Monthly Archives: September 2012

Childhood cancer Twitter chat with Children’s

Join Children’s Hospitals and Clinics of Minnesota for a Twitter chat on childhood cancer on Monday, Oct. 1, at 3 p.m. CST.

We’ll talk about:

  • Childhood cancers: How does cancer impact kids differently? What is the latest in research?
  • Children’s has a unique care philosophy for treating its pediatric cancer patients. What is it and how does it impact the patient and family experience?
  • What is Children’s doing to advance cancer research?

There are a few ways you can participate:

  • On Twitter, follow the hashtag #childrenschat
  • You can also follow the chat via the live stream below, which will activate at 3 p.m. Monday.

You can submit questions in advance by:

  • Using  the hashtag #childrenschat on Twitter
  • Email your questions/comments to [email protected]
  • Entering your questions/comments in the box below when the chat starts at 3 p.m. Monday

Chat leaders include:

Dr. Kris Ann Schultz

Dr. Joanna Perkins

Noelle’s story: The danger of one bite

Noelle Dilley

Noelle Dilley knew the moment she bit into what looked like a chocolate cupcake it was contaminated. Tears streamed down her face as she ran to her mom.

The cupcake had peanut butter in it. Noelle, 10, is severely allergic to peanuts.

She and her family were at a church picnic. The cupcake looked tempting. It would be for most 10-year-old kids. Who would have thought it contained the one ingredient Noelle can’t have.

Noelle was tested and diagnosed with a peanut allergy – among other allergies – when she was around 3 years old after suffering a reaction to a small amount of peanut butter, said her mom, Renae Zaeska. The Atwater, Minn., family was told that with every peanut exposure, the reaction would be worse than the previous one for Noelle.

When Noelle was 5, one bite of a Butterfinger turned into a helicopter ride and a five-day stay at St. Cloud Hospital.

This reaction would be worse, Zaeska thought.

Noelle’s mouth started to burn. He ears ached. Her stomach hurt. On this day – of all days – Zaeska didn’t have Noelle’s EpiPen.

She grabbed Noelle and sped to the emergency room at Meeker Memorial Hospital in Litchfield, Minn. By the time they got there, Noelle’s eyes had started to swell and she began to wheeze. The medical team used an EpiPen and steroids. But Noelle needed additional care.

For the second time in her life, she traveled in a helicopter. She was taken to Children’s Hospitals and Clinics of Minnesota where she spent 31 harrowing days.

At Children’s, Noelle went into cardiac arrest and CPR was performed. Her heart started pumping again, but her lungs were so inflamed and full of mucous she was unable to use them. She was ultimately put on ECMO (extracorporeal membrane oxygenation), a technique that provides cardiac and lung support to patients whose heart and lungs are severely distressed.

She underwent surgery, endured numerous procedures including bronchoscopy and was tested time and time again as she recovered.

“After this whole accident, I’m terrified…I pray to God that we never have to go through this again,” Zaeska said. “I wish I could put a bubble around her.”

“For four minutes, she was gone,” she said.

Now, Noelle and her family – who were able to stay at the Ronald McDonald House inside Children’s during the hospitalization– are home, where they belong.

“In the PICU at Children’s, we all have been privileged to care for Noelle and adore her family.  To see her so desperately ill, knowing that her heart and lungs stopped working, to help rescue her from her critical illness, then to see her walk out of this hospital is indescribable. This is exactly why we embrace caring for children,” said Dr. Ken Maslonka, PICU medical director.

The fifth-grader has been home since Sept. 19. She’s working with a tutor at home and continuing physical, occupational and speech therapy before returning to school for half-days.

Noelle’s school has taken various precautions to help protect her and students with food allergies, Zaeska said.

School staff has eliminated peanuts and peanut products in the food served to children, Zaeska said. They’ve created a peanut-free zone for Noelle at lunch. They’ve also added a wash basin where kids can wash their hands before entering the classroom.

The school can’t limit what parents send with their kids, however, Zaeska said.

Noelle’s parents read labels, know which companies use peanuts in food process, and check out which restaurants are “safe” and take steps to prevent cross-contamination.

Their days of dining outside the home will be fewer since Noelle’s hospitalization.

“We’ve told Noelle that we won’t eat out like we used to,” Zaeska said.

According to the Food Allergy and Anaphylaxis Network (FAAN), nearly 6 million or 8 percent of children have food allergies. Peanuts are a top food allergen.

“The best advice for families with severe food allergies is: know to the best of your ability what your child is allergic to, always be prepared for an acute allergic reaction every moment of every day, do your best to keep your child in a safe environment away from the offending allergens at home, school, restaurants,” Maslonka said.

You can read more about Noelle on CaringBridge.


Preparing kids (for things that weren’t their idea!)

This is a post by Jeri Kayser, who’s been a Child Life Specialist at Children’s Hospitals and Clinics of Minnesota since 1985. Her educational background is in child development and psychology. She has three children who have been a great source of anecdotes to help illustrate developmental perspective. They’re wonderful at being good sports about it.

Something needs to happen; something that was not your child’s choice, and it’s going to require some cooperation on their part. Maybe it’s a trip to the dentist, a haircut, a move to a new school or dinner with some overbearing relative at a restaurant with cloth napkins. Like all successful endeavors, a little planning can go a long way.

Working with children about to have surgery gives me a pretty unique vantage point as to what helps when preparing a child for something new and challenging. The following are some thoughts to consider when faced with this daunting task.


How do you feel about what’s coming up? What have been your experiences doing this event and what have you found helped or did not help? Personal confession: Going to the dentist is not on my top million list of things to do. I know this about myself so when it came time for my kids’ first visits to the dentist, I was honest about my feelings. I knew that anything I said about the upcoming visit to the dentist was going to contain some of my bias. While explaining what would be the sequence of events, I included where I felt challenged and what I did to make it better. Your emotional context of the event is going to be different from your child’s because you are unique individuals with unique perspectives.

Respect your knowledge of your child

How does your child best take in information? Do they need time to process or does time make them more anxious as they imagine every worse case scenario? Do they learn better hands-on or are they a better visual learner and like to read about a new event before they participate? Every child, at each stage of their development, is going to have their own way of approaching new information.

Find out what your child already knows

Often, when a parent has just confessed to me that they haven’t told their child anything about surgery, the child will be able to go into immense detail about what is going to happen. They know. They listen. They pay attention. The information is just so much more meaningful when there has been a direct conversation with opportunities to ask questions. When you ask your child what they already know, their response can give you helpful guidance in how they understand the event and what, if any, misconceptions they might have.

What to expect and what is expected of them

Not knowing what is going to happen is usually the source of anxiety, not what is actually happening. We as adults can think through all of the possibilities of what to expect and have more life experiences from which to draw. Kids tend to get more anxious about stepping into the great unknown and fear that loss of control. Explaining what will be happening in a step-by-step approach is comforting in its sense of predictability. Be sure about your facts. Shorter descriptions tend to be more accurate and easier to listen to. End the timeline of the event with something you will be doing when you are done and back home. This helps reinforce that the event won’t last forever and normalcy will return. Kids also need to know what is expected of them, when will they be required to be cooperative and what the repercussions for misbehavior are.

Questions from the audience

Make sure you leave time for questions right after you’ve finished explaining what will happen or later when your child may have additional thoughts on the topic. If you ask a person if they have any questions, the typical response is no.  A more helpful way to get to their thoughts could be to say, “Think of three questions you might have about (fill in the blank).” If you can’t answer a question, have your child write it down and make a list of questions to bring to whomever is most likely to have the answers.

Was it like what you thought it would be like?

This is a good question to sum up the experience. This is also a good question to encourage conversation about what went well and what they would want to change to make it even better the next time. If things didn’t go well, there is actually much to be learned by that. Success is a good ego booster, but failure is a better teacher. As you process what happened, you are also teaching your child how to face a new challenge, which is an invaluable gift for the rest of their life. Well-prepared kids tend to face any challenge with more skill, confidence and success.

Bonus round

It is very gratifying to watch your kids handle something you weren’t sure they could, and their self-discovery of just how strong they can be is priceless.

#childrenschat: The work continues after Childhood Cancer Awareness Month

September is National Childhood Cancer Awareness Month. Childhood cancer affects nearly one in 10,000 kids each year, and nearly 13,000 children under the age of 21 are diagnosed each year in the United States. While cancer is still the leading cause of death in children between infants and age 15, survival rates have increased significantly over the past few decades – up from 58 percent in the 1970s to nearly 80 percent in recent years.

While we’re glad there’s a month dedicated to raising awareness around childhood cancer, our work at Children’s Hospitals and Clinics of Minnesota doesn’t stop on Sept. 30. We continue working toward early detection, creating the best outcomes for our patients and advancing research.

On Monday, Oct. 1, we invite you to join Dr. Kris Ann Schultz and Dr. Joanna Perkins from our Cancer and Blood Disorders Clinic during #childrenschat to discuss what we’re doing to advance childhood cancer research.

Follow the hashtag #childrenschat on Twitter from 3 p.m. to 4 p.m. CST on Twitter. If you’re unable to participate or follow the chat, we’ll share a transcript of the chat on Tuesday, Oct. 2, right here on the Kids’ Health Blog. We can still take your questions, too. You can submit questions in advance by Tweeting them to @ChildrensMN with the #childrenschat hashtag or sending them to [email protected]

#childrenschat leaders:

Dr. Kris Ann Schultz





Dr. Joanna Perkins






• Childhood cancers: How does cancer impact kids differently? What is the latest in research?
• Children’s has a unique care philosophy for treating its pediatric cancer patients. What is it and how does it impact the patient and family experience?
• What is Children’s doing to advance cancer research?

We hope you will join us on Oct. 1. Read more about Childhood Cancer Awareness Month here.

The truth about exercise and pregnancy

Dr. Deb Krahl has been a practicing OB/GYN for 16 years. She received her medical degree from the University of Minnesota before completing her residency training at the University of California-Irvine. She has been with Aspen Medical Group for the last nine years and is currently the lead OB/GYN physician there. She is excited to be among the OB/GYN’s delivering at The Mother Baby Center.

Regular exercise is important to keep your heart, muscles and bones healthy. Exercise is just as important during your pregnancy and can have benefits during labor as well as help you get back into shape quicker after the baby is born. During pregnancy, regular exercise can help with backaches and constipation, prevent or treat gestational diabetes and improve your moods, help you sleep better and increase your overall energy level.

With the information overload in today’s world, it can be confusing for expectant moms to know which types of exercises are safe and which ones should be avoided in pregnancy. I hope this blog post will give you sound medical tips to follow as you start or continue an exercise regimen during your pregnancy.

1. Always check with your doctor first. Touch base with your doctor before beginning an exercise program to make sure you do not have an obstetric or health problem that would limit your activity.

2. Don’t overdo it. During exercise you should be able to talk normally and keep your heart rate under 140 beats per minute to avoid overexertion.

3. Be aware of the physical changes. The hormones in pregnancy cause the joints and ligaments to become more relaxed, so avoid any jerky movements that could cause injury. Also, with the added weight of the baby bump in the front, your balance and center of gravity are altered. This can cause you to be more unstable in certain positions, which can lead to falls and injury to you or your baby.

4. Don’t exercise to lose weight during pregnancy. You can exercise in pregnancy to stay in shape and feel better, but you shouldn’t try to lose weight in pregnancy by exercising or restricting calories.

Safe exercises for everyone during pregnancy:

Walking and swimming are great ways to start an exercise program. Cycling is a very good aerobic activity but after the first trimester, you should only cycle on a stationary bike to prevent falling off a road bicycle as your belly grows. Low impact and water aerobics, as well as strength training, are also terrific ways to get or stay in shape during your pregnancy. For any exercise activity, you should avoid lying on your back or standing still for prolonged periods of time after the first trimester.

Safe exercises for individuals in good shape prior to pregnancy:

If you’re a runner, you can continue running in pregnancy but may need to modify your routine or total distance, especially in the third trimester. Talk to your doctor to get specific questions answered.

Exercises and sports to avoid during pregnancy:

Any activities where you could lose your balance and fall should be avoided in pregnancy. This includes waterskiing, downhill snow skiing, horseback riding, gymnastics, tennis and racquetball. Any contact sports such as soccer, basketball and ice hockey should be avoided. Lastly, no scuba diving or using water slides in pregnancy.

Exercise tips:

Always warm up before and cool down after you exercise. Drink plenty of water and avoid exercising in hot, humid weather. Make sure you wear comfortable clothing and a supportive bra.

What to watch for during exercise:

If you experience any of these symptoms while exercising, you need to stop and call your doctor immediately: vaginal bleeding, dizziness, chest pain, uterine contractions, leakage of fluid from the vagina or decreased fetal movement.

Exercise during pregnancy has many benefits both during the pregnancy and after delivery. Even just a brisk walk every day can make a difference. All you need is the motivation to get out there and do it.

Visit The Mother Baby Center’s Facebook page for updates on its anticipated arrival. Due date: February 2013.

Teen dating 101: What makes a relationship healthy?

This is a post by Amy Moeller. Amy is a therapist who has worked with children and adolescents for 25 years. She works in the Adolescent Health Department at Children’s Hospitals and Clinics of Minnesota and treats teenagers experiencing depression, anxiety, social struggles and chemical dependency. In addition, Amy co-founded The Family Enhancement Center in south Minneapolis 17 years ago. She works at the center part time with children and families who have been affected by physical abuse, sexual abuse and neglect. Amy is married and the mother of three children. 

School has started and with a new school year comes new friends and people to “hang out with.” My son and his friends tell me that no one uses the word “dating,” anymore. You “hang out” with someone. When questioned further, it sounds like dating to me.

Dating has changed since I was in high school. It’s neither wholly better or worse. It’s just different. Gone is the traditional “date” where boy picks up girl, and they go to a movie or out to a restaurant. Instead, they hang out in packs for the night. For the most part, I see this as a good thing. With a group of friends, they have each other’s back. Some would argue that this increases peer pressure and what they may do in a group, they may not do alone. This has not been my experience either in my work or in my own home. Peer pressure can be present anywhere. Whether a teen has the self-esteem and the skills to resist it is the key. It doesn’t matter whether they’re on a traditional date or with a pack.

So, what does a healthy relationship look like? Since some adults have trouble with this concept, it’s paramount we educate and provide guidance to our teens as they form relationships.  As a mom, I’ve discussed the following points with my children, and I hope you’ll find them beneficial, too:


You knew this was coming, right? This is the hallmark of any healthy relationship. Communication means you can share things about yourself and about your feelings. You can express worries, fears, and insecurities without fearing the other person will ridicule them or put them down. There can be disagreements without fighting. In a healthy relationship, people stay calm and talk about how they feel.

Respect and trust

Respect each other. In healthy relationships people view each other as equals. Girls should not buy into the myth that “he is the boss.” In a healthy relationship neither person controls or serves the other.  Your partner’s wishes and feelings have value. Let your partner know that you are making an effort to keep their ideas/wishes/needs in mind.  Trust means that you and your partner are not possessive of each other. You can spend time apart and with other friends without the other person becoming suspicious.

Negotiation and compromise

Negotiation means you talk until you reach an agreement. Compromise means each person gives up a little of what they want until an agreement is reached. This is not always easy, but it is a skill children and teens will carry with them throughout life. “Give and take” is the name of the game.  Try to solve conflicts in a fair and rational way. Be assertive, not aggressive. Being assertive means you ask for what you want in a clear and respectful way. Being aggressive means using intimidation, threats or force to get what you want. If you feel you are being bullied, then the other person is being aggressive, not assertive.


Be supportive of each other. Offer reassurance and encouragement to your partner. Support each other’s goals and aspirations. Encourage your partner to do their very best.

Signs of an unhealthy relationship

Parents typically discuss dating rules with their teen. They talk about where they are going, what they are doing and when they will be home. But have you discussed red flags, different forms of abuse and unhealthy qualities in a relationship?

Some of the first signs that your teen is in an unhealthy relationship is that they spend all their time with that person. They lose contact with their other friends and seem only to be with their significant other. That person discourages your teen from seeing other friends and family and interferes with their past routine activities.

Some questions to discuss with your teen: Is the other person putting you down? Does he/she harass or embarrass you? Does he/she try to keep you away from friends and family? Does he/she spy on you or want to keep constant tabs on you? Does he/she want to look at your text messages or want the passwords to your social media sites? These are all red flags and signs of emotional abuse.

Physical abuse includes not only hitting but also pushing, shoving, kicking or grabbing. In the past 12 months, one in 10 teens reported they have been hit or physically hurt on purpose by a boyfriend or girlfriend. Twenty percent of American teenage girls report that they have been hit, slapped or forced into sexual activity by their partners.

Sexual abuse includes not only rape but also any unwanted sexual contact or trying to constantly talk a person in to sexual things they have said “no” to.

Let your teen know that if they think they are in an abusive relationship or they have questions about healthy relationships, talk to a trusted adult. This could be a parent, teacher, school counselor, pastor or a friend’s parent.  Hopefully it will be you, their parent, but if not, give them other resources.

If you need to reach out for more help you can contact:

The National Domestic Violence Hotline: 1-800-799-SAFE

The National Teen Dating Abuse Helpline: 1-866-331-9474


Making safe simple booth visit helps prevent at-home emergency

For the past two years, we’ve taken our Making safe simple program to the Minnesota State Fair. For 12 days from dawn until after dusk, we educate fairgoers on ATV, bike, car seat, and household safety.

Our goal is to help families prevent injuries and, in the case of an emergency, how to best respond. We hope no family experiences an emergency. But reality tells us it will and does happen.

Each year, 5,000 children die and another six million are hurt because of unintentional injuries. One in four kids is hurt seriously enough to need medical attention. We believe that, together, we can make safe simple.

That became even more apparent after the fair when we received the following email from Sarah who had visited our Making safe simple booth. Hours within visiting the fair, her family had taken our advice and put it into action to prevent an emergency from escalating. Here’s her story:

THANK YOU for the great, life-saving, or at least, garage-saving safety information your team provided at the Fair. My family and I visited your booth today and took your safety quiz this year. We’ve gone in the past and had fun, but this year it was extra helpful.

I got a “hard” question in the Plinko area and was asked about how to operate a fire extinguisher. I had to think about it a bit, but came up with a passable answer. The volunteer then taught us the PASS acronym about pulling the pin, aiming, squeezing the trigger and sweeping back and forth.

Not eight hours later, I looked out the back window of our kitchen and saw our grill on fire, flames all over the front. My husband and I jumped to our feet, grabbed the extinguisher and knew EXACTLY what to do. The fire was put out safely in just a few seconds—before the flames could jump to the adjacent tree, our garage, fence or the neighbor’s house. Whew!

Please pass my heartfelt thanks along to your wonderful team of fair volunteers. The information they provided helped us calmly and effectively deal with a household emergency—before it became a real emergency. We are all safe and sound tonight because of your help!

Thanks, Sarah, for sharing your story.


West Nile virus cases are up; you can take precautions

Empty water-holding containers like rain barrels, flowerpots and buckets.

The number of West Nile virus cases is quickly rising in the United States. There’s a record-setting number of  cases up to this point in the year since the virus was first detected here in 1999, according to the Centers for Disease Control and Prevention.

As of Sept. 4, 48 states had reported West Nile virus infections in people, birds or mosquitoes. The CDC received reports of 1,993 cases of the viral disease in people, including 87 deaths.

While more than 70 percent of the cases have been reported in Texas, South Dakota, Mississippi, Oklahoma, Louisiana and Michigan, there have been cases in Minnesota, too.

“Most people — adults and children — who are infected by West Nile virus, show no symptoms at all.  The disease can present like many other viral illnesses with fever, headache, and body aches. Sometimes a rash on the trunk or swollen lymph nodes are seen,” said Dr. William Pomputius, medical director of Infectious Disease and Immunology at Children’s Hospitals and Clinics of Minnesota. “In general, 1 in 150 people may develop severe disease with high fever, stiff neck, and nervous system symptoms, but children are much less likely than adults to have this complication. Parents concerned about their child’s health should see their health care provider.”

The latest report from the CDC serves as a reminder that we should take precautions to avoid the mosquito-borne illness.

The No. 1 way to prevent getting West Nile is to avoid a mosquito bite. We know that’s easier said than done. So, we compiled some tips from the CDC and the Minnesota Department of Health to help:

  • Eliminate water-holding containers from your property. Get rid of mosquito breeding sites by emptying standing water from flowerpots, buckets and barrels. Change the water in pet dishes and replace the water in birdbaths weekly. Drill holes in tire swings so water drains out. Keep children’s wading pools empty and on their sides when they aren’t being used.
  • Use mosquito repellent that contains up to 30 percent DEET (10 percent for children)
  • Wear long sleeve shirts and pants
  • Avoid outdoor activity during dusk and dawn, when mosquito activity is highest.


Zeroing in on childhood obesity

This is a post by Dr. Julie Boman, a pediatrician at Children’s Hospitals and Clinics of Minnesota.

The fact that September is National Childhood Obesity Awareness Month means that childhood obesity is well accepted as an epidemic in our country. Children’s Hospitals and Clinics of Minnesota recently released a white paper that examined the issue of childhood obesity. The assessment revealed a startling conclusion from an obesity expert with the World Health Organization that “the die is cast by the age of five,” referring to the prenatal and early childhood determinants of a child’s likelihood of becoming obese.

The frustration is that we know the causes and even the solutions, but the pathway to success is far from clear.  We know that getting kids to exercise more, eat healthier and avoid too much screen time are part of the equation. However, when we add in the factors of underlying health disparities, food deserts, the need for family-based interventions or acceptance of healthier prenatal and early childhood practices, the answers quickly become far more complicated.

For me, the complicated nature of the problem simply means that we need more creativity and flexibility in how we tackle the problem. As someone who has devoted her career to the health interests of children, I can’t stand by and watch more children come into Children’s clinic with conditions that, 20 years ago, were almost exclusively associated with adults: Type 2 diabetes, high blood pressure, elevated cholesterol, and liver disease.

That’s why earlier this year, in partnership with the Minnesota Chapter of the American Academy of Pediatrics and supported by Children’s, I spearheaded an initiative focused on providing support and resources to the Minneapolis Latino community to foster healthier eating and more physical activity. Called Vida Sana Minneapolis, the initiative is built on several guiding principles that we believe are critical to the success of the program:

  • Community-based: Engaging community partners in the planning and implementation of the program.
  • Family-based: Understanding the powerful influence family dynamics have on a child, particularly if the goal is to prevent problems in the first few years of a child’s life.
  • Culturally-appropriate: We can’t assume a one-size fits all approach.
  • Responsive. Letting families shape a program that they need rather than imposing a program on them.

Initially supported by a grant from the National Initiative for Children’s Healthcare Quality, we’ve built a coalition of 15 different private and public organizations that have a vested interest and desire to promote healthy lifestyles with the Latino community. The response so far is inspiring. At our kick-off event in July, attendance far exceeded expectations with more than 200 people participating in a mini health fair that included health screenings and education on nutrition and physical activity. More importantly, we’ve seen a sustained interest from Latino families and other community interests. After just two months of weekly evening events that include Zumba classes and activities for children, we’re already expanding our programming to include nutrition classes for families, Zumba and yoga for kids and are considering an additional night of Zumba for adults.

The growth doesn’t stop there. Thanks to a newly-formed partnership between Children’s and HealthPartners focused on childhood obesity, the Vida Sana project will continue to build by broadening our reach, more active recruitment within the community and incorporating elements such as BMI screenings and physician engagement. Vida Sana continues to gain interest from potential partners and others interested in highlighting how we’ve approached the program. As proud as we are of that growth, this program alone won’t solve the problem.

The bottom line is, when it comes to the issue of childhood obesity, we can’t afford to wait for the perfect solution. By building on the lessons learned from previous efforts and being flexible to allow for real-time learning and adjustment, programs like Vida Sana can make a difference. Yes, the problem is severe but, as the last several months working on this project have shown me, there’s also reason to be optimistic for one fundamental reason: parents want their children to be healthy. There is no greater motivation; our job is to empower them to make the choices that will achieve that goal.

For more information about Vida Sana, contact Dr. Julie Boman at [email protected]. For more information about Children’s childhood obesity efforts, contact Anna Youngerman at [email protected].

First-time moms-to-be: What to expect during the last three months

Dr. Deb Krahl has been a practicing OB/GYN for 16 years. She received her medical degree from University of Minnesota before completing her residency training at the University of California-Irvine. She has been with Aspen Medical Group for the last nine years and is currently the lead OB/GYN physician there. She is excited to be among the OB/GYN’s delivering at The Mother Baby Center.

For most first-time moms-to-be, the last three months of their pregnancy are a mixture of excitement, joy and anticipation, but there are also concerns about labor and becoming a parent in general. Some moms-to-be are energized and relish each and every day of their pregnancy wishing it could last 50 weeks instead of 40 weeks. Other expecting moms are exhausted due to lack of sleep and low back pain, have extremely puffy feet and are counting the days and hours until they can go more than two hours in between bathroom breaks. No matter what experience you’re having as a first-time mom-to-be, here are some practical tips to consider during the last three months of your pregnancy:

Maximize your sleep. Take advantage of sleeping in on weekends and naps when you can. Once the baby is born, you won’t have this luxury!

Keep busy. If you work, keep working your normal schedule as long as possible (assuming you are physically able and there are no restrictions from your doctor). If you exercise, continue your low impact routine to stay in shape for labor and delivery and your overall health.

Spend more time with your partner. Go see a movie, out to dinner, or on walks. Once you become parents, your time alone as a couple is significantly decreased and will be influenced by who you trust to watch the baby if you do want couple time together.

Learn more about the labor and delivery process. The most comprehensive way is to take a Labor and Delivery class offered through the hospital or your doctor’s office. These classes usually cost $100 and include a tour of the hospital. If you don’t want to spend money on these classes, I strongly recommend doing the FREE TOUR of the Labor and Delivery area that all hospitals offer. It would also be helpful to read about the stages of labor and pain relief options available. The more familiar you are with your surroundings and what to expect for each stage in labor, the more relaxed you will be when it happens.

Learn more about newborn care and breastfeeding. First-time moms-to-be are often caught up thinking about Labor and Delivery and forget to learn about basic newborn care and techniques for breastfeeding. There are many books on these two topics, so find ones that appeal to you. If you don’t have time to read up before the birth, don’t worry! Hospitals have great videos to watch after the baby is born in the postpartum rooms, and your pediatrician will be another wonderful source for years to come regarding questions about your baby.

Take your DHA. DHA is proven to help with baby brain development. You need to take DHA in addition to your prenatal vitamins every day after 28 weeks. Check your prenatal vitamins as some already have the DHA in them.

Don’t worry about how your labor will go. It’s normal for expecting moms to be nervous about labor (even OB/GYN doctors don’t know how their labors are going to go when they’re pregnant!), but don’t let it consume your thoughts. Your Labor and Delivery nurses and your doctor will be there to help guide and support you through the process. Be an active participant in your labor and be open to options for pain relief. It doesn’t matter if you get an epidural or if you have a vaginal delivery or Cesarean section; the important part is to have a healthy mom and baby! Your labor team will do everything in their power to accommodate your wishes in labor and make it a wonderful experience as you bring your new child into the world.

For first-time moms-to-be, the last three months of pregnancy are usually a mixture of physical and emotional changes. Hopefully, the above tips will help guide you in your preparation for labor and becoming a parent!

Like The Mother Baby Center on Facebook and visit the website.