Things You'll Need

Dr. Spock's Baby and Child Care : 8th Edition
by Benjamin Spock, M.D.

(Page 3 of 3)

Buying things ahead of time. Some parents don't feel like buying anything until they have their baby. The idea that shopping for things ahead of time might cause the pregnancy to come to a bad end is common in many cultures. Parents may not want to tempt fate.

The advantage of getting and arranging things ahead of time is that it lightens your burden later. A certain number of mothers feel tired and easily discouraged when they begin taking care of the baby themselves. Even a little job like buying a bag of diapers looms as an ordeal.

What do you really need? Even if you don't have everything prepared ahead of time, it's wise to at least have some necessities on hand before you deliver. The sections that follow should help you decide what to buy ahead of time and what you might buy later (or never). For deciding which brand to purchase, I suggest you check the most recent copies of journals such as Consumer Reports for the latest information on safety, durability and practicality.

Checklist

Things You'll Need Right from the Start:

• A safety-approved car seat (see page 35).

• A crib, cradle, bassinet, or cosleeper — even if the baby sleeps with you at night, he'll need a place for naps.

• Several snug-fitting cotton sheets, a plastic mattress cover, and two or three cloth mattress liners.

• Several small cotton blankets for swaddling and perhaps a heavier blanket for warmth.

• A few T-shirts or onesies; in cooler climates, two or three sleepers.

• Diapers, either disposable or cloth, or a diaper service (see page 67); wipes. (Cloth diapers have many uses, even if you choose disposables for the baby's bottom.)

• Nursing bras and (probably) a breast pump (page 278) if you plan to breast-feed.

• Two or three plastic bottles and nipples; more bottles and a supply of formula if you plan to bottle-feed.

• A cloth sling or front-pack baby carrier.

• A diaper bag with compartments for diapers, wipes, ointment, a folding plastic changing pad, and nursing supplies.

• A digital thermometer and a child's nose syringe with bulb suction.

Car seats. One of the biggest dangers your newborn faces is the ride home from the hospital — unless you use an infant car seat. Be sure the seat has a label showing that it meets government safety standards for use in cars. Always place your newborn in the back seat facing backward. Babies should never be placed in front of a working air bag; an exploding air bag can seriously injure or even kill a small child.

There are two basic kinds of car seats for babies. One kind always faces backwards and has a handle so that it can be used as a baby carrier. The other kind is a convertible seat that can be turned around to face forward once your baby is large enough (over twelve months old and over twenty pounds). Either kind is safe. If possible, get a new seat. If a seat has been in an accident in the past, it might not hold up in a second one, even if it looks okay. Over time the plastic weakens, so that a seat that has been in the family for years may not provide adequate protection. Choose a seat that uses a harness to hold the child rather than a shield or bar, which can injure a child in a crash.

Consumer Reports frequently updates its ratings of car seats. I also suggest you send for "The Family Shopping Guide to Car Seats" from the American Academy of Pediatrics (see Resource Section for address) and call the Auto Safety Hot Line (800 424-9393) for information on car seat safety notices.

It's hard to put a car seat in correctly (I took a week-long course to learn how) so, if you can, have a certified child safety seat inspector show you how. Many hospitals and fire stations run free car seat installation programs. You can find one near you by calling the hospitals, or look online at www.nhtsa.dot.gov. You'll find more detailed information on car seats on page 735.

A place to sleep. You may want to get a beautiful, expensive bassinet, lined with silk. But your baby won't care. All she needs are sides to keep her from rolling out and something soft but firm in the bottom for a mattress. You might also decide to have your baby sleep in bed with you (see page 59 for the pros and cons).

Having a firm surface is important, because babies can more easily suffocate if they lie face down on a very soft mattress. (Even though babies should sleep on their backs to prevent crib death, sometimes they end up face down anyhow.) A simple bassinet on wheels is convenient at first. Sometimes there's a cradle that's been in the family for many years. A cardboard box or a drawer with a firm, tight-fitting pad also works well for the first couple of months.

A cosleeper is a three-sided box that sits alongside your bed with the opening facing you. It's wonderful to be able to reach your baby without getting up, especially if you are breast-feeding. For safety, it's important that the cosleeper attaches firmly to the bed, so that there isn't a gap a baby could be caught in.

Most parents start with a crib. For safety, a crib should have slats less than 2 3/8 inches apart and any cut-out openings on the ends should also be less than 2 3/8 inches across. It should have a snug-fitting mattress, childproof side locking mechanisms, and at least twenty-six inches from the top of the rail to the mattress set at its lowest level. Look out for sharp edges and for corner posts that stick up more than one-sixteenth of an inch; that's high enough to snag an article of clothing, which could trap or strangle a baby. It should be sturdy, with the mattress support firmly attached to the headboard and footboard. Cribs made before 1975 often have lead paint and are safe only if all the old paint has been stripped off. If you're buying a new crib, look on the box to see that it meets federal safety standards. For used cribs, hand-me-downs, and family heirlooms, you have to be the safety inspector.

Your baby doesn't need a pillow for her head, and you should not use one. Likewise, it's best to keep stuffed animals out of your baby's crib or cradle; little babies don't care much about them, and they may pose a suffocation risk. Cloth bumpers can look great, but they don't do much to protect small babies, and can also become a suffocation hazard if they come loose.

For more on sleep and sleep safety, see page 57.

Equipment for bathing and changing. Babies can be bathed in the kitchen sink, a plastic tub (get one with a wide edge to rest your arm on), a dishpan, or a washstand. A spraying faucet that works like a minishower is great for rinsing the baby's hair and keeping him warm and happy. Molded plastic bathing tubs with contoured pads or liners are useful and generally inexpensive.

A bath thermometer is not necessary but can be a comfort to the inexperienced parent. Always test the water temperature with your hand anyway. Water should never be hot, only lukewarm. Also, never run warm water into the tub or sink while the baby is in it unless you are sure that the temperature is constant. The temperature setting on water heaters should be set at a maximum of 120 degrees to prevent scalding.

You can change and dress your baby on a low table or bathroom counter, where water is handy, or on the top of a bureau that is at a comfortable height. Changing tables with a waterproof pad, safety straps, and storage shelves are convenient, though expensive, and may not be adaptable for other uses later. Some types fold; some have an attached bath. Wherever you change your baby (except on the floor) it's wise to keep one hand on your baby at all times: safety straps are nice backups, but don't trust them.

Diapers are discussed on page 67. For diaper wipes, you can use a washcloth with soap and water or you can use moist paper towels. If you want the convenience of premoistened diaper wipes, use the ones without chemicals and perfume, which can cause rashes.

Seats, swings, and walkers. An inclined plastic seat in which your baby can be strapped, carried short distances, and set down almost anywhere and from which she can watch the world go by is a useful accessory. (Some infant car seats can be used for this purpose, too.) The base should be larger than the seat; otherwise it will tip over when your baby becomes active. There are also cloth seats that move with the infant's movement. Be careful about placing your baby in any kind of seat on countertops and tables, as her movements might inch the seat off the edge.

Baby seats tend to be overused in that the baby is apt to be always in it and so is deprived of bodily contact with people (see page 48). A baby should be held for feedings, comforting, and at other times. Plastic baby seats are also not the best things for carrying babies: Your baby will be happier and more secure in a cloth sling or Snugli, and you get to have both arms free, with less strain on your shoulders.

Young babies usually love motion, and a swing can be wonderfully calming. A cloth baby sling does the same thing, of course, but a swing is useful to give you a break. I don't think that babies actually become addicted to swinging, but too many hours of the same hypnotizing motion probably isn't best for them.

Infant walkers are a major cause of injury (see page 117). Other than providing temporary amusement, their benefits are nonexistent and their dangers clearly proven. They should not be used. Manufacturers now make stationary walkers that bounce, swivel, or rock. They come with toys attached for entertainment and are much safer for children.

Strollers, carriages, and backpacks. A stroller is a handy way to take a young child when you shop or run other errands. Strollers are best for babies who can hold their heads up steadily. Newborns and little infants do better in a cloth front pack, from which they can look up into their parent's face and hear their heartbeats. A folding umbrella stroller can be easily carried on a bus or in a car, but be sure it's a sturdy one. Products that combine a car seat and stroller are attractive, and they make it easy to go from car to stroller without having to wake up a sleeping infant. On the other hand, they aren't as compact as the folding umbrella variety. Children should always be strapped into their strollers.

A carriage (pram) is like a bassinet on wheels; nice to have for the first few months if you plan on taking long strolls with your baby but hardly necessary. An alternative, after your baby has outgrown the soft front pack, is to go to a backpack. These items can be very sophisticated, with metal frames and padded hip belts that let you carry a large baby or toddler without much strain. Your baby can look over your shoulder, chat with you, play with your hair, and fall asleep with her head nestled into your neck.

Play yards (playpens). Some parents and psychologists disapprove of the imprisonment of a baby in a pen, fearing that it may cramp the child's spirit and desire to explore, but I've known many babies who spent several hours a day in pens and who still ended up demon explorers with high spirits. A young infant can be left safely in her cradle or crib, but once your baby starts crawling, it's very helpful to have a confined place where she can play safely while you take care of other business. There are play yards designed to fold into compact travel-size cases, which are great for going on visits. They are recommended for children up to thirty pounds or thirty-four inches tall.

If you are going to use a play yard, you should start putting your baby in it each day from about three months. Babies differ — some tolerate play yards well, some poorly. If you wait until a baby starts to crawl (six to eight months), the play yard will surely seem like a prison and be met with persistent howls.

Bedding. Blankets made of acrylic or a polyester-cotton combination are easy to wash and nonallergenic. A knitted shawl is a particularly convenient form of blanket for babies because it wraps around them so easily when they are up and stays tucked in when it is over them in bed. Make sure there are no long threads for the baby to wrap around fingers or toes or large holes that a baby can get caught in. Blankets should be large enough to tuck well under a crib mattress. A baby wearing a fleece sleeper probably doesn't also need a blanket, unless the room is chilly. Babies should be comfortable, not overheated.

Cotton receiving blankets, which furnish little warmth, are useful for wrapping around the baby who would otherwise kick off the bed coverings or for tightly swaddling the young baby who is comfortable and secure and can sleep only when held immobile.

You'll probably want a plastic mattress cover. The plastic cover that comes on most new mattresses is not sufficient by itself; sooner or later urine gets into the air holes and makes it smell. A cloth mattress pad lets air circulate under the sheet; you'll need three to six pads, depending on how often you do laundry. Waterproof sheeting that has a flannelette covering serves the same purpose. A thin plastic bag such as one from the dry cleaner should never be used in a crib, because of the danger of suffocation if the baby's head gets tangled in it.

You will need three to six sheets. They should fit snugly so that they don't come undone and pose a suffocation risk. The best sheets are made of cotton knit. They are easy to wash, quick to dry, spread smoothly without ironing, and do not feel clammy when wet.

Clothing. Remember that your baby will be growing very rapidly during the first year, so be sure you buy her clothing to fit loosely. Except for diaper covers, it's generally better to begin with three- to six-month-size clothes instead of newborn or "layette-sized" clothing.

A baby or child doesn't need more in the way of clothing or covering than an adult; if anything, less. For example, nightgowns are entirely practical and can be worn night and day. The mittens on the ends of the sleeves, which are to keep babies from scratching themselves, can be worn open or closed. Long gowns make it harder for babies to kick off their coverings; short ones may be preferable for hot weather. Buy three or four; more if you can't do laundry every day.

Undershirts come in three styles: pullover, side-snap closing, and a one-piece type that slips over the head and snaps around the diaper. The type with side snaps is slightly easier to put on a small baby. Medium weight and short sleeves should be sufficient unless your home is unusually chilly. A one-piece shirt that snaps under the crotch (a onesie) stays in place easily. The most comfortable fabric for children is 100 percent cotton. Start with the one-year-old size or, if you are fussy about fit, the six-month size. Buy at least three or four. It will be convenient to have two or three more, especially if you don't have a washer and dryer. If you cut or pull off the tags, they won't irritate your baby's neck.

Stretch suits can work for day or night. Check the insides of the feet regularly. They can collect hair, which can wind around the baby's toes and be painful. Sweaters are useful to add extra warmth. Be sure that the neck opening has sufficient give or that there are shoulder snaps, well-secured buttons, or zippers up the back to adjust the fit.

Knitted acrylic or cotton caps are all right for going outdoors in the kind of weather that makes grown-ups put on caps or for sleeping in an equally cold room. Avoid using caps that are too large at night, because they can cover the baby's face as she moves around while sleeping. For milder weather caps are unnecessary; most babies don't like them anyway. You don't need booties and stockings, at least until your baby is sitting up and playing around in a cold house. Dresses make a baby look pretty but are otherwise unnecessary and are bothersome to the baby and the parent. A sun hat with a chin strap to keep it on is useful for the baby who will tolerate it. See page 115 about shoes.

Some parents find good used clothes or hand-me-downs a good choice for rapidly growing children. Watch out for scratchy lace close to the face and arms; it can make even an adult irritable. Headbands are cute, but if they're too tight or itchy (or if a ponytail is too tight), they can hurt the head. Most important, be on the lookout for any loose buttons or decorations that can pose a choking hazard and ribbons and cords that can get wrapped around a baby's arms or neck.

Toiletries and medical. Any mild soap will do for the bath. Avoid liquid baby soaps and deodorant soaps; they may cause rashes. For all but the most soiled areas, plain water works fine. There are "no-tears" shampoos that are gentle on babies' eyes. Cotton balls are useful at bath time for wiping the baby's eyes. Baby lotion is not really necessary unless your child's skin is dry, although it's pleasant to rub it on, and babies love massage. Many parents now prefer to use creams and lotions that don't have scent or color added. They often cost less than the usual baby products.

Baby oils, most made of mineral oil, have been used extensively for dry or normal skin or for diaper rash. But tests have shown that mineral oil itself may cause a very mild rash in some babies, so it is sensible not to use it routinely unless you find by testing that it has more advantage than disadvantage in your baby's case.

Baby talcum powder should be avoided because it is irritating to the lungs and can cause significant problems if inhaled. If you need powder, baby powder that is pure cornstarch is safer.

An ointment containing lanolin and petrolatum, in a tube or jar, protects the skin when there is diaper rash. Pure petrolatum jelly also works well, but it can be messy.

Infant nail scissors have blunted ends. Many parents find infant nail clippers easier to use and less likely to cut the baby. I prefer using a nail file: there's no chance of drawing blood, and files don't leave jagged edges that can cause scratches.

You'll need a thermometer to take your baby's temperature, in case of illness. Digital thermometers cost about $10, are fast, accurate, easy to use, and safe. High-tech ear thermometers are less accurate and much more expensive. Old-style thermometers that contain mercury aren't safe. If you have one already, don't just throw it in the garbage; call your local sanitation department for proper disposal.

If the mucus from a cold is interfering with feeding, a child's nose syringe with bulb suction is helpful to remove it. See page 799 for other items to keep in your medicine cabinet.

Feeding Equipment. If you're planning to breast-feed, you may not need any equipment other than yourself. Many nursing mothers find that it's also helpful to have a breast pump (see page 278). Hand-operated pumps are often slow and tiring to use; good motorized pumps are expensive but can be rented from medical supply stores, and many hospitals have programs that loan out pumps at low cost. If you pump, you'll need a few (at least three or four) plastic bottles to store the milk and the nipples to go with them. Breast pads, nursing bras, nipple shields, and other items are described in the breast-feeding section (page 242).

If you know ahead of time that your baby is going to bottle-feed, buy at least nine of the eight-ounce bottles. In the beginning you will use six to eight a day for the formula. Plastic bottles don't break when adults — or babies — drop them. You'll need to have a bottle brush, too. For water and juice (not needed in the first months), some parents prefer to use four-ounce bottles. Buy a few extra nipples, in case you are having trouble making the nipple holes the right size. There are all kinds of specially shaped nipples but no scientific proof for the claims made by their manufacturers. Some nipples withstand boiling and wear and tear better than others. Be sure to follow instructions on when to replace old nipples.

You don't need to sterilize baby bottles if your tap water is safe to drink (see page 288 on sterilization).

It is no longer considered necessary to warm a baby's bottle, although most babies prefer their formula at least room temperature. Hot water in a pot works well. An electric warmer is handy when the hot-water supply is undependable. There is a special warmer that plugs into an automobile cigarette lighter. Never warm a baby's bottle in a microwave oven: Hot spots in the milk can be scalding even when the bottle feels cool. Always test the milk temperature on the underside of your wrist.

Small round bibs are useful for keeping drool off clothes. For the mess that babies or children always make with their solid food, they need a large bib of plastic, nylon, or terry (or a combination), preferably with a pocket along the lower edge to catch the food that comes running down. A formed plastic bib with a food catcher on the bottom is easily rinsed. A terry bib can also be used for wiping the face — if you can find a dry corner. Bibs make wonderful gifts.

Pacifiers. If you decide to use them, three or four will do (see page 63). The practice of blocking up a baby bottle nipple with cotton or paper and using it as a pacifier is dangerous, because the contraption can easily fall apart, leaving little pieces that are a choking hazard.

Copyright © 1945, 1946, 1957, 1968, 1976, 1985, 1992 by Benjamin Spock, M.D.
Copyright renewed © 1973, 1974, 1985, 1996 by Benjamin Spock, M.D.
Revised and updated material copyright © 1998, 2004 by The Benjamin Spock Trust

About the Author

Benjamin Spock, M.D., practiced pediatrics in New York City from 1933 to 1947. He then became a medical teacher and researcher at the Mayo Clinic, the University of Pittsburgh, and Case Western Reserve University in Cleveland. The author of eleven books, he was a political activist for causes that vitally affect children: disarmament, day care, schooling, housing, and medical care for all. He had two sons, a stepdaughter, and four grandchildren. Dr. Spock, who died March 15, 1998, at age ninety-four, was married to Mary Morgan. Dr. Spock's Baby and Child Care has been translated into thirty-nine languages and has sold fifty million copies worldwide since its first publication in 1946.