Rebornne Baby American Baby

Alertness in the Womb
Learn how your baby moves and experiences life in utero.

Asleep and Awake

From early on in your pregnancy, your baby is more like a newborn than you might think. He sleeps, moves around, listens to sounds, and has thoughts and memories. Here's how:

Just like newborns, fetuses spend most of their time sleeping. At 32 weeks, your baby sleeps 90 to 95 percent of the day. Some of these hours are spent in deep sleep, some in REM sleep, and some in an indeterminate state -- a result of his immature brain. During REM sleep, his eyes move back and forth just like an adult's eyes. Some scientists even believe that fetuses dream while they're sleeping! Just like babies after birth, they probably dream about what they know -- the sensations they feel in the womb.

Closer to birth, your baby sleeps 85 to 90 percent of the time, the same as a newborn.

On the Move

Around the ninth week of pregnancy, your baby starts making her first movements. Those movements are probably visible with an ultrasound, even though they can't be felt for several more weeks. By 13 weeks, your baby may be able to put a thumb in her mouth, although the sucking muscles arent completely developed yet.

Although your baby's first muscle movements were involuntary, the first voluntary muscle movements occur around week 16. After this point, awake or asleep, your baby moves 50 times or more each hour, flexing and extending her body, moving her head, face, and limbs, and exploring her warm, wet home by touch. A baby may touch her face, touch one hand to the other hand, clasp her feet, touch her foot to her leg, or her hand to the umbilical cord. By week 37, your baby has developed enough coordination so that he or she can grasp with the fingers.

Along with these common movements, babies perform some odder activities, including licking the uterine wall and "walking" around the womb by pushing off with its feet.

Fetuses also react with motion to their mother's actions. For instance, ultrasounds have shown a fetus bouncing up and down when the mother laughs. Watching this on the screen, moms-to-be often laugh harder, and the fetus starts moving up and down even faster!

Second or third children may have more stretching room in the womb than first babies because a woman's uterus is bigger and the umbilical cord longer after her first pregnancy. These children usually get more motor experience in utero and tend to be more active infants.

By week 29, you should be feeling your baby move at least 10 times an hour.

Learning and Memory

Along with the ability to feel, see, and hear comes the capacity to learn and remember. For example, a fetus may be startled by a loud noise, but stops responding once the noise has been repeated several times.

Twins at 20 weeks' gestation can be seen developing certain gestures and habits that persist into their postnatal years. In one case, a brother and sister were seen playing cheek-to-cheek on either side of the dividing membrane. At one year of age, their favorite game was to take positions on opposite sides of a curtain, and begin to laugh and giggle as they touched each other and played through the curtain.

Studies have also shown a baby can feel and remember its mother's emotional state. An experiment in Australia revealed that unborn babies were participating in the emotional upset of their mothers who were watching a disturbing 20-minute segment of a movie. When the babies were reexposed to this film up to three months after birth, they still showed recognition of the earlier experience.

In the 1980s, psychology professor Anthony James DeCasper, PhD, and colleagues at the University of North Carolina at Greensboro performed a study with a feeding contraption that allows a baby to hear one set of sounds through headphones when it sucks faster, and to hear a different set of sounds when it sucks slower. This experiment revealed that within hours of birth, a baby already prefers its mother's voice to a stranger's, suggesting that it must have learned and remembered the voice from the womb. Newborns also preferred a story read to it repeatedly in the womb over a new one. And the same soft music that soothes them in utero soothes them again after birth.

Newborns can not only distinguish their mother's voice from a stranger's, but would rather hear Mom's voice, especially the way it sounds filtered through amniotic fluid rather than through air. They also prefer to hear Mom speaking in her native language than to hear her or someone else speaking in a foreign tongue.

Babies in the womb are probably reacting to the overall sound of voices and stories, not their actual words. But the conclusion is the same: the fetus can listen, learn, and remember at some level, and, as with most babies and children, he likes the comfort and reassurance of the familiar.

Baby's Developing Senses
How baby learns to see, hear, smell, touch, and taste.

How baby learns to see, hear, smell, touch, and taste.

Shortly after your baby is conceived, she seems to be just a tiny little tadpole. But nine months later, she's a real person with five acute senses. How do those senses develop? Read on and find out.

Touch
Just before the eighth week of gestation, an embryo develops its first sensitivity to touch. The first parts of its body to experience sensitivity are the ones that are the most sensitive in adults. It starts in the cheek and then quickly extends to the genital area (10 weeks), palms (11 weeks), and soles of the feet (12 weeks). By 17 weeks, the abdomen and buttocks are also sensitive. Your baby may experiment with this newfound sense of touch by stroking his or her face or sucking on a thumb, as well as feeling other body parts and seeing how they move.

By 32 weeks, nearly every part of the body is sensitive to heat, cold, pressure, and pain.

Taste
By 13 to 15 weeks a fetus's taste buds already look like a mature adult's, and the amniotic fluid that surrounds the fetus can smell strongly of curry, cumin, garlic, onion, or other strong tastes from a mother's diet. Studies show that a fetus's swallowing increases when surrounded by sweet tastes and decreases with bitter and sour tastes.

During the last trimester, the fetus is swallowing up to a liter a day of amniotic fluid, which may serve as a "flavor bridge" to breast milk, which also carries food flavors from the mother's diet.

By birth, babies have a strong sense of taste. Newborns can discriminate between tastes and have shown definite taste preferences. Even preemies as young as 33 weeks suck harder on a sweetened nipple than on a plain rubber one.

Smell
A fetus's nose develops between 11 and 15 weeks. Until recently, scientists didn't believe that fetuses would have any sense of smell, since it was assumed that smelling depended on air and breathing. However, the latest research has opened up a new world of possibilities.

The nasal system is made up of no less than four subsystems, and it's now believed that the amniotic fluid surrounding the fetus passes through the baby's oral and nasal cavities, triggering these senses.

Studies have shown that newborns are drawn to the odor of breast milk, although they have no previous experience with it. Researchers think this may come from cues they have learned in prenatal life.

Hearing
The womb is not a silent place. There's blood whooshing through the mother's vessels, gurgling and rumbling from her stomach and intestines, and the tones of her voice and the voices of others.

A baby's ears begin to form at around eight weeks and become structurally complete at about 24 weeks. But as early as 18 weeks, the bones of the inner ear and the nerve endings from the brain have developed enough for your baby to hear sounds such as your heartbeat and blood moving through the umbilical cord. He may even be startled by loud noises! For the rest of the pregnancy, sound serves as a baby's major information channel.

By week 25, your baby begins to hear your voice -- and your partner's -- and may even recognize those voices as early as week 27. Sounds may be muffled, though, because the ears are still covered with vernix, the thick, sticky coating that protects the skin from becoming chapped by the amniotic fluid.

A fetus's movements or body patterns may change in response to sounds. Many pregnant women report a fetal jerk or sudden kick just after a door slams or a car backfires. A baby's heart rate often slows down when its mother is speaking, suggesting that he not only hears and recognizes the sound, but is calmed by it.

Sight
Vision is the last sense to develop. In utero, eyelids remain closed until about the 26th week in order for the retinas to fully develop. Around week 26, the eyes open and even begin to blink! At birth, a baby's vision is perfectly focused from 8 to 12 inches.

As soon as their eyes open in the womb, twins seem to have no trouble locating each other and touching faces or holding hands.

Just as the womb isn't completely quiet, it isn't totally dark, either. As early as week 18, when the eyes are still closed, a baby's retinas can detect a small amount of light filtering through a mother's tissue if she's out in the bright sun or under strong lights. By week 33, the pupils of the eye can now detect light and constrict and dilate, allowing your baby to see dim shapes. Studies shining a bright light on the belly of a woman at 37 weeks have shown a baby's heart rate speeding up in response, or the baby turning toward the light. (Note: Exposing a fetus or premature infant to bright light before it's ready can damage its eyes.)

Common Birth Defects
What causes these problems, and how will they be treated?

Introduction

Each year in the United States, about 150,000 babies are born with birth defects ranging from mild to life threatening. The three leading categories of birth defects are structural/metabolic, congenital infections, and other conditions. While progress has been made in the detection and treatment of birth defects, they remain the leading cause of death in the first year of life. Birth defects are often the result of genetic and environmental factors, but the causes of well over half of all birth defects are currently unknown. The following is a brief sketch of the most commonly noted birth defects.

Congenital Heart Defects
What is it?
Congenital heart defects can affect any of the different parts or functions of the heart, which is responsible for pumping blood through the body. Defects can include holes in the wall of the heart, a heart that beats too quickly or too slowly, valve defects that prevent blood from flowing smoothly, or other malformations that prevent the heart and circulatory system from functioning efficiently.

How common is it?
Heart defects are among the most common birth defects. Each year more than 25,000 U.S. infants are born with heart defects. These defects can be very mild, exhibiting no symptoms for many years, or they can be severe, requiring immediate attention at birth. In most cases, doctors cannot pinpoint what causes a baby's heart to develop abnormally. So far, scientists believe there are both environmental and genetic factors that contribute to congenital heart defects. Women who contract rubella or some other viral infections may have a greater risk of having a baby with a heart defect. Certain chronic illnesses in the mother, such as diabetes, can increase the risk of congenital heart defects in the baby. Doctors have identified certain drugs, such as some taken for acne and depression, as risk factors. Studies have also shown that cocaine or alcohol use during pregnancy can increase the risk of heart defects in the developing baby.

How is the baby affected?
A defect in the heart can impair its ability to circulate oxygenated blood through the body. The baby may exhibit a variety of symptoms, such as a rapid heartbeat or breathing difficulties, especially during exercise. In infants, this tendency to tire easily may interfere with nursing and result in poor weight gain. Some children with heart defects show a pale grayish or bluish coloring of the skin. There are some babies and children with heart defects who experience no symptoms; the defect may be diagnosed when the doctor hears an abnormal sound called a murmur. Some defects are so slight that the baby may appear healthy for many years after birth.

What are the treatment options?
The prognosis for children with congenital heart defects has improved significantly in the past 40 years. Today, most heart defects can be corrected, or at least helped, by surgery, medicines, and devices such as pacemakers. There are prenatal tests that can detect many heart defects before birth. A special form of ultrasound may show a fetal heart that is beating too quickly or too slowly. In that case, medications may be able to restore a normal heart rhythm. Surgical interventions after birth have also improved. Until recently, it was often necessary to make temporary surgical repairs in infancy and postpone full corrective surgery until later in childhood. Today, half of children who require surgery to correct a heart defect can undergo the procedure before age 2.

Clubfoot
What is it?
Clubfoot describes a range of foot and ankle abnormalities. The defects can be mild or severe and can affect one or both feet. An affected foot points downward, with the toes turned in. If both feet are affected, as they are in about half of all cases, the toes will turn in toward each other rather than pointing straight ahead. The foot bones, ankle joints, and ligaments of the foot may be abnormal or tight, making it difficult to bring the foot into a normal position. There are also milder foot abnormalities that may appear similar to clubfoot.

How common is it?
Clubfoot is one of the most common birth defects. Each year, about 5,000 U.S. babies are born with the most severe forms of clubfoot. Clubfoot is almost twice as likely to affect boys. Milder forms of foot malformation are even more common and tend to affect both sexes equally. In most cases, doctors can't pinpoint what causes clubfoot. It was once thought that the malformations were caused by a twisted or cramped position in the mother's womb. But many scientists today believe clubfoot starts early in pregnancy, probably around the 10th week of gestation. Heredity and some environmental factors, such as smoking during pregnancy, are likely at the root of the defect.

How is a child affected?
Clubfoot is not painful in infancy. The child is not affected until he tries to stand or walk. Without treatment, the poorly aligned foot and ankle can't move normally, resulting in an awkward gait. If both feet are affected, the child may walk on the balls of his feet or on another part of the foot such as the side or top. This can result in sores and hard calluses and may even interfere with the growth of the entire leg.

What are the treatments?
The disabling effects of clubfoot can be avoided with early treatment. Generally, treatment will begin soon after birth. The most common treatment is a series of casts, which gradually train the foot to stay in the proper position. It can take three to six months of casting to straighten the foot. Other cases will require surgery to place the bones in proper position and to open and lengthen joints. This surgery often takes place around the age of 6 months. Because clubfoot can recur, frequent checkups during the first seven years of life are recommended.

Down Syndrome
What is it?
Down syndrome is a genetic disorder. It includes a combination of birth defects including mental retardation, characteristic facial features, and often a range of health issues, such as impaired hearing, impaired vision, and heart defects. It is caused by the presence of an extra chromosome.

How common is it?
Down syndrome is one of the most common genetic birth defects, affecting about one in every 1,000 babies. In the United States, there are approximately 350,000 individuals with Down syndrome. Mothers who are over age 35 are at greater risk of having a baby with Down syndrome. Prenatal testing can diagnose or rule out this disorder.

How does it affect the child?
All children with Down syndrome are affected with some degree of mental retardation. The degree of retardation varies widely, although it's usually in the mild to moderate range. The physical characteristics of the baby are not good indicators of the level of mental retardation. Down syndrome produces characteristic facial features. A child may have eyes that slant upward. Her mouth, nose, and ears may be small. Some children have short necks and small hands with short fingers. Children with Down syndrome generally can achieve most of the major milestones of childhood, such as walking, talking, and using the toilet, although often they do these things later than other children. Special education programs are often recommended, but many Down syndrome children are able to participate with their typical peers in the classroom and in extracurricular activities. Down syndrome often comes with a variety of medical problems, including heart, vision, and hearing difficulties.

What treatment is available?
There is no cure for Down syndrome. However, with early intervention and special education, many babies born with Down syndrome can grow up, attend school, and participate in a social life. Today, many Down syndrome adults live semi-independently in group homes, holding down jobs and taking part in their communities. Some Down syndrome adults marry.

Cerebral Palsy
What is it?
Cerebral palsy is the term used to describe conditions that affect the control of movement and posture. It is caused by damage to the part of the brain that controls muscle movement. Symptoms range from mild to severe, but the condition tends not to worsen as the child gets older. Physical therapies and other treatments can significantly improve the condition. Many children with cerebral palsy also have other medical conditions, such as metal retardation, learning disabilities, or problems with vision, hearing, or speech.

How common is it?
Cerebral palsy is generally not diagnosed until the child has reached age 2 or 3. Approximately two children out of 1, 000 over the age of 3 have cerebral palsy. Currently in the United States, about 500,000 individuals -- both children and adults -- are diagnosed with cerebral palsy. Scientists do not know exactly what causes cerebral palsy, but recent research has shed some light on the topic. In about 70 percent of all cases, the damage to the brain takes place before birth. In a small number of cases, cerebral palsy is caused during delivery or in the first months of life. Rh disease, as well as certain infections during pregnancy, such as rubella and toxoplasmosis, are known to increase the risk of brain damage to the fetus. Brain damage can also occur when the placenta is not functioning properly. Premature babies who weigh less than 3 1/3 pounds are up to 30 times more likely to develop cerebral palsy than full-term babies. Doctors used to believe that a lack of oxygen during difficult deliveries was a primary cause of cerebral palsy, but recent studies suggest that only about 10 percent of cases fall into this category.

How is the child affected?
Parents may become concerned when a child has trouble reaching physical milestones. A child with cerebral palsy may have trouble rolling over, sitting, walking, and crawling. Some children have low muscle tone and appear floppy; others have increased muscle tone, which makes them appear stiff. There are three major types of cerebral palsy. About 70 percent of CP cases are categorized as spastic cerebral palsy, in which muscles are stiff, making movements and walking difficult. Dyskinetic cerebral palsy affects 10 to 20 percent of CP patients. It is characterized by fluctuations in muscle tone. Children with this form of CP may have trouble sitting or swallowing. Ataxic cerebral palsy is the least common form; it affects balance and coordination. A person with this type of CP may walk with an unsteady gait and have difficulty with fine motor tasks.

What are the treatments?
While there is no cure for cerebral palsy, with treatment and physical therapy most children can significantly improve over time. Physical therapy often begins soon after diagnosis, helping a child improve motor skills such as sitting and walking. There are drug therapies and surgical procedures for some types of CP. Many children work with a speech therapist to improve their communication skills, and with an occupational therapist to manage the skills of daily living.

Genital and Urinary Tract Defects
What are they?
Birth defects of the genitals or urinary tract can involve the kidneys, ureters, bladder, urethra, and male and female genitals. For boys, the genitals include the penis, prostate gland, and testes. For girls, they include the vagina, uterus, fallopian tubes, and ovaries. Some of the most common defects include renal agenesis, hydronephrosis, hypospadias, and ambiguous genitals.

How common are they?
Abnormalities of the genitals and urinary tract are among the most common of all birth defects, present in as many as one in 10 babies. Some abnormalities are minor and produce no symptoms. Other malformations can be more serious, causing urinary tract infections, pain, or kidney damage. Many urinary tract defects can be diagnosed at birth with an ultrasound. The causes of most urinary and genital birth defects are unknown, but some abnormalities are inherited from parents who either have the disorder or carry the gene for it.

How is the child affected?
The symptoms of urinary and genital birth defects vary. Often children born with this kind of defect are prone to urinary tract infections, high blood pressure, and other problems. A baby born with a single kidney (unilateral renal agenesis) may be at increased risk for high blood pressure, kidney stones, or kidney failure. Hydronephrosis, caused by a blockage in the urinary tract, can cause kidney failure. Children with bladder extrophy or epispadias may have bladder-control problems. A child born with ambiguous genitals may suffer significant psychological stress. Many genital and urinary tract defects can be painful.

What are the treatments?
There are many successful surgical options to treat birth defects involving the genitals and urinary tract. In fact, some surgeries can be performed even before the baby is born. For example, significant hydronephrosis is diagnosed in about one in 500 pregnancies during a prenatal ultrasound examination. Sometimes, doctors will opt to insert a small tube into the fetus's bladder to reduce the kidney swelling. Prenatal treatment of these kinds of obstructions has been the most successful form of fetal surgery to date. Other surgeries are available to affected babies, in infancy or early childhood, to correct the different kinds of defects. Some children require multiple surgeries to achieve normal urinary and genital function. Sometimes, as in the case of ambiguous genitals, psychological counseling is recommended in addition to surgical intervention.

Spina Bifida
What is it?
Spina bifida is the most common of a group of birth defects called neural tube defects. The neural tube is the part of the embryo that eventually develops into the brain and spinal cord. The neural tube forms early in pregnancy, by the 28th day after conception. When something goes wrong in this process and the neural tube does not close properly, the spinal cord and sometimes the vertebrae do not develop normally. The backbone and spinal cord can be affected.

How common is it?
Spina bifida is one of the most common severe birth defects, affecting approximately one in 2,000 babies. Spina bifida is usually an isolated birth defect. Almost all babies born with spina bifida and other neural tube defects are born to parents with no family history of these problems. Still, scientists to believe there are both genetic and environmental factors at work. Spina bifida occurs more frequently among Hispanics and whites of European descent; it is less common among African-Americans and Asians. Women with certain chronic health conditions, including diabetes and seizure disorders, have an increased risk of having a baby with spina bifida.

How is the child affected?
There are three forms of spina bifida, each producing different symptoms. The first is occulta -- this form is usually without symptoms. It presents as a small gap in the vertebrae, but the spinal cord and nerves are normal and these children generally have no related problems. The second form is meningocele. This is the rarest form and shows as a cyst or a lump poking through the open part of the spine. It can be corrected with surgery. The final form is myelomeningocele. This is the most severe form. A cyst may affect the spinal canal, spinal cord, and nerve roots. Or there may be no cyst, just an exposed section of the spinal cord. There is a high risk of infection, and even after surgery to close the open section, leg paralysis and bladder and bowel control problems remain. Many children will require a wheelchair.

What are the treatments?
Depending on the type of spina bifida in question, treatments range from none to multiple surgeries. A baby with the most severe form of spina bifida will usually require surgery within 48 hours of birth. Soon after surgery, physical therapy is recommended. There are prenatal approaches to the birth defect as well. Studies show that up to 70 percent of neural tube defects, including spina bifida, could be prevented if pregnant women consumed adequate amounts of folic acid, especially in the earliest stages of pregnancy. Folic acid is found in many foods such as orange juice and beans and is also available in most multivitamins. Spina bifida can often be detected through prenatal testing, such as blood tests, ultrasound, and amniocentesis. Prenatal surgery to repair spina bifida birth defects is in the experimental phase.

Congenital HIV Infection
What is it?
Congenital infections are one of the three major categories of birth defects. The best known in this category is rubella (German measles). However thanks to widespread vaccination programs, rubella is rare in this country. Viral infections and sexually transmitted infections such as HIV are still present in the United States and can endanger a developing fetus. HIV is the virus that causes AIDS. About one baby in 2,700 born in the United States has congenital HIV infection.

How is the child affected?
HIV-infected babies may appear normal at birth, but as many as 20 percent will develop AIDS in the first year of life. Many more will show symptoms by age 6. A person with AIDS can't fight disease normally and is highly susceptible to infections and certain cancers. A child with AIDS is especially at risk for serious illnesses from common bacteria because the virus weakens the immune system. These problems can be life threatening or fatal. Many children who develop AIDS in the first year of life die before age 4.

What treatments are available?
In recent years, much has been learned about the treatment and prevention of HIV infection, particularly for pregnant women. A recent study showed that drug treatment during pregnancy can greatly reduce the risk that an HIV-infected mother will pass the virus on to her child. In addition to drug therapy, other steps can be taken. A woman with HIV may reduce the risk of infecting her baby by opting for a cesarean birth, before natural labor begins and her membranes have ruptured. Also, if a woman and her doctor are aware of her HIV status during pregnancy, certain precautions can be taken during prenatal care to reduce the risk of the infection being transmitted to the baby. The doctor may avoid certain procedures that would increase exposure of the fetus to the mother's blood, such as amniocentesis. The Centers for Disease Control (CDC) recommends that a baby born to an HIV-infected mother be treated with certain drugs in the early weeks of life as a precaution against life-threatening, opportunistic infections.

Fetal Alcohol Syndrome
What is it?
Fetal alcohol syndrome is one of the most common known causes of mental retardation, and it's the only one that is entirely preventable. FAS is a group of mental and physical birth defects that occur because of excessive consumption of alcohol by the mother during pregnancy. These women either drink excessively throughout pregnancy or have episodes of binge drinking during pregnancy. When a pregnant woman drinks alcohol, it travels through the placenta to her fetus. A developing fetus takes much longer to break down alcohol and as a result, the alcohol level in a fetus's blood can be higher and remain elevated longer, heightening the exposure of the fetus to alcoholic effects. This can cause the baby to suffer lifelong damage.

How common is it?
Every year in the United States, as many as 2,000 to 12,000 babies are born with fetal alcohol syndrome. As many as 10 times that number are born with what doctors call fetal alcohol exposure, a less-severe condition. FAS occurs in 40 percent of women who are alcoholics or chronic alcohol abusers. Fetal alcohol exposure can occur in the children of women who drink moderately or lightly during pregnancy.

How is the child affected?
Children born with fetal alcohol syndrome are abnormally small at birth. They may have small eyes and an upturned nose. The heart may not have formed properly, and many children with this birth defect have a small or abnormally formed brain. Most have some degree of mental retardation. Many also exhibit difficulties with learning, attention span, coordination, and behavior. The effects of FAS last a lifetime. Adults with FAS often find it difficult to live independently and hold down a job. They may require treatment and supervision for psychological and behavioral problems.

What are the treatments?
The primary focus of FAS treatment has been to educate women about the dangers of drinking alcohol during pregnancy. Although many women know that heavy drinking can cause birth defects, many don't realize that even light or moderate drinking can have effects on a developing fetus. In fact, no amount of alcohol consumption has been proven safe, according to the March of Dimes, a nonprofit health agency dedicated to the study and reduction of birth defects. Children born with FAS may require psychological and behavioral counseling, special education to cope with their learning disabilities, and medical treatments throughout their lives.

Fetal Development at a Glance
A quick guide to baby's growth in the womb.

First Trimester

Here's a month-by-month guide to your baby's development:

Month 1
Tiny limb buds, which will grow into arms and legs, appear.

The embryo looks like a tadpole.

The heart and lungs begin to form. By the 25th day, the heart starts to beat.

The neural tube, which becomes the brain and spinal cord, begins to form.

At the end of the first month, the embryo is about 1/2 inch long and weighs less than 1 ounce.

Month 2
All major body organs and systems are formed but not completely developed.

The early stages of the placenta, which exchanges nutrients from your body for waste products produced by the baby, are visible and working.

The ears, ankles, and wrists form. The eyelids form and grow but are sealed shut.

Fingers and toes develop.

By the end of the second month, the fetus looks more like a person than like a tadpole, is about 1 inch long and still weighs less than 1 ounce.

Month 3
After 8 weeks as an embryo, the baby now is called a "fetus."

The fingers and toes have soft nails.

The mouth has 20 buds that will become "baby teeth."

You can hear your baby's heartbeat for the first time (10 to 12 weeks) using a special instrument called a Doptone.

For the rest of pregnancy, the body organs will mature, and the fetus will gain weight.

By the end of this month, the fetus is 2-1/2 inches long and weighs a little over 1 ounce.

Second Trimester
Month 4
The fetus moves, kicks, and swallows.

The skin is pink and transparent.

The umbilical cord continues to grow and thicken to carry enough nourishment from mother to fetus.

The placenta is fully formed.

By the end of the fourth month, the fetus is 6 to 7 inches long and weighs about 5 ounces.

Month 5
The fetus becomes more active, turning from side to side and sometimes head over heels.

The fingernails have grown to the tips of the fingers.

The fetus sleeps and wakes at regular intervals.

The fetus has a month of rapid growth. At the end of the fifth month, the fetus is 8 to 12 inches long and weighs 1/2 to 1 pound.

By the end of the fifth month (20 to 21 weeks), fetal activity can be felt by the mother.

Month 6
The skin is red and wrinkled and covered with fine, soft hair.

The eyelids begin to part and the eyes open.

The finger and toe prints can be seen.

The fetus continues its rapid growth. At the end of the sixth month, the fetus is 11 to 14 inches long and weighs 1 to 1-1/2 pounds.

If born at 24 weeks or more, the fetus might survive with intensive care.

Third Trimester
Month 7
The fetus can open and close its eyes and suck its thumb.

The fetus exercises by kicking and stretching.

The fetus responds to light and sound.

If born now, the fetus has a good chance for survival.

The fetus is now about 15 inches long and weighs about 3 pounds.

Month 8
Rapid brain growth continues.

The fetus is too big to move around much but can kick strongly and roll around.

You may notice the shape of an elbow or heel against your belly.

The bones of the head are soft and flexible to make it easier for the baby to fit through the birth canal.

The lungs may still be immature. If born now, before 37 weeks, the fetus is premature but has an excellent chance for survival.

The fetus is now about 18 inches long and weighs about 5 pounds.

Month 9
At 37 to 40 weeks, your baby is full term.

The baby's lungs are mature and ready to work on their own.

During this month the baby gains about 1/4 to 1/2 pound a week.

The baby moves into position to be born, usually dropping into a head-down position and resting lower in the mother's pelvis.

By the end of the ninth month, the baby weighs 6 to 9 pounds and is 19 to 21 inches long.

Genetics and Your Baby
How genetics influence your baby's looks and personality.

How Does Genetics Work?

As you wait for baby, you've probably tried to picture what he might look like. Will he be tall like his father? Will he have curly hair like yours? Or is he going to inherit his grandfather's sense of humor?

Experts estimate that there are 60,000 to 100,000 genes (made up of DNA) in a human being's 46 chromosomes. A baby gets 23 hromosomes from his mother and 23 from his father. With all the possible gene combinations, one pair of parents has the potential to produce 64 trillion different children. This probably gives you an idea of how impossible it is to predict just what your baby will look like. The science of genetics is complicated, but with a short course you can get some information to guide your imagination.

Remember learning about genes and fruit flies in high school biology? Back then, you were told that the dominant gene always beats out the recessive one. Well, scientists have always known humans are more complicated than fruit flies. But in recent years, they've learned just how much more complicated.

As it turns out, most human traits are polygenic -- the result of many genes acting together. To complicate things even further, for some traits -- such as height, weight, and especially personality -- environment also has a significant influence on which genes are expressed and which remain muted.

Eye Color

If there were just one pair of genes involved in selecting eye color, there would be at maximum three shades of eye color -- brown, blue, and perhaps green. But human eyes come in a whole spectrum of different shades of these colors. That's because eye color is a polygenic trait.

Eye color is determined by the amount of melanin, or brown pigment, in the iris. Dark eyes have large amounts, blue have very little, and other colors -- green, hazel -- have varying amounts. Because different genes are probably responsible for how much brown pigment you inherit and where it shows up in the eye (more brown or blue can fall in the center or outer edges of the eye) there's a great possibility for a wide variety of hues. It's even possible for two blue-eyed parents to have brown-eyed offspring.

Facial and Body Features

Certain facial characteristics such as dimples, widow's peak, and facial symmetry (a high eyebrow on one side of your face, for instance) are believed to be dominant and filter down through the generations. Hand shape, finger shape, toenail shape, and unusual traits such as hair with double cowlicks often appear over generations.

Fingerprint patterns have been shown to run in families. And crooked teeth can be inherited too, because the configuration of the jaw and the tilt of the teeth are genetically determined. There's even a specific gene for "gap tooth" that's been discovered and is believed to be dominant.

To get an idea of what quirks and facial features your child may inherit, examine photos of relatives over generations. If it turns out most family members have a prominent chin or a round face, these are fairly strong traits that are likely to be passed on.

Height and Weight

For a rough estimation of adult height, take the average of Mom's and Dad's height. Then add two inches for a boy or subtract two inches for a girl. So if you're 5 feet 2 inches and your husband is 5 feet 10 inches, the average between you is 5 feet 6 inches. Therefore, your son will likely grow to be 5 feet 8 inches, your daughter, 5 feet 4 inches. Of course, genetics being what it is -- unpredictable -- this gauge is not ironclad. Your child may turn out to be taller than the taller parent or shorter than the shorter one.

Other powerful factors in your child's ultimate height are nutrition and health. If your baby's genes are programmed for 5 feet 5 inches, she may not get there if her diet is inadequate or if something else interferes with her growth. On the other hand, she may grow to be taller than expected, as studies have shown that improved diet has contributed to greater height over the centuries.

How slim or overweight your child will be is impossible to guess. Genes will only predispose a child to be a certain weight -- they don't guarantee it. When both parents are obese, the child will likely be overweight too. A child may become obese because of her genes, the family's eating habits, or a combination of both factors.

Hair Color

In general, dark hair is dominant over light. But as with eye color, your baby's hair can turn out to be a beautiful range of shades between your hair color and that of your partner. It depends on the colors, or pigments, you both have in your hair and how they mix. Parents with similar hair color may have a baby with a hue that's slightly different, but within their color range.

But surprise colors can certainly appear from parents with different hair colors. This usually occurs when a recessive color gene in one parent comes through and mixes with another one. So a black-haired parent carrying a recessive gene for blond hair could potentially have a blond child if that gene is expressed and mixes with a blond gene from the other parent.

As for red hair, which was once considered recessive, it's now believed to be dominant over blond. You can even be a redhead and not know it. Your hair may have a reddish hue that's masked by a stronger brown or black pigment.

Personality

Experts say there's no doubt that many personality tendencies -- for instance, how she reacts to noise -- are genetically hardwired in baby from birth. But experts also agree that environment has a huge influence on behavior. For instance, a child may inherit the tendency to jump into risky activities (a "novelty-seeking" gene has been identified). However, your influence on her and her environment may cause that adventurousness to be expressed to a lesser degree, in a different way, or not at all.

In the same way, children who inherit a creative bent or perfect pitch (also proven to be genetic) will bloom in an encouraging environment. But if they're not exposed to art materials or musical instruments, the talent may lie fallow. Luckily, it works in reverse too -- a child born without that genetic endowment can still, through work and determination, learn to paint or develop good pitch. There's hardly any trait that's entirely genetic or environmental.

Twin Pregnancy

Pregnancy with identical twins, who come from a single fertilized egg that divides into two embryos, happens by chance. There's no known genetic link. But pregnancy with fraternal twins, babies who come from two separate eggs and two sperm, seems to be genetically influenced. That's because the tendency for a woman to ovulate more than one egg at a time is inherited. So if there's a history of fraternal twins in your family, you have a higher chance of having a set, too.

The big question is whether double or multiple ovulation is a recessive or dominant gene. That's difficult to determine, since more twins are conceived than born. One twin can die in utero, or a woman can miscarry both twins so early in pregnancy that she may not even know she was expecting. Since experts don't know how many fraternal twins are actually conceived, they can't say for sure whether the gene is dominant.

With all the possible combinations of genes that influence your baby's looks and personality, it's impossible to know what your baby will actually look like. But that's part of the fun of expecting a child -- you get to fantasize to your heart's content. And whether your baby gets your gorgeous curls or Daddy's straight locks, once she arrives she'll never bore you by staying the same!

The Pros and Cons of Learning Baby's Sex
Should you find out if you're expecting a boy or a girl?

Should you find out if you're expecting a boy or a girl?

Some parents can't wait to learn the sex of their baby. Others are content to wait until their baby makes its grand entrance. Here are the pros and cons of finding out your baby's sex:

Reasons to find out:
You only have to agree on one name

You can buy sex-specific clothes

You can decorate the nursery

You can better prepare for events after baby's birth, such as scheduling a bris (a Jewish circumcision ritual)

You may feel more connected to your baby

It may make the baby seem more real

It helps assure you that everything is okay

Reasons to wait:
The surprise can be exciting

The last few weeks of pregnancy may be more bearable not knowing

You could have fantasies about a baby of either sex

It's the way people have been doing it for centuries

It might annoy your relatives!

But what if you and your partner can't agree? One solution is for one partner to learn the sex and not tell the other. Or find out together and keep it a secret from the rest of the world. Either way, you'll find out the sex of your child sooner or later, so stop worrying and enjoy your pregnancy.

Medical Miracles in the Womb
Learn about new medical treatments for the unborn baby.

Medications

Few parents have to face the prospect of their baby being born with serious birth defects. But for babies with any of about a dozen specific disorders, treatment before birth can improve their health. While prenatal surgery is the most dramatic example of how the new field of fetal medicine is saving babies, many more children have been helped by other less risky procedures. Find out how these measures could save your child.

If you're considered at risk for delivering prematurely, your doctor may recommend prenatal injections of drugs, called corticosteroids, aimed at speeding the development of your baby's lungs and other organs. Risk factors for early labor include preeclampsia, diabetes, or third-trimester bleeding. Since 1994, the use of corticosteroids has reduced preemie infant deaths by about 30 percent and has cut the rates of two serious complications: respiratory distress syndrome (by 50 percent) and bleeding in the brain (by 70 percent).

A less common problem, abnormal fetal heart rhythm, can also be corrected with prenatal medicine. Your doctor can diagnose a heart arrhythmia only 10 to 12 weeks into pregnancy by listening to your baby's heart and then following up with more detailed ultrasounds. To treat it, medicine is either given to the mother or delivered directly into the fetus's bloodstream via a technique called cordocentesis. Guided by ultrasound, the doctor inserts a thin needle through the mother's abdomen and into a tiny blood vessel in the umbilical cord, then injects the drug.

Transfusions

A blood transfusion while still in the womb can help a fetus with severe anemia resulting from Rh disease (an incompatibility between the blood of the mother and her fetus that causes destruction of the baby's red blood cells). Transfusions are usually given using cordocentesis and can begin as early as the 18th week of pregnancy, saving more than 90 percent of these babies. Fortunately, Rh disease is rare today; women who have the Rh-negative blood associated with it are routinely given shots of a substance called immunoglobulin, which usually prevents the disease in their babies.

A technique similar to cordocentesis can also transplant bone marrow cells into fetuses who would otherwise be born with certain life-threatening immune system disorders and anemias, such as sickle cell.

Fetal Surgery
Closed-uterus fetal surgery
Closed-uterus fetal surgery, in which the baby remains in the womb while the defect is fixed, is usually performed around 28 weeks. It's most commonly used to relieve urinary tract blockages. When the blockage is severe, the bladder becomes swollen with urine, causing the fluid to back up and damage or destroy the kidneys. To correct the problem, a surgeon, guided by ultrasound, inserts a needle into the fetus's bladder. Through the needle, the surgeon puts in place a shunt that allows the bladder to drain continually until birth, when the blockage can be repaired.

Open fetal surgery
Open fetal surgery is a newer area of prenatal medicine, also performed at around 28 weeks. The surgeon makes a cesarean-like incision into the mother's abdomen and partially removes the fetus from the uterus to correct the defect.

Open surgeries have been performed to repair the following defects:

Severe cases of spina bifida, an exposed and unprotected spinal cord

Congenital diaphragmatic hernia, a hole in the diaphragm which allows the abdominal organs to move up into the chest

Tumor of the lungs, fluid in the lungs, and large tumors along the spine

However, opening up the uterus mid pregnancy poses risks for both mother and baby. Among other things, it often leads to premature labor and delivery and exposes the mother to the usual risks of surgery, like infection. For these reasons, researchers are developing new, safer techniques.

Your should know:

The information on this Web site is designed for educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health problems or illnesses without consulting your pediatrician or family doctor. Please consult a doctor with any questions or concerns you might have regarding your or your child's condition.