It’s a season of emotions when you’re having your first child.

Excitement and happiness lead the positive charge, nervousness settles right there in the middle and fear and anxiety creep into the mix as well.

Who knew two tiny pink lines on a pregnancy test could lead to something so earth shattering?

You’ve probably got a lot of questions running through your head, and it’s natural to run to Google for a lot of things. But Mfowethu (mm-FOE-eh-too) Langeni, DO, a family medicine physician who specializes in obstetrical care with OSF HealthCare, has a kickstart list of what to expect when you’re expecting.

First trimester | Increased hormones, morning sickness, first appointment!

Pregnancies are broken up into three trimesters, and Dr. Langeni says the best way to start things off is to schedule a first trimester appointment with a local obstetrics & gynecology provider (OB/GYN).

"Your first trimester is between the first week to the 13th week of pregnancy. During that time, you can expect to have your initial OB visit. It usually takes a little longer than subsequent visits, but it's one of the most important visits to have. During it, we'll talk about your family history, medical history, if you've been pregnant before,” Dr. Langeni says.

You’ll need to get some blood work done to figure out your blood type and make sure everything looks OK. You can also expect to undergo a pelvic exam, checking the anatomy.

You can also talk to your doctor about genetic screening to find out what things your baby may be at-risk for. These are things like cystic fibrosis, sickle cell disease, or Down syndrome.

One major change that comes with pregnancy is hormonal. This can lead to what’s well-known as “morning sickness,” which varies from mother to mother.

"A lot of times moms will experience morning sickness the most in the first trimester. It's usually because of the pregnancy hormone (human chorionic gonadotropin, or hCG) that spikes really high," Dr. Langeni says. "Then it starts to taper off, so those symptoms start to go away. You can get some nausea or vomiting throughout the whole duration of your pregnancy, but it's usually going to be the first and early second trimester."

Medications are available to ease the nausea and vomiting, but it’s important to have that conversation with your OB/GYN on when it’s safe (for you AND the baby) to take any medication. Dr. Langeni says he prefers to focus on diet recommendations first before jumping right into meds. He recommends eating smaller portions of food more often during the day as a starting point.

Second trimester | Grow, grow, grow!

"It's week 14 to week 27. This trimester is where your baby's internal organs are actively growing really fast," Dr. Langeni says. "This trimester is where you may see your baby bump grow and feel baby moving. It's also where an ultrasound will be performed to check the anatomy of the baby to make sure the baby is doing OK and the arms, legs, heart, brain and all the organs look OK." 

Arguably the most exciting part of the second trimester is finding out the sex of the baby and getting those adorable ultrasound photos.

You’ll keep seeing your OB team and at the end of the second trimester, you’ll get testing done to see if you have gestational diabetes.

Third trimester | It’s almost baby time!

In the third trimester, mothers’ office visits become more frequent. You’ll see your care team every two weeks from week 28-36, and then once a week from weeks 36-40.

"This is the part of the pregnancy where you start to talk about 'how am I going to deliver my baby?' There are different methods, vaginal delivery vs. C-section," Dr. Langeni says. "If we need to get baby out a little early, for whatever reason. We'll also talk about the things we're going to do once you're at the hospital. Are you going to have medicines? Do you want no medicine? We'll talk about pain management and things like that so you can get acclimated on what to expect when baby is right around the corner."

Dr. Langeni says it’s extremely important to have a conversation with your OB about water breaking scenarios ahead of it actually happening.

"If you feel like your water broke, it's always recommended to come to the hospital or your primary obstetrician," Dr. Langeni says. "They'll do some tests to make sure your water is truly broken. But sometimes your water doesn't break, and then a scenario pops up where 'I'm past due and my water hasn't broken. I'm not going into labor, what should I do?' Those are really good discussions most providers will have with their patients before something like this happens. Then at least when something like this may happen, it's not the first time you're hearing about it."

Some OB teams will tell the mother she needs to be induced by a certain date, due to health and wellness of mother and baby.

"It depends on what your primary OB has in place for you. From my experience, a plan may be set in place that says when you hit a certain gestational age, for any reason, then we're going to go ahead and induce. Or if you haven't gone into labor by a certain point, we'll have you come to the hospital to start that labor process, so you can have a natural delivery."

If you’re in your third trimester and you haven’t scheduled a hospital visit to learn the lay of the land, you probably should! Dr. Langeni says this is a great way to see what a birthing suite will look like where you plan to deliver, learn more about the process and figure out specifically where to go in the hospital.

You can reach out to OSF HealthCare hospitals around the Ministry by filling out this form for a birthing tour. A Mission Partner will get back to you shortly and help set up your walkthrough!

Now, it’s baby time! OSF has a “hospital bag essentials” checklist for the mother, baby and support person during your stay you can find here. Birthing classes before you head to the hospital are important as well. Find those resources here.

OSF has OB/GYNs and care teams throughout the Ministry. You can find a list of providers here, along with locations and additional resources to help you on your journey to parenthood!

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The newest tool for protecting our littlest population is now available in the United States. 

The respiratory syncytial virus (RSV) vaccine was initially approved in summer 2023 for adults 60 and older, quickly followed by a recommendation by the U.S. Food and Drug Administration (FDA) for pregnant women. The goal of vaccinating pregnant women would be to pass on RSV antibodies from mom to baby.

"(Pregnant women should get the vaccine) somewhere between 32-36 weeks of pregnancy. As long as they receive the vaccine and give birth two weeks after or more after getting the vaccine, the baby should be having good protection for their first year of life,” says Kinnera Are, DO, a pediatrician with OSF HealthCare.

When is RSV season?

Dr. Are says RSV season normally starts in October, goes through the winter, and wraps up in March or April.

"We are expecting to see it this year, but hopefully not as bad as it has been the last couple of years,” Dr. Are adds.

What babies are eligible?

Infants eight months and younger are eligible for the RSV vaccine, along with older infants who have serious medical conditions like chronic lung disease and heart conditions.

"Some infants at higher risk are eligible to get the vaccine for their second RSV season. So, the second year October through March. Some things that would put them at higher risk if infants have chronic lung disease and prematurity and needed oxygen or medications within the last six months. Otherwise, we can offer it during that second season to infants from American Indian heritage or Alaskan Native heritage,” Dr. Area says. “Severely immunocompromised infants are eligible for that second season, and infants with cystic fibrosis who have issues with their lungs. Or if they're very small and are having issues with growth, they may also be eligible." 

How to protect infants and others from RSV

Ways to protect infants from RSV are on par with other respiratory illnesses.

-          Stay away from sick individuals

-          Keep kids home if sick (fever, runny nose)

-          Prioritize good sleep

-          Focus on good eating habits, hydration

-          Wash your hands

"RSV will show symptoms like most other respiratory illnesses. So, you may start off with congestion and runny nose, maybe a fever or a cough," Dr. Are says. “RSV, especially in the infant age group, tends to affect the lungs a little bit more than older kids. So, you may see more of that cough or congestion that's not coming out.”

Days 3-5 are usually the worst

"Any respiratory illness, but especially RSV, is worse between days three and five. Based on where the infant is when they come in, we'll guide them to see if they're getting better or do we expect it to get worse before it gets better,” Dr. Are says.

When it’s time to go to the emergency department

“Two things that would make me tell someone they need to go to the emergency room; One, if the infant is having respiratory distress like breathing really fast, having trouble breathing or having a lot of wheezing that is not getting better and it's very persistent," Dr. Are says. “You can give us a call (at the pediatrics office) but we'll probably recommend you go to the emergency room. The other thing is dehydration. Severe hydration can be shown in no wet diapers for eight hours and no urine output for eight hours. That's a sign they probably need some IV fluids and need to go to the emergency room for care.”

If a pregnant mother didn’t get the RSV vaccine, your child’s pediatrician will ask if they want the baby to get the vaccine in the first few visits.

Normally, symptoms can be managed at home. Antibiotics aren’t prescribed, since RSV is a virus, but sometimes the virus can cause a secondary bacterial infection like pneumonia, which could call for antibiotics. You can use a nasal suction tool to keep the baby’s nose and airways clean, which is especially important when they’re eating or sleeping.

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Their sleep schedule is becoming more “normal,” and they're hitting some of their first milestones. 

Then, it's time to introduce them to solid foods. 

But with a new adventure can come a fear about things like allergens. 

According to the United States Department of Agriculture (USDA), “The Big 9” of food allergies are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans and sesame. 

This long list may be daunting to new parents, but Michael Endris, MD, a pediatrician with OSF HealthCare, offers some tips to help guide parents through the journey.

“We know that the earlier introduction of those high allergen foods is beneficial and protective against developing those food allergies,” Dr. Endris says. "Every child is going to be a little bit different. But usually in that four to six-month range is when they are ready to introduce those foods. There are a few steps that we're looking at before we're talking about introducing that.”

Dr. Endris recommends starting to start introducing solid foods, including allergens, during the four to six month window of your baby's life.

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You’re finally getting into a rhythm with your newborn baby.

Their sleep schedule is becoming more “normal,” and they’re hitting some of their very first milestones, but guess what? It’s time to introduce them to solid foods.

With a new adventure, comes fear about things like allergens. According to the United States Department of Agriculture, “The Big 9” of food allergies are milk, eggs, fish, shellfish, tree nuts, peanuts, wheat, soybeans and sesame.

This long list may seem daunting to new parents, but Michael Endris, MD, a pediatrician with OSF HealthCare, offers some tips to help guide you through the journey. He says it’s not necessary to sit outside the emergency room (ER) when introducing an allergen for the first time.

"If kids don't have any other food allergies or risk factors to food allergies like family history or eczema, which can place kids at a higher risk of having food allergies, we don't need to worry about eating those foods outside the ER just in case anything bad happens,” Dr. Endris says.

Four to six-month window

"We know that the earlier introduction of those high allergen foods is beneficial and protective against developing those food allergies. Every child is going to be a little bit different. But usually in that four to six-month range is when they are ready to introduce those foods. There are a few steps that we're looking at before we're talking about introducing that,” Dr. Endris says.

Milestones to hit before eating solids

“First, kids should be old enough to sit up in a chair without completely slouching over. That's a good marker that they're strong enough to get that food where it needs to go. We want to make sure they are interested in it,” Dr. Endris says. "Infants have a reflex where if you load a spoon up with food and try to put it in their mouth, their tongue will push it out. Usually, that reflex goes away around 4 months or so. If we notice the baby is uncoordinated or not accepting the food, then we want to try again in a week and see if that reflex is gone."

The Centers for Disease Control & Prevention (CDC) recommends parents work on their children developing fine motor skills during this time.

-          Pinching or picking up food with their fingers

-          Develop chewing skills

-          Learn to accept and enjoy a variety of foods

Acceptable textures for food include being smooth (strained or pureed), mashed or lumpy, finely chopped or ground. Start with mashed foods first, then transition to finely chopped or ground.

Baby-led weaning

Instead of relying strictly on purees and baby cereal, some parents choose to go the baby-led weaning (BLW) route. This allows parents to offer solid foods to babies to let them feed themselves. The food offered supplements the baby’s diet, while breast milk or infant formula remains the main foundation.

"Baby-led weaning is a great way to incorporate a diverse diet. We want to make sure that as a part of that, there's some of those high allergen foods involved. It's also a great way for babies to work on those fine motor skills of being able to pick those foods up and feed themselves,” Dr. Endris says.

However, it’s important to cut foods properly before serving your child. Fruits, vegetables and cooked meats can be cut into “finger-sized” slices that your baby is able to hold. Avoid round foods like whole berries and grapes. Make sure to cut the blueberries in half and then mash them before feeding your baby.  

Also avoid hard or crunchy foods like popcorn, nuts or tortilla chips that can be a choking hazard.

The National Institutes of Health (NIH) recommends only feeding your infant when he or she is healthy; do not offer the feeding if they have a cold, vomiting, diarrhea or other illness. Give the first feeding at home in a safe environment, not at a day care facility or restaurant.

The caregiver feeding the infant should be completely focused on the baby, without any distractions, and spend at least 2 hours with the infant after the feeding to watch for any signs of an allergic reaction.

When feeding peanut butter, the NIH recommends mixing 2 teaspoons of peanut butter with 2-3 teaspoons of hot water. Stir until the peanut butter is dissolved, thinned and well-blended. Allow the peanut recipe to cool and then feed.

What if my child has an allergic reaction?

"If a child is having anaphylaxis, which is not only hives or a rash, but they are vomiting, wheezing or acting really sleepy. If your "mom alarm" is going off and you think something is wrong with your child, then we want to make sure we're calling EMS or going to the emergency department to address that,” Dr. Endris says.

If you have any fear or anxiety this may happen with your child, Dr. Endris says there are safe environments inside the pediatrician’s office you can pursue.

"We can offer testing to see if your child is at an increased likelihood of having those significant reactions. If so, we can do a food challenge in the office with an allergist to make sure we are there in case anything unfortunate does arise,” Dr. Endris says.

If your child has a rash around the mouth, their eczema is flaring up, or they have diarrhea in the coming days, Dr. Endris recommends giving your child’s pediatrician a call to discuss the symptoms.

Hitting the one-year mark

Hopefully by one year old, your baby has developed strong motor skills for eating and is enjoying a wide variety of foods.

However, it is widely recommended to not allow babies to eat honey before they reach one year old. Honey can cause botulism, a type of food poisoning, for kids under the age of one.

On the other hand, once your baby reaches one year old, you can start offering whole milk (Vitamin D milk) to your child. It is recommended to discuss this switch with your pediatrician beforehand.

"We want to make sure those kids are staying on breast milk or infant formula until they're a year old. We want to avoid introducing any cow's milk until they are of that age. They can have cow's milk products like cheese or yogurt before then, but we want to make sure their primary nutrition comes from the infant formula or breast milk,” Dr. Endris says.

Once your child hits the 1-year mark, breast milk or formula is still a viable option to keeping infants’ diets nutritious. But soon after, you can begin to wean the child off breast milk or formula and allow whole milk to take its place.

The CDC says you can move your baby to low-fat (1%) or fat-free dairy milk once they are 2 years old.

When can my baby have water?

After six months, offering small amounts of water to your baby is OK. But before six months, babies drinking water can actually lead to diarrhea and malnutrition. Limit the amount of water your baby drinks at a time to 2-3 ounces, and only offer it if the baby’s hunger has been satisfied by breast milk or formula.

Study released about early introduction of allergens

Dr. Endris and his team at OSF St. Joseph Medical Center in Bloomington, Illinois were a site that participated in a study to bring forth the early introduction of allergens.

The Intervention to Reduce Early Peanut Allergy in Children (iREACH) study was launched by the Center for Food Allergy and Asthma Research (CFAAR) at Northwestern University Feinberg School of Medicine & Robert H. Lurie’s Children’s Hospital of Chicago.

Through the guidelines recommended in the study, the investigators hoped to find a way to prevent peanut allergy and reduce the amount of people who are allergic to peanuts.

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After nearly six decades of research, experiments and testing, the U.S. Food and Drug Administration has officially approved the first RSV vaccine.

Respiratory syncytial virus (RSV) is a common respiratory virus that causes mild, cold-like symptoms. While the virus is normally mild in most people, it can be extremely serious for infants and some higher-risk older adults.

Douglas Kasper, MD, section head of infectious disease at the University Of Illinois College Of Medicine Peoria and an infectious disease specialist for OSF HealthCare, says, currently, the Arexvy vaccine is only approved for individuals 60 and older but the hope is to expand who can receive the RSV vaccine by the end of summer.

“There are ongoing trials looking at vaccinating mothers who are pregnant,” Dr. Kasper says. “This would be for potential protection of unborn children, but that has not been approved yet. There’s expected re-evaluation of that data coming this summer. Hopefully by August we get some updated patient groups.”

Dr. Kasper says if the RSV vaccine is successful in pregnant women, it could provide life-saving antibodies for their babies.

“We’re trying to use the mother’s ability to create an immune response, because the baby cannot do that on their own. So if we can vaccinate during pregnancy, which is the study group we’re awaiting data for, there would be a huge benefit for young children that currently does not exist,” Dr. Kasper says.

Dr. Kasper says this vaccine is much different than the COVID-19 vaccine.

“This is not an MRNA vaccine which is something we talked very commonly with COVID-19,” Dr. Kasper says. “This is more of a traditional vaccine. The person is being exposed to a protein from the virus and then they make an immune response that protects them if they were ever exposed to the virus. It’s much more akin to the influenza vaccine that most people are comfortable with.”

Dr. Kasper says most older adults who get RSV experience mild symptoms. But he says doctors have seen a change in RSV symptoms during the COVID-19 pandemic.

“Particularly those with chronic lung disease, RSV can almost mimic COVID-like illness that brought some people to the hospital,” Dr. Kasper says.

Dr. Kasper adds that the late summer timing would be good to expand the RSV vaccine for other high-risk groups, since most cases are normally seen in the fall through spring.

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Every year, thousands of babies are born at OSF HealthCare hospitals.

At OSF Saint Francis Medical Center in Peoria alone, roughly 2,200  babies were born in 2022.

This means any day now, parents will be attempting to add solid foods to the breast milk or formula their baby only eats now. This can be a scary idea for new parents!

The Centers for Disease Control and Prevention (CDC) recommends not introducing solid foods to your baby until after they’re at least 4 months old, and there are signs to look for to see if they’re developmentally ready.

Your child should be able to:

• Sit up alone or with support.
• Control their head and neck.
• Opens their mouth when food is offered.
• Swallow food rather than push it back out onto the chin.
• Bring objects to the mouth.
• Try and   grasp small objects, such as toys or food.
• Transfer food from the front to the back of the tongue to swallow.

Anne Orzechowski, an Advanced Practice Nurse with OSF HealthCare who specializes in family medicine has some tips to help parents make a smooth transition.

“The best way to introduce your infant to greens is to pick one vegetable. Then if you have an infant that is above 4-6 months, you can puree it to a consistency that is safe for them to get down. Just give it a try with their rice cereal and see how they do. Pick one at a time, and make sure they aren’t allergic to it,” Orzechowski says.

The American Academy of Pediatrics says most kids don’t need to be given foods in a certain order. By the time your baby is 7 or 8 months old, they can eat from a variety of food groups. This could be infant cereals, meat or other proteins, fruits, vegetables, grains, yogurts and cheeses, and more.

Orzechowski recommends steaming vegetables to reduce the risk of choking.

“You could do carrot coins!” Orzechowski says. “You can steam pretty much anything. As long as it’s cut up into tiny pieces that they won’t choke on.”

Not sure what food group to introduce to your child first? Orzechowski has some suggestions.

“I think introducing veggies before you introduce fruits is helpful. It’s exciting to them, they start to like it, they look forward to it. Then once you introduce a fruit, they’re like ‘wow!’ she says.

Orzechowski says vegetables and fruits have plenty of health benefits for kids, like fiber. She says the fiber from fruits and vegetables will help keep your child regular and benefit their digestive tract.

The CDC has additional tips for preparing food for your children.

• Mix cereals and mashed cooked grains with breast milk, formula, or water to make it smooth and easy for your baby to swallow.
• Mash or puree vegetables, fruits and other foods until they are smooth.
• Hard fruits and vegetables, like apples and carrots, usually need to be cooked so they can be easily mashed or pureed.
• Remove all fat, skin, and bones from poultry, meat, and fish, before cooking.
• Remove seeds and hard pits from fruit, and then cut the fruit into small pieces.
• Round foods like hot dogs, sausage and string cheese should be cut into short thin strips instead of round pieces that could get stuck in the airway. Grapes, cherries, berries and tomatoes should be cut into small pieces.

Anne Orzechowski interview clips