Bringing up babies

NEW CASTLE, Pa. -- Kerry Voland pours cereal into five small white bowls and two bigger ones. The big ones are for Mom and Dad. The little ones are for Kristin, Jacob, Zachary, Lauren and Joshua.
Tyler isn't having corn flakes today. He's opted for a granola bar.
It's a snapshot of morning in the life of Steve and Kerry Voland, parents of six -- one set of twins, one set of quadruplets.
Other parents see the 6-year-old twins and 2-year-old quads and ask, "How do you do it?" Others say, "I can't imagine four at once."
Tyler and Joshua are the twins; quads Kristin, Jacob, Zachary and Lauren were born in 1999.
But Steve and Kerry Voland can't imagine just one.
As the nation focuses on its newest headline-grabbing multiple birth -- the Al Qahtani septuplets born July 12 in Washington, D.C., the Volands offer some advice.
Most important, Mrs. Voland said, is to enjoy the babies because, with the house full, "it goes so fast, one day just rolls into the next." And relax a bit on housecleaning -- her little ones won't remember an immaculate floor, she said, but "they'll remember if I read them a book."
Have a routine: "The best advice I can give is get a routine going and stick with it," Mr. Voland added. "Everything else is playing it by ear." Besides maintaining feeding and nap times, a common bedtime ensures parents will get a couple of hours each day to regroup.
Mrs. Voland reminds the new mom: "Don't be afraid to ask for help." For the Volands, Grandma did laundry for the first two years of the quads' life.
Try to make some time for yourself. (Now that the babies are older than 2, Dad was able to play in a softball tournament on Saturday, and Mom went to a concert with the grown-up girls.)
There will be some tough days of misbehaving and discipline and little private time, the Volands said, but, all in all, the good outweighs the difficult.
"It's a joy," Mrs. Voland said. "People say, 'I feel sorry for you.' Don't feel sorry for me. ... There's so much joy too. People who have one baby only get one smile at the end of the day. I get six."
Voices of experience: In Greenville, Pa., three sisters from a set of quintuplets (another girl and a boy succumbed to medical problems) also offer their experience to the new family. Emily, Alli and Katie Simunich are 13. All three girls say they value always having a friend to play with or talk to.
"Be nice to your mom, give her space," Katie suggested to the new septuplets. "Be nice to each other, and be quiet."
On advice for the new mom, Katie said: "Be prepared to get up early in the morning and sometimes to stay up late. And, also, I want to tell her good luck."
Differences in kids: The girls' mother, Terry Simunich, tells of appreciating the differences among her daughters: While Emily is interested in nail polish and makeup, Katie spends her time bringing home snakes and turtles. And Alli, who still has some lingering medical complications, never likes to be without at least one of her sisters.
Across the United States in 1999, there were 7,300 births that included three or more babies. That number reflects a decline for the first time in a decade, according to statistics compiled by the Centers for Disease Control and Prevention.
The number represents a rate of 185 per 100,000 live births. Multiple births had more than doubled from 1990 to 1998, increasing from 3,000 to 7,600, with a rate from 73 to 194 per 100,000.
Ohio statistics: Across Ohio, multiple births have grown at an even higher rate, according to state Department of Health statistics. In 1990, there were 158 births of three or more babies at once, a rate of 95 per 100,000 births. In 1999, they more than doubled to 314 with a rate of 207 per 100,000 births.
As that number rose, labor and delivery complications declined. While there were complications among 75 percent of triplet-and-higher multiple births in 1990, that number dropped to 60 percent in 1999. Single deliveries experience complications in about 35 percent of births.
In an April report which released the national statistics, CDC officials said two-thirds of such births were the result of fertility-enhancing therapies. Risks include prematurity, low birth weights, infant death and severe lifelong disability.
The Simunich quints were the result of fertility drugs, and each suffered medical complications as youngsters.
Dr. Sayed El-Azeem, director of high-risk pregnancy services at the St. Elizabeth Health Center in Youngstown, said multiple births of three or more are almost always the result of fertility drugs. Still, among women using the drugs, about 90 percent conceive only one baby. A goal is to reduce the risk of prematurity and health problems by monitoring medications carefully so women do not conceive several children at once. Other techniques are used to increase the longevity of such pregnancies.
Highest in Youngstown: In Youngstown, the doctor said, the highest multiple birth has been quadruplets.
Aside from the physical concerns, families also face emotional strain during this time of "very, very dramatic change," said Dottie Enrico, content editor for Primedia's Web site.
While most people consider the practical things, they tend to forget there will be emotional strains on parents individually and on a marriage, she said. Parents will worry they aren't giving their children enough time and attention.
"It's all the basic things you have to deal with times seven or times three or four," she said.
Ms. Simunich recalls the difficulty of accepting the babies' limitations and illnesses when they were first born, of seeing 9-day-old Rachel die of lung disease and losing Bradley to respiratory complications after 10 months.
"We went through a lot of rough stuff for a long time," Ms. Simunich said.
Max Simunich, the girls' father, also recalls the emotional stresses of raising the girls. The couple are now divorced.
Despite the heartache of watching two of the children die and seeing the others struggle, Max Simunich would recommend that another couple take the same chance.
"We went through three or four years of emotionally difficult times, but I have three beautiful daughters at home now," he said. "I can't hardly argue with it."
He would remind the Washington, D.C., couple that despite illnesses and setbacks, never give up hope. Even though Alli struggled in the hospital for more than a year, she made it home. Doctors had given up on her.
"You just never know, you really never know," he said. "And don't give up."

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