Our Brave Warrior of Hydrocephalus, Miles Rhodes

Written by Alex Rhodes

Miles was born on October 14, 2011 at 37 weeks gestation after what was a healthy pregnancy and normal birth; we were beyond blessed to have this beautiful baby boy enter into our lives. The first three months of Miles’ life presented the normal newborn/infant challenges – feeding regimens, late nights, early mornings, lots of crying, the usual. Except around that three-month mark, we noticed Miles’ cry became a little bit higher pitched and his head began to grow in size at what seemed to be a faster rate than normal. We did some researching and Googling and of course were scared to death at what it could possibly be. The word “Hydrocephalus” kept popping up in all of our research; a condition my husband and I had never heard of. Certainly, this couldn’t be what our perfect, beautiful, brand new baby boy had. How could that be possible?

Sadly, after visiting our pediatrician on January 25, 2011 (we’ll never forget that day), our suspicions of Hydrocephalus were one step closer to being confirmed. We were instantly referred to Penn State Hershey to visit one of the best Neurosurgeons in the country, Dr. Mark Iantosca to confirm what in fact was going on. We all know that not much seems to happen quickly in the medical world but what occurred over the next several months happened so quickly; looking back, it seems like a blur. Upon meeting with Dr. Iantosca for the first time (not even 24 hours after our initial visit with our pediatrician), a series of CT scans, an MRI, physical exam and an x-ray, Miles’ Hydrocephalus condition was confirmed. It was at this very instant that our lives would change. Forever. In that moment, it seemed like there could be nothing worse. In retrospect, we feel blessed and fortunate to be where we are as a family, where Miles is as a little boy. What I’ll describe later might help to make that more clear.

As mentioned previously, after our initial visit with Dr. Iantosca, everything moved very quickly. Dr. Iantosca informed us that Miles’ condition of Hydrocephalus was not only severe but also very complex. Perhaps I should back-up and explain, “What is Hydrocephalus”? After all, before this we had never heard of it either. Hydrocephalus is a condition where fluid (cerebral spinal fluid or CSF) builds on the brain. This can be due to multiple things – a traumatic event or injury, a congenital defect in the womb or at birth, an infection, etc. Since the body is unable to drain its own CSF in people with Hydrocephalus, the fluid then builds on the brain, causing pressure to build, resulting in adverse side effects on the brain and body (which as you can imagine impacts many things – mobility, vision, earing, etc.).

In Miles’ case and what made his condition so severe and complex, were multiple ‘elocutions’ or ‘cysts’ that were in the brain, filled with CSF, and blocking the rest of the CSF from draining on its own (a normal bodily function, our bodies/brains drain our CSF constantly without us ever even knowing). As a result of his body’s inability to drain his CSF, steps needed to be taken to address the multiple cysts in his brain. In the early days and weeks after first learning of Miles’ condition, he had 5+ surgeries to puncture and drain the cysts in an attempt to allow the body to drain his CSF naturally. External drains were placed in Miles’ brain to allow the CSF to drain outside of his body (these drains are called EVDs, external ventricular drains) and allow CSF to be tested for possible infections or issues (amongst other things). While one of these EVDs was in place and the CSF was being tested regularly, we were informed that Miles tested positive for a highly contagious and antibiotic resistant infection. The infection needed to be treated urgently and swiftly. As part of the infection Miles had a PICC line placed where my husband and I had to administer high doses of antibiotics for several weeks. During this time, Miles’ Hydrocephalus was unable to be treated until the infection was cleared of his system. This weighed on us heavily – it extended our hospital stays, made Miles increasingly more uncomfortable and left us anxious to continue making progress to fight this condition that was inhabitating our sweet little boy.

The sun finally appeared between a thick patch of clouds and we received the good news that the infection was rid of Miles’ body. Now, back to work!

Dr. Iantosca and his incredible team operated several more times in an attempt to stabilize his condition in order to avoid placing a shunt. Shunts are very often used to treat Hydrocephalus, they’re an amazing piece of modern technology that are able to do what the body is unable to do, drain CSF via a valve/pump system which connects to a tube that most often extends from the brain behind the patient’s ear and into their abdomen, all the while draining the CSF. The CSF then reabsorbs and recirculates into the body. A shunt sounds like the golden ticket right? Well, not quite. As with any foreign piece of equipment or mechanical system placed in the body, they do not come without complications and in the case of shunts, infections and malfunctions (clogs, breaks in the tubing, etc.). Dr. Iantosca and his team worked tirelessly to solve Miles’ case without placing a shunt but unfortunately, a shunt for Miles was inevitable. Today, 2O+ surgeries and four shunts later, we’re approaching our 1-year “shuntiversary”. A holiday often celebrated by Hydrocephalus warriors when they’ve been shunt revision free for a year or any significant period of time that’s successful and worthy of celebrating!

In addition to the shunt side effects I mentioned, Hydrocephalus has caused other difficulties in Miles’ development. About a year after he was diagnosed with Hydrocephalus, he was also diagnosed with a seizure condition known as infantile spasms. This condition was treated by a controversial and extremely expensive medication known as ACTH. The medication needed to be administered once again by my husband and I through an injection in Miles’ leg for 6-weeks. It was terrible, for all involved but yet again, a rainbow appeared from behind the clouds and Miles remains seizure free for close to a year. In addition to the seizure disorder, Miles also continues to experience physical and mental delays from his conditions and multiple long-term hospital stays and frequent bouts of immobility. He his privileged to receive Early Intervention Services through the State of Pennsylvania, specifically Physical, Occupational and Speech therapies.

So, you’ll remember a few paragraphs ago when I mentioned the day Miles was diagnosed felt like the worst day of our lives, but I ended my sentence with how blessed we feel as a family today. Through it all – the surgeries, the diagnosis, and hospital stays, infections, you name it we’ve seen it – we’re here today, standing strong as a family with that same beautiful little boy. He starts and ends each day with a smile and laughs all of the way through, despite his delays he is the toughest kid we know and fights like no other to do exactly what he knows he’s capable of. His beautiful qualities wrap themselves around each and every person he meets. We constantly worry about the obstacles and adversities he may face but we were told once and it stays with us, “Miles will always attract amazing people, because that’s whom he is”. This could not be more true.

I’ll end all of this by saying, I found out I was pregnant with Miles on March 1, 2011. If someone told me on that day that this is what our child would endure I would never have believed you, that’s not possible. We still have questions and thoughts of anger and frustration but mostly we’re filled with joy and thankfulness for all of the blessings we’ve been given. Our son, our family and an amazing extended family that consists of a phenomenal hospital that’s right in our back yard, Penn State Hershey Medical Center. An equally phenomenal neurosurgeon, Dr. Mark Iantosca that could choose to lend his skills and expertise anywhere in the world but he’s at Hershey, for which we are so thankful. A best-in-class facility, nurses and care staff that keep us comfortable and safe, and lend a warm and loving ear when the day just seems to get you down. But most of all, we’re thankful that in all of these people, with all of the different experiences and skill sets they possess, they love and care for our son as if he’s their own and they choose to work and care for patients and warriors like Miles at Penn State Hershey. For that we and as a community, we are truly blessed.


If you have absolutely any concerns or suspicions at all, it’s absolutely ok to be paranoid and neurotic. You are your child’s advocate and voice, they need you to be this way! Your pediatrician should be your first stop if you notice any of the initial signs and symptoms. If there is cause for concern, you will likely receive a referral to a local Neurosurgeon or Neurologist. They will guide you on the best course of action from there as every child’s case and treatment plan is vastly different.


Signs & Symptoms: http://www.mayoclinic.org/diseases-conditions/hydrocephalus/basics/symptoms/con-20030706

Research, Detailed Information and Further Resources: http://www.hydroassoc.org/hydrocephalus-resource-library/

Support Groups and Hydro Community Network:


Glossary of Medical Terms often Used in a Hydrocephalus Diagnosis:


Facebook Hydrocephalus Family Support Group (families across the world are in this group):


Pennsylvania Early Intervention Services – developmental support (birth to 3 years): http://www.portal.state.pa.us/portal/server.pt/community/early_intervention/8710

Follow Miles’ Warriors on Twitter – @Miles_Warriors

My personal contact information that can be shared with anyone looking for more information or just needs a support unit: alexandrarho@gmail.com

Memories In The Making


As a parent, nothing is more important than providing caring and nurturing childhoods for your little ones with life-long memories. Spare of the moment trips to the local ice cream shop or to the movies is always exciting for children, but looking forward to family traditions or holding onto keepsakes help ground core family values. This will create traditions for generations to come. Here is a great list of ideas that every family can try, or use to generate their own ideas, to create memories that last a lifetime.

Memories in the Home

Milestone Picture Frame – Some of my favorite pictures in friends’ homes are the frames that show month by month pictures of the baby until they reach age 1 or year by year school pictures. There is just something about past verses present photos that is a fantastic conversational piece. I look forward to populating my frame at home when we receive the printed pictures.

Height Notches – Find a doorway that is typically closed or out of the way and make marks each year at your growing kid’s heights. Pick a day each year and make it a tradition. Try every morning of their birthdays or every first day of school. This is a great way to make your house a home and show how much your family has grown under that roof.

Seasonal Cooking – Cooking together as a family to create special seasonal treats is a great way to bond as a family. You can enjoy the seasons as they change, and at the same time, use it as a teaching tool to your children. Bake a pie together, a cake for their uncle’s birthday or scones for Valentine’s Day brunch. Do remember, cooking can be dangerous depending on the age of your children, so choose something based on ease and safety.

Family Keepsakes

Year of Memories Picture Book – Printed photo books are a fantastic quick way to relive each year of growth, accomplishments and laughter. You, your guests, and most importantly, your children will be able to look back to your shelf at home to see how their family has grown throughout the years. Many online sites offer printed photo books at a discounted rate around the holidays. It does take a couple of hours to put together, but this couple of hours per year is well worth it!

Letters to Your Child – This is a great little secret to keep until your baby is well into adulthood. Write letters to your child for the future. Write when you are feeling particularly nostalgic or when a big event is about to unfold. These letters will bring joy, tears and laugher to your children who are already growing up too fast. They can be about what you wish they knew about life lessons, about upcoming weddings, or just about your daily life with them at that age. Once they are adults, it will bring a whole new level of understanding of their childhood, of you as their parents, and will be something they treasure forever.

Baby Book – I honestly did not think my baby book was all that important until I was older and wanted to look back at my family and myself when I was a baby. I also realized its importance when I decided to have children of my own. This book is a great place to write down small memories, record growth, milestones, and place funny baby pictures. This also makes a great gift when your child decides to get married or have babies of their own!

Seasonal Traditions

Seasonal traditions are just as important as family traditions or holiday traditions. You can enjoy all seasons with your whole family and have something to look forward to, regardless of what else is happening in your everyday lives. One tradition I personally love is outdoor dinners. Go out for a picnic in a nearby park, put a blanket down in your backyard and camp out, or travel to an outdoor restaurant. These can be fun in the mild weather months, and the kids are destined to enjoy the change of scenery.

Apple and Pumpkin Picking – Fall traditions are great outings for everyone. Babies can be strapped to your body; little kids can run around collecting their favorite fruit and burn some energy. What do you do with the box? Get the kids together the following day or weekend and make apple pie, apple sauce, candy apples, carve pumpkins, roast pumpkins, and the list goes on.

Sledding, Ice Skating and Snowmen – Nearly every child I know loves the outdoors when the flurries begin. Get everyone bundled up and take an hour to go to a nearby hill with a sled. This is one of the simplest and cheapest ways to create fast family bonding time. If you are lucky enough to have frozen lakes, enjoy the outdoors. For those of us without, there are many indoor and outdoor rinks. And don’t forget, a picture the kids will cherish forever is the annual snowman picture, packed with overly bundled children!

Museums – Is the standard spring weather not cooperating for outdoor activities just yet? Take the family to a museum or exhibit. You’d be surprised how many exhibits are geared toward families with children. They are also typically very educational in addition to fun. This does not need to be an expensive or lengthy venture. An hour or two at a museum stimulates children and allows you to share great experiences without the many electronics interfering.

Annual Friends Vacation – One of my favorite memories as a child was the large multi-family vacation that we used to take. It didn’t matter if we traveled far by plane or an hour away to a house rental on a lake. The same 4 families with all of their children came together for a long weekend or entire week every year. We were able to create one large family, step away from our all too busy lives and catch up. I can’t wait to start doing that with my friends as we are starting families of our own.

Baby Keepsakes

Hand & Footprints – Whether you want to try ink or clay, baby handprints and footprints are adorable. And of course, there are a bunch of adorable picture frames that incorporate these clay molds to showcase in your home. Those of us who aren’t artistic can still dip a foot in paint and press it against a piece of paper. When the little fingers smear the paint trying to make a fist, it only creates character on the page. It is amazing to see how fast the little infant hands and feet grow!

Silver – A small gift your baby may receive is a silver cup, spoon, bootie or hair brush/comb. These can be engraved and become very sentimental. We have also purchased a baby pearl bracelet with a silver charm engraved with our daughters first and middle names. Put them up on a high shelf for safekeeping and pass them down through generations to come.

Quilt & Blanket – Homemade quilts and knitted blankets are such a treasure to have and hold onto. They are unique and special for both the maker and the receiver. If you are unable to make a quilt, there are many sites such as etsy that you can purchase something handmade and have their name sewn onto it to make it more personal. We were lucky enough to have talented family and friends make these special blankets, and they are just wonderful to have for the baby.

Piggy Bank – Saving money is an important lesson to learn for all people, even young children. A special piggy bank (or any animal bank) is a great tool to show how any contribution can be special and important. When your child receives money as a gift or finds a quarter on the ground, allow them to put the money in the tiny slot to save (that part is very fun for children!) Of course there are a ton of different kinds, just be sure to keep breakable banks out of reach until they are older.

Hospital Keepsakes – The hospital swaddling blanket, hospital bracelet and hat are keepers for my family. We put the blanket with other blankets, the hat in our small keep bag with our favorite clothes that she grew out of too fast, and the hospital bracelet in the baby book. Sentimental keepsakes are what we will go back to when our children are starting kindergarten, graduating from high school and getting married. I wouldn’t recommend keeping everything your baby ever touches (because who goes through all of those boxes in the attic?), but a few special keepers are wonderful.

Holiday Traditions

Decorating the House – Once it is time to get in the holiday spirit, homes should be filled with beautiful decorations. Kids at all ages can help put cards and holiday keepsakes around the house; decorate a tree or light candles. Play some holiday music, sing carols and have fun with it every year. Once your family is all involved, the tradition will grow with every passing year.

Baking and Cooking – What child doesn’t look forward to holiday cookies, gingerbread men or sugar cookie houses? Whether you solely decorate cookies and houses together or go through the entire baking process, this is something families can do together at all ages. Put wax paper down all over the kitchen table, make bowls of colored frosting and add sprinkles. This can be an easy and cheap way to have a blast every year. Don’t forget to take the messy hands/face pictures too!

Family Picture – Take a family picture at a family outing every year. Maybe you like to go ice skating, maybe your little one loves sledding, or maybe you try a new bakery every year. Side by side pictures of a growing family can be a wonderful comparison for the whole household to enjoy.

Treat & Holiday Event Sequence – Have a warm cup of hot cocoa around the fire in the morning and go cut down your own Christmas tree. Make some yummy fried treats as family, light the candles and sing carols around the glowing menorah. Whatever your holidays are, you can make the same sequence of traditions every holiday and stick with it as a family. Your children will remember the tradition and look forward to it. No matter what religion or holiday you celebrate, holiday traditions are something your entire family can look forward to.

You Make Us The Happiest Parents In The World


Almost every Mom and Dad must feel this way. What may seem like small moments to some may feel like the most perfect moments to a parent. This is one of the greatest joys of having children. They turn your world upside down and you love it. These are some of the small moments I am sure others can relate to that melt my heart.

When you first open your eyes in the morning, look up at me, and smile that big gummy smile as you see my face.

When you giggle at the funny sounds I make when I change you into your tiny clothes in the morning.

When you smile with crazy enthusiasm because you can stand just by holding onto my fingers, and realize you can do it.

When you reach for a toy and realize you were able to grab and hold onto it it by yourself.

When you stare intently at the book we are reading together and play with the pages while I pretend you are listening to the story.

When you screech and giggle, jumping up and down, banging the toys in your jumper because it is the best joy in the world to solely jump up and down.

When you see the dog play with his bone and watch with such intensity because he is the most amazing creature in the world.

When you stop crying and look at me with teary eyes, happier that I am holding you.

When you chuckle at the sound of raspberries on your belly because what else could be funnier?

When you squirm and kick in delight, laying on your back, as we sing a song to you.

When the inevitable ear-to-ear smile flashes across your face, as my head appears from behind my hands, in a game of peak-a-boo.

When you taste pears for the first time today, squish it around in your mouth, and realize you get to eat more of this amazing food.

When you fall asleep limp in my arms, cuddling up to my warmth, with full trust that I will love and take care of you.

How To Battle Energy And Water Bills With A New Baby


As my husband would say, “start saving now.” Although I don’t disagree, there are great ways to save around the house when it comes to raising a newborn. Many of these points can also be used without a small child, but as you begin to look closer at your money with a new addition to the family, this is a fantastic way to start.

Baby Room Temperature Control

Maintaining high temperatures in your home because she has cold tiny feet is not the most efficient use of your gas/electricity. Purchase a heater with a thermostat for temperature control. Set the heater to your desired temperature only heating (or cooling) her bedroom. Safety note: Find something that is safe for the baby and will not allow them to get burned. In my house, we set the heater to 73 degrees about a half hour before bedtime. This allows you to use your body heat combined with hers during the day and heat her room to a higher temperature at night. You can then keep the house at a cooler temperature (or warmer during the summer time), and solely heat the room that you need warmer at night. Do keep in mind, you should select a model with safety controls that turn the device off when knocked over and does not get too hot (no burning babies). Wall mounted heaters are also a great option and are safe.

Smart Strips

Smart strips are energy efficient power strips. There is one control outlet that controls the majority of the outlets in the power strip. Typically I plug a floor lamp into this outlet. All standard devices plug into the general outlets. When you turn your lamp on, all general outlets will turn on. When you turn it off, all general outlets turn off. This is great for the space heater that never gets turned off when you leave a room, for the coffee pot that remains on throughout the day and for the baby toy that doesn’t need to stay active when no one is home. The other two red outlets will remain on regardless of the other outlets. These outlets you would use for a clock or other items that need to be plugged in at all times. This will get rid of all ghost loads and turn anything off that doesn’t need to be on when you aren’t in the space. They are an inexpensive way to ensure sleep deprived parents remember to turn devices off.

Dress Baby Correctly

Babies cannot regulate body temperature very well when they are young. As your baby grows older, he will be able to regulate his temperature. I have read it takes 2 years for children to regulate properly, but other sources say it can take longer. Until then, dressing your son for the weather is very important. If you put your baby in three warm layers in the dead of summer, you need to over-cool your home to compensate. Dress the baby for the season, within reason, and you will be able to keep your house closer to the outdoor temperatures.


Daylight, believe it or not, heats homes regardless of outdoor temperature. Use this to your advantage. In warm months, shut your shades to reduce heat gain within your home. And in cool months, open your shades to allow the sun to naturally heat your home. Added bonus? Natural light is proven to boost happiness! Who doesn’t love a happy baby?


Operate your windows to cool or warm your home without electricity doing it for you. This works best in summer months in the cool evenings. On the other hand, windows in the wintertime can work against you. If you are unable to replace old drafty windows, put up a plastic winter barrier. I am not sure I believe how much the window insulation box says you will save per year, but I can assure you it helps.


The Nest is a thermostat system that is easy to install and completely maximizes your temperature control within the home. You turn the dial to your desired temperature throughout the day and it learns your patterns and does it for you. You can also lower/raise the temp by your phone when you are away (fantastic for those weekends you forget to turn the stat down and remember when you’re half way to grandma’s house.) There is an upfront cost, but the payback is both high and quick.

Insulate house

This is more costly, but substantially more effective. Look around your area for a company that completes a free assessment of your home and choose the most efficient areas to insulate. This will be an investment that continues to pay you back year after year.

Washing Bottles and Clothes

It is no secret that babies eat often and this requires you to wash food containers and clothing three times as much. Common sense will tell you to wait until you have a full load of wash before you run the washer. If you can’t abide by that rule because you need something washed faster, select a smaller setting on the washer or add towels to the load. Tip? Buy more bibs for teething, drooling babies. It takes much less room to wash 4 sets of bibs compared to sets of clothes.

Bottle washing! Do not run the water on high the entire time you are washing. This can easily waste over 30 gallons of water a day. Use two bowls in your sink – one to soak parts in warm soapy water before you wash them, and the other for scrubbed parts waiting to be rinsed. The warm bath starts the cleaning process; you scrub each piece with your brush and place it in the clean bowl, turn on the water and then rinse. Do it for just one month and the proof will be in your monthly statement.


General guidelines from hospitals will tell you to sterilize breast pump parts, bottles and nipples three times a week. Many people will leave a large pot of water on the stove and heat it up when they need it. Try using hot water from your sink instead of heating a pot of cold water. This will reduce the amount of time it takes to boil water, but it also uses less gas or electricity. The small amount of water that will be added to a hot water tank is heated with little effort. The cold water sitting on your stove takes a lot more effort to heat.


When your little one loves those splashy baths, it’s easy to get caught up in bathing him often. It can be a fun bonding experience or can relax an upset baby. Bathing your child only twice or three times a week will definitely improve your water bills. If you can’t lose the bubbly bonding time, give him longer baths and bathe him less frequently; just don’t forget to turn the water off when it is play time. If you need another reason, the Wall Street Journal recently published a story suggesting bathing your child more than two-three times per week may increase the risk for eczema. Let’s keep the skin’s moisture in and allergens/microbes out. http://www.wsj.com/articles/are-you-bathing-your-baby-too-much-1415031555

12 Tips For Choosing And Surviving Baby Daycare


Daycare is a very important and exciting topic to start thinking about during pregnancy. All kinds of questions flow through your head such as which daycare to choose, what to look for, how much is too much, will they spend enough time with the baby and where do we feel comfortable enough to leave the baby all day. It is extremely important to choose the right place for your family and to be prepared for the daycare life when it arrives. After reading all that I could on the subject, making my own spreadsheet, touring multiple centers and now sending my daughter to one, luckily, we found what seems to be the perfect place for us. I have found that after talking to friends with very great and not-so-great daycare experiences, and friends who chose to forgo the entire experience altogether, everyone will have different opinions and needs for their families. This may be one of the hardest decisions you need to make in your child’s early life. The staff at the care center will be holding your child, playing with your child, feeding your child, and helping them grow and learn. I have compiled a list of some of the most helpful tips and words of advice I have received and have experienced, and in return, need to share.

  1. Book ASAP

All daycare centers within 50 miles of my house are booking 10 months or more in advance. Do yourself a favor and spend the time now. Many families I met through the hospital at 8 or 9 months pregnant were on wait lists in their areas because they looked too late. The small deposit they require to hold your spot is well worth the investment.

  1. Location

Kick off your search with important and wide-ranging filters such as location and cost. Would you rather the center closer to your work, your partner’s work or home? Who is dropping the baby off, who has more flextime at work for sick pick-ups and who has the car for the drop off? Personally, we chose a center near our home because it is a much closer drive to get a sick baby home, next to our pediatrician, and is convenient to drop baby off / do errands close to home / and pick baby up on a day off. On the other hand, a good friend of mine enjoys breast-feeding the baby at work during her lunch break; that would be a fantastic perk as well.

  1. Cost

Daycare centers are expensive for a reason. They are the primary caregivers for your child during the day. You rely on them heavily and expect them to be dependable. Before you decide on a maximum price you would like to pay, research all types of daycare in your area so you can make an informed decision. Ultimately, you will choose what you can afford and what you feel comfortable spending. Try not to make this the sole reason for your decision-making.

  1. Certificates

Each state has laws on mandated requirements such as maximum kid to staff ratios based on age, cleanliness, etc. Learning the ratio requirements will help you determine if the facility is just at the minimum or is providing more care than required (usually a great sign). Our infant requirement is 1 staff to 4 babies. Could you imagine 2 adults with 8 screaming infants? Yikes. This was very important to my husband and I. We felt as if our daughter would not receive the one-on-one attention we wanted her to get on a daily basis if we stuck with a center that only met that minimum. Those stats are definitely worth paying close attention to.

  1. Vacation and Flexibility

Flexibility with scheduling was also very high on our list. Will the center allow you to start by working from home one day/week when you return to work and switch to 5 days/week in a few months? Do they have vacation time where you are not required to pay for that week? These are all very important issues as you plan your year with the center. Do keep note – most centers do require you to pay for care even if you keep the baby home one day. The centers need to pay their staff for when you are scheduled to be there, regardless if you show up or if your baby is sick.

  1. Tour

This was a great way to get to know the people in each room and understand first hand how they run their business. People told me I would ‘feel’ the difference between the centers and make a decision. I simply didn’t believe them until I actually spent time in each one. Some feel like a cold place of business, some feel warm and homey, and others feel like a school. Choose what is most important to you; hopefully you find a good mixture as we did. Be sure to talk to the caretakers in the baby room. Ask questions about their daily schedule, how often the babies are changed, about how they organize diapers/clothes, what they do throughout the day, when the kids move to the next room, and any other details that come to mind. Don’t be shy; they want to give you all the information you need to make your decision.

  1. Bottle Feeding

Now that you have chosen your daycare of choice, it is time to start thinking about the transition from home life to life with other caregivers. It is extremely important that you slowly adjust how your child consumes her food before sending her off to daycare. If she excels at breastfeeding, but not yet at the bottle, this will make for an extremely difficult transition when she is being bottle fed without you there. If you use formula, you have already completed this step. In the weeks leading up to your return to work, start to pump and give him bottles during the daytime hours. You will need to teach your baby how to take the nipple of a bottle instead of the breast during the day. The added bonus – this allows dad and family members to assist in feeding time. Once she can take a bottle from both you and family, his transition to caregivers at daycare will be much more seamless (and much less stressful for you!).

  1. Visit Before Starting Care (Again)

About a week before you start daycare, visit the facility. You will most likely need to fill out paperwork about the baby now that you have had her and finalize payments. My advice – take an extra half hour to go to the room your child will be starting in, sit down on the play mats, and chat with the staff. Start a personal connection with them, you and your baby. Tell the caregivers about him, what he likes, what his cries can mean, what he has just started experiencing, etc. Ask them about their backgrounds, how they like the facility, what the routine is like for drop off and pick up, what they want you to bring in the first day, where to store the car seat, how hot or cold the room can get so you know how to dress your baby, when is the baby too sick to bring in, and ask for suggestions on how to make their lives easier. Caregivers enjoy talking to parents about their days and you will enjoy getting to know who will be spending time with your child.

  1. What to Bring

Most daycares will give you a list of items to bring with you the first day. For example: labeled milk/food with dates and your child’s name on each piece (tops, lids, bottles, jars), diapers and wipes, a few sets of clothes with tags initialed, bibs initialed, a blanket labeled, 2 sets of sheets labeled, pacifiers labeled, etc. There is a lot of labeling – think about it – many babies rolling around losing socks, throwing up on bibs and pants, dropping blankets, etc. Label everything. A wonderful purchase we made were the dishwasher safe name labels for all of our daughter’s bottles, nipple tops and lids. They stay adhered for about 4 months of boiling. It is much easier to keep writing her name on painters tape every morning and sticking it to the bottles. We also use 2 of the same patterned reusable bags to take to and from daycare (labeled of course). You will have dirty clothes and bottles going home with you every day and need to bring new food, replacement clothes and bibs for the next day and replenish diaper stashes. Using the same bag has helped us organize at night before the morning craziness begins.

  1. Doctor Advice

Talk to your pediatrician at the 2-month check up about taking your baby to daycare. They will have a form to give the center with shots and allergy information. They will also have many tips and information on your child’s first cold. She will get sick at daycare. The cold will go away and a new one will return quickly. Learn when to call (fever temperature, types of coughing, breathing problems, stool problems, etc.) and when it is most likely just a bad cold. Sick babies are sad enough, let’s not add not knowing what to do to the equation.

  1. Purchases for the Home (the things no one tells you to put on your registry)

Here are a few purchases for your home that you need when the baby is sick or feels lousy after first trips to daycare. I recommend purchasing these or putting them on a list before you start daycare because it is much harder to tow a sick child to the store than a happy or sleeping child. 1: Cool mist humidifier (warm mist humidifiers present mold problems, talk to your doctor about warm versions if you have one). These are great to help loosen up the congestion. 2. Bulb syringe – sucking the snot out of the baby’s nose is not a happy time for either of you, but will make him feel better. 3. Saline drops – will also loosen up the little congested noses. 4. Angled crib pillow – this will keep baby slightly upright when stuffy, reducing the amount of times she is up during the night because she can’t breathe. 5. Baby Tylenol – talk to you doctor about this first. Multiple doctors in our pediatrician’s office recommended using this when the baby has a fever (this will reduce fever and help you determine if you need to bring the baby in for a sick visit). 6. Pedialyte – talk to your doctor about this too. Our pediatrician recommended this if the baby is not eating and needs some type of nourishment.

  1. It’s OK to be Sad

Drop off at daycare is a sad time for the parents, especially the mother for the first couple of weeks (well for me, first couple of months). Yes, they will take care of her, and yes, she will have a good time. She will grow to enjoy spending time with and will build relationships with the staff even at 3 months of age. The first time she smiled at a caregiver when I handed her off was the first morning I didn’t cry. The first time she started to babble with funny noises and laugh different laughs I understood how quickly she is learning from other children. And, the first time a caregiver told me to try a new toy because she was advancing quickly enough to enjoy it, I realized the extra expert advice was a nice thing to have.