Netcare Guide 2016

newborn NETCARE’S

2016 guide

Netcare’s babycare guide Special Edition Parenting... Your Way!

www.mamasnpapasmag.com

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She s' soaking up new

Because your baby is the biggest sponge of all.

She s' soaking up new

sounds and scents.

Because your baby is the biggest sponge of all.

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Giggles, tickles and your touch during a JOHNSON’S® bath have been shown to promote happy, healthy development.

While the soothing scent, the soft lather and the silky smooth lotion after bath help enhance the experience.

A baby first learns about the world through her senses. Research shows that sensory stimulation ® Trademark © Johnson & Johnson (Pty) Ltd 2015 in the critical first 3 years of a baby’s life helps strengthen the neural processes necessary for Giggles, tickles and your touch during a JOHNSON’S® bath lifelong learning.

Safe. Mild. Effective.

Bruner, Charles, et al. “Early Learning Left Out: An Examination of Public Investments in Education and Development by Child Age.” Voices for America’s Children (2004).

sounds and scents.

have been shown to promote happy, healthy development.

learn more about go to: While the soothing scent, the soft lather and the silky smooth BathJOHNSON’S®, time is special for your baby. It’s a time when lotion after bath help enhance the experience. www.johnsonsbaby.co.za all her senses are engaged – she watches in awe as the bubbles burst, feels the gentle pressure of your Johnson’s Baby SA

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_BABY_SENSE_SPONSORSHIP_R2.indd Remember, your baby’s2brain is like a sponge… and bath time can be so much more than just cleansing. It’s an ideal opportunity for multiTo learn morestimulation about JOHNSON’S®, go to: her ability to sensorial that encourages www.johnsonsbaby.co.za think, love and grow.

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newborn

contents NETCARE’S

2016 guide

63

56

the first fifty hours

the fourth trimester

12 Meet your newborn 16 A whole new world outside the womb 18 Breast is best: Understanding the basics about breastfeeding 22 Time to touch: Your baby’s need for closeness 24 The art of winding a baby 26 Rub-a-dub-dub: Bathing a baby 30 Bum business 101: Nappy-changing tips 34 Special delivery: When your baby is diagnosed with special needs

37 Baby essentials 39 Sleep secrets 41 A beautiful bond 43 Expressing breast milk 46 Soothing those cries 50 Caring for your preemie at home 53 Two or more: Caring for multiples

COVER

10 The First Fifty Hours 36 The Fourth Trimester 58 Good To Know Dossier 69 Health Matters 83 Marking The Milestones 95 Birthing A New Mother 109 Fathers Matter

good to know 56 Basic baby massage 58 What’s behind birthmarks?

60 Reflux, colic and sensitivity 63 The first year 66 Your baby’s first outing 68 Circumcision

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Image: ©ISTOCK

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Contents.indd 1

SECTIONS

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newborn

contents

NETCARE’S

2016 guide

79

114 fathers matter

70 Immunisation and vaccinations 74 Vaccination schedule 75 Common baby ailments 79 Doctor, doctor!

81 Giving baby medicine

110 Why dads matter 112 When you’re feeling down 114 Let’s talk about sex after baby 118 Looking ahead to the future 120 Three superpowers you didn’t know you had

marking the milestones 84 Every baby is unique 86 Week 0 to 4 88 Month 1 to 4 90 Month 5 to 8 92 Month 9 to 12 94 Red flags

birthing a mother 96 Your body after birth 100 Why confinement?

102 From a woman to a mother 105 Mental health for mothers

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Contents.indd 2

directory 122 Netcare Stork’s Nest Directory

REGULARS 03 Netcare Managing Director’s Message 04 Netcare Group Nursing Director’s Message 06 Editor’s Letter 122 Directory 124 Your personal notes

70 92 COVER AND IMAGES: ©ISTOCK.COM.

health matters

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ou are about to embark on an incredibly exciting journey – the adventure that is parenthood. Some of you have travelled this road before, whereas others will be following this path for the very first time. Whether you’re a newbie or a seasoned professional, everyone needs a little guidance, so Netcare Stork’s Nest has compiled this handy book as a roadmap for this all-important expedition. The Netcare Babycare Guide is filled with insightful information to answer all the questions you may have while looking after your bundle of joy, which can be both exhilarating and overwhelming.

As a nursing professional, I have been fortunate to see many babies being born and I can attest to the fact that each time is a special and unique experience, which is what we aim to preserve at our Netcare hospitals. It is a privilege and an honour to help bring little ones into the world, and one that we – Netcare doctors, nurses and midwives – take very seriously.

Welcome to the Netcare family, and if this is not your first time, welcome back! You can rest assured that you are in good hands and we will do all we can to make this a wonderful and stress-free journey for you.

netcare group nursing director’s message

Joining You On The Parenthood Journey A warm welcome to all parents

Kind Regards Shannon Nell Director: Netcare Nursing

Netcare’s Babycare Guide 2016

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netcare managing director’s message

Dear Parents,

have great pleasure in introducing you to a new edition of Netcare Babycare Guide, a special publication compiled by Netcare that will help guide you through the first few months of parenthood.

Being a proud father of three, I have found parenthood to be one of the most rewarding, yet humbling experiences life has to offer. It is humbling because each child always has something new to teach its parents, so I am reminded daily of how much I still have to learn!

It is most likely that you have chosen a Netcare facility as the place you will be welcoming your little one into the world because your healthcare professional has admitting privileges at this hospital. We understand the great level of trust and responsibility that has been placed in our hands and so will do everything in our power to ensure that your experience will be a wonderful one.

We know that, as a parent, you are concerned about the safety and well-being of your child before and after birth. As Managing Director of the Netcare Hospital Group, I would like to reassure you that your chosen Netcare healthcare facility will have all the required resources, competency and skills on hand to provide you with peace of mind.

When it comes to the health and well-being of patients, Netcare hospitals are renowned for their excellent facilities and best practices in a number of healthcare specialties. We are regarded as hospitals of choice because of our effectiveness in dealing with complex medical conditions. The Netcare group has long been a hub of innovation and technical prowess within the South African healthcare landscape industry. Sound medical advice, world-class knowledge, and a high standard of care are exactly what you will find at Netcare hospitals around South Africa.

Speaking from personal experience, I am positive that parenthood will bring you more love, joy and excitement that you ever thought possible and Netcare is honoured to play a small role in this.

I wish you and your family all the best for the future.

Kind regards Jacques du Plessis Managing Director of the Netcare Hospital Group

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Netcare Stork’s Nest

Mother & Baby Wellness Clinics Peace of mind for you and your baby

• Antenatal classes and postnatal support • Baby massages • Breastfeeding guidance • First aid and CPR courses Netcare VCD 7967 | IF_rev english 01.2016

• Immunisations • Nanny courses • Baby milestone tracking

For more information on Netcare Stork’s Nest clinic in your area visit: www.storksnest.co.za, www.netcare.co.za, call: 0860 NETCARE (0860 638 2273) or e-mail us at: customer.service@netcare.co.za You’re in safe hands

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mamas & papas founding editor letter

RAISING NEW LIFE

he world of parenting can be very overwhelming, especially for first-time parents.

The Netcare Babycare Guide has been specially compiled with careful thought and love to equip you with knowledge, sharpen your skills and guide you through the most exiting and rewarding journey of your life.

I believe that parenthood is one of the most humbling experiences for responsible parents. Raising a child requires a combination of love, commitment, discipline and a measure of financial stability. It is our hope that this guide will become your toolkit to answer your questions and direct you to the right channels for assistance.

The guide aims to help you through the challenges of caring for your newborn baby and walk you step by step through the developmental milestones you can anticipate in your baby’s first year of life. Knowledge is power and it is very difficult to monitor and manage what you do not know. Motherhood is considered by many to be intuitive, but babies do not come with instruction manuals. This is as close as we can come to giving you the guidelines to not only survive the first year, but also emerge triumphant, with a healthy and happy baby.

Not forgetting the crucial role that fathers play, we have included some specific advice for dads on the realities of supporting their partners through the birthing process, bonding with their newborns and, of course, ways to seek help for themselves if needed. As you begin your journey

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with the Mamas & Papas Circle of Friends with this booklet, we encourage you to share photographs of your precious newborn baby with us, to be featured on the Hall of Fame of our monthly Mamas & Papas magazine. And as you move gradually through the parenting milestones, we are here to support you until the day your little one enters Grade One. We encourage you to connect with us on social media for relevant tips and advice, and if you misplace this copy of your Netcare Babycare Guide, it is available as a free download at www.mamasnpapasmag.com.

Love new life…

Nawaal Nolwazi Mdluli CEO and Founding Editor of Mamas & Papas Magazine Mamas and Papas Webzine And Magazine Mamas_n_Papas

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newborn NETCARE’S

2016 guide

Founding Editor & CEO of Kwenta Media

Nawaal Nolwazi Mdluli

Managing Editor Copy Editor Features Editor Features Writers Fashion & Beauty Editor Fashion Assistant

Tracy Maher Nicky De Bene Loren Stow Thina Mthembu, Hlulani Masingi Tumi Mdluli Tebatjo Manamela

Senior Designer Designer Junior Designer Digital & Web Specialist

Lelethu Tobi Mmabatho Mahange Siphokazi Masele Lekeke Mahlo

New Business Development Team New Business & Sales Manager Sales Executive Brand Managers Operations & Finance Manager Admin Assistant Office Drivers Advisory Board

Publisher Physical Address

Postal Address Websites Subscription Queries Advertising Editorial Information & Enquiries Printers Distribution Digital Copy

Nuraan Motlekar La-eeba Anthony Wezi Njovu, Kholiwe Nkambule Kelly Moyo Tebatjo Manamela Yusuf Msinyi, Gabriel Mashishi Grace Masuku, Mohammed Bhabha, Lethepu Matshaba, Dr Herman Netshidzivhani, Dr Ashraf Ahmed, Major-General Jackie Modise, Dr Bongani Khumalo, Dr Alessia Gioliano, Maria Sterrenberg, Dr Sumayya Ebrahim, Veerash Srikison, Dr Birgit Katharina Bothner, Dr Antonio Rodrigues Kwenta Media (Pty) Ltd. Fourways View Office Park, Block C, First Floor, Cnr Sunset Ave and Sunrise Blvd, Fourways Tel: 011 467 5859, Fax: 011 467 2808 or 086 672 6468 Mamas & Papas: P.O. Box 4437, Dainfern, 2055 www.mamasnpapasmag.com / www.kwentamedia.com subs@mamasnpapasmag.com advertising@mamasnpapasmag.com editorial@mamasnpapasmag.com info@mamasnpapasmag.com / info@kwentamedia.com Formeset Netcare issuu.com

Netcare’s Newborn Guide is published by Kwenta Media (Pty) Ltd on behalf of Netcare Hospitals.

Copyright owned by Kwenta Media.

(Pty) Ltd. All rights reserved.

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the first 50 hours Pillars.indd 10

“There are words in the soul of a newborn baby, wanting and waiting to be written.” – Toba Beta

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the first 50 hours

MEETING YOU Meeting your newborn… from the top of their downy head to the tip of their tiny toes.

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FROM TOP TO TOE Y our baby’s head will be large in relation to their body, making up about a quarter of their whole body’s length.

Y our baby’s head will have soft spots on it, called fontanelles, where their skull bones still has to fuse together. Their brain is covered by a tough membrane to protect it, so don’t worry about touching your baby on their head. The first fontanelle will close at four months and the last at 9 to 18 months. our baby may have loads of hair or none at Y all; it depends entirely on each little newborn.

Whatever hair is there at birth usually falls out over time and is replaced by new hair, which can be quite different in colour and texture. our baby’s skin is soft and will be a reddish Y colour, with slightly blue-ish hands and feet for a few days until their blood supply reaches all the parts of their body. You will also notice that your baby is covered all over by very soft downy hair called lanugo; this will also disappear after a few weeks. This hair as well as the white creamy substance on their skin – called vernix – waterproofs their skin in the watery womb. Vernix is actually good for a baby’s skin and can be left on to absorb naturally into their skin. our baby’s eyes may be red and a little Y swollen due to pressure in delivery. They can only see about 25cm in the distance, but they will not be able to focus clearly. One eye may even move independently of the other; this is completely expected and will get better as your baby’s eye muscles become stronger. If your baby’s eyes are brown at birth, they may remain so, as is the case with most African and Asian infants, while most white infants are born with blue-grey eyes which change over time and eye colour is only determined at about 3 to 6 months. our baby’s ears are very soft and flexible, Y and even perhaps a little squashed and folded. This is completely normal and their ears should straighten out over time. Your baby’s sense of hearing is highly developed at birth and they will

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the first 50 hours

ringing a new life into the world is the most emotion-laden experience of a lifetime and the often-romanticised images we see in the media can be far from the truth of the moment. Your baby may look a little strange: blue-ish, perhaps with an oddly shaped head if they’ve arrived naturally via the birth canal, screaming their little lungs out. But never fear because your baby’s skin will soon plump out and their cries will be replaced with beautiful little newborn sounds.

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the first 50 hours

respond to your voice and the soothing sounds you make. our baby’s nose and mouth are usually filled Y with mucous when they’re born, which is suctioned away to help with their breathing.

Newborns have reflexive sneezing which helps to clear their nasal passages, so don’t worry that they’re coming down with a cold. Even a tiny amount of mucous in your newborn’s nose can cause rather noisy breathing.

Your baby’s mouth is ready for its most  important job, suckling. In fact your baby may even be born with blisters on their lips or fingers from all the sucking they’ve done while still in your womb. You may notice some white spots on your baby’s palate when they open wide for a yawn or cry. These are called Epstein’s pearls and, along with fluid-filled cysts sometimes found on their gums, will disappear in the first few weeks.

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JAUNDICE It is very common for newborn babies to develop jaundice and the treatment is very effective. What you need to know:  In most cases jaundice is caused by an immaturity of the liver and raised bilirubin levels in the blood; it is very rarely a serious threat to your baby’s health.  Jaundice is discovered between the second to fifth day, peaks at day seven and then clears within the first two weeks.  It starts with a yellowish tinge to skin on the face and the whites of the eyes and then spreads to the rest of the body.  Sometimes jaundice may last longer in breastfed babies.  In most cases jaundice will resolve itself, but your nurses and doctor will advise what you can do to speed up your baby’s recovery.

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Far from being your baby’s ‘first test in life’, APGAR scores actually save many babies’ lives by alerting doctors and nurses to any potential challenges that a baby may have directly following birth. These tests confirm a baby’s immediate condition at birth and whether they need any further medical intervention; they have no bearing on the future health and development of your baby.

The word APGAR stands for Activity, Pulse, Grimace, Appearance and Respiration, and each of these are tested at one minute and again at five minutes after birth. If there are potential problems, another may be done a further 10 minutes later, and babies born by Caesarean section will be automatically assessed again 15 minutes after birth.

Understanding APGAR Results  A score of 7 to 10 is considered typical.  A score of 4 to 7 may indicate medical intervention, such as resuscitation.  A score of 3 or below requires immediate medical attention. n

the first 50 hours

APGAR TESTS AND SCORES

How APGAR Scores Are Added Up Test Activity

0 Points Limp

(muscle tone)

1 Point

2 Points

Some: Arms and

Active: Movement

legs extended

with flexed arms

Total

and legs Pulse

Absent

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

(heart beat) Grimace

Absent

Under 100 beats

Above 100 beats

per minute

per minute

Facial grimace

Crying, sneezing,

(reflexes)

coughing, pulls away

Appearance

Blue-grey pale all

Pink body and blue

Normal over the

(skin colour)

over

extremities

entire body –

Respiration

Absent

Irregular, weak

completely pink Regular, crying

(breathing)

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the first 50 hours

A WHOLE NEW WORLD

Coming to grips with life outside the womb. magine the moment your baby is born, small, fragile and completely dependent on you.

Imagine what it must feel like to go from your womb where there is no such thing as hunger, feeling hot or cold, or being apart from you.

Bombarded from the moment their first cries ring out, your baby is tasked with taking in monumental new experiences through their five senses.

TOUCH Your baby’s sense of touch is highly developed at birth. Their hands and mouth are very sensitive and they use them to explore their new world. Their entire body is accustomed to being continually and

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deeply hugged by the walls of your womb, as they were swayed and gently bounced along for nine months; recreating this womb-space will continue to be calming and soothing for your baby in the early weeks and months of life.

TASTE Relatively underdeveloped as a sense, your baby will be able to distinguish sweet from bitter and sour or acidic tastes, but will prefer sweet above all, which is why breast milk is sweet.

SIGHT Another fairly underdeveloped sense, your baby’s

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the first 50 hours WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

sight will develop over weeks, months and even years. At first your baby will see best at a distance of approximately 20cm to 25cm, the distance between your face and theirs while breastfeeding, but they will mainly be able to see the clear distinctions between dark and light and make out the shape of your hairstyle and smiling mouth.

HEARING Your baby’s sense of hearing is rather well developed at birth and even during their time in your womb, where they are surrounded by the loud shushing noise of your blood rushing through your veins and muffled voices. Your baby will be greatly soothed by

your voice and will love to listen to your lullabies. In fact, their brain is wired to seek out the sounds of speech over any other sounds in their environment so that the journey to learning how to talk has already started.

SMELL Very well developed at birth, your baby recognises familiar smells and uses their sense of smell to root out the source of their survival – their mother and her breast milk. Avoid using perfumes in the first weeks, as it will mask your natural smell that your baby so loves and may also over-stimulate their senses. n

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the first 50 hours

BREAST IS BEST reastfeeding is best, for your baby, for you and for developing your bond. It offers your baby three of the essentials for their survival – nutrition, closeness and warmth – making it one of the most important gifts you can give to them.

THE FIVE SECRETS OF SUCCESSFUL BREASTFEEDING While breastfeeding is natural, it does not always come easily. Remember these tips and you will soon be on the road to breastfeeding success.

1.

Start As Soon As Possible: Preferably start within the first hour of birth, and then breastfeed often from there on out. Remember that your breast is replacing the placenta’s job of nourishing your baby, so your baby will expect to be fed often and in small amounts.

2. Keep It Up: It can be surprising just how often your baby will want to feed at the breast; on average 12 to 14 times in a 24-hour cycle in the early weeks, and an absolute minimum of 8 times per day. Your newborn’s tummy is as small as a marble at birth and holds only about 5ml, so small and frequent feeds are required.

AMAZING MOTHER NATURE Colostrum (your first milk) has a laxative effect, helping your baby to pass their first meconium poo. It also passes your natural immunity onto your baby, which is important for their fragile immune system. Colostrum is made in very small amounts, perfect for your baby’s tiny tummy, and the frequent feeds in the first 3 to 4 days also stimulate your breasts to produce enough milk.

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Understanding the basics, secrets of success, and beating those breastfeeding blues!

3. Take It One Day At A Time: Breastfeeding changes often in the early days and remember that each mother and baby is unique. ay 1 – Your baby should feed within the hour of birth D if there are no complications, and then irregularly for the rest of their first day, anywhere between every 1 to 8 hours. ays 2 and 3 – Your baby is getting stronger and will D likely want to feed more regularly, even every hour, so stick with it, mom! ays 3 and 4 – Your milk will come in and your D baby will get much more from each feed so they will feed for a little longer but stay a little fuller,

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the first 50 hours

slowly spreading their feeds out to 2 to 3 hourly again.

4. Work On A Proper Latch: If your baby is not latching properly it can cause distress for them and yourself (see insert for tips and tricks). This is a common challenge so do not be afraid to ask for help from your nursing sister. You will know your baby is not latched properly if:  Your nipples hurt and are flattened, cracked or bleeding.  Your baby gets frustrated on your breast.  Your baby is sucking hard but not really swallowing much.  Your baby’s mouth makes a clicking sound as it’s not forming a proper seal around your nipple.  Your baby is still unhappy after a feed.

5.

Find The Perfect Position: Comfort during breastfeeding is really important because you are going to be doing it often. There are many different positions, but remember that your baby’s nose should be facing your nipple head-on and their tummy should be touching your tummy or chest. radle Position: Sit upright and cradle your baby C in the crook of your arm, facing towards you. Use a pillow for support and keep your baby’s body nestled closely to yours, even touching their skin to your skin. Use your free hand to hold your breast and guide your nipple into your baby’s mouth. ying Down: A lovely position that will use gravity L to help your milk flow. Imagine you are reclined on the couch on your side, hand holding your head up. Lie your baby facing you, ensuring their nose is to your nipple, and support their back by gently holding them close to you. Do be careful not to fall asleep in this position or let your breast completely cover your baby’s face. ootball Hold: Hold your baby like a rugby ball, F tucked in closely with both arms. Again, you can use a pillow on your lap to raise your baby up and support their weight. This is a great position for feeding twins, as you can feed two babies simultaneously.

CRADLE POSITION

LYING DOWN

FOOTBALL HOLD

DON’T FORGET! DADS CAN HELP Research shows that moms are more likely to breastfeed successfully if they are supported and encouraged by their partners. Remember to tell the mother of your baby that she is doing a great job, allow her the time to breastfeed, and even offer to bring her a glass of water or juice because breastfeeding is rather thirsty work!

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the first 50 hours

BEAT THE BREASTFEEDING BLUES Breastfeeding is unique to every mother; some will find it comes very easily while others may struggle. The benefits of breastfeeding your baby are so immense that it really is worth finding a way through the challenges you may face, and there are many solutions for common breastfeeding blues. racked Or Sore Nipples: This is common and is 1. C usually caused by an incorrect latch, but it can also just be your nipples becoming used to breastfeeding. Give your breasts some extra care and attention:  Keep your nipples dry and change your breast pads often.  Squirt a little of your own breast milk on your nipple after a feed and let it air dry.  Invest in a good quality nipple cream or ointment with lanolin.  Give your breasts some fresh air and sunshine every day.  Enquire about laser therapy for sore, cracked nipples, which is offered by many hospitals. hrush: Small white spots on your nipples and inside 2. T your baby’s mouth are caused by a fungal infection called candida albicans. It must be treated because it can spread to your baby. Speak to your healthcare provider. astitis: An inflammation of the breasts that happens 3. M when bacteria manage to penetrate cracked nipples or when milk ducts become blocked. You can prevent mastitis by regularly breastfeeding, but severe mastitis must be treated by a doctor who may prescribe painkillers and a course of antibiotics.

You may have mastitis if:  You have a sore hard lump in your breast.  Your breasts feel unusually warm or inflamed.

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 Your breasts are very lumpy after a feed.  You feel run down and sore.

4. Engorged Breasts: Very common in the first weeks, especially if you miss a feed and first thing in the morning. Your breasts will become hard, lumpy and very uncomfortable. Release some milk from your breasts by breastfeeding or expressing milk. A warm or cool compress can also help.

Tak

Our i make

HOME REMEDIES FOR MASTITIS  Feed your baby regularly.  Express milk from the affected breast if you cannot wait until your baby’s next feed.  Get plenty of rest wherever possible.  Take a warm shower or apply a warm facecloth to your breast to help the milk flow.  Soak your breast in a bowl of warm water several times a day.  Gently massage your breast while breastfeeding your baby.  Ensure your breastfeeding bra is comfortable and not restrictive.

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the first 50 hours WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

LATCHING LIKE A PRO The first step to breastfeeding is latching. Remember that many successful breastfeeding mothers start off with difficulty in this area, so practice really does make perfect.  Your baby needs to take your nipple and part of the dark circle around your nipple (the areola) into their mouth.  Tickle their lips with your nipple to encourage your baby’s natural rooting and suckling reflex and then move your breast into the right position, placing your nipple in the back of your baby’s mouth.  Be hands-on with this and don’t be afraid to grab a whole bunch of boob in the process, just to help your baby along. Eventually you will not need to manhandle your own breasts but at the outset, your baby needs the extra help from you.  When latched properly, your baby will be able to breathe and you shouldn’t feel any serious pain.

At first breastfeeding can feel quite strange and tingly and a rush of hormones will start your milk flowing, as well as releasing loads of love hormones and even telling your enlarged womb to start shrinking.

EMEMBER! If you struggle with latching, please ask for help from your nursing sister. n R

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 Padded Nursing Bra 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 • Gentle support of your sensitive, changing breasts; ideal for day/night use; maternity and nursing • Soft cup style non-underwire nursing bras are highly recommended by lactation consultants • The stretchy; silky soft and breathable fabric moulds to your changing body • Wider, more supportive shoulder straps • Easy to wash and care for

for your growing needs

Seamless Adjustable Nursing Bra Imagine a bra that fulfils your every need - comfort, support, style, quality, fit and then add function and convenience. These are all critical elements that make the difference between a good and a “great” nursing bra.

No irritating seams or stiff underwire Simple one-handed release clasp for easy nursing Complimentary bra extender adding to adjustability Fully adjustable for your comfort and support

Available at Baby City, Baby Boom, Babies ‘R’ Us at Toys ‘R’ Us, Dis-Chem, 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

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hether you call it Kangaroo Care (KC) or Skin-to -Skin Contact (SSC) the idea is similar; to hold your naked baby against your bare chest, skin-to-skin, from the moment they are born.

This closeness is most commonly associated with saving the lives of premature babies, but it is a biological need for every baby and has many decades of evidence-based research that praise its benefits.

WHY BABIES NEED CLOSENESS

TIME TO TOUCH Answering your baby’s biological call for closeness.

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Babies who are separated from their mothers for even short periods of time experience stress; remember, they have literally been a part of their mother for their entire existence thus far. Separation from their mother makes a baby feel unsafe, and cortisol (the stress hormone) is released in the brain; they cry and release precious energy, their breathing becomes irregular and their body temperature drops.

Once reunited, it can take up to an hour to regulate a baby’s heartbeat and temperature once again.

THE BENEFITS OF CLOSENESS When a baby is kept on their mother’s chest, skin-to-skin, from birth and in the days and weeks following birth, research shows they experience the following benefits:  Warmth from their mother and the soothing sounds of a heartbeat that they know so well.

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 Regular breathing, a steady heart rate and stable blood pressure.  Promotion of breastfeeding by allowing a baby to naturally root for the breast.  The baby’s smell, touch and rooting noises stimulate the release of hormones in the mother’s brain that are required for breastfeeding and bonding.

WORDS: LOREN STOW. IMAGES: SHUTTERSTOCK

HOW TO DO SKIN-TO-SKIN CONTACT (SCC) The idea is simple: place your naked baby (with just a nappy on) on your naked chest with their tummy facing downwards. You can then wrap a blanket around you both for additional warmth and privacy. You then stay in that mother-baby-unit for as long as possible.

Points to remember:  T he first two hours following birth are essential in ensuring your baby feels safe and secure, and promoting breastfeeding.  Plan ahead and let the nursing staff in your hospital know that you want to do SSC from birth, and ask your partner to remind them on the day.  SSC should not be broken at all in the first 2 to 3 days, but you can have a stand-in person (dads and grandmothers are wonderful at this job) so you can take short breaks.  The mother-baby-unit should be prioritised because it meets essential needs for both baby and mother.  SSC should continue for as long as possible, with as much time dedicated to it as possible in the days and weeks following birth.

THULA, THULA, BABA… A recent study found that premature babies that experienced SSC, as well as being sung to by their mothers, showed improved heart rates compared to babies who had SSC without singing.

The lullabies also had a de-stressing effect on the mothers. The study shows that despite living in a world that is wired with technology, when mothers do what comes naturally to them their babies’ needs are most profoundly met. n

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THE ART OF WINDING A BABY Babies are generally very enthusiastic feeders and winding your baby helps them to release the air that they’ve swallowed along the way.

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ome babies need only to be lifted into an upright position for a glorious burp to burst forth, while others will need a little more coaxing. If the trapped air bubbles are not burped up they can cause your baby significant discomfort and pain.

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HOW TO SPOT A WIND You’ll know your baby needs winding when they refuse to drink before their feed is finished because the air bubble makes them feel full or uncomfortable. If this happens, pause for a mid-feed winding session. Other signs that a wind may be bothering your baby are a grimaced expression, looking and/or crying as though they’re in pain.

WORDS: LOREN STOW. IMAGES: MOTHERANDBABY.BLOB.CORE.WINDOWS.NET, LINDYCALDWELL.COM. AU/BLOG/DOES-MY-BABY-NEED-TO-BURP, BABYSENSE.COM.

WINDING YOUR BABY 101  Always keep a cloth or towel handy in case your baby spits up some milk with their burp. This is called posseting and it is completely normal for babies to often bring up a little milk and even residual mucous with their feeds.  It is a good idea to wind your baby after every feed or even during a feed if necessary. Their digestive system is very immature and they need help to get rid of the air bubbles that can become very painful for them.  Wind your baby for around 10 minutes, but keep in mind that winding can eventually over-stimulate your baby and cause its own discomfort.  If you can’t seem to get a wind out after 10 minutes stop and try again later.  You don’t only have to wind your baby at feeds; if you sense they have a cramp or a wind at any time it’s a good idea to try to help them release it.

COMMON WINDING POSITIONS Every baby is different, so try a variety of positions to see what works best for them.  Sitting up: Face your baby away from you and lean them forward slightly. Support your baby’s chest with their chin in your hand and gently rub and pat their back. ver your shoulder: Hold your baby O facing over your shoulder, supporting their back and head with your arm.

Gently rub or pat their back. n your lap: Lay your baby across your O lap on their tummy, making sure to support their head. Use your free hand to rub and pat their back. This position is not advisable after a big feed because their tummy will be full.

STUBBORN WINDS Winding your baby is sometimes challenging. If you are struggling, try changing positions or even asking another person to try for you. Sometimes babies can have colic for up to three months, which makes them cry inconsolably for long periods of time during the day, and often they also have severe winds that cause even more pain. If your baby is struggling terribly with winds, speak to your healthcare provider who can suggest treatments that prevent the winds from forming in the first place. n

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RUB-A-DUB-DUB

Bathing and grooming your baby.

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our baby’s first bath is a milestone that you simply won’t forget. While you will probably want to stare at their tiny little body with awe and wonder, they will be feeling quite exposed and vulnerable, so bath time can also bring on many tiny tears and screams. The key to your baby’s bath time routine is to be prepared and have everything you need close at hand.

SETTING THE SCENE FOR BATHTIME BLISS You may find it easier to bath your baby in a smaller plastic bathtub in the early weeks. When you’re at home this can be done in their nursery, with the lights dimmed down low, a heater on hand to warm the air in the room, soft music playing, and no other distractions.

Have the following ready:  T he bath half-filled with water that is around 29.4°C (check with your elbow or wrist, or have a thermometer ready)  Two towels  A jug  A cotton facecloth  Cotton wool  Baby shampoo  Mild baby soap or cleanser  Baby lotion  Surgical spirits to clean the cord  Bum cream  Nappy  Clothing

TOP TIP! Have everything ready and laid out, jars opened, nappy spread out, towels ready. It will make everything much easier – especially when you have only two hands and wish you had four!

BATH TIME: STEP BY STEP  Double check you have everything you need within reach and ready to use, but do not leave your baby for even a moment.

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 Lie your baby on their back on their changing mat; much of the bath actually happens before you put your baby anywhere near the water.  Undress them, leaving their nappy on, and wrap them in one of the towels so that they don’t feel vulnerable and cold.  Use pre-sterilised and cooled (to lukewarm) water in a small container and wash each eye using a separate damp cotton wool ball so that if there is an eye infection brewing, it is not passed from one eye to the other.  Use a face cloth to wash the rest of your baby’s face, neck, ears and head.  If you need to wash your baby’s hair, do this next.

While still wrapped in the towel, hold your baby’s head over the side of the bath to wash their hair and put them back on the changing mat to rub and pat their hair dry.  Remove the nappy at the last possible moment and open the towel that has been keeping your baby warm and secure. Apply a gentle baby wash, which is then rinsed off, leaving them clean) or even a sensitive baby wash at this point, before you get them in the bath.  Double-check that the temperature of the water is still right (not too cold by this point). Lower your baby into the bath, supporting their neck and shoulders with one arm and gently but securely holding them because they can get very slippery when wet.  Wash your baby’s body, or rinse it if you’ve used a baby wash, paying special attention to folds and creases which could get caked with milk residue (like the neck) or be extra sweaty (like the folds of the arms and between their legs).  Once done, place your baby on a clean towel that is ready and waiting on their change mat. Swiftly cover them up and pat them dry.  Apply lotion to their body and put on a new nappy.  Before you get them dressed remember to clean their umbilical cord stump.  This is also the perfect time to do a little baby massage.  Once this is all done, get them dressed and breathe a sigh of relief!

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 Newborn babies do not need to bath every day, a simple ‘Top and Tail’ (see below) is enough.  Avoid bathing your baby if they are hungry or tired.  Choose the right time of day; either when the day is warmest, or even at night just before their last feed and long sleep, it is your choice.

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

TOP AND TAIL Newborn babies do not get very dirty and so they really do not need a bath every day of the week.

For the first six weeks you can follow a ‘Top and Tail’ routine 3 to 5 days a week.

Here’s what you’ll need: Prepare the room and gather your bathtime basics (see above), as well as a container of clean, warm water.

Taking Care Of The Top…  Wash their eyes, face, ears and neck using the cotton wool swabs and the facecloth.

Make sure you get into all the little creases of the neck because milk does tend to cake in these folds and babies do tend to get damp and develop rashes here.  After cleaning the creases ensure you pat them dry properly.  Gently wash your baby’s hands and armpits as well, patting them dry afterwards. … And The Tail  Remove your baby’s nappy to thoroughly wash their genital area using the warm, damp facecloth. Remember to wash the penis and testicles properly, but never pull back the foreskin in uncircumcised boys, as this will happen on its own at around two to three years.

With a girl, wipe from front to back to prevent any risk of infection from their anus.  In all instances make sure you get into every crease and gently wash all areas before patting the genitals, bum and creases in the upper legs until properly dry.  Do your baby’s umbilical cord care and replace their nappy, getting them dressed as well if you do not plan to do any baby massage at this point. n

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BUM BUSINESS 101 Everything from what to expect on the poo front to nappy changing tips – your baby’s bum is now your business!

our baby’s bodily functions will become so much more interesting than you could ever have imagined before having children. It is almost mindboggling how much attention you will give to wee, poo and nappies for at least the first two years of your child’s life. We’re about to answer questions you didn’t even know you’d have before your baby arrived.

IS THERE SUCH A THING AS TOO LITTLE WEE? The general rule of thumb is that your baby should be going through 10 to 12 nappy changes a day; that is a change with every feed at least. An average of 8 to 10 wet nappies a day is typical of a newborn baby. Breast milk contains as much as 80 percent water, so breastfed babies are at a very low risk of dehydrating and if you feed your baby on demand, it will be impossible for them to dehydrate.

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THE POO FILES Your baby’s poo will become particularly interesting in the early weeks. This will all start with their first poo called meconium, which will be like nothing you’ve ever experienced! Dark black or green with the consistency of tar, it will be challenging to clean off, that we can guarantee. Once the first poo has come and gone, it’s important to remember that there is a very wide range of ‘normal’ when it comes to baby poo.

A breastfed baby may poo once every 10 days or 10 times in one day, and constipation is rare.

A formula-fed baby will need to poo every day and may become constipated more regularly.

In time you will get to know your baby’s unique pooprofile so that you can tell if there is something out of the ordinary. Poos, especially the breastfed variety, come in many different colours and consistencies, depending often on what you eat. These can range from mustardlike poos, to lumpy ones or creamy and seedy poo’s.

Trust us, you will be morbidly fascinated.

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the first 50 hours There is no need to worry about your baby’s poos unless:  Their poo remains chalky and white, suggesting that there is no bile from the liver to digest their food.  Their poo is black and like tar after the meconium phase, indicating that there is possibly blood in your baby’s digestive tract.  There is blood in their poo, suggesting that there is bleeding near your baby’s rectum that needs medical attention.

IS YOUR BABY CONSTIPATED? You will not be the first or the last parent who counts the days from their baby’s last poo, wondering if they could be constipated. Remember that breastfed babies can poo very irregularly, therefore a soft poo, no matter how many days apart, does not indicate constipation. Small and hard pelletlike poos, however, are a dead giveaway. You can help your baby relieve their constipation by gently

massaging their tummy in a clockwise direction, rubbing their legs and feet while they’re on their back. A warm bath is also a good way to help them pass a poo. If you’re concerned, ask your healthcare provider about the best recommended treatment .

HOW TO DIAGNOSE DIARRHOEA A runny tummy is very dangerous for a young baby because serious and even fatal dehydration can take place within hours. Always be alert for signs of dehydration. However, it is once again very rare in breastfed babies and more common in formula-fed babies. Watch out for:  A sudden increase in the number of poos that your baby passes.  Poos that happen more often than with every feed.  Poos that are very watery.  Signs of illness such as poor feeding, a newly blocked nose, fever and lethargy accompanying watery poo.

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WORLD HEALTH ORGANIZATION AND UNICEF GUIDELINES When to seek medical attention for diarrhoea in a baby under 6 months: If a baby becomes sick with a temperature, vomiting or diarrhoea, they advise you to continue to breastfeed the baby on demand (which might be more often than usual). If you are bottle-feeding, add additional rehydration fluids over and above their formula and water intake for the day. If the symptoms coincide with other symptoms (a fever with vomiting / a fever with diarrhoea / diarrhoea and vomiting), or if there have been three runny stools in a 24-hour period, it is important to seek medical attention immediately.

 With boys, it’s a good idea to put an extra wipe over their penis because they love to wee all over everything in the middle of a nappy change.  Thoroughly clean your baby’s bum with the wipes because urine and faeces can actually burn a baby’s delicate skin and cause a terrible rash.  Use a good quality bum or barrier cream.  Never leave your baby unattended on a changing table or high surface during a nappy change; they can easily wriggle and have a serious fall.

NAPPY CHANGING TIPS AND TRICKS  Always ensure your hands are clean before you start.  Have a nappy-changing kit or bag close at hand that has all your essentials: clean nappy, plastic bag for the used nappy, wipes and bum cream.  Always have a spare set of clothes if you’re out and about in case your baby needs a full clothing change.  Use the front of the nappy to wipe excess or bulky poo from your baby’s bum and then wipes for the rest.  Place the soiled nappy out of reach of your baby… trust us!

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In the case where your baby has diarrhoea and you are unable to reach the doctor immediately for whatever reason, you can make a rehydration solution at home: Ingredients 8 teaspoons sugar ½ teaspoon salt 1 litre of previously boiled and cooled water Remember  Follow the recipe exactly.  Ensure all utensils, cups, bottles and water is sterile.  Give your baby ¼ to ½ a cup of solution for every diarrhoea stool.  Give the solution in a bottle, medicine syringe or dropper. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

HOMEMADE ORAL HYDRATION SOLUTION:

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SPECIAL DELIVERY When your baby is diagnosed with special needs. our baby has been born with special needs and the journey you are about to take will amaze and humble you. It will be filled with surprises and challenges, wonderful gifts and unforeseen lessons that you never knew you wanted to learn! You will look back on this day and be forever thankful. Unless there are urgent medical concerns, for the first few days try to let the future take care of itself while you get to know your baby.

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MORE ALIKE THAN DIFFERENT Your baby has special needs, yes, but you will soon discover that they have more similarities to other babies than differences. If your baby has health challenges, your presence, your touch, your voice and your love are invaluable. Don’t underestimate the power of your love.

The ABCs Acknowledge Your Emotions: You may be in shock and experiencing a whole range of emotions, from grief to denial and even anger. Give yourself permission to have these feelings and don’t judge yourself for them.

Talk about your feelings and seek professional help if needed.

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WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

TELLING THE WORLD How do you tell your friends and family? What do you tell them? Do you even tell them at all? The choice is ultimately yours to make. However, parents of babies who are born with special needs find that it is sometimes best to ‘set the tone’. In other words, the way in which you respond to your baby’s diagnosis will be the way in which the people in your life are likely to respond as well. If you are sending out text

messages or birth announcements, you may want to share your baby’s diagnosis; add that your new baby is much-loved and a very important addition to your life, and that their support is appreciated. Try not to take hurtful, insensitive or ignorant comments personally and focus rather on the positive support you will receive. An outpouring of support often overwhelms many parents of babies born with special needs.

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Become Informed: After a period of getting to know your baby better, go out and learn as much as you can about your baby’s diagnosis. Knowledge is power and this way you will be best equipped when it comes to their care and development. Seek out local support groups and organisations, talk to other parents whose children have the same or similar diagnoses and join online support groups. There literally is a world of support at your fingertips.

Celebrate Your Baby: Allow yourself to enjoy your baby as any other parent would. Cuddle, play, sing and dance. Celebrate your baby’s milestones and achievements, and share your joy with friends and family.

EARLY INTERVENTION – START NOW! Early Intervention (EI) is a holistic approach adapted to the specific needs of your baby and could include specialist medical intervention, physiotherapy, occupational therapy, speech therapy and sensory integration therapy, amongst others. The earlier you start to work with your baby on achieving milestones, the better your baby’s future development will be.

EI will enable them to reach their full potential.

These therapies can also help you to become intimately involved in what’s happening in your baby’s world, helping you to understand where your baby is and how to help them to get to the next step.

Recognising when they have reached that next step is a beautiful moment, each and every time!

A LIST OF POSSIBLE QUESTIONS TO ASK These questions are not pretty, but they are practical, and they can help you to accept your baby’s diagnosis and plan for the future: 1. What caused my child’s special need?

2. Could this have been prevented?

3. Did something go wrong during pregnancy or delivery to cause this?

4. Can this be cured or will my child outgrow it?

5. What sorts of intervention will my child need?

6. How will this affect my child?

7. Will it happen again to another child?

8. Will this affect our other children?

9. How can we explain the disability to our other children, family and friends?

10. Is there an organisation or support group we can join? n

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“In the sheltered simplicity of the first days after a baby is born, one sees again the magical closed circle, the miraculous sense of two people existing only for each other, the tranquil sky reflected on the face of the mother nursing her child.�

Anne Morrow Lindbergh

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BABY

ESSENTIALS There is so much to buy and prepare for your baby’s homecoming; much of which can be expensive, confusing and overwhelming. We look at the essentials you will need when it comes to your baby’s first months home, grouped by daily activity.

SLEEP TIME CHECKLIST Necessities  1 x cot [design to insert boxes to tick off]  1 x mattress  3 x linen sets  5 x swaddling blankets  3 x fleece blankets Nice-to-haves  1 x baby sleep monitor  1 x sleep sack (especially for winter)  1 x mobile  1 x mosquito net

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Go easy on the cot linen, bumper sets and pillows, as more bedding in a cot is linked to a higher risk of Sudden Infant Death Syndrome (SIDS); not only is it unnecessary, but it could actually be dangerous.

DRESSING TIME CHECKLIST Necessities  10 x baby vests (a mix of long-and short-sleeved)  10 x babygros (a mix of warm and cool)  4 x jerseys (2 in summer)  6 x socks or booties  5 x washable bibs  1 x sun hat Nice-to-haves  1 x going home outfit from hospital  2 x cute outfits for special occasions

FOR AN EASIER CHANGE Clothes with press-studs and wide-necked tops will make changing your newborn a whole lot easier!

BATHTIME CHECKLIST Necessities  1 x baby bath  4 x towels  4 x face cloths  1 x fragrance-free aqueous cream  1 x box of ear buds (for umbilical cord)  1 x surgical spirits  1 x box of cotton wool swabs (for eyes)  1 x nail scissors or nail clippers  1 x soft-bristle hairbrush Nice-to-haves  1 x bath support aid  1 x bath water thermometer  1 x relaxing musical CD for atmosphere

FEEDING TIME CHECKLIST Necessities  2 x breasts (they are always on call, the milk is free, the perfect temperature, and they are sterile!)

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 1 x box of breast pads  3 x nursing bras  1 x nipple cream (lanolin-based)  6 x burp cloths Nice-to-haves  1 x nursing pillow  1 x breast pump  1 x bottle-feeding system  1 x comfortable nursing / rocking chair

NAPPY TIME CHECKLIST Necessities  1 x change table (or appropriate surface)  1 x change mat  2 x burp cloths or change mat covers  8 to 10 x nappies per day (or thereabouts) Nice to haves  1 x nappy bin, to keep those smells at bay

OUT-AND-ABOUT TIME CHECKLIST Necessities  1 x piccolo seat for the car  1 x pram  1 x baby bag (see insert) Nice-to-haves  2 x back car window guards for the sun  1 x sling for wearing baby close to you

BABY BAG CHECKLIST Leaving home will no longer resemble anything you’ve experienced before; you will need to take everything your baby may need with you. While it is possible to use your nursery items, many moms find it easier to have a set of items just for their baby bag so that they know it’s always stocked and ready to go.

1 x wet wipes 1 x bum cream 5 x nappies (more or less) 1 x burp cloth 1 x swaddling blanket 1 x medium blanket (for the sun, or for sitting on) 2 x toys (for entertainment) 2 x change of clothes (for accidents) n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

the fourth trimester

SUFFOCATION RISK

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SLEEP SECRETS Baby sleep experts do not advise starting any form of sleep training until your baby is six months or older.

leep – or lack thereof – plays a major role in parenting and the truth is that no matter what your plan is you can realistically expect at least some sleep deprivation for at least the first three months.

THE FIRST FEW WEEKS Focus on getting to know your baby’s natural sleeping, feeding and waking routine. While they sleep 18 to 20 hours a day, this is taken in two to three-hourly segments around the clock. Your newborn will wake primarily to feed because their tummy is very small and frequent feeds are essential for their health and growth. They have no concept of day and night and the best advice is to try and sleep when your baby sleeps because you will need to wake frequently at night to feed and soothe your baby.

BIRTH TO TWO WEEKS It is normal for your baby to sleep almost constantly, only waking to feed, and sometimes you will need to actually wake your baby to feed.

From week three they wake more regularly, every 2 to 3 hours.

UNDERSTANDING NIGHT AND DAY Your baby has no concept of the passing of days and you can help your baby by gently introducing them to a flexible day-night routine. While your baby will wake for 2 to 3 hourly feeds, all babies usually have one longer sleep that lasts 4 to 5 hours, and this can often be during the day. The idea is to try make this longer sleep happen at night so that they can learn to have

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THE SLEEP ENVIRONMENT It is a good idea to create a night sleep environment that will help your baby to sleep soundly:  Always put your baby to sleep in the same place at night.

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 In the early days do not be too worried if your baby falls asleep while feeding, but do try to put your baby in their cot drowsy and ready for sleep, but not actually asleep yet.  Ensure the room is the right temperature, dimly lit and soothing.

SUDDEN INFANT DEATH SYNDROME (SIDS) Since the start of the ‘Back to Sleep’ campaign launched in 1994 by the American Academy of Pediatrics (AAP), SIDS has decreased by more than 50 percent. Remember these safety tips at all times:  Put your baby to sleep on their back, alternating the side of the head that they sleep on each time to avoid developing flat spots.  Breastfeed your baby as any amount of breastfeeding is associated with a reduction in the risk of SIDS.  Use a firm mattress and avoid soft, fluffy items of bedding, cot bumpers, and stuffed toys.  Don’t overheat your baby with too many layers.  Sleeping with a dummy can prevent SIDS.  Avoid co-sleeping completely if you or your partner drink, smoke, sleep heavily, or are on any medication.  Avoid letting your baby sleep in their own nursery and rather have them room in with you for the first months of life. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

the fourth trimester

longer night sleeps and you can also get a few good hours in at one go. The way this is done is to not allow them to have that longer nap in the day. Although they – and you – may be tired, ensure you do not let them sleep for longer than three hours before you wake and feed them. In time your baby will be tired enough to take this longer sleep at night.

In the day…  Keep sound levels normal, even when your baby sleeps.  Engage with your baby while they’re awake.  Don’t let your baby stay awake for longer than an hour because they will become overtired and overstimulated.  Learn to read your baby’s tired signals; for example, sneezing, arching their back, not making eye contact and fussiness.  Help to calm your baby for sleep by removing them from a stimulating environment, swaddling them and gently rock them until they are drowsy and ready for sleep.  Do not allow your baby to sleep for longer than three hours, even if you have to wake them up for a feed.

In the night…  Set the stage for the long night sleep by bathing your baby in a dimly lit, warm room.  You can add a soothing baby massage after the bath.  Do not wake your baby up at three hours, this time wait for them to wake you for the next feed. At first this may well be within 2 to 3 hours, but once you stop the long day nap they will be tired enough to stretch this night sleep longer and longer before they naturally wake.  When your baby wakes for a feed and a change at night, be sure to handle them with love and care but be as quiet and calm as possible.  Once you’ve changed their bum and given them their feed, see if you can put them straight back into their cot and let them fall asleep independently.  If they cry, especially in the first three months, respond quickly to soothe them.

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BEAUTIFUL BOND Ways for moms and dads alike to nurture an unbreakable bond with their baby.

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ENGAGE WITH ME Your newborn baby is by far most interested in faces; yours in particular. It is no coincidence that they can see best at a distance of approximately 20cm to 25cm, the exact distance between your face and theirs when you are breastfeeding. Use this time to talk to your baby, stare in their eyes and make very animated facial expressions, smiles, frowns, wide eyes and so on. Dads can make eye contact during bath time, nappy-change time or baby massage by remembering to keep their faces the perfect distance from their baby’s face and also using exaggerated expressions to interact with their baby.

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TOUCH ME Touch is as important to your small baby’s development as nutrition and warmth. Read more about skin-to-skin contact or Kangaroo Care (page 22) where you hold your naked baby on your skin, chest to chest, as often as possible. This creates a profoundly intimate bonding experience that both mom and dad can do whenever and wherever you get the time. Meaningful touch can be done at bath time, bedtime, feeding time and anytime that your baby is fussy.

SING TO ME Hearing is one of your baby’s most highly developed senses at birth and they are wired to tune into the sound of your voice. While classical music or the sound of a baby mobile above their cot may be nice, there is nothing like the sound of your voice as you sing soothing lullabies, or simply talk to your baby and tell them what they’re seeing, experiencing and doing at that time. Talking to your baby is not only a bonding experience, but it creates a language-rich environment and helps to wire their brain in preparation for them to start talking themselves. Both moms and dads can give their babies the gift of hearing their voices.

FATHERS FIRST It can often be difficult for a dad to find the time, space or confidence to bond with their newborn baby.

Their partners may appear to have everything under control. They may feel like their hands are just too big to handle such a tiny little body. Or they may think that their presence is just not that important to their baby.

This could not be further from the truth; your baby needs you and knows you. Your voice is well-known to your baby who has heard it while in the womb.

Your smell will become known to your baby and will soothe them in times of distress. While breastfeeding is very important in the early weeks and months, you can truly bond with your baby from the moment they arrive. This will benefit your baby, your partner and yourself more than you could ever imagine. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

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here are many ways that mothers bond with their babies out of necessity; for example, breastfeeding throughout the day and night, and being the person most likely to take maternity leave after their baby is born. It is not uncommon for dads to feel a bit like a spare wheel in the early days and moms can even sometimes feel as though their primary job is to provide boobs and change bottoms.

Although breastfeeding and spending a lot of time with your baby will be an incredible bonding experience, there are other magical ways for you and your partner to bond with your newborn baby. This early bond is very important in creating pleasurable moments in parenting, allowing you as a parent to better understand and even predict your baby’s needs and building your baby’s trust in you as their parent.

It is impossible to spoil a newborn; as the title of this section indicates, this period is your baby’s Fourth Trimester, a time that they are meant to spend in your womb having every need met instantly and yet can’t because of the physical impossibility of birthing a bigger baby. They are so fragile and so in need of you – not only now, but also for years to come – that this time together really sets the stage for a lifelong bond.

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How to confidently express, store and use your breast milk.

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EXPRESSING BREAST MILK

lthough breastfeeding is always best, there may be times that you will want to (or need to) bottle-feed your baby. The best way to do this is to express, store and use your own breast milk. It is not nearly as complicated as it sounds, as long as you stick with some basic guidelines.

EXPRESSING The most complicated part of expressing breast milk is probably choosing from the many different breast pumps on the market. Once you’ve selected your pump and read the instructions, remember these expressing tips: 1. Wash your hands and find a comfortable, quiet spot.

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2. Pumping harder does not always mean more milk; expressing should not hurt, so pump at a level that feels comfortable.

3. Breasts can only release the milk when let-down occurs, causing the milk ducts to widen and pushing the milk out.  Your let-down reflex relies heavily on hormones, so simply touching your breast, hearing your baby cry, experiencing loving feelings and so on can bring in your milk.  On the other hand, feelings of anger or stress can interfere with your let-down reflex and block your milk release.

4. If you are struggling with your let-down reflex try:  Thinking of your baby’s face or their cries and coos.  Keeping their blanket close by and breathe in that wonderful baby smell.

5. Mimic real breastfeeding by pumping for longer and shorter, and softer and firmer squeezes to stimulate your milk flow. You will soon find what works best for you. Change breasts every 5 to 7 minutes and try to express for a total of 20 to 30 minutes.

6. Pumping in the mornings commonly yields more milk.

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Wait at least 30 to 60 minutes since last breastfeeding and don’t express less than an hour before your next breastfeeding session.

8. T he amount you will be able to express will vary depending on your baby’s age, the last time you breastfed or pumped, the time of day, the quality of your pump, whether you’re stressed out or relaxed and so on. However you should be able to express approximately half a feed if you pump between feeds, or a full feed if you pump for a missed feed:  Full feed in week one: 60ml  Full feed in weeks one to three: 90ml  Full feed in months three to six: 150ml

HANDLING AND STORING YOUR MILK Well done for expressing your milk, it truly is an achievement when you are sporting that little bottle or bag of your milk! Now you just need to store it safely so that it doesn’t spoil before your baby receives the benefit of it. Keep these pointers in mind:

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USING YOUR BREAST MILK

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

So you’ve expressed your milk, stored it lovingly and now you are going to give it to your baby – well done! Follow the tips below to ensure your milk doesn’t lose any essential nutrients during the process: Warm your milk slowly at low temperatures 1. because high heat can kill the live cells that are so important to your baby’s health.

Warm your milk to between room and body 2. temperature by running under cold and then warm water.

3. Thaw your frozen milk in the fridge.

4. It is normal for human milk to separate; simply swirl it around to mix it.

5. Do not warm your milk in the microwave or on the stove; high heat changes its composition. n

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 Never re-freeze milk; thawed milk can be kept in the fridge for up to 24 hours or at room temperature for 4 hours, before it will spoil.

1. Use glass, hard plastic or even milk freezer bags.

2. Store your milk in the smallest amount that your baby will drink – you can always add a little more milk to a feed, but throwing away breast milk is a terrible feeling!

3. Date your milk on the container using non-toxic marker.

4. You can combine milk pumped on different days; just remember to write the date of the oldest milk on the container.  You can add fresh milk to cooled milk in the fridge.  You can add fresh milk to frozen milk if it’s cooled first in the fridge and there is less milk than the total frozen amount.

5. Expressed milk can be kept in the fridge for up to eight days, otherwise freeze it.

6. Storage guidelines:  Fresh milk can be stored in a deep freeze chest (-18˚C) for up to 12 months, in a fridge-freezer (-18˚C variable) for 3 to 4 months, in a fridge (4˚C) for 8 days, and at room temperature for 6-10 hours (if under 22˚C) or 4 hours (if under 26˚C).

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SOOTHING THOSE CRIES Crying is your baby’s primary form of communication, so what are they trying to tell you? ne of the biggest challenges in the first weeks is learning to understand your baby’s unique needs and wants, often communicated to you through cries.

Sometimes you will struggle to decode your baby’s cries and this can be overwhelming. Over time, however, you will begin to understand your newborn’s crying patterns and become more confident. Until then, read on for some of the most common reasons your baby may be crying.

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A newborn baby needs to sleep for most of the day, some needing more and others needing less. Look for signs of back arching, avoiding eye contact and attempts to suck their fists and so on. If it’s nearing an hour since their last nap, this could be reason for their crying. In order to get them to sleep you will need to first remove them from a stimulating environment, soothe them and get them calm and drowsy enough to sleep happily. If your baby has just woken up, you can eliminate this from your possible reasons and move on.

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2. ARE THEY TIRED?

3. ARE THEY IN PAIN OR UNCOMFORTABLE?

REMEMBER! Your baby’s cries do not mean that you are a bad parent – they are simply a form of communication.

Your job is to meet your baby’s needs and therefore soothe their cries as quickly as possible, and to do this you can use a process of elimination to figure out what they may need.

1. ARE THEY HUNGRY? When was the last time your baby was fed? If your baby is sucking their fists or trying to root for your breast, it is a good indication that they’re hungry. Remember that your baby will want to feed on demand; trying to distract them with other activities like a bath or a bum change can make them even more distressed and will impact their ability to feed properly. Of course, if they have fed recently, then you can eliminate this from the possible reasons and move to the next reason.

Having a wind or colic can cause your baby moderate to severe pain and discomfort. In the case of a wind (see page 24) you may notice that your baby is pulling their knees up to their chest and/or tensing their body. If your child cries endlessly for hours after you’ve tried everything you can think of to soothe them, they may have colic (see page 64).

Other reasons for discomfort can be a nappy that is too tight, bathwater that is too hot or too cold, an ear infection, or a dirty nappy. If it is none of these, move on.

4. ARE THEY TOO HOT OR TOO COLD? Babies do not regulate their temperature very well, so you will need to add layers and remove layers accordingly as the room temperature changes. Feel your baby’s neck to see if they feel hot or cold. If yours is a summer baby, use a light swaddling blanket and go easy on the layers. If your baby is not too hot or too cold, move on.

5. ARE THEY OVERSTIMULATED? Newborn babies can become overstimulated very quickly by sounds, sights, movement and even smells, and they cannot switch off to these without your help. While stimulation is good, it is important to remember that too much stimulation can

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overwhelm them to the point of crying. In order to help your baby to calm down you need to remove them from the busy, loud environment that has caused their overstimulation. Aim for a place that is quieter (although not silent), a little darker and more peaceful. If your baby is not overstimulated, move on.

6. ARE THEY LOOKING FOR ATTENTION OR TOUCH?

So you’ve tried everything you can think of and your baby is still crying? Why not try one of these proven methods?

Movement: Babies love to move, so take a drive in the car, slowly dance with your baby, or invest in a baby sling so that you can carry them around with you.

Music: Good quality classical music for babies is a great way to soothe them, but your singing voice is first prize every time.

Sucking: Your baby may be soothed by a dummy at times when breastfeeding or bottles are not appropriate; the sucking reflex calms your baby’s heart rate and relaxes their muscles.

Water: After spending most of their life in a watery womb, it can be very soothing for your baby so run a warm bath and get both of you in there, skin-to-skin, for some soothing time. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

Sometimes your baby needs the opposite! All babies love attention and touch, and sometimes they cry because they’re lonely. If you have checked that your baby is not hungry, tired, in pain, too hot or cold, or overstimulated, perhaps the answer is that your baby needs you to hold them, sing to them and look them in the eyes.

Being physically close to you is a real need that your baby cries to be met.

SOOTHING SECRETS

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CARING FOR YOUR PREEMIE AT HOME You are your baby’s safe place.

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he day you get to take your baby home is a triumph and a joy, but it is often also shaded with trepidation. Yes, you are finally going home, but you are also leaving the safety and security of 24-hour care. Firstly, remember that your baby will not be discharged unless they are ready for this next big step.

HEALTH CHALLENGES Babies born before 37 weeks are considered premature and they can often face health challenges, including struggling to regulate their temperature, difficulty feeding, jaundice, irregular breathing and the need for oxygen supplementation, among others. Your preemie baby may need to spend days, weeks or even months in the Neonatal Intensive Care Unit (NICU) but thankfully, with medical intervention and care, many preemie babies recover and go on to lead happy and healthy lives.

At the time of discharge, your baby will no longer require 24-hour medical care, but they will still need supportive care once they get home and their medical care and check-ups will continue. Before you are discharged your baby’s medical needs will be discussed with you at length by the team who have cared for them thus far. Take this moment to embrace full responsibility once again for your baby’s care; make notes, ask questions and diarise follow-up appointments. Being prepared will help you feel more in control.

MEDICAL NEEDS AFTER DISCHARGE Your baby may require regular medical follow-ups and evaluation after they are discharged to ensure that they are growing and developing well. In addition, there are some common health challenges that many preemie babies face in the long term: Apnoea: It is common for preemie babies to have apnoea, or pauses in breathing, that will most likely improve over time. Your baby will not be discharged if these apnoea episodes cause a slow heart rate or change in colour. However, you will need a breathing monitor because, while apnoea episodes are minor, you may need to deal with them by stimulating your baby to breathe again.

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TIPS FOR PREPARING YOUR HOME  Try to plan for a few quiet weeks at home as your baby’s immune system grows stronger.

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 Ensure trips out the home are limited to doctor’s and clinic appointments only for the first few weeks.  Doctor’s waiting rooms can often be filled with sick people; call ahead and arrange to wait with your baby in an examination room instead.  Most doctors will advise that you avoid public places during the first few weeks and to limit home visitors.  Feeding and sleeping are very important for your baby; they may need to sleep for even longer than a typical baby and they may feed more often because they feed much less each time. n

KANGAROO CARE OR SKIN-TO-SKIN CONTACT (SSC) SSC has saved the lives of many premature babies and studies show that by giving your baby loads of skin-to-skin contact, your bond will improve, breastfeeding will be easier and your baby’s overall health will benefit. Read more about SSC on page 22. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

Breathing issues: Your baby may be discharged with an oxygen tank to supplement their oxygen intake.

This will eventually become unnecessary as they get bigger and stronger.

Infections: All babies’ immune systems are underdeveloped, and a preemie baby may take longer than average to develop a strong immune system. Be vigilant when it comes to keeping your baby safe from germs and from other people who may be carrying colds and flu.

Developmental needs: Many premature babies will need early intervention specialists to help them to meet their milestones. This could be physiotherapy or occupational therapy, and remember that if a delay in your baby’s development is picked up early, therapies can help them to catch up to their peers quickly.

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TWO OR MORE! Caring for multiples.

t goes without saying that welcoming twins, triplets or higher-order multiples simply doubles, triples or quadruples the common challenges that every new parent faces. Yes, there is the saying that the rewards are also increased, but then there are also many unique challenges that parents of singletons need never even consider.

EXPECTED AND UNEXPECTED CHALLENGES Of course with multiples there are certain expectations; for example, caring for more than one baby will mean household chores will take a back seat, sleep will become even more elusive, and finances will become all the more strained.

However, unexpected challenges can include feelings of guilt and even resentment as you have less one-on-one time for each baby and stress and fatigue impacts on your relationships with your partner, family and friends.

REACH OUT Every parent needs to know how to ask for help and none more so than parents of multiples. It is essential that you garner support from friends and family, your community, and your church if applicable. Create a list of things you need help with and when someone offers you a hand, force yourself to accept it; this can be cooking dinners, running errands, bathing the babies or watching the babies while you catch some shut eye.

FORMAL SUPPORT  Join a support group for parents of multiples and speak to others who have walked in your shoes.  The stress of parenting multiples can lead to an increase in the risk of Post Natal Depression (PND) (see page 116). If you feel you are not coping emotionally and the ‘baby blues’ are not abating, talk to someone and find help.

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for each baby and everyone gets stuck in and does what they need to do. It will get easier over time.

Dressing: While some parents choose to colourcode their multiples’ clothes to find them more easily, others simply share out their babies’ clothes and wait until they’re a little older before they start to dress them according to their unique personalities.

Sleeping: Do not underestimate the importance of getting as much sleep as you can. This is the perfect time to call in helpers and volunteers so that you can catch up on some much needed sleep. Getting your babies on a synchronised sleeping schedule is a must, but even then sleep will still be elusive. If you cannot get long-term help from friends or family, it is a good idea to alternate night shifts with your partner so that at least every second night you get a good night’s rest.

MAINTAINING YOUR RELATIONSHIP

Feeding: This will be virtually continuous for the first weeks and may feel overwhelming. It is possible to breastfeed multiples and it may well be worth paying for a consultation with a specialised lactation consultant in order to prepare for the basics. Breastfeeding also helps with financial strain, as well as ensuring your babies have the healthiest start. However, if you find the strain of constant breastfeeding too much, you may choose to bottlefeed your babies expressed breast milk. This will allow others to take on the task of feeding while you are able to do other things.

Bathing: This can be significantly more difficult with multiples. Some parents choose to bath each baby separately; allowing for some precious one-on-one time with each baby. However, this may become simply impossible with higher-order multiples, in which case you need a pair of hands

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 Try to give each other little breaks every day.  Ask each other what you particularly need help with that day. C arve out some alone-time together every day; it is not easy.  Reassess your expectations and use your imagination when it comes to finances, home, love and parenting.

Despite the very real challenges that multiples bring, they do bestow incredible rewards. Loving several babies at once, watching how their unique personalities form and being awed at how their own relationships form between them; there is no doubt that multiples have a special kind of magic about them! n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

MEETING YOUR MULTIPLES’ BASIC NEEDS

It is not at all surprising that even the most solid of relationships face challenges brought on by multiples; with every ounce of energy going towards taking care of babies, there can be very little left over for your partner, never mind yourself. However, this is when you need your partner the most.

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“Having a baby is a real life-changer. It gives you a whole other perspective on why you wake up each day.�

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BASIC BABY MASSAGE

The gift of touch… ouch is an instinctive act that is calming, soothing, loving and deeply healing at times. It comes in many forms from caressing a head full of soft downy baby hair to holding a baby while they sleep, or even gently squeezing a tiny hand. Touch communicates love and when it comes to your baby’s development, it is as essential as breathing or eating.

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DID YOU KNOW? Touch is beneficial for your baby’s well-being and health, and it has many sensory, relaxation and stress-relief benefits. It can also help your baby to physically grow bigger and stronger because touch triggers nerves in your baby’s brain that help them to absorb food, gain weight, sleep better and grow stronger immune systems.

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good to know dossier THE HIDDEN SENSE BEHIND TOUCH Touch involves a less commonly known ‘sixth sense’ called proprioception. This sense tells your body parts where they are in relation to each other and the world around them. Stimulating this sense has a real effect on mood and emotions; for example, how a hug can make a person feel better, or a comforting blanket is soothing when you’re feeling ill. This is why deep pressure touch is so comforting and why your newborn baby may prefer to be swaddled, because it is a like a whole-body hug.

BABY MASSAGE Regular baby massage calms and soothes your baby, gives them great health benefits and is a way of demonstrating your love for them. It can be done any time of the day and it can add a wonderful dimension to bath and bedtime. Set the stage for your baby’s massage by ensuring the room is warm enough, you have the correct oils or lotions on hand, and that the environment is calming and soothing.

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

YOU CAN DO IT! If you want to learn more about baby massage, there are many courses you can go on and classes you can attend, even with your baby in tow. If you cannot find the time or finances to do a class, remember that touch is very instinctive so don’t avoid massaging your baby simply because you haven’t done a course.

STEP BY STEP  Firstly rub the lotion or oil in your hands to warm it up (don’t ever squirt it directly onto your baby as it’ll be cold and will likely give your baby a fright). Use a

gentle lotion or oil that agrees with your baby’s skin.  Very gently but firmly start rubbing your baby’s legs and squeezing their little feet, and be sure that your baby can see you the whole time.  Turn next to your baby’s tummy and chest; gently place your hands flat on the centre of your baby’s body and then smoothly spread them to the side, as if you’re flattening the pages of a book.  You can also do small circles outwards with your hands.  You can work with your baby’s arms by also rubbing gently and ending off with their hands.  Talk or sing to your baby and maintain eye contact the whole time.

Always be on the lookout for signs that your baby is not enjoying the process, like crying or arching their back. Also be careful not to do too much massage at once because your newborn baby’s sensory system is very sensitive. Rather start slowly and gradually increase the length of the massage. If you are ever unsure, speak to your paediatrician or find a massage therapist to train you. However, to touch your baby is natural and incredibly beneficial for them as well as for you.

FATHERS’ GENTLE HANDS Research has found that fathers who do baby massage for 15 minutes a day for one month on their babies before bedtime are more expressive and show more enjoyment and warmth during playtime with their babies. So baby massage isn’t just good for the baby, it’s also a beneficial way in which fathers can bond with their babies. n

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WHAT’S BEHIND BIRTHMARKS? Many babies are born with birthmarks and they are given many names; salmon patches, stork bites, port-wine stains, café au lait spots or even ibala. Importantly, birthmarks are most likely nothing to be concerned about. Here is everything you need to know!

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WHEN SHOULD YOU BE CONCERNED? The vast majority of birthmarks are completely harmless; however, when there are a large number of birthmarks or if they’re located close to the spine, they could point to an underlying condition.

This will most likely be picked up by your doctor or nurses, but if you are concerned speak to your baby’s paediatrician. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

Ibala requires no special treatment and the majority of these birthmarks will disappear without any treatment within the first 12 months.

Birthmarks are found anywhere on your baby’s body.

Salmon patches (so called because of their light colour) are commonly found at the nape of the neck, on the eyelids or around the nose and mouth. Mongolian spots (darker blue-black birthmarks) are commonly found on the lower back and buttocks at birth, but can also occur on the wrists, ankles, shoulders and knees. It is important to remember that these birthmarks fade with age.

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id you know that every baby has birthmarks (nevi simplex) or ibala (in Zulu) before they are born? These marks are created by dilated capillaries in the unborn baby’s skin. By the time a baby is ready for birth, two thirds will have no birthmarks remaining at all. The majority of birthmarks that one third of babies are born with are completely harmless and most will fade with time.

If your baby is born with a birthmark you may notice that it becomes darker when they are upset or cry. It may also actually grow bigger in the early months, but most will stop growing and start to get smaller again between five to 18 months of age. Eventually many will fade completely.

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REFLUX, COLIC & SENSITIVITY Bringing a newborn home is never an easy job, but all babies are different.

Some newborns are naturally content, while others can be called colicky or sensitive, causing frequent distress and crying.

ven the most content newborn can have periods of fussiness; newly developing sensory systems are almost always at the root of this, as is reflux due to an immature digestive system. But when does a baby go from being a little difficult to being in need of intervention?

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IS IT COLIC, REFLUX OR SENSORY SENSITIVITY? As many as half of all babies will regurgitate some of their feeds in the first three months; it is known as gastro-oesophageal reflux or GER. This is completely normal and many babies have no discomfort, so keeping a burp cloth handy is the most you’ll have to worry about. However, some babies can develop GERD (gastro-oesophageal reflux disease), which is more serious and requires medical intervention. It can cause a baby discomfort and pain and also lead to increased sensitivity and extended periods of crying.

HOW DO YOU KNOW IF A BABY HAS GERD? While many babies spit up some of their feeds, a small percentage go on to develop GERD. Signs and symptoms include complications such as failure to gain weight, bleeding, respiratory problems and oesophagitis. GERD can sometimes be difficult to diagnose because it can be confused with colic and just typical GER. If you are concerned, ask your doctor about the ways they can diagnose and help your baby.

You could help your baby by ensuring your baby is upright during feeds and for a little while afterwards.

There is also the option of expressing and then thickening your breast milk with a teaspoon of rice cereal, so that it sits more ‘heavily’ in your baby’s tummy. If this doesn’t help and the symptoms are severe, then special medication can be prescribed.

As with all medications, there may be side effects, but most work very quickly and if the problem is in fact GERD, relief from symptoms should be obvious.

THE IMPACT ON BONDING Bonding with your baby is essential in the first year of life, and this can be seriously impacted if your baby is incredibly needy, fussy, crying and difficult to soothe. If you feel that your bond with your baby is at risk, seek support quickly. Don’t try to rough it out. Speak to someone who will understand you and can offer you support while your baby is still developing their sensory and digestive systems.

A DELICATE SENSORY SYSTEM The majority of babies go through stages of being fussy; it is a normal part of development as your baby’s digestive and sensory systems mature. Approximately one in 10 babies are so sensitive; however, that it can negatively impact on basic daily routines such as feeding, sleeping, bonding and even developing motor skills.

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CALM BABIES BECOME SENSITIVE TOO  Stress Can Make Your Baby More Sensitive If you have had a busy day with your baby, going to doctors’ appointments, possibly delaying feeds because you’re stuck in traffic, or your home is full of noisy visitors, this can all create a stressful environment for your baby and increase their chances of reaching a sensory overload. our Baby Will Become Less Sensitive The Y Older They Get – As a baby gets older, they usually get better at coping with their sensory world, and many babies under three months are naturally prone to sensitivity. ime Of Day Matters – Usually towards early T evening, all the sensory stimulation of the day has accumulated and a young baby may struggle with a sensory overload, which makes them more fussy and prone to crying than usual.

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THE LAST WORD A new baby needs to learn how to cope with their sensory world – both within their little bodies and outside of them. It is common for newborns to have GER, and some are even diagnosed with GERD. Due to immature sensory systems, most babies are sensitive to any stimulation for at least the first three months.

However, some babies can be overly sensitive – what starts out as a slight case of reflux or a wind can end up as a full-blown meltdown for a newborn that is particularly sensitive.

Your baby may be particularly sensitive if:  T hey are hysterical for more than three hours a day, three days a week, for three consecutive weeks.  If their crying is impacting on their routines of feeding and sleep.  If their crying is negatively impacting your ability to bond with your baby.  If your baby is older than four months.

If any of the above points apply to you, seek help and advice from your paediatrician or a qualified infant occupational therapist, who is trained and understands how babies’ sensory systems develop.

Most importantly, do not blame yourself or believe you are an inadequate mother, because seeking help is the best thing you can do for yourself and your baby. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM, DEPOSITPHOTOS.

While your baby’s digestive system gets used to digesting milk, they may experience GER or even GERD, causing discomfort and even some pain. Many babies are able to deal with this discomfort, but there are other babies for whom this is just too much and it pushes them into a sensory overload. This accumulation throughout the day may build up and contribute to a late afternoon and early evening bout of crying where your baby may struggle to become soothed and fall asleep.

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Good To Know Dossier

THE FIRST YEAR As you cross the threshold of your home for the first time carefully carrying your tiny little bundle of love, you also step into a period of intense change and often overwhelming responsibility.

These five quick and effective survival tips for the first 10 day will last you well into the first year!

makes getting an extra hour of sleep here and there an absolute must!

Sleep Everyone needs sleep, you included! An amount of sleep deprivation is completely normal when it comes to raising a young family, so it’s important to prioritise getting enough sleep. Alternate getting up early with your partner, ask someone to help with chores so that you can sleep when your baby sleeps,

Diet You need to care for your body while breastfeeding. Ensure you are following a hearty and healthy diet as well as taking supplements as prescribed. In fact, did you know that your body needs even more nutrients during breastfeeding than it did during pregnancy? It may be more difficult to do

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with the increased demands of a newborn, but a good diet will pay off in the long run.

Share The Load You are not meant to do it alone. Share responsibilities with your partner and reach out to support structures in your family, friends and community. While you may be the only person with the breasts, others can assist with household chores, bathing your baby, changing nappies and putting them to sleep. It really does take a village to raise a child.

Make time to be with your partner As difficult as it may be at first, make time to spend alone with your partner. Parenting a young family can add stress to even the most solid relationship, so time out together every day goes a long way to keeping your relationship strong and healthy for your and your children’s benefit.

Me-time You need to claim time for yourself (see page 119) in order to recharge your batteries and to give the best of yourself to your family. If you are running on empty, you simply will not have what you would dearly love to give.

Starting a family is exhilarating and beautiful and tiring and terrifying all at once; it is many things and most certainly is not an easy ride. Ensure you prioritise the above points, buckle up tightly and enjoy the ride!

DADS MATTER FROM DAY ONE While it may seem that mothers take on the bulk of responsibilities when it comes to caring for a newborn, fathers can and do make a difference from day one! While you may be forced to return to work sooner than you’d like, you can ensure that you take part and help out when you return from work in the evenings. You can relieve your partner’s stress and feelings of responsibilities by spending time with your baby; bathing them, holding them, soothing them and so on. n

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YOUR BABY’S FIRST OUTING

Many new mothers experience cabin fever at some point; fight those feelings of isolation by getting out and about with your baby! Actually walking out the door will be a whole lot more daunting though, but you needn’t worry if you remember these five tips!

What To Bring Make sure your baby bag is packed with everything you need (see page 38) and you have a safety seat for your baby if you are travelling by car.

breastfeeding in, or that you will need to plan your trip between feeds. Why not go to a friend or family member’s house for a cup of coffee, or go to a local coffee shop that you know well?

Where To Go Keep it simple and even stay a little closer to home if possible. Spending a long time driving to and from your outing will eat into your precious time out. Also remember that if you’re breastfeeding, you will want to choose a place that you feel comfortable

Keep Your Expectations Realistic Don’t expect to go grocery shopping, on very long drives, or running errands with your newborn; at least not at first. The point of the exercise is to get out of the house, not to get things done. Take it easy and don’t put too much pressure on yourself.

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Give Yourself A Pat On The Back Well done for venturing out into the world for the first time with your newborn baby – with all the stuff that needs to be carted around and the nerves associated with the first few outings, you have done well! It doesn’t matter if your baby cried the whole way or if you underestimated the time it would take to get back home for their feed, or even if your baby had a giant explosive poo all over you while you sipped on your decaf latte – the point is that you did it and it will get easier and easier!

Do It Again!

Practice really does make perfect when it comes to taking your baby out and about in the early days. Each new outing will present challenges that you can learn from and pretty soon you will be able to do it with ease. n

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CIRCUMCISION If you and your partner have been blessed with a baby boy, you may have made the very personal decision to have your son circumcised.

Circumcision is the removal of the foreskin, or prepuce, of the penis. The circumcision site will usually take between seven to 10 days to heal and while you may be nervous to attend to the fragile-looking penis after surgery, caring for it is easier than you may think: leanliness – Keep the site clean and dry where C possible. Change wet nappies as quickly as you can and rinse the area with warm water after each bowel movement. etroleum jelly – Your doctor may make a P recommendation. Some prefer to keep a dressing over the healing penis before wrapping the gauze dressing to prevent sticking. Without a dressing, you should still apply a little petroleum jelly to the tip. The doctor performing the circumcision may prescribe an antibiotic ointment to be applied daily for five to seven days. This works in a similar way to the petroleum jelly, minimising the chances of the raw area of the penis from sticking to the nappy.

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rying powder – The aloe-based medicated D drying powder you use for the umbilical cord stump (NOT surgical spirits) may be used for the healing penis and your doctor may recommend this.

WATCH FOR INFECTION The tip will be a little red and swollen and you can expect a spot or two of blood. Contact your paediatrician immediately if you notice the following symptoms:  Persistent bleeding from the site  Fever  Increased redness, swelling of the penis  Oozing from the site  Inability to urinate normally within six to eight hours after the circumcision.

Whether the circumcision is performed at the hospital or as part of a religious ceremony, the penis needs to be taken care of to prevent infection. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

WHAT IS CIRCUMCISION?

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Sir Francis Bacon

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IMMUNISATION AND VACCINATIONS A critical issue! mmunising your baby will offer them protection against a host of common diseases, some of which can have longterm negative consequences. Both the government and medical community strongly support immunisations as they prevent infant mortality from preventable causes. All the diseases on the vaccination schedule are vaccinepreventable.

THE BENEFITS OF VACCINATIONS A vaccination can save your child’s life from diseases that once injured or killed thousands of children across the world. Every new vaccination goes through long and careful review by scientists, doctors and healthcare professionals, so once they reach the clinic they are safe for your child.

Vaccinations help protect not just your child, but also your whole community; the more children are vaccinated against a disease, the less likely the disease will be able to resurge and claim lives. In addition, vaccinations save time and money because your child will be less likely to catch or develop the vaccine-preventable disease in the first place; it is a good investment in your child’s health. Vaccinations also protect future

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PUBLICALLY AVAILABLE VACCINATIONS

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generations from death or disability, as the polio vaccination has done for our generation.

Vaccinations are not offered for free in private hospitals, but these private hospitals do offer vaccinations that are not available in government institutions, such as Hepatitis A, Mumps and German Measles (or Rubella), and the Meningococcal Vaccine.

HOW DO VACCINATIONS WORK AND ARE THEY SAFE? Most vaccines are made from the inactivated (killed) viruses or parts of the weakened (attenuated) live viruses. For these reasons, they will not harm your baby. By giving your baby a small sample of the virus, their body is prompted into developing a resistance to it.

VACCINATION RECORD You will be issued with a vaccination card when your baby is born in order to record all the vaccinations they receive. Mothers are notified when their babies are due for their next visit for a vaccination.

Note: South African schools and day-care centres always request a child’s vaccination schedule and may refuse entry if it is not up to date.

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

WHAT SIDE EFFECTS CAN YOU EXPECT? Common side effects of vaccinations may include a fever, slight discontent and a mild rash. There may also be some tenderness at the injection site.

A combination vaccine contains a few vaccines in a single injection. For example, Diphtheria, Tetanus, Pertussis and Heamophilus influenzae type b (HIB) and Inactivated Polio. n Visit your local Stork’s Nest Clinic for more advice on immunisation and vaccines. Go to www.storksnest.co.za.

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VACCINE SCHEDULE Age

Birth

EPI Schedule (6/10/14 wks)

Private (6/10/14 wks)

Private (6/10/14 wks + HepB at Birth

Polio˚ (OPV)

Polio˚ (OPV)

Polio˚ (OPV)

BCG vaccine

BCG vaccine

BCG vaccine

Age

Birth

Option 3 in Private (2/4/6 mnths)

Polio˚ (OPV) BCG vaccine

Hepatitis B

**

8 weeks or 2 months

8 weeks or 2 months

Polio² (OPV)

Polio² (OPV)

Polio² (OPV)

Rotavirus¹ (RV)

Rotavirus¹ (RV)

Rotavirus¹ (RV)

Pneumococcal vaccine¹ (PCV)

Pneumococcal vaccine¹ (PCV)

Pneumococcal vaccine¹ (PCV)

Pneumococcal vaccine¹ (PCV)

DTaP-IPV/Hib¹ + HBV¹

DTaP-IPV-HibHBV¹

DTaP-IPV-HibHBV¹ OR DTaPIPV-HBV/Hib¹

DTaP-IPV-HibHBV¹ OR DTaPIPV-HBV/Hib¹

Polio² (OPV) Rotavirus¹ (RV)

Abbreviations: *DTaP = Diphtheria, tetanus, acellular pertussis *IPV/Hib = Inactivated polio & haemophilus influenza type b *HBV = Hepatitis B vaccine. **Hep B only given at birth if vaccine schedule is started with Infanrix Hexa(GSK)at 6 weeks. This does not apply if Hexaxim(Sanofi) is given.

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health matters 10 weeks

14 weeks

9 weeks

Rotavirus²(RV)

Rotavirus²(RV)

Pneumococcal vaccine² (PCV)

Pneumococcal vaccine² (PCV)

Rotavirus²(RV)

DTaP-IPV/Hib² +HBV², OR DTaPIPV-Hib-HBV²

DTaP-IPV/Hib² +HBV², OR DTaP-IPV-HibHBV²

DTaP-IPV-HibHBV², OR DTaPIPV-HBV/Hib²

Rotovirus²(RV)

Rotovirus²or³ (RV)

Rotovirus²or³ (RV)

Rotovirus²or³ (RV)

Pneumococcal vaccine² (PCV)

Pneumococcal vaccine³ (PCV)

Pneumococcal vaccine³ (PCV)

Pneumococcal vaccine³ (PCV)

DTaP-IPV/Hib³ +HBV³, OR DTaPIPV-Hib-HBV³

DTaP-IPV/Hib³ +HBV³, OR DTaP-IPV-HibHBV³

DTaP-IPV-HibHBV³, OR DTaPIPV-HBV/Hib³

3 or 4 months

4 or 6 months

9 months

Pneumococcal vaccine² (PCV) DTaP-IPV-HibHBV² OR DTaPIPV-HBV/Hib²

DTaP-IPV-HibHBV³ OR DTaPIPV-HBV/Hib³

Measles¹

Measles¹

Measles¹

Pneumococcal vaccine³ (PCV)

Meningococcal vaccine¹ (MCV)

Meningococcal vaccine¹ (MCV)

Pneumococcal vaccine4 (PCV)

Pneumococcal vaccine4 (PCV)

Hepatitis A1 (repeat 6 months later)

Hepatitis A1 (repeat 6 months later)

Hepatitis A1 (repeat 6 months later)

Chickenpox¹ (the first and booster doses can be given at 12 and 15 months)

Chickenpox¹ (the first and booster doses can be given at 12 and 15 months)

Chickenpox¹ (the first and booster doses can be given at 12 and 15 months)

Meningococcal vaccine² (MCV)

Meningococcal vaccine² (MCV)

Meningococcal vaccine² (MCV)

MMR¹ (measles, mumps + rubella)

MMR¹ (measles, mumps + rubella)

Meningococcal vaccine² (MCV) if not given at 12 months

Meningococcal vaccine² (MCV) if not given at 12 months

12 months

15 months

Measles¹ Meningococcal vaccine¹ (MCV)

12 months

15 months

Pneumococcal vaccine4 (PCV)

MMR¹ (measles, mumps + rubella) Meningococcal vaccine² (MCV) if not given at 12 months

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18 weeks

DTaP-IPV/Hib4 +HBV4, OR DTaPIPV-Hib-HBV4

DTaP-IPV/Hib4 +HBV4, OR DTaP-IPV-HibHBV4, HEPA2

DTaP-IPV/Hib4 +HBV4, OR DTaP-IPV-HibHBV4, HEPA2

Polio

Polio

Polio

MMR²

MMR²

MMR²

18 months

DTaP-IPV/Hib, OR DTaP-IPVHib-HBV4 OR DTaP-IPV-HBV/ Hib4, HEPA2

Measles² 6 years

Tetanus + diphtheria (6 years)

Chickenpox²

Chickenpox²

From 9 years

Human papillomavirus vaccine (HPV)

Human papillomavirus vaccine (HPV)

Human papillomavirus vaccine (HPV)

From 9 years

Chickenpox² Human papillomavirus vaccine (HPV)

12 years

Tetanus + diphtheria

Diphtheria, tetanus, pertussis, polio, MMR

Diphtheria, tetanus, pertussis, polio, MMR

12 years

Diphtheria, tetanus, pertussis, polio, MMR

 In South Africa, our public sector clinics work on a government-regulated Extended Programme of Immunisation (EPI). These vaccinations are free of charge. Private sector clinics, where you will pay for your vaccinations, are able to offer extra vaccinations not available on the EPI.  Above are the tables that depict the EPI schedule as well as the three different private schedules you could choose from. Some private clinics are able to offer EPI vaccines at no charge, although you will be charged for the appointment. Your clinic or paediatrician will be able to advise you. n

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MAGES: ©ISTOCK.COM.

¹ First dose in the series ² Second dose in the series ³ Third dose in the series 4 Booster

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COMMON BABY AILMENTS There are some common ailments that babies may develop in their first eight months. By understanding them better you will be more prepared to make informed decisions about how to treat them or when to seek advice from your healthcare professional.

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1. BABY ACNE These tiny pimples that break out on your baby’s face are usually harmless.

What to do: Continue washing their face with warm water and avoid harsh soaps. Moisturise if you see their skin is becoming dry and flaky. If you notice that any of the pimples are becoming yellow and crusty, check your baby does not have a skin infection, symptoms of which include loss of appetite and/or a fever.

2. COLIC Uncontrollable or persistent crying affects roughly about 20 percent of newborn babies. It is not usually harmful to your baby, but can cause distress for your baby and yourself.

What to do: It’s a good idea to call your doctor to rule out any possible underlying causes for the crying, as well read further about colic, reflux and sensitivity on page 64.

3. CONSTIPATION Formula-fed babies are prone to episodes of constipation from time to time; this can be caused by not getting enough fluids and the formula not agreeing with their developing digestive system.

What to do: Speak to your doctor about relieving your baby’s constipation through changing to breastfeeding instead, possibly increasing their fluid intake, adding olive oil to their formula, massaging their tummy and so on. Read more about constipation on page 30.

4. COUGHS AND COLDS Babies and young children are especially prone to catching coughs and colds because their immune systems are still immature. You will know the difference between a common cold and the flu because a cold usually develops slowly and your baby will still be happy to play and eat rather well. On the other hand flu usually hits suddenly and leaves your baby without an appetite and not interested in any socialising.

What to do: If your baby has a cold regularly, clean

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clothing, giving them a lukewarm bath, and/or giving them a dose of infant Paracetamol. Keep a close eye on them until the temperature abates for at least 24 hours.

8. NAPPY RASH

A flaky scalp that often looks red and oily is caused by a build-up of oil and shedding skin. This is not a harmful condition.

What to do: More frequent hair washing and use a soft brush to gently encourage the scales to come off.

Many babies will develop a nappy rash at some point. You can prevent nappy rash by ensuring you change your baby’s nappy regularly and clean and protect their bum. However, the nappy rash often has nothing to do with how diligent you are!

What to do: If your baby develops red, blistery or painful-looking skin, continue to keep their nappies dry, try to rinse their bum at every change, avoid using wipes that contain fragrance or alcohol, pat their skin dry and avoid rubbing the sensitive area, invest in a good-quality barrier cream or ointment, and if possible let your baby go without a nappy for a while.

6. EAR INFECTION

9. TEETHING PAIN

Ear infections commonly occur in conjunction with colds and coughs. Signs and symptoms include crying for no apparent reason, a high temperature, diarrhoea, and/or a discharge from the ear.

What to do: You should contact your healthcare provider if you suspect your baby has an ear infection.

When teeth start to push through the gums, it can cause pain for your baby. You’ll know they may be teething if they start to chew on toys, get a fever or flushed red cheeks, dribble excessively and/or have a runny nose and loose tummy.

What to do: Giving them infant paracetamol will help as well as letting them chew on something hard or cold, like a biscuit or carrot, or a lolly.

5. CRADLE CAP

7. FEVER Body temperature rises when it’s faced with an infection of some kind, so a fever indicates that your baby’s body is fighting an infection.

What to do: When your baby develops a temperature or fever, take note of how high it is and when you’ve taken it. Repeat this every 20 to 30 minutes. If your baby is showing signs of distress, their temperature continues to rise, and they perhaps have additional symptoms such as diarrhoea or vomiting, contact your doctor immediately. If you are able to control their temperature by removing some layers of

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10. THRUSH This is a common infection caused by the candida fungus. It invades a baby’s throat and mouth, forming cracks in the corners of the mouth and white or yellowish patches on the lips, tongue and inside the mouth. These sores can be painful and make it difficult for your baby to feed, as well as cause nappy rash. What to do: Contact your doctor immediately as you and your baby will need to be treated for this condition. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

your baby’s nose with a saline solution, suction excess mucous and use a humidifier to moisten the air. If they have a temperature you can give your baby a dose of infant Paracetamol as directed on the packaging or by your pharmacist. However, if your child is under three months, is developing persistently high temperatures, appears to be lethargic, has difficulty breathing and/or is refusing to eat you, should contact your healthcare provider immediately for advice.

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DOCTOR, DOCTOR! It is important to understand what common ailments your baby may develop so that you also know when it’s time to contact your doctor for advice or to make an appointment.

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WHEN YOU CALL, HAVE THE FOLLOWING INFORMATION READY:  Your baby’s age, weight, temperature and method you used to monitor it (if applicable).  Any medications your baby is taking and the prescribed doses.

CALL EMERGENCY SERVICES (082 911) IF YOUR BABY:  I s too weak to respond to you – a sign that something is wrong with your baby and they need medical or emergency assistance.  Has a bluish tinge to their nails, lips and gums – this is a sign of circulatory problems.  Stops breathing for more than 10 to 15 seconds.

CALL YOUR PAEDIATRICIAN It can often be difficult to decide whether to call the doctor or not, refer to page 82 for more on common ailments your baby may develop, but if you notice any of the

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following it is advised to contact your doctor immediately:  Breathing – if your baby is breathing with difficulty and/ or making grunting noises  Chest – if your baby’s chest is congested  Eyes and ears – a yellow or green discharge is a sign of an infection  Feeding – if your baby refuses to feed successive times through the day. Dehydration is a serious risk; loss of appetite may also be a sign of illness or infection  Skin – yellow skin is a sign of jaundice; any unexpected blisters or rashes  Stools – constipation (a swollen or tender abdomen with no bowel movement in 24 hours in a formulafed baby) and diarrhoea for more than two successive nappies  Temperature – your baby’s temperature runs too high or too low (see tip box)  Umbilical cord stump or circumcision area – signs of an infection here may be additional redness and swelling of the area as well as any oozing or bad odour  Vomiting – if vomiting occurs regularly during the day and is of sudden onset (in other words, not reflux).

Gauge Your Average Temperature: Normal: 36°C to 37°C Fever: >37.2°C Emergency: 39°C Please note fluctuations of 0.5° to 1°C will occur during the day, with cooler temperatures in the evening. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

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BE PREPARED Keep all emergency numbers at hand, including numbers for:  Your paediatrician  Midwife or home doctor  Local pharmacy  Local hospital  Emergency services

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GIVING BABY MEDICINE Although no parent wants their child to be ill, there may be times when you will have to administer drops or medicine to your baby.

Follow these tips and rest assured!

Ear Drops 1. Wrap your baby snugly in a blanket, ensuring their arms and legs are out of the way.

2. Lay your baby down on a firm surface and tilt their head to expose the ear.

3. Support their neck if needed with an extra blanket.

4. Gently insert the dropper around 3mm into their ear, stopping if you reach any resistance.

5. Squeeze the prescribed number of drops into their ear and press gently on the front of the ear to help the liquid into the ear canal.

Keep your baby still in this position for a few 6. minutes to prevent the drops from leaking out of their ear again.

Eye Drops 1. Wrap your baby as per point 1 of ear drops.

2. Secure your baby firmly in the crook of your arm, supporting their neck and head, and tilt their head back slightly.

3. Rest the dropper on the inside of the bridge of the nose to prevent accidently poking their eye.

4. Gently squeeze the prescribed amount of drops into their eyes.

Nose Drops 1. Wrap your baby as per point 1 of ear drops.

2. Secure your baby firmly in the crook of your arm, supporting the neck and head.

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3. Tilt the head slightly back and to the side, otherwise the drops will go straight down their throat.

Place the dropper gently into each nostril and 4. squeeze out the prescribed dosage.

5. Keep them in the position for a few moments to ensure the drops don’t leak back out again.

By Mouth – Syrup Or Drops 1. Wrap your baby as per point 1 of ear drops.

2. Lie your baby on your lap, hold them securely and tilt their head back slightly.

3. Squirt the prescribed dose from a clean syringe into the back of your baby’s mouth, as far back as possible.

The front part of your baby’s mouth is very 4. sensitive and they may gag if they taste the medicine on their tongue.

By Bum – Suppositories 1. Lie your baby on their back on a firm surface.

2. Take both ankles in one hand and gently tuck your baby’s legs back into their tummy.

3. Dab a little petroleum jelly or KY jelly onto the nose of the suppository and gently, but firmly, insert into your baby’s anus.

4. Hold it there for a moment with the tip of your finger.

You will feel the suppository slide into the rectum.

5. If you are too gentle, the anal muscles will reflexively push it out again.

 Always check the expiry dates on the medication container.  Remind your doctor of any previous adverse reactions your baby might have had to a particular medication.  Ensure that courses of medication prescribed by your doctor are completed if required to do so, such as antibiotics.  S ome medications need to be stored in the refrigerator. n

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WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

HEALTH HAZARD WARNING!

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marking the milestones

“Life isn’t a matter of milestones, but of moments.”

Rose Kennedy

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hile it may be easy to imagine that your baby is learning to ‘simply be’ in the first year, they are in fact set on a course of life-altering development that will impact on the rest of their lives. Your baby will develop more in their first year than they will in the rest of their lives, and while this may seem rather daunting, remember that many of your baby’s milestones are hardwired – the seeds are already there, you simply need to provide a fertile ground from which the seeds can sprout and grow!

WHAT MAKES A FERTILE GROUND FOR YOUR BABY TO GROW? Provide loads of stimulating one-on-one interaction between you and your baby, create a secure environment for their lives to unfold and, most of all, shower them with love, love, love!

WHAT IS A MILESTONE? Milestones are markers in your baby’s development, but they are guidelines only. As long as your baby is

EVERY BABY IS UNIQUE An introduction to the milestones in your baby’s first year.

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IS MY BABY OKAY? One of the most natural things for new parents is to wonder – and sometimes worry – if their baby is developing like other babies. Is their baby okay? This urge to compare your baby to other babies is natural; it helps you to understand and learn more about your

baby’s development and take an interest in them. But it must be cautioned that you should only ever compare your child in an honest environment and also that you must celebrate your child for their uniqueness.

What is an honest environment? Well, this is one where other moms can admit to mistakes, where they can share their true frustrations, joys and worries. It is not an environment where only the picture-perfect is discussed and the niggling worries are swept under the carpet. In a dishonest environment you may end up feeling as though your baby – and indeed even you – are not okay, when in fact you are doing just superbly!

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developing at a fairly steady pace, whether they meet a milestone slightly early or slightly late has no impact on their long-term development. However, it is important as a parent to know how your baby develops, so that you can give them everything they need in order to flourish.

WHY IS UNIQUENESS SO IMPORTANT?

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

No two babies are the same and while this may sound obvious, it is not so obvious when you are wondering why your little one is the last to take to crawling in your parenting social circle. Avoid labelling your baby as a ‘slow developer’ or ‘fast developer’ and instead see your baby as unique. Celebrate each new milestone and truly enjoy your baby’s progress through their first year – they will go from a tiny little bundle that simply eats and sleeps to a gregarious little baby who will be smiling and laughing, playing and engaging, learning and growing before your very eyes. Enjoy every moment! n

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0–4 WEEKS

Most babies are able to do the following by the end of their first month...

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Y our baby is working hard at mastering the basic reflexes needed for survival such as sucking, swallowing, coughing, grasping, blinking and startling.  Your baby’s hands will be clenched in fists most of the time.  Your baby’s eyes are not coordinated, so they may cross from time to time.

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PHYSICAL DEVELOPMENT

COGNITIVE DEVELOPMENT  Your baby will watch an object at 20cm to 25cm away, especially if it moves slowly from side to side.  Your baby will be fascinated by their fingers.  Your baby will love the sound of your voice.

LANGUAGE DEVELOPMENT  Your baby will communicate mostly by crying and sometimes cooing.  Your baby may prefer familiar voices and music and can be soothed by them.  Your baby may turn to a familiar voice.

SOCIAL AND EMOTIONAL DEVELOPMENT  Your baby will be sleeping for 17 to 19 hours a day on average.  Your baby enjoys being held and rocked.  Your baby will begin to recognise you and their primary caregivers.

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

TINY TALKERS! Language development in the first year is an excellent predictor for future academic, social and behavioural development, so prioritise communication by playing these games with your newborn baby:  Talk to your baby as much as possible in a highpitched soothing voice – ‘parentese’.  Choose several songs and rhymes that you sing to your baby often – every day if possible.  Always respond quickly to your baby’s cries. This is, after all, the first ‘communication’ between the two of you – your baby cries and you respond.

Consistency is important. n

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1 – 4 MONTHS

By the end of 12 weeks your baby will develop the following...

PHYSICAL DEVELOPMENT  When on their tummy your baby should be able to lift their head and chest, looking both ways.  Your baby’s hands are not balled up in fists all the time anymore.  Your baby can focus their eyes on an object and track it as it moves.  Your baby can wrap their tiny fingers around an object placed in their hand.  Your baby will love kicking their legs out and squirming around.

COGNITIVE DEVELOPMENT  Your baby will notice and move their head to different colours and light.  Your baby is attracted to people’s voices.  Your baby will start to investigate the world around them by putting things in their mouth.

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 Your baby will try to reach towards a toy that makes a noise.

LANGUAGE DEVELOPMENT Y our baby will make cooing and gurgling noises, especially when you talk to them or smile at them.  Your baby will cry when they need something.  Your baby will be laughing.  Your baby will start to associate sounds with certain objects.

SOCIAL AND EMOTIONAL DEVELOPMENT  Your baby will start to smile back at you.  Your baby will love playing games like peek-a-boo.  Your baby will enjoy being gently tickled and bounced.  Your baby is soothed by a familiar voice.

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TINY TALKERS! Encourage your baby’s communication skills and give them the best possible start in life!

Playtime Ideas:  Whisper sweet nothings in your baby’s ear without touching them. When they turn towards the sound of your voice, give them a big kiss!  Start to focus your baby’s attention on different sounds: soft, loud, fast, slow and so on.  Now’s the time the start finger and toe songs such as ‘this little piggy’ or ‘round and round the garden’.  Start to develop ‘joint attention’ – the milestone where a baby realises that they can focus on something along with another person. You can start by attracting your baby’s attention to a soft toy: “See the teddy bear? He’s coming to kiss you… Here he comes!” All the while look back and forth between your baby and the teddy so that your baby learns that you can both give attention to the same thing.

Good Ideas:  Play good quality classical music and songs that are associated with specific times of day.

Repeat your baby’s sounds back to them and  encourage your baby to experiment with making sounds – in other words have little babbling conversations to and fro with your baby.  Act as a ‘tour guide’ by giving your baby a running commentary of what you and they are up to “Here is your bottle. It’s nice and warm, isn’t it?

Yes, I know you love your bottle!”  Try to distinguish between your baby’s different cries and act accordingly: “Yes, I hear that you’re tired. Let’s make a plan to take a little nap. I hear you, my love.” n

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5 – 8 MONTHS By the end of eight months your baby will develop...

PHYSICAL DEVELOPMENT

LANGUAGE DEVELOPMENT

 Your baby may start to teeth causing some discomfort and irritation.  Your baby is now working at coordinating their hands and eyes, reaching for objects.  Your baby can hold their own bottle during feeds.  Your baby will be able to sit – supported or not – and will be able bounce up and down on their legs when you support them.  Your baby can turn over on their own.  Your baby may scoot backwards on their stomach; a precursor to crawling.

 Your baby will be babbling in a rhythmic way.  Your baby will recognise their own name.  Your baby can respond to simple one-word requests, such as ‘wave bye-bye’, ‘come’ and so on.  Your baby repeats sounds over and over.

COGNITIVE DEVELOPMENT  Your baby will start to copy facial expressions and gestures, such as waving.  Your baby will focus on an object and reach for it.  Your baby begins to search for objects that are dropped, or ones that are no longer there.  Your baby will most likely only be able to focus on one toy at a time.

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SOCIAL AND EMOTIONAL DEVELOPMENT  Your baby has a strong attachment and preference for you.  Your baby can recognise all their regular caregivers, family and their own reflection in the mirror.  Your baby realises they are separate from you now, so they start to develop separation anxiety and a sense of stranger-anxiety around people they don’t know.  Your baby will respond negatively to a toy being taken from them.

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WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

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TINY TALKERS! Your baby’s ability to communicate will impact on their cognitive, behavioural, social and emotional development – you can prioritise their communication development at home by following these tips!

During Playtime:  Your baby will love action songs and rhymes, finger songs and clapping games such as ‘This little piggy’, ‘Round and round the garden’, ‘If you’re happy and you know it’, and so on.  You can play games of differentiation, where you put two different objects in front of your baby and ask them to pass you one of them – obviously heap lots of praise when they pass you the correct item, and if not, simply say ‘thank you’ and help them pick the correct one. Never punish your baby for an incorrect choice.  Continue to give all objects, pictures and animals sounds as you go along. Your baby simply loves putting sounds to things such as a dog saying ‘woof’ or daddy’s car going ‘vroom’!

Good Ideas:  Remember to sing, talk and read to your baby regularly.  Always name things, people and activities throughout your day.  Talk to your baby in short sentences, slow down and repeat key words over and over again, for example: “It’s time to bath.

You love to bath. Let’s bath!”

Remember: Your baby is now not just learning to listen out for language; your baby is now using language to learn about their world and their place within it. You cannot talk, sing, read or play too much! n

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9 – 12 MONTHS At the close of your baby’s first year they will...

PHYSICAL DEVELOPMENT  Your baby can drink from a cup, even if it’s with a little help.  Your baby starts to use only one hand to reach for things.  Your baby is able to eat finger foods by themselves and possibly even porridge with a spoon.  Your baby can sit up by themselves, unsupported.  Your baby can crawl along flat surfaces and up stairs.  Your baby can walk while being supported by someone else.

COGNITIVE DEVELOPMENT Y our baby imitates your and other caregivers’ movements.  Your baby can point to things they see at a distance.  Your baby is able to respond to simple instructions.

 Your baby will drop a toy when offered a new one.  Your baby understands how to use common objects, such as a spoon for eating and brush for their hair, and so on.

LANGUAGE DEVELOPMENT  Your baby will imitate words and sounds they hear you make.  Your baby will start to say their first words.

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WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

 Your baby is able to say yes and no by nodding and shaking their head.  Your baby starts to interact more verbally.

SOCIAL AND EMOTIONAL DEVELOPMENT  Your baby will try to keep you or their caregiver in sight.  Your baby will develop a favourite toy or blanket.  Your baby will make their feelings known by shouting or pushing.  Your baby will still experience separation anxiety at times.  Your baby may share toys and belongings with other babies.  Your baby understands what ‘no’ means.

TINY TALKERS Your baby’s ability to communicate will impact on their cognitive, behavioural, social and emotional development – you can prioritise their communication development at home by following these tips!

During Playtime:  Your baby will love action songs and rhymes, finger songs and clapping games such as ‘This little piggy’, ‘Round and round the garden’, ‘If you’re happy and you know it’, and so.  You can play games of differentiation, where you put two different objects in front of your baby and ask them to pass you one of them – obviously heap lots of praise when they pass you the correct item, and if not, simply say ‘thank you’ and help them pick the correct one. Never punish your baby for an incorrect choice.  Continue to give all objects, pictures and animals sounds as you go along. Your baby simply loves putting sounds to things such as a dog saying ‘woof’ or daddy’s car going ‘vroom’!

Good Ideas:  Remember to sing, talk and read to your baby regularly.  Always names things, people and activities throughout your day.  Talk to your baby in short sentences, slow down and repeat key words over and over again.

Remember to be on the lookout for your baby’s attempts to communicate verbally or through gesture and always respond with excitement and praise. n

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Is my child developing ‘normally’? ilestones are general guidelines for when your baby will acquire certain new skills, but every child develops at their own pace. Some babies will reach their milestones earlier than others, and this should not be of concern. However, it is also important to be able to notice if your baby is struggling significantly in a certain area of development, which may be due to an underlying cause that needs attention.

A red flag points to a skill that all babies should have by at least a certain point; if they don’t have this skill by a certain point, they could face more challenging delays.

Red flags differ from regular milestones; they are figurative warning flags that should prompt a parent to take action and seek professional assistance for their baby or toddler. Remember: If your baby ever stops developing or regresses at any point, you should take your baby to see a paediatrician.

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By 4 Months  Doesn’t respond to loud noises.  Doesn’t smile at people.

By 7 Months  Still very floppy or very stiff.  Shows no affection to primary caregiver.  One or both eyes consistently turn in or out.  Does not respond to sounds .

By 12 Months  Doesn’t crawl or move along the floor in some way.  Cannot stand when supported.  Doesn’t search for objects that are hidden.  Doesn’t use gestures such as waving or shaking head.  Doesn’t sit steadily on their own.  Doesn’t babble.

WHAT IS EARLY INTERVENTION? Early intervention involves taking action as soon as a possible problem emerges. Years of research and practice have found that the earlier a baby or toddler receives specialised intervention, the easier they will be able to reach their full potential. Early intervention could include medical involvement, help from an occupational, speech or physiotherapist, and support from a paediatrician or nursing sister. It is a holistic, child-centred approach that can only be of great benefit. n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

RED FLAGS

RED FLAGS IN THE FIRST YEAR

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“The moment a child is born, the mother is also born. She never existed before. The woman existed, but the mother, never. A mother is something absolutely new.�

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YOUR BODY AFTER BIRTH Learn more about the first six weeks after birth, also known as fourth trimester...

The first six to eight weeks after the birth of your baby is termed the Peurperium or postnatal period, and is a time of emotional and physical re-adjustment.

Sister Letty-Anne Johnston, Manager of the Netcare Storks Nest at Netcare Park Lane explains what you can expect to be happening with your body after birth.

“This is a time where a mother’s body undergoes physical and hormonal changes that return her uterus to its pre-pregnant state,” she says.

YOUR BODY A pregnancy is a long process and the massive changes a pregnant woman’s body undergoes many physical

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changes during her 40-week journey to motherhood. A healthy diet, adequate rest and moderate exercise, such as walking and postnatal exercises offered by a health professional, will assist with toning and strengthening her body. This in turn will boost her self-confidence. Pelvic floor exercises will strengthen and tone the pelvic floor muscles, which support the pelvic organs.

BREASTFEEDING Changes occur in the breasts during pregnancy; they increase in size and the areola enlarges and darkens. The breasts may even secrete colostrum prior to the birth.

With the delivery of the placenta, the breastfeeding hormones kick in. Placing baby in skin-to-skin contact within the first 30 minutes after birth, gets baby off to a good start with breastfeeding. Colostrum is produced in the first three to five days post delivery, and after this the breasts fill with the mature milk. Initially the breasts may become uncomfortably full and feeding may be painful. However, regular breastfeeding helps to alleviate the discomfort and cold cabbage leaves worn in the bra between feeds help to soothe painful breasts.

There are other products available at your local pharmacy to soothe full breasts. The application of a warm cloth to the breast prior to a feed helps to get the breast milk flowing, softening the area around the nipple and areola, allowing baby to latch onto the breast properly. It is important to ask for assistance when latching baby to the breast for the first time to help prevent cracked and painful nipples. Breast pads may be worn in the bra to prevent leakage. Afterbirth pains due to the contracting of the uterus and a letdown reflex may be felt as the baby starts to nurse. A wellbalanced diet and adequate rest and fluid intake, along with regular feeding, is essential for success.

HYGIENE It is important to keep the vulva and perineum (situated between the opening of the vagina and the anus/back passage) clean and dry post delivery. Sr Johnston explains:

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 The medical staff will do regular vulval swabbing until the mother can manage by herself.  For vaginal tears and stitching (after an episiotomy), a salt bath three times a day will help with healing.

Ice packs to the perineum help to soothe any discomfort.  A caesarean scar needs to be kept clean and dry.

Any oozing or excessive pain could be a sign of an infection. omfortable cotton panties worn with maternity C pads that are changed regularly, will help to prevent infection.  Any signs of redness, swelling, offensive discharge and increased pain should be investigated.

VAGINAL BLEEDING After the birth of her baby a mother will experience heavy vaginal bleeding, with the occasional gush of blood when she is breastfeeding. The flow decreases over the next 10 or so days, also becoming lighter in colour. Some women can bleed for up to six weeks.

Overdoing things during the postnatal period can lead to a postpartum haemorrhage and infection, the signs of which are the return of heavy bleeding, pain and clotting. Fever, pain, swelling and a smelly discharge indicate an infection and the mother should contact her doctor immediately. Normal menstrual bleeding will resume around the second to third month after the birth and later, around six months or more, if a mother is exclusively breastfeeding day and night.

YOUR SIX-WEEK CHECK-UP Most doctors request that a new mother goes for a six-week check-up to have tests done and to see that all is in order, explains Sr Johnston.  The uterus is examined to check that it has returned to its pre-pregnant size and a pap smear is performed to check for any abnormal cells. Pregnancy is a time when the body can be vulnerable due to strain on the immune system.  Caesarean scars and episiotomy wounds are examined for healing and stitches are removed where necessary.

 Any other health concerns are discussed, as well as the different options regarding contraception.

DON’T FORGET… You are a V.I.P. – a Very Important Parent – so you need to take good care of yourself.  Eat a well-balanced diet, drink plenty of water and get adequate rest.  Engage in moderate exercise until your six-week check-up. Walking and swimming are a good start and will help to tone and reshape your body.  Returning to intimacy may take some time due to lack of sleep and physical discomfort, but keeping the lines of communication open and maintaining your sense of humour will help.  Lubrication may be needed initially due to hormonal changes.  Contraception options need to be discussed.  When you are ready, have a night off to reconnect and recharge your batteries.

BELLY BINDING While some women’s bodies seem to pop right back into their pre-pregnancy shape, for many this is not the case. Pregnancy changes your body from the inside out, especially in your mid-section, which has been stretched to accommodate a growing baby.

Belly binding is the practice of massaging and then firmly wrapping your torso and can be done for a few weeks or up to a couple of months. In some cultures, even the hips and upper thighs are wrapped tightly so that all the parts of the body involved in the birth can be supported and allowed to heal.

While belly binding is relatively new in Western cultures, Bopha Isisu (or wrapping the stomach) has been an integral part of life in many global women for centuries. Western medicine is now catching up as doctors are starting to prescribe belly binding as a way to help the stomach muscles and uterus return to their original form. Make your own using any nonstretch fabric such as towels, sheets or scarves or buy a belly wrap. Ensure you choose wisely, because some can cause itching, sweating and discomfort. n

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WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM, WRAPSODYBABY.COM.

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he African custom of ‘confinement’ at first sounds restrictive and punitive, but it is actually an ancient ritual that showers a new mother with abundant relaxation, confidence and the precious time she needs to understand her new baby most intimately. In the West it is called ‘maternity leave’ and both concepts should be celebrated and sanctified as a most important part of welcoming a new life and birthing a new mother.

Celebrating and sanctifying maternity leave.

WHY MATERNITY LEAVE MATTERS At a time when resources are becoming increasingly scarce for everyone, it may be tempting to cut your maternity leave short in order to return to your job and your income. For many people maternity leave is seen as a luxury, but in actual fact it is far more than that – it is a necessity for both mother and child.

WHY CONFINEMENT? Most ancient tribal customs from across the globe dictate a period of confinement for a new mother, and yet somewhere along the way maternity leave has become considered as just a little ‘time off’ – a kind of holiday if you will – and yet the truth couldn’t be more polarised from this ill-conceived notion. Becoming a mother and nurturing a new life is a task of monumental proportions.

It is a journey, a crossing-over and life-changing event with lifelong repercussions. Simply put, maternity leave

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matters because it makes better mothers, who in turn raise healthier and happier children.

The fact of the matter is a newborn baby needs its mother as much as it needs oxygen to breathe, warmth in which to feel secure, and nourishment to survive.

But in order for this mother-child duo to flourish, the mother needs precious time – uninterrupted by work, financial strain and other stresses. Of course, a newborn baby left to the care of another may survive,

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Of course babies benefit from their mothers’ taking maternity leave or observing confinement. However, mothers also benefit from having the time to process biological, hormonal, emotional and physiological changes in order to fulfil her baby’s needs. A new mother also needs to feel safety and security during this period, thereby reducing her risk of becoming stressed, anxious or depressed.

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THE BENEFITS OF TAKING MATERNITY LEAVE

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

THE NEW SCIENCE OF MOTHERBABY BONDING

but certain essential ingredients for its long-term possibilities and development that only a mother can provide, will be forever missing.

And now that research is providing us with a way to see inside a baby’s brain as it grows and develops, it becomes more important to raise awareness around the impact of care in the first three years, which essentially forms the foundation and sets the trajectory for the rest of that human being’s life.

While all babies need essential care – nutrition, warmth, a safe environment and healthcare – new research proves that love is simply the best ingredient when it comes to preventing disease, boosting immunity and enhancing IQ in a newborn baby.

World renowned endocrinologist turned mind-bodymedicine guru, Deepak Chopra M.D., shares in the book he co-authored Magical Beginnings, Enchanted Lives: A Holistic Guide to Pregnancy and Childbirth (Harmony, 2005): “Those hugs and kisses are a force of nature more powerful than ever thought.”

So what is this bonding made up of? Well, lots of cuddling which helps baby to thrive, drinking in that newborn baby smell (yes, literally falling in love with your baby’s smell), enjoying your baby’s smiles and smiling at them in return (there is very little else on the planet that is as heart-warming as your child smiling at you), being quick to soothe your baby (stress is a grave physical burden on a baby) and, for heaven’s sake, slow down and pay your baby the attention they so desperately need.

Dr Chopra explains far more eloquently, “Once your baby is born, all the cells in both of your bodies act in secret synchronicity to create those simple but incredible connections between the two of you. But despite all of the science involved, it’s the power of love – pure and simple – that can protect your child from illness, shape her future relationships, and rearrange her genes to her benefit. In a year or so, when you kiss your toddler’s boo-boo better, she’ll think you’re magical. And the truth is, you are.” n

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FROM A WOMAN TO A MOTHER The transition from being a woman to becoming a mother is more than just crossing a proverbial line in the sand. It is more like a dance – sometimes slow and deliberate, sometimes painful and exhausting, and sometimes utterly incredible. here are very few predetermined steps to this dance, and there is no set playlist either. This dance is unique to each mother and the beat of her own drum, but there are some guiding lights that can make the dance of motherhood more comfortable and stress-free.

1. IT’S ABOUT MUCH MORE Choosing the right gynaecologist or midwife, deciding on a nursery theme, choosing the perfect name… these are things that you may have concentrated on during your pregnancy. However, there is much more to this process than simply growing a baby, it is also about growing you as a mother. It is a journey of continually stepping up, understanding more and going deeper into yourself and your new role. It is not a line that you cross over, one day you’re a woman and the next you’re a mother – rather it is an ongoing ‘dance’.

2. YOU’RE NOT IN TOTAL CONTROL AND THAT’S OKAY Perhaps the most surprising part of crossing from womanhood to motherhood is the loss of control.

Up until your baby is born you decide what you wear, what you eat, when you sleep, when you work, when you play, who you are in a elationship with, who your

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friends are… you control it all, and you’re good at it all.

Then your baby arrives and within hours or days you realise that your life is no longer under your control.

As a mother you don’t sleep, eat, make love, socialise or work in the way that you did before, because it’s not up to you. The reality is you may not even find the time to brush your teeth or hair in an entire day, never mind finish a cup of tea or eat, because your baby’s needs come before your own. It can be a major reality check when you’ve done it all on your own and suddenly you realise that you can’t do this on your own and you actually need help, but you are completely unprepared for how to ask for it, and when it’s offered you’re not sure how to accept it.

3. IT TAKES A VILLAGE No mother should do this alone – many midwives, childbirth educators and nurses will implore new mothers to find support. It is good to be in control of your life, career, relationships and so on, but motherhood is a place where no woman should go it alone. However, this is the reality for many Western-urbanised mothers, no matter their cultural background. Once your baby arrives, you may find yourself in a situation where you feel – maybe for the first time in your life – that you are not coping.

These feelings are completely natural in motherhood, but our expectations as women and the messages we receive from our Westernised societies go against this reality. This leaves new mothers who are essentially no longer in control, tired most of the time, missing their old lives (yes, it’s true) and living with all sorts of guilt for not feeling totally on top of the world.

4. STEP UP AND REACH OUT In an ideal world your family and community look after you as a mother while you look after your baby. But for a number of reasons this is not always possible – sometimes mothers are single, sometimes families are far away, sometimes finances are absent and, even when everything is in place, it can be tough. Becoming a mother is hardly ever easy.

When the going gets tough – and it will for every mom – remember that you are your biggest strength

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5 THIS TOO SHALL PASS Nothing lasts forever, especially not those difficult to remember first weeks and months, when the days and nights can be long and lonely. Avoid comparing yourself to unrealistic constructs of motherhood found in society or the media. While it is completely natural to reach out and want to know if your feelings are normal, only compare yourself and your baby in an environment where you can speak honestly and receive reassuring and truthful feedback; for example a support group or nursing sister. Do not seek advice or assurances in places or from people who are playing a game of ‘pretending’ everything is perfect all the time, because that’s simply not real. And last but not least, remember that the days are long but the years are short.

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REAL MOMS SHARE THEIR STORIES: “My support was my sister, the women at my Bible study group who were several women with children around the same age. We really carried one another’s burdens. Meals also helped in the beginning.” – Karien Prinsloo “I think I was a natural-born mama. Everyone would like help I am sure, but it doesn’t always happen. I had the support of my mother briefly [before she passed away], but otherwise it was just me. It wasn’t until my second-born arrived that I realised how the support of a relaxed family unit makes for a relaxed and contented baby.” – Katie Stone “I needed help. A few of my close friends had babies a few months before me and their guidance was awesome.” – Candace Swemmer “From the moment you meet your baby, love radiates out of you like the sun. But if my mother didn’t wake me at night to breastfeed my newborns they probably would’ve starved. If my partner hadn’t bathed the babies, they probably would’ve stank. If my sister didn’t cut their nails, we’d probably be scarface family. Children are raised by everyone that crosses their paths.” – Rene Kettle Owens n

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

and guiding light, but even you need to find support from people and a system that understands and acknowledges truthfully what it’s like to become a mother. A place you can go and be understood and accepted on your journey into motherhood.

Where you share common values with others and can be honest about your experiences without fear of being judged.

On a practical level, determine how, when and from whom you are going to get support and then put your plans in place. Ask friends to make you frozen dinners, arrange for people to help you with your housework, and find someone you trust to watch your baby while you get some needed rest and rejuvenation.

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MENTAL HEALTH FOR MOTHERS When does a little stress or feeling blue turn into Post Natal Depression (PND)? Learn the strategies of coping and know the signs and symptoms of PND.

eing a new mother and raising a young family is a naturally busy time and it can often feel stressful, which is completely normal. There are certain ways in which you can prepare yourself for these inevitable stresses.

SPECIFIC STRESSORS Stressors are those events that put pressure on a person, causing stress, anxiety or feelings of sadness and worry.

There are a variety of specific and common stressors you may experience simply by virtue of having a new baby in your life that may affect you on a daily basis.

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Stressors For Stay-At-Home Moms As your baby grows older you will start to get on top of the stressors of having a brand new baby, and you may continue to struggle with some of them. But in addition, you may experience: eelings of isolation, which can lead to all sorts of F negative thoughts, actions and feelings of lethargy.  Financial stress may be a reality if you have decided to leave your job and need to get by on one income instead of two. This can lead to marital stress, feelings of insecurity and worry over the future.

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Stressors For New Mom New mothers can face much more stress than usual because their lives, bodies and hormones change dramatically.  Hormonal and physical changes post-birth can be difficult to understand and cope with. You may find you have the ‘baby blues’, are teary or very emotional. You may also be dismayed that your body has not returned to the shape you expected, leaving you with negative feelings about yourself.  Prolonged sleep deprivation is a very real stressor, which makes even the simplest daily tasks that much more difficult, not to mention caring for a new life. You may feel incredibly tired, groggy, and even prone to emotional outbursts when you’ve been without sleep for any length of time.  Marital conflict can rear its head as a new family emerges. Opinions that you and your partner hold close may not always complement each other, and you might find that you are arguing more often than normal.  If you already have a young child, you may be suffering from overwhelming feelings of guilt towards your child, who may not fully understand what’s going on with a new baby in the house.  If your new baby is medically fragile and has health or development challenges, you will be faced not only with a busy schedule seeing doctors, and potential lengthy hospital stays, but you will also be dealing with feelings of confusion, sadness, anger and disappointment.

Stressors For Working Moms Just like stay-at-home moms, you have probably dealt with the stressors of having a brand-new baby, but leaving your baby to return to work brings with it a whole new set of challenges and stressors:  You may feel guilty at some point, at least in the beginning, for leaving your baby to return to work.

You may even feel guilty about being happy to return to your job.  You could feel pressure from your colleagues and managers at work, who may not be sympathetic to the fact that you want to express breast milk, or that you want to use your lunch-hour to call to check up on your baby.  From time to time even the best laid plans fall down, and there will be moments when your car breaks down, your baby is ill and your most important client is arriving for an hour-long presentation that you’ve left at home in your rush to get to work on time. These things happen, and yet knowing that they happen does not lessen the feelings of anxiety and stress when they do.

HOW TO BEST COPE WITH THESE STRESSORS Leon de Beer of the South African Federation for Mental Health (SAFMH) explains that there certain steps you can take to prepare for and cope with these stressors. “We encourage expecting and new mothers to discuss possible stressors that may arise with family and friends who have already gone through starting a family.

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prior to having a baby, “Partners should be supportive of this and willing to give mothers time-out to do this.”

HOW IMPORTANT IS A SUPPORT SYSTEM? “A support system is vital,” says De Beer, and where family and friends are not close by, he recommends joining activity and community groups, attending WellBaby Clinics, or joining your local church. A supportive environment allows a new mother to be heard, to assist her with childcare, advice, or simply lend an ear. This kind of support is very important and can make the world of difference when it comes to dealing with stressors that are part and parcel of this journey.

SIGNS AND SYMPTOMS OF A MORE SERIOUS MENTAL HEALTH ISSUE: De Beer warns that the following symptoms indicate that a mother must see their healthcare provider:  When anxiety or negative emotions become irrational, persistent and prolonged.  When negative emotions are directed towards the baby.  When anxiety or negative emotions interfere with your ability to perform daily tasks such as bathing, eating, sleeping, caring for your baby, etc.  When anxiety or negative emotions manifest in physical symptoms such as panic attacks, heart palpitations, inability to sleep or eat, etc.

“Prolonged anxiety, stress and negative emotions can be very dangerous,” De Beer warns. He adds that mothers need to be aware in the first six weeks after birth of Puerperal Psychosis, which is brought on by post-pregnancy hormones. This can cause new mothers to become psychotic and even harm their baby. “If you are hearing voices, thinking irrational thoughts, or contemplating harming your baby, seek help immediately!” n For help, please contact your local healthcare provider or: The SA Federation for Mental Health: (011) 781 1852, e-mail safmh@sn.apc.org, or visit www.safmh.org.za Post Natal Depression Support Association: SMS ‘help’ and your name to 082 882 0072 and they will contact you, or visit www.pndsa.org for more information.

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

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They should also read as much as possible and get as much information as they can from antenatal classes or clinics,” he advises.

Look for answers and information specifically around sleep deprivation, financial planning, how to cope with a sick baby, marital conflict and any other stressors that are applicable to your situation. “It is also important that you save enough money for your maternity leave,” De Beer urges, and then also suggests the following coping strategies: Marital Conflict – Talk about how you’re going to handle the following as a couple:  Division of attention  Sleep deprivation  Possible coping strategies  Changes to intimacy  Keeping lines of communication open.  Planning practicalities like household chores.  Encouraging sensitivity towards each other.  Arrangements for ‘time out’ when needed.

Stay-At-Home Mothers  Join activity groups.  Visit a local park or play area where there are other mothers.  Meet with friends and family as much as possible (avoid cabin fever at all costs).  Make contact with your local Well-Baby Clinic.

Working Mothers  Create an open discussion with your employer around time-management and maintaining a good work-home balance.  Discuss in advance what arrangements can be made in the case of emergency leave, such as working from home.  Where possible, arrange day care close to work so that you can pop in and check on your baby if need be, and also be as close as possible to your baby in case of an emergency.  Do a thorough background check on the person or facility you have chosen to take care of your baby, as this will increase your confidence in them.  Insist on regular communication with your baby’s caregiver.

De Beer urges all new mothers to create and find opportunities to continue to do what they loved to do

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“My father used to play with my brother and me in the yard. Mother would come out and say, ‘You’re tearing up the grass.’

‘We’re not raising grass,’ Dad would reply.

‘We’re raising boys.’”

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WHY FATHERS MATTER Dads matter because they aren’t moms. That is the simple answer. The more complicated answer is that fathers instinctively do things differently to mothers.

here mothers tend to be more gentle, soft and embracing, fathers tend to be more boisterous, fun and challenging.

Men parent in ways that give their children more freedom to explore and contribute incredible amounts to their children’s development; while it is common knowledge that there are certain things that only a mother can give her child, the truth is now being told of the unique gifts that only fathers are able to impart as well.

YOU MATTER, DAD Fathers’ roles have changed dramatically in the last few generations from one of being purely a provider for their families to now taking a much more active role in daily parenting tasks and responsibilities. It can be overwhelming at times and it is only natural to sometimes wonder if, as a father, your contribution is making a real difference. Is it worth going the extra mile, so to speak?

The answer is an emphatic and resounding ‘Yes!’

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dads matter There are a myriad ways in which your presence as an active father is contributing to your child’s longterm positive development, but there are two ways in which you as a father give your children something that your partner simply cannot.

The first is in the way you play (simple as it sounds) and the second is in what you don’t do.

WORDS: LOREN STOW. SOURCE: CIVITAS (THE INSTITUTE FOR THE STUD OF CIVIL SOCIETY IN BRITAIN). IMAGES: ©ISTOCK.COM.

YOU PLAY DIFFERENTLY Fathers are more boisterous, adventurous and exciting than mothers when it comes to playing with their children – throwing, jumping, rough-and-tumble games, wrestling, unpredictability and loads of laughter. However, when required, fathers are quick to correct behaviour, expect siblings to take turns and encourage independence.

When your child jumps into your arms, you are teaching them trust.

When you build blocks together, you are teaching your child how to solve problems and think logically. When you expect your child to take turns, you are teaching them self-control and social skills. When you run races, you are teaching your child that competitiveness is actually okay, it is good to feel driven by results.

YOU ARE SIMPLY DIFFERENT Fathers are less likely to be their children’s shadows. In other words, they give their children

much more freedom than mothers tend to – to explore their world and get into messes. What turns most mothers’ hair grey is perfectly natural in a father’s parenting skill set. And this is great because when dads parent in this way they teach their children selfsufficiency, self-esteem and skills development. In fact, research even supports the notion that social skills and self-esteem have less to do with mothers’ influence and far more to do with fathers’ influence. Your child will enjoy incredible benefits simply by you doing what comes naturally!

JUST IN CASE YOU ARE NOT CONVINCED… Here is a quote from Dr Kyle Pruett, specialist in child and adolescent psychiatry at Yale University, when he was interviewed on the Evolution of Dad website: “One of the most important things about dad is that he is not mom... and that the world beyond mom really begins with dad. Children who’ve had involved fathers often can take a bigger slice of the world and not be scared by it.

I think one of the other barriers to involved fathering is that society perpetuates this equation in stone – that the distant, productive, ‘bring home the bacon’ father is the only way to really love your children. Children wouldn’t buy into that for a minute! They need to know who this guy is, why he’s in their life, why he loves them, and what he loves about them.

If you want to reduce gang membership, teen pregnancy, dropping out of school, abuse and neglect of children, and substance abuse, you can do it by engaging fathers early and often in the lives of their children.

We know this from the science; we know it makes sense. It’s not easy, but it absolutely works! It works on these problems like aspirin on a headache. And our failure to connect the dots here with what we know is a huge unfinished problem. And our children absolutely deserve for us to stop fooling around and fix this.” n

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WHEN YOU’RE FEELING DOWN, DAD Postnatal depression (PND) is not just experienced by mothers with chaotic hormone changes. International research shows that between 1:10 and 1:25 fathers also suffer from PND, but they often remain silent and embarrassed, trying to force themselves to get over it. he Medical Research Council did a landmark study of over 86 957 families and found that as many as 21 percent of fathers have experienced PND by the time their children reach 12 years.

This makes male postnatal depression a much more common occurrence than many people realise and with studies now also confirming that children (and particularly boys) are negatively affected by depressed fathers, it becomes an even more concerning statistic.

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WHAT ARE THE RISK FACTORS? While all men can potentially develop PND, it is suggested that fathers with a partner who already suffers from PND have a more than doubled risk of developing the condition as well. In fact, some doctors believe that PND in one parent should prompt clinical attention for the other without fail. Other risk factors include:  First-time fathers

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SYMPTOMS OF PND

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

While the symptoms of PND are mostly the same for both genders, in men the onset of PND seems to occur later in the child’s life and their reaction to the feelings of depression often manifests in different ways. Dr Will Courtenay, whom the American Psychological Association has referred to as a leading psychologist in the field of masculinity, explains on his website (postpartummen.com) that researchers are starting to understand that men have symptoms of depression that are unique to their gender.

These include: Unique symptoms:  Increased anger  Increased conflict with others  Increased abuse of alcohol and drugs  Violent behaviour  Impulsiveness  Taking reckless risks, such as having extramarital sex.

Classic symptoms:  Sad mood  Loss of interest or pleasure in life  Weight fluctuation  Sleep issues  Restlessness  Fatigue  Difficulty concentrating and making decisions  Thoughts of suicide or death.

WHAT TO DO IF YOUR PARTNER HAS PND According to the Postnatal Depression Support Association South Africa, getting professional help tops the list, followed closely by talking but holding back on the urge to criticise your partner in any way. Acceptance is very important, as well as to not take anything personally. Calmness, supportive acts and words are also helpful. Lastly, it is important that you take care of yourself as well, as living with a partner who has PND can be difficult.

When it comes to children and even young babies, a depressed parent can have a negative impact.

Children need to be assured that they are not to blame for their parent’s mood, and they especially should not be pulled into the middle of any arguments. The nondepressed parent also needs to ensure that they spend a lot of time with their children, creating happy and relaxed experiences for them.

WILL IT EVER END? Postnatal depression can become a chronic and debilitating condition if not treated. With intervention, it can improve dramatically and even be completely cured. The key is to get professional help as quickly as possible. Many men do not accept that they have the right to feel depressed, or they try their hardest to ‘snap out of it’. However PND is not a choice you make; it is a condition that you develop due to the massive life changes that becoming a father entails. It happens in fathers much more often than any person or expert previously believed, and its effects can be devastating on a young family. It is not a sign of weakness to ask for help. You owe it to yourself and your family. n For further information and support, contact: Postnatal Depression Support Association South Africa: 082 882 0072 or sms your name to the number and someone will contact you back, e-mail info@ pndsa.org.za or visit www.pndsa.org.za.

Postpartum Men: Visit www.postpartummen.com or www. saddaddy.com.

Postpartum Dads Project: Visit www. postpartumdadsproject.org.

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 Older fathers  Less educated fathers  Fathers who are living under tremendous stress  Fathers who have marital or relationship issues with the mother of their baby.

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WHAT WAS SEX LIKE PRE-BABY? A healthy sexual relationship prepregnancy bodes well for a good intimate relationship after baby has arrived. However, an intimate disconnect prior to pregnancy or during pregnancy will make it more difficult to rebuild this part of the relationship once the baby arrives.

Another major impact on post-baby intimacy is whether the baby was planned or unplanned, and if fertility treatment was used.

AND BABY MAKES THREE! While the bulk of the physical and hormonal changes brought on by pregnancy, childbirth and breastfeeding rest on your partner’s shoulders, it is naive to think that a man does not also experience major changes emotionally and socially after the birth of a baby.

For some men their partner’s new role as mother is a turn on, and for others it can flip their erotic switch to the off position, it really is a personal experience.

Then there is the question of attention… It takes a strong and secure man to manage being sidelined, especially if his partner made him the centre of her universe

DAD, LET’S TALK ABOUT SEX Intimacy is one of the most important aspects of a healthy relationship; it is one of the activities that set a partnership or marriage apart from a friendship. It ebbs and flows with life’s changes and one change guaranteed to affect sexual intimacy is the birth of a baby.

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before their baby arrived, and he allowed this. He may struggle to be second in line without a clearcut role in the new tri-faceted relationship between mother, father, and baby. Many men also feel at odds with themselves, wondering if their sole purpose now is to bring home the bacon?

WHAT ABOUT YOUR PARTNER? Of course it takes two to tango when it comes to growing a healthy intimate relationship after your baby is born, so what’s happening with your partner that could affect her ability or desire to be intimate? The all-engrossing task of caring for a young baby is physically, emotionally and mentally tiring. In addition, the changes in her body image and hormone production after birth (especially if she’s breastfeeding) are all serious contenders in keeping her libido lower than low. However the biggest killer of intimacy in a relationship post-baby is if the man is unavailable, still behaves like a bachelor, or does something like taking up a new hobby.

ROLL UP YOUR SLEEVES Believe it or not, helping around the house is a big turn-on for your partner but don’t expect to get back in the sack right away because your partner really needs sleep, so lots of cuddling without expecting any sexual payback is wonderful for her.

Also keep in mind that this cannot start a few days prior to your 6-week ‘free to have sex again’ milestone;

DID YOU KNOW? Undergoing fertility treatments can have an enormously negative impact on a couple’s sexuality and it is completely natural to expect the recovery of intimacy to take time.

it needs to come from a sincere and consistent effort. She will need loving attention, lots of thoughtful compliments on the great job she’s doing as a mom, and support in your new roles as parents… all of this increases her desire for you.

The more you roll up your sleeves,

the more her desire grows. The less involved you are with the new roles of parenting, the less her desire for you will grow.

LET’S TALK SEX Finding the time and privacy to have sex can also be a realistic

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challenge in the long-term after baby arrives, so morning quickies or a quickie while baby is napping often become common. Be careful though to not get into a situation where your partner feels that she’s simply fulfilling a duty, still try to find time to seduce and please her. The key is creativity and celebrating the different landscape of post-baby intimacy. This involves communication, empathy and caring that will encourage your partner to want to make time for intimacy.

QUICK TIPS Remember the following tips for getting post-baby intimacy started again: Take into account whether baby was planned, unplanned or whether you had to use fertility treatment.

Roll your sleeves up and jump into your new role as father.

Understand your partner’s challenges on a physical, hormonal and emotional level.

Be creative and celebrate the different landscape of sexuality during the baby years.

Make the effort to communicate, care and indulge your partner.

Remember, the more involved you get, the more your partner’s desire for you grows. n

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dads matter WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

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There are so many things to think about right now, but have you thought about tomorrow, a year, 10 or 20 years down the line? Your child is a lifelong commitment, one that you will need to honour daily. uring the pregnancy, you and your partner may have shared your dreams for your child’s future. Those were just dreams, and you need to give your child a solid platform from which to launch a life filled with aspirations and achievements.

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dads matter WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

LET THE PLANNING BEGIN… 1. Registering The Birth South African law stipulates that you need to register your baby within 30 days of their birth to get a birth certificate. This will most likely have been done at the hospital, but if you had an alternative birth plan, you need to ensure that this has been taken care of.

2. Draw Up A Will If you do not already have a will, there is no time to waste. Alternatively, you need to ensure that your existing will has been amended. You and your partner need to discuss your wishes regarding the guardianship of your child should something happen to either of you, or both of you. NOTE: Your will needs to be dated and signed to be valid. It is best to have one drawn up for you by your lawyer.

3. Education You want your child to have the best opportunities one day and a solid education will ensure an advantage in a competitive world. Schooling can range from expensive to exorbitant depending on your selection, with further education even more so. You may need to enrol your child now or very shortly into a primary school and this will require a generous deposit. Day care and preschool will follow shortly. Consult a financial advisor and take out an education policy for your child’s tertiary education.

4. Life And Medical Benefit Schemes You need to be prepared for any medical emergency as well as expected day-to-day costs.

If there comes a time when you cannot provide adequately for your family or you are not there at all, you will want them to be taken care of. A financial advisor can tailor a solution to best suit your requirements.

5. Create A Budget You may have never lived according to a budget or perhaps you had a ‘flexi-budget’ each month. Your life has now changed and your baby’s needs come first. Allocate finances monthly for everything that is non-negotiable such as food, medical bills, school fees, clothing and policies to ensure your child’s needs are met.

With a little planning, you can spend more time with your family secure in knowledge everyone has been provided for. n

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SUPERDAD… 3 SUPERPOWERS YOU MIGHT NOT KNOW YOU’VE GOT! Most fathers have the best intentions; they want to be fully involved in their children’s lives.

However, when coupled with life and family responsibilities, the question becomes where do you even start?

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ll fathers have three superpowers that can make the biggest difference to their children’s lives, because they help them to achieve in the three areas that are most important to their children’s development; namely to spend time with their children, to be there for their children, and to take the reins of responsibility for their children. To make it even simpler, the three areas can be summed up as time, presence and accountability.

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dads matter are hundreds of studies, papers and even entire books dedicated to the importance of play in the father-child relationship. Of course, dads play differently to moms, offering more exciting and interactive moments, which their young children just love. The play styles of both parents are so important to a young child’s development, so don’t forget to play with your child in the way that comes naturally to you as a dad.

SUPERPOWER 2: OMNIPRESENCE While it is always first prize to be physically present in your child’s life, when you’re faced with responsibilities that take you away from home, you have the amazing super power of being able to be present even when you’re not there. You may work long hours, or spend days away for business, or perhaps you don’t live with your family for whatever reason. Life happens and it’s important to know that you can still be there for your child. It could be a phone call every afternoon when you’re away at work; it could be a bedtime Skype session; a SMS or a small note in a lunchbox, etc. With some creative thinking, it is totally possible to still foster in your child the absolute belief that you are always there for them. It is about showing that you care, taking time to know your child’s interests and making it crystal clear that they are loved.

WORDS: LOREN STOW. IMAGES: ©ISTOCK.COM.

SUPERPOWER 3: HIGH EXPECTATIONS

SUPERPOWER 1: YOU ARE A PLAYMASTER You can easily achieve in the area of Time if you use your playmaster superpower. Never underestimate the power of play in your child’s early development. In fact, there are some researchers who feel that while mothers impact on their children’s development in a variety of ways, fathers make possibly their biggest contribution through play with their children. There

Fathers naturally have high expectations for their children by systematically applying and imposing rules and expectations. So in addition to taking responsibility for your family in a variety of ways, you also teach your children that they are accountable for their actions. While mothers teach sympathy, care and helpfulness based on their nurturing and overwhelmingly accepting behaviour, fathers stress justice, fairness and duty when they expect their children to behave in a certain way. By putting rules in place you teach your children the objective truths of right and wrong; preparing them for the real world. n

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directory

stork’s nest

NETCARE

directory For a Netcare Stork’s Nest near you:

western cape Stork’s Nest Netcare Blaauwberg Hospital Tel: 021 554 9388 Stork’s Nest Netcare Christiaan Barnard Memorial Hospital Tel: 021 480 6143 Stork’s Nest Netcare Kuils River Hospital Tel: 021 900 6530 Stork’s Nest Netcare N1 City Hospital Tel: 021 590 4196/1

Stork’s Nest Netcare Linmed Hospital Tel: 011 748 6279 Stork’s Nest Netcare Mulbarton Hospital Tel: 011 682 4300 Stork’s Nest Netcare Park Lane Hospital Tel: 011 480 4125 Stork’s Nest Netcare Pinehaven Hospital Tel: 011 950 5400 Stork’s Nest Netcare Sunninghill Hospital Tel: 011 257 2039

free state Stork’s Nest Netcare Kroon Hospital Tel: 056 215 1419

Stork’s Nest Netcare Sunward Park Hospital Tel: 011 897 1732

gauteng, johannesburg

Olivedale Mother and Baby Wellness Centre Tel: 011 777 2176

Stork’s Nest Netcare Clinton Hospital Tel: 011 724 2334 Stork’s Nest Netcare N17 Hospital Tel: 011 365 1573

Stork’s Nest Netcare Waterfall City Hospital Tel: 011 304 6600

gauteng, pretoria

Stork’s Nest Netcare Garden City Hospital Tel: 011 495 5158

Stork’s Nest Netcare Akasia Hospital Tel: 012 522 1192

Stork’s Nest Netcare Krugersdorp Hospital Tel: 011 951 0707

Stork’s Nest Netcare Femina Hospital Tel: 012 304 1781

Stork’s Nest Netcare Linkwood Hospital Tel: 011 485 3250

Stork’s Nest Netcare Montana Hospital Tel: 012 523 3255

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directory Stork’s Nest Netcare Pretoria East Hospital Tel: 012 422 2300 Stork’s Nest Netcare Unitas Hospital Tel: 012 677 8212

polokwane Stork’s Nest Netcare Pholoso Hospital Tel: 015 296 6500

kwazulu-natal Stork’s Nest Alberlito Hospital Tel: 032 946 6956 Stork’s Nest Netcare Parklands Hospital Tel: 031 208 1346 Stork’s Nest Netcare St Anne's Hospital Tel: 033 897 5309 Stork’s Nest Netcare St Augustine's Hospital Tel: 031 268 5008 Stork’s Nest Netcare The Bay HospitalTel: 035 980 6161 Stork’s Nest Netcare Umhlanga Hospital Tel: 031 560 5528

eastern cape Stork’s Nest Netcare Cuyler Hospital Tel: 041 995 9113

rustenburg Stork’s Nest Netcare Ferncrest Hospital Tel: 014 568 4200

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