Pregnancy BUMP&baby issue 14 by BUMP&baby

High-oil specialist skincare 100% NATURAL

for scars, stretch marks, uneven skin tone Scientifically proven and designed to effectively work with the skin to deliver optimal skin health

POWERFUL FORMULATIONS. POWERFUL RESULTS.

Bio-Oil® Skincare Oil is a specialist skincare product formulated to help improve the appearance of scars, stretch marks and uneven skin tone. Available in the original and 100% natural versions at participating stockists. Individual results will vary.

Take comfort in knowing your family’s protected with AA Life Insurance. Voted NZ’s Most Trusted Life Insurance Brand^ for the ninth time.

Visit aalife.co.nz | Call 0800 801 830

2 202 L if e Insuran c e

^AA Life Insurance has been voted by New Zealanders as NZ’s Most Trusted Life Insurance Brand in the 2022 Reader’s Digest Trusted Brands survey. AA Life Insurance policies are underwritten by Asteron Life Limited. Terms, conditions, and exclusions apply.

Saving your baby’s cord blood could save your baby’s life. It takes just a few minutes to painlessly collect umbilical cord blood from your newborn baby. Saving the stem cells from this blood may give your child the chance to recover from many serious illnesses and conditions – now and into adulthood. It’s a once in a lifetime opportunity. Here in New Zealand, we have our own world class cord blood storage facility at CordBank. Only CordBank collects and stores your baby’s cord blood right here in New Zealand. They’re 100% New Zealand owned and operated, and they deal exclusively with cord blood – the world’s most proven source of stem cells. And because your child’s cord blood stem cells are stored here, they’re close at hand and protected by New Zealand law. To learn more about the lifesaving value of cord blood stem cells go to cordbank.co.nz or phone 0800 CORDBANK.

cordbank.co.nz

contents

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magical journeys

52 36

42 TESTING TIMES

Do you suffer from perinatal anxiety?

8 EDITOR’S LETTER

26 THE MAGIC TOUCH

Challenges and triumphs

10 ONLINE ANTENATAL COURSE

Pregnancy, antenatal and baby massage

28 KEEP ON MOVIN'

Take our course in the comfort of your own home

12 PARENTAL GUIDANCE News, views and products we rate

Our cover māmā Georgia is ready to meet her new little boy

32 ALL ABOUT ABS

And enjoy a PeekaBox full of goodies

Vitamin C skincare COVER | Photographer: Annupam, @annupam, annupam.com; Hair & Make-up: Kylie Wakefield, @barebeautywithkylie; Styled by: Maddie Long, @seventhsister, the7thsister.co.nz; Model Māmā: Georgia Koale, Red11 Models, @georgiiaotene, @red11models, redeleven.net.nz; Photographic studio: Progear, @progearphoto, progear.co.nz; Clothing and jewellery: Green dress zara.com/nz, earrings hm.com/nz

Shop From Home 20 SUBSCRIBE TO BUMP&baby

34 GET YOUR GLOW ON!

36 SWEETS FOR MY SWEET Recipes for pregnancy treats

Pregnancy screening tests explained

46 WOMB TO GROW The perfect science of the placenta

Pregnancy safe strength training

Managing Diastasis Recti

16 COVER BUMP

Birthing bag, checklist and support services

Health+ Wellness 22 THE ANXIOUS MAMA

Every Issue

126 RESOURCES

Your Growing Bump

66 BUMP&baby MALL.CO.NZ The online store that delivers everything – except the baby!

122 DIRECTORY Some of our fave businesses to support

48 SEEING LIFE BEFORE BIRTH The photography of Lennart Nilsson

50 TURN, BABY, TURN When baby is the wrong way around

52 MY MAGICAL JOURNEY Kiwi women share how pregnancy empowered them

58 WIN A PĒPI PACK Send in a picture of your baby bump and be in to win a $700 pēpi pack thanks to Chicco and Isoki Pregnancy BUMP & baby

contents

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embracing the wonder of birth 107 YOUR BREA STFEEDING TOOLKIT Tips for successful feeding

108 BREA ST PALS Protect and soothe with these essentials

Newborn+ Postpartum

Nursery+ Equipment

96 IN STITCHES Ten gentle ways to care for your postpartum stitches

70 EARTH BABY

78 Life+ Insight 60 CHOOSING YOUR PARENTING ST YLE Are you a rock, paper or tree?

62 GOING SOLO Support for single mamas

Create an eco-friendly nursery

72 PRETT Y LITTLE THINGS Bright and modern nursery inspiration

74 NURSERY NESTING Time to get organising!

76 L AY ME DOWN TO SLEEP Safe sleeping spaces for your pēpi

64 FLY AWAY WITH ME

78 SLEEPY TIME

Tips for planning your babymoon

Cosy baby sleeping bags

Pregnancy BUMP & baby

80 NURSERY NOOK Special stories for small people

82 ON A MISSION How to choose the right pram for you

85 ON MY WAY Car seat safety and installation

110 Labour +Birth

88 HOW TO MANAGE PAIN DURING CHILDBIRTH Every mama is different

90 THE WONDER OF BIRTH Welcoming three gorgeous souls into the world

98 LULL ABY AND GOODNIGHT Helping your baby to fall asleep and stay asleep

101 A HEALTHY BOOST FOR NEW MUMS Lactation support from a Kiwi mama

102 IT TAKES A VILL AGE Support on your breastfeeding journey

110 THRILLS AND SPILLS Reflux and silent reflux

113 WA SHABLE WONDERS The ins and outs of reusable nappies

114 WHAT GOES IN Everything you need to know about baby poo

116 YOUR BABY’S SKIN Newborn skin conditions

120 NOT TOO HOT, NOT TOO COLD The right temp for your baby

130 FUN WITH GRANDMA AND GRANDAD How grandparents can get involved

we're all about

family

kia ora

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PREGNANCY

Issue 14

Challenges and triumphs When I was pregnant, I found myself fascinated by birth. I would watch episode after episode of the TV series One Born Every Minute, which was both torturous and exhilarating. It’s a “can’t-look-away” combo of intense pain and extreme triumph and, while I had never (and still have never) given birth naturally, it’s absolutely amazing to see what our bodies can do. Growing and birthing a human is truly magical. However, no pregnancy, birth, or newborn is alike, and each stage comes with its own challenges. I have two amazing, sassy, and special little girls who are six and three and both were born by C-section. While my first pregnancy was a breeze of joy and anticipation (combined with being uncomfortable, of course), my second was filled with extreme worry due to perinatal anxiety (see pages 22-25). My first daughter was a laid-back newborn. She slept through the night at nine weeks, smiled at everyone, and would go to the postman if you handed her to them. But my second was restless from the second she was born. She was a screamer and suffered from extreme separation anxiety. She didn't like anyone but me and she wouldn’t be put down… For two years. So while you may be scrolling through Instagram at the “perfect” pregnancy and the “breezy” newborn, just remember – no day is without its challenges for every mama-to-be and new mum. Today you may have zero sleep and are still in your PJs, but tomorrow you could be fully showered, dressed, and out the door by 8am. Being pregnant and having a newborn is a one-day-at-a-time process, and there will be challenges, but there will also be so many triumphs. The first latch, the first gummy smile, the first time they wrap their little hand around your index finger. You will melt every single time. So, Mama – gather your support system, tighten your mum bun, and pop your coffee in the microwave. You are strong, you are capable, you are wonderful, and you can do this!

C h arlo tte

CHARLOTTE COWAN, EDITOR

Want to learn more about pregnancy in your own environment? The Introduction To Antenatal Online Course, in association with Nest Pregnancy and Parenting, is available at bumpandbaby.co.nz or by scanning this QR code. Turn the page for more info.

Pregnancy BUMP & baby

PREGNANCY BUMP&baby IS AVAILABLE FROM SELECTED RETAILERS OR VISIT BUMPANDBABY.CO.NZ TO SUBSCRIBE. PUBLISHERS / Tony and Aana Marinovich tony@bumpandbaby.co.nz aana@bumpandbaby.co.nz EDITOR / Charlotte Cowan editor@bumpandbaby.co.nz ART DIRECTOR / Emma Henderson design@bumpandbaby.co.nz DIGITAL EDITOR / Maraya Robinson SUBEDITOR / Katherine Granich ADVERTISING ENQUIRIES Tony Marinovich tony@bumpandbaby.co.nz Ange Steiger ange@bumpandbaby.co.nz DIGITAL ENQUIRIES digital@bumpandbaby.co.nz social@bumpandbaby.co.nz

PREGNANCY BUMP&baby PUBLISHED BY TOTS TO TEENS PO Box 70, Kumeu Auckland 0841, New Zealand or The Media Barn 91 Moontide Road, RD2 Kumeu Auckland 0892, New Zealand T: +64 9 412 5123 JOIN US ONLINE! bumpandbaby.co.nz facebook.com/bumpandbabynz pinterest.com/bumpbabynz instagram.com/bumpandbabymagazine 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 original 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. Prices on products are a guide only and may differ from stockist to stockist.

From Bump, to Birth, and Beyond!

Due to arrive in A CITY NEAR YOU! AUCKLAND (MAY)

WELLINGTON

14 & 15 May Eventfinda Stadium

28 & 29 May Lower Hutt Events Centre

CHRISTCHURCH

WAIKATO

11 & 12 June Christchurch Arena

2 & 3 July Claudelands Events Centre

Bay of Plenty

AUCKLAND (OCT)

24 & 25 September Trustpower Arena

8 & 9 October Eventfinda Stadium

CLAIM YOUR FREE TICKETS ONLINE MORE INFORMATON AT BABYEXPOS.CO.NZ

online course

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YOU'LL LEARN ABOUT...

b i t e -s i z e Y O J N E HOM E! T A s o e vi d

• Choosing your LMC • Birthing Options • Pregnancy Discomforts • Informed Consent • Pregnancy Nutrition • Scans & Monitoring • Premature Birth • Your Birth Plan • Induction • Pelvic Floor • Baby Clothing • Perineal Massage • Position of Baby for Birth • Signs of Labour • Stages of Labour • Positions in Labour • Assisted Delivery • Labour Support

Introducing the online

Introductory to Antenatal Course

Brought to you by Nest Pregnancy & Parenting and BUMP&baby magazine This is the perfect course to do with your partner when you find out you’re expecting, or a great refresher if this isn't your first baby. Watch and/or listen to our online course in your own time to better understand your pregnant body, birth options, and to feel more confident about labour and birth. A friendly, easy-to-understand course made up of bite-sized sessions, each ranging from 5- to 15-minutes long, so you can binge-watch or select a different session to watch every few days. This is the perfect introductory course for yourself, or as a gift to a friend, to get a handle on pregnancy and everything to expect in the next nine months.

COURSE BONUS!

“We both loved the bite-sized workshops, they were so easy to listen to at the end of each day; we would make a cuppa and watch them together ” Caylie

UNLOCK EXCLUSIVE DISCOUNTS AND LOTS OF PRACTICAL, BONUS DOWNLOADABLES.

ALL THIS FOR JUST $28.75

bumpandbaby.co.nz/courses 10

Pregnancy BUMP & baby

Made for Me

Introducing our new Electric Breast Pump Quiet and discreet, use anywhere Lightweight, portable and efficient Gentle on hard-working breasts

tommeetippee.co.nz

Parental guidance... News, views, and handy products in the pregnancy and parenting space.

WARM IT UP!

These new portable bottle warmers from Kiwi company Lil Moo are USB charged, sleek, compact, and ready to take anywhere. They use slow-heat technology to heat your baby's bottle to 37, 40 or 45 degrees – and are a super-cute addition to any baby bag!

Lil Moo Portable Bottle Warmer in Blush Pink, $119.99, lilmoo.co.nz

reusable nappies

IF YOU’RE OUT AND ABOUT If you’re out with your baby, pack a few extra reusable nappies for the day, as well as a wet bag. Then just roll the soiled nappy up and put it in your wet bag with any dirty cloth wipes etc, and close the zip – that will help keep any smell contained. For more tips on reusable nappies, turn to page 113!

Pregnancy BUMP & baby

FIND YOUR NURSING BRA SIZE

During pregnancy your breast size will typically grow significantly. To find the right size for your nursing bra, measure around your back and under your bust (this is your band size). Then measure again around your back and snugly across the fullest part of your breasts. Then, subtract your band size from your fullest bust measurement. Each whole number difference is one cup size. A difference of two inches is a B cup, three inches is a C cup, four inches is a D cup, and so on.

treat yourself

Growing a human is no joke, so self-care is a must. Give yourself the gift of this new Dyson Coralle straightener – you deserve it!

Dyson Coralle straightener in fuchsia with case, $749, dyson.co.nz

noteworthy

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TOXIN-FREE CLEANING

After years of suffering debilitating headaches every time she cleaned her home, Megan Bennett from Mangawhai set out on a journey to create a truly fragrance- and toxin-free cleaning product. The Cleanz system consists of one soap-based concentrate that is toxin-, allergen-, and fragrancefree and is boosted with the power of chamomile for its antibacterial, anti-fungal, and antiallergenic properties. It’s the perfect one-stop-shop for highly health- and budget-conscious parents and parentsto-be who simply want to know that they are creating the safest environment for their families.

Cleanz Starter Kit, $69, cleanz.co.nz

1.61 The average number of births that New Zealand women will have over their lifetime.

From $29.50, nellietier.co.nz

~ Stats NZ

PROTECT AND NOURISH WITH NELLIE TIER

Nellie Tier (nellietier.co.nz) has developed a luxurious natural skincare range founded on the practices of phytotherapy and aromatherapy, utilising the therapeutic properties of natural plants and their ability to heal, protect, and nourish the skin. One hundred percent New Zealand made and owned, the company’s focus on products to care for families can be traced back to the brand name, Nellie Tier, named for founder Ann’s grandmother – a young Irish woman who settled here in the early 1900s. The Nellie Tier BABY range has been developed with future generations in mind. Using only the finest essential oils and botanical extracts, combined with high-grade aloe vera and New Zealand Manuka honey, the range is completely natural, gentle, calming, soothing, and nourishing to care for young, soft baby skin.

BOND WITH YOUR PĒPI

Ilado NZ’s range of maternity necklaces are inspired by the ancient Mayan tradition of building a bond with babies while in the womb. A built-in mechanism inside each pendant produces a soft, soothing chime which creates an auditory bond with your baby and a sense of calm and relaxation for mama. From $115, ilado-nz.com

Pregnancy BUMP & baby

noteworthy

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ACC COVER FOR BIRTH INJURIES

BOHBOH BABY BY BOH RUNGA

bohboh baby, from $25, bohrunga.com

Jewellery designer Boh Runga has launched a new lifestyle brand, bohboh, which includes a baby line featuring her popular marigold motif. The range includes baby wraps, sheets, booties, beanies, headbands, teethers, and shorties – and all bohboh baby products are made using OEKO-TEX certified organic cotton and are packaged in a beautiful box ready to be gifted to a new mama.

A proposed bill to extend ACC cover to a specified list of maternal birth injuries is currently before the select committee. The Accident Compensation (Maternal Birth Injury and Other Matters) Amendment Bill would amend legislation to ensure women who sustain tears, uterine prolapse, and some other physical trauma in labour and childbirth can access funded treatment, including surgeries and pelvic physiotherapy. Many of these injuries share characteristics with sprains or strains, but aren’t currently covered by the scheme, despite 85% of New Zealand women experiencing an injury when giving birth. The changes could benefit an estimated 18,000 Kiwi women each year.

What’s in

BUH-BYE BABY BRAIN

a name?

The Motherhood Blend from Franjos Kitchen combines Kiwi nootropic superfood Ārepa with faba bean protein to energise the body and refresh the mind, helping mums to beat brain fog.

Discover how the power of numbers could positively influence your child for their whole lifetime. Baby Name Numerology, $30, Penguin Books

Say what?

did you know?

Best Baby Names 2022, $24, Penguin Books

Parents in the US are paying a professional “baby namer” up to $14,000 to name their children!

The teenage pregnancy rate in New Zealand has halved in 20 years, while the proportion of women in their 40s giving birth has jumped by 30%. Stats NZ.

Pregnancy BUMP & baby

COMPILED BY CHARLOTTE COWAN

Franjos Kitchen Motherhood Blend, $73.50, franjoskitchen.com

An easy-to-browse A-Z book of more than 9,000 names – plus tips on navigating your baby-naming quest!

NEW

WITH ALL-NATURAL COTTON MILK HYPOALLERGENIC DERMATOLOGICALLY TESTED

A newborn’s soft, delicate skin is a truly wonderful gift of nature, and every mum’s instinct is to protect it for as long as possible. Which is why Swisspers® Baby has harnessed the natural power of Australian Cotton Milk, along with Certified Organic Aloe Vera and Natural Vitamin E. Gentle, natural and pure, it’s a great choice for keeping your bubba’s skin as soft and pure as the day they were born.

swisspersaus

our cover bump

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Boy, oh boy!

Cover model Georgia Koale is a stay-at-home supermum of twin boys and is expecting another little boy, but neither pregnancy has been plain sailing.

ive-year-olds Isaac and Xavier were born at 28 weeks gestation, weighing 670 grams and 1200 grams respectively. Following a stressful, high-risk pregnancy, Georgia was in hospital for a month before the tiny babies were born via emergency C-section. “It was a really scary time,” says Georgia. “What I didn’t know was when my first son Isaac was born, he actually wasn’t breathing and they had to take him away to resuscitate him. It was really quiet in the room; no one was talking to me. But when Xavier came out, I heard a tiny little cry, like a mouse. I’ll never forget the sound.” The twins were in the NICU at Auckland Hospital for three months and Georgia says it was both the amazing and traumatic. “It was the best experience, even though we were going through a rough time,” she says. “The amazing nurses made our journey bearable and enjoyable. We went home four months after they were born and our kids are thriving now; they’ve had no issues at all.”

New baby brother!

After suffering irregular and debilitating periods for four years following the birth of her twins, Georgia was diagnosed with Polycystic Ovarian Syndrome (PCOS) in 2021 and she and husband Beulah were told it may be difficult for them to conceive any further children. “It was a rough year,” recalls Georgia. “My skin was bad, I gained 10kg in a matter of three to four weeks, and then [on top of that] hearing that it would be hard for us to have another baby if we wanted to have more children... I had always only wanted two kids and we had twins, so it was two-in-one, but once we heard that we probably wouldn’t get to have any more kids, I was upset.”

I was pregnant at all until maybe 22 or 23 weeks. I had no symptoms at all, my body didn’t change, I didn’t gain any weight in Once on medication for her PCOS, the first trimester at all, although I was quite Georgia began taking ovulation tests which sick and tired from 16 weeks,” says Georgia. – to her surprise – came up positive, so “I remember when we had our first scan, Georgia and Beulah decided to try for I was nervous that I might not actually be a baby. And it worked. “I was shocked, pregnant! The third trimester was when all happy, and surprised that I actually was the problems came crashing down. I was pregnant,” she says. “My husband was experiencing quite bad cramps all down my freaking out; he was super-happy! I told legs, and then I started to get pain in the my kids first and they had the cutest right side of my back. I’m not one to reach reaction: They were so excited, they out for help when I’m in pain, I just deal screamed. They’re at a really good age where with it – but it got quite bad.” they can understand having a baby and After multiple visits to a chiropractor having a sibling. It makes it 10 times more and osteopath, which only made the pain exciting seeing your kids being so excited!” much more unbearable, Georgia ended up in hospital. “Each day I would be a 10 out The f irst scan of 10 pain-wise. It was insane how much Due to COVID-19 restrictions, Beulah pain I was in. It wasn’t just my back, it was was unable to attend the first ultrasound shooting down my legs, I couldn’t feel my of the baby with Georgia. “I thought it feet sometimes, my legs would go numb, would be the perfect time to prank him,” my hands would go numb. I was at the point she says. “Since we have twin where I had tried everything. boys, I had an idea to say that I was in so much pain and we were having twins again! I couldn’t do it anymore.” So I walked out and he knew Following multiple tests, I was shocked, something was up. He said, doctors diagnosed Georgia happy, and ‘Is there two?’ and I said, ‘Try with two fractures on either another number!’ and he was side of her sacrum (the surprised that like, ‘WHAT? You’re joking, big bone which holds the I actually was there’s three?’ and I nodded pelvis and the lumbar bone my head. He was so shocked, together) and a prolapsed disc pregnant. but in a funny way. But no, just above it. we just have the one, which “That was insane to is good! I’m excited to see how different it is hear because I hadn’t done anything, it from the newborn stage just having one baby. just happened over time," she says. "It was Although the twins were the best babies upsetting, but at least we know what it is. ever; it was a breeze. I was so lucky.” At the moment I’m bedridden and we have a lot of appointments to figure out what my A rough third trimester birth plan will be. I wanted a natural birth After a relatively easy and symptom-free this time but I’m not too sure what’s going to first and second trimester, Georgia started happen because it takes three to six months experiencing pain in her back during the for these fractures to heal and, unfortunately, third trimester. “I honestly did not feel like I don’t have that amount of time.” Pregnancy BUMP & baby

our cover bump

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The breastfeeding journey

I'm a very loving mother. I'm very adventurous, hands-on, and always present.

With her twins in NICU for the first three months of their life, Georgia wasn’t able to breastfeed them straight away. She hopes her journey with this baby will be different. “[With the twins] I was expressing milk and for some reason, the pump was very painful for me. I’m hoping this time around I can get more help with breastfeeding. I’m excited to be on that journey again and hopefully I’ll be able to breastfeed a lot better this time around."

Embracing her pregnant body

Georgia says that while she loves knowing that her body is creating a human being, it can be difficult accepting the changes in her body. “I’ve had a lot of issues with body image, always, even before I was pregnant with the twins,” she says. “But I’m not as bad this time because I know I can get back to where I was – hopefully! I have a high risk of getting preeclampsia because I’ve had it before, and I’m the type of body that I get big all over, not just my belly, so it gets me a little bit down. I wanted to keep training up until I give birth and that didn’t happen for me – with my body and my back and the pain, I couldn’t keep going with my exercise – but you’ve got to listen to your body, and I have to remember that we are creating a life.”

Being a mum

Photographer: Annupam, @annupam, annupam.com; Hair & Make-up: Kylie Wakefield, @barebeautywithkylie; Styled by: Maddie Long, @seventhsister, the7thsister.co.nz; Model Māmā: Georgia Koale, Red11 Models, @georgiiaotene, @red11models, redeleven.net.nz; Photographic studio: Progear, @progearphoto, progear.co.nz; Clothing and jewellery: White dress zara.com/nz, earrings hm.com/nz.

Pregnancy BUMP & baby

INTERVIEW BY CHARLOTTE COWAN

“I’m a very strict mum, but in a loving way. I am a strong believer in a routine and I have pretty good time management, so I’m strict on time – feeding times, naps, and being in their own bed. I’m a very loving mother. I’m very adventurous, hands-on, and always present – that’s my goal as a mother. My main inspiration was my mum, and I feel like I’m the same type of mum as my mum was to me and my sister.”

Relax, we’ve got

YOU COVERED

Award-winning reusable nursing pads. Kind to mums and kind to planet earth.

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What’s in the BUMP&baby PeekaBox? We work with the most amazing pregnancy, mother, and baby brands to bring you our BUMP&baby PeekaBox – jam-packed with amazing products, full-sized samples, and vouchers. Look out for the following brands that we love and regularly include in the BUMP&baby PeekaBox: • TERRA • Bear & Moo • Queen Bee • MAM • Philips • ZOONO • Mammas Milk Bar • EarthSmart • Treasures • Only Organic • Tui • Lansinoh • Made4Baby • Seedlip • Cetaphil • Bio-Oil • Weleda • Harraways • Swisspers • Palmers • QV • Dermal Therapy and many more!

Check out our website bumpandbaby.co.nz/ subscribe to see the current box of treasures that you'll receive when you subscribe. We promise you'll love them all!

Pregnancy BUMP & baby

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The awardwinning, all-terrain Thule Urban Glide 2 stroller is for active families on the go! Scandinavian design and quality you can trust. foray.nz

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Pregnancy BUMP & baby

The anxious

mama

If you are suffering from increased anxiety during or post-pregnancy, you are not alone, writes Yvonne Walus.

Pregnancy BUMP & baby

health+wellness

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WHAT CAUSES PERINATAL ANXIET Y?

f you suffer from heightened anxiety while you are pregnant, or within the first year of giving birth, this is medically termed “perinatal anxiety”. Of course, mood swings, stress and nervousness are all part of being pregnant. However, for about one in 10 pregnant women in New Zealand, anxiety can morph into a constant state of acute apprehension or feeling overwhelmed, which affects their emotional wellbeing. During an anxious pregnancy, women may worry about anything and everything – including test results, stillbirth, premature labour, disabilities, or birthmarks. They may be scared of giving birth (see Hannah’s story on page 24), concerned that they won’t be able to breastfeed or that breastfeeding will hurt, terrified that they won’t bond with their baby, or that they won’t be a good mum. Even though maternal specialists focus primarily on postnatal depression, it’s important to realise that anxiety too is a serious and important mental health issue, and that many women experience it throughout their entire pregnancy, as well as after giving birth.

Pregnancy is a time of joy, but it’s also a time of change. Your body is not your own, your sense of identity gets an overhaul (“I’m going SYMPTOMS TO WATCH OUT FOR Many pregnant women report negative to be a mum!”), you’re suddenly too tired to go out, and your study is being converted changes in emotion such as mood variations, into the baby’s room. Then there are the apprehension, or agitation. So when should we suspect that what we’re experiencing falls usual pressures unrelated to the pregnancy outside the ordinary? Some of the symptoms – such as the price of petrol, working from home, or tension in your personal life. of perinatal anxiety to look out for during pregnancy include the following. All these stressors that can pile up to unmanageable levels. • Panic attacks (a racing heart, palpitations, All the advice about what to do and body shaking). • A worry that won’t go away. what not to do even before you conceive (folic acid, anyone?) could also be to blame. • New obsessive or compulsive behaviours. • Severe mood swings. Mothers-to-be and new mamas often feel bombarded with expectations on how to • Feeling constantly sad. look, feel, interact, and think. There is • Feeling constantly on edge. a worrying mismatch between reality and • Losing interest in all the normal things that bring joy. our preconceived notions of what pregnancy, • Disrupted sleep. childbirth, and motherhood should look • Withdrawing from friends and family. like. Social media depictions of “perfect” pregnancies and blissful motherhood • Irritability. moments don’t help. • Muscle tension or pain. “Trying to reach the ultimate pregnancy • Headaches. health touted online, yet not go broke or THE RISK FACTORS feel like a failure. is tough and for a lot [of women], near on impossible,” says Cath, Women with a history of pregnancy loss, an Auckland midwife. “Many of my clients infertility, or problems with their current fall victim to unrealistic expectations of pregnancy have a higher probability of a reality that is never going to be fulfilled.” suffering from perinatal anxiety. Outsideof-the-pregnancy issues such as stressful life Another common cause of perinatal anxiety may lie in the past. events, relationship issues, For women like Charley, financial difficulties “Your fears are and whose previous pregnancy can be risk factors, too. ended heartbreakingly not what makes Those with a family or with a ruptured fallopian personal history of anxiety, you, and they and those lacking social tube, perinatal anxiety is an understandable won’t break you. support, are also in the consequence of the trauma groups. You are a strong, high-risk she suffered (you can read Single parents her story on page 25). For and members of the loving person others, it could be family LGBTQIA2+ community who is on this may experience intensified history. Amy, a Wellington mum who lost her baby journey with the perinatal anxiety because of their unique situation niece to Sudden Infant support of her Death Syndrome (SIDS), and the very real fear had a stress-free pregnancy, loved ones.” of how society might react to their parenthood. but her anxiety started after This is also true of very young parents her daughter was born. “I became a slave to the fear that she might also die in her sleep,” who may face stigma and judgement from those around them. she said. “I bought one of those motion monitors with sensor pads in her cot… Although only women can be formally The trouble was, she didn’t like sleeping diagnosed with perinatal anxiety, a study from the University of Auckland’s Centre there. Whenever she fell asleep in the for Longitudinal Research found one in 50 bassinet, the baby capsule, or in her rocker, I watched her to make sure she was breathing. men experienced depression or acute anxiety As in, I didn’t take my eyes off her.” before the birth of their children.

Pregnancy BUMP & baby

REAL-LIFE STORIES…

*Warning: These stories may be triggering, so please take care.

Hannah's story

“As in many other countries, New Zealand women are assessed for postnatal depression following childbirth,” said Dr Lisa Underwood. However, she continues, “There is no routine screening of women during pregnancy, and none for fathers before or after the birth of their children, since they are not usually engaged in routine perinatal care.”

IF YOU ARE FEELING OVERWHELMED…

The good news is that perinatal anxiety can be treated once recognised. The not-so-good news is that it may fail to be recognised because it’s a relatively new concept, still inadequately understood by some healthcare professionals who might not recognise anxiety as a mental health disorder. “There is a shortage of professionals specialised in maternal health, so it can be difficult for people to access the help,” says Christina Bond, a maternal psychologist and managing director of Matrescence. “It’s important to continue to reach out until they find the support they need.” Matrescene offers a free downloadable Postpartum Plan to assist with alleviating anxiety at matrescence.nz/ postpartum-plan-download. Taking charge and learning about the symptoms of perinatal anxiety might help you recognise if you have it. You don’t need to self-diagnose, but being well-informed about perinatal anxiety means that you can raise the topic with your LMC, GP, Plunket, or your local community health centre. Midwife Cath advises figuring out the root cause of the perinatal anxiety. “There are often underlying issues that haven’t been resolved around childhood experiences, grief, communication, and relationships,” she says. Whānau support is crucial – just ask for help. Talk to your loved ones about their

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I am 16 weeks pregnant and, on the whole, I think I definitely have been feeling more anxious than I did pre-pregnancy. It’s such a long wait until the first big 12-week scan, to know if everything is actually fine and going ahead. Then I was presented with the option of doing the NIPT genetic test. There are three different options, each one goes up in price and tests for more abnormal conditions or disorders. It’s so hard to know what to do. If I had all the money in the world, I would choose the most expensive one that tests for everything. But I’m quite young and healthy,

pregnancies – you may discover that they, too, felt anxious before they became parents. Talk to your partner about the responsibility you’re jointly taking on – yes, it does seem bizarre that a baby will rely on you for its emotional, physical, psychological, and educational health. But you know what? It seems bizarre to all new parents, so you are not alone. Read that last bit again: You are not alone. Your fears are not what makes you, and they won’t break you. You are a strong, loving person who is on this journey with the support of her loved ones. Remember the simple things that are within your control: Nutrition, gentle exercise, meditation, relaxation, walks in nature. They won’t magically solve any problems, but they will make you better equipped to deal with the hurdles. The Mental Health Foundation offers this advice: “Doing things that make you feel better, stronger, and more in control will help your recovery.” Trust your heart, for it will lead you on the right path, and trust your instincts to shout at health professionals and demand medical intervention if you suspect something’s not right. Most important of all, trust yourself – you’ve got this!

so I decided to do the least expensive “core” test which tests just the main three syndromes. However, a friend received some negative results from her testing, and I started to question if I had made the right choice. But my obstetrician reassured me that the core test was a great option and sometimes you can actually find out too much information and, at the end of the day, it’s only a percentage, not a certainty. Another thing I have been thinking about it a lot lately is the birth, and it’s been making me feel really anxious. I find myself waking up in the early hours of the morning and then somehow, my mind starts thinking about the birth and visualising all the things I probably shouldn’t be thinking about... Not this early on, anyway! Maybe it’s because my friend has just given birth and I have been living vicariously through her, seeking all the details. I think educating myself on what can happen during birth is great, but I have decided now I really want to start working on having a positive mindset so that I stop saying to people, “I’m so scared!” and go into the birth with tools to help relax myself for the best possible outcome. Some calming advice I had was that it’s just one day, and while it might be one of the toughest things I ever do, it will be over in a short while. And if I think more about the end goal of a happy, healthy baby in my arms, I am more likely to want to push through the difficulties I might face.

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Charley's story

My story with perinatal anxiety actually took place during my third pregnancy. My pregnancy with my first daughter went by without a hitch, but my second pregnancy ended at around seven weeks with a speedy ambulance ride, a ruptured ectopic, and emergency surgery on Easter Sunday. My pregnancy ended that way as, despite many symptoms, I was not listened to by my GP. During that surgery I lost the baby and one of my fallopian tubes and it was an extremely traumatic and painful experience. A year later, I became pregnant with my second daughter. From the get-go, I was nervous due to my previous experience and, once again, my GP would not listen. Luckily for me, I had an obstetrician with my first daughter, and when I called him in floods of tears, he sent me for a number of ultrasounds to ensure the baby was in the right spot. During my pregnancy I had a number of other stressful family events occur but in terms of my actual pregnancy, I was okay… Until around 26 weeks. I had already been told by my OB that I had an anterior placenta, which means it sat at the front of my uterus and acted like a giant shockabsorbent pillow. So unless my baby kicked on my side, I couldn’t feel it. Cue multiple panic attacks. The first time, I used my doppler but because the baby had moved since the last time I had used it, I didn’t know where to find her heartbeat. I ended up in tears at A&E at 10pm, where it took the doctor about five seconds to find her heartbeat and reassure me she was okay. Over the next few weeks, I ended up at the hospital for monitoring twice, at my OB’s office at least

three times, at the GP a number of times. Every time 100% convinced that my baby had died, and every time I was reassured that she was fine. Most of the health professionals were understanding, and my OB was happy for me to be monitored whenever I was worried, but in reality, no one could convince me that she really was fine. By the time I gave birth by scheduled C-section at 39 weeks, I was in an absolute state. I had now added “huge facial birthmark” to my list of worries about the baby, and I was just a mess. My husband was sick of my panicking, my mum thought I had lost my mind, and I just wanted my baby out. I just needed to know she was alive. And she was, she was gorgeous and a chunky 4.3kg. But… She did have a facial birthmark. And rather than enjoying her, I focussed on that tiny little mark on her cheek for the first few days of her life. I obsessed about it. Any other time, it would have been nothing at all. It was about two centimetres long, definitely not huge by any means, and three years later, it has faded so much it’s almost impossible to see. Plus, now I think it just makes her special. But at the time, I was devastated. I even had my newborn photographer edit it out of the pictures. Seems so irrational now. And sad. My anxious pregnancy then led to undiagnosed postpartum depression for at least two years. To top it all off, unlike my first breezy baby, my second daughter was really challenging. I couldn’t put her down, I couldn’t give her to anyone else, she would scream and scream constantly. She’s still a little 14kg firecracker at three years old. We call her our tiny tornado. Pregnancy is not an Instagram picture; it can be really hard for a number of reasons. If you are feeling overwhelmed, be your own advocate – ask for help, and keep asking until you find someone who will listen to you and understand you. You don’t have to feel this way, take it from me.

“If you are feeling overwhelmed, be your own advocate – ask for help, and keep asking until you find someone who will listen.”

HELP IS HERE IF YOU NEED TO TALK TO SOMEONE IMMEDIATELY – CALL OR TEXT 1737 TO REACH A TRAINED COUNSELLOR. IN AN EMERGENCY, CALL 111. • Perinatal Anxiety & Depression Aotearoa pada.nz • Lifeline 0800 543 354 • Anxiety New Zealand 0800 269 4389 • Speak to your GP or your LMC

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The magic

touch

Massage therapist Jules Hayden from Mamas Retreat (mamasretreat.co.nz) shares how massage can ensure you get the best out of your pregnancy and motherhood journey.

ouch is the first sense to develop at six to nine weeks gestation in utero, and it is the last sense to leave us before we pass away. It is what makes us feel safe and helps us to begin to make sense of the world. Pregnancy can be an exciting and challenging time due to the many physical, mental, and emotional changes happening in your body, and massage can help keep baby and mama at optimum health at this time. Your body undergoes many changes during pregnancy and postpartum, and some of these can be very stressful and uncomfortable. Receiving pregnancy massage gives time and space to deeply relax. A relaxed mama can have a happier, healthier pregnancy, and this can lead to a better childbirth experience.

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LABOUR PREPARATION MA SSAGE PREGNANCY MA SSAGE

Pregnancy massage can be performed from the first trimester onwards, as this is the trimester when mamas often feel the worst physically and mentally. Many women will not seek massage until the third trimester ,when they feel physically and mentally overwhelmed as they try to wind down on their maternity leave (which is usually one to two weeks before giving birth). It’s important to note that some spas and therapists may not provide pregnancy massage until the second trimester as they may not be trained in first trimester massage.

A relaxed mama can have a happier, healthier pregnancy and this can lead to a better childbirth experience. Pregnancy massage… • Has been proven to reduce stress and anxiety and manage hormones. • Can assist in general mood improvement as massage calms the parasympathetic nervous system. • Rejuvenates energy in the body because it gives time to rest and completely relax. • Can relieve nausea and heartburn in some women. • Relieves aching neck, sore back, and heaviness in the pelvic bones, leg cramps, swelling of the ankles and feet and oedema (fluid retention). • Builds a feeling of connectedness with your baby. • Improves sleep due to less muscle tension and generally feeling less uncomfortable. Each stage of pregnancy is dynamic, and massage techniques should be adapted to each stage of this change. Touch provides a way for a mama to tune into changes occurring in her body, and pregnancy massage is incredibly beneficial in relieving ailments such as fatigue, sore and swollen legs, sciatica, headaches, neck pain, and shoulder pain. Pregnancysafe essential oils can be used during each trimester but in much lower doses, as the oils can cross the placenta.

Labour is the final stage of birth and, just like any big event, you need to prepare for it. Labour preparation massage is typically undertaken from 37 weeks, or if you have gone beyond your due date. Labour preparation massage includes a combination of relaxation techniques, acupressure, yoga, exercises, optimal maternal positioning, essential oils, and strong massage techniques. This massage will not force the body to go into labour, but will instead work to get your body and mind, as well as your baby, ready for birth. The massage will help the cervix to soften, but labour will not begin until mama and baby are truly ready. Goals of this massage include… • Relaxing the mother-to-be. • Releasing stored emotional blocks to help with readiness for labour. • Preparing the birthing muscles. • Assisting the body in activating contractions and labour. • Helping with cervical dilation through the use of acupressure points. • Stimulating specific acupressure points thought to help move the baby down the birth canal. •H elping with oxytocin production to facilitate labour. • Providing a nurturing and safe space for the mother to be and process any fears or anxiety about labour.

POSTNATAL MA SSAGE

Postnatal massage is essential for a new mum, as they can often feel depleted and out-of-balance following pregnancy and birth. The golden month – or 40 days postpartum – is a huge transition period, and massage can help you navigate the physical and emotional strains during this time. Postnatal massage promotes relaxation and circulation, and relieves anxiety, exhaustion, tension, and postpartum blues. It can also help with hormone regulation, swelling, sleep issues, and milk production, and can speed up the healing process and assist with C-section recovery.

BABY MA SSAGE

Baby massage is a wonderful way for mum and baby to bond. For some, bonding can happen immediately, but for others it may take some time due to a variety of reasons, such as a difficult pregnancy or birth experience, lack of sleep, colicky baby etc.

Healthy touch is an early language that is easily understood ,and infant massage can improve the relationship between parents and baby and relieve stress in infants and caregivers.

MA SSAGE AFTER MISCARRIAGE

Miscarriage can be a very difficult experience to navigate. Around one-third of pregnancies end in miscarriage, and often women feel very alone in navigating this territory. If a woman is in the first trimester, she may not have told anyone, and can feel especially alone. This massage helps bring a state of peace and prepares the body and mind for future conception. During this massage, muscles receive oxygen and blood to restore the tissues and assist recovery. It also increases the flow of lymph, which improves the health of the immune system and helps to reduce unwanted fatigue and symptoms related to depression and anxiety.

by relax your ba Wild Ferns Honey Babe Calming Massage Oil 120ml, $25, wildferns.co.nz A unique blend of soothing and moisturising sweet almond, calendula, chamomile, and coconut oil to condition baby’s skin during massage.

Scullys Baby Massage Oil 120ml, $10.90, scullysnz.com This natural blend of almond, apricot kernel, and chamomile oils will help soothe and relax your baby – perfect for after the bath and before sleep.

Sleep Tight Massage Oil (Fragrance Free) 150ml, $17.95, made4baby.co.nz Suitable for sensitive skin, this mineral oil-free massage oil has a sweet almond oil base combined with avocado, rosehip, and jojoba oils to gently condition baby’s skin.

Pregnancy BUMP & baby

movin' Keep on

Pregnancy BUMP & baby

Boost your physical, mental, and emotional wellbeing during pregnancy with these strength training exercises from personal and postnatal trainer Fleur Park (corerestore.co.nz)

ost experts would agree that being active during pregnancy is not only healthy and beneficial for mum and baby, but it also assists in preparing the mother’s body for the many changes that occur during pregnancy and the demands of labour and the postnatal period. Although you may need to modify your routine, continuing to include exercise during pregnancy allows you to regain some control of what is happening to your body by helping to counteract the physiological changes that affect not only the neurological connection with certain muscle groups but also your postural alignment. Strength training during pregnancy is an amazing way to look after the overall wellbeing of the mother. It boosts energy levels and improves your mood while helping to relieve common aches and pains associated to pregnancy due to the impact of the growing weight of the baby. This weight forces the spine into a lordosis position (exaggerated anterior pelvic tilt) causing pain and discomfort and placing a lot of strain on the joints and ligaments. The upper back can display signs of Kyphosis (exaggerated rounding of the upper back and shoulders) from the breasts increasing in size and the mother’s center of gravity changing. Therefore, focusing on strengthening the posterior/back of the body with some pregnancy safe strength exercises can help to reduce the severity of these physiological changes. If you have any specific questions or concerns, always contact your LMC to get the green light before starting any exercise regime.

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Here are some strength training exercise circuits that are safe and specific to each trimester and can be done in the comfort of your own home. Try completing the circuit two to three times, making sure to rest for 30 seconds between exercises and 60 seconds between rounds. Remember to listen to your body and rest more if needed.

FIRST TRIMESTER - -1-12 weeks

Early in the pregnancy excessive tiredness and morning sickness can be your biggest challenge. Here is a quick energising strength routine for the first trimester that will work the entire body.

1.SQUAT TO PRESS SCULPTS YOUR LEGS, GLUTES AND SHOULDERS.

Stand with feet hip-width apart holding a dumbbell in each hand at shoulder height. Keep your shoulders pulled back and down away from ears and engage your core. Lower into a squat position by pushing back from your hips first before bending at the knees. Driving through your heels come back up to standing as you press the dumbbells overhead, keeping ribs down and core engaged. Do 10-12 reps.

2. REVERSE LUNGE WITH BICEP CURL TONES YOUR LEGS, GLUTES AND BICEPS.

Stand with feet hip-width apart and hip bones even – both facing straight ahead. Hold a dumbbell in each hand at your sides, keeping your shoulders back and down and your core engaged. Step your right foot back and lower your knee until your legs are bent at 90 degrees and your back knee is hovering just above the ground. At the same time, curl the dumbbells up to your chest keeping your elbows close to the body. Push through the heel of the front foot, bringing the right foot forward back up to standing position and lowering the dumbbells back down to your sides. Repeat on the other side. Do 8-12 reps on each side.

3. BENT OVER SINGLE ARM ROW AND TRICEP KICKBACK SCULPTS YOUR BACK AND TRICEPS. Start by staggering your stance with your right foot in front of the left and hip-width apart. The right knee is slightly bent and right hand is resting on your right thigh. Hold a dumbbell in your left hand with your arm fully extended toward the ground. Row the dumbbell back towards the hip while keeping your elbow tucked closely to your side. Then extend your arm from the elbow straight behind you squeezing your tricep. Reverse the motion back to start position. Do 8-12 reps on each side.

SECOND TRIMESTER

--- 13-26 weeks

This circuit focuses on isolating muscles that require extra attention to keep the pregnant body correctly aligned and pain-free as weight and centre of gravity start to change.

1.GOBLET SQUAT STRENGTHENS LEGS, GLUTES AND UPPER BACK.

Hold a dumbbell at chest height, keeping it up close to your chest in a goblet position (palms up, supporting only one end of the dumbbell). Set your feet slightly wider than shoulder-width and your toes pointing out (30 degrees). Begin squatting down by pushing back the hips and then bending at the knees. Slowly control the decent down, keeping your shoulders back and down away from your ears and your core engaged, with your heels flat on the floor at all times. Only go as low as you feel comfortable, and then reverse the movement by squeezing your glutes at the top. By holding the dumbbell in the goblet position you will also increase your upper back strength to further improve your posture. Do 10-12 reps.

2.SK ATER DEADLIFT GRAB STRENGTHENS YOUR LOWER BACK, HAMSTRINGS AND GLUTES. Holding dumbbells directly at your sides, stand with your feet hip-width apart with hip bones both facing forward. Create a strong and stable upper body by engaging your core and setting your shoulders back and away from your ears. Step back with one foot as far as you comfortably can. As you step back, begin bending or hinging at the hips, as if you are trying to place the dumbbells down on the floor. Keep your back flat, and bend the front knee slightly. Make the decent slow and controlled and once you feel a nice stretch along your hamstring, reverse the movement and bring your feet back together while squeezing your glutes. Do 8-12 reps.

3. SINGLE ARM BENT OVER ROW STRENGTHENS BACK AND ARMS.

Place an outstretched arm up on a bench or a chair for support. Place the foot of the other leg flat on the ground next to the bench and position the dumbbell underneath your free arm. Row the dumbbell towards your hips, keeping your elbow close to your side and retracting your shoulder blade towards your spine. If you need to, hold the dumbbell wider than normal to avoid hitting your pregnant belly. Slowly lower the dumbbell back down to fully extend your arm. Do 8-12 reps.

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THIRD TRIMESTER

--- 27- 40 weeks

Modifying and regressing is a must now as the baby bump increases in size. Some movements become uncomfortable or even painful, while others can be challenging to complete safely due to instability with the center of gravity continuing to change. This circuit allows for the changes occurring to the body during the later stages of pregnancy by focusing on comfort and stability.

1.SUMO SQUAT STRENGTHENS THE LEGS AND GLUTES AND OPENS THE HIPS UP.

Hold a dumbbell between both of your hands with shoulders back and down and arms extended down in front of hips. Take a wider than a shoulder-width stance, and turn your feet out 30-45 degrees. Set your shoulders back and down and engage your core, keeping the dumbbell in your outstretched hands at pelvis height begin squatting down slowly with control. Keep your back straight and your feet flat on the floor making sure knees follow the line of the toes. Push back up to standing position. Do 8-12 reps.

2.SWISS BALL CURL TO LATERAL RAISES STRENGTHENS THE ARMS FOCUSING ON BICEPS AND SHOULDERS.

Sit on a swiss ball with a good stable base, shoulders back and down and your core engaged, holding dumbbells at your side. Start the exercise by curling the weights up to your shoulders using the bicep muscle by bending at the elbow while keeping the rest of your arm stationary and close to your sides. With control, slowly return the weights back to the starting position before raising the dumbbells straight out to your sides with a slight bend at the elbow until your arms are parallel to the floor no higher than shoulder height. Then slowly lower the weights back down to your side, that’s one repetition. Do 8-10 reps.

3.SWISS BALL BANDED ROW STRENGTHENS ARMS AND UPPER BACK.

Sit on a swiss ball with a good stable base, shoulders back and down and your core engaged. Anchor a resistance band to a point directly in front of you at chest height (i.e. on a door handle) and with outstretched arms, cross over the band and pull elbows back towards hips squeezing the shoulder blades together. Slowly release the band with control back to the starting position. Do 10-15 reps.

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TRAINING TIPS

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It’s advisable that you receive clearance from your LMC before starting any kind of exercise during pregnancy. Listen to your body and don’t overexert yourself. If you experience any pain, nausea, headaches, dizziness, chest pain, vaginal bleeding, fatigue etc, you should stop immediately and seek medical advice. After the first trimester, avoid exercises that require you to lie on your back for extended periods of time. Warm up and activate muscles before completing the circuits and cool down after with some gentle stretching and myofascial rolling and releasing. Stay cool and hydrated and try to have a snack before and after to ensure energy levels are kept stable.

These recommendations are a general overview. Each woman will have her own specific fitness level, training age/experience and physical ability which should always be taken into consideration. This is why it’s vital to consult with your LMC first, so you have peace of mind and confidence knowing your fitness routine is safe.

Scan for your video exercise guide

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All about abs Pregnancy and postnatal osteopath Sarah Boughtwood (sarahboughtwoodosteopath.co.nz) explains the symptoms and treatment of Diastasis Recti, or “abdominal separation”, during and post-pregnancy.

PREVENTION DURING PREGNANCY

Early into pregnancy, starting some core and pelvic floor exercises has been demonstrated to help reduce the degree of separation. Ask your pelvic physio or qualified personal trainer who specialises in pregnancy and postpartum for some simple exercises to do. Remaining physically active in pregnancy is also vital for general pregnancy health and

Pregnancy BUMP & baby

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bdominal separation is one of the most common conditions that occurs in pregnant women. Diastasis Recti means that during the course of pregnancy, your abdominal muscles (Rectus Abdominus muscles) separate. The Rectus Abdominus muscle runs vertically from the Xiphoid process and costal cartilage of ribs anteriorly (the front) to your pubic bone in the pelvis. Linea Alba is a band of connective tissue between the left and right Rectus Abdominus muscles, joining them together. As your baby and uterus grows during pregnancy, this places strain on the front of your belly and, in turn, the Linea Alba becomes over-stretched and creates a larger space between the left and right Rectus Abdominus muscles, creating a gap down the middle. Most women get Diastasis Recti in the third trimester of pregnancy to some degree. The size of the gap or separation varies per women. Luckily for most women, this resolves itself within six weeks after delivery. However, 33% of women still suffer from Diastasis Recti at 12 months postpartum.

WHAT TO DO DURING PREGNANCY

• Early into pregnancy start some pelvic and core exercises to maintain their strength and support. • Maintain a healthy pregnancy weight. • Support healthy bowel movements by fibre in your diet, water, using a footstool when passing a poo, and eating kiwifruit. • Avoid heavy lifting. • Engage your core gently and bend from the knees when you are lifting heavy objects. • Roll on to your side and push up with your arms when getting out of bed. • Ask your health professional about wearing an abdominal soft brace over your belly. A healthcare practitioner can feel the gap between the two Rectus Abdominus muscles using their fingers along your belly. This typically happens after birth. Sometimes an ultrasound is used the diagnose the Diastasis Recti to see the extent of the separation. A gap bigger than 2cm is considered Diastasis Recti.

WHAT NOT TO DO IF YOU HAVE DIA STA SIS RECTI

You will know if you have abdominal separation if you have a visible bulge or “doming” when you sit up and/or softening around your belly button. reducing Diastasis Recti. General exercise including walking, pregnancy yoga and pilates, swimming, and guided gym sessions are very beneficial during pregnancy and postpartum once you are signed off to return to exercise. Healthy bowel habits and passing stools once or twice a day is also very important. Being constipated places a large amount of strain on your abdominals. Ask your health professional for advice if you are struggling with constipation. Additionally, try elevating your feet when passing stools as this reduces the strain on your bowel and abdomen. You can also practise breathing with your diaphragm. Place one hand on your upper chest and the other on your belly. Focus on when you breathe in, your belly rises 60% and your upper ribs the remaining 40%. When you breathe out, your belly and ribs shrink back to their original location.

There are certain movements and exercises you need to be careful with and avoid. • Sit-ups or crunches. • Planks or push-ups, unless modified by a health professional. • Double leg lifts. • Heavy-lifting. • Sitting straight up when getting out of bed.

WHEN TO A SK FOR HELP…

For some women, the separation is small, and they don’t even notice it. For other women it can cause or be part of the other pains. The abdominal muscles in combination with the diaphragm, pelvic floor, and back muscles create your core strength. When this is compromised, you might experience back pain, pain during sex, urinary incontinence, pelvic pain, hip pain, or an umbilical hernia. As an osteopath, I always recommend a check-up after birth, this may be with myself or ideally myself and a pelvic physiotherapist. Osteopaths can help check the body after birth, guide you back in to exercise when it is appropriate and help with any new aches and pains that can come with motherhood. These might include sore neck, shoulders, back relating feeding, lifting, carrying your newborn, birth trauma, and so on. An osteopath can also refer you to a specialist if needed regarding your Diastasis Recti. Most women do not need to see a specialist, but in rare instances, surgery might be needed. Pregnancy BUMP & baby

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Pregnant people can experience a number of different types of skin discoloration, including melasma (aka the pregnancy mask) – vitamin C skincare is totally safe to use during pregnancy and can help fade its appearance. Look for L-Ascorbic acid on the label which is the chemically active form of vitamin C.

GET YOUR GLOW ON!

essano Vitamin C Brightening SPF15 Moisturiser, $19.99, essano.co.nz; The Edit Miracle Worker C-Serum, $140, theeditcosmetics.co.nz; Dermalogica BioLumin-C Gel Moisturiser 50ml, $115, dermalogica.co.nz; La Roche-Posay Vitamin C 10 Brightening Serum 30ml, $74.99, laroche-posay.com. au; BOOST LAB Vitamin C Brightening Serum, $34.95, farmers.co.nz; Bondi Sands Everyday Skincare Gold’n Hour Serum, $22.99, bondisands.com.au

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Pregnancy BUMP & baby

COMPILED BY CHARLOTTE COWAN

L OV E

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SWEETS FOR MY SWEET Simple, wholesome, and delicious treats to enjoy during your pregnancy.

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apple and blackberr y pie

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APPLE AND BLACKBERRY PIE PREP TIME: 30 MINS, PLUS 1 HOUR CHILLING COOK TIME: 50 MINS / SERVES 6 PASTRY • 1⅔ cups (200g) rye flour, plus extra for dusting • ⅓ cup (40g) icing sugar • 150g chilled butter, cut into cubes • 3 tsp iced water • 1 egg, whisked

1. To make the pastry, whisk the flour and sugar

together in a bowl. Tip the mixture out onto a work surface and make a well in the centre. Add the butter and use the heels of your hands to bring everything together, adding a little of the iced water as you go. Keep smooshing it all together until you have a rough dough, with some pea-sized bits of butter throughout. 2. Shape the dough into a disc, then wrap and chill

plum and al mon d ca ke

FILLING • 4 large apples • ½ cup (110g) white (granulated) sugar • ¼ tsp ground cinnamon • 1 cup (130g) blackberries

it in the fridge for about 30 minutes. For the filling, peel, core, and slice the apples. Place the apple in a saucepan with most of the sugar, the cinnamon, and a splash of water. Cook over medium heat, stirring often, for about 10 minutes or until the apple has softened. Remove from the heat and set aside. (If time allows, chill the apple.) 3. Tip the apple into a 6 cup (1.5 litre) pie dish and

sprinkle the blackberries over the top. On a lightly floured surface, roll the pastry into a large rectangle about 4mm thick. Cut the pastry into long strips. Lay six or seven strips across the top of the apple mixture, then spin the pie dish 90 degrees and "lattice" in the next layer of pastry strips. 4. Brush the egg over the top of the pie and

sprinkle the remaining white sugar over the top. 5. Place the pie in the fridge to chill for 30 minutes.

Preheat the oven to 200°C. Bake the pie for about 30–40 minutes or until the pastry is golden. Serve warm with cream or ice cream.

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Note:

This quick almond cake recipe is a great base for any kind of seasonal or preser ved fruit.

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PLUM AND ALMOND CAKE PREP TIME: 15 MINS / COOK TIME: 30 MINS SERVES 6–8 • 8–10 plums • 2 eggs • ½ cup (125ml) milk • ¼ cup (60g) butter, melted • 1 cup (100g) almond meal • ½ cup (110g) caster (superfine) sugar • ⅓ cup (50g) plain (all-purpose) flour • ½ tsp baking powder • ½ tsp ground cinnamon • A pinch of salt • Thick (double) cream, to serve 1. Preheat the oven to 180°C. Grease and line

a 20-24cm springform cake tin with baking paper. 2. Halve the plums, removing the stones, then slice

them into quarters or eighths, depending on the size. Scatter the plums over the base of the cake tin. Add the eggs, milk, and melted butter to a bowl and whisk to combine. 3. Combine the remaining ingredients in a bowl,

then pour in the egg mixture and mix until you have a smooth batter. Pour the batter over the plums and smooth the top. 4. Bake the cake for 30 minutes or until golden

brown on top and cooked through. Serve warm, with some lovely thick cream.

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HONEY JUMBLES

PREP TIME: 20 MINS, PLUS 1 HOUR CHILLING COOK TIME: 15 MINS / MAKES ABOUT 12 • ¼ cup (65g) unsalted butter • ½ cup (175g) honey • ¼ cup (45g) brown sugar • 1 tsp vanilla bean paste • 1 ½ cups (225g) plain (all-purpose) flour, plus extra for dusting

FLORENTINES

PREP TIME: 15 MINS, PLUS 15 MINS CHILLING COOK TIME: 10 MINS / MAKES ABOUT 18 • ¼ cup (60g) unsalted butter

• 100g caster (superfine) sugar • ½ cup (100g) brown sugar • 2½ tbsp single (pure) cream • 200g flaked almonds • ⅔ cup (100g) dried cranberries • 1 tsp vanilla bean paste •2 00g chocolate

ORANGE ICING

• 1 egg white • 1½ cups (185g) icing sugar • Grated zest and juice of 1 orange 1. Combine the butter, honey, brown sugar,

a large, heavy-based saucepan over high heat. Cook the butter and sugars, stirring, for 5 minutes or until you have a smooth, golden-brown caramel (if it looks crystallised, keep stirring and cooking and it will come together).

and vanilla in a small saucepan over medium heat. Cook, stirring, for a few minutes or until the mixture has melted into a thick caramel. Remove from the heat and set aside to cool for 5 minutes. Sift the dry ingredients into a bowl. Pour in the butter mixture and milk and stir until well combined. Cover the dough and pop it into the fridge to chill for 1 hour.

2. Pour in the cream and stir until well combined,

2. Preheat the oven to 180°C. Line two baking

1. Line a baking tray with baking paper. Place

then cook for a few minutes. Add the almonds, cranberries, and vanilla and stir well. Reduce the heat to low. 3. Working quickly, place 1 tablespoon of the

mixture on the tray and press down to form a circle, then repeat with the remaining mixture. Keep the pan sitting over low heat and stir the mixture every now and then. Pop the tray into the fridge for 10 minutes or until set. 4. Stir the chocolate in a heatproof glass bowl over

a saucepan of simmering water until smooth. Cover the base of each biscuit with a little chocolate, then press it onto the tray to even it out. Return to the fridge to set. Drizzle any remaining chocolate over the Florentines and finish with a tiny sprinkle of sea salt. Store in an airtight container for a few weeks.

• ½ tsp bicarbonate of soda (baking soda) • ½ tsp ground cinnamon • ½ tsp ground ginger • A pinch of freshly ground nutmeg • A pinch of ground cloves • 1 tbsp milk

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trays with baking paper. Divide the dough into four pieces. Roll out one piece into a 15cm long sausage on a lightly floured surface. Cut the sausage into three pieces and flatten each into an oval shape. Place on the tray, leaving room for spreading. Repeat with the remaining dough. 3. Bake the biscuits for 8–10 minutes or until they

have puffed up a little and are dry to the touch. Transfer to a wire rack to cool. For the icing, whisk the egg white in a small bowl until foamy. Sift in the icing sugar, then add the orange zest and juice, a little at a time, and whisk until the mixture is smooth and thick. 4. Spoon about 1 teaspoon of icing onto each

biscuit and gently spread to cover. Store the biscuits in an airtight container for up to a week.

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Note: If available, use tin

a blood orange to make the icing – it will add colour and some ex tra tang.

Images and text from Around the Kitchen Table by Sophie Hansen and Annie Herron, photography by Sophie Hansen, $45, Murdoch Books

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> F

or many people, along with the excitement, pregnancy can also be a worrying time; you are carrying very precious cargo, pregnancy can affect different people in different ways, and complications can occasionally arise. For this reason, from your very first antenatal appointment with your LMC (lead maternity carer), you will be offered a variety of screening tests and monitoring to double-check you and baby are healthy and well as your pregnancy progresses.

FIRST ANTENATAL BLOOD TEST

At your first appointment, your LMC will give you a form for a blood test at your local medical laboratory. Just one sample can provide a lot of information. Here’s what will be checked: FULL BLOOD COUNT – the test will check iron, platelet, and white blood cell levels, and whether you are A, B, O, or AB blood group. Low iron levels can cause you to feel more tired, and mean you may be less able to manage blood loss during birth. High levels of white blood cells can indicate an infection is present. Platelets help blood to clot to stop bleeding. Your LMC will advise you if there are any concerns. RHESUS (RH) FACTOR – this is a protein (“D antigen”) found on the surface of some people’s red blood cells. Most people’s blood has the protein; they are described as being Rh positive (Rh+). If your blood doesn’t have the protein, you’re Rh negative (Rh-). Why is this important? Well, if you are Rh- and your blood and your baby’s blood mix, you can make antibodies that can cause complications (severe anaemia or jaundice) with this baby, or subsequent ones. An injection of “Anti-D” will be required if you bleed during pregnancy or birth to prevent your body from making these potentially harmful antibodies. ANTIBODIES – antibodies are produced as part of our immune system to help protect us from disease. However, certain antibodies can be harmful to your baby. If any harmful antibodies are present, monitoring and treatment will be recommended.

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Testing

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The team at Nest Pregnancy and Parenting (nestpregnancyandparenting.co.nz) explains the screening tests you and your baby will be offered during your pregnancy.

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ultrasound scans ULTRASOUND SCREENING MAY BE OFFERED FOR A VARIETY OF REASONS. HERE ARE SOME COMMON SCANS THAT MAY BE OFFERED:

DATING SCAN When: In the first 14 weeks of your pregnancy. Why: To check roughly when your baby is due, and to confirm whether you are having one baby or twins (or more!).

RUBELLA IMMUNITY – catching rubella

(AKA German measles) in pregnancy can cause miscarriage or serious health issues for your baby. Most women will have immunity. If you are not immune, the MMR vaccination after your baby is born can provide immunity for future pregnancies, but it is not able to be given during pregnancy. HEPATITIS B – this can often be symptomless, but can cause significant health problems, including liver damage. If you are found to have hepatitis B, your baby will be offered immunoglobulin and vaccination at birth to help prevent them becoming infected. SYPHILIS – this is an infection that can be passed between partners during sex, or from mother to baby during pregnancy. It can cause serious health issues if left untreated but, if syphilis is found, early treatment can help avoid these problems. HIV – this virus affects the body’s ability to fight infection and can cause AIDS. It is passed on by contact with blood or body fluids. An HIV positive mother can pass the virus to their baby during pregnancy, birth, or breastfeeding,

NUCHAL TRANSLUCENCY SCAN When: Ideally 12 weeks, but generally between 11 weeks + 2 days, and 13 weeks + 6 days. Why: Part of the first trimester combined screening for Down Syndrome and other conditions.

ANATOMY SCAN When: At around 18–20 weeks. Why: To measure parts of baby’s body to check that they are growing as expected and to look for any issues. If you want to, you can find out what sex your baby is.

but with treatment and preventative measures, it’s possible to reduce the risk of baby becoming infected to less than 1%. DIABETES – the test will check if you already have, or are at risk of developing, diabetes. If you have or develop diabetes, you will be offered information and support. A later diabetes test at 24-28 weeks pregnant will check whether you are developing diabetes during pregnancy (“gestational diabetes”). See the next page for more details about gestational diabetes.

SCREENING FOR DOWN SYNDROME AND OTHER CONDITIONS

You can choose to have tests to check whether your baby is likely to have Down Syndrome or some other rare genetic conditions. The screening offered will depend how many weeks pregnant you are. If you are less than 14 weeks pregnant, you will have a blood test and a scan of your baby. If you are 14-20 weeks pregnant, you will only have a blood test. Levels of certain hormones and proteins in your blood are measured and this, combined with information such as

GROWTH SCANS When: In the third trimester. Why: Your LMC may recommend additional scans if you want to check baby’s growth. Scans in pregnancy are non-invasive and generally thought to be safe for both mum and baby. However, ultrasound can potentially cause biological body changes and so, as tempting as those keepsake scan pictures may be, it’s recommended to keep scans to a minimum and have them for medical reasons only.

your age and weight, is assessed to provide a “risk result” which you should receive within 10 days. Your results will show you are either low risk (if your baby has a low chance of having one of the conditions screened for) or increased risk (if there is an increased chance that your baby has Down Syndrome or another of the conditions screened for). While it can be scary to receive an increased risk result, it does not mean that your baby definitely does have one of these conditions. In fact, most women who receive this result find their baby does not have a condition – either through further diagnostic tests or when their baby is born. If you receive an increased risk result, your LMC will be able to give you more information and let you know your options. If you would like to, they can refer you to a specialist obstetrician to discuss diagnostic testing and its risks. It is your choice whether to have diagnostic testing after an increased risk result. Some parents want to know for certain whether their baby has one of these conditions, while others decide to wait until baby is born. Pregnancy BUMP & baby

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As tempting as those keepsake scan pictures may be, it's recommended to keep scans to a minimum and have them for medical reasons only.

GESTATIONAL DIABETES

Diabetes is a condition where someone has too much sugar (glucose) in their blood. When this happens in pregnancy, this is called gestational diabetes, and it can cause health issues for mum and affect baby’s growth. Diabetes screening checks whether you have, or are at risk of, developing diabetes while you are pregnant. Why does diabetes sometimes develop in pregnancy? First, we need to talk about insulin. Insulin is a hormone that moves glucose from food, through the blood and into the muscles, where it is converted into energy. Sometimes, pregnancy hormones can stop insulin working well, or the demands of the growing baby may mean mum needs more insulin than her body can produce (a woman’s insulin needs double or triple during pregnancy). This can cause sugar to build up in the blood because it can’t get to the muscles.

DIABETES SCREENING IS OFFERED:

• As part of the first antenatal blood test, where the HbA1c test measures your average blood sugar level for the past four to six weeks. If your HbA1c level is high, this means more sugar has been circulating in your body and you have a higher risk of getting diabetes while pregnant. • When you are 24–28 weeks pregnant. This is called the oral glucose challenge or polycose test) and measures how effective your body is at processing sugar. It involves drinking a sugary drink and, after an hour, giving a blood sample. • If your results from either of the two previous tests were high, your LMC will offer you an oral glucose tolerance test. This needs to be done on an empty stomach, so will be carried out in the morning. A blood sample will be taken on arrival to check sugar levels after fasting, and then again two hours after you have drunk a sugary drink. This test confirms whether you have gestational diabetes or not. If you have or develop gestational diabetes, you will be referred to a specialist team and offered information and support to help manage it. In most cases it can be managed

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through diet and exercise, although some women will require insulin or another medication. Gestational diabetes is temporary and usually goes away once baby is born. You are, however, at higher risk of developing diabetes in the future, so do make sure you are checked every year for life.

ROUTINE CHECKS AND TESTS AT ANTENATAL APPOINTMENTS

If you thought your positive pregnancy test would be the last time you’d need to pee on a stick for a while, you’d be wrong! Your LMC will routinely test your urine at your antenatal appointments using a simple dipstick test. They will be checking to see if your urine contains: • P ROTEIN – which can be one of the symptoms of pre-eclampsia, a rare but serious pregnancy complication. • S UGAR (GLUCOSE) – this is an initial check for diabetes. • B ACTERIA – high levels may indicate a urinary tract infection. This is easily treated with antibiotics. Your LMC will perform other checks to ensure you and your baby are healthy and well. At your antenatal appointments, your LMC is likely to: • Take your blood pressure (high blood pressure can be one of the symptoms of pre-eclampsia). • Measure and feel your bump to assess baby’s growth and position. • Listen to baby’s heartbeat.

INFORMED DECISION-MAKING

Most people opt for screening to provide reassurance that all is well, rather than with the expectation that there’s something wrong. It’s worth bearing in mind, however, that waiting for results can be nerve-wracking, and occasionally the information obtained from these tests may not actually be reassuring. It’s also important to remember that many of the screening tests are not diagnostic, but simply indicate the level of risk. As with any test or procedure in pregnancy and birth, remember it’s your body and your baby and your decision whether to undergo screening or not. Your LMC can help you to decide what’s right for you and your baby. Book your antenatal class or postnatal workshop now at nestpregnancyandparenting.co.nz

And be sure to check out our Introductor y To Antenatal Online Course by scanning this QR code, or visiting bumpandbaby.co.nz (more information on page 10).

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grow

Womb to

Professor of Chemistry Julie Pollock explains the "perfect science" of the placenta, proteins, and how oxygen is delivered to a baby in pregnancy.

MEAL DELIVERY SERVICE

After the mother eats, her body breaks the food down into glucose, amino acids, fatty acids, and cholesterol that travel through channels or transporters in the placenta to the foetus. They provide the energy and the building blocks that the growing foetus uses as it develops organs, tissues and bones. Vital electrolytes like sodium, chloride, calcium, and iron pass through their own specific channels in the placenta or just diffuse from the mother’s side to the foetus. Foetuses require oxygen for growth, too. Since their lungs are not exposed to air, they can’t breathe on their own. Instead they rely on their mothers to provide the required oxygen through a remarkable biochemical process. I’m a biochemist, and it’s this process that made me fall in love with the discipline when I was a student. It’s my favourite topic to present to my students today, and helps explain why pregnant women can get so easily winded.

O HAIL, HAEMOGLOBIN

Some ingenious biochemistry is at the root of how oxygen travels throughout the human body. A protein called haemoglobin is responsible for picking up oxygen in your lungs and carrying it via your bloodstream to all of your tissues. Haemoglobin contains

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iron, and it’s responsible for blood’s red color. It’s made up of four subunits, two each of two different types. Haemoglobin’s four subunits can bind to one oxygen molecule each. Each subunit contains one iron atom bound to a special compound called a heme that can interact with one oxygen molecule. It’s an all-ornothing situation; for haemoglobins in the same vicinity, they’re either all holding onto oxygen or have all released their oxygen. It depends on the concentration of oxygen in the environment the haemoglobin finds itself in. When you take a good breath, the concentration of oxygen is high in your lungs. Haemoglobin in the area automatically picks up oxygen. Then it travels via your blood to tissues with lower oxygen concentrations, where it gives up the oxygen.

OX YGEN FLOW

Foetuses are not exposed to air, and their lungs don’t fully develop until after they’re born, so oxygen is another on the long list of things they must get through the placenta from their mothers. Haemoglobin proteins are too big to cross the placenta. The maternal haemoglobins must give up their oxygen molecules on their side so the oxygen can cross over and be picked up by the foetal haemoglobins on the other side. The predicament is that since this is all happening in such close quarters, the haemoglobins should either all be holding on to oxygen or all be releasing it. In order to circumvent this problem, a baby’s haemoglobin differs in structure from the mother’s haemoglobin. With just a few changes to the amino acids in its protein sequence, foetal haemoglobin does not bind well to BPG, the molecule that

Oxygen is another on the long list of things a foetus must get through the placenta from its mother.

PHOTOGRAPHY LENNART NILSSON. JULIE POLLOCK IS THE ASSOCIATE PROFESSOR OF CHEMISTRY AT THE UNIVERSITY OF RICHMOND. THIS ARTICLE IS REPUBLISHED WITH PERMISSION FROM THE CONVERSATION.

othering is synonymous with “nurturing”, probably because mums start providing for their children even before they’re born. A foetus relies on its mother to provide all the essentials. The placenta is key here; this organ develops in the uterus and is like a gateway that lets mum pass baby everything it needs to support its development.

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before birth

SEE OUR WEEK-TO-WEEK PREGNANCY GUIDE AT BUMPANDBABY.CO.NZ / WEEK-BY-WEEK

helps oxygen get loose from adult haemoglobin. So at the placental interface, where there’s a lot of BPG, the maternal haemoglobin lets go of the oxygen and the foetal haemoglobin grabs ahold of it tightly. This process allows for effective and efficient transfer of oxygen from the mother to the foetus.

THE FIRST BREATH

Shortly before babies are born, they start making some adult haemoglobin so that when they are breathing on their own, they can perform appropriate oxygen transfer throughout their little bodies. Usually by the time a baby reaches six months of age, the levels of foetal haemoglobin are very

low, replaced almost completely by adult haemoglobin. Academically, I knew about this remarkable biochemical process. But it wasn’t until I was pregnant with my son that I really understood it. My miles in spinning class decreased, I lagged behind my husband and dog on our daily walks, and I ran out of breath climbing the three flights of stairs to my office. My son’s haemoglobin was stealing my oxygen, so I had to breathe in more to complete routine tasks. Once my baby was on the outside, breathing on his own with his mature haemoglobin functioning appropriately, I was more amazed than ever at the perfection of the science. Pregnancy BUMP & baby

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S eeing

life before birth

A stunning set of images captured by Swedish photographer Lennart Nilsson have transfixed the world for more than five decades. 48

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n 1952, Swedish photojournalist Lennart Nilsson happened upon an embryo preserved in formaldehyde in a glass jar in a hospital in Sweden. Measuring just a few centimetres, the embryo fascinated Lennart and he took it home to photograph it. That one embryonic encounter sparked a 12-year project to use photography and technology to document life before birth. Together with medical experts, and in collaboration with five hospitals in the Stockholm region, Lennart produced unrivalled crystal-clear colour images of the 266 days between conception and birth. The photographs were published both in his book A Child is Born and in a Life Magazine article entitled "Drama of Life Before Birth" in 1965. Such images have never been reproduced.

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Ultrasound technology wasn’t invented until the late 1950s and wasn’t commonly used to track pregnancies until the 1970s. So, enlisting the help of two endoscope experts – who created optical tubes with macro lenses and wide-angled optics that could be inserted into a woman’s body – Lennart created the images that are beautiful, intriguing, and fascinating. Perhaps the most well-known is "Foetus 18 Weeks", which featured on the cover of Life Magazine in April 1965 (below) and depicts a foetus in its amniotic sac with its umbilical cord winding off to the placenta. This has been named one of the 20th century’s greatest photographs.

HOW DID HE DO IT?

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You can see more of Lennart Nilsson’s amazing life before birth images in our week-to-week pregnancy guide at bumpandbaby. co.nz/week-byweek

For privacy, it would impossible for a photographer to have such medical access in 2022, as doctors, health professionals and parents are far more careful with foetal and maternal safety. Lennart’s photos are incredibly artistic and, for some parents, provide some of the best insight and education into their baby’s development from conception until birth.

WHY HAVEN’T THESE PHOTOGRAPHS BEEN RECREATED?

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“Everyone interprets images differently, depending on their social, cultural, and religious background. In the digital era, I believe it is more important than ever to go back and take a look inside ourselves. What better way of doing that than with these photos?” said Jan Stene, art gallery director and curator of Lennart's definitive black and white series, to The Guardian in 2019. It was Lennart Nilsson's wish that his images were never used for political debate about pro-life.

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Turn, baby, turn

Between three and four percent of babies will be in a breech position at full term. OB-GYN Dr Susan Fisher explains what happens if your baby is around the wrong way.

s anyone who’s been pregnant knows, babies move around a lot in the uterus, kicking, punching, stretching, and all but doing cartwheels. As pregnancy advances and growth accelerates, there’s less wiggle room, and the dance party winds down to a yoga session as the baby’s movements become more constrained.

but increasing the risk of the head getting stuck later on. In that case, the umbilical cord may also emerge from the birth canal first. If the cord becomes compressed when the baby follows, this critical lifeline, which is still connected to the placenta and the mother, is cut off. Some babies take their time getting situated in the right position. As gestation progresses, the incidence of breech THE RIGHT WAY presentation falls. By 32 weeks, about The uterus is pear-shaped with the 90 percent of babies are head down, widest end at the top beneath and that number increases the mother’s ribcage and the Some babies to nearly 97 percent at term. narrowest at the bottom, near It is likely that you will notice take their the cervix. For most of the the accompanying shape time getting gestation, the baby is upright. change of your abdomen And the end of your pregnancy, situated in the as the baby shifts lower and the best way for the baby to right position. protrudes farther forward. fit into this confined space is As gestation HOW TO DIAGNOSE upside-down, with the back of the head ready to enter the birth A BREECH BABY progresses, canal. This orientation, optimal the incidence How will your obstetric care for delivery given the structure provider know if your baby is of breech of the pelvis and birth canal, is oriented correctly? An initial called the head-down position presentation diagnosis is made by a physical (or, alternatively, the cephalic exam. A clinician presses firmly falls. or vertex position). on your abdomen to locate Though most babies will assume the your baby’s head and bottom. But studies head-down position in time for delivery, have shown that this is far from an exact other presentations, known as breech science. Ultrasound is used to confirm positions, are possible. They increase your a breech presentation. chances of having a Caesarean section.

UNDERGOING AN ECV

THE WRONG WAY

The baby’s bottom may be directly adjacent to the birth canal. It can act like a stopper. Or the baby may be oriented feet-first, making the initial descent through even a partially dilated cervix relatively easy,

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If your baby is still in the wrong position at term, your health care provider may discuss with you the possibility of having a procedure called external cephalic version (ECV). Pushing from the outside, one or two clinicians try to manoeuver the

unborn baby into a head-down position. It’s usually done around 37 weeks, when there is enough amniotic fluid to facilitate movement of the baby. In the rare case when a complication arises, delivery can be done without risking the problems that are common in premature infants. The low-tech method usually works. A recent analysis of data from several studies shows a 60 percent decrease in

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breech births and a 40 percent reduction in Caesarean sections. Ask your health care provider about what to expect during the process – how long it might take and what the recommended preparations are. Some women describe the procedure as uncomfortable, while others experience little to no pain. Ultimately, it could help you avoid a Caesarean section.

WHAT NEXT?

What happens if the attempt to turn the baby fails? In the United States, 95 percent of women whose babies are in a breech position at term have to have a Caesarean section. Experts think that the low percentage of vaginal births among women carrying breech babies has been responsible for the substantial decrease in serious problems associated with these deliveries.

Edited extract from Taking Charge Of Your Pregnancy by Susan J. Fisher, HarperCollins, ebook $22.99. Pregnancy BUMP & baby

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JOURNEY

Five Kiwi women celebrate how pregnancy empowered them in personally unique ways.

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Sharna

38 WEEKS PREGNANT

“I absolutely loved being pregnant, and feel so blessed to be able to get pregnant and carry my babies to full term. When I’m pregnant and growing these beautiful babies is when I feel most beautiful. The underwater shoot was completely out of my comfort zone but [my photographer] Renee is amazing and made me feel so comfortable – and the images speak for themselves.” PHOTOGR APHED AT WHANGAREI AQUATIC CENTRE BY RENEE ANDERSON OF T WIG & THISTLE PHOTOGR APHY

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Thalia 38 WEEKS

“I had miscarriages before this pregnancy and a few scares and hospital visits early on, so I loved every movement. It told me we had a little fighter in there that really wanted to meet us earthside. Our bodies do this incredibly amazing thing and we go through so many changes so fast and – in the scheme of things – it’s such a short time. But now I have these photos forever to remember that it wasn’t all bad and hard work.” PHOTOGR APHED IN STUDIO BY KIMBERLY-JOY PHOTOGR APHY

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Emma

30 WEEKS PREGNANT

“I had a bump photoshoot with my other two and it has been so special to look back at the pictures with the kids. They ask questions about what it was like and if I could feel them kicking and growing! It’s also a great time for you as mum to really give attention to your growing bump. The third time around there’s not much time to stop, to think and imagine how this little life is going to assimilate into the current family dynamic, so it was a special time to give thought and space and recognise them as already being a part of the family.” PHOTOGR APHED AT A FRIEND’S HOUSE BY EMILY BARRETT OF BIRTHCOLLECTIVE.NZ

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Jayde 37 WEEKS

“I have made a conscious effort to really embrace and show off my bump throughout this pregnancy, hoping that it would inspire other women to do so as it is such a beautiful journey. Our bodies are so incredible and the way that we can create a little life inside of us should be celebrated immensely. For too long women have felt like they can’t have their bump out or they have to wear baggy clothing, and I had a lot of people ask if I would wear a bikini in summer as that was when I’d be in the third trimester and my answer was always ‘Absolutely!’ I’m proud of my bump – it’s my best accessory. I’m going to miss it so much!” PHOTOGR APHED AT TAYLORS MISTAKE BEACH, SUMNER, CHRISTCHURCH BY SAR AH LOUISE PHOTOGR APHY

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Avis

34 WEEKS PREGNANT

“I love capturing life’s milestones, the most precious of which is my pregnancy journey. Each time I look at my maternity photos, I am reminded of the joy and anticipation that comes with growing a child in my womb.” PHOTOGR APHED AT BETHELLS BEACH BY ROSAMOND DEL A CRUZ OF JOURNEY BY ROSE PHOTOGR APHY

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SHOW US YOUR BUMP

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Choosing your parenting style Think back to how you were raised. Do you want to parent in the same way, or do things differently? Whānau Āwhina Plunket explains the three broad types of parenting styles.

rom the time they’re born, children rely on their parents and family to protect them and to provide what they need. Parents are the single most important influence in a child’s life, and the relationships we have with our children have a much bigger impact on them than things like where we live or how much money we have. The way we parent them has a big impact too. Children tend to thrive when parents are warm and loving and provide clear guidance and support. They’re more likely to listen to your guidance when they feel understood. But parenting is hard, and no one gets it right all the time. It helps to remember these important points... • There’s no such thing as a perfect parent. • There’s no one right way to parent. • Every child is different, and has their own personality and unique qualities, and these can change over time – you need to adapt your parenting to meet their needs as they change.

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• You’re not just a parent, you’re a person with your own needs – looking after those needs makes parenting easier. • It’s okay to ask for help – all parents need it at times. Above all else, a loving relationship with your child is what’s important. There are three broad parenting styles: Authoritarian style (the rock), Permissive style (the paper), and Authoritative/ Supportive style (the tree). Many parents use a combination of styles (possibly being tougher than usual when they’re stressed, or more permissive than usual when they’re exhausted, for example), but tend to use one the most.

THE ROCK

This style of parenting is mostly hard and inflexible. Authoritarian parents often focus on unquestioning obedience, strict rules, and enforce harsh punishments when their directions aren’t followed.

These parents sometimes think they need to be tough on their children so they’ll learn important family values and life lessons. Children with authoritarian parents can: • Be more anxious. • Only think they’re loved if they do what their parent says or behave the way they want them to behave. • Have less self-confidence and self-esteem. • Be less independent. • Be more easily influenced by their peers. • Reject their parents and their values when they hit the teenage years.

THE PAPER

Permissive parents are also known as helicopter parents. Someone who parents this way often gives in to their children to keep the peace, and they like to rescue or save them from anything that might be hard or upsetting. This can mean their children may be: • Less able to deal with frustration or disappointment.

life+rela tionships

WHAT YOU NEED TO KNOW

There’s no such thing as a per fect parent, and there’s no one right way to parent.

“Parents are the single most important influence in a child’s life.”

Above all else, a loving relationship with your child is what’s impor tant. There are three broad parenting styles – authoritarian (the rock), authoritative (the tree), and permissive (the paper). Most parents use a mixture of the three styles, depending on how they’re feeling. A good general approach is to be flexible, but stay consistent about what’s impor tant.

• Overly dependent and insecure. • Find it harder to develop persistence and problem-solving skills. • Less confident in their personal decision-making. • Less considerate and more likely to blame others for their problems. Some parents might take this approach because their parents had an authoritarian style, and they want their kids to have a happier childhood than they did.

THE TREE

This style of parenting is firm but fair. Authoritative parents set limits and expect children to stick to them, but they can be adjusted over time as needed. These parents respond to their children’s needs and listen to their views. "Tree" parents let their children know what their expectations are, have reasonable consequences if that’s not what happens, and they praise good behaviour.

Children of authoritative parents tend to: • Respect others. • Be self-motivated. • Have good self-esteem. • Know what they want and how to get it. Most parents use a mixture of these three styles, depending on how they’re feeling. It’s a good idea to think about: • How you were parented – the good and the not so good. • How you want to parent your child. • The way you interact with your child now, and the way you manage them. • How this might feel to your child or how you think your child sees you. • Whether you want to (or need to) change what you’re doing to make sure your child has good memories and grows up to be a happy and capable adult.

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Whānau Āwhina

Plunket’s tips for a firm and fair approach Give your child lots of love and positive attention, and be your child’s safe and secure place to come back to. Know what normal behaviour is for your child’s age. This will help you have realistic expectations of them. ry to spend time doing something T they like with them every day. Remember, it’s about quality, not quantity. " Catch" them being good, and give them lots of praise for it. Have a routine, but know that some days won’t be plain sailing. ive lots of warning so they know G what’s coming next – plan, and keep them informed. ive them simple choices, like G whether they’d like to wear the red or the blue T-shirt. Agree on a small number of rules (too many and your child will be overwhelmed and won’t be able to remember them) and stick to them. I f they break rules, follow through with consequences that are reasonable and related. For example, if they draw on something they shouldn’t draw on, take the crayons away for a bit. Understand that all children are different. Think about your children and the things that upset or challenge each of them – one approach doesn’t fit all. emember you’re a role model R for your kids – they’ll learn more from what you do than what you say, so behave how you want them to behave.

TAKE THE PARENTING STYLES QUIZ AT WHANAU.SKIP.ORG.NZ Pregnancy BUMP & baby

life+rela tionships

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Going solo Facing pregnancy alone? Here’s how to rally support and make the next nine months a positive and joyous experience.

regnancy is an exciting and daunting time for any mum-to-be, but more so if you don’t have a partner to support you. While you spend nine months making a gorgeous little human, you don’t want to stress about how to get through it alone; help is available.

Antenatal care provided by a midwife/ Tapuhi ā-Whare or GP is free to New Zealand residents and citizens, and that includes your stay in a public hospital or birthing centre, any referrals to a hospital or specialist obstetrician, and postnatal home visits from a midwife to look after you and your new baby. The easiest way to choose a midwife in your area is through the Find My Midwife website (findmymidwife. co.nz). If you prefer specialist care, your GP can give you a list of obstetricians in your area. It’s important to feel comfortable with your LMC and to choose someone who is easy to talk to, happy to answer your questions and alleviate your concerns, and someone who is genuinely interested in the welfare of you and your baby.

ice real mum adv

It’s okay to cry. I allowed my morning shower to become my therapy cry time so I could also let it all out. Block social media if it’s going to make you upset. I blocked anyone and everyone associated to my ex-husband so this hugely tough time didn’t become even tougher. Do something for you! Even if it’s scheduled months in advance, do it. It's vital to have small occasions just for you to look forward to. You don’t have to do it alone. Allowing yourself to be vulnerable and accept help will heal you more than you will ever know. → Sarah Simpson, solo supermum to two wonderful, well-rounded children

Pregnancy BUMP & baby

BUILD A SUPPORT SYSTEM

Reach out to friends, family, and other loved ones who can support you during your pregnancy and beyond. You have the right to take whomever you choose to appointments, antenatal classes, and ultrasounds, so ask them to attend these with you and have them ask the questions you haven’t. It doesn’t have to be the same person each time; create a circle of people who can support you. And when you are having a tough time, use your circle for emotional support.

CONNECT WITH YOUR COMMUNIT Y

Use social media or community groups to connect with other single parents or pregnant mums-to-be in your area. There are also organisations such as Birthright, Single Parent Services, and Auckland Single Parents Trust that offer practical assistance. Birthright offers a range of social services for the children and parents of families led by one person in a number of regions around New Zealand, including parent education programmes, budgeting advice, and parenting networking opportunities.

PICK A BIRTHING PARTNER

Your birth partner is your go-to support person during labour and birth, along with your LMC. You don’t have to have one, but if you’re worried about going through the birthing process alone, your birthing partner can be a trusted whānau member, a close friend, or a doula. Choose someone who has a calm and reassuring presence,

but also someone who will listen and speak up for you if necessary.

WORK OUT YOUR BUDGET

Try to organise your finances before the baby arrives so you don’t have to stress about money and taking care of a newborn. Make a spreadsheet of your monthly expenses before baby, and then add in your post-baby expenses such as nappies and clothing. Do your best to save as much as you can to cover your expenses while you are on maternity leave. You may also be entitled to 26 weeks of government-funded parental leave payments while you are absent from your job. And most importantly, live within your means and cut back on extras that aren’t necessary or that you don’t use, such as gym memberships, streaming channels, or subscriptions.

LOOK AFTER YOURSELF

This can be an overwhelming time, and it’s important to remember that you are strong and resilient, but you don’t have to be superwoman. Take time to rest, put your feet up, soak in a bath, or go for a stroll with a friend. Think of the things that bring you joy, and do them. It’s also okay to worry, to cry, and to feel all the feels. Surround yourself with people you love and try to enjoy your pregnancy. You got this, mama!

127 turn to page FOR A LIST OF HELPFUL AND SUPPORTIVE SERVICES

COMPILED BY CHARLOTTE COWAN

CHOOSE YOUR LEAD MATERNIT Y CARER (LMC)

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Fly away with me Before you book your babymoon, here are a few things to keep in mind.

'C a

Pregnancy BUMP & baby

u se

I 'm

na in' o l e av

jet p la

n e. . .

ou’ve survived first-trimester morning sickness and now that you’re feeling more human, how amazing would it be to get away before the baby arrives? Now that overseas travel is more of a reality, you may want to get away for a “babymoon” before you’re housebound with a newborn. Whatever your holiday plans, when you’re pregnant, there are a few extra things to consider before you head away.

HOW FAR ALONG ARE YOU?

Many pregnant women travel in the second or early third trimester, as they feel better and can still get around without being uncomfortable. But if you’re travelling after 26 weeks, many travel insurance companies won’t cover you on a “regular” travel insurance policy. Also, many airlines won’t allow pregnant women to fly after the end of their 36th week, and most require a letter from your LMC after 28 weeks, confirming your due date, that you are healthy, and that your pregnancy is straightforward. Different airlines have specific requirements, so make sure you check your airline’s terms before booking your tickets.

CAN YOU DRIVE INSTEAD?

It’s often easier, more comfortable and – in current times – safer, to drive to your destination, as you can stop whenever you need to in order to stretch your legs, go to the toilet, and rest. Economy Class isn’t too comfortable when it comes to space and proximity to other people, plus with the current global pandemic situation, it may be easier to avoid it! When in the car, make sure your lap belt is placed as low as possible beneath your baby bump and lying across the thighs. Your shoulder strap should be above the belly and lying in-between your breasts.

DOES YOUR DESTINATION HAVE THE RIGHT MEDICAL CARE?

If you should end up becoming unwell or delivering your baby prematurely or unexpectedly while you’re on holiday, is the location you’re travelling to one which has modern medical technology available? Flying during pregnancy can slightly increase your risk of developing DVT (deep vein thrombosis) because the level of bloodclotting proteins increases during pregnancy and the anticlotting protein levels decrease. If you’re driving, stop often to walk around, and if you’re flying, make sure you drink plenty of water and stretch or elevate your legs whenever you can. Remember that some of the Pacific islands don’t have major hospitals, so keep this in mind.

WHEN WILL YOU BE HOME?

It’s better to travel early, while there’s still plenty of time before your due date. Not only will you be more comfortable (as difficulty sleeping and swollen ankles will still be far off in the future), it’s also safer – so you’re not risking being airlifted off a tropical island. Most importantly, if you do choose to travel while you’re pregnant, enjoy it! New babies bring with them all sorts of schedule changes and surprising things you need to adapt to (not to mention the amount of stuff they require when you’re travelling with them), so be safe but enjoy the luxury of having only a few bags and ample time to eat a meal without interruptions while you still can.

ARE YOU IMMUNISED?

When travelling to some countries, you might need special immunisations (and there might be some which aren’t recommended during pregnancy), and there may be locations which aren’t safe for pregnant women. These can include countries with confirmed cases of the Zika virus, or developing countries where safe food and water aren’t readily available. Also, some countries may have specific COVID-19 vaccine requirements for entry, so before travelling, make sure you check with your travel agent. You can apply for an International Travel Vaccination Certificate through My Covid Record, by calling 0800 222 478, or at a pharmacy, and check safetravel.govt.nz for further advisories and information.

travel friends

b.box Insulated Drink Bottle, $34.95, bearandmoo.co.nz Double-walled stainless steel keeps liquids cool for up to eight hours and warm for up to six.

HAVE YOU A SKED YOUR LMC?

Before you go anywhere, run it by your lead maternity carer to ensure there are no concerns which might limit your ability to travel. You may need to stay close to a hospital or medical centre, or you may have a medical condition which means you need to take special care.

New Edition Hand Sanitiser 150ml, $8.99, bumpandbabymall.co.nz Gentle on your hands, alcohol-free, and scientifically proven to kill 99% of germs for up to 24 hours.

Bio-Oil Skincare Oil (Natural) 60ml, $16.99, bio-oil.com Formulated with 100% natural ingredients, Bio-Oil Skincare Oil (Natural) is your must-have for stretch marks and uneven skin tone when travelling and for every day during your pregnancy.

Mamma’s Milk Bar Ginger Drops, $13, mammasmilkbar.com Natural lozenges made with Manuka multifloral honey and Matakana ginger to combat pregnancy and/or travel nausea.

Pregnancy BUMP & baby

GET EVERYTHING YOU NEED, WITHOUT LEAVING THE HOUSE Home to Kiwi mums’ favourite brands, BUMP&baby Mall (bumpandbabymall.co.nz) is your one-stop baby shop.

The versatile Moby Smart Sling tub, $99.90, grows with baby through three stages. >> BATHING > BABY BATH & BATH SUPPORT

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Pregnancy BUMP & baby

bumpandbabymall.co.nz

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FIND IT ALL AT OUR MALL BATHING BOOKS & MAGS CLOTHING FEEDING & NURSERY PLAY & LEARN FERTILITY HEALTH & WELLNESS NAPPIES & CHANGING NURSERY OUT AND ABOUT SAFETY SKINCARE SLEEP TEETHING & DUMMIES

Snug as a bug in a ... capsule, with Edwards & Co Avery Capsule, $249. >> OUT & ABOUT > CARSEATS & CAPSULES

A DD TO C A RT

Designed to keep your child's pacifier close-at-hand. Gobstopperz Minis Rainbow, from $24.95. >> SLEEP > DUMMY HOLDERS AND COMFORTERS

Complete your bubba’s nursery with these multi-functional fitted bassinet sheets from XO Kids, $49.95. >> NURSERY > SHEETS

We're open all hours at bumpandbabymall.co.nz Handmade with care and all-natural fibres, the Cariboo Seagrass Bassinet, $149, is the sweetest spot to change little baby bums. >> NURSERY > CHANGE TABLES

Take the hassle out of changing a wet bed, with Brolly Sheets, from $54.95. Place on top of your bottom sheet, tuck in the wings and sleep directly on top. >> SLEEP > OTHER

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Pregnancy BUMP & baby

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Made with natural cotton to provide a top sheet layer of luxurious comfort for your baby’s delicate soft skin. Lovekins Premium Nappies, $24.99. >> NAPPIES > DISPOSABLE NAPPIES

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To be used along with the Safe T Sleep Sleepwrap Body Wrap, this head wedge helps to position baby's head on alternate sides at each sleep to help prevent flat head. $19.99. >> SLEEP > SLEEP WRAPS & WEDGES

Announce the exciting times with these Love Bubs Pregnancy Milestone Cards, $35. >> PLAY & LEARN > MILESTONE CARDS

Noopi nappies are made from 70% plant-based sustainable and renewable materials, from $12. >> NAPPIES & CHANGING > NAPPIES > DISPOSABLE NAPPIES

Place the EmeTerm Sickness Relief Band, $162, on your wrist for relief from nausea and vomiting caused by morning sickness. >> HEALTH & WELLNESS > MORNING SICKNESS

A nourishing blend of antioxidantrich oils, Pure Mama Belly Oil, $69, promotes elasticity and helps prevent stretch marks. >> SKINCARE & GROOMING > STRETCHMARKS

A DD TO C A RT

Premium-certified Mānuka Honey 80+, Mānuka Oil, Aloe Vera and Calendula help Honey Babe Shampoo & Wash, $25, gently cleans delicate skin and scalp. >> SKINCARE & GROOMING > BABY SHAMPOO

Pregnancy BUMP & baby

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Little World knows how to treat delicate hair and skin to a careful, gentle clean, from $25. >> SKINCARE & GROOMING

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For yourself or a great gift, Māmā Life Tee & Mini Life Onesie set, $63, >> CLOTHING > MATERNITY

The perfect baby bag with all the functionality you’ll need. Vanchi Emmy Backpack & Amelia Convertible Pram Caddy Bundle, $309.90. >> NAPPIES & CHANGING > NAPPY BAGS

Adjustable 'snaps' and available in a tonne of sizes. Trust Bear & Moo for cool, comfy nappies, from $17.95. >> NAPPIES & CHANGING > NAPPIES > REUSABLE NAPPIES

This hospital-grade breast pump makes expressing breast milk comfortable and efficient. Unimom Opera from More Than Milk, $475. >> FEEDING > BREAST FEEDING > PUMPS

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Keep little tootsies warm with Lamington Merino Wool Crew Socks, $17.95. >> CLOTHING > BABY > SOCKS

Protect your baby from the elements with the Hear Me Roar Darling 5-in-1 Multi Capsule Cover, $44.95. >> OUT & ABOUT > STORM & SUN COVERS

SleepDrops for Babies, $39, is a completely natural sleep formula, used by Kiwi parents for more than 10 years! >> SLEEP > SLEEP SUPPORT

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nursery+equipment

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Ecosprout organic cotton cellular bassinet blanket, $34.90, ecosprout.co.nz

Earth baby Create an eco-friendly nursery with these sustainable ideas.

ECO-FRIENDLY FURNITURE

Typically the first purchases for your nursery will be big items such as a cot, changing table, feeding chair, and chest of drawers. When sourcing these items, choose sustainable timber with finishes that are lead- and phthalate-free. For your cot, it’s more sustainable to choose an option that converts into a toddler bed and add an eco-friendly mattress made of organic, chemical-free materials. For other furniture, try to use raw, solid wood where possible, or upcycle any items you may have in your home – such as an armchair that could be repurposed into a feeding chair. If you want to purchase new, try and pick investment pieces that will last a number of years so you’re not constantly replacing them – this might be a little more expensive, but it’s a lot more sustainable!

ORGANIC LINEN

When it comes to bedding, choose natural organic fibres such as merino, linen, cotton, and bamboo. Babies have sensitive skin, and synthetic fibres can irritate them and disrupt their sleep. Fibres such as organic cotton and bamboo are soft, highly absorbent, and gentle. They are also environmentally friendly, 100% biodegradable, and can be used all-year-round.

Natural Paint Co. paint, 1L $49, 2L $79, 4L $159, naturalpaint.co.nz

Q Toys natural wooden cargo train, $89, fairplay.nz

TOXIN-FREE PAINT

If you want to add a pop of colour to the walls on your nursery, choose a paint which is non-toxic, low-odour, and non-VOC – meaning it doesn’t contain volatile organic compounds which can give off harmful gases. Breathing in VOCs can cause breathing issues, headaches, and nausea, and can remain in the air for years after the paint has dried. Sealing your existing paint with a natural paint means your baby won’t be breathing in nasty fumes throughout the night. Brands such as Natural Paint Co. (naturalpaint.co.nz) and Dulux (dulux.co.nz) offer super-cute paint colours without nasty ingredients. For a medium-sized nursery, you will need around six litres of paint.

Babyletto "Hudson" three-drawer change dresser, $919, bellybeyond.co.nz

NATURAL DÉCOR

You can continue to create a healthy environment for your baby with the décor in your nursery. Choose toys that are made from wood, wool, cotton, or natural rubber instead of plastic, and opt for natural fibre rugs that use vegetable dyes or are undyed. High-quality natural fibre rugs will last longer and can be used in different rooms in the house due to their neutral colour. And where possible, shop locally and buy New Zealand-made; this not only helps to reduce your carbon footprint, it helps support Kiwi businesses.

ature nurture with n Mocka "Poppy" natural jute floor rug (large), $189.95, mocka.co.nz

tip Buying secondhand is a great way to be sustainable, but make sure any finishes are non-toxic and meet today’s safety standards. 70

Pregnancy BUMP & baby

COMPILED BY CHARLOTTE COWAN

Made with sustainable New Zealand pine and CARB II compliant MDF

nursery+equipment

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Pretty

little things

- nursery. Pro tips to create your pepis

1. A great way to create more storage is by whitewashing old crates.

2. Crafting in pregnancy is not only mindful but terrific for nesting. Try creating pom poms out of tulle for a cute hanging nursery accessory.

3. Buntings are fun and easy to do but also a great way to bring texture, fabric and colours into the room. Just make sure that the string is out of reach of any baby and well secured.

4. Whether you’ve got hard floors or carpet, a textural rug creates a sense of cosiness and can accentuate key colours in the nursery.

5. If you choose to keep your walls plain, you can enhance your room with decals or wall art. They’re super-cute and easy to change when your child gets older.

6. Don’t forget lightshades and pendant lights – spend some time searching for fun lighting as there are some amazing options out there!

7. Cots come in a variety of colours but there’s always the option to paint them your favourite hue with non-toxic paint.

8. Search for laundry baskets for your soft storage – there are some gorgeous options available and they are light, functional and easy to move.

Pregnancy BUMP & baby

dermaltherapy.co.nz Available from all

stores & online at chemistwarehouse.co.nz

nesting

Time to get organising! Here’s how declutter your nursery and incorporate easy storage solutions.

@littlecrowninteriors

Nursery

nooks

o begin organising your baby’s nursery, it’s important to divide and conquer. Create specific zones: One for feeding, one for changing, one for sleeping, and one for play. This will help you set up and organise each area with exactly what you and your baby will need, which will help make the space feel calm and relaxed.

@fashionaablekay

NAIL YOUR NAPPY STATION

CREATE A QUIET & CALM FEEDING ZONE

tip

@nukkodesign

is a great place to keep swaddles, blankets, and books as they will be easy to grab and you won’t need a bookmark! A basket beside your chair is a good idea for spare swaddle storage or to dispose of spilled-on items.

GET ROLLIN’!

A storage cart on wheels is super-helpful for moving the essentials between zones and rooms. Use it to store nappies, wipes, burp cloths, bibs, bottles, pumping essentials, and a jar for spare dummies. Plus essentials for you, including lip balm, breast pads, nipple shields, nipple creams, a water bottle, and your phone. Keep it near your nappy or feeding station and move it around as needed.

The most important thing in this zone is that everything you TAME THE TOYS AND need is in arm’s reach, as once Don’t forget BOOKS! you’ve settled in to nurse, you To display and store your baby’s to include can’t be hopping up and down book collection, solutions such a laundry and breaking your baby’s latch! wall-mounted racks, shelves, and Must-haves for this zone include hamper and ledges are both practical and a nursing chair – stylish is great rubbish bin! cute. Plus, if you fix a wooden but comfort is key – a nursing or metal rod underneath the pillow, and a side table. The side shelving, you can hook on table should be near a power point, so you buckets or baskets to store small toys and can plug in your breast pump, a charger for rattles. Extra baskets and bins can be stored your phone, and a soft light for night-time under the cot or in the wardrobe to hold feeds. Nearby movable shelving or a ladder any spare toys and books.

Pregnancy BUMP & baby

easy reach

@jolaylebaby

You’ll be spending a lot of time here, trust us! And despite being tiny, babies need a lot of nappies and wipes, and often quite a few creams on top of that. In your nursery zone, choose a changing table with drawers – similar to a dresser – to store all your spare essentials such as extra onesies or pyjamas (for middle-of-the-night explosions), your bulk supply of wipes, and any nappy rash creams. Add drawer dividers to create individual compartments and label them – this will help you keep everything organised. Above the changing table, add a set of shelves where you can easily grab a nappy or wipe in emergency situations!

nursery+equipment

COMPILED BY CHARLOTTE COWAN

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Pregnancy BUMP & baby

SnüzPod4 Bedside Crib, $549, edwardsandco.nz

Lay me down How to choose a safe sleeping space for your pēpi.

Cariboo Gentle Motions Bassinet, $249, cariboo.co.nz

SNUGGLE DOWN

Shnuggle Dreami Moses Basket, $299, babyonthemove.co.nz

Chicco Next2me Magic Crib, $599, babycity.co.nz

Pregnancy BUMP & baby

to sleep

new baby will spend up to 18 hours a day, or around 65% of their first 12 months, sleeping – so one of the most important purchases you will make is a safe sleeping space for your wee one. Bassinet, co-sleeper, wahakura, or cot? Here are some things to consider…

SMALL SPACES

When it comes to smaller beds for your newborn, there are a number of options – the most common being a bassinet. Bassinets are typically light, meaning they can be easily transported from room to room, and they are usually small enough to fit in the parents’ bedroom, which is recommended for the first six months of your baby’s life. Bassinets are often more accessible than cots (with lower sides), which can be helpful following a C-section, so you don’t have to bend to lift the baby from the cot multiple times during the day and night. Babies will typically remain in a bassinet for three to six months, but they need to transition to a cot once they can sit up, push up, or roll over. Similar to a bassinet, bedside or co-sleepers are height-adjustable and open on one side to effectively widen your own bed, and make nighttime feeding easier. Moses baskets, wahakura (woven from harakeke flax), baby nests, or Pēpi-Pod sleep spaces are other options.

IS MY BA SSINET SAFE? UNFORTUNATELY, THERE ARE NO NEW ZEALAND SAFETY STANDARDS FOR BASSINETS, BUT RED NOSE AUSTRALIA ADVISES: • Ensure the bassinet has a sturdy bottom and wide, stable base so it can’t tip over. If the bassinet stand is designed to fold, ensure there’s a locking mechanism so it can’t do this while in use. • Make sure all four sides of the bassinet are at least 300mm higher than the top of the mattress base to stop baby falling out.

• Choose a firm, flat mattress that’s the correct size for your chosen bassinet – the mattress should be no thicker than 75mm. • Have good breathability zones on all four sides to reduce the risk of suffocation and to provide good ventilation for your baby.

nursery+equipment

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keep your pēpi safe Make sure your baby always sleeps on their back to keep their airway clear. Always put them in a safe sleeping space. Ensure sheets or blankets around mattress bases are snugly fitted, and don’t put toys or any other loose items in the sleeping space with your baby. Always put them back in their own bed after feeding – don’t fall asleep with them in your arms. Protect baby with a smokefree whānau, home, and car.

Made with sustainable New Zealand pine and screened for harmful chemicals

THANKS TO BABY REEF. PHOTOGRAPHY BY RENEE ANDERSON OF TWIG & THISTLE PHOTOGRAPHY. COMPILED BY CHARLOTTE COWAN

BIGGER BEDS

Some parents will choose to place their newborn immediately into a cot, where children can sleep from newborn until around two to three years of age. Most cots are quite large, so may be difficult to fit in the parents' room. They typically have two height settings for the base, so it can be lowered once baby can sit, and many will also convert to a toddler bed, making them more economical in the long run. In New Zealand, household cots must meet mandatory safety standards, which include design and construction requirements; passing impact, strength, and durability tests; and having warning labels attached. If you’re unsure if the cot you are looking at meets the requirements of safety standard AS/NZS 2172:2003, talk to an in-store expert.

Babyhood Kaylula Mila Cot, $1499, babyhood.co.nz

NIGHT NIGHT

Mocka Boston Cot, $449.95, mocka.co.nz

Babyletto Gelato 3-in-1 Convertible Cot, $859, dimples.co.nz

Take me away! Nuna Sena Aire Travel Cot, $499, dimples.co.nz

Pregnancy BUMP & baby

nursery+equipment

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2-in-1 Converting from a sleeping bag to a sleep suit with legs using four-way zippers, this multi-functional sleep suit bag is made from easy-care organic cotton and has a silky smooth feel, allowing your little one to move freely during sleep.

L OV E

ergoPouch Sleep Suit Bag 2.5 TOG (2-4 years), $89.95, ergopouch.com.au

Living Textiles Sleeping Bag 0.2 TOG (6-18 months), $49.99, babycity.co.nz

SLEEPY TIME

ergoPouch Cocoon Swaddle Bag 2.5 TOG (0-3 months), $59.95, ergopouch.com.au

Sleeping bags so cosy, you wish they made them in adult sizes!

Love To Dream Sleep Bag 2.5 TOG (6-18 months), $94, bellybeyond.co.nz Tommee Tippee Grobag Snuggle 1 TOG (0-3 months), $49.99, tommeetippee.co.nz

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FOR MORE ON TOG RATINGS

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COMPILED BY CHARLOTTE COWAN

Merino Kids Go Go Bag Standard – All Seasons Weight 0.5-1.8 TOG (3-24 months), $189, merinokids.co.nz

Award-winning sleepwear for newborns and babies Loved by babies and mothers around the world, our Cocoon Swaddle Bag will help your precious little bundle slumber safely and soundly. Suitable from newborn to 12 months, it converts to an arms-out sleeping bag once your baby starts to show signs of rolling. Made from natural fibres, it comes in three TOG ratings to keep your baby at the optimal warmth throughout the year. The 1.0 TOG is perfect for hospital temperatures and made from a luxurious blend of Organic Cotton and Bamboo. Receive 15% off your order with code BBEP15 when shopping on ergopouch.com.au exclusive to you* *T&Cs apply, see website for details.

Breathable natural fibres Safe-sleep compliant 2-in-1 transitional system TOG-rated for warmth

Call us: 1300 668 929

Chat and shop online: ergopouch.com.au

Email us: cs@ergopouch.com.au

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nook

Nursery

Teach your little ones to explore and embrace their feelings with these special stories. What If… ?, $24.99, Exisle Publishing Why worry about monsters under the bed when you could wonder, "What if the clouds were purple and orange and green?" Your little ones will adore this playful exploration of words and their power to change how we feel.

I Am Me, Little Big Bully, The Grief Wave, $19.99 each, EQ Publications (tracemoroney.com)

behind the book Trace Moroney’s new My Emotions series equips children (and their associated grown-ups) with valuable skills to navigate their way through life’s ups and downs.

Welcome To The World, $28, Penguin Books (release date 7 June 2022) A tender and lyrical picture book that explores new senses, people, and places that babies and young children experience for the very first time.

When You’re Older, $27.99, Allen & Unwin Beautiful and warm, this special book reveals an older brother’s hopes for the amazing experiences he will share with his new baby brother –when he’s older.

Peter Rabbit: I Love You, Grandma, $15.99, Penguin Books This book is a heartwarming and affirming ode to the special bond shared between grandmother and grandchild.

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FOR MORE FUN WITH GRANDMA AND GRANDDAD

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WHY DID YOU DECIDE TO CREATE THE MY EMOTIONS SERIES?

My Emotions series is an extension of my previous work in emotional literacy (the Feelings series and the Things I Love series) explaining feelings – and ways to identify and manage them – to young children. My Emotions series describes complex emotions that often accompany inevitable events in our lives – such as bullying (either as the victim, the bully, or a witness); grief and loss (associated with death and symbolic grief – like divorce or loss of a friendship); self-esteem; and resilience.

WHY DO YOU THINK BOOKS ARE AN IMPORTANT PART OF A CHILD’S EARLY YEARS? Discussing tricky or uncomfortable subject matters can be challenging for many parents and caregivers – and it is important to acknowledge we are limited in what we can teach by our own experiences and knowledge. My picture books provide a gentle way in which to broach difficult subjects – for young children, adolescents, and adults alike!

HOW WILL YOUR BOOKS HELP PARENTS NAVIGATE EMOTIONS IN SMALL CHILDREN My Emotions series sensitively describes difficult concepts in a way that children can understand. Each book offers a range of well-researched techniques to help children build valuable coping skills, and helps prepare them to navigate their way through life’s inevitable ups and downs.

COMPILED BY CHARLOTTE COWAN

Baby Touch: Feelings, $15.99, Penguin Books This adorable book helps to stimulate your baby’s senses and introduces them to different feelings and emotions with high-contrast colours and a touch-and-feel on every double page.

Four reasons to get excited about our new baby.

DUE SOON

phil&teds voyager buggy, $1099, and double kit, $269 (each), philandteds.com

On a mission If you have special requirements when it comes to choosing a stroller, here are some tips that might help make your decision a little easier.

If you have twins… With most strollers made for just one baby, choosing an option for twins can be daunting. We break down the options…

INLINE DOUBLE: Inline double (or Before you choose a double stroller, ask yourself what your lifestyle is like. Are you often in crowded spaces? How big is your car? These things will determine which kind of stroller you need!

double the fun Mountain Buggy Duet Luxury, $1299, dimples.co.nz

tandem) strollers have the benefit of being narrow like a single pram where the seats stack to sit in tandem with each other. They can either face forward or face each other. These strollers are typically the same width as a single stroller, so are easier to squeeze into narrow spaces and manoeuver through doors or around sharp corners. Many inline doubles will allow different combinations of bassinets/carrycots, stroller seats, and capsule car seats.

CONVERTIBLE: Convertibles are single

prams that convert to double prams by attaching a second stroller seat, capsule car seat or – in some cases – even a bassinet/ carrycot. Convertibles are great because you can easily unclip the second seat and turn it back into a single stroller if you only need to take one child out and about.

SIDE-BY-SIDE: This is the more traditional option and features two seats which are next to each other. Some side-byside options allow you to turn the seats to face the front or the rear, while others are fixed in place. While these strollers are wider than the other two options, both babies will be within arm’s reach and wee ones love to sit beside each other! 82

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iends fourwheeled fr

No stroller is invincible, and there is always a chance it could still tip over – so if there's a chance you may fall, have someone walk with you when possible if you’re out and about.

If you are a ru n n e r… Traditional prams are great for walking on the footpath, but they’re not built for bumpy terrain or high speeds, and that’s where a jogging stroller comes in. Here’s what to look for…

L ARGE WHEELS: Whether you like to

run on the footpath or over bumpy trails, it’s a good idea to choose a three-wheeled stroller with large diameter wheels. For off-road running, look for tyres with built-in treads – which will stand up to asphalt, dirt, rocks and roots – and a fixed or locking front wheel, as a swivelling front wheel will start to wobble at fast speeds.

Baby Jogger City Select 2, $1099, babyjogger.co.nz

Silver Cross Pioneer Eclipse, $1999, silvercross.co.nz

If you need

SOLID SUSPENSION: Suspension is

what makes the journey smooth for both parent and baby, so look for a stroller with a solid suspension system (often labelled “all-terrain” and/or “high suspension”) that can handle jolts and bumps.

stabilit y… If you have a disability, disorder, or impairment where you could have a seizure or fall (such as epilepsy), here are some things to consider…

HAND BRAKE: A hand brake can help

reduce the speed of your stroller when you are running downhill, so you won’t lose control. Some jogging strollers have both a hand brake and a parking brake, which locks the stroller into place once you have stopped.

Mountain Buggy Terrain, $1099, babycity.co.nz

FIVE-POINT HARNESS: Always choose a jogging stroller with a five-point harness which will hold your child firmly in place.

FOUR WHEELS: Four-wheeled prams are

more stable as they have evenly distributed weight and a stable centre of gravity, so they are less likely to tip over. Compact fourwheeled prams can also be more lightweight, making them easier to lift and fold.

ADDED PADDING: If there is a chance

you may push your pram over during a fall or seizure, choosing a stroller with extra padding – or the option to add extra padding – will help protect the baby.

s joyful jogger

SAFET Y STRAP: Try adding a tether strap

Your baby should be at least six months old and be able to hold their head up without support before joining you on a jog.

that attaches to the pram and hooks around your wrist so the pram cannot roll away from you. It’s a good idea to choose a strap that is stretchy so if you do fall, the pram will stay with you but not tip over. Just make sure you don’t choose one that is too long.

L ABELS: If you become confused Thule Glide2, $1199, thule.com/en-nz

during a fall or seizure, tie a label with some emergency contact numbers to the handle of the stroller so passers-by know whom to contact. Pregnancy BUMP & baby

GOLD Revolve360 Rotational All-In-One Conver tible Car Seat

BOLD MOVES: Innovative rotating car seat makes it easier than ever to get your child in and out of the car—no matter what kind of vehicle you have

ON-THE-GO RECLINE: Easily adjust your child’s seat for maximum comfort, without having to reinstall the seat or bother your baby

360 DEGREES OF EASE: Install the Revolve360™ once and you’re done—the Sure360™ Safety Installation System with LockStrong™ and Tether360™ keeps it safe, secure and simple

ACE THE INSTALL: Bead Level Indicator makes it easy to level the Revolve360 to achieve the safest, most accurate installation in all vehicle types

GROW WITH GOLD: Offers 10 years of use and 3 modes—Rear Facing (2kg –18kg), Forward Facing (10kg – 30kg), and Booster (18kg – 55kg)

GOLD STANDARD SAFETY: Side impact, temperature and rollover tested, as well as tested for structural integrity at energy levels approximately 2x the federal crash test standard We’re so confident you’ll love the Revolve360, we back it with our Evenflo Gold Lifetime Warranty

AVAILABLE AT

Chase Harnessed Booster

Tr i b u t e 5 C o n v e r t i b l e C a r S e a t

your child’s height while in booster seat mode, while the enhanced side

seat gives great vehicle fit with side-impact protection

Featuring a headrest design that allows the vehicle belt to self-adjust to

Combining safety, comfort and easy, the compact Tribute care

walls and head support provide comfort and safety for the child.

Rear-facing and forward-facing

This combination booster provides an exceptional value.

Compact design

Machine-washable fabrics Side impact tested Live video installation support

5-point harness

AVAILABLE AT

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While it seems convenient to leave a sleeping baby in a capsule, it is safest to transfer them to a flat sleep surface once they’re out of the car.

I'm on

my way

Ensure your precious cargo is safe when travelling with these tips from certified restraint technician Carla Canty (safensnug.co.nz).

hen it comes to choosing a car seat for your little one, the options can feel endless and overwhelming. The simple answer is that the safest seat is one that fits your vehicle and baby, and is used correctly. Trying the seat in your car and learning how to use it correctly are two of the best things you can do before baby arrives. Here's some advice on choosing and installing your baby's first car seat.

CAPSULE OR CAR SEAT?

The first choice you’ll need to make is between a detachable infant capsule and a convertible, or "all-in-one", car seat). Capsules are designed for newborns, so they’re light and have smaller parts to fit a baby comfortably. They have a carry handle and attach to a base that is left in your vehicle, making it easy to transfer baby in and out when you’re on the go. Their longevity is based on the limits of the seat and growth of your baby, but typically

you will use them for between four and 18 months – most people find that they’re too heavy to carry after around six months. Capsules are also only rear-facing, which is the safest way for babies and small children to travel until they are at least two years old. Car seats are fixed into the vehicle and have a range of longevity, again based on the seat limits and your child’s growth. Many can be used safely from birth and can swap from rear- to front-facing, and some can last until your child is ready to fit a seat belt. Pregnancy BUMP & baby

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CHECKS TO ENSURE YOUR SEAT IS INSTALLED SAFELY HOW MUCH SHOULD I SPEND?

Budget is often the determining factor for which type of seat parents choose. More expensive does not mean safer, so it’s important to find a seat that suits your needs. Many parents choose to hire a capsule for between $40 and $80 a month, and then move to a car seat later to avoid multiple large purchases.

FEATURES TO CONSIDER…

• ISOFIX/LATCH: This system allows you to fit a car seat directly into a vehicle using metal bars instead of a seat belt; this can be easier if your vehicle has the capability. • Harness height adjustment: Some harnesses adjust by rethreading it through the seat, and others have a built-in mechanism. • Adjustable recline: Multiple recline modes can make it easier to install the car seat at a safe and comfortable angle. • Cover cleaning: Some covers are machine washable and/or can be removed without moving the seat. • Width: If you already know that you’re planning a large family, future-proof by purchasing a narrow seat. • Extended limits: Look for a seat with limits that can maximise a child’s time rear-facing and harnessed, keeping them safer for longer. • Extra “nice to have” options: Sun visors, cup holders, harness holders, cooling fabrics, and QR-code instruction videos.

1. Vehicle fit For newborns, the seat should be on a 45-degree angle – you can check with a free angle app to calculate where the baby’s shoulders sit. 2. Within limits Check that your child fits within the limits of the seat in the way it’s installed. 3. Safe and solid There should be less than 2.5cm movement by the car seat in any direction at the connection point.

years is the typical lifespan of a car seat, from the date of manufacture. 86

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Child restraint technicians are available throughout New Zealand and are trained to help you install your car seat. Find your closest technician at nzta. govt.nz/safety/what-wakatohi-is-doing/educationinitiatives/child restraints/ find-a-child-restrainttechnician

4. Harness fit Ensure the shoulder height of the harness and the crotch buckle are the correct placement as per the car seat’s instruction manual. The chest clip, if the seat has one, should be at armpit level.

When you’re on a budget Edwards & Co Avery Capsule, hire from $50, babyonthemove.co.nz Getting your baby in and out of the car is a breeze with the new Baby Jogger City Turn! Featuring a secure rotating mechanism, the car seat can swivel 180° with one hand in rear-facing mode. Newborn-ready, it grows with your child to a height of 124cm and converts to forward-facing.

fyi

5-10

5. Harness is tight You should not be able to pinch together the harness strap at the shoulder.

When you only want to buy one Baby Jogger City Turn, $899, babyjogger.co.nz

When space is limited Infasecure Cosi Compact ll, $299, infasecure.co.nz

Keep your pēpē safe We know that installing a child restraint isn’t the easiest thing to do, so we have a range of free and helpful videos, which are available in English and Te Reo at www.nzta.govt.nz/childrestraints

How to manage

pain

during childbirth

When it comes to pain relief during labour, every woman is different.

omen have always used different methods to try and reduce pain during childbirth. Over the years these methods have included inhaling opiates, a warm compress, magical charms, and even sprinkling animal dung in a hot drink. Anaesthesia started to be used in childbirth in the 1800s, typically involving ether or chloroform. Today, drugs such as nitrous oxide (gas and air), epidurals, and pethidine are regularly used during labour. Epidural is the most comprehensive option, a type of anaesthetic that is injected into the back, numbing the nerves that carry the pain impulses. Pethidine is injected into the thigh or buttock. It works as more of a relaxant, by mimicking the natural endorphins it reduces the transmission of pain signals sent by the nerves to the brain. While natural “mind-body” methods (such as massage) have been used for aeons, in recent years more sophisticated strategies such as controlled breathing techniques, immersion in water, and self-hypnosis have emerged. These methods started to be more actively promoted in the US and parts of Europe from the 1990s. These two groups of pain relief methods (pharmacological and nonpharmacological) have different purposes. Anaesthesia aims to relieve labour pain, whereas natural methods aim to help

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What is hypnobirthing?

Hypnobirthing aims to reduce fear, pain, and anxiety during childbirth by using calm breathing techniques, some deep relaxation, guided mediation, visualisation, positive suggestions, and affirmations. Hypnobirthing teaches women to calm the body and mind into a state of self-hypnosis by focusing her attention inwards and concentrating deeply. The philosophy behind hypnobirthing is to remove the fear of giving birth. The fear is said to cause tension in the body, and releasing the tension will therefore ease the pain of childbirth.

women cope with it. But what does the research say about women’s experiences of pain relief and whether – and in what circumstances – these various relief methods actually work?

THIS ARTICLE IS PUBLISHED WITH PERMISSION FROM THECONVERSATION.COM

ONE SIZE DOESN’T FIT ALL

In general, discussions of childbirth often centre on the pain women experience during labour and birth, and rightly so, as how women are supported to cope or manage labour pain makes a difference to the immediate experience of childbirth and has a long-lasting impact on women’s wellbeing. But women’s needs and preferences for how to manage pain during childbirth differs. Some women plan to use some form of anaesthesia as they want to feel in control during labour and to have a pain-free birth. They might make this decision during pregnancy, either because of a previous positive experience of medications or a negative experience of an unmedicated birth or, for first-time mums, a fear of “unbearable pain”. Other women make the decision to use anaesthesia after labour has started, usually at a critical point where they feel out of control, exhausted, and unable to cope with the pain. As the women in these situations

are more likely to express feelings of guilt and failure, this is an area where more support and care is needed. Women who choose mind-body methods usually want a vaginal, intervention-free birth. This decision tends to be made during pregnancy, and some preparation is usually undertaken, such as attending a hypnobirthing antenatal class. However, it is important to note that natural methods are not always promoted, offered, or made possible by maternity care providers.

THE EVIDENCE

Pharmacological and non-pharmacological methods, when they meet women’s needs, can help women feel relaxed, calm, in control, and even more energised during labour. Experiments have found that anaesthesia, particularly an epidural, can be effective in reducing labour pains. But not all the evidence is positive. Some women continue to experience pain after an epidural has been administered, referred to as “breakthrough pain”. Epidurals can also slow down a woman’s labour and can lead to further interventions such as delivery using forceps or ventouse (a suction device). Other popular forms of anaesthesia such as gas and air, pethidine, or remifentanil have also been found to cause side effects such as dizziness and nausea. Over the last decade or so, there have been developments in “patient-controlled” anaesthesia, with women able to push a button to receive doses of pain relief (such as remifentanil) as needed. Further studies into whether and how this method impacts on women’s experiences of pain relief, and how it compares to other forms of anaesthesia, are needed. Natural methods also have a mixed evidence base. Experiments have found immersion in water, relaxation, acupuncture, and massage can provide

better satisfaction with pain relief, and some methods (relaxation and acupuncture) can lead to less interventions (such as forceps or Caesarean births). In qualitative research, some women found natural methods less effective in helping them to cope with their labour pain, and some mind-body methods such as hypnosis, mindfulness and aromatherapy need more evidence. An interesting difference between the different types of pain relief is that when effective, anaesthesia can enable women to feel more connected with others in the birth room, whereas mind-body methods enable women to feel more connected to their bodily responses. It is also important to note that being relieved of pain does not necessarily equate with satisfaction. A positive, satisfying birth is linked to women feeling safe, supported, and respected regardless of their pain relief preferences.

WHAT MATTERS MOST

It is important to acknowledge that women’s experiences of pain are influenced by the relationships with their caregivers. When women are able to form a trusting relationship with their caregiver, they report more positive experiences of birth overall, regardless of the pain relief method used. A lack of positive relationships or support from maternity care providers may increase the likelihood of a traumatic birth experience. Women need to have timely access to information about different painmanagement methods, including the risks and benefits of each approach so that an informed decision can be made. Gill Thomson is a Professor in Perinatal Health at the University of Central Lancashire. Claire Feeley is a Postdoctoral Research Associate at the University of Central Lancashire.

Calmbirth

The Calmbirth Childbirth Preparation Programme (calmbirth.nz) is based on the belief that pregnancy, labour, and birth is a natural process that can be experienced calmly and joyfully. Calmbirth doesn’t advocate for one way to give birth, but aims to release the fear of labour and birth, and help Kiwi mamas understand the process using an unbiased, researched, holistic, and collaborative approach. Calmbirth classes are available in Auckland, Wellington, Christchurch, and Dunedin, or via Zoom. Pregnancy BUMP & baby

The wonder of birt h

A special insight into the births of three gorgeous new souls, captured by Kim McGregor (kimberlyjoyphoto.co.nz) and Emily O'Dell (whangareibirthphotographer.co.nz). 90

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PHOTOGRAPHY BY KIMBERLY-JOY PHOTOGRAPHY

"A break between those last few contractions which were well and truly at their peak as my daughter was about to enter the world."

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“We did it! All those months of prepping and planning, and she’s here.”

The birth of Aumarire

Aumārire Jane Peata Smith was born at 40 weeks and 1 day, just before Christmas last year. Weighing 3.55kg/7.13lb, mum Catherine delivered Aumārire at home in a birthing pool with help from midwives, her husband, and mother-in-law. Thankfully, Catherine's one- and three-year-olds slept through the whole thing!

“Taking a moment to look over all of her beautiful, perfect little details, including finding out she was a little girl!”

Pregnancy BUMP & baby

"I just wanted to lie down, but I needed his head to engage, so I had to walk around outside the hospital."

"The bath was my favourite part of the labour; it was so peaceful."

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"Once we made the decision that my natural birth was no longer safe, I was feeling at peace about my efforts to try, and so excited to finally meet Seb."

PHOTOGRAPHY BY KIMBERLY-JOY PHOTOGRAPHY

The birth of Sebastian The newest addition to the Pendergrast family was delivered safely at 37 weeks, weighing (3.26kg/7.2lb). Going into labour at the zoo, Laura went straight to hospital. Her fifth baby and fourth C-section, Laura wanted a natural birth and tried with each baby. But in the end, wee Seb was born following a peaceful drugfree hypnobirthing labour, which ended in a peaceful emergency C-section.

Pregnancy BUMP & baby

The birth of Owen

Owen Loots was welcomed to the world by VBAC one day early, weighing 3.69kg/8.13lb. With no family in New Zealand, mama Heleen was accompanied at the birth by her midwives, husband, and photographer, Emily. The gender of wee Owen was an exciting surprise!

Pregnancy BUMP & baby

labour+birth

PHOTOGRAPHY BY EMILY 0'DELL – WHANGAREI BIRTH PHOTOGRAPHER

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"My husband wanted to assist with catching the baby and passing him to me – we didn't know the gender up until that point!"

"Baby Owen's first latch captured by us and the photographer to show our family oceans away."

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In stitches How to care for your stitches and promote comfort and healing following childbirth.

,t wn

hat

b els

et t

We ll

hen you give birth vaginally, you may experience some tearing of the perineum – the area between the anus and vulva – or possibly need an episiotomy, which is an incision made during labour to enlarge the vaginal opening. Thankfully, most tears are minor, but it’s not uncommon to require stitches following childbirth. Typically, the deeper the cut or tear, the longer the healing time, but here are 10 practical ways you can help the healing process.

1. COOL RELIEF

Carefully placing a cooling strip or wrapped ice pack on your perineum, particularly within the first 24 hours following childbirth, can help relieve pain, tenderness, and swelling. Small bags of frozen veges such as peas and corn can be a lifesaver, or try placing your maternity pad in an airtight container inside the freezer for a few hours before use. Just be sure never to place ice or an ice pack directly on your skin – always wrap in a paper towel or thin tea towel first.

2. TACKLING TOILET TRIPS

That first toilet trip following childbirth can be uncomfortable, so make sure you’re drinking enough fluids to avoid constipation and to dilute urine, and don’t hold it in. Try urinating in a warm water bath to take the sting out, or press a wad of clean toilet paper or tissues against your perineum when you bear down.

3. THE PERI BOTTLE

A peri bottle (short for perineal cleansing) can be bought at the chemist and provide

Pregnancy BUMP & baby

BLOW-DRY YOUR VAGINA

Blow-dr ying your vagina with your hair dr yer on a lowheat setting for two to three minutes after soaking in the bath not only helps prevent bacteria grow th, the warm, dr y heat does wonders for a tender, swollen perineum.

tremendous relief. Fill your peri bottle with warm water just before you go to the toilet and gently squeeze it between your legs, spraying your undercarriage during and after for a cleansing and soothing rinse-off. Instead of wiping dry, pat your stitches using soft, clean toilet paper or tissues.

5. HERBAL SOOTHERS

You may be a sceptic when it comes to trying herbal remedies, but the soothing qualities

in plants such as witch hazel can bring immediate relief. There are a number of witch hazel sprays and gels available, and you could also consider filling your peri bottle with a mixture of half water, half witch hazel to use every time you urinate or when you need to cool the burn. It can be purchased from chemists or health shops. Witch hazel can also be added to a maternity pad or a compress to help reduce inflammation.

Safe to use in the hours and days post birth, this spray will help soothe your bruised or swollen perineum, supporting the healing process. Natures Touch Relief Perineal Spray 50ml, $23, naturestouch.co.nz

BECAUSE… OUCH!

The witch hazel and aloe vera blend in this gel provides cooling, instant relief, promotes rapid healing of sensitive skin tissues and is anti-inflammatory. Squeeze a dollop onto a new maternity pad and smear it around, then place the pad in an airtight container in the freezer. Allow it to thaw a little before use. Viva La Vulva Padsicle Gel, $29.95, vivalavulva.com

7. STOCK UP ON MATERNIT Y PADS

On the subject of pads, you can’t beat the good old-fashioned maternity pad. Maternity pads are longer, softer, and more absorbent than ordinary sanitary pads. They will be supplied to you in hospital, but make sure you buy two or three packs for your first few days at home, as you’ll need to change your pad every few hours. Post-birth vaginal bleeding is typically heavier than your average period, and you should avoid using tampons until you’re completely healed.

8. STRENGTHEN YOUR

PELVIC FLOOR MUSCLES

Increasing the blood flow to your perineum can help heal bruising. Regular exercise of your pelvic floor muscles not only helps speed up the healing process, it also improves bladder control which can weaken

Pop this strip in the freezer before placing it directly onto your perineum to provide soothing, cooling relief to the irritated, swollen or tender area following childbirth. BodyICE Woman Perineum Strip, $26.75, bodyice.com

6. STAY CLEAN AND DRY

Keeping your stitches clean and dry reduces the chance of infection. That means washing more often than you normally would, changing your maternity pad regularly, and rinsing and patting dry your stitches each time you use the toilet. Wear cool cotton underwear or stock up on disposable mesh maternity panties that allow air flow while still holding your maternity pad in place.

Made using hypericum and calendula, this kit helps to ease the discomfort of postpartum vaginal swelling, soreness, and tears and offers instant pain relief. It can also be used after C-section delivery to reduce healing times. Viva La Vulva Perineal Healing Spray Kit, $39.95, vivalavulva.co.nz

after childbirth. If you’re not sure where your pelvic floor is, try mentally picturing the muscles around your vagina and bottom, then squeeze and tighten, holding these muscles for a few seconds at a time before releasing. Do this a few times each day to strengthen your pelvic floor muscles.

9. SOAK IN A SITZ BATH

Try running a shallow warm bath and soak three times a day for 20 minutes at a time for the first seven days post-childbirth. The warm water helps relieve discomfort and ensures you keep your stitches clean. Some studies suggest that cold water may actually be more healing, but make sure to discuss this with your doctor before you try it. Remember to pat your stitches dry after your bath rather than rub them.

10. WHEN YOU CAN, REST

It’s important you find time to rest. Ease yourself into your new routine and take time out to put your feet up. Accept offers of help from family and friends, and allow yourself the time to heal.

R E C O V E R IN G F R O M C -S E C T IO N S T IT C H E S If you’ve had a Caesarean section, it will take a number of weeks to recover from the abdominal surgery. Try some of these tips to help speed up your recovery. Avoid putting pressure on your abdominal area as it’s likely to be painful at first. Use your hands or a pillow to support your incision when you cough, sneeze, or laugh. Get up and move about, but avoid lifting anything heavy. Try showering instead of soaking in a bath, at least for the first few weeks after delivery. Keep your stitches clean and dry, patting them dry rather than rubbing. Pregnancy BUMP & baby

newborn+postpartum

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Lullaby and good night

Baby sleep and early development specialist Kenna Zachinsky (babysleep.nz) shares advice for helping your baby fall asleep… And stay asleep.

I’M TIRED, MAMA

Most parents assume that children should go to sleep when they start getting cranky. But, in fact, that’s too late! This behaviour indicates that the baby is overtired. Start observing your baby towards the end of their awake time. You may notice that the baby loses interest in the activity, slows down, starts sucking fingers, looks for a pacifier, or can't concentrate. This is the moment when the "window to sleep" opens. It is the time when it's easy for the baby to fall asleep. But it doesn’t last long! Straight after, they might begin to cry, get nervous, etc.

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CREATE A BEDTIME RITUAL

There are three to five simple actions that you repeat every time before putting your baby to bed. It is the way to show your child that it's time to get some rest. These five to 15 minutes allow you to perform a consistent and predictable transition to sleep, and also it is an essential part of self-soothing. Bedtime ritual example: 1. Say good night to Dad/other family members/pets. 2. Put the blinds down. 3. Turn on white noise. 4. Read a special book/sing a lullaby/ gently massage your baby. 5. Kiss goodnight. As your baby grows up, you can adjust the ritual and change its duration. By the age of two, children are eager to read books or listen to audio books. The main thing is to maintain consistency and the ritual's main purpose: Comfort and relaxation. We aim to soothe the child so that they are almost asleep, and we only need to help them close their eyes. Depending on age, duration and these steps may differ. Why might the ritual not work? • The baby doesn't like it. • The baby is getting engaged rather than relaxed. • The ritual continues for hours (just one more song/feed/cuddle... And so on).

POSITIVE SLEEP A SSOCIATIONS

How children fall asleep depends on their sleep associations. If they need Mummy's assistance, they are unlikely to self-soothe. Children of all ages (and even adults) have sleep associations, whether they’re aware of them or not. How does it work?

Imagine you went to sleep in your bed and, in the middle of the night, you wake up to find yourself on a bench in a park. You’d be completely alert in a second! So, if your baby falls asleep while being rocked, they want to have the same conditions when they wake up between sleep cycles. And to fall asleep again, they need to be rocked again… And so on, and so forth.

If your baby has a negative sleep association, it is likely to be the main reason for the night-waking! What makes a sleep association negative or positive? •N egative sleep associations require somebody to do something for the baby – such as feeding, rocking, holding hands, or driving around in a car. • Positive sleep associations are things that babies can do to fall asleep that don’t require anybody else, such as humming, sucking on their thumb or fingers, banging their feet against the mattress, rocking back and forth, or lifting their legs. •E xternal sleep associations or sleep aids are positive cues that let your baby know it’s time to sleep; for example, white noise, swaddling, or a cuddly toy. Most often, associations occur at the time of sleep interruptions (such as illness/ teething/regression/growth spurts). Parents choose one way to soothe their baby, and that kicks off the habit.

THANKS TO BABY MATHESON. PHOTOGRAPHY BY RENEE ANDERSON OF TWIG & THISTLE PHOTOGRAPHY.

hildren need consistency and predictability. Hence, a bedtime routine introduced early into everyday life helps settle your baby and comfort them. So, to make your parental life easier: Play with your baby, slow down by the end of their usual awake time, have some quiet time, notice signs of tiredness, don't forget about the bedtime ritual, and put your calm and relaxed little one to bed. Now, let’s have a closer look at every part of this process.

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signs of

TIREDNESS

NIGHT FEEDS

During the first year of life, it’s common for babies to wake at night for food and comfort. But sometimes, due to a habit or incorrect daily rhythm, babies might wake up to be fed at night quite often. First of all, what does "too often" mean? These are the average numbers: • First four months – feed on demand (three to five feedings). Newborns should not go more than four hours between each feed. • Six to eight months – two to three feedings a night. • Eight to 12 months – one to two feedings. • 12 to 18 months – zero to one feeding. What are the outcomes of frequent night feedings? • If you feed the baby too often, then their excretory and digestive systems continue to work all night without rest. It leads to a quick filling of the nappy, which may cause physical discomfort for the baby and, therefore, awakening. • Frequent awakenings lead to fragmented or broken sleep, which means the body can't recover properly. A bad night's sleep leads to a deterioration of daytime naps; the baby becomes cranky and wants to be held all day long.

SLEEP AIDS SWADDLING

Many cultures have been using swaddling for centuries. Swaddling helps to recreate the feeling of security your baby had in your womb when she had less room. Feeling held and snug might help calm and soothe them, so you may find that swaddling your baby helps them to cry less. Make sure that you give your baby plenty of space to move their legs and feet, particularly room to bend their legs up and out at the hips. Leave the head uncovered, and don't swaddle above the shoulders. Always place your swaddled baby to sleep on their back, and stop swaddling your child as soon as you notice signs of rolling.

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• • • • • • •

Yawning Slowing down Fluttering eyelids Dif ficult y focusing Sucking on fingers Looking at one spot S eeming wear y – not interested in toys

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signs of

OVERTIREDNESS • • • • • • •

Chicco Physio Soft Soother 0-6m 2-pack, $17.95, chicco.co.nz

Pulling ears Rubbing eyes Whimpering Grizzling or cr ying Too excited Second wind Getting clumsy

WHITE NOISE

White noise is used to muffle household noises while the baby is sleeping. There is no research on the harm of white noise – the choice is yours. But here are some safety rules: • Th e noise source should be at least one metre from the baby’s ears. • Th e volume should not higher than 50 decibels (as if it is raining heavily outside). I would recommend starting it during the bedtime ritual and leaving for the entire sleep duration. But don't expect any magic! White noise only helps to soften all the other sounds.

DUMMIES

Miracle Blanket, $39.99, babyonthemove.co.nz

Most babies have a strong sucking reflex. Some babies even suck their thumbs or fingers before they're born. Beyond helping with nutrition, sucking also has a soothing effect. If the baby feeds very quickly, they might need a dummy to satisfy their sucking reflex. If your baby has trouble settling down, a dummy might do the trick. Also, sucking on a dummy at naptime and bedtime might reduce the risk of sudden infant death syndrome (SIDS).

Hushh Continuous White Noise Machine, $75.95, bumpandbabymall.co.nz

SleepDrops Baby Sleep Support Pack, from $54.90, sleepdrops.co.nz Herbal support for babies and toddlers (0-3 yrs) to go to sleep any time of the day or night, combined with the relaxing aromas of organic massage oil to soothe your baby and send them off to sleep.

It is a common assumption that a dummy can interrupt mum's and bub's sleep – the baby loses it, and the mum has to get up and give it back. Try to follow these rules: • Do not return the dummy to the baby's mouth if they spat it out before falling asleep. • If the child spits out a dummy straight after falling asleep, it is unnecessary to give it back. • I f the baby does not spit out the dummy immediately after falling asleep, carefully remove it so that the baby is not getting used to sucking during shallow sleep. • You can gradually teach the baby to fall asleep without a dummy. First, take it immediately after falling asleep, then a little earlier, so that the baby sucks it only to calm down before bedtime.

mama insight

A healthy boost for

ne w mums

Searching for healthy lactation support, Wendy Poon started her small business (mammasmilkbar.com) to help all Kiwi mums feed their babies with the best liquid gold.

hen Auckland mum-of-two Wendy Poon gave birth to her first child, she found that breastfeeding wasn’t as easy as she thought. Tired and struggling from low milk supply, Wendy searched for natural and healthy ways to boost milk production without relying on sweet lactation treats. Coming up emptyhanded and tired of being unable to find a healthier alternative to deliver lactation support, Wendy started making her own blends with 100% natural ingredients, and Mamma’s Milk Bar was born. “From one mum wanting to help other mums, we want to help mums feel that they are doing their best for their babies and their families, and have one less thing to stress about with maternal nutrition and being able to breastfeed,” says Wendy.

SPONSORED CONTENT

Julia’s business More than Milk (morethanmilk.co.nz) was born out of a 17-year career working with children and inspired by becoming a mother herself. Passionate about helping other mums enjoy their breastfeeding journey, her first More than Milk offering – BelleMa breast pumps – was launched while Julia was still working at the hospital as a lactation consultant. This work gave her crucial insight into what Kiwi mums needed, which led to her creating the “perfect breast pump”. “I wanted to provide a pump that helped mums increase their supply, saved them from the hassle of hiring and trialling different pumps, and ultimately offered them a pain-free experience,” says Julia. While it sounds like a big ask, many grateful mums can testify to just what a blessing their BelleMa pumps have been.

“This pump saved my breastfeeding journey when I was ready to give up.” The newest pump to the market, the BelleMa Euphoria Plus, has a built-in

battery to make it portable and two motors for easy double-pumping – mums can essentially halve their expressing time. And if there’s one thing new mums need, it’s more time!

GETTING THE RIGHT ADVICE WHEN IT COUNTS Julia’s passion for helping mums hasn’t stopped with award-winning breast pumps – she also offers in-person and online breastfeeding consultations to provide one-on-one support and tailored plans.

“Julia’s advice saved my breastfeeding journey.” Midnight Googling when you’re anxious, sleep-deprived, and recovering from labour rarely provides the answers you need, which is why Julia has developed this service. “A big part of it is helping mums feel confident and at ease while navigating the different challenges. Breastfeeding can be much harder than first expected, and every journey is different,” she says.

Julia’s top five

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TIPS FOR BREASTFEEDING SUCCESS

Feed your baby within the first hour of birth – before they enter the post-birth recovery snooze mode. Go skin-to-skin – it regulates your new babe’s temperature and helps stimulate your milkproducing hormones. You’ll also notice their feeding cues much more easily in this position. Be prepared for an exhausting night or two – go with the flow as your babe feeds what may seem like constantly. This brings in your milk. Master your latch – if you are unsure, ask for help! Nipple tenderness is common for the first seven to 10 days, but if it extends beyond this, seek help. Get the support you need – if it’s not going well, don’t suffer through it. Breastfeeding isn’t always easy, so get support as soon as you need it.

STRUGGLING WITH BREASTFEEDING or simply want to be prepared for your journey ahead? Visit morethanmilk.co.nz or Instagram @morethanmilknz for loads of free advice and amazing products to support breastfeeding, or book a consultation with Julia. Pregnancy BUMP & baby

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L OV E

pad up!

BR EAST PALS Protect and heal your nipples with these breastfeeding essentials.

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Tommee Tippee Made for Me Nipple Cream, $24.99, tommeetippee.co.nz Just’nCase Reusable Contoured Nursing Pads $24.90, justncase.co.nz Pure Mama Nipple Butter, $39, puremama.com Silverette cups, $89.90, silverette.co.nz Nude Alchemist Nipple Nectar 30g, $21.95, nude-alchemist.com Weleda Nipple Care Cream, $29.90, weleda.co.nz Medela Purelan Lanolin Cream 7g, $14.99, medela.com Reusable Merino Nursing Pads (two pairs), $24.90, woolmother.com

COMPILED BY CHARLOTTE COWAN

It only takes one wet T-shirt disaster to make a new mum appreciate a good pair of nursing pads! Just’nCase reusable nursing pads from Kiwi company Confitex are available in black and beige. They are superabsorbent, leakproof, and they won’t scrunch up in your bra – and they can even be tumble-dried!

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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!

Lansinoh® HPA® Lanolin l 00% ultra-pure lanolin

Soothes, heals & protects cracked nipples 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 breast feeding 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.

Lansinoh® Breastmilk Storage Bags

• Strong & leakproof • Pre-sterilised • BPA & BPS free

Lansinoh® Ultra Thin, Stay Dry Nursing Pads

• Absorbs 20x its weight • Unique BLUE LOCK™ Core disperses moisture • Discreet, contoured & super soft • Stays securely in place

For Ht1Jrt in/Jornt.Ation About brtASt/JUtli"!), 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® Thera0 Pearl® 3-in-1 Breast Therapy 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 Thera0 Pearl 3-in-l Breast Therapy. Lansinoh Thera0 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 Thera0 Pearl's unique design conforms to your breast to provide 360° relief.

Lansinoh Thera0 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 Thera0 Pearl can help reduce the time spent expressing.

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Thrills and spills

Although reflux can be worrying, it’s common in newborns. Whānau Āwhina Plunket offers advice for combating the big spill.

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WHAT IS REFLUX? Reflux occurs when your baby’s stomach contents are released back up towards their mouth. It is unlikely to harm your baby or cause any long-term problems. Your baby may have signs of reflux after a feed that include: • Bringing up milk during or shortly after feeding. • Burping, belching or swallowing hard.

REFLUX IS NOT THE SAME A S VOMITING

Reflux and vomiting are different. Reflux is effortless, while vomiting is forceful. Some reflux and regurgitation is normal and will usually improve as your infant grows and their digestive system matures. Reflux often increases between six weeks to four months, and for some children it will continue until they are 12 months old. If you aren’t sure whether your baby is experiencing reflux or vomiting, call PlunketLine to speak to a registered nurse.

THANKS TO BABY GIFFORD. PHOTOGRAPHY BY RENEE ANDERSON OF TWIG & THISTLE PHOTOGRAPHY.

WHAT CAUSES REFLUX?

The oesophagus is the tube connecting the throat to the stomach. At the end of an oesophagus, before the stomach, is a ring of muscle called a sphincter. This keeps food after it is swallowed in the stomach. Reflux or silent reflux occurs when the sphincter doesn’t work correctly and allows stomach contents, which can include food and stomach acids, back up into the oesophagus. For some children, this can cause discomfort and periods of being unsettled. Both reflux and silent reflux are common in infants as they have a shorter oesophagus and their sphincters are not fully developed. Reflux usually resolves without treatment as the sphincter strengthens and baby grows. If your baby brings up a lot of milk, they may be hungry again and you might need to feed them again sooner than usual. For most babies, you don’t have to do anything about reflux. It is a natural process which will get better by itself. Changing from breastfeeding to bottles won’t help. There are also many over-the-counter products aimed at reducing wind, colic, and reflux, but there is no scientific evidence that shows these preparations work. If you choose to use such a preparation, make sure you choose one that has no alcohol or sugar.

Tips to help your baby with reflux during feeding

Take your time with feeds.

Try to stay calm and relaxed during feedings, if possible. Burp your baby during feeding. Don’t force your baby to take more milk than they want – some babies like to eat smaller amounts more often. For bottle feeding, check that the hole in the teat is not too big, as feeding too quickly can make reflux worse. Use large bibs and a towel or cloth after feeds to catch the milk and protect clothes.

after feeding

Hold your baby upright for a short time after they feed. Try not to handle your baby too much. Where possible, it may be helpful to change baby before or during a feed, rather than afterwards when their stomach is full.

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What you need to know

SILENT REFLUX Silent Reflux is also known as Laryngopharyngeal Reflux or LPR. Silent reflux is when the weak muscle at the top of the stomach means some food is squeezed upwards into the oesophagus, causing the baby’s stomach contents come up the oesophagus and flow into the back of the throat and nasal passages. However, unlike reflux, the stomach contents are not released back as far as the baby’s mouth, and there may not be any outward symptoms of spilling at all. This is a common condition in babies and, for most of them, it is nothing to worry about. An estimated 8% of newborns experience either excessive or “silent” reflux, which can result in a very unhappy baby. With silent reflux, painful “heartburn” symptoms are experienced instead of vomiting. Because there is no vomiting, this can be confused with wind or colic. Babies suffering from silent reflux typically experience discomfort 60 to 90 minutes after feeding. Silent reflux is different to vomiting because reflux or spilling is effortless, while vomiting is forceful. As the baby’s stomach contents fall back into the stomach instead of being burped or spit up, it can be difficult to identify that silent reflux is upsetting your baby. As long as your baby is healthy and growing normally, reflux is not usually something to be concerned about.

SYMPTOMS

This type of reflux doesn’t always cause obvious symptoms, hence why it is called “silent”. Signs to look out for in your baby or young child might include: • Hoarseness. • Chronic cough (or “barking”). • Noisy breathing, wheezing, or pauses in breathing. • Chronic respiratory conditions (such as bronchitis) and ear infections. • Trouble feeding, spitting up, refusing to feed, or inhaling milk. • Difficulty gaining weight. • Gagging. • Nasal congestion.

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HOW TO FEED YOUR BABY IF THEY HAVE SILENT REFLUX

While breastfed and bottle-fed babies suffer from reflux equally, studies have shown that reflux in breastfed babies tends to be shorter and less frequent than those who are bottlefed. Breast milk is generally digested fast, so it has less time to hang around and cause trouble. Regardless of how you are feeding your baby, here is some advice on how they should be fed.

FEED YOUR BABY IN AN UPRIGHT POSITION

If you are breastfeeding, you may need to try different positions to find the best one that will allow your baby to remain fairly upright during feeding. Some mothers report success by having their baby face their breast while straddling their leg. Others prefer to stand up while feeding their baby in a modified twin-style hold.

KEEP FEEDS SMALL AND FREQUENT

Your baby may prefer to feed often, and this is actually better for them than a large, sudden intake of food, as this causes less pressure on the stomach muscle.

KEEP YOUR BABY UPRIGHT

For at least half an hour after feeding, keep your baby upright. You may want to hold them on your shoulder or perhaps use a front pack or baby seat.

INTRODUCE A REFLUX-FRIENDLY ROUTINE

Try to keep to a routine where your baby feeds when he wakes up, so that they’ll have plenty of time to allow the milk to digest before lying down to sleep.

DON’T LET YOUR BABY FALL A SLEEP WHILE FEEDING

Catnapping on the breast or bottle always leads to pain once the feed has finished, so try to avoid feeding when your baby is tired.

Reflux is normal and happens in about half of babies. For most babies, you don’t have to do any thing about reflux, as it’s a natural process that will get better by it self. There are things you can do to help such as taking your time with feeds, burping your baby, and holding them upright af ter you feed them. Reflux is unlikely to harm your infant or cause any long-term problems – it is dif ferent than vomiting. If you are worried about your newborn’s health, talk to your doctor, Plunket nurse, or call PlunketLine on 0800 933 922 for parenting help. It’s a free, 24 / 7 ser vice. WHEN TO VISIT A DOCTOR

In a small number of babies, reflux can lead to problems including gastro-oesophageal reflux disease (GORD). Speak to your Plunket nurse or doctor if you’re worried, or if you notice any of the following in your baby: • Long or frequent periods of irritability and crying. • Reflux is forceful, or is green/dark yellow. • Blood in the reflux. • Their back arches after feeds. • Poor sleeping. • Poor weight gain. • Long-lasting cough or wheezy breathing. • Changes that you are unsure about. • The reflux continues after your baby turns one year old.

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Washable

wonders

Breastfed poo is watersoluble, so they can go straight into the washing machine!

Thinking of giving reusable nappies a go? Hannah Porter from Bear & Moo (bearandmoo.co.nz) shares everything you need to know! HOW MANY WILL I NEED?

Reusable nappies need to be changed regularly, just like disposable nappies. You will likely want to change your baby every couple of hours at the beginning until you find what works for you. Newborns tend to wet or dirty regularly, so in those first few weeks, you could be going through 10 or more nappies a day! But it does even out and, before long, you might only need around five a day. I would recommend having 25 reusable nappies in your stash – the more you have, the less regularly you’ll need to wash them!

THE SETUP

There are lots of different reusable nappy types. Bear & Moo offers two for the early days…

NEWBORN NAPPIES

These are an all-in-one style nappy, so they’re just like a disposable except with domes, and you wash them. They also have a dome in the middle to keep the nappy out of the way of the umbilical cord when babe is fresh. There’s no pockets or inserts, you just put the nappy on and go, easy! These fit from super-little up to about 5kg.

ONE SIZE FITS MOST (OSFM)

The OSFM nappies are the best value for money. They fit from approximately 3.5kg to 18kg, so are ideal for bigger newborns (or from after the first couple of weeks), right through until toilet training in many cases. These either come with a suede lining or a bamboo lining (suede is a stay-dry fabric to keep babe dry; bamboo is a natural fibre but slower to absorb, so they will feel when

they are wet), and a microfibre insert. The insert goes inside the pocket – that’s the absorbent part. You can add additional absorbency with other inserts, such as bamboo or hemp, to help the nappy last longer before needing to be changed. The OSFM nappies have domes all across the front so you can dome them down to fit a small babe, and as they grow, you can change the dome settings to make the nappy bigger. All you need to get started is the nappy itself (and the insert it comes with for OSFM). Everything else is optional.

KEEPING THEM CLEAN

Washing is the most common reason that people don’t choose cloth nappies as they always think it will be harder than it is. The key is to keep it simple. When you remove the nappy, put it into a “dry pail”

tips and tricks • Start with one reusable nappy a day so you can get used to them – then you can add more as you go. • If you find you’re getting leaks, it’s usually either the fit or absorbency. • Start with daytime; it’s much easier because

(ideally an empty bucket/basket with holes in it and no lid) if it’s just wet. If it’s dirty, plop any poo into the toilet that you can (you should be doing this with disposable nappies too, otherwise it just sits in landfill forever), or rinse under the laundry tap, then add to the dry pail. When you have a pile ready to wash (don’t leave them longer than two to three days), place them in a warm/hot wash – ideally 40 to 60 degrees – for at least an hour with a good detergent. This is called a pre-wash. Once they’ve had their pre-wash, they can sit for another day if you need to, or you can add other small items such as baby clothes, flannels etc to bulk out the machine. This next wash is called the “main wash” and should again be 40 to 60 degrees and a long cycle with a good detergent. Ideally you want to do a pre-wash every two to three days, and main wash every three to four days.

for getting organised

you will be changing the nappy more frequently. • A few extras that might help are cloth wipes (just like a flannel – add water and use instead of wet wipes), a silicone brush (helps to clean the poo off), and a wet bag for out and about.

• Don’t feel bad if you use some disposables too! It’s about making it work for you. Every cloth nappy you use saves one from landfill and saves you money. One a day is 365 nappies saved, and around $140!

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What goes in… Tiffany Brown explains the ins and outs of your baby’s poo.

WHEN TO SEEK HELP

Check with your doctor if your newborn is not pooing at all, as this could be a sign they’re not eating enough. • Changes in stool consistency to maroon-coloured or bloody stools, black stools after day four, white or grey stools, more than their normal amount per day, or stool with a large amount of mucous or water may be indicative of problems.

• Diarrhoea leading to dehydration can be symptomatic of a virus or bacteria.

hether you feel mild amusement or abject horror, getting intimately acquainted with your baby’s number ones and twos is an unavoidable step on your parenting journey.

IN UTERO

AFTER BIRTH

After birth, baby’s first poo is dark greenishblack, sticky meconium, and you should see at least one meconium movement and one wet nappy in the first day of life. Sometimes a red or salmon-coloured substance can be seen in the nappy; this is just uric acid crystals caused by concentrated urine. Stool and urine output increases as baby starts to feed. At the second or third day after birth, you can expect at least two wet and two wet/dirty nappies each day. By the end of the first week, baby will be ! y bum budd producing roughly five to six The Nude Alchemist wet nappies every 24 hours, Booty Balm 30g $20, and moving their bowels nude-alchemist.com between four and 12 times. With nourishing

A rudimentary system of nutrient intake and waste expulsion gets underway while baby is still in utero and babies begin to pee regularly once the kidneys form at around 13 to 16 weeks’ gestation. The placenta is the instrument on duty here, efficiently removing waste products and delivering nutrients. Shortly before birth a waste botanical oils, healing herbs, and essential product called meconium THE FIRST WEEK oils, this balm assists is produced in the intestines. In the first week, stools with moisturising and Sometimes a baby may will change from the tarry soothing your baby's delicate skin. black meconium, through produce meconium while still a range of dark green shades in utero. The waste collects to the mustard yellow hue of newborn in the amniotic fluid, and results in a small number of babies experiencing meconium poo. After these transitional stages, the aspiration syndrome (MAS), when the poo gradually becomes less sticky, more watery, and eventually chunky, or seedy, baby aspirates or breathes in the meconium, like wholegrain mustard. which blocks the airway and deprives For breastfed babies, the first milk, known oxygen. The condition is serious, but as colostrum, acts as a laxative to help push treatable, and thought to be caused by foetal distress or complications with the placenta the meconium out of their system. Within or umbilical cord. MAS is more common a day or two the meconium is all cleared and in babies born at term, or slightly after. by about day three, when your milk comes

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• Though unusual in the newborn period, constipation can sometimes occur as baby grows, when they experience hard stools, or have trouble passing stool.

in, you should expect to see the change to runny, yellow stool, and an increase in number of movements.

BEYOND THE FIRST SIX WEEKS

Breastfed babies may go four to five days without moving their bowels; this is normal and nothing to be concerned about. Breastfed babies generally pass loose, runny stools, which is an indication that baby is absorbing the solids in your milk. After starting solids, babies usually pass more stool than before. Formula-fed newborns may have fewer bowel movements than breastfed babies, and the colour is light brown or greenish. They may poo between one and four times a day. After a month, babies may poo only every second day, and after starting solids, you can expect one or two poos a day. The stool of formula-fed babies is firmer and paste-like, but shouldn’t be any firmer than peanut butter. A switch from breastfeeding to formula feeding will probably cause changes in both stool consistency and frequency of nappy changes.

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Your baby’s skin

fter birth, your baby’s skin is sensitive and may start to flake. Over time, their skin will thicken and adjust to the new environment, but there a number of skin issues you may notice during the first few week or months after birth.

MILIA

Milia – also known as milk spots – are tiny white bumps that are keratin-filled cysts. Up to 50% of newborns have milia on the face, and most will resolve over weeks to months. Milia in newborns may also occur on roof of the mouth (Epstein pearls) or the gums (Bohn nodules). These will also disappear without treatment.

SUCKING BLISTERS

THANKS TO BABY JORDY. PHOTOGRAPHY BY RENEE ANDERSON OF TWIG & THISTLE PHOTOGRAPHY

Sucking blisters are caused by vigorous sucking by the baby while still in the womb. Intact blisters or erosions may be found on the forearm, wrist, hands, or fingers. They resolve within a few days to weeks.

JAUNDICE

Jaundice is the yellowing of your baby’s skin and the whites of the eyes, and is usually due to your baby’s blood containing an excess of bilirubin. Bilirubin is made by the breakdown of red blood cells. It’s hard for babies to get rid of bilirubin at first and it can build up in their blood, tissues, and fluids. Mild jaundice is common, and typically starts two to three days after your baby’s birth, resolving after seven to 10 days. All babies with jaundice should be assessed by a midwife or doctor; in particular if your baby becomes jaundiced in the first 24 hours after birth, or seems listless and has a fever.

Soon after birth, many new parents are confronted with unexpected skin conditions in their wee baby. Don’t freak out! They’re more common than you think.

BABY ACNE

Baby acne (neonatal acne) is common, and presents as small red bumps, often on the cheeks, that self-resolves by a few months of age. Acne occurring a little later (onset after three months) is known as infantile acne, and in addition to red bumps, will have comedones (white heads and black heads) and sometimes cysts. Infantile acne may self-resolve; however, if persistent or significant, see your GP to assess if treatment is required.

NAPPY RA SH

Also known as napkin dermatitis, nappy rash is due to irritation of the normal skin barrier of your baby’s bottom from the wetness of their nappy. Nappy rash is an angry red rash that can be sore when wiped. To treat nappy rash, keep your baby’s bottom dry by changing their nappy more often and, with clean hands, gently pat a thick layer of a protective barrier cream on the irritated skin before you put on a new nappy.

CRADLE CAP

Cradle cap is extremely common and is seen most commonly in babies between three weeks and 12 months old. It looks like thick, scaly, dry patches of skin on your baby’s scalp or forehead, and is likely caused by hormones overstimulating your baby’s oil-producing glands. A yeast commonly found on the skin may also play a role. Cradle cap is harmless and does not hurt your baby, but you can help to remove the cradle cap by massaging moisturiser onto the scalp and using a soft toothbrush to gently remove the scales. Pregnancy BUMP & baby

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Eczema – also called atopic dermatitis – affects up to 20% of children. Approximately 80% of children with eczema develop it before the age of six. It can be due to skin sensitivities, a family history or, rarely, food allergies. It tends to show up initially on the cheeks but can also appear on the arms, legs, chest, behind the knees, inside armpits and elbows, and in the creases of your baby’s legs. The backs of the hands can also be affected due to sucking. Eczema looks like dry, scaly skin, and may have little red bumps which ooze when irritated. Eczema is itchy, and as babies cannot scratch, they will often rub affected areas, for example the back of the head, causing temporary hair loss. It generally comes and goes but can be worse in the hot summer months and is irritated by some fabrics. If you suspect your baby has eczema, see your GP for advice on how to treat it.

d soothe & shiel Chicco Natural Sensations Nappy Cream 100ml (4-in-1), $11.95, chicco.co.nz Specifically designed to treat and protect the sensitive skin in the nappy area.

BIRTH MARKS STORK BITES AND ANGEL KISSES (NAEVUS SIMPLEX)

These are dark red or pink patches which commonly appear on the eyelids, between the eyebrows, and on back of the neck. They occur in up to half of all newborns. These marks often will become more visible in the first few weeks (especially when your baby is hot or crying) and they’ll fade gradually with time. Most facial marks fade within the first two years; however, marks on the nape of the neck can be persistent, although these are generally not obvious as they are covered by hair.

MONGOLIAN SPOTS (CONGENITAL DERMAL MELANOCYTOSIS)

These are a blue-grey birthmark that usually affects the lower back and bottoms of newborns. They are common in children with darker skin and they typically fade by the time the child reaches school age.

HAEMANGIOMAS

Also known as a strawberry birthmark, haemangiomas are found in one to two per cent of newborns. They may start small and quickly grow in the first three to six months before they plateau. After 12 months, haemangiomas begin to spontaneously reduce in size. Fifty percent of haemangiomas will have disappeared by the time the child is five years old. Treatment is not necessary unless the haemangioma is in a site where it can impact on function, such as near the eye, mouth, or sometimes the nose.

PORT WINE STAINS Cetaphil Baby Ultra Moisturising Bath & Wash 230ml, $12.99, cetaphil.co.nz This soap-free hypoallergenic formula blends one-third baby lotion with soothing aloe vera for a rich lathering wash that gently cleanses delicate baby’s skin without drying.

A port-wine stain is usually a large flat patch of purple or dark red skin that can occur anywhere on the body. This type of birthmark is permanent, but can be treated by a skin specialist in due course. If the port wine stain is on the forehead or includes the eye, it is important your baby is seen by a paediatrician, dermatologist, and ophthalmologist.

QV Baby Moisturising Cream 250g, $20.99, qvskincare.com.au Replenishes the skin and helps relieve dry areas. Suitable for use every day and with conditions such as eczema and dermatitis.

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>DO...

• Pat your baby’s skin dry after a bath – rubbing can irritate the skin. • Only use moisturisers that are suitable for babies. • Make sure your baby isn’t hot as this can dry their skin.

>DON'T... • Ask your GP before treating your baby with any creams or ointments.

• Use talcum powder.

• Think you have to bath your baby every day – a few times a week is fine. • Apply creams and cleansers that contain added perfumes, alcohol, or chlorhexidine (a disinfectant and antiseptic) as these are harsh on baby’s skin and will cause a reaction.

The Nude Alchemist Eczema Relief 50g, $22.50, nude-alchemist.com Soothes and calms dry, itchy skin, and conditions while moisturising and promoting skin regeneration. This allnatural cream acts as an emollient, locking in moisture to maintain skin hydration and providing a protective barrier against further irritants. Suitable for all ages (from 3 months+) and the most sensitive skin.

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COMFORT IS KEY

Newborns regulate their body temperature by releasing heat through their head, so steer clear of hats unless you’re outside in chilly temperatures or wind, or protecting baby from excessive sunshine. How can you tell if baby is comfortable? If fed and changed but still unhappy, baby may be too hot or cold. Check for perspiration, wet hair, red cheeks, or quickened breathing as signs of potential overheating. Note that extremities may feel cold to your touch because their circulation is still developing. Check the neck, tummy, or chest for warmth or sweat, and cool them immediately if these signs are present. Babies may be too cold if their hands and feet are looking slightly blueish. Add a layer of clothing or turn up the heat to restore their temperature equilibrium.

SWADDLES AND SLEEPSACKS

The swaddling of babies has been drifting in and out of fashion for centuries. Infants are bundled to mimic the experience of a safe and soothing womb environment. For active sleepers, or parents challenged by the intricacies of wrapping and tucking swaddles, there are sleep sacks or suits which can be used in preference. Once baby starts to roll over, it’s no longer safe to swaddle. If the swaddle doesn’t work for you or your baby, you may need to choose footed sleepwear or slightly warmer fabrics for sleep time instead.

TOGS, TOGS, TOGS

A TOG (or Thermal Overall Grade) rating is an indication of how warm a garment will keep your baby. Higher TOG ratings are better for winter, lower for summer. At temperatures of more than 25°C in their nursery, babies will likely only need a short-sleeved body suit or equivalent to be comfortable. Between 22° and 25°C, they’ll need a body suit and sleep sack with a 0.5 TOG rating. At 18° to 21°C, a short-sleeve body suit and footed onesie with a 1 TOG sleep sack will keep them cosy. Between 15° and 17°C, increase sleep sack TOG rating to 2.5, and below 15°C, increase to 3.5 TOG.

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hoosing layers for newborns can be a fraught exercise. Advice on this topic has morphed, changed, and regurgitated over the decades, and the majority of parents experience some consternation over the responsibility of keeping baby comfortable.

Not too hot, not too cold Tiffany Brown shares tips on how to keep the temperature of your baby just right.

BEDTIME BLISS

There are a number of choices available to you for infant sleep. Experts recommend baby sleeps in the same room as you for the first six months or so. Be aware that the more bodies there are in a room, the higher the temperature, so, again, be cautious about overdressing your baby.

76 turn to page

FOR MORE ON BABY BEDS

IT’S ALL MATERIAL

Organic cottons, merino, muslin, and other natural, breathable fabrics are ideal for babies. Materials promoted as “flame resistant” are often chemically treated to decrease the risk of catching fire, but these chemicals may have potentially adverse health effects. Instead, choose materials in natural fibres with a “snug-fitting” label.

HOW MANY LAYERS?

A pervasive rule-of-thumb in the baby lexicon is to dress them in one more layer than you would usually wear, but obviously this varies according to your own internal thermostat and the external temperature in your home. The recommended temperature for a baby’s room is between 16° and 20°C.

At this temperature, a cotton onesie and swaddle or sleep sack should be sufficient.

LESS IS MORE

It’s preferable for baby to be slightly underdressed rather than heavily overdressed. The danger of overheating has been linked to an increased risk of Sudden Infant Death Syndrome (SIDS). Don’t use loose blankets when babies are sleeping, and avoid loose clothing which can ride up the body and cover baby’s face. Soft bedding is also a known suffocation hazard.

TAKING THEIR TEMPERATURE

Digital rectal or temporal (forehead) thermometers are recommended for babies; avoid ear, oral, or armpit thermometers as these can’t provide accurate readings. Babies are considered feverish at a temperature of 38°C or higher, and this is a sign their little body is fighting off an illness. If baby is feeding well and doesn’t appear to be in much distress, keep them comfortable and avoid dehydration by offering feeds regularly. If baby is under two months old with a feverish temperature accompanied by other symptoms such as vomiting, diarrhoea, ear pain, stiff neck, or rash, isn’t interested in feeding, or has a fever which lasts more than 72 hours, call your doctor straightaway.

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helpful resources

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Birthing ba g

It’s a good idea to pack a bag in case of an emergency – or simply to have all the essentials together in one place when you give birth. MUM

Books/magazines

HOME COMFORTS

Pyjamas or night shirt, preferably one that buttons up in front (at least two pairs)

Cash/credit cards/wallet

Take your own pillow and pillowcase to the hospital or your birthing centre. It’ll bring you comfort and might even make it easier to drift off to sleep in the minimal moments you’ll get.

Dressing gown Nursing bras x 3 Bikini/tank top (water birth option) Cotton knickers x 10 Socks Slippers Drink bottle Portable speakers, earpods (hypnobirth, music) Sandals (for the shower) Clothes to wear home (alas, still your pregnancy clothes, because even after the baby’s out, your tummy will be still be swollen) Toiletries (your usual overnight stuff)

A few pairs of big granny undies (high-waisted) because if you have a C-section you don’t want the elastic to rub the stitches

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BABY Car capsule or car seat (already installed and ready for the baby) Blankets x 2 Muslin wraps x 2 Baby bodysuits x 4 Socks/booties x 2 Beanie

Make-up (to be honest, you probably won’t bother with it, but just in case)

Going home outfit

Breast pads and nipple cream

Nappies and baby wipes

Any medications or vitamins you are taking

Bottles/formula/steriliser if you plan to bottle-feed

- --

Copy of your birth plan

PARTNER

List of people and numbers to call after birth (store them in your phone)

A change of clothes, toiletries (toothbrush, deodorant), water bottle, some snacks and water, something to read, money for the parking meter (and for the vending machine!). Phone/camera.

Snacks and bottles of water Camera (with extra batteries or charger) Mobile phone and charger

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Maternity pads (these should be supplied by the hospital, but you’ll feel better knowing you have them available)

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REFRESHMENTS If you "run hot", take a mini fan, face cloth, or face mist to keep you feeling refreshed during contractions, in labour, and in the days following.

- --

handy tips

Toiletries: Free up room in your bag with miniature toiletries or decant what you have into smaller containers. Clothing: Don’t assume your little bundle will fit "newborn" baby clothing. If they’re overdue or simply on the larger size, they might already be ready for the next size up! (See the size guide below.)

NEWBORN

0-3 MTHS

SIZE: 0000 WEIGHT up to 4kg

SIZE: 000 WEIGHT up to 6kg

ANTENATAL CLASSES College of Midwives auckland.midwife.org.nz/ for-birthing-women/antenatalclasses

introduction to

ULTRASOUND

Nest Parenting & Education nestpregnancyand parenting.co.nz ANXIETY/DEPRESSION Depression Helpline 0800 111 757 depression.org.nz Lifeline 0800 543 354 lifeline.org.nz

Support

Mental Health Foundation mentalhealth.org.nz Mothers Helpers mothershelpers.co.nz Perinatal Anxiety and Depression Aotearoa pada.nz APPS BreastfedNZ Māmā Aroha BREASTFEEDING BreastFed NZ breastfednz.co.nz BreastfeedingNZ Facebook page facebook.com/ breastfeedingnz Feeding and Work womens-health.org.nz Lactation Consultants nzlca.org.nz La Leche League lalecheleague.org.nz Plunket plunket.org.nz Women’s Health Action infantfeedingsupport.org.nz C-SECTIONS Your Caesarean Section Birth yourcsection.co.nz/home/ electivesections CAR SEAT SAFETY Car Restraint Technician nzta.govt.nz New Zealand Transport Agency nzta.govt.nz Safe 'n Snug safensnug.co.nz Sit Tight Education sittight.co.nz

se rvices CHILD’S HEALTH Kids Health kidshealth.org.nz PlunketLine 0800 933 922 plunket.org.nz DOULAS Bespoke Births bespokebirths.co.nz New Zealand Doulas nzdoulas.nz GENERAL HEALTH Healthline 0800 611 116 Health Navigator healthnavigator.org.nz Ministry of Health health.govt.nz IMMUNISATION COVID-19 health.govt.nz Immunisation Advisory immune.org.nz MIDWIFERY Find Your Midwife findyourmidwife.co.nz MISCARRIAGE Miscarriage Support NZ miscarriagesupport.org.nz Sands sands.org.nz PARENTAL LEAVE & BENEFITS New Zealand Government govt.nz/browse/work/ parental-leave

Work and Income NZ workandincome.govt.nz/ eligibility/children/having -a-baby PREGNANCY Kellymom Parenting & Breastfeeding kellymom.com

Pregnancy Counselling Services pregnancycounselling.org.nz Pregnancy Health NZ pregnancyhelp.org.nz SINGLE PARENT SUPPORT SERVICES Auckland Single Parents Trust heartsandminds.org.nz Birthright birthright.org.nz Solo Parent Support workandincome.govt.nz/ products/a-z-benefits/soleULTRASOUND SUPPORT SERVICES Ministry of Health health.govt.nz/publication/ new-zealand-obstetricultrasound-guidelines WOMEN’S HEALTH National Women's Health nationalwomenshealth.adhb. govt.nz Women’s Health Action womens-health.org.nz YOUR RIGHTS Maternity Rights NZ maternity.org.nz

As explained by midwives.co.nz, an ultrasound scan uses sound waves to create a picture of your baby in the uterus. "Scans" are carried out by trained professionals (sonographers) and the main purpose of a pregnancy ultrasound scan is to check your baby’s anatomy, growth, and development – and to check for other things such as the placenta placement. Each pregnancy is different, and depending on your own personal circumstances, you may have additional tests and scans; however Wellington Ultrasound list these as the most common scans for New Zealand mums-to-be: FIRST TRIMESTER SCREENING OR NUCHAL TRANSLUCENCY (NT) WHEN: 11-13 weeks WHAT: Nuchal translucency is a measurement of fluid behind a baby’s neck. It’s a non-invasive screening tool to see how likely it is that your unborn baby could have a chromosomal abnormality. ANATOMY SCAN WHEN: 19-21 Weeks WHAT: A thorough check of your little one’s anatomy and growth/development. Some birth defects cannot be diagnosed early in pregnancy, but most can be picked up at this scan. Fortunately, these defects are rare.

GROWTH SCAN WHEN: Closer to your baby's due date WHY: To track your baby’s growth to ensure that the baby is born at the optimum time for their wellbeing. The placental function, placement, and the level of amniotic fluid – among other things – are checked at this time.

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helpful resources

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A new

language

A super-quick lesson in pregnancy lingo. You’re welcome!

amniotic fluid – the liquid that surrounds a baby in the uterus (commonly called "waters") amniotic sac – the sac that surrounds the baby, inside your uterus anaesthetic – an administered drug that gives total or partial loss of sensation of a part or the whole of the body anaesthetist – a doctor who specialises in giving the anaesthetic to a patient antenatal – meaning "before birth" (also called "prenatal" and "antepartum") APGAR score – a test given one minute after a baby is born, then again five minutes later, that assesses a baby’s appearance, pulse, grimace (reflex), activity (muscle tone), and respiration. A perfect APGAR score is 10; typical APGAR scores are seven, eight, or nine. A score lower than seven means that the baby might need help breathing birth canal – the cervix and the vagina. the route that the baby travels through to be born birth plan – a written document describing a woman’s preferences for her care during labour and birth Braxton Hicks contractions – a tightening of the uterus that feels like a labour contraction. Braxton Hicks contractions are not painful and do not get stronger and closer together like true contractions

breaking of water – when a healthcare practitioner bursts the sac holding the amniotic fluid using an instrument with a pointy tip. Often used to speed up a labour that has slowed breech – when the baby is positioned inside the uterus with its bottom or feet down (instead of its head) Caesarean section – a surgical procedure where a baby is delivered through a cut in the abdomen and uterus (also called C-section) cervix – the narrow, lower end of the uterus that softens during labour to allow the baby to come out contraction – strong and often painful tightening of the uterus, indicating that the cervix is dilating as well as helping the baby make its way out crowning – a point in labour when the baby’s head has reached the external vaginal opening and can be seen from the outside dilation – the opening of the cervix, usually measured in diameter from 1 to 10 centimeters embryo – a fertilised egg from the time of conception until week eight of pregnancy epidural – an anaesthetic that can be used in labour where drugs are used to numb the lower half of the body for birth pain relief first-degree tear – a tear involving only the perineal skin (adjacent to the vaginal opening) that occurs at the time of delivery

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first trimester – weeks one to 14 of pregnancy fontanelles – soft spots on a baby’s head that allow its skull to compress during birth so it can pass through the birth canal forceps – instruments shaped like a large tong that is placed around the baby’s head to encourage the baby through the birth canal during childbirth full-term – 37 to 42 weeks gestation/ pregnant gestation – the length of time that a baby is in the uterus home birth – labour and birth that takes place in someone's home, under the supervision of a midwife induced – when a professional tries to artificially "kick-start" a woman’s labour jaundice – when a baby's skin and the whites of their eyes appear yellowish, caused by an excess of a chemical called bilirubin in the blood labour – the process a woman’s body goes through when her baby is born lactation consultant – a professional trained to give advice and support about breastfeeding and breast milk meconium – a black tar-like substance; baby's first poo midwife – someone who has been specially trained to care for women physically and mentally during pregnancy, labour, birth, and the postpartum period

Nappy morning sickness – nausea, vomiting, and aversions to certain foods and smells. Symptoms are not restricted to morning only multiple pregnancy – when a woman is carrying more than one baby Neonatal Intensive Care Unit (NICU) – an area in hospitals for babies who need high-level medical care post-birth obstetrician – a specialist doctor who has training in pregnancy and childbirth paediatrician – a specialist doctor who has undertaken training in treating children perineum – the area of skin between the anus and vagina placenta – an organ that connects to the wall of the uterus and nourishes the baby during pregnancy, through the umbilical cord postnatal – after the baby is born premature – when a baby is born before 37 weeks of pregnancy

chat

You’ll be changing up to 10 nappies a day in the first month, so it pays to get down with the vocab.

scented or unscented, in travel packs or in big bulk packs you can put into refillable containers.

CLOTH NAPPY Often made of cotton or bamboo, cloth nappies are reusable fabric nappies.

BARRIER CREAM AND NAPPY RASH PRODUCTS Powders, lotions, and creams to help treat and prevent nappy rash and chafing of delicate bottoms and legs.

DISPOSABLE NAPPY A one-use nappy that is thrown out after use. Compostable options available. NAPPY BIN This can be a simple lidded bucket, a pedal-bin with a lid, or even nappy disposal systems where you open a lid, put the dirty nappy in, and turn the top to seal the nappy into its own nappy bag. BABY WIPES You can make your own reusable wipes from terry cloth, or purchase disposable baby wipes which are

SWIM NAPPY Nappies that can be worn in the swimming pool or at the beach, which hold in poo but allow wee to soak through (regular nappies can’t be worn in water because their absorbency would make them too heavy and bulky). NAPPY BAG Totes and backpacks, some with special adapters to hang on the pram, with lots of convenient pockets to hold nappies and

supplies for when you’re out and about. CHANGE MAT Disposable, wipeable, or even washable, these are great for nappy changes on the go, for travelling, and for public restrooms. CHANGE TABLE Special waist-height furniture that makes changing your baby’s nappy more convenient and saves you bending over and straining your back. Caution: Never leave a baby unattended on a change table. WET BAGS Waterproof fabric bags to hold dirty clothing, swimwear, or used cloth nappies. NAPPY WALLET A compact bag to hold one or two nappies and a travel pack of wipes. Great for your handbag or in the car.

second trimester – 14 weeks to 26 weeks of pregnancy special care nursery (SCN) – an area in hospital for babies who need special medical care stretch marks – lines or patterns that can appear on the tummy, breasts, or legs during pregnancy. This happens because the skin stretches TENS machine – Trans-Electrical Nerve Stimulation, a machine used for pain management during labour third- or fourth-degree tear – a tear of the perineum involving the skin, muscles, and anus. Classed as more severe than a first-degree tear

third trimester – From 26 weeks to 40 weeks of pregnancy trimester – a time span of certain months during pregnancy with different phases of foetal development. See "first trimester", "second trimester", and "third trimester" on the previous page/s ultrasound – a scan of the uterus (womb) and baby during pregnancy umbilical cord – a cord-like structure that connects the baby to the placenta, allowing nutrients and oxygen to be carried from the woman to the baby

uterus – a woman’s womb vacuum cap/ventouse – a suction device that can be used during the end of labour to help to pull the baby down the birth canal water birth – when a baby is born submerged in a birthing pool, either at home or at a birthing centre waters – the amniotic fluid that surrounds an unborn baby inside the uterus

newborn+postpartum

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Fun wit h

Grandma and Grandad!

re h

air t han I do !

Hey, grandparents, it might be hard to know what to do with a new baby, but playing with your grandchild creates joy, intimacy, self-esteem, and openness – try these activities and ideas.

kid, Hey,

Edited extract from Grandparenting Grandchildren: New Knowledge and Know-How for Grandparenting the Under 5s, by Dr Jane Williams, PhD and Dr Tessa Grigg, PhD, $32.99, Exisle Publishing

130

Pregnancy BUMP & baby

our grandbaby is learning the sounds of language and how to replicate them, from scratch. While having heard sounds in utero, they were muffled and often distorted, their own mother’s voice being the clearest sound heard. At birth, hearing is the most well-developed sense, and your grandbaby’s hearing is better than it ever will be again in their whole life, so the more exposure they have to the sounds of language or languages, the better. • Face-to-face communication is essential for developing communication skills. Speak face-to-face with your grandbaby and small grandchild and give them a chance to respond – even if it is only with babble or nonsensical verbal sounds. Use the "my turn, your turn" method: You say something directly to your grandchild (they must be looking at you or, if visually impaired, be aware of your presence, right with them) and wait for them to respond. Do not rush into further conversation. Babies really have to think about, and process, an oral response. But they can do it! Practice and time are important. • Do not expose your grandbaby to screens. They learn nothing about language and communication from a non-responsive picture. However, if you live away from your grandbaby and use video technology for face-to-face communication, this is another matter entirely. Video technology enables you to respond to your grandbaby in an interactive way even if you are thousands of kilometres away. • Read to your grandbaby from birth. Babies love lyrical, rhythmical prose, although what they love most is your voice. If you read the most boring of textbooks to a baby in a sing-song, lyrical way, they will love it, regardless! Read simply illustrated books. Black outlines on a white page are great. If you have any of the Dick Bruna series still in the cupboard from your own children, these are perfect. Simple, one- dimensional, clearly outlined drawings are ideal for your grandbaby. • Talk to your grandbaby using a sing-song voice whenever you are doing something with them or to them – massaging body parts, exercising, dancing, playing with musical instruments, changing nappy/ diaper or clothes, etc. • Sing and play action rhymes and body movements with your grandbaby. Nursery rhymes are ideal.

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