Babies Cry

Seven reasons babies cry and how to soothe them Reviewed by the BabyCenter Medical Advisory Board Last updated: November 2006

Highlights How can I tell why my baby is crying? I can't figure out why she's crying. What should I do? Babies cry. There's no way to avoid it — it's one way they communicate. Since your baby can't flat out tell you, you may worry, "How will I know what she wants?" It can be difficult at first, but a large part of parenting is trial and error and you'll soon learn to anticipate her needs, read her cues, and wipe away her tears. Here are the most common reasons babies cry. If your little one is wailing, work your way down the list and chances are you'll find something that helps.

How can I tell why my baby is crying? She's hungry Once you learn to recognize the signs that your baby wants to eat — she'll fuss, make noises, and root around for your breast if you pick her up — you'll get pretty good at feeding her before she starts to really cry. Until then, checking to see if she's hungry is a good first step when your baby cries. Food might not stop her crying right away, but let her keep eating if she wants to. She'll stop once her stomach is full.

She needs a fresh diaper Some babies let you know right away when they need to be changed. Others don't mind when their diapers are soiled — it's warm and comfortable to them. (Parents are often surprised when they pick up their infant and find she's been sitting in a dirty diaper and never made a sound.) Either way, this one is easy to check and simple to remedy.

She's too cold or hot Newborns like to be bundled up and kept warm. (As a rule, they need to be wearing one more layer than you need to be comfortable.) So when your baby feels cold, like when you remove her clothes to change her, she'll express her discomfort by crying. You'll learn how to quickly change a diaper and wrap your baby back up. Be careful that you don't overdress her, since she's less likely to complain about being too warm than about being too cold and won't cry about it as vigorously.

She wants to be held Babies need a lot of cuddling. They like to see their parents' faces, hear their voices, and listen to their heartbeats, and can even detect their unique smell (especially Mom's milk). After being fed, burped, and changed, many babies simply want to be held. You may wonder if you'll "spoil" your child by holding her so much, but during the first few months of life that isn't possible. Infants vary a lot in how much they want to be held. Some demand a lot of attention, while others can spend long periods of time sitting calmly by themselves. If your baby likes the attention, pick her up, wear her in a front carrier or sling, or place her next to you.

She can't take it anymore While newborns often thrive on attention, they can easily become overstimulated and have a meltdown. You may find that your baby cries longer than usual after spending a holiday with many adoring family members or has periods at the end of each day when she seems to cry for no reason. Newborns have difficulty processing all the stimulation they receive — the lights, the noise, being passed from hand to hand — and can become overwhelmed by too much activity. Crying is their way of saying, "I've had enough." This usually happens when your baby is tired. Take her somewhere calm and quiet and let her vent for a while, and then see if you can get her to sleep.

She doesn't feel good If you've just fed your baby and checked that she's comfortable (she can be troubled by something as subtle as a hair wrapped

around her toe or a clothing tag that's poking her), but she's still crying, consider checking her temperature to make sure she isn't ill. The cry of a sick baby tends to be distinct from the hunger or frustration cry, and you'll soon learn when your baby's cries "just don't sound right" and she needs to be taken to the doctor.

None of the above Sometimes you might not be able to figure out what's wrong. Many newborns develop periods of fussiness when they're not easily soothed. These fussy periods can range from a few minutes of crying to full-blown colic. Colic is defined as inconsolable crying for at least three hours a day and at least three days a week. Even if your baby isn't crying this much, these episodes may be difficult for you. When all else fails, try the tips below.

I can't figure out why she's crying. What should I do? Wrap her up and hold her close Newborns like to feel as warm and secure as they did in the womb, so try swaddling your baby in a blanket, wearing her, or holding her against your shoulder. But be aware that some babies find swaddling or cuddling too constrictive and respond better to other forms of comfort such as rhythmic movement or sucking a pacifier.

Let her hear the rhythm Babies are used to the sound of your heartbeat; that's another reason they love to be held close. You can also try playing soft music, singing a lullaby, or even putting her close to the rhythm of an electric fan or the white noise of a vacuum cleaner.

Put her in motion Sometimes just the motion of carrying your baby will be enough to calm her. Other times, it may help to rock her gently in a rocking chair or swing, set her in her bouncy seat, or place her in her car seat on top of the dryer while it's on (the dryer's vibrations can cause her seat to move enough to fall off, so make sure you stay by her side while you do this!). You could also push her around outside in her stroller or take her for a ride in the car.

Massage her Most babies love to be touched, so a massage might be just the thing to soothe your baby. Don't worry about not knowing the perfect movements — as long as they're gentle and slow, they should bring comfort. Also, try rubbing your baby's back or belly. This will help if she's having gas pains — which may be the problem with some colicky babies.

Let her suck on something Even when she's not hungry, sucking can steady an infant's heart rate, relax her stomach, and calm her flailing limbs. Give her a pacifier or a finger to clamp onto and let her go to town.

Take care of yourself No baby ever cried herself to death, but a crying baby can be very stressful for new parents. You're chronically sleep-deprived and may already be unsure about how to care for this baby. Mom's emotions are all over the place due to the hormonal changes she's going through. Dad may not be sure what role he should play in caring for the newborn or whether he'll ever get Mom's attention again. Add a crying baby to this scenario and many parents can become overwhelmed with feelings of incompetence.

If you know your baby's needs have been met and you've tried to calm her but she's still crying, it's time to take care of yourself so you don't get too exasperated:

• Put your baby down in a safe place and let her cry for a while. • Call a friend or relative and ask for advice. • Give yourself a break and let someone else take over.

• Put on quiet music to distract yourself. • Take deep breaths. • Remind yourself that nothing is wrong with your baby and crying won't hurt her — she may just need the release. • Repeat to yourself, "She will outgrow this phase." • Whatever you do, don't take your frustration out on your baby by shaking her.

Fortunately, babies (and their parents) are resilient and somehow manage to get through even the most difficult crying episodes. Take heart that by the time your baby is 8 to 12 weeks old, she'll be better able to soothe herself and much of the crying will stop.

At what age is it safe for my baby to fly?

Expert Answers Lane France, pediatrician

Ideally, your baby should be at least 2 to 3 months old before he flies. This will give his immune system a chance to grow strong enough to resist the germs that often make the rounds in airplane ventilation systems. It also gives the two of you enough time to settle into a routine and master the art of breast- or bottle-feeding.

If you can't wait that long, your baby should be okay to fly after his 2-week checkup — provided he has a clean bill of health and you had a full-term pregnancy without complications. Premature babies are especially susceptible to germs, so it may take longer before they're ready to go on an airplane trip.

If you have any questions about whether your baby is healthy enough to fly, ask his pediatrician for advice. Note that airlines do not allow any baby younger than 1 week to fly without a doctor's note.

Many parents worry that the changes in air pressure that happen when you fly can harm their baby's ears. It's true that "popping ears" during takeoff and landing can be a bit painful for infants, but it won't cause any lasting damage. (The pressure changes can be very uncomfortable if your baby has an ear infection, however. If so, you may need to postpone your flight.)

Your baby will feel more comfortable if he has something to suck on during takeoff and landing, so you may want to breastfeed or give him a bottle or pacifier. You can give him some infant pain reliever (such as acetaminophen) if his ears really seem to bother him.

Editor's Note: To minimize disruption to your baby's schedule when crossing time zones, you may want to keep one watch set to your home time so you'll know what your baby is expecting next. Caring for a baby full time is stressful even while staying home, much less at 30,000 feet in the air. If possible, travel with your mate, another relative, or a sitter.

Birthmarks Reviewed by the BabyCenter Medical Advisory Board Last updated: November 2006

Highlights What are birthmarks? What do they look like and which ones are most common? Do birthmarks require medical attention? Can my baby's birthmark be removed? What can I do to become more accepting of this situation?

What are birthmarks? Birthmarks are areas of discolored skin that are on a baby's body at birth or that show up within a few months after delivery. Over 80 percent of babies have some kind of birthmark. Some endure for life, while others fade away over time.

Most birthmarks fall into one of two categories: vascular or pigmented. Vascular birthmarks are caused by blood vessels that have accumulated below the surface of the skin. They range in color from pink to red to bluish, depending on the depth of the blood vessels. Pigmented birthmarks — usually brown, gray, bluish, or black — result from an abnormal development of pigment cells.

What do they look like and which ones are most common? Birthmarks come in a wide range of shapes, sizes, and colors, and they can show up anywhere on the body. Some birthmarks are referred to as nevi ("nevus" is the singular). The most common varieties are:

• "Stork bites," "angel kisses," salmon patches, and vascular stains: Blotchy pink or purple flat marks that are formed by dilated capillaries near the surface of the skin. This is the most common type of birthmark, with up to 70 percent of babies having one or more.

These birthmarks can become more noticeable when your baby cries or when there's a change in temperature. The ones on the back of the neck, called stork bites, usually last into adulthood. The ones on the forehead or eyelids, called angel kisses, usually go away by age 2.

• Café au lait spots: Tan or light brown flat patches that sometimes appear in multiples. Between 20 and 50 percent of newborns have one or two of these pigmented birthmarks. They usually fade or get smaller as a child grows, although they may darken with sun exposure.

• Moles: Clusters of pigment-making skin cells. Moles vary in size and may be flat or raised, black or brown, hairy or not. Many moles don't show up until a child is a few years old.

Moles that are present at birth are called congenital nevi, or birthmark moles, and about 1 percent of babies have them. These moles often start out flat and become slightly larger and more raised.

• Bluish or grayish Mongolian spots: Large, flat areas of extra pigment on the lower back or buttocks that are most common in babies with dark skin: 95 to 100 percent of Asian, 90 to 95 percent of East African, 85 to 90 percent of Native American, and 50 to 70 percent of Hispanic babies have them. (Only 1 to 10 percent of Caucasian babies do.) Mongolian spots usually fade by school age, although they may never disappear altogether.

• Port-wine stains, or nevus flammeus: Present at birth, these vascular birthmarks range from pale pink to dark purple and can appear anywhere on the body, although they show up most often on the face or head. About 1 in 300 infants is born with a port-

wine stain.

Light port-wine stains might fade, but most endure and get bigger as the child grows. Sometimes port-wine stains can thicken and darken (the birthmark on former Russian president Mikhail Gorbachev's head is one example). They can also form cobblestones, or small lumps, on the surface of the skin over the course of decades.

• Hemangioma: This term is used to describe a variety of blood-vessel growths. These flat or raised lesions can be large and disfiguring or small and not very noticeable.

Hemangiomas affect about 2 to 5 percent of babies and are more common in girls, preemies, and twins. Twenty percent of children who have hemangiomas have more than one.

Hemangiomas occur mostly on the head and neck, and, unlike other birthmarks, they can grow rapidly. They usually show up during the first six weeks of life — only 30 percent are visible at birth — and grow for about a year, usually getting no bigger than 2 or 3 inches.

Then, without treatment, they usually stop growing and begin to turn white and shrink. This reversal process can take three to ten years. While many hemangiomas leave normal-looking skin in their wake, others can cause permanent skin changes.

One type of hemangioma, a superficial hemangioma (formerly called a strawberry hemangioma), appears on about 2 to 5 percent of babies. This raised pink-red mark tends to grow and then disappear — half are flat by age 5, and nine out of ten are flat by age 9.

A deeper hemangioma (formerly called a cavernous hemangioma) appears as a lumpy bluish-red mass. It grows quickly in the first six months and is usually gone by the time a child reaches his teens. Such hemangiomas are bluish in color because the abnormal vessels are deeper than those in the superficial hemangioma.

Do birthmarks require medical attention? According to dermatologist Seth Orlow, director of pediatric dermatology at New York University School of Medicine, most birthmarks are harmless, and many go away on their own in the first few years of life.

There are a few exceptions, though. In fact, 40,000 U.S. children a year have birthmarks that need medical attention. So it's important to have your child's healthcare provider take a look at all of your child's birthmarks. Potential problems include:

• Port-wine stains near the eye and cheek are sometimes associated with vision problems like glaucoma, or with seizures and developmental delay. (This is known as Sturge-Weber syndrome.)

• Large hemangiomas, depending on where they're located, can interfere with eating, seeing, or breathing. Hemangiomas can sometimes grow internally, threatening the health of an organ. Others can be cosmetically disfiguring.

• Birthmarks on the lower spine may extend beneath the skin and affect the nerves and blood flow to the spinal cord.

• Groups of six or more café au lait spots may be a sign of a genetic disorder called neurofibromatosis type 1 (NF-1). Children with NF-1 usually have the spots at birth or by age 2, although the number may increase in childhood and occasionally later in life. About 50 percent of people with NF-1 also have learning disabilities.

• Certain especially large moles that are present at birth have an increased risk of eventually becoming cancerous.

• Some prominent or disfiguring birthmarks can become psychologically damaging to a child over time.

Can my baby's birthmark be removed? It depends. Some of the conditions mentioned above (like a hemangioma pushing on the eye) might require removal. If a birthmark isn't disfiguring or causing physical problems, your baby's doctor may suggest that it's best to leave it alone.

Of course, the sight of a large hemangioma on your child's face can be distressing, and it's understandable if you want to do something about it now. But because most of these birthmarks will fade by the time your child's ready for school, your doctor may not recommend any special treatment.

Some experts have challenged this wait-and-see approach, arguing that early intervention to treat certain birthmarks can be helpful because enough of them don't go away on their own. So you may want to get more than one opinion about treatment.

Treatment options Depending on the birthmark, treatment options include surgery, laser therapy, and topical, oral, or injected steroids. Orlow says that almost all surgical birthmark-removal treatments can cause some scarring.

While in the past port-wine stains could not be treated, the introduction of the first pulsed-dye laser 20 years ago revolutionized the management of these birthmarks, especially on the face.

What can I do to become more accepting of this situation? Coming to terms with your baby's birthmark, especially one that's large or disfiguring, can be a tall order. Find out all you can about the type of birthmark it is, so you'll feel better able to discuss it with your baby's healthcare provider. You may also find it helpful to talk with other parents who are grappling with the same thing.

For more birthmark information and referrals, visit the website of the American Academy of Dermatology or the Vascular Birthmark Foundation.

Moles Reviewed by the BabyCenter Medical Advisory Board Last updated: March 2005

Highlights What are moles? Do moles change over time? Are moles dangerous? What should I watch for in my toddler's mole? Should I have my toddler's mole removed? Is there any way to prevent my child from developing moles?

What are moles? Moles, or nevi, are spots on the skin. They can be flat or raised, large or small, oval or round, mottled or even-colored. Their shade is caused by pigment cells, called melanocytes, and they can range from tan to pink, brown, or black. They can appear anywhere on the skin. No one knows exactly what causes moles, but almost everyone has at least a few.

About one in every hundred babies is born with a mole. These birthmark moles are called congenital nevi. Other types of moles are most likely to develop in the first 20 years of life, though it's possible to get moles at any age.

Do moles change over time?

Yes. Moles generally go through a life cycle of about 50 years of gradual change. Typically they start out flat and freckle-like, then enlarge over time. They commonly become darker during the teen years, during pregnancy, and upon exposure to the sun. Some develop hairs, and some become more raised and lighter in color.

Are moles dangerous? Most moles aren't dangerous, but almost 50 percent of melanomas start in moles. Since melanomas are very rare in young children, there's no need to panic if your toddler has a mole. But it's still a good idea to monitor moles carefully. Melanomas do start showing up as early as the teen years.

Some moles are more dangerous than others. A congenital mole — one your toddler was born with — is more prone to developing melanoma. Your doctor should examine any congenital moles at well-child visits and refer you to a dermatologist if she thinks they need further evaluation. Read more about birthmark moles.

Another type of mole that's more likely to develop melanoma is a dysplastic nevi, or atypical mole. These are larger than a pencil eraser and irregular in shape. Usually they have uneven color with lighter, uneven borders and dark brown centers. Sometimes there are black dots at the edges. Your child's doctor or dermatologist will want to examine any atypical moles.

What should I watch for in my toddler's mole? Besides having your doctor or dermatologist monitor your child's moles during regular visits, you'll want to keep an eye on your child's moles yourself. The American Academy of Dermatology has a few guidelines to help you determine whether a mole needs prompt professional attention. They're called the ABCDs:

• • • •

A is for asymmetry — if one half of the mole doesn't match the other half B is for the border of the mole — if the edge of the mole is ragged, notched, or blurred in any way C is for color — if the mole is a mix of brown, black, and tan rather than one solid color throughout D is for diameter — if the mole is larger than a pencil eraser (about 6 mm).

If you notice any problem with the ABCDs, make an appointment with your child's doctor to have her examine the mole. Also, if your child complains that the mole is itchy or it's growing noticeably, it's time to have the doctor take a look.

Should I have my toddler's mole removed? There's usually no need, but if your toddler has a mole that's uncomfortable because it's in an area that's often rubbed or that's embarrassing, talk with a dermatologist about the options. She may be able to easily remove the mole in her office.

Is there any way to prevent my child from developing moles? It's mostly a matter of genes, but sun exposure can increase the number of moles and darken the ones that already exist, especially in those with lighter skin. So you can try to keep your child out of the sun during peak daylight hours and make sure he has sunscreen on before he heads outdoors. You might also choose parks and playgrounds with lots of shade and have him wear wide-brimmed hats and long-sleeved shirts and pants whenever practical.

Baby sleep basics: Birth to 3 months Reviewed by the BabyCenter Medical Advisory Board Last updated: February 2007

Highlights Typical sleep patterns at this age How you can establish good sleep habits What's next?

Typical sleep patterns at this age Newborns sleep a lot — typically 14 to 18 hours a day during the first week and 12 to 16 hours a day by the time they're a month old. But most babies don't stay asleep for more than two to four hours at a time, day or night, during the first few weeks of life.

The result? Lots of sleep for your baby and a very irregular — and tiring — schedule for you. Your job is to respond to your newborn's cues, so you'll probably be up several times during the night to change, feed, and comfort him.

What's going on Baby sleep cycles are far shorter than those of adults, and babies spend more time in rapid eye movement (REM) sleep, which is thought to be necessary for the extraordinary development happening in their brain. REM sleep is lighter than non-REM sleep, and more easily disrupted.

All this unpredictability is a necessary phase for your baby and it doesn't last long — though it may seem like an eternity when you're sleep-deprived.

What's next At 6 to 8 weeks of age, most babies begin to sleep for shorter periods during the day and longer periods at night, though most continue to wake up to feed during the night. They also have shorter periods of REM sleep, and longer periods of deep, nonREM sleep.

Somewhere between 3 and 6 months, experts say, most babies are capable of sleeping through the night. They're not talking about eight hours, though — they generally mean a stretch of five or six hours.

Some infants sleep for a long stretch at night as early as 6 weeks, but many babies don't reach that milestone until they're 5 or 6 months old and some continue to wake up at night into toddlerhood. You can help your baby get there sooner, if that's your goal, by teaching him good sleep habits from the start.

How you can establish good sleep habits Here are some tips for helping your baby settle down to sleep:

Learn the signs that mean he's tired. For the first six to eight weeks, most babies aren't able to stay up much longer than two hours at a time. If you wait longer than that to put your baby down, he may be overtired and have trouble falling asleep.

Watch your baby for signs that he's tired. Is he rubbing his eyes, pulling on his ear, or developing faint dark circles under his eyes? If you spot these or any other signs of sleepiness, try putting him down to sleep. You'll soon develop a sixth sense about your baby's daily rhythms and patterns, and you'll know instinctively when he's ready for a nap.

Begin to teach him the difference between day and night.

Some infants are night owls (something you may have gotten a hint of during pregnancy) and will be wide awake just when you want to hit the hay. For the first few days you won't be able to do much about this. But once your baby is about 2 weeks old, you can start teaching him to distinguish night from day.

When he's alert and awake during the day, interact with him as much as you can, keep the house and his room light and bright, and don't worry about minimizing regular daytime noises like the phone, TV, or dishwasher. If he tends to sleep through feedings, wake him up.

At night, don't play with him when he wakes up. Keep the lights and noise level low, and don't spend too much time talking to him. Before long he should begin to figure out that nighttime is for sleeping.

Consider starting a bedtime routine. It's never too early to start trying to follow a bedtime routine. It can be something as simple as getting your baby changed for bed, singing a lullaby, and giving him a kiss goodnight.

Give him a chance to fall asleep on his own. By the time he's 6 to 8 weeks old, you can start giving your baby a chance to fall asleep on his own. How? Put him down when he's sleepy but still awake, suggests Jodi Mindell, associate director of the Sleep Disorders Center at Children's Hospital of Philadelphia and author of Sleeping Through the Night.

Mindell advises against rocking or nursing your baby to sleep, even at this young age. "Parents think that what they do this early doesn't have an effect," she says, "but it does. Babies are learning their sleep habits. If you rock your child to sleep every night for the first eight weeks, why would he expect anything different later on?"

Not everyone agrees with this strategy, however. Some parents choose to rock or nurse their babies to sleep because they believe it's normal and natural, because they enjoy it and their baby is thriving and sleeping well, or simply because nothing else seems to work.

Baby sleep basics: 3 to 6 months Reviewed by the BabyCenter Medical Advisory Board Last updated: February 2007

Highlights Typical sleep at this age How you can establish healthy sleep habits What's next?

Typical sleep at this age At 3 months, most babies sleep a total of 12 to 15 hours a day, including nighttime sleep and naps.

Sleep training opportunity Typically, by age 3 months or so, babies have started to develop more of a regular sleep/wake pattern and have dropped most of their night feedings.

This doesn't mean you should suddenly impose a rigid sleep program on your 3- or 4-month-old. In fact, your baby may already have developed sleep patterns that fit in well with your family life. But if you'd like to help your baby sleep longer at a stretch and keep more regular hours, now might be a good time to try some type of sleep training.

Keep in mind that every baby is on a unique developmental schedule. Observe how your child reacts to sleep training, and if she doesn't seem ready, slow down and try again in a few weeks.

Sleeping through the night At some point between 3 and 6 months, most babies are capable of sleeping through the night. We're not talking about eight hours, though. "Through the night" at this age generally means a stretch of five or six hours (though some children will sleep much longer).

This may not sound like much if you're hoping for eight or nine hours of sleep yourself. But it's an important milestone for you as well as your baby, allowing you to get through a few sleep cycles and feel more rested in the morning.

If your baby isn't yet sleeping five or six hours straight, you're not alone. Many babies still wake up more than once at night for feedings in the 3- to 6-month stage. But by 6 months, if not before, your baby's likely to be ready for night weaning, if that's what you choose.

Waking up again If your baby already sleeps for long periods at night, enjoy it. But babies who've slept through the night for weeks or months may start to wake up again — so don't be surprised if you're suddenly getting up every couple of hours again.

It can be frustrating and puzzling if your baby does this, but she has her reasons. She may be increasingly socially aware and wake up crying for your company. Or she may be working so hard to master new skills, like rolling over or sitting up, that she practices in her sleep and wakes herself up.

How you can establish healthy sleep habits Here are some tips for helping your baby sleep well at this age:

Establish a set bedtime and regular nap times — and stick to them. When your baby was a newborn, you knew it was bedtime when you started noticing signs of sleepiness (eye-rubbing, earpulling, and so on). Now that she's a little older, you should establish a regular bedtime, as well as consistent nap times, to regulate her sleep patterns.

Some babies naturally nod off by 6 every night. Others still seem wide awake at 8 or later. And of course your household routine will influence her sleep schedule, too.

Choose a reasonable bedtime that suits your family's schedule and stick to it as much as possible. If your baby seems to want to stay up past bedtime, consider this: Energetic behavior late at night can be a sign that a child is tired.

You can start to plan naps for a specific time every day, too, such as at 9 a.m., noon, and 3 p.m. Or you can just put your baby down about two hours after she last woke up. As long as she's getting enough opportunities to sleep, either approach is fine.

If your baby's having a hard time getting to sleep or staying asleep, whether during naps or at night, try putting her down sooner. Being too tired can make it hard to settle down and get restful sleep.

Begin to develop a bedtime routine. If you haven't already done so, now's a good time to start a bedtime routine. Your ritual can include any or all of the following: giving your baby a bath, getting her changed for bed, reading a bedtime story or two, singing a lullaby, and giving her a kiss goodnight.

Whatever routine works for your family is fine, as long as you do it in the same order and at the same time every night. Babies

thrive on consistency.

Wake your child in the morning to set her daily clock. It's fine to wake your baby up in the morning if she's sleeping past her usual waking time, to help set her daily clock. Your baby needs to follow a regular sleep/wake pattern and recharge with naps during the day. Waking her up at the same time every morning will help keep her on a predictable sleep schedule.

Encourage your child to fall asleep independently. All of us, babies and adults alike, wake up several times every night for brief periods (anywhere from a few seconds to a few minutes). As adults, we put ourselves back to sleep each time — and we don't even remember doing it.

The ability to get back to sleep is key when it comes to snoozing through the night. Some babies seem to do this naturally. But if your baby doesn't, it's a skill she'll have to master. One way to get her started is to put her down when she's drowsy but awake.

If your baby needs more help and you think she's ready, you can try a more involved method of sleep training. Your options include various no-cry and cry-it-out techniques. What will work best for you depends on your parenting style, your personal beliefs, and your child's particular needs.

Baby sleep basics: 6 to 9 months Reviewed by the BabyCenter Medical Advisory Board Last updated: February 2007

Highlights Typical sleep at this age How you can establish healthy sleep habits What's next?

Typical sleep at this age By age 6 months, most babies sleep a total of 11 1/2 to 15 hours of sleep a day (between nighttime sleep and naps) and are capable of sleeping for long stretches at a time.

Between the ages of 6 and 9 months, many babies consolidate their daytime sleep into two naps, one in the morning and one in the afternoon. Don't be concerned, though, if your baby continues to take three naps a day. Keeping consistent times for bedtime and naps will help regulate his sleep patterns.

Ready for sleep training If your baby hasn't yet settled into a sleep pattern that fits your family life, now might be a good time to try some type of sleep training. Sleep training methods can help your baby go to sleep more easily, sleep for longer periods at night, and keep more regular hours.

Sleeping through the night If your baby now sleeps for nine or ten hours at night, it means he's figured out how to settle back to sleep — a sign that you're raising a good sleeper.

If your baby isn't yet sleeping at least five or six hours straight, you're not alone. Many babies still wake up at night for feedings in the 6- to 9-month stage — though most are ready for night weaning, if that's what you choose. But babies this age don't necessarily wake up because they're hungry.

We all wake up several times every night for brief periods of time. And as adults, we put ourselves back to sleep each time — so quickly we don't even remember it in the morning. If your baby hasn't mastered this skill, he'll wake up and cry during the night

even if he's not hungry.

Waking up again Babies who were great sleepers may suddenly start waking up at night or have difficulty falling asleep between 6 and 12 months of age. Why? Sleep disturbances often go hand-in-hand with reaching major milestones in cognitive and motor development and with separation anxiety.

At 6 to 9 months, your baby may be learning to sit up, crawl, or possibly even cruise or walk — quite a list of achievements! Not surprisingly, he may not want to stop practicing his new skills at bedtime and may get so excited that he'll wake up to try sitting up just one more time.

Separation anxiety could also be the cause of your baby's wake-up calls. Waking up and finding you not there may cause some distress. But he'll probably calm down as soon as you enter the room and greet him.

How you can establish healthy sleep habits Here are some tips for helping your baby sleep well at this age:

Develop and follow a bedtime routine. If you haven't already established some sort of bedtime ritual, start now. A bedtime routine should help your child wind down and get ready for sleep, and at this stage your child will really begin to participate.

Whether your routine includes giving your baby a bath, playing a quiet game, getting your child ready for bed, reading a bedtime story or two, or singing a lullaby, make sure you do it in the same order and at the same time every night. Babies like having routines and schedules they can count on.

Keep your child on a consistent schedule. You'll both benefit from having a daily schedule that includes set times for bed and naps. That doesn't mean your baby has to eat lunch at exactly 12:15 every day, but it does mean you should try to stick to a fairly predictable schedule. If your baby naps, eats, plays, and gets ready for bed at about the same time every day, he'll be much more likely to fall asleep easily.

Encourage your child to fall asleep on his own. To nap well and sleep through the night at this age, your baby has to learn to fall asleep on his own. Try putting him down before he nods off, so he can practice. If he cries, the next move is up to you. Do wait at least a few minutes to see if he's really upset or just fussing a little before settling down.

Try putting him to bed earlier. If your baby's used to going to sleep after 8:30 p.m. and suddenly begins to wake up during the night, try making his bedtime a half-hour earlier. Surprisingly, you may find he's much more likely to sleep through the night.

Practice getting "unstuck." Children who are learning to sit or stand up may practice their new skills at night in their crib and get stuck in an upright position once they're sitting or standing up. If this is happening to your baby, you'll need to teach him how to lie back down.

Take a week or two to help him practice getting "unstuck," not necessarily in his crib but wherever you're spending time together. Make it a game — sit him up and then lay him down. Do the same with standing, helping your baby sit down at first and then encouraging him to do it on his own.

Baby sleep basics: 9 to 12 months Reviewed by the BabyCenter Medical Advisory Board Last updated: February 2007

Highlights Typical sleep at this age How you can establish healthy sleep habits

Typical sleep at this age At 9 months, babies typically sleep 11 to 14 hours a night and nap twice a day for one to two hours at a time.

Ready for sleep training If your baby hasn't yet settled into a sleep pattern that fits your family life, now might be a good time to try some type of sleep training. Sleep training methods can help your baby go to sleep more easily, sleep for longer periods at night, and keep more regular hours.

Sleeping through the night If your baby now sleeps for nine or ten hours at night, it means she's figured out how to settle back to sleep — a sign that you're raising a good sleeper.

If your baby's still waking up at night for feedings, she's probably ready for night weaning, if that's what you choose. But babies this age don't necessarily wake up because they're hungry.

We all wake up several times every night for brief periods of time. And as adults, we put ourselves back to sleep each time — so quickly we don't even remember it in the morning. If your baby hasn't mastered this skill, she'll wake up and cry during the night even if she's not hungry.

Waking up again Don't be surprised if your sound sleeper suddenly becomes a night owl or has a hard time falling asleep at this age. Why? Sleep disturbances often go hand-in-hand with reaching major milestones in cognitive and motor development and with separation anxiety.

At 9 to 12 months, your baby's likely to be crawling, pulling up, and learning to walk. And because she's refining and expanding on these skills, she may wake up at night to practice or be too excited to fall asleep. If she can't soothe herself back to sleep, she'll end up crying for you.

Separation anxiety could also be the cause of your baby's wake-up calls. Waking up and finding you not there may cause some distress. But she'll probably calm down as soon as you enter the room and greet her.

How you can establish healthy sleep habits This is a time to continue working on the techniques you and your baby learned in the first nine months, including:

Stick to a consistent bedtime routine. We can't say it often enough: You and your baby will both benefit from a nightly bedtime ritual. You can opt for the tried-andtrue — giving her a bath, reading her a bedtime story, and tucking her in — or add a quiet game into the mix.

Make sure your baby finds the routine soothing. For example, if she hates taking baths, move them earlier in the day. Or sing songs if she'd rather chew on a book than be read to. Just be sure to follow the same routine every night. Children thrive on

consistency and feel more secure when they know what to expect.

Make sure your baby has a regular schedule. Bedtime may go more smoothly if you make an effort to keep the rest of your baby's daily schedule consistent, too. If she naps, eats, plays, and gets ready for bed at about the same time every day, she'll be much more likely to fall asleep without a struggle.

Give your child plenty of chances to fall asleep on his own. If you want your baby to sleep independently, she needs opportunities to practice this important skill. Instead of nursing or rocking her to sleep, let her practice falling asleep on her own by putting her in bed when she's relaxed and drowsy. Otherwise she'll probably cry when she wakes up during the night and need your help to drop off again.

When can my baby start sleeping through the night?

Expert Answers The BabyCenter Editorial Team

When babies are able to sleep through the night and when they actually do are often very different things. Some infants as young as 3 months old can snooze for six to eight hours at a stretch. Others won't sleep this long until they're 12 months. But most babies (70 percent) do sleep through the night by the time they hit 9 months, according to the National Sleep Foundation.

Not that "sleeping through the night" means a full night of uninterrupted sleep for you. "'Through the night' is defined as from midnight until five o'clock in the morning," says Judith Owens, a pediatrician and director of the Pediatric Sleep Disorders Clinic at Hasbro Children's Hospital in Providence, Rhode Island.

You may have heard that bigger babies and babies who eat solids are better sleepers — but it's not true. Your baby's ability to sleep through the night is related to age, not size or diet.

There's no research to prove that adding rice cereal to the evening bottle, for instance, will help your baby sleep better or longer. In fact, this practice is a choking hazard, and offering solids too early can deprive your baby of the necessary nutrients in breast milk or formula. The American Academy of Pediatrics (AAP) recommends that babies be exclusively breastfed for the first four to six months.

You play a big part in your baby's sleep habits. "Put her to bed drowsy but awake by the time she's 4 months old," says Owens. "This will help her avoid developing a dependence on you to fall asleep and make it easier for her to fall back to sleep on her own when she wakes at night."

Baby sleep training: Cry it out methods Reviewed by the BabyCenter Medical Advisory Board Last updated: January 2007

Highlights What is the "cry it out" method? What's the theory behind CIO? I'd like to give the Ferber method a try. How do I do it? Practical tips for trying a CIO method from parents and experts Do these methods work? Parents' voices Why are some people against CIO methods? CIO isn't right for my family. Do I have other options?

What is the "cry it out" method? People often think this method of sleep training involves leaving babies alone to cry for as long it takes before they fall asleep. But "cry it out" (CIO) simply refers to any sleep training approach — and there are many — that says it's okay to let a baby cry for a specified period of time (often a very short period of time) before offering comfort.

In his 1985 book Solve Your Child's Sleep Problems (revised and expanded in 2006), pediatrician Richard Ferber presented one method of getting children to sleep that has become virtually synonymous with CIO — so much so that you'll hear parents refer to any CIO method as "Ferberizing."

Ferber himself never uses the term "cry it out." And he's only one of a number of sleep experts who say that crying — while not the goal — is for some children an unavoidable part of sleep training.

What's the theory behind CIO? The "cry it out" approach assumes that falling asleep on your own is a skill like any other and that your baby can master this skill if you give him the opportunity.

The idea is that if your child gets used to having you rock him to sleep, or he always falls asleep while nursing, he won't learn to fall asleep on his own. When he wakes up during the night — as all children and adults do as part of the natural sleep cycle — he'll become alarmed and cry for you instead of being able to go back to sleep.

By contrast, if your baby learns to soothe himself to sleep at bedtime, he can use the same skill when he wakes up at night or during a nap.

Crying isn't the goal of this sleep training method, but advocates say it's often an inevitable side effect as your baby adjusts to sleeping on his own. They say the short-term pain of a few tears is far outweighed by the long-term advantages: a child who goes to sleep easily and happily on his own, and parents who can count on a good night's rest.

Ferber is perhaps the most well known expert who advocates a CIO-style sleep training method, but he's not alone.

Pediatrician Marc Weissbluth, author of the popular book Healthy Sleep Habits, Happy Child, doesn't endorse CIO per se, but says that crying may be a necessary part of helping some children develop healthy sleep habits.

BabyCenter sleep expert Jodi Mindell, author of Sleeping Through the Night: How Infants, Toddlers, and Their Parents Can Get a Good Night's Sleep, is often called a kinder, gentler Ferber. Her "basic bedtime method" is a variation on Ferber's classic progressive-waiting technique.

I'd like to give the Ferber method a try. How do I do it? First, wait until your baby is physically and emotionally ready to sleep through the night, usually between 4 and 6 months of age. Ferber doesn't designate a precise age at which to begin his technique, since it can vary so much depending on the child.

If you're not sure whether your baby's ready, you can always give it a try. If you encounter too much resistance, wait a few weeks and try again.

Step 1 Put your baby in his crib when he's sleepy but still awake.

Step 2 Say goodnight to your child and leave the room. If he cries when you leave, let him cry for a predetermined amount of time. (See "How long should I leave my child alone?" below.)

Step 3 Go back into the room for no more than a minute or two to pat and reassure your baby. Leave the light off and keep your voice quiet and soothing. Don't pick him up. Leave again while he's still awake, even if he's crying.

Step 4 Stay out of the room for a little bit longer than the first time and follow the same routine, staying out of the room for gradually longer intervals, each time returning for only a minute or two to pat and reassure him, and leaving while he's still awake.

Step 5 Follow this routine until your child falls asleep when you're out of the room.

Step 6 If your child wakes up again later, follow the same routine, beginning with the minimum waiting time for that night and gradually increasing the intervals between visits until you reach the maximum for that night.

Step 7 Increase the amount of time between visits to the nursery each night. In most cases, according to Ferber, your baby will be going to sleep on his own by the third or fourth night — a week at the most. If your child is very resistant after several nights of trying, wait a few weeks and then try again.

How long should I leave my child alone? In his book, Ferber suggests these intervals:

• • •

First night: Leave for three minutes the first time, five minutes the second time, and ten minutes for the third and all subsequent waiting periods. Second night: Leave for five minutes, then ten minutes, then 12 minutes. Make the intervals longer on each subsequent night.

Keep in mind that there's nothing magical about these waiting periods. You can choose any length of time you feel comfortable with.

Practical tips for trying a CIO method from parents and experts • •

Set the stage for success before you try a CIO method by developing a bedtime routine and sticking to it. For example, a bath, a book, a lullaby, then to bed, at the same time every night. This way your child knows exactly what to expect. Develop a solid plan and make sure you and your partner are prepared before you begin sleep training — both practically and emotionally. On the practical side, it's probably not a good idea to launch your sleep plan if your partner is about to take off on a business trip, for example, or if your in-laws are coming for a visit. On the emotional side, talk the plan over with your partner and make sure you both understand and agree on how to proceed. That way you'll be able to support each other if you run into rough patches.

•

Once you launch your plan, stick to it. Parents who've been through sleep training agree that consistency is the key. Unless you realize that your child simply isn't physically or emotionally ready and you decide to put the program on hold for a while, follow through with it for a couple of weeks. When your baby wakes you up at 2 a.m., you may be tempted to give in and hold or rock him, but if you do, your hard work will be wasted and you'll have to start over from square one.

• •

• •

Plan to lose a little sleep. Begin the CIO method on a night when it won't matter if you miss a little sleep. For example, if you work all week, you might want to start on a Friday night, so you'll be able to catch up on lost sleep by the time Monday comes around. Prepare yourself for a few difficult nights. Hearing your baby cry can be excruciating, as every parent knows. During the waiting periods, set a timer and go to a different part of the house, or turn on some music, so you don't have to hear every whimper. As one BabyCenter parents says, "The first couple of nights could be rough for you. Try to relax and know that when it's all over, everyone in your household is going to sleep more easily and happily." Make it a team effort. During waiting periods, do something enjoyable with your partner, like play cards or listen to music. If you find the crying intolerable after a while, let your partner take over so you can take a walk or a warm bath. When you're refreshed, you can give your partner a break. Adapt the method to fit your family. If you want to try a method like this but find it too harsh, you can use a more gradual approach. For instance, you can stretch out Ferber's seven-day program over 14 days, increasing the wait every other night rather than every night. Remember your primary objective: To give yourself and your child a good night's rest.

Do these methods work? For some moms and dads, CIO methods work just the way they're supposed to. After a few nights and a few tears, their child sleeps contentedly through the night. For other parents, when the tears continue and the promised sleep doesn't come, it's time to try something else.

In the end, no approach to baby sleep works for everyone. A technique that's perfect for one child may be completely ineffective with another, even another child in the same family. So just because your best friend or your sister had good luck with a CIO method doesn't mean it's right for you. And even if it works with your first child, it may not do the trick with your second.

Parents' voices "It worked for me." I have two kids. The first one was never left to cry it out — we rocked, sung, walked, drove her to sleep until she was old enough to be read a story. Then, with baby number two, I decided to try CIO...and after one night, it worked. At 12 months, she goes to sleep at night by herself and never cries. It was the best thing I did — my husband was against it, but he wasn't the one up four or five times every night for nine months straight! Now our household is very happy and everybody sleeps well. — Lisa P. My daughter woke every hour on the hour in her crib. I tried every other method available. Finally, at 7 months, we let her cry it out. It took three to four weeks to complete the sleep training and even though it was the hardest thing I've had to do thus far, it was so worth it. She now sleeps about ten hours a night and loves her crib. We're both happier and have more energy to play. — Samantha My 5-month-old was waking every two hours at night. I was so tired I wanted to die. I finally caved in, put in earplugs, and let him cry it out — which he did, all night! But then, something amazing happened the next night: He slept a full 12 hours and awoke rosy and cheerful. It's been that way ever since, and he's even a better napper now. I know that it is hard to listen to your precious little one cry, but a sleep-deprived, miserable mom and baby is a terrible thing too. — Anonymous My son "cried it out" for 40 minutes one night and now sleeps through every single night so peacefully. I don't think those lone 40 minutes were torture when you consider the payoff: He's better rested, and I'm energized and in a positive frame of mind each day with my kids. — Hilary "It didn't work for me." My well-meaning friends are all Ferber addicts. I went against my own instincts with our son and tried with no success. They promised it would get better each night, but on the third night he cried for three hours, much longer than the first two. I felt like a failure and, of course, stressed from all of his crying. Babies have their own personalities, and you shouldn't feel pressured into doing something that "works for everyone else." — Kelly We tried the Ferber method with our daughter at 6 months. The first night was awful. The second night was easier. The third night was worse — she got so upset that she threw up. So now she's in bed with us, we love having her with us, and I still feel awful for those three terrible nights when we were all miserable. — A loving mom As a last resort, I broke down and gave Ferber a try. It's been two and a half weeks and I see no real improvement. My daughter goes down faster at night, but the crying breaks my heart. I miss snuggling with her. She still wakes up every 30 to 90 minutes

after her first two-hour stretch. She shrieks when it's time for a nap. I broke down and nursed her to sleep for her afternoon nap because I couldn't stand to see her so exhausted. — Guilt-ridden and anxious mom I've been struggling and struggling with the "cry it out" method. We let our baby cry for several nights and it never led to falling asleep. She only got more agitated and upset. She can usually fall asleep if I get her drowsy by rocking, singing, etc., and we have a bedtime routine. If she cries, it signals to me that she needs more help falling asleep. — Amy M.

Why are some people against CIO methods? Some parents and parenting experts are opposed to letting a baby cry without responding immediately. They argue that it could threaten the child's trust in his parents and thus his sense of safety and security in the world.

In response to concerns like these, Ferber says that a baby who's given lots of attention and love during the day can be left alone at night without suffering lasting harm.

"A young child cannot yet understand what is best for him, and he may cry if he does not get what he wants," Ferber writes. "If he wanted to play with a sharp knife, you would not give it to him no matter how hard he cried, and you would not feel guilty or worry about psychological consequences. Poor sleep patterns are also harmful for your child and it is your job to correct them."

CIO isn't right for my family. Do I have other options? Maybe you don't want to let your baby cry. Or you tried a CIO method and it didn't work for you. Every child is different and no single method is right for everyone. Read about other ways to help your baby learn to sleep through the night.

Baby sleep training: Night weaning Reviewed by the BabyCenter Medical Advisory Board Last updated: January 2007

Highlights At what age will my baby be ready for night weaning? How do I know if my baby's ready? What the experts say Practical tips for night-weaning your baby Parents' voices

At what age will my baby be ready for night weaning? It varies considerably with the individual baby. But somewhere between the ages of 4 and 6 months, most babies are getting enough calories during the day to sustain them for five or six hours at night. Even so, it's not at all unusual for younger babies to sleep for much longer stretches without needing to eat — or for older ones to continue to wake up to eat.

At the same time, your baby has other important needs. Few things are more satisfying and reassuring to a baby than being held and fed in a parent's arms. If you've recently gone back to work and are less available during the day, your baby may want to nurse or take a bottle at night as a way of reconnecting with you. And you may notice that your baby wakes up more often when he's teething or going through a developmental change.

For all these reasons, it's important to approach the weaning process gradually and gently, keeping in mind that your baby is still young and has a tremendous need for comfort, closeness, and reassurance — particularly from you.

How do I know if my baby's ready? If your baby's at least 4 to 6 months old, you can probably begin taking steps to wean him from feeding during the night. Of course, even if your baby doesn't need to eat in the middle of the night, he may still wake up wanting to. Babies who are used to eating several times a night tend to wake up out of habit, and it can take time to change this routine.

It's important to maintain your health and well-being, and you won't be able to if you're chronically sleep deprived. So whether to put an end to your baby's night feeding depends in part on how it's affecting you.

If you enjoy nursing or giving a bottle to your baby at night, there's no reason to stop — he'll eventually quit on his own. On the other hand, if you find yourself feeling grumpy and exhausted — and your baby's physically ready for the change — maybe it's time.

If you're not sure whether your baby's ready, talk to your doctor.

What the experts say In his book Solve Your Child's Sleep Problems, pediatrician Richard Ferber says unnecessary night feedings may actually cause sleep problems. According to Ferber, if a baby wakes to feed several times during the night, a very wet diaper or digestive problems may cause him to wake up and then want to feed more, creating a vicious cycle.

Pediatrician William Sears, on the other hand, emphasizes the benefits of night feedings for the bond between parent and child. Sears urges parents not to rush to night wean, as long as the feedings aren't too disruptive to the family. In The Baby Sleep Book, Sears offers strategies like sleep sharing and nursing while lying down to make night feedings easier for parents.

In the end, as with all parenting decisions, you should do what's best for you and your family.

Practical tips for night-weaning your baby • Approach the weaning process slowly and gradually. Start by giving your baby less time on each breast or a smaller amount of milk in his bottle at each feeding. Try to prolong the intervals between feedings by patting and comforting your baby and gently urging him to go back to sleep.

• Make sure your baby gets plenty to eat throughout the day. As your baby grows and becomes more active, he may not want to stop to nurse or take a bottle during the day, and he may try to make up for it at night. To make sure he gets enough to eat, take scheduled breaks during the day for a quiet bottle or nursing session in a place with no distractions.

• Offer your child extra feedings in the evening so he won't be hungry in the middle of the night. You may even want to wake him for a final feeding before you go to bed yourself.

• If your baby's bottlefed and at least 6 months old, you can gradually dilute the nighttime bottles with water. Start by substituting water for one quarter of the milk. Gradually use more water over subsequent nights until, eventually, the bottle contains only water. Your baby may be less inclined to wake up for a bottle of water.

• Don't try to night wean your baby during a time of transition — for example, if you're just about to return to work or take a family vacation. If you've recently become less available during the day, make sure to give your baby extra cuddle time when you're together, so he'll feel more connected and be less likely to seek comfort in the middle of the night.

• Have your partner comfort your baby when he cries during the night. If you're the one caring for him at night, the smell of you or your breast milk is likely to make your baby want to feed. If you're sleep sharing, try having your partner sleep between you and your baby.

• Gradually eliminate feedings, one at a time. Gently soothe and comfort your baby when he wakes to feed, and explain that it's sleepy time, not feeding time. Tell him he can nurse or have his bottle in the morning, and now's the time for sleep. Speak firmly and gently while patting his back or tummy. Even though he's too young to understand your words, he'll gradually understand the

meaning, and your presence will soothe him. In many cases, babies cry only a little for a night or two before adapting to the new system.

• If you try to eliminate feedings and your baby cries inconsolably for several nights in a row, go back to your normal routine and try again in a week or two.

Parents' voices I moved my daughter into her own room at 11 weeks, and she did well with two night feedings of no more than five minutes each. During a trip out of town, she shared a bed with my husband and me for five nights and woke up a minimum of five times a night to nurse, with some feedings lasting over 45 minutes. I figured out that it was my close proximity that kept waking her up. I suggest that if you can't put your baby in her own crib, create some distance between you when you sleep. Your scent and presence is too tempting for her to sleep soundly. I try to sleep with my back to my baby or with my husband between us. This helps most of the time when I want to have her close to me at night. — Rose At 6 months old, my son all of a sudden started his night waking again. I tried to resist feeding him, but as soon as I got him back to sleep and put him down he would start crying again. Then one night, when I could no longer take it, my husband went in and rocked him back to sleep and he didn't wake up again until morning. The next night I sent my husband in again and the same thing happened. I think my son associates me with his feedings so he expects me to feed him when I come to him in the middle of the night. — Jackie I find that my 2-month-old breastfed baby sleeps longer at night if I feed him more often in the evening. By bedtime, he has a full tummy. His last feeding is at midnight, and he'll sleep up to six hours. I also noticed that once I cut out all caffeine from my diet and stopped eating sweets after 3 p.m., he started to sleep longer at night. — Linda I've been breastfeeding my son since birth, but to get him to sleep longer at night, I give him a little formula at his last feeding. Instead of nursing, I pump. I have quite a supply built up in the freezer! I don't think the small amount of formula he's being given really affects our breastfeeding relationship, and the extra sleep is good for us both. — Dani I broke my 2-month-old of night feedings by offering him his pacifier instead of my breast. After a few days, he stopped waking up to be fed at night. — Liz Follow your instincts when it comes to feeding in the middle of the night: If it feels right to you, continue. In America, we're so quick to make babies sleep alone. In other countries, babies stay with their mothers a lot longer. This time will go by so quickly, and eventually he won't be nursing at all, so enjoy it, day or night. — Olivet I've had night waking issues with all three of my breastfed babies but for different reasons. My oldest woke because of developmental milestones, my middle one woke purely to eat, and my youngest is 9 months and still not sleeping through the night because of separation anxiety. Every baby is unique and has different needs. There's no easy answer — just tune in to your child. — Becky

Recovering from a cesarean delivery Reviewed by the BabyCenter Medical Advisory Board Last updated: January 2009

Highlights How will I feel after a cesarean delivery? What will I get for postpartum pain relief? What's recovery like during the first few days? What's recovery like after I leave the hospital? How active should I expect to be? What will my scar be like? Emotionally speaking, what should I expect?

How will I feel after a cesarean delivery? Like any new mother, you'll probably feel both euphoric about and overwhelmed by the new person in your arms. But you'll also be recovering from major abdominal surgery while dealing with typical postpartum issues such as engorged breasts, mood swings, and vaginal discharge. C-section patients typically stay just three or four days in the hospital before going home. But your recovery will be measured in weeks, not days, so once home you'll need help taking care of yourself and your new baby. What's more, if you have other children, they may be feeling needy after you've been away from them for a few days, to say nothing of the fact that you're returning home with a new baby! Plan to get all the help you can.

What will I get for postpartum pain relief? If you have an epidural or spinal for your c-section, your anesthesiologist may add morphine, which can provide excellent postpartum pain relief for up to 24 hours without the grogginess that you get from systemic narcotics. Some anesthesiologists leave the epidural in for 12 to 24 hours after surgery so you can get more medication through it if needed. Once your regional analgesia is no longer providing adequate pain relief, you'll be given systemic pain medication, usually pills containing a narcotic and possibly acetaminophen. It may help to take ibuprofen, too. You'll also be given a stool softener to counteract the constipating effect of the narcotic. If you have general anesthesia for your surgery or you don't get a dose of morphine through your spinal or epidural afterward, you'll be given systemic narcotics for immediate postpartum pain relief. You'll either get a shot of pain medication every three to four hours or you'll use a system called "patient-controlled analgesia": You push a button when you're feeling discomfort that delivers medication through your IV. A machine controls the doses so you don't get more than what's safe. In any case, don't be shy about asking your nurse for more medication if you're uncomfortable. You don't need to suffer in silence, and the longer you wait to ask for the medication you need, the harder it is to control pain in the end. If the medication that's been ordered for you isn't covering your pain, let your nurse know. If the nurse can't help you, ask to see an obstetrician or anesthesiologist. The more comfortable you are, the easier it'll be to breastfeed your baby and to get moving again.

What's recovery like during the first few days? You may feel groggy and possibly nauseated right after surgery. Nausea can last up to 48 hours, but your caregiver can give you medication to minimize your discomfort. Many moms also feel itchy all over, particularly those who received narcotics in their epidural or spinal. If this happens to you, let your caregiver know so she can give you medication to relieve the itchiness. If you plan to breastfeed, you can start in the recovery room right after surgery. Ask the nurse to show you how to nurse in the side-lying position or using the football hold, so there won't be pressure on your incision. Breastfeeding can be challenging in the days after a c-section because of the pain from a healing incision. Ask to see a lactation consultant as soon as possible to help you position your baby comfortably so you don't end up with sore nipples. If the hospital doesn't have a lactation consultant, ask for the nurse who's the resident expert.

You may feel numbness and soreness at the incision site, and the scar will be slightly raised, puffy, and darker than your natural skin tone. Your doctor will come by daily to see how you're doing and check that the wound is healing properly. Anything that puts pressure on the abdominal area will probably be painful at first, but you'll feel a bit better day-by-day. Be sure to use your hands or a pillow to support your incision when you cough, sneeze, or laugh. Your nurse will come by every few hours at first to check on you and help you. She'll take your vital signs, feel your belly to make sure your uterus is firm, and assess the amount of vaginal bleeding. Like any woman who just delivered a baby, you'll have a vaginal discharge called lochia, which consists of blood and sloughed-off tissue from the lining of your uterus. For the first three or four days, it will be bright red. Your nurse will also instruct you on how to cough or do breathing exercises to expand your lungs and clear them of any accumulated fluid, which is particularly important if you've had general anesthesia. This will reduce the risk of pneumonia. If everything's okay, your nurse will remove your IV and urinary catheter, usually within 12 hours of surgery, and you'll likely be able to start eating bland, mild foods if you feel like it. You might have some gas pain and bloating during the first two days. Gas tends to build up because the intestines are sluggish after surgery. Getting up and moving around will help your digestive system get going again. If you're in great discomfort, the nurse may give you some over-the-counter medication that contains simethicone, a substance that allows gas bubbles to come together more easily, making the gas easier to expel. Simethicone is safe to take while breastfeeding. You may be encouraged to get out of bed the day of surgery and certainly by the next day. (Do not, however, attempt to get up by yourself. The nurse should be at your side the first time.) In the meantime, get the blood going in your legs by wiggling your feet, rotating your ankles, and moving and stretching your legs. Just walking to the bathroom may seem impossible at first, but moving around is important for your recovery. It will help your circulation and make it much less likely that you'll develop blood clots. What's more, it will make your bowels less sluggish, which will help you feel a whole lot more comfortable sooner. It's also important to get to the bathroom to urinate regularly. A full bladder makes it harder for the uterus to stay contracted and increases pressure on the wound. By the second day, you should be taking a couple of short walks with help from your partner or a nurse. Try to take your walks a short time after you've taken pain medication, when you're likely to feel more comfortable. In three to four days, your doctor will probably remove your sutures or staples. This takes just minutes, and you may feel a small pinch but no pain. After that, if all's well, you'll be sent home.

What's recovery like after I leave the hospital? Expect to need help – and lots of it – once you get home. If nobody offers, ask for support from your partner, parents, in-laws, and friends. If you're worried that you may not have enough support, hire paid help if you can afford it. You'll likely be given a prescription for more painkillers and a stool softener before you leave the hospital. You may need prescription painkillers for up to a week after surgery, gradually transitioning to over-the-counter pain relievers. (If you're breastfeeding, don't take aspirin or drugs containing acetylsalicylic acid.) Drink plenty of fluids to help you avoid constipation. Your incision will likely feel better day-by-day, quite noticeably so after several days, though it may continue to be tender for several weeks. Call your caregiver if you have signs of an infection, including:

• • •

warmth, redness, or swelling at the incision site oozing from the incision site; worsening or sudden onset of pain any fever (even if your incision looks fine)

Your vaginal bleeding and discharge should be diminishing, though it may last up to six weeks. It should gradually turn from bright red to pink and then yellow-white. If menstrual-type bleeding continues past the first four days after delivery or comes back after slowing, call your healthcare provider. For more information on warning signs of a medical problem in the weeks after delivery, see our article on when to call your practitioner.

How active should I expect to be? While it's essential to get plenty of rest once you're home, you also need to get up and walk around regularly. Walking promotes healing and helps prevent complications such as blood clots. But don't overdo it. Start slowly and increase your activity gradually. Since you're recovering from major abdominal surgery, your belly will feel sore for some time. Take it easy and avoid heavy household work or lifting anything heavier than your baby for eight weeks. In six to eight weeks, you'll be able to start exercising moderately – but wait until your caregiver gives you the go-ahead. It may be several months before you're back to your former fit self. You'll be able to resume sexual intercourse in about six weeks if you're feeling comfortable enough, with your caregiver's okay.

What will my scar be like? At first, the scar will be slightly raised, puffy, and darker than the rest of your skin, but it'll start to shrink significantly within six weeks of surgery. A c-section incision is only 4 to 6 inches long and about 1/8 inch wide. As the incision site continues to heal, your scar will more closely match your skin color and will narrow to about 1/16 inch wide. It might be itchy while it's healing. C-section scars are usually very low on the abdomen. A low-lying scar will eventually be hidden by your pubic hair, probably way below the waistband of your underwear or bikini bottom.

Emotionally speaking, what should I expect? Moms have a wide range of emotions after a c-section, so it's hard to predict how an individual will feel. You might feel disappointed if you had your heart set on a vaginal birth. Or you might not care about how you gave birth, particularly if you had complications and were worried about your baby's well-being. Some women who end up in surgery after a long, drawn-out labor feel a sense of relief, while others are upset that they ended up with a c-section after doing all that work. And others have mixed emotions. Some moms say they feel cheated out of a vaginal delivery, especially if they took childbirth classes and fantasized about the "ideal birth." Others say they feel as if they're somehow less of a woman because they needed a c-section. All of these feelings are common and may be difficult to resolve. If you feel this way, it may take some time to reconcile the reality of your birth experience with what you'd imagined during your pregnancy. It might help to know that many women find their baby's birth, whether vaginal or c-section, very different from what they expected. If you have nagging doubts about whether the surgery was really necessary, talk to your practitioner about it and ask her to review the decision with you. Remember that you're also likely to have the range of emotions common to most mothers during the postpartum period, regardless of how they gave birth. Postpartum blues are common, whether you had a c-section or a vaginal birth. If you're feeling really blue, seek help. You may be suffering from postpartum depression. Finally, you may be frustrated if it seems to be taking you a long time to recover. Remember that just healing from the surgery is likely to take a significant amount of time and energy. Add to that all the postpartum changes your body is going through – along with your new round-the-clock parenting responsibilities – and you're bound to be in less-than-top condition for a while. Try to cut yourself some slack and be patient. In time, you'll be feeling better and enjoying life with your new baby.

Body changes after childbirth Reviewed by the BabyCenter Medical Advisory Board Last updated: January 2009

Highlights How long will it take for my uterus to shrink? How much weight will I lose right after giving birth? How come I can't tell when I need to pee? Will my vagina and perineum ever get back to normal? What's this vaginal discharge? What should I expect if I'm breastfeeding? What will it be like if I'm not breastfeeding? Why am I feeling so moody? Why am I losing my hair? What's going on with my skin?

How long will it take for my uterus to shrink? By the time you go into labor, your uterus is about 15 times heavier (not including its contents!) and its capacity is at least 500 times greater than before you conceived. Within minutes after your baby is born, contractions cause your uterus to shrink, clenching itself like a fist, its crisscrossed fibers tightening in the same way they do during labor. These contractions cause the placenta to separate from the uterine wall. After the placenta is delivered, the uterus clamps down even more, closing off open blood vessels in the area where the placenta was attached. As the uterus continues to contract, you may feel cramps known as afterpains.

For the first couple of days after birth, you can feel the top of your uterus at or a few finger widths below the level of your belly button. In a week your uterus weighs about a pound - half of what it weighed at delivery. After two weeks it's down to a mere 11 ounces and located entirely within your pelvis. By four to six weeks, it should be close to its pre-pregnancy weight of about 2.5 ounces. This process is called involution of the uterus. Even after your uterus shrinks back into your pelvis, you may continue to look somewhat pregnant for several weeks or longer. That's because your abdominal muscles get stretched out during pregnancy, and it will take time – and regular exercise – to get your belly back in shape.

How much weight will I lose right after giving birth? You probably won't return to your pre-pregnancy weight for some time, but you will lose a significant amount of weight immediately after delivery. Subtracting one 7- to 8-pound baby, another pound or two of placenta, and another 2 pounds or so of blood and amniotic fluid leaves most new moms about 12 pounds lighter.

The weight keeps coming off, too. All the extra water that your cells retained during pregnancy, along with fluid from the extra blood you had in your pregnant body, will be looking for a way out. So you'll produce more urine than usual in the days after birth — an astounding 3 quarts a day. And you may perspire a lot, too. By the end of the first week, you'll lose about 4 pounds of water weight. (The amount varies depending on how much water you retained during pregnancy.)

How come I can't tell when I need to pee? You may not be able to feel the urge to pee in the first days after you give birth, especially if you had a prolonged labor, a forceps or vacuum-assisted vaginal delivery, or an epidural. This is caused by your bladder becoming temporarily less sensitive. But with all the extra fluid your kidneys are processing, your bladder fills up rapidly, so it's essential for you to give yourself a chance to urinate frequently even if you don't feel the urge to.

If too much urine accumulates in your bladder, you might have a hard time making it to the toilet without leaking. What's more,

your bladder could become over-distended. This can cause urinary problems and also makes it harder for your uterus to contract, leading to more afterpains and bleeding.

If you can't pee within a few hours after giving birth, a catheter will be put in your bladder to drain the urine. (If you deliver by csection, you'll have a urinary catheter for the surgery and the following 12 hours or so.) Let the nurse know if you're having difficulty urinating or are only producing a small amount of urine when you pee. If your bladder gets too full, it can actually prevent you from being able to urinate.

Will my vagina and perineum ever get back to normal? If you give birth vaginally, your vagina will probably remain a little larger than it was before. Right after delivery, the vagina remains stretched open and may be swollen and bruised. Over the next few days, any swelling you might have starts to go down, and your vagina begins to regain muscle tone. In the next few weeks, it will gradually get smaller. Doing Kegel exercises regularly helps restore muscle tone.

If you had an episiotomy or a tear, your perineum needs time to heal so wait to start having sex again until you get the okay from your practitioner at your postpartum checkup. If you continue to have tenderness in that area, delay intercourse until you feel ready. In the meantime, figure out what you want to do for contraception. When you do feel ready (both physically and emotionally) to have sex again, be sure to go slowly. When you start having intercourse, you'll probably find that you have less vaginal lubrication than you did when you were pregnant, due to lower levels of estrogen. This dryness will be even more pronounced if you're breastfeeding, because nursing tends to keep estrogen levels down. Using a lubricant is a big help. (Be sure to buy a water-based lubricant, particularly if you're using a barrier method because oil-based lubricants can weaken latex, which can cause a condom to break or ruin a diaphragm.)

What's this vaginal discharge? It's normal to have vaginal discharge, called lochia, for a month or two after you give birth. It consists of blood and sloughed-off tissue from the lining of the uterus. For the first few days after birth, the lochia contains a fair amount of blood, so it will be bright red and look like a heavy menstrual period. You'll likely have a bit less discharge each day, and by two to four days after you've given birth, the lochia will be more watery and pinkish in color. By about ten days after you've given birth, you'll have only a small amount of white or yellow-white discharge, which will taper off over the next two to four weeks. Some women may continue to have scant lochia or intermittent spotting for a few more weeks.

What should I expect if I'm breastfeeding? Hormonal changes after delivery prompt your breasts to start producing milk. When your baby nurses during the first few days after birth, he's getting colostrum, a thick yellowish substance that your breasts produced during pregnancy. His suckling triggers the release of the hormones prolactin, which stimulates milk production, and oxytocin, which causes the milk sacs and ducts to contract, propelling the milk to your nipples. (This is the so-called "letdown" reflex.) If those first breastfeeding sessions cause some abdominal cramping, it's because oxytocin also triggers uterine contractions. When your milk comes in, usually a few days after delivery, your breasts may get swollen, tender, hard, and uncomfortably full. This is called engorgement and it should get better in a day or two. Nursing your baby often is the best thing you can do for relief. In fact, frequent nursing right from the beginning sometimes prevents engorgement altogether.

What will it be like if I'm not breastfeeding? If you're not breastfeeding, you'll still begin to produce milk, and a few days after you give birth, your breasts will become engorged. This may cause considerable discomfort that lasts for several days. The pain tends to peak three to five days after you give birth.

In the meantime, wear a supportive bra around the clock and put cold packs on your breasts, which will ease the swelling and help inhibit milk production. (Be sure to cover the cold packs with cloth to protect your skin.) It can take several weeks for your milk to dry up completely. If you need to, you can take acetaminophen or ibuprofen for pain relief. If you're extremely uncomfortable, you can express just enough milk to make the situation more tolerable. This may prolong the process, however, because stimulating your nipples and emptying your breasts signals your body to make more milk. Avoid applying warmth to your breasts since this, too, can encourage milk production.

Why am I feeling so moody? Mood swings may be due to a number of factors, including hormonal changes, discomfort you may still be experiencing from labor and birth, sleep deprivation and the other demands of caring for a new baby, as well as the emotional adjustment to motherhood. Whatever the cause, it's common to feel a little blue, usually beginning a few days after giving birth and lasting for a few days. If the feeling doesn't go away on its own in the first few weeks or you find that you're feeling worse rather than better, be sure to call your caregiver. You may be suffering from postpartum depression, a more serious problem that requires treatment.

Why am I losing my hair? If your hair got thicker during your pregnancy, you may now start to shed it in handfuls. This happens to some new moms in the first few months after having their baby. Don't worry - you won't go bald. During pregnancy, high estrogen levels may prolong your hair's growing phase, causing less to fall out than usual. After you give birth, your estrogen levels tumble and you begin to shed more. Over time, the rate of new growth and shedding will return to what it once was. Your hair should be back to its pre-pregnancy thickness about six to 12 months after you give birth. On the bright side, if you suffered from excess facial and body hair during pregnancy (the result of an increase in hormones called androgens), you can expect to lose that hair three to six months after having your baby.

What's going on with my skin? Hormonal changes, stress, and the fatigue brought on by new parenthood may affect your skin along with the rest of your body. Some women who had perfectly clear skin during pregnancy will have more breakouts in the months following delivery. On the other hand, if you suffered from acne during pregnancy, particularly if it appeared for the first time or got worse, you may begin to see some improvement now.

If you have chloasma (darkened patches of skin on your lips, nose, cheeks, or forehead), it'll begin to fade in the months after giving birth and probably go away completely, as long as you protect your skin from the sun. Any stretch marks you developed will gradually become lighter in color, though they won't disappear altogether.

What are the biggest hidden household dangers for newborns?

Expert Answers Martin N. Simenc, child safety expert

It doesn't take much work to keep a newborn safe. At this age, a baby's too small to get into much trouble on his own. He's not ready to stick buttons in his mouth or climb out of his crib, and it will be quite a few months before he starts toddling toward the stairs.

Still, it's not too early to make safety a top priority. Even before your baby arrives, you can learn how to handle the hidden dangers for newborns. Safe sleeping: To reduce the risk of sudden infant death syndrome (SIDS), newborns should sleep on their back on a firm mattress. Don't let your baby sleep with anything soft and cushy like a pillow, sheepskin, comforter, or plush toy. A warm one-piece outfit, or sleeper, is a safer choice than a blanket, which could cover his head and restrict his ability to breathe. Using crib bumpers is discouraged for the same reason. The mattress should fit tightly so your baby can't get trapped between it and the side of crib. Make sure that the crib doesn't have any missing or broken parts or any gaps greater than the width of a soda can.

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Get more information on the safest bedding and sleepwear for babies.

Safe diaper changes: Even the smallest babies can find a way to roll off a changing table if left unattended. Buy a table with safety straps or add straps to your current table. Even if your baby is strapped in, you should never leave him alone. (That phone call can wait.) You can avoid the risk of falling entirely by changing your baby on the floor using a receiving blanket or an unfolded cloth diaper as a changing pad.

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Find out more about childproofing your nursery.

Safe bathing: Whether you wash your baby in a baby bathtub, a sink, or a tub, never leave him unattended for a second. Once he's sitting up, a bath seat may seem like a handy safety device, but it can create a false sense of security. Hundreds of babies have drowned after tipping over or slipping out of their bath seats.

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Get more bath safety tips.

Here's how to protect your baby from other unexpected hazards:

• • • •

Keep heavy or breakable objects out of reach. Move objects such as picture frames and ceramic figurines away from the changing table and crib so your child can't knock them over. Place baby furniture away from hazards. Keep cribs and changing tables away from windows, window cords, and hanging mobiles to prevent your child from getting tangled, suffocating, or falling out the window. Secure unstable furniture. Make sure tall or unstable pieces of furniture are securely braced to the wall, especially if you live in an earthquake-prone area. Prevent falls. When you have a baby in your arms, a simple trip or fall can be disastrous. To help prevent falls, use lots of nightlights, put fresh carpet grips under your rugs, keep clutter off the floor, and fix or install stair railings.

Make your home fire-safe. Place functional smoke detectors in each bedroom, in the adjacent hallway, and on each level of your home. If your smoke detectors are more than ten years old, replace them. You should have at least one fire extinguisher on each floor of your house and a carbon monoxide detector next to the sleeping areas.

Milestone charts: What you can expect from birth to age 3

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Reviewed by the BabyCenter Medical Advisory Board Last updated: September 2006

Babies grow in such unique ways: The baby who sits up weeks before her peers might be one of the last to learn how to crawl. Or the 18-month-old who's still communicating with grunts and gestures suddenly bursts forth with prepositional phrases at 2 years. That's why we created this series of charts. Since babies aren't identical — thank goodness! — the charts allow for variations in stages of development. Use them to gain insight into what you're observing in your baby today and to preview what you can look forward to in the months ahead. One thing you shouldn't use the charts for, however, is grist for the worry mill. Each chart is meant as a guide, not as a source of concern.

Child's Age

Mastered Skills (most kids can do)

Emerging Skills (half of kids can do)

Advanced Skills (a few kids can do)

1 month

• Lifts head when lying on tummy • Responds to sound • Stares at faces

• Follows objects briefly with eyes • Vocalizes: oohs and aahs • Can see black-and-white patterns

• Smiles, laughs • Holds head at 45-degree angle

2 months

• Vocalizes: gurgles and coos • Follows objects across field of vision • Notices his hands • Holds head up for short periods

• Smiles, laughs • Holds head at 45-degree angle • Makes smoother movements

• Holds head steady • Can bear weight on legs • Lifts head and shoulders when lying on tummy (mini-pushup)

3 months

• Recognizes your face and scent • Holds head steady • Visually tracks moving objects

• Squeals, gurgles, coos • Blows bubbles • Recognizes your voice • Does mini-pushup

• Rolls over, from tummy to back • Turns toward loud sounds • Can bring hands together, bats at toys

4 months

• Smiles, laughs • Can bear weight on legs • Coos when you talk to him

• Can grasp a toy • Rolls over, from tummy to back

• Imitates sounds: "baba," "dada" • Cuts first tooth • May be ready for solid foods

5 months

• Distinguishes between bold colors • Plays with his hands and feet

• Recognizes own name • Turns toward new sounds • Rolls over in both directions

• Sits momentarily without support • Mouths objects • Separation anxiety may begin

6 months

• Turns toward sounds and voices • Imitates sounds • Rolls over in both directions

• Is ready for solid foods • Sits without support • Mouths objects • Passes objects from hand to hand

• Lunges forward or starts crawling • Jabbers or combines syllables • Drags objects toward himself

Child's Age

Mastered Skills (most kids can do)

Emerging Skills (half of kids can do)

Advanced Skills (a few kids can do)

7 months

• Sits without support • Drags objects toward herself

• Lunges forward or starts crawling • Jabbers or combines syllables • Starts to experience stranger anxiety

• Waves goodbye • Stands while holding onto something • Bangs objects together • Begins to understand object permanence

8 months

• Says "mama" and "dada" to both parents (isn't specific) • Passes objects from hand to hand

• Stands while holding onto something • Crawls • Points at objects • Searches for hidden objects

• Pulls self to standing, cruises • Picks things up with thumb-finger pincer grasp • Indicates wants with gestures

9 months

• Stands while holding onto something • Jabbers or combines syllables • Understands object permanence

• Cruises while holding onto furniture • Drinks from a sippy cup • Eats with fingers • Bangs objects together

• Plays patty-cake and peek-a-boo • Says "mama" and "dada" to the correct parent

10 months

• Waves goodbye • Picks things up with pincer grasp • Crawls well, with belly off the ground

• Says "mama" and "dada" to the correct parent • Indicates wants with gestures

• Stands alone for a couple of seconds • Puts objects into a container

11 months

• Says "mama" and "dada" to the correct parent • Plays patty-cake and peek-a-boo • Stands alone for a couple of seconds • Cruises

• Understands "no" and simple instructions • Puts objects into a container

• Says one word besides "mama" and "dada" • Stoops from standing position

12 months

• Imitates others' activities • Indicates wants with gestures

• Takes a few steps • Says one word besides "mama" and "dada"

• Walks alone • Scribbles with a crayon • Says two words besides "mama" and "dada"

Child's Age

Mastered Skills (most kids can do)

Emerging Skills (half of kids can do)

Advanced Skills (a few kids can do)

13 months

• Uses two words skillfully (e.g., "hi" and "bye") • Bends over and picks up an object

• Enjoys gazing at his reflection • Holds out arm or leg to help you dress him

• Combines words and gestures to make needs known • Rolls a ball back and forth

14 months

• Eats with fingers • Empties containers of contents • Imitates others

• Toddles well • Initiates games • Points to one body part when asked • Responds to instructions (e.g., "give me a kiss")

• Uses a spoon or fork • Matches lids with appropriate containers • Pushes and pulls toys while walking

15 months

• Plays with ball • Uses three words regularly

• Scribbles with a crayon • Runs • Adopts "no" as his

• "Helps" around the house • Puts his fingers to his mouth and says "shhh"

• Walks backward

favorite word

16 months

• Turns the pages of a book • Has temper tantrums when frustrated • Becomes attached to a soft toy or other object

• Discovers the joy of climbing • Stacks three blocks • Uses spoon or fork • Learns the correct way to use common objects (e.g., the telephone)

• Takes off one piece of clothing by himself • Gets finicky about food • Switches from two naps to one

17 months

• Uses six words regularly • Enjoys pretend games • Likes riding toys

• Feeds doll • Speaks more clearly • Throws a ball underhand

• Dances to music • Sorts toys by color, shape, or size • Kicks ball forward

18 months

• Will "read" board books on his own • Scribbles well

• Strings two words together in phrases • Brushes teeth with help • Stacks four blocks

• Throws a ball overhand • Takes toys apart and puts them back together • Shows signs of toilet training readiness

Child's Age

Mastered Skills (most kids can do)

Emerging Skills (half of kids can do)

Advanced Skills (a few kids can do)

19 months

• Uses a spoon and fork • Runs • Throws a ball underhand • Enjoys helping around the house

• Understands as many as 200 words • Recognizes when something is wrong (e.g., calling a dog a cat)

• Washes and dries own hands with help • Points to picture or object when you call it by name • May know when she needs to pee

20 months

• Feeds doll • Takes off own clothes • Dumps an object in imitation, such as throwing garbage away

• Learns words at a rate of ten or more a day • Can walk up stairs (but probably not down)

• May start exploring genitals • Draws a straight line • Names several body parts

21 months

• Can walk up stairs • Able to set simple goals (e.g., deciding to put a toy in a certain place)

• Throws a ball overhand • Kicks ball forward • Stacks six blocks

• Names simple picture in a book • Can walk down stairs

22 months

• Kicks ball forward • Follows two-step requests (e.g., "Get your doll and bring it here")

• Does simple puzzles • Draws a straight line • Names several body parts

• Puts on loose-fitting clothes • Might be ready for a big bed • Understands opposites (e.g., tall vs. short)

23 months

• Names simple picture in a book • Uses 50 to 70 words

• Opens doors • Sings simple tunes • Takes more of an interest in playing with other kids

• Talks about self (likes, dislikes) • Asks "why?"

24 months

• Names at least six body parts • Half of speech is understandable • Makes two- to three-word sentences

• Talks about self • Arranges things in categories • Can walk down stairs

• Begins to understand abstract concepts (e.g., sooner and later) • Becomes attuned to gender differences • Learns to jump

Child's Age

Mastered Skills (most kids can do)

Emerging Skills (half of kids can do)

Advanced Skills (a few kids can do)

25 and 26 months

• Stacks six blocks • Walks with smooth heel-to-toe motion

• Uses pronouns (e.g., I, me, you) • Washes and dries own hands

• Speaks clearly most of the time • Draws a vertical line

27 and 28 months

• Jumps with both feet • Opens doors

• Understands descriptions (e.g., big, soft) • Draws a vertical line

• Starts to recognize ABCs • Balances on one foot

29 and 30 months

• Brushes teeth with help • Washes and dries own hands • Draws a vertical line

• Draws a circle • Balances on one foot

• Puts on a T-shirt • Names one color • Names one friend

Child's Age

Mastered Skills (most kids can do)

Emerging Skills (half of kids can do)

Advanced Skills (a few kids can do)

31 and 32 months

• Recites own name • Draws a circle

• Puts on a T-shirt • Balances on each foot for a second • Recognizes ABCs • Brushes teeth by herself

• Uses two adjectives • Draws a cross • Points to objects described by use

33 and 34 months

• Names one color • Names one friend • Carries on a simple conversation

• Alternates feet going up and down stairs • Uses prepositions (e.g., on, in, over) • Speaks clearly most of the time (75 percent can be understood) • Stacks eight blocks

• Is toilet trained during the day • Wiggles thumb • Expresses a wide range of emotions • Draws a stick figure

35 and 36 months

• Describes how two objects are used • Uses three to four words in a sentence • Names two actions (e.g., skipping, jumping)

• Hops and skips • Follows a two- or threepart command • Separates fairly easily from parents • Rides a tricycle

• Balances on each foot for three seconds • Gets dressed without help

Your newborn How your baby's growing: Because he was curled up inside your uterus until recently, your newborn baby will probably look scrunched up for a while, with his arms and legs not fully extended. He may even appear bowlegged. Don't worry: Your baby will stretch out, little by little, and by the time he reaches 6 months, he'll be fully unfurled! In the meantime, as he adjusts to life outside the warm, safe confines of your womb, he may enjoy being swaddled in a light blanket. • Learn more fascinating facts about your newborn's development.

Your life: You're a parent!

This week, reality sets in — you have a baby! He's all yours, he's home with you, and he's dependent on you for love, care, and feeding. No doubt you've been reading up on what to do and how to do it. We have plenty of articles and tools to refresh your memory and teach you new tips, but here's our best advice this week: Don't try to master the art of caring for a baby all at once. Take it easy, take it slow. Your newborn is more durable than you might think. He's getting used to you as much as you and your partner are getting used to him. Like all good relationships, this one will take some time.

Your 1-week-old How your baby's growing: Your baby's eyesight is still pretty fuzzy. Babies are born nearsighted and can see things best when they're about 8 to 15 inches away, so she can see your face clearly only when you're holding her close. Don't worry if your baby doesn't look you right in the eye from the start: Newborns tend to look at your eyebrows, your hairline, or your moving mouth. As she gets to know you in the first month, she'll become more interested in having eye-to-eye exchanges. Studies show that newborns prefer human faces to all other patterns or colors. (Objects that are bright, moving, high-contrast, or black-and-white are next in line.) • Learn more fascinating facts about your 1-week-old's development.

Your life: Breastfeeding discomfort Two to four days after your baby's birth, your milk "comes in," filling your breasts and causing what's known as engorgement. (Until that happens, your nursing baby is drinking a nourishing pre-milk called colostrum.) This important shift has an unfortunate side effect for some new moms: It can create mild to considerable discomfort. Why? Your body is forcing milk from the glands that create it out to your nipples, and you're also dealing with a postpartum drop in hormone levels and the still-unfamiliar sensation of a newborn's suckling. Your breasts may feel tender or hard and hot, and they may swell or seem to throb. Don't take this as an indication that breastfeeding isn't for you because it's too painful. Engorgement is a short-lived condition that will diminish as your body adjusts to breastfeeding. Some helpful ways to reduce the pain in the meantime: • Take a warm shower. • Apply warm compresses (such as a washcloth soaked in hot water and wrung out) to your breasts before each feeding. • Express a small bit of milk from each breast before nursing. A full breast can make latching on more difficult, causing your baby to position her mouth in the wrong place. She then has to work harder to get the milk, which translates to tissue pain. • Wear a supportive nursing bra. Some women prefer to wear one even at night. • Nurse every two to three hours. Don't avoid feedings because of the pain — the more you nurse, the better your breasts will feel. • Drink lots of fluids to keep yourself well hydrated and to maintain milk production. • Alternate breasts. • Apply a cool compress after you feed. Try a baggie of crushed ice or a sack of frozen vegetables.

3 questions about: Jaundice

What is jaundice? Jaundice is a condition that causes a yellowish discoloration of the skin and the whites of the eyes. If you press your finger against the nose or chest of a fair-skinned baby with jaundice, you can see this yellow tinge. If your baby has dark skin, you can see the yellowness in the whites of the eyes or in the gums. The most common type of jaundice develops on the second or third day of life — about when the baby is being discharged from the hospital — which is why it's important to know about it and keep an eye out for it. Most of these cases, called physiologic jaundice, disappear on their own in two weeks.

What causes jaundice? A newborn has more red blood cells than her body needs, and often, when a baby's immature liver can't process them quickly enough, a yellow pigment called bilirubin (a byproduct of the red blood cells) builds up in the blood. Much of this bilirubin leaves the body in the baby's stool, but about half of babies develop some degree of jaundice during the first two weeks of life. Preemies and babies with genetic diseases or infections are especially vulnerable. Some breastfeeding babies develop jaundice if they don't get enough breast milk, because the bilirubin isn't able to exit the body through body waste. Breastfeeding jaundice usually shows up in the first two weeks of life. When jaundice is detected within the first 24 hours, it may be due to a blood-group incompatibility with the mother (the mother is Rh-negative and the baby is Rh-positive), infection, or an underlying liver problem.

Should I worry? Most newborn cases of jaundice are harmless and require no treatment. The doctor may order blood tests to measure your baby's bilirubin levels, which usually involve taking a small amount of blood from your baby's heel. In moderate cases of jaundice, the doctor may prescribe phototherapy (light therapy), which involves placing the baby naked under special blue lights that help her body break down the bilirubin so that it can be excreted. This can be done in the hospital or at home with a portable unit. A special kind of fiber-optic blanket, called a bili blanket, has a similar effect. In addition to phototherapy, it's important to keep your baby well hydrated and to identify and treat any underlying medical issues. Your doctor may recommend breastfeeding more often or supplementing with formula to give your baby more fluids and help her pass more bilirubin in her stools. The goal of treatment is to lower the bilirubin level to prevent the buildup of toxic levels in the baby's brain (a disease called kernicterus). With monitoring and treatment, the risk of kernicterus or other complications drops to almost none.

Your 2-week-old How your baby's growing: Your womb was a warm and cozy environment, and it takes time for your baby to adjust to the various sights, sounds, and sensations of life outside your body. You may not be able to detect much of a personality just yet as your baby spends his time moving in and out of several different states of sleepiness, quiet alertness, and active alertness. The only way your baby knows to communicate is by crying, but you can communicate with him through your voice and your touch. (He can now recognize your voice and pick it out among others.) Your baby probably loves to be held, caressed, kissed, stroked, massaged, and carried. He may even make an "ah" sound when he hears your voice or sees your face, and he'll be eager to find you in a crowd. • Learn more fascinating facts about your 2-week-old's development.

Your life: The baby blues It seems to make no sense: At a time when you expected to be so happy, you feel down, weepy, moody, or irritable. In fact, there are very good reasons why about half of new moms get the so-called baby blues.

During the first weeks home with a baby, sleep deprivation, recovery from childbirth, the demands of newborn care, lack of experience with babies, and not having enough help can all be highly stressful. The huge hormonal shifts that occur after you give birth can also affect your moods, especially if you have a history of severe PMS. Then factor in modern America's expectations about moms "doing it all" and new moms being "blissed out," and you have the makings of a perfect storm for mild depression. Knowing that these feelings are normal can help. It's a good idea to confide your feelings to people you love and trust: your partner, your parents, another relative, or a close friend. Connecting with other new parents online or in your community can help you see that you're far from alone. Carve out time for yourself. Let your partner or a grandparent stay with your baby while you visit a friend, go shopping, or just take a relaxing bath. Even sitting outside or taking a walk with your baby in the fresh air can be beneficial. Leave work behind. Really! Remember this is maternity leave. Turn off your cell phone and avoid your computer. Use these weeks to nurture your ties with your family. If feelings persist more than a couple of weeks, tell your doctor. You may have postpartum depression (PPD), a more serious condition. The causes of PPD aren't completely understood, but it's not a reflection on whether you're a "good" mom or "coping well." Symptoms of PPD include extreme anxiety, panic attacks, changes in eating habits (overeating or loss of appetite), insomnia, and thoughts of harming yourself or your baby.

3 questions about: Reducing the risk of SIDS What is SIDS? Sudden infant death syndrome (SIDS) is sometimes called crib death. It occurs when a baby under 1 year old dies suddenly and without warning, usually while asleep.

Should I worry? Even though SIDS is the leading cause of death among babies between 1 month and 1 year, it's still rare. SIDS claims about 2,500 victims a year — that is, fewer than 1 in 1,000 — usually between the ages of 2 and 4 months. No one knows exactly what causes SIDS, although the following factors are thought to increase the risk:

• A parent or caregiver who smokes • Sleeping facedown on the mattress • Being born prematurely • Low birth weight • Sleeping on a too-soft surface • Being too hot while sleeping

How can I reduce my baby's risk? Always put your baby to sleep on his back. When pediatricians and SIDS researchers began recommending this practice in 1992, the rate of SIDS deaths fell an astounding 50 percent. Even putting your baby to sleep on his side isn't advisable. Clear the cradle or crib of any pillows, soft toys, and bumpers, which can unexpectedly cover your baby's mouth and affect his breathing. Keep your baby's head uncovered. Keep the room cool (around 65 degrees Fahrenheit), especially if you swaddle your baby.

Don't overdress your baby at bedtime — put him in as little or as much clothing as you'd wear to bed. Some experts advise against sleeping with your newborn in your bed during the early months because the soft bedding is a risk. Others believe that sharing a bed allows parents to respond more quickly to changes in their baby's breathing or movements. If you do co-sleep, remove fluffy comforters and make sure the mattress is firm. Your baby should sleep on his back even in your bed.

Never smoke around your baby and keep him away from those who do. It's possible that breastfeeding your baby and giving him a pacifier during sleep may lower his risk for SIDS, but more research is needed to confirm these links.

Your 3-week-old How your baby's growing: Babies love and need to suck, so don't discourage it. In fact, you may have already discovered that a pacifier works wonders in helping your baby calm down. When the "binky" or your finger isn't available, your baby may even be able to find her thumb or fingers to soothe herself. The American Academy of Pediatrics recommends using a pacifier at nap time and bedtime, based on evidence that using a pacifier may reduce the risk of SIDS (sudden infant death syndrome). That said, there's no need to reinsert the pacifier if it falls out once your baby's asleep. • Learn more fascinating facts about your 3-week-old's development.

Your life: Bonding Some moms talk about feeling an instantaneous, consuming love right from the beginning. That's become the prevailing image of what "bonding" is supposed to be like. But bonding isn't a single, magical delivery-room moment. For more than half of new mothers, feeling connected takes a bit longer — and for good reason. Birth, delivery, and recovery can be taxing physical experiences, especially if there are complications. If you've never spent a lot of time around babies, let alone been completely responsible for taking care of one, anxiety and worry about doing everything right can intrude too. Your relationship with your child is not so different from your other relationships — it can take time and many interactions for those feelings of attachment to develop and ripen. So there's no need to feel guilty if you look at your long-awaited baby and feel like you're staring at a little stranger. In a sense she is. Give it time and eventually you won't be able to imagine life without her. If after several weeks, however, feelings of aloofness or even resentment continue, you could be suffering from postpartum depression. Ten percent of new moms suffer from this form of depression, triggered largely by hormonal changes after delivery. In addition to prolonged feelings of ambivalence about motherhood, accompanying symptoms include insomnia, anxiety, changes in appetite, and thoughts of harming yourself or your baby. Postpartum depression has nothing to do with your fitness as a mom and everything to do with biochemical changes you have little control over. Call your ob-gyn or midwife now — don't wait until your postpartum checkup. The sooner you seek help, the sooner you'll feel better.

3 questions about: Colic What is it? Colic is extended frantic crying in an otherwise healthy and well-fed infant. It's thought to affect between 10 and 25 percent of babies under 3 months of age. All infants cry more in the first three months of life than at any other time in their lives, but colic is different. Some doctors define it by the rule of threes: three hours of crying at a time, at least three times a week, for at least three weeks in a row — usually starting between the third and sixth week of life. The "colicky" episodes often come on suddenly in the evening hours. Many babies will cry intensely, unable to be soothed, clenching their fists and drawing up their legs. Every baby is different, but colic usually fades away by around 3 months.

What causes colic? No one's sure. Some people theorize that it's due to a baby's immature digestive system or to food allergies. Others believe the cause may be a still-developing nervous system or a baby's temperament that allows her to be easily overstimulated. Although colic can make parents feel helpless and guilty, it's temporary — and it's not a sign of a long-term problem.

What can I do about colic? Each baby is different and is comforted by different measures, so you may need to experiment with a few techniques to find what works best for your baby. Here are some suggestions: Try to create a calming environment that mimics what life was like in your uterus: snug, warm, and calming. Swaddle your baby firmly in a blanket. Rock her in your arms or in a rocking cradle. Try holding her in an upright position to help her pass some gas. Some colicky babies are soothed by loud repetitive sounds, such as a vacuum, dishwasher, clothes drier, or "white noise" machine, all of which are probably reminiscent of the sound of your internal

organs from the inside. Or combine sound and motion by taking a car ride. Other ideas: a warm bath, a warm hot-water bottle or towel placed on your baby's stomach (make sure the temperature is comfortable on her skin), or a pacifier. Some parents report that their baby's colicky symptoms improve with an over-the-counter medicine called simethicone, which may reduce intestinal gas.

Hearing a baby cry can be frustrating and exhausting. It's helpful to have someone who can take turns with you holding and pacing with your baby. If you have to set your baby in her crib or another safe place for a few minutes to use the bathroom (or to have a good cry yourself), rest assured that leaving her alone for a few minutes, even if she's crying, is not going to hurt her. Do let your doctor know if the cry sounds shrieking and pained, if your baby stops gaining weight, if she has a fever, or if the colicky symptoms go beyond age 3 months— as these may be signs of health problems.

Your 4-week-old How your baby's growing: Your baby may gurgle, coo, grunt, and hum to express his feelings. A few babies also begin squealing and laughing. Be sure to coo and gurgle back, and talk to your baby face to face. He'll enjoy holding your gaze now. If you have things to do, your baby will still enjoy hearing your voice from across the room. And don't feel silly about using baby talk — babies are particularly attuned to this high-pitched, drawn-out way of communicating, which can actually teach your baby about the structure and function of language. • Learn more fascinating facts about your 4-week-old's development.

Your life: Mixed feelings Even when you're the happiest person on earth to be a new parent, it's common to have nagging little feelings of disappointment. Not that you want to tell anyone. But you spent nine months imagining what your baby would be like and now here he is — perhaps not exactly what you'd pictured. Parents of a baby born with a health problem are especially vulnerable to this feeling of not getting what they'd bargained for. But parents of healthy children often have such feelings too. In all of these situations, there's a wonderful new baby to celebrate. And yet there's often an imaginary baby to mourn before the real baby can be fully embraced. Rarely does anybody talk about this phenomenon, but it's perfectly normal and human. So if your joy is tinged with a little regret, don't feel guilty. Give yourself a little space to privately grieve, and then count the blessings you do have.

3 questions about: Vaccines Why are so many vaccines recommended for babies? No parent enjoys seeing her baby getting shots or taking medicine. But vaccines are designed to provide protection against serious diseases and many people consider them the most important part of well-baby checkups. Some of those diseases (such as polio and diphtheria) were much more common a hundred years ago, but are rarely seen now in the United States, thanks to immunization programs. How do they work? Vaccines contain "weakened" or killed versions of the virus or bacteria that causes a disease. After a baby receives the vaccine, his immune system creates antibodies to the virus or bacteria that will protect him against the disease if he's exposed. What's the vaccine schedule? Immunizations given in the first year include the following: • DTaP: Protects against diphtheria, tetanus, and pertussis (whooping cough). Five doses: at 2, 4, and 6 months, between 15 and 18 months, and between 4 and 6 years. • Flu ("influenza"): Protects against the influenza virus, which can cause severe respiratory infections and pneumonia. A yearly dose is recommended for those 6 months to 18 years old during flu season (fall and winter). Children younger than 9 getting a flu shot for the first time need two doses of vaccine the first year they're vaccinated, administered one month apart. • HBV (hepatis B): Protects against the hepatitis B virus, which attacks the liver. Three doses: at birth, between 1 and 2 months, and between 6 and 18 months. • Hib (Haemophilus influenzae type b bacteria): Protects against meningitis, blood infection, pneumonia, and epiglottitis. Four doses: at 2, 4, and 6 months, and between 12 and 15 months.

• PCV (pneumococcal) vaccine: Protects against pneumococcal pneumonia (a common lung disease), meningitis, and ear infections. Four doses: at 2, 4, and 6 months, and between 12 and 15 months. • Polio (IPV or inactivated polio virus): Protects against polio, which can cause paralysis and death. Four doses: at 2 and 4 months, between 6 and 18 months, and between 4 and 6 years. • Rotavirus vaccine: Protects against rotavirus, which causes severe diarrhea, vomiting, fever, and dehydration. Unlike the other vaccines, it's a liquid given by mouth. Three doses: at 2, 4, and 6 months. Vaccines recommended for babies after age 1 include varicella (for chicken pox), MMR (for measles, mumps, and rubella), and hepatitis A.

Your 5-week-old How your baby's growing: Smiling is universal. A baby's first smile happens at about the same time in all cultures, so get ready for your baby to reward all your loving care with a beaming, toothless, just-for-you grin. This will probably make your heart melt, even if you've just had your worst night yet. • Learn more fascinating facts about your 5-week-old's development

Your life: The postpartum checkup Soon you'll have the last of the series of checkups that began with your first prenatal trip to your doctor or midwife. Your care provider will want to be sure you're doing fine — emotionally as well as physically — following the stresses of pregnancy, labor, delivery, and becoming a new parent. During the pelvic exam, your doctor or midwife will want to see that any tears, scratches, or bruises to your vagina or cervix have healed. If your cervix is healed, you may also have a Pap smear. She'll examine your perineum if you had an episiotomy or tearing. She'll also feel your belly to be sure that there's no tenderness, and if you had a c-section she'll inspect your scar to see how it's healing. Your breasts will be checked as well. If you're breastfeeding, your caregiver will examine you to find out whether you have any clogged ducts, which could lead to an infection like mastitis. If you aren't nursing, she'll want to be sure there are no hard or sore areas that might indicate an infection. She'll also want to see if your milk is drying up. You'll probably be told it's fine to begin having sex again, although many new moms don't feel their sex drive or energy kick in for a few more weeks or even months. Regardless of your interest level, you ought to discuss postpartum birth control, because it's possible to get pregnant before you've gotten your period back and even if you're breastfeeding. Your caregiver will also be concerned about your emotional health. As many as 4 out of 5 new moms become mildly depressed, commonly called the baby blues. However, if these down feelings last more than two weeks, you may have postpartum depression, a more serious condition. Your doctor or midwife can recommend interventions that really help, such as a therapist who sees lots of moms like you or an antidepressant that's safe to take when nursing.

3 questions about: Working with your child's doctor How often will my baby see a doctor? Most pediatricians and family physicians like to see newborns for well-baby checkups once or twice in the first ten days of life and then at 1 month, 2 months, 4 months, 6 months, 9 months, and 12 months. If your baby has any medical problems or difficulty gaining weight, your doctor may want to see your baby more often. How can I get the most out of these well-baby checkups? Doctors are busy, and it's likely that the checkup will fly by and that you'll be distracted by your baby at the visit, so come prepared with our doctor visit worksheets. Jot down in advance any questions you may have. Keep a notebook and pen in a handy place at home, and bring it to appointments so you can write down information like your baby's weight, length, and vaccinations, as well as any advice or instructions the doctor provides. If you forget to ask something during the appointment, don't worry. You can always call the doctor between appointments and have your question answered by phone. You're the expert on your baby — and the doctor is the expert on baby care and health — so good communication is key. If you disagree with your doctor's advice or feel your comments are being dismissed, speak up. It may be that you've misunderstood one another. Most doctors appreciate your honesty and want their interaction with you and your baby to be rewarding and informative. If you find that you have serious disagreements, you may want to find another doctor with whom you feel more comfortable. Ask friends for referrals. What if I need to talk to the doctor after hours?

Be sure you know what the routine is in your doctor's practice. Most physicians have a system for responding to questions and concerns — usually either a message service you can call to leave your name and number, or a nurse advice line that you can reach after hours. Also find out how emergencies are handled in the practice and which local emergency rooms and after-hours clinics you can access. The most important thing to remember about seeking your doctor's advice is that there are no stupid questions when it comes to your baby's health.

Your 6-week-old How your baby's growing: Now that your baby's awake for longer periods during the day, you can use these times to support his sensory development. Try singing your favorite lullabies or playing music. You don't have to limit yourself to children's songs. Fill the house with the sounds of music — from the Black Eyed Peas to Mozart — and watch as your baby expresses his pleasure through coos, lip smacks, and jerking arm and leg movements. • Learn more fascinating facts about your 6-week-old's development.

Your life: Sex after the baby You're tired beyond belief. Your sexual desire is nil (thanks to readjusting hormone levels, particularly if you're breastfeeding). Everyday life with a baby is so different from the life you were living when he was conceived that those days seem a distant memory. Just because your doctor proclaims you physically ready for intercourse doesn't mean the rest of you is ready to go along, even if your mate is. Whether or not you feel like making love, you and your partner can still focus on loving one another. According to a University of Wisconsin study, 65 percent of women did some sexual touching with their partner during the first month after childbirth and 34 percent performed oral sex, while only 17 percent had intercourse. Here are a few common postpartum concerns about sex: Will intercourse hurt? If you had any stitches due to a tear in your perineum, an episiotomy, or a difficult delivery, your vagina may still feel tender, and it may be months before the soreness goes away. If you're recovering from a cesarean section, you may still feel sore along your lower abdomen, where you have a scar. The missionary position may put pressure where you're sorest, so consider other positions. If you're breastfeeding, changes in your hormone levels may lead to vaginal dryness. If so, try using a lubricated condom or a water-based lubricant. Has my vagina been stretched out? The vagina is very elastic, expanding to accommodate a baby and often reverting pretty close to pre-pregnancy size afterward — but it's normal for it to be larger than it was before. How much larger depends on various factors: how big your baby was, how many children you've had, and whether you do Kegel exercises regularly to help strengthen your vagina's muscle tone. Will my husband still be attracted to me sexually? If your husband seems distant or less interested in sex himself, remember that he's going through a lot too. It's likely he's exhausted and stressed by the new demands of having a baby in the house. He may also need time to get adjusted to the fact that his sexy wife is now a mother. Talking frankly about your feelings and all the weird changes having a baby brings can draw you closer. If the time's not yet right for sexual intercourse, you can still cuddle, kiss, hug, and please each other in other ways.

3 questions about: Fever Why does my baby have a fever? This may be your baby's first fever, so you're probably nervous. But take heart in knowing a fever is a sign that your baby's immune system is doing its job in fighting an infection. When your baby becomes ill because of a virus or bacteria, his body responds by raising its temperature. A fever is actually a good thing rather than a problem in and of itself. Should I call the doctor? Until your baby reaches the 3-month mark, you should always seek medical advice if: • Your baby has a rectal temperature higher than 100.4 degrees Fahrenheit (38 degrees Celsius). • Your baby looks pale or flushed, is listless, or has no appetite, or if his behavior and appearance have changed in ways that worry you. When you call your doctor, it's important to tell her how high your baby's temperature has gone, how you took it, and what other symptoms your baby's having. Based on this information, your doctor will help determine how serious your baby's fever is and tell you whether it's safe to give him medicine. Be sure not to give your baby medicine before talking to a doctor — it can be

dangerous to give him the wrong dosage, and medication can mask your baby's symptoms, making it hard for the doctor to give appropriate care. If the fever is higher than 100.4 degrees, your doctor will probably ask you to bring your baby to the office to be examined and treated. How can I make my baby more comfortable? • Cool him off by removing layers of clothing or giving him a sponge or tub bath with lukewarm water for about five to ten minutes. This will reduce his body temperature as water evaporates from his skin. Avoid cold baths, which may cause your baby to shiver, raising his core body temperature even more. • Feed him regularly and offer extra feedings to help prevent dehydration. • If the doctor recommends it, give your baby the appropriate dose of acetaminophen. • Never try to cool a baby by putting rubbing alcohol on his skin, as it can be absorbed into his bloodstream and cause seizures or other serious problems.

Your 7-week-old How your baby's growing: Your baby's brain is expanding in size and complexity. It will grow about 5 centimeters during the first three months. You may notice short periods of time when your newborn is quiet and alert. This is prime time for learning. Use these calm intervals to get better acquainted with your baby — talk to her, sing to her, describe the pictures on the walls. She may not be able to add to your conversation just yet, but she's learning nonetheless. New textures for her hands to feel and new sights and sounds (all in moderation) are all learning opportunities. Even bath time becomes a laboratory for understanding the world around her. • Learn more fascinating facts about your 7-week-old's development.

Your life: Guilt over not breastfeeding Today's society puts a lot of pressure on new moms to breastfeed. No doubt breast milk is the perfect first food. However, there are many reasons why breastfeeding just doesn't work for some women and their babies, including illness, discomfort, and frustration. Guilt over not breastfeeding can hit especially hard if you had planned during pregnancy to do so but then circumstances made it impossible or more difficult than you'd expected. Both breast milk and commercial formula nourish growing babies. If you've given up on breastfeeding — or are thinking of doing so — be sure to discuss your choice with your doctor or a certified lactation consultant. Talk through your feelings and don't be too hard on yourself. The main thing to remember is that how you feed your baby is ultimately not as important as providing her with love and care.

3 questions about: Hearing How do I know if my baby can hear well? "She sleeps through everything!" you might marvel. "But is her hearing all right?" All babies should receive a newborn hearing screen before leaving the hospital, as recommended by the American Academy of Pediatrics and the National Institutes of Health. (Estimates show that 2 to 3 of every 1,000 babies are born with some degree of hearing loss.) Luckily, most babies are born with excellent hearing. A baby who turns when you enter the room or is beginning to coo and make pre-speech sounds probably hears just fine. You can check your baby's hearing in a simple way: When your baby is awake and alert, stand behind her and clap your hands behind her head. If her hearing is good, she should startle at this loud, sudden noise. Repeat the experiment a couple of times to be sure. A baby with normal hearing may respond to noise by turning her head to find the source of the sound. If your baby doesn't notice you until she can see you, it could be a sign that her hearing is impaired. What can cause hearing problems? Some babies are born with hearing difficulties because of a hereditary problem. A family history of deafness can be a red flag. Other causes include exposure to infections such as rubella (German measles) or CMV (cytomegalovirus) in utero, problems during delivery that compromised the supply of oxygen to the baby, meningitis, hypothyroidism, or prematurity. Some birth defects also cause deafness. In some cases, a hearing problem is temporary, caused by a cold, a middle ear infection, or a large buildup of earwax. Or the inner ear could be damaged because of an injury, a tumor, or a virus. What if there's a problem? If you have any concerns about your baby's hearing, be sure to tell your baby's doctor, who can examine your baby's ears, run hearing tests, or refer you to an audiologist (hearing specialist) or a pediatric ENT (ear, nose, and throat doctor), who can do a more in-depth ear examination.

Early diagnosis is important for hearing problems. Hearing loss that goes untreated can cause your baby to have trouble with learning and language development in the future, but early diagnosis and treatment usually leads to normal development of language skills. Treatment for impaired hearing may include a hearing aid, which can be made to fit even a tiny baby. Later, such children may be candidates for a cochlear implant, a device that uses electrodes to process sound, as well as speech therapy.

Your 2-month-old: Week 1 How your baby's growing: Your baby can tell the difference between familiar voices and other sounds, and he's becoming a better listener. He can also show you that he's in tune with his environment. Notice how he looks to see where certain noises are coming from. An ongoing conversation (although seemingly one-sided) can help your baby develop his sense of place. He may even watch your mouth as you talk, fascinated by how it all works. You'll be amazed by his ability to communicate with a growing repertory of coos (musical, vowel-like sounds), smiles, and unique cries to express his different needs. • Learn more fascinating facts about your 2-month-old's development.

Your life: Loving your partner Very few parents feel amorous in the weeks following childbirth, for some pretty understandable reasons. It's important to remember, however, that being a new parent doesn't mean that you're no longer a sexual being. Even if you don't have time, stamina, or interest in having sexual intercourse, you and your partner can still find ways to express your love for each other. Love through talk. Keep the lines of communication open no matter how stressed you feel. Remember that you're both going through huge changes in your life. Talking about them can help you feel closer. Frame complaints so that they don't sound accusatory: Instead of saying, "You shouldn't do ___," for example, try, "I feel ___ when you do ___." Love through laughter. When your life has turned upside down and you're so tired you could be mistaken for a zombie, it's as appropriate to laugh about it as to cry. Poke fun at your own mistakes together. Love through escape. Leave your baby in the care of a trusted relative or sitter while you go on a date. See a movie, go out for dinner or dessert, or do something else you can enjoy together. Just being away for a couple of hours can recharge you. Love through touching. Sex isn't all about intercourse. Kissing, cuddling, caressing, and other kinds of physical intimacy don't require a lot of energy and can help you relax. Love through time. Remember that these topsy-turvy weeks are temporary.

3 questions about: The 2-month exam What will the doctor be looking for? She'll weigh and measure your baby, checking his length and the size of his head to be sure he's growing at the proper rate. Your baby's vision and hearing will be checked, as will his heart and lungs. The doctor will examine him from head to toe, front and back, making sure that he's healthy and meeting his developmental milestones. She'll screen for common infant health issues, including diaper rash, baby acne, thrush, and cradle cap. This is a great time to bring up questions you have about breastfeeding, returning to work, and any other health or behavior concerns. Print out our doctor visit worksheet to take with you to the appointment. Which vaccines will be recommended? At this visit, it's recommended that your baby get the following vaccines: hepatitis B; polio; DTaP (diphtheria, tetanus, and pertussis); Hib, to protect against meningitis; pneumococcal, to protect against severe bacterial infections, ear infections, and meningitis; and rotavirus (given by mouth), to prevent stomach flu. What questions will the doctor ask? Most likely she'll cover the baby basics: • Your baby's feeding: Breast milk or formula, how often and how much? • Your baby's elimination: How many bowel movements and wet diapers per day, and what is the consistency and color of the bowel movements? • Your baby's sleep: How many consecutive hours at night, in what position, and where? • Your baby's behavior and development: Does he respond to your voice, smile, and coo? Does he look at faces and track objects with his eyes? What does he do during tummy time?

What's your new-father IQ? Take our quiz to see if you know all there is to know about life as a dad.

Take the quiz 1. How long should you let your newborn cry at night before picking him up? a. Less than one minute b. Five to ten minutes c. Ten to 15 minutes d. Until he stops 2. How many times a day does the average newborn eat? a. Three meals a day b. Every four hours c. Eight to ten times d. On the hour every hour 3. What's the standard advice on how long after childbirth you should wait until you and your wife can have sex again? a. One week b. Six weeks c. Three months d. Until your wife says so e. Until her doctor gives the green light 4. What's the number one never-leave-home-without-it item you should bring for an afternoon at the park with your 6month-old? a. Your cell phone b. A burp cloth c. The video camera d. A diaper e. Sand toys 5. If you want to buy your 9-month-old new clothes, what size should you buy? a. 6 to 9 months b. 10 to 16 pounds c. 12 to 18 months d. Small 6. What sort of postpartum present would your wife-turned-mom appreciate the most? a. An outfit for the baby b. A bouquet of flowers c. A gift certificate to pamper herself with a facial, massage, or manicure -- and the time off to schedule it 7. What do Graco, Perego, and Maclaren all have in common? a. They were heroes in World War I

b. They make pasta and tomato sauce c. They build sturdy strollers d. They are wineries in California's Napa Valley 8. Which one of these should you use to clean your baby's umbilical cord? a. Rubbing alcohol b. Hydrogen peroxide c. Soap and water d. Baby shampoo 9. Which one of these words just doesn't belong? a. Sling b. Exersaucer c. Pixel d. Swaddle 10. Where should the baby sit in the car when you bring him home from the hospital? a. On your wife's lap in the back seat b. In an infant car seat facing forward in the front seat c. In an infant car seat facing backward in the front seat d. In an infant car seat facing backward in the back seat 11. What should you always bring your wife when she breastfeeds? a. A glass of water b. A magazine c. Her favorite beer d. The TV remote 12. What's the average amount of time it takes for a baby to sleep through the night? a. Three weeks b. Three months c. 12 months d. Two years 13. Postpartum blues refers to: a. Songs women sing in the delivery room b. A woman's sadness and moodiness after giving birth c. The incandescent color of the sky 14. Your wife is so sleep deprived that she can't see straight. You: a. Call your mother b. Ask your mother-in-law to come visit c. Offer to take the 2 a.m. feeding

d. Hire a night nurse

Top tips for dads on bonding with your baby by Jodi Picoult Reviewed by the BabyCenter Medical Advisory Board

Highlights Give a midnight bottle Have a staring contest Play kangaroo Take a bath together Read the sports page Set a table for two Change a diaper Be there for a cold or fever Bench press Be a texture board Take pictures Roughhouse (within reason) One of my clearest memories of early motherhood involves early fatherhood. I never would have expected my husband — a champion coach in the delivery room — to be so indifferent to the trophy we were taking home. Sure, he loved our son, but he insisted it wasn't the same for him as it was for me. I got to feed Kyle, spend the day with Kyle, rock him to sleep; my connection to our new son was so profound that he might as well have still been linked by an umbilical cord. On the other hand, my husband would come home from work and seem completely baffled by the baby.

Well, Tim found out quickly what most moms know from the very start: namely, that a baby's got charm and grace galore. I'd hand him Kyle to watch for a moment, and come back to find the two of them grinning like fools on the couch.

Now, after having three children, I realize my husband was just shy. Taking care of a newborn is often elementally reduced to feeding and comforting, and some new dads don't know if they've got the right equipment for the job. The real secret of malebonding with a baby is realizing that you're not supposed to try to be another mother. Your child already has one of those, and what she really needs is for you to be yourself. Still feeling a little shy? Try these break-the-ice activities.

Give a midnight bottle After I began to supplement breastfeeding with formula, my husband offered to get up for the middle-of-the-night banquet. Okay, so maybe I bullied him into it at first, but before long he told me he enjoyed having that time with the baby. No one else around, crickets chirping outside, and bizarre infomercials on TV. Once, I overheard my husband having a 3 a.m. conversation with a sound-asleep Kyle. "You know what, buddy?" he was saying. "We're the only two people in the universe who know that they aired that same show about Wilt Chamberlain four nights in a row."

Have a staring contest Prowess is a guy thing, right? Lest you believe that little baby of yours is a pushover, engage her in a time-honored ritual of seeing who'll blink first. She may surprise you. Babies love to contemplate faces, and chances are that before she gets bored you'll have dropped your gaze, wondering where she got that incredible dimple, or whether her ears look like your mom's or your wife's.

Play kangaroo My firstborn was a colicky baby who was never happy unless someone was holding him. At the end of the day, Tim used to come to the rescue by strapping on a Snugli and going about his business — raking leaves, setting the table, tossing a ball for the dog — all with Kyle cuddled against his belly.

Take a bath together

A new dad we know dreaded the nights when it was his turn to bathe his son — the combination of screaming baby and slippery skin made him nervous. One night, he simply stripped down himself and took the infant into the tub with him. Lo and behold, the baby was calm for the entire duration of the bath. Being snuggled against his father's chest made all the difference.

Read the sports page Aloud. Let's face it: Goodnight Moon can get you only so far. After the 1,500th reading of the classic book, my husband finally threw in the towel. I walked by the nursery at bedtime to hear him very sweetly crooning the details of a Patriots game to Kyle. The baby loved every minute of it ... it didn't matter what his father was reading, just so long as he was.

Set a table for two If your baby is old enough to be eating solid food, then you might as well be the maitre d'. It's entertaining — see the food go in, watch it come right back out!

Change a diaper Talk about bonding at the earthiest level — with babies, the bottom line (no pun intended) often involves cleaning up a mess. During a change you get to touch the baby, and talk to him, but it's sometimes hard to see a silver lining when a soggy lining is so much more evident. Still, fair's fair. My friend Mary's husband once asked her what she did all day with the baby, so she lined up 18 dirty diapers in neat, plastic piles on the front stoop for him to see when he came home.

Be there for a cold or fever Nobody wants their baby to get sick, but there's nothing like an illness to prove how much the little guy really needs you. A night spent rocking a sick child will make you painfully, preciously aware of what parenting is all about.

Bench press The bad news is that once you're a parent, you don't have much time to get to the gym. The good news is that you have just acquired a fabulous set of hand weights, approximately 7 to 20 pounds. Once our kids' necks could support the weight of their heads, Tim would balance their bodies on his palms and then carefully curl them, bench them, whatever struck his fancy ... and both his biceps and the babies loved it.

Be a texture board One of the greatest attributes of men is that they feel great (or they probably wouldn't be daddies in the first place). From the rough shadow of beard to a silky moustache to a crewcut hairdo, a father is a tactile delight. Beware: Little fingers can get a punishing grip on chest hair.

Take pictures Nothing makes as flawless a subject as your own child. An added benefit? All the grandmas and grandpas and uncles and cousins who are the recipients of the prints can't help but notice what a great time you're having being a dad.

Roughhouse (within reason) Studies have shown that mothers and fathers hold their babies in very different ways. Moms are more likely to cuddle; dads tend to get a little more physical. You should never shake a baby, but you can certainly stimulate her muscles. If your child is old enough to sit up, she might like being tossed gently in the air, or getting bounced on a knee, or being carried beneath the arm like a football ... things that Mom isn't as likely to do, but that are sure to bring squeals of delight.

Sleep-sharing: The family bed Reviewed by the BabyCenter Medical Advisory Board Last updated: January 2007

Highlights What is sleep-sharing and how common is it? How do I know whether sleep-sharing is right for my family?

Check in with your partner Check in with your baby What are the long-term effects of sleep-sharing on children? Safety and sleep-sharing Parents' voices

What is sleep-sharing and how common is it? Co-sleeping, sleep-sharing, the family bed: Whatever you call it, it means regularly sharing a bed with your child instead of sleeping separately.

It turns out that many families sleep together all over the world. And it's a growing trend in the United States. A national study published in 2003 found that between 1993 and 2000, the number of babies 7 months old or younger who usually shared a bed with an adult grew from 5.5 percent to 12.8 percent.

How do I know whether sleep-sharing is right for my family? The decision to establish a family bed is a personal one: What works for other families may not work for yours.

• Your child's health and safety are the most important considerations. The American Academy of Pediatrics recommends against sleep-sharing for the health and safety of the child — but sleep-sharing advocates disagree. Read "Safety and SleepSharing," below, for more about this.

• Some people love the coziness of sleep-sharing. Others say having a squirmy child in bed with them makes it difficult to sleep.

• Some babies sleep better next to their parents. Others seem happier sleeping on their own.

Other important considerations:

Time for bonding For today's busy families, snuggling in bed together can be a way to connect after a long day apart. Co-sleeping can particularly enhance closeness between the father or other partner and the baby, who don't have the physical connection that a nursing mother and her baby do or may simply have less time to spend together during the day.

Night feedings Moms who co-sleep say it's easier to breastfeed and bottle-feed with their baby right next to them.

If you breastfeed your baby, once you get comfortable with nursing on your side with your baby curled next to you, you may find that you barely wake up when it's time to feed. You help your infant latch on, then sink back into slumber.

If you bottle-feed, you can have a prepared bottle in the refrigerator to give your child when she wakes up, then go back to sleep as soon as she's settled.

Others say the proximity causes their baby to wake up more often to feed. And co-sleeping can make it harder to wean your baby from waking up at night to nurse or take a bottle. Breastfeeding babies, in particular, smell their mothers' milk, and many develop the habit of waking repeatedly at night to feed long after they have a physical need to do so.

Your relationship with each other Some moms and dads discover that the family bed makes it harder for them to find time alone together to reconnect, or puts a damper on their sex life. Other parents say it makes them more resourceful and creative about finding private time.

If you share a bed with your child, you may need to plan for time alone with your partner instead of waiting for it to happen spontaneously. Depending on your point of view and how you're feeling, planning for intimacy could be a drag — or a fun new adventure.

Check in with your partner Choosing to sleep-share should be a family decision. So before you start, make sure your partner is comfortable with the arrangement. You run the risk of damaging your relationship if you decide independently that this is what you're going to do or pressure a reluctant partner to agree.

Talk the issue over together and consider the pros and cons. Consult friends who sleep-share and find out how it's working for them. Brainstorm with your partner about ways to make private time for yourselves. Let your partner discuss his reservations, if any, and listen to what he has to say. Talk openly about your own feelings.

If either of you still has doubts, one strategy is to agree to a trial period of two weeks or so and check in with each other when that period is over. As with all parenting decisions, it's important to consider each other's feelings and point of view before making a decision.

Check in with your baby Many parents who have no intention of sharing their bed end up doing so when they find that it's the only way they get can their newborn to sleep. For some babies, sleeping alone is hard to get used to after nine months in utero. They crave closeness and comfort.

But not every baby enjoys a shared sleeping arrangement. If you have a family bed and your baby's restless or fussy at night, you might try putting her in her bassinet or crib to see if she seems happier there. Or, if crowding is the problem, consider getting a larger bed or a bedside bassinet to give everyone a little more room.

What are the long-term effects of sleep-sharing on children? Pediatrician William Sears — an advocate of attachment-style parenting, which emphasizes the close bond between parent and child — believes babies who co-sleep grow to be more confident and independent, because of the early nurturing co-sleeping provides. And many parents who have co-slept with their kids would agree.

Some traditional child development experts have argued that a child who sleeps with her parents will become overly dependent. As sleep-sharing has become more widespread in the United States in recent years, though, it has also become more accepted, and some of this skepticism has faded.

For example, in the original 1985 edition of sleep expert Richard Ferber's famous book Solve Your Child's Sleep Problems, he advised parents against co-sleeping. But in the 2006 revised version, Ferber's views mellowed considerably.

In that book, he writes, "Children do not grow up insecure just because they sleep alone or with other siblings, away from their parents; and they are not prevented from learning to separate, or from developing their own sense of individuality, simply because they sleep with their parents. Whatever you want to do, whatever you feel comfortable doing, is the right thing to do, as long as it works."

If you sleep with your baby, it may be difficult to persuade her to move into her own bed later. Some children who spend their early years in the family bed resist sleeping anywhere else — at least at first. But most kids will happily sleep on their own once they've made the transition.

Safety and sleep-sharing The U.S. Consumer Product Safety Commission (CPSC) and the American Academy of Pediatrics (AAP) recommend against sharing a bed with a child under the age of 2, citing an increased risk of death from suffocation, SIDS (sudden infant death syndrome), strangulation, or another unexplained cause. But other experts and parenting groups disagree, saying co-sleeping is safe and beneficial if done properly.

For more information, read what the CPSC, the AAP, and sleep-sharing advocates have to say.

If you decide to try sleep-sharing, don't leave your baby to sleep alone in an adult bed — it's not designed with infant safety in mind. Naturally you won't always be going to bed when your baby does, so consider putting her in a bassinet or crib for naps and at night until she wakes up for her first feeding.

And be sure to observe the following additional safety precautions for as long as they're age appropriate:

Safe sleeping position No matter where your baby sleeps, put her down to sleep on her back. Experts say that following this "back to sleep" practice is the most important thing you can do to reduce your baby's risk of SIDS.

Safe sleeping environment

• • •

Never smoke or allow others to smoke around your infant, whether or not you're co-sleeping. Some studies have found that babies who share a bed with parents who smoke are at higher risk for SIDS. Childproof the room you and your baby sleep in. The day will come when she can get out of the bed and explore while you sleep.

Safe sleeping companions

• • • • • • • • •

Never co-sleep with your infant if you're under the influence of alcohol or other drugs. These intoxicants could interfere with your awareness of your baby's presence and her cries. If you're extremely overweight, sleep-sharing might not be safe for your baby. Installing a crib or a co-sleeper next to your bed is a less risky way to go. Don't sleep in clothing that has long strings or ribbons on it or wear jewelry in the family bed. Don't let older children sleep next to a baby younger than one year. They could accidentally harm the baby by rolling over or kicking in their sleep. Keep pets out of the bed. Safe mattress and bed Put your baby to sleep only on a smooth, flat mattress. It's not safe for babies to sleep (with or without you) on a waterbed, an egg-crate mattress, a couch, an armchair, or any other surface that's not firm and could interfere with your baby's breathing — firm and flat is the rule.

• • • • •

Ideally, place your mattress on the floor. That way, if by chance the baby rolls off, she won't have far to fall. Place rugs or pillows on the floor around the mattress to cushion falls, If your mattress isn't on the floor, equip it with a bed rail (or two, if it's not against a wall on one side). Use mesh rails, not rails with slats that could entrap a baby's head. If your mattress is against a wall or anything else, check daily to make sure there are no gaps that your baby could slip into. Fill any gaps with tightly rolled towels. The same goes for gaps between headboard or footboard and the mattress.

•

Don't use a headboard or footboard with slats more than 2 3/8 inches apart or cutouts — these can entrap a baby's head.

• •

Position the bed away from room features that might be a hazard for a baby, such as cords for window blinds, lamps that can be pulled over, and so on. Safe bedding

•

To make sure your baby can breathe freely, keep pillows, blankets, comforters, and other bedding away from her face.

• • •

Make sure fitted sheets fit securely so they can't be pulled loose. Don't use sheepskins or any type of cushy mattress cover.

Safe sleepwear

• • •

For warmth, dress your baby in layers. Footed pajamas and sleeveless sleep sacks ("wearable blankets") can help. (Get more ideas for keeping your baby warm without blankets.) To avoid overheating, dress your baby more lightly than you would if she were sleeping alone. A safe alternative If you feel uneasy about having your baby in your bed but you don't want her in another room, she can sleep near you in a bassinet or a crib. Some bassinets (often called co-sleepers or bedside bassinets) are designed to attach to and be level with the bed. The AAP, while it discourages sharing an adult bed with your baby, says having your baby in your bedroom but in a separate sleeping space (even one right next to the bed) reduces the risk of SIDS.

Sex and the new dad Reviewed by the BabyCenter Medical Advisory Board

Highlights How long do we have to wait before having sex again? Is it true we don't need to worry about birth control for now? We've gotten the green light for sex, but my wife doesn't seem to be into it. Am I doing something wrong? How can I woo my wife back into the mood? We're ready for the big night. Anything I should know?

How long do we have to wait before having sex again? Doctors and midwives advise that you wait four to six weeks after the birth of your baby. The uterus and cervix undergo significant changes during childbirth, and they need time to heal. During this healing phase the lining of the uterus, especially the site where the placenta was attached, is susceptible to infection. Intercourse, tampons, and anything placed in the vagina may introduce bacteria and cause an infection. The flow of lochia, which is a sign that the lining is healing, can last from three to eight weeks. When the lochia flow is no longer bright red, it signals that healing is near completion, and it's probably safe to have intercourse again. However, if your partner is healing from an episiotomy or vaginal tear, you'll need to wait longer still. She'll find out at her first postpartum exam (usually four to six weeks after delivery) whether she has the green light for sex.

But just because you can't have intercourse doesn't mean that you have to rule out intimacy altogether. Oral sex and other forms of "outercourse" like masturbation are safe a few days after delivery. If your mate has stitches from an episiotomy or vaginal tear, be sure you avoid contact with that area in order not to disrupt the healing. While you may be concerned that the bacteria in your mouth could increase your partner's risk of infection, you needn't worry as long as the stimulation is strictly external (in other words, stick to the area around the clitoris). Stay away from the vagina and the perineum and everything should be fine.

Even if you're not up for sexual activity, it's still important to stay physically connected to each other through hugs, kisses, massages, or just holding hands.

For more advice on sexual activities that are safe in the first few postpartum weeks, click here.

Is it true we don't need to worry about birth control for now? Absolutely not — unless you're ready for another baby! While it's true a woman isn't fertile immediately after birth, especially if she's nursing, it's impossible to predict how long this stage will last. Although she may not menstruate for months after giving birth, her body usually releases its first postpartum egg before she gets her period. So she won't know that she's ovulated until about two weeks later. And if you're playing birth-control roulette, that's two weeks during which you might have hit the jackpot.

Those carefree days during pregnancy when you didn't need to think about birth control are definitely over, so do put some time into figuring out what type of contraception will work for you. Chances are your mate's healthcare practitioner will bring up the topic of contraception at her first postpartum checkup (usually four to six weeks after delivery) — a good time for her to get refitted for a diaphragm, pick up a new Pill prescription, or discuss other options. But it's a good idea to check out contraception choices before you show up for your first postpartum checkup so you'll be prepared to make a decision if you need to have a prescription filled.

We've gotten the green light for sex, but my wife doesn't seem to be into it. Am I doing something wrong? Reality check: There can be a huge gap between physical and emotional readiness for intimacy. Even if it's been six weeks, even if your partner's been told she can go ahead and have sex again, she may not be ready. She may be afraid of pain, she may need more time, and she may just be exhausted. Your best bet: Give her some space, lots of affection, and no pressure. A few well-placed compliments won't hurt either.

And don't hesitate to put yourself in your partner's shoes: She may have barely regained her strength from giving birth, and now she's giving what energy she has to the baby. If she's breastfeeding, her body is constantly in demand, and even if she's not, taking care of a newborn is an intensely physical job. Finally, don't forget that during the recent miracle of your baby's birth, your partner spent several hours with the most private parts of her body on display to a roomful of nurses, midwives, and doctors.

"After giving birth, a woman may feel like her body is not her own, and she will want to reestablish some boundaries," says Judith Steinhart, a certified sex therapist. "Sex can seem like one more demand, meeting one more person's needs."

As your partner adjusts to a whole new role, she may have little energy left at the moment for physical loving. But that doesn't mean she loves you any less. In fact, many couples find the period after childbirth very romantic, if not very sexual.

How can I woo my wife back into the mood? Wooing is exactly the right approach; you need to romance your wife almost as if you were dating again. In a sense, she's not the same person you drove to the hospital a month or two ago. She's still your wife, but now she's also a mother. And while you both love each other, you're each going through the process of falling in love with a whole new person that you created together.

These can be bewildering, enchanting, and exhausting times — for both of you. While your partner's hormones and her body are doing things they've never done before, you're both coping with sleep deprivation and adjusting to the joys and stresses of your new addition.

So if you're ready to get intimate and she's not, courtship is key. Keep things simple at first. Start with cuddling, since this may be all that either of you has the energy to handle. Remind her that you find her attractive, and make her feel like a woman, not just a mother It may take time to resume some normalcy, but sex will be part of your lives again. Really.

We're ready for the big night. Anything I should know? Remember to take things slowly, find a comfortable position, and let your partner control the pace. She may still be sore, or afraid of any pain. And don't forget about foreplay: Not only is it fun, but it enhances lubrication. Postpartum women tend to be rather dry during sex, even more so if the baby is nursing. So don't assume she's not turned on, but do use some lubricant, such as K-Y Jelly or Astroglide to ease any awkwardness or discomfort.

One other thing: Be prepared for your baby to interrupt your first forays into sexual intimacy. Whether it's naptime or the middle of the night, assume the baby will wake up crying at exactly the wrong time. But don't let this deter you from making another date to make love. Welcome to the world of parenting.

Sex secrets every new parent should know Highlights Tips for parents with babies Get more great sex advice Finding time for making love is tough with a new baby in the house, and no one knows that better than veteran parents. That's why we asked them how they keep the home fires burning. Here are their best tips and tricks (wink, wink, nudge, nudge) for squeezing in some love time.

Tips for parents with babies Don't limit your sexual escapades to the bedroom "Before the baby, we stuck to the regular old in-the-bed routine," says Kristine Kalish of Denver, Colorado. "Now we do it in the car, on the couch while the baby naps, in my office, or just anywhere we can." Besides, having sex in unusual places heightens the thrill for some people, so it may actually improve your sex life.

Redefine sex All roads don't have to lead to intercourse. There are lots of ways to have fun if you don't have time for a full-blown lovemaking session. Stoke the fires by making out for a few minutes before dinner, or cop a feel when he passes you on the way to change the baby's diaper. If your partner is willing but too tired to seal the deal, pleasure yourself while he or she watches. "My wife's presence makes it more exciting for me, and sometimes she gets excited enough to participate," says Tim Kahl of Sacramento, California.

Take advantage of naptime When the baby goes down for a nap on weekends, it's time for you two to get down, too. Of course, if you're sorely sleep deprived, rest up. But it's important not to use all your quiet moments to catch up on chores. The laundry and dishes can wait while you make time for each other.

Talk your way into sex When your baby's asleep, uncork a bottle of wine, dim the lights, and indulge in good old-fashioned conversation. "Sometimes Rich and I stay up talking about the days before we had Alex," says Dawn Ham-Kucharski of Canton, Michigan. "It reminds us that we had a life as a couple before parenthood. Before we know it, we're having sex."

Hire a sitter and get out of the house We're not promising you'll get any action if you ask your partner out on a date, but it's a start. Plan something romantic like dinner for two at a fancy restaurant or, if cost is an issue, park at a spot with a view and have a picnic. One couple, who asked to remain anonymous, found a new use for their minivan. It seems that if you put down all those seats in back, you'll have a wide, comfortable spot for adult fun.

Don't wait for privacy if you don't have to If you wait for a time when the baby will be out of the house or even in another room, you could be in for a long dry spell. New parents learn pretty quickly that you have to grab your chances when you can, even if the baby is nearby! In a BabyCenter sex survey of 20,000 parents, nearly 60 percent said they had sex with the baby in the room.

Turn up the heat and seduce each other Getting in the mood can be difficult for harried new parents. It's hard to switch gears from Mom and Dad to lovers. To warm his engine, call him at work and talk dirty for a few minutes, or write him an e-mail detailing all the things you'd like to do to him. It'll titillate him and keep you in his thoughts all day. Or give him time to go for a bike ride or shoot some hoops — He'll be relaxed and rejuvenated for you! You can also come to bed naked or initiate sex — dads' top two favorite teasers, according to our recent sex survey.

Dad, you can seduce your honey by reading her a love poem out loud, washing her hair, or taking the kids out so she can relax and pamper herself. Remember, foreplay isn't just something you do right before sex; it can happen all day. But then again, real foreplay works too. Nearly 60 percent of the women in our sex survey said nothing beats touching, hugging, stroking, and kissing to get them in the mood.

And if at first you don't succeed, ask directly If you're starting to feel edgy because you haven't been intimate with your partner for a while, tell him or her. Avoid guilt-inducing statements such as "You must not be attracted to me anymore" — they just sound defensive. Instead, tell your sweetie you miss kissing, touching, rubbing up against each other. Who could resist that?

When do most couples start having sex again after their baby is born? When do most couples start having sex again after their baby is born — and how often do they do it?

Expert Answers

The BabyCenter Editorial Team

Sex after baby — like sex before baby — is different for every couple. Still, it's fun (and comforting) to know how other new parents are faring between the sheets, so we surveyed 20,000 parents to find out when and how often they had sex.

First-time parents told us that two months after the baby was born, they were making love two to three times a month. Although doctors usually recommend waiting six to eight weeks, slightly more than 20 percent said they couldn't wait and went ahead with sex in the first month. By month six they reported doing it more often — three to five times per month. (Click here to see all the results of the BabyCenter Sex Survey.)

Sex (or the lack of it) is on many couples' minds after their baby is born. Maybe you're looking forward to being chest to chest with your partner again instead of finding new ways to get around a big belly. Or maybe you're so tired and busy that getting back into the sexual swing is pretty far down on your list — after sleeping, eating, and just caring for a newborn. Mom's physical condition is a big factor, too; even if you can find the time and have the energy, your body may still be healing and not ready for intercourse. If you're worried that you're the only one whose sex life is on hiatus, you might find it comforting to know that most parents of newborns have sex 75 percent less often than they did before pregnancy. (Don't panic, that number improves with time.)

Interestingly, new parents who already have at least one older child reported making love more often in the months after delivery than first-timers — an average of three to four times a month two months after delivery, and four to seven times a month by month six. Experienced parents seem to have learned some tricks for fitting sex into their busy lives.