ANSWERS

Time to get creative. Think outside of the box...literally. A walk-in closet can potentially be converted into a nursery. You’ll want a crib that’s minimal in design, with space below for storage, and a small dresser that doubles as a changing table is ideal. On shelves that are used to house your shoes and bags, line up a row of colorful bins to keep things organized. Approach the glider with designer’s eye in mind—if it will sit in your bedroom, choose a slipcover or upholstery in a color or pattern that works with your bedding and overall palette.

- Serena Dugan

Look for coordinating bedding that comes in crib and twin sizes. It doesn’t have to match exactly, but the colors and patterns should definitely work together. You could also think about adding a sham to your toddler’s bed that’s in the same pattern as the crib bumper. It’s a simple way to pull one pattern throughout a room. Storage is essential for shared rooms, so be sure you have plenty of bins to corral the toys and books for both children. Be smart with furniture as your space is limited. Choose a trundle bed for your toddler; it’s perfect for sleepovers or as extra storage.

- Serena Dugan

Start with the bedding. Keep the basics (bumper and crib skirt) all white with gender color accents reserved for the trim and piping. Add a pop of pattern with crib sheets in coordinating patterns and colors. For your little girl’s crib, consider a punchy pink. It’s feminine but unique. For your son’s crib, fresh-cut green would be a great compliment. But nothing too minty. Warm, livable green for the walls would look great. Try for a tone of the same green as your son’s crib. If you want the traditional pink and blue nursery, paint the walls a crisp perfect white and mix different shades of blues for your son’s crib and pinks for your daughter. You can either do two gliders, slipcovered in white with a pop of pink or blue. Or you can do all-white gliders with personalized pillows.

- Serena Dugan

You’re going to spend A LOT of time in your glider, especially in the middle of the night. So it really is something to splurge on. Think about your space—gliders come in a lot of different sizes so you want to choose one that’s comfy but doesn’t overwhelm the room. Above all, it should have a smooth gliding mechanism and supportive cushions. Dads love a glider with a higher back and bigger arms because it’s simply more comfortable for them. The beauty of a slip-covered glider is that you can change up the look instantly, so it can go from baby to big-kid room without missing a beat.

- Serena Dugan

Looking for the perfect crib before you know what style you’re going for can be daunting. So my first suggestion would be to figure out the look you want for the nursery. Is it vintage, modern, classic or bohemian? From there, you can figure out what type of crib will work best given the style you’re going for. Classic cribs have minimal embellishments and traditional lines. Vintage cribs are often made of iron with distressed painted finishes. Modern cribs have a simple linear design with minimal detailing. I also love an out-of-the-ordinary paint finish. Any semi-gloss wall paint can turn a classic crib into a major style statement.

- Serena Dugan

I love turquoise and orange with pops of chocolate brown. Bold colors feel vibrant and clean, especially when paired with modern designs and geometric shapes. Paint the walls turquoise and choose bedding with graphic style. Rugs are like artwork for your floor, so don’t be afraid of going bold with color and pattern. Balance all the colors with an all-white glider (slip-covered for washability, of course. Whatever you bring into your son’s room, stay true to what inspires you and has meaning. I also love the combination of navy, white and orange. It’s a classic combination that can go slightly nautical with the addition of a few accent pieces.

- Serena Dugan

A soft lilac paint is a perfect choice for a girl’s nursery. From there you can take a minimalist approach with white lacquered furniture or give it a vintage vibe with a wrought iron crib. For bedding, a flax-and-white bumper looks amazing with a pale aqua crib sheet. The look is so fresh and modern, yet feminine. I also love the idea of a white-on-white color palette. Add a feminine touch with a stunning chandelier for just the right amount of shimmer to fill the room and oversized white leather poufs for extra seating.

- Serena Dugan

I love going beyond traditional baby décor and working eclectic finds into the nursery. Sometimes the unexpected pieces make the most unique touches for this special room. Consider transplanting your favorite pieces from other places of the house or embark on a treasure hunt for artwork that can grow with your child. Whether it’s new or old, always go with the pieces that resonate with you. Think outside of the box and experiment. Maybe that colorful piece of modern art in the guest room would look playful and chic in your nursery.  Or maybe you finally have a place to put the zebra print rug you have been eyeing for years. And then there are the little details to consider. Pillows add pops of personality no matter where you throw them, a stunning chandelier becomes an instant focal point and artful accents easily translate to any living space.

- Serena Dugan

The key is to go with a color palette and furniture that works in a nursery AND an older child’s room. That way you can simply switch out bedding and key pieces of décor to take it from baby to big kid. Most cribs convert to a toddler bed and some even become headboards, all you need is a standard bed frame. If you have the space, add a twin-size bed or daybed to the room right away. A lot of crib bedding collections come in twin and full sizes, so you can create a coordinated look right away. A dresser doubles as a changing table with the simple addition of a topper or changing pad. My biggest piece of advice is to buy the most durable, highest-quality items you can afford. The investment is worth it.

- Serena Dugan

Functionality is key, so keep these four words in mind: Sleep, Change, Feed and Store. Approach all of these items as: functionality first, but with design as a priority too. Falling in love with pieces and blending eclectic looks with gorgeous textures is what my nursery style is all about. I love choosing a bumper and crib skirt that can go with a lot of different colors and patterns. There’s no easier way to update your crib than by simply switching out the fitted sheet. To maximize space, turn your dresser into a changing table by simply adding a changing topper. And be sure to set it up so that you have easy access to all the essentials. A cozy glider is a nursery essential. It’s the spot where you’ll spend the most time with your baby, so it should be comfortable. Make it a statement piece by choosing a slipcover in a bold pattern or color. To put the fun in functional, go with colorful storage bins sized for books, toys, laundry and other piles that need a place to go.

- Serena Dugan

As a former decorative painter, I love how paint can transform a room. My rule of thumb: don’t be afraid to add pattern to a wall. It creates an instant wow-factor, making your nursery especially unique. I love the way vertical stripes break up a large wall area. You can keep the stripes subtle by choosing tones that are close to one another or go with a bold palette to create more pop. To create large polka dots on the wall, use the lid from a gallon of paint as your template and trace it onto your wall. The scale is perfect. A lot of people often assume that if there is pattern on the walls there cannot be pattern in the room. Not true! As long as the scale varies and the colors harmonize, it works. If you’re thinking more about a solid wall, then keep in mind how color sets the mood. Reds and oranges can warm up a space and add instant energy, while blues and greens keep things cool and calm. I recommend swatching at least three paint colors of varying tones and shades before you decide on the perfect palette for your nursery.

- Serena Dugan

 It used to be that gender-neutral rooms were boring and predictable. Not so any more. There are so many fun and creative ways to create a beautiful nursery that works for boys or girls. If you’ve already fallen in love with a crib bedding collection then let it be your color guide throughout the room, playing up the non-gender specific tones. Otherwise, you could keep things quiet and soothing with a mocha-inspired palette that layers textures and natural elements. Or go for soothing and sophisticated with all-white bedding. A splash of saturated color on the walls will really make the white pop. I love the modern mix of turquoise and orange, especially with furniture and accessories that are clean, simple and minimal. Periwinkle blue is another one of those shades that can really go either way, boy or girl. Once your baby arrives, add little extras to make the room more girl- or boy-centric.

- Serena Dugan

Thanks for asking this great question.  Typically, the two month old baby is going to determine his own sleep schedule & the pattern of wake, eat, activity, sleep is going to repeat every 3-4 hours (which is why these early stages are so hard!). 

Night may still be 1-2 wake ups for feeds & baby is not quite ready for sleep training.  However, I have a question for you – what do you mean by “refusing” to take naps?  Is baby crying & fussing when put down for the nap? How long does that last? Although two months of age is certainly early for sleep training, it’s certainly OK to have baby cry for a short period before napping - - and perhaps your perception of “refusing” could be overcome by letting him cry a little bit & fall asleep naturally.

This kind of conditioning will likely put you in a better position when actually starting to sleep train – because baby will have already learned that mommy is going to let me cry a little bit & when my little body needs a rest! 

But - - my #1 tip on getting through this period is active & PLAYFUL awake time – tummy time, play time, bath time – should all be as active & engaged as possible!  However possible, and it’s not easy!, schedule your days around baby’s cycle.  Plan awake time when you can be with baby AWAKE – feed & then play.  Focus on tummy time during each awake cycle. If baby is in the stroller or car seat during awake time – he may fall asleep & disrupt the wake/sleep pattern you’re working on.

Although parenting is just simply EXHAUSTING at this stage, try as best as you can to engage in play time when awake. Two months of age is an awesome time for tummy time – some amazing tips on tummy time (and all kinds of play!) on my One Sassy Doctor blog.

- Dr. Jen Canter

I recommend (and work with) Quinny strollers and think they are amazing. They have several models. With a stroller it's key to find one that works with your lifestyle. For maternity clothes you should shop at Rosie Pope Maternity of course ;) If you follow-me on Facebook or Twitter or sign-up for my Morning Coffee Newsletter you will be the first to find out about sales and special offers.

To register I recommend a big box baby retailer in your area. Also don't be fooled into thinking you need a lot of gear for your baby. There are many items you can get after the wee one is born. Here's a link to my blog on the Baby Registry Must Haves.

- Rosie Pope

The most important thing is that the mattress is VERY firm and that it fits the bassinet or crib well, without spacing or gaps (these can be very dangerous for wee ones). Crib mattresses ensure that your baby not only sleeps comfortably, but also that he's safe while sleeping. The mattress should be firm so that if your baby curls up next to the side of the crib, he or she can't become stuck between the crib parts and an ill-fitting mattress. So if you have to have one custom made make sure that it is firm enough and fits well. Also since your bassinet is home made you should make sure that it meets the current safety standards. 

- Rosie Pope

I think it's wonderful that you want to celebrate with them, even though you can't be there.  A long distance shower is a wonderful idea. You could always use Skype to connect 2 events (one you and family and friends are at) and really connect with them. You could contact a local baker aand have  some cupcakes, treats delivered to them. You can also have the gifts shipped directly to them and just ask them not to open until the party. They can invite some local friends to celebrate with them locally. Ideally ask your brother if his wife has any local friends you can contact that might be willing to help you out long distance to bring it all together. The key thing with the shower is to celebrate the event in a way that is meaningful to you and  your family. There are no rules or right and wrong. Do what works for you. Have fun! 

- Rosie Pope

Follow the advice of your health care provider, there is even special physical therapy to help strengthen the pelvic floor, and don't forget to do your kegels.

- Rosie Pope

Here's a link to my blog Baby Registry Must Haves

- Rosie Pope

I think that non-traditional treatments can help. I think that you should work with someone that specializes in this and has the proper certifications. I am a fan of the YinOva Center in NYC (and have interviewed them about acupuncture for kids).  Find a great practitioner in your area, you should ask friends and your physician for referrals.

- Rosie Pope

I think that motherhood takes many forms and if you have a loving and supportive family I think you are doing a brave and wonderful thing. My advice is to take the help of your family and friends when they offer it and let them  support you along the way. Good luck!

- Rosie Pope

You have to do what feels right for you. This is a tough decision, but ultimately you and your husband should decide together what is best for your family. They will still be thrilled whether they find out in person or on the phone or via Skype.

- Rosie Pope

I wrote a blog to help relive some of the stress, here's the link Baby Registry Must Haves

- Rosie Pope

It is a really tough time both emotionally and financially. I think each family has to do what works for them and I know not all families can afford the lengthy and costly process, that many times isn't successful.

For another question I received  I assembled a list of possible sources for help with the financial part of the infertility struggle.  I'm going to include them here.

• The Inter National Council on Infertility Information Dissemination (INCIID) has a scholarship program called INCIID the Heart. Anyone can apply—there is no age or income limit. The only requirement is that you have a medical need, a financial need, no insurance coverage for IVF, and a compelling story. For more info visit www.INCIID.org
• EMD Serono has a program, called Fertility Lifelines Compassionate Care. Patients with no coverage can apply to receive one cycle for free, depending on their medical and financial need. Click the link or call Fertility Lifelines at 866-LETS-TRY, and they will send you information
• You should also ask your doctor or nurse if they know of any fertility scholarship programs  in your community. Most of these programs have age and income limits.

Best Regards

- Rosie Pope

It is my recommendation that you should discuss this with your pediatrician or health care provider, as they will be familiar with your specific medical situation and will be in the best position to diagnose.

- Dr. Jen Canter

You should discuss this with your healthcare provider, as they will know your specific situation. Typically "hot yoga" is not recommended while you are pregnant. Most moms are able to continue with their work our regimen while pregnant. The key is to listen to your body and stay in contact with your healthcare provider.

- Andrea Orbeck

You should discuss with your healthcare provider, as they will know your full medical history. For a normal pregnancy (wtih no complications) flying during the first pregnancy should not be an issue.

- Dr. Amos Grünebaum, MD

I think starting early makes sense. Make sure you give yourself several months so you aren't rushed in your decision. Here is a link to my blog  Nanny 101. Good  luck!

- Rosie Pope

Induction of labor is a procedure to induce contractions in preparation for a vaginal delivery. This is  usually done with medications but there are other ways like breaking your water. Many women report that inducing labor is more painful that spontaneous labor, but it also depends on how it's being done. If your induction begins with the cervix already opened then it's likely that the induction will not last as long and is likely less painful. If epidural is something you had considered anyway, then you have the option to get an early epidural, before contractions become too painful.  Other options include certain intravenous medications. Discuss with your provider what your options are to decrease the pain effectively.

- Dr. Amos Grünebaum, MD

First, hope you're going somewhere fun!  There are a few factors to consider when making this decision:

• Age of baby & risk of infection - a baby almost 2 months old is over the hump for the most significant risk of newborn infections, but not entirely. However, keeping your hands washed and keeping the airplane ride as sanitary as possible (move away from the grumpy lady hacking up a lung next to you) would be smart if you do travel by airplane. On an infection risk front - I'd vote: CAR. 
• Passengers & comfort - airplanes can be a nightmare if your baby cries - and he/she will!  Change in air pressure creating discomfort for baby ears (pacifiers or bottles help) as well as noise factors may produce more crying than normal. There are online buzzes about baby-free zones on airplanes giving you a clue as to some of the public sentiment towards the crying baby on the airplane.  On a Passengers & Comfort front, I'd vote CAR.
• Expense - cars are less expensive than airplanes!  I'd vote CAR.

1. Music
2. Frequent "stretch & walk" stops
3. Talk to your baby
4. If possible, have a friend/parent in the back seat to tickle & coo.
5. Feed about 30 minutes prior to the start of the trip, not just before & try to coincide rests with feeds. 
6. Also think about naps - if there is a time your baby zonks out for a long time, take advantage of it.
7. Remember safety:  no cell for momma, car seat back facing and secure for baby!

One point to add - sedating a baby with Benadryl at this age is an absolute NO - could be quite dangerous in fact.

- Dr. Jen Canter

Together you can read the What to Expect book, it goes through each stage of your pregnancy and can be really helpful. But I find that what often works best best is a childbirth class for both of you once you are in your second trimester. 

In they class they will go into great detail on how your body is changing and all of the medical details that should help your husband understand. If you are in NYC we offer at MomPrep the A-Z of Childbirth and Newborn Care. I find that this class is very eye-opening for many dads-to-be, and great for couples to attend together. If you aren't in NYC ask your healthcare provider for classes in your area. Good Luck!

- Rosie Pope

Thank you so much for your kind words. It sounds like you have been through so much, and at such a young age. Stay strong!

- Rosie Pope

It is really important that you can communicate with your Nanny and that she respects your wishes.  If you feel like she is spending too much time housekeeping and not enough time being a Nanny then she needs to listen to your wishes. 

I would first try speaking with her and also keep in mind that if your son really loves being with her she is likely showing him enough attention.  At the end of the day though you have to feel 100 % comfortable with the person taking care of your children and for this you have to trust your instincts.

- Rosie Pope

We control so little of our pregnancies, announcing that we're pregnant is one of the things we do get to control. If you aren't ready yet then don't tell until you are.

- Rosie Pope

I completely understand the anxiety you are experiencing and it is completely normal.  If you are able to make an appointment with your OB at around 8 weeks that should help to ease your mind.  You will then need to go again at 12 weeks but having this extra appointment will allow you to see the baby's heartbeat and check that everything is looking normal for that stage.  All that being said it is still hard to control the anxiety.  Try and keep yourself busy and remember that the fact that you are worrying is the first sign that you are going to be a wonderful mom. 

- Rosie Pope

I wrote a blog that details my approach to introducing solid foods. I hope this will be helpful.

- Rosie Pope

You have a lot of kiddos on your plate! Congratulations. Balancing attention for your twins and your toddler must be very challenging, and it's terrific that you're seeking some advice on the topic!

Although you may have tried several of these strategies already, we thought we'd offer some tips! Here are Dr. Jen's Tips for Dividing Special Time With Lots Of Kiddos!

1. Include your older children in the care & play activities with your younger one as much as possible. If they are part of the process, it will be easier to explain, "Now you can help mommy give Baby some special time! Could you go build her a little Baby building, while I work on her walking & talking?"
2. Ask a trusted family member or friend to spend some special time with your older children - even if it's just doing an art project in the other room! This makes the older children feel special, and you do not have to announce that you'll be using the time to have alone time with Baby.
3. Don't be too hard on yourself - honestly, Baby is not going to know the difference!  She enjoys her older siblings and will benefit from the exposure to language and social interactions. A little special time is great for both of you - - but you're in the thick of it now and give yourself a pat on the back for trying!

- Dr. Jen Canter

Having had a chemical pregnancy does not increase your risk in the next pregnancy, and exercise has never been correlated with inducing an early miscarriage. Exercise during pregnancy is generally healthier than being a couch potato and our professional organizations generally recommend exercise during pregnancy as long as you follow some precautions.  You should make sure to not get overheated and get hydrated enough before, during, and after exercise.   As your pregnancy progresses, you may want to listen more to your body and slow down when it's getting too much.

- Dr. Amos Grünebaum, MD

Hopefully this will help here is a link to the sizing guide from Rosie Pope Maternity. There is a link to a sizing guide on the detail page for each product sold on the site.

- Rosie Pope

I recently wrote a blog post about this very thing: Nanny 101 I hope this helps.

- Rosie Pope

The "right" time to make the transition into a bed will depend on what is going on in your life and your little one's life. It became the "right" time for us because I became pregnant with Wells and wanted to make sure JR was out of the crib long enough that he wouldn't be upset that Wells was sleeping in his crib. 

- Rosie Pope

Over the last decade there has been a major change in screening for certain genetic issues. Some tests are routinely included in the first visit blood tests, others are done based on your history. At your first visit, your doctor will usually get a history and find out whether you belong to a certain ethnic group or have a background that requires certain blood tests.  Around 12 weeks an ultrasound and blood test are usually recommended to check your risk for Down syndrome. The results of those tests will usually let you know if further testing is needed. In addition, if there are further questions you may want to see a genetic counselor who will review your history and recommend additional tests and inform you about your options.

- Dr. Amos Grünebaum, MD

It is really important to start to learn what works best for your child and what techniques they respond to best. Only you will know when the timing is right, as you know your child and your situation best. I can tell you for my oldest the pacifier was his absolute favorite thing in the world. It would hang out of the corner of his mouth as he tried to string together a sentence. At the same time to loving the pacifier he has also responded well in the past to when we made a change we made it completely e.g. the dropping of a nap.  Other children prefer gradual weaning. So with the pacifiers I explained to him that he wouldn't have them anymore because they were for babies teething and he was a big boy now and had his teeth (I know this wasn't completely accurate but it was the only thing I thought he would understand that would make tangible sense and not seem like I was punishing him).

- Rosie Pope

This is a terrific question. First, I am wondering why you want to wean your son from the pacifier at 19 months if he is only using it during sleep and periodically in the car? If he’s only using it to FALL asleep and during car trips, there is really no rush and he may wean himself in the next few months.

I am a super flexible rational pediatrician/mom, and believe that there are simply some things that MAKE LIFE EASIER and are not harmful to kids. There is a whole lot of controversy about pacifiers for young infants learning to nurse – let’s stay away from that for now.

For a 19 month old developing appropriately, it’s perfectly OK to use a pacifier to fall asleep. However, if you do want to WEAN, I have two words for you… The first word is COLD. The second word is TURKEY. COLD TURKEY!

It may be tough at first, but based on my professional and “mom” experience with pacifiers, it works best. One of our sons was attached to his pacifier beyond the age of two (when, I believe, you should really start the weaning process). We had an airplane trip scheduled when he was two years and three months old. I told him there were no pacifiers on airplanes. I took it away. He didn’t cry. It was over and he never asked for it again. (Probably not the smartest idea since there were a bunch of pacifier faced kids on the same plane, but it didn’t seem to bother him!).

- Dr. Jen Canter

There are lots of quick ideas you can make ahead for lunch that are still nutritious for you while you are preggers. Make sure you have some protein, whole grains, dairy and some fruit. Also you can sprinkle milled Flax seeds on your lunch for some extra Omega 3's.  Here are some of my fav entrees for a quick lunch:

• I love making wraps with chicken and cheese, fresh veggies. Use whole grain tortilla for your wrap for extra nutritional content
• Hummus with a wholegrain pita, with fresh veggies, cheese and some fruit
• Whole wheat bread with almond or cashew butter and some fresh strawberries for a super quick sandwich 
• Egg salad on whole wheat bread or on a bed of spinach is super yummy and easy to make ahead.
• Pasta salads are wonderful and you can get a lot of variety with them you can make them Mediterranean, Italian, Asian, Mexican just by changing up the ingredients 
• Grain based salads, try some new grains like Quinoa (really high protein grain) or bulgur wheat, or brown rice salad add cheese, tomatoes, spinach and a light vinaigrette, and some chickpeas or black beans for protein.

I hope these help you along the way. Good luck!

- Rosie Pope

I'm a big fan of What to Expect when You're expecting. 

- Rosie Pope

I am so sorry about your loss. My heart goes out to you. Timing is best discussed first with your healthcare provider to find out what their recommendation is. Then you and your husband need to discuss what is right for you emotionally. I found that communication with my husband was so critical in such a difficult time.

- Rosie Pope

You should discuss this with your healthcare provider, but typically "hot yoga" is not recommended while you are pregnant.

- Andrea Orbeck

One thing babies and teenagers have in common: PIMPLES!  Why?  HORMONES! It sounds like your baby has one of the multitude of rashes that have many things in common:

1. They are benign (harmless).
2. They are transient (temporary).
3. There is nothing we can do about them!
4. They do not hurt your baby!
5. They all have confusing names!
6. They make for a good baby book photo J
7. You should still show these rashes to your doctor 

- Dr. Jen Canter

First of all I am so sorry that you are going through this.  Second of all, one of the most frustrating things people can tell you is to "just relax" when you are trying to get pregnant even if they are trying to be helpful.   Your doctor is right and this is totally in the realm of normal.  My advice would be to set a date when you decide that if you are not pregnant by that point you'll seek extra testing.  I would suggest 12 months of trying would be a good date to ask for more testing, but if you want to go sooner, do what feels right for you.  This should allow you to relax just a little ever the next 4 months and try and just go for it knowing that if it doesn't work you have a plan.  I will keep all my fingers and toes crossed for you.

- Rosie Pope

What does the word GRIPE mean, anyway?  I looked it up!  Gripe means to complain about something.  Well, if I was a baby with gas with a teeny tiny tummy just learning to work right, I’d certainly complain! 

- Dr. Jen Canter

This is a totally  normal feeling and I don't know a single family that hasn’t felt the same stresses and growing pains.  It is important to remember that grandparents have really good intentions and are so excited to  meet the new bundle of joy.  It is also importnat to remember that your sister is about to become a mom and grandparents have to respect that this is her own new family.  She has to communicate with them and set boundaries about when they can be there and what they can do that would be most helpful.  It is also hard to know what will be helpful or annoying until the baby is here so ask them to be flexible and respect he choices if she changes her mind.  Ultimately grandparents can be an a mazing asset, so help them help you.

- Rosie Pope

 Many people have children into their late 30s and early 40s.  If you are concerned about the potential increase in risks of certain things for both you and the baby I suggest visiting a genetics councilor (your OB-GYN will be able to point you in the right direction), to discuss what the risks are in your particular situation.  You can then make the decision with all the facts and feelings at your fingertips.

- Rosie Pope

There is tremendous variation in potty training for kids in general, and when you have twins (I have two sets!) that variation shows up more apparently. In fact, we experienced the same with each of our sets. It was actually the twin we did NOT expect to potty train first that DID potty train first each time! 

It is completely 100% normal – and in fact your non-trained twin may be seeking more attention by doing it slowly! Both of your children are in a healthy range for potty training, and I wouldn’t give it a bit more thought. Try and refrain from calling attention to the distinction or putting extra emphasis on the “proud” of the potty-trained twin. Good luck!

- Dr. Jen Canter

 I just wrote a blog post that should help answer this for you What to Pack for the Hospital. I hope that helps.

- Rosie Pope

I think it is smart to take time and choose a caregiver that you are comfortable with. I would recommend interviewing a few and once you find someone have them shadow  you for a few hours and see your babies routines and what kind of care you want your baby to receive to make sure it is a good match. The International Nanny Association has great advice on hiring a nanny and other information you may find helpful. 
 
 Here are a few things I would make sure to cover in the interview:

• Ask them about their experience and if you can get a letter of reference from 2 previous employers. 
• Ask if they have any training in early childhood development. 
• Share with them your own philosophy and what is important to your family including religious or cultural beliefs, lifestyle, and beliefs on discipline.
• In the interview give them scenarios involving baby and ask how they would handle those situations. Bring up things like crying, discipline, separation anxiety, and illness. Listen and take notes to their responses.
• Tell them your schedule and your infants schedule and ask if there is anything in their life that would affect them being able to come to work during the times you need them.
• Ask if they are CPR certified and if not are they willing to take a CPR class.
• Do a background check (if you go through an agency make sure the agency does a background check).
• Listen to your own instinct and once you find someone introduce them to your child and pick someone that you and your child feel comfortable around.

Good luck!

- Rosalie Hunt - RN

My oldest is almost three and my youngest is 6 months.  I think it is a great idea to make the transition before your new baby arrives.  Get your toddler excited about the new bed by talking about moving into the big kids bed. Also make the new bed feel safe and cozy like the crib (with protective side rail) and  dress the bed similarly to the crib, if your crib had no blankets or pillows then don't use on the bed. Make this a fun time and try not to stress about it. Don't worry if the transition may take some time but do stick with it once you've decided to do so. Good luck!

- Rosie Pope

You must be one tired momma! Random changes in a child’s sleep pattern are not uncommon, especially in the toddler years.

Dr. Jen's Tips on Early Morning Wakening:

1. Make are the room is dark, and I mean DARK. Your child may be responding to the squeak of light coming through the window. 
2. Check if he’s getting a new tooth. Tooth pain may be the culprit!
3. Using the example of the ever so exhausting behavioral modification “let him cry it out”, instead try “let him play it out”. Sneak in at night and place a safe toy in the crib – one that he can play with on his own. When he wakes up, magic! There is something for him to keep busy with.
4. Alternatively, and a little harder for mom, “let him cry it out”. Go in 10 minutes after you hear him, then 15, then 20. He may fall back asleep, and he may not. But he’ll slowly learn that mom is not jumping into action at the first cry.
5.  If all of this fails, prepare a light milk snack or water bottle for him, and see if he’s simply waking up a bit hungry. I’d try this once or twice and just to see if it does the trick temporarily!
6. Finally, if all else fails, do what I did: wake up with him! It’s brutal at first, but I’ve found an early rise gives a head start on a healthier day for MOM. Take a moment to prepare your own food for the day or catch a bit of exercise while your little one is temporarily occupied in a safe environment. This is especially helpful for moms who work outside the home – perhaps not for moms who are at home full time.

- Dr. Jen Canter

I think that the celebration can be whatever works for you. Let your mother in law do the planning and just enjoy the celebration. My favorite things for a great shower include a fun mocktail, cupcakes, candy and finger food. A great activity is to have newborn diapers and sharpies so people can write notes and words of encouragement to the parents. Will make those 2am diaper changes a lot more fun. Whatever shape the day takes enjoy it!

- Rosie Pope

I think it's best to have someone else do the painting for you.  There are also several different kinds of paints on the market each with different levels of risk. Latex paint (can be cleaned with soap and water) is considered safe to be around while you are pregnant, though you may not enjoy the smell.  Even with latex paint there are several types that have less bad smells and either low or no VOC's (check with your paint store for "green" paints). Oil based paints would require you to be out of the house during and after the painting until the fumes have cleared (several days) and are strongly discouraged.

- Rosie Pope

Great question! I ofent get this question in childbirth classes. I recommend packing 2 bags. One bag for labor and one bag for postpartum. You can bring the labor bag with you when you go and do not have to bring the postpartum bag to the hospital until after you deliver. The hospital will have necessary items for you and the baby such as diapers, gowns and blankets so these are all just extras that will make your stay more comfortable. You can always ask your doctor or midwife what they recommend as well. Feel free to add whatever you think will make you feel more at home. Hope this helps.

Labor bag –

• Your own pillow - hospital pillows are not usually that comfortable and they may only have 1 per room).
• Flip flops (they give you hospital non-slip socks but if you want to walk around in labor or get in the shower you may find flip flop sandals more comfortable.
• Camera and camera battery charger - make sure your camera is packed or pack a disposable one so you don’t miss out on taking those first pictures.
• Pen and paper - for writing down times things happen – for example the time your water broke so you can look back after and remember how your labor went.
• Baby book - if you have one with a footprint section you can bring that and ask the nurse to stamp the newborn footprints on that page.
• Clear liquid that you like - usually in labor until you deliver many doctors recommend you only consume clear liquids so if you have a favorite sport drink, fruit juice, popsicle, bring it and make sure it is labeled when you put it in the labor and delivery kitchenette. Ask your provider about this one because some are stricter and only allow water or ice chips while in labor.
• Music – IPod or walkman, you can bring speakers that preferably are battery charged because some hospitals do not like you using their outlets as well as earphones. Music helps to relax you and set the mood.
• Phone charger - and a plan of how you will let family and friends know once your little one is born. For example I have seen couples send out a text at first just letting everyone know mom and baby are doing well and then you can make follow up calls later after you have spent some time with baby.
• Eye mask and earplugs - similarly to when you’re traveling your sleep in the hospital may be disturbed especially while you are in labor by sounds and light. These may help you take a much needed nap.
• Toiletry bag - hospitals have toothbrush and toothpaste but it may be nice for you to have your own toiletries to freshen up.
• Tools for childbirth - anything else you plan on using for comfort in labor such as a birth ball, hot or cold pack, massage tool, lotion, lip gloss. 
• I have also seen some parents get a local newspaper the day the baby is born which is a nice memento for you and your child to look back on and see what was going on in the world the day they were born. 

Postpartum/newborn bag

• Robe & slippers  - many times moms are having visitors and also walking around the halls back and forth from the nursery so having your own robe may help you feel more comfortable.
• Comfortable outfit to go home in  - remember it takes time for the uterus to shrink back down so you may feel afterward like your 5 months pregnant so comfort is key.
• Outfit for baby to go home in.
• Breastfeeding bra and breastfeeding pillow  - can be helpful and more comfortable for you.
• Car seat - most hospitals require you take baby home in a car seat so this doesn’t need to come until the day you are discharged home.

- Rosalie Hunt - RN

Making nutritious baby food can be a wonderful process and as your child gets older making food with them can be a lot of fun. I just published some great information about this on my blog. Please look through my guidelines there and I inlcudes a great book and some online resources to help you with this process. Good luck!

- Rosie Pope

If you want the best of the best, the Mandarin Oriental offers a fabulous pre-natal massage but it is very pricey!

- Rosie Pope

Congratulations on your awareness for fitness during your pregnancy! It’s a challenge when it’s hot because you are likely to be experiencing a warmer internal body temperature as it is and being in too warm of tempurature can be miserable and dangerous for y

• Goodbye to Abs?
• Tighten Your Tush & Sculpt Your Arms
• Big Belly Doesn't Mean Bad Back

- Andrea Orbeck

It is a huge decision but 3 quick points.

1. It’s good to find a nanny that has previously been with a family for many years and is leaving because children are too old as oppose to another reason.
2. A nanny has a big hand in raising your children so you should feel as though they are a member of your family.
3. Always do a background check. Good luck!

- Rosie Pope

How about a piece of jewelry with a blue or pink stone? Women love jewelry and the stone color is a nice tie in with the upcoming arrival. Depending on his budget, you can get a variety of pieces from earrings to rings.

- Rosie Pope

I would suggest getting a personalized necklace with her baby’s initials on it. Check out Jenny Present.

- Rosie Pope

I think this is a very personal decision and starting a family is all about starting your own traditions and not following everybody else’s. So do whatever feels right and don’t be afraid to consider using both names.

- Rosie Pope

The important thing is to conceal them. Either run them through a hole in the wall, or conceal in a bureau or cupboard. But remember, it is important to educate your children about what is dangerous, such as wires.

- Rosie Pope

The costs can vary widely and on average are about $10,000-$11,000 per yer. But  those costs will depend on your childbirth (c-section, or vaginal birth), how you feed your child (breast or formula), whether or not you will have childcare costs, cloth or disposable diapers. For instance if you are stay at home and are nursing washing your own diapers, the costs would be far less  than a full time nanhy, feeding forumla and using disposable diapers. I have put together a list of online resources that may help you determine a good range.

Online resources:

• BabyCenter calculator
• Investopedia budgeting for a new baby
• Modern Mom average cost of a newborn
• ABC news story on cost of having a child

Good luck!

- Rosie Pope

Unfortunately the sofa/day bed was a custom piece of furniture designed by me and made in my studio.

- James Stanley

Cabs are considered public transportation so you are not legally required to have a car seat. However, you will feel safer if you bring one and just deal with all the schlepping. It is more than worth it! Also, NYC is a great walking (stroller) city and the subways are fabulous, so maybe try a different form of transportation. If you try the subways look for the icons on the map that indicate elevators. Really handy when planning your routes around the city.

- Rosie Pope

Two points on this, the first being you should generally avoid foods colored red in the first year as they tend to cause more allergies. Second, after the first year your child should be consuming a diet rich in many colors, a rainbow if you will, and by that I don’t mean jelly beans, I mean a plate of green, red, and yellow veggies.

- Rosie Pope

Rosie Pope Maternity. Many of the clothes in my line work for both pregnancy and beyond.

- Rosie Pope

It’s hard to know what will work for you and what won’t work until you have the baby but now that you are becoming parents you have to do what is right for your family (meaning you, your partner, and baby) and set the boundaries for the rest of the family. 

I believe your partner should handle his family and you yours. You should explain to them that if they want to be there when the baby is born that you will have certain times that are just for your family (you, your husband and the baby). Help them understand that this is a critical time of adjustment for your new family. That way you are allowing them into the baby’s life while still setting the ground rules.

- Rosie Pope

I am so sorry to hear about your problems. With these issues, the best person who can help you manage the pregnancy is a maternal-fetal medicine (MFM) specialist, a high risk pregnancy doctor. You can call hospitals and find out who their MFMs are or you can go to their website and find a high risk obstetrician MFM. Here is Cornell's MFM website. 

- Dr. Amos Grünebaum, MD

It is not recommended to keep a crib bumper/border  inside the crib with the baby as it may cause serious injury or death. 

Many health organizations and Sudden Infant Death Syndrome (SIDS)  groups recommend that parents skip the crib bumper, as these products may actually put children at greater risk for suffocation or SIDS.  The organizations that recommend this include:

• American Academy of Pediatrics,
• Consumer Product Safety Commission
• First Candle/National SIDS Alliance
• National Institute of Child Health & Human Development

So I would recommend not using the border/bumper in your child's crib.

- Rosie Pope

For information about private concierge services please contact momprep@rosiepope.com

- Rosie Pope

Our fall line will have more sizes! Stay tuned.

- Rosie Pope

The situation is different for every woman. Speak with your Physician as they know your specifics and can provide the best advice.

- Rosie Pope

Thank you for your question.  I designed the couch myself and built it in my shop. Most apartments in NYC are smaller spaces and need smaller furniture.

- James Stanley

With the right communication in a marriage having children only makes things better. There are of course going to be difficult times but as long as you keep up the communication you will be able to experience a life so full of love and happiness you will wonder why you ever thought about not having children.

- Rosie Pope

You are definitely not alone in your fear of needles. I see many mothers who are nervous about blood draws and IVs. It sounds like you are trying to conceive and you are aware that during pregnancy there is some blood work your doctor or midwife will need to take. There are a few things you can do that I have seen help mothers who feel the same way you do:

- Let your doctor or midwife, or person taking the blood work or starting the IV know about your fear of needles. This way they can explain the process and hopefully ease some fears for you. 

- Have a support person with you.  Ask someone (your partner or a friend) to come with you if you have to get blood work taken and talk to you during the procedure. Ask them to tell you a funny story or a good memory you share. The more descriptive the better. This person will not only give you moral support but the story will distract you so you do not think so much about the blood work while you are getting it drawn.

- Use relaxation techniques.  Things like slow deep breathing, listening to relaxing music on your ipod, or visualizing something in your minds eye that makes you happy can also be very helpful. Practice a few relaxation techniques at home before you go to get blood work taken.

- Stay well hydrated.  The more hydrated you are the easier it is for the provider to draw blood work or start an IV. So before you go to your appointment drink lots of water!

If these things do not help you then I would encourage you to talk to your doctor or midwife about other therapies that you could use. Best of luck to you!
 

- Rosalie Hunt - RN

Schedule is everything. You sound like an amazing woman for handling so much. You just have to remember that after august the writing will be done. I would sit down and really figure out a schedule that allows you to do everything that you need to do in a day. It will also help you figure out what things are not necessary during this crazy time crunch. I imagine the best time to work is going to be early morning or late evening when your children are asleep. Stay laser focused and remember that august will come and go and you can look back and be very proud that you managed to get this all done. Good luck!

- Rosie Pope

We hope to expand our online product offerings in 2012.

- Rosie Pope

Because this choice is related to your religious beliefs, you have to get comfortable with how much preparation you are willing to do. I have had clients that have asked a friend to order and hold the supplies, or give them a list of things to pick-up once you go into labor. I’ve had others who have registered online and then arranged for overnight shipping once they’ve gone into labor. And take solace in the fact that everything you need for the first few days of your baby’s life will be provided by the hospital. All they really need is love and you’re going to provide loads of it.

- Rosie Pope

Although you addressed this question to me, I thought you'd appreciate a response from MomPrep Expert and Nursery Design Aficionado James Stanley:

In a lot of NYC apartments, people convert their dining area or a section of their living room into a small second bedroom or home office, etc. You could carry out such a conversion by putting up a wall that divides the space and adding a door to create a baby nursery. It sounds much more complicated than it really is. Look at your current space and have a carpenter build a wall with a door.

-James

- Rosie Pope

We don't have a MommyIQ test specifically for your situation. We do offer several online. We also have new curriculum being developed on our YouTube channel.

- Rosie Pope

I am so sorry to hear about your child.

There are many different heart conditions, and some are more severe than others. Many congenital heart conditions are more difficult to detect prior to birth than others. In addition, it's important to identify exactly which condition that baby had because the risk of it happening again depends on what congenital heart disease it is.

After having had a child with a heart condition, you would be considered high risk in the next pregnancy and should have preconception counseling as well as a more intensive work-up during pregnancy. That would include an early ultrasound around 12 weeks of the pregnancy and an anatomic ultrasound around 20 weeks as well as a fetal echo around 20-22 weeks. Because you are high risk, it's recommended you see a maternal-fetal medicine specialist (a high risk pregnancy doctor) before getting pregnant to get counseled and develop a plan for the next pregnancy.

 

- Dr. Amos Grünebaum, MD

First and foremost, I’d suggest seeing your pediatrician to assure your little guy doesn’t have an ear effusion (fluid) making him feel physically uncomfortable with the motion of being placed on the table. That may be a simple reason he’s all of a sudden acting this way.  As a 19 month old, you also may be facing an independent little one who just doesn’t like the feeling of being constrained.  My answer would be to see your pediatrician first, and thereafter adapt your changing to the floor on a mat – some battles are not worth fighting.  This battle may also become dangerous, if your little guy really resists you it may create a setting where he can fall.
 

- Dr. Jen Canter

That’s exactly it!  Make it baby V’s own space with paint, decals, names, etc.  Use your wall space to mount things. Remember babies like color, it stimulates the brain.

- James Stanley

I did the pink and purples in the room for the show and the girls loved it. But I also like a deep chocolate brown, reverse maybe and do pastel pink and one accent wall in the chocolate, with hot pink trim.

- James Stanley

This is one of my favorite questions to answer.  Getting a toddler to stay in bed is not easy.  Your son knows that vomiting makes you upset, and is basically an extension of crying.  You had elements in your question that answered it for you – consistency and “crying it out” are a good start.  I have a prescription for toddler sleep that I’ll share – try this and let us know how it goes!

 Dr. Jen’s Tips For Toddler Sleep:

 1. Pick a good day to start. This may be a challenging experience! Make sure to choose a day where you have the best chance at some rest the following day.

2. Explain What’s Going To Happen. Before the bedtime routine (we’ll get to that), make a point to sit down with your little one and say something like this: “Mommy (and Daddy) have our room and our bed, and you have your room and your bed. We love you and love being with you. But, we all need a good night of sleep in our own room- Mommy (and Daddy) in our room, and you in YOUR room. “

3. Pick a consistent bedtime. Try your best to pick a sensible bedtime- taking in account your family’s schedule and your child’s age. For example, choosing a 7pm bedtime (and missing seeing a working parent) vs. an 8pm bedtime (and saying goodnight) is not necessary. Do what works- but do it regularly.

4. Choose a routine with your child. Every family has their own unique night-time wind down. For our children, it was baths, a bit of horsing around (tickling, silly chasing, rolling on the floor) followed by more quiet play/reading and- always- snuggles. Let your child guide you into what he/she loves- and use those cues to design a routine that’s best! Try and do your routine in a room outside of the child’s bedroom.

5. Put you child to bed: AWAKE. This is a key point in sleep training. Keep time in the bedroom to a minimum. Tell your child, “We’re going to bed now! Mommy in my bed, and you in your bed! I love you. We’re done with snuggles & tuck-ins now and I’ll see you tomorrow!” A kiss, a hug, a tuck in and then- LEAVE. Use a small nightlight if this comforts you child.

6. Don’t give in! It is incredibly hard when you are totally exhausted, isn’t it? Commit to consistency. If/when you child comes into your room, WITHOUT TALKING, either guide him/her back to the room, or carry him/her back into bed.

7. Keep it going. If your child comes back again (now this is the hard part!) keep it up. Again, WITHOUT TALKING, either guide him/her back to the room, or carry him/her back into bed. No talking, no kisses, no snuggles. It’s not easy! But this is the key- our 7th tip is the lucky one! If you can do this you are golden!

8. Praise your child. No matter how brutal the night was for you, praise your child by saying something like, “I am proud of you for trying to sleep in your own bed and we’re going to do this together again tonight”. Have a special treat, do a fun dance or art project, and celebrate his/her accomplishment together!

9. Expect Crying! This is one of those “this too shall pass” phases in parenting- expect a crying as your child becomes more comfortable with self-soothing. Each day will get better.

10. Give Yourself A Break. We’ve all been there- we’ve all done that! Pat yourself on the back.

- Dr. Jen Canter

This is a wonderful question and reflects your concern for your little one’s safety and comfort.  The simple answer is:  once your baby is busting out of the swaddle, it is time to stop swaddling!  In fact, once your baby rolls over, swaddle time is over!  So, it sounds like your baby solved the problem for you – 6 months old is a completely appropriate time to stop swaddling.  However, keep in mind that loose blankets or other soft toys/bedding remain an unsafe sleep situation for a child this age.

- Dr. Jen Canter

Start with your space and with how you will be using the room. Will it only be a nursery or will it double as a guest room? Also if you love a sailing theme think about what it is you like and think of other ways you can bring that into the space with curtains, pillows or a rug. You can bring a lot into a room just with paint or even a decal or a piece of art on a wall as a focal point. Also on my blog about My Favorite Rooms there are a few more ideas. Whatever you do have fun and make sure the room reflects your personal style!

- Rosie Pope

A 7 cm uterus (about 3 inches) is considered normal for a non-pregnant woman, so I am unclear why you were told that yours is too big. Most doctors would likely do a sonogram if they feel the uterus is too big to find out if there is a problem.

- Dr. Amos Grünebaum, MD

This must be a challenging way to become a new daddy!  I applaud you for asking the question and seeking out methods to solve this problem.  First, let’s explore one carefully thought through issue:  Is your husband holding your little one with the proper support to assure his comfort?  This is by no means raised as an issue here to make an assumption that your husband is doing something wrong, just a good idea to check this off the list as a possible reason. On that note, here are some baby holding tips – specifically regarding head control:

1.  Allow the back of the baby’s head to rest inside the inner part of the elbow, with the length of the body resting on the forearm. The outer hip and upper legs should rest gently within your hand. The baby’s inside arm should rest over his chest/abdomen.
2. Another way to hold a young baby is - gently and carefully - having the baby’s tummy facing your upper chest (beneath your shoulder) using the same side hand to hold the baby’s body, and the opposite side hand to support the baby’s head from the back.
3. It feels natural to a baby to be held, snugly, when in the arms of an adult caretaker. Use caution when letting school age siblings hold a baby; have the sibling sit on a chair with and adult in close proximity to make sure the baby remains safe.

Now that safe and comfortable baby holding is out of the way -  Babies do sense certain smells and sensations that may cause them to gravitate towards one caretaker or another.  If you are nursing, perhaps put a little bit of milk on your hubby’s shirt – or take your shirt or another item and let him use that as a burp cloth.  Alternatively, you take the “this too shall pass” approach – and just sit tight and keep trying.  Eventually your little one will “get it” and be able to comfortably snuggle in daddy’s arms just like mommies!

- Dr. Jen Canter

The good news is that most babies with plagiocephaly (the medical word for having a flattened head shape in the back) will have spontaneous resolution (will go away on it’s own). I have  two recommendations for you:

1. Increase your tummy time!  One of the best ways to encourage development of the coordination and muscles that we’ve found are weaker now that babies are put on the back to sleep is to dedicate yourself to a committed period of tummy time each day. 
2. Vary head position while awake.  Of course, when baby is sleeping, back position (not side!) is the safest.  But, when your baby is awake in the car seat, bouncer or stroller if you slightly vary head position this will reduce the constant pressure on the back of the head that leads to plagiocephaly.

Definitely point this out to your doctor to make sure it is a healthy plagiocephaly and there is no additional care needed. Good luck!

- Dr. Jen Canter

Depression is something experienced by many women and it can be effectively treated on different levels.

Because your doctor will want the healthiest course of action for you and your baby, you will likely see many different approaches to your pregnancy including the use of safe prescription drugs to treat your depression.  Here are several options that you and your doctor can use to help you through the depression.

*    Support groups
*    Private psychotherapy
*    Medication
*    Light therapy
 

- Dr. Amos Grünebaum, MD

A schedule is a mom’s best friend.  Try as early as possible to get on a feeding, napping, snuggling, playing, & bathing routine.  Make the routine work for both you and baby; and listen to your baby’s cues as the routine develops.  The routine will gradually change over time, of course, but sticking to the same schedule as much as possible will make it easier once sleep training starts.  I’d stress that during the initial feedings when baby is little, your pediatrician would be the best resource to discuss feeding schedule (when to do feeding on demand vs. scheduled feeds).  In general, schedule is best as early as possible, as long as you’re paying attention to your pediatrician’s specific instructions regarding feeding schedules. 
 

- Dr. Jen Canter

Thank you for the question. Even though this was addressed to me, I thought that this question should be responded to by our MomPrep Expert Dr. Amos Grunebaum, MD:

I am sorry to hear about your miscarriage. This happens in over 20% of all pregnancies.

A miscarriage should not deter you from planning your next pregnancy and getting pregnant right away. The chance of this happening again after one miscarriage is not increased compared to women who never miscarried, and it's safe to get pregnant right away.

In fact, a study has now confirmed that women who conceive within six months of their initial miscarriage have the best chance of a healthy pregnancy with the lowest complication rate.

-Dr. Amos Grunebaum
 

- Rosie Pope

I’ve outlined some basic toy and play safety topics for discussion with your child care providers below, so here are Dr. Jen’s Toy & Play Safety Tips for Child Care Providers!

1. Make sure your provider understands how toys are intended to be used, and that instructions are understood.
2. When opening new toys, it is important to discard plastic wrappings. When assembling toys or changing batteries, it is important to secure small parts and batteries in a safe place. Also, tools used such as a screwdriver, may present their own safety hazards.
3. Make sure your provider understands age recommendations for toys and what your expectations are for safe play between different aged siblings. Do you want older children to play with small parts in a designated area of the house? Do you want your provider to double-check after clean up?
4. Explain safety hazards with soft toys and young children. Soft toys (as well as blankets, pillows, and other soft items) are not intended to be in the sleep environment of young babies.
5. If a toy breaks, it may present a new safety hazard. Make sure your expectations are clear — do you want her/him to throw a toy away when it breaks, or show to you to decide about the next step?
6. Toys should be put away safety to avoid unnecessary trips and falls. Toy boxes and toy chests should have a lid that will stay open in any position and ventilation holes.
7. Think about small parts with children ages 3 and younger, or older children who exhibit hand-mouth behaviors. Think about long strings/cords and the risk of strangulation. Explain this to your provider. Don’t have toys with long cords in reach of an infant’s sleep or play space.
8. Broken or un-inflated balloons are a choking hazard. This is one of the most common causes for choking. Discuss this with your provider.
9. Talk about your expectations when you provider buys your child a gift. Do you want to see it first and make sure it is something you feel is safe?
10. If your child has a developmental or physical disability, make sure to explain specific safety issues that may apply.

- Dr. Jen Canter

My husband used to tease me that if medicine didn’t work out for me, I could join the circus and be a professional vomit catcher.  Man, oh man, did I catch a whole lot of vomit with my two sets of twins!  When my babies would regurgitate – it was always projectile vomit to my husband, and it was a spit up to me (beauty is in the eye of the beholder). 

Most babies will spit up after eating, this is because it takes several months for the muscle that keeps food down (the lower esophageal sphincter) to be strong enough to avoid babies spitting up so gracefully after liquid meals (formula or breast milk) - even small volume liquid meals. 

How much is a spit up and how much is a vomit?  How far does a spit up go and how far does it have to go to be projectile?  We don’t have a standard measurement for this – but here are some helpful tips to know when we need to be concerned about vomiting and babies:

Dr. Jen’s Tips on Vomit, Puke, Barf… Those Lovely Words Related To Regurgitation:

1. Vomiting occasionally when it is only milk is usually normal in small babies.  Prepare for it, and I welcome a dual in baby vomit catching any day.  I will win.
2. Some recurrent vomiting may be a sign of reflux, or Gastroesophageal Reflux Disease (GERD).  You should discuss vomiting with your pediatrician if:
    a.   Your baby vomits frequently because he or she may not gain weight properly.
    b.   Your baby cries after vomiting or arches his or her back, because this may mean he is uncomfortable due to stomach acid irritating the esophagus. 
3. Projectile (as in, it shoots out and not down) vomiting (which can be only mild) that is frequent may be a sign of pyloric stenosis – a dangerous, even life-threatening condition if not diagnosed.  You should call your doctor immediately if your baby frequently vomits in a projectile manner.

- Dr. Jen Canter

Have you ever seen someone holding a baby and think “Uh Oh! Please support that baby’s head!".  Do you say something?  Well, I sure do! It's a bit different than hemming and hawing over whether you tell someone she has a run in her stocking! There is definitely an important foundation behind the "support the baby's head" belief.

Newborn babies have large heads in proportion to the rest of their body. This coupled with neck muscles that are not yet strong enough to support the head; means the head must always be supported.
 

So, how does one properly hold a baby?

• Allow the back of the baby’s head to rest inside the inner part of the elbow, with the length of the body resting on the forearm. The outer hip and upper legs should rest gently within your hand. The baby’s inside arm should rest over his chest/abdomen.
• Another way to hold a young baby is - gently and carefully - having the baby’s tummy facing your upper chest (beneath your shoulder) using the same side hand to hold the baby’s body, and the opposite side hand to support the baby’s head from the back.
• It feels natural to a baby to be held, snugly, when in the arms of an adult caretaker. Use caution when letting school age siblings hold a baby; have the sibling sit on a chair with and adult in close proximity to make sure the baby remains safe.
• Speaking of holding a baby and safety, diaper changes are a common time for babies to accidentally fall - because adult caretakers may reach for a diaper and the baby may (surprise!) fall.
  We were all little babies once, enjoy this special time and hold on, the best is yet to come!

- Dr. Jen Canter

No, it’s not a dream.  He’s back!  That little guy who is just delicious and adorable during the day may not be as delicious and adorable when he wakes up at 2:47 am to come into your bed.  We’ve all been there! Here are my tips for getting your toddler BACK TO BED!
 

1. Pick a good day to start. This may be a challenging experience! Make sure to choose a day where you have the best chance at some rest the following day.
2. Explain What’s Going To Happen. Before the bedtime routine (we’ll get to that), make a point to sit down with your little one and say something like this: “Mommy (and Daddy) have our room and our bed, and you have your room and your bed. We love you and love being with you. But, we all need a good night of sleep in our own room- Mommy (and Daddy) in our room and you in YOUR room. “
3. Pick a consistent bedtime. Try your best to pick a sensible bedtime- taking in account your family’s schedule and your child’s age. For example, choosing a 7pm bedtime (and missing seeing a working parent) vs. an 8pm bedtime (and saying goodnight) is not necessary. Do what works- but do it regularly.
4. Choose a routine with your child. Every family has their own unique night-time wind down. For our children, it was baths, a bit of horsing around (tickling, silly chasing, rolling on the floor) followed by more quiet play/reading and- always- snuggles. Let your child guide you into what he/she loves- and use those cues to design a routine that’s best! Try and do your routine in a room outside of the child’s bedroom.
5. Put your child to bed: AWAKE. This is a key point in sleep training. Keep time in the bedroom to a minimum. Tell your child, “We’re going to bed now! Mommy in my bed, and you in your bed! I love you. We’re done with snuggles & tuck-ins now and I’ll see you tomorrow!” A kiss, a hug, a tuck in and then- LEAVE. Use a small nightlight if this comforts you child.
6. Don’t give in! It is incredibly hard when you are totally exhausted, isn’t it? Commit to consistency. If/when you child comes into your room, WITHOUT TALKING, either guide him/her back to the room, or carry him/her back into bed.
7. Keep it going. If your child comes back again (now this is the hard part!) keep it up. Again, WITHOUT TALKING, either guide him/her back to the room, or carry him/her back into bed. No talking, no kisses, no snuggles. It’s not easy! But this is the key- our 7th tip is the lucky one! If you can do this you are golden!
8. Praise your child. No matter how brutal the night was for you, praise your child by saying something like, “I am proud of you for trying to sleep in your own bed and we’re going to do this together again tonight”. Have a special treat, do a fun dance or art project, and celebrate his/her accomplishment together!
9. Expect Crying! This is one of those “this too shall pass” phases in parenting- expect a crying as your child becomes more comfortable with self-soothing. Each day will get better.
10. Give Yourself A Break. We’ve all been there- we’ve all done that! Pat yourself on the back.

- Dr. Jen Canter

I have a vivid memory of my mother-in-law’s (formerly sparkling) California kitchen floor spattered over RIDICULOUSLY with sweet potatoes, chicken bits and cereal from our then one year old twin girls. We were vacationing (if you can call it that…) and their routine was disrupted.  Like New York bagels, my daughters knew the difference – the food was called the same, and looked pretty much the same, but the texture and taste were different to them.  Toddlers are to FOOD are like (I imagine/dread) Teenagers are to MOOD.
 
My OH PLEASE Picky Toddler Eating Tips!

ONE FOOD AT A TIME is OK:  Just like a new pair of shoes, toddlers need time to become acquainted and comfortable with new foods. Some toddlers, actually, like to EAT only one food at a time!  It is OK to begin a meal with fruit, and end it with veggies.  The average toddler needs about 1000 calories a day, a good way to judge this is 40 calories per INCH of height.

HOO cares what time it is:  Have breakfast for dinner, dinner for breakfast.   Again, do what works for you and your toddler.  Broken up pancakes, eggs and fruit for dinner and chicken bits for breakfast all end up in the same place!

PACK A NUTIRTIONAL PUNCH:  Make your choices count.  Try and include COLORFUL fruits and veggies, whole grain carbohydrates (brown rice, whole wheat bread) and lean protein (chicken breast, lower fat meat) within the balance of the day.

LIGHTEN UP – Toddlers are SUPPOSED TO BE PICKY!  It is part of the territory.  Don’t beat yourself up if he or she isn’t drooling over the sweet potatoes you remembered to bake, or that chicken you specifically went to the market for a cut into tiny bites.

EAT together – This is a tip that worked well in our house when our twins were toddlers. They ate what we ate!  Rather, we ate what they ate!  If I roasted a chicken, I included carrots and sweet potatoes in the pan and cut it up for our kids.  Hamburgers and avocadoes cut up for the little ones were put onto a bun and jazzed up for us.

ALL together – Include your little on in meal preparation early on.  By the end of a long day, making apple slice flowers and smiley face potatoes may be the last thing the busy parent can do – but try and make it FUN!  Talk while you are cooking; explain what’s on the plate. Use meal time as a time to work on language and social development.

SIZE & SHAPE – My number one feeding tip is:  Make sure you are feeding your toddler food that is appropriate in size, shape and texture.  This means avoiding foods that may be swallowed whole (no whole grapes, raw carrots, nuts, raw celery, hot dogs) and assuring that any foods on your toddler’s plate are small, soft, and easy to chew.

Enjoy – Creating a meal time that is a fun and loving part of the day, early on, is going to start you off on a good path.  Smile when your child spits sweet potatoes across the room onto your new shirt.  It’s going to pass soon (and you’ll miss it!).

- Dr. Jen Canter

No Grief Baby Teeth – Dr. Jen’s TOOTH advice.

Ahhhh!  Baby is finally sleeping through the night and, just maybe, you are too?  Chime in loud organ music here, please.  YOU ARE ABOUT TO ENTER THE TEETHING ZONE.  We’ve all been there!  And we’ve all gotten through it, but those periods where you little one is uncomfortable can be made BETTER if you understand Dr. Jen’s TOOTHY advice:

Timing:  Baby teeth traditionally start coming in between 6 months to one year of age, give or take a few months.

Order:  Babies usually have a first tooth eruption in the bottom center, the rest follow and usually come in pairs (two lower, two upper).  Babies usually have a full set of pearly whites by the age of two and a half.

Ouchy:  As new teeth erupt, there is minor inflammation of the gum tissue causing pain and even a low-grade fever (less than 101°F).  This discomfort may be alleviated by letting your baby gnaw on something cold and/or texture.  Your baby may chew (gnaw is more like it!) on objects such as a pacifier, mom’s nursing nipples (yes, ouch, personal experience!), or even the side of the crib rail if you baby pulls to stand!  If the pain is making your baby wake at night an appropriate dose of acetaminophen may do the trick.

Trickle:  Drooling may be increased during periods of teething and can irritate the skin.  Use some gentle soothing cream intended for babies’ skin during this time to serve as a barrier.

Hachoo:  Poor Mr. Teething.  He gets blamed for everything.  Baby cranky, must be Mr. Teething.  Baby isn’t sleeping well, has diarrhea, has reflux, has a rash…must be Mr. Teething again!  Although teething may indeed cause low-grade temperature and discomfort, make sure to run any new or unusual symptom by your pediatrician!

You’ll All Get through It:  Like all stages in the magical world of babies, the good news is we’ve all gotten through it!
 

- Dr. Jen Canter

1. Cleanliness Is Next To Godliness  When handling breast milk, make sure you are working in a clean area and wash your hands (well).  Also make sure that you are using clean containers/bags for expressed milk storage.  If you’re storing your milk in re-usable nursing storage bottles, pick one of these options: use a microwave steam sterilizer, wash with hot soapy water, or run them through the dishwasher. 
2. Forget About Those Ice Cube Trays  Use hard plastic bottles specifically designed for storing breast milk, with a screw cap or tight fitting lid; or use heavy plastic bags designed for breast-milk storage.  Store milk in amounts that make sense for your baby’s age and the amount he or she may drink in one session.  For example, you may want to store 4 ounces per container for your 2 month-old, but 6 - 8 ounce s per container for your 4 month-old.  
3. Chill Out In the fridge, breast is BEST within 24 hours of refrigerated storage. If you refrigerated your milk more than 72 hours ago, throw it out.
4. Freeze Ease If your freezer is attached to a refrigerator (the kind most of us have in our homes), milk is good there for one month.  If you have a deep freezer (am I dating myself here to say like the kind in Sam’s Butcher Shop on the Brady Bunch?), you can store breast milk up to six months - but it’s best to use it within 3 months.  Make sure to keep milk at the back of the freezer where the temperature is coldest.
5. Quick Thaw McGraw To thaw for frozen milk in advance,  put in the fridge for up to 24 hours.  For immediate usage, you should place frozen milk in a bowl of lukewarm water.  Never (ever!) use a microwave to defrost or heat breast milk or formula, as heating is uneven and may result in scalding your baby’s mouth.  Once milk is frozen and defrosted, do not refreeze it.

- Dr. Jen Canter

 It's is not irresponsible to have a baby at your age. However, at 43 years of age there is a big risk of infertility. Seeing a reproductive endocrinologist (RE) will help you improve your chances getting pregnant and having a healthy baby. Don't delay, because every month counts.

- Dr. Amos Grünebaum, MD

You should always discuss with your healthcare provider  before working out while pregnant as every pregnancy is different, but it is generally understood that if you were working out before your pregnancy you can work out during your pregnancy. There are certain modifications that will need to be made later in your pregnancy but you should discuss this with your healthcare provider.

- Rosie Pope

I want to high 5 every woman who has the battle scars (or sag in this case) of having a little one!

- Andrea Orbeck

I want to high 5 every woman who has the battle scars (or sag in this case) of having a little one!

As you all know, I am a weight training advocate. All moves pilates and core will cinch the abs back in to give you a much tighter corset and being lean enough to see them requires good eating and regular cardio to do all that you can in the girth department.   If you want to see A Great Ab Routine you can look at this one I developed for MomPrep for during pregnancy. You can just ignore the modifications since you are post-baby.

- Andrea Orbeck

It depends on who you are telling. If you are telling your parents it would be cute to buy a #1 granddad and grandma mug on their next visit. If you want to tell a large group all at one time you could  host a dinner party and announce it then so that everyone can celebrate together.

- Rosie Pope

Make sure you talk to your toddler as much as possible about the upcoming arrival and what a wonderful thing this is going to be. Talk to them about the hospital and the first time they will meet the baby and how special this will be. Make sure you have some presents on hand for your toddler so that when your baby is getting lots of attention and presents your toddler can have some too. Maybe even include one from the baby.  Make sure to allocate some one-on-one time with your toddler after the baby comes and know that while it may be a difficult transition at times, you are doing a wonderful thing giving your toddler a little sibling. 

- Rosie Pope

 My favorite postpartum belly wrap on the market today is the organic wrap by Belly Bandit.  It’s a wonderful product, especially when combined with pre- and postnatal pilates, both of which are available at MomPrep.  Nothing like developing a strong core before birth to  make getting back into shape worlds easier!  I’m also quite a fan of  fennel tea to get help with the postpartum water weight.  However, be sure to check with your health care provider before starting an exercise program or adding any herbal teas to your diet.

- Rosie Pope

Before you consider yourself overweight, it's important that you figure out exactly how much you could be overweight. Calculating your BMI or Body mass Index will tell you the range of being overweight or being obese. At this calculator you can enter your height and weight and it will calculate the BMI.

• Underweight (BMI < 18.5 kg/m2); total weight gain range: 28 to 40 pounds
• Normal weight (BMI 18.5 - 24.9 kg/m2); total weight gain range: 25 to 35 pounds
• Overweight (BMI 25.0 - 29.9 kg/m2); total weight gain range: 15 to 25 pounds
• Obese (BMI ? 30.0 kg/m2); total weight gain range: 11 to 20 pounds

Your optimal weight would be a BMI between 18.5 and 24.9, and achieving your optimal weight will improve your chances getting pregnant by improving your hormones. Women who are overweight often don't ovulate (do you ovulate?) and losing weight make you more likely to ovulate and get pregnant. And once you are pregnant a normal BMI will decrease pregnancy complications such as miscarriage, medical problems, premature delivery, and cesarean section.

- Dr. Amos Grünebaum, MD

Unfortunately we do not currently offer our courses as webinars, we hope to do so in 2012. In the mean time I would recommend speaking with your pediatrician for baby sign language programs in your area. It's a wonderful experience to share with your child.

- Rosie Pope

Absolutely. I would recommend ordering in your normal size. I wear many of my designs without any alterations when I'm not preggers, especially the pieces that have spandex, they tend to be more adaptable. Please post pics on our Facebook page of any pieces you wear.

- Rosie Pope

Thank you for the question. Even though this was addressed to me, I thought that this question should be responded to by our MomPrep Expert, Dr. Jen Canter:

The Dr. Jen “pediatrician” answer is to assure safe sleeping (my tips are Alone, Back, Crib) as there are no black & white reasons for same vs. different rooms.  As a parents of two sets of twins, I’m going to share what my husband and I decided to do, so I’m wearing the Dr. Jen “momma” hat here:

 We have same sex twins (two girls and two boys).  I’m first going to give advice for same sex, and then throw in some advice for opposite sex twins.  We kept both sets of our twins together, in the same room, in separate cribs.  We plan on keeping it that way until the older set hits puberty (rescue me please when that happens!) 

 Here are Dr. Jen’s Tips for twin room sharing:

 1. Safety & Ease For Babies – I wanted both sets, when they were young, to be near each other to make it easier for me to nurse and care for them.  I wanted as little baby moving as possible, especially at night. 

2. Bonding – Our girls are best friends, and our boys are best friends.  They want to be together.

3.  Sharing – My belief applies not only for twins, but for siblings close in age.  If your children want (beg, plead) to be separate, and if you have the space, there are other ways to learn these lessons.  But sharing a room is a nice way, too.

4.  Teenage Years - As long as we still have the space, our plan is to move the older set into separate rooms in late middle school or early high school, as long as they want to be separate.  Privacy is important for teenagers, and if you’re able to accommodate I personally believe it’s a good idea.

5.  Individuality – Even though our two sets each share a room, they have the choice to give their own individual styles in their “areas”.  One girl likes pink, one likes turquoise (like her mom).  One girl is perfectly neat (and collects…money….and has her money collection perfectly laid out on her shelf).  My other darling is a bit… messy!  My boys both are totally obsessed with Spiderman, so it’s a Spiderman love festival in there.

6. Opposite Sex Twins – If you have the room, you may choose to separate opposite sex twins earlier than same sex twins for some obvious reasons (“Mom I want a pink room with purple polka dots” may be an indication….) but most certainly by early puberty (10-11). 

-Dr. Jen
 

- Rosie Pope

 Sounds like you have been going through a lot breastfeeding you’re 4 week old. It can be very challenging trying to find a balance of what is best for you, your baby and your family regarding feeding routines. What I usually recommend is exactly what you did to try to pump first and then put your baby to breast and see if that helps slow down the letdown.  It sounds like that did not work for you and your baby is lactose intolerant so formula feeding has also been challenging. 

If it has only been a few days and you are feeling regret what you could try is pumping once or twice a day only. That way your baby gets a combination of some breast milk and some formula and you still have time to spend with your two year old.  If you do decide to do this I would recommend seeing a lactation consultant to help you.  
Regarding your child’s lactose intolerance I would recommend talking to your pediatrician about switching to soy formula or a formula that is specific for infants with sensitive stomachs. There are many on the market that are very good for infants that have lactose intolerance.

 Lastly mothers with overactive let down can be more likely to experience clogged milk ducts when they stop feeding so be aware and call your doctor or midwife if you notice one breast becoming red, swollen or extremely sore.  I wish you all the best and whatever you decide is best for you and your family.

- Rosalie Hunt - RN

Jogging strollers are not recommended for newborns due to the possible rough ride. However you can take a brisk walk with your newborn by placing the baby in a baby carrier or sling, plus the extra weight of the baby will increase your workout. If you can get some time quick workout while the babe is sleeping use 3lb hand weights and do an arm circuit, it will tone those sexy summer arms and maintain that fat burning heart rate!

- Andrea Orbeck

The first step towards making that a career would be an honest assessment of your skill set – figure out what services you could bring to moms in your area.  For those areas in which you don’t feel confident, begin to seek out experts that can help complete your service offerings.  Wishing you all the very best and I admire your entrepreneurial spirit!

- Rosie Pope

In my opinion, there is no need to potty train at this point. An ideal age is when your child seems interested between ages 2 and 3 before preschool begins. However, many preschools do not insist on children being potty trained. My son is 3 in September and only just learned how. 

- Rosie Pope

Thank you for watching the show!  I thought that your question was best answered by MomPrep Expert Rosalie Hunt, RN. – Thanks Rosie Pope

Circumcision is a decision you and your family can make with your medical care provider/doctor.  Some families in the United States decide they would like their infant son’s circumcised and others choose not to have them circumcised. If you choose to have your son circumcised most often it is done in the hospital after your son is born usually the second day of life by your obstetrician. Some cultures perform the circumcision later, for example in the Jewish culture a bris is done on the 8th day of life by a trained Mohel. Circumcisions can also be done later in a male’s life by a urologist.

Regarding care of your infant’s circumcision, what we tell parents in the hospital is right after a circumcision there is usually a gauze dressing on the tip of the penis that is removed after a few hours by the nurse or doctor.  Once the original gauze is removed and the infants diaper needs to be changed you can clean with baby wipes or a very soft cloth with water as you normally clean wiping from front to back being extra gentle because the area is very sensitive.  Once you have cleaned the area is important to put a small amount (pea size) of A&D ointment or petroleum jelly on the tip of the penis while it is healing to prevent it from drying. Then you can put a clean diaper on as you normally would. Always contact your health care provider/doctor if the infant is not voiding, the penis is bleeding, oozing or if you have any questions or concerns.

Also you mentioned the umbilical cord care. You actually do not need to do anything special to the umbilical cord while you are waiting for it to fall off.  It usually takes 1-2 weeks for the umbilical stump to fall off. The most important thing is to keep the area dry and clean, meaning no diapers over the cord and no baby bathtub baths, ONLY sponge baths until it falls off.  Contact your health care provider/doctor if the area around the cord stump is red or oozing or if you have any concerns.

To see a video demo of how to give a proper sponge bath with the umbilical cord attached for you can watch it in my Infant Care 101 Tutorial.    
 - Thanks Rosalie Hunt, RN

- Rosie Pope

 I really love the book Super Baby Food. It has great instructions and guidelines on what foods to start when as well as quick tips to hel you make your own baby foods while providing a nutritious diet to your wee one.

- Rosie Pope

A fetal kick count, counting the fetal movements, is among the most important observation to ensure the baby's health. Every pregnant woman should learn how to count her fetus' movements.

The fetal kick count is done usually after 24 weeks of the pregnancy to monitor the fetal health. There are numerous ways to count your baby's movements and numerous opinions on how many movements you are looking for within a certain amount of time. The American College of Obstetricians and Gynecologists (ACOG) recommends that you time how long it takes you to feel 10 kicks, flutters, swishes or rolls. Ideally, you want to feel at least 10 movements within 2 hours. Most likely you will feel 10 movements in much less time.

Here is another method to do the Kick Count.

• Count fetal movements once a day, preferably at the same time every day and within 1 to 2 hours after a meal. Early evening after dinner is a good time because the fetus is usually more active then.
• Get a sheet of paper and pen to indicate the movements.
• Have a clock or watch nearby to observe the time passed.
• Lie on your side while counting, preferably on your left side.
• Mark down the start time.
• Count any movement you feel -- a roll, a kick, or a "swish" -- except for the smallest flutters.
• Count until you have felt four fetal movements.
• Mark down the finish time, and the total amount of time it took to count the four movements.

Call your doctor or go to the hospital if there are less fetal movements as described above 

- Dr. Amos Grünebaum, MD

What you are describing is very common for mothers that go back to work.  Many times mothers at work are not able to pump as often as they would be feeding their infant. Since breastfeeding works by supply and demand, the less you stimulate your breasts by pumping or breastfeeding the less milk you produce.

What I would recommend is try to pump more while you are at work. Start by just one extra time while you are at work.  It is unfortunate that some places of work make it a challenge for mothers who are pumping to be able to really take the time they need to pump. Make sure to talk to your work if you are feeling this way. If you need pumping at work resources look under my name on ask the expert and see the question about breastfeeding resources. Best of luck and keep up the good work!

- Rosalie Hunt - RN

 My favorite postpartum belly wrap on the market today is the organic wrap by Belly Bandit.  It’s a wonderful product. 

- Rosie Pope

I am a big fan of the Medela pumps. I would recommend renting before you buy, that way you can return it if you find that particular pump isn't right for you. Ask your Dr. about where to locate in your area. Also check with your insurance company many plans reimburse some of the costs.

- Rosie Pope

Thank you for the question. Even though this was addressed to me, I thought that this question should be responded to by our MomPrep Expert, Dr. Jen Canter:

That’s a great question, and this is one of the more common questions I receive from parents.  It does sound like your little one is giving you cues to start potty training.

 Here are Dr. Jen’s tips on potty training:

 1. There are various theories on potty training and the appropriate age to start based on culture, development and personal parenting style.  My perspective is this:  You’ll know when it’s time!

2. Your kiddo old is telling you something, he’s interested in the potty.  That doesn’t necessarily mean he’s ready for potty training, but it does mean you can practice and get ready.  Him pulling his pants down and letting you know about potty time means he’s feeling the sensation that he has to go, and that’s an indication to give it a try.

3. Where to start?  Purchase a potty seat.  I used the ring that goes right on the toilet, and had a little step stool in front XXXXXX (yes, you can buy the potty and put him on and see what happens).  He also may be modeling YOUR behavior (yes, we all go potty, we know you do, I do, don’t be embarrassed!).   You mentioned he has an older sibling; your 18 month old may also be modeling HIM.   There is no harm in purchasing a potty seat and starting to model training habits.  He may be ready, and he may not be ready and both are fine at his age.

-Dr. Jen
 

- Rosie Pope

It takes some time after pregnancy for a woman’s body to get slowly back to normal, and after a cesarean section it also takes time for the uterine scar to heal. A safe time to get pregnant is usually about 18 months after delivery, and many doctors recommend that you don’t get pregnant for at least 9 months after having had a cesarean section, though in certain circumstances you may want to wait longer. Your doctor is your best source to let you know when to get pregnant, because she knows best about your medical issues and how your cesarean section was done.

- Dr. Amos Grünebaum, MD

 Depending on your budget I would recommend the following:

• For an inexpensive option look for a  re-sale shop for a rocking chair, sometimes you can find beautifyl vintage rockers there
• For a medium budget - Babys-R-Us has a great selection in many different styles to choose from. I particularly like this model  
• If budget is not a concern I love Marimekko fabric covered rockers at one of my favorite stores ducduc

Another great tip if you find a rocker you like but don't like the fabric. Go to fabric.com and find a fabric you love and re-cover it for a personal one-of-a-kind rocker! Have fun.

- Rosie Pope

You can contact us  to find out more about or private services. Just select MomPrep as the contact subject and include your contact information.

- Rosie Pope

It is a really tough time both emotionally and financially. I think each family has to do what works for them and I know not all families can afford the lengthy and costly process, that many times isn't successful.

For another question I received  I assembled a list of possible sources for help with the financial part of the infertility struggle.  I'm going to include them here.

• The Inter National Council on Infertility Information Dissemination (INCIID) has a scholarship program called INCIID the Heart. Anyone can apply—there is no age or income limit. The only requirement is that you have a medical need, a financial need, no insurance coverage for IVF, and a compelling story. For more info visit www.INCIID.org
• EMD Serono has a program, called Fertility Lifelines Compassionate Care. Patients with no coverage can apply to receive one cycle for free, depending on their medical and financial need. Click the link or call Fertility Lifelines at 866-LETS-TRY, and they will send you information
• You should also ask your doctor or nurse if they know of any fertility scholarship programs  in your community. Most of these programs have age and income limits.

Best Regards

- Rosie Pope

Are you set on the two middle names, because if you’re not I would use one of your middle names for Stella and the other for Holly: Stella Julia and Holly Grace.  If not, I like Holy Addison Grace and Stella Julia Grace.  Using Grace twice is a nice way of tying the two names together.

- Rosie Pope

The postpartum period is a balancing act of taking care of your baby’s needs and your own needs. The majority of your time is usually spent taking care of baby and having the occasional girls night, date night, or happy hour is something that is important and necessary for many new mothers. Reconnecting with friends or loved ones can help to refresh and rejuvenate you. If you decide to have a glass of wine or a drink here are the recommendations for breast feeding:

• Do not feed right after you drink since the alcohol does go into breast milk. Instead feed once before you have a drink then your body has time (2-4 hours) to process the alcohol before you feed again.  With one drink and hours to process there is no problem breast feeding normally at the next scheduled feeding.  
•  If you go out and really kick up your heels and have many drinks then it is probably best to “pump and dump” the next scheduled feeding.  By this I mean pump before you go out so baby can get pumped milk for the next scheduled feeding and you can pump the milk after you drink and dump or dispose of that one pumping.

- Rosalie Hunt - RN

  Here is a link to the playmat on Amazon

- Rosie Pope

Tummy time should start early.  Check with your pediatrician at your first newborn visit whether your baby is ready. Once you get the go ahead, be sure to do it every day.  Remember every baby is different some babies last only a few minutes before they get upset and others can last a lot longer.  Do whatever feels right for your baby.  Stay with them and give calming words of encouragement.

- Rosie Pope

I wanted to commend you for asking this question. Many times the topic of Post-Partum Depression gets swept under the rug and it is something that 15%-20% of women after childbirth experience. Post-Partum Depression symptoms include sadness, depression, difficulty bonding with your baby, upsetting thoughts, difficulty sleeping, feeling out of control or like you want to harm yourself or others.  

If you ever feel like you are suicidal or want to harm yourself or others call the suicide prevention hotline listed below and get help immediately.

Post-Partum Depression is different than “Baby Blues” which 80% of women after childbirth experience. Baby Blues are mild mood changes that happen after the birth and last only 2-3 weeks whereas Post-Partum Depression last beyond that. Unlike other medical conditions Post-Partum Depression (also known as a Perinatal Mood Disorder) has no set defined time and untreated can last up to a year or more.  

The good news is that with help Post-Partum Depression is treatable and temporary.  Women that have cesareans are more likely to experience Post-Partum Depression as well as women whose birth did not go as planned or is traumatic. 

It sounds like for you this has been going on for over a year and I encourage you to talk today to your care provider (primary care doctor/obstetrician/midwife) they will help you find a treatment that works for you.  

There are many different treatments including talk therapy, group therapy or support groups, and medication. Find what works for you and stick with it and you will notice a difference.  There are also wonderful resources online and in the community where you can speak with a professional.

Do not keep this to yourself, talk to a professional who can help you.  I wish you all the best in your recovery. Thank you again for being brave enough to bring up this topic so you and other mothers can get the help you deserve. 

Some helpful resources:

• Postpartum Support International   - 1800-944-4PPD
• Cesarean Section Recovery – 
• National Suicide Prevention Hotline – 1800-273-8255

- Rosalie Hunt - RN

I am sorry for your struggles. I will keep positive thoughts for you on this journey. I have assembled a list of possible sources for help:

• The Inter National Council on Infertility Information Dissemination (INCIID) has a scholarship program called INCIID the Heart. Anyone can apply—there is no age or income limit. The only requirement is that you have a medical need, a financial need, no insurance coverage for IVF, and a compelling story. For more info visit www.INCIID.org
• EMD Serono has a program, called Fertility Lifelines Compassionate Care. Patients with no coverage can apply to receive one cycle for free, depending on their medical and financial need. Click the link or call Fertility Lifelines at 866-LETS-TRY, and they will send you information
• You should also ask your doctor or nurse if they know of any fertility scholarship programs  in your community. Most of these programs have age and income limits.

I wish you all the best.

- Rosie Pope

PCOS or Polycystic Ovary Syndrome is a complex medical condition and the #1 cause for women who have problems getting pregnant. The main fertility problem for women with PCOS is the lack of ovulation. Even so there is already the PCOS diagnosis, the first step before starting any treatment is to check your husbands sperm count and your fallopian tubes, to make sure he has good enough sperms and the tubes are open before fertility medications are used.

Women with PCOS are often overweight, and losing weight to an optimal weight (BMI 18.5-24.9) usually improves chances getting pregnant. Any of the usual diet plans including exercise can help you get to your optimal weight.  I recommend that you work with your physician and possibly a nutritionist to come up with a plan that works for you.

There are certain medications like Clomiphene (pills) and Gonadotropins (shots) that can be used to stimulate the ovary to ovulate. Metformin can be taken with fertility medications and helps to make PCOS women ovulate on lower doses of medication. Finally, IVF in-vitro fertilization is often successful getting women with PCOS pregnant.
 

- Dr. Amos Grünebaum, MD

Of course! Baby showers are about celebrating you and your baby so feel free to do whatever makes you happy and don’t worry about anyone else’s opinion.

- Rosie Pope

My heart has been so warmed by well wishes like yours.  It was not easy to share my story but I am so glad I did so and I know it was the right decision.  It brings me great joy to be able to tell you that my husband and I welcomed our second son, Wellington Reade Pope, on February 5, 2011.  Daron, JR, and I could not be filled with more joy.  We feel so blessed to be able to have another baby.Miracles really do happen every day. 

- Rosie Pope

Thank you so much for sharing your story. We are 2 very lucky ladies! I wish you the best with your 2 wee ones.

- Rosie Pope

For some infants getting a bath and diaper change is not a problem and even relaxing and for other babies these activities can be stimulating and upsetting.  It sounds like your son like many other newborns (0-3month olds) does not like feeling exposed and would prefer to be swaddled or held.  Here are some tips for the babies that are unhappy at diaper and bath time:

• Be prepared – Have everything you could possibly need ready before you start. This will make both diapering and bath time as smooth and quick a process as possible. So if baby does not enjoy these activities he does not have to tolerate them very long. 
• Tag team – Have someone help assist you with bath time. Sometimes having an extra set of hands and make the process easier for you and less stressful.
• Find Distractions – Sing a relaxing lullaby or show your infant their favorite rattle or toy to distract them during diaper changes this may be very helpful. 
• Adjust the routine – If you had been giving baths at night try them in the day or vice versa.  Also most infants up to 3 months do not need a bath every day. So maybe just wiping the neck and face with water daily and try bathing 2 times a week followed by a relaxing infant massage. Most infants do not like sponge baths but prefer the infant tubs. 
• Be patient – The more relaxed and calm you are the more it will help baby to relax and be calm as well. Know that infants up to 3 months are still considered newborns and really prefer a womb like environment (warm, swaddled) and being exposed makes them uncomfortable. As time goes on and your child becomes used to these routines and will become more and more comfortable with them. Remember your child’s Pediatrician can also be a great resource. Best of luck.  

- Rosalie Hunt - RN

I would recommend that you find the best fertility specialist in your area and work with them on the right solution for you. I would even recommend getting several opinions.  Since every woman's situation and every woman's body is different these experts are the most capable at helping you with your specific situation. I wish you all the best on this journey.

- Rosie Pope

 There are so many things that  could influence this I  recommend that you speak with your pediatrician.

- Rosie Pope

The costs vary greatly and depend on insurance coverage. Check with specialists in your location as well as with your insurance provider.

For Genetics Doing IVF and detecting genetic issues are two separate procedures.
IFV or in-vitro fertilization is a procedure that helps you get pregnant by mixing the egg with a sperm outside the body, and then inserting the fertilized egg, the embryo, several days later into the uterus. Detecting genetic issues is usually done with certain blood tests or tissue tests. So IVF is a therapy while detecting genetic issues is a diagnostic test.

- Dr. Amos Grünebaum, MD

A large diaper bag, such as my London Shopper Classic or Leisure edition.  Moms with twins often have a hard time finding bags large enough to carry all the swag and London Shopper is perfect.

- Rosie Pope

 I thought that your question should also include a reply by our MomPrep Expert, Andrea Orbeck. I’ve included his response here:

• The treatment for sciatica is not so much in the form of an exercise, but a stretching routine. Sciatica is caused when the nerve is compressed or pinched from all of your butt muscles and causes that burning and radiating pain that bites you in the butt and can even radiate down the leg and in to the feet. The easiest cure is to do a series of stretches that opens up the hips and lengthens the tight muscles off of the nerve! You can then follow a strengthening routine that places even contraction on the muscles surrounding the butt muscles to ease the emphasis on the muscle group. Check out the Spine Health site to learn about quick and easy stretches that will give you some much needed relief!    

- Rosie Pope

The first step towards making that a career would be an honest assessment of your  your skill set – figure out what services you could bring to moms in your area.  For those areas in which you don’t feel confident, begin to seek out experts that can help complete your service offerings.  It sounds as though your expertise lies more in childcare and child development, so perhaps you should consider a career as a parenting concierge rather than one who focuses strictly on maternity.  Wishing you all the very best and I admire your entrepreneurial spirit!

- Rosie Pope

 My favorite postpartum belly wrap on the market today is the organic wrap by Belly Bandit.  It’s a wonderful product, especially when combined with pre- and postnatal pilates, both of which are available at MomPrep.  Nothing like developing a strong core before birth to make getting back into shape worlds easier!  I’m also quite a fan of  fennel tea to get help with the postpartum water weight.  However,  be sure to check with your health care provider before starting an exercise plan or adding any herbal teas to your diet.

- Rosie Pope

 They are made by Chloe – bought them last season, and am hoping they make it through quite a few more!

- Rosie Pope

I have had wonderful luck at Rachel Riley.  Not only is she a fellow Brit, but she has a lovely lovely staff at her store on Madison  Avenue in Manhattan.

- Rosie Pope

 My favorite postpartum belly wrap on the market today is the organic wrap by Belly Bandit.  It’s a wonderful product, especially when combined with pre- and postnatal pilates, both of which are available at MomPrep.  Nothing like developing a strong core before birth to  make getting back into shape worlds easier!  I’m also quite a fan of  fennel tea to get help with the postpartum water weight.  However, be sure to check with your health care provider before adding an exercise plan or any herbal teas to your diet.

- Rosie Pope

Thank you for watching! I actually wear my maternity line (even when I'm not pregnant). The dress  you are speaking of is part of my Rosie Pope Maternity Line. You can see the clothes I wear on the show here: Get Rosie's Look The blue and white dress I think you are referring to is The Hampton Tunic in navy from the fall line (not out yet but stay tuned).

- Rosie Pope

 Thank you so much for the lovely compliment!  I have my hair cut at John Frieda.

- Rosie Pope

For tricky nursing questions like this one, I really love  “What to Expect in Your First Year” by Heidi Murkoff as a reference.  In the meantime, here are a few quick pointers: 

• Try to increase the quantity of food in the last feeding before sleep.
•  If you are planning to give up breast feeding soon, one trick is to supplement his feeding with formula in addition to breast milk to be sure your little guy isn’t waking up because he is hungry.  
• If you feel like he is using feeding on the breast to sooth as opposed to actually being hungry, you might want to offer him a pacifier, though that is a personal choice.  
• If you don’t like the pacifier, try other soothing techniques  before you offer the breast.  You know your baby best so do what works for him – I found that rocking, singing or turning on the mobile worked for my boys.  

Best of luck!

- Rosie Pope

Each family’s experience is different, but I’ve found that running my own business does allow me to make my own schedule to a certain extent.  The trick is really to figure out a schedule that allows you to be with your children and to work, but not at the same time as you will feel like you are not doing either justice.  

For me, that means getting up early to work, , followed by breakfast with my kids and getting ready for the day. Then I work through the middle of day, stopping in time to be with my kids again for dinner, bath and bedtime. Once they’re settled for the night, I pick the work back up and work again until around 1AM.  While this does let me manage to have life and work somewhat balanced, I don’t seem to get much sleep!  I do also have wonderful help: a great nanny and my mother-in-law nearby. 

If work is something that is important to you, you should be able to maintain it with a comprehensive schedule. Above all, you have to be flexible!  And know, even with the best schedule in the world you can’t do everything – when something needs to give, remember that your children and your marriage should come first!

- Rosie Pope

Thank you! I do design my own line, it is available on my website and in our store on 90th and Madison Ave here in NYC, Rosie Pope Maternity. I also design my clothes to transition well from pregancy to post-baby bod. I often wear the clothes on the show. To see/purchase the items I wear each week on Pregnant In Heels you can visit Get Rosie's Look

- Rosie Pope

Firstly, let's be forgiving on ourselves  and remember that sometimes our pregnancy and delivery are less than perfect situations to bounce right back from. You had a larger than average baby, a C-section and a hernia repair!

Start with getting the foundation strength back. Basic core training of the deep core muscles that are safe and progressive. Then progress out to the larger movements that return us back to shape. Start slow, safe and realistic to your time and circumstance.

• Reps of 10-12 and build your way up to 20 over several weeks. Listen to your body while at the same time, don't be afraid to challenge yourself!
• I recommend starting with the circuit of abs, reverse bridges, squats, reverse lunges and biceps and triceps. 2x per week and graduate to 3.
• As for cardio, take baby with you on a good, hearty walk every day in the stroller. If weather is keeping you indoors, get creative at nap time...stairs, jumping jacks and a stationary bike for 20 minutes leaves you lacking for nothing. If you are burning calories, the rest is just geography - gym or home-sweat is sweat and burn is burn!
• With your husband away, rely on the momgroups who have your goals in common. It's supportive, accountable and great to meet on a regular basis to get your butts in gear!
• Plan your meals! Just as baby is on a feeding schedule, you must be on one too! Eat every 3 hours at least and fill your plate with green, rich colors from vegetables and lean and clean protein. Avoid the overly processed refined foods and watch your portions!
  It's the mindless eating that shows up on our butts the most.

- Andrea Orbeck

Thank you! I appreciate the feedback. I have an amazing team.

- Rosie Pope

- Rosie Pope

Each person’s experience with the medication is different, so my first advice would be to ask your health care provider how they think your body will respond.  For me, it wasn’t that the medication itself that made me gain weight, it was that I was a little depressed and turned to food for comfort.  Above all, the most important thing is to do whatever it takes to reduce your stress levels.  So, if chocolate helps, eat it!  If, on the other hand, the idea of gaining weight is causing you undue stress, then make sure to eat healthy (which always makes one feel better physically – a lovely side effect).  Wishing you all the very best of luck. 

- Rosie Pope

With respect to fitness, patience and time are 2 words that take on a whole new meaning after baby is born.

It can be very frustrating when we expect the fat to melt off after delivery and it doesn't!
Here are a couple things to keep in mind: You just got out of your '4th trimester'. This is the 6 months where your new baby routine challenges your energy, your sleep and your hormones.After that comes a very busy baby who greatly influences your schedule, not always booking in time for your traditional workout

My Advice: If you can't find the time, change what the time you do have to look different. 

• Only 30 minutes while the baby is sleeping? The laundry can wait.
• You now have an opportunity to do that circuit of (1 minute each) of step ups, squats, abs, reverse lunges, bicep curls and tricep presses. That's just 6 moves, one minute each for 3 rounds of 18 minutes total, leaving a 2 minute stretch in the same amount of time it took for your friend to drive to the gym and look for parking

- Andrea Orbeck

You would be surprised how much toddlers can understand. Try explaining to her why you are asking her to do (or not do) certain things.  You may need to explain over and over again but eventually, she will probably get it.  It is also important to stick to your guns if certain principles are really important to you.  By refusing to waver on those most important topics,  it will help them to become important to your children too…but pick your battles!  You don’t necessarily want to have a constant blow-out battle over the color of socks that your little one gets to wear on a given day, after all.

- Rosie Pope

 Here is a link to the playmat on Amazon

- Rosie Pope

Nursing on the plane may be slightly difficult, but in my experience it is such a help for both mom and baby:  the swallowing motion helps baby relieve ear pain from pressure changes, and the nursing can keep your jublies from engorging during those looooong travel days.  

If you are worried about modesty,  I would recommend the Udder Cover which we sell at our boutique on Madison Avenue (please call 212.608.2036 to order it directly).  It covers baby and your exposed breast, but has a handy dandy built-in metal rim that allows you to peek in on your little one while they’re eating.  Safe travels!

- Rosie Pope

Thank you for the question. Even though this was addressed to me, I thought that this question should be responded to by our MomPrep Expert, Rosalie Hunt, RN:

It is not a myth in the beginning when establishing milk supply you do want to offer both breasts. Breastfeeding works by supply and demand, so the more you feed the more you produce and establishing production in the beginning is important.

Once breastfeeding is established you can offer one side and you will notice your baby will usually feed until the breast is empty. Once that breast is empty if he/she still seems eager to feed more you can offer the other side. Your baby may also be more hungry periodically during growth spurts. 

If your baby falls asleep after that feeding and does not seem interested you do not need to feed on the other side. Just make sure for the next feeding you offer the side you did not feed from previously.  Keep up the good work! -Rosalie Hunt RN

- Rosie Pope

Just as  adults develop preferences about things that stimulate us, such as our television programs, books, and music, babies can develop strong feelings about one play mat over another.  If you aren’t sure which one will strike your baby’s fancy, take him on a trip to Babies R Us and let him try out a variety of mats to see which one seems to entertain him the most.

You can also keep trying with the mat you currently own before you give up on it entirely.   Sometimes adding a little pillow under the  head helps, and you could also remove some of dangly bits if you feel like over-stimulation is causing his aversion to the mat. 

In terms of specific brands, I know from experience that my first son hated most mats, but adored the Baby Einstein mats.  Tiny Love Classic Developmental Mobile is fantastic.  I also love to play Mozart and do baby massage but make sure to take a course or read a book on it first!  Most importantly, keep talking to your baby, language is a great stimulator. 

- Rosie Pope

Thank you for the question. Even though this was addressed to me, I thought that this question should be responded to by our MomPrep Expert, Rosalie Hunt, RN:

The good news is you are producing enough for your baby to be happy and healthy and grow! Unfortunately the leaking is annoying and even occasional embarrassing.  It is normal and very common for breasts to leak some for at least 6 months when exclusively breastfeeding. Your breasts may continue to leak the whole time you are breastfeeding and for some mothers sometimes even small amounts 3-6 months even after the baby has weaned. Every mother is different and some people leak more than others. Usually the leaking gets less over time.

Common times leaking occurs when :

• You start feeding on one side- the other side leaks
• You hear a baby cry
• You think of your baby
• You have sex/orgasm and release oxytocin
• Your breasts are full and it is time or past time to feed

You commented on how full your breasts were so one thing that could help you is to make sure you are feeding frequently (every 4 hours).  Try to empty your breasts (by feeding or pumping) before they get uncomfortably full, especially at night.  Frequently emptying can also help prevent leaking.

Some advice for what to do when your breasts feel full and you start leaking if you are able to then feed or pump. If you are not able to feed or pump or they do not feel especially full then apply gentle pressure using the palm of your hand directly over the nipple area. That gentle pressure may help the leaking stop.

You mentioned that you do not like wearing pads but perhaps shopping around to find the right pads may help. Many women like the absorbent disposable pads like "pigeon" breast pads. Others like the silicone type like "lilypadz". The silicone pads do not absorb but they work by applying gentle pressure to the nipple to help prevent leaking. Some mothers prefer cloth reusable pads and I have even heard of mothers cutting maxi-pads and inserting those in the bra because they wicked the moisture away.

So although you can not stop the leaking because it is an involuntary "Milk Ejection Reflex" you can be prepared for it. Wishing you the best.  -Rosalie Hunt RN

- Rosie Pope

I am sorry you are having such a hard time.  There are many reasons why a baby would have intense crying attacks that aren’t soothed by feeding, burping, changing or other.  I would recommend that you make an appointment with your pediatrician and tell him or her exactly what is going on  so that he or she can help you figure out the best way to approach this challenge.

- Rosie Pope

For a wonderful memento that the girls can keep forever, I would suggest a children’s  Bible engraved with the baby’s name and date of the baptism.   For their mom, I would recommend the Rosie Pope Maternity Classic London Shopper diaper bag – it has plenty of room for multiple babes!

- Rosie Pope

What a fantastic event!  For a truly wow piece, I would recommend our Oscar Dress which can be done in a variety of chic colors.  Our Fall 201 line (coming out soon) also has several fabulous options, including our Angelina and Catherine Gowns.

- Rosie Pope

Even though eight months can feel like an eternity when you’re trying so hard for a baby, keep in mind that it can take  many couples with no fertility issues up to a year to get pregnant.  Some food for thought:

• Have you tried ovulation sticks?  You can buy them from your local pharmacy, and they are hugely helpful in tracking your cycle.  Knowing when you ovulate can take a bit of the guesswork out of trying to conceive.
• Have you talked to your gynecologist?  They should have some great advice about how to increase your odds of conception each month.  

If you find that you are still having troubles, despite actively trying for 12 months, you should definitely make an appointment with your health care provider.

My fingers and toes are crossed for you -  please let me know how it goes!

- Rosie Pope

I was partial to the Medela breast pump,  and also like the bottles that come with it.  For other bottle brands, I’ve found that Dr. Brown’s is great for simulating natural flow.  However, each baby is different so you may have to try several different brands before you find one that works perfectly for your little one.

- Rosie Pope

Thank you so much for your kind message!  When I was pregnant, I found myself relying on the “What to Expect” series.  They have oodles of information on everything you can imagine, and were so reassuring when I was desperate for information.  Remember to be kind to yourself through this process. It can be a hard road at times when our body doesn't respond like we expect it to.

I thought that your question should also include a reply by our MomPrep Expert, Dr. Amos Grunebaum. I’ve included his response here:

It's generally recommended to see a specialist after 12 months of trying, and after 6 months if you are over 35.

Ask yourself these questions:

• Do you have irregular cycles?
• Do you make love more than 2-3 times a week?
• Do you have any medical problems?
• Does he have any medical problems?

If you answered "yes" to any of these qustions, then you should see a specialist and get tested right away. - Dr. Amos Grunebaum

- Rosie Pope

The great name hunt is such an all-consuming one for so many of my clients!  With so many options, it can be such an overwhelming task.  I suggest looking in unique places for the name options (such as the mastheads of magazines that you like, or the credits on movies or television shows) and waiting for that “Ah-ha!” moment when you find one that really charms both you and your partner.   

- Rosie Pope

Oh, the dreaded toddler sleep conundrums!  In my experience, it seems sleep issues only get thornier as your babe gets older.  I’ve found that there are so many more factors that contribute to toddler sleep issues than with a baby, so I really recommend checking with your pediatrician for his or her specific advice.  In our house, I found that having an established bedtime routine is an immense help.

- Rosie Pope

Being short of breath is one of the symptoms during pregnancy that could be normal, but it also could be a sign of a more serious problem. Your blood volume increases normally by about 50% during pregnancy, and that puts a strain on your heart. The best thing to do is to see your health care provider and get examined to make sure everything is OK. Your health care provider will often do some tests to ensure there is no serious underlying problem.

- Dr. Amos Grünebaum, MD

Having gone through my own journey, I so hope it happens for you and wish you best of luck in that journey.  The first step would be finding a doctor that you trust.  If it is difficult where you live, look for teaching hospitals nearby – they frequently have wonderful teams of specialists.

- Rosie Pope

It is completely up to you whether you wish to disclose your pregnancy during a job interview.  Many federal and state laws actually consider it discriminatory for a potential employer to even ask whether you are pregnant or have children during the interview process.  Once you are hired, there are a number of other legal protections that would prevent your employer from firing you simply because you have a child on the way.

However, do keep in mind that while you may have many legal protections, it would be probably be in the best interest of your family to find a company whose values and policies most closely align with your needs as a mother.  It’s always much more fulfilling to work for a company that values you as a worker AND a mother! 

- Rosie Pope

The store is  Duc Duc here in New York City.  It's one of my favorite places!
 

- Rosie Pope

Ask your health care provider for lactation consultants in your area. Here are some national resources.

BREASTFEEDING SUPPORT

• National Breastfeeding Hotline - 1-800-994-9662
• Guide to Breastfeeding
• CDC Guide to Breastfeeding
• American Academy of Pediatrics
• La Leche League International
• ILCA- International Lactation Consultant Association Great For Finding Certified Lactation Consultants

RESOURCES FOR PUMPING MOTHERS

• US Department of Labor – Mandatory Break Time for Breastfeeding Mothers
• Business Case for Breastfeeding
• Surgeon Generals Call to Action to Support Breastfeeding
• United States Breastfeeding Committee – Legislation supporting Breastfeeding Breaks for Pumping Mothers

- Rosalie Hunt - RN

There have been many studies that show that if it is possible for mom and baby;  breast milk is the ideal food for babies for the first year of life.  Breast milk benefits for babies include health benefits such as antibodies in the milk that help fight infection and prevent illnesses immediate and long term (ex: diabetes, asthma). Also breastfed babies have decreased SIDS (sudden infant death syndrome) rates in the first year of life. Breast milk has the perfect balance of nutrition for infants.

There are also other benefits to breastfeeding for mom. Mothers that breastfeed have a lower risk of breast cancer, ovarian cancer, and type 2 diabetes. Also is also the cost savings of breastfeeding. For example you said that you pump did you know that Breastfeeding equipment is allowed as a medical tax deduction!

Formula is a supplement that may be necessary in some cases. If you are not sure if you can breastfeed talk to your medical provider.  If you are able to give some breast milk for the first year of life that would be best, but again there are other circumstances that may go into your decision and don't feel guilty if you can't.  

Deciding breast milk or formula is a very personal decision. There is no right or wrong answer, do what works for you and and your baby.

- Rosalie Hunt - RN

The answer is yes. Breastfeeding works by supply and demand. So the more you feed the more you produce. By skipping a feeding and giving formula and not pumping can cause the milk supply to decrease.  For mothers who need to supplement I recommend talking with a lactation consultant as soon as possible to try to prevent a decrease in supply. 

- Rosalie Hunt - RN

Most often the answer to this is yes, but it also depends on how often the baby is getting a bottle and how soon it is introduced. It is easier for a baby to drink faster from a bottle than the breast. The bottle nipple hole is large and baby does not have to work as hard to get the milk/formula out. Therefore if a baby has been drinking from a bottle many times a day going back to the breast is more work for them. For that reason, sometimes, not always, it is hard to go back to breastfeeding if the baby has been bottle feeding.

- Rosalie Hunt - RN

Nausea and vomiting is the so-called "morning sickness". which is a very common condition during early pregnancy.

For many women the nausea  isn't limited to just the morning and it can happen anytime during the day or even at night. Although it can seem like it will last forever, nausea and vomiting usually go away after the first trimester. Most of the nausea disappears after 10-12 weeks of the pregnancy. Try some of these tips to help prevent and soothe nausea:

• Eat frequent, small meals (6 to 8 small meals a day) rather than 3 large meals.
• Avoid fatty, fried, or spicy foods.
• Try eating starchy snacks, like toast, saltines, Cheerios, or other dry cereals when you feel nauseated.
• Keep some by your bed and eat them before you get out of bed in the morning.
• If you feel nauseous in the middle of the night, reach for these starchy foods.
• It's also a good idea to keep these snacks with you at all times, in case of nausea.
• Try drinking carbonated drinks like ginger ale or seltzer water in between meals.
• Ask your doctor if you should change prenatal vitamins if it seems to be making your nausea worse.
• Sometimes taking your prenatal vitamin at a different time (e.g. at night not in the morning) can also help.
• Ask your doctor about taking vitamin B6 for nausea and vomiting that doesn't get better with dietary changes

For some women, the nausea of the first trimester is so severe that they become malnourished and dehydrated. These women may have a condition called hyperemesis gravidarum (HG). HG refers to women who are constantly nauseated and/or vomit several times everyday for the first 3 or 4 months of pregnant.

If you think you might be vomiting excessively, call your doctor immediately. If you lose too much fluid you might become dehydrated. Dehydration can be dangerous for you and your baby.

 

- Dr. Amos Grünebaum, MD

I applaud you for reaching out and asking questions as well as for not giving up on breastfeeding! Many mothers struggle with breastfeeding you are not alone.  Breastfeeding is not always second nature; it takes time and a lot of patience. With breastfeeding you have to find a balance for what works best for you and your baby. Many mothers feel guilty if it does not go as easily as they thought it would.

The quick answer is the American Academy of Pediatrics recommends breastfeeding/giving expressed breast milk exclusively for the first 6 months, then breastfeeding/giving expressed breast milk with foods from 4-8 months and up to a year or beyond. 

The key is find what works for you and your baby and don’t feel guilty if/when you decide to stop. If you feel like you need more support talk to your child's primary care provider or a certified lactation consultant in your community

- Rosalie Hunt - RN

Most medications taken by the mother cross from into the blood and get from there into breastmilk, though usually only in very small amounts. Before you take any medication, you should discuss with your health care provider to see if you really need the drug, if there are other options, whether it affects the milk, and what effect if any the medication can have on the baby.

Most drugs reach the maximum of level in about 1-2 hours after they are taken, so a good time to take the medication,  would be right after the baby is breastfed before going putting the baby to sleep for the night.
 

- Dr. Amos Grünebaum, MD

I love that your are bringing gifts for the Mom as well as the baby. If you need more ideas for the babaghanoush let me know. As for the mom I think creating a care bag for her to take to the hospital is a wonderful idea. You can buy a diaper bag (of course I'm biased and love our London Shopper Classic or London Shopper Leisure ) and then fill it with some of the following things:

• Indulgent Snacks as well as nutritional ones (she is going to be absolutely starving post delivery and it is hard to get anything delicious in the hospital).
• Fennel Tea Bags -- wonderful for losing the water weight right after delivery.
• Some pampering items, buy a good brand that smells great of mini shampoo/conditioner,  facial moisturizer, facial cleanser, lotion, toothbrush and toothpaste to make that first shower  post-birth amazing.
• Lovely pair of comfortable pajamas for her to lounge around in the hospital room, feel comfortable and still be able to receive guests.
• Beautiful journal or note book and pen so she can take down her first thoughts when meeting her new baby
• Copy of What to Expect in the first year so she can immediately start reading about her new baby's development.

Any or all of these things would make the perfect gift. And congratulations on being a God parent it is a wonderful honor!

- Rosie Pope

Both came from one of my fave stores here in New York City - Duc Duc. Happy nursery decorating and be sure to watch me on Access Hollywood Live the week of April 12, decorating another nursery. I'll have some great tips.

- Rosie Pope

I use and love Graco. They are very safety conscious and have great designs (some of those car seats can have such wild prints on it might give you a headache!). Combine this with the "snap n' go" stroller base for easy clicking in and out with the car seat. This base is light weight and you can fold it up in one fell swoop. Both can be purchased from www.babiesrus.com. If you can, go into the store so you can have one of the staff show you how to use it. They can be really helpful.

Also, for running I just love the Bob stroller. It is really easy to push, comfortable for your child and actually rather easy to fold and travel with. You can also get a car seat attachment for that as a newborn is too young to go in it. Also, be careful about running before your wee one has better head control because all the bobbing around can be dangerous. Ask you pediatrician when they think it safe to go from speed walking to running behind your stroller.

- Rosie Pope

We will be carrying your size starting this Fall (from Sept 1, 2011) but I do apologize that we don't have them in just yet. In the meantime, tell me a little more about your style and I'll recommend some brands that I think you'll like. And, congratulations on your pregnancy.
 

- Rosie Pope

Long menstrual cycles are known as "oligomenorrhea", is when you have 8 or less cycles per year. Cycles that are so far apart are usually associated with ovulation problems, you either do not ovulate, or you ovulate too infrequently.

Not getting your periods (amenorrhea) and having irregular and long cycles (oligomenorrhea) is often due to "anovulation" which means that you are not ovulating.

Reasons for not ovulating (anovulation) could include polycystic ovary syndrome (PCOS), premature ovarian failure, or hypothalamic amenorrhea.

One way to make the diagnosis is by keeping a BBT (basal body temperature) chart for at least 2 months. Then schedule an appointment with your physician to discuss. If a diagnosis of anovulation is made, your doctor will need to examine you and do some tests to find out the possible causes. Each cause would be treated differently.

- Dr. Amos Grünebaum, MD

Yes! Yes and yes! You are going through epic changes, your expanding in places that you never thought possible, hormones are surging through your veins- no wonder there is temptation to feel the blues! Exercise will:

• Promote circulation
• Boost the feel good endorphins
• Give you a vehicle to release feelings
• Maintain strength, which will promote a positive self image
• Help you sleep better

We know it’s hard to get up and go when seeing your toes can be challenging enough, but trust us, exercise can make all the difference!
 

- Andrea Orbeck

Be aware that it’s normal during pregnancy. Your blood pressure changes quite a bit during pregnancy due to progesterone coursing through your system. It’s dilates the veins and makes the blood pressure drop, which can make you feel suddenly lightheaded. If you feel dizzy during exercise, sit down, sip water and wait it out.

Remember that drinking water is important because you want the blood volume to help with the pressure and getting up slowly enough to allow your blood pressure to reach your head in time!  If you are concerned discuss with your health care provider.
 

- Andrea Orbeck

Yes! Just because your abdominals are stretching out doesn’t mean it’s time to stop your core conditioning! Keeping your abs strong all throughout your pregnancy will not only help with posture, prevent back pain, but will also assist you in pushing during labor! Once you receive the abdominal green light from your health care provider, you can safely do your regular abdominal routine until the beginning of the 2nd trimester.

After that time, avoid lying on your back, your growing baby may place undue pressure on your organs. It’s best to maintain your core strength by staying upright with your heart. Too, if you have diastasis recti (splitting of the abs), ensure you speak with your health care provider to understand your limitations with ab work.
 

- Andrea Orbeck

Protein is the building block to growing tissue and well, your baby is made of really adorable  growing tissue! You’ll find it in lean meats like chicken, turkey, eggs, dairy, nuts and beans.
 

- Andrea Orbeck

If I had to pick my top 3, it would be protein, folic acid and iron. Fiber is a good one too (did I say only 3?) on account of the lovely pregnancy related constipation that will undoubtedly come.
 

- Andrea Orbeck

The fact that everything is so out of one's control. I remember once the embryos were transferred lying in bed willing them to implant and then getting so worked up about it I would just cry because as crazy as it sounds I just wanted to help them attach but clearly that is impossible. Then once I started crying I would worry that the stress would stop them implanting and so the vicious cycle would continue. The despair that comes out of the lack of control and the waiting is really hard to deal with.

- Rosie Pope

There is much confusion and fear around the topic of what foods and drinks to add or avoid while pregnant. I've given a brief no-no list of some of the top foods to avoid.

Fish with high levels of mercury.  

Two federal agencies which tests fish for mercury are the Food and Drug Administration and the Environmental Protection Agency. . Of the tests conducted, these are the fish which contained the highest levels of mercury and are advised to avoid while pregnant:

Mackerel, Marlin, Orange Roughy, Shark, Swordfish, Tilefish, Tuna, Ahi, Seabass, and Grouper

This list applies to fish caught and sold commercially

The fish with the least amount of mercury and deemed safe to eat are:

Anchovies, Butterfish, Catfish, Clam, Crab (Domestic), Crawfish/Crayfish, Croaker (Atlantic) Flounder, Haddock, Herring, Mackerel, Mullet, Perch, Pollock, Salmon (Canned), Salmon (Fresh), Sardine, Scallop, Sole, Tilapia, Trout (Freshwater), Whitefish

Remember to cook thoroughly. Noting rare and nothing seared!

Unpasteurized Dairy Products

Unpasteurized milk is not heat-treated to kill organisms in the milk. In the United States, the Food and Drug Administration has regulations that require all cheese made with unpasteurized milk to be aged at least 60 days before being sold. However, there are some fancier cheese that are the exception and should be avoided including:  Brie, Camembert, Feta, Gorgonzola, and Roquefort.

Fresh made dressings that contain raw eggs should be avoided as well!

Alcohol

We hope we don't have to explain this one. Some studies indicate that a glass of wine in the later trimesters are ok, however we say better safe than sorry and waiting is better. Just think of how much you will deserve that glass of champagne when you make it to the end!

- Andrea Orbeck

A pregnancy test becomes positive only after the fertilized egg has first implanted into the uterus and then sends enough amounts of hCG, the pregnancy hormone, into your blood stream.

Implantation, when the fertilized egg implants into the endometrium, happens about a week after ovulation, ranging 6-12 days, and it takes another 3-4 days after implantation (9-10 dpo: days after ovulation) for the blood pregnancy test to first become positive. To know if you are pregnant or not a pregnancy test is the best indicator.

Pregnancy Tests: 

• Blood Pregnancy test: If you are pregnant then the blood pregnancy test is usually positive within 3-4 days after implantation or about 9-10 days after fertilization and ovulation.

• Urine (Home HPT) Pregnancy Test: The urine pregnancy test will usually not become positive in most women until a missed period or about a week after implantation. Many manufacturers of urine pregnancy tests want you to believe that the urine test is usually positive before a missed period, but only about 25% of pregnant women will test positive with the HPT 2 days before a missed period, and about 40% the day before the missed period.

- Dr. Amos Grünebaum, MD

Ovulation is the key factor in fertility and knowing the methods of finding out if and when you ovulate is important to improve fertility.

Without ovulation you cannot get pregnant and timing sex in relation to ovulation is important, as you only have six fertile days each menstrual cycle; the day of ovulation and the 5-6 days before ovulation day.

The ovulation day determines when you are most fertile in your menstrual cycle. You may decide to pinpoint ovulation as a method of natural birth control or if you are trying to conceive. Some methods of finding out when you ovulate and when ovulation happens can be easily done at home, while others require more sophisticated testing.

There are several methods of finding out if and when you are ovulating and some of them are more reliable than others. 

Methods of finding out if and when you ovulate:

• Progesterone in the blood - Close to 100% but only retrospectively
• Ultrasound - 80+% reliable
• OPK Ovulation Predictor Kit - 90+% predictable
• Basal Body Temperature Charting - Over 90% reliable but only retrospectively
• Ovulation and Fertility Calculator - Not 100%
• Cervical Mucus Changes - 80+% reliable
• Ovulation Pain: Mittelschmerz - Less than 50% reliable
• Saliva Ferning Ovulation Test

- Dr. Amos Grünebaum, MD

About 80% of infertility is caused by one or more of these three problems and should be checked in the following order:  

1. Ovulation Problems
2. Sperm Problems
3. Fallopian Tube Problems

Infertility testing is straightforward.  Ovulation is the first step in identifying a fertility issue.  If ovulation is OK, usually if your menstrual cycles are regular and your egg quality blood tests are fine, then the next step is usually to check the ejaculate.  If that's OK, the fallopian tubes are checked next.

- Dr. Amos Grünebaum, MD

To improve your chances of getting pregnant, you need to make love on your fertile days. Once a day, every day during your 5-6 fertile days.

You only have 5-6 fertile days each cycle, the 4-5 fertile days before and the day of ovulation. Having sex more than 5 days before the day of ovulation or having sexual intercourse the day after ovulation will not get you pregnant.

- Dr. Amos Grünebaum, MD

Infertility is caused in about 1/3 of cases by male problems, 1/3 by female problems, and in 1/3 of cases there are problems in both the male and female.

The top 3 explanations for infertility are:

1. Sperm Issues
2. Ovulation Issues
3. Problems with the Fallopian Tubes

In about 15% of infertility cases, no specific problem is found after both the man and woman have been tests and this is called "unexplained infertility".

- Dr. Amos Grünebaum, MD

The specialist who takes care of infertility issues for women is a reproductive endocrinologist or "RE" for short.

For men it is usually a urologist.

- Dr. Amos Grünebaum, MD

It is normal to gain weight during pregnancy. The amount of weight you gain depends on your weight pre pregnancy. 

For mothers that were of average weight when their pregnancy began the typical weight gain is between 25-35 lbs. For mothers who were underweight when their pregnancy began the typical weight gain is 28-40 lbs. For mothers that were overweight when their pregnancy began the typical gain is 15-25 lbs.

The most important thing to remember with regards to nutrition in pregnancy is to try to eat a balanced diet with lots of fruits, vegetables, whole grains and low fat proteins. It is recommended pregnant mothers eat an extra 300 calories per day. So for the average woman eating 2200 calories per day that would now be 2500 calories per day. So many mothers are curious where does the weight go? 

Some things to consider that impact your weight during pregnancy:

• Blood average weight is 3 pounds
• Breast changes weigh 2  pounds
• Womb weighs 2 pounds
• Baby average weight is 7.5 pounds
• Placenta average weight is 1.5  pounds
• Aminotic Fluid average weight is 2 pounds
• Fat & Protein average weight is 7 pounds
• Retained Water average weight is 4 pounds

- Rosalie Hunt - RN

Breech means that the baby is bottom or feet are facing down rather than head facing down. There are some doctors and midwives that will deliver a breech baby vaginally but most will recommend a cesarean if your baby does not turn to be head facing down.

Check with your provider on that. The reasoning for this is that the head is the largest part of the baby’s body to come out so if the head comes out first it allows the rest of the body to be delivered easily. If the head does not come out first there can be complications which your provider will talk to you about.

That being said there are a few things you can try to encourage the baby to move head down, though none of these are proven methods:

• Yoga - You could try going to a prenatal yoga class. Positions like downward facing dog where the hips are higher than the chest can help baby come out of the pelvis and may give baby more room to turn.
• Swimming- Some women report swimming helps encourage the baby to turn. This could be because your are horizontal and also shifting your pelvis.
• Acupuncture- Acupuncture has been shown to help a baby turn. For this make sure you see a certified acupuncturist who specializes in pregnancy.  
• Chiropractor - Chiropractic care, specifically the Webster technique has also been reported to make more room in the pelvis and therefore allow baby to turn. Again for this make sure you have a certified chiropractor trained in the Webster technique. 

Before trying these techniques I would also talk to your primary care provider and let them know you are trying these things to encourage the baby to turn. Best of luck. 
 

- Rosalie Hunt - RN

In the four to six weeks following delivery your body goes through many physical changes both immediate and gradual as you transition back to your non pregnant body. Typically you will follow up with your provider during that time to check in and see how things are going. Normal things you will experience include:

• Vaginal bleeding – Vaginal bleeding also called lochia immediately following delivery it will be heavy like a menstrual period for the first week then will gradually get lighter and darker during week two postpartum and eventually turn clear. Some women have small spotting of dark brown blood up to three or four weeks. Call your provider if you pass a large clot,  have increased red bleeding, or saturate a maxi pad in 30 min. 
• Breast milk comes in - The milk you have the first few days is called colostrum, it is gold in color and less in volume.  Day 3-5 typically your full milk, which if you were to express would look whiter will come in. You will notice your breasts feel full. If you ever have one breast that is red, painful or swollen call your care provider it could be an infection of the milk duct. 
• Uterus shrinks down - After delivery the uterus begins the process of involution where it shrinks back down to pre-pregnancy size.  This usually takes 6 weeks. Sometimes mothers notice mild uterine cramping but if it is more uncomfortable for you talk to your care provider. 
• Vagina - The vaginal muscles have stretched to accommodate baby so they may be swollen or sore the first few days or weeks postpartum.  It can take 6 weeks for them to return to how they were before delivery. Due to that your care provider will probably recommend nothing in and out of the vagina for 6 weeks (no sex, and no tampons). Pelvic floor exercises for example Kegles are wonderful exercises you can do to tone that area, increase circulation and promote healing. 
• Bladder and Bowels – Some times the bladder can experience some trauma during delivery and may not fully empty following delivery. Because of this it is a good idea postpartum to make sure you try to urinate at least every 3-4 hours. Your body is getting rid of extra fluid so you may urinate more than usual. Call your care provider if you are unable to void or have pain when urinating. Many mothers are also worried about the first bowel movement postpartum. Make sure you stay well hydrated and eat a high fiber diet to avoid constipation. Some pain medications taken postpartum can increase constipation so if you become constipated talk to your provider about a stool softener.
• Hemorrhoids – Some women experience hemorrhoids postpartum. These can be treated with cold compresses, topical ointments (such as witch hazel) or pain medications. If you experience this talk to your care provider.
• Hair Changes Postpartum – Some mothers find they lose hair postpartum. This is because during pregnancy hormones increased hair growth and now that mom is no longer having those pregnancy hormones so her hair is going back to its original state. It is normal and will return to the normal growth cycle in a few months. 

These are just some physical postpartum changes women have following delivery. If you have specific questions or concerns talk to your care provider.

Also it is good to keep in mind besides physical changes there are also emotional changes that occur postpartum.  Some are joyful emotions of excitement of seeing your baby, and others are mixed emotions including postpartum blues (mood changes lasting 2 weeks) and even for some mothers postpartum depression (feelings of sadness that do not go away even after 4 weeks postpartum).  If you experience postpartum depression do not keep it to yourself. Talk to your care provider and know you are not alone there are resources available to help you such as Postpartum Support International.

- Rosalie Hunt - RN

That is a hard question to answer. Everyone's labor is different. On average labor time for a first time mother is 12-24 hours (for most it is closer to 24 hours).  Typically subsequent deliveries tend to be faster than the first but it is hard to predict. For most mothers labor is a gradual process.  

The stages of labor are as follows:

• Stage 1 Labor - The Cervix opening from 0-10cm
• Early Labor- can last up to 12 hours, cervix dilates from 0-3cm, in early labor typically contractions are mild to moderate and go from 30min apart to eventually every 5 min. 
• Active Labor- can last 6 hours more or less,  cervix dilates from 3-7cm, contractions in active labor and stronger and more uncomfortable and come typically 2-5 min apart. This is when most mothers call their provider and go to the place they are delivering. 
• Transition- this can last anywhere from a few min to a few hours, cervix dilates 7-10cm, contractions are strong and closer together. This can be a time in labor when mothers need extra support to cope with contractions. At 10 cm dilated mother is ready to go to stage 2 - pushing.
• Stage 2 - Pushing & Delivery of infant - At this point in labor mothers usually feel rectal pressure or the urge to push. Pushing can take anywhere from a few minutes to a few hours. 
• Stage 3 - Delivery of the Placenta - typically this happens spontaneously 5 -20 minutes following delivery. 

Just a reminder every mother is different and it is good to keep in touch with your provider as your labor progresses so you arrive at the place you are giving birth at the right time for you. 
 
 

- Rosalie Hunt - RN

This is a very common question I get in classes. Here are the signs of labor but remember if you are ever concerned call your care provider and talk to them.  
 
Normal labor usually starts 2 ways, with contractions or with the bag of water breaking. True labor contractions get longer, stronger and closer together and cause your cervix (the bottom of the uterus) to dilate (open). 

Mothers may experience "braxton hicks" or warm up contractions during pregnancy that come and go. These are not true labor contractions because real labor contractions do not stop, instead they get closer together, last longer and get stronger.  

I generally tell moms the 5-1-1 rule as a good sign of when to call your care provider when you think you are in labor. This 5-1-1 means that contractions are 5 min apart, lasting 1 min long each, and it has been like that for 1 hour. This is a good sign that you could be in labor.  I remind mothers to call their care provider at this point and talk to them about how they are feeling and your care provider will let you know if they think it is the right time for you to come to the place you are delivering. Again this is a general rule of thumb that may be different for mothers where it is your first than for mothers where it is your 2nd, 3rd or 4th child. So always check with your provider if you have questions.

Another sign of labor is the water breaking. Once your water breaks call your care provider and talk to them to see if it is time for you to go to the place you are delivering. 
 
Things to be concerned about and to call your provider immediately would be if you experience contractions or water breaking before 37 weeks (this is considered preterm), if you have constant pain (usually pain comes during a contraction for about one min then goes away between),  if you have vaginal bleeding, or do not feel the baby move.  If you have concerns it's always ok to call your
 

- Rosalie Hunt - RN

When choosing a provider think about what is important to you.

• Do you want to deliver at a hospital, birth center or at home?  
• Do you know you want pain medication like an epidural or do you want natural childbirth?
• Do you have any medical conditions that make your pregnancy high risk?
• What is the providers philosophy on labor and birth?
   

These are just a few examples of questions for you to ask yourself so you make sure to find a provider that is a good fit for you.  I think it is also a good idea to talk with the provider you choose on your first visit about their practice. Keeping open communication with your provider is very important to make sure you are both on the same page throughout your pregnancy.  Here are descriptions of the different types of providers that all deliver in the United States:

• Obstetricians - Obstetricians are doctors who specialize in women's health and reproduction. They must complete the requirements set by the American Board of Obstetrics and Gynecology (ABOG).  The requirements include: Graduating from an approved medical school, and completion of four years of residency training. After completing the residency training they must pass a test administered by the American Board of Obstetrics and Gynecology (ABOG) to be board certified. Some pursue a sub-specialty such as infertility or maternal/fetal medicine. Obstetricians are trained to take care of healthy, low-risk pregnancies as well as treat health problems or complications that occur in pregnancy, labor or birth. They are trained to provide not only medical care but also surgical care (such as a cesarean) if necessary. Obstetricians deliver in hospitals or at birth centers. 
   
• Family Practice Doctors - Family Practice Doctors are trained doctors that care comprehensively for the health needs of the whole family including women during pregnancy and in labor. Physicians who specialize in family medicine must graduate from medical school and completed an accredited 3 year residency. They are certified by the American Board of Family Medicine. They are not trained in surgical care so if that would become necessary the mother would need to switch to an obstetrician. A family practice doctor may deliver in hospitals and birth centers. 
   
• Midwives - A midwife is a health care professional that provides women's health and reproductive care including delivery and postpartum care. The services a midwife provides depend on the certifying and licensing credentials required by each state. Because of the additional licensing requirements of nursing a Certified Nurse Midwife provide the most comprehensive health care services to women. Midwives specialize in low risk pregnancies and tend to believe in facilitating natural childbirth as much as possible. Midwives are not trained in surgical care so if a cesarean would become necessary the mother would need to switch care to an obstetrician. Midwives deliver in hospitals, birth centers and home births. 
   

- Rosalie Hunt - RN

1. Take a Childbirth Education Class - having a Certified Childbirth Educator who has seen many labors teach you hands on ways to help mom and practicing those things from class before labor is one of the best things you can do.  
2. Be Prepared - Educate yourself learn a little bit about labor, read books, explore online resources (see my website links for my favorite spots) and talk to labor professionals (ex: your provider) about how labor progresses.  Be informed and know a little bit about what to expect. You both may have learned a lot together from reading or classes but she may forget some of that when she is focusing on coping with contractions. Talk with mom about what kind of support she will want and practice ahead of time.  If you are prepared and know ahead of time what she wants and can offer her a massage, help her with position changes, and relaxation techniques she will be most grateful. 
3.  Don't Panic - Sometimes in labor the pain of contractions may be scary to mom's who have never gone through labor before. Contractions are a normal part of labor and serve a purpose so what she is feeling is actually very normal and will help to bring baby. Even though it is normal mom's sometimes panic when the contractions become intense. The best thing for you to do is NOT panic with her. If  you find yourself in this situation take a deep breath and remind yourself you will be a better help if you are calm.  I also encourage you to make eye contact with mom, don't be scared to get close, talk in a calm voice and remind her she is ok, breath with her slow deep breaths. Doing this will usually help to calm a mother who is scared. If you find you are not able to stay calm yourself or calm mom ask for help. Your Doctor, Midwife, or Nurse will be happy to help you. 
4. Provide physical as well as positive emotional support - Mothers in labor may want physical support such as massage, hugs, or holding her hand.  She also will need emotional support such as positive affirmations "you're doing great", "you are so strong", "I love you".  These kind words help remind her that she is not alone and you are there for her. I can emphasize enough how much kind words or loving gestures help a mother in labor. 
5.  Remember mom's basic needs - When mothers are coping with contractions they may not be thinking about the position they are in, how long it has been since they went to the bathroom or drank water. It will help mom if you recognize these things and ask her (in between contractions) if she would like a sip of water, to go to the bathroom, have another support pillow or change positions.  She may not even realize she was tensing her shoulders until you offer a shoulder massage. Your help will relive her discomforts so she can focus on what she needs to do in labor. Also don't forget about your own needs.  For example prepare ahead of time some snacks to keep your energy up, and make sure you are using proper body mechanics when giving a massage so you don't hurt yourself.  
    

- Rosalie Hunt - RN