Natural Family Planning

From U.S. Department of Health & Human Services

Natural Family Planning, also known as NFP, is a method of birth control that does not use any drugs or devices.

How effective is natural family planning?

Of 100 couples who use natural family planning methods each year, anywhere from 1 to 25 will become pregnant. Natural family planning can be an effective type of birth control if all three methods are used and if all are always used correctly.

What is natural family planning?

A woman with a normal menstrual cycle has about 8 days a month when she can get pregnant. These include the five days before she ovulates (when an egg is released), the day she ovulates, and about one to two days after ovulation.

Natural family planning (sometimes known as fertility awareness or the rhythm method) is an approach to birth control some couples use to predict when these fertile days happen. It involves paying close attention to the menstrual cycle by using methods that include:

Basal Body Temperature Method

Calendar Method

Cervical Mucus Method

When all three methods are used together, it is known as the symptothermal method.

Basal Body Temperature Method

Basal body temperature is the “baseline” temperature when you are relaxed and rested (like when you first wake up in the morning). During ovulation (when the ovaries release an egg and you can get pregnant) the basal temperature goes up a little. You can predict the days you’ are likely to be fertile if you track and record your basal temperature each day for a few months.

How it Works

Your basal temperature is typically between 96 and 98 degrees before you ovulate. After you ovulate, your temperature will rise just a bit, usually less than one degree. Such a small change is hard to detect and is best done with a basal body thermometer (available at drug stores). Write down and keep track of your temperature each day. A Basal Body Temperature Chart can help you do that. You can find one here.

Knowing when your temperature increases will not tell you for certain when you are fertile, but it can give a pretty good idea. You are most likely to get pregnant two to three days before your temperature peaks and the day after that. After your temperature has been higher for three days, the chances of getting pregnant drop.

Keep in mind that sperm can stay in a woman’s body for several days after she has sex. If you have sex without birth control during the first part of your period, you might get pregnant.

Calendar Method

With the calendar method, you predict fertile days by charting and recording how long your menstrual cycles last.

How It Works

Track how many days each of your menstrual cycles last. Use a calendar and write down when each cycle starts, beginning with the first day of your period. Keep a record of how many days your cycle lasts each month.

To get the best information, you’ll need to track and record how long your cycles last for at least eight months. If you can do this as long as 12 months, though, it’s even better.

To predict the first day you’re likely to be fertile (the most likely time for you to get pregnant if you have unprotected sex) in your new cycle:

-You will need your menstrual cycle information from at least the past eight months, a calendar and a pen.

- Subtract 18 days from the total days of your shortest cycle. Take that number and count ahead from the very first day of your next period (count the day your period begins).

- Example: your shortest cycle lasted 27 days. 27-18= 9 days. On your calendar circle the date your next period starts, and beginning with that day count ahead 9 days. So, if you period starts on the 2nd day of the month, you’d count ahead to the 10th day of the month. Put an “X” on the calendar for that day.

To predict the last day you’re likely to be fertile in the cycle:

- Subtract 11 days from the total days of your longest cycle. Take that number and count ahead from the very first day of your next period (count the day your period begins).

- Example: your longest cycle lasted 29 days. 29-11=18 days. On your calendar circle the date your next period begins, and starting with that day count ahead 18 days. If your period starts on the 2nd day of the month, you’d count ahead to the 19th day of the month. Put an “X” on the calendar for that day.

The days between the two “X’s” are when you’re most likely to get pregnant. If you don’t want to get pregnant, then don’t have sex on those days, or use birth control (like a condom, diaphragm, or cervical cap).

Keep this in mind: the calendar method can predict the days you are most likely to be fertile, but isn’t always 100% accurate, especially if your cycles don’t always last the same number of days. It’s best to use other fertility awareness methods, too.

Cervical Mucus Method

With this method, you pay attention to the changes that happen with your cervical mucus (such as color and thickness) over the month.

How it Works

Just after your period, there a few “dry days” when no mucus is present. These are days when you aren’t likely to get pregnant.

As an egg gets ready to be released (known as ovulation), more mucus is produced and it’s often white or yellow in color with a sticky feel to it. These are not safe days for unprotected sex.

The most mucus is produced just before ovulation. Here, it’s clear and slippery, like raw egg whites. It can be thick enough so it spreads apart on your fingers. This is the time a woman is most likely to get pregnant.

After three or four “slippery” days, less mucus is produced and anything you see is probably sticky and a darker “cloudy” color. This is usually followed by a few “dry” days before your period starts again. The time between the “slippery days’ and when your period starts are days when pregnancy isn’t likely to happen.

Use a tissue or your fingers to check your mucus several times each day. Note whether it’s cloudy and tacky or clear and slippery. Chart the changes on a calendar. You can label days as Dry, Sticky/Cloudy, and Slippery/Clear.

Advantages of Natural Family Planning

-Natural family planning methods are safe and reasonably effective in preventing pregnancy.

-These methods can not only help you avoid pregnancy, but they can also work if you want to become pregnant by helping to predict which days you are most fertile.

-These methods are inexpensive and do not require a clinic visit (although it’s an excellent idea to discuss your plan with a health care provider). To search for a family planning clinic near you, visit Office of Population Affairs. (Clinic search box can be found at the bottom of the page on the right side.)

-Natural family planning has no side effects and does not cause problems with using medication.

Drawbacks of Natural Family Planning

-Your partner must agree and cooperate.

- Natural family planning methods provide no protection against Sexually Transmitted Infections.

- Most women don’t have totally regular menstrual cycles or periods.

 -You cannot definitely know the exact days you will get pregnant.

 -Natural family planning takes time and effort each day to track days of menstrual cycle, chart temperature and cervical mucus.

Helpful Links

My Next Period

Fertility Friend

Co-sleeping and Bed Sharing

AUGUST 2, 2011. Posted in: NIGHTTIME PARENTING

via kellymom.com

What is co-sleeping?

Co-sleeping essentially means sleeping in close proximity to your child. It may be in the same bed or just in the same room. Some ways of co-sleeping that different families use are:

• Bed-sharing/Family Bed:
  Parent(s) sleep in the same bed with the child.
• Sidecar arrangement: 
  Securely attach a crib to one side of the parents’ bed, next to the mother. Three sides of the baby’s crib are left intact, but the side next to the parents’ bed is lowered or removed so that mother and baby have easy access to one another. Commercial cosleeper/sidecar cribs are also available.
• Different beds in the same room:
  This might include having baby’s bassinet or crib within arm reach of the parents (easier at night) or just in the same room; or fixing a pallet or bed for an older child on the floor next to, or at the foot of, the parents’ bed.
• Child welcomed into parents’ bed as needed:
  The baby/child has her own bedroom, but is welcomed into the parents’ bed at any time. In many families, children start their overnight hours in a separate bed or room, but are welcomed into the parents’ bed after a night waking.

According to the American Academy of Pediatrics, “Room-sharing without bedsharing is recommended— There is evidence that this arrangement decreases the risk of SIDS by as much as 50%.” The AAP recommends that babies and parents sleep on separate surfaces, as this is the simplest way to eliminate the specific risks of bed-sharing.

Advantages of co-sleeping

Co-sleeping is not the best fit for every family, but it can have many advantages:

• Parents often get more sleep.
• Babies often get more sleep. Baby stirs and almost wakes up when she needs to nurse, but since she is right beside mom, mom can nurse or soothe her back to sleep before she fully wakes up.
• Breastfeeding during the night is easier when baby is nearby.
• Breastfeeding at night helps to maintain your milk supply.
• Night nursing also tends to prolong the child-spacing effects of breastfeeding.
• No nighttime separation anxiety.
• Fewer bedtime hassles.
• It’s lovely to wake up next to a smiling baby!

Co-sleeping Safety

The ISIS Infant Sleep Information Source website notes:

The most recent studies have shown that most bed-sharing deaths happen when an adult sleeping with a baby has been smoking, drinking alcohol, or taking drugs (illegal or over-the-counter medicines) that make them sleep deeply.

Sometimes people fall asleep with their babies accidentally or without meaning to. This can be very dangerous, especially if it happens on a couch/sofa where a baby can get wedged or trapped between the adult and the cushions.

General Safety Guidelines for Bed-sharing –

Any sleep surface that baby uses (including cribs, nap surfaces, or adult beds) should be made safe for baby:

• The sleep surface should be firm. Do not put a baby on a waterbed mattress, pillow, beanbag, sheepskin or any other soft surface to sleep.
• Bedding should be tight fitting to the mattress.
• The mattress should be tight fitting to the headboard and footboard (or sides of the crib).
• There should not be any loose pillows, stuffed animals, or soft blankets near the baby’s face.
• There should not be any space between the bed and adjoining wall where the baby could roll and become trapped.
• The baby should be placed on his back to sleep.
• Babies (with or without an adult) should never sleep on a sofa, couch, futon, recliner, or other surface where baby can slip into a crevice or become wedged against the back of the chair/sofa/etc.

Additional guidelines if baby is sharing sleep with another person:

• Do not sleep with baby if you are currently a smoker or if you smoked during pregnancy – this greatly increases SIDS risk.
• Do not sleep on the same surface as your baby if you are overly tired or have ingested alcohol/sedatives/drugs (or any substance that makes you less aware).
• Older siblings or other children should not sleep with babies under a year old.
• Other potential hazards: very long hair should be tied up so that it does not become wrapped around baby’s neck; a parent who is an exceptionally deep sleeper or an extremely obese parent who has a problem feeling exactly how close baby is should consider having baby sleep nearby, but on a separate sleep surface.

Night nursing and ear infections?

You might hear that breastfeeding your baby in a lying down position will cause ear infections. Research indicates that this is not true. Also, keep in mind that with most nursing positions, baby is lying down while nursing anyway – whether mom is or not!

Can co-sleeping cause psychological problems in my child?

People who are uncomfortable with the idea of co-sleeping often suggest that co-sleeping is “less healthy” than the child sleeping alone and will cause psychological damage to the child, cause baby to become too dependent on the parents, etc. Dr. James McKenna counters these suggestions:

In part, this view represents a personal and arbitrary judgment that anyone is entitled to make as long as it is not passed on as scientific fact. Such judgments are based on Western values favoring the perception of how individualism and infant autonomy are best promoted and obtained. No study has shown, however, that the goals for separateness and independence (or happiness, for that matter) are obtained in the individual by, among other things, separate sleeping arrangements for parents and children, nor do any studies demonstrate negative consequences for children or parents who choose to cosleep for ideological or emotional purposes, except when cosleeping is part of a larger psychologically disordered set of family relationships or when cosleeping occurs under dangerous social or physical circumstances. The only studies of the psychological or social effects of cosleeping reveal not negative but positive consequences. One study among military families revealed that cosleeping children receive higher evaluations of their comportment from their teachers than do solitary sleeping children and are under-represented among psychiatric populations, when compared with children who do not cosleep [Forbes JF, Weiss DS: The cosleeping habits of military children.Mil Med 1992; 157:196-200]. Lewis and Janda found that college-age students who coslept as children were better adjusted and more satisfied with their sexual identities and behavior than college-age students who did not cosleep [Lewis RJ, Janda H: The relationship between adult sexual adjustment and childhood experience regarding exposure to nudity, sleeping in the parental bed, and parental attitudes towards sexuality. Arch Sex Behav 1988; 17:349-363] . Clearly, we need to change our conceptualization concerning what constitutes a normal or healthy childhood sleep pattern!

– From: Stein MT, et al. Cosleeping (Bedsharing) Among Infants and Toddlers. Pediatrics 2001 Apr; 107(4); 873-877

See also: What are the long term effects on my baby of sharing a bed? by Dr. James McKenna

More information

Co-sleeping safety

Safe Sleep Resources from Platypus Media

Where Babies Sleep from the ISIS Infant Sleep Information Source

Guidelines to Sleeping Safe with Infants by James J. McKenna, Ph.D.

Handouts on sharing sleep safely

Bed-sharing and infant sleep from the UNICEF UK Baby Friendly Initiative

Attachment Parenting International – Infant Sleep Safety

Babies sharing their mothers’ beds while in hospital: a sample policy from the UNICEF UK Baby Friendly Initiative

Guideline on Co-Sleeping and Breastfeeding, Clinical Protocol Number 6 from the Academy for Breastfeeding Medicine

AAP Policy Statement: SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment (Oct. 17, 2011)

Attachment Parenting International’s response to the CPSC

The New Zealand Experience: How Smoking Affects SIDS Rates by Barry Taylor, Sally Baddock, Rodney Ford, Ed Mitchell, David Tipene-Leach, and Barbara Galland, from Mothering magazine (Issue 114, September/October 2002)

Logistics: Making co-sleeping work for your family

Rooming-in at the Hospital: Assessing the Practical Considerations by Martin Ward-Platt and Helen L. Ball, from Mothering, Issue 114 September/October 2002.

Excerpts from the book Good Nights – The Happy Parents’ Guide to the Family Bed (and a Peaceful Night’s Sleep!) 

How to make sleep sharing work from BabyCenter.com, with input from James McKenna, PhD

Co-sleeping: Yes, No, Sometimes? by William Sears, MD

Collections of co-sleeping articles

Sleep & Family Bed articles from Mothering.com

Sleep & Family Bed Articles at The Natural Child Project

Making & defending the decision to co-sleep – Research and opinion articles on co-sleeping

Responding to criticism is written about breastfeeding, but can be applied to any other parenting choice that draws criticism from others. Some of the links included are directly geared toward co-sleeping.

Somebody’s been sleeping in my bed! by Amy Spangler, from Amy Spangler’s Feeding Times, December 2004.

Ten Reasons to Sleep Next to Your Child at Night by Jan Hunt at The Natural Child Project

Sleep With Me: A Trans-Cultural Look at the Power – and Protection – of Sharing a Bed by Meredith F. Small, from Mothering magazine, Nov/Dec 1998″

The Family Bed: An Expert’s Opinion by David Servan-Schreiber, MD, Ph.D.

Sleeping Through the Night by Katherine Dettwyler, Ph.D.

Go Ahead — Sleep With Your Kids by Robert Wright

Annals of Parenthood: Sleeping with the Baby – Which Side of the Bed Are You On? The Author and His Wife Defied the Experts by John Seabrook. This article is reprinted from an article first published in the Nov. 8, 1999 issue of the New Yorker Magazine, and includes the interview with Dr. Richard Ferber where he said

“…There’s plenty of examples of co-sleeping where it works out just fine. My feeling now is that children can sleep with or without their parents. What’s really important is that the parents work out what they want to do.”

Research and discussion of research

Mother-and-Baby Behavioural Sleep Laboratory Professor James J. McKenna’s area at the University of Notre Dame website. Dr. McKenna is best known for his pioneering studies of the differences between the physiology and behavior of solitary and co-sleeping mothers an infants-and the connection these data might have in addressing SIDS risks. He is a Professor at the University of Notre Dame and runs the University of Notre Dame Mother-Baby Behavioral Sleep Laboratory.

Parent-Infant Sleep Lab, Department of Anthropology, University of Durham, UK. The Parent-Infant Sleep Lab is the home for a team of researchers led by Dr Helen L. Ball
who are examining various aspects of infant sleep and night-time parenting. Their website includes research papers, project descriptions, presentations and other resources.

McKenna JJ, McDade T. Why babies should never sleep alone: a review of the co-sleeping controversy in relation to SIDS, bedsharing and breast feeding. Paediatr Respir Rev. 2005 Jun;6(2):134-52.

Okami P, Weisner T, Olmstead R. Outcome correlates of parent-child bedsharing: an eighteen-year longitudinal study. J Dev Behav Pediatr. 2002 Aug;23(4):244-53.

Baby bedsharing fears dismissed. Discussion of the above Okami study from BBC News.

Car Seat Safety Info

Car crashes are a leading killer of children 1 to 12 years old in the United States. The best way to protect them in the car is to put them in the right seat, at the right time, and use it the right way.

NHTSA released new guidelines.  Under the new guidelines, NHTSA is advising parents and caregivers to keep children in each restraint type, including rear-facing, forward-facing and booster seats, for as long as possible before moving them up to the next type of seat.

For instance, the safety agency recommends using the restraints in the rear-facing position as long as children fit within the height and weight limits of the car seat as established by the manufacturer. The rear-facing position reduces stresses to the neck and spinal cord and is particularly important for growing babies.

NHTSA said that its new guidelines are consistent with the latest advice from the American Academy of Pediatrics, which advises parents to keep kids in rear-facing restraints until two years of age or until they reach the highest weight or height allowed by their car safety seat's manufacturer. There is no need to hurry to transition a child to the next restraint type.

AAP Policy In March 2011, the American Academy of Pediatrics released its revised Child Passenger Safety recommendations. The statement increased the minimum age that children should ride rear-facing in infant and convertible seats from 1 to 2 years and the age that children should remain in the rear seat from 12 to 13 years. Though intended to educate parents on the best practices to protect their children from death or injury while riding within a vehicle, these recommendations also provide guidance to state lawmakers seeking to enact child passenger safety legislation that best protects children. The following provisions should be included within child passenger safety legislation:  Infants and toddlers should ride facing the rear of the vehicle until at least 2 years of age. States may choose to adopt age 1 requirements immediately, and phase in a requirement to ride rear-facing until age 2 within 2 to 4 years, with provision for educating parents in the interim about the benefits of riding rear-facing as long as possible.  Young children should ride in car safety seats with a harness until at least age 4, with guidance educating parents and caregivers about the benefits of riding in a seat with a 5-point harnessup to the highest weight or height allowedby the manufacturer.  School-aged children should ride in belt positioning booster seats until at least age 8 or until the seat belt fits correctly, as described by the AAP and NHTSA.  Children should ride in the rear-seat until age 13

1) Find a Car Seat Technician in your area. 

Search your area for a certified car seat technician to make sure your car seat is properly installed, and shows you how to probably install it. Car Seat Inspection Stations

2) Car seats do have expiration dates. They have a 6-10 year limit. Depending on the seat and the plastic it's made out of.

 Does the expiration date really matter?Is this just a way for the car seat manufacturers to make more money? You wouldn't give your kids milk that is beyond its expiration date, or medicine beyond its expiration date - so too, your child shouldn't be riding in an expired seat. One of the main reasons seats expire is that they are made of plastic. Plastic becomes brittle and weak as it ages - two qualities you don't want in a car seat that has to withstand severe crash forces. Therefore it's important that the plastic is new enough that the car seat will be able to perform properly. Car Seat Safety FAQ

3) Use the LATCH system OR the seat belt...NOT both

Often times, I have heard moms tell me that they install their car seats with the latch and then the seat belt, just as a precaution. The common misconception is that using both is doubly safe. In fact however, it is the opposite.It seems like common sense that it would hold the seat in place better, but actually, a car seat is supposed to be able to move and flex a small amount during an accident to absorb some of the impact. If you used both, it could possibly cause too much of the force to be transferred to the child...or having two straps could simply put too much stress on the car seat's belt path, causing the plastic to break and have the child and car seat fly out of the windshield.Truth of the matter is this: we don't know WHY we can't do it, all we know is that EVERY.SINGLE. car seat manufacturer says not to, so it would be safe to assume that it has failed for some reason or another. Since they don't release crash test info, we can only speculate on theories.You CAN use the top tether ONLY with a seat belt, to help secure the top of the seat from moving. Just NOT the entire latch system. If you're using a seat belt, leave the anchor ALONE. LATCH

4) No Aftermarket Products!

Most simply put: If it didn't come with your car seat, it isn't safe to use.

Aftermarket car seat products are items not sold with a car seat. The products claim extra comfort, style and protection, but do not be fooled! Aftermarket products may void your car seat’s warranty. Worse yet, they can prevent your child from being secured correctly or can come loose in a crash and cause serious injury. Some common aftermarket products include, head support cushions, harness strap covers, car seat covers, add-on toys and trays, seat belt adjusters and headrest mirrors. Until these products are tested and there are federal guidelines for them, do not use add-on items with your car seat. Aftermarket Products

5) Know how to safely and properly clean your car seat.

Be very careful to follow the manufacturer's instructions when you wash the car seat. You cannot soak the straps, you cannot use harsh cleaners, and for some car seats, you can't put the cover in the dryer either. Yet another case of "READ YOUR MANUAL." If you don't follow the instructions, you can quite literally ruin your seat.

Harness straps may not be washed, they are not to be submerged. Why not: Soaking the straps in even just plain water can wash away the fire-retardant chemicals on the harness and currently, there is no way to get that back. Even worse, washing with detergents that have bleach alternatives, optical brighteners, and a laundry list (no pun intended) of chemicals can weaken the integrity of the straps, causing them to fail in an accident. Your best bet is to wipe down the straps with a damp wash cloth and mild soap like dove (IF NEEDED). If you have already washed your straps before reading this, call your car seat manufacturer and explain the mistake. Most of them will ship you replacement straps for free as a courtesy. (Not sure about that part, but replacement harnesses are not that expensive). Washing Straps

6) Installations need to be TIGHT

You should not be able to move your car seat side to side more than 1inch...that's it, an inch. In a car accident, the force is much stronger than you are, so that 1 inch becomes even looser.

Ideally, you want the child coupled as tightly as possible to the harness system and carseat, and the carseat coupled as tightly as possible to the vehicle with the seatbelt or LATCH system.  When you do this, the child gains all the benefit of "ride-down time" provided by the crushing frame of the vehicle in a crash.  With a loose installation of any kind, the child gets less ride down time and suffers a more severe crash into the harness system.

What can happen: besides the obvious, whiplash...severe shaking of the brain could cause swelling and bleeding and possibly death. Imagine the car seat striking the window or another passenger. Is my car seat tight enough?

7) That little thing that's called a chest clip...it goes on the chest, no really- IT DOES!

(a general rule of thumb is to have it even with the armpits, you can never go wrong if you remember that)The chest clip is designed to keep the harness straps properly positioned on the child’s shoulders; this is important because the harness is the component that keeps the child restrained in the car seat. A study by the National Highway Traffic Safety Administration (NHTSA) showed that 59% of child harnesses are not tight enough. If the harness is loose and the chest clip is too low, one or both harness straps can slide off the child’s shoulders, allowing the child to potentially be ejected from the car seat in the event of a crash.In a collision, the chest clip can cause damage and/or internal bleeding to vital organs in your child's abdominal region, which is not protected by the ribcage. Where should the chest clip be on my child?

See picture for correct and incorrect placement.

Photo courtesy of There Is Nothing Better Than Being A Mommy.

8) Harness straps should fit snugly!

The easiest way to check to see if your harness straps are too loose is the pinch test. Secure your child in the car seat and buckle the harness as usual. Using your thumb and pointer finger, try to pinch one of the harness straps at your child’s collarbone level. If you’re able to pinch the strap, the harness is not tight enough. You should not be able to pinch any excess Be sure that you don't get the harness straps TOO tight-there is such a thing. You don't want it digging into the child's body, making it uncomfortable for them.What can happen:Loose harness straps leave your child at an elevated risk of injury during a crash because they may allow your child to move out of position; they can even lead to ejection from the child seat during a crash. How tight should the straps be?

See Picture for correct and incorrect tightness.

Photo courtesy of  There Is Nothing Better Than Being A Mommy.

9) Can my child wear a winter coat in their carseat?

Generally, no.  For safety, the harness straps must remain tight on the child's shoulders regardless of any clothing.  You can put a blanket over the child, OUTSIDE the harness straps or put your child's coat on backwards after they are in the seat.  For infants in cold weather, an aftermarket "cozy" that zips over the infant carrier rather than fitting under the child is another solution. Can my child wear a winter coat in their seat?

10) Find out if you're allowed to have the handle on your infant seat up while driving.

Infant seats all have different rules as to whether or not the handle is allowed to be in the "carry" position while the seat is in the car. Know your particular car seat's rules. Seats that aren't designed for it say to put it down because a child can smash into it or be hit with broken pieces in an accident.

11) Boosters Are For Big Kids

Most kids need to ride in a booster seat from about age 4 until age 10-12.

If your child isn’t using a booster, try the simple test below the next time you ride together in the car. You may find that your child is not yet ready to use a safety belt without a booster.

The 5-Step Test.1. Does the child sit all the way back against the auto seat? 2. Do the child's knees bend comfortably at the edge of the auto seat? 3. Does the belt cross the shoulder between the neck and arm? 4. Is the lap belt as low as possible, touching the thighs? 5. Can the child stay seated like this for the whole trip? 

If you answered "no" to any of these questions, your child needs a booster seat to make both the shoulder belt and the lap belt fit right for the best crash protection. Your child will be more comfortable, too!

For best protection, all children should ride in the back seat until they are ready to drive. It's twice as safe as the front seat.

12) No Gaps Allowed Between Baby's Crotch/Groin Area and Harness

 This is really only an issue with newborns, but an important one. If there is a gap between crotch and harness buckle, roll up a washcloth or receiving blanket and put it in a upside-down U shape, with the middle between baby's crotch and the harness and the rest lying flat between the legs. This is one of the only "add-ons" allowed. When in doubt, call the manufacturer.

13) Know the Proper Guidelines for Outgrowing a Seat

Outgrowing a seat has nothing to do with legs touching the seat. There has never been a case of legs breaking from touching the seat and even if there were -- would you choose for your child to break their legs or their neck? Only one of those can be fixed. Your child has outgrown a seat in weight when they reach the max limit for that position. This is non-negotiable. When rear-facing, your child has outgrown their seat in height when there is less than an inch of the hard shell left at the top of the seat above your child's head. This ismeasured perpendicular to the seat's recline. However, there is a new seat that has different guidelines -- so be sure to read the manual for your seat!

14) Don't let your straps stay twisted, ever.

Your straps need to lie flat with no twists, 100 percent of the time. Check to make sure the straps are flat and straight every single time you put your baby in the car seat. Letting them twist can create weak points or even damage the straps permanently if you let them stay twisted. They create a point where they can break or distribute force unevenly and can injure your child. It takes two seconds -- just fix it.

Certain seats with thicker straps like Britax and Radians don't twist as easily, and other harness designs can sometimes make it difficult for the straps not to twist. This is something to consider when buying a seat, as having to constantly untwist straps can be really annoying.

15) Know if your seat allows Bracing

Bracing means having the car seat touch the back of the front seat. If you have advanced air bags, this is completely unsafe! You'll have to read your vehicle owner's manual to see if they allow bracing. Even if the car seat allows bracing, if the car itself does not, the seats CAN NOT touch. 

16) Clear your car of projectiles.

Those BPA-free metal water bottles are totally awesome and earth-friendly, but unless you can clip them to something, they are a dangerous projectile. In fact, any loose item in your car is potentially deadly because when you're driving 75 miles per hour and have to slam on your brakes, those items are also going 75 miles per hour. This applies to your diaper bag, purse, and scalding hot coffee. Utilitze the trunk, glove box, and put your cell phone in your pocket. Buy cargo nets if you don't have a trunk so nothing can fly forward from the back. If you have sun shades on your windows, they can only be the cling type, not the retractable ones with the big bar. This also means your pet needs to be secured, for your safety as well as theirs.

A good rule of thumb is if you couldn't throw it at someone's head without hurting them, it needs to be secured. This also applies to any toys you give your child to play with in the car as well, and if your big kid isn't in their booster and it's not attached with the LATCH system, strap that in as well.

17) The best install is the safest install.

 Neither the seatbelt nor LATCH (Lower Anchors and Tethers for CHildren) is safer than the other (and no, you can't use both). The middle of the backseat is safer than the side. However, the deciding factor in any of these is where and how you get the best installation. If it's the side with the seatbelt, or the middle with LATCH, that's what's best in your car. Also make sure if your car allows for LATCH borrowing. If it doesn't allow it, the seat can not be placed in the middle without it's own LATCH hooks. 

18) RTFM (Read the #^!&ing Manual)

Most car seats have a specific location for the manual on the seat so that it's kept with it at all times. That's because almost every single question you could have is listed in that little booklet, and the manufacturer's number is there for anything else. Use it. Even car seat pros utilize this booklet. Every single car seat is different with different rules, and this booklet (or the PDF of it online if you lost yours) is your golden ticket to proper car seat usage.

19) Buying/Using a used car seat

If you are considering using a second-hand car seat, use the checklist below. If you can check off each one of these statements, then the second-hand seat may be okay to use. If coming from a trusted source. 

• The seat has never been involved accident.
• The seat has labels stating date of manufacture and model number. You need this information to find out if there is a recall on the car seat or if the seat is too old.
• The seat has no recalls. If you do find a recall on the car seat, you should contact the manufacturer as some problems can be fixed.
• The seat has all its parts. If the seat is missing a part, contact the manufacturer as some parts can be ordered.
• The seat has its instruction book. You can also order the instruction manual from the manufacturer.
• The seat has been cleaned properly. Straps never submerged in water, cover properly cared for. You can get replacement straps and covers from the manufacture. 

20) When to replace a seat

ALWAYS DEFER TO YOUR MANUAL!

NHTSA recommends that car seats be replaced following a moderate or severe crash in order to ensure a continued high level of crash protection for child passengers. Car seats do not automatically need to be replaced following a minor crash.

What defines a minor crash? A minor crash is one in which ALL of the following apply:

• The vehicle was able to be driven away from the crash site.
• The vehicle door nearest the car seat was not damaged.
• None of the passengers in the vehicle sustained any injuries in the crash.
• If the vehicle has air bags, the air bags did not deploy during the crash and
• There is no visible damage to the car seat.

Never use a car seat that has been involved in a moderate to severe crash. Always follow manufacturer’s instructions.

21) Flying Bring the seat onboard or check it at the gate?  

Did you know the safest place for your little one during turbulence or an emergency is in a government-approved child restraint system (CRS) or device, not on your lap?

A CRS is a hard-backed child safety seat that is approved by the government for use in both motor vehicles and aircraft.

The FAA has approved one harness-type restraint appropriate for children weighing between 22 and 44 pounds. This type of device provides an alternative to using a hard-backed seat and is approved only for use on aircraft. It is not approved for use in motor vehicles. Learn more about harness-type restraint.

The FAA strongly urges parents and guardians to secure children in an appropriate restraint based on weight and size. Keeping a child in a CRS or device during the flight is the smart and right thing to do.

Runway emergencies are just like car crashes, except at 150 mph rather than 30 mph. And most parents would pale at the thought of having their child on their laps going to the store at 30 mph, but think nothing of having their child on their lap on the plane at 150 mph.

At 150 mph your child would be your airbag, or they would go flying inside the cabin. A 20 pound child in a 150 mph crash would have 3,000 pounds of force to them. That's enough to be fatal to themselves, and whomever they impact.

In addition to the lack of safety for a child and the people nearby, there is a risk to checking a carseat. If you must check a carseat, put it in its original packaging with padding in the box. Or maybe another box with padding. And then gate check it (it's far more convenient to use the seat on board than to drag a big box to the gate). All too often I see parents check their carseats at the ticket counter, wrapped in nothing but a plastic bag to keep the cover clean. The cover being clean at the other end is the least of the concerns. The worst thing that can happen is that a carseat arrives at the other end with damage that cannot be seen. The only way to find out that there's damage is during or after a crash when the seat has failed. Or the seat is obviously broken when you pick it up. This is at least an obvious replacement, and so again, someone will have to go to a store and buy a new seat, but at least it's known that the seat is broken and should not be used.

From the FAA:

Did you know the safest place for your little one during turbulence or an emergency is in a government-approved child restraint system (CRS) or device, not on your lap?

From the AAP:

Occupant protection policies for children younger than 2 years on aircraft are inconsistent with all other national policies on safe transportation. Children younger than 2 years are not required to be restrained or secured on aircraft during takeoff, landing, and conditions of turbulence. They are permitted to be held on the lap of an adult. Preventable injuries and deaths have occurred in children younger than 2 years who were unrestrained in aircraft during survivable crashes and conditions of turbulence. The American Academy of Pediatrics recommends a mandatory federal requirement for restraint use for children

on aircraft.

Vaccine Exemption Laws

From National Vaccine Information Center

There are three types of exemptions:

Religious

Medical

Philosophical

You also have the option in most states to be exempted from vaccination or re-vaccination if you can show proof of existing immunity. You can go to a private laboratory for a blood test to determine if there are enough antibodies to prove existing immunity to a disease such as measles or whooping cough. A blood test that measures antibody levels can cost $55 or more, depending on the disease.

State vaccine requirements provides a map that shows what kind of exemption(s) each state accepts. You can also click on each state and it will provide additional information about filing your exemption.

Self Weaning Under 12 Months?

From Kelly Mom

Introduction

True SELF-weaning before a baby is a year old is very uncommon. In fact, it is unusual for a baby to wean before 18-24 months unless mom is encouraging weaning. However, it is verycommon to hear a mother say that her baby self-weaned at 9 or 10 months old, or even earlier. How do we reconcile these statements?

What is self-weaning?

A baby who is weaning on his own:

§  is typically well over a year old (more commonly over 2 years)

§  is at the point where he gets most of his nutrition from solids

§  drinks well from a cup

§  cuts down on nursing gradually

Child-led weaning occurs when a child no longer has a need to nurse – nutritionally or emotionally. The solids part should rule out self-weaning in babies under a year since, for optimum health and brain development, babies under a year should be getting most of their nutrition from breastmilk.

What factors might lead mom to think that her baby is self-weaning?

When a mother says that her baby self-weaned before a year, there is a chance that she interpreted a normal developmental stage (perhaps combined with her own wishes) as baby’s wish to wean. Low milk supply can also play a part.

Low milk supply

If mom’s milk supply is reduced, baby may become less interested in nursing, and of course decreased nursing will lead to an even lower milk supply. If milk supply is low, baby may grow to prefer a cup or bottle simply because he can get more milk this way. As long as baby is nursing on cue and removing milk thoroughly, mom’s breasts will produce the milk that baby needs. There are a number of things that might interfere with the milk production process after lactation has been established. Some factors that commonly come into play in baby’s second six months include:

§  Scheduled feedings or other things that reduce baby’s nursing frequency too much (for example, pacifier overuse or sleep training). The answer to “how much is too much?” will depend on the particular mother-baby pair. A consistent decrease in nursing frequency will signal your body to decrease milk supply.

§  Rapid weight loss. A sudden decrease in mom’s calorie intake can result in decreased milk supply.

§  Medications or herbs that reduce milk supply (hormonal contraceptives, for example).

§  Early introduction of solids (before 6 months). Besides interfering with baby’s immunologic health, solids before six months often results in baby taking less milk at the breast and thus results in a decrease in milk supply.

§  Overly rapid increase in the amounts of solids. Again, this results in baby taking too little milk at the breast and thus a decreased milk supply. Keep in mind that mom’s milk supply will naturally and gradually decrease as baby begins to eat greater quantities of solid foods – this is fine and expected. What you want to avoid is increasing solids/decreasing milk supply too quickly, as breastmilk is what baby needs for proper growth, health and brain development through the first year and beyond.

For more on milk supply, including how to increase it, see Got Milk?

Normal developmental stages

It is common and normal for babies to show less interest in breastfeeding sometime during the second six months. This is developmental and not an indication that baby wishes to stop nursing.

Older babies tend to be distractible and want to be a part of all the action around them. Your baby may be more interested in learning about the world than in eating during the day (these same babies often increase their night nursing to make up for their busy days).
If baby is being given a bottle or sippy cup frequently, he discovers that he can walk/crawl around with it and not miss a thing, whereas nursing generally requires sitting still and not looking around for a few minutes. For this reason, some babies develop a preference for the bottle or cup at this developmental stage.

Milestone times, such as crawling and walking, and stressful times like teething or illness can also cause baby to be less interested in nursing – these types of things are common in the second six months. Nursing strikes (when baby quits nursing suddenly) also tend to be more common around this age, perhaps due to the same factors.

Our society tends to produce the expectation that babies can and should become independent as quickly as possible. Babies are considered more independent when they sleep alone, sleep through the night, potty train, wean, etc., As a result, babies are often pushed toward these milestones before they are ready – emotionally or physically. Because of this societal mindset, many moms don’t even consider the idea that baby’s disinterest in breastfeeding might be temporary, but simply go ahead and wean.

This is not saying that a mother’s choice to wean a baby this age is necessarily a bad choice for her family. A mother who wishes to wean her child at this point can certainly take advantage of baby’s temporary disinterest in nursing to initiate mother-led weaning.

However, it should understand that this is not self-weaning but a temporary developmental stage. Mom is making the choice, not baby. Once mom knows that she has a choice in the matter, she can better make an informed decision of whether to wean or to seek the benefits of continued nursing.

Tips for avoiding premature weaning

The following suggestions can be helpful in preventing baby from weaning prematurely:

Keep breastmilk primary in baby’s diet during the first year

§  If you feel that your milk supply is low, take measures to increase it.

§  Offer breastmilk first, before any solids, through at least the first year. Don’t let solids become more important than breastmilk during the first year.

§  Increase solid foods gradually. An example of a gradual increase in solids would be 25% solids at 12 months, 50% solids at 18 months, and 80% solids at 24 months.

§  Sugared drinks (and juice, too) are “empty calories” and will keep baby from feeling really hungry – limit or eliminate these. Water can also fill baby up and decrease nursing frequency. Click here for suggestions on offering water and juice.

Minimize the risk of baby developing a preference for the bottle or cup

§  Limit (or eliminate) bottles. If baby must be supplemented due to separation from mom, then only use bottles when you are physically separated from baby. Use a newborn-flow nipple, no matter how old your baby is, to reduce the risk that baby will grow to prefer the fast flow of a bottle. If baby is older than six months, seriously consider using a cup rather than a bottle.

§  Limit or eliminate pacifier use when you are with baby, so that your baby’s desire to suck encourages him to nurse more often.

§  Avoid allowing baby to walk around with bottles or sippy cups.

If baby is very busy and doesn’t want to stop and nurse

§  Try different and novel nursing positions in which he can have more control and perhaps see what’s going on around him – baby standing up, sitting on your lap facing you, etc.

§  Try singing, talking, telling stories, playing finger games, reading, etc. while nursing.

§  Try wearing a nursing necklace or bright colored scarf to help hold baby’s attention when nursing.

§  Give baby a small toy to hold and play with when nursing.

Be aware of your own subtle cues that encourage weaning

§  Offer baby the breast often; don’t wait until he “demands” to nurse. Be aware that the “don’t offer – don’t refuse” method of breastfeeding is a weaning technique.

§  Be available to nurse when baby wants to. Saying “not now, but later” is certainly part of the natural give and take of a nursing relationship as your child gets older, but don’t overuse it and don’t forget the “later” part – offer to nurse later, rather than waiting for baby to ask.

§  Diversion/distraction by mom is a weaning technique, particularly if used frequently.

§  Avoid limiting times or places for nursing. This is another weaning technique.

§  Allow baby to nurse at night if he wishes. Baby will nurse more often if he is in your room and/or bed, and many families get more sleep this way.

§  If you feel you need to phase out night nursing before baby does it on his own, then it may be helpful to make a conscious effort to increase daytime nursing.

§  Keep in close contact – carry and hold your child often. This will make breastfeeding more accessible to baby. Restricting access to nursing is a weaning technique.

Be aware of normal developmental stages

§  Pay attention to your child’s natural growth rhythms. Be aware of times that are not true weanings.