Our Guide to Babies. Kids on the Coast / Kids on the City Magazine by Shore Media

Our guide to

BABIES F rom bump to birth and beyond

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NEW LEAF IS

branching out! NEW CENTRE ALEXANDRA HEADLAND

Opening in January 2016 with places available from ages 6 weeks to school-age. Contact us to secure a place for your child.

372 Mons Rd, Forest Glen, QLD 4556 Phone 07 5453 7077 Email enquire@newleaf.qld.edu.au www.newleaf.qld.edu.au

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SUNSHINE COAST GRAMMAR SCHOOL A Service of the Presbyterian and Methodist Schools Association

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Our guide to

BABIES F rom bump to birth and beyond Our Guide to Babies celebrates the journey of having a baby and all the joys and challenges along the way. You will find useful information to help you enjoy this adventure…from bump to birth and beyond. From getting the right nutrition during pregnancy to choosing the right caregiver for your pregnancy and baby’s birth, and from feeding your baby to recognising the signs of postnatal depression, our guide has it covered. Make sure you check out our fantastic selection of useful products, books and apps. We’d love you to share your must-have discoveries for pregnancy, birth and motherhood with us via our website.

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36 CHECK THIS OUT & COMPETITIONS - WIN THESE GREAT BABY PRODUCTS 40 POST BIRTH 84 PARENTS TALK: BABY PRODUCTS 86 HANDY BOOKS & APPS www.kidsonthecoast.com.au

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The information contained in this guide is provided for educational purposes only and is not intended to be a substitute for professional and/or medical advice. You, the reader, assume full responsibility for how you choose to use this information. Nothing contained in these topics is intended to be used for medical diagnosis or treatment. Always seek the advice of qualified healthcare professionals for your own wellbeing and that of your baby.

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Contributors Kerryn Anker

Whether it was writing as a young girl, interviewing family members or as a professional journalist, Kerryn has always been passionate about telling stories. These days she is kept busy with her young daughter Saharna, who loves to keep her mummy on her toes. Aside from the rare quiet moments she is able to write, Kerryn also enjoys spending time at the beach with her family, good coffee and laughing with friends.

Megan Blandford

Megan Blandford is a freelance writer specialising in travel, parenting and business features across a variety of online and print publications. Megan lives in country Victoria with her husband, two daughters and a growing collection of animals. You can find more of her writing at www.theplacesyoullgo.com.au

Annaliese Carter

Annaliese Carter is the Club Manager at Snap Fitness Redcliffe. With 10 plus years in the health and fitness industry, Annaliese is a wealth of knowledge and motivation for everyone looking to reach their health and fitness goals. www.snapfitness.com.au/redcliffe/

Belinda Costello

Belinda Costello is a mother of three rambunctious children, a wife and a registered nurse who is currently a stay at home mum. She is a maternity services consumer representative and passionate advocate for womenâ&#x20AC;&#x2122;s rights in childbirth.

Belinda Hopper

Belinda can usually be found at her computer researching, writing, or editing. Otherwise she is likely to be sipping chai tea, engrossed in the next book for her book club. Belinda loves to hang out at the beach with her three girls and cafe-surf with her husband. Her undergaduate degree was in Communication, majoring in professional writing, from UWS. She studied fiction and novel writing with New York Gotham Writersâ&#x20AC;&#x2122; Workshop and in 2015 she completed her Masters in Creative Writing at the University of the Sunshine Coast. Belinda lives by the motto why clean when you can create?

Nik Makim

Nic is a holistic nutritionist, naturopath, yogini and wholefood cook. She established Makim Wellness, a health, food and lifestyle online magazine, because she is passionate about helping others live their life to its fullest potential. The foundation of all her health advice begins with the nourishment of nutritional food and Nic and her team create healthy meals and treats at the Berkelouw Cafe in Eumundi. She is also mum to three children. You can read more at www.makimwellness.com or follow her on Twitter @MakimWellness. www.kidsonthecoast.com.au

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Meg Nagle

In between breastfeeding her youngest boy, chasing after her oldest two boys, blogging and occasionally sleeping, Meg is an International Board Certified Lactation Consultant (IBCLC) in private practice and works with women to help them reach their breastfeeding goals. Meg has a degree in Psychology and was a La Leche League Leader (breastfeeding counsellor) for seven years before becoming an IBCLC. She blogs about all things breastfeeding and has recently written her first book Boobin’ All Day…Boobin’ All Night: A Gentle Approach to Sleep for Breastfeeding Families. www.themilkmeg.com

Dr Tanya Obertik

Tanya is a GP currently working at the Palmwoods Clinic Family Practice and is proud to have recently become involved at the newly built Coastal Women’s Health Clinic on 2nd Ave, Maroochydore, that focuses purely on women’s health. She is also a Royal Australian College of GPs examiner for training GPs. Tanya completed her training in general practice and obtained her diploma of family planning in the UK before moving to Australia in 2009. www.doctorobertik.com.au

Jessica Jane Sammut

Jessica Jane Sammut is a leading writer, editor and journalist for Australian national media and global brands, who is ‘living the dream’ in her little white shack in Noosa with her two mini-me balls of fire, Zac and Finn.

Penny Shipway

Penny Shipway has more than 10 years’ experience as a print journalist in newspapers, magazines and online. She climbed the ranks at News Corp, editing many of the Quest Newspapers in Brisbane, and broke news stories for Australian Associated Press (AAP). Now a mother of two, Penny has shed the fast-paced city life to dip her toes in the ocean, settling on the Sunshine Coast to raise her beautiful girls. She juggles parenthood with freelancing and is writing a novel for tweens.

Cassy Small

Cassy Small is a freelance writer and mamma to a sweet little six-year-old and a feisty four-year-old. A Sunshine Coast local for over 15 years, Cassy loves nothing better than hanging out with the family on a quiet stretch of sand at Kawana.

Michelle Vogrinec

When Michelle is not caring for her three gorgeous boys, Joshua, Jacob and Max, she is Managing Director of GAIA Skin Naturals Australia. Her company’s signature brand, GAIA Natural Baby has become the most widely distributed natural and organic baby skincare range in the Australian market, and is stocked in leading supermarkets, pharmacies, baby stores and health food shops nationally and across the globe. www.gaiaskinnaturals.com

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How to P repare for

Pregnancy by Dr Tanya Obertik www.doctorobertik.com.au

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SO YOU’VE DECIDED IT’S THE RIGHT TIME TO HAVE A BABY. FIRSTLY, CONGRATULATIONS! IT’S A WONDERFUL ADVENTURE TO EMBARK ON. START FOLIC ACID

If you’ve made this conscious decision you’ll be in a great position to get all your ducks in a row and optimise your health.

Folic acid should ideally be taken for a month prior to conception and for the first three months of pregnancy. It helps to reduce the risk of neural tube defects such as spina bifida.

There are many few things to consider at this time – finances, living arrangements, support networks, work and health. I’m going to focus on health.

Generally it is recommended that you take 500mcg each day but there are a few circumstances that more is recommended so speak to your GP. Folic acid is found naturally in green leafy vegetables, legumes, citrus and whole grains and can be bought as a standalone vitamin at the supermarket or pharmacy. I generally don’t recommend that using the expensive pregnancy multivitamins are necessary, but some women prefer to use these.

Before you even start trying for a baby, it is a good idea to pop in to your GP for a chat. They will be able to identify any pre-conception concerns such as the following: • Is your pap smear up to date? Generally a pap smear won’t be done during pregnancy, so even if you fall pregnant easily it will be about a year before your next smear so it’s important that it’s not already overdue.

GET ACTIVE! I’d recommend at least 30 minutes cardio workout three to four times a week. Everyone knows the importance of exercise and this holds true for conception and pregnancy. Maintaining a healthy weight and keeping your body fit and strong will have a profound effect on conceiving, a healthy pregnancy, labour and your post labour time.

• If you’re in a newish relationship it is sometimes advisable to have an STD screen and get anything treated if necessary, as STDs can be transmitted to baby and cause pregnancy or labour complications. • Your GP will also generally arrange for you to have some blood tests. These will also identify whether or not you’re immune to rubella and chickenpox. If you’re not they will discuss your suitability to having these immunisations and if you do, remember that it is recommended that you do not fall pregnant within the four weeks following either of these immunisations.

Don’t overdo it though. Too much of anything is a bad thing. Plus, when you do fall pregnant, remember that your training regime may have to change but should not stop.

LIFESTYLE Start making some lifestyle changes now. Even if you aren’t planning on falling pregnant in the next couple of months, it can be a big challenge to stop smoking, stop your weekend drinking or change your diet. Start making some changes early on to make this adaptation easier.

• If you are on any medications your GP will also review their safety in pregnancy and make changes as necessary. • Any medical conditions should be discussed with your GP to clarify their impact and importance in pregnancy. Importantly, mental health conditions should never be overlooked as the hormones of pregnancy and breast feeding can have a very powerful effect on them.

If you have found out you are pregnant and you haven’t considered any of these aspects, don’t panic. Your body was ready to fall pregnant. Trust in nature. But if we can prepare, then a bit of a helping hand can be a wonderful thing.

Editor’s note: This article was published originally as an online article on our website on August 24, 2015

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Nutrition for

Pregnancy Nic Makim, Naturopath ND www.makimwellness.com

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FROM THE MOMENT I BECAME PREGNANT, MY WHOLE LIFE HAS REVOLVED AROUND SOAKING UP AS MUCH OF MY GORGEOUS LITTLE ONES AS POSSIBLE. THIS REQUIRES ENORMOUS AMOUNTS OF ENERGY WHICH I ACQUIRE FROM OPTIMAL NUTRITION, DAILY EXERCISE AND MY YOGA PRACTICE. FROM A HEALTH PERSPECTIVE, THE NINE MONTHS SPENT IN THE WOMB AND THE MONTHS BEFORE CONCEPTION ARE THE MOST CRITICAL PERIODS OF OUR LIVES. Scientists are increasingly discovering that a mother’s health and nutrition during pre-conception and pregnancy have a profound effect on the health of the infant and that patterns of disease in adulthood can be traced to infant nutrition.

SUPPLEMENTS

BALANCE

• essential fatty acids – omega 3 (DHA) supplementation during pregnancy has been shown to support the neurological and immune development in children, improving hand to eye co-ordination by two years age and with less allergy in the first year of life

I recommend taking a practitioner range of supplements specifically formulated for pregnancy, including: • multivitamin and minerals

A healthy diet may also shape your baby’s food preference later in life. From my personal experience of three blissful pregnancies and clinical experience at Makim Wellness, energy levels and balancing mood swings seem to be the most often asked questions. To maintain energy levels and balance mood swings, enjoy well-balanced, nutritious, low glycemic meals regularly through the day. At each meal try to include:

• high potency probiotic with colostrum. During pregnancy, the need for vitamins B1, B2, B6, B12, C, D, K, choline, folic acid, zinc, calcium, magnesium, phosphate and iron increases. Folic acid plays a vital role in the development of your baby’s organs and tissues, your energy levels, reduction of sugar cravings and may also reduce the risk of neural tube defects such as spina bifida. Good sources of folic acid can be found in barley, beans, eggs, endive, dark green leafy vegetables (spinach, broccoli, Brussels sprouts, kale, spring greens), lentils, liver, sprouts, soybeans, yeast and homemade muesli.

• Protein such as quinoa, nuts, seeds, eggs, cheese, chicken, grass-fed beef, oily fish, legumes, lamb and spirulina • Carbohydrates such as vegetables (especially dark green leafy vegetables), whole grains, quinoa and brown rice • Essential fatty acids (EFA) such as chia oil, chia seeds, flaxseed, flaxseed oil, coconut oil, cod liver oil, evening primrose oil, seaweed, walnut oil, wheat germ oil, olive oil, sardines, mackerel and salmon. EFAs are also associated with reduced risk of high blood pressure in the mother

Vitamin D has been shown to have numerous benefits during pregnancy, including reducing the risk of pre-eclampsia, insulin resistance and gestational diabetes. Vitamin D is also critical for fetal development and immune function. Walk in the glorious sunshine for ten minutes every day to soak up the vitamin D, and enjoy foods rich in vitamin D such as cod, halibut, herring, butter, egg yolk, milk and sprouted seeds.

Research shows that getting a good supply of choline during pregnancy helps restructure a baby’s developing brain for improved performance and improving the memory of adults. To boost levels of choline, eat free-range eggs, beans, chicken, milk, lentils, split peas, wholegrain cereals, yeast, spinach, flaxseed and lecithin. www.kidsonthecoast.com.au

For smooth skin and to help reduce the risk of stretch marks boost zinc levels by eating grass-fed beef,

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brewers yeast, capsicum, nuts, fish, egg yolks, ginger, milk, lamb, sunflower and pumpkin seeds, whole grains and yeast.

optimal nutritional levels. Drink a glass of water and wait ten minutes to curb the craving. Choose organic, local, fresh, unprocessed foods when possible. Light cardio and yoga will help you feel good and keep you committed to a healthy lifestyle.

MORNING SICKNESS Morning sickness may be due to hormonal changes and nutritional deficiencies. To help reduce your symptoms of morning sickness:

WHAT TO AVOID

• avoid an empty stomach by eating small protein meals regularly

• soft serve ice cream and thick shakes

Foods to avoid during pregnancy: • ham and other processed meats

• avoid strong smelling and fatty foods

• cold, smoked and raw seafood, especially oysters

• eat a ginger biscuit, ginger supplement and/or drink ginger or peppermint tea before getting out of bed in the morning

• paté • self-service salad bars or packaged salads, such as coleslaw and pasta salad

• maintain a supplementation program to avoid nutritional deficiencies

• soft cheese, such as brie, camembert, feta, cottage and ricotta

• drink as much as two litres of water – a dehydrated body functions less efficiently • eat iron rich foods such as lean, grass-fed beef and lamb

• liver – although a rich source of iron, liver also contains high levels of vitamin A, which, in excess, can be harmful to a developing baby

• ensure adequate, regular and consistent amounts of sleep each night

• strictly avoid alcohol and cigarette smoking, and reduce or avoid caffeine intake

• effective relaxation is essential – try techniques such as yoga or meditation

• trans fatty acids such as hydrogenated oils – these are in many of the processed foods found in packages, cans and boxes

• maintain a reasonable work and personal schedule

• fish containing mercury such as marlin, shark, swordfish, barramundi, ling, tuna and barramundi

• address chronic pain and/or depression.

CRAVINGS

• commercial fried foods

Sweet cravings may be due to hormonal changes and nutritional deficiencies. Be aware of what you’re craving and prepare alternative foods to satisfy your cravings such as berries and seeds drizzled with a little honey, a green smoothie or cacao and chia seeds, banana with almond butter, a few pieces of quality dark sugar-free chocolate containing raw cacao, oven roasted sweet root vegetable chips or an apple with a slice of parmesan cheese. Keep sugar out of the house and use small amounts of rapadura sugar or honey instead. Eat five small, well-balanced meals and take supplements to ensure you are receiving

• soy imitation foods such as soy milk and soy yoghurt • vegetable oils canola and corn • limit white flour, soft drinks and sugar Stress management techniques, massage, a manageable workload and regular, indulging treats are all important for a healthy pregnancy. Try to indulge in at least ten minutes every day to meditate, lie down or sit quietly to listen and ‘tune in’ to your beautiful body and precious baby. Enjoy, indulge and glow through your pregnancy.

Editor’s note: This article was published originally as an online article on our website on July 10, 2013

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MATER MOTHERS’ PRIVATE BRISBANE AND REDLAND Since 1960, Mater Mothers’ Hospitals have been committed to providing the very best maternity care, delivering more than 10,000 babies each year and welcoming each new baby into the world while supporting every family. As the largest private maternity and newborn service in Queensland, Mater Mothers’ Private Brisbane is second to none when it comes to providing compassionate, leading-edge care. The goal at Mater Mothers’ Private Brisbane is to make the arrival of your new baby as happy and stress-free as possible. That’s why Mater offers a comprehensive selection of exceptional support facilities and services for you and your family. During your stay, you’ll enjoy a family-friendly environment in a specifically designed single ensuite room, complete with day bed for your partner to stay overnight, personal baby bathing facilities and a patient entertainment system with access to the internet and Foxtel and free Wi-Fi on your own device. A contemporary menu, specifically designed by Mater chefs and dietitians for your health and wellbeing, is cooked fresh in-house daily and delivered to your bedside. For those who live in the Bayside area, Mater Mothers’ Private Redland offers an outstanding maternity facility. Located within Mater Private Hospital Redland, Mater Mothers provides you with exceptional maternity care close to family and friends. Mater Mothers’ Private Redland is linked to Mater in South Brisbane and specialises in the care of low to medium risk birthing mothers and babies, and offers many of the same support facilities as South Brisbane. Mater Mothers’ Private Brisbane and Redland midwives work closely with obstetricians to deliver exceptional care for you and your baby. Mater midwives are familiar with the expectations of your obstetrician and communicate regularly with them during your labour and birth to support your individual birthing plan. Following the birth, the midwifery and nursing team will look after you on the postnatal ward. The experienced midwives caring for you and your baby in each postnatal unit are able to provide you with breastfeeding information, assistance and support. If you or your baby have special requirements, your midwife or doctor will refer you to the Mater Mothers’ Breastfeeding Support Centre at Mater Mothers’ Hospital, South Brisbane for a specialist consultation. This Support Centre is also available on a fee-for-service basis to anyone requiring breastfeeding support once you have left hospital. For women with high-risk pregnancies, Mater at South Brisbane offers a state-of-the-art maternal fetal medicine service which provides expert diagnosis and management of complex obstetric cases. If your baby needs extra care after birth, Mater also boast one of Australia’s leading Neonatal Critical Care Units which includes intensive care, high dependency and special care cots. To find out more about what to expect when you’re expecting as well as antenatal and postnatal information for both yourself and your baby, visit www.matermothers.org.au. If you’d like to see more, why not take a virtual tour of the postnatal rooms at Mater Mothers’ Private Brisbane or at Mater Mothers’ Private Redland. www.matermothers.org.au www.kidsonthecoast.com.au

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Private Queensland’s most trusted maternity service

Mater Mothers’ Private is second-tonone in providing compassionate, leading-edge care. Our expert team are here to welcome your precious new family member and, if your baby needs extra care, we also boast one of Australia’s leading Neonatal Critical Care Units. You’ll enjoy a family-friendly and hotelstyle environment with luxurious private rooms including; ensuite, day bed for your partner to stay overnight and personal baby bathing facilities. To book online or view our full list of obstetricians visit www.matermothers.org.au. We look forward to meeting you and your family soon.

The caring continues into your home through our award-winning range of maternity and baby care products, developed by Mater Midwives and Mums.

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Your guide to choosing a

caregiver by Megan Blandford

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IF YOU’RE PREGNANT, CONGRATULATIONS … AND WELCOME TO THE MINEFIELD OF NAVIGATING YOUR MATERNITY CARE CHOICES. In making this first major decision, it’s impotant to realise the difference between an obstetrician and a midwife. While many think them to be similar, they are in fact different fields that fall under the wider umbrella of maternity care. “Obstetrics is a medical speciality, so that’s probably who you want caring for you if you have a medical condition that’s associated with your pregnancy or your labour and birth,” Miller explains. “But it’s a life event rather than a medical event in the majority of cases. Midwives are specialists in providing holistic care for pregnancy in low risk situations, where you don’t require surgical intervention, for example.”

Although the care of you and your baby should, perhaps, be a straightforward plan, the available options aren’t always well communicated by those around you. This can be due to an assumption that you’ll follow a mainstream path, or it can involve some political agendas from those within the health industry. “The main problem we have is a lot of misinformation and misperceptions about the options,” says Yvette Miller, maternal health promotion researcher at Queensland University of Technology. Ultimately, the best thing you can do is be informed about the options available to you and your rights throughout the entirety of your maternity care, from pregnancy and birth through to postnatal care. Your research will be rewarded: with that self-education and informed decision-making comes the security of having made the choice that’s right for you and your family.

Another consideration is the level of maternity and parenting education you feel you’d like to receive. In most cases, this is given to a basic level. “Most women will do just the public antenatal education which prepares them for a birth at a public hospital, so you don’t get any of the extras around water birth or breathing techniques or things like that,” Young says. That may suit you and your partner and/ or birthing partners, or you might like to look into alternative options delivered by midwives, doulas or other birthing educators.

WHO WILL LEAD YOUR CARE? One of your main choices is whether you want your maternity care led by an obstetrician or a midwife. There is no right or wrong answer; rather, it’s a matter of deciding which option best suits your particular circumstances, values and other considerations such as costs.

It’s also worth giving some detailed thought to what will happen after the birth. Miller explains, “Because obstetricians are specialists in the medical experience of pregnancy, once they have a live mum and a live baby that’s the conclusion of their role. They’re not specialists in normal postnatal care, breastfeeding, those kinds of things; they’re specialists in avoiding or treating medical complications associated with pregnancy or birth.” While there are community-based postnatal care options, such as your GP or health nurse, these are up to you to navigate by yourself without any considered transition from one carer to the next.

While your GP is generally your first point of contact when it comes to maternity care, they will direct you to specialised care options. “The GP will refer you to a public hospital or to the obstetrician of their choice,” explains Mary Young from the Sunshine Coast’s Know Your Midwife, a private practice group of experienced midwives, offering continuity of care from conception through to parenthood. This is certainly a time to speak up if you have particular preferences for a particular hospital, obstetrician, midwife or shared care arrangement. “The GP is the gatekeeper to the whole of your maternity care,” says Young. “You have to do the research because unless you start searching or come across another way by word of mouth, the majority of women simply do exactly what their GP says. You need to look for what suits you.”

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Midwifery care may give you a more continuous process. “That settling in, bonding period isn’t really a part of an obstetrician’s job, but with midwifery care it is within their scope of practice,” Miller says.

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If you think you might like maternity care that’s all encompassing, a shared care (sometimes referred to as collaborative care) option could be right for you. This means that you’ll be cared for by an obstetrician as well as a midwife, and is a strong focus of the health system into the future. This covers all bases and is available at many local hospitals.

Young adds that there is a difference between the facts of the legislation and the realities behind them, which midwives are experiencing. “In 2010 it was said that every hospital in the country was to grant visiting rights to Medicare eligible midwives, and that has not happened,” she says. These realities can limit your options somewhat, or at the very least means you need to be rather determined and highly informed if following a less mainstream path.

PUBLIC OR PRIVATE? Your next decision is whether to go through the public or private healthcare system. Both offer various levels of collaborative care between obstetricians and midwives, and some hospitals also offer a birth centre option which can provide a different feel to your birthing environment.

“What’s happened now is that all women, regardless of their model of care, are expected to birth in a hospital,” says Miller, “and that’s the only place where your healthcare provider will have full insurance for the birth.”

CAN YOU GIVE BIRTH AT HOME?

Of course, the cost variance between the private and public options is a major determinant of your access to each service, as is whether you have private health insurance with maternity cover.

Home birthing is an option in Queensland and offers a different experience for parents and babies. Home birth support groups find that women generally choose this option for two reasons, explains Clara Domingo from Homebirth Queensland. “Some women have had a bad experience at hospital and don’t feel like it’s a nice memory, so they’ll do it at home the next time. Then there are women who want to have a space for themselves and to choose who their care practitioner is.”

PRIVATE: You’ll need private health insurance and a referral from your GP in order to access private maternity care. You can choose your obstetrician, and you will need to do some research with your insurer to find out the costs involved.

“It’s an intimate experience,” describes Domingo. “There’s no transition between hospital and home, and your older kids can be there too.” This continuity of your carer between pregnancy, birth and postnatal care is attractive to many parents, as is the choice associated with who your carer is. If you choose to birth at home, you can seek out your own midwife and/or doula – the latter will act as a non-medically qualified supporter during your pregnancy and birth – or opt to not have any medical assistance at all. You have ultimate control, although this doesn’t come without its highly publicised risks if an emergency situation arises or if medical intervention is required.

PUBLIC: Although you do not have the same level of say over who your maternity carer is in the public system, there aren’t any costs involved. There is also the option of private midwives, who can work with obstetricians within the public or private hospital systems in order to give you a more tailored shared care arrangement. This means you can choose the midwife who will see you through the entirety of your maternity care. This can be covered, in part, by Medicare so that you aren’t out of pocket for the entire portion of your maternity care, however your midwife needs to be a Medicare provider in order for this to happen. “There were government changes a few years back whereby private midwives could become eligible and get a provider number so you could claim their pregnancy and postnatal care,” says Miller. These changes – and some pending changes that will see insurance required for home births – have, unfortunately, reduced the numbers of private midwives practicing in Queensland. www.kidsonthecoast.com.au

The idea of giving birth at home certainly isn’t for everybody, but it’s an option that’s important to many. “We should all have the power of choice,” Domingo says. “If you feel safer at hospital, that’s where you need to go, and if you want to give birth at home that should be respected.”

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In this case, it’s a matter of knowing your rights and speaking up in order to gain changes to your care that best suit you. Miller says, “Many women don’t realise you can make a request to change your care provider, even if you’re in the public system.”

At the moment, private midwives can attend home births with the mums-to-be claiming their services on Medicare. This is only the case until late 2016, however. “There are women who want private midwifery care for an out-of-hospital birth, and very soon they aren’t going to have that option available at all,” warns Miller.

Certainly, that sense of needing to know your options and be your own spokesperson throughout your maternity care and the first months of your baby’s life is important. This will give you not just the birth you’re hoping for, but an entire experience that matches with your specific circumstances.

CONTINUITY OF CARE There is a strong push (excuse the pun) towards the continuity of care throughout the stages of pregnancy, birth and postnatal care. This means that the same carer can see you through each of these steps, providing you with someone who knows your history and knows how you’d like to proceed into the next stages.

FURTHER INFORMATION

This is often an ideal situation for many reasons. “It’s important not just in maternity care, but to avoid clinical errors and to make the best care decisions as you move through that pathway,” says Miller. “The communication quality improves with continuity of your care providers as there’s a shared knowledge not just about the clinical aspects of your case but also your values and preferences – they’re all maintained when you have that continuity of care, and good quality decision-making becomes so much easier.”

For more information on Medicare options, visit www.health.gov.au To locate midwives who are eligible for Medicare, visit www.eligiblemidwives.com To find a doula to support you during your baby’s birth, visit findadoula.com.au or do some online research for your local area. SUPPORT ON THE SUNSHINE COAST Know Your Midwife: www.knowyourmidwife.com.au

Of course, nothing is completely black and white, and for some women the continuity of care model isn’t the best option. “Some women involved in our research have said if they’re in the public system they’d actually prefer not to have continuity of their carer because they don’t get to choose their carer,” Miller explains. “If you have continuity of care with someone who isn’t a very good match it can be a disadvantage.”

Sunshine Coast Midwifery: www.sunshinecoastmidwifery.com.au SUPPORT ON THE GOLD COAST My Own Midwife: myownmidwifegc.com Midwives First: midwivesfirst.com.au Coastal Midwives: www.coastalmidwives.com.au

This fits with the current strong focus that health policies have on ‘woman centred care’ – that is, having your care needs (and those of the baby) focused around each individual woman. It’s a concept that’s designed to give you the power of active involvement in your care, and it’s a responsibility you should take seriously. As the National Guidance on Collaborative Maternity Care states: “Important concepts for woman-centred communication include informed choice, informed consent and informed refusal of recommendations for care.”

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Homebirth Queensland: www.homebirth.org.au (Gold Coast support groups run on the second Monday of each month) SUPPORT IN BRISBANE The MAMA Centre: www.mamaqld.com My Midwives: www.mymidwives.com.au Homebirth Queensland: www.homebirth.org.au (Brisbane support groups run on the second and fourth Monday of each month)

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CLICK TO VISIT THE WEBSITES

WATER THERAPY CLASSES FOR BUBS AND BUMPS Swim Fit have partnered with Sports & Spinal Physiotherapy to create Bubs & Bumps, the first ever pre and post natal hydrotherapy class for Sunshine Coast women. Designed by the Sunshine Coast’s leading women’s health specialists, this 45-minute class will help you prepare for the birth of your little one and assist in your recovery after birth. Bubs & Bumps is a fantastic opportunity to nurture yourself and connect with other mums-to-be and mums from the second trimester of pregnancy through until your baby is four months old. The classes are held indoors in a private and very relaxed warm water environment. A maximum of just 12 women per class ensures quality one on one time with the instructor, and allows individual progress to be monitored to ensure the exercises you are prescribed are specific to your needs. Bubs & Bumps classes will commence in November 2015 across all Swim Fit Aquatic Centres. Bookings are essential and class numbers are strictly limited, so contact your nearest Swim Fit centre now to book your spot. Book before the end of October and your first class will be FREE! Individual classes cost $16 or buy a 10-class pass for $140. For the class timetable, visit www.swimfit.com.au COOLUM – 07 5473 9042 NAMBOUR – 07 5476 0455 BUDERIM – 07 5445 6685 COTTON TREE – 07 5443 5601

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Birth Choices...

Vaginal Birth after Caesarean

by Belinda Costello

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SO, YOU HAVE JUST FOUND OUT YOU’RE EXPECTING AGAIN. IF YOUR LAST BABY WAS BORN BY CAESAREAN SECTION, YOU MAY THINK THAT MEANS YOUR NEXT BABY WILL HAVE TO BE BORN THE SAME WAY. WHILE THIS MAY BE TRUE AS THERE ARE NO GUARANTEES IN BIRTH, THIS IS NOT THE ONLY OPTION. A VAGINAL BIRTH AFTER CAESAREAN, ALSO KNOWN AS VBAC, IS ALSO ONE OF THE OPTIONS AVAILABLE TO EXPECTING MOTHERS WHO HAVE PREVIOUSLY HAD A CAESAREAN BIRTH. With 32% of all births in Australia being by caesarean section, many women face the decision about what to do for their subsequent births. So, what are the choices, the risks and the rewards of choosing a VBAC. And why is it so important to some women?

women, however, there are individual specific considerations which may increase the potential harms associated with planned VBAC. Facilitating shared decision making will enable women to make informed decisions about their birth options.

The decision to plan a VBAC can be daunting as women carry with them the emotions and the experience of their previous birth. The success rate of a VBAC is as high as, if not higher than, a vaginal birth for first-time mums. And the chance of a successful vaginal birth is the same for most previous caesarean mums as it is for any other mum, varying from 70 per cent to 90 per cent dependant on the kind of caregiver and hospital chosen. Yet only a minority of women opt for a VBAC.

There is often discussion about the risks of VBAC as there is a slight increase in the chance that a woman’s previous scar will rupture during labour. Currently that risk is believed to be 0.5 percent or 1 in 200 births. The VBAC information page on the website of the Government of Western Australia Department of Health states: The risk of uterine rupture is less than all the other risks for women in labour i.e. Baby not coping with contractions during labour (fetal distress), shoulder dystocia (where the shoulders get stuck after the head is born), postpartum haemorrhage (excessive bleeding after the baby is born) or cord prolapse (where the umbilical cord comes before the head of the baby).

Only about 28% of Australian women who have had one previous caesarean currently choose to try a VBAC. This may be due to fear of not achieving a VBAC or they may simply not want to go through the trial of labour to have it end in a repeat caesarean. Some women are comfortable with their previous caesarean and are happy to choose it again. Whatever the reason for their decisions, women should be supported to make an informed choice to decide on the type of birth they want. The ‘Queensland Clinical Guidelines: Vaginal birth after caesarean section (VBAC)’ released by the Department of Health in July 2015 states:

Having a caesarean increases the risk to mother and baby for every subsequent birth, regardless whether the mode of birth is a VBAC or an ERCS. For most women, having a VBAC is the less risky choice of those two options, as an ERCS carries higher rates of haemorrhage, hysterectomy and placenta accrete in future pregnancies. Having a VBAC rather than a repeat caesarean can drastically reduce the risks to mother and child.

There are infrequent, significant clinical harms with both planned VBAC and ERCS [elective repeat caesarean section]. Findings from a large systematic review concluded planned VBAC is a reasonable and safe choice for most

No birth option is risk free and every woman has different factors that will influence the value she places on each set of risk. Only the expecting mother can decide what is more or less important, as each woman and her previous experience and current pregnancy is

THE RISKS

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the mother’s own skin bacteria, which passes vital antibodies onto the child.

unique. Health care professionals can and should help each woman to go through the relative risks and give her the information she needs to make the choice that best suits her and her particular circumstances.

One great motivating factor in trying for a VBAC is that the mother is far less likely to be separated from their baby, unless the baby requires special help. In comparison, a baby born by caesarean is often routinely separated from its mother at birth. For some, this is just for five minutes while the baby is warmed and dried and a paediatrician does a few checks. For some, this separation is far longer as some hospitals have a policy of not allowing a baby into recovery with its mother unless a midwife is available to care for the baby while the mother is cared for by the theatre recovery staff. This separation can last many hours and can cause great distress for some women.

THE REWARDS There are many reasons for women choosing to attempt a VBAC and it could be to achieve just one or a combination of the following rewards. Since medical induction for a VBAC is contraindicated, most women will begin to labour spontaneously. It is now believed that the baby’s lungs being fully matured is one of the things that starts labour, along with a peak in the love hormone, Oxytocin, and the breastfeeding hormone, Prolactin. Spontaneous onset of labour helps mothers to ensure that their baby is fully ready to be born and assists with bonding and milk coming in quickly. It is for these reasons some women who chose a repeat caesarean may prefer to wait for labour to start spontaneously before going to hospital for a caesarean, thereby allowing their baby to choose its birthday. Of course, sometimes a baby needs to be born before spontaneous labour is able to occur and mothers, being the fierce creatures they are, fight hard to ensure their baby receives the same benefits.

Last but not least, some women experience an immense sense of satisfaction in giving birth vaginally. This is often one of the greatest motivators however is also the quickest thing to be discarded by mothers in the face of anything wrong with their baby and a caesarean section being necessary. Women who feel like this sometimes face judgement for wanting to know what it is like to birth vaginally, yet it has to be acknowledged as a main motivator. I witnessed a conversation recently between two friends and first-time mothers who had both just given birth and were reunited in the postpartum ward. They talked about their births and how no one would have been able to explain to them what birth was like prior to them going through it, and I mused that this is what some caesarean mothers must feel after their births – the sense of not knowing what it is like.

Another reason many women try hard to have a VBAC is so they can avoid major abdominal surgery and be up and out of bed and able to care for their new baby and any older siblings much quicker than they would be after a ERCS. Babies who are born vaginally also have lower rates of admission to the neonatal intensive care unit (NICU) and overall better health outcomes in the long term, with lower rates of diabetes, asthma and obesity. There is currently much research being conducted to understand why this is, however it is generally believed to be due to the way a baby’s skin and gut is colonised with bacteria during the birth. Babies born by caesarean section are usually handled more by hospital staff than those born vaginally, and this is thought to lead to babies being colonised with hospital bacteria rather than

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All caesarean mothers understand what it is to lay down on a theatre bed and accept major surgery for the sake of their baby, so it is fair to say they, like most mothers, are a selfless group of women as a caesarean is no small thing. However, the wistful longing to understand what a natural birth is like can be powerful in many women and the sense of wonder after trying for a VBAC and succeeding can be overwhelming for many women.

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FINDING SUPPORT

• Type of care: Midwifery care is more likely to result in a VBAC than obstetric care. Midwives are the experts in ‘normal’ birth and a VBAC birth is essentially the same as any other vaginal birth with just the slight extra risk of rupture. Midwives are well equipped to observe when a birth requires assistance from other health care providers.

The International Caesarean Awareness Network (ICAN) has a huge amount of information on caesareans as well as VBAC, and countless birth stories that may help women understand their options going forward. There are also many forums and FB groups where women gather to share their stories and gain encouragement and support.

• Spontaneous onset of labour. Whatever option you choose for your next birth after having had a caesarean section, always remember you have choices. Speak with your midwife or doctor to discuss all the available options, look at the resources online and join a support group to explore what is best for you and your baby. Always remember…the choice for your baby’s birth is yours.

There are a number of factors that can help a woman have a successful VBAC, should she want one: • Type of hospital: Public hospitals in general have a higher rate of success for VBACs as they have higher rates of vaginal births than private hospitals. If you have several hospitals in your area to choose from, you may wish to call them to find out their VBAC success rates.

FURTHER READING

• Continuity of care: Women receiving care from the same caregiver the whole way through their pregnancy have a higher rate of VBAC success.

Queensland Centre for Mothers & Babies – ‘Choosing how to birth your baby: A decision aid for women with a previous caesarean section’ www.havingababy.org.au

• Caregivers: Supportive caregivers who are understanding of the emotional needs of a woman who is trying to achieve a VBAC can increase the chances of a successful vaginal birth. www.kidsonthecoast.com.au

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NURTURE YOUR FAMILY’S WELLBEING… NATURALLY Getting back to nature and nurturing our inner selves, loving one another and being an awesome friend or family member is what life should be all about. Inspire Me Naturally offers an extensive range of beautiful items to nurture the health and wellbeing of the whole family, including Himalayan Crystal Rock Salt Lamps and other products such as ultrasonic diffusers, coconut oil products and essential oils. BENEFITS OF HIMALAYAN NATURAL SALT LAMPS If you have ever experienced the air at a waterfall, on a mountain top, at the seashore or after a thunderstorm, then you have experienced the results of negative ions and you know how the air smells fresher and how much easier it is to breathe. Many studies have shown various benefits of Himalayan natural salt lamps. Himalayan natural salt lamps can: • provide relief from hay fever, asthma, allergies and sinus-related illnesses • reduce stress and depression • increase mental alertness and concentration • enhance the immune system • purify the air • eliminate cigarette smoke odours around the home • reduce electro-magnetic pollution • aid in the healing process • create a soothing, relaxing, calming and refreshing environment. HOW DO SALT LAMPS ACTUALLY WORK? Himalayan Salt Crystal Lamps are a natural negative ion generator. Salt is naturally hygroscopic which means it naturally attracts moisture. The interaction of humid air with the surface of a salt crystal releases negative ions. When a salt crystal is heated slightly, it generates negative ions. In order to facilitate this, a small light bulb (usually 7 to 40 watts) or tea light is placed inside a salt crystal. Therefore, it is important to remember that any salt crystal lamps or tea light holders under normal conditions will only generate negative ions when it is warmed by the internal light bulb or tea light. The size of the salt crystal lamp and the conditions of the surrounding area, will ultimately determine the radiant effect of a negative ion discharge. Being made from natural salt crystals, the lamps will never be identical, and fissures and irregularities can naturally be present. For the best quality, best prices and fast delivery, browse the range of products offered by Inspire Me Naturally. www.facebook.com/InspireMeByJaniceFerguson www.inspiremenaturally.com.au www.kidsonthecoast.com.au

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F rom bump to birth and beyond! KIDS ON THE COAST & KIDS IN THE CITY READERS SHARE SOME OF THEIR BABY EXPERIENCES WITH US ON FACEBOOK.

WERE YOUR BABIES OVERDUE, EARLY OR RIGHT ON TIME?

DEARNE: First one 10 days late… Induced... 14 hour labour… Code blue emergency Caesar – daughter, aged 12 – still running late and hard to get moving! Second one (boy, aged 9 now) was going VBAC… Failed 15 hour labour… Code blue emergency Caesar. But at least he was on his due date!

REBECCA: My first was on time but then they got earlier… and earlier. Stupid PPROM and stupid IC. 38, 25, 37, 26, 34 and 31 weeks.

CHRISTINE: 40, 38, 38, 40 and 41+1. Last one was assisted eviction.

your say SHELLY: Two born on their due dates and one emergency Caesar 10 days early.

KEL: I had a prem, one on time due to being induced and one that was two weeks late.

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NANCY: After 42 weeks my little one appeared.

LAUREN: All three exactly six days before due date.

BEC: 39, 39+3 and 39+5.

JOEANNE: Both late. One eight days late and the other seven days late.

DANIELLE: First due date, second two weeks over, third two days early.

ANNE: That’s the only time you are grateful if you have a shorter than average menstrual cycle, coz it means you probably conceived earlier than the tables allow for. Both my babies were born 10 to 12 days prior to my “expected delivery date”.

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WHAT ARE THE ITEMS YOU COULD NOT HAVE LIVED WITHOUT IN THE BIRTHING SUITE? MIRANDA: The shower!

KYLIE: Drugs.

TINA: My doula!

WHAT BABY PRODUCTS DID YOU FIND YOU JUST DIDN’T NEED? AND WHAT WERE THE THINGS YOU COULDN’T LIVE WITHOUT? GAIL: Lots of hugs and love, food – either breast or bottle, home-made veges – he wouldn’t eat stuff out of jars, nor would his sister, dry behind and warm bed. Really, they don’t need much more – all the stuff just is a total waste of money. Nighties, blankets, bonnets, mittens, booties, a pram for a walk and MORE LOVE AND HUGS.

CHARLOTTE: Bumbo! Couldn’t live without the muslin wraps/ burp cloths/blankies – they’re so versatile!

AMY: Change table is one bulky expensive thing I’ll never buy again. I just changed my baby on a mat wherever!

SYNDA: Bumbo and Baby Bjorn Bouncer.

GEN: Didn’t need a Moses basket or a cot, ended up co-sleeping. Didn’t need a baby bath, bathed with me or in the sink. Didn’t need a mini food blender – mine wouldn’t eat my food no matter how well pureed it was. In the end, onesies, nappies and bibs were what I needed most.

KELLY: Three kids later and so many things I may have not needed but did LOVE. Loved my nappy bin! Did need my cot. So many things depend on different children and different parents. I DID NOT need a Bumbo or baby bath for long. I went without a Jolly Jumper (but some parents swear by this for sanity). My first two never had swings but it was a lifesaver for my third! Although I didn’t use their cot mobiles heaps it was precious at certain ages. I would suggest functionality depends on certain people’s needs (basics, helpful functions, or beyond). I would imagine the responses to this question will vary greatly and be quite personal?

CHRISTINE: Couldn’t live without my electric swing while cooking dinner.

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SARAH: My hubby. He was SENSATIONAL!!

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BABIES MAKE LIGHT WORK OF PUMPING… Pumping breastmilk can be a real chore. But Medela’s new award-winning compact double electric breast pump Swing maxi is here to help! Its innovative two-phase expression technology results in more milk in less time. It is perfect for all mothers looking for a simple and time-saving solution. Its double pumping action can help to increase and sustain milk supply, it has a range of vacuum levels and settings to ensure your comfort, and it is easy to use. It is light and compact and can be used with batteries or a main adapter – ideal for use at home or on the go. The Swing maxi costs $449 and is available in all good retailers.

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…STORING AND FEEDING Medela’s Breastfeeding Starter Kit contains a range of products for the breastfeeding mum. Whether a mother is exclusively breastfeeding or additionally pumping, the Breastfeeding Starter Kit is an easy and safe solution to collect, store and feed. It is also easy to sanitise. Each set contains one Calma teat, two 150ml bottles with multi-lid, 12 disposable nursing pads, Purelan 100 nipple cream, one QuickClean microwave bag and five Pump&Save bags. Available in all good retailers. RRP $49.95. Find out more at www.medela.com.au.

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GET CLOSER TO NATURE Tommee Tippee has introduced the Closer to Nature Express and Go system to make life easier for mums who express. The range uses a single pouch to express, store, warm and feed your child, so there’s no need to transfer milk at any stage and you’ll never lose a precious drop. The Complete Breast Milk Starter Set includes two extra slow flow teats, a breast pump adapter set, 20 breast milk pouches, a pouch and bottle warmer, a breast milk storage case, and two breast milk pouch bottles with slow flow teats. The range is available at Babies R Us, Baby Bunting and Big W. Find out more at www.closertonaturebaby.com.au.

PRETTY IN PINK Holster has launched its first super soft, ultra-cute ballet with a pretty pink bow trim for the tiniest of tots. Made from soft PU upper, velour lining and a twill outsole, the adorable style is available in pretty pink and winter white. RRP $24.99. To find out more visit www.holsterfashion.com.

WIN! WIN! WIN!

STICK ‘EM UP! Sticky Bellies are removable stickers that help you record those important milestones with style and ease. Use the stickers to stick on yourself or your baby’s clothing and take a photo that will capture life’s most precious moments, from pregnancy to the first weeks and months of your baby’s life and beyond. Available in a variety of different designs. Sticky Bellies cost $19.95 and are available at Sunshine Coast boutique store Isla and Me www.islaandme.com.au.

YOU COULD WIN SOME OF THESE PRODUCTS!

VISIT THE ‘WIN AND SAVE’ SECTION ON OUR WEBSITE TO ENTER. www.kidsonthecoast.com.au

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CLOSE TO YOUR HEART Carry your little one safe, secure and in style with Chekoh Baby Carriers. They are available in a range of fashionable prints for modern mums and dads. The lightweight, breathable fabrics are designed for the Australian climate and make wearing your baby close, cosy and comfortable for both of you. Available to purchase online at www.chekoh.com.

BREASTFEED IN STYLE The Laila & Spot versatile Cube Tee makes breastfeeding easy and looks great too! The longer length is perfect for over leggings, skirts or jeans, and it is available in two colourways: red, black and white or blue, black and white. It features a ‘second skin’ for easy breastfeeding and a hidden zip pocket. This is a standout piece to bring a splash of colour to your wardrobe. It is made from light breathable viscose/Spandex and cotton/Spandex and comes in sizes small to extra large. The Cube Tee is $55 and available at www.lailaandspot.com.au.

ADD SOME STYLE TO THOSE NAPPY CHANGES The Meister and Me Nappy Change Clutch is an absolute essential for any new mum. It features two internal pockets designed to hold your wipes and nappies, as well as a padded waterproof change mat. These clutches allow you to change your baby anywhere! RRP $49. Available in various prints. See www.meisterandme.com for more details.

IN THE NET If it can nip or sting you, Australia seems to have it in abundance! But help is now at hand for your little ones. The Dreambaby netting products protect babies from bugs including mosquitos and spiders. They also provide a shaded environment when needed for strollers, baby carriers and yards. The Dreambaby Travel System Insect Netting Value Pack is perfect when you are on the go and includes one Dreambaby Stroller and Play-Yard Insect Netting and one Dreambaby Carrier Insect Netting. This handy dual set of insect nets will protectyour little one from nasty insect bites and stings, and provide a more shaded environment for baby. RRP $19.95. For more information visit www.dreambaby.com.au.

AN AWESOME GIFT FOR AN AWESOME NEW DAD The ‘New Dad’ Bloke Box is a unique gift for any expecting father! New dads are sometimes forgotten or get stuck with baby items made for only the mother. The products included are perfect for both dad and baby – your other half will be the coolest dad going around! Items in the box for dad include a camo patterned nappy bag, basic training book Pocket Commando Dad, two earplugs for when he’s off duty, and two nose pegs for those smelly situations! Items for baby include three Sanctum Australia organic products (shampoo, moisturiser, bottom balm), organic baby wipes by WotNot Australia, novelty baby moustache dummy and a unisex baby beanie. Buy one for the new dad in your life from www.blokeboxes.com.au. RRP $150.

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BEST DRESSED BUB Eeni Meeni Miini Moh have created a luxury gift box for newborn babies, featuring the softest natural cottons, delicate trimmings and subtle prints, all beautifully wrapped in the finest of tissue and presented in a signature white box tied with a grosgrain ribbon. With an assortment of newborn gift boxes to choose from, it is easy to select the perfect gift for an expecting parent. Ideal for a baby shower gift or a congratulatory present for a valued team member, a newborn box is guaranteed to be well received and much appreciated. Featuring items from the timeless, unisex Pure newborn collection, with a choice of the ‘Welcome to the World’ or ‘Once Upon a Time’ print. Ranging in price from $125 to $375, these beautiful gift boxes are available from their Brisbane stores or online at www.eenimeeni.com.

MAKE FLIGHT TIME NIGHT-NIGHT TIME Love to travel but dread the thought of your baby staying awake for the entire flight? Fly Babee Sleep Easy Cover can help. It is the first product in the world to address the issues of getting a baby to sleep on an airplane. It blocks out 97% of the light and distraction, is 100% breathable and allows bub to sleep on the go. It also easily attaches to all strollers. Fly Babee featured on Shark Tank and won over investor Janine Allis! RRP $99.95. For more information visit www.flybabee.com.au.

THE COMFORTABLE WAY TO BREASTFEED

DESIGNER BABIES Pappe has a delightful range of designer clothing and accessories for babies and toddlers. From bibs, to wraps, and blankets to adorable knot-hats, you can dress your little one in style. Available in a range of colours and styles. Prices start at $16.95 for their Mossy Mossy Organic Bibs. Their Knipton Waffle Blanket would also make a great present for the new mum at $129.95. For more information visit www.pappe.com.au.

Breastfeeding is a pleasure and you should be able to do it in comfort. The innovative Ergobaby Nursing Pillow helps you maintain the right posture while feeding, increasing the comfort levels for you and your baby. Moulded from solid foam that maintains its shape, the pillow offers ergonomic support for your baby and a tension-free posture for you. Smart contouring positions your baby tummy-to-tummy for a good latch, and aids digestion by supporting your baby’s head above tummy-level. RRP $129. Visit www.ergobaby.com.au for more details.

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Earning your

mummy stripes

UNEXPECTED CHANGES TO YOUR BODY AFTER BUB by Kerryn Anker

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For new mums, information on what to expect when you are expecting normally only extends to your bundle of joy and how you can both navigate through this unfamiliar territory unscathed. But in the haze of the early days you may stop for a second to look in the mirror, wondering where that radiant pregnancy glow went, why your favourite pair of shoes is now one size too small and why earning your stripes has a different connotation now that your body has been stretched to its limits.

Mater Mothers’ Hospital in Brisbane encourages women to move well and get plenty of rest during their pregnancy to help with the recovery of their body post-birth. Reducing excess strain can help protect the tummy and pelvic floor muscles. Sunshine Coast author and mother-of-two Rebecca Mugridge says adjusting to life as a mum was a challenge in itself, let alone dealing with the visible changes to her body after giving birth to her daughters. “My body was very different and I didn’t feel like myself anymore after putting on more than 30kg during my first pregnancy. I felt ugly, overweight and extremely stressed,” says Rebecca.

Expectations and preconditioned imagery of what a woman’s body will look like after having a baby don’t always match the reality, from that belly bump that doesn’t seem to want to budge to shedding more hair than the family cat. Knowledge of what to expect, the longevity of these changes and how to embrace these newfound womanly curves can make the transition into motherhood a little less rocky and the road forward a lot smoother.

“I had this expectation that my body would bounce back, like the celebrities bodies do. I felt this pressure to look like I did pre-pregnancy and was surprised by the many changes that had happened to my body.” After feeling like she was trapped within her own house and her own body, Rebecca decided to start walking with her baby in her pram to get some fresh air and a new perspective. Building back up her confidence with each step she was taking, Rebecca used her personal experience of the changes to her post-birth body to write the parenting book, The Pram Diet.

Obstetrician and gynaecologist Dr Robyn Aldridge says there isn’t a strong focus among expecting mothers to discuss or seek information on the changes that occur to their bodies after birth, with many understandably more focused on the labour. Dr Aldridge says changes in the size and shape of the abdomen, breasts and feet, as well as hair loss and a weak pelvic floor are particularly common occurrences for most women after having a baby.

“Even after all the walking there are still saggy bits on my tummy and stretch marks, but I have embraced these changes and have let go of that image I had of my younger self pre-baby,” Rebecca says.

“It is important for women to expect some or all of these changes and recognise that they are part of the process,” she says.

“I became more realistic that, as a mum, I am going to look different and that my tummy is going to be a little saggy from now on.”

“It will take time to recover, but if you’re worried about any particular ramifications, it is a good idea to discuss them with your obstetrician at the postnatal visit – usually six weeks after birth.”

WHAT GOES UP MUST COME DOWN In life what goes up, in most cases, has to come down. As a new mum, this isn’t something that you expect to relate to your cup size. With increased levels of hormones pumping through the body during pregnancy, many expecting mums may notice that their breasts have gotten bigger. Despite all the stretching and growing the body goes through during this time, some mums notice that they have a smaller cup size, months after giving birth.

A LITTLE EXTRA BAGGAGE Feeling like a so-called ‘yummy mummy’ in the early days is a phrase many new mums don’t feel they can relate to. After the abdominal muscles have stretched and strained over the nine-month pregnancy, what’s left for many women is a little extra, unwanted baggage. www.kidsonthecoast.com.au

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DON’T FORGET THOSE PELVIC FLOOR EXERCISES

Writer and mother Jenn Rian has seen the humorous side to the change in her cup size, creating the hashtag #ThingsThatLookLikeMyPostBabyBoobs. Using everyday items and placing them on her chest to illustrate how her body has changed, Jenn has likened her breasts to such things as deflated balloons and bread dough.

It’s drilled into you from the start of your pregnancy right through to after bub is born, but those simple pelvic floor exercises you do while brushing your teeth actually make a world of difference.

WHEN THE SHOE DOESN’T FIT

Exercise physiologist Esme Soan says 50% of women have some degree (symptomatic or asymptomatic) of pelvic organ prolapse postpartum. She says it is very important to do your pelvic floor exercises every day with 92% of mums with stress urinary incontinence at 12 weeks postpartum still having issues five years down the track.

A big surprise for some new mums after having their baby is the discovery that their favourite pair of heels no longer fit. This is extremely confusing for a sleepdeprived mum who can’t quite work out why all the shoes in her wardrobe have now shrunk. Doctors believe that due to the extra weight and increased looseness of joints during pregnancy, the arch of the foot can in fact flatten out.

“The pelvic floor is a complex web of muscle, fascia and fibrous tissue. It functions to support the pelvic organs and help control bladder and bowel function,” Esme says.

Rebecca says after making peace with all the changes to her body after giving birth to her two girls, she was shocked to discover after her second pregnancy she could no longer fit into her shoes.

“At the end of pregnancy the weight of the baby on the pelvic floor has been found to be equivalent to a 100kg man standing on a trampoline.

“I knew that sometimes your feet swelled during pregnancy, but I was unaware that your feet can increase in size completely and even become wider,” she says.

“Many mothers I see are really keen to get back into shape and exercise after having their baby, but steps should be taken to repair and protect the pelvic floor prior to engaging in any high impact or high intensity exercise.”

“There are all these heels and boots that I can no longer wear. It could be seen as a good excuse to go shoe shopping.”

Esme says five great exercises that are appropriate and pelvic floor safe for pregnancy and postpartum include:

HAIR LOSS During pregnancy, most women are thrilled to witness their hair growing at a rapid rate and, in some cases, becoming thicker. This is caused by an increase in oestrogen levels in the body, which prolong the growing phase of your hair and result in less hair falling out. A pregnant woman will lose less hair on a daily basis compared to what she did beforehand.

• squats (can be onto a chair or with assistance from a Swiss ball) • any aerobic work such as bike, walking, deepwater running, aqua aerobics, swimming, dancing, jogging or whatever you enjoy • wall push-ups

However, once bub is born, it is very common for these luscious locks to shed as the hormone levels in the body drop.

• side planks • belly breathing – inhale and let your belly expand and pelvic floor relax. Then exhale and gently draw up your pelvic floor and imagine drawing your belly button to your spine to engage your lower abdominals.

Doctors find this to be a real concern for new mums who are fearful of going bald. But they assure new mums that this is a temporary phase and should calm down when bub is around six-months-old. www.kidsonthecoast.com.au

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SAFE, COMFORTABLE AND STYLISH CARRIERS

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Personal trainer and mother-of-two Cassandra Porter runs a ‘me time’ mums fitness class in Brisbane, encouraging women to dedicate some time to themselves, nurturing and empowering their bodies.

RESOURCES

Cassandra says the ‘me time’ class is about mums looking after and caring for themselves, while releasing those feel-good endorphins that make you feel calm and relaxed.

Mater Mother’s Private Hospital: www.matermothers.org.au

Dr Robyn Aldridge, obstetrician and gynaecologist (Eve Health): www.evehealth.com.au

Esme Soan, exercise physiologist (Pear Exercise Physiology Pregnancy & Women’s Health): www.pearpregnancy.com.au

“As women, we spend so much time devoted to our children and our family. It’s equally important to look after ourselves as well as feel positive about our bodies,” she says.

Rebecca Mugridge, author: www.authorrebeccamugridge.com

“My body went through so many changes after having my two girls, but I acknowledged that it was all part of the process. At the end of the day you have created this amazing human being – that’s what is most important.”

LINKS

Cassandra Porter, personal trainer (Positive BODY Personal & Group Training): Email positivebodypt@live.com Raising Children’s Network: www.raisingchildren.net.au Pregnancy, Birth & Baby: www.pregnancybirthbaby.org.au

CLICK TO VISIT THE WEBSITES

It is important for women to expect some or all of these changes and recognise that they are part of the process.

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COMMON ailments babies face in their first 12 months by Belinda Hopper IT IS DIFFICULT TO SEE YOUR BABY SICK OR IN PAIN, ESPECIALLY IN THE MIDDLE OF THE NIGHT WHEN HELP IS LEAST ACCESSIBLE. SO HERE’S A LIST OF THE MOST COMMON AILMENTS BABIES FACE IN THEIR FIRST YEAR OF LIFE. This should not replace the consultation and advice of your doctor. Rather, consider it your middle-of-thenight, first port of call in finding out the likely reasons for your baby’s discomfort. Trust your instincts: call an ambulance if you think it’s serious. But be encouraged that in most cases, this too shall pass.

BABY ACNE Around six weeks of age baby’s face can suddenly be inflamed with infantile acne, due to mum’s hormones still coursing through their system. In rare cases, it may be due to a hormone imbalance. Symptoms: Baby’s face appears red with white pimply pustules and blackheads that persist for about a month. Treatment: Avoid thick moisturisers and clean their face with a washcloth, gentle cleanser and running water. It should clear up in a month or so. For prolonged cases, the doctor may prescribe topical medications or refer to an endocrinologist.

COLIC

Symptoms: Around three weeks old, baby starts to scream for about three hours at a time, often starting early evening, until they fall asleep, exhausted. They writhe, clench their fists, arch their backs and even vomit. Treatment: Some babies are soothed by lying tummy-down along your forearm. Speak with your doctor about wind drops, gripe water or probiotics to alleviate tummy problems. Try changing formulas if your baby is formula fed. If breastfed, speak with your health professional about foods you eat that may cause sensitivity. Monitor your baby’s response to stimuli and avoid things that trigger or worsen colic. Swaddle them firmly and create a calm environment with soothing music. Sucking a dummy or thumb helps some babies self-soothe. Colicky babies prefer movement: try a sling or walks in the pram. It’s exhausting caring for a colicky baby, but they still thrive and grow out of it as suddenly as they develop it.

This list shoulde not replace th consultation and advice of your doctor.

Internal discomfit may be due to an immature digestive system, acid reflux because of an immature oesophageal sphincter or sensitivity to food passed through the mother’s milk. In their first month, babies block out their environment to sleep. After that, some develop colic as a stress response to external stimuli.

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high-fibre foods such as pureed prunes, pears and barley cereal, and decreasing low-fibre foods such as bananas and rice cereal. A bottle of water with liquid from boiled prunes can help. Give your baby tummy time or crawling time, and lay them on their back and move their legs. If increased fluid and fibre doesn’t help, the doctor may prescribe a mild laxative, suppository or enema.

COLDS Babies’ immune systems are immature, making them vulnerable to the 200+ viruses that cause colds. Symptoms: One of the first symptoms is nasal congestion. The mucus might start out clear and then turn yellowish or green. Sniffily noses, fevers, persistent coughs and loss of appetite are common. Treatments: Babies under three months with a fever above 38 degrees need to be seen by a doctor immediately, preferrably in an emergency department. There are a variety of serious infections which can be life threatening in young babies. Babies need a lot of fluids when they have a temperature, but a blocked nose makes it hard to feed. Fifteen minutes before feeding, turn on a vaporiser with a few drops of menthol or eucalyptus oil to let the steam clear their nasal passages. Put a few drops of saline in one nostril at a time and use a syringe to suction out the mucus. Cough and cold medicines should not be given to babies. Ibuprofen can be given for fever to babies over 3 months old (please refer to the dose on the bottle based on your child’s weight), however please seek medical advice as soon as possible.

CRADLE CAP

CONSTIPATION

Diarrhoea is when bowel motions are watery instead of formed. Viral or bacterial infection, parasites, antibiotics or food allergies are known causes. The danger is dehydration from fluid loss, so look out for lethargy, dry eyes, dry mouth and fewer wet nappies.

Cradle cap is a yeast crust that forms on a baby’s scalp. It’s a dermatitis that develops between one month and two years, because mum’s hormones still in baby’s system overstimulate their oil glands. Symptoms: It may present as a light smattering, or the baby’s head may be covered with waxy scales stuck to their scalp in hues of yellow, orange and pink. Treatment: Massage some olive oil into their scalp every few days and wash it out with mild shampoo. Never pick the scabs off, as this can lead to permanent bald patches. Use a soft baby hairbrush to sweep away dry flakes. The doctor may prescribe medicated shampoo in severe cases.

DIARRHOEA

It is normal for breastfed babies to pass a bowel motion anywhere from 10 times a day to once a fortnight. Formula-fed babies usually pass a bowel motion every day. If babies on solids have not used their bowel for three days or their daily stools are hard and difficult to pass, they are constipated. If it hurts to push, the less likely they will try. A buildup leads to a misshapen colon, which reduces the sensation of needing to go, affecting their long-term ability to pass a bowel motion unassisted.

Symptoms: Baby’s bowel movements suddenly become more frequent and take on a sloppy consistency. They may have increased thirst and a loss of appetite, a temperature or abdominal cramps. Treatment: List what your baby has eaten in the previous 24 hours. Note changes to their diet that may have caused the diarrhoea. Keep fluids up and their diet bland. Yoghurt helps to replenish their gut flora. Track the frequency of diarrhoea to monitor fluid loss and don’t introduce new foods until it has passed. Your doctor may prescribe an electrolyte solution to help rehydration. Your baby requires medical attention if they have a high fever, bloody diarrhoea, abdominal pain, vomiting or weight loss.

Symptoms: Most constipation starts when solid foods are introduced. Watch for blood in the nappy, which suggests a rectal fissure caused by a hard stool. Baby may have a hard or painful lower abdomen, be restless and cranky, or cry when they strain to pass a motion. Treatment: Constipation is due to dehydration and a lack of fibre. If your baby is formula-fed, try different brands. Monitor diet and fluid intake, increasing www.kidsonthecoast.com.au

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- Post Birth -

Trust your instincts: call an ambulance’s if you think it serious.

EAR INFECTIONS Ear infections are common because the Eustachian tube between baby’s ears and throat is flat, allowing fluid to accumulate in the middle ear, producing a culture for germs. The infected fluid presses on the eardrum, producing intense pain. Symptoms: Baby may pull their ears, become restless or cry in pain, especially when lying down or feeding. They may also develop a fever and diarrhoea. Treatment: Give ibuprofen for pain and fever (for babies over 3 months – refer to the dose on the bottle based on your child’s weight). Feed in an upright position so formula or milk cannot enter the ear canal. See the doctor if you suspect an ear infection as they may need antibiotics. Recurring infections may require a simple ear grommet surgery.

ECZEMA Eczema is a genetic skin irritation and sensitivity that results in dry, inflamed, itchy skin that usually develops on a baby’s cheeks, neck, underarms, elbows or behind the knees. Babies who develop eczema have a greater risk of developing allergies and asthma.

NAPPY RASH A baby’s skin is vulnerable to irritation, especially when trapped inside a nappy rubbing up against urine and faeces. The chemicals in soaps and creams used to clean and moisturise their bottom may also contribute to a persistent, painful nappy rash.

Symptoms: Eczema presents as a red, inflamed, itchy rash that may be dry and scaly, crusty or weepy, particularly if it has been scratched or rubbed. It usually shows up around the three-month mark as dryness on the cheeks and may slowly develop on other parts of the body.

Symptoms: A red, painful rash around baby’s genitals, anus and bottom cheeks that may develop little white pustules.

Treatment: Trim baby’s nails so they can’t scratch. Use warm water and gentle cleansers. Apply fragrance-free cream or natural ointments such as pawpaw on the affected areas once dry. Feeding and drooling can irritate sensitive skin. Dab on pawpaw ointment before feeding and bedtime. In severe cases, the doctor may prescribe an antihistamine or topical treatment. Massage in Emu oil for a natural antibacterial remedy. www.kidsonthecoast.com.au

Treatment: Check your baby’s nappy often and change it as soon as you notice it’s soiled, leaving enough room for some airflow. Use fragrance-free wipes and smear a zinc-based barrier cream on each time you change their nappy. Use soap-free washes in the bath to maintain their PH balance. Gently pat your baby’s bottom completely dry after a bath. Lay them on a towel without a nappy and let them kick freely for 15 minutes each day.

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TEETHING

your Use this list as ight, middle-of-the-nll in first port of ca ely lik finding out the ur reasons for yo rt. baby’s discomfo

Every baby experiences teething differently. Some have no symptoms while others are out of sorts for months. Baby’s first tooth can appear as early as three months and as late as twelve months, but the norm is around seven months. Symptoms: Common teething symptoms include drooling, rashes on the cheeks, biting or chewing, refusal to feed, sleeplessness, general irritability, tugging at ears and crying. Teething may cause bleeding under the gums, which presents as a bluish lump. Some babies develop low-grade fever. Treatment: Cold teething rings and wet washers can provide something to bear down on to alleviate sore gums. Babies like cold, soft food when their gums are sore. Amber teething necklaces are not recommended as they pose a choking hazard. Topical teething gels numb baby’s gums for temporary relief.

URINARY TRACT INFECTION (UTI) Babies develop urinary tract infections (UTIs) when bacteria enter the urinary tract or from blockages. UTIs are an inflammation and infection that may affect any part of the urinary tract. UTIs are more common in boys than girls and more common in noncircumcised than circumcised boys.

WIND Babies tend to gulp down air with their milk, trapping it in their tummy and causing discomfort.

Symptoms: Sometimes a fever is the only symptom. Other symptoms include unexplained crying or irritability, crying when urinating, cloudy or bloody urine, diarrhoea or odd-smelling urine. A boy’s penis may become red and swollen.

Symptoms: Baby may stop feeding before they are full to writhe and cry in discomfort. Treatment: Breastfed babies have less wind as they have better control over milk flow. You can help bottle-fed babies by holding them upright and tilting the bottle up so there is no air in the teat. After every feed hold your baby over your shoulder and massage their back to encourage them to burp. Or try sitting them up, their chin resting in your hand, or lay them across your lap. Have a cloth handy as they may bring up some milk with the air.

Treatment: Newborns are usually hospitalised for treatment with IV antibiotics. Take your baby to the doctor if you suspect a UTI, as it can lead to longterm damage of the kidneys, even kidney failure. Your doctor will obtain a urine sample to determine the correct antibiotic and may suggest an ultrasound, x-ray or scan to rule out blockages and conditions that require corrective surgery. www.kidsonthecoast.com.au

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Breast, Bottle,

Both? by Cassy Small

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PERHAPS THE MOST BASIC OF REQUIREMENTS FOR YOUR BABY CAN OFTEN BE FRAUGHT WITH A MIXTURE OF CONFUSION, FRUSTRATION AND GUILT. WE’VE SIFTED THROUGH THE BOTTLES, BOOBS AND BREAST PUMPS TO EXPLAIN YOUR OPTIONS FOR FEEDING YOUR BABY. BREASTFEEDING

getting enough milk. The ABA advocates feeding on demand and observing signs of hunger as opposed to following feeding schedules. “A baby’s tummy is approximately the size of a clenched fist, so it will need to be fed little amounts at regular intervals. It’s common for young babies to be fed up to 12 times over a 24 hour period,” says Dr Griffiths.

The original food source since the beginning of time, breast milk is perfectly designed by nature for human infants. The benefits of breastfeeding are vast and research has proven its ability to build resistance to infection and disease as well as reducing the risk of allergy and food intolerance. The Australian Breastfeeding Association (ABA) is Australia’s leading authority on breastfeeding and responsible for education and support for mothers throughout their breastfeeding experience. ABA spokesperson Dr Maya Griffiths says that the official recommendation is for mothers to breastfeed their baby exclusively for the first six months. The World Health Organisation furthers this by saying that breastfeeding should continue until the age of two. This is a statement that the ABA also supports.

“Is my baby getting enough” is a common question asked by breastfeeding mothers.

“From birth, the colostrum that a baby receives in breast milk is vital for their health and contains antibodies which fight infection. An older baby benefits from breastfeeding due to the fatty acids which are unique to breast milk and assist in brain development. You simply can’t replace that in formula,” Dr Griffiths says.

• Gaining weight and generally alert and active.

The following signs indicate that your baby is receiving enough breast milk: • Breastfeeding frequently – at least 8 times over 24 hours • Plenty of pale, wet nappies – at least 5 disposable or 68 cloth nappies in 24 hours • Two or more soft bowel motions a day Sometimes despite the best of intentions, things don’t go to plan. The serene image of a mother breastfeeding her child is one that’s ingrained in many of us. The reality, as many mothers discover, can be quite different. “It’s important for new mothers to remember that breastfeeding is a learned skill,” says Dr Griffiths. But she reassures that support is on hand for mothers who are having problems with breastfeeding. “It’s vital to get the right help as early as possible.”

It’s not just the baby that benefits. Breastfeeding mothers release relaxing feel-good hormones that help in bonding with baby. Research also confirms that breastfeeding assists in post-pregnancy weight loss, can prevent osteoporosis and reduce the risk of developing breast and ovarian cancer.

Support options include the ABA 24 hour help line 1800 mum 2 mum (1800 686 268), email counselling via the ABA website (www.breastfeeding.asn.au), group meetings and home visits. “Lactation consultants will often visit twice daily in those first few days to establish a good pattern with breast feeding,” she says.

The breastfeeding relationship between mother and baby is one of nature’s miracles. Your baby and your own body are hardwired to know instinctively what to do. Your breasts make milk in response to your baby’s sucking. The more milk the baby takes, the more milk you make. This is sometimes the solution for mothers concerned about their baby not www.kidsonthecoast.com.au

Other common problems experienced with breastfeeding include tongue tie, breast refusal and inverted nipples,

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and Dr Griffiths confirms that with the right support many of these problems can be overcome.

nutrients such as Omega 3 and probiotics,” he says. The other major ingredient in formula is protein and this can consist of cow’s milk-based whey protein or casein. Formulas that are whey dominant or even 100% whey are often advised for younger babies as they are easier to digest and can limit common side effects from formula use such as constipation.

Breastfeeding in public is a topical issue with instances of mothers being banned from public places reported in the media. “It’s unfortunate that the sexualisation of women’s breasts can interfere with public opinion on breastfeeding and in turn effect a mother’s decision to breastfeed her baby,” says Dr Griffiths. Whether to breastfeed in public or not is the personal decision of a mother and according to the Sex Discrimination Act 1984 “it is illegal in Australia to discriminate against a person either directly or indirectly on the grounds of breastfeeding.” While for some, private mothers rooms provide the safe place desired to breastfeed while out and about, the ABA suggest that as experience with breastfeeding grows, mothers will be more confident about their decision to do so in public spaces.

Dr Lapsys adds that formula-fed babies often consume a greater volume of milk when compared to breastfed babies. “With breastfeeding you can never be fully certain the volume of milk the baby is receiving. Formula is much more controlled and some babies who have been upset and unsettled may suddenly sleep better or be generally happier once that volume is increased,” he says. Parents are faced with a confusing array of options when selecting a formula for their baby. Marketing claims on the tin can all be subtly different and there’s much to consider. Often it can be a case of trial and error in finding the right one for your baby. As your baby changes, so does its nutritional requirements and it’s important that your choice of formula transitions through the various stages. Parents are urged to seek advice from their doctor or child health consultant.

INFANT FORMULA Infant formula is the only alternative for young babies who aren’t receiving breastmilk. The decision to formula feed is a personal one and can be due to a variety of medical or social reasons. Some women, despite their best attempts at breastfeeding, are simply unable to provide adequate nutrition for their child from breastfeeding alone. The Infant Nutrition Council is the peak body for the infant formula industry in Australia and New Zealand and is responsible for education and the regulation of the formula industry. “We know that breastmilk is best, but if a baby doesn’t get breastmilk then it’s important they have a scientifically proven substitute,” says CEO Jan Carey. Parents can be reassured that the nutritional needs of their children can be fulfilled by infant formula. “Formula is the most regulated food product in the Australian market,” says Jan.

The decision to formula feed is a personal one and can be due to a variety of medical or social reasons.

“Infant formula is designed to mimic the profile of breastmilk,” says clinical dietician Dr Naras Lapsys. “Formula contains a good profile of oils, calcium and a significant component of carbohydrate. Some fortified formulas may also be supplemented with additional www.kidsonthecoast.com.au

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- Post Birth -

While some mothers are physically unable to breastfeed, some prefer bottle over breast for more personal reasons. Stella is a mother of two who decided from birth that breastfeeding wasn’t something she was comfortable with. “Although I had my reservations, I tried breastfeeding my first baby. But we had problems latching on so I had him on formula from then. I also expressed for the first five months. For my second baby I knew straight away I didn’t want to breastfeed and came to hospital prepared with my bottles,” she says. Stella suffered a lot of guilt over her decision and was on the receiving end of criticism from hospital staff and friends. “My children are older now and I don’t regret my decision for a minute. They’re happy, healthy kids and performing really well at school. To feel like you love your children less because you formula fed them isn’t fair,” she says.