How a multiple pregnancy is diagnosed

The increased use of ultrasound has made it possible for the vast majority of parents to find out in advance whether there’s more than one baby on the way. This wasn’t the case a decade or two ago, when it wasn’t unusual for as many as 40 percent of multiple pregnancies to be undiagnosed prior to labor and delivery.

Even if you haven’t had an ultrasound, certain red flags may alert you and your caregiver to the possibility that you may be carrying twins. These are the warning signals:

■ Fraternal twins tend to run in your family.

■ You have been taking fertility drugs.

■ You experienced excessive nausea and vomiting during the first trimester.

■ Your uterus is growing more quickly or is larger than what would be expected at a particular point in your pregnancy.

■ You notice more fetal movement in this pregnancy than in previous pregnancies (assuming, of course, that this is your second or subsequent pregnancy).

■ More than one fetal heartbeat is heard.

If your caregiver suspects that you may be carrying multiples, he will likely send you for an ultrasound. Early ultrasound can detect more than 95 percent of multiple pregnancies.

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004

How will I know when my baby is sick?

A lot of first-time parents worry that they will fail to pick up on the warning signs that their baby is seriously ill. Fortunately, most quickly discover that their “parent radar” is more finely tuned than they thought and that they are able to zero in on the following symptoms of illness with relatively little difficulty:

■ Runny nose (usually caused by a viral infection such as the common cold, but can also be triggered by allergies or chemical sensitivities);

■ Coughing (can be caused by the common cold, allergies, exposure to cigarette smoke and other irritants, or chronic lung diseases);

■ Wheezing (caused by the narrowing of the air passages in the lungs and the presence of excess mucus in the major airways);

■ Croup (a noisy, seal-like bark that is caused by an inflammation of the windpipe below the vocal cords);

■ Diarrhea and/or abdominal cramps (can be triggered by a gastrointestinal problem, a food sensitivity, or other illnesses);

■ Vomiting (caused by a related illness and generally only cause for concern if your child is becoming dehydrated);

■ Changes to your baby’s skin color (e.g., extreme paleness or extreme flushedness; can be the result of a systemic or localized infection);

■ Rashes (caused by a viral or bacterial infection or an allergic reaction to a food, medication, or other substances);

■ Behavioral changes such as extreme fussiness or lethargy (caused by an illness or infection);

■ Fever (caused by an infection, a reaction to an immunization, or overdressing your baby).

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004

How to shop for your babies without going broke

Equipping a nursery for one baby is expensive enough. Equipping one for two or more babies can be enough to bankrupt a family — or so you might think. “A lot of parents have to get past the idea that everything has to be new for the babies,” says childbirth educator and mother of twins Joyce MacKenzie. “It’s safety and practicality you’re after, not the most beautiful crib in the store window.”

Although there’s a real temptation to run out and buy your babies matching brand-name gear, there are cheaper ways to acquire what your babies need. Here are some tips from parents who’ve been there:

■ Borrow as much baby gear as you can.

Just make sure that whatever you borrow meets current safety standards.

■ Shop secondhand.

You can find nearly new brand-name baby products at most consignment stores for half their original price or less. Although the better secondhand stores go out of their way to avoid carrying cribs or car seats that don’t comply with current safety standards, mistakes can and do happen. Therefore, the onus is still on you to make sure that the items you’re purchasing are up to snuff.

■ Don’t scrimp on the double (or triple or quadruple) stroller.

It’s the one thing that will keep you mobile. Note to parents expecting quadruplets: You might want to consider purchasing two doubles rather than one quadruple stroller if someone else will always be with you when you’re out with the babies. They’re easier to maneuver and easier to pick up secondhand.

■ Get by with a little help from your friends.

If your friends are planning to have a baby shower for you and they ask what you want, suggest a car seat or other big-ticket item. Your friends can pool their funds and buy you something you really need, rather than a lot of cutesy frilly dresses or sailor suits!

■ Go bargain hunting.

See if a local baby store or department store would be willing to give you a break if you bought all of your baby gear through them. If you’re purchasing two or more cribs, car seats, high chairs, and so on, you represent a lot of purchasing power. Don’t be afraid to bargain a little.

■ See if you can solicit some outright donations.

One family was able to convince the owner of a local pharmacy to let them have every seventh bag of diapers free.

■ Eliminate the frills.

Save money on baby wipes either by making your own (fill a squirt bottle with a mixture of liquid

baby soap and plain water, and then buy some inexpensive washcloths) or by making a box of wipes go further by cutting the wipes in half (one family swears that an electric knife works like magic).

■ Cut corners where you can.

You can save on disposable diapers by using high-quality brand names during the night (when you really want the babies to stay dry!) and lower-quality generic brands during the day. Another good strategy is to start buying diapers when you’re pregnant: one couple expecting triplets had 1,600 diapers stockpiled by the time their babies came home.

■ Don’t look a gift horse in the mouth.

Save items such as used baby bottles, nipples, caps, lids, and acetaminophen samples from the hospital if your children spend some time in the NICU (neonatal intensive care unit). Otherwise, these items are thrown away by hospital staff.

■ Don’t overspend in the clothing department.

As a rule of thumb, twins need 1 1⁄2 times rather than 2 times as much clothing as a single baby.

■ Ask your baby’s doctor for a deal.

See if your children’s pediatrician will reduce the co-pay per visit given that you’re buying his services in bulk! Also, don’t be embarrassed to ask for any free coupons and baby-product samples that he may be able to pass your way.

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004

Coping with grief during pregnancy

Pregnancy is an emotional time, so it’s hardly surprising that it can trigger painful feelings of grief about the deaths of loved ones. If, for example, you recently lost a parent or a grandparent, or your partner died during your pregnancy, you may regret the fact that this special person in your life didn’t live long enough to meet your new baby. And, of course, the breakup of a marriage can trigger waves of grief that are not unlike the grief that many people experience following the death of a loved one. So if you find yourself unexpectedly single midway through your pregnancy, you may find yourself grieving the loss of your marriage and your hopes and dreams of co-parenting along with your ex.

A loved one’s death doesn’t have to be recent to trigger waves of emotion, incidentally. Some women who lost their mothers during childhood or their early teens find that they experience a period of “re-grieving” when they find themselves motherless during pregnancy. “I found myself with so many questions that a woman would normally ask her mother,” says Kelly, a 35-year-old mother of one. “It was the loneliest feeling in the world to realize that I didn’t have a mother to share my own journey to motherhood with.”

If you find that grief is affecting your ability to enjoy your pregnancy, you may want to talk to a friend who has been through a similar loss, find out if there is a grief support group operating in your community, or set up an appointment with a grief counselor who has experience with your particular type of loss.

Regardless of what type of support you line up for yourself, it’s important to find a healthy way to vent your feelings of loss so that you can break free from the tidal wave of grief that may threaten to drag you down and give yourself permission to look forward to the wonderful future that awaits you and your new baby.

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004

Styles of Parenting

Diana Baumrind, a psychology professor at the University of California at Berkeley, extensively studied parenting styles by observing families firsthand. She identified three different styles of parenting and also determined that one is more effective in raising confident children.

• Permissive. You dish out a lot of affection, but you make few demands on your kid and wouldn’t consider yourself a strong disciplinarian. You’d rather be your kid’s best friend than her parent.
• Authoritarian. You use a lot of commands and threats based on an absolute standard of conduct and higher authority. You rarely ask your child what he thinks or consider compromising or negotiating. You believe in indoctrinating your child with respect for work, authority, and tradition. There’s no give-and-take.
• Authoritative. Your parenting combines confident authority with reasoning, fairness, and love. You encourage your child’s input and acknowledge your own responsibility as an adult but also your child’s individual needs and desires.

If you think you’re too permissive, see if any of these statements reflect your attitude:

• I want to raise my child differently from how I was raised. My parents were too strict, and I don’t have a good relationship with them.
• My schedule takes me away from my family a lot. This is my way of making up for not being there for my kids.
• Everyone gives their kids things. Why should I be any different?
• I’m trying to be a friend to my kids. I think that’s a big part of raising children and being a good parent.
• I want my child to be happy and have a happy childhood. Always being on his case for his behavior isn’t going to help develop that outcome.
• I’m afraid to say no to my child. He might not love or approve of me.
• My child has had some tough breaks, and I’m just trying to make things easier.
• I don’t believe in punishment.
• I’m afraid that if I say no I might crush my child’s self esteem or spirit.
• Bad behaviors just go away on their own. They’re really just a phase.

If you think you’re too authoritarian, see if any of these statements fit you:

• I’m exhausted. I really don’t have time to listen to my kid’s opinions.
• I believe kids should be seen, not heard.
• This is how I was raised, and it’s how I plan to raise my kids.
• Deep down this isn’t my philosophy, but my spouse is authoritarian. I’m copying my parenting partner’s style of discipline.
• I think kids today are spoiled and need a firm hand, or they will never respect authority.
• I don’t know another way to discipline my kids.
• I’m afraid to lose control.
• I believe in a family culture where you respect your elders and there is a clear hierarchy.

Which parenting style do you think produces kids who are more confident as well as more respectful? You’re right if you guessed “authoritative.” Consistently using this style of parenting greatly improves the chances that you will raise a more respectful, confident, happier child who also has a healthy relationship with you. What will make you decide to change your current style of discipline? What is the first step you need to take to make that change happen?

Source : 12 Simple Secrets Real Moms Know. GETTING BACK TO BASICS AND RAISING HAPPY KIDS . Michele Borba, Ed.D. 2006

Being pregnant and in an abusive relationship

According to a study reported in Obstetrics and Gynecology, one in five pregnant teens and one in six pregnant women can expect to experience physical or sexual abuse during her pregnancy — abuse that puts her at increased risk of experiencing miscarriage or giving birth to a low-birth weight baby.

Some pregnant women report an escalation of abuse during pregnancy, whereas others indicate that they only feel safe while they are carrying a child because they feel confident that their partner wouldn’t do anything to hurt the baby — something that can lead to repeated pregnancies as a way of escaping abuse.

Many women who have been putting up with abuse decide to make the break during pregnancy or shortly after the birth, fearing that the abuser may harm the baby. (Their concern about their baby’s well-being is justified, by the way: studies have shown that more than 50 percent of men who abuse their female partners also abuse their children and many others threaten to abuse their children.)

“It took me nine months after my son was born to finally leave an abusive relationship,” says Janna, a 35-year-old mother of two. “When I realized that my partner would be abusing my son, I realized I’d had enough.”

If you are in an abusive relationship and have made the decision to leave, here are some steps that can help you and your children get out as safely as possible:

■ Pack a suitcase and leave it in the care of a trusted friend or neighbor. Include clothing for yourself and your children, prescription medicines, toiletries, and an extra set of car keys.

■ Set up your own bank account and leave the passbook in the care of a friend.

■ Make sure that all of the important records you might need are in a place where you can find them quickly. These include birth certificates, Social Security cards, your voter registration card, your driver’s license, medical records, financial records, and documents proving ownership of the house and car.

■ Know exactly where you’re going and how to get there. If you will be staying with a friend or family member, make sure that person is prepared for the fact that you could show up at their doorstep at any time.

■ Call the police if you need help leaving or if you wish to press charges against your partner.

■ Arrange for counseling for yourself and any children you may already have. You may need some support in breaking free of the cycle of abuse and preparing for a happier future with your new baby.

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004

Real Mom’s Secret : A Mother who Loves Teaches Worth. Is This Part of Your Parenting?

Here are some questions to ask yourself:

1. How well do you really know your child?

• What are your child’s real passions, the things he loves to do? What are his interests, his hobbies? What does he tune in to or seem fascinated about?
• What are her true talents? For instance, does she draw well? Does she have great rhythm, incredible grace, endurance, a kind heart? Does she think in numbers, have an amazing vocabulary?
• What are his academic abilities? For instance, does he remember things quickly, enjoy reading or listening, like to write, have a knack for numbers, have a long attention span?
• How does she handle social settings? Is she more of a watcher or a joiner? Does she lead or follow? Does she buckle to peer pressure or stand up to it? Does she prefer to be around lots of people, a few, or none at all? Does she make friends easily or need guidance? Is she more of an extrovert or an introvert?
• How well does he handle pressure or criticism? Do deadlines stimulate or paralyze him? Does he need reminders, or is he self-motivated? When he fails, does he need encouragement, or does he pick himself right back up? Does criticism shrivel him or help him? Does he welcome competition or wither? Is he laid back or intense? Does he have positive or negative self-esteem?

2. Thinking now about the profile you’ve just created for your child, you need to ask yourself whether your hopes and dreams for her are based on who she really is or on who you want her to be. Are your current expectations—the ones you’ve more recently crafted for your child’s life—matching your kid so that they enhance his self-esteem? Are your dreams in line with your kid? What would need altering? Here are some things to consider: Would you say for the most part that your child is thriving or barely surviving? Loving the competitive pace or dreading it? Jumping out of bed each morning with an “I can’t wait” attitude for practice or playgroup or violin, or using excuses to get out of it? Is she talking excitedly about gymnastics or that new chess

club you’ve enrolled her in, or is she feigning headaches? Is your kid really capable of taking the accelerated class, doing the chore, participating in soccer or the playgroup? Are some of the tasks above his level of ability? Is he mature enough? Is this something he really wants to do, or is this your dream? Does he have the skills needed to succeed? Write a list of your concerns. Doing so will help you develop a plan to deal with them.

3. Has your kid or someone else ever wondered out loud if you’re being sensitive to who your kid really is?

4. If you’re sitting in a room and your child walks in unexpectedly, do your eyes light up with joy no matter what’s the latest mishap?

5. If there is one thing you could do to be more sensitive to your child and show your unconditional love, what would it be?

Source : 12 Simple Secrets Real Moms Know. GETTING BACK TO BASICS AND RAISING HAPPY KIDS . Michele Borba, Ed.D. 2006

What’s up, doc? Things to talk about with your doctor

Fifteen years ago, women didn’t show up on their doctors’ doorsteps until they had missed their second period and were 99 percent sure they were pregnant. Today, most doctors recommend that their patients come in for a checkup before they start trying to conceive.

The reason for the change in thinking is obvious. Recent studies about the benefits of preconception health have served to hammer home an important message: It’s not enough to quit smoking, improve your eating habits, and start popping prenatal vitamins the moment the pregnancy test comes back positive. To give your baby the best possible start in life, you need to ensure that you are in the best possible health before you start trying to conceive.

Here’s why.

Even though today’s pregnancy tests are highly sensitive and allow women to test for pregnancy sooner than ever before, you probably won’t know for sure that you’re pregnant until at least four weeks after the date of your last menstrual period — perhaps even longer if your cycles are particularly lengthy or irregular. During this time when you’re wondering whether you’re pregnant, your baby’s major organs are being formed — a process that medical science refers to as either organogenesis or embryogenesis. That’s why it’s so important to be as healthy as possible before you start trying to conceive. This means setting up an appointment to see your doctor for a preconception checkup.

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004

The Twelve Qualities Your Child Needs for a Life That’s Happily Ever After

Look at your child and try to picture him or her in twenty-five years as a grown-up. What do you see? Does your son or daughter have these twelve essential qualities:

1. Is he happy, optimistic, and secure? Does he have authentic self-esteem?

2. Is she in a healthy, loving relationship? Does she have good friends and loyal allies?

3. Does he have a strong moral compass? Does he have good values and strong character?

4. Does she have empathy and compassion for all people? Is she kind, unselfish, and humane?

5. Does he have self-control and patience? Can he delay gratification?

6. Is she able to make good decisions on her own?

7. Is he self-reliant?

8. Is she responsible and internally motivated? Does she have a good work ethic?

9. Is he practical and resourceful in handling day-to-day living?

10. Is she resilient? If life throws her a curve, can she bounce back?

11. Is he confident and positive about his identity and strengths?

12. Does she have fun? Does she laugh? Is her life balanced between work and love, self and others?

Yes, each of our kids is born with a certain temperament and genetic predisposition. Certainly there are some things about our kids’ development that are not under our control— but many are.

Source : 12 Simple Secrets Real Moms Know. GETTING BACK TO BASICS AND RAISING HAPPY KIDS . Michele Borba, Ed.D. 2006

Getting ready to get pregnant : Have you been diagnosed with endometriosis?

Endometriosis is the name given to a medical condition in which tissue similar to the tissue that lines the inside of the uterus grows outside the uterus, typically on the surfaces of organs in the pelvic and abdominal regions. Endometriosis is one of the top three causes of female infertility. Approximately 30 percent to 40 percent of women with the condition experience fertility problems.

Researchers are unsure why endometriosis affects fertility, but they think that the condition may interfere with the uterus’s ability to accept an embryo, change the egg in some way, or prevent the fertilized egg from making its way to the uterus in its normal fashion.

Because endometriosis often goes undiagnosed, it’s important to be aware of the key symptoms of this medical condition so that you can seek treatment sooner rather than later if you suspect you may be affected:

■ extremely painful (even disabling) menstrual cramps

■ heavy menstrual periods

■ premenstrual spotting

■ bleeding between periods

■ chronic pelvic pain (including pain in the lower back and pelvic region)

■ pain in the intestinal region

■ painful bowel movements or painful urination during menstruation

■ gastrointestinal symptoms (especially the urge to evacuate or pain with bowel movements)

■ fatigue

■ difficulty becoming pregnant.

Note: In vitro fertilization (IVF) has proven to be quite effective in treating infertility in women with endometriosis.

Source : The Unofficial Guide to Having a Baby. Second Edition . Ann Douglas and John R. Sussman, M.D. 2004