Infant Health

What is infancy?

Infancy is generally the period from birth until age two years. It is a time of a lot of growth and change for children and families.

This health topic covers some of the many issues related to infant care, including: feeding, sleeping, safety and childcare

This information is provided with full-term infants specifically in mind. It is not meant to provide all the information you need to care for your infant.

What are the best strategies for feeding my baby?

Breast feeding, also called nursing, is often the ideal source of nutrition for newborns and can be an easy, healthy, and inexpensive way for a mother to feed her child.

Why is breast-feeding recommended?

Breast milk contains a wide range of nutrients important for baby’s growth and health. In addition, recent NICHD-supported research also suggests that some of the specific fatty acids contained in breast milk play important roles in helping brain development. For example, two specific fatty acids, known as DHA and AA, may help increase infants’ cognitive skills.

Breast feeding is beneficial to the mother, too:

• Nursing helps a woman’s body secrete hormones, causing her uterus to contract and heal. These hormones also postpone the restarting of menstruation.
• Breastfeeding reduces the chance of postpartum depression, enhances mother-infant bonding, and can create a sense of accomplishment and satisfaction.
• Some authorities believe that breast feeding women have lower risks of developing breast and uterine cancers.

How long should a mother breast feed?

According to the American Academy of Pediatrics (AAP) Policy Statement on Breast feeding, women who don’t have health problems should feed their infants only breast milk for at least the first six months of life. After this time, the AAP suggests that women try to continue to breast-feed for the first 12 months of life because of the benefits to both the mother and baby.

The AAP recommends that infants who are weaned (meaning they are no longer breast-fed) before 12 months of age should drink iron-fortified infant formula and not cow’s milk. Many types of infant formulas available in the United States are fortified with DHA and AA, and all formula available for pre term infants is fortified with these fatty acids.

The AAP also suggests introducing solid foods at six months of age. The Academy recommends introducing single-ingredient foods one at a time for a several-day trial before adding a new food.

During the first six months, water, juice, and other foods are generally unnecessary for breastfed infants. Infants should not have anything with fluoride, such as adult toothpaste, during their first six months, whether they are breast- or formula-fed.

What is jaundice?

Jaundice (jawn-DISS) is an illness that can cause a baby's skin, eyes, and mouth to turn a yellowish color. The yellow color is caused by a buildup of bilirubin, a substance that is produced in body during the normal process of breaking down old red blood cells and forming new ones.

What causes jaundice?

Normally the liver removes bilirubin from the body. But for many babies, in the first few days after birth the liver is not yet working at its full power. As a result, bilirubin level in the blood gets too high, causing the baby’s color to become slightly yellow. This is called jaundice.

If your baby has jaundice, it usually does not mean that your baby has liver problems or a “bad liver.” In most cases, it just means that the baby’s liver is slower in removing bilirubin from the blood during the first few days after birth.

How is jaundice treated?

Although jaundice is common and is often not serious, all babies with jaundice need to be seen by a health care provider.

Many babies need no treatment for jaundice. Their livers start to catch up quickly, usually within a few days after birth, and begin to remove bilirubin normally.

For some babies, however, doctors prescribe photo-therapy—treatment using a special lamp—to help break down the bilirubin in their bodies. In some cases, high levels of bilirubin could cause brain injury.

If your baby has jaundice, ask your health care provider how long his or her jaundice will last after leaving the hospital, and schedule a follow-up appointment as directed. If your baby’s jaundice lasts longer than expected, or an infant who did not have jaundice before starts to turn yellowish after going home, contact your health care provider right away.

How can I help my child with sleep?

Helping a child learn to fall asleep and stay asleep is one of the more challenging parts of infant care. Newborns tend to sleep or drowse for 16 to 20 hours a day. Their “internal clocks” are not yet set, so they sleep a lot both during the day and night. Newborns also have small stomachs, so they need to be awake for regular feedings.

After a few months, babies usually begin to sleep in longer stretches at night and are awake for longer periods during the day. Practicing bedtime routines and putting your baby into the crib before he or she falls asleep can help build better sleep patterns.

What is Sudden Infant Death Syndrome (SIDS)?

SIDS is the sudden, unexplained death of an infant younger than one year old. It is the leading cause of death in children between one month and one year of age. Health care providers don’t know exactly what causes SIDS, but they do know certain things can help reduce the risk of SIDS.

How can parents reduce the risk of SIDS?

The best way to reduce the risk of SIDS is to always place babies on their backs to sleep for naps and at night. Babies who sleep on their backs are less likely to die of SIDS than babies who sleep on their stomachs or sides. Placing your baby on his or her back to sleep, for naps and at night, is the number one way to reduce the risk of SIDS.

What are some ways to keep my baby safe?

Keeping your baby safe is one of the most important jobs for parents. The U.S. Consumer Product Safety Commission publishes a booklet called "The Safe Nursery" that provides information on a variety of potential hazards and ways to help keep your infant safe.

What about safety for my infant in the car?

In addition to safety at home, car seat safety is an important part of taking care of your child. The AAP publishes "Car Safety Seats": A Guide for Families, which discusses what type of car seats are best at what ages and other important aspects of car seat safety. Each car seat is different so it is important to carefully review and follow the manufacturer’s instructions.

The AAP also has a section on its Web site dedicated to Safety and First Aid.

What is hyperthermia and how can I prevent it in my child?

The term hyperthermia (pronounced high-purr-THER-mee-yah) refers to heat-related illnesses—or those associated with exposure to high temperature in the environment, causing high body temperature. When the body is exposed to high temperatures, like on a hot day, the body normally cools itself using different mechanisms, such as heavy sweating and losing heat through the skin. But in certain situations, such as when inside a parked car when it is warm or humid, or in a desert climate where it is can be very hot and dry, sweating and other mechanisms may not be enough to cool high body heat. As a result, the body’s temperature rises quickly and may damage the brain and other organs in the body. Normal body temperature is 98.6 degrees Fahrenheit—Hyperthermia occurs when the body heats up to 104 degrees Fahrenheit. Body temperature of 107 degrees is usually fatal.

Heat illnesses typically progress from “heat stress”—Physical and emotional stress at being in a hot environment; to “heat exhaustion”—characterized by dehydration, extreme thirst, and weakness/dizziness; to “heat stroke”—which may cause delirium, convulsions, coma, and death.

In the last decade, deaths from hyperthermia have increased, especially among children and pets, mainly as a result of them being left alone in a car for even short periods of time. A child’s body is less effective at cooling itself than an adult body is, and adults can alter their environment by taking off clothes. Even when the outside temperature is at “room temperature” (about 72 degrees Fahrenheit), the temperature inside a car can increase to more than 100 degrees Fahrenheit in just 30 minutes. So, even when the weather is comfortable outside, children are at high risk for heat stroke and death from being left alone in a car.

Parents and caregivers should never leave a child alone in a car, not even with the windows down, and not even for a minute. Parents and caregivers should also develop plans for leaving their car to ensure that everyone exits the car safely and no one is left in the car accidentally. If you see a child left alone in a parked car, you should call 911 to request emergency help—It could mean the difference between life and death for that child.

What about child care for infants?

For many parents and families, child care comes from someone other than the child’s mother. To understand how this type of care influences child development, the NICHD started the Study of Early Child Care and Youth Development (SECCYD) in 1991.

The major goal of the study was to examine how differences in child care experiences relate to children’s social, emotional, intellectual, and language development, and to their physical growth and health. The study examined how quality, quantity, and type of child care setting affect children’s development.

Specific findings from the Study include the following:

• Higher quality care was associated with better child outcomes.
• The number of hours in care mattered in terms of child outcomes to some degree.
• The child care type or setting (child care home, child care center, etc.) had different effects on children at different ages.
• Parent and family characteristics were more strongly linked to child development and child outcomes than any aspect of child care.

The Study also developed a Positive Care giving Checklist (PDF - 1.16 MB) that parents can use to examine the quality of care their child is receiving.

Preterm infants (those born before the mother has been pregnant about 38 weeks) often have special needs. Pre term infants, also known as preemies, are babies born before the mother has completed 37 weeks of pregnancy (or on or before 259 days from the first day of the last menstrual period). Pre-term infants often have special needs, even after they leave the hospital. Infants born only a few weeks preterm (between 34 and 37 weeks, or “late pre term”) often have special needs during the first two years of age. Pre term infants may need to spend time in a Neonatal Intensive Care Unit (NICU) at the hospital until they are big and strong enough to go home. Preterm babies may also need special care even after leaving the NICU. You should talk to your health care provider about your infant’s specific care needs.