Friday, October 02, 2009

How to Make Sure Your Baby Equipment is Safe

The United States Consumer Product Safety Commission (CPSC) protects the public from serious risk, injury or death posed by consumer products. Here are several of their suggestions for purchasing safe baby equipment and products:

  • Baby Strollers or Carriages: should have a wide base to prevent tipping and the stroller's breaks should securely lock the wheels. If you're transforming the stroller into a carriage, make sure leg openings can close to prevent your baby from falling out. Make sure the stroller's shopping basket is directly over or in front of the rear wheels to ensure stability.
  • Toys: you should have a meticulous eye for any strings that might get wrapped around your baby's neck or detachable pieces he or she can choke on. Rattles should also be sturdy enough to withstand being dropped or struck so they do not break. Toys should not be left with your baby while he or she is sleeping.
  • Cradles: must have a sturdy bottom and wide base for stability. The cradle should have smooth surfaces, free of protruding staples or other hardware that can injure your baby. The cradle should also have strong legs and locks to prevent it from folding while your baby is inside. The CPSC also suggests using a firm mattress that fits snugly inside the cradle.
  • Car Seats: automobile crashes are the leading cause of death for children in the United States and installing your car seat properly is crucial. Read the directions and practice installing your car seat before your baby arrives. Also refer to your car's owner's manual to see if any other guidelines are provided. Make sure your car seat appropriate for your baby's weight and height.

For more information about product safety, visit the U.S. Consumer Product Safety Commission Website or call them at 800-683-2772.

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Halloween Costumes for Pregnant Women

If you happen to look for a maternity Halloween costume this year, you will inevitably run into the same costumes over and over again: pirate, devil, fairy, angel, nun, etc. It looks like costume companies haven't gotten very creative with the unique body shape that pregnancy brings. Luckily, creative folks have taken things in their own hands. Here are some Halloween costume ideas for you:

Are Haunted Houses Safe While Pregnant?

Are haunted houses safe while pregnant? It depends.

If the haunted house is one for children, meaning something extremely mild in the scare factor, then it should be fine. But the later you are in your pregnancy paired with the intensity of a professional haunted house could be cause for concern.

Aside from being frightened, raising your blood pressure, along with your baby's, and the anxiety and distress that could cause pre-term labor, there are other factors to consider (as if that wasn't enough):

  • The darkness and tripping over something you cannot see. (I know my balance is certainly off.)
  • Loud startling noises can also affect the baby.
  • Smoke or fog machines are not healthy to breathe in.
  • They are often crowded and people push and shove -- could be dangerous.
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Thursday, October 01, 2009

Stay-At-Home Moms: Who They Really Are and How They Rate Themselves

More stay-at-home mothers give themselves better marks as parents than do mothers who work outside the home, according to an analysis released Thursday.

The analysis, by the Pew Research Center, is based on several of their telephone polls, the most recent of which was conducted this summer and included 1,815 people 16 and older. It found that among the at-home mothers, 43 percent rated themselves 9 or 10, at the top of the scale, while 33 percent of working mothers did so.

“In perhaps the most powerful evidence of the cross-pressures that many working mothers feel every day,” the study said, “only 13 percent of moms who work full time say having a mother who works full time is the ideal situation for a young child.”

The Pew study,along with a new Census Bureau analysis also released Thursday, provides fresh details on the nation’s 5.6 million stay-at-home mothers. The bureau’s analysis, which considered census data from 2007, found that mothers who do not work outside the home are likely to be younger, Hispanic or foreign-born.

For example, the study found that 44 percent of stay-at-home mothers are under age 35, while only 38 percent of mothers in the labor force are under 35. It also found that 27 percent of stay-at-home mothers are Hispanic and 34 percent are foreign born, while 16 percent of mothers working outside the home are Hispanic and 19 percent are foreign born.

Women without a job outside the home are more likely to have an infant in the household and have less than a high school degree, the bureau found.

“It makes sense that the stay-at-homes are younger, as young people are more likely to be in school,” said Guillermina Jasso, a sociology professor at New York University.

The bureau’s analysis is part of its study on “America’s Families and Living Arrangements.” Officials say it is the agency’s first look at who the nation’s stay-at-home mothers are.

The Pew study found that 3 out of 10 stay-at-home mothers say family responsibilities keep them out of the labor force. While two-thirds of women with children 16 or younger work full time outside the home, most say they would prefer to work part time, the Pew study said.

The Pew study also found that in 66 percent of married couples with children under 18, both spouses were in the labor force.

The census data also revealed that the nation’s 5.6 million stay-at-home moms represent 24 percent of all married couples with children under 15.

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Will Ferrel Expecting his Third Son!

According to his rep., former Saturday Night Live star Will Ferrell(42) and his wife, auctioneer Viveca Paulin(40), have a 3rd son on the way!

Their sons, Mangus (5 1/2) and Mattias (2 1/2), will be meeting their little brother in January.

The couple met in acting class in 1995. Will Ferrell was recently nominated for a Tony for his famous George W. Bush impersonation that was featured in his Broadway show.

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Heart Disease Link to Prenatal Flu Exposure: Study

Children of women infected with influenza during pregnancy have a substantially higher risk of heart disease late in life, according to a study published on Wednesday.

The findings underscore the danger facing pregnant women from the H1N1 swine flu virus, or any other strain of flu, and also demonstrate that what happens in the womb can affect a person decades later.

Caleb Finch of the University of Southern California and colleagues studied records from the 1918 flu pandemic and found that boys whose mothers were infected during the second or third trimester of pregnancy with them had a 23 percent greater chance of having heart disease after age 60 than boys whose mothers were not infected.

Girls exposed in the second or third trimesters were not at greater risk for cardiovascular problems. But girls infected during the first trimester were 17 percent more likely than the general population have heart disease later in life.

Boys whose mothers had flu while pregnant were also more likely to be slightly shorter than their peers, Finch's team reported in the Journal of Developmental Origins of Health and Disease.

The researchers examined records of more than 100,000 people born around the time of the 1918 flu outbreak in the United States. They also examined the height of 2.7 million men born between 1915 and 1922, using military enrollment records from World War II.

Results showed that average height increased every successive year except for the period coinciding with fetal exposure to the flu pandemic.

"The 1918 flu was far more lethal than any since. Nonetheless, there is particular concern for the current swine flu, which seems to target pregnant women," Finch said.

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Surgery During Pregnancy May Treat Heart Defects

Infants born with a rare heart defect may have better outcomes when surgery to repair the heart is done while the infant is still in the womb, Harvard University researchers say.

The condition, hypoplastic left heart syndrome, occurs when the fetus's left ventricle is underdeveloped and the heart cannot pump enough blood to sustain life. It affects about 1 in 10,000 newborns, and without open-heart surgery within a week of birth, these infants face death. Even with the heart repair, the children lead restricted lives and need at least one heart transplant, researchers say.

"Using the new procedure, in about 30 percent of the fetuses [with technically successful operations], there was an outcome of a two-ventricle circulation after birth," said Dr. Doff B. McElhinney, an assistant professor of pediatrics at Harvard Medical School and an associate in cardiology at Children's Hospital Boston.

How well the infants in the study will fare over the long term isn't known, but the researchers intend to follow them as they grow up, McElhinney said.

In fetuses, aortic stenosis usually progresses to hypoplastic left heart syndrome, the study explains. Prenatal intervention could reduce the total number of surgeries required over a lifetime, eliminate the need for a heart transplant and possibly improve the children's quality of life, he said.

According to the study, 51 of 68 procedures were considered technically successful, and 17 infants (33 percent of the 51) were born with a fully functioning heart.

The operation involves threading a catheter through the mother's abdomen into the fetus's heart. A balloon at the end of the catheter enlarges the aortic valve that controls blood flow from the left ventricle into the aorta and then into the body, McElhinney explained.

The window for performing the procedure is narrow -- at around 20 to 21 weeks of pregnancy, McElhinney said. With time, experience and better technology, the success rate will get better, he added.

"By no means is this revolutionizing the care for all fetuses with hypoplastic left heart syndrome," he said. "It's applicable only in a small subset of those with this disease, and it's working in a relatively small percentage of those in whom we attempt it," he said. And even infants who had a successful procedure needed additional procedures after birth, he noted.

Still, while not a "ringing success," he said it reinforces the belief that prenatal intervention can be used to change the development of serious forms of heart disease.

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Smoking in pregnancy risks psychotic children

Mothers who smoke during pregnancy put their children at greater risk of developing psychotic symptoms as teenagers, British scientists said on Thursday.

Researchers from four British universities studied 6,356 12-year-olds and interviewed them for psychotic-like symptoms such as hallucinations or delusions. Around 19 percent had mothers who smoked during pregnancy.

Just over 11 percent, or 734 of the total group, had suspected or definite symptoms of psychosis.

Many previous studies have shown cigarettes can harm the fetuses of mothers who smoke while pregnant. The risks include causing babies to be born smaller and increasing the risk of sudden infant death syndrome or heart defects.

Stanley Zammit, a psychiatrist at Cardiff University's School of Medicine who led the study, said the more the mothers smoked, the more likely their children were to have psychotic symptoms.

"We can estimate that about 20 percent of adolescents in this cohort would not have developed psychotic symptoms if their mothers had not smoked," he said.

Despite countless studies flagging up the risks to babies, it is estimated that between 15 and 20 percent of women in Britain smoke during pregnancy.

The researchers also found drinking during pregnancy was associated with increased psychotic symptoms, but only in children whose mothers had drunk more than 21 units of alcohol a week in early pregnancy.

The reasons for the link between maternal smoking and psychotic symptoms are not clear, but Zammit and colleagues suggested that exposure to tobacco in the womb might affect a child's impulsivity, attention or cognition.

Only a few mothers in the study, which was published in the British Journal of Psychiatry, said they had smoked cannabis during pregnancy, and this was not found to have any significant link with psychotic symptoms.

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Wednesday, September 30, 2009

Treat mild diabetes in pregnancy, study suggests

Even women with mild gestational diabetes should receive treatment to improve the health of both mother and baby, according to a federally funded study that should help resolve a longstanding controversy in obstetrics.

Rates of gestational diabetes have been increasing as more U.S. women enter pregnancy overweight. Moderate-to-severe cases of the condition are always treated, but there has been uncertainty among doctors on whether women with mild increases in blood-sugar levels warrant additional care.

"Healthcare providers do not wish to overtreat women or unnecessarily alarm them, nor do they wish to impose extra costs, including self-glucose monitoring," said Dr. Mark Landon, lead investigator and interim chair of obstetrics and gynecology at Ohio State University Medical Center.

The study, published in the New England Journal of Medicine, assigned 958 women with mild gestational diabetes, who were between 24 and 31 weeks’ pregnant, to receive either diabetes treatment or no treatment. The women who received treatment were counseled on diet and glucose monitoring and, if necessary, received insulin.

Most of the babies in both arms of the study were born at normal weights. However, in the treatment group, 7.1% of infants were too large — defined as at or above the 90th percentile — compared with 14.5% in the untreated group. Babies in the treated group were less likely to be born via Cesarean section or to suffer trauma at birth.

Women in the treated group gained less weight during pregnancy, had fewer preterm births and fewer cases of preeclampsia, a sudden increase in blood pressure. The study was conducted at 14 sites and funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

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Mom's Obesity During Pregnancy Tied to Daughters' Early Puberty

Consequences of obesity in women may extend years into their daughters' lives, study findings hint.

The researchers found that daughters of obese mothers, versus normal- or under-weight mothers, were about three times more likely to start menstruating before their 12th birthday.Previous studies have shown overweight girls tend to enter puberty at an earlier age and children of obese women tend to be overweight themselves, Dr. Sarah A. Keim, of the National Institutes of Health in Bethesda, Maryland, and colleagues note in the journal Epidemiology.

In the current study, daughters of obese mothers were more likely to begin menstruation at a young age, "even if they themselves were not overweight," Keim told Reuters Health in an email correspondence.

Keim's group interviewed 597 women between 22 and 32 years old to determine the age they began menstruation. Overall, 121 of the daughters reported first menstruation at age 11 or younger, while 158, 147, and 171 reported the same at the ages of 12, 13, and 14 years or older, respectively.

They compared this information with the mothers' prepregnancy weight, height, and other information recorded when the moms participated in the 1959 to 1966 Collaborative Perinatal Project.

Daughters of mothers who were obese were 3.3 times more likely to begin menstruating when younger than 12 years old, relative to daughters of women who were not obese.

Menstruation at age 12 was 2.7-times more likely among daughters of obese women. These associations held in analyses that allowed for mothers' height and other factors linked with early menstruation.

By contrast, the investigators found no early menstruation link in the daughters of women who were normal or underweight when they got pregnant.

The researchers call for further investigations to explain these associations. For example, mothers and daughters may share diet and exercise habits. Or, as Keim pointed out, carrying excess weight during pregnancy may alter fetal development "in ways we are still trying to understand."

Source

Tuesday, September 29, 2009

Early Pregnancy Loss Linked to Intense Labor and Low Food Intake

Life is all about tradeoffs and recently published research by Virginia J. Vitzthum, a senior scientist at Indiana University's Kinsey Institute for Research in Sex, Gender, and Reproduction, and professor in the IU College of Arts and Sciences' Department of Anthropology, has shown that during periods of intense labor and low food intake, rates of early pregnancy loss can more than double.

The findings, reported recently in the American Journal of Human Biology, are the first to show seasonality of early pregnancy loss in a non-industrialized population -- in this case rural Bolivian women -- and the first to demonstrate a relationship between economic activities and early pregnancy loss.

Vitzthum's research challenges the past belief that nearly all early pregnancy losses are caused by genetic defects in the embryo. Genetic defects wouldn't change with the seasons, so Vitzthum's findings show that environmental factors must also play a major role in early pregnancy losses.

"This finding applies to U.S. moms just as much as Bolivians, and it applies to psychosocial resources just as much as food supply," Vitzthum said. "As well as healthy food, pregnant women also need good working conditions and adequate social support from family, friends and workplace to keep their risks of early pregnancy losses low."

"Until recently, it was assumed that women everywhere had similar reproductive biology," she said. "We now know that women vary tremendously, and these differences affect women's health."

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Essay: Pregnancy Is No Time to Refuse a Flu Shot

This article is by Anne Drapkin Lyerly, Margaret Olivia Little and Ruth R. Faden.

Pregnant women are deluged with advice about things to avoid: caffeine, paint, soft cheese, sushi. Even when evidence of possible harm is weak or purely theoretical, the overriding caveat is, “Don’t take it, don’t use it, don’t do it.”

In a few contexts, the admonition is warranted; in most, it is merely inconvenient and anxiety provoking. But in the case of pandemic influenza, it may be deadly. With the second wave of swine flu at hand, and up to 50 percent of the public at risk, the usual mode of thinking about pregnancy and medications threatens to make a worrisome situation worse.

The dangers of this mentality became frighteningly apparent this summer, when a study in The Lancet reported strikingly high rates of death and of complications like pneumonia in pregnant women with H1N1 influenza. Pregnancy meant a fourfold risk of hospitalization, sometimes with a tragic outcome; all the pregnant women who died had been relatively healthy to begin with.

The Centers for Disease Control and Prevention have since put pregnant women at the top of the priority list for the vaccine, and have recommended that pregnant women start antiviral medications as soon as possible after exposure to the virus and after the onset of flu symptoms.

But if experience is any indication, even these forceful recommendations may not be enough to overcome reluctance among pregnant women and those who care for them. Even though the seasonal flu vaccine is recommended for pregnant women in particular, in one study only 15 percent received the vaccine — a rate far lower than any adult group for whom it is recommended.

And despite recommendations that antiviral drugs be started as soon as flu symptoms appear, many pregnant women in the Lancet study were not treated soon enough. Delays ranged from 6 to 15 days from the time that symptoms started, and 2 to 14 days from the time the women were seen by a doctor. Not one of the six pregnant and relatively healthy women who died received medication within 48 hours of the onset of her illness.

This is a sadly familiar pattern. After the thalidomide disaster of 1960s, and the very real concerns it raised about the impact of drugs on fetal development, many ended up viewing the use of any medicine by pregnant women as anathema. As a result, doctors and women alike often eschew or discontinue medications for serious illnesses, even when the harms of untreated disease, for women and the children they bear, are worse than any risks of medication.

Poorly treated asthma during pregnancy, for example, is associated with higher rates of pregnancy complications for women, as well as growth problems in the fetus and premature delivery. By contrast, women whose asthma is controlled with medication do as well as women without asthma, and so do their babies. Untreated diabetes early in pregnancy elevates the chances of severe birth defects to as high as 1 in 4.

And yet even when the evidence is clear, pregnant women find it hard to fight against the “don’t take it, don’t use it, don’t do it” mentality, which focuses our minds and emotions only on the risks of taking a drug. Obscured from view are the risks of the disease itself.

Overcoming this mindset will take work on several fronts. Every effort needs to be made to alert pregnant women and clinicians about the special risks of H1N1 in pregnancy. Educational efforts need to be honest about the reasoning behind these important recommendations, including both the limits of what we know and the reasons that concern for pregnant women is now so great.

But the key to success, now and in the future, will be the conduct of research that is specific to the needs of pregnant women. Concerns about the ethics of research involving these women mean that we know far less about how to treat or prevent disease during pregnancy than for other adults and children. The urgent threat of H1N1 flu has brought into sharp relief the fact that pregnant women can and should be protected through research, not from it.

Studies enrolling pregnant women in trials of vaccines for swine flu, financed by the National Institute of Allergy and Infectious Diseases, are now under way at six major medical centers. Researchers are also studying ways to guide the use of antiviral drugs to suit pregnant women’s changed metabolisms. Experts suggest that studying blood samples from as few as two dozen women is all we need to determine whether the standard adult dose of antivirals is effective for treatment or protection during pregnancy.

If there was ever a time to rewrite the playbook on how to think about drugs, vaccines and pregnancy, this is it. The lives of women and babies depend on it.

Anne Drapkin Lyerly is an associate professor of obstetrics and gynecology at Duke, Margaret Olivia Little is director of the Georgetown Kennedy Institute for Ethics, and Ruth R. Faden is director of the Johns Hopkins Berman Institute of Bioethics.

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Monday, September 28, 2009

Having a Baby: Training and the Quality of an Obstetrician

When it comes to delivering a baby, it really does matter where a doctor was trained: some residency programs produce better obstetricians than others.

This is the conclusion of a study that evaluates programs based on how well the patients treated by the programs’ graduates fared.

The researchers analyzed the records of 4.9 million deliveries in Florida and New York State from 1992 to 2007, looking for complications like infections and bleeding after vaginal and Caesarean section deliveries.

The 4,124 obstetricians overseeing the deliveries had graduated from 107 different residency programs.

The programs were divided into five groups, based on their graduates’ rate of complications. Among women whose babies were delivered by doctors trained in the top fifth of programs, 10.3 percent experienced complications. For the others, the complication rate was 13.6 percent.

“You can look up on the Web and see what the mortality rate is for cardiac surgeons,” said Dr. David A. Asch, executive director of the Leonard Davis Institute of Health Economics at the University of Pennsylvania. “We determined that obstetrics and gynecology residency programs also differ in the quality of the physicians they produce.”

Dr. Asch declined to say which obstetrics programs did the best.

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Today is Officially Family Day

Repeated studies coming out of the National Center on Addiction and Substance Abuse (CASA) show that children who eat at least five meals a week with their families are less likely to smoke, drink and use drugs. According to studies from Harvard University and many others, they are also more likely to get good grades and less likely to be obese.

Several state and national organizations, including CASA, have launched initiatives to raise awareness regarding the significance of family meals. The president and governors of all 50 states have proclaimed or supported CASA's Family Day — A Day to Eat Dinner with Your Children on the fourth Monday of every September, which is today.

"If I could wave a magic wand to make a dent in our nation's substance abuse problem, I would make sure that every child in America had dinner with his or her parents at least five times a week," CASA chairman Joseph Califano said.

While the quality of food is often better — more fresh vegetables and fruit, for example — it's the quality of family time that is of greatest value to children, said Megan McLachlan, a family wellness educator with the Fox Cities Parent Connection and a former high school teacher.

"Family meals are a main factor in staying connected your children," said McLachlan, who makes family meal time a priority with her husband and children, ages 9 and 11. "It's a great forum for communication, for learning table manners, for staying connected. It's a great place to work on many, many things."

As it stands, surveys indicate only 60 percent of kids eat regular meals with their parents, and close to half have televisions on during mealtime.

Families who can't eat dinner together because of parents' work schedules might opt instead for family breakfast or lunch during summers, said Amy Mankiewicz, a counselor with Parent Connection in Oshkosh. If they can't do it during the week, she said, try to make it work on the weekends. When children want to spend time instead with their friends, invite those friends to dinner, she suggested.

"You can be creative. Maybe you all sit down together for a health snack," she said. "The most important thing here is that you're finding and making the time to connect with your children."

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Ways to Save Money on Baby Gear

When it comes to buying baby products, there’s a lot to choose from–and there’s a lot of stuff you can live without. Here’s how to get high-quality, safe baby gear without spending a bundle.

  • Get more mileage from your baby registry
  • Friends and relatives want to give you gifts, so take advantage. But before you add a product to your registry, make sure it’s right for you and your lifestyle. Test-drive products in the store and take your baby registry as seriously as if you were paying the tab yourself. Register for big-ticket items like a stroller, car seat and crib. Who knows? Friends and relatives may go in as a group and buy them for you.

    Don’t forget to register for everyday items, such as diapers in all sizes except for newborn, and baby wipes. You’ll need those items for years to come. Babies will outgrow newborn diapers in a flash, so it doesn’t pay to register for that size. And don’t register for clothes. You’ll get those anyway as baby gifts.

  • Take advantage of freebies and coupons
  • One of the best ways to save is to shop with coupons when products go on sale, then stock up. That’s a good way to save money on baby food, diapers and baby wipes, for example. And take advantage of baby-related trade shows that come to your town as these shows are great spots to pick up promotional free products and coupons.

  • Compare prices online
  • Once you know what you want when it comes to baby gear, you can go online and find the best price. But watch out for shipping charges. For heavier items, it might make sense to go to the store instead.

  • Buy used
  • Garage sales make sense for buying items that often aren’t used every day, such as backpack carriers, a bicycle trailer or bicycle-mounted seat. Consignment stores are often great spots for gently used clothing, toys and other gear.

    In general, a used product should either be new, or look like new to you. Don’t give your baby something that doesn’t look safe. Some products, like a car seat or crib, you should always buy new because their safety standards are constantly being updated, so you want to make sure you’re buying the latest version. And whether it’s new or used, check the CPSC’s website to make sure it hasn’t been recalled.

  • Buy as your baby grows
  • Except for the basics, such as a crib, car seat, and stroller, you don't need to buy many baby products until you're sure you'll need them. The wait-and-see approach gives you time to check with friends about their experiences with specific baby products. This can save you money as you’re likely to discover that you may not need certain items, or may be able to borrow them.

  • Stock up in the fall
  • Fall is prime baby bargain time, since retailers tend to clear their inventory to make room for next year's products, which arrive between November and January.

  • Shop around
  • The trick is to do your homework and research products before you shop online or step foot in the baby products super store.

    Prices can vary from one shopping venue to another, sometimes dramatically. Mega stores and discount chains such as Babies "R" Us, Sears, Target, and Wal-Mart often have the lowest prices. For personal attention and informed sales help, smaller stores may be a better bet. Another plus: Mom-and-pop stores have more leeway to offer on-the-spot discounts, especially if you're a regular customer. Just be sure to ask, "Is that your best price?"

  • Don’t cave under pressure
  • Keep in mind that salespeople everywhere may have an incentive to push their most expensive wares. And beware of the emotional pull of lines like: "But it's for your baby" and "It's not every day that you have a baby." Unless you're on your guard, it's easy to be persuaded to spend, spend, spend.

  • Watch for sales
  • Toys "R" Us, Babies "R" Us, and BuyBuyBaby stores routinely put out newspaper inserts and in-store fliers with big savings on brand-name baby items. At other stores you can sign up for special email promotions (Carters, Baby Gap and Osh Kosh have regular discounts for those on their email lists.)

  • Keep baby food costs down
  • If you use formula, buy the store brand in the powdered version. That’s the least expensive option. And stock up when it goes on sale. (All infant formula sold in Canada and the U.S. must meet the same basic safety requirements, so if your baby likes store-brand formula, there’s no reason not to buy it.)

    And when you start your baby on solid food, try making your own. You’ll be amazed by how easy and cost effective it is to make your own baby food.

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