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Sanjay Gupta MD

Survival Guide for New Parents

Aired May 01, 2004 - 08:30 ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

SANJAY GUPTA, HOST: Good morning and welcome to HOUSE CALL.
When you are expecting a baby, you worry and you plan about the birth, about staying healthy. But this show is about how to survive once your new bundle of joy arrives. You'll be juggling feedings, raging hormones, sleep schedules and a post-baby body. This morning we're going to give you easy to follow tips and advice on how to handle that first year.

One of the earliest choices posed to parents is whether to breast-feed.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): The number of nursing mothers is on the rise, studies show 70 percent of new moms begin breastfeeding in the hospital. But that number drops dramatically when you check with them just a few months later. Why?

REBECCA SLOAN, MOTHER: It is hard. People and books that I've read have said it's natural. It's not supposed to hurt. It hurts. It hurts.

GUPTA: Rebecca Sloan had a hard time get her baby to nurse at first.

SLOAN: The first two week, your nipples are so sore; it's hard because you have to be patient. And because of the emotional state that you are in and the lack of sleep that you have.

GUPTA: Rebecca stuck with it. Now her daughter Teagan is thriving.

SLOAN: It is so natural once you get over those hurdles. It's absolutely wonderful.

GUPTA: Research shows breast-fed baby are less likely to get sick. They have fewer ear and chest infections, less gas and diarrhea, and are less likely to suffer from allergies, asthma, diabetes and cancer. Breast-fed babies also have a lower risk of Sudden Infant Death Syndrome and of obesity in childhood. And children who are breast-fed do better on I.Q. test.

AMY SPANGLER, CHAIR, U.S. BREASTFEEDING CMTE.: Four months to 6 months of exclusive breast-feeding is what seems to be need, for babies to get the life-long benefits that breast-feeding provides.

(BABY COOING)

UNIDENTIFIED FEMALE: Oh, goodness.

GUPTA: Breast-feeding saves money, too. You can save up to 1,000 bucks in the first year compared to buying formula and bottles.

(END VIDEO CLIP)

GUPTA: Working moms have an even harder time with breast- feeding. Pumping breast milk at work can be a challenge. But there are lots of benefits for moms who choose to breast-feed. It speeds weight loss, cuts down on your risk of ovarian and breast cancer, and may strengthen bones.

To help us talk about the ups and downs of the first year, and give us some tips on how to survive it is Heidi Murkoff, the author of some very popular books, I seen them. "What To Expect When You Are Expecting," and "What To Expect In The First Year."

GUPTA: First of all, welcome.

HEIDI MURKOFF, AUTHOR, "WHAT TO EXPECT IN THE FIRST YEAR": Thank you.

GUPTA: Breast-feeding a very common topic, we've been doing a whole series on this. Lots of e-mails coming in on this.

MURKOFF: Yes, I know.

GUPTA: Let's try and get to our first one right away. The first question coming from Jennifer in Georgia, who writes, "I'm due with our first child in three weeks." Congratulations. "I'm feeling a little guilty over choosing to formula-feed him rather than breastfeed. Several factors went into this decision, how can you put my mind at ease?"

MURKOFF: First of all, lose the guilt. I know it comes standard issue for moms. Trust me, I know. I'm a mom, too. But it's not productive. I mean breast is best for a whole number of reasons you can probably already recite in your sleep, so I'm not going to torture you by listing them. But formula is a lot better than it ever was before.

GUPTA: Why is it better?

MURKOFF: Well, one advance, for instance, is the addition of brain-boosting fatty acids to certain formulas that come naturally in breast milk. And so that's one great way. So they do mimic breast milk better than they used to. I also think it's possible to bottle- feed with as much love as you breast feed. And I recommend parents actually, if they are bottle-feeding, open up their shirt, moms and dads, and get some good skin-to-skin cuddling while they're bottle- feeding. So...

GUPTA: That bonding experience is very important.

MURKOFF: Exactly. And also make eye contact while you are bottle-feeding. And these things are built into breast-feeding. You have to make a more of a concerted effort when bottle-feeding.

GUPTA: That's good advice. You know, the working moms, especially listening out there, having an especially a hard time sometimes trying to continue their breast-feeding after returning to work. But it's not all or nothing, right? I mean what about the combination?

MURKOFF: I think so many women are under the impression that breast-feeding is an all or nothing proposition. And it really isn't at all. I mean exclusive breast-feeding is ideal...

GUPTA: You get some benefit.

MURKOFF: Yes, but any amount of breast-feeding is better than none. And if you feel you just can't keep it up around the clock, you don't have the time, you don't have the energy, you can't work out the logistics, then just do the combo. And you know, combine breast- feeding and bottle-feeding in any way that's going to work for you without feeling guilty.

GUPTA: That's good advice. And another big topic I know that you've talked about and written about is weight gain. This is a lot...

MURKOFF: Ah, huh!

GUPTA: Women talk about this a lot?

MURKOFF: Yes, you do gain a bit of weight when you are pregnant.

GUPTA: It happens. And if it -- here are some good numbers to keep in mind. If you are at normal weight before pregnancy, experts recommend you gain between 25 to 35 pounds. If you are overweight that range may slip a bit to 15 to 25 pounds. But if you're underweight prior to getting pregnant, experts say you should gain at least 28 pounds. That's number we heard.

After 9 months of gaining weight it's shedding the pounds though, that becomes the biggest challenge for most moms.

MURKOFF: Ah, yes. That is the challenge. And you know, you lose 12 pounds right off the bat at delivery. That's more than Atkins can promise you. You know, more than the South Beach Diet. And over the next week or so you're going to lose another five pounds or so of extra fluid. After that, it definitely becomes more of a challenge. And it depends. I mean obviously it has a lot to do with how much you gained in the first place. You know, a 25-pound weight gain that was mostly baby and baby byproducts, is going to drop off a lot faster than a 45, 50, 55-pound weight gain.

GUPTA: Right. Well, went to a lot of experts and found some stories. And here's what we found out. (BEGIN VIDEO CLIP)

ELAINE LOYACK, PERINATAL FITNESS INSTRUCTOR: Good job, moms.

GUPTA: Losing weight. It's one of the hardest things to do after pregnancy. The most common question, how quickly can you get back to exercise? Elaine Loyack runs a power strolling class in Raleigh, North Carolina.

LOYACK: It's a walk, not a run.

GUPTA: She won't accept women into her class without a note from their doctor and not right away.

LOYACK: We like to see new moms after their six-week postpartum checkup.

GUPTA: Most moms gain an average of 30 pounds during pregnancy. Eighteen to 20 of that can usually be lost within a month of having the baby. It's those last five to 10 pounds that can be hard to get rid of. Easter Maynard gained 40 pounds during her pregnancy. Six months later she's lost 35 pounds. She has another inspiration.

EASTER MAYNARD, NEW MOTHER: I love being able to workout with my kid. I know that I wouldn't do it if I didn't have the opportunity to bring her with me.

GUPTA: And that may be one of the best secrets of losing post- pregnancy weight. Exercise with your baby. You're more likely to stick with it. Other tips, start slow. Only simple exercises the first week or two. A slow walk can get blood flowing to help heal C- section incisions or other delivery damage.

LOYACK: It might help mom deal with her baby blues.

GUPTA: No ab crunches. They might hurt you. Instead, focus on pelvic tilts, abdominal compressions and slow belly breathing to strengthen and tone your middle.

LOYACK: Take a drink of that water, mom.

GUPTA: Stay hydrated, especially if you are nursing. And eat sensibly. Strenuous dieting should be avoided.

(END VIDEO CLIP)

GUPTA: Diet is important for new moms. And if you are nursing you need to be careful not to cut back too much. After all, you are still eating for two.

Let's try and squeeze another e-mail in here. Donna from Louisiana asking, "How much should I exercise during the different stages of my pregnancy?"

First of all, a lot of women, do they exercise during pregnancy? MURKOFF: Yes. And you know, the first step that you've got to take before you suit up and head for the Stairmaster is that your doctor's office, your practitioner's office to get the green light to go ahead with pregnancy exercise. And most women will get that because in most pregnancies, exercise is not only not harmful, but it is incredibly beneficial.

And you want to choose an exercise routine that's right for you. So if you are very active pre-pregnancy, you can probably continue to be very active. With a few caveats because you don't ever want to exercise to the point of exhaustion. And you definitely don't want to overheat because your metabolism is already way up when you are pregnant. So avoid exercise in really hot temperatures.

GUPTA: Don't get dehydrated.

LOYACK: Don't get dehydrated because dehydration can lead to preterm labor. You know, if it's really, really hot and humid like it is every summer, then instead of heading outside for a jog, you might want to take a brisk walk around your air-conditioned mall.

GUPTA: Good advice. We're speaking with Heidi Murkoff author of "What To Expect When You're Expecting."

From battling weight to battling depression, coming up on HOUSE CALL.

(BEGIN VIDEO CLIP)

SANDRA, POSTPARTUM MOM: I just feel overwhelmed. Trains of thought get interrupted and I don't know why it's such a struggle.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Baby blues or a case of post- partum depression? Plus...

(BEGIN VIDEO CLIP)

KATHY WESSEL, MOM: I remember laying there for like 45 minutes just holding the pacifier in his mouth, while I'm trying to get sleep at the same time.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Sleep is crucial to new moms. We'll give you tips to get those Zzz's.

First, take this week's "Daily Dose" quiz. Can you get pregnant while nursing? The answer when we come back.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE (voice-over): Checking the "Daily Dose" health quiz. We asked: can you get pregnant while nursing? The answer is yes. Although breast-feeding delays menstruation, ovulating could start at any time, so it's better to be prepared.

GUPTA: New motherhood brings joy for sure, but also sometimes sadness. Something called the "baby blues," which can start pretty soon after coming home from the hospital. Those blues should ease up after a couple of weeks, but for 10 percent to 15 percent of new moms, those feelings don't go away.

(BEGIN VIDEO CLIP)

SANDRA: A lot of anxiety, panic attacks. Just feeling like I couldn't leave home. Feeling like I was a little bit worthless, because here I had this beautiful new baby, had a wonderful 3-year- old, and things in my eyes were just terrible.

GUPTA (voice-over): Eventually Sandra was diagnosed with Postpartum Depression, which is like any other major depression, except it usually starts sometime after the baby is born in the postpartum period.

SANDRA: I'd never been depressed before in my life. I didn't know what I was experiencing was depression really.

DR. DIANA DELL, PROFESSOR, DUKE UNIVERSITY: Easily half of women with postpartum depression have never been depressed before. And those people are actually at a considerable disadvantage, because someone who has been depressed before may recognize the symptoms sooner than a new mom, who is having all these experiences that she can't explain.

GUPTA: Symptoms of which can include hopelessness, anxiety, lack of interest in your baby, feelings of guilt of not being a good mother, and another important one, lack of sleep.

SANDRA: Not being able to sleep compounds some of that feeling that you are getting of hopelessness. How am I going to get up and do this? Because you are physically tired and you are mentally exhausted.

GUPTA: Sandra sought professional help.

DR. ZACHARY STOWE, DIR., WOMEN'S HEALTH, EMORY UNIV.:

I think that just letting them know that it can happen is the first step. And then if it does happen, letting them know that, in my opinion, it is one of the easiest things to treat that I have encountered in psychiatry.

GUPTA: Sandra went to therapy, got the advice and support from other moms, and took anti-depression medication, which was safe, even though she was breast-feeding.

(END VIDEO CLIP)

GUPTA: It's important that moms who think they may have postpartum depression get help, because unlike getting the blues, it doesn't go away by itself. The on set of postpartum depression can happen up to a year after birth because hormones are still fluctuating, especially as you stop breast-feeding. And experts say mom's sleep needs to be protected since trouble sleeping can be one of those symptoms. So letting mom get enough sleep can make things get better.

We're talking about surviving new parenthood with Heidi Murkoff. She's author of "What To Expect In The First Year," and "What to Expect When You're Expecting."

First of all, let's clear up something. And this is an important...

MURKOFF: Mm-hmm. Yes.

GUPTA: ... topic that you've talked about. What's the difference between baby blues and postpartum depression?

MURKOFF: Well, baby blues are much more common. They are much milder and they're much less enduring. They usually start around the third day postpartum, which I don't think is very surprising. Because that's about the time you are coming home from the hospital, so you are feeling very, very overwhelmed, very hormonal because there have been precipitous drops in estrogen and progesterone, which can take your mood down with you.

But you know, usually with a little extra TLC and a lot of extra sleep hopefully; dads take note, most news moms start to feel pretty much in the pink within a couple of weeks. But if those symptoms continue, they become more pronounced.

GUPTA: More than a couple of weeks you are saying?

MURKOFF: Definitely. Then you might be dealing with postpartum depression.

GUPTA: And you can get this treated, though, right? There are medications...

MURKOFF: Absolutely.

GUPTA: ... even if you are breast-feeding.

MURKOFF: Absolutely. The treatment might include -- will definitely include therapy and might include medication. And there are medications you can safely take while you're breast-feeding. Something else they might try is Bright Light therapy, which can be used either instead of medication or in addition to it. But the most important thing is that a woman gets the help that she needs.

GUPTA: Some of the psychiatrists we've talked to about this saying it's one of the easiest things, in fact, that they can treat.

MURKOFF: Absolutely.

GUPTA: So good there.

MURKOFF: Absolutely.

GUPTA: Let's get another e-mail in now as well. Susan in Texas writes, "I gave birth to my son was I was 23 years old. I had never heard of postpartum depression and no one talked to me about it. I began imagining that I would drop my son over railings or hurt him in some way. I was terrified, even afraid to tell my closest friends. Too much of that precious time was lost to me because of my fears that I or someone else would harm my son in some way."

This is a really scary story, Heidi.

MURKOFF: It's so heartbreaking. And for so many years, postpartum depression was something that was just swept under the carpet of medical practice. Women didn't talk about it, even amongst themselves. They were ashamed to bring it up with their doctors. Doctors didn't recognize the symptoms. They certainly didn't treat it. And so women suffered basically in silence and so did their babies. And I think we're getting better at recognizing and treating postpartum depression. Some doctors are screening for it routinely.

GUPTA: Right. And what you are doing today, recog -- telling women to recognize it, such an important message. I hope they are listening.

MURKOFF: I hope so too.

GUPTA: It's really important. Heidi Murkoff.

When HOUSE CALL continues: is sleep a long-lost friend of yours? Stay tuned.

UNIDENTIFIED FEMALE (voice-over): The plan: baby sleeps, mom sleeps. Maybe not. Coming up, how you can get enough sleep and get your new bundle of joy to do the same.

(COMMERCIAL BREAK)

GUPTA: Welcome back. We are talking about surviving new parenthood. And as any bleary-eyed parent may attest, getting your baby on a normal sleep schedule can be the key to survival. Studies show 25 percent of young children experience problem while sleeping. Which may present problem for everyone as well.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): Kathy Wessel's son Jonathan had trouble getting to sleep on his own when he was a baby.

WESSEL: He still didn't want to go to sleep by himself. He still wanted me there.

GUPTA: What's the No.1 lesson Kathy had to learn?

DR. GARY MONTGOMERY, SPECIALIST, CHILDREN'S SLEEP: After you give them feedings you put them into the crib awake, but drowsy so that they can learn to fall asleep on their own. GUPTA: Other sleep training tips: don't let your infant sleep too long during the day, shorten naps and they'll sleep longer at night, take advantage of natural circadian rhythms, give the baby some sunlight during the day, and don't let them get overtired before you put them to bed. Avoid putting your baby to bed with a pacifier. He may get used to and have trouble sleeping without it. Begin to delay your reaction to fussing at 4 to 6 months of age. Wait a few minutes and see if your baby will settle himself. If he doesn't, pat or console, but try not to pick him up. Most important, be consistent. Use the same routine for naps, bedtime and awakenings in the middle of the night.

MONTGOMERY: The baby has to see the same thing done each night to really learn that this is the routine. And if they are consistent, the baby can learn new habits in anywhere from three to seven nights. It can be solved fast.

(END VIDEO CLIP)

GUPTA: Newborns need to sleep an average of 16 to 17 hours a day. But unfortunately, that may only be one to two hours at a time. There is relief in sight, though. The American Academy of Pediatrics says by around 3 to 4 months of age, your baby should be sleeping through the night and definitely by 6 to 7 months old.

We're going to ask Heidi Murkoff about that. She's the author of the books, "What To Expect When You're Expecting" and "What To Expect In The First Year."

MURKOFF: Hmm.

GUPTA: Are there any rules about this, Heidi?

(LAUGHTER)

GUPTA: How about the sleep deprivation thing?

MURKOFF: Oh, rules. Yes! That is a rule, you will be sleep deprived. You need to buy some extra strength under eye concealer, for sure.

(LAUGHTER)

MURKOFF: But no, every baby is different. Especially breast-fed babies have the physiological need to feed during the night for longer than bottle-fed babies. Because breast milk is more digestible, so it doesn't last as long in the tummy. But by about four months of age, most babies are physically capable of sleeping through the night. Whether they do or not is pretty much up to their parents.

GUPTA: Let's see what the people on the streets think about this. We went to the street of Atlanta to try to take a question. Here it is.

(BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: What's the best strategy on how to get your child to sleep through the night, and make sure that the parents are getting a good night's rest, too?

(END VIDEO CLIP)

GUPTA: Well, that does seem to be the biggest concern. Just about everyone we talked to out there.

MURKOFF: Exactly. Parents aren't sleeping if baby isn't sleep. Well, it really depends on how old the baby is. There's no point in trying to get a 10 or 11-month-old to sleep through the night. But by the time the baby is 4 or 5 month old -- may be 6 months old, you can start using some sleep training strategies.

GUPTA: Such as?

MURKOFF: Something that you're comfortable with. It has to be something that you are comfortable with. So, a really hard-core approach that you can try when the baby is about 6 months old is crying it out. But that's real hard core, and a lot of parents are not comfortable with that. That's just letting the baby cry and within a few days, maybe a week, the baby stops crying, decides it's not worth it and sleeps through the night.

A kinder and gentler approach is a sort of modified crying it out. Where you don't ignore the baby's cries altogether, but you go in and offer quiet comfort. Maybe a whispered I love you or some other consistently used phrased, a few pats. But you don't pick her up.

GUPTA: Right. Right.

MURKOFF: And if she continues to cry, and she will, you go in and offer that a few moments later. Idea: stretch the time between those wakings.

GUPTA: Well, you know, according to a lot of studies that we looked at, bed sharing or co-sleeping is also an important thing and a very personal decision.

MURKOFF: Very personal.

GUPTA: About 50 percent of infants spending at least some time sleeping in an adult bed. Questions coming in about this as well.

Scott from Texas asking, "We have a newborn baby boy. He's two weeks old. I've been trying to keep him in the bassinet. But after my wife feeds him, she usually keeps him in bed and lets him sleep with us. I hear different opinions about this.

MURKOFF: Well, the only opinion that matters is really their opinion.

GUPTA: Mm-hmm. MURKOFF: But there are some considerations that you want to keep in mind. First of all, that safety has to come first. Conditions in the family bed have to be as safe as conditions in a baby safe crib.

GUPTA: That can be a real problem and a serious problem.

MURKOFF: Absolutely! A very serious problem.

GUPTA: Loose bedding, big pillows.

MURKOFF: No loose bedding. No pillows at all! No fluffy bedding, no pillow top mattresses. And a lot of parents have pillow top mattresses. So parents are going to have to compromise in the comfort department in order to sleep safely with their baby. Also, mom and dad both have to be on board with the baby being on board the family bed.

GUPTA: Personal decision, important stuff.

When we come back, we're going to fill you in on some of this week's top medical stories. Stay tuned for more HOUSE CALL.

UNIDENTIFIED FEMALE (voice-over): Poor air quality is on the rise and could be making you sick. Find out how your neighborhood ranks after the break.

Plus...

(BEGIN VIDEO CLIP)

(CRYING BABY)

UNIDENTIFIED FEMALE: There we go. Happy baby.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: We'll show you where to surf for information that will help you truly enjoy that first year of parenthood. Stay tuned.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

CHRISTY FIEG, CNN CORRESPONDENT (voice-over): The American Lung Association released its new State Of The Air report Thursday. It found most major cities have high levels of microscopic, soot-like particles that can increase the risk of asthma, heart attacks, strokes and lung cancer. Go to www.lungusa.org for 10 tips to protect yourself.

Also a new study by the American Diabetes Association says with current obesity rates, 366 million people worldwide will have diabetes by the year 2030; doubling the current number. Those with diabetes are more than twice as likely to develop heart disease and stroke than those without the disease. Christy Fieg, CNN.

(END VIDEO CLIP)

GUPTA: If you are struggling with the first year; the internet can be an excellent resource. Go to www.parents.com, click on "Advice by Age," then "Newborn." Check on the top 10 parent mistakes to avoid.

Also, surf to www.zerotothree.org, click on "Parents," and then go to the "Tip of the Week Archives." There you're going to learn about some easy to read baby signals.

Well, it's been a pretty interesting show. We appreciate everyone watching. I'd like to thank Heidi Murkoff as well.

Excellent advice today. Thank you so much.

MURKOFF: It was a pleasure. It was fun.

GUPTA: That is all the time we have for this week, but make sure to watch next weekend. We're going to be talking about how far you can push the human body. From swimming, to Antarctica, to fire eating, that's next weekend 8:30 Eastern. Don't forget to e-mail us your questions for next weekend as well.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com

Aired May 1, 2004 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SANJAY GUPTA, HOST: Good morning and welcome to HOUSE CALL.
When you are expecting a baby, you worry and you plan about the birth, about staying healthy. But this show is about how to survive once your new bundle of joy arrives. You'll be juggling feedings, raging hormones, sleep schedules and a post-baby body. This morning we're going to give you easy to follow tips and advice on how to handle that first year.

One of the earliest choices posed to parents is whether to breast-feed.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): The number of nursing mothers is on the rise, studies show 70 percent of new moms begin breastfeeding in the hospital. But that number drops dramatically when you check with them just a few months later. Why?

REBECCA SLOAN, MOTHER: It is hard. People and books that I've read have said it's natural. It's not supposed to hurt. It hurts. It hurts.

GUPTA: Rebecca Sloan had a hard time get her baby to nurse at first.

SLOAN: The first two week, your nipples are so sore; it's hard because you have to be patient. And because of the emotional state that you are in and the lack of sleep that you have.

GUPTA: Rebecca stuck with it. Now her daughter Teagan is thriving.

SLOAN: It is so natural once you get over those hurdles. It's absolutely wonderful.

GUPTA: Research shows breast-fed baby are less likely to get sick. They have fewer ear and chest infections, less gas and diarrhea, and are less likely to suffer from allergies, asthma, diabetes and cancer. Breast-fed babies also have a lower risk of Sudden Infant Death Syndrome and of obesity in childhood. And children who are breast-fed do better on I.Q. test.

AMY SPANGLER, CHAIR, U.S. BREASTFEEDING CMTE.: Four months to 6 months of exclusive breast-feeding is what seems to be need, for babies to get the life-long benefits that breast-feeding provides.

(BABY COOING)

UNIDENTIFIED FEMALE: Oh, goodness.

GUPTA: Breast-feeding saves money, too. You can save up to 1,000 bucks in the first year compared to buying formula and bottles.

(END VIDEO CLIP)

GUPTA: Working moms have an even harder time with breast- feeding. Pumping breast milk at work can be a challenge. But there are lots of benefits for moms who choose to breast-feed. It speeds weight loss, cuts down on your risk of ovarian and breast cancer, and may strengthen bones.

To help us talk about the ups and downs of the first year, and give us some tips on how to survive it is Heidi Murkoff, the author of some very popular books, I seen them. "What To Expect When You Are Expecting," and "What To Expect In The First Year."

GUPTA: First of all, welcome.

HEIDI MURKOFF, AUTHOR, "WHAT TO EXPECT IN THE FIRST YEAR": Thank you.

GUPTA: Breast-feeding a very common topic, we've been doing a whole series on this. Lots of e-mails coming in on this.

MURKOFF: Yes, I know.

GUPTA: Let's try and get to our first one right away. The first question coming from Jennifer in Georgia, who writes, "I'm due with our first child in three weeks." Congratulations. "I'm feeling a little guilty over choosing to formula-feed him rather than breastfeed. Several factors went into this decision, how can you put my mind at ease?"

MURKOFF: First of all, lose the guilt. I know it comes standard issue for moms. Trust me, I know. I'm a mom, too. But it's not productive. I mean breast is best for a whole number of reasons you can probably already recite in your sleep, so I'm not going to torture you by listing them. But formula is a lot better than it ever was before.

GUPTA: Why is it better?

MURKOFF: Well, one advance, for instance, is the addition of brain-boosting fatty acids to certain formulas that come naturally in breast milk. And so that's one great way. So they do mimic breast milk better than they used to. I also think it's possible to bottle- feed with as much love as you breast feed. And I recommend parents actually, if they are bottle-feeding, open up their shirt, moms and dads, and get some good skin-to-skin cuddling while they're bottle- feeding. So...

GUPTA: That bonding experience is very important.

MURKOFF: Exactly. And also make eye contact while you are bottle-feeding. And these things are built into breast-feeding. You have to make a more of a concerted effort when bottle-feeding.

GUPTA: That's good advice. You know, the working moms, especially listening out there, having an especially a hard time sometimes trying to continue their breast-feeding after returning to work. But it's not all or nothing, right? I mean what about the combination?

MURKOFF: I think so many women are under the impression that breast-feeding is an all or nothing proposition. And it really isn't at all. I mean exclusive breast-feeding is ideal...

GUPTA: You get some benefit.

MURKOFF: Yes, but any amount of breast-feeding is better than none. And if you feel you just can't keep it up around the clock, you don't have the time, you don't have the energy, you can't work out the logistics, then just do the combo. And you know, combine breast- feeding and bottle-feeding in any way that's going to work for you without feeling guilty.

GUPTA: That's good advice. And another big topic I know that you've talked about and written about is weight gain. This is a lot...

MURKOFF: Ah, huh!

GUPTA: Women talk about this a lot?

MURKOFF: Yes, you do gain a bit of weight when you are pregnant.

GUPTA: It happens. And if it -- here are some good numbers to keep in mind. If you are at normal weight before pregnancy, experts recommend you gain between 25 to 35 pounds. If you are overweight that range may slip a bit to 15 to 25 pounds. But if you're underweight prior to getting pregnant, experts say you should gain at least 28 pounds. That's number we heard.

After 9 months of gaining weight it's shedding the pounds though, that becomes the biggest challenge for most moms.

MURKOFF: Ah, yes. That is the challenge. And you know, you lose 12 pounds right off the bat at delivery. That's more than Atkins can promise you. You know, more than the South Beach Diet. And over the next week or so you're going to lose another five pounds or so of extra fluid. After that, it definitely becomes more of a challenge. And it depends. I mean obviously it has a lot to do with how much you gained in the first place. You know, a 25-pound weight gain that was mostly baby and baby byproducts, is going to drop off a lot faster than a 45, 50, 55-pound weight gain.

GUPTA: Right. Well, went to a lot of experts and found some stories. And here's what we found out. (BEGIN VIDEO CLIP)

ELAINE LOYACK, PERINATAL FITNESS INSTRUCTOR: Good job, moms.

GUPTA: Losing weight. It's one of the hardest things to do after pregnancy. The most common question, how quickly can you get back to exercise? Elaine Loyack runs a power strolling class in Raleigh, North Carolina.

LOYACK: It's a walk, not a run.

GUPTA: She won't accept women into her class without a note from their doctor and not right away.

LOYACK: We like to see new moms after their six-week postpartum checkup.

GUPTA: Most moms gain an average of 30 pounds during pregnancy. Eighteen to 20 of that can usually be lost within a month of having the baby. It's those last five to 10 pounds that can be hard to get rid of. Easter Maynard gained 40 pounds during her pregnancy. Six months later she's lost 35 pounds. She has another inspiration.

EASTER MAYNARD, NEW MOTHER: I love being able to workout with my kid. I know that I wouldn't do it if I didn't have the opportunity to bring her with me.

GUPTA: And that may be one of the best secrets of losing post- pregnancy weight. Exercise with your baby. You're more likely to stick with it. Other tips, start slow. Only simple exercises the first week or two. A slow walk can get blood flowing to help heal C- section incisions or other delivery damage.

LOYACK: It might help mom deal with her baby blues.

GUPTA: No ab crunches. They might hurt you. Instead, focus on pelvic tilts, abdominal compressions and slow belly breathing to strengthen and tone your middle.

LOYACK: Take a drink of that water, mom.

GUPTA: Stay hydrated, especially if you are nursing. And eat sensibly. Strenuous dieting should be avoided.

(END VIDEO CLIP)

GUPTA: Diet is important for new moms. And if you are nursing you need to be careful not to cut back too much. After all, you are still eating for two.

Let's try and squeeze another e-mail in here. Donna from Louisiana asking, "How much should I exercise during the different stages of my pregnancy?"

First of all, a lot of women, do they exercise during pregnancy? MURKOFF: Yes. And you know, the first step that you've got to take before you suit up and head for the Stairmaster is that your doctor's office, your practitioner's office to get the green light to go ahead with pregnancy exercise. And most women will get that because in most pregnancies, exercise is not only not harmful, but it is incredibly beneficial.

And you want to choose an exercise routine that's right for you. So if you are very active pre-pregnancy, you can probably continue to be very active. With a few caveats because you don't ever want to exercise to the point of exhaustion. And you definitely don't want to overheat because your metabolism is already way up when you are pregnant. So avoid exercise in really hot temperatures.

GUPTA: Don't get dehydrated.

LOYACK: Don't get dehydrated because dehydration can lead to preterm labor. You know, if it's really, really hot and humid like it is every summer, then instead of heading outside for a jog, you might want to take a brisk walk around your air-conditioned mall.

GUPTA: Good advice. We're speaking with Heidi Murkoff author of "What To Expect When You're Expecting."

From battling weight to battling depression, coming up on HOUSE CALL.

(BEGIN VIDEO CLIP)

SANDRA, POSTPARTUM MOM: I just feel overwhelmed. Trains of thought get interrupted and I don't know why it's such a struggle.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE (voice-over): Baby blues or a case of post- partum depression? Plus...

(BEGIN VIDEO CLIP)

KATHY WESSEL, MOM: I remember laying there for like 45 minutes just holding the pacifier in his mouth, while I'm trying to get sleep at the same time.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Sleep is crucial to new moms. We'll give you tips to get those Zzz's.

First, take this week's "Daily Dose" quiz. Can you get pregnant while nursing? The answer when we come back.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE (voice-over): Checking the "Daily Dose" health quiz. We asked: can you get pregnant while nursing? The answer is yes. Although breast-feeding delays menstruation, ovulating could start at any time, so it's better to be prepared.

GUPTA: New motherhood brings joy for sure, but also sometimes sadness. Something called the "baby blues," which can start pretty soon after coming home from the hospital. Those blues should ease up after a couple of weeks, but for 10 percent to 15 percent of new moms, those feelings don't go away.

(BEGIN VIDEO CLIP)

SANDRA: A lot of anxiety, panic attacks. Just feeling like I couldn't leave home. Feeling like I was a little bit worthless, because here I had this beautiful new baby, had a wonderful 3-year- old, and things in my eyes were just terrible.

GUPTA (voice-over): Eventually Sandra was diagnosed with Postpartum Depression, which is like any other major depression, except it usually starts sometime after the baby is born in the postpartum period.

SANDRA: I'd never been depressed before in my life. I didn't know what I was experiencing was depression really.

DR. DIANA DELL, PROFESSOR, DUKE UNIVERSITY: Easily half of women with postpartum depression have never been depressed before. And those people are actually at a considerable disadvantage, because someone who has been depressed before may recognize the symptoms sooner than a new mom, who is having all these experiences that she can't explain.

GUPTA: Symptoms of which can include hopelessness, anxiety, lack of interest in your baby, feelings of guilt of not being a good mother, and another important one, lack of sleep.

SANDRA: Not being able to sleep compounds some of that feeling that you are getting of hopelessness. How am I going to get up and do this? Because you are physically tired and you are mentally exhausted.

GUPTA: Sandra sought professional help.

DR. ZACHARY STOWE, DIR., WOMEN'S HEALTH, EMORY UNIV.:

I think that just letting them know that it can happen is the first step. And then if it does happen, letting them know that, in my opinion, it is one of the easiest things to treat that I have encountered in psychiatry.

GUPTA: Sandra went to therapy, got the advice and support from other moms, and took anti-depression medication, which was safe, even though she was breast-feeding.

(END VIDEO CLIP)

GUPTA: It's important that moms who think they may have postpartum depression get help, because unlike getting the blues, it doesn't go away by itself. The on set of postpartum depression can happen up to a year after birth because hormones are still fluctuating, especially as you stop breast-feeding. And experts say mom's sleep needs to be protected since trouble sleeping can be one of those symptoms. So letting mom get enough sleep can make things get better.

We're talking about surviving new parenthood with Heidi Murkoff. She's author of "What To Expect In The First Year," and "What to Expect When You're Expecting."

First of all, let's clear up something. And this is an important...

MURKOFF: Mm-hmm. Yes.

GUPTA: ... topic that you've talked about. What's the difference between baby blues and postpartum depression?

MURKOFF: Well, baby blues are much more common. They are much milder and they're much less enduring. They usually start around the third day postpartum, which I don't think is very surprising. Because that's about the time you are coming home from the hospital, so you are feeling very, very overwhelmed, very hormonal because there have been precipitous drops in estrogen and progesterone, which can take your mood down with you.

But you know, usually with a little extra TLC and a lot of extra sleep hopefully; dads take note, most news moms start to feel pretty much in the pink within a couple of weeks. But if those symptoms continue, they become more pronounced.

GUPTA: More than a couple of weeks you are saying?

MURKOFF: Definitely. Then you might be dealing with postpartum depression.

GUPTA: And you can get this treated, though, right? There are medications...

MURKOFF: Absolutely.

GUPTA: ... even if you are breast-feeding.

MURKOFF: Absolutely. The treatment might include -- will definitely include therapy and might include medication. And there are medications you can safely take while you're breast-feeding. Something else they might try is Bright Light therapy, which can be used either instead of medication or in addition to it. But the most important thing is that a woman gets the help that she needs.

GUPTA: Some of the psychiatrists we've talked to about this saying it's one of the easiest things, in fact, that they can treat.

MURKOFF: Absolutely.

GUPTA: So good there.

MURKOFF: Absolutely.

GUPTA: Let's get another e-mail in now as well. Susan in Texas writes, "I gave birth to my son was I was 23 years old. I had never heard of postpartum depression and no one talked to me about it. I began imagining that I would drop my son over railings or hurt him in some way. I was terrified, even afraid to tell my closest friends. Too much of that precious time was lost to me because of my fears that I or someone else would harm my son in some way."

This is a really scary story, Heidi.

MURKOFF: It's so heartbreaking. And for so many years, postpartum depression was something that was just swept under the carpet of medical practice. Women didn't talk about it, even amongst themselves. They were ashamed to bring it up with their doctors. Doctors didn't recognize the symptoms. They certainly didn't treat it. And so women suffered basically in silence and so did their babies. And I think we're getting better at recognizing and treating postpartum depression. Some doctors are screening for it routinely.

GUPTA: Right. And what you are doing today, recog -- telling women to recognize it, such an important message. I hope they are listening.

MURKOFF: I hope so too.

GUPTA: It's really important. Heidi Murkoff.

When HOUSE CALL continues: is sleep a long-lost friend of yours? Stay tuned.

UNIDENTIFIED FEMALE (voice-over): The plan: baby sleeps, mom sleeps. Maybe not. Coming up, how you can get enough sleep and get your new bundle of joy to do the same.

(COMMERCIAL BREAK)

GUPTA: Welcome back. We are talking about surviving new parenthood. And as any bleary-eyed parent may attest, getting your baby on a normal sleep schedule can be the key to survival. Studies show 25 percent of young children experience problem while sleeping. Which may present problem for everyone as well.

(BEGIN VIDEO CLIP)

GUPTA (voice-over): Kathy Wessel's son Jonathan had trouble getting to sleep on his own when he was a baby.

WESSEL: He still didn't want to go to sleep by himself. He still wanted me there.

GUPTA: What's the No.1 lesson Kathy had to learn?

DR. GARY MONTGOMERY, SPECIALIST, CHILDREN'S SLEEP: After you give them feedings you put them into the crib awake, but drowsy so that they can learn to fall asleep on their own. GUPTA: Other sleep training tips: don't let your infant sleep too long during the day, shorten naps and they'll sleep longer at night, take advantage of natural circadian rhythms, give the baby some sunlight during the day, and don't let them get overtired before you put them to bed. Avoid putting your baby to bed with a pacifier. He may get used to and have trouble sleeping without it. Begin to delay your reaction to fussing at 4 to 6 months of age. Wait a few minutes and see if your baby will settle himself. If he doesn't, pat or console, but try not to pick him up. Most important, be consistent. Use the same routine for naps, bedtime and awakenings in the middle of the night.

MONTGOMERY: The baby has to see the same thing done each night to really learn that this is the routine. And if they are consistent, the baby can learn new habits in anywhere from three to seven nights. It can be solved fast.

(END VIDEO CLIP)

GUPTA: Newborns need to sleep an average of 16 to 17 hours a day. But unfortunately, that may only be one to two hours at a time. There is relief in sight, though. The American Academy of Pediatrics says by around 3 to 4 months of age, your baby should be sleeping through the night and definitely by 6 to 7 months old.

We're going to ask Heidi Murkoff about that. She's the author of the books, "What To Expect When You're Expecting" and "What To Expect In The First Year."

MURKOFF: Hmm.

GUPTA: Are there any rules about this, Heidi?

(LAUGHTER)

GUPTA: How about the sleep deprivation thing?

MURKOFF: Oh, rules. Yes! That is a rule, you will be sleep deprived. You need to buy some extra strength under eye concealer, for sure.

(LAUGHTER)

MURKOFF: But no, every baby is different. Especially breast-fed babies have the physiological need to feed during the night for longer than bottle-fed babies. Because breast milk is more digestible, so it doesn't last as long in the tummy. But by about four months of age, most babies are physically capable of sleeping through the night. Whether they do or not is pretty much up to their parents.

GUPTA: Let's see what the people on the streets think about this. We went to the street of Atlanta to try to take a question. Here it is.

(BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: What's the best strategy on how to get your child to sleep through the night, and make sure that the parents are getting a good night's rest, too?

(END VIDEO CLIP)

GUPTA: Well, that does seem to be the biggest concern. Just about everyone we talked to out there.

MURKOFF: Exactly. Parents aren't sleeping if baby isn't sleep. Well, it really depends on how old the baby is. There's no point in trying to get a 10 or 11-month-old to sleep through the night. But by the time the baby is 4 or 5 month old -- may be 6 months old, you can start using some sleep training strategies.

GUPTA: Such as?

MURKOFF: Something that you're comfortable with. It has to be something that you are comfortable with. So, a really hard-core approach that you can try when the baby is about 6 months old is crying it out. But that's real hard core, and a lot of parents are not comfortable with that. That's just letting the baby cry and within a few days, maybe a week, the baby stops crying, decides it's not worth it and sleeps through the night.

A kinder and gentler approach is a sort of modified crying it out. Where you don't ignore the baby's cries altogether, but you go in and offer quiet comfort. Maybe a whispered I love you or some other consistently used phrased, a few pats. But you don't pick her up.

GUPTA: Right. Right.

MURKOFF: And if she continues to cry, and she will, you go in and offer that a few moments later. Idea: stretch the time between those wakings.

GUPTA: Well, you know, according to a lot of studies that we looked at, bed sharing or co-sleeping is also an important thing and a very personal decision.

MURKOFF: Very personal.

GUPTA: About 50 percent of infants spending at least some time sleeping in an adult bed. Questions coming in about this as well.

Scott from Texas asking, "We have a newborn baby boy. He's two weeks old. I've been trying to keep him in the bassinet. But after my wife feeds him, she usually keeps him in bed and lets him sleep with us. I hear different opinions about this.

MURKOFF: Well, the only opinion that matters is really their opinion.

GUPTA: Mm-hmm. MURKOFF: But there are some considerations that you want to keep in mind. First of all, that safety has to come first. Conditions in the family bed have to be as safe as conditions in a baby safe crib.

GUPTA: That can be a real problem and a serious problem.

MURKOFF: Absolutely! A very serious problem.

GUPTA: Loose bedding, big pillows.

MURKOFF: No loose bedding. No pillows at all! No fluffy bedding, no pillow top mattresses. And a lot of parents have pillow top mattresses. So parents are going to have to compromise in the comfort department in order to sleep safely with their baby. Also, mom and dad both have to be on board with the baby being on board the family bed.

GUPTA: Personal decision, important stuff.

When we come back, we're going to fill you in on some of this week's top medical stories. Stay tuned for more HOUSE CALL.

UNIDENTIFIED FEMALE (voice-over): Poor air quality is on the rise and could be making you sick. Find out how your neighborhood ranks after the break.

Plus...

(BEGIN VIDEO CLIP)

(CRYING BABY)

UNIDENTIFIED FEMALE: There we go. Happy baby.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: We'll show you where to surf for information that will help you truly enjoy that first year of parenthood. Stay tuned.

(COMMERCIAL BREAK)

(BEGIN VIDEO CLIP)

CHRISTY FIEG, CNN CORRESPONDENT (voice-over): The American Lung Association released its new State Of The Air report Thursday. It found most major cities have high levels of microscopic, soot-like particles that can increase the risk of asthma, heart attacks, strokes and lung cancer. Go to www.lungusa.org for 10 tips to protect yourself.

Also a new study by the American Diabetes Association says with current obesity rates, 366 million people worldwide will have diabetes by the year 2030; doubling the current number. Those with diabetes are more than twice as likely to develop heart disease and stroke than those without the disease. Christy Fieg, CNN.

(END VIDEO CLIP)

GUPTA: If you are struggling with the first year; the internet can be an excellent resource. Go to www.parents.com, click on "Advice by Age," then "Newborn." Check on the top 10 parent mistakes to avoid.

Also, surf to www.zerotothree.org, click on "Parents," and then go to the "Tip of the Week Archives." There you're going to learn about some easy to read baby signals.

Well, it's been a pretty interesting show. We appreciate everyone watching. I'd like to thank Heidi Murkoff as well.

Excellent advice today. Thank you so much.

MURKOFF: It was a pleasure. It was fun.

GUPTA: That is all the time we have for this week, but make sure to watch next weekend. We're going to be talking about how far you can push the human body. From swimming, to Antarctica, to fire eating, that's next weekend 8:30 Eastern. Don't forget to e-mail us your questions for next weekend as well.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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