What to Expect the First Year (26 page)

Ready to pop a cork, add an extra shot to your latte, or order your burger rare after 9 months of a job (and meat) well done? Go ahead—you earned it. Just remember that while breastfeeding moms definitely have more wiggle room when it comes to diet and lifestyle, there are still some substances that are smart to avoid or cut back on while you're nursing your little one. Fortunately, many are the same ones you probably already weaned yourself off of in preparation for or during pregnancy—so you're not likely to have new habits to kick or curtail.

Nicotine.
Many of the toxic substances in tobacco enter the bloodstream and eventually your milk. Heavy smoking (more than a pack a day) decreases milk production and can cause vomiting, diarrhea, rapid heart rate, and restlessness in babies. Though the long-term effects of these toxic substances on your baby aren't known for sure, it's safe to speculate that they aren't positive. On top of that, it is known that secondhand smoke from parental smoking can cause a variety of health problems in offspring, including colic, respiratory infections, and an increase in the risk of SIDS (
click here
). So talk to your doctor about getting the help you need to quit. If you can't manage to stop smoking, your baby is still better off being breastfed than being formula-fed. However, do try cutting back on the number of cigarettes you smoke each day, and don't smoke just before breastfeeding.

Alcohol.
Alcohol does find its way into your breast milk, though the amount your baby gets is considerably less than the amount you drink. While it's probably fine to have a few drinks a week (though no more than one in a single day), it's smart to limit your consumption of alcoholic drinks in general while nursing.

Heavy drinking comes with some serious risks when you're breastfeeding. In large doses, alcohol can make baby sleepy, sluggish, unresponsive, and unable to suck well. In very large doses, it can interfere with breathing. Too many drinks can also impair your own functioning (whether you're nursing or not), making you less able to care for, protect, and nourish your baby, and can make you more susceptible to depression, fatigue, and lapses in judgment. Also, excesses in alcohol can weaken your let-down reflex.

If you do choose to have an occasional drink, sip it right after you nurse, rather than before, to allow a couple of hours for the alcohol to metabolize. If you're not sure if your body has metabolized the alcohol by the time you're ready for a next feeding, you can test your breast milk using Milkscreen: Just dip the plastic strip that comes with the kit into expressed milk, wait 2 minutes, and check to see if the test pad on the end of the strip turns colors. If it has,
it means there's still alcohol present (and that means you should reach into the freezer for some stored breast milk instead).

Caffeine.
One or two cups of caffeinated coffee, tea, or cola a day won't affect your baby or you—and during those early sleep-deprived postpartum weeks, a little jolt from your local coffee bar may be just what you need to keep going. More caffeine probably isn't a good idea because too many cups could make one or both of you jittery, irritable, and sleepless (enough said?). Caffeine has also been linked to reflux and colic in some babies. Keep in mind that since babies can't get rid of caffeine as efficiently as adults, it can build up in their systems. So limit your caffeine while you're breastfeeding, or switch to or supplement with caffeine-free drinks.

Herbal medications.
Although herbs are natural, they aren't always safe. They can be just as powerful—and in some cases, just as toxic—as some drugs. And as with drugs, chemical ingredients from herbs do get into breast milk. The problem is, few studies have been done looking at the safety of herbs, so little is known about how they affect a nursing baby. To add to the confusion, there are no rules for the distribution of herbs, and the FDA doesn't regulate them. Even herbs like fenugreek (which has been used for centuries to increase a nursing mother's milk supply and is sometimes recommended in small amounts by lactation consultants) can have side effects. So to play it safe (always a good policy when nursing your little one) ask your doctor before taking any herbal remedy. Think twice before drinking herbal tea or breastfeeding brews, too, which the FDA has urged caution on until more is known (ask the pediatrician if you're not sure). For now, stick to reliable brands of herbal teas that are thought to be safe during lactation (these include chamomile, orange spice, peppermint, raspberry, red bush, and rose hip, among others), read labels carefully to make sure other herbs haven't been added to the brew, and drink them only in moderation.

Chemicals in your diet.
Nobody goes out of their way to add more chemicals to their diet—and really, you don't have to go far too far to find them (additives, preservatives, artificial colors and flavors, pesticides and other residues on produce; hormones in poultry, meat, and dairy … it's a chemical jungle out there). Happily, it's easier than ever to stay away from chemical additives and chemical residues, because manufacturers are offering more and more products that are mostly or completely free of them. Since chemicals added to your diet are added to your breastfed baby's, it makes sense to steer clear from as many as possible, something you can do by practicing a little prudence—and a lot of label reading. As a general rule, try to avoid processed foods that contain long lists of additives, and try the following tips for safer eating:

• Sweeten safely. If you're looking to save calories without sparing sweetness, you have more options than ever. Stevia, Nectresse, Sunett, Splenda, and Equal/Nutrasweet are all considered safe during lactation (though it's best to use Equal in moderation, and avoid it entirely if you have PKU or your baby does). Agave can be used during lactation but in small amounts. Whey-Low, a refined sugar substitute (it's a blend of sucrose, fructose, and lactose but with many fewer calories than regular sugar), is safe during lactation (and it's not thought to be a problem
for the lactose intolerant, either). The one sweetener that's not sweet when you're breastfeeding: Sweet 'n Low (aka saccharine).

• Go organic. Certified organic fruits and vegetables are now widely available in supermarkets, as are organic dairy products and organic poultry, meat, and eggs, and products made with organic grains (like cereal and bread). Choose them whenever you have the choice (and can afford the usually steeper price), and you'll be minimizing the number of chemicals your baby is exposed to through your breast milk. But also realize that a certain amount of pesticides and other questionable chemicals will most likely end up in your diet, and thus your baby's, despite best efforts—and that small amounts are nothing to stress about. In other words, it isn't necessary to drive yourself crazy (or drive yourself all over town, or drive your marketing budget into uncomfortable territory) in order to fill your grocery cart with organic-only products. When organic isn't available, or if you just can't afford the extra cost, peel or scrub fruits and vegetable skins well (use produce wash for extra protection). Keep in mind that local produce usually contains lower levels of pesticides and preservatives than produce that must travel long distances—a good reason to visit a farmers market, or even to grow your own.

• Stay low-fat. As it was during pregnancy, it's smart to choose low-fat dairy products, as well as lean meats and poultry without the skin, for two reasons. First, a low-fat diet will make it easier to shed your pregnancy weight gain (something you're likely eager to do). Second, the pesticides and other chemicals ingested by animals are stored in their fat (and in their organs, such as liver, kidneys, and brain, which is why you should eat these meats only rarely while you're breastfeeding). Going lean means you'll be avoiding more of those chemicals. Since organic dairy, poultry, and meat products don't pose the same potential risk, select them when you can, especially when you're reaching for a higher-fat variety.

• Fish selectively. The same EPA guidelines on fish safety that apply to pregnant women apply to breastfeeding ones. So to minimize your (and your baby's) exposure to mercury, avoid eating shark, swordfish, king mackerel, and tilefish, and limit your consumption to 6 ounces per week of tuna (chunk light tuna contains less mercury than tuna steaks and canned albacore) and 12 ounces (total) per week of salmon (wild is best), sea bass, flounder, sole, haddock, halibut, ocean perch, whitefish, pollack, cod, tuna (canned is safer than fresh), butterfish, catfish, crab, mussels, scallops, calamari, and farm-raised trout. Anchovies, clams, tilapia, sardines, and shrimp are low in mercury and can be eaten while breastfeeding as well. Wondering whether going fish-free might be a healthier option for you and your baby? Actually, guidelines recommend that breastfeeding moms eat a minimum of 8 ounces per week of low-mercury fish, since the nutrients found in seafood (especially fatty fish like salmon and sardines) have been shown to boost a baby's brainpower.

Want some really good fish news? Sashimi, raw oysters, and rare salmon can be ordered up again.

Prenatal development (from microscopic egg to cuddly newborn) may be a tough act to follow—but the first 12 months of your baby's developmental life (taking your little one from tiny blob to buzzing, busy toddler) will be pretty impressive, too. Make that mind-blowing—hard to believe, and amazing to watch. Your little one's large motor skills will progress at an astonishing pace—first head control and then progressive body control (rolling over! sitting! cruising!). Sensory and thinking skills (baby brain power) will soar—at first your newborn will turn toward a sound or to watch someone's face, but by year's end baby will be copying sounds and actions. Coos will evolve to babble and then to real words. Small motor skills will be finessed—holding a rattle at first with a full fist, then neatly snatching up a small piece of food with chubby thumb and tiny index finger.

These developmental milestones follow roughly the same timeline for most babies in the first year, but the pace and pattern of development is far from uniform. Some 5-month-old babies may be sitting pretty (and unsupported) while others haven't even rolled over yet. Some 10-month-olds may be walking up a storm, others talking up a storm, and some are taking their sweet time with both. Some babies may speed ahead early in most departments, while others get a later start, eventually catching up or even zipping past. Some babies are relatively consistent in their pace of development while others develop in fits and starts. Illness or a major change in baby's life can temporarily throw development off pace altogether. But most of the time, what's normal developmentally is what's normal for your one-of-a-kind baby.

If babies are all over the map developmentally, why bother mapping development at all? Developmental norms are useful for comparing your baby to a broad range of normal infants in order to assess his or her progress and to make sure your baby's development is on target. Or for comparing your baby's
rate of development one month to the next—to see if he or she is holding steady, lagging a little, or racing ahead. Your doctor will also look for certain milestones at each well-baby visit, to be sure that your baby's development fits within the (very) wide range of normal for his or her age.

Your baby, like every baby, is one of a kind—incomparable, really. Which is why comparing your baby with the baby down the block or an older sibling can be misleading—and sometimes, unnecessarily stressful. So can obsessing over developmental timelines. As long as your baby is reaching the majority of milestones on time, his or her development is on target—which means you can sit back and marvel at those amazing achievements instead of analyzing them. If, on the other hand, you notice that your baby is consistently missing milestones or seems to be suddenly slipping significantly in development—or if you have that gut feeling that something isn't right—check in with the doctor. Most likely there's no problem at all (some babies just move forward on a slower-than-average pace), and you'll get the reassurance you're looking for. If a lag is identified, the right intervention will help your little one maximize his or her developmental potential.

Not interested in seeing where your baby falls out on the developmental timeline? That's perfectly fine. Timelines aren't a must-do—especially if your little one is regularly being assessed at well-baby visits. Let your baby do the developing and leave the screening to the doctor.

For more on developmental milestones, go to
WhatToExpect.com
.