Care Guide - Premier Health

Multiple Miracles
Care Guide
Introduction....................................................................................................... 2
Morning Sickness*.......................................................................................... 4
Prenatal Testing*.............................................................................................. 5
Fetal Movement Count*............................................................................... 6
Preeclampsia*................................................................................................... 8
Preterm Labor*...............................................................................................10
Pregnancy Activity Levels*.........................................................................13
Bed Rest Exercises for Pregnancy*.........................................................15
Bed Rest Exercise List*.................................................................................16
Breathing Techniques for Labor*............................................................24
Tips on Caring for More than One Baby*............................................25
Breastfeeding More than One Baby*....................................................29
Bottle Feeding Your Baby*.........................................................................30
Common Questions about Formula*...................................................31
Bottle Feeding More than One Baby*...................................................34
Essentials for Multiples*............................................................................35
New Baby Resources for Parents*..........................................................38
New Baby Resources for Children*........................................................40
Multiple Baby Resources and Books*....................................................43
*Revised with permission. © The Ohio State University Wexner Medical Center, Columbus, Ohio, Patient
Education. All rights reserved. The Ohio State University Wexner Medical Center is not responsible for
any consequences resulting from the use or misuse of the information on these handouts.
Perinatal Partners
Jiri Sonek, MD, RDMS
Christopher Croom, MD
David McKenna, MD, RDMS
Christine Kovac, MD
Melanie Glover, MD
Richard O'Shaughnessy, MD
Samantha Wiegand, MD
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2
Welcome to Multiple Miracles,
Premier Health’s specialty clinic for
pregnant women carrying more than
one baby. Our goal is to work with
your obstetrician to provide the safest
and healthiest birth experience for
you and your babies.
exams and regular visits. Finally, we
will suggest when and what type
of delivery your obstetrician should
perform. We want you to know that
your babies’ and your safety are of
utmost importance to us as we care
for you.
Multiple Miracles provides an all
encompassing approach to your care
from conception to delivery. This
begins by using ultrasound to find
out the number of placentas and
dividing membranes present (see
illustration on next page). For certain
types of multiple fetuses (babies not
yet born), this step is critical since
it can tell your doctor if your babies
are at risk for conditions that can
be very serious. You will also receive
a thorough assessment of your
nutritional needs. With this
information, a special diet, exercise
and activity plan will be designed
just for you and your type of
pregnancy. You will be offered
screening for birth defects as well
as those of the placenta (afterbirth)
using the most advanced techniques
available anywhere in the world.
Throughout your pregnancy we will
follow you closely with ultrasound
Multiple births are always high risk
pregnancies and there are a number
of health problems that may occur
with either the babies or the mother.
Our doctors have in depth training and
over 100 years of combined experience
caring for women pregnant with
multiple fetuses. Our care team is
unique in the region and provides
you the opportunity to receive the
best care possible anywhere, right
here in your community. In addition,
Miami Valley Hospital has the most
experienced, nationally recognized
Level IIIB Neonatal Intensive Care Unit
(NICU) in the region. Should the need
arise, please know that our NICU offers
the highest quality care and the latest
technology possible to care for your
new babies.
Knowing that many health problems
can occur with multiple fetuses,
our team will do our very best to
identify them as quickly as possible.
If problems develop, we will discuss
them with you and your family and
perform any special treatments to
achieve the best outcome possible.
Thank you for choosing our team to
care for you and your family.
What Kind Of Twins Do I Have?
Dichorionic Diamniotic
Dichorionic Diamniotic
Two placentas, two sacs
Two placentas (fused placentas), two sacs
Monochorionic Diamniotic
Monochorionic Monoamniotic
One placenta, two sacs
One placenta, one sac
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Morning Sickness
Nausea and Vomiting during
Pregnancy
Diet
Eat small meals more often to
prevent an empty stomach. Foods
that are easy to digest include:
Nausea and vomiting during early
pregnancy is sometimes called
morning sickness. Morning sickness:
• dry foods
• Can happen any time of the day.
• saltine crackers
• Usually begins about the 6th week
of pregnancy and gets better by the
13th week.
• cereals
• Most likely happens because
hormone levels in your body change
rapidly during early pregnancy.
• Can be caused by stress, not eating
for several hours, or certain odors.
If morning sickness is a problem, you
may worry about the health of your
baby. If you are in good health before
pregnancy, your growing baby will
have enough nutrients for the first
months of pregnancy.
Tips on what to do:
Rest
Take rest periods or naps more often.
Keep a slice of toast, saltine crackers,
pretzels, or dry cereal at your bedside.
It may help to eat something before
you get out of bed.
• toast
• bagels
• pasta
• potatoes.
Drink water, juices, and other fluids
between meals.
Liquids
When vomiting occurs, take sips of
clear liquids only. As the nausea
passes, increase the amount of
liquids to ½ cup every hour. Some
examples of clear liquid are JELL-O®,
clear soft drinks (7UP®), apple juice,
tea, and broth.
Avoid greasy or highly seasoned
foods
High fat foods or highly seasoned and
spicy foods may cause your morning
sickness to get worse. It is best to
stay away from these foods.
Follow-Up
Call your doctor, clinic, or go to the
Emergency Department if:
• You cannot keep liquids down for
24 hours.
• You have abdominal (belly) pain,
fever, dizziness, severe weakness or
feel faint.
These may be signs of a more serious
problem.
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Prenatal Testing
First Trimester Screening
Most times, the first trimester
screening occurs between the 11th
and 14th week of pregnancy. This
screening uses a blood test and
ultrasound measurements to help
predict the risk of chromosomal
problems such as Down syndrome.
Ultrasound can confirm the baby’s
age, the type of twins, and find other
problems early in the pregnancy. Also,
this is the only screening that can find
chromosomal problems in triplets and
higher multiple pregnancies.
Quad Screen
At 4 to 5 months, a quad screen,
sometimes called an AFP test, is
offered. A blood sample will be taken.
The tests tell whether the baby is at risk
for some birth defects of the brain, the
spinal cord, or the chromosomes such
as Down syndrome. An abnormal
test does not mean that your baby
has any birth defects. It does mean
that more tests may be ordered to
check for problems.
Glucose Challenge Test
At 6 to 7 months, a "Glucose
Challenge" test is ordered by your
doctor. During your pregnancy, your
body must make more insulin to take
care of the food that you eat. If your
body does not make enough insulin,
the sugar level in your blood will rise.
Ultrasound
The ultrasound machine uses sound
waves to outline and photograph the
developing baby in your womb. The
test is painless. You will lie on your
back. A probe is gently glided across
your abdomen (belly) by your doctor
or a technician.
This test identifies the number of
babies and the baby's position in
the uterus. It shows the outline and
organs of your baby. Most times, an
ultrasound is done in the second half
of your pregnancy and may be repeated
if your baby is having problems.
Your doctor may order other tests
that, include the non-stress test and
the biophysical profile test.
Non-stress Test
A non-stress test records your baby's
heart rate on a special machine called
a "Fetal Monitor." You may be asked
to push a button every time the baby
moves. The test is painless and most
times lasts 30 to 45 minutes.
Biophysical Profile
A biophysical profile test is a special
ultrasound, which is used to check
your baby's movements, breathing
and amount of amniotic fluid (bag of
water) surrounding the baby. It may
follow a non-stress test.
You will be given a sweet soda to
drink. You will be asked not to drink
or eat anything for one hour following
the soda. Do not chew gum or smoke.
The nurse will check your blood sugar
level by drawing blood one hour after
you have had the sweet soda. If your
blood sugar is high, you will be
scheduled for more testing.
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Amniocentesis
An amniocentesis is a procedure
where the doctor puts a needle
through the mother's abdomen to
remove a small amount of amniotic
fluid, which surrounds the baby.
Ultrasound is used to find the best
place to insert the needle. The fluid is
then sent to the laboratory for testing.
In women at risk, an amniocentesis is
done during the second trimester to
test for some genetic diseases in the
baby. It may be done during the third
trimester to test for the lung maturity
of the baby.
Fetal Echocardiography
A fetal echocardiogram is a special
ultrasound of your baby's heart.
This test can be done in our
ultrasound department or by a
pediatric cardiologist (heart doctor)
at Dayton Children's. It is a test to
check for certain heart defects in
your baby.
Fetal Movement Count
What does fetal movement
count mean?
Fetal movement count (also called
a kick count) is the number of times
the baby moves during a given period.
Babies do not move all the time. They
may sleep for about 20 minutes and
then wake up and move around. One
way to check on your baby's health
before birth is to count the number
of times he or she moves for a certain
period each day.
You can feel movement as the baby
pushes against the wall of your
uterus (womb). You can also feel the
baby move by placing your hands on
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your belly. Sometimes you can see a
ripple or little bump on your abdomen
when the baby changes position. Some
women describe the movements as
"rolling", "stretching" or "pushing".
Each feeling of movement counts as
one movement. Write the number
of movements down on the record
provided or make your own record.
How should I record the
movements?
Choose a time twice a day to count
your baby's movements. Try to plan
your fetal movement counts at the
same time each day. After you eat a
meal is often a good time. Follow
these steps for this simple, but very
important test of your baby's health.
• Get into a comfortable position.
Lie on either your left or right side
to move the weight of the uterus off
the large blood vessels. Oxygen is
carried through these blood vessels
to your uterus and to your baby.
• Use the record sheet on the next
page to record the movements.
• Look at a wall clock, watch, cell or
smartphone and write down the
time you start counting.
• Each time the baby moves make a
mark on the paper.
• After one hour, count the number of
marks you have made.
− If the baby has moved 8 to 10
times or more, you may stop
counting.
− If the baby moves less than 8 to
10 times in an hour, count the
movements for another hour. If
there are still less than 8 to 10
movements in that hour, call
your doctor, nurse, or Labor and
Delivery at (937) 208-2408.
Fetal Movement Counts
Write down each time your baby moves in one hour. Please do movement counts two
times a day, after meals. If you notice the movements are less than 8 to 10 in a one hour
period, continue to count for one more hour. If you still have less than 8 to 10 movements,
call your doctor, nurse or Labor and Delivery at (937) 208-2408.
Date
Time
Movements
Total
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Preeclampsia
Preeclampsia is a condition that only
happens while you are pregnant.
Symptoms include severe swelling,
high blood pressure, and protein in
your urine.
Preeclampsia may be called by several
different names. You may have
heard it called toxemia, high blood
pressure of pregnancy or PIH
(pregnancy-induced hypertension).
What causes preeclampsia?
The cause of preeclampsia is not
known. Preeclampsia begins at
conception, but symptoms do not
usually show until after 20 weeks of
pregnancy.
Women who are at risk for developing
preeclampsia include those with:
• Diabetes
• Obesity
• Chronic high blood pressure
Signs of Preeclampsia
You or your doctor may notice these
symptoms:
• Protein in your urine
• A rise in your blood pressure
• Low urine output (not passing much
urine or less than usual)
• A lot of swelling in your feet, face,
eyes or hands
• Kidney disease
• Weight gain greater than two
pounds per week
• African American
More severe symptoms are:
• First pregnancy
• Severe headache
• First pregnancy with a new partner
• Hard time breathing, getting your
breath
• Two or more fetuses
• Mothers and/or sisters who had the
disease
• Seizures (convulsions)
• Age 17 or younger or 35 and older
• Blurry vision or seeing spots
• Severe heartburn
If you notice any of these symptoms,
call your doctor right away. Do
not wait until your next scheduled
appointment.
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Treatment
Treatment for this condition is very
important for your health and the
health of your baby. For example,
your baby may not grow well because
your body is not supplying enough
oxygen and food. In severe cases, it
may cause the baby's death.
• If often rest periods do not lower
your blood pressure, and decrease
swelling, you will need to remain in
bed at home.
− Take rest periods often, lying on
your side. Rest or nap for 1 to 2
hours mid-morning and 1 to 2
hours mid-afternoon.
− Eat well-balanced meals that
include high-protein foods such
as meats, fish, eggs, peanut
butter, milk, and beans. Foods
high in protein will help increase
nutrition to your baby. If you have
questions, ask your doctor, nurse,
or dietitian.
• Drink plenty of fluids such as water,
juices and milk
• For most women, preeclampsia
ends with delivery and blood
pressure returns to normal within
several days.
• However, you may be at risk for
developing preeclampsia with
future pregnancies.
Postpartum Preeclampsia
For most women, preeclampsia ends
with delivery and the blood pressure
returns to normal levels. In some
cases, often within 48 hours of
childbirth, blood pressure is still very
high. Your doctor may take a number
of blood and urine tests to check your
health. Medicines may be given to
lower blood pressure and to prevent
seizures.
Late term postpartum preeclampsia is
possible, but very rare. It starts about
4 to 6 weeks after delivery.
If you have been at risk for
preeclampsia and do not feel well,
call your doctor right away. Do not
wait until your postpartum visit to
be seen.
• Keep all appointments with your
doctor so he or she can monitor
your health.
• If bed rest at home does not improve
your symptoms, you may be admitted
to the hospital for bed rest,
medications, and close observation.
• If preeclampsia continues to
become worse, the doctor may
suggest that delivery of the baby is
needed.
• You may be given medication such
as magnesium sulfate to decrease
your risk of seizures.
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Preterm Labor
Preterm labor is labor that starts
more than three weeks before your
baby is due (before 37 weeks of
pregnancy). An early delivery can
cause the baby to have problems
with breathing, eating and keeping
a normal body temperature. Early
treatment of preterm labor may
prevent a preterm birth.
The cause of preterm labor is
not known. It can happen to
any pregnant woman during any
pregnancy, but some conditions may
increase the risk.
Who is at Risk for Preterm
Labor?
These conditions may increase your
risk of preterm labor:
• A history of preterm labor or preterm
delivery in a past pregnancy.
• Twins, triplets, or more with your
current pregnancy.
• Two or more second trimester
abortions or miscarriages.
• A weak cervix.
• Previous surgery on the cervix, such
as a cone biopsy.
• Severe kidney or bladder infections.
• Bleeding problems with this
pregnancy that happen after
14 weeks into the pregnancy.
• Cervical dilation (opening) or
thinning before 30 weeks.
• Many uterine contractions before
30 weeks.
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Signs of Preterm Labor
Each of the following may be a sign of
preterm labor. If you have even one
of these signs, call your doctor right
away.
• Uterine contractions every
10 minutes or more often: Uterine
contractions are the tightening
and relaxing of the muscle of the
uterus. Contractions occur normally
throughout pregnancy as the
uterus stretches and grows. These
"normal" contractions happen a few
times a day and when you change
your position. Uterine contractions
that cause preterm labor occur in a
regular pattern and are frequent.
I f your uterus is contracting, you
will feel your entire abdomen get
tight (hard) and then relax (soften).
It may also feel like the baby is
“balling up.” They may be painless
but can cause your cervix to open.
• Low, dull backache: Backache may
come and go or be constant. It may
happen along with a “balling up”
feeling of your abdomen. It can
be felt below the waist and is not
relieved after lying down, a change
in position or a heating pad.
• Menstrual-like cramps: The cramping
feeling occurs in the lower abdomen
just above the pubic bone. It may
come and go or be constant. It
may feel like the beginning of your
menstrual period.
• Increase or change in vaginal
discharge: Vaginal discharge is
normally thick and white during
pregnancy. It may increase in
amount or become more watery,
pink or tan, like your mucous plug.
• Pressure in the lower abdomen,
back or thighs: This pressure may
feel like heaviness in the pelvis or
like the baby is pushing down or
falling out.
• Intestinal (bowel) cramping, with
or without diarrhea: You may have
the feeling of "gas pains.”
Treatment for Preterm Labor
Your doctor may ask you to try some
of these behaviors to see if they help
with preterm labor:
• Stop what you are doing. Lie down on
your left or right side for one hour.
• Quickly drink several cups of fluid
that do not contain caffeine during
that hour.
• If you have four or more contractions
in one hour or any of the other
warning signs after rest and fluids,
call your doctor or Labor and Delivery.
Do not wait any longer than one
hour for the symptoms to go away.
You need to go to the hospital to get
medicine to stop the preterm labor.
• Call your doctor or Labor and
Delivery right away if you have:
− Bleeding
− Fluid leaking from your vagina
− Change in vaginal discharge
− Frequent contractions (every
5 minutes or less)
Managing Signs of Preterm
Labor
If you are at risk of having preterm
labor, your care during pregnancy
may be changed:
• Your doctor will see you more often.
You will be asked about symptoms
of preterm labor and your cervix
will be checked on each visit. These
findings will be discussed with you.
− Talk to your doctor about attending
childbirth education classes. If you
have been placed on bed rest, ask
if you can attend or be part of the
birth activity portion of the class.
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• Work outside the home may have to
be decreased, changed, or stopped.
This depends on the type of job you
have and your risk of preterm labor.
Discuss your job with your doctor
early in your pregnancy.
− No heavy cleaning should be done,
including mopping or scrubbing
floors, vacuuming, changing
curtains, and moving furniture.
• Physical activity may need to be
changed or stopped, including but
not limited to these activities:
• Sexual activity may have to be
decreased or stopped, depending
on your medical condition. Report
any symptoms of preterm labor that
continue for more than one hour,
after sexual activity.
− Do not do physical sports or
activities including jogging,
bicycling, tennis, long walks, or
frequent trips up and down stairs.
− Do not lift heavy grocery bags or
laundry baskets.
− Long trips by car or plane should
be discussed with your doctor.
• Breast massage or preparing your
nipple for breastfeeding should not
be done until three weeks before
your due date. Breast stimulation
releases hormones that may cause
contractions.
• In some women, stress may add to
preterm problems. If you are feeling
stressful or anxious about things,
be sure to talk them over with your
support person, doctor, or nurse. If
needed, your doctor can refer you
to someone to help you cope with
those issues.
Beginning at about 28 weeks, your
doctor will work with you on planning
for your delivery. Also, our staff can
assist your doctor with this planning.
If so, please give our office a call.
Important Phone Numbers
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
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Pregnancy Activity Levels
When you have a high risk pregnancy,
your doctor may order more rest until
your baby is born. There are several
levels of activity from light activity
(Level 1) to bed rest (Level 3). These
levels are used to protect your health
and the health of your baby.
About Your Activity Level
• Depending on your needs, your
doctor may change your activity
level during your pregnancy.
• Your emotional health is as important
as your physical health. It is
important to find ways to manage
both your physical activity and stress.
• Do not do stressful exercise. First,
talk with your doctor or nurse about
any activities you may want to do.
• Your doctor or nurse will talk with
you about sexual activity.
Level 1
Level 1 has the fewest limits. You can
do some activities, like walking, but not
others, such as playing sports. Balance
each activity with time for rest.
• Get 8 to 10 hours of sleep each day.
• Rest one hour in the morning and
one hour in the afternoon. When
you rest, lie down on your left side.
• Do light household chores only
15 or 20 minutes at a time. Get
help for heavy cleaning or activities
that involve bending, stretching,
lifting, pushing, pulling or standing
on your feet for any length of time.
• If desired, take short walks (2 to 3
blocks). Talk to your doctor about
other light exercises you can do.
• Go on short errands or shopping
trips, but pay attention to the
amount of movement for the
activity. Use an elevator or escalator
instead of the stairs. Find activities
that involve sitting, such as going
to a movie or dinner, instead of
walking.
• Talk with your employer if you work
outside of the home, and your doctor
advises you to decrease your hours or
to change to working part-time.
• Other:_______________________
____________________________
Level 2
This has more limits than Level 1. In
Level 2, you need to spend most of
your day lying down.
• Get 8 to 10 hours of sleep each day.
• Rest most of the day. Lie on your
left side as much as possible. You
may get up to go to the bathroom
and take a short 10 to 15 minute
shower.
• Talk with your doctor about light
exercises you can do to keep your
muscles strong. See Bed Rest
Exercises for Pregnancy on the
following pages.
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• Make simple meals that do not
take a long time to prepare for you
and your family, or have family and
friends bring meals so you do not
need to cook.
• You will need help with housekeeping,
laundry, and grocery shopping. Any
activity that keeps you on your feet,
or involves, bending, stretching,
lifting, pushing, or pulling needs to
be done by someone else.
• If you work outside the home, you
must stop work and be on sick
leave. This is for your health and
the health of your baby.
• If you have other children who need
care, talk with family and friends, or
a child care provider to get support.
• Other: _______________________
____________________________
Level 3
If you have been placed on Level 3
activity, this means you need to be
on bed rest all day. Level 3 activity
can be very hard as you want to be
up and about, but for your health and
the health of your baby, lying down is
best.
• Get 8 to 10 hours of sleep each day.
• Rest in bed all day. Lie on your left
side as much as possible.
• You may get up to go to the
bathroom and take a short
10 minute shower.
• Climb stairs slowly and only if
absolutely necessary.
• You will need help at home for
all chores and family care.
• Eat meals in bed, lying on your side.
• Leave the house only for doctor
visits.
• Other: _______________________
____________________________
Coping with Bed Rest
If you are placed on bed rest, it is
very important for your health and
the health of your baby. It can be
hard to stay lying down. Try these
tips to cope with your activity level:
• Find activities you can do lying
down, such as puzzles, games,
watching TV, reading, talking on the
phone, skype™ or video chat with
friends.
• Join an online support group.
Use a handheld device, such as
a smartphone, tablet, or laptop
computer to make it easier to stay
connected.
• Talk to friends on social networks, or
start a blog about your pregnancy.
• Take an online course through your
local college or see if there are free
webinars you can watch.
• Contact your local bookstore to see
if they have an online book group
you can join.
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Bed Rest Exercises for
Pregnancy
A simple exercise program will keep
your muscles toned and improve your
circulation while you are on bed rest.
It helps your body:
• Tone muscles to reduce stiffness
and muscle strain that occurs with
bed rest. Muscles need to be strong
for getting into or out of bed and to
help with recovery after delivery.
• Use an online website such as
Helping Hands and help direct
family and friends who want to
help with meals, transportation,
housework or other support.
• Work on a hobby that you can do
lying down such as scrapbooking,
hand sewing, knitting or crocheting,
play video games, and write in a
journal or paint.
• If you have small children, find
activities you can do with them,
such as reading, playing with small
toys, or singing. Use your computer
to play music and watch them
dance. You do not have to move.
Your kids just want you to be part
of these activities.
• Remind yourself, that you are doing
something wonderful by taking
good care of yourself and your baby.
• With good posture.
• Keep from having problems with
blood flow, such as blood clots in
the deep veins of the legs, called
DVTs. It can also help increase blood
flow to the uterus (womb) and
fetus.
• Reduce the stress and boredom that
comes with less activity and lengthy
bed rest.
How to Exercise Safely
• Do each exercise slowly.
Movements should not cause you
to work hard or get tired. See how
your body responds. Spread out
exercises during the day.
• Do not use your stomach muscles,
strain or hold your breath.
• Report any uterine contractions,
bleeding or amniotic fluid loss to
your nurse or doctor.
• If you are allowed to walk, keep
good posture.
• Do warm up exercises while sitting
on the side of the bed.
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Bed Rest Exercise List
Try to do each set of exercises two to three times a day. Go slowly and if you notice
stress or strain, STOP. Do not use your stomach muscles for these exercises.
Exercises to relax your neck and shoulders (repeat each exercise 5 to 10 times)
These exercises can be done lying down or sitting up. If your doctor has limited your time
sitting up, then you may do them lying down. Slightly turn on one side or the other.
1.
• Bring your chin in towards your chest.
• Pull your shoulders up towards
your ears.
• Slowly roll your head towards the
left and then the right. Relax and
repeat.
• Roll your shoulders forwards in a
circle, then, backwards in a circle.
Relax and repeat.
3.
• Pull your shoulder blades together in
the back of you. Relax and repeat.
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2.
4.
• With your arms straight out in front of
you, reach forward as far as possible.
Relax and repeat.
Bed Rest Exercise List
Try to do each set of exercises two to three times a day. Go slowly and if you notice
stress or strain, STOP. Do not use your stomach muscles for these exercises.
Arms (repeat each exercise 5 to 10 times)
These exercises can be done on your back or side, depending on how you are to told
to lie in bed.
5.
6.
• Tuck your chin and push the back
of your head into the pillow. Then,
stretch your arms down toward your
knees, one at a time.
• Lying on your left side, use your
right arm to draw a large circle in
the air making the circle bigger and
then smaller. Next, lie on your right
side and use your left arm to draw
a large circle in the air making the
circle bigger and then smaller.
• You may also do these exercises on
your back, depending how you are
told to lie in bed.
• Tighten and release your fists.
• Bend and straighten your elbows.
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Bed Rest Exercise List
Try to do each set of exercises two to three times a day. Go slowly and if you notice
stress or strain, STOP. Do not use your stomach muscles for these exercises.
Legs, knees, ankles, and feet (repeat each exercise 5 to 10 times unless it
says something else)
7.
9.
• Bend your right leg at the hip and at
the knee. Keep your heel flat on the
bed. Slide your heel up towards your
buttocks.
• Keep your left leg straight.
• Bend your right leg so the heel is flat
on the bed.
• Then, straighten out the leg and
repeat this with your left leg.
8.
• Bend your right leg at the hip and at
the knee. Keep your heel flat on the
bed. Slide your foot to one side then
back to the middle. Repeat with your
left leg.
18
• Place the right heel on top of the left
ankle. Slide your right foot up the left
leg until it reaches the knee. Then,
slide it back down to the ankle.
Repeat with your other leg.
Bed Rest Exercise List
Try to do each set of exercises two to three times a day. Go slowly and if you notice
stress or strain, STOP. Do not use your stomach muscles for these exercises.
Legs, knees, ankles, and feet (repeat each exercise 5 to 10 times unless it
says something else)
10.
To help your leg muscles, try these
exercises lying on your back.
11.
To help your leg muscles, try these
exercises sitting up.
• Keep your legs straight and toes
pointed towards the ceiling.
• Bend and straighten your right
knee 5 to 10 times. Repeat on
your left knee.
• Tighten your thigh muscles by lifting
your right leg in the direction of your
waist. Hold for five seconds and
release. Repeat with your left leg.
• Now, straighten your right leg in
front of you and move your foot
and ankle up and down. Repeat
with your left leg.
• Do this activity if you can sit up for
meals or if you can get up to use the
toilet or bedside commode.
19
Bed Rest Exercise List
Try to do each set of exercises two to three times a day. Go slowly and if you notice
stress or strain, STOP. Do not use your stomach muscles for these exercises.
Legs, knees, ankles, and feet (repeat each exercise 5 to 10 times unless it
says something else)
12.
13.
• For your knees, keep your legs
straight on the bed, and roll your
knees inward and outward.
• For your ankles, move each foot
up and down in a pumping
motion about 15 to 20 times
every 1 to 2 hours.
20
• Keeping your legs on the bed,
move your left foot in a circle and
then move it in the other direction.
Repeat with your right foot.
Bed Rest Tips
Getting In and Out of Bed When on Bed Rest
Move slowly and ask for help when getting out of bed. Do warm up exercises
before you get out of bed, such as ankle circles and leg pumps. This will get your
body ready for movement.
• To move from side to side in bed:
Keep your head on the pillow and
roll like a log.
• To sit up in bed: Keep your head on
the pillow and use the up button on
your electric hospital bed.
• Use both arms to push yourself up
to a sitting position while you swing
your legs over the edge of the bed.
I MPORTANT: Never sit straight
up without using your hands or
turning to one side first.
• Then roll to one side.
21
Bed Rest Tips
Using a Bedpan
Comfort during Bed Rest
Use pillows and the electric bed controls
to reduce muscle strain, this will help
prevent muscle pain, soreness, or
stiffness from staying in bed. Be aware
of how you are lying in bed to keep
yourself comfortable. Below are some
ways to keep your joints supported.
• Lie flat on your back in bed and keep
your head on the pillow. Slightly raise
the head of the electric bed. This
will make using the bedpan more
comfortable.
• When you are in bed, try to keep your
spine as straight as possible, no matter
how you are lying. If your spine is
twisting or sagging, this can cause
muscle strain.
• Bend both knees, put both your feet
flat on the bed, then lift your bottom.
• Slide the bedpan underneath you.
With the bed flat, remove the bedpan
the same way.
22
• Place a small towel roll under your
lower back for added support.
• Lying on your left side is the best
position for the most blood flow to
your uterus and the baby. To prevent
strains, place a pillow under your belly
and between your knees or behind
your back. Ask your nurse for extra
pillows.
Bed Rest Tips
Deep Breathing and Relaxation
• Lie on your side or back with knees
bent. Rest one hand on your belly.
Breathe in deeply through the nose
so your hand is raised up by your
belly. Breathe out slowly through
your mouth. Repeat deep breathing
five times.
• Ask your support person or one of
your health care team members to
give you a massage.
• Close your eyes. Beginning with
your toes and feet, relax each body
part as you work your way up your
body. Relax your thighs, buttocks,
back, shoulders, neck, jaw, eyelids,
and forehead. Now imagine yourself
enjoying the feeling of calm.
23
Breathing Techniques for Labor
There are different breathing techniques for labor. You may learn many of them in a
childbirth education class. A few examples are shown on the this page.
Slow Paced Breathing
• Take a "cleansing breath" as your contraction
begins. Breathe in (inhale) through your nose
and then let the air out (exhale) through your
mouth, letting your body completely relax.
• Keep your eyes focused on something, such
as a picture on the wall or by thinking of
some beautiful place in your mind.
• Breathe in through your nose (count 1, 2, 3, 4)
then exhale through your mouth (count 1, 2,
3, 4) as if gently blowing a candle flame.
Pace yourself at one-half your normal
breathing rate.
• As your contraction ends, take another
cleansing breath.
Modified Paced Breathing
• Take a cleansing breath and totally relax.
• Keep your eyes focused on something, such as
a picture on the wall or by thinking of some
beautiful place in your mind.
• Inhale through your nose (silently say
1000 in) and exhale through your mouth
(silently say 1000 out).
• As your contraction ends, take another
cleansing breath.
Patterned Paced Breathing
• Take a cleansing breath while relaxing your
entire body.
• Keep your eyes focused on something, such
as a picture on the wall or by thinking of
some beautiful place in your mind.
• Inhale and exhale with 3 to 4 shallow upper
chest breaths (AH-HEE), followed by softly
exhaling (AH-BLOW).
• As your contraction ends, take another
cleansing breath.
24
Tips on Caring for More
than One Baby
Caring for your new babies will be
exciting, but also can be very tiring.
For this reason, it is important to
have lots of support. Ask for help
from friends, relatives, your local
place of worship, or a teenager you
trust from the neighborhood. Tell
them the type of help you need, such
as household chores, feeding babies,
or to just have a break from the
daily routine. Do not try to be super
parents, ask for help.
Feeding
Your decision to breast or bottle feed
should be based on what method best
meets the needs of you, your babies,
and your family.
• The feeding method you choose
during your pregnancy may need to
be changed to better meet you and
your babies’ needs.
• While breast milk is best, talk
with your bedside nurse, lactation
(breastfeeding) specialist, La Leche
League, or baby’s doctor for questions
you may have about feeding your
babies. You may need to both breast
and bottle feed your babies.
Breastfeeding
Breastfeeding more than one baby is
possible. Be patient with yourself and
your babies while you learn to feed
more than one at a time.
• Eat healthy foods, drink plenty of
water, and have some help at home
so you can rest, while you build up
and maintain your milk supply.
• Talk to your bedside nurse or
lactation consultant about
positioning when breastfeeding.
A special breastfeeding pillow,
which fits around your waist, allows
two babies to lie on either side of
your breasts and feed together.
• Start off breastfeeding one twin at
a time until breastfeeding is going
well. When each baby can latch
on correctly, you can then begin to
breastfeed both babies at the same
time.
• If one baby has a stronger sucking
reflex, have that baby breastfeed
first. This helps with milk flow and
makes feeding easier for a twin who
has a weaker sucking reflex.
• Nursing both babies at the same
time saves you energy and time.
Breast compressions can be done
to help your baby with a weaker
sucking reflex to feed better.
• You may find it easier to put your
babies on the same feeding schedule
so you can rest while they are sleeping.
You may choose to breastfeed one
child and bottle feed the other and
switch at the next feeding time.
If you choose to feed them separately,
and one cries while feeding the other
one, offer a pacifier, rock the infant in
an infant carrier, or try singing.
25
For more in depth information
on breastfeeding refer to the
InJoy booklet, Understanding
Breastfeeding: Your Guide to a
Healthy Start.
Bottle Feeding
By holding the babies close to you
and making good eye contact, you
can have the same feeling of
closeness while bottle feeding as
with breastfeeding. If your babies
eat slowly, ask your nurse to show
you other holding positions and ways
to help your babies eat better.
• If you have room in your refrigerator,
try to make enough formula for at
least 24 hours. Mix the formula and
place it in a pitcher with a closed lid,
or pour the formula into bottles and
store them in the refrigerator.
• If you pour the formula into bottles,
only pour the amount the babies
are taking at each feeding to reduce
waste. You will also need at least
8 bottles per baby for a 24 hour
period.
• Warm the formula before giving
it to your babies. The safest way
to heat a bottle of formula is to
run warm water over it until it is
room temperature. Always check
the temperature first before giving
a bottle to your baby. Shake a
few drops on your inner arm. The
formula is ready when it no longer
feels hot or too cold.
I MPORTANT: Do not use the
microwave to warm the bottles.
This can create hot spots that can
burn your baby’s mouth.
26
Diapers
Choose whatever type of diaper,
disposable or cloth that best meets
your needs. Using cloth diapers can
save money, but having access to a
washer and dryer is necessary, and
washing them will take lots of time.
Pre-folded diapers, 2 dozen for each
baby, will get you through at least
two days. Some parents choose
disposable diapers because they
require less work.
Infant Seats or Chairs
At about six months of age, you can
begin to use infant seats or chairs
when your babies have good head
support, this will allow them to
explore their world. This also allows
the babies to interact with each other
when they are placed side-by-side or
face-to-face.
Stroller
There are several types of strollers to
choose from:
• A side-by-side stroller has the babies
lie or sit next to each other.
• A seated front-to-back stroller
allows the babies to lie down, or sit
up at various levels.
• In a face-to-face stroller, the babies
sit facing each other
• Umbrella strollers that are attached
can be used when your babies are
sitting up and have good head
support.
A stroller that holds more than one
baby allows you to shop with your
hands free and enjoy walks during
nice weather. Consider how much
space you have in your car when
selecting strollers. Try out the strollers
in the store to see how it collapses and
make sure it will fit in the car. Always
secure your babies with the stroller
seat belt.
Toys
Babies born together learn to share
and take turns earlier and more easily
than do single children. It is not
necessary to have two of each toy.
However, each baby should have one
toy to play with.
• As your babies get older, you may
decide that each child should have
his or her own toys and a separate
place to store them.
• Consider dividing the toys and
storing them in plastic laundry
baskets to rotate their playing time.
Store some, and play with others,
and rotate toys every few months.
Brothers and Sisters
The birth of more than one baby at
the same time can be hard for other
children in the family. Sisters and
brothers soon learn that the babies
tend to attract attention wherever
they go. They also need lots of work
that takes much of mom and dad's
time. Here are some tips:
• Introduce big brother and sister to
visitors first, before introducing the
babies. Talk about the brother or
sister’s recent accomplishments.
• When your child needs you, spend
five minutes of your time. This will
be more helpful than spending an
hour when it is a better time for you.
• Plan special times with grandparents,
friends, or relatives to give the brother
or sister a chance to feel special.
• Spend time alone with the other
children and do one-on-one activities,
like reading a story or taking a walk.
Use sitters or friends to watch the
babies for you.
• Talk to your older children about
their feelings. Try to keep calm and
understand that behaviors such as
wetting, thumb sucking, and nail
biting are short term responses to
the stress of having new siblings.
27
Helpful Hints
• It can be hard to remember
everything the first few weeks.
Do not trust your memory, write it
down. Keep several lists.
− In the first few weeks, write down
the babies’ feedings and number
of wet and dirty diapers for
24 hours.
− Keep a shopping list of must have
supplies for babies and the family
− Keep a list of questions and
concerns for you or your babies'
doctor
− Write down dates of milestones
such as, social smile, babbling,
sitting, crawling, etc. You may
want to use a first year calendar.
− Simplify your housework. Do not
try to clean your house in one day.
Clean one room a day and break
it up into small jobs. Accept help
with cleaning. Do not feel you
have to do it alone.
• More than one baby is much harder
to keep an eye on than a single
baby, as they can go in opposite
directions quickly. Make your home
as safe as possible. Safety gates and
play pens provide safe play areas.
Post emergency phone numbers
such as the Poison Control Center by
each phone.
28
• Rest when your babies sleep during
the day. Having more than one
baby means having more feedings
during the night, unless you feed
them together. Put older siblings
down for naps or quiet time so you
can rest, too. By resting or sleeping
when your babies sleep during the
day, you can reduce the stress of the
daily routine.
• Swings may also be helpful when
your babies need to be soothed. If
the babies become upset, 5 to 10
minutes in the swing has been
shown to be a calming effect.
• If you have identical or fraternal
babies who look alike, you may
worry about how to tell them apart.
Use a different color nail polish on a
toe nail or stitch initials in a piece of
their clothing to help identify them.
Soon after birth, you will not have
problems, as even identical babies
have differences.
Breastfeeding More Than One Baby
Mothers may choose to breastfeed each baby one at a time. Some mothers prefer to
feed both babies together. This is more successful if you wait until each baby latches
well and you are comfortable with breastfeeding. A sitting position may be easier
when starting.
Football hold supported by pillows
Cradle hold/football hold combination
Side lying position with mother sitting up
Side by side position with
mother lying down
29
Bottle Feeding Your Baby
The American Academy of Pediatrics
or AAP recommends breast milk
(human milk) for the first year of life
and beyond. Pumping breast milk
for bottle feeding is an option. If
there are medical reasons to use an
iron-fortified infant formula to feed
baby, your doctor will help you to
choose a product.
Getting Started
1. Wash your hands well with soap
and water for 20 seconds or use an
alcohol-based hand sanitizer, such
as Purell® before feeding your child
or handling formula.
2. Feed your baby when there are
signs of hunger, such as putting
hands to mouth, or tongue moving.
This may be every 2 to 4 hours. If
your baby sleeps longer than four
hours, wake your baby for his or her
feeding. Plan to feed your baby at
least 8 to 12 times in 24 hours.
abies who are given breast milk
B
may be hungry faster than babies
using infant formula. Breast milk is
easier to digest.
3. Relax, sit down, and make yourself
comfortable. Hold your baby in a
semi-upright or side lying position
while feeding.
4. To get your baby's attention, stroke
the upper lip or cheek with your
finger or with the tip of the bottle’s
nipple. Your baby's head will turn
and mouth will open in response to
the stroking. When you place the
bottle nipple in your baby’s mouth,
your baby should begin sucking.
5. Hold the bottle at a slight incline so
the top of the bottle fills completely
with breast milk or formula to
prevent baby from swallowing air.
If your baby is drinking a bottle of
mixed formula, make sure to throw
away any leftover mixed formula
within one hour. Do not put it
back in the refrigerator or reuse it.
6. Burp your baby every ½ to 1 ounce
from the bottle. Try burping if
your baby wants to stop eating too
soon. Burping helps your baby get
rid of the extra air in the stomach.
Air causes a baby to feel full and
not comfortable. A small amount
of breast milk or formula may
come up when burping and this is
normal.
7. Allow your baby to decide when
he or she has had enough to eat.
Do not force your baby to finish
a bottle. Towards the end of a
feeding, baby may fall into a light
sleep. You may still notice some
sucking movements. This is just a
reflex and does not mean that the
baby is still hungry. Let your baby
suck on your finger or a pacifier.
Hold your baby close and talk softly
during the feeding. Skin to skin contact
can be done during feeding. Your baby
will enjoy the warmth and feel of your
skin. For more information, please ask
your nurse for the handout Skin to Skin
Contact for Your Baby.
our baby is taking _____milliliters (mls) every ____hours today. If you are
Y
not sure how much your baby is eating talk with your doctor or nurse.
30
Common Questions
about Formula
How long is breast milk or
formula needed for a healthy
diet?
It is needed at least the first year
of life. Do not add anything to the
bottle formula, including honey,
sugar, cow's milk, or cereal unless
directed by your doctor. The doctor
will tell you when you should start
solid foods and cow's milk.
What types of formula should I
give my baby?
Your baby's doctor will suggest what
formula he or she believes is best for
your baby. Always check the expiration
date on the label, do not use expired
formula.
• Ready-to-Use Formula – This formula
comes in ready-to-feed 2 ounce or
4 ounce bottles or cans. If you buy
the cans, pour the formula into a
sterilized bottle. You need to supply
your own sterilized bottle nipples.
They do not come with ready to use
products. Use within 48 hours and
throw away any leftover formula.
• Powdered Formula – powdered
formula costs less than ready to use
or liquid concentrate, but it takes
the most time to prepare. Mix
1 scoop of powder for every
2 ounces of water, or as directed
by your doctor if your baby has
special nutrition needs.
F or example, if you need to make
4 ounces of formula, use 4 ounces
of water and add 2 scoops of formula.
You will need sterilized bottles and
nipples ready to fill after mixing the
formula. Use within 24 hours of
mixing and throw away any leftover
mixed formula.
• Liquid Concentrate Formula –
Concentrate will cost you less but
you must read the mixing directions
on the label. Mix the concentrate
with equal amounts of water. For
example, if you want 4 ounces of
formula use 2 ounces of concentrate
and 2 ounces of water. You will need
to have ready, sterilized bottles and
nipples after mixing the formula.
Use within 48 hours and throw away
any leftover mixed formula.
31
What type of bottles and
nipples should I use to feed my
baby?
No one type of bottle or nipple is
better than another. Your baby will
help you decide which one is best by
how they are able to use it. There
are several you may want to try. All
infants should be on a low flow or
slow flow nipple unless your doctor
tells you to use another kind of
nipple.
Can I change formula if my baby
does not like it?
Do I need to sterilize bottles and
nipples?
Treat formula like a medicine. Call
your baby's doctor before changing
the brand of formula. Do not change
the brand because of a coupon or ad
for another brand. If you think your
baby does not like the formula or your
baby has problems digesting it, call
your baby's doctor.
Yes. Health care providers
recommend sterilizing bottles and
nipples by placing them on the
top rack of your dishwasher. If a
dishwasher is not available, check
with your doctor or nurse on
sterilizing bottles and nipples.
Common signs to watch for when
babies have problems with formula are:
• Vomiting right after the feedings
• Recurring diarrhea (loose stools) or
constipation (hard stools)
• Frequent bouts of crying after
feedings
• Signs of colic with a firm, enlarged
and tender tummy right after a
feeding
• Fussy behavior and/or waking at
night
• A rough, rash on the face and
around the rectum (opening for
bowel movements)
• Frequent colds and/or ear infections
Talk to your baby’s doctor if you see
any of these signs.
32
What is the safest way to heat a
bottle of formula?
• The safest way to heat a bottle of
formula is to run warm water over it.
• Do not place a bottle in a pan of
water on the stove and bring it to a
boil. This destroys the protein in the
formula and is too hot for baby to
drink.
• Do not microwave formula.
Microwaving causes uneven
heating. The bottle may feel cool to
you, but the formula inside can be
very hot and burn your baby.
• Always check the temperature first
before giving a bottle to your baby.
Shake a few drops on your inner
arm. Formula is ready when it no
longer feels hot or too cold.
Other Safety Tips
• Do not let baby drink a bottle of
formula lying flat. Feeding a baby in
this position increases the chance of
ear infections and choking. Decay
of baby teeth and jaw problems
are also common if you feed in this
position.
• Do not lay a baby down with a
propped bottle. Propped bottles
increase the risk of choking.
• Know how to use a bulb syringe.
Sometimes babies choke when
you are feeding them. Your nurse
will show you how to use the bulb
syringe to suction your baby's
mouth and/or nose.
• Do not give your baby homemade
formula. Formula made from cow's
milk (fresh or evaporated) does
not have the same nutrients as
commercially made formula. Babies
cannot digest cow's milk.
33
Bottle Feeding More Than One Baby
34
Feeding both babies supported by pillows
Feeding one infant in parent's lap and the
other in carrier or car seat
Feeding both babies in infant carriers
or car seats
Feeding one infant in parent's lap while
supporting the other infant in a car seat
or infant carrier
Essentials for Multiples
Quantity
Items
Clothing
4 to 5 each
Onesies T-shirts
4 to 5 each
Terry sleepers and/or blanket sleepers (depending on the season)
4 to 5 each
Kimono gowns
5 pairs
Socks/booties
1 each
Bunting/Hats/Bonnets
10 to 12
Small drool bibs
4 to 5 each
Outfits
2 dozen
Cloth diapers for burping
1
Hamper
2 boxes
Baby detergent
1 to 2 bottles
Stain remover for clothing
1 to 2 bottles
Stain remover for carpet
Bedding
1
Cradle/bassinet (optional)
1 each
Crib
1 each
Bumper pad
2 each
Mattress covers (waterproof)
2 to 3 each
Crib sheets
2 to 3
Waterproof pads
2 to 3
Crib blankets
6 to 8 each
Receiving blankets
Bath Items
1
Baby bathtub
2 to 3 each
Hooded bath towels
5 to 6
Baby washcloths
1 to 2 bottles
Baby soap
1 to 2 bottles
Shampoo
1 to 2 bottles
Powder
1 to 2 bottles
Lotion
35
Essentials for Multiples
Quantity
Items
Diaper Items
4
Waterproof lap/changing pads
2 to 3 packs
Jumbo/mega disposable diapers
8 dozen
Cloth diapers (if no disposables)
3 to 4 each
Diaper covers (for cloth diapers)
2 to 3 boxes
Baby wipes
1 to 2
Diaper pails
1
Changing table
Feeding Items for Breastfeeding
1
Double electric breast pump
4 to 5
Nursing bras
1 box
Breast pads (cloth or disposable)
1 box
Plastic liners (4 and 8 ounces)
6 to 8 each
Bottles ( 4 and 8 ounces), rings, nipples, caps
1
Bottle/Nipple brush
Health Items
1
Cool mist humidifier
1 each
Thermometer
1 each
Bulb syringe
1
Diaper rash ointment
1 each
Acetaminophen drops
1
Infant nail clippers/scissors
Cotton balls/ Q-tips®
36
Essentials for Multiples
Quantity
Items
Assorted Items
1
Large diaper bag
1
Comb and/or brush
1 each
Infant carrier type car seat
1 each
Infant head support rest
1 to 2
Front carrier (optional)
1
Nursery monitor
1 each
Musical mobiles (optional)
1 to 2
Baby swings (optional)
1 each
Bouncy seats (optional)
1 to 2
Night lights
1
Stroller (twin/triplet)
1
Cordless telephone and answering machine
Baby toys (activity gym, rattles, mirror, teethers, and the like)
For Later
1 each
Convertible car seat (T-bar/5-point restraint take up the least
room)
1 each
High chair
10 to 12
Feeding bibs
1 each
Booster chair
1 each
Backpack-type carrier
1 to 2
Baby gates
1 to 2
Play yards
1 each
Exersaucer, jumping seats (optional)
1 each
Child proofing gadgets (socket covers, cabinet locks, corner cushions)
Feeding utensils, bowls, sippie cups (no spill)
37
New Baby Resources
for Parents
Preparing for Multiples: The Family Way
by Cindy Carter
ISBN 978-0-9890337-2-5
For more information on caring for
yourself and your newborns see the
Injoy booklet, Understanding Mother
& Baby Care: A Guide to the First Two
Weeks.
This book provides general information
for families expecting more than one
baby.
In addition, here is a list of books
and DVDs on topics that teach new
parents about their baby. These are
available at public libraries, bookstores,
and from online vendors.
Books
And Baby Makes Four: Welcoming a
Second Child Into Your Family
by Hilory Wagner,
ISBN 0-380-79505-1
Advice from pediatricians, psychiatrists,
obstetricians, midwives, parents and
childbirth educators. Includes special
activities to share with the first child
during the last few weeks of pregnancy.
Beyond One: Growing a Family and
Getting a Life,
by Jennifer Bingham Hull
ISBN 978-1-58-005104-0
The author writes about the first three
years of life with two children, providing
tips, insights, and comic relief.
Eat, Sleep, Poop: A Common Sense
Guide to Your Baby’s First Year
by Scott W. Cohen
ISBN 978-1-43-911706-4
Cohen, a pediatrician, gives practical
advice to parents of infants while
sharing his own sometimes comical
first year as a father.
38
Show Dad How: The New Dad’s Guide
to Baby’s First Year
by Shawn Bean
ISBN 978-1-61-628111-3
In a series of nearly wordless, highly
informative, often hilariously illustrated,
step-by-step activities, dads-to-be learn
how to do dozens of useful tasks.
The Everything Parent's Guide to
Raising Siblings: Eliminate Rivalry,
Avoid Favoritism, and Keep the Peace
by Linda Sonna
ISBN 1-59337- 537-9
Written by a child psychologist. Discusses
all parts of sibling relationships.
Twice Blessed: Everything You Need
to Know about Having a Second Child
– Preparing Yourself, Your Marriage,
and Your Firstborn for a New Family
of Four
by Joan Leonard
ISBN 0-312-25430-X
What to expect as the family grows
from three to four during the first
weeks after baby’s birth and through
the first year.
Welcoming Your Second Baby
by Vicki Lansky
ISBN 1-931863-44-X
Practical tips and advice including
“how I did it” suggestions from real
moms.
DVDs
Bringing Baby Home DVD
publisher Liandrea Company
71 minutes
This DVD covers birth to six months
with demonstrations on daily activities
such as diapering, bathing, and
breastfeeding. It also discusses basic
health concerns including colic,
jaundice, fever, and vaccine reactions.
Growing Green Babies
publisher Gaiam Americas
100 minutes
This program offers parents pre- and
post-natal advice, as well as a guide
to creating a green nursery, holistic
medical and nutritional tips, and
organic recipes. Also included is a
guide to sustainable living cleaning
products, cosmetics, diapers, and other
home goods.
Preparing for Parenthood
publisher New Screen Concepts
30 minutes
Host Whoopi Goldberg talks about
prenatal care, how to prepare for a
baby’s birth, and how and where to
get parenting help.
Taking Care of Baby: Tips and
Techniques
publisher Snowden Media
25 minutes
This DVD is aimed at parents as
well as teen babysitters. Clear
demonstrations show how to hold
and lift, diaper, bathe and feed babies.
Basic home medical care of babies is
also explained. In English and Spanish.
To Be a Father
publisher New Screen Concepts
30 minutes.
Hosted by Ray Romano, this film
shows how fathers can actively
participate in the healthy development
of their newborn babies and young
children.
Phone Apps
Total Baby App
This app can track all of your baby's
"events" such as, diaper changes, naps,
milestones, and doctor visits. The app
includes timers and reminder alarms.
Baby Kicks App
This app helps you keep track of your
baby's movement during pregnancy.
As soon as your unborn baby starts
moving you can start tracking your
baby's kicks, add notes, see how he or
she is growing each week, and share
this with others by email.
Websites
American Academy of Pediatrics
http://www.healthychildren.org
The AAP is a national professional
association. “Healthy Children” is their
website for parents. Here you will find
parenting tips, free brochures, news,
and health topics affecting children
from birth through 21.
Girls Health
http://www.girlshealth.gov
This is part of the U.S. Department
of Health and Human Services. It is
for girls 10 to 16 years old and their
parents. It focuses on health and
social topics that girls are concerned
about and helps motivate them
to choose healthy behaviors. The
message is positive and supportive.
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Kids Health
http://kidshealth.org
This highly respected website has
three sections: one for parents, one
for children ages 6 to 13, and one for
teens, ages 14 to 19. Age appropriate
articles on health and social topics,
written by experts, are supported by
related articles and websites. Child
and teen sections have interactive
quizzes and news feeds. Readers can
sign up for e-newsletters.
Lamaze International
www.lamaze.org
This website has pregnancy, birth
and baby rearing information, online
chat and newsletters, and locations of
childbirth classes.
March of Dimes
www.marchofdimes.com
This website is dedicated to improving
the health of babies by preventing birth
defects, premature birth and infant
mortality. The sections “Pregnancy”
and “Newborn” are aimed at parents.
Includes online videos, a blog and an
e-newsletter. In English and Spanish.
Medline Plus
http://medlineplus.gov
A service of the U.S. National Library
of Medicine, this website is a portal
to trustworthy websites about all
health topics. Use the search box for
“pregnancy,” “parenting,” “siblings,”
“multiples,” etc. In English and
Spanish.
National Healthy Mothers, Healthy
Babies Coalition
www.hmhb.org
Doctors, nurses, and teachers provide
prenatal and infant care information
in the “You & Your Family” section.
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National Responsible Fatherhood
Clearinghouse
www.fatherhood.gov
This is a service of the U.S. Department
of Health and Human Services. Click
on the tab “For Dads” to find tips and
information about being a father. In
English and Spanish.
Understanding and Raising Boys
www.pbs.org/parents/raisingboys
This is an online guide from the
Corporation for Public Broadcasting
(PBS). There are links to online videos,
articles, and question and answer
sections from health experts.
Women’s Health
http://www.womenshealth.gov
This site offers information and links
about pregnancy, childbirth, and
caring for a newborn. Once at the site,
click on A-Z Health Topics then P then
Pregnancy.
New Baby Resources for
Children
These books and DVDs are available
at public libraries, bookstores and
from online vendors to help teach
children about new siblings.
Books for Children
A New Brother or Sister, ages 4-8
by Charlotte Guillain
ISBN 1-432-94813X
Colorful photos help siblings-to-be
learn what happens when baby is
born, what he or she will be like and
need, and how to help care for baby.
Pictures of baby equipment and
resources for parents to find out more
are included.
Arthur and the Baby, ages 4-8
by Marc Brown
ISBN 0316129054
I’m a Big Brother, ages 2-5
by Joanna Cole
ISBN 0-06-190065-6
The famous aardvark is not sure he
is happy about the new baby in the
family. When he is asked to help with
the baby, Arthur feels much better.
Told from a new big brother’s point of
view, the book shows how each child
is important in the family. Includes a
"Note to Parents” that suggests how
to talk with older children about the
changes that are coming.
Baby Baby Blah Blah Blah!, ages 5-8
by Shipton and Chessa
ISBN 0823422135
When her parents tell her that they
are expecting a baby, Emily makes a
list of pros and cons.
Baby on the Way, ages 4-8
by Sears and Kelly
ISBN 0-316-78767-1
This book focuses on things an older
child can do that the baby can't, and
how to make friends with the baby.
Big Sister Now: A Story about Me and
Our New Baby, ages 2-4
by Martha Topol
ISBN 1-59147-243-1
A girl learns to cope now that she is
no longer the baby in the family. She
finds out that she can do things to
help that baby cannot. End of the
book includes tips for parents about
sibling rivalry.
Brand-New Baby Blues, ages 2-5
by Anne Beier
ISBN 978-0-06-053233-8
Rhyming book about a new big sister’s
frustrations about having a baby brother
and how she learns to look forward to
his growing up to be her playmate.
Cornelius P. Mud, Are You Ready for
Baby?, ages 3-7
by Barney Saltzberg
ISBN 978-0-76-363596-1
I’m a Big Sister, ages 2-5
by Joanna Cole,
ISBN 0-06-190062-1
Told from a new big sister’s point of
view, the book shows how each child
is important in the family. Includes a
"Note to Parents” that suggests how
to talk with older children about the
changes that are coming.
Little Rabbit’s New Baby, ages 5-7
by Harry Horse
ISBN 978-1-56145-431-0
A family expands from one rabbit-child
to four when triplets are born. Happy,
loving chaos in a cozy home.
Look at Me!, My New Baby, Waiting
for Baby, and You and Me, ages 2-4
by Rachel Fuller
Various ISBNs
This series of four books is for toddlers
awaiting and adjusting to the birth of
a new sibling. They cover pregnancy,
welcoming baby, and learning to play
and live together.
New Brothers and Sisters, ages 6-8
by Elizabeth Raum,
ISBN 1-4329-0825-1
Teaches children what to expect from
their new brother or sister, how to help
their family prepare and how to tell
adults when they need help.
Cornelius, a little pig, realizes he is not
quite ready for the new baby in his house.
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On Mother’s Lap, ages 0-3
by Ann Herbert Scott,
ISBN 0-618-05159-7
A little Inuit boy discovers there's room
for himself and his baby sister on their
mother's lap.
Our New Baby, ages 5-9
by Jen Green
ISBN 9-7807-49675-004
Features children of different races and
ethnic backgrounds who are expecting
a new baby in their own families.
Peter’s Chair, ages 2-5
by Ezra Jack Keats
ISBN 0-670-06190-5
A classic book about an AfricanAmerican family. Peter has a new baby
sister, and everything is changing. His
cradle, crib, and high chair have been
painted pink. Peter's going to save his
little blue chair even if he has to run
away to do it.
What to Expect When Mommy’s
Having a Baby, ages 2-5
by Heidi Murkoff
ISBN 0-06-053802-3
Pregnancy and parenting expert
Murkoff helps children and parents
prepare for the birth of a new child.
Where Do Babies Come From?, ages 3-6
by Angela Royston and DK Publishing
ISBN 0-7894-0579-2
A simple introduction to development.
The focus is not on the reproductive
act, but on how a baby duck, a kitten,
and a human grow inside the mother
and are born. The book has multi-racial
and ethnic photos.
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DVDs
Hey, What About Me?, ages 5-9
publisher Goldhil Media
ISBN 1594430004
Three children and their baby siblings
demonstrate games, lullabies, and
bouncing rhymes that can be done
with a baby.
Brothers and Sisters, ages 4-8
publisher Nickelodeon
ISBN 1415756279
Kids learn about relationships between
siblings, welcoming new family
members, and working out conflicts
between sisters and brothers. Features
Dora the Explorer and Blue.
That New Animal, ages 3-6
publisher Weston Woods
ISBN 054538639X
Based on a popular book, two dogs
learn to adjust when a baby comes
home.
Three Bears and A New Baby, ages 3-8
publisher Sony Wonder,
ISBN 0738925349
Sesame Street characters help a little
bear adjust to having a new baby
sister.
Multiple Baby Resources
and Books
Dayton Mothers of Twins Club:
The Dayton Mothers of Twins Club
was founded in 1943 by Ann Franklin. It is the oldest of its kind in the
United States, and was designed to
meet the needs of a mother of
multiples, both emotionally and
socially. Please go to their website
at www.daytontwinsclub.com for
more information.
Mothers of Twins Club: Annual
membership includes monthly
meetings with speakers, playgroups,
parties, and early access to
semi-annual clothing and equipment
sale that is open to the public. Go to
their website at www.cmotc.org or
email [email protected]
for more information.
Mothers of Multiples East Columbus:
Members have access to monthly
meetings with speakers, group
activities, monthly newsletter, and a
semiannual clothing and equipment
sale. Both moms and expecting
moms are welcome at the monthly
meetings. For more information go
to their website at https://www.
facebook.com/mothersofmultiples
or email [email protected]
La Leche League: Provides meetings and
access to leaders for breastfeeding help
and information. Call 1-800-LaLeche
or go to www.lllohio.org/groups/
columbus.html for meeting and leader
contact information in Columbus and
surrounding cities.
Ohio Federation Mothers of Twins
Club: Provides a monthly support
group for parents. Go to their
website at www.ofmotc.org for more
information or call (614) 261-8369.
Twins Magazine: A subscription
magazine for parents published
8 times a year. For more
information on subscribing go to
www.twinsmagazine.com or call
(888) 558-9467.
Twins Day Festival in Twinsburg,
Ohio. An annual festival held the first
weekend in August to celebrate all
multiples. For more information, go to
their website at www.twinsdays.org
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premierhealth.com/maternity
P-C-PED51357-4/2016
110 N. Main St.
Dayton, Ohio 45402