Most children are diagnosed with ASD around 4 years of age, but the CDC now recommends screening at a younger age to ensure early intervention and better developmental outcomes.

Despite widespread research, the cause(s) of ASD is unclear, making efforts to inform parents about early signs and symptoms challenging. Authors Julia Cook and Dr. Laura Jana (illustrations by Allison Valentine) take a novel approach with their picture book, Amazing Me—It’s Busy Being 3!

Amazing Me can be downloaded online for free as part of the CDC’s “Learn the Signs. Act Early” campaign, designed to teach parents about child development and early warning signs of autism and other developmental disorders.

Amazing Me features Joey the kangaroo demonstrating developmental milestones appropriate for 3-year-olds. These include social/emotional skills (taking turns in games), language/communication skills (following instructions with two or three steps), cognitive skills (playing make believe), and movement/physical skills (climbing and running). A milestone checklist appears at the end of the book. Parents can also find tips for spotting delays, talking to doctors, and getting referrals on the CDC website.

Read here for more information on ASD or visit the Autism Society.

“What if children…owe our constellation of traits not only to the genes we inherit at conception, and not only to the world we encounter after birth, but also to the nine eventful months in between?”

In other words, what if your life is mapped out for you before you’re even born?

She’s not talking about the general inheritance of certain traits from one’s forebears, but rather the choices a pregnant woman makes that will have specific outcomes in the child’s life for years to come.

As a science writer, Paul knows that there is a burgeoning body of research focused on the womb and what’s going on inside. The idea of “fetal origin” has been increasing in recent years, and Paul’s book Origins: How the Nine Months Before Birth Shape the Rest of Our Lives is a fascinating look at what scientists are learning.

Paul’s gift is to translate that research into everyday language, empowering readers to make healthier choices for themselves and their children.

Yes—there are choices. While Paul writes about the influences outside of the womb that affect the baby within, including exercise, depression, chemical exposure, stress levels, even catastrophic world events. Some of these influences are obviously not within our control, but others are. And Paul’s book is hardly a doomsday scenario; rather, she encourages women to focus on the positive influences they can have on their babies during pregnancy. Paul doesn’t just preach these changes in habit, but instead she makes changes throughout her own pregnancy, generously sharing her personal experiences with the reader in an effort to lead by example.

While the whole book is a fascinating blend of sound medical research and personal experience, I found the sections on mood and diet—two things with which every pregnant woman is well acquainted—most intriguing.

Emotions
It’s easy to accept that a pregnant woman should eat well and exercise. Some people might have a harder time believing that an expectant mother’s mental state could have a very real affect on her fetus. After all, we’ve long rejected the sweeping “insanity of pregnancy” diagnosis given to emotion-charged, pregnant women in the 19th century, just as current thinking rejects the notion that a woman’s desire to be pregnant is the same thing as wanting to have a penis (a Freudian theory). However, current research recalls “maternal impressions,” a popular 18th century belief that specific acts or thoughts of the mother would physically manifest in the child. While today’s science is not saying exactly the same thing, recent studies show that a woman’s emotional state “can influence the fetus’ developing brain and nervous system, potentially shaping the way the offspring will experience and manage its own emotions—a kind of material impressions redux,” writes Paul.

Researchers are still trying to find out whether a mother’s mood can be transmitted to the fetus, how that might happen, and how those moods might affect fetal development. One study of depressed women found that an increase in maternal heart rate, blood pressure, and respiration, caused an increase in fetal heart rate as well. Whether the cause is genetics or related to the mother’s nervous system, the result is also apparent after birth. As Paul writes, research shows that children of depressed mothers are more reactive to stress, more irritable and harder to soothe, have more sleeping problems and higher levels of cortisol (a stress hormone) in their blood.

Diet
Two-thirds of American women of childbearing age are overweight. One in five who give birth is obese. Paul quotes a 2009 study that found 73 percent of American women failed to follow weight gain guidelines during pregnancy, with most overweight women gaining too much weight. More recent studies show that overweight and obese women are more likely to have children with birth defects (which can occur at conception or in early pregnancy) and children who are overweight.

One is tempted to say that “intergenerational transmission of obesity” is environmental given that kids will eat what their parents eat. But Paul shares a study that looked at siblings who were born after mothers had successful anti-obesity surgery. These children were 52 percent less likely to be obese compared to their siblings who were born to the same mother when she was obese. These children shared the same mother, but completely different intrauterine environments. (If you’re interested to learn more about how genetics, environment, and maternal choices play a role in a child’s risk for obesity, read this.)

Getting personal
Readers who’ve gone through a pregnancy will feel a certain kinship as Paul offers candid and engaging glimpses of her pregnancy and everyday life with her husband and older son. She has a knack for taking broader issues and making them personal and interesting. When she writes about pregnant women and diets, for example, she examines the way Americans view and experience food in general before recounting her own quest for healthier eating, including the details of a particular grocery run. When she writes about babies forming their dietary preferences while still in the womb, tasting their mothers’ food via amniotic fluid, she considers her own unborn child.

“As I dig into my Penang curry with chicken and green beans, I’m thinking not about calorie counts or nutrient quotas, but about the distinctive diet to which my future child is already being exposed: the exuberantly polyglot menu of a twenty-first century Manhattan dweller with a world of tastes—Indian, Mexican, Chinese, Italian-American pizzeria—just down the block,” she writes.

There’s certain anticipation as you near the last chapter, “Nine Months.” The whole book has led up to this moment, the birth of her child, and because of Paul’s engaging writing, you feel like you are about to witness your friend’s birth. Yet, it is the one time when Paul fails to share a complete picture of her experience. She writes about how modern doctors try to manage all aspects of pregnancy and childbirth; how interventions change the actual length of pregnancy; how the cesarean section (c-section) rate in the U.S. continues to grow.  “Women undergoing a scheduled c-section, like me, may know their future child’s birthday months in advance,” writes Paul, leaving one to wonder why she’s having a c-section. In fact, by the end of a book filled with introspection, the absence of explanation is jarring.

What she does share of the birth is, again, recognizable to any mother: “There’s a moment of stillness,” she writes. “I realize that I’m holding my breath. Then—an eruption of noise and motion. In the din there’s a sound I hear above all the others: a baby’s cry, rising in indignation.”

It’s the moment that makes all of those nine months of planning and plotting and worrying and research just slip away.

Will this book make pregnant women worry that they aren’t doing the right thing, or enough of it?

Is it just one more tome telling mamas-to-be what to do, sending them over the edge of overachieving anxiety?

No, I don’t think so. Paul’s tone is far from judgmental, and she reminds the reader of something very important: there is no “ideal pregnancy” to aspire to. She says, “There is instead a highly personal and particular shaping of the fetus for the specific world into which it will be welcomed.”

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, assistant preschool teacher, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.

But when her child was 15 months old and scheduled to move from the infant to the toddler room, the child care center told Alicia that she would not be able to nurse her child during her lunch breaks in the toddler classroom. She would still have access to the infant room or the staff lounge, but the toddler room was off limits. She recalls the center telling he, that it was “inappropriate to expose the toddlers to breastfeeding because some of their parents might object.”

Alicia immediately wrote a letter to the director with a tidy list of bullet points refuting that position by stating that breastfeeding is appropriate for toddlers, not in any way indecent, and completely protected by the law. She wrote that she enjoyed being in her daughter’s classroom, and that she wanted her daughter to feel comfortable—not excluded or ashamed.

After reading the letter, the director re-evaluated the center’s position and informed Alicia that she could breastfeed her child anywhere she chooses.

“I was pushing a comprehensive breastfeeding-friendly initiative to the board when the child care center got into financial trouble and suddenly closed,” says Alicia, who was able to breastfeed her daughter, now 5, for four years. (She currently breastfeeds her younger daughter, age 2). “It’s not that they were hostile to breastfeeding before; they were trying to be breastfeeding-friendly. I just brought up some issues that they hadn’t dealt with before and hadn’t had to think about yet.”

The business side of breastfeeding
All across the nation, the concept of a “breastfeeding-friendly” child care center is gaining momentum. According to the Centers for Disease Control and Prevention, two-thirds of American infants are routinely cared for by someone other than a parent, and about half of those children attend child care centers (the other half are in home-based settings). Whether traditional or home-based, child care providers “play an important role in promoting breastfeeding” for those mothers who use them, say the CDC.

In an effort to track how well child care centers nationwide do or do not support breastfeeding, the CDC Breastfeeding Report Card has a category that first appeared in 2010 called “State child care center regulation supports lactation.” States given the “optimal” rating based on the National Resource Center for Health and Safety in Child Care and Early Education best care standards on breastfeeding, provide accommodations for a mother to breastfeed her child onsite.

The 2011 report card rated only six states—Arizona, California, Delaware, Mississippi, North Carolina, and Vermont—“optimal.” All other states were either “less optimal” or “not optimal,” which suggests that U.S. day care centers still have a long way to go in supporting breastfeeding mothers.

It’s not just the CDC promoting breastfeeding in child care centers. Michelle Obama’s “Let’s Move” Child Care Checklist encourages child care centers to handle expressed breast milk and welcome mothers to breastfeed onsite.

There still is no nationwide program that specifically targets breastfeeding support by child care providers, but several states do have their own resource kits.

Apart from the health and financial benefits to both a mother and baby, it turns out that breastfeeding is also the best choice for child care centers. “Breastfeeding makes good business sense,” says The Wisconsin Department of Health Services in their “Ten Steps to Breastfeeding Friendly Child Care Centers” resource kit. The department cites research that shows companies providing time and space for women to express milk enjoy significant cost savings, including lower rates of absenteeism, lower health care costs, better retention of employees, and higher productivity and company loyalty. “We know it will take the active involvement of many public and private partners to change systems, community, and individual behaviors,” they admit, but note that child care centers are a key environment to make progress.

Wisconsin’s resource kit includes a self-appraisal questionnaire to help the child care center evaluate how they may already be helping breastfeeding mothers, and thoroughly reviews 10 steps—everything from training staff to offering comfortable places for moms to breastfeed or pump, to even incorporating the concept of breastfeeding in learning activities that will transform any center into a truly breastfeeding-friendly one.

Child care centers are “the natural and logical place for supporting breastfeeding,” says the Texas WIC program’s “Supporting Breastfeeding Mothers: A Guide for the Childcare Center.” The program notes that child care centers benefit from breastfeeding babies too: “Infants are more resistant to illness, diapers have less odor, baby is happier, [and] breastfed baby spits up less”—all things that would be appealing to any child care worker.

Working with your care providers
Of course, that’s not to say that a “less optimal” or “not optimal” state has no hope. New York—a “less optimal” state—encourages child care centers to achieve the “breastfeeding-friendly” designation. Like the Texas program, the New York Department of Health mentions the same benefits breastfeeding brings to child care centers, but adds another incentive: meals containing breast milk are reimbursed by the Child and Adult Care Food Program. An official breastfeeding-friendly designation can also help market the center in advertisements and on the Department of Health’s directory of breastfeeding-friendly day care centers.

Caroline Moran, director of the Imagine Early Learning Center at DUMBO in Brooklyn, New York, sees supporting breastfeeding as just part of the job. The center hosts educational seminars on breastfeeding and welcomes parents to send bottles of expressed breast milk or visit anytime during the school day to breastfeed their children. Imagine’s official Breastfeeding Support Policy, which includes contact information for breastfeeding resources, is part of the registration package.

“I think part of our job is to have a relationship with the parents,” says Moran. “One where we support them and make it as easy as possible for them to leave their children in a safe and nurturing environment.”

That kind of comfort can pave the way for extended breastfeeding, as it did for Carrie Bishop and Abigail Hill, both mothers in Athens, Georgia, who use child care while breastfeeding their toddlers.

Bishop (who breastfeeds her 2-year-old son) has always been able to breastfeed onsite. “[At pick-up time], the center would simply say, ‘Oh, have a seat.’ They never made me feel weird about it,” says Bishop, an instructional designer at the University of Georgia.

Hill, a clinical social worker, says child care staff welcomed her bottles of expressed milk and daily lunchtime visits to breastfeed first her older daughter and then her son (now 2 and still breastfeeding).

When looking for a child care center, Bishop suggests finding one that already has breastfeeding support policies, or, learn to speak up. You might have to be the parent who shows them how to handle breast milk, how to gently swirl instead of shake, how to offer smaller quantities in several bottles.

One mother who isn’t worried about early weaning is Sarah Ciccarello, an elementary school teacher in San Jose, California (an “optimal” state). Understanding that breast milk can sit at room temperature for 6–8 hours, the center where she sends her 4-month-old son agreed to re-offer partially consumed bottles of breast milk to complete a feeding. (As long as the bottles are refrigerated and the feeding is completed within 1–2 hours.) Staff also agreed to refrain from feeding her son for 1–2 hours before his scheduled pick up, so he’ll be hungry enough to nurse. She has breastfed her son onsite with no problems. When he went on a bottle-strike after Christmas break, they called her on the phone so she could plan to visit and feed him during her lunch break.

If your child care center isn’t as knowledgeable about best feeding practices but is receptive to learning more about breastfeeding, then you might need to pave the way to help future mothers navigate the uncertain waters of returning to work or school.

To jump-start the conversation, consider the following advice from the United States Breastfeeding Committee: “Integrating breastfeeding into child care settings promotes good health for the baby and mother, saves money, and contributes to the overall well-being of a community. It is not just a parent issue, a child care issue, or a health and nutrition issue, but ultimately an important public health issue that affects everyone.”

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, assistant preschool teacher, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.

Research reveals new information about the importance of breastfeeding and breast milk, but what we know about breastfeeding basics is pretty uniform. There’s no shortage of parenting websites and books, or even videos on YouTube, that will tell you why breastfeeding is best for babies and show you tips and techniques to get breastfeeding off to a good start. So what makes this DVD special?

It’s all about the presentation. The tone. The message: There is no singular right way to breastfeed; you are not alone in your concerns, worries, obstacles; you can do this. That’s where this DVD shines. Helped by the fact that it features real moms breastfeeding and talking about it, giving the video a refreshing sense of authenticity.

It starts out with the encouraging suggestion that breastfeeding is simply the next part of what you’ve already been doing:

“For nine months, you’ve been making a miracle,” says the narrator Alyson Steel). “…And your decision to breastfeed your baby will continue the brilliant work you’ve already done, because breastfeeding is the single most important step you can take to ensure your baby’s continued growth, health and well-being.”

The moms who appear in the video look like people you know, of various ethnicities, ages, body sizes and shapes, and tattoo preferences. Sometimes they talk directly to the camera, but most of the time they are busy having genuinely sweet interactions with their babies—snuggling, gazing in adoration, and of course breastfeeding.

And this is real-life breastfeeding: you see it all. Sometimes the moms are completely shirtless, sometimes they are only partly exposed, but either way the viewer gets what she needs the most—seeing what a real-time breastfeeding latch looks like, not some drawing that bears little to no relation to what you see when you look down at your snuffling and gaping child. The material might sound explicit to some with more modest tastes, but it’s a DVD about breastfeeding, for heaven’s sake. And everything is presented in a matter-of-fact way—a glimpse into what life would be like if breastfeeding was more visible in this country, with partners and siblings alike comfortably hanging about while mom and baby do their thing.

The DVD’s script offers sound information and the latest research on breastfeeding, but delivers the facts in a conversational tone. I was happily surprised to see that it included footage of a Breast Crawl—something never discussed with me when my son was born just five years ago. In the clip, a brand new baby wriggles his way up his mother’s naked torso and instinctively finds a breast, crying just a little until finally latching on, nearly unassisted.

“The fact is that babies come into the world already knowing how to breastfeed,” intones the narrator. This is something all mothers at least inherently suspect, even when experiencing breastfeeding problems, but seeing it in action like this is quite moving.

Another pleasant surprise was the take on different breastfeeding positions. “Until a few years ago, we made a very big deal about positions for you and your baby,” says the narrator. These days, however, the best thing is “whatever works best for both of you.” The DVD does illustrate different common holds like the cradle, cross cradle, football, and side-lying positions, but it also encourages simply lying down with your baby on top of you, with as much skin-to-skin contact as possible. “In this position, you don’t have to do a thing, because your body supports your baby completely, and gravity does the rest.”

The nuts and bolts of the DVD (how breastfeeding works, why it’s important, how to do it) aren’t that surprising, but they are thorough, taking you from the first days after birth to the experience of weaning (the narrator does remind us of the AAP’s recommendation to breastfeed exclusively for six months, then at least one year or beyond).

There are also sections that discuss the partner’s role (“Simply put…to nurture you, so you can nurture your baby”) and frequently asked questions. Before you hear the expert answers to those FAQs, you first get moms sharing their individual experiences on the issue, which means you get a lot of different answers, sometimes with overlap, but mostly showing you that there is often no “one answer fits all” solution to common breastfeeding questions. This technique illustrates the idea that while breastfeeding has some universal qualities, it’s a highly individual experience.

The FAQ section also makes a case for finding a support network, reminding the viewer that every problem you might experience while breastfeeding has absolutely been experienced before by someone else, and there’s a solution to that problem. A tight circle of real-life buddies can get you through a lot. Lactation consultants and other experts can move mountains, but sometimes you just need to hear another tired mom like you say, “I hear you. It will get better.” You reach the credits feeling less isolated as you begin to navigate the world of breastfeeding.

The DVD’s production values are solid. Everything is brightly lit, glowing with lots of white backgrounds—a nice, refreshing reprieve for sleep-deprived eyes. I was a little surprised to learn that filmmaker David Stark has no children of his own. My initial reaction was, “Why was a man with no direct connection to breastfeeding compelled to make a breastfeeding DVD?” If you are wondering the same thing, he does address that here, while paying heartfelt tribute to his own mother. And while the DVD makes it very clear that it’s not a substitute for medical advice, it does credit six breastfeeding experts who support the medically sound advice.

Of course, mothers are the experts of their own experiences, and some of the most poignant, stick-with-you moments come from moms speaking (seemingly) off-the-cuff about what breastfeeding means to them.

“When I nurse, it is the most amazing feeling…together he and I are growing and I am giving him what he needs to be a strong, healthy young man…[it’s] like nothing I ever thought I would experience,” says one emotional mom. “And I wouldn’t trade it for the world. I would never trade that for anything.”

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.

The day was consumed with whining by my 5-year-old son and voice-raising by me—back and forth, a cycle we couldn’t seem to break. I was hoping for a bit of bedtime magic.

I asked Tommy to sit with me and read Yawning Yoga: A Goodnight Book for a Good Night’s Sleep, a new picture book by Laurie Jordan.

It proved to be the magical touch we both needed.

Bedtime in our house can be laborious. Tommy resists it like many children.

Today had been particularly tedious and Tommy was unusually ornery. I didn’t know what to expect when I suggested we read Yawning Yoga. I was surprised by Tommy’s willingness to curl up next to me, book in hand.

Appropriate for any child who enjoys picture books, Yawning Yoga uses short and playful poems to describe various yoga moves. Instructions for Downward-Facing Dog, aptly named “Dog-Tired Down Dog,” include, “Get onto all fours like your 4-legged friend. Becoming a dog is fun to pretend.” Aaron Randy’s illustrations are bright and cheerful yet surreal and dreamy, such as a child lying in a bed-sized plate of spaghetti, preparing to have her arms and legs wiggled by a parent for the “Spaghetti Test.” The pictures also have a cozy, warm, glowing quality, which is appropriate given the book’s final word, Namaste, which means “The light in me sees the light in you.”

The yoga poses are arranged in a specific sequence, starting with broad exercises that gradually become more focused and calm. The exercises at the beginning of the book are intended to “blow off steam,” while those at the end target stretching, breathing, and guided visualization.

Tommy grinned his way through each exercise. The first poem, “Greet the Moon,” had him stretching his arms to the ceiling pretending to catch a passing star. “Good Night Little Body” was similar to a bedtime routine we often do in which Tommy says goodnight to each body part. He thoroughly enjoyed having me wiggle his arms and legs for the “Spaghetti Test,” although it took a while for him to relax his limbs enough to get the full effect. We both enjoyed “Ocean Breath.” “That’s so relaxing,” sighed Tommy. “Wishing Star” encourages children to describe a star in their imagination and introduces the concept of meditation, which I appreciated. In “Mind’s Eye” readers travel somewhere “safe and secure” thinking about what they see, hear, and feel when they get there. I chose a beach. Tommy picked Pump It Up, one of those places where a warehouse-sized building is crammed full of gigantic inflatable bounce houses and screaming children.

While we enjoyed all of the poems, a few tripped us up. Some of the language of “Jiggle and Wiggle” gave Tommy pause—“What’s Jell-O?” he asked, as we tried to mimic the movement of an unfamiliar food. And we completely misread “The Twister,” not understanding that we were supposed to lie down. We realized later that there was an illustrated index featuring black and white photographs of each yoga pose along with detailed instructions.

Questions have been raised about the safety of yoga for young children. Since this book relies more on gentle stretching and relaxation, it’s unlikely to cause any problems. Poses are not held but gently explored—in the “Dog-Tired Down Dog,” the child stays busy wagging his or her “tail” and moving “paws” in a way that would be natural in even non-yoga imaginative play. (For more on yoga dos and don’ts, see baby gooroo’s safety tips.)

Calming words and soothing pictures aside, I loved this book because it encouraged interaction between parent and child. You can’t just read the book, you have to get in on the action and try out each exercise.

I can see this book becoming a regular part of our bedtime routine. When Tommy whispered “Namaste” to me at the end, it was an incredibly sweet moment—a good note on which to end a stressful day.

When my alarm went off at 6 a.m. the next morning, I was shocked to find Tommy still asleep in his own bed (he usually crawls into our bed sometime during the night).

Was it the magical influence of Yawning Yoga: A Goodnight Book for a Good Night’s Sleep? I don’t know, but we’re reading it again tonight!

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.

The transition from breastfeeding fully to not breastfeeding at all starts the moment you give your child something to eat or drink other than breast milk. Ideally, weaning occurs gradually over a period of weeks, months, or years. Occasionally, a crisis occurs and a mother is forced to wean quickly.

Mother-led weaning
Mothers who choose to wean may still have mixed feelings as the process unfolds. Talking with other mothers about their weaning experiences can often make the transition easier. During mother-led weaning, mothers typically replace one daily breastfeeding at a time with solids or liquids, depending on their child’s age and ability. Weaning slowly gives you, your child, and your milk supply time to adjust.

Sudden weaning has distinct drawbacks. Not only can it lead to plugged ducts and mastitis (a breast infection), it can also trigger a range of emotions such as guilt or sadness. Feelings of sadness may be due in part to the shift in hormones—a decrease in prolactin and a reintroduction of menstrual hormones—that occurs when a mother stops breastfeeding. But more often the sadness is the result of breastfeeding coming to an abrupt end.

Child-led weaning
In child-led weaning, the child breastfeeds at her own pace and mom follows her lead. Child-led weaning usually occurs over months, and breastfeeding patterns are often erratic. Your child may only breastfeed in the morning or at night, or once every other day. Some children go a day or two without breastfeeding and then breastfeed several times a day for two or three days. Eventually, your child will stop breastfeeding altogether and be fully weaned.

Occasionally, children 12 months or younger will suddenly refuse to breastfeed. Mothers often interpret this as a sign that their baby is ready to wean, but it probably just a temporary strike. Sometimes the cause of a nursing strike is obvious—ear infection, sore throat, fever, teething—but more often no cause is found. Most babies will resume breastfeeding after several days. Should this occur, increase cuddle time, hand express to relieve fullness, and be patient!

Some mothers who prefer child-led weaning may still find themselves wanting to stop breastfeeding before their child has completed the process. You can still follow your child’s lead, while creating boundaries to accelerate the process.

“In societies where children are allowed to nurse ‘as long as they want’ they usually self-wean, with no arguments or emotional trauma, between 3 and 4 years of age,” writes anthropologist and breastfeeding expert Kathy Dettwyler. While there’s no official “average weaning age,” children typically self-wean around the globe anywhere from the ages of 2 and 7.

Typically, in the U.S., we associate weaning with solid foods, but given that only 43 percent of women in the U.S. are still breastfeeding at six months (the recommended age for introducing solid foods), weaning is often linked to formula use. You may not intend to wean your baby when you supplement with formula, but since milk production is driven by supply and demand, formula use can decrease milk supply, which in turn can lead to earlier-than-anticipated weaning.

For more tips on weaning check out our guide. Click here to read one mother’s experience with child-led weaning.

What is a fever?
A fever itself is not a disease or an infection—it signals your body’s response to one. When you get a viral or bacterial infection, your body responds by raising its temperature, which in turn switches on its immune system. Fevers increase the release and activity of white blood cells, which fight germs, making a good case for not treating low fevers but letting them do their job instead.

Our body temperatures naturally fluctuate throughout the day: higher in the late afternoon and early evening, lower between midnight and early morning. Children’s temperatures vary by age (infants often have higher base temperatures). Your child has a fever if his oral temperature is over 99.5°F (37.5°C); rectal temperature is over 100.4°F (38°C); axillary (under the armpit) temperature is over 99°F (37.2°C); or tympanic (in the ear) temperature is over 100.4°F (38°C). According to the American Academy of Pediatrics (AAP), fevers above 105°F (40.6°C) are considered dangerous and require prompt medical attention. In addition to monitoring your child’s temperature, you should pay close attention to other symptoms.

How to take your child’s temperature
Mercury thermometers were once the mainstay of thermometer technology, but digital thermometers now dominate the marketplace. A recent study by physicians at Children’s Hospital Boston reinforced the fact that glass thermometers are a safety hazard due to broken glass and mercury.

Digital thermometers are specifically designed to check your child’s rectal, oral, axillary, or tympanic temperature and are placed in your child’s rectum, mouth, armpit, or ear. Some digital thermometers are versatile and can be used for rectal, oral, or axillary purposes, while others are made for use in the rectum or ear only.

For newborns–3 months:

• Use a rectal thermometer.
• Rectal thermometers can be used up to age 5.
• There are some concerns about inserting a rectal thermometer too far and perforating (causing a hole in) the rectum. Some thermometers have safeguards, like a wide handle, designed to keep this from happening. When taking a rectal temperature, insert the thermometer only ½–1 inch into the anal opening and hold it loosely in place.

For babies 3 months–3 years:

• Use a rectal, axillary, or tympanic thermometer.
• A tympanic thermometer requires precision and proper use. You might want to get some instructions from your baby’s doctor or nurse before using a tympanic thermometer.
• An axillary temperature is the least accurate of the three temperatures. An axillary temperature can be as much as two degrees lower than a rectal temperature.

For children 4–5 years:

• Use a rectal, oral, axillary, or tympanic thermometer.
• Children can begin holding an oral thermometer under their tongues for the required amount of time around this age.
• To ensure accuracy, wait about 30 minutes after meals, snacks, or drinks to take an oral temperature.
• Wait at least 20 minutes after bathtime to take your child’s temperature, since bathing can affect any temperature reading.

When to call your doctor
The presence of other symptoms play a part in helping parents decide whether to call their child’s health care provider when their child has a fever. Parents may choose to watch and wait if their older child with a higher fever is still able to play and interact normally. But a lower fever accompanied by other symptoms may signal a need for immediate attention.

Call you child’s health care provider right away if any of the following occur:

• 2-month-old or younger with a rectal temperature of 100.4°F (38°C) or higher
• 3­- to 6-month-old with a temperature of 101°F (38.3 C) or higher
• 6-month-old or older with a temperature of 103°F (39° C) or higher
• Sore throat, earache, cough, skin rash, painful urination, stiff neck, diarrhea, vomiting, or seizure
• Behavioral change—fussier than usual, sleepier than usual, confused, unresponsive, lethargic
• High fever for more than 24 hours, even if there is no obvious cause
• History of  febrile (fever induced) seizures

Difficulty breathing, swallowing, or awakening—call 911 immediately.

Finally, parents should feel comfortable calling their child’s health care provider anytime they have a question or concern.

How to treat a fever at home
Fevers typically last 1–2 days. During this time, encourage (but don’t force) your child to drink liquids, as a means of replacing the fluid lost through fever-induced sweating. Dress your child in less clothing—bundling your child, even if she complains of being cold, can cause a higher fever. If your child has chills, use a thin blanket rather than more clothes to keep her comfortable. Try other home remedies to relieve fever such as a sponge bath using lukewarm water (not cold—if your child begins shivering, take her out of the bath). Older children who are active can simply play in the tub.

You can give acetaminophen (Tylenol) to children older than 3 months of age and ibuprofen (Advil, Motrin) to children older than 6 months of age. Before administering any medications, discuss the proper dosage with your child’s health care provider, as it’s based on your child’s weight, not age. Never give your child aspirin. Anyone under the age of 21 should not take aspirin due to its association with Reye’s syndrome (a potentially fatal disease).

Finally, if you breastfeed, keep breastfeeding! Research shows that breastfed babies are less likely to have fevers after vaccinations. Regardless of the source of fever, breastfeeding delivers anti-inflammatory properties, antibodies, and comfort to your ill child when she needs it the most.

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.

Pantley is known for her No-Cry books on sleeping, napping, separation anxiety, potty training, and discipline. The No-Cry philosophy is all about “avoiding tears, stress, and anger and making positive changes in the most productive ways,” she writes in her latest book.

Her gentle and reassuring tone do much to accomplish this.

“While your current struggles with your child’s picky eating are real, important, and frustrating, they will pass in time,” she writes.

Even so, it’s important to provide good nutrition to support both these early years of rapid growth, and in the long-term by establishing healthy eating choices that will influence the rest of their lives.

Pantley’s book helps identify the picky eater and whether he or she is actually unhealthy, reminding you that picky eating is rarely dangerous. Perhaps most importantly, she reminds that you are a loving and normal parent, even if your child’s picky eating has worried you, angered you, or made you feel guilty.

When people talk about picky eating, they so often focus on the control issues—your child is refusing certain foods just so she can control some small part of his or her overwhelming world. One of the book’s strengths is that Pantley goes well beyond that, exploring all of the different reasons why kids are picky.

Why are some kids so picky, or seemingly predisposed to reach for the sweet stuff? Pantley explains:

• Genetics. Research shows that parents who were picky eaters often pass that trait on to their own children.

• Evolution. Breast milk is sweet; poisonous, toxic, or spoiled foods are sour and bitter. Unfortunately, many vegetables fall into that bitter range and invite rejection. (Pantley writes, many vegetables could be sweetened naturally by roasting to caramelization, or mixed with healthy sweets like raisins, yogurt, or cheese.)

• Biology. Babies have more taste buds than adults and therefore “a more enhanced recognition of sweet tastes.”

• Anatomy. One in four babies are “supertasters,” with an unusually high number of taste buds that make many foods distasteful.

• Smell. Scent accounts for 70–80 percent of flavor. Babies and young children have an enhanced sense of smell that makes familiar and soothing smells more appealing.

• The Total Experience. This is Pantley’s term for the overall shape, color, and texture of food and how children like to explore it (and reject it for any of those reasons).

• Familiarity. Unborn babies experience various tastes from their mother’s diet through the amniotic fluid that surrounds them. After birth, those tastes are passed from a mother to her child through breastfeeding. Children typically stick to what they know.

• Growth. Children’s appetites sometimes match the ups and downs of their growth spurts.

• Control. “This is one of the times that he actually has the final say: no matter how hard anyone tries, they cannot make a child swallow something,” she writes.

• Lack of wisdom. Simply put, kids don’t know or care about nutrition!

But parents do know and should care, and it’s important to persevere and offer healthy foods even during periods of picky eating. “Research shows that food preferences are established early in life,” she writes, so you don’t want to get into the habit of caving in, giving the unhealthy food your child is demanding. That creates a “vicious cycle,” writes Pantley.

“By the time your child outgrows these dietary limitations, his food habits are set in place and harder to change,” she adds.

To make it easy on you, Pantley arms you with food facts. She talks about the negative effects of sugar, sodium, fats, and chemicals (including hormones, antibiotics, and pesticides found in food), and the positive effects of eating whole grains, fruits, and vegetables, and dining as a family.

Most importantly, she says, children learn eating habits primarily from their parents. Introducing healthy foods into your child’s diet is the perfect time to examine your own eating habits and lead by example.

But what if you don’t know where to start? Not to worry. Pantley gives you a plan.

She tells you how to prepare both your attitude and your kitchen. She gives you correct portion and serving sizes. And she offers a list of rules, giving you permission to break a few of them when appropriate.

The “Tips, Tricks, and Tactics” chapter is a goldmine: a host of ways to serve your picky eater his favorites, while covertly changing the recipe to make it healthier. There’s even a guide on how to change the recipe gradually over time, for those perceptive eaters who might notice the difference.

There are also tips on making mealtime “fun.” No doubt you’ve already seen a sandwich shaped by a funky cookie-cutter, some cloying nickname given to an otherwise still-uninspired dish, or a pile of vegetables sculpted into something resembling a circus clown. She doesn’t discount those ideas, as they well might work, but she also discusses ways to involve the children themselves in food preparation and presentation.

Another helpful guide offers healthier snacks based on your child’s less healthy favorites. (For instance, if French fries are a favorite, try baked sweet potato or butternut squash fries.) She has also come up with a helpful mix-and-match list of both dips and food for dipping.

The last part of the book is reserved for recipes including stews, casseroles, muffins, and other dishes that look, for the most part, quite appealing to any-aged eater (though vegetarians and vegans will want to look elsewhere for more choices). Only a few of the recipes sneak in healthy food in the guise of sweets; most of the time, there’s no deception, only food that is prepared and meant to look like itself. Pink potatoes are just that, simply tinted with a mix of white and sweet potatoes. There are 21 recipes in all—not quite enough to make this feel like a cookbook, but enough to be a good jumping-off point or inspiration to find other healthy, kid-friendly cookbooks.

Honestly, the book would still be valuable without the recipes. Pantley’s no-shame attitude is a gift to desperate parents dreading mealtimes. In an ideal world, meals and snacks are meant to be bonding times, opportunities to regroup and relax with loved ones. “The rituals that surround food and eating should be pleasant,” she writes. This book is a beacon to anyone who has lost sight of that.

Mary Jessica Hammes is an Athens, Georgia-based writer, trapeze instructor, knitter, gardener, comic book enthusiast, and hula hooper. She is mom to Tommy.