Pregnancy BUMP&baby issue 2 by BUMP&baby

ISSUE 02

from

FTC0401_2May_L

newborns to toddlers

new born nursery checklist

BathTime

SleepTime

FeedingTime

OntheGo

ESSENTIAL

ESSENTIAL BEDDING

ESSENTIAL

Baby bath (1) Soft washcloth (6-8) Soft towels (4-6) Toiletries: baby wipes, barrier cream, shampoo & baby body wash Bath thermometer (1) Non slip bath mat (1) Grooming kit (1)

OPTIONAL Bath toys (2-4)

PlayTime OPTIONAL Bouncer (1) Play gym/mat (1) Exerciser (1) Swing (1) Fabric books (3) Soft toy (Newborn) (2-4) Music (3)

shop online at farmers.co.nz

Mattress protector (2-4) Fitted sheet & top sheet (4) Blankets (2-4)

FURNITURE Cot (1) New mattress (1)

OPTIONAL Wrap (2-4) Swaddle (1) Bassinet (1) Mobile (1) Night light (1)

ChangeTime OPTIONAL Change table (1) Change mat (1) Nappy disposal unit (1)

Highchair (1) Bibs (6-8) Bottles (4-8) Teats (6-8) Bottle brush (1) Steriliser/Bottle warmer (1) Nursing pads (6-12) Breast pump (1) Burp cloth (4-8) Storage bag/Bottles (4-6) Teether (3-4) Nursing bras (3-4)

OPTIONAL Soothers/Dummies (6-8) Feeding pillow (1) Nipple cream (1) Spill mat (1)

Capsule/Convertible carseat (1) Stroller (1)

OPTIONAL Baby view mirror (1) Storm cover (1) Carrier (1) Change bag (1) UV shade (1) Pram toys (2-4) Pram liner (1-2) Pram blankets (2)

Health&Safety ESSENTIAL Thermometer (1)

OPTIONAL Baby monitor (1) Baby gates (1)

FTC0401_2MAY_R

Growing in Connection Programme

From left: Marisa, Taize and Jack.

A foundation of love Being a mother of four, Marisa Weymes knows how hard it is to find time for ‘quality one-on-one’ with her little ones. Since completing the PORSE Growing in Connection Programme, her attitude to parenting and childcare has changed. “I completed the Growing in Connection Programme as it was my goal to become a PORSE Professional Educator and this course was a part of that journey.” “This was the best ECE course I have ever done. I was at an extra special stage in my life, only 10 weeks away from having my fourth child.” Marisa had her first child Shae, when she was 16 and used home-based childcare. “After seeing the benefits of home-based childcare, I knew that I wanted to be an Educator and I have never looked back. I love my job and the relationships I have developed with the children and their families. It has also meant I can spend time with my own children.” After doing the Growing in Connection Programme Marisa says she understood her children more. “We raised our children with the belief and model of attachment parenting but when it came time to transition them to kindergarten and school, they did not detach well from us and it was a stressful experience. As parents it made us wonder if the this model was the right choice but after completing the course our faith was restored and we felt confident we were doing the right thing.”

“Not only did it reinforce my own beliefs on attachment parenting but opened my eyes to a whole deeper level of parenting and helped me understand my baby’s cues and watching for those moments to connect together,” says Marisa. “I recognised so many more cues with my youngest child, Taize, that I didn’t see with my other children. I’m not rushing to do anything. I’m giving him the time to express himself.” During the programme, Educators and parents learn about early brain development and how important the first three years of life are. As a mother is soothing and comforting an

Whakat i p u i te hononga

growing in

connection

Understanding the science of relationships and building a foundation of love Growing in Connection focuses on what we all need to reach our full potential. It encourages participants to think about how they interact and build relationships with the children in their lives. We explore the wonder of human development,

upset baby, she is wiring their brain to understand love and trust.

learning and behaviour alongside environmental

“The negative is a feeling that is connected to your brain and the brain will store the

factors that influence every individual from birth

negative. So we want to make sure all the children we care for have positive experiences.

and throughout life.

Every interaction is growing the brain.”

Our trained facilitators provide informative, useful

Another part of the programme focuses on the time parents spend with their children.

and cutting edge programmes backed by child

“This made me reflect. When you have four children it is difficult to give them time on their own. But a big highlight for me from the programme was that we need to slow down and stop to reflect more.”

mental health specialists, researchers and early childhood education tutors.

Learning about the importance of secure attachment relationships was also a highlight for Marisa. “Children have a circle of security which I now see everywhere. A child in a playground will always look back to their person of attachment. If there is a strange person who comes in and the attachment person isn’t there, the child can become distressed or anxious. This shows that secure attachment relationships give them experience and confidence.”

“The course has given me the tools to be a better person, parent, partner and Educator. My family, extended family and everyone around me benefits.” To find out more contact us on

0800 023 456 porse.co.nz

To find out when a course is being run in your area, call

0508 FOR LIFE www.forlifenz.com

l for Idea rian a s e Ca hers Mot

360˚

Swivel Brings Baby Close for Safe Sleep

CONTENTS 50

LOVE YOUR LIFE

COSY CHIC Cool-weather maternity clothing

PREGNANCY

Issue 02

SUBSCRIBE AND WIN Get two issues for only $22

137

DIRECTORY Shop til you pop

142

THE LAST WORD Words of wisdom to make you smile

DRESS YOUR BUMP Pregnancy style tips from Kelly Coe

SOFT & SUPPLE SKIN Beauty products for face & body

HELLO! A few words from our editor

QUICK FIX

JUST BUMPED INTO… New and noteworthy gear, research, and info for mums and bumps

THE SHOE EDIT Put your most fashionable foot forward

THE SKIN YOU’RE IN What to expect from your epidermis

WHAT’S COOKIN’? 4 scrummy dinners from My Food Bag & Nadia Lim

CONCEPTION & PREGNANCY

MYTH OR FACT? Fertility fictions debunked

MAYBE BABY? Early pregnancy signs & symptoms

40 WEEKS, 40 TIPS Advice for every stage of pregnancy

CONSTANT CRAVINGS Why do I want pickles & ice cream?

SEX & THE PREGNANT MAMA What you need to know about getting it on

QUITTING TIME You need to quit smoking now

WOOLLY WISHES A sweet little lamb-themed baby shower

BABY SHOWER GAMES THAT ARE ACTUALLY FUN Your guests will thank you Pregnancy BUMP & baby

CONTENTS

132

LABOUR & BIRTH

80 126

OVERDUE! WHAT CAN YOU DO? We know you’re uncomfortable. Hang in there!

YOUR BIRTH PLAN How to make one you can live with

CONTRACEPTION OPTIONS You’re gonna have to think about it sometime

128

132

DADDY DUTY Why dads should take parental leave too

102

106

Pregnancy BUMP & baby

126

100

BACK IN MY DAY… Old-fashioned stuff we’re glad they stopped doing

UP TO STANDARD Making sure your baby’s cot is safe

YOUR NEWBORN

BEYOND THE BABY BLUES Opening up about postnatal depression

122

CHOOSING CHILDCARE 101 What are the options?

ASK US ANYTHING Your embarrassing questions answered

WHAT TO EXPECT IF YOU HAVE A C-SECTION Be prepared, just in case

FIRST SIX MONTHS

10 THINGS NEW PARENTS REALLY WANT Leave this article open for visitors to see

108

SAFE & SOUND Put your baby to bed safely

I'm pumped! Are you?

116

112

SET UP FOR SUCCESS Starting breastfeeding without stress

116

BEST BUYS FOR BREASTFEEDING MUMS Products we love

118

COLIC OR REFLUX? Cry me a river – no, don’t, actually

TIPS FOR STARTING SOLIDS It’s a messy job, but your baby will love it

136

A SOLID START Super-cool feeding accessories

HELLO!

PREGNANCY

Issue 02 NEW MUM MUST-HAVE The Philips Avent Comfort Manual Breast Pump is lightweight and discreet, with an ergonomically shaped handle for comfort and control. A great on-the-go option for discreet breast milk expressing. RRP$136.99, available from baby retailers

Available from selected retailers or visit bumpandbaby.co.nz to subscribe. PUBLISHERS Tony and Aana Marinovich tony@bumpandbaby.co.nz aana@bumpandbaby.co.nz EDITOR Katherine Granich editor@bumpandbaby.co.nz ART DIRECTOR Emma Henderson design@bumpandbaby.co.nz ADVERTISING ENQUIRIES Tony Marinovich tony@bumpandbaby.co.nz

Editor's note

rr... That chill in the air means snuggly layers, hot cocoa, and woolly socks, right? And when you’re pregnant, comfort in the cooler months is even more important. Welcome to the Autumn/Winter 2016 issue of BUMP & Baby, which is all about your pregnancy and your newborn – and keeping you cosy yet chic, whether you’re between meetings at work or rugged up in front of the heater at home. Pregnancy is such a surreal time, isn’t it? Those early weeks, when you feel a bit yuck and can’t quite believe there’s an actual human being growing inside of you, give way to awe when you can make out the shape of tiny feet and hands on the ultrasound scan. And those first fluttering movements – magical! That is, until late pregnancy when it feels like those once-tiny feet are now sticking right in your ribs, particularly when you try to turn over at night. We’re celebrating all of those moments with a plethora of articles for every stage of your pregnancy. And when you’re ready to talk about birth and your new baby, we’ll be there too, with real tips from other mums, and expert advice to ensure you’re empowered to make the best decisions for your body and your baby. Lastly, check out our website bumpandbaby.co.nz for more info on every stage of pregnancy and new babyhood. Stay warm!

Find us at facebook.com/bumpandbabynz for giveaways, helpful tips, cool products, latest news, and advice from other mums-to-be.

Pregnancy BUMP & baby

PREGNANCY BUMP&baby PUBLISHED BY TOTS TO TEENS PO Box 70 Level 1, 190 Main Road Kumeu, Auckland 0841 New Zealand The Media Barn 91 Moontide Road Kumeu Auckland 0892 New Zealand T: +64 9 412 5123 F: +64 9 412 5133 ONLINE bumpandbaby.co.nz facebook @bumpandbabynz instagram @bumpandbabynz pinterest @bumpandbabynz Tik Tok @bumpandbabymagazine PRINTER OVATO Limited Pregnancy BUMP&Baby ISSN 2463-283X is published bi-annually (2 issues per year) The opinions expressed and statements made in Pregnancy Bump&baby are those of the contributors and advertisers and do not necessarily represent the views of the publishers. Pregnancy Bump&baby, on behalf of itself and the authors, asserts copyright on all material appearing in Pregnancy Bump&baby and none of it shall be reproduced wholly or in part without the prior written consent of the publishers. The publishers reserve all rights in respect of all material received and accepted for publication. Pregnancy Bump&baby reserves the right to edit or abridge all articles, letters, or other material (solicited or otherwise) accepted for publication. While every care has been taken in the research and compilation of this publication, it is not intended to replace professional or medical advice. To the best knowledge of Pregnancy Bump&baby, all information herein is correct at the time of publication. Please contact your healthcare provider in the first instance for medical assistance and advice.

EDITOR'S PHOTO: NIGEL MARPLE • CLOTHING BY BREASTMATES BREASTMATES.CO.NZ AND CARBON SOLDIER WWW.CARBONSOLDIER.COM.

ONLINE ENQUIRIES digital@bumpandbaby.co.nz social@bumpandbaby.co.nz

Just bumped into… The latest news, info, and gear for stylish mums, bumps, and babies BATHTIME = GOOD FOR MUM & BABY When parents rub their babies' skin in the bath, it stimulates the vagus nerve and causes a relaxation response. And according to a Johnson & Johnson survey, 84% of parents say that bath time is some of the best quality time they have. So go on, run a bath!

WE LOVE Just look at this gorgeous, feminine new perfume, Valentina Poudre, in its nudecoloured bottle – with terracotta powder blended with the creamy floral notes of iris and tuberose and mixed with vanilla and sandalwood, it’s a delicate dream. 50ml EDP $152, 80ML EDP $202, from Farmers

THE GRASS JUST GOT GREENER

SPUD PATROL

So let's say (hypothetically speaking) you don't have a sprawling designer kitchen. The Boon Patch drying rack is perfect for narrow spaces, like the windowsill or that utterly useless area behind the sink. It holds all of your just-washed baby accessories: Bottles, sippy cups, dummies... And best of all, it looks great year-round – no green thumb required. RRP$30, babyfirst.co.nz for stockists

QUICK FACT

. MM 12

Pregnancy BUMP & baby

IS THE INITIAL SIZE OF THE EGGS OF HUMANS, RABBITS, DOGS, PIGS, AND WHALES.

A new study suggests that eating a lot of potatoes during pregnancy could be linked to gestational diabetes. Women who eat two to four servings of potatoes per week may be 27% more likely to suffer from diabetes during pregnancy. So consider cutting back on the fries...

NOTEWORTHY

MYTH THE PERFECT PLAYLIST?

WOMEN ARE FERTILE ALL THE TIME.

Fact: You're only fertile for a few days around ovulation. And while your egg can survive for 12-24 hours, sperm can survive for 5-7 days. Since men can produce sperm any time, they're the ones who are always fertile!

soft & gentle

CALM THE CHAOS, MANAGE THE MESS

If you’d describe your life as “less than organised”, this compact volume might just be the key to helping you better prepare for the practical side of new parenthood. I Want to Be Organised, by Harriet Griffey (Hardie Grant $25.95), has simple steps to help tackle the disorder in each area of your life, from decluttering the lounge to organising your diary – essential for mums on the go! Now, about that unfinished nursery...

easy grip

A New York OB/ GYN has come up with what he says is the perfect play list to give birth to. Available on Spotify, the playlist mirrors the birthing experience, starting with songs that are slow and mellow, then transitioning into songs with a stronger beat for when it’s time to push, and concluding with Bach’s “Unaccompanied Cello Suite #1” performed by the legendary Yo-Yo Ma for the moment women first meet their newborns. tinyurl.com/ birthingplaylist

GENTLE PUMPING

simple assembly

Soft and simple, the Chicco Natural Feeling Breast Pump’s design allows it to gently express and automatically release the suction, never gripping harshly – so promotes optimum milk flow. It’s easy to sterilise and re-assemble, too, which is what every busy breastfeeding mum wants! RRP$79.95, chicco.com. au for stockists Pregnancy BUMP & baby

NOTEWORTHY FEED THE BUMP

KEEP YOUR BIB ON

DELICIOUS NEW COOKBOOKS TO KEEP YOUR BABY BELLY HAPPY

What’s for Dinner? 80 Weeknight Favourites, by My Food Bag and Nadia Lim (Allen & Unwin $39.99) Take the stress out of weeknight meals with these recipes great for couples and families. (And check out some of these scrummy dinners on page 58!)

TRIED & TESTED Every hospital bag needs a tube of Medela Purelan to help soothe and protect your nipples during pregnancy and breastfeeding. 7g $11.99 and 37g $20.99 from Baby City, Baby Factory, and pharmacies

Pregnancy BUMP & baby

Julia & Libby’s Wholefood Kitchen, by Julia & Libby Matthews (Penguin $50) With an emphasis on wholefoods and processed-food-free eating, these energyrich, nutritious recipes are mostly gluten and dairy-free. With bonus beauty product recipes.

Made of 100% food-grade BPA free silicone, this super-cute, super-stylish Make My Day bib has a built-in crumb catcher and it's even dishwasher safe. 6m+, RRP$25, babyfirst.co.nz for stockists

Toast, by Sabrina Fauda-Rôle (Hardie Grant $19.99) Tartines, open sandwiches, bruschetta, canapés, artisanal toasts... Who knew you could do so many things with a slice of bread? Great for satisfying those crunchy cravings.

QUICK FACT

ABOUT 150 NZ MEN WILL RECEIVE A NEW BABY AS THEIR GIFT ON FATHER'S DAY (SUNDAY 4 SEPTEMBER).

NOTEWORTHY STOP BEFORE YOU POP

COOL APP Birth support in your pocket! Originally launched in the Netherlands in 2014, the Doula Contraction Labour Coach is great for the early to middle stages of labour when you’re not quite ready to go to hospital yet. Available free for iPhone and Android, it features a contraction timer, voice coaching, breathing assistance, and a playlist of soothing music. Visit doula-app. com for more info.

If you're thinking about taking ibuprofen or aspirin during pregnancy, don't. They can both cause problems with the foetal blood flow. in fact, check with your lMC before you take any medications during pregnancy, just to be safe.

GIVING BACK TO THE EARTH

JUST ONE CLICK Did you know you can now register your baby’s birth online at registermybaby.dia.govt.nz? The Department of Internal Affairs (DIA) recently recorded the 50,000th online birth registration since the service went live. 90% of parents now register their baby’s birth online, with an average of around 130 a day, says Registrar General of Births, Deaths and Marriages Jeff Montgomery. DIA are currently working on other services where parents will be able to use their digital birth registration to access a range of agencies digitally. “For example, parents registering a birth online can now register their child for an IRD number by ticking a box,” says Jeff. “Just one click and a bunch of hassles for parents disappear around applying for Working for Families Tax Credits, Paid Parental Leave, child support, KiwiSaver or setting up a bank account for their newborn.”

What will you do with your baby’s placenta? Many Kiwi parents choose to bring it home from hospital and then plant it in the garden with a tree or plant, which is a beautiful way to remember your baby’s birth. Hawke’s Bay birth educator Janine Gard has developed the Earth-Friendly Kete, handcrafted flax cocoons which come with a biodegradeable bag, instructions, and even a poem to read during the burial. POA from earthfriendlyketes.com

COLOUR ME PINK & BLUE The PANTONE 2016 Colour of the Year is actually two colours – Rose Quartz and Serenity (PANTONE 13-1520 and PANTONE 15-3919 for the design geeks). “Joined together, Rose Quartz and Serenity demonstrate an inherent balance between a warmer embracing rose tone and the cooler tranquil blue, reflecting connection and wellness as well as a soothing sense of order and peace,” says the PANTONE website. Yep, perfect for the nursery!

Pregnancy BUMP & baby

NOTEWORTHY

GET YOUR FLU JAB! Pregnant women are nearly five times more likely to be admitted to hospital with influenza than women who are not pregnant. Because of this greater risk, pregnant women are eligible for free influenza immunisation from now until 31 July 2016. Influenza isn’t just a bad cold – it can be serious and can kill. For more information about influenza or the influenza vaccine, talk to your Lead Maternity Carer or doctor, or go to www.fightflu.co.nz or call 0800 IMMUNE (0800 466 863).

DON'T TELL ME IT'S FLU SEASON AGAIN ALREADY!

STILL LOOKING FOR ANSWERS New research from the University of Birmingham has shown that unfortunately, progesterone supplements in the first trimester of pregnancy do not improve outcomes in women with a history of unexplained recurrent miscarriages. The findings mark the end of a five-year trial and provide a definitive answer to 60 years of uncertainty over the use of progesterone treatment for women with unexplained recurrent pregnancy losses. The study of 826 women with previously unexplained recurrent miscarriage showed that those who received progesterone treatment in early pregnancy were no less likely to miscarry than those who received a placebo. This was true whatever their age, ethnicity, medical history, and pregnancy history. Though the results of the trial are disappointing, it will allow researchers to direct their efforts towards exploring other treatments that can reduce the risk.

Pregnancy BUMP & baby

QUICK FACT

WEEKS IS THE MEDIAN GESTATION AT BIRTH OF BABIES BORN IN NEW ZEALAND.

SUPERFOOD AT YOUR FINGERTIPS Everyone wants to live and eat healthfully, but finding nutrient rich foods that are also convenient to cook with can be a challenge (especially when you’re pregnant and don’t feel much like cooking anyway). GO Superfood is a brand new range of Superfoods that is nutrient rich and packs a health punch, along with that all-important convenience factor. Add to your morning smoothie, stir some kale powder into pesto, and mix the beetroot powder with hummus – one teaspoon is all it takes. RRP$11.90 to $64.90, gosuperfood.co.nz for stockists

Absorb nature’s gift.

As your baby relies on its nutrients from your blood, it’s imperative to maintain healthy iron levels while pregnant. Spatone is scientifically tested and shown to help maintain healthy iron levels during pregnancy.

•Gentle on the stomach •No mixing, no measuring •Less likely to constipate

Available from selected health food stores and pharmacies. Always read the label and use only as directed. McKenna, et al. Clinical and Laboratory Haematology, 2003, 25(2), 99-103* # Trefriw Wells Spa Ltd was a financial sponsor of this research. * Research was conducted on pregnant women.

NOTEWORTHY

QUICK FACT

2 OUT OF 5

WOMEN GIVING BIRTH IN NEW ZEALAND ARE FIRST-TIME MOTHERS, ACCORDING TO A REPORT RELEASED BY THE MINISTRY OF HEALTH (MATERNITY TABLES 2013).

NEW WINTER RANGE NZ maternity company Breastmates (breastmates.co.nz) has just released their Autumn/Winter 2016 range of stylish maternity and breastfeeding clothing made with mums-to-be and breastfeeding mamas in mind. Check out their soft, snuggly new range of tops, dresses, pants, and more in gorgeous solids and colours. We love this cosy Peach 2-Tone Hoodie (pictured, RRP$65.90).

ON YOUR MARK, GET SET, SWIM! Conception is a race to the egg, and sperm that can swim well are more likely to be successful! SwimCount is the first at-home fertility test for men that accurately measures motile sperm cells – the ability of the sperm to swim – which are necessary to make a woman pregnant. Available in NZ at Unichem and Life pharmacies for $99.99, swimcount.co.nz

Pregnancy BUMP & baby

BUMP & BABY MALL Shop at bumpandbabymall.co.nz – our new virtual mall – for amazing bump and baby products. We have a massive selection with dozens of brands. We’d love you to log in! What could be more fun when you’re pregnant than having a good browse through one of the most extensive pregnancy, bump and baby malls. Take a peek… And enjoy! We’d love you to come and visit

bumpandbabymall.co.nz

Healthy

eating for

pregnant and breastfeeding mums

It’s important to maintain a healthy, balanced diet while pregnant or breastfeeding to pass on good nutrition to your baby.

LIGH SUPE THOUSE rangeRFOOD com S in thirte es flavo en urs

A balanced diet includes a variety of healthy foods from the each of the four main food groups: fruits and vegetables, breads and cereals, milk and dairy products, and protein. Try to eat five to six meals and drink two to three litres of water per day. Take care when cooking, buying, preparing and storing food so it’s as safe as possible to eat. Among other nutrients, pregnant mums need a sufficient supply of iron. While women need 18mg of iron per day, pregnant women need 27mg. Foods rich in iron include meat, seafood, green leafy veggies, legumes, berries and stone fruit. It’s not always possible to get enough nutrients through diet alone, so supplementation may be required to help give the best start to your baby’s life. This is especially important for mums with restricted or inadequate food intake (for example, vegetarians, or obese women restricting energy intake to prevent weight gain). Support your energy and vitality with Lighthouse Organic Spirulina Powder. It contains high-quality spirulina that delivers over 100 nutrients including iron, magnesium and B vitamins. The powder is safe for pregnant and breastfeeding mums and is easily digested, with a sweet, natural pineapple flavour and no added sugar. Enjoy it in water, juice, your smoothie, or a healthy superfood treat.

TORE!

NEW IN-S

Talk to our caring staff to find out more. Always seek medical advice before taking supplements while pregnant or breastfeeding. If you have any pre-existing medical conditions, consult a health professional prior to use. Always read the label and take as directed. If symptoms persist, see your healthcare professional. Sup plementary to a balanced diet. TAPS PP7894

www.health2000.co.nz

SUBSCRIBE & WIN

We have the most amazing magazine subscription offers, including beautiful pregnancy packs and chances to win great prizes.

Yay, you’re pregnant! Choose from the following: Single issue hard copy or digital copy

Digital copy pregnancy bundles

2-issue subscription and PeekaBox combo

Subscribe at

BUMPANDBABY.CO.NZ

- --

FIND IT ALL AT OUR MALL BATHING BOOKS & MAGS CLOTHING FEEDING & NURSERY PL AY & LE ARN FERTILIT Y HE ALTH & WELLNESS NAPPIES & CHANGING NURSERY OUT AND ABOUT SAFET Y SKINCARE SLEEP TEETHING & DUMMIES

GET EVERYTHING YOU NEED, WITHOUT LEAVING THE HOUSE

Home to Kiwi mums’ favourite brands, BUMP&baby Mall (bumpandbabymall.co.nz) is your one-stop baby shop. PREGNANCY

Just like bees are programmed to find the flowers, so too are sperm programmed to find your eggs!

Myth or fact?

When it comes to baby-making old wives’ tales, it’s hard to separate fact from fiction, says Penny Voigt.

Pregnancy BUMP & baby

FERTILITY FICTIONS

Lifting your legs in the air for 20 minutes after having sex will help you get pregnant? THE IDEA

SOUNDS LOGICAL, BUT THE FACT IS SPERM ARE CHEMICALLY PROGRAMMED TO FIND YOUR EGG, NO MATTER WHAT POSITION YOU’RE IN.

hen you hit 35, you’ll have no chance of getting pregnant.” “You’re not conceiving because you’re too stressed.” “Lifting your legs in the air after sex helps the sperm travel faster.” “Eating certain foods will cause twins.” “Staying on the pill too long leads to infertility.” Have you heard any of these? Whether or not you’re planning to get pregnant soon it’s helpful knowing which fertility myths are just plain nonsense and which have a grain of truth to them. Read on to find out more about these common fertility myths.

myth Women are fertile

all the time.

You’re only fertile for about 24 hours of each cycle. That’s how long each egg can survive after ovulation. If two or more eggs are released, your window of fertility could extend to 48 hours. As sperm can live up to five days in optimum conditions, that potentially increases your fertile phase to around seven days per cycle. be

b a c k w he

I'll

myth Women can ovulate

more than once in each menstrual cycle.

o u'

re d

Hormones in your body control ovulation, so once you’ve ovulated, it won’t happen again until your next cycle. Even in the case where two or more eggs are released, this always occurs within 24 hours of the first egg being released.

myth Avoid certain foods if

you want to get pregnant.

Eating yams is unlikely to lead to twins and soy has never been linked to infertility? While there are certainly foods that boost

Being on the Pill for too long delays pregnancy? YOUR CYCLE SHOULD REGULATE

WITHIN A FEW WEEKS OF DITCHING THE PILL AND, BARRING ANY OTHER ISSUES, YOU CAN EXPECT TO OVULATE WITHIN THAT TIME FRAME TOO. IN FACT, STUDIES SHOW THAT AROUND 80% OF WOMEN WHO STOPPED USING THE PILL CONCEIVED WITHIN A YEAR.

fertility, keeping you healthy and helping regulate your hormones, there’s no conclusive evidence suggesting certain foods make you more or less fertile. When it comes to caffeine, though, studies do suggest limiting your caffeine intake if you’re trying to conceive.

myth Over 35, your chance

of conceiving is zero.

According to French birth records dating back to between 1670 and 1830, one in three women aged 35 to 39 could not conceive after a year of trying to get pregnant. Medical advancements and improved lifestyle have made a radical difference, with more recent data confirming 82% of women aged 35 to 39 do actually conceive within a year.

myth Menopause starts

when a woman runs out of eggs.

Changes to your hormone levels which affect your ability to mature and release eggs from your ovaries signal the start of menopause. You’ll still have around 10,000 eggs left when menopause starts. Pregnancy BUMP & baby

FERTILITY FICTIONS

myth Most couples

conceive within three months of trying.

It generally takes the average couple without any fertility issues between six and 12 months of active trying before conception occurs. Of course, it could happen a lot sooner too.

myth The more sex you have,

the more likely you are to conceive.

Until recently, an every-other-day sex strategy was recommended when trying to conceive. But more recent research suggests that for a man with a normal sperm count, having sex every day during his partner’s fertile days, is more likely to result in conception. More than once a day, on the other hand, means less sperm, and although it only takes one sperm to fertilise an egg, there is strength in numbers!

Male fertility does not decrease?

IT MAY SURPRISE YOU TO LEARN THAT INFERTILITY IS NOT LIMITED TO WOMEN. AS MEN AGE, THEIR TESTOSTERONE DECLINES, AND AFTER THE AGE OF ABOUT 35, SPERM WILL BE FEWER, SLOWER, AND LESS VIABLE. STATISTICS SHOW THAT 35 TO 40% OF FERTILITY PROBLEMS ARE CAUSED BY MALE CONDITIONS, ANOTHER 35 TO 40% BY FEMALE CONDITIONS, AND THE LAST 20 TO 30% IS A COMBINATION OF THE TWO, AS WELL AS A SMALL PERCENTAGE OF UNKNOWN CAUSES.

myth All women ovulate

myth Adopt and you’ll

Ovulation dates and fertility cycles differ from woman to woman. Generally, women ovulate about 10 to 16 days before their next period, but cycles can differ in length – from 24 to 34 days. Unless you’re doing an ovulation test, it’s impossible to pinpoint your ovulation period.

It’s worthwhile exploring medical treatment for infertility before going down this road. But no, adoption is not a cure for infertility, and studies reveal that the number of couples getting pregnant after adopting is roughly the same as in couples who don’t adopt.

myth Stop stressing and

myth Alcohol = infertility.

at the same time.

h job, bu

t so

m e b o d y 's g o

Pregnancy BUMP & baby

It s a

i t!

you’ll get pregnant.

Infertility is a medical problem rather than a result of you being too stressed or not relaxing enough. While relaxing may improve your quality of life and help you better manage feelings of stress, it’s not the cause of infertility.

get pregnant.

There’s certainly some truth to this. While an occasional drink is fine, binge drinking or drinking to excess can lead to irregular menstrual cycles, cutting down your chances of conceiving. Medical advice suggests avoiding alcohol when trying to conceive.

At Repromed, our goal is to do whatever we can to help you realise your dream of having a child. Repromed is a fertility service specialising Dr Guy Gudex

Medical Director

in assisted reproductive technologies (ART) and is highly respected for it’s quality of care and innovative procedures. Repromed offers a full range of services including: • Fertility assessment/investigation

Dr Karen Buckingham

• Ovarian reserve testing (AMH) • Pre-implantation genetic diagnosis (PGD) • Pre-implantation genetic screening (PGS) • In Vitro fertilization (IVF) • Intra cytoplasmic sperm injection (ICSI)

Prof Neil Johnson

• Elective Egg Freezing for fertility preservation • Sperm freezing • Embryo freezing • Surgical sperm retrieval • Intrauterine insemination (IUI)

Prof Cindy Farquhar

• Ovulation induction (OI) • Donor sperm, eggs and embryos using personal or clinic donors • Counselling and support • Recurrent pregnancy loss management

Dr Marian Carter

• Surrogacy Repromed Fertility Specialists 105 Remuera Road, Remuera Please call us in confidence 09-5241232 or visit our website

Dr Emily Liu

Dr Shelley Reilly

www.repromed.co.nz

Maybe baby? Think you might be pregnant, but not quite sure? Before you reach for a pregnancy test, take a look at these early signs and see if any feel familiar, writes Penny Voigt.

Gotta go? Increased HCG levels make you wee more often.

Pregnancy BUMP & baby

EARLY EXPECTATIONS

Darkening areolas

Frequent weeing

Human chorionic gonadotropin (hCG), also called the pregnancy hormone, is responsible for this one. Once the embryo implants itself in the uterus, hCG is released, flooding your body with the hormones needed to sustain your pregnancy. The result is a need to wee more often. An increase in hCG levels also results in a positive on your home pregnancy test. HCG increases the blood flow to your kidneys, making them more efficient during pregnancy, which is a good thing when you’re weeing for two.

Sore breasts

Swollen and sensitive breasts are a common pregnancy symptom. It feels a lot like when you get your period, only worse! Breast tissue is particularly hormone-sensitive and as progesterone and hCG hormones start flooding your body, increased blood flow to your breasts can make them swell and feel heavier than usual. Wear your most supportive bra or get fitted by a professional. Remember to leave a little extra room as they are likely to keep growing.

During pregnancy, and even as early as a week or two after conception, you may notice your areolas (the area surrounding your nipples) begin darkening. It’s a result of surging pregnancy hormones as your body prepares your breasts to feed your baby. Totally harmless and very common, it’s probably one of the first changes to your body that you’ll notice. Have no fear if you develop bumps on your areolas. Called Montgomery tubercles and similar in appearance to goosebumps, these little bumps keep your nipples lubricated, something you’ll be grateful for when you’re breastfeeding.

Spotting

From about 5 to 10 days following conception, light bleeding may occur. Called “implantation bleeding”, it’s a sign that the embryo has embedded itself in your uterine wall. Spotting can be similar to a period, only much lighter and shorter than normal. It should only happen after conception, so if it continues, get checked out by your doctor or midwife.

Cramps

Tummy aches and cramps, similar to those you get just before your period, are triggered by the embryo implanting itself in to the uterine wall and your uterus stretching to prepare itself for the next nine months.

Missed period YOUR PERIOD COMES

EACH MONTH IF YOUR EGG ISN’T FERTILISED. SO IF YOU’RE MISSING A PERIOD, THERE’S A GOOD CHANCE YOU’RE PREGNANT. IT’S THE MOST OBVIOUS SIGN OF PREGNANCY BUT NOT ALL WOMEN MISS A PERIOD WHEN NEWLY PREGNANT. IF YOU’RE USUALLY FAIRLY REGULAR AND YOU’VE MISSED ONE, TRY TAKING A PREGNANCY TEST.

Headaches

IN THE FIRST FEW WEEKS OF PREGNANCY, INCREASED BLOOD VOLUME CAN TRIGGER FREQUENT, MILD TENSION HEADACHES. AS YOUR BODY ADJUSTS TO THE ELEVATED HORMONE LEVELS, THESE SHOULD EASE UP. BE SURE ANY PAIN MEDICATION YOU TAKE IS SAFE FOR PREGNANCY. Fatigue

Hit a sudden slump and just too exhausted to keep up with your usual activities? Your loss of energy is down to hormones and your body’s efforts to nurture your growing baby’s development. As early as two weeks following conception, your body starts using up your calories to feed your growing baby, wiping out your own energy stores. Take time out to catch up on the zzz’s with an extra few minutes' sleep in the morning or a late-afternoon power nap.

Pregnancy BUMP & baby

EARLY EXPECTATIONS

Food cravings

SOME BELIEVE THAT FOOD CRAVINGS ARE SIMPLY YOUR BODY’S WAY OF LETTING YOU KNOW WHAT IT NEEDS. RESEARCH SHOWS THAT AROUND 90% OF PREGNANT WOMEN EXPERIENCE FOOD CRAVINGS. AVOID “EATING FOR TWO”; CHOOSE HEALTHY OPTIONS OVER EMPTY CALORIES AND BUMP UP YOUR NUTRIENT INTAKE. Nausea

Morning sickness can strike fairly early in some pregnancies, but generally it starts around week six. And for some pregnant women it’s not limited to mornings only! There’s no clear reason why nausea and vomiting occurs in pregnancy, although it’s likely linked to changes in hormones. Around 50 to 90% of women suffer from some form of morning sickness. To minimise it, try nibbling on dry crackers before getting out of bed, eat smaller, more frequent meals, and sip tea without milk, or drink ginger ale.

Smell sensitivity

Bloating

Many mums-to-be swell up early on as a result of the boost in progesterone and oestrogen. Progesterone helps relax smooth muscle tissue, including that in your gastrointestinal tract. As a result, your gut works slower to allow your body more time to digest nutrients for your growing baby, leaving you feeling bloated and gassy. Eat smaller meals more often and avoid foods that give you gas.

If everything smells a little off to you, there’s a chance you could be expecting. Although no scientific reason exists, many women report a smell sensitivity during pregnancy. Stay away from strong-smelling foods, wash clothing more often, try using unscented toiletries, and get your partner to take out the rubbish.

Constipation

Backaches

It’s no wonder you’re all over the place, with pregnancy hormones flooding your body and causing sore breasts, fatigue, constipation, and headaches. Mood swings are a normal part of pregnancy and you’re likely to feel a little hormonal in the early stages. It’s down to your body adjusting, obviously.

This one is likely to continue throughout your pregnancy, as your body shifts and changes to accommodate your growing baby. If you don’t normally suffer from back pain, it could be a sign that your ligaments are loosening up.

Pregnancy BUMP & baby

Those same hormones that leave you feeling bloated and swollen can cause a few other problems too. Because your digestive system slows down, food may not pass through as quickly, and you could end up being constipated.

Mood swings

Body temperature

If you’re actively trying to get pregnant, you may have been tracking your body temperature to pinpoint ovulation. Typically, it’s about a half a degree higher when you’re ovulating until you get your period two weeks later. If it stays elevated beyond the two weeks, it may be a sign that you’re pregnant.

Dizziness or fainting

Sounds like something out of a movie, when the leading lady discovers she’s pregnant and swoons. But it’s actually based on reality. Low blood sugar or blood pressure in the early stages of pregnancy can cause you to feel dizzy and even faint. Ensure you stay wellhydrated and eat small meals, more frequently, to avoid a woozy episode.

The Auckland Radiology Group has been serving the greater Auckland community for over five decades from Pukekohe in the south to Glenfield in the north. At ARG we are dedicated to excellence in Radiology services with the latest equipment, clear, accurate results and ongoing staff training. Most importantly, this also means offering you the best service in a calm and caring environment. With 22 Ultrasound rooms and our team of 25 sonographers, you can be assured of appointments within a short booking timeframe and all of your images will be reviewed and reported on by our Specialist Radiologists. Our 30 minute appointments allow your sonographer time to complete a thorough examination and you will be given a USB stick with key images from your scan. Please remember to take your referral with you. In NZ all residents are entitled to four difference types of obstetric scans which are partially funded by the NZ Government. These are:

The Dating Scan is offered between 6 and 10 weeks and is predominantly about confirming your accurate dates The Nuchal Translucency (NT) Scan between 12 weeks to 13 weeks 6 days

A Nuchal fold scan contributes to a risk assessment of your baby having Down’s Syndrome or other chromosomal abnormalities.

The Anatomy Scan between 18 – 20 weeks

This scan is often the one that most expectant parent feel excited about – not only because it’s a real milestone but also because your baby will be looking less like a vague shape and more like a baby! You should let the sonographer know at the beginning of the scan if you’d like to know the sex of your baby (occasionally baby may be lying in a way that means the sonographer cannot advise you on the sex). This is also the longest and most complex clinical exam. Your sonographer will be concentrating as they will want to ensure that they take all the required images and measurements for our radiologists to review. If there are any signs of problems, we’ll give your LMC a call and you will be offered another scan. Some of many things that they’ll be looking at are: • The spine and abdomen to see that everything is aligned and developed. • The size and shape of your baby’s heart (which is now the size of your fingernail) • Baby’s kidneys and bladder. • The stomach, which you should be able to see below the heart. • Your baby’s hands and feet.

Growth Scan at 32 – 41 weeks

This ultrasound scan checks that your baby is growing and developing healthily.

Ultrasound Branches: 101 Remuera Rd • Avondale • Glenfield Hauraki • Henderson • Howick • Kohimarama • Panmure Papakura • Ponsonby • Pukekohe • Queen St • Royal Oak

arg.co.nz

40 From Week One (when you won’t even know you’re pregnant!) right through to Week 40, here are useful tips and advice for every stage of pregnancy.

WEEKS, 40 TIPS 30

Pregnancy BUMP & baby

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0 Just take it one week at a time, Mama, and you'll get through!

PREGNANCY

GET YOUR STRETCH ON

Week 1

You probably won’t know that you’re pregnant yet, but now is the time to get yourself conceptionready. Don’t smoke, drink alcohol, or take any drugs, and try to reduce caffeine. Exercise regularly and eat a healthy balanced diet. Maintaining a healthy body weight (BMI) has benefits for conception and for your pregnancy. 32

Pregnancy BUMP & baby

WEEK 2

Research shows there are some key areas of health women should focus on prior to conception and in the early days of pregnancy. Look for information about iron, vitamins, iodine and folic acid, and get your levels tested to make sure you and your baby are as healthy as you can be.

WEEK 3

Tired? Sick? Period late? Sore boobs, or nauseated at the smell of your breakfast? Yes, you just might be pregnant. Wait at least until the first day your period is due to take a home pregnancy test. The test gauges your urine for the pregnancy hormone hCG (human chorionic

PREGNANCY

to as a first antenatal screening, these tests include a complete blood count and testing for various diseases which may affect your pregnancy.

WEEK 5

Have a chat to your GP about your options for choosing a lead maternity carer (LMC). You can select a midwife or group of midwives, or choose to be under obstetric care for your pregnancy. At this point you’ll also start to think about where you’d like to have your baby.

WEEK 6

Don’t let the term fool you: Morning sickness can happen any time of the day or night. Getting plenty of rest and eating small snacks like dry crackers regularly can help, as can ginger, lemon, or acupressure wristbands. If you find yourself losing weight or if you can’t keep anything down, talk to your LMC right away for advice.

WEEK 8

Exercise may be the last thing you feel like doing, but your pregnant body will love you for it if you can get off that couch. Be sure to keep exercise low-impact because you’re more susceptible to injury right now. Yoga, walking, or swimming are all great options.

Week 9

Friends may get suspicious if you keep turning down social invitations, but you’re likely to feel more inclined to stay home than face a crowd right now. Remember, real friends support you no matter what’s happening in your life, so it's okay to take time out to focus on the big changes ahead.

Week 7

Eating as nutritious a diet as possible in early gonadotrophin), which is at its highest pregnancy is important. level first thing in the morning. Get But if your constitution a mid-stream urine sample for the most accurate result. is still wobbly, find something healthy that you can eat, and stick Week 4 with it. Be it green apples, Confirm your pregnancy ginger tea, wholegrain with a visit to your GP. toast, or boiled eggs, some A blood test is more accurate than a urine test, people think your body and your doctor will order craves what it needs. So as long as it’s healthy, give a range of other tests at in to temptation. the same time. Referred

An apple a day keeps nausea at bay for some women!

Pregnancy BUMP & baby

PREGNANCY

Focus on connecting with your partner in the early days of pregnancy.

Week 10

How’s your partner feeling right now? Amid your excitement, nausea, and anticipation, their thoughts may have been drowned out by your own. Take time to communicate and share your feelings before you let the rest of the world in. You’ll need each other more than ever in the months ahead.

WEEK 11

If morning sickness is still an unwelcome visitor, explore other remedies. A naturopath may be able to recommend supplements to support your liver and digestive system. Listen to music or watch a laugh-out-loud comedy. If nothing else, these activities can take your mind off the nausea. Remember to contact your LMC if symptoms are really affecting your daily life.

Pregnancy BUMP & baby

FACT

AROUND 1% OF PREGNANT WOMEN EXPERIENCE HYPEREMESIS GRAVIDARUM, WHICH IS SEVERE MORNING SICKNESS THAT CAUSES WEIGHT LOSS, DEHYDRATION, AND MORE. TALK TO YOUR LMC IF YOU HAVE SEVERE NAUSEA.

WEEK 12

You’ll probably have a noticeable bump by now, and you’ll be reaching for anything in your wardrobe that’s comfortable around your middle. Maternity clothes can be expensive, but you’ll get plenty of wear out of them so don’t be afraid to invest. You can also find great deals on Trade Me or in recycled boutiques and op shops.

WEEK 13

It might be time to tell family and friends your exciting news. Along with their congratulations, people will share their advice, whether you want it or not. Smile politely and thank them, but don’t feel obligated to take it if it doesn’t feel right. This is your pregnancy and nobody else’s.

Week 14

Your baby is now more likely to reach term as you move into the second trimester this week. If you’re suffering morning sickness, this is also likely to ease. Make the most of this trimester by eating better, exercising more, and enjoying the miracle of pregnancy.

The secret to a better iron supplement. Absorption.

Significantly more iron is required during and after pregnancy. The safest way to supplement your iron is with a natural product. The average person’s body will dissolve and absorb 20% of most solid supplements, eliminating the remaining 80% and possibly causing unpleasant side effects such as constipation, gas and bloating. Dietary iron is absorbed at an average rate of 10%, while the iron in most supplements is absorbed at rates between 2% and 10%, depending on the forms of iron used. Because Floradix is a liquid solution it is absorbed more easily. And Floradix boasts one of the highest iron absorption rates of up to 25%, through the use of iron gluconate and yeast.

•

Non-constipating formula

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Highly absorbable iron gluconate

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Vitamin C increases iron absorption

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No alcohol, nuts, lactose, dairy or animal derivatives

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No chemical preservatives, colourings or flavourings

TC062 TAPS PP6472

Floradix and gluten-free Floravital are a great way to help maintain the health and vitality of your mums-to-be and nursing mothers.

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Is your bump outgrowing your regular clothes? It's time for maternitywear!

Week 15

Because of your reduced immunity and the increased risk of food-borne illness, it's recommended that you avoid certain foods while you’re pregnant. These include deli meats, cold pre-cooked meat, pâté, unpasteurised cheese, raw eggs, raw seafood, pre-prepared salads or sandwiches, and soft-serve ice cream. Be scrupulous with hand-washing and hygiene around food, and reheat leftovers until they're piping hot.

WEEK 16

Taking up pregnancy yoga is a fantastic idea. Gentle on the body, the combination of stretching and deep breathing conditions both body and mind for the amazing task of being pregnant and giving birth. Taking a group class also gives you a great opportunity to meet other mums-to-be.

WEEK 17

Antenatal classes can fill up quickly, so check out what’s available in your area and book in now. If taking a class is not your bag, think about finding or forming a pregnancy group in your community or online. Having a support network once your baby arrives may be more important down the track that it seems now.

Pregnancy BUMP & baby

Week 18

If you’re finding it hard to sleep, look at sleep inducement and relaxation strategies. Practical measures may help, like reducing your caffeine intake (by avoiding tea, coffee, soft drinks, and chocolate), eating lightly in the evening, and minimising

exercise close to bedtime. Deep breathing, massage, progressive muscle relaxation, and guided imagery could also help.

WEEK 19

Girl or boy? If you want to find out the gender of your baby, the anatomical scan you’ll have around now can probably tell you. The scan will also check for anything unusual with your baby’s body. Checking anatomical measurements reassures you and your LMC that your baby is growing well and there are no problems.

PREGNANCY

WEEK 23

Week 20

You’re halfway there! If you’re experiencing lower back or joint pain from the effects of your burgeoning bump, it’s a good idea to try a pregnancy support belt, or "belly band". Worn snugly under your bump, these can relieve pain, maintain good muscle tone, reduce abdominal strain, and improve your posture.

WEEK 21

Walking is a wonderful way to keep fit during pregnancy. Take some valuable time out, make plans with your partner, or catch up on gossip with a friend, all while getting the gentle exercise you and your baby need. Now might be a good time to invest in new trainers. But be warned! Pregnancy can enlarge your feet.

WEEK 22

Your second trimester is a great time to take a "babymoon" holiday if you can. The idea is for you and your partner to get some rest and relaxation, enjoying your last opportunity to chill out before baby arrives. Drink plenty of fluids when travelling by air, and take frequent breaks when travelling by car.

Nesting refers to the hormonal drive you may experience to "prepare the nest" for your baby’s arrival. This might mean a flurry of activity to get your baby’s room ready, an insatiable desire to clean out the cupboards, or an uncontrollable urge to spit-shine the skirting boards. Just take care not to put yourself in physical danger and be wary of strong chemicals.

WEEK 24

Hormones are the driving force behind pregnancy. From pimples to fits of rage, from your lush flowing locks to breaking down in tears over TV commercials, hormones are to blame. Take this time to read up on natural birth and the preparatory role pregnancy hormones play in a successful birth.

FACT

IF YOU WADDLE WHEN YOU WALK, IT'S NOTHING TO DO WITH HOW BIG YOUR BELLY IS. "PREGNANCY SWAGGER" IS CAUSED BY YOUR CENTRE OF GRAVITY SHIFTING AND YOUR JOINTS RELAXING, NOT YOUR BUMP SIZE!

Week 25

Babies develop the

ability to hear at around 18 weeks, and by now they will also respond to the sounds they hear. Playing music, singing, and talking to your bump are lovely ways to bond and feel connected to your baby.

WEEK 26

You may be advised to take a screening test (called a polycose test) to test for gestational diabetes mellitis (GDM). This is a condition that affects two to 10% of pregnant women, but don't worry, a diagnosis of GDM can usually be managed through diet. For about half of women diagnosed with GDM, the condition is only temporary. Pregnancy BUMP & baby

Don't try this at home! Seek out a registered acupuncturist.

WEEK 27

Kegel exercises are designed to strengthen your pelvic floor muscles. Get in the habit of doing these exercises at least a couple of times every day to assist you during labour, ease your baby’s birth, and reduce the likelihood of incontinence after pregnancy.

WEEK 28

Pelvic girdle pain (PGP) or symphysis pubic dysfunction (SPD) is more likely to occur for women who work in hard physical jobs or who have had previous problems with lower back pain or an injury in that area. You may need treatment from a physio or pain relief medication to manage this condition.

Week 29

What do you really know about breastfeeding? Your body is busy preparing itself to nourish your baby, so take the time now to explore how breastfeeding works, and how you, your baby, and your hormones work together to establish a successful breastfeeding relationship.

WEEK 30

Fluid retention can cause swelling in your feet, ankles, and hands. Pressure on the nerves around your wrists caused by this extra fluid may create a tingling or numb sensation called Carpal Tunnel Syndrome. Because it’s your body’s response to dehydration that causes it to store water and retain fluid, drinking more water can alleviate your symptoms.

Pregnancy BUMP & baby

WEEK 31

You’ll be monitored during your pregnancy for pre-eclampsia, a potentially serious condition characterised by elevated blood pressure, protein in the urine, and oedema (swelling). Mild pre-eclampsia can be managed, but more serious cases may compromise baby’s development by affecting blood flow to the placenta. Recent research indicates low-dose aspirin and calcium supplements may reduce the risk of pre-eclampsia.

WEEK 32

Braxton-Hicks is the name given to practice contractions, sometimes called "false labour". These stomach "tightenings" are not usually painful, they come and go fairly randomly, and they often disappear when you change your position. While the contractions can thin the cervix and ready your body for labour, they won’t lead you to the delivery suite.

WEEK 33

Your pregnancy will reach "term" at 37 weeks, but some women experience pre-term labour prior to this. Pre-term labour does not necessarily mean you’ll have a premature baby. If you experience painful contractions, pelvic pressure, watery discharge, vomiting, bleeding, or reduced foetal movement, then contact your LMC immediately for advice.

FACT

Week 34

Acupuncture is widely recognised as an alternative therapy with benefits for pregnant women. The discipline focuses on releasing blocked energy centres to prepare both your body and your baby for the birthing process. Acupuncturists also use massage in their treatments, which can be very relaxing at this stage of pregnancy.

A WOMAN'S UTERUS EXPANDS TO OVER 500 TIMES ITS NORMAL SIZE DURING PREGNANCY.

PREGNANCY

WEEK 35

The best birth plan may be the one that allows for the birth plan to go out the window once labour starts. Nevertheless, it’s a good idea to go through the exercise of writing a birth plan. You’ll focus your ideas about the elements of the birth experience you feel are important, and give your delivery team a guide to your wishes.

Week 36

There are a tonne of resources online and at your local library to help you choose a name for your baby. Choosing a name is a big deal, but don’t let it overwhelm you. As long as the name you select feels right to you and your partner, it’s the right name for your baby.

WEEK 37

You’re officially full term! Be sure you know the signs of labour so you know what you’re experiencing when it begins. Generally speaking, you should wait at home for as long as you can before heading to the hospital, but speak to your LMC if you’re unsure. Pregnancy BUMP & baby

PREGNANCY

Pregnancy BUMP & baby

r b a g we l l a h

f ti

WEEK 38

Get ready for the hospital by packing a bag. Don’t think you’ll be able to fling a few things together once labour starts. Making sure you've got your toothbrush, organising some breastfeeding bras, or packing comfy clothes to wear post-bump will be the last things on your mind when contractions start, but you'll be glad you thought ahead once your baby is born.

WEEK 39

Are you impatient to meet your baby? You’ve come a long way through pregnancy, and while you might find the last few weeks excruciating, remember that babies arrive in their own good time. Your baby is still preparing for the outside world, with brain and lung development the most crucial final stages of gestation.

Week 40

You're in the home stretch! Now put your feet up and rest.

This is it: Your last chance to prepare yourself for your baby’s arrival. Put your feet up and take it easy as much as possible. Resist any urge to do much more than sleep, read, watch TV, or chat on the phone. Any day now your baby will be here, and your life will change in unimaginable ways. Enjoy your new baby!

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YOU MADE IT! 40

k you

Pa c

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HUGGIES® Nappy-Pants now come with new MOTIONFLEX® Technology - improved soft, stretchy side panels and flexible leg elastics that move with your wriggly baby, maintaining a snug, comfy fi t day and night. Together with wipes, they’re endorsed by Plunket, so you know they work best together for a happy, comfy groover. And they’ll love the fun, new Mickey and Minnie designs.

Join the HUGGIES® Baby club and go into the draw to WIN a 6 month supply of HUGGIES® products† at huggies.co.nz

SLOUCHY FASHION IN WARM SOFT FABRICS LIKE MERINO, KEEP YOUR BUMP COSY AND COMFORTABLE.

STYLE

When the weather cools down, style heats up. Bump up your winter fashion in these cosy looks

STYLE

CROSS-OVER NECKLINES GIVE YOUR CHANGING SHAPE A GOOD LINE BUT NIPPING IN YOUR SILHOUETTE A LITTLE UNDER THE BUST.

HEDI DRESS BY NOPPIES, $123 FROM QUEENBEE.COM.AU

STYLE

A BUSINESS BUMP CAN BE SUPER SOPHISTICATED IF YOU KEEP YOUR BASIC WARDROBE AND YOUR COLOURS SIMPLE , AND IMPORTANTLY, MAKE SURE YOUR HAIR AND SHOES ARE ROCKING THE LOOK YOU ARE AFTER.

SNUGGLE UP IN SOFT KNITS FOR THAT WARM AND NURTURING VIBE

PHOTOGRAPHY COURTESY OF QUEENBEE.COM.AU

STYLE

SHOPPING

1 1. Naturalizer Pull-On Wedge $199 2. TOMS Sandstorm Leather Leila Bootie $190 3. Diana Ferrari Ankle Boot $189 4. Toretti Riding Boot $399 5. Toretti Boot $359 6. TOMS Black Suede Embossed Leila Bootie $170 7. Naturalizer Suede Boot $219 8. Deuce Duran Shoe $109.90 9. Addiction Shoe $249 10. Minx Shoe $249 11. TOMS Grey Tribal Del Rey Sneaker $120 12. TOMS Black Stripe Jutti Flat $120 13. Deuce Ritter Mid Canvas Shoe $129.90

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Pregnancy BUMP & baby

The shoe edit

Put your best foot forward this winter with new-season footwear to keep you stylish and comfortable right down to your toes.

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Dress your bump

Clothing designer and founder of fashion labels Augustine, Charlo, and Stella Royal, Kelly Coe knows how to dress for every occasion with flair – including pregnancy! Kelly is expecting her third child and definitely hasn’t sacrificed any of her usual glam or sparkle this time around. Here are her top tips for dressing your bump with style.

WE LOVE IT!

k Get a great pair of

1. Nero Maternity Sweater $69.90 from Breastmates 2. Dasia Maternity Slim Boyfriend Jeans $99.99 from JeansWest 3. Rose Bud Top $110 from EGG 4. Dasia Maternity Denim Pencil Skirt $89.99 from JeansWest 5. Sequin Tank $149.90 from EGG 6. Tie Wrap Coat $449.90 from Witchery 7. Boston & Bailey Sahara Blanket Wrap $79.99 from Farmers

Pregnancy BUMP & baby

STYLE TALK with Kelly Coe

Whether you're snuggled up or showing off, these new season maternity styles are right on trend.

maternity jeans (they're essential!). Make sure you get a fitted pair with a soft, wide waistband that’s comfortable on your bump. Wear with long-sleeved, figurehugging tops and a long cardi, or pair with a floaty top. k I wear a lot of Augustine sequin skirts. They have an elastic waistband, so I can wear them fitted with a loose chiffon top and still feel stylish and sparkly, yet comfortable. k Wear loose, floaty dresses, but belt them with a thin belt below your bump. That way you’re comfortable and yet still show off your bump, giving your body some shape so

you don’t look like you’re wearing a big tent. k If you have a special occasion, go all out and wear something fitted and glamorous! Find a beautiful dress that has some stretch or give in the fabric so you can fit your bump comfortably. k Wear some colour! Your beautiful bump deserves better than an all-black outfit.

HELLO WORLD a new journey begins

SHOPPING

Soft & supple skin WE LOVE IT!

Not only can pregnancy hormones trigger all kinds of changes to your skin, but autumn and winter weather can also contribute to a feeling that your skin just isn’t your own! If you’re in need of some extra moisture this chilly season, here are some beautiful hydrating products that’ll get you loving your skin once again.

1. Matakana Botanicals Macadamia & Wild Fig Bath and Massage Oil $23.90 2. Earths Botanicals Cucumber and Mint Hand + Body Lotion $19.90 3. Great Barrier Island Bee Co Manuka Honey Bath and Shower Creme $15.90 4. Trilogy Hydrating Mist Toner $29.90 5. Great Barrier Island Bee Co Manuka Honey Beeswax Body Butter $17.90 6. Trilogy Certified Organic Rosehip Oil 20ml $23.90, 45ml $39.90 7. Weleda Stretch Mark Massage Oil $28.90 8. Bio-Oil 60ml $20.45

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Pregnancy BUMP & baby

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The product most recommended by doctors for pregnancy stretch marks. Colmar Brunton, 2014

“The one thing my pregnant friends and I discussed at length was stretch marks – once you’ve got them, they’re there for good! I used Bio-Oil throughout, morning, noon and night... in fact, I haven’t stopped using it since Liam’s birth. Now that I’m pregnant with twins, I’m going to be using it more than ever! What’s also nice is that it’s not oily – you can put it on and then get dressed immediately and it doesn’t stain your clothes. You’ve no idea how many friends and family I’ve told about Bio-Oil!” Tracy with Liam

Bio-Oil® helps reduce the possibility of pregnancy stretch marks forming by increasing the skin’s elasticity. It should be applied twice daily from the start of the second trimester. For comprehensive product information, and details of clinical trials, please visit bio-oil.com. Bio-Oil is available at pharmacies and selected retailers at the recommended selling price of $20.45 (60ml). Individual results will vary.

But you still look pretty cute.

The skin you’re in

While many women bloom during pregnancy, quite literally glowing with vitality and good health, others are not as fortunate. Acne, stretch marks, pigmentation, and hair in places it shouldn’t be: You’d be forgiven for thinking you’re going through puberty again! As with puberty, hormonal changes to the skin are a normal part of pregnancy and you’re likely to experience at least some of these. Take a look at what skin changes you can expect during pregnancy and what you can do to help minimise their effects. 56

Pregnancy BUMP & baby

CHANGING FACES

stretch marks

spider veins

Increased blood volume and pregnancy hormones in your body can cause tiny, squiggly red or purple capillaries just below the surface of your skin to branch out and become more visible during pregnancy. Spider veins, resembling a small spider’s web, usually form on the face below the eyes or cheekbones, but can appear on the neck, hands, arms, and ears. Completely harmless, spider veins usually develop during the first and second trimester, with over a quarter of mums-to-be experiencing these. Spider veins usually fade about six or seven months after baby is born. In the meantime, if they bother you, try using foundation or concealer to cover them up.

LINEA NIGRA

As your pregnancy progresses, your skin stretches more and faster than usual. Pregnancy hormones in your body can also disrupt your skin’s protein balance, leaving it thinner. These changes to your skin can cause stretch marks to appear around your breasts, tummy, and thighs; pinkish or reddish streaks that run down your skin, fading to thin silvery or brown lines about six months after baby is born. Around 90% of pregnant women are likely to experience stretch marks. There is no magic treatment to prevent stretch marks, but there are things you can do to help minimise them. Gain weight slowly and steadily during your pregnancy by eating a healthy diet and exercising regularly. Stretch marks are also more likely to occur when the skin is not very elastic, so applying moisturising creams and vitamin E oils can lessen their effect.

You’re probably not even aware of the faint white line that runs from your tummy button to your pubic bone. Called Linea Alba, it’s barely visible before pregnancy, but sometime in the second trimester of your pregnancy, thanks to those pregnancy hormones again, the Linea Alba becomes a Linea Nigra; a much darker and more noticeable line. It should gradually fade after baby is born, but to help slow down the darkening, cover up your tummy and use sunscreen when you’re outdoors. There is some evidence linked to a darkening in skin tone and a deficiency in folic acid, so make sure you’re eating a healthy diet.

skin pigmentation

One of the first signs of pregnancy that you’ll notice is a darkening of your skin. Along with your nipples and areolas (the skin around your nipples), any moles and freckles you have may darken or become bigger. The area around your tummy button, armpits, and inner thighs may also appear noticeably darker, and while these areas of your skin may lighten over time, your nipples are likely to remain darker than they were before pregnancy. Being in the sun can cause these areas of your skin to darken, so ensure you cover up, wear a hat, and apply a decent sunscreen whenever you go outdoors. If you're feeling self-conscious about your skin, apply a tinted moisturiser, foundation, or concealer to help cover up any uneven skin tone. The good news: Pigmentation should fade within a few months of your baby’s birth.

itchy skin

Most noticeable over the tummy and breasts, as your skin stretches during pregnancy, you may experience itchy skin. Itchiness can also be caused by common skin conditions like eczema, which you may develop for the first time while you're pregnant. Typically, itching occurs in the folds of your skin, like the insides of your knees or elbows. Cut back on warm baths or showers, and avoid using cleansing products that contain strong detergents or perfumes as these can irritate or dry your skin, making it more prone to itchiness. Instead, use mild, moisturising soaps or pH-balanced body washes and moisturise your skin with unperfumed products. Try smoothing calamine lotion on to your itchy skin, or add some oatmeal to your bath. Avoid getting overheated, as heat rash can make itching worse. The combination of an already overheated pregnant body, dampness from excessive perspiration, and the friction of skin rubbing against clothing can cause your skin to rash. Wear loose, cotton clothing and stay indoors or stick to the shade.

the pregnancy mask

Called Chloasma or the mask of pregnancy, brown patches of pigmentation on your forehead, cheeks and neck are caused by your body producing extra melanin. Melanin is responsible for determining your skin colour, and during pregnancy the hormones estrogen and progesterone stimulate this over-production. About two out of three mums-to-be experience Chloasma during pregnancy, and it’s more noticeable in brunettes and darker-skinned women. As with skin darkening in other parts of your body, exposure to sunlight can cause the brown patches of Chloasma to darken on your face. Use a good sunscreen and wear a hat when outside in the sun, and avoid being outdoors at the hottest time of the day.

ACNE

Spots during pregnancy are rarely as severe as those of adolescence, and your bumps and pimples will gradually subside after baby is born. Increased hormone levels encourage the production of sebum, the oil that keeps your skin supple. Too much sebum causes your pores to become blocked, resulting in greasy skin and pimples. Because your pregnant skin is more sensitive than usual, avoid using abrasive scrubs and exfoliants. Mild, oatmeal-based facial scrubs help unblock oily pores while gently cleansing your skin. Cleanse no more than twice a day and if your skin is dry, use oilfree moisturiser. Use make-up sparingly and remove it completely at the end of the day. Avoid using antiacne prescription medicine while pregnant.

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What’s cookin’ These four delicious dinners from Nadia Lim and My Food Bag are perfect for autumn and winter evening meals – and they’re healthy, too!

1 TOFU, BLACK BEAN AND MUSHROOM SLIDERS WITH CARAMELISED ONIONS

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FOOD

TERIYAKI CHICKEN WITH SESAME GREENS, PICKLED COURGETTE AND RICE

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TOFU, BLACK BEAN AND MUSHROOM

SLIDERS WITH CARAMELISED ONIONS

Serves 4–5 / Ready in: 45 minutes / Prep time: 25 minutes Cook time: 25 minutes tofu, black bean patties Tofu, Black Bean Patties • 1 x 400g can black beans, drained and rinsed • 200g firm tofu • 1 carrot, peeled and grated • ¼ onion, very finely diced or grated • 125g portobello mushrooms, very finely chopped • 1 teaspoon lemon pepper • 1 teaspoon paprika • 1 clove garlic, minced • ¼ cup chopped mint leaves • 2 tablespoons soy sauce • ½ cup quick cook oats • ¼ cup fine breadcrumbs • 1 egg

Carrot and Parsnip Chips • 2–3 parsnips, cut into 2cm thick chips • 2 carrots, cut into 2cm thick chips Mushrooms • knob of butter • 125g portobello mushrooms, thinly sliced To Serve • 8 –10 slider buns, cut in half horizontally (or 4–5 large burger buns) • ¼ cup mayonnaise • 2 tomatoes, thinly sliced • ½ cup caramelised onions • lettuce leaves

1. Preheat oven to 200°C. Line two oven trays with baking paper. Place beans in a large bowl and roughly mash until most have been crushed. Using your hands and a paper towel, squeeze moisture out of tofu, breaking it up slightly as you squeeze it. Crumble tofu into bean mixture. Add all remaining tofu black bean patty ingredients, season with pepper and mix well using clean hands. If the mixture is too moist, add more oats and breadcrumbs (up to ¼ cup more of each) until the consistency is firm enough to shape – how wet the mixture will be depends on the tofu. Set aside for 5 minutes to allow mixture to firm up slightly. 2. Toss parsnips and carrots with a drizzle of oil on first prepared tray. Bake for 20–25 minutes until golden and cooked through. Turn once during cooking. 3. Use a quarter cup measure to scoop out patty mixture and roll into large balls. Shape into patties, about the size to fit slider buns. If using large buns, use a half cup measure per patty. 4. Heat a drizzle of oil in a large, non-stick fry-pan on medium heat. Cook patties, in batches, for 2–3 minutes each side until golden brown. Use a fish slice to push down on patties to ensure a crust is formed. Transfer to second prepared tray. Place burger buns, cutside-up, on tray next to patties and place in oven for 5 minutes until buns are lightly golden and patties are warmed through. 5. In same pan patties were cooked in, heat butter on medium heat and cook mushrooms for 1–2 minutes each side until softened. To serve: Spread top half of each bun with mayonnaise. Place tofu black bean patty on bottom half with sliced tomato, caramelised onions, mushrooms and lettuce. Serve with carrot and parsnip chips. ENERGY 2313KJ (551KCAL), CARBOHYDRATE 63.5G, PROTEIN 22.7G, FAT 19.7G

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TERIYAKI CHICKEN WITH SESAME

GREENS, PICKLED COURGETTE AND RICE Serves 4–5 / Ready in: 35 minutes / Prep time: 15 minutes Cook time: 20 minutes Pickled Courgette • ²/³ cup rice wine vinegar • 2 tablespoons sugar • 1 teaspoon salt • 2 courgettes, peeled into ribbons Teriyaki Chicken • ¼ cup soy sauce • 2 tablespoons white wine • 3 tablespoons brown sugar • ¼ cup water • 1 teaspoon finely grated ginger • 2 cloves garlic, sliced • 600g boneless chicken thighs (skin on)

Sesame Greens • 1 teaspoon oil • 2 teaspoons sesame oil • 300g green beans, trimmed and sliced 1cm • 150g frozen podded edamame beans, defrosted • 2 spring onions, thinly sliced • zest of 1 lemon • 2 tablespoons toasted sesame seeds* To Serve • steamed jasmine rice • 1 spring onion, green part only, thinly sliced • 1 lemon, cut into wedges

1. Start by cooking the rice to go with the meal. While rice is cooking, prepare rest of meal. In a small pot, bring vinegar, sugar and salt to the boil. Remove vinegar mixture from heat and pour over courgette ribbons, cover and leave to cool in the fridge. 2. Mix soy sauce, wine, sugar, water, ginger and garlic together and set aside. 3. Heat a drizzle of oil in a large fry-pan (preferably non-stick) on medium heat. Pat chicken dry with paper towels and cook, skin-side down, for 6 minutes until skin is golden. Drain excess fat from pan, turn chicken over and add teriyaki sauce. Reduce heat to low and simmer chicken in sauce for 4–5 minutes, while spooning sauce over chicken. Add 1–2 tablespoons water if sauce is reducing too quickly. 4. Heat oil and sesame oil in a large fry-pan on medium heat. Add green beans and stir-fry for 2 minutes. Add edamame beans and spring onions and cook for a further 1–2 minutes. Season with salt and add lemon zest and sesame seeds. Drain courgettes. To serve: Place rice, chicken and sesame greens onto plates. Drizzle with sauce from the pan and serve with pickled courgette. Garnish with green part of spring onion and squeeze over lemon juice just before eating. *Tip: Toast sesame seeds in a small, dry fry-pan on medium heat for 30–60 seconds until light golden, moving pan frequently to avoid burning. ENERGY 2209KJ (526KCAL), CARBOHYDRATE 61.6G, PROTEIN 36.3G, FAT 13.7G

3 HERB AND CITRUS PORK WITH ROAST BUTTERNUT, PEAR AND KALE SALAD

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PAN-FRIED FISH WITH MEDITERRANEAN

POTATOES AND GRAPE AGRODOLCE

Serves 4–5 / Ready in: 35 minutes / Prep time: 15 minutes Cook time: 30 minutes

HERB AND CITRUS PORK WITH ROAST

BUTTERNUT, PEAR AND KALE SALAD

Serves 4–5 / Ready in: 35 minutes / Prep time: 15 minutes Cook time: 25 minutes Roast Butternut, Pear and Kale Salad • 8 00g butternut (leave skin on), diced 2cm • 2 red onions, cut into 2cm thick wedges • 2 tablespoons olive oil • 2 teaspoons runny honey • 150g curly kale, tough stems removed, leaves very finely sliced • 2 tablespoons extra virgin olive oil • juice of 1 lemon • 2 ripe pears, cored and thinly sliced

Herb and Citrus Pork • 600g pork fillet (at room temperature) • 1 tablespoon finely chopped rosemary leaves • 1 tablespoon finely chopped thyme leaves • zest of 2 lemons Dressing • juice of 2 mandarins • 1 teaspoon wholegrain mustard • 1 teaspoon runny honey To Serve • 2–3 tablespoons chopped roasted hazelnuts, cashew nuts or almonds

1. Preheat oven to 200°C. Line an oven tray with baking paper. Toss butternut, red onions, olive oil and honey on prepared tray. Season with salt and pepper, and roast for about 25 minutes or until tender and golden. Turn once during cooking. 2. Pat pork dry with paper towels. Combine with rosemary, thyme, lemon zest and a drizzle of olive oil. Leave to marinate at room temperature while you prepare the rest of the meal. 3. Place kale in a large bowl with oil, lemon juice and a good pinch of salt. Use your fingertips to gently “massage” the kale and set aside to marinate – this helps to soften the kale. 4. Heat a drizzle of olive oil in a large fry-pan on high heat. Season pork with salt and fry until browned, about 1 minute on all four sides. Place pork on top of vegetables to finish cooking for 6–8 minutes or until cooked medium. Set aside to rest, covered with foil, for 5–10 minutes before slicing. 5. Mix all dressing ingredients together with a pinch of salt. To serve: Toss roast vegetables with marinated kale and pear. Divide salad between plates, top with slices of pork, pour dressing over the pork and salad, and scatter over nuts. ENERGY 1997KJ (475KCAL), CARBOHYDRATE 36.6G, PROTEIN 32.8G, FAT 22.9G

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Mediterranean Potatoes • 700–800g agria potatoes, peeled and diced 1.5cm • ½ cup olive tapenade (store-bought) Grape Agrodolce • 2 tomatoes • ½ red onion, peeled and finely diced • 2 tablespoons brown sugar • 2 tablespoons soy sauce • ¼ cup red wine vinegar • 2 tablespoons olive oil • 2 00g green grapes, cut in half

Pan-fried Fish • 600g boneless, skinless white fish fillets • ½ cup flour seasoned with ½ teaspoon salt To Serve • 120–150g rocket leaves • ½ cup chopped parsley

1. Preheat oven to 230°C. Line an oven tray with baking paper. Toss potatoes with a drizzle of olive oil on prepared tray and season with salt and pepper. Roast for 30 minutes or until golden and tender. Turn once during cooking. 2. While potatoes are cooking, prepare agrodolce. Cut tomatoes in half, scoop out seeds with a teaspoon then dice flesh 1cm. Place red onion, tomatoes, brown sugar, soy sauce, red wine vinegar and olive oil in a small pot on high heat. Boil for about 6 minutes or until sauce reduces to a syrupy glaze. Remove from heat and stir through grapes. 3. Heat a drizzle of olive oil in a large fry-pan (preferably nonstick) on high heat. Pat fish dry with paper towels and remove any remaining scales or bones. Dust with seasoned flour and fry for about 1–2 minutes each side or until just cooked through. 4. Toss olive tapenade through cooked potatoes. To serve: Divide rocket between plates, and top with potatoes and fish. Spoon over agrodolce and garnish with parsley. ENERGY 1926KJ (459KCAL), CARBOHYDRATE 50.3G, PROTEIN 36.0G, FAT 11.7G

Extracted from What’s For Dinner? by My Food Bag and Nadia Lim. RRP$39.99. Published by Allen & Unwin.

FOOD

PAN-FRIED FISH WITH MEDITERRANEAN POTATOES AND GRAPE AGRODOLCE

When it comes to your cravings, balance is key!

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FEEDING FRENZY

Constant cravings

Are you really craving bacon sandwiches, fresh fruit, or even something unusual like pickles and ice cream? Dietitian Angela Phillips talks about pregnancy cravings, what they mean, and how to keep healthy when all you want is chocolate (even though it gives you heartburn!).

y now, if you're pregnant, you will likely be aware that “eating for two” during pregnancy is a myth, despite people who still say to you, “Go on, you can have it, it’s for the baby!” While your nutrition needs do increase, the overall increase in calorie requirements during pregnancy equates to about 12%. For most women this is equivalent to a wholegrain sandwich with cheese and tomato, or a wholegrain peanut butter sandwich and a banana. If you have a BMI of over 30kg/m2 (your health practitioner can help you calculate this) prior to pregnancy, the extra food you require is the equivalent of two apples. Unfortunately, that means if you are craving a whole pizza at midnight, or dunking fries into your thickshake to accompany your anchovy ice cream sundae, you’re out of luck! Cravings can be very weird and wonderful and can lead to very entertaining stories of partners heading out in the middle of the night to try sourcing the desired food. For some women, these cravings can be even stranger, including non-food items such as clay, tar, or cigarette butts. This is called “pica”, which is Latin for “magpie”, a bird notorious for eating almost everything it comes across. This is more common

in children, but can occur during pregnancy. It has been speculated this is related to women trying to obtain a nutrient they are deficient in; however, the foods they crave have little or no nutritional benefit. Despite this, an article published in the Journal of the American Dietetic Association reported pica practices of pregnant women are associated with lower maternal haemoglobin (iron store) levels at delivery. Researchers interviewed 281 women following delivery and categorised them into four groups. Group One (53.7% of women) craved ice; Group Two (14.6%) craved ice and freezer frost; and Group Three (8.2%) craved other items such as baking soda, baking powder, clay, and dirt. When comparing the three pica groups to Group Four, the non-pica group, the pica groups had significantly lower haemoglobin. Despite this, the foods they craved did not provide a source of iron. If you are experiencing cravings, it is important they are not displacing good, quality food, and they are not leading to poor health outcomes. If you are experiencing pica-like cravings, and struggling to control them, talk to your +health professional. You may like to get your haemoglobin and ferritin tested if it has not been checked already. Pregnancy BUMP & baby

FEEDING FRENZY IF YOU'VE GOT FOOD CRAVINGS, USE THESE "LIKE FOR LIKE" ALTERNATIVES BELOW TO TRY KEEP YOUR SALT, EXCESS OR SATURATED FAT, AND SUGAR INTAKES LOW.

If you’re craving

sweet foods

If you’re craving

high-fat foods FRIES Homemade oven chips Roasted potatoes (less surface area, so less fat)

BURGERS

CHOCOLATE

Homemade burger Choose wisely if getting takeaways (go for the smaller burger)

Hot chocolate with trim milk Bliss balls Avocado and cacao mousse

Mini potato-top pie

MINCE PIE

BISCUITS Reduced sugar biscuits Homemade slice made with nuts/seeds and dried fruit

LOLLIES A few squares of dark chocolate

ICE BLOCKS Homemade frozen diluted juice

If you’re craving

salty foods

Be aware of the salt levels in foods such as baked beans, pasta snack, cup-of-soup etc. Low salt = less than 130mg per 100g

ICE CREAM

POTATO CHIPS

Try a Yonana Dessert Machine (makes an ice-cream-like dessert from bananas plus other fruit) Homemade frozen smoothie

Potato stix or popcorn Flavoured chips have more salt than ready-salted, so avoid these in particular

MILK SHAKES Smoothie

RICH DESSERTS WITH CREAM

IF YOU’RE USING LOTS OF SALT IN COOKING Use it at the table instead so it seasons the outside of food – you’ll taste it more so you can use less

BAKED BEANS

Homemade fruit crumble (use oats and nuts in topping) served with yoghurt

pregnancy is associated with improved outcomes for you and your baby regardless of what your pre-pregnancy weight was. However, a recent study in NZ showed two-thirds of women were confused about the appropriate level of weight gain.

APPROPRIATE WEIGHT GAIN (KG)

Underweight (BMI<18.5) 12.5-18 Healthy weight (BMI 18.5-24.9)

11.5-16

Obese (BMI >30)

5-9

Overweight (BMI 25-29.9)

Pregnancy BUMP & baby

There is no scientific evidence to support the fact that a particular food craving is indicative of women requiring a certain nutrient, but regardless of whether there is evidence to link the craving with a deficiency, ensuring you’re meeting your nutritional requirements is a win-win. A great approach to pregnancy nutrition is putting your energy into getting a balance of foods in the day. This may displace cravings, as your body is satisfied from eating plenty of these good-quality foods.

AS A BASIC GUIDE, ENSURE YOU'RE EATING:

k Protein at each meal (meat, fish, chicken, nuts, legumes, dairy)

k 3 servings of dairy or dairy alternatives per day to get your calcium intake (milk, yoghurt, fortified almond milk, cheese) k Plenty of omega 3 (fish [especially oily fish], flaxseed, green leafy vegetables) k At the very minimum 3 servings (handful sized) of vegetables k 2 servings or more of fruit per day k Iron-rich foods regularly (red meat, fish, chicken, nuts, legumes, tofu, fortified cereals) k Good quality grains (brown rice, quinoa, oats)

Lite baked beans

ACHIEVING OPTIMAL WEIGHT GAIN during

BMI RANGE PRE-PREGNANCY

Try not to wake up in the middle of the night to get a drink of water and accidentally eat a whole pizza.

7-11.5

Here are some easy ideas to help you get some of the nutrients you need more of during pregnancy:

HIGH PROTEIN (P), CALCIUM (C) AND IRON (I) SNACK IDEAS:

k Smoothie – banana, berries, yoghurt (C/P), trim milk (C/P)

k Nuts (P/I), Almonds (C/P/I) k Chickpeas/lentils/nuts/seeds (P/I) added to salads

k Hard-boiled eggs (P/I) on toast for breakfast

k Cheese (C/P) and tomato on low-fat wholegrain (I) crackers

k Milo with trim milk (C/P/I) k Yoghurt (P/C) k Feta (P/C) and vege fritters k Cottage cheese (C/P) and vegetable sticks

Looks like it's business time!

50% QUICK FACT

OF FIRST-TIME MUMS AND 75% OF FIRSTTIME DADS ARE NERVOUS ABOUT "DOING IT" DURING PREGNANCY. 68

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TABOO SUBJECT

Sex the pregnant mama When you’re newly pregnant, having sex might be the furthest thing from your mind – particularly if you’re suffering morning sickness and other uncomfortable symptoms.

lanning to expand your family can mean you’ll need a lot of, ahem, practice. So if you’ve been trying for a baby for some time, you and your partner will probably hit pregnancy running, sexually speaking. And if you’re well and truly in the habit of regular sex when you become pregnant, you may find there’s no need to make changes to a good thing. Or perhaps all this preparation gives a couple a sense of having achieved a “job well done”, and a feeling that it’s time to put the brakes on that side of your relationship for a while. There is no formula for how you’ll both feel and react to the news of your pregnancy, and no way to predict how it will affect your sex life. Carry on as normal or experience great changes – either way, you’ll naturally have questions about sex during pregnancy. Your partner will as well, so it’s important to seek out the information you need. Take a deep breath, try to quash any squeamishness or feelings of insecurity, and ask your midwife, obstetrician, or GP straight out. These professionals will be more than happy and not at all embarrassed to address your concerns or queries directly. There is an extremely wide definition of "normal" when it comes to sex during pregnancy, just like there is a wide range

of "normal" in sex outside of pregnancy. All couples are different and will move through the pregnant time in their relationship with different rhythms. Pregnancy is incredibly unique to every woman, and can even be quite different for an individual woman between each pregnancy. Male partners experience pregnancy in many different ways too, albeit on a more psychological level than a physical one. Pregnancy is driven by hormones, and these changes affect women in different ways. Some women experience a dramatic increase in libido, others the same to a lesser extent – and still others will find the opposite to be true. (Hands up if you're thinking the couch and a tub of ice cream sounds more appealing than a session in between the sheets right about now.) If you are the pregnant woman in the relationship and you find your sex drive has plummeted right to your swollen ankles, take heart that you’re in good company. Many women feel this way. But it is important to communicate with and encourage sensitivity in your partner, who may need help to understand the change in you. Tending to your emotional and psychological needs will be more important right now than having sex. Keeping the lines of communication open and sharing your feelings will help to keep

ALL COUPLES ARE DIFFERENT AND WILL MOVE THROUGH THE PREGNANT TIME IN THEIR RELATIONSHIP WITH DIFFERENT RHYTHMS.

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TABOO SUBJECT

DESPITE COMMON FEARS AMONG WOMEN, THERE IS NO CONNECTION BETWEEN SEX AND EARLY PREGNANCY LOSS OR MISCARRIAGE IN A NORMAL PREGNANCY. your sense of intimacy alive. Touching, cuddling, and massage are wonderful ways to feel connected. There wouldn’t be many pregnant women who’d turn down the offer of a good foot rub at the end of a long day. If your partner still struggles to accept this slow-down on the physical side of your relationship, remind them pregnancy is a relatively short time. You may also need to encourage them to seek support from your professional team, or even from their peers. Getting a bit of objective input from a mate during a run or over a weeknight pint may help to get things in perspective. So you’re one of the lucky ones whose libido goes through the roof during pregnancy? Good for you! Sex is arguably one of the most enjoyable ways to keep up your exercise quotient. Regular, moderate exercise and keeping fit helps your body to prepare for labour. Exercise helps to keep your moods on an even keel while all those hormones are raging round your body. And it helps both body and mind to be in tip-top condition to deal with the physical and psychological demands of growing a brand new human being. But, you may ask: Is it safe? Yes, it is perfectly safe to be sexually active during pregnancy, with just a few exceptions. There are some medical reasons, such as placenta praevia, risk of pre-term labour, or carrying multiples, which might exclude you. Your LMC will monitor and advise you on any of these conditions, but double-check with them if you’re unsure. Despite common fears among women, there is no connection between sex and

Pregnancy BUMP & baby

early pregnancy loss or miscarriage in start to really feel the physical effects a normal pregnancy. As long as you’re up for of the extra weight they’re carrying. it, and your partner is on board, you’ve got Pressure on your pelvis, swelling, back a green light. Partners can often worry that pain, and a shift in your centre of gravity sex might hurt the baby, but this is not true. can have you groaning and feeling Both orgasms and the prostaglandins in off-kilter. Both this physical discomfort semen can trigger uterine contractions. and a too-common psychological But having sex up to your due date is preoccupation with one’s size can affect unlikely to bring about labour in a normal a woman’s sense of sexual desire all over pregnancy. Remember, though, that the again. It’s also true that – for first-time prostaglandins contained in semen can be mums especially – you may just simply beneficial to soften the cervix and get your have too much to think about to be body ready for delivery, concerned with much tip particularly if you’re overdue. else, sex included, while Many women find themselves expecting a baby. Make time turning to sex in the very last So you may find for intimacy days of pregnancy to help yourselves at-it-likehurry things along. This is While it's important rabbits at some or all the one of those old wives’ tales not to force the issue if stages of your pregnancy. that actually has a measure of Or it might be more it's not feeling right for a case of "pass the ice truth to it. And it’s perfectly either of you, do try to cream" in your home. safe to try once you’ve passed your due date, unless your make the time and space Either way, something pregnancy is high-risk. to maintain a sense of to keep in mind is that It’s possible your sexual opportunities for closeness and intimacy intimacy, sex and privacy appetite will wax and wane together during your can be pretty hard to during your pregnancy. Many women experience feelings of come by once your baby pregnancy. morning sickness, vomiting, arrives on the scene. nausea, and depleted energy in the first Welcoming a new baby to the fold is trimester, which can certainly leave you a naturally stressful time in many ways. couch-bound and lacking interest. As you A strong partnership heading into the enter the second trimester, you may journey will help to smooth the road experience a return of energy and a lessening no end. And enjoying each other’s of queasiness. This can combine with a jump company while you anticipate the in oestrogen levels to give you a surge of upcoming life-changing event will libido. Make the most of it if this happens to enrich the experience, whether that you. By the third trimester, many women takes place in the bedroom or not.

uitting time Q Quitting Whether you’re already pregnant or still trying to conceive, quitting smoking is probably the most important decision you’ll ever make about your own and your baby’s health, says Penny Voigt.

Pregnancy BUMP & baby

here’s little doubt that smoking during pregnancy or when trying to conceive negatively affects the health and wellbeing of your unborn child; in fact, it’s the number one cause of adverse outcomes for babies. Miscarriage, premature birth, low birth weight, and infant death are just some of the side effects directly related to smoking during pregnancy.

SMOKING DURING PREGNANCY IS DANGEROUS Cigarette smoke contains more than 4,000 chemicals, including cyanide, lead, and at least 60 cancer-

SMOKE SIGNALS

YOUR SMOKING DIRECTLY AFFECTS YOUR BABY An oxygen deficiency can have devastating effects on your baby’s growth and development. Research shows that smoking during pregnancy doubles the chances of premature birth, low birth weight, and the risk of stillbirth. Here are some of the ways that smoking during pregnancy impacts on your baby.

Weight and size / It’s understood that a pack-a-day habit during pregnancy can reduce your baby’s birth weight by as much as 200 grams, while smoking two packs a day shaves off nearly 500 grams or more. It may seem like a good idea to deliver a smaller baby, but stunting your baby’s growth in the womb has long-term negative consequences. Body and lungs / Babies who are undersized tend to have underdeveloped bodies. That means their lungs may not be ready to work on their own. Your baby could spend its first few days or even weeks attached to a respirator, and may have continuing breathing problems or be especially vulnerable to asthma because of delayed lung development. Heart / Research in the US found that babies whose mums smoked during pregnancy were at far higher risk of congenital heart defects, as much as 20 to 70% more than babies of non-smoking mums. Brain function / Smoking during pregnancy has a lifelong impact on your baby’s brain, as children of pregnant smokers are more likely to have learning disorders, behavioural problems, and low IQs.

SMOKE CONTAINS MORE THAN 4,000 CHEMICALS, INCLUDING CYANIDE, LEAD, AND AT LEAST 60 CANCERINDUCING COMPOUNDS.

s moke , you

need

to but

t out!

FACT CIGARETTE

If you

inducing compounds. When you smoke during pregnancy, these toxins enter your bloodstream and are passed on to your baby. Your blood is, after all, your baby’s only source of oxygen and nutrients. While all of these chemicals are harmful to your baby, the worst of these are nicotine and carbon monoxide. These two toxins account for almost every smokingrelated complication in pregnancy. Nicotine causes the blood vessels in your body to narrow, including those in the umbilical cord, while red blood cells that would normally carry oxygen begin picking up molecules of carbon monoxide instead, effectively starving your baby of its essential supply of oxygen.

WHAT CAN I DO? The good news is you can make a difference. Within 24 hours of quitting smoking, all carbon monoxide has left your body and your lungs begin functioning better. After a year of quitting smoking, your risk of a heart attack literally halves. Aside from the cost savings, quitting smoking means you and your baby will live longer, healthier lives.

THE FACTS ABOUT SMOKING AND FERTILITY Ideally you should quit smoking before you conceive, as you’ll have a far better chance of getting pregnant. Here are some facts you should know about smoking when trying to get pregnant: k Smokers take longer to conceive and are more likely to have fertility problems. k Women who smoke are more likely to take longer than a year to conceive. k If your partner is also a smoker, this significantly adds to the length of time it will take you to conceive. k Smoking women reach menopause earlier than non-smoking women. k The more you smoke, the more you impact your ability to get pregnant, and the longer it will take you to conceive. k Heavy smoking can damage your ovaries and uterus, making it even harder to get pregnant.

GET SOME HELP Quitting smoking isn’t easy. Finding a way to do it will depend on what works best for you. Here are some methods you could try to help you kick the habit:

Nicotine Replacement Therapy (NRT) / Gum, lozenges, or patches can

help reduce your nicotine cravings and ease withdrawal symptoms. Prescription medication / Talk to your doctor or medical professional about treatment using medication that directly affects brain chemistry, helping control withdrawal symptoms. Alternative therapies / Hypnosis or acupuncture can reduce cravings and help you relax. Cut back / Gradually reduce the number of cigarettes you smoke each day until you’re no longer smoking at all. Cold turkey / If you have strong willpower, try throwing away your last pack and never looking back. Stock up on gum, veggies, and lollies to keep your mouth busy when the urge strikes.

Quitline 0800 778 778, quitline. org.nz and smokefree.org.nz /

Organisations like these provide a number of free resources, as well as ongoing support and advice when you need it. Pregnancy BUMP & baby

Woolly wishes Little lambs and soft details bring a sense of old-fashioned sweetness to this precious baby shower.

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BABY SHOWER

A simple burlap bunting gives understated charm. Pregnancy BUMP & baby

The cake was filled with Bavarian cream and strawberries, yum!

Simple centrepieces of daisies and delicate baby's breath are elegant. The vintage christening gown is a family heirloom.

Pregnancy BUMP & baby

BABY SHOWER

Old-fashioned baby toys and accessories made pretty table decorations.

Jam jars were the perfect drinking vessels.

ALL PHOTOS COURTESY JENNIFER JONES OF JENNIFER JONES PHOTOGRAPHY (JENNIFERJONESPHOTO.COM). PRINTABLES AVAILABLE AT CLIENTS.JENNIFERJONESPHOTO.COM/VINTAGELAMB_NEWZEALAND.

ecause her daughter Taylor wasn't planning to find out her baby's sex ahead of time, grandmato-be and professional photographer Jennifer Jones decided to keep the baby shower theme gender-neutral. She used the nursery's bedding set as inspiration for this vintage lamb-themed baby shower, incorporating the oldfashioned elements of cottage chic design which the mum-to-be loves. "Taylor’s shower was filled with whimsy, organic textures, warmth and, most of all, love!" Jennifer smiles. "I kept the color palette neutral with warm creams, beiges, browns and whites." Jennifer designed all of the invitations, labels, and other printables to coordinate with the theme. Guests were welcomed by a vintage chalk board featuring the baby's ultrasound photo, and the

chose Guest s che or a st a mou ss the to gue flower der. n e g ba by's

entryway displayed a treasure trove of vintage, organic elements. A vintage high chair stood by the main table holding thank-you envelopes for the guests to write their addresses on as well as a little “Dear Baby” note card to fill in for the new arrival. Above the table hung a twine clothesline with white, cream, and beige baby items, in keeping with the gender-neutral theme. The pom-poms were crafted from coffee filters. The dessert table held a multitude of sweet things, and the cake was made by a family friend. The sweet “Thank Ewe” lamb cookies were made by another friend. Powdered sugar and cinnamon donut holes filled glass vases, and a three-tiered vintage serving stand held meringues and chocolate-covered pretzels. White picket boxes containing yarn balls with little potted plants, and a vintage toy graced the guests' tables, while cutlery and serviettes were held by a napkin ring made of burlap ribbon and knobbly yarn. "Although it was such a delight planning, creating, and decorating for our daughter’s baby shower, the most priceless element was sharing this special time with our dear friends and family," Jennifer remembers. "It was such an honor to celebrate the coming of our little grandchild with everyone!"

e w r o g h a s m y es b a B are actually f u t a n h t (really!) If the thought of cheesy, cringe-worthy baby shower games leaves you squirming with shame and embarrassment, fear not! Here are a few fun favourites from our party planning experts that’ll liven up your baby shower without making you blush.

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PARTY TIME

Did you say baby?

This is a great little icebreaker and kicks off the minute your guests arrive. The object of the game is to avoid saying "baby" for the duration of the baby shower. As you greet each guest, give them a nappy pin or clothes peg to wear. Any time a guest says the forbidden word, they lose the pin the person they said "baby" to. At the end of the game, the person who has collected the most pins, wins. Simple.

Who am I, baby?

When sending out your baby shower invites, ask your guests to bring along their own baby photo, or email it to you to print out before the big day. Gather all baby photos, number them, and post them up on a wall. Have each guest try to match the baby photo up with the grown-up version. The most correct guesses wins. This game works well with celebrity babies, too, by including photos of the adult celebrities and having guests pair them up.

Drawing baby

Hand out paper plates and pens to all of your guests. They’ll be drawing a picture of a baby, and the best drawing wins. The snag is, they have to draw the baby on the paper plate, while it’s balanced on top of their head. Get ready for a few laughs as your guests use a little bit of creativity and a whole lot of dexterity to draw a baby.

Hang the washing

We all know that mummies are exceptional multitaskers so this game aims to test exactly that. Line your guests up with a toy baby on one hip and a phone on one ear and have them hang out the washing “one-handed”. The first one to finish wins.

Guess the baby food

If you’ve ever wondered what exactly is in baby food, now’s your chance to find out. Line up about ten different jars of baby food, number each lid, and remove the labels. Each guest gets to sample the jars and write down what they think it is. The guest with the best taste buds wins this game.

Nappy race

Divide your guests into two teams, each with a roll of toilet paper. The aim of the game is to design a creative nappy out of toilet paper. Each team has five minutes to put the “nappy” onto one of the team members, and the most inventive nappy wins.

My waters broke!

Freeze a tiny plastic baby or jelly baby in a tray of ice cubes and give each guest an ice cube in their drink. The winner is the guest whose ice melts first, releasing the baby. You decide whether or not artificial induction methods like holding the ice cube under a lamp or adding hot liquid are allowed!

Pass the nappy

For this fun adaptation of "pass the parcel", you’ll need a pair of kitchen gloves, a knife and fork, a cloth nappy, and an unwrapped block of chocolate. Place the chocolate inside the cloth nappy and the knife and fork in the centre of the circle of guests. Get someone to randomly stop and start the music while guests pass the nappy from person to person. When the music stops, the person with the nappy has 30 seconds to unwrap the nappy and cut off and eat a square of chocolate using the knife and fork.

Feed the baby

Making a mess is mandatory in this game. Divide your guests into teams of two, each with their own bib (or possibly a rubbish bag or poncho!), spoon, and jar of baby food (fruit flavours are best!). Use a timer to see how long it takes each team to feed each other while blindfolded. The fastest, messiest duo wins.

Pin the baby on to the mummy

Remember “pin the tail on the donkey”? The baby shower version of this classic party game is not that different. Using a poster-sized picture of mum-to-be with her pregnant belly in profile and a magazine clipping of a baby, have guests take turns to be blindfolded and try to pin the baby on to mummy’s tummy, with the closest baby to tummy winning. Spit the dummy

Line up your guests and have each one spit a dummy as far as they can. The winner is the one who spits the dummy furthest.

Nappy raffle

It’s estimated that newborn babies go through about 70 nappies a week. Crazy, but true. For this game you’ll need to let guests know that you’ll be raffling off an amazing prize at the baby shower, and entry into the raffle is a packet of nappies; the more they bring, the more entries into the raffle. It’s a great way for mum-to-be to stock up on much-needed nappies. Pregnancy BUMP & baby

Overdue! What can you do? So your due date has come and gone. Is there anything you can do to bring on labour? Tiffany Brown investigates.

orty long weeks have passed, and with each one your excitement and fear have mounted in equal measure. Your due date finally arrives... But your baby has other ideas. You now enter a state of flux. Between due date and arrival date you’ll play a unique waiting game. Poised and ready for that tiny bundle to burst into your life, at the same time you’ll be clinging to life-as-you-know-it as the countdown continues. You’ll probably be frustrated and longing for pregnancy to be over, while grateful for every extra minute’s worth of mental preparation time. It’s enough emotional upheaval for anyone to be a quivering mess, much less a hormone-ravaged pregnant woman. So the first thing to do is recognise the imperative need to relax and breathe, to keep calm and carry on. Babies are uniquely in tune with their mothers’ moods, and an environment of stress may

ONLY 2-5% OF BABIES ARE BORN ON THEIR DUE DATES, AND AROUND 40% ARRIVE WITHIN THE TWO WEEKS BEYOND THAT DATE.

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well prolong your labour further. If your pregnancy progresses 40 weeks to the estimated due date (EDD), it is referred to as a post-dates, post-term, prolonged, or more commonly an overdue pregnancy. Your EDD is only an estimate of your baby’s arrival. It’s completely normal to give birth within one to two weeks either side of the date. The oft-repeated phrase “babies come when they’re ready” rings more true than you might have thought. Only 2-5% of babies are born on their due dates, and around 40% arrive within the two weeks beyond that date. You may be frustrated, but the last weeks of pregnancy are crucial to your baby’s development. Contrary to popular opinion, the last stage of pregnancy is not simply about your baby getting chubby and descending the birth canal. The vital processes engaged in the last weeks of the third trimester are numerous. Antibodies shift from you to your baby to protect them against infection and disease, essential fat and iron stores are established, and baby perfects their sucking and swallowing technique for successful breastfeeding. Critical brain development continues, while fetal lung development enters the final stages before birth. In fact, it is the lungs’ readiness for breathing that triggers the process of labour.

AM I LIKELY TO BE OVERDUE? You are statistically more likely to go overdue if:

You don’t know the exact date of your last menstrual cycle

This is your first pregnancy

You’ve previously had an overdue pregnancy

Your mum or sisters have had overdue pregnancies

k k

You’re obese Your baby is a boy

LATE ARRIVAL

I'm serving this baby an eviction notice!

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OVERDUE? What NOT to do…

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Lung surfactant is a soapy substance which coats the lungs and keeps the alveoli (air sacs) open. Alveoli sacs enable breathing by allowing for gas exchange when oxygen is drawn from the blood and carbon dioxide is expelled through exhalation. Millions of alveoli begin to be produced around 36 weeks of pregnancy, and surfactant production also steps up in the last few weeks to prepare for air breathing. Special cells called macrophages provide immunity to lung infection by neutralising viruses and bacteria. A protein in lung surfactant activates the macrophages to begin a process of migration to the wall of the uterus, creating an inflammatory response that begins the labour process. There has long been concern in the medical and midwifery communities that interventions such as medical inductions are being over-prescribed in normal pregnancies. About a quarter of all labours in the UK, Canada, Australia, and USA are induced before 41 weeks. Inductions carry inherent risks to mother and baby. Serving your baby with an eviction notice before they are ready to be born may put them at risk of complications after birth, while medical induction of labour very often leads to more interventions during the birth. Of course, there are certainly situations where labour induction is medically advisable and necessary to protect mother and baby, but it is increasingly common for inductions to be arranged for convenience rather than necessity. The brain response to the natural initiation of labour is the release of oxytocin, the powerful hormone that causes uterine contractions. A rise in oxytocin prompts the brain to produce endorphins to ease the pain of labour. Medical induction effectively skips these two first steps in the labour process. Many women find the immediacy of an induction, as it mimics natural labour with synthetic hormones and an artificial thinning of your cervix, much more difficult to endure. The safest and healthiest way to bring your baby into the world is for labour to begin naturally and spontaneously. So what can you do to naturally encourage a spontaneous kick-start to labour? Having sex will bound to be a nudge, nudge, wink, wink suggestion proffered by many friends and family.

LATE ARRIVAL

Don’t try to bring on labour prior to your due date. You may be impatient, but it’s important to give baby a chance for full gestation to 40 weeks if possible.

k Don’t over-stimulate

your uterus, for example with excessive nipple stimulation. Don’t use evening primrose oil. Believed to help soften the cervix and ready the body for labour, published studies have found no

such effectiveness, but a possible connection with prolonging the active stage of labour. Don’t use herbs or other remedies without appropriate direction. Don’t use an alternative practitioner who is not specifically

k k

In actual fact, sex does offer a number of advantages. Unless you’ve been advised to abstain, both orgasms and nipple stimulation can bring on contractions. The prostaglandins in semen are also cervix-softening fats – the very same often used in a medical induction, in fact. Castor oil has been a long-time recommendation from midwives that is now falling out of favour due to possible side effects. The castor oil theory involves stimulating the smooth muscle of the bowel, producing prostaglandins and encouraging the uterus to get working. These days the recommendation to avoid associated nausea, diarrhoea, and dehydration is to replace castor oil with spicy food instead. Moderate exercise, such as walking or yoga, has not been officially sanctioned as a way to encourage the start of labour, but in a low-risk pregnancy this sort of exercise will help both body and mind maintain its equilibrium. Anecdotally, "uneven" walking such as walking along a kerb has been reported as successful to get labour started, due to the slight jolting motion it provides the baby. Acupuncture and acupressure have also been linked to getting labour underway. As well as preparing women for the last stages of pregnancy, the therapy can help

trained for administering treatment in pregnancy. Don’t stress about being overdue. Try to enjoy these last days before the newborn tornado sweeps through your life and you completely forget what it’s like to sleep.

both mother and child prepare for the birthing process and the first weeks of life. Acupuncture is based on the beliefs of traditional Chinese medicine, where the concept of two opposing forces in the body – yin and yang – getting out of balance creates energy (chi) blocks which need to be released. Pregnancy acupuncture concentrates on relieving symptoms of morning sickness, back and pelvic pain, depression, headaches, and sleep problems. Induction acupuncture involves the invigoration of a woman’s energy and directing that energy downwards to encourage and allow for birth. From informal reporting, most practitioners agree just one treatment is usually all that’s required for a post-dates woman to go into spontaneous labour, particularly for those who have already received acupuncture treatment during the pregnancy. If one treatment fails to produce results, only one or two additional sessions are usually required. So hang on in there, mums-to-be. You’ve done an amazing job growing your baby for 40 long weeks. A few more days might just be worth it to get the best birth outcome for both of you.

Finding a childcare centre you can trust As a parent of an infant or toddler faced with choosing a childcare centre, how can you trust a centre will provide the best education and care for your child? What will happen to the routines you have worked so hard to establish? Will your child get enough attention? BestStart has been providing quality education and childcare to New Zealand’s youngest for almost 20 years. You can trust us, here’s why…. • We believe you are your child’s most important teacher. Children have their own rhythm and pace and we work with you to help your child feel safe and develop strong, trusting relationships with their teachers. • Your child becomes responsive to learning when the natural rhythm of their day is followed. Our centres are planned to allow free movement, responding to and extending upon their interests. • The NZ Early Childhood Curriculum, Te Whariki supports your child’s well-being, exploration, communication and sense of belonging. This encourages individual and social development, building confidence and self-esteem. • Infants are cared for in a nurturing and respectful environment where their routines and individual needs are the priority. Toddlers are provided with a wide range of activities and experiences that allow them to develop at their own pace, with teachers there to support and extend their interests. • Children receive the best start as lifelong learners when their teachers are valued and supported. BestStart teachers receive professional support that is second to none.

For more information visit BestStart’s website beststarteducare.co.nz

When you visit a centre, discuss how they can accommodate your routines. Talk with staff about communications and planned learning, so you will know your child is happy and progressing well.

I suppose I’d better start thinking about my birth plan!

Pregnancy BUMP & baby

THINKING AHEAD

Your birth PLAN Much of what happens during labour and delivery is beyond your (or anyone’s!) control. That’s why many mums-to-be What is a birth plan? find it helpful to A birth plan is a simple, concise, usually one-page statement that write a birth plan. lists your preferences for your It gives them baby’s birth. It helps ensure that all those directly involved – you a sense of and your partner, doctors, and empowerment, midwives, are all on the same page when it comes to the and a feeling of important issues in your labour reassurance that and delivery. It’s a set of basic guidelines, a sort of go-to their preferences document, for all parties to refer for labour and to when it comes to things like pain relief, medical intervention, delivery are made positions for labour and birth, clear up-front. birthing partners and those in the delivery room, and care of baby after birth.

How do I write my birth plan?

Start by visiting the hospital or birthing centre you’re having your baby at to check what facilities and arrangements are available. Talk to other mums who may have had babies at the same hospital or birthing centre to find out about their experiences. Once you’ve done your research, begin writing down your wishes as they come to mind. Here are some things you may want to include in your birth plan.

Your birth partner

Decide whom you want to have with you while you’re in labour. Will this person stay with you all the time, or are there certain stages of your labour when you’d prefer to be on your own? Will you include any other children you Pregnancy BUMP & baby

THINKING AHEAD

tip

may have? What about family members? Will your birth partner remain with you if you need to have a Caesarean delivery? What do you want your birth partner to do for you during labour and delivery?

Pain relief

List your choices for pain relief in order of preference. Do you prefer natural pain relief like gas and air, acupuncture, breathing techniques, massage, reflexology, and TENS, or would you like the option of pethidine or an epidural? Are you planning on bringing a reflexologist, acupuncturist, herbalist, or aromatherapist into the labour room with you? Also specify those pain relief methods you would prefer to avoid altogether.

Labour & birth

Be flexible! Keep in mind that things won’t always go according to plan, so it’s important you allow some flexibility in your birth plan. Many new mums are disappointed if they don't get their "dream birth", so focus on being realistic.

Music & lighting

Decide on the type of birth you would like and list your preferences for position during labour and delivery. Do you want to stand, lie down, use the shower, or walk around during labour? Is there a birthing position you prefer? Will you stand, squat, or kneel on all fours during delivery? Is there any birthing equipment that you’d like to use – a birthing chair, birthing ball, bean bag, or birth pool?

Determine the type of atmosphere you’d feel most comfortable in during labour and delivery. Consider things like lighting, the temperature in the room, and the noise around you. You may want to write a playlist of music that you find soothing, or specify whether you want the lights dimmed or if you’d prefer a brighter, more cheerful space. Make a list of any items you want to bring with you: Family photos, a camera, your iPod, etc.

Intervention & assisted birth

Delivery of baby

If your labour is not progressing fast enough, write down whether or not you would like any intervention. How would you prefer to be induced? Do you feel strongly about assisted delivery using forceps or a ventouse? What about an episiotomy or a caesarean delivery? Or will you leave it up to your doctor or midwife to determine whether these are necessary?

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Write down the things that are important to you about your baby’s birth. Will your partner cut the umbilical cord? Do you wish to have baby placed directly onto your tummy following birth? Would you like to breastfeed baby immediately, or wait until baby has been washed and clothed first? What are your preferences when it comes to breastfeeding or bottle-feeding baby?

FACT

FOR FIRST-TIME MUMS, THE FIRST STAGE OF LABOUR CAN LAST FROM SIX TO 36 HOURS.

Unexpected situations

Decide what you would like to happen if baby has to go to the special care baby unit. Will you or your partner go with baby? Do you wish to care for baby as much as possible yourself? Will you transfer with baby to another hospital if a transfer is necessary? It makes total sense to be prepared for the big day; getting your ideal birth down on paper helps you to focus and to plan ahead. But remember to be flexible and keep in mind that things don't always go to plan. After all, the most important thing is the safe delivery of your little bundle of joy.

My birth plan USE THIS BIRTH PLAN TEMPLATE TO HELP YOU CREATE YOUR OWN PERSONAL BIRTH PLAN. Full name: Partner’s name: Today’s date: Due date: OR Induction date: Doctor / midwife’s name: Birthing centre / hospital name: My delivery is planned as: Vaginal C-section Water birth VBAC I’d like my... Partner Parents Other children Other …present before AND/OR during labour During labour, I’d like: Music played (I will provide) The lights dimmed The room as quiet as possible As few interruptions as possible As few vaginal exams as possible Hospital staff limited to my own midwife/ LMC, doctor, & nurses (no students or interns present) My partner to be present the entire time

Other Nothing During delivery, I would like to: Squat Semi-recline Lie on my side Be on my hands and knees Stand Lean on my partner Use a birthing chair Other Immediately after delivery, I would like: My partner to cut the umbilical cord To deliver the placenta spontaneously and without assistance To see the placenta before it is discarded To keep the placenta to take home

I’d like to spend the first stage of labour: Standing up Laying down Walking around In the shower In the bathtub/birthing pool

If a C-section is necessary, I would like: To make sure all other options have been exhausted To stay conscious My partner to remain with me the entire time My partner to hold the baby as soon as possible To breastfeed in the recovery room

I do not want: An enema My pubic area shaved A urinary catheter An IV, unless I’m dehydrated

I would like to hold baby: Immediately after delivery After being wiped clean and swaddled After weighing Someone else to hold baby first

For pain relief, I’d like to use: Acupuncture Breathing techniques Cold therapy Distraction Massage Meditation Reflexology Standard epidural TENS Walking epidural

I would like to breastfeed: As soon as possible after delivery Later Not at all I’d like to feed baby: Only with breast milk Only with formula On demand On schedule With the help of a lactation specialist Pregnancy BUMP & baby

WHY AM I CRAMPING AFTER SEX? WHAT HAPPENS IF MY WATERS BREAK IN PUBLIC? WHY IS MY VAGINA SWOLLEN? WHY ARE MY BREASTS SO ITCHY?

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EMBARRASSING QUESTIONS

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f ome o s r e v o u unc o y p l To he mysteries rd a w k w a the more childbirth, d n a y c n a n g of pre here are the answers to some of the questions you’ve been dying to ask bu t didn’t kn ow how.

here’s no doubt that being pregnant has its perks: Shiny hair, an all-over glow, an enviable cleavage and, of course, your gorgeous bundle of joy at the end of it all. What’s not so great are the weird and wonderful changes to your body and the endless embarrassing questions you’re too afraid to ask.

WHY AM I CONSTIPATED? Constipation is a common problem during pregnancy, predominantly caused by surging pregnancy hormones which cause the muscles in your bowels to relax, allowing food in your digestive tract to hang around for longer. Your expanding uterus also plays a part as it takes up more space, which means your bowels have less space to do their work in. Drink plenty of fluids and increase your fibre intake to keep things moving along smoothly. There are no stupid questions when it comes to pregnancy, although sometimes we'd really rather not know the answers!

WHY AM I HAVING EROTIC DREAMS? Extra blood flow to your genitals, raised oestrogen levels, and sensitive, enlarged breasts can kick start your sex drive as your pregnancy progresses, and it’s not unusual for it to filter through to your dreams. Erotic dreams, often involving ex-boyfriends, partners or random Pregnancy BUMP & baby

acquaintances, are quite normal, so expect a few nighttime fantasies of your own.

Why do I leak in my first trimester?

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With the extra pressure of baby pressing down on your bladder, it’s not uncommon to experience involuntary leaking when coughing, sneezing or laughing while pregnant. Although it’s usually only a few drops, it can be embarrassing. Doing regular pelvic floor exercises can help reduce incontinence.

CAN MY BABY FEEL US HAVING SEX? It’s highly unlikely that baby will feel you having sex, although baby may feel a squeeze as your uterus contracts during orgasm. Your unborn baby is enclosed in a bubble of amniotic fluid, cushioning him from every move you make and acting as a buffer.

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Cramps or contractions after sex are usually the result of an orgasm or prostaglandins found in semen. To calm any cramps, try resting and relaxing or stretching out cramped muscles.

WHY IS MY VAGINA SWOLLEN? Extra blood flow surging through your body and joints in preparation of childbirth and delivery, along with the pressure of baby on your pelvic area, could cause your vagina to swell.

WHY AM I GETTING ACNE? Sometime around the six-week mark, you may experience a pimple breakout. Progesterone surges in your body cause your glands to increase acne-secreting oils which can clog up pores and cause bacteria to build up, leading to breakouts. Wash, rinse, and moisturise your skin regularly, keep your hair clean and oil-free, and follow a healthy diet with plenty of fresh fruit, vegetables, and water.

WHY DO I FEEL SO GASSY? As baby grows, the space around your digestive tract becomes tight. Surging hormones slow down digestion, which leads to excess wind and bloating. Unfortunately you don’t have the same control over your muscles during pregnancy, so it’s likely you’ll need to burp and fart a little more often than normal. Try changing your diet, eating smaller, more frequent meals, or do some light exercise to alleviate any gassiness.

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Increased vaginal discharge occurs in almost all pregnancies, so it’s quite normal to feel a little wet down there in the first trimester. This is because your body is producing more progesterone, which helps protect your growing baby against infections that could otherwise travel up to your uterus. Provided there is no blood in your discharge, you have no need to worry. Wearing a panty liner will help you feel more comfortable.

WHY AM I WEEING ALL THE TIME?

WHY AM I CRAMPING AFTER SEX?

WHY ARE MY BREASTS SO ITCHY?

99%

OF PREGNANT WOMEN WOULD PREFER THAT THE STORK DELIVERS THEIR BABY. WE'RE NOT SURE WHAT THE OTHER 1% IS THINKING.

You’ve probably noticed your breasts and nipples are growing and changing in preparation for breastfeeding. As your breasts grow, the sensitive skin stretches, often triggering an insatiable itch which isn't easily or discreetly scratchable. Try moisturising your nipples and breasts using a lanolin cream, cocoa butter, coconut oil, or vitamin E oil after showering, and avoid wearing potentially irritating fabrics like wool or cashmere. For added support, start wearing your maternity bras now. If a rash develops or you notice a bloody discharge from your nipples, consult your doctor right away as it could be something more serious.

EMBARRASSING QUESTIONS

WILL I HAVE TO HAVE MANY INTERNAL EXAMINATIONS DURING LABOUR? A vaginal examination is usually done when you first arrive at hospital or the birthing centre, and then every two to four hours thereafter to assess your labour’s progress. If you’ve had an intervention and your waters have been broken, or there is concern about baby’s healthy, you may need more frequent examinations. Vaginal examinations are uncomfortable for many women, so talk to your doctor or midwife if you have concerns.

SHOULD I SHAVE MY BIKINI LINE BEFORE GIVING BIRTH? Back in the day, women were shaved before having their baby in the event they needed an episiotomy. Nowadays it’s not necessary and really down to personal choice whether or not you shave or wax your bikini line. Most doctors are fine working around a little pubic hair, but you may need to tidy up the area above your legs if you’re having a Caesarean birth.

WHAT SHOULD I WEAR WHEN I GIVE BIRTH? This will largely depend on the type of labour and delivery you are intending. If you’re planning a water birth, you may want to wear a swimming top or bra if you’re not comfortable being naked. For the delivery room, consider the following when choosing an outfit: Will it be comfortable? Will I mind if it gets ruined? Will it be easy to breastfeed baby in? A comfortable T-shirt or front-opening nightie are both good options.

WILL MY PARTNER GO OFF SEX IF HE WATCHES ME GIVE BIRTH? It’s hard to know how your partner will react; while some men are fascinated by the whole process, others find it confronting. Talk to your partner beforehand to ensure he knows what to expect or have him stand stay by your side if you are concerned about his reaction.

WHAT IF I POOP DURING BIRTH? It’s quite possible you may defecate while pushing baby out, as the muscles you’ll use are the same ones you use to poop. When baby moves through the birth canal,

there’s no room for anything else. The good news is nature usually takes care of it all, and you’ll likely need to empty your bowels during early labour. If you do poop during delivery, it’s not a problem and your midwife will simply clear it up, probably before you even notice.

WILL I NEED STITCHES AFTER GIVING BIRTH? If your perineum stretches so far that it tears or your doctor performs an episiotomy, you may need stitches. A local anaesthetic is given to numb the area before the stitching, and your stitches will dissolve over the next few days. With all your attention focused on your new baby, it’s highly likely you won’t even notice.

WHY DOES MY BABY LOOK LIKE HE’S COVERED IN CREAM CHEESE AFTER BIRTH? Called vernix, this cheese-like coating helps protect your new baby from any infection. It’s usually absorbed into your baby’s skin within the first two days, but many hospitals bathe baby in the few hours following birth, so you probably won’t even be aware of it.

HOW MUCH WILL I BLEED AFTER BIRTH? Bleeding is your body’s way of getting rid of the lining of your uterus after birth and it will be similar to a heavy period. Immediately following birth will be the heaviest bleeding and you may even experience some clotting, so you’ll need to change your maternity pad every few hours or so for the first few days. The bleeding will become lighter but usually continues for about four weeks, changing in colour from bright red to brownish red.

WILL SEX EVER FEEL THE SAME AGAIN? It may seem hard to believe, but yes, your sex life will be the same again. You will need time to heal, especially if you’ve had any tearing or stitches, but by the six-week mark most women feel ready to try sex again. Speed up your healing process by doing your pelvic floor exercises, as these will assist with improving muscle tone and blood flow to this area. If you're anxious about whether it will hurt, use a waterbased lubricant, and remember to use a form of contraception.

What if my waters break in public?

There’s not a lot you can do if your waters break while you’re out, except mop it up and get yourself home. Towards the end of pregnancy, most babies move down into the pelvis head-first. Their head acts like a plug, slowing the flow of fluid when your waters break, so you’ll most likely experience a trickle rather than a gush. If you are nervous, keep a towel in the car or wear a sanitary pad when you need to go out.

GO AHEAD, ASK US ANYTHING!

Do you have an embarrassing question about pregnancy, labour, birth, or motherhood? Ask and we’ll answer! Email editor@bumpandbaby.co.nz with your question, or find us on Facebook at facebook.com/ bumpandbabynz and send us

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What to expect if you have a C-section 92

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HAIL, CAESAR!

What is a C-section?

Answer: A Caesarean delivery (C-section) is the operation performed to extract a baby from its mother's womb non-vaginally. C-sections have been performed for centuries and, contrary to popular opinion, are not probably named for Julius Caesar (the story is too long and complicated to recount here; suffice to say the earliest recorded mention of Caesarean deliveries predates the great emperor himself by several hundred years). The C-section operation involves making a surgical incision into the skin, abdomen, muscle and, finally, the uterus, to allow for delivery of the baby. The operation may be planned ahead of time, or may be required on an emergency basis once your labour has started.

Whether you’re having a planned Caesarean or an unexpected one, it’s important to know what you’re in for, just in case, explains Tiffany Brown. Pregnancy BUMP & baby

If only giving birth in any manner was as easy as opening a zipper!

Why would I need a C-section?

Answer: Various reasons may prompt a planned C-section. Your medical team may recommend the procedure due to complications during the pregnancy, like when the placenta is covering the cervix, otherwise known as placenta praevia. Expecting multiple babies often leads to a planned C-section due to one or more babies being in an abnormal position. If your baby is breech (positioned with their feet pointing downwards) or transverse (side or shoulder first), your midwife or obstetrician may well recommend a C-section delivery. C-sections may also be recommended if you have a mechanical obstruction (such as a large fibroid) obstructing the birth canal, or you may be advised to have a second C-section if you have had one previously. Likewise, pre-existing health conditions like complex heart problems, high blood pressure, or an infection that could be passed to your baby during delivery may bring a recommendation of C-section surgery. The advantage of a planned C-section is that you’ll be given an exact date for the operation, helping you to plan for the birth. Elective C-sections for non-medical reasons are becoming more popular, particularly for women who have had a previous C-section and therefore feel more familiar with this kind of birth. However, it is important to remember a C-section delivery is a major surgical procedure which requires significant medications and a recovery period, and which can impact your newborn’s first days, compromise breastfeeding success, and pose risks to you both. If it’s not medically necessary, a vaginal birth will almost always be safer than a C-section. Your medical team can give you more information on VBAC (vaginal birth after C-section), which is an option for many women.

60-80%

A RECENT TRIAL SHOWED OF WOMEN WHO HAD A PREVIOUS C-SECTION, AND WHO ATTEMPTED TO LABOUR NATURALLY WITH A SUBSEQUENT PREGNANCY, WERE ABLE TO HAVE A SUCCESSFUL VAGINAL DELIVERY.

Why would I need an emergency C-section? Answer: An emergency C-section scenario may arise if your labour fails to progress despite you having strong contractions over a period of several hours or more. Fatigue and exhaustion will set in, putting both you and your baby at increased risk. Labour may be stalled due to your cervix not opening wide enough to let the baby descend, or your baby’s head may be too large. A stalled labour is the main reason for emergency C-sections. Concerns over the supply of oxygen to the baby may also give rise to the need for a C-section procedure. During the early stages of labour, your baby’s heartbeat will be closely monitored. Sometimes changes in the heartbeat can mean interruption to the flow of oxygen. If a loop of umbilical cord emerges ahead of your baby, or if the cord is compressed by your uterus during contractions, an emergency C-section might be required.

How should I prepare for a planned C-section?

Answer: You’ll be given a date and time along with hospital details prior to your operation. You will probably need to have blood tests prior to your hospital stay, screening for your blood type and haemoglobin levels, just in case you need a transfusion during the procedure. You will be advised not to eat or drink anything from about midnight the night before your surgery, and to have a shower before you go to hospital to reduce the risk of infection. If your C-section is planned before 39 weeks gestation, you may need an amniocentesis to test for your baby’s lung maturity.

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What can I expect to happen if I have a C-section?

Answer: If you’re having a planned C-section, you will check in to hospital at the organised time and be prepped for the surgery. Your tummy will be cleansed and a catheter, or tube, will be placed into your bladder to collect urine. IV lines will be placed into your arm or hand to give you intravenous fluids or medication. Usually a planned C-section will be performed with an epidural, a combined spinal epidural (CSE), or a spinal anaesthetic. These medications numb the lower part of your body but allow you to remain awake during the procedure. It’s normal to experience "pushing and pulling" sensations, but you won’t feel any pain. You will be allowed to have support person with you during the operation, and this person will be provided with theatre clothes. If your C-section is an emergency procedure, it’s more likely you’ll be put under with a general anaesthetic, and your support person will be asked to leave the theatre. The operation typically takes around 3-4 hours. First, an incision is made in your abdominal wall. This is usually made horizontally near the pubic hairline, and is called a bikini incision. (That’s right: If you have a run-of-the-mill C-section without complications, no one will be able to tell when you’re back in your bikini.) If a larger incision is needed or if the baby needs to be delivered immediately, a vertical incision may be required from just below your tummy button to just above the pubic bone. The next step in the procedure is to make a uterine incision. Again, this is usually made horizontally across the lower part of the uterus, referred to as a low transverse incision. Finally, the baby is delivered through these incisions. The obstetrician will clear your baby’s mouth and nose of fluids, then clamp and cut the umbilical cord. The placenta is then removed and the incisions stitched up. You will be encouraged to give your baby skin-to-skin contact right away after delivery, as long as baby is well. Skin-to-skin regulates body temperature, calms your baby, and regulates breathing, heart rate, and blood sugar levels. It also encourages production of oxytocin, the hormone that helps your breast milk flow, to get breastfeeding established. If you have had a general anaesthetic and are unable to give your baby skin-toskin, your partner or support person may fill in for you.

' ction isn

t the "eas

y way out"!

Answer: The typical hospital stay after C-section surgery is 3-5 days. As the anaesthesia wears off, pain may interfere with oxytocin production, so it’s important to manage your pain to allow for successful breastfeeding. You may be given pain relief via a self-dosing pump through your IV drip. Midwives will be available to help you with breastfeeding, and you can begin as soon as you feel up to it. Post-surgery medications will be prescribed with breastfeeding in mind. Soon after the operation, you’ll be encouraged to move and walk around in order to speed up recovery, prevent constipation, and avoid blood clots. Your incision site will be monitored for any signs of post-operative infection. Your fluid intake, bladder and bowel function will also be monitored.

A C - se

What happens after the surgery?

TIPS FOR A QUICK RECOVERY (after C-section surgery)

• Rest as much as possible. Avoid lifting (lift nothing heavier than your baby) and get as much help with housework and baby care as you can. Your body’s focus will be on repairing your wound site, recovering from the anaesthetic and other medications administered during the surgery and, of course, feeding your baby. The housework can wait. • Support your tummy. A pregnancy belt will give you good support. • Drink lots of fluids, especially water. This will help replace fluid lost during the operation, and is essential for breastfeeding, as well as preventing constipation. Other edible constipation remedies are kiwifruit, psyllium husk, and prunes. • Eat a healthy diet. You’ll need plenty of energy to recover from surgery and feed your baby. Include fruits and vegetables, lean proteins, and healthy fats, as well as lots of slow-release carbohydrates for energy, like whole grains, potatoes, and root vegetables. • Take medication for pain relief. It’s better for you and your baby, particularly for breastfeeding, that you are not in pain. • Check with your doctor about supplementing your iron, and vitamins B, C, and D levels. With your body fighting to regain its strength, you might need some extra nutritional help.

What about when I go home?

Answer: To aid in your recovery, it’s a good idea to get some help. Maximise whatever employment leave your partner can manage, and take up offers of help from family and friends. You mustn’t lift anything heavier than your baby for a couple of weeks. It’s also important not to drive for at least two weeks, and don’t start to exercise again for four to six weeks. Pregnancy BUMP & baby

Back in my day… Pregnancy, birth, and baby care sure were different “back then”, as Penny Voigt says.

s tough as pregnancy is, it doesn’t compare to what mums-to-be had to go through several decades ago. And while pregnancy itself hasn’t changed, technology, nutrition, and the pace of life have brought many positive changes to pregnancy. Here’s a look at just how much pregnancy, delivery, and mum’s recovery have changed over the last few decades.

Finding out the big news

Thirty years ago, confirming a pregnancy involved a trip to the doctor with a urine sample, and then a lengthy wait to find out the result. Most women simply waited until they’d missed two periods and already knew they were pregnant before visiting the doctor. The home pregnancy test did not become mainstream until the late 1970s. Today a quick trip to the pharmacy or supermarket to purchase a home pregnancy test will confirm a positive or negative result as early as two or three weeks into the pregnancy.

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PREGNANCY THEN VS NOW

Technology and testing

Back in the day finding out the sex of the baby was simply not an option. Ultrasound technology wasn’t around until the late 1980s, so parents had to wait until the baby was born to find out its gender or discover any health issues. Advances in technology mean today’s parents find out whether they’re having a boy or girl early on in their pregnancy. 3D and 4D scans clearly show baby’s features and movements, while diagnostic testing during pregnancy can determine any health issues before baby arrives.

Eating and drinking

Thankfully, long gone are the days when doctors held newborns upsidedown and spanked their bottoms.

Thirty years ago, nothing was off-limits. Mums were encouraged to continue eating and drinking as they always did, and an ailing mum-to-be could go ahead and pop any medication she wanted. Many doctors asserted the benefits of dark beer to boost iron levels, while quitting smoking was discouraged as it was believed that stopping would lead to high blood pressure. For pregnant women today, diet is an important part of a healthy pregnancy. If it’s not organic or all-natural, it’s usually best avoided. Modern mums-to-be are armed with a list of foods to avoid, alcohol intake is limited, and smoking during pregnancy is taboo (for good reason!).

Dad’s involvement

In the past, the delivery room was strictly for mums and doctors only. During labour, dads would hang out in the waiting room while mum and the doctors got on with delivering the baby. Today’s dads are far more hands-on and expected to be there every step of the way. As well as serving as coaching partner during contractions, many dads help deliver the baby and cut the umbilical cord. Pregnancy BUMP & baby

PREGNANCY THEN VS NOW

Maternity wear Maternity fashion of the past made pregnant women look huge: Trapeze dresses, smock tops and big, floppy bows. Many mums-to-be sewed their own flowing, tent-like dresses in groovy fabrics. Maternity wear today is all about accentuating your bump, and you’ll find all your regular non-pregnancy faves now come in maternity styles too. From clingy maternity dresses and tops fresh off the high street, to sexy maternity bras and panties, jeans, and even bikinis, today’s pregnant mums wear clothing that’s both stylish and comfortable.

New mums today are usually up and out of bed early after delivery. Babies can be roomed with their mum, while a hospital stay of 24 hours is normal for vaginal births, and some mums even choose to leave right after baby is born.

Feeding the baby

Shaving, enemas, and episiotomies

In the past shaving, enemas, and episiotomies were standard practice before delivery. Enemas were thought to help make more room for baby to move through the birth canal, while shaving mum’s pubic area helped tidy things up down there. Most women endured a routine episiotomy, a cut made to make the birth opening larger. Today, mums-to-be no longer have to go through any of these. Along with being painful, enemas were found to be of no benefit, while small nicks from shaving could lead to infection. Scientific studies have debunked the routine episiotomy, showing that a small cut could lead to deeper and more painful tearing.

Labour and delivery

Until the late 1980s when epidurals became popular, mums-to-be had little to say in how baby was delivered. Strong anaesthesia would knock out mum during labour, and being heavily sedated meant she was

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unable to fully participate in the delivery or help push during the final stage of labour. So intervention was inevitable and doctors would often have to use forceps to pull baby out. Midwives were uncommon and women choosing a midwife were often labelled "hippies". Pregnant mums today are actively involved in labour and delivery, and many women write their own birth plan outlining how they would like the birth to progress. Pain relief options are widely available, midwives are de rigueur, and many women choose a doula to assist in their labour and delivery.

In hospital

Years ago, newborn babies would remain under observation in the nursery for at least their first 24 hours of life. Babies were wheeled out to their mums at a particular time each day, for feeding and most new mums stayed in the hospital or "maternity home" for several days and even weeks.

In the early 1970s, less than a quarter of new mums breastfed their babies while in hospital. In fact, mums were often discouraged from breastfeeding and given medication to dry up their milk. Breastfeeding rates hit a peak in the mid 1980s when more than 60% of mums nursed their babies while in hospital. Today breastfeeding is actively encouraged for its health benefits for both baby and mum. A wealth of information and resources are available to help new mums breastfeed.

Going home

When leaving the hospital, baby was usually placed in a Moses basket or carrycot in the back seat of the car. Seat belts, if there were any, were lap belts and certainly not mandatory. Sometimes the new mum just held baby in the front seat, while dad drove home nervously. Today’s baby car seats are bought after extensive research into safety, comfort, and reliability, and often require several training sessions on how to install the seat in the car, and how to correctly strap baby into the seat!

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Daddy duty

It’s usually mums who take the most time off when a newborn arrives – but dads should take parental leave, too, explains Tiffany Brown.

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Soon after becoming a father, a man’s testosterone level decreases by around 30%, calming him and making him biologically more likely to stick around and offer support. Skin-to-skin contact is not only important for mother and baby after birth. It can influence baby’s relationship with dad too. Laying your baby on their father’s naked chest can be a lovely way to calm them down when unsettled and unable to be consoled otherwise. The hormone oxytocin goes to work,

PHOTOGRAPHY: KARYN FLETT

Many dads feel a little passed over in ou often hear about the the early days, when breastfeeding means role physical closeness plays in establishing mum tends to maintain a monopoly on the baby’s time. But there are lots of ways dads effective attachment between mother and can help share the load, helping mum get a bit more rest and continuing to develop baby in the early weeks of life, particularly through breastfeeding. that important bond at the same time. Changing nappies and dressing baby What is lesser known is that fathers can also form strong bonds with their infants, gives dads a great opportunity for plenty encouraging secure attachment to both of cuddles and lots of eye contact. These parents. The first days and weeks directly activities are good for developing trust in your baby. Playing with baby and using after birth provide the first opportunity a variety of facial expressions helps them for a new family to establish itself and learn, while holding or rocking baby to get to know each other. The bonding that ensues, and the support that is shared sleep are ideal ways to get involved. between new parents, is a vital first step It makes sense for fathers to take their in your parenting journey. turn or even take the lead in transporting their infant in a baby carrier. Men generally No matter how much leave from work have broader shoulders and a stronger your baby’s father can manage to take build to wear their babies in slings or after you give birth (the more the better!), remember, the process of packs, and keeping baby paternal bonding begins as close to them this way further tip nurtures the father-child bond. soon as you discover that you’re Find a fun "job" A recent study showed expecting. If possible, have him go with you to maternity that your baby's specialised baby massage for infants benefited both baby appointments and share all dad can be the details of the pregnancy and dad. Babies enjoyed the responsible for, calming effects of soothing together. Talking about birth such as bathing massage, while massaging options and parenting styles, attending an antenatal class the baby or taking the baby proved a good stress together, and talking about the him for a walk reliever for the men. Now that movements you start to feel as could be just what you all need in the pram pregnancy progresses can really during those early days of every evening sleeplessness and tears! help establish the paternal bond after work. Paternal bonding is more while your baby is in utero. than just a concept. Research Singing, talking, and touching shows fathers experience various hormonal mum’s belly are all ways babies begin to know and respond to their fathers. And by changes during the process of pregnancy and birth, similar to women. Towards the time your baby arrives, dad will already the end of their partner’s pregnancy, for feel a connection with his little bundle. example, men experience a rise in cortisol. When fathers bond successfully with The so-called "stress hormone", cortisol their infants, research shows the children grow to have a significant increase in helps a father to be more attached to and physical and mental development. There focused on his newborn. Prolactin is also at work, encouraging is also improvement in academic, social, and psychological areas. Early bonding bonding and attachment. Expectant fathers and new dads also experience a surge of reduces stress for both father and baby, and they are less likely to become involved vasopressin, the "monogamy hormone" which drives a dad's commitment levels with crime, alcohol abuse, or drugs in the future. and urge to protect his family.

PRECIOUS BOND

Skin-to-skin contact is good for dads and babies, too.

increasing during skin-to-skin contact and helping both parents’ nurturing instincts to kick in. This early bonding pays dividends down the track too, when your baby grows up to be a child who is as happy to be comforted by dad as they are by mum when upset. Taking the opportunity to bond with their newborn infant means fathers can have a strong influence on the future contentment of the family. Babies gain great benefits from the establishment of early bonds with their fathers.

HOW MUCH PARENTAL LEAVE CAN DADS TAKE? The legal entitlement to parental leave for Kiwi dads is up to two weeks, depending on employment status prior to the birth. However, dads can take more when they apply to share part of their partner’s leave entitlement. Pregnancy BUMP & baby

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If you're feeling shattered, you're not alone.

POSTNATAL DEPRESSION

Beyond the baby blues It’s normal to feel a bit down following childbirth. But what if your feelings don’t improve, or you aren’t coping? You may have postnatal depression, also known as PND. Katie Thomas explains.

here is an expectation in our society for pregnancy, birth, and motherhood to be the happiest, most fulfilling time in a woman's life. And all too often, we get the idea that pregnancy should be glowing, with a straightforward, easy birth and a post-baby body that bounces immediately back into shape – all the while we’re raising a beautiful, healthy, happy child who sleeps through the night, and at the same time we’re maintaining a perfect home and making great strides in a career. For a majority of women, this fantasy is not even remotely close to reality – and that’s okay. The typical nuclear family of a mum, partner, and children living alone in a household is a relatively recent phenomenon. This leaves a huge number of mothers or carers at home alone with their baby for the most part of the child's upbringing. The phrase “It takes a village to raise a child” is a beautiful truth, simply meaning you cannot do it alone, and you are not expected to. Whether you have extended family around you, a close group of friends, or even caring neighbours

nearby, you are never alone and should not feel that way. Having a baby can be incredibly isolating, and even with the most supportive network of people around you, it can be an overwhelming and scary time.

THE HORMONE FACTOR Pregnancy, birth, and early motherhood are a roller-coaster ride of hormones. From the minute you conceive, you have increased levels of progesterone and oestrogen pumping through your body (20-30 times more than normal), often causing drastic changes to your mood. Some women hardly notice a change in themselves; craving a few odd foods and having slightly tender breasts can be the worst of it. But for many it is a struggle to find the energy to get out of bed, keep any food down from the nausea, and just generally feel lousy. Luckily, these symptoms mostly settle down by the end of the first trimester. After the baby is born, hormone levels drop abruptly, and once the endorphins following birth begin to fade out, moodiness and emotions can take over.

The “baby blues” are a widely known mood drop occurring at around two to three days post-partum, peaking at five to seven days, and improving by two weeks at the latest, affecting up to 80% of all mothers. The baby blues may have symptoms of feeling low, weepy, anxious, unable to cope, unable to sleep, crying spells, irritable, feeling overwhelmed, lonely, and just generally sad. It is extremely important to remember that this is a completely normal part of the post-partum period and that most women do experience it. Be sure to speak to your lead maternity carer as openly as possible regarding your feelings and any concerns you may have.

RISK FACTORS FOR PND If you are still suffering from these symptoms two to three weeks post-partum and they are intensifying, then it has possibly progressed into postnatal depression. This term is nothing to be afraid of, nothing to be embarrassed about, and nothing to hide. Around 10-20% of mothers suffer from PND. Those who have experienced some level of depression in the Pregnancy BUMP & baby

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past, be it themselves or someone close to them, may have different fears and worries to those that are living it for the first time. There are certain situations and risk factors that may be influencing the onset of PND, including: • Being a first-time mother • Having a particularly traumatic birth • A history of depression, PND, bipolar, or other mood disorders • A lack of support from family, friends, or partner • A history of infertility • Recent trauma or stress • Biological/physiological factors (genetics, hormones, or physical damage following birth) • Infant-related issues (challenging temperament, health issues) • Your physical environment • General extra life stresses. Most likely it is a combination of a lot of things, but it is important to remember that it isn't your fault you are feeling this way, there is nothing you have done wrong, and whatever else is going on is secondary to you and your baby at this point.

SYMPTOMS OF PND The more extreme symptoms following the baby blues may include some or all of these: • Insomnia even though you are exhausted • Fatigue • Lack of appetite • Frequent crying • Difficulty concentrating • Lack of interest in the baby • Lack of interest in activities you would normally enjoy • Feeling worthless, anxious, obsessive, nervous, helpless, angry, scared or guilty • Feeling like you are incompetent or not a good enough mother is very common and often goes with feeling guilty. As important as it is to acknowledge these feelings and not shut them away. Try to remind yourself that you are doing the best you can and it will not always feel like this. Finding at least one person you can openly speak to, if it's your partner, a friend, family member, or your LMC, is crucial to help you through this time. Experiencing one or two symptoms mildly from the above list does not necessarily mean you have PND, particularly if you have suffered with the symptom in the past. Speaking to your

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IT CAN BE REALLY HARD FOR KIWI WOMEN TO ASK FOR HELP. BUT GETTING TREATMENT FOR PND IS CRITICAL TO YOUR HEALTH AND WELLBEING.

POSTNATAL DEPRESSION

LMC or GP will help to resolve what is thought to be going on, and further help can be received from the right source. PND is often confused with other post-partum issues such as baby blues, post-partum anxiety, post-partum obsessive compulsive disorder, or post-partum psychosis. Post-partum anxiety affects approximately 10% of women and has symptoms such as extreme anxiety, restlessness, agitation, shortness of breath, dizziness, sweating, cold or hot flushes. Post-partum OCD is less common, at around 3-10% affected, and mostly consists of distressing thoughts and images, or overwhelming fears of hurting your baby. This can be so extreme that you may refuse to touch your baby out of fear that you might harm them somehow. Post-partum psychosis is the least common, with only one in 1,000 women affected. This is the most severe and dangerous post-partum illness, causing hallucinations and manic behaviour; it must be treated as soon as possible as it can develop very quickly and both mother and baby are at risk of harm. There are certainly overlaps with all of these conditions, and some women can experience symptoms of more than one.

HOW TO COPE

HELPLINES FOR MUMS

Depression helpline 0800 111 757 Healthline 0800 611 116 Plunketline 0800 933 922

ONLINE RESOURCES FOR MUMS

plunket.org.nz mothersmatter.co.nz postnataldistress.co.nz depression.org.nz mentalhealth.org.nz mothershelpers.co.nz bumpandbaby.co.nz

If you or someone you know have any symptoms, there are some positive methods that can help. Rest and physically take care of yourself as much as you can. Simply having a nutritious meal and a shower can make the world of difference. Venturing outside for a walk with your baby or meeting a good friend for coffee can put things into perspective; sunshine and fresh air will be extremely beneficial for you. Ask a trusted friend or family member to watch the baby for an hour or two so you can have some alone time to do something enjoyable for yourself; get your nails done, go for a walk in nature, or just sleep! Slow down your usual life routine, try not to stress about the housework, and get rest when you can. If you have older children, ask family or other mothers to help out with them if possible. Be kind and gentle to yourself, and try to remember that these feelings will diminish eventually and you are doing an amazing job. It is so easy to get lost in the emotions of guilt and feeling incompetent,

but recognising that you are not coping and could really benefit from some help shows strength and the desire to make a positive change. Try to be open and confide in family and friends; speaking with loved ones will immediately make it feel less overwhelming in your mind.

SUPPORTING SOMEONE WHO HAS PND If you are close to someone who is suffering from PND or depression, there are many things you can do to be helpful and supportive. Being an ear to listen and shoulder to cry on are invaluable, as well as offering help with childcare or housework. Be reassuring, patient, and understanding; it can be extremely difficult to express personal pain without fear of being judged, so providing a safe and loving environment is the best gift you can give to a friend.

GETTING HELP There are multiple support options for mothers in need of help. There is a lot of information and help online that may be beneficial for personal use or how to help others. Chat forums with other supportive mothers can be useful to see just how common these feelings are and that there is a way through. Plunketline and Healthline are 24/7 helplines that you can call to discuss post-partum issues with a nurse. Sometimes talking on the phone can be a good start to building up courage before you see a doctor. Speaking to your LMC or GP is a really good idea, so they can determine what exactly is going on and what is going to be the best solution. Follow their lead and be as honest as you can; they have helped a lot of other mothers in the same situation. They may suggest a number of things like community post-natal depression groups, counselling, therapy, home help, community mental health services, or anti-depressants. It is so important to remember that there is help available for whatever your situation may be. No one should suffer in silence. Motherhood is the most incredible and rewarding job you will ever have. You can and will get to a place of loving and enjoying every moment. Pregnancy BUMP & baby

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10 things new parents really want Go ahead and leave this page open when you have visitors, new mums and dads – Breastmates founder and mum of two Frances McInnes shares things that help in the early days.

h, how exciting! You've just received the late-night text message or early morning phone call announcing the birth of your newest niece, nephew, grandchild, godchild, or good friend’s tiny bundle of joy. No doubt the first question on your lips will be, “When can I visit?” But before you make a beeline for the florist’s or the local baby boutique, take a few minutes to think about what the new parents really want and need from their nearest and dearest at this special – but stressful – time.

Never wake the baby.

Newborns sleep. A lot. You may find it frustrating that your new little niece is always zonked out when you’re around, because you want to get a look at her eye colour and feel those tiny fists grasping your fingers. But one of the most irritating things a new parent hears is, “When is she going or wake up?” or “Surely she’s had enough sleep by now!” Resist the urge to touch a newborn when her mother isn’t looking, and if she’s asleep in her cot, for heaven’s sake, leave her alone!

Always take food. New parents are usually exhausted, wild-eyed, slightly panicked, and stumbling through the days in a sleep-deprived fog. The last thing on 106 Pregnancy BUMP & baby

their minds is cooking. Create a simple, nutritious meal at home, pack it in an easyto-heat, disposable container, and call or text message to let them know you’ll be dropping off a meal at dinnertime. Then do just that – knock softly, hand over the food, tell them you don’t need the container back, and skedaddle. A handy tip: Write the reheating instructions on the lid or foil cover in permanent marker, along with how long it will last in the fridge or freezer.

Never comment on the state of the house. New parenthood

is fraught with responsibilities, and quite often the housework is one of the first things to slide when you’re up all night with a newborn baby, breastfeeding, doing endless amounts of laundry, and somehow learning what this little creature needs to survive. Don’t even think about commenting on how messy their house is. If you’re a really good friend, you can offer to help tidy up while the new mother looks after the baby. Or consider treating them to a gift certificate for a local cleaning company to come over and do a one-off houseclean. But be careful how you present this gift – you don’t want to come across condescending. If you’re a parent yourself, say something like, “I remember when my baby was born and I never seemed to find the time to tidy up! I hope this eases things a little for you.”

Always offer to run errands and help out. If you’re on your way

over for a scheduled visit, call and ask if the new parents need anything picked up from the supermarket. Mention that you’re stopping at the local fruit and vegetable shop and ask what their favourite fruit is. Ask if there are any treats they might like. New mothers often find that chocolate is off the menu when they start breastfeeding (because of the high caffeine content), so check whether they’d like some fresh fruit or baked goods instead.

Never outstay your welcome.

Don’t expect to turn up on the doorstep and stay for hours, unless you’ve been specifically asked to do so! Limit your visits to no more than half-an-hour during the first few weeks, and never turn up unannounced. Always check to make sure it’s an appropriate time to visit, and if the new parents seem stressed out when you arrive, offer to return at a more convenient time – and don’t take it personally if the new parents are distracted or unattentive to you, or if a new breastfeeding mum needs to feed her baby and doesn't feel comfortable feeding in front of you just yet.

Always listen and ask questions. Let the new parents lead the conversational direction! If they want to

HELPING HANDS

New mums will appreciate a thoughtful, non-judgemental guest!

parents like to keep their baby close while they learn to trust themselves. Once they trust that their baby won’t “break”, they’ll feel more comfortable about others holding him or her. talk endlessly about the birth, the way they spend their days, or how many soiled diapers their new baby creates in a 24-hour period... Let them. New parenthood can be monotonous in the extreme, and many new mothers and fathers need to talk about what’s going on just to get it out of their systems and normalise what’s going on.

Never offer unsolicited advice. The new parents are doing the

very best they can, and unless you see something obviously dangerous to their health or the health of their newborn baby, bite your tongue. This is not the time to offer your opinion on breastfeeding versus formula-feeding, vaccinations, sleep routines, etc. If you are asked for your

opinion, give it gently, and remember that the new mum or dad might just be looking for some words to reinforce their own ideas.

Always wash your hands and ask before holding the baby. It’s common sense and good manners to wash your hands before holding a newborn, so just do it. No need to ask about the hand-washing – the new parent will be silently grateful you took the initiative. Also, never grab for the baby, especially if he or she is crying. Always ask if you can have a “quick cuddle” and if the new parent hesitates, take the hint. Over the next several months you’ll have oodles of opportunities to hold the growing little one, but in the first few weeks, many new

Never expect to be offered refreshments. If you want a cuppa or

a cold drink, get it yourself, and make sure to offer the new mother and father a drink as well. And don’t go away grumbling that the cookies you brought didn’t get opened.

10 Always compliment the

new parents. Of course you’re there

to see the baby, but remember the new parents need support and praise at this vulnerable time! Boost their confidence by commenting on how well they are doing and how healthy their baby is. Tell them you’re proud of them and you think they’re doing an amazing job. It might just be the boost they need! Pregnancy BUMP & baby

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SLEEPY TIME

Safe

&sound

Ah, sleep, precious sleep – the holy grail for all new parents! It’s important to ensure you’re following safe sleep practices when it comes to your newborn, says Tiffany Brown.

ollowing the trauma of birth, it’s common for babies to sleep long and deeply for one or two days. Babies need to recover from the ordeal, and can be affected by medications or surgery used to assist birth. This should be a wonderful thing for a new mum who is desperately tired and ready for a big sleep herself! But in reality, most of us find it hard to ignore the rush of adrenalin-like new-baby hormones which have us absolutely buzzing from the job we’ve done. Sleeping it off is often the last thing we feel like doing when we’d much rather gaze at our brand new bundle snoozing beside us. But the “fast asleep newborn” phenomenon can give new parents a false sense of the road ahead.

START WITH FEEDING Setting up a successful feeding relationship can help enormously with baby settling into a great sleep routine from the very start. As many midwives are known to recite: “If baby’s tummy is full, baby will sleep.” Getting to grips with breastfeeding or managing bottle feeds can be allconsuming in those early days, taking up to an hour to feed baby in any one feeding session. And yet newborns can only cope with around 45 minutes of "awake time" before needing to have another round of sleep. Often the numbers simply don’t add up and both mother and baby (and dad, for that matter) are left frustrated, distressed, and exhausted. Arm yourself with knowledge before your baby arrives, so you’re in the best position to get your baby feeding well and, subsequently, sleeping soundly beyond the first couple of days after birth. At post-natal birthing units around the country, the accepted practice is to swaddle newborn babies, laying them to sleep on

their backs, separate to mum but close to the bed in a small cot. The marvellous midwives tend to make it look so easy. But you do eventually have to go home and manage without them. So, a few nights later, you find yourself blearily awake at 3am with a squawking infant (cluster feeding is probably beginning as your baby tries to get your milk to come in), looking at your partner in bewilderment as you take desperate turns trying to fashion a square of fabric into something vaguely resembling the impeccably wrapped swaddle those midwives managed to wrap your baby in so effortlessly.

BACK TO SLEEP, PLEASE Babies should be placed on their back for every sleep. After many years of research into SUDI (sudden unexpected death in infancy) and its likely causes and best methods of prevention, it is now well established the "back to sleep" position is best. Babies breathe best when their face points upwards and the space around their head is clear. Placing them on their tummies can increase the possibility of suffocation. Sleeping on their side is also problematic due to the risk of rolling on to the stomach. It is suggested that the risk of SUDI may also be increased with tummy or side placement, because baby is breathing the "pocket" of air around their mouth which contains their exhaled gases. Recent research has also shown the areas of the brain which warn of impending danger are less developed in SUDI babies. This could be why they fail to wake up when oxygen supply is limited.

SPACE TO SNOOZE One thing you can organise prior to baby’s arrival home from hospital is their sleep space. While it's fine for newborns to go straight into a cot and it’s not necessary to Pregnancy BUMP & baby

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be further minimised by ensuring adults never sleep in the same room as baby if they are intoxicated by alcohol, drugs, or medications, by keeping the house smokefree at all times, and by breastfeeding baby exclusively until around six months of age.

DRESS APPROPRIATELY

tip If you're swaddling your baby, be careful not to do

so too tightly, as too-tight swaddling has been linked to hip problems and is detrimental to normal hip development. sleep them in a smaller bassinette or Moses basket-style crib, these are lovely pieces for little ones if you can afford or have been lucky enough to inherit one. These units can also be a little more portable, offering freedom of sleeping location. The Ministry of Health currently endorses the pepi-pod (made from plastic) and whakawhetu (traditional flax-woven) sleep space products. Both are designed to offer vulnerable babies a safe sleeping environment during the first five months of life, while allowing for easy parental reassurance through close proximity and loving touch.

CO-SLEEPING Co-sleeping refers to the "attachment parenting" style of sleeping a baby very close to their parents, particularly its mother. Fans of this style of sleep point to global cultures who have practiced co-sleeping in various forms for centuries, including "baby-wearing" in sling-style carriers during the day, and sharing beds at night. Research supports the idea that babies form more secure attachments when they are allowed to sleep in very close

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proximity to their parents. Secure bonds with caregivers can give children an increased sense of independence in the future, and reduced crying minimises the production of the stress hormone cortisol.

SAFETY FIRST However, there are potential hazards to co-sleeping. There are safety recommendations to follow if you plan to use a sling for sleeping your newborn during the day, particularly in terms of the appropriate fit for the adult wearing the sling, and guidelines for keeping baby’s face clear. The website slingbabies.co.nz is a fantastic resource for due diligence on slings prior to your due date. When a baby sleeps in a bed with adults, there is a danger of suffocation if much larger adult bodies roll onto the baby during the night. These dangers can be avoided using an appropriate co-sleeping bassinette. These units attach to the side of your bed, effectively "widening" the bed and creating a separate space for baby to sleep securely, while maintaining close proximity. The risks of co-sleeping can

Dressing baby appropriately for the season and monitoring room temperature can also play a vital part in ensuring good sleep. Newborns are unable to regulate their own body temperature. Don’t rely on feeling the limbs to judge their comfort; this can mislead you as the circulatory system is not yet well developed. Instead, feel your baby’s chest or back, under their clothes, for temperature – you’ll know if they are feeling too cold or too warm. Bedclothes for infants should be tightly fitted to the mattress, with no loose fabric, trims, or embellishments that could trap or strangulate your baby. To make the sleeping space warmer in the cooler months, put extra blankets underneath the sheet rather than over the top of baby, as movement and kicking during sleep can dislodge covers and leave your baby cold. Many parents prefer sleeping bags for babies. These are available in various weights for different seasons to keep your little one cosy and warm. Clothing that keeps your baby comfortable is often defined as one more layer than you would wear during winter, and one less layer during summer. This rather arbitrary suggestion can leave you confused. Keeping a close watch on your baby’s level of contentment, along with feeling their chest and back, and experimenting with various combinations of layers of clothing when there is no other obvious reason for distress may be more reliable. The ambient temperature of your baby’s immediate sleep environment should be around 20 degrees Celsius. If your home is not air-conditioned, get a thermometer to monitor the temperature and adjust with the use of windows, heaters or fans as necessary.

Happy baby, happy mum Breast milk is vitally important for the healthy development of newborn babies. Our range of breast pumps are designed to help you in your breastfeeding journey, making it easier and as comfortable as possible to give your baby all the goodness of your breast milk, giving them the best start in life.

Comfort breast pumps

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No snoozing on the job, kiddo!

Set up for success Breastfeeding may be natural, but it’s not always easy. The painful truth is, many mums struggle to breastfeed and, while some persevere through the pain and frustration, for others it’s easier to quit. To help set you up for breastfeeding success, we’ve rounded up our smartest tips and solutions from the experts. 112

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tip Try different positions Finding the best position for both you and your baby will take a little practise and experimentation. Once you have baby properly positioned, everything else should fall into place. Try various positions to alleviate sore nipples, as baby’s latch will be different depending on the angle you’re holding him at.

tip Create a

breastfeeding station

tip Don’t wait

to ask for help

Getting help early on can save you weeks of frustration and give you the encouragement you need to continue breastfeeding. Talk to the maternity nurses at your birthing centre or hospital, or make an appointment with a lactation consultant if you need advice on latching, breastfeeding positions, and to reassure yourself that your baby is feeding enough. Some hospitals and birthing centres have lactation consultants on staff certain days of the week, so definitely ask for help.

Find a quiet corner to set up your breastfeeding station. Along with a comfortable chair, you’ll need a few breastfeeding essentials within easy arm’s reach: A breastfeeding pillow, nipple cream, burp cloth or muslin (in case of any spills), breast pads, and a large bottle of water. You may want to include a few books or magazines too.

tip Don’t feed for hours

Newborn babies usually don’t need to feed for hours at a time, so know the difference between a feeding baby and one who is using your nipple as a dummy. Release baby’s mouth from your breast after 20 minutes or so of feeding by carefully inserting a finger into his mouth to release the suction. If he fusses, then let him continue feeding. Remember, to ease painful gas bubbles that can accumulate in baby’s tummy, be sure to burp baby well after and during feeds.

tip Look after

tip Get the right latch

Your baby’s mouth needs to cover the lower part of your breast and areola so that the nipple hits his high palate to stimulate sucking. When baby is latched correctly, you should feel a gentle pulling sensation on your breast. You’ll know baby is swallowing when his temple and lower jaw move rhythmically and you hear him take a breath after he swallows. If baby doesn’t latch correctly, you could end up with cracked, bleeding nipples.

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BREASTFEEDING

your nipples

MOISTURISE YOUR NIPPLES USING LANOLIN OR COCONUT OIL, OR TRY EXPRESSING A FEW DROPS OF BREAST MILK ONTO EACH NIPPLE AFTER FEEDING. USE BREAST PADS TO STOP LEAKS BETWEEN FEEDS, AND AIR DRY YOUR NIPPLES AS OFTEN AS POSSIBLE TO REDUCE CRACKING AND BLEEDING.

tip Painful,

engorged breasts Shortly after baby is born, your breasts will flood with milk and may become engorged, red, and tender, making it difficult for baby to latch on correctly. Feed baby as soon after birth as possible and avoid giving baby a bottle while he is learning to breastfeed, as this could lead to nipple confusion. Regular feeding, at least eight times in every 24 hours, will help regulate your milk supply. While showering, gently massage your breasts with a warm flannel to help with the milk flow, or place a cold compress or cabbage leaves on your breasts after feeding to reduce swelling and to draw any excess milk out of your breasts.

tip Use a breast pump

if needed

To build up your milk supply, use a breast pump between breastfeeding. Pumping will remove more milk from your breasts, which will increase your milk supply. Some lactation consultants recommend pumping each breast once a day when your breasts are full and baby is not as hungry. That way you’ll have a stock of breast milk you can store in the freezer so your partner can feed your baby too. Pregnancy BUMP & baby

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bed or feeding chair. Cut down on fruit juices which may contain too much sugar, and avoid alcohol and caffeine, as these can interfere with baby’s sleep patterns.

tip Look out for thrush

Thrush is a fungal infection that can develop on your breasts and be passed to baby’s mouth when breastfeeding. Symptoms include sore nipples, achy breasts, or itchy and cracked nipples. If you notice little white spots in baby’s mouth or baby has a nappy rash that doesn’t seem to clear up, consult your doctor or paediatrician, as you’ll need to treat both your breasts and baby’s mouth with a prescription anti-fungal. To prevent thrush, air-dry your nipples, use breast pads in your bra, wear a clean bra every day, and reduce the amount of sugar and yeasty products in your diet.

Who knew I'd be this hungry?

tip Remember to eat IT’S EASY TO BECOME SO FOCUSED ON YOUR NEW BABY THAT YOU FORGET TO LOOK AFTER YOURSELF. BUT YOU’LL NEED AN EXTRA 300 TO 500 CALORIES A DAY TO PROVIDE ENOUGH ENERGY FOR YOUR BODY WHILE YOU’RE BREASTFEEDING. MAKE GOOD CHOICES ABOUT WHAT YOU’RE EATING, AS FOLLOWING A HEALTHY DIET IS AS ESSENTIAL WHEN BREASTFEEDING AS IT WAS WHEN YOU WERE PREGNANT. KEEP UP YOUR ENERGY BY CHOOSING PLENTY OF FRESH FRUITS, VEGETABLES, AND WHOLE GRAINS. CHOOSE PROTEIN-RICH FOODS LIKE LEAN MEAT, EGGS, DAIRY, BEANS, LENTILS, AND SEAFOOD. tip Invest in practical

breastfeeding clothing

A good breastfeeding bra is vital; not only will it be easier to feed your baby, it provides excellent support for swollen, tender breasts. Button-up shirts and blouses are great options for easy breastfeeding, or layer up with a camisole underneath your shirt to camouflage your tummy. Invest in one or two breastfeeding tops with specially designed openings

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that make it easier to breastfeed baby, and if you’re concerned about feeding in public, use a soft cashmere shawl or breastfeeding cover to drape over your shoulders and cover up baby while breastfeeding.

tip Top up your fluids

It’s super important to drink plenty of water before and during breastfeeding to avoid dehydration and headaches. Fill up a large water bottle and keep it next to your

tip Find a support group

It’s a good idea to research local breastfeeding resources or support groups in your area. There are also a number of free online resources that provide valuable breastfeeding advice. Getting help and support right from the start will save you weeks of upset and disappointment.

tip Keep calm and

think peaceful thoughts

Feeling stressed can affect your milk production and the start of your milk flow, so staying calm and relaxed is important for ensuring the experience is enjoyable and successful for both you and baby. Try a warm shower beforehand, sit somewhere quiet, listen to relaxing music, or take deep breaths while baby is feeding.

tip Don’t give up

If you’re concerned that you’re not making enough milk for baby, remember that the more you breastfeed, the more milk your breasts will produce. If baby is getting enough milk, he will be gaining weight and will have about six wet nappies a day.

BREAST ESSENTIALS

IN THE BAG Keep every precious drop of milk safely stored in the freezer. Breast Milk Storage Bags 20 pack $9.95 from breastmates.co.nz

PILLOW TALK The U-shape wraps around your body for support and helps you get in the right position for feeding. Also a great option for breastfeeding twins. Night Owl Nursing Pillow $99 from breastmates.co.nz

SO SIMPLE Just suction to your breast and this compact pump naturally draws the milk for you. Silicone Breast Pump $27 from haakaa.co.nz

Best buys for breastfeeding mums

FAST & EFFICIENT This three-piece modular steriliser works in as little as six minutes. Philips Avent 3 in 1 Steriliser $209.99 from baby retailers

Breastfeeding isn’t always easy, but these tried-and-tested products can really help.

WE LOVE IT!

TO DO LIST A light-hearted, lovely gift for a new mum. 100 Things to Do While Breastfeeding by Melissa Addey, $27 from lllnzshop.org.nz

GOOD VALUE This kit contains everything but the breast pump! Tommee Tippee Closer to Nature Complete Starter Kit $99 from baby retailers

GREAT BUY!

LITTLE HELPERS If your nipples are cracked or sore, these little lifesavers in two sizes will help you to continue breastfeeding. Philips Avent Nipple Protectors $21.99 from baby retailers

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o r ref c i l o lux C

If your baby is crying more than seems normal, it could be nothing, or it could be colic or even reflux. How do you know the difference? Penny Voigt explains. 118

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A CRYING SHAME

WHAT CAUSES COLIC?

oes your baby seem to cry more than he should? Does he often spit up his milk after a feed? While these are quite likely signs of a healthy baby, they could be something else. So how do you tell the difference between normal crying and something a little more concerning? To help you determine whether or not your baby has colic or reflux, here are some of the signs and symptoms to look out for.

WHAT IS COLIC?

Colic is the term used to describe problem crying in otherwise healthy babies. While most babies cry on average for about 2.5 hours in any 24-hour period, babies with colic will cry more often for no apparent reason, often exhibiting signs of discomfort. Colic occurs in as many as one in five babies and can last for several hours at a time, even late into the night. As hard as you try to calm and comfort your baby, the crying persists, and there seems to be no solution to the crying.

WHAT ARE THE SYMPTOMS AND SIGNS?

To help you identify whether your baby has colic, follow the "rule of threes": • Crying starts at three weeks old; • Crying lasts for more than three hours at a time; • Crying occurs at least three times a week; • Crying continues for at least three weeks in a row. In addition to the rule of threes, other signs and symptoms to look out for include: • Loud, piercing wails, more screaming than crying. • Baby pulls his legs up and clench his hands into tiny fists. • Baby closes his eyes or opens them very wide, furrowing his brow, and could even hold his breath. • Baby may pass gas or spit up. • Baby appears active and quite frantic, and won’t settle to sleep or eat.

The exact cause of colic is unknown; however, it’s not considered genetic or related in any way to the type of pregnancy or childbirth you had, and it has nothing to do with your parenting skills! There are a number of theories behind what causes colic. Here are a few of them: Overstimulation Newborns can tune out sights or sounds around them, allowing them to sleep and eat without being disturbed. But by the end of their first month, this mechanism disappears and can leave babies more sensitive to stimuli around them. So many new sensations can overwhelm baby, resulting in a need to release this stress through crying. The colic ends when baby learns to filter out these stimuli to avoid a sensory overload. Immature digestive system Food passing through baby’s gastrointestinal system may not break down completely, causing painful gas in the intestines. Infant acid reflux Thought to be a trigger for colic, gastro-oesophageal reflux disease (GORD) is the chronic form of acid reflux.

Food allergies or sensitivity

An intolerance to lactose is thought to cause tummy pains that may set off colic. Exposure to cigarettes Studies show that mums who smoked during or after pregnancy are more likely to have babies with colic.

HOW TO TREAT COLIC

To avoid overstimulating baby, steer clear of situations where baby may feel overwhelmed by noise or bright lights, particularly towards the end of the day. Instead, create a calm, peaceful environment by dimming the lights and keeping noise levels down. You could try swaddling or wrapping baby snugly in a blanket so he feels secure, or try white noise or soothing music, or take baby for a walk to calm him. Some colicky babies find relief when you apply pressure to their tummy. Try placing baby face-down on your lap or upright with his tummy against your shoulder, or use the "colic carry", where baby lies face-down with his belly on your arm, and gently rub or pat his back. If you’re breastfeeding, pay careful attention to what you’re eating, as some foods can cause baby to suffer from gas or a sore tummy. Try using gas drops, gripe water, or consider probiotics, but remember to talk to your doctor before administering any medication to baby or before making any changes to his diet.

WHAT SHOULD I BE WORRIED ABOUT?

If you are concerned and think your baby may have colic, it’s a good idea to talk to your GP, even if it’s just to get some reassurance that baby is still thriving despite the continuous crying. The good news is that colic doesn’t last and usually around the threemonth mark, the crying stops as abruptly as it started. The keys to surviving this nightmarish time are knowledge and patience.

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REFLUX

A CRYING SHAME

WHAT IS REFLUX?

Gastro-oesophageal reflux or GOR occurs when milk that your baby has swallowed is vomited or spit up after a feed. Because babies have immature digestive systems, the ring of muscle controlling the valve between the oesophagus or food pipe and the stomach may not work properly. This means that when baby's tummy is full, milk and acid can come back up the food pipe, causing discomfort. As baby grows, the muscular valve at the entrance to his tummy grows stronger and his stomach capacity increases too. Around 90% of babies with reflux outgrow it by the end of their first year. Here are three factors that contribute to infant reflux: • Baby lying flat most of the time; • An almost completely liquid diet; • Babies being born prematurely.

HOW DO I KNOW IF MY BABY HAS REFLUX?

Your baby may bring up small amounts of milk (called posseting) or occasionally vomit after eating. He may also have hiccups and cough and splutter

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WHEN SHOULD I CALL THE DOCTOR?

a little. This is completely normal, and provided your baby is otherwise well, you don’t need to worry.

HOW CAN I PREVENT REFLUX?

Try these tips to help prevent reflux: • Feed baby in an upright position. • Hold baby upright for 20-30 minutes after each feed. • Try giving baby smaller, but more frequent, feeds. • If you bottle-feed baby, burp him every two to three minutes during feeds, and make sure that the hole in the teat isn't too large. • Try raising the head end of your baby's cot by putting a rolled-up blanket or wedge underneath the mattress.

ARE THERE ANY TREATMENTS FOR REFLUX?

Most babies with reflux who are otherwise healthy do not need specific treatment, as they tend to outgrow the condition over time. If baby's reflux is severe, your doctor may advise that you cut out cow’s milk to rule out an allergy or food intolerance, or try an infant antacid to help neutralise the acid in baby’s tummy.

Bringing up a little milk or occasional vomiting after feeds is nothing to worry about. But do see your doctor if your baby: Is not gaining weight; Is projectile vomiting; Spits up green or yellow fluid or spits up blood; Refuses his food; Has blood in his stool; Has difficulty breathing or has a chronic cough; Begins spitting up at age 6 months or older; Is unusually irritable after eating.

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Up to STANDARD Is your baby as safe as they can possibly be in the cot you use at home? Tiffany Brown delves into cot safety and explains what new parents need to look for.

he cots we use in Kiwi homes are covered by the provisions of the Standard AS/NZS 2172:2013 Cots for household use – Safety requirements. Suppliers of home-use cots are obliged by law to supply only those cots which meet or exceed the requirements of the Standard, so when you purchase a new cot, make sure you look for verification that the Standard has been met. The same Standard, with some modifications, applies to secondhand cots.

What makes a cot safe?

Some of the features of the Standard for keeping your child safe in their cot include: • The space between the bars must be between 50mm and 95mm, no more or less, to prevent baby trapping their limbs or head. • When the mattress is centred in the middle of the cot, the distance between the mattress and the sides or ends of the cot must not exceed 20mm. • There must not be any components in the cot that could be used by the child to climb over the sides, such as horizontal or diagonal bars. • The construction of the cot’s materials must be permanent and fixed. Otherwise the cost must require a tool or other method of assembly that cannot be tampered with by your child. • The cot’s "dropside" must be able to move freely, while the dropside guides should be firmly fixed. • When the cot is closed, the distance between the lower rails and the mattress base should measure between 12mm and

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COT SAFETY

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COT SAFETY

Keep stuffed toys and loose blankets out of the cot, for safety's sake.

16-20˚C

IS THE OPTIMUM TEMPERATURE FOR YOUR BABY'S ROOM. 30mm. The bottom edge of the lowest rails must not be higher than the top of the mattress base. • The cot must not have any loose or missing pieces. • There should be no sharp edges or points in the cot that could cause injury, or catch or snag your child’s clothing. • Nothing should protrude into the cot more than 5mm, such as nuts, corner posts, or decorative features. Your child could fall or get caught on these and be injured. New cots also need to be fitted with information labels and markings. These should provide complete assembly instructions, manufacturers’ information, and safety and maintenance details. Manufacturers’ information and warnings must be permanently marked on the cot mattress base.

Preloved or secondhand cots

These last two requirements do not apply to secondhand cots. However, cot safety is a serious issue. Before you accept or give away a preloved cot, be aware that your cot must comply with the Standard. If it does not comply, you may be held personally liable. And if you are selling a secondhand cot on Trade Me that does not comply, you

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could be individually fined up to $200,000. If you’re unsure, it pays to double-check at standards.co.nz. If you’re buying secondhand, you’re best to compile your own safety checklist. As well as doublechecking there are no protrusions or old-fashioned features that do not conform to the safety Standard, check the paint on your secondhand cot is not lead based.

What else can I do?

Ensure your child’s cot is placed in the safest spot in the room they are to sleep in. Move the cot away from the window, particularly if the room is not on the ground floor. Ensure any potential strangulation hazards are well out of reach, such as blind cords, curtains, and curtain strings. Mobiles and hanging toys look adorable and may provide your baby with opportunities to gaze and coo, but make absolutely sure they are fixed fast and out of reach. Babies are fairly immobile in bed to start with, but they’ll soon be moving and wriggling around in there. Take care from the outset to ensure any hanging items can’t detach and fall on them, or that your child cannot get entangled in them. Same goes for other wall items like pictures, mirrors or shelves. Cover electrical outlets with safety guards, and keep the cot well away from any heaters, dehumidifiers, or air conditioners you may use in the room.

Cot mattresses should be clean, flat, and firm. Mattress protectors, sheet sets, and blankets may be purchased new or secondhand, but if you are going to use pre-loved ones, make sure they are well washed and that they came from a smoke-free home. Mattresses present a health hazard to your child if they’re allowed to get damp. Make use of sunny days to air out the mattress regularly. Place the mattress in direct sunlight outside your home, and rotate it frequently – by turning and flipping it over – to minimise pressure spots building up, particularly at the head end. Never put toys, pillows, or bumper pads into the cot with your baby, as these are suffocation and strangulation hazards. Sheets, blankets, or duvets should be securely tucked in around your child’s body to prevent loose material covering their face and suffocating them. If you choose to warm the cot prior to bedtime with a wheat bag or hot water bottle, be sure to remove it before putting baby down to sleep. To prevent overheating, cot bedding should preferably be made of breathable fabrics. Use sheets, blankets, or sleeping bags for your child that are machine washable, and if possible made of natural fibres. Over-heating is a risk factor for SUDI (sudden unexplained death of an infant), so you need to try to regulate your baby’s temperature as well as you can. Natural fabrics like wool and organic cotton are best.

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Contraception choices

After baby arrives, it’s time to think about contraception. Family Planning New Zealand (familyplanning.org.nz) shares info on your options – talk to your LMC or GP about what's right for you.

BARRIERS MALE CONDOM WHAT IS IT? A thin rubber barrier.

Best used with lubricant (water based) HOW DOES IT WORK? Fits over erect penis and catches sperm when the man ejaculates

HORMONAL CONTRACEPTION

k Can be used by breastfeeding women k Useful for women who can’t take

COMBINED PILL

DISADVANTAGES

combined pill

WHAT IS IT? Pill made of two hormones,

May have irregular bleeding

VAGINAL RING

CHANCE OF GETTING PREGNANT

oestrogen and progestogen HOW DOES IT WORK? Stops ovaries from releasing an egg each month

k Typically 15% but 2% if used perfectly

CHANCE OF GETTING PREGNANT

HEALTH CONCERNS

hormones, oestrogen and progestogen. Sits inside vagina HOW DOES IT WORK? Stops ovaries from releasing an egg each month

k Very small chance of blood clots, heart

CHANCE OF GETTING PREGNANT

every time k DO NOT USE oil-based lubricant or some anti-thrush creams HEALTH CONCERNS None known

Typically 8% but less than 1% if used perfectly

ADVANTAGES

attacks and strokes. More likely in women over 35 who smoke, are obese or have a family history of the above conditions k Very slight increased risk of cervical cancer

Easy to use, easy to carry Used only when needed Helps protect against STIs Available from Family Planning clinics and other healthcare providers k Can buy from pubs, clubs, pharmacies and many shops k Cheaper on prescription

k k k k

DISADVANTAGES

k Some people are allergic to rubber k Must be put on when penis is erect and

before sexual intercourse k Some people say it reduces sexual feeling k Can slip off or break

FEMALE CONDOM WHAT IS IT? A thin polyurethane barrier HOW DOES IT WORK? Goes into the

WHAT IS IT? NuvaRing contains two

ADVANTAGES

k Simple and easy to take k Doesn’t interfere with sexual intercourse k Periods usually regular, shorter, lighter and less painful k Less chance of cancer of lining of the womb or ovaries k Can be taken up to menopause if a healthy non-smoker DISADVANTAGES

k Should not be used by women over 35 who smoke k Must remember to take it daily k May have irregular bleeding

Typically 8% but less than 1% if used perfectly HEALTH CONCERNS Very small chance of blood clots, heart attacks and strokes. More likely in women over 35 who smoke, are obese or have a family history of the above conditions ADVANTAGES

k Lasts for 3-4 weeks k Useful for those who forget pills

DISADVANTAGES Should not be used

by women over 35 who smoke

DEPO PROVERA WHAT IS IT? An injection of progestogen HOW DOES IT WORK? Stops ovaries

from releasing an egg each month CHANCE OF GETTING PREGNANT

PROGESTOGEN-ONLY PILL

Typically 3% but less than 1% if next injection given on time HEALTH CONCERNS No serious concerns

CHANCE OF GETTING PREGNANT

WHAT IS IT? Pill made of one hormone

ADVANTAGES

Typically 21% but 5% if used perfectly HEALTH CONCERNS None known

– progestogen

ADVANTAGES

mucus in cervix and may stop ovaries from releasing an egg each month

k One injection lasts 12 weeks k Doesn’t interfere with sexual intercourse k Usually no periods k Useful for women who can’t take

vagina and prevents sperm entering the woman’s body

k Helps protect against STIs k Women can use it k Easy to use DISADVANTAGES

k k k k

Relatively expensive Can be noisy Can get them from the internet Need to insert every time

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HOW DOES IT WORK? By thickening

CHANCE OF GETTING PREGNANT

combined pill

Typically 8% but less than 1% if used perfectly HEALTH CONCERNS No serious risk

DISADVANTAGES

ADVANTAGES

k Doesn’t interfere with sexual intercourse k Can be used at any age

k Irregular bleeding, no periods

or occasional heavy bleeding k Periods and fertility take an average of 6 months to return after stopping the injection

BIRTH CONTROL

OTHER METHODS FERTILITY AWARENESS WHAT IS IT? Woman checks body

temperature, cervical mucus and periods. These body signs show when you are more likely to get pregnant

LONG-ACTING REVERSIBLE CONTRACEPTION IMPLANT WHAT IS IT? Progestogen is released

from 1 or 2 rods implanted under the skin of the arm HOW DOES IT WORK? By thickening mucus in cervix and may stop ovaries from releasing an egg each month CHANCE OF GETTING PREGNANT

Less than 1% HEALTH CONCERNS No serious risk ADVANTAGES

k Lasts 3 to 5 years – fit and forget k Useful for women who can’t take

combined pill k Useful for those who forget pills or injection appointments DISADVANTAGES Irregular bleeding often gets better with time and can be controlled with medication

INTRA-UTERINE DEVICE (IUD) WHAT IS IT? Put inside the womb. Copper

IUD or progestogen releasing Mirena (IUS) HOW DOES IT WORK?

Stops sperm reaching an egg

HOW DOES IT WORK?

k Vasectomy – male tubes cut to stop

ADVANTAGES

the sperm getting to the penis k Tubal ligation – clips put on female tubes to stop the egg getting to the uterus

k After learning method, no further costs

CHANCE OF GETTING PREGNANT

or visits to health professionals required k Helps you understand how your body works

Less than 1%

DISADVANTAGES

long-term scrotal pain k Tubal ligation – very slight risk from reaction to anaesthetic or damage to internal organs

k Expert instruction needed to learn

method k No sexual intercourse during fertile time k Must chart temperature and cervical mucus daily k Body signs can be difficult to recognise and may vary

EMERGENCY CONTRACEPTION WHAT IS IT? Emergency Contraceptive

Pills (ECP) or copper IUD used after unprotected sexual intercourse HOW DOES IT WORK? Delays ovulation or stops sperm reaching an egg CHANCE OF GETTING PREGNANT

k ECP – 2% for women of average weight, 6% if overweight k IUD – less than 1% HEALTH CONCERNS

k ECP – none known k IUD – risk of pelvic infection if STI present

ADVANTAGES

k Reduces chance of pregnancy

– fit and forget k Doesn’t interfere with sexual intercourse k IUS – lighter periods or no period at all, suitable for women with heavy periods DISADVANTAGES

k Needs to be inserted by an experienced

doctor or nurse k IUD may cause heavier periods or cramping k IUS may cause irregular bleeding in the first few months

An operation

Typically 25% but can be 3% if used perfectly HEALTH CONCERNS None

IUD and Mirena – less than 1% HEALTH CONCERNS Very small chance of pelvic infection when IUD put in

k Can stay in place for 5 years or more

WHAT IS IT? Permanent contraception.

CHANCE OF GETTING PREGNANT

ADVANTAGES

PERMANENT CONTRACEPTION: VASECTOMY AND TUBAL LIGATION

after unprotected sexual intercourse k ECP – can be used up to 72 hours after unprotected sexual intercourse k Can have ECP at home for future use k Can be used if other method fails, eg broken condom or missed pill k Can buy from pharmacies DISADVANTAGES

k ECP should be started within 72 hours

of unprotected sexual intercourse k ECP may not be effective for heavier women k IUD needs to be fitted by an experienced doctor or nurse and can be uncomfortable

HEALTH CONCERNS

k Vasectomy – rare possibility of

ADVANTAGES

k Once only k Permanent DISADVANTAGES

k Not easily reversible k Requires an operation k May have short term side effects, eg pain, bruising

Choosing childcare

101

Whether you are returning to work full-time, part-time or are wanting childcare for other reasons, choosing the right option for your child can be a bit overwhelming. Maternity nanny and postnatal advisor Katie Thomas explains the types of care available.

here are multiple childcare providers available in New Zealand to meet the needs of individual families. All sorts of factors go into finding the right fit for you, such as cost, location, hours, the age of your child, and any specific needs you and your children may have. Understanding the differences between the options can be confusing. Here is an outline of each of them.

FAMILY MEMBER OR FRIEND PROVIDING CHILDCARE: This is simply finding a friend or family member to care for a child of any age, in their home or yours. It is similar to having a nanny in the sense that it is generally a one-on-one scenario with flexible hours, but it can be a cheaper alternative. Having an already known and trusted person care for your child can be reassuring, but finding a balance between employment and family/friendship can be a challenge.

SHARED CARE WITH OTHER PARENTS: Mothers will sometimes balance childcare needs between themselves. If parents have gaps after school or after other childcare that require

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care, they can help one another out within themselves when needed, on a casual or regular basis. This generally means the child will have playmates around, and it can be very cheap or often free.

IN-HOME CHILDCARE: This is a single carer working in their own home or in one of the families' homes, with more than one child in their care. They are sometimes mothers themselves with their own children at home or at school. Otherwise they are often trained in some sort of childcare and first aid, and can provide flexible hours. The children can be ages 0-5, will have socialisation from their peers, and will be taken on outings. The child-to-adult ratios differ for every situation, depending on the children's ages, but the general rule is one adult to no more than four children, and no more than two children under the age of two in each home. Fees differ between carers, depending on qualifications, experience and subsidies. Generally, in-home care ranges from $5-$10 per hour per child.

for children of any age. Each family pays less than they would a one-on-one nanny, and often rotate whose home they spend the day at. Potential issues need to be discussed at the beginning, such as whose house, what happens if a child is ill, who provides food and snacks, etc. Hours are generally flexible and the children will have socialisation from each other.

NANNY SHARE: This is two or more

AU PAIR: This is a domestic carer who

families sharing the same nanny in one of the families' homes and receiving care

lives in your home and is often foreign and generally a female (but not always). They

MIND THE BABY

NANNY: This is a carer coming into the

family's home and caring for a child of any age one-on-one. The majority of nannies are trained in some sort of childcare or first-aid and can provide flexible hours. As they are coming into your home, other services are often provided, such as light cleaning and cooking. The more experienced and qualified the nanny, the higher the hourly rate, ranging from $15-$25 per hour.

provide cheap childcare to children of any age, in return for food and a room. Each au pair situation is different, but they are often trained in some sort of childcare and first aid and can provide flexible hours. Fees differ and can be hourly or weekly, but are generally around $250-$300 per week, as well as added hosting and agency costs. It is a one-on-one care option that is often more affordable for families with several children, but an au-pair may not be as highly trained as a nanny and may be here in the country for other reasons too.

PLAYCENTRE: This is a communitybased, parent-run childcare option for children aged 0-5. Sessions are short at around two to four hours and cost up to $5 per session. They generally require a lot of involvement from the parents, and drop-off sessions should be discussed with the individual centre. Playcentre focuses on parents themselves being a child's most valuable teacher, and encourages them to stay and learn alongside their children. The ratio of adults to children ranges from 1:5 to 1:3. Each playcentre is run differently

and has different regulations, and many will allow you to come for a few free sessions to try things out before committing.

KINDERGARTEN: Also known as kindy, this is an education and care centre that is governed by a kindergarten association. They have traditionally only provided half-day morning or afternoon sessions for 3-4 year olds, but increasingly more are offering full days (up to six hours) to families, and some are now taking children as young as 2.5 years old. They run the Pregnancy BUMP & baby

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MIND THE BABY

How much socialisation your child will get is a consideration when choosing the type childcare you want.

DAYCARE: Also often known as an early

childhood centre or a preschool, daycares provide care for children aged 0-5. Depending on who runs them and how they are funded, they can be public or private. Daycare ratios differ between centres depending on policies and the amount of qualified teachers they employ. In New Zealand we have a policy that ensures at least 50% of teachers in daycares are qualified with an early childhood degree or similar. A general idea of a ratio would be 1:5 (1 adult to 5 children) for children under the age of 2, and 1:6 for children over the age of two; that is just a guide and does vary. Daycares can be open from 7.30am to 6pm all yearround, so are a popular option for parents working full-time. Children have high amounts of socialisation, and very little one-on-one time with the adults caring for them. Fees range from $25+ for a half- day session, to $55+ for a full day, depending on subsidies and the centre itself. 130 Pregnancy BUMP & baby

same as the school term and school hours, sharing the same school holidays, and are mostly only open between 8.30am-3pm. Children have high amounts of socialisation, and very little one-on-one time with the adults caring for them. As they are mostly government-funded, fees are generally pretty low at around $2-$5 per session, and ratios can be as high as 1:10, but these vary between each kindy. There are multiple childcare-related subsidies here in New Zealand for families that meet specific requirements; researching online and speaking to the right people will help clarify what you and your family may be entitled to. The government provides funding up to 20 hours a week, and up to six hours a day of Early Childhood Education for all children aged three and four years old who are attending approved programmes. Finding the right childcare fit for your family can be a challenge. Talk to trusted people around you who have experience with different childcare providers. Go and visit places or people you are interested in; be open about what you are looking for and what you expect for your child. But most importantly, go with your gut feeling about what is going to be the best fit for your child and your family.

Trust us with the l o v e of your life For over 40 years, we’ve provided more than full and part time care and education for babies, toddlers and preschoolers – we’ve provided a Kindercare family where we keep children safe, we share their discoveries, we guide their enquiry and we fill their days with love and fun. At Kindercare, you’ll discover: • A culture of kindness that fosters respectful care • Creative, flexible environments where learning happens through play • Specialised baby care – filled with sensory experiences • Skilled, responsive teachers who know and love your child • Home-cooked meals, active outdoor time and calm rest periods

se Becau en childr r matte

Call us or pop in for a visit and let’s see how we can help you. Locations in Auckland, Christchurch, Hamilton and Wellington

0508 546 3372 or visit www.kindercare.co.nz

Here comes the aeroplane! Starting solids is messy but we'll help you navigate the process.

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NOURISHING ADVICE

Tips for starting solids If your baby is six months old, it’s time to start thinking about starting solid foods. Here's how to get started and what to remember.

tarting solids is an important solids. Her natural stores of iron will have milestone in your baby’s life. begun to deplete by this stage, and she may Not only are you introducing not be getting enough iron in her breast milk your little one to a world of or formula, so you’ll need to supplement her tastes and textures, you’re iron and zinc intake through the food she eats. also setting her up for a lifetime of good eating habits. As HOW DO I START MY BABY tip baby learns new skills and discovers ON SOLIDS? Plunket interesting tastes and textures, you When introducing baby to solids may find that starting your baby on New Zealand there are two methods you could solids is challenging and messy. To try: Spoon-feeding purées or advises help you determine whether your baby-led weaning. against baby is ready for solids, here are Spoon-feeding purées involves introducing starting your baby off with smooth some tips that might help. solids too purées of fruits, vegetables, and HOW DO I KNOW MY BABY early, as this baby cereals, gradually progressing IS READY FOR SOLIDS? to more textured foods over can lead to From around six months old, your a couple of months, with finger food allergies foods being introduced around baby will begin showing signs that and gastric she is ready for solids. Here are seven to eight months old. some of the signs to look out for: With baby-led weaning, your problems. • Baby will seem hungry even after baby determines when she is ready Similarly, you have fed her. to start solids, typically around the waiting too • She’ll take a keen interest in any six-month mark. Baby is fed the long can cause softer, well-mashed and easy-tofood you’re eating and may even reach out for your food and open deficiencies chew bits of the same meal the her mouth. in important rest of the family eats, and • Baby is able to control her tongue minerals that misses out on the purée stage and mouth, so will open her mouth of introducing solids. baby needs when a spoon approaches and close You could also mix the two to grow and methods and introduce your baby it over the spoon. • She will swallow any food rather to both purées and finger foods develop. than push it out with her tongue. from the start. The key to any • She can sit up and hold her head and method of weaning or introduction to neck up on her own. solids is allowing your baby to go at her • Her birth weight has doubled. own pace, giving her the opportunity to By the time baby reaches six months old, explore various tastes and textures, and her digestive system will be able to handle discover her favourites. Pregnancy BUMP & baby

133

NOURISHING ADVICE

INTRODUCING BABY TO SOLIDS Here are a few steps to follow when introducing your baby to solids: • Choose a time when both you and your baby are calm and relaxed. • As milk is still the most important part of your baby’s diet, breastfeed her or give her a formula feed first. • Sit baby in a highchair or on your lap. • Offer her one or two teaspoons of smooth, puréed fruit, veges, or cereal once a day, or let her sample a small spoon of well-mashed, soft food that the rest of your family is eating. • Let her taste the food by sucking it off the spoon. • If at first baby spits out the food, be patient and try again at another time or with a different food type. • Introduce new foods slowly and allow her time to get used to a variety of tastes and textures. You’ll quickly discover which tastes she prefers over others. • Start with one food at a time and add a new food every two to four days. • Start with one to two teaspoons of food a day, gradually building up to about a quarter-cup of food. • Follow her appetite; she’ll quickly let you know if she’s still hungry.

WHAT SHOULD I START WITH? It’s important you continue to breastfeed or formula feed your baby when starting on solids, to keep her hydrated and ensure she gets the essential nutrients she needs.

Breast or formula milk will still be her main source of food, at least for a few more months as she gradually increases her intake of solid foods. The most common first baby food is single-grain, iron-fortified cereal. These boost your baby’s iron intake and they’re easy for her to digest. You can also start her out with puréed fruits and vegetables like carrots, pears, prunes, kumara, avocado, bananas, and peaches. Feed her one new food at a time and wait two to four days before starting a new food. After each new food, watch for any signs of an allergic reaction such as diarrhoea, rash or vomiting. If your baby experiences any of these, consult your doctor immediately. Here are some solid foods to start with: • Baby cereals are a good first food as they contain the necessary iron essential for baby’s healthy development. Combine one teaspoon of cereal with four to five teaspoons of breast milk or formula, slowly thickening by adding more cereal as baby gets used to swallowing. • Puréed vegetables and fruit including apples, pears, apricots, potato, kumara, and pumpkin. Start with a single fruit or vegetable, then gradually combine fruits and vegetables to provide a more varied diet. • Mashed or finger foods. Wait until baby is a little older, around the nine to 12 month mark, before introducing finely chopped or mashed finger foods like soft fruit and vegetables, ground meat and soft rice.

tip What should I avoid? THERE ARE A NUMBER OF FOODS TO AVOID FEEDING BABY EARLY ON. THESE INCLUDE ADDED SALT, SUGAR, AND ARTIFICIAL SWEETENERS. DAIRY PRODUCTS SHOULD BE AVOIDED UNTIL BABY IS AT LEAST NINE MONTHS OLD, WHILE EGG AND COW’S MILK SHOULD ONLY BE INTRODUCED WHEN BABY IS OVER A YEAR OLD. HONEY, CITRUS, NUTS, DRIED FRUIT, AND PEANUT BUTTER SHOULD ALL BE EXCLUDED BECAUSE OF ALLERGY RISK OR GASTRIC PROBLEMS.

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GENERAL GUIDE From six months: • Try a new food in the morning or afternoon so that if baby has any reaction to it, you’re able to deal with it during the day, rather than at night time. • Once you know that baby is happy with certain foods, try offering her solids in the evening to fill up her tummy before sleep. • Introduce a new food every two to four days. • If baby refuses or doesn’t like one food, try something else instead. It can take her a while to decide she likes a food, so don’t give up on the one she refused, but try her with it a few days later.

From six to eight months: • Introduce baby to a variety of foods and a range of tastes and textures. • Mix any food she doesn’t like with foods that she does enjoy, to encourage her to eat a good range of foods. • Work towards feeding her three meals a day.

From eight to nine months: • Baby can hold her own food now and will try to feed herself, so prepare yourself for a mess! • Feed her pieces of fruit, vegetables, and even toast that she can hold herself.

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A solid start

When your baby is ready to start eating solid foods, you’ll want to get a look at these cool feeding accessories and helpers – they mightn’t minimise the mess, but they’ll definitely make the job more fun!

THE COWS CAME HOME Great for portable hydration! 300ml Wide-Neck Stainless Steel Bottle $29.90 from haakaa.co.nz

KAI TO GO Fill your own for no-mess meals on the go. Kai Carrier Reusable Food Pouches 10-pack $23.90 from breastmates.co.nz

GREAT BUY!

GROW WITH ME This dishwasher-safe feeding set grows with your baby. Philips Avent Mealtime Set $41.99 exclusively from Babycity

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Pregnancy BUMP & baby

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Pregnancy BUMP & baby

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0800 466 863 or visit www.immune.org.nz

Tasty meals, healthy babies Introducing your baby to a variety of fresh foods from an early age sets the stage for a lifetime of healthy habits. Philips Avent offers you a range of food preparation solutions, including the unique combined steamer and blender and the versatile food storage system. First steam fruit, vegetables, fish or meat and then simply lift and flip the jar over to blend it, no transfer of food required.

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PILATES & PHYSIOTHERAPY Pregnancy & Post-natal fitness • health • wellbeing

Pilates Group Mat Classes and Private Sessions available in central Auckland. Private and ACC Physiotherapy. CONTACT WENDY: 022 030 6639

www.positivelyyou.co.nz

PORSE In-home childcare PORSE offers a number of in-home childcare options for families. We’ll support you in choosing a special Educator or Nanny for your family.

0800 023 456 porse.co.nz

140 Pregnancy BUMP & baby

BUMPER SHOPPING

Expert obstetric scans available are: • Dating • Nuchal Translucency (NT) • Anatomy • Growth

Quality Reusable Wall Decals

Ultrasound Branches: 101 Remuera Rd Avondale • Glenfield • Hauraki Henderson • Howick • Kohimarama Panmure • Papakura • Ponsonby Pukekohe • Queen St • Royal Oak

www.stickytiki.nz

arg.co.nz

From Hospital to Home

Symphony Rental

Good hygiene, good health Sterilising is all about protecting your baby from harmful bacteria. Research has shown that it can take your baby up to a year to develop the same kind of immune system as adults. Steam sterilisation is quick and effective.

www.facebook.com/Philips.Avent.NewZealand www.philips.co.nz/avent

Pregnancy BUMP & baby

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THE LAST WORD

PHOTOGRAPHY: KARYN FLETT

You hear people say it all the time, how life changes so drastically. But you can't possibly grasp how beautiful that is until you have your child. - P!NK

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Pregnancy BUMP & baby

the ONE

the ORIGINAL STROLLER.

An icon from the start, this fully-loaded original adapts to every age and journey. From newborn to toddler, from the cit y to woods, sand and snow, the versatile Bugaboo Cameleon³ makes it easy to go everywhere you want to go. The Bugaboo Cameleon³ Classic Collection combines elegance and sophistication for the timeless look that makes a true classic. European model shown.

Push-button folding mechanism.

The Lullaby Magic Travel Cot features a removable bassinet fixture for newborns and a nightlight with music and nature sounds. Also included a mobile with detachable plush toys. Also available in Geometric print (Black/Grey)

Scan & Watch

Pregnancy BUMP&baby issue 2

Articles inside

Daddy duty

Constant cravings

40 WEEKS & 40 TIPS