Pregnancy BUMP&baby issue 7 by BUMP&baby

ISSUE 07

S H OW U S YOU R BU M P PH OTO CO M P WI N N E R S

Gu t feeling:

Get out !

YOU R M IC R O B IO M E I N PR EG NAN CY

TR AVE L WITH BABY

H E ALTHY 25 S NAC KS FO R

PR EG NANT MUMS

I N C R E D I B LE B I R TH S

8 4 g n i d e e f t s a e r b page

l a i c e sp

H e l p!

M Y BABY HAS A FE VE R

ITIONS S O P G N I S BEST NUR • K L I GEAR M E H G T N L I L K A A • M • AL MUMS E R M O R F S • TIP

CONTENTS

Our

Plunket nurses are

just a phone call away Whatever the time of day or night a PlunketLine nurse is always available. If you’ve got questions about your child’s well being, sleeping, breastfeeding or you just need to talk – give one of our nurses a call. They are highly qualified, and are there to support you and your baby’s health and happiness. They’re ready to listen. You don’t need to be enrolled with Plunket to phone.

0800 933 922 [ save the number to your contacts ]

Free 24/7

plunket.org.nz facebook.com/PlunketNZ/

from any phone in NZ

In the first 1000 days we make the difference of a lifetime | Whanau awhina

When should you

15 COMMON QUESTIONS new mums ask PlunketLine

CALL

My baby has a fever! What should I do?

PLUNKETLINE?

A: You should call PlunketLine 24 hours a day, seven days a week, whenever you have a question or concern about your baby’s health and wellbeing, or you need parenting advice or information about looking after your little one. Here’s why.

abies don’t come with instruction manuals, and when you’re a parent of a newborn, you will probably feel at some point like you don’t have any idea what you’re doing. All new parents feel this way, and the good news is, it’s normal to have questions you don’t know the answer to and to need expert advice. That’s where PlunketLine comes in. It’s a toll-free parent helpline and advice service available 24 hours a day, seven days a week. When you call PlunketLine on 0800 933 922, a Plunket nurse will listen to your concerns, and they’ll give you advice and info on parenting issues and your child’s health and wellbeing. It's also free to call PlunketLine from your mobile.

When’s the best time to call Plunketline? It’s available 24/7, and you can call any time, even if you’re still under the care of your LMC. We’re helpful if you’re worried about your baby, even in the middle of the night! What qualifications do Plunket nurses have? Plunket Nurses are registered nurses with additional qualifications in well child health, so when you call PlunketLine, you know you’re speaking to nurses who know about family and child health. What else does Plunketline do? PlunketLine is also a great way to access our nationwide family support network. It is a gateway to many services, including referrals to local Plunket nurses and services. You don’t have to be registered with Plunket to access or use PlunketLine services.

I think my baby is teething! What can I do to help make him more comfortable?

Is it normal for my baby to sleep this much?

When can I expect contact from the Plunket nurse after my midwife has finished seeing me?

Why is my baby wanting to feed all the time?

How often should I be bathing my baby?

“It's rewarding to be there for parents who phone PlunketLine, really worried, or sometimes very stressed and sometimes just needing reassurance and being able to help.” – Anne, Plunket Nurse

How do I know my newborn is getting enough milk?

When will I know that I have bonded with my baby?

I’m breastfeeding my baby, so is it okay if I drink coffee?

My baby has a rash. What could it be?

My breasts are sore and hard, and my baby won’t latch on! Is there something I can do?

I’m feeling pretty low… Is this just the “baby blues”, or could I have PND?

My baby’s poo is really strangelooking all of a sudden. Should I be worried?

My baby is really fussy lately. Could it be colic?

Should I put sunscreen on my baby?

BROUGHT TO YOU BY PLUNKET AND BUMP&BABY

CONTENTS

Congratulations on you r new ar r ival! Pregnancy is an incredible experience, and we aim to make things stress-free when it comes to choosing the right products to prepare and ease your journey from pregnancy to parenthood. Our team are ready to listen and offer tailored advice on any decisions you’ll need to make to help you find the right products to suit your lifestyle. Our bub club loyalty program is a great way to stay informed and up to date with special offers and promotions. Simply sign up in store or online and begin your parenting journey with babycity. Use this babycity checklist to help you gather all the essentials you’ll need to welcome your new arrival home.

e ou m t Cu

CONTENTS

100% natural liquid iron supplement

To support you and your baby

100% natural liquid iron supplement Less likely to constipate Contains no additives or preservatives Spatone is suitable for all stages of pregnancy and is scientifically tested 1 and shown to help maintain healthy iron levels during pregnancy. It only contains naturally occurring iron-rich mineral water that is easily absorbed, gentle on the stomach and less likely to cause constipation.

LEARN MORE www.martinandpleasance.com 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.

FIND US ONLINE

bumpandbaby.co.nz

ARTICLES, TIPS, ADVICE, REVIEWS, BABY GEAR, GIVEAWAYS, AND MORE! BRING YOUR BUMP TO BUMPANDBABY.CO.NZ.

HAVE YOU HEARD OF HYPNOBIRTHING? If you’re keen on a drug-free labour and birth, you might want to give hypnobirthing a try.

BIRTH STORIES New mums share their experiences of labour and birth, in their own words.

YOUR PREGNANCY WEEK BY WEEK What’s going on in there? Our weekby-week pregnancy guide explains what’s happening to your pregnant body, how your baby is growing and developing, and what dads-to-be need to know about pregnancy.

50 SHADES OF POO So you’ve never actually changed a nappy before, and you’re not sure if what you’re seeing in there is, well… Normal? Welcome to the wacky world of baby poo.

WHAT DOES BIRTH FEEL LIKE FOR YOUR BABY? No doubt you’ve wondered what birth would feel like for you – but have you ever thought about what it might feel like for your baby?

SIGN UP FOR OUR E-NEWSLETTER! EACH MONTH WE SEND A SPECIAL E-NEWSLETTER FILLED WITH ARTICLES, STORIES, AND PRIZES! BUMPANDBABY.CO.NZ HUMOUR, ARTICLES, NEWS, AND PRIZES. YOUR QUICK FIX OF PREGNANCY INFO! FACEBOOK.COM/BUMPANDBABYNZ SPOT PRIZES, STORIES, AND BEAUTIFUL BUMP PHOTOS TO INSPIRE YOU THROUGHOUT PREGNANCY. INSTAGRAM.COM/BUMPANDBABYNZ 6

Pregnancy BUMP & baby

CONTENTS

CONCEPTION & PREGNANCY

10 FERTILITY MYTHS AND FACTS Common lifestyle factors which affect your chances of conception

DOES THE PILL AFFECT LONG-TERM FERTILITY? The answer might surprise you

58 THIS MAGIC MOMENT Unforgettable birth photos

QUICK FIX

KIA ORA! A few words from our editor

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

WHAT WE’RE READING Books for parents and parents-to-be

SUBSCRIBE & WIN Get two issues for only $26

138

BUMPER SHOPPING Shop ’til you pop

142

THE LAST WORD Words to live by

36 LOVE YOUR LIFE

SNACK ON THIS 25 healthy snacks for pregnant mums

SHOW US YOUR BUMP Winners of our first beautiful bump giveaway

YOU, YOUR BABY, AND 10,000 OTHER ORGANISMS What’s your gut got to do with it?

BEAUTIFUL DREAMER New-season musthaves for mums

WHY GOOD NUTRITION MATTERS The connection between what you eat and your baby’s health

THE PREGNANT MAMA’S GUIDE TO DENTAL HEALTH Take good care of your teeth

IMMUNISATION: KNOW YOUR OPTIONS What expecting mums need to know

MAKING SENSE OF STRETCH MARKS Is there anything you can do to stop them?

NEXT BIG THING The latest and greatest in beauty trends and products you definitely need to know about

PREGNANCY

Issue 07

& Pregnancy BUMP & baby

ING B U M

PE FO

R G UID

S BREAST

CONTENTS

R ALL M

SPECIAL FEATURE: BREASTFEEDING

MAKING MILK How breast milk changes over time

BREAST MILK: THE FACTS Everything you ever wanted to know… And some stuff you didn’t

124

IS IT SAFE TO EXPRESS BREAST MILK BEFORE GIVING BIRTH? Maybe, maybe not

112

BREASTFEEDING A TEETHING BABY No, your baby won’t become a vampire

116

YOUR GUIDE TO BREASTFEEDING Give yourself and your baby some time to figure it out

20 THINGS YOU SHOULD KNOW ABOUT BREASTFEEDING Tips from mums who have been there, done that

NUTRITION FOR NURSING MUMS All you should be eating in order to make good milk

100

ASSUME THE POSITION Different ways to hold your nursing baby

102

OUCH! MY ACHING BOOBS! Mastitis, engorgement, and thrush, oh my!

Pregnancy BUMP & baby

SHOULD I SIGN MY BABY UP FOR KIWISAVER? Expert advice

BABY’S FIRST BOOKS Stocking up their little library

SET UP FOR SUCCESS Smart tips and solutions from breastfeeding experts

120 122

LACTATIONBOOSTING RECIPES Nadia Lim's recipes for breastfeedingfriendly treats

FIRST SIX MONTHS

106

JUST NIPPING OUT Breast care products to soothe and heal

108

HOW DO I KNOW IF MY BABY HAS HAD ENOUGH? Ensuring your baby is drinking their fill

110

YOUR NEW BFFS: BREAST FRIENDS FOREVER Breastfeeding products

20 TIPS FOR TRAVELLING WITH YOUR BABY Cue “I will survive” on the radio

128

WHAT THE BOOKS DON’T TELL YOU ABOUT NEWBORNS The good, the bad, and the ugly

132

TAKING CARE OF LITTLE TEETH Looking after those tiny pearly whites

136

HELP! MY BABY IS BURNING UP! What to do and when to call the doctor if your baby has a fever

124 TRAVEL PRODUCTS to save your sanity and get you outside

CONTENTS

Tear Free

O% Parabens & Mineral Oils

Soap Free

Hypoallergenic

Because happy, healthy skin starts with Cetaphil foundations. Available in Supermarkets and Pharmacies Distributed in New Zealand by Healthcare Logistics, 58 Richard Pearse Drive, Airport Oaks, Mangere. Phone: 0800 174 104. www.cetaphil.co.nz CET17-03-0154

KIA ORA!

ALWAYS BE A UNICORN Look, if you've got the choice between a plain car seat or a Clek Foonf Tokidoki Unicorno Disco car seat, you're gonna go unicorns, right? RRP$939, clek.nz for stockists

PREGNANCY

Issue 07

Available from selected retailers or visit bumpandbaby.co.nz to subscribe.

WE LOVE IT!

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

hat’s your favourite part of pregnancy? If I had to choose, my smart-aleck answer would be, “When it’s over!” You see, pregnancy doesn’t agree with me as well as it agrees with other mums-to-be. I spend the entire time alternately throwing up everything and craving really revolting things like double cheeseburgers for breakfast. You’ve heard the old joke about pregnant women wanting to eat pickles and ice cream? Yep, that was me. But then I threw them up. It was not pretty. If I set my sarcasm aside, I’d say that my favourite part of pregnancy is actually the very end. Those last days leading up to your due date when your baby could come at any minute, and you just have to surrender to the inevitability of making no firm plans for the foreseeable future. Yes, the end of pregnancy can be uncomfortable, when you feel stretched to capacity and have to get up to wee 12 times in the night. But it’s also really special, because you know you’re going to meet your baby soon, but you’re not exactly sure when. So you wait, and you communicate with your little one through the language of touches and kicks, and you rub your belly, and you dream. All you have to do is be in the moment. I love that part. I even love very early labour, when it doesn’t hurt too much but you’re suddenly aware, in the most amazing and mind-blowing way, that the time has come – all 40 weeks (more or less) have been leading up to this moment. This issue we’re introducing a new feature celebrating your beautiful bumps and that joy and wonder that pregnant mums experience. Thank you so much for sharing your gorgeous bump photos with us, and with all of New Zealand, so we can all be awed by the miracle of pregnancy. We can’t wait to show you.

Pregnancy BUMP & baby

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

COVER MODEL ISOBEL: BENESCH (BELANDBEAU.COM) • PHOTOGRAPHER: KATE LITTLE PHOTOGRAPHY (KATELITTLEPHOTOGRAPHY.COM) • LOCATION: JONKERS FARM (JONKERSFARM.CO.NZ) • DRESS: SPELL DESIGNS (SHOP.SPELLDESIGNS.COM) • EDITOR'S PHOTO: NIGEL MARPLE • EDITOR'S CLOTHING: BREASTMATES.CO.NZ

Editor's note

ADVERTISING ENQUIRIES Tony Marinovich tony@bumpandbaby.co.nz

Just bumped into… The latest news, info, and gear for stylish mums, bumps, and babies.

fyi

LITTLE MEALS FOR LITTLE ONES Here’s a helping hand for busy mums! Tiny Foragers provides locally sourced organic toddler meals for children 12 months and older. Made fresh and snap-frozen to ensure each meal retains its nutritional value, the mini meals come in scrummy flavours like Beef Casserole, Chicken and Sweetcorn Risotto, and Pumpkin, Spinach, and Ricotta Cannelloni. Confession: The Strawberry, Apple, and Ginger Crumble is

so delicious, we didn’t share with our toddler taste-tester. We’re not even sorry. Order from tinyforagers.co.nz (Auckland only) or thebabybag.co.nz (rest of NZ).

Priced from $21.25, find them at youngliving.co.nz

Pregnancy BUMP & baby

Here’s a weird pregnancy fact: Your vagina can change colour when you’re pregnant. Known as Chadwick Sign, some women report their vulva turns purple or bluish, and around 10% of women also get blue varicose veins in their genital area too. Fortunately, things should go back to normal following birth! ESSENTIAL OILS FOR BABIES With soothing formulas made without alcohol, parabens, synthetic fragrances, artificial dyes, or other unwanted ingredients, Seedlings products are made with only 100% plant-based ingredients, infused with Young Living essential oils diluted to a strength safe for your baby’s skin. The light, calming scent includes a blend of Lavender, bergamot, coriander, geranium, and ylang ylang to leave your baby feeling calm, snug and secure.

NOTEWORTHY

LITTLE LUXURIES Bella Buttercup’s new Mini Bar activity gym perfectly caters for parents who enjoy apartment living or simply have less room in the home. Designed for both entertainment and development, it incorporates six toys, three of which can be suspended from the bar at any time. The toy sets are a mix of silicon and natural wood, coming in a range of boy, girl, and gender-neutral colours. RRP AU$200 plus shipping from bellabuttercup.com.au

winner

TREASURED MO

IRON WOMAN

MENTS

Palmerston North photographer Ta mara Milldove recently receive d a Gold award at the 2018 RISE International Ph otography Awar ds for this intim image of a mum ate cradling her ne wborn for the fir time. See more st of Tamara's go rgeous photos page 58 and at on birthandnewbo rn.co.nz

Attention, iron-deficient mums: Floradix now comes in tablet form! Made from herbs and vegetable extracts with organic iron gluconate, they provide the same dosage of iron as the classic Floradix Formula liquid iron tonic. Great for pregnant and breastfeeding mums, RRP$30.80 from your local health food retailer. Pregnancy BUMP & baby

CALLING ALL FUTURE FOODIES Future Foody is a nutritionist-curated meal delivery program focused on optimising the nutrition that babies get in their first 1,000 days. With menus designed and cooked fresh by chefs, using the best organic, NZ-grown produce, they combine superfoods with modern techniques to create meals that are nutritionally dense, delicious, and convenient. With three stages depending on where your baby is at with eating solid foods, prices start from $4.50 and weekly subscriptions from $29.

Available online at futurefoody.co.nz

Pregnant mums are urged to #sleeponside Pregnant women in New Zealand will benefit from a public health campaign providing vital information that could reduce the number of stillborn babies during late stages of pregnancy. The Sleep on Side Stillbirth Prevention Campaign (#sleeponside) advises expectant mums to and oxygen supply to the baby. The Sleep on Side sleep on their side from 28 weeks of pregnancy. campaign raises awareness of the increased risk The campaign has been developed by the of stillbirth for such women and encourages University of Auckland and the Ministry of Health, a change in the sleeping position from 28 weeks in partnership with child health research charity of pregnancy.” For more information about Cure Kids, following new evidence that has the Sleep on Side Stillbirth Prevention Campaign visit potential to save lives of approximately 16 unborn sleeponside.org.nz org.nz or speak to your LMC. babies a year in New Zealand. Professor Lesley McCowan, Head It’s estimated that of the University of Auckland’s Obstetrics and Gynaecology Department, who leads , there would be a the initiative, says, “Lying on your back decrease in late stillbirths nationally. Internationally, from 28 weeks presses on major blood vessels, change in sleeping position has the which can reduce babies a year. blood flow to the womb

if all pregnant women go to sleep on their side from 28 weeks of pregnancy 10% save up to 100,000

Pregnancy BUMP & baby

this

potential to

NOTEWORTHY

SOFTLY SCENTED

Nivea Soft Mix Me Cream Kit RRP$10.99

$32 from prints-princesses.co.nz

Stack your scents with the new Nivea Soft Mix Me Cream Kit, with three new fragrances joining original NIVEA Soft so you can create more than 25 unique aroma combinations while keeping your skin soft and moisturised. Along with Soft Original, the new NIVEA Soft Mix Me range includes the fresh and cool scent of Chilled Oasis, the romantic and charming notes of Berry Charming, and the fragrance of fresh pineapple and exotic fruits in Happy Exotic. it’s an affordable, aromatic treat.

SIZE DOES MATTER Peach or pumpkin? Mango or melon? Track your little one’s growth with these cool Kiwi-made week-by-week size comparison cards. Based on foods you know and love, you can follow baby’s growth from week 4, when your baby is just the size of a poppy seed, all the way to week 40 when they are the size of a... Actually, we’ll let the cards tell you that!

ROCK ON, MAMA

fro

$1 59

fro

roc

kit

n z. co

Rocking isn’t just for babies – these beautiful, handcrafted wooden balance boards will help you get moving in a gentle way. Rock-it Boards are made in Hawkes Bay from NZ pine and provide a unique low-impact way to improve balance, build core strength, and work on overall fitness. Great for post-pregnancy exercise, they’re also helpful for post-surgery rehabilitation, toning, and stretching.

I did a lot of research for these cards. There are some apps out there that compare the baby size to fruit already, but I found that the fruit sizes never matched up to the size of the baby! I went out and measured a lot of fruit in fruit shops and supermarkets, and compared them to the size of the baby for each week!

~ Jenna Brocket t, graphic designer

Pregnancy BUMP & baby

BABY SKINCARE AS EASY AS A-B-C

GOT MORNING SICKNESS? THINK PINK!

Developed to be gentle and soothing for delicate baby skin, ABC Arbonne Baby Care is pure, safe and beneficial for your little one. Made with natural oils and botanical extracts, they’ll leave your baby’s skin truly nourished.

Rooty Moot, New Zealand's first naturally pink, sparkling ginger drink, saves the day with his vibrant personality. A natural cocktail mixer, mocktail mixer or simply served nude over ice, he is one sassy drink. Rooty Moot is made with pure Nelson water, is low in sugar, and chock full of punchy ginger and galangal goodness. What’s even cooler is his superpower to help soothe nausea. Check him out at rootymoot.com

Lotion $21, Hair and Body Wash $21, Diaper Rash Cream $21, Sunscreen SPF30 $33, all from arbonne.com

Support for mums who have had traumatic births Kiwi mums who experience traumatic births can now access online support with the launch of My Birth Story (mybirthstory.org.nz), a new website designed to provide resources and a forum for processing and healing to mums who have experienced a traumatic birth. “The site came out of my own experience, where I struggled to find information that was New Zealand-based or that wasn’t focussed on specific mental health issues. There was little related to negative experiences around birth,” says website founder Kate Hicks. “I didn’t even know birth trauma was ‘a thing’ until about four months into being a mum.” The site, aimed at Kiwi mums, their families, and friends, provides reassurance, validation, and support after a negative or traumatic birth experience. My Birth Story suggests ways people can process their experience and has a strong focus on external support resources and organisations that can offer further help.

WASTE-FREE, TOXIN-FREE CLEANING We’re pretty darn interested in Resparkle, an Aussie brand of affortable organic cleaning products developed for your home and nursery. There’s a nontoxic Natural Nursery & Toy Cleaner we are so taking in the nappy bag to our next Well Child appointment (you know you cringe every time your baby picks up a toy from the floor and puts it in her mouth), Natural Baby Laundry & Soaker that’s suitable for sensitive, delicate baby skin, and Natural Hand & Surface Sanitiser that will definitely make public restroom change tables easier to bear. Check out resparkle.com.au for the whole range of home cleaning products – shipping to NZ is super-reasonable.

Pregnancy BUMP & baby

NOTEWORTHY

Natures Sway Baby Hammocks

WE LOVE IT!

Celebrating 25 years of rocking babies safely to sleep, Natures Sway is swinging in with a new fabric to nurture your newborns. A superior weave and softer touch complement the hammock’s firm back support and gentle curve. The newest model includes natural webbing that stabilises and secures the hammock to help keep little ones sleeping safely. The natural wool mattress will help regulate your baby’s temperature, while the comfortable curve will keep them safely on their back. Have your baby sleep nearby you, wherever you are, convenient and safe. Perfect for the first six months. Hammock RRP$269, hammock and stand package RRP$419, deluxe hammock and stand package RRP$469, all from naturessway.co.nz

Huggies gives 500,000 nappies to families in need The South Auckland Nappy Bank has provided over half a million Huggies nappies to families in need! Plunket has partnered with Huggies for more than 25 years, and the South Auckland Nappy Bank initiative was set up as part of that partnership in 2017. Nin Roberts, who leads partnerships at Plunket, says, “It has been heartening to help almost 2,000 of our young families in South Auckland with free nappies and wipes kindly donated by Huggies, as we know they are an essential item in so many households.” Plunket nurse Rimpal Kant, who works in South Auckland, adds, “Some families are reluctant to tell us they are struggling financially, so being able to offer nappies helps take the mention of money out of our conversation. It’s really great to help families who need it."

In 2013, 21,000 babies were born in South Auckland;

13% OF THE TOTAL

NUMBER OF BABIES BORN IN NEW ZEALAND.

fyi

SUPPERTIME SAVIOUR

Delivering in Auckland, Wellington, Hamilton, Tauranga, Rotorua and Palmerston North, with more delivery areas being announced soon.

New parenthood is notoriously characterised by meals eaten lukewarm, on the go, or one-handed while holding a crying baby. Enter WOOP Balance, a new subscription meal kit that promises you’ll have a healthy, delicious, and balanced dinner in half the time – all prep work is done for you, including peeled veges and made-from-scratch sauces, so your meal will be on the table in record time. It’s great for new parents who are desperate to eat anything other than takeaways. From $92, visit woop.co.nz to find out more. Pregnancy BUMP & baby

NOTEWORTHY

FACT

Prem and sick babies benefit from crowdfunding A crowdfunding experiment to raise funds for groundbreaking paediatric research in Wellington has generated almost $20,000. The money, raised by electricity retailer Powershop, will support research into the effects of anaemia among premature babies, and the use of Statistics NZ data to track the long-term health outcomes of premature babies. The funds were raised by offering Powershop customers special Neonatal Trust branded electricity at a premium rate, with funds going directly to the Neonatal Trust. Powershop’s Tom Probert says this kind of fundraising was largely untested in the New Zealand market. “It’s not traditional donating, and it’s not traditional corporate sponsorship. The reality is, we didn’t know if people would make a donation to a great cause through their power company. We were prepared to raise a few hundred dollars, but we have a great community within our customer base and the generosity really showed with the Power for Good campaign.” Over the course of the campaign, 2,115 customers donated an average of $8 each. Probert says the campaign was so successful they are going to make it permanent and they're currently seeking other charities to benefit.

RPP$249.95, visit tommeetippee.co.nz for stockists

YOUR BABY CAN TASTE THINGS IN THE WOMB. STRONG FLAVOURS LIKE GARLIC CAN PASS THROUGH THE AMNIOTIC FLUID THAT SURROUNDS YOUR BABY, SO YOUR BABY MAY BE ABLE TO “TASTE” THEM. BRING ON THE GARLIC BREAD!

BEST DRESSED Check out the new summer maternity and breastfeeding styles from Franny at Breastmates! They're colourful and comfortable, a combination every pregnant and nursing mum needs. breastmates.co.nz

BARISTA-MADE BOTTLES Turn your benchtop into a café counter with the new Tommee Tippee Closer to Nature Perfect Prep Machine, which promises a perfectly prepared (and warmed) bottle in less than two minutes. Brilliantly easy!

Pregnancy BUMP & baby

#MadeOfSeattle

Ultimate luxury, all star safety hand selected suiting fabric including baby soft coordinating insert In a contemporary, tailored cut.

Rainier 2AXT

For more information visit nz.diono.com

What we’re reading

BOOKSHELF

The latest thoughtprovoking and relevant books for expectant mums and new parents 20

Pregnancy BUMP & baby

Every Girl Needs a Plan, by Bianca Chatfield and Leigh Russell (Hardie Grant RRP$29.99) Written by a former Australian Diamonds netballer and a leadership specialist, this is a practical guide to life and work, covering all the basics you need to master to be your best self – from emotional fitness, to leadership confidence, to building your own brand. The Heart of Jesús Valentino: A Mother’s Story, by Emma Gilkison (Awa Press RRP$40) It’s every expecting parent’s nightmare: Something is wrong with your unborn baby. When Emma and Roy discovered their baby had a rare medical condition, they had two heartbreaking options. Should they end the pregnancy or continue in the knowledge their baby would die soon after birth? A stunning, compelling memoir that is our editor’s pick for book of the year. It’s an extraordinarily beautiful story that will show you the most profound blessings can come out of the hardest choices. After the First Six Weeks, by Midwife Cath (Allen & Unwin RRP$32.99) Week six is a major milestone for both babies and parents, and this comprehensive guidebook will provide a roadmap to "what's next", starting at six weeks and taking you through to the end of the first 12 months. The Natural Home, by Wendyl Nissen (Allen & Unwin RRP$39.99) A practical guide for everyday living packed full of recipes and tips for living a balanced and sustainable life based on an old-fashioned model of growing and cooking your own food, avoiding artificial products, and doing your best to avoid letting unnecessary chemical cocktails into your life. Mind That Child: A Medical Memoir, by Dr Simon Rowley (Penguin RRP$38) Leading paediatrician Dr Simon Rowley provides a rare

glimpse into what it means to be entrusted with the most precious of responsibilities – a young human life. Charting his decades of medical experience, Rowley touches on an array of issues, from the high-stakes management of tiny pre-term babies to the serious impacts of drugs, alcohol, and technology on developing minds. A mustread for any parent and a wonderful insight into the high-pressure medical world. The Woman’s Herbal Apothecary, by JJ Pursell (Fair Winds RRP$36.99) Written to accommodate the novice herbalist as well as the more advanced practitioner, this book is divided by the major cycles of a women’s life: Pre-childbirth, reproductive years, menopause, and beyond. Each section discusses physical complaints and how to treat them with DIY herbal remedies and concoctions specifically recommended for each phase of life. When We Remember to Breathe, by Michele Powles and Renee Liang (Magpie Pulp RRP$22.50) Through births, death, stumbles, and first steps, Michele Powles and Renee Liang wrote. And together these gifted writers – one an author, the other a paediatrician – achieved something remarkable: Their words have fearlessly and charmingly laid bare the raw joy, beauty, discomfort, and humour of modern motherhood. The Nourished Toddler, by Dr Julie Bhosale (Bateman RRP$39.99) In this follow-on from The Nourished Baby, Dr Julie Bhosale unpacks the science of the major developmental changes across toddlerhood and just what foods will help fuel this. With detailed meal plans for each stage, recipe ideas, and guidance on more specialist areas, it's your one-stop-shop for nourishing your toddler.

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true or false

My weight doesn’t matter.

FALSE It does make a difference to your fertility if you’re overweight or underweight. Both obesity and being underweight can interfere with your hormones, which can, in turn, impact on your ability to get pregnant. Your menstrual cycle and ability to ovulate can be negatively affected if you’re not consuming enough healthy foods, fats, and overall kilojoules. Women who are obese or underweight can take longer to conceive and can face more complications during pregnancy and birth than women of healthy weights. Also, your partner’s weight can also affect his fertility – being underweight can affect a man’s sperm quality, while being overweight can also reduce his fertility.

true or false

Alcohol reduces my chance of pregnancy.

TRUE While it’s tempting to “loosen up” by having a few drinks before a night of passion, excessive alcohol consumption has been shown to decrease fertility, not help matters. And while you may have heard anecdotes about friends getting pregnant after a night of drinking and partying, it’s more likely coincidence combined with improper use of contraception (forgetting to take their birth control pill or use a condom, or not ensuring condoms were used properly). If you need help quitting drinking, get in touch with the Alcohol Drug Helpline (0800 787 797 or alcoholdrughelp.org.nz).

true or false

Smoking is okay, as long as I quit once I’m pregnant.

FALSE We all know about the dangers of smoking, right? Well, what you may not realise is that smoking can reduce your fertility and make it harder to get pregnant in the first place. And secondhand smoke is bad for you (and your baby) whether you’re trying to conceive, are pregnant, or have a newborn. Also, a 2016 study found that smoking was associated with decreased male sperm count, decreased sperm motility (how sperm swim), and poor sperm morphology (how sperm are shaped). Smoking is also associated with decreased IVF success rates too. If you smoke, stop now. Contact Quitline (0800 778 778 or quit.org.nz) for free help.

Pregnancy BUMP & baby

10 fertility myths and facts

How much do you know about these common lifestyle factors and how they can affect your fertility? We sort the true from the false.

REAL OR RUMOUR?

true True or false: My age is important.

Pour some sugar on me? Not if you're trying to get pregnant!

Age is the most important variable affecting fertility. Statistics NZ says that the median age of women having their first baby is 28, and the median age for all women having babies is 30 – a figure that has remained steady since 2001. Fertility NZ says the peak reproductive age for women is between 19 and 25, but acknowledges that many couples are not in a position to be able to start a family at this time, and therefore choose to start families in their late 20s and early 30s. But keep in mind that your ovarian reserve (the number of healthy eggs you have available for ovulation and fertilisation) decreases as you grow older. This means that by the time you’re 35, you have about a 15-20% chance of conceiving each month.

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REAL OR RUMOUR?

true or false

Stress can affect my fertility.

TRUE While yes, women around the world become pregnant in highly stressful situations (war, famine, etc), stress can have an affect on your reproductive cycle – and on your overall health and wellbeing. Stress can affect how your hypothalamus (the gland in your brain that tells your ovaries to release eggs) functions, meaning that if you’re really stressed out, you might ovulate later in your menstrual cycle, or not at all. A study showed that women who took a special stress reduction course later had significantly greater chances of succeeding with IVF. So take a look at your stress levels. If you work a high-stress job, see if you can find ways to reduce your stress or address it through mindfulness, meditation, counselling, yoga, or some other method that gives you stress relief. Talk to your GP for more help with this.

true or false

false True or false: It’s okay if my partner smokes a bit of weed once in a while.

While many countries are relaxing their stance on marijuana, it’s not something you want to be smoking when you’re trying to conceive – and it’s not something your partner should be indulging in either. A 2015 study found that men who smoke marijuana have lower sperm concentration, lower sperm count, lower percentage of motile sperm, and poorer sperm morphology. There’s also an association between marijuana and lowering testosterone levels. Researchers do say these effects are reversible in time (as the chemicals from marijuana leave the body), so if your partner stops smoking a few months before you try conceiving, you’ll have better chances. for women, smoking pot can affect your menstrual cycle and can suppress the parts of your brain that control the release of female hormones.

My partner’s underwear style doesn’t matter.

TRUE Contrary to some popular beliefs, researchers have concluded that it doesn’t matter whether males wear tighty-whities, boxer shorts, boxer-briefs, or no underwear at all – it doesn’t make a significant difference to his fertility. However, if you’d prefer he replace his entire drawer with some sexy new undies, we won’t say anything if you bend the truth a bit.

true or false

My usual prescription drugs are okay to take.

FALSE If you’re on any prescription drugs – in fact, if you’re taking any medication at all, or using any alternative medicines or herbal medicines – check with your GP or fertility specialist ASAP about how they can affect your fertility and chances of conceiving. Some antidepressants, for example, can interfere with normal ovulation, and some herbal medicines and essential oils are not recommended for women who are trying to conceive or are already pregnant. Don’t go coldturkey on anything without professional medical advice, however – it’s important you work with your doctor on this.

Pregnancy BUMP & baby

true or false

Timing is everything.

TRUE Many people think that if they just keep having sex all the time, they’ll eventually get pregnant. But you’re most fertile in the middle of your menstrual cycle, when you’re ovulating, and so experts recommend concentrating your bedroom efforts in this window to increase your likelihood of natural conception. There are

lots of apps and websites that can help you to determine when you are ovulating through various methods (counting days since your last menstrual period, tracking your periods, taking your temperature, checking out your cervical mucous), so if you need some hints for when the best time of the month to have sex is, try learning a bit more about your cycle.

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CONTRACEPTION CONCERNS

Does the pill affect long-term fertility?

he combined oral contraceptive pill is a popular form of contraception, and is taken by an estimated 100 million women worldwide. The pill’s most obvious use is to prevent pregnancy. But it’s also prescribed to treat acne, regulate periods, alleviate menstrual pain, and reduce the symptoms of conditions like endometriosis and polycystic ovarian syndrome. The average duration of pill use is estimated to be about three to five years, but varies widely by country. Research suggests that most women want to promptly return to their pre-pill fertility levels when they stop taking the contraceptive. But some women have difficulty falling pregnant after ceasing the pill, leading them to question whether the contraception affected their long-term fertility. This myth is so pervasive that researchers have identified fear of infertility as a key reason for women avoiding this effective form of contraception.

How does the pill work?

The pill works by effectively switching off a woman’s natural production of ovarian oestrogen and progesterone and replacing this with a synthetic version of both hormones. This sets off a number of mechanisms: Inhibiting egg release (ovulation), changing the consistency

Pregnancy BUMP & baby

or thickness of cervical mucous, and altering the lining of the womb so that implantation of a fertilised egg is less likely. The early contraceptive pill used much higher doses of hormones than currently available pills, which also vary in their dose of hormones. Most pills contain the oestrogen ethinyl oestradiol, and there are a number of different synthetic progesterone-like compounds in different pill formulations. Women often try a number of pills throughout their reproductive lifetime and, unsurprisingly, find it difficult to recall the exact duration they’ve taken a particular pill. All these variables mean it’s difficult for researchers to make general conclusions about the effects of “the pill”: it’s not just one particular hormonal agent taken for a defined time in one particular group of women.

Fertility

A woman’s fertility declines with age, particularly from 36 or 37 years and this is, in part, genetically determined. Fertility is also affected by general and gynaecological health, concurrent illness, weight, exercise levels, cigarette smoking, and stress. Weight above and below the recommended range for height can have an impact on fertility. Health-based fertility problems are often signalled by irregular or absent menstrual cycles. This is one of the body’s natural

S ho r t

“safety valves” to protect against pregnancy when the health of the foetus or mother may be at risk.

Long-term effects of the pill

It’s difficult to assess the effects of the pill on a woman’s fertility when so many other factors may be contributing. Some women will return to their normal levels of hormone secretion within a couple of days of ceasing the pill. Others may take up to six or 12 months. But the majority of women will return to normal within the first few months. The very limited evidence we have suggests the pill has no overall effect on long-term fertility. A review of studies comparing reversible forms of contraception found between 79% and 96% of women were able to get pregnant in the 12 months after they stopped taking the pill. Another study reported that pill users who ceased the pill in order to become pregnant had some delay in conceiving. But this impairment of fertility was temporary and limited to the first few months after coming off the pill. Overall, the pill – when taken as directed – is extremely effective at inhibiting fertility in the short term. With the evidence showing no longterm impact on fertility, this myth is no reason to avoid the pill.

story: It 's

probably not a problem.

AUTHOR: SONIA DAVISON, ENDOCRINOLOGIST, JEAN HAILES & SENIOR POSTDOCTORAL RESEARCH FELLOW, MONASH UNIVERSITY. REPUBLISHED FROM THECONVERSATION.COM/MONDAYS-MEDICAL-MYTH-THE-PILL-AFFECTS-LONG-TERM-FERTILITY-8150

Have you been on the pill for a long time, and you’re wondering whether it’s having an impact on your ability to get pregnant? Endocrinologist Sonia Davison investigates whether the pill affects longterm fertility.

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SNACK on this Pregnancy is the one time in your life when your eating habits directly affect another person. There is an increased demand for additional nutrients during pregnancy, and maintaining a balanced diet is one of the greatest gifts you will give your developing baby. For some women, snacking will be their new way of eating during pregnancy. Several small meals throughout the day may help to relieve nausea and, with the limited space left in your stomach, snacks may be all there is room for. Nutritionist Gina Urlich (nutritionbyginarose.com) shares 25 delicious, healthy pregnancy snacks to try.

LITTLE BITES

CELERY AND PEANUT BUTTER

Celery is a very low-calorie food, which is great for the times when you just want to eat something crunchy. And topping it with delicious peanut butter gives you nourishing fats and protein. Research has shown that eating celery provides antioxidants and antiinflammatory effects that help improve blood pressure. Celery’s high percentage of water and electrolytes can prevent dehydration, and special compounds help celery act as a diuretic to reduce fluid retention. Puffy hands and feet during pregnancy are common, and should be closely monitored by your LMC.

CHIA PUDDING

Take five minutes to meal prep a few jars of chia pudding, and you have a nutritious snack pre-prepared for days ahead. Chia seeds are a fabulous source of fibre to prevent uncomfortable constipation, which is common during pregnancy. They also contain omega-3, which is important for your baby’s developing nervous system.

Keeping up the recommended vege intake during pregnancy will provide you and your baby with an abundance of vitamins, minerals, and antioxidants. Plant foods will also support healthy bowel movements; constipation is common during pregnancy due to an increase in the hormone progesterone, which relaxes smooth muscles throughout the body, slowing down the digestive tract.

HARD-BOILED EGGS

One of the world’s most nutrient-dense foods, the humble egg is a nutrient powerhouse, with an abundance of B-group vitamins and all the fat-soluble vitamins including vitamins A, E, D, and K. Egg yolks contain choline, which has a specific and very important role in brain development. It is important for pregnant women to consume enough protein to support growth of foetal tissue, and protein is a building block for bones, muscles, tissues and blood. An additional 25g of protein per day is indicated in the second and third trimesters.

RICE CAKES TOPPED WITH NUT BUTTER AND SLICED FRESH STRAWBERRIES

A healthy take on PB&J! This little concoction will provide you with a balance of macronutrients: A serving of carbohydrates, protein, and good fats. These macronutrients will help balance your blood sugar levels and sustain your energy to keep up with the demands of pregnancy.

SALAD IN A JAR • ½ cup cooked quinoa • 1 cup diced veges – tomato, capsicum, cucumber, spring onion, celery • ½ cup sprouted beans • 2 tbsp olive oil • 1 tbsp balsamic vinegar

1. Layer ingredients in a jar in the order above. 2. Mix oil and vinegar together in a small bowl, then pour over salad. Pregnancy BUMP & baby

LETTUCE WRAPS

Lettuce wraps are an easy-peasy snack with endless flavour combinations. Get creative! Adding a source of protein (chicken, meat, fish, cheese, or egg) and filling them up with diced veges is a delicious way to get you to the next meal.

PREGNANCY BLISS BALLS

diy There has been promising research to show consuming dates in the third trimester positively affects the outcome of labour and delivery! Dates have an oxytocin-like effect, which helps stimulate uterine contractions, and reduces postpartum haemorrhage.

WILD ALASKAN SALMON ON RICE CRACKERS

Essential fatty acids, particularly omega 3s (DHA), are important for your baby’s brain and nervous system and the normal development and function of the eyes and vision. Consuming good amounts of omega 3s during pregnancy has also been linked with normal gestation length. Omega 3 fats are essential for maintaining normal moods, and deficiency of omega 3 fats has been linked with postnatal depression. Wild Alaskan salmon is a wonderful, nutrientdense food to support mum and baby.

Pregnancy BUMP & baby

• 12 medjool dates • 1 cup almond meal • ½ cup pumpkin seeds • 2 tablespoons nut butter • cup raw cacao powder • ½ cup desiccated coconut • ½ cup melted coconut oil • Extra cacao powder for dusting

1. Remove seeds from dates before placing into a food processor. 2. Place almond meal, pumpkin seeds, nut butter, cacao powder, coconut, and coconut oil into the food processor and blend until well-combined and mixture sticks together when pressed. 3. Roll tablespoon-sized amounts into balls, then lightly dust in cacao powder. Store in an airtight container in the fridge.

ROASTED KUMARA CHIPS WITH GREEK YOGHURT DIP

Roasted kumara contains a good amount of fibre as well as vitamin A. Vitamin A found in foods is essential for visual health, immune function, and foetal growth and development. Roasting kumara in olive oil enhances the absorption of fat-soluble vitamins like vitamin A. The combination of tart Greek yoghurt dip and sweet kumara chips is a match made in heaven.

APPLE AND CHEESE

Crispy, crunchy foods are a common pregnancy craving, and nothing beats biting into a fresh New Zealand apple. Combining apple and cheese slices gives you a macronutrient-balanced snack. Protein-rich cheese is also a fabulous source of calcium. Calcium helps your body regulate fluids, and it’s also involved in blood clotting, wound healing, and it helps build your baby’s bones and tooth buds. During pregnancy, your baby starts to lay down calcium into its bones from around 20 to 25 weeks. If a pregnant woman doesn’t keep up with the recommend daily intake of calcium, her baby will start drawing from her reserves. A common sign of calcium depletion is muscle cramps, as muscle is where the body will first pull calcium to give the baby.

PEAR SLICES WITH ALMOND BUTTER

Pectin is a natural fibre found in pears and is effective in treating constipation. Pectin also slows the breakdown of starches and sugar, which helps prevent blood sugar spikes that can cause glucose intolerance, unhealthy weight gain, and gestational diabetes. Smother sliced pears with almond butter and a sprinkle of cinnamon for a snack to nourish and satisfy cravings.

GUACAMOLE DIP WITH ALMOND CRACKERS

Mother Nature got it oh-so-right when she made the avocado. Providing nutritious, heart-healthy fats, about half your day’s fibre, vitamin A, potassium, and folate (which is critical in preventing certain birth defects like spina bifida and neural tube defects), the avocado is delicious sliced on top of rice cakes or as guacamole dip with almond crackers.

LITTLE BITES

diy

MEDJOOL DATE STUFFED WITH ALMOND BUTTER

How do you satisfy those sugar cravings in a healthy way? Stuff dates with almond butter! They are decadent and super nourishing. Almond butter is a healthy fat and protein source that will slow down the release of sugars from the date, resulting in balanced blood sugar levels.

This smoothie gives you a number of healthy benefits – antioxidants, minerals, folate, omega-3, fibre, selenium, calcium, and protein – and smoothies are a fabulous way to get a whole lot of nutrition into a glass. You can add a heap of veges without even knowing they’re in there! Try and make your smoothies balanced with protein (nuts, seeds, dairy, protein powder), good fats (nuts, seeds, avo, coconut), and carbs (one or two pieces of fruit).

PREGNANCY GLOW SMOOTHIE • ½ cup frozen berries • 1 small frozen banana • 1 small courgette • 1 handful spinach • 1 tablespoon chia seeds • 1 tablespoon flaxseeds • 3 brazil nuts • 2 tablespoons greek yoghurt • 1 cup of milk of choice • Protein powder (optional) • Extra water for desired consistency

1. Place all of the ingredients in a blender and blend to desired consistency. Add extra water if you prefer it to be thinner.

COURGETTE FRITTERS

Eating while pregnant isn’t necessarily about quantity, it’s about quality, and any snacks that help you add more veges into your diet is a good thing. Grating courgettes and mixing with ricotta cheese and fresh herbs, or other veges like peas and corn, makes delicious and nutritious fritters. Top with fresh sliced avo and microgreens, or a dollop of sour cream.

FANCY SCROGGIN

Scroggin isn’t just for tramping in the bush! It’s a great snacking material to help balance blood sugar levels and provide much-needed vitamins and minerals to support the high demands of pregnancy. Simply mix together 2 cups dried fruit (apricots, dates, raisins, dried cranberries), 2 cups raw nuts (almonds, walnuts, cashews, brazil nuts), ½ cup pumpkin seeds, ½ cup sunflower seeds, ¼ cup cacao nibs, ¼ cup toasted coconut flakes, and 50g dark chocolate. Store in a big jar.

BONE BROTH WITH PALEO BREAD

Bone broth may sound a little weird as a snack, but hear me out – as the broth simmers away over a long period of time, minerals and other nutrients leach from the bones into the water, leaving you with an incredibly nourishing liquid. This is a wonderful thing for anyone to consume, but it can be especially beneficial for pregnant and breastfeeding women. Bone broth is a great source of protein and collagen too. It is nutrient dense and inexpensive to make. If you can’t stomach making your own, buy a high-quality bone broth from your local store. Eat with paleo bread for a delicious, nourishing snack.

ROASTED CHICKPEAS

FRITTATA

• Tin of chickpeas • Olive oil • Sea salt

1. Preheat oven to 180°C. Line a baking tray with baking paper. 2. Thoroughly rinse a can of chickpeas and dry between two tea towels. 3. Spread chickpeas on a lined baking tray. Drizzle generously with olive oil and a sprinkle of sea salt. 4. Roast in the oven for 20 to 30 minutes. You may want to shake the tray a few times while cooking. 5. Eat while they’re still warm and crispy.

• Olive oil • Leftover roast veges: Potato, kumara, pumpkin, broccoli, courgette, capsicum, cauliflower • 6 eggs, whisked • Salt and pepper • Grated cheese

1. Drizzle olive oil in a baking dish. 2. Chop roast veges and place in baking dish. Pour over whisked eggs and season with salt and pepper. Top with grated cheese. 3. Bake at 180°C for 30 minutes or until egg is cooked through.

If you haven’t roasted chickpeas, then you haven’t lived! They're yummy and satisfyingly savoury.

Pregnancy BUMP & baby

LITTLE BITES

diy Muesli is a nutritious and filling snack for any time of the day, not just breakfast. Add seasonal fruits and berries for a guilt-free sweet treat.

CUCUMBER, CHEESE, AND SAUERKRAUT STACKS

This combination may sound a bit odd, but believe me, it’s a flavour sensation – fresh, crunchy cucumber, creamy cheese, and zesty sauerkraut. Yum! Start with sliced cucumber, add grated cheese, top with sauerkraut, then dig in. Sauerkraut contains live and active probiotics, which have beneficial effects on the health of your digestive tract. During pregnancy, maintaining beneficial gut bacteria is crucial for your baby’s health because of the relationship between the gut and the immune system. As your baby passes through the birth canal, she receives your gut microbiome to build her immune system. Including probiotic-rich foods like sauerkraut, yoghurt, kefir, and kombucha will help keep your gut happy.

MUESLI SLICE

• 1 cup rolled oats • ½ cup flour • ½ cup raisins • ½ cup dried cranberries • ½ cup sunflower seeds • ½ cup sesame seeds • ½ cup pumpkin seeds • ½ cup desiccated coconut • 125g butter • 2 tbsp peanut butter • ½ cup honey • ½ cup dark choc chips

1. Pre-heat the oven to 180°C. Line a slice tin with baking paper. 2. In a large bowl, mix the rolled oats, flour, raisins, dried cranberries, sunflower seeds, pumpkin seeds, and desiccated coconut together. 3. In a small saucepan on a low heat, melt the butter, peanut butter, and honey together, stirring constantly. 1. Combine the wet and dry ingredients and mix well. Press the mixture into the lined slice tin with your hands. 1. Bake for 20 minutes or until golden. Immediately after removing from the oven, use an egg flip to press down. Cut slice only after it is completely cooled.

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NUTTY CHOC CHIP COOKIES

• 2 tbsp coconut oil, melted • 2 tbsp honey • 1 tbsp natural peanut butter • 1 egg • 1 tsp vanilla extract • 1½ cup almond meal • ½ tsp baking powder • 1 tsp cinnamon • pinch of sea salt • ¼ cup chopped dark chocolate/ cacao nibs • ¼ cup chopped walnuts

1. Preheat oven to 180°C. Line a baking tray with baking paper. 2. Whisk together the coconut oil, honey, peanut butter, egg, and vanilla extract until well combined. 3. Fold the almond meal, baking powder, cinnamon, and sea salt into the wet mixture until just combined. Stir in chopped chocolate and walnuts. 4. Roll tablespoon-sized amounts of dough into balls, then place on lined baking tray and flatten slightly. 5. Bake for 10 to 15 minutes until golden.

BANANA PANCAKES

• 1 mashed banana • 2 eggs, whisked • cup buckwheat flour • ½ teaspoon baking powder • Optional add-ins – cinnamon, vanilla, chopped nuts, blueberries

1. Combine all ingredients in a bowl and mix well. 2. Heat a griddle on medium heat with a little coconut oil or butter. 3. Using your 1/3 measuring cup, drop dollops of mixture into the hot pan. Cook for two minutes each side or until golden. 4. Serve with a dollop of greek yoghurt or smear of nut butter!

GRANOLA, GREEK YOGHURT AND BLUEBERRIES • 1 cup brazil nuts • 1 cup almonds • 1 cup oats • ½ cup pumpkin seeds • ½ cup coconut flakes • 2 teaspoons cinnamon • 2 tablespoons coconut oil • 1 tablespoon honey • 1 teaspoon vanilla extract • ½ cup dried fruit • cup chia seeds • Greek yoghurt and fresh berries, to serve

1. Preheat oven to 160°C. Line two baking trays with baking paper. 2. Combine brazil nuts, almonds, oats, pumpkin seeds, coconut flakes, and cinnamon in a large bowl. 3. In a saucepan, melt coconut oil, honey, and vanilla on low heat, stirring frequently. Mix well and pour over dry mixture in bowl. 4. Spread the mixture evenly over the two baking trays, then bake in the oven for 15 minutes or until golden. 5. Let the mixture cool, and then add dried fruit and chia seeds. Mix well and store in an airtight container.

HUMMUS AND CARROT STICKS

A delicious plant source of protein with sweet carrot crunch. Basic hummus recipes contain six healthy ingredients: Chickpeas, olive oil, garlic, lemon juice, sea salt, and tahini. Chickpeas, like all beans and legumes, contain starch, which is a complex carbohydrate that the body is able to use steadily for energy. This means that you won’t get any sudden surges and crashes in energy like you would with refined carbohydrates.

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Nutritionist Jessica Giljam-Brown (BSc Human Nutrition) of wellnessbyjessica. com explains how the very necessary bugs living in your body can help or hinder your health during pregnancy.

ou may assume that you and your baby are the only two beings in your pregnancy relationship but, in fact, there can be as many as 10,000 other species living on or in your body. Your diet and lifestyle choices can decide if these co-inhabiting bugs are friend or foe.

THE BUGS WE LIVE WITH

Humans rely on the symbiotic relationship with our microbiome to survive. In simple terms, this means that humans couldn’t function without the collection of bacteria, fungi, and viruses that live in and on our bodies. These tiny organisms live on your skin, in your eyelashes, in your gastrointestinal system, in your saliva and mouth, in the uterus, breast tissue, placenta, and even in semen. Some of these organisms live with us but don't offer us any benefit or harm, some are parasitic and cause disease and illness, and others help us. The majority of research of the human microbiome focuses on how different bacteria impact human health.

HOW DO BACTERIA BENEFIT HUMANS?

The human gut has the greatest concentration and variety of bacteria compared to anywhere else in the body, so it makes sense that this is where all the action happens. Bacteria play an important role in our gut by: • Breaking down indigestible fibre and turning it into fatty acids which provide fuel for gut and liver cells, and regulate parts of the immune system. • Producing vitamin K and many B vitamins. • Increasing the absorption of minerals. • Inhibiting the growth of other harmful bacteria. • Teaching the immune system which foreign substances (such as food, pollen, different bacteria) to react to. • Stimulating gut cells to make 90% of your total serotonin (your “happy” neurotransmitter).

Pregnancy BUMP & baby

You, your baby, and 10,000 other organisms

THE GUTS OF IT

HOW DOES MY MICROBIOME IMPACT MY BABY?

The bacteria in the gut begin to colonise before birth, and are fully established by about age two. During this time, your baby’s gut matures and develops alongside their gut bacteria, with the two systems feeding off of each other and working together. The first place that your baby is exposed to bacteria is while growing inside of you. Bacteria cells have been found inside amniotic fluid and placental tissue – a place once thought to be sterile. Your baby is then exposed to bacteria while passing through the birth canal, or from your skin and the hospital environment during a Caesarean birth, then from your breast milk, or from skin-to-skin contact, and contact with the baby’s environment as it grows. The first place that a baby will gather organisms from is from its mother, so it is critical that mum has a healthy and diverse microbiome (collection of organisms) to pass on. Benefits of healthy gut bacteria for mum: • Reduced risk of postnatal depression, preeclampsia, gestational diabetes, pre-term labour, and excessive weight gain. • Improved blood glucose control, digestion, and production of nutrients. • Prevention of thrush, urinary tract infections, and mastitis. • Less constipation during pregnancy. Benefits which will be passed on to baby: • May reduce the risk of eczema when breastfed by mother who takes probiotics. • A strengthened immune system which will impact the baby for the rest of its life. • May decrease risk of asthma and allergies.

Yes, your microbiome is working on some gut renovations right now.

CAN I INFLUENCE MY MICROBIOME?

Looking after your microbiome is much like caring for a fish tank. Imagine that the tank is your body, and the fish represent all the different kinds of organisms. You want to have lots of the low-maintenance, harmonious fish, and not too many of the feisty, problem-causing fish – but just enough to keep the other fish from overbreeding. Just like with a fish tank, you need to keep your body free from pollutants and feed it the right nutrients to create a healthy environment. Pregnancy BUMP & baby

THE GUTS OF IT

RT HOW TO SUPPO ME YOUR MICROBIO

HOW CAN I SUPPORT MY BABY’S GUT MICROBIOME?

Sleep

Prebiotics

Prebiotics are the fertiliser for your gut bacteria. Non-digestible soluble fibre feeds the bacteria, helping them to multiply. You can use specialised prebiotic supplements or increase your intake of soluble fibre-rich foods like potatoes, onions, green bananas, asparagus, artichokes, lentils, oats, and peas.

Question antibiotic use

Antibiotics are life-saving medicine, but are overprescribed in many cases. Question your GP about the type and necessity of antibiotics for you or your baby, and ask if there are any other options, as sometimes probiotics, natural medicine, and diet changes are just as effective as antibiotics. (However, if antibiotics are prescribed, ensure you follow the instructions for their use and do not stop them before the course of antibiotics is finished.) Antibiotics are non-selective and destroy both good and bad bacteria or, at least, stop them from multiplying. This then leaves you open to an overgrowth of opportunistic organisms like yeast – and can cause problems for years to come. Studies show that gut bacteria can be impacted for years after a single treatment with antibiotics. This can be problematic in mothers, but more so in babies, as their gut microbiome and immune system are still developing.

Lack of sleep can change your gut bacteria, increasing the number of harmful bacteria. Another good reason to prioritise sleep, both for you and your baby!

Destress

Stress shuts down gut and immune function, which can enable harmful organisms to take over. This then impacts the amount of serotonin produced in the gut, and can worsen your stress levels and mood. It is important for good gut health to find time to relax, practise calming breathing techniques, and to adjust your perspective on the things causing you stress.

Probiotic foods

Food-based sources of probiotics in fermented foods are safe for pregnant women and have the added benefit of containing nutrients and fibre. Probiotic foods include organic yoghurt, kefir, sauerkraut, kimchi, miso, and traditional pickles.

Avoid disruptive chemicals

Pesticides, herbicides, artificial sweeteners, food additives, colours, preservatives, chemicals from plastics, skincare products, and home cleaning products have all been shown to impact gut bacteria. Choose organic and natural foods and products free from harmful chemicals whenever possible, including baby care products.

How to CHOOSE AND TAKE PROBIOTICS + Look for a product with a mixture of lactobacillus, bifidobacterium, and bacillus species in it. + Refrigerated probiotics are not always the best. Shelf-stable, freeze-dried probiotics often have higher levels of bacteria.

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+ Always choose a well-known brand, and get advice from a health professional so you are prescribed the correct probiotic for your issue. + Start with a half dose for a week before moving to a full dose.

+ If you've had IBS or gut issues in the past, it can be worth testing to see which gut bacteria are present. + Take probiotics three hours away from antibiotics, and take for a minimum of four weeks after finishing antibiotics.

A healthy mum is the most important factor for your baby. If you are healthy, you pass this on to your child. As your baby will be getting the majority of its bacteria from you, you need to first make sure that you have a healthy collection to give. If you suffer from irritable bowel syndrome or other digestive issues, it is a good idea to start working on your gut health before trying to conceive. This helps to ensure that your baby is exposed to a good ecosystem of organisms from day one. Continuing to look after your gut with good food, probiotics, lots of sleep, and avoiding harmful substances and high stress levels from preconception until post-breastfeeding will give your baby’s microbiome the best support possible. Your baby will continually pick up new organisms from your skin, mouth, breast milk, family members, and from your home and outside world. Collecting organisms from the environment is just as important as the ones baby gets from you; for this reason, you should try to expose your baby to different environments and households. As your child grows up, allowing them to play in the dirt, with household pets, and in public areas will help to diversify their microbiome. Frequent use of antibacterial home cleaners and hand soaps, disinfecting aerosols, and hand sanitisers have been found to change a child’s gut microbiome enough to put them at an increased risk of childhood obesity. Eco-friendly and more natural cleaning products should be used to avoid over-sanitising your home or body and changing the precious balance of gut bacteria. Basic hygiene rules still apply, like washing your hands before eating and after using the toilet, and washing dishes and surfaces regularly – but use a detergent-based cleaner instead of an antibacterial product. There are differences in gut bacteria profiles between babies that were born prematurely, via a Caesarean section, or who are exclusively formula-fed. Research suggests that these differences may contribute to a range of diseases later in life. Probiotics can be used to expose a baby to different strains of bacteria that they may not have been exposed to yet but would have been if they had experienced a vaginal delivery or were breastfed. The probiotic should be low-dose, contain two to three strains, and be chosen by an experienced and qualified practitioner.

FIND ME IN THE FRIDGE

Always read the label. Use only as directed.. If symptoms persist consult your healthcare professional. Metagenics Metagen (NZ) Auckland.

NZR2685 - 10/18 TAPS NA10530 10/18

Specially formulated probiotic to help support the healthy bacterial balance and gut health of both mother and baby during this important stage of life and development.

REAL OR RUMOUR? Apple or biscuit? Apple or biscuit... Wait, why am I asking you, baby bump? I'm the grownup here!

Why good nutrition matters Is there a connection between a mum-to-be’s nutrition and her baby’s health? Tiffany Brown investigates.

f you’ve ever been pregnant and politely turned down the offer of a glass of wine or an unsafe or unhealthy snack from an older woman, you may well have heard the offerer mutter something about her own generation to the effect of, “We didn’t follow all these crazy rules when we were pregnant, and our kids all turned out all right, didn’t they?” Well, did we? According to Ministry of Health figures, around 66% of Kiwi adults are overweight or obese. Chronic illness

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abounds, diseases and disorders are rampant... In fact, it seems as if we may never have been more unhealthy. So did we really turn out all right?

Hold up a minute, Grandma While studies on the last few generations of children from alcohol-free, or at least minimum-alcohol-consuming mothers, as well as those consuming a more nutritionally optimised diet before and after conception are limited, there has

been plenty of research over the last few decades supporting the notion both your pregnancy and pre-pregnancy eating can affect your child’s birth outcome. As far back as 1987, the World Health Organisation (WHO) announced there are “well-established direct causal impacts on intrauterine growth retardation (IUGR or low birth weight)” from factors including pre-pregnancy weight, paternal weight, gestational weight gain, caloric intake, cigarette smoking, and alcohol consumption. Essentially, if you’re underweight or overweight during pregnancy, if you pack on too many pounds while pregnant, and/or if your diet goes out of control, and especially if you’re smoking or drinking, your baby’s risk of IUGR is

MATERNAL INFLUENCE

elevated, and future health risks also increase for your children. The risk to your unborn baby from smoking and alcohol has received a great deal of attention, and most modern day mums-to-be are unsurprised to be advised by their maternity team to stay off the cigarettes and give the booze a swerve. We also know good maternal nutrition during pregnancy can protect children from diabetes, stroke, heart disease, kidney disease, and memory loss later in life.

Dad’s health matters, too

Recommendations abound as to sensible diets during your pregnancy, but is there as much information available to expectant parents, particularly fathers? It’s not only mums who might want to consider their nutritional intake when planning a family. Paternal obesity has been associated with fathering children who are more likely to become obese and struggle with metabolising carbohydrates in the future. Their children experience changes to the gene expression in their fat tissue that is consistent with premature ageing and the development of degenerative disorders. The way in which diet can affect gene expression is called epigenetics. Although genes cannot be altered, they may be influenced into turning on or off. Research indicates men with low folate levels, for example, could pass on a tendency to develop birth defects and chronic diseases such as diabetes and cancer in later life to their unborn children. So paying heed to the nutritional needs of both parents prior to conception goes way beyond simply encouraging fertility and increasing your chances of conception.

The wisdom of our ancestors

Perhaps the answers lie in our ancestry. Mid-20th century research into smaller, more remote populations of healthy people revealed special provisions made for nutrition in the pre-conception period for both mother and father. Where there was access to seafood, traditional peoples always consumed fish eggs, which are rich in cholesterol, vitamin B12, choline, selenium, calcium, magnesium, and omega-3 fatty acids. Mountain-dwelling communities used high-quality dairy products from the season when the grass

IMPORTANT TAKEAWAY: WORKING ON YOUR OWN BEST HEALTH BEFORE TRYING TO CONCEIVE CAN ONLY BE A GOOD THING. was green and rapidly growing, as grass-fed milk is higher in fat-soluble vitamins, pigments, conjugated linoleic acid (CLA), and omega-3 fatty acids than grain-fed milk. In the remote Masai community, men and women were only allowed to marry after spending several months consuming milk from the wet season when the grass was lush and animals were producing a milk much more nutrient-dense than other times of the year. Traditional societies also prized liver and other organ meats, bones and skin, fats, seafood, and the local plant foods for a nutritive preconception diet. Many traditional societies also place emphasis on consuming warm foods in the prenatal period, surmising that a warm uterus makes for increased fertility.

Get back to nature

Our modern lifestyles and preferences may not lend themselves to this kind of fare, and yet it may be wise to adapt the principles inherent in this traditional model of nutrition. The first step is to choose locally produced, organic, hormone-free, nourishing whole foods. Research bears out a reduction in all types of processed foods, particularly sugars, processed oils, takeaways, fried foods, sweets, beverages, and alcohol can improve your dietary profile, which will benefit your fertility and the health of your future children. Studies have shown a gluten-free diet can help improve fertility. Gut healing may also be beneficial, and you can make a start by taking a good-quality probiotic (50-80 billion-count). You may also consider visiting a holistic natural health practitioner for more specific recommendations based on your specific situation and lifestyle.

toxins by switching to non-toxic cleaning and personal care products. Avoid plastics, or make sure they are BPA-free if avoidance is impossible. Filter your air with plants and flowers instead of chemical room sprays. Make a shoes-off-at-the-door policy in your home, and wipe the paws of your pets after they’ve been outside to reduce your exposure to foot-borne pesticides and heavy metals.

Stress less

Some experts have called for more research into the effect of maternal stress on fertility, feeling this to be a much-overlooked factor for many couples who are struggling to conceive. Certain yoga poses can encourage open, relaxed, and nourished reproductive organs. Meditation, breathing, visualisation, massage, nature, sleep, exercise, acupuncture and journalling can all be useful tools to limit and manage stress in our busy lives.

Put your health first

While it may seem there is an abundance of conflicting information out there for a pregnant or potentially pregnant pair, the important takeaway here is that working on your own best health before trying to conceive can only be a good thing. Beside short and long-term benefits for your future children, you two will also benefit from more balanced lifestyles, improved energy, controlled weight, healthier bodies and minds, and feel a little more ready to meet and delight in the next stage of your lives.

Detox your life

Further limit your exposure to Pregnancy BUMP & baby

The pregnant mama’s guide to dental health “Gain a child, lose a tooth” is an old wives’ tale that warns of your unborn child leaching calcium from your teeth in order to grow its own pearly whites. While that’s not quite how it works, dental care is important for pregnant women, as Tiffany Brown explains.

Pregnancy BUMP & baby

THE TOOTH OF IT

hen you become pregnant, you become responsible for creating a little human being, right there inside yourself. Amazing, isn’t it? What you might not realise is that your pregnant body will prioritise your baby’s needs for growth and development ahead of your own. (Just when you thought your swollen ankles, morning sickness, and forgetfulness were punishment enough!) Your baby’s nutrition requirements can be drawn from where they are available in your body in order to grow their little body inside you. Vital nutrients like calcium, phosphorous and other minerals may literally be pulled from your bones in order to supply your infant. This drain on your body’s resources, combined with massive hormonal changes during pregnancy producing increased blood flow, can make for a tough time for your mouth and teeth. Gums may be sensitive, swollen, inflamed, and tender to the touch, while tooth pain and sensitivity are also common. Hot and cold foods can trigger or worsen these sensitivities, and many pregnant women may experience gum disease and an increased likelihood of tooth decay.

Pregnancy BUMP & baby

THE TOOTH OF IT

NEED TO KNOW

Because your baby needs calcium...

At around four months’ gestation, your baby’s teeth and bones begin to calcify, increasing calcium requirements, with a further growth period and dramatic increase in the need for essential minerals at around seven months’ gestation. The main component of teeth, calcium is the most important mineral for you to supply to your baby as he or she develops. It is obtained by your body through calcium-rich foods, and its absorption is affected by various factors. Although dairy products can be a good source of calcium, green leafy vegetables are more calcium-dense, so it’s wise to include both in your diet. Green leafy vegetables are also great for you and your baby as they contain additional minerals, vitamins, antioxidants and iron. In descending order: Watercress, pak choi, fresh basil, rocket, and cooked spinach are the vegetables most commonly available with the highest concentration of calcium. Lemons and oranges are also surprisingly high in calcium, and the boost of vitamin C in these citrus fruits is helpful for your immunity while pregnant.

FYI

DENTAL X-RAYS SHOULD BE AVOIDED DURING PREGNANCY. CHECK-UPS AND CLEANING ARE THOUGHT TO BE SAFE, AND YOU'LL BE MOST COMFORTABLE IF THESE ARE CARRIED OUT DURING THE SECOND TRIMESTER. 44

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HERE ARE SOME COMMONLY ASKED QUESTIONS ABOUT TEETH DURING PREGNANCY.

Q ...And phosphorus and vitamin D, too

Phosphorous is the mineral that makes teeth hard, and is easier to come by in the diet than calcium. High-protein foods like meat and milk are rich sources of phosphorous, as are beans, nuts, and lentils. While naturally obtained vitamins and minerals are superior to those obtained by supplements, if you are unable to include the right foods in your diet, you may need to take supplements. Discuss this with your LMC if you have concerns. Maintaining an adequate vitamin D level is essential for effective absorption of calcium and phosphorous in the body, so be sure to get some safe sun exposure every day if possible. Remember, most sunblock preparations screen out the UVB rays required for the skin to make vitamin D. Exercise is also important in order for your body to absorb minerals well. And because water carries nutrients from you to your baby through the placenta, ensure you are drinking enough fluids every day. A sunny walk each day followed by a long drink of water with a squeeze of lemon doesn’t sound too arduous, does it?

Caution: Stay away from these

There are also some key substances you should avoid when pregnant for the sake of your teeth. Caffeine, alcohol, smoking, drugs, and many medications (like certain antibiotics) should be avoided so as to not interfere with proper absorption of vitamins and minerals and thus to pass on good nutrition to your baby. If you do need antibiotics, your LMC, dentist and/or doctor will be able to prescribe a course recommended to use while pregnant.

Does pregnancy wreck your teeth? A: Not necessarily. It is thought that hormones affect your body’s ability to deal with plaque and bacteria in the mouth when you are pregnant, giving rise to an increased risk of gum disease, tooth decay, and discomfort in the mouth. But not all pregnant women will experience this.

Is there anything I can do to avoid tooth problems during pregnancy? A: Many cultures believe a robust pre-conception period of care for both parents ensures a healthy pregnancy. Preparations mainly involve eating a diet rich in the iron and minerals required by your developing baby. Foods include wild-caught fish and fish roe, cod liver oil, oysters, clams, and mussels, organic, free-range eggs, liver, walnuts, coconut, bone marrow, yams, and fresh figs. Investigating these traditional ways of preparing both parents for conception can maximise your nutrient profile, putting you in the best position to nurture your infant.

What about morning sickness? A: Just when you thought it couldn’t get any worse… Dental advice is to wait at least 30 minutes after throwing up before you brush your teeth. The acid produced by your stomach will assault your teeth as its contents make their return journey, so it’s wise to leave your mouth to recover by neutralising that acid with saliva before you introduce the toothbrush.

How should I care for my teeth while pregnant? A: Irritated or inflamed gums during pregnancy are common. Switch to a soft toothbrush and ditch the electric toothbrush for now.

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Immunisation:

Know your options Did you know that certain immunisations are recommended for pregnant women? Mary Nowlan, Medical Writer and Karin Batty, Technical Writer at The Immunisation Advisory Centre explain what you need to know.

accines have done such a great job that most of us haven’t seen how serious vaccine-preventable diseases can be. While many vaccine-preventable diseases might be mild for many people, they can be very serious for some. In many cases, the reason we immunise young babies is that they are at highest risk if they catch these diseases. Some may die from illnesses that older children are able to fight off. Some of the vaccine-preventable diseases are very rare in New Zealand, but we still need to be immunised in case a traveller from overseas brings it in or if we travel overseas. Other diseases that our parents or you experienced in childhood, such as chickenpox, measles, and mumps, can be very serious even for previously healthy children, and cause long-term disability. The good news is immunisation helps protect against these and many other preventable diseases. And you can start that protection even before baby is born!

Pregnancy BUMP & baby

PLANNING TO HAVE A BABY?

Ideally, before you get pregnant, check that you are up-to-date with your immunisations. You may have missed out or be eligible for some that weren’t available before. Don’t rely on memory (yours or your parents')– immunisation schedules do change, so Mum may not know exactly which vaccines you had, or when. Check your Plunket or Well Child baby book, medical notes, and if unsure, get immunised – it is not harmful to have more doses. Immunisation before pregnancy helps protect against some viruses likes measles, mumps, rubella, and chickenpox that can damage your unborn baby. The vaccine that you may have missed in particular is MMR – the measles, mumps, and rubella vaccine. You should not have this vaccine when you are pregnant, and it is recommended that you delay pregnancy for four weeks after having it.

Most people who are brought up in New Zealand and Europe will have had or been exposed to chickenpox virus. But if you spent your childhood in tropical countries, such as Asia or the Pacific Islands, you may not have been exposed to chickenpox. If you do not know if you had chickenpox or the chickenpox (varicella) vaccine, you may be able to have this vaccine before or after, but not during, pregnancy. Discuss your immunisation needs with your doctor or practice nurse.

ALREADY PREGNANT?

If you find out during your pregnancy that you are not fully immunised, consider catching up as soon as you can, particularly if you plan to have more babies. By protecting yourself, you reduce the risk of your baby catching a vaccine-preventable disease from you. Pregnant women who are not immune to chickenpox should avoid contact with someone who has chickenpox, but if they do, seek medical advice.

PROTECT + PREVENT

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Immunisations recommended in pregnancy THE VACCINES THAT ARE RECOMMENDED IN PREGNANCY ARE VERY SAFE, AND ONLY THE ANTIBODIES THAT YOUR BODY MAKES CAN PASS TO YOUR UNBORN BABY, NOT THE VACCINE ITSELF.

+ Whooping cough (pertussis) PROTECTION SHARED WITH YOUR BABY Immunisation during pregnancy stimulates your immune system to make protective proteins called antibodies. The antibodies circulate in your bloodstream to help protect you from getting sick. They also travel across the placenta into your baby’s bloodstream and help protect them until their own immunisations start.

VACCINES NOT RECOMMENDED DURING PREGNANCY

As mentioned, certain vaccines contain a weakened live form of the virus, such as MMR and chickenpox (varicella) vaccines, and as a precaution are not recommended during pregnancy. Sometimes, these vaccines have been given accidently when a woman doesn’t know she is pregnant. There is no evidence of harm to their babies, but because these weakened viruses can cross the placenta, these vaccines are not recommended for pregnant women.

Young babies are at serious risk from whooping cough – at times it may cause them to stop breathing and can result in brain damage. Out of the all babies who catch whooping cough, around half of them need hospital treatment, some need intensive care, and some may even die. When baby is born with lots of your antibodies, they will be protected against this disease and from the dangerous toxins that the infection releases. By being vaccinated, you are also protected from catching whooping cough and passing it to your baby. In this way, more than nine out of 10 babies are protected against whooping cough for their first few months of life. By being immunised in pregnancy, your baby is protected in two ways: • Your baby is provided with temporary protection to fight whooping cough. • It helps protect you from catching whooping cough and passing it to your baby.

+ Whooping cough vaccine (Boostrix) is given during the

third trimester of pregnancy, from 28 to 38 weeks – the earlier the better. It is FREE from your GP and recommended for each pregnancy.

+ Seasonal influenza

It is also important to have the seasonal influenza (flu) vaccine. Pregnant women are five times more likely to be admitted to hospital with the flu than women who are not pregnant. Changes to your immune system and your restricted ability to breath put you and your unborn baby at greater risk if you catch the flu virus. When you are vaccinated, your baby will also have some protection against flu when they are born and you are less likely to pass the flu to your baby. Babies who get flu can be very sick and need hospital treatment. Influenza vaccine is available during the influenza season from April until 31st December each year. You can receive the vaccine at any time during pregnancy to protect you and your baby.

PREGNANT WOMEN ARE FIVE TIMES MORE LIKELY TO BE ADMITTED TO HOSPITAL WITH THE FLU THAN WOMEN WHO ARE NOT PREGNANT. 48

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PROTECT + PREVENT

tip Baby's first immunisations

Breastfeeding your baby while they are receiving their immunisations can help comfort them, and can make this particular well child visit go a lot faster. Ask your practice nurse or GP if you should give your baby pain relief following the immunisations, but do not give it beforehand.

AFTER BABY IS BORN Breastfeeding

If you can, choose to breastfeed your baby. Breast milk contains compounds that help to protect your baby from some infections. Unfortunately, breast milk is not likely protect against whooping cough, which is why immunisation during pregnancy is the best way to help protect your baby until their own immunisations start.

Immunisation schedule for baby

The protection that your antibodies provide is only temporary, so it is very important that your baby receives their immunisations on time. Vaccines teach your baby’s body to recognise and fight an infection before it can spread. Your baby’s immune system is theoretically capable of responding to hundreds of vaccines at the same time. The small number they’re given – even four in

one visit – are easily dealt with. If you delay giving your baby their immunisations, they will be at risk of getting very sick just at a time when they are getting more adventurous and are being exposed to more germs.

Which vaccines will my baby receive?

For most vaccines, your baby will need three doses until they are fully protected. Immunisations start at 6 weeks of age, then 3 months and 5 months. At these times, your baby will receive two injections and one oral vaccine: • INFANRIX-HEXA protects against diphtheria, tetanus, whooping cough, polio, hepatitis B, and Haemophilus influenzae type b (Hib). • SYNFLORIX protects against 10 types of pneumococcal bacteria. • ROTARIX , a rotavirus vaccine, is given

by mouth at six weeks and three months – for safety reasons, the first dose is only given to babies younger than 15 weeks of age. You don’t have to worry about being exposed to rotavirus if you change the nappy of a baby who has been recently vaccinated against rotavirus. The vaccine strain of rotavirus from vaccinated babies is very unlikely to cause illness in other people. As always, it is good practice to wash your hands thoroughly after changing a nappy. Even if any live vaccine virus is shed in the nappy, it is not likely to make you sick as it is weakened, and you will have good immunity against rotavirus as it is a very common illness.

FOUR-IN-AROW TODDLER IMMUNISATIONS

When your baby is 15 months old, they will get their first doses of MMR and varicella vaccines and booster doses of pneumococcal and Hib – this involves four injections. It is best to do these all at the same visit to reduce stress and clinic visits, and to avoid missing them. Pregnancy BUMP & baby

PROTECT + PREVENT

FACT

FREAKED OUT BY NEEDLES? THOSE USED TO GIVE IMMUNISATIONS TO BABIES ARE ACTUALLY REALLY SMALL – AROUND 16-25MM LONG.

WHAT'S NEXT

Most children will not have any more immunisations until they are four years old, just before they start school. At this time, they will have a final MMR dose and a booster dose against diphtheria, tetanus, whooping cough and polio. Some children with medical conditions are recommended extra vaccines because they have a higher risk of complications from some preventable diseases. It is worth considering giving your child an influenza vaccine each year, which can be given from the six months of age. Vaccinating your child against flu will help protect your family and your child from getting very sick. For more information about all of these vaccines, have a look at immune.org.nz/vaccines 50

Pregnancy BUMP & baby

HOW CAN YOUR FAMILY HELP TO PROTECT YOUR BABY

Whooping cough is a highly contagious bacterial infection that lasts for weeks or months. Nine out of 10 people not immune to the disease will catch it if they are living in the same house as someone with whooping cough. Whooping cough is most infectious before and a few weeks after the cough begins. Prevent anyone with a cough or who is unwell from close contact with your newborn. Ensure that you and other members of the family regularly wash their hands or use hand sanitiser to reduce the spread of any germs they might have picked up. Make sure that any teenagers and children that live with you or visit your baby often are up-to-date with their immunisations. Children are a frequent source of infection to a household, bringing in illnesses from school and nursery. There is little evidence of a need for grandparents or fathers to have the whooping cough vaccine. It is unclear if this “cocooning” concept is protective. It is better to get the vaccine yourself in pregnancy and to keep people who are coughing away from your baby. It is a good idea for your whole family to receive the influenza vaccine each year. It can help stop the spread of the virus. Most people don’t even know they are infected and don’t show any symptoms, but can pass it to your baby if they are not immunised.

MAKE AN INFORMED CHOICE TO HELP PROTECT YOUR FAMILY Immunisation helps protect you, your family and community from a range of nasty but preventable diseases. Like all medicines, there are benefits and risks to vaccines. Serious risks like a severe allergic reaction are extremely rare and nurses are trained to look after baby if that should happen. On balance, any risks are far outweighed by the great benefit in avoiding the serious consequences from these diseases.

Protecting your baby starts before birth When you’re pregnant, free vaccines can help protect you and your new baby before they are fully immunised.

IMMUNISATION DURING PREGNANCY Inﬂuenza and whooping cough (pertussis) immunisations are recommended and free for all pregnant women in New Zealand. These types of vaccines are used internationally during pregnancy and are a very safe way to protect both mother and baby. Immunisation during pregnancy causes the mother’s immune system to make antibodies. The antibodies circulate in her blood stream to help protect her from getting sick. They also travel across the placenta into her baby’s blood stream and help protect the baby after birth, before baby has completed their ﬁrst three immunisations. WHOOPING COUGH Babies, particularly those younger than 6 months of age, can get very sick or even die from whooping cough. Immunisation between 28 and 38 weeks of pregnancy can help protect your baby for up to 3 months after they are born. Babies then develop their own protection through immunisations at 6 weeks, 3 months and 5 months of age.

visit immune.org.nz or speak to your doctor or practice nurse for more advice. TAPS approval number: NA 8613

INFLUENZA (FLU) Pregnant women who get influenza have a much higher risk of developing complications like pneumonia, being admitted to intensive care, experiencing premature labour, and/or delivery problems. They also have a higher risk of dying from influenza than women who are not pregnant. Their unborn baby is more likely to be born small for age, become distressed in labour, and/or be delivered by caesarean. You can have the vaccine anytime during pregnancy, which will help protect your baby for up to 6 months after birth. The vaccine is free during the influenza season (usually early March to end of December). IMMUNISATION AND BREASTFEEDING Mothers pass some antibodies to baby in their breast milk - these don’t interfere with baby’s own immunisations and in fact may help them work better. You can continue your usual breastfeeding after baby receives immunisations, including the rotavirus vaccine. Mothers can be immunised themselves while still breastfeeding.

SHOW US YOUR

PICTURE THIS

bump 52

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MAYA, 37 WEEKS PREGNANT “My husband and I went out, bought some milk powder, and picked flowers and greenery together to create our own milk bath photo shoot. It cost next to nothing and we had so much fun!” PHOTOGRAPHER: SHAYNE DONGHI

We were blown away by the beautiful, blossoming bump photos you shared with us in our first Show us your BUMP competition! Here are our five winners, and their glorious, gorgeous bumps. Pregnancy BUMP & baby

PICTURE THIS

ELYSE, 38 WEEKS PREGNANT “Interacting with my baby through my tummy was the most magical moment. When I would give my belly a little poke, she would kick or poke back to me. It was like we were talking; she was letting me know she was there.” PHOTOGRAPHER: CHELSEA HAWORTH (CHELSEAHAWORTH PHOTOGRAPHY.CO.NZ)

REAL OR RUMOUR?

MAOPA, 35 WEEKS PREGNANT “I had no expectations, yet pregnancy was the most beautiful and amazing time of my life. Challenging at times, but so worth it. I want to do it again!” PHOTOGRAPHER: ORIWIA SOUTAR (ORIWIASOUTAR.COM)

BRITTANY, 36 WEEKS PREGNANT “My favourite thing about my pregnancy was watching my bump grow. It was exciting just knowing we were getting closer to the arrival of our baby!” PHOTOGRAPHER: CRYSTAL MACKENZIE

Pregnancy BUMP & baby

PICTURE THIS

JOZEPHYR, 35 WEEKS PREGNANT “This pregnancy was the biggest surprise of my life. It’s my third blessing – before this, I had two baby angels. The most magical moment of my pregnancy was waiting until my wedding day to find out the gender of my baby.” PHOTOGRAPHER: KIRIBATI MARSTERS (KMARSTERSPHOTOGRAPHY.COM)

Pregnancy BUMP & baby

S how us your bump Do you have gorgeous pregnancy photos? Send us a beautiful BUMP photo and you’ll be in to win a stunning out-andabout prize package!

BUMP&baby is running a year-long search for beautiful pregnancy photos! Send in yours and you’ll not only be in to win amazing prizes, we’ll also publish all of the winning photos in BUMP&baby magazine!

ENTER AT bumpandbaby.co.nz 42

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BIRTH IS AMAZING

THIS magic

MOMENT 58

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BIRTH IS AMAZING

"MUM-TO-BE HANNAH WAS SIMPLY A GODDESS.

She gave birth at home in Wellington, surrounded by her family. The way she went through each contraction with the help of her mother and the support of her partner Matthew was truly special to witness. The atmosphere where Hannah laboured was so serene, calm, and inviting, but the rest of the home was filled with excitement and eagerness to meet the new baby – big brother and sister had even made a banner saying 'Happy Birthing!' to hang from the window. A divine little boy, Emrys, was welcomed earthside in the early afternoon."

BRINGING YOUR BABY INTO THE WORLD IS AN INCREDIBLY INTIMATE AND PERSONAL EVENT. RISE INTERNATIONAL BIRTH PHOTOGRAPHER OF THE YEAR 2018 TAMARA MILLDOVE (BIRTHANDNEWBORN.CO.NZ) SHARES SOME OF THE STUNNING BIRTHS SHE'S BEEN PRIVILEGED TO CAPTURE ON CAMERA. Pregnancy BUMP & baby

BIRTH IS AMAZING

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BIRTH IS AMAZING

"I LOVE PHOTOGRAPHING THIS FAMILY.

Jennifer and Jamie are filled with pure love and raw emotion when their babies enter the world, and I felt so privileged to be there for the births of both their first and second children. Jennifer had a blissful daytime birth. She worked hard through each contraction, but her family supported her the whole time with lots of laughter, love, and pure contentedness at the joy of a new life. Firstborn Kyron made sure Mummy was taken care of by patting her back and sharing her ice block. There were happy tears and hugs all around when baby Lincoln arrived."

BIRTH IS AMAZING

By the time I got to hospital, she was pretty tired, as Kiran had been working hard. Later that evening, it was decided that for the safety of both mum and baby, a C-section would be best. I was incredibly humbled to be allowed in theatre to capture the birth. It was all very fast – within minutes, baby Rayanne was born, and her parents couldn't have looked more in love when they first saw her. Kiran was so empowered and strong throughout it all. I truly admire her." 62

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ALL PHOTOGRAPHS REPRODUCED WITH KIND PERMISSION OF THE FAMILIES PHOTOGRAPHED BY MATERNITY, BIRTH, AND NEWBORN PHOTOGRAPHER TAMARA MILLDOVE (BIRTHANDNEWBORN.CO.NZ)

"I WAS AND STILL AM IN AWE OF THIS MUM.

"THIS LITTLE BABY GIRL CAME QUICKLY!

Mum Abby laboured like a champion with the help of her partner, two friends, and her midwife. Baby Dylan was born in a lovely, calm water birth surrounded by joyous reactions from her mum's support team. Dylan was quite alert, and I remember thinking how amazing it would be if I could capture her looking at the camera – and then she did it! It immediately became one of my favourite photos."

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BODY OF EVIDENCE Embrac e tho

Making sense of stretch marks

se t

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Why do we get stretch marks, and what (if anything) can we do about them?

tretch marks – most pregnant women get them, and although few seem to be happy about them, they’re known as “tiger stripes” for a reason. Stretch marks are a visible reminder of what your amazing body has done to grow and nurture your baby, which may or may not make you feel better about their appearance during pregnancy. But what are stretch marks, exactly, and is there anything you can do about them?

What are stretch marks? Also known as “striae gravidarum”, pregnancy-related stretch marks are essentially scars that appear in places on your body where the skin is stretched beyond its elastic limit (which physicists define as the maximum force that can be applied to a solid material before the onset of permanent deformation – pretty scientific, right?). Stretch marks appear when your underlying tissue expands (like when you’re growing a baby) and the skin above stretches to accommodate this expansion. Stretch marks usually appear on your abdomen and breasts, and also on your thighs and buttocks – almost anywhere that the skin is stretching beyond its usual capacity. They often look like bluish or reddish streaks.

How do I know if I’ll get stretch marks? Over 90% of pregnant women develop stretch marks. There are a number of factors involved in determining whether you’ll get stretch marks, and how visible they might be. Generally speaking, the younger you are, the more firm your skin is, and this means the elastic limit of your skin is lower – so you are actually more likely to develop stretch marks if you’re a young mum-to-be. Hormones and genetics also have something to do with it. If you develop stretch marks on your breasts as an adolescent, you’re more likely to develop stretch marks on your abdomen during pregnancy. Also, women who gain more weight during pregnancy or who have bigger babies are also more likely to get stretch marks. One study demonstrated that weight gain over 15kg,

Pregnancy BUMP & baby

high BMI, and higher neonatal birth weight were correlated with the occurrence of stretch marks. Other factors include being pregnant with twins or multiples, and going past your due date. But nearly 45% of women develop stretch marks before 24 weeks, so don’t be alarmed if they show up early.

What can I do about stretch marks? Pregnant women throughout the ages have tried various remedies in the hopes of preventing stretch marks. The ancient Greeks and Romans used olive oil, while Ethiopians and Somalis used frankincense. The Japanese use camellia oil. Other natural remedies include aloe vera, apricot oil, macadamia or almond oil, cocoa butter, or coconut oil. Some specially formulated creams and stretch mark products may help to fade their appearance even if they can’t prevent them. Post-pregnancy, some women try laser treatments and microdermabrasion to try to fade the appearance of stretch marks. It’s important that whatever remedy you do try, you only use quality products, and you consult a professional before embarking on something that might potentially be irritating to your skin or damaging to your body.

Will my stretch marks always be so obvious? While some stretch marks stay red or pink, most do eventually fade to white and become less conspicuous in appearance. And take heart that many women who develop stretch marks during their first pregnancy don’t get them in subsequent pregnancies, although never say never. Try to find a way to learn to love your tiger stripes and look at them as evidence of the incredible journey your body has been on during pregnancy and birth – wear them as a badge of honour!

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BEAUTY

3 2

Skip using your fingers and try a rose quartz roller instead. This multi-tasker improves blood circulation and skin tone, and also promotes lymphatic drainage.

Beautiful Dreamer New-season beauty must-haves for mums.

1. Young Living Savvy Minerals Lipstick in Wish RRP$41 2. Elizabeth Arden Limited Edition Fourever Glow Highlighting Powder RRP$72 3. Revlon Color Stay Prep & Protect Primer RRP$32 4. Omorovizca Rose Quartz Roller RRP$111 5. Natural Instinct Rejuvenating Rosehip Oil RRP$22.99 6. Byredo Eleventh Hour EDP 50ml RRP$214 7. rms beauty Champagne Rosé Luminiser RRP$59 8. Bondi Sands GLO Shimmer One-Day Tan RRP$22.99 9. Young Living Savvy Minerals Foundation in Dark No 1 RRP$66 10. Young Living Savvy Minerals Foundation in Warm No 2 RRP$66 11. Smashbox Cali Contour Palette RRP$62

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WE LOVE IT!

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For your face: Natural Instinct Skin Refining Cleansing Oil RRP$24.99

INGREDIENT HERO: ARGAN OIL Extracted from the kernels of Morocco’s argan tree, argan oil is rich in beneficial nutrients including fatty acids and vitamin E, making it great for moisturising your hair and skin naturally.

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Next big thing The latest and greatest in beauty and body trends.

ITCHY SCRATCHY Sensitive skin? Check out AVEENO’s new Skin Relief Gentle Scent Body Wash and Moisturising Lotion (RRP$19.49 each) designed for itchy, dry skin. The dermatologist-tested formulas are clinically proven to be as gentle to sensitive skin as fragrance-free products, and provide instant relief and restore moisture. With naturally active ingredients including colloidal (finely milled) oatmeal and shea butter, they’re scientifically proven to seal in moisture and keep skin hydrated for 24 hours. Soap-free, dye-free, and allergy-tested, they’re a great new option for sensitive skin.

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TRENDING

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There are lots of products on the market which promise to help reduce the appearance of stretch marks, but we’re definitely partial to those with natural ingredients:

NEROLI OIL not only improves the tone and texture of skin, it also increases serotonin levels in the brain, so you’ll feel happier too. Product to try: LUSH Therapy Massage Bar RRP$18.50

ALMOND OIL has a high content of fatty acids that protect skin from drying and improve the skin’s barrier function, keeping it smooth and supple. Product to try: Weleda Stretch Mark Massage Oil RRP$29.90

EVENING PRIMROSE OIL is loaded with vitamin E and also contains gamma linolenic acid, an omega-6 fatty acid that purports to help heal skin. Product to try: Nature's Touch Belly Oil RRP$38

COCOA BUTTER possesses softening, moisturising, and healing properties and is lovely to massage into the skin. Product to try: Palmer’s Cocoa Butter Massage Lotion for Stretch Marks RRP$17.50

ROSEHIP OIL contains fatty acids which convert to prostaglandins that stimulate your skin’s regenerative powers and provide moisture. Product to try: Natural Instinct Skin Drink Body Lotion RRP$12.99

HAIR TODAY, GONE TOMORROW? lush locks you swept back from your forehead while bowing to the porcelain god in the midst of morning sickness are on their way out after your baby arrives – it’s hormones, dahling. But why? During pregnancy, increased levels of oestrogen “freeze” your hair in the growing cycle, meaning that hair you’d normally shed doesn’t do so – meaning your hair is thicker and fuller. And after you give birth, those oestrogen levels decline and all that lustrous hair starts falling out, usually three or four months after pregnancy. So what can you do about it? Enter NIOXIN, the number-one salon brand for thicker, fuller hair, whose award-winning 3-Part Systems Kits are designed to strengthen,

We love: NIVEA SUN UV Face BB Cream with SPF50 RRP$13.99 & Natural Instinct Tinted Face Natural Sunscreen SPF30 RRP$24.95 Kit RRP$69 from salons (visit nioxin.com to find a salon near you).

THERE ARE NO KNOWN SIDE EFFECTS FROM USING NIOXIN PRODUCTS WHILE PREGNANT OR NURSING, BUT ALWAYS CONSULT WITH YOUR PHYSICIAN DURING PREGNANCY, WHEN BREASTFEEDING, OR WHEN UNDERGOING ANY OTHER MEDICAL TREATMENTS.

Did you know that up to 75% of mums experience hair thinning and loss after pregnancy? Yes, those

nourish, and treat hair from its foundation. Check out their consultation tool at nioxin. com/en-EN/consultation-tool to see which kit would best suit your hair, then take the NIOXIN 30-day challenge – cleanse, optimise, and treat your way to thicker, fuller hair.

ATTENTION, SUN ’SHIPPERS It’s super-important to protect your skin from the sun’s rays when you’re pregnant. Increased hormones can cause your skin to become more sensitive, and ultraviolet rays can cause a breakdown of folic acid – not to mention that overheating can cause dehydration and can stress your body (and your baby). Slop on that sunscreen when you are going outside and reapply often to prevent burning. Pregnancy BUMP & baby

Join us online for advice, support, and our Breastfeeding Naturally videos.

BreastfeedingNZ

&baby

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Eating for feeding: NUTRITION FOR NURSING MUMS GET COMFORTABLE: Best breastfeeding positions Is my baby getting enough? HOW TO KNOW PLU S S O M UC H M O R E

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FACT

Each nipple has 15 to 20 tiny openings which release breast milk.

YOUR NIPPLES EACH HAVE A NUMBER OF SMALL OPENINGS WHICH RELEASE BREAST MILK – IT DOESN’T JUST FLOW FROM THE CENTRE LIKE A HOSE! IT’S MORE LIKE A SHOWERHEAD, WITH LOTS OF LITTLE OPENINGS FOR MILK TO FLOW FROM.

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Sometimes your milk flow will be more like a fountain than a tap!

THAT’S AMAZING

Breast milk: THE FACTS Here are some interesting facts you might not have realised about breast milk – and yes, some of them are just plain weird! fact What you eat doesn’t change the composition of your breast milk.

Eating fatty foods won’t make your breast milk richer in fat, and drinking lots of milk won’t increase the amount of calcium in your breast milk – it doesn’t quite work that way. Instead, it’s more important to eat as healthfully as possible, with a varied diet containing lots of nutrients, vitamins, and minerals so that you don’t become depleted.

fact Producing breast milk consumes 25% of a breastfeeding mum’s body’s energy.

It's hard work! Your brain uses 20% of your body’s energy, by comparison.

fact Breast milk contains around 200 different sugars.

When it comes to the chemical makeup of your breast milk, you might be surprised to learn it contains about 200 different sugar molecules – which serve a variety of purposes, from providing sustenance for your baby’s bacterial population in the early days, to promoting the growth of good gut bacteria.

fact Breast milk is more complex than the milk of any other animal.

Remember those 200 different sugar molecules? By comparison, cow’s milk only has 50. And while about 10% of the calories from breast milk are proteins, that number is 50% in cow’s milk. Nobody knows why breast milk is so different to cow’s milk (and goat’s or sheep’s milk, or the milk of any other species) – scientists are still trying to figure it out.

fact Breasfeeing doesn’t always lead to weight loss.

If you’ve been told that breastfeeding will cause you to rapidly drop any weight you gained during pregnancy, try not to count on it, because this doesn’t always happen. Your weight depends on your diet and activity levels, just as it does when you’re not pregnant or breastfeeding, and while the amount of energy it takes for your body to make breast milk doesn’t vary, our activity and the foods you’re eating are still the key to post-pregnancy weight loss. Those early days with a newborn can be exhausting, and you may find you’re resting to conserve energy, or eating extra calories because you feel hungrier now your stomach isn’t being squashed by your baby. However, the longer you breastfeed, the more energy your body will expend – so if you’re making more milk to feed an older baby or toddler, your body will be expending more energy doing so. The bottom line: Some women lose weight breastfeeding, but just don’t depend on it.

fact Curry for dinner? Your breastfed baby might be able to taste it.

Then again, he might not be able to. The flavours of the food you eat can transfer through your breast milk, but not for every breastfeeding mum, and not all the time. This occurs when tiny undigested molecules of the food you’ve eaten pass through your intestinal barrier and then through the cellular system that makes your breast milk. But it doesn’t happen for all mums, and the only way to know is by going ahead and eating that spicy meal, then monitoring your baby’s reaction – and even that’s not foolproof. We say, go ahead and enjoy that delicious curry! Pregnancy BUMP & baby

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fact Smoking negatively affects your breast milk.

Smoking is bad for your health and your baby’s health, and it’s also bad for breastfeeding. Smoking can decrease your milk production, and not only that, it takes more than an hour and a half for your body to get rid of half of the nicotine of one cigarette – so your baby is definitely getting nicotine from your breast milk if you’re smoking. Babies with mums who smoke also have an increased risk of getting colic, not to mention absorbing all of the dangerous chemicals from secondhand smoke. Please, if you smoke, quit for your baby’s sake. Talk to your LMC and visit quit.org.nz for free help.

FACT

Babies drink 67% of the milk in your breasts. BABIES EAT UNTIL THEY’RE FULL, NOT UNTIL YOUR BREASTS ARE EMPTY – ON AVERAGE, THEY CONSUME ABOUT 67% OF THE MILK THAT’S AVAILABLE IN YOUR BREASTS. AND YOUR BREASTS WILL MAKE MORE MILK IF THEY’RE HUNGRIER, TOO.

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fact If you drink coffee, it might just keep your baby up all night.

All right, maybe not all night, but it can make your baby restless because yep, you guessed it: Breastfed babies do, in fact, get caffeine via your breast milk. It takes a newborn 80 hours to metabolise caffeine, so if you have a new baby, you might want to lay off the coffee (or switch to decaf). Older babies may take only a few hours to metabolise it, so you might get away with a cuppa or two without seeing any negative effects. But in general, keep your intake of caffeine to below 60-180mg per day.

fact You need to drink more water when you’re breastfeeding. If you’re breastfeeding, you might notice you’re more thirsty than normal – this is because you actually need more water when you’re breastfeeding. Drink at least one extra glass of water each time you breastfeed to help combat that dry mouth.

fact Your baby can smell your breast milk.

It’s true that your baby can smell you – it’s actually your breast milk she’s smelling! This is why she’ll turn her head and “root” at the breast when she’s hungry.

fact Your milk changes during breastfeeding.

When your baby first starts suckling, she will be getting foremilk, which contains mostly lactose and proteins. As feeding progresses, your breast milk changes to hindmilk, which is made up of fat and is high in calories.

fact Your breast milk glands grow during your second trimester of pregnancy.

Thanks to an increase in oestrogen, lactogen, and other hormones, your breasts start preparing to produce breast milk during your second trimester by growing sac-like milk glands.

fact The removal of your placenta is what triggers breast milk to start being made.

When you give birth to the placenta following your baby’s birth, it triggers the activation of the hormone prolactin, which tells your breasts it’s time to make breast milk.

fact Breastfeeding lowers your baby’s risk of childhood illnesses. Studies show that breastfeeding reduces the risk of ear infections, respiratory infections, gastroenteritis, and other childhood illnesses.

fact Your breast milk doesn’t store alcohol, so don’t “pump and dump”.

Many mums think that if they drink alcohol, they should “pump and dump” their breast milk – but there’s no point, because breast milk doesn’t store alcohol. Alcohol is, however, present in your breast milk, just as it’s present in your bloodstream after you drink it. As a general rule, it takes women two hours to metabolise the alcohol from one standard drink. So don’t pump and dump – either feed your baby pre-expressed breast milk, wait to have a glass of wine between feeds when you know your baby won’t be feeding again for a couple of hours, or wait until your body has metabolised the alcohol before feeding your baby.

THAT’S AMAZING

FACT Your baby can “ tell” your breasts what they need from your milk. WHEN YOU BREASTFEED, A LITTLE BIT OF YOUR BABY’S SALIVA IS PULLED BACK INTO YOUR NIPPLE WHEN SHE’S SUCKLING FROM YOUR BREAST, AND THIS SALIVA CAN “TELL” YOUR BREASTS WHAT ANTIBODIES YOUR BABY’S IMMUNE SYSTEM NEEDS.

This is why it’s important to eat a healthy, balanced diet with lots of vitamins and minerals – so you’re getting enough of the good things your baby needs.

fact No two mums have breast milk that’s the same.

Breast milk is always changing based on your baby’s needs, and it’s individual to every baby! That’s why it’s impossible to duplicate. No two mums have the same breast milk, and the same mum will even have different breast milk every time she breastfeeds her baby.

fact Breast milk contains stem cells.

Stem cells are passed from mother to baby in breast milk and help boost immunity. Research has demonstrated that stem cells from breast milk can now be directed to become other body cell types such as bone, fat, liver, and brain cells.

fact How much milk you produce has nothing to do with your breast size.

It’s all about the amount of breast milk-producing tissue that’s in your breasts. Mums with small breasts can have just as much milk as those with large breasts – and mums with large breasts can struggle to make breast milk too. Talk to your LMC, a lactation consultant, your GP, or your Plunket nurse if you’re concerned you’re not making enough milk.

fact Breastfeeding has longterm benefits for mum’s health.

Mums who breastfeed have lower risks of developing certain types of cancer, including ovarian cancer and breast cancer. They also have lower risks of developing postnatal depression (PND), heart disease, strokes, and Type II diabetes.

Breast milk: It's a magical substance!

fact Breast milk contains the same vitamins that are in Mum’s body.

fact You’re probably right-breasted.

75% of mums produce more breast milk from their right breast, whether they’re right-handed or left-handed.

fact Breastfeeding mums get more sleep.

On average, breastfeeding mums sleep 45 minutes more each night than those who feed their babies formula – possibly due to the time it takes to prepare bottles, while breast milk is ready right from the breast without any prep time needed.

fact Breast milk has healing properties.

Have you ever heard of putting breast milk on your sore nipples to help heal them? Breast milk contains special infectionfighting substances, antibodies, healthy bacteria, white blood cells, microbials, and more, and can help to heal your cracked or grazed nipples, so massage some breast milk on the sore spots to help speed up recovery. Pregnancy BUMP & baby

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Set up for success

Breastfeeding may be natural, but it’s not 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 some of the experts.

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READY, SET, BREASTFEED

Som et i m es y

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tip Get the right latch

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 a lactation consultant if you need advice on latching, breastfeeding positions, and to reassure yourself that baby is feeding enough.

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 your baby is latched correctly, you should feel a gentle, pulling sensation on your breast. You’ll know your baby is swallowing when his temple and lower jaw move rhythmically and you hear him take a breath after he swallows. If your baby doesn’t latch correctly, you could end up with cracked, bleeding nipples.

tip Try different

positions

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

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tip Dealing with painful,

tip Look after your nipples

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

engorged breasts

Shortly after baby is born, your breasts will flood with milk and may become engorged, red, and tender, making it difficult for your baby to latch on correctly. Feed your baby as soon after birth as possible and avoid giving him 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

tip Create a

breastfeeding station

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, 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 pacifier. Release your 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 your baby’s tummy, be sure to burp him well after and during feeds.

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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 your baby is not as hungry. That way you’ll have a stock of breast milk you can store in the fridge or freezer so your partner can feed your baby, too.

READY, SET, BREASTFEED

tip Wear practical

breastfeeding clothing

tip Watch for thrush THRUSH IS A FUNGAL INFECTION THAT CAN DEVELOP ON YOUR BREASTS AND PASS TO YOUR BABY’S MOUTH. SYMPTOMS INCLUDE SORE, ITCHY, OR CRACKED NIPPLES, AND ACHY BREASTS. IF YOU NOTICE LITTLE WHITE SPOTS IN YOUR BABY’S MOUTH OR HE HAS NAPPY RASH THAT WON'T CLEAR UP, SEE YOUR GP AS YOU’LL NEED TO TREAT YOUR BREASTS AND BABY’S MOUTH WITH A PRESCRIPTION ANTIFUNGAL. TO PREVENT THRUSH, AIR-DRY YOUR NIPPLES, USE BREAST PADS, WEAR A CLEAN BRA EVERY DAY, AND REDUCE THE SUGARY AND YEASTY PRODUCTS IN YOUR DIET.

tip Finding 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 could 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 your baby. Try taking a warm shower, sitting somewhere quiet, listening to relaxing music, or taking deep breaths while baby is feeding.

tip Don’t give up

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

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 THAT MAKE IT EASIER TO BREASTFEED YOUR BABY, AND IF YOU’RE CONCERNED ABOUT FEEDING IN PUBLIC, USE A SOFT SHAWL OR MUSLIN TO DRAPE OVER YOUR SHOULDER AND COVER UP YOUR BABY WHILE YOU'RE BREASTFEEDING.

tip Remember to eat

It’s easy to become so focussed on your new baby that you forget to look after yourself. But you’ll need at least 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. You may also want to bump up your vitamin intake with a multivitamin.

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Is it safe to express breast milk before giving birth? Some women, especially those with diabetes, are recommended to express milk while still pregnant and to save it for their newborn. But it’s not for everyone.

ome hospitals are advising women to collect this milk in the last weeks of pregnancy, ready to give to their newborn baby, if needed. Midwives, doctors, and lactation consultants may suggest this in particular to women with diabetes in pregnancy. Although collecting colostrum before giving birth is not new, it is now more widely promoted. Yet there has been little research on the practice. And some people are concerned that collecting it when pregnant could bring on labour early, potentially increasing the risk to mother and baby. So is it safe for women to collect their own colostrum while pregnant? And are there some situations that are more risky than others?

WHAT IS COLOSTRUM AND HOW DO WOMEN COLLECT IT? Colostrum contains high levels of antibodies, the proteins that not only fight infections but program a baby’s immune system for life. We don’t know why some women’s breasts start producing colostrum in pregnancy; many women won’t have any until after they give birth. If women are advised to collect colostrum while still pregnant, they usually “express” these early drops of fluid by stimulating their nipples by hand rather than using a breast pump. The amount women collect varies from nothing, to a few drops, to a teaspoonful or more. They collect it in a syringe or small sterile jar, which they store in the freezer at home. They then bring it (still frozen) to the hospital when they give birth, where it is thawed if needed to give to the newborn baby while he or she is one or two days old.

WHY DO WOMEN COLLECT IT? The most common reason why women consider expressing colostrum early is if they have diabetes in pregnancy, whether that’s existing diabetes or diabetes that only came on while

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HEALTH CHECK

THE MOST COMMON REASON FOR WOMEN CONSIDERING EXPRESSING MILK WHILE PREGNANT IS IF THEY HAVE DIABETES.

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LATE IN THEIR PREGNANCIES, SOME WOMEN NOTICE COLOSTRUM (EARLY MILK) LEAKING FROM THEIR NIPPLES.

Other women may want to express milk before giving birth because they had a low milk supply with a previous baby or they know their baby has a medical condition that might make it hard to breastfeed well, like a heart condition. While there can be short-term benefits to newborn babies from being fed colostrum expressed before birth, no one has studied if there are any longer-term benefits. There also doesn’t seem to be much difference between the quality of the colostrum expressed before birth and colostrum expressed 24 hours afterwards.

FACT A RECENT STUDY FOUND ONE IN FOUR

RISKS TO MOTHER AND BABY

By stimulating their nipples and expressing milk while pregnancy, women could bring WOMEN COULDN'T COLLECT ANY COLOSTRUM on contractions and give birth early. This is WHEN TRYING TO EXPRESS WHILE PREGNANT. because nipple stimulation leads to an increase in the hormone oxytocin, which plays a role in both milk let-down and contractions. pregnant (pregnancy-onset or gestational diabetes). For this reason, women who need a Caesarean (for instance, Before birth, all babies receive a continuous supply of food if their baby is not “head down” or if they have had previous in the form of glucose from their mother. This stops suddenly Caesareans) have been advised not to express while pregnant. at birth and as babies transition to life outside the womb, they Another concern is that stimulating the nipple and the have a period of low blood sugar (hypoglycaemia). increased contractions could reduce blood flow to the womb. However, this adaptation to outside life takes longer for babies So, expressing while pregnant is not recommended when of mothers with diabetes. About one in four or five of these babies the foetus is not growing well, or has other medical conditions develop hypoglycaemia soon after birth. If untreated, this could such as macrosomia (excessive weight), or there is too much cause seizures or brain damage. fluid in the womb. To treat hypoglycaemia, these babies are often supplemented with infant formula since mothers’ milk does not “come in” for IS IT RIGHT FOR ME? a couple of days after birth. A study by researchers at La Trobe University and the University While breast milk is much better than formula at bringing of Melbourne which was recently published in the Lancet found blood sugar to normal levels, there may not be enough milk in the that expressing while pregnant is safe for women with diabetes in breast to boost the newborn baby’s blood sugar levels. So babies low-risk pregnancies in late pregnancy (from around 36 weeks). of women with diabetes are more likely to be admitted to a special After studying over 600 women, the study found no increase in care nursery for treatment. But if the mother has a small supply early births or admissions to neonatal intensive care. However, of breast milk ready to feed the baby – a few millilitres in a syringe one in four women couldn’t collect any colostrum. or spoon – they could avoid this. Before this trial, researchers had only run three small studies If the mother has collected colostrum before birth, the newborn of expressing colostrum while pregnant, and no randomised trials baby may also be less likely to need infant formula, which has for women without diabetes. a number of risks to the immature gut. Giving formula based on So if you have questions about expressing while pregnant, cow’s milk to newborns may also increase their risk of allergies ask your health care professional about your individual situation. and developing diabetes themselves. They are best placed to discuss the risks and benefits.

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AUTHORS: LISA AMIR (ASSOCIATE PROFESSOR IN BREASTFEEDING RESEARCH, LA TROBE UNIVERSITY), ANITA MOORHEAD (TRIAL COORDINATOR, LA TROBE UNIVERSITY), DELLA FORSTER (PROFESSOR OF MIDWIFERY AND MATERNITY SERVICES RESEARCH, LA TROBE UNIVERSITY), SUSAN WALKER (PROFESSOR OF OBSTETRICS AND GYNAECOLOGY, UNIVERSITY OF MELBOURNE). REPUBLISHED FROM THE CONVERSATION (THECONVERSATION.COM/HEALTH-CHECK-IS-IT-SAFE-TO-EXPRESS-MILK-BEFORE-GIVING-BIRTH-78399)>

S BREAST

tommeetippee.co.nz

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Making milk Ever wondered how breast milk changes in your baby’s first few weeks? From colostrum to mature milk, it takes time for your breast milk to change, but it’s always providing your baby with just what they need at the time.

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MILK IT

Days 1-2: Colostrum

The first milk your breasts will produce after your baby is born is called colostrum. Colostrum is usually a creamy yellow colour (part of the reason it’s called “liquid gold”) and is thick and sticky. You won’t produce much colostrum, but what you do produce is extremely rich in fat-soluble vitamins, protein, minerals, and antibodies. It’s the perfect “first food” for your baby, as its rich composition helps to keep your baby satisfied in those early days when their little tummy can only hold about five millilitres at first! Colostrum looks different to mature milk because it’s tailored to what your newborn needs in those first 24-48 hours of life. Don’t panic if you think you’re not producing very much milk at this stage, because it really is worth its weight in gold for what it is giving to your baby.

Days 2-14: Transitional milk

As your baby learns to suckle at the breast, your colostrum will start to change from thick and yellow to a lighter yellow colour. At some point in the first two weeks of your baby’s life, colostrum will gradually transition to being mature milk – but while it’s doing so, you may notice that the quantity of your milk starts to increase in demand to your baby’s desire to feed. This happens because the level of the hormone progesterone decreases in your body following your baby’s birth. Your baby is still getting just the right levels of vitamins, minerals, and antibodies to meet their needs, so don’t worry that your milk isn’t “quality” – it is! Your breasts are just learning to build up their supply of milk in response to your baby’s needs.

FACT IN THE FIRST

I’M WORRIED ABOUT MY MILK SUPPLY!

There are a number of products on the market which are said to help breastfeeding mums increase their milk supply – lactation cookies and teas, herbal supplements, vitamins, and more. But your first port of call should always be your LMC, Plunket nurse, or another medical professional, who can help to answer your questions about how much milk your baby needs, how breastfeeding is going for you, and what to do if you feel like you are not producing enough breast milk. Don’t go rogue – talk to a professional first.

Day 14+: Mature milk

At some stage around the two-week mark following your baby’s birth, your milk will become lighter in colour and also greater in volume! You may find that you can produce quite a lot of breast milk at each feed, and that your breasts will ache, leak, and feel “full” when it’s feeding time. Your baby will have learned how to feed more efficiently by this point, and you’ll see them gulping and swallowing a lot more as they drink. Your milk production will continue to increase during the first month, and will change in response to your baby’s growth and needs. Mature milk consists of foremilk and hindmilk: FOREMILK: Often watery, sometimes bluish in colour, this milk flows at the start of your baby’s breastfeed and will quench their thirst, but is low in fat and high in protein and lactose (milk sugar). It’s important to keep your baby latched on and drinking until the hindmilk starts flowing. HINDMILK: This is higher in fat and calories and will satisfy your baby’s hunger. It flows after the foremilk as you continue to feed your baby. Mature milk is a “living fluid” and contains ingredients that are specifically tailored to your baby – for example, if your baby gets an infection, the proportion of white blood cells in your milk will increase to fight it off. Pretty amazing!

24 HOURS AFTER YOUR BABY IS BORN, YOU WILL PRODUCE ABOUT 30ML OF COLOSTRUM. Pregnancy BUMP & baby

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Your guide to breastfeeding Breastfeeding may seem daunting, but remember, both you and your baby will need to learn how to breastfeed successfully. Give yourselves some time to figure it out. 86

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he Ministry of Health recommends exclusive breastfeeding for the first six months of your baby’s life. Exclusive breastfeeding means that, since birth, your baby has only had breast milk (from the breast or expressed) and prescribed medicines. Try to breastfeed your baby exclusively until they are around six months old. If your baby is exclusively breastfed, they don’t need water or any other drinks or food until they’re around

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It's your right to feed your baby anywhere, any time, and any place!

Breast milk = good for baby, good for you Breast milk is the perfect food for your baby because: • It’s all that your baby needs to eat and drink for about the first six months. • It helps to protect your baby against colds, tummy bugs, infections, and allergies. It also helps to protect your baby from dying suddenly in their sleep. • Breastfeeding helps your baby to feel safe and secure.

This skin-to-skin contact with you after birth is good for your baby’s physical health and helps you to bond with each other. Skin-to-skin contact is the best way to keep your baby at the right temperature and it encourages the baby to start breastfeeding. You and baby will spend some time recovering from the birth. Within an hour, your baby will start to show interest in breastfeeding. Baby will: • Feel the warmth of your body. • Feel your body rhythms. • Recognise your voice. • Smell the breast. • Start to push upwards towards the breast. • Open their mouth. • Suck their tongue. Your midwife will help you to position your baby for breastfeeding and make sure that baby has a good latch on your breast.

THE FIRST MILK: COLOSTRUM six months old. After six months, exclusive breast milk is not enough on its own for your baby to grow and develop. You should start your baby on solid food and also continue breastfeeding until they’re at least one year old. When you’re away from your baby, try to ensure that they’re fed with expressed breast milk rather than infant formula.

PREPARING FOR THE FIRST FEEDS Newborn babies are placed straight onto their mothers as soon as they are born.

It’s important in the first few days that your baby feeds whenever they need to, so that they get the first milk, or colostrum. Colostrum is the first milk that your baby gets. This special milk is yellow in colour and is thick and sticky. Colostrum protects your baby from infections and gives your baby their first food. Your baby feeds on colostrum for the first few days until your milk "comes in". This is when your breasts start making more milk and the milk changes from thick and sticky colostrum to normal breast milk, which is thinner and whiter.

Breastfeeding is perfect for you too because: • It gives you a chance to rest while you are feeding your baby. • It helps you to feel close to your baby. • It saves you time. • It’s free. • It may reduce your risk of some cancers and bone disease.

BABY’S HUNGER SIGNS Babies will show hunger signs when they are ready for a breastfeed. These may happen with eyes closed or open. The hunger signs are: • Rooting around with the mouth – opening the mouth and moving the head as if looking for the breast. • Sucking movements and sucking sounds – often quite soft sounds. • The tongue coming out of the mouth and almost licking the lips. • Hand-to-mouth movements. • Sucking the fingers or hand. • Opening the mouth and possibly turning the head in response to a touch around the mouth area. These signs are often called early hunger signs. If you miss these early hunger signs, your baby will cry. Crying is a late hunger sign. Try to not let this happen, or your baby may be too upset to feed well.

HOW LONG ON EACH BREAST? Different women find different ways to breastfeed, but as a general guide: • Feed your baby from one breast for 20 to 30 minutes. • Change your baby’s nappy, then feed your baby from the other breast. • Remember to start the next feed on the breast that you last fed from. • New babies need to feed about eight to 12 times every 24 hours. This means that you will be feeding your baby during the night. Some days your baby will need more feeds. Pregnancy BUMP & baby

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HOW TO BREASTFEED

A good latch is the key to successful breastfeeding. Babies should be breastfed “tummy to tummy”. If you can see your baby’s tummy button, they’re not turned close enough to latch well. Make sure that: • You bring baby in close. • Baby’s head is tilted back. • Baby’s mouth is wide open. • Baby’s tongue is forward and right down. • Baby’s chin touches your breast and baby’s nose lines up with your nipple. • Gently tickle the top part of baby’s lip with your areola (the darker area around the nipple). Bring your baby to your breast quickly so the bottom lip is pushed back to form a suction cup. Let your baby take in a large mouthful of breast, not just the nipple.

Let your baby take in a large mouthful of breast, not just the nipple.

DOES BABY HAVE A GOOD LATCH? Your baby’s chin will be touching the breast but their nose should be reasonably clear. Baby’s bottom lip will be turned outwards and not turned inwards. They’ll be sucking quite quickly, but once the milk starts to flow they’ll change to rhythmic, longer sucks with some short pauses. You’ll also start to hear baby swallowing – this will happen more as your milk comes in and flows more. Your baby’s cheeks should stay rounded when sucking.

FEELING COMFORTABLE If it doesn’t feel comfortable – start again. Slip your finger into the corner of your baby’s mouth between their gums, with the soft side (not the nail) next to the lip so that you gently break the suction. If you let your baby suck the wrong way, it can cause problems. If you feel pain in your nipples or breasts, ask your midwife for help.

POSITIONING YOUR BABY There are different ways that you can hold your baby to breastfeed – find the ones that are comfortable for you. Cross-cradle position: It’s often easier to start breastfeeding by holding the baby in

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the cross-cradle position. This means that the baby’s head is supported with your hand at the base of their neck. The position of your hand is important as the baby needs to be able to tilt their head back slightly. Make sure that your arm or hand is not behind the baby’s head, or they might not be able to tilt it back. Your other hand is supporting your breast. Cradle hold: Once baby is latched well, you can change to a cradle hold, which might be more comfortable. Release your hold on your breast (unless it is very heavy and full, in which case you may need to support it during the feed – see the underarm/ rugby hold below) and move your arm gently around the baby. Underarm or rugby hold: The underarm or rugby hold can also be useful if your breasts are heavy, as the weight is partially supported by the baby. Also, using a lying-down position or the underarm or rugby hold can be useful if you’ve had a Caesarean.

IF YOUR BREASTS FEEL SORE AND HARD (ENGORGEMENT) Many women’s breasts start to feel full, sore, and hard as their milk supply increases (the milk "comes in"). This

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tip Look after yourself YOU NEED TO LOOK AFTER YOURSELF WHILE BREASTFEEDING, WHICH MIGHT MEAN ASKING OTHERS TO HELP YOU. MAKE SURE THAT YOU EAT A WELL-BALANCED DIET AND DRINK LOTS OF WATER. AVOID ALCOHOL, CAFFEINE, AND SMOKING, AS THESE CAN AFFECT YOUR MILK SUPPLY AND YOUR BABY’S HEALTH.

feeling is most common three to five days after baby’s birth. If your breasts are really sore and hard, and feel too full, it helps to put something cool on them after a feed. This can reduce the hot, swollen feeling. If your baby is finding it tricky to get a good latch, you can hand express a little milk first. This will soften the areola (the darker area around the nipple) so that it’s easier for baby to latch – and less painful for you.

BLOCKED MILK DUCTS OR MASTITIS Talk to your midwife or doctor straightaway if you feel unwell and part of your breast is red or feels sore, hot, or lumpy. You may have a local inflammation caused by a blocked milk duct or a more general breast infection (mastitis). It is better for you and baby if you continue breastfeeding. It is important to empty the sore breast; if this is too hard to begin with, feed from the other side until the sore side "lets down". Be sure to empty the sore side by feeding or pumping. Massaging the sore area gently at the same time can help, as does warming the breast before feeding. Emptying the breast will help to reduce the blockage and keep your milk flowing. It is important that you have bed rest for at least 24 hours and that you drink plenty of fluids. Keep the sore area warm with a wheat pack or wrapped hot water bottle, or cold pack if preferred – whatever will help you to feel more comfortable. Your doctor may prescribe an antibiotic to reduce the inflammation, but if caught early, this is not usually necessary. Wear a supportive bra that does not cause painful pressure. Some babies will be able to empty both breasts every time they feed. Others will be full after one. Although babies often prefer one breast, make sure that baby feeds from both breasts throughout the day to avoid blocked milk ducts.

BREASTFEEDING IN PUBLIC Breastfeeding is the perfect way to feed your baby when you’re out. Breast milk is free, fresh, and requires no preparation. It’s your right to feed your baby anywhere, any time and any place. Some mums might be shy, but breastfeeding is part of everyday life – it’s not something that should be hidden away. Here are some tips if you feel a little uncomfortable. • Get the support of friends and whanau. Ask them to sit with you in a café or on a bench in a shopping mall while you feed your baby. • Be comfortable. Before you start, make sure that you have somewhere to sit that is comfortable and has back support. • Practise before you go out. Try breastfeeding your baby in front of a friend or the mirror to practise your technique and see what works best for you. • Wear the right clothing. Wear a nursing bra that can be undone with one hand. Tops that are easy to pull down or push up can also help. You can cover up using a large wrap, muslin, shawl, or blanket draped around your shoulders. • You could also try a baby sling or carrier. Make sure that your clothes are easily adjustable so that you can feed your baby without having to take the sling off.

Sore nipples

You may have sore nipples until your breasts become used to breastfeeding. Nipples are usually most sore in the first week after baby’s birth. They should feel better seven to 10 days after baby’s birth. During that first week, the initial soreness should wear off 15 to 30 seconds after the baby has latched. If it doesn’t, ask your midwife for help. You may need help with positioning and latching your baby. If nipple soreness continues into the second week, or gets worse rather than better, get help. If there is a problem with baby’s latch this can be corrected, or the soreness may be due to another issue.

DRINKING ALCOHOL Alcohol passes through your breast milk to your baby, so you should avoid it while you are breastfeeding. Drinking alcohol can also lower your milk supply and it might make your baby irritable, unsettled or sleepy, and not able to feed well. If you do have a few drinks, make sure that you avoid breastfeeding for at least a couple of hours afterwards. You could use expressed milk instead. If you choose to drink, make sure that your baby has someone looking after them who is alert to their needs and free from alcohol or drugs.

FOR MORE HELP OR INFO • Breastfeeding NZ YouTube Channel youtube.com/user/breastfeedingnz • Breastfeeding NZ Facebook Page facebook.com/breastfeedingnz • La Leche League lalecheleague.org.nz • HealthEd healthed.govt.nz • Ministry of Health health.govt.nz Reprinted with permission of The Ministry of Health (health.govt.nz) Pregnancy BUMP & baby

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Lactation-boosting recipes R ALL M

BREASTFEEDING COOKIES

Looking to increase your milk supply? Eating galactagogue ingredients may help. Nadia Lim shares these two delicious recipes to try.

Makes: 18-20 cookies Prep: 10 minutes / Cooks in: 12-14 minutes Oats, fennel, brewer’s yeast, and flaxseed are all considered to be galactagogues – in other words, substances that promote lactation in animals and humans. So, when I was a new breastfeeding mum, I created a recipe using all these ingredients in a cookie! They’re the perfect snack for when you’re up at night breastfeeding (I had a little cake tin of them by my feeding chair!). They’re so tasty my husband Carlos was always eating them, though! • 2¼ cups rolled oats (make sure you use fine rolled oats, not the large jumbo rolled oats) • ½ cup brown sugar, firmly packed • 1-2 tablespoons brewer’s yeast/ savoury yeast flakes • 2 tablespoons ground flaxseed or LSA • Good pinch salt • 1 tablespoon fennel seeds, lightly toasted and ground* • 1 teaspoon ground cinnamon • 100g butter, melted (or coconut oil for dairy-free) • 1 egg

1. Preheat oven to 180°C. Line a baking tray with baking paper. 2. Place all ingredients in a mixing bowl and mix together until well combined. 3. Roll tablespoons of mixture into balls and place on prepared baking tray, evenly spaced apart. Use a fork to gently flatten cookies. 4. Bake for 12-14 minutes until light golden. Leave cookies to cool. Enjoy a couple with a glass of milk! They will keep for up to a week in an airtight container, or can be frozen.

Place fennel seeds in a fry pan and toast on medium heat for a few minutes until light golden and fragrant. Finely crush/grind in a mortar and pestle.

Nutritional information (per serving) Kilojoules 452 / Calories 107 / Carbs 10.4 g Sugar 3.9 g / Total fat 6.1 g / Protein 2.6 g

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tip To make dairyfree, use coconut oil instead of butter if you are avoiding dairy.

tip Brewer’s yeast can be found in the health food section of the supermarket, or a health food specialty store.

RECIPES

tip To make dairy-free, use almond or soy milk.

HOT FENNEL AND HONEY MILK DRINK Serves: 1 / Prep: 5 MINUTES / Cooks in: 5 MINUTES This simple hot milk drink is perfect snack for breastfeeding mums, containing fennel seeds (a known galactagogue which promotes lactation), cinnamon, and honey. • 1 teaspoon fennel seeds (or alternatively you can use ground fennel) • 1 cup milk • 2-3 teaspoons honey • 1 teaspoon ground cinnamon

1. Place fennel seeds in a fry pan and toast on medium heat for a few minutes until light golden and fragrant. Finely crush/grind in a mortar and pestle. (Note: You can do a few tablespoons of fennel seeds at a time and keep aside for more milk drinks.) 2. Add milk to pan, along with crushed fennel, honey, and ground cinnamon, and stir until milk is warm/hot (but do not let it boil). Pour into a mug and enjoy with a cookie!

Nutritional information (per serving) Kilojoules 916 / Calories 216 / Carbs 26.4 g Sugar 25.5 g / Total fat 8.3 g / Protein 9 g Recipes courtesy of Nadia Lim. For more nourishing recipes for new mums, visit nadia.co.nz Pregnancy BUMP & baby

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Nutrition for nursing mums Thanks to our knowledgeable friends at Huggies (huggies.co.nz) and nutritionist Leanne Cooper from Cadence Health, here’s (almost) everything you ever wanted to know about what you should be eating while breastfeeding.

s an adult, there is unlikely to be any other time in your life where you require so many extra nutrients. It only takes a few glances at your baby, who can appear to grow overnight, to realise that if you are their single source of nutrition, you are going to have to put some extra nutrition into your diet. Skipping meals, taking shortcuts, or overdoing things can quickly take a toll, and remember a happy,

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healthy mum makes parenting a whole lot easier. Having said that, nursing mothers are not exempt from imperfect eating habits, and if you look at the overwhelming numbers of infants being raised in sub-optimal living conditions around the world, it becomes clear that only severe and prolonged restriction significantly alters breast milk. Mother Nature has made food for babies very resilient, so that our future has the best chance.

EAT TO FEED

YOU MAY HAVE NOTICED A FEW EXTRA LUMPY BITS AROUND YOUR THIGHS AND BOTTOM. THE GOOD NEWS IS THAT PART OF THE ENERGY NEEDS FOR BREASTFEEDING CAN BE MET BY THESE CLEVER LITTLE STOCKPILES.

HOW MUCH MORE IS ENOUGH?

All in all, we are not absolutely sure of how many kilojoules any one nursing mum requires. Research tends to suggest that women who maintain a stable weight while breastfeeding take in about an extra 2,500 kJs/d (around 590 calories). Current government recommendations are an extra 2,000 – 2,100 kJ/d. Factors such as dietary habits, weight gain during pregnancy, method of feeding (exclusive or

complementary), ethnicity, health status, and activity levels all need to be accounted for. I know that doesn’t make it sound easy. The best guide is you and your body. Avoid being hungry, monitor your energy levels, eat a healthy, varied diet, and make adjustments as needed. Stick to whole, natural, and unprocessed foods where possible, and keep in mind that eating a wide variety of food appears to expose your baby to a wide array of tastes that may assist with eating habits later.

Breastfeeding generally creates an appetite: If you find that you are uninterested in food or if you are in any doubt, chat to your Plunket nurse or see an appropriate health care professional. It’s probably worth noting that in order to produce milk, you don’t require any special food yourself – such as milk, for example. The amount of breast milk you make is by and large a function of demand; that is, if your baby requires more milk, your body responds by making more available. So if your baby is going through a growth spurt, offering an additional feed will mean that your body will, over the course of a few days, produce more milk. Based on an average milk production of about 850ml a day, breastfeeding may mean you need an extra 2,000-3,000 kJ per day (around 600 calories a day). There is, of course, a huge variation from one mum to the next, but this gives you a rough guide. You may have noticed a few extra lumpy bits around your thighs and bottom. The good news is that part of the energy needs for breastfeeding can be met by these clever little stockpiles (usually around 2-4 kg) that have been deposited prior to your baby arriving. That’s just one of the many benefits of breastfeeding. Almost all nutrients are required in greater amounts in order to supply breast milk with its power-packed nutrition and, in many cases, additional calories are also required. If you are already eating a very healthy nutrient-packed diet, then you may simply need to eat a little more, whereas others may need to make dietary changes to ensure they gain the increased nutrients. It’s believed that only severe and prolonged restrictions to intake significantly affect breast milk. Rather, deficits tend to affect Mum, so perhaps you could say the effect on your baby is indirect. Most mums will agree when they feel rested (don’t scoff, it can happen sometimes), healthy, and well-nourished, parenting can be a whole lot easier. Pregnancy BUMP & baby

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COMPARED TO PREGNANCY

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590 calories is about the size of a low-fat meal; the ideas below are just 250 calories, so you can see 500+ calories is a reasonable-sized meal. • Pita bread and hummus • Banana smoothie • Toasted sandwich • Bowl of cereal and some yoghurt • Egg and toast Many mums find eating small additional snacks the easiest option. It can be less taxing and time-consuming to grab a snack than to prepare a meal. Some snacks include: • Smoothies • Nuts and dried fruit • Cream cheese bagel • Toasted cheese sandwich • Baked beans on toast 5 • Egg on toast • Salmon and cream cheese bagel • Fruit and yoghurt So next time you pop on to the 5 -7 sofa and “assume the position”, grab a healthy snack to nourish you both. Do this at least twice in the day and you will be doing nicely.

THE NITTY-GRITTY DETAILS

Don’t be too focused on numbers, as that’s truly not what eating is about. Focus instead on quality, nutrient-dense meals at regular intervals. An increase in total food intake, if from healthy options, will generally go hand-in-hand with an increase in most nutrients. Nursing mums don’t need extra stress from number-crunching RDIs and so on. For those who like to know, the following details reflect the nutrients that are required in greater quantities; the figures in the brackets are the RDIs during lactation.

PROTEIN (67mg/d) Increased protein requirements to account for the production of immune substances and amino acids for development of tissue. Up to 70% of protein is utilised in milk production. Protein requirements increase to 1.1g per kg of body weight.

VITAMIN A (1100µg/d) Also required for tissue production. Pregnancy BUMP & baby

EXTRAS

Amounts of foods required to meet at least 70% of the RDIs for nutrients for lactating women. Amounts based on an energy range of 9200-12300 kJ/d.

0-2.5 • 1 doughnut • 3 sweet biscuits • 25g of chocolate

MEAT/EQUIVALENTS

• 65-100g cooked meat • 80-120g cooked fish • 2 small eggs • 65-100g cooked legumes

1.5

DAIRY

• 250ml milk • 200g pot of yoghurt • 40g or 2 slices of cheese

VEGES

• 1 cup of cooked veges (75g) • 1 cup of salad • 1 small potato

5-6

FRUIT

• 1 medium piece of fruit (150g) • 2 small fruits • About 8 strawberries • About 20 grapes or cherries

BREADS/CEREALS

• 2 slices of bread • 1 cup cooked rice, pasta, noodles • 1 cup of breakfast cereal • 1 cup of porridge

4 4 -6

For a more comprehensive guide, use the food groups and serving guides above (see also healthed.govt.nz for Healthy Eating booklets).

The RDI is based on the transfer of about 425µg per day to baby, hence the increased requirement is +400µg per day.

based on the amount that appears in breast milk and the increase in energy demand from breastfeeding.

VITAMIN C (85mg/d)

RIBOFLAVIN (1.6mg/d)

Breast milk contains a concentration of vitamin C and, on average, there is 50mg/d secreted into breast milk. Interestingly, though, the levels in breast milk are reasonably stable.

Also increased and based on energy demands; this is currently at 0.5mg extra per day.

VITAMIN D Also emerging as a health concern, particularly in populations who have dark skin and those who are veiled or housebound. While the upper limit (UL) is unchanged from 80µg/d across the lifespan, it is important to ensure that these at-risk groups are monitored. The adequate intake (AI) is given to be 5µg/d across all age groups.

THIAMINE (1.4mg/d) The B-group vitamins are integral in the energy production that is required in order to produce milk. The increase of 0.3mg/d is

NIACIN (17mg/d) Niacin, too, is required for lactation (about 1mg/d), and along with the amount in breast milk (around 1.4mg) it is estimated that an additional requirement of 2.4mg/d is expected.

VITAMIN B6 (2mg/d) Required at +0.6mg/d due to the role of B6 in protein production and the level found in breast milk.

VITAMIN B12 (2.8µg/d) Required at +0.4µg/d based on about 0.33µg in breast milk. It is important to note that vegan mothers should be monitored to ensure access to B12.

SOURCE: FOOD FOR HEALTH, DIETARY GUIDELINES FOR AUSTRALIANS; A GUIDE TO HEALTHY EATING, AUSTRALIAN GOVERNMENT, DEPT OF HEALTH AND AGING, NHMRC 2005

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WHAT DOES THAT EQUATE TO?

SERVES PER DAY

Food groups

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EAT TO FEED

Smoothies are power-packed

One way to pack a bunch of superfoods into one meal is via a smoothie. Smoothies are one of the best snack foods. The combination of natural yoghurt, your choice of milk, ground nuts and seeds, and some berries will help you maintain your fluid intake, and adding in the extra calories will likely meet many of your other nutrient needs.

SUPERFOODS MAY HELP

Research consistently shows that to prevent disease, to live longer, or to just be healthier, we need to eat fruit and vegetables, whole grains, and healthy fish; do regular exercise; and avoid smoking and alcohol. There is some argument for supplements such as fish oils and certain other nutrients that are low in our diets, so it is best to get advice on these.

FOLATE (500µg/d) A deficiency of folate shortly after giving birth is quite common; an increased requirement is suggested to be 100µg/d. Foods rich in folate include green leafy vegetables, legumes, nuts, beans and other vegetables. When folate is added to food it’s known as folic acid, and many labeled products are now fortified with B9. Many of our breakfast cereals, breads and juices are fortified with folic acid.

IODINE(270µg/d) IODINE Iodine has recently been emerging as a deficiency concern in Australia and New Zealand, and is essential for normal growth and development. The RDI rises considerably by 120µg /d. Foods rich in iodine include oysters, sushi (containing seaweed), canned salmon, bread with iodised salt, snapper, some cheddar cheeses, and eggs.

IRON (9mg/d) Iron is one of the few nutrients required in lesser amounts, at least until your

As well as eating a wholefood diet of mostly unprocessed foods, we should consider certain foods that rate particularly highly for their health-giving benefits; we might call them "superfoods". If you were to ask 10 nutritionists what they consider to be the top 10 superfoods, you are very likely to get 10 very different answers. However, we know for sure that some foods pack more of a punch than others in terms

of nutrient profile and beneficial compounds including antioxidants. When you pool the findings, there are some very definite superfood contenders. • Fish, especially those high in omega-3 oils such as salmon. • Many veges, particularly those that are strongly coloured such as dark green vegetables like broccoli, or orange vegetables like carrots, as well as those that are aromatic, such as garlic. • Fruit, particularly berries and tomatoes, and those rich in vitamin C, such as acerola and red capsicums. • Nuts, seeds, and foods rich in oils such as almonds, flaxseeds, and avocado. • Herbs are finally beginning to be credited as superfoods, something many cultures have known for a very long time. • Yoghurt for healthy bacteria.

What about extra calcium?

CALCIUM LEVELS ARE FAIRLY STABLE DUE TO A NUMBER OF PHYSIOLOGICAL CHANGES IN YOUR BODY, SO THE AMOUNT REQUIRED IS UNCHANGED. DURING LACTATION, YOUR BODY IS BETTER ABLE TO ABSORB CALCIUM FROM FOOD IN THE INTESTINES, PLUS THERE IS AN INCREASED BONE TURNOVER (WHICH IS REPLENISHED DURING WEANING) AND POSSIBLY AN INCREASED RETENTION OF CALCIUM. ALTOGETHER, THIS AIDS CALCIUM BALANCE. THE RDI FOR CALCIUM IS 1000MG/D. menstrual cycle is reestablished. The RDI drops to 9mg/d for the first six months. The iron intake in the maternal diet is not reflected in breast milk, even under supplementation. Women who experienced issues related to iron status during pregnancy should also consult a healthcare professional about ongoing monitoring.

ZINC (12mg/d) Zinc is found in breast milk at levels of around 1.35mg/litre, and based on this and the uptake (availability of 42%) of zinc, the RDI is increased by 4mg/d.

RDI = Recommended dietary intake µg = micrograms mg = milligrams Pregnancy BUMP & baby

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MATERNAL DIETARY INFLUENCES

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Interestingly, the actual volume of breast milk is reasonably stable regardless of your Many parts of breast milk are consistent across feeds and over time. There are some diet; however, ensuring you have plenty to drink will help in two ways. Firstly, that can vary with your diet; for example, the type of fat in your diet resembles the oxytocin (the hormone involved in milk production) can cause feelings of thirst. type of fat in your breast milk. Keep in Secondly, keeping your body well hydrated mind that, even with such fluctuations, can reduce the risk of constipation and of the total calories remain consistent. Supplements can alter some nutrient levels course hemorrhoids – now that’s a definite motivator. Your urine should not be dark in breast milk; for example, vitamin B2 and vitamin C show a fast dose-related response in colour or strong in odour; these can be signals that you to supplementation or dietary changes, while iron and are dehydrated. calcium don’t. Lactose found Drink just to your desired in breast milk is largely level and keep an eye on the independent of your diet. signs of dehydration so you The protein found in breast can respond accordingly. Opt milk, mainly casein, doesn’t for water or healthy choices appear to be influenced by the that are free from added In many cases maternal diet, even in cases sugar, additives, and other mothers will lose where the mother is severely unwanted compounds. weight even with undernourished. Cow's milk the extra caloric is not suitable for babies for FOODS AND intake, though numerous reasons, including BREAST MILK some may not its composition of proteins Many new mothers are begin losing weight and its lack of taurine (an advised that eating oranges, until weaning important amino acid for spicy food, onions, and starts or even later. brain and eye function). cabbage may upset their Any effort to lose Normal variations in infant’s tummy and so should weight is best dietary habits by nursing be avoided, but research considered after mothers don’t appear to suggests that for most babies baby is two months significantly influence the these foods are not a problem. old, to allow both volume or content of her However, there is increasing mother and baby to have settled research into the effect that milk. Mothers with poor into a routine and nutrition can produce milk common allergy-causing for their bodies to with lower energy, protein, foods such as wheat, eggs, have adjusted to and fat; however, this is nuts, milk, and dairy products changes. Up to strongly influenced by the may have on infants. 2kg per month loss severity of the deficiencies Additionally, studies show in mothers who that nursing mothers who and the duration and is gained normal more likely in extreme cases. consume high amounts of weight during Studies in countries fish (such as salmon and pregnancy appears where nutrition is mackerel) in their diet may to be safe, with no compromised have shown pass on the health-giving adverse outcomes benefits from the omega-3 that the milk of nursing for baby or mother. mothers remains sufficient fatty acids to their baby – this to meet the needs of their can be particularly helpful in babies, assuming they feed on demand. families with a history of asthma (ABA, 2004). While restricting a mother’s diet ARE THERE FOODS to assist a baby experiencing an allergy doesn’t have widespread support, research TO AVOID? Overall, not really. You will hear from is continuing into the beneficial effect of different people that a certain food should maternal diet on preventing infant allergy be avoided, but often this is based on (Palmer, 2004) over treating it. Talk to your cultural beliefs and practices rather than GP or Plunket nurse about what you scientific information. As with any diet, it should be eating if you're concerned.

ek -a

FLUID

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Weight loss

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is ideal to avoid junk foods, as they provide excessive calories with little nutrition. Try to avoid additives in your food where practical; instead, opt for clean, whole foods. Ideally what you want is more bang for your buck, so to speak: Foods where the available space is packed with goodness.

FISH AND BREASTFEEDING While the critical time for development is during the foetal stages, Food Standards Australia New Zealand (FSANZ) recommend that breastfeeding women generally don’t require special recommendations, as the transfer of mercury is very low through breast milk. Still, for safety, women can continue to follow the same guidelines as pregnant women in relation to fish intake.

WHAT ABOUT CHOCOLATE?

Sometimes a little bit of chocolate during one of those long, quiet feeds can be just the trick. But yes, all things in balance. A little bit of chocolate won’t hurt either of you; just keep it to a treat and enjoy it. If you really feel bad about it, opt for something such as organic dark chocolatecovered goji berries – at least you can argue that you are getting something healthy this way!

EAT TO FEED

Vitamins and minerals that are provided by different food allergens Milk: Vitamins A, D, B2, B5, B12, calcium, and phosphorus Egg: Vitamins B12, B6, B2, B5, biotin, and selenium Soy: Thiamin, vitamins B2, B6, B9, calcium, phosphorus, magnesium, iron, and zinc

Wheat: Thiamin, vitamins B2, B3, B9 (if fortified), and iron

KEEPING THE BALANCE WHEN YOU HAVE TO AVOID FOOD

The info above provides a brief example of some of the vitamins and minerals that may be an issue if a specific allergy-forming food is removed from the diet. Keep in mind this list doesn’t include essential amino acids and essential fatty acids (EFAs) as well as other nutritive factors. Any food or food group you remove from an otherwise healthy, balanced diet should be replaced. Any dietary amendment must be undertaken with careful consideration, in particular changes that involve a reduction in variety and food groups as this can mean reduced nutrient intake, insufficient calorie intake, and the development of other food sensitivities from over-exposure to a limited range of foods. Alternative foods that are either fortified or rich in specific nutrients may need to be sourced.

HUGGIES.CO.NZ/BABY-CARE/BREASTFEEDING/NUTRITION

ALLERGIES AND THE BREASTFED INFANT

We now know that breastfeeding offers some protection against the formation of allergies. Breastfed babies are less likely to experience an allergy. For example, breastfeeding can be particularly helpful in infants whose family has a history of allergies, such as those with asthma, sinusitis, wheezing, and eczema (NHMRC, 2003). Research suggests that the antibodies in breast milk (specifically IgA) may bind to food proteins to form a complex that reduces the likelihood of these proteins crossing into baby’s blood (Palmer et al, 2004). While altering your diet (for example, reducing the intake of common allergens such as eggs, nuts, dairy, and gluten, or expressing off the foremilk, which is higher in lactose) is not generally well-supported by research, you will hear of many practitioners recommending such changes and that they have been successful. Who’s to say that research just hasn’t caught up to anecdotal evidence? We now know that parts of egg protein can pass whole into breast milk, so who knows what other food compounds may pass that we are unaware of as yet? Ultimately, do what works best for you and your baby, as long as you have all the nutritional bases covered.

Allergies:

What to look out for From the time of your baby’s first breastfeeds, it is best to assume that they won’t have any problems. Unless you have a strong family history of sensitivities or have an older child with proven allergies, the general recommendation is to eat a well-balanced diet and not restrict or limit any foods. Those rich in calcium, iron, and iodine are particularly beneficial, as they tend to be the nutrients which most commonly become low during periods of lactation. Likewise, carbohydrates

and protein are useful to maintain energy, and for cell renewal. Some babies can be particularly sensitive or allergic to foods which filter through via breast milk. The most common reactions are to foods such as seafood, cow’s milk and dairy foods, peanuts, tree nuts, and eggs. Generally the reaction is seen in the baby’s behaviour as they become more unsettled and grizzly, and change their feeding and sleeping patterns. Some mums find that keeping a food diary is useful to track what they have eaten. It is unclear exactly how long it takes for food to be digested and metabolised into breast milk, but four to 12 hours is a realistic

estimate for most mums. Here are some symptoms of allergy or food sensitivity in breastfeeding babies: • Unsettledness, crying and colicky behaviour. • Not responding to the usual comfort and soothing measures. • A rash which does not seem to be related to illness. • Frequent, loose bowel motions which are different to the baby’s usual pattern. It is important not to assume your baby’s unsettledness is because they are reacting to something you have eaten. There are lots of causes for crying. Try comforts like rocking and calming, bathing, massage, extra feeds, and going for a walk.

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ALCOHOL AND BREASTFEEDING

The amount of alcohol that passes to breast milk is roughly equivalent to the mother’s blood alcohol level. It appears that acetaldehyde (the toxic metabolite from alcohol) may also pass into breast milk. Studies show that within 30 minutes, just one standard drink alters breast milk and can have a mildly sedative effect on baby, as well as reducing mother’s let-down reflex. Alcohol may interfere with the release of oxytocin in many lactating women. Also, a sleepy infant is less likely to be able to suck and, of course, drowsiness in babies is not ideal with concerns about SUDI/cot death. Research suggests that motor development is also impaired in infants exposed to alcohol through breast milk and with the reduced ability for infants, particularly very young infants, to detoxify alcohol, the ramifications for development are potentially huge. Other concerns with alcohol consumption include its possible link with mother’s inability to cope and potential depression – alcohol has a depressive effect on our systems. Being nutritionally empty, alcohol can reduce appetite and replace food; combining these effects we begin to see a potentially negative spiralling effect on the mother-baby relationship. While breastfeeding, it is best to avoid alcohol, particularly in the first three months. The New Zealand Government recommends zero alcohol intake for breastfeeding mothers for the duration.

DRIP METHOD COFFEE 110-150mg/cup

PERCOLATED COFFEE 65-120mg/cup

INSTANT COFFEE 40-60mg/cup

WHAT ABOUT A CUPPA? STRONG BLACK TEA 40-60mg/cup

COLA DRINKS 40-50mg/cup

WEAK BLACK TEA 20-30mg/cup

Should I take a multivitamin supplement?

It’s always advisable to seek professional advice if you’re considering taking a supplement during pregnancy and breastfeeding. In some cases, vitamins and minerals can mask deficiencies or even interact with medications. Your healthcare professional might recommend a multivitamin supplement if you fit into the following categories: • Vegetarians. • Teenagers who may have an inadequate food intake. • Women with an inadequate diet or are under stress or those who smoke or are exposed to other chemicals either by trade or geography. • Substance misusers (of drugs, tobacco, and alcohol). • Obese women who are restricting their energy intake to prevent weight gain.

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Caffeine content of selected drinks (mg)

COCOA, 2 TEASPOONS 12mg

DECAFFEINATED COFFEE 2-5mg/cup

HERBAL TEA none

Caffeine is quickly absorbed and reaches a peak concentration in the body within an hour. While the actual amount that you consume – and which then turns up in your breast milk – is variable, it is estimated that 0.06% to 1.5% of the amount of caffeine you drink crosses into breast milk. Caffeine can also sit in the body for long periods; this is particularly so for newborns. Caffeine has an affinity with the fatty, creamy layer of breast milk and, consequently, tends to be most concentrated two hours after it is consumed. It appears that caffeine can reduce milk supply and may be implicated in recurrent mastitis (ABA, 2004). Some findings also show that mothers who drink caffeinated beverages have lower iron levels in their breast milk than those who don’t have caffeine; this may explain the increased prevalence of iron deficiency anaemia in countries where a lot of coffee is drunk. Babies of mothers consuming large amounts of caffeine can show signs of agitation, jitteriness, constipation, and general unsettledness. But don’t panic: You need not deny yourself small pleasures in life such as the occasional cup of tea or coffee. However, it is best to keep your intake to one or two cups once in a while, ideally after feeding. The American Academy of Paediatrics suggests that nursing mothers consume no more than three cups of coffee a day (equivalent to less than 300mg/day); they also warn that smoking increases the effect of caffeine in the body, so mothers who smoke should reduce this amount even further (or better yet, quit smoking).

SOURCE: CENTRE FOR HEALTH PROMOTION AND RESEARCH 1995

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“I want to give you

everything you need

little one”

Tired of being tired? When you’re pregnant, you need significantly more iron than you did before you were expecting. Your body uses iron to make extra blood for you and your baby. And yet, many women don’t get enough of this important natural mineral. Floradix is a liquid iron supplement packed with fruit and vegetables extracts which helps pregnant women maintain their iron levels during this time of extra demand, without the unpleasant side-effects of other iron supplements. Floradix is one of the tastiest and most effective ways to top up on iron because, unlike tablets, it’s absorbed immediately. That’s why Floradix is New Zealand’s No.1* iron supplement.

Tired of being tired? Take Floradix® AVAILABLE FROM SUPERMARKETS, HEALTH FOOD STORES AND PHARMACIES NATIONWIDE Read the label and use as directed. Pregnant women should consult their doctor prior to taking any supplements or over the counter medicines. Endeavour Consumer Health, Auckland. TAPS NA 10069 *IRI-Aztec, Total Grocery & Pharmacy combined. MAT to 15/04/2018.

Learn more at Floradix.co.nz

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Lay down with your body parallel to your baby's body. Rest your head on a pillow or your arm so you're comfortable.

WITH A SLING

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Essentially a cradle-hold, but a bit more discreet. Good for feeding while out and about. Try a rugby-ball hold in a sling too.

RUGBY BALL

Hold your baby under your arm with her body supported by a feeding pillow. Helpful for large-breasted mums.

KOALA HOLD

Let's get comfortable with these POSITIONS Experiment with these different breastfeeding positions until you find one (or more) that works for you and your baby. 100 Pregnancy BUMP & baby

Seat your baby on your knee and support her head and neck. This can be good for feeding out and about.

BACK LYING

Semi-reclined, lay your baby across your stomach. You can also try laying them over your shoulder, with support.

ASSUME THE POSITION

CROSSFRONT

SIDE-LYING CRADLE

Semi-reclined with your baby's body supported by your stomach and arm.

TWINS

Hold both babies across your lap on a cushion, with one tucked close to your body and the other cradled behind their sibling.

DOUBLE RUGBY BALL

CRADLE

Hold your baby across your lap. Support your baby's head and body with the same arm as the side you're feeding on.

Use a feeding pillow or cushion to support your babies' bodies while you support their heads and upper backs with your hands.

CROSSCRADLE

UPRIGHT LATCH

Hold your baby across your lap, supporting her head and body with the opposite arm as the side you're feeding on. Helpful if you have large breasts.

Semi-reclined or seated, support your babies' bottoms over your knees or on a pillow. Swaddling can help.

RUGBY BALL & CRADLE

INVERTED SIDE-LYING

Lay down with your baby's chin pointing toward yours. Can be good for post-Caesarean feeding.

Tuck one baby under your arm and the other across your lap. Good when they're getting too big to hold together in front. Pregnancy BUMP & baby

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REAL OR ING B U ED RUMOUR? E F

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My aching boobs!

If you’re breastfeeding and things feel, well, a bit uncomfortable, here’s what to look out for – and what to do about it.

he most natural thing in the world? With a bit of luck, every breastfeeding mother experiences times of intense satisfaction and bonding with their offspring. But sadly, for most, these happy moments will be peppered with times of intense discomfort, often escalating into painful issues you need to seek treatment for. Here is a rundown of some of the most common breastfeeding problems, and their fixes.

Latching on

In the moments following birth, your baby is programmed to seek the breast. If you’ve had a relatively problem-free birthing experience, you will be encouraged to adopt a semi-reclined position with your naked baby fairly high on your bare chest, a perfect position for effective latching. This “skin-to-skin” position has a host of benefits for both of you, and baby should eventually wriggle down to find your breast and latch on without needing much assistance. Unfortunately, when birth has not been straightforward due to interventions, Caesarean delivery, or other complications, skin-to-skin contact may be delayed or even impossible. In this case, a breastfeeding mother may need to express milk to feed her baby and stimulate her milk production. The services of a specialised lactation consultant are essential if this is the case.

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Engorgement

Engorged breasts occur when your breasts flood with milk and become full and heavy, sometimes even rock-hard, tender to the touch, and hot. This tends to happen when your newborn is around four days old and your early milk (colostrum) gives way to full milk, often referred to as “when your milk comes in”. Though painful, the best way to deal with engorgement is to carry on as normal, trusting your baby to deal with the production when they are able. It’s tempting to perhaps express and try to “empty” your sore boobs, but doing so will just encourage more milk production and could worsen the problem. Demandfeed your baby as normal, applying hot towels to the breasts just before feeding to allow milk to flow and to let your baby enjoy a more effective feed. After feeding, you can massage some arnica cream into your breasts or place cool packs on the sore areas to alleviate your discomfort. Stick with it! Feeding will become easier as your baby grows and is better able to deal with your milk flow.

Mastitis

Occurring when one of your milk ducts gets blocked and most commonly caused by engorged breasts, mastitis is an inflammation of the breasts you should watch out for and try to remedy quickly. If the inflammation becomes infected, the situation can escalate quickly and may necessitate a course of prescription antibiotics which, in turn, may compromise successful breastfeeding and can lead to thrush infections. Eating chopped raw garlic can be very effective to remedy infection (disguise the sharp flavour with peanut butter or honey to make it more palatable). Blocked ducts can often be visually located, as the area may be red and obvious, perhaps even quite hard. Massage the affected area as much as possible, and use hot towels or a hot water bottle to encourage milk flow. Drink plenty of water and encourage your baby to feed from the affected breast as much as possible to help clear the blockage. If you feel unwell, sluggish, or feverish, you may have an infection and should seek medical help.

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Inverted nipples Thrush

Pink nipples, pain between feedings, and shooting pains are all symptoms of thrush in the nipple area. Thrush is a yeast infection caused by an over-production of the fungus candida albicans. This fungus is always present in our bodies, but various factors can destroy the good bacteria that keeps candida albicans in check, such as eating too much dietary sugar, bread, wheat, cheese, and fermented food products, or the use of antibiotics. If your nipples become infected with thrush, your baby’s mouth is likely to become infected with oral thrush, and then you risk passing the infection back and forth indefinitely until it's treated. Acidophilus, vinegar, or the antifungal/antiseptic remedy gentian violet can be used for both mum and baby to try to retard an infection in its early stages, but if you progress to the shooting pains stage, you may need to treat the problem with a prescription anti-fungal remedy from the pharmacy. See your LMC or GP if you or your baby have thrush.

Cracked nipples

Most commonly caused by an incorrect latch position, sore, red, and grazed nipples are not a necessary part of breastfeeding, despite what many mums think! Sadly, though, many mums learn this once the damage is already done. Breast milk itself is the best natural remedy for sore nipples, so leave some on your nipples after feeding for healing and try to let them air-dry. Don’t feel like it’s too late if you’re already back home with your baby; your midwife or Plunket nurse can help, or seek the help of a lactation consultant to correct any latching issues that may be causing the problem. It could also be an issue with your baby’s mouth, such as a tongue tie, creating latching problems, so be sure to seek help. Bundle up baby and head to your local La Leche League meeting, a wonderful charitable organisation dedicated to offering breastfeeding support. The camaraderie you’ll find with other breastfeeding mums will do you no end of good there, too.

If your nipple retracts rather than protrudes when you gently squeeze your areola between your thumb and forefinger, you have what is known as flat or inverted nipples. Breastfeeding is still a viable option for you, although you can expect it may be a little more challenging for you both. Using a breast pump to get your milk flowing before putting baby to your breast is advised. With the help of your lactation specialist or postnatal care team, you may decide the use of nipple shields could be effective to improve your baby’s latch and promote more successful breastfeeding.

Painful or overactive let-down

Some mums experience this as a prickly pins-and-needles sensation, while some can feel achy. Either way, try to relax and breathe through it. Switch to the other breast if it helps to alleviate the sensation. Be mindful though, if the sensations become really painful or if you become feverish, you may have an infection and should seek treatment.

Low milk supply? Feed as often as you can, and as often as your baby wants to. Frequent demand-feeding, supplemented by pumping if necessary, is the sure-fire way to increase milk production. 104 Pregnancy BUMP & baby

Supporting you through breastfeeding As natural and wonderful as breastfeeding can be, we all know that it can sometimes come with challenges. Lansinoh has been supporting breastfeeding mums for over 30 years and our aim is to help you through the challenges, should any arise, so you can continue breastfeeding for as long as you like. Below we look at some common issues that can crop up and ways of managing them. It is very possible to breastfeed without experiencing any issues, but if you do, it’s good to know help is at hand! ®

10 0 %

D NATURAL AN Y LL A CLINIC PROVEN

Lansinoh HPA Lanolin ®

Lansinoh Thera°Pearl 3-in-1 Breast Therapy

100% ultra-pure lanolin Soothes, heals & protects cracked nipples

It can be a bit shocking to new mums to learn that the recommended way to administer cold therapy used to be a bag of peas or a frozen nappy in the bra! Thankfully, now there is Lansinoh Thera°Pearl 3-in-1 Breast Therapy.

Cracked nipples are one of the most common challenges of breastfeeding and often indicate a problem with the way the baby has latched onto the breast. Speaking to a lactation consultant or breastfeeding counsellor can help you sort out the issue. In the meantime, Lansinoh HPA Lanolin will soothe the nipple, and is clinically proven to support the healing process. The ultra-pure lanolin penetrates deeply to restore and maintain the moisture content essential for healthy, supple skin. The lanolin is so pure that there is no need to remove before breastfeeding. Lansinoh HPA Lanolin is all natural, contains no additives or preservatives and is hypoallergenic.

♥ Also

available & loved by NZ mums:

Lansinoh Breastmilk Storage Bags ®

‡

Lansinoh Ultra Thin, Stay Dry Nursing Pads ®

• Strong & leakproof

• Absorbs 20 x its weight

• Pre-sterilised

• Unique BLUE LOCK™ Core disperses moisture

• BPA & BPS free

• Discreet, contoured & super soft • Stays securely in place

For more information about breastfeeding, visit: www.lansinoh.com.au

@lansinohaustralia

Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. Wilson Consumer Products, Auckland TAPS NA 9925

Lansinoh Thera°Pearl reusable packs can be used either warm or cold, depending on your needs. Engorgement is when the breasts feel hard, swollen and tender. This can be relieved by emptying your breasts by feeding your baby or expressing your milk and using cold therapy. Cold therapy can help to soothe the pain and swelling associated with engorgement. Similarly, cold therapy can help provide soothing relief for the symptoms of mastitis (which is an inflammation of the breast and sometimes even an infection). If you believe you have mastitis, it is important to see your doctor straight away. Lansinoh Thera°Pearl’s unique design conforms to your breast to provide 360° relief. Lansinoh Thera°Pearl can also be used warm on the breast before a feed to encourage let-down (the reflex that makes your milk available to the baby). When used warm with a breast pump, Lansinoh Thera°Pearl can help reduce the time spent expressing.

Lansinoh is available in pharmacies nationwide ®

SHOP TO SOOTHE WASH & WEAR

Leakproof and lovely with a hint of lace, these are a breastfeeding must-have. Philips AVENT Washable Breast Pads 6-pack $27.99 from babycity.co.nz

HOT OR COLD

Lansinoh TheraPearl 3-in-1 Breast Therapy breast pads can be used warm or cool to encourage let-down and help relieve engorgement and mastitis symptoms. RRP$34.99 WE LOVE IT!

PROTECTION IN A TUBE

Help soothe sensitive, sore, or irritated nipples during pregnancy and breastfeeding with Medela Purelan. 37g RRP$20.99, from pharmacies and baby retailers

Just nipping out Keep your nipples in tip-top shape with these brilliant breast care products for nursing mums.

STIMULATE OR SOOTHE

Developed with a breastfeeding expert, use warm to stimulate milk flow before a feed, or cool to soothe soreness. Philips AVENT Thermopads RRP$30.99 from babycity.co.nz

CARE NATURALLY

Weleda Nipple Cream helps tone nipples in preparation for breastfeeding and provides soothing relief for tender, cracked nipples. RRP$29.90 from weleda.co.nz

GREAT BUY!

CLOSER CONTACT

Available in small, medium, and large and designed to help in situations of difficulty latching, flat, inverted, or sore nipples. Medela Contact Nipple Shields RRP$23.50

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LITTLE LIFESAVERS

Made of ultra-fine, soft, taste-free silicone, Philips AVENT Nipple Protectors provide relief for sore or cracked nipples during breastfeeding. RRP$21.99 from babycity.co.nz

SILVER STARS

Made of 925 sterling silver, known for its antimicrobial and anti-inflammatory properties, Silverette cups help prevent and alleviate nipple pain, cracks, and irritation. RRP$88 from mothernurture.co.nz

NUK is a registered trademark of MAPA GmbH, Germany Distributed in New Zealand by Rumina Natural Care Ltd, Auckland Freephone: 0800 333 006 - email: info@rumina.co.nz

My busy life doesn’t

NUK Breast Pumps. Helps you to continue breastfeeding. It’s true that breast is best. It gives the ideal combination of anti-bodies and nutrients for your growing baby. But sometimes you may have trouble establishing pain-free, successful breastfeeding. A pump can be used to help clear blocked ducts or engorged breasts, to give you a break from feeding if you are suﬀering from sore nipples and to maintain your milk supply if your baby is unable to latch on. And what can you do if you need time away from your baby? A doctor’s appointment, meeting, or special occasion calls for some flexibility. Breast Pumps can be used for these times, to ensure that your baby isn’t denied a nutritious meal.

What type of breast pump is best? NUK has a range of pumps and storage systems to suit your lifestyle. We have developed our breast pumps with the greatest of care to make expressing as comfortable as possible for you. The NUK Jolie Manual Pump is easy to use and quiet, so handy to use while baby is sleeping next to you. If you want the odd night oﬀ, or have occasional appointments, then this pump will suit your needs.

NUK Luna

NUK Jolie The NUK Luna Single Electric Pump is ideal for mums who need to express regularly. It has a 2-phase rhythm; a fast pumping action to stimulate milk flow and a slower but stronger pumping rhythm for maximum milk flow. The soft silicone cushion fits the shape of the breast perfectly and is especially gentle on the delicate breast tissue, so is ideal for new mums. The battery option lets you pump on the go. The NUK Double Electric Breast Pump is the ultimate in eﬃcient pumping when you need a lot of expressed milk, such as when returning to work or with multiple babies. The 32 suction and speed settings let you customise the rhythm to suit you, mimic breastfeeding and achieve optimal milk flow. NUK Double

Loving nourishment You can store your expressed milk in NUK Breast Milk Bags or NUK Breast Milk Containers. Feeding time should be an opportunity to snuggle and relax. It is also the perfect way for dad or gran to experience a special closeness with your baby when asked to take charge of feeding. NUK is available at leading baby stores and pharmacies. Find out more at nuk.net.nz

NUK. Understanding Life.

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“Is my baby eating enough?” is a question breastfeeding mums often ask, as there’s no reliable way to measure the volume of milk that’s coming out of your breasts. Tiffany Brown shares some hints for knowing whether your breastfeeding baby is, in fact, drinking their fill.

hile pregnancy and childbirth may do many interesting and unexpected things to your body, installing a measuring device at each breast is not one of them! Unlike formula, which is measured, allowing the volume ingested to be tracked, a common cause for concern for breastfeeding mums is wondering if your breasts are producing enough milk and, subsequently, if baby is getting enough to drink. So how can you be sure? These general guidelines can help.

FEEDING FREQUENCY If your newborn baby is feeding at least six to eight times a day, he should be getting

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enough milk. But don’t worry if he is feeding much more often than this. Newborn babies regularly “cluster feed”, and it may seem they are seeking the breast endlessly on arrival into their strange new world. Breastfeeding is a supply-and-demand arrangement. Frequent feeding is your baby’s way of increasing your milk production. Rather clever, isn’t it?

COMFORT During the early stages of breastfeeding, the first few moments of a feeding session may hurt or be uncomfortable, but as long as any pain or discomfort subsides and feeding feels easier once your baby settles in to his feed, you can be sure your breast milk is flowing as it should.

SUPPLY AND DEMAND

WHAT ARE SOME SIGNS THAT BABY IS SATED? Baby’s hands are open, fists are no longer bunched Baby’s body feels loose and relaxed Baby may have hiccups but is calm and relaxed Baby may fall asleep Milk may dribble from Baby’s mouth Baby seems peaceful and content As you both settle into breastfeeding, your breasts should swell with milk and become firmer before a feed, and once your baby feeds and “empties” them, they’ll feel softer and more comfortable again.

SKIN CLUES Another indication your newborn is getting enough milk is her skin colour and texture. Does her skin seem a healthy hue after feeding? Does her skin seem firm, and does it bounce right back if you squeeze it gently? Breastfeeding is food, and it’s also hydration, so these visual cues indicate she’s getting all she needs.

NAPPY TIME In the early days after your baby is born, you’ll find yourself spending a good deal of

time discussing the contents of your baby’s nappies. And because what goes in must come out, it makes sense that nappy output is further confirmation breastfeeding is going according to plan. In the first 48 hours, you should expect at least three to four wet nappies from your newborn. His wee should be pale and odourless. If it isn’t, make sure you talk to your maternity team straightaway, as there may be an infection present. After five days, he should be producing at least six wet nappies every 24 hours, and his poo will now be a yellowy-mustard colour. Yes, it pays to stock up on disposables, or have a very efficient system in place to deal with your baby’s reusable nappies, before baby arrives. Friends and family often gift nappies or a voucher for a nappy service to new parents, which is a thoughtful way to help out in the early weeks.

GULPING IT DOWN Over time, you’ll be able to hear and see the swallowing action your baby makes while feeding, particularly once your milk progresses through colostrum to foremilk to hindmilk (or when your milk “comes in”). In the first days of your baby’s life, you should be able to see her facial muscles moving as she sucks and swallows. As time goes by, the rhythm of her feeding will start to change, and she may take pauses during feeds. Often babies will begin to come off the breast spontaneously when they have had enough. The degree to which breastfed babies are affected by wind varies widely. Watch for signs of discomfort after a feed beyond the three or four days old mark. You may need to help your baby release that wind, and you can do this by walking with them in an upright position, with a little bounce in your step, or skin-to-skin contact. There are plenty of “holds” you can use to release wind too. Often a larger male hand is perfect for this job, so rest while Dad does the work.

ALERTNESS Does your baby seem alert when she is awake, and does she make it clearly known when she is ready to feed again? These are also signs she’s feeding well and getting plenty of milk from you.

Can I overfeed my breastfed baby?

Possibly fuelled by the desire to encourage and normalise breastfeeding, the notion you can’t possibly overfeed your breastfed baby is prevalent today, and you’ll hear it often if you express any concerns. And while it is true that a content, healthy newborn will not overfeed, there are unfortunately situations where an infant may overfeed. Mainly due to gastric complications, these are often accompanied by large weight gains and gastric symptoms such as tummy pains, excessive gas, greenish watery poo, or lots of “spilling” (regurgitating) after feeding. This may be a sign that your baby has a problem with gastric reflux, also known by the terms acid reflux, silent reflux, gastro-esophageal reflux (GER), gastro-oesophageal disease (GERD), or heartburn. Another gastric complication is lactose intolerance, and these symptoms are often misdiagnosed as colic, reflux, or milk allergy or intolerance. Exclusively breastfeeding your newborn is the best way to ensure he will not overfeed, but be sure to look out for any of these symptoms and investigate further if you feel he is not as healthy and content as he should be. Pregnancy BUMP & baby

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FANCY A CUPPA?

With aniseed, caraway, fennel, fenugreek, and lemon verbena, Weleda Nursing Tea is mild and refreshing. RRP$20.90 from weleda.co.nz

FREEZER FRIENDLY

Ideal for storing and freezing expressed breast milk, Lanisoh Breast Milk Storage Bags are leak-proof with double-sealed tops and side seams. They're also pre-sterilised for convenience. RRP$29.99

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GO WITH THE FLOW

Traditionally known for its galactagogue and nutritive properties, Nature's Sunshine Fenugreek assists with healthy breast milk production. RRP$31.20 from naturessunshine.co.nz

DAILY DOSE

Provides 20 important nutrients including folic acid, iodine, DHA, vitamin D3, and iron. Blackmores Pregnancy & Breastfeeding Gold RRP$29.99

Your new BFFs: breast friends forever Preparing to breastfeed? Here's our round-up of helpful products nursing mums swear by.

RELAX & PUMP

Sit more comfortably, with no need to lean forward when pumping. Philips AVENT Comfort Single Electric Breast Pump RRP$299.99 from babycity.co.nz

WE LOVE IT!

WEAR YOUR CAKE

This cute contour bra gives a smooth profile in polka-dot mesh lace and stretch satin. Cake Lingerie Mousse Padded Plunge Wireless Nursing Bra RRP$59.90 from cakematernity.com

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RECOMMENDED BY MUMS

ALL YOU NEED

With a soft silicone cup especially designed to mimic a baby's natural feeding action while providing gentle and efficient expression, the Tommee Tippee Closer to Nature Electric Breast Pump is easy to use, portable, and lightweight. RRP$249.95

GREAT BUY!

TEA FOR TWO

Infused with rosehip, marshmallow, and fennel, Totally Devoted Lactation Tea is a naturally sweet drink to be enjoyed hot or cold. RRP$25.95, totallydevoted. co.nz for retailers

GREAT BUY

Perfect for occasional use, the Medela Harmony Breast Pump is easy to assemble, use, and clean. RRP$69.99 from selected baby retailers and pharmacies

TANK UP

Wire-free and seam-free, the Medela Maternity and Nursing Tank comes in black and white and has one-handed open-and-close clips. Great for layering. RRP$64.99 from babycity.co.nz

BREATHABLE COMFORT Natracare Nursing Pads keep lactating Mums comfortable by absorbing any leakage, preventing the skin from becoming damp and irritated. RRP$11.50

NO SPILT MILK Use a single pouch to express,

store, warm, and feed. Fits baby food pouches too. Tommee Tippee Express and Go Pouch and Bottle Warmer RRP$129.99

DOUBLE DUTY

Two-phase expression with the efficiency of double pumping, this light and compact double breast pump can also be used hands-free. Medela Swing Maxi RRP$499.99 from selected pharmacies and baby retailers

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Breastfeeding a teething baby

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Are you freaked out by the prospect of breastfeeding a baby who’s teething and wants to gnaw on everything? You’re not alone. Most mums worry whether they will have to stop nursing once tho little teeth start coming in, explains Yvonne Eve Walus.

ill my baby bite me?” is a question many breastfeeding mums ask once their baby starts teething. Fortunately, lots of babies are model citizens, latching and sucking without incident even after their teeth have come in. Others may need guidance, and while it may seem like a bit of a nuisance at the time, next year you probably won’t even remember it ever happening.

WHY PERSEVERE WITH BREASTFEEDING? Some people might try to discourage you from nursing your baby because they think that teeth are a sign your baby is ready for real food. While it may be true that it’s time to introduce solids, there’s no reason to discontinue breastfeeding until you and your baby are ready. Unlike bottle feeding, breastfeeding is unlikely to lead to tooth decay. One of the reasons nighttime bottles may cause dental problems is due to the liquid from the bottle flowing into the baby’s mouth, bathing the teeth for long periods of time and thus allowing bacteria to flourish. Breast milk doesn’t flow unless the baby is actively sucking, and when the baby is actively sucking, then she is also swallowing, so breast milk doesn’t usually pool in the mouth. In addition, milk from the breast enters the baby’s mouth behind the teeth, so it doesn’t even come into contact with the danger areas. Another good reason not to switch to the bottle is that breastfeeding promotes better mouth development and optimal teeth alignment. Several recent studies

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SHARP FACT: THE MECHANICS OF SUCKLING An actively nursing baby will not bite, because her tongue covers her lower teeth while she sucks.

BABY SHARK

found that babies who were exclusively breastfed for the first six months were less likely to suffer from dental issues such as open bites, cross-bites, or overbites, than those who were breastfed for shorter lengths of time or not at all.

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You may be one of those lucky mums whose baby never bites. But if he does happen to slip up, you will most likely discover that it’s not as painful as you may have imagined, because your baby hasn’t yet mastered the skill of chomping or chewing. Just like the baby’s first grip, the first bite is unlikely to hurt. (Usually it surprises them as much as it surprises you!) Rest assured that the biting behaviour is subconscious – the baby doesn’t really mean to injure you, he’s simply discovering the world using the brand-new and satisfying technique of gnawing. That’s why any biting that may happen when breastfeeding is temporary. It can easily be stopped with a little persistence on your part, coupled with understanding of what’s actually going on. First of all, as soon as you notice the first teeth emerging, become more vigilant during breastfeeding. Keep your finger ready to break the suction and be prepared to remove your breast as soon as the baby’s rhythmic suckling stops, before she starts to feel playful or distracted. If your baby attempts to bite at the beginning of a breastfeeding session, try giving her a teething toy or a cold flannel to chew on before nursing, to stop those little gums from itching. When she’s ready for her meal, make sure her mouth is really wide open, and praise her when she latches on correctly, without biting. Don’t breastfeed a distracted baby. If he’s wriggling, rolling, or pushing against you with his arms, he’s probably not hungry enough. Babies aged four to six months often start-stop their feeding at the slightest distraction – sometimes they may even forget to let go before they turn around. When your baby first becomes aware of the rest of the world, he will have a hard time concentrating on nursing. Once he gets a little older, he’ll find it easier to multitask. If your baby is younger than a year old, it’s highly unlikely that his temporary distractibility is an attempt at self-weaning.

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Do you have enough milk?

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SOMETIMES WHEN YOUR MILK SUPPLY DIPS, THE BABY MAY PULL ON THE NIPPLE OR BITE, TRYING TO SQUEEZE OUT MORE. REMEMBER, IF HE IS GAINING WEIGHT APPROPRIATELY, HE’S GETTING ENOUGH TO EAT. IF YOU HAVE ANY CONCERNS, SPEAK TO YOUR MIDWIFE, DOCTOR, OR A LACTATION CONSULTANT.

normal position over the lower teeth – this will stop the sucking action and expose the biting edges.

» Some babies might bite to get your

attention. Focus on your baby while breastfeeding, as this will help prevent the behaviour, and also alert you to when baby is about to bite. Offer her a teething toy and tell her, “This is for biting. Be gentle when you nurse.” Biting might also happen at the end of a nursing session when baby is getting bored and is no longer hungry. The solution

SCRAPING

is the same as for the attention-seeking baby: Watch your baby closely and take her from the breast as soon as she’s done.

HOW DO I KNOW MY BABY IS ABOUT TO BITE? Watch for any tension in your baby’s jaw while nursing – this may be a sign that she’s getting ready to clamp down. She may also pull her tongue back from its

When the teeth first cut through, before they become less sharp, your baby may unintentionally scrape you with her new pearly whites. Here are some suggestions that might help prevent it: • Position the baby so that her weight is supported well with pillows or arm rests. Move her slightly in different ways (higher, lower, or side to side) until there is no downward pressure on your breast. • Make sure the baby’s chin is up, with his top teeth not bearing down on the nipple. Talk to him so that he looks up at you when feeding, or hold a toy for him to inspect. • Support your breast with your fingers and point the nipple down more, so that it won’t rub against baby’s upper teeth.

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WHAT SHOULD I DO IF MY BABY BITES ME? Stopping the nursing session is usually the most effective way to teach that breast and biting do not go together. If you do get nipped, say “No” in a firm voice and then remove the baby from your nipple. Once she figures out that biting means no more breast, she will learn to behave. If baby is still hungry, she may get upset when you end the meal, so wait a few moments, and if she’s still intent on nursing, give her another chance. Don’t scream (we know it's difficult when you're surprised or it hurts!). Too big a reaction may amuse the baby enough to make her want to repeat the action again, or it might scare her into not wanting to suckle again. Most babies let go immediately, but in the rare event when this might not happen, place your finger between your baby’s gums in order to break the hold. If that doesn’t work, pull the baby closer towards your breast, which seems counter-intuitive, but the motion will either disengage the baby, or will make it more difficult for her to breathe, causing her mouth to open. All babies are different, so what works for you will depend on your baby’s age and personality. This is probably the first time you’ll need to correct your baby’s behaviour, so consider this time period as a lesson in guidance and discipline.

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YOGA MATS

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20 things

you should know about

breastfeeding Here are 20 helpful tips from real mums who’ve been there, done that.

Lots of mums want to know what the best position for breastfeeding is. The best position for breastfeeding is: The position that works best for you. If you prefer to breastfeed while laying down, then do that. If you’d rather sit in your recliner in the lounge with your legs crossed on the seat, then do that. Everyone will have an opinion about the best position for breastfeeding, but the only person whose opinion matters is you. ~ Yvonne

Just try to make it through the first six weeks, and things should get easier. The first two or three weeks are the hardest, and the time when you might feel like you need the most support. If your hospital or birthing centre offers breastfeeding classes, go to them. Or if they have a lactation consultant available, make an appointment to see them and get them to watch you breastfeeding. It can be really helpful to have an expert troubleshooting with you. ~ Claudette

Get as much rest as you can. It really does help promote milk production. ~ Roxane

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Make yourself a little basket of breastfeeding must-haves and keep it next to the spot where you breastfeed the most. Nipple cream, clean breast pads, snacks, a big water bottle, a muslin or burp cloth, a book or magazine… Anything you think you might need. When your baby is latched on and eating, you might feel like you’re trapped in place for a while! So have your little kit handy. ~ Kate

To help you remember which side to start feeding from next time, wear a hair tie around the wrist of that side so you’ll have an easy visual reminder. ~ Allison

It’s okay to break the latch if it’s hurting or uncomfortable, and start over. Often babies who are super-hungry latch on and try to start drinking, but they don’t have a very good latch and it can hurt. Put your pinkie finger in the side of your baby’s mouth to help them break the latch, then pull your breast out and start over. It’s hard if you think your baby might not re-latch (especially if it’s been hard to get them to latch in the first place) but a poor latch can lead to cracked and bleeding nipples and painful grazes, so you want to get that latch right, even if you have to try a few times. ~ Farida

Drink water! Lots and lots of water. Especially when you’re breastfeeding, because it’s thirsty work. Have a big glass of water or a full water bottle by your side when you’re feeding. Trust me, you’ll need it! ~ Meghan

HELP AT HAND

The lactation consultant I saw when my baby was born told me that breastfeeding is like dating – compatibility between a mum and baby is important, and sometimes it comes easily, while other times it is more difficult. Every baby is different, so just because it was easy with your first baby doesn’t mean there’s something wrong if it’s not as easy with your second baby – and vice-versa! ~ Rachael

If you know another mum who is breastfeeding her baby, ask her if you can watch her feeding – it doesn’t look anything like in the movies! Watching a baby latch on and feed can be really helpful for first-time mums who haven’t seen it before. ~ Clementine

10.

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Does your baby keep falling asleep at the breast? If so, try tickling their feet, stroking the side of their face and under their chin, changing their nappy mid-feed, gently blowing on their hair, or changing position. ~ DeeAnn

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Ask your LMC to check your baby for tongue tie, as this can make breastfeeding painful even if your baby’s latch looks good. It’s usually easy to resolve if that is the problem. ~ Nicky

15.

Try not to stress out over pumping lots of breast milk to have in the freezer – it’s wonderful to have a big reserve of milk but the most important priority is that your baby gets fed in the first place. Over-pumping can be exhausting and can also lead to problems like clogged milk ducts and mastitis. Wait until you and your baby have fully established breastfeeding before you try to pump extra milk, unless you’re following medical advice that says otherwise. ~ Maeve

Let your baby drink her fill at the first breast and wait until she comes off on her own, then offer her your second breast. Some babies will drink from only one breast at each feeding, while others will want to drain both. Don’t worry about how long your baby is latched on to each breast for – let her set the pace. ~ Alexa

If you’re using a breast pump, check to see whether the flange (the part that goes over your breast) comes in a different size which might fit your breast better. If you have large breasts, you might find a larger flange will work better for you when pumping. Contact the manufacturer or check with the retailer where you bought your breast pump to see where to buy different-sized flanges. ~ Hannah

Use a breastfeeding pillow! They’re firmer than regular pillows or tri-pillows, and they fit around your middle to give you support for your baby while they’re feeding. Take one to the hospital with you so you can use it right from the start. It can really take the pressure off your back and shoulders. ~ Sheryl

If you’re trying to get your baby to latch on but it’s not quite working, try grabbing hold of your breast like you’re holding a burger – they need to have a big mouthful in order to be able to pull your nipple deep into their mouth. And wait until your baby’s mouth is completely open before trying to latch them on! ~ Tessa

17.

Lanolin-based nipple creams were a godsend for me. I used to get a clean pair of breast pads out, dot some nipple cream in the centre of each, and have them ready to go when I was breastfeeding so I could easily swap out the wet breast pads for a clean one once my baby was done feeding. It was heaps easier than trying to put the nipple cream on the nipple itself! ~ Fiona

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Try not to clock-watch when it comes to breastfeeding, as your baby is the best clock there is! And they don’t always feed at regular intervals. Sometimes they just want a little snack, and other times they want a three-course meal… Just like we do. ~ Emily

19.

Practise breastfeeding in private until you’re comfortable, and then when you feel confident, try breastfeeding out in public or at someone else’s home. Feeling stressed out and flustered can mean your baby will also feel fussy and upset, making the whole thing an ordeal. I practised in front of a mirror so I could see what it looked like and that way I knew when I was ready to go for a coffee with a friend and breastfeed at my local café without feeling like I was flashing the world! ~ Michelle

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Give yourself permission to take things one day at a time. Your milk supply will fluctuate, your baby’s feeding habits will change, and depending on what else is going on in your life, breastfeeding might be a different experience every day. That’s okay! ~ Karine Pregnancy BUMP & baby

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FOR MORE INFO

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The breast advice

THERE ARE A NUMBER OF KIWI-SPECIFIC WEBSITES AND RESOURCES YOU CAN CHECK OUT WHEN YOU WANT TO KNOW MORE ABOUT BREASTFEEDING – HERE ARE SOME OF OUR FAVOURITES. BUMP & baby

(bumpandbaby.co.nz)

New Zealand’s only pregnancy and newborn magazine has a website too! With heaps of helpful articles on feeding your baby, along with nutrition info, practical tips, essential products, and input from nutritionists, lactation consultants, midwives, and other health professionals.

BreastFedNZ

(breastfednz.co.nz)

A breastfeeding app which provides simple, “in the moment” support and advice to breastfeeding mums and their partners. There are six chapters, all covering key phases of breastfeeding, and it includes personal stories and photos from other mums throughout their breastfeeding journey.

Plunket

(plunket.org.nz)

Tried-and-true info about betting ready to breastfeed, nutrition, FAQs, problems and solutions, and more, the Plunket website is an excellent resource for breastfeeding information and advice.

Plunketline

(0800 933 922)

Talk to a real, live person 24 hours a day, seven days a week, whenever you have a question or concern about your baby. Staffed by Plunket nurses, who are registered nurses with additional qualifications in well child health, and who will listen to you and give you advice. Free to call from your mobile too.

La Leche League NZ (lalecheleague.org.nz)

Offering support and resources for breastfeeding mums, La Leche League NZ hold free monthly information and discussion meetings around the country, and also offer support over the phone, via email, and on social media. Many groups also hold coffee mornings, where mums can come with their babies to meet other breastfeeding mums in a baby/breastfeeding/child-friendly environment.

New Zealand Breastfeeding Alliance (babyfriendly.org.nz)

Information about the Baby Friendly initiative in NZ, maternity unit policies on breastfeeding, and your rights as a breastfeeding mum. You can also find a list of accredited Baby Friendly facilities and community services around NZ.

New Zealand Lactation Consultants Association (nzlca.org.nz)

The professional association of the International Board Certified Lactation Consultant (IBCLC) in New Zealand. Helpful info about what lactation consultants do, how they work, and how to find one near you.

Ministry of Health (health.govt.nz)

Comprehensive info about preparing for breastfeeding, what to expect, troubleshooting problems, and support, written by health professionals for Kiwi mums-to-be and breastfeeding mums.

Breastmates

(breastmates.co.nz)

Online maternity boutique with a wealth of articles on many aspects of infant feeding, with a particular emphasis on anecdotes and shared experiences from a community of other real mums.

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More comfort, more milk When you are comfortable and relaxed, your milk flows more easily. That is why we created our most comfortable breast pump yet - sit comfortably with no need to lean forward and let our soft massage cushion gently stimulate your milk flow.

Comfort breast pumps

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

DOLLAR$ AND $EN$E

Should I sign my baby up for

KIWISAVER?

Did you know there are real benefits to joining your newborn to KiwiSaver? We spoke to Amanda Morrall, Head of Communications and Education at Simplicity NZ Ltd, to find out more. Q: What are the benefits of signing my baby up for KiwiSaver?

Q: When should I sign my baby up?

AMANDA: KiwiSaver is a simple, accessible, low-cost investment vehicle which can help get your child get into their first home faster, or provide them with a more comfortable retirement. When it was first introduced, there was a bonus of $1,000 for anyone new to KiwiSaver. It worked well. More than a decade later, there are now over 2.8 million KiwiSavers in this voluntary scheme. Although the $1,000 kickstart has since been scrapped, there are still good reasons to join. Compound interest is the main one. The earlier you start saving, the better off you’ll be. When your wee one grows up and joins the workforce, they’ll pay into their KiwiSaver account, as will their employer at a current rate of 3% + 3%. Additionally, when your child turns 18, if they contribute at least $1,043 a year, they’ll get another $521 each year for free from the Government. It may be hard to picture the future when you have a newborn in your lap, but kids grow up way faster than you want them to, so it's something to consider early on.

AMANDA: Albert Einstein famously described compound interest as the eighth wonder of the world. The sooner you start, the longer your child has to benefit from it. The real power of KiwiSaver comes from the impact of regular contributions over time. As a parent, it’s important to weigh up your ability to pay into the account. For some cash-strapped parents struggling to meet daily bills, it may not make sense. The question of when to sign up a child, therefore, depends on the parents' circumstances.

Q: How do I sign my baby up? Do they need an IRD number?

AMANDA: KiwiSaver is managed through the IRD and everyone in it requires an IRD# to get started, including your baby. You’ll also need a birth certificate and supporting documentation proving the identity of both parents (driver’s licence or passport). There is no other special paperwork involved. If your child is already in KiwiSaver and switching to another provider, only one parental ID is required. As a guardian, you’ll be responsible for managing your child’s KiwiSaver account.

KEY CONSIDERATIONS IF YOU’RE THINKING ABOUT A KIWISAVER ACCOUNT FOR BABY: • KiwiSaver is locked in: It can only be accessed at retirement or for your child’s first home (not yours). • No free money: Kids are not eligible to receive member tax credits until they turn 18. • Fees: Make sure you understand what fees you’re paying on your child’s account. This is especially important if you ignore the account,

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as the effect of fees over time will erode the value of the account. Most providers charge an annual membership fee of between $20-30 PLUS an investment management fee. The latter is the one most KiwiSaver members fail to understand. From birth to 18, not paying the annual fees means an extra $540. That savings compounded further

Q: How much money should I be putting into their KiwiSaver account, and when? AMANDA: There is no minimum amount required to open a child’s KiwiSaver account, nor is it mandatory to make regular contributions. This makes KiwiSaver a low-pressure investment vehicle; however, the more you can chip in, the better off your child will be. For example, if you contribute $5 a week from birth until age 18, your child could have more than $7,500 in their account. (That assumes a 5% rate of return net of fees and tax). It’s a good head start on a firsthome deposit.

Q: Are there any disadvantages to signing my baby up to KiwiSaver? AMANDA: Don’t forget that KiwiSaver is locked in. Once you sign up your child, they’re committed. For some parents struggling with their own finances, it may not make sense to open an account that either gets ignored or which becomes too stressful to maintain. The majority of parents who first took up the $1,000 kickstart have been non-contributors. So do it only if it's right for your family.

to age 30 means an extra $2,100 potentially toward a house deposit. Simplicity does not charge an annual membership fee for kids in its scheme. • Fund type: It’s important to know what fund you’re invested in. Loosely, they break down to conservative, balanced, and growth. Balanced and growth funds are more heavily weighted in shares, which tend to be riskier because of market volatility. The upside to the

risk is you can generally expect greater returns over time. Some providers charge higher fees on growth-oriented funds, so if you’ve put your child into KiwiSaver in a growth fund and not contributed into it regularly, high fees could be chipping away at the balance. • PIR (Prescribed Investor Rate): As a non-tax payer, your child will be in the lowest tax rate of 10.5%. Make sure you haven’t accidentally put them into a higher PIR rate.

$30 a year is a big deal to a small kid.

$ As NZ’s fastest growing KiwiSaver plan, we save our members more than $6 Million p.a. in fees. Now, we’re even saying goodbye to the $30 membership fee for kids. Sign them up today, at: simplicity.kiwi Simplicity NZ Ltd is the issuer of the Simplicity KiwiSaver Scheme. See www.simplicity.kiwi for Product Disclosure Statement.

GROWING LITTLE READERS

Board books are perfect for babies – sturdy and hard-wearing, they're easy for little hands to grasp.

BABY’S FI R S T BOO KS

KAKAPO DANCE, BY HELEN TAYLOR (Penguin RRP$15.99) All the birds in the forest are singing and dancing. All except Kakapo. Kakapo can’t coo and glide like Kereru, chirp and twirl like Fantail, hop and chime like Bellbird, or whistle and waddle like Whio. But the other birds are having so much fun that he can’t help joining them – in his own Kakapo way. A playful read-out-loud story about NZ bird song and movement. HEDGEHOG HOWDEDO, BY LYNLEY DODD (Penguin RRP$15.99) It is winter, and the garden is full of sleeping hedgehogs. All is peaceful now, but what will happen when they wake up in spring? Teach your baby to count with this delightful board book story about hibernating hedgehogs from the creator of Hairy Maclary and Friends. ROALD DAHL’S OPPOSITES AND ROALD DAHL'S 123, ILLUSTRATED BY QUENTIN BLAKE (Puffin RRP$15.99 each) Day and night, big and small, hungry and full... Or count from one to 10! Teach your baby opposites and counting in these funny and clever baby books starring the Enormous Crocodile, from the world of Roald Dahl.

AVAILABLE FROM DECEMBER

I AM LITTLE FISH: A FINGER PUPPET BOOK, BY LUCY COUSINS (Walker Books RRP$18.99) Time to splish, splosh and splash in the deep, deep sea with Little Fish and his fishy friends! Dip, dive, and swim along to the rhyming text and delightful underwater illustrations, with a colourful finger puppet and peek-aboo holes on every page. WELCOME: A MO WILLEMS GUIDE FOR NEW ARRIVALS, BY MO WILLEMS (Walker Books RRP$27.99) "This is YOU. Take a good look. How remarkable it is that you are you." This enjoyable guide for new

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arrivals is perfect for gifting to new babies and new parents alike! Using bold graphics, a clever, heartwarming narrative that playfully interacts with the reader, and a surprise mirror, this is a one-of-a-kind welcome to the world from one of the best-loved picture book creators of our times. ABC ANIMALS, BY INGELA PETERSON ARRHENIUS (Walter Foster Jr RRP$18.99) Adorably illustrated with 26 cool and unusual animals, from alpacas to zebras, ABC Animals colourfully presents a world of fun and learning for young readers and families alike. Meet some of the world’s most unusual animals with this fun approach to learning the alphabet! In this new title from Walter Foster Jr., ABC Animals combines learning the alphabet with discovering new animals from around the world in a board book young children and parents will love. ABC: SEE AND SAY ALL THE LETTERS OF THE ALPHABET, BY AINO-MAIJA METSOLA (Wide Eyed Editions RRP$14.99) Help your baby learn their alphabet with stylish artwork from Aino-Maija Metsola. With sturdy pages for little hands to hold, young readers will enjoy naming objects on every spread as they learn their A to Z. COCO: MY FIRST COCO CHANEL, BY ISABEL SANCHEZ VEGARA AND ANA ALBERO (Frances Lincoln Children’s RRP$14.99) Meet Coco Chanel, the world famous fashion designer! This inspiring little biography follows the life of the iconic first lady of fashion, from her early life in an orphanage where she is a genius with needle and thread to her time as a cabaret singer, hat maker, and, eventually, international fashion designer. We love the quirky illustrations!

#MadeOfSeattle

why just travel, when you can traverze... diono traverze in yellow sulphur

the original luggage-style super-compact and superlight stroller created to make traveling easier for families on the move.

For more information visit nz.diono.com

SMOOTH RIDE

RIDE ON

With luxury styling, multiterrain handling, and air suspension, The Silver cross Special Edition Surf Henley is more than just looks. RRP$1,799 from silvercross.co.nz

A problem-solver for travelling families, transforming into a car seat for toddlers up to 15kg while still retaining luggage storage capacity. Mountain Buggy bagrider RRP$149 from babycity.co.nz

IN THE BAG

For the modern wandering urban-boho mama, Obi Kinomi's range of nappy bags come in cool colours you won't mind toting around. Baby Weekender RRPAU$297 from obikinomi.com

WIPE AND GO

Infused with organic essential oils and natural plant extracts, Natracare Organic Cotton Baby Wipes are gentle on sensitive baby skin. RRP$9.99

20 tips for travelling with your baby

BE SEATED

The phil&teds lobster is the world's fastest-deploying high chair. Flat-packs for travel and clips on to most tables. RRP$129 from babycity.co.nz

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Most child-free travellers find the experience of getting from place to place fairly tedious. But once you have a baby, travelling by car, plane, train, sea, or camel becomes challenging, adventurous, amusing, frustrating, exhausting, and more. But boring? Not at all. Make the most of the experience with these tips from Tiffany Brown.

OUT & ABOUT STROLL, FOLD, AND GO

R OA D TRIPPING

Perfect for travelling, the Diono Traverze can be wheeled to the plane door, then folded with one hand and stowed in the overhead bin. Starting from RRP$399, nz.diono.com for stockists

WE LOVE IT!

1. Prepare for the journey. Before

you set off, check tyres and spares, tyre-change gear, water and oil. Ensure there are unobstructed views for the driver, even if the boot is loaded up, after the car is packed and ready to go. Choose the quickest route possible, not the scenic route. There’s no excuse not to know which way is fastest with the modern technology of satellite-led GPS systems.

2. Keep the supplies you’ll

need while travelling within easy reach. A separate bag packed with nappies, wipes, spare clothes, feeding gear, a few toys, and a small first aid kit will save you scrabbling around in depths of your luggage for the items you need. And remember the big people! Prepare some supplies for yourselves, too. It’s easy to neglect your own needs when baby is so little, but ensuring you have refreshments, extra layers, device chargers, reading materials, etc handy is just as important.

3. Break up the journey

by stopping for meals and drinks, visiting playgrounds, calling in on relatives en route, or even staying overnight. Stop every one to three hours during the day, or every three to six hours at night for nappy changes, bathroom breaks, feeding, leg-stretching, and fresh air.

BACKSEAT DRIVER

Installation of the Britax Boulevard ClickTight Convertible Car Seat is as easy as buckling a seat belt. RRP$599, britax.co.nz for stockists

6. Know when to quit. If fatigue is winning out on the road, know that not only is it okay to give up and rest, it’s much safer for you and your fellow travellers. Whomever is waiting for you at the other end would rather you arrive late and fresh than not at all.

4. If there are two adults travelling,

take turns in the driver's seat. Sit in the back to entertain baby, and rest when they sleep to freshen up before taking charge of the wheel again. Consider driving at night to put some miles behind you while your baby is likely to sleep for longer than in the day.

5. Playing and singing simple songs

and nursery rhymes can be helpful in multiple situations, whether your baby is fussy, upset, or just in a playful mood.

BABY ON BOARD

With full ergonomic lumbar support for your back and hips and a zip-off day pack, the Mountain Buggy Escape baby carrier is ready for adventures. RRP$329 from babycity.co.nz

F LY I N G HIGH

7. It pays to check out the rules

of the airline you’re travelling with so you can sort out what you’ll need in-flight in terms of baby gear. Can you take your stroller right up to the gate? Will your baby bag be counted as hand luggage? What are the requirements around formula or baby food? Figure this all out before you turn up to the airport to make the journey run more smoothly.

8. Choose a window seat over an aisle

seat. It will be a little more difficult to manoeuvre in and out of the window position, but on the aisle you’ll continually be pulling your baby and yourself back in over the armrest as other passengers, cabin crew, and refreshment trolleys trundle past.

9. While you may not want to invest in

travel-friendly baby gear, products designed to make travelling easier will be a godsend

if you can get your hands on them. Beg or borrow from friends, try swap sites or local trade and exchange groups, or investigate hire options. Wearing small babies in slings or carriers makes life much easier when it’s handy to be able to have your hands free to carry other bags or hand over your passport. Airlines very generously allow families with infants to board ahead of other travellers, but consider this will effectively mean at least half-an-hour longer on the plane. If your flight is long and your baby is full of energy, it may be preferable to enjoy the wide open space of the airport lounge til the very last moment.

10.

11. Mitigate the effect of the cabin

pressure change when taking off or landing by feeding your baby throughout the ascent or descent.

12.Bring plenty of diversions for your

baby, like books and quiet toys. Your fellow passengers will not thank you for bringing baby’s favourite noisy battery-operated or squeaky plaything! Pregnancy BUMP & baby

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OUT & ABOUT

COLOUR ME TRENDY

With sturdy materials, one-piece fold and all-terrain tyres, the Bugaboo Fox is the ultimate in lightweight travel prams. RRP$2,159, bugaboo. com for stockists

RIDE IN STYLE

From birth to booster, the Clek Foonf convertible car seat keeps littlies safe on the road and in the air. Easy to clean too. RRP$799 from clek.co.nz

C A R R E N TA L S , TA X I S , A N D P U B L I C TRANSPORT

HANDS-FREE

The Mountain Buggy Juno baby carrier has four carrying modes and can be used for newborn to toddler. RRP$249 from babycity.co.nz

16. Car rental companies can provide

car seats, usually for a small extra charge. While this will save you transporting your own, for ease of use, baby’s comfort, and your own piece of mind, it may be preferable to take one with you.

17. In NZ, taxis, shuttles

OV E R N I G H T A C C O M M O DA T I O N S TA Y S

13.

Check out what there is available ahead of time, and if your accommodation offers a portable cot or crib, ask that it be set up for you before you arrive. Also be sure to check about bedding, as some accommodation providers will expect you to provide this yourself. For sensitive babies, taking your own linen from home is a good choice anyway, as this will make the environment more comfortable and familiar for them.

14.Ensure you have a good

understanding of the facilities available. Is there a bath, or can they provide a separate baby bath? Is there a highchair?

15.It’s a good idea to ask if there

is a play gym or infant toys available, too, especially if you’re booking a private accommodation option – owners usually have access to this type of gear and will be happy to go the extra mile for you. I’ve even heard of an accommodation owner who set up a Christmas tree for a travelling family with small children who stayed for the week across 25 December!

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and buses are exempt from the requirement to restrain infants in approved child seats, although most taxi companies will allow you to fit your own if you prefer. Bus companies like InterCity allow the use of child seats with the purchase of a ticket whereas, like airlines, children under two travel free if they travel in an adult’s lap.

GENERAL TIPS FOR A POSITIVE T R AV E L EXPERIENCE

GREAT BUY!

Laws in other countries differ, so be sure to do your research if you plan to take taxis or shuttles overseas with your infant.

19.Employ some baby massage

techniques. If you haven’t already, book in for a baby massage class in your area. These techniques come in very handy during breaks from their travelling seat. Massage can also help your baby relax and cope better with the transitions required when travelling.

PRAM WITH X-FACTOR

A dream to drive, fold, and store, the Britax Flexx lives up to its name. Easy to change to a tandem stroller too. RRP$899 plus RRP$349 for the tandem pack, britax.co.nz for stockists

20.Chill out. Things can and will go

wrong when you travel, so try to maintain a sense of humour even in the worst case. Because parental anxiety is the number one way to worsen the situation for a stressed-out infant, as challenging as it gets, try to "fake it til you make it" and plaster a grin on your face to reassure your baby that despite the strange circumstances, they can always rely on you to be their happy place.

WORLD'S PUREST WIPES WaterWipes are only wipes that contain just 99.9% water and a drop of fruit extract, RRP $7.99 from supermarkets, chemists, and online

REAL OR RUMOUR? The horror! Why don't babies come with instruction manuals?

NO STUPID QUESTIONS

What the books don’t tell you about newborns You’ve read it all: How many bodysuits your baby needs, what music to play at night, the importance of routine... And yet, deep inside, you worry how ready you actually are for that parenting game. Once the scary bit – the giving birth part – is over, you’ll have to face something even more terrifying: Taking care of an infant. Yvonne Eve Walus gives it to us straight.

Q: What if I don’t love my baby? ANSWER Look, you probably won’t, at first. I know, you’ve heard about that overwhelming rush of love you’ll feel upon seeing your newborn for the first time. Perhaps those who claim it misremember, or perhaps they’re the lucky ones, but reality is usually different. What many mothers feel right after giving birth is exhaustion coupled with relief that it’s finally over. When you hold the baby for the first time, you may feel like an actor without a script forced to play a role you haven’t studied. So give yourself a few days to bond with this little red and wrinkled human being, and you’ll soon realise that your baby is the most important thing in the entire world. If you still feel nothing after a week, tell your lead maternity carer. Sometimes just talking about it helps;

other times you might need a support group of women who are in the same situation as you, or treatment for postnatal depression (PND).

Q: How do I hold my newborn? Something about supporting the head, but how do I take her out of the cot? ANSWER If your baby is laying down, put one of your hands under her head and splay your fingers for maximum support. Slide your other hand under her bum until you reach her upper back. Lift and bring her to your chest or shoulder, or just hold her in the crook of your arm. Adjust the hand that’s on her back so that the hold is comfortable.

Q: Is changing nappies as gross as I imagine? ANSWER No, it’s surprisingly all right. The first few nappies are dark with meconium, which can get a bit sticky and smeary (not unlike tar). Then they change to light brown, and they don’t smell bad, because the baby is only drinking breast milk or formula. Of course, do put it in the bin ASAP if it’s a disposable nappy, or rinse it out as soon as you can if it’s cloth. But on the whole, it’s honestly not as bad as the first time your baby gets bit by a mosquito.

Q: Speaking of which, cloth or disposable? ANSWER No. Just – don’t even start the argument. Do whatever you want, and it’s nobody’s business to criticise.

Q: No, but really? ANSWER Really. But all right. If money’s one of your motivators, remember to compare not only the price of disposables versus the price of cloth nappies, but also the price you pay for rubbish removal (a disadvantage of disposable nappies) versus the price of water, washing powder, and electricity (the disadvantage of cloth nappies). If the environment is your concern, again, it’s generating rubbish versus using up water and electricity. Your calculations, your choice, and it’s always the right choice – for you.

Q: Did someone mention mosquito bites a while back? ANSWER Sorry. The first time a mosquito bites your child, you’ll want to hunt down that insect and its whole family and kill them all. Your baby will probably not even notice, but your feelings of guilt and inadequacy will stay with you for years. Pregnancy BUMP & baby

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NO STUPID QUESTIONS

ANSWER First of all, don’t stress. If it

Q: What else should I protect my tiny baby from before he can even roll over? ANSWER The following advice might sound sensible or paranoid, so take it or leave it, depending on what feels right. • Be careful with your hot drink while you’re breastfeeding. • Never pass anything to someone over the baby’s head (or any other part of the baby), in case you’re clumsy and the object falls onto the baby. • Watch older children while they interact with the baby, and make sure they don’t feed her anything or give her any small objects that might end up in her mouth. • Check the cot for loose muslins, pillows, soft toys, or anything else that might end up covering the baby’s nose or mouth. • Check with your LMC regarding the most up-to-date advice on sleeping positions and co-sleeping. • Never leave your baby unattended: Not in the car, not in a shopping trolley, not in a public toilet. • Okay, this last one is not paranoid: Never leave your baby alone in the car.

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Q: Swaddling – yes, no? ANSWER That’s another one of those

topics, the ones where you’ll be given contradicting advice. The theory goes that babies like to feel snug and restricted, and swaddling them in a piece of natural fabric (like an oversized muslin or a swaddling blanket) will give them a sense of security and make them sleep better. And guess what: This expert advice is right some of the time. Some babies love being swaddled, others will fight to free their arms and legs. Try it out and see whether it makes your baby happy.

Q: My best friend wants to visit, but I don’t feel ready for company. ANSWER Do a quick check to make sure you’re not depressed. No? Then blame the baby: Tell your friend the baby still needs time to settle in.

Q: What do I do if the baby swallows a foreign object? ANSWER Go to the doctor. If it's

a battery, coin, pill, or something else that's dangerous, call an ambulance and go to the emergency room RIGHT NOW. But know this: Swallowing objects, getting gum in the hair, or sticking a bean up the nose are all parenting challenges classified as "tomorrow's problems". Today, try to get as much sleep as you can.

Q: Other new mums make breastfeeding look so easy – they do it with one hand, while Q: Right, but what if a moth flies into drinking ice water the baby’s ear? with the other, while ANSWER Make the room completely having an intelligent dark and shine a torch next to the baby’s The moth will fly out to follow the conversation, but I just head. source of light. Now, seriously, stop can’t get the hang of it. worrying and go to sleep.

DISCLAIMER: THIS IS A LIGHTHEARTED AND HUMOUROUS ARTICLE INTENDED TO MAKE YOU GIGGLE. OBVIOUSLY WE RECOMMEND YOU GET IN TOUCH WITH YOUR LMC OR GP STRAIGHTAWAY IF ANYTHING HAPPENS THAT YOU'RE WORRIED ABOUT. YOUR AND YOUR BABY'S SAFETY AND WELLBEING ARE PARAMOUNT. WE KNOW THIS. WE JUST WANTED TO HELP YOU LIGHTEN UP A BIT.

happens, it happens. If not, there’s always the bottle. No big deal. Secondly, yes, at the beginning there’s a lot to remember. With one hand, you’re supposed to support the baby. With the other hand, you’re supposed make your breast into a wedge. With your third hand (yes, all mothers need octopus arms), you gently open the baby’s mouth, while the fourth hand is pumping the little arm up and down to prevent the baby from falling asleep during the feed. (It’s a bit like learning to drive a manual car, and you think you need three legs, five hands, and eyes that can look straight ahead as well as into three mirrors.) Keep asking your midwife or a lactation specialist to help you until you get the hang of it, or until you decide that the stress is worse for the baby’s wellbeing than an artificial nipple.

PROTECT WHAT’S MOST IMPORTANT TO YOU How safe would your home be if a quake occurred tomorrow?

We can’t predict earthquakes, but we can prepare for them. One of the best places to start is with your home. Whether you rent or own the home you live in, you can take steps today that will make it safer for you and your family during an earthquake. Fasten tall and heavy furniture Falling furniture, particularly tall or heavy items (bookcases, cabinets, TVs, fridges) can be a hazard during an earthquake.

Remove or replace brick and concrete chimneys Brick and concrete masonry chimneys may crack, shift or collapse in an earthquake, causing damage to people and property. They can topple or collapse through the roof, or fall outwards damaging other parts of your property. • Do you use your ﬁreplace? If not, could you remove the chimney and remove an earthquake hazard?

• Look around your home – what might topple or shift in an earthquake?

• If you still use your chimney, consider replacing it with a lighter metal flue within a timber-framed surround.

• Secure furniture using brackets or other fasteners to the wall or shelf they sit on. Your local hardware shop should have the items you need to get the job done.

• Cracks, tilts or missing bricks could be a sign that your chimney needs immediate attention. Ask a licensed builder for advice.

Secure your valuables Household items can make a big mess and be dangerous if they fall and break during a quake. ‘Baby-prooﬁng’ is the perfect time to take some simple steps that will make your home even safer. • Use non-slip mats and Blu tack to help keep ornaments and precious objects in place. • Add safety catches to cupboard doors and drawers and move heavy items to lower cupboards. • Make sure pictures are well secured, with hook sizes sufficient to support the weight of the item and squeezed shut to keep the picture in place.

We can all do something to make our homes safer, and the best time to start is now. For more information, visit eqc.govt.nz/prepare

P E AR LY WH ITES

Taking care of little teeth You may not realise that thinking about caring for your baby’s teeth starts as soon as that tiny little nib of a first tooth show up. Yvonne Eve Walus answers some frequently asked questions about caring for your baby’s first teeth.

lthough you may not be ready to say goodbye to your baby’s toothless grins, the time will come for them to celebrate the milestone of their first tooth making its white, jagged appearance. Typically, this happens when the baby is between four to seven months old though, of course, like everything else, it’s likely to vary.

Q: Brushing before the baby has teeth – is that even a thing? ANSWER: If you want to get your baby used to the idea of brushing teeth, you can start by rubbing his gums – very gently – with a clean finger or a soft cloth after each feed. However, until the first white bits break the surface, tooth decay is unlikely.

Q: Which tooth is likely to come out first? Where do I look?

Q: So when should I start using a baby toothbrush?

ANSWER: This will be adding a new item to your list of daily chores, but you will have to start brushing your baby’s teeth as soon as they break through. Clean them very gently with a special baby toothbrush: One that’s super-soft, with a very small head, and with safety shields to prevent the baby from grabbing it and pulling it too far into her mouth. If you opt for a finger toothbrush, choose one that’s made of food-grade silicone. Whichever toothbrush you end up with, remember to rinse it in boiling water after each use and let it air-dry somewhere away from cleaning or bath products.

Q: What about toothpaste?

ANSWER: Yes to baby toothpaste – not the adult version. To begin with, use only a teeny amount, as big as a grain of rice. When your baby is 18-24 months old, increase the amount to a pea-size dollop. Because you’re using such tiny amounts, there’s no need to rinse after brushing.

ANSWER: Typically, the first to arrive are the two bottom FINGER BRUSH incisors (the ones in the An easy way to start! front of the mouth), usually Use the "brush" together. Sometimes your baby side for gentle teeth might not open her mouth cleaning, and the "dimple" side for Q: How do I do it? wide enough for you to see massaging gums. ANSWER: Place the baby the teeth, and you will have Jack N' Jill Silicone to check for them with your on his back on the bed or on Finger Brush 2-pack finger. A few months later, a soft surface, or hold him in RRP$10.50 the corresponding top two the crook of your arm. Gently front teeth will follow. After that, the order open his mouth with your fingers and slide the toothbrush over the teeth. Brush switches up a bit and the upper middle teeth appear next, so your baby will have on the inside as well as the outside of the four on top and two at the bottom. By then baby’s teeth, and when the molars come you will definitely be able to see them. in, brush the chewing surfaces, too. Pregnancy BUMP & baby

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P E AR LY WH ITES

Q: What if my baby won’t let me brush? BRUSHIN' RASPBERRIES

With organic calendula and organic raspberry flavour, it's sugar-free too. Jack N' Jill Natural Toothpaste RRP$9.50

HAPPY APPLE

Non-foaming so your baby won't sputter on a mouthful of froth. Brush-Baby Baby and Toddler Toothpaste RRP$6.75 from smilestore.co.nz

Q: Can’t I just wipe their baby teeth with a cloth?

ANSWER: Cleaning your baby’s gums and tongue with a soft wet cloth after each feed is a great idea while the baby has no teeth, but do change to a toothbrush as soon as those pearly whites become visible.

Q: Do I need to clean their tongue too?

ANSWER: Yes. Remember, good oral hygiene is about the whole mouth, not just the teeth. The tongue carries the most germs, so brush it last, after all the teeth have been done, using gentle backto-front strokes.

Q: How long should I brush for?

SOOTHE SORE GUMS

Grumpy baby with sore gums? Try this – with calendula, chamomile, and a mild natural vanilla flavour, it's suitable from four months. Jack N' Jill Teething Gel RRP$23.50

WIPE OUT

Great for cleaning baby's mouth after feeding. Brush-Baby Dental Wipes RRP$12.50 from smilestore. co.nz, Jack N' Jill Baby Gum & Tooth Wipes RRP$17.99

ANSWER: Around two minutes for a full set of milk teeth, but obviously shorter for babies with only one partial tooth. Remember, over-brushing is not a good idea, as it strips off the tooth enamel. Just a few seconds per tooth will be sufficient.

Q: Twice a day like adults, or after every feed?

ANSWER: Twice a day, morning and evening, until your baby is able to hold the toothbrush properly and do it themselves (usually about the same time as developing a pencil grip, around five years of age). You will, however, have to supervise them until they’re about eight, to make sure they do it properly.

Q: Can’t I just leave my baby’s mouth alone? Cavemen (and women) didn’t have toothbrushes.

ANSWER: Dentists aren’t budging on this one: You have to brush your baby’s teeth as soon as they appear. No, cavemen didn’t have toothbrushes, but their diet and lifestyle were different.

ANSWER: Some babies don’t feel too happy about a toothbrush suddenly arriving in their mouths. This is more common than you think, so here are a few ideas from fellow parents who’ve been there: • Let your baby see you brush your teeth – most likely, he will want to copy you. • Make brushing time a family activity and do it all together. • Use the toothbrush as a chewing toy for your baby – this will get him used to having a toothbrush inside his mouth, and it might also partially clean his teeth even before you have a go at it. • An interestingly shaped, colourful toothbrush may help. • Or have two brushes: One for the baby to hold, the other for you to brush with. • Make it fun! Sing a silly song, look in the mirror, brush only one tooth at a time with clapping in between. • Don’t stress if on some days you don’t manage a full session. The important thing is that your baby has positive associations with toothbrushing, and that it’s part of her daily routine.

Q: Right, what else can I do to prevent cavities?

ANSWER: If your baby uses a bottle, make sure you only fill it with water, breast milk, or formula. Avoid normal milk, sugar water, and juice – sweet liquid can settle on the teeth and promote tooth decay. If your baby needs a bottle for night-time comfort, fill it only with water. Similarly, don’t put anything sweet on the baby’s dummy.

Q: How do I know whether my baby’s teeth are healthy?

ANSWER: Inspect the teeth regularly to detect any decay. Gently lift back the baby’s lips to check that the teeth are smooth and uniformly coloured. If you notice a dull white band along the base of the tooth, or any brown spots, take her to your family dentist or local dental clinic. In NZ, dental care is free for children under 18.

TAKING CARE OF BABY TEETH FOREVER

CHEW ON THIS

Great for teething babies, you can also pop a tiny amount of teething gel on it and keep in the fridge for teething relief. Brush-Baby Chewable Toothbrush RRP$8.95 from smilestore.co.nz

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Before you know it, those baby teeth will start wobbling and falling out (in early primary school). To store them, buy or make a tooth album or a tooth memory box. Just remember to hide it well for as long as children believe in the Tooth Fairy.

More babies accept our soothers first time

Different shield shapes and decoration for every occasion. Traditional shield style with modern but understated designs. Traditional shield style with glow handle, making it easier to find in the dark. With night and sleep themed decorations. Traditional shield style with bright and playful designs.

Available in 2 age stages

Find out more at tommeetippee.co.nz **68% of babies accepted this new style soother first time, compared to just 43% for the old style closer to nature design – in an independent product trial conducted by Swift research, February 2013 with 112 UK mothers and babies.

FEVER SIGNS

HELP! My baby is BURNING UP!

WHAT IS NORMAL? For babies, temperatures should be between 36˚C and 37.5˚C, though the time taken, the thermometer used, and how the temperature is taken can cause fluctuation.

Having a sick baby can be a very scary experience, especially when your baby is quite young. If your baby has a temperature, how do you figure out what is normal or high? And if it is high, how do you bring it down while trying not to panic? Preparation is the key to managing this situation, says Amber Hall.

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WHAT’S HIGH? A temperature of 38˚C in a baby younger than three months means the child likely has a fever. After three months, 38.5˚C. This also applies to toddlers. However, high temperatures may be caused by too many clothes or coverings. It’s important to take into account your child’s history as well as any symptoms or signs they might have.

HOW TO TAKE THE TEMPERATURE OF A BABY The best ways for a parent to take a baby’s temperature include an ear thermometer, one that can be placed or passed across the forehead, or an infrared thermometer. Don’t rely on placing your hand on your baby’s forehead.

COMMON CAUSES OF HIGH TEMPERATURES

HOW TO TELL IF YOUR CHILD MIGHT HAVE A TEMPERATURE BEFORE YOU REACH FOR THE THERMOMETER A scratchier mood than normal, rosier cheeks, sleepiness, and a lack of hunger can all suggest a temperature, as well as older children complaining of cold when they are hot to the touch, or complaining of sore muscles or joints. Use a thermometer to confirm whether they have a fever – don’t rely on these signs.

WHEN SHOULD YOU BE CONCERNED? A doctor should always check a baby under the age of three months if a fever is suspected. Parents should also be alert for any hint that btheir aby is bothered by light or appears to have some stiffness in their neck. These are signs which could mean meningitis. Vomiting, a rash, problems with breathing, or more than normal sleepiness are other reasons you should take your baby to the doctor.

If you are in any doubt or you are concerned about your baby’s health, contact Plunketline on 0800 933 922 to speak to a Plunket nurse. HOW TO BRING BABY'S

Viral infections can cause a mild fever and not last very long, in which case the child’s immune system is doing what it's meant to – fighting off the infection. A fever lasting no more than two days and caused by colds, flu, or infections of the ears or throat are not too serious if they occur no more than once a month. Teething can make their temperature rise too, though usually it stays under 38.5˚C. Also, a baby can be affected quite quickly by the sun's heat. More worrying, urine infections, pneumonia or other lung problems, meningitis, and blood problems can all lead to high temperatures.

TEMPERATURE DOWN

Patting a child’s neck and forehead with a damp cloth and removing some clothing will help, so long as the child doesn’t then become too cold. An age- and weightappropriate dose of paracetamol can be given with a doctor's guidance, along with clear fluid to sip. Cold baths, fans, and body sponging are too drastic for a baby or small child – don’t do them.

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Quick 5 with our cover model BEST BUMP DRESSING TIP Flowy maxi dresses with slightly longer sleeves you can wear during and after your pregnancy will be your best friend! GO-TO PREGNANCY SNACK Bliss balls! They are healthy and help keep you energised, while having a bit of sweetness that will curb sugar cravings. MOST SPECIAL MOMENT Finding out I was having another boy ( four boys has been my dream since I was a teenager). FIRST THING YOU DID AFTER BABY ARRIVED Cried tears of joy! BIRTH ADVICE: Be flexible and go in open-minded. Have a birth plan and educate yourself, but keep in mind that you don't have control over what will happen. My best labours were when I wasn't set in my thinking of how things would go. 142

Pregnancy BUMP & baby

We loved how this has been styled...

LOCATION: Jonkers Farm (jonkersfarm.co.nz) PHOTOGRAPHER: Kate Little Photography (katelittlephotography.com) MODEL: Isobel Benesch @isobelbenesch CROWN: blossomandwild.com DRESS: freepeople.com CHILDREN'S CLOTHING: mybrotherjohn.com, naturebaby.co.nz, bobux.co.nz

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Pregnancy BUMP&baby issue 7

Articles inside

How do I know if my baby has had enough?

Making milk

Why good nutrition matters