The addition of a new baby to the family brings many changes and challenges, especially when you're having twins or multiples. In addition to the logistics of caring for two (or more) newborns, many parents have the added task of caring for older children.

Older siblings, particularly if they were previously an only child, may have difficulty adapting. However, there are some ways to prepare yourself and your family for all the chaos and joy multiples can bring.

1. Involve your children. During your pregnancy, talk early and often about the new babies, giving your child as much time as possible to get used to (and even excited about!) the idea. When practical, let your child help with picking out nursery décor, shopping for other baby items and baby-proofing the house. Get your child a baby doll to learn to care for and schedule visits with friends or relatives who have newborns. It is important for your child to have some trial periods of seeing you hold and care for other babies.

2. Limit other big changes when possible. New babies on the way might mean that your older child needs to move from a crib to a bed or into a new bedroom. If possible, make this transition well in advance of your anticipated delivery so he is comfortable in a new environment and doesn't feel suddenly displaced by new siblings. If he is hitting a big developmental change, such as toilet training, try to complete this before the babies are born or to wait until things have settled down again after. Also, be prepared for some regression. Your toddler who was drinking from a cup and peeing on the potty may want to return to bottles and diapers to claim back a little more of your attention. Be patient and offer praise for "big kid" behaviors.

3. Plan ahead for your hospital stay. Think about who you could call on in the middle of the night or who could support you in labor if your spouse needs to stay with the children. Also, keep in mind that twins and multiples come with a higher risk of preterm delivery, which might extend their hospital stay. In the event that they need to spend time in the NICU, who would be able to help care for the rest of your family back at home? Whenever your new bundles of joy come home, consider having them bring a gift for their older siblings to remind them they haven't been forgotten.

4. Give older siblings responsibilities. With newborn multiples, the cycle of feeding, changing, bathing and (hopefully!) sleeping added to routine household tasks like cooking or laundry can be daunting. Encourage older siblings to help with the babies and housework. Sure, chores done by these little helpers may take longer or be less-perfectly executed, but the moment of rest you get and the sense of importance they get makes it worth it. Make time for one-on-one interactions with your older children each day doing something that's fun for them, and encourage friends, relatives or neighbors to take them on special outings without the babies.

5. Be patient. Finding a new rhythm takes time. Being able to juggle raising multiples, caring for the rest of your family and managing everyday life doesn't happen overnight. Be patient with yourself and your other family members, as you embark on this new journey.■

Dr. Eleanor Eichman is a pediatrician at Sixteenth Street Community Health Centers.


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