With more and more women starting families later in life, and the use of fertility treatments becoming more common, the rate of multiples has risen in the last 20 years. As these pregnancies become more commonplace, doctors, parents, and educators continue to learn more about the health and development of these children.

I had the unique experience of babysitting male triplets from the time they were 5 years old. They are now 16, and still a part of  my life — though I no longer have the task of supervising them. As they grow into young men, they continue to teach me the joys — and stresses — of raising multiples. In addition, I have two friends who had the pleasure of giving birth to triplets. Using my interaction with all three families as a source for inspiration, the tired and proud parents and I created these tips for parents of multiples.

Establish routines.
This is your number one stress-minimizing strategy, and should remain a priority throughout your multiples’ lives. Establishing a routine means you must be prepared. This comes in many forms: Having clothing, bottles and diapers always available is a necessity. Establishing feeding, bedtime and daily routines creates a sense of structure and security for your children, as well as allowing you time to get things done around the house. Without structure, you will quickly feel you are either bathing or feeding your children 24 hours a day.

Ask a friend or family member to document important events.
When you are caring for multiples, your main concern is the children’s primary needs such as food, clothing and sleep. You are less likely to worry about taking pictures of them coming home and documenting all the important “firsts” that parents like to record. Asking a close friend or family member to keep baby books or photo albums will help take the stress off you to organize those cherished memories. When asked if she thought this was a good tip, one mother of multiples said “I wish I thought of that! I barely have any pictures of their early years!”

Bond with each of your children.
This may be tricky, considering you are still working on establishing a routine. Use feeding and bath time as a good opportunity to connect with your children individually. They will no doubt feel a close connection to each other as multiples, but establishing individuality and unique bonds with you and your spouse is equally as important.

Take care of yourself.
A recent study in the April issue of Pediatrics showed that women who give birth to multiples are 43 percent more likely to suffer from postpartum depression than women who give birth to a single child. Talk with your spouse about how you can both stay healthy before and after the babies are born. A friend of mine who has 16-year-old triplets says a woman stopped her in the hallway at her last doctor’s visit before the boys were born. She said “Always feed yourself first.” She went on to explain this meant physically, emotionally and spiritually. “Feeding” yourself is necessary in order to provide for the other members of your family.

Ask for help.
It may mean asking for help establishing breastfeeding routines in the early days or asking family members or friends to help with rides to soccer practice when they are eight. You are going to need help with multiples! Do not be ashamed to say you need a helping hand — your family and friends will most likely understand and be willing to switch your laundry, drop off a meal or listen to your concerns in order to be there for you and your children.

Preparing for and raising multiples is a unique experience, one that only another parent of multiples can truly understand. Look online for local support groups to find guidance from those who have been through this experience before or are living it now. These parents may be able to tell you where the best playgrounds for multiples are in your area. (As one parent of multiple describes: The best playgrounds for multiples are ones that are completely fenced in!) You may establish close friendships with other parents that last a lifetime!

Finding a babysitter or caregiver for multiples can be challenging. If you don’t have family or friends that can help out, you will need to look for someone who is energetic and organized — the two main features of a successful caregiver to multiples. This is also where a support group comes in handy — references are a must!

Your pediatrician or neonatal specialist will be an important source of information and guidance for you. Multiples may have specific health care needs that singletons don’t. Make a list of questions prior to appointments so you don’t forget what you wanted to ask. You may need to bring along an extra friend or family member to document the doctor’s responses, as you will surely have a lot on  your plate, and may not be able to remember everything he or she says.

But the most important thing to remember when raising multiples: You are multiply blessed!

Jennifer Cerbasi teaches at a public school for children on the autism spectrum in New Jersey. As a coordinator of Applied Behavioral Analysis programs in the home, she works with parents to create and implement behavioral plans for their children in an environment that fosters both academic and social growth. In addition to her work both in the classroom and at home, she is also a member of the National Association of Special Education Teachers and the Association for Supervision and Curriculum Development.

Millions of Americans watch the hit reality TV series “Jon & Kate Plus 8” on TLC. 

They are now following Katie Irene Gosselin and Jonathan Keith Gosselin into a fifth season of parenting their eight children — fraternal twin girls and a set of fraternal sextuplets.

The show is taped in the Gosselin home — the “set” includes permanent light fixtures.

Lately, the drama has focused on whether Jon did or did not cheat on Kate with either of two women spotted with him over Memorial Day weekend and, more recently, at a mall.  He insists the women are the wife and daughter of plastic surgeon Dr. Larry Glassman who performed Kate’s tummy tuck surgery.

I don’t really care whether Jon has been faithful to Kate or not.  My question about him and his wife is about how they can justify turning  their kids’ lives into entertainment, with unknown, possibly severe, psychological fallout.

No one knows the precise psychological impact of having parents who are “acting” like parents for the cameras or having producers around who are hoping for high drama, but the impact could be significant and negative.  Life has to stay interesting to keep viewers around, after all. Decisions about how to handle family crises, including the question of whether to stay a couple at all, might well be colored by  worries about how it all will play out on TV.

Kate Gosselin recently went on a vacation with her eight kids to North Carolina. They were accompanied by body guards and camera crews.

This is like having a stage mother (and father) on steroids.  Because in this case, she’s on stage, too.  How does one of the children decide to drop out of the series?  If he or she did, would that child risk losing parental attention and love?  Who has the moral right to decide that another human being’s life story will be played for television audiences?

Movie stars and politicians often have enough good sense to understand — as good parents — that they need to protect their children from the glare of bright lights and media exposure.  They understand that their own notoriety shouldn’t be a ball-and-chain for their kids.  They don’t want their sons and daughters defined by them.  They want them to have their own lives — for real.

I hope that each and every one of the Gosselin children grows up to be happy and healthy. But if they should end up depressed or on drugs, I hope they find therapists who will explore whether part of their pain is a feeling that their lives were stolen from them, whether they were put on display like zoo animals under glass, all for fame and profit.

Dr. Keith Ablow is a psychiatry correspondent for FOX News Channel and a New York Times bestselling author. His newest book, “Living the Truth: Transform Your Life through the Power of Insight and Honesty” has launched a new self-help movement. Check out Dr. Ablow’s Web site at livingthetruth.com.

I want to talk today about a recent story that caught my attention because of its tragic nature. It’s the story of a 9-year-old girl in Brazil who got pregnant with twins after she was allegedly raped by her stepfather.

When this story first came out, a lot of people asked me how it was possible for a 9-year-old girl to even get pregnant.  But the fact remains that once a female starts menstruating ― which can be as early as 8 years of age ― she is able to ovulate, and therefore, able to become pregnant.

The other question I was asked pertained the risks involved with having a pregnancy in such a young body. Now, there is very little data on pre-teen pregnancy, but there is a lot of data on teen pregnancy. And I can tell you from personal experience – these pregnancies can be quite risky.

Aside from the horrible psychological trauma that any young girl in this scenario would have to face, the physiologic changes that occur in a young person carrying a pregnancy could be quite dangerous to her body and to the unborn child.

Some of the risks that a pregnant 9-year-old could have include premature delivery, growth-restricted infants, uterine rupture and pelvic trauma.

Compounding the tragedy of this case, today we learned that the young girl aborted her twin pregnancy.

As I have said before in many of my blogs, children need to be protected. And adults that commit these kinds of crimes need to be severely punished.

Congratulations mom, on the birth of your eight beautiful children! Being the resident obstetrician here at FOX News, my staff has been asking me all day today “Oh, Dr. Manny did you hear about the lady who had octuplets in California? Isn’t that amazing?”

And yet, despite the fact that I’m very happy for these parents, and I’m very proud of the physicians and nurses that took care of this patient, I also realize that this was a very high-risk pregnancy that could have easily ended up with significant problems. That’s the topic I want to talk about.

Many times we tend to focus on these medical miracles, and we often do not realize all the potential complications that could arise when facing challenging clinical scenarios.

Take, for instance, the story that we did a couple of years ago about the woman who had twins at the age of 60 — after that story ran, I started getting phone calls from women all over the world, asking how they too could have children after the age of 55.

I assisted in that delivery, and what many people don’t know is that that there were many issues we had to deal with having a patient over the age of 60 delivering twins. The same thing is true for anybody that has a multiple pregnancy because a woman’s womb was generally made to birth only one child at a time. When we artificially enhance that number by 3, 4, 5 or 6, we are playing Russian roulette.

The most common complication for multiple pregnancies is prematurity. A premature infant has a significant risk of developmental delays, visual problems and hearing problems.

There are also a number of maternal complications that can arise from multiple pregnancies like high blood pressure, diabetes and significant post-partum bleeding.

So the take-away is this: Medicine has a beginning and an end. But somehow, many people tend to forget the middle part – and that is the part that must be clearly understood by the patient and physician for the miracle to take place.

A 52-year-old woman serving as a surrogate mother for her daughter, a contestant on NBC’s “American Gladiators,” has given birth to two of her own grandchildren, a set of twins.

The babies, a boy and a girl, were born Wednesday at an Arizona hospital, the family said.

“I just feel so blessed and fortunate. It’s the best experience of my life,” Crystal Sirignano told The Flint Journal for a story published Friday.

“I don’t regret one second, even the times when I didn’t feel good. None of that was as bad as watching what my daughter went through.”

She has owned Total Body Fitness in Grand Blanc for 25 years while husband D.J. owns John’s Steakhouse in Goodrich, where the couple live.

Crystal Sirignano offered to become a surrogate for her daughter after Kendra Sirignano went through several failed infertility treatments and surgeries.

SAN ANTONIO —  Doctors who successfully separated twin boys joined at the head said Monday that the 9-month-olds are expected to have a “very good chance” at a normal life.

Doctors at Christus Santa Rosa Children’s Hospital in San Antonio performed the four-hour operation Friday.

“They’re in two separate beds,” said Richard Wayne, administrator of the children’s hospital. “They’re babbling. They’re smiling. They’re eating. They’re very happy. They’re beautiful little children. They’re being held by the parents, and they’re doing very well.”

A Nigerian woman gave birth to an unusual set of quadruplets on Friday.

Nelly Itula, 40, delivered identical twin girls and fraternal twin boys, officials at Sinai Hospital in Baltimore said.

The babies were delivered by Caesarian section. The girls weighed slightly more than two pounds, and the boys weighed slightly more than three pounds.