious brain and spinal cord damage, seizures, eye damage or blindness, developmental delays, and possibly death. It is estimated that as many as 1,400 babies a year die from being shaken, so be sure to warn relatives and babysitters about this danger.

The vestibular system inside your baby’s ears provides feedback to him about where his body is in space. Babies who don’t move around and spend most of their time in cribs, play yards, walkers, and other baby-holding devices show poorer growth and slower body mastery than those who have been carried, rocked, and allowed plenty of floor freedom during their crawling and walking phases.

Unless your baby is in pain, hungry, or highly sensitive and easily overstimulated, using motion stimulation can usually cause him to stop crying, grow more alert, and focus on his environment. You can provide motion by rocking him; carrying him on your chest in a soft carrier; using an automatic baby swing (but only for short periods); gently moving him back and forth in a face-down position on an exercise ball; or by moving him up and down or side to side with your arms in wide arcs while you support his head and neck.