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Anorexia #NationalEatingDisorderAwarenessMonth

Posted on February 26, 2025 by Patrick Hercules

Anorexia nervosa, more commonly known as anorexia, is an eating disorder that involves severe calorie restriction and often a low body weight based on personal weight history. It is a complex condition that has mental, behavioral, and physical symptoms.

People who have anorexia often have a strong fear of gaining weight and may think they’re overweight, even if they are not. To prevent gaining weight or to continue to lose weight, people with anorexia often limit the amount or type of food they eat. They do this by restricting the number of calories they consume, resulting in a nutrient deficit and usually, but not always, a very low body weight.

Anorexia can cause changes in the brain due to malnutrition. If left untreated, weight loss can get to a point where people with anorexia are at high risk of serious physical harm or death. Anorexia has the second-highest death rate of any mental illness, surpassed only by opioid overdoses. Most anorexia-related deaths stem from heart conditions and suicide.

There are two subtypes of anorexia nervosa based on eating behaviors:

Restrictive anorexia– the person severely limits the amount and type of food they eat

Binge-purge anorexia– the person greatly restricts the amount and type of food they eat. However, they also have binge-eating and purging episodes where they eat large amounts of food in a short time and then intentionally vomit or use laxatives or diuretics to get rid of what they consumed.

Anorexia involves physical, behavioral, and emotional and mental signs and symptoms.

Emotional and mental signs of anorexia include:

Intense fear of gaining weight
Body dysmorphia
Obsessive interest in food, calories, and dieting
Fear of certain foods or food groups
Being very self-critical
Denying the seriousness of your low body weight and/or food restriction
Feeling a strong need to be in control
Insomnia

It is common to have other mental health conditions alongside anorexia, you may have additional mental and emotional symptoms.

Behavioral signs of anorexia include:

Changes in eating habits or routines, such as eating foods in a certain order or rearranging foods on a plate
A sudden change in food preferences, such as eliminating certain food types or food groups
Making frequent comments about feeling “fat” or being overweight despite weight loss
Purging through intentional vomiting and/or misusing laxatives or diuretics
Going to the bathroom right after eating
Misusing diet pills or appetite suppressants
Compulsive and/or excessive exercising
Continuing to limit calories even when your weight is love for your sex, height, and age
Wearing loose clothing and/or wearing layers to hide weight loss and stay warm
Withdrawing from loved ones and social events

Physical signs and symptoms of anorexia can include:

Significant weight loss over several weeks or months
Not maintaining an appropriate body weight based on your height, age, sex, stature, and physical health
Unexplained change in growth curve or body mass index (BMI) in children and still-growing adolescents

Physical signs and symptoms of anorexia that are side effects of starvation and malnutrition include:

Dizziness and/or fainting
Fatigue
Abnormal heart rhythm
Low blood pressure
Feeling cold all the time
Absent periods or irregular menstrual periods
Bloating and/or abdominal pain
Muscle weakness and loss of muscle mass
Dry skin, brittle nails, and/or thinning hair
Poor wound healing and frequent illness

Anorexia is a complex condition with no singular cause. Research suggests that a combination of certain factors may be responsible, such as:

Genetics
Brain changes
Trauma
Environment and culture
Peer pressure
Emotional health

Anorexia nervosa affects all gender identities, races, ages, incomes, and body types. It is also more common among teenagers, although people of any age can develop anorexia. Teens can be more at risk due to all of the changes their bodies go through during puberty. They also face peer pressure and can be more sensitive to criticism or casual comments about weight or body shape. Certain factors can raise the risk of anorexia and other eating disorders, including:

Family history
A history of weight bullying
A history of dieting
Transitions

A healthcare provider can diagnose anorexia nervosa based on the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The three criteria include:

Restriction of calorie consumption that leads to weight loss or a failure to gain weight. This results in a significantly low body weight based on your age, sex, height, and stage of growth.
Intense fear of gaining weight or becoming fat
Having a distorted view of yourself and the seriousness of the state of your health

If you have signs and symptoms of anorexia, a healthcare provider will do a complete medical history and physical exam. They will ask questions about your:

Dietary history
Exercise history
Psychological history
Body image
Purging frequency and elimination habits (use of pills, laxatives, and diuretics)
Family history of eating disorders

Treatment for anorexia varies depending on the person’s needs. They may receive treatment through inpatient or outpatient care based on their current medical and mental state. Treatment for anorexia most often involves a combination of:

Individual and group psychotherapy
Medication
Hospitalization

A person with anorexia or any eating disorder will have the best recovery outcome if they receive an early diagnosis. If you or someone you know are experiencing signs and symptoms of anorexia, be sure to talk to a provider as soon as possible.

To find out more about our mental health services or to schedule a virtual appointment, call (718) 670-5316 to speak with our intake coordinator or call (718) 670-5562 to reach the clinic.

All content of this newsletter is intended for general information purposes only and is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. Please consult a medical professional before adopting any of the suggestions on this page. You must never disregard professional medical advice or delay seeking medical treatment based upon any content of this newsletter. PROMPTLY CONSULT YOUR PHYSICIAN OR CALL 911 IF YOU BELIEVE YOU HAVE A MEDICAL EMERGENCY.

Tuberculosis

Posted on February 25, 2025 by Patrick Hercules

Tuberculosis is a serious infectious disease that mainly affects the lungs. It is caused by a bacteria called Mycobacterium tuberculosis. Tuberculosis can spread when a person with the illness coughs, sneezes, or speaks, releasing tiny droplets of germs into the air. Another person can breathe in the droplets, and the germs will enter the lungs.

When tuberculosis germs survive and multiply in the lungs, it is a TB infection. A TB infection can happen in one of three stages, each with symptoms.

Primary TB infection is the first stage of TB infection. Immune system cells find and capture the germs, which the immune system may destroy. However, some captured germs can still survive and multiply.

Most people don’t have symptoms during primary infection. Some people may have flu-like symptoms, including:

Low fever
Tiredness
Cough

Latent TB infection is the stage following primary TB infection. Immune system cells build a wall around lung tissue with TB germs, which keeps them under control. However, the germs survive. There aren’t any symptoms during latent TB infection.

Active TB disease happens when the immune system can’t control an infection. Germs cause disease throughout the lungs or other parts of the body. Active TB disease can happen right after primary infection, but it usually occurs after months or years of latent TB infection. Symptoms of active TB disease in the lungs begin gradually and worsen over a few weeks. Symptoms can include:

Cough
Coughing up blood or mucus
Chest pain
Pain with breathing or coughing
Fever
Chills
Night sweats
Weight loss
Loss of appetite
Tiredness
Not feeling well in general

Extrapulmonary tuberculosis occurs when an active TB infection spreads from the lungs to other body parts. Symptoms vary depending on what part of the body is infected. Common symptoms can include:

Fever
Chills
Night sweats
Weight loss
Not wanting to eat
Tiredness
Not feeling well in general
Pain near the site of infection

Common sites of active TB disease outside of the lungs include:

Kidneys
Liver
Fluid surrounding the brain and spinal cord
Heart muscles
Genitals
Lymph nodes
Bones and joints
Skin
Walls of blood vessels
The voice box or larynx

People with active TB infection can spread tuberculosis easily, especially in crowded spaces.

To diagnose a TB infection, a healthcare provider will perform an exam that includes:

Listening to you breathe with a stethoscope
Checking for swollen lymph nodes
Asking you questions about your symptoms

Your healthcare provider will order tests if:

Tuberculosis is suspected
You were likely exposed to a person with active TB disease
You have health risks for active TB disease

Your healthcare provider will determine whether a skin or blood test is best. X-rays, sputum tests, and other lab tests can also diagnose a TB infection.

Your healthcare provider may treat you with drug treatments if you have a latent TB infection. This is especially true for people who are at an increased risk of active TB disease. Most latent TB infections are treated for three or four months. Active TB may be treated for four, six, or nine months. Specialists in TB treatment will determine which drugs are best for you.

It is important to take every dose as instructed when your healthcare provider prescribes medication. You must complete the full course of treatment, as it is important for killing the bacteria in your body and preventing new drug-resistant bacteria.

If you are experiencing symptoms of tuberculosis, you must receive treatment from a doctor as soon as possible. You can schedule an appointment at Flushing Hospital Medical Center’s Ambulatory Care Center by calling (718) 670-5486.

Robotics: Gastric Bypass

Posted on February 19, 2025 by Patrick Hercules

Gastric bypass or “Roux-en-Y” is a metabolic and weight-loss procedure that works by modifying your digestive system so that you consume and absorb fewer calories. It modifies your stomach and also your small intestines.

Similar to other bariatric surgery operations, gastric bypass is recommended for people who have clinically severe obesity. It has been shown to help relieve a long list of obesity-related health conditions, including:

Type 2 diabetes
Hypertension
Obstructive sleep apnea
GERD (chronic acid reflux)
Heart disease
Hyperglycemia
Fatty liver disease
Hyperlipidemia
Osteoarthrosis

The Roux-en-Y procedure gets its name from how it changes your digestive system. “Roux-en-Y” means “in the shape of a Y”. The procedure divides your stomach and small intestine, connecting each new segment to form a “Y” shape. This procedure reduces the functional part of your stomach to a small pouch, separating it from the rest with surgical staples, and restricting the amount of food your stomach can hold. Then, it connects the new stomach pouch to a lower segment of your small intestine. This means that when food goes through your digestive system, it will now bypass most of your stomach and the first part of your small intestine, causing your digestive system to not absorb all of the nutrients or calories in your food.

Gastric bypass surgery requirements are similar to those of other bariatric procedures. A qualified healthcare provider must recommend you for surgery. You may be a candidate for gastric bypass surgery if you:

Have been diagnosed with class III obesity
Have a BMI of at least 35 with at least one obesity-related condition
Have obesity-related type 2 diabetes

Most Roux-en-Y surgical procedures today are laparoscopic, a minimally invasive surgical technique. However, sometimes they are done with robotic assistance.

There are many potential advantages of robotic-assisted surgery over other types of surgery including:

Robot-assisted surgery provides the surgeon with 3D images of inside your abdomen that create a clearer picture for them to reference as they operate compared to the 2D images used during laparoscopic surgery
Under the surgeon’s direction, the robot can move more freely and with more versatility than a human hand
You’ll have a few tiny scars rather than one large incision scar (as with open surgery)
You’re more likely to experience less pain and less bleeding after surgery compared to open surgery
You’re more likely to have a quicker recovery time than with open surgery

To learn more about the robotic surgical procedures at Flushing Hospital Medical Center or to schedule an appointment, call (718) 670-5000.

Signs Your Blood Sugar is Too High

Posted on February 14, 2025 by Patrick Hercules

Hyperglycemia, also known as high blood sugar, is common in people who have diabetes. It occurs when too much sugar (glucose) is in the blood and the body has too little insulin or if the body can’t use insulin properly to regulate blood sugar levels.

People with diabetes can experience hyperglycemia episodes frequently.

Hyperglycemia usually doesn’t cause symptoms until blood sugar levels are high – above 180 to 200 milligrams per deciliter (mg/dL), or 10 to 11.1 millimoles per liter (mmol/L).

Symptoms for hyperglycemia develop slowly over several days or weeks. The longer sugar levels stay high, the more serious symptoms can become. However, some people who’ve had type 2 diabetes for a long time may not show any symptoms despite high blood sugar levels. Early symptoms of hyperglycemia include:

Frequent urination
Increased thirst
Blurred vision
Feeling weak or unusually tired
Headache

Recognizing early symptoms of hyperglycemia can help identify and treat it right away.

If hyperglycemia isn’t treated, it can cause toxic acids called ketones, to build up in the blood and urine. This condition is called ketoacidosis. Symptoms include:

Fruity-smelling breath
Dry mouth
Abdominal pain
Nausea and vomiting
Shortness of breath
Confusion or disorientation
Loss of consciousness
Dehydration
Rapid heartbeat

Hyperglycemia most often results from a lack of insulin. This happens due to insulin resistance and/or issues with the pancreas, the organ that makes insulin.

However, other hormones can contribute to the development of hyperglycemia as well. Excess of the stress hormone cortisol or the growth hormone can lead to high blood sugar.

Chronic hyperglycemia over the years can damage blood vessels and tissues in your body. This can lead to a variety of complications, including:

Retinopathy
Nephropathy
Neuropathy
Gastroparesis
Heart disease
Stroke

Hyperglycemia is diagnosed when a healthcare provider orders blood work to screen for the condition and diagnose diabetes. These tests may include:

Fasting glucose tests.
Glucose tolerance tests.
A1c test.

Injected insulin is the main way to treat hyperglycemia episodes. Everyone requires different doses. Your healthcare provider will work with you to determine which dose is best to treat and prevent high blood sugar. Dietary changes and exercise plans can also help manage your blood sugar to prevent hyperglycemia.

If you’re experiencing symptoms of hyperglycemia, you can receive treatment from an endocrinologist at Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486.

The Link between Alcohol and Cancer

Posted on February 13, 2025 by Patrick Hercules

The Office of the Surgeon General recently issued an advisory calling for updated warnings on alcoholic beverages, cautioning that the consumption of alcohol heightens the risk of several types of cancer.

The current labels on alcoholic beverages warn about drinking while pregnant, drinking while driving, and operating machinery, as well as other general “health risks”. The Office of the Surgeon General noted that alcohol consumption contributes to approximately 100,000 cancer cases and 20,000 cancer-related deaths each year. Therefore, the public needs to be warned about the link between alcohol consumption and an increased risk of cancer.

Alcohol has been classified as a carcinogen “primarily due to its metabolite, acetaldehyde, which has the ability to bind to DNA and potentially cause mutations”, says Dr. Vasilis Vasiliou PhD, chair of the Department of Environmental Health Sciences and the Susan Dwight Bliss Professor of Epidemiology at the Yale School of Public Health. Acetaldehyde may also increase the risk of aerodigestive cancers, which are cancers that affect the upper respiratory and digestive tracts. Aerodigestive cancers include cancer of the lip, tongue, salivary glands, and other oral and nasal regions. “Furthermore, acetaldehyde may have a more pronounced effect on individuals with mutations in DNA-repair enzymes, such as BRCA1 and BRCA2. Mutations in these BRCA1 and BRCA2 enzymes can increase the risk of developing breast or ovarian cancer”, Dr. Vasiliou says.

Dr. Vasiliou acknowledges that the adverse effects of alcohol are significantly influenced by the dose-response relationship, which considers both the quantity of alcohol consumed daily and the duration of consumption over time. These factors, along with co-exposures to environmental contaminants, play a pivotal role in determining the severity of alcohol-related risks. Such interactions suggest that alcohol’s harmful effects cannot be fully understood in isolation but should instead be evaluated within the broader context of combined exposures to other environmental and lifestyle-related carcinogens.

Dr. Vasiliou offers this advice when it pertains to alcohol and its link to cancer:

Do not start drinking for health reasons
Limit consumption
Consider personal and family health risks
Seek non-alcoholic sources of antioxidants

Synergistic interactions with other environmental carcinogens and lifestyle factors influence the risk of cancer from alcohol consumption. Reducing alcohol intake, alongside minimizing exposure to other known carcinogens such as tobacco smoke, environmental pollutants, and chemical toxins, is a critical strategy for lowering overall cancer risk. Comprehensive prevention efforts should address not only alcohol consumption but also broader environmental and lifestyle factors.

Congratulations to Flushing Hospital Medical Center for being Recognized as Pediatric Ready!

Posted on February 12, 2025 by Patrick Hercules

Congratulations to Flushing Hospital Medical Center for being recognized as Pediatric Ready! by the New York Always Ready for Children Pediatric Recognition Program.

Flushing Hospital Medical Center participated in the program which aims to ensure that every ill and injured child receives appropriate emergency medical care within New York State emergency departments. The hospital was recognized for its efforts and dedication to help set the standard for the best possible pediatric care in New York.

This recognition is a testament to Flushing Hospital’s commitment to pediatric readiness in medical and traumatic emergencies. Participating in the New York Always Ready for Children Pediatric Recognition Program indicates participation in the National Pediatric Readiness Project, having a physician and nurse Pediatric Emergency Care Coordinator, and a willingness to share resources and collaborate with other hospitals in New York State to improve pediatric care.

This program is supported by the EMS for Children Innovation and Improvement Center, the Federal Health Resource and Service Administration (HRSA), the American Academy of Pediatrics, the Emergency Nurses Association, the American College of Emergency Physicians, and the American College of Surgeons.

The Always Ready for Children (ARC) Pediatric Recognition Program is a state and region-wide recognition system for emergency departments committed to improving their pediatric care. The program was created, managed, and maintained by the region’s EMS for Children State Partnership Programs (EMSC), with support from the Health Resources and Services Administration and the EMSC Innovation and Improvement Center.

Low-Sodium Foods for Hypertension

Posted on February 11, 2025 by Xavia Malcolm

Hypertension or high blood pressure can be caused by several factors including a diet that is rich in high-sodium foods.

Consuming too much sodium may increase blood pressure; therefore, a low-sodium diet is often recommended for people with hypertension.

A low-sodium diet aims to limit sodium intake to less than 2,300 milligrams(mg) per day. This can be achieved by eating salt-free foods or those that contain less than 140 mg per serving.

Foods you can include in a low-sodium diet include:

Eggs
Fresh legumes
Unsalted nuts and seeds
Dried beans
Canned vegetables with no added salt or low sodium
Fresh poultry, fish, or beef
Whole grains
Herbs and spices
Avocado and olive oils

Some high-sodium foods to avoid are:

Smoked or cured foods
Pizza
Processed foods
Pickled vegetables
Salted nuts
Canned meat
Canned beans with salt added
High sodium canned soups
Soy sauce
Tomato sauce
Instant pudding

Another popular diet to follow when managing hypertension is the DASH (Dietary Approaches to Stop Hypertension) diet. The DASH diet promotes foods that are rich in potassium, fiber, magnesium and protein, and are low in saturated fat and sodium.

Working with a registered dietitian can help you manage hypertension. Your dietitian can create personalized meals that focus on lowering sodium consumption, maintaining healthy blood pressure and improving overall health.

The Difference between a Midwife and a Doula

Posted on February 7, 2025 by Patrick Hercules

Nurse midwives and certified doulas serve as members of a birthing team. Both have different training and education and provide various means of support and care during pregnancy, labor, and beyond.

Certified nurse midwives have master’s degrees in midwifery and often have experience working as labor and delivery nurses. Similarly to OB/GYNs, they support gynecological health and pregnancy care from a medical perspective.

Certified nurse midwives are trained to perform the following healthcare services:

Perform annual wellness exams
Perform gynecological exams
Provide prenatal care
Prescribe medications
Give labor-inducing drugs
Monitor the fetus using electronic equipment
Order pain medications during labor
Order an epidural
Perform an episiotomy
Deliver a baby vaginally
Assist with C-sections
Resuscitate a baby
Stitch tears
Provide STI testing and care
Postpartum checkups and breastfeeding support

If you are having a baby outside of your home, you’ll need either an OB/GYN or a certified nurse midwife to deliver your baby.

Certified doulas are trained care professionals, not medical caregivers. Certified doulas don’t necessarily have degrees in healthcare. They earn credentials and accreditations from dedicated training agencies or programs. Their focus is on providing physical and emotional support throughout your pregnancy, delivery, and the postpartum period. Doulas can provide support and education that’s on the periphery of your medical well-being as well.

Different doulas provide different kinds of services. Some may specialize in pregnancy and delivery, while others may provide a full spectrum of services, including supporting you after your baby arrives. Services they offer can include:

Birth coaching, such as teaching you different birthing positions and techniques for reducing labor discomforts
Healthy pregnancy advice such as nutritional counseling
Helping draft your birth plan and advocating for your wishes during labor and delivery
Providing mental health check-ins and advice for self-care
Continuing to support you after your baby arrives with advice on breastfeeding and helping around the house with meal preparation and housework
Education for your support people, like a partner or friend who’ll be in the delivery room or will be caring for your baby with you

Researchers have suggested that using a birthing doula can lead to better birth outcomes, including:

Shorter labors
Less reliance on medications and epidurals
Lowered risk of C-section
More satisfaction with the experience of labor

Certified doulas may be most helpful for people who:

Are giving birth for the first time
Are from underrepresented groups, including people of color and members of the LGBTQIA+ community
Have experienced trauma in prior births
Wish to have an unmedicated, natural labor, and delivery

The most important consideration when choosing a midwife or a doula is finding someone you like, trust, and feel comfortable around. Someone who respects your opinions and viewpoints on pregnancy and the birthing process can be beneficial.

Experience can be another important factor. Doulas and midwives with more years of experience will bring different skills and perspectives than someone more recently trained.

For more information about Flushing Hospital Medical Center’s Women’s Health Center, please call 718 670-5702.

Appendicitis

Posted on February 6, 2025 by Patrick Hercules

Appendicitis occurs when the appendix becomes clogged, infected, and inflamed. It can cause acute pain in your lower abdomen, however, for most people, pain begins around the belly button and then moves. As inflammation worsens, appendicitis pain typically increases and eventually becomes serious.

Symptoms of appendicitis include:

Sudden pain that begins on the right side of the lower belly
Sudden pain that begins around the belly button and often shifts to the lower right belly
Pain that worsens with coughing, walking, or making other jarring movements
Nausea and vomiting
Loss of appetite
Low-grade fever that may rise as the illness worsens
Constipation or diarrhea
Belly bloating
Gas

Additional symptoms that may develop later in some people can include:

Malaise
Urinary symptoms- needing to go more frequently or more urgently
Bowel paralysis

The size and location of the appendix make it easy for it to become clogged and infected. Your large intestine is home to many bacteria. If they become trapped in your appendix, they overgrow and cause an infection. The bacteria then multiplies quickly causing the appendix to become inflamed and filled with pus. If it is not treated right away, the appendix may burst or break open.

Some common causes of inflammation, swelling, obstruction, and infection in your appendix include:

Hardened poop (appendix stones)
Lymphoid hyperplasia
Colitis

Other factors that could block the opening of your appendix can include:

Tumors
Parasites
Cystic fibrosis

Risk factors for appendicitis include:

Age – anyone can develop appendicitis, but it most often happens in people between the ages of 10 and 30
Your sex – men have a slightly higher risk of appendicitis than women

To help diagnose appendicitis, a healthcare provider will likely take a history of symptoms and examine the abdomen. Tests used to diagnose appendicitis can include:

A physical exam
Blood tests
Urine tests
Imaging tests

Appendicitis may spontaneously resolve if the cause suddenly goes away on its own. This might happen if an obstruction in your appendix gets unblocked and passes through the intestines, or if an infection causing lymphoid hyperplasia in your appendix suddenly improves. However, you shouldn’t assume this will happen or that it has happened, even if your pain has reduced.

The standard treatment includes medicine such as antibiotics and surgery to remove the appendix. Appendicitis is considered an emergency, so it is treated in the emergency room.

If you are experiencing symptoms of appendicitis, visit Flushing Hospital Medical Center’s Ambulatory Care Center. To schedule an appointment, please call (718) 670-5486. If there is an emergency, please call 911.

Parenting: Helping Children Adjust to a New Baby

Posted on February 5, 2025 by Patrick Hercules

When it comes to welcoming a new sibling, children can have a variety of reactions depending on their age. They can be happy and excited, sad, angry, and upset. Knowing what to expect from each age group can make handling the changes in your family easier.

Here is some information from the American Academy of Pediatrics to help parents prepare older siblings for a new sibling:

For children aged one to two years

They may not understand what it means to have a new sibling. However, you can bring up the topic with your child so they can get used to it. It is also important to reassure them that they are loved.
You can read children’s books about newborns and siblings with your older child before the new baby arrives so they can become familiar with words such as sister, brother, and new baby.
Once the new baby arrives, be mindful of spending time with your older child. You can make them feel special by giving them a special gift and spending one-on-one time with them.

For children aged two to four years

They are learning to share with others and may feel the need to compete for your attention. Therefore, it is important to explain to your older child that there will be times when you will need to take care of the new baby first. They may also have difficulty adjusting to changes in your family’s routine.
Find chances to talk about the new baby before the new baby arrives. You can mention that a new baby will be in the family when you start buying nursery furniture or baby clothes or when your child asks about Mom’s growing belly. Continue to read children’s books about newborns and siblings with your older child.
Remind your older child about when they were a baby, by showing them their baby pictures. If you use some of their old things for their new sibling, let them play with them for a bit before they get ready for the new baby.
Be honest with your older child. Explain that the baby will be cute, but will also cry and take a lot of your time and attention. It is important to let your older child know that it may be a while before they can play with the new baby and that they will need to be gentle when they play or help care for the baby.
Involving your older child in planning for the baby will make them less jealous.
Time the major changes in your older child’s routine. Finish toilet training or switching from a crib to a bed before the baby arrives if possible. If it isn’t possible, wait until after the baby is settled at home.
Expect your older child to regress a little after the new baby arrives. Older children may return to an earlier stage in their development when a new baby arrives.
Set aside some special time for your older child. You can read to them, play games with them, listen to music with them, or talk with them. Show them that you love them, and want to do things with them.
To make your older child feel included, find ways to invite them to help with the new baby.
When family and friends visit the new baby, ask them to spend time with your older child to help them feel special and not left out.

For children who are older than five years

They are usually not as threatened by a new baby as younger children are. However, they may resent the attention the new baby gets.
Tell your older child what is happening in words they can understand before the new baby arrives. Explain what having a new baby means and what changes may affect them.
Have your child help prepare for the new baby by having them help fix up the baby’s room, pick out clothes, or buy diapers.
After the new baby arrives, have someone bring your older child to the hospital to meet their new sibling, if they are not already there. This will help them feel that they are part of the growing family.
Help your older child feel that they have a role to play in caring for the baby when the new baby is brought home.
Don’t overlook your older child’s needs and activities.

Please be mindful that children have different personalities that may affect how they respond to the new baby.

Preparing your older child for the arrival of a new baby can be challenging, but following these recommendations can make the transition much easier.