A Word on Wipes.

Although we haven’t officially counted, there have to be about as many brands and types of wipes as there are tennis shoes—environmentally friendly all-natural wipes, scented and unscented, with aloe and without, in round containers, in rectangular refillable containers, and packaged in reusable or disposable travel packs. And while they may only cost a few cents a wipe if you don’t go for the top of the line or opt for fancy packaging, the cost can really add up. While the principles discussed in the “Buying Diapers” section generally apply to buying wipes as well, here are a few additional things to consider when buying and using wipes.

• Packaging. After one look at the shelves, you won’t need us to tell you that when it comes to buying wipes, you pay for packaging. However, doing so is not always a bad thing. For example, someone who clearly had firsthand experience in the use of wipes on the go must have come up with the handy little travel-sized packs, and many parents find the added convenience well worth the extra money. That said, it is useful to hang on to reusable plastic travel containers. By simply buying large refill packs and restocking them yourself, you can save yourself the extra expense. 
• Don’t flush ’em. Enough said—almost. There are very few wipes on the market that don’t have the potential to wreak havoc on your plumbing. Be sure to check package labels before buying if you are determined to find wipes that are flushable, because most of them are not.
• The overuse of wipes. Believe it or not, not every diaper change requires the use of wipes. This is not only because pee rarely irritates the skin, but also because today’s super-absorbent disposable diapers effectively limit the amount of pee that even comes into contact with the skin. Reserving wipes for cleaning up poop can save you a considerable amount. Also keep in mind that a moist tissue, a wet washcloth, or even a quick rinse in the tub may be used in place of baby wipes when convenient.

Preparing Your Family for a New Baby.

How should we prepare our older children for their new baby brother or sister?

A new baby brings joys and challenges to a family. Parents are excited but they are also nervous about how their older children will react to the newborn. All sorts of questions come up: How should we tell our older children that they are going to have a baby brother or sister? Will they be jealous of the new baby? How can we help them get along?

Children of different ages will react differently to a new baby. Knowing what to expect from each age group will make it easier to handle the changes in your family.

Ages 1 To 2 Years

Children of this age will not understand much about what it means to have a new brother or sister. However, let your child hear you talk about the "new baby" and feel your excitement. She may not understand why you are excited, but your attitude will rub off on her and she will feel excited too.

Keep in mind, you may not be able to satisfy the needs of both children all the time—especially not by yourself. If you feel overwhelmed, look to your spouse, other relatives, and friends for support and an extra set of arms.

Other ideas to help prepare your very young child for a new sibling include

• Look at picture books about a new baby. At the very least, your child will become familiar with words like "sister," "brother," and "new baby."
• When the new baby arrives, try to do something special for your older child to reassure her she is still loved. Some ideas include giving her a special gift; letting her spend some time alone with dad, grandma, or another special adult; or taking her someplace special.

Ages 2 To 4 Years

At this age, your child is still very attached to you and does not yet understand how to share you with others. Your child also may be very sensitive to change and may feel threatened by the idea of a new family member. Here are some suggestions that may help ease your preschooler into being a big brother or big sister.

• Wait a while before telling your preschooler about the baby. Explain it to your child when you start buying nursery furniture or baby clothes or if he starts asking about mom's growing "stomach." Picture books for preschoolers can be very helpful. So can sibling classes (ask your hospital if it offers them). Try to tell your child before he hears about the new baby from someone else.
• Be honest. Explain that the baby will be cute and cuddly but will also cry and take a lot of your time and attention. Also, make sure that your older child knows that it may be a while before he can play with the new baby. Reassure your child that you will love him just as much after the baby is born as you do now.
• Involve your preschooler in planning for the baby. This will make him less jealous. Let him shop with you for baby items. Show him his own baby pictures. If you are going to use some of his old baby things, let him play with them a bit before you get them ready for the new baby. Buy your child (boy or girl) a doll so he can take care of "his" baby.
• Time major changes in your child's routine. If you can, finish toilet training or switching from a crib to a bed before the baby arrives. If that is not possible, put them off until after the baby is settled in at home. Otherwise, your child may feel overwhelmed by trying to learn new things on top of all the changes caused by the new baby.
• Expect your child to regress a little. For example, your toilet-trained child might suddenly start having "accidents," or he might want to take a bottle. This is normal and is your older child's way of making sure he still has your love and attention. Instead of telling him to act his age, let him have the attention he needs. Praise him when he acts more grown-up.
• Prepare your child for when you are in the hospital. He may be confused when you leave for the hospital. Explain that you will be back with the new baby in a few days.
• Set aside special time for your older child. Read, play games, listen to music, or simply talk together. Show him that you love him and want to do things with him. Also, make him feel a part of things by having him cuddle next to you when you feed the baby.
• Ask family and friends to spend a little time with your older child when they come to see the new baby. This will help him feel special and not left out of all the excitement. They might also give him a small gift when they bring gifts for the baby.
• Have your older child spend time with dad. A new baby presents a great opportunity for fathers to spend time alone with older children.

School-Aged Children

Children older than 5 years are usually not as threatened by a new baby as younger children are. However, they may resent the attention the new baby gets. To prepare your school-aged child for a new baby,

• Tell your child what is happening in language she can understand. Explain what having a new baby means and what changes may affect her—both the good and the not so good.
• Have your older child help get things ready for the new baby by fixing up the baby's room, picking out clothes, or buying diapers.
• If possible, have your older child come to the hospital soon after the baby is born so she feels part of the growing family.
• When you bring the new baby home, make your older child feel that she has a role to play in caring for the baby. Tell her she can hold the baby, although she must ask you first. Praise her when she is gentle and loving toward the baby.
• Do not overlook your older child's needs and activities. Let her know how much you love her. Make an effort to spend some time alone with her each day; use that as a chance to remind her how special she is.

Baby's First Days: Bowel Movements & Urination

Urination

Your baby may urinate as often as every one to three hours or as infrequently as four to six times a day. If she’s ill or feverish, or when the weather is extremely hot, her usual output of urine may drop by half and still be normal. Urination should never be painful. If you notice any signs of distress while your infant is urinating, notify your pediatrician, as this could be a sign of infection or some other problem in the urinary tract.

In a healthy child, urine is light to dark yellow in color. (The darker the color, the more concentrated the urine; the urine will be more concentrated when your child is not drinking a lot of liquid.) Sometimes you’ll see a pink stain on the diaper that you may mistake for blood. In fact, this stain is usually a sign of highly concentrated urine, which has a pinkish color. As long as the baby is wetting at least four diapers a day, there probably is no cause for concern, but if the pinkish staining persists, consult your pediatrician.

The presence of actual blood in the urine or a bloody spot on the diaper is never normal, and your pediatrician should be notified. It may be due to nothing more serious than a small sore caused by diaper rash, but it also could be a sign of a more serious problem. If this bleeding is accompanied by other symptoms, such as abdominal pain or bleeding in other areas, seek medical attention for your baby immediately.

Bowel Movements

Beginning with the first day of life and lasting for a few days, your baby will have her first bowel movements, which are often referred to as meconium. This thick black or dark-green substance filled her intestines before birth, and once the meconium is passed, the stools will turn yellow-green.

If your baby is breastfed, her stools soon should resemble light mustard with seedlike particles. Until she starts to eat solid foods, the consistency of the stools may range from very soft to loose and runny. If she’s formula-fed, her stools usually will be tan or yellow in color. They will be firmer than in a baby who is breastfed, but no firmer than peanut butter.

Whether your baby is breastfed or bottle-fed, hard or very dry stools may be a sign that she is not getting enough fluid or that she is losing too much fluid due to illness, fever, or heat. Once she has started solids, hard stools might indicate that she’s eating too many constipating foods, such as cereal or cow’s milk, before her system can handle them. (Whole cow’s milk is not recommended for babies under twelve months.)

Here are some other important points to keep in mind about bowel movements:

• Occasional variations in color and consistency of the stools are normal. For example, if the digestive process slows down because the baby has had a particularly large amount of cereal that day or foods requiring more effort to digest, the stools may become green; or if the baby is given supplemental iron, the stools may turn dark brown. If there is a minor irritation of the anus, streaks of blood may appear on the outside of the stools. However, if there are large amounts of blood, mucus, or water in the stool, call your pediatrician immediately. These symptoms may indicate an intestinal condition that warrants attention from your doctor.
• Because an infant’s stools are normally soft and a little runny, it’s not always easy to tell when a young baby has mild diarrhea. The telltale signs are a sudden increase in frequency (to more than one bowel movement per feeding) and unusually high liquid content in the stool. Diarrhea may be a sign of intestinal infection, or it may be caused by a change in the baby’s diet. If the baby is breastfeeding, she can even develop diarrhea because of a change in the mother’s diet.
• The main concern with diarrhea is the possibility that dehydration can develop. If fever is also present and your infant is less than two months old, call your pediatrician. If your baby is over two months and the fever lasts more than a day, check her urine output and rectal temperature; then report your findings to your doctor so he can determine what needs to be done. Make sure your baby continues to feed frequently. As much as anything else, if she simply looks sick, let your doctor know.

The frequency of bowel movements varies widely from one baby to another. Many pass a stool soon after each feeding. This is a result of the gastrocolic reflex, which causes the digestive system to become active whenever the stomach is filled with food.

By three to six weeks of age, some breastfed babies have only one bowel movement a week and still are normal. This happens because breastmilk leaves very little solid waste to be eliminated from the child’s digestive system. Thus, infrequent stools are not a sign of constipation and should not be considered a problem as long as the stools are soft (no firmer than peanut butter), and your infant is otherwise normal, gaining weight steadily, and nursing regularly.

If your baby is formula-fed, she should have at least one bowel movement a day. If she has fewer than this and appears to be straining because of hard stools, she may be constipated. Check with your pediatrician for advice on how to handle this problem.

World Breastfeeding Week

1–7 August 2012

World Breastfeeding Week is celebrated every year from 1 to 7 August in more than 170 countries to encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding.

Breastfeeding is the best way to provide newborns with the nutrients they need. WHO recommends exclusive breastfeeding until a baby is six months old, and continued breastfeeding with the addition of nutritious complementary foods for up to two years or beyond.

World Hepatitis Day

28 July 2012

WHO World Hepatitis Day is marked to increase the awareness and understanding of viral hepatitis and the diseases that it causes. It provides an opportunity to focus on specific actions such as:

• strengthening prevention, screening and control of viral hepatitis and its related diseases;
• increasing hepatitis B vaccine coverage and integration into national immunization programmes; and
• coordinating a global response to hepatitis.

Hepatitis viruses A, B, C, D and E can cause acute and chronic infection and inflammation of the liver leading to cirrhosis and liver cancer. These viruses constitute a major global health risk with around 240 million people being chronically infected with hepatitis B and around 150 million people being chronically infected with hepatitis C.

A Special Message to New Fathers

While this time can be challenging for new fathers, it can also be uniquely rewarding.

Adjusting Priorities

Just as mothers occasionally need to readjust their priorities, fathers now have a golden opportunity to show more of their nurturing side by caring for Mom, the baby, and possibly other siblings. Although not all fathers have the option of paternity leave from work, those who do and take advantage of it may find it priceless. If Mom was the center of a sibling’s universe and Dad was only an afterthought, Dad may suddenly be more “cool” once a newborn comes home. By adjusting his priorities (at home and at work) and “rising to the occasion,” Dad can strengthen an already strong bond with Mom as well as with the new child. By working as a team, parenting couples may be amazed at how well they can adapt to their new, stressful circumstances.

Teamwork

Of course, balancing the seemingly constant demands of the baby, the needs of other children, and the household chores is not always easy. Nights spent feeding, diapering, and walking the floor with a crying baby can quickly take their toll in fatigue for both parents. But by working as a team to relieve each other for naps, for exercise, and for “downtime,” parenting couples might find that even though they share less “quality time” together, they may actually feel closer than ever. Sometimes there may be conflict and jealous feelings. These are normal, and thankfully, temporary. Life soon settles into a fairly regular routine that will once again give you some time to yourselves and restore your sex life and social activities to normal. Meanwhile, make an effort for just the two of you to spend some time together each day enjoying each other’s company while the baby is sleeping or somebody else is caring for her. Remember, you’re entitled to hold, hug, cuddle, and kiss each other as well as the baby.

Playing with Baby

A positive way for men to deal with these issues is to become as involved as possible in caring for and playing with the new baby. When you spend this extra time with your child, you’ll get just as emotionally attached to her as her mother will.

This is not to say that moms and dads play with babies the same way. In general, fathers play to arouse and excite their babies, while mothers generally concentrate on more low- key stimulation such as gentle rocking, quiet interactive games, singing, and soothing activities. From the baby’s viewpoint, both play styles are equally valuable and complement each other beautifully, which is another reason why it’s so important to have both of you involved in the care of the baby.

FEEEDING GUIDELINES FOR PARENTS

Parents’ responsibilities include: 

• Choosing food 
• Setting routine 
• Creating a positive, nonstressful mealtime environment 
• Being a role model for their child

• Regarding mealtime as a family time

Parents need to:

 •Offer new foods repeatedly (8-10 times) to establish acceptance or rejection of that

food 

•Offer 3 meals and 2 healthful snacks per day 

•Teach skills such as handling of spoons and drinking from a cup to encourage self-feeding.