10 milestones for the first 2 years of your baby

Every milestone -- from when your baby first holds up her sweet little head to when she speaks her first word -- is thrilling. These moments aren't just exciting and fun; they're also markers that can clue you in to your baby's development. Most parents already know to look for the much-lauded ones, like rolling over and walking. But of the multitude of milestones cited by the American Academy of Pediatrics, some are considered more significant. Here, 10 milestones that are worth paying a little extra attention to during your child's first two years:

1. Eye contact

(between 6 and 8 weeks)

This is one of the first milestones you'll notice, and it's a big deal not just because your baby is finally paying attention to you, and following you with her eyes, but also because it indicates that her neurological growth and ability to communicate are on track. She's demonstrating that her brain is registering a familiar face. In a sense, she's saying, "Hey, I know who you are."

Laura Weber was worried when, at 4 weeks, her infant, Nicole, never met her gaze. "Whenever I tried to make eye contact with her, she'd look over my shoulder instead," says the mom of three from Fredericksburg, Virginia. Fueling her concern was the fact that her first daughter, now 4, hit all the milestones on the early side of "normal." When Weber voiced this at Nicole's checkup, her pediatrician stressed that with milestones, there's a wide range of normal. Indeed, Nicole reached this one at 3 months, the late side of normal. If Nicole hadn't begun to make eye contact after 3 months, her doctor would have suggested vision testing to rule out eye disease. The next step would have been to look for signs of attachment or behavior problems. But experts urge parents to refrain from jumping to the worst-case conclusion. "You have to be very cautious about assuming your child has a certain condition. It has to be taken in context with so many other things," says Martin Stein, M.D., director of developmental-behavioral pediatrics at Rady Children's Hospital San Diego, California. The more likely reason for no eye contact is that you're looking at the wrong times. "An infant needs to be in a quiet but alert mental state to respond in this way, and most of the time an infant is awake she's tired or hungry," says Dr. Stein. The lesson? Be patient, and keep your eyes open. (Parenting.com: Infant milestones )

2. Social smile

This isn't the spontaneous smile that happens when your few-hours-old infant passes gas or your 3-week-old grins at the ceiling. A social smile is reciprocal, meaning your baby smiles in response to someone else's smile. It's a sign that several different parts of the brain are maturing. It says he's able to see short distances, make sense of an object (in this case a smiling face), and produce his own smile in return. A social smile also boosts bonding, since it's one of the first forms of communication between parent and child. If despite your encouraging grins you don't notice a social smile by 3 months, bring it up with your pediatrician; rarely this can signal eye problems or an attachment disorder. Again, being patient and looking for times when your baby is well rested may be all it takes to see him smile.

3. Cooing

During your baby's first several weeks, she communicates mainly by crying. But around 8 weeks, there's a lot of activity that begins to take place in the brain's front temporal lobe (the brain's speech center) that lets your baby coo. "I often half jokingly say that if she has a social smile, can follow movement with her eyes, and can coo, it means she has the ability to go to college, since there's so much that has to be working right in the brain for these things to occur," says Dr. Stein. When she coos, she's using the back of her throat to create vowel sounds like ah-ah-ah and oh-oh-oh. Try talking back, and she may respond with another ah-ah-ah. Don't expect your infant to coo on cue though; she still needs time to master her coo conversation. One of the best things you can do to promote this is to narrate your life: "Mommy is putting on your shoes so we can go to the park. Do you like the park?" Whatever you talk about, your baby just loves the sound of your voice. If she doesn't spontaneously coo by 3 months, check with your doctor, who'll most likely run hearing tests. (Parenting.com: The social life of babies )

4. Babbling

Eventually your baby will move on to babbling. This is different from cooing because it requires using the tongue and the front of the mouth (rather than the throat) to make sounds like nah-nah-nah and bah-bah-bah. Different situations inspire babbling in different babies. For Erin England Acosta's daughter, Samantha, a change of scenery seemed to be all it took. "Samantha hardly made a peep until she started day care at 6 months, and after the first week, she was babbling up a storm," says the Orange, California, mom. Once your baby begins babbling, she'll probably want to try out her newly acquired skill -- a lot. This practice will ultimately bring her to the next significant milestone at 6 to 8 months: reciprocal babbling. This shows that she's learned she can respond to another person's voice by using her own -- a crucial first step in early language. If you don't hear babbling by the time your baby is 6 months, talk with your pediatrician to discuss your concerns.

5. Reaching and grabbing

"When a child begins to reach and grab, it says she can act intentionally on the world," says Claire Lerner, director of parenting resources for Zero to Three, a national nonprofit organization devoted to promoting healthy development for infants and toddlers. "It shows desire, interest, and curiosity, which are all critical for learning." To encourage reaching and grabbing, get down on the floor with your baby and place a favorite toy just out of reach. The more opportunities you create, the more you engage her senses and entice her to touch, smell, look, and learn about objects.

6. Pulling up to a stand

(9 to 10 months)

One of the first signs that your baby is getting ready to walk is that he begins to pull himself up to a standing position. "This is one of the most important gross motor [large muscle] milestones because it shows the stability and strength of the legs and trunk, which are both necessary for walking," says Dr. Stein. It also shows that your child has the motivation to reach a goal -- to get to that red block sitting on the coffee table, for instance. To help your child learn to pull himself up, it's a good idea to give him lots of time to be unencumbered -- to limit the time he spends in the car seat, stroller, and such. At age 1, Mary Hoskins-Clark's oldest daughter, Katie, now 5, wasn't making any attempts to pull herself up to a stand. "In fact, she wasn't even crawling," says the Westfield, New Jersey, mom of three. So Katie's pediatrician recommended she be evaluated by an occupational therapist, who concluded there was nothing hindering her ability to crawl or walk. The therapist suggested that Hoskins-Clark simply needed to entice Katie to crawl, pull up to a stand, and walk (instead of carrying her everywhere, which she was prone to do), by encouraging her to come and get her favorite toy or sippy cup. Sure enough, at 14 months, Katie started to crawl. Around 16 months she started to pull up to a stand, and was walking at 19½ months.

7. Pincer grasp

There's the crude pincer grasp that occurs around 7 or 8 months, when babies use all of their fingers and their thumb to pick up a spoon or toy. Then, a few months later, they refine the skill and, with either hand, very neatly take their thumb and forefinger to pick up one Cheerio or one piece of a puzzle. "Getting the pincer grasp is one of the biggest keys to independence," says Lerner. "Eventually, a child will use this grasp to do essential things like feed and dress herself and brush her teeth." Encouraging this skill is as simple as letting your child hang out in her high chair with a few Cheerios or crackers. What if she isn't catching on? Give it time. Only if your child isn't using the pincer grasp by 12 months should you get an evaluation to assess her fine motor skills. (Parenting.com: Motor skill delays )

8. Gesturing

When your child has eaten all his peas and motions with wide-open hands "all gone," or points to his favorite book on the bookshelf, this is a preverbal form of language. Developmental experts say that gesturing is a clear sign that your child knows what he's thinking, and he's aware that he can communicate that to you as well. If you consistently gesture to your child, he'll probably imitate you eventually by doing it back. As with all of the milestones, give him time to get the hang of it before presuming that he's not on track.

9. First word

The past months of cooing, babbling, pointing, and gesturing have all been steppingstones to the formation of speech. When your daughter sees a ball and pronounces "ba" or "ball," her brain is making the connection between that sound and the object. "This also signals she's beginning to understand that a sound or a word is a symbol for an object," says Lerner. On average, children begin talking around 12 months. By 15 to 18 months, some kids may say between 20 and 50 words, while others may say only 5 to 10. At this age, a child should also understand some words, such as when you ask her to "show me your nose." The best way to promote speech? Spend time talking or singing to your child. Daily reading is another excellent way. If there are no words by 18 months, raise your concerns with your pediatrician, who'll want to rule out hearing problems or screen for developmental delays. (Parenting.com: Baby's first words )

10. Pretend play

If you're looking for a little insight into your own habits, look at your toddler, who will often begin pretend play by imitating you. At 21 months, Carina Kilroy would jump at the chance to "catch up with friends" via the family's cordless phone. "Even though she could speak in sentences, when she picked up our phone she just babbled in nonsensical language, but with inflection. You could tell she was trying to sound just like me," says her Reno, Nevada--based mom, Dana Kilroy. There's also a serious side to pretend play -- it's critical to building your child's symbolic thinking. Ultimately, a baby who lives in a rich learning environment will have lots to smile, coo, and babble about.

 

Calcium and your BABY

Milk and other calcium-rich foods have always been a must-have in kids' diets. After all, calcium is a key building block for strong, healthy bones. But most kids ages 9 to 18 don't get the recommended 1,300 milligrams of calcium per day.

 

That's not surprising when you consider that many kids now drink more soda than milk, which is one of the best sources of calcium. And teens who smoke or drink soda, caffeinated beverages, or alcohol may get even less calcium because those substances interfere with the way the body absorbs and uses calcium.

 

But at every age, from infancy to adolescence, calcium is one nutrient that kids simply can't afford to skip.

 

What Calcium Does
During childhood and adolescence, the body uses the mineral calcium to build strong bones — a process that's all but complete by the end of the teen years. Bone calcium begins to decrease in young adulthood and progressive loss of bone occurs as we age, particularly in women.

 

Teens, especially girls, whose diets don't provide the nutrients to build bones to their maximum potential are at greater risk of developing the bone disease osteoporosis, which increases the risk of fractures from weakened bones.

 

Younger kids and babies with little calcium and vitamin D intake (which aids in calcium absorption) are at increased risk for rickets. Rickets is a bone-softening disease that causes severe bowing of the legs, poor growth, and sometimes muscle pain and weakness.

Calcium plays an important role in muscle contraction, transmitting messages through the nerves, and the release of hormones. If blood calcium levels are low (due to poor calcium intake), calcium is taken from the bones to ensure normal cell function.

When kids get enough calcium and physical activity during childhood and the teen years, they can start out their adult lives with the strongest bones possible. For optimal bone health, the Institute of Medicine (IOM) recommends:

 

1 to 3 years old — 700 milligrams of calcium daily
4 to 8 years old — 1000 milligrams
9 to 18 years old — 1,300 milligrams

Getting enough calcium is just part of the equation. Kids from 1 to 18 years old also should get 600 IU of vitamin D daily. If you don't think your kids are getting the nutrients needed, talk to your doctor about modifying their diet or using vitamin supplements.

 

When Kids Can't — or Won't — Eat Dairy

Some kids can't or won't consume dairy products. Here are some ways to make sure they get enough calcium:

Kids with lactose intolerance: Kids with lactose intolerance don't have enough of the intestinal enzyme (lactase) that helps digest the sugar (lactose) in dairy products. These kids may have cramps or diarrhea after drinking milk or eating dairy products.

Fortunately, low-lactose and lactose-free dairy products are available, as are lactase drops that can be added to dairy products. Also ask your doctor about tablets that kids with lactose intolerance can take that allow them to eat dairy products and thus benefit from the calcium they contain. Hard, aged cheeses (such as cheddar) are also lower in lactose, and yogurts that contain active cultures are easier to digest and much less likely to cause lactose problems.

Kids with milk allergy: The proteins in milk might cause allergic reactions in some people. Casein is the principal protein in cow's milk, accounting for about 80% of the total milk proteins. Casein is what makes up the curd that forms when milk is left to sour. The remaining 20% of cow's milk proteins are contained in the whey, the watery part that's left after the curd is removed. Someone may be allergic to proteins in either the casein or the whey parts of milk and sometimes even to both.

Talk to your doctor if you think your child may be allergic to milk. Formula-fed infants with a cow's milk allergy may need to be switched to soy-based or hypoallergenic formula. For older kids, good alternatives to milk and milk products include calcium-enriched rice or soy milk (if soy is tolerated), vegan products (such as vegan cheese), and other soy-based (again, if soy is tolerated) or rice-based frozen desserts, sorbets, puddings, and ice pops.

Vegetarian kids: Parents of kids who are ovo-vegetarians (they eat eggs, but no dairy products) or vegans (they eat only foods from plant sources) may be concerned about whether a dairy-free diet can supply enough calcium.

Although it can be more of a challenge to get the recommended amounts of calcium in a vegetables-only diet, good sources of calcium include dark green leafy vegetables, broccoli, chickpeas, and calcium-fortified products, including orange juice, soy and rice drinks, and cereals.

Teens who think dairy products are fattening: Adolescent girls, in particular, may decide to diet and avoid eating dairy foods they think will make them fat. But it's important for your teen to understand that an 8-ounce (240-milliliter) glass of skim milk has only 80 calories and zero fat and supplies one quarter of a teen girl's recommended daily calcium intake.

In fact, people who eat diets rich in calcium may actually weigh less and have less body fat. In one study, adolescent girls who had an extra 300 milligrams of calcium each day, which is equivalent to one glass of milk, weighed up to 2 pounds (907 grams) less than girls who didn't get the extra calcium.

You can also offer low-fat and nonfat dairy products as healthy alternatives to whole milk products — and instead of sodas and sugary fruit drinks that have very little nutritional value. If your teen drinks juice, offer calcium-fortified 100% fruit juices (not too much juice, though, as that can contribute a lot of sugar and calories).

Also talk to your teen about osteoporosis and the importance of dairy products and other calcium-rich foods in a healthy diet.

How to Let Your Baby to Self Settle to Sleep

The idea of having babies settle themselves to sleep seems crazy to parents who have sat up all night trying to get them to stop crying. But it can be done. Try these steps to get your baby to settle themselves to sleep.

1. Understand that your baby, thinking simply, associates various object, people, and activities with going to sleep. These are called "sleep associations". If a sleep association involves you, then your baby will think they need you to fall asleep. If a sleep association involves feeding or rocking, your baby will think they need food and/or rocking to fall asleep.

Other sleep associations include pacifiers, bottles, and teddy bears, This is not inherently bad thing, since it is natural for a baby, but as the parent, you need to choose the best association for your child to have a complete and restful night's sleep.

2. Establish a sleep association from day one. After bringing your newborn home from the hospital, settle them into their room and try various associations that make your baby calm and comfortable.

3. Talking softly to your baby is the most widely-accepted method.

4. Know that it is important to establish good sleep habits early on, before any habits form. Ensure your baby is in a good routine, preferably with set times for daytime naps and nightly bedtime. This helps your baby understand what you expect and when you expect it, and this helps your settling training work much faster.

5. Decide on a personal level that you are going to stop rocking, feeding, driving or whatever else you are doing to get your baby to sleep. Many people will advise you to just leave your baby to cry and they will eventually fall asleep. On the other hand, this is contested by many with the following reasoning: They reason that babies cry because they are unable to protect themselves and afraid of being deserted by their parents. A child that stops crying gives up the hope of being "rescued", and loses trust in you, the parent, as the protector. This can greatly affect a child's development and self-confidence. Still, it is your personal choice.

6.Teach your baby to fall asleep independently by giving them the opportunity to do so. Many babies need a period of winding down to fall asleep, and by not letting them cry at all, they can miss the opportunity to learn to fall asleep. These techniques can work quickly with a lot of babies; however, consistency is very important to making them work effectively. If you use the controlled crying at 7pm, 10pm and 2am, then at 4am feed baby to sleep in your bed, the program is not going to work quickly, if at all. To use one of these programs, you need to be sure you can listen to your baby crying for a period of time and be consistent with how you respond.

7. These techniques also give you a middle ground between not letting your baby cry and the cry it out method.

Tips

Settle the baby, then leave the room for increasing periods of time, giving baby the opportunity to fall asleep independently. You start with 2 minutes settling, and leave the room for 2 minutes, then 2 minutes settling, out of the room for 4 minutes, etc. Up to a maximum of leaving your baby for 10 minutes. This has been shown to be one of the most effective methods of teaching babies to self-settle, provided it is used consistently at all sleeps and any night-waking.

The cry it out method involves leaving your baby until they go to sleep by themselves. This often works very quickly - in as few as 3 nights - but it can mean listening to your baby crying for long periods of time.

This technique can be useful for toddlers who are 'trying it on,' for example continually requesting more stories, another bottle, every excuse but going to sleep. It can also be suitable if you have tried controlled crying with an older baby, but you are finding going in to resettle them is upsetting them further.

Why Do Yout Infant Cry in her Sleep

Types
Babies make many different kinds of sounds while they are sound asleep. Babies can gurgle, grunt, coo, fuss and even cry while still remaining asleep. Some throat rattling and nose whistling may also occur during a baby's sleep cycle. Outright crying during sleep is usually limited to a short burst or two of unhappy-sounding crying or fussing. If the baby does not settle down again within about five minutes, then he is actually awake.

 

Causes
The main cause of an infant crying during sleep is due to his unusual sleep schedule. Babies spend about half of their 16 to 20 hours of sleep per day in the restless form of REM (rapid eye movement) sleep. Even older children and adults move and make sound during REM sleep cycles. After a few months, babies will gain the ability to sleep deeper, eliminating much of the sleep crying that young infants do. Other causes of sleep crying could include colic, discomfort or hunger.

 

Considerations
Many parents believe that if an infant makes a sound that it is an indication the baby is awake and ready to get up and eat or play. Not so. Babies may fuss for up to five minutes during sleep and then continue back to deeper sleep. It is important to keep an eye on an infant during this crying period to make sure the she is not actually awake. If the crying continues for more than five minutes then the baby is awake and needs attention.

 

Solutions
There are not many solutions to helping to prevent an infant from crying in his sleep. Sleep crying and fussing is a natural process that will eventually go away on its own. However, it is possible to eliminate some crying by making the baby as comfortable as possible. Always place a baby to sleep when he is full and has clean clothes and diaper. Try to prevent colic by keeping the baby burped and avoid spicy foods if breastfeeding.

 

Warning
It is extremely important not to mistake real crying for sleep crying. Sleep crying is usually muted and broken. Real crying generally includes high-pitched wailing that does not stop quickly. Always tend to a crying baby immediately when she is awake.

Don't Shake Your Baby!

Taking care of a fussy baby, or a baby who cries and cannot be consoled, is very, very stressful. Sometimes, usually out of frustration, a caregiver will shake the baby forcefully, in an attempt to make him stop crying. Never shake a baby because his tiny, fragile brain may be damaged. 

It takes only a few seconds of shaking to cause irreversible brain damage in an infant. Further damage can occur if the shaking ends with the baby hitting something, like a wall or mattress. When a baby is shaken to the point where his brain is damaged, it is called shaken baby syndrome (SBS) or shaken impact syndrome. 

SBS is the leading cause of death in child abuse cases in the United States. The average age of the victims is between 3 and 8 months. In most cases, the person who injures the baby is a young male in his early 20s. He often is the baby's father or the mother's boyfriend.  

When a baby is shaken forcefully, the brain strikes the inside of the skull. This causes blood vessels and nerves to burst and the brain tissue to tear. Afterwards, the brain swells, causing more pressure and more damage. About half the babies who have SBS die. 

Children who survive may suffer: 

• Partial or total blindness 
• Hearing loss 
• Seizures 
• Developmental delays 
• Learning problems 
• Paralysis 
• Mental retardation

In mild cases, the baby may appear normal after the shaking. But over time, he may develop one or more of the problems listed above. Often a problem is first noticed when the child goes to school and has trouble learning or behaving. 

SBC can be totally prevented, especially when parents recognize when they are frustrated and get help to reduce stress.

What you should know about shaking a baby

What can parents do to help soothe a crying baby?

 

The Canadian Paediatric Society has information for parents about colic and crying. The following suggestions might also be helpful.

 • Check to see whether the crying is a signal that your baby needs something specific, like a diaper change, feeding, relief from being too hot or too cold, or attention, or has a fever .

 • Hold your baby. This will not spoil him. However, some babies do not like being passed from person to person.

 • Wrap or swaddle your baby in a soft blanket.

 • Turn off the lights and keep surroundings quiet. Too much stimulation can often trigger crying or make it worse.

 • Soft music, white noise or a gentle shushing noise can soothe some babies. 

 • Many babies are soothed by motion. Try walking with baby in a sling or in a stroller. Rock or sway with baby in a gentle, rhythmic motion. Or try going for a ride in a car.       

 • Sucking sometimes helps babies to calm and relax. You can provide this by allowing your baby to breastfeed or by offering a pacifier.

 • Give your baby a warm bath.

 

What if my baby keeps crying?

 

If your baby continues to cry after you've made sure there's no specific problem, try to stay calm and be aware of how you feel. Are you upset? Are you frustrated? Are you angry? Take a moment to relax. Here are some suggestions to help calm yourself:

 • If you feel like you might lose control, stop! Place your child safely in the crib, take a time-out and leave the child's room for a few minutes.

 • Take slow and deep breaths.

 • Say NO a few times loudly, or count to 10, 20 or 30..

 • Hold onto something soft.

 • Listen to gentle music or nature recordings.

 • Cry.

 • Take a shower.

 • Talk to a friend, family member, neighbour, or anyone else you trust, and get some support.

 • If you ever feel you may hurt your baby, call for help: a local crisis line, your child welfare agency, or police. Check the first pages of you local phone book for the emergency numbers in your area.

 

What are the signs a baby may have been shaken?

 

Common signs include:

 • Unusual sleepiness or extreme fussiness

 • Refusing to eat, poor feeding or vomiting for no apparent reason

 • Usual smiling, eye-contact, babbling responses are lost

 • Body stiffness or seizures(legs and arms become stiff or uncontrollable)

 • Appears to have difficulty breathing

 • Eyes are not focused, pupils size is unequal or your baby can't follow a movement with his eyes

 

What should you do if you think your baby has been shaken?

 • Call 911, see your doctor or got to an emergency room immediately.

 • If your baby stops breathing or has seizures before emergency help arrives, call 911.

 • If your baby is vomiting, gently roll her whole body to one side at the same time (like rolling a log) while supporting the neck to prevent choking and breathing in the vomit.

 

Shaking is not first aid! 

 

If your baby is not breathing, shaking will not help. The only way to help a baby breathe is Cardiopulmonary Resuscitation (mouth-to-mouth breathing). Call 911 and start mouth-to-mouth breathing. Many community organizations, such as St. John Ambulance or Red Cross, offer inexpensive or free courses for these first-aid skills.

 

Where can new parents go for help and support?

 

Being a parent or caregiver is not easy. A baby's constant crying can be stressful, and can cause you to feel frustrated. You're probably not sleeping much while trying to meet your baby's needs around the clock.

 

Try to arrange for regular child care relief so you can get some rest. Find a friend, family member or someone else you trust who can look after your baby for short periods while you get a break. If people that you trust offer help, accept it. Know your caregiver. Never leave your child with someone you don't trust, or someone who has violent reactions.

 

Remember, no matter how upset you feel, DON'T SHAKE YOUR BABY.

 

If you have concerns or questions, talk to your paediatrician, family doctor, or public health nurse, and look for local community resources that support parents.

 

Don't harm a baby in a moment of frustration. The effects could last a lifetime.

Never Shake Your Baby

What is Shaken Baby Syndrome?

 

Shaken Baby Syndrome (SBS) is a type of Abusive Head Trauma (AHT). The victims are babies who have are shaken violently and repetitively with or without the head hitting something. The effects can be very serious and can include lifelong injury or even death.

 

SBS or AHT can cause:

 • Damage to a child's brain.

 • Permanent disabilities, like blindness or paralysis.

 • Death.

 

Children less than 1 year old are the most at risk because they cry more often, but older children can also be seriously injured if they are shaken violently. No child, at any age, should ever be shaken.

When Do Babies Cry? 

Babies usually cry because they need something. Normal babies cry when they are: 

• Hungry 
• Tired 
• Wet 
• Uncomfortable 

Healthy babies might cry up to two or three hours a day. A baby with colic may cry all day long. Sometimes your baby just wants to be picked up and held.  

Things To Try 

• Give the baby a bottle of boiled water after it has been cooled 
• Gently rub the baby's tummy 
• Offer a pacifier—sucking is a comfort 
• Walk or rock the baby snuggled up close to your chest so the baby can feel your heartbeat 
• Take the baby for a walk in the fresh air 
• Sing or talk to your baby 
• Wrap the baby in a soft blanket 
• Call a friend or relative to talk about your frustration or see if they can relieve you for a while 

Diet for post-baby weight loss

• Don't start dieting too soon

Your body needs time to recover from labor and delivery. Give yourself until your six-week postpartum checkup before you start watching your calorie intake and actively trying to slim down. And if you're breastfeeding, experts recommend that you wait until your baby is at least 2 months old before you try to lose weight. (If you're a nursing mom, you may also want to read our article on a healthy breastfeeding diet.)

Starting a diet too soon after giving birth can delay your recovery and make you feel more tired – and you need all the energy you can muster to adjust to life with your newborn. In addition, if you're nursing, dieting can affect your milk supply. If you're patient and give your body a chance to do its work, you may be surprised at how much weight you lose naturally, especially if you're breastfeeding.

• Be realistic about weight loss

Keep in mind that you may not be able to return to your exact pre-pregnancy weight or shape. For many women, pregnancy causes permanent changes such as a softer belly, slightly wider hips, and a larger waistline. With this in mind, you might want to adjust your goals a bit. For a reality check, see our photo gallery of real post-baby bellies.

• Eat up – and take your time!

With a new baby and schedule, it can be hard to find the time to eat. But skipping meals can make energy levels lag – and it won't help you lose weight. Many moms find that eating five to six small meals a day with healthy snacks in between (rather than three larger meals) fits their appetite and schedule better. (A small meal might be half a sandwich, some carrot sticks, fruit, and a glass of milk.)

Don't skip meals in an attempt to lose weight – it won't help, because you'll be more likely to eat more at other meals. And you'll also probably feel tired and grouchy.

Even if you've never been much of a breakfast person, keep in mind that eating breakfast can help keep you from feeling famished – and tired – later in the morning, and it can give you the energy to be more active.

In addition, numerous studies show that skipping breakfast can sabotage your weight loss efforts. According to the National Weight Control Registry, which has tallied the successful strategies of dieters who have lost an average of 66 pounds and kept it off for 5.5 years, 78 percent of the dieters eat breakfast daily.Slow your eating down, too, if possible. When you take your time eating, you'll notice that it's easier to tell when you feel full – and you're less likely to overeat.

• Embrace exercise

There's no magic pill to help you lose weight: A healthy diet combined with regular exercise is the best way to shed the pounds – and to keep them off. And it's important to exercise while trying to lose weight to ensure you're losing fat instead of muscle.

Once you're ready to begin losing weight, start by eating a little less and being more active – even if you're just taking a quick walk around the block with your baby in the stroller.

Find out whether your body is ready for exercise and visit our postpartum fitness area for information on getting back into shape.

• Lose weight slowly

Don't go on a strict, restrictive diet. Women need a minimum of 1,200 calories a day to stay healthy, and most women need more than that – between 1,500 and 2,200 calories a day – to keep up their energy and prevent mood swings. And if you're nursing, you need a bare minimum of 1,800 calories a day (most nursing moms need more like 2,000 to 2,700 calories) to nourish both yourself and your baby.

If you're breastfeeding, you'll want to make sure to take it slow – losing weight too quickly can cause a decrease in your milk supply.

Too-rapid weight loss can also release toxins that are stored in your body fat into the bloodstream – and into your milk supply. (Toxins that can make it into your bloodstream include environmental contaminants like the heavy metals lead and mercury, persistent organic pollutants like PCBs and dioxins, and solvents.)

Weight loss of about a pound and a half a week is safe and won't affect your milk supply if you're nursing. To achieve this, cut out 500 calories a day from your current diet (without dipping below the safe minimum) by either decreasing your food intake or increasing your activity level.

• Be choosy about foods and drinks

Research shows that consuming low-fat milk and dairy products and choosing whole grain products like whole wheat bread and whole grain cereal can help you lose weight. Other good choices include low-fat, high-fiber foods such as fruits (like apples, oranges, and berries) and raw vegetables (like carrots, jicama, and red pepper strips) for healthy snacks.

Other ways to squeeze in more fruits and veggies: Make fruit (or veggie) smoothies, use fruit or vegetable salsas or vegetable reduction sauces (sauces made from puréed vegetables) over fish or chicken, add shredded carrots to your sandwich, try grilled vegetables, and try puréed vegetable soups. (Puréeing your soup makes it creamy without having to add cream, which is high in calories and saturated fat. It's also a great way to eat veggies you might not ordinarily eat on their own.)

Fat has twice as many calories as carbohydrates or proteins, so trimming the extra fat from your diet is probably the easiest way to cut calories. Look for low-fat or fat-free dairy products (you don't need to drink whole milk in order to make quality breast milk!), choose broiled or baked rather than fried foods, and limit your intake of sweets, which have extra calories from sugar and fat.

Keep in mind, though, that fat is an important nutrient, so your goal isn't to eliminate it from your diet. In fact, including some fat at each meal will help you stay full and keep you from overeating carbohydrates. (Too many calories from any source – fat, protein, or carbs – can lead to weight gain or keep you from accomplishing weight loss.)

The trick is to choose "good" fats rather than "bad" fats. The best fats are mono- and polyunsaturated fats, like those in canola oil, olive oil, avocado, olives, nuts and seeds, and fatty fish like salmon. The oils to avoid are saturated and trans fats, which can contribute to heart disease and perhaps diabetes, and can be transferred to breast milk, too.

Saturated fats are found in meats and dairy products, and trans fats are typically found in many fried foods, snack foods, and baked goods. (Food labels specify which kinds of fats the products contain.)

Finally, although you should be drinking about 8 or 9 cups of fluids each day, watch what you drink – a surprising number of calories can be hidden in juice, soda, and coffee drinks.

• Daily food plan for healthy post-baby weight loss

The food plan below adds up to 2,200 calories a day for breastfeeding moms. For non-breastfeeding moms, it totals 1,800 calories a day. Use this as a rough guide – your individual calorie needs will vary depending on your weight, metabolism, and activity level, and also on how much you're breastfeeding.

Tips for Losing Weight After Pregnancy

Eager to get back into shape now that you're no longer pregnant? For long-term success – and to keep yourself feeling good along the way – keep these tips in mind.

When you do get started with a workout routine, you'll want to focus on three different areas: Core strength, cardio and strength training.

1. Core Strength

Pregnancy can weaken some areas of the abs, not surprising when you consider there was a baby squished in there for nine months. You may be yearning to jump into an ab program complete with crunches and sit-ups, but your abs do need some TLC once your doctor has cleared you for exercise.

You may be wondering which exercises to do, and how much of them, in order to help lose fat around the belly. It's important to remember that you can't spot reduce fat from certain areas of your body with specific exercises. Getting flatter abs involves losing overall body fat with a combination of cardio, strength training and a healthy diet. Even then, you may still have a little fat around the lower belly. This is an area many women store excess fat, particularly after pregnancy, so try not to put too much pressure on yourself to get a flat belly.

This doesn't mean you shouldn't be doing ab exercises, because you do need to strengthen the muscles that have stretched and possibly weakened during pregnancy. Some basic exercises you may want to start with include:

• Pelvic tilts
• Ball Crunches
• Back extensions
• Core Strength Exercises
• Modified plank
• Dead bug

Make sure you get your doctor's OK before you do these exercises, and start with one set of 10 to 16 reps of each exercise 2 to 3 times a week, adjusting that to fit what feels right to you. You can add sets or try more challenging exercises over time.

Keep in mind that if you have diastasis, a separation of the two halves of your rectus abdominis (the outer abs), you may need to modify your ab exercises. 

2. Cardio

Along with core strength, you'll want to incorporate cardio into your routine, but you may not be able to do the same activities you were doing before -- at least, not for a while. High-impact exercises, such as running or aerobics, may not be comfortable as your body recovers. As one of my postpartum clients put it, "I feel like something critical is going to fall out every time I try to jog." When you're just starting out:

• Start slow and easy. Many new moms find they can tolerate walking, starting with about 20 minutes a day, 3 days a week. If you can handle more, try getting some kind of activity in every day.
• Stick with low-impact activities. If high-impact exercises don't feel good, try walking, swimming, working out on the elliptical trainer or other activities that aren't jarring on the body and joints. Over time, you'll find it easier to transition into higher-impact activities.
• Work at a moderate-high intensity, a level 5 to 6 on the perceived exertion scale. Allow your energy levels to guide you in your workouts, backing off if you feel tired or vice versa.

As you get stronger, you may want to up the intensity with interval training about once a week, which can help you burn more calories. You can also add a stroller to your walking routine, which is great for adding challenge while allowing you to exercise with the baby. Experts have found that you can burn 18 to 20% more calories if you walk while pushing a stroller. Pushing it up a hill will burn even more calories, and there are even baby-friendly exercise groups you can join, such as Stroller Strides or Baby Boot Camp.

Losing Weight After Pregnancy

Now that your new baby is here, you have a lot to think about: when to feed her, what to do if she cries -- and how to get rid of those extra pounds you packed on during your pregnancy.

If you started out at a normal weight and gained the 25-35 pounds your doctor probably recommended, it shouldn't take you more than a couple of months to get back to your pre-pregnancy weight if you watch what you eat and exercise.

If, on the other hand, you were overweight before your pregnancy or you put on more weight than your doctor advised, it could take much longer -- up to a year -- to get the weight off. Any baby weight you don't take off could stick with you for a long time.

"It's very critical that you do get the weight off, because if you don't it has been associated with overweight and obesity 15 to 20 years later in life," says Debra Krummel, PhD, RD, endowed professor in the University of Cincinnati department of nutrition.

And although every new mom is eager to look like her old self again, one of the most important things to remember is to be patient with yourself. Your favorite celebrity might have gone straight from the delivery room into her size 0 jeans, but she may not have done it in a way that was good for her body.

• Why do I Still Look Pregnant?

One of the first thing new moms notice after having a baby is the fact that they may still look several months pregnant for awhile after giving birth. This is absolutely normal. Remember, you had a baby in there for nine whole months. From the moment you give birth, your body starts working to shrink your belly back to its pre-pregnancy state, or something close to it, but it's a slow process. It takes about four weeks for your uterus to contract to its normal size, and many women will lose about 8 to 20 pounds during that first two weeks as the body gets rid of all that extra fluid.

It will also take time for your hips and pelvic area to shift back to their pre-pregnancy state, so it's normal for things to be out of whack after giving birth. 

• How Do I Lose This Baby Weight?

Though you may be eager to jump into a workout program or diet, easing into light exercise is crucial for keeping your body safe and injury-free. Even the fittest moms may have trouble getting back to exercise. After all, having a baby is a major ordeal and something you'll need time to recover from. You'll need clearance from your doctor and, depending on what kind of birth you had, it may be 4 to 8 weeks before you can engage in serious exercise.

Breastfeeding can help you lose weight, requiring an extra 500 calories from you a day and helping reduce some of the fat you gained during pregnancy. If you do breastfeed, make sure you're giving your body the fuel it needs for that extra energy demand. Now isn't the time to go on a diet; restricting your calories too much can reduce your milk supply, and losing too much weight (more than two pounds a week) can actually release toxins that wind up in your milk.

The good news is, you can still exercise if you're breastfeeding. Studies show that moderate exercise won't affect milk production as long as you're giving your body enough calories.

How to lose Weight After Pregnancy

Having a baby changes your life -- it also changes your body. You may be surprised by some of those changes if you're a new mom, wondering why it takes so long for your belly to shrink, how to lose the baby weight and whether your body will ever be the same.

If you look at some celebrity moms out there, you may think you should emerge from the hospital looking as though you were never even pregnant. But, the reality is a little different. Having a baby affects every part of your body and, despite what's going on in Hollywood, it can take up to a year for your body to make a full recovery. Find out what you can do to help your body bounce back and lose the baby weight in a healthy way.

• Don't diet.

It may sound strange, but going on an official "diet" could derail your post-pregnancy weight loss goals. Feeling deprived of your favorite foods while you're already stressed out by your new role as mom could actually cause you to gain weight, Johnson says.

"If you go back to eating healthy and eating for your hunger, most women find that the weight comes off pretty naturally," she says.

Instead of dieting, she recommends eating a well-balanced variety of foods. Keep different snacks in the house to keep you from feeling hungry and give you energy throughout the day. Apple slices, carrot sticks, and wheat crackers are all good for noshing.

No matter how much you want to lose weight, try not to dip below 1,800 calories a day, particularly if you are breastfeeding. The U.S. Department of Agriculture's MyPyramid site can help you design a personalized eating plan based on your age, activity level, and weight loss goals. The site even has a special section for breastfeeding moms.

• Load up on "super foods."

When you're a new mother, your body needs maximum nutrition, especially if you're nursing. Choose foods that are heavy in the nutrients you need and light in calories and fat.

Fish is one of these "super foods" because it's packed with DHA, an essential omega-3 fatty acid that helps your newborn develop a healthy brain and nervous system. The best sources of DHA are cold-water fish such as salmon, sardines, and tuna (stick to canned light tuna because albacore tends to be high in mercury).

Milk and yogurt are also super foods because they're high in the calcium you need to keep your bones strong. And don't forget the protein. Lean meat, chicken, and beans are low in fat and high in protein and fiber. They're good for you, and they'll keep you feeling full for longer.

• Breastfeed.

Whether breastfeeding can actually help you lose weight is still up in the air -- some studies find that breastfeeding exclusively can help you return to your pre-baby weight faster, while others find no difference in weight loss between women who breastfeed and those who bottle feed.

What is for sure is that breastfeeding is good for your baby, boosting immunity and providing a number of other important health benefits. And nursing exclusively lets you add about an extra 300 calories a day to your diet (you can add slightly more calories if you have a really big eater or twins). Just make sure that if you do breastfeed, you don't use it as an excuse to eat whatever you want.

• Drink up.

Drinking plenty of water throughout the day prevents you from getting dehydrated. It also fills you up so that you don't eat as much, and some research has found that it may speed up your metabolism.

Whether you need the often-recommended eight glasses a day isn't certain, so Johnson recommends using the color of your urine and how often you need to go to the bathroom as guides. If you're drinking enough fluids, your urine should be relatively clear, and you should be going to the bathroom about every three to four hours.

• Move it!

Diet is important, but it's only one part of your post-pregnancy weight loss plan. You also need to incorporate aerobic and strength training exercises after pregnancy to burn calories and keep your muscles and bones strong. "Exercise, beyond helping you lose weight, provides so many benefits to a new mom," Johnson says. "It helps with depression, it helps with the sleep issue ... it helps in relieving stress -- and having a new baby in the house can definitely be stressful."

You don't have to hit the gym to get back in shape after pregnancy -- taking a brisk walk with your baby in the stroller is enough to get your heart pumping and muscles working. "You want to shoot for at least 150 minutes a week," says James M. Pivarnik, PhD, FACSM, professor of kinesiology and epidemiology at Michigan State University and president-elect of the American College of Sports Medicine. With a new baby, finding 30 minutes in a row might be impossible, so Pivarnik suggests breaking up the time into 10-minute increments. Then try to work your way up to 20- or 30-minute sessions.

Lugging around a baby all day is itself a workout, but you still need to add some strength training. Use light weights -- or even a couple of soup cans -- as resistance. Many health clubs and community centers offer "mommy and me" classes that will let you incorporate your baby into your workout routine. But before you start any exercise program, get your doctor's approval, especially if you had a C-section.

• Get some sleep.

It may seem impossible to get a full eight hours of sleep when you have a baby summoning you like clockwork throughout the night, but being sleep deprived could make it harder for you to shed the baby weight. In one study, new moms who slept five hours or less a night were more likely to hold onto their extra pregnancy weight than women who slept seven hours. When you're tired, your body releases cortisol and other stress hormones that can promote weight gain. "Also when you're exhausted, you don't feel like taking good care of yourself," Johnson says. "You're less likely to choose healthy food. You're more likely to grab something through a drive-through. You're also less likely to get physical activity."

Your friends or family members may have told you to "sleep when your baby sleeps," and that's good advice. Catch as many naps as you can during the day and go to bed early -- at least until your baby starts sleeping through the night.

• Ask for help.

If you're struggling to lose the weight, enlist the help of your doctor and a dietitian. The dietitian can help you design an eating plan that will let you lose weight safely and effectively, while the doctor can guide you on how much weight you need to lose and when you can start exercising.

How to soothe your crying baby

It is common to feel frustration, anxiety, and even anger when faced with a crying baby—especially if your baby wails for hours on end and won't calm down. Equally frustrating is a baby who seems indifferent, upset, or who won't cuddle or make eye contact with you.

In stressful situations like this—when your baby won't stop crying or won't respond to you and when you are feeling frustrated, tired and angry—you need to develop some strategies for taking care of yourself. When you're calm and centered, you'll be better able to figure out what's going on with your child and soothe his or her cries.

• Recognize your limits. Pay attention to internal warning signs when you are feeling overwhelmed. The sooner you spot your personal limits, the easier it is to plan ahead—for extra help, a break, an excursion outside or a quick pep talk from a friend or loved one. The small things you do to prepare will help you get in the best frame of mind to care for your baby.
• Remember that time is on your side. For most babies, crying peaks at six weeks and then gradually eases off. There is an end to the crying on the horizon! You may have to put in a little extra work right now and be very patient, but things will get better.
• Reach out for support. If you can, enlist help during the fussiest times of the day. Say yes when people offer to help with housework, meals or babysitting. Find a group of moms to talk to and get out of the house when you can. Knowing you have some help on the way can make a big difference.
• You don't have to be perfect. Parenting is not about perfection. It would be impossible to be fully present and attentive to an infant, especially a crying infant, 24 hours a day. Experts estimate that meeting your infant's needs at least one third of the time is enough to support healthy bonding and secure attachment. Don't worry about getting it exactly right all of the time. Instead, try to relax and enjoy the times when your baby isn't crying.

Shaken Baby Syndrome occurs when a baby is shaken. The blood vessels in a baby's head cannot tolerate the impact of shaking and can break.

• Each year about 1,000 children die from Shaken Baby Syndrome.
• Death, brain damage, mental retardation, seizures, or blindness may result from shaking a baby.
• Shaking usually happens when parents or caregivers become frustrated or angry when they are not able to stop the baby from crying.
• Shaken baby syndrome is 100% preventable.

What Parents Should Know About Baby's Cries

1. First, a perfect signal is automatic. A newborn cries by reflex. The infant senses a need, which triggers a sudden inspiration of air followed by a forceful expelling of that air through vocal cords, which vibrate to produce the sound we call a cry. In the early months, the tiny infant does not think, "What kind of cry will get me fed?" He just automatically cries. Also, the cry is easily generated. Once his lungs are full of air, the infant can initiate crying with very little effort. 

Second, the cry is appropriately disturbing: ear-piercing enough to get the caregiver's attention and make him or her try to stop the cry, but not so disturbing as to make the listener want to avoid the sound altogether. 

Third, the cry can be modified as both the sender and the listener learn ways to make the signal more precise. Each baby's signal is unique. A baby's cry is a baby's language, and each baby cries differently. Voice researchers call these unique sounds cry prints, which are as unique for babies as their fingerprints are. 

2. Responding to baby's cries is biologically correct. A mother is biologically programmed to give a nurturant response to her newborn's cries and not to restrain herself. Fascinating biological changes take place in a mother's body in response to her infant's cry. Upon hearing her baby cry, the blood flow to a mother's breasts increases, accompanied by a biological urge to "pick up and nurse." The act of breastfeeding itself causes a surge in prolactin , a hormone that we feel forms the biological basis of the term "mother's intuition." Oxytocin, the hormone that causes a mother's milk to letdown, brings feelings of relaxation and pleasure; a pleasant release from the tension built up by the baby's cry. These feelings help you love your baby. Mothers, listen to the biological cues of your body when your baby cries rather than to advisors who tell you to turn a deaf ear. These biological happenings explain why it's easy for those advisors to say such a thing. They are not biologically connected to your baby. Nothing happens to their hormones when your baby cries. 

3. Ignore or respond to the cry signal? Once you appreciate the special signal value of your baby's cry, the important thing is what you do about it. You have two basic options, ignore or respond. Ignoring your baby's cry is usually a lose-lose situation. A more compliant baby gives up and stops signaling, becomes withdrawn, eventually realizes that crying is not worthwhile, and concludes that he is not worthwhile. The baby loses the motivation to communicate with his parents, and the parents miss out on opportunities to get to know their baby. Everyone loses. A baby with a more persistent personality— most high-need babies—does not give up so easily. Instead, he cries louder and keeps escalating his signal, making it more and more disturbing. You could ignore this persistent signal in several ways. You could wait it out until he stops crying and then pick him up, so that he won't think it was his crying that got your attention. This is actually a type of power struggle; you teach the baby that you're in control, but you also teach him that he has no power to communicate. This shuts down parent-child communication, and in the long run everybody loses. 

You could desensitize yourself completely so that you're not "bothered" at all by the cry; this way you can teach baby he only gets responded to when it's "time." This is another lose-lose situation; baby doesn't get what he needs and parents remain stuck in a mindset where they can't enjoy their baby's unique personality. Or, you could pick baby up to calm him but then put him right back down because "it's not time to feed him yet." He has to learn, after all, to be happy "on his own." Lose-lose again; he will start to cry again and you will feel angry. He will learn that his communication cues, though heard, are not responded to, which can lead him to distrust his own perceptions: "Maybe they're right. Maybe I'm not hungry." (See ) 

4. Be nurturing. Your other option is to give a prompt and nurturant response. This is the win-win way for baby and mother to work out a communication system that helps them both. The mother responds promptly and sensitively so that baby will feel less frantic the next time he needs something. The baby learns to "cry better" , in a less disturbing way since he knows mother will come. Mother structures baby's environment so that there is less need for him to cry; she keeps him close to her if she knows he's tired and ready to sleep. Mother also heightens her sensitivity to the cry so that she gives just the right response. A quick response when baby is young and falls apart easily or when the cry makes it clear there is real danger; a slower response when the baby is older and begins to learn how to settle disturbances on his own. 

Responding appropriately to your baby's cry is the first and one of the most difficult, communication challenges you will face as a mother. You will master the system only after rehearsing thousands of cue-responses in the early months. If you initially regard your baby's cry as a signal to be responded to and evaluated rather than as an unfortunate habit to be broken, you will open yourself up to becoming an expert in your baby's signals, which will carry over into becoming an expert on everything about your baby. Each mother-baby signal system is unique. That's why it is so shortsighted for "cry trainers" to prescribe canned cry-response formulas, such as "leave her to cry for five minutes the first night, ten minutes the second," and so on. 

5. It's not your fault baby cries. Parents, take heart! If you are responsive to your baby and try to keep him feeling secure in his new world, you need not feel that it's your fault if your baby cries a lot. Nor is it up to you to stop your baby's crying. Of course, you stay open to learning new things to help your baby (like a change in your diet or a new way of wearing baby), and you get your doctor involved if you suspect a physical cause behind the crying. But there will be times when you won't know why your baby is crying—you'll wonder if baby even knows why he's crying. There may be times when baby simply needs to cry, and you needn't feel desperate to make him stop after trying all the usual things. 

It's a fact of new parent life that although babies cry to express a need, the style in which they do so is the result of their own temperament. Don't take baby's cries personally. Your job is to create a supportive environment that lessens baby's need to cry, to offer a set of caring and relaxed arms so that baby does not need to cry alone, and to do as much detective work as you can to figure out why your baby is crying and how you can help. The rest is up to baby. 

"When I was confused about my mothering, I asked a seasoned calm, impartial mother to observe how I handled my baby on a typical day in my home. Although I know I'm the expert on my own baby, sometimes it's hard to be objective, and a voice of experience can be helpful." 

6. What cry research tells us. Researchers Sylvia Bell and Mary Ainsworth performed studies in the 1970's that should have put the spoiling theory on the shelf to spoil forever. (It is interesting that up to that time and even to this day, the infant development writers that preached the cry-it-out advice were nearly always male. It took female researchers to begin to set things straight.) These researchers studied two groups of mother-infant pairs. Group 1 mothers gave a prompt and nurturant response to their infant's cries. Group 2 mothers were more restrained in their response. They found that children in Group 1 whose mothers had given an early and more nurturant response were less likely to use crying as a means of communication at one year of age. These children seemed more securely attached to their mothers and had developed better communicative skills, becoming less whiny and manipulative. 

Up until that time parents had been led to believe that if they picked up their baby every time she cried she would never learn to settle herself and would become more demanding. Bell and Ainsworth's research showed the opposite. Babies who developed a secure attachment and had their cues responded to in a prompt and nurturing way became less clingy and demanding. More studies were done to shoot down the spoiling theory, showing that babies whose cries were not promptly responded to begin to cry more, longer, and in a more disturbing way. In one study comparing two groups of crying babies, one group of infants received an immediate, nurturant response to their cries, while the other group was left to cry-it-out. The babies whose cries were sensitively attended to cried seventy percent less. The babies in the cry-it-out group, on the other hand, did not decrease their crying. In essence, crying research has shown that babies whose cries were listened and responded to learned to "cry better"; the infants who were the product of a more restrained style of parenting learned to "cry harder." It is interesting that the studies revealed differences not only in how the babies communicated with the parents based on the response they got to their cries, but there were also differences in the mothers, too. Studies showed that mothers who gave a more restrained and less nurturant response gradually became more insensitive to their baby's cries, and this insensitivity carried over to other aspects of their parent-child relationship. Research showed that leaving baby to cry-it- out spoils the whole family. 

7. Crying isn't "good for baby's lungs." One of the most ridiculous pieces of medical folklore is the dictum: "Let baby cry, it's good for his lungs." In the late 1970's, research showed that babies who were left to cry had heart rates that reached worrisome levels, and lowered oxygen levels in their blood. When these infants' cries were soothed, their cardiovascular system rapidly returned to normal, showing how quickly babies recognize the status of well being on a physiologic level. When a baby's cries are not soothed, he remains in physiologic as well as psychological distress. 

The erroneous belief about the healthfulness of crying survives even today in one of the scales of the Apgar score, a sort of test that physicians use to rapidly assess a newborn's condition in the first few minutes after birth. Babies get an extra two points for "crying lustily." I remember pondering this concept back in the mid 1970's when I was the director of a newborn nursery in a university hospital, even before fathering a high-need baby had turned me into an opponent of crying it out. It seemed to me that awarding points for crying made no sense physiologically. The newborn who was in the state of quiet alertness, breathing normally, and actually pinker than the crying infant lost points on the Apgar score. It still amazes me that the most intriguing of all human sounds—the infant's cry—is still so misunderstood. 

Why your baby like sucking fingers

But don't pull the plug just yet. It's perfectly natural for newborns to give thumb sucking a big thumbs-up. Here's why:

Babies are born to suck. Sucking is an inborn reflex for babies because it's how they eat. So it's definitely a good thing that your baby has figured it out. 

Sucking calms your baby down. Even when you've just finished feeding your baby, she might still clamor for more sucking action. That doesn't mean she's ready to chow down again. In addition to suckling to fill their tummies, babies need "nonnutritive" sucking, the kind that mellows them out. It's the whole reason we have pacifiers in the first place — sucking helps a baby calm down. Some babies, like your own little thumb sucker, love nonnutritive sucking more than others.

Thumbs are always at hand. There's a reason your baby's already going to town on her thumb: Like Mount Everest, it was there. Of course, the first few episodes were probably just accidental taste tests, but when your baby figured out how comforting her thumb was, she soon found out how to get it in her mouth on purpose. 

So why not pull the old switcheroo and get your baby to suck on a pacifier instead? Well, you could, if the thumb sucking really bothers you. And as a bonus, you have more control over when and where your baby uses a pacifier, which makes it easier to take it away in the end. Something else to consider: Studies show that using a pacifier while sleeping reduces the risk of SIDS.

But there are also some advantages to a thumb sucking baby: With her thumb at her side (literally), your newborn has a built-in way to calm herself down any time she's feeling cranky, with no help from Mom required. Even better — you'll never have to dive under your baby's crib in the middle of the night looking for a lost pacifier. Thumbs don't get lost (thankfully!).

A good rule of thumb if your baby continues to uses her thumb or a pacifier for the long-term: As your child grows, too much of either can disturb the alignment of your child's teeth and even the structure of her mouth, so you'll definitely want to wean her off before her permanent front teeth come in, around age six. Most kids stop thumb sucking on their own by the time they're four (usually because their preschool classmates tell them it's babyish). You can help that process along while your child is still a toddler by offering other comfort objects (like a beloved stuffed animal) when she reaches for her thumb.

But for the time being, you can let your happy little sucker suck to her heart's content (and be glad she's found such a handy way to soothe herself).

Breaking the Thumb-Sucking Habit

For some new babies, the thrill of "open mouth, insert thumb" begins within weeks of birth. For others, thumb sucking is a continuation of a habit perfected well before they were born — and the proof is in those adorable ultrasound pics! But whether your little one started thumb sucking in utero or acquired a taste for her thumb soon after birth, it's hard not to worry that a fondness for thumb sucking now means that your child will still be sucking it in middle school — or that you'll be pulling your hair out when you get the giant bill for the orthodontic work she'll need. 

                                 

Support, Guidance Key

"If a child who is older than 5 or 6 is still sucking his thumb and having difficulty stopping, parents ought to think about what they can do to help him," Hack says. Before insisting that a child go "cold turkey," it's important to observe how deeply entrenched your child's behavior is, she says. How often does your child suck and in front of whom? If it happens only at bedtime or in front of family members, it's a less serious problem than if it happens at school or in social situations.

Attempts to steer a child away from thumb-sucking can backfire if they are not tempered with support and guidance. Don't nag or reprimand your child, and don't pull a child's finger out of his mouth. These kinds of actions can result in a power struggle, experts say. "The truth is most kids over 6 really do want to stop, but they need some extra help," Goldstein says.

Simple Treatment Plan

Breaking a habit is a much easier feat when the child is a willing participant. Many parents have success with a simple behavioral approach that engages the child in the process. Here's how it works:

First, says Hack, call a one-month moratorium on discussion. "If finger-sucking is part of a power struggle, not mentioning it may help extinguish the behavior," she says. Next, buy poster board and stickers and make a "progress chart." Offer a prize at the end of each week for no sucking -- and a larger reward at the end of the month. Make sure that your child has an active role in the plan; for example, decide together how many slip-ups he's allowed each week and have him choose the stickers and place them on the chart.

It may also be helpful to place a bitter-tasting liquid on the nail (not directly on the finger), especially at night, as a reminder not to suck. Products for this purpose are sold over the counter, but home remedies can be just as effective. What worked for Michael was perfume. Each night for two weeks, I asked him to choose a bottle of perfume from my collection. He would sniff them all, pick one, and I would place a dab at the tip of his finger. "Yuck," he'd always say, but he clearly welcomed the crutch. Mittens, gloves, or a finger-splint may also be worn at night. It may take six weeks or more to successfully break the habit.

Dentists Can Help, Too

While your child is trying to change his or her behavior, it's essential to give lots of praise and support: an extra cuddle, a special outing, playing a new game together. Be aware of situations that might promote thumb-sucking, like TV or riding in the car. "Use your imagination to guide your child to other means of solace that are more age-appropriate," Hack says.

If this program doesn't work, don't despair. Breaking a longstanding habit is difficult and some children may need additional help. Talk to your child's dentist, who may recommend inserting a device in the child's mouth that prevents sucking. These oral appliances go by names like "palatal bar" and "crib" and come in fixed and removable versions.

If the problem seems particularly resistant to treatment, this may be a signal that your child is troubled about a deeper problem, Goldstein says. In this case, you may want to seek the advice of a mental health professional.