Clinical Reference Systems: Pediatric Advisor 10.0
Baby Equipment and Supplies
Before a baby is born, most parents prepare a special room.
They buy a layette including clothing, a place to sleep,
feeding equipment, bathing equipment, and diapers.
The most common mistake parents on a limited budget make
during this time is the purchase of items they don't really
need or expensive versions of essential pieces of equipment.
Indeed, instead of buying everything you need, you may be
able to borrow some baby equipment from friends or
relatives.
Some baby equipment is essential, some is helpful but not
essential, and some is unnecessary for most families. These
three categories of equipment are described below. The
final section explains why walkers are not only unnecessary
but also dangerous.
ESSENTIAL EQUIPMENT
- Safety car seat
Child restraint seats are essential for transporting
your baby in a car. They are required by law in all 50
states. Consider buying one that is convertible; that
is, a seat that you can use from the time your child is
a newborn to the time your child reaches 40 pounds and
40 inches. While your child weighs less than 20 pounds,
the car seat faces backward. When your child weighs
more than 20 pounds, the seat is moved to a
forward-facing position.
Car seats must conform to federal safety standards.
They are also ranked by consumer magazines.
Many hospitals have a rental program for car seats that
can save you money unless you are going to have several
children.
For more information, see Car Safety Seats.
- Crib
Your baby will spend much time in the crib unattended,
so you must make certain it is a safe crib. Federal
safety standards require that the crib bars of all cribs
built after 1974 be no more than 2 and 3/8 inches apart.
The purpose of this restriction is to prevent a child
from getting his head or body stuck between the bars.
If you have a crib built before 1974, check the distance
between the bars. The width of 2 and 3/8 inches is
approximately the width of three fingers. Do not buy or
use a crib with spaces larger than this. Also check for
any defective crib bars.
The mattress should be the same size as the crib so that
your baby's head can't get caught in the gap. It should
also be waterproof.
Bumper pads are unnecessary because infants rarely
strike their head on the railings. The pads have the
disadvantage of keeping your baby from seeing out of the
crib. Also, an older infant might climb on top of the
pads and possibly fall from the crib.
During the first 2 or 3 months of life it may be more
convenient for feeding during the night to have your
baby sleep next to your bed in a bassinet. A drawer,
cardboard box, or basket with a firm pad on the bottom
will also work.
- Bathtub
You can buy small plastic bathtubs and molded sponge
linings. A large plastic dishpan will also suffice. A
kitchen sink works well if you are careful about
preventing your child from falling against hard edges or
turning on the hot water, thereby causing a burn. Until
the umbilical cord falls off, keep the water level below
your baby's navel. Most children can be bathed in a
standard bathtub by the time they are 1 year old.
- Bottles and nipples
If you are feeding your baby formula, you will need
about ten 8-ounce bottles. Although clear plastic
bottles cost twice as much as glass ones, you will be
glad you bought the unbreakable type the first time you
or your baby drops one. If you use disposable bottle
liners, you probably will need only five bottles.
You will also need 5 to 10 nipples. If you prepare more
than one bottle at a time from concentrated formula, you
will need a 1-quart measuring cup and a funnel for
mixing a batch of formula. If you use powdered formula,
the measuring cup is unnecessary.
- Diapers
You can choose disposable or cloth diapers. The rate of
diaper rashes is about the same with both kinds of
diapers. If you're concerned about using diaper pins,
worry not. Modern diaper covers come with Velcro
straps. The main advantage of disposable diapers is
that they are very convenient. They make family travel
easier, and day care centers can operate more
efficiently. The superabsorbent-gel diapers have the
advantage of not letting urine leak out of the diaper.
The main disadvantage of disposable diapers is that they
cost more. The average cost of disposable diapers is
about 20 cents per diaper. Cloth diapers delivered and
cleaned by a diaper service cost about 12 cents per
diaper. If you buy and wash your own cloth diapers, the
average cost each time you use a diaper is 3 cents
(after the initial purchase of the diapers).
Which type of diaper to use can be a difficult decision.
Why not take advantage of both options? Use cloth
diapers when you are home. Use disposable diapers when
you are away from home. Use disposables when your child
has diarrhea because they prevent leakage of watery
stools. During a baby's first 2 or 3 months of life,
when most mothers are exhausted by new baby care,
consider using a diaper service rather than washing
diapers yourself. You will find that modern diaper
services are very efficient, provide excellent
sterilized diapers, and pick up dirty diapers once a
week.
For more information, see Diapers.
- Pacifier
A pacifier is often useful for soothing babies. To
prevent choking on the pacifier, the pacifier's shield
should be at least 1 and 1/2 inches in diameter and the
pacifier should be one single piece. Some of the newer
pacifiers are made of silicone (instead of rubber),
which lasts longer because it doesn't dry out. The
orthodontic-shaped pacifiers are accepted by some babies
but not by others.
For more information, see Pacifiers.
- Nasal suction bulb
A rubber suction bulb is essential for helping young
babies whose breathing has been made difficult by sticky
or dried nasal secretions. A suction bulb with a blunt
tip is more effective than a bulb with a long tapered
tip and is less likely to irritate the nasal lining.
(Bulbs with long tapered tips are used for irrigating
ears.) The best suction bulbs on the market have a
small clear plastic tip (a mucus trap) that can be
removed from the bulb for cleaning.
For more information, see Colds.
- Thermometer
A rectal thermometer is most helpful if your baby
becomes sick. The digital thermometers that display the
temperature in 30 seconds are worth the few extra
dollars. If you buy a glass thermometer, the ones with
four color zones are easier to read.
For more information, see
How to Measure a Temperature.
- Diaper and bottle bag
For traveling outside the home with your baby, you will
need an all-purpose backpack to carry the items that you
need to feed your baby and change diapers. Packs often
fit on the back of strollers. Backpacks are more
comfortable and convenient than shoulder bags.
- Highchair
During the first 6 months of life you can hold your baby
whenever you feed him. However, you will need a
highchair when your child can sit unsupported and is
eating solid foods.
The most important feature of a high chair is a wide
base that prevents the high chair from tipping. The
tray needs to have a good safety latch. The tray should
also have adjustable positions to adapt to your infant's
growth. A safety strap is critical. Plastic or metal
chairs are easier to clean than wooden chairs.
Small portable, hook-on highchairs that attach directly
to the tabletop are gaining in popularity. They are
convenient and reasonably priced. The ones with a
special clamp that keeps your child from pushing the
chair off the tabletop with his feet have a good safety
record. By 2 years of age, most toddlers can sit in a
youth chair.
- Training cup
By the time your child is 1 year old, she will want to
hold her own cup. Buy a spillproof one with a weighted
base, a lid, and a spout. By 2 years of age, most
children can use a regular cup.
- Bib
To keep food off your baby's clothes, find a molded
plastic bib with an open scoop on the bottom to catch
the mess.
- Safety gadgets
Once your child is crawling, you will need safety
gadgets such as electric-outlet safety plugs, cabinet
door safety locks, bathtub spout protectors, toilet
clamps, and plastic corner guards for sharp table edges.
HELPFUL EQUIPMENT
Some of the following items provide your child with forms of
transportation or special places to play. They all have
some advantages. However, if none of them are available,
you can carry your child whenever necessary, and your child
can play on a blanket on the floor.
- Changing table
Diapers need to be changed many times a day. You can
use a bed to change your baby, but bending over the bed
so many times a day may cause back strain. If you have
a changing table you won't have to bend over every time
you change your child. A regular table or buffet
covered with a changing pad can work as well as a
special baby-changing table.
- Automatic swing
Swings are entertaining to most babies. They are
especially helpful for crying babies. They come in
windup-spring, pendulum-driven, or battery-powered
models. The mechanisms of the latter two types of swing
are quieter than the first. Make sure a swing has a
sturdy base and crossbars.
- Front-carrier or sling
Cloth carriers or slings that allow you to carry your
new baby in front against your chest are great. They
give your child a sense of physical contact and warmth.
The slings are helpful during breast-feeding. They
allow you freedom to use your hands. Buy one with head
support.
Carrying a baby in front after the age of 5 or 6 months
can cause a backache for the parent.
- Backpack
Backpacks are useful for carrying babies who have good
head support and are at least 5 or 6 months old. They
are an inexpensive way to transport your baby when you
go shopping, hiking, or walking anywhere. The inner
seat of the carrier can usually be adjusted to different
levels.
- Stroller
Another way to transport a baby who has outgrown a
front-carrier is a baby stroller. The most convenient
strollers are the umbrella type, which fold up, and ones
that have at least one reclining position. A safety
belt is important to keep your baby from standing up in
the stroller and falling out. A sun shade is also great
for inspiring an afternoon snooze.
- Infant seat or bouncer seat
An infant seat is a good place to keep a young baby when
the baby is not eating or sleeping. A bouncer seat has
the added advantage that your baby can make the seat
move by him- or herself. Infants prefer this inclined
position so they can see what is going on around them.
Buy one with a safety strap, but don't substitute it for
a car seat. After children are 3 to 4 months old they
can usually tip the infant seat over, so stop using it
when your baby reaches this age.
- Playpen
A playpen is a handy and safe place to leave your baby
when you need uninterrupted time to cook a meal or do
the wash. Babies like playpens because the slatted or
mesh sides afford a good view of their environment.
Playpens can be used both indoors and outdoors.
As with cribs, the slats should be less than 2 and
3/8 inches apart. Playpens with a fine-weave netting
are OK, although sometimes older infants can climb out
of them. Bottomless playpens are gaining in popularity.
Your baby should be introduced to the playpen by the age
of 4 months so that she feels good about staying in it.
It is very difficult to introduce a baby to a playpen
after the baby has learned to crawl.
Do not string any objects on a cord across the playpen.
Your baby could become entangled in them and strangle.
- Gates
A gate is essential if your house has stairways that
your baby must be protected from. A gate also helps
keep a child in a specific room with you and out of the
rest of the house (for example, when you are working in
the kitchen). Many rooms can be closed off with doors.
All gates should be difficult for a baby to climb. The
strongest gates are spring-loaded.
- Humidifier
A humidifier is helpful in dry climates or areas with
cold winters. The new ultrasonic humidifiers are quiet
and have other advantages. Do not buy a vaporizer
because the steam it produces could burn a child.
Vaporizers also do not deliver humidity at as fast a
rate as humidifiers.
- Food grinder
The time comes when your baby must make the transition
from baby foods to table foods. A baby-food grinder
takes the work out of mashing up table foods. It's as
effective as a blender, easier to clean, and less
expensive. Food processors have the advantage of
allowing you to make larger quantities faster than a
baby-food grinder. If you buy all your baby food in
jars, this item is not necessary.
- Teethers
During teething, many infants like to chew on something.
Teethers are available in many shapes, sizes, and colors
to help comfort and distract your baby.
UNNECESSARY EQUIPMENT
Some baby equipment is usually not worth the investment, but
your judgment may be different. You can bathe your baby
without a special bathinette. Nursery monitors or intercoms
will not prevent crib deaths and may interfere with your
baby learning how to comfort himself. Baby carriages or
buggies generally have been replaced by baby strollers,
front-carriers, or backpacks. You can determine if your baby
is being fed enough without a baby scale. You can prepare
warm formula without a bottle warmer. And shoes are not
needed until your child has to walk outdoors.
An infant feeder is a bottle with a nipple on one end and a
piston on the other. It is used to feed strained foods to
young babies. Infant feeders are advertised as a "natural"
step between bottle- and spoon-feeding. However, babies
don't need any food other than formula or breast milk before
they are at least 4 months old. When they are 4 months old,
spoon-feeding works quite nicely. Infant feeders are
unnecessary and can lead to forced feedings.
HARMFUL EQUIPMENT: WALKERS
Over 40% of children who use walkers have an accident
requiring medical attention. They get skull fractures,
concussions, dental injuries, and deep cuts. There have
even been some deaths. Most of the serious walker injuries
occur from falling down a stairway. When a crawling child
falls down steps, his tumbling breaks his fall. When a
child goes down a stairway in a walker, he accelerates and
crash-lands at the bottom.
Some parents believe walkers help children learn to walk.
On the contrary, walkers can delay both crawling and walking
if used over 2 hours a day.
Don't buy a walker. But if you have one, take the wheels
off. If you're not convinced of the dangers and leave the
wheels on, be sure to keep the door to any stairway locked.
Children in walkers have crashed right through gates.
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