Parent and Baby

Written on April 11, 2008 – 4:37 pm | by Staff |

WEEK 4 – How big is your baby this fourth week?

Baby weighs 9 pounds and is 21 inches long this week.

Baby Care and Equipment

Baby Slings and Front Carriers

Baby slings and front carriers offer parents and others a wonderful, close way to carry baby. It’s a piece of baby equipment that can mean a lot; when baby’s in a front carrier, you continue bonding.

Because your baby grows so quickly these first months, you will probably use a front carrier only for about 3 or 4 months. Although probably you’d like to use it longer, your back will say “No!”

Advantages. There are many advantages to carrying baby “kangaroo-style” during the first few
months. One study showed babies carried this way cry less. You are close to baby, yet your arms are free. The swaying motion and the wrapped-close feeling may remind baby of the womb, which may help settle him. Slings and carriers are also great for nursing privately in a public area.

How they work. A sling is just what it sounds like. Baby is placed on his back in the sling and carried as if he were in a hammock, close to your body. A front carrier is like a backpack, only it’s on the front. Baby is placed in the carrier part, facing inward when he’s very small and facing outward as he gets older (3 months).

Comfort and safety considerations. Comfort and safety are the most important factors to search for. Check for the following when shopping for a sling or front carrier:

• Straps and snaps are secure so they can’t work loose.
• Belts and buckles have some form of backup security, such as double loops or plastic stops.
• Check manufacturer’s weight and age recommendations for the carrier.
• Fabric is sturdy and washable. Is it soft enough for baby’s skin?
• Seams are reinforced with double stitching at points of stress.
• Shoulder straps and neck straps are cushioned.
• Padded belts make the carrier comfortable for you.
• Product meets the Juvenile Products Manufacturers Association (JPMA) safety standards.

Nail Care

You may be surprised at how quickly baby’s nails grow. Sometimes a baby’s nails have to be cut soon after birth! You may feel leery about cutting nails that are so tiny, but once you’ve done it a few times, you’ll be a pro.

A baby’s nails are thin and very flexible, but they can soon become long enough and sharp enough to scratch him. Trimming them prevents injuries.

How to clip baby’s nails. Nail scissors or clippers made for a small child are a good choice. When baby is asleep or relaxed, take one finger in your hand, hold it fingertip-down, away from you. Snip or cut the nail straight across. Don’t cut into the quick {the flesh under the nail). Or you can file baby’s nails with an emery board. Some parents even nibble them off!

Trim how often? You’ll probably need to trim his nails about every 2 weeks. As a rule of thumb, the bigger the finger, the faster the nail grows, so you may have to trim the thumbs more often. (No pun intended.) As baby starts to use his hands more frequent!] he’ll wear down some of the nails. Be sure to check his nails often, j ragged nail can scratch him.

Toenails. Don’t overlook toenails. They are worn down more consistently than fingernails because of contact with socks, bootie and footed sleepers. Check his toes at least every few weeks, but he probably won’t need toenails trimme more often than once a month, if that. Once he begins walking, you’ll need to check his toenails more often. Long toenails may make) walking uncomfortable.

Baby Massage—Jaw Area

Your baby is doing a lot of sucking now. That could cause tension around his mouth and jaw. To help relieve some of this tension, massage around his jaw. Make small circles or and around his jawbone with your fingertips. His mouth may open in contentment.

Keeping Baby Warm

A newborn may have a bit of trouble regulating his body temperature. It can take awhile for his body thermostat to begin working. If your baby seems chilled or you live in a cold climate, we have some tips to help keep him warm.

• Cuddle baby close to you when you hold him. This warms him.
• Swaddle him tightly in a receiving blanket.
• Lay him down with a hot-water bottle wrapped in a soft blanket next to him or under him.
• Before he goes to sleep or takes a nap/ prewarm his sheets with a heating pad or a hot-water bottle. Be sure sheets are not hot when you put him down. Remove the heat source before you put him down.
• Dress him in a blanket sleeper—you won’t need extra blankets.

When you change your baby’s diaper, bend and straighten his legs in a bicycling motion. This activity helps strengthen his leg muscles.

Giving Baby Water

Some parents believe their baby needs more fluid than he takes in at his feedings. Unless advised to do so by your pediatrician, do not give baby water or sugar water between feedings. It will fill his tummy, resulting in him eating less at his next feeding.

Supplemental Feedings

If you must provide your baby with supplemental feedings while you breastfeed, wait until you’ve
been breastfeeding for at least 4 weeks, if possible. This gives your body a chance to adjust and ensures a good milk supply. It also keeps baby from taking a liking to a bottle (baby finds it’s much easier to feed from a bottle than a breast). Some babies refuse to breastfeed after they become used to a bottle. Occasional supplemental feedings shouldn’t be a problem after 4 weeks.

Choosing Child Care for Baby

If you and your partner work, child care may be one of the most important decisions you must make for baby. You might find it challenging as you begin your search for child care. Where do you start?

Seek referrals. Ask friends, family members and co-workers for referrals to people or places they know about. Talk to people in your area. Ask at your church, temple or others in the area if they sponsor any programs. Contact Child Care Aware (800-424-2246) or a local referral agency about local resources. If you’re interested in hiring a nanny for care in your home, contact a referral agency. See the Resources list, page 492, for some contacts.

Check references carefully. Whomever you choose to provide care for your child, be sure to check references before you make a final decision! This applies to centers as well as in-home caregivers (your home or theirs).

Allow plenty of time to find the right situation. Finding the best situation for your baby can take time. Begin the process several weeks before you need it (maybe several months in special situations like twins). Often this means finding child care before your baby is born. Some places may have a waiting list. There is a shortage of quality child care for children under age 2. If you find a care provider you are comfortable with, but it’s not time to leave your baby, ask to put down a deposit and set a date for child care to begin. Keep in touch with the care provider, and plan to meet before you place your child in daily care.

Make your baby’s 1-month well-baby checkup now.

Child-Care Options

You have many decisions to make when choosing someone to care for your baby. You want the best setting and the best caregiver for your child. The way to find that is to know what your options are before you begin looking. You have many choices when it comes to child care. Examine your needs and the needs of your child before you decide which to pursue.

In-home child care. With in-home care, the caregiver can be a relative or nonrelative. It’s easier on you to have someone come to your home to take care of your child. You don’t have to get the baby ready before you go out in the morning. You never have to take your child out in bad weather. You save time because you don’t have to drop off your baby or pick him up somewhere.

In-home care is an excellent choice for a baby or small child because it provides one-on-one attention (if you only have one child at home). The environment is familiar to the child.

Caregiver is a relative. When the caregiver is a relative, such as a grandparent, a sister or someone else in the family, you may find the situation more challenging than you thought it would be. It may be harder to maintain your relationship with your caregiver while asking or telling him or her to do things as you want them done.

Caregiver is not a relative. In-home child care by a nonrelative can be very expensive. You are hiring someone you do not know to come into your home and take care of your child. You must be diligent in asking for references and checking them thoroughly.
A drawback to in-home care is the isolation your child may feel as he grows older. Children need to interact with others, to learn to share and to play. While in-home care can be an excellent choice for your baby, as the child gets older, you may have to arrange opportunities for the child to be with other children.

Care in a caregiver’s home. Many parents opt to take their child to someone else’s home for child care. Often these homes have small group sizes and offer parents more flexibility, such as keeping the child longer on a day you have a late meeting. They may offer a homelike setting, and your child may receive lots of attention.

However, homes are not regulated in every state, so you must check out each situation very carefully. Contact your state’s Department of Social Services and ask about requirements. In some places, local agencies oversee caregivers who are members of their organization. Those who provide care must abide by certain standards, such as the maximum number of children allowed in the home (including their own), and the maximum fees they may charge. They may have to attain certain standards, such as CPR and first-aid certification.

Steps for finding an in-home caregiver. Whether you choose to have someone come to your home or take your child to another person’s home, following the suggestions listed below can help you find the best caregiver for your child.

Advertise in local newspapers and church bulletins to find someone to interview. State how many children are to be cared for and their ages. Include information on the days and hours care is needed, experience you are seeking and any other particulars. State that references are required and that you will be checking them.

Talk to people on the telephone first to determine whether you want to interview them. Ask about their experience, qualifications, child-care philosophy and what they are seeking in a position. Then decide if you want to pursue the contact with an in-person interview. Make a list of all your concerns, including days and hours someone is needed, duties to be performed, need for a driver’s license and supplying a benefits’ policy. Discuss these with the potential caregiver.

Call all references. Have the potential caregiver provide you with the names and phone numbers of people he or she has worked for in the past. Call each family, let them know you are considering this person as a caregiver and discuss the person’s strengths and weaknesses with them.

Check out the situation. After you hire someone, drop by unannounced occasionally. Notice how everything appears when you do this. Pay attention to how your child reacts each time you leave or arrive. This can give you a clue as to how your child feels about the caregiver. Do this for any type of child care you choose.

Child-care centers. A child-care center is a larger setting in which many children receive care. Centers vary widely in the facilities and activities they provide, the amount of attention they give each child, group sizes and child-care philosophy.

Inquire about training required for each child-care provider or teacher at the center you are interested in. Some facilities expect more from a care provider than others. In some cases, a facility hires only trained, qualified personnel; in other cases, they train the personnel or provide additional training.

Some child-care centers do not accept infants; infants take a great deal of time and attention. If the center accepts infants, the ratio of caregivers to children should be about one adult to every three or four children (up to age 2).

Don’t be fooled by appearances. Even the cleanest, brightest place is useless without the right kind of care provider. Check out the center thoroughly. Visit it by appointment, then stop in unannounced a few times. Meet the person in charge and the people who will care for your child. Ask for references of parents whose children are currently being cared for there. Call and talk to these parents before making a final decision.

Care for an infant Be sure the place you choose for your infant can meet his needs. A baby must be changed and fed, but he also needs to be held and interacted with. He needs to be comforted when he is afraid. He needs to rest at certain times each day.

When searching for a place, keep in mind what care your child will require. Evaluate every situation as to how it can respond to the needs of your baby.

Cost of child care. Paying for child care can be a big-budget item in household expenses. For some families, it can cost as much as 25% of their household budget. Public funding is available for some limited-income families. Title EE is a program paid for with federal funds. Call your local Department of social Services to see if you are eligible.

Other programs to help with child-care costs include a federal tax-credit program, the dependent-care assistance program and earned-income tax credit. These programs are regulated by the federal government.

Going to sleep and waking up helps baby bond with parents.

Special-care needs. If your baby needs one-on-one care, you may have a harder time finding child care. In these special cases, you may need to allow extra time seeking a qualified care provider.

Contact the hospital where your child has received care. Ask for references, or call your pediatrician. They may be in contact with someone who can help you. It may make sense for the care provider to come to your home if your child has special needs.

Caring for a sick child. All children come down with colds, the flu or diarrhea at times. Today, there are ways to handle an illness if you can’t take time off from work to stay home.

In many places, “sick-child” day-care centers are available. They are usually attached to a regular day-care facility, although some are connected with hospitals. A center provides a comfortable place where an ill child can rest or participate in quiet activities, such as story time. Often a registered nurse heads the facility. This person can administer medication when necessary. Fees for this type of service run from about $25 to $55 a day.

Some cities have “on-call” in-home care providers who come to your home when your child is too sick to be taken anywhere. The program is usually run by an agency that deals with child care, and caregivers charge by the hour. Getting a person to come to your home is usually on a first-come, first-served basis, so you may have to wait a day for a provider. However, this can bean excellent way to care for a child who is too ill to be taken away from home.

Milestones This Fourth Week

Sleep and Your Baby

By this time, baby is beginning to adapt to the cycle of day and night, and hopefully, to your schedule. He is developing regular sleep patterns. He may sleep for as long as 6 hours at a time. Your baby’s brain affects how he rests. His sleep is different from yours. A baby spends longer time in REM sleep, in which the heart rate and breathing increase, brainwaves intensify and the eyes move under the lids. Dreams occur at this time. REM sleep is lighter than non-REM sleep.

During the deepest phase of non-REM sleep, growth hormone is released in baby’s body and he actually “grows in his sleep.”

While your baby is in this state, you may see him sucking, moving his legs and arms, making faces and making sounds. He wakens easily. He won’t begin to experience non~REM sleep until he’s about 4 months old. During the deepest phase of non-REM sleep, growth hormone is released in baby’s body and he actually “grows in his sleep.”

EM sleep is essential for brain growth. A great deal of learning and development are occurring in this sleep phase. Research has shown that facial expressions associated with the release of hormones and chemicals important in brain development happen in REM sleep.

Going to sleep and waking up helps baby bond with parents. When he falls asleep, he is separating from you. When he wakens and needs to be comforted and you are there, it reinforces the security of your presence.

Baby’s Vision

Your baby’s color vision is not fully developed by the fourth week of life. However, don’t avoid showing him colorful objects because you’ve heard baby sees black and white the best. Bold colors in simple shapes can be stimulating. He’ll also enjoy toys that include music, movement and color.

Baby can now see faces and objects clearly that are 18 inches away. His eyes are coordinated most of the time, and he’ll follow an object with his eyes. His favorite object to look at is still the human face. He may focus on one or two features, often toward the edge of the face, such as the chin or an ear. He loves to watch your expressions change.

Other Changes You May Notice

Grasp reflex. His grasp reflex is developing. He may briefly hold
onto anything you put in his hand before he lets it go.

Head movements. He turns his head from side to side to follow an object with his eyes. He may lift his head high enough to clear the area beneath him, but it takes awhile to do it—as long as 30 seconds. He can hold up his head briefly while he’s lying on his stomach.

Baby can now see faces and objects clearly that are 18 inches away.

Starting to move. When your baby kicks his legs in the air, he’s starting to move. You’ll notice he begins to move more as he gets older. That’s why it’s so important never to leave him alone, even fora second, on a changing table or some other surface he could fall from.

Different types of cries. He may cry loudly if he finds an activity uncomfortable or painful, and he may fuss during a bath. By this week, you may be able to hear a difference in his crying. You may begin to discern whether baby’s cry means he’s hungry, wet, tired or bored. He may also start making noncrying sounds. By this week, you may be able to hear a difference in his crying.

Mom’s voice is special. Your baby can distinguish his mother’s voice from a stranger’s. Some sounds cause him to quiet down and listen, such as singing, talking or music.
Note: See also the box on page 58, Milestones This Week,

What’s Happening This Fourth Week?

Regularity of Bowel Movements

About this time, baby’s bowel movements begin to fall into a regular pattern. Your baby will have one or two movements a day that look like a mustard puddle or thick green soup.

Feed on Schedule or on Demand?

In the world of child development, some believe that a child should conform to a regular schedule, as an adult does. This is the basis of the “Babywise” philosophy developed by Gary Ezzo and based on his Christian parenting programs. Others in the child development world believe a baby should be fed when he acts hungry; that is, “on demand.” The baby is not really “demanding” to be fed; rather, he is expressing his need to be fed in the only way he can—by crying.

Feeding on schedule. The “Babywise” program advises parents to create a routine whereby parents direct a baby’s feedings. Babies are not fed on demand when they are hungry. They are fed when the parents determine they should be fed. Parents establish a feeding time, a sleep time and a time when baby is awake. To accomplish this, parents limit their newborn’s feedings to only one feeding every 2-1/2 to 3 hours. A breastfed baby must nurse for 30 minutes, even if he doesn’t want to. This is supposed to assure him of sufficient calories.

After feeding, baby is expected to stay awake for a period, followed by a nap no longer than 1 to 1-1/2 hours. Supporters of the philosophy state that by 8 weeks, parents can stop the night feeding, even if baby wakes up crying.

Feeding on demand. Those who oppose this practice state that many babies, especially newborns, cannot go an entire night without feeding—their tummies are too small. Even by 8 weeks, their stomachs may not be large enough to allow them to go hours without feeding. Dehydration is another concern when babies are not fed frequently throughout the day and night.

Experts say that babies know when they are full and shouldn’t be forced to eat more than they want. This could lead to eating problems later in life. They suggest feeding baby on demand. They warn that not feeding baby when he is hungry could lead to insecurity in baby because his needs are not being met.

Crossed Eyes

What it is. Many babies have crossed eyes, also called strabismus or lazy eye, at this early age. It is normal for baby’s eyes not to move in unison because his eye-muscle control has not fully developed. Don’t worry that baby has a problem if you notice this condition at this time.

What to do. When this problem does occur, it usually appears in an older baby, around 3 or 4 months of age. If you notice your baby’s eyes are crossed then, consult your baby’s doctor. Many treatments are available, including an eye patch to cover one eye, glasses, exercises for the eye, medication or surgery.

Failure to Thrive

What it is. If your baby has not gained back enough weight to reach his birth weight by this time, his doctor may be concerned about v”failure to thrive.” The problem may also be suspected if baby was gaining weight, then stops suddenly for no apparent reason.

What to do. Increase the frequency of the feedings you give baby. Feed him longer, too. Try to get him to take more at each feeding—don’t rush him to eat. Setting up a feeding schedule may help increase his caloric intake. Consultation with a dietitian or breastfeeding (lactation) specialist may provide you with additional strategies. If your baby is not getting enough breast milk from nursing, you may be advised to supplement with formula or pumped breast milk.

Contact your pediatrician. He or she will want to know about a failure to thrive because weight gain is extremely important to baby at this time. In addition to additional or supplemental feedings, baby’s doctor may advise you to give baby vitamin or nutritional supplements.

Other treatment. When these measures don’t solve the problem, baby may need to be admitted to the hospital for further evaluation. Intravenous (IV) therapy may be needed. More serious causes of failure to thrive may also be considered.

How to Take Baby’s Temperature

In some situations, your doctor may advise you to take baby’s temperature. This can be a little unnerving if you’ve never done it before. You can take baby’s temperature rectally, axillary {under the armpit) or with an ear thermometer.

Rectal thermometer. This is probably the most common way of taking a baby’s temperature. Rectal thermometers are inexpensive to purchase and easy to use. Follow the suggestions below to make the task easier.

1. Apply a lubricant, such as petroleum jelly, to the tip of the thermometer.
2. Lay baby on his stomach, across your lap or on a firm surface.
3. Hold him steady to prevent sudden movements. Spread his buttocks so you can easily see the anal opening. Gently insert the tip of the thermometer about 1/2 inch into the rectum. Hold it in place with your hand to get an accurate reading and to prevent injury.
4. After 2 to 3 minutes, carefully slide out the thermometer and read it.

Axillary thermometer. When you take baby’s temperature under his arm, use a rectal thermometer.

1. Make sure your baby’s underarm is clean and dry, then place the thermometer in the armpit.
2. Press baby’s arm tightly against his side, or hold it across his chest to keep the thermometer in position.
3. After 4 to 5 minutes, remove and read.

Ear thermometer. This type of thermometer is a fairly new addition to a parent’s medicine cabinet.

1. Lay your baby on his back on a safe surface, and turn his head away from you.
2. Gently pull back on his ear to straighten the ear canal. Point the thermometer straight into the ear canal.
3. Activate the thermometer while holding the ear canal open.
4. Wait for a beep, and repeat in the other ear. Use the highest number.
5. Because of the difficulty with correct placement in young infant’s ears, accuracy may be affected.

Toys and Play This Fourth Week

Choosing Appropriate Toys

When you choose toys for baby, think about his capabilities. Choose] those that are safe and appropriate for his age. It’s smart to select toys that he’ll be able to play with in many different ways as he matures.

It can be tempting to buy toys or games now and in the future that are a little advanced for your child. However, a young child will not enjoy a toy or game that is too difficult.

Make Funny Faces

By this time, your baby may be playing with you. A 4-week-old uses his facial expressions to engage your attention. This is his form of play! You can play with him by holding your face about 12 inches away from his and making funny faces. Or stick out your tongue. He’ll enjoy it, and it’s a wonderful way to communicate.

Bring your face close to baby’s, and slowly move your head from side to side. Make mouth noises. Open and close your eyes in an exaggerated movement. Hold his hands near your eyelashes so he feels the movement. Blow gently on his neck. These silly games help him focus and direct his attention.

A 4-week-old uses his facial expressions to engage your attention. This is his form of play!

Keep Talking to Baby

Your baby can pick up your mood from your voice, so talk to him a lot. You can talk in parentese (see Week 3) and regular speech. You will be helping him begin to understand that communication can express emotion. Read aloud to him, too. Read him books, the paper or anything else you read. Material doesn’t matter—it’s the sound of your voice he’ll enjoy. Talk to him while you stand behind the head of his crib, out of his range of vision. Move into his field of vision as you speak to him, so he makes the connection between your voice and your presence.

Sing nursery rhymes to baby, while you gently clap his hands together. Clap in time with the song you sing. Play music to him when he’s awake, but don’t leave it on as abackground noise.You want baby to listen to some sounds, not learn to ignore them.

Expose Him to Different Textures

Babies like texture. Let baby experience many different textures by lightly stroking his skin with different types of fabric. Velvet, silk, terry cloth, light wool, corduroy—use any at hand, but try not to tickle him.

Shake a Rattle

Lay baby on the floor on his back. Kneeling behind him, gently shake a rattle about 12 inches above his head until his eyes find it. Move it slowly from side to side while his eyes follow it.

Baby is still sleeping about 15 1/2 hours a day.