What to Expect the First Year (3 page)

The first year of life is like no otherâand it's arguably the year that most impacts all the years that follow: how healthy they are, how happy they are, even how many of them there are. Clearly, the first is a very big year for those so little.

Take growth, with a typical doubling of birth weight in the first 20 weeks and a tripling of birth weight by the first birthday. Length (or height, by the time your child is standing at a year) has increased by perhaps 50 percent, and brain growth (as roughly measured by head circumference) has increased by 30 percent.

One-year-olds are already 40 percent of their adult height, and their brains are nearly 80 percent of adult size. Who else but an infant grows 10 inches in a year? But physical growth is not the most remarkable change. Within minutes and hours of birth, a baby's physiology remarkably transforms from one that is suited only for intrauterine life to one that can survive
unattached
. Before birth, oxygen comes not from the air but from the mother's blood circulating to the placenta. Unborn babies get nutrition by that same route, bypassing their unused digestive tracts. Likewise, for eliminating most of the products of metabolism. But, as the umbilical cord is cut, blood flow dramatically shifts from placenta to lungs, and breathing is established to exchange oxygen and carbon dioxide. Not long after, as the newborn baby is put to breast or bottle, the digestive tract is also recruited to do its new job.

Fortunately, parents do not need to do much to make all this happen. The transitions at birth mostly occur automatically, flawlessly, and on schedule. Without minimizing the challenges of pregnancy, labor, and delivery, mothers (and fathers, too) soon realize that greater challenges lie ahead. Namely, nurturing a newborn's development.

* * *

Most of the behavioral repertoire of newborns isâto use a popular, but imperfect termâ
hardwired
. A new-born's brain and nervous system are preprogrammed to do what babies need to do to survive and to thriveâat least initially. Babies are programmed to cry, to suck. They are programmed to startle and to be soothed. Without thinking, they provide eye contact to their parents. And, gratefully, they are programmed to smile. Babies do not need to be taught to enjoy their parents' voices and songs, and they have built-in
clocks to eventually accommodate their parents' daily rhythms of wake and sleepâthough this accommodation may not happen right away, as many of you will soon learn.

But, returning to the machine metaphor of a baby's brain being “wired,” for development over the early months, it is important to know that there is an early and ongoing process of
rewiring
. This is because the neural pathways in babies' brains are highly plastic. Rewiring (think: fine-tuning) of the brains of infants and toddlers has been an important and central insight of modern neuroscience research. Learning language and motor skills, developing social skills, being able to process new information by exploring the world with all of the senses, and particularly listening to the human voice, all help rewire the infant's brain. Listening to stories being read and playing with parents on the living room floor are examples of neuroscience in action. Parenthood is largely about reshaping and fine-tuning these neural pathways. For brain development, the first 3 years are most important, but the first 12 months are critical. Parents have tremendous influence over how well this happensâby providing for their infant's physical and emotional needs, by keeping their child safe and healthy, and by facilitating early learning.

This all sounds like a huge responsibilityânot only like a job for a grown-up, but a job for a professional. And, if this is your first baby, you will not be alone in feeling, at times, under-prepared for the job â¦ and overwhelmed by it. And yet how could it be that the responsibility for overseeing this most important year in a child's life is given to the parents with the least experienceânew parents?

But, fortunately, just as newborns are endowed with some essential survival tools, so are parents. Parental instinct may not kick in as swiftly and automatically as a newborn'sâbut that's okay. Between the nurturing parents received themselves as newborns and the nurturing (and support, and advice) they'll turn to friends, family, online communities, and professionals for, it's remarkable how quickly that gap is filled. And it clicks.

The more you know about the job ahead, the faster it clicks. Twenty-five years ago, when the first edition of
What to Expect the First Year
was introduced, it quickly became the “bible” of baby careâmuch as my 2,500-page pediatric textbook served as my pediatrics “bible.” And today, even with access to information about all things parenting at the fingertips of anyone with a smart-phone, I'm confident that this brand new third edition will step in to hold the hands of a new generation of new parents in a way no other resource can.

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