A Guide to Your Baby's Sleep and Naps

10 Steps to Help Prevent SIDS

Parents who know about SIDS may think of it as their worst nightmare. Sudden infant death syndrome is known as SIDS or crib death. It’s when a baby 12 months or younger dies during sleep with no warning signs or a clear reason.
Before your worries keep you from sleeping at night, know that although there is no 100% way to prevent SIDS, there is a lot you can do lower your baby’s risk. Since parents widely began following the steps below, the SIDS rate in the United States has dropped more than 50%.
Put a Sleeping Baby on His Back
Your baby’s risk of SIDS is very high any time he sleeps on his side or stomach. (A baby placed on his side can roll over on his stomach.) These positions put your baby’s face in the mattress or sleeping area, which can smother him.
So, every time you put your baby in his bed to sleep -- for naps, at night, or any time -- lay him down on his back.
Tell anyone who takes care of your baby how essential it is to lay your sleeping baby on his back each time. That includes grandparents, babysitters and childcare providers, older siblings, and others. They may think one time won’t matter, but it can. When a baby who usually sleeps on his back is suddenly laid on his stomach to sleep, the risk of SIDS is very high.
If you’re worried your baby might choke while sleeping on his back, don't be. Choking is very rare, and healthy babies tend to swallow or cough up fluids automatically. If you’re concerned, ask your pediatrician about elevating the head of your baby's bed.
Once your baby can roll over both ways, which usually happens around 6 months, he may not stay on his back. That’s OK. It’s fine to let him choose his own sleep position once he knows how to roll over.
Firm Bed, No Soft Toys or Bedding
To prevent smothering or suffocation, always lay your baby down to sleep on a firm surface, like a safety-approved mattress with a fitted sheet. All your baby’s crib needs is the fitted sheet -- don't put blankets, quilts, pillows, sheepskin, stuffed toys, or crib bumpers in your baby's crib.
To confirm the safety of your baby's mattress or crib contact the Consumer Product Safety Commission at 800-638-2772 or www.cpsc.gov.
Don't Smoke Around Your Baby
Here’s a huge incentive to stop smoking before you get pregnant: Babies born to women who smoked during pregnancy die from SIDS three times more often than babies born to nonsmokers. Smoking when you're pregnant is a major risk factor for SIDS, and second-hand smoke around your infant also increases the chances of SIDS. Don't let anyone smoke around your baby.
Keep Your Sleeping Baby Close, but Not in Your Bed
When a baby sleeps in the same room as mom, studies show it lowers the risk of SIDS. But it's dangerous for a baby to sleep with another child or an adult in the same bed, in an armchair, and on a couch.
If you bring your baby into your bed for comforting or breastfeeding, be sure to put the baby back in his own cradle, bassinet, crib, or co-sleeper (a crib-like bed that attaches to an adult bed) when you're ready to sleep.
Never bring the baby to bed with you when you're very tired or using medicines that affect your sleep.
Breastfeed as Long as You Can
Breastfeeding your baby can lower the risk of SIDS by as much as 50%, though experts aren't sure why. Some think breast milk may protect babies from infections that increase their SIDS risk. Do not drink alcohol if you breastfeed because that increases your baby’s risk of SIDS.
Immunize Your Baby
Evidence shows babies who’ve been immunized in accordance with recommendations from the American Academy of Pediatrics and the CDC have a 50% reduced risk of SIDS compared with babies who aren’t fully immunized.
Consider Using a Pacifier to Put Baby to Sleep
Putting your baby to sleep with a pacifier may also help prevent SIDS, though researchers aren't sure why. There are a few tips to follow when using a pacifier:

1. If you're breastfeeding, wait until your baby is at least 1 month before starting to use a pacifier. Introducing a pacifier too soon can lead to nipple confusion and cause your baby to prefer the pacifier's nipple over your own.
2. Don't force your baby to take the pacifier if he doesn't want it.
3. Put the pacifier in your baby's mouth when you put him down to sleep, but don't put it back in his mouth after he falls asleep.
4. Keep the pacifier clean, and buy a new one if the nipple is damaged.
5. Don't coat the pacifier with honey, alcohol, or any other substance.

Keep Your Baby From Overheating
Because overheating may raise a baby's risk of SIDS, dress your infant in light, comfortable clothes for sleeping, and keep the room temperature at a level that's comfortable for an adult.
If you're worried about your baby staying warm, dress him in a "onesie," pajamas that cover arms, legs, hands, and feet. Remember, don't use a blanket -- your baby can get tangled in it or pull the blanket over his face.
Steer Clear of Products That Claim to Reduce the Risk of SIDS
It's best to avoid any product that says it can reduce your baby's risk of SIDS because most aren't proven safe or effective. Cardiac monitors and electronic respirators also haven't been proven to reduce SIDS risk, so avoid these, too.
Don't Give Honey to an Infant Under 1 Year Old
Because honey can lead to botulism in very young children, never give honey to a child under 1 year old. Botulism and the bacteria that cause it may be linked to SIDS.
Remember, your baby's health care provider is always available to answer any questions you have about SIDS, SIDS prevention, and keeping your baby warm, happy, and safe.

The Importance of Well-Baby Visits

The Importance of Well-Baby Visits

In your baby's first year, every month brings changes: tiny smiles, budding teeth, and eventually, crawling and walking. During well-baby visits, your pediatrician will check for proper growth and development and answer your questions about eating, sleeping, and vaccinations.
The first exam should be 24 to 48 hours after your newborn leaves the hospital, says pediatrician Tanya Remer Altmann, MD, FAAP. She's a clinical instructor at Mattel Children's Hospital at UCLA and author of the American Academy of Pediatrics' Mommy Calls: Dr. Tanya Answers Parents' Top 101 Questions About Babies and Toddlers.
Later visits typically happen at 2 weeks and at 1, 2, 4, 6, 9, and 12 months of age, she says. Here's what you can expect during well-baby checkups.
Baby Growth
During each visit, the doctor will measure your infant's weight, length, and head circumference. "I examine every baby from head to toe," Altmann says. "The first year is such a crucial time, and we want to make sure that babies are on track and doing everything that they should be."
The doctor will make sure that the fontanels (soft spots on your baby's head) are closing properly. She will also check your infant's eyes, ears, and mouth and listen to the heart and lungs. Next, the doctor will feel your baby's abdomen and check the genital area. She'll also look for rashes and jaundice and examine the arms, legs, and hips.
While every parent loves a checkup that ends with a clean bill of health, the exams are crucial to uncover problems, such as hernias, undescended testicles, or heart murmurs that require a specialist's attention. Spotting health problems early may mean improved treatment, Altmann says. For example, she says, "there's something called congenital hip dysplasia where the hip doesn't develop properly in the socket, and if you catch it early, it's something that is completely correctable."
Doctors also look for developmental markers at each visit, she says, such as your baby's ability to make eye contact, smile at you, or sit up without support.
Baby Vaccinations
Your baby will get the first recommended vaccination, the hepatitis B vaccine, before leaving the hospital, Altmann says. At later well visits, your baby will receive vaccines to prevent whooping cough, mumps, measles, and other childhood diseases.
Questions for Your Pediatrician
New parents may find themselves tuned in to when their baby needs a diaper change, or they may need a seasoned pro to guide them through the trials of cradle cap and trimming tiny fingernails. Certainly, if parents are worried that their baby seems ill, they should call the pediatrician any time of day or night, Altmann says.
But well visits are the perfect time to pick the doctor's brain. You just might learn that sticky or seedy bowel movements are normal in the early weeks, or that filing your baby's fingernails works just as well as cutting them.
Expert Tip
"Remember, no matter how old your baby is, she loves to hear your voice. Talk to her, sing to her, read to her. Your words will help her language blossom." -- Hansa Bhargava, MD

 

Expert Answers for Diaper Rash Questions

Expert Answers for Diaper Rash Questions

Do your toughest questions about diaper rash come up after hours? Help is on the way.  Here, pediatricians offer their best advice on large and small topics to help ease your little one’s discomfort.

Should I change my baby’s diet?

Some foods, such as fruit juices, can give babies diarrhea or make their poop goopy, leading to diaper rash. Taking antibiotics or starting solid foods can also affect their digestion. You can try minor adjustments, but don’t change your baby's diet for long -- or stop giving medicine -- without talking to your doctor.

Does teething cause diaper rash?

Teething and diaper rash often happen at the same time but are unlikely to be related, says Nannette Silverberg, MD, a dermatologist at St. Luke's-Roosevelt and Beth Israel in New York.

Do I need to wipe off all the ointment every time I change the diaper?

Ointments like zinc oxide are like wax for your car, says Elaine Siegfried, MD, professor of pediatrics and dermatology at Saint Louis University.
You’re putting a thick layer of paste between your baby’s skin and irritating liquids. Rubbing it all off hurts more than it helps. Pat urine dry gently and wipe away poop, then apply some extra ointment.

Will dabbing an antacid on the rash help?

Maybe. Diarrhea can be very acidic. If the rash was caused by diarrhea, a liquid antacid may be worth a try, says Wanda Filer, MD, a board member of the American Academy of Family Physicians. You may have a bottle of this chalky liquid in the medicine cabinet to ease heartburn.  Dab a little on your baby's rash with a cotton ball, let it dry, then add diaper ointment to shield the skin before the next messy diaper.

Should I switch to cloth diapers?

The right answer will depend on what works best for your baby.  There's no clear proof that one type of diaper is better for diaper rash.
If you prefer disposables, give them a fair chance. Rashes tend to grow in moist environments, and disposables are very good at wicking liquids away from a baby’s skin.
Switch to another brand if you've tried everything and your baby still has a sore bottom. A fragrance or dye could irritate her skin or even cause an allergic reaction. Plain white diapers are safest, says Siegfried.
Rarely, babies are allergic to all disposables and do better with cloth diapers. Just be sure to change them very frequently. If your baby has a rash, check the diaper every hour and at least once at night.
Cloth diaper systems may keep your baby's bottom drier than traditional cotton diapers. They come with flushable liners, fleece liners, super-absorbent inserts, and outer covers or wraps.
Some foods, such as fruit juices, can give babies diarrhea or make their poop goopy, leading to diaper rash. Taking antibiotics or starting solid foods can also affect their digestion. You can try minor adjustments, but don’t change your baby's diet for long -- or stop giving medicine -- without talking to your doctor.

What if the rash spreads to other body parts?

If red patches, spots, or bumps start to show up outside the diaper area, your child may have an infection.  Ask your doctor about prescription medicine.

What can I do to give my baby some relief?

The simplest thing is to let your baby’s bottom get some air. Before and after baths and naps, or whenever you get a chance, leave the diaper off for a few minutes. This gives his skin a break from constant rubbing and kills harmful germs that thrive in dark, wet places like the inside of a diaper.
To ease the pain, try a good soak in an oatmeal bath like the ones sold for itchy skin. And, of course, ointments protect bottoms from chafing and irritating liquids. “Zinc oxide pastes are the standard of diaper care,” says Silverberg. “Children tend to feel a soothing relief when these are applied.”

How long will diaper rash last?

If a rash doesn’t start getting better after three days of TLC or is getting worse, it’s time to call the doctor.