Next to choosing a pediatrician, selecting the perfect nanny could be the most daunting task facing a parent. But it doesn’t have to be an occasion for tearing one’s hair out.

There’s that all important and difficult to state ‘something’, of course, that makes nanny and parent click. That is, the perfect nanny is one whose character and values reflect what the parents themselves aim for. You’ll want someone who is willing to follow your rules without resistance. Offering suggestions and advice is valuable. Ignoring the way you choose to run your home is not. Finding that combination leads effortlessly to trust, confidence in the nanny and a smooth working relationship.

Not far behind is whether that same simpatico exists between nanny and child. Any serious candidate should be introduced to the newborn. Babies operate by sense of smell, touch and limited vision. But they do make implicit value judgments, just as adults do. The infants reaction can range everywhere from instant crying to instant mother-love. Naturally, you’ll want to get a nanny who evokes something closer to the latter.

There are practical considerations, as well.

Some adults are naturally more disease resistant than others. Circumstances may lead them to less frequent exposure, too. A part-time nanny may have more than one family to care for. That introduces the possibility of exposing your somewhat fragile child to germs from others. This should be covered delicately, but decidedly. The perfect nanny will understand your concern and address it forthrightly and honestly.

Any reputable agency, and their employees or sub-contractors, will provide thorough reference checking. That includes personal references from past clients, criminal background checks, DMV history and evidence of a good health certificate.

Even a person just finding their first nanny job can still be the perfect choice, though. Everyone must start somewhere and a first-timer may well be the eager-to-please, determined-to-do-well nanny you are looking for.

It isn’t necessarily the case that he or she will lack experience with children, either. Many mothers, grandmothers, nurses and others regard the prospect of being a nanny as very fulfilling. The best way to find out, of course, is simply to ask.

Once you’ve narrowed down the list to one or two, discuss details.

Propose a contract. An agency will usually have one they use. Include a 90-day trial period in which either can back out without penalty. Look into what options for a replacement nanny (at least temporarily) may be provided if it doesn’t work out. Ask about sick leave and discuss paid vacations and medical insurance.

Remember, as emotional as the choice may be in some respects, you are hiring a professional to do an important job. Some aspects need to be approached like a business.

Good luck!

The first considerations are age and weight. Infants under age one should be provided with a safety seat specifically tailored to their size. It should also be rear facing and not intended for use by older babies.

Those older than one but less than four will weigh on average between 20-40 lbs. They’re also, of course, taller than infants and the older they are the taller. That opens up the possibility of a forward-facing car seat, which is a little more convenient for parents. It should be still installed in the back seat, though.

Convenience doesn’t have to be sacrificed for any of these goals, of course. Many models are convertible. That is, they can be turned from a rear-facing position to forward-facing with a few simple movements. Still, keep in mind the correct age and weight characteristics.

As an aside, there’s a difference between an infant seat and an infant car seat. The former is just a baby carrier that can be placed in the car, on the floor or table at home. A car seat is specifically designed to be used in the car.

Fortunately, clever designers have blurred the line between the two. Many models are available that do, indeed, allow strapping the child safely into the car. It can then be unbuckled and used as a carrier.

Since it is to be used in the car, though, it will be important that it satisfies certain criteria. A 5-point harness attachment design is key. This allows parents to use the car’s safety restraining belt to attach the car seat at the hips, shoulders and between the legs. That provides a very stable, secure platform.

It’s helpful to have an overhead shield, too. These are padded covers that rotate down over the child. A variation is the T-shield, a padded T-shaped section that attaches to the shoulder straps.

Look for models with a tether at the top that can be attached from the top of the child’s car seat to an anchor point in the car. That adds extra safety. Some have a system called LATCH (Lower Anchors and Tethers for Children). This eliminates the need to use the car’s safety belts which, after all, were designed for larger children and adults. The car seat attaches, instead, entirely to the anchors. Vehicles made after Sep, 2002 all have these systems.

Other attributes of a good car safety seat can involve convenience for the parent and comfort for the child.

Children come naturally in different shapes. Like the adults they will become, some are slender, others more rounded. Some are a little longer or taller. That means they all fit a little differently in the seat.

A car safety seat that makes it easy to safely and securely add or remove padding, blankets and more provides additional comfort and safety. At the same time, parents have to spend less time adjusting the seat to make a good fit. That’s a win-win situation for both. Some even have integrated travel vests that can be buckled around the child.

That same double-theme of safety and convenience is carried on by seat designs that make it easy to insert and adjust the restraining straps. Parents are busy folk and it’s easy to succumb to the temptation to take a short cut. But no one wants to sacrifice safety. A design that requires only a few seconds to install or move the seat satisfies all those needs.

Some newborns’ symptoms are eased by changing their positions. Rolling the infant on its side especially followed by pressing it up against the mother’s abdomen has worked for many distressed children and parents.

Sounds in general may be one of the most popular methods for treating colic.

The sound of ocean waves has settled more than one colicky baby. Some studies suggest it emulates the environment in the womb. Until the final answer is validated, experience continues to favor this method as one which works.

Even certain artificial sounds can serve as a distraction and, possibly, a (temporary) cure. While anecdotal, many parents report that the sound of a vacuum cleaner causes their baby’s symptoms to disappear. This may be because the noise is startling, making them forget their painful stomach. Or, it may help the child release gas or even produce hormonal changes. Not fully scientific, but well worth a try.

Even white noise has proved beneficial in many households. The static from a TV set, or the general noise provided by special CDs can help. It may be that the method simply helps lower stress.

It would seem that babies have little reason to experience stress. But everything is new and adapting to it takes effort. While this isn’t the same as adult stress, a calming atmosphere does reduce the odds of acid reflux and other physical circumstances that can be related to colic.

Music can be an important means to applying this method. Music does indeed have charms to sooth the savage breast, as the poet says. A gentle Chopin Piano Etude or a pleasing Vivaldi piece are recommended by music experts. Some studies also provide evidence that it helps young minds develop, too. But a lilting nursery tune isn’t just for the Irish, either.

The connection between colic and sound or music cure is unclear, but the technique gets a lot of ‘votes’ from real experts: real parents!

Certain foods or drink may be beneficial, too.

Check with your doctor first, but small amounts of herbal tea has been known to help some babies’ colic symptoms. Never give strong teas to a newborn. But gentle green or dilute peppermint tea may be helpful, if approved by your physician. They’re also good for the immune system.

Some physicians say that altering the formula or method of feeding for bottle fed babies can help reduce colic. Babies sometimes get too much air in the stomach, which promotes colic. Here again, be guided by your doctor’s advice. But colic may be caused, at least in part, by abdominal gas so there can be something to this.

A whole range of health issues can be addressed by breastfeeding. While there is no sure cure for colic, proper breastfeeding can help reduce gas and definitely does provide antibodies to stave off diseases. Some stomach bacteria are helpful, but others give off gases that can cause upset.

Last, but far from least, let time be your healer.

Patience, per se, won’t cure colic. But it is nevertheless beneficial to both parent and child. Since the condition tends to occur within a few weeks of birth, but goes away spontaneously after a few months, waiting is one valid form of treatment. At the same time, ample patience will help parents keep their sanity during this trying time.

Time really does heal. Some newborns never get colic. But virtually all who do will see it disappear after a few months at most. If the symptoms persist longer, see your physician for a diagnosis that may reveal a different condition, such as lactose intolerance.

Now it’s your turn.

After birth, the newborn’s umbilical cord may change color. It can alter from green to brown to black. Not to worry! This is all part of the natural process as the cord dries out in preparation for falling off. This typically takes about 1-2 weeks.

During those days the only care needed is to keep the area clean and avoid bumping the cord.

The section around the navel is comprised of sensitive skin. Just press on your own navel even as an adult and you’ll see. It takes only modest pressure to feel discomfort. Babies are, naturally, a little more tender. No need to be paranoid, just cautious.

Keeping the cord area clean will help prevent infection. The skin is the body’s first line of defense against disease. It provides a physical barrier against bacteria, viruses, fungi and other organisms that are seen as ‘foreign invaders’ that provoke the immune system into a response.

But a baby’s immune system is still under considerable development for the first year. It doesn’t yet have all the normal complement of antibodies to counteract common germs. So, keeping the area flexible and free of dirt will help prevent those germs from getting inside.

It’s rarely necessary to swab the area with alcohol. In fact, a contemporary study suggests that this is mildly counterproductive. While not actively harmful, the cord will likely drop off a couple of days sooner if left alone.

But, babies are babies and the area can attract dirt, food and a host of other things. Again, not to worry! A little gentle wipe with a soft, wet cloth will do the trick. Sterile water is often all that’s required.

When a little more thorough cleansing power is needed, mild and well-diluted antibacterial soap with a soft cotton cloth can do a perfect job. Avoid ordinary washcloths if they become stiff and a little harsh after they’re no longer brand new.

If moisture gets trapped where it won’t dry out within a few minutes the lowest setting of the hair dryer can help. Make sure the air doesn’t get hot. A baby’s skin is very sensitive.

Avoid covering the stump with the diaper. Also, keep it folded down far enough so that the top ridge doesn’t push or bend the cord as the baby is moved around or picked up. Be sure to change soiled diapers right away to keep the area dry and free from possible infectious agents.

A sponge bath is best during this period. In theory it’s possible to use a tub filled below the navel. But babies will get tilted, slip and other movements will likely occur that splash the area with soapy water. A little drip from a sponge bath isn’t a disaster, but keeping water to a minimum is best.

Never succumb to the temptation to give the stump any assistance in falling off. It will do so naturally at the right time all on its own. Tugging can tear the skin and produce pain and possible infection.

The first, and one obvious to anyone, is to ensure everyone’s safety. That means both baby and pet. Newborns are the most precious thing in the world to parents, and rightfully so. But the family pet is beloved as well. Keeping them both safe is imperative.

Fortunately, that only requires a little forethought and some preparation. Dogs large and small, of course, will need to be monitored and perhaps restrained, depending on breed and individual character.

Some will see the new little one as prey. Others are merely curious. Either situation can lead to harm to the child. When first introducing the dog to the baby, ensure the dog is controlled with a sturdy leash. Kneel down to the level of both baby and pet. Keep an arm wrapped around the dog’s chest to prevent lunging. Keep the muzzle at least a foot away.

Sniffing without physical contact is ok. Licking, while not toxic, is not recommended at this stage. A baby’s immune system is still maturing. Even though dog saliva contains special antibodies that protect them, they do pick up things that shouldn’t come in contact with the child’s skin. Some children are allergic to the proteins in pet saliva.

Cats can be harder to control. They’re more likely to be fearful or to playfully lash out with a claw-extended paw. They also slip off a standard leash a little easier. When acclimating them to this interesting new thing in the house, use a chest harness to ensure complete control.

Naturally, neither should ever be left in areas where the two can come into contact unsupervised. That will require a little creativity. Dog barriers, high cribs and other preparations can keep almost all dogs at bay. Cats are more difficult, but ensuring they don’t have access to the baby’s room is possible. It does require vigilance, though.

Of course, in a small percentage of cases, the baby will actually be allergic to pet dander. Official figures vary, but the total population of allergy sufferers is about 10%, only a small portion of which are allergic to dander. Also, of that 10%, only a very small portion are infants. So, the overall odds are very low.

In those cases, just as with adults, avoiding contact is best. Many parents won’t want to remove a loved pet from the household entirely. The situation is not an unresolvable dilemma, though. Very little pet dander remains airborne for long. Frequent washing of bedding and a once-per-month wash of the pet can help a lot.

Of course, the situation is far from all negative or worrisome. Pets and babies can have a wonderful bond of the sort that exists with other family members and the pet. A caged pet bird or lizard can be just as much a delight for a baby as for anyone else. Many dogs have actually rescued babies from dangerous situations, either directly or by alerting an adult.

Anything which irritates the skin can cause diaper rash. A baby’s skin is very sensitive. Still, there are a few common causes.

Long exposure to urine and feces is one example. Pure urine is not infectious. But it mixes readily with organisms, providing them with a growing medium. Bacteria are often found in feces, as a normal part of the body’s disposal of potentially harmful ‘invaders’.

One organism in particular accounts for a large number of diaper rash cases: yeast. This common fungus grows well in moist, warm environments, such as soiled diapers. Even when waste isn’t present, excessive humidity in the air encourages moisture under the diaper. That condition is especially likely in skin folds that trap moisture.

Other causes are possible, as well.

A change in diet can increase stool production, which increases the time the baby’s skin is exposed to it. Ironically, even a new cleansing product can cause diaper rash. Though rarely the cause, thanks to considerable testing, some babies are sensitive to certain products. A new detergent or fabric softener, or even a new disposable wipe, can irritate the skin.

And, not least, some babies are simply more sensitive than others to potential irritants. Tight diapers that are perfect for one will chafe another.

Home treatment is all that’s required in the overwhelming majority of cases of diaper rash.

In most cases, simply cleaning your baby gently but thoroughly will provide the right environment for time to do the rest. Changing diapers promptly and often will help prevent any instance or reoccurrence. Rinsing with warm water during a change to remove all trace of urine and feces is a good idea.

There’s rarely a need for swabbing with alcohol and it can often be counterproductive. It tends to dry the skin excessively. Patting with a soft towel followed by air drying is best. Allow the area to dry thoroughly before fitting the baby with a new diaper.

For babies that tend to develop diaper rash, avoid diapers or outer pants that have elastic bands that tighten against the legs. This blocks air flow that helps to keep the area dry. They may also chafe.

For more serious cases, an antifungal cream may be called for. There are over the counter ointments and prescription strength creams. Which is needed depends of course on individual factors that should be discussed with your physician.

With proper care almost all cases of diaper rash can be conquered within a few days. For those that persist or grow, see your doctor. Any time the rash is accompanied by pus or boils you should seek professional treatment for your baby at once.

No one size fits all. Even among highly competent physicians there is a considerable variety in personality. Choosing one that suits you is important for a number of reasons. You’ll have questions and some doctors will make you feel rushed, others are more patient. You’ll have to call them at odd hours. Do they provide care willingly or reluctantly? Will they get back to you right away, or hours later?

After you’ve narrowed the field of candidates, you’ll want to cover some basics in a face-to-face interview. Basic screening could be done via phone or email, but you’ll want to meet at least the three final ones on your list. Although, some do get lucky and find just the right one the first time out!

Naturally, you’ll examine their degrees and certificates. Not all medical schools and/or residency programs are created equal. It makes a difference whether a doctor trained at the Mayo Clinic or did field work in Africa. Both have their strengths. Are they board certified in pediatrics? Any qualified pediatrician, as opposed to just a family physician or general practitioner, will be. Are they a member of the American Academy of Pediatrics? This is standard, but not universal.

You’ll want to know with what hospital they are associated. If the choice comes down to a close call between two, this could be a deciding factor. Hospitals have differing policies on insurance and their own ‘feel’. Some are simply closer to home than others. All these things can help you decide. Will the person you choose see your newborn while he or she is still at the hospital after delivery? That tells you something about the level of care and interest in individual patients.

You’re not limited to one pediatrician, and in fact you may be referred at times to a specialist. But your primary care physician will (and should) usually be one person who sees your baby consistently. He or she will become familiar with your baby. That experience counts for something.

In a group practice, who covers for the primary physician in his or her absence? Try to meet that person. When they do refer you to a specialist whom would it be? Try to interview that person as well. The same goes for support staff. Is there an RN in the office who specializes in pediatrics?

Finally, you’ll want to sound out the candidate on such issues as immunization. Are they in favor of vaccinations, or opposed to them? What schedule do they follow? What approach do they take to issues of diet and nutrition?

Your obstetrician is a good source for a recommendation, of course, as are friends and family. Some do double-duty, of course. Your local hospital is another good source for references. If you’ve exhausted those obvious choices, you can try a few good websites that may list pediatricians in your area.

American Academy of Pediatrics: www.aap.org
American Board of Pediatrics: www.abp.org
The Health Pages: www.thehealthpages.com
The Doctor Finder: www.docfinderplus.com

You’ll find information about the pediatrician’s training, specializations, accepted insurance plans and more.

New parents sometimes read about potential difficulties associated with feeding infants cow’s milk, and so shy away from formula based on it. But all commercial formulas are safe and nutritious.

Cow’s milk isn’t a preferred food for babies under 12 months. That much is true. But that’s chiefly because it doesn’t have the same percentage and type of proteins, fats, carbohydrates and other compounds that is contained in natural human breast milk. And, indeed, a small percentage of newborns are lactose intolerant.

But baby formula based on cow’s milk isn’t just your regular dairy product in a different bottle with a higher price sticker. The formula is carefully prepared. The cow’s milk fats and proteins are altered to emulate human breast milk to a very high degree.

But, for those few who truly have difficulty digesting cow’s milk-based infant formula, there are good alternatives.

Soy-based formula is a healthy choice. They’re useful primarily for those babies who lack the enzyme to correctly break down lactose, the natural sugar in cow’s milk. Here again, it’s important to get soy formula, not soy milk. The latter is not appropriate for newborns.

A specialized formula called protein hydrolysate is another alternative for those who have some types of milk allergy. The proteins in the formula are already broken down to products that would result from natural digestion. For those rare but unfortunate few babies who are born with a family history of milk allergies, it can be a lifesaver.

Beyond the general category of ingredients, there are many types of infant formula. They differ primarily in cost and convenience.

Powdered formula is the least expensive. It’s designed to be mixed with water. It’s possible and usually safe to mix with tap water. But many parents will want to use bottled water to ensure purity, which largely eliminates the price advantage.

Concentrated liquid formula is also intended to be mixed with water. It has the advantage of being a little easier to prepare, but (like powdered formula) requires careful measurement. The right ratio of formula to water is important for optimal nutrition and ease of digestion.

Ready-to-use formula, by contrast, is already pre-mixed to the exact concentration and form for instant use. Like the others it can be fed warm or cool, whichever the baby prefers. Not surprisingly, it is also the most expensive.

Some formula labeled ‘enhanced’ contain DHA (docosahexaenoic acid) and ARA (arachidonic acid), which are omega-3 fatty acids found in natural human breast milk. They’re safe, but research is mixed on how much extra benefit they add.

All formulas are safe and nutritious, but all carry the same requirements. They should be prepared with clean, preferably sterile, utensils. Hands that contact anything that would make its way into the baby’s mouth should also be thoroughly cleaned before feeding.

Prepare formula to the exact concentration recommended and feed only what the baby wants. Don’t force the infant to take more than it is willing to consume after waiting a few minutes to relax caregiver and child. If it hasn’t drunk the ‘right’ amount or at the time desired, simply wait and try again later. Babies regulate according to an internal clock, not the one on the wall.

Developing fetuses receive their immunization protection in part from their own immune system, and in part from antibodies supplied by the mother through the umbilical cord. But even after birth, the newborn immune system is still immature. It will be a year before the child develops the full complement of antibodies that help fight off ever-present bacteria, viruses and other disease causing germs.

During those first critical months, breastfeeding mothers can help supply their newborns with protective antibodies through the colostrum and breast milk. But some mothers can’t breastfeed. And, most importantly, even mother’s milk doesn’t supply full protection against the wide number of potential diseases.

Parents can give their child extra protection by having them vaccinated.

The principle of vaccination is very simple. In some cases, a quantity of dead organisms that would otherwise cause disease are used in a solution that is given via injection, sugar table, nasal spray or pill. In other cases, genetically-modified live organisms are used. In both cases, the disease causing germ has been neutralized.

But the basic biochemical makeup of the germ is still present. That stimulates the body’s immune system, which has evolved to recognize these proteins as ‘foreign invaders’ and to release antibodies to combat them. Since the organisms can’t cause disease, there’s minimal impact. But the body still releases the antibodies, and so builds up immunity should live, functioning germs ever be encountered. That prevents the disease before it occurs.

Is it Effective?

Decades of clinical research and common experience confirm the view that vaccines do work. They have reduced the incidence of rubella, whooping cough, smallpox, polio and a range of other once-common childhood diseases.

In the rare instance that a child still does get one of these diseases, the symptoms are often drastically reduced. What, in generations past, might have been a permanently crippling disease or a death sentence is now almost always a minor inconvenience.

Are Vaccines Risky?

While no vaccination is completely without risk, modern genetically modified viruses used in vaccines represent a very low risk. It’s nearly unknown for a child, for example, to develop rubella from a vaccine. Consider how many people, young and old, get flu vaccines every year. Almost none ever get the flu.

But why take any risk, no matter how small? Because, the risks of serious harm should the child contract the disease the vaccination protects against are high. Thanks to widespread vaccination over the past few generations, many of these diseases are rare in the U.S. and elsewhere. But the potential effects are serious. That tips the risk-benefit ratio heavily in favor of vaccinations.

Junk Science Is Common

Many uninformed people have exaggerated the risks of vaccines. It was popular at one time, for example, to assert that vaccinations caused autism. The Mayo Clinic, in a recent meta-study that examined over 200 studies from major research organizations, found nothing to support this claim.

So it goes with so much of what is written on health today. Someone raises an unfounded concern. Professionals from a diverse group of organizations, including the CDC (Centers for Disease Control), major public and private universities, world renowned hospitals and others investigate. Invariably, they find the claims of risk to be overblown.

Conclusion

Vaccinations are an excellent method to help give your newborn the best start in life. Stimulating the immune system very early in life to develop antibodies against disease causing organisms drastically lowers the odds of contracting the disease later in life.

That has proven true with whooping cough, rubella, diphtheria, smallpox, chicken pox, polio and many more that only a few generations ago devastated entire communities.

Look into the subject by reviewing professional sources. You’ll find that vaccines are good for your newborn.

Traveling with your baby can seem like planning a 13th century caravan across the desert. There are a thousand things, it seems, to consider. But with modern transportation, communication and baby-friendly facilities in so many places, it’s really not that bad.

Naturally, you won’t forget to bring the basic supplies. You’ll want a supply of diapers, diaper rash cream and a bag for soiled diapers. You should bring some teething gel and infant paracetamol for pain relief on the road. Newborns should not be given aspirin. Petroleum jelly is a must. Sunscreen is helpful for those circumstances where you can’t keep the sun entirely off. Babies have very sensitive skin.

You’ll want a good bonnet and the ability to layer clothing for changes in temperature. That change can be from an air-conditioned car to the hot sun at grandmother’s house. Or, it can equally be from the heated car to a house that is a little chilly for the newborn. Be prepared for either eventuality.

Avoid traveling by air for the first year whenever possible. This isn’t just a courtesy to the other passengers. Pressurized cabins, recycled air, pressure changes from takeoff and landing, and other issues represent a stress to your baby’s system. Breastfeeding mothers will find it hard to find privacy at feeding time and both parent and onlooker can be made uncomfortable.

For auto travel, you’ll need a good child safety seat, one that is specifically designed for infants. It should be rear facing and be installed in the back seat. An air bag that deploys in the front seat can cause serious harm, both from direct impact and the hard jerk to a baby’s neck. Always take the time to secure the car seat properly.

However you travel, food and drink are essential bring-alongs. Babies get hungry on an internal schedule that is not synchronized with parental convenience. Telling them to ‘wait until we get there’ is not an option, as it is with older children. The ability to breastfeed conveniently and safely is best. For those on formula, having some means of warming formula is good. Special warmers are available that plug into the cigarette lighter socket.

The ability to perform a diaper change on the road is another must. The alternative isn’t merely discomfort, but a bad smell for you and increased likelihood of diaper rash for the infant. A portable changing station or pad will make that chore much easier.

Newborns are much more susceptible to germs than older children, since their immune systems are still developing. Keeping exposure at a minimum is important. Avoid having every family member and friend breath on or touch the newborn. Insist that only those with clean hands and no colds get close.

Sure, there are lots of challenges to face when traveling with a newborn. But, like that 13th century caravan, it can be an adventure!