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COMPLETE GUIDE TO BABY & CHILD CARE
By PAUL C. REISSER
TYNDALE HOUSE PUBLISHERS, INC.Copyright © 2007 Focus on the Family
All right reserved.
Chapter OnePreparing for Parenthood
Whether you are just beginning to think about starting a family ... or have just learned that you are going to be a mother or a father in a few months ... or are a day or two away from an expected delivery date ... or are planning an adoption ... or have a baby (or two) in your arms ... or have a house full of toddlers, school-age children, adolescents, or a combination of all ages ... or are proud grandparents, this book is dedicated to enhancing the journey you have started.
Parenting is an adventure, a source of incredible fulfillment, a humbling responsibility, and a unique privilege. It's a voyage of discovery with a long learning curve. On many occasions, it brings both laughter and tears. It is, above all, a priceless gift from God-one that deserves to be received with joy and treated with the utmost respect.
Many people enter parenthood unexpectedly, at times even suddenly, often in a state of panic. Nearly everyone who accepts the assignment develops qualms at some point. You may have already progressed from "Am I really ready for all the responsibility of bringing up a child?" to "What am I going to do if ______ happens?" to "How in the world did I get into this?"
If any of those questions havepassed through your mind, take heart, and remember some fundamental truths of parenting:
You're not alone. Many millions have traveled the path before you.
You probably know a lot more than you think.
It's never too late to learn, to mold your attitudes and refine your skills.
Whether you're aware of it or not, the process of becoming a mother or a father actually begins well before the doctor announces, "It's a boy!" or "It's a girl!" It begins before conception. In fact, it begins before the physical intimacy that sets the biological marvel of reproduction in motion.
And for an event of this importance, it's nice, as much as is humanly possible, to be prepared. This chapter is all about getting ready, but it's worth reading even if a lot of water has already passed under your parental bridge.
Fearfully and Wonderfully Made: How a Baby Develops
Many authors and poets, after hearing the cry and seeing the first flailing movements of tiny arms and legs at the moment of birth, have declared that the process of coming into the world is a miracle.
But while childbirth is truly awe inspiring, the real miracles began long before this transition of the baby from one environment to another. If you are expecting an arrival in the near future, be assured that a host of wondrous and marvelous events have already taken place. Just six days after conception, the union of egg and sperm that created a new person, a tiny cluster of 64 to 128 cells embedded in the thickened lining of the uterus. Within seventy-two hours of establishing a temporary residence in the warm sanctuary of the womb, this new human being sent a powerful hormonal signal to override the mother's monthly cycle, preventing the shedding of her uterine lining.
Then began the astonishing process of differentiation, as new cells took on particular shapes, sizes, and functions, aligning themselves into tissues and organs, eyes and ears, arms and legs. Each of these cells contained all of the information needed to make any of the multitudes of cell types in the body. Yet during the process of constructing and organizing, integrating and communicating with one another, individual cells began to express unique qualities in very short order, but in a seamless and orderly pattern. The intricacy and timing of these events are nothing less than masterpieces of planning and engineering.
See color insert for photos of fetal development, page A1-A3.
Before the end of the first six weeks of life, your child's heart has started to beat, eyes are developing, the central nervous system is under construction, most internal organs are forming, and small buds representing future arms and legs have sprouted. One cell created by the union of egg and sperm has now become millions, and your new daughter or son has reached the length of one-quarter of an inch (0.6 cm).
By the end of eight weeks, the fingers and toes have been formed. Heart, lungs, and major blood vessels have become well developed. Taste buds and the apparatus needed for the sense of smell have appeared. Tiny muscles have generated body movements, which at this point a mother cannot feel.
When twelve weeks of growth have ended, your baby has reached a length of three inches (7.6 cm). The heartbeat can be heard using an electronic listening device. All of the organs and tissues-including heart, lungs, brain, digestive system, kidneys, and reproductive organs-have been formed and are in place. The only necessary remaining ingredient is time: six more months for growth and maturation.
Sixteen weeks after conception, eyebrows and hair are growing. Your baby, now measuring six to seven inches (about 15 to 18 cm) and weighing nearly as many ounces (about 170 to 200 gm), kicks, swallows, hiccups, wakes, and sleeps. Soon the mother can begin feeling movement inside, an important milestone still referred to as quickening.
At twenty weeks, with weight now approaching one pound (about 450 gm), your baby can hear and react to sounds, including Mom's heartbeat and stomach rumblings, as well as noise, music, and conversations outside the uterus. (Whether any of these sounds are recognized or become part of early memories is uncertain.)
At twenty-six weeks of life, breathing movements are present, although there is no air to be inhaled. Depending on their weight, babies born prematurely at this time have a 60 to 80 percent chance of survival with expert care, although complications are common.
With each additional week that passes within the mother's womb, the baby's likelihood of surviving a premature delivery improves, the risk of long-term complications declines, and the medical care needed after birth usually becomes less complex.
The final fourteen weeks are the homestretch, during which your baby grows and gains weight very rapidly. By the end of thirty-two weeks, the bones are hardening, the eyes are opening and closing, the thumb has found its way into the mouth, and the arms and legs are stretching and kicking regularly. Your baby is sixteen to seventeen inches (about 40 to 43 cm) long and weighs almost four pounds (about 1.8 kg). Over the next four weeks, the weight nearly doubles, and you feel all sorts of kicks, prods, and pokes much more strongly. A baby born at this age needs some assistance with feeding and keeping warm and could still develop more complicated medical problems as well. However, the vast majority of those born a month or so ahead of schedule do very well.
Finally, after a few more weeks of rapid weight gain (about half a pound per week during the last six weeks of gestation), your baby is fully developed and ready to meet you.
Every mother and father awaits the birth of a child with a mixture of anticipation, excitement, and anxiety. Who is this new person? Will this be a son or a daughter (or more than one)? What will he or she be like? Will she have her mother's eyes? Will he have his father's chin? Will everything be in the right place? Could there have been any problems that occurred silently during the time between conception and birth?
Some of these questions-but certainly not all of them-may be answered by ultrasound or other types of tests before the moment of birth. Furthermore, a baby may have some initial problems that clear up quickly and easily, while a more serious disturbance may not be apparent until a number of days, weeks, or even months have passed. Obviously, everyone involved in the debut of a new life is hoping, praying, and working toward the safe arrival of a healthy baby to a healthy mother. While no one can guarantee this happy outcome, there are many positive steps and basic precautions that can dramatically increase the likelihood of a joyful "special delivery."
Planning Ahead: Lifestyle and Health Questions for the Mother- (and Father-) to-Be
In a very real and practical sense, parenting begins well before the news arrives that a new family member is on the way. The state of the union of the parents-to-be and particularly the health of the mother before pregnancy strongly affect her health during pregnancy, which in turn plays a vital role in the baby's well-being both before and after delivery.
If you are planning to begin a family, or even if your pregnancy is well under way, you would be wise to review the following list of self-assessment questions. Much of what follows is directed toward the mother, but the ongoing health and habits of both parents are very important. (Expectant fathers, please read on.)
One important note: This book is not intended to be a comprehensive resource on pregnancy and childbirth. The information given in this and the next chapter is intentionally limited to parenting before the delivery-matters that specifically affect the health of the baby to be born. This is not to imply that a mother's health is any less important or that her well-being and her child's are not intimately connected. Nevertheless, the length, breadth, and depth of pregnancy care are beyond the scope of this book. If you are pregnant (or may be soon), it is very important that you find a physician who will not only guide you through pregnancy but also recommend books and other materials from which you can learn more about this miraculous process.
How well are you taking care of your (one and only) body?
Imagine what would happen if a strict law were passed declaring that you could buy only one automobile in your lifetime. Suppose the law also included a stiff penalty for riding in anyone else's vehicle. If your car ever became seriously damaged or fell apart, you would have to walk-everywhere. How well would you take care of your one and only car if the only alternative would be a pair of very sore feet? Would you fill its tank with the cheapest grade of no-name gas or find the highest-octane premium fuel on the market? Would you get the oil changed, engine tuned, and wheels aligned on a regular basis or wait for rumbles, rattles, and warning lights to appear before heading for the service station? When you weren't using it, would you keep the car snug in the garage or let the elements beat on it mercilessly day and night?
The analogy to your one and only body should be obvious: If it deteriorates and malfunctions, you can't borrow anyone else's. And neither can your baby. Poor nutrition, smoking, and the use of alcohol and drugs can have a serious impact on your baby's development, especially during the first eight weeks, when the vital organs are under construction. But your pregnancy may not even be confirmed until this period has already passed. Therefore, the habits you develop well before you even think about having a child are very important.
So how are you treating yourself? Specifically:
How's your nutrition?
Contrary to what you may hear on talk shows and infomercials or what you may read on Web sites that promote eccentric diets and expensive supplements, good nutrition does not involve magic formulas, rigid restrictions, or tackle boxes full of vitamins. At the same time, "eating right" isn't just something you should do during pregnancy and then return to a collection of unhealthy food habits. (If your four favorite foods are burgers, soft drinks, doughnuts, and chips, for example, you need to start making some serious changes.)
Instead, you can and should make a decision to choose high-quality foods for a lifetime-not only for yourself, but for your child(ren) as well. In fact, you are probably already familiar with some basic principles of healthy eating that continue to be reinforced by research and consensus among health professionals. You can review these in "Some ABCs of Good Nutrition," beginning on page 771, but for now we want to emphasize a few key points:
When we say that a pregnant woman is "eating for two," it doesn't mean that she should double her food intake. In fact, her overall energy requirements increase by only about 15 percent-roughly 300 calories per day, or the amount contained in a modest snack such as a combination of an apple, an ounce (30 g) of cheese, and an eight-ounce (240 ml) glass of skim milk.
The amount of protein recommended during pregnancy is about 60 grams per day-10 grams more than for a nonpregnant woman. This should not be difficult to obtain from dietary sources such as lean meat, poultry (minus skin), fish, eggs, nuts, dried beans, and peas. Unless specifically advised otherwise by your obstetrician or a registered dietitian, additional high-protein supplements or beverages should not be necessary. A cup (240 ml) of cottage cheese, for example, contains nearly 30 grams of protein, as does half a chicken breast or a quarter pound (120 g) of ground beef. Two eggs contain 12 to 13 grams.
Eat lots of fresh fruits and vegetables-seven or more servings per day. These provide wholesome nutrients, fiber, vitamins, minerals, and a diverse group of compounds called phytochemicals that help protect us from heart disease, cancer, and other disorders. Sample widely from a variety of colors-green, red, yellow, orange, blue, and tan/white-because phytochemicals associated with different colors of fruits and vegetables appear to provide a variety of health benefits.
Gravitate toward whole-grain foods rather than those made from refined or processed grains. Fiber, vitamins, and minerals are lost during refining and processing (though some are replaced), while whole-grain products contain a variety of useful compounds, including antioxidants, phytochemicals, folic acid, B vitamins, iron, and vitamin E.
If you are a vegetarian, you should be able to continue through an entire pregnancy without difficulty, provided that you include a wide variety of foods. If you eat absolutely no animal products, such as milk, eggs, or cheese, you may become shortchanged on protein and calories, as well as on iron, calcium, vitamin B12, and zinc. Careful attention to the protein content of foods such as legumes (beans and peas), nuts, soy products, and grains, as well as vitamin and mineral supplementation under the guidance of your obstetrician or a registered dietitian would be advisable.
What about vitamins and other supplements? Theoretically, a woman who eats a variety of fresh, high-quality foods should not need to take supplemental vitamins and minerals. But certain substances are so critical to a healthy pregnancy that most physicians will prescribe prenatal vitamins to make up for any deficiencies in the mother's diet. Remember, however, that supplements are not a replacement for healthy eating habits.
There is evidence that taking supplemental folic acid will reduce the likelihood that the newborn will have one of several types of major problems known as neural tube defects. Within the first month after conception, a tubelike structure forms from which the brain and spinal cord develop. If the tube does not close properly, serious abnormalities of these vital structures can result. Unfortunately, neural tube defects may occur before you know you are pregnant. Therefore, the Institute of Medicine (see margin note on page 10) recommends that all women of childbearing age take 0.4 mg of folic acid daily to reduce the risk of a neural tube defect occurring in an unexpected pregnancy. Once a woman becomes pregnant, she should take 0.6 mg of folic acid daily. Most prenatal vitamins contain at least this amount. (You may see these amounts of folic acid expressed in micrograms-a tiny amount equal to a thousandth of a milligram, often abbreviated mcg or µg. For example, a vitamin label may say that a tablet contains 400 mcg of folic acid, which is the same amount as 0.4 mg.)
If you have already had a child with a neural tube defect, a higher dose of folic acid-4 mg per day-is recommended for a month prior to the time you plan to become pregnant and should be continued through the first three months. (This amount of folic acid requires a doctor's prescription.) You can, of course, obtain folic acid through foods such as dark green leafy vegetables, cereals, whole-grain breads, citrus fruits, bananas, and tomatoes. However, in light of the research favoring supplementation, you should check with your physician about the amount of folic acid recommended for your pregnancy.
Excerpted from COMPLETE GUIDE TO BABY & CHILD CARE by PAUL C. REISSER Copyright © 2007 by Focus on the Family. Excerpted by permission.
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