Pregnancy & Baby

 

Pregnancy & Baby

Planning For A Baby

Starting a family means overwhelming change. By planning ahead, you can begin to prepare emotionally and physically for pregnancy and parenthood. Here are some suggestions that can put you on the path toward a healthy and enjoyable pregnancy.

Your preconception checkup

Start by seeing your healthcare provider for a preconception physical exam. Ideally, this should occur six months before you try to get pregnant. Tell your provider you want to get pregnant, and together you can discuss your health status and prospects. At your visit, you should:

• Address any major health problems. If you have a chronic illness such as high blood pressure, diabetes, asthma, lupus, or epilepsy, discuss how this affects your pregnancy plans.
• Discuss the safety of any prescription or nonprescription medications you use. Your provider may advise you to eliminate some drugs now and to plan on stopping or changing others as soon as you know you're pregnant. Don't forget to discuss your vitamins and supplements as well; even "natural" products might impair your fertility or harm an unborn baby.
• Ask your provider whether you fall into any high-risk categories for genetic disorders and whether you should see a genetic counselor for advice or testing. If you or your partner are over a certain age, have a family history of disease, have a certain ethnic background, or have been exposed to significant radiation, your children may be at increased risk of disorders.
• Update your immunizations. Your provider can test you for immunity against preventable diseases that pose risks to pregnant women or their babies. It's best to update your vaccinations at least three months before conceiving.
• Test for and treat other disorders and infections before you conceive. Once you're pregnant, not only do you have to worry about the illness itself, but you're also limited in your choice of treatments.
• Talk about your contraception history. If you've been using birth control pills, Norplant, Depo-Provera, or an IUD, ask your provider how long you should wait before trying to conceive.
• Evaluate your weight. Both overweight and underweight can affect your fertility and the health of any baby you conceive. If you have a weight problem, ask your provider for guidance on achieving a healthier weight.
• Discuss your nutritional needs. Your provider can give you eating guidelines that will ensure the proper nourishment of a new embryo. You will probably also be told to take a supplement containing folic acid, which can significantly reduce the risk of certain birth defects. Because you need sufficient levels of this vitamin in your body at the time of conception, you should start taking it as soon as you plan on trying to conceive.

Your environment

• After you schedule your preconception exam, you might consider these additional steps:
• Wean yourself from alcohol, recreational drugs, and tobacco. These substances can reduce your fertility and seriously injure a baby. Avoiding them will make you a healthier mom.
• Take care of any teeth and gum problems before you conceive. Experts recommend minimizing anesthesia and routine X-rays while pregnant. Also, pregnancy makes the gums sensitive, so dental work is more uncomfortable.
• Consider what changes you may need to make in your home and work environment if you become pregnant. Avoid home renovations or hobbies involving chemicals while you are trying to conceive. Does your workplace expose you to illnesses, X-rays, paints, solvents, pesticides, cleaning agents, or other possible hazards? Look into precautions, a transfer, or a leave of absence.

Your finances

• Having a baby isn't cheap. Advance planning can help keep the costs manageable. For example:
• Check your health care coverage. Does it cover prenatal care, tests, hospital costs, and newborn care? If you have restrictions on providers, facilities, or visits, make appropriate choices -- or consider changing or supplementing your coverage. If you don't have health insurance, do your best to get some, even if it's a bare-bones policy. If you experience any complications, you'll be glad you have coverage.
• If you work, investigate your options for maternity leave. Find out whether the Family and Medical Leave Act (FMLA) or the Pregnancy Discrimination Act applies to your company. Check your partner's options as well.
• Start thinking about how you will budget and pay for pregnancy and childrearing. Will you need childcare? Can you start saving now?

How Conception Happens?

Given the number of things that must fall into place in order to start a baby, it's a wonder it ever happens at all. The creation of a human being requires the right environment, the right ingredients, the right timing, and a great deal of luck.

The first step occurs when an egg cell from a woman unites with a sperm cell from a man to form an embryo -- the beginning of a human being. This process is called conception.

The menstrual cycle

Most women of childbearing age go through a cycle of physical events every month. The cycle is measured by the most obvious of these events: her menstrual period, the few days in which blood and tissue pass from the vagina. Most of the other events involved in the menstrual cycle are harder to track because they occur internally. The first day of the period is designated day 1 of the cycle. On average, a woman's cycle lasts 28 days, but that can vary widely among individuals.

The steps in the menstrual cycle are triggered by the rise and fall of certain hormones (chemical substances in the body). Several glands -- including the pituitary in the brain and the ovaries (egg-producing organs) in the reproductive tract -- manufacture and release these hormones. The varying hormone levels signal the organs of the reproductive tract to respond in a particular way at different points in the cycle.

Each month, one of these hormonal signals tells the uterus (womb) to prepare for the possibility of pregnancy. Over the course of the next two weeks, a layer of blood-rich tissue builds up on the inside surface of the uterus. This lining called the endometrium, is meant to serve as a bed in which a developing baby can grow.

Meanwhile, some of the eggs inside one of the ovaries begin to mature. Each ovary contains many thousands of immature eggs, but only a small proportion respond in any given month. Of these, usually, only one egg ultimately reaches maturity. At the midpoint of the cycle -- usually about day 14 -- that egg emerges from the wall of the ovary and makes its way into the nearby fallopian tube, a narrow, hollow structure that carries the egg to the uterus. The release of the egg from the ovary is called ovulation.

Most of the time, conception does not occur. The egg proceeds down the fallopian tube and reaches the uterus with no interruption. In such a case, the uterus eventually sheds its blood-rich lining, causing the menstrual period. The egg passes out of the body along with the blood and tissue.

Fertilization

In order for conception to occur, sperm cells from a man must be present in the woman's reproductive tract at the time the egg enters the fallopian tube. This can happen in several ways. If the woman has intercourse with a man during the week preceding ovulation, then he may deposit semen (a fluid containing sperm cells) into the woman's vagina. Some of the sperm can make their way through the cervix (the opening of the uterus, located at the end of the vagina), into the uterus, and on up into the fallopian tubes. There, one of them may meet with the egg as it travels down one of the tubes toward the uterus.

Intercourse is not the only way to get sperm in position. Another way is for a doctor to place sperm cells directly into the woman's uterus at the right time in her cycle, a technique called intrauterine insemination. These sperm can also swim up the fallopian tubes, seeking the egg.

When sperm meets the egg, they attempt to penetrate the egg's outer layer. When one succeeds, the egg's outer surface forms a barrier to prevent other sperm from penetrating. The union of the sperm and egg is called fertilization.

The fertilized egg is the first cell of a new human being. It contains a complete set of the genetic information necessary for the development of a baby. Half of that genetic material comes from the mother, carried in the egg; the other half comes from the father, carried in the sperm cell. That means the baby will have a combination of characteristics from both parents.

Critical next steps

Conception is only the first step; once the egg and sperm unite to create a fertilized cell, that cell must go through many more steps to grow into a baby.

As it floats down the fallopian tube toward the uterus, the cell divides into two. Those two cells then divide to make four, and the division continues. In a week or so after fertilization, the growing cluster contains about 100 cells. It then attaches itself (implants) to the wall of the uterus, where it settles down to grow.

Some of the cells in the cluster form the embryo, the part that will eventually develop into a baby. Other cells multiply to form an organ called the placenta, which connects with the uterine lining to draw nourishment and oxygen from the mother's blood to sustain the developing embryo. The placenta also produces hormones, which enter the mother's bloodstream and spread through the body. These hormones alert the body that a baby is growing in the uterus, and they signal the uterus to maintain its lining rather than shedding it. That means the woman does not have a period that month. This may be her first sign that she is pregnant.

Over the next few weeks, the embryo grows and develops at a rate faster than at any other point in its existence, including all childhood and adulthood. By about seven or eight weeks after conception, the embryo has formed all its vital internal organs and its external structures, and it is called a fetus. Over the remaining months of pregnancy, the fetus grows from less than an ounce to about seven or eight pounds in size, and its organs develop to prepare it for life after birth.

What can go wrong?

The conception process is hardly foolproof. An ovary might not release an egg successfully. Or the egg might be flawed or damaged -- something that is more likely to occur the older the woman gets, or if she smokes, uses drugs, or is exposed to radiation or other phenomena that can damage immature eggs. A man might have trouble producing sperm, or his sperm may be misshapen or slow-moving. Damaged sperm or eggs may not be able to join successfully, or they may produce a fertilized egg that cannot survive the early stages of growth.

Other problems have to do with the organs and systems in the woman's body. A blocked or bent fallopian tube can prevent an egg from entering the uterus. Problems with the endometrium may keep a fertilized egg from implanting. Levels of hormones that are too high or low can throw off the entire cycle. Fortunately, medical treatment can now fix many of these problems.

Still, even if all the systems are in order, the timing must also be right. If the sperm enter the uterus too long before the woman ovulates, they die before the egg arrives. If they come too late, they miss the chance to meet the egg in the fallopian tube.

Although fertilization can occur only when an egg is present, it's important to remember that not all women ovulate regularly. Sometimes an egg emerges earlier or later than usual. This is particularly true for younger women and for women with irregular periods. For that reason, some possibility always exists that a woman in her childbearing years might be fertile at any moment, even during her period.

For this reason, couples who do not want to have a baby should use contraception every time they have sex. The risk of conception at the beginning or end of a woman's cycle may be tiny, but it does exist. Couples that engage in natural family planning (the timing of sex to achieve or avoid pregnancy, based on physical signs of the woman's fertility) can reduce the odds of an unplanned birth by keeping close track of a woman's cycles and other signs over a long term. Even this system, however, can fail, simply due to the unpredictability of a woman's body.

Am I Pregnant?

While a missed period is one of the biggest clues that a woman is pregnant, it's usually not the first sign. Some women suspect they are pregnant before their menstrual cycle is late.

Symptoms that might indicate you are pregnant include:

• Tenderness of the breasts and nipples
• Fatigue (1-6 weeks after conception)
• Frequent urination (6-8 weeks after conception)
• Nausea, queasiness, vomiting (first half of pregnancy)
• Food cravings (entire pregnancy)
• When a woman suspects that she is pregnant, she should visit a doctor to confirm her condition as soon as possible.
• Laboratory blood tests can verify pregnancy as soon as 6 or 7 days after conception.
• A urine test may detect pregnancy as early as 10 days after conception.

The blood and urine tests both measure the level of human chorionic gonadotropin (HCG), a hormone that is only produced in a woman's body when she has placental tissue growing there. The placenta is the tissue within the uterus (womb) through which the mother provides nourishment to the fetus.

The Importance Of Prenatal Care

One of the most important things you can do for yourself and your baby is to seek proper prenatal care. Prenatal care consists of:

1. Regular appointments starting early and continuing throughout the pregnancy
2. Laboratory testing for potential problems with the developing baby or yourself
3. Monitoring for problems such as abnormal changes in blood pressure, blood chemistry, urine chemistry, and weight
4. Getting plenty of exercise and eating properly
5. Giving up bad habits such as smoking, drinking alcohol, or using street drugs.
6. It is also important for a woman to alert her doctor immediately if anything unusual occurs during pregnancy, such as:
7. The baby's movement is greatly reduced or stops.
8. She experiences vaginal bleeding or cramping.
9. She develops swelling of her hands and face, or persistent headaches.
10. She leaks amniotic fluid from her vagina.
11. She develops pain in her abdomen.
12. Improved technologies and more accurate prenatal tests now make it possible to spot complications earlier and take appropriate action in time to save the fetus and/or the mother.
13. Things To Avoid During Pregnancy
14. A woman's habits greatly influence the health of her unborn child. When pregnant, a woman should avoid the following:
15. Alcohol. Consuming alcohol while pregnant can cause birth defects and other problems. Consistent alcohol use during pregnancy can cause fetal alcohol syndrome, a permanent and lifelong condition.
16. Cigarettes. Smoking is linked to low birth weight, premature birth, miscarriage and other complications. Nicotine causes blood vessels to constrict. That means the baby won't get the proper oxygen and nourishment it needs to grow.
17. Medications. Many over-the-counter (OTC) and prescribed medications can harm an unborn child. Your physician can give you a list of which medications you can take safely during pregnancy.
18. Narcotics. Illegal drugs, such as cocaine, can deprive developing babies of vital oxygen and nourishment. This can lead to birth defects, or cause addictions in newborns.
19. Caffeine. Discuss with your doctor how much caffeine, if any, you can have during your pregnancy. Caffeine is found in coffee, tea, colas, and other products
20. Contact with cat feces. A serious disease that can be contracted from cleaning cat litter boxes is toxoplasmosis), which is spread by a microbe that causes lymph-node and nervous-system problems. In pregnant women, this parasite can cause birth defects, stillbirths and miscarriages.

Facts About Pregnancy

• Four in 10 young women become pregnant at least once before they reach the age of 20 -- nearly 1 million a year.
• Improved technology has made home pregnancy tests about as accurate as blood tests-nearly 99 percent under perfect conditions.
• Recent research shows that some exercise is healthy during pregnancy.
• To calculate the due date, one can follow a guide called Nägele's rule. This calculates the estimated date by subtracting 3 months from the first day of the last menstrual period and adding 7 days. increased
• Older women have an increased chance of bearing twins.
• 10 to 20 percent of pregnant women do not have morning sickness.
• The risk of miscarriage in all pregnancies is around 15 to 30 percent. If the baby is developing normally the risk of miscarriage falls to less than 3 percent.
• The overall risk of delivering a baby with a birth defect is approximately 3 percent.
• The chances of a child dying in the later stages of pregnancy or soon after delivery are less than 1 percent.

Signs Of Pregnancy

Your period is late. Could you be pregnant?

For most women, a missed period is the first sign of pregnancy. But there are many reasons a period might come late or even skip a month, including dietary changes, intensive exercise, travel, and stress. And some women have periods so irregular that they can't predict when the next one will come.

If you're pregnant, it's also possible for you to think you've had your period when you didn't. When a newly fertilized egg attaches to the wall of the uterus, sometimes it prompts a little bleeding. This typically occurs a few days before the time you would expect your period to come if you weren't pregnant. If your periods are normally light, you might assume that this implantation bleeding is your period.

In other cases, wildly fluctuating hormone levels in the first week or two after conception may prompt some bleeding from the lining of the uterus similar to a period. And a few other conditions -- such as infections or uterine polyps (abnormal growths) -- can cause bleeding that may look like a period.

So, although a missed period is certainly your best clue to a possible pregnancy, it's not a definitive sign. Your suspicions may increase if you have other symptoms of early pregnancy, such as:

1. Extreme fatigue
2. Breast tenderness
3. Nausea, with or without vomiting
4. Constipation, gas, and/or bloating
5. Abdominal cramps
6. Frequent urination
7. Food cravings or aversion
8. Mood swing
9. Increased vaginal discharge

Some pregnant women experience one or two of these symptoms. Some have many of them. And some have no symptoms at all. Symptoms may even be different from one pregnancy to another in the same woman. The presence or absence of such symptoms is no indication of the health of a pregnancy.

Obviously, many of these symptoms may occur for other reasons, or be confused with other ailments. For example, feelings of nausea or abdominal discomfort might occur with a gastrointestinal virus or food poisoning -- or pregnancy. Fatigue may mean depression, a cold or flu, anemia (low iron levels) -- or pregnancy. Frequent urination could be a sign of a urinary tract infection, diabetes, too much coffee -- or pregnancy.

By the time you add the stress of wondering whether you've conceived, either because you're hoping for a baby or because you're worried that your birth control failed, it can be hard to tell what's happening based on symptoms alone. The easiest way to be sure is to use a home pregnancy test.

If a home test indicates that you're pregnant:

1. Check your health insurance and determine your coverage and options
2. Contact your provider to schedule your first prenatal visit
3. Avoid alcohol, drugs, and tobacco
4. Drink water often
5. Eat as well as you can
6. Rest when you feel the need

Home Pregnancy Tests

Although a few women seem to know immediately when they conceive, intuition isn't enough for most. Symptoms of pregnancy are vague and varied enough that it's hard to be sure, and some women have no symptoms at all. If your period is overdue and you think you might be pregnant, there's no need to agonize: A home pregnancy test is a fast and easy way to find out.

You can buy a home pregnancy test without a prescription at the drugstore or supermarket. Most tests involve urinating directly onto a test stick or into a cup (into which you dip the test stick). You then watch to see whether the stick changes color in a particular way. Results take only a few minutes.

The home pregnancy test works by detecting the hormone hCG (human chorionic gonadotropin), sometimes called the pregnancy hormone. In a normal pregnancy, the developing embryo starts producing hCG as soon as it implants in the wall of the uterus. The hormone circulates through the mother's system, entering the blood and urine.

Some blood tests can detect this hormone as early as the eighth or ninth day after conception. A home test can find it in urine as early as the day your next period is due -- so by the time you realize your period is late, you can probably do an accurate home test. Used according to directions, most home pregnancy tests are about 99 percent accurate.

Sometimes a home test will fail to detect a pregnancy. Usually, this happens when a woman takes the test before her hormone levels are high enough to trigger a positive reading. If you get a negative reading and your period doesn't come after a few more days, you should take another test; by then, your hormone levels may be high enough to cause a positive result. If you're still in doubt, call your health care provider. Sometimes a pregnancy that doesn't register on a home test will appear on a blood test done at your provider's office.

For a few pregnant women, hormone levels remain low or undetectable even on blood tests for weeks or months. In such a case, if the woman continues to show signs of pregnancy, her provider may recommend an ultrasound exam, which uses sound waves to reveal the contents of the uterus. An ultrasound exam can show the presence of a growing embryo as early as the fourth or fifth week after the first day of the last period.

Home tests are more likely to miss a pregnancy than to report one that isn't there. Still, it's possible -- though rare -- for a woman to get a positive reading on a home test even if she isn't pregnant. In such cases, the test may be responding to another condition that can mimic the hormonal action of pregnancy. Some of these conditions are serious, such as ectopic pregnancy (when a fertilized egg implants outside the uterus), molar pregnancy (in which an egg develops into an abnormal mass rather than a baby), and certain tumors.

Any positive reading on a home test should prompt a call to your healthcare provider to set up an appointment. If you have a condition other than pregnancy, that will become apparent from your prenatal exams. In nearly all cases, though, a positive home test means a growing baby.

Being Pregnant

• Pregnancy Calendar
• Eating and Weight Gain
• Tips for Healthy Eating During Pregnancy
• Provided by National Institute of Diabetes and Digestive and Kidney Diseases
• Talk to your healthcare provider about how much weight you should gain during your pregnancy.
• Eat foods rich in folate, iron, calcium, and protein, or get these nutrients through a prenatal supplement.
• Talk to your healthcare provider before taking any supplements.
• Eat breakfast every day.
• Eat high-fiber foods and drink plenty of water to avoid constipation.
• Avoid alcohol, raw fish, fish high in mercury, soft cheeses, and anything that is not food.
• Aim to do at least 30 minutes of moderate activity on most days of the week. Talk to your healthcare provider before you begin.
• After you deliver your baby, continue eating well. Return to a healthy weight gradually.
• Slowly get back to your routine of regular, moderate physical activity.
• Take pleasure in the miracles of pregnancy and birth.
• Should I Be Physically Active During My Pregnancy?
• Provided by National Institute of Diabetes and Digestive and Kidney Diseases
• Almost all women can and should be physically active during pregnancy. Talk to your healthcare provider first, particularly if you have high blood pressure, diabetes, anemia, bleeding, or other disorders, or if you are obese or underweight.
• Whether or not you were active before you were pregnant, ask your healthcare provider about a level of exercise that is safe for you. Aim to do at least 30 minutes of moderate activity (one that makes you breathe harder but does not overwork or overheat you) on most days of the week.

Regular, moderate physical activity during pregnancy may:

• Help you and your baby to gain the proper amounts of weight.
• Reduce the discomforts of pregnancy such as backaches, leg cramps, constipation, bloating, and swelling.
• Improve your mood, energy level, and feelings about the way you look.
• Strengthen your muscles and improve your blood flow.
• Improve your sleep.
• Help you have an easier, shorter labor.
• Help you to recover from delivery and return to a healthy weight faster.
• Follow these safety precautions while being active during your pregnancy:
• Choose moderate activities that are unlikely to injure you, such as walking, aqua aerobics, swimming, yoga, or using a stationary bike.
• Stop exercising when you start to feel tired, and never exercise until you are exhausted or overheated.
• Drink plenty of water.
• Wear comfortable clothing that fits well and supports and protects your breasts.
• Stop exercising if you feel dizzy, short of breath, pain in your back, swelling, numbness, sick to your stomach, or if your heart is beating too fast or at an uneven rate.

First Trimester Checklist

Once you've absorbed the news that you're pregnant, your thoughts may turn to how much you need to learn and do in the next few months. Here are some suggestions for where to start.

Physical needs

Call your healthcare provider immediately to set a date for your first prenatal visit.

Evaluate your diet. Make a commitment to taking your vitamins, drinking eight glasses of water daily, and eating small, frequent meals high in protein, iron, and calcium. If your appetite is low or you're suffering from nausea, do your meal planning and shopping in advance. Be sure to pick up lots of healthy snacks, so you'll eat right when you do feel hungry.

Set aside time to rest. While body changes may not yet be visible, your body is still working very hard.

Exercise moderately. Check into pregnancy exercise classes and fitness club memberships. Ask your provider to approve your fitness plans; in general, a reasonable minimum for most pregnant women is a 20-minute walk daily, plus cardiovascular exercise -- brisk walking, aerobics, swimming, or bike riding -- for 15 minutes three times per week.

If you haven't already, stop using alcohol, tobacco, and recreational drugs. Cut down on caffeine. Avoid taking any medications unless your provider says they're OK.

Once you notice breast growth, buy a supportive maternity bra. Be aware that your breasts will continue to grow throughout pregnancy, so plan to buy a larger size later.

Emotional needs

Start a journal to record your feelings, apprehensions, and anticipations.

Establish connections with women who are pregnant and at the same time you are. Find them at pregnancy exercise classes or through online bulletin boards at websites devoted to pregnancy and parenting.

Photograph yourself monthly.

Talk with your partner about your hopes, dreams, and fears about parenthood. Take time to recall your own childhood. In what ways do you want your children's lives to be similar or different? What values would you like to incorporate in your own parenting?

Start envisioning how you'd like to have birth: a home, at a birthing center, at a hospital? Who would you like to be with you? Research your options.

Practical needs

Buy or borrow a few pregnancy books. Be aware that advice on pregnancy and childbearing covers a wide range. Before you settle on a particular guide, spend a few hours in the bookstore or library leafing through the selection to find an approach that feels compatible. In addition to books on health and nutrition, you might want a write-in pregnancy planner, calendar, or diary.

With your partner, decide how and when to tell your relatives, friends, bosses, and co-workers about your pregnancy.

Reorganize your long-term calendar to allow for childbirth and the restrictions of a new baby. Determine when you might schedule parental leave from work. If you have plans for a vacation, you might want to take it sooner rather than later; the second trimester is usually best for traveling.

Start budgeting for life with a baby. How much can you spend on baby clothes, furniture, and gear? Make a plan to cover new expenses such as medical insurance, life insurance, and childcare. Investigate college savings funds.

Check your home for lead and radon, and make arrangements to correct any problems. If the paint is flaking or peeling, have a professional remove or seal it.

Decide where the baby will sleep and where you will keep its furnishings. Start clearing out the area, and decide what needs to be done to fix it up. If your home needs renovations, arrange for them now.

Check out the sale racks at maternity departments. You won't need maternity clothing for a while yet, but the items being cleared out now may be the right season for your last months of pregnancy. Many shops provide a strap-on tummy pillow so you can try things on before you develop your own bulge. Buy large, and double-check return policies.

Second Trimester Checklist

The second trimester can be a particularly enjoyable time -- you're probably past most of the discomforts of early pregnancy, and you haven't yet developed the aches and pains of advanced pregnancy. Now is the time to accomplish many of the tasks you'll want to take care of before the baby comes. Here are some ideas of how to use your time.

Continue to take care of your physical self:

• Eat well, with an emphasis on protein, calcium, and iron.
• Maintain a regular, moderate exercise schedule.
• Do Kegel exercises to strengthen your pelvic muscles.
• Check out your options for yoga, aerobics, or swim classes designed for pregnant women, and sign up.

Keep up with your prenatal checkups, which will probably be monthly at this point. During this trimester, your provider may talk with you about scheduling various tests, including the glucose tolerance test to screen for gestational diabetes and the AFP test or amniocentesis to look for birth defects.

Go shopping:

• Shop for maternity clothes.
• Shop for comfortable shoes that are low-heeled with good arch support. You may need a larger size during pregnancy.
• Shop for baby furnishings and clothing. In some families, it's traditional not to bring baby items into the house before the baby is born; at many stores, though, you can make selections and set your purchases aside for later pickup.
• Register for baby items at a store with a gift registry.
• Talk to friends and family about whether they can spare hand-me-downs or let you borrow baby equipment.
• Investigate classes on childbirth education, breastfeeding, and infant CPR. You'll want to consider not only which topics or approaches interest you, but also date, location, and cost. Once you determine your preferences, sign up well in advance.

If you are working, review your company's policies:

• Verify when and how to request maternity leave and how much you can claim, paid or unpaid. Determine whether your employer is covered by the Family and Medical Leave Act (FMLA)
• If you are planning to return to work after the baby is born, check your employer's policies on child care, flexible hours, and personal leave
• If you plan to breastfeed, find out whether your employer has arrangements for moms who pump their milk
• Take stock of your home, and accomplish these tasks before you're out of energy or time:
• Clean the house thoroughly, including closets
• Buy a fire extinguisher for your home, if you don't have one already. Install smoke detectors and carbon monoxide detectors
• Assemble a first-aid kit that includes what you'll need for a baby. Post emergency numbers next to your telephone
• Put non-slip pads under area rugs and on steps. They'll add protection as your balance suffers with pregnancy growth, and later when you're carrying a baby around
• Organize any old photos or albums now, as you may never get to them once the baby comes. Buy some new albums to cover your life with a baby.
• Create mantras or self-affirmations for yourself. Find words or phrases that resonate with you. Then repeat them to yourself, gently and nurturingly. You don't need to share them with anyone else. For example:

1. I am well. I am strong. I am beautiful
2. I am taking care of myself and my baby
3. I can give birth. I will be okay, and I can do it.
4. I am carrying a baby. I am working hard. I deserve to eat well

Have fun:

• Take pictures of your pregnant belly
• Consider making a plaster cast of your pregnant belly
• Keep a journal, writing down your emotions, apprehensions, and anticipations.
• Keep records of first movements, waist measurements, weight gain, and other milestones.
• Talk with pregnant friends and friends who are already parents
• Go out to dinner, go to the movies, or see a show or a concert
• Take a trip now, before it is too uncomfortable to fly or drive

Third Trimester Checklist

As you enter your third trimester, you may begin to wonder how you'll get everything done in time. The truth is, you may not complete all the tasks you've set out for yourself, particularly because your growing body requires more of your energy. Here are some ideas on where to place your priorities.

Continue to take care of your physical self:

• Eat frequent, small, healthy meals and drink plenty of water.
• Schedule at least one 15-minute rest period daily, or more if you need it.
• Walk daily and do gentle stretches. Continue other exercises as appropriate, with approval from your provider.
• Continue Kegel exercises to strengthen your pelvic muscles.
• To reduce your risk for episiotomy or severe tears, begin perineal massage by week 36 or earlier.
• Familiarize yourself with the signs of premature labor and real labor.
• Keep up with your prenatal exams. Expect these checkups to increase to twice per month by the seventh or eighth month and weekly in the ninth month. In this trimester, you should talk with your provider about the birth process and potential complications and interventions.

Plan for the event of childbirth:

• Talk with your partner about your concerns or fears about labor, the role you'd like your partner to play, and how he or she can best advocate for you.
• With input from your provider and your partner, write a birth plan outlining your preferences on labor methods, birth positions, monitoring, pain management, interventions, infant circumcision, and other procedures.
• Take a tour of the hospital or birth center. Find out whether you need to pre-register or fill out any paperwork.
• Work out the details of how you will get to the hospital or center when labor starts.
• Determine who will be with you during and after the birth, and make arrangements to notify them.
• If you have older children, make arrangements for both daytime and nighttime care.
• Pack your bag for the labor room and your hospital stay.
• Make plans with your partner for the first weeks after the baby is born. Who will be at home with you? What help will you need?

Prepare your home:

• Stock up on dry and canned foods.
• Prepare meals and freeze them.
• Complete your shopping for baby clothes, furnishings, feeding supplies, and other gear.
• Pick up some disposable diapers and wipes, or sign up for a diaper service and have your first load of diapers delivered.

Buy a few books on parenting and baby care. Be aware that approaches to these topics cover a wide range. Spend a few hours looking over the selection in the bookstore or library to find those whose philosophy feels right for you. If you are planning on breastfeeding or attachment parenting, also buy a book specifically on that topic.

Decide on baby names.

Choose or create baby announcements. Make your list of who will receive them, and address the envelopes. If you're ordering printed announcements, you can often get the envelopes in advance.

If you don't have one already, buy an easy-to-use camera, digital camera, or video camera, and learn to use it. Disposable cameras are a good fast choice.

Take care of your emotional self. Remember that pregnancy may encourage mood swings or emotional responses. Let yourself cry, laugh, and talk to yourself. Ask your partner, mother, sister, or friends to let you vent.

Have fun:

• Indulge yourself with a facial or pregnancy massage, manicure, or pedicure.
• Take a leisurely walk with a friend.
• Go to a restaurant, movie, or concert. Once the baby arrives, you won't have the chance to do that for a while!

Prenatal Testing

Some tests, called indicated tests, are usually reserved for women who are considered at increased risk due to something their medical or genetic history or an abnormal result in a screening test. However, some indicated tests, such as ultrasound, are being used more often during pregnancy, regardless of whether the mother or fetus is at risk of health problems.

Prenatal tests include:

1. Ultrasound
2. Alpha-fetoprotein
3. Contraction stress testing
4. Non-stress testing
5. Fetal motion count
6. Amniocentesis
7. Other screening tests
8. Ultrasound

Ultrasound, or sonogram, uses high-frequency sound waves to form an image of the uterus, placenta, and fetus. This view into the uterus allows doctors to measure many details about the fetus, including:

Growth of the fetus

Abnormalities of the fetal structures such as the heart, brain, limbs, kidneys, and stomach

Birth defects

• Amount of amniotic fluid
• Location and development of the placenta
• Gestational age or duration of the pregnancy
• The test can be performed almost any time during pregnancy. In the earliest months, it can be performed with a probe placed in the vagina. However, most are performed with a wand placed on the abdomen over the uterus.

Alpha-fetoprotein (AFP)

Between 15 and 18 weeks, the doctor may perform a test to determine the level of alpha-fetoprotein (AFP) in a pregnant woman's blood. AFP is a substance normally produced by a growing fetus. In AFP testing, a blood sample taken from a vein in the arm is analyzed. If the test shows that the AFP level is higher or lower than normal, further tests will be done to confirm or rule out fetal problems.

High AFP levels will occur with twin pregnancies. Also, measuring AFP can help determine the presence of a type of birth defect called a neural tube defect. Neural tube defects are an abnormality in which the spinal cord or brain does not form properly. An increased level of AFP may be found in the blood of a woman whose fetus has a neural tube defect or an abdominal wall defect in formation. An AFP level that is lower than normal may be linked to an increased risk of Down syndrome.

Contraction Stress Testing

This test uses a fetal monitor to continuously record the baby's heart rate and uterine contraction on special paper. A decrease in the fetal heart rate in response to contractions of the uterus is a positive test result. This may involve the use of oxytocin or other means to cause uterine contraction. The test is performed when the fetus is believed to be at increased risk for stillbirth. A negative test suggests that the fetus is at low risk for stillbirth, whereas a positive test indicates that the fetus may be in danger.

Non-Stress Testing

In this procedure, the fetal monitor is attached to the mother's abdomen and records the fetal heart rate. The doctor listens for increases, or accelerations, in the fetal heart rate. If the baby is believed to be asleep, a buzzer is sounded to awaken the fetus. Like contraction stress testing, this test is also performed when the fetus is believed to be at increased risk for stillbirth, but it does not require uterine contractions. A flat fetal heart rate can indicate an increased risk of stillbirth.

Fetal Motion Count

There are a variety of ways in which this test is performed but all rely upon a sudden change in the number of fetal movements in a specified period of time. In most cases, the mother keeps track of the number of times she feels the baby move. Further tests will be performed if the mother notes a sudden decrease or absence of movements. Although some physicians use this procedure because it is easy to use and inexpensive, the appropriate role of fetal motion counting in prenatal care is controversial.

Amniocentesis

The amniotic fluid that surrounds the growing fetus can yield important information. Amniocentesis allows a small sample of this fluid to be collected for analysis. Using a sonogram as a guide, doctors insert a long, thin needle through the abdominal wall and the wall of the uterus into the fluid cavity surrounding the fetus.

Nice To Know:

Amniocentesis is usually offered to women who are at an increased risk for having a baby with a birth defect. These women include those who will be age 35 or older on their due date and those who have a history of birth defects in their immediate family.

Amniocentesis may be done for many reasons:

1. To identify genetic defects
2. To test for fetal lung maturity
3. To detect isoimmunization to Rh factor

Genetic amniocentesis. One of the most common reasons for amniocentesis is to identify genetic defects. Genes carry the master plan of a person's physical makeup. Because the amniotic fluid and the developing fetus are formed from the same cells, they share the same genetic makeup. Amniotic fluid can therefore be studied to see whether the fetus's chromosomes are normal. Amniocentesis may also be done as a follow-up procedure in the event of a positive AFP test. Since the results of genetic amniocentesis may influence parental decisions about whether or not to carry a pregnancy to term, it is performed early, usually during the fourth month.

Amniocentesis for fetal lung maturity. This test is performed if there is concern that the infant may be at risk for lung development problems. In order to remain open, the lungs require a substance known as surfactant, the lack of which is a major cause of lung problems in premature infants. Amniocentesis for fetal lung maturity testing is usually reserved for situations in which early delivery is desirable, but the lung maturity of the fetus is in question.

Amniocentesis for isoimmunization. Isoimmunization occurs when Rh or other antibodies from the mother cross the placenta and destroy red blood cells in the fetus, causing anemia. This destruction can be measured by testing the amniotic fluid for bilirubin, a reddish-yellow pigment formed mainly by the decomposition of hemoglobin in worn-out red blood cells. Amniocentesis for isoimmunization is usually performed at various intervals during the second half of pregnancy.

Other Screening Tests

• A number of other screening tests provide further assurance that a baby is progressing normally. These tests include:
• Human chorionic gonadotropin (HCG). This substance can be measured in blood or urine samples taken from the mother. The most common reason to measure HCG is to diagnose pregnancy. However, physicians also use HCG testing to detect Down syndrome in a fetus.
• Estriol. Earlier in pregnancy, this measurement can be used in conjunction with maternal age, AFP, and HCG to help in the prediction of Down syndrome.

Complications

Most pregnancies are uncomplicated and end with the birth of a normal, healthy baby. Early diagnosis and treatment of any complications will often prevent serious problems.

Regular check-ups can help you learn to recognize the difference between normal changes and those that can indicate a problem. Problems during pregnancy include:

1. Birth defects
2. Ectopic pregnancy
3. Preeclampsia
4. Bleeding
5. Miscarriage
6. Loss of amniotic fluid
7. Diseases in Pregnancy

Need To Know:

1. If you experience any of the following symptoms, notify your doctor immediately. Do not wait until your next scheduled checkup.
2. Vaginal bleeding or spotting
3. Sudden pronounced weight gain
4. Sharp or prolonged pain in your abdomen
5. Severe vomiting
6. Visual problems such as dimness, blurring, flashing light, or seeing dots
7. Sudden and serious swelling of the face, hands, and feet
8. Severe and ongoing headache
9. Painful, burning urination
10. Decreased urination
11. Chills and/or fever
12. Sudden escape of fluid from the vagina
13. Birth Defects

The overall risk of delivering a child with a birth defect is only 3 percent. The most common defects are those associated with the brain and spinal column, heart, and limbs.

The other main defect involves chromosomes in the cells of the fetus. The most common occurrence is Down syndrome. The risk of Down syndrome ranges from less than 1 in 1,000 in young women to 1 in 100 for women who conceive at age 40.

Ectopic Pregnancy

In an ectopic pregnancy, the fertilized egg attaches itself in a place other than inside the uterus. More than 95 percent of ectopic pregnancies occur in a fallopian tube. The narrow fallopian tubes are not designed to hold a growing embryo, so the fertilized egg in a tubal pregnancy cannot develop normally. Eventually, the thin walls of the fallopian tube stretch to the point of bursting. If this happens, a woman experiences severe pain and bleeding, and her life may be in danger.

Ectopic pregnancy occurs in 2 percent of reported pregnancies in the United States. Even so, death from ectopic pregnancy is rare, occurring in less than 1 of every 2,500 cases. This low rate is largely a result of new techniques to detect ectopic pregnancy at an early stage when it can be treated successfully.

Need To Know:

An ectopic pregnancy can cause a rupture of the fallopian tube. If you are pregnant and experience sudden, sharp, severe abdominal pain seek treatment immediately.

Preeclampsia (Toxemia)

Preeclampsia is characterized by high blood pressure, swelling of the face and hands, and protein in the urine after the 20th week of pregnancy. It is a potentially serious condition that, if left untreated, can lead to complications or death in the mother or the baby.

There is no specific treatment for preeclampsia, nor is it known how to prevent it. The only sure way to end the preeclampsia is to deliver the baby, sometimes despite the fact that the baby may be premature.

Bleeding

Up to 25 percent of all pregnant women have bleeding at some point in pregnancy, and of these women, about half will have a miscarriage. Vaginal bleeding is the chief sign of miscarriage in mid-pregnancy. Bleeding in later pregnancy can result from serious problems with the placenta. These could be that the placenta is too low and covering the cervix (placenta previa) or that it has prematurely separated from the uterine wall (abruption). These conditions often need to be treated by doing a cesarean delivery.

Need To Know:

If bleeding is slight or spotty, there may be no cause for concern. But report moderate to heavy bleeding in pregnancy as soon as possible, because it may be a sign of one of the following problems:

• Miscarriage (if it occurs before 20 weeks)
• Preterm labor (if it occurs between 20 and 37 weeks)
• Problems with the placenta (the organ that nourishes the developing fetus) conditions in which it lies too low in the uterus or begins to separate from the inner wall of the uterus before birth
• If you have any bleeding along with pain or cramping during pregnancy, immediately call your doctor or go to an emergency room.

Miscarriage

Miscarriage, technically called spontaneous abortion, is defined as the loss of a pregnancy before 20 weeks of gestation. It has been estimated to occur in 15 to 30 percent of all pregnancies.

More than 50 percent of miscarriages in the first trimester are caused by chromosomal abnormalities. Infections, uncontrolled diabetes, uterine abnormalities, or a woman's production of certain antibodies during pregnancy can also cause an early miscarriage. The warning sign of vaginal bleeding and uterine cramps precedes nearly all miscarriages.

Loss of Amniotic Fluid

The developing fetus floats in amniotic fluid, which is contained in the amniotic sac. During pregnancy, the amniotic fluid increases in volume as the fetus grows. Amniotic fluid volume is greatest at approximately 37 weeks of gestation when it averages 1,000 ml.  Approximately 800 ml of amniotic fluid surrounds the baby at full term (40 weeks). This fluid is constantly circulated by the baby swallowing and "inhaling" existing fluid and replacing it through "exhalation" and urination.

Amniotic fluid accomplishes numerous functions for the fetus, including:

1. Protects from outside injury by cushioning sudden blows or movements
2. Allows for freedom of fetal movement and permits symmetrical musculoskeletal development
3. Maintains a relatively constant temperature for the environment surrounding the fetus, thus protecting the fetus from heat loss
4. Permits proper lung development because the fetus breathes the fluid into the lungs

When a woman goes into labor her "water breaks" and amniotic fluid leaks from the uterus and through the vagina. Normally, a woman's water does not break until labor is underway, however, sometimes amniotic fluid is lost too early. This can make it difficult for the fetus to grow and develop fully before birth, cause premature delivery, jeopardize the baby's lung development, and put the fetus at risk for infection. About 35 percent of preterm deliveries occur because of early rupture of the amniotic sac.

If a pregnant woman notices any fluid leaking from her vagina, she should go to the hospital emergency room at once. She may go into pre-term labor, although many mothers' whose waters break early do not deliver for a number of weeks, allowing the baby to grow bigger and the lungs to mature before birth.

Diseases In Pregnancy

Many of the potential problems in pregnancy are best managed when they are detected early. The exams and tests done as part of routine prenatal care are intended to detect the early signs of these and other complications.

Gestational Diabetes. A small percentage (one to four percent) of pregnant women develop diabetes mellitus, usually in the second or third trimester, referred to as gestational diabetes. The disease poses a serious threat to both the woman and her unborn child. Gestational diabetes has been linked to neonatal hypoglycemia and having a large newborn. The disease often resolves immediately after delivery.

Hypertension. Hypertension (high blood pressure) during pregnancy can be life-threatening to both the woman and the fetus. Hypertension can cause seizures, organ disturbances, edema (swelling of body tissues), and protein in the urine. Together these symptoms cause a condition called preeclampsia, which can result in premature delivery and fetal death.

Rubella. Also known as German measles, the disease is usually not serious in children and adults. But if a woman is infected just before or during pregnancy, the disease can cause heart problems, deafness, and other serious problems for the fetus. A rubella vaccine should not be given to a woman who is pregnant or a woman planning to become pregnant within three months. Most women are immune and, therefore, the baby is not at risk.

Preparing For Birth

No two births are alike. Labor is a series of changing conditions, and no amount of examination can predict how a woman or her baby will respond.

What Type Of Delivery Is Best?

• The mother's health and/or baby's condition will largely determine the type of delivery.
• Vaginal birth is the traditional style of delivery in which the mother is an active participant.
• Cesarean birth is a surgical delivery through an abdominal incision.
• Often the position of your baby or the placenta affects the course of labor. Cesarean delivery may be needed if the baby's position cannot be changed or if the placenta's position makes vaginal delivery a risk. A Cesarean also is needed if the fetus is unable to tolerate labor and is becoming low on oxygen, or if the labor fails to progress.

Is This Labor?

Labor is a series of uterine contractions that open the cervix for birth. Your due date is a good guide in determining if you are indeed in labor. But it's important to remember that babies are often born days or weeks before or after due dates. Signs the baby will soon be born include:

• Irregular tightening or contractions of the uterus
• Increased and thickened vaginal secretions
• Pink or brown-tinged discharge indicating breakdown of the mucus plug sealing the uterus
• Labor often starts slowly. Regular, uncomfortable contractions that come more often than one every 10 minutes may mean the woman is in labor.
• Many women are told to leave for the hospital when contractions are 5 to 10 minutes apart or if there is bleeding or leaking of amniotic fluid.
• If your physician believes continuing the pregnancy might harm you or your baby, he or she may induce labor. Induction of labor often involves chemical or physical stimulation. Techniques include:
• Physical stimulation to loosen the amniotic sac from the uterine wall
• Rupturing the membranes with a special tool
• Administering a drug to start labor, either by giving it intravenously (oxytocin) or into the vagina (prostaglandins)
• Putting It All Together
• Provided by YourMedicalSource.com
• Here is a summary of the important facts and information related to pregnancy:
• Having a baby is one of the most important events in a woman's life. Most women worry about whether the baby they are carrying is healthy.
• Early and regular prenatal care is the best insurance against problems in pregnancy.
• Prenatal tests usually assure the parents that the pregnancy is progressing normally and allow doctors and parents to spot problems early.
• If a woman is concerned about the health of her baby, she should immediately discuss it with her physician. Tests can often alleviate any concern.

Post Delivery

Postpartum Needs: A Checklist

Here is a sample list of typical postpartum needs. Your own list will depend on many variables; for example, it will be much more extensive if you have other children or are a single parent. At a bare minimum, you will need someone to:

• Prepare dinner for you for at least five days (ideally ten).
• Do your laundry for at least five days.
• Pick up major housecleaning once a week for six weeks.
• Go food shopping for at least five days.
• Be an errand person on short notice for the first week (a must if your partner will be back at work).

Provide one-on-one care for the first five days minimum. This depends on the circumstances of the birth; if your birth is in any way traumatic, you will need seven to ten days of care. This can be your partner, but if he will be at work or you are single, you must find someone else.

How to handle the postpartum requirements

Some women freeze enough meals to last a week and stock the house with non-perishables. Nevertheless, you'll still need fresh items, and someone to run for these. Often the father is willing, although he may be loathed to leave you and the baby for very long.

Help with the laundry is a must, particularly if you are washing diapers. Regarding the housecleaning, note the extended period recommended for assistance. Believe me, that's being conservative; ideally, you would have someone weekly for the first year or more. The last thing you'll want to do with a few precious moments when the baby is finally asleep is to spend them mopping the floor!

Your immediate family is an ideal source of postpartum support, but it must not be your only one. The family has by nature a somewhat limited scope, with inbred attitudes and beliefs generally made more extreme by stress. As there is almost no time in your life more stressful than the early weeks with a newborn, you will need the objectivity of those outside your family unit, even if you must deliberately seek it out.

The bottom line in dealing with family members is to be honest and clear about what you do and do not want, and what you can and cannot handle. Be specific; if Mom offers to help, go ahead and ask her to take out the trash, scrub the toilet, whatever. And do be realistic about your emotional state at this time; your explosive and depressive tendencies, and your outright limitations. It is not the end of the world if you have an angry outburst; your mother is old enough to understand and should be able to fend for herself.

My sample support system

When I had my last baby, my husband and I were living with my two teenagers in a fairly small house. I had a rather long labor, so my mother offered to come and help out for a while. After thinking it over, she decided to stay at a nearby motel. She could afford it and didn't mind as long as she could get to know her newest grandson. She was over every morning at 8:00 (unless we requested otherwise) and left in the evening. Several nights she made dinner early and took the older kids back to her place to eat, so my husband and I could have some privacy. She did laundry, and cleaning and was totally there for me emotionally. The length of her visit had been open-ended from the start; she ended up staying for two weeks. Looking back, this was a very precious time for us and was one of the greatest gifts she has ever given me.

Post-Birth Activity

What Habits Should I Keep Up After My Baby is Born?

Provided by National Institute of Diabetes and Digestive and Kidney Diseases

Following healthy eating and physical activity habits after your baby is born may help you return to a healthy weight more quickly, provide you with good nutrition (which you especially need if you are breastfeeding), and give you the energy you need. You can also be a good role model for your growing child. After your baby is born:

Continue eating well. Eat a variety of foods from the five food groups. If you are not breastfeeding, you will need about 300 fewer calories per day than you did while you were pregnant.

If you are breastfeeding, you will need to eat about 200 more calories a day than you did while you were pregnant. Breastfeeding may help you return to a healthy weight more easily because it requires a great deal of energy. Breastfeeding can also protect your baby from illnesses such as ear infections, colds, and allergies, and may help lower your risk for breast and ovarian cancer.

When you feel able and your health care provider says it is safe, slowly get back to your routine of regular, moderate physical activity. Wait for 4 to 6 weeks after you have your baby to begin doing higher levels of physical activity. Doing physical activity that is too hard, too soon after delivery, can slow your healing process. Regular, moderate physical activity will not affect your milk supply if you are breastfeeding.

Return to a healthy weight gradually. Lose no more than 1 pound per week through a sound eating plan and regular physical activity after you deliver your baby.

Weight Loss After Pregnancy

• Post-Delivery: Why Return to a Healthy Weight?
• Provided by National Institute of Diabetes and Digestive and Kidney Diseases
• Why should I try to return to a healthy weight after delivery?

After you deliver your baby, your health will be better if you try to return to a healthy weight. Not losing weight after your baby is born may lead to overweight or obesity later in life, which may lead to health problems. Talk to your healthcare provider about reaching a weight that is healthy for you.

Be good to yourself

Pregnancy and the time after you deliver your baby can be wonderful, exciting, emotional, stressful, and tiring, all at once. Experiencing this whirlwind of feelings may cause you to overeat, not eat enough, or lose your drive and energy. Being good to yourself can help you to cope with your feelings and to follow eating and physical activity habits for a healthy pregnancy, a healthy baby, and a healthy family after delivery. Here are some ideas for being good to yourself:

1. Try to get enough sleep.
2. Rent a funny movie and laugh.
3. Take pleasure in the miracles of pregnancy and birth.
4. Invite people whose company you enjoy to visit your new family member.
5. Explore groups that you and your newborn can join, such as "new moms" groups.
6. Postpartum Depression

What Is Depression After Pregnancy?

Depression after pregnancy refers to the negative thinking and feelings of despondency that many women experience after the birth of a child. In addition to the sad, lifeless feelings that accompany any depression, women who suffer from depression after pregnancy often fear that their baby will somehow be harmed and may worry that they are "bad" mothers.

Depression after pregnancy may be mild, moderate, or severe, and may be temporary or long-lasting. But it is treatable, manageable, and in some cases, preventable. Depression after pregnancy is generally divided into three types:

The baby blues, also called maternity blues, natal blues, or postpartum blues, is a temporary "down" period common among new mothers. Tearfulness, fatigue, irritability, difficulty sleeping, mood swings, and other signs of the baby blues usually begin one to two days after birth and may last up to three weeks.

Postpartum depression is a mood disorder characterized by negative thinking patterns and feelings of hopelessness, sadness, and despondency. Unlike the temporary baby blues, postpartum depression deepens and lasts beyond the first month after birth. The new mother may feel like she has fallen into a dark hole, have obsessive thoughts, and find herself unable to shake troublesome worries.

Postpartum psychosis is a rare form of postpartum depression that affects one in every thousand women. It usually begins within three to ten days after a woman gives birth. These women experience a break from reality: they may lose weight quickly without dieting, go without sleep for more than 48 hours, or experience delusions and hallucinations. Postpartum psychosis is a crisis that requires immediate professional intervention.

Need To Know:

Although depression after pregnancy usually appears shortly after childbirth, it can begin at any time during the first year. If symptoms occur after the first months, they may be more subtle and difficult to detect. Spouses or family members may notice changes before the new mother does.

Nice To Know:

Q. Instead of feeling happy after my baby was born, I cried constantly and felt terribly anxious. What's normal and what's not?

A. Normal reactions include irritability, anger, crying, exhaustion, tension, restlessness, anxiety, and insomnia, all of which appear about three days after birth and may last for about two weeks. If these symptoms worsen and extend beyond a few weeks, you may be experiencing true postpartum depression and should consult a physician or other health care professional.

Q. I was fine for the first month after my baby was born. Then I began feeling terrible. Is this the baby blues?

A. At least half of new mothers get the baby blues, a mild form of depression that begins a few days or a week after delivery and usually lasts no more than two weeks. Since you started feeling low about six weeks after delivery, it may be true postpartum depression, which can last from two weeks to a year. It is less common, affecting 10 to 20 percent of new mothers. Best to consult your physician.

Facts about postpartum depression:

• At least half of all new mothers experience some form of postpartum depression, usually temporary baby blues.
• True postpartum depression affects 10 to 15 percent of women who give birth.
• One in one thousand women who have a child will suffer from postpartum psychosis.
• Women who have several children can suffer postpartum depression after the birth of any child, whether it be their first or tenth.
• Although postpartum depression has been discussed since ancient times, it has only been recognized as a treatable condition since the mid-1980s.
• Steps can be taken to prevent postpartum depression before the baby arrives.
•  Baby Gear Guide

Planning for a baby can be both exciting and anxiety-producing -- but it can also be fun, as you prepare to welcome a new life into your home. We've provided some checklists to help you organize your needs.

Remember: No list can be perfect for every household or parent. We recommend you review these ideas and select the items you think will work for your family, but don't buy too much in advance. You will have a better idea of what you need and what makes your baby comfortable after she or he is born. You may also receive hand-me-downs or gifts that can supplement your purchases.

Baby's First Wardrobe

• Organizing some clothes for the baby may give you a sense of order in the last few hectic weeks of your pregnancy. Wash items before the baby wears them, but you may want to wash only one or two of each type of item to start -- you may find that certain styles or sizes aren't right for you and your baby. Save your receipts, so you can return unwashed, unworn items to the store.
• Look for easy-care clothes that provide access to diaper changes. Don't overbuy fancy garments; you'll find that your baby spends much more time in sleepwear, even outside the house. And you're likely to get a few cute going-out outfits for gifts.
• Newborn sizes are too small for most babies unless they are premature or low-weight. Size 3 months is actually designed to fit newborns up to 3 months of age; size 6 months is for babies aged 3-6 months, and so on.
• Obviously, clothing needs will vary depending on climate and season. You should adjust the following list to add or remove some warmer items as needed.
• 3 short-sleeve snap shirts, size 3 months
• 3 long-sleeve snap shirts with mittens over hands, size 3 months
• 2 snap or lap-shouldered shirts, size 6 months
• 4 onesies, size 3 months or small
• 2 onesies, size 6 months or medium
• 1-2 baby gowns
• 3 stretchy sleepers, size 3 months
• 3 stretchy sleepers, size 6 months
• 1 blanket sleeper (bag-style will fit for a longer period)
• 2 pairs of crew socks, size newborn
• 6 pairs of crew socks, size small
• 1-2 loose cotton sweaters
• 1-2 soft hats or bonnets
• 1-2 special outfits
• 2-4 small baby bibs -- to protect clothing from drool or spit-up
• 2-4 receiving blankets
• 12 plain cloth diapers -- to use as burp clothes and to cover surfaces under your baby's head (such as in a car seat or carrier)

Toiletries And Diapers

• With a baby on the way, consider stocking your bathroom with some of these common baby toiletries.
• Bathing and grooming: The basics
• Baby bathtub -- a plastic unit to sit in a tub or on the counter; look for an infant insert, non-skid surface, and drainage plug
• No tear or organic/natural baby shampoo
• Baby liquid soap
• Baby comb and brush
• Baby manicure set -- including nail scissors, toenail clippers, gentle files
• 2 hooded towels
• 4 baby wash clothes
• Bathing and grooming: Possible Extras
• Baby-safe bath toys
• Bath toy bag or tray
• Bath seat -- for older babies who like to sit up in the tub
• Baby visor -- to keep water and soap out of baby's face
• Water temperature gauge -- a bath thermometer or bath mat that alerts you if the temperature is too hot
• Spout protector -- some double as a bubble bath maker
• Plastic cushion pad -- for you to kneel on by the side of the bath
• Medicine cabinet: The basics
• Rectal thermometer -- for the most accurate temperature reading in infants
• Petroleum jelly (Vaseline) -- to lubricate the thermometer
• Liquid infant formulations of acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) -- to relieve pain and fever
• Nasal aspirator -- to remove mucus from an infant's stuffy nose
• Saline nasal drops -- to loosen nasal congestion
• Medicine cabinet: Possible Extras
• Natural colic relievers, such as Hyland's
• Pacifiers and pacifier clips
• Diaper supplies: if using disposables
• 2 packages of size newborn
• 2 packages of size small

Hint on disposable diapers: Don't buy too many of any one brand until you have the chance to experiment and see which brands fit your baby best. Also, your preferred brand may change as your baby grows and changes shape.

Diaper supplies: if using cloth

• 60-80 small cloth diapers if you're using a diaper service (but check first to see if the service provides diapers); you may opt for fewer if you're washing them yourself
• Diaper wraps with velcro in newborn, small, and medium size
• Diaper pins for extra protection
• Diaper changing supplies
• Changing area -- can be a specifically purchased changing table or any convenient surface with a secured, washable pad on top
• A small bottle of olive oil or baby oil -- helpful for cleaning baby's first few bowel movements, which tend to be black and tarry
• A small bottle of alcohol -- to clean the umbilical cord stub
• Sterile cotton balls -- apply oil or alcohol
• A small mirror, music box, mobile, or other distraction to calm baby during changes
• Extra receiving blanket -- newborns often don't like to be undressed, and covering part of the baby's body may make changes easier
• Wipes -- if using disposables, aim for a brand that contains little or no alcohol and perfumes; or for reusables, have a supply of cotton washcloths or small cloth diapers to be wet with fresh water
• Zinc oxide ointment to prevent diaper rash
• Diaper pail or diaper disposal unit, with a supply of plastic liners
• Diaper changing extras
• Electric wipe warmer
• Lap pads -- washable flannel-covered rubber pads to protect changing surface
• Diaper bag

You can use a sturdy backpack or purchase a specifically designed diaper bag with multiple compartments, a built-in changing pad, plastic lining, and easy zipper closing. Stock your bag with extra diapers, wipes, a change of clothing, an extra hat and pair of socks, some soft toys and/or rattles, plastic bags to put used diapers in, a small tube of ointment, and sealed hand wipes or gel for use on your hands. Add bottles, ice packs, formula packs, and other supplies as needed.

Breastfeeding Supplies

While breastfeeding is healthy and natural, it isn't necessarily easy! For many new mothers, it is hard, physical work. But the rewards are plenty, starting with excellent nutrition for your baby and unsurpassed quality time for both of you. Here are some suggestions for making your new nursing relationship more comfortable.

Nursing station:

Find a chair that fits you comfortably, supports your back and arms, and can be yours alone for those first few months. Some moms like to purchase or borrow a rocker or glider.

Find a good nursing pillow, to elevate your baby to the right position. You might use regular bed pillows, or you might prefer a special breastfeeding pillow that wraps around your body, supporting your arms, neck, shoulders, and back. Popular brand names include Boppy and My Brest Friend.

Don't skip the footrest. A footrest reduces stress on your legs and back and elevates your lap for a better baby position. You can purchase a specific nursing stool, use an ottoman, or just grab a cardboard box.

Keep a basket or tote bag near your chair, stocked with necessities; then you can easily move the basket or bag if you change your nursing location. Your basket might include a water bottle, non-perishable healthy snacks, magazines, a pen and pad to jot down lists and notes, a cordless phone, plain cloth diapers to catch spit-up, and an extra receiving blanket.

Other useful items for breastfeeding:

• Nursing bras. Try them on at your local maternity store to find one with clips you can manipulate easily with one hand.
• Nursing pads. Pads inside your bra help you avoid wet, milky marks on your clothing. You can buy washable pads of soft cotton or disposable pads.
• A nursing shawl. Some moms like a special shawl or cover-up for nursing in public.
• A tube of lanolin. Lanolin soothes and heals sore, tender, or chapped nipples.

Breastfeeding books or videos.

A visit with a lactation consultant. This is a great gift to give yourself: Sign up to have a professional lactation consultant come to your home, watch you nurse, and offer you advice and support.

Pumping supplies:

If you are interested in pumping and storing breastmilk, consider these supplies:

Breast pump. If you plan on pumping frequently, you can rent or buy efficient electric pumps, such as Ameda's Purely Yours or Medela's Pump in Style. For occasional pumping, many moms prefer hand-held battery-operated or manual pumps, such as the Ameda/Egnell One-Hand Breast Pump or the Avent Isis Breast Pump.

Sterile milk storage bags, clips or ties, and labels. For occasional pumping, you can store it directly in bottles.

Storage rack, bin, or box for the freezer.

Bottles and nipples. Consider four 4-ounce and two 8-ounce bottles to start. Nipples come in different sizes, in varying rates of flow, and varying materials. Buy a few different kinds, and when you determine which works best for your baby, stock up on that brand. See our Bottlefeeding Supplies list for more suggestions.

Bottle brush and nipple brush.

Bottle warmers. These warmers are designed to heat frozen breastmilk easily without destroying the nutrients or leaving the milk too hot for the baby, or you can use a kitchen bowl and hot water.

Steam sterilizer. Some sterilizers are designed to use steam from the microwave; others are electric.

Bottlefeeding Supplies

No one bottle style or nipple is necessarily better than others -- what's best for you is the one your baby likes. Nipples, in particular, vary by material, shape, size, and rate of flow. Ask your healthcare provider for a recommendation, or try the samples from your delivery center or hospital. When you find one that suits you and your baby, stock up on that brand. Nipples deteriorate with use and will need to be replaced every three to four months. You will know the nipple is in need of changing when the formula flows out in a stream instead of a slow, steady drip, or when the nipple thins, discolors, swells, cracks, tears, or gets sticky.

The basics:

• 6 plastic 8-ounce bottles
• 6 plastic 4-ounce bottles
• Disposable bottle liners, if you choose that type of bottle
• 12 nipples and collars
• 6-12 bottle covers/caps
• Bottlebrush and nipple brush
• Dishwasher basket and/or drying rack for bottles, nipples, and collars
• Large liquid measuring cup for mixing powdered formula
• Infant formulas as recommended by your pediatrician
• 1-2 cold packs and an insulated container for traveling with premade bottles

Bottlefeeding extras:

• Bottle warmer
• Automobile bottle warmer; this plugs into the lighter opening on your dashboard

Furniture And Linens

• Many families set aside a room or part of a room as the baby's own. For that, you may want some or all of the following items.
• Bedroom furniture: The basics
• Bassinet or cradle for the first few months
• Bedside sleeper -- for families who intend to co-sleep, this compact unit fits flush against the adult bed, with padded rim sides for the remaining three sides
• Crib -- verify your purchase meets these safety standards:
• no more than 2 3/8 inches between bars or slats
• no cracked wood or peeling paint
• steel stabilizer bars in the frame
• rail height at least 22 inches when the mattress is at its highest position
• adjustable mattress level
• teething rails covered with plastic

Crib mattress -- verify your purchase meets these safety standards:

• firm
• fits snugly into the crib, with no more than two adult finger-widths of space between the mattress and crib
• Chest of drawers (surface can double as changing area)
• Changing table -- look for a comfortable height and a secured or snug-fitting waterproof pad with a strap to hold the baby securely
• Rocker or other comfortable chair where you can sit while feeding or holding the baby
• Bedroom Linens
• Waterproof mattress cover
• 2-4 fitted quilted pads
• 2-4 waterproof sheets or bassinet or crib pads (washable flannel-covered rubber pads)
• 2-4 bassinet or crib sheets
• 2-4 crib bibs -- to go under baby's head and catch spit-up or drool; alternatively, you can use a flannel-covered rubber lap pad or a plain cloth diaper under baby's head
• Crib bumpers -- optional pads to cushion crib sides; for safety, these should not be puffy, and they should be removed when the child is able to pull himself up and might use the bumpers as a stepping tool to climb out
• Crib dust ruffle and baby comforter -- optional decorative items
• Bedroom Extras
• Lamp
• Night light
• Baby monitor
• Mobile(s) to go over crib and/or changing table -- remove or raise these before the baby is able to grab them
• Baby mirror to attach to crib
• Black and white toys
• Vaporizer or humidifier
• For other rooms
• When a baby isn't asleep, he or she may enjoy some of these safe-seating options:
• Bouncing seat. This portable infant seat supports the baby in a half-sitting position. The baby's own motion makes the seat rock or bounce gently. The seat should have straps to secure your child and a removable, washable liner. Some easily disassemble so the pieces can be packed for travel.
• Exersaucer. This stationary seat, safer than a walker, allows the baby to stretch and use his or her legs and to practice standing. It comes with a circular tray with toys.
• Motorized baby swing. A swing can calm a baby and provide some downtime while the parents eat dinner or do chores. The swing should have a wide, stable base and a seat belt. Some come with cradle attachments for newborns; the cradle or seat may double as a carrier.
• Portable crib. This lightweight playpen/crib is designed to fit through doors (for easy moving between rooms) and to fold quickly and easily into its own carrier for travel. It can make a secure place for a child to play or sleep in an otherwise unsafe room or when traveling. More expensive versions include bassinet inserts (for infants under 15 pounds) or changing station inserts. Before putting your child in one, make sure you thoroughly read the instructions, and that all four sides are securely locked and the floor is taut and flat.

First-Aid Kit

Accidents do happen -- and when they do, a well-stocked, easy-to-locate first-aid kit will streamline your emergency response. Consider these steps to building a personalized kit.

Gather phone numbers

Write down the phone numbers for the following, and tape this information inside your kit (and by every telephone in the house):

Your health care providers and the nearest hospital

Nearby relatives or neighbors who can provide immediate assistance (such as childcare for a sibling or a ride to the hospital)

Poison Control Center

Local emergency services, if "911" is not available in your area

Your own cell phone number and your own home phone number, along with your address and the nearest cross street, in case a babysitter or someone else makes an emergency call from your home

Choose your container(s)

Select a container that is durable, simple to open, and easy to carry. Consider using a plastic art supply box or a plastic tackle box. You may decide to create a large kit for in-home use and a smaller one for the car or your diaper bag.

Many parents purchase a commercial, pre-packaged kit. While these kits are economical and compact, you should consider whether you need to add items that suit your family's specific needs. Plus, by stocking your own kit, you are more likely to familiarize yourself with the contents and their correct uses.

Assemble your kit

Consider which items of these are essential for your family:

Fever, infection, or pain:

1. Thermometer -- a rectal thermometer for infants, and an oral or ear thermometer for older children
2. Petroleum jelly (Vaseline) -- used to lubricate a rectal thermometer
3. Acetaminophen (Tylenol) and/or ibuprofen (Motrin, Advil) in infant or children's formulas -- to reduce fever and relieve pain; include the dosing chart from the box
4. Medicine dispenser -- most infant and children's medications come with a measuring and dispensing tool, but if not, consider a syringe, spoon, dropper, and/or medicine cup to administer medicine to your child
5. Rubbing alcohol wipes to clean thermometers, tweezers, and scissors

Congestion:

Nasal aspirator bulb syringe and saline nasal drops. Children's formula liquid decongestant or antihistamine, as directed by your pediatrician

Cuts/scrapes:

1. Hydrogen peroxide -- to clean cuts and scrapes
2. Sterilized cotton balls -- to apply the peroxide
3. Mild liquid soap or prepackaged baby-safe cleansing wipes -- to clean minor scrapes
4. Antibacterial cream and/or antibiotic ointment -- to minimize infections in cuts and scrapes
5. Adhesive bandage strips in various sizes and shapes -- choose a gentle, less-sticky type for children's skin
6. Gauze pads and/or rolls -- for cuts that are odd sizes; consider gauze rolls 1/2 to 2 inches wide as well as 2-inch-square and 4-inch-square pads
7. Adhesive tape -- to secure the gauze
8. Sharp scissors -- for cutting tape
9. Alcohol pads -- to clean scissors

Allergic reactions:

1. Diphenhydramine (Benadryl) in infant or children's formulas -- for minor allergic reactions and certain emergencies; consult your provider for use and dosage
2. Self-injectable epinephrine, if prescribed -- for children with life-threatening allergic reactions from bee stings, peanuts, or shellfish

Rashes/bug bites:

• Topical calamine lotion -- relieves minor itching due to poison ivy, rashes, or insect bites
• Hydrocortisone cream -- used for rashes or insect bites; ask your health care provider whether you need 1/2 percent or 1 percent formulation
• A rub-on stick of antihistamine, such as Benadryl -- easy to apply right on an insect bite (unlike a spray)

Ticks/splinters:

Tweezers -- clean before use with the alcohol pads

Breaks/sprains/aches and pains:

Heating pad

Ice pack -- consider a chemical ice pack that does not require freezing, as well as conventional ice packs for your freezer

Elastic bandages, such as ACE wraps -- for wrapping sprained joints or making a sling for a broken arm, wrist, or hand

Diarrhea:

Rehydration fluids, such as Pedialyte -- use only under the advice of your health care provider

Poison response:

Syrup of ipecac -- to cause vomiting after accidental ingestion of certain types of poison. Never use without calling Poison Control or your health care provider first and receiving specific instructions.

Over-the-counter activated charcoal -- also used for accidental ingestion. Again, use only when instructed by Poison Control or your provider.

Other helpful items:

• Plastic gloves
• Pen flashlight with extra batteries -- for checking ears, nose, throat, and eyes
• First-aid manual, with directions on performing CPR, printed out or bookmarked
• Warm blanket, stored near your kit
• Read and review

Read your first-aid manual now to familiarize yourself with emergency care and the use of the contents of your kit. Check your first-aid kit periodically and replenish any items that were used or have become outdated.

Car Seats And Strollers

Getting out and about with a newborn might seem challenging at first, but even just a walk around the block or a trip to the mall can refresh both you and your baby. Having equipment that works easily for you makes the difference between an excursion being a major troop movement or an easy jaunt. Following are some of your options.

Car seats

By law in the United States, all infants who are under one year old or weigh less than 20 pounds must be properly restrained in a rear-facing car seat. You have two buying choices:

Infant car seat: An infant car seat looks like a wide bucket with a carrying handle that swings up for use outside the car. In the car, it may be secured directly with the seat belt, or it may snap into a base, which itself is secured with the seat belt. The base is more convenient because it means you do not have to wrestle with the seat belt each time you put the seat in or out. The chief advantage of using an infant-only seat is that when your baby falls asleep in the seat -- as will often happen -- you can move the seat into or out of the car without unstrapping and waking the baby. When not in the car, the seat itself can double as a carrier, feeding chair, or rocking seat. Some come with wheeled bases that turn the seat into a stroller (see below).

Infant-toddler car seat: An infant-toddler car seat (also called a convertible car seat) is larger and heavier, and it is designed to stay in the car, secured with a seat belt. The chief advantage of the convertible seat is its longevity. For infants, the seat is positioned rear-facing; when the baby is both over 20 pounds and also over one year old, the same car seat can be repositioned facing forward, for use for several more years. In the early months, you may want to use a specially designed headrest or rolled-up receiving blankets, towels, or cloth diapers to support your baby's head and neck in this rather large seat.

Soft Carriers

Front-pack carriers have straps that go over the parent's arms and, often, across the back. Slings fasten over one shoulder with a double-ring closure. Both types allow a parent to carry the baby snugly on the chest or hip, with hands and arms free. One recommended brand of front pack is Baby Bjorn.

Strollers

Strollers come in several varieties; your best choice depends on the age of your baby, where you expect to use it, and your needs for portability or durability. When buying a stroller, ask these questions:

1. Is the handle the right height for the primary user?
2. Is it easy to roll, steer, and turn one-handed?
3. Is it easy to fold, lift, and move one-handed?
4. Does it have a sun or rain shield?
5. Does it have storage space?
6. Do all its wheels swivel and have brakes?
7. Does it have a warranty? Will the store repair it if a part breaks?
8. Does it have the Juvenile Products Manufacturers Association (JPMA) certification?

Your stroller options include the following:

Carriage strollers: For a new baby, you use this type of stroller in the carriage position, which enables the baby to lie down facing the parent. When the baby gets older, you reverse the direction of the handle, and you have a conventional stroller with a seat that can be set to an upright or reclining position. The chief drawback to these strollers is their weight; they can be cumbersome to fold and carry. Styles with lighter aluminum frames are available but cost more.

Upright stroller: This conventional stroller has only a sitting position and therefore is more appropriate for older babies who can sit up comfortably. It is lighter and easier to handle than a carriage stroller, but sturdier than an umbrella stroller. It folds flat but does not collapse into a narrow shape.

Umbrella stroller: This lightweight and inexpensive version of the upright stroller folds up swiftly and neatly into a shape similar to an umbrella. Some city-bound families find it indispensable for its ease of going up and down steps and in and out of buses, taxis, or subways.

Jogging stroller: This expensive option features bicycle-like wheels and brakes. It is designed for long walks or runs on foot, not for errands that require getting in and out of cars or buses frequently.

Multi-seat stroller: Also called tandems, these double- and even triple-seaters are ideal for families with twins, triplets, or closely spaced siblings. Options include front-and-back models, side-by-side models (watch for tight doorways!), and also sit-and-stand versions that allow a younger child to sit and an older one to stand behind and ride.

Travel systems

For some families, a travel system is a practical choice. This product combines several options in one: It consists of a rear-facing infant car seat that snaps into a wheeled base to create a stroller. This enables a parent to move a sleeping child easily from car to stroller. A separate base remains secured in the car so that the parent can easily snap the seat into that base for car travel. The car seat also doubles as a carrier. As with any infant car seat, once the child reaches 20 pounds, you need to buy a front-facing car seat. You can then convert the stroller to a conventional upright stroller.

If you already own an infant rear-facing car seat, another versatile option is to purchase a separate stroller base -- a metal frame designed to turn a standard infant car seat into a stroller. The base cannot later be converted into a conventional stroller; however, it is lightweight and folds compactly. The combination is ideal for an airplane trip, as the folded base is small enough to stash under an airplane seat, while the baby remains in the car seat during the plane ride. This eliminates the need to carry both a stroller and a car seat on a plane. Recommended brand: Babytrend Snap N Go.

Childproofing

As your baby begins to crawl and walk, you will want to take stock of your home's safety. You may decide to keep certain rooms -- particularly those with tools or hobby equipment -- off-limits to the baby at first. For baby-safe rooms, you may opt to purchase a few safety items. Remember, though, that safety items and childproofing supplies are only a second level of defense. To protect your child's welfare, remove hazards, never leave a child unattended except in a crib or other controlled environment, and train him or her in safe behavior.

To help you in your babyproofing, look for these items at your local toy store, drug store, or baby supply store:

1. Covers for electrical outlets
2. Cord holders and shorteners to keep drapery and power cords out of reach
3. Corner guards for sharp-edged end tables and cocktail tables
4. Safety gates to block off rooms
5. Baby-safe locks for drawers, cabinets, appliances, and toilets
6. Stove knob covers to prevent children from turning on the heat
7. VCR cover to keep objects out of the tape slot
8. Doorknob covers to prevent children from entering off-limits rooms

Baby's First Library

Reading and babies -- what fun! While newborns can't talk or fully understand words, they do respond to sounds, melodies, and the rhythm of your voice. Babies also respond to your warmth and interest in playing and cuddling.

As you settle down to read with your baby, he or she may grab the book or even chew on it. (That's one reason for those sturdy board books!) But as you persist, your baby will learn to focus on the images in the book and screen out distractions. Over time, your baby will recognize and anticipate the pictures and the sounds that go with them. As your baby grows, she or he will enjoy leafing through familiar books independently and soon will toddle over to you, book in hand, to request a reading.

Following is a list of baby classics. Consider borrowing them from your local library, registering for some on your baby registry, or purchasing them yourself, either new or used. They are all guaranteed to delight babies and grown-ups alike.

Favorites by Eric Carle:

1. Brown Bear, Brown Bear, What Do You See?
2. Polar Bear, Polar Bear, What Do You Hear?
3. The Very Hungry Caterpillar
4. The Very Quiet Cricket
5. Papa, Please Get the Moon for Me
6. Essentials by Margaret Wise Brown:
7. Goodnight Moon
8. Big Red Barn
9. The Runaway Bunny
10. The Noisy Book
11. A Child's Good Night Book
12. Simple and soulful from Ezra Jack Keats:
13. Whistle for Willie
14. The Snowy Day
15. Peter's Chair
16. Pet Show
17. Apt. 3
18. Humorous animals from Sandra Boynton:
19. Moo, Baa, La La La
20. Doggies
21. Blue Hat, Green Hat
22. The Going to Bed Book
23. Barnyard Dance!

Early board books:

1. Touch and Feel series, by Deni Bown
2. Baby Faces series, by Roberta Grobel Intrater
3. My First Word Board Book, by Angela Wilkes
4. Pretty Brown Face, by Andrea Pinkney
5. Jamberry, by Bruce Degen
6. The Carrot Seed, by Ruth Krauss
7. Pat the Bunny, by Dorothy Kunhardt

Rhyming and repetition picture books:

1. Is Your Mama a Llama? by Deborah Guarino
2. Are You My Mother? by P.D. Eastman
3. Green Eggs and Ham, by Dr. Seuss
4. Caps for Sale: A Tale of a Peddler, Some Monkeys and Their Monkey Business, by Esphyr Slobodkina
5. Sheep in a Jeep, by Nancy Shaw
6. Here Come the Tickle Bugs! by Uncle Sillyhead III
7. Tumble Bumble, by Felicia Bond

Books about love:

1. Love You Forever, by Robert N. Munsch
2. The Kissing Hand, by Audrey Penn
3. All the Places to Love, by Patricia MacLachlan
4. Guess How Much I Love You, by Sam McBratney
5. Mama, Do You Love Me? by Barbara M. Joosse

Numbers and letters:

1. Dinner at the Panda Palace, by Stephanie Calmenson
2. Ten, Nine, Eight, by Molly Bang
3. Chicka Chicka Boom Boom, by John Archambault
4. Dr. Seuss's A B C, by Dr. Seuss
5. I Spy Little Letters, by Jean Marzollo and Walter Wick

Just plain fun picture books:

1. Harold and the Purple Crayon, by Crockett Johnson
2. Frederick, by Leo Lionni
3. The Giving Tree, by Shel Silverstein
4. Corduroy, by Don Freeman
5. Blueberries for Sal, Robert McCloskey
6. Peek-A-Boo! by Janet and Allan Ahlberg
7. Good Dog, Carl, by Alexandra Day

COURTESY: http://health.yahoo.com/centers/pregnancy/506