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As many as 85 percent of women experience morning sickness. It is usually worst in the first trimester. Morning sickness can range from mild to a severe form called hyperemesis gravidarum, which causes such persistent nausea and vomiting that the woman can lose weight. The study investigated the effects of “normal” morning sickness, not hyperemesis gravidarum.
The researchers looked at the results of 10 studies that involved hundreds of thousands of pregnancies. The results were published in the August issue of the journal Reproductive Toxicology.
Lead author Dr. Gideon Koren, a pediatrician at The Hospital for Sick Children in Toronto, said the high levels of the hormone human chorionic gonadotropin that is released by the placenta cause morning sickness. The hormone also causes the fetus to be healthier and decreases the risks associated with pregnancy.
One study Koren examined found that women who did not experience morning sickness were three to 10 times more likely to suffer a miscarriage. Another study found that 9.5 percent of women without morning sickness gave birth pre-term, compared to only 6.4 percent of women who had morning sickness. A smaller study found that 45 children whose mothers had morning sickness had higher IQ scores than those who did not have symptoms. The effect was more apparent in women with moderate to severe morning sickness.
Having morning sickness does not guarantee that a woman’s baby will be healthy, and not getting sick does not mean that a woman should worry about her baby’s health. Koren hopes that the findings can provide comfort to women suffering from morning sickness. Medication is available to treat the condition.
The age at which babies begin teething can vary, but most babies start teething by six months. The bottom front teeth usually appear first, followed by the top front two.
You may notice several tell-tale signs that your baby is teething. Your baby may drool, chew on solid objects, be cranky or irritable, and have sore or tender gums. There is disagreement about whether teething also causes fever and diarrhea.
If your baby is in pain, there are several ways that you can offer relief.
- Rub your baby’s gums with a clean finger, moistened gauze pad, or damp washcloth. Applying pressure and massaging your baby’s gums can reduce the amount of discomfort.
- Offer your baby a teething ring made of firm rubber, but not one filled with water because it can break. Keep the teething ring cold, but not frozen. You can also try a chilled washcloth.
- Some babies get relief by drinking from a bottle. If you offer your baby a bottle, fill it with water. Prolonged contact with the sugar in formula, milk, or juice can cause tooth decay.
- If your baby is eating solid food, gnawing on something hard, such as a peeled and chilled cucumber or carrot, can provide relief. Watch to make sure your baby doesn’t choke.
- You can also try an over-the-counter medication for babies that contains acetaminophen (Tylenol) or ibuprofen (Advil or Motrin). Avoid teething medications with benzocaine because that could potentially lower the amount of oxygen in the blood.
- Babies tend to drool a lot when they are teething. Wipe your baby’s chin to prevent a rash from developing.
Parents can usually treat the symptoms of teething themselves. If your baby seems to be in extreme pain or develops a fever or other symptoms of illness, call your pediatrician.
You should wash your baby’s gums with a damp washcloth every day. After the teeth begin to appear, use a small, soft-bristled toothbrush and a smear of toothpaste to brush your baby’s teeth. You should take your baby to a pediatric dentist no later than his or her first birthday.
A sippy cup is a plastic cup with a snap-on or screw-on lid that is used to transition a child from a bottle or breastfeeding to a regular cup. Sippy cups are available with a variety of spouts and with or without handles.
The right age to introduce a sippy cup varies from child to child. Some are ready at six months old, while others don’t start using a sippy cup until their first birthday. Most babies are ready between seven and nine months.
Start with a soft, nipple-like spout that will be familiar to your baby. Show your baby how to raise the sippy cup to his or her mouth and tilt it to drink, but don’t share a cup with your baby because that could spread bacteria. It may take some time for your baby to get used to using it properly. You can try a variety of kinds until you find a sippy cup that works well for your baby.
You can give your baby half of the formula in a bottle and the rest in a sippy cup. You can help your baby get used to the sippy cup by dipping the tip of the spout in breast milk or formula.
Touch the spout to the roof of your baby’s mouth to encourage your baby to suck. You can also put a bottle nipple (without a bottle) in your baby’s mouth and switch to a sippy cup after the baby starts to suck.
If your baby sucks on the spout but can’t get any liquid to come out, try removing the valve or cutting a slit in it. Some babies find it easier to drink from a straw than from a spout. You can put a very small amount of liquid in the sippy cup and teach your baby to drink without the lid, and then replace the lid.
Some babies will drink water, juice, or whole milk from a sippy cup, but not breast milk or formula. Babies can have small amounts of juice at six months, but they should not have cow’s milk until one year. Babies should have no more than 32 ounces of milk and a half cup of juice per day. If your child is thirsty at other times, fill the sippy cup with water.
You should not let your child take a sippy cup to bed or walk around drinking from it for long periods of time because that can contribute to tooth decay. A sippy cup may present a challenge when it comes time to wean your child, but there is less potential for tooth decay with a sippy cup than with a bottle.
Thoroughly wash the sippy cup, especially the lid and plastic stopper, between uses to prevent the growth of bacteria and mold. Some research has noted possible health problems associated with bisphenol A in bottles and sippy cups. Look for a sippy cup that is BPA-free. Don’t let your child drink from a sippy cup that is scratched or damaged because it can be contaminated with bacteria. If the cup contains BPA, some of it could be released.
Making sure toddlers get adequate nutrition is important as they transition from breast milk or formula to a varied diet. Here are some guidelines to help you make sure that your toddler is getting enough essential vitamins and nutrients.
Toddlers generally need about 1,000 to 1,400 calories per day. The exact amount will depend on your child’s activity level, age, and size. Use your judgment and monitor your toddler’s behavior for indications of when he or she has had enough to eat.
The MyPlate food guide provides recommendations for the food needs of toddlers. For a child 12 to 24 months old, follow the guidelines for a 2-year-old, but be aware that your child may not need that much food yet.
A 2-year-old needs three ounces of grains, while a 3-year-old needs four to five ounces. Half of that should be from whole grains. One ounce equals one slice of bread, one cup of ready-to-eat cereal, or ½ cup of cooked rice, pasta, or cereal.
A 2-year-old should eat one cup of vegetables per day, and a 3-year-old should eat 1 ½ cups. Make sure vegetables are well-cooked and cut into small pieces.
Both 2- and 3-year-olds should eat one cup of fruit per day. For reference, a banana is one cup.
A 2- or 3-year-old should consume two cups of milk or other dairy products per day. One cup equals 1 ½ ounces of natural cheese, two ounces of processed cheese, or one cup of yogurt.
A 2-year-old should eat two ounces of meat and beans every day, while a 3-year-old should eat three to four ounces. One ounce is equivalent to ¼ of cooked dry beans or one egg.
Toddlers should get 700 milligrams of calcium and 600 international units of vitamin D every day. You can meet the calcium requirement with two servings of dairy products, but your child may need vitamin D supplements. Discuss this with your pediatrician. Children 12 to 24 months old should drink whole milk for normal growth and brain development, unless there is concern about overweight or obesity or a family history of obesity, high cholesterol, or heart disease. In that case, your doctor may recommend 2% milk. After age 2, most children can drink 1% or non-fat milk.
If your child doesn’t like the taste of milk and is at least a year old, you can mix cow’s milk with breast milk or formula and gradually increase the amount of cow’s milk. If your child is unable to drink milk or eat dairy products for medical reasons, try other products, such as calcium-fortified soy beverages, juices, breads, and cereals; cooked dried beans; and dark green vegetables, such as broccoli, bok choy, and kale.
After they are weaned off iron-fortified formula and cereal, toddlers are at risk for iron deficiency, which can affect growth, learning, and behavior. Cow’s milk is low in iron and can reduce the absorption or lead to loss of iron. Limit your child to 16 to 24 ounces of milk per day, and serve iron-rich foods, such as meat, poultry, fish, enriched grains, beans, and tofu, with foods that contain vitamin C, such as tomatoes, broccoli, oranges, and strawberries, to improve absorption. Continue to give your child iron-fortified cereal until 18 to 24 months.
If you are concerned about your toddler’s nutrition, discuss it with your pediatrician. Never give your child a vitamin or mineral supplement without discussing it with your doctor.
You will know that you can start to introduce solid food when your baby is able to sit up well and hold up his or her head. Your baby should also stop trying to push food out with his or her tongue. Your baby may also begin to make chewing motions and seem hungry even after eight to 10 feedings per day of breast milk or formula. Your baby will probably begin to show interest in foods that you are eating. Most babies are ready to try solid foods when they have doubled their birth weight and are at least four months old.
When introducing solid foods, you should first give your baby breast milk or formula. Then give the baby pureed solid food, such as sweet potatoes, squash, applesauce, bananas, peaches, or pears, or a small amount of single-grain cereal mixed with enough breast milk or formula to make it semi-liquid. Use a soft-tipped plastic spoon, and begin with a small amount of food on the tip of the spoon. Do not add cereal to your baby’s bottle, because he or she may not realize that food is meant to be eaten with a spoon while sitting up. After your baby gets used to eating pureed or semi-liquid foods, you can progress to strained or mashed food, and then to small pieces of finger foods.
Introduce new foods one at a time, and wait at least three days to see if your baby has an allergic reaction before introducing a different food. Symptoms of an allergic reaction include diarrhea, vomiting, swelling in the face, wheezing, or a rash. Your pediatrician may recommend that you wait to introduce foods that have a greater likelihood of causing an allergic reaction, such as soy, dairy, eggs, wheat, fish, and nuts.
You do not need to introduce foods in any particular order. If your baby doesn’t seem interested in a particular food, wait a week and try again.
Begin feeding your baby solid food once a day, and give him or her time to get used to the spoon and swallowing food. You can gradually increase the amount of solid food and mix less breast milk or formula with the cereal. Feed your baby solid food once a day at first, then twice a day at six or seven months, and then three times a day at eight months. If your baby leans back in the chair, turns his or her head away from the food, plays with the spoon, or refuses to open his or her mouth, your baby has had enough to eat.
If you are feeding your baby jars of baby food, put some in a bowl and feed your baby from that. If you put the spoon in your baby’s mouth and dip it back in the jar, you will not be able to use the leftover food later. Throw away any jars of unused baby food within two days of opening them.
You can start feeding your baby in a car seat or bouncy seat and switch to a high chair when your baby is able to sit up on his or her own.
Your baby’s stools may smell different and become firmer after you introduce solid food. If your baby becomes constipated, avoid rice cereal, bananas, and applesauce and give other fruits and vegetables and oatmeal or barley cereal instead. You can also offer your baby two to four ounces of water in a sippy cup.
; mso-bidi-language: AR-SA;”>You should still give your baby breast milk or formula until one year of age. Solid food cannot replace all of the vitamins, iron, and protein in breast milk or formula.
Many parents have heard conflicting advice on whether or not they should let their baby suck on a pacifier. Pediatricians say there are pros and cons.
A pacifier can be an effective way to calm a crying baby. Babies soothe themselves through their suck reflex. Some babies do not get enough time with a bottle or breastfeeding and may benefit from sucking on a pacifier. It is also easier to get a child to stop sucking on a pacifier than to stop sucking on a thumb.
The American Academy of Pediatrics recommends that parents let a baby fall asleep with a pacifier for the first year to reduce the risk of sudden infant death syndrome (SIDS). It is helpful to have the baby suck on the pacifier while falling asleep, but there is no additional benefit after the baby has already fallen asleep.
There are potential downsides to allowing your baby to suck on a pacifier. If a pacifier is introduced too early, a baby who is just learning to nurse may become confused. You should wait to introduce a pacifier until after your baby has gotten used to nursing, which typically takes a few weeks. Parents also sometimes offer their baby a pacifier when the baby is really hungry.
A study has found that children who use pacifiers are more likely to develop ear infections. Researchers believe this may be due to a change in pressure between the middle ear and the upper throat.
Babies who suck on a pacifier too much can develop misaligned teeth if the mouth becomes fixed in an unnatural position. Talking with a pacifier in the mouth can also lead to speech problems.
If you decide to give your baby a pacifier, check the label to be sure it is the right size for your child’s age. Select a pacifier with a symmetrical nipple and a shield that is wider than your baby’s mouth and has air holes. Choose a bisphenol A-free plastic pacifier. Studies have shown that some plastics can disrupt infants’ endocrine systems.
You should never put a pacifier on a cord around your baby’s neck or crib because the baby could be strangled. You should not allow children to share a pacifier. Do not dip the pacifier in anything sweet, especially not honey, before giving it to your baby. If the pacifier falls on the floor, rinse it well, or better, clean it with soap and water.
Pediatricians are divided on when is the appropriate time to wean a child off a pacifier, with some suggesting nine to 12 months and others saying by three years.
When you decide that it is time for the pacifier to go, tell your child in advance so that he or she is prepared. You can gradually wean your child off the pacifier by limiting its use to certain rooms or times and by not putting it back in your baby’s mouth if it falls out at night. You can cut the pacifier, show your child that it is damaged, and throw it away together. Never give a damaged pacifier to your child. Many children naturally lose interest in a pacifier around six to 12 months of age. Once you have decided that your child should give up the pacifier, be consistent and do not give in if your child asks for it.
Co-sleeping, or the practice of parents sharing a bed with their infant, is controversial in the United States. Some parents and doctors believe it is beneficial, while others believe it poses safety risks.
Advocates of co-sleeping believe it promotes breastfeeding by making it more convenient and makes it easier for a nursing mother to attune her sleep cycle to her baby’s. It can also help infants to fall asleep more quickly, especially in their first few months of life and when they wake up in the middle of the night. Co-sleeping can help babies to sleep more during the night because they wake up more often and feed for shorter periods of time, which can allow them to get more total sleep. Co-sleeping can help parents who are away from their infants during the day feel a sense of closeness to them. Some researchers believe it can reduce the risk of sudden infant death syndrome (SIDS) because babies and parents wake up more frequently.
Opponents of co-sleeping say it poses a risk of suffocation and strangulation. Parents, caregivers, or siblings can roll onto or against the baby while sleeping. Some researchers believe co-sleeping can contribute to SIDS, but the research is unclear and ongoing. Co-sleeping with a parent who smokes may increase the risk of SIDS. A baby can suffocate if it becomes trapped between a mattress and headboard, wall, or other object. It can also suffocate from being face-down on a waterbed, regular mattress, pillow, blanket, or quilt. Infants can be strangled if they get their heads caught in spaces in a bed frame.
Co-sleeping can also make it difficult for parents to get a good night’s sleep. An infant who co-sleeps may have trouble falling asleep at naptime or when the baby needs to go to sleep before the parent is ready.
If you choose to co-sleep, always place your baby on its back with its head uncovered. Be sure that your headboard and footboard do not have spaces where your baby’s head could get caught and that your mattress fits snugly in the frame to prevent the infant from getting trapped between the mattress and the frame. Never allow your baby to sleep in an adult bed alone. Do not let the baby sleep on a soft surface, such as a soft mattress, sofa, or waterbed. Do not use pillows, comforters, quilts, or other soft or plush items. Use a sleeper instead of blankets. Do not drink alcohol or take medication or drugs that could prevent you from waking up or cause you to roll over onto the infant. Keep your bed away from draperies or blinds so that your baby will not be strangled by cords.
If you want to keep your baby close to you but not in your bed, you can place a bassinet, crib, or play yard in your bedroom. You can also use a device that looks like a bassinet or play yard with one side missing that attaches to your bed and will prevent you from rolling over onto your baby.
If you are co-sleeping, talk to your doctor about when to transition your baby to sleeping in a crib. Making the switch before six months of age is usually easier because the co-sleeping habit is not yet ingrained and other developmental issues, such as separation anxiety, have not yet emerged.
Finding the best day care for your child can be a confusing, stressful process. Here are some expert tips to consider.
A high-quality day care should help children develop socially, emotionally, cognitively, and physically so that they are ready for school when the time comes. Keep these aspects of development in mind when choosing a program.
Ask family and friends for recommendations, and research options in your area. Facilities accredited by the National Association for the Education of Young Children meet strict standards for quality. If you are looking for a home-based day care, look for a provider accredited by the National Association for Family Child Care. The National Association of Child Care Resource and Referral Agencies provides lists of state-licensed facilities, inspection reports, state fact sheets, and information on day care and family child care regulations. There are no federal standards for day care centers, and licensing and regulations vary by state.
Children should be supervised at all times, and there should be low teacher-to-child ratios. There should be one teacher for every three to four infants or young toddlers, for every four to six older toddlers, or for every six to nine preschoolers to ensure that your child receives necessary one-on-one attention.
Classrooms should be well-organized and include a wide array of age-appropriate toys and materials. Staff should follow daily and weekly schedules that include a variety of activities, such as art, music, outdoor play, reading, and dramatic play.
Teachers’ education is also important. Teachers should have degrees in early childhood education and receive regular professional development to improve their skills.
Ask about the program’s policies on a wide variety of health and safety issues, including immunizations, hand washing, diaper changing, illnesses, injuries, and emergency procedures. All staff should have undergone a background check and should be certified in CPR and first aid. Be extra careful when looking at family child care providers, since they are less strictly regulated than child care centers.
Look for a licensed facility that asks for input from parents and staff to improve their program and offers teachers professional development. You and the staff should share the same core values and be able to communicate freely at all times to support the growth and progress of your child.
Child development experts agree that having children perform household chores teaches teamwork and a strong work ethic. Everyone needs to feel needed, and chores are a great way to build your child’s sense of responsibility and self-worth, while decreasing the burden on you and your spouse.
What are some age-appropriate chores that your child can perform? The experts at WebMD have some suggestions:
Children two to three years old can put their toys away, feed pets, put their dirty clothes in the hamper, clean up spills, dust, and stack books and magazines. Four- and five-year-olds can make their beds, bring in the mail or newspaper, clear the table, water flowers, unload utensils from the dishwasher, and wash plastic dishes in the sink. A six- or seven-year-old can sort laundry, sweep the floor, set and clear the table, help make lunch, and clean his or her bedroom.
Make a list of all the chores that need to be done to enable your home to run smoothly. Allow children to choose which chores they want to do so they will be less likely to complain and try to avoid doing them. Children tend to respond well if they feel that they have choices.
Create a chores chart that lists each chore, whose responsibility it is, the deadline for getting it done, and a space to place a check mark when it has been completed. You can make two charts – one for daily chores and another for weekly ones.
Teach your child how to do chores gradually. Start out by showing the child how to do the chore step-by-step, then let your child help you. After that, allow the child to do the chore while you supervise, and finally allow him or her to do it alone, without supervision.
Make sure you set clear expectations and explain why it is necessary for the chore to be done, and set consequences if the chore is not done. Offer praise for a job well done, but don’t expect your child to do the chore perfectly right away. If the child falls short, offer suggestions for improvement, but don’t do the chore yourself. Most importantly, be consistent, and your family will be able to work together to get chores done so that you will be able to spend more quality time together.