First year vision, hearing and growth
How to check baby's vision/hearing development and growth during first year?
(A) Birth to 6 weeks:
- Babies lie with their legs pulled up and head resting on one side. They like sleeping most of the time.
- Most babies are unable to distinguish all colors, can focus on things only upto 12 inches closer to their face and in few cases, their eyes may appear 'criss crossed'. This is normal and their vision gradually becomes ok in a few months. That's why during first 3 months, baby gives more attention to black & white pictures/toys at close range.
- When you pick up the baby, head wobbles and needs support due to weak neck muscles.
- Most babies' hearing is fully developed by end of 1st month. But they take a couple of more months to coordinate their hearing and vision in order to react properly.
(B) 6 weeks to 3 months:
- Baby's eyes start tracking slow movement of finger, eyes are now well coordinated with any criss-crossing issue gone and they begin to gradually recognize people's faces. They gain optimal proper vision as their eyes grow and get fine tuned during the first year.
- Head is a lot steadier but still cannot sit as the baby usually rolls back.
(C) 3 to 6 months:
- Get your baby's hearing ability checked during routine checkups. Most babies react to a loud noise, turn towards a noisy direction or calm down when soft music is played.
- Baby can how hold the head up and look around. Still not able to sit or stand without any support.
(D) 6 to 12 months:
- Most babies can now sit alone by leaning on hands and move forward by lifting up their body.
- Gradually, they can now stand and walk with support if someone holds their hands.
(E) 12+ months/After about 1 year:
- Baby is able to sit without any support. Can crawl, stand and walk a bit too.
- Starts uttering some words like 'dada', 'mama'.
Handling baby feeds
What to feed during first couple of years? What important precautions must be taken?
(A) Recommended feeding guide:
- First 4 months: During first 3 months after birth, most babies need to be fed every 3 hours. Give only mother's/formula milk as it is totally sufficient. Each breastfeeding round should usually last about 10 to 15 minutes. Do not give water, juice or any other solid food.
- 4 to 8 months: Continue breastfeeding/formula milk but when the baby is able to hold his head upright without any support, gradually start semi solid food like squashed apple, banana, fresh yogurt, semi liquid cereal. Don't try giving many new things around the same time. Introduce one new food every week but do not give honey to any baby before he/she is 1 year old.
- 8 to 12 months: In addition to feeding/breastfeeding as in previous months, also start giving very small, chopped soft fruits and cooked mashed vegetables. You may also give few teaspoons of fresh juice.
- 12+ months: Some women still continue to breastfeed which is excellent for the baby. Also start giving external non formula milk. After heating the milk, check its temperature by putting a few drops on your elbow or at the back of your hand, just before feeding the baby. Set a day routine of about 3 meals and 3 small snacks.
(B) Frequency(How many times):
- Babies usually pass potty/stool about 3 to 4 times and urinate about 5 to 6 times in a day, which is a good indicator that they are being fed well. Note that burp is necessary when feeding by bottle. Its ok if breastfed babies do not burp sometime.
- Slight 'spitting out' of milk is normal but you might be 'overfeeding' if the baby vomits or cries after feeding or gains too much weight over time. Do not force the baby to finish milk while bottle feeding. A baby may convey his hunger by bringing his hands close to the mouth and gently sucking his hands/lips.
- Breastfeeding: Its extremely important to breastfeed your baby for at least 12 months or ideally, as long as possible as it helps in building baby's immunity, brain development and alignment of teeth. Many mothers are known to have breastfed for 2 years. If breastfeeding is not possible, use instant formula milk but it takes babies more time to digest formula milk as compared to digesting mother's breast milk.
- Milk bottle: When using a milk bottle during bottle feeds, make sure that bottle is washed with soap & then sterilized thoroughly by submerging the bottle parts in a pot of hot boiled water for at least 5 minutes. Let the bottle and parts dry on a clean towel subsequently. Normal cleaning process does not usually remove all bacteria. Sterilize the bottle once a day.
- Wash your hands with soap for at least 20 seconds before feeding your baby and make sure that baby's neck is supported with your palm or strap the baby into a baby chair. Do not leave the milk bottle in baby's hands during nap time as it may cause choking.
Handling crying baby
How to take care of frequent baby cries?
- First step is to check whether its been more than 2 hours since the baby was last given milk/food as the baby might be hungry. Or baby's diaper may have gotten dirty and is crying to seek attention.
- If the baby still continues to cry, change his position from lying on back to front or vice versa. If baby is sitting or was just given milk, then hold the baby upright against your shoulder for a couple minutes and pat baby's back. This may trigger a burp or baby may pass wind/gas.
- Many parents hold the baby in their arms for a long time & the baby would start crying the moment they put him down. This happens because the baby gets used to the comfort of parents' arms. Its important not to hold the baby in your arms for 'unnecessary' reasons or for more than 5 minutes at home. If more than 6 months baby is asking to be held in arms for no reason, be firm and politely say no. If the baby still cries, let him/her cry for 5 minutes, take a deep breadth, play soft music and wait for the child to calm down. A firm 'Shhh' noise also works well.
- Smile/talk to your baby or tickle gently. Checking appropriate clothing helps as baby might be feeling too hold or cold. If using cloth diapers, make sure they are 100% cotton and not made of polyester or synthetic material.
- Ensure nose is not stuffed as it may hamper baby's breathing. Gently squeeze and clean the nose. Multiple episodes of too loud cries usually convey some illness. Also check if there is any rash or fever. Seek medical advice if needed.
Handling sleep problems
Baby awake during night time? How to set baby's sleep cycle?
- Sleep duration: A newborn baby usually sleeps for 12 to 20 hours a day expecting to be fed every 3 to 4 hours. During the first 3 months after birth, the baby usually sleeps more at night and less during the day. Do not superimpose a sleep schedule in the first 6 weeks.
- Setting sleep cycle: After about 6 to 8 weeks of birth, start the following daily routine to set proper sleeping cycle...
a) Around same time every night, start a routine of giving a warm bath, light oil massage, feeding, burping and quietly putting the baby to bed after dimming the lights. For burp, lay your baby upright against your shoulder with his stomach against your chest and gently rub his back.
b) Try waking up the baby around the same time every morning.
c) During day time, gradually start keeping the baby awake especially after feeding for at least 30 minutes by moving around, making some sounds, showing toys and changing baby's position. The baby may also cry a bit but persist and be patient. Limit baby’s daytime naps to no more 2 naps of about 3 hours each and try putting him to sleep around the same point in time. If the baby is too resistant, wait for a week and try this routine again.
- Usually by 4 to 6 months, most babies sleep for about 4 hours during day time and 7 to 10 hours every night. At about 5 months of age, the baby usually learns to roll over, so make sure the baby sleeps at a safe place.
- Cry baby approach: Try this approach around the time when baby is 6 months old.
a) It may seem heartbreaking but if the baby is not able to sleep, leave the room and let the baby cry for 5 minutes.
b) Then return to the room, do not pick the baby in your arms but pacify the baby for a couple of minutes only
c) Leave the room again while the baby is awake. Repeat this cycle till the baby falls asleep. This approach obviously assumes that the baby is not sick or hungry. Do not feel guilty and don't give up... and your baby will not love you less if you take this approach! Follow the same approach if the baby wakes up during night time. Within a week or so, your baby will start sleeping without you in the room.
- Driving around: In exception cases when the baby is not falling sleep despite trying everything, put the baby in a car seat and drive around slowly for a few minutes till he falls asleep. Signs that a baby is about to sleep is the hands- which will get loose and unclenched as he/she goes into deep sleep.
Handling teething issues
How to handle teething issues?
- Age: Most babies get their first teeth between 4 and 8 months of age although some may get the first tooth even after a year. Lower front teeth usually come first and if the teeth are not straight, they usually straighten over time. Your baby should have the 20 primary teeth by around 3 years of age. Baby teeth shouldn't fall until permanent teeth start coming around 6 years of age. Teeth actually start developing inside the gums during pregnancy. For month by month baby growth during pregnancy: Click here.
- Signs of teething: Baby chewing fingers/toys, drooling or sucking thumb to help relieve pressure and possible uneasiness, itchiness in their gums. If drooling excessively, wipe your baby's face to avoid any rash or skin irritation. Sometimes, gums may get a bit swollen before the teeth is about to sprout but they return back to normal soon after eruption of teeth.
- Contrary to popular belief, teething does NOT cause any diarrhea or fever. Onset of those diseases is mostly due to some infection.
- Pacifier: A soft, good quality plastic teething ring or pacifier may be given for chewing to the baby. Try giving soft/solid foods like peeled carrot, cucumber. Make sure you wash them and give very small pieces to avoid any choking hazard. Do not allow chewing of any household object as it may cause choking and do not give aspirin to anyone below 20 years of age as it may be harmful.
- Cleaning: As soon as the first couple of teeth come out, start rubbing/cleaning the gums/teeth with a soft, clean and wet cloth using your washed hands without any toothpaste. After a month of doing this, start brushing gently with a baby toothbrush using very little non-fluoride baby toothpaste.
Handling baby's skin and bathing
What is the right bathing approach and how to take care of baby's skin?
- Do not worry if after birth, baby's skin appears dry or flaky. After a few days with proper care, skill will regain its smoothness.
- During first 3 months, give bath to your baby every alternate day using a small tub. If the weather is hot/humid, a daily bath would be nice. Ensure that the water level is maximum till his naval after you make the baby sit inside the tub. Avoid multiple baths during the day as it may trigger skin dryness.
- Clean your baby's nose and wipe his eyes with a clean soft cloth. Make sure you especially wash the genitals area, under arms, face and the neck as these areas are more prone to sweating. Gently wash the rest of his body with water and a mild baby soap. Never rub the baby's skin but pat dry using a soft towel.
- After the bath, apply a baby lotion and gently massage his body using vitamin rich natural/herbal oils to avoid any skin dryness/rashes. Avoid sprinkling baby powder as the baby may inhale its small particles leading to nasal cold/cough.
- Do expose the baby to mild sunlight during warm weather as it helps strengthen bones and muscles.
Handling baby vaccinations
What are the mandatory and optional vaccinations for the baby?
- A vaccine boosts the immunity of a baby and stimulates his body to produce antibodies which help in fighting diseases.
- Do not delay or miss a vaccination shot as it may put the baby at risk of getting a disease. Prevention is better than making frequent hospital visits for a cure.
- To comfort him and lessen his pain when the injection is being given, give the baby a pacifier in his mouth, distract him using a small rattling toy, stand near your baby holding his hand.
- Baby's cry/pain is only for a few minutes but the benefit lasts for many years. Its important that the parent remains absolutely calm even though your heart may be crying inside when the needle is poked!
- For vaccination chart, mandatory/optional vaccines details and what diseases a vaccine avoids: Click here.
Handling potty training
How to potty train a baby?
- When the baby is 2 years old, start potty training to train the baby for passing urine/stool in the toilet . As a first step, buy a potty seat.
- Encourage the baby to sit on the potty seat without any diaper after 1 hour of feeding milk/meal. Talk to the child for a few of minutes and take a break if the child resists. Even if the baby does not urinate or pass stool, have patience but keep encouraging the baby to use the seat.
- Show how the urine/stool disappears by flushing the toilet. Gradually, this will convey the objective of using a toilet seat to the baby.
- Do not scold a child if he/she does not use the toilet seat. But express happiness by smiling and shower praises when they pass urine/stool using the seat.
- Gradually reduce the use of diapers once the child starts using the potty seat. Most children get potty trained by the age of 3 years but rare night stool/urine accident may occur till the age of 5.
Handling common illnesses
What needs to be done in case of a common illness?
- Diarrhea/Loose Motions: Normally, a baby passes soft/watery stools 3 to 4 times a day in the first few months. When babies are fed by a bottle, colour of stool is usually green or reddish brown. If the frequency of stool is much higher, talk to a doctor.
- Constipation: Some babies develop this or pass hard stool after you start giving them solid food. Give them enough liquids and balanced food to avoid this.
- Vomiting: Some spitting of milk/food after feeding is normal. But if the baby is vomiting after a feed, then you might be overfeeding the baby. If the vomiting still persists, seek medical advice.
- Jaundice: Within a week of birth, some babies' skin and eyes turn a bit yellow. This is usually due to jaundice which is normal and you need not worry about it. Make sure you give adequate early morning sunlight exposure to your baby for about 15 minutes and jaundice goes away in 5-7 days. If the yellowness persists even after a week, contact a doctor.
- Fever/Cough/Cold: Do not worry if fever upto 101 degrees occurs once in a while. Cough/Cold usually occur due to some dust or stale air. Ensure proper cleanliness and ventilation of room with fresh air. For symptoms, causes for fever and treatment: Click here.
Handling diaper rash
How can we avoid or treat diaper rash?
- Rash sometimes occurs on the skin in the diaper area due to prolonged dampness or exposure to urine/stool. Baby's sensitive skin usually becomes red or pink in color and may be slightly itchy also.
- For treating minor rash, just let the baby be without diapers for as long as possible exposing the affected area to air. Minimize diaper use at home till full recovery. If you are going out somewhere and need to put on a diaper, use super absorbing disposable diaper. Do not tighten it too much, keep it a bit loose to allow the skin to breathe.
- Even if you need to put on the diaper, change the dirty one as soon as it becomes wet or dirty. Rinse the affected area with warm water and pat dry gently. Never rub or wipe baby's sensitive skin. Do not use plastic pants until rash is gone.
- If the weather is too cold, place the baby in a crib over several layers of towels along with a baby blanket on top.
- If rash persists for more than 3 days, add about 1 tablespoon(20 ml) of baking soda to a tub of warm water, soak a soft cloth in it and gently pat/rub the skin. Children older than 18 months- may sit in this tub with a few inches of warm water - under adult supervision. Very important: Never leave a child alone in the bath tub filled with water.
- Usually, a rash should go away or show signs of improvement within 5 days. But if redness or itchiness increases, consult a doctor to check for any fungal or bacterial infection.