Month 4

What's Happening to Me?


Your placenta is fully functioning and will serve as your baby's lungs, stomach, intestines, and kidneys. In addition to nurturing, the placenta also functions as a gland to produce progesterone and other enzymes and hormones necessary to maintain a pregnancy. Nausea and fatigue are subsiding.

Emotionally you may feel more comfortable with the idea of being a mother and may feel more physically relaxed. Some women experience a heightened sense of sexuality now and throughout their second trimester.

Your waistline is beginning to thicken, and you may be starting to "look" pregnant. Loose clothing is a must.


NEWSLETTER
Table of Contents

Baby's Development

Are You A Vegetarian?

Back to Basics

Child Passenger Safety in the Car

Feeling Safe

Intimacy During Pregnancy

Big Kids and Babies

Mommy's Notes

Baby's Development
During the fourth month, your baby's limbs and joints are fully formed, and the muscles are getting stronger. The sex organs are now developed enough to identify your baby as a boy or girl. Fingerprints are developed. Baby's eyes, nose, ears, mouth, and lips are formed; and toenails and fingernails are in place. Even the eyebrows and eyelashes have emerged. He or she has vocal cords and taste buds. There is a growth of fine hair (lanugo) all over baby's body. While you may not realize it, your baby is now quite active in the womb due to nervous system, muscle, and skeletal development. Toward the end of the fourth month, some women say it feels like the bursting of tiny bubbles. These feelings quickly intensify. By the end of the fourth month, your baby will weigh five to six ounces and will measure approximately six inches.

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Are you a vegetarian?
Achieving a balanced diet with sufficient quantities of protein and all the vitamins and minerals does not require any more effort if you are a vegetarian. By eating foods in combination, you will gain all the necessary amino acids. For example, if you are eating grains-rice or corn-combine them with dried beans or peas or nuts. If your meal is made up of fresh vegetables, add a few sesame seeds, nuts, or mushrooms to supply the missing amino acids. If you do not eat any dairy products, you will need to be a little more careful that your diet is rich in foods that contain calcium, vitamin D, and riboflavin. Consult your doctor about vitamin B12, which is found only in animal sources. A lack of it could lead to a form of anemia.

Prenatal vitamins will be prescribed by your physician, as appropriate. If you have any questions or concerns, be sure to jot them down for your next visit.

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Back
   to Basics

Eating four servings daily from each of these food groups is a good guideline to help ensure that you and your baby are getting all the nutrients you need. Your doctor may also prescribe a prenatal supplement containing extra vitamins, minerals, calcium and folic acid.
Vegetables and Fruits
Major sources of vitamins A and C and folic acid. Needed for: 		Breads and Cereals
Major sources of thiamin, niacin, iron, and zinc. Needed for:
Healthy skin and eyes
Formation of placenta
Formation of blood and blood vessels
Formation of bone, teeth, skin, cartilage 		Red blood cell formation
Digestion and appetite
Growth of bones and tissue
Formation of nerve and digestive system
Meat and Meat Alternates
Major sources of protein, iron, thiamin, vitamins B6 and B12, folic acid, and zinc. Needed for: 		Milk and Dairy Products
Major sources of protein, calcium, riboflavin, vitamins B12 and D. Needed for:
Growth of uterus, breasts
Digestion and appetite
Development of muscles and nervous system
Growth of placenta and baby
Red blood cell formation 		Growth of uterus, breasts
Increased blood volume
Formation of strong bones, teeth
Development of muscles and nervous system
Growth of placenta and baby

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Child Passenger Safety in the Car...

    what you must know

          by Phaedra Walton

First a question: Would you, a responsible adult, allow your child (or grandchild, neighbor's child, etc.) to swim alone or play with matches because he or she wanted to? Would you let them hang out a third-story window because you couldn't stand the tears when you said, "No"? Of course not. But every day, responsible adults allow these same children to ride improperly restrained (or even unrestrained) in the automobile. Most of them don't realize that a fall from a three-story building has the same effect on a child's body as a sudden stop or crash at only 30 mph!
In this country, automobile collisions are the #1 cause of preventable death and serious injury in children and young adults. It doesn't always take a crash-a sudden stop or improperly used safety seat can also have devastating consequences. And by "serious injury," I mean things like permanent brain damage, epilepsy, and spinal cord injuries. The "prevention," of course, is having everyone properly buckled up for every ride. (Remember, everything unrestrained goes flying -- an unrestrained adult can be thrown and kill a properly restrained child.) Seat belts are easy; car seats are not.

Many of us know the law: A child must be both 4 years old and at least 40 pounds to legally use only an adult seat belt. Unfortunately, adult seat belts are made to restrain a grown man's body, not a child's. Children are safest when riding in a car seat or booster seat for as long as they fit. And, if the child's safety isn't enough to convince you, the fines might be: $270 per unrestrained or improperly restrained child under 4 years/40 pounds, or $135 for children over 4 years/40 pounds and under 16 years. Plus, your auto insurance may go up, and the court may require you to attend a two-hour education program! (I know. I'm one of the instructors.) Yikes!

Because part of what I do is check car seats for the courts, I know the most common mistakes people make. Even parents who believe they are doing everything right often can make improvements.

Here are some guidelines:

  • First, and most important, read all instructions for your car seat or booster and follow them exactly. Store instructions with the seat so you can refer to them later.
  • Do not allow stickers to be removed from the seat. One of them has the car seat's exact manufacture date and may be important if your seat is recalled for any reason. Also, send in the registration card that came with your seat. (If you have moved or didn't send it in, you can call the manufacturer's 800 number and still register the seat. They fix recalls free of charge.)
  • Children under one year of age should ride facing the rear of the car. Even if your child has outgrown the infant seat (at around 20 pounds or, for a tall child, when the top of baby's head is one inch from the top of the seat), it is important to keep them facing rear for a year. Many of the newer convertible seats-the big seats that hold infants and children up to about 40 pounds-will accommodate a rear-facing child up to 30 pounds.
  • Children in car seats are safest in the middle of the back seat, if the seat can be secured firmly. If this isn't possible, then either side of the back seat is preferable to the front seat. In fact, the recommendation is that all children age 12 and under ride in the back seat. Never put a rear-facing infant in the front seat if there is a passenger air bag. It's a deadly combination.
  • The car seat should be reclined for a rear-facing child (no more than 45 degrees) but in the upright position for a forward-facing child. (Heads and necks can snap forward too much when an older child is reclined.)
  • Make sure harness straps are snug and properly positioned. Unless the instructions state otherwise, use only the uppermost slots for all forward-facing children. (This is because often the middle slots are not reinforced.) Use slots at or above the shoulders for forward-facing children and at or below the shoulders for rear-facing.
  • Keep harness straps untwisted. Twisted straps dig into tender skin; flat straps help distribute crash forces more evenly and safely.
  • That plastic clip that you may have pushed into the tray shield is actually one of the most important safety features on your car seat! It's called a retainer clip and must be buckled at the child's armpit level on every ride. Your seat may not pass federal safety standards without it! It keeps the straps properly positioned on your child's shoulders.
  • You should not be able to move your car seat forward or sideways when it is properly installed in the car. (Exception: a rear-facing infant-only seat may be flipped up toward the car seat-back. Because of this, the harness must fit snugly.) When installing the seat, place your knee into the car seat and put your full body weight into the seat, then buckle the automobile's seat belt. If you are securing the seat with a continuous lap-shoulder belt, check the car's owner's manual to see if you need to use the metal locking clip that came with your car seat. Then follow locking clip instructions carefully. It goes on the car's safety belt to keep the child's seat from moving.
  • NEVER use a car seat that has been in a crash. Also, don't put your child in a seat unless you know its history. Seats over 10 years old can be dangerous and should be destroyed.
Children look to us to keep them safe. It's not always a fun job, and your decisions may not help you win a popularity contest. But the day may come when the unexpected happens. Be prepared. You can't replace a precious child.

For more information on child passenger safety, contact SafetyBeltSafe U.S.A. at (310) 222-6860 or (800) 745-SAFE, or visit the website at www.carseat.org.

This article was reprinted with permission from the La Caņada-Flintridge Magazine.

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Feeling Safe
Feeling safe during pregnancy is of the utmost importance.
Here are a few basics:

  • Wear a seat belt whenever you are in your car. Be sure to place the lap belt under your abdomen area for good protection for you and your baby.
  • Wear low-heeled shoes. They won't throw you off balance as easily as high-heeled shoes, and they reduce the chance of back pain.
  • Avoid toxic substances, including insecticides, paint, and industrial chemicals, as well as hazardous environments such as rooms with limited ventilation.

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Intimacy During Pregnancy
During the second trimester, many women experience an increased sexual desire. Fatigue and nausea are subsiding; you may feel more energetic. Increased blood flow to the breasts and pelvic region, as well as an elevated level of estrogen, also contribute to this feeling. There is freedom, of course, from having to use contraceptive methods.

It's only natural to wonder how sexual activity may affect your unborn baby. Research has taught us that sex during pregnancy is healthy and may be continued into your pregnancy as long as you feel comfortable. There is no information suggesting that sex harms the baby. The womb is completely sealed off by the mucous plug. The baby is safely protected in a bag of fluid that completely surrounds it. The amniotic sac is an excellent cushion; and once the baby is firmly attached to its mother's uterus, it is 		unlikely intercourse can cause miscarriage. There are certain pregnancies where sex is not okay. Consult your physician.

Discuss intimacy during pregnancy with your physician. As long as sex isn't too athletic, sex is recommended throughout pregnancy unless your physician advises you otherwise. If you feel abdominal pain, bleeding, or any signs of labor, discontinue sexual activities and notify your physician.

There tends to be some loss of libido during the first and third trimesters. This could be a result of increased hormonal activity at the beginning of pregnancy, causing nausea and tiredness, and of your pregnancy shape at the end. Even if you don't feel like making love, many couples explore other ways of touching and giving sexual pleasure to each other.

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Big Kids and Babies
If you haven't done so already, now is the perfect time to tell your children they'll soon have a new brother or sister. Depending on their ages, you may get a variety of responses, from confusion, jealousy, or joy. Sibling rivalry is normal and should be expected. Whatever your child's initial reaction, you can make the transition easier if you involve him in preparations for the baby. Children can help in a variety of ways, including helping with household chores, sharing in choosing names for the baby, selecting new toys and clothing, and helping prepare the nursery. If the baby necessitates a bedroom change for an older brother or sister, do it early in the pregnancy. Then everyone will be settled when the baby arrives.

School-aged children may exhibit fewer sibling rivalry tendencies because their lives are not totally centered around mom and dad. Younger children may need a bit more patience. Until now, they haven't had to share your attention with anyone 		else, and your stay in the hospital may be the first time your child has been separated from you. Be sure children of any age realize that your hospital stay is not due to an illness and that pregnancy and childbirth are normal.

Let your older child know how special he or she is by registering him or her for Big Kids and Babies, a one-hour class designed to help siblings adjust to the idea of becoming older brothers or sisters. The class teaches children how to properly hold and interact with an infant, acknowledging their important contributions.

Children also tour the BEGINNINGS Family Birth Center so they can see where mom and baby will be. Emphasis is placed on teaching the older sibling the importance of being baby's first friend. For more information or to register, call the BEGINNINGS line at (818) 952-2272.

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