Notice: Sitting too long may be dangerous for young infants

Cote, from McGill University Health Center in Montreal, and colleagues report that deaths among infants in a sitting position accounted for about 3 percent of the infant deaths they reviewed as part of their study.

"Caution should be used when placing younger infants in car seats and similar sitting devices, whether the infants have been born prematurely or not," Cote and colleagues report in Archives of Disease in Childhood.

"Based on other studies that have looked at the level of oxygen in the blood of infants in a sitting position, as compared to being in bed, I would say one hour at a time should be the maximum," Cote told Reuters Health.

Cote's group conducted a 10-year review, through December 2000, of all sudden unexplained deaths between birth and 1 year of age that occurred in the province of Quebec. They used medical and coroners' records to identify 99 explained deaths, caused by heart-related problems or infections; and 409 unexplained deaths.

Overall, 10 infants in the unexplained death group and 7 in the explained death group died while sitting in a car seat or other sitting device. All other deaths occurred while infants were lying down.

When the researchers accounted for age at death and adjusted for prematurity, they found that 9.4 percent of the infants who died at less than 1 month of age were in a sitting position at the time of death. By contrast, just 2.4 percent of older infants died while in a sitting position.

After reviewing individual cases of young infant deaths, time spent in a sitting position, the presence of airway problems "may have contributed to the death of the infants in a sitting position," Cote and colleagues note.

Recommendations concerning traveling in car seats and the use of infant seats should consider the findings of this study, the researchers conclude.

The Move of your baby : Sitting Up and Rolling Over

It's a joy (and a little scary too) to watch your once-stationary lump become a giggling, wiggling little person. Suddenly, you'll notice her practicing new moves with the concentration of an Olympic athlete. (And if she decides to try her first flip on the changing table — watch out! All hands and eyes on deck!) Between four and six months, she'll likely learn these four acrobatic feats:

• Roll from her tummy to her back, and then back again. Tummy-to-back usually comes first, because she can use her arms to propel herself up and over from the belly-down position.
• Push herself up on her arms — first her forearms, then all the way up on her hands.
• Sit up and survey the world.
• Reach for and grasp a toy (or a hank of your hair!).

To encourage these developing skills, make sure your baby has the freedom to stretch, roll, reach, and squirm. Give her plenty of playtime on the floor — and on her tummy (with you supervising and cheering her on, of course) — and be sure she's not spending too many hours in baby-busiers like the swing, stationary walker, stroller, or car seat (all of which have their time and place, but can restrict movement). To buff up her bitty biceps, put her on her tummy with a few enticing toys just out of her reach; she'll push herself up to see them, then practice stretching toward the interesting objects. To help her learn to sit, it's fine (as long as she has good control of her head and neck) to prop her up with a rolled towel, nursing pillow, or other firm cushion. If she slumps or slides, it could mean that she's not ready, so stop the sitting session and try again later.

All this moving and grooving means something else too: If you haven't started childproofing yet, get out those outlet plugs, safety gates, and cabinet locks. It's just a hop, skip, and jump to crawling, cruising, and walking from here, so be prepared!

Little Secrets of a Sleeping Baby

1.    Know that crying is normal. It is how we respond that matters.

When I was pregnant with BabyC, I knew that for the first few months of her life, she would wake often during the night, but I envisioned sweet nights with her – a dim light, a comfortable rocking chair, nursing her until she faded back to sleep. And in my imagination, these scenes of maternal bliss were always quiet. So I was not prepared for the nights during those early weeks when BabyC would wake at 2 AM and I would do everything I knew to do – nurse her, burp her, change her, hold her, rock her, try nursing again – and she would only cry. There were nights when she would wail, eyes squeezed shut, for hours, while I tried everything to soothe her. Looking back, I realize that in my mind, I believed that my success as a mother was tied to my ability to stop my baby's cries, as quickly as possible. If she cried, I felt that I was failing.

With this mindset, when Husband and I discovered that bouncing BabyC stopped her crying, we latched on to that as our life vest for parenting. Bouncing became the way that we put BabyC to sleep every single time. We thought we had discovered a genius secret for curing babies' cries. Every parent needs one of these exercise balls, we told our friends.

Of course, it was no wonder that BabyC couldn't sleep well when every time she transitioned from one sleep cycle to the next, she needed to be bounced up and down, for longer and longer periods of time. Bouncing may have stopped her crying for a while, but by using this technique, we were completely overriding whatever self-soothing abilities BabyC might have had if given the chance to use them. And as her parents, we were missing valuable opportunities to really listen to her cries, learn to understand them, and develop appropriate responses.

There is a significant body of research that shows that infants will learn to self-soothe if given the chance. As a new mother, I wish that I had paused to listen before jumping to stop BabyC's cries and, in doing so, perhaps given her a chance to develop her own ways of soothing. I wish that I had thought carefully about what my soothing techniques were teaching her about sleep. And I wish that, at least occasionally, I had given her the chance to try to fall asleep without my intervention. After all, she might have surprised me. It would have been easier for me to think clearly about these things if I had thought of my job as being to support my baby in learning how to sleep rather than being to stop the crying.    

Since those desperate days of early motherhood, I have learned a great deal about respecting and listening to babies from the writing of Magda Gerber. She wrote,

"[Crying] is the way a baby expresses her feelings and she should be allowed to do so. Rather than trying to stop your child from crying by distracting her, try to figure out why she is crying so that you are able to help her."

BabyC cried because she was tired. I responded by distracting her with bounces until she was lulled to sleep. I now realize that what she needed was to be heard, not hushed. I am  not suggesting that we should ignore babies' cries – not at all – but simply that we be thoughtful about responding in a non-intrusive way that is consistent with how we want the baby to eventually learn to sleep. In reality, this may be just a small shift in our actions, but it is a huge shift in our intention, and it actually requires greater attention to our babies. I believe that this simple shift in thinking may have prevented the sleep problems we found down the road.

2. Develop predictable routines for both the day and night.

Exposure to light during the day and darkness at night helps new babies to develop circadian rhythms and sleep more at night. Getting fresh air and sunshine during the day is good for parents and babies alike. A study of 6- to 12-week-old infants found that those that slept well at night were exposed to more light during the early afternoon . In addition, following a consistent bedtime routine improved sleep in a large randomized controlled trial of infants and toddlers identified as having sleep problems . In this study, babies that received a bath, massage, and snuggles each night were quicker to fall asleep, woke less in the night, slept for an average of 36 more minutes per night, and were in a better mood in the morning! It is never too early to develop these routines.

3. Be emotionally available at bedtime.

In a study of babies aged 1-24 months, the more emotionally available mom was at bedtime, the easier it was for baby to settle to sleep and sleep well during the night [3]. Other factors such as where the baby slept and whether nursing was part of the bedtime routine were found to have little effect on sleep in this study. The authors described emotionally available moms as:

Sensitive – "affectively attuned to their infants, demonstrated a clear awareness of infant cues, interpreted them accurately, and responded contingently and appropriately." 

Structuring –  "prepared their infants for bed using positive, quiet, soothing bedtime routines that gently guided the infant toward sleep."

Nonintrusive - "showed recognition of their infants' need to sleep by not initiating new interactions with the infant and avoiding high-volume, intrusive talk."

Nonhostile – "showed no overt or covert irritability or anger toward the infant at any point during bedtime."

An emotionally available parent makes the baby feel safe at bedtime, even when saying goodnight is difficult. 

If your current sleep situation is not working and it is affecting the health of your family, you may wish to lovingly and respectfully make some changes to your baby's sleep habits. Encouraging your baby to self-soothe will make it easier for her to transition from one sleep cycle to the next during the night without your help. Change is always hard for babies, and this is especially true around bedtime. Here are some things you can do to ease your baby through this transition:

4. Consider your baby's stage of development.

Young babies (<3-4 months) need our help with regulating stress and should not be left to handle it on their own for prolonged periods. In addition, there are developmental stages that are particularly difficult times to make changes to sleep routines. For example, between 4 and 6 months, babies are experimenting with their new-found power to elicit a response from a caregiver (I smile at you and you smile back!). Between 8 and 11 months, most babies go through a period of separation anxiety. Decreasing parental involvement at bedtime during these developmental stages can be confusing and distressing for babies [4]. Unfortunately, these same stages often bring some natural struggles with sleep, but it is best to ride these periods out and wait until your baby is in a more stable place. Be mindful of other transitions in your baby's life as well. If she is going through changes in childcare or working on a new skill such as crawling, wait until these have passed before attempting changes in her sleep. And be aware that some children, particularly if they are fearful or anxious, may just need closeness at bedtime for a while. For an in-depth understanding of child development as it relates to sleep changes, I highly recommend the book Bedtiming by developmental psychologists Isabela Granic and Marc Lewis. Other sleep advice books and sleep researchers largely ignore these ideas, and I'm convinced that appropriate timing is a critical factor in both the stress and success of attempting sleep changes.

5. Talk with your baby about the upcoming changes.

Babies almost always understand more language than we realize. Do not underestimate the value of helping your baby prepare for a transition. In one study of babies entering daycare for the first time, when mothers spent more days preparing their babies for the transition by attending daycare with them, they were more likely to maintain secure attachment during this change .

6.  Be present and supportive for your baby during bedtime changes.

If you are encouraging your baby to self-sooth and learn to sleep on her own, you eventually need to decrease your presence and soothing at bedtime. Several studies have measured cortisol in rhesus monkey infants separated from their mothers. They found that when infants were separated to a different cage but were still able to see and hear their mothers, they cried more but had little to no cortisol response compared to babies that were totally isolated from their moms. Staying close to your baby during this transition may mean that she protests more, but your presence is still helping her cope with the change and regulate her stress. That may mean staying in the room at first and gradually withdrawing your presence, or it may mean returning to reassure your baby periodically. Either way, you are telling your baby, "I know this is hard for you, but I'm still here."

This last point highlights another shift in my thinking about infant crying. Once we realized that we had saddled BabyC with an association between bouncing and sleeping and that this was interfering with her sleep, I started trying to let her fall asleep in my arms without movement. She cried and cried and cried, pleading with me to stop being silly and start bouncing her. In my desperate new mama mind, I thought, "This isn't working. She won't stop crying. I'm clearly not helping her." Again, I was tying my success as a mother to my baby's cries, and I felt that I was failing. I finally set her down in her bed and left the room, returning every few minutes to reassure her. Ultimately, I think that this method can be an acceptable way of supporting babies through this transition, but I wish that I had tried letting her fall asleep in her bed while I sat close to her. I wish that I had known that her crying didn't mean that my presence was meaningless to her, that me being there as she learned to sleep may have reduced her stress through the transition.

Many sleep experts advise that extinction – letting babies cry-it-out without any reassurances – is the fastest way to good sleep and results in less crying in the long run. They're probably right, but again, I think we need to stop measuring our success by minutes of crying. A more gradual approach may take longer and require more patience, but it is likely less stressful to the baby. A crying baby may be protesting, struggling to fall asleep in a new way, or frustrated by the change, but she is not necessarily in distress or despair. When we let our babies know that we hear them and acknowledge their emotions, they'll probably keep telling us how they feel for a while, and that's OK. Every baby is different, but I now believe that most babies benefit from a gradual approach with more parental support. 

Infant Sleep Facts Every Parent Should Know

In order to better understand the how-to's of getting you and your baby to enjoy going to sleep and staying asleep, here are some important principles of sleep that every new parent needs to understand.

1. How you sleep. After dressing or undressing for bed, most adults help themselves relax for sleep by performing various bedtime rituals: reading, listening to music, watching TV, or having sex. As you drift into sleep, your higher brain centers begin to rest; enabling you to enter the stage of deep sleep called "non-REM" (non-rapid eye movement -- NREM), or deep sleep (also called quiet sleep). Your mind and body are quietest during this stage of sleep. Your body is still, your breathing is shallow and regular, your muscles are loose, and you're really "zonked." After about an hour and a half in this quiet sleep stage, your brain begins to "wake up" and start working, which brings you out of your deep sleep and into light sleep or active sleep, called rapid eye movement or "REM" sleep. During this stage of sleep your eyes actually move under your eyelids as your brain exercises. You dream and stir, turn over, and may even adjust the covers without fully awakening. It is during this sleep stage that you may fully awaken to go to the bathroom, then return to bed and fall back into a deep sleep. These alternating cycles of light and deep sleep continue every couple hours throughout the night, so that a typical adult may spend an average of six hours in quiet sleep and two hours in active sleep. Thus, you do not sleep deeply all night, even though you may feel as though you do.

2. How babies enter sleep. You're rocking, walking, or nursing your baby and her eyelids droop as she begins to nod off in your arms. Her eyes close completely, but her eyelids continue to flutter and her breathing is still irregular. Her hands and limbs are flexed, and she may startle, twitch, and show fleeting smiles, called "sleep grins." She may even continue a flutter-like sucking. Just as you bend over to deposit your "sleeping" baby in her crib so you can creep quietly away, she awakens and cries. That's because she wasn't fully asleep. She was still in the state of light sleep when you put her down. Now try your proven bedtime ritual again, but continue this ritual longer (about twenty more minutes). You will notice that baby's grimaces and twitches stop; her breathing becomes more regular and shallow, her muscles completely relax. Her fisted hands unfold and her arms and limbs dangle weightlessly. Martha and I call this "limp-limb" sign of deep sleep. Baby is now in a deeper sleep, allowing you to put her down and sneak away, breathing a satisfying sigh of relief that baby is finally resting comfortably.

NIGHTTIME PARENTING LESSON #1:

Babies need to be parented to sleep, not just put to sleep. Some babies can be put down while drowsy yet still awake and drift

others need parental help by being rocked or nursed to sleep.

The reason is that while adults can usually go directly into the state of deep sleep, infants in the early months enter sleep through an initial period of light sleep. After twenty minutes or more they gradually enter deep sleep, from which they are not so easily aroused. As you probably know from experience, if you try to rush your baby to bed while she is still in the initial light sleep period, she will usually awaken. Many parents tell me: "My baby has to be fully asleep before I can put her down." In later months, some babies can enter deep sleep more quickly, bypassing the lengthy light sleep stage. Learn to recognize your baby's sleep stages. Wait until your baby is in a deep sleep stage before transitioning her from one sleeping place to another, such as from your bed to a crib or from carseat to bed or crib.

3. Babies have shorter sleep cycles than you do. Stand adoringly next to your sleeping baby and watch him sleep. About an hour after he goes to sleep, he begins to squirm, he tosses a bit, his eyelids flutter, his face muscles grimace, he breathes irregularly, and his muscles tighten. He is reentering the phase of light sleep. The time of moving from deep to light sleep is a vulnerable period during which many babies will awaken if any upsetting or uncomfortable stimulus, such as hunger, occurs. If the baby does not awaken, he will drift through this light sleep period over the next ten minutes, and descend back into deep sleep. Adult sleep cycles (going from light to deep sleep, and then back to light sleep) lasts an average of 90 minutes. Infants' sleep cycles are shorter, lasting 50 to 60 minutes, so they experience a vulnerable period for nightwaking around every hour or even less. As your baby enters this light sleep, if you lay a comforting hand on your baby's back, sing a soothing lullaby, or just be there next to baby if he is in your bed; you can help him get through this light sleep period without waking.

NIGHTTIME PARENTING LESSON #2:

Some babies need help getting back to sleep.

Some "resettlers" or "self-soothers" can go through this vulnerable period without completely awakening, and if they do wake up, they can ease themselves back into a deep sleep. Other babies need a helping hand, voice, or breast to resettle back into deep sleep. From these unique differences in sleep cycle design, we learn that one of the goals of nighttime parenting is to create a sleeping environment that helps baby go through this vulnerable period of nightwaking and reenter deep sleep without waking up.

4. Babies don't sleep as deeply as you do. Not only do babies take longer to go to sleep and have more frequent vulnerable periods for nightwaking; they have twice as much active, or lighter, sleep as adults. At first glance, this hardly seems fair to parents tired from daylong baby care. Yet, if you consider the developmental principle that babies sleep the way they do -- or don't -- for a vital reason, it may be easier for you to understand your baby's nighttime needs and develop a nighttime parenting style that helps rather than harms your baby's natural sleep rhythms. Here's where I'm at odds with modern sleep trainers who advise a variety of gadgets and techniques designed to help baby sleep more deeply through the night -- for a price, and perhaps at a risk.

5. Nightwaking has survival benefits. In the first few months, babies' needs are the highest, but their ability to communicate their needs is the lowest. Suppose a baby slept deeply most of the night. Some basic needs would go unfulfilled. Tiny babies have tiny tummies, and mother's milk is digested very rapidly. If a baby's stimulus for hunger could not easily arouse her, this would not be good for baby's survival. If baby's nose was stuffed and she could not breathe, or was cold and needed warmth, and her sleep state was so deep that she could not communicate her needs, her survival would be jeopardized.

One thing we have learned during our years in pediatrics is that babies do what they do because they're designed that way. In the case of infant sleep, research suggests that active sleep protects babies. Suppose your baby sleeps like an adult, meaning predominantly deep sleep. Sounds wonderful! For you, perhaps, but not for baby. Suppose baby had a need for warmth, food, or even unobstructed air, but because he was sleeping so deeply he couldn't arouse to recognize and act on these needs. Baby's well being could be threatened. It appears that babies come wired with sleep patterns that enable them to awaken in response to circumstances that threaten their well being. We believe, and research supports, that frequent stages of active (REM) sleep serve the best physiologic interest of babies during the early months, when their well being is most threatened.

NIGHTTIME PARENTING LESSON #3:

Encouraging a baby to sleep too deeply, too soon, may not be in the best survival or developmental interest of the baby. This is why new parents, vulnerable to sleep trainers' claims of getting their baby to sleep through the night, should not feel pressured to get their baby to sleep too long, too deeply, too soon.

6. Nightwaking has developmental benefits. Sleep researchers believe that babies sleep "smarter" than adults do. They theorize that light sleep helps the brain develop because the brain doesn't rest during REM sleep. In fact, blood flow to the brain nearly doubles during REM sleep. (This increased blood flow is particularly evident in the area of the brain that automatically controls breathing.) During REM sleep the body increases its manufacture of certain nerve proteins, the building blocks of the brain. Learning is also thought to occur during the active stage of sleep. The brain may use this time to process information acquired while awake, storing what is beneficial to the individual and discarding what is not. Some sleep researchers believe that REM sleeps acts to auto-stimulate the developing brain, providing beneficial imagery that promotes mental development. During the light sleep stage, the higher centers of the brain keep operating, yet during deep sleep these higher brain centers shut off and the baby functions on her lower brain centers. It is possible that during this stage of rapid brain growth (babies' brains grow to nearly seventy percent of adult volume during the first two years) the brain needs to continue functioning during sleep in order to develop. It is interesting to note that premature babies spend even more of their sleep time (approximately 90 percent) in REM sleep, perhaps to accelerate their brain growth. As you can see, the period of life when humans sleep the most and the brain is developing the most rapidly is also the time when they have the most active sleep. One day as I was explaining the theory that light sleep helps babies' brains develop, a tired mother of a wakeful infant chuckled and said, "If that's true, my baby's going to be very smart."

7. As they grow, babies achieve sleep maturity. "Okay," you say, "I understand this developmental design, but when will my baby sleep through the night?" The age at which babies settle – meaning they go to sleep easily and stay asleep varies widely among babies. Some babies go to sleep easily, but don't stay asleep. Others go to sleep with difficulty but will stay asleep. Other exhausting babies neither want to go to sleep nor stay asleep.

In the first three months, tiny babies seldom sleep for more than four-hour stretches without needing a feeding. Tiny babies have tiny tummies. Yet, they usually sleep a total of 14-18 hours a day. From three to six months, most babies begin to settle. They are awake for longer stretches during the day and some may sleep five-hour stretches at night. Between three to six months, expect one or two nightwakings. You will also see the period of deep sleep lengthen. The vulnerable periods for nightwaking decrease and babies are able to enter deep sleep more quickly. This is called sleep maturity.

NIGHTTIME PARENTING LESSON #4:

An important fact for you to remember is that your baby's sleep habits are more a reflection of your baby's temperament rather than your style of nighttime parenting. And keep in mind that other parents usually exaggerate how long their baby sleeps, as if this were a badge of good parenting, which it isn't. It's not your fault baby wakes up.

8. Babies still wake up. When babies mature into these adult-like sleep patterns varies among babies. Yet, even though babies achieve this sleep maturity some time during the last half of the first year, many still wake up. The reason? Painful stimuli, such as colds and teething pain, become more frequent. Major developmental milestones, such as sitting, crawling, and walking, drive babies to "practice" their new developmental skills in their sleep. Then between one and two years of age, when baby begins to sleep through the above-mentioned wake-up stimuli, other causes of nightwaking occur, such as separation anxiety and nightmares.

Even though you understand why babies are prone to nightwaking, you realize it's still important for parents and babies to get a restful night's sleep, otherwise, baby, the parents, and their relationship won't thrive.

When will baby say MaMa

Many of the sounds your baby makes these days are repeated syllables like "ba-ba" or "ga-ga" -- advanced fare, compared to the coos and raspberries of months past.

She does her best to imitate your inflections, so what she's saying sounds more like normal speech than ever.

Encourage her by doing these things:

• Get excited when she accidentally says a real word like "mama" or "dada." She'll want to say it again and again for additional praise. Around her first birthday, she'll start using these words properly to refer to you.
• baby has pointed to. This boosts her vocabulary.
• Describe objects around your home or pictures in books to help your baby learn more words. Reading every day also helps a lot.

Your Baby's Development This Week

Your baby is becoming more independent, partly because she's learned how to control her hands. Now she can eat or play with what she wants.

If your baby can't already do these things, she will within a few weeks:

• Hold things with her thumb and forefinger: She no longer needs to clumsily rake items toward herself; she can pick up cereal Os or teethers with precision.
• oke objects with her index finger: She's handy enough to stick out a single finger, aim at something that interests her, and connect or put her finger into a hole.
• Try to draw. Hand your baby a crayon, show her how to scribble on paper, and she'll attempt to create her first work of art.
• Also, be prepared for her to want to share your drink. She enjoys sipping from a cup.

Month 11, Week 1 Tips

• Offer your baby age-appropriate toys with moving parts; she'll love moving beads along wires and turning wheels on trucks.
• A stack of blocks is irresistible to a baby. Leave some around and she may not only knock down towers, she may build them.
• Repetition helps your baby learn, so read her favorite book twice or play "This Little Piggy" as long as she's giggling.
• Imitation helps your baby learn proper uses for household items. Cheer when she places a phone to her ear or tries putting your shoes on her feet.
• Your baby may not pronounce her first word properly. Praise her to show that you understand her, and then say the word correctly so she'll learn the right pronunciation.
• It's OK if your baby relies on a security blanket for comfort. That's encouraged by many pediatricians because it can make bedtime easier.
• Sing songs with your baby. Music can help the brain develop, and she can start to learn words from some favorite songs!

Your Baby Developmental milestone: Talking

Your baby learns to talk during his first two years of life. Long before he utters his first word, he's learning the rules of language and how adults use it to communicate.

He'll begin by using his tongue, lips, palate, and any emerging teeth to make sounds (cries at first, then "ooh's" and "ahh's" in the first month or two, and babbling shortly thereafter). Soon those sounds will become real words – "mama" and "dada" may slip out and bring tears to your eyes as early as 6 months.

From then on, your baby will pick up more words from you and everyone else around him. And sometime between 18 months and 2 years, he'll begin to form two- to four-word sentences. As your baby makes mental, emotional, and behavioral leaps, he's increasingly able to use words to describe what he sees, hears, feels, thinks, and wants.

Here's how you can expect your baby's talking to progress. If she's being raised in a bilingual environment, language milestones usually occur at about the same time in both languages.

In utero

Many researchers believe the work of understanding language begins while a baby is still in utero. Just as your unborn baby gets used to the steady beat of your heart, she tunes into the sound of your voice and can discern yours among others.

Birth to 3 months

Crying is your baby's first form of communication. And one cry doesn't fit all: A piercing scream may mean she's hungry, while a whimpering, staccato cry may signal that she needs a diaper change. As she gets older, she'll develop a delightful repertoire of gurgles, sighs, and coos.

As for her ability to understand language, she's starting to recognize what words sound like and how sentences are structured as she listens to those around her.

4 to 6 months

At this stage, your child starts to babble, combining consonants and vowels (such as "baba" or "yaya"). At about 6 months she can respond to her name. You may hear the first "mama" or "dada" now and then too. Though it's sure to melt your heart, your baby doesn't equate those words with you quite yet. That comes later, when she's almost a year old.

Your baby's attempts at talking will sound like stream-of-consciousness monologues in another language with endless words strung together. Vocalization is a game to your baby, who's experimenting with using her tongue, teeth, palate, and vocal cords to make all sorts of funny noises.

At this stage, babbling sounds the same, whether you speak English, French, or Japanese in your home. You may notice your child favoring certain sounds (like "ka" or "da"), repeating them over and over because she likes the way they sound and how her mouth feels when she says them.

7 to 12 months

When she babbles and vocalizes now, your baby sounds as if she's making sense. That's because she's trying out tones and patterns similar to the ones you use. Foster her babbling by talking and reading to her.

13 to 18 months

Now your child is using one or more words, and she knows what they mean. She'll even practice inflection, raising her tone when asking a question by saying "Up-py?" when she wants to be carried, for example. She's realizing the importance of language as she taps into the power of communicating her needs.

19 to 24 months

Though she probably says fewer than 50 words, your child now understands much more than she can say. And she picks up more words every day, so watch your language! She may even string two words together, making basic sentences such as "Carry me."

By the time she's 2, your child may use two- to four-word sentences and sing simple tunes. As her sense of self matures, she'll start talking about what she likes and doesn't like, what she thinks and feels. Pronouns may confuse her, which is why she might say "Baby throw" instead of "I throw."

25 to 36 months

Your toddler may struggle for a while to find the appropriate volume to use when talking, but she'll learn soon enough. She's also starting to get the hang of pronouns, such as "I," "me," and "you." Between ages 2 and 3, your child's vocabulary continues to expand and she understands most of what you say to her. She'll string nouns and verbs together to form simple sentences, such as "I go now."

By the time your child turns 3, she may be a pretty sophisticated talker. She'll be able to carry on a sustained conversation and you'll be able to understand most of what she says. She'll even oblige when you ask her to do more than one thing at a time. ("Get the book and put it on the bookshelf.")

Finger Foods for Babies 6 - 12 Months

Grains

Cooked pasta - macaroni, rotini, penne, pieces of rice cakes, oat ring cereal like Cheerios®, Melba toast, pieces of roti or tortilla, Bran flakes, strips of bread or toast with the crust removed - dry or with butter or margarine.

Vegetables and Fruits

Pieces of fruit without peel or skin, soft cooked vegetables: Avocado; banana; peach; pear; kiwi; watermelon; or grapes, quartered. Cooked broccoli, cauliflower, carrots, yam, or squash.

Milk & Dairy

Cheese slices, small cubes or strips of pasteurized cheese (after 9 months).

Meat & Alternate (well cooked)

Tofu, ground meat or chicken, small (pea sized pieces of tender meat or chicken, fish (de-boned and flaked), quartered meatball, egg, small beans (black beans, navy beans) or larger beans cut in half (kidney beans).

What are Finger Foods for Babies 6 - 12 Months

Finger foods are small pieces of food that your baby can pick up and eat easily. Eating finger foods helps your child to learn how to bite and chew and to use her fingers and hands to feed herself. Eating finger foods also improves your child's coordination and helps her to get used to different food textures. This resource will give you ideas for finger foods and show you how you can help your child progress from mashed foods to finger foods.

Tips

Sit down with your child while he eats, and whenever possible, eat with him. Never leave your child by himself while he is eating.

• Sit your child in a high chair to eat. 
• Hard and sticky foods can cause choking and should be avoided. Some of these foods are nuts, seeds, globs of nut or seed butters, raisins, popcorn, ice cubes, chips, gum, marshmallows, hard candies or jellybeans. Cut round foods like carrots, grapes and hot dogs in 4 pieces lengthwise and then into small pieces. 
• Don't use hard foods (like raw vegetable sticks) for teething. Your baby can break off a piece and choke. 

When your child is comfortable eating infant cereal and soft, lumpy, mashed foods from a spoon, he may be ready to try finger foods.

• Watch for signs that your baby is ready to try finger foods. Signs include grabbing the spoon while you're feeding him, interest in what you're eating, and trying to take food from your plate. Other developmental signs that your baby is ready for finger foods are that he can sit up in a high chair by himself, and is learning to crawl. 
• Babies are often ready to try finger foods sometime in the 6-10 month period, but there's no set time that all babies are ready. By about age 1 year, most babies will be able to eat many of the family foods served at mealtimes. 
• Start with soft, cut up foods. At first your baby might just scoop up the food in her fist, but she will soon learn to pick up pieces using her thumb and forefinger. 
• Fruits should be peeled and cut into small pieces with the pits removed. Cook vegetables until they are soft or grate hard raw vegetables. 
• Babies can enjoy soft finger foods before they have teeth. They can gum foods into smaller pieces. 
• Offer a variety of foods from the four food groups from "Eating Well with Canada's Food Guide" 

5 Tips to Reduce Your Milk Supply

If you are still expressing in place of each of your baby's feeds, and want to stop, it is best togo gradually, just as you would when weaning your baby from your breast. This is much easier on your body. Your breasts will stay more comfortable, you will be less prone to getting a breast infection and you won't experience the abrupt hormonal shift you would with the "cold turkey" style of weaning, which leaves some moms feeling sad and depressed.

 

5 Tips to Help You Feel Better To Reduce Your Milk Supply

1. Eliminate one pumping session each three to four days.Express only enough milk as needed for comfort. This gradual weaning from the pump gives your body a chance to adjust to the decrease in stimulation.

2. Apply cold cabbage compresses.Placing "compresses" inside each cup of your bra will also help to make you more comfortable. Reapply refrigerated cabbage leaves about every two hours, or as they wilt, until your milk supply slows. This is a good treatment for severe engorgement. Often moms feel relief in as little as two hours (Breastfeeding: A Guide for the Medical Profession, Ruth Lawrence, MD, 1994). You can continue this treatment as needed.

3. Do not bind your breasts.This is an outdated practice, can be very uncomfortable and may lead to a plugged duct or even a breast infection. Wear a comfortable, but supportive all-cotton bra that won't restrict your circulation. A sports bra may be perfect for you at this time, but be sure it isn't uncomfortably snug.

4. Take something for the pain.Try a pain reliever that is compatible with nursing. Get the okay from your care provider before usingacetominophenoribuprofen.

5. Try ice.Ice can help to reduce swelling and may help you to remain more comfortable as your milk supply is decreasing. A bag of frozen peas for each breast works well (but don't eat the peas, since you will be defrosting and refreezing.) Ice your breasts for 15 to 20 minutes at a time, at least four times each day, or as needed for comfort.

How-much-milk-does-my-six-month-old-baby-need

How much milk you give your baby depends on whether you are breastfeeding or formula feeding.

If you have been breastfeeding, now your baby is six months old there's no reason to stop. You can carry on breastfeeding for as long as you both wish. Your baby can continue to enjoy the health benefits that breastmilk gives.

You can't measure the amount of breastmilk your baby is taking, so let your baby be the guide. She may want to continue with a breastfeed first thing in the morning and at bedtime.

As your baby starts to eat more solid foods, you may find that feeds between meals become shorter and eventually stop. However, just like you, your baby's appetite can change from day to day, so you may find your baby sometimes wants a breastfeed after a meal.

The Department of Health does recommend that breastfed babies older than six months have a daily vitamin D supplement of seven micrograms (mcg). The supplement comes in the form of drops. Your health visitor can show you how to give your baby drops.

It's not that breastmilk is deficient in vitamin D. It's rather that it's hard to be sure you and your baby can get enough vitamin D all year round. Our bodies make vitamin D when our skin is exposed to sunlight. Vitamin D is important for growing healthy bones and teeth.

If you have been giving your baby formula milk, you can continue to do so. Once your baby is fully established on solids, the minimum amount of formula she should have is between 500ml and 600ml (about a pint) a day.

As long as your baby is having 500ml of formula a day, she won't need a vitamin D supplement. The formula already has vitamin D added.

After a year your child only needs about 350ml (12oz) of milk (breast, formula or cows' milk) a day.

You may also want to offer other drinks once your baby has started solids, as well as breastmilk or formula. The best choice is always water, although you can offer well-diluted fruit juice with meals if you wish. Offer drinks in a cup with a soft spout or a lidded beaker.

How to treat Hair Loss in Women

Many women are dismayed to see hair falling out in clumps, either following childbirth, during or after menopause or due to other causes. While some daily hair loss is normal, thinning hair and partial baldness is a frightening prospect for women. What causes hair loss in women and what natural treatments are available that are not chemically based or dangerous to health?

Causes of Hair Loss in Women

There are various reasons why a woman's hair may thin or fall out. If hair loss occurs as a result of an underlying condition or disease, the specific condition needs to be treated first.

A woman's hair loss is different to the typical receding hairline and crown loss in men. Instead, androgenetic alopecia causes a general thinning of women's hair, with loss predominantly over the top and sides of the head. Hair loss or thinning hair can be the result of:

Shampoos, dyes and hair products - shampoos, conditioners and hair colorants often contain harmful chemicals and ingredients that strip or damage hair and may even cause hair to fall out over time. Typically, there are around 10-20 types of synthetic chemicals in commercially manufactured shampoo. Always shop for an organic, natural shampoo in order to prevent damage to the hair.

Childbirth - it is common to lose hair around 3 months after childbirth. This is a result of hormone levels adjusting after pregnancy. This is a temporary problem and hair should return to its pre-pregnancy state within 6 - 12 months.

Menopause - hormonal imbalance is the most common reason for thinning hair in older women. Estrogen levels drop as a woman goes through menopause and other hormones such as DHT (dihydrotestosterone) can become imbalanced, affecting hair growth. Although female hormones may not have as much impact on hair loss as male hormones, it is still a factor when it comes to hair loss in women.

Hair loss can be the result of exposure to nuclear radiation, X-rays, anti-cancer drugs or a severe nutritional deficiency, stress, flu, pneumonia or typhoid fever.

Natural Treatments for Hair Loss in Women

A homeopath may prescribe lycopodium for hair loss after childbirth and sepia for hair loss related to menopause and childbirth. See a qualified homeopath for correct diagnosis and treatment.

An herbalist may suggest a daily intake of rosemary tea to improve circulation to the head. Rinsing the hair with nettle vinegar is said to lessen hair loss. Three herbs for balancing female hormones are dong quai, chaste tree berry, and wild yam. Combined, these herbs make a great formula for balancing female hormone levels. Always consult an herbalist for a specific condition since certain herbs can be toxic if taken in excess.

Increase intake of vitamin B complex, Vitamin E, calcium, magnesium, choline and inositol to help the hair to grow and remain healthy.

Cutting down on alcohol and sugar and eliminating nutritionally deficient junk food from the diet can slow down hair loss. Stick to a natural, healthy diet that includes good fats, protein, whole grains and plenty of organically grown fruits and vegetables in order to prevent hair loss and thinning hair. If hair loss is the result of hormonal imbalance, eat foods such as rice, potatoes, wheat, yams, apples and alfalfa. Regular exercise will help with overall health and reduce stress levels.

Hair Loss After Pregnancy and Childbirth

A woman's hair is her glory, at least according to the age-old adage. If you're like most women, you spend a lot of time and money keeping your hair looking its best. During pregnancy your hair was probably the thickest, fullest you had ever seen it. Then, to your despair, you noticed it falling out in large amounts after your baby was born. You are probably desperate to find out how to stop hair loss after having a baby.

The normal growth process for each hair consists of 3 phases - the growth phase (2 – 8 years), resting phase (about 3 months) and shedding phase. The hormonal changes that occur in a woman during pregnancy cause an increase in the amount of time her hair remains in the growth phase which results in her hair appearing thicker. The average number of hairs that a normal person loses is 100 per day but this hormonal reaction causes pregnant women to lose as little as 50 or less.

After pregnancy the temporarily retained hair sheds which can be worrying for the sufferer, but it is only the excess hair that is falling out and once the shedding has passed the hair will usually return to its original density as it was before pregnancy within 6 months.

Treatment is not usually necessary but failure of the hair to recover six months after pregnancy indicates other possible causes. Stress, a change in lifestyle and strain on the body are other factors that can perpetuate the problem of otherwise temporary hair loss following childbirth. Such factors can cause a more longstanding condition called Diffuse Thinning. Repeated incidences of hair loss after pregnancy can result in less hair growing back each time also giving rise to Diffuse Thinning.

In order to avoid this type of hair loss it is very useful to consider using suitable treatments at each bout of hair loss. This approach helps to minimise the damage that each episode can cause and ensure hair is recovered to its optimum potential.

Hair Loss After Having a Baby

Hair loss after delivery is very common, particularly between three and nine months after birth.

The reason for this is that during pregnancy there is a change in the normal pattern of hair growth and loss, resulting in much less hair being lost than usual.

At about three months after delivery the hair follicles, which have been in an extended phase of growth, change to a shedding phase.

The result can be a significant thinning of the hair, but no treatment is required and after another four to six months the usual balance of hair growth and loss will be re-established.

Sometimes the hair loss can be more marked in one area, but bald patches do not tend to occur.

Step 1

Recognize that some hair loss is normal. Before your pregnancy, you normally shed up to 100 hairs each day. However, during pregnancy you had a larger than normal amount of estrogen. This keeps the hair in the growing stage longer, which in turn keeps you from shedding the normal amount of hair. This is why woman often have beautiful, healthy hair during pregnancy. However, after the baby is born your estrogen level drops to its pre-pregnancy state and your hair begins falling out again. This is normal and will slow down in six months to a year.

Step 2

Choose hairstyles that aren't stressful on the hair. American Pregnancy suggests avoiding hairstyles that are tight and stressful on the hair strands such as braids or tight cornrows. Wear your hair as loosely as possible to prevent stress breaks. One protective thing you can do is wearing your hair in a bun by gathering it in a satin or silk scrunchie, wrapping the hair around the scrunchie, and securing it with a clip or bobby pins. If you really want to keep it out of your way and prevent it from breaking, try a new, shorter haircut while your body is returning to normal.

Step 3

Supplement your diet with vitamins and minerals that have been linked to healthy hair. Vitamin B, zinc, Vitamin E, Biotin, and Vitamin C are all recommended by American Pregnancy as helpful in reducing the amount of hair lost after childbirth. Amazing Pregnancy also suggests making sure you are getting enough antioxidants in your diet. The easiest way to accomplish this is to include lots of fruits and vegetables. Antioxidants are responsible for helping the body remain healthy and are thought to provide protection to the hair follicles as well.

Step 4

Breast-feed your baby. Breast-feeding keeps your body producing more hormones than it does when you aren't breast feeding. According to Pregnancy Families, many breast-feeding women don't lose hair until after their menstrual cycle returns. This simple fact makes breast-feeding healthy for you and your baby.

Step 5

Change your hairstyle after your baby is born. Choose a shorter, easier-to-care-for style that you don't have to fuss over and that will prevent you from noticing the hair loss. This is also good advice for any new mother who finds that she doesn't have the necessary time to devote to longer hair and is constantly unraveling it from her baby's hands.

Step 6

Realize that "this, too, shall pass"--and if it doesn't within six to twelve months, you should see a doctor. Losing your hair is not an attractive thought, and not all women will have to deal with it. But for many women, it is a natural part of childbirth and motherhood that passes with time.

If your GP found areas of obvious inflammation on your scalp, it is possible there is another condition affecting your scalp.

You don't say which gel your GP prescribed, but it would be worth returning to your GP in three to four weeks.

This will allow him to review the problem and to assess whether the treatment has been beneficial.

Several medical conditions can cause hair loss (anaemia and thyroid problems, for example) so if you are feeling unwell in any way it would be worth talking to your GP about it.

Does your baby bring up milk after feeding?

Almost all babies posset (some more than others) during the early months. Posseting is the regurgitation of small quantities of undigested milk following each feed. Your baby's oesophageal sphincter – the little valve between the oesophagus and stomach – is very immature after birth and although it is designed to prevent regurgitation, it usually takes time to mature a before it starts to do its job efficiently. You also are more likely to have an oversupply of milk in the first few weeks, so until this supply settles down (six weeks), most babies will posset (regurgitate) often.

Your baby's tummy is the size of a walnut for the first few months and until this matures and can hold a larger quantity of milk, it is perfectly normal for your baby to posset after every feed. It is also common to see your baby bring up milk at other times as well, such as:

• Each time you change his/her position. 
• When you pick him/her up. 
• When you are changing his/her nappy. 
• When settling and asleep. 

You can expect posseting to peak between the age of 1-4 months and this is because from 1 month, your baby will receive bigger feeds, much bigger than he/she needs as supply and demand evens itself out. Once your supply has settled down (from three months) and your baby matures and starts solids, possetting will naturally settle down and stop.

Each baby is different and there is no guarantee when it will stop for your baby. Usually by 18 months it will have stopped completely. From four months, as the sphincter muscle matures, and as they eat more solid food and spend more time in an upright position, you can expect it to decrease greatly in most cases. Posseting causes no pain or discomfort and your baby will have no other symptoms other than effortless regurgitation of milk after feeds. Your baby should be feeding normally and gaining weight if it is expected normal posseting.

If your baby is refusing to feed or fussy when feeding, projectile vomiting, unsettled and not gaining weight, I suggest you seek medical advice. If you are concerned in any way, seek medical advice, check things out and have your fears resolved. It is always better to be safe than sorry.

Jen's top management tips for posseting:

• Handle your baby extra gently, especially when winding. 
• In the first 6 weeks only, express a small amount of the first breast you are offering. This will eliminate excess volume when you have an oversupply. 
• Raise the head of the cot slightly. 
• Raise your baby's head slightly when changing his/her nappy. 
• Give smaller feeds more frequently (limit to maximum of 45 minutes). 
• Keep your baby upright after feeds for 15 minutes. 
• Start solids by 4-5 months. 
• Don't wear your good clothes whilst feeding or for 15 minutes after the feed. 
• Avoid changing your baby's nappy when their stomach is full. 

Your infant Developmental milestones: Teething

Teething

Cutting teeth isn't one of those milestones a baby reaches all at once. Transitioning from that gummy grin to a mouthful of gleaming teeth is a rite of passage that can take your little one three years to complete. Whenever the first tooth peeks through, celebrate it by taking pictures and noting its arrival date in your child's baby book.

Learn the right way to care for your baby's gums and emerging teeth, when fluoride is okay, whether you need to floss, when and how to brush, and more.

 

By the time your little one is 3, he'll have a mouthful of choppers that he can brush himself, a basic step on the road to self care. (Because he won't have the skills to do a good job, though, be sure to lend him a hand until he's at least 6 years old.)

How it develops

While some babies breeze through the teething process, many seem to struggle with it and experience discomfort. Among the symptoms your teething baby may exhibit:

• Drooling (which can lead to a facial rash)
• Gum swelling and sensitivity
• Irritability or fussiness
• Biting behavior
• Refusing food
• Sleep problems

Teething may be accompanied by a slight fever or an upset stomach. If your baby has a fever higher than 101 degrees Fahrenheit or 38.3 degrees Celsius, is vomiting, has diarrhea, or has any other symptoms that worry you, don't just chalk it up to teething. Give his doctor a call.

Most babies get new teeth in this order: First the bottom two middle ones, then the top two middle ones, then the ones along the sides and back.

Is your baby teething?

Teething symptoms could be due to a host of other issues. To determine whether teething is to blame for your little one's fussiness, look for a sudden change in behavior. "We used to think teeth moved gradually," says Dr. Greene. "Now we know there are some days when teeth move a lot and others only a little." Most children will only be bothered by the large, intense movements.

If in doubt, it never hurts to try a teething remedy. If you're wrong, most symptoms aren't a sign of anything that would need immediate attention – the exception is a fever. Anything over 100 degrees Fahrenheit warrants a trip to the doctor.

When do your infant get Teeth?

When it develops

The journey starts in the womb. While you were pregnant, your baby developed tooth buds, the foundation for baby teeth (also called milk teeth). Rarely, a baby will be born with a tooth or two or grow a tooth in the first few weeks of life. The vast majority of babies sprout their first tooth between 4 and 7 months of age.

If your baby's an early developer, you may see her first white cap (usually one of the bottom middle teeth) as early as 3 months. If she's a late bloomer you may have to wait until she's a year old or more. The last teeth to appear (the second molars, found in the very back of the mouth on the top and bottom) usually begin coming into place by your baby's second birthday.

By age 3, your child should have a full set of 20 baby teeth.

Teething Symptoms

Teething symptoms vary and can range from severe to nothing at all. Most children will experience at least one of the following symptoms as their teeth prepare to break through their gums:

• trouble falling asleep 
• fussiness 
• drooling 
• runny nose 
• rash around the chin or mouth 
• red cheeks 
• swollen gums 
• biting 
• an increased need to suck 
• rejection of breast or bottle 
• congestion 

Traditional Teething Timetable

70% of of babies get teeth according to this guideline:

6 months: lower central incisors – cutting teeth

7 months: upper central incisors 

7.5 months: lower lateral incisors

9 months: upper lateral incisors

12 months: lower first molars (bicuspids) – grinding and chewing teeth

14 months: upper first molars

16 months: lower canines (cuspids)

18 months: upper canines

20 months: lower second molars

24 months: upper second molars

WEIGHT & HEIGHT OF THE AVERAGE INFANT

Babies grow so fast during their first year. You might wonder if your baby is growing normally. Infants usually double their birth weight by 6 months and triple their birth weight by 1 year. Your pediatrician or health care provider will monitor your baby's length and weight carefully during her first year.

Most health care providers use the Center for Disease Control's growth charts. Babies should measure between the 10th and 90th percentile on their growth chart. A healthy, full-term baby boy should weigh between 6 and 9 ½ pounds at birth, 15 and 20 pounds at 6 months, and 20 and 26 pounds by 1 year to stay in this range. He should measure about 18 ½ to 21 inches at birth, 25 to 27 ½ inches at 6 months, and 28 ½ to 31 inches at 1 year to fall within the range for length. Your baby should stay around the same percentile as he grows.

Baby girl measurements vary slightly by a half pound and half inch less at birth and 2 pounds and a half to 1 inch less at 6 months and 1 year.

Growth Spurts

Infants normally experience growth spurts from time to time during their first year. They usually occur around baby's second week, second, fourth and sixth month. You may notice your baby wants to eat more and often during these times.

Growth Indicators

The CDC lists four different growth indicators to help health care providers assess a baby's nutritional and health status; short stature, underweight, overweight and risk for overweight. If your baby falls below the 5th percentile length for age or weight for length she would be considered short stature or underweight. Above the 95th percentile weight for length is considered overweight and above the 85th percentile a baby may be considered at risk for overweight. If you think your baby falls into any of these categories or you have concerns, consult your pediatrician or health care provider.

Feeding Practices

To ensure your baby's best chance of growing and gaining weight appropriately, feed your baby as recommended by the American Academy of Pediatrics. They suggest only giving breast milk or formula for the first four to six months, then slowly adding solid foods to your baby's diet. If you are feeding your baby powdered or concentrated formula, mix the formula as instructed on the container. Too much or too little water can affect a baby's calorie intake and thus his growth.

Potential

The first year of life for a baby is an exciting one. So many changes occur as she grows and develops. Many parents worry about their baby's progress, especially height and weight. Many factors influence a baby's height and weight including genetics, health and if your baby was born full term or premature. Her weight and length will also fluctuate throughout the year. There is no "perfect" weight or height. Every baby will grow at a different rate as she develops into a toddler.

When Can Infants Fly on Planes?

Assuming that both mother and baby are healthy, you can travel at two weeks of age. In some cases you can fly even sooner than this, but I would recommend holding off if it is not absolutely necessary.

There are a number of things to take into account when deciding to fly with a newborn. First, you are exposing the baby to possible infections on a crowded airplane. Colds and flus are easily transmitted in a closed airplane cabin with recirculated air, and those viruses are much more dangerous to a baby at a week or two of age than one who is four or six months old. Breastfeeding transfers many protective antibodies to a baby, however, and may help make her less susceptible to infections.

Second, babies are notoriously unpredictable in the first few weeks, with irregular sleeping, feeding, and crying times. While this can certainly be managed, it may be very draining to Mom and Dad to travel before a baby has "settled." Some babies do this by two weeks, others not until three months!

Third, Mom should be healthy and recovered from the delivery. Women are at greater risk of problems such as blood clots in the legs after delivering a baby, and sitting for a long period on an airplane only increases this possibility. If you travel this early, you should wear support hose, drink plenty of fluids, and get up frequently during the flight to walk and stretch.

If there were any problems or complications with the delivery, then airplane travel should be avoided until the baby's doctor gives approval. Premature babies, and babies who had respiratory or feeding problems in the first week, fall into this category.

Obviously, there are many factors to consider when making plans to travel with a newborn. A one- or two-hour flight is less problematic than a six- or seven-hour, transcontinental or transoceanic flight. I would recommend that the baby have her first visit with the pediatrician prior to traveling.

Travel by Plane with an Infant

Visions of a screaming, inconsolable child haunt many parents preparing to fly with an infant. No one wants to be the parent on the plane with the upset baby for the duration of the flight. The anticipation of potential problems is usually worse than the actual experience. Preparation for the flight increases the odds of a smooth trip for you and the other passengers. Surviving a flight with an infant makes you feel like a traveling pro who can handle anything.

Before making the decision try this: think of how long your flight will be, then seat you child on your lap and see how long he'll last there.

Do not feel obligated to purchase a seat for your child. Children under two fly free or for a nominal fee when you hold them on your lap. Unlike in a car, your lap is safe & comforting to your child.

1. Purchase a giant diaper bag. Lap children are not entitled to a piece of luggage; only a diaper bag.

2. Plan to breastfeed if you can. Attendants do not warm bottles or formula.

3. Consider dressing your child in a one piece footed pajama if you're worried about losing clothes. Dress the child as comfortably as possible. Being on a plane, let alone in one seat, for many hours isn't fun.

4. Pack the diaper bag as if you're going on a trip for a day. Make sure you have a change of clothes or two outfits, diapers, toys (stickers, crayons & paper for toddlers), changing pad, baby wipes, and utensils.

You must declare baby food, formula & medicines. Babies and toddlers ARE exempt from the 3-1-1 rule.

5. Consider buying some new toys to surprise your child; they will keep his or her attention longer. You may choose to hold onto these toys until well into the flight, when your child gets antsy or to distracted from a temper tantrum. If the flight goes well, save the toys for the flight home.

6. Surprise your child with a piece of candy or treat you have refused in the past. Tiny lollipops are a good choice as the sucking can help with ear pressure.

7. Bring earplugs. Not for you or your baby, for the people around you. If your child cries uncontrollably, you can show your concern by handing your neighbors an inexpensive pair of foam earplugs with a kind smile.

8. Arrive early at your gate. Ask the attendant for a "Gate Check Tag" for your stroller. They will stow your stroller with the luggage in the belly of the plane, but bring it to you when you exit it the plane, so you don't have to carry your child to baggage claim.

9. While you are at the gate, ask the attendant if they will board families with small children first. This is usually a common practice, but not always. You can relax a bit if the answer is yes.

10. Serve your toddler juice or water by bringing a "reuse or toss" cup with lid & straw. Attendants will provide drinks on most flights, but they do not provide straws or lids. You could have a spill that wets you, him or the stranger next to him when he accidentally bumps his tray-table. Consider picking up a cup, straw & lid from a concession stand before boarding your flight in a pinch.

11. Bring a blanket to cover your baby, but as soon as you sit down in your seat, request extra pillows & blankets. Pillows are not items you will want to pack, as they are bulky. If you don't like the idea of your child's face on the airline pillow, cover it with your blanket from home. Your arms will need extra cushioning, if your child takes a long nap and you can't move.

12. Do not try to carry everything on board you will possibly need. You cannot quickly or easily get to things under your seat or in the over-head. They will go unused and be a useless burden to carry. Think minimalist.

13. Travel during nap time. Some children fall asleep in a plane, no different than while riding in a car.