Mother’s Guide

A life after maternity hospital (A must read for mothers of new born babies)

Congratulations on the arrival of your little one! Nothing compares to the joy of bringing your first baby home from the hospital. And nothing compares to the terror of those first few hours at home, when you and your partner realize that you have absolutely no idea how to care for this initially adorable, now screaming newborn. But don’t fear: although it’s hard to imagine right now, within a few weeks you’ll have a routine down. In the meantime, take a deep breath, focus your bleary, sleep-deprived eyes and read up. We’ve got everything you need to know to care for your baby, from sleep tips to games to feeding and introducing foods.

You’ve puffed, panted, pushed, and perhaps even let out a shriek or two. Now the newest member of your family is finally here, more beautiful than you might ever have imagined. Take a second to enjoy it, because you’re about to get caught up in the whirlwind of new parenthood. Before you know it, the nurses will have given you a crash course in newborn care, wished you luck, and whisked you out of the hospital and into the beginning of your life as a mother.

Suddenly you realize that, although you spent weeks preparing for labor and delivery, there was scant to no preparation for the many life changes that accompany the appearance of that much-anticipated baby. Although people mentioned that you’d be sore and sleep-deprived, no one really told you anything else about what life with a newborn is like. They didn’t warn you about the occasional hours of nonstop crying. They also didn’t mention the indescribable joy of seeing that precious little one asleep in the crib, thumb in mouth, tiny bottom sticking up in the air. There’s no parenthood orientation, no job description—it’s just you, your partner, and baby, all hanging in there as best you can and taking it hour by hour, day by day.

Don’t be concerned if you don’t feel an instantaneous connection with your baby. Dr. Samuel J. Meisels, President of the Board of Zero to Three, a national organization for infants, toddlers, children and families, says bonding doesn’t always take place in the immediate post-partum period. Especially if there’s been a difficult delivery or if Mom and baby are separated immediately after birth; it may take some time for parents to feel the kind of love that we expect to experience right away. “Don’t worry if there isn’t that ecstatic moment after birth,” he says. “You will still attach to your child and develop a loving relationship.”

The transition from not-parent to parent is a huge one, agrees Rebecca Shahmoon Shanok MSW, PhD, Founding Director of the Institute for Infants, Children, and Families, which is part of the Jewish Board of Family and Children Services in New York City.

“It’s important to recognize that you are not going to be a perfect mother,” she says. “You and your spouse will be cranky and tired at times—it just goes with the territory. You have completely new responsibilities, and holding that fragile-looking infant makes it obvious just how much your baby needs you. It takes time to grow into your new role, to really feel like a parent. It may take six months or even a year,” she explains, adding that, “You need to tell yourself, ‘I may not yet feel like a parent but I will develop my capacity to be a good mother by doing what needs to be done, by getting to know my baby, developing a daily routine and allowing myself to grow into my new role at my own pace.’”

Try swaddling your baby for better sleep.

Swaddling is comforting to many newborns because it reminds them of being inside the womb. “Swaddling is a helpful tool, but it is not universal,” explains Dr. Gregory Germain, MD, a pediatrician at Yale-New Haven Children’s Hospital in Connecticut. “Some babies are truly comforted by a tight swaddle, and some babies are irritated by a tight swaddle and do better with their hands free,” he explains.

If you decide to swaddle your baby, be sure he isn’t getting overheated. “At night, over-bundling has been questionably linked to SIDS (via overheating),” says Dr. Karen Sadler, MD, a pediatrician in Boston, Massachusetts. “In general, infants should be clothed in whatever adults need to be comfortable, plus one thin layer.” If your baby feels sweaty or hot in his blanket, try dressing him in nothing but a diaper before swaddling him. If he still feels hot, stop swaddling altogether.

Spoil away!

During the first few months of your child’s life, there’s no such thing as giving too much tender love and care. “Babies need to know that you are there when they are distressed,” says Dr. Germain. “Going to a crying young infant and comforting them is never a bad thing.” While it’s important to let your baby know you’re there for her, it is OK to occasionally let her cry for a minute or two. “If your baby is crying and you’re in the middle of a load of wash, there is no harm in letting your baby cry for a while as you’re finishing your other life duties,” Dr. Germain assures.

Develop a consistent bedtime routine.

Setting a consistent nighttime routine—such as a warm bath and bedtime story—can be a helpful sleep trigger for your baby. It may not work right away, but after a couple of weeks your child will likely fall asleep easier and stay asleep longer. According to Dr. Robert Jacobson, MD, chairman and professor of pediatrics with the Mayo Clinic in Rochester, Minnesota, this bedtime routine should include creating a peaceful setting in the home. “As twilight comes and the house gets quieter, probably the most important thing in this modern age is to turn the TV off an hour before the baby is going to fall asleep,” he says, explaining that the TV tends to charge the air and keep babies awake.

Let the swing be your friend!

Some people worry that they’ll spoil their baby with a swing, but all bets are off for the first few months of life. If your baby refuses to nap in his crib during the day, but easily falls asleep in his swing, by all means let him swing to his little heart’s content! Keep in mind, you should never leave your baby unattended or let him sleep in the swing through the night. “The American Academy of Pediatrics (AAP) warns that some infants might curl over in a seat and obstruct breathing,” explains Dr. Sadler. “In practice, I think if parents are awake and watching, and the child isn’t small or premature, the swing is OK,” says Dr. Saddler, adding that swings are a good way to get colicky babies to sleep

When can my child sleep with a blanket?

“The best sleep environment is consistent, quiet, dark, and has a steady, slightly cool temperature,” says Dr. Sadler. “Blankets are not bad, per se, but can easily contribute to an overly constricted, over-bundled child. If a child is comfortable and warm enough in sleepwear alone, consider not using a blanket.” Dr. Sadler says if parents do choose to use a blanket for their sleeping child, the fabric should be thin, tucked into the mattress at the foot of the crib, and should come up only to a baby’s chest. It should never cover a baby’s head.

When can my child sleep with a stuffed animal or doll?

Perhaps your little one received the softest, sweetest teddy bear from her grandparents when she was born—you want her to enjoy it, but is it safe to put in the crib with her? “Objects that are soft and fluffy—pillows, some blankets, stuffed animals, and toys—are not recommended for the young infant under about six months,” cautions Dr. Sadler, explaining that if a child wedges his face into these items during sleep, it contributes to his risk of SIDS. “The peak age for SIDS is between four and sixteen weeks.” “After eight months or so and into the toddler years, children can experience separation anxiety as their parents leave them to go to sleep. In this situation a toy or stuffed animal, as long as it is safe, can be the transitional object that a child uses to soothe himself in the absence of his parents,” says Dr. Sadler.

How do I know when my child is ready to go to sleep without a bedtime bottle or nursing?

“There are two separate issues in this question,” says Dr. Sadler. “The first is the need for food before sleep. Most infants ‘fill up’ before sleep, which enables them to maximize their night sleep stretch. A small pre-bed snack is appropriate right through the toddler years as part of a bedtime routine.”

Using a feed to get to sleep is a separate issue, says Dr. Sadler. “After three to four months of age, when a child can usually sleep a six- to eight-hour night, it becomes important not to inadvertently teach a child to rely on a bottle or the breast to fall asleep.” She recommends that children be fed, then put in their cribs sleepy but still awake. “This way, when they awaken at night, they won’t demand a feed to transition back to sleep which disrupts the night for parents.”

Is there a certain age when my child will stop needing a nap?

Just as all children are different, they vary widely in when they drop their daytime sleeping. “Some active one-year-olds are already not napping (or substituting quick ‘cat naps’ instead) while some five-year-olds are still sleeping after their morning kindergarten,” says Dr. Sadler. “If provided a consistently structured day, however, most children are pretty good about getting the sleep they need. For the child who truly needs the sleep and isn’t getting it, behavioral clues are crankiness, low energy or lack of focus.”

When you first breastfed your tiny newborn, you probably couldn’t imagine a time when he’d be ready for solid foods. Now that he is, you may be a little daunted about how to begin. But relax: As long as you’re following the recommendations of the World Health Organization and American Academy of Pediatrics (AAP) to breastfeed exclusively for six months, your baby’s digestive system will be mature enough to handle a wide variety of healthy foods. That means there are few hard-and-fast rules about the order you can introduce solid foods to your baby’s diet. Here’s what you need to know about baby food, including which foods to delay because of potential allergic reactions or choking hazards.

Precautions and getting started

There are a couple of important precautions to keep in mind. Introduce one new food at a time, and wait a few days before you introduce the next, says the American Dietetic Association. This way if your baby has a reaction — such as a rash, diarrhea, vomiting or wheezing — you’ll be able to identify the culprit. If there are any allergies in your family (that could mean anything from hives when you eat strawberries, to hay fever, eczema or anaphylaxis) you might want to talk to her doctor about extra safety measures. If you have any questions about your baby’s readiness for certain foods, don’t hesitate to bring it up at her next checkup or talk to a dietitian. (There are a few foods best left for later. See Waiting List, below.)

So how do you begin? The conventional method used to be to start baby on iron-fortified infant cereal somewhere between four and six months. Many people still start with cereal because it’s easy to prepare and a good source of iron. But you don’t have to. Look to what’s local, seasonal and on your table. “If the rest of the family is enjoying peaches because they’re in season, put half a peach through a hand-held food grinder with some liquid to make a purée,” she says Ellen Desjardins, public health nutritionist with the Region of Waterloo Public Health in Ontario, Canada.

Whatever you’re serving, start with about a tablespoon. Give your baby that taste of something new when she’s happy, not just before bedtime or when she’s ravenous. Keep the experience positive. Don’t force her to eat a food she doesn’t like, but do introduce it again in a few days or weeks — sometimes it takes a few tries. You’ll know she’s had enough from cues like closing her mouth or turning her head away.

Managing baby's diet

Babies need dietary iron starting at about six months. (They’re born with stores of iron that run out around four months. If yours has been on non-iron-fortified formula, make the switch to iron-fortified formula at this time.) While your baby does get iron from breastmilk or some formulas, it’s a good idea to introduce an additional source of iron as an early food. Baby cereal is one good source, but there are others. When babies were given solids at a younger age, meat was one of the last items introduced because of concerns about giving a small baby a big load of protein, says Desjardins. But after six months, you can give your baby some well-cooked, puréed meat, even if you’ve just started solids. Or she might prefer ground-up cooked beans. Limit deli meats because they contain a lot of salt and additives.

If you like, you can prepare all your baby’s food from fresh ingredients, but commercial baby food is perfectly acceptable, too. Choose a single food rather than a combo at first. Don’t contaminate the jar by spooning food directly from the jar into baby’s mouth — put what you need in a dish so the uncontaminated jar can go back in the fridge. Food is good there only for three days after opening.

Unfamiliar foods

Your baby will begin with smooth puréed foods, but you’ll want to move out of that stage as she becomes ready for different textures. If you’re using a manual food grinder or tiny food processor, gradually reduce the amount of liquid for a chunkier consistency.

When you’re introducing a new texture, sit with your baby so you can see how he handles the unfamiliar food. Show him how you chew with exaggerated chewing motions. “If he gags terribly, wait a bit longer,” says Desjardins. “But remember that gagging is a natural reflex. It just means he’s not used to the lumpier texture.” Later, you can mash cooked vegetables with a fork. Around nine months you can move to finger foods — well-cooked little pieces that your baby can grip between his thumb and index finger.

Some babies like thawed frozen peas or blueberries, still cold. Your baby probably won’t be much good with a spoon until he approaches a year and a half.

These are messy times, but when your baby squishes some banana through his fingers, he’s just discovering his food. Along with healthy meals, your child gets a lot of important messages at the table. He learns that a meal is a sociable time when he gets to enjoy the companionship of his family and he learns about good food choices.

Can I Start Solids Earlier Than Six Months?

While it’s not recommended, plenty of parents start their babies on solids a little ahead of schedule. If you’re tempted to begin before six months — perhaps because your baby is on the bigger side or displays signs of readiness like reaching for your food at the table — keep in mind that baby’s digestive system and swallowing ability are less mature, and that there’s no benefit to doing so. When you do start, the idea at first is to simply get your baby used to gumming and swallowing purees. Milk will still be the main event. By the time he’s one, a variety of nutritious grown-up foods will have edged out breast milk or formula in your baby’s diet. Meanwhile, remember: There’s no race to get your baby consuming everything under the sun. In fact, a 2006 policy paper from the AAP reported that exclusive breastfeeding in the first half year is correlated to lowered risk of obesity later in life.

If you stop breastfeeding earlier than six months, that doesn’t mean you should start solids. If your baby’s four months old or more, switch to iron-fortified formula, the same as you would do with a four-month-old baby fed non-iron-fortified formula.

Choking Prevention

Some foods pose a significant choking hazard. By far the most dangerous are round, rubbery foods like hot dogs and grapes. These should be cut into quarters until your child is at least four years old and able to chew and swallow steak. Other problem foods include nuts (especially peanuts), raw carrots and seeds like unpopped or partially popped popcorn. Children should be at least three and able to chew and swallow crusty bread before they have these foods. The bits of peanut in chunky peanut butter may also pose a problem.

Here are some tips for avoiding choking problems:

  • Don’t let your child run or tip back in her chair while she’s eating.
  • Be extra vigilant if you’re attending a party or visiting someone else’s home: High-risk foods may be more accessible than at home.
  • Don’t give raw carrots to a teething baby. If she manages to chew off a piece, she could choke.
  • Delay hard candy and gum.

You can be flexible about the order in which you introduce solids, but there are a few foods to leave until later:

7 or 8 months

Wait until now for:

  • Tomatoes, citrus fruits, strawberries and kiwi
  • Wheat
  • Soy
9 months to 1 year

Wait until now for:

  • Whole milk (homogenized 3.25 percent butterfat)
  • Fish
1 year

Wait until now for:

  • Egg whites (although egg yolks are OK after six months)
  • Shellfish
  • Honey
2 years

Wait until now for:

  • Two-percent milk

3 years

Peanut butter – while there’s still controversy about timing, it may be best to wait until now to serve your child peanut butter. You won’t prevent an allergy, but it makes sense to wait until a child’s immune system is more mature. If anyone in your family has a nut or peanut allergy, talk to your doctor about having your child tested first.