Pregnancy BUMP&baby issue 18

Your kids need your help to make their rooms as safe as possible.

Get it done with the simple steps above.

Visit eqc.govt.nz/be-prepared to prepare your home and protect your whānau.

tommeetippee.co.nz

Our Most Breast-like Bottle Ever.

Makes swapping from breast to bottle and back again easy.

— You’ve got this.

We’ve got you.

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health+ wellness 32 WHEN SICKNESS STRIKES

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Every issue

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PREGNANCY

Aotearoa

CPR, birthing bag, checklist, and support services

48 HOME GOURMET

Tips for a better night's sleep

Wholesome, go-to dishes you'll love

36 CAN I TAKE ANTIDEPRESSANTS DURING PREGNANCY?

54 YOU’VE CHANGED Body changes during pregnancy

22 NAVIGATING THE UNKNOWN

38 A LITTLE TLC

What to expect on your journey with multiples

Pregnancy relaxation must-haves

Unexplained and secondary infertility

40 PICKLES AND ICE CREAM, STAT! Pregnancy cravings and hydration

42 SUGAR HIGH Balancing blood sugar during pregnancy

58 GREAT EXPECTATIONS Kiwi women share how pregnancy empowered them

64 WIN A PĒPI PACK Send in a picture of your baby bump and be in to win an amazing pēpi pack full of goodies!

28 LOVE AND A LITTLE BIT OF SCIENCE IUI and IVF basics explained

JAIMEE LUPTON "A s c a p a b l e a s w o m e n a r e , w e s h o u l d n’ t b e ex p e c t e d t o d o i t a l l o r a c t l i ke i t ’s e a s y."

EMBRACING

joy A F T E R L O S S BROUGHT TO YOU BY TOTS TO TEENS

125 RESOURCES

ISSUE 18

Our cover māmā Jaimee shares her journey to baby

34 SLEEPYHEAD

PLUS EXPERT BREASTFEEDING GUIDANCE

News, views, and products we love

14 COVER BUMP

Staying active during pregnancy

Tips and help to prepare your mind and body for fertility treatment

Worth the wait

10 PARENTAL GUIDANCE

Sick of feeling sick? We get it!

fertility +IVF

26 PREPARE YOURSELF

8 EDITOR’S LETTER

46 EXERCISE 101

56 TWINNING

When to contact your GP

Take our in-depth course at home

Why meditation can work wonders

How to stay mentally healthy

24 A SKING FOR HELP

7 ONLINE ANTENATAL COURSE

45 MEDITATION STATION

30 A HELPING HAND The ins and outs of the surrogacy process

PREGN A NCY • BIRTH • P OS TPA RTUM • NE W B A BY • BRE A S TFE E DING... We de li ver ever y t hin g except t he b aby

COVER | Cover māmā: Jaimee Lupton @jaimee Photographer: Annumpam @annupam, annupam.com Make-up: Luisa Petch @glamsquad nz, glamsquad.co.nz Stylist: Lulu Wilcox @luluwilcox, lulu@luluwilcox.com

48 Pregnancy BUMP & baby

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72 life+ relationships

nursery+ equipment

66 GET TO WORK

76 NURSERY NOOK

How to balance career and motherhood

Special stories for small people

70 EVERY FAMILY IS DIFFERENT Tips and advice for queer parents

72 WHAT’S IN A NAME?

Shop from 78 home THE URGE 20 JOIN OUR BUMP&BABY FAM And enjoy a BUMP&baby Box full of goodies

Naming rules and current trends

123 DIRECTORY

74 DREAM ON

Some of our favourite businesses to support

What your pregnancy dreams mean

TO NEST

Cleaning, building, washing… Oh my!

80 A ST YLISH SPACE How to create a gorgeous nursery

82 COLOUR ME HAPPY Pick the perfect colour palette for your baby's room

84 BED TIME! Baby beds you’ll absolutely adore

86 THEY SEE ME ROLLIN’ Stylish strollers

89 FLY WITH ME Travelling with pēpi

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newborn+ postpartum labour+ birth 92 AM I IN L ABOUR? Answering common labour day questions

94 WELCOME TO THE WORLD Capturing three very special birthdays

100 CRY BABY Why babies cry at birth

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102 SKIN DEEP The importance of skin-to-skin contact

104 LET’S FACE IT A guide to cleft lips and palates in newborns

107 SQUEEZE THE DAY Strengthening your pelvic floor post-birth

108 THE MILK Y WAY The wonders of breast milk

114 A SSUME THE POSITION Breastfeeding positions

116 GOOD NIGHT, SLEEP TIGHT Transitioning pēpi into their own room

118 SHAKE, SHAKE, SHAKE Super-cute rattles

120 WHEN DO...?

Development FAQs answered

122 I WILL PROTECT YOU The importance of immunisations

130 I WILL COME TO YOU WHEN YOU CALL A poem by Jessica Urlichs

online course

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ENJOY bite-sized videos AT HOME! YOU'LL LEARN ABOUT...

• Choosing your LMC • Birthing options • Pregnancy discomforts • Informed consent • Pregnancy nutrition • Scans and 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 Antenatal Class 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 five 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 Pregnancy BUMP & baby

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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

The journey to having a baby is different for everyone. From the “Whoops, there’s another line!” to “Oh wow, it only took a couple of months” to “Why is this not happening for us?”

– it’s always overwhelming and sometimes very complicated.

When you think about it, the likelihood of that one clever sperm finding its way to an egg at just at the right time and creating a perfect little human is quite a lot to ask. Stats show that women under 30 have about a 25% chance of getting pregnant naturally each cycle. That chance drops to 15% for women over 35, and by 40, the chance of getting pregnant naturally each month is just 5%. So if your egg and sperm combo was successful, well done, you! But for those struggling on their baby journey, it can seem like a never-ending cycle of hope and disappointment.

Our cover mama Jaimee has been through a lot of heartache, including infant loss and IVF, and we know so many women are in the same position. At BUMP&baby we like to support all mamas – pregnant or hoping to be – so we have included a special section on fertility and IVF in this issue. From unexplained and secondary infertility, to the difference between IUI and IVF, to the legalities of surrogacy – including real-life stories – we want to help all future parents find their happy ending. And for all those who are still waiting, we know it can be such an isolating and lonely experience, but you are not alone. It will be worth the wait.

Take care, mamas-to-be!

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 to page 7 for more info.

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ART DIRECTOR / Emma Henderson design@bumpandbaby.co.nz DIGITAL EDITOR / Maraya Robinson SUBEDITOR / Katherine Granich ADVERTISING ENQUIRIES Tony Marinovich tony@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 / Webstar 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.

PHOTOGRAPHY BY MOIRA MEIRING OF WILD LITTLE HEARTS.

Worth the wait

EDITOR / Charlotte Cowan editor@bumpandbaby.co.nz

COMING TO A CITY NEAR YOU! AUCKLAND WAIKATO wellington

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Parental guidance...

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

did you know?

About 80% of babies are born with some sort of birthmark, with the most common being a “stork bite” or “port wine stain”.

Most birthmarks are caused by tiny blood vessels under the skin becoming dilated during labour, and usually disappear after a few years.

RESEARCHERS PILOT WORLD-FIRST PROGRAMME FOR AUTISTIC KIDS

INCLUSIVE COMFORT

Dear Mumma is expanding its maternity lingerie options to cater to a wider range of women with ever-changing, pregnant bodies. Their sleepwear already goes up to size 18 and includes discreet in-built stretch panels, extra fabric around the tummy, and extra length in the front. And now, their next collection of maternity bras will go up to an F cup for a chic, modern, and functional option for expectant and new mums.

From $59, dearmumma.co.nz

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Pregnancy BUMP & baby

A new programme to identify and support children showing signs of autism is being piloted by researchers from the Autism Clinic at Te Herenga Waka – Victoria University of Wellington.

Through the programme, 300 health and education professionals have been trained to identify the early signs of autism in children aged under five and to refer them to the Autism Clinic for immediate support, says Clinic Lead Dr Hannah Waddington.

Free support will be provided to 60 children and their families over 20 weeks in the Wellington region.

“We know it’s really difficult for families to find help. A child may be diagnosed as autistic but there’s often no assistance available for ages," says Dr Waddington. "By offering support as soon as signs of autism are observed, we hope to reduce a lot of stress and improve outcomes for the whole whānau."

The programme pilot will be evaluated later this year to assess the effects of providing this type of early support for children and their families.

noteworthy

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SCAR SUPPORT

If you’re having (or recovering from) a C-section birth, Myscar is for you. Myscar offers premium Caesarean silicone strips that can improve your scar’s healing and appearance, providing you with the best recovery and aesthetic result. Recommended by obstetricians, plastic surgeons, and pelvic health physios throughout New Zealand, you can get yours from $200 at myscar.co.nz

PLASTIC-FREE LUXURY

STOP THE LEAKS!

Lansinoh Nursing Pads offer superior leak protection, absorbing 20 times their weight with InvisiLock core for instant moisture dispersion. Dermatologist-tested and gentle on sensitive skin, they feature a thin, contoured design for discreet comfort, with breathable air pockets promoting skin health. Available in 24 and 60 packs.

Lansinoh Nursing Pads, from $12.50, lansinoh.com.au

Two Kiwi brands, Kowtow and Nature Baby, have released a new plastic-free capsule collection to support mum and baby in the early days.

Each piece blends the distinctive styles of both brands and showcases Kowtow’s signature Fairtrade organic cotton.

The collection offers a matching cardigan and pant set in a khaki melange, accompanied by the Willow Blanket – a cosy essential to keep mama and baby warm.

Finished with corozo nut buttons, the capsule is entirely plastic-free and is available in sizes XXS-XXL for Kowtow and 0-3 months to 2Y for Nature Baby. nz.kowtowclothing.com naturebaby.co.nz

Fun fact

Even identical twins – who share the same genetic makeup – have different fingerprints.

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JUST LIKE MAMA

Inspired by mums and designed by experts, the Closer to Nature Baby Bottle has an extra-wide neck and breast-like teat to help your baby have the most natural bottle-feeding experience. Made from super-soft silicone, the teat has a special breastlike shape that encourages a natural latch and prevents nipple confusion when switching between bottle and breast. This works by mimicking the flex and movement of mum’s breast, allowing your baby to feed at a pace that feels comfortable and natural to them. It also features an anti-colic valve to prevent the symptoms of colic by ensuring your little one ingests more milk and less air.

For more, visit tommeetippee.co.nz

GET PERSONAL If you think there’s nothing cuter that personalising all of your baby’s belongings, get yourself a Cricut! The Cricut EasyPress Mini in Zen Blue is now available in New Zealand, so you can easily customise blankets, wraps, and even stuffed animals using heat transfer. With a compact design and a ceramic-coated heat plate, the Cricut EasyPress Mini can easily curve with contours, get between buttons, squeeze into seams, and effortlessly glide over oddly shaped surfaces to transfer your design. Oh, the things you can create!

Podcasts for parents

The Birth Hour Podcast Created for mothers to share their inspirational birth stories.

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The New Mamas Podcast A space created to give first-time mamas a voice to have honest and raw conversations about motherhood.

Raising Good Humans Effective approaches and tools to make your parenting journey less overwhelming from Dr Aliza Pressman, a developmental psychologist and parent educator.

The Whole Parent Podcast Evidencebased parenting strategies, blending psychology with real-world experience.

NEW RESEARCH INTO PERINATAL DEPRESSION

Recent research conducted by the Karolinska Institutet has found that women who have a premenstrual disorder (such as premenstrual syndrome or premenstrual dysphoric disorder) may also be at greater risk of depression during or after pregnancy.

While pregnancy pauses menstruation – and its accompanying symptoms – evidence shows premenstrual disorders are probably caused by an abnormal response to normal hormone fluctuations, meaning this break may not be without its challenges. The hormonal fluctuations that happen during and after pregnancy can also precipitate perinatal depression, a condition that affects 10-20% of pregnant women and that shares a significant symptom overlap with depression.

Women with a history of premenstrual disorders are five times more susceptible to developing perinatal depression if they become pregnant and are around four-anda-half times more likely to experience antenatal depression.

The study serves as a call for heightened awareness and suggests that women with a history of premenstrual disorders should be closely screened for perinatal depression, and provided with the help and resources they may need for their mental health before and during pregnancy, and just after giving birth.

COMPILED BY CHARLOTTE COWAN.

Cricut EasyPress Mini (Zen Blue), $139.95, spotlight.co.nz

noteworthy

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IT’S IN THE BAG SABEN has launched its latest innovation for mamas, the Atlas Backpack. Designed to combine functionality with style, the Atlas Backpack is made using durable leather and lightweight recycled nylon, and features multiple compartments and extras. We love the dual external bottle holders and the loop to easily hook your backpack on to your stroller for added convenience. $599, saben.co.nz

Did you know?

Babies are born with almost 50% more bones than adults.

LEARNING THROUGH PLAY

Lovevery has launched its subscription Play Kits in New Zealand.

The early learning system supports families with expert-designed play essentials for children and resources for parents. The Play Kits are stage-based play essentials for a child’s developing brain, available for ages 0 to 4 years and delivered by subscription every two to three months, according to a child’s developmental window. AUD$130, lovevery.com

TŪĪ TURNS 40 Since the 1980s, the legend of Tūī Balms’ effectiveness as a skin healer has spread: it now is a Kiwi icon for natural skincare and one of New Zealand’s favourite baby balms. The co-op’s annual donations of 5% of sales also support charities across Aotearoa. Viva Tūī Balms! tuibalms.co.nz Pregnancy BUMP & baby

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Mama

AND ME

our cover bump

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Jet-setting entrepreneur Jaimee Lupton is ready to take on her new normal as a busy mum.

Pregnancy BUMP & baby

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J

aimee Lupton lives a busy and exciting life.

The founder of MONDAY Haircare, she has recently launched two new hair and body brands, Osana Naturals and Chalon.

Happily engaged to Nick Mowbray – co-founder of ZURU Toy Company – 31-year-old Jaimee and 39-year-old Nick split their time between their home in Coatesville, Auckland, and Sydney, Los Angeles, and Asia.

Expecting a baby girl is both an exciting and overwhelming time for the couple whose first daughter – sweetly monikered Gingernut – was born sleeping in 2022.

But Jaimee says she is so excited to see what the “new normal” looks like for the pair as parents.

“It’s been a roller coaster”

Over the course of about four years, Jaimee endured two rounds of IVF, experienced the stillbirth of her first daughter at 24 weeks, and had failed embryo transfers and a subsequent miscarriage before becoming pregnant with her daughter.

“It’s the most difficult thing I’ve ever been through, but also the thing I want more than anything,” she says. “I’ve had a huge fear of losing the pregnancy again, which has been very challenging, especially in the early days.”

But while Jaimee says the 24-week mark was a difficult point to cross, the pregnancy has been healing.

“I thought this pregnancy would bring back that trauma [of losing Gingernut], but I’ve found it very healing and special.

I’ve had the most incredible friends and my family around me who have checked in on me consistently, and connected with so many strangers wishing us well.”

“The loss of a child is uniquely diff icult”

Following the devastating loss of her first daughter, Jaimee launched Gingernut’s Angels (gingernutsangels.com), an organisation that financially assists families whose fertility journey are not straightforward.

“Grief is such a difficult thing for anyone to go through, but the loss of a child is uniquely difficult,” says Jaimee.

“It’s something that only others who have experienced it can fully empathise with, like a club that no one wants to be a part of.”

Jaimee says through her own journey, she connected with hundreds of people in New Zealand and around the world who are in various stages of the fertility process.

And more often than not, loss is a part of that journey.

“Something that comes up time and time again when people want to continue to try for a baby is how cost-prohibitive IVF and other fertility treatments are,” she says.

“Rounds of IVF can cost tens of thousands of dollars, and while we’ve been in the fortunate position to be able to pay those bills when they come in, not everyone is.

It breaks my heart to think that how much money someone has in the bank would determine whether they get to be a parent,” she says. “The hope for our first year is to make 100 grants in Gingernut’s honour – I want there to be little angels all over New Zealand connected to Gingernut, and for that to be her legacy.”

It’s the most difficult thing I’ve ever been through, but also the thing I want more than anything.

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our cover bump

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our cover bump

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It breaks my heart to think that how much money someone has in the bank would determine whether they get to be a parent.

“Mum was a very hands-on mum, and she was also a social worker, so she instilled compassion for others in us from a very young age. I feel compelled to help people where I can, which is what Gingernut’s Angels was born from,” she says.

“My parents are the kind of people who will drop anything to help others, so I’m sure they’ll be a big part of helping us to raise her.

I’ll probably send her to my mum to learn the skills I lack – like cooking!”

One of three girls herself, Jaimee found out the gender as soon as possible with her second pregnancy, and was over the moon to find out she was expecting another girl.

“Throughout the journey of trying to get pregnant, so much is out of your control,” she says. “So it was reassuring to me to know as much as I could.

“It’s been really beautiful being able to get out the clothes and things I had bought for her sister and know they will be used.

I’ve always wanted to be a girl mum; I love the idea of raising a young woman.”

Jaimee says she also can’t wait to watch fiancé Nick in the role of Dad. “His approach with everything else in life, including business, is just to jump in and tackle things head-on,” she says.

“If something isn’t working or needs to

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be solved, he’ll spend hours and days locked in a room until it’s done, [so] it’s going to be so interesting to see how that translates to fatherhood. I expect him to be the fastest and most efficient at changing a nappy (and no doubt telling everyone he’s now the best at it!).”

But jokes aside, Jaimee says she wants her daughter to see that whatever dad does, mum can do, too. “I want my daughter to know that she’s just as capable as her male counterparts. I also hope that her dad and I can teach her the value of hard work, passion, and commitment when it comes to her own hopes and dreams, whatever they may be.”

“I feel compelled to help”

Jaimee says she learned a lot about compassion and hard work from her own parents when she was growing up, and hopes to pass that on to her daughter.

“You shouldn’t be expected to do it all”

With several brands on the go, it’s difficult to take time away but Jaimee says the plan is to have three months off before trying to find a new normal of juggling work and baby.

“I look up to a lot of women who have children and also run businesses, and they talk about balance being a myth,” she says.

“You can have it all, but you can’t have it all at the same time. As capable as women are, we shouldn’t be expected to do it all or act like it’s easy. It’s not, it’s hard. No matter what your unique juggle is – whether you own your own business or work out of the home, or work in the home – it’s never easy, but it’s worth it.”

Photographer: Annumpam @annupam, annupam.com Makeup: Luisa Petch @glamsquad nz, glamsquad.co.nz Stylist: Lulu Wilcox @luluwilcox, lulu@luluwilcox.com Model mama: Jaimee Lupton @jaimee Dress: Denim by Levi's @Levis_anz, beige suit by cos @cosstores

INTERVIEW BY CHARLOTTE COWAN.

“I’ve always wanted to be a girl mum”

Saving your baby’s cord blood could save your baby’s life.

It takes just a few minutes to collect umbilical cord blood from your newborn baby. Saving the stem cells from this blood can 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

O rder your

MAMA-TO-BE

AMAZING VALUE BUMP&baby SAMPLE BOX + ANTENATAL COURSE OFFER! What’s in the BUMP&baby Box? We work with the most amazing pregnancy, mother, and baby brands to bring you our BUMP&baby Box – 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 Box: Bear & Moo, Phloe, Palmers, Tommee Tippee, Kiwi Garden, Mammas Milk Bar, Tui, Floradix, Lansinoh, Bio-Oil, Weleda, NUK, Dermal Therapy, Trilogy, Silk Baby and many more!

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EMBRACING joy A F T E R L O S S

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ISSUE 18

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PREGNANCY

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Navigating the unknown Have you been diagnosed with unexplained or secondary infertility? Dr Devashana Gupta, Medical Director at Repromed (repromed.co.nz), explains what that means for you and the treatment available.

WHEN SHOULD I CONTACT A FERTILIT Y SPECIALIST?

This really does depend on your age and how long you’ve been trying to conceive.

A general rule is that if you’ve been trying to conceive and haven’t become pregnant after 12 months, it’s a good idea to seek help.

If you’re over 35 years old or you have a health condition that may impact your fertility, we would suggest you might want to seek help sooner. You can ask your GP to refer you, or self-refer to a fertility clinic to get investigations underway.

WHAT IS UNEXPLAINED INFERTILIT Y?

Unexplained infertility is a term used in the medical field when a couple is having difficulty getting pregnant, but there’s no

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obvious reason why from the test results.

Around 15-25% of heterosexual couples experience unexplained infertility, but this doesn’t mean it’s impossible to conceive – it just might take longer or require a different approach.

Being diagnosed with unexplained infertility means there is no identifiable cause, however, there are a number of factors that can reduce fertility, including: • Infrequent sexual intercourse, especially just before ovulation (i.e. when the cervical mucus is clear, stretchy and receptive to sperm); • Cigarette smoking; • Excess or insufficient weight; • Excessive alcohol and drug consumption; • Excessive caffeine consumption.

WHAT IS SECONDARY INFERTILIT Y AND IS IT COMMON?

Secondary infertility is common and happens when you have difficulty getting pregnant or carrying a pregnancy to term after you’ve already started your whānau with one or more children. It can take people by surprise if they didn’t have trouble conceiving their first child, but is understandable as age impacts the quality of eggs.

One of the biggest factors that contributes to secondary infertility is age, but there may also be other factors at play including: • Hormonal disruption/imbalance after the first pregnancy; • The time it took to conceive the first pregnancy; • Family history, including the age of the mother’s mother when she was menopausal.

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Megan’s journey with unexplained infertility

Our fertility struggles feel like a distant memory, but also still so fresh. The irony of all the years spent actively avoiding becoming pregnant, yet when we decided that we wanted to start a family, the thought of it never happening was much, much worse. There was never an explanation as to why I was not getting pregnant. I had numerous scans which all came back normal and even had an exploratory surgery for possible endometriosis, which also came back clear. My husband’s “samples” looked fine, so doctors couldn’t really give us any reason at all.

While we were going through all of this, the clock kept ticking! I went through so many emotional struggles as I watched friends and relatives get pregnant and go on to start their families. My younger brother and sister-inlaw had two kids in the time we were trying.

Friends had babies “before” they felt ready, others moaned about how miserable they felt to be pregnant and the rage burned inside me as it all felt so unfair!

WHAT ARE SOME OTHER REA SONS FOR COUPLES HAVING DIFFICULT Y CONCEIVING?

Outside of unexplained infertility and secondary infertility, there may be a number of other reasons. Physically, some people may experience difficulty conceiving if there are, for example, blocked or damaged fallopian tubes, poor quality semen, or a lack of regular ovulation.

Stress can also be a factor. Not only can stress reduce your sex drive, but it can also affect ovulation and sperm production.

Although it’s said that in general, infertility causes stress, rather than the other way around, stress can still have an impact when trying to conceive.

WHAT TESTS WILL BE RUN?

To try to figure out what is causing difficulties when you’re trying to conceive,

fertility specialists will run several tests, often called “investigations”. These tests include a semen analysis, an assessment of ovulation and ovarian reserve, a pelvic ultrasound, and a check to see whether the fallopian tubes are open or not.

WHAT ARE THE NEXT STEPS?

Once the tests have been completed, our fertility specialists will look at what treatments may be available depending on the results of the tests.

Sometimes it can be as simple as starting a pre-conception health programme that focuses on nutritional, lifestyle, and environmental factors to optimise reproductive health.

Other times, a more specific treatment like lipiodol (flushing of the fallopian tubes), IUI (Intrauterine Insemination), or IVF (In Vitro Fertilisation) will be recommended.

ARE THERE ANY LIFEST YLE CHANGES THAT CAN HELP?

There are many lifestyle factors that have been proven to influence or enhance your

After ruling out different causes and paying for IUI privately, we were fortunate enough to be given an appointment at one of the top fertility clinics in London, where we were living at the time. Fortunately for us, we met the funding criteria, and after the 12-month wait from our referral to our initial appointment, we were provided funding for one round of IVF (egg collection and embryo transfer) and an additional two frozen embryo transfers, if necessary.

But the roller coaster wasn’t over. My egg collection was incredible – 33 eggs, 21 of which fertilised and 10 of which made it to good-quality day-five embryos. So chances were good, but that was still not a guarantee.

Our first few embryo transfers (both fresh and frozen) didn’t stick, and the worry and stress continued. Counselling was provided by the IVF clinic, and this was so worthwhile, as it was a chance for us both to chat about the stress and emotional toll it was taking on us.

After so many unsuccessful attempts, the stars aligned and I was pregnant... With twins!

After the journey it took to get to this point, I was so fortunate to have a fairly smooth pregnancy and delivery with a healthy boy/girl pair, born at the end of 2019.

After nearly five years of trying to conceive, our family was complete!

chances of getting pregnant, both before and during fertility treatment. It takes 100-120 days for eggs and sperm to mature, so what you do in the four months prior to conception has an impact.

A few key changes include following a healthy diet and avoiding processed and sugary foods, doing regular low-impact exercise, reducing your stress levels, taking a pre-natal supplement to include folic acid and folate, and limiting exposure to chemicals.

WHERE YOU CAN SEEK SUPPORT

If you’re experiencing difficulties when trying to conceive, talking to a fertility counsellor or joining a support group is a great next step. Fertility NZ (fertilitynz.org.nz) has fantastic support groups all around New Zealand to help those who are facing challenges when trying to conceive. Given that around one in four New Zealanders experience fertility issues, it may help to know that you’re not alone and that support is available to you whenever you need it.

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Asking for help Struggling to get pregnant? Dr Isabelle Duck explains subfertility, infertility, and when to see your GP.

T

he conception of a baby is a truly phenomenal occurrence, but some couples may struggle to fall pregnant, and there are no words to describe how difficult it can be if faced with this challenge.

To make a baby, several important events need to occur. A woman’s ovaries need to produce an egg; and that egg needs be transported down the fallopian tube into the uterus. Enough mobile sperm needs to be produced by her partner, one of which needs to swim to the egg, and fertilise it.

Then, the fertilised egg needs to implant within the lining of the uterus. Each of these is like a piece in the puzzle and a woman will

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not fall pregnant naturally if one of these pieces is missing. Firstly, some definitions…

Subfertility: is defined as a situation where the possibility of a couple conceiving naturally does exist, but it takes longer than the average amount of time.

Infertility: is the inability to conceive naturally after one year of trying.

Sometimes a couple may be aware of the possibility of subfertility prior to trying for a baby. A woman may have previously had a diagnosis which is known to occasionally make conception and implantation more difficult. One example is polycystic ovaries (PCOS). Women with polycystic ovaries sometimes ovulate (produce an egg) less

frequently than average. Although women with this condition are able to conceive, it may take longer and sometimes they require intervention from a fertility specialist.

Occasionally, a couple may be struggling to become pregnant, but there is no clear reason for this.

FACTORS WHICH ARE KNOWN TO REDUCE FERTILIT Y

If a woman is less than 40 years of age, she has an 80% chance of conceiving within one year, if there is regular intercourse with her partner.

There are several factors, however, which can to reduce the chances of conception.

Smoking reduces fertility and, in women,

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have regular unprotected intercourse (two or three times a week) throughout a woman’s menstrual cycle as this will optimise the chance of pregnancy.

ARTICLE REFERENCES AVAILABLE ON REQUEST.

WHAT WILL BE TESTED BY YOUR GP

it can also harm a developing baby. In men, there is an association between semen quality and smoking. In New Zealand, women who are smoking are not eligible for publicly funded fertility treatment.

Being overweight or underweight can affect a woman’s fertility. Help with weight management can be discussed with your GP.

WHEN TO SEE YOUR GP

In New Zealand, if a woman is aged 35 or above, then investigations are considered if a couple has been trying to conceive for six months or more. If a woman is below 35, then investigations are considered after 12 months. It is recommended that a couple

medical conditions or a family history of a neural tube defect. During pregnancy, iodine supplementation is also important as it supports a baby’s brain development.

This should be taken throughout the whole pregnancy until the end of breastfeeding.

A woman will need a blood test, which will differ depending upon whether or not she OTHER MEDICATIONS AND DIET has regular menstrual cycles. This tests for If you are trying for a baby, it is imperative hormone levels and sexually transmitted that you inform your GP if you are taking infections, but may be more comprehensive any regular medications, as some medications if the cycles are irregular or infrequent. Your are known to harm a developing baby.

GP will give advice on when this blood test Likewise, if you are prescribed or given will need to be completed, as the hormone any medication while you are pregnant by levels differ depending upon where a woman a health professional, it is important that is during her menstrual cycle. they are aware of your pregnancy (or of the Rubella status will also be tested, and possibility of pregnancy). This applies to vaccination offered if a woman has reduced all herbal medications and over-the-counter immunity. You must wait at least one medications. Once you become pregnant, month before conceiving there are important dietary after having this vaccine. which need to While the fertility restrictions Contracting rubella during be discussed with your GP pregnancy can harm journey can be and midwife. a developing baby. frustrating and PSYCHOLOGICAL In addition to these tests, a cervical screening test is SUPPORT overwhelming, strongly recommended.

Many couples find the there is a lot This test has recently process of investigating changed and in many of help available and managing fertility instances involves a vaginal challenges difficult and for couples. self-swab. may find counselling A man will also need helpful. There are also a blood test for sexually transmitted several support groups throughout the infections and he will be asked to provide country where couples can share their a semen sample. This will need to be experiences. Fertility NZ is a charitable dropped off at the laboratory within trust which offers a network of established one hour of collection and your GP will support groups throughout New Zealand. give specific advice on how to obtain the More information can be found at semen sample. Please also note that not all fertilitynz.org.nz laboratories process these samples, so it is Whilst the fertility journey can be important to make sure that the sample frustrating and overwhelming, there is dropped off at the correct laboratory. is a lot of help available for couples.

It is important to remain physically and FOLIC ACID AND IODINE psychologically well throughout fertility SUPPLEMENTATION investigations and treatment. Keeping If you are trying for a baby, it is important communication channels open with your that you are taking a folic acid supplement. partner is essential, and your GP, fertility This is strongly recommended as it helps services, and support groups are available to prevent neural tube defects, such as spina to answer your questions. bifida. Ideally folic acid needs to be taken from four weeks pre-conception until the Dr Isabelle Duck is a General Practitioner end of week 12 of the pregnancy. Your GP and the Clinical Director of Urgent Care can advise on which is the best dose, as a at Silverdale Medical Centre in Auckland higher dose is needed if a woman has certain (silverdalemedical.co.nz).

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Fertility treatment can be tough on your mind and body. Here are some tips to help you prepare.

f you have been having difficulty conceiving, you know how much it can take a toll on your mental, emotional, and physical health. The journey can be isolating and anxiety-filled, so it’s important that your number one priority is to take care of yourself. Here are a few ways to be mindful of your wellbeing.

BE INFORMED

Make sure you get all the information you need from your fertility doctor before you start treatment, and ask as many questions as you need to. Knowing exactly what treatment entails will help calm your mind.

Join support groups on social media or in your local area, or there are organisations such as Fertility NZ ( fertilitynz.org.nz) that offer online services and workshops for those navigating infertility.

GO OVER YOUR FINANCES

While some people may be able to secure public funding for IVF (contact your district health board for eligibility criteria), the cost of fertility treatment – including consultations, medications, scans etc – can be expensive. Create a budget breakdown and consider financial planning to ensure

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you can afford the treatment and any additional expenses that may arise.

KEEP MOVING

It can be so easy to sit at your computer all day, every day, researching or searching for answers. But it’s important to pull yourself away from the screen and find a relaxing distraction. Meditation, walking, or journalling can help you to relax, or plan something fun you can look forward to, such as catch-up with old friends, a night out with your partner, or a mini-break or overseas holiday.

TALK ABOUT IT

Fertility journeys are overwhelming, so make sure you open up and speak to people in your life, such as your best friend or partner, that you trust with your feelings.

If you feel like you’re not coping, speak with your GP, fertility doctor, or counsellor ASAP. Counselling may be included in your fertility clinic’s treatment plan, so make sure you ask!

STRENGTHEN YOUR BODY

Make sure your look after your body with healthy eating, regular exercise, fresh air,

FOR PARTNERS It can be difficult to know how to show support for your partner when they are going through fertility treatment.

Here are some simple ways to do so.

LISTEN: It can be easy to fall into the trap of trying to fix the problem, but sometimes, just listening to your partner vent is all they want. Offer supportive words and be empathetic to how they feel, but don’t try to offer solutions.

BE AVAILABLE: Attend appointments and scans where you can, offer to help with injections, or plan a nice weekend day out or some help out around the house (especially if you have other children).

RESPECT THEIR PRIVACY: Don’t tell everyone you come across that you’re going through fertility treatment.

Decide together whom you are going to tell and what you are going to share with them before treatment starts.

ORGANISE EXTRA HELP: Fertility medications may make your partner extra tired and possibly not as eventempered as normal, so organise extra meals, help cleaning the house, or a hand in picking up the other children from school and taking them to extracurricular activities.

and sufficient sleep. Quit smoking and reduce (or remove) alcohol consumption and ask your fertility specialist about any supplements that may be helpful to take.

If you are feeling particularly stressed or anxious, try doing some breathing exercises – you can find these and more resources at anxiety.org.nz

ADDED EXTRAS

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HELP AND SUPPORT FOR THOSE ON A FERTILIT Y JOURNEY. MA SSAGE

Fertility massage incorporates a variety of massage techniques, including deep tissue massage, acupressure, reflexology, lymphatic drainage, and abdominal massage. Your massage therapist may also use gentle stretching and mobilisation techniques to release tension and improve mobility in the pelvic area.

The benefits of fertility massage include: • Improving blood circulation to the reproductive organs; • Reducing adhesions and scar tissue in the pelvic area; • Supporting hormonal balance by stimulating the endocrine system and promoting the release of hormones involved in ovulation and menstrual cycle regulation; • Relieving stress and tension.

The best time for fertility massage is typically after your period up until ovulation occurs, but specific recommendations will depend on your individual needs (such as if you are starting fertility treatment). Your massage therapist will be able to advise the best time for you.

ACUPUNCTURE

Acupuncture is a form of Traditional Chinese Medicine (TCM) that involves inserting thin needles into specific points on the body to stimulate energy flow and promote balance. In TCM, fertility is believed to be influenced by the flow of Qi (pronounced “chee”), or vital energy, through the body’s meridians.

Acupuncture aims to restore balance and harmony to the body’s energy flow, addressing imbalances or blockages that may contribute to infertility. By targeting specific acupuncture points related to reproductive organs and systems, acupuncture is thought to regulate hormones, improve blood flow to the uterus and ovaries, support ovarian function, and reduce stress.

YOGA

There is no exercise so far that has consistently been proven to improve fertility, but yoga can help to...

Reduce stress: Yoga is known for its stress-relieving benefits, helping to reduce levels of cortisol and promote relaxation.

Improve blood flow and circulation: Gentle stretching and mindful movement can improve blood circulation throughout the body, including the reproductive organs.

Strengthen the pelvic floor: Specific yoga poses and exercises target the pelvic floor muscles, which play a crucial role in reproductive function, including supporting the uterus and bladder.

Help the mind-body connection: Yoga emphasises the connection between mind, body, and spirit, fostering a sense of harmony and balance.

Check out

these fertility

SUPPLEMENTS

Fertility supplements contain a combination of vitamins, minerals, antioxidants, herbal extracts, and other nutrients that are believed to have beneficial effects on fertility.

Here are some ingredients that may help with fertility…

Folic acid: Folic acid has also been shown to increase the chances of conception, especially in women with irregular cycles.

Vitamin D: Supports hormone regulation and reproductive health.

Vitamin B12: Adequate levels of vitamin B12 may support regular ovulation and improve egg quality.

Iron: Iron is essential for healthy blood flow and oxygen transport, which is important for reproductive function.

Zinc: Supports sperm production and may improve sperm quality.

Coenzyme Q10 (CoQ10): Acts as an antioxidant and may improve egg quality in women.

Omega-3 Fatty Acids: Found in fish oil and may support hormonal balance and improve fertility in both men and women.

practitioners

ALWAYS CONSULT YOUR GP OR LMC BEFORE TAKING ANY SUPPLEMENTS!

MA SSAGE THERAPISTS

SUPPORT GROUPS

• mamasretreat.co.nz • bloommassage.co.nz • ritualmassage.co.nz

ACUPUNCTURISTS • glowbody.co.nz • ponsonbywellness.co.nz • taoclinic.co.nz • happybodyacupuncture.co.nz • thehouseofacupuncture.co.nz • chinesemedicine.org.nz/find-apractitioner/

Social media or in-person support groups can provide a valuable source of emotional support, encouragement, and information for those navigating the challenges of infertility. They are a safe and understanding environment where you can share your experiences, express your feelings, ask questions, and receive support from others who truly understand what you’re going through.

Some support groups to try: • fertilitynz.org.nz/support-groups • facebook.com/FertilityNewZealand • facebook.com/groups/pcosnp • facebook.com/groups/IVFSupportNZ

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Love and

a little bit of science Dr Devashana Gupta, Medical Director at Repromed (repromed.co.nz), answers your IUI and IVF questions.

IUI IVF

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WHAT IS IUI AND HOW IS IT DIFFERENT FROM IVF? Intrauterine Insemination (IUI) is a process in which specially prepared sperm is placed directly into the uterus, making it faster and easier for it to “swim” to its target and increase the chance of conceiving. This type of treatment cycle can be done “naturally” without medication, or with medication to stimulate the ovaries and regulate ovulation.

In Vitro Fertilisation (IVF) is where the eggs are collected under local sedation and mixed with prepared sperm in the clinic laboratory incubators. The fertilised eggs develop into embryos, and then one high-quality embryo is placed back into the uterus to hopefully begin a successful pregnancy. Where there are sperm-related issues, it may be recommended to include sperm injection technology (ICSI) in your IVF cycle, which involves the insertion of a single selected sperm directly into the egg to increase the chance of fertilisation. This helps improve the chance of conception further.

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HOW MANY IVF CYCLES ARE USUALLY REQUIRED TO CREATE A SUCCESSFUL PREGNANCY?

WHAT HAPPENS DURING THE IVF PROCESS?

IVF is an incredible option for those who need help overcoming a range of fertility issues. It may be daunting initially, but you’ll have a dedicated fertility team working beside you to make the process as simple as possible for you.

After initial consultations with your fertility doctor and investigations have been completed, there are five steps of IVF...

1.Egg collection

First, the ovaries are injected with a hormone that encourages the development of follicles (the fluid-filled sacs in the ovaries that usually contain eggs). The fluid is then suctioned out of the developed follicles, allowing the eggs to be collected and placed in a culture dish. This is a simple procedure that is performed in theatre by a doctor under light anaesthetic.

2. Sperm preparation and insemination

Next, the semen sample is collected and prepared. The healthy sperm is then either inseminated into the dish with the collected eggs, or directly into the egg for IVF with ICSI, and left overnight in the hope that fertilisation will occur.

3. Fertilisation

PHOTOGRAPHY BY MOIRA MEIRING OF WILD LITTLE HEARTS. THANKS TO MOIRA AND CONSTANT.

If fertilisation has occurred by the morning after collection, the fertilised eggs, now called “embryos”, are left to develop in the laboratory. The embryos are cultivated at body temperature in an incubator for about five or six days.

4 . E m b r yo t r a n s f e r

The laboratory team will decide when to transfer the highest-quality embryo to the uterus. This procedure is completed by your fertility doctor and is very simple, much like a smear test.

5. P r e g n a n c y t e s t

Fourteen days after the egg collection, a pregnancy test is taken via a simple blood test to see if the process has been successful.

This is often a tough time of waiting, as you can imagine.

It really varies from person to person, and success rates depend on a variety of factors, including the age of the person trying to conceive, their overall health, and any specific fertility issues they might be facing.

For some, the first cycle is successful, while for others, it might take several attempts.

IS IT POSSIBLE TO TRANSFER MORE THAN ONE EMBRYO?

It is possible, but not standard practice today due to the health risks of multiple pregnancies. Historically, more than one embryo was transferred in each cycle, often resulting in twins or triplets with higher health risks. That’s why it’s standard in New Zealand to only transfer a single embryo in each IVF cycle now.

WONDERING ABOUT IVF PUBLIC FUNDING?

Public funding for IVF treatment may be available for those who meet the eligibility criteria set by the New Zealand Government. Your GP can refer you for assessment, or you can self-refer via a fertility clinic. The public funding criteria varies, depending on which region you’re in, but the assessment considers things such as: • Your age.

•H ow long you’ve been trying to get pregnant.

• If you already have children.

• Whether you smoke.

•Y our weight, based on your body mass index (BMI).

The assessment criteria change from time to time. If you do not meet the criteria, making lifestyle changes like quitting smoking or losing weight could help you to become eligible. Your specialist will discuss this with you at your appointment.

To be eligible for any funded treatment, you and your partner (if applicable) both have to be New Zealand citizens or eligible to live in New Zealand for at least two years.

If all criteria are met, you’ll be randomly allocated to a fertility clinic. The wait list varies by clinic, but across New Zealand there’s currently a 12-18 month wait time for public funding.

For more information, head to govt.nz/ browse/family-and-whanau/fertilityissues-and-assisted-reproduction/ how-to-get-fertility-treatment/

If you’d like to discuss your fertility options, you can book a free 15-minute phone consultation with a Repromed fertility doctor at repromed.co.nz Pregnancy BUMP & baby

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Surrogacy is a rewarding but often complicated process for couples on a journey to having a baby, explains Yvonne Eve Walus.

WHAT IS SURROGACY?

Surrogacy helps people become parents when they can’t do it on their own. It’s an arrangement in which the surrogate agrees to carry and give birth to a child for another individual or couple (the intended parents).

There are two main types of surrogacy: Traditional surrogacy – in which the surrogate uses her own egg. While in-vitro fertilisation (IVF) may be used, traditional surrogacy can often be achieved via intrauterine insemination, which is medically less complex.

Gestational surrogacy – in which the surrogate carries an embryo made using the egg and sperm of the intended parents or donors, so she’s not genetically related to the baby. This surrogacy requires IVF and embryo transfer.

WHAT DOES THE LAW SAY?

Being a surrogate is legal in New Zealand, but it can’t be done for financial gain.

A surrogate can only be paid “reasonable expenses”, such as prenatal vitamins or travel to and from medical appointments.

Under New Zealand legislation, a surrogate mother and her partner are the legal parents of the child, no matter whose egg and sperm were used.

This means that the intended parents must adopt the child to be recognised as the legal parents, and to do that they need the consent of the surrogate mother and her partner for the adoption.

If the surrogate parents have a change of heart about giving up the baby, the intended parents cannot have the surrogacy arrangement enforced. Similarly, should the intended parents decide not to adopt the baby, the surrogate parents are legally obliged to care for it. The court must be satisfied that the intended parents are “fit and proper” people to adopt the child.

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A helping hand THE SURROGACY JOURNEY and other gynaecological tests, and then, Nicola is married and has children of her of course, the embryo transfer/s. own. When I ask what motivated her to A few emotional topics needed to be do this awesome altruistic thing, she shrugs broached, such as what if the foetus has off the praise. She doesn’t consider herself an abnormality, or what if the pregnancy a very spiritual person, yet she always felt that threatens Nicola’s life, and fortunately all being a surrogate would be in her journey. parties were on the same page. There was When she learned that her colleague Andrew also a lot of paperwork, the most surprising and his husband Jake wanted to have a baby, of which was the consent form that Nicola’s husband, Shaun, needed to she didn’t hesitate. “I told Andrew right away I’d carry sign. From his perspective, “The process their child for them,” she said. it’s nothing to do with him, From there, the conversations takes a long time, but officially the law will happened organically and it’s not easy, consider him and Nicola the baby’s legal parents Although she hadn’t ruled but there’s a until the adoption process out egg donation, Nicola good reason was happy to learn the guys is completed. The families it’s not easy.” knew someone who could do will have a custody agreement that for them. “My husband in place so that Andrew wasn’t comfortable with his children having and Jake can look after the baby, but if there are decisions to be made about the child’s a half-sibling anyway, and I knew it would be easier to hand over a baby that was never wellbeing, it will be up to Nicola and her biologically mine, just one that I was lucky husband. “It's crazy,” is how Nicola sums enough to carry.” it up.

Medically, there were counselling Her advice for someone considering appointments, pelvic exams, ultrasounds, becoming a surrogate? “It’s a huge decision.

Nicola: The surrogate

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Q& A

Q: Can you be a surrogate if you’ve never had children?

A: There is no medical or physical reason that would prevent you from being a surrogate; however, fertility clinics prefer to work with someone who’s given birth at least once.

Q: Can you be an egg donor if you’ve never had children?

A: Yes, but you need to be between 20 and 36 years, be a non-smoker, and have no significant health issues.

Q: Is there an age limit to be a surrogate?

This can depend on which fertility clinic you are using, but for many, the upper and lower age limit is between the ages of 25 and 40.

Nicola with husband Shaun, intended parents Andrew and Jake, and Millie with husband Troy.

The process takes a long time, and it’s not easy, but there’s a good reason it’s not easy, so make use of the counselling sessions to make sure you’re comfortable doing this.

Ultimately, I trust Andrew and Jake as parents, both together and independently, to raise a healthy happy child.”

Millie: The egg donor

Millie is friends with Jake, the other half of the couple. “You can have my eggs,” she told him. “But I’m not keen to carry my biological child to then hand it over.”

As an egg donor, she needed to complete blood tests and counselling before starting hormones and an IVF cycle. Legally speaking, as soon as the egg is fertilised, it no longer belongs to the donor – instead, it becomes the future child of the person who receives and carries it, and that person’s partner.

Millie’s husband, Troy, was on board with her decision to donate her eggs, though he did find it strange to have to sign a document saying he was informed of the donor process. “Why is it still the case in

Q: How much does it cost?

A: One cycle of IVF can cost between $11,500 and $17,000, which includes average medication costs and excludes genetic screening costs, although you may be eligible for public funding for up to two cycles. The surrogate and the egg donor can only be recompensed for their expenses, such as travel or vitamins.

Q: Do we need to go before the Ethics Committee?

A: Surrogacy in New Zealand requires an application to the Ethics Committee on Assisted Reproductive Technology (ECART). The ECART meets six times a year and considers applications made by fertility clinics for certain assisted reproductive procedures. In essence, they decide whether the intended parents will be good parents, and whether the surrogate and the donor

2024?”, they wondered together, especially given that there doesn’t seem to be a corresponding requirement for sperm donors.

Millie’s advice for anyone wanting to donate eggs is open and honest communication, both with the health professionals as well as the people around you. “Everyone I know is very supportive of what I’m doing. Their reactions range from ‘I’ve considered it as well’, to ‘Wow, I could never [do that], you’re amazing’.”

At the end of the day, Millie donated her eggs because it felt right. “For me, it was about wanting to help. Personally, I wouldn’t be able to donate to someone unknown, but there is anonymous donation for those who prefer to go that route.”

If you’re donating anonymously, there is a law that requires you to be identifiable to the child and the child’s parents in future.

Andrew & Jake: The intended parents When Andrew and Jake started dating, they said all along that they wanted to have kids.

They got the idea for surrogacy from the social movement “Love From Your Dads”, an undertaking dedicated to changing the stigma against same-sex parents. It took a lot of time and effort to put it all together because the process wasn’t linear, and it contained so many moving parts.

Information was hard to find, even online,

understand their roles and rights. Once the committee has received and reviewed your application, it can make any of the following decisions: Approve, approve with conditions, defer, or decline the treatment.

Q: The current legal process in New Zealand is based on outdated laws.

Are we doing anything to change that?

A: There is a new bill called the Improving Arrangements for Surrogacy Bill. If passed, the bill will mean that the intending parents are automatically made the legal guardians of the child when they take custody, instead of having to go through the formal adoption process.

It will also require the intended parents to pay child support if they refuse to take custody of the child once it is born. Watch this space…

so engaging a good lawyer experienced in surrogacy issues helped a lot. “Time is against you, and fertility clinics have waiting lists,” Andrew says. “The sooner you start, the better.”

The process is costly because public funding for IVF is not available for same-sex male couples. With same-sex couples, there’s also the question of whose genetic material would be used. And for all couples or single people, it’s important to realise that the surrogacy journey doesn’t always guarantee success. You need to be emotionally resilient, as it’s impossible to prepare yourself for all the curveballs the universe will throw at you. Support from your loved ones is important – choose what you want to share and set their expectations to avoid well-meant but untimely questions.

How much will Andrew and Jake disclose to their child? “I’ll be a scrapbook dad,” Jake says, “scrapbooking the story of where they came from.” The guys will be open and honest, cultivating an environment of nothing to hide, but mindful of providing age-appropriate information. They will also share all the milestones with Nicola and Millie.

To the incredible people out there who already are – or who consider being – donors or surrogates, the guys have a message: “This is the biggest gift you could ever give.

It means the world. Thank you.”

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When

sickness strikes

Sick of being sick? Emma Michelsen, mum-of-two and founder and CEO of morning sickness supplement brand Daisy (drinkdaisy.co.nz), shares her experience with HG and the latest research into why it occurs.

Morning sickness is defined as nausea and vomiting that happens in the first few months of pregnancy. Despite the name, it can last all day and happen any time of day. Its most severe and excessive form is called hyperemesis gravidarum (HG) and leaves many of its sufferers needing round-the-clock care.

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F

rom royalty to Hollywood to excessive vomiting. By the time I gave birth to my son, I had clocked 20 hospital celebrities, morning sickness and hyperemesis gravidarum have admissions, given up my employment and had moved back in with my parents to received a star-studded spotlight.

Celebrities like Kate Middleton receive round-the-clock care. and Kelly Clarkson have not only shared Unfortunately, I’m not alone in what their pregnancy journeys, but also shed light I went through. Up to 90% of pregnant women experience some degree of nausea on the often-underestimated condition. or vomiting, often referred Their candidness has raised to as “morning sickness”. awareness and shown that Up to 90% of even the glitz of celebrity For some, it is relatively pregnant women mild, life isn’t a shield from the coming and going experience some during the first trimester challenges of pregnancy.

But despite the media degree of nausea without much fuss. But for the 10% of those who attention, we still see vast or vomiting, disparities in funding suffer from hyperemesis and research dedicated to gravidarum, it can be lifeoften referred women’s reproductive health. changing and traumatic, to as “morning and is the most common cause of hospitalisation in MY STORY sickness”. pregnancy. Morning sickness It hit me quietly at five weeks pregnant, stopping my caffeine in general causes 8.6 million hours in lost addiction in its tracks. I took this as gentle work and costs the global healthcare system encouragement to fuel my body with the US$5 billion per year. nutrients it needed to grow a healthy baby.

While morning sickness may not hinder By six weeks, I was onto my second hospital foetal development, it imposes a significant admission for intravenous fluids, and by impact on a person’s quality of life. In the eight weeks, I was admitted with suspected case of hyperemesis gravidarum, substantial appendicitis-turned-torn-muscles due evidence shows adverse outcomes when

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a baby in utero is not getting all it needs from its mother. Research highlights that the first 1000 days of a baby’s life is critical to its overall development, but it isn’t commonly known that this number includes the gestation period. Despite my wholesome intentions, my healthy happy son was made from anti-nausea medication, frozen Coke, and white bread!

*TO READ THE FULL STUDY, NATURE.COM/ARTICLES/S41586-023-06921-9

THE PREGNANCY STIGMA

Daisy Blackcurrant and Ginger Morning Relief, $24.50, drinkdaisy.co.nz

Frank Green Cup with Straw, $54.99, nz.frankgreen.com

The burden of nausea and vomiting in The guidelines provide crucial clarity on treating hyperemesis gravidarum. While pregnancy highlights the need for prompt the treatment approach remains unchanged, and effective treatment but despite this, surveys have shown that many women are there is now a more definitive message about denied medications for these conditions. the safety and effectiveness of first and Misleading beliefs dating back to the second-line anti-nausea medications. early 1900s have led to Historically, there has been some hesitance by damaging practices, like healthcare professionals to dismissing symptoms as If you suffer from purely psychological, leaving prescribe medication during HG and morning women feeling isolated and pregnancy, but the guidelines sickness, please always contact unsupported. confidently affirm the safety your GP or LMC and effectiveness of those before trying any drugs backed by extensive IS IT HORMONE-RELATED? treatment options. evidence and research. They A new study published in peer-reviewed science journal specifically clarify concerns Nature* reports that women around Ondansetron and Metoclopramide, which are both used for with abnormally high levels of the hormone GDF15, and who are sensitive to it, are at this purpose. And for severe hyperemesis gravidarum symptoms, the guidelines higher risk of hyperemesis gravidarum. recommend considering a combination GDF15 is produced by the placenta, but also other tissues when a woman is of medications, leveraging their varied not pregnant. This hormone is known to mechanisms for more effective relief. cause nausea, vomiting, and appetite and In the past, many hospitals have used the presence of ketones in urine to taste changes. The research suggests that determine the need for hospital admission hyperemesis gravidarum may be prevented by strategically raising GDF15 levels prior or the administration of IV fluids and to pregnancy. It also provides the first antiemetics. In some cases, ketone levels have suggestive evidence that an interaction even influenced decisions on discharging between certain maternal and foetal genes patients. But according to the new RCOG guidelines, “Ketonuria is not an indicator plays a role in recurrence risk, but larger of dehydration and should not be used to studies are needed. assess severity.”

NEW GUIDELINES Instead, the guidelines advocate for Earlier this year, The Royal College of more comprehensive assessment tools, Obstetricians and Gynaecologists (RCOG) like the PUQE score (Pregnancy-Unique published a long-awaited update to their Quantification of Emesis) and HELP (Hyperemesis Level Prediction), which guidelines for the treatment of nausea and vomiting in pregnancy and hyperemesis consider a range of symptoms including gravidarum. The comprehensive approach emotional wellbeing. They also encourage promises to improve care for hyperemesis doctors to use their clinical judgement gravidarum sufferers, and while this is to assess dehydration, moving away from based in the United Kingdom, we can hope a sole reliance on ketones.

The new guidelines acknowledge the to see this update have global reach and implementation. long-term effects of hyperemesis gravidarum

and its profound impact on women’s quality of life. For the first time, a strong emphasis is placed on assessing both physical and mental health during pregnancy, and healthcare professionals are encouraged to refer women for psychological support when needed.

Another crucial aspect now documented is the high risk of hyperemesis gravidarum recurrence in subsequent pregnancies.

This acknowledgment is vital for better preparation and support for women planning future pregnancies.

All of this ground-breaking research addresses significant issues in hyperemesis gravidarum care, and can contribute to a comprehensive new approach. This will ensure women receive the most effective and safe treatment, so they can hope to thrive and not just survive.

IT WILL ALWAYS BE WORTH IT

By the end of my pregnancy, I was a shadow of my former self. I had grieved the glowing pregnancy I so desperately wished for and had lost confidence in my body’s own ability to do as nature intended, becoming anxiously reliant on others. Despite my pregnancy struggles, I will always be thankful to have two happy, and healthy babies delivered at full-term. My dream is to raise awareness and funding to support the research in this space – for women to live in a world where complications cannot rob us of the joy of carrying life.

Emma Michelsen spent two years developing Morning Relief, a waterdissolvable formulation to support women suffering from morning sickness and hyperemesis gravidarum with science-backed ingredients for more info, visit drinkdaisy.co.nz

HG and morning sickness support Healthline (0800) 611 116 Hyperemesis Peer Support NZ @hyperemesisgravidarumaotearoa Pregnancy BUMP & baby

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Sleepy head

Having trouble sleeping? Sarah Boughtwood, Pregnancy and Postpartum Osteopath (sarahboughtwoodosteopath.co.nz), explains some causes and shares tips to get a better night’s sleep.

COMMON CAUSES OF SLEEP DISRUPTION IN PREGNANCY Reflux/heartburn

One of the most common struggles in pregnancy is reflux/heartburn. This occurs due to the physical compression of the stomach from the growing baby and the hormonal effects of oestrogen and progesterone on the sphincter/valve at the top of the stomach that keeps stomach acid down. These two factors allow stomach acid to go back up the oesophagus/throat, creating a burning sensation in your throat.

This can be exacerbated by lying down, which means it is particularly frustrating at night when you are trying to sleep.

Insomnia

Having trouble falling asleep, staying asleep, or waking early and being unable to go back to sleep can be very stressful and frustrating during pregnancy. Often, it doesn’t matter how tired you are, as your body won’t allow you to sleep. Up to 80% of pregnant women can struggle with insomnia, especially in the third trimester.

R e s t l e s s l e g s y n d r o m e (R L S )

RLS is when you have uncomfortable sensations in your legs which creates a constant urge to move them. Restless leg syndrome is typically worse during periods of rest – especially at night – and for some women, it can be debilitating. There are

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some studies linking low iron, folate and/ or low vitamin D levels with RLS, so ask your health practitioner if a blood test and supplement may be helpful. Another hypothesis links RLS with hormonal changes, especially in the third trimester.

Luckily, RLS resolves on its own after birth.

O ve r a c t i ve b l a d d e r (O B)

How annoying it is to wake frequently just to wee a tiny few drops, only to be woken again not long later to wee again?

Frequent urination in pregnancy is very common due to a variety of reasons, including bladder compression by the uterus and hormonal changes in pregnancy.

Pregnancy aches and pains

As a pregnancy osteopath, I commonly treat pregnant women at all stages of pregnancy with various aches and pains. Often these aches and pains are worse in the evening and can disrupt sleep. The most common aches and pains include hip pain, lower back pain, pelvic pain, rib pain, reflux, restless legs syndrome and general back pain.

Osteopathic treatment is aimed at reducing pain, improving joint mobility, improving blood flow and lymphatic drainage, and making pregnancy more enjoyable. We use hands-on, physical therapy techniques, treating the whole body to help the pregnant women adapt to pregnancy. Tailored advice with at-home tips and tricks make the world of difference so having a good night’s sleep can be prioritised again.

Sleep hygiene

Whilst often overlooked and scrolling social media in bed is very common, it can actually be detrimental to your sleep quality. During the two to three hours before bed, dim the lights and avoid screens, and try gentle stretching, a light evening walk, and reducing your fluid intake.

s tips and trick

TO TRY AT HOME

Evening walks In the afternoon and/or after dinner, try going for a 20-minute gentle walk. This is especially helpful for restless leg syndrome.

If you have a job that requires you to sit at a computer, try going for a 10-minute walk at lunchtime. Walking has so many health benefits, but in pregnancy, is it important to gently keep our bodies moving, improving muscle strength, blood flow, cardiovascular health, and so on.

Sleeping posture Side-sleeping is recommended in pregnancy, and I recommend you start this early into pregnancy to build a natural habit. Try using pillows to support areas of the body that are sore, such as a pillow between your knees, a pillow wedged behind your lower back, and lying on top of a pillow lengthwise under your belly and hip for rib and hip pain. If you suffer from reflux, try sleeping on your side but propped up to a 45-degree angle with a pillows, so gravity can help keep the stomach acid down.

Early dinner If you suffer from reflux, eat small meals throughout the day and eat dinner early (two to three hours before bed) to help prevent reflux after meals and when trying to sleep at night. Also take note of any foods that make your reflux worse and try eliminating them. You can also ask your health practitioner about medication that can help relieve your symptoms.

PHOTOGRAPHY BY RENEE ANDERSON OF TWIG & THISTLE PHOTOGRAPHY. THANKS TO MAMA KELSEY.

G

etting good, quality sleep in pregnancy is so important – yet, for many pregnant women, it is no easy task. There are a wide variety of reasons why sleeping in pregnancy can be difficult. Around 75% of pregnant women struggle with sleep at some stage during pregnancy, and this further increases to 98% in the third trimester. But it is not all doom and gloom; some simple changes can make the world of difference.

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Can I take antidepressants during pregnancy?

Mental health conditions are common among pregnant and postpartum women, but is it okay to take medication to treat them?

M

ental health conditions including anxiety and depression are among the most common disorders affecting women during pregnancy and after birth.

Evidence shows mental health conditions in pregnancy increase the risk of complications for the mother and baby.

However, there is some stigma around taking antidepressants while pregnant or breastfeeding. So how should you decide whether or not to take antidepressants during these periods?

MENTAL HEALTH IN PREGNANCY AND AFTER BIRTH

Untreated anxiety and depression in pregnancy have been linked to an increased risk of stillbirth, premature birth, low birth weight and low APGAR scores (a test done at birth to check the baby’s health in various domains).

In addition, anxiety or depression during pregnancy may lead to increased maternal weight gain, substance use, or smoking.

These lifestyle factors can also lead to complications for the baby.

Anxiety and depression during and after pregnancy can affect bonding between mother and baby, and hinder the child’s behavioural and emotional development.

Meanwhile, complications in the pregnancy may worsen mental health symptoms for the mother.

Not coping during pregnancy and especially after giving birth is demoralising and puts women at risk of self-harm.

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TREATMENT OPTIONS

Depending on the severity of symptoms, treatment options for women during and after pregnancy range from social and emotional support (for example, support groups) to psychological interventions (such as cognitive behavioural therapy) to medical treatments (for example, antidepressants).

Understandably, many women are reluctant to take medications during pregnancy and while breastfeeding due to concerns the drugs may cross over to the baby and cause complications.

Robust evidence about medication use in pregnancy is lacking. This may be due to ethical limitations around trialling medications in pregnant women.

The limited data available – mainly from observational studies on selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), the most commonly prescribed antidepressants during pregnancy – has mixed results.

While some studies have reported no noticeable increase in the risk of congenital malformations, evidence has shown a marginal rise in abnormalities such as heart defects (an extra two cases per 1,000 babies with SSRIs).

COLLABORATIVE DECISIONS

There is a delicate balance to strike between treating your mental health and preventing harm to the baby. To make well-informed decisions, an open discussion between you and specialised mental health care providers on the benefits and risks of starting or continuing antidepressants is essential.

Given poor mental health increases the risk of adverse outcomes for the baby, it may well be that taking antidepressants is the best way to protect the baby.

For women already taking antidepressants, it’s not usually necessary to stop using them during pregnancy.

Sudden cessation of antidepressants increases the risk of relapse.

Continuing breastfeeding on antidepressants is likely the best decision because of the low levels of drugs infants are exposed to in breast milk, the advantages of breastfeeding for the baby, and the risks of not taking antidepressants when indicated.

Recently revised guidelines on mental health care in the perinatal period (during pregnancy and after birth) warn health professionals against the dangers of failing to prescribe necessary medication.

These guidelines also recommend repeated screening for symptoms of

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“Anxiety and depression during and after pregnancy can affect bonding between mother and baby.”

tips for Staying mentally healthy during pregnancy

depression and anxiety for all women during the perinatal period. This is crucial to providing women with an early referral to perinatal mental health services if needed.

At present, mental health conditions during pregnancy and after birth often go undetected and untreated.

PUBLISHED WITH PERMISSION FROM THECONVERSATION.COM.

SUPPORTING PERINATAL MENTAL HEALTH

Mental illness in pregnancy is a significant public health problem. Screening is not always delivered effectively and women may be reluctant to engage due to stigma, time restraints, and lack of childcare or social support.

To address this, strategies need to be put in place to identify solutions that work best for you. This might include assistance with childcare, access to telehealth, visits from a perinatal mental health professional, or written information on medications.

Include your partner or a friend who may be best placed to support you in making complex decisions and choose an LMC that is respectful of individual needs and who provides compassionate care if and when you feel uncertain regarding mental health options.

By Alka Kothari, Associate Professor, Faculty of Medicine, The University of Queensland, Australia.

Get lots of sleep

Drink plenty of water

Perhaps the best way that you can look after your mind is to get lots and lots of rest. A good night’s sleep is essential for clearing your head and allowing yourself some time to relax.

While ensuring that you are well-hydrated is essential for the physical health of you and your bub, it will also do wonders for your head.

Drinking plenty of water is a great way to calm yourself, clear your head and boost your mood.

Eat a balanced diet Not getting the nutrients you need can negatively affect your mood, perhaps more than you realise. While sustaining a balanced diet is the first step towards maintaining your mental health, ensuring that you are switching up your recipes helps you avoid falling into a boring routine that negatively affects your attitude towards food.

Move your body Maintaining an exercise routine is also just as beneficial for your internal state as it is for your physical health. Getting out for a walk increases your physical fitness at the same time as it does your mental wellness.

Staying inside for days on end can negatively affect your mental health so doing daily exercise is a great way to refresh yourself and gain some clarity on what’s going on inside your head.

Try some meditation Meditation, particularly the kind that involves deep, concentrated breathing, is a fantastic way to clear your mind and focus on feeling some positive energy (for more, turn to page 40).

Keep communicating Ensuring that your routine involves catching up and communicating with the important people in your life is one of the best ways to look after your mind. Talking about what you are feeling is one of the simplest yet most effective ways that you can release some of that build-up of mental pressure. Finding someone to talk to, whether it’s a friend, your family, or a professional, will improve your mental state exponentially and will benefit you more than you realise.

If this story has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 0800 LIFELINE or free text HELP (4357). For other support services

127 turn to page Pregnancy BUMP & baby

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love!

nourishing, + holistic

Frankie Apothecary’s new blend of nourishing, botanical oils have been carefully selected for their nutrient and antioxidant profiles, to hydrate and support skin during pregnancy. Belly Beautiful works to fight stretch marks and scars, and supports skin as it expands, while also calming sensitive or itchy skin with the soothing, healing properties of wildcrafted Kawakawa.

A little TLC

Pregnancy relaxation must-haves

101 Ways To Find Calm by Rebecca Ballagh, $29,99, Allen & Unwin NZ • Lush Tisty Tosty Bath Bomb, $10, lush.com/nz/en • Love Tea Pregnancy Pyramid Tea Bags, AUD$15, lovetea.com.au • Angel Delivery Nurture Candle, $39, angeldelivery.co.nz • Waiheke Ceramics Tea Cup (green), $29, and Sand Landscape Cup (beige) from $30, waihekeceramics.co.nz • Frankie Apothecary Belly Beautiful, $49.90, frankieapothecary.co.nz Natures Touch Nause-Aid Pulse-Point, $16, Goodnight Pulse-Point, $17, and Harmony Pulse-Point, $19, naturestouch.co.nz • Forget Me Not Journals Soft Cover Notebook, from $49, forgetmenotjournals.com • Bennetts Feijoa Milk Chocolate Bar, $6, bennettschocolate.co.nz Kind Face Weighted Eye Mask (beige), $75, and Linen + Wisewool Sleep Mask (green), $69, kindface.co.nz

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COMPILED BY CHARLOTTE COWAN.

L OV E

Always read the label and use as directed. Douglas Pharmaceuticals Ltd, Auckland

W

e’ve all heard about pregnancy cravings.

We’ve seen the women on TV or social media send their significant other out for deepfried chocolate-covered pickle at 3am and then change their mind as soon as they have it. But now, especially if you’re in your second trimester, you’re probably living that cravings life!

WHY DO WE GET CRAVINGS?

Food cravings are common and, of course, vary widely from person to person. But what's the cause? It’s believed (although not completely known) that pregnancy cravings are a result of a combination of hormonal changes, emotional and psychological factors, and nutritional needs.

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ce

p la ct

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What your pregnancy food cravings might mean.

Th e p

Pickles and ice cream, stat!

p to

oke

yo u r p i c

kle

.

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drink up!

Do I need to add electrolytes?

by up to 50%, so hydration

But I don’t like water! What should I do?

needs to be on the top of

Try adding some orange

electrolytes to water

your daily must-dos! Water

or lemon wedges to your

during pregnancy is not

helps transport nutrients

water and make sure it’s icy

necessary, but if you’re

to the baby through the

cold. Treating yourself to

suffering from cramping,

placenta, supports the

a cute insulated drink bottle

leg pain, headaches,

During pregnancy, there are significant fluctuations in hormone levels, including oestrogen, progesterone, and human chorionic gonadotropin (hCG). These hormonal changes can affect your sense of taste and smell, making certain foods more appealing and others unappetising (suddenly hating coffee, anyone?).

replenishment of amniotic

with a straw might also help

swelling, or extreme

fluid, regulates body

motivate you to take sips

tiredness, add a packet

temperature, and reduces

throughout the day! If that’s

of electrolytes to your

swelling and fluid retention

still not working, other

water. Or, if you're on the

(among other things).

liquids such as caffeine-

run, an electrolyte sports

free tea, coconut water,

drink will also do the trick.

EMOTIONAL AND PSYCHOLOGICAL FACTORS:

During pregnancy, your

blood volume increases

HORMONAL CHANGES:

Heightened emotions and stress during pregnancy may lead to cravings for comfort food which can provide temporary relief from stress or anxiety.

H Y D R ATI O N A N D D E H Y D R ATI O N:

Sometimes, what seems like a food craving may actually be a sign that you’re thirsty! Dehydration can manifest as cravings for salty or savoury foods, so it’s essential to stay hydrated during pregnancy.

NUTRITIONAL NEEDS:

COMPILED BY CHARLOTTE COWAN.

Pregnancy places increased demands on your body for nutrients such as vitamins, minerals, and macronutrients like protein and carbohydrates.

Cravings may be your body’s way of asking for something specific.

In most cases, adding

How much?

or smoothies will do the

You should aim to drink

trick. Fruits and veges also

around 12 cups of water

contain water, so snack

Why do I only want to eat ice?

daily (that’s about 3 litres).

on some watermelon,

A condition known as pica,

This should be increased

strawberries, or cucumber

ice cravings may be related

if you are physically active

(all of which have high

to anaemia. Contact your

or are in a hot climate.

water content).

GP or LMC for a blood test.

WHAT DO MY CRAVINGS MEAN?

There are some instances where certain found in vegetables. Folate is crucial cravings may indicate a need for particular for preventing neural tube defects and nutrients, such as… supporting foetal development.

• Craving lollies: While cravings for lollies • Craving red meat: A craving for red and other sweet treats is common during meat could suggest a deficiency in iron.

Iron is essential for the production pregnancy and may not necessarily indicate of red blood cells and to prevent a specific nutrient deficiency, anaemia, which is common could suggest a need for It's important they during pregnancy due to quick energy. It’s important increased blood volume. to maintain a to keep your blood sugar stable the day; for more on Your GP can organise a blood balanced diet during test to check your iron levels. this, see pages 40-41. that includes • Craving salty foods: • Craving fruit: Craving fruit, especially citrus fruits such as is essential for the healthy a variety of Salt oranges or lemons, may indicate development of your baby’s foods. a need for vitamin C. Vitamin cells, tissues, and organs.

C is important for immune If you’re craving salt, try to function and the absorption of iron, choose options such as salted nuts or seeds, which is especially crucial during pregnancy. olives or legumes seasoned with herbs, You could also be dehydrated or deficient spices, and a pinch of salt. And lots of water! in folate.

EVERYTHING IN MODERATION • Craving dairy products: Cravings While it’s important to pay attention to for dairy products such as milk, cheese, or yoghurt might signal a need for calcium your cravings during pregnancy, it’s equally and/or iodine. Iodine is a crucial nutrient as important to maintain a balanced diet during pregnancy and plays a vital role in that includes a variety of nutrient-rich foods. the development of your baby’s brain and Your LMC or nutritionist can provide nervous system. more information on essential foods during • Craving leafy greens: Craving leafy pregnancy but there’s no harm in that extra greens like spinach or kale could suggest piece of chocolate cake every now and then. a need for folate, iron, or other nutrients You are growing a human, after all!

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Sugar high

B

lood sugar imbalances impact just about everything, but specifically female hormones. They negatively impact the reproductive hormones in women (and men too), and this will impact an array of symptoms, including challenges with fertility or an increased risk of health complications during pregnancy.

WHAT IS BLOOD SUGAR?

Before we get into how blood sugar impacts fertility and pregnancy, let me explain how blood sugar works.

When we eat sugar or carbohydrates, it breaks down into blood sugar. The more carbohydrates you eat, the more blood sugar you’ll have.

When blood sugar levels go up, our pancreas secretes a hormone called insulin.

Insulin is like a little ferry boat – it comes into your bloodstream, picks up the blood sugar, and transports it out of your blood, into your cells. It drops it off into three main locations – your liver cells, muscle cells, and fat cells. Once insulin moves blood sugar out of your blood, blood sugar levels then start to drop.

The more starches and sugars you eat, the higher your blood sugar will go, and the more insulin your pancreas releases. High blood sugar is often followed by a steep drop in blood sugar, which can bring on cravings, low energy, fatigue, feelings of anxiety, shakiness, irritability, and it will also make morning sickness worse if you’re pregnant.

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Often when blood sugar drops, this causes people to reach for a carbohydrate or sugar-rich snack, the result of which causes another spike in blood sugar, followed by a crash, and the roller coaster of high and low blood sugar begins.

BLOOD SUGAR AND FERTILIT Y HORMONE IMBAL ANCES

When it comes to fertility, blood sugar imbalances can lead to issues for both women and men as it can disrupt the delicate balance of reproductive hormones, such as insulin, oestrogen, and testosterone.

For example, in polycystic ovary syndrome (PCOS) – which is the leading cause of infertility – insulin resistance leads to elevated insulin levels, which in turn can increase androgen production (male hormones like testosterone) by the ovaries.

This hormonal imbalance can interfere with ovulation and menstrual regularity, affecting fertility.

The same effect can happen to women who don’t have PCOS but have insulin resistance, as consistently having high blood sugar levels can disrupt the regularity of ovulation. Balancing blood sugar levels can help improve ovulation frequency and increase the chances of conception.

INFL AMMATION

Balancing blood sugar levels can also help with lowering inflammation levels. Imbalanced blood sugar levels can contribute to chronic low-grade inflammation in the body. Inflammation can affect fertility by disrupting ovarian function, impairing egg quality, and interfering with implantation.

By stabilising blood sugar levels, inflammation can be reduced, which may also help to improve fertility outcomes.

PHOTOGRAPHY BY RIA RAWIRI OF PHOTOGRAPHY BY RIA.

Registered Clinical Nutritionist Natalie Brady (nataliebrady. co.nz) explains the connection between blood sugar balance, fertility, and pregnancy.

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When it comes to fertility, blood sugar imbalances can lead to issues for both women and men as it can disrupt the delicate balance of reproductive hormones such as insulin, oestrogen, and testosterone.

EGG QUALIT Y

Keeping blood sugar levels in check also helps to improve egg quality, as high blood sugar levels can lead to the formation of advanced glycation end products (AGEs), which are compounds that can damage proteins in the body, including those found in eggs. This can impair egg quality and decrease fertility.

METABOLIC HE ALTH

When adopting a healthy lifestyle which is supportive of blood sugar, you also help to support metabolic health, which helps with maintaining a healthy weight. Obesity and excess weight can negatively impact fertility by disrupting hormonal balance, interfering with ovulation, and increasing the risk of conditions like PCOS and insulin resistance.

As you can see, balancing blood sugar levels – which can be done through diet, exercise, and lifestyle changes – can positively impact fertility by regulating hormones, promoting regular ovulation, reducing inflammation, improving egg quality, and managing weight.

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BLOOD SUGAR AND PREGNANCY

When it comes to pregnancy, balancing blood sugar levels is crucial for supporting a healthy pregnancy for a number of reasons.

GESTATIONAL DIABETES

It can help to reduce the risk of gestational diabetes, which is a type of diabetes that develops during pregnancy and affects around 20% of women. It is characterised by high blood sugar levels that can pose risks to both the mother and the baby.

By maintaining balanced blood sugar levels before and during pregnancy, the risk of developing gestational diabetes can be reduced.

METABOLIC CHANGES

There are also many metabolic changes going on inside your body during pregnancy which can affect blood sugar. This causes pregnant women to become more insulin resistant, which is another reason why eating in a way that is supportive of blood sugar can help you maintain a healthy pregnancy and help support the health of your baby.

Blood sugar matters, and should be a priority when building a balanced meal when pregnant. High blood sugar in pregnancy is known to cause birth defects, and can impact your baby’s growth, development, and metabolic health.

Research has shown babies exposed to high blood sugar during pregnancy can have an altered metabolism for life.

Being exposed to high blood sugar can “turn on” the genes that predispose your baby to obesity, diabetes, and heart disease.

Research has shown even mildly elevated blood sugar during pregnancy has been linked to serious health problems. So it is something to take seriously.

Sugar-balancing smoothie Starting your day with a sufficient amount of protein is also a great way to keep blood sugar levels in check. Here is a delicious and nutritious blood sugar supportive smoothie to enjoy.

• 30 grams of vanilla protein • 1 tbsp almond or peanut butter • 1 to 2 tbsp chia seeds • ½ cup blueberries • 1 large handful of spinach • 1 to 1½ cups unsweetened almond milk Simply add all ingredients into a blender and blend until smooth. Enjoy!

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Is my blood sugar out of balance?

Here are some signs your blood sugar may be out of whack…

• Increased hunger and food cravings • Fluctuations in energy levels, particularly in the afternoon • Mood changes • Irritability • Increased thirst • Frequent urination • Difficulty concentrating • Trouble shifting weight • Feeling weak or tired • Elevated HBA1C levels • Hormonal imbalances, such as PCOS

PREGNANCY COMPLICATIONS

Balancing blood sugar also helps to minimise other pregnancy complications, such as reducing the risk of preeclampsia (high blood pressure during pregnancy), preterm birth, and macrosomia (large birth weight).

Not only that, high blood sugar levels can also increase the mother’s risk of developing complications such as infections, urinary tract infections (UTIs), and excessive weight gain during pregnancy.

By keeping blood sugar levels stable, these risks can be minimised, promoting overall maternal health and well-being.

If you’d like more information about how to support a healthy pregnancy, check out my online prenatal nutrition course to optimise your health and your baby's health at nataliebrady.co.nz

SO WHAT CAN YOU DO TO BALANCE YOUR BLOOD SUGAR LEVELS?

The easiest way to keep blood sugar levels within a normal range is to make sure you add protein, fibre and fat onto every plate of food you make. Here’s why…

• Protein: Protein helps to keep blood sugar levels steady. When consumed alone, protein does not generate a rise in blood sugar. Protein is also very satiating, and it helps to switch off our hunger hormones.

Good protein options include meat, poultry, fish, eggs, beans, and legumes. Nuts and seeds also contain small amounts of protein.

• Fibre: Fibre helps to slow down the absorption of nutrients into our bloodstream, specifically glucose. My favourite fibre-rich foods are non-starchy vegetables, but other great sources include chia seeds, flaxseeds, and psyllium husk.

When it comes to fruit, they also contain some fibre. Vegetables and fruit are best eaten in their whole state.

• Fat: Fats have the least impact on blood sugar. When consumed alone, fats have no effect on circulating blood sugar. Fats are the most satiating nutrient. They also help to slow down the absorption of your meal, which helps to avoid steep glucose spikes. Good fat sources include avocado, nuts, seeds, olive oil, avocado oil, coconut products, Greek yoghurt, cheese, olives, nut butters, and seed butters.

Outside of food, there are other factors that can impact blood sugar levels, such as exercise, sleep, stress, caffeine, and supplements. Exercise helps to suck up excess glucose from your bloodstream and dumps it into your muscle cells. Weight and resistance training is particularly beneficial for keeping blood sugar levels in check.

Natalie is a Registered Clinical Nutritionist and holistic health blogger with a Diploma in Holistic Nutrition and a certificate in Quantum Reflex Analysis (Kinesiology).

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Meditation station Why just 20 minutes of meditation a day can work wonders, according to Claire Robbie, founder of The School of Modern Meditation (wearesomm.co).

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regnancy is a peak human experience; one that tests us to the nth degree. There’s an amplification of different hormones affecting not just our bodies but also our minds and emotions. The physical changes and sleep challenges, the anticipation of birth, not to mention the fact that after pregnancy and birth you’re now responsible for the life of another human being… Whoa!

To understand why a meditation practice is helpful before, during, and after pregnancy, it’s a good idea to get an idea of what meditation really is, and what it is not.

Interoception is what I call the meditation “superpower”. It’s a neurophysiological process that’s basically the capacity to tune into our inner landscape of sensation, emotion, and thought. When this part of our brain comes online, it has an immediate regulating effect on the nervous system.

WHAT IS MEDITATION?

MEDITATION AND PREGNANCY

To say “I meditate” is basically like saying When it comes to pregnancy, there isn’t one “I do sport.” There are different types, thing on that list of benefits above that isn’t techniques, and lineages, most of which deeply and profoundly useful. have been influenced by yogic and Buddhist In pregnancy you sleep so much less, traditions. Yes, meditation is old, so let’s make the sleep of a much but it has stood the test of time.

Meditation better quality. As hormones rage Modern medicine and through your body, meditation isn’t a silver can help you release, process, neuroscience are only just starting to give us the data around bullet, but it and have some compassion for the unlimited benefits of is a way to what you are experiencing. a meditation practice.

As you become more and more take care of self-aware and practise the skill For the purposes of this article, let’s say that meditation is a seated of interoception, you are learning ourselves practice in which you close your sustainably a skill that you can carry into eyes and shift your attention the birthing process, and into and deeply. motherhood. inwards to a focal point for an The most important thing extended period of time, ideally to really “get” is that consistency is key when around 20 minutes every day. it comes to meditation. By this I mean, you THE BENEFITS OF MEDITATION have to practise every day to really start to There are some overarching benefits see shifts and experience the benefits. of meditation that transcend the style OPEN MONITORING MEDITATION or type you might practice, and these are: For more than 10 years now, I have practised • Better quality of sleep; an “Open Monitoring” style of meditation.

• Improved processing of stress and strong emotions i.e. a more regulated This is a practice that doesn’t require nervous system; guidance, a mantra (word that we repeat • The cultivation of “interoception”. internally), or any kind of focus point.

This type of meditation is 100% about surrender and allowing whatever you are experiencing to be there.

I have found it transformational, not just in my relationships and work, but also during each of my pregnancies and births.

MY OWN PREGNANCY AND BIRTH EXPERIENCE

My last pregnancy was incredibly difficult emotionally and physically. First of all, because it was a complete shock at 43, but also because it was at the height of the COVID pandemic, I developed gestational diabetes, and I was starting up the meditation centre I had just founded.

We also bought our first home and moved one week before I gave birth!

A daily meditation practice didn’t make everything perfect, but helped me cope with the intensity of that period, and in coping I became more resilient.

The capacity to tune into my body and relax into sensation while I was giving birth was one of the factors that allowed me have another unmedicated natural birth. I also experienced postnatal depression with both of my two children, and meditation helped me navigate through that journey.

Meditation isn’t a silver bullet, but it is a way to take care of ourselves sustainably and deeply. The absolute magic, mystery, and power of what our bodies are capable of and the self-awareness, restoration, and deepening of the relationship we have with ourselves are only just the beginning of what this practice has given me.

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Incline hip bridge

>> Exercise 101 Seven must-know tips for staying active during pregnancy from Renée Norman and Jenna Smith – founders and trainers at She Moves NZ (she-moves.co.nz).

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eeling overwhelmed when it comes to pregnancy and exercise? That’s completely understandable! Amid the whirlwind of pregnancy, staying active (in most cases) is really important, so let’s explore seven tips to conquer pregnancy fitness without the overwhelm.

1.

SHIFT YOUR FOCUS TO MAINTAIN RATHER THAN GAIN

During pregnancy, it’s time to think of yourself as being in a maintenance phase, rather than a time of achieving a new goal or personal best. It’s not the time to try anything new, it’s also a time where you’ll need to avoid exercise activities that could result in falling, such as water-skiing, horse-riding, or motocross.

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2.

TIPS FOR EXERCISING DURING MORNING SICKNESS

Morning sickness affects a significant portion of pregnant women, with estimates ranging from 70% to 80%. If this is you, it’s so important to listen to your body and adjust your exercise routine accordingly.

• Choose the right time of day: Think about the time of day you feel your best. Is there a window in your day where you feel good?

If so, do your exercise then.

• Avoid exercising immediately after eating, as this can increase nausea.

• Drink water before, during, and after exercise to prevent dehydration and reduce nausea.

• If you feel too nauseous while exercising, stop, take a break, and try again later.

• Know that in the majority of cases morning sickness will stop by 12-14 weeks.

If you need to really reduce your exercise to get through the first trimester, be kind to yourself, choose gentle forms of movement like walking or yoga, and know it likely won’t last for the duration of pregnancy.

note

For more information about postpartum pelvic floor exercises, head to page 107.

3.

MODIFY MOVEMENT FROM 16 WEEKS

If you feel good, you can continue your normal exercise routine up until 16 weeks.

At 16 weeks it’s recommended that pregnancy modifications take place – this is to protect the core, and minimise abdominal separation and pelvic floor issues.

At this point we recommend shifting to low-impact exercise. This is a controversial topic in the fitness world, and while some women continue to run and do high-impact training, in our opinion, concentrating on low-impact exercise is the best option.

Engaging in activities such as running and jumping adds extra strain to the pelvic floor, especially when it’s already bearing the weight of a growing baby. There is little to gain in continuing with high-impact and more chance of risk to the pelvic floor.

4.

COMMENCE A PELVIC FLOOR PROGRAMME

It’s recommended that pelvic floor muscle training should commence on a daily basis to reduce the risk of urinary incontinence. Think of your baby growing from a chia seed all the way to a melon and all that downward pressure! It’s also extremely important that you learn to relax your pelvic floor, especially if you intend on having a vaginal delivery.

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friendly exercises!

INCLINE HIP BRIDGE

5.

BE MINDFUL OF YOUR HEART RATE

Working out to a perceived rate of exertion of seven out of 10 is recommended, with one being sitting down and chilling, and 10 being unable to possibly push any harder.

We always say it’s a good idea to be able to maintain a conversation – so while you are exercising, check in with yourself. Could you hold a conversation? If so, great! You’re working in a safe zone. If you’re struggling to chat, it’s a sign to pull back a little. You want to be able to talk, but not quite sing! If you are able to sing, then you are not working hard enough. It’s about finding that middle ground where you still get a good workout, but don’t push it too hard.

STRAIGHT LEG DONKE Y KICK S

1. Starting position: Start on all fours with wrists under shoulders and knees under hips.

Extend one leg back, keeping spine stable and hips square.

2. Exhale, zip up through your core, and lift your extended leg to hip height, as shown at left.

3. Repeat, inhaling on the downward phase and exhaling on the upward phase.

4. Keep a neutral spine, hips squared, leg nice and long, head lifted.

5. Repeat 15-20 reps on each side.

Straight Leg Donkey Kicks

1. Starting position: Kneel facing a sturdy incline surface (such as a bench or countertop) with your feet hip-width apart.

Note that the higher the incline, the easier the exercise will be to perform, and the less pressure it will place on your core.

2. Hand placement: Place your hands slightly wider than shoulder-width apart.

3. Take a natural breath in, and on the downward phase, slowly lower your chest towards the incline surface by bending your elbows.

4. Exhale and zip up your core as you push through your palms, extending your arms to return to the starting position.

5. Complete 10 reps.

1. Starting position: Lie on your side with legs stacked, elbow under shoulder.

2. Take a natural breath in and on an exhale, engage your core, lift hips into a side plank and perform a "clam shell", opening your top knee away from your bottom knee.

3. On an inhale breath, close the top knee and return to the starting position.

4. Complete 10 reps on each side.

Incline Press-up

1. Starting position: Sit on the floor with your back against the couch. Place your elbows on the couch behind you.

2. Bend your knees and place your feet flat on the floor, hip-width apart.

3. Move your feet so that when you lift your hips, your legs form a 90-degree angle at the knees.

4. On an exhale breath, zip up through the core, press through your heels, and lift your hips upward, pushing against the couch and into your elbows.

5. Squeeze your glutes at the top of the movement. A good idea can be to have a pillow (as shown at left) and give it a squeeze at the top to work your inner thighs also.

6. On an inhale breath, lower your hips back down to the floor.

7. Repeat for 10 reps.

INCLINE PRESS-UP

Side Plank Clam Shell

Try these p r e g n a n c y -

SIDE PL ANK CL AM SHELL

During pregnancy, it’s time to think of yourself as being in a maintenance phase, rather than a time of achieving a new goal or personal best.

6.

STAY COOL

It’s important to monitor your temperature during exercise. In pregnancy, a woman’s internal temperature is higher than her external temperature, and her baby has no way of cooling down. Prolonged periods of raised temperature may cause harm, so be mindful of keeping cool, work out in an area with lots of air flow, and keep hydrated.

7.

NOT ALL PERSONAL TRAINERS OR ONLINE PROGRAMMES ARE CREATED EQUAL

In New Zealand, to gain your personal trainer certification, you do not need to study pre/postpartum exercise and 90% of trainers have not done the additional study.

Therefore, they have very little understanding on how to train a pregnant women. Please do your research when signing up to programmes or on to a bootcamp/fitness class. Ask questions and never assume your trainer is qualified in this area.

You deserve to be in safe hands while you are growing a tiny human. Each time you prioritise exercise during pregnancy, it’s a moment to be proud of yourself – because while it may not always be easy, it’s always worth it, benefiting both you and your little one.

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CHERRY AND CHOCOL ATE PE ANUT BUT TER SUNDAE page 53

This is the quickest pudding – the peanut and chocolate sauce is so easy and requires no skill. Peanut butter, chocolate, and cherr y together is a favourite.

Ser ve the sundaes in tall frosted glasses (pop them in the freezer for 10 minutes) with long sundae spoons for digging right to the bottom of the glass. Any unused chocolate sauce keeps well in the fridge and can be reheated at a moment’s notice (or eaten cold by the spoonful).

HOME GOURMET Wholesome go-to dishes that are simple to make and bursting with f lavour.

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yum

This one is a take on the traditionally Chinese spring onion oil, but with a hit of chilli and turmeric, and sit s on top of a thick lime yoghur t.

You can buy really good thick Greek yoghurt from the supermarket or your local shop. If your yoghurt is not thick (and by that I mean spoonable, almost the consistenc y of clotted cream), then you can strain the yoghurt yourself. Hang it in a piece of muslin or a clean thin tea towel over a mixing bowl overnight or for as long as you have to thicken it. It’s fine out of the fridge overnight.

FRIZZLED SPRING ONION AND OLIVE OIL DIP page 50

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Frizzled SPRING ONION AND OLIVE OIL DIP SERVES 4 • 1 bunch of spring onions, trimmed • 150ml extra virgin olive oil • 1 teaspoon Turkish chilli flakes or ½ teaspoon chilli flakes • 1 teaspoon caster sugar • ½ teaspoon ground turmeric • 150g thick strained Greek yoghurt • Zest and juice of 2 unwaxed limes

1. Prep and frizzle the spring onions Trim then thinly slice both the white and green parts of 1 bunch of spring onions, then put them into a small pan with 100ml olive oil and 1 teaspoon Turkish chilli flakes and cook over a low-medium heat until you can hear everything begin to sizzle. Cook until the edges of the spring onions are beginning to brown and crisp. Add 1 teaspoon sugar and ½ teaspoon ground turmeric and cook for another minute.

2. Cool and season Take the pan off the heat and allow the oil to cool in the pan. Once cool, season with salt and pepper.

3. Season the yoghurt and serve Mix 150g thick strained Greek yoghurt with the juice and zest of 2 limes, season well with sea salt, then put into a shallow bowl or on a plate. Swirl in the oil and serve with warm bread or raw veg for dipping.

Another place to stick your pickle!

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CHEESE AND pickle ROAST POTATOES WITH CHILLI-DRESSED LEAVES SERVES 4 • 1kg new potatoes, scrubbed clean • 10 cornichons (35g), roughly chopped, plus 100ml of the brine from the jar • 100ml extra virgin olive oil • 3 fresh red chillies • Juice of 1 unwaxed lemon • 100g Comte cheese or vegan mature cheddar-style cheese • 1 head of radicchio or other bitter lettuce

1. Preheat the oven and parboil the potatoes Preheat the oven to 200°C/180°C fan. Bring a large pan of salted water to the boil, add 1kg scrubbed new potatoes and cook for 10-20 minutes, depending on their size, until they are just cooked. Drain and leave the potatoes to steam dry in a colander.

2. Season and roast the potatoes Tip the potatoes into a roasting tin, toss them with 50ml cornichon brine, 2 tablespoons olive oil and salt and pepper, then roast for 15 minutes. Remove the tin from the oven and, using a potato masher, squish the potatoes until they crack and expose some of the soft, fluffy insides. Pour over another 2 tablespoons olive oil and return to the oven for another 30-40 minutes, turning the potatoes halfway, until golden and crispy.

yum A tray of these for dinner is just about the best thing I can think of to eat. Squashed crisp-edged potatoes, tossed and baked in pickle brine to give them a subtle but important chip-shop-vinegar feeling.

3. Make the chilli dressing Prick 3 fresh red chillies with the tip of a sharp knife – this stops them exploding when they are cooked. Using a pair of metal tongs, hold the chillies one at a time over a gas flame until they’re blackened and blistered all over. If you don’t have a gas hob you can do this in a dry frying pan.

Once they are all blistered, put them in a small bowl, cover and leave for 15 minutes. This way they will steam in their own heat and the skins will peel off easily.

Once cool enough to handle, peel the chillies, open them up and scrape out all the seeds. Discard the seeds and finely chop the flesh.

Put in a mixing bowl with the remaining olive oil (70ml) and the juice of 1 unwaxed lemon and mix well. Season to taste with sea salt and black pepper.

4. Finish the potatoes and dress the leaves Once the potatoes are golden and crisp, add 50ml of cornichon brine while the potatoes are still hot, then toss with 10 roughly chopped cornichons and a generous grating of Comte or vegan Cheddar. Tear 1 head of radicchio into bite-sized pieces, season with salt and toss in the chilli dressing.

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CRISPY GARLIC EGG-FRIED rice

SERVES 2 GENEROUSLY, OR 4 AS PART OF A MEAL

• 500g cooked jasmine or basmati rice • 1 cucumber • 150g radishes, leaves trimmed • 1 tablespoon crispy chilli oil or chilli crisp • 3 tablespoons soy sauce or tamari • 1 teaspoon maple syrup • Zest and juice of 1 unwaxed lime • 8 cloves of garlic, peeled and very thinly sliced (use a mandoline if you have one) • 3 tablespoons neutral oil (such as groundnut) • 2 tablespoons sesame seeds • 4 free-range eggs • 1 bunch of spring onions, very finely sliced

1. Cook the rice if needed If you don’t have leftover rice, cook around 170g rice now, to give 500g cooked rice.

2. Make the cucumber and radish salad With a rolling pin gently smack 1 cucumber and 150g trimmed radishes so they split but don’t break up completely. Chop the cucumber into 2cm pieces and put them into a serving bowl with the radishes. Add 1 tablespoon crispy chilli oil, 2 tablespoons soy sauce, 1 teaspoon maple syrup and the zest and juice of 1 unwaxed lime and mix until everything is coated in the dressing.

3. Make the crispy garlic Thinly slice 8 peeled cloves of garlic with a knife or very carefully with a mandoline. Put 3 tablespoons of neutral oil into a small frying pan or saucepan and add the sliced garlic and 2 tablespoons sesame seeds.

Put the pan over a medium-low heat and allow everything to cook slowly for 3-5 minutes until the garlic is very lightly golden and crisp. Be careful here to cook until just golden.

Taking the garlic too far or too brown will make it bitter, so don’t be tempted to cook it on a high heat. Drain the garlic and seeds with a sieve (keeping the oil), then leave to cool on some kitchen paper.

4. Beat the eggs and fry the rice Beat 4 eggs well with another tablespoon of soy sauce. Put the reserved oil in a large wok or frying pan over a high heat, then, once hot, add 500g cooked jasmine or basmati rice and spread it out in an even layer to heat through for a minute. Now stir until all the rice is coated in a little oil.

5. Add the eggs Push most of the rice to one side of the pan. Add the beaten egg to the empty side, stir the egg quickly to fry and partly cook it, then stir it into the rice and cook for another minute or two.

Take off the heat.

6. Serve the rice Mix a quarter of the crispy garlic and sesame seeds into the cucumber and radish salad. Divide the rice between four bowls and put some of the salad on the side of each. Finish the rice with the remaining crispy garlic and sesame, and top with a bunch of very finely sliced spring onions.

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yum Crispy garlic adds texture and sweet toast y flavour to the rice. Garlic crisped in oil like this will improve just about any meal, so once you have mastered it you can top all your meals with it. The rice comes with an easy little smacked cucumber and radish salad which lift s and adds crunch. if you wanted to you could add some shredded greens or blanched frozen peas as well. If you are vegan you could add some crumbled soft tofu instead of the eggs.

CHERRY AND CHOCOLATE PEANUT BUTTER sundae SERVES 4

• 400g fresh or frozen cherries • 3 tablespoons maple syrup • 2 tablespoons smooth peanut butter • 1 tablespoon cocoa powder • A big pinch of flaky sea salt • 8 scoops vanilla ice cream or frozen yoghurt, about 1 x 400ml tub (vegan if needed)

1. Prepare and cook the cherries If you have 400g fresh cherries, congratulate yourself, then stone and halve them and set aside. If you are using frozen cherries, put them into a small saucepan with 1 tablespoon maple syrup and cook on a medium­low heat until they are warm and soft, still with a little liquid. Remember the liquid will thicken as they cool.

2. Make the peanut and chocolate sauce In a bowl, whisk together 2 tablespoons smooth peanut butter with 2 tablespoons maple syrup (or 3 tablespoons if using fresh cherries), 1 tablespoon cocoa powder and a big pinch of flaky sea salt. You might need to add a little water here if your peanut butter is thick.

PHOTOGRAPHY BY AARON MCLEAN PHOTOGRAPHY 2023.

3. Make the sundaes Get yourself 4 glasses or bowls, scoop some cherries into the bottom of each glass, then add a scoop of ice cream, the peanut chocolate sauce, more cherries, another scoop of ice cream and the rest of the cherries and chocolate sauce.

Edited extract from Easy Wins by Anna Jones, RRP $59.99, HarperCollins.

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You’ve changed Pregnancy nose isn’t the only weird change your body may go through when you’re pregnant.

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here are certain changes people expect to experience when they get pregnant. Whether that’s unconventional food cravings, a “glowing” complexion or morning sickness.

But some of the changes the body goes through during pregnancy can be a tad more unconventional.

Recently, many women have taken to social media to share photos and videos of their noses before and during pregnancy.

The trend, being termed “pregnancy nose”, has highlighted how some women’s noses swell and change shape during pregnancy.

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It’s not known how common this is as everyone’s hormone levels are different and everyone responds differently to changes in them. The change may also be more noticeable for some women.

This change is nothing to worry about and is only temporary, typically resolving six weeks after birth.

The reason it happens is due to the significant increase in hormone levels that happens during pregnancy – particularly because of the increase in oestrogen, which relaxes the blood vessels in all the body’s tissues. This allows more blood into the

nose’s tissues, causing it to expand and change shape – looking larger and puffier.

These hormonal changes can also cause a runny and stuffy nose (pregnancy rhinitis) and nosebleeds, which affects one in five pregnant women.

But pregnancy nose isn’t the only change your body may go through when you’re expecting.

BIGGER HEART

The heart undergoes a number of changes during pregnancy in order to accommodate the baby’s growth.

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“The heart develops thicker muscles and changes size during pregnancy.” ensure there’s enough oxygen getting to the baby to support its development.

PUBLISHED WITH PERMISSION FROM THECONVERSATION.COM

CHANGES IN SKIN COLOUR

Just as the abdominal organs are squished and moved to make room for the growing foetus, the heart is pushed higher up in the chest as a result.

Not only that, the heart also develops thicker muscles and changes size during pregnancy. This is because the heart has to work a lot harder at this time – beating up to eight times more per minute compared to pre-pregnancy – in order to pump the additional volume of blood around the body and to the baby. In some cases, the amount of blood a woman circulates throughout her body doubles during pregnancy. This helps

Most of us have heard of the pregnancy “glow”, which causes some women’s skin complexion to appear brighter. But some women experience a condition known as melasma, which causes the skin around the eyes, nose, chin and upper lip to darken.

It’s actually an extremely common condition, affecting around 75% of pregnant women – but is more typical in women with darker complexions. These changes will vary between women, and will typically disappear shortly after birth or when they stop breastfeeding.

The exact cause of melasma in pregnancy is unknown, but increases in oestrogen and progesterone are thought to be involved.

The skin surrounding the nipple (called the areola) can also become darker during pregnancy. Again, it’s not entirely certain why this happens, but it could be to help newborn babies identify the nipple for feeding.

Newborns aren’t able to fully distinguish colour – only things that are very saturated and red – and they can’t see much more than about 30cm from their face. They actually distinguish light and dark much better, so the contrast of the dark areola compared the light surrounding skin may help them.

For most women, their areola may remain slightly darker permanently after pregnancy.

HAIR GROWTH (AND LOSS)

For many women, their hair grows and looks healthier during pregnancy thanks to the increase in oestrogen in the body, which causes the hair follicles to remain in growth mode.

Unfortunately, these hormone changes affect all hair follicles – not just those on the head. This means that hair growth can

also happen in less desirable place during pregnancy – including the upper lip, upper thighs, abdomen, and back, this disappears after pregnancy.

Some women also find that they lose their hair instead during pregnancy. This process is typically caused by the shock of pregnancy on the body, causing the hairs to go into “resting” phase, then shed. This usually subsides as the pregnancy progresses.

Hair loss can also happen after giving birth, due to the drop in oestrogen levels as hormones return to normal. Hair loss usually peaks around four months after birth. In most cases, hair grows back and returns to normal.

ORAL HEALTH CHANGES

Pregnancy can cause many changes in oral health. Increases in oestrogen and progesterone can make the gums more susceptible to bleeding, infection, and damage. In fact, approximately 70% of pregnant women experience gingivitis.

Teeth are also at an increased risk of damage and cavities during pregnancy, especially if a woman has experienced morning sickness.

This is because stomach acid can dissolve the protective lining on teeth.

Teeth may also feel wobbly during pregnancy. This is due to both oestrogen levels, alongside increases in a hormone called relaxin. It causes all ligaments in the body to become more flexible during pregnancy in order to aid in childbirth.

But while this is useful in some parts of the body (such as the pelvis), relaxin also affects the ligament anchoring each individual tooth in place, causing teeth to feel loose.

In some rare cases, tooth loss can happen.

It isn’t clear exactly how many pregnant women experience tooth loss. Typically, if a woman loses any teeth during pregnancy it’s due to years of poor oral health – not just the changes that happen to oral health during pregnancy.

While some of the changes you’ll experience during pregnancy are less than ideal, they’re all designed to ensure the baby develops properly in the womb. And luckily, most of these changes are only temporary – disappearing shortly after birth.

By Adam Taylor, Professor and Director of the Clinical Anatomy Learning Centre at Lancaster University.

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Twinning Growing two gorgeous humans? Multiples NZ (multiples.org.nz) explains what to expect on your journey of double the excitement, double the anticipation, and double the love!

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earing “it’s twins!” at your first ultrasound can bring up all the feelings – excitement, shock, joy, overwhelm. You went in expecting to see one heartbeat and surprise, there are two! Don’t panic, mama – having twins can be daunting but it’s also a unique and thrilling ride.

THE TWIN FACTOR

Twins make up about 2% of all pregnancies in New Zealand – 75% of these will be fraternal and 25% identical.

• Fraternal twins (dichorionic) occur when two eggs are released by the mother, at about the same time, and are fertilised by two different sperm.

• Identical twins (monochorionic) are the result of a single fertilised egg dividing in two, resulting in two babies who share about 90% of their genes.

“Chorionic” relates to how the amniotic membranes are set up, and is diagnosed by ultrasound.

YOUR LMC

Multiple pregnancy is considered high-risk; therefore your midwife or GP must recommend you be referred to an obstetrician, and the responsibility for your care will be transferred to that specialist.

You should be referred to an obstetrician as soon as possible, so that potential complications can be considered and assessed – so do not accept delays! This is particularly important if you are having identical twins as, complications such as Twin-to-Twin Transfusion Syndrome can start as early as 16 weeks.

It’s understandable that if you have

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It’s important to keep an open mind about the pregnancy and birth, and to always bear in mind that the health professionals providing your maternity care have the same objective: Healthy babies and a healthy mama.

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did you know? of all pregnancies in New Zealand will be twins – 75% of these will be fraternal and 25% identical.

PHOTOGRAPHY BY TAMMY HALL PHOTOGRAPHY. THANKS TO BABIES CHARLOTTE & FRANKIE.

already found an LMC that you feel comfortable with, you may feel upset about your care being transferred to a specialist. But it’s important to keep an open mind about the pregnancy and birth, and to always bear in mind that the health professionals providing your maternity care, whether they are obstetricians or midwives, have the same objective: Healthy babies and a healthy mama.

pre-eclampsia – which occur in singleton pregnancies, but are more common in twin pregnancies. The most common complication in multiple pregnancy is the risk of premature labour and pre-term birth.

DELIVERING TWINS

How you deliver your twins (either vaginally or via C-section) depends on various factors, including the position of the babies, their gestational age, and your own health.

TTTS Vaginal delivery is possible for many twin Twin-to-Twin Transfusion Syndrome pregnancies, especially if both babies are in (TTTS) is a rare complication of identical a head-down position (vertex presentation). twin pregnancies. It occurs However, C-section may when there is an imbalance in recommended in certain Warning be blood flow between the twins situations, such as if the babies signs for are in a breech position or if through the shared placenta, and the lives of both twins there are other complications.

TTTS can be endangered. In a twin Labour and delivery of twins Between 16 to 28 weeks, watch for pregnancy affected by TTTS, may progress differently than one twin (the donor twin) sends a sudden increase for singleton pregnancies. in the size of your a disproportionate amount In some cases, labour may start abdomen and shiny of blood to the other twin spontaneously, while in others, red skin, with a feeling (the recipient twin) through labour may be induced or of it being stretched or blood vessel connections scheduled for medical reasons. tight. If this happens, in the placenta. As a result, During labour, continuous your LMC needs to the recipient twin receives foetal monitoring is typically arrange an urgent scan to assess what too much blood and may performed to assess the is happening. develop excessive amniotic wellbeing of both babies. fluid (polyhydramnios), The birthing team, which putting pressure on the uterus and causing may include obstetricians, midwives, nurses, discomfort for the mother. Meanwhile, and neonatal specialists, will be prepared the donor twin may not receive enough to manage any potential complications blood, leading to reduced amniotic fluid that may arise during the birth of twins. (oligohydramnios) and poor growth or development.

PREMATURE BIRTH About one-quarter of all twin pregnancies Multiples NZ Medical Advisor, Dr Emma share a placenta, so if you have a scan that Parry, defines preterm birth as “when birth shows you are having twins, it is important occurs after 20 weeks’ gestation and up to to find out if they are sharing a placenta 36 weeks and 6 days”. Babies born between before 16 weeks’ gestation. After this, scans 24 and 28 weeks are known as extremely are not accurate enough to diagnose whether premature. the placenta is shared.

The average pregnancy length for twins is 37 weeks – this means a lot of twins (40%) OTHER COMPLICATIONS are premature.

Twin pregnancies have increased risks for The good news is that the medical care both the mother and the babies. There is an pre-term babies receive is constantly evolving increased risk of anaemia, vaginal bleeding, and improving, which is resulting in high gestational diabetes mellitus (GDM), and survival rates for these babies.

Recent research indicates that there is very little difference in the survival rates of premature multiples, compared to singletons of the same gestational age.

Survival to discharge for premature babies is about 79% at 24 to 26 weeks, and 98% at 30 to 32 weeks – and these parameters are being constantly moved back, with the survival of extremely premature babies.

THE FIRST YEAR

Managing newborn twins is all about the general logistics of caring for two newborn babies. Like all logistical exercises, it will probably be easier than you think, and some good planning will really help prepare you for those early days!

Before your multiples are born, simplify your lifestyle and household, and sort out your finances so that you can reduce financial stress, and be able to afford some help with childcare, if you need it.

The first year with multiples mostly revolves around establishing routines for feeding and sleeping – very similar to singleton babies, but only more so!

Most mums of twins agree that one routine for all the babies works best for everyone – so all babies are fed and put to sleep at the same time.

The key suggestions for managing your new babies, from other experienced parents of multiples, are: • To take life one day at a time.

• For mums to look after themselves – eating well (especially if you are breastfeeding), sit down and relax when you can, and get some time out.

• To organise lots of help from friends and family, and childcare organisations, before the babies are born.

• For parents to look after each other, nurture their relationship, and work as a team – although multiples are hard work, they are a great opportunity for partners to build a really strong bond!

ort help and supp

If you need support during your pregnancy, you can phone your local multiple birth club (multiples.org.nz/about-clubs/) or Multiples NZ (0800 4 TWINS) for advice. If you are having problems finding a specialist in a timely fashion, your local hospital must provide care (your GP can refer you to the required service) or you can contact the Ministry of Health to find a local LMC: phone 0800 MUM 2 BE (0800 686 223).

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Karolyn 37 WEEKS PREGNANT

“I loved learning about all the changes taking place within my own body under this armour of love (the bump). To be honest, I was always a bit freaked out by baby bumps and being able to see/feel a baby move from outside.

But when it came to my own, I was fascinated with it and just loved understanding the whole physiological aspect of it all.”

--PHOTOGR APHED AT SUMNER BEACH, CHRISTCHURCH,

BY DANIELLE HARDY OF INVIEW PHOTOGR APHY.

GREAT EXPECTATIONS FIVE GORGEOUS KIWI WOMEN SHARE THEIR UNIQUE AND POWERFUL PREGNANCY JOURNEYS. 58

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Zoe

32 WEEKS PREGNANT

“I wasn’t enjoying how I felt about the changes within my body throughout pregnancy, so I thought a maternity shoot would be a good way to feel confident and to be able to look back at my pregnancy journey. I am so glad I got a shoot done because I have very few photos of my bump due to my level of confidence throughout my pregnancy. I am finally at the other end of it and realise how special pregnancy and a woman’s body is.”

--PHOTOGR APHED AT BETHELLS BEACH, AUCKL AND,

BY NATALIA BOWERS OF LITTLE LOVELY PHOTOGR APHY.

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Jennifer 30 WEEKS PREGNANT

“I loved going for beach walks – just me and bump – and taking my time. My partner would join when he could, which was a lovely time for just us while the other kids were at school.”

--PHOTOGR APHED AT THE PHOTOGR APHER’S HOME

BY JESSIE L ALICH OF SOMEDAY PHOTOGR APHY.

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Ingrid

36 WEEKS PREGNANT

“Photographers have the great ability of capturing all the little moments, the details, and the special memories – pregnancy being no different. I spent a lot of time in awe of my body. Loving it, but being frustrated at the same time around not being able to do things I once did, or wear things that I used to, or adapting to changes.

It’s nice to be able to look back at some beautiful memories during this time and still be in awe.”

--PHOTOGR APHED AT INGRID’S HOME

BY CL AIRE DEWSON PHOTOGR APHY.

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Tahlia

31 WEEKS PREGNANT

“Having a beautiful bump has made me the most confident I’ve ever been in my life! I love that it’s the first home for our girl – it feels very empowering.

I now have amazing images that I will cherish for years to come.”

--PHOTOGR APHED AT THE PHOTOGR APHER'S STUDIO BY TONI L ARSEN PHOTOGR APHY.

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SHOW US YOUR BUMP

and be in to win!

PEPI CARE PACK AGE WORTH OVER $450!

BUMP&baby is running a year-long search for beautiful pregnancy photos.

Send in yours and you’ll not only be in to win amazing prizes, we’ll also publish our 10 winning photos across two issues of BUMP&baby magazine!

See details for the prizes and enter at bumpandbaby.co.nz/win SPONSORED BY 64

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BUMP&baby’s am azingweek-by-week

WEEK 14 In the 1950s, Swedish photojournalist Lennart Nilsson embarked on 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 crystalclear 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.

BUMP&baby readers have the chance to see these fascinating, thought-provoking images in our week-to-week pregnancy guide at bumpandbaby.co.nz/week-by-week.

Measuring around four centimetres, your baby’s facial muscles have learnt to squint, frown and grimace.

Their kidneys are processing urine and they can even try to suck their thumb.

WEEK 33

Now the size of a pineapple, at 33 weeks your baby is able to show the rooting reflex by turning their head and opening their mouth to respond to stimulation of the cheek. They are also practising sucking and swallowing.

WEEK 27

At 27 weeks, baby is now the size of a cauliflower head and spends 10-20% of the time taking practise breaths (of amniotic fluid), an important exercise to strengthen the lungs.

Scan to see images

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Get to

work

Tiffany Brown explores how to balance the demands of a career with the uncertainties of pregnancy.

W

ith women making up nearly half of New Zealand’s paid workforce since the 1980s, it’s likely most of us will work during our pregnancy. What impact will pregnancy have on your job? The response depends on what kind of work you do, and what sort of pregnancy you experience.

IS IT SAFE TO WORK WHILE PREGNANT?

This depends on both your job and your state of health when you become pregnant, and on any pregnancy complications.

Most pregnant women find they can continue employment with only minor adjustments to their routine.

RISK Y BUSINESS

The riskiest jobs you can do while pregnant involve: • Exposure to chemicals, radiation, or other hazardous substances or materials; • Carrying or lifting heavy loads; • Working with animals; • Requiring long periods of standing or climbing; • In environments of extreme heat or cold; • Exposure to loud noises or vibrations, such as from heavy machinery; • Requiring you to work more than 40 hours per week.

If your work involves any of the above, consider your own situation carefully.

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Seek support from your partner or another advocate, and arrange to talk to your employer about how the risks can be mitigated. It may be that you could move into a different position for the duration of your pregnancy, or work from home as an alternative. Employers are required to take care of all their employees – including pregnant ones – with appropriate health and safety provisions, and these can change as a result of pregnancy. Consult a workplace relations specialist if you have ongoing concerns.

THE NIGHT SHIFT

Because melatonin – which involves our circadian rhythms – plays a role in the

protection of the placenta, shift work may be more risky during pregnancy than routine daylight work. Recent research indicates that women who work two or more night shifts a week, or on rotating shifts, may be at higher risk of miscarriage or other adverse pregnancy outcomes than those on a regular day shift.

WORKING THROUGH YOUR PREGNANCY SYMPTOMS

Many of us will suffer from nausea, fatigue, thirst, frequent urination, and back pain during our pregnancies. Experiencing them at work, rather than in the comfort of your own home, can add a layer of frustration or discomfort.

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Be prepared; working while pregnant may not be a picnic for you, but the more you can plan ways to get through, the faster the time will go.

Silver lining: Many women feel the distraction of work can take their mind off these low-grade but persistent pregnancy troubles.

• Try to identify and avoid nausea triggers so you're not left running to the loo every few minutes. Moderate snacking on bland foods throughout the day can help, as can sipping on ginger tea or ginger beer. Fresh air can make a world of difference, avoid stuffy spaces and use your breaks to get outside or near to a window.

• If fatigue is the pregnancy symptom you’re struggling with – and the boss is likely to frown at you napping at your work station – try to compensate by maximising sleep during non-work hours. Experts recommend at least 8.5 to 9.5 hours of sleep a night during pregnancy. Remember, growing a new human is tiring work!

• Back or pelvic pain is another pregnancy doozy many of us struggle with. These pains arise as your clever body produces hormones, which loosen ligaments and joints. Standing for long periods may worsen your pain, as may sitting. Take breaks as often as possible, move your body, and stretch out your muscles.

Wear supportive shoes, pay attention to your posture, and always bend your knees to lift with your lower body instead of your back. Ice packs or heating pads may help, as could a pregnancy support belt.

• Keep up hydration by making sure you have access to fresh water near your working spot, or bring some to work with you. You should drink around two litres of water per day when pregnant.

• On the flip side, you’ll need to pee more often. If you’re not in a job where you can get easy access to the bathroom, consider asking if you can take shorter, more frequent breaks to compensate. Holding on can weaken your bladder and lead to urinary tract infections.

• While you’re under no obligation to tell your employer or colleagues about your pregnancy until you’re ready to, you may find they are more sympathetic when they know.

WHEN YOU CAN’T WORK AT ALL

Some complications prompt a recommendation to stop work completely during pregnancy. A less drastic approach is to cut back on working hours, or make other changes to how you do your job. Medical professionals balance the risks of adverse pregnancy outcomes with the potential stress and anxiety it could cause to restrict your normal activities. These may include: • Pre-term labour, including women expecting twins or multiples; • High blood pressure, or a risk of pre-eclampsia; • A placenta praevia diagnosis; • A cervical insufficiency, or history of pre-term birth, stillbirth, or late-stage miscarriage; • If your baby isn’t growing correctly, or if you have intrauterine growth restriction (abnormally small foetal weight).

WHEN TO STOP WORK When to start your maternity leave is a real “piece of string” decision.

Every pregnancy is different, but when making your decision, you might consider the following: How easy has the pregnancy been for you, particularly in your working environment? It might be worth much more than a few weeks’ salary to give yourself time to rest and relax before the baby comes.

How ready are you to give birth?

Many of us bury ourselves in our work as a distraction from the reality of what’s to come. Carving out some time to calmly read up about the journey ahead might be what you need.

Is your working environment set up to cater to your needs well? If you work flexible hours that allow you to rest, if you have a low-stress workload, plenty of accommodation for appointments, or an enjoyable group of work colleagues, perhaps you’ll feel more comfortable working closer to your due date.

Are you a driven person that hates sitting around at the best of times? If that’s the case, and it’s safe to do so, keep working as long as you can.

Think about you and your needs.

The fact is, pretty soon you’re going to come a distant second to this new little human for a while. If you think you’ll miss binge-watching the latest series, taking long baths, getting a pedicure, having hour-long phone conversations, or just gazing out the window for uninterrupted stretches of time, finish up work well ahead and indulge, while you can.

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tips

PRIYA'S STORY

for returning to work

Many women will return to work shortly after giving birth – whether by choice or necessity – and this can come with its own unique challenges. Here are some tips to help make the transition smoother for you and your family.

Communicate with your employer

Before returning to work, have open and honest conversations with your employer about your needs and expectations. Discuss any accommodations or adjustments that may be necessary to support your transition back to work, such as flexible hours, remote work options, or a gradual return schedule.

Plan ahead

Take the time to plan and organise your childcare arrangements well in advance of your return to work. Research and visit potential childcare providers, discuss schedules and routines with family members or caregivers, and make any necessary arrangements for transportation and logistics. Remember that childcare can be expensive but there are support options available; visit workandincome.govt.nz/ products/a-z-benefits/childcare-subsidy for more info.

Ease back into work

Consider starting back at work gradually, if possible, to give yourself time to adjust and ease back into your routine. This could involve working part-time hours initially or having a flexible schedule for the first few weeks back.

Set realistic expectations

Be realistic about what you can accomplish during your first few weeks back at work. Give yourself permission to adjust gradually and prioritise tasks based on their importance and urgency and if you need help, reach out to your employers or workmates for support.

Be kind to yourself

Remember that it’s normal to feel a range of emotions as you adjust to being back at work after giving birth. Give yourself grace and compassion during this time, and don’t be too hard on yourself if things don’t go exactly as planned. It’s common to get the mum guilts, but there are ways to stay connected with your baby while you’re at work, such as video calls, photos, or messages from your caregiver. Taking breaks to check in with your baby can help ease any feelings of separation anxiety and provide reassurance throughout the day.

And remember, you’re working to create the best life for your family!

+ PREGNANT EMPLOYEE RIGHTS

Legal protections mean pregnant women cannot be fired because they’re pregnant or applying for parental leave.

Pregnant women are entitled to 10 days’ special leave for midwife or specialist appointments. Pregnant employees and their partners are also afforded special rights in terms of leave entitlements and pay, and employers are not legally allowed to contravene other rights. Find out more about your parental leave entitlements and rights at employment.govt.nz/leave-and-holidays/parental-leave.

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Corporate mum-to-be Priya Sharma had a difficult time with her first trimester.

She experienced nausea but was unaware she was pregnant for the first eight weeks.

At first, she kept her pregnancy a secret from her employer and colleagues at the multinational company where she works as a manager in financial assurance.

“I was initially quite stressed about announcing my pregnancy during our busy season at work, because at that point in time I was working in a team where nobody else had experienced a pregnancy or had children,” says Priya.

With an average workplace age of 25 years, Priya felt her coworkers wouldn’t understand the added pressure of working while pregnant, and she felt may be an expectation for her to push through and “show up”, even into the evenings, which could take a physical and mental toll.

When she did come clean and tell her senior management, however, she found them to be “unwaveringly supportive”.

“I definitely realised that pregnancy in the workplace is a part of life and people need to accept that whether they like it or not,” she says. “So I changed my attitude; I became very unapologetic about my boundaries and what I could handle, because this way my teams could get the best of me.”

Priya prioritised only doing what she thought was healthy, and worked hard during the day so she could get the sleep she needed at night.

Priya worked up until her due date and she and her partner welcomed their first child in February. Upon returning to work, Priya says she continued to be confident in setting boundaries from the get-go.

“It’s not like we are taking a back seat at all just because we have a baby at home,” she says. “Our contribution and performance at work should be seen as equal to someone who needs to leave early to attend an event or social sports game."

Priya says easing into the corporate setting by starting with part-time hours is important for a lot of women returning to work after maternity leave because it is less of a shock to the system.

“It allows us to figure out the balance as we go,” she says. “Having these conversations openly and in advance with our teams at work are important to help set the tone and expectations so our teams can best support us on our return.”

Choose Kindercare for heart-centred childcare We’re here to support your whānau and walk alongside you in these preschool years.

We believe that a strong partnership with families is vital in creating a sense of community and belonging for your child.

We would love to support you and your child through their early years with aroha, ako, fun and play.

Visit us and experience the Kindercare difference today.

kindercare.co.nz

Every family

is different

Ho

w

luc

ky

to

ha

ve

tw

om

um

mi

es .

Tips and advice on navigating parenthood as a queer parent.

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PHOTOGRAPHY BY MICHAELA PENNY OF HARPER + WILLOW PHOTOGRAPHY. THANKS TO MAMAS CHANÉ AND CHANTÉ AND BABY OLIVIA.

OWNING OUR NARRATIVE

As LGBTQI+ people, we are used to coming out. We have to do it on a daily basis at the supermarket checkout, the GP, to delivery people and taxi drivers. It’s a pain – but what it has done is steeled us for unnecessarily intimate conversations with strangers. And once you have kids, you’ll find yourself having a lot of them.

We like to pre-empt questions about our families by loudly and proudly asserting ourselves before anyone has to ask. There’s a sense of power in owning the narrative in this way, and it protects us from being caught off-guard. This might mean at the newborn baby drop-in, when all the other mums have obviously postpartum bodies, you say, “Hi, I’m Lotte – it was actually my wife who gave birth.” Stu tries to slip into conversation as quickly as he can that he and John adopted the children: “We know that the moment they meet us and see we are two gay dads, they will start wondering the ‘how’ of it all. I’d rather just be straight (first time for everything!) and answer the inevitable question. We are proud to have adopted and we teach the kids to be proud of being adoptees; there is no shame in it.

That doesn’t mean we want to immediately share intimate details of our children’s life story (that’s our kids’ choice to do if they wish when older; it’s their story), but at least we have addressed the pink and sparkly elephant in the room.”

We’ve also found it useful to be really clear with new people about what our children call us. To the uninitiated, there’s little to differentiate Dad from Daddy or Mummy from Mama, but for our kids, their two parents’ names are as different as “Mum” and “Dad”.

Something we’ve both been really aware of is providing consistency for our children in the language used about their family from all of their caregivers. A conversation with a child-minder, schoolteachers, or grandparents so that they know Lotte would never refer to her daughter’s “father” but rather her “donor” goes a long way. Likewise, in Stu’s case, explaining why we don’t use the phrase “taken from” in terms of adoption is hugely important. Once we’ve passed on this kind of information, ideally in a face-to-face conversation, followed up with an email or text message, we’re not afraid to pull people up on it when they don’t get it right. It can be easy to shrug off mistakes in that very English way of not wanting to make a fuss.

But it matters.

TEACHING PRIDE

Something that’s a lot harder to control is what happens when our children encounter other children who ask them about their family. And perhaps they do so in a way that feels confrontational. There’s going to be a time in their lives, and hopefully we can put it off as long as possible, when they are made to feel different. All we can hope is that we’ve given them enough confidence and equipped them with enough tools to be able to talk about their families with pride.

Do

“There’s going to be a time in their lives, and hopefully we can put it off as long as possible, when they are made to feel different.”

• Be honest with your children.

• Talk to them about their family and how it was made even before they can talk back.

• Say the words “gay” or “trans” – we have been conditioned to see these words as “inappropriate” for children to know about or say. This is the sad legacy of living in a world that centres on heterosexuality.

• Tell them that every family is different – some have two dads, one mum... Some even have a mum and a dad.

• Be ready to answer deep questions at awkward times.

• Smile, laugh, be playful and affectionate as you have these discussions.

• Let your child know they can ask you anything, at any time. Nothing is awkward or difficult to discuss, so nothing is off-limits.

Don’t • Pretend you’re just like everyone else.

We’ve talked to our children about their origin stories from before they could talk back to us. This means there’s no big reveal moment where they find something out about themselves. They grow up always knowing. When she was two, Lotte’s daughter was fond of telling people that she had “two mummies and a donut”. She meant donor. Having a healthy sense of humour, as with so much of parenting, is key!

Of course, at age three a child can’t understand the nuances of her conception, but she can grasp the basics, like whose tummy she was in. As queer parents we are constantly having to come out throughout our child’s life – every new school or club or holiday, it never stops being something we have to at the very least acknowledge and most often explain to others. But the way we discuss it within the family gets inevitably to a deeper level. As parents of older children, you may have spoken to them about their origin story throughout their life, but that’s not to say new questions or desires might arise. It’s a conversation that will go on long into your child’s adult life and it will shift and change as they do and your relationship with them evolves too.

• Tell a child they are extra special because of the way they came into your world.

• Put things off until they’re old enough to understand.

• Whisper or avoid words like “adoption” or “donor” – these are not dirty words.

• Say anything that isn’t true.

• Expect these conversations to happen in a linear fashion.

Extract from The Queer Parent by Lotte Jeffs & Stu Oakley, Bluebird, $44.99.

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What’s

in a name?

Love the name Prince, King, or Duke for your baby? Sorry, but they’re a no-no. Here’s why…

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hoosing a name for your baby is one of the most exciting things during pregnancy. With so many to choose from, it can be overwhelming, but for some parents, their chosen name is simply not allowed.

A ROYAL NO

Te Tari Taiwhenua Department of Internal Affairs shared the names most declined by the Registrar-General of Births, Deaths and Marriages in 2023. Leading the pack was Prince, taking over from King, which had taken out the top spot for the previous 13 years. Some other names declined include Princess, Royal, Sovereign, and Queen.

PHOTOGRAPHY BY RIA RAWIRI OF PHOTOGRAPHY BY RIA. THANKS TO MAMA JUDEA AND BABY ECHO.

THE RULES

So why were these names declined?

In Aotearoa New Zealand there are guidelines in place to ensure that names don’t cause offence, are a reasonable length, and don’t represent an official title or rank.

The law allows the Registrar-General of Births, Deaths and Marriages to decline registration of names which fail to comply with those guidelines. The RegistrarGeneral reviews the names that don’t meet the criteria on a case-by-case basis.

Whether a name is offensive or not is a judgement call, and each name is considered in its entirety to determine whether it meets statutory criteria.

“Names are a gift, and they are an important part of a person’s identity,” said the Registrar-General of Births, Deaths and Marriages, Russell Burnard. “We encourage parents to think about their child and how they might feel about their name later in life.

“When a name is in review, we give parents the opportunity to present the reasoning for the name. Then we make a decision, considering the balance of how the name may be perceived by the public, and the Department’s obligations under the law.”

Tips from the Registrar-General • Don’t use official titles or ranks, or names that resemble one.

• Don’t use numeric characters or symbols, like a backslash or a punctuation mark.

• Avoid names that might be considered offensive.

• Limit the name to 70 characters, including spaces.

Top 10 declined names in 2023 1. Prince 2. Bishop 3. III 4. King 5. Major

6. Royal 7. Messiah 8. Princess 9. Prynce 10. Rogue

2023 top names in

GIRLS Charlotte Amelia Isla Olivia Harper Willow Lily Ava Ella Hazel

BOYS Noah Oliver Luca Jack Leo Theodore George Henry Charlie Hudson

In Aotearoa New Zealand there are guidelines in place to ensure that names don’t cause offence, are a reasonable length, and don’t represent an official title or rank.

REGISTERING PĒPI

Remember to register pēpi online at smartstart.services.govt.nz/ register-my-baby Every baby born in New Zealand must be registered, usually within two months of being born (with some exceptions).

It’s free to register your baby, but there is a cost to order a copy of their birth certificate, if you want one. You can also apply for their IRD number at the same time.

For more information about registering your baby – for example, if you’re not in a relationship with the other parent – visit govt.nz/browse/family-and-whanau/ having-a-baby/registering-a-new-babyand-getting-a-birth-certificate

NEED NAMING HELP?

Baby name consultant Sonya Prior ( @thebbnamer) shares her thoughts on 2023’s naming trends and her predictions for 2024.

2023 Last year was the year of quiet luxury, which was very much reflected in naming.

Florence, Penelope, Iris, Arabella, and Clara all reached the top 100, while names such as Brooks, Wilder, and Rafferty entered the charts.

Biblical boy names, such as Micah, Gabriel, Solomon, and Abraham, grew in popularity, with no recorded declines, and Noah reached the number one spot.

But the trend I was most surprised by was in rise of millennial-esque names across both genders. Scott, Morgan, Zack, and Kieran entered the charts for 2023, and Bella, Zara, and Madison made strong moves from the top 100 into the top 50.

2024 Eclectic grandpa/grandma style has already cemented itself as a strong trend within fashion for 2024, which is an easy one to see traverse into naming. With vintage names such as Theodore (#6), Arthur (#11), Hazel (#10), and Evelyn (#12), already popular in the top 100, I expect to see more unlikely nursery-to-nursing-home names enter the charts. Think Ruth, Pearl, Agnes, Hector, Gordon, and Winston.

One of my biggest requests is gentle, soft-sounding names, particularly for boys, so I expect to see this category grow.

Established favourites include Leo, Arlo, Beau, and Billy climbing 37 spots to break into the top 100. Gentle boy names I think could prove popular include Ellis, Gene, and Owen.

What is a baby name consultant?

A baby name consultant brings an outside perspective to one of the biggest initial choices parents make – what to name their child.

Working with the information expectant parents share, consultants distil information, collate data and pull together a tailored recommendation that suits their preferences, cultural backgrounds, familial traditions, and so forth.

It’s a fun yet odd little niche that I like to think of as naming SparkNotes for parents!

If you need some baby name help, contact Sonya at thebbnamer@gmail.com.

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Pr

e gnanc y is a w il d r

ide .

Dream on Having some crazy pregnancy dreams? Here’s what they could mean!

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eird dreams interrupting your sleep? Many mums-to-be experience fascinating, frightening, and just plain freaky dreams during pregnancy. And because you’re waking frequently at night to pee, you’re able to recall your dreams more vividly than ever.

Blame those wild hormones if you like, fuelling your emotions and intensifying your dreams, but your pregnancy dreams may also be a way of coming to terms with your new role as a parent. Whether it’s a change in sleep patterns or fluctuating hormones, experts believe there are a number of dream themes that pregnant women experience.

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FORGETTING THE BABY

Dreams about losing your baby or forgetting your baby somewhere are very common, and quite possibly linked to your fear of not being ready to be a parent, or anxiety you may be feeling related to the responsibility of being a parent. You may feel unprepared to look after a baby and fearful about the unknown.

WATER

Water is seen as a powerful theme, and could symbolise a feeling of new beginnings and new life, or a feeling of cleansing. Or it may be a representation of concerns you have about labour and childbirth. Watery dreams

such as surfing in the ocean, floating in a pool, or puddles of rain may be a reflection of your physical thoughts and feelings of your baby moving in amniotic fluid or your waters breaking during labour.

JOURNEYS AND TRAVELLING

Both exhilarating and terrifying, these dreams could be about travelling through a maze of tunnels or corridors, visiting a foreign country, or driving on an endless road. They may represent feelings of being out of control, a fear of the unknown, or your reluctance to confront the unknown, an emotion typically experienced towards the end of your pregnancy.

life+rela tionships

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how to

banish bad

Journal it Kowhai & Co Notes to Mindfulness Journal in Linen, $74.95, kowhaiandco.nz

Magic Of I Ether Dream Journal, $60, loftwaiheke.co.nz

Papinelle Dream Discover Journal, $19.95, papinelle.co.nz

UNUSUAL CREATURES

Dreams that feature bizarre or fantastical creatures that don’t exist in the waking world could symbolise the emergence of new aspects of yourself, the unknown journey of pregnancy and motherhood, or the transformative nature of the pregnancy experience.

LOSING TEETH

PUTTING THE BABY BACK

Mums-to-be may be concerned about the health of their baby as it grows and develops during pregnancy. Dreaming about giving birth and then putting the baby back could be a reflection of your desire to check that your baby is developing normally, and then placing your baby back in your uterus to continue growing.

Dreams about crumbling teeth, rotten teeth, or losing teeth are symbolic of losing control.

This may be your feelings of stress about how pregnancy will affect your work or your relationship with your partner. Or they may symbolise fears or concerns about losing your sense of identity or individuality as you transitions into the role of a parent.

CHEATING PARTNER

FEELING TRAPPED

As you near the end of your pregnancy, these dreams are common and can include both positive and negative birth experiences.

Anxiety about birth is natural, and your dreams are a normal part of your mind’s preparation for this life-changing experience.

Nightmarish dreams about being trapped or locked in may simply be your feelings of helplessness and vulnerability, your lack of control, and a feeling that you will no longer have the freedom to do what you want.

Dreaming of infidelity is usually a sign that you feel vulnerable or insecure. As your body changes, you might not always feel attractive, creating worry about whether your partner still desires you or you'll ever get your pre-pregnancy body back.

CHILDBIRTH AND LABOUR

dreams Establish a relaxing bedtime routine. Soak in a warm bath, read a good book or practice relaxation techniques. But whatever you choose to do, stay away from screens!

Try to manage stress and anxiety. The thought of giving birth or looking after a newborn can be overwhelming and pregnancy can cause stress on your body. Try to reduce some of your stress and anxiety by practicing mindfulness, yoga, or progressive muscle relaxation to help promote better sleep.

Limit exposure to negative content. Avoid watching or reading disturbing or upsetting content, especially before bedtime.

This includes news stories, horror movies, or violent or intense television shows – especially about pregnancy or birth – that may linger in your subconscious mind and influence your dreams.

Address underlying issues.

If you’re experiencing frequent or recurring bad dreams that are interfering with your daily life, consider seeking support from a mental health professional.

Keep a dream journal.

Keep a journal by your bedside and write down any dreams you remember when you wake up. This can help you track recurring themes or patterns in your dreams and learn about their underlying meanings. It can also provide a sense of closure by allowing you to process and release any lingering emotions from the dream.

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nook

Nursery

Sweet touch-and-feel books to stimulate little minds.

Animals (MiniTouch), $16.99, Allen & Unwin Your baby can explore different textures and hear new words with this supercute mini touch-and-feel board book.

Baby Touch: Hugs and Kisses, $23, Ladybird With bright colours and adorable pictures, this book is full of touch-and-feel patches to explore and ends with a peekaboo mirror finale!

Touchy feely They’re fun and sweet to read but why are touch-and-feel books good for your baby’s development?

Sensory stimulation Mister Seahorse’s Ocean Friends by Eric Carle, $20, Penguin Eric Carle’s colourful art sets each fun scene for these classic characters to come to life in a special story for little hands.

Touch-and-feel books engage the senses by offering various textures, materials, and surfaces to explore. As babies touch the different textures, they receive tactile feedback, which helps stimulate their sense of touch and enhance sensory processing skills.

Cognitive development Interacting with touch-and-feel books encourages cognitive development by promoting exploration, curiosity, and problem-solving skills. Babies learn to differentiate between textures, shapes, and colours, which helps build early cognitive concepts, such as spatial awareness.

That’s Not My T. Rex...

by Fiona Watt, $15.99, Usborne Join five friendly T. Rex as they stomp through the pages of this dinosaur-themed addition to this popular touch-and-feel book series.

Turning pages, grasping objects, and exploring different textures all contribute to the development of fine motor control and hand-eye coordination.

What Does Penguin Like? $16.99, Igloo Books The velvety softness of Penguin’s fur is a tactile element that invites your little one to engage their sense of touch, enhancing their sensory development in a fun way.

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Multi-sensory experience As babies explore the textures in the book, they also look at the accompanying illustrations and listen to your voice, creating a rich and engaging sensory experience for them to enjoy.

COMPILED BY CHARLOTTE COWAN.

Fine motor skills

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The urge to nest As you come to the end of your pregnancy, you may experience the curious phenomenon known as “nesting”. Here’s what it’s all about.

Dazz All Purpose Cleaning Spray Starter, $9.50, dazz.co.nz

Cleanz Essential Kit, $39, cleanz.co.nz

Figgy & Co Kitchen & Bathroom DIY pack, $60, figgyandco.co.nz

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MANIFESTATIONS OF NESTING

Nesting can manifest in a variety of ways, but common nesting behaviours include: Cleaning frenzy: You may feel an overwhelming urge to scrub, dust, and sanitise every corner of your home, from top to bottom. Cleaning supplies become cherished allies in the battle against dust, mould, and grime.

Organisational overhaul: Nesting often involves a huge amount of organisation!

You may meticulously sort through and wash baby clothes, arrange nursery furniture, or create elaborate storage systems for nappies, wipes, and other essentials.

DIY: You might channel your nesting energy into home improvement projects, such as painting the nursery, assembling furniture, or tackling long-delayed DIY tasks (carefully!).

Stockpiling supplies: Nesting may also involve stocking up on baby essentials, from WHAT IS NESTING? nappies and wipes to onesies and blankets.

The nesting instinct drives expectant mamas Nesting is a term used to describe the to ensure they have everything their baby instinctual behaviour exhibited by many might need once they arrive. pregnant women as they approach labour Cooking and more cooking: You may and childbirth. It typically occurs during batch-cook meals in advance and store the third trimester but can start earlier them in the fridge or freezer to and is characterised by an intense desire to eat during the first weeks clean, organise, and prepare your with your baby. Hearty soups, home for the new baby’s arrival.

Nesting casseroles, pasta dishes, and serves baking can be easily reheated UNDERSTANDING THE URGE as a way for and enjoyed with minimal effort.

While the exact cause of nesting is unknown, one theory suggests expectant SAFET Y FIRST! that nesting is linked to hormonal mamas to While it’s satisfying to complete changes, particularly a surge in exert some all your nesting tasks, make sure oxytocin levels, which is often control. you do so safely. Don’t climb on referred to as the “love hormone” tables or chairs or lift anything too or “bonding hormone”. Oxytocin heavy. Ladders are also a no-no and always plays choose non-toxic cleaning products. And a crucial role in childbirth and breastfeeding if you get tired, sit down and take a break. and is believed to influence maternal behaviour, including nesting.

EMBRACING NESTING Another theory is that nesting serves For many mamas, nesting is a deeply as a way for expectant mamas to exert satisfying and rewarding experience. a sense of control and readiness amidst the uncertainty and anticipation of childbirth.

It allows you to channel your energy and By creating a clean, organised, and nurturing excitement into tangible preparations for your baby’s arrival, fostering a sense of environment for their baby, mamas-to-be connection and anticipation. While the may experience a heightened sense of intensity of the nesting instinct may vary preparedness and security. from person to person, embracing the urge It’s also an old wives’ tale that once can be a meaningful and fulfilling part of nesting urges begin, you’re close to going your pregnancy journey. into labour.

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A stylish

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Interior designer and new mum Jewel Harris ( @jewel_harris) shares the inspiration behind her nursery and tips for creating a beautiful space for your baby.

A

s an interior designer and a new parent myself, I understand the importance of creating a space that not only nurtures your baby but also reflects your personal style. There is something so soothing about creating a cosy and calm space in your home for your baby. Here are some tips and trends to help you design a serene and stylish nursery that both you and your little one will love.

WHAT’S TRENDING?

I’m someone who is constantly looking for inspiration everywhere, and I find that taking my time inspires me. The style I see in current interior design trends leans towards contemporary design. You would have noticed more minimalism and a focus on functional furniture, with warm neutral tones and accents.

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If you want to follow this trend for your nursery, it’s all about having as little clutter as possible to make it easier to find things when you need them. To prevent minimalism from appearing too plain, try adding soft furnishings for texture. Textural aesthetics gained significant momentum in 2023, particularly through materials and rendered walls. For 2024, we should expect this trend to continue through.

Bouclé is a must for a nursery! It’s that fluffy, fleecy fabric mostly used in the upholstery of rounded furniture.

Bouclé has found itself in many furniture stores and celebrity homes. Its soft, bubbly texture just adds a level of comfort that a quiet space for your baby needs.

FUNCTIONAL FURNITURE

Infants thrive in environments that promote relaxation and tranquillity. When it came to choosing furniture for our nursery, I knew I wanted this soft look and cosy ambience.

I was very drawn towards a swivel chair and ottoman from nood. A swivel chair helps to rock your baby to sleep while also offering

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Lily & George Bailee Plush Bunny, $35, acornandoak.co.nz

nood Furniture Floral Bloom Vase, $29.99, nood.co.nz

Decor NATion Native Mānuka Oil Print, $40, decornation.info

Tik Tak Design Co. Baby Mobile, from $119, tiktakdesignco.com

Stokke Sleepi Bed V3, $1,299, babyonthemove.co.nz

a comforting space to sit.

Longevity should always be on your mind when it comes to a new purchase, especially anything for your baby, as they grow so fast! When selecting furniture for the nursery, prioritise functionality, without compromising on style. Invest in pieces that serve multiple purposes, such as a convertible crib that can be transformed into a toddler bed, or a dresser with a changing table top. Opt for quality furniture that will withstand the test of time and grow with your child.

NURSERY PHOTOGRAPHY BY CASEY VAN LIEFDE.

DREAMY DÉCOR

Numero 74 Small Star Cushion, $59, littlewhimsy.co.nz

Adored Illustrations Darling Baby Journal, $69, acornandoak.co.nz

An ottoman or a side table can be a practical and handy addition to your nursery and this is a great place to start adding decor.

I love incorporating sentimental pieces I like to constantly refresh a stack of books, into our nursery that I’ve collected over the swap out a candle, or even add a vase with last few months. This is what creates a sense fresh flowers to give a pop of colour. Make of warmth for me and the feeling of home. sure you still have room to put down your I’ve found the cutest things from some small feeding accessories to make it businesses in New Zealand. easier during feed times.

Acorn + Oak, a beautifully Infants Bookshelves are perfect curated online store, has all the to display décor and other little essentials that I needed, thrive in keepsake items. A book, and Little Whimsy has stylish a teddy, and some art are all you environments décor, toys, and accessories that need, but whichever pieces you that promote we used for our nursery. choose to incorporate into your botanical relaxation and Hand-illustrated nursery is entirely your choice. prints from Decor NATion can There are a number of décor tranquillity. add subtle natural colour and items that you can embrace softness, and I never thought by simply altering the colour to suit your I’d be so obsessed with a baby mobile, but theme. Something that helps me when I am! The one from Tik Tak Design Co. styling any space is groupings of three and is beautifully handmade with 100% New moving each item around until something Zealand wool. And as baby grows, there is visually sticks. always something to offer from these stores.

nood Furniture Lexie Swivel Chair in Cream, $1,999, nood.co.nz

nood Furniture Sheepskin Round Rug, $799, nood.co.nz

A LITTLE SOMETHING ELSE

Infuse the nursery with warmth and cosiness by incorporating soft textures throughout the space. Consider plush rugs, snuggly blankets, and tactile cushions to create a sensory-rich environment.

Textural elements not only add visual interest, but also provide comfort for both you and your baby. These can be beautiful accent pieces that can enhance the overall appeal of a room.

Designing a nursery is an exciting opportunity to create a nurturing and inspiring space for your little one. By incorporating these tips and trends, you can design a nursery that not only meets your practical needs, but also reflects your unique style and personality.

Remember to enjoy the process and cherish every moment as you start your new journey as a parent.

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Colour me happy How to choose the perfect colour palette for your nursery.

hile initially your pēpi will only be able to see in black and white, it’s not long before they’re able to take in the vibrant world around them. Picking your nursery colours can be a daunting task, with endless shades to choose from – so where to start?

1. GET INSPIRED

Seeking inspiration from things that are close to your heart. It could be anything – from your favourite children’s book, a beloved toy or a cherished childhood memory. Can’t find anything in your memory bank? Then head online and take a look at Pinterest or Instagram for colour combinations you love. tip

You can even try a lick of paint on the ceiling; it’s often considered the fifth wall!

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2. NOT TOO BRIGHT?

Wall colours that are too overstimulating may interfere with your baby’s sleep and overall comfort. These colours include a big blocks of bright red, electric yellow, vibrant blue, and neon shades. Consider using softer, muted, or pastel tones such as soft blues, gentle greens, light yellows, lavender, pale pinks, and warm neutrals.

These colours create a soothing and calming atmosphere, which can help babies feel more relaxed and at ease.

3. CREATE HARMONY

Choosing a colour palette involves finding a harmonious balance between different shades. Start by selecting the primary colour for the room, which typically becomes the wall colour. From there, add complementary and accent colours. These accents can appear in furniture, bedding, accessories, or even decorative wall art. Ensure the colours complement each other and create a cohesive atmosphere. Don’t know which colours complement each other? A complementary colour wheel is easy to find online.

4. TAKE THE TEST

Before committing to a colour scheme,

test paint samples to see how the colours look under your nursery’s specific lighting conditions. Lighting can significantly affect how colours appear, and this step will help you visualise how your chosen shades interact with the room’s natural light. This is an opportunity to fine-tune your selection.

5. CONSIDER THE FUTURE

Your baby will grow faster than you can imagine, so to make the most of your nursery design, it may be a good idea to opt for a neutral base colour. Neutral walls and furniture provide a canvas that can easily adapt to changing preferences as your child grows. Colourful and easily replaceable accents, like pillows, artwork, rugs and throws, can add personality and adaptability.

6. MAKE IT YOUR OWN

If you’re renting your home or not able to pain the nursery’s walls for any reason, add personal touches to bring your chosen colour palette in. Removable decals, prints, toys, bedding, and curtains can all help to make your nursery the dreamy haven you have imagined, without a lick of paint on the walls!

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Bed time!

Tips and advice on choosing the best bed for your newborn.

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ne of the big pre-baby purchases you will make is where pēpi will sleep once they are born. From bassinets, to co-sleepers, to cots, there are a bunch of options to choose from, but not all will be right for you, your home, or your baby.

Here’s how to find the perfect fit for your growing family…

THE CHOICES BA SSINETS

Bassinets are a popular choice that offer a cosy and compact bed that keeps pēpi close to you during the night. Typically small, lightweight, and portable, bassinets are designed for babies up to around six months old and often have mesh sides for breathability and visibility.

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CO-SLEEPERS

Co-sleepers have one open side and can be either pushed up or attached securely to the side of your bed, allowing your baby to sleep within arms' reach, while still having their own separate sleeping space. Co-sleepers mean your baby is close by for night feeds and comfort, and they often feature adjustable heights and breathable mesh sides. They can be used safely until your baby is able to roll over.

MOSES BA SKETS

Often made from a woven or wicker material, Moses baskets are a great portable option as they feature sturdy handles and a removable frame, which makes them easily transported from room to room (or house to house). Depending on their size, babies can stay in a Moses basket until they are around six months old, or when they can sit up unaided.

WAHAKUR A

Wahakura is a traditional Māori sleep space for pēpi, woven from harakeke (flax) and fitted with a mattress.

Guidelines for wahakura differ among weavers but it is recommended that the height of the wahakura be at least 15-17cm (for more information, visit sudinationalcoordination.co.nz).

Wahakura provides pēpi their own safe space when co-sleeping, up until around five or six months of age.

COTS

Cots are the most cost-effective option as they are a long-term sleeping solution.

Sturdy and secure, they typically feature an adjustable mattress height which allows you to lower the cot as your baby grows and becomes more mobile, reducing the risk of falls. Many cots can also transform into toddler beds or daybeds as your baby grows.

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Adinkra Designs Co-sleeper Bolga Moses Basket Bundle, from $419, ecosprout.co.nz

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Babyletto Scoot 3-in-1 Convertible Cot, $889, dimples.co.nz

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!

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PRACTICAL POINTS

Before choosing a bed for your newborn, here are some questions to ask…

Shnuggle Air Bedside Crib, $519, dimples.co.nz

With any baby bed, it’s super-important to choose a mattress that is safe.

It’s recommended that your baby sleeps in your room until they are at least six months old. While a cot might be the most practical and budget-friendly option, it’s not going to work if your room is tight on space – so a bassinet, co-sleeper, or Moses basket might be a better choice.

SIZE

It’s cute, but is it safe?

MATTRESS MATTERS

Measure the interior dimensions of your baby’s bed carefully to ensure that the mattress fits snugly, without any gaps around the edges. Any gaps should be less than 20mm with the mattress centred in the bed to ensure there is no risk of your baby getting trapped.

COMPILED BY CHARLOTTE COWAN. PHOTOGRAPHY BY NATALIA BOWERS OF LITTLE LOVELY PHOTOGRAPHY. THANKS TO BABY HARPER.

Can I f it a cot in my room?

For a bassinet/co-sleeper: The mattress should be no more than 40mm thick to prevent suffocation.

For wahakura: For regional guidelines, visit sudinationalcoordination.co.nz/sites/ default/files/national-sudi-preventionnational-safe-sleep-device-quality-specguidelines_2021.pdf.

For a cot: The mattress should be between 100 and 150mm thick.

Where you can, always look for the mattress that is recommended for your specific baby bed, or ask the retail store for advice.

Firmness: The mattress should be firm and flat, as mattresses that are too soft put your baby at risk of suffocation. To test the firmness, press your hand firmly down on the mattress surface – it should provide little give when pressure is applied and bounce back once your hand is released.

Extras: Mattresses only need a waterproof protector and fitted sheet (ensure these are both fitted tightly).

Never wrap your mattress in plastic.

No matter how much you love the aesthetic of the baby bed you have chosen, your number one priority should always be safety.

There are mandatory safety standards for cots in New Zealand, so when you’re looking for a cot, check it’s displaying a AS/NZS 2172:2003 safety standards sticker. If you can, try not to opt for a secondhand cot – but if you do, make sure it meets the mandatory safety standard too.

Boori Neat Kids Cot Bed in Cherry and Almond, $499, urbansales.co.nz

art by RIWA Wahakura Rīwā, $225, artbyriwa.co.nz

There are so many options, how will I know if it’s a good choice?

If there’s one way to find out whether you’re making the right choice, it’s to ask other mamas! Jump on to parenting websites or forums and look for any reviews or recommendations. Or ask your friends and family for their experiences, good and bad.

Questions to ask include: Is it easy to assemble and adjust? How long did it last?

Is it sturdy or did it break easily? Is it easy to clean? Is it value for money? Does it convert to a bed?

Woolbabe x Honest Wolf Moses basket, $599, woolbabe.com The warmth and breathability of wool makes it an ideal fibre for a Moses basket!

I’ve chosen my bed, now what extras do I need?

In short, you don’t need anything. Other than a mattress, protector, and cover, your baby’s bed should be stuff-free. No pillows, no bumpers, no loose blankets or covers, and no toys. And always make sure the bed is positioned away from hanging mobiles, cords, curtains, and other choking hazards.

4baby Sleeptime Bedside Sleeper, $299, babybunting.co.nz

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The Jiffle wagon is a 6-in-1 stroller with capsule compatibility, bassinet, seat, duo, ride-along board, and doubles as a wagon cart. It’s the perfect on-the-go solution that grows with you and is ideal for expanding families.

Edwards & Co Oscar M2, $999, edwardsandco.nz

The Jiffle wagon, $2,499, infagroup.co.nz

ENHANCING THE DAY-TODAY

W They

see me

rollin’

Black and grey are classic and timeless but if you want to stand out as a super-stylish mama, here are some pram picks for you!

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hen it comes to choosing the perfect pram, practicality always comes first. Is it easy to fold up?

Will it fit in my car? Does it have all the safety features? It simple to use day-to-day?

Can I store all my shopping? Is it quick to clean? But once those are out of the way, it’s time to focus on aesthetics! Colour, accessories, and Instagrammability (not a word, but you know what we mean) can also come into play if you want to be an on-trend mama when you’re out and about.

Here a few reasons why choosing a stylish stroller might be worth your while!

MAKING A STATEMENT

Your stroller/pram/pushchair – whatever you choose to call it – can be more than just a mode of transportation for your little one, it can also reflect your personal style and taste. Opting for something more on-trend can allow you to make a statement and express your individuality as a parent.

Whether you prefer sleek and modern designs, vibrant colours, chic patterns or shiny hardware, there’s a stroller out there to suit your aesthetic preferences and complement your lifestyle.

Parenting a newborn can feel like a whirlwind of nappies, feedings, and sleepless nights, so it’s important to do or have things that spark joy in your life! A cool stroller can turn heads, start conversations, and even influence other mamas, making your trips to the park, shops, or your neighbourhood stroll a little more enjoyable and memorable (even though you may feel less than stylish and live in comfy pants and oversized tees!).

INVESTING IN QUALIT Y

While style is undoubtedly important, it’s essential to remember that functionality and quality should never be compromised.

Many on-trend strollers on the market offer a perfect blend of fashion and function, boasting features such as lightweight construction, easy manoeuvrability, and innovative design elements. By choosing a stylish stroller from a reputable brand, you can enjoy the best of both worlds – a fashionable ride for your baby and peace of mind for yourself.

CREATING SOCIAL MEDIA MOMENTS This may not be your jam but some mamas love capturing a social media moment and a stylish stroller can take your Instagram or TikTok game to the next level. Get creative with fun posts and remember, lots of people might have opinions on the pram you choose, but stand by your selection – they don’t have to push it!

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BabyStyle Oyster Max, $999, babystyle.co.nz

Seats up to four children aged six months and up!

Wonderfold W4 Luxe Quad Wagon, $2,199, babybunting.co.nz

Babybee ROVER3, $1,099.99, nz.babybeeonline.com

buy!

Great budget Baby Way NZ Gold Series 2-way Compact Bassinet, Stroller + Feeding Tray, $229, babywaynz.com

leclercbaby XL Influencer, $899, leclercbaby.com

Stokke YOYO² Stroller, $799, stokke.com

COMPILED BY CHARLOTTE COWAN.

Nuna Mixx next Stroller, $1,259, nunababy.com

Pack up and go anywhere with MIXX next.

On the move, it’s a smooth ride you can manoeuvre with one hand and fold out flat for deep sleeps. Packed away, its compact fold lets it fit into tighter spaces, so you can take more trips to more places.

L OV E

YOYO² is a versatile stroller from birth to toddler. Sturdy and super-manoeuvrable, it has been designed to provide optimal daily comfort for your child. Its compact design means it can be stored in the smallest space at home or in the car boot, and it’s light enough to be worn over the shoulder.

The leclercbaby XL Influencer is a sleek stroller that folds and unfolds in 1.5 seconds. With large all-terrain wheels, soft padding for comfort, and a 5-point magnetic harness, it’s the only stroller you’ll need for everyday use or extended trips.

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Travel tip!

It’s a good idea to feed your baby during take-off to help them get used to the pressurised cabin. Suckling on the breast, or a bottle or dummy, can help to ease pressure on their ears.

Fly

with me Planning on travelling with pēpi?

Here’s everything you need to know.

WHEN CAN I TAKE MY BABY ON A PLANE?

Some airlines, such as Jetstar, will not allow newborn babies under 48 hours old to fly, and you will also need a medical note to fly with a baby under seven days old.

Many airlines do not have a lower-age limit specified, but it is advisable not to fly until your newborn is a few weeks old.

CAN I TAKE A CAR SEAT?

On most airlines, children under two years old can sit on their parent’s lap during a flight, free of charge (or for a small fee if you are flying internationally). If you would prefer to bring your own car seat or capsule on board for your baby to sleep in, you will

typically be charged for the extra seat that the car seat will occupy. Most airlines, including Air New Zealand, also have requirements for the car seat, including: • It must be in a safe working condition; • You must be able to seat your baby with their arms and thighs within its frame; • You must be able to show a certification label approving it for use on an aircraft (you can usually find examples of these labels on the airline’s website); • You cannot bring a child booster seat onboard.

Before your flight, check with the airline to ensure that they allow the use of baby capsules on board and what their specific regulations or requirements are.

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Safe

L OV E

Travels!

THE INFASECURE ADAPT MORE CAPSULE makes no compromises when it comes to safety, comfort, convenience, versatility, and style. Compatible with over 30 market leading strollers including The Jiffle, Leclercbaby, and more!

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Maxi Cosi Cabriofix i-Size Capsule, $349, babybunting.co.nz

You can’t book a flight for your baby until it is born.

BOOK A BA SSINET

For long-haul flights, it’s a good option to book a bassinet for your baby to sleep in and to give you a break. Bassinets are at the front of the aircraft and are attached to the wall when required.

Bassinets can only be used when your baby is sleeping (for safety reasons) and most airlines will have an age and weight limit for infants. And as there are a limited number of bassinets on each flight, make sure you reserve one as early as you can!

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Edwards & Co Otto, $449, edwardsandco.nz

CAN I TAKE A STROLLER ON THE PLANE?

Nuna PIPA next, $489, nunababy.com

Airlines will usually allow a compact stroller on board, depending on the size of the aircraft and the space available. Always check with the airline before taking the stroller on board the flight, as it may count towards your baby’s baggage allowance.

WHEN YOU ARRIVE

Familiarise yourself with the rules in each of your destination countries, as some may have specific rules regarding the use of infant car seats in vehicles, such as taxis or rental cars. If you are not taking a car seat or capsule with you, your travel agent can help to organise transfers that include car seats once you arrive.

If your baby is on formula, you can usually bring your feeding equipment on board – but contact the airline before you board!

leclercbaby MF Plus, $749, laclercbaby.com

PHOTOGRAPHY BY FRANCES WILKINSON OF EARTHSIDE PHOTOGRAPHY. THANKS TO BABY CARLY FAE. COMPILED BY CHARLOTTE COWAN.

Note that children under two years old will usually not have the same baggage allowance as an adult (as in they may not be allowed checked-in baggage), but you should be able to check in one or more of the following: a bassinet or portacot, car seat/capsule and stroller.

If you choose to check in any of the above, it’s a good idea to invest in a travel bag, so your baby’s things don’t end up with scuff marks, fabric tears, or broken buckles. Some airlines will have these available for you free of charge; just ask at check-in.

InfaSecure Adapt More, $899, infagroup.co.nz

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Labour of love Labour is one of the great unknowns for first-time mamas, so we've answered some common labour day questions!

WHEN WILL I GO INTO LABOUR?

Your due date is a rough estimate of when your baby will be born but unfortunately (unless you’re having a scheduled C-section), there’s no way to predict precisely when your little one will arrive.

Around 90% of pregnant mums go into labour between 37 and 42 weeks of pregnancy, but only 5% of mums deliver on their baby’s due date. Some are induced, some have planned C-sections, and still others give birth prematurely (before 37 weeks gestation).

To put it simply, your baby will come when it’s good and ready!

HOW DO I KNOW IF MY CONTRACTIONS ARE THE REAL THING?

Labour contractions are different from Braxton-Hicks contractions in a few distinct ways. They’re centred in your pelvis and many women describe them as period-like cramps, but worse. They will start off being quite irregular, but will soon settle into a pattern, and will increase and decrease as your baby moves around. If they start to increase in intensity, duration, and closeness, you are probably in labour. Call your LMC if you think this is the case!

WHAT IS FALSE LABOUR AND HOW WILL I KNOW?

Braxton-Hicks contractions are “practice” contractions that many pregnant mamas mistake for the real thing. They are what’s known as “non-productive” contractions because they don’t result in birth and are merely annoying and painful for some women.

Braxton-Hicks contractions are usually irregular, happen in your abdomen rather than down low in your pelvis, don’t get

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worse or more painful over time, don’t increase in intensity and duration, and don’t keep you from being able to carry on a conversation. Braxton-Hicks contractions also usually recede if you stand up and walk around.

WHAT ARE THE EARLY SIGNS OF LABOUR?

Many of the earliest signs of labour are so subtle that you may not realise your body is telling you the time has come! Here are some things to look out for: Nausea, vomiting, and/or diarrhoea: By the end of your third trimester, morning sickness should be a distant memory – and then one day, suddenly, you may find yourself heaving up your dinner or running to the toilet. While nausea, vomiting, and diarrhoea can occur in late pregnancy because your growing baby is crowding your gastrointestinal system, these are also early signs of labour.

Lower back pain: 80% of pregnant women experience back pain during labour, and this can often begin as a tingling soreness or cramping which starts in your lower back and moves forward to your pelvis. “Back labour” will feel like severe discomfort in your lower back, which hurts the most during contractions and can also be painful during contractions too.

Cramps: Labour contractions can begin with back pain, pressure, and cramping in your lower pelvis – like period cramps.

Losing the mucous plug: If you go to the toilet and wipe, and then find a jelly-like substance streaked with a little bit of blood on the toilet paper, you may have lost your mucous plug. This is the thick membrane that blocks the entrance to your cervix, which your body sheds to prepare for labour.

It might come out all at once, or a little at

Many of the earliest signs of labour are so subtle that you may not realise your body is telling you the time has come! a time (like a thick discharge). If your mucous plug is accompanied by bright red blood, bleeding, or liquid discharge (your “waters”) that keeps leaking, contact your LMC.

HOW WILL I KNOW IF I’M IN ACTIVE LABOUR?

Active labour is the time when you want to call your LMC for instruction, and have your birthing partner on standby to take you into hospital or the birthing centre. Here are some signs you’ve progressed from early

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PHOTOGRAPHY BY CATHERINE SMITH.

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labour to active labour…

Your waters break: You may feel like you’ve wet yourself, or you may just have wet underwear. When your waters break, it’s not like a balloon popping under your clothes; it’s more like a gushing sensation, or a slow trickle. If you squeeze your pelvic floor muscles and you can’t stop or control the leaking, then it’s probably not urine – it’s your waters, or the amniotic fluid which your baby has been swimming in. However, keep in mind that not all women experience

their waters breaking early in active labour.

If your waters break and you’re experiencing contractions, this is definitely a sign of labour – but if your waters have broken and you’re not contracting yet, your LMC may want you to wait a bit longer before coming into hospital. Your waters should be pale straw-coloured – if they’re red, brown, or green, contact your LMC straightaway.

Regular contractions: Irritatingly, contractions can stop and start – sometimes days before you actually give birth. But once

that vague crampy feeling turns into regular contractions that increase in intensity, duration, and closeness together, you’re in labour. Your LMC will have a guide as to when they want you to come into hospital, so check with them before you head in.

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Welcome to the world

"There was a lot of discomfort having my third-degree tear assessed before heading into theatre."

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PHOTOGRAPHY BY EMILY O'DELL PHOTOGRAPHER.

Three magical birthdays captured by Frances Wilkinson of Earthside Photography (earthside.nz, @earthsidephotography _nz/).

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"The moment I stood up in my living room after giving birth, it all felt so surreal."

The birth of

Carly Fae

Carly Fae Strecker was born unexpectedly at home on her due date, weighing 3.61kg.

The first baby of Courtney and Conrad, Carly “practically just popped out” on the living room floor following only three hours of labour. No one was expecting a first birth to be so swift, and the midwife only just made it!

Suffering from a painful thirddegree tear, mum Courtney was taken by ambulance to hospital that same day for surgery.

"Getting to feed and latch Carly for the first time was a moment of pure joy."

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“Working hard through the final surges of transition with my husband by my side."

“The moment my baby was finally with me and put on my chest – the best feeling ever, with many tears!”

“My baby was born semi en-caul, which I didn’t know about until I saw my photos!”

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The birth of Asher

PHOTOGRAPHY BY FRANCES WILKINSON OF EARTHSIDE PHOTOGRAPHY.

Asher Cloud was born

by VBAC at 39 weeks and one day and weighed 2.6kg. After a smooth labour and delivery, where Asher was born semi en-caul (wrapped in the amniotic membrane), mum Louie suffered a massive bleed and subsequent hemorrhagic shock during surgery. This was followed by an infection and postpartum preeclampsia.

After many days recovering in hospital, Louie was finally reunited with her baby at home.

“Seeing him closely for the first time. Every push I made was worth it.”

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"I used the TENS machine to manage the contractions."

PHOTOGRAPHY BY FRANCES WILKINSON OF EARTHSIDE PHOTOGRAPHY.

"I was so relieved and overjoyed when Lydia latched straight away.

The midwives showed me how to help her."

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"The best feeling in the world!"

The birth of Lydia

Lydia Simone Moyle was born 10 days overdue, weighing 3.67kg. Amanda and husband Blake had planned a home birth, but the baby was showing potential signs of distress in the last week and required continual monitoring at a hospital during the birth. But Amanda still chose to use hypnobirthing practices alone until the 35th hour of labour, when she got an epidural just in time to start pushing. Amanda and husband Blake had tried for a baby for three years, with two losses along the way, so finally meeting Lydia was incredibly surreal and special.

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Why do babies cry when they’re born? Professor of Midwifery Hannah Dahlen explains!

W

hen babies are born, they all seem to cry. But not all newborn babies cry straight away. Here’s what’s going on.

WHAT HAPPENS AT BIRTH?

When a baby is born, they move from your warm body, and out of their dark, watery world into a much cooler, drier, and brighter one. It’s a bit of a squeeze and as the baby comes out, the cooler air hits their wet skin, which makes them gasp. They also gasp when the midwife or doctor touches their body to help them come into the world.

That gasp is their first breath, which usually comes with a cry. And when this happens the gasp or cry triggers a change in how the baby gets oxygen and moves it around their body.

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WHY DON’T ALL BABIES CRY?

Sometimes this switch to moving oxygen around the body doesn’t happen smoothly.

There might be problems with the baby’s heart, or there may have been a difficult SO WHAT CHANGES? birth. For instance, the baby might have In the womb, babies depend on you for been very short of oxygen in the womb oxygen – via the placenta and umbilical and need some help to start breathing cord. The placenta filters oxygen-rich blood when they are born. from you and the umbilical Babies born by C-section cord then pumps that to the might be slower to breathe Babies born and cry because they don’t unborn baby. in water may have the fluid squeezed from But once babies are born, their first breath or cry triggers the lungs like they do when not even a whole range of changes to the through the vagina. realise they born way their heart moves blood And sometimes, newborn are born. babies don’t cry at all. around their body. So, rather Babies born in water may than breathing fluid from the womb, they can now breathe air and get not even realise they are born because they oxygen into their lungs. don’t feel cold air as they come into the The process of being born also squeezes world. So they tend to just breathe quietly, water out of the baby’s lungs, allowing and turn pink (showing they are getting enough oxygen), without crying. them to work properly.

A newborn baby crying is a sound parents and health workers are happy to hear because it usually means the baby won’t Hannah Dahlen is the Professor of need any extra help to breathe. But not all Midwifery, Associate Dean Research newborn babies cry. And it’s not always and HDR, and Midwifery Discipline something to be worried about.

Leader at Western Sydney University.

PUBLISHED WITH PERMISSION FROM THECOVERSATION.COM

Cry baby

Did you know you can talk to a Plunket nurse anytime of the day or night?

PlunketLine is here 24/7 for parenting support – and you don’t have to be a Plunket client.

Our nurses offer free support via phone and video calls on areas such as sleep, adjusting to parenthood, children’s health, breastfeeding and so much more.

0800 933 922

Kei konei mātou we are h ere

Skin to skin

The team at Nest Pregnancy and Parenting (nestpregnancyandparenting.co.nz) explains the importance of skin-to-skin contact post-birth.

O

WHAT IS SKIN-TO-SKIN?

Skin-to-skin refers to a baby being laid directly onto their mum’s chest as soon as possible after birth, for at least one hour or until after the first feed where possible .

The baby is dried with warm towels while lying on mum’s chest. Once this is quickly done, more warm towels cover both mum and baby while skin-to-skin continues.

If you have a Caesarean birth, an attempt is usually made to try and get baby across your chest. If this isn’t possible, partners can step in and take on this role.

This initial caring touch plays an important role in infant wellbeing, and benefits baby and mum in a wide variety of ways. These major benefits mean that whenever possible, skin-to-skin is accepted as standard practice for all healthy newborn babies.

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THE BENEFITS

Some of the main points from a large body of research shows that this initial touch with your baby: • Brings baby’s heart rate and breathing to the expected rate more rapidly than a baby left without skin-to-skin.

• Helps to regulate baby’s temperature.

• Increases interest in feeding and starts to activate digestion.

• Sleeps well after the first feed.

•R eleases hormones to aid breastfeeding more rapidly than when baby is separated from mum.

• Reduces stress hormones that may be present, allowing mum and baby to be calm and relaxed.

• Allows release of hormones that increase bonding between mum and baby.

• Stabilises blood glucose levels.

• Means less crying in the days after birth (for baby and mum) and some evidence suggests it lowers the risk of postnatal depression.

WHAT IF MY BABY IS UNWELL?

If your baby is premature or unwell at birth, it may still be possible to initiate skin-to skin contact. For these babies, it promotes better levels of blood oxygen and supports growth. It may also reduce the time spent in hospital. Skin-to-skin contact with a baby in special care units is often called “kangaroo care”.

Although skin-to-skin is often talked about as something that happens at birth, it is beneficial at any time. It is particularly useful to comfort a distressed baby and also helps to increase mum’s milk supply. There is no such thing as too much skin-to-skin!

And be sure to check out our Introduc tor y to Antenatal Online Course by scanning this QR code, or visiting bumpandbaby.co.nz (more information on page 7).

Book your antenatal class or postnatal workshop now at nestpregnancyandparenting.co.nz

PHOTOGRAPHY BY CONSTANT MEIRING. THANKS TO MAMA MOIRA AND BABY ANOUK.

ne of the changes within the last 10 years in the New Zealand maternity system is the ability to have immediate contact with your baby at birth.

Gone are the days when the first cuddle with your baby is after they’ve been “checked out” by your LMC, cleaned, wrapped up, and presented to you some time later.

All New Zealand maternity units and hospitals now follow guidelines that promote mum having immediate and extended time with her baby at birth.

This precious time is called skin-to-skin contact, and whether you have a vaginal birth or a Caesarean birth, the sooner your baby gets that close-skin connection, the better for both of you.

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This initial caring touch plays an important role in infant wellbeing, and benefits baby and mum in a wide variety of ways.

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Let’s

face it

An easy-to-understand guide for parents with babies diagnosed with a cleft lip and/or palate from Dr Zac Moaveni.

P

arenthood is one of life’s most fulfilling experiences. The journey is filled with many unknowns, however, and for some parents, concern about potential birth abnormalities is very real. One of the most common is cleft lip and palate (CLP for short).

As a plastic surgeon specialising in facial and paediatric reconstructive surgery, I have had the privilege of supporting many families through the treatment journey.

Here are the answers to come common questions parents may have about cleft lip and palate.

WHAT IS CLP?

A cleft is a gap or split in the upper lip, the roof of the mouth (palate), or both.

For reasons we don’t fully understand, the tissues that form the face and mouth do not fully fuse together. This results in an opening that can range in size, affecting both appearance and function.

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HOW COMMON IS CLP AND WHY DOES IT OCCUR?

Cleft lip and palate are among the most common birth abnormalities, occurring in approximately 1 in every 700 births worldwide. In the wider Auckland area, our cleft team treats approximately 40 new babies each year.

The exact cause of CLP is not always clear, but they are thought to result from a combination of genetic and environmental factors. Certain medications, maternal smoking, and family history of CLP can increase the risk of cleft formation.

CAN YOU SEE CLP ON ULTRA SOUND?

In some cases, a cleft lip can be detected on routine prenatal ultrasounds as early as 18 to 20 weeks of pregnancy. However, cleft palate may not always be visible on ultrasound due to its location inside the mouth.

WHAT CHALLENGES DOES A BABY WITH CLP ENCOUNTER AFTER BIRTH? This really depends on the location and extent of the cleft. Feeding can be a challenge in the first few weeks, particularly if the palate is involved,

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FACTS & RESEARCH

While CLP is common, health professionals and scientists have unanswered questions about why they occur. Is one cleft the same as another? What are the gene-environment interactions? Is it possible to reduce the incidence of cleft? Will my children’s children be born with a cleft?

The University of Auckland’s Department of Obstetrics & Gynaecology is looking into all of this in a study for families who have a recently had a baby with a cleft. The case-control study, led by Louise Ayrey, recruits families with a cleft and families without a cleft and compares the early

pregnancy experiences for both. A small saliva sample is taken to look at the genes they know to be present in cleft families and possibly find others.

“It’s the first time that New Zealand has had funding to investigate this and there is much that is not known,”

The team includes plastic surgeons, speech therapists, orthodontists, dentistry, ENT, and maxillofacial surgeons. We also have a clinical psychologist in the team to help support our families and children throughout their treatment.

Surgical repair is usually performed in stages, with the first surgery to repair the cleft lip between three and six months of age. Repair of the cleft palate typically follows when the baby is around nine to 12 months old.

The team continues to monitor children until adulthood and each part of the treatment or further surgeries comes at the appropriate stage.

WHAT DOES THE FUTURE LOOK LIKE FOR A CHILD WITH CLP? as the gap in the palate interferes with sucking and swallowing. Babies are incredibly versatile and adaptable though, and often learn to feed well with time.

Our speech therapists are experts at helping and supporting parents with feeding.

The palate is also important for speech, so as the child gets older, our focus changes from feeding to getting the speech right.

WHAT IS THE TREATMENT FOR CLP? Treatment for cleft lip and palate typically involves a number of experts working together to get the best outcome.

We continue to monitor children with CLP for their speech, hearing, and dentition, any other issues that may arise. With support and timely treatment, children born with CLP generally go on to do well in school and sport.

One of the most satisfying aspects of being part of the cleft team is seeing our babies thrive and grow into wonderful young adults. It’s a gentle yet powerful reminder that perfection comes in many forms.

says Louise. “It is hoped the research may offer some answers for the next generation.”

You can learn more about the study in a video entitled Cleft Lip and Palate Research New Zealand: Closing the Knowledge Gap, available now on YouTube.

did you know?

Across New Zealand there are about 100 cases of cleft lip and/or palate per year.

Cleft palate occurs more often than a cleft lip, but they can also happen together and affect one or both sides of the lip and palate.

Cleft palate is more frequent in females and cleft lip in males, but both occur in either gender, too.

Dr Zac Moaveni is a Facial and Paediatric Plastic Surgeon at Middlemore Hospital, Auckland.

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Kaylin From her 20 week scan, “Boo”, as she was affectionately known, lived up to her nickname and surprised her parents by having a cleft lip. A subsequent 3D scan at Starship Children's Hospital showed there was also a cleft palate.

“Straightaway I was overwhelmed with advice on how to ‘fix’ her,” says Kaylin's mum, Sarah. “I never saw anything wrong with her, and saying she had to be fixed really hurt. When she arrived early, she was perfect.”

A plate was fitted in baby Kaylin’s mouth at seven days old to help seal the cleft in her palate, which made swallowing easier, but the first three months were a whirlwind of milk, says Sarah.

“Expressing, exploding bottle valves, choking, milk pouring out the nose…”

CLEFT JOURNEYS… Evie-Paul

Evie-Paul was born November 2021 with a unilateral cleft lip, and a bilateral cleft palate.

She has also recently been diagnosed with Pierre Robin Sequence – a condition that occurs during foetal development.

An anomaly with Evie-Paul’s lip was noticed at her 19-week anatomy scan and following a another high-resolution scan, she was diagnosed with both cleft lip and palate. It was also noticed that the central portion of her gum bone was missing, which is common with bilateral palate clefts.

“It took a while to come to terms with the upcoming journey, and I was filled with a lot of fear very suddenly,” says Evie-Paul's mama, Karli. “I had big dreams of a birth centre delivery, and being able to breastfeed etc – all the things a cleft of Evie’s nature inhibits.”

Karli says Evie’s feeding has been her biggest hurdle. “The first challenge was finding a bottle that Evie was able to get milk from,” she says. “A baby with a cleft as wide as Evie’s has virtually no ability to suck, so it was a lot of

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trial and error.” Evie ended up with a nasogastric feeding tube (NG tube) at four weeks old, which she kept for a couple of months.

“Unfortunately the road didn’t end there with feeding difficulties," says Karli. "We had a number of issues relating to fluid aspirating into her lungs, poor muscle strength, and her fear of eating, which all ultimately led to her feeding tube being replaced." At two-and-a-half years old, Evie is still currently fed via NG tube.

She can eat solid food as she pleases – but she has all fluid, medication, and a special highcalorie milk via the NG tube.

Evie has had four surgeries in her short life and is awaiting her fifth. As she grows, there will be many more surgeries.

“Since Evie has had the NG tube this time, she is doing well,” says Karli. “She’s growing well and her development is catching up!

She attends regular speech therapy classes privately, and she attends daycare each week.

She’s a social, loving, and very cheeky wee girl who, one day, will have the biggest story to share!”

Then came the surgery journey.

“Our positive attitude made everything easier to deal with,” says Sarah. “We’d dress up in our prettiest dresses to go see our friends at the hospital.

No test, probe, jab or hospital stay was something to be afraid of. I explained everything as we went, even if it was going to hurt. She has averaged a surgery a year, but every one is just another hurdle to fly over. But I’ll always miss her baby smile with tongue sticking through her nose,” she says.

Kaylin, now 11, says other kids sometimes ask why she has a wonky nose. “I just tell them that I was born with a hole in my mouth but now it’s all fixed and we go and play,” she says.

“Some kids do bully me but Grandma says it’s because they have something wrong inside them, but you just can’t see it. I know that they are being mean because it is their problem, not mine.

I have at least two more big surgeries to come but nothing has stopped me yet, so I don’t think they will either.”

Mama Sarah says Kaylin’s cleft journey has shown her how to be brave, strong, and empathic. “It was never a birth defect to us – it was a challenge that she more than rose to and it made us all stronger.”

FOR INFORMATION AND SUPPORT VISIT CLEFT.ORG.NZ OR FACEBOOK.COM/CLEFTNZ

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Nothing to see here! Just tryin

my se lf...

Advice from Anna Thompson, Advanced Pelvic Floor Physiotherapist (healthdownsouth.co.nz), on how to care for your pelvic floor after birth.

g n o t to we e

Squeeze the day!

exercise such as swimming, biking, Pilates, and workouts to strengthen the legs, arms, back, and core. It is best to refrain from running, jumping, and heavy weights until three months postpartum, or until you’ve had clearance from a pelvic floor physiotherapist.

GET A SSESSED!

P

regnancy and childbirth can cause physical changes within the pelvic floor that can be challenging for many women. Postpartum pelvic floor issues are common and include bladder and bowel incontinence, prolapse, perineal tears, and painful sex – yet they are often overlooked aspects of the postnatal journey.

LEAK AGE AND PROLAPSE

Urinary incontinence affects approximately one-third of women postpartum, causing involuntary leakage of urine during activities such as coughing, sneezing, or exercising.

Similarly, prolapse affects approximately 50% of women and occurs when the pelvic organs – such as the bladder, uterus, or rectum – descend into the vagina. This can result in pelvic pressure and heaviness, as well as bladder and bowel issues.

These problems arise due to the prolonged stretch on the pelvic floor muscles and connective tissues during pregnancy by the growing baby and hormonal changes.

This is why those who give birth via C-section are unfortunately not spared pelvic floor issues, as is often thought.

SQUEEZE AND LIFT

Pelvic floor exercises are paramount for strengthening the pelvic muscles and helping to manage and prevent prolapse and incontinence. These exercises involve squeezing and lifting up around the vagina like you are trying to stop yourself passing

wind and urine. It is important to ensure the movement is isolated to just the pelvic floor.

These exercises are safe to begin three to four days after birth, even if you have stitches.

Complete three to five sets of pelvic floor exercises a day, aim to do five contractions that you hold for up to 10 seconds, and 10 short, quick contractions each time you do your exercises. Being able to relax your pelvic floor is just as important as being able to squeeze it strongly, so ensure after each contraction that you allow the pelvic floor to fully relax before contracting again.

START SLOWLY

Safe return to exercise is essential after childbirth as well to avoid exacerbating pelvic floor dysfunction. It is recommended that during the first six weeks after birth, you should focus on adequate rest to enable recovery, so start with pelvic floor exercises and low-impact exercises such as walking and yoga for mental health benefits.

After six weeks you can gradually resume low-impact body-weight or light-weighted

It’s advisable for all women to have a pelvic floor assessment with an experienced pelvic floor physiotherapist at six weeks postpartum. A physiotherapist can determine your risk of developing pelvic floor issues and a personalised plan can be put in place to minimise this risk and ensure a safe return to exercise and activity.

If you are experiencing any troublesome symptoms related to the pelvic region, your physiotherapist can support you with targeted exercises and lifestyle modifications that address your specific concerns and enable you to live a life without pelvic floor dysfunction.

Seeing a pelvic floor physiotherapist involves taking a thorough history and symptom screening, as well as a vaginal examination to thoroughly assess muscle strength, endurance, coordination and relaxation.

ACC coverage of maternal birth injuries can help with the cost of seeing a physiotherapist, you can discuss with your LMC, GP, or physiotherapist as to whether ACC cover is applicable in your situation.

If finances are an issue, Te Whatu Ora has pelvic floor physiotherapists at most major hospitals which you can access free of charge with a referral from your LMC or GP. By completing some simple exercises and seeking support from a pelvic floor physiotherapist when needed, you can optimise your recovery, empowering you to embrace the joys of motherhood with vitality and strength.

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PHOTOGRAPHY BY CELESTE SHIELS PHOTOGRAPHY. THANKS TO MAMA KATE AND BABIES DUSTY AND PIXIE.

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The milky way

Registered nurse, lactation consultant, and owner of The Mama Coach Lindsay Mullen (lindsay-mullen.themamacoach.com) shares the wonders of breast milk – and the reasons why you might not have enough.

W

hen we talk about the many benefits of breastfeeding, we often promote the fact that breast milk can help keep your baby healthy.

You may have heard that breast milk can heal wounds faster, disappear eczema, or heal nappy rash. Recent research has noted that the composition of human milk varies greatly from individual to individual, showing that breast milk quite literally changes in response to our own baby’s needs.

This research also proved that a woman's breast milk has more infection-fighting cells when her baby is sick than when they are well. So what are these living cells and organisms in our milk that are helping our little ones grow and stay healthy?

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BREAST MILK COMPOSITION Human milk consists of 87% water, 1% protein, 4% fat, and 7% carbohydrates.

It also contains many vitamins and minerals (such as calcium, phosphorus, magnesium, potassium, and sodium). Breast milk also contains millions of live cells, including immune-boosting white blood cells as well as stem cells, which are thought to help organs develop and heal. According to scientists, one teaspoon of breast milk has as many as three million germ-killing cells in it!

Let’s look at the specific properties in breast milk that help keep your baby healthy…

Stem Cells

Breast milk is the only adult tissue so far that has been discovered to contain more than one type of stem cell. Much research is still needed into what the stem cells do and how they keep our babies healthy, but it is thought that these stem cells promote the growth of bones and muscle tissue in the infant.

We know from research that the stem cells are able to cross the gut and migrate into the blood of the nursed baby. From the blood, they travel to various organs like the brain, and turn into functional cells. More research is still needed on the function of these stem cells, but it is pretty incredible to think a piece of your DNA is being passed via your breast milk directly to your baby to help them grow.

Prebiotics

fyi The smallest newborn babies can sniff out breast milk because it has very specific fragrances that are attractive to infants. Babies can also recognise their own mamas simply by smell.

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Human milk oligosaccharides are essentially like a prebiotic that feeds the good bacteria in your baby’s gut, helping the gut to defend against bad bacteria that may enter.

We know that breast milk contains more than 150 different types of human milk oligosaccharides, showing its powerful effect at boosting the immune system of our babies.

Antibodies

Antibodies are a certain protein found in breast milk. These antibodies allow a mum

to pass immunity to her baby via different immunoglobulins in her breast milk.

Colostrum (your first milk), in particular, includes high amounts of immunoglobulins which help protect babies from illness in their first few days as their own immune system develops.

When you are exposed to viruses and bacteria, you produce your own antibodies.

These antibodies then transfer to your baby via your breast milk, therefore helping them fight off the germs we are exposed to and hopefully keeping them healthy.

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Oxytocin

Oxytocin, often referred to as our “love hormone”, is a very important hormone during breastfeeding. Oxytocin is generated in you and your baby when your baby suckles at the breast. Its main job is to ensure ejection of the milk from your nipple to your baby; however, it has some other very important benefits for you and baby. Oxytocin has been shown to decrease sensitivity to pain, promote healing, reduce stress, and lower blood pressure in both mums and babies, as well as arousing intense feelings of love, wellbeing, and calm.

Once breastfeeding is established, your baby’s brain will release oxytocin whenever they see or smells you, or hears your voice, playing a vital role in helping you bond with your new baby.

It's also thought that mums who breastfeed have higher oxytocin levels than those who give their babies formula, and scientists have linked this with enhanced mothering behaviour, including more eye contact, caressing, affectionate language, and faster responsiveness to all things that contribute to a happy, healthy baby.

Alpha-lactalbumin

Recent research has begun to look at a component in breast milk called human alpha-lactalbumin and its effects on reducing cancer. One study found that the risk of childhood cancer in children who breastfeed for 9.6 months or longer was 23% reduced (Su et al). While much more research needs to be done on this, it is generally believed that breastfeeding lowers your child’s risk of developing some forms of cancer.

PHOTOGRAPHY BY CELESTE SHIELS PHOTOGRAPHY.

Melatonin

Melatonin is a naturally occurring hormone in your body that helps you to sleep and wake. Your pineal gland produces it and releases it into your bloodstream to help regulate your circadian rhythm. Your body tends to produce the highest levels of this hormone when it’s dark. Some melatonin passes into your breast milk, with typically a higher concentration of melatonin being in milk passed to your baby at night.

A study has shown that breastfed babies slept longer than formula-fed babies, and this was thought to be due to this melatonin (Cohen Engler et al, 2012). We know through other research the importance of sleep plans on brain development, and this finding is thought to help explain why research finds breastfed babies have higher IQs.

PREGNANCY

SUPPLY AND DEMAND If you find yourself concerned about a potential undersupply of breast milk, the initial advice often revolves around consuming oatmeal, taking fenugreek, pumping after feeds, feeding on demand, and power pumping. While these strategies are commonly recommended, it’s crucial to delve deeper into understanding what might actually be causing the decrease in milk supply – or if a decrease exists at all.

Many mothers worry their supply has diminished when the engorgement common in the early stages of breastfeeding subsides.

This change is often misinterpreted as a dwindling milk supply; however, what typically occurs at around 3-4 weeks postpartum is a natural regulation of milk supply to match the baby’s needs, resulting in softer breasts.

Nevertheless, numerous factors within our bodies can influence milk production, including health conditions, dietary habits, lifestyle choices, and medications. Here are some unexpected contributors to a decrease in milk supply and how to address them.

FATIGUE AND STRESS

As mothers, we frequently prioritise the needs of others above our own, often neglecting self-care. However, when the body is under stress or fatigued, milk production can suffer.

Postpartum fatigue and insufficient rest are common causes of low milk supply. Despite the challenges, finding ways to prioritise self-care is essential. Consider napping when the baby sleeps, breastfeeding in

If you become pregnant while breastfeeding, the hormones your body creates as a result of the new pregnancy can decrease your milk supply. Most women notice this around the 16-20 week gestation period, but it can happen sooner. It's important to recognise that in this situation there is not much you can do to increase your milk supply while pregnant. There is no need to stop breastfeeding while pregnant; however, if your baby is under a year old, make sure you watch their weight gain closely and consider supplementing if you are concerned. Children who are over a year and getting more nutrition from solid food likely would not require supplementation.

comfortable positions (like on your favourite comfy chair with your feet up, or side-lying in bed), and seek support with chores and childcare tasks from your support person.

YOUR HEALTH

Certain health conditions, such as hypothyroidism, anaemia, or infections, can significantly decrease milk supply.

Consulting with a healthcare provider for an examination can help rule out these concerns and aid in restoring your milk supply.

PEPPERMINT AND SAGE

Small amount of these herbs should not cause an issue; however, taken in large doses, peppermint and sage have been associated with a decrease in milk supply. So if you have all of a sudden become addicted to peppermint tea or have been sucking on some menthol cough drops recently and notice a drop in milk supply, this may be the culprit. Cut it back a bit and see if you notice a difference in your supply.

BIRTH CONTROL

You may notice a drop in your milk supply after starting to take hormonal birth control (particularly those containing oestrogen).

If you are using a form of hormonal contraceptive and your baby’s weight Pregnancy BUMP & baby

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support

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gain slows or stops, or you observe a drop in your milk supply, speak with your GP about alternatives. There is usually a safe and reliable alternative you can use to protect yourself from unwanted pregnancy.

For most mothers, progestin-only forms of contraception do not cause a decrease in milk supply if started after the sixth to eighth week postpartum and if given at normal doses. However, there are still reports that some women do experience supply problems with these pills, so if you choose this method, you still want to be aware of the potential to decrease supply.

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If your supply is still dropping and you’re having a hard time getting the baby to latch, speak with a lactation consultant to help develop some strategies to get your little one back on the boob.

THE TOP-OFF TRAP

In my practice I often see mums get into what I like to call “the top-off trap”. They think that they do not have enough milk supply to satisfy their baby or they are COLD MEDICATION told that giving an extra “top-off” bottle A common drug in cold medications is pseudoephedrine. Pseudoephedrine has (whether formula or expressed breast milk) will help their baby sleep through the night been noted in studies to decrease milk supply by as much as 24% in a breastfeeding and will satisfy their hunger.

But what ends up happening is similar mother. Therefore, if you're dealing with to the dummy issue – your baby is now a cold, it is best to avoid this specific not stimulating the breast anymore and is medicine. Instead, focus on resting and staying hydrated. Use saline nasal spray and instead suckling at a bottle. Some babies even then begin to prefer the flow of milk steam treatments to help with congestion. from the bottle and will then get fussy on Lozenges are generally considered safe the breast, causing the during breastfeeding, mum to think it’s her but always check the According to milk supply dropping packaging for direction. scientists, one further, and then mum ends up giving an even DUMMIES teaspoon of bigger bottle.

As a lactation consultant, This can often start registered nurse, and sleep breast milk has a spiral away from coach, I truly believe that a dummy can be a great as many as three breastfeeding. If you find yourself in this situation tool when used in the million germright way. It can, however, and you really want to to breastfeed, cause supply trouble if killing cells in it. continue it is important to reach offered to breastfed babies out to your local lactation more than the breast. consultant to help develop strategies to Again, we have to think back to the basics of how breastfeeding works. The more our increase your milk supply and help get your baby back on the breast. babies suckle, the more milk we make. So if, instead of suckling on your breast, your HELP IS AVAILABLE baby is suckling on their dummy, your body Breastfeeding your little one can be more is missing out on that demand instruction, of a struggle than many mums anticipated. and therefore will not make the milk that your baby may require.

When you’re having one of those days, take a second to congratulate yourself on all the In those first few weeks of breastfeeding, benefits you are passing along to your baby. hold off on offering the dummy until your Whether you breastfeed for a minute or breastfeeding is well established and your a years, you are giving your child immediate baby is gaining weight well. While dummies can be a great tool in some instances when protection from illness, but you’re also setting them up for a lifetime of good health. breastfeeding is not feasible (such as to If you’re struggling to get your stride with soothe your baby in the car while driving), breastfeeding or feel as though you have the best thing to soothe your baby and help supply issues, please reach out to a lactation your milk supply is to offer a feed. consultant for help. For support services, Babies breastfeed for hunger and also comfort. Demand breastfeeding is a great head to page 127.

If for any reason you have made the way of providing your baby the safety choice not to breastfeed, or if Mother and comfort they crave while keeping your Nature has made that choice for you, supply up. If your baby has become a bit of please know that formula is also a great a dummy gremlin, try focusing on offering choice of nourishment for your baby. the breast before the dummy and increase your breastfeed offerings.

A fed and happy baby is best!

ARTICLE REFERENCES AVAILABLE ON REQUEST.

Supply

Another option may be progesteronereleasing IUDs. These IUDs deliver the hormone directly to the lining of the uterus, which only leads to a slight increase in progesterone levels in the bloodstream (much lower than that found with the progesterone-only pill), therefore decreasing the chance that your milk supply will be affected.

Supporting you through breastfeeding While breastfeeding has a lot of benefits for you and your baby, it can be challenging, especially in the early days. It’s common to experience some discomfort, sensitivity and sore nipples due to lactating issues, hormonal changes, and nursing frequency.

SORE, CRACKED NIPPLES

ENGORGEMENT & MASTITIS

Beyond the initial tenderness of your baby’s first feeds, the most common cause of sore or damaged nipples is poor positioning and attachment.

This can happen when the baby doesn’t always take a big mouthful of breast. If you are struggling, it is recommended to seek out the support of your midwife, child health nurse or lactation consultant.

It is normal for your breasts to become larger and feel heavier and a little tender when they begin to produce more milk. Occasionally this fullness can lead to engorgement when the breasts feel very hard and painful. Ease the symptoms with Lansinoh® Thera°Pearl 3-in1 Breast Therapy reusable packs.

In the meantime, Lansinoh® HPA® Lanolin can soothe, heal, and protect sore and cracked nipples. Made from 100% pure Lanolin, Lansinoh® HPA® Lanolin does not clog pores or milk ducts and is clinically proven to accelerate healing. Being all natural and hypoallergenic, it is safe for you and your baby, and doesn’t need to be removed before breastfeeding.

Available in 15g and 50g.

The unique design conforms to your breast like a bag of peas to provide 360° relief and can be used hot or cold. Cold therapy with Lansinoh® Thera°Pearl can help to soothe the pain and swelling associated with engorgement and provide soothing relief for the symptoms of mastitis* – inflammation of the breast. Lansinoh Thera°Pearl can be used warm on the breast before a feed and when expressing to help the milk flow. *If you believe you have Mastitis, please seek medical attention from your healthcare provider.

LEAKING MILK Leaking breastmilk can be uncomfortable and maybe a little awkward at times as your levels of oxytocin, the hormone that produces the milk ejection reflex (MER) or letdown action, are still adjusting. For this, take advantage of Lansinoh® Ultra Thin Stay Dry Nursing Pads.

They help absorb the leaking breastmilk and comes in handy while your body is adjusting to your baby’s feeding needs.

Lansinoh® disposable nursing pads feature a gentle, breathable, quilted lining with a leak-proof outer layer to ensure your clothing stays dry and stain-free. What sets Lansinoh® nursing pads apart is their impressive absorbency, thanks to the innovative Blue Lock™ technology. Additionally, each pad is individually packaged and equipped with two non-slip adhesive tapes to securely keep it in place, offering you peace of mind and comfort as you navigate this transitional phase of motherhood.

Available in a pack of 24s and 60s.

Lansinoh is available in pharmacies and supermarkets nationwide

lansinoh.com.au

Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. Wilson Consumer Products, Auckland TAPS NA BG248 *source: 24 New Zealand Mums who trialled Lansinoh® HPA® Lanolin Nipple Cream, Nursing Pads & 3-in-1 Breast Therapy.

Supportive back rest.

Complete wraparound design.

Secures to the body.

Stays in place.

Flat-top firmness Adjustable Fit. Ideal for C-section tummies.

Twin & plus size range Suggested as safest nursing pillow. *By NBC News & Consumer Reports.

Assume the position

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Every māmā/pēpi journey is unique, so have a go at testing various positions and use whatever feels good for you both.

You will most probably use different positions for different circumstances, places, and times of the day.

KOALA HOLD

The koala hold (upright breastfeeding) makes breastfeeding comfortable for babies who suffer from reflux or ear infections.

Pēpi is sitting upright, while facing you and straddling your thigh.

Support pēpi with the arm on the same side that they are feeding, and support your breast with your opposite hand.

This position is great for both a baby who needs head support or for an older baby who can sit upright on their own.

PHOTOGRAPHY BY MOIRA MEIRING OF WILD LITTLE HEARTS. THANKS TO MAMA LING AND BABY VIDA.

There are multiple recommended breastfeeding positions, here are a few that may work for you.

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SIDE-LYING POSITION

RUGBY BALL HOLD

This is a good position to try if you have had a C-section, have generous breasts, or for forceful let-down. Place your little one at your side, with their legs and feet tucked under your arm. You may like to rest your arm and body on a pillow for support.

Your baby’s head is held in your hand closest to them and your other hand can be used to support your breast.

Your pēpi should be facing you, with their mouth at nipple height. This position is also recommended for tandem feeding, where you can breastfeed two babies at once.

This position is comfortable for a māmā who’ve had a C-section, because pēpi doesn’t put pressure on the mother’s abdomen. This is also a great way for you to get some rest while nursing your little one. Start by laying on your side with your baby on their side, facing you. Your pēpi should be positioned so their nose is opposite your nipple. Use your lower arm to cradle your baby’s back, or you can tuck a rolled-up receiving blanket behind your baby to help nestle your little one close to you while you use your arm to support your own head. You can support your breast with your other hand.

#1 Nursing pillow choice of lactation consultants and millions of mums for 25 years.

CROSS-CRADLE HOLD

Cross-cradle hold allows you to have more control over how your baby latches on.

Many māmā find that they are able to get their pēpi latched more easily with this hold. Instead of supporting your baby’s head on your forearm (cradle hold), use the hand of that arm to support your breast. Bring the opposite arm around the back of your pēpi. Support your baby’s head, neck, and shoulder by placing your hand at the base of your baby’s head with your thumb and index finger at your baby’s ear level. Like the cradle hold, your baby will be tummy to tummy to you.

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FOR A LIST OF BRE A STFEEDING SUPPORT SERVICES.

CRADLE HOLD

This is the most common way to hold your pēpi, but other holds may be easier for latching a newborn baby. To start, cradle your baby’s head on your forearm with your little one’s nose opposite your nipple. It can be helpful to place pillows underneath your baby to bring them up to nipple height and support your elbows. Use that hand to support your baby’s bottom.

Make sure your baby’s head and bottom are level.

Turn pēpi on their side, so that your baby is tummy to tummy to you. Then bring your baby to your breast.

www.mybrestfriend.co.nz Distributed in NZ by Rumina Natural Care Ltd, Auckland Customer care freephone 0800 333 006

Good night, sleep tight Kenna Zachinskaia (@kenna.nz) explains how to navigate moving your baby from co-sleeping into their own room.

C

Dr

o-sleeping – whether sharing a bed with your baby, or having them close by – has been a long-standing tradition in many cultures worldwide. For some parents, it fosters a deeper bond and offers a sense of security for both baby and parent. However, as babies grow, there comes a time when transitioning them to their own room becomes necessary for their development and for the well-being of the entire family.

This transition can be met with mixed emotions and challenges, but with patience, understanding, and the right strategies, it can be a smooth and positive experience for everyone involved.

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g of milk and m umm

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UNDERSTANDING THE NEED FOR TRANSITION

As babies grow older, their sleep patterns evolve, and so do their needs. While having your baby in the same bed or room as you may have provided comfort and convenience during the newborn stage, as infants become more mobile and aware of their surroundings, having their own space becomes important for fostering independence and healthy sleep habits.

Transitioning to solo sleeping can also promote better quality sleep for both the baby and parents. Babies who have learned to self-soothe and fall asleep independently are more likely to sleep through the night, leading to improved rest for everyone in the household.

Note: It is recommended that babies should sleep in the same room as you or the person looking after them for their first six months of life.

(SOURCE: PLUNKET)

STRATEGIES FOR TRANSITION Establish a bedtime routine

Implement a consistent bedtime routine to signal to your baby that it’s time for sleep. This could include activities such as a warm bath, gentle massage, reading a book, or singing a lullaby. Consistency is key to helping your baby understand when it’s time to wind down and prepare for sleep.

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Encourage self-soothing

Help your baby develop the ability to self-soothe by allowing them some time to settle themselves to sleep. While it’s natural to want to comfort your baby immediately when they cry, giving them the opportunity to learn to calm themselves can be beneficial in the long run.

Gradual transition

Start by gradually transitioning your baby to their own room. Begin with naps in the crib or bassinet during the day before moving on to night-time sleep. This allows your baby to become familiar with their new sleeping environment in smaller, manageable doses.

Create a comfortable environment

Make your baby’s room a cosy and inviting space. Use soft lighting, soothing colours, and familiar objects such as stuffed animals

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COMMON MISTAKES TO AVOID Rushing the transition

One of the most common mistakes parents make is trying to transition their baby to their own room too quickly.

Rushing the process can lead to stress and anxiety for both the baby and the parents.

Take your time and allow for a gradual adjustment period.

Inconsistency

Consistency is crucial when it comes to establishing healthy sleep habits. Avoid sending mixed signals by occasionally allowing your baby to co-sleep or bringing them back to your bed or room during the transition period. Stick to your plan and remain consistent in your approach.

Neglecting sleep associations

Be mindful of the sleep associations you create for your baby. Avoid relying on props such as rocking or feeding to help your baby fall asleep, as this can create dependency and make it harder for them to self-soothe when waking during the night.

O ve r s t i m u l a t i o n a t b e d t i m e

Be mindful of the environment you create at bedtime. Avoid overstimulating activities or screens before bedtime, as this can make it difficult for your baby to relax and settle down for sleep.

N e g l e c t i n g yo u r n e e d s

Remember to prioritise self-care and rest during the transition process. It’s natural to feel anxious or emotional about moving your baby to their own room, but taking care of yourself will ultimately benefit both you and your baby.

PHOTOGRAPHY BY NATALIA BOWERS OF LITTLE LOVELY PHOTOGRAPHY. THANKS TO BABY LYLA.

SEEKING SUPPORT AND FLEXIBILIT Y

to create a comforting atmosphere.

Consider using white noise machines or gentle lullabies to help lull your baby to sleep.

Be patient and persistent

Understand that the transition may not happen overnight, and be prepared for some resistance from your baby. Stay patient and consistent in your approach, reassuring your baby with gentle words and touch as they adjust to their new sleeping arrangement.

Transitioning your baby to their own room can be a challenging journey, and it’s vital to seek support from your partner, family, or friends during this time. Having a support system in place can provide emotional encouragement, practical assistance, and reassurance that you’re not alone in facing the challenges of this transition.

Additionally, consider consulting with your paediatrician or a sleep specialist for guidance and advice tailored to your baby’s specific needs and circumstances. They can offer valuable insights and strategies to help make the transition smoother and more successful.

If you’re sharing your bed with your baby, put them beside you in their own baby bed – such as a Pēpi Pod or wahakura – this may help reduce the risk of your baby suffocating while they’re asleep.

CELEBRATING MILESTONES AND EMBRACING CHANGE

As challenging as it may be to move your baby to their own room, it’s also a time to celebrate milestones and embrace the changes that come with your baby’s growth and development. Transitioning your baby to their own room marks a significant step towards independence and autonomy, both for your baby and for you as a parent.

Take pride in the progress your baby makes as they adjust to their new sleeping environment, and celebrate the small victories along the way.

Embrace the opportunity to create new bedtime rituals and traditions that will help your baby feel secure and loved in their own space. Whether it’s reading a bedtime story, singing a special lullaby, or sharing a nightly snuggle before tucking them in, these moments can become cherished memories that strengthen the bond between you and your baby.

While the transition from co-sleeping to solo sleeping may come with its challenges, it also opens the door to new possibilities for growth, learning, and connection between you and your growing child. By approaching the transition with patience, understanding, and a spirit of celebration, you can help make the journey a positive and rewarding experience for both you and your baby.

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When do...?

WHEN DO BABIES SMILE?

Babies typically start smiling at around six to eight weeks of age. This initial smiling is often in response to basic stimuli, such as your face or voice.

There are two main types of smiles in babies: Reflexive smile: This type of smile is usually seen in newborns and occurs involuntarily, often while they are sleeping.

It’s usually a response to gas or muscle movements, rather than social interaction, and is common when babies are relaxed.

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Social smile: Around six to eight weeks of age, babies start to develop social smiles. Social smiles indicate that they are beginning to recognise and respond to social cues, which is an essential part of their emotional and social development.

WHEN DO BABIES LAUGH?

You can expect your baby to start laughing around three to four months of age. Laughter indicates their growing ability to engage with and respond to the environment around them.

WHEN DO BABIES START MAKING SOUNDS?

Around two to three months, babies begin to make cooing sounds. These are soft, vowel-like sounds, often made when they are content or engaged.

Between four and six months, they will start babbling. Babbling involves repeating consonant-vowel combinations, such as “ba-ba” or “ma-ma”. This stage is essential for speech development as babies experiment with different sounds and learn to control their vocal muscles.

PHOTOGRAPHY BY NATALIA BOWERS OF LITTLE LOVELY PHOTOGRAPHY. THANKS TO BABY SAGE.

Wondering if your baby is developing as they should be?

Here are some FAQs answered!

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first few weeks of life, a baby’s vision is still developing, and they may not yet be able to focus their eyes or track moving objects accurately. However, by around two to three months, most will start to demonstrate improved eye coordination and the ability to follow objects with their gaze.

You can encourage your baby’s visual tracking skills by moving colourful toys or objects within their field of vision and observing their responses.

WHEN DO BABIES ROLL OVER?

By six to nine months, babies may begin to imitate the sounds they hear, such as animal sounds or simple words like “mama” or “dada”. While they may not fully understand the meaning of these words yet, imitation is an important step in language development.

WHEN DO BABIES FOLLOW MOVEMENT?

Babies typically begin to visually track or follow movement with their eyes around two to three months of age. During the

seat, such as a high chair or Bumbo.

Tripod sitting: As babies gain strength and stability in their muscles, they may start to sit in a tripod position, using their hands for support in front of them.

Independent sitting: Eventually, babies will develop the ability to sit up without any support. At first, their sitting may be a bit wobbly, but with practice, they will become more stable and confident in their sitting abilities.

It’s important to provide opportunities for your baby to practice sitting up, but always under supervision to prevent falls or injuries.

Most babies roll from their tummy to their back and vice versa between the ages of three and six months. However, others may take WHEN DO BABIES CRAWL? a bit longer, up to seven months, or more.

Usually, babies will start to The rolling-over milestone is an crawl between eight and 12 months, important part of a baby’s motor although – as with all developmental development. It signifies milestones – they may increasing strength and begin earlier or later. note: coordination in their muscles, The timeline for crawling particularly in their neck, can vary widely among babies, Babies all develop and some may skip crawling shoulders, and core. at their own pace, altogether and move directly From back to tummy: Many babies learn to roll to pulling themselves up so don’t stress! from their back to their and walking. However, But if you are tummy first. This often here’s a general progression worried your baby of crawling: happens because they have more strength in their upper Pre-crawling movements: is not hitting bodies to push themselves Before crawling, babies their milestones, often engage in a variety of over from this position. contact your GP pre-crawling movements to From tummy to back: Rolling from tummy to or paediatrician. strengthen their muscles and back usually follows shortly develop coordination. These after rolling from back to tummy. It may movements may include rocking back and take a bit longer for babies to master this forth on their hands and knees, scooting on direction of rolling because it requires more their belly, or pushing themselves backward. coordination and upper-body strength.

Traditional crawling: Traditional crawling involves moving forward on hands WHEN DO BABIES SIT UP? and knees, with the tummy off the ground.

Babies can begin to sit up without support Some babies may start with an army crawl, between the ages of four and seven months, where they drag themselves forward using and on their own from around nine months. their arms while keeping their bellies close to The ability to sit up unsupported the ground. Eventually, they may transition requires strength in the muscles of the to a more classic crawling style. back, neck, and core, as well as balance Exploratory crawling: As babies and coordination. become more proficient at crawling, Supported sitting: Before sitting up they use this newfound mobility to independently, babies often develop the explore their surroundings. They may ability to sit with support. This might crawl towards objects of interest, navigate involve propping them up with pillows or around obstacles, and begin to understand cushions, or placing them in a supportive spatial relationships.

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I will

protect you

Everything you need to know about childhood immunisations from Healthify He Puna Waiora (healthify.nz).

I

n the past, many children died or were left with lifelong problems from diseases such as diphtheria, tetanus, polio, measles and whooping cough but, today, we use vaccines to immunise children against these and other diseases.

Vaccines stimulate your child’s immune system to produce antibodies, exactly like it would if they were exposed to the disease.

This means that if they are infected with a disease (from a cough, sneeze, blood etc), the protective antibodies are already in their blood to quickly fight off the infection.

Even if vaccinated people do get sick from the disease, they usually get a mild form of that disease, recover faster, and are less likely to have serious complications.

WHY DOES MY BABY NEED VACCINATIONS?

Babies are born with immunity to some infections because their mother’s antibodies are passed on to them in the womb, but this immunity doesn’t last long. As they grow, they need vaccinations at specific ages to protect them from a number of life-threatening diseases.

WHEN ARE THE VACCINATIONS?

The National Immunisation Schedule (healthed.govt.nz/products/the-nationalimmunisation-schedule) lists the group of vaccines that are offered free to babies and children in New Zealand and the age at which they should be given. Here are the diseases your baby will be immunised against in the first six months.

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6 weeks

• Rotavirus (first dose must be given before 15 weeks) • Diphtheria + tetanus + whooping cough (pertussis) + polio + hepatitis B + Haemophilus influenzae type b (Hib) • Pneumococcal disease

3 months

• Rotavirus (second dose must be given before 25 weeks) • Diphtheria + tetanus + whooping cough + polio + hepatitis B + Haemophilus influenzae type b (Hib) • Meningococcal B (can be given at 8 weeks)

5 months

Vaccinations are most often given as injections in the arm or leg, but the rotavirus vaccine is given as drops into the mouth.

AFTER THE VACCINATIONS

Book your baby’s vaccination appointment early in the day and plan a calm day afterwards. After being pricked by Vaccination the needle, your baby may cry but try to stay calm and relaxed. Hold on time is them, comfort them, and talk the most calmly. Feeding pēpi straightaway effective way can also help to calm them down. to protect You will need to stay for 20 minutes after the vaccination to babies and ensure your baby does not have children from a rare, but serious, allergic preventable reaction. This reaction is treatable.

disease.

• Diphtheria + tetanus + whooping cough + polio + hepatitis B + Haemophilus influenzae type b (Hib) • Pneumococcal disease • Meningococcal B (can be given at 4 months)

SIDE EFFECTS

Most reactions to vaccines are mild, such as fever or redness at the injection site. These reactions show that your baby’s immune response is building and the vaccine is working. If you are worried, contact your GP straightaway.

PHOTOGRAPHY BY NATALIA BOWERS OF LITTLE LOVELY PHOTOGRAPHY. THANKS TO BABY HARPER.

WHAT IS A VACCINE?

bumper shopping

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Full page: 215mm width x 297mm deep

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bumper shopping

MOTHERHOOD + FAMILY PHOTOGRAPHY

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124 Pregnancy BUMP & baby

helpful resources

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Baby

CPR

St John (stjohn.org.nz) explains how to perform CPR the right way.

1. ASSESS DANGERS

•M ake sure that you, the baby, and bystanders are safe from any dangers.

•D o not put your own safety at risk.

2. IS THE BABY

RESPONSIVE? •C heck for a response by calling the baby’s name loudly and gently squeezing their toes.

•M oving or making a noise is regarded as a response.

• I f there is no response, the baby is unresponsive and in danger of dying because of their airway becoming blocked.

3. SEND FOR HELP

• Call 111 for an ambulance or send someone else to call.

• It is important to call an ambulance as soon as possible so that advanced resuscitation assistance is on its way.

Remember – you will be keeping the baby alive with CPR, but they need additional care to start their heart. If you are on your own, and a phone is not readily available, do CPR for about one minute then call for help. If portable, bring the phone with you to the patient.

4. OPEN AND

CLEAR THE AIRWAY When a person is unresponsive, their muscles relax. The tongue is a muscle and so relaxes.

This is dangerous because the back of the tongue can flop downwards against the back of the airway and block it. This means the baby cannot breathe.

In any unresponsive person, it is important to open the airway: • In a baby, this is done simply by moving the head into a neutral position and lifting the chin.

• If you see anything in the baby’s mouth, use two fingers to sweep it out.

Scan the QR code to see a demonstration of how to perform CPR on an infant.

note This form of CPR is for a baby which is generally regarded as being under the

age of one year. To learn CPR for a child over the age of one, head to stjohn.org.nz

5. CHECK TO SEE

WHETHER THE BABY IS BREATHING NORMALLY When the airway is open and clear, check for normal breathing: • Look and feel for movement of the lower chest and stomach area.

• Listen and feel for air coming from the nose or mouth.

• Check for any movement.

I f the baby is breathing, move them and support them on their side with their head in a neutral position, and continually monitor their breathing. Note that occasional gasps of air are inadequate to sustain life and should be ignored.

6. IF THE BABY

IS NOT BREATHING • Position the baby on any flat surface or even support them on your lap or arm.

• Place two fingers of one hand in the centre of the chest, just below an imaginary line between the nipples.

• Push down hard and fast 30 times (push down one third of chest depth). Do not worry about pushing too hard – good CPR requires you to push hard and fast.

• Once you have completed 30 compressions (pushes) on the chest, breathe into the baby’s mouth two times.

To breathe into the baby: • Keep the head in a neutral position with one hand.

• Seal your lips around the baby’s mouth and nose.

• Gently puff into the baby until you see the chest rise.

• Remove your mouth, take a fresh breath, and puff into the baby again.

• Continue with the cycle of 30 chest compressions and two breaths until the ambulance arrives.

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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)

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

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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

126 Pregnancy BUMP & baby

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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.

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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

128 Pregnancy BUMP & baby

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 chat

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

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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I’ll Come

to you

When You Call A poem by Jessica Urlichs.

I sleep on the surface now And I’ll come to you when you call My tired eyes adjust to the dark You’re a baby, after all.

And when you’re in a bigger bed And calling down the hall If monsters find you in your dreams I’ll come to you when you call.

And when you’re staying at your friends If you suddenly feel alone I’ll come to you when you call And I’ll bring us both back home.

And if the night should take a turn No matter what you’ve done I’m here, I’m here, I’m always here I’ll always be your mum.

130 Pregnancy BUMP & baby

There are no limits, or confines No schedules and no rules If you need me, I’ll be there I’ll come to you when you call.

And if harder days should find you With a family of your own I’ll come to you when you call Please just pick up the phone.

But for now, I’ll hold you in the night You’re still so very small I hope you know I’ll always show Because I come to you when you call.

From Beautiful Chaos: On Motherhood, Finding Yourself and Overwhelming Love by Jessica Urlichs, $35, Penguin Life.

Print me at bumpandbaby.co.nz!

COMPILED BY CHARLOTTE COWAN.

And even when you’re not I’ll come to you when you cry When you’re standing, calling from your cot There will be no question why.

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