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.
- Car safety 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 is 1 year old AND 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.
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.
Avoid sleep positioners. They are both unnecessary and rarely have caused suffocation. Babies will stay on their back until they learn to roll over. Once they learn to roll over, they no longer need to sleep on their back.
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. Soft bumper pads carry a small risk for suffocation. 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.
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. Plastic bottles usually are preferred over glass bottles because they don’t break. Avoid any plastic bottles that contain the chemical bisphenol A. Discard any old bottles that have become cloudy in appearance. 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.
You can choose disposable or cloth diapers. They perform equally for preventing diaper rashes. If you’re concerned about using diaper pins, diaper covers come with Velcro straps. The main advantage of disposable diapers is that they are very convenient. They make it easier to travel, and day care centers can operate more efficiently. The superabsorbent-gel diapers do not leak.
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).
If you are breast-feeding, you may want to know how often your baby wets so you can check if your baby is getting enough breast milk. It is easy to know when a cloth diaper is wet. It is more difficult to know when a disposable diaper is wet, but you can insert a cotton ball or piece of tissue.
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.
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 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.
- 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.
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. Avoid glass thermometers that contain mercury.
- 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.
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.
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.
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. Avoid baby slings until 4 months of life because they have caused suffocation in some babies.
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.
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.
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.
A gate is essential if your house has stairways that your baby must be protected from. Only wall mounted gates should be used at the top of stairs. A gate is also helpful for keeping 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). Pressure loaded gates can be used for these circumstances. All gates should be difficult for a child to climb.
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.
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.
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-feeding 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
Walkers are dangerous. 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.
Written by Barton D. Schmitt, MD, author of “My Child Is Sick”, American Academy of Pediatrics Books. Published by RelayHealth.
Last modified: 2010-09-02
Last reviewed: 2010-06-02 This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Pediatric Advisor 2011.4 Index
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