Dr. Spock’s Baby and Child Care for India will be published in India on November 1, 2012.

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 Buy the new e-book on Amazon for $1.99

“Trust yourself. You know more than you think you do.”

—Dr. Spock

Over 50 million copies of Dr. Spock’s baby care book sold—now available in e-book format for the first time.

Generations of parents have relied on Dr. Benjamin Spock’s timeless bestseller, Dr. Spock’s Baby and Child Care. It remains the source book, the most authoritative and reliable guide available—no other book besides the Bible has sold so well. Now, after sixty-five years in print, the 9th edition of the beloved guide for new parents is published by Skyhorse Publishing in a color, e-book format for the very first time.

While it is still available in paperback, Dr. Spock’s Baby and Child Care is now available for Kindle, Nook, and iPad from Skyhorse. Along with more than 1,000 pages of invaluable time-tested wisdom as in its previous editions, the e-format will include a search function to help parents locate terms, and updated information by Dr. Robert Needlman on relevant topics, such as:

• Child care in an era of expanding choices
• Promoting success without overstressing competition
• Electronic media and the obsession with electronic games
• New views on nutrition: how to prevent obesity and other chronic illnesses, and enrich happiness
• Creative coping with the stress of economic insecurity
• Diversity in cultures, families, parenting beliefs, and children themselves
• The newest thinking on children with special health and developmental needs
• Solid approaches to common, yet severe conditions including ADHD, autism spectrum disorders, and depression

 Buy the new e-book on Amazon for $1.99

Generally (but not always) if you can do your first labor without drugs, the others are easier. This one wasn’t so easy. The baby was facing up, and the pushing was painful and took longer than expected. I know she had second thoughts about natural childbirth as the labor wore on. If I hadn’t been there, I have no doubt the nurse would have “felt sorry” for her and encouraged her to get an epidural. But the next day, I asked this patient if she was sorry that she didn’t end up getting an epidural; she said no, she was glad, because she felt so great afterwards, and the baby was so alert and nursed so well. Her husband was awfully proud of her too.

 You don’t run a marathon with the goal of avoiding discomfort, and some mothers-to-be want to experience childbirth as women have experienced it for millennia. Natural childbirth isn’t for everyone, but I wish the healthcare team, in our wisdom, could individualize care, and rather than responding reflexively that epidural anesthesia is the answer to everyone’s labor pain, target our support measures to the desires of the laboring woman.

What does this mean for a mother-to-be? Talk to your doctor or midwife, take a tour of your labor unit, talk to your support team, and try to set the scene for the sort of labor you hope to have. Labor is unpredictable, and will probably not go exactly as expected. But preparation: educational, psychological, and logistical, can help shift the odds towards whatever you consider ideal.

So what do you need to do?

• Get in shape. Normal body weight, strength, and stamina make pregnancy easier and healthier. Now is a great time to sart toning up. Strong abdominal muscles prevent low back pain; regular aerobic exercise, if continued through the pregancy, make labor easier. Being fit from the start helps you stay comfortable  as you carry your growing baby.
• Eat well. You don’t need to eat specific foods while you are trying to conceive, but some fish high in mercury content should be avoided for three months before conception and throughout pregnancy. For a full list of which fish and other foods to avoid, see the information from the Centers for Disease Control.
• Take folic acid. Here is one simple recommendation that will help prevent birth defects—take a folic acid supplement every day. 400 micrograms or 0.4 milligrams of folic acid is now recommended for all women in their childbearing years, regardless of whether they are trying to get pregnant. The amount of folic acid most women get in the diet just isn’t enough. 400 micrograms a day can be found in folic acid supplements, in any women’s multivitamin, and in over-the-counter prenatal vitamins. One word to the wise here: more is not better. Mega-doses of vitamins are not good for a developing embryo and should be avoided, unless prescribed by your physician.
• Avoid acohol and drugs. You’ve probably already heard that alcohol causes birth defects. Yet many women come to their first prenatal appointment upset that they had some drinks before they knew that they had conceived. A rare glass of wine probably doesn’t cause harm, but daily moderate drinking or episodic heavy drinking can cause fetal alcohol syndrome (FAS), with mental retardation, unusual facial features, and poor growth. Subtle problems may be found with lower levels of alcohol use. Recreational drugs may also be dangerous to the developing baby. Cocaine causes spasms of the blood vessels, and can lead to miscarriage, preterm delivery, poor fetal growth and even fetal death. Marijuana probably has some of the same risks as cigarettes, since toxins get into the bloodstream and reach the baby. If you wouldn’t let your child use a drug, you shouldn’t use it during pregnancy. Fertility is also decreased in men who smoke marijuana daily.
• Be a nonsmoker. Babies of smokers are more likely to deliver early and to be smaller than they should be—a half a pound smaller per pack-a-day smoked. Infertility and miscarriage are more frequent in smokers, too. Research has even shown that SIDS, sudden infant death syndrome, is more common if the mother smoked. The best approach is to start pregnancy as a non-smoker. If you need help quitting, talk to your doctor or midwife, and check out this helpful Internet resource.
• Limit caffeine. One or two caffeinated drinks a day is probably OK. Excessive caffeine has been associated with miscarriage.
• Avoid any unnecessary medications. If you take prescribed medicine, be sure your doctor is aware that you may become pregnant.

Many doctors and midwives offer a pre-conception appointment, so you can get individualized health and lifestyle advice.  For women who aren’t in perfect health or who have potentially toxic exposures, taking care of yourself before pregnancy assures that you will be in your best shape in early on when the baby’s organs start to form. Remember, early embryonic development begins before you may know that you are pregnant, and weeks before you start prenatal care. Now is the best time to start taking care of your baby-to-be!

Two words to the wise first:

1. This article is for mothers-to-be in the last month of pregnancy. Before that time, preterm labor can be mild, and is much easier to treat if you come in early on. So if you are more than a month before your due date, these guidelines are not appropriate for you. If you think you may be having signs of labor, call your doctor or midwife, or go to your hospital!

2. It is always a good idea to get advice from the professional who knows you best. If you have had rapid labor in the past or if you have complications of pregnancy, individualized specific recommendations from your doctor or midwife will be most useful. These recommendations are not one-size-fits-all for every mother-to-be.

Are You Having Contractions?

The contractions of real labor are typically strong and regular, and get stronger over time. In true active labor, contractions are typically uncomfortable enough that you have to change your activities to get through. You may need to pace around, or change your breathing, or make yourself relax. During true labor contractions, people around you can usually tell that something is happening-they can see it in your face. When contractions are strong like this, coming every 2-5 minutes for at least an hour, it is usually time to head in.

Did your water break?

If you have any question that you broke your water, call your practitioner. About ten percent of women break their water before labor begins. Although usually a pop and then a gush, constant trickling can also be a sign that amniotic fluid is leaking. Once the bag of waters has opened, the baby is less protected from bacteria from the vagina, and infection can occur. If you don’t go into labor on your own shortly, induction of labor is usually advised. On the other hand, most women don’t break their waters before labor, so you most moms can’t wait for this sign to tell them it is time to head in.

Are You Bleeding?

A small amount of vaginal bleeding, usually mixed with some mucus, is common within a week or two before labor. This is the “mucus plug”, and is of no significance. It is also common to have a little bleeding after an internal examination or after intercourse late in pregnancy. Bleeding like a period is never normal in pregnancy, and should lead you to immediately contact your practitioner or go to the hospital.

What do you do if this seems like real labor?

Most practices want to hear when their patients are coming in to the hospital. You should receive a phone number to call in case of emergency. If they don’t give you a special number, the office number that you use to make appointments probably is forwarded to an answering service on off-hours. Be sure you have appropriate contact information for problems and that you know what you should do when you are in labor.

And don’t forget to do a dry run of how you are going to get there, and have bags packed a few weeks ahead! The big day is almost here!

The first six weeks
For most jobs, federal laws require that your employer cover the six weeks of postpartum recovery as any they would handle any other disability leave. Depending on your contract you might use sick days, short-term disability pay, or, if you are out of sick time, leave without pay. Some contracts specify maternity leave policy, but the first six weeks can’t be less generous than disability leave would be for any other condition. One silver lining if you end up having a cesarean: you may be able to extend the “disability” time to eight weeks, with a note from your physician.

Through 12 weeks
If you are covered under the Family and Medical Leave Act (FMLA), you are allowed twelve total weeks of parental leave, but this runs simultaneously with any other paid leave. Generally FMLA allows you to get six more weeks after your first six “disability” weeks. You may be able to work out an arrangement with your employer to work part time for several months or spread these six weeks of days through the child’s first year of life. The law doesn’t require that you be paid during this time, though. If you worked part time last year, work for a smaller company, or haven’t been at your job a year, you may not be covered by FMLA, and your employer isn’t required to allow more than the disability time off. But many smaller firms have policies that parallel the FMLA.

Beyond three months
Some jobs and some states have more generous policies than those required by federal law. Check with human resources to find out the policies at your workplace, and with www.nationalpartnership.org to find out state-by-state requirements. You also may be able to individually negotiate leave beyond your employer’s standard benefits.

People may seem judgmental about how much maternity leave you take. You may feel pressured to go back to work quickly, or to take more time off than you really want, or both. Keep in mind that it is usually easier to go back to work earlier than planned than it is to extend your leave as the time to return gets close. Many experts recommend planning for maximal leave, and then going back early if that seems right when the time comes. Listen to your heart, and talk to those who know you best. The decision on how much time to take off is a very personal one. You are the one who knows best what is right for you and your family.

Guiding our children toward healthy eating habits isn’t easy. Children are not particularly concerned about the problems that come from unhealthful diets. The foods served at school may not be what you would offer at home. Television and other electronic media give children the wrong message. Just think about the kinds of foods that are advertised to children — they’re mostly not vegetables. Children are bombarded with commercials for sugar-coated cereals and fast foods; they know the jingles even before they can read. It’s no wonder they grow up with the message firmly implanted that junk foods are what they want. (The processed food industry spends something like $12 billion each year marketing its products to children. Some countries have laws against this activity, but in the U.S., when it comes to food there is no limit to what can be told, and sold, to children.)

The link between TV viewing and obesity is very strong: the more TV a child watches, the more likely he is to become obese. Better nutrition is just one of the many good reasons to limit TV viewing. Of course, what we feed our children is only part of the equation; we also have to figure out better ways to build exercise into our lives and our children’s.  As a general rule, children pay more attention to what their parents do than to what they say. So, if we want our children to get a healthy start in life and to maintain it by continuing to eat well and stay fit, we have to lead by example.

Awareness of the role of nutrition in health has never been higher.  In fact, there is so much information coming out all the time that it’s easy to become confused.  If you were actually to follow each new recommendation, you’d never know what was going to show up on your plate.

There are some basic concepts, though, that almost everyone agrees on. Healthy diets contain less saturated fat and refined sugar, and more complex carbohydrate, lean protein, and unsaturated fat.  Simple foods – whole grains, fruits, and vegetables – provide a complex mix of nutrients that support health during childhood and throughout life. If you offer healthful foods in a predictable and pleasant setting, you can count on your children to eat enough to meet their needs. The sections that follow should help you to figure out how make these principles work for you and your children.

Food preferences are learned early. Children who are cheerfully and regularly offered a variety of healthy foods learn to prefer these foods. The trick is to make them a regular part of the family diet, without putting too much emphasis on the fact that they are “good for you” (with the clear implication that “nobody really likes to eat this stuff”). Telling a child, “If you eat your broccoli, I’ll give you some dessert,” just makes him hate broccoli. If healthful foods are part of the family routine, children accept most of them naturally.