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Harvard Commentaries
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Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School


Woman to Woman Woman to Woman
 

Surviving Baby's First Year: You Can Do It!


August 09, 2013

By Alice Y. Chang M.D.

Harvard Medical School

While I was pregnant a friend told me, "Alice, you are about to undertake one of the most challenging experiences of your life." I didn't get it. I thought nothing could top making it through medical school. But, at the end of my baby's first year, I now understand what she meant. With the benefit of hindsight, I can now tell you what made the first year crazy, challenging and confusing for me.

One of the biggest challenges was sorting through advice and warnings from books, friends, relatives and the media, all while sleep-deprived and spending my waking moments trying to decipher my baby son Sam's needs. With the advantage — or disadvantage — of a medical degree, I was constantly struggling between my medically trained mind (where is the evidence?) and my practical, and often desperate mind (if it doesn't hurt the baby, why not try it?).

The following are a few of my tips on surviving advice during the first year. I don't mean to add yet another voice of opinion, but hopefully these will give you the safe ways to follow your own voice and limit anxiety during a physically and mentally demanding year.

Baby SamHow To Handle a Crying Baby

Most of the time, as long as the baby is fed and changed and not uncomfortable, the advice for a colicky baby or for one who won't go to sleep is to let him cry. Hah. Easier said than done for most of us.

For the colicky baby, get help and avoid feeling responsible. No one is at fault for this condition. In fact, no one can explain colic yet. Check with your pediatrician to make sure there is no sign of other problems, illness or allergies. And there is no harm in trying to change what you eat if you are breastfeeding. However, while some people swear by herbal drops, I am wary enough of consuming unregulated herbal products that I didn't want to try them with my baby.

Some days, moving my son from one activity to another helped. On others, we just needed to let him cry it out. Sometimes, a bath, car ride or the baby swing helped. While we had family debates about the use of a pacifier and whether my son would be using it until he was 21, I used it for a few months, and then he would no longer take it. I also tried eliminating caffeine, chocolate, milk products and spicy foods from my diet but this didn't seem to help. (And to this day, I still contend that spicy food cannot be at fault or you would have entire cultures of colicky babies).

Magically, one day, it just all went away. And that's the only thing that is true about all colicky babies — they do get better.

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Feeding

Do not feed the baby any strawberries, nuts, chocolate, cow's milk or egg whites until the first year. Chances for your child developing these allergies are greatest within this first year. Because these allergies can be fairly significant and life threatening, it is safest to avoid these foods.

Breast-feeding for at least six months to a year is optimal. Don't let anyone mislead you, breastfeeding is not easy. But the health benefits, the protective effect of the mother's antibodies, the nutritional aspects, the bonding with the baby and the decreased risk for asthma and other allergic conditions should not be ignored. If you are having problems, don't give up without seeking help. And this unfortunately is not always from your doctor. The best sources of help are not only other mothers, but La Leche League and other mothers' help groups.

When Sam was old enough to eat solid foods, my pediatrician kept urging me to get my son to eat more solids, but it was never really quite clear how to do this. Then, my neighbor, the mother of three, suggested I let him feed himself the foods that we were eating. And miraculously, my son became a voracious eater.

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Sleeping

Thanks to the "Back to Sleep" campaign to have all babies sleep on their backs, the incidence of sudden infant death syndrome has decreased. We still don't understand what causes SIDS, but why take a chance?

Don't forget tummy time. Because babies are now on their backs, they don't get the tummy time to develop their neck and abdominal muscles. Make sure to watch your baby when she is on her tummy. Try a nursing pillow or your lap if the baby doesn't enjoy the tummy. Use toys to keep him or her interested.

Should you let your baby sleep with you in your bed (called co-sleeping)? Essentially, a baby is smart and likes to be around a warm body. Lying next to you in your bed, babies also can smell that Mom or Dad is around. There are obvious dangers, such as rolling over or smothering the baby. Some people warn that baby will get too used to sleeping with Mom and Dad and won't want to sleep on his own. But when I was desperate for a few more hours of sleep, I would take my son to bed. He was still able to sleep in the crib the next night.

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Should You Discipline a Baby?

We are not in agreement in our house about this. Words such as "spoil" and "manipulation" have been thrown around. I contend that although a baby can learn what he likes and ask for it, he will have time to learn rules when he gets older. In Korea, parents don't believe kids are capable of understanding rules until they reach school age — about 5 years old. This is also in agreement with many psychologists who feel that the ability to understand right and wrong comes around that age. It is true that children may be able to learn how to follow rules before the age of 5, but understanding the reason behind rules comes at a later age. And in Korea, school-aged children are disciplined enough to study very hard at a young age. So if you are more comfortable bending rules for your baby, don't feel you are spoiling your child.

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Best Advice

So my best advice to new mothers is to:

  1. Follow your instincts.
  2. Check with your doctor to learn what could be dangerous or to make sure your baby isn't sick.
  3. Check with another new mother for practical tips. If you don't have a friend or family member with new mom experience, find a mommy group through a local hospital or community group, or even the Internet.
  4. Repeat Step 2 when in doubt about any new mommy tips.
  5. Finally, follow your instincts.

And to dispel one final myth – baby joys are not always obvious from day one. When you are sleep-deprived and just trying to get a shower and change of clothes for yourself, you may wonder why any of us should go through this. Rest assured — plenty of joys await that you will understand by the end of the first year. And that's one secret that I leave to you to discover.

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Alice Y. Chang, M.D. is a former instructor in medicine at Harvard Medical School. She is currently associated with University of Texas Southwestern Medical Center. Her clinical interests and experience are in the fields of primary care, women's health, hospital-based medicine and patient education.

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