How to Prepare Your Older Children for a New Baby

A new baby brings joys and challenges to a family. You’re excited, but you may also be nervous about how your older children will react to the newborn.

All sorts of questions come up: How should we tell our older children that they are going to have a baby brother or sister? Will they be jealous of the new baby? How can we help them get along? 

Children of different ages will react differently to a new baby.

Knowing what to expect from each age group will make it easier to handle the changes in your family.

Toddlers – Ages 1 To 2 Years

Children of this age will not understand much about what it means to have a new brother or sister. However, let your child hear you talk about the “new baby” and feel your excitement. She may not understand why you are excited, but your attitude will rub off on her and she will feel excited too.

Keep in mind, you may not be able to satisfy the needs of both children all the time—especially not by yourself. If you feel overwhelmed, look to your partner, other relatives, and friends for support and an extra set of arms.

  • Look at picture books about a new baby. At the very least, your child will become familiar with words like “sister,” “brother,” and “new baby.”
  • When the new baby arrives, try to do something special for your older child. Reassure her that she is still loved. Some ideas include giving her a special gift, letting her spend some time alone with dad, grandma, or another special adult, or taking her someplace special.

Preschoolers – Ages 2 To 4 Years

At this age, your child is still very attached to you and does not yet understand how to share you with others. Your child also may be very sensitive to change and may feel threatened by the idea of a new family member. Here are some suggestions that may help ease your preschooler into being a big brother or big sister.

  • Wait a while before telling your preschooler about the baby. Explain it to your child when you start buying nursery furniture or baby clothes or if he starts asking about mom’s growing “stomach.” Picture books for preschoolers can be very helpful. So can sibling classes (ask your hospital if it offers them). Try to tell your child before he hears about the new baby from someone else.
  • Be honest. Explain that the baby will be cute and cuddly but will also cry and take a lot of your time and attention. Also, make sure that your older child knows that it may be a while before he can play with the new baby. Reassure your child that you will love him just as much after the baby is born as you do now.
  • Involve your preschooler in planning for the baby. This will make him less jealous. Let him shop with you for baby items. Show him his own baby pictures. If you are going to use some of his old baby things, let him play with them a bit before you get them ready for the new baby. Buy your child (boy or girl) a doll so he can take care of “his” baby.
  • Time major changes in your child’s routine. If you can, finish toilet training or switching from a crib to a bed before the baby arrives. If that is not possible, put them off until after the baby is settled in at home. Otherwise, your child may feel overwhelmed by trying to learn new things on top of all the changes caused by the new baby.
  • Expect your child to regress a little. For example, your toilet-trained child might suddenly start having “accidents,” or he might want to take a bottle. This is normal and is your older child’s way of making sure he still has your love and attention. Instead of telling him to act his age, let him have the attention he needs. Praise him when he acts more grown-up.
  • Prepare your child for when you are in the hospital. He may be confused when you leave for the hospital. Explain that you will be back with the new baby in a few days.
  • Set aside special time for your older child. Read, play games, listen to music, or simply talk together. Show him that you love him and want to do things with him. Also, make him feel a part of things by having him cuddle next to you when you feed the baby.
  • Ask family and friends to spend a little time with your older child when they come to see the new baby. This will help him feel special and not left out of all the excitement. They might also give him a small gift when they bring gifts for the baby.
  • Have your older child spend time with dad. A new baby presents a great opportunity for fathers to spend time alone with older children.

School-Aged Children – Ages 5 and above

Children older than 5 years are usually not as threatened by a new baby as younger children are. However, they may resent the attention the new baby gets. To prepare your school-aged child for a new baby,

  • Tell your child what is happening in language she can understand. Explain what having a new baby means and what changes may affect her—both the good and the not so good.
  • Have your older child help get things ready for the new baby by fixing up the baby’s room, picking out clothes, or buying diapers.
  • If possible, have your older child come to the hospital soon after the baby is born so she feels part of the growing family.
  • When you bring the new baby home, make your older child feel that she has a role to play in caring for the baby. Tell her she can hold the baby, although she must ask you first. Praise her when she is gentle and loving toward the baby.
  • Do not overlook your older child’s needs and activities. Let her know how much you love her. Make an effort to spend some time alone with her each day; use that as a chance to remind her how special she is.

Source: Adapted from Sibling Relationships (Copyright © 2007 American Academy of Pediatrics, updated 3/2007). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Breastfeeding During the COVID-19 Pandemic

The outbreak of COVID-19 is a stressful time for everyone. This may be especially true for mothers who are breastfeeding and concerned about their baby’s health. However, new moms can successfully start and maintain breastfeeding during the pandemic​, with some recommended precautions.

Benefits of breastfeed​ing d​uring a pandemic

  • Breastfeeding is good for babies. It protects them from many infections. While it is still not clear if this is true for the COVID-19 virus, breastfed infants are generally less likely to have severe respiratory symptoms when they get sick.
  • Breastfeeding i​s good for moms. Hormones released in the mother’s body during breastfeeding promote wellness and can relieve stress and anxiety.
  • Breast milk is readily available. No purchase necessary!

Is breastfeeding and exp​ressed breast milk feeding safe during the COVID-19 pandemic?

COVID-19 spreads between people who are in close contact, mainly through respiratory droplets when an infected person coughs, sneezes, or talks. To date, there is no evidence that COVID-19 is passed from mother to baby in breastmilk. Breastfeeding has been shown to be safe when a mom has other illnesses like the flu.

Can my baby continue breas​tfeeding or drinking expressed breast milk if I test positive for COVID-19 or if I am a person under investigation?

Yes, babies can still receive breast milk even if you test positive for COVID-19. It is recommended that you pump or express your breast milk after carefully cleaning your breasts and hands and have a healthy caregiver feed your baby the expressed breast milk.

It’s also very important to clean your breast pump after each use. Follow CDC guidelines for proper cleaning and disinfecting recommendations.

Remind all caregivers to wash hands thoroughly before touching bottles, or feeding or caring for your baby. If you decide to breastfeed directly, take all the recommended steps to prevent the potential spread of the virus, including using a mask and following careful breast and hand hygiene.

If I have COVID-19, can​ I stay in the same room with my infant?

If you have COVID-19 or are suspected of having COVID-19, staying in a different room from your baby is the safest way to keep your newborn healthy. A healthy caregiver should take care of the baby and can feed expressed breast milk.

If you and your family decide to keep your baby in the same room as you, keep a distance of at least 6 feet from your baby. When closer than 6 feet, wear a mask and make sure your hands are clean.

If you have COVID-19, you can stop isolating yourself from your baby once you are fever-free without use of fever medicines (acetaminophen or ibuprofen) for at least 72 hours; when your other symptoms of COVID-19 are improving; and when at least 10 days have passed since your symptoms started.

​Tip: Ask your pediatrician​ for help with getting your baby to latch on again once you can restart breastfeeding.​

How can I maintai​n my milk supply if I am sick with COVID-19?

Hand pumping and hand expressing breast milk is especially helpful in the first few days after your baby is born to get the milk supply going. Frequent pumping (or breastfeeding if you have chosen to directly breastfeed and are following the strict precautions noted above) should line up with your infant’s feeding demands, about 8-10 times in a 24-hour period.

Most medications are safe to take while breastfeeding, but always check with your doctor.

​While this may be a stressful time, try to stay optimistic and practice healthy habits to reduce stress as much as possible. This includes getting enough sleep, eating​​ plenty of healthy foods, and getting regular exercise.​

Do not hesitate to ask for help if you have trouble with feeding, nipple pain, low milk supply, or with any other concerns.

How can I protect my infant from​ COVID-19 infection?

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer. Look for one that is 60% or higher alcohol-based. Avoid touching your face, eyes, nose, or mouth with unwashed hands. Also, be sure to clean visibly dirty or possibly contaminated surfaces your infant may touch.

If you feel sick, be extra careful to cough or sneeze into your sleeve or a tissue. Throw away used tissues immediately and wash your hands.

Practice physical distancing by avoiding public spaces and stay 6 feet away from others whenever possible. And be sure that everyone in your home avoids close contact with anyone with respiratory symptoms such as coughing or individuals with probable COVID-19.

Your pediatrician is here to ​help

After leaving the hospital, it is important that your baby’s first follow-up visit happen in person so your baby can be measured and weighed accurately. Many doctors are scheduling newborn visits during specific times (such as first thing in the morning) to limit exposure to sick patients. While some doctors are also doing more work via phone and video, this is not the best option for newborns.


Breastfeeding is a key preventive health step for baby and mother, even during the pandemic. Talk with your pediatrician about how to keep your baby healthy and what resources might be available in your community to help you.

By Temitope Awelewa, MBCHB, MPH, FAAP, IBCLC, is a board-certified general pediatrician, a physician informatics officer and a clinical assistant professor of pediatrics at the University of Iowa. Within the American Academy of Pediatrics, she is a member of the Section on Breastfeeding and the Chapter Breastfeeding Coordinator for the Iowa Chapter of the American Academy of Pediatrics. Source: American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Why Choose a Pediatrician?

Expectant couple sitting outside café
Expectant couple sitting outside café

Why should you choose a pediatrician?

Pediatricians are trained to:

  • Help you determine healthy lifestyles for your child and useful ways to role model your choices.
  • Offer advice to prevent illness and injuries.
  • Provide early and appropriate care of acute illness to prevent its progression.
  • Treat life-threatening childhood conditions requiring intensive care.
  • Guide you in anticipating your child’s needs from newborn to 21.

As part of their extensive training, pediatricians are experienced in the physical, emotional, and social development of children. Children may be too young or shy to talk so pediatricians understand the importance of listening carefully to your child, and to you. Pediatricians answer your questions, helping you to understand and promote your child’s healthy development. Pediatricians also address issues affecting a child’s family and home environment.

Pediatricians understand that children are not simply small adults.
As part of their extensive training, pediatricians are experienced in the physical, emotional, and social development of children. Children may be too young or shy to talk so pediatricians understand the importance of listening carefully to your child, and to you. Pediatricians answer your questions, helping you to understand and promote your child’s healthy development. Pediatricians also address issues affecting a child’s family and home environment.

Last Updated 11/21/2015. Source How Special Is Your Child? (Copyright © 1998 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

New Moms: Bonding With Your Baby


If you have a delivery without complications, you’ll be able to spend the first hour or so after birth holding, stroking, and looking at your baby. Because babies are usually alert and very responsive during this time, researchers have labeled this the sensitive period.

The first exchanges of eye contact, sounds, and touches between the two of you are all part of a process called bonding, which helps lay the foundation for your relationship as parent and child. Although it will take months to learn your child’s basic temperament and personality, many of the core emotions you feel for her may begin to develop during this brief period immediately after birth. As you gaze at her and she looks back, following your movements and perhaps even mirroring some of your expressions, you may feel a surge of protectiveness, awe, and love. This is part of the attachment process.

It’s also quite normal if you do not immediately have tremendously warm feelings for your baby. Labor is a demanding experience, and your first reaction to the birth may well be a sense of relief that at last it’s over. If you’re exhausted and emotionally drained, you may simply want to rest. That’s perfectly normal. Give yourself until the strain of labor fades and then request your baby. Bonding has no time limit.

Also, if your baby must be taken to the nursery right away for medical attention, or if you are sedated during the delivery, don’t despair. You needn’t worry that your relationship will be harmed because you didn’t “bond” during this first hour. You can and will love your baby just as much, even if you weren’t able to watch her birth or hold her immediately afterward. Your baby also will be fine, just as loving of you and connected to you.

Last Updated 11/3/2014. Source Caring for Your Baby and Young Child: Birth to Age 5 (Copyright © 2009 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Heading Out With Baby


Technically speaking there aren’t many items that we consider a must-have before taking your baby out of the house, especially if you’re not planning on strolling far from home. There are, however, definitely some useful items we’ve found best to have on hand, and others that we feel have earned their characterization as modern-day conveniences. Here are a few thoughts and suggestions for when you’re ready to get on the go again.

Diapering supplies. It’s Murphy’s Law of Newborns that if you don’t have a diaper within arm’s reach at all times, babies are all but guaranteed to poop the first chance they get.

Accommodating change (of clothing). Expect to need at least one complete change of clothing—definitely for your newborn, but quite possibly for yourself as well. Blowouts, leaks, and spills are far less stressful if you’ve planned ahead.

Food for thought. Newborns don’t care how recently they’ve been fed before setting out on an adventure. The minute you and your newborn step out the door, any semblance of a feeding schedule you may have achieved within the confines of your home has the distinct possibility of flying right out the window. In short, you’ll never regret being prepared to feed your baby on the go.

Baby carriers. Right off the bat let us tell you that we love baby carriers. They offer new parents a comfy, cozy, baby-friendly, hands-free option when on the move. Remember, though, that your baby should not routinely sleep in the carrier. If she falls asleep while being carried, check frequently to ensure that her head and neck are straight and her face is uncovered. If possible, it is best to put your baby in a safe crib or bassinet for naps.

Weight limits. Some baby carriers aren’t designed for use by small infants. If you plan on using one early on, double-check the lower weight limit first.

Support. As we’ve mentioned, babies are born with poor head control and neck support. Be sure to choose an appropriate carrier for your baby’s development and motor abilities. Avoid using a carrier that curls your baby’s body into a “C” shape or where your baby’s head drops forward to a chin-to-chest position; this position can pinch off your baby’s windpipe. Make sure your baby’s head is up and above the fabric, her face is visible, and her nose and mouth are not covered by any part of the carrier or by your body or clothing.

Comfort level. Not all baby carriers are created equal when it comes to comfort. You’ll want to consider ease of use—how comfortable you are strapping it on and putting your baby in it—as well as how comfortable you find the carrier to be. Remember to factor in how much you plan on using the carrier, because some are perfectly comfortable at first but quickly become less so when put to the test by heavyweights.

Price points. Factor in cost to determine if you’re getting what you pay for. This really is a personal preference. Some parents consider the more expensive, Cadillac-equivalent baby carriers to be well worth the price they must pay for them—especially if they are easier to use and as a result, end up being put to more use. Others find that the more economical models serve their purposes just as well.

Strollers. From the basic umbrella stroller to a top-of-the-line double jogging stroller, parents these days have nearly unlimited options to meet their needs—whether it’s transporting your baby through a shopping center, going on a daily jog, or strolling a colicky baby down the hallways of your own home (a “remedy” that, in some parents’ minds, even justifies the purchase of an extra stroller specifically for use indoors!). You may ultimately find that having a few different strollers is worthwhile—a lightweight umbrella stroller for quick trips or to use when traveling, a sturdier stroller for outdoor errands, and a jog stroller if you’re the athletic type (or want to look or feel the part)—but for the time being, you’ll want to narrow your scope a bit and look for strollers that are appropriate for newborns.

Rate of recline. In general, newborns need strollers that offer a fair degree of recline because their development does not yet allow them to sit upright and hold their heads high. Some stroller seat backs even recline completely to aid with napping—a feature whose usefulness extends well beyond the first few weeks and months. Most jogging strollers, on the other hand, aren’t recommended for use during the first 5 or 6 months because they aren’t designed to recline (although some have secure enough harnesses and positioning for younger babies).

Canopies and covers. Whether it’s windy, rainy, or sunny out, some type of stroller canopy is guaranteed to prove useful in protecting your baby from the elements. Some cover more than others, so consider the weather variations in your area. These may also help your baby sleep while in the stroller, and keep well-intentioned but nevertheless germ-covered hands from reaching in and touching your baby.

Travel systems. A car seat and stroller may come as a matching set, or a special attachment can allow car seats of various makes to hook on securely to a stroller. Each of these options allows for easy transfer of your baby from car to stroller and back without requiring you to remove her from her seat. If you don’t plan on keeping your baby in her car seat while strolling, this option is unnecessary. If you do plan on taking advantage of the convenience of (potentially) uninterrupted slumber in the car seat, just be aware that there is growing concern among experts that allowing infants to spend extended amounts of time in their car seats (and seats in general) may not be good for infants for a variety of reasons. What counts as “extended amounts of time”? Unfortunately, we don’t have an answer for you (because there isn’t one yet), but we suggest that in addition to never leaving your infant unattended in a child safety seat, you don’t get into the habit of relying on it as a prolonged sleep site.

Last Updated 8/7/2013. Source Adapted from Heading Home With Your Newborn, 2nd Edition (Copyright © 2010 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Join Our Mommy & Baby Support Group

When you welcome a newborn into the family, you also welcome a host of questions and challenges. It’s times like this that you rely on the support and guidance of others — family and friends especially, but also from the community of new moms who are probably wondering and worrying about the same things.
Pediatrics Plus offers a Mommy and Baby Support Group that was created for just that reason.
Led by clinician Danielle Izzo, a Family Nurse Practitioner and Certified Lactation Counselor, the group meets every other Wednesday to answer questions, offer support, and give moms and babies a safe place to interact.
Here’s what some group moms had to say:
“This group has been great…it is so nice to be able to talk with other new moms. I always leave having learned new things to try.”
“I’ve learned a lot by going there and have enjoyed sharing the joys and challenges of motherhood with everyone. I look forward to going! ”
“I recommend this group to any mothers in the area who are breastfeeding or planning to breastfeed. Being able to meet with other breastfeeding mothers in person, with support and information provided by a certified lactation counselor, is very helpful.”

We hope you’ll join us! The Mommy and Baby Support Group meets every other Wednesday from 6:30-7:30pm in the Pediatrics Plus lower lounge. It is free and open to the public.
• Wednesday, May 29,
 6:30 PM
• Wednesday, June 12, 6:30 PM
For more information, call Danielle Izzo at (203) 239-4627 or click here to visit the Meetup Group online.