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A practical guide to the first three years

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9Zh^\cArthur Brown, Peter Cooling, Tish Jones
:Y^idg^Va Jemima Dunne

Dorling Kindersley
8dchjaiVci:Y^idg Jinny Johnson
BVcV\^c\:Y^idgh Penny Warren, Esther Ripley
BVcV\^c\6gi:Y^idg Marianne Markham
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HZc^dgEgdYjXi^dc:Y^idg Jenny Woodcock
EgdYjXi^dc8dcigdaaZg Alice Holloway
8gZVi^kZIZX]c^XVaHjeedgi Sonia Charbonnier
?VX`Zi9Zh^\cZgCharlotte Seymour
JHBZY^XVa8dchjaiVci Aviva Schein, MD
JH:Y^idgh Shannon Beatty, Beth Hester

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I’ve learned a lot about babycare in the last five years or so. The
lessons have come from my children (four sons), my stepchildren
(two daughters), my daughters-in-law, and my 11 grandchildren.
The basics of child development and the principles of baby and
child nurturing change little, but there’s room for progress and
improvement in all sorts of subtle ways. Some of these just nudge
us in a different direction while others seem so fundamental we
ask ourselves what took so long.
I’m grateful to all the new members of my extended family
for all of them have taught me something useful—even the
youngest, Maggie and Evie, my identical twin granddaughters.
It’s been thrilling to listen to, observe, note, learn, and inwardly
digest the hundreds of small things that have refined my thinking
about baby and childcare. They’re all reflected in this new edition
of one of my favorite books.
  8dciZcih
Introduction 8
1 The newborn 20
2 Equipment 32
3 Clothing 40
4 Holding and handling 50
5 All about diapers 58
6 Bathing and hygiene 70
7 Feeding 86
8 Bowel and bladder function 132
9 Sleeping 142
10 Crying 158
11 Physical development 178
12 Intellectual development 206
13 Social behavior 236
14 Playing 264
15 Outings and travel 282
16 Home safety 292
17 Home medicine 308

Index 344
Acknowledgments 352
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There must be parents who feel nothing but joy at the news that they
are expecting a baby, but they are few and far between. Once the initial
excitement is over, most parents would confess to having mixed feelings
about the prospect of having a baby.
Your fears are natural
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INTRODUCTION 11
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INTRODUCTION 15
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16 INTRODUCTION
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INTRODUCTION 19
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 I]ZcZlWdgc
Soon after delivery, your baby will be examined and his weight, head
circumference, and length will be measured in order to form a baseline
against which his future development will be assessed. Don’t try to compare
your baby with others; doctors and midwives don’t. The only comparisons
that should be made are with himself at different stages. The average birth
weight is 5 pounds 8 ounces–9 pounds 12 ounces (2.5–4.5 kilograms),
but if your baby is smaller, don’t worry. The normal range varies according
to genetics, race, and nutrition. The average length of a new baby is
19–20 inches (48–51 centimeters), but again big variations are common.

Physical impressions
The head
Size I]ZVkZgV\ZcZlWdgcWVWn¼h]ZVY
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Shape NdjgWVWn¼h]ZVY^hjca^`ZanidWZ
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The fontanelle I]Z[dciVcZaaZ^hi]Zhd[i
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22 THE NEWBORN

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The skin
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PHYSICAL IMPRESSIONS 23
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nZaadle^\bZciXVaaZYW^a^gjW^c!^cXgZVhZh^c
i]ZWaddYVcYXVjhZhi]Zh`^cVcYZnZhid
Xdadg#E]nh^dad\^XVa_VjcY^XZh]djaYXaZVgWn
i]ZZcYd[i]Z[^ghilZZ`!Vhadc\Vhi]Z
WVWn^h[ZZY^c\lZaa#
The umbilicus
>bbZY^ViZanV[iZgW^gi]i]ZjbW^a^XVaXdgY
^h XjiVWdji(·)^cX]Zh-·&%XZci^bZiZgh
[gdbi]ZWVWn¼hVWYdbZc#EgZhhjgZ^h
ZmZgiZYdc^iWnVXaVbeVcYi]Zhijbe
h]g^kZahVcYYgdehd[[l^i]^c&%YVnhdghd#
HdbZWVW^ZhYZkZadejbW^a^XVa]Zgc^Vh
hbVaahlZaa^c\hcZVgi]ZcVkZa!Wjii]ZhZ
cZVganValVnhXaZVgjel^i]^cVnZVg#>[ndjg
WVWn]VhdcZVcY^iZcaVg\ZhdgeZgh^hih!
X]ZX`l^i]ndjgeZY^Vig^X^Vc#
The breasts
7di]bVaZVcY[ZbVaZWVW^ZhXVc]VkZ
hldaaZcWgZVhihViW^gi]0i]ZnbVnZkZc
]VkZVha^\]iY^hX]Vg\Zd[b^a`#I]^h^h
XVjhZYWni]ZegZhZcXZd[bViZgcVa
24 THE NEWBORN
]dgbdcZh^ci]ZWVWn¼hWdYnVcY^i
gZhdakZhcVijgVaan#CZkZgignidhfjZZoZVcn
d[i]Zb^a`dji#I]ZhlZaa^c\l^aahjWh^YZ
l^i]^cVXdjeaZd[YVnh#
The genitals
I]Z\Zc^iVahd[Wdi]WdnhVcY\^gahVgZ
cVijgVaanaVg\ZgViW^gi]i]Vci]ZgZhid[
i]Z^gWdY^Zh#I]ZhXgdijbdgkjakVbVn
ZkZcadd`gZYVcY^c[aVbZY#I]^h^hV
cVijgVadXXjggZcXZVcY^hXVjhZYWni]Z
bdi]Zg¼h]dgbdcZhXgdhh^c\i]ZeaVXZciV
^cidi]ZWVWn¼hWaddYhigZVb#I]ZhZ
]dgbdcZhbVnVahdXVjhZVXaZVgdgl]^iZ
Y^hX]Vg\Z^c[ZbVaZWVW^Zh!VcYZkZcV
hbVaaVbdjcid[ kV\^cVaWaZZY^c\#DcXZ
V\V^c!i]^h^heZg[ZXiancdgbVaVcYl^aaXaZVg
COMMON BLEMISHES
Birthmarks
Quite commonly there are small red marks on a
baby’s skin, particularly on the eyelids, on the
forehead, and if you lift up the hair, at the back of
the neck just under the hairline. They result from the
enlargement of tiny blood vessels near the surface of
the skin and are traditionally called stork bites. Both
of my sons had them and they disappeared, as they
do in most children, by the time they were six
months old. In some babies, however, these marks
may not disappear until they are about 18 months.
Another common birthmark is the so-called
strawberry mark. This appears after a couple of days
but fades before the child is three years old. If you’re
at all worried by your baby’s birthmark, ask your
pediatrician for advice and reassurance.
Pimples
It is not unusual for a baby to have small white
pimples over the bridge of the nose, called milia.
These pimples are not abnormal so never, ever
jecVijgVaanV[iZgVXdjeaZd[YVnh#
=dlZkZg!^[ndj¼gZViVaaldgg^ZYWni]^h!
XdciVXindjgYdXidg#
Stools
6WVWn¼h[^ghihiddahVgZjhjVaanYVg`\gZZc
VcYhi^X`nVcY]VkZkZgna^iiaZhbZaa#I]^h^h
WZXVjhZi]ZnVgZbV^canbZXdc^jb!l]^X]
^hY^\ZhiZYbjXjh[gdbi]ZbjXjh\aVcYh
^ci]ZWdlZa#>i^hi]Zdcan`^cYd[bdi^dc
ndjgWVWnl^aaeVhh[dgi]Z[^ghiild
dgi]gZZYVnh#<gVYjVaandkZgi]ZcZmi
i]gZZdg [djgYVnhndjl^aacdi^XZi]Vii]Z
hiddahX]Vc\ZXdadg#I]ZVeeZVgVcXZVcY
Xdch^hiZcXnd[i]Zhiddahl^aai]ZcYZeZcY
dcl]Zi]ZgndjgWVWn^h]Vk^c\WgZVhi"b^a`
dg[dgbjaVsee p.134#
squeeze them. They are caused by a temporary
blockage of the sweat glands and sebaceous glands
that secrete sebum to lubricate the skin. They nearly
always disappear after a few days.
Rashes
Many babies develop a skin condition called
FSZUIFNB
UPYJDVN. The baby’s skin becomes red and
blotchy, with small white bumps that appear and
disappear quite rapidly. The whole rash only lasts for
a couple of days and will disappear without
treatment. If you’re in any doubt, you should talk to
your pediatrician.
Body hair
Babies are born with varying amounts of hair, called
lanugo, on their bodies. Some babies have only a
soft down on their heads, others are covered in very
coarse hair over their shoulders and down their
spines. Both are quite normal, and the hair usually
rubs off soon after birth.

Newborn behavior
>[ndjXdcXZcigViZdcndjgWVWnVcY
dWhZgkZ]^bXVgZ[jaandkZgi]Z[^ghiilddg
i]gZZYVnhd[a^[Z!ndjl^aaWZXdbZ[Vb^a^Vg
l^i]cdgbVa^c[VciWZ]Vk^dgVcYl^aa\Zi
VXXjhidbZYidndjgWVWn¼h^Y^dhncXgVh^Zh#
>i ^hZhhZci^Vai]VindjaZVgcidjcYZghiVcY
]^hh^\cVah0hiVnl^i]]^bVhbjX]Vh
edhh^WaZ!idlViX]]^b!cjghZ]^b!VcY
eaVnl^i]]^b#
>[ndjdWhZgkZ]^bXadhZanndjbVn
cdi^XZi]Vi]ZYdZhhZkZgVajcZmeZXiZY
i]^c\h/]ZbVnh]^kZgfj^iZhjYYZcan[dgcd
gZVhdc0]ZbVnbV`ZhdbVcnhcj[[a^c\
cd^hZhi]VindjldcYZg^[]^hcdhZVcYV^g
eVhhV\ZhVgZWadX`ZY0]ZbVnZkZchide
WgZVi]^c\Vaid\Zi]Zg[dghZkZgVahZXdcYh#
CdcZd[i]ZhZWZ]Vk^dgh^hVWcdgbVa#>ci]Z
[^ghilZZ`hd[a^[ZndjgWVWnl^aaWZ\^kZcV
]ZVg^c\hXgZZc^c\iZhiWni]Z]dhe^iVa#
Sounds
Breathing6cZlWdgcWVWn¼hajc\hVgZ
hbVaaVcYWgZVi]^c\l^aahZZbh]Vaadl
l]ZcXdbeVgZYiddjgh#L]Zcndj[^ghi
\didndjgWVWnndjbVnWZjcVWaZid
YZiZXii]Vi]Z^hWgZVi]^c\#9dc¼iWZ
[g^\]iZcZYWni]^hWZXVjhZi]ZWgZVi]^c\
l^aa\Zihigdc\ZgZVX]YVn#
6aacZlWdgcWVW^ZhbV`ZhigVc\Z
hdjcYhl]Zci]ZnWgZVi]Z#HdbZi^bZh
i]Z WgZVi]^c\^h[VhiVcYcd^hnVcYVidi]Zg
i^bZh^ibVnWZ^ggZ\jaVg#NdjgWVWnbVn
hcj[[aZl^i]ZVX]WgZVi]^cVcYdjiVcY
ndjbVni]^c`]Z]Vh\diVXdaY#I]^h^h
cdicZXZhhVg^anhd#>cbdhiWVW^Zh^i^h
WZXVjhZi]ZWg^Y\Zd[i]ZcdhZ^hadl!
VcY i]Zhcj[[a^c\cd^hZ^hXVjhZYWni]ZV^g
ign^c\id\Zii]gdj\]i]ZkZgnhbVaacVhVa
NEWBORN BEHAVIOR 25
eVhhV\Zh#6hndjgWVWn\gdlhdaYZg!i]Z
Wg^Y\Zd[i]ZcdhZl^aa\Zi]^\]ZgVcY
i]Z hcj[[a^c\hdjcYl^aa\gVYjVaanhide#
Dci]Zdi]Zg]VcY!^[^i^ciZg[ZgZhl^i]
ndjgWVWn¼h[gZZYdbidhjX` i]Zcndj
h]djaYiVa`idndjgeZY^Vig^X^VcdgcjghZ"
egVXi^i^dcZg!WZXVjhZ]ZbVncZZY
igZVibZcil^i]cdhZYgdehWZ[dgZ[ZZY^c\#
CdhZYgdehh]djaYdcanWZjhZYjcYZg
bZY^XVahjeZgk^h^dc#
Ndjh]djaY!]dlZkZg!WZXdcXZgcZY
VWdjindjgWVWn¼hWgZVi]^c\^[^iZkZg
WZXdbZhaVWdgZY!ZheZX^Vaan^[ndjcdi^XZ
i]Vii]ZX]Zhi^hWZ^c\h]VgeanYgVlc^c
l^i]ZVX]WgZVi]VcYi]ZWgZVi]^c\gViZ
]Vhg^hZcid+%dgbdgZWgZVi]heZg
b^cjiZ#6cnd[i]ZhZh^\chlVggVcih
^bbZY^ViZbZY^XVaViiZci^dcsee p.310#
Sneezing7VW^ZhVgZkZgnhZch^i^kZid
Wg^\]ia^\]ihVcYhdbZi^bZhhcZZoZ
l]ZcZkZgi]ZndeZci]Z^gZnZh[dgi]Z
[^ghi [ZlYVnh#I]^h^hWZXVjhZi]Za^\]i
hi^bjaViZhi]ZcZgkZhidi]ZcdhZVhlZaa
Vh idi]ZZnZh#NdjXVcigni]^hdji[dg
ndjghZa[i]ZcZmii^bZndj[ZZaVhcZZoZ
Xdb^c\dc/^[ndjadd`^cidVWg^\]i
a^\]indjl^aa[^cYi]VindjVgZVWaZid
egZX^e^iViZi]ZhcZZoZ#:kZc^[ndjgWVWn
^h hcZZo^c\Vadi^iYdZhc¼icZXZhhVg^anbZVc
i]Vi]Z]VhVXdaY#I]Za^c^c\d[VWVWn¼h
cdhZ^hkZgnhZch^i^kZ!VcYhcZZo^c\^h
ZhhZci^VaVh^iXaZVghdjii]ZcVhVaeVhhV\Zh
VcYegZkZcihYjhi[gdb\Zii^c\Ydlc^cid
i]Zajc\h#
HiccupsCZlWdgcWVW^Zh]^XXjefj^iZV
adi#I]^h^hcdgbVa!idd!VcY^ih]djaYc¼i
Wdi]Zgndj#=^XXjehVgZXVjhZYWnhjYYZc!
^ggZ\jaVgXdcigVXi^dchd[i]ZY^Ve]gV\b
26 THE NEWBORN
VcYVgZVh^\ci]Vii]ZbjhXaZh^ckdakZY^c
gZhe^gVi^dc¸i]dhZWZilZZci]Zg^Wh!i]Z
Y^Ve]gV\b!VcYi]ZVWYdbZc¸VgZ\Zii^c\
higdc\ZgVcYign^c\idldg`^c]Vgbdcn#
Reflexes and movements
6aacZlWdgcWVW^Zh]VkZgZ[aZmZh!l]^X]
VgZ^chi^cXi^kZbdkZbZcihYZh^\cZYid
egdiZXii]Zb#I]ZhZgZ[aZmZhaVhijci^a
kdajciVgnbdkZbZcihdcndjgWVWn¼heVgi
iV`Zi]Z^geaVXZ!\ZcZgVaanVgdjcYi]gZZ
bdci]hdaY#Ildd[i]ZbdhiZVhngZ[aZmZh
idZa^X^iVgZi]dhZi]ViegdiZXii]ZZnZhVcY
i]dhZi]VibV^ciV^cWgZVi]^c\/ndjgWVWn
l^aaXadhZ]^hZnZh^[ndjidjX]]^hZnZa^Yh
VcYl^aabV`Zhigj\\a^c\bdkZbZcihl^i]
]^h]VcYh^[ndj\Zcian]daY]^hcdhZ
WZilZZcndjgi]jbWVcY[dgZ[^c\Zg#
The rooting reflex>[ndj\Zcianhigd`Z
ndjgWVWn¼hX]ZZ`ndjl^aa[^cYi]Vi]Z
ijgch]^h]ZVY^ci]ZY^gZXi^dcd[ndjg
[^c\ZgVcYdeZch]^hbdji]#=ZbV`Zhi]^h
gddi^c\bdkZbZcil]Zc]Z^hhZVgX]^c\
NEWBORN REFLEXES
3PPUJOHTVDLJOH
SFGMFY
:PVS
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JOTUJODUJWFMZ
UVSO
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PG
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NPWF

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[dgndjgWgZVhiidhiVgi[ZZY^c\see p.91#
The sucking reflex :kZgnWVWn^hWdgc
l^i]i]ZgZ[aZmidhjX`VcYndjghl^aaWZ\^c
idYdhd^[hdbZi]^c\^heji^c]^hbdji]
dg^[ndjegZhhdci]ZjeeZgeVaViZ_jhi
WZ]^cYi]Z\jbh#HjX`^c\bdkZbZcihVgZ
ZmigZbZanhigdc\VcYi]ZnaVhi[dgfj^iZ
Vadc\i^bZV[iZgi]Zhi^bjaVi^dcidhjX`!
hjX]VhV[^c\ZgdgVc^eeaZ!]VhWZZc
gZbdkZY#>[ndjlVciidWgZVhi[ZZY^i^h
^bedgiVcii]Vindjejii]ZWVWnidi]Z
WgZVhiVhhddcV[iZgYZa^kZgnVhedhh^WaZ#
NdjgWVWn]Vhid\ZijhZYidi]ZVXijVa
iZX]c^fjZd[WgZVhi"[ZZY^c\!_jhiVhndjYd!
hd^i]Zaeh^[]Z]Vhi]ZedlZg[jaYZh^gZid
hjX`VhVhi^bjajh#
The swallowing reflex 6aaWVW^ZhXVc
hlVaadll]Zci]ZnVgZWdgc!hdi]ZnXVc
hlVaadlXdadhigjbdgb^a`^bbZY^ViZan#
The “walking” reflex 6cZlWdgcWVWn
l^aabdkZ]^haZ\h^cVlVa`^c\VXi^dc^[ndj
]daY]^bjeg^\]ijcYZgcZVi]i]ZVgbhVcY
aZi]^h[ZZiidjX]V[^gbhjg[VXZ#I]^h^hcdi
$SBXMJOH
SFGMFY
:PVS
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VQ
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DSBXMJOH
QPTJUJPO

XIFO
IFT
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PO
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TUPNBDI
8BMLJOHTUFQQJOH
SFGMFY
8IFO
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IPME
ZPVS
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VOEFS
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JO
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QPTJUJPO
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IJT

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B
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BDUJPO

i]ZgZ[aZmi]ViZcXdjgV\ZhVWVWnidhiVcY
jeg^\]iVcYlVa`see p.188#>[ndj]daY
ndjgWVWnjeg^\]iVcYaZii]Z[gdcid[]^h
aZ\h\ZcianidjX]i]ZZY\Zd[Vhda^Y
dW_ZXi!]Z¼aaVjidbVi^XVaanWg^c\]^h[ddije
^cV`^cYd[hiZee^c\bdkZbZci#
The “crawling” reflex L]ZceaVXZYdc
]^hhidbVX]ndjgcZlWdgcWVWnl^aa
VhhjbZl]ViVeeZVghidWZVXgVla^c\
edh^i^dc#I]^h^hWZXVjhZ]^haZ\hVgZhi^aa
XjgaZYjeidlVgY]^hWdYnVhi]ZnlZgZ
^cndjgldbW#L]ZcndjgWVWn`^X`h]^h
aZ\h]ZbVnZkZcWZVWaZidh]j[[aZ^cV
XgVla^c\bVccZgVcYbVnVXijVaanbdkZ
jeha^\]ian^c]^hXg^W#I]^hgZ[aZml^aa
Y^hVeeZVgVhhddcVh]^haZ\hjcXjgaVcY
]Z^hVWaZida^Z[aVi#
The startle or Moro reflex >[ndjgWVWn
]ZVghVadjYcd^hZXadhZid]^b!dg^[]Z¼h
WZZcgdj\]an]VcYaZY!]Zl^aai]gdl
dji]^hVgbhVcYaZ\h!l^i][^c\Zgh
djihigZiX]ZY!^cVcViiZbeiidXViX]dcid
.PSP
SFGMFY
4IPVME
ZPVS
CBCZT
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ESPQ
CBDL

IF
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UISPX
IJT
*G
ZPV
QVU
TPNFUIJOH

GPS
FYBNQMF
B
GJOHFS

JO

MJNCT
VQ
XJUI
GJOHFST
PVUTUSFUDIFE

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JU

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NEWBORN BEHAVIOR 27
hdbZi]^c\#=Z¼aaaZi]^ha^bWh[VaaWVX`
hadlanidlVgY]^hWdYnVcYl^aai]ZcWZcY
]^h`cZZhVcYXaZcX]]^h[^hih#I]^h^hVaVg\Z
dg¹\gdhhºgZhedchZidVhi^bjajhVcY
bVcncZlWdgcgZhedchZhVgZa^`Zi]^h#;dg
^chiVcXZ!l]Zcndjgndjc\WVWnhZZhndj!
]ZjhZhi]Zl]daZd[]^hWdYnid\gZZindj#
>i¼hdcanl]Zc]Z\ZihidVWdjiZ^\]idg
c^cZbdci]hdaYi]Vi]Zh^beanhb^aZhVcY
gZVX]Zhdji]^hVgbhidndj^cVbdgZ
bVijgZ\gZZi^c\#
The grasp reflex 6cZlWdgcWVWnl^aa
VjidbVi^XVaani^\]iZc]^h[^c\ZghVgdjcY
Vcni]^c\i]Vi^hegZhhZY^cidi]ZeVabd[
]^h]VcY#=ZXVc\gVhekZgni^\]ian!VcY
^bbZY^ViZanV[iZgW^gi]i]^hgZ[aZm^hhd
higdc\i]Vi]^hl]daZlZ^\]iXVcWZ
hjeedgiZY^[]Z\gVhehndjg[^c\Zgh#I]^h
gZ[aZm^hadhiWni]Zi^bZ]Z^h VWdjii]gZZ
bdci]hdaY#>[ndjidjX]i]ZhdaZhd[ndjg
WVWn¼h[ZZi!ndjl^aacdi^XZi]Vi]^hidZh
XjgaYdlclVgYVh^[id \g^ehdbZi]^c\#
(SBTQ
SFGMFY
TVSQSJTJOHMZ
UJHIUMZ
28 THE NEWBORN
Bonding
6cZlWdgcWVWnhaZZeh[dgbdhid[]^h[^ghi
YVnh!hdndjh]djaYheZcYVaad[]^hlV`^c\
i^bZl^i]]^b#GZhZVgX]]Vhh]dlci]Vi
e]nh^XVaXdciVXil^i]ndj!i]ZhdjcYd[
ndjgkd^XZ!VcYi]ZhbZaad[ndjgWdYn!VgZ
kZgn^bedgiVciYjg^c\i]Z[^ghi[ZlYVnhd[
a^[Z#9jg^c\i]^hi^bZndjgWVWn[dgbhV
WdcYl^i]ndjl]^X]!^[ZcXdjgV\ZY!^h
jc^fjZVcYjcWgZV`VWaZ#
I]^hWdcY^c\egdXZhh^hcVijgZ¼hlVn
d[Zchjg^c\i]ViX]^aYgZcVgZcjgijgZYVcY
i]Vii]Z]jbVcgVXZVhVl]daZhjgk^kZh#
=dlZkZg!^ci]ZcdgbVaXdjghZd[ZkZcih!
l]Zi]ZgndjVgZWgZVhi"[ZZY^c\dgWdiiaZ"
[ZZY^c\ndjgWVWn!]Zl^aaVjidbVi^XVaan\Zi
i]ZXadhZXdciVXi]ZcZZYhl]^aZndjVgZ
[ZZY^c\!X]Vc\^c\!VcY]daY^c\]^b#=Z
l^aa \Ziid`cdlndj!ndjghbZaa!VcY
i]Z hdjcYd[ndjgkd^XZ#
>[![dgVcngZVhdc!ndjgWVWn^hiV`Zc
idi]ZcjghZgn[dgdWhZgkVi^dc!dgidi]Z
cZdcViVaheZX^VaXVgZjc^i!bV`ZZkZgn
Z[[dgiidk^h^i]^bVhd[iZcVhedhh^WaZ#:kZc
^[]Z]VhidWZXVgZY[dg^cVc^cXjWVidg!
ndjXVcidjX]VcYXVgZhh]^bi]gdj\]i]Z
edgi]daZh!iVa`id]^b!VcYedhh^Wan[ZZY
]^b#>i^h^bedgiVciidiV`ZVaai]ZhiZeh
ndjXVcidgZYjXZi]Zi^bZndjVgZ
hZeVgViZY[gdbndjgWVWn#
Eye contact is essential
6aagZhZVgX]ed^cihidi]Z[VXii]Vie]nh^XVa
XdciVXiWZilZZcbdi]ZgVcYWVWnh]djaY
hiVgiVhhddcV[iZgW^gi]Vhedhh^WaZ#
;jgi]ZgbdgZ!ZnZXdciVXih]djaY[daadl
^bbZY^ViZanV[iZgW^gi]l]ZgZkZgedhh^WaZ#
BdhiX]^aYYZkZadebZciZmeZgihjhZYid
hVni]ViWVW^ZhXdjaYcdihZZegdeZganjci^a
i]Z^gZnZhXdjaY[dXjh!WjiWVW^ZhXVc
^ciZgegZih]VeZhVcYdjia^cZh#I]Zh]VeZ
VcYdjia^cZd[ndjg[VXZl^aaWZgZXd\c^oZY
WnndjgWVWnl^i]^c(+]djgh#GZhZVgX]
]Vhh]dlci]Vi^i^hndjgZnZhndjgWVWn
hZVgX]Zh[dgVcYXdcXZcigViZhdcdcXZ]Z
]Vh[djcYi]Zb#;jgi]ZgbdgZ!WVW^ZhXVc
Ydi]^hl^i]^cV[Zl]djghd[W^gi]#
8ZgiV^canl]ZcbnhZXdcYhdclVhWdgc
VcY>a^[iZY]^bdcidbnhidbVX]VcY
XVaaZY]^hcVbZ]ZdeZcZY]^hZnZh
^chiVcianl]Zc]Z]ZVgYbnkd^XZVcY
[a^X`ZYi]ZbVgdjcYi]Zgddbjci^ai]Zn
XVbZidgZhidcbn[VXZ#
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30 THE NEWBORN
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 :fj^ebZci
Go shopping for equipment in the last couple of months before your baby
is due, while you can still shop on your own and you feel reasonably
energetic. You’ll be faced with a seemingly endless choice of “essential”
items, but don’t be swayed by clever advertising. Ask friends or relatives
which items of equipment they found useful and, more important, which
ones they bought but never used.

Choosing equipment
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34 EQUIPMENT

Changing and bathing

CHANGING AND BATHING EQUIPMENT >[ndja^`Zi]Z^YZVd[]Vk^c\VheZX^Va
New baby X]Vc\^c\VgZV!WjiYdc¼ilVciidWj^aY
• Changing unit with storage drawers dcZdgXdckZgiVe^ZXZd[[jgc^ijgZa^`ZV
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• Cotton balls X]Vc\^c\bVidcVX]Zhid[YgVlZghdgdc
• Baby wipes i]Z[addg^hhj[[^X^Zci#
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• 4 packs disposable diapers
or
• 24 cloth diapers
Diaper liners
Diaper pins
Plastic pants
2 diaper buckets

Older baby
• Toothbrush
• Bath seat and/or nonslip mat for big bath
• Potty
• Steps for reaching the sink

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Feeding
FEEDING EQUIPMENT
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b^c^bjbd[Zfj^ebZci¸[ZZY^c\WgVhVcY New baby/breast-feeding
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WdiiaZhVcYVWgZVhiejbe^[ndjlVciid • Breast pads
ZmegZhhhdbZb^a`#7diiaZ"[ZZY^c\bdi]Zgh • Breast pump if you need to express milk
l^aa]VkZidWjnVXdbeaZiZ[ZZY^c\`^isee • Bottles or breast milk storage containers for
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t expressed milk
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YZh^\cZYidbdkZ^cVcYdjia^`ZV]jbVc • Bottles
c^eeaZl]ZchjX`ZY# • Nipples
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cZZYZfj^ebZci[dgbVh]^c\[ddY^cidV • Large pot for boiling bottles and sterillizing
hbddi]Zcdj\]ejg‚Z#Ndj¼aaVahdcZZY the nipples
jcWgZV`VWaZY^h]ZhidhZgkZ^i^c#HeZX^Va • Bottle brush
Y^h]Zhi]Vi`ZZei]Z[ddY]diVgZVkV^aVWaZ!
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hinaZ^hi]ZeaVhi^XW^Wl^i]VedjX]i]Vi • Baby spoons and forks
XViX]ZhYg^ehVcYe^ZXZhd[[ddYVcYXVc • Trainer cups
WZlVh]ZYZVh^an# • Blender or liquidizer
;dgVcdaYZgWVWnndj¼aaVahdcZZY • Bibs
hdbZ [dgbd[]^\]X]V^gVcYi]ZgZ^hVl^YZ • Highchair and/or booster seat
kVg^ZinidX]ddhZ[gdb#BV`ZhjgZi]ZX]V^g • Safety harness
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VYVeiVWaZ[ddigZhihVcYhZVih
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36 EQUIPMENT

Sleeping
I]ZWZhiX]d^XZ[dgVcZlWdgc^hVXVgg^Zg!
l]^X]^hZVhnidbdkZ[gdbgddbidgddb#
I]ZcVXg^Wl]Zci]ZWVWndji\gdlh^i#
8]ddhZVXg^Wl^i]ildbViigZhh
]Z^\]ih!hdndjYdc¼i]VkZidWZcYidd[Vg
^ci]ZZVganYVnh!VcYl^i]h^YZhi]ViYgde
Ydlc¸^i¼hbjX]ZVh^Zgid\Ziidi]ZWVWn#
BV`ZhjgZi]Vii]ZXg^W¼hh^YZgV^ahVgZXadhZ
id\Zi]Zg!hdndjgWVWn¼h]ZVYXVc¼i\Zi
hijX`#I]ZXg^WbViigZhhh]djaY[^ihcj\an!
Vaadl^c\cdbdgZi]VcdcZ[^c\Zgidha^YZ
WZilZZci]ZbViigZhhVcYi]ZXg^Wh^YZ#
;dVbbViigZhhZhVgZWZhi0hdbZ]VkZ #BTTJOFU
BOE
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NBLFT
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"
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;daY^c\![VWg^X"h^YZYigVkZaXg^WhVgZjhZ[ja
[dgkVXVi^dchVcY\d^c\djil^i]i]ZWVWn
^ci]ZZkZc^c\#7VWnhaZZe^c\WV\hVgZ jcYZgdcZnZVg#6hhddcVhndjgWVWn
jhZ[ja[dgdaYZgWVW^Zh#6aaZfj^ebZcibjhi h]dlhh^\chd[WZ^c\VWaZidXa^bWdjid[
Xdbeanl^i]adXVahV[ZinhiVcYVgYh# ]ZgXg^W!ndj¼aacZZYidWjnVWZY¸hdbZ
6kd^YWjbeZghVcY[aZZXZhVhi]Zn Xg^WhVgZYZh^\cZYidXdckZgi^cidWZYh#
^cXgZVhZi]Zg^h`d[i]ZWVWndkZg]ZVi^c\¸
WVW^Zhl]d\Ziidd]diVgZViV\gZViZg Outings and travel
g^h`d[Xg^WYZVi]#9dc¼iejiWjbeZgh^c Ha^c\hVgZVedejaVglVnd[igVchedgi^c\
Xg^Wh!dgjhZVaddhZWaVc`Zi[dgWVW^Zh VcZlWdgcWVWn0i]Zn¼gZa^\]iVcY
Xdb[dgiVWaZ!VcYVaadlndjidXVggnndjg
WVWnXadhZl]^aZ`ZZe^c\Wdi]]VcYh[gZZ#
SLEEP EQUIPMENT AND ACCESSORIES
I]Zha^c\h]djaYWZjhZYl^i]VcZX`
New baby ViiVX]bZcijci^andjgWVWnXVchjeedgi
• Baby carrier ]Zgdlc]ZVY#7VX`eVX`h!l]^X]]VkZ
• Waterproof sheet to protect mattress (tie-on hjeedgi^kZ[gVbZhi]VibV`Z^iZVh^Zgid
sheets are good) WZVgVaVg\ZgWVWn¼hlZ^\]i!VgZhj^iVWaZ
• Cotton sheets dcXZndjgWVWnXVch^ijeWn]ZghZa[#
• Cotton cellular blankets Ndj¼aaVahdcZZYhdbZ[dgbd[higdaaZg#
• Fleecy blanket I]ZdcZndjX]ddhZl^aaYZeZcYdcWdi]
• Baby monitor ndjgWjY\ZiVcYndjga^[ZhinaZ#6aVg\Z
XVgg^V\Z^h^begVXi^XVa^[ndja^kZ^cVhbVaa
Older baby VeVgibZci!i]gZZ[a^\]ihje0V[daY^c\
• Full-size crib with foam mattress a^\]ilZ^\]ihigdaaZgdgVXVgg^V\Zl^i]V
• Crib comforter (for babies over 12 months) gZbdkVWaZXVgg^Zg^hbdgZhj^iVWaZ#

=dlZkZg!VXVgg^V\ZdgVXVgg^V\Z$higdaaZg^h
bjX]bdgZXdb[dgiVWaZ[dgVndjc\WVWn
i]VcVa^\]ilZ^\]ihigdaaZg!l]^X]YdZhcdi
jhjVaand[[ZgZcdj\]hjeedgi#;dgi]Z[^ghi
i]gZZbdci]h!ndjgWVWnbjhiWZVWaZid
a^Z[aVi^cl]ViZkZgndjX]ddhZ#
6cn`^cYd[higdaaZgdgXVgg^V\ZcZZYh
idWZZVhnidejh]!]VkZ\ddYWgV`Zh!V
]VgcZhh!dgg^c\h[dgdcZ!VcYVbZX]Vc^hb
idegZkZcii]Z[gVbZ[gdbXdaaVeh^c\#Ndj
l^aaVahdcZZYVlViZgegdd[XdkZgVcYV
hjch]VYZ[dg^i#
Car seats
L]ZcZkZgndjiV`ZndjgX]^aY^cVXVgndj
bjhiXdbeanl^i]hV[ZingZ\jaVi^dch#6XVg
hZVi^hdcZ^iZbndjXVccdiYdl^i]dji^[
ndj^ciZcYidiV`ZndjgWVWn^cndjgdlc
dgVcndcZZahZ¼hXVg#CZkZgWjnVhZXdcY"
]VcYhZVijcaZhhndjXVcWZXZgiV^ci]Vi^i
]VhcdiWZZcYVbV\ZY^cVcVXX^YZci#
6aaWVW^ZhjcYZgdcZnZVgdaYVcYje
id'%edjcYh.`^ad\gVbhh]djaYigVkZa^c
VgZVg"[VX^c\hZVi!l]^X]egdk^YZhWZiiZg
egdiZXi^dc[dgVndjc\WVWn¼h]ZVY!cZX`!
VcYhe^cZ#I]ZhZhZVihVgZedgiVWaZhdi]Zn
XVcWZjhZY[dgXVggn^c\ndjgWVWnidVcY
[gdbi]ZXVg!VcYbdhiXVcViiVX]dcidV
higdaaZg!VhlZaa#CZkZgejiVgZVg"[VX^c\
hZVi^ci]Z[gdcid[i]ZXVg#
6cdaYZgWVWnXVc]VkZV[dglVgY"
[VX^c\hZVi!l]^X]bjhiWZ[^mZY^ci]ZWVX`
hZVid[i]ZXVg#I]ZhZVgZYZh^\cZYidWZaZ[i
^ci]ZXVg#HdbZcZZYidWZ^chiVaaZY0
di]ZghjhZZm^hi^c\hZViWZaih#8]^aYgZcje
idi]ZV\Zd[(nZVghVcY)%edjcYh&-
`^ad\gVbhh]djaYh^i^cV[dglVgY"[VX^c\
XVghZVi#8]^aYgZcjeidi]ZV\Zd[-nZVgh
VcY-%edjcYh(+`^ad\gVbhbjhijhZV
WddhiZghZVi#6X]^aYh]djaYcdih^i^ci]Z
[gdcihZVijci^aViaZVhi&'nZVghdaY#
CHOOSING EQUIPMENT 37
Additional equipment
:kZcndjc\WVW^Zha^`ZidhZZl]Vi¼h\d^c\
dcVgdjcYi]ZbVcYVWdjcX^c\WVWnX]V^g
^hjhZ[ja[dgVWVWnWZ[dgZh]ZXVch^i#
6alVnheaVXZi]ZX]V^gdci]Z[addgVcY
bV`ZhjgZh]Z^hhV[ZanhigVeeZY^c#
6ai]dj\]bVcneZdeaZ[^cYeaVneZch
gZb^c^hXZcid[VWVWneg^hdc!hdbZ[^cY
i]Zb^ckVajVWaZ#>[ndjYZX^YZidWjndcZ
ndjgX]d^XZl^aaWZWZilZZcVXdaaVeh^WaZ
cnadc"bZh]ZYeZcVcYgV^a!dgVhfjVgZ
lddYZceZc0Wdi]]VkZVeVYYZYWVhZ#
CARRYING EQUIPMENT
• Front-carrying fabric sling with neck support for
newborns. Make sure it’s washable.
• Backpack for an older baby.
• Carriage with solid body and collapsible fabric
hood,
or
• Carriage with removable carrier,
or
• Folding stroller that reclines for a young baby
(there are many types available, ask other
people which they prefer),
or
• Carriage/carrier combination—can be used as
a carrier on wheels for young baby and
converts into a stroller. There are combinations
called travel systems that include a car seat,
or
• All-terrain, three-wheeler stroller.
• Sunshade for summer.
• Waterproof cover for stroller.
• Rear-facing car seat for baby up to 20 pounds
(9 kilograms).
• Front-facing car seat for older child—this is
compulsory in many states, up to various ages
and weights. Check your local regulations
• Changing bag to carry spare clothes/diapers.
38 EQUIPMENT
Your baby’s room
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dg[^aaZYl^i]ZmeZch^kZ[jgc^h]^c\h!Wji^i
YdZhcZZYidWZlVgb!XaZVc!hV[Z!VcY
ViigVXi^kZ#BV`ZhjgZi]Vii]Z[jgc^ijgZ
^hZVhnidl^eZXaZVcVcY]Vhhbddi]!
gdjcYZYZY\Zh#6cneV^cijhZYh]djaYWZ
cdcidm^XVcYaZVY"[gZZ#
6alVnhjhZ[aVbZegdd[[VWg^X[dg
WZYY^c\!je]dahiZgn!VcYXjgiV^ch#Bdhi
^bedgiVci!ndjgWVWn¼hgddbh]djaYWZ[jc!
l^i]eaZcind[Wg^\]iXdadgh!e^XijgZh!VcY
bdW^aZhidhi^bjaViZ]ZghZchZh#I]ZXdadgh
d[cVijgZ¸WajZ!nZaadl!VcY\gZZc¸VgZ
hV^YidWZhddi]^c\[dgndjgWVWn#EV^cii]Z
lVaah^cX]ZZg[jaXdadgh!jhZheaVh]Zhd[
eg^bVgnXdadgh[dgXjgiV^chVcYVXXZhhdg^Zh
VcYejii]^c\hidadd`Vidci]ZlVaah#
BASIC FURNISHINGS
• Baby carrier and stand.
• Crib (you can put a baby carrier in the crib
to begin with).
• Changing area with storage for diapers and
other items.
• Storage for clothes and toys.
• Baby monitor so you can hear her if she wakes
or cries.
• Low chair where you can sit when feeding.
• Thick curtains or good blinds to keep the room
warm and dark.
• Dimmer switch to provide low levels of light
for night changing or feedings.
• Shelves for books and toys.
• Mobiles hung over the crib and changing area.
• Pictures on the walls and on a bulletin board in
her room. Change the pictures regularly to keep
her interested.
What your baby will need
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ZheZX^VaanVWdkZdgidi]Zh^YZd[i]Z
X]Vc\^c\VgZV#>[ndjeaVcidWj^aYndjg
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hjg[VXZdcl]^X]ideaVXZi]ZX]Vc\^c\
bVi#L^YZ"ideeZYX]Zhihd[YgVlZghbV`Z
^YZVaX]Vc\^c\iVWaZhWZXVjhZi]Zn]VkZV
aVg\Zhjg[VXZVgZVVcYeaZcind[hidgV\Z
heVXZ[dgY^VeZghVcYXadi]Zh#>i^hV\ddY
^YZVidWj^aYh]ZakZhVWdkZl]ZgZkZgndj
eaVXZ^i#BV`ZhjgZi]Vii]Zhjg[VXZ^h
hbddi]!i]ZcXdkZg^il^i]VlVh]VWaZ
XdkZg^c\VcYejiVeVYYZYX]Vc\^c\bVi
dcide#I]Z[addgXdkZg^c\h]djaYWZ]ZVkn
YjinVcYZVhnid`ZZeXaZVc0Xdch^YZgXdg`
i^aZhdgk^cnal^i]VXdjeaZd[cdcha^egj\h#
8VgeZi^hlVgbVcYVWhdgWhcd^hZWji^h
]VgYZgid`ZZeXaZVc#
Room temperature
6WVWn¼hgddbYdZhc¼icZZYidWZkZgn
lVgb!Wjih]djaYWZ`ZeiViVXdchiVci
iZbeZgVijgZ#6gdjcY+*•;&-•8^h
hj^iVWaZ^[ndjgWVWn^hXdkZgZYl^i]
ildWaVc`ZihVcYVh]ZZi#>[i]Zgddb^h
lVgbZg!jhZ[ZlZgWaVc`Zih#>[ ndjYdc¼i
lVciid]ZVii]ZZci^gZ]djhZidi]^haZkZa!
ejiVi]ZgbdhiVi^XVaanXdcigdaaZY]ZViZg^c
]Zggddb#
Adapting the room for a toddler
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ZkdakZidhj^i]ZgcZZYhVhh]Z\ZihdaYZg
VcYbdgZbdW^aZ#H]Z¼aacZZYeaZcind[
[addgheVXZ[dgXgVla^c\VcYiV`^c\]Zg[^ghi
hiZehhd`ZZe[jgc^ijgZidVb^c^bjb#
L]Vii]ZgZ^hh]djaYWZhiZVYnVcYhiVWaZ
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l^i]djiVXX^YZcih#7ZZmigVVlVgZd[i]Z
hV[Zing^h`h[dghbVaa!^cfj^h^i^kZidYYaZgh
VcY[daadli]ZgZXdbbZcYVi^dchdce#'.+#
6ihdbZhiV\Z!h]Zl^aacZZYidbdkZ
[gdb]ZgXg^WidVWZY!WjiYdc¼igjh]]Zg#
BdhieVgZcihbV`Zi]Zhl^iX]WZilZZci]Z
V\Zhd[ildVcY[djg#NdjbjhiYd^il]Zc
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DcXZh]Z]VhVWZY!h]ZXVc\Zidjid[^i
Wn]ZghZa[VcYZmeadgZ]Zggddb!hdndj
cZZYidWZXZgiV^ci]ViZkZgni]^c\^hhV[Z#
Storage space
BV`ZhjgZi]ZgZVgZeaZcind[eaVXZhid
`ZZeidnhhd^i^hZVhn[dgndjgX]^aYid
`ZZe]Zgi]^c\h^cdgYZg#>i¼hbjX]bdgZ
[jcideaVnl^i]idnh^[ndjgX]^aYXVc[^cY
i]ZbZVh^anVcYYdc¼i]VkZidhZVgX]^c
hZkZgVaY^[[ZgZcieaVXZh[dgVaai]Ze^ZXZh#
I]^hYdZhcdicZZYidWZh]ZakZh!YgVlZgh!
eaVhi^XhiVX`^c\WdmZh!dgaVjcYgnWVh`Zih
Vaaegdk^YZ\ddYhidgV\Z[dgX]^aYgZc¼h
i]^c\h#9dc¼ildggniddbjX]VWdji
i^Y^cZhhi]dj\]¸^i¼h]Vk^c\V\ddYi^bZ
i]ViXdjcih#
6WaVX`WdVgYdgVheZX^ValVaaVgZVi]Vi
ndjgidYYaZg`cdlhh]Z¼hVaadlZYidX]Va`
dcbVnVahdWZlZaXdbZVhhddcVhh]Z¼h
gZVYnidYdhd#
ADAPTING A ROOM FOR A TODDLER
• Nonslip rugs to make wooden floors cosier to
sit on.
• Bedside table for nightlight and drinks; make
sure she can’t pull on cords.
• Low table and chair where your toddler can sit
and draw and play.
• Low hook where she can hang up her coat.
• Bulletin board for her special pictures.
• Toy boxes on wheels.
 8adi]^c\
All parents take great pride in their new baby’s appearance and it’s very
tempting for you and your family and friends to rush out and buy lots of
clothes for him. It’s up to you what you choose, but there’s absolutely no
need to spend a lot of money. Remember that your child is going to grow
rapidly during these first years, and he will grow out of clothes very
quickly. As far as your baby is concerned, he doesn’t mind what he wears
as long as it is soft and comfortable and can be put on and taken off
without too much trouble.

Choosing clothes W^gi]id&nZVg

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Wjii]ViYdZhcdibZVc]Z¼h\d^c\idhiVn
hXgjejadjhanXaZVc#I]ZgZl^aa^cZk^iVWanWZ
VXX^YZcihVcYaZV`h[gdbY^VeZgh!VcY]Z¼h
WdjcYidhe^ijeVcYYg^WWaZhdbZi^bZh¸
Vaad[l]^X]l^aabZVc[V^gan[gZfjZci
X]Vc\Zhd[Xadi]^c\#7Z[dgZndjgWVWn^h
BASICS FOR A NEW BABY
• 6–8 T-shirts/undershirts or Onesies
• 6–8 one-piece stretchies/pajamas
• 2 cardigans/sweaters (4 for winter babies)
• 2–3 pair of socks and padders
• 2 pair of mittens
• 2 nightgowns (choose one with drawstring
bottoms to keep feet warm)
• 1 blanket or shawl
• Protective clothing and sunhat for sun
protection

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• One-piece snowsuit for winter
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lVh]VWaZVcYXdadg[Vhi#
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VY^hi^cXi^dcWZilZZcYVnlZVgVcY
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c^\]iXadi]ZhVgZdcZ"e^ZXZhigZiX]^Zh#
6hndjgWVWn\ZihdaYZg!haZZehj^ihbV`Z
VXdhnVaiZgcVi^kZ#>[ndjWjnI"h]^gihdg
DcZh^Zh!Wjnl^YZ"cZX`ZYdcZhi]Vi\ddc
dkZg]^h]ZVYZVh^an¸WVW^Zh]ViZ]Vk^c\
i]Z^g[VXZhXdkZgZY#DcZh^ZhVgZjhZ[ja
WZXVjhZi]ZnXVcWZ[VhiZcZYjcYZgi]Z
WVWn¼hY^VeZg#7jnWg^\]ianeViiZgcZY
DcZh^Zhi]ViXVcWZjhZYVhI"h]^gihidd#
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42 CLOTHING
BUYING CLOTHES FOR A NEWBORN
• Whatever sizing system the manufacturer uses,
make sure you buy a size that will last until
your baby’s at least two months old. He won’t
be uncomfortable if his clothes are slightly too
big. It’s more practical than buying the newborn
size, which he’ll quickly grow out of.
• Buy only machine-washable, colorfast clothing
for your baby.
• Make sure any clothing you buy allows easy
access to the diaper, so there’s the minimum of
undressing involved. One-piece stretchies with
snaps in the crotch or down the front and legs
are the easiest to put on.
• In the early weeks, you may find it simplest to
use nightdresses that can just be lifted up to
get at the diaper.
• Clothes that open down the front or have wide
necks are the best because babies hate having
their faces covered.
• Clothes that fasten up the front also mean you
don’t have to turn your baby over when you’re
dressing him.
• Material should be soft and comfortable with
no hard seams or rough stitching; check the
neck and waistband before buying. Buy terry
cloth, cotton, or pure wool clothes; if you buy
clothes made of man-made fibers check that
they feel soft and comfortable.
• Buy nonflammable clothing.
• Avoid lacy shawls or cardigans—your baby’s
tiny fingers can easily get caught in the holes.
• Avoid white—it gets dirty quickly and needs
more care when washing. Babies look as nice in
bright colors as in the pastels traditionally
specified for them.
• If you buy a hat, either buy one with a
chinstrap, or sew some ribbon on it. Many
babies hate wearing hats and pull them off
unless they’re tied on under the chin.
Additional clothing for a baby
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i]ZWVh^Xhl^aaWZYZiZgb^cZYWn[^cVcXZh
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e^ZXZd[Xadi]^c\!Wjii]ZgZVgZhdbZ^iZbh
i]ViVgZbdgZegVXi^XVai]Vcdi]Zgh#
>chjbbZg![dgZmVbeaZ!XdiidcI"h]^gih
VcYh]dgihdgXdiidcYgZhhZhVgZi]Zbdhi
hj^iVWaZWZXVjhZi]Zn¼gZXddaVcYaZVkZi]Z
WVWn¼ha^bWh[gZZ0^cl^ciZg!b^c^"igVX`hj^ih
VcYdkZgVaahVgZegVXi^XVaVaiZgcVi^kZhiddcZ"
e^ZXZhigZiX]^Zh#DcXZndjgWVWn^hbdW^aZ
]Z¼aacZZYXadi]^c\i]Vi\^kZhVYZfjViZ`cZZ
egdiZXi^dc#?jhia^`Zl]ZcndjgWVWnlVh
kZgnndjc\!hi^X`idXadi]Zhi]Vi\^kZndj
ZVhnVXXZhhid]^hY^VeZg!WZXVjhZWni]Z
i^bZ]Z¼hXgVla^c\!]Z¼hcdi\d^c\idlVci
idhiVnhi^aa[dgkZgnadc\#6aaXadi]ZhndjWjn
h]djaYWZbVX]^cZlVh]VWaZVcYXdadg[Vhi#
Check fit regularly
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PUTTING ON A UNDERSHIRT
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DRESSING A BABY—BIRTH TO 1 YEAR 43
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44 CLOTHING
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 DRESSING A BABY—BIRTH TO 1 YEAR 45

UNDRESSING A NEWBORN

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DEALING WITH STAINS

Vomit/feces Use an enzyme-containing detergent after you’ve removed the vomit and
rinsed the garment with cold water.

Milk Remove milk stains by rinsing the clothing thoroughly in cold water and
then using an enzyme-containing detergent.

Egg If there is an egg stain on clothing, soak in cold water for an hour before
laundering in the usual way.

Fruit and chocolate Douse tough stains such as chocolate or grape juice with seltzer, rub until
the discoloration has gone, then wash as usual.

Blood Soak bloodstains in cold water for thirty minutes. If they don’t come out
use an enzyme-containing detergent. If this fails, try a few drops of
ammonia on the stain.

Lipstick Dab stain with a soft white cloth that’s been dipped in rubbing alcohol; or
use a pre-wash stain stick, then wash as normal.

Grass Remove grass stains with alcohol if they are resistant to laundering.

Chewing gum Soften the gum with paint thinner before gently pulling the gum away
from the fabric, or freeze the garment and scrape it off.
46 CLOTHING
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CHOOSING CLOTHES—1 TO 3 YEARS 47
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MAKING CLOTHES LAST
• When foot pajamas get too short for comfort,
cut off the feet for an extra month’s wear.
• Reinforce the knees on the inside of new jeans
with the extra fabric you trim from the bottom
of the legs, or use iron-on patches.
• Make summer shorts from long winter
pants that are too short or have gotten
worn at the knees.
• When your child outgrows an expensive jacket,
you can cut out the sleeves and let her wear it
as a vest.
• Run a dark blue crayon, indelible pencil, or a
fountain pen filled with blue/black ink over the
white line when jeans have been let down.
48 CLOTHING
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 CHOOSING CLOTHES—1 TO 3 YEARS 49

CHOOSING SHOES FOR TODDLERS

There’s no need to put your baby into shoes until
he’s walking. The bones in your baby’s feet are soft
and pliable—so pliable that even the pressure of
tightly fitting socks can misshape toes if your baby
wears them regularly. When it’s very cold, or when
he starts to crawl, you can put on socks or booties,
but make sure there’s plenty of room for his feet to
move around.
When buying shoes, go to a reputable shoe store
and make sure the assistant has been trained to
measure and fit children’s shoes. She should always
measure the foot for width and length before
bringing any shoes for your child to try on. Once the
shoes are on, she should press the joints of the foot
to check that the foot is not restricted in any way /FX
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crease up and hurt when he’s walking and to some rain boots for wet weather. In summer, leather
double-check there’s no slipping. sandals, canvas shoes, or sneakers are fine as long
The type of shoe you buy will be determined by as they fit properly.
when and where it is to be worn. Your child will You should never buy second-hand shoes. Good
need a sturdy, well made pair of leather shoes once shoes are an essential means of ensuring that your
he is running around and playing outdoors, and child has good feet in adult life.

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accidentally damage their child. It’s important to get used to holding your
baby properly, not just for her comfort but for your own sake. You’ll never
manage to feed or bath her successfully if you are unsure about holding her.

Handling your baby W^gi]id&nZVg

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HOW TO PICK UP A NEWBORN BABY

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 HANDLING YOUR BABY—BIRTH TO 1 YEAR 53

In a sling I]ZgZ^hcdgZVhdcViVaal]n h]Z¼he^X`ZYje#L]Zch]ZgZVX]Zhi]^h

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Picking up your older baby
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HOW TO CARRY AN OLDER BABY

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HANDLING YOUR CHILD—1 TO 3 YEARS 55
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AVOIDING BACK STRAIN
Babies and toddlers inevitably require lots of
lifting and carrying, not to mention the carriages,
strollers, and other equipment that go along with
them. It is important for the protection of your
back that you learn a lifting technique that avoids
injury and strain. Don’t lift with straight legs and
curved back, because this puts strain on your
back. Instead, keep your back straight, bend your
to take the weight.
56 HOLDING AND HANDLING
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Children need you
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h]Z VYdeiZYVegV\bVi^XVeegdVX]idi]Z

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 6aaVWdji
Y^VeZgh
Until your child starts to use the potty, probably some time during the third
year, he will have to wear diapers both day and night. During the first few
months life may seem like an endless round of diaper changing. But don’t
despair. As your child grows and gains more control over bowel and bladder
muscles, he will go for longer without excreting and urinating and the
number of diapers you need to change will decrease. By about two and
a half, he will probably become aware of wanting to go to the bathroom.
It is at this point, and not before, that you should start toilet training.

Diapers and changing W^gi]id&nZVg

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60 ALL ABOUT DIAPERS
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ndjgWVWnVadcZdcVcnhjg[VXZi]Vi^h
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CLEANING A GIRL
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Disposable diapers W^gi]id&nZVg
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DISPOSABLE DIAPERS—BIRTH TO 1 YEAR 61
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62 ALL ABOUT DIAPERS

HOW TO PUT ON A DISPOSABLE DIAPER

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CHOOSING DISPOSABLE DIAPERS
There are many different types of disposable
diaper to choose from and they come in a variety
of sizes to fit the age and weight of your baby.
When trying them, consider the following:
• How absorbent is the diaper and does it keep
your baby’s bottom dry?
• Is it comfortable around the legs and does it
fit around the body well? Check for any hard
edges that might irritate your baby.
• You’ll need to balance price against efficiency.
Buying cheaper diapers might be a false
economy if they are not as absorbent or
effective as a more expensive brand.
64 ALL ABOUT DIAPERS
Cloth diapers W^gi]id&nZVg
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XVcV[[dgY#I]Znl^aaaVhiadc\ZgVcYWZ
bdgZVWhdgWZci#
DIAPERS AND ACCESSORIES
Here is a selection of reusable diapers and
equipment. Provided your baby is changed
regularly he will be happy in any style.
PLASTIC COVER
FABRIC DIAPER WITH
VELCRO FASTENER
FFABRIC DIAPER LINERS AND
LINER SAFETY PINS
Cotton squares I]ZhZigVY^i^dcVa
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Muslin squaresI]ZhZVgZVWdjii]Z
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hd[iZg#I]ZnVgZ^YZVa[dgcZlWdgcWVW^Zh
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Wjii]ZnVgZcdikZgnVWhdgWZcihdcZZY
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Fitted cotton I]ZhZI"h]VeZYY^VeZghVgZ
bVYZd[Vhd[iZg![^cZg[VWg^Xi]VcdgY^cVgn
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VcYVgZbdgZhigV^\]i[dglVgYidejidc#
Plastic covers I]ZhZXdkZgh!l]^X]XdbZ
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All-in-one reusables I]ZhZd[[ZgVaai]Z
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bVX]^cZlVh]VWaZ!XVcWZWg^\]ianXdadgZY!
VcY]VkZKZaXgdXadh^c\iVWhVcYZaVhi^X^oZY
aZ\h#BVYZd[hZkZgVaaVnZghd[VWhdgWZci

[VWg^X!i]Zn]VkZVaZV`"egdd[djiZgaVnZg!hd
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HOW TO PUT ON AN ALL-IN-ONE CLOTH DIAPER
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FABRIC DIAPERS—BIRTH TO 1 YEAR 65
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66 ALL ABOUT DIAPERS
Diaper washing and sterilization
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FABRIC DIAPERS—BIRTH TO 1 YEAR 67
TIPS FOR USING CLOTH DIAPERS
• Use a disposable inside a cloth diaper for extra
absorbency at night. You can also use this
method when you’re traveling and want to
avoid an awkward change.
• Use stretch fabric covers over plastic covers—
they look neater than plastic covers on their
own. Frilly and patterned plastic covers are also
available if you want something prettier.
• Always keep your fingers between the diaper
and the skin if fixing with a pin.
• When you’ve put on the diaper run your fingers
around the legs to be sure it’s not too tight.
• To save time, fold all the diapers ready for use
and put the diaper liners in position.
• Make sure that the diaper fits snugly around
your baby’s body. It gradually gives, so if it’s too
loose it will slide down.
Tips for washing fabric diapers
• Keep plastic gloves near the sterilizing bucket
for lifting diapers out; or use plastic tongs.
• If you use powder sterilizer, always put the
water in before the powder. Otherwise the
powder spreads through the air when you add
the water and you may inhale it.
• Both drying in the open air and in a tumble
drier keep the fabric softer. Drying on the
radiator tends to harden the fabric. It’s better
to invest in a rack to place over the bath or use
a pull-out clothesline if you can’t dry outdoors
or in a tumble drier.
• Keep any diapers changed at night in a
separate bucket, or in a large plastic bag,
and add them to the new day’s solution the
following morning.
• Some buckets have special holders for air
fresheners. If yours doesn’t, hook a piece of
wire through a freshener and attach it above
the waterline.
68 ALL ABOUT DIAPERS
Diaper rash
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DIAPER RASH CHART
Appearance Cause
Redness and broken skin in the leg Inadequate drying
folds. after bathing.
Rash that starts around the Ammonia
genitals rather than the anus. dermatitis.
Strong smell of ammonia.
Spotty rash all over the genitals, Extreme form of
bottom, groin, and thighs, which ammonia
eventually leads to thick and dermatitis.
wrinkled skin.
Rash that starts around the anus Thrush.
and moves onto the buttocks.
Brownish-red scaly rash on the Seborrhoeic
genitals and buttocks and dermatitis.
anywhere the skin is greasy.
Small blisters all over the diaper Heat rash.
area.
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Treatment
Meticulous and thorough drying. Do not
use powder.
General diaper rash treatment, above.
If this doesn’t work, seek medical advice.
Seek medical advice if rash persists after
trying general treatment, above, first.
Get medical advice. You will probably be
given nystatin cream and medicine.
Ointment for rash, prescribed by your
doctor. You might also get a special lotion
if the scalp is very scaly and sore.
Don’t use plastic covers, and leave off
the diaper as much as possible.

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USING DIAPERS—1 TO 3 YEARS 69
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Part of your daily routine is to keep your baby clean. This will be reasonably
easy when she’s very small, but as your baby becomes more active you’ll find
that you will not only have to clean her more often, but also that the daily
bath will require more effort. By the time she’s two she may want to try
washing herself.

Washing your baby W^gi]id&nZVg

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TOPPING AND TTAILING A YOUNG BABY
This means cleaning your baby by washing her face,
hands and diaper area, without undressing her
completely. Remove her clothes, leaving her
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GIVING YOUR BABY A BATH

It is important that your baby doesn’t get cold when need at hand: bath, two large towels, facecloth,
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free of drafts, and that you have everything you diaper, and clean clothes.

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GIVING YOUR BABY A SPONGE BATH

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or if she really hates being undressed, give her a of clothing at a time. You can also place your baby
sponge bath. Get everything you need ready. Sit her on a changing mat and use the same techniques.

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76 BATHING AND HYGIENE
BATHTUB BATHING TIPS
• Always run cold water first. If you start with hot
water, the bottom of the tub may be too hot
and could burn the baby.
• Cover up hot faucets with a washcloth or towel
so there’s no risk of scalding.
• Don’t pour more hot water into the tub while
the baby is in it—she could be scalded.
• Make sure that you put your baby in the tub
(and lift her out of the tub) with your back
straight, taking the strain with your thighs.
• Don’t let your baby stand up in the tub without
your support—she could slip and fall.
• If your child starts to jump up and down in the
tub—no doubt rejoicing in a newly found skill
—be very firm about making her sit down
again, or she could easily topple over.
• Don’t be tempted to see if your baby can sit
unsupported. She could easily tumble under the
water and get a bad scare—bad enough to put
her off baths for a while.
• Never, ever, leave your baby alone in the tub.
Even if you turn around for a moment she
could slip under the water and drown.
• Don’t let the water out while the baby’s in the
tub. She may be frightened by the disappearing
water and by the noise.
• Don’t dust your baby with talcum powder after
a bath—it’s very drying to the skin and can
cause irritation.
• If you’re at work during the day, make the
most of bathtime—it can be a great time to
play and relax with your baby.
• Have some toys exclusively for use in the tub,
to make bathtime a special treat.

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84 BATHING AND HYGIENE
Possible problems &id(nZVgh
Fear of hair washing
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ijW!dgi]ZVbdjcid[lViZg^c^i4>h^i
WASHING YOUR TODDLER—1 TO 3 YEARS 85
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\Zciansee below# w
GETTING HER USED TO WATER
Another way of getting your child used to water
on her face is to take her swimming. Once she’s
got used to splashing and getting her hair wet,
you’ll be able to start hair washing. This is
especially easy if you take a shower after
swimming in the pool. You can then gently and
deftly introduce the idea of having a shampoo in
the shower, using a nonsting baby shampoo: a
quick shampoo should only take a couple of
minutes.
You can also use the shower attachment at
home, encouraging your child to play with the
spray, playing it up to her shoulders and
eventually onto her hair and face. When she’s
used to wet hair, you can then quickly shampoo
and rinse it.
If she likes swimming in a pool, take advantage
of any swimming classes that you can attend with
your child where you do most of the teaching
(with help from an instructor if you need it).
Being able to swim may save your child’s life.
If possible, it’s a good idea to make sure that she
has learned to swim before she starts school.
 ;ZZY^c\
The main aim of infant feeding is to provide adequate nutrition. It helps
to bear in mind that while breast-feeding is undoubtedly best if, for any
reason, you don’t breast-feed your baby, he’ll still thrive on bottle feeding.
Don’t feel guilty if you make this decision; concentrate on the needs of your
baby. The love and affection that you give your baby while you’re feeding
is as important as any milk. And once he’s on solids, the important rule to
remember is to take your lead from your child; as long as you offer a wide
variety of foods he doesn’t have to have “essential” foods every day.
Remember, above all, that food is a pleasure.

Nutritional needs W^gi]id&nZVg

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88 FEEDING
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BREAST-FEEDING—BIRTH TO 1 YEAR 89
MILK SUPPLY AND DEMAND FEEDING
All mothers are anatomically equipped to feed
their babies and there is no such thing as
mother’s milk that does not suit a baby: the milk
the breasts produce is the baby’s natural food.
• There is no such a thing as a mother physically
incapable of feeding her baby: the size of your
breasts bears no relation to the amount of milk
that you can produce, although breast
enlargement or reduction surgery can affect
your ability to breast-feed.
• Milk is produced in deeply buried glands, not
the fatty tissue of the breasts, so don’t worry
if your breasts are small: they BSFF adequate.
The amount of milk that you produce is
dependent on how much your baby takes,
on the principle of supply and demand. For
example, if your baby’s appetite is not very
great then your breasts will not produce very
much milk because they’re not being stimulated
by your baby to do so. If your baby is an eager
feeder, your breasts will respond and produce
more milk. The amount of milk available for
your baby will fluctuate throughout the whole
time that you breast-feed, according to how
much your baby takes.
• If your baby is hungry half an hour after being
fed, don’t worry. Your breasts will have
produced some milk for your baby to feed on,
and they’ll soon build up a supply for his new
needs. When the need for more food slows
down, the breasts will produce less.
• A newborn needs 2–3½ fluid ounces (60–100
milliliters) of milk per 1 pound (500 grams) of
body weight, so a 7 pound 11 ounce (3.5
kilogram) baby needs 14–24 fluid ounces
(400–650 milliliters) daily. Each breast
produces 1½–2 fluid ounces (40–60 milliliters)
of milk in three hours so a daily output of 24–
35 fluid ounces (700–1000 milliliters) is ample.
90 FEEDING
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COLOSTRUM
During the 72 hours after delivery, the breasts
don’t produce milk. Instead, they manufacture a
thin, yellow fluid called colostrum. This fluid is
made up of water, protein and minerals and it
takes care of all your baby’s nutritional needs
during the first days of his life before your breast
milk comes in.
Benefits of colostrum
Colostrum contains invaluable antibodies that
protect your baby against diseases like polio and
influenza, as well as intestinal and respiratory
infections. It has an additional laxative effect that
stimulates the excretion of meconium (TFF
Q).
It’s important to give your baby the breast
regularly in the first days, both to feed on the
colostrum and to get used to latching on to the
breast (TFF PQQPTJUF).
Every time your baby cries in the early days you
can give him your breast, but for only a couple of
minutes each side at first so that the nipples
don’t get sore. Giving your baby the breast also
helps the uterus to contract.
The first contact
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The let-down reflex
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bVcj[VXijgZd[b^a`^ci]Zb^a`\aVcYh0
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eVhhZY[gdbi]Zb^a`\aVcYhidi]Zb^a`
gZhZgkd^ghWZ]^cYi]ZVgZdaV#I]^hegdXZhh
]VeeZchl^i]^chZXdcYhVcY^h`cdlcVh
i]ZaZi"YdlcgZ[aZm#NdjbVn[ZZai]^hgZ[aZm
kZgnedlZg[jaan/^c[VXi!i]ZkZgnh^\]idg
hdjcYd[ndjgWVWnbVnig^\\Zg^i!VcYb^a`
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Vci^X^eVi^dcd[[ZZY^c\#
How to hold your baby
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The rooting reflex
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GIVING A BREAST-FEED
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Giving your baby the breast
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92 FEEDING
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BREAST-FEEDING TIPS
• You may find that because your let-down reflex
is too efficient, your milk pours out too quickly
and chokes the baby as soon as he sucks. You
can slow the flow down by expressing a little

milk first (TFF
Q).
• If your nipple is soft and small and your
baby has trouble finding it, put a cold, wet
cloth on it for a moment—your nipple will firm
up and protrude.
• Milk flows in both breasts at every nursing
and it’s best to use both breasts at each
feeding. Start with the heavier breast.
Bonding
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How long on each breast
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Removing baby from breast
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What to wear to breast-feed
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BREAST-FEEDING POSITIONS
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BREAST-FEEDING—BIRTH TO 1 YEAR 93
Breast-feeding positions
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ZkZgni]gZZ]djgh!VcYViildidi]gZZ
bdci]hVeegdm^bViZanZkZgn[djg]djgh#
=dlZkZg!ZkZgnWVWn^hY^[[ZgZci#
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V[iZgi]Z^gaViZZkZc^c\[ZZY^c\Wni]Z
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i]ZZVganYVnhd[[ZZY^c\hVldbVcbVn

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bZci^dch^iidndj!VcYXZgiV^can^[[g^ZcYh
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i]Z bZVchVcYXVeVX^inid[ZZY]ZgWVWn#
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WZXVjhZ[ddYcZZYha^fj^YidY^ajiZ^iVcY
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BREAST-FEEDING—BIRTH TO 1 YEAR 95
ENSURING A GOOD MILK SUPPLY
• Rest as much as you can, particularly during
the first weeks after the birth of your baby. This
is a time when you should sit rather than stand,
and lie rather than sit.
• Your milk flow will be affected if you are tense,
so go through your prenatal relaxation routine
and make sure that you have a period to
yourself every day when you can lie down.
• Go to bed as early as you can. You will be very
tired anyway since your sleep patterns will
probably be broken by your baby.
• As far as the house is concerned, let the
housework go. Don’t do anything but the
most urgent things.
• Make sure your diet is well balanced and
protein-rich. Don’t eat a lot of highly refined
and processed carbohydrates (cakes, cookies,
candy, or chocolates).
• You may need iron supplements and possibly
some vitamin supplements; ask your doctor.
l^i][aj^YdjcXZ&*b^aa^a^iZghd[eaV^c!
XddaZYWd^aZYlViZgidfjZcX]]^hi]^ghi#
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]VhVabdhiXZgiV^can]VYZcdj\]b^a`id
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• Drink about 5 pints (3 liters) of fluid every day
while you’re breast-feeding; some women find
they need a drink near them while feeding.
• Most of your milk is produced in the morning
when you are rested, so if you constantly rush
around or become tense during the day you’ll
find by evening that your supply is poor.
• If your baby doesn’t take all the milk available
in the early feedings of the day, express the
remainder. This will ensure that the supply is
restored up throughout the day.
• Get help and support from everyone around
you who is positive and optimistic. TTalk to your
pediatrician, lactation consultant, or nurse
practitioner; speak to friends who’ve had
babies and get advice from them.
• If you are unable to give your baby a feeding
because you’re away or because you’re ill,
express the milk off to keep the supply going.
96 FEEDING
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EXPRESSING BY HAND
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BREAST-FEEDING—BIRTH TO 1 YEAR 97
EXPRESSING TIPS
• Expressing milk should never hurt. If it does,
you’re not doing it correctly. Stop immediately.
• Every piece of equipment and all containers
should be sterile; your hands must be clean.
• If you’re worried about your baby not going
back to breast-feeding after a feeding from a
bottle, try giving the expressed milk from a cup,
with a spoon. They should both be sterilized.
• Milk must be stored correctly otherwise it will
spoil and make your baby ill. As soon as you’ve
until it is needed; it will keep for 48 hours. You
can freeze the milk for up to six months; the
expressed milk should be put into sterile plastic
containers that can be sealed. Don’t use glass;
it might crack.
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98 FEEDING
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BREAST-FEEDING—BIRTH TO 1 YEAR 99
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IF YOU’RE ILL
As long as you feel like breast-feeding, continue
to do so—even if you have to go to the hospital.
You may have to make special arrangements with
the nursing staff, but if this is what you want,
argue firmly for it, and don’t be dissuaded.
• If you have to have an anesthetic you will not
be able to breast-feed—not only will you be
too groggy afterwards, but the drugs you have
been given will have passed into your milk.
• If you have advance warning of an operation,
try to express and freeze your milk. This way
the baby will not miss your milk, even if he
misses the pleasure of feeding from you.
• If you are confined to bed with a bad cold or
flu, you can express your milk so your partner
can feed the baby if you feel too weak.
• If you’re too ill even to express milk your baby
will have to be given formula milk by bottle or
by spoon. He’ll probably protest at first, but will
acquiesce as he becomes hungrier.
100 FEEDING
Care of your breasts
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 CARE OF YOUR BREASTS 101

BREAST PROBLEMS
Problem Prevention Cure

Cracked nipples Shooting pain
when the baby suckles.
Feed little and often in the
first few days. Keep the
nipples dry by using
disposable breast pads or
clean hankies.
Keep feeding if at all possible. If
necessary, express the milk by hand
(not by pump), and feed the baby
by bottle or spoon.

Engorgement Extremely full Feed your baby frequently Have a hot bath and gently express
and painful breasts with a and try to encourage him some milk, or encourage it to flow by
swollen areola. to empty your breasts massaging toward the nipple.
regularly.

Blocked duct A hard red patch
on the outside of the breast
where the duct lies. This can
often occur as a result of
engorgement or if your bra or
clothes are too tight.
Same as for engorgement.
Wear a properly fitting bra
and keep feeding the babyy
in different positions
throughout the day.
Frequent feeding, offering the breast
with the blocked duct first so that it
is properly emptied. Express the
breast if necessary.

Mastitis Acute infection of the Same as for a blocked Antibiotics prescribed by your doctor.
milk duct resulting in a pus- duct. If this fails it will have to be drained
filled lump. surgically. You can, however, continue
to feed, even if you need an operation.

Breast abcesses This infection,
which results from an untreated
blocked duct, can make you feel
feverish; you may have a shiny
red patch on your breast.
Same as for a blocked Same as for a blocked duct. You will
duct. probably be prescribed antibiotics by
the doctor. Unless instructed
otherwise, you can continue to feed
your baby from the affected breast.

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102 FEEDING
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HYGIENE AND PREPARATION TIPS
• Always wash your hands before sterilizing,
preparing, and feedings.
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contact with your baby’s food is thoroughly
cleaned or sterilized before use and always
clean the work surface before starting to
prepare the formula.
• Sterilize every piece of equipment you use
for making up your baby’s bottles, as well
as pacifiers and teething rings.
• Make up the bottles according to the
instructions. Never add anything extra.
• Give the bottle to your baby as soon as it is
ready. Do not make up bottles in advance.
• Never give your baby leftover milk. Throw
away any milk that’s left in the bottle.

CLEANING EQUIPMENT

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MAKING UP A POWDER FORMULA

Bottles must be mixed strictly in accordance with when you need them. Bacteria can multiply fast in
the powder-to-water proportions recommended by bottles of warm formula, so don’t make up bottles
the manufacturer or by your doctor. Make bottles in advance and store them.

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 BOTTLE-FEEDING—BIRTH TO 1 YEAR 105

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BOTTLE TEMPERATURE
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BOTTLE-FEEDING—BIRTH TO 1 YEAR 107
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BOTTLE-FEEDING TIPS
• Don’t feed your baby when he’s lying flat; it is
very difficult to swallow in this position and
your baby may gag or even be sick.
• Never leave your baby with the bottle propped
up on a pillow or cushion. Not only is it very
dangerous because your baby could choke, but
he could become very uncomfortable if he has
to swallow a lot of air along with his formula
because of the angle at which the bottle’s been
propped. Moreover, your baby misses out on
the cuddling and affection that he should enjoy
while he nurses.
• Don’t try to force your baby to finish the bottle
after he has stopped sucking: he knows when
he’s had enough.
• Even if you think the formula isn’t right for your
baby, don’t change it without consulting your
pediatrician or nurse practitioner. It is very rare
for a brand of milk to be responsible for a baby
not eating well. Sometimes a baby is allergic to
cow’s milk, and may have to have a hydrolized
(broken down so it’s more easily digested)
formula. Always ask your doctor for advice.
Never change to a substitute formula without
checking with your pediatrician.
108 FEEDING
Possible bottle-feeding problems W^gi]id&nZVg
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BOTTLE-FEEDING—BIRTH TO 1 YEAR 109
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110 FEEDING
Night feedings W^gi]id&nZVg
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TIPS FOR NIGHT FEEDS
• Feed your baby in bed so that you are warm
and comfortable, but always put him back in
his crib afterward.
• If you’re very tired, and you are breast-feeding,
express enough milk for the nightfeeding and
put it into a sterile bottle, so your partner can
give the baby the bottle.
• Keep some diaper-changing necessities in your
bedroom so you can feed and change your
baby with minimal disturbance.
• It’s easy to get cold sitting up in bed so have
a sweater or robe handy.
• Have a drink by your bedside in case you get
thirsty while feeding.
• If your baby’s in another room and you’re
concerned about not hearing his cries, invest in
a baby monitor.
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 INTRODUCING SOLIDS—6 MONTHS 111

Introducing solids +bdci]h

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112 FEEDING
What foods to give
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TIPS FOR FEEDING
• Give your baby only one new food at a time
and then wait for several days to see if there’s
an adverse reaction.
• Use dry infant cereals that you have to make
up rather than ready-mixed cereals; they
contain more iron and are more nutritious.
• Only give cereal once a day.
• If your baby doesn’t like taking food from a
spoon, dip a clean fingertip into the food and
let him suck it off.
• If you find it difficult to feed your baby on your
lap, put ]^b in a baby seat on the floor.
• Keep plenty of paper towels nearby to mop up
any mess.
• Even early solids, especially banana, can stain
clothes, so put a small cloth bib on your baby.
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 ESTABLISHING SOLIDS—6 MONTHS TO 1 YEAR 113

Establishing solids +bdci]hid&nZVg

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114 FEEDING
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FOOD INTOLERANCE AND ALLERGY
Don’t worry too much, but take sensible
precautions with the foods you give your baby
—especially if you or your relatives have allergies.
• Don’t give your baby foods containing wheat
flour or gluten before he is seven months old
since he may find them difficult to digest.
• Avoid giving your baby soft-boiled eggs until
he is about one year old.
• Don’t give a baby under one years of age
honey; it can cause infant botulism, a rare but
serious disease.
• Don’t give your baby very high-fiber breakfast
cereals as they are too difficult to digest.
• Avoid unpasteurized cheese until your baby is
at least two years old.
• If your baby has a relative who suffers from
an allergic condition, avoid giving him peanuts,
or foods containing peanuts, and shellfish until
he is at least three years old.
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 ESTABLISHING SOLIDS—6 MONTHS TO 1 YEAR 115
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TIPS FOR FOOD PREPARATION
• Before steaming and puréeing fruit, peel, remove
the seeds and any parts that may choke the baby
and cut up into small pieces. Do the same for
the vegetables.
• Give your baby meat, cooked any way you like
and then puréed. Don’t forget fish, chicken, and
chicken livers, which are cheap, quick, and easy to
prepare. Thin down the puréed meat with
vegetable water or soup.
• Always choose the freshest-looking vegetables
(not wrinkled or dull-looking ones), and cook
them as soon as possible.
• Handle fruit and vegetables gently. Don’t cut them
until you have to and don’t crush and bruise them
because this destroys the vitamin C in them.
• Cook vegetables and fruit in as little water as
possible, with a tightly fitting lid on the pot, so
they are steamed rather than boiled. This helps
to retain the vitamins.
• Cook soft-skinned fruit and vegetables in their
skins because this helps to retain the vitamins
and will also give your child fiber. You may have
to remove the skin if it’s very tough and likely to
choke your baby.
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edhh^WaZ#9dc¼ihidgZXdd`ZYVcYgVl[ddYh
id\Zi]Zg!VcYejigVlbZVidg[^h]dcV
eaViZVii]ZWdiidbd[i]ZgZ[g^\ZgVidghd
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WZadl#9dc¼i`ZZe[ddY^ci]Z[gZZoZg
adc\Zgi]Vci]Zi^bZgZXdbbZcYZYWni]Z
• Use cast-iron cooking pots. A little iron will be
absorbed into the food and helps to boost
your child’s iron supply.
• Always make the food a suitable consistency for
your baby’s age. For example, a thick milk for your
six-month-old baby; a thicker cream for your
seven-month-old baby; and a slightly chunky
mash for a nine month old.
• Don’t use copper pans for green leafy vegetables
as copper breaks down vitamin C.
• Don’t cook canned foods for too long or you will
destroy the vitamin content.
• Don’t add salt or sugar to your child’s food; the
immature kidneys can’t handle a heavy salt load
and you will be doing your child a favor if you
don’t encourage a sweet tooth.
• Avoid using too many saturated fats in your
cooking—use safflower or corn oil instead.
• Don’t prepare vegetables or soak them in water
a long time before you cook them or you will
destroy the vitamin content.
• To discourage bacteria from growing, put your
baby’s food into the refrigerator as soon as it has
cooled to room temperature.
116 FEEDING
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VcYcZkZggZ[gZZoZYZ[gdhiZY[ddY#
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READY-PREPARED FOODS
• Check the list of ingredients on the can or jar.
They are listed in order of concentration, so never
buy anything in which water is listed first.
• Make sure that the jar is vacuum sealed when you
open it, otherwise it may be contaminated.
• Don’t buy “mixed dinners;” they usually contain
a lot of thickener.
• If possible, buy meat and vegetable dishes
separately and then combine them if you want
a “mixed dinner.”
• Don’t keep opened jars in the refrigerator for longer
than two days. Throw them away after that.
^cV]jggn!Wjii]ZnVgZbdgZZmeZch^kZ
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bV`^c\jeW^\WViX]Zh#>[ndj¼kZ[gdoZc
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]ZVi^c\i]Zbjefj^X`an#
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[ddYhh^beanVYYlViZg0i]ZlViZg^cl]^X]
ndj¼kZhiZVbZY[gj^idgkZ\ZiVWaZhl^i]cd
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• Don’t buy anything that has added salt, sugar,
modified starch or monosodium glutamate (MSG).
• Never store food in opened cans; put it into a dish
or bowl and keep it covered in the refrigerator.
• Don’t heat the food up in the jar—it could crack.
• It is very unhygienic to feed the baby from the jar
then keep the rest for a second meal, since it will
have become contaminated with saliva. It’s all
right to feed your baby from a jar if he’s going to
eat it all or if, for example, you’re on the move
and you don’t mind throwing away what’s left
when he’s had enough.
 ESTABLISHING SOLIDS—6 MONTHS TO 1 YEAR 117
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Giving drinks
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WEANING YOUR BABY ON TO A CUP
When he’s six months old, introduce your baby
to drinking from a cup as part of the process of
weaning from breast or bottle. The best times to
use a cup are at the lunchtime and late afternoon
feeding when he’ll probably be eager to eat
solids. Give him solids first and then try the cup.
There are a variety of special cups available.
Cups with spouts are best at the beginning
because they let the liquid drip out and the baby
has to half suck and half drink to get anything.
Hold the cup yourself and offer only a few sips of
milk at first, but release it as soon as he wants to
take it from you. As he gets more dexterous, he
can use a two-handled cup; the kind with slanted
lips are ideal because they don’t have to be
tipped far before the liquid comes out. Some
babies, however, prefer an open cup.
Your baby will gradually wean himself off the
morning feeding. He’ll still want a breast-feed or
bottle before bedtime until he’s at least a year
old—more for comfort than for food.
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118 FEEDING
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SELF-FEEDING TIPS
• Tuck a few tissues under the neckline of your
baby’s bib to keep his neck from getting wet as
he practices drinking.
• If a baby won’t wear a bib, put a colored scarf
round his neck to protect his clothes.
• If your baby is going to sneeze, get out of the
way or you will get covered in food.
• Fit a kitchen towel holder on the back of the
highchair or near it.
• Keep the highchair well away from your
walls—your baby will be quite capable of
throwing food by now.
• Get a nonslip bowl if you can since it will stay
in place while your baby is trying to get food
onto his spoon.
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]Zae]^bidWZXdbZbVcjVaanYZmiZgdjh
 ESTABLISHING SOLIDS—6 MONTHS TO 1 YEAR 119

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FINGER FOODS
If self-feeding with a spoon seems to frustrate your baby will be able to handle them easily, and even
baby, but his appetite is good, try finger foods. Your if the food is hard he will suck it.

Fruit and vegetables Protein

• Any fresh fruit that is easy to hold, cut into a slice, • Cubes of low-fat cheese
without the skin or seeds, e.g. bananas • Macaroni and cheese
• Any cooked vegetable that you can make into a • Pieces of cheese on toast
stick or a shape that is easy to grasp, e.g., carrots • Hamburgers cut into small, easily held pieces
• Mashed potato • Scrambled eggs
• Cottage cheese
Grains and cereals • Any kind of meat, preferably white, in pieces that
• Small pieces of sugarless dried cereal are easy to pick up
• Little balls of cooked rice • Chunks of firm fish, taken off the bone
• Whole-wheat bread (without the complete grains) • Sliced hard-boiled eggs—only give him yolk until
• Whole-wheat crackers (without complete grains) he’s aged one year
120 FEEDING
SAFETY TIPS
• You should be careful not to give your child a
piece of food that might stick in his throat or
be inhaled, so you should avoid nuts, fruit with
stones and seeds, unpeeled fruit with tough
skins, and raw vegetables.
• Don’t ever leave your child eating or drinking
alone in a room. If he gags, chokes, or vomits,
he needs immediate help (TFF
Q). 
• Don’t be obsessive, but be careful with
mealtime hygiene. Use clean utensils, a clean
highchair, and a clean bib.
• When you are storing food in the refrigerator,
cover containers with plastic wrap, and never
put cooked with uncooked meat together.
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 FOOD AND EATING—1 TO 2 YEARS 121

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DON’T GIVE YOUR CHILD:
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X]^aY]VhidZVi^cdgYZgidWZ]ZVai]n¸]Z • Popcorn
_jhi]Vhid]VkZeaZcind[hZch^WanXdd`ZY! • Whole nuts or very rough whole-wheat bread,
[gZh][ddYh[gdbl]^X]idWj^aYjeV with pieces of whole grain
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^bedgiVcieVgid[]^hY^ZiVh^i^hVjhZ[ja • Fruits with stones or pits, such as plums
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<^kZndjgX]^aYViaZVhidcZcjig^i^djh specifically requests them
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122 FEEDING

FOOD GROUPS
Food group Food Content

High protein Chicken, fish, lamb, beef, pork, offal, Protein, fat, iron, vitamins A, D, B
eggs, cheese, legumes

Milk and dairy Milk, cream, yogurt, ice cream, cheese Protein, fat, calcium, vitamins A, D, B2
products

Green and yellow Cabbage, sprouts, spinach, kale, Minerals, including calcium, chlorine,
vegetables green beans, squash, lettuce, chromium, cobalt, copper, manganese,,
celery, zucchini potassium, and sodium

Citrus fruit Oranges, grapefruit, lemons Vitamin C

Other vegetables Potatoes, beets, corn, carrots, Carbohydrates, vitamins A, B, C

and fruit cauliflower, pineapples, apricots

Breads and cereals Whole-wheat bread, noodles, rice Protein, carbohydrates, vitamin B,
iron, and calcium

Fats Butter, margarine, vegetable oils Vitamins A, D

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 FOOD AND EATING—1 TO 2 YEARS 123

SAMPLE DIET FOR A 14-MONTH-OLD CHILD

Day 1 Day 2 Day 3

Breakfast Breakfast Breakfast

1 egg, scrambled, ½ slice
buttered whole-wheat toast
1 cup diluted orange juice, 5
ounces (25 grams) yogurt, 2
tablespoons baby muesli, with
wheat germ, 1½ fluid ounces
(50 milliliters) milk, ½ banana
2 ounces (50 grams) cereal plus
milk, 1 cup diluted fresh orange
juice, ½ banana

Mid-morning Mid-morning Mid-morning

1 cup diluted orange juice, 1 cup diluted fruit juice, 1 cup water, 1 apple
1 apple 1 cookie

Lunch Lunch Lunch

2 ounces (50 grams) white fish, 1 cup milk, 1 cup water, 2 fish Egg florentine, (2 tablespoons
½ whole-wheat bread roll, fingers, 1 tablespoon peas spinach, 1 egg, 1–2 ounces/25–
1 tablespoon green beans, 50 grams cheese), 1 pear,
1 cup diluted fruit juice 1 yogurt (sugar-free), 1 cup milk

Mid-afternoon Mid-afternoon Mid-afternoon

1 cup water 1 cup water 2 cups diluted apple juice,
1 oatmeal cookie

Dinner Dinner Dinner

6 ounces (150 grams) beans, 1 egg omelette with 1 ounce Ham sandwich with whole-
2–3 ounces (50–75 grams) (25 grams) cheese, tablespoon wheat bread, cubes of cheese,
potatoes, 2 ounces (50 grams) fresh green beans, 1 cup milk, raw carrot, cubes of melon
cheese, ½ banana, 1 cup milk ¼ slice whole-wheat bread

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FOOD AND EATING—1 TO 2 YEARS 125
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126 FEEDING
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TIPS FOR FEEDING TWO-YEAR-OLDS
• Always make sure that a meal contains at least
one food you know your child likes.
• Always serve small amounts and allow second
helpings. A full plate is intimidating to a child.
• Keep foods simple. Children like to see what
they are eating: they don’t like messy foods.
• Always offer a variety of foods to guarantee
a balanced diet.
• Liven up your toddler’s meal by using colorful
food.
• Until your child is going to school, include
a finger food in a meal when possible.
• Include foods that are fun to eat, like jelly,
oven-baked potato chips, or an ice cream cone.
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Organizing mealtimes
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MAKING MEALTIMES FUN
As with all feeding, the key word is flexibility. You
and your child should enjoy yourselves, so give a
little thought to making mealtimes entertaining for
all of you.
• Ice cream cones don’t have to be used just for ice
cream. Fill one with cheese and tomato chopped
together or tuna fish salad. This allows you to give
your three-year-old a snack on the move.
• Encourage your child to “build” his meal from
sandwiches, cubes of cheese, vegetables, and
dried fruit. He can build a house, a car, or a boat,
and when it is finished, eat it.
FOOD AND EATING—2 TO 3 YEARS 127
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[aZm^WaZl^i]]^b#
• If he wants to use a knife, give your child a plastic
or blunt-ended one.
• Let your child use a straw for drinking sometimes.
So he won’t tip the drink over, cut the straw off so
there is no more than 2 inches (5 centimeters)
above the cup, or use a flexible straw.
• Be open to innovation and occasionally serve your
child’s meal on a doll’s plate or on a flat toy.
• Fill a cake pan with lots of different finger foods,
like cubes of cheese, pieces of cold meat, raw
vegetables, fruit, and tiny sandwiches, and let your
child pick what he wants.
128 FEEDING
Possible feeding problems 'id(nZVgh
The overweight toddler
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]ZVai]nhcVX`hsee p.130#
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FOOD AND EATING—2 TO 3 YEARS 129
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Talk to your pediatrician
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130 FEEDING
Snacks &id(nZVgh
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SNACKS—1 TO 3 YEARS 131
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 7dlZaVcY
WaVYYZg[jcXi^dc
The most important event that will occur in the process of bowel and bladder
control will be when your child manages to stay dry and clean both day and
night. However, this won’t happen until she’s physiologically and mentally
mature enough to cooperate. You can’t speed up this process—you can only
help your child as she gradually gains control over her own body.

Passing urine W^gi]id&nZVg

>cndjc\WVW^Zh!i]ZWaVYYZgZbei^Zh^ihZa[
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Bowel movements W^gi]id&nZVg

;dgi]Z')]djghV[iZgYZa^kZgnndjgWVWn
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134 BOWEL AND BLADDER FUNCTION
Stools of the breast-fed baby
9jg^c\i]Z[^ghiYVndghd!ndjgWVWn¼h
hiddahl^aaWZ\gZZc^h]WaVX`!hbddi]!hi^X`n
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Stools of the bottle-fed baby
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WVWn[ZYdc[dgbjaViZcYhid]VkZbdgZ
[gZfjZcihiddahVcYi]ZhiddahiZcYidWZ
[^gbZg!WgdlcZg!VcYhbZaa^Zgi]Vci]dhZ
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Changes in bowel movements
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YdZhc¼ibViiZg^[i]ZhiddahX]Vc\Z^c
VeeZVgVcXZ[gdbdcZYVnidi]ZcZmi#
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Possible bowel problems W^gi]id&nZVg
Constipation
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BOWEL MOVEMENTS—BIRTH TO 1 YEAR 135
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Diarrhea
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136 BOWEL AND BLADDER FUNCTION
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Gaining control &id'nZVgh
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Gaining bowel control
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WZilZZc^ccZghZchVi^dchVcYi]Ze]nh^XVa
gZVa^ind[jg^cVi^c\VcYeVhh^c\[ZXZh#Ndj¼aa
cdi^XZi]^hVlVgZcZhhl]Zc![dgZmVbeaZ!
h]ZhjYYZcanhidehl]Vih]Z¼hYd^c\VcY
ed^cihid]ZgY^VeZg!dgViigVXihndjg
ViiZci^dcl^i]VXgndgVh]djii]ZcY^gi^Zh

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V[jaagZXijbVcYV[jaaWaVYYZgl^aa
egdWVWandXXjgViVWdjii]ZhVbZi^bZ!Wji
]ZgVW^a^inidYZVal^i]i]ZildhZchVi^dch
l^aaWZY^[[ZgZci#
Introducing a potty
>i¼hbjX]ZVh^Zgid¹]daYdcºidV[jaa
gZXijbi]Vc^i^hidV[jaaWaVYYZg!VcYndjg
X]^aYl^aaegdWVWanVX]^ZkZWdlZaXdcigda
[^ghi#7ZXVjhZd[i]^h!^i¼hl^hZid]Zaendjg
X]^aYjhZi]Zediin[dgWdlZabdkZbZcih
[^ghi#>i¼hVahdhZch^WaZ[gdbndjged^cid[
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egZY^XiVWaZ!VcYndjXVcegZeVgZ[dgi]Zb
dc ndjg X]^aY¼h WZ]Va[ L]Zc ndjg X]^aY
GAINING CONTROL—1 TO 2 YEARS 137
Xadi]ZhdgY^VeZghhdi]Vicdi]^c\]^cYZgh
]Zg\Zii^c\dcidi]Zediin^ci^bZ#
6[iZgh]Z¼hWZZcdci]Zediin!l^eZ]Zg
Wdiidb[gdci"id"WVX`^c\^gahl^i]id^aZi
eVeZgVcYejii]ZeVeZg^ci]Zediin#;ajh]
i]ZXdciZcihd[i]ZediinYdlci]Zid^aZi#
GZbdkZVcnigVXZd[[ZXZhVcYg^chZ^idji!
i]ZclVh]^il^i]Y^h^c[ZXiVci#
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ediin¸^il^aa]VkZi]Zdeedh^iZZ[[ZXindj
hZZ`!VcYl]ZcndjcZmihj\\Zhii]Vih]Z
jhZ^indjb^\]iWZ[VXZYl^i]Ved^ci"
WaVc`gZ[jhVadgZkZcViVcigjb#>chiZVY!
_jhi[dg\ZiVWdjii]Zediin[dgV[ZlYVnh
VcYi]ZcgZ^cigdYjXZ^i^cVXVhjValVn#
138 BOWEL AND BLADDER FUNCTION
Gaining bladder control
I]^hegdXZhhl^aa]VkZidWZ\gVYjVaVcY[dg
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Va^iiaZjg^cZl^i]djihedciVcZdjhan
Zbein^c\#DcZd[i]Z[^ghih^\chd[i]^h
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V[iZgVgZVhdcVWaZaZc\i]d[i^bZ[dg
ZmVbeaZ!V[iZgVcV[iZgcddccVe#DcXZ
ndjgX]^aYhiVnhYgngZ\jaVgani]gdj\]dji
i]^hcVe!ndjXVchiVgiidaZVkZd[[i]Vi
Y^VeZg#7Z[dgZndjejindjgX]^aYYdlc
[dg]ZgcVe!ZcXdjgV\Z]ZgidZbein]Zg
WaVYYZg#>[h]ZYdZh!Xdc\gVijaViZ]Zg0^[
h]ZYdZhc¼i!Ydc¼ibV`ZV[jhh!_jhi ign^i
V\V^cVcdi]ZgYVn#
L]Zch]ZXVcYdi]^hhjXXZhh[jaanVcY
XVc^cY^XViZidndji]Vih]ZlVcihid\d
id i]Zediin!ndjXVchiVgiaZVk^c\d[[
Y^VeZghXdbeaZiZanYjg^c\i]ZYVn#
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Xdb[dgiVWan[dgV[Zlb^cjiZhl]^aZndj
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TIPS
• Let your child develop at her own pace. There is
no way that you can speed up the process. You
can only be there to help your child along.
• Let your child decide whether to sit on the
potty. You can suggest that she does but you
should never force the issue.
• Treat your child’s feces in a sensible manner,
and never show disgust or dislike for them.
They’re a natural part of your child and initially
she’ll be very proud of them.
• Do not delay once your child has signaled she
wants the potty, since control is only possible
for a short time.
• Always praise your child and treat her control
as an accomplishment.
I]ZgZl^aaWZVXX^YZcih!hdWZegZeVgZY[dg
i]ZbVcYValVnhWZhnbeVi]Zi^X#CZkZg
hXdaYndjgidYYaZg^[h]Z]VhVcVXX^YZci/
^i¼hcdi]Zg[Vjai#?jhiXaZVcjeVcYX]Vc\Z
]ZgXadi]^c\l^i]djiV[jhh#
Toilet “training”
>Vbl]daZ]ZVgiZYanV\V^chiid^aZiigV^c^c\#
;dgbZ!i]ZgZVgZcdVg\jbZcih^c[Vkdg
d[ ^i0i]ZgZVgZdcanVg\jbZcihV\V^chi^i#
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Vii^ijYZhi]ViVYkdXViZ¹igV^c^c\ºVX]^aY¼h
WdlZabdkZbZcihVcYWaVYYZg[jcXi^dc
h]djaYWZXdbeaZiZanZgVY^XViZY[gdbX]^aY
XVgZVcYX]^aYYZkZadebZci#
I]ZgZVhdch>[ZZai]^hhdhigdc\anVgZ
h^beaZ#>i^h^bedhh^WaZidigV^cVX]^aYid
YdVcni]^c\jcaZhh]ZgWdYn]VhYZkZadeZY
idVed^cil]ZgZ^i^hVcVidb^XVaanVcY
e]nh^dad\^XVaanVWaZideZg[dgbi]ZiVh`h
i]VindjYZbVcYd[^i#
L]ZcVeea^ZYidWdlZaVcYWaVYYZg
[jcXi^dc!i]^hbZVchi]Vi^i^h^bedhh^WaZ
[dgndjgX]^aYidXdcigdaZ^i]Zgd[i]ZhZ
jci^ai]ZWdlZaVcYi]ZWaVYYZgbjhXaZh
VgZhigdc\Zcdj\]id]daYjg^cZVcY[ZXZh!
VcYi]Vi!ViVh^\cVa[gdbi]ZWgV^c!i]Z
cZgkZhidi]ZWdlZaVcYWaVYYZgVgZ
bVijgZZcdj\]iddWZni]ZdgYZgid
ZkVXjViZ#>[ i]^haZkZad[YZkZadebZci]Vh
cdiWZZcgZVX]ZY!i]ZgZ^hcdi]^c\i]Vi
ndjgX]^aYXVcYdidVY]ZgZidndjg
¹igV^c^c\ºegd\gVb#
NdjXVchZZ^bbZY^ViZanl]ViVYgZVY[ja
edh^i^dci]^hejihndjgX]^aY^c#H]Z^h
VlVgZd[l]VindjlVci!Wji]ZgWdYn^h
jcVWaZidYd^i#NdjgidYYaZg¼hYZh^gZid
eaZVhZndjdkZgg^YZhVabdhiVaad[]Zgdi]Zg
YZh^gZh!VcYh]Zl^aaWZ[gjhigViZYVcY
jc]VeenVicdiWZ^c\VWaZid#H]ZbVn[ZZa
^cVYZfjViZ!Vh]VbZY!\j^ain!dggZhZci[ja#

>[ndj^ch^hidcid^aZiigV^c^c\l]Zcndjg
X]^aY^hcdigZVYn[dg^i!i]ZgZhjaiXVcdcan
WZhVYcZhh#NdjggZaVi^dch]^el^i]ndjg
X]^aYl^aaYZiZg^dgViZ#Ndjl^aaWZXdbZV
hdjgXZd[jc]Vee^cZhh!VcYWdlZa
bdkZbZcihVcYediinigV^c^c\l^aaWZXdbZ
Gaining control 'id(nZVgh
L]^aZ^i^ha^`Zani]VindjgX]^aY]VhVagZVYn
h]dlch^\chd[bjhXaZXdcigdaVcY]VhVc
VlVgZcZhhd[jg^cVi^dcVcYWdlZa
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]Vhc¼i#>[i]^h^hi]ZXVhZ!Ydc¼ildggn#
I]ZegdXZYjgZ[dg]Zae^c\ndjgX]^aYid
jcYZghiVcY]ZgWdY^angZfj^gZbZcih^hi]Z
hVbZ!cdbViiZgl]ViV\Zh]ZhiVgih#
>[!]dlZkZg!ndjgX]^aY]Vh\V^cZY
hdbZXdcigda!ndj¼aa[^cYi]Vih]Z¼aa
Xdci^cjZid^begdkZYjg^c\i]^hnZVg#>i
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nZVghdaYVeegdm^bViZan.%eZgXZcid[\^gah
VcY,*eZgXZcid[Wdnh]VkZXdbeaZiZ
WdlZaXdcigdaVcYZkZc\didi]Z
WVi]gddbVadcZ#=dlZkZg!i]ZhVbZ
hijYnVahdh]dlZYi]VibdgZi]Vc]Va[i]Z
X]^aYgZci]ViV\ZlZgZhi^aalZiVic^\]i!
Vai]dj\]i]ZnXdjaY\dl^i]djiVY^VeZg
Yjg^c\i]ZYVn#
Staying dry at night
7aVYYZgXdcigdaVic^\]iXdbZhaVhid[Vaa#
>i ^hd[iZccdiedhh^WaZ[dgVild"VcY"V"
]Va["nZVg"daYX]^aYid]daYjg^cZ[dgbjX]
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hiVgiaZVk^c\d[[i]Zc^\]i"i^bZY^VeZg^h
l]Zch]ZlV`ZhjegZ\jaVganl^i]VYgn
Y^VeZg#L]Zci]^h]VeeZch!aZVkZd[[i]Z
GAINING CONTROL—2 TO 3 YEARS 139
VWViiaZ\gdjcYd[ndjgWVWn¼hl^aaV\V^chi
ndjgcZgkZh!VcYndjl^aaValVnhWZi]Z
adhZg#NdjXVccdibV`ZndjgWVWneVhhV
hiddadg`ZZeVY^VeZgYgn!VcY^[ndjign!
ndj¼aah^beanbV`ZndjgX]^aYb^hZgVWaZ
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ZcXdjgV\Z]ZgidZbein]ZgWaVYYZgWZ[dgZ
h]Z\dZhidhaZZe#AZVkZVediinWZh^YZ
i]Z WZYVcYhj\\Zhih]ZjhZ^i^[cZXZhhVgn
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i]Vih]ZXVchZZl]Vih]Z¼hYd^c\VcYWZ
egZeVgZYid]Zae]Zg^[cZXZhhVgn#
>i¼hVW^\hiZe[dgndjgX]^aYidhide
gZan^c\dcndjVcYidiV`ZgZhedch^W^a^in
[dgjh^c\i]Zediin]ZghZa[#:cXdjgV\Zndjg
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^bedgiVcii]Vindj]ZaeVcYi]Vih]Z[ZZah
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7ZegZeVgZY[dgVXX^YZcih!WjicZkZg
\ZijehZiWni]Zb#NdjXVcb^c^b^oZi]Z
Vbdjcid[ldg`Wn/
™ egdiZXi^c\i]ZbViigZhhl^i]VgjWWZg
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™ ejii^c\VhbVaagjWWZgh]ZZidcided[
i]ZX]^aY¼hdgY^cVgnh]ZZi!l^i]V]Va[
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140 BOWEL AND BLADDER FUNCTION
Getting used to the toilet
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dgWdm^c[gdcid[i]Zid^aZihdi]Vih]ZXVc
Xa^bWjeZVh^an#H]dlndjga^iiaZWdn]dl
Possible bowel and bladder problems 'id(nZVgh
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VadcZ!gZheZXi]Zgl^h]Zh#=dlZkZg!Yd
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>[ndjgX]^aY^hlZiYjg^c\i]ZYVnVcY
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i]ZhZ^ckZhi^\Vi^dchbVnWZejid[[jci^a
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i]ZeZY^Vig^X^VcVWdjiVjg^cVgnegdWaZb!
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Bed-wetting
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VWaZidWZYgnVic^\]ijci^alZaaeVhi[djg
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UP

TIPS
• Whenever you travel, make sure that you have
a potty with you so that your child can go under
any circumstances without having to wait. Put the
potty on the floor in the back of your car so that
you can stop anywhere along the road instead of
having to worry about finding a public restroom
in a hurry.
• If she sits down and can’t do anything, turn on
the faucets; this works for babies as well.
• If you keep star charts for different
accomplishments, keep one for each success.
• If you have a potty in the bathroom, you and your
child can go to the toilet at the same time.
i]^c`^c\bVn]Zae#9dc¼ibV`ZVW^\i]^c\
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dc!VhhjgZndjgX]^aYi]Vi^il^aaZkZcijVaan
hide!WZXVjhZ^iYdZh#H]Zl^aa_jhidji\gdl
^i!hdWZXVabVcYhnbeVi]Zi^XViVaai^bZh#
Regression
>[ndjgX]^aYhjYYZcanhZZbhidadhZWaVYYZg
VcYWdlZaXdcigdaVcYgZ\gZhhZhidVc
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e]nh^XVa^aacZhhdgVcZbdi^dcVaY^hijgWVcXZ#
HdbZi^bZhi]ZXVjhZ^hdWk^djh¸VcZl
WVWn![dgZmVbeaZ!bVnbV`ZndjgX]^aY[ZZa
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[dg]ZgidignViiZci^dc"hZZ`^c\WZ]Vk^dg
idYZigVXi[gdbi]ZcZlWVWn!l]^X]bVn
^cXajYZlZii^c\VcYhd^a^c\]ZgXadi]Zh#
HiVgi^c\cjghZgnhX]dda!bdk^c\idVcZl
]djhZ!dgndjgVWhZcXZXdjaYVaahi^bjaViZ
i]ZhVbZeViiZgcd[WZ]Vk^dg#>[cdcZd[
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bVn]VkZYZkZadeZYVc^c[ZXi^dcdgbVn
GAINING CONTROL—2 TO 3 YEARS 141
• Let your child accompany you to the bathroom at
an early age so that she can learn from watching
you. This works particularly well with boys.
• Tell your child quite firmly and sympathetically
that accidents will always be ignored and forgiven,
and that she should not worry about them.
• Get a potty well before you think your child will
need it. You can explain why it is there and that
when she is old enough she’ll be able to use it.
This may give your child an incentive to try.
• Be wary of flushing the toilet when your child’s
with you—many are frightened by the noise, and
by the fact that “part of them” is being taken away.
]VkZVb^cdgVcVidb^XVaVWcdgbVa^in^c]Zg
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Toddler diarrhea
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 HaZZe^c\
A newborn baby spends most of the time asleep but as he gets older
regular sleeping patterns will emerge. By the time he’s three months old
he’ll have one main wakeful period a day, usually at the same time and
often in the late afternoon or early evening. By the time your child is
12 months old, he’ll probably be having two naps a day, one in the morning
and one in the afternoon, and will be sleeping through the night. Although
the sleeping patterns will gradually come to resemble those of an adult
during the second and third year, your child will still need a brief nap during
the day because of the energy he’s using in growing and in play.

All about sleeping W^gi]id&nZVg

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lZY^Yc¼iVWVcYdcWZYi^bZgdji^cZh#
Where your baby should sleep
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144 SLEEPING
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What your baby should wear
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cZZYX]Vc\^c\[gZfjZcian!ndj¼aalVci
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daY!ndjbVnlVciidjhZVhaZZe^c\WV\!
ZheZX^Vaan^ci]Zl^ciZgsee p.36#Ndjg
BED-MAKING TIPS
• Your baby will be most comfortable wrapped
in sheets and blankets made of natural fibre—
cotton is ideal.
• Do not use blankets with fringes—he may suck
on them.
• Avoid lacy, openwork shawls because your
baby’s fingers might get stuck in the holes.
• You can use your own old sheets, cut to the
correct size, in addition to new ones. The more
you have, the less frequently you’ll have to do
the wash.
• Use a pillowcase as a sheet—just slide the
mattress into it. When one side gets dirty just
turn the mattress over.
WHAT BEDDING TO USE
T
Temperature What to use
57ºF (14ºC) Sheet and four blankets
or more
60ºF (16ºC) Sheet and three blankets
65ºF (18ºC) Sheet and two blankets
68ºF (20ºC) Sheet and one blanket
75ºF (24ºC) Sheet only
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 ALL ABOUT SLEEPING—BIRTH TO 1 YEAR 145

Putting your baby down to sleep

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Getting your young baby to sleep

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146 SLEEPING
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Getting your older baby to sleep
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\didhaZZeVic^\]i#
SLEEPING TIPS
• Keep pre-bedtime as happy and pleasant as
possible.
• Try giving a comfort suck from the breast or the
bottle just before he’s put to bed.
• Develop a routine and stick to it. Don’t put your
baby straight to bed: work out a routine of play,
then bath, bed, story, song, and then goodnight.
But don’t leave the room; quietly tidy up so that
your baby learns that he can drift off to sleep
without actually “losing” you.
• Let your baby develop comfort habits (see above).
• Rock your baby’s crib if he finds that soothing.
Security objects
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Xdb[dgi^chiZVYd[ndj#
• Play a musical mobile. Many babies are fascinated
by the movements they make and are soothed by
the sound.
• Don’t take your older baby out with you in the
evenings, even if you used to do this earlier with
no problems. He’ll be used to his own routine and
his own room and will be frightened by being
moved somewhere else.
• When he does cry, always go back but don’t pick
him up immediately. See what’s wrong first—he
may just need you to change his position or adjust
the temperature in the room.

Naps
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Possible problems W^gi]id&nZVg
Early wakers
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hbVaai]VindjgWVWnXdjaYX]d`Zdci]Zb#
ALL ABOUT SLEEPING—BIRTH TO 1 YEAR 147
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l]daZ[Vb^an^[i]Zgdji^cZhd[VYjaiVcY
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Going out at night
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dcidVaZc\i]d[hig^c\#>il^aaVahd]Zae^[
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eaVnl^i]#BV`ZhjgZi]Zgddb^hc¼iidd
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148 SLEEPING
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Ydc¼iYZaVn0\dVidcXZVcY\^kZVaai]Z
Xdb[dgiVcYV[[ZXi^dcndjXVc#
Night wakers
Young babies>i^hVWhdajiZanZhhZci^Va
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ALL ABOUT SLEEPING—1 TO 2 YEARS 149
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150 SLEEPING
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HELPING YOUR TODDLER TO SLEEP
During the day
• Make up a nap time box for your child with
favorite toys and books that he can look at as he
gets sleepy before a nap. Don’t include good or
expensive books—they may get ripped up. Use
board books or old books. A good alternative is to
make up your own books by pasting interesting
pictures from magazines onto cardboard and then
covering them with clear plastic.
• Give your child a occasional treat by letting him
take a nap in your bed, or somewhere near you.
• If your child won’t take a nap, make sure that he
has a rest time where he is calm and quiet.
• If your toddler won’t go to sleep, put on a long-
playing tape or CD. Teach your child that the rest
time is not over until the music stops.
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In the evening
• Don’t put your child to bed immediately after an
exciting game or rough-and-tumble—he will have
great difficulty settling down, which will be
frustrating for you. Give him 10–15 minutes to
quiet down, sitting with you watching TV or
looking at a book.
• Even a small child likes to look at a book in bed
so, if your baby is quite happy, leave him with a
favorite, nonscary book.
• Put a dab of your perfume or aftershave on your
child’s pillow and suggest that he breathe it in
deeply. Deep breathing is relaxing and calming
and will help your child get to sleep.
• Give your toddler a bath before bedtime and
follow this with a warm drink and a story in bed.
 ALL ABOUT SLEEPING—1 TO 2 YEARS 151

Bedtime routines
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152 SLEEPING

Dealing with a sleepless child

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i]Zhd"XVaaZYgjaZhidi]Zl^cY#>[ndj[ZZa ™ Bn]jhWVcYVcY>VaiZgcViZYc^\]ih¹dc
^i¼hcZXZhhVgnidignhdbZi]^c\a^`Zi]^h Yjinº/dcZhiVnZYl^i]i]ZX]^aY0i]Z
>hj\\Zhii]Vindjign^ihddcZggVi]Zgi]Vc di]ZggZbV^cZYhaZZe^c\jcaZhhi]ZgZ
aViZg#>¼bXdck^cXZYndj¼gZcdiWjn^c\ lVhVgZVaZbZg\ZcXn#

TIPS FOR EARLY WAKERS

• Put a pile of cloth or board books at the bottom
of the crib or bed for early morning “reading.”
Make sure that there is enough light to see by;
if there isn’t, leave on a low-wattage nightlight
when you put your toddler to bed.
• Put a soft box or plastic bucket at the side of the
bed or crib with small toys, crayons, paper, bits of
cloth, or interesting household articles in it, so he
can play with them.
• Leave a paper bag with some fresh fruit or bread
at the bottom of the bed; never put the food in a
plastic bag for safety reasons.
• Leave a drink of water in a plastic cup within
reach of your child.

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Refusing to go to bed
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9jg^c\i]ZYVni]ZhZY^[[^XjaiX]^aYgZcVgZ
YZa^\]i[jaVcYkZgngZlVgY^c\!WjindjeVn
i]ZeZcVainVic^\]i#
Ildd[bn[djghdchlZgZhaZZeaZhh!
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eg^cX^eaZh[dgXde^c\#Ndj]VkZid\Zindjg
eg^dg^i^Zhg^\]i/cddcZXVc[jcXi^dc
egdeZgan[dgadc\l^i]djiVYZfjViZhaZZe
VcYVeVgZci^hcdZmXZei^dc#HaZZe^hidd
^bedgiVciidb^hhVcYndjVgZ_jhi^[^ZY^c
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cdiVYdeiV[ZlegV\bVi^XgjaZh^ceaVXZd[
i]ZdaY"[Vh]^dcZYYd\bVi^XdcZh4
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[ZZidci]Z[addg!dcVXdjX]!^cndjgaVe#
ALL ABOUT SLEEPING—1 TO 2 YEARS 153
™ 7Z[aZm^WaZVWdjiWZYi^bZ#AZ[iid
i]ZbhZakZh!bdhiX]^aYgZc\didhaZZeVi
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ZkZc^c\!l]Zi]Zgndjejii]ZbidWZY
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gddbdci]Z^gdlc!^chiZVYd[]Veen^c
ndjgXdbeVcn4
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I]^hd[iZcgZaVmZhX]^aYgZcVcYbV`Zh
i]ZbhaZZen#
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Rapid-return technique
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154 SLEEPING
All about sleeping 'id(nZVgh
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i^bZ!eZgnZVg#
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hide]Vk^c\cVeh!Vai]dj\]i]ZbV_dg^in
hi^aacZZYVgZhieZg^dY^cYddghV[iZgajcX]
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Sleep routine
8]^aYgZcVWdjii]ZV\Zd[ildVcYi]gZZ
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TIPS FOR MAKING BEDTIMES EASY
• Mark bedtime with an alarm or a timer, so that
you can give your children five minutes warning.
• For a young child, have a toy clock next to the
real clock and set the hands of the toy clock to
bedtime. When the hands of the real clock match
up with the toy clock, it is time for bed.
• Keep a child’s bedtime as near the same time as
you can every night to help establish regular
sleeping patterns.
• Children are often not sleepy at their bedtimes.
They like the time to slow down just lying in bed
looking at a new toy, reading a new book, or
chatting to one another. It is a good idea to have
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children who are near each other’s own age
sharing a bedroom until they require privacy.
• Once your children get into a bed, lie down with
them before you leave them to go to sleep. It is
very nice for them; it warms up the bed, and their
last memories are of your closeness. It is also very
relaxing for you: I did it with my children and I
nearly always found that I dropped off before they
did. It was a tradition we started when they were
young but continued after they went to school.
 ALL ABOUT SLEEPING—2 TO 3 YEARS 155

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dgXgn^c\l^i]Y^higZhh#>i^hldgi]bV`^c\ Bedroom rituals
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156 SLEEPING
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Possible sleep problems 'id(nZVgh
Delaying tactics
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ALL ABOUT SLEEPING—2 TO 3 YEARS 157
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/ 8gn^c\
Many newborn babies cry a lot, so be prepared for it. If you expect your
baby to cry, and treat it as normal when she does, you’ll find it easier to
cope with. If your baby is one of the few who doesn’t cry much, think of
it as a bonus. In order to understand why your baby is crying, and how you
can provide comfort, bear in mind that what upsets a baby, and what
comforts her, changes as she develops. A new baby may cry when she’s
undressed for a bath; a one-year-old may cry when you leave the room.
The new baby will be comforted by being snugly wrapped up in a towel;
the one-year-old will be comforted by the sight of you returning.

All about crying W^gi]id&nZVg

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160 CRYING
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Never leave your baby to cry
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The mother’s response
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ALL ABOUT CRYING—BIRTH TO 1 YEAR 161
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Crying spells
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162 CRYING
Causes of crying W^gi]id+bdci]h
Hunger
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GENERAL CRYING CURES
If your baby still seems fretful, try some, or all, of
the following remedies as part of your crying cure.
Most babies are soothed by movement and
sound, and many parents find it relaxing, too.
Movement
• Rock your baby—rocking chairs and swings are
ideal for this.
• Walk or dance with your baby.
• Bounce your baby gently in your arms or on a
bed or in the crib.
• Put your baby in a bouncy seat, and rock it
gently for her.
• Take your baby for a ride in the car, or a walk
in her carriage, stroller, or sling, even at night.
• If you are on your own, put your baby in a sling
and just let her cry. Keep doing whatever you
want to do and try to ignore the crying.
Sound
• Talk, sing, or croon to your baby.
• Put on the radio or television.
• Put on the vacuum cleaner, or let a faucet run
forcefully into the sink for a few minutes.
• Give your baby a noisy toy. Shake and rattle it.
• Play tapes or CDs of calm music.
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 CAUSES OF CRYING—BIRTH TO 6 MONTHS 163
Temperature
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IF CRYING IS DIFFICULT TO COPE WITH
One of the things you should be aware of is that
every parent at some time or other contemplates
doing something physically violent to her or his
children. Most mothers with newborn babies who
are exhausted and trying to pacify a screaming baby
will confess that they have thought of doing
anything to stop the baby crying. It is not abnormal
to think such things. It’s only abnormal to do them.
A crying baby can be particularly difficult to
handle before your period. Mothers who are ideal
parents—very loving and caring, sympathetic, and
patient for the rest of the month—can find the few
days prior to menstruation a challenging time.
Most mothers are aware when they begin to lose
hold of themselves and are able to control violent
Undressing
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behavior against their children. But if you feel
yourself sliding down a slippery slope, you should
seek help, first from your partner, or from a friend,
but also from your doctor.
Get help if necessary
If you ever find yourself hitting or shaking your baby,
don’t feel that it is an admission of failure to seek
help. You must do so immediately, both for your
child’s sake and your own. Don’t stand by and let
your partner injure your child either: try to make him
or her see that what he or she is doing is wrong. If
he or she is impervious to your pleas, seek help on
behalf of both of you. Contact your doctor, or the
police immediately.
164 CRYING
COLIC
This term describes unexplained recurrent bouts
of crying usually in the late afternoon or evening,
though they can occur any time. The crying may
be intense and brief or last for hours, and is not
generally pacified by the usual remedies. The
baby’s face gets red and she draws her legs up.
Many causes have been suggested, such as
overfeeding, underfeeding, gas, being picked up
too much or too little, indigestion and tension.
It has always seemed to me that tension is the
most likely cause. You’re busy in the evening and
it’s likely that your baby picks up on the tension
and responds by crying.
Since your baby is likely to cry every night for
12 weeks, I’m against using medicine to prevent
it. Of course, try to soothe your baby, but don’t
expect her to respond readily. Take comfort from
the fact that these colicky spells come only at
night and usually only last for three months. Colic
generally stops without you doing anything and is
rarely serious.
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 THE CAUSES OF CRYING—6 MONTHS TO 1 YEAR 165
Fatigue
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Causes of crying +bdci]hid&nZVg
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ALL ABOUT CRYING—1 TO 2 YEARS 167
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168 CRYING
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™ >cndjgViiZbeihVihnbeVi]nVcY
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X]^aY¼hVYkZcijgdjhhe^g^iVcYhide]Zg
[gdbWj^aY^c\]ZghZa["Xdc[^YZcXZ#
Frustration
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i]Vindj¼aaWZi]ZhdjgXZd[[gjhigVi^dc
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Temper tantrums
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l]Zcedhh^WaZ!gZheZXii]^hVcYYdc¼i
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ldggn^[h]ZdcanlVcihidZVi\gZZc
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Nighttime crying
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i]Vindj\^kZi]ZZkZc^c\Vg]ni]bi]Vi
 ALL ABOUT CRYING—1 TO 2 YEARS 169

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170 CRYING
All about crying 'id(nZVgh
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d[]Zgdlcedh^i^dc^ci]Z[Vb^an!Vbdc\
[g^ZcYh!VcY^ci]ZldgaY^c\ZcZgVa0h]Z
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VgZcdadc\ZgXdc[^cZYidh^beaZdcZha^`Z
i]Z[ZVgd[hZeVgVi^dc#I]ZgZVgZVaahdgihd[
cZlVcYjcjhjVai]^c\h]VeeZc^c\ZkZgn
TIPS FOR MAKING SEPARATION EASIER
Separation anxieties
Children over the age of three still dislike being
separated from their parents, even if they are only
going to spend the evening out of the house. Up to
the age of five or six it is quite normal for a child to
shed a few tears until she is reassured about some
of the details of the evening.
One of the most difficult separations for a child of
this age is when her mother goes into hospital for
the birth of a new baby. In addition to the jealousy
that most children feel at this time (TFF
Q),
there is the upheaval of being separated from the
mother. Prepare your toddler well in advance of the
birth by talking about the new baby, about your
going into hospital, and about who will take care of
her while you are away. Ideally it should be
someone she knows well who understands her
routine and can ensure that it continues while you
are away. Try to let her visit you as often as possible
while you are in hospital.
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i]Znb^\]iV[[ZXi]Zg#H]Z]Vhid[VXZ
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hjgeg^h^c\i]Vih]Zd[iZcgZhdgihidiZVgh#
Making separation easier
• Always spend a few minutes with your child
quietly doing something nice before you leave.
Never rush off without a proper goodbye.
• If you make a promise that you will be back by
a certain time, keep it and, when you go, remind
your child that you will always come back. If you
are delayed, call to explain why.
• Have a goodbye ritual—tell a story or play a
game, give a hug, blow a kiss as you get into the
car, wave to your child as she stands on the step.
• Think up a few games—kiss a child’s palm and
fold her fingers around it. Tell her if she needs a
kiss from you while you’re away there is one for
her in her hand.
• Never keep the fact that you’re going out a secret
from your child. Talk about it ahead of time.
• If you are going to have a babysitter, ask her to
come a half hour before you leave so she can
start a game with your child before you go.
Fears real and imagined
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Dealing with fears
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172 CRYING
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]daY]Zg^cndjgVgbhl]^aZndj[^aa^i!
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i]Zgdji^cZd[ejii^c\^ci]ZYZiZg\Zci
VcYhiVgi^c\i]ZbVX]^cZ#Ejindjg]VcY
DEALING WITH INJURIES
You don’t want your child to grow up being
babyish about minor injuries, but you should never
underestimate one, especially if you can see the
damage. There is no point in saying that a small
scratch doesn’t hurt, because the sight of blood
will scare your child and she will use pain as an
excuse for your attention. Whenever your child
comes to you with an injury give sympathy and
support and use placebos whenever you can. The
best possible placebo is a kiss and a cuddle and
a gentle word. Next, try a favorite drink or snack,
then suggest a small treat—perhaps your child’s
favorite food for the next meal, or having a tea
party in the garden. Always keep your “magic”
ointment handy. In our house it is a simple
antiseptic that can be used for all cuts and
abrasions. It is very soothing and if your child
believes that an ointment will work and take away
the pain, you are halfway there.
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Dealing with irrational fears
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Crying from overtiredness
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ALL ABOUT CRYING—2 T0 3 YEARS 173
Pre-school nerves
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Take your child to the nursery
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ALL ABOUT CRYING—2 TO 3 YEARS 175
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BREATH HOLDING
As your child gets older she may try holding her
breath and her face might become quite blue
during them. In this instance, try any of the
following tips:
• Blow gently on your child’s face.
• Sprinkle a few drops of cold water on your
child’s face or apply a cold cloth.
• Gently pinch your child’s nostrils together for
a second or two.
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FAMILY CONFLICT
Your children have to grow up knowing the facts
of life, one of which is that adults disagree
occasionally, get angry, and have quarrels, but for
heaven’s sake, don’t let them be frequent.
Don’t argue in front of the children
If your partnership is going through a difficult
period, don’t fight in front of the children. Children,
of course, want their parents to inhabit an ideal
world where there is no arguing, no anger, and no
acrimony, and they get very insecure when the
people they love most don’t seem to love each
other. The greatest deterrent to having a quarrel
with my husband came when my second-youngest
ALL ABOUT CRYING—2 TO 3 YEARS 177
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son, at four-and-a-half years old, snuggled up next
to me right after we had had an argument, looking
very doleful. When asked what was wrong he said,
“I don’t know, but the world doesn’t feel right.”
Most children have an instinct to be peace-
makers; mine certainly did. As soon as they heard
a raised voice or an opinion vehemently expressed,
they’d start diversion tactics like, “Do you want a
cup of coffee, mom,” and then actually interject
with, “Please don’t get in a woos,” their term for
getting upset. It is very hard to lose your temper
when a child is pleading with you to stay calm.
Remembering the damaging effect that witnessing a
argument can have on a child is a great deterrent.
 E]nh^XVa
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Watching your baby grow and develop is one of the most exciting aspects
of being a parent, and during the first year you’ll be astounded by how
quickly your child changes. With each passing week, he’ll gain control over
the various muscles in his body so his coordination will improve, and with
this improved coordination he’ll be able to sit, crawl, stand, and, eventually,
walk and run. His manipulation abilities will improve and gradually, over
the months, he’ll develop fine control over his movements.

General development W^gi]id&nZVg

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Milestones
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180 PHYSICAL DEVELOPMENT

MILESTONES: BIRTH TO 6 MONTHS

Month Milestone

Birth • Head control when on his back If you grasp your baby around the upper chest and lift
his body from the mattress, his head will be so heavy and floppy that it will just hang
back. This is why it is so important to support his neck and head carefully.
• Sitting Your baby won’t be able to sit up at all without support. If you hold him in a
sitting position his back will be round and his head will loll forward. He’ll be very wobbly,
and will collapse immediately unless supported.
• Crawling Your baby will be born with a crawling reflex (TFF
Q),  but will lose this as
soon as his body uncurls from the fetal position.

1 • Mobility Your baby will have lost his newborn appearance, but his legs will still be bent.
He may lift his head.
• Manipulation Your baby’s hand will be held in a tight fist; he’ll reflexively grasp anything
put in his palm.
• Head control when on his stomach Your baby will lie with his head to one side, with
his bottom pushed up in the air, and his knees slightly bent underneath his body.
• Sitting Your baby’s back will still be rounded and he’ll only be a little steadier. However,
he’ll try and hold his head up for a second or two when held by you.

2 • Mobility Your baby continues to stretch himself. When lying on the floor, he can lift his
head to a 45-degree angle and hold it for a few moments.
• Manipulation He’ll hold his hand open more often and his grasp will become voluntary.
• Head control when on his back If you lift your baby from the mattress by holding on
to his hands, he’ll be able to hold his head in line with the rest of his body for a second or so.
• Head control when on his stomach Your baby’s body will be more fully stretched out
and he’ll be able to lift his head from the mattress for a moment or two.

3 • Mobility Your baby’s body will be completely uncurled and his legs will be extended.
He’ll hold up his head.
• Manipulation His hands will generally stay open although he may not be able to grasp
anything for long.
• Head control when on his back If you pull your baby up from a lying position by his
hands, he will keep his head up in line with the rest of his body without additional help
from you.
• Head control when on his stomach He will now lie quite flat and
be able to raise his head and hold it in this po
time. He’ll begin to take the weight of his sho
slightly outstretched forearms.
• Standing Once your baby can support his
head, he’ll enjoy being held facing you
with his feet touching your knees. Lift him
up and down so he feels his feet in contact
with your legs and learns the sensation of
taking his weight.
AT THREE MONTHS
 GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 181

Month Milestone

4 • Mobility Your baby should be able to roll from side to side and on to his back. He’ll
support himself on his forearms.
• Manipulation Your baby will have discovered his own hands, which he’ll suck and play with.
• Head control when on his stomach Your baby will be able to raise both legs off the
mattress. He’ll be able to support his chest and head by propping himself up on his
forearms. This way he’ll be able to see what’s going on around him.
• Sitting If you hold your baby in the sitting position, he will be able to sit with his head held
up; the lower part of his back will still be rounded, but the upper part will be almost straight..
• Crawling Your baby will probably raise chest and legs off the floor while making
swimming movements with his arms.

5 • Mobility When placed on his stomach, your baby will push his head off the mattress.
He’ll roll from back to side.
• Manipulation Your baby will be able to grasp objects between his hands and will love
sucking his own feet this way.

6 • Mobility Your baby will be able to twist in all directions and may sit briefly unsupported.
• Manipulation Your baby will be able to hold an object between finger and thumb and
may be able to rotate his wrist.
• Head control when on his back Your baby’s head and neck will be so strong and well--
controlled that he’ll be able to raise his head from the mattress and look at his toes.
• Head control when on his stomach Your baby will be able to take the weight of his
head, shoulders, and torso on his outstretched hands, and roll from his back to his side.
• Sitting Your baby will be able to sit up without support, but only for a few seconds.
• Crawling Your baby will be able to support the top half of his body on outstretched arms,,
and you may see the first signs of crawling when he bends his knees up below his body.
Although he’s moving into the crawling position he probably won’t yet have got the hang
of it, the result of which will be his rocking back and forth.
• Standing By now he’ll probably make jumping movements by bending and straightening
his knees and hips whenever he’s held in a standing position.

AT SIX MONTHS
182 PHYSICAL DEVELOPMENT

MILESTONES: 7 MONTHS TO 1 YEAR

Month Milestone

7 • Mobility Your baby’s ability to sit will improve, although he may have to bend forward
to balance himself.
• Manipulation The finger and thumb become completely opposable. Your baby will hold
an object in each hand and can transfer small objects from one hand to the other.
• Sitting He will be able to sit alone but will be very unsteady. His back will still be
rounded and he will have to support himself with both arms, probably by placing them
in front of his body as a kind of brace. However, in this position he won’t be able to move
his hands in any way because he’ll be relying on them for balance. Any movement will
result in his tumbling over.
• Crawling Probably within a month of the previous stage your baby will have begun to
take his body’s weight on one outstretched arm when he wants to.
• Standing He may start a sort of dancing movement instead of jumping and he’ll also start
to hop from one foot to another. Babies quite often place one foot on top of the other then
pull out the underneath foot and repeat the whole movement over and over again.

8 • Manipulation Your baby’s dexterity will improve and he’ll use a pincer movement to
grasp small objects.
• Sitting Your baby will be able to sit up completely unsupported and will be able to turn
around. He will still be a bit unsteady so always make sure that he is surrounded by soft
cushions in case he topples over.
• Crawling Your baby will have begun to pull himself forward on the floor with his head
held erect, making kicking movements.
• Standing If he hadn’t started his dancing movement instead of jumping, this will begin
about now and he’ll start hopping from one foot to another. He may also start standing
on one of his feet, pulling out the lower foot and repeat it endlessly.

AT EIGHT MONTHS
 GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 183

Month Milestone

9 • Mobility Your baby will make determined efforts to crawl and may be able to support
himself on his hands and knees.
• Manipulation Dexterity continues to improve. He begins to poke his index finger into
holes in toys.
• Sitting Your baby’s balance will be so well-developed that he’ll be able to swing his torso
to look around and will be able to reach forward without losing his balance.
• Standing He can take his full weight on his feet, but can’t balance yet. If you support
your baby firmly underneath the arms, he will be able to take his weight on his legs and
will try to move one foot in front of the other. Supported on your lap, he will try to take a
step or two forward. At this stage, you must support your baby very securely to take most
of the weight, because his balance is still primitive.

10 • Mobility Your baby will be able to crawl with both his arms and legs straight. He’ll pull
himself to a standing position.
• Manipulation Your baby will be able to hold two objects in one hand. He’ll be a little
clumsy in releasing them.
• Standing The muscle control of his knees and feet will have improved and he will begin
to pull himself up to a standing position on furniture, despite the fact that his balance is
still far from good.

11–12 • Mobility Your baby will probably be able to toddle when supported but will “cruise”

along furniture by himself (TFF
Q).
• Manipulation Your baby will be able to hold crayons, feed himself, and give and take
objects. Coordination will improve daily.

AT TEN MONTHS
184 PHYSICAL DEVELOPMENT
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 GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 185

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Helping your baby to sit up
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SAFETY TIPS WHEN PROPPING YOUR BABY UP
• At about five to six months old, most babies learn
to roll over from their back to their sides and then
from their front on to their back. Once your baby
acquires this skill, he must never be left lying
anywhere except on the floor, in a space that
you’ve cleared of all hard or sharp objects. You
should never leave your baby alone anywhere.
• When your baby is propped up, surround him with
cushions. By the age of six months, when only his
lower back needs support, he should still be
padded around the bottom with cushions.
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Propping your baby up
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• Never leave him propped up on a chair or bed
—he should always be on the floor.
• At about seven months old, when your baby will
start to sit up, but topple over many times while
attempting to do so. You must surround him with
cushions or pillows so that he does not get hurt.
• Beware of leaving lightweight cribs, furniture
(chairs, for example), or carriages within his reach.
Your baby could easily pull them over by grabbing
the side of something unstable and attempting to
pull himself upright.
186 PHYSICAL DEVELOPMENT
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SAFETY TIPS
• Never leave your baby alone.
• Remove furniture with sharp edges and corners.
• Remove anything breakable from a surface that
is less than 3 feet (1 meter) from the floor.
• Don’t leave wires trailing across the floor.
• Cover sockets with safety plugs.
• Make sure that there are no electric switches
less than 3 feet (1 meter) from the floor.
• Put safety gates across doorways and at the
bottom of the stairs.
• Try to keep the floor clear of small, sharp toys.
• Make sure all fireplaces are guarded.
• Don’t leave any cloths hanging from tables,
which a baby could reach up and pull.
• Make sure that all furniture is sturdy and
fixtures are safely attached to the wall.
• Never leave anything hot on the table in the
same room as your baby.
• Make sure that stair balusters are not wide
enough apart for a child to squeeze through.
• Make sure that all cabinet doors are closed
firmly and that the handles are out of a
crawling baby’s reach; if they aren’t, lock them
or seal them with masking tape.
• Make sure that all containers of poisonous
substances are locked away or out of reach.
Crawling
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VhhiV\ZhbdgZi]VcV\Zh#L]Vi¼hbdgZ!
ndjh]djaYc¼ildggn^[ndjgWVWnh]dlhcd
^ciZgZhi^cXgVla^c\#HdbZWVW^Zh]ViZan^c\
dci]Z^gijbb^ZhVcYi]ZnVgZjhjVaani]Z
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VgdjcYi]Zb#I]Znl^aaegdWVWanaZVkZ
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Helping your baby crawl
L]^aZ>VbkZgnbjX]V\V^chiiZVX]^c\
ndjgWVWnidbV`Zdgi]dYdmXgVla^c\
bdkZbZcih!ndjXVcZcXdjgV\Z]^bid
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edhh^Wanjh^c\dcZd[]^h[Vkdg^iZidnh
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cZZYh^i!eVgi^XjaVgan^[]Z¼h\Zii^c\i^gZY
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ValVnhegV^hZVcnZ[[dgihi]Vi]ZbV`Zh#
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 GENERAL DEVELOPMENT—BIRTH TO 1 YEAR 187
jhZVaa]^hdlcgZhdjgXZh!^cXajY^c\]^h
YZiZgb^cVi^dc!id\Zi^i#
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i]Z[addgndjghZa[VcYXgVlal^i]]^b#
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YVc\Zgdjh!XVcWZZcXdjgV\^c\[dg
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Shuffling
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bdkZbZciidegdeZa]^bhZa[[dglVgYVcY
WVX`lVgY#I]^hXVcWZVcni]^c\[gdbV
h^YZlVnhXgVW"a^`ZbdkZbZciidV`^cYd[
h]j[[a^c\dc]^hWdiidbl^i]dcZaZ\
ijX`ZYjcYZgcZVi][dgaZkZgV\Z#>iYdZhc¼i
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VYdeih¸VaaVgZVXXZeiVWaZ#I]Z^bedgiVci
i]^c\^hi]Vi]Z¼hbVhiZgZYi]ZVgid[
bdk^c\0^i¼hV\gZViVX]^ZkZbZci!VcY]Z
h]djaYgZXZ^kZVadid[egV^hZ[dgYd^c\hd#
9dc¼iY^hXdjgV\ZndjgWVWn[gdbVcndYY
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Y^hXdkZg]dlidXdcigdaVcYbdkZ]^hWdYn
^c]^hdlceVgi^XjaVglVn#
The crawling baby
DcXZVWVWn]VhaZVgcZYi]Z`cVX`d[
XgVla^c\dgh]j[[a^c\!]ZXVce^X`je
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lViX]ZYXdchiVcian#=Z¼aaVahdcZZYVadid[
gddbhdi]Vi]ZXVcbdkZVgdjcYidi]Z
[jaaZmiZcid[]^hXVeVW^a^i^Zh#;dgi]^h
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VhXjg^djhVcYVYkZcijgdjhVhedhh^WaZ!
ignid\^kZ]^beaZcind[XaZVg[addgheVXZ#
NdjgXgVla^c\WVWn^h\Zii^c\higdc\Zg
ZkZgnYVn!hdWZlVgZd[Vcni]^c\i]Vi¼h
g^X`Zindg[gV\^aZWZXVjhZ]ZXdjaYWgZV`
^ikZgnfj^X`an#
NdjgWVWnl^aaVahd\ZibjX]Y^gi^Zg
cdl!VcYl^aaejiVcndW_ZXi]Z[^cYhdc
i]Z[addghigV^\]i^cid]^hbdji]#7ZhjgZ
i]Vi]ZYdZhc¼i\dcZVgeZih¼[ZZY^c\
Wdlahdga^iiZgeVch#NdjgWVWn¼h`cZZhl^aa
iV`Zfj^iZVWVh]^c\!hdeji]^b^cid
dkZgVaahdgeVcih#IgnidZchjgZi]Vii]Z
[addg^hkZgnhbddi]dgXdkZgZYl^i]
hdbZi]^c\hd[iidegZkZciVWgVh^dch#Ndjg
WVWnYdZhc¼icZZYh]dZhVcYh]djaY\d
h]dZaZhhjci^a]Z¼hlVa`^c\#
Standing
7ZXVjhZVWVWn¼hYZkZadebZciegd\gZhhZh
[gdb]ZVYididZ!XdcigdadkZgi]ZbjhXaZh
d[i]Z`cZZh!adlZgaZ\h!VcY[ZZi^hgVgZan
VX]^ZkZYWZ[dgZiZcdg&&bdci]h#>i¼hdcan
Vii]^hi^bZi]Vi]Z¼hhigdc\Zcdj\]VcY
]Vhhj[[^X^ZciWVaVcXZidiV`Z]^hl]daZ
lZ^\]idc]^h[ZZiVcYhiVcYje#
Sitting down
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Ydlc!VcY^ijhjVaaniV`ZhVWVWni]gZZdg
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idi]Z[addgV\V^c[gdbVhiVcY^c\edh^i^dc#
=ZjhjVaanYdZhi]^hWnh^ii^c\Ydlc
WVX`lVgYl^i]Vi]jbe!dgWnXVgZ[jaan
ha^Y^c\]^h]VcYhYdlci]Zhjeedgijci^a
]^hWdiidb^hdci]Z[addg#
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WVWnWnadlZg^c\]^bYdlc\Zcianhdi]Vi
188 PHYSICAL DEVELOPMENT

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XVcVahd]ZaeWncdi\Zii^c\Vc\gnl]Zc
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“Cruising”
6[iZgndjgWVWn]Vh\V^cZYhj[[^X^Zci
Xdc[^YZcXZ[gdbejaa^c\]^bhZa[je^cidV
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]Z¼h]daY^c\dcidVcYi]Zc\gVYjVaan
^cX]^c\]^h]VcYhVadc\i]Zhjeedgi0]Z
i]ZcWg^c\hi]ZgZhid[]^hWdYn^cida^cZ
l^i]]^h]VcYhWniV`^c\hbVaah^YZlVnh
hiZeh!dcZ[ddiV[iZgi]Zdi]Zg#6h]Z\Zih
Xdc[^YZcil^i]i]^hbZi]dY!]Z¼aa]daYdc $SVJTJOH
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^i¼hdcanV[ZllZZ`hWZ[dgZ]Zl^aaaZi\d
d[i]ZhjeedgiVcYbdkZ[dglVgYidi]Z VgbhjeVcY[dglVgY!ha^\]ianWZciVi
cZmie^ZXZd[[jgc^ijgZ#I]ZhZ[^ghi[Zl i]ZZaWdlh#>i^hcdijci^andjgWVWn]Vh
hiZehVgZkZgnjchiZVYn#Id^cXgZVhZi]Z WZXdbZegd[^X^ZciVilVa`^c\i]Vi]Zl^aa
l^Yi]d[i]ZWVhZ!]Zl^aa`ZZe]^h[ZZi Wg^c\]^h[ZZiXadhZgid\Zi]ZgVcYaZi]^h
l^YZVeVgiVcYWVaVcXZWn]daY^c\]^h ]VcYhYgdeid]^hh^YZh#

HELPING YOUR BABY STAND

• Don’t put socks or shoes on your baby’s feet. He
has much better grip and balance when his feet
are bare. If your house is cold, put booties with
suede soles on your baby’s feet. Make sure that
all your baby’s clothing is loose so that movement
isn’t restricted.
• All the furniture in the room should be heavy,
firm, and stable so that there’s no risk of it
toppling on the baby as he holds onto it.
• Resist the temptation to hurry your baby with
standing or walking. He’ll do it in his own good
time and nothing you do can rush the process.
• Don’t play tricks on your baby by suddenly
removing your support. This will give your baby
a bad fright and could damage his trust in you,
because until that moment you were the one
thing he could rely on.
• Don’t start to use sleeping bags for the first time
now—your baby will try to stand and will fall. If
he’s used to one it’s all right to continue with it.
• Make sure that all wires and cords are tucked
away or firmly tacked down. He may start by
cruising around furniture, but a cord may seem
an ideal “hold” once he’s on the move.

General development &id'nZVgh
9jg^c\i]ZhZXdcYnZVg!ndjgWVWn¼hWdYn
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ejY\nVeeZVgVcXZ!WZXdbZh[^gbZg!
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aZhhfj^X`an!i]VcaVg\ZX]^aYgZc#
Physical milestones
At 13 to 15 monthsNdjgWVWnh]djaYWZ
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[gdbndjdgWn]daY^c\dcid[jgc^ijgZ#
At 15 to 18 monthsNdjgWVWnl^aaWZ
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jcV^YZY#=Zl^aaegdWVWanWZ\^cidlVa`
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[ZZil^YZVeVgiVcYZaWdlh]^\]#EgVXi^XZ
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VaVg\Zhd[iWVaai]Vi]ZXVcignid`^X`id
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At 18 to 20 monthsLVa`^c\l^aaWZXdbZ
hiZVY^ZgVcY]^hVgbhl^aaYgdeYdlcid]^h
h^YZ#NdjgidYYaZgl^aaVabdhiXZgiV^can
lVciidlVa`jehiV^gh#
At 21 to 24 months NdjgidYYaZgl^aaWZ
VWaZidbV^ciV^c]^hWVaVcXZl]^aZ]Z
WZcYhdkZgide^X`hdbZi]^c\jeVcYl^aa
cdi[VaadkZg#9VcXZl^i]]^bid]Zae]^b
egVXi^XZVl^YZgVc\Zd[bdkZbZcih#
GENERAL DEVELOPMENT—1 TO 2 YEARS 189
Manipulation milestones
At 12 months NdjgWVWnl^aa]VkZ
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At 13 to 15 months NdjgWVWnl^aaWZ
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]ZbVnhiVgiiV`^c\d[[]^hh]dZh#
At 18 months NdjgWVWnXVcWj^aYV
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At 2 years NdjgWVWnl^aa]VkZaZVgcZY
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i]ZYddg`cdWVcYbVnWZVWaZidjchXgZl
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190 PHYSICAL DEVELOPMENT
Walking &id'nZVgh
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WZilZZcc^cZVcY&*bdci]h!Wjii]ZgZ¼h
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i]ZhVbZlZaaYZ[^cZYhiV\Zhd[
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Xdc[^YZcXZVcY\ddYWVaVcXZ#
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idlVa`^hdcZd[i]ZbdhiY^[[^Xjaii]^c\h
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HELPING YOUR CHILD WALK
• Arrange the furniture around the room so that he
can go down one side, across, and up the other.
• Initially, spaces between furniture should be no
bigger than the width of your baby’s arms so that
he can hang on to something with one hand and
stretch out the other to reach the next support
easily. If the gaps are too big, your baby won’t be
able to reach the support that will enable him to
cross the space.
• While your baby is learning to walk, make sure
that the floors aren’t slippery—one bad bang may
keep him from walking for several weeks.
Stages of walking
1 NdjgWVWnbVn]VkZhiVgiZYXgj^h^c\
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WZXdbZhbdgZXdc[^YZci!l^aahiVgiid
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]Vhi]ZXdc[^YZcXZVcYi]ZWVaVcXZid
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3 NdjgWVWnl^aaZc_dni]Z^cYZeZcYZcXZ
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WZi]ZcZ\di^Vi^dcd[i]ZheVXZWZilZZc
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XVc]daYdcidWdi]hjeedgihVidcXZ#
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• Make sure the room is baby-proofed, with no
cords or objects that can be pulled over.
• He doesn’t need shoes or socks; bare feet are
safer not only because there’ll be no risk of
malformed feet but also because he’ll be able to
grip well and get used to the sensation of weight.
• A useful aid to complement cruising and your
baby’s first steps is a pushing toy or cart. Make
sure it has a stable wide base so it won’t topple
over. Don’t use a baby walker.
• Always stay nearby when your baby is taking his
first steps.

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• Keep all the handles of pans turned away from
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WALKING—1 TO 2 YEARS 191
SAFETY TIPS
• Remember that once your toddler can walk
he’ll also be able to climb, so install
childproofing devices on all windows: either
bars or special fasteners that allow the window
to be opened only a few inches.
• Keep possible hiding places like cabinets or
chests securely locked so that your baby can’t
disappear and get locked in.
• Door locks must be out of reach.
• Do not allow your unsupervised child into a
backyard with access to the street. Teach
the street-training drill as soon as possible.
• Teach your toddler how to negotiate stairs
properly, by sitting on the top stair, putting his
legs down to the one below, and then
following with his hands.
the front of the stove.
• Never leave anything hot lying where your
toddler can reach it. Keep it out of his reach
until it is absolutely cold.
• Glass doors should never be so clean that your
toddler bumps into them. Put colored paper or
stickers on the glass to make them visible.
• Keep all medicine in a medicine chest, high up
and always locked. Never carry medicine
around in your purse.
• Move cleaning products out of reach or store
them in a locked cabinet.
• Don’t put rugs on polished floors unless they
are backed with double-sided tape or carpet
grip to stop them from slipping.
• Don’t let your child near anything that is small
enough to be swallowed or pushed up his nose
or into his ear.
• Keep all sharp instruments, including kitchen
equipment, out of your child’s reach.
• Never leave sewing materials or tools around.
• Never leave your child alone near water.
192 PHYSICAL DEVELOPMENT
-
-2
Your toddling child
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 GENERAL DEVELOPMENT—2 TO 3 YEARS 193

General development 'id(nZVgh

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HAND–EYE COORDINATION
Month Skill
Up to 2 Until he is about eight weeks old
your baby will not have learned to
use his hands. He’ll be learning to
focus; the maximum distance at
which he’ll be able to focus will be
about 8–10 inches (20–25
centimeters).
2–2½ Your baby will have opened his
hands and will watch them with
fascination. Focusing distance is
not much more than 12 inches (30
centimeters) so he’ll bring hands
and fingers up to his face so he
can watch them moving.
2½–3 Your baby will watch his hands
very carefully and with a lot of
concentration. When he does this
you’ll know that he has made the
connection between seeing and
doing. At about this age your baby
may make a clumsy movement with
either hand to get near an object.
3–4 Your baby will touch everything in
sight, and will be learning how to
measure distances using his hands
and eyes. He’ll look at an object
and then confirm the distance by
trying to reach it. Instead of using
an open hand, he will try to make
a fist before he connects with it.
4–6 Your baby’s hand–eye coordination
will be developing rapidly, so he
judges distance well and his eyes
will be mature enough to focus on
objects at any distance. He will
also be learning to grasp, so when
he reaches out and touches an
object he’ll open his fingers and
curl them around whatever he
wants to hold.
COORDINATION—BIRTH TO 1 YEAR 195
How to help
Your baby will try to focus on anything that
is moving, for instance a colorful mobile.
However, your face will be the most
interesting object in his life, so make sure
he sees it often and close. Hang interesting
objects in his line of sight, no further than
10 inches (25 centimeters) away.
As soon as your baby’s hands are open, they
are ready to have things put into them. The
most interesting toys are the ones that make a
noise, like a rattle. They are also useful because
your baby starts to make a connection betweenn
what his hands are doing, what his eyes are
seeing, and what he can hear.
Your baby is learning to judge distances and
to move his hands to where his eyes think
something interesting is happening. Put a
string above his crib or carriage with lots of
interesting objects hanging from it. Let them
swing freely so that your baby can reach up
and touch them and see them move as a
result of his action.
Your baby will now be too old for swinging
things. If something goes out of reach it will
only frustrate him because he wants to grasp
it. Instead of having objects dangling from a
string, secure them to the sides of the crib.
You can hold out an object so that he can
try to get hold of it. Always wait until he’s
touched it before handing it over.
Your baby really needs lots of practice at
reaching out and grasping things; he’ll also
have a great deal of fun doing it. You can
encourage him to do this by holding out the
most interesting objects you can find, for
example, anything that makes a noise or is
an interesting shape. It could be a plastic
bottle, a ball of wool, or car keys.
196 PHYSICAL DEVELOPMENT

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202 PHYSICAL DEVELOPMENT
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HOW THE TEETH COME IN
The first to erupt are usually the lower front
incisors, then the two upper incisors. The two
upper lateral incisors come next, followed by the
lower ones. After this, the first upper molars erupt
and then the first lower molars. The upper canines
come in next, one on each side, followed by the
lower ones. The second molars erupt first in the
lower
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204 PHYSICAL DEVELOPMENT
Fighting tooth decay
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TEETH—1 TO 3 YEARS 205
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VISITING THE DENTIST
Take your child for his first dental check-up
before his third birthday, and make sure that this
visit is as relaxed and pleasant as possible. Take
your child for this visit when his teeth are healthy
rather than waiting for signs of problems.
Get your child used to the sight of the
instruments and the smell of the surroundings
by taking him with you when you go for your
own checkup. If he can be trusted, and if your
dentist has no objections, sit the child on your
lap and let him watch while the dentist examines
you. He’ll no doubt be fascinated and will be
delighted to copy your example. Just before your
child’s visit, play a game of going to the dentist
and look into each other’s mouths. Then, when
you actually get to the office, prearrange for the
dentist to look at your mouth before he looks at
your child’s.
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Your baby is the most responsive and rewarding pupil you will ever meet.
She wants to do more things, explore more areas, and widen her horizons
more than anyone else you know. She also wants to please you, and the
combination of these qualities gives her an appetite for learning that
should thrill you. One of the most important things to remember is that
she is never too young to learn, though you’ll have to tailor the way you
introduce her to new experiences or the ways you try to teach her. Don’t
set her tasks that are beyond her capabilities, as this will only lead to
frustration. Guide her in all things, but never try to force her.

Learning W^gi]id&nZVg
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208 INTELLECTUAL DEVELOPMENT
WHAT YOUR BABY UNDERSTANDS
Newborn baby Your baby will concentrate on
your face if you bring it close to her, and she can
distinguish your voice from other people’s. When she
hears your voice her eyes will move in the direction
of your face and she will try to follow it if you move
your face close to her. She can recognize your face if
you place it about 8–10 inches (20–25 centimeters)
away from the time she’s 36 hours old.
Four weeks If your face is close enough for her
to focus on, she’ll watch you while you are talking
and she’ll mimic your talking by opening and closing
her mouth. She may stop crying when you pick her
up because she knows you are a source of comfort.
She imitates the movements of your face: she can
use the right muscles to smile and grimace.
Six weeks She will smile back at you and her
eyes will follow a moving toy.
Eight weeks If you hold something brightly
colored above her head, she will take a few seconds
to focus on it and will then follow it as you move it
from side to side.
Three months She will immediately see a toy
held above her. She will smile when you speak and
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will squeal and gurgle with pleasure. There will be
obvious signs of curiosity and interest in what is
going on around her.
Four months At feeding times, she will show
signs of excitement. She will laugh and chuckle
when played with. She will love being propped up
because she’ll be able to see what is going on; she
will turn her head in the direction of sounds.
Five months She’ll be aware of strange
situations and can express fear, disgust, and anger.
Six months Your baby will become very
interested in mirrors and in seeing herself in one.
Eight months She will know her name and will
understand the word “No.” She will probably have
developed little sound signals like a cough to attract
your attention when she reaches out for something
she wants. She’ll probably want to feed herself at
around this time.
Nine months She’ll show a will of her own and
may stop you when you try to wash her face. She
will concentrate very hard on toys and games and
will even turn a toy over in her hand so that she can
examine it carefully. When an object is hidden under
a cloth, she’ll lift the cloth up to see the object.
Ten months She’ll probably be able to clap her
hands and wave bye-bye. She’ll show that she
understands a small number of words, and very
short, simple statements.
Eleven months She’ll know, and will enjoy,
simple games like “Peek-a-boo.” Her other favorite
game will be dropping things and having you pick
them up. She’ll become very noisy and will want to
shake and bang anything that makes a noise.
Twelve months She will do anything to make
you laugh and will repeat it over and over again.
She’ll enjoy “reading” simple books with you and
will help you undress her by lifting up her arms
when you take off her clothes. She may know a few
simple words like bottle, bath, ball, and drink.

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LEARNING—BIRTH TO 1 YEAR 209
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 LEARNING—BIRTH TO 1 YEAR 211

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212 INTELLECTUAL DEVELOPMENT
Learning &id'nZVgh
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INTELLECTUAL DEVELOPMENT
12 months Your baby likes looking at simple
books with you and loves a joke—she will repeat
anything that makes you laugh. She’ll understand
that she should hold up her arms when you dress
her and she knows the meaning of simple,
frequently used words like shoe, bottle, and bath.
She may even say one or two intelligible words.
15 months She will show you that she wants to
brush her own hair. She’ll know what kissing means
and will give you a kiss if asked. She’ll be very
thrilled by any new skill and will want to help you
with household chores like dusting. Even though
she doesn’t understand individual words she can
understand quite complex sentences.
18 months When you are reading together she
will point to things, like a dog, ball, or cow. She will
recognize a cow and say “Cow.” She’ll know the
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different parts of her body: if you ask her where
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nose, her mouth, and her eyes. She’ll know the
difference between her nose and Mommy’s nose.
If you ask her to fetch something she will.
21 months She will come to you, attract your
attention, and take you to things that she is
interested in or has a problem with. She’ll love
scribbling with a pencil. She’ll begin to understand
and obey simple requests and questions.
2 years She likes her own company and will play
happily on her own. Instead of just scribbling with
a pencil, she will make up-and-down strokes in
imitation of writing. She knows the names of many
familiar objects and toys and will use the words
with meaning. Once she learns the meaning of a
word she may repeat it continuously.
 LEARNING—1 TO 2 YEARS 213

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LEARNING—1 TO 2 YEARS 215
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 LEARNING—1 TO 2 YEARS 217

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218 INTELLECTUAL DEVELOPMENT
Learning 'id(nZVgh
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INTELLECTUAL DEVELOPMENT
2 years and 3 months She will try to build
houses and castles with blocks and will repeat new
words when you encourage her. She knows who she
is and can say her name. She’ll begin to pit her will
against yours, and may become negative. She’ll say
the word “No” more often and won’t always
conform to your wishes.
2 years and 6 months She loves helping you
and will help with chores, putting things away, and
bringing things to the table. She’ll know both her
first name and last name. She can draw horizontal
lines and vertical lines and can name several
common objects. A boy will notice that his sex
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organs stick out from his body wheras those of
his mother, and of his little girlfriends, do not.
2 years and 9 months She’ll begin to ask
questions. She’ll know the difference between boys
and girls. She’ll learn nursery rhymes and will be
able to repeat them. She’ll begin to understand
numbers. She’ll try to draw a circle but won’t be
able to complete it successfully without help.
3 years She’ll like to play with other children.
She’ll know more nursery rhymes and will almost be
able to draw a circle. She’ll know the difference
between words such as on, under, and behind, and
will be able to form complicated sentences.
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220 INTELLECTUAL DEVELOPMENT
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iV`Zi]ZZcYd[[i]ZXVggdih!ndjXdjaY
hiVgiVY^hXjhh^dcVWdji]dlVaaeaVcih]VkZ
LEARNING—2 TO 3 YEARS 223
gddihWZXVjhZi]ZncZZY[ddY^cdgYZgid
\gdl#CZmii^bZndjVgZ^ci]ZWVX`nVgY!
ndjXdjaYejaajeVij[id[\gVhhVcYh]dl
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hidee^c\VcYlVk^c\dcigV[[^X!VcYhddc#
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di]ZgeZdeaZVgZ[ZZa^c\#H]ZbVnh]dl
i]Z[^ghih^\chd[ZbeVi]nWnlVci^c\id
EARLY READING
Some children have a natural inclination toward
reading early and writing before their peers. If
yours is one of them, encourage and help but
never push. Your child can only master these
advanced skills when the brain and intellect are
sufficiently developed. You are not able to know
whether your child’s brain is capable of reading
(and later writing), so take your lead from her.
Until this happens, simply continue read to her,
point out and name objects in books, and
encourage her to repeat them.
I’m against using “flash cards” when your child
finds it onerous and boring. In this instance
you’re only doing it for your own satisfaction and
pride. This should never be the reason for making
your child do anything. But if your child is eager
to learn words and gets pleasure from
remembering flash cards, do encourage her as
much as you can. Don’t try to make her read.
When she’s ready, she’ll start pointing out words.
Only then should you start to help her.
224 INTELLECTUAL DEVELOPMENT
Xdb[dgindj^[ndjhZZbhVY#IV`Z
VYkVciV\Zd[i]^hVcYhiVgiidiZVX]]Zg
VWdjii]ZcZZYidi]^c`d[di]ZgeZdeaZ0
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idhdX^Va^oZVcYWZVbZbWZgd[V\gdje#
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idWZVWaZidbVcV\Zl^i]djindj#
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i]Vindj¼aa]VkZidlZ^\]l]ZcndjVgZ
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`cdlaZY\Zi]VibdhiX]^aYgZcbVcV\Zid

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i]g^kZdc^ihdbjX]i]Vii]Znb^hhhX]dda
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]ZaendjgX]^aY\ZidkZgi]Z[g^\]iZc^c\
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Assessing a nursery or playgroup
I]ZgZVgZhZkZgVaY^[[ZgZciineZhd[\gdje
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I]ZbdbZcindjgX]^aYWZ\^chidheZV`^h
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h]ZXVcaZVgc#H]ZgZVX]ZhVhiV\Zl]ZgZ
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i]Z\ZcZgVahZfjZcXZi]ViVaaX]^aYgZc
[daadlVhi]Z^gheZZX]YZkZadeh#LZVahd
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WZ[dgZh]Z`cdlhl]Vii]ZldgYhbZVc!
h]Z¼aaa^hiZcidVcnX]Vc\Zh^chdjcY!VcY
SPEECH—BIRTH TO 1 YEAR 225
id\dVcYk^h^ii]Z\gdjeVcYh^i^cdc
hdbZd[i]ZXaVhhZh#>[edhh^WaZ!heZcYV
l]daZbdgc^c\dgVl]daZV[iZgcddci]ZgZ
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l]Zi]Zgi]ZiZVX]ZghVgZhig^Xi!l]Zi]Zg
ndjVeegdkZd[i]ZlVni]ZX]^aYgZcVgZ
igZViZY!l]Zi]Zgi]ZZck^gdcbZci^h]Veen!
^c[dgbVaVcYXdhn!VcYl]Zi]Zgi]Z
X]^aYgZchZZb]Veen#>[ndjXVc!add`Vi
i]Z[VX^a^i^ZhVcYiVa`idVcdi]Zgbdi]Zg
l]dhZX]^aY\dZhidi]VieVgi^XjaVg\gdje#
DcXZndj]VkZX]dhZcVcjghZgndg
eaVn\gdje!Vh`^[ndjXVciV`ZndjgX]^aY
Vadc\idVhZhh^dcV[ZllZZ`hWZ[dgZh]Z
^hYjZidhiVgi!hdi]Vih]ZXVc\ZijhZYid
ZkZgni]^c\#I]^hl^aa]Zae]ZghZiiaZ^cbdgZ
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WZ[dgZh]ZWZ\^chidheZV`!VcYl^aahddc
`cdli]Vi[^ghidcZeZghdcheZV`h!VcY
i]ZcVcdi]Zg[daadlh#
Early speech
;dgZVX]bdci]i]VindjgWVWnYZkZadeh
h]Zl^aabVhiZgcZlldgYhVcYcZl
\gVbbVi^XVagjaZh#7jiaZVgc^c\idheZV`
^ihZa[^h^c[^c^iZanbdgZ^bedgiVcii]Vc
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NdjgX]^aY¼hbV^cXdcXZgcl^aaWZ
Xdbbjc^XVi^c\VcY^ciZgVXi^c\l^i]
i]ZeZdeaZVgdjcY]Zg#
8]^aYgZcYZkZadeVii]Z^gdlcheZZY!
VcYi]^hVeea^ZhidheZZX]lZaaVhdi]Zg
VheZXihd[YZkZadebZci#9dc¼ildggn^[h]Z
226 INTELLECTUAL DEVELOPMENT
YdZhc¼ihZZbidWZVhfj^X`Vie^X`^c\je
aVc\jV\ZVhdi]Zgh¸ZcXdjgV\Z]ZgVcYaZi
]ZgiV`Zi]Zi^bZh]ZcZZYh#
How speech develops
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V[iZgW^gi]!WVW^Zhl^aagZhedcYbdgZid
heZZX]i]VcidVcndi]Zgcd^hZ#
Up to six weeks 6hhddcVhndjgWVWn^h
Wdgch]Z¼aahiVgiidbV`ZhdjcYh#>c^i^Vaan
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a^iiaZWjgWa^c\cd^hZhVhVbVg`d[eaZVhjgZ
VcYXdciZcibZci#
Around six weeks H]Z¼aaWZ\^cidgZhedcY
idndjghb^a^c\[VXZVhlZaaVhndjgkd^XZ
l^i]VbdgZZmV\\ZgViZY\jg\a^c\#
6ai]dj\]h]Z¼hcdia^iZgVaaniVa`^c\idndj
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l^i]bdji]VcYidc\jZbdkZbZcihVcY
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Three to four months NdjgWVWnl^aa
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d[l]Vih]Z¼hhVn^c\Vii]^hi^bZ#
Seven months H]Z¼aaWZ^cXgZVh^c\an
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bjh^X#H]Z¼aaZmeVcY]ZgXdd^c\^cidild"
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Eight months NdjgWVWnl^aaXdci^cjZid
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VcngZeani]Vi¼hbVYZidndj#=ZgWVWWa^c\
bVnWZXdbZfj^iZbjh^XVa!VcYh]Zb^\]i
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g]nbZid]Zgdgl^cYje]Zgbjh^XWdm#
Nine months NdjgWVWn¼hheZZX]l^aa
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egdcdjcXZi]Zbl^i]hZciZcXZ"a^`Z
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^cidcVi^dcd[VYjaiheZZX]h]Z¼aahVn!
¹8V"bVbV"YV]"WV#ºDcXZh]ZhiVgihid
bV`ZjehdjcYha^`Zi]^h!iZX]c^XVaanXVaaZY
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UPP

Eleven to twelve months NdjgWVWnl^aa
egdWVWanhVn]Zg[^ghi¹gZVaºldgYhhdbZ
i^bZYjg^c\i]^hbdci]#I]ZZbZg\ZcXZd[
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a^`ZbVbV!YVYV!Vc^bVahYd\!XVi!VcY
dW_ZXihXje!WVaa#
Simplifying words
I]ZX]Vc\Z[gdbWVWWa^c\idhVn^c\egZX^hZ
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I]Zdi]ZgegZ[ZgZcXZi]ViX]^aYgZc
h]dlVii]^hhiV\Z^h[dghjWhi^iji^c\Vc
SPEECH—BIRTH TO 1 YEAR 227
Zmeadh^kZhdjcYl^i]VaZhhZmeadh^kZdcZ#
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¹idZ!ºVcY¹Wdeº[dg¹ede#º
Helping your baby talk
™ DcZd[i]Z[^ghiineZd[ldgYhndjgWVWn
aZVgchVgZaVWZaldgYhi]Vi^YZci^[ni]Z
cVbZhd[i]^c\h#>cXdckZghVi^dchl^i]
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¹>¼aa\ZindjgXdViº^chiZVYd[hVn^c\
¹>¼aa\Zi^i#ºNdjgX]^aY^haZVgc^c\i]Z
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^cidi]ZXVg#º
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egdeZganWjindjjcYZghiVcYl]Vih]Z
bZVch!Ydc¼ibV`Z]ZgignidhVn^i
BILINGUALISM
Children thrive on having two languages to learn.
When young babies are learning to talk, they can
make all linguistic sounds. They find a new
language much easier than adults do. It also
seems to be easy for them not just to learn them,
but also to think and speak in two languages. I
remember watching my young godchild looking
from her French mother who was speaking
French, to her English father, who was speaking
English. She was just two-and-a-half years old,
but she replied to her mother in French and her
father in English. I would encourage exposing
children to more than one language.
228 INTELLECTUAL DEVELOPMENT

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SPOTTING IF SOMETHING IS WRONG
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year. As in everything else, children develop hdjcYhVcYhZciZcXZh#6alVnhhidel]Vi
speech at different rates. But if your child is still ndjVgZYd^c\VcYadd`VindjgWVWn
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speech, discuss the issue with your pediatrician, ndjgiZYYn4ºVcY¹LVhi]Vic^XZ4ºH]Z
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d[]ZgheZZX]!h]Z¼aaXdggZXii]ZZggdgh
VcYhjWhi^iji^dchi]Vih]ZjhZYidbV`Z#
The beginning of classification
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SPEECH—1 TO 2 YEARS 229
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230 INTELLECTUAL DEVELOPMENT

igjX`VcYVYjX`!h]Z¼aabV`Zi]Z
THE FIRST SENTENCES
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Some time before your child’s second birthday >ci]ZhVbZlVn!X]^aYgZcXVcVahd
she’ll start to string words together. This is an jcYZgZmiZcYldgYh#;dgbdhiX]^aYgZc!
important milestone because it shows that she’s i]ZldgYVc^bVajhjVaan_jhiVeea^Zhid
aware of the relationship between objects. Your bVbbVahVcYi]ZVc^bVahi]Vii]ZnbZZi
baby’s first sentences will be limited in meaning. ^ci]Z^gZkZgnYVna^[Z0i]Znd[iZc]VkZ
They’ll probably explain something that has just Y^[[^XjainjcYZghiVcY^c\i]Vi[^h]!^chZXih!
happened or describe what someone is doing. VcYW^gYhXVcWZXViZ\dg^oZYVhVc^bVah!
Her sentences will be concerned with: idd#L]ViZkZgZVganldgYhndjgX]^aY
aZVgch!h]Z¼aahddcWZ\^cidjhZi]Zbid
What’s happening Me run bZVcVkVg^Zind[i]^c\h#6h^c\aZldgY
Cow go moo XVcWZVaVWZa[dgV\gZZi^c\!VYZbVcY!
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Who possesses what My dolly \^kZi]ZbbZVc^c\#AViZgdc!h]Zl^aaaZVgc
Mommy dress idX]Vc\Z]ZgheZZX]^cidcVi^dcidh^\cVa
Grandma bag Y^[[ZgZcibZVc^c\h#

Where things are Doll in box Expanding vocabulary

Daddy in
backyard
Ball in bath
Repetition Me more milk
Play again
Where something’s gone Drink all gone
No more toy
Her sentences won’t follow adult grammatical
rules—that develops later—but they have a logic
of their own. She’ll learn fairly early that certain
words are used together. She’ll repeatedly hear
“Pick up,” “Put on,“ “Go out,” and will continue
to use them as one word even when joining them
to others. So she’ll have “Car pick up,” “Door go
out.” She’ll make the past tense by adding “d” to
anything—“I wented”, “You goed,” “I gaved.”
To make words plural, she’ll add an “s” to the
end—”Look, fishes,” “Mouses,” “Gameses.”
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Helping your child to understand
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SPEECH—1 TO 2 YEARS 231
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h]Zl^aaXZgiV^canjcYZghiVcYi]ZbZVc^c\
d[ndjgaVhiXdbbZci#
Looking at books together
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232 INTELLECTUAL DEVELOPMENT
a^iiaZe^\^c Three Little Pigs#IdYYaZghd[iZc
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The value of nursery rhymes
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Having conversations
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h]Za^`Zh!l]Vih]Z^hYd^c\!dg]dli]^c\h
ldg`#=Vk^c\Vh`ZY]Zgi]ZfjZhi^dc!ndj
]VkZidh]dlgZVaVcYh^cXZgZ^ciZgZhi
^c]ZggZhedchZ[dg]ZgidaZVgci]Vi
XdckZghVi^dc^hldgi]l]^aZ#H^b^aVgan!l]Zc
h]ZVeegdVX]Zhndjl^i]VfjZhi^dc!Vc
SPEECH—2 TO 3 YEARS 233
VeeZVa[dg]Zae!dg_jhiVgZfjZhii]Vindj
XdbZVcYhZZhdbZi]^c\ZmX^i^c\!ndj
]VkZidh]dlV\Zcj^cZ^ciZgZhi^cl]Vi
h]Z^hYd^c\VcYhVn^c\#>ci]^hlVn!ndj
XVcXdcig^WjiZidl]Vih]Z^hi]^c`^c\!
jcYZghiVcY^c\!VcYaZVgc^c\#>[ndj
gZhedcYid]Zggjcc^c\XdbbZciVgnd[
i]^c\hh]Z^hYd^c\l^i]VhZg^Zhd[
VWhZcib^cYZY¹bbh!ºh]Z¼aacdidcan\Zi
a^iiaZ^cgZijgci]Vih]ZXVcaZVgc[gdb!Wji
h]Z¼aafj^X`anaZVgcndj¼gZcdi^ciZgZhiZY
VcYh]Z¼aahideign^c\idZc\V\Zndj#
Helping language to expand
NdjXVc]Zae]ZgWn\^k^c\YZhXg^ei^dchdg
^chigjXi^dchi]ViVgZbdgZYZiV^aZYi]Vc
ndjcdgbVaanldjaY#;dg^chiVcXZ!^[h]Z^h
]Vk^c\Y^[[^Xjain\Zii^c\]ZghlZViZgdkZg
]Zg]ZVY!ndjXVchVnhdbZi]^c\a^`Z!¹D]!
YZVg!i]ZdeZc^c\^cndjghlZViZg^hidd
hbVaa[dgndjg]ZVY#ºL^i]i]^hZaVWdgViZ
lVnd[hVn^c\¹>¼aa]Zaendj!ºndj¼gZ
^cigdYjX^c\]ZgidViaZVhii]gZZcZl^YZVh
VcYi]gZZcZlldgYh#>[h]ZXVc¼ia^[i
hdbZi]^c\VcYndjXVc!ndjXVced^cidji
i]VindjXVca^[i^iWZXVjhZndjVgZhigdc\Zg
i]Vch]Z^hVcYi]ZdW_ZXi^h]ZVkn#
IVa`VWdjiXdadgh!h]VeZh!VcYiZmijgZh
l]ZcZkZgedhh^WaZ#¹NdjVgZ\d^c\id]VkZ
i]ZgZYVeeaZ#>¼aa]VkZi]Z\gZZcdcZ#º
¹Add`Vii]ZegZiinWajZ[adlZgl^i]i]Z
adc\hiZb#AZi¼hhbZaai]Z[adlZg#º¹DjgXVg
]Vh[djgl]ZZah#I]^higjX`]Vhadihd[
l]ZZah#AZi¼hignidXdjcii]Zb#DcZ!ild!
i]gZZ![djg![^kZ!h^m!hZkZc!Z^\]i#º
NdjXVcVahd]Zae]Zgdjil^i]
XdckZghVi^dc#>[ndjVh`]Zgl]Vih]Z]Vh
WZZcYd^c\^ci]ZWVX`nVgYVcYh]ZXVc¼i
234 INTELLECTUAL DEVELOPMENT
\Zii]ZldgYhid\Zi]Zg!ndjXdjaYed^ci
]Zg^ci]Zg^\]iY^gZXi^dcWnhVn^c\!¹L]Vi
Y^YndjbV`Z^ci]ZhVcYWdm4ºdg¹=dl
Y^Yndj\ZiYdlc[gdbi]Zided[i]Z
Xa^bWZg4º¹L]ZgZY^Yndj\ddcndjg
ig^XnXaZ4ºNdjXVcegdbei]ZggZhedchZhWn
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Zc_dnZY^cVXdckZghVi^dc!lVh[dgbZid
aZVkZVWaVc`i]Vii]ZnXdjaY[^aa^cl^i]i]Z
HELPING WITH GRAMMAR
As your child begins to understand the more
complicated aspects of grammar, you can help, as
before, by simply repeating what she has said in the
correct form. As she starts to apply the constructions
more and more widely, help her to use them in the
correct way with new words and expressions.
Negatives
With your help, your child can learn to put the
negative where it belongs. By listening to you, she
learns to use won’t, can’t, wouldn’t, hadn’t, wasn’t.
Your child says, “I not eat biccit.” You say, “You
didn’t eat your biscuit.”
Your child says, “No candy left.” You say, “Oh,
dear—there isn’t any more candy.”
Questions
In the same way, you can teach her how to ask
questions correctly and to use the appropriate words
that precede questions.
Your child says, “Go out?” You say, “Where shall
we go?”
Your child says, “More?” You say, “Would you like
some more ice cream?”
Your child says, “Coat on?” You say, “Why do you
put your coat on?”
In this way, your child learns to use the “wh” words,
such as what, who, which, where, and why.
ldgYi]Zn`cZl#Hd![dgZmVbeaZ!^c
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i]ZXa^bWZg!>XdjaYegdbeii]Zbl^i]¹D]!
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XVhiaZhl^i]ndjgTTT!ºVcYbnX]^aYgZc
ldjaYh]dji¹WjX`Zi#º
Adjectives
One of the best ways to teach your child about
adjectives and the relationship of one object to
another is to do it by opposites. If your child says,
“big ball,” you can look around for a smaller ball
and then introduce her to the concept of opposites
like big and small.
You will be able to show her that compared to
each other, one is bigger than the other and one is
smaller than the other. Similarly, you can introduce
other concepts to your child, such as wide and
narrow, thick and thin, deep and shallow, heavy and
light, hard and soft. Always demonstrate with the
appropriate objects and, if possible, make it into a
kind of game.
Possessive pronouns
Your child says, “I bring book here,” and you can
say, “You were over there and you brought your
book to me here.”
Your child says, “I hate this biccit.” You say, “Then
I’ll eat your biscuit and you can eat my biscuit.”
Your child says, “This Jennifer coat, that Mommy
coat.” You say, “Yes, that is your coat, Jennifer, and
this is my coat.”
This way your child learns how to use the words
“my” and “yours.”

Asking and answering questions
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VcYZmegZhh]Zg^YZVh^cldgYh#
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igZViZYhZg^djhan!hd\^kZi]ZbdhiVXXjgViZ!
igji][jaVchlZgndjXVc#9dc¼i[dWndjg
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id\^kZ]Zg^c[dgbVi^dci]ViVYYhid]Zg
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ndjgX]^aYVh`h¹L]n^h^igV^c^c\4ºYdc¼i
gZhedcYl^i]!¹7ZXVjhZ^i^h#ºIgn!^chiZVY!
Vh^beaZZmeaVcVi^dc!a^`ZXadjYhVgZ[jaad[
lViZgVcYi]ZlViZg^h[Vaa^c\WVX`idi]Z
ZVgi]^cgV^cYgdeh#
NdjgX]^aY¼hfjZhi^dchVgZjhjVaankZgn
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ldgYhidZmegZhh]ZgfjZhi^dch[jaan
Zcdj\]#6alVnhZmVb^cZi]ZfjZhi^dcid
hZZl]Vii]Zed^cid[^i^h#>[ndjgX]^aY
Vh`h!¹L]Vi¼hi]Vi4ºVcYndjhVn!¹6
gjaZg!ºh]ZbVnlVcibdgZi]VcVcVbZ#
HdndjXdjaYhVn!¹>i¼hVgjaZgVcYndjjhZ
^iidbZVhjgZi]^c\h0add`!i]^hWdd`^hh^m
^cX]Zhadc\#>i¼hVahdjhZYidYgVlhigV^\]i
a^cZh#AZi¼hYgVldcZid\Zi]Zg#º
H]ZbVnd[iZcVh`fjZhi^dchi]VihZZb
jcVchlZgVWaZVi[^ghi!a^`Z!¹L]nW^gYh
[an4º7jil]Vih]ZbVngZVaanbZVc^h
¹L]nYdW^gYh[an4=dlYdW^gYh[an4L]n
YdW^gYh[aVei]Z^gl^c\h4!ºhdiZhidji
i^YW^ihd[^c[dgbVi^dcVcYi]ZchVnidndjg
X]^aY¹>hi]Vil]VindjbZVc4º
SPEECH—2 TO 3 YEARS 235
Always answer truthfully
>[ndjYdc¼i`cdli]ZVchlZgidV
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WZVWaZidjcYZghiVcYi]Zigji]#I]^h^h
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VcYhZm#>i¼hValVnhWZhiidVchlZgi]ZhZ
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VchlZg#=dlZkZg!Ydc¼ibV`Zi]Zb^hiV`Z
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ndj]VkZidiZaai]Zl]daZigji]#NdjYdc¼i#
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ndjgX]^aYYdZhc¼ijcYZghiVcYZcdj\]id
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eVgid[i]Zigji]i]Vih]Z^hVWaZidY^\Zhi
VcYjcYZghiVcYsee p.259#
LISPING
This is common speech defect in children who are
just learning to talk. It occurs because the child
simply has not mastered all the sounds needed to
speak, so she substitutes a similar sound that she
can make. The child may be copying another child
with a lisp. This can become a habit, however.
Neither of these is anything to worry about and
usually stops without treatment.
Lisping may indicate a more serious underlying
problem though. It may be caused by a degree of
deafness, a cleft palate, or a faulty action of the
tongue. Although these possibilities should have
been excluded at your child’s regular
developmental checkups, if you are at all
concerned about a child’s persistent lisping,
consult your pediatrician so that speech therapy
can be started if necessary.
 HdX^Va
WZ]Vk^dg
The foundations of your child’s social behavior are laid in infancy. The way
you treat your child and the way he responds to you and the outside world
will be part of his makeup. Social development in early childhood goes
through well defined stages. From being a very nongregarious newborn,
your baby will join the surrounding social group by imitating others. One
of the most important guides in this early period is the mother, or primary
caregiver. Babies who establish warm, loving, outgoing relationships with
their mothers are motivated to make friendly relationships with other people
by the pleasure they feel in this early relationship.

Personal development W^gi]id&nZVg

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238 SOCIAL BEHAVIOR
Social milestones
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 PERSONAL DEVELOPMENT—BIRTH TO 1 YEAR 239
=Z¼aaaVj\]djiadjYl]Zc]Z^hWZ^c\
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Between the fifth and sixth month
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“Difficult” babies
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242 SOCIAL BEHAVIOR

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Your baby as part of the family

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Boundaries W^gi]id&nZVg
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d[Z[[^X^ZcXn!_jhi^XZ!VcYhV[Zin#
Understanding bad behavior
CdWVWnWZ]VkZhWVYanYZa^WZgViZan!
Vai]dj\]bVcnVi^gZYVcYZm]VjhiZY
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higVc\Zgh#I]^h^hcdindjgWVWn¼h[Vjai!
VcY]Zh]djaYcZkZgWZWaVbZY[dgl]Vi
BOUNDARIES—BIRTH TO 1 YEAR 243
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a^[Z#=Z¼aaX]VaaZc\ZndjgegZ[ZgZcXZhVcY
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VcYi]ZdgYZgi]Vi]ZZVih^isee p.120#
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[gjhigViZYVcYVc\gn#
Help your child
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244 SOCIAL BEHAVIOR
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When to say “No”
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Possible concerns W^gi]id&nZVg
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VXZgiV^clVn#>h^beanhiViZYl]VilVh
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i]VibnX]^aYldjaYgZbZbWZg!aZVgc!VcY
cdiYd^iV\V^c#>Y^YcdiX]Vhi^hZVcY>
ig^ZYcdiidWZXdbZVc\gn#DcanVhi]Zn
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i]Zbi]Zdeedgijc^inidgZh^hil^i]djibn
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ZmeaVcVi^dc[gdbdi]ZgbZbWZghd[i]Z
[Vb^an#=dlZkZg!i]^hl^aadcanWZhjXXZhh[ja
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l]Vii]ZXdggZXilVnidWZ]VkZVXijVaan^h#
^cidi]ZXgZVhZd[]^hcZX`0]^h\g^eVhndj
ejindjg[^c\Zg^cid]^hi^cneVabVcY[ZZa
^i\gVheZYi^\]ian#
Postpartum depression
BdhildbZc]VkZ[ZZa^c\h`cdlcVhi]Z
WVWnWajZhV[iZgX]^aYW^gi]#I]ZhZVgZ
XVjhZYWni]ZYgVbVi^XYgde^c]dgbdcZ
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l^i]ndjgWVWn#GVe^YbZY^XVaViiZci^dc
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ZmeZg^ZcXZi]ZhZ^ckVgn^c\XdbW^cVi^dch#
6hlZaaVh[ZZa^c\hhjX]Vh]deZaZhhcZhh
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aZi]Vg\n!Vcm^Zin!iZch^dc!haZZeY^[[^Xjai^Zh!
adhhd[^ciZgZhi^chZm!dWhZhh^kZi]dj\]ih!
[ZZa^c\hd[\j^ai!VcYaVX`d[hZa["ZhiZZb#
>[ndj]VkZVcnd[i]ZhZhnbeidbhYdc¼i
WdiiaZjendjg[ZZa^c\h¸hZZ`]Zae#<did
ndjgYdXidgdg\ZiXdjchZaa^c\#I]ZhddcZg
igZVibZcihiVgihi]ZWZiiZg!VcYndjg
YZegZhh^dch]djaY^begdkZ^cV[ZllZZ`h#
Antisocial babies
?jhiVhi]ZgZVgZVYjaihl]d`ZZe
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h^beanVW^iVci^hdX^Va#I]ZnYdc¼ihb^aZ
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WjiYdZhc¼i\didhaZZe#NdjgWZhiZ[[dgih
[V^aidbV`Zi]^h`^cYd[WVWnhjccn!VcY
ndjbVn[ZZandjVgZaVk^h]^c\adkZida^iiaZ
Z[[ZXi#7jiYdc¼iWaVbZndjghZa[¸hdbZ
WVW^ZhVgZ_jhia^`Zi]^h0ndjVgZcdiVadcZ#
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VcY]Zae^cgZijgc#I]ZWVWnl]dVXih
b^hZgVWaZdgl]d_jhihiVnh^ccZjigVa\Zih
aZhh^cgZijgc#A^[Z^hcdiVheaZVhVci[dg
]^b!hd]ZbVn\gdljeidWZVigdjWaZY
^cY^k^YjVa#6hVeVgZcindjbVn]VkZid
ldg`]VgYid\ZindjgX]^aYidWZbdgZ
edh^i^kZ#6ai]dj\]ndjbVn[^cY^iY^[[^Xjai!
ndj]VkZidignndjgWZhiid\ZindjgWVWn
BOUNDARIES—BIRTH TO 1 YEAR 245
id[dXjhdcndj!ida^hiZcidndj!idhb^aZ
Vindj#>[ndjXVc\ZiidVhiV\Zl]ZgZ
ndjgWVWn^hgZhedcY^c\idndjgdkZgijgZh!
bdhid[]^hjc]Vee^cZhhVcYndjghl^aaWZ
Vi]^c\d[i]ZeVhi#
Babies with disabilities
6aaWVW^ZhYZkZadeViY^[[ZgZciheZZYh!
[gdb kZgn[VhiidkZgnhadl#>iXVcWZ
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cdi`ZZe^c\jel^i]i]Z\ZcZgVahdX^Va
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eZY^Vig^X^Vc#=dlZkZg!b^cdgegdWaZbh
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l^i]VcVWcdgbVa^in#
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eZdeaZ^ch^b^aVgh^ijVi^dch!hdXdciVXiVcn
gZaZkVciV\ZcX^Zh#
HEAD BANGING
Toward the end of the first year, some babies
begin to bang their head against the end of
the crib. This is rarely a sign of abnormality, and
there’s little risk of brain damage; most babies
grow out of it quite quickly. However, minimize
the risk by padding the ends of the crib with a
quilted fabric, and by buffering the crib and the
wall if it causes an irritating banging noise. Try
giving your baby a relaxing bath at bedtime and
an extra long cuddle—some psychologists think
that such children may need more physical
attention and stimulation. Music may also be
soothing. If your baby continues to bang his head
for several months, talk to your pediatrician.
246 SOCIAL BEHAVIOR
Personal development &id'nZVgh
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idYYaZg¼hbddYbVnX]Vc\Z[gZfjZcianVcY
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WZ]Vk^dgcdlVcYaViZg#
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nZVg"daYidYYaZghWZXdbZbjX]bdgZ
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iZVX]^c\ndjgX]^aYWnndjgZmVbeaZ#
Likes and dislikes
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^bbVijgZidbVcV\Zl^i]djii]Zb#
Balancing his needs
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idXdcigdaVcYYdb^cViZi]ZldgaYVgdjcY
 PERSONAL DEVELOPMENT—1 TO 2 YEARS 247
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248 SOCIAL BEHAVIOR
Personality
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l]^X]h]dlh^ihZa[l^i]^ci]Z[^ghi[Zl
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THE TIMID CHILD
Some children are naturally shy; they keep to
themselves, and speak very little. Don’t
immediately think that your child has problems
and become overanxious and overprotective.
A child who is talkative on home ground may be
completely silent and withdrawn in a strange
place or when confronted with strangers. This
happens in many children around the age of one.
In a new situation, don’t increase your child’s
difficulties by insisting that he join in immediately.
Allow him to sit quietly on your knee or to stand
by your side while he takes in what everyone is
doing and becomes familiar with it. After half an
hour or so, when you can sense that he is feeling
more comfortable, gradually encourage him to
join in your conversation. Even a shy child, if
encouraged in this gentle, slow way, will join in
with new friends and new games after an hour
or so. But remember to introduce new
experiences slowly and allow your child to get
used to them before moving on to other ones.
If your child is very timid and shy he may
become very upset if you try to leave him with a
babysitter. You must try to understand your child’s
feelings and still give him your love no matter
how irritating the situation is. He’ll grow out of
this clinginess with your help, but he’ll need to
gain a sense of security first.
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Playing and sharing
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250 SOCIAL BEHAVIOR
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ONLY CHILDREN
Although only children undoubtedly benefit from
the constant love that they receive, and grow up
feeling very close to both parents and friends,
there are few who don’t confess to having
wanted brothers and sisters at some stage in
their lives. This is rarely a serious problem, but
one of the things you can do to mitigate any
possible problems is to introduce your baby to
other babies of the same age. As your baby
reaches the sociable age, around 18 months to
two years, make a real effort to find friends for
him and invite them to visit you at home.
Try not to overindulge
It’s easy for parents to overindulge an only child
and to make him feel too important. You’re going
to have to curb your desire to give him all that he
wants and, just as important, all your attention.
It’s important that he learns to accept that he
can’t have everything he wants and be the
permanent center of your world, just as a child

in a larger family has to (TFF
Q).
It may be tempting to be possessive and over-
protective. This can be bad for you and your child.
You’ll feel bereft when he becomes independent
and needs you less, but your child will lose out on
a sense of curiosity, adventure, and independence
and may become clingy. You mustn’t shy away
from disciplining your child either. Like any other
child, he has to be shown the right way to
behave if he’s to grow up able to mix with others.
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Boundaries &id'nZVgh
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When to use discipline
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BOUNDARIES—1 TO 2 YEARS 251
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252 SOCIAL BEHAVIOR
Avoiding problems
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BEHAVIOR GUIDELINES
Learning the rules of social behavior and learning
self-control takes time; it doesn’t take months, it
takes years. Don’t expect him to remember what you
said last time. He isn’t necessarily defying your
previous instruction, he may simply have forgotten
it. A child of two has a very short memory, so be
forgiving and repeat your instructions. Words never
mean as much as actions, and you really do have to
show your child how to behave. Here are some of the
things that you can do.
• Have as few “rules”—those instructions that
cannot be broken under any circumstances—as
possible. “Don’t” is a very negative word and if
you are not careful, by the time your child is two,
you could be prefacing everything you say with
“Don’t.” “Do” is a very positive word so reinforce
with positive “dos” and cut down the “don’ts.”
• Don’t give vague instructions; try to be very clear.
Instead of saying “Don’t be naughty,” tell him
exactly what you don’t want him to do.
• If you give your child instructions, always give a
reason why. If you tell your child that his tricycle
has to be put away when he’s finished using it at
night, explain that otherwise it may get rusty in
the rain and not work. Try to avoid saying
“Because I say so” when he asks you why.
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• Always reward good behavior with praise and
affection, possibly even with a treat if your child
has accomplished something difficult. You can
help him distinguish between good and bad
behavior just by withholding praise and rewards
from acts you don’t approve of.
• There is no better way to get your child to do
something than to show that you do it, too. If you
want your child to take off his dirty shoes at the
door, show him that you do it, too.
• Be consistent. Don’t let your standards slide and
give one instruction on one occasion and the
opposite on another (although you can show that
under certain circumstances you are prepared to
be flexible). There is no reason why your child
shouldn’t have a lot of ice cream on his birthday,
because he knows that that day is special, but he
should learn not to expect the same on the
following day.
• Always admit your mistakes to your child, no
matter how young he is, and always be generous
when you do something wrong. It makes your
child feel that the world is fair and just. Don’t be
afraid to say, “naughty Mommy,” or “Mommy
shouldn’t have done that,” or “You are right. I
won’t do it again.”

Possible concerns &id'nZVgh
The aggressive child
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BOUNDARIES—1 TO 2 YEARS 253
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254 SOCIAL BEHAVIOR
Overindulgence
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STUTTERING
Nearly all children of this age have jerky speech
that, on occasion, may turn into a real stutter. This
may be because your child has so many ideas in
his head that he thinks more quickly than he can
speak. It may also be that he is very excited and
simply can’t articulate properly. Stutters can also
appear for a short time and then disappear again.
Stay calm and don‘t draw your child’s attention to
the stuttering. Don’t jump in with the word that
you think your child is looking for. Simply accept
his speech. Making your child feel nervous and
self-conscious about the way he talks will only
increase his tendency to stammer.
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BOUNDARIES—1 TO 2 YEARS 255
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256 SOCIAL BEHAVIOR
Personal development 'id(nZVgh
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258 SOCIAL BEHAVIOR
Encouraging security
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add`#CZ^i]Zgd[i]ZhZi]^c\h^ha^`Zanid
hi^bjaViZhZmjVa[ZZa^c\h^cndjgX]^aY!VcY
]Z¼aadcanWZZbWVggVhhZY^[ndjVgZ#
 PERSONAL DEVELOPMENT—2 TO 3 YEARS 259
Answering children’s questions
8]^aYgZcl]dVgZZcXdjgV\ZYidVh`
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h^mdghdYZeZcY^c\dci]ZX]^aY#6aa
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d[XVg^c\!adk^c\!VcYi]ZgZhedch^W^a^i^Zh
^ckdakZY^c^ci^bViZgZaVi^dch]^eh#
HANDLING GENITALS
Babies usually become aware of their genital
organs toward the end of the first year, but
handle them without any obvious pleasure.
Handling eventually does bring a pleasurable
sensation, and then fondling becomes more like
real masturbation. Most children of both sexes
masturbate, and it’s simply unreasonable to
expect them not to. Despite the myths, it will
not lead to blindness or insanity.
It is perfectly normal for a boy to handle his
penis. After all, he handles every other part of his
body that sticks out. In young children, this is
rarely done for any length of time or for any
purpose. The pleasure it brings is more general
than sexual. It is not until children are much older
that they feel sexual excitement.
Don’t scold your child
There is no reason to discourage a child from
handling genitals, nor should you stop him from
masturbating. That will only cause furtiveness,
and worse, it may stop your child from discussing
anything about genital organs in later life. Unless
masturbation is an obsessional means of escaping
from reality, the best way to treat it is by paying
no attention to it at all. If by accident it happens
in public, distraction is the best course of action,
but never, ever, scold your child for it.
260 SOCIAL BEHAVIOR
Boundaries 'id(nZVgh
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gZVhdcl^i]ndj!ndjXVcZmeaV^cl]Vi
Y^hX^ea^cZ^h#I]^hlVn]Zl^aa\gdlje
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gZhedch^W^a^inVcYeVgi^X^eVi^dc^cYZX^h^dch#
9dc¼iZmeZXiWa^cYdWZY^ZcXZ[gdbVX]^aY#
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WZXVjhZ]ZjcYZghiVcYhl]nndjlVci^i#
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b^hiV`Zd[iVa`^c\dkZgZkZgnYZX^h^dc!VcY
cZkZg_jhiiZaa^c\ndjgX]^aYl]ViidYd#
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\^kZVh^beaZdgYZg!jcaZhhndj[ZZai]Vi
ndjgX]^aY^h\d^c\idWZgZXVaX^igVciVcY
Vhd[iZgVeegdVX]bVnWZWZiiZg#
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dei^dch!VcY]Z]VhidaZVgci]^hh`^aaa^`Z
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VgZ\d^c\id\^kZ]^bVX]d^XZ/aZi^iWZ
dcZ]Zl^aa[^cY[V^ganh^beaZ!dcZndjYdc¼i
gZVaani]^c`^h^bedgiVcil]^X]ZkZglVni]Z
YZX^h^dc\dZh#9dc¼iignid[ddandjgX]^aY
Wn\^k^c\VX]d^XZl]ZcndjgYZX^h^dc^h
VagZVYnbVYZ0ndjldc¼i[dda]^b#
When to insist
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]Zae[jacZhh!jchZa[^h]cZhh!VcYXdjgiZhn
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WjiWnegdk^c\idi]ZX]^aYi]Vi^ilVh
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igji]!cdbViiZg]dlWVY^ilVh!VcYcd
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6OEFSTUBOEJOH
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Possible concerns 'id(nZVgh
An aggressive antisocial child
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WZXdbZhVgZ\jaVg[ZVijgZ!]dlZkZg!^i^h
jhjVaanVgZhedchZidildi]^c\h/VaVX`d[
Z[[ZXi^kZgZhigV^ciVcYY^hX^ea^cZ[gdbi]Z
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ZmeZg^ZcX^c\VaVX`d[eVgZciVaViiZci^dc!
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eVgZcihVgZVabdhiZci^gZangZhedch^WaZ[dg
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>[ndj]VkZVcV\\gZhh^kZX]^aY!add`
XadhZanVii]ZlVnndjVcYndjgeVgicZg
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ndjghZakZhndj¼aaVabdhiXZgiV^can[^cYndj
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idaZgVci!VcY\ZciaZndjghZa[^cVaandjg
YZVa^c\hl^i]]^b#9dc¼i[dg\ZindjgX]^aY
l^aa^b^iViZZkZgni]^c\ndjYd!^cXajY^c\
WZ^c\V\\gZhh^kZ#
>[ndjgX]^aYhjYYZcanWZXdbZh
V\\gZhh^kZdghiVgihWjaan^c\!i]^h^hVhjgZ
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X]^aY¼ha^[Z!VcYndjh]djaYadd`XVgZ[jaan
BOUNDARIES—2 TO 3 YEARS 261
[dgi]ZXVjhZd[^i#>cVndjc\X]^aY^il^aa
cZVganValVnhWZ[djcY^c]^hgZaVi^dch]^e
l^i]ndj!ndjgeVgicZg!dgi]ZgZhid[i]Z
[Vb^an!dgidiZch^dc^ci]Z]dbZ#9dc¼i
i]^c`i]VindjXVcejaai]ZlddadkZgV
ndjc\X]^aY¼hZnZhWnhlZZe^c\i]^c\h
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jedci]ZVibdhe]ZgZ!VcYi]^hXVcXVjhZ
\gZVi^chZXjg^in#
Shyness
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hijY^Zhh]dli]VijeidiZceZgXZcid[
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egZY^hedhZhi]Zbidh]nWZ]Vk^dg#HjX]
X]^aYgZch]dli]Z^gh]ncZhhWn\^k^c\
Zk^YZcXZd[Y^ha^`^c\cZlZmeZg^ZcXZh0ZkZc
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i]Znl^aaheZcYbdhid[i]Zi^bZXa^c\^c\
idi]Z^gbdi]Zgh¼aZ\hdg]^Y^c\i]Z^g[VXZh#
STEALING
Most young children are used to taking things
that belong to others—their mother’s makeup,
a sibling’s toy, or their father’s keys—just because
they want to play with them, and at home this
isn’t usually a problem. However, young children
are incapable of understanding the “property
rights” of others, and you may discover that your
child has taken something while you were out
shopping or visiting a friend’s home. If this is the
case, explain to the child that this is stealing, and
that stealing is not allowed. Eventually, your child
will get the idea. It isn’t necessary to have the
child accompany you when you return the object,
unless the habit has become persistent and you
feel that extra enforcement is necessary. Most
children feel penitent enough on being found out.
262 SOCIAL BEHAVIOR
“HABITS”
Nail-biting, thumb-sucking, and carrying a
comforter are not abnormal in a young child.
Don’t try to stop them, and certainly never by
force, ridicule, or deprivation. They are nearly
always caused by tension of some kind and they
happen in about half of otherwise normal
schoolchildren. For the most part, they are
unconscious, nervous habits and are best cured
by encouraging pride in appearance. For example,
the majority of children stop nail-biting when they
become more concerned about their appearance
and become interested in the opposite sex. At
this age, social considerations begin to outweigh
personal habits.
I don’t believe in discouraging these habits. As
they get older, children sense what is acceptable,
impose self-control, and only indulge in their
habit in private No one can persuade me that
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Selfishness in children
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BOUNDARIES—2 TO 3 YEARS 263
An overindulged child
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 EaVn^c\
Play has a vital role in your child’s development and provides a platform for
learning, especially about becoming sociable. To learn to become sociable,
a child has to have contact with children of the same age, and these
contacts will mainly be made through play. Parents now know that for their
children to be healthy and happy and to grow up well adjusted, they need
to be given liberty to play for as long as possible. To this end, parents
provide their children with all sorts of play equipment and toys, with an
emphasis on their educational value.

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TOYS AND GAMES FOR BABIES
Never in a baby’s development is play more
synonymous with learning than in the first few
years of life. She is learning to see properly and
discovering how to use her hands and how to
master hand-eye coordination (TFF
Q).  She
may learn quite a lot simply by watching and
moving her own hands, but she’ll practice and
perfect her new skills with any toys you give her.
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l^i]^c]ZggZVX]#
What toys to give
From about five weeks =Zgk^hjVa[^ZaY
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bVi#I]Zn¼gZZVhnidbV`Z[gdb]djhZ]daY

Suitable toys %FWFMPQJOH
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• Mobiles • Rattles • Mirror • Music boxx • Large/ :PV
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• Activity center • Books • Cooking utensils IBOEoFZF
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266 PLAYING
^iZbh^[ndjYdc¼ilVciidWjni]Zbsee
opposite#
By three months H]Z¼aaadkZdW_ZXihi]Vi
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dgVcn[dgbd[idni]Vih]ZXVch]V`Zdg
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a^\]ilZ^\]i!jcWgZV`VWaZ!lVh]VWaZgViiaZ
i]Vi]VhVhbVaaZcdj\]]VcYaZ[dgndjg
WVWnid\gVheZVh^anVii]^hhiV\Zh]Z
ldc¼i]VkZi]ZbjhXaZhigZc\i]dg
XddgY^cVi^dcid\g^edcidVcni]^c\[dg
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By four months EaVhi^XXjeh[^aaZYl^i]
SAFETY TIPS
• Make sure the toys you buy are for the
appropriate age group.
• Never give your child anything to play with
that is so small that she might swallow it by
accident or gag on it, or push it up her nose
or into her ear.
• If you buy an second-hand painted toy make
sure that the paint is leadfree. Young children
put everything into their mouths and children
have been known to get lead poisoning from
toys covered with paint containing lead. (This
applies to second-hand furniture, too.)
• Never leave your baby alone while she is
playing, not even in a playpen.
• Always provide nontoxic crayons and pencils.
For your own sake, make sure that the crayons,
pencils and felt-tips markers you provide will
wash off surfaces and fabrics.
• Don’t buy toys made from thin rigid plastic.
They break easily and leave sharp edges.
• When you buy soft toys, check for a safety
label. If there’s no label, make sure that there
are no sharp pieces of wire used to hold any
pieces on, and check that eyes and noses are
firmly secured to the fabric.
WZVch!dglViZg"[^aaZYXdciV^cZghl^aaVahd
bV`Z^ciZgZhi^c\cd^hZh!VcYh]Z¼aaWZVWaZ
id]daYi]ZbWZilZZcWdi]]VcYh#
By six to ten months6cndW_ZXii]Vi^h
hbVaaVcY]VhXgZk^XZh!]daZh!dg]VcYaZh
i]VindjgWVWnXVced`Z]Zg[^c\Zgh^cid
dglgVei]ZbVgdjcYl^aaWZ^YZVa#I]Zn
h]djaYWZWg^\]ianXdadgZYVcY!^[edhh^WaZ!
bV`ZVcd^hZ!a^`Zg^c\hl^i]WZaahdci]Zb#
EjiV[V^ganaVg\Z!heZX^VaanYZh^\cZY
WVWnb^ggdg^c]ZgXg^W¸h]Z¼aaadkZhiVg^c\
Vi]Zgdlc[VXZ#CZkZgWZiZbeiZYideji
dcZd[ndjgdlcb^ggdgh^ci]ZXg^W¸^i
XdjaYZVh^anWgZV`#
Bjh^XWdmZhhZZbidegdk^YZZcYaZhh
[VhX^cVi^dc[dghbVaaWVW^ZhVcYXVceaVnV
eVgi^cndjgWZYi^bZgdji^cZsee p.144#
I]ZWZhidcZh]VkZVhig^c\i]Vii]ZWVWn
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6Xi^k^inXZciZghi]Vi]VkZVhZg^Zhd[
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ViiVX]ZYidVe^ZXZd[[jgc^ijgZdgi]Z
ijW#6hndjgWVWn¼hbVc^ejaVi^dcVW^a^i^Zh
^begdkZ!h]Z¼aaadkZeaVn^c\l^i]i]^h#
Ten to 12 months DcXZndjgWVWn]Vh
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WZVWaZid]daYX]Va`!eZcX^ah!XgVndch!
VcY!ZkZcijVaan!eV^ciWgjh]Zh#H]Z¼aaWZ
bdgZbdW^aZcdlVcYh]Zl^aaZc_dnWZ^c\
VWaZidejaadgejh]idnha^`ZigV^ch!XVgh!dg
lVa`^c\Yd\h#Egdk^YZ]Zgl^i]hdbZidnh
dchig^c\hhdi]ViVhh]Zh^ihdci]Z[addg
h]ZXVcYgVli]ZbidlVgY]Zg#
Games to play together
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ndjg[VXZWZ]^cYVhXVg[dgVidlZa^chiZVY
d[ndjg]VcYh#
7jnVaVg\Z^c[aViVWaZWZVX]WVaaVcY\Zcian
gdaa^iidlVgYndjgWVWn#DcXZh]ZXVch^i
jchjeedgiZY!h]Z¼aaWZVWaZidWViVWVaa

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ndjgWVWn]dlid[^aajeVXdciV^cZgl^i]
VhZaZXi^dcd[idnVc^bVahdgeaVhi^X
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I]ZcZcXdjgV\ZndjgWVWnidignVcYndj¼aa
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VcYZbein^c\]ZgXdciV^cZg#
7VW^ZhhZZbid]VkZZcYaZhheVi^ZcXZ
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]ZaendjgWVWnYZkZadeXddgY^cVi^dc#I]Zn
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aVg\Ze^ZXZhVgZWZiiZg[dgndjc\ZgWVW^Zh
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Making use of household objects
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WZ\^kZchdbZ#:kZgni]^c\h]ZXdbZh
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ldgaYd[ZmX^iZbZci[dgndjgWVWn#=ZgZ
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a^`ZidignVh¹idnhº[dgndjgX]^aY/
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XdaVcYZghVcYh^ZkZh![jccZah!eaVhi^X
bZVhjg^c\heddch!eaVhi^XXjehl^i]a^Yh!
268 PLAYING
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idYdl^i]i]Zb#
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_Vghl^i]WZVch!XdadgZYWZVYh!dgeVeZg
Xa^eh^ch^YZ#BV`ZhjgZi]Vii]Za^Y^h
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FUN WITH EVERYDAY THINGS
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 PLAY—BIRTH TO 1 YEAR 269

BABY MASSAGE
Massage is a wonderful way to express your love
for your baby; in the early days it helps the bonding
process between you and your child—it helps to
calm an unsettled baby and can help an anxious
mother come to terms with handling her precious
new baby. Older babies and toddlers also benefit
from massage; it is an effective way of soothing a
fretful baby and can help an overexcited toddler
relax. Work from the head down, with light strokes,
ensuring that both sides of the body are massaged
symmetrically. Use sweeping strokes and do each
part two or three times. On small areas, use only
your fingertips. On some parts of her body you will
need two hands and on others one.

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270 PLAYING
Play &id'nZVgh
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TOYS AND GAMES FOR TODDLERS
Your toddler’s coordination will improve greatly
this year, as will her manipulative skills. Toys that
make use of both of these will provide the most
enjoyment, but be prepared for your child to be
a bit clumsy at first and give her large items.
Household objects will continue to be popular,
but other toys may stretch coordination and
mental processes further.
Suitable toys
• Shape sorters • Stacking blocks • Building
blocks • Hammering table • Push/pull toys
• Dolls • Cars • Crayons and felt markers
• Paints and brushes • Blackboard • Books •
Modeling clay • Sandbox • Wading pool • Slide
• Swing • Climber frame • Wagon
Toys to help manipulation
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Playing with paint
6aaX]^aYgZcadkZideV^ciVcYYgVl!Wji
Yjg^c\i]^hnZVgndjbVn[^cY^iY^[[^Xjaiid
^ciZgegZiZmVXianl]Vi¼hWZZcYgVlc#BV`Z
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VgZVVcYi]ZX]^aYWnXdkZg^c\i]ZiVWaZ
VcY[addgl^i]VlViZgegdd[XdkZg^c\dg
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dghbdX`#
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Zc_dnign^c\djiVgZWadX`eV^ci^c\VcY
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]VkZidegdk^YZi]ZZfj^kVaZcid[VgjWWZg
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d[Xdiidc!VXdg`!]Va[VcVeeaZ!dgV
ediVid¸Vcni]^c\!gZVaan!i]VindjgX]^aY
XVc]daYZVh^anVcYjhZ^cVhiVbe^c\

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Y^h]#H]dl]Zg]dlidY^ei]Zhedc\Zdg
XdiidcVcYhiVbe^idci]ZeVeZg#
>ci]ZhZXdcYiZX]c^fjZWadWhd[
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i]^X`eVeZg#;daYi]ZeVeZghdi]Vii]Zild
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XVcWadli]ZeV^ci^cidY^[[ZgZcih]VeZh
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FUN WITH PAINT
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PLAY—1 TO 2 YEARS 271
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272 PLAYING
PAINT TIPS
• Keep paint in small plastic jars, preferably the
nonspill variety that have a hole in the top for
the paintbrush.
• Plastic egg cartons make a difficult-to-spill
artist’s palette for your child.
• Children love making their own paint, so make
up a little liquid starch in a small container and
provide some bottles of food coloring. Children
can add the food coloring until they have the
color they require.
• Cleaning up is easier if you add a little bit of
detergent to finger paints.
• You can make a paint that will stick to a shiny
surface like glass or aluminum foil by mixing a
few drops of food coloring, an egg yolk, and
powdered detergent. However, if you are using
egg, make sure your that the child is not
allergic to eggs.
• If you buy your child felt-tip markers or crayons,
make sure they’re the fat, chunky ones because
they’re easier to hold. Make sure they are
washable, too.
• Take a fairly large block of synthetic foam
rubber and cut different-sized holes in it. Stand
up all your child’s bottles, brushes, and jars in it
so they won’t fall over.
• A utensil tray makes very good storage for
bottles, jars, and paintbrushes.
• Put drawing paper on a paper towel dispenser
and attach it to the wall in your creative corner.
• Keep your old newspapers for floor covering, or
use a large plastic tablecloth.
What paper to use
>cZmeZch^kZbV`Zhd[eVeZg!lVaaeVeZg!
h]Za[eVeZg!daYZckZadeZh!WgdlceVeZg
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i]^hlVn!eV^ci^c\hXVcWZlVh]ZYd[[l^i]
VYVbeXadi]dgeVeZgidlZaZmeZg^bZci
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hjg[VXZWZhi#
What brushes to use
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Wgjh][gdbVcdaYgdaa"dcYZdYdgVci
WdiiaZ/iV`Zi]ZWVaa[gdbi]ZcZX`d[i]Z
WdiiaZl^i]Vheddc![^aal^i]eV^ci!VcY
gZeaVXZi]ZWVaa#
Preserving drawings
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^gdc^c\^idcidVe^ZXZd[Xadi]#AVn^i[VXZ
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Ve^ZXZd[a^\]i"XdadgZYXadi]!VcYi]Zc^gdc
^i[^gbanViVadl"id"bZY^jbiZbeZgVijgZ#
I]ZYgVl^c\l^aaigVch[Zgidi]ZXadi]#
BV`ZhjgZndjaZi^iXddaWZ[dgZndjbdkZ
^i[gdbi]Z^gdc^c\WdVgY#6cdi]Zgi^e^hid
hegVnYgVl^c\hl^i][^mVi^kZ!dg]V^ghegVn
^[ndjjhZ^i#I]^hl^aa`ZZei]ZXdadgh[gdb
WZ^c\gjWWZYd[[#I]ZgZ^hVahdV¹bV\^Xº
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heVg`a^c\lViZgVcYaZi^ih^idkZgc^\]i#I]Z
 PLAY—1 TO 2 YEARS 273

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i]Zhdaji^dcVcYaZi^ih^ijci^a^i^h
XdbeaZiZanYgn#

Playing with water

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]VkZ]VY#IgnhdbZd[i]Z[daadl^c\!Wji
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VcYhegVnV]dhZdgheg^c`aZgdkZg^i#
L]Zc^i¼hXdbeaZiZanlZi!^i¼aabV`ZV
eZg[ZXiha^YZ[dgndjgX]^aY#
CREATIVE MATERIALS
™ BV`ZVhbVaa]daZ^ci]ZWdiidbd[V
eaVhi^XXdciV^cZgVcY[^aa^il^i]XdadgZY Glue
lViZg#6iiVX]^iidi]ZWVX`d[ndjg Mix 8 ounces (250 grams) flour with a teaspoon
X]^aY¼hig^XnXaZVcYaViZg!W^XnXaZ#H]Z¼aa of salt in a pan. Add 20 fluid ounces (600
WZVWaZidhZZi]ZXdadgZYigV^ai]ZlViZg milliliters) water slowly until it’s absorbed into a
]VhaZ[iVhh]ZXnXaZhVadc\# paste. Simmer for five minutes then cool and
™ >[ndj]VkZViVe^ci]ZWVX`nVgY!ejiV refrigerate in an airtight container until required.
XdciV^cZgd[hd^acZVg^ihdi]Vih]ZXVc
b^mlViZgl^i]i]Zhd^aVcYbV`Zje]Zg Modeling dough
dlcbjY#>i¼hbZhhn!Wjiadihd[[jc# Mix three parts of flour to one part of salt, then
™ BV`ZVc¹^XZWZg\ºi]ViXVcWZeaVnZY stir in one part of water. Color with food coloring
l^i]^ci]ZWVi]ijWdg^cVlVY^c\edda# and store in an airtight container.
EjihdbZ[ddYXdadg^c\^cidVWVaaddc
i]Zc[^aa^il^i]lViZg#Eji^i^cVeVcVcY Mock play dough
eaVXZ^i^ci]Z[gZZoZg#L]Zc^i¼hhda^Y! Mix together equal parts of salt and flour. Add
eg^X`i]ZWVaaddcVcYeZZa^id[[¸ndj¼aa a little oil and then add enough water to mix to
WZaZ[il^i]VeZg[ZXi!gdjcY¹^XZWZg\#º a stiff dough. Knead until soft and stretchy.
Playing with sand
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Slides, frames, and swings
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Rough and gentle games
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Wd^hiZgdjh\VbZh!l]^aZdi]ZghegZ[Zg
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idn\j^iVghWZ[dgZ\gVYjVi^c\idegdeZg
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PLAY—1 TO 2 YEARS 275
]Zae]ZgiddbjX]!]Zg^ciZgZhi^ci]Z
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XVcVahdgZhjai^cVX]^aYWZ^c\jcVWaZid
XdcXZcigViZl]Zch]Z\ZihidhX]dda#
Is my child stimulated enough?
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i]Zg^\]iZfj^ebZci!ndjYdc¼i]VkZid
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l]Vih]ZcZZYh^h[gZZYdbidVaadl]Zg
i]dj\]iegdXZhhZhidZmeVcYhdi]Vih]Z
XVc[daadlcZl^YZVhVhi]ZndXXjgid]Zg!
VcYhZZeaVni]gdj\]id^ihXdcXajh^dch#
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Vaai]Z[VX^a^i^Zhi]Vih]ZcZZYh#DcXZndj
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ndjgX]^aYidYZX^YZl]ViidYd!cdindj#
>i¼hWZhiidaZi]ZgVadcZidjhZ]Zgdlc
^bV\^cVi^dcVcYcdi^ciZg[ZgZ#
SAFETY TIPS
• Keep her far away from any kind of pool
containing water. No matter how small or
shallow it is, even if she can swim, she should
never be left unattended.
• Any game that involves metal implements is
potentially dangerous, for example, metal
buckets and spades or toy pistols. So is any
game with sharp or pointed instruments, such
as bows and arrows or toy knives.
• Never let your toddler go anywhere near or
handle fireworks or matches.
276 PLAYING
How you can help
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™ HiVgiid[^aaVYgZhh^c\"jeWdm#Eji^c
STORAGE TIPS
• Save plastic containers with lids for storing blocks
or other small toys. Those made for ice cream or
margarine are ideal.
• Use brightly colored labels for easy identification
of what’s inside your containers.
• Large glass jars are good for storage because you
can immediately see what’s inside them.
• Never throw out any shoe boxes—they make
good beds for dolls as well as houses or barns.
• Loop a plastic mesh basket over the faucets in
the tub to store all bathtub toys.
• Use a flat-topped chest for storing larger toys.
This can double up as a table.
• Your child’s toys are bound to get strewn around
your home. Try to keep a basket in each room to
make for quick and easy neatening.
• Keep a special bag or box of toys in the car.
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CLEANING AND PREPARING TOYS
• Always buy machine-washable stuffed toys.
• You can use a vacuum cleaner clean stuffed toys
in between washes.
• Try to buy plastic toys that can be put into the
dishwasher when they are dirty.
• If plastic toys have got out of shape, you can soak
them in hot water and then re-mold them with
your fingers.
• Clean and deodorize smelly toys by sponging
them with a cloth that has been soaked in a
solution of baking soda.
• You can dry clean your child’s soft toys by shaking
them in a bag containing a generous amount of
baking powder.
 PLAY—2 TO 3 YEARS 277

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TOYS FOR 2- TO 3-YEAR-OLDS
Children of this age are gaining steadily in
independence, control of language, and new
skills. They like to build things up and knock them
down, and they love “let’s pretend” games.
Suitable toys
• Large-piece jigsaw • Modeling clay • Plastic
building bricks • Scissors (blunt-ended) • Glue
• Carriages and strollers • Tea sets • Toy
washing machines, cooking utensils • Playhouse
• Tricycle • Cars and trucks • Jungle gyms

Imitative games
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278 PLAYING
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Games to help manipulation
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Jigsaw puzzles
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i]Z_^\hVlejooaZdkZgVcYdkZgV\V^c#
PLAY—2 TO 3 YEARS 279
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Learning through play
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280 PLAYING
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TELEVISION
Some babies are introduced to television while they
are still in their cribs. Their parents see television as
a built-in babysitter to keep children amused. For
a lot of children television is more popular and
consumes more of their playtime than all other play
activities added together. Here are some of the
reported facts about television:
• Television is at its least useful when a child is
left to watch it alone. Even if she’s watching a
highly educational program she’ll get less out
of it if she watches it in an entirely passive way.
But if she watches with other children who
comment on it, or with an adult who asks
questions and makes observations, the
program can act as a springboard for ideas
and discussion.
• Some parents let television interfere with the
usual eating and sleeping routines, leading to
upset digestion and tired children.
• Watching television can curtail other activities,
especially outdoor play and playing with other
children; it may leave little time for creative play.
• Television often presents information in a more
exciting and dramatic way than schoolbooks and
schoolteachers. Children therefore often find
books and schoolwork boring.
• Television cuts down on conversation and other
social interactions in the family.
Learning about colors
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• Characters on television are often presented as
exaggerated stereotypes and children come to
think that people in a given group have the same
qualities as the people portrayed on the screen
and this influences their attitude toward them.
• If a child watches too many programs portraying
crime, torture, and cruelty, this may blunt a child’s
sensitivity to violence so that she accepts violent
behavior as normal.
• Two groups of children were studied for the
effects of violence on television. One group saw
violent programs, the other did not. The studies
showed that the young children in the group
who watched the violent programs were
noticeably more aggressive, both with other
children and with their toys, than those
children who had not been exposed to the
same programs.
• Children are great imitators and as the
lawbreakers often seem more glamorous than the
heroes, children tend to identify with the villains.
• Television can present models for the behavior of
the different sexes and for life roles and careers.
This in turn gives rise to similar expectations in
children that are not always the best.
• If children are really interested in programs they
have seen they may want to find out more by
reading or asking grown-ups about the subject.
 PLAY—2 TO 3 YEARS 281

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Learning about letters

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No baby is too young to take on an outing. In fact, with a young baby you
can go just about anywhere and, provided he can look around, he’ll enjoy
the change of scene even if he doesn’t understand quite what’s going on.
Planning ahead is the secret, and the younger your baby the more carefully
you need to plan. If you are well organized, outings with your baby can be
a great joy, and the sooner that you start after bringing your baby home
from the hospital, the better. Looking after a baby doesn’t preclude parents
from resuming the active life that they had before. One word of warning,
though: don’t be too ambitious or undertake very long trips at first.

Local outings W^gi]id&nZVg

Planning your outings
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WHAT TO TAKE FOR A YOUNG BABY
• A changing surface (that can be a fold-up
plastic mat or a cloth diaper)
• Disposable diapers
• Baby wipes
• Breast pads if breast-feeding
• Bottle and milk powder if bottle-feeding
• Hat (sun hat for summer, warm one for winter)
• Sweater
• Toys for distraction
• Plastic bag for dirty diapers
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idX]Vc\ZndjgWVWndci]Z[addg¸
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^i¼h[jcidh^i^cV cZVgWneVg`id[ZZY
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Using a baby sling Using a stroller

Ha^c\hVgZdcZd[i]ZbdhiXdckZc^Zci 6higdaaZg^hVWhdajiZanZhhZci^Va^[ndjYdc¼i
bZi]dYhd[XVggn^c\VWVWnVhlZaaVhdcZ lVciidXVggnndjgWVWn^cVha^c\dgl]Zc
d[i]ZdaYZhi#I]Zn]daYndjgWVWnhZXjgZan ]Z¼hidd]ZVknidXVggn#HigdaaZghl^i]hZVih
V\V^chindjgX]Zhihdi]VindjVcYndjg
WVWn]VkZi]ZhZXjg^ind[WZ^c\XadhZid
WHAT TO TAKE FOR AN OLDER BABY
ZVX]di]Zg0i]ZnVahdaZVkZndjg]VcYh[gZZ#
7jnVlVh]VWaZha^c\WZXVjhZndjgWVWn^h • A changing surface
WdjcYidhe^ijedc^i!VcYign^idcWZ[dgZ • Disposable diapers
ndjbV`Zndjg[^cVaX]d^XZ#>i]Vh\diidWZ • Baby wipes
ZVhnidejidcVcYidlZVg#I]Zh]djaYZg • Baby food and spoon
higVehbjhiWZl^YZZcdj\]idhjeedgi • Non-messy snacks
ndjg\gdl^c\WVWn¼hlZ^\]iXdb[dgiVWan! • Feeding cup and some water
VcYWdi]ndjVcYndjgeVgicZgbjhi[ZZa • Bib
gZaVmZYlZVg^c\^i#>i]VhWZZchV^Yi]ViV • Hat
WVWnh]djaYc¼iWZXVgg^ZY^cVha^c\jci^a]Z • Sweater
XVchjeedgi]^hdlc]ZVY#I]^h^hcdiigjZ# • Toys for distraction
NdjXVcXVggnndjgWVWn^cVha^c\Vhhddc • Plastic bag for dirty diapers
284 OUTINGS AND TRAVEL
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TIPS FOR STROLLERS
• Never leave your baby unattended.
• Always make sure that the stroller is fully
extended and that the frame is locked in position.
• Never let go of the stroller for a moment without
putting the brakes on first.
• Always put the safety harness on your baby.
• Never, ever, put shopping on the handles of the
stroller; it could tip over backward.
• From an early age, teach your child to keep his
fingers away from the wheels.
i]Via^ZXdbeaZiZan[aViVgZZhhZci^Va[dgkZgn
ndjc\WVW^Zh#6ai]dj\]WVW^Zh[^ifj^iZ
hcj\an^cidi]ZXjgkZYh]VeZd[VhigdaaZg!
^i^h^bedgiVciidbV`ZhjgZi]ZnVgZlZaa
hjeedgiZY#:kZcVi^cnWVWn!^[VlV`Z!XVc
WZegdeeZYjeidiV`Z^ci]Z^ciZgZhi^c\
h^\]ihVgdjcY]^b#6alVnhbV`ZhjgZi]Vi
ndjgWVWn^hhV[ZanhigVeeZY^c#
Using a backpack
6WVX`eVX`^hVjhZ[jabZVchd[XVggn^c\
VcdaYZgWVWnl]dXVch^ijelZaaVcYl]d
]VhWZXdbZ]ZVknidXVggn^cVha^c\!idd#
DcXZV\V^c!^iaZVkZhndjg]VcYh[gZZ!Wji
^iVahdVaadlhndjgWVWnidhZZbjX]bdgZ
d[l]Vi¼h\d^c\dcVgdjcY]^b#7Z[dgZndj
WjnVWVX`eVX`!Ydi]Z[daadl^c\/
™ Igndci]ZWVX`eVX`^ci]ZhidgZ!l^i]
ndjgWVWn^c^i#
™ 8]ZX`i]Vii]ZWVWn¼hhZViXdbZh
]Va[lVnYdlcndjgWVX`#I]^h^hkZgn
^bedgiVciWZXVjhZ^ieaVXZhi]ZhigV^c
dcndjgWVX`VcYcdidcndjgh]djaYZgh0
^iVahd`ZZehi]ZWVWnhiVWaZ#
™ BV`ZhjgZi]Vii]ZeVX`]VhVhV[ZinhigVe
id`ZZei]ZWVWn^ceaVXZVcYVlV^hiWZai
[dgndjid`ZZe^ihZXjgZ#8]ZX`i]Vii]Z
h]djaYZghigVehVgZlZaaeVYYZY#
• One disadvantage of strollers compared to
carriages is that in cold weather your child is more
exposed. If you don’t have a padded chair cover,
lay a blanket over the stroller seat before you put
the baby in. Wrap the blanket around him.
• If your baby falls asleep before you get home
either put the stroller down into the lie-back
position or tuck him up comfortably with pillows.
• If you have an older child and a baby, fit a stroller
board onto the stroller to save the toddler’s legs.

™ 8]ZX`i]VindjgWVWnXVch^iXdb[dgiVWan
VcYi]Vii]ZaZ\deZc^c\hYdc¼igZhig^Xi
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id[gZZ"hiVcY^c\hZVih#
Going shopping
Ignidh]deZVgan^ci]Zbdgc^c\l]Zci]Z
hidgZhVgZaZhhWjhn#L]Zcndj\didV
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ndjgh]dee^c\XVgi#L]ZZai]ZXVgiYdlc
i]ZXZciZgd[i]ZV^haZh#NdjgWVWnl^aa
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XVcXVjhZX]Vdhl^i]VhjeZgbVg`Zi¼h
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hi^aaWgZVhi"[ZZY^c\ndjgWVWn!eaVcidh]de
WZilZZc[ZZY^c\h#>[ndj¼gZ\d^c\idWZdji
[dgVl]^aZ!]VkZbdhid[ndjgh]dee^c\
YdcZWZ[dgZndj]VkZid[^cYhdbZl]ZgZ
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=Vk^c\VXVg^hdcZd[i]Z\gZViZhi
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igVchedgiVi^dc!VcY^iegdk^YZhVc^YZVa
[ZZY^c\VcYX]Vc\^c\VgZV#
Eating out
>ci]Z[^ghibdci]hndjgWVWnl^aaYdoZd[[
VabdhiVcnl]ZgZ!hdZVi^c\djil^aaWZ
fj^iZZVhn#=dlZkZg!Wni]Zi^bZ]Z¼hc^cZ
bdci]hdaY]Z¼aaWZXVeVWaZd[`ZZe^c\
]^bhZa[VlV`Z0]Z¼aaWZ`ZZc[dgVcncZl
ZmeZg^ZcXZVcYVgZhiVjgVci!l^i]higVc\Z
eZdeaZYd^c\ZkZchigVc\Zgi]^c\h!l^aa
[VhX^cViZ]^b#8]ddhZndjggZhiVjgVci
XVgZ[jaanVcYignid[^cYVX]^aY"[g^ZcYan
eaVXZi]Viegdk^YZh]^\]X]V^gh#6alVnhiV`Z
ndjgdlchcVX`hl^i]ndj!VcYVhhddcVh
ndj¼kZhZiiaZYndjgWVWn^c]^hhZVi!\^kZ
LOCAL OUTINGS—BIRTH TO 1 YEAR 285
]^bi]ZhZiddXXjen]^b#=VkZeaZcind[
idnh[dgY^higVXi^dcgZVggVc\^c\eVeZg
cVe`^ch^hVahdV\ddYVXi^k^in#NdjbVn
[^cY^ildg`hWZiiZg^[ndj[ZZYndjgX]^aY
WZ[dgZndjVcYndjgeVgicZghiVgi#
Using public transportation
>[ndj¼gZh]dee^c\dcndjgdlc!l^i]V
higdaaZg!VX]Vc\^c\WV\!VcYV\gjben
WVWn!\Zii^c\dcejWa^XigVchedgiXVchZZb
a^`Zi]ZaVhihigVl#=dlZkZg!i]ZgZVgZ
hdbZi^ehid\ZidkZgi]ZldghiegdWaZbh#
™ 6kd^YigVkZa^c\Yjg^c\gjh]]djg#
™ L]Zcedhh^WaZ!XVggnndjgWVWn^cVha^c\
dgWVX`eVX`#I]^haZVkZhndjg]VcYh[gZZ
VcYbV`Zh\Zii^c\dcVcYd[[VWjhdg
igV^cZVh^Zg#
™ 8VggnY^higVXi^c\idnhl^i]ndj!VcYi^Z
dcZdgbdgZidi]ZhigdaaZgdgWVX`eVX`#
™ >[ndj¼gZVh`ZYidaZVkZndjghigdaaZg^cV
heZX^Vaaj\\V\ZhZXi^dc!bV`ZhjgZndj
\Zije^ceaZcind[i^bZidgZig^ZkZ^i
WZ[dgZndjghide#
™ CZkZgWZZbWVggVhhZYidVh`[dg]Zae#
TIPS FOR SHOPPING WITH BABIES
• When you’re carrying your child in your
backpack remember your child’s grasping
fingers can reach bottles and cans in a store.
• When you take your child into the supermarket,
keep him supported and under control by using
your own harness to strap him into the cart.
• For emergencies keep a few disposable diapers,
wipes, and plastic bags in the glove
compartment of the car for quick changes.
• Shopping seems to make children hungry and
therefore fretful. Avoid this by taking a snack.
• You can use the opened trunk of the car, with
a blanket laid over it, as a surface on which to
change your child.
286 OUTINGS AND TRAVEL
Local outings &id(nZVgh
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SHOPPING WITH TODDLERS
• Encourage your child to become familiar with
shopping. Give him the wrappers or boxes of
things on your shopping list and suggest he
find them for you by matching them up with
products on the shelves.
• Toddlers can get lost in stores. Dress yours in
an easily spotted coat or hat in a bright color.
• As soon as possible, teach your child his name,
address, and telephone number. In the
meantime, insert a label with this information
inside his coat in case he does get lost.
• I used to use a referee’s whistle on a string
around my neck to summon my children. We
had a code: one whistle—come quickly; two
whistles—run; three whistles—emergency.
• Any outing can be a lesson in disguise. In the
supermarket you can teach your child about
healthy eating (that beans are better than
spaghetti) or bargains (that buying large cans
works out cheaper than getting small ones).
• It’s a scary prospect but you can make sure
your child could find his way alone when he’s
near home by giving the same running
commentary as you approach your house. “And
here’s that big tree on the corner, now we turn
right, past the mailbox, and here’s our street,
and our house, the fourth one on the left.”
]VgcZhhZh!WVX`eVX`h!VcYW^XnXaZhZVih
VgZjhZ[jaVaiZgcVi^kZhVcYXVchdbZi^bZh
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Using the stroller
6hndjgX]^aY\ZihdaYZg!]Zldc¼iWZ
]Veen_jhih^ii^c\^ci]ZhigdaaZg!Wjil^aa
lVciidlVa`Vadc\l^i]ndj#I]^hbVn
WZ^cXdckZc^Zci!ZheZX^Vaan^[ndjVgZ
h]dee^c\!VcYndjl^aa]VkZidYdndjg
jibdhiideZghjVYZndjgidYYaZgidhiVn^c
^i#>cbnZmeZg^ZcXZ!i]ZWZhilVnd[Yd^c\
i]^h^hidiV`ZVadc\dcZd[ndjgX]^aY¼h
[Vkdg^iZidnhVcYVhcVX`#
>[ndjgX]^aY^hhdgZhiaZhhi]Vi]ZbV`Zh
h]dee^c\^bedhh^WaZ!ndjXdjaYejindjg
X]^aY^cV]VgcZhh#BV`ZV\VbZd[^i^[]Z
gZh^hih#=Zl^aa[ZZaVhZchZd[[gZZYdbVcY
^cYZeZcYZcXZ!Wjindj`cdli]Vi]ZXVc¼i
lVcYZgVlVn[gdbndjVcY\Ziadhi#6
lg^hia^c`i]Vi¼hhZXjgZanViiVX]ZYidi]Z
]VgcZhhl^aa]ZaeegZkZcindjgX]^aY[gdb
WZXdb^c\hZeVgViZY[gdbndj#
Using a bicycle seat
>[ndj]VkZVW^XnXaZndjbVn[^cY^i[jc
idiV`ZndjgidYYaZgdci]ZWVX`#I]ZgZVgZ
ild`^cYhd[W^XnXaZhZVi¸[gdci"bdjciZY
VcYgZVg"bdjciZY#I]ZhZa^\]ilZ^\]i
eaVhi^XhigjXijgZh[^icZVianVcYhZXjgZan
dcidVW^XnXaZ[gVbZVcYXVcVXXdbbdYViZ
VX]^aYd[jeid)-edjcYh''`^ad\gVbh#
BV`ZhjgZi]VindjgX]^aY¼h[ZZiVgZVlVn
[gdbi]Zl]ZZahVcYi]Vii]ZgZ¼hVhigdc\
hV[Zin]VgcZhh[dgndjgX]^aY#>[ndjYZX^YZ
ndjYdlVciidjhZi]^hbZi]dYd[
igVchedgiVi^dc!Wdi]ndjVcYndjgX]^aY
bjhilZVgegdiZXi^kZXnXaZ]ZabZih#
 LOCAL OUTINGS—1 TO 3 YEARS 287

Shopping with an older child [Vkdg^iZWdd`hVadc\#L]Zcndj\d^cid

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I]ZdcanZ[[^X^ZcilVnd[\Zii^c\VgdjcY!
ZheZX^Vaanl]Zch]dee^c\!^hidiV`Zndjg Special excursions
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lVn!dcZVYjaiXVc\Zii]Zh]dee^c\YdcZ! egdWVWanWZeVgid[ndjgidYYaZg¼hYV^an
l]^aZi]Zdi]ZgdXXje^Zhi]ZX]^aY#I]ZgZ^h gdji^cZWjii]ZgZl^aaWZdXXVh^dchl]Zc
Vahdi]ZVYYZYWdcjhd[Vcdi]ZgeV^gd[ ndjlVciideaVcVheZX^VaZmXjgh^dca^`Z
]VcYhid]ZaeXVggni]Zh]dee^c\]dbZ# i]ZodddgVWdViig^e#>cndjgeaVch!iV`Z
I]Zbdhi^bedgiVcii^e^hid`ZZendjg ndjgX]^aY¼heZghdcVa^in^cidVXXdjci#
idYYaZg^cV]VgcZhhhdi]VindjXVc L]Vi¼h]^hViiZci^dcheVc4>h]ZkZgn
XdcXZcigViZdcl]Vindj¼gZYd^c\l^i]dji VXi^kZ4>[]Z^h!Ydc¼ieaVcid\dVcnl]ZgZ
]Vk^c\idldggnVWdjil]Vi]Z¼hYd^c\#Dg l]ZgZ]Z¼h\d^c\idWZXdc[^cZYid]^h
ndjXVcejindjgX]^aY^ci]ZhjeZgbVg`Zi higdaaZg[dgadc\dgndj¼aagj^cZkZgnWdYn¼h
XVgihd]ZXVc¼igjcVlVn0jhZi]ZhigVehhd YVn#>[!l]Zci]ZYVnVgg^kZh!ndjgidYYaZg¼h
]ZXVc¼iXa^bWdjiZ^i]Zg#6hndj\dVgdjcY ^cVWVYbddY!edhiedcZi]Zdji^c\0
i]ZhidgZ!Vh`ndjgX]^aYfjZhi^dcha^`Z! h^b^aVgan^[ndjcdadc\Zg[ZZaa^`Z^i#IV`Z
¹8VcndjhZZi]ZWV`ZYWZVch4º¹L]^X] Zcdj\]hcVX`h[dgi]Zl]daZYVnVcY
^hi]ZaVg\ZhiXVc4º¹L]^X]VeeaZhYdndj ^cXajYZVkVg^Zind[i]Zb#
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X]^aYgZcadkZWZ^c\^ckdakZY^ci]^hlVn0
ndjXVcZkZcaZii]ZbX]ddhZi]Z^g[Vkdg^iZ
[ddYhVcYejii]Zb^ci]ZXVgi#
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bnX]^aYgZcfj^ZilVhidaZii]Zbeji
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VgdjcYVcYi]ZciV`Z^iVaadjil]ZclZ
\diidi]ZX]ZX`djijcWZ`cdlchiid
i]Zb/^ilVhi^bZ"Xdchjb^c\!Wji^ilVh
bdgZeZVXZ[ja#
>[ndjVgZc¼i\d^c\[ddYh]dee^c\Wji!
hVn!Xadi]Zhh]dee^c\^chiZVY!hi^aa`ZZe
ndjgidYYaZg^cV]VgcZhh!WjiiV`Z]^h

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288 OUTINGS AND TRAVEL

Car trips W^gi]id&nZVg

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ZkZgnYVna^[Z!VcYi]ZhddcZgndjgWVWn
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Car safety
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dcndjgaVe#6alVnhjhZVXVghZVihj^iVWaZ
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XjggZcihiViZVcYhV[ZingZ\jaVi^dch#7Z[dgZ
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XdchjbZgVcYhV[ZinVYk^XZ#
Feeding your baby
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bjai^ean#>chiZVY!eaVcV]ZVYWneVX`^c\
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Vi]Zgbdhd[Wd^aZYlViZg#I]Zcb^mi]Z
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YdZhc¼i[^c^h]!WZXVjhZi]Z[ddYl^aaWZ
XdciVb^cViZYl^i]hVa^kV!VcY\Zgbhl^aa
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Changing your baby
9^hedhVWaZhVgZWn[Vgi]ZZVh^ZhiidjhZ
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igVkZa^c\!hdVaandjcZZYVgZhdbZWVWn
l^eZhVcYVeaVhi^XWV\[dgY^ginY^VeZgh#

CAR TIPS
• Never leave your child alone in the car.
• When the temperature is very hot, avoid heat
exhaustion and heatstroke by only taking your
baby on essential short trips early in the
morning and at night when it is cooler.
• Secure a blind or piece of thick cloth on the car
window to protect a baby from the sun.
• Remove all loose objects from the back ledge
in case of accident.
• Always keep a bag with spare diapers and
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CAR TRIPS—1 TO 3 YEARS 289
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PREVENTING CARSICKNESS
Some children are more prone to carsickness than
others. Most grow out of it as they get older, but
there are ways to minimize the risks:
• If your child gets carsick, ask your pediatrician
to suggest a suitable medicine.
• Keep your child occupied.
• Don’t give your child rich or greasy food within
a few hours of leaving.
• If your child wants a snack during the trip, give
him dry cookies or a candy.
• Don’t become overanxious. Children quickly
pick up on their parents’ moods and this can
make them apprehensive and more prone to
carsickness. Excitement and apprehension play
a part, and children tend to suffer more on the
outward trip than on the return one.
• If your child gets very pale or very quiet, stop
the car. Provide a plastic bag or bowl to be sick
in, if necessary.
• Keep a supply of plastic bags in the car, baby
wipes to clean your child up, a change of
clothes, and something to take away the taste.
290 OUTINGS AND TRAVEL
Air travel W^gi]id(nZVgh
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WHAT TO TAKE WITH YOU
• Child’s passport and immunization record,
if necessary.
• Lightweight bag for baby’s equipment.
• Folding travel crib, if crib unavailable.
• Stroller, carrier, backpack, or sling.
• Plastic mat for diaper changing.
• Bouncing chair if used.
• Pack of disposable diapers; buy supplies at
destination.
• Diaper changing equipment.
• Potty if needed.
• Plastic bags for dirty diapers.
• Thermos flask for days on beach.
• Bottle-feeding equipment if required.
• Nonspill cup, plastic dish, and spoon if weaned.
• Toys and games.
• Comforters if used.
• Quick-drying, noncrease clothes.
• Sun hat, if necessary.
• Long-sleeved shirts and long-legged pants.
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 AIR TRAVEL—BIRTH TO 3 YEARS 291

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SAFE SUN TIPS
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™ 9dc¼iignidZVidgYg^c`]di[ddYl]^aZ Keep babies in the shade at all times. Do not
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™ AZindjgWVWneaVnl^i]Vaai]Z^c"[a^\]i pigment so they have much less protection from
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[ddYigVn!eaVhi^XhV[Zin^chigjXi^dch[gdb ultraviolet rays can lead to skin damage and skin
i]ZhZViedjX]!]ZVYe]dcZh[dgi]Z cancer in later life.
bdk^Zhdg[dgbjh^X# • In very hot weather, avoid taking your baby out
in the sun between 11 a.m. and 3 p.m. when
Toward carefree foreign vacations the sun is at its highest.
NdjgWVWn¼hcZkZgiddndjc\idigVkZa • Dress your baby in a wide-brimmed hat and loose,
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^hjeidndjVcYndjg^cY^k^YjVaiVhiZh¸^i cloudy days.
bVnWZXVbe^c\!hiVn^c\^cVajmjgn]diZa! • Make sure the carriage or stroller has an
dghlVee^c\]djhZhl^i]Vcdi]Zg[Vb^an# adjustable sunshade to shade your baby.
L]ZgZkZgndj\d!bV`ZhjgZi]Vii]Zn]VkZ • Be particularly careful near snow and water
VYZfjViZ[VX^a^i^Zh[dgndjc\X]^aYgZc# where reflected light is strong.
L^i]djii]Zb!ndj¼gZcdi\d^c\idZc_dn • Apply sunblock of at least SPF 30 to your child
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 =dbZhV[Zin
Accidents in the home cause a large percentage of deaths of children
between the ages of one and four. Most of these incidents are avoidable,
so take the time and care to minimize the chances of anything happening
in your home. Most accidents are caused by a chain of events rather than
a single occurrence—for example when someone is ill or tired, or when
something unusual is happening.

Room-by-room safety
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RISK FACTORS
The chances of an accident happening are increased
by the following factors:
• If your child is tired, ill, or hungry.
• If parents are tired or ill or if the mother is
premenstrual or pregnant.
• When there’s great excitement in the home, such
as when you’re going on vacation or expecting
the arrival of a new baby.
• If your child is considered hyperactive.
• If you and your partner aren’t getting along, or
if you’re actually fighting.
• If your child doesn’t have anywhere safe to play.
• If correct safety precautions haven’t been
followed.
• If the equipment you use for your baby doesn’t
comply with safety standards.
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294 HOME SAFETY
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ROOM-BY-ROOM SAFETY 297
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ROAD SAFETY
It’s never too early to teach your child the safety code
for crossing the street. Whenever you want to cross
the street, always go to a pedestrian crossing if
possible or find the safest place to cross—one
where you can see clearly in all directions and
drivers can see you. Stop by the curb, hold your
child’s hand or her harness, look in both directions
for traffic, and listen. If traffic is coming, let it pass.
Look in both directions again and when nothing is
coming, walk across; don’t run. Continue to look
and listen as you cross. Keep up commentary about
what you’re doing, looking for, and listening for.

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Emergency first aid

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Unconsciousness
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• If there are no signs of breathing, you should give
five rescue breaths (TFF
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If on your own, do CPR for one

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see
p.302

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see p.299


Rescue breathing for a child

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see p.299


RECOVERY
R POSITION
For a baby under one year bent and the lower leg straight. Make sure her
Cradle your baby in your arms with her body facing lower arm is clear of her body. Bend her upper arm
slightly toward you. Keep her head lower than her at the elbow so that it supports her body,
body to help keep the airway open. place her upper hand under her cheek
to help keep the head back.
For a child
An unconscious child who is breathing should
be placed in the recovery position to
keep her airway open and to
allow liquids to drain from her
mouth. Roll your child over onto
her side with the uppermost leg
302 HOME SAFETY

Chest compressions for a baby under one year

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p.301

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see
p.301

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 EMERGENCY FIRST AID 303

Shock
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Warning
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304 HOME SAFETY

Burns and scalds

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p.303

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see
pp.300–302


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Warning
• Do not touch the affected area or attempt to burst
any blisters that form.
• Don’t put lotion or fat on the area.
• Don’t cover a burn with an adhesive dressing.
• Don’t cover the burn with a “fluffy” dressing or any
cloth that sheds lint.
• Don’t remove anything that is sticking to the burn:
you may cause further damage to the skin or tissue

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and introduce infection.
• Don’t overcool your child; it could cause hypothermia.

Clothing on fire

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 EMERGENCY FIRST AID 305

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306 HOME SAFETY

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 EMERGENCY FIRST AID 307

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begin resuscitation.

FIRST AID KIT

Always have a first aid kit in your home (and a children in a cool dry place. Check the contents
separate one in the car). Keep it out of reach of your regularly and restock as necessary.

• Sterile gauze squares in various sizes for • Blunt-ended tweezers and scissors
cleaning wounds. • Disposable gloves
• A box of adhesive dressings in various sizes. • Protective face mask for rescue breathing
• Sterile dressings with bandages attached in • Antiseptic cream
various sizes. • Calamine lotion
• Small and large roller bandages such as gauze or
crêpe bandages. Other useful items
• A roll of 1 inch (2.5 centimeter) hypoallergenic • Children’s acetaminophen and/or ibuprofen liquid
adhesive tape. • Insect repellent
• A sterile eye pad with bandage attached. • Antihistamine syrup
• 2 triangular bandages • Sunscreen with the highest protection factor
• Safety pins • Digital thermometer
 =dbZ
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All parents are worried when their child is sick. The difficulty can lie in not being
able to identify what’s wrong with the child (especially when he’s too young to
tell you how he feels) and in not knowing how serious the ailment really is. All
children get sick at some stage, but modern medicine is so efficient that few
illnesses now pose the threat that they once did. Health care professionals
can identify and prescribe for the ailment; it’s the parents’ job to provide the
essential nursing and comfort. Sometimes it’s difficult to know when to ask
for help, but if you’re worried, it’s always best to seek medical advice.

When to ask for medical help

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310 HOME MEDICINE
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 USING A THERMOMETER—BIRTH TO 3 YEARS 311

Using a thermometer W^gi]id(nZVgh

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TYPES OF THERMOMETERS AVAILABLE

Never use a mercury thermometer in your child’s
mouth; he may bite it and swallow mercury, which is
poisonous. Digital thermometers are harder to break
and easy to use with children of all ages and can be
used in the mouth, under the arm, or rectally.
A baby’s temperature should be taken rectally for
the most accurate reading. To take the mouth
temperature, ask your child to open his mouth and
raise his tongue. Place the thermometer under his
tongue and ask him to place the tip of his tongue
behind his lower front teeth to hold the
thermometer in place. Ask him to close his lips, but
not his teeth, over it. Wait until the thermometer
beeps and read the number in the window. Ear
thermometers are accurate and give a reading in
seconds. Strip thermometers are less accurate than
the others, but simple and safe to use. Always wash
a thermometer after use in soap and cold water.

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GIVING MEDICINE TO A BABY OR CHILD

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 GIVING MEDICINE—1 TO 3 YEARS 313

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314 HOME MEDICINE
Being a nurse to your child
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316 HOME MEDICINE
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COMFORT AND RECUPERATION TIPS
• Give your child treats. If he has a sore throat give
him ice cream.
• Cool cotton sheets are soothing to a feverish
child. Change the bed regularly.
• When your child is vomiting, always be there, and
support his forehead with the palm of your hand.
Give him some water to rinse his mouth with, and
perhaps a mint to suck afterward to take away
the bad taste.
• Put a table next to the bed for his toys, books,
fruit juices, or water.
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over your child’s lap. You could also support a
sanded wooden plank on two chairs placed
either side of the bed.
• Buy some new toys for your child. Don’t give them
to him all at once, but one at a time.
• If your child isn’t feeling too sick you could try
wrapping the toys up so that you can play a game
together. Ask him to guess what’s in the packages
by feeling them, then let him tear off the paper.
 BEING A NURSE TO YOUR CHILD 317

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YViZ#>[i]ZW^iZ^hhjeZg[^X^Va!XaZVci]Z
ldjcYVcYaZVkZ^ideZcdgejiVaddhZ"
[^ii^c\\VjoZYgZhh^c\dc^i^[cZXZhhVgn#>[!
]dlZkZg!i]ZldjcY^hhZg^djh!dgdcndjg
X]^aY¼h[VXZ!i]ZcndjbjhihZZ`bZY^XVa
MEDICAL INDEX 319
VYk^XZVhhddcVhedhh^WaZ#6c^bVaW^iZhVgZ
jhjVaanYZZeVcYY^gin!hdndjgX]^aYbVn
WZegZhXg^WZYVcVci^W^di^X#
7^iZh[gdbdi]ZgX]^aYgZcXVcWZZkZc
bdgZhZei^Xi]VcVc^bVaW^iZh#I]ZhZ
h]djaYWZXaZVcZYVcYaZ[ideZc!VcY^[
ndj¼gZViVaaldgg^ZYWni]Zbndjh]djaY
hZZ`bZY^XVaVYk^XZ#
>[ndjgX]^aY^hW^iiZcWnVhcV`Z!Y^Va
.&&[dgVcVbWjaVcXZ#9dcdiaZi]^blVa`!
WjiaVn]^bYdlc#L]^aZndjVgZlV^i^c\[dg
bZY^XVa]Zae!lVh]i]Zhjg[VXZd[i]Zh`^c
VcYVeeanVegZhhjgZWVcYV\Z[gdbVWdkZ
i]ZW^iZVh[Vgjei]Za^bWVhedhh^WaZ#>[
edhh^WaZ!^YZci^[ni]ZhcV`Z#>[ndjVgZ^cVc
VgZVl]ZgZed^hdcdjhhcV`ZhVgZegZkVaZci!
hZZ`VYk^XZVhidl]Zi]Zgndjh]djaY`ZZe
ZbZg\ZcXnhZgjbdc]VcY#
N Blisters
I]ZhZbVnWZ[dgbZYVhVegdiZXi^dc
idi]ZWdYnl]ZgZ^i]VhWZZcX]V[ZY!
WjgcZY!dggjWWZY#
What to do 6Wa^hiZgh]djaYWZaZ[i^ciVXi#
CZkZgeg^X`^i0aZVkZ^i^ciVXiVhadc\Vhndj
XVc#>[VWa^hiZg^hdcVcZmedhZYVgZV!
h^beanXdkZg^il^i]VhbVaaeVYd[\VjoZ
`Zei^ceaVXZl^i]hjg\^XVaiVeZ#I]ZWa^hiZg
l^aahjWh^YZd[^ihdlcVXXdgYVcYi]Zh`^c
WZXdbZhYgnVcY]VgY#>il^aaX]Vc\Z^ih
XdadgidVgVi]ZgYVg`e^c`VcYl^aa
\gVYjVaan[Vaad[[#9dc¼iYdVcni]^c\id
Y^hijgWi]^hcVijgVaegdXZhh#
N Bruise
I]^h^hVejgea^h]"gZYhiV^c^ci]Zh`^c!
jhjVaangZhjai^c\[gdbVWadldgV`cdX`
i]VigjeijgZhi]ZhbVaaWaddYkZhhZahcZVg
i]Zh`^c¼hhjg[VXZ#>ijhjVaaniV`ZhiZcid
[djgiZZcYVnh[dgVWgj^hZidY^hVeeZVg
320 HOME MEDICINE
XdbeaZiZan0Vh^i[VYZh!^iX]Vc\ZhXdadg
idbVgddc!i]Zc\gZZcdgnZaadlVhi]Z
WaddYe^\bZcihWgZV`YdlcVcYVgZ
gZVWhdgWZYWni]ZWdYn#GZhi^c\!Xdda^c\!
VcYgV^h^c\i]ZV[[ZXiZYeVgil^aahddi]Z
VcneV^c#6Wgj^hZ^hgVgZanhZg^djh#
>[VWgj^hZVeeZVghl^i]djiVcngZVhdc!
i]^hXdjaYgZaViZidjcXdbbdcWji
hZg^djhXdcY^i^dchhjX]VhaZj`Zb^V
VcY]Zbde]^a^V#
What to do 6b^cdgWgj^hZcZZYhcd
igZVibZciViVaa!_jhiVXjYYaZVcY
gZVhhjgVcXZ^[ndjgX]^aY^hjehZi#>[i]Z
Wgj^hZ^haVg\Z!VeeanVXdaYXdbegZhh[dg
]Va[Vc]djgdghd#I]^hl^aaXdciV^ci]Z
Wgj^h^c\#HZZ`bZY^XVaVYk^XZ^bbZY^ViZan
^[i]ZeV^cVcYWgj^h^c\VgZc¼i\Zii^c\
WZiiZgl^i]^c)·+]djgh0i]^hb^\]ihj\\Zhi
VcjcYZgan^c\[gVXijgZ#6ahdhZZ`bZY^XVa
VYk^XZ^[VWgj^hZVeeZVghhedciVcZdjhan
l^i]cdVeeVgZciXVjhZ#
N Burns
>i^hVabdhi^cZk^iVWaZi]VindjgX]^aYl^aa
Wjgc]^bhZa[dcVgVY^Vidgdg]di[VjXZiVi
hdbZed^ci!YZhe^iZndjgZ[[dgih#
What to do 8ddai]ZWjgcWneaVX^c\^i
jcYZgXdaYgjcc^c\lViZg[dgiZcb^cjiZh!
dgjci^aeV^chjWh^YZhsee p.304#I]Z
WZhiigZVibZci^hidegdiZXii]ZWjgc
l^i]Vcdc"hi^X`YgZhh^c\#Di]Zgl^hZjhZ
VhiZg^aZ\VjoZYgZhh^c\dgcdc"[aj[[n
bViZg^VaVXaZVcXdiidc]VcY`ZgX]^Z[l^aa
Yd#9dc¼igZbdkZVcnXadi]^c\i]Vi^h
hi^X`^c\idVWjgc#
HZZ`bZY^XVaVYk^XZ#>[ndjgX]^aY]Vh
WZZchZkZgZanWjgcZY]ZbjhiWZiV`Zcid
i]ZcZVgZhi]dhe^iVaZbZg\ZcXngddb[dg
egdeZgbZY^XVaigZVibZci#
N Congested or runny nose
CZ^i]ZgeZgh^hiZcinZaadlbjXjhbjXjh
l]^X]Xdci^cjZh[dgadc\Zgi]Vc[^kZdgh^m
YVnh!cdgVgjccncdhZ^hcdgbVa#7di]d[
i]ZhZh^\ch^cY^XViZi]VindjgX]^aYbVnWZ
hj[[Zg^c\[gdbVk^gVajeeZggZhe^gVidgn
^c[ZXi^dc#>[nZaadlhZXgZi^dch\ddc[dg
bdgZi]Vch^mdghZkZcYVnh!ndjgX]^aY
bVncZZYVci^W^di^Xh#6XaZVglViZgncVhVa
Y^hX]Vg\ZdkZgVadc\eZg^dY^hbdgZa^`Zan
idWZXVjhZYWnVaaZg\^Xg]^c^i^h#
What to do 6hi]ZZVg!cdhZ!VcYi]gdVi!
VcYi]Zajc\hVgZXdccZXiZYWnVhbVaahZi
d[ijWZh!VcVidb^XVaanheZV`^c\!Vc
^c[ZXi^dc^cVcndcZeaVXZXVckZgnfj^X`an
XgZZeVadc\i]ZijWZhid^c[ZXiVcdi]Zg
eaVXZ#;dgZmVbeaZ!VX]gdc^X^c[ZXi^dcd[
i]Zb^YYaZZVgXVcaZVYidVXdcY^i^dc
XVaaZYhZgdjhdi^i^hbZY^V!dgdi^i^hbZY^V
l^i]Z[[jh^dc!l]^X]bVnV[[ZXi]ZVg^c\
VcYi]ZYZkZadebZcid[heZZX]#HZZndjg
YdXidg^[ndjhjheZXindjgX]^aYbVn]VkZ
VcZVg^c[ZXi^dc#
N Chicken pox
I]^h^hVkZgnXdbbdc^c[ZXi^dci]Vi
X]^aYgZc^ckVg^VWanXViX]!Vh^i¼hdcZd[i]Z
bdhiXdciV\^djhd[VaaX]^aY]ddYY^hZVhZh
see p.340#NdjgX]^aYl^aaWZXdciV\^djh
[gdbdcZidildYVnhWZ[dgZi]ZgVh]hiVgih
idi]Zi^bZl]Zci]ZWa^hiZghhXVWdkZg#
I]ZX]^X`Zcedmk^gjh^hi]ZhVbZdcZi]Vi
XVjhZhh]^c\aZh]ZgeZhodhiZg!l]^X]bVn
V[[ZXiVYjaih!eVgi^XjaVgandaYZgdcZh#
8]^X`Zcedmd[iZchiVgihl^i]V
iZbeZgVijgZd[&%%#)·&%'•;(-·(.•8#
>ckZgnndjc\X]^aYgZc!]dlZkZg!i]ZgZ^h
]VgYanVcng^hZ^ciZbeZgVijgZ0i]ZgVh]
bVnWZi]Z[^ghih^\c#I]^hl^aaVeeZVg^c
XgdehdkZg[^kZidhZkZcYVnhVcYl^aaWZ

ZmigZbZan^iX]n#6i[^ghi!i]ZhedihVgZa^`Z
YVg`gZYe^beaZh!Wjil^i]^cVXdjeaZd[
]djghi]Znl^aa]VkZYZkZadeZYVhbVaa
Wa^hiZgdcidei]VigZhZbWaZhVYgded[
lViZg#I]Zhedihl^aaZkZcijVaanhXVWdkZg
VcYYgded[[#I]ZgVh]jhjVaanhiVgihdci]Z
X]^aY¼higjc`VcYi]ZchegZVYhid]^h[VXZ!
hXVae!Vgbh!VcYaZ\h#>ci]ZldghiXVhZh!
i]ZhedihXVcVahdVeeZVg^ch^YZi]ZX]^aY¼h
bdji]!cdhZ!ZVgh!kV\^cV!VcYVcjh#Ndjg
X]^aYl^aaWZXdciV\^djh[dgdcZdgild
YVnhWZ[dgZi]ZgVh]hiVgihjci^ai]Zi^bZ
l]Zci]ZWa^hiZghhXVWdkZg#
What to do I]Zbdhi^bedgiVcii]^c\id
Yd^hidhidendjgX]^aY[gdbhXgViX]^c\i]Z
hedih#>[ndjYdc¼iYdi]^hi]ZhXVWbVn
XdbZd[[VcYi]ZgZhjai^c\ldjcYbVn
WZXdbZ^c[ZXiZYVcYXVcaZVkZVhXVg#I]Z
WZhiigZVibZci[dgi]^h^hVbd^hijg^oZg
XdciV^c^c\Vci^hZei^X!hjX]VhXVaVb^cZ
adi^dc!Veea^ZYVigZ\jaVg^ciZgkVah#@ZZe
ndjgX]^aY¼hcV^ahh]dgiidb^c^b^oZi]Zg^h`
d[^c[ZXi^dch]djaY]Zejaai]ZhXVWhd[[#
NdjgX]^aYbVn[^cYi]Z^iX]^cZhhhd^ciZchZ
i]Vi]ZXVc¼i\ZiidhaZZe!hdndjgYdXidg
bVnegZhXg^WZVcVci^]^hiVb^cZ[dggZa^Z[#
<^kZndjgX]^aYi]ZgZXdbbZcYZYYdhZd[
VXZiVb^cde]ZcidXdcigda]^hiZbeZgVijgZ
VcYbV`ZhjgZ]ZYg^c`heaZcind[[aj^Yh#
>[ndjgX]^aY^hhi^aalZVg^c\Y^VeZgh!aZVkZ
i]Zbd[[VhbjX]Vhedhh^WaZidegZkZci
edhh^WaZ^c[ZXi^dc#
N Colds
6XdaY^hXVjhZYWnVk^gjhi]VilZXVccdi
igZViheZX^[^XVaan#I]ZgZ^hcdVci^W^di^Xid
l]^X]i]Zk^gjh^hhZch^i^kZ!hd^iXVccdiWZ
`^aaZY#I]^hbZVchi]Vi^i]VhidWZ
dkZgXdbZWni]ZWdYn¼hdlcYZ[ZchZ
bZX]Vc^hbh!l]^X]jhjVaaniV`ZhiZcid
MEDICAL INDEX 321
[djgiZZcYVnh#I]Zk^gjh^c[ZXihVcY^c[aVbZh
i]ZbZbWgVcZhd[i]ZcVhVaeVhhV\ZhVcY
i]gdVi!egdYjX^c\i]ZlZaa"`cdlc
hnbeidbhd[hdgZi]gdViVcYgjccncdhZ#
HdbZi^bZhi]Zk^gVa^c[ZXi^dclZV`Zch
i]ZWdYnVcYVaadlhVhZXdcYVgnWVXiZg^Va
^c[ZXi^dcidYZkZade#I]Zidch^ahVcY
VYZcd^YhbVnWZXdbZhldaaZc!VcYhd
bVni]Z\aVcYh^ci]ZcZX`#>[i]Zidch^ah
WZXdbZ^c[ZXiZYidch^aa^i^h!Vci^W^di^X
igZVibZcibVnWZgZfj^gZY!hdhZZ`
bZY^XVaVYk^XZsee p.336#
8daYhVgZXdbbdc^cndjc\X]^aYgZc!
VcYid]VkZ[^kZdgh^mXdaYhVnZVg^hfj^iZ
jhjVa#7VW^ZhjcYZgh^mbdci]hVgZaZhh
a^`ZanidXViX]XdaYhWZXVjhZd[i]Z
Vci^WdY^Zhi]ZngZXZ^kZ[gdbi]Z^gbdi]Zgh!
ZheZX^Vaan^[i]Zn¼gZWgZVhi"[ZY#
What to do >cVndjc\WVWnVXdaYXVc
XVjhZfj^iZVadid[Y^higZhhWZXVjhZ^ibVn
WadX`i]ZcdhZVcYegZkZciWgZVi]^c\
Yjg^c\[ZZY^c\#9dc¼iaZindjgX]^aYhj[[Zg
i]^hlVn0hZZ`bZY^XVaVYk^XZ#Ndjl^aa
egdWVWanWZ\^kZccdhZYgdehidjhZWZ[dgZ
ZVX][ZZY^c\!VcYi]ZhZl^aa`ZZei]ZcVhVa
eVhhV\ZhXaZVgadc\Zcdj\][dgi]ZWVWnid
ZVi#CZkZgjhZcdhZYgdehjcaZhhi]ZnVgZ
egZhXg^WZYWnndjgYdXidg#
7ZXVjhZVaai]ZjeeZgV^geVhhV\Zh!
i]ZcdhZ!VcYi]Zh^cjhZh^cVc^c[VciVgZ
XdccZXiZYWnh]dgiijWZh!Vc^c[ZXi^dcd[
dcZeVgiXVcfj^X`anhegZVYidVcdi]Zg#
;dgi]^hgZVhdcVXdaYbVngVe^YanWZXdbZ
WgdcX]^i^hVc^c[ZXi^dcd[i]ZgZhe^gVidgn
igVXi!idch^aa^i^hsee p.336),VcYhdbZi^bZh
di^i^hbZY^V^c[ZXi^dcd[i]Zb^YYaZZVg#
>[ndjgX]^aYXdbeaV^chd[VhdgZi]gdVidg
ZVgVX]Zsee p.325!hZZ`bZY^XVaVYk^XZ
WZXVjhZ]ZbVncZZYVci^W^di^Xh#DaYZg
X]^aYgZchZZbid[ZZai]Zhnbeidbhd[V
322 HOME MEDICINE
XdaYaZhhi]VcVYjaih!hdi]ZgZ^hcdgZVhdc
idjhZdkZg"i]Z"XdjciZgXdaYbZY^X^cZh[dg
VX]^aY^ci]ZlVndcZb^\]i[dgVcVYjai#
N Cold sore/Herpes simplex
9Zhe^iZi]Z^gcVbZXdaYhdgZh]VkZ
cdi]^c\idYdl^i]VXdaY!di]Zgi]Vc
i]Z[VXii]ViVXdaYV[[ZXihi]Z^bbjcZ
hnhiZbVcYgZYjXZhgZh^hiVcXZid^c[ZXi^dc!
l]^X]bVnVaadli]Z]ZgeZhh^beaZmk^gjh
idVXi^kViZ#Eg^bVgn]ZgeZhh^beaZm
^c[ZXi^dcbVndXXjg^cndjc\X]^aYgZc#
I]^h^hVcVXjiZ^aacZhhl^i]VkZgn]^\]
[ZkZg!adihd[eV^c[jabdji]jaXZgh!VcY
\gZViY^[[^XjainhlVaadl^c\#
What to do >[ndjcdi^XZV]ZgeZhWa^hiZg
Xdb^c\je!XdciVXindjgYdXidg#H]ZbVn
egZhXg^WZdgVaVXnXadk^gdggZXdbbZcY
VXnXadk^gXgZVb!l]^X]^hVkV^aVWaZdkZgi]Z
XdjciZg#>[jhZYZVganZcdj\]!i]^hXVc
XdciV^cdgb^c^b^oZi]ZViiVX`d[]ZgeZh#
I]Z]ZgeZhk^gjh^heVhhZYdcWnY^gZXi
XdciVXi#BdhiX]^aYgZcl]d\ZiXdaYhdgZh!
jhjVaanVgdjcYi]Za^eh!cdhZ!VcYedhh^Wan
dci]ZX]ZZ`hVcYX]^c!\Zii]Zb[gdb
VYjaihl]d`^hhi]Zb#>i^hfj^iZXdbbdc^[
dcZeVgZci^ci]Z[Vb^an]VhVXdaYhdgZ[dg
di]ZghidXViX]i]Zk^gjh[gdbi]VidcZ
eVgZci0^i^hZfjVaanedhh^WaZ[dgndjgX]^aY
id^c[ZXidi]ZghVhlZaa#
N Colic
>cVWVWnjcYZg[djgbdci]hd[V\ZXda^X
YZhXg^WZhVXgn^c\heZaa!Yjg^c\l]^X]i]Z
WVWn¼h[VXZWZXdbZhkZgngZYVcYWdi]aZ\h
VgZYgVlcjeid]^hhidbVX]Vh^[]Z^h^c
\gZVieV^c#I]^hXgn^c\heZaajhjVaanXdbZh
^ci]ZZVganZkZc^c\0Yjg^c\i]ZgZhid[i]Z
YVni]ZWVWn^h\ZcZgVaanXdciZciZY#I]Z
Xgn^c\XVcgZVX]hXgZVb^c\e^iX]VcYaVhi
[gdbdcZidi]gZZ]djgh#I]ZWVWnYdZhc¼i
jhjVaangZhedcYidhddi]^c\iZX]c^fjZh
i]Vildg`Vidi]Zgi^bZh#8da^X^hhd
Xdbbdci]Vi^i^hgZ\VgYZYWneZY^Vig^X^Vch
VhcdgbVa!Wji[dgeVgZcih^iXVcWZY^[[^Xjai
idZcYjgZ#I]ZXVjhZ^hcdi`cdlc#>i^h
d[iZcVi^ihldghiVih^mlZZ`hWji
Y^hVeeZVghWni]gZZid[djgbdci]h#
What to do IgnVaai]ZlVnhd[hddi]^c\
ndjgWVWni]Vildg`Vidi]Zgi^bZhd[i]Z
YVn#I]^hbVnbZVcndjVgZXdchiVcian
d[[Zg^c\i]ZWgZVhidgWdiiaZ0X]Vc\^c\
Y^VeZgh0Wjge^c\0cjgh^c\VcYgdX`^c\0
lVa`^c\l^i]i]ZWVWndcndjgh]djaYZg0
ejii^c\i]ZWVWn^cVha^c\V\V^chindjgWdYn0
eaVn^c\bjh^X[dgXdchiVciWVX`\gdjcYcd^hZ0
dglVa`^c\]^b^cVXVgg^V\ZdghigdaaZg#Ign
d[[Zg^c\ndjgWVWnVeVX^[^Zg^[]ZhZZbhid
lVciidhjX`Vaai]Zi^bZ#=Vk^c\VlVgb
WVi]gZaVmZhbdhiWVW^ZhVcY]Zaehl]Zci]Z
Xgn^c\^hVi^ihldghi#
>[ndj[^cY^i]VgYidXdeZ!hZZ`bZY^XVa
VYk^XZidgZVhhjgZndji]VindjgWVWn^h
]ZVai]nVcYl^aa\gdldjid[i]ZXda^X
ZkZcijVaan#NdjgYdXidgdgcjghZegVXi^i^dcZg
XVcegdk^YZkVajVWaZVYk^XZVcYXdjchZa^c\
l]^aZndjgWVWn^hhi^aa]Vk^c\ViiVX`h#
N Conjunctivitis
I]^h^hVc^c[aVbbVi^dcd[i]ZXdc_jcXi^kV!
l]^X]^hi]ZdjiZgXdkZg^c\d[i]ZZnZ#>i
bV`Zhi]ZX]^aY¼hZnZadd`gZY!VcY^iXVc
[ZZa^iX]ndghdgZ#
What to do >[ndjgX]^aYYZkZadeh
¹e^c`ZnZ!ºZmVb^cZi]ZZnZidhZZ^[i]ZgZ
^hV[dgZ^\cdW_ZXiigVeeZYjcYZgcZVi]i]Z
a^Y#>[i]ZgZ^h!ignidg^chZi]ZZnZl^i]
iZe^YWd^aZYlViZgidhZZ^[ndjXVclVh]
i]Z[dgZ^\cWdYndji#>[cdi!\didndjg

eZY^Vig^X^Vc#>[i]ZgZ^hcdiV[dgZ^\cdW_ZXi
dgigVjbV!i]ZXVjhZd[i]Z¹e^c`ZnZº
XdjaYWZk^gVadgWVXiZg^Va^c[ZXi^dcdgVc
VaaZg\^XgZVXi^dc#>cXVhZndjgX]^aY¼h
Xdc_jcXi^k^i^hcZZYhVci^W^di^XigZVibZci!
hZZ`bZY^XVaVYk^XZ#
N Coughing
6Xdj\]^hi]ZWdYn¼hcVijgVagZ[aZmid
^gg^iVi^dcd[i]Zi]gdVi!i]ZkZgnWVX`d[
i]ZcdhZ!VcYi]ZbZbWgVcdjha^c^c\d[
i]ZV^geVhhV\Zh#>id[iZcVXXdbeVc^ZhVc
^c[ZXi^dcd[i]ZjeeZgV^glVnh!i]Zi]gdVi!
dgi]ZadlZgV^glVnh!VcYi]ZejgedhZd[
i]ZXdj\]^hidgZbdkZZmXZhhbjXjhdg
e]aZ\b#7nXdj\]^c\i]Ze]aZ\b^h
addhZcZY!Wgdj\]ije^cidi]Zbdji]!VcY
i]ZchlVaadlZY#6cn\ZgbhZm^hi^c\^c^i
VgZi]Zc`^aaZYWni]ZVX^Y^ci]ZhidbVX]#
6XdbbdcXVjhZd[Xdj\]^c\Vic^\]i^h
bjXjhYg^ee^c\[gdbi]ZcdhZVcYh^cjhZh
^cidi]ZWVX`d[i]Zi]gdVi#=dlZkZg!
Xdj\]^c\XVcVahdWZYjZidVaaZg\ndg
Vhi]bVVcYcdi^c[ZXi^dc#
What to do 6Xdj\]i]Vi^hbZgZanV
gZhedchZid^gg^iVi^dcVcYcdiidi]Z
egZhZcXZd[ZmXZhhbjXjh^hXVaaZYVc
jcegdYjXi^kZXdj\]WZXVjhZ^iYdZhc¼i
Xdj\]djiVcne]aZ\b#6Xdj\]i]ViYdZh
\Zig^Yd[bjXjh^hXVaaZYVegdYjXi^kZ
Xdj\]#6cjcegdYjXi^kZXdj\]hZgkZhcd
jhZ[jaejgedhZVcYXVcWZZmigZbZan
^gg^iVi^c\idVndjc\X]^aY0^iXVcZkZc
egZkZcihaZZe#>i^h^bedgiVciid
Y^[[ZgZci^ViZWZilZZcVYgn!jcegdYjXi^kZ
Xdj\]VcYVlZi!egdYjXi^kZdcZi]Vi
egdYjXZhe]aZ\b#
8dj\]bZY^X^cZh^c\ZcZgVaVgZcdi
Z[[ZXi^kZ!WjiXdj\]hjeegZhhVcihbVnWZ
egZhXg^WZY[dgVX]^aYl^i]VkZgnhZkZgZ!
MEDICAL INDEX 323
Ygn!jcegdYjXi^kZXdj\]i]Vi¼hY^hijgW^c\
]^hhaZZe#DkZg"i]Z"XdjciZgXdj\]
bZY^X^cZhVgZcdadc\ZggZXdbbZcYZY[dg
X]^aYgZcjcYZgi]ZV\Zd[ild!VcY^c[Vci
egZeVgVi^dchVgZcdadc\ZgVkV^aVWaZdkZg
i]ZXdjciZg#
NdjXVcZVhZi]Z^gg^iVi^dcd[Vc^\]i"
i^bZXdj\]Wnijgc^c\ndjgX]^aYdc]^h
h^YZdg]^h[gdci!dgWnegdee^c\]^bdc
e^aadlh^[]Z¼hdkZgdcZnZVgdaY#CZkZgaZi
i]ZXdj\]^c\WZXdbZhdhZkZgZi]ViVadc\
WdjiXVjhZhndjgX]^aYidkdb^i#
6egdYjXi^kZXdj\]!]dlZkZg!h]djaY
cdiWZhjeegZhhZYWZXVjhZ^i¼hhZgk^c\V
jhZ[jaejgedhZ#>i^h]Zae^c\iddkZgXdbZ
^c[ZXi^dcWnXaZVg^c\bjXjh[gdbi]ZV^g
eVhhV\Zh#HZZ`bZY^XVaVYk^XZ[dgV
egdYjXi^kZXdj\]i]ViaVhih[dgbdgZi]Vc
')]djghVh^ibVncZZYigZVibZci#
N Cradle cap
6i]^X`nZaadlZcXgjhiVi^dcdci]ZhXVae!
XgVYaZXVedXXjghbV^can^cWVW^Zh!
Vai]dj\]X]^aYgZcjeidi]ZV\Zd[i]gZZ
XVc]VkZ^i#I]ZnZaadlhXVaZhVeeZVg^c
hbVaaeViX]ZhdgXVcXdkZgi]ZZci^gZhXVae#
8gVYaZXVe^hcdiXVjhZYWneddg]n\^ZcZ#
7VW^Zhl]dhj[[Zg[gdb^iegdWVWan_jhi
]VkZ\gZVh^ZghXVaeh#8gVYaZXVebVnadd`
jch^\]ian!Wji^i^hfj^iZ]VgbaZhhjcaZhh^i^h
VXXdbeVc^ZYWngZY!hXVanVgZVhZahZl]ZgZ
dcndjgWVWn¼hWdYn!^cl]^X]XVhZndjg
WVWnbVn]VkZhZWdgg]Z^XZXoZbV#
What to do 9dc¼iignidgZbdkZi]Z
hXVaZhl^i]ndjg[^c\Zgh#>[i]Znldc¼i
Wgjh]dji!i]ZnbjhiWZaddhZcZY[^ghi#
HbZVgVa^iiaZWVWnd^adgVfjZdjhXgZVbdc
ndjgWVWn¼hhXVaeVcYaZVkZdkZgc^\]i#
I]^hbV`Zhi]ZhXVaZhhd[iVcYaddhZ!VcY
i]Znl^aalVh]VlVnl]Zcndjh]Vbedd
324 HOME MEDICINE
i]ZcZmiYVn#>[i]ZXgVYaZXVeWZXdbZh
]VgYVcYi]^X`!ndjbVncZZYidXdci^cjZ
i]ZigZVibZcidkZgViZc"YVneZg^dY#HZZ`
bZY^XVaVYk^XZ^[ndj¼gZldgg^ZY!dg^[ndjg
WVWn]VhgZYhXVanVgZVhZahZl]ZgZ#
N Croup
>cX]^aYgZcWZilZZci]ZV\Zhd[dcZVcY
[^kZ!Xgdjefj^iZd[iZcVXXdbeVc^ZhVXdaY#
I]ZcVbZYZhXg^WZhi]ZhdjcYd[V^gWZ^c\
^c]VaZYi]gdj\]VXdchig^XiZYl^cYe^eZ!
eVhi^c[aVbZYkdXVaXdgYh#NdjgX]^aYbVn
\didWZY[ZZa^c\fj^iZlZaa!WjilV`Zl^i]
Vi^\]iX]ZhiVcY]VkZ\gZViY^[[^Xjain
WgZVi]^c\^c0Zm]Va^c\^hZVh^Zg#
What to do >[ndjcdi^XZi]^h`^cYd[
WgZVi]^c\ndjh]djaYhZZ`bZY^XVaVYk^XZ#
DXXVh^dcVaan!i]ZWgZVi]^c\XVcWZhd
aVWdgZYi]Vii]ZgZ¼hVg^h`d[hj[[dXVi^dc#
>[i]^h^hi]ZXVhZignid`ZZendjgX]^aY
XVabVcY^cVcjeg^\]iedh^i^dc^cVbd^hi!
]jb^YVibdhe]ZgZVcYXVaaVcVbWjaVcXZ#
HiVnl^i]ndjgX]^aYjci^a]ZaeVgg^kZh#>[
cZXZhhVgn!iV`Z]^bidi]Z]dhe^iVandjghZa[#
IdbV`ZWgZVi]^c\ZVh^Zg!egdejendjg
X]^aY^cVcjeg^\]iedh^i^dcl^i]e^aadlh!
VcYbV`ZhjgZi]Vi]Z^hXdb[dgiVWaZ#>[
]Z¼hkZgnVaVgbZY!iV`Z]^bdcndjgaVe!
]daY]^b[^gban!VcYignid\Zi]^bidXden
ndjgWgZVi]^c\#A^hiZc^c\idndjWgZVi]^c\
^cVcYdjil^aaiV`Z]^hb^cYd[[]^h[ZVg0^[
]Z¼hgZaVmZY!WgZVi]^c\l^aaWZZVh^Zg#
BV`ZhjgZi]Vii]ZV^g^cndjgX]^aY¼h
WZYgddb^hc¼iiddlVgb!Vhi]^hXVcYgn
VcY^gg^iViZi]ZVagZVYn"^c[aVbZYV^g
eVhhV\Zh#DeZci]Zl^cYdlVcYaZihdbZ
XddaV^gWadl^c#Bd^hiZcZYV^g^hhddi]^c\
idi]ZeVhhV\Zh!hdigniV`^c\]^bidi]Z
WVi]gddbVcYgjcc^c\i]Z]dilViZgd[
i]Zh]dlZgl^i]i]ZYddgVcYi]Zl^cYdlh
h]ji#H^i^ci]^hhiZVbnVibdhe]ZgZl^i]
ndjgX]^aYdcndjgaVebVnWZiZaa^c\]^bV
hidgnVii]ZhVbZi^bZ#>[ndjXVc¼iYd
Vcni]^c\ZahZ!eaVXZVeVcd[Wd^a^c\lViZg
^cndjgX]^aY¼hgddb#CZkZgaZVkZndjgX]^aY
l^i]Wd^a^c\lViZg^ci]Zgddb#6[iZgi]Z
[^ghiZe^hdYZd[Xgdje!hZZ`VYk^XZVWdji
igZVi^c\Xgdjehdi]VindjXVcYZVal^i]^i
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N Cuts and abrasions
:mVb^cZVcnldjcYidhZZ]dlYZZe^i^h
VcYl]Zi]Zg^i^hWaZZY^c\egd[jhZan#>[^i^h
Wdi]YZZeVcYWaddYn!\ZibZY^XVa]Zae#
What to do >[^i^hVhbVaa\gVoZ!lVh]i]Z
VgZVl^i]XaZVclViZgVcYVeeanVXaZVc!
Ygn!cdc"hi^X`YgZhh^c\i]Vi¼haVg\Zgi]Vc
i]Z^c_jgn#>[i]ZXji^hWaZZY^c\!Veean
egZhhjgZY^gZXiandkZgi]ZldjcYVcYgV^hZ
^iVWdkZi]ZaZkZad[i]Z]ZVgisee p.302#
8dkZgi]ZldjcYl^i]VhiZg^aZYgZhh^c\#
N Diarrhea
I]ZbV^chnbeidbd[Y^Vgg]ZV^hi]Z
[gZfjZcieVhhV\Zd[addhZ!lViZgnhiddah#
9^Vgg]ZV^hVh^\cd[^gg^iVi^dcd[i]Z
^ciZhi^cZh#7ZVg^cb^cY!]dlZkZg!i]Vi^i
^hcdgbVa[dgWgZVhi"[ZYWVW^ZhideVhh
[gZfjZcilViZgnhiddah#
9^Vgg]ZV^cVWVWn^hValVnhhZg^djh
WZXVjhZd[i]ZYVc\Zgd[YZ]nYgVi^dc#
>[VXXdbeVc^ZYWnkdb^i^c\^cVndjc\
X]^aY!^i^hhZg^djh[dgi]ZhVbZgZVhdc!
ZheZX^Vaan^[^i^hVahdVXXdbeVc^ZYWn[ZkZg
VcYhlZVi^c\#
What to do HZZ`bZY^XVaVYk^XZ
^bbZY^ViZan^[ndjgWVWn^hjcYZgdcZnZVg
daYVcY]Vh]VYY^Vgg]ZV[dgh^m]djgh!dg
^[VX]^aY]VhY^Vgg]ZVl^i][ZkZgVcY

kdb^i^c\!^[]Zhi^aa]VhY^Vgg]ZVV[iZg
ilZakZ]djgh!dg^[i]ZhiddahVgZ\gZVhndg
XdciV^cbjXjhdgWaddY#<^kZndjgX]^aY
[gZfjZcihbVaah^ehd[VcdgVagZ]nYgVi^dc
hdaji^dc#I]^hXdciV^chhj\VgVcY
ZaZXigdaniZhi]Vi]ZaegZYjXZi]ZVbdjci
d[[aj^YadhiVcYgZeaVXZ[aj^Y^ci]ZWdYn#
EVnXadhZViiZci^dcid]n\^ZcZl]Zc
VX]^aY]VhY^Vgg]ZV#I]Z^c[ZXi^dcXdjaY
hegZVYi]gdj\]djii]Z[Vb^an^[ndjgX]^aY
YdZhc¼ilVh]]^h]VcYhV[iZg\d^c\idi]Z
id^aZidg^[ndjYdc¼ilVh]ndjghV[iZg
X]Vc\^c\]^hY^VeZgh#
N Drowsiness
>cVcdgbVaanVaZgiX]^aYYgdlh^cZhhXVcWZ
Vhnbeidbd[V[ZkZg!]nedi]Zgb^Vl]Zc
i]ZWdYniZbeZgVijgZ[VaahWZadlcdgbVa!
dgYZ]nYgVi^dc#>iXVcVahddXXjgWZ[dgZdg
V[iZgV[ZWg^aZhZ^ojgZ![daadl^c\VWadlid
i]Z]ZVYsee p.307!dgVhVgZhjaid[
bZY^XVi^dchjX]VhVci^]^hiVb^cZh#
>[ndjgX]^aY^hYgdlhnWjiXdciZciZY!
^hZVi^c\lZaa!VcY]VhVcdgbVaWdYn
iZbeZgVijgZ!i]ZgZ^hcdXVjhZ[dgVaVgb0
ndjgX]^aY^hegdWVWan_jhi[ZZa^c\Va^iiaZ
haZZen#>[!]dlZkZg!ndjgX]^aYWZXdbZh
Ygdlhnl]^aZgZXdkZg^c\[gdbVc^c[ZXi^djh
Y^hZVhZhjX]VhbZVhaZhdgX]^X`ZcedmVcY
XdbeaV^chd[V]ZVYVX]ZVcYcZX`eV^c!i]^h
XdjaY^cY^XViZZcXZe]Va^i^hdgbZc^c\^i^h¸
Wdi]d[l]^X]VgZhZg^djhXdcY^i^dchVcY
gZfj^gZ^bbZY^ViZbZY^XVaViiZci^dc#
What to do 8]ZX`ndjgX]^aY¼hWdYn
iZbeZgVijgZ#>[^i¼hdkZg&%%#)•;(-•8!]Z
]VhV[ZkZg0^[^i^hjcYZg.*•;(*•8!]Z^h
hj[[Zg^c\[gdb]nedi]Zgb^V#>cZ^i]ZgXVhZ!
hZZ`bZY^XVaVYk^XZ#
>[i]ZYgdlh^cZhh^hVXXdbeVc^ZYWn
Y^Vgg]ZVVcYkdb^i^c\!`ZZejendjg
MEDICAL INDEX 325
X]^aY¼h[aj^Y^ciV`ZidegZkZcii]Zg^h`d[
YZ]nYgVi^dc#>[]^hXdcY^i^dcYdZhcdi
^begdkZ!hZZ`bZY^XVaVYk^XZ#
8]ZX`idhZZ^[ndjgX]^aY]VhgZXZ^kZY
VWadlidi]Z]ZVY0Vh`^[ndjgX]^aY]VhV
]ZVYVX]ZdgcZX`VX]Z0hbZaandjgX]^aY¼h
WgZVi]VcYX]ZX`i]Za^fjdgXVW^cZi¸]Z
bVn]VkZYgjc`VaXd]da#8]ZX`i]Z
bZY^X^cZXVW^cZi[dghaZZe"^cYjX^c\Ygj\h#
>cVcnd[i]ZhZXVhZh!hZZ`bZY^XVaVYk^XZ#
>[ndjgX]^aY]Vh]VYVhZ^ojgZ!aZi]^b
gZhiV[iZgi]ZhZ^ojgZ]VheVhhZYVcYhZZ`
bZY^XVaVYk^XZ#
N Earache
I]ZbV^cgZVhdci]ViZVgVX]Z^hVXdbbdc
V^abZci^cWVW^ZhVcYndjc\X]^aYgZc^hi]Z
VcVidbnd[i]ZZVg#I]^c`d[i]ZZVgVh
ildhZXi^dchhZeVgViZYWnVbZbWgVcZ!
i]ZZVgYgjb#I]Z[^ghihZXi^dc^hVeVhhV\Z
aZVY^c\[gdbi]ZdeZc^c\d[i]ZZVgidi]Z
ZVgYgjb#I]^h^hi]ZVjY^idgnXVcVa#I]Z
hZXdcYhZXi^dc!WZ]^cYi]ZZVgYgjb!^hi]Z
b^YYaZZVg#>c[aVbbVi^dcd[i]ZdjiZgZVg^h
XVaaZYdi^i^hZmiZgcV0^c[aVbbVi^dcd[i]Z
b^YYaZZVg^hXVaaZYdi^i^hbZY^V#I]Z
:jhiVX]^VcijWZh!l]^X]VgZh]dgiVcYl^YZ
^cndjc\X]^aYgZc!a^c`i]Zb^YYaZZVgid
i]ZWVX`d[i]Zi]gdVi#I]ZejgedhZd[i]Z
ijWZh^hidZfjVa^oZegZhhjgZ^ci]ZZVgh!
Wjii]ZnVgZd[iZci]ZhdjgXZd[ZVg
egdWaZbh^cndjc\X]^aYgZc#
Di^i^hbZY^V^hi]ZbdhiXdbbdcZVg
V^abZciWdi]WZXVjhZd[i]ZXdchigjXi^dc
d[i]Z:jhiVX]^VcijWZhVcYWZXVjhZ
WVW^ZhheZcYbdhid[i]Z^gi^bZan^c\
Ydlc#I]ZXdbW^cVi^dcd[i]ZhZild
[VXidghbV`Zh^ibjX]ZVh^Zg[dgWVXiZg^Vid
igVkZa[gdbi]ZcdhZVcYi]gdVihigV^\]iid
i]Zb^YYaZZVg#>c[aVbbVi^dcd[i]ZbjXjh
bZbWgVcZd[i]Z:jhiVX]^VcijWZhXVjhZh
326 HOME MEDICINE
i]ZbidWZXdbZWadX`ZY#I]^higVehi]Z
WVXiZg^V^ci]Zb^YYaZZVg!l]ZgZi]Zn
bjai^ean#DWk^djhan!VkZgnndjc\X]^aY
XVccdiiZaandji]Vi]^hZVg]jgih!Wji^[]Z
]Vh^cZmea^XVWaZ[ZkZg!kdb^i^c\!Y^Vgg]ZV!
VcYadhhd[VeeZi^iZ!VcYXZgiV^can^[]Z
ejaahVi]^hZVg!ndjbVnWZg^\]iidhjheZXi
i]Vi]^hZVghVgZigdjWa^c\]^b#
What to do HZZ`bZY^XVaVYk^XZ^[ndj
hjheZXindjgX]^aY]VhZVgVX]Z#=Zl^aa
cZZYidWZZmVb^cZYidXdc[^gbi]Z
Y^V\cdh^hVcY!^[i]ZXVjhZ^hdi^i^hbZY^V!
ndjgYdXidgbVngZXdbbZcY
VXZiVb^cde]Zc[dgi]ZeV^c!VcYedhh^Wan
cVhVaYgdehidXaZVgi]ZjeeZgV^glVnh#>[
i]ZeV^c]Vh\dcZdc[dgbdgZi]Vc')
]djgh!ndjgX]^aYbVncZZYVci^W^di^Xh#
CZkZg!ZkZgejiVcni]^c\^cidndjg
WVWn¼hZVgh!VcYYdc¼iVeean]di
XdbegZhhZhidi]Zdjih^YZd[i]ZZVg#
H^b^aVgan!^[i]ZXVjhZd[i]ZZVgVX]Z^hV
Wd^adghdbZi]^c\ZahZ^ci]ZdjiZgZVg!
Ydc¼iigZVi^indjghZa[#HZZ`bZY^XVaVYk^XZ#
N Eczema
>c[Vci^aZZXoZbVd[iZc\dZh]VcY^c]VcY
l^i]Vhi]bV!VcYi]ZildVgZXdbbdcan
hZZcid\Zi]Zg#:XoZbVegdYjXZhV
\ZcZgVa^oZYgVh]dci]Z[VXZ!WZ]^cYi]Z
`cZZh!VcYdci]Z^ccZgh^YZd[i]ZVgbh
VcYlg^hih#I]ZgVh]^hjhjVaan^iX]n!Ygn!
gZY!VcYhXVan0^c^ihldghihiViZ!^iXVc
lZZefj^iZegd[jhZan#Ndjl^aacdi^XZ
i]Vii]ZZXoZbVlVmZhVcYlVcZh#>ibVn
WZWgdj\]idcWnVXdaYdg^[i]ZWVWn]Vh
]VYVhaZZeaZhhc^\]idgVijbbnjehZi#
D[iZcVhi]bVdgdi]ZgVaaZg\^X
XdcY^i^dchbVngjci]gdj\]djii]Z
[Vb^an!hdndjbVn[^cYi]ViVgZaVi^kZ
]VheZc^X^aa^chZch^i^k^in!Vcdi]Zg]Vh
Vhi]bV!Vcdi]Zg]VhZXoZbV!Vcdi]Zg
]Vh]Vn[ZkZg#
What to do Ndj¼aacZZYidhZZ`bZY^XVa
VYk^XZ[dgndjgX]^aYVcYndjbVnWZ
gZ[ZggZYidVh`^cheZX^Va^hi^[i]ZZXoZbV
^hY^[[^XjaiidigZVi#
I]Zhidgndc^c[Vci^aZZXoZbV^hgVi]Zg
\ddY/bVcnX]^aYgZc^begdkZWni]ZV\Zd[
ild!VcYbVcnbdgZYdhdWni]ZV\Zd[
hZkZc#JhjVaan^il^aa]VkZY^hVeeZVgZYWn
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edhh^W^a^ind[ZXoZbV[aVg^c\je^caViZga^[Z
^[]Zh]djaYhj[[ZghZkZgZbZciVadg
e]nh^XVaigVjbV#
;dgi]ZZkZgnYVnXVgZd[VWVWnl^i]
ZXoZbVd[i]Zh`^c!>ldjaYhj\\Zhii]Z
[daadl^c\/Vkd^YdkZgWVi]^c\!h^cXZhdVe
VcYlViZgVgZYZ]nYgVi^c\#>chiZVY!jhZ
WVWnadi^dcdcXdiidcWVaah!l]^X]l^aaYd
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EVnViiZci^dcidXaZVca^cZhh!eVgi^XjaVgan
VgdjcYi]ZY^VeZgVgZVVcY[VXZ#9gZhh
ndjgX]^aYl^i]XdiidccZmiidi]Zh`^cVi
Vaai^bZhVcYVkd^YlddaVh^iXVcWZ
^gg^iVi^c\VcYbV`Zi]ZZXoZbVldghZ#
GjW^chd[i!WaVcYXgZVbhVcYd^cibZcih
ZmVXianVhegZhXg^WZY#
N Epilepsy
6[iZg[ZWg^aZhZ^ojgZh!i]ZcZmibdhi
XdbbdcXVjhZd[hZ^ojgZh^cX]^aYgZc^h
Ze^aZehn#:e^aZehnXVciV`Zild[dgbh/
VWhZcXZhZ^ojgZhVcY\ZcZgVahZ^ojgZh#
L^i]VcVWhZcXZhZ^ojgZndjgX]^aY
hjYYZcan¹WaVc`hdjiº[dgVXdjeaZd[
hZXdcYhVcYadd`hkZgneVaZVcYkVXVci#
=Zldc¼i[VaaYdlcdgWZXdbZ^cXdci^cZci
Wji]Z¼aaWZXdbeaZiZanjcVlVgZd[]^h
hjggdjcY^c\h#L]Zc]ZhcVehdjid[^i
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6X]^aYhj[[Zg^c\[gdbV\ZcZgVadg\gVcY
bVahZ^ojgZ!l^aa]VkZh^b^aVghnbeidbhid
[ZWg^aZhZ^ojgZhsee p.332#
What to do Ndjh]djaYYZVal^i]
Ze^aZei^XhZ^ojgZh^ci]ZhVbZlVnVh[ZWg^aZ
hZ^ojgZhsee p.332!i]ZchZZ`bZY^XVa
VYk^XZ#NdjgX]^aYbVn]VkZiZhihidVhhZhh
i]Za^`Za^]ddYd[i]ZhZ^ojgZhgZXjgg^c\!VcY
l^aai]ZcgZXZ^kZbZY^XVaigZVibZci#
>i^hehnX]dad\^XVaan^cVYk^hVWaZidigZVi
X]^aYgZchj[[Zg^c\[gdbZe^aZehnVh
¹Ze^aZei^X#ºIgZVindjgX]^aYVhndj
cdgbVaanYd!WjiiV`ZXZgiV^cegZXVji^dch¸
aZVkZi]ZWVi]gddbYddgdeZc^cXVhZVc
ViiVX`dXXjgh^ci]ZWVi]ijWVcY`ZZeV
XadhZZnZdc]^bl]Zc]Z¼hhl^bb^c\#
N Eye discharge
6hi^X`nZnZ^h[V^ganXdbbdc^ci]Z[^ghi
lZZ`dghdV[iZgndjgWVWn^hWdgcVcY^i
^hcZVganValVnhXVjhZYWnVa^iiaZWaddYdg
Vbc^di^X[aj^Y\Zii^c\^cidi]ZWVWn¼hZnZ
Yjg^c\W^gi]#
What to do I]ZgZ^hValVnhi]Zedhh^W^a^in
i]Vii]Zhi^X`nZnZ^hXVjhZYWnVWVXiZg^Va
^c[ZXi^dc!hdhZZ`bZY^XVaVYk^XZ_jhi^c
XVhZ#=dlZkZg!jhjVaanVaai]Vi^hcZZYZY^h
XVgZ[jaXaZVch^c\l^i]VXaZVcXdiidcWVaah
hdV`ZY^chiZg^aZlViZg#L]ZcndjlVh]
ndjgWVWn¼hZnZ!ndjh]djaYValVnhYgVl
i]ZhlVW[gdbi]Z^ch^YZXdgcZg!cZVgi]Z
cdhZ!idi]ZdjiZgXdgcZg!VcYi]Zci]gdl
^iVlVn#>i¼h^bedgiVciidjhZVhZeVgViZ
hlVW[dgZVX]ZnZ#
N Fever
I]ZgVc\Zd[cdgbVaWdYniZbeZgVijgZ^h
.+#-·.-#+•;(+·(,•8#6cni]^c\dkZg
&%%#)•;(-•8^hV[ZkZg!Vai]dj\]i]Z
MEDICAL INDEX 327
]Z^\]iViZbeZgVijgZgZVX]Zh^hcdi
cZXZhhVg^anVcVXXjgViZgZ[aZXi^dcd[i]Z
hZg^djhcZhhd[i]Zh^X`cZhh#6[ZkZg^hcdi
^c^ihZa[Vc^aacZhhWjiVhnbeidbd[dcZ#
6eVgi[gdbVcn^aacZhh!ndjgX]^aY¼h
iZbeZgVijgZl^aagZ[aZXii]Zi^bZd[YVn
VcYVXi^k^inaZkZa/6[iZgVhigZcjdjh\VbZ
d[hdXXZg![dgZmVbeaZ!i]ZiZbeZgVijgZ
XdjaYiZbedgVg^anWZdkZg&%%#)•;(-•8#
6iZbeZgVijgZd[dkZg&%%#)•;(-•8
XdjaYWZhZg^djh^cVWVWnjcYZgh^m
bdci]hdaY#>[i]ZiZbeZgVijgZgZbV^ch
]^\]!i]ZgZ^hVahdVha^\]ig^h`d[V[ZWg^aZ
hZ^ojgZsee p.332#
What to do >[ndjhjheZXii]VindjgX]^aY
]VhV[ZkZg!iV`Z]^hiZbeZgVijgZ!i]Zc
X]ZX`^iV\V^c^c'%b^cjiZhidhZZ^[^i]Vh
kVg^ZY#Lg^iZYdlcZVX]gZVY^c\#
EjindjgX]^aYidWZYVcYgZbdkZbdhi
d[]^hXadi]^c\!ZkZc^[i]Zgddb^hXdda#
6X]^aYl^i]V[ZkZgcZZYhidWZXdkZgZY
dcanWnVa^\]iXdiidch]ZZi#<^kZX]^aYgZc¼h
a^fj^YVXZiVb^cde]Zc^ci]ZgZXdbbZcYZY
YdhZid]ZaeWg^c\Ydlci]ZiZbeZgVijgZ#
>[i]ZiZbeZgVijgZ^h]^\]!\^kZVaiZgcViZ
YdhZhd[VXZiVb^cde]ZcVcY^Wjegd[Zcid
gZYjXZ^c[ZkZgVcYi]ZcidXdcigdai]Z
iZbeZgVijgZ#CZkZg\^kZVhe^g^cidVX]^aY
jcYZg&+nZVghd[V\ZVh^i]VhWZZca^c`ZY
idi]ZYZkZadebZcid[GZnZ¼hhncYgdbZ#
:cXdjgV\ZndjgX]^aYidYg^c`VhbjX]
a^fj^YVhedhh^WaZWnd[[Zg^c\]^bhbVaa
Vbdjcihd[[aj^YVigZ\jaVg^ciZgkVah#6h`
[dgbZY^XVaVYk^XZegdbeian^[/ndjgX]^aY^h
jcYZgh^mbdci]hdaY0ndjgX]^aY]VhV
hZ^ojgZ0]Z]Vh]VYVhZ^ojgZWZ[dgZdg
hZ^ojgZhgjc^ci]Z[Vb^an0ndjgWVWn]Vh
V[ZkZgi]ViaVhihbdgZi]Vc')]djghdg
i]gZZYVnh^cVX]^aY0ndjVgZldgg^ZY
VWdjiVcnd[i]Zdi]Zghnbeidbh#
328 HOME MEDICINE
N Fingers caught in door
Jci^andjgWVWnaZVgch]dlYddghldg`!
i]ZgZ¼hValVnhi]Zg^h`i]Vi]^h[^c\ZghbVn
WZXdbZigVeeZY#
What to do >[i]Zh`^c^hWVYanWgd`Zc
VcYi]ZgZ^hVcnhZg^djhWaZZY^c\!iV`Zndjg
X]^aYidi]ZcZVgZhiZbZg\ZcXngddb
^bbZY^ViZan#>[i]Z[^c\Zg^hWaZZY^c\
egd[jhZan!egZhhdci]ZeaVXZl]ZgZ^i^h
WaZZY^c\VcY]daYndjgX]^aY¼h]VcYje^c
i]ZV^g#L]Zci]ZWaZZY^c\hideh!ejidcV
Ygn!XaZVc!cdc[aj[[nYgZhh^c\^[edhh^WaZ
VcYejindjgX]^aY¼hVgb^cVha^c\[dgi]Z
ig^eidi]Z]dhe^iVa#
N Gluten sensitivity/celiac disease
I]^h^hVegdWaZbi]VidXXjghl]Zc\ajiZc
VegdiZ^cXdciV^cZY^cbdhiXZgZVah
ZmXZei[dgg^XZVcYXdgcYVbV\Zhi]Z
a^c^c\d[i]Z^ciZhi^cZh!l]^X]XVjhZhV
\ajiZchZch^i^k^in#Jcl^ii^c\an!i]ZgZ[dgZ!
ndjbVn[ZZYndjgWVWnl^i]VcVaaZg\Zc!
h^cXXZhdbZWVWnXZgZVahXdciV^c\ajiZc#
6X]^aYl^i]\ajiZchZch^i^k^in^c^i^Vaan
h]dlhV¹[V^ajgZidi]g^kZ#ºI]^hbZVch
i]Vii]ZX]^aYl^aaeZg]Vehcdi]VkZVh
bjX]ZcZg\nVhndj¼YZmeZXi!bVnWZV
a^iiaZhaZZen!VcYldc¼i\V^clZ^\]ifj^iZVh
fj^X`anVh]Zh]djaY#Ndjl^aaVahdcdi^XZ
i]Vii]ZhiddahVaiZgcViZWZilZZcV[Viin
Xdch^hiZcXn!hdi]Vil]Zcndjidignid
[ajh]i]ZbVlVni]Znldc¼i\d¸i]ZnhiVn
VcY[adVi¸VcYaddhZhiddah#I]^h^hWZXVjhZ
i]ZVaaZg\^XgZVXi^dc^ci]Za^c^c\d[i]Z
WdlZaegZkZcihi]ZXdggZXiY^\Zhi^dcVcY
VWhdgei^dcd[[ViinhjWhiVcXZh#NdjgX]^aY
bVn]VkZ[gZfjZciWdjihd[Y^Vgg]ZVVcY
WZeVaZVcY^gg^iVWaZVadid[i]Zi^bZ#=Z
l^aaVahd]VkZVWYdb^cVaY^hiZch^dcVcY
kdb^i^c\#>[i]^hXdcY^i^dc\dZh
jcY^V\cdhZY^cndjc\\^gah^iXVcaZVYid
VYZaVn^ci]ZdchZid[bZchigjVi^dc#
>c^ihkZgnVYkVcXZYhiV\Z!\ajiZc
hZch^i^k^in!dgXZa^VXY^hZVhZ!egdYjXZh
VWcdgbVaWdYnXdc[^\jgVi^dc#I]Z
VWYdbZcWZXdbZhY^hiZcYZYl^i]]VgYan
Vcn[Vidci]Za^bWhdgWdYn!i]ZbjhXaZh
d[i]ZaZ\hVcYVgbhWZXdbZlVhiZY!i]Z
idc\jZWZXdbZhhbddi]!VcYi]ZgZbVn
WZhlZaa^c\d[i]ZVc`aZh#I]Z]V^gl^aaWZ
i]^c#=dlZkZg!\ajiZchZch^i^k^in^hcdikZgn
XdbbdcVcYi]Z[VXii]Vi^i^hXVjhZYWnV
kZgnXdbbdc[ddYhij[[h]djaYcdibV`Z
ndjjccZXZhhVg^anlVgndgdkZgVcm^djh
VWdjindjgX]^aY¼hY^Zi#
What to do DcXZVY^V\cdh^h]VhWZZc
bVYZ!ndjgX]^aY]VhidWZ\^kZcV\ajiZc"
[gZZY^Zi!l]^X]bZVchi]Vil]ZVi!gnZ!
WVgaZn!VcYdVihl^aa]VkZidWZZmXajYZY#
NdjgX]^aYl^aa]VkZidgZbV^cdcV\ajiZc"
[gZZY^Zi[dga^[Z#
I]Z[^ghii]^c\i]Vindjl^aacdi^XZ^h
Vc^begdkZbZci^ci]ZbddYd[ndjgX]^aY#
I]^hjhjVaanVeeZVghl^i]^cV[ZlYVnh!VcY
^h[daadlZYWnV\gZVian^begdkZYVeeZi^iZ
VcYXdchZfjZcilZ^\]i\V^c#Ndjl^aai]Zc
cdi^XZVX]Vc\Z^ci]ZVeeZVgVcXZd[i]Z
hiddahVcYi]Z[gZfjZcXnd[WdlZa
bdkZbZcih!Vai]dj\]i]^hbVniV`ZlZZ`h#
6[iZgWZ^c\dcV\ajiZc"[gZZY^Zi[dgh^m
bdci]hidVnZVg!ndjgX]^aYh]djaYWZ
l^i]^ci]ZcdgbVagVc\Z[dglZ^\]i!
Vai]dj\]]^h]Z^\]il^aaiV`ZVWdjiild
nZVghidgZXdkZg#
N Hay fever
=Vn[ZkZg!dgVaaZg\^Xg]^c^i^h!^hh^b^aVg
idVhi]bVZmXZeii]Vii]ZVaaZg\^XgZVXi^dc
dXXjgh^ci]ZbjXjhbZbWgVcZhd[i]Z
cdhZVcYZnZa^Yh!cdii]ZX]Zhi#

I]ZXdcY^i^dc^hVahd`cdlcVhVaaZg\^X
g]^c^i^hVcYXVjhZhhcZZo^c\!VgjccncdhZ
l^i]XaZVgY^hX]Vg\Z!VcY^iX]n!lViZgn!
gZY"g^bbZYZnZh#>ibdhiandXXjgh^cheg^c\
VcYhjbbZgVcY^hjhjVaanXVjhZYWnV
gZVXi^dcideaVciedaaZc#=Vn[ZkZg^h
igdjWaZhdbZ!Wji^hcdijhjVaanhZg^djh#
What to do >[ndjgX]^aY^hhcZZo^c\Vadi!
X]ZX`]^hiZbeZgVijgZidbV`ZhjgZi]Vi
]Z^hc¼i^aal^i]Vc^c[ZXi^dchjX]Vh
^c[ajZcoVdgVXdbbdcXdaY#9^hXdjgV\Z
ndjgX]^aY[gdbgjWW^c\]^hZnZh0i]^hl^aa
bV`Zi]ZbldghZ#7Vi]Z]^hZnZhl^i]Xdda
lViZgidZVhZi]Z^gg^iVi^dc#HZZ`bZY^XVa
VYk^XZVhhddcVhedhh^WaZ^[ndji]^c`ndjg
X]^aYbVnWZhj[[Zg^c\[gdbVbdgZhZg^djh
^c[ZXi^dc!dg^[i]Z]Vn[ZkZg^hbV`^c\ndjg
X]^aYb^hZgVWaZ#>[ndjgX]^aY¼hXdcY^i^dc^h
hZkZgZ!]ZbVncZZYidhZZVcVaaZg\^hiVcY
]VkZVhZg^Zhd[iZhihidigVX`Ydlci]Z
VaaZg\Zci]Vi^hXVjh^c\]^hhnbeidbh#
I]ZgZVgZkVg^djhbZVhjgZhndjXVc
iV`Zidignidb^c^b^oZi]ZhZkZg^ind[
ViiVX`h#LViX]i]ZedaaZcXdjciZVX]YVn
VcY!^[^i^h]^\]!Y^hXdjgV\ZndjgX]^aY
[gdbeaVn^c\cZVg[gZh]anbdlc\gVhh![dg
ZmVbeaZ#JhZhnci]Zi^Xhij[[^c\[dgndjg
X]^aY¼he^aadlhVcYYjkZi!gVi]Zgi]Vc
[ZVi]Zgh#@ZZendjg]djhZVhYjhi"[gZZVh
edhh^WaZ#:kZc^[ndjgX]^aY^hc¼iVaaZg\^Xid
Yjhi!VYjhinVibdhe]ZgZValVnhbV`Zh
]Vn[ZkZgldghZ#
EgZeVgZVcZbZg\ZcXneVX`[dgdji^c\h#
>ih]djaYXdciV^ceVeZgcVe`^ch!ZnZYgdeh
idgZYjXZi]ZZnZ^gg^iVi^dc!Vbd^hiidlZa
idhddi]ZndjgX]^aY¼hZnZh!VcYl]ViZkZg
bZY^XVi^dc]VhWZZcegZhXg^WZY#Ndjg
YdXidgbVnWZegZhXg^WZVhiZgd^YcVhVa
hegVndgVcdgVaVci^]^hiVb^cZid]Zae
gZa^ZkZi]ZXdcY^i^dc#
MEDICAL INDEX 329
N Hives (see Urticaria)
N 
Infectious fevers (TFF
Q)
N Measles
I]^h^hV]^\]an^c[ZXi^djhY^hZVhZ0^iXVc
Vahd]VkZfj^iZhZg^djhXdbea^XVi^dch!
cVbZanecZjbdc^Vsee p.331VcY
bZc^c\^i^hsee p.330#NdjgX]^aY^hbdhi
a^`ZanidXViX]i]ZY^hZVhZWZilZZci]Z
V\Zhd[dcZVcYh^m0^iiV`Zh^ihbdhi
hZg^djh[dgbjcYZgi]ZV\Zd[i]gZZ#
>i\ZcZgVaaniV`ZhiZcid[djgiZZcYVnh
[dgi]Zhnbeidbhd[bZVhaZhidVeeZVg
V[iZgndjgX]^aY]VhWZZc^c[ZXiZY#I]Z[^ghi
hnbeidbhVgZh^b^aVgidi]Vid[VcdgbVa
XdaY¸gjccncdhZ!V]dVghZXdj\]!VcYV
[ZkZg#;dgi]Z[^ghiildYVnhi]Z
iZbeZgVijgZl^aaWZVWdji&%%#)·&%'•;
(-·(.•8#>ibVn[VaaWg^Z[anWZ[dgZ
WZXdb^c\Vh]^\]Vh&%)•;)%•8#>i¼hVi
i]^hhiV\Zi]Vii]ZgVh]\ZcZgVaanhiVgihVh
Wgdlc^h]"gZYhedihWZ]^cYi]ZZVgh!VcY
i]ZchegZVYhidi]Z[VXZVcYi]ZgZhid[
i]ZWdYn#I]ZgZbVnWZhbVaagZYhedih!
ZVX]l^i]Vl]^iZXZciZg^ci]Zbdji]
@dea^`¼hhedihWZ[dgZi]ZgVh]hiVgih#Ndjg
WVWn¼hZnZhbVnWZXdbZgZYVcYhdgZ#
6iVgdjcYi]ZV\Zd[&(bdci]hndjg
X]^aYl^aaWZ^bbjc^oZYV\V^chibZVhaZh
l]Zc]Z]Vh]^hBBGbZVhaZh!bjbeh!
VcYgjWZaaV^bbjc^oVi^dcsee p.339#
What to do Add`^ci]ZX]^aY¼hbdji][dg
h^\chd[@dea^`¼hhedih#6h`[dgbZY^XVa
VYk^XZidXdc[^gbbZVhaZh#L]^aZndjgX]^aY
]VhV[ZkZg![daadli]Z\ZcZgVa^chigjXi^dch
[dgXde^c\l^i]]^\]iZbeZgVijgZhsee
p.315#7Vi]Z]^hhdgZZnZhl^i]aj`ZlVgb
lViZgVcYY^bi]Za^\]ih^[i]VibV`Zh]^b
bdgZXdb[dgiVWaZ#=ZegdWVWanldc¼iWZ
330 HOME MEDICINE
kZgn]jc\gnl]Zc]Z¼h[ZkZg^h]!Wji
bV`ZhjgZi]Vi]ZYg^c`hVYZfjViZ
Vbdjcihd[a^fj^YWnegdk^Y^c\hbVaaWji
[gZfjZciYg^c`h#HZZ`bZY^XVaVYk^XZ
^bbZY^ViZan^[ndjgX]^aY]VhVcnd[i]Z
[daadl^c\/V]^\]iZbeZgVijgZ[djgYVnh
V[iZgi]ZgVh]]VhVeeZVgZY0ZVgVX]Zdg
aVWdgZYWgZVi]^c\0Ve]aZ\bnXdj\]0dg
^[]ZWZXdbZhhZb^"XdchX^djh#
N Meningitis
6c^c[aVbbVi^dcd[i]ZbZc^c\Zh!i]Z
bZbWgVcZi]VihjggdjcYhi]ZWgV^cVcY
he^cVaXdgY!bZc^c\^i^h^hXVjhZYWnk^gVadg!
bjX]bdgZhZg^djhan!WVXiZg^Va^c[ZXi^dc#
I]Z^aacZhhhiVgihl^i][aj"a^`Zhnbeidbh!
]^\]iZbeZgVijgZ!bdiiaZYh`^c!a^bWeV^c!
VcYXdaY]VcYhVcY[ZZi#6hi]Z^c[ZXi^dc
YZkZadeh!i]ZX]^aYl^aa]VkZV]ZVYVX]Z!
hi^[[cZX`!hZch^i^k^inidWg^\]ia^\]i!
^cXgZVh^c\Ygdlh^cZhh!VcYkdb^i^c\#
7VXiZg^VabZc^c\^i^hbVnVahdaZVYidVgVh]
i]ViYdZhcdi[VYZl]ZcegZhhZY#8]ZX`
i]^hWnegZhh^c\V\aVhhdcidi]ZgVh]#>[^i
^hXVjhZYWnbZc^c\dXdXXjhi]ZhbVaa
ejgea^h]"gZYhedihl^aacdiY^hVeeZVg#
What to do BZc^c\^i^h^ha^[Z"i]gZViZc^c\
VcYi]ZY^hZVhZXVcYZkZadekZgnfj^X`an!
hd^icZZYhjg\ZciVXi^dc#>[ndjhjheZXi
bZc^c\^i^h!WZegZeVgZYid^ch^hidcjg\Zci
bZY^XVaViiZci^dc#IV`ZndjgX]^aYidi]Z
cZVgZhiZbZg\ZcXngddbd[i]ZcZVgZhi
]dhe^iVadgXVaa.&&[dgVcVbWjaVcXZ#
BZc^c\^i^h^hXdc[^gbZYWniV`^c\V
hVbeaZd[XZgZWgd"he^cVa[aj^Yi]gdj\]V
ajbWVgejcXijgZ#NdjgX]^aYl^aaWZ
igZViZY^ci]Z]dhe^iVa!VcY!^ci]ZXVhZ
d[WVXiZg^VabZc^c\^i^h!VaaXadhZXdciVXih
l^aaVahdWZigZViZYidegZkZci[jgi]Zg
hegZVYd[i]ZY^hZVhZ#
N Mumps
I]^hY^hZVhZ^hjcXdbbdcYjZid\ddY
kVXX^cVi^dcgViZhsee p.340#>ijhjVaan
iV`Zh&+id'&YVnh[dgi]Zhnbeidbhid
VeeZVgV[iZg^c[ZXi^dc#L]Zci]Z^c[ZXi^dc
YdZhdXXjg!ndjbVn[^ghicdi^XZi]Vindjg
X]^aYhZZbhjcYZgi]ZlZVi]Zg#I]Z
edh^i^kZhnbeidbl^aaWZ^[i]Z\aVcYhhlZaa
je^c[gdcid[VcYjcYZgi]ZZVgdcdcZdg
Wdi]h^YZhd[ndjgX]^aY¼h[VXZ#I]^hhlZaa^c\
l^aaWZVXXdbeVc^ZYWn[ZkZgVcYi]Z
\aVcYhl^aaWZiZcYZg#
What to do 6h`[dgbZY^XVaVYk^XZid
Xdc[^gbi]ZY^V\cdh^h#6ai]dj\]i]ZgZ¼hcd
heZX^[^XigZVibZci!ndjXVcYdVadiid
bV`ZndjgX]^aYbdgZXdb[dgiVWaZ#GZYjXZ
]^h[ZkZgjh^c\i]ZgZXdbbZcYZYYdhZd[
X]^aYgZc¼hVXZiVb^cde]Zcsee p.327#
D[[Zga^fj^Y[ddYh^[]Z[^cYh^iY^[[^Xjaiid
X]Zl!VcYeaZcinidYg^c`#6iVgdjcYi]Z
V\Zd[&(bdci]hndjgX]^aYl^aaWZ
^bbjc^oZYV\V^chibjbehl]Zc]Z]Vh
]^hBBGbZVhaZh!bjbeh!VcYgjWZaaV
^bbjc^oVi^dcsee p.339#
N Nettle rash (see Urticaria)
N Nosebleeds
=Zbdgg]V\^c\[gdbi]ZcdhZ!dg
cdhZWaZZYh!VgZbdhid[iZcXVjhZYWn
YVbV\ZidVeViX]d[hbVaaWaddYkZhhZah
an^c\kZgncZVgi]Zhjg[VXZd[i]Zh`^c_jhi
^ch^YZi]ZcdhZ#CdhZWaZZYhVgZjhjVaan
XVjhZYWnVWadldg^c_jgnidi]ZcdhZ
Yjg^c\gdj\]\VbZh!dgh^beanWZXVjhZ
ndjgX]^aYeZgh^hiZciane^X`h]^hcdhZ#
What to do I]^hhbVaaeViX]d[WaddY
kZhhZahXVcWaZZYVadi!WjiigncdiideVc^X#
CZkZgi^endjgX]^aY¼h]ZVYWVX`!WZXVjhZ

WaddYi]Vi^hhlVaadlZYXVc^gg^iViZi]Z
hidbVX]VcYXVjhZkdb^i^c\#I]^h^cXgZVhZh
i]ZWaddYegZhhjgZ^ci]Z]ZVYVcYXgZViZh
ViZcYZcXn[dgi]ZcdhZidWaZZYV\V^c#
6eean\ZciaZegZhhjgZl^i]ndjgi]jbW
VcY[^ghi[^c\ZgdcZ^i]Zgh^YZd[i]ZcdhZ
jci^ai]ZWaZZY^c\]VhhideeZY#I]^hl^aa
"^cX]+"b^aa^bZiZg
jhjVaan]VeeZc^cilddgi]gZZb^cjiZh#>[
cdhZWaZZYhdXXjg[gZfjZcianhZZ`bZY^XVa
VYk^XZ#NdjgX]^aYbVnWZgZ[ZggZYidV
heZX^Va^hi[dgXVjiZg^oVi^dcd[i]ZYZa^XViZ
VgZVh^ch^YZi]ZcdhZ#
N Pertussis (whooping cough)
A^`ZbdhiX]^aY]ddY^aacZhhZh!l]dde^c\
Xdj\]hiVgihd[[l^i]VXdj\]!Vgjccn
cdhZ!VcYVha^\]iiZbeZgVijgZ#I]^heZg^dY
XVcaVhi[dgjeidildlZZ`h#I]^hl^aaWZ
[daadlZYWnhZkZgZ!eVgdmnhbVaXdj\]^c\
l]ZcndjgX]^aYl^aa]VkZY^[[^XjainYgVl^c\
WgZVi]#I]^h^hl]Zci]ZX]VgVXiZg^hi^X
¹l]ddeºdXXjgh#7gZVi]^c\Y^[[^Xjai^ZhVgZ
ZkZc\gZViZg[dgWVW^Zh!l]dbVncdi
YZkZadei]ZiZX]c^fjZd[l]dde^c\id\Zi
V^g^cidi]Zajc\h#
What to do 6h`[dgbZY^XVaVYk^XZ#
6ci^W^di^XhVgZZ[[ZXi^kZ^ci]ZgjccncdhZ
hiV\Z#EZdeaZl]d¼kZWZZc^cXadhZXdciVXi
l^i]i]Z^c[ZXiZYX]^aYbVnWZegdiZXiZY
[gdbl]dde^c\Xdj\]^[\^kZcVci^W^di^Xh
Yjg^c\i]Z^cXjWVi^dceZg^dY#L]Zcndjg
X]^aYhiVgihdcVXdj\]^c\Wdji!]daY
]^b[^gbanVcYignidXVab]^bYdlc#
>[]Z¼hiZchZ]Z¼aa[^cY^iZkZcbdgZY^[[^Xjai
idXViX]]^hWgZVi]#Hjeedgi]^b^cV
h^ii^c\edh^i^dcidbV`ZWgZVi]^c\ZVh^Zg#
:Vi^c\bVnegdkd`Zkdb^i^c\#Ign\^k^c\
hbVaaVbdjcihd[ZVh^anZViZc[ddY
bVh]ZY^[cZXZhhVgn^bbZY^ViZanV[iZg
VXdj\]^c\[^i#
MEDICAL INDEX 331
NdjgX]^aYl^aaWZkVXX^cViZYV\V^chi
l]dde^c\Xdj\]VheVgid[]^hgdji^cZ
^bbjc^oVi^dch#
N Pin worms
I]^h^hi]ZbdhiXdbbdcineZd[^c[ZXi^c\
ldgb#I]ZhZi]^c!
l]^iZldgbha^kZ^ci]ZgZXijbVcYi]Z
[ZbVaZhXgVlai]gdj\]i]ZVcjhidaVn
i]Z^gZ\\hdci]ZhjggdjcY^c\h`^c#I]^h
egdYjXZhi]ZXaVhh^Xhnbeidbhd[^iX]^c\!
ZheZX^VaanVic^\]i#L]ZcVX]^aYhXgViX]Zh
]^hWdiidb]ZbVne^X`jei]ZZ\\hjcYZg
]^h[^c\ZgcV^ah#>[]Zejih]^h]VcY^c]^h
bdji]!i]ZZ\\hl^aaWZ^c\ZhiZYV\V^c#
What to do >[ndjcdi^XZndjgX]^aY
hXgViX]^c\]^hWdiidb!ZheZX^VaanVic^\]i!
hVkZndjgX]^aY¼hhiddahVcYZmVb^cZi]Zb
[dgi]Zi]gZVYa^`Zldgbh#>[ndj[^cYi]Zb!
\ZibZY^XVaVYk^XZ#BZY^X^cZidZgVY^XViZ
i]Zldgbh^hVkV^aVWaZl^i]VegZhXg^ei^dc
[gdbndjgeZY^Vig^X^Vc#7ZXVjhZ^c[ZXi^dc
hegZVYhZVh^an!ZkZgndcZ^ci]Z[Vb^an
h]djaYWZ\^kZci]ZigZVibZci#@ZZendjg
X]^aY¼hcV^ahh]dgi!VcY^ch^hi]ZlVh]]^h
]VcYhV[iZg\d^c\idi]ZWVi]gddb#
N Pneumococcal infection
I]^h^hXVjhZYWnVhigV^cd[i]Z
streptococcus bacterium#>cbdhieZdeaZ
i]ZWVXiZg^jb^hXVgg^ZY^ci]ZcdhZVcY
i]gdVil^i]djiXVjh^c\Vcn]Vgb!Wji
^c[ZXi^dcXVcaZVYidbZc^c\^i^h!ZVg
^c[ZXi^dch!VcYecZjbdc^V!hd^i^h
ediZci^VaanhZg^djh^cndjc\X]^aYgZc#
What to do EcZjbdXdXXVa^c[ZXi^dch
XVcWZigZViZYl^i]Vci^W^di^Xh#7VW^ZhVgZ
cdlgdji^cZand[[ZgZYVkVXX^cVi^dcV\V^chi
ecZjbdXXVa^c[ZXi^dcsee p.339#
332 HOME MEDICINE
N Pneumonia
8dbbdcX]^aY]ddYk^gVa^c[ZXi^dchVcY
gVgZg^c[ZXi^djhY^hZVhZhhjX]VhbZVhaZh
VcYl]dde^c\Xdj\]bVnWZVXXdbeVc^ZY
WnecZjbdc^V#>ci]^hh^ijVi^dci]Z
^c[ZXi^c\dg\Vc^hbZciZghi]Zajc\hVcY
lZV`Zchi]Z^gYZ[ZchZh#I]ZWgdcX]^Va
ijWZhWZXdbZ^c[aVbZYVcYegdYjXZ
ZmXZhh^kZbjXjh!VcYajc\[jcXi^dcWZ\^ch
idYZiZg^dgViZhdi]Vii]Zajc\hXVc¼iZmeZa
i]ZbjXjh#>ii]Zc[dgbh^cida^iiaZeddah^c
i]Zajc\h!l]^X]WZXdbZ^c[ZXiZY#
I]Z^c^i^Vah^\chd[ecZjbdc^VVgZVc
^cXgZVhZYWgZVi]^c\gViZVcYY^[[^Xjain
WgZVi]^c\#7aj^h]XdadgVgdjcYi]Zbdji]
^cY^XViZhVcVYkVcXZYhiV\Z#L]Zcedda^c\
d[bjXjhdXXjgh^cVhbVaaV^geVhhV\Z!i]Z
YZZeZgeVgid[i]Zajc\WZndcYi]Z
WadX`V\ZWZXdbZhhZVaZYd[[#I]Z[aj^Y
bVnXdaaZXiidi]ZZmiZcii]Vi^igZcYZghV
a^iiaZhZXi^dcd[i]Zajc\XdbeaZiZanhda^Y0
i]^h^hVhbVaaVgZVd[ecZjbdc^V#>[V
aVg\ZgV^geVhhV\ZWZXdbZhWadX`ZYd[[!
i]ZVgZVd[ecZjbdc^VXVcWZZmiZch^kZ#
What to do >[ndjcdi^XZVcnd[i]Z
VWdkZh^\ch!hZZ`bZY^XVaVYk^XZ
^bbZY^ViZan#BZVcl]^aZ!hiVnXVabVcYign
i]Z[daadl^c\bZVhjgZhid]ZaendjgX]^aY/
`ZZei]ZV^gbd^hiWngjcc^c\VWVi]dgi]Z
h]dlZgVcYh^ii^c\^ci]ZWVi]gddbl^i]
]^b#BV`Z]^b[ZZaXdb[dgiVWaZVcY
hZXjgZ#IgnidhjeedgindjgX]^aY^cVc
jeg^\]iedh^i^dcidbV`ZWgZVi]^c\ZVh^Zg#
N Rashes
BdhigVh]Zh]VkZVc^ciZgcVaXVjhZVcY^c
ndjc\X]^aYgZci]ZnVgZVXaVhh^Xhnbeidb
d[hdbZd[i]ZbdgZXdbbdc^c[ZXi^djh
[ZkZghsee p.340#I]ZnbVnVahdWZi]Z
gZhjaid[VcVaaZg\n#
What to do GVh]ZhjhjVaan^ckdakZ
YVbV\Zidi]ZhbVaaWaddYkZhhZah^ci]Z
h`^cVcYi]ZgZ^hkZgna^iiaZndjXVcYdid
XdggZXii]^hWnVeean^c\Vcni]^c\idi]Z
h`^c¼hhjg[VXZ#=dlZkZg!ignidgZa^ZkZi]Z
hnbeidbhd[^iX]^c\VcYWjgc^c\Wn
Veean^c\VXdda^c\adi^dc!a^`ZXVaVb^cZ!
h^cXZegdadc\ZYhXgViX]^c\bVnWgZV`i]Z
h`^cVcY^cigdYjXZ^c[ZXi^dc#>i^hWZiiZg
cdiidjhZVci^"hi^c\dgVci^"WjgchegVnh
dcVgVh]WZXVjhZi]ZnbVnXdciV^cadXVa
VcZhi]Zi^Xhi]ViXVcig^\\ZgVaaZg\^X
gZVXi^dch^ci]Zh`^c#>[ndjVgZXdcXZgcZY
VWdjindjgX]^aY¼hgVh]!dg^[i]ZgVh]
WZXdbZh^c[ZXiZY!hZZ`bZY^XVaVYk^XZ#
N Roseola infantum
I]^hY^hZVhZ^hd[iZcXdc[jhZYl^i]gjWZaaV
see p.340#NdjgX]^aYl^aahjYYZcan\ZiV
]^\][ZkZgd[VWdji&%'•;(.•8l^i]dji
Vcndi]Zghnbeidbh#6hi]ZX]^aY¼h
iZbeZgVijgZgZijgchidcdgbVa!]Z¼aa
YZkZadeVgVh]d[eVaZgZYhedih#GdhZdaV
^c[Vcijb^hbdhiXdbbdc^cX]^aYgZc
jcYZgi]ZV\Zd[ild#
What to do HZZ`bZY^XVaVYk^XZid\Zi
VcVXXjgViZY^V\cdh^h#I]ZgZ^hcdheZX^[^X
igZVibZci^hcZZYZY!di]Zgi]Vc`ZZe^c\
i]Z[ZkZgYdlcsee p.315!VcYbV`^c\
hjgZi]VindjgX]^aY^hXdb[dgiVWaZ#
N Rubella (German measles)
I]^h^hVk^gVaY^hZVhZ!a^`ZbZVhaZh!VcY^h
cdlgVgZYjZid\ddYkVXX^cVi^dcgViZhsee
p.340#I]Z^c^i^VahnbeidbhgZhZbWaZV
b^aYXdaYl^i]VgjccncdhZ!VhdgZi]gdVi!
VcYViZbeZgVijgZd[a%%#)•;(-•8#I]Z
gVh]jhjVaanVeeZVghVXdjeaZd[YVnhV[iZg
ndjgX]^aYhiVgihid[ZZajclZaa#I]Zhedih!
l]^X]hiVgiWZ]^cYi]ZZVghVcYdci]Z

[dgZ]ZVYWZ[dgZbdk^c\Ydlcidi]ZWdYn!
VgZeVaZVcY[aViVcYVgZcdiVhXadhZ
id\Zi]ZgVhi]dhZ^cbZVhaZh#I]ZndcanaVhi
[dgildidi]gZZYVnh#I]Z\aVcYhdci]Z
WVX`d[ndjgX]^aY¼hcZX`l^aaVabdhi
YZ[^c^iZanWZhldaaZcVcYi]ZnbVnhiVna^`Z
i]^hV[iZgi]ZgVh]]Vh\dcZ#I]Zhnbeidbh
jhjVaanaVhiVWdjiiZcYVnh#
What to do <ZiVcVXXjgViZY^V\cdh^hhd
ndjXVccdi^[nVcnegZ\cVcildbVcl^i]
l]dbndjgX]^aY]VhWZZc^cXdciVXi0
^i¼hVahd^bedgiVci^cgZaVi^dcidedhh^WaZ
^bbjc^oVi^dcViejWZgin#I]Z^c[ZXi^dc^h
hdb^aYi]Vii]ZgZ^hcdi]^c\ndjXVcYd
di]Zgi]Vc`ZZendjgX]^aYXdb[dgiVWaZ
VcY\^kZ]^beaZcinidYg^c`#@ZZe]^b
^cYddghjci^ai]ZgVh]]VhWZZc\dcZ[dg
V[ZlYVnh#
6iVgdjcYi]ZV\Zd[&(bdci]hndjg
X]^aYl^aaWZ^bbjc^oZYV\V^chigjWZaaV
l]Zc]Z]Vh]^hBBGbZVhaZh!bjbeh!
VcYgjWZaaV^bbjc^oVi^dcsee p.339#
N Scarlet fever
6ahd`cdlcVhhXVgaVi^cV!i]^h^hVi]gdVi
^c[ZXi^dci]Vi^hXVjhZYWnVhigV^cd[
higZeidXdXXjhWVX^aajhi]Vi^hcdadc\Zg
Xdbbdc#>ihiVgihl^i]VhdgZi]gdViVcY
V[ZkZg!i]Zidch^ahWZXdbZhldaaZcVcY
^c[aVbZY!VcYndjgX]^aYbVn]VkZ
]ZVYVX]ZhVcYkdb^i#6[iZgVWdjii]gZZ
YVnh!VgVh]d[i^cnhedihbVnVeeZVg
VgdjcYi]ZcZX`VcY^ci]ZVgbe^ih!
hegZVY^c\dkZgi]Zl]daZWdYn#I]Z
idc\jZ¼hhjg[VXZbVnWZXdbZgZYVcY
hldaaZc!VcYadd`ha^`ZVhigVlWZggn#
What to do <ZibZY^XVaVYk^XZhdndj
]VkZVcVXXjgViZY^V\cdh^h#EZc^X^aa^c^h
i]ZVci^W^di^Xd[X]d^XZ[dgi]^hXdcY^i^dc
MEDICAL INDEX 333
egdk^YZYndjgX]^aY^hcdiVaaZg\^Xid^i#
Di]Zgi]Vci]^h!i]ZgZ^hcdi]^c\heZX^[^X
i]VindjXVcYdid]Zae!ZmXZeiidigZVi
i]Z[ZkZgVcYbV`ZhjgZndjgX]^aY]Vh
eaZcind[[aj^Yh#
N Seizures
>chdbZX]^aYgZclZcZkZgY^hXdkZgi]Z
XVjhZ[dghZ^ojgZh!Wji^ci]ZbV_dg^ind[
X]^aYgZcWZilZZci]ZV\Zhd[h^mbdci]h
VcY[^kZnZVghhZ^ojgZhVgZXVjhZYWnVg^hZ
^cWdYniZbeZgVijgZ#Ndjc\X]^aYgZc¼h
WgV^chVgZbdgZZVh^anV[[ZXiZYWni]^hi]Vc
VYjaih0i]Z^gg^iVi^dchi^bjaViZhi]ZcZgkZh
i]ViXdcigdai]ZbjhXaZh!l]^X]^cijgc
gZVXiWnXdcigVXi^c\k^daZcian#
L]Zc]Vk^c\VhZ^ojgZndjgX]^aYl^aa
WZXdbZjcXdchX^djhVcYl^aail^iX]
jcXdcigdaaVWan#=^hZnZhl^aagdaajeVcY
]ZbVn[gdi]Vii]Zbdji]ha^\]ian#=^h
WgZVi]^c\l^aaWZ]ZVknVcY]^hiZZi]l^aa
WZ[^gbanXaVbeZY0]ZbVnWZXdbZ
^cXdci^cZciYjg^c\i]ZhZ^ojgZ#L]Zci]Z
hZ^ojgZ^hdkZg!ndjgX]^aYl^aa[VaaVhaZZe¸
]ZbVnYg^[ihigV^\]i^cidhaZZe!VaiZgcViZan!
]ZbVnWg^Z[anlV`ZjeVcYi]Zc[Vaa^cid
VYZZehaZZe#
What to do CZkZgaZVkZndjgX]^aYVadcZ#
6ai]dj\]ndjbVnYZheZgViZanlVciid
XVaa[dg]ZaendjbjhihiVnWnndjgX]^aY
jci^ai]ZhZ^ojgZ^hdkZgidbV`ZhjgZ]Z
YdZhc¼i]jgi]^bhZa[#AddhZc]^hXadi]^c\
VcYgZbdkZVcncZVgWn[jgc^ijgZ^cXVhZ
]Z`^X`hdggdaahV\V^chi^i!WjiYdc¼iignid
gZhigV^c]^b#9dc¼iignideaVXZVcni]^c\
^c]^hbdji]#8dcigVgnidedejaVgWZa^Z[!
eZdeaZgVgZanW^iZdghlVaadli]Z^g
idc\jZhYjg^c\VhZ^ojgZVcYndjXdjaY
YdbdgZYVbV\ZWnign^c\idegndeZc]^h
_Vlh#DcXZi]ZhZ^ojgZ^hdkZg!eaVXZ]^b
334 HOME MEDICINE
^ci]ZgZXdkZgnedh^i^dcVcYXVaa[dg
bZY^XVa]Zae#
>[ndjgX]^aY]VhVhZ^ojgZd[i]^hhdgi!
ignidegZkZci]^\][ZkZgh[gdbdXXjgg^c\
^ci]Z[jijgZ#GZbdkZZmigVXadi]^c\VcY
WaVc`Zihl]Zc]Z\Zih]diVcY\^kZ]^b
gZ\jaVgYdhZhd[X]^aYgZc¼hVXZiVb^cde]Zc
VcY^Wjegd[Zc#6aiZgcViZi]Zild^cdgYZg
idWg^c\VgZYjXi^dc^c[ZkZgVcYi]ZcV
hiZVYnXdcigdad[i]ZiZbeZgVijgZ#
N Sleepwalking
6hdgid[¹bdW^aZYgZVb^c\!º
haZZelVa`^c\dXXjghl]ZcVX]^aY
lVcYZghVgdjcYi]Z]djhZl]^aZVhaZZe#
6haZZelVa`^c\X]^aYYdZhcdilVa`l^i]
]^hZnZhXadhZYVcY]^hVgbh]ZaYhigV^\]i
dji^c[gdcid[]^b#=^hZnZhl^aaWZdeZc
Wji]Zl^aaWZVhaZZe0]Zldc¼ihZZndj
VcYldc¼ijcYZghiVcYVcni]^c\ndjhVn
id]^b#BVcnX]^aYgZc\di]gdj\]Vh]dgi
e]VhZd[haZZelVa`^c\#
What to do >[ndj[^cYndjgX]^aY
haZZelVa`^c\!Ydc¼iignidVlV`Zc]^b#
AZVY]^bhadlanVcY\ZcianWVX`idWZY#
I]ZgZ^hcdcZZYid\ZibZY^XVaVYk^XZ
jcaZhhi]ZhaZZelVa`^c\^hkZgn[gZfjZci
VcYndjcZZYgZVhhjgVcXZi]Vicdi]^c\
^hhZg^djhanlgdc\#EgdiZXindjgX]^aY![dg
^chiVcXZ!Wnejii^c\VWVgg^ZgVii]Zide
d[i]ZhiV^glVnVic^\]ihd]ZXVc¼i[Vaa
Ydlci]ZhiV^gh!VcYWnbV`^c\hjgZi]Vi
cdl^cYdlhVgZaZ[ideZc#IgnidgZVhhjgZ
ndjgX]^aY^[ndji]^c`ndj`cdli]Z
jcYZgan^c\XVjhZd[i]ZhaZZelVa`^c\#
N Splinters
6aahea^ciZghXVggnVg^h`d[^c[ZXi^dc
WZXVjhZi]ZnVgZgVgZanXaZVc!hdi]Zn
h]djaYValVnhWZYZVail^i]egdbeian#
What to do JhjVaanVhea^ciZgXVcWZ
gZbdkZYl^i]ilZZoZgh#<ZcianXaZVc
VgdjcYi]Zhea^ciZgl^i]hdVeVcYlVgb
lViZg#<gVhei]Zhea^ciZgVcYYgVl^idji
Vii]ZhVbZVc\aZVh^ilZci^c#8aZVci]Z
VgZVVcYX]ZX`i]Vii]ZX]^aY]VhWZZc
^bbjc^oZYV\V^chiiZiVcjh#>[i]Zhea^ciZg
^hYZZeanZbWZYYZY!a^ZhdkZgV_d^ci!dg^h
Y^[[^XjaiidgZbdkZ!iV`ZndjgX]^aYidi]Z
ZbZg\ZcXngddb#
N Sprains
7ZXVjhZX]^aYgZcVgZhdVXi^kZVcYbVncdi
]VkZkZgn\ddYXddgY^cVi^dcl]Zcndjc\!
i]ZnXVchegV^ci]Z^glg^hihVcYVc`aZh
fj^iZZVh^an#>cVhegV^cVa^\VbZci^hd[iZc
higZiX]ZYdgidgc!VcYi]^hXVjhZhhlZaa^c\#
NdjgX]^aYldc¼ilVciidejiegZhhjgZdc
i]Z_d^ci!VcYl^aa[^cY^ieV^c[jaidbdkZ#
What to do I]ZWZhiigZVibZci[dgV
hegV^c^hgZhi0Vcn`^cYd[higV^cdci]Z
hegV^cZYeVgih]djaYWZVkd^YZY#NdjXVc
Vahd]ZaeWnejii^c\Vc^XZeVX`dci]Z
hegV^cZY_d^ciVcYZaZkVi^c\i]Za^bWid
gZYjXZhlZaa^c\VcYWgj^h^c\#I]Zc
hjggdjcYi]Z_d^cil^i]eVYY^c\VcYhZXjgZ
^il^i]VWVcYV\Z#8]ZX`i]ZX^gXjaVi^dc
WZndcYi]ZWVcYV\ZZkZgniZcb^cjiZhid
bV`ZhjgZi]Vii]ZWVcYV\Z^hc¼iiddi^\]i#
AddhZc^[cZXZhhVgn#
N Stings
>i¼hVabdhi^cZk^iVWaZi]VindjgX]^aYl^aaWZ
hijc\WnVWZZdglVheVihdbZhiV\Z!VcY
i]Vi]Z¼aaWZkZgnjehZil]Zc^i]VeeZch#
6lVhedgWZZhi^c\^hgVgZanhZg^djh!Wji^[
^iXVjhZhVcVaaZg\^XgZVXi^dc!^[ndjgX]^aY^h
hijc\^ci]Zbdji]!dg^[]Z^hhijc\WnV
cjbWZgd[^chZXih!Y^Va.&&[dgVc
VbWjaVcXZ^bbZY^ViZan#

What to do >[ndjgX]^aY]VhWZZchijc\!
YdcdiignidhfjZZoZi]Zhi^c\Vhi]^hbVn
hegZVYi]Z^gg^iVi^c\X]Zb^XVa^ci]Zhi^c\
^cidYZZeZgeVgihd[i]Zh`^c#>chiZVY!
hXgVeZ^id[[l^i]ndjgi]jbWcV^adgi]Z
h^YZd[VXgZY^iXVgY#9dc¼ijhZdkZg"i]Z"
XdjciZghi^c\egZeVgVi^dchi]ViXdciV^c
Vci^]^hiVb^cZh0i]ZnbVnXVjhZVcVaaZg\n
d[i]Zh`^cVcYVgZWZiiZgVkd^YZY#>[ndjg
X]^aY^hhijc\^c]^hbdji]!XVaa.&&[dgVc
VbWjaVcXZ#8dda]^hbdji]l^i]h^ehd[
lViZgl]^aZndjlV^i#
N Strabismus
NdjgWVWn¼hZnZhbVnhZZbb^hVa^\cZYjci^a
i]ZV\Zd[Z^\]idgiZclZZ`h!Wnl]^X]
i^bZ]Z¼aa]VkZaZVgcZYidjhZ]^hildZnZh
id\Zi]ZghiZgZdhXde^XVaan#
What to do I]ZgZ¼hcdi]^c\lgdc\l^i]
i]^hZVganhfj^ci^c\!Wji^[^ieZgh^hihV[iZg
i]gZZbdci]hhZZ`bZY^XVaVYk^XZ#:Vgan
igZVibZci^h^bedgiVcidgi]Z^bWVaVcXZd[
i]ZbjhXaZhd[i]ZZnZ!l]^X]jhjVaan
XVjhZhVhfj^ci!bVngZbV^cjcXdggZXiZY#
N Stys
6hin^hVc^c[ZXi^dc^ci]Z]V^g[daa^XaZhd[
i]ZadlZgZnZaVh]Zh#>iadd`ha^`ZVhbVaa
Wd^adci]ZZnZa^Y¸VgZYhlZaa^c\l^i]V
XZcigVaVgZVd[ejh#
What to do :nZhVgZkZgnegZX^djh#CZkZg
iV`ZX]VcXZh!VcY\ZibZY^XVaVYk^XZ^[ndj
VgZViVaaldgg^ZY#9dc¼ijhZVcndkZg"i]Z"
XdjciZgigZVibZcih!Vhi]ZnbVnbV`Z
heZX^[^XVci^W^di^XhaZhhZ[[ZXi^kZh]djaYi]Zn
WZegZhXg^WZY#NdjbVncdi^XZi]Vii]Z
ZnZaVh]^haddhZVcY^[ndjgX]^aY^h
XddeZgVi^kZndjXVcgZaZVhZi]ZeZci"je
ejh_jhiWnejaa^c\i]Z]V^gdji#>ildc¼i
MEDICAL INDEX 335
]jgiWZXVjhZi]Z^c[ZXi^dcl^aaVagZVYn]VkZ
Y^hadY\ZYi]Z]V^g[gdb^ih[daa^XaZ#NdjXVc
VahdWVi]Zi]Zhinl^i]VXdiidchlVW
Y^eeZY^cXddalViZg#
N Sunburn
HjcWjgc^h^c[aVbbVi^dcd[i]Zh`^cXVjhZY
WnZmXZhh^kZZmedhjgZidhjca^\]i#I]ZWZhi
XjgZ^hegZkZci^dc#Ndj¼aacZZYidWZhig^Xi
l^i]X]^aYgZc!l]dbVncdiVeegZX^ViZi]Z
YVc\ZghVcYi]ZediZci^Va[dgadc\"iZgb
YVbV\Z#BdhiX]^aYgZc¼hh`^c^hkZgn
hZch^i^kZidhjca^\]i¸bdgZhZch^i^kZi]Vc
VYjaih¼¸hdWZXVgZ[jaVWdjiZmedh^c\i]Z^g
h`^cidi]ZhjcViVcni^bZ#
What to do EgZkZci^c\hjcWjgc^hVadi
WZiiZgi]VcigZVi^c\^i#EgdiZXiZmedhZYeVgih
d[i]Zh`^cl^i]V\ZcZgdjhVeea^XVi^dcd[
hjcWadX`d[ViaZVhi(%HE;VWdji'%
b^cjiZhWZ[dgZ\d^c\djih^YZ#GZeZViVi
aZVhiZkZgnilddgi]gZZ]djghVcYZkZgn
i^bZndjgX]^aY]VhWZZc^ci]ZlViZg#
6alVnhXdkZgndjgWVWn¼h]ZVYl^i]V
l^YZ"Wg^bbZY]ViVcYYgZhh]^b^caddhZ!
a^\]iXadi]^c\i]ViXdkZghi]Zh]djaYZghVcY
cZX`!hjX]VhVh]^gil^i]haZZkZhVcYV
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VcVY_jhiVWaZ]ddYdghjch]VYZl^i]
l]^X]idh]VYZndjgWVWn#>[i]Zhjc^h
ZmigZbZanhigdc\!^i^hWZiiZgid`ZZendjg
X]^aY^cYddgh!ZheZX^VaanWZilZZc&&V#b#
VcY(e#b#l]Zci]Zhjc^hVi^ih]^\]Zhi#
GZbZbWZgi]VindjgWVWn^hhi^aaVig^h`d[
jaigVk^daZigVnhZkZcdcXadjYnYVnh#
>[WnX]VcXZndjgWVWnYdZh\Zi
hjcWjgcZY!XVaVb^cZadi^dc^hV\ddY
Xdda^c\Veea^XVi^dc!VcYX]^aYgZc¼h
VXZiVb^cde]Zcl^aaYdVadiidgZa^ZkZ
i]ZhdgZcZhh^ci]Zh`^cVcYWg^c\]^h
iZbeZgVijgZYdlc#>[ndjgWVWn^hgZhiaZhh
336 HOME MEDICINE
VcY^aa!iV`Z]^hiZbeZgVijgZ0^[^i^hgV^hZY
i]^hbVnbZVc]ZVihigd`Z#Ndjh]djaYhZZ`
bZY^XVaVYk^XZ^bbZY^ViZan#
N Teething
I]^h^hi]ZiZgbjhZYidYZhXg^WZi]Z
Zgjei^dcd[VWVWn¼h[^ghiiZZi]#IZZi]^c\
jhjVaanWZ\^chViVWdjii]ZV\Zd[h^mdg
hZkZcbdci]h!l^i]bdhid[i]ZiZZi]
WgZV`^c\i]gdj\]WZ[dgZndjgWVWn^h&-
bdci]hdaY#NdjgWVWnl^aaegdYjXZbdgZ
hVa^kVi]VcjhjVaVcYl^aaYg^WWaZ0]Zl^aa
ignidXgVb]^h[^c\Zgh^cid]^hbdji]VcY
X]Zldc]^h[^c\ZghdgVcndW_ZXi]ZXVc
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]VkZY^[[^XjainhaZZe^c\!VcYbVnXgnVcY
[gZibdgZi]VcjhjVa#Bdhid[i]ZhZ
hnbeidbhdXXjg_jhiWZ[dgZi]ZiZZi]
Zgjei#>i^h^bedgiVciidgZVa^oZi]Vii]Z
hnbeidbhd[iZZi]^c\Ydcdi^cXajYZ
WgdcX]^i^h!Y^VeZggVh]!kdb^i^c\!Y^Vgg]ZV!
dgadhhd[VeeZi^iZ#I]ZhZVgZhnbeidbhd[
Vc^aacZhhVcYh]djaYWZigZViZYVhhjX]#
What to do >[ndjXVc¼i[^\jgZdjil]n
ndjgX]^aY^hhd^gg^iVWaZ!VcY]Z]Vhcd
di]Zghnbeidbhd[^aacZhh![ZZa]^h\jbh#>[
Viddi]^hXdb^c\i]gdj\]ndjl^aa[ZZaV
]VgYdgh]Vgeajbe!VcYi]Z\jbVgZVl^aa
WZhldaaZcVcYgZY#Ndjh]djaYcdicZZY
id\ZibZY^XVaVYk^XZjcaZhhndjgWVWn]Vh
di]Zghnbeidbhi]ViXVccdiWZViig^WjiZY
idiZZi]^c\#CjghZndjgWVWnd[iZc#
IZZi]^c\WVW^ZhcZZYXdb[dgiVcY
XadhZcZhh#9dc¼ii]^c`i]Vii]ZVgg^kVad[
iZZi]bZVchndj]VkZidheZZYjei]Z
lZVc^c\egdXZhh#7VW^Zhl^i]iZZi]WgZVhi"
[ZZYl^i]cdY^hXdb[dgiidi]Zbdi]Zg#
9^higVXindjgX]^aYl^i]VX]^aaZY
iZZi]^c\g^c\cZkZg[gZZoZi]Zg^c\dgndjg
WVWnbVn\Zi[gdhiW^iZdgVe^ZXZd[XVggdi
dgVeeaZ¸hdbZi]^c\[^gb#HiVnl^i]ndjg
WVWn^cXVhZ]ZX]d`Zhdci]Z[ddY#>[ndjg
X]^aYhZZbhidWZ^cVadid[eV^c!\^kZ
X]^aYgZc¼hVXZiVb^cde]Zcdg^Wjegd[Zc!Wji
cZkZgZmXZZYi]ZgZXdbbZcYZYYdhZ#>[
ndjgX]^aYgZ[jhZh[ddY!ZcXdjgV\Z]^bid
ZViWn\^k^c\]^bXdaY!hbddi][ddYhhjX]
Vhnd\jgi!^XZXgZVb!dg[aVkdgZY\ZaVi^c#
N Tonsilitis
6ai]dj\]idch^a^i^hXVcWZXVjhZYWni]Z
streptococcus bacterium dgWnVkVg^Zind[
k^gjhZh!^i^hd[iZcXVaaZY¹higZei]gdVi#º
I]Z_dWd[i]Zidch^ah^hidigVe^c[ZXi^dch
Vhi]ZnZciZgi]ZWdYni]gdj\]i]Zbdji]!
VcYadXVa^oZi]Zb^ci]Zi]gdVi#;dgi]^h
gZVhdcidch^a^i^h^hjhjVaaneVgid[Vi]gdVi
^c[ZXi^dc#I]Zidch^ahVahdhZcYlVgc^c\
h^\cVahidi]ZgZhid[i]ZWdYnl]ZcVc
^c[ZXi^dc^hWZ\^cc^c\hdi]ZWdYnXVcVaZgi
Vaa^ihYZ[ZchZh#I]ZVYZcd^YhhZgkZZmVXian
i]ZhVbZ[jcXi^dc!WjiVgZVii]ZWVX`d[
i]ZcdhZ^chiZVYd[^ci]Zi]gdVi#>i^h[V^gan
ad\^XVa!i]ZgZ[dgZ![dgi]Zidch^ahVcY
VYZcd^YhidWZi]dj\]id[id\Zi]Zg#Idch^ah
VgZbdhi^bedgiVciidVX]^aYjeidi]ZV\Z
d[iZcnZVgh#I]^hXd^cX^YZhl^i]i]Zi^bZ
i]ZnVgZbdhia^`ZanidbZZi^c[ZXi^dcVcY
i]Z^gYZ[ZchZh]VkZidWZkZgnhigdc\#>[
ndjgX]^aY]Vhidch^a^i^h]Zl^aaXdbeaV^cd[
VkZgnhdgZi]gdViVcY]^hidch^ahl^aaadd`
gZYVcYhldaaZc0i]Zn¼aaegdWVWan]VkZ
l]^iZeViX]Zhdci]Zb#
What to do Ndj¼aacZZYidhZZ`bZY^XVa
VYk^XZ¸jhjVaan!ndjgX]^aYl^aaWZ
egZhXg^WZYVcVci^W^di^XidXdbWVii]Z
^c[ZXi^dc^[]Z]VhVedh^i^kZi]gdViXjaijgZ#
IdbV`ZndjgX]^aY¼hi]gdVi[ZZaWZiiZg!
\^kZ]^bVhbjX]^XZXgZVbVcYXdaYa^fj^Y
Vh]ZlVcih#

9Zhe^iZi]Z^gjhZ[ja[jcXi^dc^ijhZYid
WZ[Vh]^dcVWaZidgZbdkZidch^ahVcY
VYZcd^Yh#IdYVn!ZVg!cdhZ!VcYi]gdVi
hjg\Zdch[ZZai]ViXZgiV^cXg^iZg^VbjhiWZ
bZiWZ[dgZidch^aaZXidbnXVcWZ
Xdch^YZgZY!Vh^i^hfj^iZVbV_dgdeZgVi^dc
l^i]hdbZg^h`^ckdakZY#I]ZXg^iZg^V[dg
eZg[dgb^c\Vidch^aaZXidbnbVnWZbZiWn
VcndcZd[i]Z[daadl^c\i]gZZXdcY^i^dch/
i]ZX]^aY]VYh^mi]gdVi^c[ZXi^dch^cV
h^c\aZnZVg!dg[djgi]gdVi^c[ZXi^dch^ch^m
bdci]h!dg^[i]ZX]^aYZmeZg^ZcXZhhaZZe
VecZV!VXdcY^i^dc^cl]^X]hcdg^c\XVjhZh
i]ZX]^aYideZg^dY^XVaanhideWgZVi]^c\dg
id\Vhe[dgWgZVi]Yjg^c\haZZe#
N Toxocara
I]^hgdjcYldgba^kZh^cXVihVcYYd\h#>ih
Z\\hVgZeVhhZYdc^ci]Z^g[ZXZh!hdndjg
X]^aY^hVig^h`l]Zc]ZeaVnhdc\gdjcY
l]ZgZVc^bVah]VkZYZ[ZXViZY#=ZXVc
^c\Zhii]ZZ\\h^[]Zejih]^hY^gin]VcYh
^cid]^hbdji]#I]ZZ\\hWjggdli]gdj\]
i]Z^ciZhi^cValVaaVcYVgZXVgg^ZY^ci]Z
WaddYhigZVbidi]Zajc\h#I]ZnVgZi]Zc
Xdj\]ZYje!hlVaadlZY!VcYXdci^cjZid
YZkZade^ci]Z^ciZhi^cZh#I]ZgZVgZ
\ZcZgVaancdhnbeidbh!Vai]dj\]^[ndjg
X]^aY]VhbdgZi]VcdcZldgb]ZbVn
]VkZVWYdb^cVaeV^cVcYhj[[Zg[gdbV
adhhd[VeeZi^iZ#
What to do EgZkZci^dc^hWZiiZgi]Vc
XjgZ#9dc¼iVaadleZih^cidndjgX]^aY¼heaVn
VgZVVi]dbZVcYWZXVgZ[jal]Zcndj\d
idejWa^XeVg`h#>[ndjgX]^aY^hY^V\cdhZY
l^i]idmdXVgV]Zl^aacZZYVegZhXg^ei^dcid
\Zig^Yd[^i#;daadli]Z^chigjXi^dch
XVgZ[jaan#I]ZbdhihZg^djhZ[[ZXihd[i]^h
^aacZhh^ckdakZi]ZZnZh!hdndjgX]^aYbVn
cZZYidhZZVheZX^Va^hi#
MEDICAL INDEX 337
N Urticaria
6\ZcZgVaiZgbjhZY[dgVcVaaZg\^Xh`^c
gZVXi^dc!jgi^XVg^V^hVahd`cdlcVh]^kZh#
BdhiX]^aYgZc]VkZViZcYZcXnidYZkZade
]^kZh!Wjii]^h^h\gVYjVaanadhiVhi]Zn\gdl
daYZg#>i^hkZgnZVhnidY^V\cdhZWZXVjhZ^i
^hi]Zdcanh`^cgVh]i]Vil^aaY^hVeeZVg
XdbeaZiZanl^i]^cV[Zlb^cjiZh#
I]ZgVh]!l]^X]^hkZgn^iX]n!d[iZc
add`ha^`ZV[V^ganWVYcZiiaZhi^c\0^iXVc
Vahd[dgbaVg\ZgZYeViX]Zhl^i]jcZkZc
ZY\Zh#>ibVngZhjai^chlZaa^c\d[i]ZZnZh!
i]Za^eh!VcYedhh^Wani]Zidc\jZ#>[i]Z
aViiZgdXXjgh!ndjbjhiXVaa.&&[dgVc
VbWjaVcXZ^bbZY^ViZan#
What to do NdjXVcYdVadiidgZa^ZkZ
i]Z^iX]^cZhhWnXdda^c\^il^i]Veea^XVi^dch
d[XVaVb^cZadi^dc#I]ZgZ^hcdcZZY[dg
VcnheZX^[^XigZVibZcijcaZhhi]ZViiVX`h
VgZeZgh^hiZci#>ci]ViXVhZ!ndjh]djaYVh`
[dgbZY^XVaVYk^XZ#
I]ZgZ^hVeVgi^XjaVg[dgbd[jgi^XVg^V
XVaaZY papular urticaria, l]^X]^hXVjhZYWn
[aZVW^iZh!jhjVaan[gdbi]Z[aZVhdci]Z
[Vb^anXVi#>gZbZbWZgVXVhZd[VX]^aY
l]djhZYidVeeZVg^cdjgXa^c^XdcXZV
bdci]VcY^iijgcZYdjii]Vi^ilVh
ValVnhi]ZYVnV[iZgh]Z]VYWZZcidk^h^i
]Zg\gVcYbVVcY^ilVh]Zg\gVcYbV¼hXVi
l]d]VYi]Z[aZVh#I]ZXjgZ[dgi]^h^hid
igZVii]ZXVi[dg[aZVh!cdiid\Zig^Yd[^i#
N Vomiting
I]^h^hi]ZZmejah^dcd[i]ZXdciZcihd[i]Z
hidbVX]i]gdj\]i]Zbdji]#6WVWnbVn
he^ijehbVaafjVci^i^Zhd[XjgYaZYb^a`
V[iZgV[ZZY^c\!Wjii]^hh]djaYcdiWZ
Xdc[jhZYl^i]kdb^i^c\#Kdb^i^c\]Vh
bVcnXVjhZh!Wji^ci]ZbV_dg^ind[XVhZh
i]ZgZ^ha^iiaZlVgc^c\VcYV[iZgVh^c\aZ
338 HOME MEDICINE
WdjindjgX]^aYh]djaYWZXdb[dgiVWaZVcY
WVX`idcdgbVa#
Kdb^i^c\XVcWZVhnbeidbd[V
heZX^[^XY^hdgYZgd[i]ZhidbVX]hjX]Vh
enadg^XhiZcdh^h!dgVhnbeidbd[Vc
^c[ZXi^dchjX]VhVcZVg^c[ZXi^dc#>i
[gZfjZcianVXXdbeVc^ZhV[ZkZg!VcYZkZc
i]ZXdbbdcXdaYXVcXVjhZkdb^i^c\^[
ndjgX]^aYhlVaadlhZcdj\]cVhVaY^hX]Vg\Z
id^gg^iViZ]^hhidbVX]#>[ndjgX]^aY]VhV
WVYXdj\]i]^hXVcXVjhZ]^bidkdb^ije
[ddYi]Vi]Z]VhgZXZcianZViZc#Di]Zg
XVjhZhd[kdb^i^c\^cXajYZVeeZcY^X^i^h!
bZc^c\^i^h!b^\gV^cZ]ZVYVX]Zh![ddY
ed^hdc^c\!VcYigVkZah^X`cZhh#HdbZ
X]^aYgZckdb^iWZXVjhZd[ZmX^iZbZciVcY
Vci^X^eVi^dc!Wjii]^h^hjhjVaana^b^iZYid
idYYaZgh#Kdb^i^c\h]djaYValVnhWZiV`Zc
hZg^djhanWZXVjhZ^iXVcgVe^YanXVjhZ
YZ]nYgVi^dc!eVgi^XjaVgan^cVWVWndg
ndjc\X]^aY#
What to do EjindjgX]^aYidWZYVcY
eaVXZVWdlal^i]^cZVhngZVX][dg]^bid
kdb^i^cid#D[[Zg[gZfjZci!hbVaaVbdjcih
d[a^fj^Y!egZ[ZgVWanXddalViZg#8]ZX`]^h
iZbeZgVijgZ#>[]Z]VhV[ZkZg!igZVi^iVcY
bV`ZhjgZ]ZYdZhcdiWZXdbZidd]di
see p.327#<Zi]^bidWgjh]]^hiZZi]id
iV`ZVlVni]ZiVhiZ#HZZ`bZY^XVaVYk^XZ^[
ndjgX]^aYXdci^cjZhidkdb^idkZgVh^m"
]djgeZg^dY0^[kdb^i^c\^hVXXdbeVc^ZYWn
Y^Vgg]ZVdgV[ZkZgdkZg&%%#)•;(-•80dg
^[i]Zkdb^i^c\^hVXXdbeVc^ZYWndi]Zg
hnbeidbhhjX]VhZVgVX]ZdgVWYdb^cVa
eV^c#;ZZYndjgX]^aYWaVcY[ddYhl]Zci]Z
cVjhZVVcYkdb^i^c\]VkZeVhhZY#
GZ^cigdYjXZhda^Y[ddYhhadlan#
N Warts
I]ZhZVgZhbVaaWZc^\cajbehXVjhZYWn
i]ZlVgik^gjh#I]ZnVgZbVYZjed[Vc
ZmXZhhd[YZVYXZaahi]ViegdigjYZVWdkZ
i]Zhjg[VXZd[i]Zh`^c#I]ZnXVcVeeZVg
h^c\andg^cVaVgb^c\cjbWZghdkZgVaaeVgih
d[i]ZWdYn!^cXajY^c\i]Z[VXZVcY
\Zc^iVah#>[i]ZndXXjgdci]ZhdaZhd[i]Z
[ZZi!i]ZnVgZ`cdlcVhkZggjXVZ#>iiV`Zh
VWdjiildnZVgh[dgi]ZWdYnidWj^aYje
gZh^hiVcXZidi]ZlVgik^gjh!VcYV[iZgi]Vi
i^bZi]ZlVgihjhjVaanY^hVeeZVg
hedciVcZdjhan#LVgihVgZhegZVYWnY^gZXi
XdciVXil^i]Vc^c[ZXiZYeZghdc#
What to do>[ndjgX]^aYlVcihi]ZlVgih
gZbdkZY!dgi]ZnVeeZVgdcVeVgid[i]Z
WdYnl]ZgZi]ZnXVcZVh^an^c[ZXidi]Zg
eZdeaZ!igni]ZdkZg"i]Z"XdjciZglVgi
igZVibZcih[gdbndjge]VgbVXn#I]ZhZ
ldg`Wni]ZVeea^XVi^dcd[VlZV`VX^Y
hdaji^dcidi]ZlVgiVcYi]ZYV^angZbdkVa
d[i]ZgZhjai^c\WjgcZYh`^c#;daadli]Z
bVcj[VXijgZg¼h^chigjXi^dchXVgZ[jaanVcY
Vkd^YVeean^c\i]Zhdaji^dcid ]ZVai]nh`^c#
9dc¼ijhZi]ZhZlVgiXjgZhdclVgihi]Vi
VeeZVgdci]Z[VXZdg\Zc^iVah/ndjbVn
XVjhZhXVgg^c\#
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ajbehVgZgZVaanlVgih#6cn\gdli]dgajbe
dcndjgX]^aY¼hh`^ci]VindjVgZjcXZgiV^c
VWdjih]djaYWZX]ZX`ZY#<ZibZY^XVa
VYk^XZVhhddcVhedhh^WaZ^[i]ZlVgih
Xdci^cjZidbjai^eandg^[i]ZnVeeZVgdc
i]Z[VXZdg\Zc^iVahVcYndjlVciid]VkZ
i]ZbgZbdkZY#
 IMMUNIZATION 339

Immunization
>bbjc^oVi^dc^hdcZd[i]ZbdhihjXXZhh[ja
[dgbhd[egZkZci^kZbZY^X^cZVcY]Vh
]ZaeZYidZgVY^XViZbVcn[dgbZganaZi]Va
Y^hZVhZhi]gdj\]djii]ZldgaY#=dlZkZg!
^ihXdci^cjZYhjXXZhhYZeZcYhdchig^Xi
bV^ciZcVcXZd[Vc^bbjc^oVi^dcegd\gVb
^ci]ZXdbbjc^in!VcY^i^hi]Z
gZhedch^W^a^ind[VaaeVgZcihidZchjgZi]Vi

AGE V CCINATION
VA A HOW GIVEN REACTION
Birth– • Hepatitis B One injection Generally well tolerated,
1 month reaction at injection site
possible, but rare

2 months • Pneumococcus One injection Possible redness and swelling

• Diphtheria, tetanus, pertussis
(whooping cough), polio
and Hib
4 months • Hepatitis B
• Diphtheria, tetanus, pertussis
(whooping cough), polio, and Hib
at injection site, mild fever
One injection Slightly raised temperature;
sickness and/or diarrhea, small
lump at injection site that will
disappear in a few weeks
One injection Generally well tolerated,
reaction at injection site
possible, but rare
One injection As above

6 months • Hepatitis B One injection As above

• Pneumococcus One injection As above
• Diphtheria, tetanus, pertussis One injection As above
(whooping cough), polio, and Hib

Around • Hib One injection As above, fever; rash;

12 months generally unwell/malaise
• MMRV (measles, mumps, rubella, One injection As above
and chicken pox)

15 months • Pneumococcus One injection As above

• Hib (if not given at 12 months) One injection As above

18 months • Hepatitis A One injection As above

2 years • Hepatitis A booster One injection As above

4–5 years • Diphtheria, tetanus, pertussis One injection As above

(whooping cough), polio
• Measles, mumps, and rubella (MMR) One injection As above
or MMRV
340 HOME MEDICINE

i]Z^gX]^aYgZcVgZ[jaanegdiZXiZY#HdbZ
eVgZcihVgZVcm^djhVWdjii]Zedhh^WaZh^YZ
Z[[ZXihi]VibVndXXjgVhVgZhjaid[V
kVXX^cVi^dc#>[ndj]VkZXdcXZgch!^i¼h
^bedgiVciidY^hXjhhi]Zbl^i]ndjg
YdXidg#I]Zg^h`d[Xdbea^XVi^dch^hkZgn
hbVaaXdbeVgZYidi]Z]Vgb[jaZ[[ZXih
d[i]ZY^hZVhZhi]ZbhZakZh!l]^X]VgZ
[VgbdgZhZg^djh#=dlZkZg!^[ndjgWVWn
YZkZadehh^YZZ[[ZXihViVcnhiV\Zd[i]Z
kVXX^cVi^dcegd\gVb!ndjgYdXidgbVn
YZaVndghide^bbjc^oVi^dch#

COMMON CHILDHOOD INFECTIOUS DISEASES

Disease Incubation period Symptoms

Measles 10–14 days Runny nose, cough, inflamed eyes, fever, vomiting,
TFF
Q
diarrhea, Koplik’s spots on the inside of the cheeks at
first then after four days a rash behind the ears, then
on the face, then on the body.

Rubella (German 14–21 days Slight temperature, enlarged glands at the back of the
measles) neck, rash behind the ears then on the forehead, then
TFF
Q
the rest of the body. Rash lasts three days.

Roseola 4–7 days A high temperature with slight cold symptoms; a pink
TFF
Q
rash after three days when temperature goes down.

Chicken pox 10–21 days Dark red, irritating groups of spots that emerge
TFF
Q
every three or four days. Initially look like blisters then
scab over.

Pertussis Around 7 days Slight temperature, runny nose, slight cough then
(Whooping a convulsive cough followed by whooping breath,
cough) vomiting, cyanosis (blue coloring to skin) during
TFF
Q
coughing spasms, then exhaustion.

Mumps 17–21 days Swelling and soreness of the glands at the sides of
TFF
Q
the face, and in front of the ears, painful swallowing,
and dry mouth. Fever and generally unwell.

Scarlet fever or 2–5 days Sore throat, lack of appetite, fever, vomiting, swollen
Scarlatina glands, tiny red spots, scarlet facial flushing, and
TFF
Q
strawberry-colored tongue.
 IMMUNIZATION 341

CZlkVXX^cZh\di]gdj\]Vc^ciZch^kZ
iZhi^c\egdXZYjgZi]ViZcYhl^i]VeegdkVa!
i]ZcgZXdbbZcYVi^dc#GdiVk^gjhkVXX^cZ!
VcdgVakVXX^cZ[dgWVW^Zh!egZkZci^c\
Y^Vgg]ZV!VcY=EKkVXX^cZ!idWZ\^kZc^c
VYdaZhXZcXZ!egZkZci^c\\Zc^iValVgihVcY
XZgk^XVaXVcXZg!]VkZ_jhiWZZcVeegdkZY#
IldbdgZkVXX^cZhVgZgZXdbbZcYZY[dg
VYdaZhXZcih/IYVeiZiVcjh!Y^ei]Zg^V!VcY
VXZaajaVgeZgijhh^hViV\Z&&·&'!VcY
bZc^c\dXdXXVaXdc_j\ViZkVXX^cZViV\Z
&&dgZcigVcXZid]^\]hX]ddadgXdaaZ\Z#

Treatment Complications Immunity Prevention

No specific treatment other Ear infection, Lifelong Immunization combined

than children’s acetaminophen pneumonia with mumps and
to reduce the fever. If encephalitis, rubella vaccine
secondary infection of the gastroenteritis. around 13 months and
ears or lungs occurs 4 years.
antibiotics will be necessary.

No specific treatment. None to your child Lifelong Immunization combined

but fetal damage with measles and
could occur in a mumps vaccine around
pregnant woman. 13 months and between
4 years.

No specific treatment. Rarely infantile Usually None

convulsions. lifelong

Relive itching with calamine Encephalitis, Lifelong Varicella vaccination at

lotion. pneumonia. 12 months, booster at
4–6—may be combined
with MMR.

Antibiotics must be given Possibility of seizures, Lifelong Immunization at 2, 4,

early to be effective; fresh air. bronchitis, or and 6 months, with
Possibly raise your child’s pneumonia. booster at 15–18
head in bed to make months and then at 4
breathing easier. years.

Plenty to drink, soft food if Meningitis, Lifelong Immunization combined

chewing is painful. inflammation of the with measles and rubella
testes. vaccine around 12
months and between
3½ and 5 years.

Penicillin with bedrest as Rheumatic fever. Lifelong for None

long as fever lasts. each strain
342 HOME MEDICINE
Immunization and traveling abroad
>[ndjVgZeaVcc^c\idiV`ZndjgWVWndg
idYYaZgVWgdVY!^i^hk^iVai]Vindj[^cYdji
WZ[dgZ]VcYVWdjii]Z]ZVai]g^h`h^ci]Z
Xdjcignndjl^aaWZk^h^i^c\VcYi]Z
egZXVji^dch!^cXajY^c\kVXX^cVi^dch!i]Vi
ndjbVncZZYidiV`Z#NdjXVc\Zii]Z
^c[dgbVi^dc[gdbndjgigVkZaV\Zci!i]Z
ZbWVhhnd[i]ZXdjcignndjVgZ\d^c\id
k^h^i!i]Z9ZeVgibZcid[=ZVai]!dgi]Z
8ZciZgh[dg9^hZVhZ8dcigda#I]Z898
ejWa^h]ZhVcZlZY^i^dcd[i]Z Yellow
Book: Health Information for International
TravelZkZgnildnZVgh!\^k^c\je"id"YViZ
l i]ZadXValViZgbVnWZXdciVb^cViZYVcY
^c[dgbVi^dcdc]ZVai]g^h`hi]gdj\]djii]Z
ldgaY!VcYndjh]djaYXdchjai^ilZaa
WZ[dgZndjgYZeVgijgZYViZ#I]Z Yellow
BookXVcWZdgYZgZYi]gdj\]i]Z898
k Xdbbdc!YdcdiVaadlndjgX]^aYidhl^b
lZWh^iZ!Villl#XYX#\dk$igVkZa0WjibjX]
d[i]Z^c[dgbVi^dc!^cXajY^c\jeYViZh!^h
VkV^aVWaZdci]Z898h^iZ#
NdjgX]^aYh]djaYWZXjggZci[dg]^h
V\ZdcVaakVXX^cVi^dcha^hiZY^ci]Z
^bbjc^oVi^dchX]ZYjaZsee p.339#>[
kVXX^cVi^dc^hgZfj^gZY!ndjh]djaYhZZndjg
YdXidg!dgeZY^Vig^X^Vc!ViaZVhiildbdci]h
WZ[dgZYZeVgijgZWZXVjhZhdbZkVXX^cZh
iV`Zi^bZidWZZ[[ZXi^kZ!VcYhdbZXVccdi
WZ\^kZcVii]ZhVbZi^bZVhdi]Zgh#Di]Zg
kVXX^cZhVcYbZY^XVi^dch!l]^aZhV[ZWn
VYjaih!h]djaYcdiWZVYb^c^hiZgZYid
egZ\cVcidgWgZVhi"[ZZY^c\bdi]Zgh!dgid
X]^aYgZc!WZXVjhZi]Z^ghV[Zin[dgi]Z[Zijh!
WgZVhi"[ZZY^c\^c[Vci!dgX]^aY]VhcdinZi
WZZcYZiZgb^cZY#NdjXVcdWiV^cheZX^[^X
^c[dgbVi^dc[gdbi]Z898lZWh^iZ
gZ\VgY^c\i]ZkVXX^cVi^dch[dgigVkZaidVcn
eVgi^XjaVgVgZV!VhlZaaVhdjiWgZV`hd[
Y^hZVhZhi]ViVgZgVgZ^ci]ZJH#
Vacation health precautions
First aid kit 7ZhjgZidiV`ZV[^ghiV^Y`^i!
l]^X]h]djaYXdciV^cVeVX`V\Zd[
VY]Zh^kZYgZhh^c\h!hiZg^aZcZZYaZh!^chZXi
gZeZaaZci!Vci^hZei^XXgZVb!lViZg
hiZg^a^oVi^dciVWaZih!VaXd]da"WVhZY]VcY
hVc^i^oZg!X]^aY"hV[Z]VcYl^eZh!Y^VeZggVh]
d^cibZci^[Veegdeg^ViZ!dgVagZ]nYgVi^dc
hdaji^dcDGHhVX]Zih!VcYVcnbZY^X^cZh
i]Vi]VkZWZZcegZhXg^WZYWnndjgYdXidg#
Water safety>[ndjdgndjgX]^aYlVcih
idhl^bl]^aZdckVXVi^dc!WZVlVgZi]Vi
eVgVh^i^X^c[ZXi^dchXVcWZe^X`ZYje^[Vcn
lViZg^hhlVaadlZY#>cVgZVhl]ZgZ
h]^hidhdb^Vh^hdgdi]ZgeVgVh^iZhVgZ
^cjcX]adg^cViZYlViZg#
Water 7VW^Zh¼[ddYh]djaY!d[XdjghZ!WZ
b^mZYl^i]Wd^aZYlViZgVhjhjVa#
Di]Zgl^hZ!jcaZhhndj`cdli]Vii]ZadXVa
lViZg^hhV[Z!jhZWdiiaZYlViZgdghiZg^a^oZ
^iWnWd^a^c\dgjh^c\hiZg^a^oVi^dciVWaZih#
I]^hVeea^Zhcdi_jhiidYg^c`^c\lViZgWji
Vahdidi]ZlViZgndjjhZ[dgXaZVc^c\
iZZi]dgg^ch^c\i]Zbdji]dji#
Food 7ZlVgZd[gVlkZ\ZiVWaZh!hVaVYh!
jceZZaZY[gj^i!XgZVb!^XZXgZVb!^XZXjWZh!
jcYZgYdcZbZVidg[^h]!VcYjcXdd`ZYdg
gZ]ZViZY[ddY#
Taking medicines abroad
>[ndjcZZYidiV`ZVcnegZhXg^WZY
bZY^X^cZh[dgndjgWVWndgidYYaZgl^i]
ndj!ndjh]djaYX]ZX`^[i]ZgZVgZVcn
gZhig^Xi^dchdciV`^c\Ygj\h!egZhXg^WZYdg
dkZg"i]Z"XdjciZg!^cidi]ZXdjcignndjVgZ
k^h^i^c\#>i^hVYk^hVWaZid]VkZVaZiiZg[gdb
 IMMUNIZATION AND TRAVELING ABROAD 343

ndjgYdXidgl^i]YZiV^ahd[VcnbZY^X^cZh
egZhXg^WZY!idVkd^YegdWaZbhl^i]8jhidbh#
Traveling restrictions
8]ZX`l^i]i]ZIgVchedgiVi^dcHZXjg^in
6Yb^c^higVi^dclll#ihV#\dkdgndjg
V^ga^cZWZ[dgZndjaZVkZ]dbZidZchjgZ
i]Vindj]VkZ[daadlZYVcnhZXjg^ingjaZh
XjggZcian^c[dgXZ#>cVYY^i^dc!bV`ZhjgZ
i]VindjgWVWn]Vh]^hdlceVhhedgi¸
bVcnXdjcig^ZhcdlgZfj^gZi]ViZkZgn
eZghdc!gZ\VgYaZhhd[V\Z!]VhVeVhhedgi#
Travel insurance
L]ViZkZgXdjcig^Zhndj^ciZcYidk^h^i!^i^h
kZgn^bedgiVcii]VindjiV`ZdjiVYZfjViZ
eg^kViZbZY^XVa^chjgVcXZ!ZheZX^Vaan^[ndj
]VkZVegZZm^hi^c\bZY^XVaXdcY^i^dc#

DISEASE AND PRECAUTIONS

Disease Risk Area Vaccination

Cholera Africa, Asia, Middle East, especially in None available in the United States.
conditions of poor hygiene and Cholera is contracted from eating or
sanitation. drinking contaminated food or water.

Malaria Africa, Asia, Central and South America; None, but antimalarial pills must be
possibly southern Europe and United taken before, during, and for a month
States (check before traveling). after your trip.

Polio Everywhere except Europe, North Given as a routine to babies in the US.
America, Australia, and New Zealand.

Rabies Many parts of the world, including Not routine, but ask for advice because
Europe. it may be more common in remote areas..

T
Tetanus Occurs worldwide, but greatest risk in Given as a routine to babies in the US.
areas where children are not immunized.

TB Africa, Asia, Central and South America,
some poorer inner-city areas elsewhere.
Skin test and injection, preferably three
months before travel. Not necessary for
short visits and when staying in modern
hotels, but advisable for longer visits if
you will be living or working closely with
the local population.

T
Typhoid Everywhere except Europe, North America, TTwo injections, 4–6 weeks apart.
Australia, and New Zealand, in conditions Typhoid is contracted from drinking
of poor hygiene and sanitation. contaminated water.

Yellow fever Africa and South America. One injection at least ten days before
traveling. Infants under nine months
should not be vaccinated, and should
not be exposed to the disease.
344 INDEX
Index
A hV[Zin'.+
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VXZiVb^cde]Zc'%'!(&+
VYkZcijgdjhcZhh&.-
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V^gigVkZa'.%·&
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Vcm^Zi^Zh
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WZYgddbh(-·.
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W^Wh(*!&&-
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INDEX 345
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gZhedcY^c\id&*-·.!&+&
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[VWg^XY^VeZgh+)·*!+,
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352 INDEX

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Acknowledgments
Medical consultants for new edition:
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Cooling Brown would like to thank:
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[dgi]Z^cYZm#
Picture library: GdbV^cZLZgWadl
I]ZejWa^h]ZgldjaYa^`Zidi]Vc`i]Z
[daadl^c\[dgi]Z^g`^cYeZgb^hh^dcid
gZegdYjXZi]Z^ge]did\gVe]h/
Corbis:8VbZgdc'.0Getty Images:
E]didY^hX<gZZc0.0Mother & Baby Picture
Library: :B6E/'-,
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egdk^YZYXdjgiZhnd[6kZciAiY#
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BVg^cVGV^i]#7VX`/6ji]dgedgigV^i/8Vgdanc
9_Vcd\an[dg9@0EjcX]hidX`/7gVcYM
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6aadi]Zg^bV\Zh9dga^c\@^cYZghaZn
;dg[jgi]Zg^c[dgbVi^dchZZ/
www.dkimages.com
 This book provides a wealth of practical advice on
looking after your baby, but above all I hope it will
give you the confidence to trust your own instincts
as you respond to your baby’s needs. Remember
that no one knows your baby like you do.

“A comprehensive book that should

solve your problems.” —PARENTS MAGAZINE

 Reassuring,up-to-date guidance
for the first three years of life from this
best-selling parenting author

 The complete picture on feeding,

sleep, crying, bathing, home medicine,
hygiene, first aid, and more

 Features a stage-by-stage guide to

your baby’s physical, emotional, and
intellectual development

DR. miriamstoppard
Discover more about Miriam Stoppard’s books
at www.dk.com/miriamstoppard and from
Miriam herself at www.miriamstoppard.com

Jacket images: Front and spine: Photolibrary: Marina

Raith. Back: Author portrait: Carolyn Djanogly for DK;
PunchStock: Brand X Pictures.