ISSUE 118 DECEMBER 2017 & JANUARY 2018 R33.50 (VAT incl.) N$36.00 (Namibia)
01118
9 771025 271003
Christmas Magic There’s magic in the air!
Kick start your holiday shopping today. Grab your FREE Christmas catalogue in stores now. Cuteness at your ďŹ ngertips.
Shop ONLINE for adorable gifts at: www.babiesrus.co.za
Deals valid from 23 October to 24 December 2017 in-store or online www. .co.za
also available at
Stock available at selected stores. Limited stock available. Please contact your Use this card nearest store to ensure stock availability. For your nearest store call 087 234 8697 at Toys R Us and during office hours or visit www.toysrus.co.za. Vitality discounts do not apply on Babies R Us promotional prices. VALID FROM 23 October to 24 December 2017.
RCS is a registered Credit & Financial Services Provider. NCRCP 38. FSP 44481
C O N T E N T S YP
92
&
DECEMBER 2017 JANUARY 2018
REGULARS
04 From the editor 06 Specialist Ed’s Note 08 Letters 10 Snaps 12 Bump Talk 14 Shopping: Mom’s rescues 16 Shopping: First aid baby buys
FEATURES
18 A bump in the road (trip) 20 C-Sections: Everything you need
87
to know 24 Why labour is good for baby
LIFESTYLE 44 Real life 86 Makeover 87 Fashion 92 Nutrition 98 Last laugh
DOSSIER
22
29 Big guide to money matters 37 Big guide to a happy healthy
body
MARKETING
26 Cover Baby Competition 46 Digital subscriptions 95 Bonus corner 96 Classifieds
Cover model Dudu of G3 Models Photographer Aubrey Jonsson Make-up Maria De Vos Stylist Jess Lupton Clothes Dress available for rental at The Source JHB
48 Fertility What the fertility doctors wished you knew 50 Month one Homeopathy for new moms and babes 54 Month two Building a strong baby 58 Month three Love your ultrasounds 60 Month four Swelling and summer 66 Month five The kicks and why they count 68 Month six Your home-away-from-home birth 72 Month seven Breastfeeding: True or false? 76 Month eight Episiotomy: The cruellest cut? 78 Month nine Measuring contractions 80 Your body The skinny on your post-birth body 83 Q&A breastfeeding Can I feed twins? 84 Your baby CPR: The lifesaving basics you need to know
On the cover...
14 66
PREGNANCY FILES
20
66
92 87
54
80
56 52 74 62 83
29 37 48
58 18
24 DECEMBER 2017 & JANUARY 2018 | 3
HELEN SCHÖER
I
love a new leaf! Every Monday is a chance to start again; so is every first of the month; and of course every new year. But the biggest chance at a new leaf you’ll ever get is during your pregnancy. Of course, we all know in broad terms how to live good, healthy lives. However, in our premotherhood years we will often work too hard, party too hard, eat on the run or not at all, waste time in relationships that don’t nourish us, and put our own well-being rather low down on a long to-do list. We’ll take risks and even expose ourselves to potential harm. How quickly the picture changes, though, when we find out that another life is at stake – the most precious life ever: that of your future child. As 2017 changes into 2018 and you await the birth of your baby, please take my message to heart: If you want to be a good mother, look after yourself first. Mother yourself a little. This is not a luxury, but a
necessity. Take time to think about what kind of parent you want to be, what kind of child you want to raise and the kind of home life you want to create. Then decide what needs to change. Maybe you simply want to eat more fruit and vegetables. Maybe you want to quit smoking, or maybe you need to get out of a bad relationship. Your decision will take courage and you’ll need determination to see your choices through. Fortunately, for us women, this is easier when we do it with a baby in mind and not just for ourselves. We’re just wired that way, and it really is quite wonderful. Your Pregnancy is here to support you in your decisions and the new leaf you want to turn. Please support us in 2018 as well and keep the letters and connection going. Hugs
You could see your little one on Your Baby Magazine’s cover! Send an up-to-date photo to coverbaby@yourbaby.co.za to enter Your Baby Magazine’s Cover Baby competition! See page 26.
4 | DECEMBER 2017 & JANUARY 2018
Editor-in-chief Helen Schöer (editor@yourpregnancy.co.za) Deputy Editor Robyn Lawrenson Art Director Denise Khoele Designers Portia Ngobese; Chané Isaacs Lifestyle & Shopping Editor Joanita Cillié Digital Editor Sophia Swanepoel MARKETING Marketing Executive Zoë Smith zoe@pinpoint.co.za NATIONAL ADVERTISING Pinpoint: Zoë Smith: zoe@pinpoint.co.za, 082 457 6984 Brigitte Kolver: brigitte@pinpoint.co.za, 083 708 1588 SUBSCRIPTIONS, RENEWALS & ENQUIRIES Call: 087 740 1021, 021 065 0033 Email: subscribe@yourpregnancy.co.za SMS: “YPSUBS” to 32361 (R1 per SMS) CONTRIBUTORS Zelda Ackerman, Adele Ferreira, Aubrey Jonsson, Craig Bishop, Margot Bertelsmann, Julia Boltt, Ziska Baumgarten, Riette Grobler, Yolandi Jordaan, Cath Jenkin, Sr Burgie Ireland, Dr Lousie Gilbert, Tracey Hawthorne, Melany Bendix, Camilla Rankin, Yolandi North, Karin Steyn PUBLISHING Publisher Nikki Rüttimann Circulation Manager Adele Minnaar 011 713 9440 Product Manager Janine Snyman 011 713 9918 General Enquiries (Cape Town) Anita Grindlay-Whieldon 021 408 1278 Office Manager Maphuti Mongatane 011 713 9961 CORPORATE Published by Media24, 19th Floor, ABSA Building, 4 Adderley Street, Cape Town, 8000 Tel: 021 406 2121 CEO: Media24 Esmaré Weideman HEAD: Media24 Print Media Ishmet Davidson GM: Media24 Lifestyle Raj Lalbahadur Head of Finance: Media24 Lifestyle Jameelah Conway Printed by Paarl Media Cape and distributed by On the Dot.Copyright Media24. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted, in any form or by any means, electronic or mechanical, without the prior permission in writing from the publisher. While reasonable precautions have been taken to ensure the accuracy of advice and information given to readers, the editor, proprietors and publishers cannot accept responsibility for any damages or inconvenience that may arise therefrom. Your Pregnancy has the right to make alterations to any material submitted, and cannot be held responsible for the loss of or damage to any material submitted for publication. All prices quoted were correct at the time of going to press, and may vary from shop to shop.
Image: Hanneri de Wet
FROM THE EDITOR
YP S P E C I A L I S T E D ’ S N O T E
A changing world TINA OTTE A mother, midwife, childbirth educator and an author. Tina has been involved in the pregnancy and birth field for more than 30 years.
TO FIND OUT MORE ABOUT TINA, GO TO tinaotte.com
A
lthough pregnancy is a normal state for a woman, it is indeed, an altered state. It’s a time of profound change on every level. While pregnancy grows on you physically, so too does your mind, and your emotions stand in line for some whammies. Pregnancy is a time of transition, of being in-between places as a woman. While your body seems to have a mind of its own, and
PEOPLE SEEM TO THINK THEY HAVE A LICENCE TO TOUCH YOU AND YOUR BELLY AND ASK YOU ALL SORTS OF QUESTIONS
like that. Often there are feelings of excitement, then feelings of dread. Feelings of being blessed, coupled with feelings of resentment. Suddenly watching a sad movie or advert on TV sends you into a fit of tears, and poverty-stricken families, especially children, seem to appear in your consciousness much more than they did before. People seem to think they have a licence to touch you and your belly and ask you all sorts of questions that you haven’t even thought of, done no research on and only cause you to panic and wonder if you’ll ever be a good mother. At times you feel gorgeous, fruitful, sexy and powerful as you create a life within your body. Other times you feel as full and as round as a tick! Welcome to the world of pregnancy, the training period that’s supposed to prepare you for motherhood. A time where you learn a lot, laugh a bit, and cry more than you think. Hopefully the articles and the stories in this magazine will open up your eyes to the fact that you’re not alone. With love,
the physical changes go from being subtle to obvious in a very short space of time, your heart and soul often take time to catch up. Especially if the pregnancy is a surprise! While we so often talk about the physiological changes, we seldom speak about the tsunami of emotions we go through that are supposed to be “normal”, but oh, so don’t feel
6 | DECEMBER 2017 & JANUARY 2018
LETTERS YP L E T T E R S
WINNING LETTER THIS TIME, I HAVE CONFIDENCE With my first baby, I struggled to breastfeed. So when I fell pregnant with my second baby, I rushed out to buy Your Pregnancy magazine. It had The Better Breastfeeding Guide. This guide has taught me so much about breastfeeding; I wish I had this information with my first child. I’m now confident that when my baby comes, I’ll be ready to breastfeed with confidence. Thank you YP, I hope the team knows how many lives you’re helping out with your magazine! I can’t wait to meet our little boy and nourish him with my very own breastmilk! BULELWA SAM, WELKOM
A POSITIVE BLESSING
This year has been a miracle year for me, even though my boyfriend was very sick during the first few months. He recovered thank goodness, and during this time, I discovered I was pregnant. The news was somewhat of a shock, as I wasn’t working at the time. But my boyfriend was happy with the news. I bought my first issue of Your Pregnancy in April. I was four months into my pregnancy and couldn’t wait to learn as much as I could. I’ve been filled with excitement ever since! I love my YP because every issue teaches me something new. I loved the added surprise of the Newborn Guide. I can’t wait to meet our precious baby, who we’re naming Musa Faith. MPHO FELICIA MASEBE, SOWETO
yoNurEW BABY -KEEP GUIDE YOUR ESSENTIAL MUST
YOUR POST-BIRTH BODY
VACCINES & BABY’S HEALTH
WHAT TO EXPECT
BREASTFEEDING KNOW-HOW
NEWBORN PG 32 SLEEP
Share your stories and connect with moms-in-waiting. Send your comments to letters@yourpregnancy.co.za
ALL IN GOOD TIME
I’ve been buying and reading Your Pregnancy and Your Baby ever since I got married. These magazines comfort me, and still do. Thank you so much! I prayed for a baby, and finally in February, after 10 years of marriage, we conceived! I was overjoyed! Our loved ones were surprised, happy and even shocked at our news. My husband has accepted our pregnancy and is growing more supportive and more in love with our healthy baby girl. She’s our miracle baby! We’re naming her Kerry. My tears of sadness have become tears of joy. We’re dreaming of Kerry’s safe arrival and our bright future as a family. LYDIA DALL, AMANZIMTOTI
MY SOURCE OF STRENGTH
I’m currently five months pregnant. I’m very happy and so is my fiancé. But he sadly lost babies from previous relationships – one through a miscarriage and the other was six months old. I always see the fear of loss in his eyes and I don’t blame him for that. I’m grateful for Your Pregnancy because I get to have my questions answered and I get to go through the pregnancy journey with all the assistance I receive from the magazine, without feeling the need to pressure my man, because I know he’ll come around. He supports me financially, comes for doctor’s appointments, and touches my belly; but he’s just not ready to talk about it.
When he’s ready to be there emotionally, I’ll be waiting. He has been my source of strength since day one and I’ll be his source of strength this time around, because I know God and Your Pregnancy magazine is my source of strength too. SINDILE MAGAGULA, DURBAN
GOOD NEWS, WHEN YOU LEAST EXPECT IT!
I’m 42 years old, and discovered I was pregnant with my third child when I was admitted to hospital, due to severe back pain. Prior to my discovery, I wanted another baby desperately, and read my Your Pregnancy magazines, which helped me focus on living a healthier life to fall pregnant. The day before I was admitted to hospital, I ran 13km, and the day before that I ran 9km. My doctor did many tests to check what could be the cause of my back pain, but the results were unclear. He then requested an X-ray, which required me to do pregnancy tests first, for safety reasons. I ended up not doing the scan, due to the exciting news that I was indeed pregnant! The gynaecologist at the hospital told me I was three weeks pregnant. My hubby was thrilled to hear the news. I’m now 28 weeks along, very healthy and without complications. I always buy my YP; it’s very informative and helps me through my pregnancy. Just when I least expected it, I fell pregnant with my baby girl, Ntandokazi. GUGU THUSINI, DURBAN
WIN A CANVAS IT HAMPER WORTH R1 500! Make special family memories on beautiful canvas prints, on a 50mm blocked frame, to hang around your home or in baby’s nursery. Canvas It will ‘stretch’ your special moments with perfect precision. The two acrylic sealer coatings guarantee a no-fade print forever. Free delivery anywhere in South Africa is included on all orders. Visit canvasit.co.za or call 082 458 5390 for more info.
STEP-BY-STEP HOW TO
SWADDLING, BATHING, CHANGING, MASSAGE AND MORE!
PROUDLY BROUGHT TO
YOU BY:
8 | DECEMBER 2017 & JANUARY 2018
SEND YOUR LETTER AND CONTACT DETAILS TO: YOUR PREGNANCY LETTERS. EMAIL LETTERS@YOURPREGNANCY.CO.ZA
A CHANGE FOR THE BETTER
In February this year I missed my period and decided to take a pregnancy test. The results were positive. The pregnancy was unplanned, so I had very mixed emotions about it. I bought my first Your Pregnancy magazine, and found all the information and articles so inspiring, that my attitude towards having my baby has changed for the better. I look forward to being a first-time mommy. My partner
and parents are very supportive. Thanks for giving me hope Your Pregnancy; you guys are the best! NTWANANO MAFUMA, GIYANI
CAN’T WAIT TO MEET YOU
I’m 25 and currently 25 weeks pregnant with my first child, a baby girl. The pregnancy wasn’t planned, but from the moment I found out, I was filled with joy. My grandmother raised me, and she
Send us your pics
is so excited about being a great-granny! I already love my little miracle. My boyfriend and I live far away from my family and friends, and he works very hard to support us, especially since I’m studying. It gets lonely at times, but now I’m looking forward to meeting my new best friend! I can’t wait to be a mommy. Thank you YP for all the informative articles. CASSANDRA DUROW, DURBAN
WINNING SHOT
Dionese and 4-month-old Wihan Potgieter, Centurion
WIN A GIFT CARD!
Send us a beautiful highresolution photo of you with your gorgeous newborn baby and you could win a Baby City gift card with R500. Email your entries, with all your relevant contact details, ID number and baby’s birth date to letters@yourpregnancy.co.za
Taking Care of Your Growing Needs... Our innovative, award winning seamless range has been carefully designed to make your maternity and nursing needs comfortable and more convenient.
Seamless Maternity Bra We have taken into consideration that women’s breasts are constantly changing throughout pregnancy. Soft cup style, nonunderwire maternity and nursing bras that are comfortable, flexible and supportive are imperative in ensuring a comfortable and healthy maternity and nursing experience. Wider straps and under band for added comfort and support. Innovative side panels allow for growth during pregnancy. Supportive X back with no hooks, clasps or clips. Non-wire revolutionary support. Can also be used as a sleeping bra to help prevent sagging and stretch marks.
Lace Feeding Bra Carriwell offers this stunning maternity/feeding bra in an elegant silky soft lace, sculptured for a feminine and attractive fit. Beautifully styled and designed for your confidence and comfort, the stretchy soft lace follows the natural curves of your body and the easy-to-open cross over style offers easy access for feeding. Cross over style offers support and comfort and is ideal for day and night time feeding. Extremely soft on delicate breast tissue - no underwire clips or buttons. Soft stunning and sensual.
Available at Baby Boom, Baby City, Babies ‘R’ Us at Toys ‘R’ Us, Dis-Chem, selected Clicks and Checkers Hyper stores, Takelot.com and leading baby and maternity stores. Carriwell SA (Pty) Ltd • P.O. Box 272, Umhlanga Rocks, 4320 • Tel: (031) 564 8805, Fax: (031) 564 9647 • www.carriwell.co.za, info@carriwell.co.za
Snaps WIN A CARRIWELL HAMPER VALUED AT R1 500 Carriwell’s Organic Nursing Bra is made from highly breathable organic cotton, great for warmer times of the year. As well as being super soft, the design gives support, comfort and shape, making it naturally gentler and more comfortable for both mom and baby. The nursing bra gives unique benefits of the award-winning seamless design that gives you wireless support, comfort and shape. Carriwell organic cotton is fully certified. Available in black and natural.
Sinayo Ngubeni from Springs, with Baby Siyamdumisa Hlelolwenkosi.
Nonzuzo Mchunu from Durban is 35 weeks along at her babyshower.
Cecile Henning from Pretoria is 29 weeks pregnant with her baby boy.
Tandy and Bradley Saffy from Benoni are expecting their baby on 17 January.
Zintle Tulumani from Cape Town is 38 weeks pregnant.
Zulpha Cassiem from Pelikan Heights looks radiant in pink at 32 weeks.
Liziwe Mkosana from Joburg oozes confidence and looks beautiful!
Meisie and Themba Nkolele from Pretoria can’t wait to meet their baby!
Winning photo!
Send us a beautiful high-resolution photograph of you with your gorgeous bump or baby. Send your photo with both your names and date of birth, and where you’re from to: Your Pregnancy Snaps, letters@yourpregnancy.co.za 10 | DECEMBER 2017 & JANUARY 2018
WHERE YOU NEED IT MOST
A D V E R T O R I A L YP
AADDVVEERRTTOORRI IAALL
GERMAN ENGINEERING WHERE YOU NEED IT MOST Anatomically shaped mouth shield ensures a secure fit to baby’s face and free breathing through the nose
Orthodontic NUK Shape helps exercise gum and jaw muscles
A circulation canal carries saliva away, thereby helping to prevent soreness around the mouth Outlet for saliva Ventilated holes in the mouth shield for continuous air circulation
Anatomically Anatomicallyshaped shaped mouth mouthshield shieldensures ensures a asecure securefitfittotobaby’s baby’s face faceand andfree freebreathing breathing through throughthe thenose nose
Flush-folding ring to prevent Orthodontic Orthodontic NUKShape Shapeis pressure points NUK when baby helps gum and helps exercise gum and lying on exercise it’s stomach or side jaw jawmuscles muscles AAcirculation circulationcanal canalcarries carriessaliva saliva away, away,thereby therebyhelping helpingtotoprevent prevent soreness sorenessaround aroundthe themouth mouth Outlet Outletfor forsaliva saliva
GERMAN ENGINEERING
The first two to four years are crucial to the development of the tissues, teeth and bone structure in your child’s mouth. That’s why it’s so important to see that your baby gets the best possible dummies.
Ventilated Ventilatedholes holesinin the themouth mouthshield shieldfor for continuous continuousair aircirculation circulation
about your child’s healthy development, ring Flush-folding ringtotoprevent prevent now, and laterFlush-folding on. pressure pressurepoints pointswhen whenbaby babyisis lying lyingononit’sit’sstomach stomachororside side
NUK SIZE CONCEPT
take note that the NUK teats have various feed hole sizes. The size of the hole in the teat influences the rate at which the baby drinks. It is very important not to confuse the size of the nipple/bulb, which relates to the age group, with the hole size which relates to the feed. The hole size note that the the NUK teats influences rate at have whichvarious baby drinks feed hole sizes. The size offeeds. the hole insize is take note the NUK teats have various take notethat that the NUK teats have various various consistency of The the teat influences thesize rateofof at the which feed hole sizes. feed hole sizes. The The size the hole hole inin the drinks. It is very important the teat the rate atatwhich the thebaby teatinfluences influences the rate which the Size Concept not todrinks. confuse the size ofimportant the nipple/ 0-6 baby isisvery not toto 6-18 important baby drinks.It It very not m bulb, which relates tomthe age group, confuse confusethe thesize sizeofofthe thenipple/bulb, nipple/bulb,which which with the hole size, which relates toas breast Smallgroup, hole for thin liquids such relates with the hole S age relatestotothe the age group, with the holesize size milk, tea, water the feed. The hole size influences the which which relates relates toto the the feed. feed. The The hole hole size size rate at which baby drinks various Medium hole for milk (formula) influences the rate at baby drinks influencesM theof rate atwhich which baby consistencies feeds. The size is drinks various variousconsistency consistencyofoffeeds. feeds.The Thesize sizeisis
RIGHT... FROM THE START
to four yearssoothers are THE FIRST TWO NUK’s original orthodontic The first to years crucial toby the development of the The firsttwo two tofour four yearsare arecrucial crucial the designed orthodontists tototothe be tissues, teeth and bonepromoting structure in development ofofthe tissues, teeth development the tissues, teethand andbone bone orthodontically correct, the yourdevelopment child’s mouth. whyThat’s it’s so structure inin your child’s mouth. structure your child’s mouth. That’s healthy of That’s your baby’s tiny important to see that your baby why it’s so totosee that your baby why it’sMost soimportant important see that yourgets baby mouth. Orthdontists’ Recommend the best possible dummies. gets the best possible gets the best possible dummies. NUK before any otherdummies. brand* RIGHT... FROM THE START RIGHT... FROM THE RIGHT... FROM THESTART START DESIGNED TO orthodontic PLEASE NUK’s original soothers
NUK offers the right size soother for each age. Something that is essential for healthy oral development. The different soother development, now, asbewell as later sizes should always subject to on each as they grow up.development. about your child’s healthy about your child’s healthydevelopment, development, baby’s individual now, now,and andlater lateron. on. NUK SIZE CONCEPT NUK SIZE offers the right soother for The NUK Sizesize Concept NUK CONCEPT NUK SIZE CONCEPT each age, which is something that iseach NUK NUKoffers offersthe theright rightsize sizesoother sootherfor foreach essential for healthy oral development. age. that healthy SIZE 0 SIZE 1isisessential SIZE 2 for SIZE 2 age.Something Something that essential for healthy The different soother sizes should oral oral development. development. The The different different soother soother always be subject to each baby’s sizes sizes should should always always be be subject subject toto each each individual development. baby’s baby’sindividual individualdevelopment. development.
NUK’s original orthodontic soothers NUK’s original orthodontic soothers NUK dummies come in a wide range fun are designed by orthodontists toofbe designed by orthodontists toto be designed by orthodontists be designs and colours correct, that are guaranteed orthodontically promoting to orthodontically correct, promoting the orthodontically correct, promoting the 0-2 0-6 6-18 18-36 healthy development of face. your Best put the a smile on your little one’s m m m m healthy development ofof your baby’s healthy development your baby’stiny tiny baby’s tiny mouth. Most orthodontists and most important of all of all is the The NUK Size Concept The NUK Size Concept mouth. Most Orthdontists’ Recommend mouth. Most Orthdontists’ Recommend recommend before any other NUK Shape- theNUK teat of the NUK silicone NUK before NUK beforeany anyother otherbrand* brand* brand. and latex soothers are specially designed SIZE SIZE00 SIZE SIZE11 SIZE SIZE22 SIZE SIZE22 to mimic the shape of your nipple during DESIGNED TO PLEASE DESIGNED TO PLEASE DESIGNED TO PLEASE breastfeeding. It is hardly surprising then NUK GET’S TECHNICAL NUK dummies come in a range wide range NUK dummies come ininaawide NUK dummies come wide rangeof offun fun to find thatdesigns most paediatricians choose, or You need to be aware that the teat of the of fun and colours that are designs designsand andcolours coloursthat thatare areguaranteed guaranteedtoto haveguaranteed chosen, NUK for their own children. bottle also in different putlittle a smile onface. yourBest little NUK0-2 0-6 6-18 18-36 0-2 0-6comes 6-18 18-36 sizes put your one’s putaasmile smileon onto your little one’s face. Best mm mm mm mm in order to ensure the optimal teat for one’s face. Best and most important of and and most most important important ofof all all ofof all all isis the the all is the NUK Shape – the teat of the INVEST IN THE BEST each development stage of the baby’s NUK NUKShapeShape-the theteat teatofofthe theNUK NUKsilicone silicone NUK silicone and latex soothers are When you’re making a choice that will oral cavity. Did you know? For a baby and andlatex latexsoothers soothersare arespecially speciallydesigned designed specially designed to mimic theinshape affect you and your child, invest the to consume 70g of breastmilk, it takes totomimic shape mimicthe shapeofofyour yournipple nippleduring during of yourthe nipple during breastfeeding. best. NUK soothers promote good dental 569 sucking motions and 53 pauses in 13 breastfeeding. surprising then GET’S TECHNICAL breastfeeding. Itisishardly hardly surprising then NUK GET’S TECHNICAL NUK GETS TECHNICAL It is hardly Itsurprising then to find that NUK health so that youpaediatricians can be morechoose, confident minutes. When purchasing theteat teat,ofof please totofind that most or You need to be aware find that most paediatricians choose, or You need to be aware that the the You need to be awarethat thatthe theteat teat the most paediatricians choose, or have have chosen, NUK for their own children. NUK bottle also comes in different sizes have chosen, NUK for their own children. NUK bottle also comes in different sizes of the NUK bottle also comes in chosen, NUK for their own children. *(Source: 2013, Qualitiatve Quarter Research Consultants) in order to ensure the optimal teat for in order to ensure the to optimal different sizes in order ensureteat the for INVEST THE BEST each development stage ofof the optimal teat for each development INVEST INTHE THE BEST INVEST IN IN BEST each development stage the baby’s baby’s stage of theDid baby’s cavity. When you’re making achoice choice thatwill will oral When you’re making aa choice that cavity. you know? For aa baby When you’re making that will oral cavity. Did youoral know? ForDid baby you know, for a of baby to consume 70g affect you and your child, invest affect you and your child, invest inininthe toto consume 70g itit takes affect you and your child, invest the consume 70g of breastmilk, breastmilk, takes of sucking breastmilk, it takes 569 theNUK best.soothers NUK soothers promote good 569 best. promote good and 53 pauses best. NUK soothers promote gooddental dental 569 suckingmotions motions and 53sucking pausesinin13 13 motionsWhen and 53 pauses inthe 13teat, minutes. dental health socan thatbe you canconfident be more health so more minutes. purchasing health sothat thatyou you can be more confident minutes. When purchasing the teat,please please When purchasing the teat, please take confident about your child’s healthy *(Source: *(Source:2013, 2013,Qualitiatve QualitiatveQuarter QuarterResearch ResearchConsultants) Consultants)
Feed Hole Hole Identifier Identifier Feed Feed Hole Identifier
WHERE YOU NEED IT MOST
L
Large hole for thicker feeds
XL
Extra large holeSize for reflux formula and Concept Size Concept
0-6 milk feeds with cereal 6-18 0-6thicker 6-18 mm mm
Recommendation only. Please consider
hole forforthin liquids Small hole thin liquidssuch suchasasbreast breast your baby’s individual development. SS Small milk, milk,tea, tea,water water
clearlyMM marked on all the NUK packaging Medium (formula) Mediumhole holefor formilk milk (formula) and also on the side of the teat, with “S”, L L Large hole thicker Large holeforforThis thickerfeeds feeds “M”, “L” or “XL”. symbol represents Extra large hole for reflux formula and Extra large hole for reflux formula and small, the hole size and will either be XL XL feeds with thickermilk milkor feedsextra-large withcereal cereal medium, thicker large cross-cut Recommendation Please Recommendation only. Pleaseconsider considerthat the hole respectively. Youonly. should note your yourbaby’s baby’sindividual individualdevelopment. development. small hole for a size ONE teat is the same size hole as that size TWOpackaging teat and the clearly marked on all clearly marked onof allathe theNUK NUK clearly marked on all the NUKpackaging same goes for the other holes too. and also on the side of the teat, with and also on thealso sideon of the the side teat, of with “S”, packaging and the“S”, “M”, “L” or “XL”. This symbol represents “M”, “L” or “XL”. This symbol represents teat, with “S”, “M”, “L” or “XL”. This AUGUST/SEPTEMBER 2016 7 the size will either small, the hole hole size and andthe will either be small, symbol represents hole sizebe and will eitherlarge be small, medium, or medium, oror extra-large cross-cut medium, large extra-largelarge cross-cut extra-large cross-cut respectively. hole You should note holerespectively. respectively. Youhole should notethat thatthe the You should note that the teat small for small hole aasize ONE the small holefor for size ONE teatisishole thesame same asize size ONE teat is same size hole as size hole asasthat TWO teat and hole thatof ofathe asize size TWO teat andthe the that ofgoes a size teatholes and the same for the too. same goes forTWO theother other holes too.same goes for the other holes too. AUGUST/SEPTEMBER AUGUST/SEPTEMBER2016 201677
DECEMBER 2017 & JANUARY 2018 | 11
BUMP TALK HOPE TO FAMILIES AFFECTED BY LIFE-THREATENING BLOOD DISORDERS Storing umbilical cord blood stem cells at birth could prove to be a life-saving investment for a child, or sibling, if they are diagnosed with a life-threatening blood disorder that is treatable by a stem cell transplant. Not everyone chooses to bank their baby’s cord blood stem cells. CryoSave South Africa, a private cord blood stem cell bank in Pretoria, has recognised the plight of families who have a child with a blood disorder that can be treated with a stem cell transplant. It provides hope to families affected by leukaemia, other forms of blood cancers, and blood disorders such as sickle cell disease, through its cost-free donation programme. It offers families affected by diseases that can be treated with blood stem cells the opportunity to store the cord blood stem cells of their expected newborn
child to potentially treat a sibling who has been diagnosed with a blood disorder. To qualify for the cost-free donation programme, a sibling of the unborn child must have been diagnosed with a disease that’s currently treatable with umbilical cord blood stem cells (an FDA-approved indication for transplantation) and must be being treated by a medical specialist who agrees that the stem cells could be used for treatment. If eligible, CryoSave will enrol the family into the cost-free donation programme, provide the cord blood collection kit, and process and store (cryo-preserve) the newborn’s cord blood sample without any cost to the family. For more information on Cryo-Save or stem cell storage contact 087 8080 170 or info@cryo-save.co.za.
BRONZE YOUR BUMP FOR SUMMER! Matsimela’s In-Room Spa Bronzing Cream is just what you need to prep your skin for summer! This light-based, easy-to-apply lotion beautifully bronzes your skin. Containing a blend of specially chosen pigments to bronze fair to darker skin tones, it leaves your skin feeling soft, moisturised and silky, with a gorgeous, even application. Containing no harsh chemicals or parabens, it’s safe to use during pregnancy. Get yours for R185 from matsimela.co.za. 12 | DECEMBER 2017 & JANUARY 2018
The latest pregnancy buzz and trendy finds
BEST IN BABY FOOD MAKING NutriBullet’s new Baby Bullet is an easy-to-use, easy-to-clean blender that’s made specifically for the preparation and storage of baby foods. The Baby Bullet will be your new best friend, saving you time, and ensuring your little one gets only the best nutrition. The Baby Bullet allows the effortless creation of delicious, healthy and nutritious baby food in seconds while simplifying storage – making it the must-have accessory for new moms and dads! It’s easy to make individual meals, or to create up to six portions at a time, each of which can be stored in sealable, datedialled individual cups that can then be refrigerated or frozen. The 22-piece NutriBullet Baby Bullet set is the perfect gift for all new parents. It’s ideal for little ones ranging from six months to three years old as they adjust to finger foods. Get your Baby Bullet for R1 599. For more info and stockists, visit nutribullet.co.za.
BIN THEM OR BANK THEM? NA FT
TE
EVE
EM
SAVE L IV
LI
ES. C
FE
ST
H O O S
E
W
LY. ISE
Whether you’re welcoming a little one for the first time or adding a new sibling to a growing family, the financial pressures of parenting can be overwhelming. A new baby comes with a host of new expenses, from medical care to nursery items, travel equipment and nappies. But the good news is that there are several ways to get smart about saving. According to a 2016 survey conducted by Gumtree South Africa and Tums2Tots Online, South African moms tend to hold on to valuable baby goods long after their tots have outgrown them. “Ten percent of women surveyed had at least R40 000 worth of unused baby goods taking up space in their homes. The items are typically bought during pregnancy or the first few years of a child’s life, but are then relegated to the garage or spare room to gather dust,” says Claire Cobbledick of Gumtree South Africa. The items that most often lie dormant are car seats, carriers, baths, high chairs, baby clothes and toys that have been outgrown. Some parents are reluctant to buy pre-owned baby and children’s goods due to a perception that second-hand means lower quality. But the survey results suggest that many of these items are more likely to have been stored than used. A car seat costs up to R3 000 brand new, but you could find a perfectly good one for R1 000 on Gumtree – a significant saving on a must-have item. Top tip: before purchasing your pre-owned car seat, double check the safety features and ask your seller if it’s ever been in an accident. A stroller could cost you between R2 600 and R6 999, while the average second-hand price is around R1 400. A cot – which can cost up to R2 500 brand new, goes for around R1 500. Opting for pre-owned over new on these three essential items alone could save you as much as R6 000. It’s easy to save smart when you shop second-hand. With more than 15 000 “baby and kids” listings on Gumtree, you’re bound to find everything your little one needs, for less. Visit gumtree.co.za for more info and to get shopping!
IRTH. S
L LS CE
H E R E,
B ER
M
WITH SECOND-HAND SHOPPING
RO M SF
SAVING IS
Having a baby brings about many responsibilities. Make sure you know the facts about the lifesaving abilities of your baby’s cord blood stem cells, before you discard them as medical waste.
YOU HAVE ONLY ONE CHANCE TO GIVE THIS PRECIOUS GIFT.
INVEST IN HOPE FROM R279* PER MONTH. * Terms and conditions apply.
For an obligation-free information pack and/or consultation: email info@cryo-save.co.za or visit www.cryo-save.co.za This is for information and educational purposes only, and should not be construed as healthcare advice. Please discuss with your healthcare professional. A full list of references is available on the website and at our offices. Data on file.
Cryo-Save South Africa is jointly owned by Esperite N.V., listed at Euronext Amsterdam and Paris and JSE-listed Ecsponent Limited.
YP S H O P P I N G Mama Mio Superstar in a Jar from R450 for 15g Poisebrands.co.za
Bio-Oil, from R99 for 60ml leading retailers
Carriwell Linen Savers, R49.50 leading retailers, baby and maternity stores, selected pharmacies and takealot.com
Lansinoh 3-in-1 Therapearl Hot & Cold Breast Therapy for engorgement, swelling & pain, from R249.99, Baby Stores, Dis-Chem and pharmacies
Mom s rescues ’
These little lifesavers make a big difference – so stock up!
Jean Kelly leather backpack, R2 595 Jeankelly.co.za
Pigeon Breast Pads 36’s & 60’s, from R79.99 (36) and R99.99 (60) baby stores, selected retail outlets, leading pharmacies and online stores 14 | DECEMBER 2017 & JANUARY 2018
NUK Pelvic floor trainer, R599.99 available at DisChem or order directly at orders@artemisbrands.co.za
Images: Supplied
125ml Happy Event Cream from R90 200ml Happy Event Lotion (original), from R95 200ml Happy Event Lotion Fragrance Free (new) from R95 leading retail stores and pharmacies
YP S H O P P I N G
Iliadin Infant Drops for baby (one month – one year) from R41.96 pharmacies nationwide
Safety 1st Cradle Cap Brush & Comb, from R99.99 Baby City and Dis-Chem stores
Sudocrem Baby Care Cream from R44.95 leading retailers
First aid baby buys Stock up on these essentials for baby’s first aid kit
5 piece Medical Kit and Storage Case, R130 Clicks
Purity & Elizabeth Anne’s Fragrance Free Baby Petroleum Jelly from R15.59 leading retailers
Pigeon Nose Cleaner, R69.99 baby stores, selected retailers, leading pharmacies and online stores 16 | DECEMBER 2017 & JANUARY 2018
NUK baby forehead thermometer, from R659.99 favourite NUK Retailers
Betadine Antiseptic Ointment 20g from R41.95 leading pharmacies and retail stores (for baby under two use under advice of their pharmacists or doctor)
Images: Supplied
Elektra Multifunction Thermometer from R299.99 baby stores, selected retail outlets, leading pharmacies and online stores
YP F E A T U R E S
Make like a girl guide and be prepared, writes Margot Bertelsmann
A bump in the road (trip) WHETHER YOU HAVE to travel for work, or want to travel for fun, getting on an aeroplane or in a car for a long trip is sometimes an inevitable part of your pregnancy. And because we are such clever and evolved human beings, we now know how to manage the additional risk and take intelligent precautions so that your trip can be safe, fun and even immune to judgement from your motherin-law. Bonus. However, that definitely doesn’t mean you should take unnecessary risks, says Mike Schepers, CEO of travel vaccinations clinic Travac (travac.co.za). “In all cases, the welfare of the unborn child should be of primary importance,” he says. Here are the travel arrangements you should make to keep you and your baby safe.
WHEN TO FLY
Airlines get all bossy about how late into your pregnancy they will let you fly, because they don’t want to deliver your baby at 30 000 feet. Understandably. So check with your airline before you book. Domestic flights generally allow women closer to their due date to fly – international travel brings a whole 18 | DECEMBER 2017 & JANUARY 2018
world of complications should a medical emergency or a birth happen between countries. Some airlines want a doctor’s letter confirming your pregnancy is low-risk and you can fly. Erm, if your pregnancy is high-risk, you obviously shouldn’t take airplane trips for leisure. Many women decide to make a trip in the golden second trimester, when they feel safer about the pregnancy being established, and when their nausea and fatigue has abated, but before they feel like the Oros man in the unwieldy last few weeks of pregnancy. That’s a sensible idea – plan your travel for this time if you can. If you’re travelling by car, be aware that you may be feeling green about the gills. Chew on your ginger sweets and schedule regular walking and toileting recovery breaks – your infamous pregnancy bladder and swollen ankles will thank you, too, especially if you have been good and drinking lots to avoid dehydration and the risk of deep vein thrombosis.
MALARIA AREAS
“First prize is not to go into a malaria area when you are pregnant,” says Mike.
If you already live in a malaria area, you will be used to being careful around mozzies, and while there is medical evidence that communities who live near the anopheles mosquito develop some natural immunity, this is by no means failsafe. So keep using your prophylaxis: mozzie mats, nets, and spray-on or painton repellents, and wearing skin-covering clothes. “If you have no choice but to travel to a malaria area, don’t get bitten,” says Mike. Be paranoid about it. “Mefloquine and chloroquine are deemed safe for use during pregnancy,” he adds, “but stay away from doxycycline and primoquine.” Mike says that, when weighing up whether to take medication – or have vaccinations – you should always weigh up the risks versus the benefits. Discuss these with your doctor before you travel.
VACCINATIONS
Some countries require visitors to have vaccines against illnesses before you enter the country. Commonly requested vaccines include the yellow fever vaccine, most commonly, as well as proof that you are up to date with vaccines, or
have boosters, for polio, diphtheria, tetanus, hepatitis A and B, measles, mumps, rubella, and typhoid. “The risk to an unborn child from vaccinations is primarily theoretical,” says Mike. “No evidence exists of risks from vaccinations to pregnant women with inactivated virus or bacterial vaccines. Live vaccines pose a theoretical risk, such as yellow fever, measles, mumps, rubella, and varicella. Safe vaccines are the hepatitis A and B, meningitis, polio, diphtheria, tetanus, and typhoid vaccines.” So if you know you are at risk due to not having had a booster vaccine or a high incidence of the disease in the region you are visiting, make a choice either not to go, or to have the vaccine. As Mike says, “Benefits usually outweigh risks in high exposure areas.” “In all cases the welfare of the child should be of primary importance. If it’s a high-risk area, don’t go! It’s a few months of inconvenience or missing out on fun versus a lifetime of regret should you fall ill.” YP
Super Soft
& Sensitive Baby Wipes
TRAVELLING WITH A NEWBORN TIPS TO MAKE IT THROUGH
Imgaes: Gallo Images/Getty Images
Whether it’s to meet a granny, or just to take a sanitysaving break, sometimes travelling with a small baby has to happen. We know you’re already stressed out by the job of keeping a baby alive while occasionally getting an hour of sleep, and it would be a pity to add even more anxiety into the mix. 1. Cultivate acceptance Your best-laid plans of booking the flight to coincide with baby’s sleep time WILL go awry when the airline tells you there is a two-hour delay. There will be tears – and baby will cry, too! (Ha, ha.) If you can see the getting-there part of the journey as almost like a circle of hell you have to pass through before your paradisiacal reward, you’ll go into grit-your-teeth survival mode, and you’ll cope, because you have to. Try not to take other passengers’ nastiness and eyerolling personally. Those grumpy people have forgotten that they, too, were babies once. And your baby has as much of a right to exist as they do. 2. Take a dummy Babies’ ears hurt on flights (due to the pressure change) and they can become inconsolable. Letting them suck a dummy or breastfeed can help. 3. Pack a take-on travel bag And don’t even bother to stash it in the overhead compartment. Essentials: baby wipes, bottles, snacks, nappies, plastic nappy bags, bibs, toys, and Rescue Remedy for mom and dad. 4. Take it slow If you’re driving, schedule in frequent stops and accept you won’t get to Durbs in your usual six hours. That’s a long time for a baby to be in a car seat – and she MUST be in a car seat whenever the car is in motion, that’s not negotiable. She’ll need breaks, and so will you. The upside is many babies are lulled to sleep by a long car drive so you could get a nice, long stretch of driving in while baby is out for the count.
NEW N ATIO
R GENE
Contains 99% Pure Water Soothes and keeps baby’s skin hydrated Extra Soft with added thickness Suitable for use on Sensitive Skins including Mom and Dad
www.sp-africa.com
Pigeon South Africa
@Pigeon_SA
@Pigeon_SA
EVERYTHING YOU NEED TO KNOW
Giving birth is a wonderfully terrifying experience, no matter how you do it. But many expectant parents are doubly fearful of having a caesarean section, as it’s two processes rolled into one – childbirth and a surgical procedure! Here’s what to expect if you’re having a caesarean section, writes Cath Jenkin
WHY ARE YOU HAVING A C-SECTION?
Generally speaking, c-sections are performed by choice or for a specific purpose. If you’re delivering your child through a private healthcare facility, your gynaecologist may ask you if you’d prefer to have your baby via c-section or if you’d like to give birth naturally. In a public healthcare setting though, c-sections are only performed for medical reasons or emergencies. If your baby is large, breech, if you have some sort of obstruction in your belly, or if you are HIV-positive, it will be recommended to you by your gynaecologist or clinic nurse that you have a c-section. Almost all multiple baby births are now c-section deliveries, so if you’re having twins, you’ll be booked in for this. If you’ve had a baby via c-section before, your doctor or clinic sister may also recommend that you have your next child via a c-section, but that will be determined based on your experience and medical history too.
AN EMERGENCY C-SECTION When a mother is in labour, and
20 | DECEMBER 2017 & JANUARY 2018
progressing through a natural labour, she and her baby are regularly monitored to ensure the baby is doing well. If there’s any sort of medical emergency during labour, moms may have to undergo an emergency c-section. Your doctor will monitor you throughout your labour, and you may be determined to stick to your birth plan, but bear in mind that your health and your baby’s health are of prime importance. If your labour has stalled, or if your baby isn’t getting enough oxygen or their heart rate slows down, you’ll be admitted to a surgical theatre for an emergency c-section.
WHAT TO EXPECT
Dr Sarah Jackson, who is a specialist obstetrician and gynaecologist at the Netcare Park Lane Hospital, tells us that moms should expect their doctors to talk them through what will take place during the procedure. “There may be a delay in the c-section being performed, as the hospital staff may need to attend to any emergencies first,” says Dr Jackson. “The doctor will explain the anaesthetic to be used and how the baby will be cut out
through a small incision made in the mother’s abdomen. A spinal block is usually used during a c-section, so moms won’t be able to move their legs for a few hours after the operation. After your delivery, you’ll be taken to the ward with other moms and their babies, and can expect to be discharged after two days.” In a private hospital, you’ll stay two to three days, until your doctor is satisfied that you and your child are recovering well from childbirth.
PREPARING FOR YOUR C-SECTION
Bear in mind that recovering from a c-section can take quite a bit longer than recovering from a vaginal birth, so you’ll need extra hands at home, ready to assist when you’re discharged. But, before you head to the hospital, don’t forget to pack comfortable pyjamas with button-up tops, as these are easier for breastfeeding and clothes, nappies and blankets for your baby. For moms who are having a c-section, Sarah also recommends that you pack “netting panties – these are more comfortable as they don’t rest on the wound”.
F E A T U R E S YP
DECEMBER 2017 & JANUARY 2018 | 21
YP F E A T U R E S
MAKE YOUR CAESAREAN SECTION MORE PERSONAL Your child’s birth is a magical moment, so don’t let the idea of it also being a surgical procedure dissuade you from making it special. Here’s how you can make it a little more personal: ■ It’s possible for you to breastfeed immediately, or shortly after, you’ve given birth. Ask your doctor to facilitate this as part of the postoperative routine. ■ You could request that a birth photographer be present, or ask your birth partner to snap a picture on their cellphone as your baby is lifted from your belly. ■ If possible, you can request low lighting or even to play music during the surgery. Just check with the hospital and your doctor to ensure this is okay. ■ Ask your doctor to hold off on clamping your baby’s umbilical cord for the first few minutes, so long as your baby is breathing well. This can have substantial health benefits for both you and your baby.
AT THE HOSPITAL
Once you’re all booked in for your c-section, you may be nervous and a bit apprehensive. Remember, you’re in good medical hands! You should be able to have someone with you in the operating theatre, so your husband, partner or birth partner can go in with you. They’ll need to wear hospital scrubs and ensure that they abide by all hospital rules relating to the surgical theatre.
I’VE HAD TWO Q: C-SECTIONS. CAN I HAVE ANOTHER? The build-up of scar tissue from c-sections is a cause for concern among doctors and gynaecologists, so you’ll need to be assessed by your doctor before having a third, or further, c-section. Remember that your doctor or clinic sister is the best person to talk to about any concerns or worries you may have. 22 | DECEMBER 2017 & JANUARY 2018
YOUR CHILD’S BIRTH IS A MAGICAL MOMENT, SO DON’T LET THE IDEA OF IT ALSO BEING A SURGICAL PROCEDURE DISSUADE YOU FROM MAKING IT SPECIAL RECOVERING AT HOME
Once you’ve been discharged, your recovery won’t be over. That’s why it’s vital to have extra hands on deck at home, to help you care for your newborn baby and take care of yourself. For feeding, you’ll need help with lifting your baby up, as the wound from your c-section needs to heal. Support your stomach with extra pillows or cushions and take all the medication as it is
prescribed to you. Keep an eye on your wound, and head directly to the hospital if you experience any sign of infection or fever. You’ll have a follow-up appointment with your doctor two to four weeks after you’ve given birth, so that they can check your wound is healing well. You’ll also have a six-week check-up after you’ve given birth, so don’t forget to keep to those appointments. YP
HOW DOES HAVING A C-SECTION AFFECT YOUR MILK FLOW? The medications you’re given to use during your recovery shouldn’t affect your ability to breastfeed, but you may need to get experimental with your feeding position. Painkillers and related medication could make your baby extra sleepy though, but the medicines given to you won’t have a harmful effect on your child. Try to feed as regularly
as possible, to establish a good milk supply – it’s recommended that you breastfeed every two to three hours while establishing breastfeeding. The more traditional cradle hold could be difficult and painful for you as you recover, but many moms find that lying on their side while feeding helps for the first few days.
The product most recommended by gynaecologists for pregnancy stretch marks. Ipsos, 2016
“In my teens I got a few stretch marks just behind the knees and that’s when my mother introduced me to Bio-Oil. It worked perfectly and they pretty much went away, but I was worried I might get them again in my pregnancy. So I started using Bio-Oil again. I used it on my tummy, my back and my legs, twice a day, especially after my bath. And thankfully I didn’t get any stretch marks.” Sphokazi with Ndalénhle
Bio-Oil® helps reduce the possibility of pregnancy stretch marks forming by increasing the skin’s elasticity. It should be applied twice daily from the start of the second trimester. For comprehensive product information, and details of clinical trials, please visit bio-oil.com. Bio-Oil is available at pharmacies and selected retailers at the recommended selling price of R99.99 (60ml). Individual results will vary.
New Packaging Same Formulation
WHY LABOUR IS GOOD
FOR BABY
Our country is one of the few in the world where you can choose how you want to birth your baby. If you’re considering this, here are the facts on why vaginal delivery has many benefits for your baby, and you, writes Tina Otte WHEN PONDERING YOUR labour and birth
day, most expectant mothers think about it in terms of the effect it will have on them. But labour has huge effects on baby, and in a healthy unborn baby the effects have enormous advantages. Many mothers-to-be are led to believe that labour is unmanageable, unnecessary and unsafe for their baby. But labour has a purpose – nature has a plan to bring your baby into this world safely, and not only that, your baby’s brain and certain reflexes get “switched on” as baby moves through the birth canal. The contractions of labour provide massive skin stimulation for the unborn baby. This helps prepare the baby’s sustaining systems (baby’s own life support system) to take over as the first breath is drawn. During labour certain hormones are released to help both mother and baby deal with the stressors that labour brings. These stressors are good for a healthy baby and give your baby a fighting chance to take on the world.
LOVE THOSE HORMONES
Hormones that are released in the mother filter through to the baby and work for the baby in the following way. Oxytocin is released in massive quantities during the second and third stage of labour and indirectly works for baby, by warming up the mother’s skin and making sure baby is warm and snug when he’s laid on his mother’s chest. Her temperature will fluctuate according to how warm or cold her baby is. That’s why giving baby to mom immediately after birth (before routine weight and length checks) 24 | DECEMBER 2017 & JANUARY 2018
F E A T U R E S YP
is so important. Oxytocin also causes her breasts to be filled with colostrum, providing nourishment for the newborn as he has his first feed, stabilising his sugar levels. Endorphins provide pain relief for the baby as he works his way down the birth canal. Nature’s narcotic has no negative side effects on him, as synthetic narcotics (such as pethidine) would have. It also provides euphoria in both mom and baby at the time of birth. The alertness your newborn has is directly related to these hormones. A more alert baby draws parents in and he or she is more responsive to parents and others. Adrenaline, which is always released under stressful situations, whether good or bad, is the most important hormone in ensuring the survival of the baby. The stress hormones released at birth are equal to those released in an endurance athlete. Birth is taxing, but women and babies are well equipped to deal with it! A healthy full-term baby responds to the stress of labour with a surge of adrenaline and research suggests these high levels are a built-in defence to provide protection during birth and to help the
Imgaes: Gallo Images/Getty Images
ADRENALINE, WHICH IS ALWAYS RELEASED UNDER STRESSFUL SITUATIONS, WHETHER GOOD OR BAD, IS THE MOST IMPORTANT HORMONE IN ENSURING SURVIVAL OF THE BABY baby adapt to life outside the womb. Adrenaline helps to prepare the baby’s respiratory system for breathing. As the baby makes his way out of his mother’s body, the compression of the baby’s chest during contractions squeezes fluid from the lungs into the throat. Adrenaline allows for better re-absorption of lung fluid so the baby is better able to breathe. Adrenaline also promotes the release of lung surfactant – a soapy-like substance that allows the alveoli in the lungs to open for the first time and work
as they breathe oxygen and no longer water. This enables the lungs to expand on the baby’s first breath. Adrenaline helps a baby conserve energy and oxygen so that the baby is a good colour and will get a good Apgar score as soon as possible after birth, and there is redistribution of circulation. Stress hormones help send more blood to the baby’s brain, heart and kidneys, all of which are organs necessary for life support. The white blood cell count increases with the secretion of adrenal hormones. This also causes an increased energy supply to the baby. This is what keeps the baby so alert.
OTHER BENEFITS TO BABY
The baby’s nervous system is stimulated so that the newborn is aroused and alert for one to two hours after birth – and aware of the change in environment. The nervous system is constantly myelinated (bubble wrapped) protecting the nerves and the brain during the birth process. The baby’s pupils dilate as a result of adrenaline release, as do the mother’s. This phenomenon causes the beginnings of attachment between a mother and her baby the minute they lay eyes on each other. The sooner this happens, the better the start of the bonding process will be. As baby moves through the birth canal, the muscles of the vagina “unscrew” the baby by causing it to twist and turn as it moves down. After being curled up in one position for all the weeks of pregnancy, this helps the spine to uncurl and align before coming into the world. As the baby passes through the mother’s vagina, he or she will pick up the good bacteria from her body and colonise her bacteria in his own body. This helps him or her fight infection and is the start of a good immune system. He or she is less likely to have as many digestive complaints (such as colic or reflux) post birth. Due to the exquisite cocktail of hormones that are produced during labour and birth, mother and baby are drawn to each other and both can’t help but fall in love in the early hours and days after birth. A mother has an intense desire to protect and love her baby, which he feels very quickly. This means that he knows he is valued, wanted and loved. He knows he is welcome and important. This is already the start of building a healthy self-esteem for this baby, which may be the foundation of good things for this individual for the rest of his life. YP DECEMBER 2017 & JANUARY 2018 | 25
YP C O M P E T I T I O N
! w o n r e t n E 26 | DECEMBER 2017 & JANUARY 2018
YOUR CHILD COULD BE ON THE COVER OF YOUR BABY MAGAZINE! YOUR BABY 228
BUY IT NOW! BOOKS · BEAUTY · BEDROOMS
SEASON’S EATINGS
YOUR BABY 231
YOUR BABY 229
TEETHING TROUBLES
COOL PRODUCTS THAT WORK
8 GREAT SUMMER RECIPES
ISSUE 228 MAY & JUNE 2017 R31,50 (VAT INCL) N$34,00 (NAMIBIA)
CONQUERING CEREBRAL PALSY page 74
GENDER IS COMPLICATED
TODDLERS
| RAISE AN OPTIMIST
HOW TO SOOTHE COUGHS
WINTER HEALTH
FRUIT 7RECIPES
FIGHT FLU BANISH COLDS TREAT FEVER
ONE HOME
WHERE PARENTING SHOULD STYLES YOUR NEWBORN SLEEP?
AUTISM
EASY
FUN INDOOR GAMES TO KEEP ‘EM BUSY 9 771023 927001
Solved!
• •
PICKY EATING NAPPY RASH SUNBLOCK HOW TO MAKE YOUR TODDLER LAUGH
VEG-PACKED RECIPES TO TEMPT YOUR LITTLE ONE
GREEN NURSERY FUNNY NOISES PREEMIE CARE
HOLIDAY TRAVEL TIPS DEAL WITH DIVORCE CHOOSE A GUARDIAN PICK A PLAYSCHOOL
MOMMY
RAISE A FRUIT & VEG LOVER
STOP THE JUDGING!
8
NEW BABY
BIG DECISIONS
BABIES DON’T WARS JUST BREAK TONS OF ADVICE FROM MASSAGE TO CHECK-UPS NOVEMBER & DECEMBER 2017
OPEN-HEART GAMES SURGERY SUCCESS 06228
ISSUE 231 NOVEMBER & DECEMBER 2017 R31.50 (VAT incl.) N$34.00 (Namibia)
•
|
2
LITTLE NUMBER RILEY’S MAY & JUNE 2017
JULY & AUGUST 2017
29
SUMMER FASHION
HOW? NUTRITION • SLEEP • PLAY • CUDDLES
MAKE IT WORK!
|
BOOST YOUR BABY’S BRAIN 08229
EMI’S STORY
DISCIPLINE WHAT TO DO WHEN TOP TIPS FOR
PRAISE WITH PURPOSE
9 771023 927001
BOYS IN DRESSES?
BABY SIGN LANGUAGE
TODDLER APPS | ANGELIC ADOPTION | POTTY TRAINING TIPS
H O W T O B AT H Y O U R B A B Y | P L AY T H E R A P Y | N E W B O R N C O M M U N I C AT I O N
ISSUE 229 JULY & AUGUST 2017 R31,50 (VAT INCL) N$34,00 (NAMIBIA)
BUILDING SELF-ESTEEM
12231
9 771023 927001
BALL SKILLS & MILESTONES FOR LITTLE ONES
How to enter:
■ Send a recent photograph of your child to coverbaby@yourbaby.co.za ■ Remember to include full name, age and contact details. ■ Find competition rules on page 97
The winner of Your Baby magazine’s cover competition receives prizes to the value of R30 000 from our six sponsors. See details below and follow Your Baby on Facebook for more information.
Win a customised Pierre Fabre product hamper filled with oral care, skin care, sun care and body products for the whole family to the value of R5 000. We have you covered from top to toe! Visit www.pierre-fabre.co.za
Epi-max Baby & Junior moisturises gently and is suitable for babies and children from birth. Win an Epi-max hamper worth R1 000 and R4 000 in cash. Visit epimax.co.za
Win a Baby City gift card to the value of R5 000! You can shop like never before at SA’s favourite baby retailer. Visit babacity.co.za
Win a cash gift card to the value of R3 000 and a hamper to the value of R2 000, including Reuterina™ Junior chew tablets, Reuterina™ Drops, ear thermometer, teddy bear, nursery rhyme book and a soft blanket. Visit reuterina.co.za
Studex proudy sponsors a collection of stylish earrings for both the winner and winner’s mom, a complete fashionable outfit from head to toe for the winner, as well as a photo shoot to remember the special occasion, all to the value of R5 000. Visit aps-studex.co.za
Fisher-Price is treating our winner to amazing toys to the value of R5 000! The prize includes a selection of Fisher-Price items, including a jumperoo, a butterfly dreams mobile, and so much more. Visit fisherprice.co.za
For complete competition rules, terms and conditions, turn to page 97 DECEMBER 2017 & JANUARY 2018 | 27
FINANCIALLY READY FOR BABY
THE
BIG guide to
GETTING FINANCIALLY READY FOR BABY
PREPARE FOR BABY’S ARRIVAL
WHAT DOES YOUR LITTLE ONE NEED? BUDGET FOR BABY
MEDICAL EXPENSES MOM & BABY’S FIRST FEW DAYS
PLAN YOUR FINANCIAL SECURITY DECEMBER 2017 & JANUARY 2018 | 29
FINANCIALLY READY FOR BABY
Budget for baby…
Start working on a budget early in your pregnancy to prevent baby expenses from making too big a dent in your finances, says Riëtte Grobler LET’S BE HONEST – having a baby isn’t cheap, and
every family’s budget and needs will differ. Use these articles as a guide for average costs during your pregnancy, the birth, and for your little one’s first month or two at home. How did we calculate the prices? For medical expenses we contacted three different service providers. For product prices we compared three to four suppliers, including a big online shop, an online baby shop, a baby chain store, chemist, popular chain store, online maternity wear shop and boutique baby shops.
30 | DECEMBER 2017 & JANUARY 2018
MEDICAL EXPENSES PRIVATE GYNAECOLOGIST
Doctor’s consultations throughout your pregnancy will total between R15 260 and R17 440. Consultation fees can differ quite a bit and the amount covered by your medical aid can also differ, depending on which plan you’re on. We asked three gynaecologists in private practice in order to make our estimate: ✓ A first visit costs on average R1 068 and a follow-up costs R708. One of the doctors we spoke to charges R2 200. Expect appointments every four weeks in the first 30 weeks of your pregnancy, and after that every three weeks to 10 days closer to your due date. ✓ Your doctor will perform at least three scans at about R2 768 (first trimester) and R2 441 (second and third trimesters). ✓ Birth: Vaginal birth: between R7 420 and R16 350. C-section birth: from R8 720 to R21 800.
PRIVATE ANAESTHETIST
Images: Gallo Images/Getty Images
The cost of an epidural during the birth is between R4 687 and R6 213, because prices can differ from doctor to doctor. It’s a good idea to ask your gynaecologist beforehand which anaesthetist she works with, and then you can ask for a cost estimate. The cost also depends on whether the procedure is planned (cheaper) or unplanned, and how long the procedure takes and if there are complications.
PRIVATE MIDWIFE
The average cost of private midwife services for the duration of your pregnancy and a home birth will be R19 747. The average cost of services for the duration of your pregnancy and a hospital birth: R10 987. This includes an initial consultation (R523) and about 8-10 follow-up consultations of between R327 and R414 each. Assistance during a natural hospital birth comes to between R5 777
and R8 502. For a home birth, budget for between R7 957 and R11 336. Consultations after the birth cost about R360 each.
PRIVATE PAEDIATRICIAN
The consultation immediately after the birth and three follow-up visits in hospital will come to R1 300. Your baby’s six week check-up will cost about R926.
VACCINATIONS
Your baby’s first vaccinations (polio and BCG) are free and will be administered shortly after birth in hospital. Further vaccinations at six, 10 and 14 weeks will average R1 853 for each visit. TIP: Inoculations are free at clinics and chemists that hold state stock, so ask about this. An injection fee of between R75 and R110 will be charged though.
PRIVATE BABY CLINIC
Sometimes clinics will weigh your baby for free at 10 days of age. Follow-up visits cost about R92 each.
MEDICAL SCHEMES
To add your baby to your medical aid costs between R708 and R1 090 per month, depending on your plan. Coverage in the first three months after birth is sometimes free.
HOSPITAL EXPENSES DURING BIRTH
Private hospital: We compared the costs of three hospitals in different hospital groups. Medical schemes typically cover a stay in a general ward in full. Extra costs, such as a private room, are usually not covered. State hospital: Pregnancy and birth are free at state hospitals, except if you belong to a medical aid. Then you will be charged R9 650 for a C-section and R7 104 for natural birth. This includes ward costs. Children under six are treated for free.
Hospital stay of 2 nights after a normal birth
Hospital stay of 2 nights after a C-section
Hospital stay of 3 nights after a C-section
Extra cost of private room for a night
Hospital 1
R18 530
R28 340
R30 520
R1 090
Hospital 2
R27 577
R30 520
R35 152
R785
Hospital 3
R17 985
R22 890
R26 160
R2 180
Average
R21 364
R27 250
R30 610
R1 352
DECEMBER 2017 & JANUARY 2018 | 31
FINANCIALLY READY FOR BABY
It costs approximately R24 500 to store stem cell blood and tissue for 10 years and R27 500 to store the same for 20 years, all inclusive. One of the facilities that provided information, offers a one-, two- or fiveyear payment plan. If you choose the five-year payment plan, stem cell storage will cost you about R312 per month. Some medical schemes offer discounts for stem cell storage.
FOR MOM DURING YOUR PREGNANCY
✓ Pregnancy cushions or a breastfeeding cushion (R600). ✓ Maternity wear. Jeans cost about R550 and pregnancy leggings about R300. Tops are from R200 for short sleeves and R250 for long sleeves. ✓ Multivitamins for pregnancy cost about R260 per month. ✓ Stretchmark creams can cost about R150 for 200ml.
IN THE HOSPITAL
✓ Maternity pads, R32 for a pack of 12. Start with two packs at least. ✓ Disposable maternity panties, R53 for two. ✓ Disposable sheets, R50 for a pack of 10.
FOR BABY THE NURSERY
Your budget and personal style choice will affect these expenses. ✓ Camp cot from R742 to R5 300, wooden cots from boutique shops from R3 700 to R25 440. ✓ Mattress with air holes, from R160 to R1 060. ✓ Sleep wedge: R85 to R530. ✓ Compactum, from R742 to R19 080. ✓ Changing mat from approximately R160. ✓ Breastfeeding chair from R1 272 to R25 440. ✓ Nappy bin from R297 to R477. Remember to budget for the bag refills too, which cost about R270 for three rolls. ✓ Baby monitor. For sounds only the average is R1 060 and with digital and movement functions they cost on average R1 700.
BABY’S LINEN DRAWER
Linen: Remember that a baby’s bed is safer without a duvet, bumper and cushions. Budget for three sheets (R74-R127), two cellular blankets (R212), four swaddling blankets (R180), two cotton blankets (R170) and three muslin blankets (R170).
For breastfeeding: ✓ Cotton feeding bras, R300 for two. ✓ Nipple cream, R210. ✓ Breastpump (manual costs approximately R500 and electric R1 800). ✓ Set of three bottles costs on average R265 and breastmilk bags cost about R120 for 25.
Clothing: ✓ 4-6 long sleeve full body vests, R64 for two. ✓ 4-6 short sleeve vests, R58 for two. ✓4-6 babygros that close in front, R160 for three. ✓ 3 pants and vest sets, approximately R110. ✓ 2 warm babygros for winter babies, from R58-R190. ✓ Socks R38 for a twin pack.
FOR THE NAPPY BAG
NECESSITIES
AT HOME
The bag itself costs about R370 from a chain store, R1 700 from a designer store and R3 000 for a leather bag. Some private hospitals give you a nappy bag to keep as part of your stay.
32 | DECEMBER 2017 & JANUARY 2018
✓ Bum cream: R58-R212 (125ml). ✓ Surgical alcohol: R21 (100ml). ✓ Liquid baby soap: R68 (550ml). ✓ Baby cream: R53 (300ml). ✓ Soft cotton wool: R33 (100g).
✓ Wet wipes: R33 for a single pack, R160 for a four-pack. ✓ Nail care set, hair brush, medicine dropper, nose dropper and thermometer: R302. ✓ Petroleum jelly: R24 (250ml). ✓ Paracetamol syrup: R95 (30ml). ✓ Colic drops or gripe water: R95 (30ml). ✓ Dummy: approximately R160 for one.
BATH TIME
✓ Plastic baby bath, approximately R159; fold-up bath R636. ✓ Two baby bath towels (R106) and two facecloths (R30 for two). ✓ Bath thermometer, from R64 to R265.
NAPPIES
✓ Disposable nappies. Expect to pay approximately R160 for 66 nappies or R243 for a pack of 94 nappies, which works out to about R2.50 per nappy. If you use 10 nappies a day in the first month, you will need 300 nappies. Budget for about R800 for nappies in the first month. ✓ Cloth nappies. Twenty cloth nappies cost about R4 028, and will fit from newborn to potty training time. Four rolls of flushable nappies at R402 (R100 per roll of 100) which will last one month, and eco wash at R111 for R100 bundles of washing. TIP: Wait until after your stork tea to start stocking up on nappies, as nappies are a very popular gift and you might end up with too many size 0 nappies.
PRAMS
Travel systems that include a car seat: Entry level: R2 759 Mid level: R3 710 to R5 300 Luxury: R9 010 to R21 000+.
CAR SEATS
Invest in a car seat that you can use from birth until seven years old. These chairs can face back or front depending on your child’s age and weight. The cost is anything from R1 272 to R5 830. YP
Images: Gallo Images/Getty Images
STEM CELL STORAGE
Kitted out for baby Here’s our list of everything you need to get your baby’s nest ready, says Yolandi Jordaan
THE SECOND YOU SEE two lines on the pregnancy test, you’ll be tempted to hit the shops. But wait! Even though it’s necessary to buy some items before baby is born, other items should rather be left for later. You will find that a brand or product that worked well for someone else, won’t necessarily work well for you or your little one. So don’t be in a rush. Also remember that some of the
NURSERY
✓ Cot ✓ Mattress with air holes ✓ Mattress covers ✓ Warm blankets for winter, light blankets for summer, swaddling blankets, sleeping bags. First buy for the season your baby will be born in. ✓ Sleep wedge ✓ Night light ✓ Breastfeeding chair ✓ Breastfeeding cushion ✓ Toy basket. Newborns don’t really play with toys, so this can wait for later. ✓ Changing table or compactum ✓ Changing mat and cover ✓ Mobile to hang over changing station to keep baby amused ✓ Container for cotton wool ✓ Clock to keep track of feeding ✓ Laundry basket ✓ Bin that seals well ✓ White noise device or CD to help calm baby ✓ Humidifier ✓ Monitor
things we’ve put on our list, you might already have, like a comfortable chair for breastfeeding or a bin that seals properly. Other things on the list are up to you to decide – you might not feel the need for a breastfeeding cushion, for instance, but take our list along to the shops just in case. Also consult The Essential Shopping Guide, the free supplement that was bagged with this issue of Your Pregnancy.
BATH TIME
✓ Baby bath ✓ Bath toys. These can also wait until your baby is a little older. ✓ Bath time seat ✓ Baby towels ✓ Facecloths
CLOTHING
✓ Vests (at least 6) ✓ Babygros (at least 6) ✓ Bibs. Even if your baby doesn’t drool or posset much, bibs are useful as you will use them when baby starts on solids.
OUTINGS
✓ Pram ✓ Car seat ✓ Camp cot. The camp cot isn’t only useful for outings, but can be used for the first month or two to enable baby to sleep in your room. It is easier to have baby close, especially for night feeds. ✓ Carrier or sling ✓ Nappy bag
FEEDING
✓ Bottles. If you intend to breastfeed, you don’t have to buy bottles before baby is born. ✓ Bottle brush. Buy this when you buy the bottles. ✓ Steriliser ✓ Dummies ✓ Breastpump. It is not necessary to buy this before your baby is born, because you will mainly use it when you return to work. ✓ Breast pads ✓ High chair. At more or less six months old your baby will start on solids, so the chair can wait until after the birth.
NECESSITIES
✓ Muslin cloths ✓ Nappies. Buy the newborn size first. Your baby could be allergic to a certain brand so don’t buy too many at first. ✓ Perfumed plastic bags for dirty nappies ✓ Wet wipes ✓ Nail care kit ✓ Cotton wool ✓ Baby hairbrush ✓ Baby cream ✓ Baby cleanser ✓ Surgical alcohol ✓ Petroleum jelly ✓ Medicine. Only buy this when you need it though, as babies really shouldn’t be getting medicine before three months old. ✓ Mosquito repellent that is suitable for babies, or a mosquito net ✓ Playmat with a toy arch
DECEMBER 2017 & JANUARY 2018 | 33
FINANCIALLY READY FOR BABY
IT IS ENRICHING to have children, but
don’t be fooled – it’s expensive as well. Planning ahead and having a sound financial plan can save you a lot of unnecessary expense and stress in the future, says Jonathan Brummer from SmugMoney, a financial planning service. “Having a baby is a big step and prospective parents should ideally sort out their money affairs before the pregnancy,” says Jonathan.
TAKE 5
Plan to Proper financial planning is the key to financial security when your family starts to grow, says Riëtte Grobler
34 | DECEMBER 2017 & JANUARY 2018
A new baby means new expenses; some immediate and some as the child grows older, say Charné van der Walt from Lemons into Lemonade financial planners. Charné says prospective parents should pay attention to these five aspects of financial planning: 1. Monthly budget changes. With a child in the house the family’s monthly budget will change. If you plan to have a baby far in advance, you have some extra time to save in order to cover some of these expenses, but certainly reconsider your budget as soon as you can if the pregnancy has been a surprise. Take everything into account that will have an effect on your income. New expenses include paying more for your medical aid as you will have an extra member. 2. Build an emergency fund. This can be an amount equal to three months of income (after tax and deductions). Otherwise set a goal that your emergency fund should cover at least six months’ worth of minimum costs. 3. Save monthly for education. But how much? Ask your broker to help you work out what education will cost from playschool to tertiary level. This calculation must take into account yearly increases and whether your child will attend private or government school. If you start saving even before the birth, you have 18 to 20 years to save. You don’t have to buy an educational policy – a cash savings account at the bank from which you can withdraw every month as your child progresses at school is adequate. Consider a more formal
Where there’s a will… savings plan for tertiary education though, such as a unit trust account. 4. Decide how your family will be taken care of if the breadwinner can’t earn anymore. Put adequate life insurance and disability insurance measures (a once-off amount if you are declared medically unfit to work) in place so that debt can be paid off, your family can maintain its lifestyle and so that there are funds for your child’s education and your monthly expenses. 5. Make sure you have a testament. Your testament has to change in two ways once your baby has been born. Firstly, a testament trust is usually included as children under 18 may not inherit in their own name. Also, trustees need to be appointed. This person will be in control of your child’s money until a certain age. Secondly, a guardian or guardians need to be named in case both parents die. Choose someone who shares your values and who can afford it financially.
Images: Gallo Images/Getty Images. For more information, visit www.smugmoney.co.za and www.lemons.co.za
MATERNITY LEAVE
In South Africa women are entitled to four months’ maternity leave. Employers are not legally required to pay you during this time. This is where your emergency fund will be useful! You are entitled to apply to the Unemployment Insurance Fund if you have contributed to it through a salary deduction, says Charné. “The amount your receive will depend on factors such as how long you have been employed and what the income was on which your payment to the fund was based.” You should apply for this money as soon as your maternity leave starts. If you resign, you can’t claim.
IF YOU WANT TO STOP WORKING “Make some calculations ahead of time to be sure that you can afford to stop working and to have a plan of action, if this is something you’ve been considering. This could include moving debit orders to your partner’s bank account,” says Charné. “A plus point is if both parents’ cars
Why is a testament necessary if you are still young and the children are still little? “Death is a part of life. Having a will is important for everyone – even more so if you have small children,” says Carla Almeida, an attorney from Pretoria. “A will allows you to decide who will look after your children if something happens to both parents. Otherwise the master of the high court will decide the matter.” Carla recommends that each parent should have their own will. “If parents have a joint will and one dies, the remaining parent will not be able to change the will. It will be binding until death.” It is important to give careful consideration to who you want as your children’s guardian and to make sure that you ask them if they accept the role.
are paid off and if you have no short term debt.” Take the following factors into account to decide whether you can take a financial risk: the size of the new breadwinner’s income in comparison to the loss of salary when you stop working; the extent to which the missing salary contributed to household expenses and other important expenses such as your medical fund, and also think about changes you can make to your budget, such as deliberately spending less on luxury items. Start doing this planning before your baby arrives, so that it doesn’t feel like such a shock when you can suddenly afford less.
THAT FIRST CAR
“If parents have a few extra rands in their budget after all the expenses have been dealt with, an investment in the child’s name is a good idea,” says Jonathan. “This can help your child buy a car later, or even put down a deposit on a property.” He discourages parents from opening a tax-free savings account in their child’s
name, though. “A unit trust account is a better option, as with that they are not deprived of the advantage of the account once they start earning an income.” TIP: Jonathan says that tax-free savings accounts are a better option than educational savings accounts, as the latter often come with higher fees and fix periods and penalties if you want to change anything.
REMEMBER ONE DAY
✓ Retirement fund. “If parents stick to their retirement goals, it means that they do not put financial pressure on their children in later years,” says Charné. If your planning for your senior years is lagging a bit, Jonathan suggests that you increase the monthly amount that you are currently saving. ✓ Life insurance. “We use our assets and income to pay for our expenses and to save and plan for other goals,” says Jonathan. “The goal of life insurance is to make sure that these goals can still be achieved even if both parents were to die. As a basic guideline you need 15 to 20 times your yearly income as life insurance.”
BYE-BYE NEW CAR
Whether you can still afford a new car, or do renovations to your house once baby has arrived, will depend on how financially secure you are. This means that you have no running or short term debt, you have an emergency fund, and you live approximately 30 percent below your income level, says Charné. Jonathan adds that a good financial plan is your best asset. “A financial plan is a process by which you find out what your goals are and how you should proceed to achieve them. It calls for a disciplined approach where short and long term goals are weighed up against each other.” Try to include a bit of spoiling money in the budget, such as an evening out while granny and grandpa babysit, says Charné. “Talk openly and in a positive manner about your financial dreams. Keep your dreams alive, even if you can’t afford them right now.” YP
DECEMBER 2017 & JANUARY 2018 | 35
Your baby’s needs change, so should your supplements.
Introducing CHELA-PREG™ TRIMESTER
YBA_114817/E
RANGE
Individualised micronutrition for each unique stage of pregnancy – for a safer pregnancy. South Africa’s most compliant pre-natal supplement in terms of international best practice recommendations by the Institute of Medicine, World Health Organisation and United Nations.
Trimester 1
Trimester 2
Trimester 3
Specially formulated for the 1st trimester of pregnancy with 25 micronutrients, including 10-often ignored nutrients that are essential for optimal growth and development of placenta and fetus, including: DHA-omega 3 to boost mother’s red blood cells and for placental development.1 Extra vitamin B6 to help reduce morning sickness.2 Gentle non-constipating chelated iron, Ferrochel®, for the formation of extra red blood cells to carry more oxygen in preparation of baby’s metabolic needs.3 Quatrefolic® a natural 5-MTHF folate form of folic acid, which is better absorbed, is more effective for more people, and is essential for spinal cord closure (neural tube development).4 No vitamin E which is best avoided in the first trimester.5
Specially formulated for the 2nd trimester of pregnancy with 26 micronutrients that are essential for tissue and organ differentiation and development, including: Extra DHA-omega 3 to support the baby’s brain and nervous system development.6 Additional calcium for skeletal development.7 Vitamin E, extra vitamin C, choline and zinc for organ and tissue growth.8 More Ferrochel®, a gentle non-constipating chelated iron, for the formation of additional red blood cells to carry more oxygen to meet baby’s growing metabolic needs.3
Maximal micronutrition for rapid growth during the 3rd trimester of pregnancy with 26 micronutrients, including: Maximal amounts of calcium for strong bones, and DHA-omega 3 for brain growth and for future health, immunity and intelligence.9 Extra Ferrochel®, a gentle non-constipating chelated iron, for the formation of extra red blood cells to carry more oxygen to meet the growing baby’s high metabolic needs.3 More choline, a nutrient most important in the 3rd trimester for baby’s health and to help prevent diseases later in life.10 Extra zinc, vitamin C and vitamin E to support rapid 3rd trimester cell division and tissue growth, and to reduce the risk of pregnancy complications.11
References:1.https://www.ncbi.nlm.nih.gov/pubmed/19500960 2.https://www.ncbi.nlm.nih.gov/pubmed/7573262 3.https://www.ncbi.nlm.nih.gov/pubmed/1799918 4.http://www.gnosis-bio.com/pdf/White%20paper.pdf 5.http://www.telegraph.co.uk/news/health/news/5112656/Vitamin-E-can-increase-the-risk-of-heart-defect-in-babies.html 6.http://www.fao.org/3/a-i1953e.pdf 7.https://americanbonehealth.org/tools-and-resources/bonesensenewsletter/457-the-importance-of-calcium-during-pregnancy 8.http://www.nature.com/ejcn/journal/v58/n10/full/1601976a.html 9.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621042/ 10.https://www.eurekalert.org/pub_ releases/2014-01/epr-nss012814.php 11.http://www.fao.org/3/a-y2809e.pdf More information on ingredients available on request. This medicine has not been evaluated by the Medicines Control Council. This medicine is not intended to diagnose, treat, cure or prevent any disease. Health supplements are intended only to complement health or supplement the diet.
A first to market innovation in SA
Ascendis Supply Chain (Pty) Ltd Consumer care line / Verbruikersnavraelyn: T: 011 036 9420 E:healthinfo@ascendishealth.com W: www.ascendis.co.za
A PROUD BRAND OF
HEALTHY HAPPY BODY
THE
BIG guide to A HEALTHY HAPPY BODY
POSITIVE CHANGES page 38
YOU ARE WHAT YOU EAT page 40
TEN FOODS TO AVOID page 41
KILO CONTROL page 42
DECEMBER 2017 & JANUARY 2018 | 37
NEW MOM WELLNESS
6
Amazing Things
THAT PREGNANCY WILL DO FOR YOU
Pregnancy is full of pleasant surprises. Here’s a list of six positive changes you can look forward to
1YOUR IQ IS ON THE UP
Although many pregnant women will identify with the term porridge brain (when you seem to forget everything all the time), studies show that in actual fact you become smarter during pregnancy. Brain expert Don Joseph Goewey points to a study that found pregnant mammals to have an increase in mental sharpness and memory and could retain more information over a longer period of time. Oestrogen, progesterone and oxytocin help strengthen the part of your brain that’s responsible for memories. If you’re experiencing a bit of porridge brain, don’t worry too much. It’s probably a result of nerves and sleeplessness. Try doing a crossword or Sudoku puzzle to keep all your cylinders firing.
2HAIR AND NAIL MODEL
During your non-pregnant days, your hair goes through the same cycle... growth, rest and falling out. When you’re pregnant, oestrogen prolongs the growth phase and reduces the amount of strands that fall out, leaving hair thicker. And all of those pregnancy vitamins you’re taking? They’re jampacked with enough calcium to leave your nails strong and shiny.
38 | DECEMBER 2017 & JANUARY 2018
3BREAST IS BEST
There’s no denying that during pregnancy your boobs are going to get bigger, fuller and rounder. You can ditch the underwire bras, because not only will they be uncomfortable now, but you really won’t need them. All you need is a good maternity bra, and you can embrace your newfound curves. Studies have also shown signs that your risk of getting breast cancer after being pregnant is reduced. To lower it even further, research has shown that breastfeeding reduces your chance of getting breast cancer by 4.3 percent in general, and by 32 percent for those predisposed to the disease.
4YOU FOCUS ON YOU
There’s no stronger motivation to be healthy than when you’re pregnant. All of a sudden, your bad habits won’t just affect you – but they’ll affect your unborn baby too. If you had unhealthy habits, like smoking, drinking and unhealthy eating, pregnancy is the perfect time to correct your lifestyle. Your body will also give you signs as to when it needs rest, and being pregnant will probably lead you to listen to your body more than you ever did before. If you
haven’t given up those bad habits yet – do it now. It’s never too late.
5YOUR SEX IS ON FIRE
Literally. During your second trimester you will feel it more. By this stage, your morning sickness should have faded away, and the swollen ankles and sore back probably haven’t come yet. You have more energy and a glow about you. The increased blood supply during pregnancy makes your genitals more sensitive and ups your vaginal lubrication. Unless your doctor has given you orders not to have sex, enjoy your inner sex-goddess before your newborn arrives.
MONDAY OR FAB 6BLUE FRIDAY
Pregnancy moods are a widely spoken-about phenomenon (especially from our male counterparts). And while the flood of hormones can most definitely make you overly emotional and moody, those same hormones also work to put a smile on your face. Progesterone relaxes your muscles and therefore your body, and oestrogen can put you in a good mood just by being there. YP
Images: Gallo Images/Getty Images
DECEMBER 2017 & JANUARY 2018 | 39
HEALTHY HAPPY BODY THIS IS WHAT A HEALTHY DIET LOOKS LIKE
YOU ARE WHAT YOU EAT A healthy diet is vital for a healthy pregnancy, but what should you eat exactly? And what about supplements? IF YOU FOLLOW a healthy diet
during pregnancy, you’ll get the proper vitamins and minerals. But it’s still important to take certain vitamins and minerals as extra supplements to ensure that your baby develops optimally and you stay healthy. Ask your doctor at the beginning of your pregnancy which multivitamin they would recommend as a dietary supplement.
FOLIC ACID
Supplement your diet with folic acid, since you need to get enough of it – before and during your pregnancy. This mineral is important because it can prevent birth defects such as spina bifida, brain damage and hydrocephalus.
VITAMIN B12
This nutrient works alongside folic acid and helps to prevent birth defects such as spina bifida. It also supports the brain development of the foetus.
MAGNESIUM
It’s important to take this mineral as
Chela Preg Trimester One* R199 available at Dis-Chem and Clicks
40 | DECEMBER 2017 & JANUARY 2018
a supplement, as it lowers the risk for developmental damage caused by cerebral palsy or premature birth.
CALCIUM
Supplement your diet with calcium because it promotes the development of baby’s bones and helps to prevent premature birth and pre-eclampsia.
IRON
This important nutrient helps to transport oxygen to all your organs and the foetus. Too little iron may lead to anaemia. Supplement this mineral to help prevent premature birth and low birth weight. It also boosts your foetus’ brain development and growth.
OMEGA 3 AND 6
Omega 3 fatty acids support the development of your unborn baby’s sight, nervous system and brain. It can also help prevent postpartum depression. In addition, omega 6 helps with foetal brain development and forming of cell membranes.
VITAMIN C
This vitamin helps with the absorption of iron and with the forming of the skin of the foetus. It’s an antioxidant that strengthens the immune system.
VITAMIN D
It promotes brain development and immune function. It prevents weak bone development in your unborn baby.
ZINC
Zinc is an important mineral during pregnancy because it’s necessary for cell division.
#1 SOMETHING OF EVERYTHING A well-balanced diet is filled with a large variety of healthy food types. If you include food from all the colour groups every day of the week, you know you’re following a balanced diet. Raw and unprocessed food without colourants or flavourants has the highest nutrient value. #2 FOLIC ACID Nutritionists say you need to take a supplement, but also choose food that’s packed with this mineral: broccoli, dark salad leaves, nuts, lentils, asparagus, avocado, banana and fortified wholewheat breakfast cereals. #3 OMEGA 3 FATTY ACIDS Have oily fish such as sardines and salmon three times a week and also plenty of leafy greens. Seafood is also a source of calcium. Make sure to eat some omega 3 enriched eggs and bread. Also look for a supplement that contains DHA, especially in the last trimester, when the brain of the foetus develops rapidly. #4 FIBRE Your metabolism slows down during pregnancy, but for good reason: it helps your body absorb more nutrients. But it does unfortunately mean that you might battle with constipation. Be prepared by eating lots of veggies, fruit and fibre-rich breakfast cereals and drinking about two litres of fluid every day (preferably water or rooibos). Some other fibre-rich food: sweet potato, brown rice and popcorn. #5 IRON AND ZINC Eat enough red meat, pork, chicken, eggs, spinach, raisins, dried beans and dried fruit to keep up your iron intake. You can also take iron supplements, especially if you’re anaemic. Make sure to take vitamin C with your iron-rich food, because it helps your body absorb iron. Good sources are oranges, grapefruit, strawberries, guavas, green and red peppers, tomato, broccoli and cauliflower. You can ensure the two of you get enough zinc if you regularly eat meat, drink milk and opt for wholewheat foods.
Steer clear of these 10 foods
To protect your and your baby’s health, make sure to avoid these top 10 food nasties 1 UNPASTEURISED DAIRY
Say goodbye to all your soft, smelly cheeses, such as brie, camembert and blue cheese – feta, too, if it hasn’t been pasteurised. That’s because unpasteurised cheeses, milk and other dairy products are more likely to grow bacteria, such as listeria. Pregnant women are more susceptible to getting infected by this nasty little germ. It can cause an illness called listeriosis, which is usually mild for you but it can harm your baby and, in rare cases, even lead to miscarriage or death. Here’s the good news: nowadays many soft cheeses and feta are made with pasteurised milk, in which case they’re perfectly fine to eat. Always check the label to be sure and practise this golden rule: if in doubt, leave it out.
2 FISH HIGH IN MERCURY
Bigger fish live longer and are higher on the food chain, and the more other fish they eat, the more mercury is accumulated in their meat. Mercury is a neurotoxin that can build up in your bloodstream and can harm your baby. However, seafood is a great source of protein, iron and zinc – all crucial for your baby’s growth, while the omega 3 fatty acids found in fish help your baby’s brain development. So eat fish in moderation, just make sure it’s the kind that’s low in mercury and high in omega 3s, such as anchovies, herring, sardines and trout. A study by marine scientist Brent Newman at the CSIR found swordfish, kingklip, cape salmon and yellowfin tuna to be the South African fish with the highest mercury contents.
3 RAW OR UNDERCOOKED EGGS Raw or undercooked eggs may carry the salmonella bacteria. Salmonella poisoning is unlikely to harm baby, but it will make you unpleasantly ill. So lay off the eggs benedict and – get ready
for horrible news – avoid foods such as meringues, chocolate mousse and tiramisu, which all contain uncooked eggs. Most commercial mayonnaises are made with pasteurised eggs and are okay to eat, but check the label to be sure.
4 PROCESSED MEATS
Polony, salami, ham, hot dogs... they all carry a risk of listeria. It’s a low risk, but rather be safe than sorry and either avoid these meats or heat them to more than 73°C to kill off any bacteria.
5 RAW SHELLFISH
Raw shellfish, such as oysters, mussels, scallops, clams, shrimp, crabs and crayfish, may contain bacteria, viruses and toxins that can make you quite ill. If you eat shellfish, always make sure it’s been thoroughly cooked.
6 LIVER
Too much liver and foods rich in liver, such as pâté, are a no-no, because they contain high levels of retinol, a type of vitamin A. Too much retinol can build up in your body, which can be harmful to baby. But don’t avoid vitamin A completely – it’s important to keep your skin, eyes and immune system healthy. Get it in good amounts by eating a diet that includes butter, eggs, cheese, oily fish, carrots and broccoli.
7 RAW MEAT
Say goodbye to rare steaks – undercooked meat and poultry has a risk of carrying listeria, salmonella and the toxoplasma parasite (also found in cat litter). This last one can lead Chela Preg Trimester Two* R220 available at Dis-Chem and Clicks
to toxoplasmosis, which is a flu-like illness that may be mild for you, but potentially serious for baby, even causing miscarriage or death.
8 SUSHI (BUT NOT ALWAYS)
In Japan sushi is considered healthy in pregnancy. But in the West it’s been advised against because raw fish such as salmon can contain small parasitic worms, which have the potential to make you ill and in rare cases can be fatal. So should you or shouldn’t you eat sushi? The latest word from the UK’s National Health Service’s advisers is that eating sushi while pregnant is “usually safe”. Follow these basic rules and you should have no trouble: • If it’s raw fish, make sure it’s been frozen first, as this should kill off worms. • If it’s cured fish, such as smoked salmon, it doesn’t need to be frozen because smoking, pickling and salting should kill off worms. • Only eat shellfish that’s well cooked.
9 SUGAR
Studies show that moms who consume loads of sugar during pregnancy give birth to babies “addicted” to sugar, which puts them at risk of health problems, such as diabetes. Too much sugar also increases your risk of gestational diabetes. You don’t have to be diabetic or even prone to diabetes to suffer from gestational diabetes, so reduce your risk by laying off the sugar!
10. TOO MUCH CAFFEINE
Avoid coffee, tea and soft drinks that contain caffeine. Three cups of coffee a day or more can decrease blood flow to the placenta and affect baby’s growth. It’s also a diuretic that causes your body to lose fluids containing essential vitamins. If you really need your daily fix, don’t go over the recommended maximum of 200mg a day. YP
DECEMBER 2017 & JANUARY 2018 | 41
HEALTHY HAPPY BODY
Zelda Ackerman, a registered dietician, gives 10 tips for healthy weight gain – for you and your unborn baby IF YOU’RE PREGNANT, it’s wise to stop and think before you tuck in. With a little one in your belly, your body needs to be in tip-top shape, because if you’re healthy, baby’s also healthy. Besides, it’s not good to be overweight, and if you’re pregnant on top of that, both of you will be unhealthy. The best advice is to be at your ideal weight even before you fall pregnant. If you battle to fall pregnant, it can help to shed a couple of kilos, because being overweight can cause infertility. But if you’re pregnant already and want to gain weight wisely, follow our advice.
AM I HEALTHY?
You can easily determine if you weigh too much with the body mass index (BMI). Work out your BMI like so: divide your weight (kg) by your length squared (m2) to see which category you fall in. ≤18.5kg/m2
UNDERWEIGHT
18.5-24.9kg/m 25-29.9kg/m ≥ 30kg/m2
2
2
IDEAL OVERWEIGHT OBESE
DO IT THE HEALTHY WAY
Kilo control 42 | DECEMBER 2017 & JANUARY 2018
Perhaps you tried your best to shed the extra kilos before your pregnancy, but didn’t succeed. Don’t lose heart now. If you follow the guidelines set out here, you should pick up less weight and have a healthy pregnancy and baby.
1LISTEN TO YOUR BABY
If you’re hungry, have something healthy, and stop eating the moment you feel you’re full. Eat slowly, put your fork or spoon down between bites to allow yourself to chew, and only pick up the next forkful once you’ve swallowed. Eat veggies, fruit or salad first before tucking into the rest of your meal.
HOW MUCH SHOULD I PUT ON? The kilos you should put on depend on what you weigh when you fall pregnant
2A BALANCED DIET
Every meal should comprise three food groups: a protective food (veggies or fruit), a building food (meat, chicken, fish, milk, beans, nuts) and an energy food (carbohydrate such as pap, wholewheat bread or pasta, brown rice, potato and sweet potato). Eat a variety of vegetables and fruit, choose low-fat meat and dairy products and wholewheat starches with a low glycaemic index. Eat small amounts of healthy fats such as nuts, avocado, olives, canola margarine and olive oil.
3
STAY ACTIVE
Images: Gallo Images/Getty Images. *Pack equals one month’s supply
Exercise and an active lifestyle are necessary to keep your weight under control. Check with your doctor that it’s safe to exercise before you get started. Choose forms of exercise that won’t put you at risk of falling easily or overheating. Try swimming, vigorous walking, cycling on an exercise bike, or special pregnancy aerobics. If your doctor recommends you stay away from exercise, you can still have an active lifestyle. Take the stairs instead of the lift or escalator, park furthest away from the shops, do some chores around the house or garden, or go for a stroll around the block. You can even play ball with the kids and dogs.
4HEALTHY SNACKING
If you’re snacking all day long, you eat more than you realise. Rather have set snack times in the morning and afternoon. If you only go to bed three hours after dinner, you can add a late-night snack also. Make sure your baby gets all the nutrients she needs by choosing nutrient-rich foods to eat in between meals. Fresh fruit, raw salad veggies such as tomatoes, cucumbers and carrot sticks, or fat-free milk or yoghurt are wise choices. Keep starchy foods such as bread and rusks for meals. Put your snack in a bowl rather than eating from a big box or packet, to ensure you eat just enough.
5DON’T DIET
Fads and crash diets can be very bad for your baby. Ketones, which are formed
BEFORE PREGNANCY
FIRST TRIMESTER
WEEKLY GAIN IN TRIMESTER 2 & 3
TOTAL RECOMMENDED GAIN DURING PREGNANCY
Underweight
2.3kg
0.49kg
12.5 – 18kg
Ideal weight
1.6kg
0.44kg
11.5 – 16kg
Overweight
0.9kg
0.3kg
7 – 11.5kg
Obese
-
-
about 6kg
in your body during low carb/high fat diets, are harmful to your unborn baby’s brain and organs. The same process also takes place when you fast, and for this reason you shouldn’t go 12 hours at a time without eating.
6
CHANGE YOUR PLATE
With a smaller bowl and plate you grow used to eating smaller portions. A small plate that’s packed looks better than a big one with only a couple of spoonfuls. A small bowl also helps you not to inadvertently dish up too much.
7HEALTHY DRINKS
You can easily misjudge what you drink, and while you think you’re taking in liquids to quench your thirst, you’re also taking in a lot of sugary energy. Fruit juice, soft drinks and even tea and coffee with sugar pack the pounds. Rather opt for water, three glasses of fat-free milk per day and rooibos tea without sugar.
8
GET YOUR FIVE A DAY
Vegetables and fruit are packed with important nutrients and contain relatively little energy. They contain a large amount of fibre that helps to fill you up. If you eat half a plate of veggies, salad or fruit with every meal, you can eat enough to be full without taking in too much energy. Go for raw foods whenever you can, or cook them without adding sugar, butter or oil. Remember that dishes such as potato, pasta and rice salads aren’t really salads but starch.
9CURB THE MUNCHIES
That insatiable craving for peanut butter, chocolate or mango will take hold at same point, but you can still be in control of what you put into your mouth. If you crave something specific,
have some, but in small portions as part of meals or snacks. Don’t just give in to every weird craving you might have.
AWAY FROM 10STAY UNHEALTHY FOOD
Chips, ice cream, milkshakes, chocolate, sweets, biscuits and cake are some of the things you should rather avoid. There’s more energy in a portion of these treats than in a whole plate filled with healthy food, and the sugary stuff doesn’t contribute any good nutrients. Avoid them if possible, and if you can’t, have a small portion. When you’re bone tired, takeaways are a much easier option, but they’re packed with fat and thus unnecessary sugary energy. Rather cook ahead and freeze, so that you can just grab something from the freezer if you don’t feel up to slaving away in front of the stove. YP Chela Preg Trimester Three* R239 available at Dis-Chem and Clicks
WHY SHED THE KILOS? If you’re overweight while you’re pregnant, you have an increased risk of gestational diabetes, which could in turn result in a baby with a very high birth weight. Your blood pressure can rise, you can get pre-eclampsia, and being overweight also raises the chances of having a miscarriage and even a stillbirth. If you’re overweight, baby has a bigger chance of having birth defects such as spina bifida, dying shortly after birth, becoming overweight themselves or developing heart problems.
DECEMBER 2017 & JANUARY 2018 | 43
YP R E A L L I F E
IMAGINE BOOKING a trip on economy class, and then being upgraded to take a ride on Air Force One. That’s how my birth experience felt the second time around. I planned the birth of my first-born, Sadie, to a T; I even prayed that it would rain on the day she was born – and it did. But my birth experience was a negative one, and it impacted on my ability to mother her, as feelings of fear, disconnectedness and disappointment filled my early months of motherhood. Two years later, staring at a positive pregnancy test, I knew that this birth would be different – different healthcare providers, birth setting and labour companions. My husband Andrew and I took the road less travelled; one that some might perceive as scary or dangerous – we decided to have a home birth. I carefully researched loving and supportive midwives who would be there for me throughout my pregnancy and birth.
LABOUR BEGINS
Cornelia Owens’ second birth healed the scars and disappointments of her first traumatic, experience. As told to Marysol Blomerus
A
EXPERIENCE 44 | DECEMBER 2017 & JANUARY 2018
It’s 1am on 9 October 2014. “Could this be it?” I thought to myself, after waking up feeling my belly tightening every 10 minutes. “Should I call the midwife? What if she drives all the way to my house and it’s false labour?” I’m 40 weeks and three days pregnant, so denial is part of the package. I took a bath to try and ease some discomfort, and it worked! I went back to bed and tried to rest, but I was too excited to sleep. Months of preparation, hypnobirthing classes, and all the techniques I required stripped away any fear. I thought about my two wonderful midwives who took care of me during my pregnancy, and my birth photographer, Marysol Blomerus, with whom I felt a connection from the moment we met. Everything really was prefect. At 5am I called Marysol. Perfect birth photos were more important than having skilled professionals attend the birth of my baby – what was I thinking? It would take my second midwife Debbie around two hours to get to my house, but I didn’t panic. My husband began tidying the house and things started heating up. I asked him to fill the pool for me – seriously, who cares about dirty dishes; I’m about to have a baby! At 6am my midwife arrived. She checked my baby’s heartbeat, and
Hubby Andrew Owens comforts Cornelia through her labour
THE MIDWIFE HAPPILY EXCLAIMED, ‘NO, MY DEAR, YOU DON’T NEED TO POO – YOU NEED TO HAVE A BABY!’ it was perfect. I was doing fine, still laughing and joking in between surges (contractions). They were bearable, but I relied on Andrew to be there for me to support me through them.
Pictures: Marysol Blomerus
BIRTHING IN WATER
At about 8am, Debbie suggested I get into the water, and I felt great as soon as I did! My daughter Sadie woke up and joined me in the pool, but she was distracting me and I asked Andrew to take her out and get her ready for school. At 8:30am, I suddenly had the urge to poo! The midwife happily exclaimed, “No, my dear, you don’t need to poo – you need to have a baby.” The pressure was immense, and the urge to push took over. I remembered my hypnobirthing instructor teaching me to avoid pushing, but to breathe baby out. I would prevent tearing this way. But she also said that if I needed to push, then I should go with what I feel. It was so amazing – the urge to push only came with a surge, and in between I could calmly breathe and rest. I remember “pushing” with Sadie. This time, my body and baby were in complete control, and I was the facilitator to the process. Then the unexpected fear came of having to be transferred to the hospital, while feeling like baby was stuck. I looked up and saw Debbie’s eyes. Calm, happy, reassuring, and she said, “You’re doing great, everything is fine.” Things got loud as I could feel the baby’s head. A few surges and some hard pushes and some gentle breathing – and there it was, the burning sensation. I knew in my mind that this was it! By 8:55am, I felt huge relief as I birthed his head. And with one gentle push, I felt a slippery little body glide out. I lifted my baby from the water, and I was only interested in finding out the gender. It’s a boy! I grabbed him and instinctively wanted to hold him against my chest. When I looked up at Marysol, I said,
“I did it.” Complete silence filled the room. No bright lights and loud voices. I could actually hear my sweet baby breathing. I could feel his heartbeat on my chest, I could smell the sweet smell of a newborn.
FEELING GRATEFUL
Debbie and Andrew helped me out of the birth pool, and I sat on the edge of my bed. I breastfed Jordan for the first time,
and not once did he leave my arms. I still had to birth the placenta and Jordan was still attached to his cord. Delaying the clamping of the cord was very important to me. As I was lying in my own bed minutes after Jordan was born, with him in my arms, I felt so blessed to have experienced natural birth, moving around freely in my own home, only surrounded by the people who love me. YP
Big sister Sadie meets her new baby brother
DECEMBER 2017 & JANUARY 2018 | 45
YP D I G I T A L S U B S C R I P T I O N S
&WIN!
SUBSCRIBE
THULE URBAN GLIDE STROLLER
THULE’s Urban Glide Sport Strollers are all about safety and innovation, turning your family outings into unforgettable memories. With a sleek and lightweight aerodynamic design, it’s perfect for pavement pounding as well as short walks and everyday errands. The Urban Glide’s front wheel swivels for easy manoeuvrability and locks into place for jogging for increased stability when moving at a fast pace. The hand-activated front brake increases braking control on steep terrain, while the rear suspension provides a smooth and comfortable ride for your precious cargo. The padded seat with vented top reclines to a near flat position, allowing your little one the chance to nap, and you can keep an eye on your child through the view-in roof of the multiposition canopy, which also protects them from the sun and elements.
The winner will receive a Thule Urban Glide Stroller and Thule RideAlong Lite
Go to mysubs.co.za/magazine/your-pregnancy to subscribe. Contact MySubs at support@mysubs.co.za or 087 741 3177
ancy Subscribe to Your Pregn win a uld co u yo d Magazine an 1 299! R1 rth wo er Thule hamp
THULE RIDEALONG LITE
The durable Thule RideAlong Lite child bike seat lets you and your child enjoy everyday bike rides together – safely, easily, and in style. Mounted on the front of your bike, the RideAlong Lite is quick and easy to install and your child sits safely and comfortably in the padded seat, where the adjustable foot rests and harness ensure a perfect fit.
Subscribe to Your Pregnancy digitally for just R10 PER ISSUE & SAVE A WHOPPING 40%!
READ YOUR DIGITAL MAGAZINE ON YOUR SMARTPHONE, IPAD, ANDROID DEVICE, LAPTOP OR COMPUTER. 46 | DECEMBER 2017 & JANUARY 2018
FERTILITY 48 What the fertility doctors wished you knew FERTILITY Q&A 49 What shots do I need? MONTH 1 50 Homeopathy for new moms and babes MONTH 1 Q&A 52 Gestational diabetes MONTH 2 54 Building a strong baby MONTH 2 Q&A 56 Vegetarianism during pregnancy MONTH 3 58 Love your ultrasounds MONTH 4 60 Swelling and summer MONTH 4 Q&A 64 Which birth should I choose? Recognising the start of labour 65 Antenatal choices MONTH 5 66 The kicks and why they count MONTH 6 68 Your home-away-from-home birth MONTH 7 72 Breastfeeding: True or false? MONTH 7 Q&A 74 Can I learn hypnotherapy in a weekend? 75 Everyone’s on Eglonyl
Image: Gallo Images/Getty Images
MONTH 8 76 Episiotomy: The cruellest cut? MONTH 9 78 Measuring contractions YOUR BODY 80 The skinny on your post-birth body BREASTFEEDING Q&A 83 Help! I’m having twins! YOUR NEWBORN 84 CPR: The lifesaving basics you need to know
your
practical advice from fertility to newborn
pregnancy files DECEMBER 2017 & JANUARY 2018 | 47
YP P R E G N A N C Y F I L E S
P
RE
GNANC Y
WHAT THE FERTILITY DOCTORS
FERTILITY F I LE S
YOU KNEW No one expects to have fertility challenges when they think about falling pregnant, but for some women it’s a long and difficult process. Here’s what the fertility experts think you should know, according to Julia Boltt WE ALL ASSUME that childbearing is just something that’s going to happen naturally, but this isn’t always the case. “The most common fertility concerns are decreased egg quality in women between the ages of 37 to 45 years,” says Dr Paul le Roux, a specialist in reproductive medicine at the Cape Fertility Clinic. “There are also many couples with a male factor problem and sperm counts seem to be decreasing on a global level, possibly due to toxins in the environment. In younger women, the common problems are polycystic ovary syndrome (POS), fallopian tube blockages and endometriosis,” he says.
AGE DOES MATTER
“A female of the age of 20 has a 25 percent chance to conceive every month. A woman of the age of 40 and above has less than a five percent chance to conceive monthly. Not only does the chance of a pregnancy decrease, but also the risks of a miscarriage increase, due to an increased risk of chromosomal abnormalities in the foetus,” says specialist gynaecologist and fertility expert Dr Chris Venter of Vitalab. As you get older, there’s a decrease in both the quantity (ovarian reserve) and quality (age related) of your eggs. In his opinion, “Women get a false reassurance that they’ll be able to fall pregnant in their late 30s. To conceive naturally at 40 within a few months is the exception to the rule,” he says. “After age 37, one in three women will need fertility treatment,” cautions Dr le Roux. “Women should not delay childbearing until it’s too late. In addition, they need to ask their gynaecologist to refer them to 48 | DECEMBER 2017 & JANUARY 2018
a reputable fertility clinic early (or refer themselves) if they’re battling to conceive, to maximise their chances of conception,” he advises. “There are more women in developed countries that have children in their 30s compared to their 20s now. Although this is accepted in society now to allow women time to develop their careers and settle in with the right partner, it carries a harsh price of increased numbers of women having fertility problems. Unfortunately, there is a time limit on fertility, which doesn’t fit in with the changing social environment,” he says.
IVF ISN’T A MAGIC BULLET FOR INFERTILITY
“This is a misguided notion. IVF can certainly increase the fertility chances, but if the egg quality is poor, it won’t be successful and the couple will need to use an egg donor. Egg quality decreases with age, and in modern fertility clinics up to 30 percent of all patients need an egg donor to have a baby,” cautions Dr le Roux.
YOU CAN RUN OUT OF EGGS
“Ovarian reserve refers to the number and quality of the eggs in the ovary. Both decline with age. It’s not possible to reverse the worsening genetic abnormalities that occur in women’s eggs due to age, but it helps if there are higher egg numbers when starting
fertility treatment,” explains Dr le Roux. “We measure the egg numbers by doing two important tests – a transvaginal scan to count the number of resting eggs in the ovary (antral follicles) – antral follicle count (AFC), and we measure a chemical in the blood which the eggs produce, called AMH,” he says. Dr Venter says the aim is to create awareness about ovarian reserve among patients to know their reproductive status, and not to create anxiety. A lot of patients have said, “If only we knew this earlier, we would have started our family earlier.” However, he reassures that 90 percent of tested patients will fall within the normal range.
DON’T WAIT TO SEEK HELP
“Women should go to a fertility clinic if there is no pregnancy after one year of unprotected intercourse; or, after six months if they’re older than 37 years, or the woman has irregular periods,” recommends Dr le Roux.
CONSIDER FREEZING YOUR EGGS
“The technology to freeze eggs has dramatically improved over the years. It’s now a very successful procedure, and it’s better to do it as young as possible to get the strongest eggs frozen. This will hopefully bring hope to many women who are ready to have children, and need a back-up plan,” says Dr le Roux. “Social fertility preservation by egg freezing is now a common request, because many people don’t have a partner ready to have a baby and need to store eggs before they get too old,” he adds. “It’s not about the age of a woman’s uterus, but all about the age and quality of her eggs,” says Dr Venter. YP
USEFUL CONTACTS The Cape Fertility Clinic 021 674 2088, capefertility.co.za Vitalab Centre for Assisted Conception 0861 VTALAB (882522), vitalab.com
&
Questions Answers OUR EXPERT ANSWERS YOUR QUESTIONS Jackie Maimin
The binding of a woman’s abdomen post-delivery has been used therapeutically for centuries all over the globe. Belly Binder® is worn post-partum to assist your body in regaining its pre-pregnancy beauty and shape giving you that extra boost of confidence you deserve after child birth.
CEO of the Independent Community Pharmacy Association (ICPA)
GETTING READY – WHAT SHOTS DO I NEED?
Q: A:
I want to be as healthy as possible before I conceive. What do I need to know about vaccines?
Before your pregnancy, talk to your healthcare professional about your vaccine history and make sure you are up to date. This will help protect you and your baby. It’s very important for women who are thinking of starting a family to ensure they’ve been immunised against German measles before becoming pregnant. Rubella infection during pregnancy can cause babies to have serious birth defects with devastating, life-long consequences, or even die before birth. You can have a pre-pregnancy blood test to see if you’re immune to the disease. Immunisation against hepatitis B is also very important before pregnancy as a baby whose mother has hepatitis B is at increased risk of becoming infected during delivery. Talk to your healthcare professional about getting tested for hepatitis B. You should try get your immunisation schedule up to date before becoming pregnant, but that’s not always possible, so the ICPA advises that these two vaccines be administered during pregnancy if indicated: • During pregnancy you may get the flu vaccine to protect yourself and your baby from the flu. A pregnant woman who gets the flu is at increased risk for serious complications and hospitalisation compared to other adults. When mothers are vaccinated during pregnancy, babies are also less likely to get the flu and serious flurelated complications like pneumonia after they are born. • Pregnant women may also get the tetanus, diphtheria, and acellular pertussis vaccine (Tdap). Mothers who have been vaccinated against these diseases pass their immunity, as antibodies against these infections, to their unborn child. These antibodies are vital to protect the newborn from whooping cough (pertussis) until they’re old enough to get vaccinated themselves. Whooping cough can be life-threatening for young babies. Mothers who have not received the Tdap vaccine during pregnancy should be vaccinated right after delivery. Those who spend time with the baby should also receive the whooping cough vaccine. YP Email your question for our experts to: letters@yourpregnancy. co.za. Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.
Seamless Organic Cotton Belly Binder® Helps flatten the belly and redefine the waistline. Helps reduce uncomfortable uterine swelling and aids in decreasing bloating caused by water retention. Compresses stomach muscles together helping them to strengthen and heal quickly. Helps improve posture whilst sitting, standing and in particular breast feeding. Fully adjustable for ultimate comfort and support. Helps reduce stretch marks. Provides abdominal support and comfort after c-section. Is specifically designed to be worn comfortably under all your clothes, making you look and feel beautifully slim and attractive.
Available at Baby City, Baby Boom, Babies ‘R’ Us at Toys ‘R’ Us, Dis-Chem and leading Baby and Maternity stores Carriwell SA (Pty) Ltd • P.O.Box 272, Umhlanga Rocks, 4320 Tel: (031) 564 8805, Fax: (031) 564 9647 • www.carriwell.co.za, info@carriwell.co.za
YP P R E G N A N C Y F I L E S
HOMEOPATHY FOR NEW MOMS AND BABES GNANC
1
RE
Y
P
Homeopathy is one of the best ways to treat illnesses and discomfort in pregnancy and early childhood. Louïne van der Vyver and Karin Steyn tell us more...
MONTH F I LE S
DR JANA MOSTERT, a Johannesburgbased homeopath with a special interest in healthcare during pregnancy, labour, birth and postpartum, says homeopathy is a natural way of healing and was developed more than 200 years ago as an attempt to treat people more gently. It’s safe to use in pregnancy, doesn’t cause any deformities in the developing foetus, and has no side effects for mother or baby. Dr Mostert says homeopathic remedies work extremely well for a variety of pregnancy-related experiences, such as: ■ nausea and vomiting ■ swelling ■ depression and anxiety ■ digestive issues ■ and heartburn. There are even remedies that can be
HANDY HOMEOPATHIC REMEDIES DURING PREGNANCY ■ Nausea – Nux Vom 30ch Take 10 drops every 15 minutes until better, or Magen 1 (a complex by Natura) Take 10 drops three times daily ■ Fatigue – Carbo Veg 6ch Take 10 drops twice daily as needed ■ Anxiety/ depression – Nerva 3 (a complex by Natura) Take 10 drops three times daily ■ Sleeplessness – Coffea 30ch Take 10 drops before sleep and if woken at night ■ Haemorrhoids – Aesulus 30ch and Hamamelis 30ch mix Take 10 drops three times daily ■ Backache – Arnica 30ch and Ruta 30ch mixed Ten drops three times a day ■ Swollen ankles – Apis 200ch Take 10 drops daily ■ Bladder infection – Cantharis 30ch and Berberis 30ch mix Take 10 drops three times daily ■ Colds and flu – GripHeel (a complex by Heel), take 10 drops four times daily 50 | DECEMBER 2017 & JANUARY 2018
R
ER
N E.
O
U TJ
FO
E E N TI
FAMILY .
OR YO ST F UR
TH
RE
H
OP E
ST
EM
S
F
M
H
Although it’s possible to buy general over-the-counter homeopathic remedies, Dr Mostert advises to rather make an appointment with your homeopath where possible. “Each person’s expression and experience of an illness will be individual, and so too the remedy that is designed for you. Remedies are worked out to take into account the individual’s experience of the illness, the personality and behaviour of the individual as well as general sensitivities.”
LY
WHERE CAN I FIND HOMEOPATHIC REMEDIES?
B
BUT POTEN
AL
Postpartum adjustment may also be assisted with homeopathic remedies, such as: ■ soothing aching muscles ■ relieving symptoms of postnatal depression ■ stimulating breastmilk ■ for teething pains and colic in babies ■ bringing down fevers ■ and the reduction of symptoms developing from vaccination.
Y AB
TI
During labour and birth there are remedies to: ■ strengthen surges ■ manage anxiety ■ aid in relieving labour pains.
BIN THEM OR BANK THEM?
RO
taken for babies in breech presentation, if given early enough and before baby is engaged.
WHAT ARE CONSTITUTIONAL REMEDIES AND HOW DO THEY HELP?
Constitutional remedies are designed for the individual and can help the patient to be as balanced as they can possibly be. With good support, the body can frequently heal itself. Constitutional remedies enhance immunity in order for mother or baby not to get sick as often. They feel emotionally better and generally have more energy. Only a homeopath can offer you a constitutional remedy after careful examination. YP
REMEDIES TO HAVE ON HAND DURING CHILDBIRTH ■Arnica 30ch – Helps with aches and pains during childbirth and after ■Bellis Perennis 30ch – Promotes quick healing of the perineum after childbirth
Having a baby brings about many responsibilities. Make sure you know the facts about the lifesaving abilities of your baby’s cord blood stem cells, before you discard them as medical waste.
YOU HAVE ONLY ONE CHANCE TO GIVE THIS PRECIOUS GIFT.
INVEST IN HOPE FROM R279* PER MONTH. * Terms and conditions apply.
■Calendula 30ch – Helps prevent infection after childbirth
Images: Gallo Images/Getty Images
■Caulophyllum 30ch – Helps with fatigue during childbirth and after (a most important remedy) ■Chamomilla 30ch – Helps with stress and pain during childbirth (also colic and teething baby) ■Cimicifuga 30ch – For an easier birth if given in the weeks leading up to childbirth
For an obligation-free information pack and/or consultation: email info@cryo-save.co.za or visit www.cryo-save.co.za This is for information and educational purposes only, and should not be construed as healthcare advice. Please discuss with your healthcare professional. A full list of references is available on the website and at our offices. Data on file.
■ Mag Phos Tissue Salt – Helps alleviate pain during childbirth ■Kali Phos Tissue Salt – Helps alleviate anxiety and fatigue during childbirth
Cryo-Save South Africa is jointly owned by Esperite N.V., listed at Euronext Amsterdam and Paris and JSE-listed Ecsponent Limited.
Vanessa Brown
Diabetes specialist nurse, Centre for Diabetes and Endocrinology (CDE)
&
Questions Answers
YP Q & A M O N T H 1
OUR EXPERT ANSWERS YOUR QUESTIONS
Email your question for our experts to: letters@yourpregnancy.co.za. Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.
52 | DECEMBER 2017 & JANUARY 2018
WEIGHING IN ON GESTATIONAL DIABETES
Q:
Why should I start my pregnancy at a healthy weight if I’m just going to gain weight anyway?
A:
Vanessa answers: Gestational diabetes particularly affects women who are overweight or obese. Women should consider losing excess weight before falling pregnant, but if this isn’t the case, eating sensibly during pregnancy can go a long way to reducing the risk of gestational diabetes. Most gestational diabetes occurs in women with risk factors for type 2 diabetes. They’re unable to secrete sufficient insulin to overcome the increased insulin resistance that normally results as pregnancy proceeds. Gestational diabetes affects about one in seven births, and may persist as type 2 diabetes or “pre-diabetes”, or resolve completely when the pregnancy is over. Women who have had gestational diabetes are at an increased risk for developing type 2 diabetes later in life. A further often unappreciated fact is that children whose mothers had diabetes during their pregnancies have a greater likelihood of becoming obese during childhood and adolescence and of developing type 2 diabetes later in life. The number of women being diagnosed with gestational diabetes is increasing around the world, so finding simple and cost-effective ways to prevent women developing it is important. The rule of thumb is to choose healthy living during pregnancy. A healthy body means a stronger body, which will not only benefit the baby while in utero, but will also assist during the birth and recovery thereafter. Healthy living means eating properly, exercising regularly and doing away with bad habits such as smoking.
Limit your intake of sugar and processed food, and opt for a variety of real, whole foods. Gestational diabetes may end after the baby is born, but women with gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes in the five to 10 years after childbirth. Treatment of gestational diabetes includes healthy eating, exercise and possibly insulin therapy. It’s important to monitor blood glucose levels regularly to assess whether the ideal targets are being met. You should continue self-monitoring of blood glucose after delivery of your baby. Some women with gestational diabetes will revert to normal glucose tolerance in the weeks following delivery, but with a high risk of developing type 2 diabetes in the future. In others, diabetes remains and treatment should continue. If blood glucose levels return to normal on home monitoring without any diabetes treatment, an oral glucose tolerance test (OGTT) should be done in a laboratory six weeks after delivery. This necessary stress test for your insulin-producing beta cells assesses for any abnormality in glucose tolerance. It is done by checking the fasting blood glucose level, and if indicated by that result, drinking a solution containing 75g of glucose. The blood glucose response to the oral glucose challenge is then measured two hours later. If this test is normal, screening for diabetes should be repeated annually. To reduce the risk of developing type 2 diabetes in the future and to keep those annual tests negative, it is vital to continue with healthy eating, exercise and maintenance of a healthy weight range. Remember, your child needs you to be healthy! YP
BUILDING P
‘You are what you eat’ has special significance during pregnancy – the only time your eating habits directly affect another person. So what should you be putting on your plate to ensure optimum health for your growing baby? Tracey Hawthorne explains…
mom-to-be eats – is a key factor that affects birth outcomes and has long-term effects on the health of children,” says Johannesburg gynaecologist Dr Kiran Kalian. Dr Candace Howe, an obstetrician/ gynaecologist at HM Medical in Newport Beach, USA, concurs. She says that there’s substantial scientific research to show that metabolic programming happens in the womb, so a mother’s healthy nutritional status is extremely important. So what foods should we be eating to help our babies grow strong while they’re in the womb? “Building a healthy baby starts from before pregnancy,” Cape Townbased nutritionist and midwife Jacky Bloemraad-de Boer points out. “Eating a balanced, healthy, nutritious diet improves fertility, helps boost energy and fights early-pregnancy nausea.” Pre-pregnancy, Bloemraad-de Boer recommends a diet high in fresh whole foods that includes fruit, vegetables, complex carbohydrates, proteins and unsaturated fats. If this describes you, read on. If not, Dr Kalian advises that you consult with a trained specialist in maternal nutrition, and especially if you have an eating disorder, are overweight or obese, if you’re on a special diet or avoid certain foods or skip meals.
FIRST TRIMESTER
“The mother’s body undergoes huge changes and it needs extra nutrients 54 | DECEMBER 2017 & JANUARY 2018
in the first trimester,” says Bloemraadde Boer. “The most important macronutrients to support this are proteins, because they’re the body’s building blocks, essential for the growth and development of the placenta and for the extra blood volume needed in pregnancy.” Pregnant women need a minimum of 65-85g a day of protein, and up to 100g a day if they’re extremely tired and to help alleviate certain symptoms like nausea.
SECOND TRIMESTER
“Although the baby has developed all its organs and systems by the second trimester, it will now begin to grow in length and weight, and needs nutrients
MONTH F I LE S
to support this essential stage in its development,” says Bloemraad-de Boer. “Besides eating a balanced, healthy diet, it’s especially important to eat foods rich in calcium, magnesium and vitamin D to help the baby grow strong bones. It’s also beneficial to eat foods containing omega 3 fatty acids, which are vital for the baby’s nervous system and brain development.”
THIRD TRIMESTER
As the growing baby crowds out other internal organs, the mom may feel hungry but get full very quickly. “Eat six small meals a day rather than three bigger ones,” Bloemraad-de Boer advises. YP
EAT FOODS CONTAINING OMEGA 3 FATTY ACIDS, VITAL FOR THE BABY’S NERVOUS SYSTEM DON’T EAT THAT DOUGHNUT If you had morning sickness in your first trimester, it may feel like a blessing to want to eat all your favourite things again during your second trimester. But what if your cravings include nutrient-empty chips and burgers, ice cream and chocolate? USA neuroscientist and nutrition expert Dr Nicole Avena, author of What to Eat When You’re Pregnant (Ten Speed
Press, 2015), says that research (albeit mostly in rats) has found that not only can an in-utero diet high in fat or sugar lead to the child growing up obese, but maternal diet “can have a long-lasting impact on the child’s risk of developing mental health disorders, impaired social behaviours, lower cognitive abilities and increased response to stress”.
Images: Gallo Images/Getty Images
‘MATERNAL NUTRITION – what the
GNANC
2
RE
Y
a strong baby
P R E G N A N C Y F I L E S YP
THE MAGIC BULLETS... FOLATE, IRON AND OMEGA 3s Supplementation is always a good idea during pregnancy and should include folic acid, iodine, vitamin D and iron to ensure adequate intake. In the third trimester, some women may need to add extra iron or vitamin B12, and a calcium supplement. Speak to your medical practitioner about your supplement needs. Folic acid: Folate is a B vitamin (B9) found in leafy green vegetables such as asparagus and broccoli, liver and kidney, nuts, lentils and seeds, and oranges. It’s critically important very early in pregnancy (in the first 28 days), when the brain and spine of the baby are developing. All the B vitamins are water-soluble, which means
your body doesn’t store them – you have to top up your B9 levels every day. In South Africa, all bread and maize is fortified with vitamins and minerals, including folic acid, which is the synthetic form of folate. Dr Soha Said, a consultant obstetrician at Corniche Hospital in Abu Dhabi, United Arab Emirates, advises women to begin taking folic acid a month before they conceive and to continue for the first three months of pregnancy. Iron: “If you’re at high risk of iron deficiency, take supplementation from around 16 weeks of pregnancy, when the demands of the foetus for iron start to increase,” says Dr Kalian.
Omega 3s: Dr Deborah Pufal, a senior lecturer in nutrition at Huddersfield University in the UK, notes that a woman’s diet during pregnancy is critical for the baby’s brain development. For this reason, she says, it’s important that you get enough omega 3 fatty acids, which are involved in brain development. Fish oils are the best and most easily available source, but because so many marine fish have high levels of contaminants, current advice is that we should eat no more than two to three portions a week. Alternatives are soya and linseed oils, walnuts and enriched eggs.
DECEMBER 2017 & JANUARY 2018 | 55
Lindsay Archibald-Durham Dietician
&
Questions Answers
YP Q & A M O N T H 2
OUR EXPERT ANSWERS YOUR QUESTIONS
Email your question for our experts to: letters@yourpregnancy.co.za. Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.
56 | DECEMBER 2017 & JANUARY 2018
VEGETARIANISM DURING PREGNANCY
Q:
I’m a healthy pregnant vegetarian. I’m a bit worried about my diet as it relates to my baby though. I know that even meat-eating pregnant women often struggle with iron shortages. What can I do to ensure I get enough iron for me and my baby? I’m also not that big on dairy, so I’m worried about calcium, too.
A:
Lindsay answers: A balanced vegetarian diet can provide all the nutrients you need for a healthy pregnancy, provided you pay close attention to getting enough protein, iron, vitamin B12, calcium and vitamin D. Iron needs increase during pregnancy to aid in the development of the foetus and placenta and to maintain increased maternal blood volume. Iron needs may be greater for those on a vegetarian diet because of less efficient absorption of iron from non-animal sources. Iron supplements (or prenatal vitamins containing iron) are often prescribed for women on any kind of diet, as it is difficult for any woman to meet increased needs through diet alone. Vegetarian women should include iron-rich plant foods daily, in addition to taking their prescribed vitamins or supplements. Iron supplements should not be taken at the same time as tea, coffee, dairy products or calcium supplements as these foods inhibit the absorption of iron. Vegetarian sources of iron include wholegrains and fortified cereals, legumes, nuts, seeds,
dark green vegetables, dried fruit, eggs and blackstrap molasses. Including vitamin C-rich foods or drinks such as citrus, peppers or sweet potato at meals can increase the absorption of iron. Vitamin B12 is found in fortified foods, such as fortified cereals, meat substitutes, non-dairy milk, and nutritional yeast such as Marmite. Just as it was before pregnancy, getting enough calcium on a vegetarian diet is easy. In fact, calcium absorption from plant foods is often superior to that of dairy products. Good non-dairy sources of calcium include tofu and soy beans, dark green leafy vegetables, broccoli, pulses and baked beans, dried apricots and figs, sunflower seeds, sesame seeds and tahini, almond butter, calcium-fortified non-dairy milk, bread and calcium-fortified cereals and juices. If these foods are included in the diet every day, calcium needs are easily met. Your body will require sufficient vitamin D to absorb and use calcium. Therefore, it’s important to both mother and baby to ensure adequate intake. Vitamin D is made in the body as the result of exposure to sunlight. This nutrient is poorly supplied in all diets unless people use foods that are fortified with it, such as ready-to-eat cereals and non-dairy milks. Pregnant women who don’t regularly spend time in the sun or have darker skin will want to be sure to include fortified foods in their diet. Many prenatal vitamins contain adequate amounts of vitamin D as well. YP
A D V E R T O R I A L YP
Planning FOR THEIR FUTURE
With the birth of a child comes a great expectation. Parents see future doctors, ballerinas and award-winning actors when their babies are still dozing in their strollers. But children are expensive, and adequate financial planning is a must to ensure financial freedom and security BUT WHERE DO you start? The most sensible place would be in taking thorough stock of your current financial position.
PLAN AHEAD If your family doesn’t have a financial advisor, Sygnia’s RoboAdvisor is an ideal place for novice investors to begin planning their future. This easy-to-navigate online platform takes you through 11 simple steps to evaluate your financial position, your goals and your aspirations. It then calculates your ideal risk appetite and suggests a suitable portfolio to invest in. Best of all, you don’t need to make an appointment, find a babysitter or wash your hair to log on!
Image: Gallo Images/Getty Images
START EARLY AND KEEP UP For most parents, saving for their children’s education is a top priority, but it can be a real challenge to keep up with rising expenses. Education costs increase annually by 8 to 9 percent, which is about three percent higher than consumer price inflation (CPI) – easily outstripping most salary increases and leaving you with a tighter budget. The Sygnia TaxFree Savings Account (TFSA) with a minimum contribution of only R500 per month is an efficient investment vehicle with no dividend, capital gains or income tax payable, so your money grows faster than in a regular savings account. FUTURE PERFECT With Sygnia you can choose from a range of low-cost products, which focus on innovation through technology. The Sygnia 4th Industrial Revolution Global Equity Fund is a South African first. It offers
local investors exposure to global companies at the forefront of the 4th Industrial Revolution, which sees new technologies merging the physical, digital and biological worlds at an exponential pace. With this unit trust you can invest in the future and own a piece of a dazzling new world. And Sygnia’s recently launched Itrix range of exchange traded funds (ETFs) offers you the opportunity to diversify and track indices in developed world
All information and opinions provided are not intended to address the circumstances of any particular individual or entity. We are not acting and do not purport to act in any way as an advisor or in a fiduciary capacity. No one should act upon such information or opinion without appropriate professional advice after a thorough examination of a particular situation. Sygnia Financial Services (Pty) Ltd is a licenced financial services provider (FSP44426). Sygnia Itrix (RF) (Pty) Ltd and Sygnia Collective Investments (RF) (Pty) Ltd (“the Managers”) are registered and approved Managers under the Collective Investment Schemes Control Act,
markets. These ETFs offer an efficient, transparent and flexible way for you to invest in overseas stock markets. Saving for your child’s future is no doubt a mammoth task, but time is a powerful ally and a bright future is possible the minute you start saving. For more information on Sygnia product offerings visit sygnia.co.za, call 0860 794 642 (0860 SYGNIA), email admin@sfs.sygnia.co.za or speak to your financial advisor.
2002. Collective Investment Schemes (CIS) are generally medium to long-term investments. The Managers do not provide any guarantee with respect to the capital or return of the portfolios. The value of units may go down as well as up and past performance is not necessarily an indicator of future performance. CIS are traded at ruling prices and can engage in borrowing and scrip lending. Nothing in this advertisement shall be considered to state or imply that the CIS or any of its portfolios are suitable for a particular type of investor. ETFs trade on stock exchanges and may therefore incur additional costs associated with listed securities A schedule of fees and charges are available on request.
DECEMBER 2017 & JANUARY 2018 | 57
GNANC
3
RE
Y
LOVE YOUR
P
YP P R E G N A N C Y F I L E S
MONTH F I LE S
ULTRASOUND CAN BE used as a simple screening test or for a more in-depth diagnostic test. The use of ultrasound makes it possible to “see” inside the womb using sound waves. High frequency sound waves transmitted into the body bounce back from changes in density of different surfaces, such as those found in the body (fat, muscle, body organs and bone). Although ultrasound scanning is considered to be safe, some mothers still refuse to have one, as they feel there’s not enough long-term evidence of safety, and should only be done if a problem is suspected and a diagnostic ultrasound needs to be done. But there are many times when exposure to ultrasound gives valuable information that will clearly improve the outcome of a pregnancy.
HOW IS A SCAN CONDUCTED?
A transabdominal ultrasound is painless and noninvasive. The mother is usually required to drink plenty of fluids beforehand and asked to keep her bladder full. This will help to push the uterus out of the pelvic cavity in early pregnancy. The mother will lie flat on a bed and gel is applied liberally to her abdomen – this will help with the conduction of the sound waves. A transducer probe is moved back and forth along the mother’s abdomen, which picks up the sound waves, feeding them into a computer that then displays the image on a screen. Gradually, the uterine contours, bladder or placenta and foetus are revealed in a moving picture. The scan’s accuracy rate is dependent on the skill of the operator, and the interpretation of ultrasound varies among those who administer them. Since the development of ultrasound, methods and techniques have come a long way. Instead of looking at a screen that looks like it could be the surface of the moon, scans today can show your baby’s face in great detail. These are just some of the methods that use different 58 | DECEMBER 2017 & JANUARY 2018
imaging centres that perform the ultrasounds: • A-mode (amplitude mode) – This is the simplest method of performing an ultrasound. • B-mode or 2D mode – This is a twodimensional way of viewing the image of the foetus. • 3D ultrasound – This is the most commonly use ultrasound technique by most obstetricians. This will show the three-dimensional picture of your growing baby. • 4D ultrasound – This is similar to the 3D imaging, but provides the real-time image of the foetus.
ULTRASOUND MAY BE USED TO
• Confirm your due date by measuring the size of the foetus between 16 to 20 weeks’ gestation, or earlier. • Check if you might be carrying more than one baby. • Check for an intrauterine device that
Did you know?
The history of ultrasound doesn’t lie in obstetrics or medicine, but in warfa re, when the Allies used sonar to locate submarines during Wo rld War II. The technique was imp orted to obstetrics in the mid-1950s.
may have been in place as a method of birth control. • Monitor the growth of your baby. • Detect any abnormalities of the foetus. • Offer a window in the womb during an amniocentesis or chorionic villus sampling. • Measure the amount of amniotic fluid in the womb. • May detect the source of any abnormal uterine blood loss. • Check for a molar pregnancy, ectopic pregnancy or miscarriage if there has been no foetal movement by week 22, or if movements stop. • In some cases, determine the baby’s sex. Success of this has a lot to do with baby’s position and the skill of the person doing the ultrasound. • Assess the condition of the placenta if baby is small. • Determine the state of the cervix to check whether it has started to dilate prematurely. YP
Images: Gallo Images/Getty Images
An ultrasound scan is your chance to “meet” your baby. Here’s why these scans are important and why you’ll love them too, writes Tina Otte
NEW
GNANC
4
RE
Y
P
YP P R E G N A N C Y F I L E S
MONTH F I LE S
Swelling in pregnancy is a common occurrence, and even more so in the summer heat. Here’s why it happens, and what you can do about it, writes Tina Otte
AND SUMMER
60 | DECEMBER 2017 & JANUARY 2018
YP P R E G N A N C Y F I L E S
PUFFINESS OF THE wrists and ankles during pregnancy is caused by the accumulation of fluid in the tissues. This is probably due to the changes in the cardiovascular system, causing the blood vessels close to the surface of the skin to become more dilated in response to the increased blood volume. Even though a certain amount of fluid retention is normal, too much can become uncomfortable and could lead to certain health problems, such as high blood pressure. Each woman retains fluid according to her individual needs. An overweight pregnant woman will retain more fluid than a woman who’s underweight. Even women who show no signs of swelling carry an increased amount of fluid in their bodies during pregnancy.
dependent position, meaning, they’re lower than the rest of your body. Because of this, gravity works against your veins as they attempt to move your blood from your legs to your heart. This type of swelling is temporary and will disappear once you put up your feet and relax. Pitting oedema is more serious. This usually means that your body is retaining too much fluid. You may have puffiness in your face around the eyes and in your hands. This swelling will not disappear as quickly when you elevate the affected part.
HOW CAN YOU TELL WHICH IS WHICH?
One way to tell the difference between normal swelling and swelling that is
not so good is to do the “cake test” on your puffy ankles: Tissues swollen with dependent oedema will spring back after being pressed. If you have pitting oedema, much like a cake that is not quite done, tissues will not spring back when you press the swollen area on your ankles or feet, and it remains dented.
NOT SO SWELL
Report any increase in swelling as well as any puffiness around the face and eyes and in your hands to your doctor. These changes could signify the onset of pre-eclampsia or pregnancy induced hypertension (PIH) which is a pregnancy-related condition that is associated with high blood pressure, and which can be dangerous. YP
WHY SO WATERY?
WHEN DOES SWELLING BECOME A PROBLEM? You’ll notice that by the end of a day, when you have been up and about and standing a lot, your ankles will be swollen and your shoes may be too tight. This kind of swelling or oedema is known as dependent oedema and is caused by the position of the affected body part. When you stand for an extended period of time, your feet are in the 62 | DECEMBER 2017 & JANUARY 2018
IF YOU HAVE PITTING OEDEMA, MUCH LIKE A CAKE THAT IS NOT QUITE DONE, TISSUES WILL NOT SPRING BACK WHEN YOU PRESS THE SWOLLEN AREA HELPFUL HINTS ■ Raise your legs and hips on pillows as often as you can during the day and hold this position for about 15 to 20 minutes so that gravity can do its job.
■ Avoid tight shoes – wear open sandals or mules.
■ Lie on your left side when sleeping or resting because this will relieve the weight of the uterus off the large blood vessels that return blood to the heart.
■ Treat your swollen, hot feet and legs with a body or facial scrub or soak your feet in a cool foam bath with two drops of peppermint oil.
■ Exercise – brisk walking, swimming (excellent for swollen limbs) or riding a stationary bike three to four times a week will improve sluggish circulation. ■ When watching TV or reading, keep your feet raised to hip level and never let them dangle. ■ Do not cross your knees.
■ Avoid tight socks – this can restrict your blood flow.
■ Drink plenty of fluids. This will keep your kidneys and bladder functioning effectively. ■ The tissue salts Nat Mur and Nat Sulph every four hours helps to distribute body fluids evenly. ■ After your warm (not hot) bath sit on the edge of your bed and roll your feet back and forth on a ball or a rolling pin.
Images: Gallo Images/Getty Images
There are a number of reasons for retaining fluid in pregnancy (this is regulated by the influence of hormones). The extra fluid that you carry helps your body to produce enough amniotic fluid for your baby. This liquid protects your baby from knocks and bumps and changes in temperature. You need a bigger amount of circulating blood/fluids to meet the demands of your growing baby, as well as to help get rid of waste products. The extra volume of water in your blood slows down your circulation and this, together with the extra water in the tissues, causes swelling. In most women, swelling is more noticeable in the legs, especially around the ankles. This is because the pressure of the growing baby, together with the increased blood volume, makes it more difficult for the blood to return from the arms and legs to the heart. In the legs, however, both gravity and the weight of the uterus on the veins slows down the return flow. Swelling is often referred to as oedema.
NEW!
SAFETY TURNS EASY Now from birth
&
Questions Answers
YP Q & A M O N T H 5
OUR EXPERT ANSWERS YOUR QUESTIONS Email your question for our experts to: letters@yourpregnancy.co.za. Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.
Pigeon Baby Lotion (200ml) R55 selected retail outlets and online stores
64 | DECEMBER 2017 & JANUARY 2018
Tina Otte
Midwife, childbirth educator and specialist editor of Your Pregnancy
WHICH BIRTH SHOULD I CHOOSE?
Q:
I’m expecting my first child and am finding it extremely difficult to decide whether natural birth should be the route to take. I’m not concerned about labour itself, but rather the after effects natural birth would have on the muscle and in particular the size of the vagina. Another concern is that the process would have a negative impact on one’s libido. At this stage I’m leaning more towards having a C-section, however this is a major operation and I’m not sure whether it’s worth going through, especially since longer healing time is required.
A:
Tina answers: A woman has been designed to give birth vaginally and in reality about 15 percent
of women will need assistance in the form of a caesarean. If you have no complications and you prepare yourself physically and learn how to work with your body, vaginal birth is the best way to deliver your baby. Doing pelvic floor exercises before and after delivery is imperative in getting the tone and strength back into the perineal area. The birth itself should not have a negative impact on your libido (although coping with the challenges of being a new mom may!). Natural birth is the most spectacular, amazing event, and you should not be deprived of the experience due to misinformation. I urge you to attend childbirth education classes and get more information before making a final decision.
RECOGNISING THE START OF LABOUR
Q:
How will I know when I’m in labour? I’m 18 weeks pregnant with my first child. What if I don’t recognise labour pains and my baby is in danger?
A:
Tina answers: Some signs that labour could be approaching are slowing down of weight gain, change in energy levels and change in
vaginal discharge. More definite signs are pressure in the rectum and pelvis, cramps and groin pain with persistent lower backache, loss of mucus plug and diarrhoea. When labour starts for real, your contractions will intensify. They radiate from your lower back to the lower abdomen and even down the legs. They become progressively more frequent, regular and painful. YP
Ferrari 5-in-1 High Chair R1 999 ferraribaby.co.za
Huggies® Gold for Boys Size 3 MegaBox (144) to Size 5 (100) R390 leading retailers
ScarScience
tm
ANTENATAL CHOICES
Q:
Firstly, I’d like to congratulate you on a wonderful magazine! YP helped when we needed advice on falling pregnant and now at 23 weeks it’s still a great help. In the Pregnancy and Birth Book by Tina Otte, she lists various things you should consider when deciding on a specific antenatal class. I’m currently undecided on two classes. The contents of both are very similar, but the one offers physical exercise using a birth ball and aqua aerobics. The other one offers no physical activities. How important is the physical exercise aspect? Do you have any suggestions as to the better choice? I know that it should be a personal decision, but I want to have an idea of what should be covered in an antenatal class.
A:
Tina answers: I believe that physical exercise is one of the best things you can do to prepare your body for the challenge of labour. There are many reasons why exercising is good for you as long as you are having an uncomplicated pregnancy. I’m also aware that there aren’t many places that offer both physical exercise as well as childbirth education. You should be working out at least three times a week, over and above your childbirth lectures. Not all midwives are trained in giving appropriate exercise, so perhaps you can seek out a qualified instructor in order to get fit and join a class that you feel is the right one for you. Small classes can be very intimate and couples get to know one another really well, yet large classes (15 couples or more) can be extremely dynamic with a lot of interaction as different personalities share their humour, experience and wisdom. Childbirth classes should cover all aspects of childbirth: from vaginal delivering; to pain relief; high-tech births and deviations from the norm. Early parenting issues are usually included (jaundice, circumcision, bathing baby, cord care, fever, safety and most important – breastfeeding and crying). Some educators run a separate breastfeeding course, which I encourage you to consider. Educators should give you information based on the best available evidence, so that you can make up your own mind on what is right for you. This can only be done once you have all the facts at your fingertips. YP
IMPROVE YOUR SCARS 1 WITH SCIENCE
ScarScienceTM is a scar management system proven to be significantly effective in clinical trials.
HOW SCARSCIENCETM WORKS
ScarScienceTM is based on a four-pillar approach to ensure that healing occurs and a “good scar” is formed. ScarScienceTM is convenient and easy to use. It is a scientifically formulated programme and is recommended for surgical scars (eg. new mothers who have had a Caesarean section), ensuring visible results.
Skinsano Multipurpose Ointment 50g, 100g and 150g from R140 Baby City and Clicks
Ref: 1. Widgerow AD, Chait LA, et. al. New Innovations in Scar Management. Aes Plas Surg. 2000:24;227-234.
PHARMA
ScarScienceTM is distributed by Litha Pharma and is available at Dis-Chem and leading pharmacies. For more information visit: www.scarscience.co.za or call + 27 (0)11 516 1700
Part of Litha Healthcare Group Limited
Scar Management Programme LP. 665/04/2014
GNANC
5
RE
Y
P
YP P R E G N A N C Y F I L E S
MONTH
AND WHY THEY COUNT The first time baby kicks is a wonderful moment. Here’s how to spot when it happens, and why these kicks are more important than you might think, writes Melany Bendix
F I LE S
“IT FELT A bit like a feather tickling me, but from the inside. At first I wasn’t sure it was baby, but a few days later there was another flutter, and then another, and another, and I just knew,” Kuhle Mthembu, 32, recalls of her son’s first movements inside her belly at just 17 weeks. He was right on schedule, according to Dr Deon van Zyl, an obstetrician/ gynaecologist practicing from Mediclinic Panorama in Cape Town: “Most women start feeling flutters – or ‘butterflies’ – from around 16 weeks.” Dr Van Zyl says it’s not necessarily a cause for concern if you’re beyond 16 weeks and you haven’t felt movement yet, as “proper movements are only really felt from about 21 weeks”. Like Leanne Farish, 31, who didn’t feel any movement until she was 20 weeks. “Those early movement were like a very gentle, single throb. Now, at 26 weeks, his movements are stronger and more noticeable – like being poked from the inside. I can also see the movement now.” Deon adds that some women may only feel movement after 21 weeks: “Sometimes, if the placenta lies anteriorly (on the front wall of the uterus, towards mommy’s tummy) it can be even more difficult to feel movements, thus they could be experienced even later.” However, a lack of movement can indicate foetal distress or complications, so if you haven’t felt any movement by around 22 weeks, it is advisable to go for a check-up.
WHY KICKING COUNTS
While pregnancy experts stress that women should not get too obsessed with noting every tiny movement, counting the kicks is an important way to monitor your baby in-between check-ups. “Most women only see their gynaes or midwives every four weeks until about 32 weeks, and thereafter every two weeks, with only the last four weeks being weekly. That’s a lot of time that 66 | DECEMBER 2017 & JANUARY 2018
4 WAYS TO GET BABY MOVING 1 Drink something cold, or fizzy like soda water (avoid sugary and/or caffeinated drinks). 2 Eat chocolate! Babies move around more if moms eat a bit of sugar. 3 Get moving: a few minutes
of exercise can jog baby into action. 4 Play music or have a chat. Studies show babies in utero recognise music and are comforted by the sound of their mothers’ voices and may respond with movement.
baby goes ‘unmonitored’,” notes Dr Van Zyl. “If a pregnant woman pays attention to her foetal movements she can notice subtle changes, especially baby moving less than usual. This could be normal, but needs to be checked out as it could be a sign that baby’s getting less blood – and thereby oxygen and nutrients – and could potentially require closer monitoring or additional testing.” While there’s no ideal number of movements, Heather Pieterse of Pretoria-based Midwives Exclusive says it’s crucial to know your baby’s typical movement patterns after the 25-week mark, and to be aware of any irregularities. “The usual rule is that babies should have more than four movements in an hour, but it depends on your baby’s regular rhythm and pattern of movement,” she explains. “Some babies are quieter and calmer while others are very busy.” Aaniyah Omardien, 39, can attest to that. Her first two sons were not big kickers, but her third son (now in the third trimester) is turning out to be a real Lionel Messi: “This baby is kicking and my back is feeling it – I’ve even had to wear a lower back brace recently.”
WHEN TO WORRY
It doesn’t much matter if your baby is a gentle tickler or a soccer player, though, Heather says what’s important is that “your baby should keep to her usual pattern of movement”. If baby’s moving less than usual always go check it out, urges Deon. “If your doctor or midwife is not available, go to the labour ward at your hospital – they can also do a test (cardiotocogram) to look at baby.” “More often than not, baby is absolutely fine,” he emphasises. “Often, most (super) women are extremely busy during the day – running around at the office or after a busy toddler at home – and they just don’t notice the movements as much.” Lastly, Heather says it’s important to know that in the weeks leading up to delivery (36 weeks and onwards) babies will often sleep longer and move differently, shuffling side to side rather than outright kicks and shoves. There’s no need to panic; just count those kicks. YP
Quick and perfect for any diligent mum Dr. Brown’s newly redesigned Deluxe Bottle Sterilizer uses steam to sterilize six bottles at once! The easy-to-use electronic controls, with cycle indicators and auto shut-off makes it simple to quickly sterilize baby bottles. A removable tray perfectly holds all the bottles in a position for steam to directly reach inside each bottle. The accessory tray holds small items, such as breast pump parts, nipples and pacifiers, so you can conveniently clean all of your baby items at once. Tongs are included for you to grab the bottles once they are finished being sterilized.
Images: Gallo Images/Getty Images
Q I CAN’T EVER FEEL MY BABY KICK. WHAT’S WRONG WITH ME?” DR DEON VAN ZYL ANSWERS “Some women simply struggle more than others. Some are extremely busy and only really notice movements when they relax and focus. Sometimes the placenta ‘absorbs’ a lot of the kicks, especially early on, and it may be very difficult to feel movements. Obesity can also make it more difficult to feel movements. Or you might just not be far enough along to feel regular movements yet. But if you haven’t felt any movement from around 22 weeks, visit your doctor/healthcare provider as soon as possible for a check-up.”
Available at leading baby stores. For product support on the Dr Brown’s range contact us at support@drbrowns.co.za Follow us on Facebook: DrBrownsSA
YP P R E G N A N C Y F I L E S
Your GNANC
6
RE
Y
P
HOME-AWAY-FROM-HOME MONTH F I LE S
Private birth centres offering midwife-led births are springing up all over South Africa, ranging from luxury clinics to a simple room in a midwife’s own home; and more and more mothers are choosing birth centres over hospitals – or even home births – to welcome their babies into the world. So what can you expect from a birth centre birth, asks Camilla Rankin
68 | DECEMBER 2017 & JANUARY 2018
TAKING BACK BIRTH FROM SOUTH AFRICA’S BIRTH CRISIS With current numbers showing that about one in four – or 68 percent – of South African women in the private sector delivers their babies via c-section, far exceeding the World Health Organisation’s recommended 15 percent; with accusations flying about obstetricians bullying patients into c-sections, or inducing births according to their golf tee-off times; with the burnout rates of public sector nursing
and midwifery staff; the intense expectations and demands of fee-paying clients and with the crippling medico-legal insurance rates, it is no wonder that Dr Judith Carter, an obstetrician and gynaecologist at The Birthing Team, describes South African obstetrics as “in a state of crisis”. “Obstetrics is a dying discipline,” she says. “As a sole caregiver you carry a huge, stressful burden, and with malpractice and litigation rates skyrocketing, you are forced to take a defensive medical approach, often opting for the more controlled and predictable c-section.” Judith believes, that private birth centres, led by a team of experienced caregivers, are offering a safe, nurturing and viable solution to this crisis, that not only improves the experience and outcomes for the birthing mother, her baby and her family, but also for the professionals who are caring for them.
MOTHERS ARE DOING IT FOR THEMSELVES
The biggest drivers behind the rise in birth centres, however, are mothers themselves. Attitudes are shifting back towards pregnancy and birth being seen as a state of wellness, not illness, with women “starting to research more about birth, wanting to take an active role in their healthcare and wanting to be more in charge of their own bodies,” explains Ingeborg Sonnichsen of Genesis Maternity Clinic in Johannesburg. “Mothers are more confident these days,” agrees midwife and owner of Little Arrivals’ birth centre, Ntombi Mchunu. “They trust their bodies more, do a lot more research on the internet and talk to other mothers on forums, ask more questions and no longer just sit back and believe everything their doctors tell them.” And with this shift, more and more mothers are wanting to try for active, vaginal births away from a hospital environment: “When women are well-informed and know how their bodies work, then they look for a vaginal delivery – they look forward to it,” according to The Birthing Team. “And it’s about time,” says Sydney Grové of the Origin FamilyCentred Maternity Hospital in Cape Town. “I’ve birthed more than 23 000 babies and I know what women’s bodies are capable of. Birth is a normal life event.”
WHAT CAN YOU EXPECT AT A BIRTH CENTRE?
The facilities offered at birth centres vary hugely – some are more like boutique hotels with fine dining, hot tub-like birthing pools and sophisticated medical equipment, while others are more basic, simply offering a comfortable room and area to freely move about in a private home. But at their core each birth centre offers passionate midwife-based care
Save up to 25% on stem cell banking with Netcells Safeguard your child’s future with stem cell banking Netcells is Next Biosciences’ umbilical cord stem cell banking service. Contact Netcells directly to register Call | 011 697 2900 Email | info@nextbio.co.za Visit | www.nextbio.co.za/netcells The discount applies to members of selected schemes administered by Discovery Health.
Discovery Health (Pty) Ltd; registration number 1997/013480/07, an authorised financial services provider, administrator of medical schemes. GM_45442DHM_13/04/2017_V1
YP P R E G N A N C Y F I L E S
A PRIVATE HOSPITAL BIRTH WITHOUT THE MEDICAL AID PRICE TAG? YES PLEASE! Having an uncomplicated vaginal birth at a birth centre is by far the most affordable private option; however, even this can still burn a large hole in your bank balance, and for many without medical aid, it’s only a pipe dream. For a large portion of professional South African women, private maternity care is simply not an option without medical aid assistance, but they are still wanting a more intimate, personal birthing experience than state hospitals can offer. Now, “this forgotten middle class” as Sister Connie Ngobeni, calls it, has access to an innovative scheme, called The Birthing Team, aimed at
providing private maternity healthcare to income-earning mothers who do not have medical aid. The scheme recently launched at Netcare’s Rand Hospital in Hillbrow, Johannesburg and offers pregnant women who do not have medical aid all-inclusive, end-to-end maternity care in a private hospital for a set fee of R19 500. This fee includes a comprehensive initial screening appointment of R1 500 before you can be signed on, and then if you are eligible for the full programme, you will receive at least three ultrasounds, eight antenatal visits (six with a midwife and two with a doctor), three postnatal visits, all blood tests and dedicated
care during your normal, vaginal delivery. The fee also includes an emergency c-section, if one becomes necessary. The catch? You need to pay upfront, and your pregnancy needs to be lowrisk. “The best thing a woman can do is book early; it is preferable for her to come in for the initial screening at about 12 weeks,” says Connie. “To keep the service affordable and sustainable, we are unable to manage certain medical conditions,” says gynaecologist Dr Howard Manyonga. “Complex cases need to be referred to and managed by specialists in the public sector.”
For more information and to book your initial screening, call 011 484 0568
with a focus on natural birthing led by the mother herself, in a relaxed, more home-like environment, as well as access to emergency care (either at the clinic itself or a short distance away) should the need arise. Some will have in-house theatres for emergency c-sections, while at others a maternity hospital is close by, so if a mother needs surgery, she can be quickly moved during labour. Regardless of the level of luxury of the birth centre, because the births are midwife-led, their actions are all guided by the Midwifery Model of Care. This means that every mother can expect one-on-one attention during birth from a private midwife, or team of midwives (depending on the centre), with highquality antenatal and postpartum care; for pregnancy and birth to be considered a natural and healthy process where women who require obstetrician intervention are identified and referred in good time; and are encouraged to take 70 | DECEMBER 2017 & JANUARY 2018
charge of her own healthcare and birth choices, with greater parental control, less intervention, freedom to eat and move during labour, to give birth in any position, and to be allowed to have family and friends attend the birth.
IS THERE A DOWNSIDE?
There are always pros and cons, and birth centres are no exception. There are often strict health screening criteria, and most birth centres only accept low-risk pregnancies, and what constitutes “low-risk” depends entirely on the birth centre. So, VBACs, over 35s, breech position, or any complications in previous pregnancies, for example, are often referred elsewhere; and should a complication arise during your pregnancy, you will also often be referred – but again this depends on the birth centre’s criteria and your specific midwife. Birth can be unpredictable, so another consideration is that, should
the need arise, it can take time to gather a medical team together, or you may need to be moved to a hospital while in labour. The same applies if your baby needs medical attention. While some birth centres have paediatricians on call and the equipment needed to stabilise a baby in distress, at others your baby may need to be transported to the nearest hospital. Birth centres are quick to point out, though, that in a healthy, low-risk pregnancy, where the mother is active, feels safe and confident and is under the care of an experienced midwife, the chance of birth complications is lowered – and the academic research backs this up. Explains Ingeborg, “Women who use a midwife as their primary caregiver throughout pregnancy were found to be less likely to have unnecessary medical interventions.” “A birth centre offers parents a more personal, family-centred birth experience,” explains Ingeborg, and for many, a birth centre birth is a home birth for parents not comfortable with actually giving birth in their own homes. “It’s like going away on holiday to have a baby,” says Ntombi. “Because midwives are passionate about birth, they love it and want you to, too.” YP
Images: Gallo Images/Getty Images; Supplied
IT’S LIKE GOING AWAY ON HOLIDAY TO HAVE A BABY
True or False?
MONTH
How much do you really know about breastfeeding your baby in the early days? Tina Otte explains...
F I LE S
True
SUPPLEMENTING WITH FORMULA CAN DECREASE YOUR MILK SUPPLY
Your milk supply is based on supply and demand. Your baby’s suckling stimulates your breasts to make enough milk to match how much she demands. If you supplement with formula, your baby takes less breastmilk. The less the demand, the less milk will be supplied!
False
BREASTFEEDING WILL NEVER HURT
If breastfeeding is hurting – something is wrong! While it’s not supposed to hurt, an incorrect latch or a nipple that has thrush can cause great discomfort. Often when a latch is correct, it may be that the mother is getting used to the feeling of the baby suckling from her breast. Let down in the early days can also be uncomfortable. A visit with a lactation specialist or the clinic can sort the problem quickly. Education is key! Be sure to take a breastfeeding class while you are still pregnant.
False
BABIES MUST DRINK FOR THE SAME AMOUNT OF TIME ON EACH BREAST AT EVERY FEEDING
Just as adults and children’s appetites change daily, so do babies’. As they grow, their needs change. Some days they are ravenous and other days less hungry. A well-breastfed baby can easily satisfy herself on one breast, although this may leave mom feeling a little uncomfortable. As long as your baby has sufficient wet nappies, is gaining weight, and is well and happy, don’t stress. You may need to express from your other breast and store your milk for later to make yourself more comfortable.
ANY TIME SPENT BREASTFEEDING YOUR BABY IS WORTH IT, EVEN IF YOU MANAGE FOR TWO WEEKS 72 | DECEMBER 2017 & JANUARY 2018
False
BABIES NEED FORMULA IN HOSPITAL, BEFORE MOM’S MILK COMES IN
Breastfeeding in the first days is critical in getting your future milk supply going. Not only that, but colostrum (the concentrated “condensed milk“ type of milk), is full of antibodies and protective white blood cells. The small amount of volume of this rich milk is perfect for a newborn’s stomach, which is the size of a marble at birth. Giving formula is counterproductive and can actually cause problems. Formula should only be given under doctors’ orders and strict supervision if the mother has the desire to breastfeed her baby.
False
YOU CAN’T BREAST- AND BOTTLE-FEED. YOU HAVE TO DO ONE OR THE OTHER
You most certainly can, but only once your milk supply has settled in. If you plan to go back to work, then work with a lactation specialist in setting both systems up, well before the time. Any time spent breastfeeding your baby is worth it, even if you manage for two weeks, before resorting to formula. Your baby will reap the benefits of any time at the breast.
Images: Gallo Images/Getty Images
GNANC
7
RE
Y
P
BREASTFEEDING:
P R E G N A N C Y F I L E S YP
False
True
IF YOU CAN’T PUMP MUCH MILK, IT MEANS YOU HAVE A LOW MILK SUPPLY
How much milk a mother is able to pump is by no means an indicator of how much milk she has. It’s more of an indicator of how responsive she is to the pump and the capability of pump she is using. Babies are the best “pump” you can get and are far more efficient than the top-of-therange hospital pumps. In the case of a premature baby, however, one can expect the baby to not be able to milk the breast efficiently. Pumping is a skill that gets better with practice and as your milk supply improves, you’ll gain more comfort and confidence.
True
THE BEST WAY TO INCREASE YOUR MILK SUPPLY IS TO BREASTFEED OFTEN
The more you breastfeed your baby, the more milk you will make. It all comes back to the law of supply and demand. Of course, it is important that your baby is correctly latched, and well positioned at the breast and that swallowing can be heard.
A SMALL AMOUNT OF ALCOHOL IS OKAY WHEN YOU’RE BREASTFEEDING
False
BREASTFEEDING MOMS HAVE TO WATCH WHAT THEY EAT In some instances, there are foods that may affect a breastfeeding baby, especially milk-based foods. In most cases mom can eat anything in moderation, even some spicy foods. Remember your baby already got an idea of what food you like while in the womb. The amniotic fluid contained flavours and smells of the food from your kitchen. Breastfeeding babies get the taste of what you eat through the breastmilk and this helps prepare their palate for later in life. Eating a varied diet is a good way to introduce your baby to different tastes. If you are worried you can keep a food diary and take note of if your baby is consistently fussy after certain foods you have eaten.
Although alcohol consumption is never encouraged, there may be an occasion to feel included in a celebration and be a part of the festivities. Besides the effect alcohol could have on your baby, it can slow the let-down of milk from your breasts. Plan to feed your baby first, and then together with a meal, have your drink. One alcohol serving, that is: 90ml of white wine or 75ml of red wine or a tot/single measure (25ml) of spirit or a glass of beer (250ml), passes into your bloodstream within 90 minutes and is out of your system within three hours. Having a meal with a drink increases the speed of absorption. If your baby has settled into a good feeding pattern, then having a glass of wine with a meal, timed after a breastfeed, will most likely ensure that by the next feed time there’s nothing to worry about. Sometimes just serving a drink, not necessarily alcoholic, in a fancy champagne glass can create the same feeling. There are test strips that can be purchased to detect alcohol in expressed breastmilk. YP
False
YOU CAN’T TAKE MEDICATION WHILE YOU’RE BREASTFEEDING
There are medications, supplements and natural substances that can be taken safely while you’re still breastfeeding. Most pharmaceutical manufacturing companies protect against litigation by advising on the package insert the standard recommendation, that their product should not be used or taken when pregnant or while breastfeeding. Consult a lactation specialist to review the published data, and be certain of the literature studies and research on medications and make a clear decision on using a product or possibly find a safe alternative. The immunological and nutritional benefits of breastfeeding are exceptional. Avoid using any medical substances if it’s not necessary. DECEMBER 2017 & JANUARY 2018 | 73
Q &A
YP Q & A M O N T H 7
OUR EXPERTS ANSWER YOUR QUESTIONS
Karin Steyn
Counselling psychologist and hypnobirthing practitioner
Email your question for our experts to: letters@yourpregnancy.co.za. Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.
74 | DECEMBER 2017 & JANUARY 2018
CAN I LEARN HYPNOTHERAPY IN A WEEKEND?
Q:
How long before my due date should I start with hypnotherapy classes? Is a weekend crash course sufficient?
A:
Karin answers: I want to draw a distinction between hypnobirthing and hypnotherapy. Hypnotherapy, on the one hand, is an individual process that you will embark upon with a registered psychologist who can also do hypnotherapy for birth preparation. In such a process you might, for example, look at your own experiences of birth (when you were born and any previous children you birthed), review your personal scripts of parenting and do healing regressive work around your experience as a child of being parented, for you to embrace your position of becoming a parent. Old patterns of learning can be released and authentic resourcefulness rediscovered. You will address blocks to your confidence and clear the clutter so that you can have the birth you want and be the best parent that you can be to your child. You can also learn to do self-hypnosis and pain management. Hypnobirthing, on the other hand, is the childbirth education programme that’s designed to teach you self-hypnosis skills for managing your birth. This programme will be more affordable than personal psychotherapy. Your trainer might be a doula, midwife or birth professional, and only some are psychologists. In the course you will learn, among other things, techniques for creating a more comfortable (and even pain free) birth, birthing positions, breathing, visualisation, releasing of fears, befriending your body and bonding with the baby. I advise that you start with your hypnobirthing classes at the beginning of your third trimester. The course is five weeks long and upon completion of the course you still have a few remaining weeks before baby comes to practise, practise, and practise. The reason why we suggest starting at 28 weeks is that by this time you will be taking your pregnancy more seriously. You look pregnant and feel pregnant and the movements of your baby remind you to take your birth preparation seriously. Couples who start the classes too soon have a greater risk of losing interest and
forgetting to practise when it is really important. However, if you feel you will be committed enough to practise throughout the pregnancy, you can start as soon as you would like to. The success of hypnobirthing classes rests not on your ability to read the book and carry the knowledge of how it works in your mind, but to train your body to breathe and relax without even consciously thinking about it – through successive practising. Towards the end of your pregnancy, especially the last four weeks, you should be practising daily. Your negative beliefs about birth can be replaced through repetition of affirmations and you can create new neural pathways in the brain through the visualisation of what you would like to achieve and experience in the birth. In this way you teach your brain what you would like to feel and experience on the birth day, so that when your brain needs to select the appropriate automatic responses, you have good options in place. You can replace your fears with confidence and excitement about the upcoming birth. Through each practise session you connect with your body and your baby, building trust in your body’s ability to birth and taking precious time to bond with your baby. Babies want to know that they are loved, acknowledged and wanted. This helps them to feel safe and excited about coming to this world. Reading the book is better than having no knowledge at all; attending a weekend class is better than no classes at all; but the best you can do for yourself is to attend a proper five-week series of classes. The latter option gives you enough time to really process the material and practise the techniques that you will learn in each class. One mother reported that an unexpected benefit of the five classes was the time she got to spend with her husband, purposely creating time to focus on this new baby and bonding together as a family. She felt that five weeks of solid communication and togetherness really strengthened their relationship, which helped them to enter this new stage of their lives as a strong unit. Remember, this is not just about attaining knowledge, but about creating a practice that allows your body and brain to fully prepare for your amazing birth. YP
EVERYONE’S ON EGLONYL!
Q:
I hear all my new mom friends talking about Eglonyl. What is it? Should I also take it when my baby is born? It seems everyone is.
A:
Kwena answers: Eglonyl is prescribed for patients who suffer from psychiatric illnesses, such as schizophrenia. It’s recommended for people with psychotic illnesses; although, it’s not commonly used today due to the side effects it may
Dr Kwena Khoele Psychiatrist
cause. Eglonyl was recommended offlabel by some practitioners to enhance breastmilk production, which is one of its side effects. The use of Eglonyl to enhance milk production is not recommended by its manufacturers and psychiatrists. They advise against it because it appears in breastmilk and its safety in babies is unknown. Eglonyl can also sedate both the mother and infant, which makes it dangerous when a mother co-sleeps with her baby. YP
Lansinoh 2-in-1 Double Electric Breast Pump, R3 700 Dis-chem and babygroup.co.za
Tommee Tippee Closer To Nature Breastfeeding Starter Kit R759 Makro and Pick n Pay
Seamless Padded Nursing Bra Staying with our core Carriwell design principles; we have created the ultimate bra for moms looking for added support and shape, without compromising the core elements of a great nursing bra i.e. comfort, style, quality, fit and function. Removable Thin Foam Cups • • • •
Ideal for concealing breast pads and reducing the risk of accidental milk flow/leakage. Concealing the nipple/areola; which commonly darkens substantially during pregnancy. Enhances shape; creating the perfect silhouette under t-shirts and tight fitting clothing. Increases support for full-busted-figures by reducing the fabric-stretch in the cup area.
Traditional Seamless Design • • • • • • • • •
Seamless microfibre technology offers an exceptionally comfortable, soft, smooth fit. Designed to support your breasts and preserve your shape. Unrestrictive, revolutionary non-underwire support. Unique one handed release clasps for convenient and discreet breast feeding. Innovative side panels allow for growth during pregnancy and breast feeding. Fully adjustable with wider straps for added support. Ideal to wear day and night - maternity/nursing/sleeping. Endorsed by leading Child Birth Educators, Doulas and Midwives. Soft cup style non-underwire nursing bras are highly recommended by lactation consultants. Available at Baby City, Babies ‘R’ Us at Toys ‘R’ Us and leading maternity stores Carriwell SA (Pty) Ltd • P.O. Box 272, Umhlanga Rocks, 4320 • Tel: (031) 564 8805, Fax: (031) 564 9647 • www.carriwell.co.za, info@carriwell.co.za
YP P R E G N A N C Y F I L E S
Episiotomy THE CRUELLEST CUT? GNANC
8
RE
Y
P
A cut into the perineum to enlarge the opening of the vagina to help ease the birth – a practice first documented 200 years ago – is actually not required for most births, writes Tina Otte
MONTH F I LE S
ALTHOUGH EPISIOTOMY IS one of the most common surgical procedures carried out, their medical value is open to debate. There’s also debate over whether an episiotomy is preferable to a natural tear during labour.
HISTORY OF EPISIOTOMY
An Irish doctor first discussed the advantages of episiotomy in 1742 for difficult births. Once local analgesia and suturing material were available, episiotomy became popular. In the 1920s, Dr Delee first advocated the practice of routine episiotomy with forceps delivery. Episiotomy then became popular worldwide, with some authorities advocating routine episiotomies for all first-time mothers. There are some obstetricians who still hold this opinion! As women become more informed about labour and birth and are more involved in the decisions regarding their care, the necessity for routine episiotomy is being questioned. Recent studies show that episiotomies are often performed unnecessarily and therefore the indications for doing them are being reviewed. Studies show that routine episiotomy isn’t required for most births.
WHEN TO HAVE ONE
Many experts agree that the following are valid reasons for giving a woman an episiotomy: 76 | DECEMBER 2017 & JANUARY 2018
IF THE BABY... • is in the breech position (bottom first instead of the usual head-first position) and is born vaginally (most breech babies will be delivered via Caesarean) • is premature and can’t tolerate prolonged pushing against a perineum • is in distress and needs to be born quickly (an episiotomy can reduce the length of the second stage of labour by 5 to 15 minutes) • is very large (this is assessed by scan) • or needs easing out by forceps, due to difficulty pushing or maternal exhaustion.
WHEN NOT TO HAVE ONE
A 2017 literature review in the British medical research NGO Cochrane found no indications for doing routine episiotomies. Debatable reasons for doing an episiotomy are when the doctor or midwife feels that the perineum (the skin and tissues between the vagina and anus) is likely to tear as the baby’s head is born. There is the belief that a surgical cut is easier to repair, causes less pain and heals faster than a naturally occurring tear. A study done in 1987 by Dr Nancy Fleming concluded that “the naturally occurring laceration (tear) appears to be at least as good as an episiotomy statistically and better than one clinically, when compared in the areas of sexual function, perineal pain, time of healing and change in perineal muscle function”. This means that medical studies have shown that when a tear occurs, it may be less painful and heal faster than an episiotomy, and not the other way
around. Women with tears have also been found to resume sex sooner after birth and with less pain than women who’ve had an episiotomy. Episiotomies were also thought to prevent some degree of relaxation or damage to the pelvic floor, with a further possible complication of a cystocele (a prolapse of the bladder wall through the vagina, which can cause incontinence), a rectocele (opening between the vagina and the rectum) and the possible prolapse of the uterus. Recent studies on pelvic floor relaxation show no correlation between poor perineal function and the presence or absence of episiotomy. One British study strongly suggested that exercise, not episiotomy, is the most common factor in restoring a woman’s normal pelvic floor strength after childbirth. A 1990 study by Sleep, Roberts and Chalmers states that “the most common cause of perineal damage is episiotomy and episiotomy should only be used to relieve foetal or maternal distress, or to achieve adequate progress when it is the perineum that is responsible for the lack of progress”.
HOW IS IT DONE?
If an episiotomy is needed, the cut is made with scissors, from the vaginal opening into the perineum. This is done once the top of the baby’s head can be seen at the vaginal opening (this is called crowning of the head, and usually means that the birth is imminent). If there’s time, an injection of local anaesthetic is given into the perineum so that this area is numb when the cut is made. The cut can be
WOMEN WITH TEARS HAVE ALSO BEEN FOUND TO RESUME SEX SOONER AFTER BIRTH AND WITH LESS PAIN
made mediolaterally (towards the side) or down the midline (towards the anus). While women experience less pain after birth from a midline episiotomy compared to a mediolateral episiotomy, there is a greater chance of the midline episiotomy extending into a third degree tear (this is a tear which extends into the rectal tissue). Once the baby is born the doctor or midwife sews (sutures) the skin back together again. Dissolving stitches are usually used which disappear within two weeks.
RECOVERY
In any vaginal birth, but especially with an episiotomy, the perineum can be painful afterwards.
HOW TO RELIEVE THE DISCOMFORT
• An ice pack or cooling gel pad frequently placed on the perineum in the first 24
hours following birth significantly reduces the swelling and bruising. • After that, warmth either from a hot lamp placed near the perineum, or from sitting in warm water, is very soothing. • It’s important to keep this area as clean and as dry as possible while it is healing. • If you notice any bleeding or pus (which is a sign of infection) oozing from the site of the episiotomy or tear, or if the swelling worsens significantly, you must call your doctor or midwife. • If you still feel pain with sex some months after the birth, or if you experience urinary incontinence, you should see your doctor or midwife. • Whether you have had an episiotomy or a tear, or given birth without any perineal trauma, Kegel exercises will help you regain the support and tone of your pelvic floor. YP
STEPS TO AVOID EPISIOTOMY • Some women have tissues that naturally stretch more easily and are more likely to give birth without tearing or an episiotomy. • During a birth in which the mother is encouraged to ease the baby’s head out slowly, using a position which is aided by gravity, and the perineum is supported, it is possible to minimise tearing or the need for episiotomy. • Avoid sustained pushing and avoid giving birth on your back. Try a more upright position (being raised on pillows into a semi-reclining position is much better than lying almost flat) and let gravity help you to stretch the vagina open more evenly and slowly. • Massaging the perineum with natural oil for six weeks before your due date can improve the pliability of the skin and underlying tissues. This massage also helps women become familiar with their anatomy and accustomed to stretching sensations, which are common during the birth. • A warm, moist pad placed against
the perineum during pushing increases the circulation to this area and provides support and comfort while the tissues stretch during birth. • Try to avoid pushing using sustained breath holding. Rather use gentler, spontaneous pushing, without excessive straining, to ease the baby down through the birth canal. By preventing excessive straining during pushing you can reduce the over-stretching of the pelvic floor and push your baby out more effectively. • Epidurals often increase the need for episiotomy. In a full epidural the pelvic floor may be very relaxed and the baby’s head may not completely turn into the birthing position. Sometimes the mother is unable to push effectively. When this happens, the doctor needs to use forceps to help the baby out. An episiotomy is done to make enough room to put the forceps in position. The likelihood of this happening is reduced in women who have a partial epidural during labour.
GNANC
9
RE
Y
P
YP P R E G N A N C Y F I L E S
MONTH F I LE S
MEASURING CONTRACTIONS CONTRACTIONS CAN begin as early as
six months into a pregnancy. These early contractions are called Braxton Hicks, or practise contractions. Early labour contractions begin when progesterone levels suddenly drop. These contractions are mild and far apart. In established labour, contractions become stronger, painful and are closer together. Just before giving birth, contractions are described as expulsive. Finally, after the birth the womb stays contracted to prevent haemorrhaging.
WHAT DOES A CONTRACTION FEEL LIKE?
To contract means to make smaller. This means that the womb literally gets smaller with every contraction. It also changes in shape and becomes smaller at the top and wider at the bottom, where the cervix is. Here the womb mouth opens (dilates) for the baby to pass through. When you touch your tummy, mild contractions will make it feel soft like your cheek; moderate contractions feel firm (like your chin); and strong contractions feel hard, like your forehead. Each contraction has three phases. At first the contraction only feels tight and as it gets stronger and more painful it heralds the increment stage. Gradually the contraction reaches its peak, which is when the contraction is really painful. 78 | DECEMBER 2017 & JANUARY 2018
Then it suddenly fades (decrement phase) and is quickly gone. There is no pain between contractions. This is when the womb relaxes and recovers in preparation for the next contraction.
HOW TO TIME CONTRACTIONS
The length of each contraction is timed in seconds, and the frequency (how often contractions come), is timed in minutes. In early labour a contraction may last between 15 to 30 seconds, and may be 10 to 20 minutes apart. Just before giving birth, contractions now last for 60 to 90 seconds and are one to two minutes apart. Don’t be neurotic about timing each and every contraction, but it may be helpful to have pen and paper with you to periodically record contractions and follow the progress of your labour.
WHY SHOULD I TIME THEM?
Timing contractions will help you decide whether to go to the hospital or not. Weak, irregular contractions that subside after a warm bath means that you can
stay at home for a few hours longer (providing there are no other danger signs such as bleeding, headaches, waters broken or heart palpitations). Strong, regular contractions that get more painful and don’t go away after a warm bath, are a sign that it’s time to go to the hospital. In hospital, contractions will help your midwife or doctor keep a look out for potential problems. For example, short, frequent and painful contractions that don’t give the womb a chance to relax and don’t dilate the cervix are called hypertonic contractions. These can prolong labour and sedation or a drip could help to change this pattern. Contractions that are weak, infrequent and ineffective often occur in multiple pregnancies as well as if the mother has been sedated or if the baby is too big for the pelvis. This type of labour could also be very long with the added risk of haemorrhaging after the birth. Intervention may be necessary to prevent complications. YP
THERE’S AN APP FOR THAT! Contraction Timer helps you time how long and how frequent your contractions are when going into labour. It shows the time of each contraction, their durations and the interval between them. Download it to your phone and get timing!
Images: Gallo Images/Getty Images
The spontaneous squeezing or tightening of the womb is an important part of birth, writes Sr Burgie Ireland
FCB CAPE TOWN 10011987CT/E
Introducing our new addition to the family. We’ve added a new Fragrance Free variant to our range, because we understand that different moms have different needs. The formula still contains the same blend of emollients, olive oil and vitamin E and A, blended in perfect harmony to help regenerate your skin and regulate its moisturising process. Even though the outside has changed, on the inside it’s still the same product that’s been keeping your skin beautifully hydrated and stretchmark free for generations. www.happyevent.co.za
CK NEW PA N IG S DE
P
GNANC Y
RE
YOUR BODY F I LE S
THE SKINNY ON YOUR
post-birth body
Some postpartum symptoms may surprise you, but are completely normal. Others mean you need medical care. Here’s what you need to know, writes Margot Bertelsmann BLEEDING
• What’s normal? New moms often feel they are leaking from every orifice – breastmilk, blood and tears. And it’s true. Natural and caesar moms both experience postpartum bleeding called lochia when the body expels placental tissue and mucus. This bleeding is usually heavier for NVD moms than caesar moms and can include blood clots. The bleeding usually lasts three to six weeks, reducing in heaviness and colour over time. Use pads and avoid tampons – rather go back to them after your six-week check-up. • What’s not normal? “See your doctor if you feel itching, burning, smell a foul smell or have a fever,” says gynaecologist/obstetrician and Your Pregnancy consulting expert Dr Bronwyn Moore. And if it’s really gushing and you feel light-headed, get yourself to your gynae immediately – a haemorrhage can be dangerous.
BREASTS
• What’s normal? There’s a myth that breastfeeding makes your boobs sag. But the American Society of Plastic Surgeons says it’s pregnancy itself that causes sagging. Other factors are smoking, older age, larger pre-pregnancy bra 80 | DECEMBER 2017 & JANUARY 2018
size and number of pregnancies a woman has had. But breastfeeding does temporarily affect the look and feel of your breasts. Your breasts fill up with milk on about day three of your baby’s life (before then, she survives on colostrum). By six weeks postpartum, your body will have figured out how to regulate the supply of milk tailored to your baby’s appetite. Before then, engorged or overfull breasts are very common. “Manage this with warm showers and by applying cabbage leaves,” says Dr Moore, and feed your baby on demand rather than to a schedule. If a milk duct gets
blocked, you might experience a painful lump in a breast. Learn to massage your breasts to nudge a blockage out and express milk to relieve the pressure on overfull breasts. And lastly, your nipples can come in for a serious hammering in the early weeks: cracks, blisters, pain and bleeding from a little mouth that isn’t latching correctly yet. So it’s vital to get good breastfeeding advice from a lactation consultant as correct positioning can make all the difference. She might advise using silicone nipple shields to enable you to keep breastfeeding without as much pain.
P R E G N A N C Y F I L E S YP
• What’s not normal? Mastitis is a name for inflamed breast tissue, and sometimes, especially if it’s accompanied by an abscess (a collection of pus inside the breast tissue) it needs medical care. “One area of the breast will be more tender than the rest,” says Dr Moore, “and physiotherapists can often perform breast drainage. If you have flulike symptoms, you probably need to be treated with an antibiotic. As a very last resort an abscess can be drained by a fine needle aspiration.”
AFTERBIRTH PAIN
• What’s normal? Your uterus begins shrinking back to prebaby size (the size of a fist). Involution takes four to six weeks and can feel like period pains. Some women feel contractions while they’re breastfeeding, because the nipple stimulation during breastfeeding releases the hormone oxytocin, which both contracts breast tissue to release milk and contracts the uterus. So welcome this pain – it means you’re on your way to losing (some of) that jelly belly. Dr Moore emphasises that uterine contractions happen after NVDs as well as C-sections, and that a gush of bleeding during breastfeeding (from the uterus contracting) is also common. Heat is a relaxant, so try taking warm showers or applying a hot water bottle to your abdomen just like you would with period pains. Pass urine often as this takes pressure off your uterus. Or lie on your tummy to apply counterpressure to the area – this is safe even if you’ve had a C-section. If you had a C-section, the incision in your abdomen will be sore. Gas and food movement in your intestines can also hurt, and some women feel referred pain under their ribcage or arms, typically their right shoulders, after a caesar. “Your abdominal cavity has been opened and free air sits under your diaphragm, which your body interprets as pain,” says Dr Moore. Take your prescribed painkillers, as they will be safe for breastfeeding. For abdominal pain from gas, you basically need to fart. Try kneeling on your hands and knees and lifting your bum in the air to release air. Graceful? No. Effective? Yes. • What’s not normal? Watch out for seepage, separation of the scar tissue, and too much pain. Says Dr Moore: “Some oozing from your wound onto the dressing is okay, but there shouldn’t be lots of fluid. If the DECEMBER 2017 & JANUARY 2018 | 81
YP P R E G N A N C Y F I L E S
VAGINA AND PERINEUM
• What’s normal? Even if you didn’t tear or have an episiotomy, you can’t pass a baby with a 37cm head circumference through a vagina without some effects. So you’ll have swelling, bruising and stretching damage, and possibly stitches – which can itch, hurt or even tear. But the body has an amazing ability to heal, and will soon return to pre-birth proportions. You can help by applying ice packs or taking sitz baths. Wipe front to back when you’ve gone to the loo (as usual). And to keep the area germ-free, change your pads often. If it hurts to sit, try a doughnut cushion until the swelling in your labia subsides, which should take about two weeks. To restore pre-pregnancy muscle tone (important for continence and to enjoy lovemaking) Kegel exercises are recommended. To do this, pretend you are holding in your stream of urine – that’s the muscles you want to be toning and contracting. “There are now physios who specialise in women’s health and who can do pelvic floor rehabilitation,” says Dr Moore. • What’s not normal? Very few women report that their vaginas have stretched permanently after giving birth. “But a degree of urinary incontinence is extremely common in the first five to 10 days after birth,” says Dr Moore, either from the birth or from the months of pelvic pressure the growing baby exerted on you. “However, if you are having urine trouble and you had a catheter during delivery (for C-section or epidural), you need to do a urine test to see if you have contracted a bladder infection,” she adds.
RECTUM
• What’s normal? New moms dread one post-birth moment: your first poo! At a caesar, your organs are jiggled around and hence swollen, plus you’ve got a fresh new incision, so straining to push a stool can 82 | DECEMBER 2017 & JANUARY 2018
feel very uncomfortable. For natural delivery moms, your rectal muscles will have swollen from the passage of the baby, and you might have episiotomy or tear stitches – so you’ll also dread pushing. Many new moms develop postpartum haemorrhoids (from pushing during labour) even if they were pile-free in pregnancy. Dr Moore has a trick for making the perfect postpartum-piles ice pack: take a surgical glove, fill the fingers with water, tie them off and freeze them. Slice off a finger as needed, remove the glove part, and insert the now appropriately shaped ice into the area for relief. And to compound the indignity, constipation is very common following both types of birth – from the trauma to the area and psychological inhibition
in a process called ‘banding’ where they are actually tied off,” she says.
BABY BLUES AND POSTNATAL DEPRESSION
• What’s normal? If you suddenly find yourself sobbing (and sobbing, and sobbing), then welcome to the baby blues. A new mother can feel depressed, weepy, anxious or just confused for a few hours or days after having given birth. The exact cause is unknown although the massive hormonal changes involved in transforming from a pregnant person into a mother are probably to blame. Add the responsibility of looking after a newborn, the fear, and the exhaustion, and it is surprising baby blues affect only half of all new mothers. If your
THE KINDEST THING YOU CAN DO FOR YOURSELF, YOUR PARTNER AND THE HEALTH OF YOUR BABY IS TO SEE A DOCTOR (fear of pooing, basically). “The pain meds can be constipating and hormonal changes also contribute,” says Dr Moore. “Use a stool softener and watch your diet.” Drink lots of water and eat lots of fibre, take sitz baths to soothe swelling, and when you do pass a stool, press a sanitary pad against your perineum as a support. • What’s not normal? If you find you are actually leaking poo (faecal incontinence), this may not be as drastic as it sounds: it may actually stem from constipation, where watery stool bypasses the blockage and leaks out (overflow). Incontinence of solid stools is not common, says Dr Moore. “Incontinence usually settles, but if there is rectal incontinence and it hasn’t settled within the postnatal period you must speak to your healthcare provider.” Haemorrhoids are also initially managed symptomatically, but they may never go away completely. “Haemorrhoids that don’t resolve or cause pain and bleeding can be surgically removed by a surgeon
symptoms persist beyond a few days, though, be honest with yourself as you contemplate whether you might have postnatal depression (PND). For baby blues, you can only rely on your support system until you feel stronger. Surround yourself with people who are good for you – send unwanted visitors home – and it may help to phone a friend who has experienced baby blues, so that she can reassure you that the symptoms are very temporary indeed. • What’s not normal? If your symptoms persist and you feel you may have PND, the kindest thing you can do for yourself, your partner and the health of your baby is to see a doctor immediately. Depression is a disease – it is not your fault you’ve contracted it. You should treat it like you would any other disease: with appropriate help, and medication if required. For more information, to go the website of the Post-Natal Depression Group South Africa pndsa.co.za, or call their national helpline on 082 882 0072. YP
Images: Gallo Images/Getty Images
area surrounding the scar is red, raised, tender, or accompanied by fever, go to your doctor. And if you are bleeding actively from the vagina with clots, get it checked out. Although there may be a day or two of heavy bleeding it should not be going on beyond that and you shouldn’t feel unwell,” she says.
Q &A OUR EXPERT ANSWERS YOUR QUESTIONS
Q & A B R E A S T F E E D I N G YP
HELP! I’M HAVING TWINS!
Q:
I’m scheduled to have a caesarean as I’m expecting twins. So far, everything is going great. If they are healthy, will I be able to feed them soon after the birth as is recommended in so many books? And how on earth does a person go about feeding newborn twins? I don’t think I have enough hands.
A:
Linda Britz
Lactation specialist
Email your question for our experts to: letters@yourpregnancy.co.za. Please note that experts unfortunately cannot respond to each question personally. The answers provided on these pages should not replace the advice of your doctor.
Linda answers: Expecting twins can be quite an overwhelming thought, but as the idea of having more than one newborn becomes a reality, planning ahead for the change in your home and new lifestyle is important, to adjust well into your “new normal”. Preparation and being organised are the best way to meet the challenges that come with this double blessing, and to be as ready as you can to meet any outcome. There is good reason to give birth by C-section for twins; however, there may be a delay in your milk coming in, as your body has not experienced the process of labour, which contributes and helps initiate the movement and flow of the first newborn milk through the ducts to the nipple. Your babies will need to stimulate your breasts often to encourage the milk filling after a C-section birth. Breastfeeding twins is definitely possible. Depending on the gestational age of the babies and the circumstances that surround the birth, there are a number of different scenarios, which will determine the goals ahead with regard to lactation. Should your babies be born early, and are premature and unable to latch, then expressing milk is the next-best option. It’s of utmost importance to initiate and protect your supply. Regular breast care and massage is encouraged and should be continued after birth to encourage drainage and supply. Correctly expressing with an effective hospital-grade electric breast pump is essential, and will generally ensure a full supply and an adequate amount for each baby. Find out about all the options available with regards to breast pumps, so that you’re familiar with the equipment before birth. It may be that one baby is well and with you from birth. You will then need to express milk for the other twin. If babies are
both well, then the ideal is to do lots of skin-to-skin contact, as soon as possible after birth, and be guided by each baby. You may choose to express milk on occasion, once you have established your breastfeeding, providing you time to rest, and the opportunity for other caregivers to feed and care for your babies. Each situation is unique and individual. In the first few days and weeks, it’s usually easier to feed one at a time, to ensure that each baby is effectively latching and feeding well. Once you get to know each baby and their individual cues, then you may save time by feeding them together simultaneously. Position is important to make sure each baby and you are comfortable. The most common hold is the “rugby hold”, with each baby under an arm with their legs facing towards your back. Create a breastfeeding station where you can sit comfortably to feed. Have lots of cushions for support. A large pillow or soft mat will provide a safe area to place one baby to rest while you’re busy with the other. Tissues, nipple cream, breast pads and a burp cloth are handy items to have available for use. Store nutritious healthy snacks and water, so your needs are also met readily. Keeping a daily record and details of each baby’s activities and feeds helps you recognise patterns and identify any concerns. Source plenty of physical and emotional support. If you can afford it, get help with housework, a nanny, night nurse, your husband or relatives, to assist you through this challenging season. Make contact with a lactation consultant before birth. This will provide correct guidance, and help build your confidence. Get in touch with people who provide information for multiple births: ■ The South African Multiple Births Association (SAMBA) is a useful source of support, encouragement and motivation. - www.samultiplebirth.co.za/ ■ Twin Talk is an online community for parents with multiples. - www.twintalk.co.za - www.facebook.com/twintalkcoza - twitter.com/twintalkcoza - za.pinterest.com/twintalkcoza. YP
DECEMBER 2017 & JANUARY 2018 | 83
Be prepared in an emergency and you could save a life, writes Margot Bertelsmann
BABIES AND INFANTS are little,
delicate, uncoordinated and at risk of all kinds of calamities that can happen in an unguarded instant: falling, burns, accidental poisoning, allergic reactions and choking are but a few. But try not to become totally overwhelmed by fear. Devoting your thoughts to everything that can befall your baby is a stressful and joyless way to live. Rather, implement these simple lifesaving strategies in your home and try to relax the rest of the time.
PREVENTION IS BETTER MAKE YOUR HOME SAFER
Take a critical look around your home before baby arrives; but crucially, do it again after each major milestone, meaning once your baby can roll over, crawl and walk. At each stage, targeted safety precautions need to be followed. Keep your baby’s crib clear of cot bumpers, pillows, duvets and toys as all pose a strangulation and choking hazard. Minimise the risk of cot death by putting your baby on his back to sleep, and not smoking nor allowing smoking in your home. Co-sleep safely only. Never leave your baby on the changing table or in the bath unattended. As your baby becomes more mobile, safeguard stairs with baby gates and limit access to your pool, if you have one, with a net and gate. Move household cleaners, polishes and insect poisons from under the sink to an unreachable cupboard. Move small objects (which babies could mouthe and choke on) out of reach. Babies grow fast – above all, adapt your plan regularly.
COMPLETE A FIRST-AID COURSE
You, your nanny and/or au pair or housekeeper should all complete a basic 84 | DECEMBER 2017 & JANUARY 2018
RE
GNANC Y
THE BASICS YOU NEED TO KNOW
P
YP P R E G N A N C Y F I L E S
YOUR BABY F I LE S
first aid course. There are many courses on offer nationwide, so do an internet search, but remember that any first aid course needs to meet the requirements of the American Heart Association, the Resuscitation Council of South Africa, or the Emergency Medicine Society of South Africa. Courses cost in the region of R1 000 and should include about 16 hours of training, although many one-day courses are available. Some courses can be held in your own home with a group of people you select, which is very convenient.
HAVE AN EMERGENCY PLAN
All members of the family and all caregivers should know the emergency plan. All caregivers should instantly know the number for calling police or an ambulance. That number used to be 10111, but recent news reports about the
START HERE FOR FIRST AID COURSES
➔ NOSA Action Training Academy actiontraining.co.za/ first-aid-training ➔ Super Nannies 0861 462 669 info@supernannies.co.za ➔ PulsePoint pulsepoint.co.za, courses in your home, Johannesburg only ➔ National First Aid Academy nationally, 086 163 2200, nfaa.co.za ➔ Medical Education Center medicaleducation.co.za ➔ First Aid Academy firstaidacademy.co.za, Cape Town and surrounds ➔ St John Ambulances stjohn.org.za 086 101 7404 ➔ survivalcpr.co.za 082 896 1820
inefficiency of the call centre should have you think twice about using it. However, all three cellphone providers in South Africa have collaborated to use one emergency number (112). Dial that number from any cellphone (the number will work even if it’s locked and even if it’s out of airtime) to get help quickly. Teach older siblings that number too. If you only have access to a landline, Netcare911 will respond to your emergency whether you are a member or not (call 082 911). ER24 is a medical emergency company (084 124). It’s a good idea to check which provider operates in your area and then remember at least that one number. But do compile a list of other emergency numbers and stick them on your fridge, such as the number of poison control (0861 555 777).
HAVE A STOCKED FIRST-AID KIT
Apart from regular items such as infant paracetamol, bandages and thermometers, BurnShield springs to mind as an emergency medication that you should be able to locate and use within seconds in the case of a serious burn. (Otherwise use cold running water on the burn while help arrives.) If your infant has a severe allergy you know about, include an epinephrine kit, but only use it if you know how, and if you know your baby’s reaction is from an allergy. Otherwise, summon an ambulance instantly and perform CPR if breathing stops. YP
HOW TO PERFORM CARDIOPULMONARY RESUSCITATION (CPR) ON A BABY* *Guidelines from the University of Washington School of Medicine
1
SHOUT AND TAP If your baby is unresponsive and she is not breathing, or not breathing normally, put her on her back and begin CPR. “CPR should not be interrupted for more than 10 seconds at a time,” cautions Nick van der Walt of the NOSA Action Training Academy.
2
GIVE 30 COMPRESSIONS Give 30 gentle chest compressions at about two pushes per second. Use two or three fingers in the centre of the chest just below the nipples. Press down one-third the depth of the chest (about 3-4cm).
3
OPEN THE AIRWAY Open the airway by lifting the baby’s chin.
AIRWAY
4
GIVE TWO GENTLE BREATHS If the baby is not breathing or not breathing normally, cover the baby’s mouth and nose with your mouth and give two gentle breaths. Each breath should be about one second long and you should be able to see the baby’s chest rise with the breath. “Five sets of CPR (30 compressions per set) and five rescue breath attempts (ten breaths in total) should be performed, which should take around two minutes to complete,” says van der Walt. “Reassess pulse and breathing after that. If you can feel a pulse but no breathing, continue rescue breathing at a rate of 12 breaths per minute.” Continue with the compressions and breaths until help arrives.
BREATHING
COMPRESSIONS
Images: Gallo Images/Getty Images; Supplied
CHOKING HELP IN FIVE STEPS If your baby is coughing (while crying or gagging), allow her to continue, because coughing is the best way to dislodge an obstruction. Call 112 in the meantime.
1
thigh, making sure her head is lower than her body. Give your baby five firm blows on the back, between her shoulder blades, as you try to force the object out of her throat.
2
4
If your baby is unable to cry or cough, or is turning blue or red, her airway could be completely blocked. Tell anyone else in the house to call 112 and start the following back blows and chest thrusts. If you’re alone with your baby, do back blows and chest thrusts for two minutes, then call 112, then continue.
3
Hold your baby’s jaw with your thumb and forefingers, your other arm on her back. Now turn her over and lower your baby face down onto your
If that hasn’t worked, now turn your baby face forward, still with her head lower than her chest, and use the pads of two or three fingers to push straight down on the chest, between the baby’s nipples, about 3-4cm. Thrust five times, then check inside baby’s mouth. Only put your finger inside the mouth if you can see the object, otherwise you might accidentally push it even further in.
SLAP
CHECK
SQUEEZE
5
Continue until the object is out or help arrives.
DECEMBER 2017 & JANUARY 2018 | 85
YP M A K E O V E R
Maxi dress R799 Poetry Bag R130 Mr Price Espadrilles R299 Woolworths
BEFORE
DAWN JANSEN 36 WEEKS PREGNANT
GET A
YOUR PREGNANCY Photographer Aubrey Jonsson Stylist Jess Lupton Hair and make-up Nicci Allen
MAKEOVER We surprised a reader with a makeover to update her expectant look
STYLIST SAYS...
Dawn is in the third trimester of her pregnancy, so I selected a flowing strappy dress in a light fabric to keep her cool in summer. Wedges are great summer shoes and are a bit dressier than sandals. They also give your feet extra support. I love the fresh botanical print, which is lovely on her skin tone.
DAWN SAYS...
I felt like a whole new person at my makeover! The make-up artist was very friendly and made me feel at home. I felt so special, comfortable, confident, and like the most beautiful pregnant woman. I must say, it Want a YP makeover? Email was a great experience at 36 your phone number, your wee weeks along, and I appreciated k of pregnancy and recent preggie it very much. I love my prize pic to letters@yourpregnancy especially; it was truly something .co.za. Title your email “I want a mak I needed. Thank you, YP! eover”
LOOK WHAT ELSE OUR LUCKY MAKEOVER MOM WENT HOME WITH! A STUNNING GIFT HAMPER FROM PIGEON AND LANSINOH TO THE VALUE OF R1 120!
Get off to a good start with Pigeon and Lansinoh’s Breastfeeding Kit and give Dad a chance to breastfeed when expressing with the Pigeon Manual Breast Pump. The Pigeon Breast Pads keep you dry and comfortable, while the Lansinoh Nipple Cream will soothe sore, cracked nipples. The Therapearl 3-in-1 Breast Therapy helps relieve any engorgement or pain. Available from baby stores, Dis-Chem, selected pharmacies and retail outlets. Visit sp-africa.com for more. 86 | DECEMBER 2017 & JANUARY 2018
F A S H I O N YP
Print swimsuit R425 JT One at Woolworths. Printed bag R29 Mr Price. Rose gold sliders R199 Cotton On. Necklace: model’s own.
Soak up the sun, at the beach or poolside, in gorgeous swimwear this holiday season! PHOTOGRAPHER Aubrey Jonsson STYLIST Jessica Lupton MAKE-UP AND HAIR Nicci Allen MODEL Sophie of Boss Models PROPS Mr Price Home
DECEMBER 2017 & JANUARY 2018 | 87
YP F A S H I O N
88 | DECEMBER 2017 & JANUARY 2018
Mini frill triangle bikini top R349. Mini frill cheeky bottom R299. Aviator sunglasses R169 all Cotton On.
TOP LEFT Silver bag R350 Woolworths. Mermaid tail blanket R199.99 Mr Price Home. Mermaid swimsuit R350 Woolworths. TOP Printed shrug R699 Poetry. Scallop bikini top R119.99 and bikini bottom R449 Mr Price. Necklace R275 Poetry. LEFT Cropped vest R330 and mesh bikini bottoms R180 both Woolworths. Khaki bow sliders R199 and Backpack R449 both Cotton On.
DECEMBER 2017& JANUARY 2018 | 89
YP F A S H I O N
Mini frill spotted one-piece R499 Cotton On. Cowboy shell trim woven hat R139.99 Mr Price.
90 | DECEMBER 2017 & JANUARY 2018
F A S H I O N YP
1 9 10
2
3
8
7
4
6 1 NUXE Nuxuriance Ultra Rich Cream R625 selected retailers 2 Optiphi Solar Spritz SPF30 Sunscreen, R395 optiphi.com 3 Elizabeth Arden Eight Hour Cream Sun Defense for Face SPF 50 PA+++ R295 selected retailers 4 essence Quattro eyeshadow, R64.95 Dis-Chem 5 Long and Lasting Triple Oil Rescue R32.95 Dis-Chem 6 Moroccan Argan Oil Intense Conditioning Mask R79.95 Dis-Chem 7 Elizabeth Arden FourEver Bronze Bronzing Powder R550 selected retailers 8 L.O.V LOVtouch Nail & Cuticle Serum R169.95 Dis-Chem 9 BADGER Calming Baby Oil R335 naturescolours.com 10 LANCOME Matte Shaker R315 selected retailers
5
DECEMBER 2017 & JANUARY 2018 | 91
SUMMER BRAAI ALL RECIPES SERVE 4
Summer time is braai time in SA! Now that you’re pregnant, you may want to eat a little less red meat and a lot more vegetables and fruit. Our healthier braai recipes will help keep you glowing all through summer RECIPES AND STYLING ZISKA BAUMGARTEN PHOTOGRAPHS ADELE FERREIRA
92 | DECEMBER 2017 & JANUARY 2018
N U T R I T I O N YP
SALMON SKEWERS 2 salmon fillets, skin off 2 lemons, thinly sliced 2 tablespoons olive oil 2 teaspoons sesame seeds 1 teaspoon ground cumin ¼ teaspoon crushed red pepper flakes salt and pepper 8 bamboo skewers soaked in water for 1 hour 1 Cut salmon into 2cm cubes and thread onto bamboo skewers alternating with a slice of lemon folded in half. Set aside. 2 Mix olive oil, sesame seeds, cumin and pepper flakes and drizzle over the salmon skewers. Season with salt and pepper. 3 Braai over medium coals for a couple of minutes on each side until fish is opaque throughout, about 8-10 minutes in total. Serve with coleslaw or a green salad.
GRILLED VEGETABLE STARTER 1 head broccoli, washed and broken into florets 1 red pepper, deseeded and chopped 1 aubergine (egg plant), sliced 6 courgettes (baby marrows), tops cut off and sliced lengthways 2 mielies, husks removed 2-4 tablespoons olive oil Roast cauliflower dip 1 head cauliflower, washed and broken into florets 2 tablespoons olive oil 2 heaped tablespoons tahini (sesame seed paste) juice of ½ lime 1 tablespoon ground cumin salt and pepper, to taste
FRESH BOERIE ROLLS For the guacamole 2 avocados, peeled and stones removed ½ red onion, finely chopped 1 lime, juiced (or 1 small lemon) handful fresh coriander leaves, chopped salt and pepper, to taste For the salsa 1 large, ripe tomato ½ red onion, chopped 1 tablespoon olive oil 1 teaspoon sugar 1 teaspoon lime juice salt and pepper, to taste
To serve Braaied boerewors, cut into 10 cm lengths Lettuce leaves Grated cheddar cheese Sliced jalapeños (optional) 1 Lightly smash the avocados with a fork. Mix in the onion, lime juice and coriander leaves, then season to taste and set aside until needed. 2 For the salsa, finely dice the tomato and place in a bowl. Stir in the onion, olive oil, sugar, lime juice, salt and pepper and set aside until needed. 3 To serve, place a tablespoon or two of guacamole into a lettuce leaf. Place boerewors on top, spoon tomato salsa over and sprinkle over grated cheese and jalapeños (if using).
1 Place vegetables (broccoli florets, red pepper, aubergine, courgettes and mielies) in a bowl with oil and mix well. Season with salt and pepper and place on braai grid over medium coals for a few minutes until charred. Use tongs to turn veggies for even all-round cooking. 2 To make the dip, drizzle olive oil over cauliflower florets and roast over medium coals (or in the oven) until tender. Remove from heat and place in a blender together with tahini paste, lime juice, cumin and salt and pepper. Blitz until well blended. 3 Arrange roasted veggies on a platter and serve with a bowl of cauliflower dip. DECEMBER 2017 & JANUARY 2018 | 93
YP N U T R I T I O N
ROAST PEACH CRUMBLE 2 ripe nectarines or peaches, cut in half and stones removed 4 tablespoons brown sugar 2 tablespoons butter 2 tablespoons granola Ice cream or frozen yoghurt, to serve 1 Place each peach half on a square of heavy-duty foil large enough to cover the peach. Mix together the sugar and butter and place a teaspoon of the butter mixture into the cavity of each peach half. 2 Fold the tin foil over the peaches, sealing the edges to form a pouch. 3 Place the parcels onto the braai grid over medium coals for about 15 minutes. Remove and let cool slightly before unwrapping the parcels. Place a spoonful of granola onto each peach and serve with a scoop of ice cream.
94 | DECEMBER 2017 & JANUARY 2018
BONUS CORNER Spoil yourself with this issue’s fantastic freebies
G I V E A W A Y S YP
SMS
33404
SMS YP118SKNLOGIC WE’RE GIVING AWAY THREE SKNLOGIC HAMPERS WORTH R1 750 EACH
SKNLOGIC Cosmeceutical skincare aims to provide a skincare solution that works with the skin’s biological processes to achieve visible results. SKNLOGIC has a synergistic approach to science and nature, offering powerful formulas with optimal concentrations of active ingredients to actively improve skin health and appearance from underneath the skin. We use the maximum concentration of key active ingredients and use the highest grade of quality ingredients from around the world. SKNLOGIC products don’t contain any common irritants or cheap fillers such as parabens, mineral oil, formaldehyde, glycols, artificial colourants or sulphates. Visit sknlogic.com for more info.
SMS YP118PUREBEGINNINGS WE’RE GIVING AWAY FIVE PURE BEGINNINGS HAMPERS WORTH R1 055 EACH
Pure Beginnings ensures mothers have peace of mind with its organic products that are best for you and baby. These natural products clean, foam, smell and perform as well as any conventional product, with all the added benefits that using an organic product brings – non-exposure to potentially harmful ingredients; non-exposure to synthetic ingredients that may irritate the skin; and environmentally friendly in that they are rapidly bio-degradable and the certified organic ingredients used have not resulted in the use of insecticides and synthetic fertilisers. A great plus? Pure Beginnings is cruelty free! See purebeginnings.co.za for more info.
SMS YP118CHERUBS WE’RE GIVING AWAY FIVE CHERUBS HAMPERS WORTH R1 050 EACH
CHERUBS is one of South Africa’s most established and trusted baby brands. Parenting doesn’t come with a manual, but CHERUBS can help you through most of the thrills and spills along the way! With high quality, value-for-money wipes and other products for baby and mom, CHERUBS take care of the mess while you do the rest. CHERUBS also have a range of eco-friendly products, to tenderly care for you and your precious baby, with the promise of a nurturing, greener environment. Available at leading retailers. See cherubs.co.za for info.
SMS YP118QUDO WE’RE GIVING AWAY A QUDO HAMPER WORTH R5 250!
Become a designer and create your own jewellery with colours and styles to suit your taste, mood and outfit, with Qudo, newly available in SA. Forty-four top designs, available in many different colours, are compatible with basic rings, bangles, necklaces, leather bracelets and earrings! Creating new looks is quick and easy by simply interchanging your tops, great for adding the wow factor to stacking looks. All items are beautifully made and finished, with a choice of highly durable metal finishes of polished stainless steel and 14ct rose gold IP coating. Fabulous Swarovski® crystals are the heart of this cleverly designed range. Email qudo@tregerbrands.co.za for more info. SMS the following information to 36480: your prize code, your name and surname, physical address, email address and your contact number. Each SMS is charged at R1.50 and free minutes do not apply. Entries close 31 January 2018. By entering a competition, you agree to receive further communication and direct marketing material from Media24 (Ltd). Winners will be published on parent24.com 15 days after closing date. Go to page 97 for terms & conditions. DECEMBER 2017 & JANUARY 2018 | 95
TO ADVERTISE IN THE CLASSIFIEDS EMAIL BRIGITTE@PINPOINT.CO.ZA
Claire 082 921 1032
TO ADVERTISE IN THE CLASSIFIEDS EMAIL BRIGITTE@PINPOINT.CO.ZA
Essential for Your Growing Needs
Seamless Preggy Belly Bando® The most versatile maternity accessory you’ll ever need - The essential, super-stretchy, Seamless Belly Bando® turns regular wear into maternity wear, providing an inexpensive alternative to maternity pants, skirts and tops... Covers unbuttoned pants, skirts and shorts allowing you to wear your normal clothes throughout your pregnancy. The perfect solution to bridge the gap when tops become too short to cover your tummy. Creates the extra length you need to cover any exposed skin at the front and back. Cleverly designed to be worn in a number of ways during and after pregnancy. Fold over to support and hold up loose pants and skirts.
Available at Baby Boom, Baby City, Babies ‘R’ Us at Toys ‘R’ Us, Dis-Chem, selected Clicks stores, Takealot.com and leading baby and maternity stores. Carriwell SA (Pty) Ltd • P.O. Box 272, Umhlanga Rocks, 4320 • Tel: (031) 564 8805, Fax: (031) 564 9647 www.carriwell.co.za, info@carriwell.co.za
RULES FOR ALL COMPETITIONS, SUBSCRIPTIONS AND GIVEAWAY PAGES 1 The prize will be awarded to the first correct entry drawn at random. 2 The competitions are only open to readers in South Africa. 3 The judges’ decisions are final and no correspondence will be entered into. 4 Staff members of Media24, their advertising, PR, and digital agencies, and their immediate family members, may not enter. 5 Entries must reach us by 31 January 2018. 6 Prizes are not transferable and cannot be exchanged for cash. 7 The winner will be contacted by the sponsor to arrange delivery of the prize. 8 Winners will appear on www.yourparenting.co.za 15 days after the competition has
closed. 9 Entry into the competition constitutes acceptance of the conditions. 10 Discounts and gifts only available to subscribers with a South African postal address. 11 Prizes must be claimed within 12 months of the competition date or forfeited. 12 The subscription gift promotion is not valid in conjunction with the Vitality offer. 13 The Vitality subscription offer is only for active Vitality members. 14 Please allow six to eight weeks for delivery after the offer closes. 15 By entering a competition, you agree to receive further communication and direct marketing material from Media24 (Ltd).
TERMS AND CONDITIONS FOR YOUR BABY COVER BABY COMPETITON AND BABA & KLEUTER VOORBLADBABAKOMPETISIE 1. The competition entry will be open from 20 November 2017 – 23 March 2018. No late entries will be accepted. 2. By entering the competition, you agree to be bound by these terms and conditions. 3. Participants must be either the parent or legal guardian of the child. Media24 reserves the right to request proof of such relation. If it is proven that there is no relation between the child and the person who sent the photo, that person will indemnify Media24 against any claim from any third party should the child be chosen as a finalist. 4. You are allowed to enter both competitions for our two sister titles, Your Baby and Baba & Kleuter. 5. Only email entries will be accepted. Entries per fax, registered post, regular post or over social media or any other method other than email to the specific inboxes mentioned below will be disqualified. 6. To enter the competition a parent/guardian has to email coverbaby@yourbaby.co.za or voorblad@babaenkleuter.co.za and include a picture of their child. The photo may not be larger than 4MB – only JPGs or GIF formats accepted. Also include your baby’s full name, date of birth and where you are from, as well as your full contact details. 7. Photos submitted must be recent and taken within the last month. 8. By entering, you agree that the images may be published in Your Baby and Baba & Kleuter and on our social media platforms, including Your Pregnancy. 9. Twins and triplets or other multiples or siblings must be entered separately. 10. The child may not be older than 48 months on the closing date of the competition: 23 March 2018. 11. The competition is open to all qualifying participants within the Republic of South Africa, Botswana, Namibia, Lesotho, Swaziland and Zambia. 12. You are not eligible to participate in this competition if: you are a director, member, partner, employee, agent or consultant of Media24 or an immediate family member of these persons specified. 13. A panel of judges will select 24 finalists for Your Baby and 24 finalists for Baba & Kleuter over the competition period, so in total 48 finalists. The finalists’ pictures will be published in the May & June issue of Your Baby and the April & May issue of Baba & Kleuter. Finalists will be contacted prior to the magazines being on shelf. 14. One winner will be chosen for the July & August 2018 issue of Your Baby and another winner will be chosen for the June & July issue of Baba & Kleuter. 15. The judges decision is final and no correspondence will be
entered into. 16. The winner will be contacted shortly before the cover shoot to make arrangements for the shoot. If after three attempts at contact the organisers cannot reach the initial chosen entrant, another winner will be chosen. 17. The winner will be expected to attend the cover shoot at a time and place stipulated by the editor. If the winner is unable to come to the shoot, due to illness or being unavailable due to any other reason, the entry will be disqualified and another winner will be chosen. The prizes will go to the winner who appears on the cover. 18. The winner’s parent or guardian will be required to sign a confidentiality agreement to keep the shoot and all details about winning confidential until an agreed-upon date, which will be when the magazine goes on sale. Breach of this will result in the prizes being forfeited and legal action may be implemented. 19. All images resulting from the cover shoot remain the property of Media24, although the images will be made available to the winner’s parent or guardian for private use after the issue featuring the winner has appeared on shelf. 20. Competition prizes to the value of R30 000 per magazine/ winner will be awarded as follows: • R5 000 from Baby City • R5 000 from Pansoral • R5 000 from Fisher-Price • R5 000 from American Piercings • R5 000 from Genop • R5 000 from Reuterina Details of the prizes are on page 10 and 11 of Baba & Kleuter and page 26 and 27 of Your Pregnancy. 21. GROUNDS FOR DISQUALIFICATION Entrants will be immediately disqualified without notice to the parent or guardian if the following occurs: a. False information about the entrant is submitted. b. Photo of the entrant supplied is not a true reflection of the entrant. c. Photo of the entrant displays nudity or inappropriate behaviour not in keeping with the Media24 company values. 22. Media24 and their delivery agent does not accept responsibility or liability for any loss or damage and will also not be responsible or liable for any further expenses or fees required for purpose of using, applying or enjoying the prize won in this competition. 23. Media24 reserves the right to vary, suspend, postpone or terminate the competition and any prizes, or any aspect thereof, for any reasons whatsoever and without notice. In such event, you hereby waive any rights or expectations which you may have against Media24 and acknowledge that you will not have any recourse or claim of any nature against Media24. 24. By participating in this competition, you consent to Media24 and the six sponsors using your personal information to send you information about products, services, and special offers that may be of interest or value to you. 25. Prizes cannot be exchanged for cash.
YP L A S T L A U G H
SHEATH YOUR CLAUS Father Christmas was always a pregnant woman, says father-of-three Craig Bishop SEE, THIS PATRIARCHY is a cunning old business. You know how a cuckoo lays its eggs in another bird’s nest, and fools the parents into rearing its own offspring? Well, that, it occurs to me, is how the patriarchy works. It adopts, adapts and co-opts. With the festive season upon us, what better example than that jolly old pagan Santa Claus, aka Father Christmas. See what I mean? Father, says you? Ornamental balls, says I. Yes, apart from the beard, though, which is so fake as to be embarrassing, there ain’t nothing particularly fatherly or masculine about the man in the red jacket. My ground-trembling theory leads me to believe that originally the geezer with the reindeer was actually a woman. And a pregnant woman at that. Mother Christmas. Bear with me. I’m not saying you look like a fat old man. There’s proper scientific methodology at work here. She drives an eco-friendly sleigh, not a penis-shaped carmine Maserati, which any self-respecting male deity figure, with a planet full of presents to deliver, would of course choose to drive. That’s the first giveaway. Not convinced yet? Consider. Santa Claus’ unique talent occurs on just one very special day of the year, when a very special delivery will arrive. And while Santa makes use of the tight opening provided by the allegorical chimney, well, so too does mom-to-be fit her present through an equally tight delivery chute, too. Both sometimes get stuck. Both require little helpers to shunt them round their day.
98 | DECEMBER 2017 & JANUARY 2018
THEN THERE’S THE SHEER MAGIC OF IT ALL, THE OTHERWORLDLY AWESOMENESS OF IT ALL, HERALDING A TIME OF UNPRECEDENTED JOY I suspect back in the day, the obviously male elves staged a rebellion and overturned the status quo, replacing Mother Christmas with their own tyrannical father figure. Maybe they were unhappy with their working hours, or the stupid green outfits just like the ones their elder sisters used to force them to wear when they were toddlers. But the elves just could not remove all traces of the archetypal Mother. The truth will always out. There’s that rosy-cheeked glow, for example. There’s the obsession with sweets, crisps, chocolate cake, brandy liqueurs and all manner of Germansourced biscuits. There’s the baggy
clothes. My God, the bagginess, the bagginess! The inability to see one’s ankles, the protruding belly, the sudden obsession with other people’s kids, the enlarged boobs, the clasping of the bottom of the tummy, the waddle, the odd grunting sounds, the similarities are eerie and endless. Did I mention the baggy clothes? How about the large, bulky colourful sack that fills up mysteriously by itself and sits in a corner of the passageway biding its time till D-Day, jampacked with no man knoweth what manner of intricacies. And it does not end there, of course. It was when I started researching the psychological similarities that I really became convinced. Consider. There’s the superhuman ability to keep track of everyone who has been good and everyone who has been naughty, all year long! Yes, husbands? Yes, boyfriends? Are you with me now? Then there’s the sheer magic of it all, the otherworldly awesomeness of it all, heralding a time of unprecedented joy. Famous children’s author Roald Dahl was a trailblazer in this regard. He knew the score. “Where art thou, Mother Christmas?/ I only wish I knew/ Why Father should get all the praise/ And no one mentions you/ I’ll bet you buy the presents/ And wrap them large and small/ While all the time that rotten swine pretends he’s done it all./ So Hail To Mother Christmas/ Who shoulders all the work!/ And down with Father Christmas,/ That unmitigated jerk!” YP
meet
excursion change & bounce
™
A road trip ready nursery with portable pop-off toppers
Lift-off Snoozer converts to a Bouncer
•
Simple, push button fold and includes carry bag
•
Full-size removable Bassinet clips on and off
• •
2 integrated wheels to easily move
• •
•
•
Change table
• •
Featured here in ‘abstract arrows’, also available in ‘tan stripe’
Stockists South Africa: Baby City, Baby Boom, Babies “R” Us @ Toys “R” Us Stockists Namibia: The Baby Company Superstore Windhoek Trade Enquiries: Bambino International (Pty) Ltd. • 031 205 8309 Website: www.joiebaby.co.za
Sound & Light Unit with vibration
SCAN FOR MORE INFO
Mesh lined for ventilation on all four sides Changer Features Portable changing unit can be used on or off the cot Wipeable fabrics on changer for easy cleaning Sound & Light Unit Features 2 speed soothing vibration pairs with 5 classical lullabies and 5 nature sounds. Nightlight with 3 brightness settings Bouncer Features Snoozing seat works on the cot and converts to portable bouncing seat when used on the floor Features soft, cosy fabrics for newborn Includes an infant pillow and lower harness cover
•
Cocoon shaped, cradling seat for the cosiest naptimes
•
Fabric covered toybar includes 2 soft, plush toys
• •
2 speed soothing vibration SoftTouch, 5 point harness with lower buckle cover