Thursday, January 22, 2009

When is My Baby Ready To...?

at 11:34 PM
There may be very clear right and wrong answers for much of newborn care, but once my baby was out of the first stages of infancy, the answers weren't so obvious. "So, is it safe...now?" I found myself wondering every few weeks. Will it be safe when she reaches a certain age? Weight? Developmental stage?

Many of these issues have changed since we were kids, so asking my own mom wouldn't do any good -- back when I was a babe, either the category didn't exist (sushi and jogging strollers) or the thinking was very different (putting babies to sleep on their stomachs).

Here, pediatricians -- experienced moms themselves -- share what you need to know about safe sleeping, eating, playing, and more.

Sleep: "Is my baby ready to..."
...snooze on her tummy?
Since 1992, when the American Academy of Pediatrics (AAP) first recommended putting babies to sleep on their backs, the annual SIDS rate has decreased by about 50 percent. While some moms are ignoring the recommendation, most of us have gotten the message so loud and clear that the first time I discovered my 4-month-old on her stomach it was hard not to freak out.
What you need to know Once your baby has the upper-body strength to roll over regularly, at around 5 months, he has the strength to move away from a suffocation hazard, and the SIDS risk goes down. (The greatest risk is during the first six months.)
"I tell my patients: You should still put them down on their backs, but what babies do in the middle of the night is their business," says Jennifer Shu, M.D., director of the newborn nursery at Dartmouth-Hitchcock Medical Center, in Lebanon, New Hampshire, and coauthor of Heading Home With Your Newborn.

...have a blanket in the crib?
The official line from the AAP is to avoid blankets (they're a potential suffocation hazard) until your baby reaches her first birthday.
What you need to know Some pediatricians give the okay for babies as young as 6 months. "A small, crib-size blanket is fine for a child who can lift her head and can push it off or crawl out from under it," says Jennifer Roche, M.D., a pediatrician in private group practice in Amherst, Massachusetts. (Whether or not it stays on her all night is another issue.)

...ditch the bumpers?
Who would have thought a simple decorative touch in the nursery would end up being controversial? Some experts say bumpers are suffocation hazards and shouldn't be in the crib at all; others take a more pragmatic approach.
What you need to know To be on the safe side, avoid large, fluffy bumpers and remember to tie them to the crib as tightly as you can. Also, make sure there are no gaps -- that way your baby can't get his head stuck between the bumper and crib railings.
According to some doctors, you should take them out of the crib when your baby is sitting, around 6 months, but definitely no later than 9 months, when he begins to pull himself up to stand. Although it's not very likely, he could use the bumper as a step and launch himself out of the crib.

...sleep with toys in the crib?
With all of the nervousness about possible SIDS hazards, parents might worry about putting stuffed animals or other playthings in their infant's crib.
What you need to know depends on the plaything.
Stuffed animals. While the AAP doesn't recommend that babies sleep with plush loveys until they're 1, Ari Brown, M.D., coauthor of Baby 411, says it's okay once a baby is 6 months old, with these caveats: The stuffed toy is a small one (no bigger than the size of her head) and has no removable eyes or buttons. Your baby should also be rolling over and moving around on her own.
Mobiles and other crib toys. You should remove the mobile from the crib at the 6-month mark -- babies may then be able to make a grab for them when they sit up. As for attachable toys, as long as they don't contain small, "choke-able" parts, the only consideration is whether your baby can handle the stimulation. "Some will push the buttons repeatedly until they get sleepy. Other kids will just get more and more wired," says Dr. Shu, the mom of a 4-year-old.
Books. Since babies are likely to chew on board books, doctors recommend giving them only fabric ones in the crib -- after they turn 1.

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