All About Your Baby at Week Twenty

What is your goal for breastfeeding your baby?

In other words—how long have you planned on breastfeeding? Three months? Six months? Nine months? Twelve months or longer?

Are you reaching that goal?

Reaching Your Breastfeeding Goals

Hispanic woman holding hands of baby boy.
Inti St Clair/Getty Images

According to most surveys, while about 65 percent of mothers start breastfeeding, only about 30 percent are still breastfeeding at six months and only about 15 percent are still breastfeeding when their baby is 12 months old.

This is well below the Healthy People 2010 Targets, a set of national health objectives, that 50 percent of mothers are breastfeeding at six months and 25 percent at 12 months.

Also, remember that the American Academy of Pediatrics recommends that "breastfeeding should be continued for at least the first year of life and beyond for as long as mutually desired by mother and child."

Of course, things don't always go as planned. But if you are enjoying breastfeeding and things are going well for you and your baby, you might consider continuing to breastfeed until your baby is at least 12 months old. And if you begin to have breastfeeding problems that are getting in the way of your goal, don't hesitate to call your pediatrician and/or a lactation consultant to get some help.

These breastfeeding problems might include:

  • Biting
  • A nursing strike
  • Decreased milk production
  • Early weaning

Often, there are very simple measures you can take to overcome the most common problems which threaten your ability to breastfeed. Don't be afraid to ask, and ask again. In addition to your pediatrician and lactation consultant, talking with other young mothers may give you a number of ideas that have helped them cope with the same concerns.

Baby Food Allergy

A four or five month old baby enjoying his baby food and not showing any signs of a food allergy.
A four or five month old baby enjoying his baby food and not showing any signs of a food allergy. Photo © Nick Thompson

As parents try out new baby foods, it's ideal to wait two or three days in between each new food. Waiting a few days allows you to easily recognize which foods might be causing any food allergy or intolerance symptoms.

On the other hand, if you started two or three new foods on the same day and your baby had a problem, it would be hard to know which baby food was to blame. If you've faced this problem, however, you are not alone. Many parents are too excited watching their babies try out new things to wait the requisite two or three days. So how can you tell if your baby has food allergies?

Baby Food Allergy Symptoms

Even when they know that they should wait to start new baby foods, parents aren't always sure what signs or symptoms they are watching for. How do you know if your baby is having a food allergy or intolerance after starting a new baby food?

Most of the time, baby food allergy symptoms will be just what you would expect from an allergic reaction to a food in anyone else, including:

  • Diarrhea
  • Skin rash, including hives
  • Vomiting
  • Wheezing
  • Stomach cramps

Other symptoms, such as gas and bloating, and sometimes diarrhea, are more likely to be caused by a food intolerance.

Simply not liking the taste of something is usually not a sign of an allergy. Keep in mind that your baby may not like some foods or may have to get used to the taste or texture of some baby foods. For those baby foods that your baby doesn't seem to like right away, you may have to try several times before your baby will eat them regularly.

If you think that your baby has a true allergy or intolerance to a certain food, you should usually stop giving it to your child and move on to something else. You can usually try the food again in two or three months—especially if it was a mild reaction—to see if your baby eventually tolerates the food. Talk to your pediatrician before giving a food to your baby if it was a more serious reaction, such as one that included wheezing or if your child has a reaction to multiple attempts on trying the food.

The most common food allergies in babies include:

  • Milk
  • Eggs
  • Fish
  • Shellfish
  • Tree nuts
  • Wheat
  • Peanuts
  • Soybeans

Your Baby's Eyesight

As your baby's eyesight matures, he will enjoy looking around more.
As your baby's eyesight matures, he will enjoy looking around more and will especially like looking at a mirror at his own reflection. Photo © Andrew Taylor

How well can your baby see now?

It's probably obvious that your baby can see better now than she once did, as she follows you around the room and watches you. But you may still wonder just how good her eyesight is.

While early on in her first month, your baby could only focus on things that were about a foot away from her face, she now sees objects clearly that are several feet away. Also, in addition to the simple, high-contrast patterns that she liked as a newborn, your baby can now see more colors, shapes, and patterns.

Your baby's vision will continue to mature over the next two or three months, as she continues to appreciate an even greater variety of colors and more complex shapes and patterns. She won't actually have 20/20 vision until she is somewhere between 6 and 30 months old.

Your baby's eyes should no longer "cross" once she has reached 20 weeks of age. If you do notice your baby's eyes crossing, talk to your pediatrician, who may, in turn, recommend a consultation with a pediatric ophthalmologist.

Red Flag Symptoms

Certain red flag symptoms may send you to the emergency room with your baby.
Certain red flag symptoms may send you to the emergency room with your baby. Photo © David H. Lewis

When your child gets sick, like with a runny nose, cough, or fever, how do you know when it is a simple viral infection or something more serious?

Which symptoms should you worry about?


Most parents worry about fever, but how high a fever doesn't necessarily tell you how sick your child is. A child can have a temperature of 102 or 103 degrees F with a cold or other viral infection, but may still be eating and drinking and sleeping well and may not be very sick. On the other hand, a child can be very ill with only a low-grade fever or even no fever at all.

So instead of worrying about the actual temperature, consider your child's other symptoms when she has a fever. Symptoms might include trouble breathing, being lethargic, being overly fussy and hard to console, or skipping feedings. A fever can also be worrisome if it is hard to control, like if it doesn't come down at all after giving your child a fever reducer, such as Tylenol.

You should usually call your pediatrician or seek medical attention if your infant is:

  • Three to six months old and has a temperature at or above 101 F (38.3 C)
  • Six to twelve months old and has a temperature at or above 103 F (39.4 C)

Red Flag Symptoms

Other symptoms that should raise a red flag that your child might need immediate medical attention include:

  • Bilious (dark green) vomiting - This can be a sign of an intestinal blockage
  • Bloody diarrhea
  • Fast breathing
  • A constant cough, so that your child can barely take a breath between coughs
  • Vomiting or diarrhea that leads to dehydration
  • Being lethargic or difficult to wake up
  • Seizures
  • A bulging fontanel (soft spot)
  • A non-blanching skin rash (a rash that doesn't go away when you press on it) - A non-blanching skin rash, in contrast to those that branch, may be petechiae, small points of bleeding under the skin

Safety Alert - Car Seat Mistakes

Putting a baby in a car seat seems like it should be easy. Instead, it is pretty easy to make a mistake that could leave your baby less protected than she should be.

Rear Facing Car Seat Limits

One of the more common mistakes that parents make is that they don't understand the latest car seat guidelines: Infants and toddlers should ride in a rear-facing car seat (infant-only rear facing car seat or rear-facing convertible car seat) until they are two years old or until they have reached the weight and height limits of their car seat. Although this means that some larger infants and toddlers might have to graduate to a rear-facing convertible car seat, there are also several models of an infant only seats with higher, 30- to 35-pound weight limits that should get you to the next car seat safety milestone.

If you review infant growth charts, you will see that some babies reach 20 pounds, the weight limit of many infant-only car seats, as early as 6 to 7 months. These babies should move from their infant carrier type car seat, into a rear-facing convertible car seat. A convertible car seat can have a rear facing weight limit up to 35 to 45 pounds, so will allow you to keep your baby rear facing through to her second birthday.

Car Seat Mistakes

Other common car seat mistakes that parents make include:

  • Putting car seat harness straps in the wrong position or allowing them to be too loose
  • Putting the harness chest clip in the wrong position
  • Not using the LATCH system correctly
  • Dressing their baby in a heavy coat or covering them with a heavy blanket and then putting the harness straps over the winter coat in the car seat
  • Placing a child in the wrong car seat or wrong position in the car, for example forward facing versus rear facing
  • Putting their baby's car seat in the front seat when it has a passenger side airbag

If you are unsure if you are using your car seat correctly, consider getting a car seat inspection at a local fire station (not always available) or visiting an official car seat inspection station. Your pediatrician and her staff can help you locate an inspection station if you rare unable to find one yourself.  Many parents—even parents who are pediatricians—are surprised to learn that there are changes they can make to the way they position their baby in the car seat which leads to greater safety. If this service is offered in your community, it's a very simple measure you can take to ensure the safety of your child.


Sibling Rivalry

Even siblings that seem sweet most of the time will likely have some rivalry issues.
Even siblings that seem sweet most of the time will likely have some rivalry issues. Photo © Debi Bishop

If you have older children, you may have had a difficult week or two once you brought your new baby home.

Depending on the ages of your other children, this probably included some extra whining and crying, regression in development (wetting the bed, refusing to use the potty, daytime wetting accidents,) and lots of jealousy.

Preparing your kids for the new baby likely helped you prevent and decrease any feelings of sibling rivalry—at least in those first few months.

Unfortunately, now that your baby is awake more often during the day, she may be taking up more of your time, which can lead to even more problems with her siblings. That makes it more important than ever to take the time to help your other kids adjust to being older brothers or sisters, including:

  • Having your kids help in age-appropriate ways, such as holding the baby, getting diapers, putting clothes away, and other chores
  • Continuing to be prepared for changes and regression in your child's behavior and development, such as having more temper tantrums or having some accidents for those only recently potty trained
  • Encouraging friends and family to spend time with your other kids when they offer to help with the baby, or letting them help with the baby so that you have more time for your other children
  • Sticking to your usual routines as much as possible, including mealtimes, naps, and bedtimes
  • Setting aside special one-on-one time as often as possible with each older sibling, even if it is just 5 or 10 minutes each day

Remember that it is still important to supervise your other children, especially toddlers and preschool-age children when they hold or play with their little brother or sister.

How Long Do You Need to Keep Burping Your Baby?

While some older infants don't need any help burping, some still do.
While some older infants don't need any help burping, some still do. Photo © Amanda Rohde

The majority of parents seem to stop burping their babies when they are about six months old, as children around six months of age often learn to burp on their own.

If you notice that your baby burps on his own before this age, you can likely stop burping your baby as early as three or four months. Giving up on burping is most likely to work if it is already getting hard to get your baby to burp and he seems to be doing fine, without much gas, fussiness or spitting up.

Some babies simply swallow less air than others when they eat, especially as they get older, and so don't need to burp after they eat as often as other babies do.

If you do stop burping your baby and he starts spitting up or acts fussy after eating, continue to burp him for a few more weeks or months.

Keep in mind that some babies need to be burped in between feedings as well. If your child is fussy, it may just mean she needs to be burped. Crying causes babies to swallow air as well, and if your child has been crying, she may need to be burped even if she hasn't been fed.

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