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WAITING FOR YOUR PACKAGE TO ARRIVE
SO, YOU'RE PREGNANT. CONGRATULATIONS! WHAT WILL YOU NAME THE BABY?
The inevitable question, after sharing the happy news with friends and family, is bound to be: do you have a name picked out? After twenty-five years as a pediatrician with a private practice on Long Island, you can imagine the names I've heard. People find baby names in all kinds of places: movie credits, classical literature, baby-naming books, the Internet, and especially popular TV shows (we saw lots of Brandons, Kellys, Dylans, and Brendas when Beverly Hills, 90210 first sprang into pop culture, and we still see the expected Rachels, Monicas, Rosses, and Phoebes). Some names are embedded in my memory: there was the classically inspired Isolde Shapiro, the whimsical Scylla Finkelstein, the very serious MacArthur Smith (a girl), and the unforgettable Princess Green (Princess was her first name, not a title). I have a bit of advice about naming your baby: before you subject your child to the burden of a life as Giuliani Schwartz, or Harry Potter Patel, just pause and think about how this growing child will feel about the name. Of course, if you've given it plenty of thought and are absolutely in love with a particular name, then trust your own opinion and don't be swayed too much by the opinion of family or friends. I remember attempting to pick a name as we waited for our first child, only to have each choice vetoed by a friend or relative who had known a kid in sixth grade with that name and hated him. It's amazing how, soon after he's born, little Goober will actually look like a Goober and act like a Goober. After a few short weeks, you'll wonder how you ever considered any other name for him.
WHAT KIND OF PARENT WILL I BE?
Is this question worrying you? I thought so. You're not alone. Here's my first serious bit of advice about waiting for your child to arrive: relax.
The thought of having a baby can be frightening, especially for first-time parents. Do you want to know what I tell prospective first-time moms every day in my practice? "Look around you. Go to a mall. Take a bus. Go to a matinee at the local mall movie theater. What do you see?" There are an awful lot of munchkins out there with a pretty interesting variety of moms. And guess what? Not all of those parents are rocket scientists. One or two didn't even attend an Ivy League University. A few, as you look further, may not even have advanced graduate degrees. The majority, in fact, are average, hardworking people of normal intelligence. In other words, as you've guessed, parenting takes all kinds.
I really can't predict who is going to be the next mother of the year when I meet pregnant moms, but I do know one thing: IQ doesn't have a heck of a lot to do with it. Nor does a hefty bank balance. Some of the best moms I know aren't exactly Einsteins or Rockefellers. In truth, there are only two important parental traits that can predict a relatively easy transition to parenthood. These are common sense and a good heart, and it's tough to measure either on an IQ test. Sound judgment and lots of love are the best credentials. Here are two examples.
Mrs. CEO is a mother in our practice. She's a thirty-something Princeton graduate who holds down a high-level job, as does her equally bright husband, Mr. CEO. The CEOs' cute little girl, Clio, is now ten years old and also quite gifted; Princeton, here she comes! Clio's busy parents send her to the best private school. She has the best music teacher and even her own personal trainer. Dance classes, voice coaches, acting lessons-she's had them all. Yet in spite of all these advantages, Clio is not a very happy child. Her parents, who certainly mean well, are just not so warm as they might be. Clio could use a walk to the ice cream stand with Mom and Dad, a few more play dates with friends her own age, and perhaps fewer appointments with coaches and tutors.
Ms. Clerk is another mom in my practice. When I first met her, several years ago, she was a nervous eighteen-year-old secretary who came for a prenatal interview with her mother, the future grandma. She had no plans to marry the baby's father, and had recruited Grandma to watch the baby while she worked. Ms. Clerk had just finished high school and wasn't sure what she wanted to do with her life, but she was certain that she wanted to do a good job as a parent. She seemed sincere, if a bit frightened, and I could see from the way she interacted with her own mother that she was a sweet person. Little Clark is now eight years old and a real buster. He's sharp as a tack, has a great personality, and is a dynamite soccer player. I don't know if Clark is on a direct track to Princeton, but he's a bright, well-adjusted kid, and he has a terrific mother whom he adores and who'll make sure he gets anything in life he needs to succeed.
Of course, these two scenarios aren't mentioned to suggest that wealthy parents can't be affectionate or that all poor parents are loving. The lesson to be learned, obviously, is that a good heart and a little common sense are more important predictors of success as a parent than a high IQ, tons of money, or an impressive family tree. So the next time you find yourself lying awake at night worrying about how you're going to do as a parent, just get out of bed, go to a mall or an all-night supermarket, and look around. It takes all kinds. And remember, a little common sense, along with a lot of love, can go a long way.
A HEALTHY PREGNANCY
Let's start with the day you discovered that you're pregnant. Perhaps your doctor has just told you the good news, or maybe your little home chemistry set has just turned blue. You've told the proud daddy-and helped him up off the floor. Or maybe you're a single parent who is celebrating alone or with a close friend. Perhaps you're about to adopt a baby. The legal arrangements have been made, and you're waiting out the birth of your child. Other than morning sickness, you've got plenty to think about, too. In our own case, as the doctor who received the test results first, I had the pleasure of telling my wife that she was pregnant. I don't think she's ever forgiven me for depriving her of the chance to break the news that I was about to become a father.
Now that you know you're pregnant, it's time to pay special attention to your body, since what affects Mom will affect baby. If you're a health nut and already watch your diet, get plenty of exercise, and drink only one or two cups of coffee a day, this will be a breeze. If, however, you're like most of us and have a vice or two, then shape up! Remember you're eating for two now. You're drinking for two, also. You're puffing for two. And you're partying for two.
RULE #1: PUT OUT THAT CIGARETTE
Smoking is out. Every time a pregnant mother puts a cigarette to her lips, she is offering a drag to her unborn baby. Mothers who smoke increase their chances of miscarrying. Also, smoking during pregnancy makes babies susceptible to behavioral problems, short stature, asthma, bronchitis, pneumonia, and ear infections during early childhood, handicaps that may last right into adolescence. For that matter, stop smoking for good. Passive smoking (inhaling smoke from Mom or Dad's nearby cigarette) is just as bad. For every pack of cigarettes you smoke, the secondhand smoke your baby inhales is equivalent to one cigarette. In time your little one may develop a real smoker's cough, as well as more ear infections, and increased bouts of pneumonia, bronchitis, and asthma. He may even have learning and behavioral problems in school. To top it off, children of parents who smoke in the home have been found to have a greater risk of crib death.
If you try to stop and simply can't do it, at least cut down. If you can go from a pack a day to four or five cigarettes a day, it's a lot better than doing nothing. And when little Goober is born, if you must smoke, do it outside. Doing something to change your habits and improve your baby's health is always better than doing nothing.
RULE #2: LOSE THE BOOZE
How about alcohol? Can you still drink? Babies of heavy drinkers are often born with fetal alcohol syndrome, a condition characterized by small facial features (small heads, small chins, small jaws). More important, babies whose moms drink during pregnancy have lower birth weights and often never catch up. They end up being smaller kids and adults than they would have been expected to be based on their genetics. Fetal alcohol syndrome babies can also have smaller brains with slower-than-normal mental development and learning disorders. In fact, fetal alcohol syndrome is the leading cause of mental retardation in newborns. Finally, many of these babies have birth defects, such as a curved spine, finger and toe deformities, and organ defects. Like smoking, the more you drink, the more your baby will be harmed. Since nobody's sure just how much a safe amount of alcohol might be, it's best not to drink alcohol at all-not even an occasional drink. Your best bet: lose the booze.
RULE #3: DECAFFEINATE, BEFORE IT'S TOO LATE
How about coffee? Surely that's a vice that's permissible, no? Yes, but stick to a cup or two a day, or even better, switch to decaf. Moms who drink several cups of coffee each day during pregnancy tend to have smaller kids, and these little java-holic babes can go through caffeine withdrawal once they're born and their "supply" runs out. Such withdrawal babies are jittery, are restless, have rapid breathing, and vomit frequently.
RULE #4: NO DRUGS
Now that you've been turned off to smoking, drinking, and coffee, let's mention the real serious stuff-drugs. Make no mistake: although tobacco, alcohol, and caffeine are legal, they're still drugs. But as bad as they are, they pale in comparison to the effects of drugs such as cocaine and heroin. Nothing is as sad as the sight of a newborn addict going through withdrawal. Not only are these babies fighting addiction, they're fighting for their lives. Over 100,000 babies suffer from drug withdrawal in the United States each year. Those who make it may have birth defects, learning disorders, convulsions, growth retardation, even mental retardation. Marijuana, a "social" drug, can cause your baby to be inappropriately small and to have learning problems once he starts school. Remember, what you eat, drink, smoke, or snort is baby food.
A word about prescription drugs. Many medications taken during pregnancy can cause problems for your baby. For example, the sedatives Valium, Miltown, and barbiturates, as well as the antidepressants Elavil and Anafranil, can cause such newborn withdrawal symptoms as poor feeding, tremors (shaking), irritability, and high or low body temperature. Of course, some drugs may be not only beneficial but necessary, and taking Tylenol for a severe headache is allowable. I remember a mother-to-be telling me that she had a bad strep throat but was "toughing it out" without medication for the good of her baby. I had to remind her that the strep germ itself can pass through the placenta to the fetus, and this germ would be a lot more harmful than an antibiotic. In certain circumstances, taking medication during pregnancy is necessary. Just one suggestion: before taking any medication other than Tylenol or prenatal vitamins while pregnant, speak to your obstetrician or your future pediatrician and ask if that medication is safe for the baby. This will prevent a lot of worry later on.
Your baby's health is a question not just of what not to do, but what to do during pregnancy as well. To keep your baby comfortable and safe inside his little "trailer home," keep yourself healthy, too. As you see your profile changing from statuesque to Santa-esque, there's a tendency to panic. Don't. Also, don't let friends or family scare you. Even though that little critter inside may weigh only 7 or 8 pounds when he makes his debut, there's a lot going on in there that adds tonnage. Your breasts are getting bigger, your uterus is getting thicker, and the placenta, which is the organ that actually passes all that cheesecake on to little Goober, is no lightweight, either. It's not unusual for a woman to gain 20 to 30 pounds during pregnancy. More important to you and Goober than how much you gain is what types of food you eat.
GENERAL PRINCIPLES FOR A HEALTHY DIET
Carbs, Fats, and Protein
Most of your diet should consist of complex carbohydrates, such foods as breads, pasta, vegetables, and grains. Ideally, complex carbs should make up 40 to 50 percent of your diet. Fats, such as oils, butter, margarine and mayonnaise, account for about 30 percent of the calories you take in each day. The remaining 20-30 percent of your calories should come from protein, found in meats, fish, dairy, and legumes. This means the old-fashioned dinner of a nice big 8-ounce sirloin steak garnished with a spoonful of peas and a large dollop of buttery mashed potatoes is not the best meal, on a regular basis. In the course of a whole day, most adults need no more than 6 to 10 ounces of meat, poultry, or fish. You'll find that if you keep your intake of meats down, your fat intake will stay down as well, since there's a heck of a lot more fat in any meat than in a serving of veggies of the same size.
This doesn't mean that your pregnancy is the time to become obsessed with your diet. An occasional ice cream sundae is fine for baby, and probably a good way to treat yourself, too. My wife always indulged in a weekly Carvel shake during her pregnancies (after her weigh-in at the obstetrician). Just keep moderation in mind, and an occasional thought about the 40-50 percent carbs, 30 percent fat, and 20-30 percent protein ideal can be a good general guide.
Milk and Fluids
Sometimes people get funny ideas about health, and these myths are passed on from generation to generation with little if any scientific basis. For example, who hasn't heard the old adages "An apple a day keeps the doctor away" and "Starve a cold and feed a fever"? From time to time in this book we'll try to correct such misconceptions. Our first myth deals with milk intake during pregnancy, and it's a real pip.
myth: You have to drink milk to make milk.
truth: Cow's milk does not equal breast milk.
The milk you drink is cow's milk. The milk that you want to produce for Goober is human milk. Big difference. To make breast milk you need a well-balanced diet. If you're a good weight for your age and size now, add about 500 more calories to your daily total. Also, drink plenty of liquids. Six to eight glasses of fluids a day is a good minimum, more if you're very active. However, those six to eight glasses don't have to be filled with milk. Usually, one to two glasses of low-fat milk will do the trick.
As a final general principle, I recommend that all women take a good prenatal multiple vitamin. Your obstetrician will prescribe one for you. Actually, it's a good idea to start the vitamin several months before you become pregnant, if possible. We know that moms who have supplemented their diets with extra folic acid for a year before conception have much lower rates of delivering a baby with abnormalities of the spinal cord such as spina bifida. So make sure the vitamin your obstetrician chooses contains all the vitamin groups, including folic acid. Also, if you plan to nurse your baby, it's a good idea to continue the vitamin after you give birth.
From the Trade Paperback edition.