PREGNANCY AND

INFANT
HEALTH EDUCATION
PACKET

MATERNAL INFANT HEALTH PROGRAM (MIHP)

WWW.MICHIGAN.GOV/MIHP
TABLE OF CONTENTS
Prenatal Care......................................................................................................................................................... 3
Labor and Delivery ................................................................................................................................................ 3
Food and Nutrition ................................................................................................................................................ 4
Housing ................................................................................................................................................................. 5
Transportation ...................................................................................................................................................... 6
Social Support ....................................................................................................................................................... 6
Smoke Exposure .................................................................................................................................................... 6
Smoking and Vaping.............................................................................................................................................. 7
Alcohol .................................................................................................................................................................. 8
Medications and Substances ................................................................................................................................ 8
Abuse/Violence ..................................................................................................................................................... 9
Asthma ................................................................................................................................................................ 10
High Blood Pressure ............................................................................................................................................ 10
Diabetes .............................................................................................................................................................. 11
Stress, Depression and Mental Health................................................................................................................ 11
Family Planning ................................................................................................................................................... 12
Interconception Health ....................................................................................................................................... 12
Infant Health ....................................................................................................................................................... 13
Infant Feeding and Nutrition .............................................................................................................................. 14
Breastfeeding ...................................................................................................................................................... 15
Crying and Soothing ............................................................................................................................................ 16
Infant Safe Sleep ................................................................................................................................................. 17
Vaccines .............................................................................................................................................................. 17
Infant Development ............................................................................................................................................ 18
Take Care of Yourself .......................................................................................................................................... 19
More Information ............................................................................................................................................... 19

Cover Page Image Credit: Safe sleep image courtesy of National Institute for Children's Health Quality Safe
Sleep Flickr Album; Breastfeeding image courtesy of USDA WIC Breastfeeding Image Gallery
PRENATAL CARE
What is prenatal care? How often are prenatal care visits?
• Prenatal care is the health care you receive • Weeks 4 – 28: Every month
during pregnancy. • Weeks 29 – 35: Every two weeks
At prenatal visits, your healthcare provider will: • Week 36 – delivery: Every week
• Check to see that you are healthy. What are signs that something could be wrong?
• Find out how your baby is developing. • Dizziness or fainting
• Let you know what to expect during • Double or blurred vision; Or seeing spots
pregnancy and birth. • Fever and/or chills
• Explain how to take good care of yourself • Frequent and/or burning urination
and your baby. • Persistent or severe headache
• Discuss feeding options and the benefits • Severe or constant vomiting
of breastfeeding. Planning how you will
• Steady abdominal pain not relieved by a
feed your baby is important and allows bowel movement
you to get support ahead of time.
• Sudden gush or steady trickle of water
Why should I get prenatal care? from the vagina
• To help you have a healthy pregnancy and • Sudden swelling of face, hands, or feet
a full-term baby (born between 39 weeks • Sudden weight gain
0 days and 40 weeks 6 days). • Vaginal bleeding
• To get answers to your questions. Do not What should I do if I have any of these signs?
be afraid to ask! It is important to be sure
• Call your healthcare provider.
your concerns are addressed.
• If necessary, call 911.
• If a problem comes up, it can be
addressed right away. Where can I get more support during the
prenatal period?
Be sure to:
• Breastfeeding classes
• Go to all prenatal appointments, even if
• Childbirth education classes
you feel fine.
• Doula support
• Follow your healthcare provider’s
recommendations. • Parenting or community groups
• Pregnancy support groups
Learn more: March of Dimes - Prenatal Checkups

LABOR AND DELIVERY

Every person’s labor is different, and it may be different each time you have a
baby. Learning about labor, birth and speaking to your healthcare provider can
help you feel supported.
How will I know when I am having my baby?
• Most babies are born near their due date. It is best to stay pregnant for at
least 39 weeks to give your baby the time needed to grow and develop.
This time helps your baby’s brain, lungs, eyes, and ears, as well as their
ability to suck and swallow.
• Learning signs of labor helps provide clues when baby is coming.

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Signs that labor is starting: What else should I know?
• Muscles in your belly get tight and then • Ask questions and speak openly with your
relax. This is called a contraction. healthcare provider. This helps you feel
• A rush of clear liquid from the vagina or confident throughout the birthing process.
“water breaking” What should I bring with me?
• Pain in your belly and lower back It is important to have your health insurance card.
• Contractions get close together and You may also want to bring items for comfort. A
stronger. It can help to count the time few items to bring could include:
between contractions from the start of • Change of clothes and toiletries for you
one to the start of the next. and those who will be with you
Who should be with me during labor? (toothbrush, toothpaste, etc.)
• This is an important decision for you and • Infant car seat
your family. • Infant clothing
• Make sure the people with you make you What will happen when I arrive at the
feel safe and listened to during childbirth. hospital/birth center?
• Ask your healthcare provider how many • A healthcare provider will speak with you
people can be in the room with you. about how you are feeling and how far
What is labor? apart your contractions have been.
Labor is the process that allows your baby to be • A healthcare provider may check how
born. There are three stages to labor: your body is changing and how the baby is
1. First Stage: Contractions get more intense doing, which may involve a physical exam.
and closer together. Your body is changing What is a C-section?
to prepare for delivery. A C-section or Cesarean birth is a surgery in which
2. Second Stage: The “pushing phase” occurs your baby is born through a cut made through
so the baby is delivered. your belly and uterus. For some people with
3. Third Stage: The placenta is delivered. medical conditions, this may be the safest option.
Will it hurt? • A C-section may be planned (“scheduled”),
Labor feels different for everyone, and your body which means you and your healthcare
may feel things it has never felt before. Some provider decide when it will happen. Ask
ways for dealing with labor can include: about waiting until at least 39 weeks of
• Having someone with you that you trust. pregnancy for a scheduled C-section.
• Slow, steady breathing. • A C-section may be required in an
• Moving your body: Walking or changing emergency if there is a danger to you or
positions. your baby during labor.
• Medication: Your provider can discuss options.

Learn more: ACOG - Labor and Delivery

FOOD AND NUTRITION

Does what I eat while I am pregnant really matter?
Yes! Your baby needs nutrition to form a healthy brain, strong bones and muscles.
• Eat more healthy food: fruits, vegetables, grains, pasteurized dairy products, lean meats, and beans.
• Eat less high calorie, nutritionally empty items like cookies, chips, candy, etc. These foods are high in
fat, salt and calories and low in the nutrients needed to help your baby grow.
 • Ask your healthcare provider about foods you should avoid altogether.
• “Eating for two” does not mean to consistently overindulge. It means choosing nutritious foods for
you and your baby.
How am I supposed to eat healthy food when it costs so much?
• One way to get healthy food is to sign up for the Special Supplemental Nutrition Program for Women,
Infants and Children, also known as WIC. WIC benefits can be used at grocery stores and pharmacies
so that you can access healthy foods.
What is WIC?
• WIC is a nutrition program for women, infants and children.
• WIC supports pregnant, breastfeeding, and postpartum women, infants, and children up to age 5.
• The WIC food package is worth $30-$112 or more per month per person.
WIC can also help you learn more about:
• Nutritious food intake during pregnancy.
• The importance of prenatal vitamins.
• Breastfeeding.
• What to do if you or your baby have special nutritional risks (food allergy, anemia, obesity,
gestational diabetes, a food disorder, etc.).
• Support groups such as breastfeeding support and community or parenting groups.
To find your local WIC agency, visit MDHHS WIC (www.Michigan.gov/WIC) or call 2-1-1.
What do I do if I run out of food before I am able to buy more?
• Have a back-up plan in case you get low on food. Your baby needs nutritious food every day.
• Find out about food banks and other emergency food programs in your area.

Learn more: Ready, Set, Baby Online (www.ReadySetBabyOnline.com)

HOUSING
What if my baby and I do not have a place to live?
• There are agencies that can help you find housing.
o They can help you find a temporary place to live if you have no place to go.
o They also can help you find a permanent place to live.
o Visit MI Bridges (www.Michigan.gov/MiBridges)
What if my house or apartment is in an unsafe neighborhood?
• If you live in an unsafe neighborhood, you should have a safety plan in mind. This means knowing
exactly what you would do if you were threatened – who you would call and where you would go.
• Always lock entry doors, car doors, windows, etc.
• You may be able to get your local police to come and do a safety inspection.
How do I keep my baby safe from environmental hazards in our home?
• Find out how to prevent lead poisoning. Lead can be in old paint, household dust, soil, and some
ceramics. Learn more about lead from MDHHS MI Lead Safe (www.Michigan.gov/MiLeadSafe)
• Find out how to prevent problems caused by toxic household chemicals. These chemicals are in
cleaning products, pesticides, paint, and automotive products.

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TRANSPORTATION
How important is transportation now that I am What if I have a ride set up, but it falls through at
pregnant? the last minute?
• It is very important to have transportation • You need to have a back-up plan.
you can count on while you are pregnant. Keep phone numbers for:
What if I do not have transportation I can rely on? • Medicaid Health Plan transportation.
• Your Medicaid Health Plan can get you to • Family, friends and neighbors with cars.
pregnancy-related services. • Someone at your place of worship.
• Department of Human Services also may be • Cab companies.
able to set up transportation. • Public transportation.
• Some volunteer groups may provide rides. • You should also have a plan in case you
need emergency transportation.
Learn about transportation options: MI Bridges (www.Michigan.gov/MIBridges)

SOCIAL SUPPORT
What is social support? Why is social support important in pregnancy?
• Social support means having people to We all need social support, especially
•
turn to when when we go through big life changes.
you need • Pregnancy is a very big life change and can
them. be stressful at times.
Supportive people: What resources are available to meet people?
• Listen to you. • Childbirth education classes
• Treat you with • Pregnancy support groups
kindness and • Breastfeeding classes
respect. • Parenting or community groups
• Help you figure out how to solve problems.

SMOKE EXPOSURE
What is secondhand smoke? Secondhand smoke is also dangerous after your
• Secondhand smoke is smoke people breathe baby is born. Babies exposed to secondhand smoke:
in when someone else is smoking. • Have higher risk of Sudden Infant Death
• It is harmful to infants, children and adults. Syndrome (SIDS) and sleep-related infant
• There is no safe level of exposure. death.
How does secondhand smoke affect pregnancy? • Can have permanent lung damage.
• Are at greater risk for asthma, ear infections,
• Secondhand smoke during pregnancy can
bronchitis, and pneumonia.
cause a baby to be born too soon and too
• Can have more coughs and colds.
small. This can lead to life-long health
problems and learning delays.

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What am I supposed to do when just about • Young children have the highest risk of
everyone I know smokes? exposure to thirdhand smoke because they
• Avoid secondhand smoke in your home: put so many things in their mouths.
o Ask family members and visitors to • The chemicals in thirdhand smoke can
please smoke outdoors and thank increase cancer risk, cause headaches and
them for smoking outdoors. earaches, lower ability to fight infection,
worsen respiratory illness, and more.
o If someone gives you a hard time,
say “Sorry, but I am not taking any How can I protect myself and my baby from
chances with my baby’s health.” thirdhand smoke?
• Stay away from places where people smoke. • The only way to protect yourself and your
baby is to create a smoke-free environment.
What is thirdhand smoke?
• If you cannot avoid exposure, some ways to
• Thirdhand smoke is the leftover smoke reduce thirdhand smoke residue include:
chemicals that remain on surfaces from o Not allowing smoking in the house.
people smoking nearby. o Have smoker change clothes and
• The residue clings to furniture, clothing, shower or wash hands.
bedding, carpet, toys, and other surfaces o Frequently clean surfaces and
long after smoking has stopped. vacuum/mop.
• Thirdhand smoke contains toxic chemicals o Frequently wash
that are harmful. clothing/bedding/curtains.
How does thirdhand smoke affect my baby? What about e-cigarettes and vapes?
• Babies can be exposed to thirdhand smoke if The aerosol from e-cigarettes or vapes has
•
they chew on affected objects, crawl on cancer-causing chemicals. When somebody
affected carpet, are held by people wearing vapes or uses an e-cigarette, they exhale the
affected clothing, and many more ways. aerosol and can expose you and your baby to
secondhand and thirdhand aerosol.
Learn more: MDHHS Tobacco (www.Michigan.gov/Tobacco)

SMOKING AND VAPING

How does smoking while pregnant hurt my baby?
• Your baby’s brain gets less oxygen, which can impair your baby’s growth.
• It can impair your baby’s breathing after birth.
• It increases the risk that your baby will be born too early.
• It increases the risk of SIDS and sleep-related infant death. In Michigan, babies born to someone who
smoked during pregnancy were 4.4 times more likely to die in a sleep environment than infants born
to a person who did not smoke1.
• It increases the risk that your baby will have learning or behavior problems, including hyperactivity.
1: Sleep-Related Infant Deaths in Michigan (2010-2018) (www.KeepingKidsAlive.org)
I tried to quit before, and I could not do it. Why should I think it will be any different now?
• Now, you have the most important motivation – your baby’s health is at stake.
• There are different ways to quit, and you probably have not tried them all.
• Smoking is not the only way to cope with stress – you can learn other ways.
• You will save a lot of money that you can spend on your baby.
• It is always worth it to try to quit – you never know which time will be the time that you succeed.

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How can I quit when most of my family and friends are smokers?
• It is hard, of course, but there are some things you can do:
o Let your partner, family and friends know that you are quitting for your baby.
o Ask for their support and ask them to quit with you if you both smoke.
o Thank them for not smoking around you and your baby.
What about vaping or using e-cigarettes?
• E-cigarettes and vapes contain toxins that are not safe during pregnancy. They contain nicotine which
can damage baby’s brain and lungs. Even vapes without nicotine can harm a baby. The aerosol has
chemicals like lead and other heavy metals, which can harm a growing baby.
Learn more: MDHHS Tobacco (www.Michigan.gov/Tobacco)
Or call the Quitlink: 800-QUIT-NOW (800-784-8669)

ALCOHOL
What happens to my baby if I drink alcohol while I am pregnant?
• Alcohol can hurt your baby’s brain, heart, kidneys, and other organs.
• Your baby could be born with conditions known as fetal alcohol spectrum disorders (FASD).
• Some babies with FASD have intellectual disability.
• Your baby could be low birthweight, so they may not be off to as good a start as other babies.
• Alcohol use can increase your baby’s risk of sleep-related infant death.
What if I just have a beer or a glass of wine and do not get drunk?
• There is no safe level of alcohol you can drink during pregnancy.
• All types of alcohol are equally harmful (beer, wine, liquor, etc.).
• The best choice is not to drink at all when you are pregnant.
What if I cannot stop drinking while I am pregnant?
• It can be very hard to stop drinking, but there are many programs to help.
• Even if you have tried to stop drinking before, try again. Do not give up.
• Michigan has special programs for pregnant and postpartum people who want to quit drinking.
• Quitting drinking is one of the best things you can do for your baby and yourself.

Learn more and get help: MDHHS FASD Info (www.Michigan.gov/FASD) and SAMHSA Find Treatment
Locator (https://findtreatment.samhsa.gov)

MEDICATIONS AND SUBSTANCES

What if I use drugs/substances while pregnant? Some legal, prescription medications:
Drug use during pregnancy can lead to: • Can cause birth defects.
• Premature labor. • May cause long-term effects such as
• Miscarriage. behavior problems.
• Low birth weight, which put your baby at • But some may be necessary for your health
risk for illness and delays in development. or your baby’s health.
• Your placenta can separate from your Always take prescription drugs as directed by your
uterus, which can be life-threatening. healthcare provider (HCP). Ask before you start,
stop, or change the dosage of a prescription.
Over-the-counter medications: Is marijuana safe while pregnant or breastfeeding?
• Even well-known medicines from the • There is no amount of marijuana proven to
drugstore can be harmful in pregnancy. be safe during pregnancy or breastfeeding2.
• Always ask your doctor before using over- • Using marijuana while pregnant may be
the-counter drugs while pregnant. linked to preterm birth, low birth weight,
and problems with learning and behavior2.
Dietary supplements:
• Marijuana use can
• Dietary supplements include vitamins, increase the risk of sleep-
minerals, herbs, and amino acids. related infant death.
• Your doctor might have you take certain • Marijuana can be
vitamins and minerals during pregnancy. transferred to your baby
• Ask your doctor before taking in breast milk so it should not be used
supplements. Most supplements have not while breastfeeding.
been proven to be safe during pregnancy. 2: Marijuana and Pregnancy: SAMHSA.gov

Learn more and get help: MDHHS Get Help Now and SAMHSA Treatment Locator

ABUSE/VIOLENCE
What is domestic violence?
It is physical, emotional, or sexual abuse by your current (or past) partner.
Domestic violence:
• Happens to people of all ages, races, income levels, and faiths
• Is about getting control over another person
• Can result in serious injuries and life-long disabilities
• Happens to people who are or have been dating, living together, or married
• Happens over and over again, even if the abuser promises it will not
How does it affect my baby if I am abused while I am pregnant?
• Your baby could be at risk for brain damage, injuries like broken bones, and slow growth.
• Your baby would also hear, react and feel the violence you experience.
How do I know if I am really in an abusive relationship? Does your partner:
• Embarrass you? • Stop you from talking to friends or family?
• Call you names or put you down? • Take your money or refuse to give you money?
• Shove you, slap you, kick you, or hit you? • Tell you that you are a bad parent?
• Say “I’m sorry,” but then does it again? • Threaten to take away or hurt your
• Look at you or act in ways that scare you? children?
• Say it is your fault, or blame you or others • Destroy your property or threaten to kill
for everything? your pets?
• Control what you do, who you see or talk • Threaten to kill himself or herself?
to, or where you go? • Threaten to kill you?
If you answer “yes” to one or more of these questions, you are probably in an abusive relationship.

Learn more and get help: MDHHS Domestic Violence Information

(www.Michigan.gov/DomesticViolence) or The Hotline (www.TheHotline.org)
• National Domestic Violence Hotline: 1-800-799-7233 (or TTY 1-800-787-3224)

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ASTHMA
How can my asthma affect my pregnancy? • Talk with your healthcare provider
about your action plan.
• During pregnancy, asthma can cut back
on the oxygen your baby gets from you. • It may include:
o Drugs to control your asthma.
• The more control over your asthma, the
o Drugs to control your allergies.
less risk there is to you and your baby.
o Identifying things that trigger
What happens if my asthma is not controlled? your asthma attacks and ways
If your asthma is not controlled, risks include: to decrease exposure to them.
• High blood pressure and preeclampsia. o Monitoring fetal movements so
• Preterm birth (before week 37). you will notice if there is less
• Low birth weight. activity during asthma attacks.
• Higher risk of c-section. o Having an emergency plan
How do I make sure my asthma is controlled? • Keep all appointments and follow your
healthcare provider’s
• Have an asthma action plan to prevent recommendations.
and control asthma attacks.

Learn more: MDHHS Asthma (www.Michigan.gov/asthma)

HIGH BLOOD PRESSURE

What is high blood pressure?
High blood pressure or “hypertension” means the pressure in your blood vessels is
higher than it should be. You may have had high blood pressure before pregnancy or
may develop it during pregnancy. If diagnosed before pregnancy or during the first half
of pregnancy, it is called chronic hypertension and does not go away after delivery. If
you develop high blood pressure in the second half of pregnancy (after 20 weeks), it
usually goes away after delivery. It is not less serious, though. High blood pressure can
cause serious problems, but they may be prevented with proper prenatal care.
How will I know if I have high blood pressure? What is preeclampsia?
• The only way to know if you have high Preeclampsia is a serious condition related to high
blood pressure is to get it checked at your blood pressure. It happens when your blood
healthcare provider’s office. pressure is high, and you have other signs that your
• Have your blood your blood pressure organs are not working normally. It can happen to
checked regularly while pregnant. any pregnant person, usually in the second half of
Can high blood pressure affect my baby or me? pregnancy. It can also occur after delivery. If not
controlled, you can have seizures, which is called
Yes - Some risks are:
eclampsia. Seizures can cause serious harm,
• You could have a heart attack or stroke. including coma and death.
• Your baby could be born early. What are the warning signs of preeclampsia?
• Your baby could be low birth weight.
• Headache that will not go away
• You may have to have a C-section.
• Nausea in the second half of pregnancy
• Your placenta could separate from your
uterus, which can be life-threatening. • Vision changes
• You could develop preeclampsia. • Quick weight gain
• Swelling of the hands or face

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 • Pain in the upper belly or shoulder • Eat a healthy diet and exercise regularly.
• Difficulty breathing • Avoid gaining too much weight while you
What can I do to help control my blood pressure are pregnant.
and prevent preeclampsia? Contact your healthcare provider immediately if
• Attend all your prenatal appointments. you have any warning signs of preeclampsia or
• Talk to your healthcare provider about your blood pressure is too high.
ways to manage your blood pressure.

DIABETES
Diabetes occurs when your body does not make enough insulin or cannot use insulin well. This leads to
blood sugar (glucose) getting too high. You may have had diabetes before pregnancy or develop it
during pregnancy. If found during pregnancy, it is called gestational diabetes. Regardless of when it is
diagnosed, it is important that blood glucose is at a safe level.
Risks to your health include:
• Hypertension (High blood pressure)
• Having a large baby and needing a C-section at delivery
• Higher risk of developing type 2 diabetes
Risks to your baby’s health include:
• Being born very large and with extra fat. This can make delivery difficult and more dangerous for
your baby. It also increases the chances your baby will have weight problems later in life.
• Low glucose levels right after birth.
• Breathing problems.
• Increased chance of having type 2 diabetes later in life.
Learn more: MDHHS Diabetes (www.Michigan.gov/Diabetes). If you or a loved one has diabetes,
there are programs and trained Diabetes Educators available to help!

STRESS, DEPRESSION AND MENTAL HEALTH

What is Perinatal Mood and Anxiety Disorder (PMAD) or “postpartum?”
• It is depression or anxiety that occurs during pregnancy or postpartum (within a year after birth).
• It is very common.
• It can be mild, moderate, or severe.
How do I know if I might be depressed or anxious?
• People with perinatal depression and anxiety usually sense that “something is not right.”
Would you answer “yes” to any following statements?
• I feel very sad and hopeless most days. • I cannot sleep well because I am unhappy.
• I am not enjoying life like I used to. • I want to sleep all the time.
• I blame myself for everything. • I am confused and distracted.
• I worry about everything. • I get angry very easily.
• I am afraid and I do not know why. • I do not think I will be a good mother.
• I feel overwhelmed and have a hard • I think of harming myself or others.
time coping. • I hear voices or see things that are not
• I cry a lot. there.

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If you answered “yes” to any of these statements above, you may be anxious or depressed. You are
not alone: Many pregnant people and new parents experience this. If feelings of anxiety or depression
last for a few weeks or affect your everyday life, it is time to ask for help.
How could Perinatal Mood and Anxiety Disorder affect my baby?
It can be harder to form a strong emotional attachment. Attachment is important to your baby’s
development. Your baby could also:
• Be born too small or too early. • End up with learning problems or with
• Be fussy and/or jittery. behavior problems.
• Have feeding or sleeping problems.
Where can I get more support for my mental well-being?
• Your healthcare provider.
• Local groups such as community groups and parenting classes to connect with others.

Learn more and get help: Postpartum Support International (www.psichapters.com/mi)

FAMILY PLANNING
What is family planning?
• Family planning means using birth control to space out pregnancies and plan your family size.
• It is best to wait at least 18 months after giving birth before getting pregnant again.
• There are many different methods of birth control (the pill, IUD, patch, shot, condom, etc.).
• If you want to use birth control, you can choose the method that is best for you.
Why should I space out my pregnancies?
• It is better for your health.
• It is better for your baby’s health.
• It can be less stressful.
Where can I get family planning services?
• Your healthcare provider’s office
• Planned Parenthood
• Your local family planning clinic (www.Michigan.gov/FamilyPlanning, then select “Find a Clinic”)

Learn more: MDHHS Family Planning (www.Michigan.gov/FamilyPlanning) and Bedsider

INTERCONCEPTION HEALTH
What is interconception health?
Interconception is the time between pregnancies.
Use this time to make sure you are healthy. This is especially important if you ever had a:
• Baby with low birthweight or health problems
• Miscarriage
• Stillbirth

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What can I do to improve my health so my next baby will be as healthy as possible?
• Your healthcare provider can help you get the care you need before you get pregnant again. This will
give you the best chance to stay healthy yourself and deliver a healthy baby.
• Keep your interconception care appointments and follow your healthcare provider’s guidance.
What does interconception care include?
• Family planning services (waiting at least 18 months after giving birth to get pregnant again)
• Getting up-to-date on vaccines
• Treating infections
• Controlling chronic conditions, such as asthma, hypertension and diabetes
• Limiting contact with toxic substances, such as lead, mercury and pesticides
• Counseling and support:
o To eat right and take folic acid. o For alcohol problems.
o To gain or lose weight. o For drug problems.
o To get more exercise. o For depression, anxiety, or
o To quit smoking. stress.
o To avoid secondhand smoke. o For domestic violence.
o For possible genetic risks.
How do I get interconception care when my Medicaid ends?
You may be eligible for the Healthy Michigan Plan after pregnancy (www.Michigan.gov/HealthyMIPlan)
Learn more: Show Your Love Today (www.ShowYourLoveToday.com)

INFANT HEALTH
How do I keep my baby healthy?
• Baby’s routine is important (sleep schedule, feeding, hydration, physical activity, bathing)
• Do not let anyone smoke in your home, car, or anywhere near your baby.
• Keep your baby away from people who are sick. Make sure people who hold your baby have clean
hands and wash your hands after every diaper change.
• Clean your baby’s gums using a damp cloth twice a day. This helps prevent tooth decay when teeth
come in. Do not give sugary drinks or let your baby fall asleep with a bottle in their mouth.
• Gently hold, hug, cuddle, and comfort your baby. You cannot overdo it. This is how your baby gets
attached to you. Attachment is very important to your baby’s health and development.
When do I take my baby to the doctor’s office?
• Take your baby to their healthcare provider for well-child visits.
o These visits are usually at 1, 2, 4, 6, 9 and 12 months. Medicaid pays for them.
Call your healthcare provider if your baby:
• Has a fever over 100.4 degrees with a • Is fussier than usual.
forehead or rectal reading. • Is sleeping more than usual.
• Refuses to eat. • Is wheezing or has trouble breathing.
• Has persistent vomiting or diarrhea. • Is pulling on their ears a lot.
Follow your healthcare provider’s recommendations.
• Ask the healthcare provider before you give your baby over-the-counter medicine.
• Always keep your provider’s phone number where you can find it. You might need it in a hurry.

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INFANT FEEDING AND NUTRITION
Why do experts say breastfeeding is best for my baby and me?
• Breast milk gives nutrients to your baby to grow and be happy and healthy.
It is great for your health too!
• Breastfed babies have a lower risk of:
o Asthma, obesity, type 1 diabetes, ear infections, diarrhea, vomiting,
and SIDS.
• People who breastfeed have a lower risk of:
o High blood pressure, type 2 diabetes, breast cancer and ovarian
cancer.
• It can strengthen the bond between you and your baby.
• It can be more affordable than bottle feeding.
• It burns calories and can help you lose weight.
• Read more in the “Breastfeeding” section below!
What about bottle feeding?
• Bottle feeding may involve formula or pumped breast milk.
• Ask your healthcare provider what kind of formula is best for your baby.
• Follow formula mixing instructions carefully.
• Never heat formula or breast milk in the microwave. It can get too hot.
• Always check the temperature by shaking a few drops on your wrist.
• While feeding, hold your baby’s head up a little higher than their tummy and tilt the bottom of the
bottle up so the nipple stays full.
• Throw out any formula or breast milk that is left after a feeding.
• Do not give your baby fluids other than formula/breast milk (no juice or other sugary drinks).
• Do not let your baby fall asleep with the bottle in their mouth.
• Do not prop the bottle in your baby's mouth. This can increase the risk of choking, ear infections, and
tooth decay. It may also cause your baby to eat more than they need.
What is a normal eating pattern?
• Babies eat very often: at least every 2-3 hours. New babies need frequent feeds to get enough
calories for growth.
• Babies can have periods where they have irregular patterns such as eating every 45 minutes and then
sleeping for 2-3 hours.
• Some spit up is normal. Even if they spit up, putting your baby to sleep on their back is still the safest
position.
How can I tell if my baby is hungry?
• Learn your baby’s hunger cues. Offer your baby a feeding if your baby:
o Becomes more alert and active
o Puts hands or fists to the mouth
o Makes sucking motions with the mouth
o Turns their head toward your breast
• Crying is a late sign of hunger and can make it harder to feed or latch.

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BREASTFEEDING
Why should I breastfeed?
• Breast milk is the best food for babies in the first year of life. As infants
grow, breast milk changes to meet your baby’s nutritional needs.
• It can help protect you and your baby from certain illnesses and
diseases.
• Breastfed babies have fewer health problems than babies who do not
get any breast milk.
• Breastfeeding reduces the risk of SIDS and sleep-related infant death.
• Breastfeeding lowers risk of type 2 diabetes, certain types of breast
cancer and ovarian cancer.
How long should I breastfeed? Image credit: USDA WIC Breastfeeding
• Exclusive breastfeeding (baby gets only breast milk) is recommended for 6 Image Gallery

months. After this, breastfeeding should continue along with age-appropriate solid foods.
Experts recommend breastfeeding for at least 1 year.
• Any amount of breastfeeding is good for your baby’s health and development.
Breastfeeding takes practice and patience. For some people, learning to breastfeed can be frustrating
but others have no problem at all! There are many in-person and online supports for breastfeeding
people. If you have questions or concerns, please seek out expert support and information.
How do I know if my baby is getting enough milk?
• Many people worry about this. It is important to know that a newborn’s stomach is very small:
o At birth, a baby's stomach is the size of a marble and can only take in about 1-2
teaspoons during a feeding. At 2 weeks, a baby’s stomach is about the size of an egg and
able to take in about 2 ounces.
• The more often your baby breastfeeds, the more milk your breasts will make.
o Newborns usually eat every 2-3 hours.
• Signs that your baby is getting enough milk are:
o You can hear or see your baby swallowing.
o Tracking diapers: By day four, your baby should have at least 5-6 wet diapers every 24
hours and 3 or more stools that are yellow (or turning yellow). As your baby gets older,
you can expect the pattern of wet and dirty diapers to change.
o Baby will gain weight as expected (although it’s normal for a baby to lose a small
amount of weight in the first few days of life and then begin gaining.)
o Your baby is content after feedings, with relaxed hands and feet
o If you have any questions, contact your healthcare provider or breastfeeding expert.
Tips for making breastfeeding work for you
• Follow your baby’s lead. Every baby feeds differently and that is ok.
• Keep your baby close to you. Do skin-to-skin contact when possible but be sure you only do it
when you are awake, or when someone is nearby to help make sure you don’t fall asleep.
• Avoid using pacifiers or bottles for the first few weeks, unless for a medical reason, to help your
baby get adjusted to breastfeeding.
• Make sure your baby sleeps safely and close by – share your room, not your bed.
• Have open and honest communication with your work/school/family about breastfeeding.

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Who can help me with breastfeeding?
• WIC providers have breastfeeding support staff who can help and support breastfeeding. This
includes Peer Counselors, Lactation Consultants and more.
o Visit www.Michigan.gov/WIC, then select “Breastfeeding for WIC Clients.”
o Contact the WIC Breastfeeding Warmline: Call or text (833) 649-4223.
• Local Breastfeeding Support Groups (www.MiBreastfeeding.org)
• Your or your infant’s healthcare provider.
Learn more: MDHHS Breastfeeding (www.Michigan.gov/Breastfeeding)
and MDHHS WIC (www.Michigan.gov/WIC)

CRYING AND SOOTHING

How much will my baby cry?
• All babies cry, and sometimes they cry a lot. The amount is different for every baby, but it can be
normal for them to cry 1-2 hours a day in the first several weeks.
• Crying usually peaks between month 2 and 4 (often around 6-8 weeks).
• Increased crying tends to happen in the late afternoon and evening.
• Sometimes the crying isn’t easy to soothe and may be part of something known as “The Period of
Purple Crying.”
What should I check for when my baby cries?
• Check the basics first: Does baby need to be fed, burped, held, or have a diaper change?
• Check for comfort: Is baby dressed appropriately? Could they have an upset tummy? Are they
teething? Could there be a fabric bothering them or a loose hair wrapped around their finger or toe?
• Check for illness: Does baby have a fever? Does their cry make you feel like “something isn’t right?”
Contact your healthcare provider.
• Check for tiredness: Some babies cry when tired, especially when overtired.
• Check for overstimulation or under-stimulation: Is the room too loud? Need a change of scenery?
What are some tips for soothing my baby?
• Rock your baby in your arms, or a chair and talk softly to them.
• Try holding your baby skin-to-skin (Only if you are awake and alert).
• Offer your breast, a pacifier, or a finger to suck on.
• Swaddle safely using a sleep sack with swaddle attachments. Stop swaddling once you see signs of
rolling over. Always place a swaddled baby on their back in a crib, bassinet or pack ‘n play.
• Sing, play music, or use white noise.
• Get outside: Step outside for some fresh air or take a walk with a stroller.
• Give baby a bath (check the water temperature and ensure close supervision).
How can I cope with my crying baby?
• Ask for help. Share baby duties with your partner or have someone you trust come over.
• If you get frustrated, gently lay your baby in a crib, bassinet or pack ‘n play. Take a deep breath and
collect yourself before trying to soothe baby again. It is important that anyone caring for a crying
baby stays calm and never takes frustration out on the baby.
• Talk to your healthcare provider if you ever have concerns about your baby’s crying.

Learn more: The Period of Purple Crying (www.purplecrying.info)

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INFANT SAFE SLEEP
How should I set up my baby’s sleep space?
Setting up a sleep space focused on safety is important to prevent
sleep-related infant death. Safe sleep matters every time your baby
sleeps (naps and nights). Make sure you and everyone who cares for
your baby knows how to create a safe sleep space:
• Your baby should sleep alone in a crib, bassinet or pack ‘n play.
o Car seats, swings and other sitting devices are not
recommended for routine sleep. If your baby falls
asleep in one of these, move your baby to a crib, bassinet, or pack Image credit: NICHD Safe to Sleep®
Flickr Album
‘n play as soon as possible.
• Use a firm mattress with a tightly fitted sheet.
• Always place your baby on the back to sleep.
• Keep baby’s sleep area clutter-free: No pillows, blankets, bumper pads, or toys.
• Avoid covering your baby’s head when sleeping and avoid overheating your baby.
o Your baby should be dressed for the space he or she is in. If you think your baby is cold, use a
footed sleeper and an appropriate-sized sleep sack.
• Keep the environment smoke-free.
• Share your room, not your bed.

What if I worry about falling asleep while feeding or comforting my baby?

• Before feeding or comforting your baby, think about how tired you
are. Avoid couches and armchairs if there is a chance you could fall
asleep. This furniture can be very dangerous for babies, especially if
an adult falls asleep with a baby while on them.
• If you bring your baby into an adult bed to feed or comfort, remove
all soft items and bedding.
o See this photo on the right for an example.
• If your baby or you are ready for sleep, put your baby back into Image credit: NICHD Safe to Sleep® Flickr Album

their separate sleep space. If you fall asleep accidentally, put your baby in their separate sleep space
as soon as you wake up. An adult bed is not a safe sleep space for babies.
• Set an alarm or have a support person check on you in case you fall asleep.

Learn more: MDHHS Safe Sleep (www.Michigan.gov/SafeSleep). If you don’t have a crib or pack ‘n play,
find local resources to help by clicking on “Safe Sleep Resources by County.”

VACCINES
What vaccines are needed for pregnancy?
• Pregnant people should get vaccinated for Tetanus, Diphtheria and Pertussis/Whooping Cough, and
flu vaccine every pregnancy. It is important to be vaccinated for COVID-19 as well. Other vaccines
may be recommended based on your individual needs.
• Staying up to date on vaccines is important between pregnancies too. For example, MMR and
chickenpox vaccines should be complete, but are given either before or after pregnancy.

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Why are vaccines important for pregnancy?
• Vaccines offer protection for you and your baby during pregnancy.
• When you get vaccinated, protection (“antibodies”) crosses the placenta to your baby. This can give
your baby some protection against disease before they can get vaccinated themselves.
Why does my baby need vaccines?
• Vaccines help protect your baby from serious diseases like whooping cough, pneumonia, the flu, and
much more. These diseases can be especially dangerous for babies.
• Vaccines offer protection early in life so babies can build immunity before they may be exposed to a
disease. Protect your baby from 14 diseases by age 2 by vaccinating on time.
• Vaccines help protect against SIDS.
• Getting vaccinated is a safe, effective way to protect your baby, family and community.
What are vaccine side effects that my baby might have?
• The most common side effects are redness or swelling where the injection was given, fussiness,
and/or a low-grade fever. These may last a few days.
• Severe side effects are extremely rare. If you have concerns, contact your healthcare provider.
Should I skip or space out vaccines?
• No. Vaccinate on time, every time for all recommended vaccines. If vaccines are skipped or spaced
out, this creates a risk of catching the disease during the time of delay.
What vaccines are important for people around my baby?
• Everyone around your baby should be up to date on all vaccines, including Tdap (whooping cough),
flu and COVID-19. This includes partners, siblings, grandparents, babysitters, and more!
• When others get vaccinated, it can create a “circle of protection” around your baby.
• Take the time to have this conversation with others.
o Adults can request their Michigan vaccine record here (www.mcir.org/public)
Learn more: MDHHS Immunizations (www.Michigan.gov/Immunize)
and I Vaccinate (www.Ivaccinate.org)

INFANT DEVELOPMENT
Infant development and screening involve the following areas:
• Gross motor • Problem solving
• Fine motor • Personal-social
• Communication • Social-emotional

Your baby’s first relationship is with you. There are many ways to promote your baby’s development:
• Teach them their little world is a safe place and that they are loved.
• Quickly respond to your baby’s needs and be very gentle and loving.
• When your baby is fussy, try to uncover the reason (scared, hungry, thirsty, cold, hot, etc.)
Responding to your baby’s wants and needs will help form a strong emotional attachment between
you both. A strong bond is one of the best things for your baby’s development.

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What signs should I watch out for that could indicate my baby needs a developmental evaluation?
Signs from birth to 12 months include:
• Having eating difficulties. • Being hard to console.
• Not gaining weight or is losing weight. • Rarely making eye contact with others.
• Sleeping difficulties (too much/too little). • Not showing interest in people or things
• Showing little preference for any adult. going on around them.
• Resists holding. • Not reacting to simple games like peek-a-
• Crying for prolonged periods. boo.

TAKE CARE OF YOURSELF

SO THAT YOU CAN TAKE CARE OF YOUR BABY
• You are the most important person in • Wait at least 18 months after giving birth
the world to your baby. before getting pregnant again.
• You need to take good care of yourself, • Find someone to care for your baby so
so you can take care of your baby. you can take breaks.
• See your healthcare provider for your • When you feel down or alone, reach out
postpartum visit and interconception care. for support.
• Use family planning (birth control).

MORE INFORMATION
• Visit the MIHP website for more education, information and links to a variety of resources for you
and your family.
o For a variety of resources, go to www.Michigan.gov/MIHP and select “For Families.”
• For Breastfeeding information and resources, visit the MDHHS Breastfeeding website
(www.Michigan.gov/Breastfeeding).
• For Safe Sleep information and resources, visit the MDHHS Safe Sleep website
(www.Michigan.gov/SafeSleep).
• Your home visitor is here to support you. Have questions about something in this packet? Mark that
page and ask your home visitor for more information.

The Michigan Department of Health and Human Services will not exclude from participation in, deny benefits of, or
discriminate against any individual or group because of race, sex, religion, age, national origin, color, height, weight,
marital status, partisan considerations, or a disability or genetic information that is unrelated to the person’s eligibility.

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