CHAPTER 17

A Baby for All Seasons

No matter what time of year your baby was born in, there will be four seasons in his or her first twelve months. And as those seasons change—with sun, wind, heat, cold, rain, and, in some climates, snow coming and going with them—a wide range of new questions may come to mind. Questions that don’t necessarily apply to a particular month of a baby’s life but to a particular season of the year—questions about feeding, dressing, and playing in weather extremes, about sunburn and frostbite, about window screens and fireplace screens, about holiday decorations and maybe even about swimming lessons. Read on to make sure you and your baby are prepared for all seasons.

What You May Be Concerned About in Summer Weather

KEEPING BABY COOL

It’s summertime and the dressing is easy. Or is it? Here’s a common summer sighting: a parent in shorts, a tank top, and sandals pushing a carriage holding an infant dressed for an arctic winter. The fact is that babies—even very new babies—don’t need to be dressed any more warmly in warm weather than adults do. Not only is adding extra clothing unnecessary, it can be risky and can lead to such undesirable consequences as prickly heat and, in extreme cases, heatstroke.

Unless you’ve got an unreliable personal thermostat (you’re always warm when everyone else is cool, or you’re always cool when everyone else is warm), feel free to dress your baby as you would yourself. If you’re comfortable in shorts and a tank top, your baby will be fine in the junior equivalent. If you’re sweltering in a sweater, your baby will be, too. Lightweight, loose-fitting, light-colored clothing will be most comfortable when temperatures soar; a lightweight porous cap, hat, or bonnet will protect baby’s head without overheating it. Materials should be absorbent to soak up perspiration, but when clothing becomes damp, it should be changed—so routinely carry along an extra set of clothes for baby.

A SUMMER RASH

It’s what many babies are wearing every summer season: heat rash. Also known as prickly heat, its telltale tiny red spots on the face, neck, armpits, and upper torso are caused when perspiration builds up because of clogged sweat-gland ducts. Though the rash usually fades on its own within a week, you can treat baby with a cool bath (as always, use a very mild soap), but avoid powders or lotions that can further block the sweat from flowing. Call the doctor if pustules, increased swelling, or redness develop—these symptoms may indicate a yeast or bacterial infection.

While a baby carrier or sling constructed of heavyweight fabric can keep baby warm in the winter, it can keep him or her sweltering in the summer, especially if it covers baby head to toe. Lack of ventilation in combination with your body warmth and a high outdoor temperature could add up to excessive heat within the confines of the carrier.

Indoors in hot weather, your baby will enjoy the cooling effects of an air conditioner or fan as much as you do. Just be sure neither blows directly on the baby, that the room temperature doesn’t drop much below 72°F, and that cooling equipment and its electrical cords are out of baby’s reach. A diaper alone will do for sleeping on hot nights, but a lightweight sleeper may be needed if the air conditioner is running.

Cool hands or feet are not a sign that your baby is chilly, but perspiration (check the neck, head, underarms) is a sign of being too warm.

HEATSTROKE

Though parents commonly worry about their babies being too cold, they often don’t realize that being too hot can be just as dangerous. In the first year of life babies are particularly susceptible to heat because their temperature-regulation systems aren’t yet matured and it’s difficult for them to cool themselves effectively. As a result, overheating can lead to serious, even fatal, heatstroke. Heatstroke typically comes on suddenly. Signs to watch for include hot and dry (or, occasionally, moist) skin, very high fever, diarrhea, agitation or lethargy, confusion, convulsions, and loss of consciousness. Should your baby exhibit such symptoms, summon emergency medical help immediately and follow the first-aid procedures on page 582.

As with most other medical emergencies, the best treatment is prevention. You can prevent heatstroke in these ways:

Never leave an infant or child in a parked vehicle in warm or hot weather, even for a moment. (Keep in mind that infants and children should never be left alone in parked cars no matter what the weather.) Even with the windows open, the interior temperature can rise rapidly and dangerously. When the outdoor temperature is 96°F, for example, temperatures in the car can shoot up to more than 105°F within fifteen minutes when the windows are rolled halfway down, and to nearly 150°F if the windows are closed. Babies can die quickly under these conditions.

Don’t bundle up a baby who has a fever with blankets or heating pads. A child with a fever needs cooling down, not heating up. “Sweating it out” is not a recommended treatment in any type of weather.

Dress baby lightly in hot weather, and avoid direct sunlight. Beware of overheating in a baby carrier.

Always be sure that your child gets extra fluids in hot weather.

TOO MUCH SUN

There was a time when children who were tanned from hours of frolicking in the hot sun of a summer afternoon were considered healthy; children who were pale from too much time spent indoors were considered “sickly.” The sun’s rays, it was believed, were as wholesome as apple pie and as restorative as a week in the country.

Today, it’s known that sunshine isn’t quite what the doctor ordered. In fact, it’s what doctors now routinely order their patients to stay away from. Too much unprotected time in the sun can lead to skin cancer (including the potentially fatal melanoma), brown spots, and premature wrinkling and aging of the skin. Though a tan looks “healthy,” it’s actually a sign of injury to the skin and is that sensitive organ’s way of trying to protect itself against further damage.

Excessive exposure to the sun’s rays has also been strongly linked to the development of cataracts (they are much more common in sunny climes), and has been found to reduce body levels of beta-carotene (a substance in the body believed to be protective against cancer). If that’s not enough to make you take a dim view of bright sunshine, consider this: It can also precipitate certain other diseases, or make them worse, among them herpes simplex and some other viral skin diseases; vitiligo (white, or depigmented, spots on the skin); PKU; and photosensitive eczema. For those taking certain antibiotics (such as tetracycline) or other medications, it can cause serious side effects. A pretty long rap sheet for what was once considered an all-purpose panacea.

Daily sessions of direct sunshine were once crucial to healthy growth and development in childhood, for it was the only available source of vitamin D, which is needed for building strong bones. Today, infant formulas, all milk, and many other dairy products are fortified with the vitamin, and it is also found in the supplements that exclusively breastfed babies are given. So parents needn’t sacrifice the future of their children’s skin to ensure them the required dose of vitamin D.

To be certain your baby doesn’t suffer the consequences of too much sun, keep in mind the following sun-safety facts and sun-safety tips.

SUN-SAFETY FACTS:

Infants are particularly susceptible to sunburn because of their thin skin. A single episode of severe sunburn during infancy or childhood doubles the risk of the most deadly of skin cancers, malignant melanoma. Even seemingly innocent tanning without burning in the early years has been linked to basal cell and squamous cell carcinomas, the most common types of skin cancer, as well as to premature aging of the skin. The sun is believed responsible for at least 90 percent of all skin cancers, most of which could have been prevented.

There is no such thing as a safe tan, no matter how gradually acquired. Nor does a base tan protect the skin from further damage.

Fair-skinned individuals with light eyes and hair are most susceptible, but no one is immune from the hazardous effects of the sun’s rays.

WHAT TO LOOK FOR IN SELECTING A SUNSCREEN

High SPF. Sunscreens are labeled with a sun protection factor, or SPF, from 2 to as high as 50. The higher the number, the greater the protection. An SPF of at least 15 is recommended for babies and children, though a 30 to 45 is best for those with very fair or sensitive skin. Do not use tanning products on babies or children; they don’t protect at all.

Effectiveness. Look for a product that contains ingredients that screen out both the short ultraviolet (UVB) rays of the sun that burn and can cause cancer, as well as the longer ultraviolet (UVA) rays that tan, can cause long-term skin damage, and enhance the cancer-causing effects of the UVB rays.

Safety. Some sunscreen ingredients are irritating to or cause allergic reactions in some people, particularly infants with tender skins. Most common offenders are PABA (para-aminobenzoic acid) and forms of PABA (padimate O or octyl dimethyl PABA, for example), fragrances, and colorings. To be extra safe, do a “patch test” with a new sunscreen on your baby’s forearm forty-eight hours before using it all over his body. Once you’ve begun using a product, if your baby develops an itchy red rash or any other kind of skin reaction, or if his or her eyes seem irritated, try another product, preferably one that is designed for use by infants or is hypoallergenic. If your child has sensitive skin, look for a product with the active ingredient titanium dioxide, a chemical-free block.

Protection in the water. When your baby is going to be in the water, select a product that is waterproof (which means it will retain its effectiveness after four 20-minute dunkings) or water resistant (it will retain effectiveness after two such dunkings).

The nose, lips, and ears are the parts of the body most susceptible to sun damage.

The sun’s intensity is greatest, thus its rays most dangerous, between 10 A.M. and 3 P.M. (or 11 A.M. and 4 P.M. daylight savings time).

Fully 80 percent of the sun’s radiation penetrates cloud cover, so protection is needed on cloudy days as well as on clear ones.

Water and sand reflect the sun’s rays, increasing the risk of skin damage and the need for protection at the beach, swimming pool, or lake.

Wet skin allows more ultraviolet rays to penetrate than dry skin—so extra protection is needed in the water.

Extreme heat, wind, high altitude, and closeness to the equator also accentuate dangers of the sun’s rays, so take extra precautions under such conditions.

Snow on the ground can reflect enough of the sun’s rays on a bright day to cause a sunburn.

SUN-SAFETY TIPS:

Avoid exposing babies under six months to strong sunlight, particularly at the height of the sun’s intensity in summer or in climates that are warm year-round. Protect these young infants with a sunshade or parasol on strollers or carriages.

If adequate shade is not available, apply sunscreen on baby’s face, hands, and body at least fifteen (but preferably thirty) minutes before sun exposure. Slather on generously for older babies; use in smaller amounts on infants under the age of six months (but continue to limit exposure to direct sunlight). Avoid getting sunscreen into baby’s mouth or eyes, or on the eyelids. For extra protection on very sensitive areas, such as lips, nose, and ears, ask the doctor about using a sun-blocking lip balm or stick, or zinc oxide. Use waterproof sunscreen if baby will be going in the water.

Reapply sunscreen every two to three hours, more often during water play or if baby is sweating a lot. Carry sun-screen in your diaper bag in case you need it unexpectedly.

Initial protected exposures to the sun should be for no more than a few minutes and can gradually be increased, by a couple of minutes a day, up to twenty minutes.

In the sun, all babies and children should wear light hats with brims to protect eyes and face, and shirts to protect the upper body, even when they’re in the water. Clothing should be of lightweight, tightly woven fabrics. Two thin layers may protect better than one, since the sun’s rays can pass through some fabrics—but be wary of overdressing.

Sun exposure damages the eyes as well as the skin. Children who spend a lot of time in the sun should wear protective sunglasses that filter harmful rays. So once baby’s eight or nine months old (especially if he or she is a regular at the playground), it’s time to bring out the shades. Look for those that are labeled “100% UV protection” and meet ANSI (American National Standards Institute) standards. Getting baby in the sunglasses habit early on will help with compliance later.

During hot weather, try to schedule most outdoor activity for early morning or late afternoon. Keep children out of the midday sun whenever possible.

If your child is taking any medication, be sure that it doesn’t cause increased sensitivity to sunlight before allowing sun exposure.

Set a good example by protecting your own skin from the ravages of the sun’s rays, with a hat, sunscreen, and shades.

SIGNS OF SUNBURN

Many parents assume their babies are fine in the sun as long as there is no reddening of the skin. Unfortunately, they’re mistaken. You can’t see sunburn when it’s occurring, and when you do see it, it’s too late. It’s not until two to four hours following exposure that the skin becomes red, hot, and inflamed, and the color doesn’t peak at lobster red until ten to fourteen hours after exposure. A bad sunburn will also blister and will be accompanied by localized pain and, in the most severe cases, headache, nausea, and chills. Redness usually starts to fade and symptoms diminish after forty-eight to seventy-two hours—at which point the skin, even in fairly mild cases, may start to peel. Occasionally, however, discomfort may continue for a week to ten days. See page 577 for tips on treating sunburn.

INSECT BITES

Though most insects are harmless, their bites and stings almost always cause pain or uncomfortable itching, and can occasionally transmit serious disease or cause a severe allergic reaction. So it makes sense to protect your baby from bugs and their bites whenever you can. (For treating insect bites, see page 573.)

STING OR BITE PROTECTION

Bees and other stinging insects. Keep baby out of areas where bees congregate, such as clover or wildflower fields, fruit orchards, or near birdbaths. Protect baby even in your own backyard, especially on bright, warm days or after a heavy rain. If you discover a beehive or a wasp nest in or near your home, have it removed by an expert. To avoid attracting bees, dress your family for outdoor play in white or pastels rather than dark or bright colors or flowered prints. Don’t use fragrant powders or lotions, cologne, or scented hair spray.

Mosquitoes. They breed in water, so drain puddles, birdbaths, gutters, and other areas and things that collect water near your home, such as toys left outdoors, swing sets, and pool covers. Keep baby indoors at dusk when mosquitoes swarm, and be sure windows are screened and screens kept in good repair. A mosquito net over baby’s stroller can help protect infants. For babies over six months, use an insect repellent formulated for children, or those made with citronella or soybean oil (though these products are less effective than ones containing DEET; see below). Follow manufacturer’s directions when applying repellent, use sparingly, avoid getting it on baby’s hands or face, and wash it off with soap and water when you get inside. Lotion formulas are easier to control; a spray’s fumes can be inhaled and get into the eyes.

Deer ticks. Before outings in high tick areas, apply an insect repellent containing low concentrations (10 percent or less) of DEET (if baby is over six months old) to clothing and sparingly to uncovered skin. To prevent ingestion, don’t put it on baby’s hands. Check family, pets, and gear frequently for the pinhead-size ticks. (They are easier to spot on light-colored clothing and cling less to tight weaves.) To prevent Lyme disease, remove ticks promptly (see page 573).

All biting or stinging insects. Keep arms, legs, feet, and head covered in areas where such insects might be lurking. Where ticks are prevalent, tuck pants cuffs into socks.

SUMMER SAFETY

The arrival of summer signals a whole new set of injury possibilities. The following precautions will help minimize the chance that the possibilities will become realities:

Because warm weather often means open windows, be sure to install window guards that meet federal standards for emergency exiting on all windows in your home. Don’t depend on screens, since they can be easily pushed out by a baby. If window guards aren’t in place in your home, or where you’re visiting, open windows no more than 6 inches (and be sure they can’t be pushed open farther), or open them only from the top. You can also buy window stops that can be added to the frame to prevent the window from opening more than 4 inches. Some new windows come with the window stops already installed. Don’t put furniture, or anything else a baby can climb, under windows.

Doors, too, are often left open in warm weather, inviting crawlers to crawl and toddlers to toddle out and into trouble. Be sure to keep all doors, including sliding doors and screens, locked.

WATER, BABY?

During the dog days of summer (which can start in spring and last through fall in some areas), or in a climate that’s warm year-round, your little puppy needs more fluids to replace those lost through perspiration. Babies under the age of six months who are exclusively breastfed can almost always get all the additional fluids they need by nursing more often, but ask the doctor whether you should offer a little water on very hot days. For the very young formula-fed baby, the pediatrician might suggest giving water between bottles of formula—but again, do so only if recommended. For older babies, offer small amounts of water or diluted fruit juice in cups or bottles. (Giving too much water isn’t good for babies; see page 173.)

Once they’ve been introduced, juicy fruits such as melons, peaches, and tomatoes can provide additional fluids. Do not serve drinks that are sweetened with sugar, such as sodas, juice drinks, or punches, since they increase thirst (and aren’t appropriate for babies, anyway), or drinks that contain added salt (such as special athletic drinks).

Outdoors, never take your eyes off the baby who can crawl or toddle, and be especially watchful around swings and other playground equipment. Be sure any equipment in your own backyard is at least 6 feet from fences or walls, and that there is protective surfacing (rubber, sand, pea gravel, wood chips, or bark) under it. Babies under a year should be placed only in seat swings that have seat belts and crotch straps or in specially designed infant bucket-type swings. Don’t use metal slides in warm weather without feeling them first—in the sun they can get hot enough to cause burns.

Don’t put baby down in deep grasses or underbrush or anywhere there could possibly be poison ivy, poison oak, or poison sumac, or where he or she might get a hand on or nibble at other poisonous flowers, shrubs, or trees. When in wooded areas, be sure your baby is protected with cover-up clothing. If your baby accidentally has contact with poison ivy, oak, or sumac, remove all clothing while protecting your own hands with gloves or paper towels. Wash baby’s skin thoroughly with soap and water as soon as possible—preferably within five minutes. Anything else that might have touched the plants (clothing, stroller, even the dog) should be washed, too. Shoes should be washed, if they’re washable, or at least wiped down thoroughly. Should a reaction occur, apply calamine or another soothing lotion to relieve itching (see page 585).

Since warm weather also brings out the barbecues, take steps to protect babies from accidental burns. Keep grills out of reach of small hands. Be sure there are no chairs or anything else on which a baby can climb to reach these hot attractions. Tabletop grills and hibachis should be placed only on stable surfaces. Remember that coals can stay hot for a long time. To reduce the risk of burns, drench the coals with water when the cooking is complete, then dispose of them where your child can’t get to them. Never use grills in an enclosed space, both because of the risk of carbon monoxide poisoning and the potential fire hazard.

WATER BABIES

Parents, eager to “waterproof” their babies as well as to give them a competitive edge over their pint-size peers, are often enticed to enroll their babies in swim classes. But according to the American Academy of Pediatrics, as well as many other safety experts, swim classes are not a good idea for babies. Though it is easy to teach crawlers to float—young children float naturally because they have a higher proportion of body fat than adults—it’s unlikely they could use this skill in a life-threatening situation. Nor do infant swim lessons make children better swimmers in the long run than do lessons taken later on in childhood. There is, in fact, some question as to whether children under three can benefit at all from swimming classes. In addition, there are potential health risks. For one, if babies are allowed to put their heads under water, “water intoxication” is a possibility (see page 516). For another, early exposure to public pools could increase the risk of such infections as diarrhea (because of germs swallowed along with pool water), swimmer’s ear (because of water entering the ear), and swimmer’s itch and other skin rashes.

That doesn’t mean you shouldn’t try to help your baby to feel comfortable in water—an important first step in water safety training. Before you take the plunge with your baby, however, do acquaint yourself thoroughly with the following points. Keep them in mind, too, if you plan on enrolling your baby in a swim class:

A baby should not be taken into a pool or other large body of water until good head control is achieved—that is, when the head can be lifted to a 90-degree angle routinely. Before this skill is mastered, usually by four or five months of age, the head might accidentally bob under the water.

A baby with any kind of chronic medical problem, including frequent ear infections, should have the doctor’s okay before you allow water play. A baby with a cold or other illness (especially diarrhea) should be temporarily barred from water activities, other than in the bathtub, until recovery is complete.

The baby who likes and is used to water is probably less safe near it than one who is afraid of it. So don’t leave a child, even one who has had “swimming” lessons, or is wearing water wings or another flotation device, unattended near water (a pool, hot tub, bathtub, lake, ocean, puddle) for any period of time. Drowning can occur in less time than it takes to answer the phone and in only a couple of inches of water. If you must leave the waterside, even for a second, take baby with you.

All infant water activity should be on a one-to-one basis with a responsible adult. The adult should not be fearful of the water, because such fear could be passed on to the infant.

Swim instructors of infants should be qualified to teach swimming to babies and should be certified in infant CPR. Any class should be age and developmentally appropriate. Be wary of any instructor or program that claims that they will “drown-proof” your baby or toddler.

A baby who is fearful of the water or resistant to being dunked should not be forced to participate in water play.

AS THE FOOD TURNS

For adults, spoiled food can spoil a summer day. For babies and small children, the food poisoning it causes can be much more dangerous. So take special precautions with baby’s food in warm weather, when soaring temperatures can cause bacteria to multiply much more quickly. Follow the tips on pages 328 and 329 to reduce the risk of food poisoning. Keep several small ice packs in the freezer, ready to go. On outings, use one to keep formula, breast milk, opened jars of juice or baby food, or perishable table foods chilled, or tote beverages in a thermos or in a jar with added ice cubes (for juice only, since formula or breast milk shouldn’t be diluted by melted ice). A soft-sided six-pack cooler gives extra protection on longer outings and is easy to carry. Don’t use any food or drink (except for unopened juice boxes and baby food jars) once it’s no longer cool to the touch.

Water in which an infant plays should be comfortably warm. In general, babies like water between 84°F and 87°F. Infants under six months should never be dunked in water cooler than this. Air temperature should be at least 3 degrees warmer than water temperature, and water play should be limited to thirty-minute sessions to avoid chilling. Also, to reduce the risk of infection, pool water should be properly chlorinated, and natural bodies of water should be unpolluted and certified by local authorities as safe for family swimming.

Infants in diapers should wear either waterproof pants that have snug elastic around the leg or disposable diapers specially designed for use in the water. You don’t have to worry too much about urine leakage, but it makes sense to exit even a chlorinated pool when baby has had a bowel movement.

An infant’s head or face should not be submerged. Though babies instinctively hold their breath under water, they continue to swallow. Swallowing large quantities of water, which many babies do during water play, can dilute the blood, leading to “water intoxication.” This watering down of the blood can dangerously reduce the levels of sodium. The resultant swelling of the brain can cause restlessness, weakness, nausea, muscle twitching, stupor, convulsions, and even coma. Babies are much more susceptible than adults to water intoxication because of a smaller blood volume (it doesn’t take a huge quantity of water to dilute it) and because they tend to swallow anything in their mouths. Water intoxication is a deceptive condition. Since a baby doesn’t show any signs of trouble while in the water, and symptoms may not appear until three to eight hours after its ingestion, the illness is often not associated with swimming. Submersion also increases the risk of infection, particularly of the ears and sinuses, as well as of hypothermia (dangerously low body temperatures).

Tubes, water wings, mattresses, or other flotation devices lend a false sense of security to a baby and parent. It takes but a moment for a little one to slip from a tube or tumble off a float. Coast Guard–approved vests should be worn around the water by babies and young children, but even these should never replace constant adult supervision.

A toy bobbing in a pool can become a fatal attraction to a curious child. Keep all objects out of the pool when not in use.

A pool, wading pool, or spray with a missing drain cover should not be used until the drain is repaired. A baby or young child could be seriously injured by the force of the suction.

Adults supervising babies or children near water should be familiar with resuscitation techniques (see page 593), preferably through a hands-on course. Rescue equipment, such as life preservers, and a CPR-technique poster should be displayed near any swimming area. A phone should be readily available for emergency calls.

What You May Be Concerned About in Winter Weather

KEEPING BABY WARM

Baby, it’s cold outside. Just as when it’s warm outside, your own comfort can be your guide to dressing older babies and children. But infants under six months—because they have a greater ratio of body surface to body weight and because they can’t yet shiver to generate heat—need a little more protection in cold weather than you do.

Even when the weather is only slightly cool, a young baby should wear a hat to retain heat. When the temperature is near freezing, a hat, mittens, warm socks and booties, and a scarf or neck warmer should be standard issue. When the wind is biting or temperatures are very low, a scarf can be wrapped around the face or a knitted mask hat slipped over it, but be careful not to block the nose (and be sure any scarves are tied up well so they can’t get caught in stroller wheels or playground equipment). A raincover will keep wind and snow out of a stroller or carriage and warmth in. But even a well-bundled baby shouldn’t be out in very cold weather for long periods.

In cold weather, a lot of lightweight layers (polyester fleece is a great choice) are more effective and less restrictive than a couple of heavy garments. If at least one layer is wool, baby will be warmer. Down or imitation down makes for a warm snowsuit or bunting.

The following cold weather tips will also help to keep your baby cozy and comfortable:

Be sure your baby has recently had a meal or snack before going out—it takes a lot of calories to maintain body heat in cold weather.

If any of your baby’s clothes should become wet, get indoors and change them immediately.

A baby who’s on two feet should wear waterproof, lined boots when walking in wintry weather. The boots should be roomy enough to allow air, which will offer some extra insulation, to circulate around stockinged feet.

In a car, remove your baby’s hat and one or more layers of clothing, if possible, to prevent overheating; if not, take care to keep the car cool. Also remove some clothing on a warm bus or train.

CHANGEABLE WEATHER

If there’s any kind of weather that puzzles even those who top best-dressed lists, it’s that neither-here-nor-there weather so common in the spring and fall. For the inexperienced parent of a young baby, the puzzle is even more complex. How do you piece together an outfit from baby’s closet when the day dawns like a lamb but is expected to roar like a lion by sundown (or vice versa)?

In general, the layered look is the key to dressing for success in changeable weather. Most practical are lightweight layers, which can be easily added or subtracted as the weather unpredictably zigzags from warm to cool and back again. An extra sweater or blanket is always a sensible take-along in case the mercury takes a sudden sharp dip. A hat is a good idea for a young baby in almost any weather—a very light one with a sunshade when it’s balmy, a warmer one on blustery days. An older baby can go hatless when temperatures are in the sixties or seventies and sun or wind isn’t excessively strong. And remember, once your baby’s thermostat becomes well regulated (at about six months), let your own comfort be your baby-dressing guide. A quick check of baby’s arms, thighs, or nape of the neck (but not the hands or feet, which are almost always cool in young babies) will tell you if baby’s comfortable. If you find these body parts are cool and/or if baby is fretful, he or she may be chilly.

In windy weather, use a mild moisturizing lotion or cream on baby’s exposed skin to keep it from chapping.

Don’t worry if your baby’s nose runs when outdoors in cold weather (you can’t catch a cold from being cold). The cilia, or little hairs, which ordinarily move nasal secretions to the back of the nose instead of letting them drip out are temporarily paralyzed by the cold. Once indoors, the running should stop. A little cream or Vaseline under the nose (not in it) will help prevent chapping.

FROSTBITE

While you needn’t worry about your baby’s nose running, you’d better be concerned if the nose (or ears, cheeks, fingers, or toes) becomes very cold and turns white or yellowish gray. This indicates frostbite, which can cause very serious injury. Frostbitten body parts must be rewarmed immediately. See page 581 for how to do this.

After prolonged exposure to cold weather, a baby’s body temperature may drop below normal levels. This is a medical emergency—no time should be wasted in getting a baby who seems unusually cold to the touch all over, even under clothing, to the nearest emergency room. In the meantime, remove wet clothes, wrap baby in warm blankets or any available cloth, give a warming drink, if possible (breast milk, warm formula, warm soup), and keep baby close to your body (for warmth).

Prevent such cold weather emergencies by dressing your baby adequately, protecting exposed areas of skin, and limiting the time your baby spends outdoors in extreme weather.

SNOW BURN

It isn’t just the baby tagging along to tropical beaches for the winter holidays who is in danger of suffering a sunburn in winter—a baby enjoying a white Christmas or Hanukkah or Kwanzaa is, too. Since snow reflects up to 85 percent of the sun’s ultraviolet rays, even a weak winter’s sun can burn a baby’s sensitive skin if it bounces off a snowy landscape first. So be sure to protect your baby’s skin with clothing, a brimmed hat, and sunscreen whenever you’ll be spending a lot of time in sun and snow.

KEEPING BABY WARM INDOORS

In cold weather, baby’s room should be kept at between 68°F and 72°F by day, and about 68°F by night. If indoor temperatures are higher than this, the arid heated air can dry the mucous membranes of the nose, making them more vulnerable to cold germs, and also dry the skin, making it itchy. At night, keep baby toasty with flannel crib sheets, which tend to stay comfortable to the touch even on cold nights. Keep in mind that extra covering (for safety’s sake this should come in the form of fleecy-footed sleeper pajamas) is needed during sleep when metabolism slows. But try not to make the common mistake of overdressing your baby for bed (and if he or she awakens in the night damp with perspiration, that’s what you’re doing).

DRY SKIN

Few people of any age are exempt from the dry, itchy skin of winter. Though most people assume that merely protecting babies from the cruel assaults of wind and cold outdoors will keep their skin soft and supple, this isn’t so. The major cause of winter dry skin is found indoors, not out. In most homes, once the heating season begins, the indoor air becomes hot and dry. It’s this hot, dry air that is a major contributor to skin dryness in winter. You can help counteract this effect in these ways:

Up the moisture in your home. Get a humidifier for your heating system, or at least one for your baby’s room. See page 47 for which type to buy.

Up the moisture inside your baby. Babies (and all of us) get moisture for the skin from inside as well as out. Be sure your baby is getting enough fluids.

Up the moisture on baby’s skin.
Smoothing a good-quality baby lotion on baby’s damp skin right after the bath will help retain the moisture. Ask the doctor to recommend a particular product, or select one that is labeled hypoallergenic.

Reduce the soap. Soap is drying. It rarely needs to be used on tiny infants—except once a day in the diaper area. Crawlers may need a sudsing on knees, feet, and hands. But in general, use very little soap; particularly avoid using bubble bath or liquid soap to make bubbles in baby’s bath, since soapy water is more drying than clear water. Use a gentle soap or moisturizing skin cleanser; ask the doctor for a recommendation.

Turn down the heat. The hotter the house, the drier the air (assuming no humidity is being returned to the air as the house is heated). For babies more than a few weeks old, the home need not be warmer than 68°F. If baby seems chilled at this temperature, it’s better to add layers of clothing rather than degrees of heat.

FIREPLACE FIRES

Before there were televisions, there were fireplaces to draw families together on a cold winter’s evening. Even today, a roaring fire can rival whatever prime time has to offer, bringing warmth to both body and spirit. The trick, however, when babies and young children are part of the family circle, is to keep them safe when near the fire. Keep the fireplace covered, even once the fire’s out (embers can stay hot for hours), with a screen that’s too heavy for even strong and persistent little hands to move. If you can’t protect a baby or toddler from hot surfaces with appropriate barriers, then you shouldn’t use the fireplace. For added protection, teach your baby early on that fire is “hot!” and that touching it can cause pain. Be sure, too, that the flue is clear so fumes don’t fill the room and you don’t start a chimney fire. If baby or other family members have a chronic respiratory condition—such as asthma—consult with the doctor about whether fireplace use may worsen the problem.

HOLIDAY HAZARDS

Nothing is more wondrous to a young child than a home that’s been decked out for the holidays. But if proper precautions aren’t taken, nothing can turn out to be more dangerous. Concealed in many idyllic Currier and Ives living-room scenes are a host of hazards. All of the following are potential threats to your baby. Some should be used with care, others shouldn’t be used at all—at least until your child is older, wiser, and less vulnerable.

Mistletoe and Jerusalem cherry. Both of these can be deadly if eaten. Do not bring them into your home or let your baby play near them when visiting.

Holly. This plant is only slightly poisonous (large quantities must be consumed for a baby to suffer serious consequences), but it’s wise to keep it out of baby’s reach. Christmas cactus is safe, however.

Poinsettia. This holiday beauty can cause local irritation to the mouth, and perhaps serious stomach upset if large quantities are ingested. Keep it out of reach.

Evergreens. A cut tree should be fresh and kept well watered; any dry greens should be discarded to avoid a fire hazard. Artificial trees don’t let you off the safety hook entirely: Choose one that’s labeled “fire-resistant,” and never use electric lights on a metallic tree. Don’t allow unsupervised play around a tree; pulling up on a branch could lead to baby pulling down the tree.

Pine needles. Sweep these up regularly, and if possible, keep pine trees, wreaths, and branches out of reach of babies and toddlers. Pine needles can cause a persistent croupy cough if they lodge in the trachea; seek medical help if you suspect this.

Snow-scene paperweights. Although the liquid inside these is not poisonous, once broken, it can become contaminated with germs; discard if the paperweight becomes cracked.

Angel hair. This is spun glass, which can irritate skin and eyes and cause internal bleeding if swallowed; use high up and out of baby’s reach, if at all.

Artificial snow spray or flocking. These can aggravate a respiratory problem; don’t use if anyone in your family has one.

Tree lights. Because young children may bite these enticing ornaments and suffer internal cuts, hang them high out of reach. Keep cords out of reach, too. Be particularly careful with small blinking lights, which contain a chemical that is hazardous if ingested.

Candles. Light them and keep them completely out of baby’s reach—and, of course, away from curtains or other flammable materials. Never leave them lit and unsupervised; make sure they’re thoroughly extinguished before leaving the house or retiring at night. If you display them in a window, be sure curtains are securely tied back.

Minidecorations. Very small tree ornaments, tree lights, dreidels, or any items smaller than the diameter of a toilet paper tube (or with parts that small that can be broken or pulled off) can cause choking. Don’t use these, or use them only where you’re sure baby can’t get to them.

Tinsel, glass or plastic ornaments, and Styrofoam. All of these decorative items are alluring choking hazards. If a piece is bitten off, it can become stuck in the throat or, depending on what the ornament is made of, cause internal bleeding.

Tree preservatives. If you use these, make sure a curious baby can’t dip into the tree container for an unusual—and unhealthy—snack.

Gifts. Sure, the presents you’ve stacked up for baby are perfectly safe and appropriate for his or her play, but there’s a good chance that the gifts you’re giving to other family members aren’t. So after the unwrapping, be sure all gifts that aren’t baby-friendly are stashed out of reach.

Food and drink. It isn’t just what sets the scene that can be dangerous; what sets the table can be, too. Every year, hundreds of young children are rushed to hospital emergency rooms after downing a martini, beer, or cupful of eggnog or spiked punch left carelessly within their reach. Others choke on olives, nuts, cocktail franks, hard candy, and other favorite adult nibbles. So play it safe when you’re hosting a holiday party. Be sure that alcoholic drinks or inappropriate edibles aren’t left around, even briefly, on coffee or end tables where even moderately active crawlers can get to them. Keep in mind that no matter what the season, certain foods—such as fruitcake that’s been soaking in liquor, popcorn, chocolate, nuts, and anything containing honey—are off-limits to babies.

So deck the halls, feast, and celebrate with care. But don’t stop there. Just in case a mishap should occur in spite of all your precautions, prepare for the holidays by becoming familiar with first-aid and CPR techniques, if you aren’t already, and by posting the number of the poison control center (800-222-1222) where it will be handy.

SAFE GIFT GIVING

First on any parent’s list when doing holiday toy shopping should be safety. As tempting as toy stores are at this time of year, resist them until you’ve completely familiarized yourself with the tips for buying safe and worthwhile playthings for your baby, starting on page 307. Remember, manufacturers can’t always be counted on to produce what’s best for your baby—particularly during the holiday season you, the buyer, must beware.

UNDER WRAPS

When it comes to holiday gift wrapping, all that glitters isn’t necessarily safe. They’re festive, but those ribbons, bows, and figurines—and even the wrapping paper—can pose a choking and/or suffocation danger to a curious baby who’s exploring under the tree or menorah. So keep wrapped gifts—and ripped off wrapping—under wraps, out of baby’s reach.

What It’s Important to Know: THE SEASON FOR TRAVEL

In the days before parenthood, any season was the season for a trip. Summer excursions to a friend’s beach house, winter holidays with parents in the Sunbelt, whirlwind ski weekends squeezed in between busy work weeks, leisurely tours of Paris in the spring, escape weekends to the Caribbean when the streets back home were covered with ice, or to the mountains when they were steaming with heat and humidity.

But now what? Considering the effort involved in taking your baby across town on a simple shopping expedition—the hours of planning, the exacting execution, and the 20 pounds’ worth of baby, equipment, and supplies lugged on your aching shoulders—the logistics of a two-week vacation, or even a two-day trip to grandma’s, might seem too overwhelming to consider attempting.

Yet you needn’t wait until your children are old enough to carry their own luggage or are off to summer camp to satisfy your wanderlust or grandma’s pleas for a visit. Though vacations with baby will rarely be restful and will always be a challenge, they can be both feasible and enjoyable.

PLANNING AHEAD

The days of spur-of-the-moment weekend getaways, when a restless spirit and a few garments and toiletries flung into an overnight bag took you where you wanted to go, ended abruptly with your baby’s arrival. Now you can expect to spend more time planning a trip than taking one. Sensible preparatory steps for any trip with baby include:

Underschedule yourself. Forget itineraries that will take you through six scintillating cities in five whirlwind days. Instead, set a modest pace with plenty of unscheduled time—for an extra day on the road should you end up needing it, an extra afternoon at the beach or morning by the pool should you end up wanting it.

Update passports. You won’t be able to take your baby abroad on your passport. These days every traveler, no matter what age, needs his or her own. For information on obtaining a passport for your baby and other travel information, go to www.travel.state.gov.

Take medical precautions. If you’re going abroad, check with the doctor to be sure baby’s immunizations are up-to-date. If you’re heading for exotic destinations, ask the pediatrician if you and your baby may need specific immunizations (against yellow fever, for example) or prophylactic treatments (to prevent hepatitis A and/or malaria). For the latest information on these and other precautions you may need to take before a trip, visit the CDC’s Web site for traveler information (www.cdc.gov/travel/vaccinat.htm). Or ask the doctor for a referral to a travel clinic for specific advice about and protection from disease at exotic destinations.

Before taking an extended trip, schedule a well-child checkup if it’s been a while since the last one. In addition to providing assurance that your baby’s in good health, the visit will give you an opportunity to discuss your proposed trip with the doctor and ask any questions that might otherwise keep you up while you’re away—when it may be impossible or at least impractical, to pick up the phone and call the office. If your baby has had a checkup within the previous month, a telephone consultation may be all that’s needed.

JUST THE TWO OF YOU?

These days, security’s tighter than ever, even when it comes to traveling with a baby. If you’re taking your child overseas alone, you may need permission in writing from his or her other parent to do so—or proof that you are the sole guardian. Policies vary from country to country (and may even vary from day to day, depending who’s on duty at an entry point), so do your homework well before departure day. You should check with the airline you’re flying and your travel agent, as well as with the foreign consulate or embassy of the country you’ll be traveling to. Bring more than you think you’ll need (for instance, have the letter of permission notarized), just in case you’re asked for it.

If your baby takes medication, be sure you have enough for the trip, plus a prescription in case the supply is lost, spilled, or otherwise meets with calamity. If a medication needs to be refrigerated, keeping it on ice continuously may be difficult, so ask the doctor if it’s possible to substitute another medication that needn’t be kept cold. Since a stuffy nose can make a baby miserable, interfere with sleep, and cause ear pain when flying, also ask the doctor to recommend a decongestant in case your older baby should come down with a cold. If you are going to a place where “traveler’s stomach” might be a problem, stock up on pediatric rehydration fluids. For any medication you are taking along, be sure you know the safe dosage for a child your baby’s age, as well as the conditions under which it should be administered and the possible side effects. Also useful, especially for extended trips: the name of a pediatrician at your destination or destinations. Of course, you can also call your baby’s doctor for medical advice no matter where in the world you are.

Time your trip. What hour of the day or night you begin your journey will depend on, among other things, baby’s schedule and how he or she reacts to changes in it, your mode of travel, your destination, and how long it will take to get there. If you’re leaving the East Coast for the West by plane, for example, it might make sense to plan to arrive around baby’s bedtime (East Coast time). Assuming a nap has been taken en route, the excitement and chaos of arrival will probably make it possible to keep baby awake a couple of hours past the usual bedtime. This may enable baby to sleep until a relatively respectable 5 or 6 A.M. Pacific Time rather than rising raring to go at an indecent 3 or 4 A.M. (Of course, you will also have to pray trains and planes will be on schedule.)

Consider the advantages of traveling at off-peak times, when there are more likely to be empty seats for your baby to crawl over and fewer fellow passengers who might be disturbed.

If your baby habitually falls asleep in the car and you’re planning a long-distance car trip, plan, if possible, to do most of your driving when he or she would ordinarily be asleep—during nap times or at night. Otherwise, you may arrive at your destination with a baby who’s slept all day and is ready to play all night. If your baby sleeps well on trains or planes, but is fussy when awake in such confined quarters, coordinate nap time with travel time. But if your baby is always too excited to sleep in such environments, plan to travel after nap time to avoid crankiness during the trip.

It may seem that getting to your destination as quickly as possible makes the most sense. But it doesn’t always. For an active baby, for example, a connecting flight with some time to let off steam between legs of the trip may be better than a long nonstop.

Order ahead. When flying, don’t plan on feeding even an older baby from a standard airline selection, since the food offered is usually not appropriate for babies. Instead, plan on placing a special order, such as a cottage cheese and fruit platter and whole wheat bread, with your older baby. Special orders are usually just a one-day-in-advance phone call away, and you can often arrange for one when confirming your tickets. Even once you’ve put in your order, however, plan to take along a substantial stash of snacks. When flights are delayed or special orders go astray (not unheard of these days), long waits between meals can make baby, and everyone else in the vicinity, miserable. For flights on which no meals are served—just those little bags of almonds baby can’t dip into—make sure you take along enough food to keep the peace until landing.

Some airlines, particularly on overseas flights, offer baby foods, bottles, diapers, and bassinets. Ask about these when you make your reservations.

Arrange for suitable seating. If you’re traveling by air, either fly off-peak and have the airline save an empty seat for you, or take advantage of the 50 percent discount offered for children under two. Bring along baby’s rear-facing car seat (make sure it’s FAA approved), and use it—laps aren’t safe during takeoff, landing, or turbulence.

An aisle seat for you (so you can pace up and down, when necessary) and a window for the baby (interesting if there are clouds or sunsets to watch) are ideal, but not always possible. Whatever you do, don’t accept seats in the middle of a wide-center section, not just for your sake, but for the sake of those seated around you.

Though you can, and should, reserve space on many railroad trains in this country, you can’t reserve specific seats. But you can reserve sleeper compartments on some long-distance runs. Such compartments give you a measure of privacy, something you may really appreciate when spending long hours or days on a train with a baby.

Book in advance. You may assume that when traveling by road in off-peak seasons, motel reservations won’t be necessary. But in this nation of travelers, many roadside establishments, especially those with lower rates, hang out No Vacancy signs nightly. So plan ahead where you will be stopping overnight, allowing more time to get there than you could ever possibly imagine needing, and reserve a motel room with a crib (make sure it meets the standards on page 49, or if you can, bring a safe portable crib).

Choose a helpful hostelry. Whenever possible, look for a hotel or motel that caters to the needs of families; many do not. One clue to what you can expect is whether or not cribs and baby-sitters are available. You will probably have an uncomfortable stay at a hotel without such amenities. You will probably feel unwelcome, as well.

Equip yourself. Getting around, especially if you’re traveling without another adult or with more than one child, will be easier if you have the right equipment:

A baby carrier, if baby is small. It will free your hands to juggle luggage—important when boarding and disembarking. But don’t forget to bend at the knees when picking up that collection of bags, so baby doesn’t fall out.

A lightweight and very compact umbrella stroller, for an older baby. You can hang totes from the handles, but be careful not to let the stroller tip backward. Most airlines will let you drop off your stroller at the gate right before you step on the plane and will return it at your destination, as soon as you step off the plane.

A portable baby seat—a cloth one adds almost no weight to your luggage.

An FAA-approved car seat. You can carry it on and use it in flight when traveling by plane. If you’re traveling by train and plan on renting a car at your destination, you can rent a car seat, too—but be sure to reserve the age-appropriate seat at the time you reserve the car.

You can also rent or borrow other equipment, such as cribs, playpens, high chairs, and feeding seats, at the other end. Try to make these arrangements in advance.

Don’t rock the boat before you set sail.
To avoid unnecessary problems on your trip, avoid unnecessary changes just before it. Don’t try weaning your baby, for instance, just prior to departure—the unfamiliar surroundings and changes in routine will be hard enough to deal with without adding other stresses. Besides, no other way of feeding baby on the road is as easy for you or as comforting for baby as breastfeeding. Don’t introduce solids close to departure, either. Beginning to spoonfeed is enough of a challenge (for both of you) at home. If your baby is ready for finger foods, however, consider introducing them pretrip. Portable nibbles are great for keeping babies occupied and happy en route.

If your baby isn’t sleeping through the night, now is not the time to try to remedy the situation. There’s likely to be some regression into night waking during a trip (and for a while, upon return), and letting baby cry it out in a hotel room or at grandma’s will enhance neither your vacation nor your welcome.

Confirm. The day before your departure, confirm all your reservations if they haven’t already been confirmed, and call to check departure times before leaving home. You don’t want to arrive at the airport to find your flight’s been canceled or delayed four hours, or at the train station to find the train is going to be late.

PACKING WISELY

While virtually everything, including the kitchen sink (for rinsing off dropped bottles and dousing stains), might come in handy on your trip, packing it all would obviously not be advisable. Neither, however, would be starting out perilously underpacked. Instead, strive for a happy (albeit heavy) medium, taking only what you absolutely need, being as efficient as possible in your selection: travel sizes of liquid baby soap, acetaminophen or ibuprofen, toothpaste, and the like; the extra-trim and extra-absorbent variety of disposable diapers; mix-and-match clothes in bright patterns that conceal stains well and thus hold out longer between launderings, in lightweight fabrics that will dry fast if you need to rinse them out.

You can pack less if you’ll be someplace where you can fill in the blanks, particularly if filling them in will be part of the fun—buying a couple of tiny shorts and T-shirt sets in Bermuda, for example, or a bottle of bébé shampoo in Paris. But if you’ll be hiking in the Adirondacks or camping in Yosemite, everything that you could conceivably end up needing should end up in your backpack. For the typical trip, you will probably want to pack the following:

A diaper bag. It should be lightweight, plastic-lined, have outside compartments for storing tissues, wipes, bottles, and other needed-in-a-hurry items, and have a shoulder strap so you won’t need to tie up a free hand carrying it. The items you may want to keep handy in the bag include:

A light jacket for baby (waterproof nylon with a hood is best, since it doubles as a raincoat) or sweater in case the car, train, plane, or bus is chilly.

Enough disposable, extra-trim, extra-absorbent diapers for the first leg of your journey, and then some more, in case of a delay or a bout of traveler’s tummy. Plan on buying diapers as you go rather than carrying cases with you from home, unless you’re traveling by car and have the room, or unless you won’t be able to purchase them at your destination.

Diaper wipes for your hands (and baby’s) as well as the obvious. They can also serve to sanitize the arm of the plane seat that baby seems intent on chewing or the train window that he or she is set on licking clean and to outsmart spills on clothing or upholstery before they set into stains.

Diaper rash ointment or cream, since unfamiliar foods, fewer diaper changes, and warm weather can all prompt an outbreak of diaper rash.

A large waterproof bib, or a pack of disposable ones, to protect clothing. Just in case you accidentally leave the plastic bib in a restaurant or run out of throwaways, bring along a safety pin with which to fasten a restaurant napkin over baby’s clothes.

Some reclosable plastic bags to hold leaky bottles, dirty bibs or clothing, and soiled diapers when a trashcan isn’t immediately available.

Sunscreen, if your destination will be sunny or snowy.

A light blanket or quilt for baby to nap on or play on en route and in homes that you visit. Or take along a shawl you can wear on your shoulders and use for baby when necessary.

A small waterproof lap pad or changing pad to protect hotel beds and other surfaces when baby needs a change.

A comfort object, if your baby has one (and maybe an extra, in case you lose it).

A pair of socks or booties for a barefoot baby, in case you run into some heavy air-conditioning.

Plastic outlet covers if your baby is a crawler or walker, to babyproof hotel rooms or homes you’re visiting. You may also want to take a toilet lock if your baby is into water play. (Some chains offer babyproofing kits.)

A generous supply of snacks and beverages. Don’t rely on being able to find appropriate food for your baby on the road, in the air, or on the rails. Bring along enough food and drink for one or two more meals than you anticipate feeding, just in case. Depending on baby’s culinary repertoire, take along baby food (dehydrated, if you must travel light); whole-grain crackers; small containers of bite-size dry cereal for nibbling; ready-to-use formula for the bottle baby in disposable bottles; watered-down juice in a small bottle or thermos with a cup (if there’s a favorite sippy cup in your baby’s life, bring that, too). Carry the 3-ounce baby food jars to provide variety and avoid waste.

Plastic spoons stashed in a plastic bag, for feeding baby en route.

Paper towels, unrolled, which are more practical, stronger, and usually more absorbent than napkins.

Something old and something new to entertain your baby—the old for comfort and reliability; the new for excitement and challenge. A small activity board and a brightly illustrated board book are good choices for an older baby; a mirror, rattle, and a musical stuffed animal for a younger one. Leave home toys with a lot of pieces that can get lost or which are too bulky for easy packing and use in tight spaces—as well as toys that make noise (and headaches). For a teether, be sure to take a couple of items to gnaw on.

A small purse. Since you have a limited number of hands, carrying a separate handbag will be virtually impossible as well as a little risky (you’ll most likely look distracted and disorganized enough to qualify as easy prey for a pickpocket). Instead, keep personal items, plane, train, or bus tickets, and your wallet, with ID, money, credit cards, medical insurance information and copies of medication prescriptions, as well as baby’s doctor’s phone number and the names of recommended doctors at your destination, in a small, easy-to-identify-by-feel purse in the diaper bag. Or, as an alternative, keep your wallet handy in your pocket (if all of your travel outfits have safe, deep pockets, you’ll find life much easier).

A cell phone, to use in case of emergencies, medical or otherwise.

If you still have room (and motivation), a square yard of clear heavy-duty plastic to protect hotel furniture and rugs during feedings, and to serve as unobtrusive protection under baby’s high chair in restaurants.

A bag for baby’s clothing. Ideal for baby’s travel wardrobe is a small, lightweight, soft-sided carry-on with a shoulder or backpack strap. Since it can be kept handy in car, plane, or train, you’ll be able to get at a fresh outfit without any fuss and without rummaging through your own suitcase in public. If you choose to pack baby’s clothes in your suitcase, however, and that bag won’t be available while you’re traveling (because it’s going to be either checked through on the plane, train, or bus, or buried in the car trunk), make sure you keep an extra outfit or two for baby in the diaper bag.

A medical and toiletry bag. This bag should be inaccessible to a curious baby at all times (in overhead compartments on trains and planes, for example), and should preferably be difficult for a child to open. Ideally, it should have a waterproof and washable interior as well as a shoulder strap. Keep this bag with you as you go so that medications will be available, if needed, and to protect liquids from damage by freezing in the cargo compartment of planes. It can contain:

Any prescription medicines and vitamins to last your trip; baby acetaminophen or ibuprofen; any other medication recommended by the doctor.

For outdoor trips, insect repellent, calamine lotion, bug-bite medicine, and a beesting kit if baby is allergic.

A first-aid kit containing Band-Aids and self-adhesive gauze pads; antibacterial cream (such as bacitracin); elastic bandages for sprains; thermometer; tweezers; baby nail clipper.

Liquid baby soap, which serves as a cleanser for both hair and skin. The soaps found in hotel rooms aren’t usually gentle enough for babies.

Baby’s toothbrush, finger brush, or gauze pads for tooth wiping, if teeth are in.

Multipurpose pocketknife, with can opener and scissors (but don’t try to carry this on an airplane; it will be confiscated).

A night-light, if your baby likes to sleep with one.

GETTING THERE IS HALF THE FUN?

Not likely. But you can at least try to ensure that it will be half the hassle. Whether you will be going by land, air, or rail, there are several ways of making your trip easier.

If you’re flying. Planes have the advantage for family travel of usually being the fastest commercial way of getting from one point to another. You can make a flying trip pleasant (at least relatively so) as well as comfortable, if you:

Consider requesting bulkhead seats. They offer more leg and maneuvering room and privacy, though less storage space for diaper bags, etc. Another plus is: no seat in front of yours for baby to bang on; no passengers in front of you for baby to annoy.

Arrive early enough to take care of preboarding details like luggage and seats, and to get through security screenings, but not so early that you have an uncomfortably long wait in the air terminal.

Preboarding is an advantage offered on some airlines to those traveling with children, allowing them to settle in and stow luggage in overhead compartments before the rush. However, if you have a baby who you expect will be fidgety in close quarters (remember, you won’t be able to walk the aisles while they’re being used for boarding), you may want to wait and board last. If you’re traveling with another adult, ask if one of you can board with the luggage while the other spends some extra time with baby in the open spaces of the waiting area.

Coordinate feedings with takeoff and landing. Children are more prone than adults to the ear pressure, and sometimes pain, caused by cabin-air-pressure changes during ascent and descent. Bottle feeding (with expressed breast milk or formula) or offering finger foods or a pacifier encourages frequent swallowing, which helps prevent the painful pressure buildup and the crying that usually accompanies it. Nursing isn’t practical during these times, since baby should be buckled up for safety’s sake.

If your baby does do a lot of loud complaining, accept a kind hand from friendly fellow passengers if offered, and disregard those who give you dirty looks.

Give your baby a lot to drink during the flight; air travel is dehydrating. If you’re nursing, be sure you, too, take extra fluids—but remember, beverages with caffeine or alcohol don’t count.

If your baby prefers warmed feedings, you can ask flight attendants if it’s possible for them to warm bottles and baby food for you (without their tops). But remember to shake or stir thoroughly and to carefully double-check the temperature before serving to prevent scalding accidents, since microwaves can heat unevenly. Keep in mind, too, that on busy flights, attendants may not be able to help you out with these services.

If you’re traveling alone, feel free to ask an attendant to hold baby while you use the lavatory—but try to wait until service has been completed.

Deplane last, to avoid the squeeze and to be sure you have time to gather up all your belongings. (Let anyone who is meeting you know that you will be last off the plane.)

If you’re going by train. Traveling by train, though slower than by plane, allows children a little more mobility. Your family train trip will be easier if you remember to:

Board as early as possible to find a plum seat. If a wheelchair-bound passenger (who has first call) is not positioned in front of the first seat in a car, that’s a good one for a family to take because of the open space in front of it where baby can nap or play. Also a good choice is the four-seater unit at either end of most cars, which allows families to spread out comfortably. If the train is crowded because you’ll be traveling at peak time and your trip is long, it may make sense to buy a seat for your baby. If you have only one seat, it’s a toss-up whether to favor the window seat (so baby can watch the scenery go by) or the aisle (so you can get up frequently for walks if baby is fidgety).

Be sure to have a baby carrier if you’re traveling alone and baby can still ride in one; without it you may find it impossible to go to the bathroom. (Don’t park your baby even briefly with any stranger, no matter how friendly.)

If your train ride will be a long one, have a varied collection of toys so you can pull out a new one when your baby tires of the old. Or do some sightseeing. Looking out the window, pointing out cars, horses, cows, dogs, people, houses, sky, and clouds, is an onboard activity that has saved many a parent at the bottom of his or her bag of tricks.

Be sure to have plenty of snacks on hand for you and baby. Lines for food on trains are often long, and it would not be unusual to finally reach the counter only to find that the chicken sandwich you were counting on was sold out.

If you’re driving. Driving is slower than other forms of transportation, more taxing on you if you’re the driver, and most confining to baby. But it does give you the luxury of going at your own pace, stopping when and where you’d like, and having ready transportation at your destination. Make family auto travel safer, more pleasant, and more comfortable in these ways:

Be sure that there are seat belts for all adults and older children, car seats for younger ones, and that the car never moves until all are safely secured and all doors locked (see pages 138–139 for more on car seat safety).

Take frequent breaks (every two hours or so is ideal), since babies become restless sitting in car seats for very long stretches. When you do stop, take baby out for some fresh air, and if he or she’s mobile, a crawl or walk. Use rest stops for nursing, too.

Alternate roles. For a change of pace and companionship for everyone, alternate driving with sitting in the back entertaining baby.

Attach playthings to baby’s car seat with plastic links (or strings no longer than 6 inches) so that you won’t have to unbelt repeatedly to retrieve tossed toys.

AT HIGH ALTITUDES

If you’re heading to an area high above sea level, there are certain precautions that need to be taken. Because the sun’s rays are more intense at higher altitudes, you need to be particularly conscientious about using sunscreens and limiting sun exposure. Because fluid requirements are increased, your older baby will need several additional ounces of fruit juice or water daily while you remain at the higher altitude.

In a baby who is anemic, the reduced level of oxygen in the air may increase heart and respiratory rates and cause fatigue. This is nothing to be concerned about unless your baby has an infection or other medical condition, such as a heart ailment—in which case you should consult the doctor before making the trip. But do schedule frequent rest stops.

If you’re driving in cold weather, especially if a storm is predicted, bring along extra clothing and blankets in case you get stranded. A car can quickly turn into a deadly icebox in subfreezing temperatures.

Never leave a baby in a parked car in hot or even warm weather. Even with the windows open, the car can rapidly become a deadly oven. For that matter, never leave a baby or child in a car alone—no matter what the weather.

AT HOTELS AND MOTELS—OR OTHER HOMES AWAY FROM HOME

The first overnighter away from home with your baby can be a little unnerving. But you’ll all sleep better if you take the following precautions:

Upon arrival at your destination, do a safety check of the room you’ll be staying in—especially if your baby is mobile. Some family-friendly hotel chains offer childproofing kits; otherwise you may have to bring your own equipment. Be sure open windows, electrical cords, glasses, and so on (see pages 404–408) aren’t accessible. Cap exposed outlets and keep the bathroom door closed. Check the crib for safety (see page 401). If there’s a minibar in the room, either ask that it be emptied or make sure it’s securely locked.

If you put baby on the bed for a diaper change or play, use a waterproof pad—to protect the bed from baby and baby from a probably unsanitary bedspread.

When you’re feeding baby in the room, spread newspaper or a plastic square on the floor to protect carpeting—for courtesy’s sake, and so you won’t be stuck for damages.

Don’t confine an active baby. Crawling under your supervision is okay unless the carpet is visibly dirty; exploratory toddling is fine, too, but again under a watchful adult eye. Be sure to do a thorough check under the bed to make sure there are no hazardous (or unsanitary) objects lurking beneath.

Arrange for baby-sitters through the hotel. Most hotels and resorts offer some type of baby-sitting. But what they offer can vary wildly. It might be a hotel chambermaid looking to make some extra cash; it might be a list of phone numbers of baby-sitting agencies in the area (you’re on your own to call and hire); or it might be an onsite childcare program (most common with big resorts that cater to families). Treat any baby-sitter on the road as you would on your home turf: interview the person (or at least the service), if possible, and make sure any baby-sitter you hire is screened, licensed, insured, and bonded. Meet them at the bell captain’s or concierge’s desk, so you’ll be sure you’ve got the right person.

HAVING FUN

You’ve planned, you’ve packed, you’ve lugged, and you’ve traveled. Now it’s time to have fun. Here are some general guidelines for ensuring a bon voyage with baby:

Be realistic about the itinerary. You just won’t be able to keep up the same pace with a baby in tow as you would on a trip for adults only. Overschedule, and you’ll end up underenjoying.

Be flexible about the itinerary. If you’d planned to drive straight through from Savannah to Miami, but baby’s had it with the car seat by Daytona, consider adding an overnight stop. If you’ve scheduled two days of sightseeing in Athens, but baby’s crankiness is ruining the ruins for all of you by the first morning, postpone the Parthenon until another day.

Stick to sites where baby won’t be confined or required to be silent for long periods of time. Outdoor monuments, parks, zoos, and even some museums can be interesting to babies and young children—even if they spend most of their time just looking at other people. Hire a baby-sitter, if possible, when you want to go to the opera, a concert, or the theater.

Remember whose needs must come first—if anyone’s going to have a good time. If baby doesn’t nap or eat on time, or is repeatedly subjected to uncustomarily late bedtimes, everyone will suffer the consequences. In fact, the only schedule you shouldn’t be flexible about is baby’s. Do what the Romans do, by all means, but only if your baby can adjust easily.