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Sleep and exercise during pregnancy
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Pregnancy symptoms 8 A practical guide to healthy eating during pregnancy
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Keeping fit during pregnancy
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Baby steps along the way The stages of pregnancy
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Managing morning sickness
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IVF: What you need to know
One in six Australian couples suffer
What is in vitro fertilisation (IVF)?
from infertility. It’s important to
IVF is where hormones are given to stimulate a woman’s
remember not everyone who is having trouble conceiving will need to undergo IVF (in vitro fertilisation). 4
Parenting Insights | 2019
natural egg production. A doctor steps in at the right moment to extract the eggs. These are then brought together with sperm in a laboratory dish (rather than a woman’s fallopian tubes) to create embryos.
The embryo grows under laboratory conditions for five days, to
performed to remove a few cells from the embryo before it’s
the stage where it is called a blastocyst. This is the ideal time to
transferred to the woman to make sure that an embryo with
transfer the fertilised embryo back to a woman’s uterus.
no detectable chromosomal abnormalities is placed back into
IVF has helped thousands of couples fall pregnant, however there is no guarantee it will work for everyone.
the uterus. It doesn’t change the embryos you’ve got but it’s a way to know which ones have a normal chromosomal make up and therefore are more likely to give you a healthy baby.
When should you seek fertility help? If you’re over 35 years old and you’re not falling pregnant
How can you increase your chance of IVF success?
naturally within about six months of trying, you should consider
The best way to increase your chances of conceiving a baby
seeing a fertility specialist. If you’re under 35, it’s recommended
either naturally or with IVF, is to avoid leaving it too late. A
you try for a year, unless you have any health concerns like
woman’s fertility starts to decline significantly by the time she is
pelvic pain or irregular periods.
35, so it’s ideal to start trying before then.
Having trouble conceiving doesn’t automatically mean
Your health – and your partner’s health too – are also really
you need IVF. Talk to a fertility specialist about your individual
important. Touching base with your GP for a general health
situation and they will investigate why you’re not falling
check, eating a healthy balanced diet and exercising regularly
pregnant. The doctor might arrange some tests for both of you.
can boost your chances of conceiving.
About a third of the time when a couple are having trouble
If you’re overweight, it’s a good time to make some lifestyle
falling pregnant it can be due to a sperm problem. The doctor
changes. Smoking or taking illicit drugs can also reduce your
will arrange for a sperm test to analyse numbers and function.
chances of falling pregnant so it’s best to quit if these are things
Women are usually asked to take a blood test to make sure
you currently do.
ovulation is normal. An ultrasound to check the uterus and ovaries may also
For men, alcohol intake of more than two standard drinks a day can affect sperm quality so it’s important to moderate your
be needed to check for any cysts or abnormalities that may
drinking. Try for at least two to three alcohol-free days a week.
affect fertility.
For women it’s a good idea to minimise alcohol intake when you’re trying to conceive. No amount of alcohol has been proven
How successful is IVF?
to be safe during pregnancy, so you’re advised not to drink at all
IVF can be very successful for some couples, but again, one of
while you are pregnant.
the main factors is a woman’s age. If a woman is in her 20s or
If you have any ongoing medical conditions like asthma or
early 30s the chances of an embryo, known as a blastocyst, taking
diabetes, it’s important your condition is well managed, and there
in her womb is about 50 per cent. For women in their late 30s it’s
are asthma and diabetes medicines that are safe to use if you are
a bit lower at about 40 per cent. When a woman is over 40, the
trying to conceive, or are pregnant.
chances drop to around 25 per cent for each embryo transfer. Fortunately with IVF a lot of couples do get more than one embryo (blastocyst) formed in the laboratory. If you have more
Significant emotional stress can also affect a woman’s period cycle and can impact on your chances of falling pregnant. Trying to conceive naturally can be a time of ups and
than one healthy blastocyst you can freeze the remaining
downs, and IVF for many couples is an emotional journey too.
embryos to try again if implantation is unsuccessful, or to
Melbourne IVF recommends where possible to plan when you’re
achieve a second pregnancy. Embryos can freeze well and over
going to do IVF, to ensure that it’s at a time in your life which
90% will usually survive being thawed out, and their pregnancy
is relatively stable if possible. Couples who undergo IVF have
potential is about the same as using a fresh embryo.
to attend mandatory counselling and Melbourne IVF also has
If IVF isn’t successful the first time, the first option is to use any frozen embryos. If a couple aren’t pregnant after using their
supportive counselling as some couples need help along the way. Overall, the objective is to ensure you’re as healthy as
frozen embryos the next step is to see their fertility specialist
possible, both mentally and physically, not only to help with
again to go over their treatment. It’s really an individual approach
conception, but to maximise your chances of having a healthy,
and their IVF cycle can be tweaked to meet the needs of the
uneventful, uncomplicated pregnancy.
couple to ensure their best possible chance of conception. One of the other options is a more advanced IVF process known as advanced embryo selection. It’s where a biopsy is
Article courtesy of Bupa and Dr Scott Pearce, a senior specialist in Infertility & IVF, Gynaecology and Obstetrics 2019 | Parenting Insights
5
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Sleep and exercise during pregnancy Have a bad case of the yawns? There’s a reason for your tiredness. You’re building another whole person, and it’s taking a
3. Relax
lot of your energy. As your pregnancy progresses, you may have
• Sleep problems can be linked to anxiety, which increases as
little energy for exercise and find it hard to get a good night’s
the birth approaches. Make the most of antenatal classes to
sleep or you may find the opposite.
prepare yourself and help you relax; • Raise your concerns with your healthcare practitioner
5 ways to re-energise
– knowing the answers to common questions can make
Follow these practical tips to stay fit and overcome fatigue.
you feel much more confident and relaxed.
1. Exercise regularly • Certain exercise is generally safe during your pregnancy – it’s a great way to relax and will help you prepare for
4. Manage your sleep • Nap during the day. Even if it’s only a catnap of 15 minutes,
what lies ahead in child birth. Consult your doctor
cuddle up under a rug and let yourself drift off. Don’t worry
before starting any new regime;
– this won’t stop you sleeping at night;
GEt• Find an activity you enjoy and build it into your schedule; • Try doing a pregnancy pilates or pregnancy yoga class – these can help tone and strengthen those specific muscles you’ll be using during birth and with a newborn; • Swimming is a great pregnancy exercise as the water supports your growing belly comfortably and you can adjust your pace to suit the stage of your pregnancy; • Take a brisk walk before dinner. This will also help you
• During the later stages of pregnancy, sleeping on one side with a pillow under your tummy and one between your knees may help you sleep better; • Go to bed at regular times; • Make sure that your bedroom is tidy and well ventilated, as this will help you sleep and breath easy; • If these solutions don’t work, talk to your healthcare practitioner.
relax and make it easier for you to sleep; • Don’t strain yourself – it’s perfectly safe to exercise provided you don’t push yourself too hard; • Stay within weight gain guidelines. The heavier you are, the more tired you’ll feel.
5. Manage your diet • Eat frequent, small meals. They’ll give you energy all day. Choosing lighter meals will make it more comfortable as your room inside dwindles as your baby grows bigger; • Power lunch. Try a sliced chicken breast or a bowl of split-pea
2. Manage your activity
soup that’s high in iron and protein and won’t let you down in
• Pull up a chair. Whether on the job or doing household
the middle of the afternoon;
chores, take a seat when you need to, don’t overdo it; • Prioritise activities and cut out nonessential chores; • Reassess your socialising and ask family and friends not to call late in the evening. Explain that you’re trying to get plenty of rest before your baby arrives; • Try to do restful activities just before bed. Try a bath, a massage, reading or a walk in the garden or around the
• Snack smart. Try dried fruit or fortified cereal for a carbohydrate boost. Nuts and fresh fruit contain modest amounts of essential fats and carbohydrates that fuel the body; • Avoid rich or fatty foods and stimulating drinks such as caffeinated soft drinks. Instead, opt for water, fruit and vegetable juices or fruit smoothies to keep you hydrated and energised healthily.
block. Avoid falling asleep in front of the TV or spending a lot of time online.
Article courtesy of Nestlé Start Healthy Stay Healthy For more information on pregnancy health and nutrition, visit starthealthy.nestle.com.au 2019 | Parenting Insights
7
Pregnancy symptoms For many women the ‘diagnosis’ of pregnancy follows a few weeks of wondering, “Am I pregnant?,” due to a range of small signals that things are changing in your body. For others, the changes occur much later and for a lucky few they travel through the whole journey wondering what the fuss is about. Midwives and other care providers often spend a good portion of their consultation time discussing the many signs and symptoms of pregnancy trying to allay concerns and describe what is normal.
Early days through the first trimester (12 weeks) Women who have been pregnant before often experience an “ah-ha” moment, noticing smells are different, or that they have an unusual taste in their mouth. The most obvious sign is that a period is missed with sore breasts, a common pre-menstrual sign, often continuing signifying some of the hormonal changes occurring in pregnancy. Wearing comfortable clothes may help to relieve the tender feelings. The other very common issue is extreme tiredness until it generally improves after 12 weeks. Tiredness in these early stages can be difficult to explain when trying to conceal a pregnancy, and may only be relieved by many day time naps and early nights. A few other early issues include: • Frequent urination – as your baby grows in the early stages the pressure of the uterus has an impact on the bladder causing feelings of a frequent need to pass urine • Nausea and vomiting of pregnancy (Morning sickness) – hormonal and blood flow changes contribute to this very common problem which is often challenging to deal with. Small frequent meals and at times complementary therapies such as ginger and acupuncture can help but medication is also occasionally needed • Vaginal blood loss – any blood loss should be reported to your care provider, but this is a common complaint in the first trimester
The middle period During the second trimester women often look and feel much better and appear to bloom. For the unfortunate ones where morning sickness continues during this period, they often also end up experiencing a number of other digestive problems: 8
Parenting Insights | 2019
• Constipation – can start due to the bowel slowing down
blood loss or gushes of fluid from the vagina. During this period
in digesting food
it is also important to consider what the baby within is doing
• Heartburn, indigestion and reflux – less room for the stomach and again slowed digestion
and to observe that baby is moving and that the overall level of movement at the same time each day is reasonably consistent.
• Haemorrhoids – from dilated blood vessels and straining to use the bowels
A last obvious and common issue is abdominal cramping, which can occur as Braxton Hicks contractions (that occur in late
Other problems during this period include bleeding gums,
pregnancy and early labour) increase as the body gets ready for
bleeding noses, leg cramps, sore joints and restless legs.
labour to start. These cramps, including period like pain and back pain, are very common even before labour starts but need to be
The home stretch – 28 weeks until birth
discussed with your care provider.
The list of common discomforts in the third trimester is nearly
Whilst pregnancy is a time of excitement and joy, some
endless as pregnancy impacts nearly all the organs in the body
of the symptoms discussed can have an impact on a woman’s
and hormonal changes are extensive. Mentally women often
ability to enjoy this special time. A good care provider
start to become a little more anxious and frightened about
who listens and provides some active solutions to the
what is to come. As baby grows the uterus puts pressure on
common discomforts is a really invaluable addition to your
many parts of the pelvis and back pain is very common. The
pregnancy journey.
growth of baby varies so, of course, the issues that occur also vary markedly. The problems of the early and middle part of pregnancy are often magnified and unfortunately as sleep is
Article courtesy of
disturbed women start to feel very weary. Unusual symptoms should be discussed with your care provider including headaches, visual disturbances, itchy skin and rashes, vaginal
Liz is the Managing Director of My Midwives and the Pregnancy Babies & Children’s Expo Midwife in Residence. She has been a midwife for almost 30 years.
EXPO MIDWIFE IN RESIDENCE
Discuss your
Pregnancy & Newborn queries and concerns with our very own PBC Expo Midwife in Residence Liz has almost 30 years experience in helping to deliver babies, but more important than that, she is passionate that every woman feels informed, safe, respected and cared for during this special time in her life. Look out for Liz’s dedicated stand at our Expos along with her unique antenatal classes presented daily.
2019 | Parenting Insights
9
A practical guide to healthy eating during pregnancy
E
ating well when you are pregnant is important — a balanced diet, plus a supplement that contains folate and iodine is
essential. Following a healthier lifestyle is a positive change you can make at this time. You might like to start thinking about a general health overhaul as well as following a nourishing diet, getting more exercise, quitting smoking (if you smoke), and cutting back on alcohol. These are all helpful changes for you to make for both your health, as well as for your growing baby.
What should I be eating? Folate Folate is needed for healthy growth and development. Taking folate reduces the chance of neural tube defects (e.g. spina bifida) in your baby. It is recommended that women trying to conceive take an extra 400 µg/day of folic acid. The best way to get this is from a supplement. It is important to take this at least one month before and three months after you become pregnant. You still need to eat foods that contain folate. Rich dietary sources of folate include green vegetables, fruit, and fortified cereals. Iodine Iodine is a nutrient we need in very small amounts. It is part of thyroxine, a hormone of metabolism, growth and development. We need more iodine when pregnant and breastfeeding. This is for growth and development, especially of your baby’s brain. Mild iodine deficiency can lead to subtle cognitive and neurological problems. Studies show that the Australian population is mildly iodine deficient. How much iodine do I need? • pregnant women need 220 micrograms of iodine (also written as µg) • breastfeeding women need 270μg • all women should take a supplement with 150μg during pregnancy and breastfeeding. How can I include iodine in my diet? • regularly include fruit, vegetables, fish and iodised salt in your diet • these days breads and cereals are made with iodised salt, and some pregnancy and breastfeeding multivitamins – be sure to check the label.
10 Parenting Insights | 2019
Morning sickness Most women suffer from sickness early in their pregnancy. Iron
This is usually due to hormonal changes of pregnancy and can
The amount of iron you need increases during pregnancy. Good
affect you at any time of the day. Symptoms usually disappear
dietary sources of iron include red meats, fortified breads and
or become much milder by around 16 weeks.
cereals, green leafy vegetables, legumes and some nuts. You
Some tips to help you manage your morning sickness include:
can help your body absorb more iron from non-meat sources
• eating small amounts every two hours as an empty stomach
by including Vitamin C rich foods at the same meal e.g. tomato, capsicum, citrus fruits and kiwifruit. It can be hard to get enough iron from your diet. An iron supplement could be useful and may be recommended by your
can cause nausea • avoiding smells and foods that make you feel worse • eating healthier carbohydrate foods such as dry toast, crackers, breakfast cereals or fruit
dietitian, midwife or doctor.
• eating fewer fatty and sugary foods.
Fish, omega-3 and mercury
Listeria
Fish is an important part of your diet. It is an excellent source
When you become pregnant, it is important to be careful with food
of protein and is low in saturated fat. It also has high amounts
that might be contaminated with Listeria. These bacteria move into
of omega 3 and is a good source of iodine. However, a small
the placenta and can cause premature birth or miscarriage.
number of fish contain higher amounts of mercury. Food
Foods that might carry Listeria and should be avoided include:
Standards Australia New Zealand has set the following guidelines
• raw/ uncooked /smoked meat and seafood,
for safe fish intake during pregnancy and women planning a
ready to eat chilled seafood
pregnancy (1 serve = 150 g):
• deli meats, cooked cold meat, pate, meat spreads
• one serve per fortnight of shark (flake) or billfish
• leftovers (more than 24 hours after cooking)
(swordfish / broadbill and marlin) and no other fish
• pre-prepared salads, smorgasbords, buffets
that fortnight
• unpasteurised milk and soft serve ice cream
OR
• soft cheeses (brie, camembert, ricotta, feta, blue).
• one serve per week of orange roughy (Deep Sea Perch)
Hard cheeses like cheddar and tasty are safe processed
cheeses, plain cream cheese and plain cottage cheese
or catfish and no other fish that week OR
• two to three serves per week of any other cooked fish and seafood not listed above.
are fine if purchased sealed and stored in the fridge • unwashed raw fruit and vegetables • raw eggs or foods containing raw or partially cooked eggs.
Caffeine
It is easy to make safe choices by following these tips:
Limit drinks containing caffeine during pregnancy. Cola,
• freshly prepared and cooked foods have low levels of bacteria.
Mountain Dew soft drink, tea, coffee, chocolate, chocolate-
Bacteria grow over time, so avoid eating food if it has been
flavoured beverages, cocoa and guarana energy drinks all
made more than 24 hours since being prepared. Always
contain caffeine. It is best to not have more than three serves per day of these food and drinks.
reheat to steaming hot • raw fruit and vegetables should be washed thoroughly before eating
Alcohol There is no known safe level of alcohol intake during pregnancy. Alcohol crosses the placenta and can lead to physical, growth and intellectual problems in some babies. It is recommended to
• Listeria is destroyed in normal cooking, so freshly cooked hot food is safe if eaten straight away • even those foods listed above that are higher risk can be eaten safely if heated above 74° C for over two minutes.
avoid all alcohol during your pregnancy. Article courtesy of Mater Mothers’ Hospitals For further information on healthy eating during pregnancy, visit matermothers.org.au
2019 | Parenting Insights
11
Keeping fit during Pregnancy Exercising and maintaining your
Caesarean deliveries have not been shown
fitness during pregnancy is vital, not
to offer protection against incontinence in
only for helping your body handle the
the long term if the pelvic floor muscles
extraordinary stresses and demands of pregnancy and childbirth, but
have been affected during pregnancy. The good news is incontinence can be prevented or cured in most cases, with
Pelvic floor muscle exercises work best
to help your physical (and mental)
health professionals recommending pelvic
in conjunction with other daily healthy
recovery afterwards. This article offers
floor muscle exercises as the first line of
bladder and bowel habits, such as
an overview of how to exercise safely
defence (Fritel, et al., 2010; Price, et al.,
drinking up to two litres of fluid (preferably
during pregnancy, and where to go for
2010). These exercises are important for all
water, especially if you are breastfeeding),
men and women, but particularly pregnant
eating a healthy, balanced diet, and
women and women who have had a baby.
undertaking regular exercise to maintain
further information and /or help.
Pregnancy and the pelvic floor
a healthy weight.
prepare to be inundated with stories –
So how do I exercise my pelvic floor?
primarily bad – about stretchmarks, reflux,
Pelvic floor exercises can be done
How do I exercise and maintain my fitness during pregnancy?
swollen ankles and the lack of decent
anywhere, seated or standing.
Regular exercise during pregnancy is an
When you announce you are pregnant,
maternity wear. What you won’t often hear though, are the stories of women losing control of their bladder and wetting their pants. It is
1. Visualise a muscular sling as the floor
essential way of helping your body handle
of your pelvis running from your tail bone
the increased demands on your joints,
to your pubic bone.
muscles, heart and lungs.
2. Lengthen your spine and relax
Regular exercise (at the right intensity)
something women should be told given
your shoulders. Focusing on your back
can help reduce back pain, improve or
research shows one in three women who
passage, lift and squeeze upwards and
maintain muscle tone, reduce leg cramps,
have ever had a baby will wet themselves
inwards as though you are trying to avoid
swelling and constipation, and improve
(Chiarelli, Brown, & McElduff, 1999), and the
passing wind, then bring that pelvic floor
sleep patterns. Women who exercise
more babies you have, the more likely you
lift through to the front, as though you are
regularly often feel better about themselves
are to leak urine.
also trying to stop the flow of urine.
and their changing body during pregnancy.
And while incontinence should not
3. Lift and squeeze your pelvic floor
be considered normal or a natural part of
for as long as possible. Aim to hold for
having a baby, pregnancy can lead to its
three seconds initially, building up to 10
Ideal exercises during pregnancy (if no complications)
onset due to several factors.
over time. Make sure you breathe normally
• walking
One such factor is the production of
throughout and ensure your shoulders,
• low impact aerobics
the hormone relaxin, which softens the
buttocks, thighs, hands and feet remain
• water aerobics
tissues in your body, allowing them to
relaxed.
• pregnancy exercise classes
expand as your baby grows. It also allows
4. Rest your pelvic floor for the
• cycling (on a stationary bike)
your pelvic floor to stretch during birth.
same amount of time as your lift, before
• swimming (freestyle not breaststroke)
The softening effect of relaxin,
repeating. Aim for three to five, or even
• light weight training (see your fitness
combined with the increasing weight of
10-second holds in one set. Repeat twice
your baby places pressure on your pelvic
more throughout the day.
instructor for assistance with your program)
urinary leakage. The pelvic floor muscles
or relax, or if you want to make sure
Exercises to avoid during pregnancy
and ligaments, which help to keep the
you’re using the correct technique,
• heavy weights
bladder shut, are also stretched at birth and
make an appointment with a continence
• bouncing – especially star jumps,
can be permanently lengthened.
professional.
floor muscles, makes you more at risk of
12 Parenting Insights | 2019
If you can’t feel your muscles hold
or similar activities
• contact sports
• high impact or jerky movements
• any activities or exercises
• prolonged bouncing, as this can
The Foundation has also written a booklet,
overstretch the pelvic floor muscles.
that cause pain • excessive twisting and turning activities • exercises that require you to hold your breath
The Pregnancy Guide, a FREE resource
Remember that pain or shortness of
for women and health professionals
breath should not be felt at any time.
available in hard copy or downloadable
STOP exercising and seek advice from
from the Continence Foundation of
your doctor or midwife if you experience
Australia website.
any of the following:
• exercises that involve standing on
The Pelvic Floor First website pelvicfloorfirst.org.au has further
• dizziness, faintness, headaches,
one leg for a period of time
blurred vision, nausea or vomiting
• pushing off with one leg at a time when
information on safe exercises, as well
swimming – try to push off with both
• any kind of pain or numbness
as more detailed information on pelvic
feet when turning
• discomfort or feeling extremely tired
floor muscle exercises and causes and
after you have exercised
• excessive breaststroke at the end of your pregnancy, as this puts stress on
symptoms of incontinence.
• vaginal bleeding, contractions, leaking
your pelvis • prolonged standing, static exercises
Women can also phone the
of amniotic fluid (the water around your
FREE National Continence Helpline
baby), or reduced movements of your baby.
on 1800 33 00 66, which is staffed by continence nurse advisors who can
e.g. standing still and doing arm weights • highly choreographed exercises or those that involve sudden changes in direction • lifting your hip to the side while kneeling on your hands and knees
Where can I get more information?
offer advice, resources and referrals to
The Continence Foundation of Australia,
local clinics.
in conjunction with The Pregnancy Centre, has developed a FREE Pregnancy Pelvic
• activities involving sudden changes in intensity
Floor Plan app, which guides women through safe exercising during pregnancy
• exercises that increase the curve
Article courtesy of Maria Whitmore Continence Foundation of Australia and The Pregnancy Centre continence.org.au
and the maintenance of bladder and
in your lower back
bowel health.
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13
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Preventing food allergies I
ntroducing solid foods to your baby is a very exciting milestone. These days however, with the rise in food allergy this excitement
is often tainted by anxiety around food allergy possibly occurring. This, combined with lots of new research and therefore many changes to recommendations, can confuse parents about the best way to move your baby from first mouthful to family foods. The following is an up to date summary of what every parent needs to know. It is not fully understood why allergy, especially food allergy, has increased so quickly in recent years, particularly in young children. Allergy prevention information is important to parents, and rightly so. In Australia, recent studies show that 8% of infants have an immediate food allergy and that severe reactions (anaphylaxis) have increased fourfold in the last 14 years. The reason for this is a complex mix of lifestyle, environment, and genetics. No single causative factor has been identified. There are many studies on allergy prevention underway. Starting with pregnancy, mothers are manipulating their diet hoping to reduce food allergy risk for their child. This is not supported by research and it is recommended that a varied and healthy diet is consumed during pregnancy and while breastfeeding. A mother restricting her diet to prevent food allergy in her infant is not supported by research. Being cautious with dietary restrictions is important as inadequate nutrition in a pregnant mother can cause poor growth in babies and is not recommended. The age of your baby’s first mouthful is one of the most studied aspects of allergy prevention. Despite evidence not yet informing an optimal time, starting to introduce solids between 4-6 months is currently recommended. Continue to breast feed whilst introducing solid foods if possible.
Recent research has allowed new recommendations to be adopted to reduce allergy risk. The full version of these guidelines can be found via the Australian Society of Clinical Immunology and Allergy (ASCIA – allergy.org.au). Common allergy causing foods should be introduced before 12 months. This includes well cooked egg, peanut butter and other tree nut pastes, cow’s milk (dairy), soy, sesame, wheat, fish, and other seafood. Once introduced, give these foods to your baby twice or more per week to maintain tolerance. Introducing a food, then not giving it regularly may result in food allergy development. Commence iron-rich foods as one of the first foods (e.g. rice cereal). Foods can be introduced in any order, texture and at a pace that suits your baby. The common allergy causing foods should be introduced along with fruits, vegetables, and grains when the family are consuming them. Trialling a new food every 2-3 days will enable you to identify whether your child reacts to that food. If your baby does react to foods as they are introduced, seek medical advice. For those diagnosed with food allergy, the only current treatment is avoidance of that food. A medical practitioner or accredited practicing dietitian (APD) will assist with advice to avoid certain foods if needed. Article by Lauren Gladman Accredited practicing dietitian (APD) specialising in infant, child and adolescent nutrition for 13 years. Mum to Isla (5 years) and Finn (3 years), with baby number 3 due in January 2019. Courtesy of Baby Mum-Mum rice rusks BabyMumMum.com.au
14 Parenting Insights | 2019
Baby steps along the way The stages of pregnancy
W
hether you are pregnant for the first time or an experienced mum, every pregnancy will be unique. A normal pregnancy lasts between 37 and 42 weeks, usually an average of 40 weeks, with the weeks of pregnancy divided into three sections (or trimesters). But what’s going on inside your growing belly during this time? Here’s what usually happens to you and your developing baby from day 1 to delivery.
First trimester Weeks 1 to 12 You – During the first trimester, pregnancyrelated hormone changes can affect your whole body. When you are pregnant, your womb doesn’t shed its lining as it normally does at the end of your menstrual cycle, so you won’t have a period. So for some women, a missed period is the first sign of a pregnancy. As well as a missed period, you might have other early symptoms of pregnancy, including: • tender or swollen breasts • needing to pass urine more often • tiredness due to hormonal changes • nausea and vomiting (morning sickness) • feeling bloated • mood swings • food cravings or aversions. Not all women have all of these symptoms Your baby – In the first trimester, your baby’s body and organs develop quickly.
By the time you are 10 weeks pregnant all your baby’s body parts are present, if not quite fully developed. There will be a heartbeat, and tiny fingernails on tiny hands, and a face with a profile. Your baby gets nutrients from your blood through the placenta, while waste products from the baby are returned to your circulation to be removed from your body. By the time you are 12 weeks pregnant your baby is about 60 mm long. At this stage, your baby’s forehead grows with the developing brain, the ears are forming, and the eyelids are still sealed shut to protect the developing eyes. The baby is also able to make a fist as its muscles and nerves start to work together.
Second trimester Weeks 13 to 27 You – Your pregnancy will start to show during the second trimester although exactly when this happens varies from woman to woman. Any sickness or nausea usually gets better by the time you’re 16 to 20 weeks pregnant. You may get backache, hip pain or pelvic pain because pregnancy hormones cause your ligaments and tendons to relax, and your posture may change as your baby grows. You may first feel the baby move around 18 to 20 weeks, but this varies between women and may be a few weeks earlier if it’s not your first pregnancy. The movements become much more vigorous and obvious as the baby gets bigger and stronger. Your baby – In the second trimester, your baby’s organs grow larger and mature, muscles continue to form, and the skeleton starts to harden. The baby’s kidneys start to work and pass small amounts of urine. By 19 weeks your baby is more active, is able to hear, and is covered in fine hair called lanugo. Your baby now has eyebrows and eyelashes; toenails have formed and unique footprints and fingerprints. By the end of the second trimester, your baby has a chance of surviving if born prematurely, but would need
Sources Australian Government Department of Health. Healthdirect. Pregnancy birth and baby [Online] [Accessed Jan 2015] Available from: pregnancybirthbaby.org.au womenshealth.gov Office on Women’s Health. US Department of Health and Human Services [Online] [Last updated Sept 2010, accessed Jan 2015] Available from: womenshealth.gov © Bupa Australia Pty Ltd January 2015. This information is intended as a guide only and should not be relied on as a substitute for professional medical advice. Bupa Australia Pty Ltd is not liable for loss or damage you suffer arising out of the use of or reliance on the information, except that which cannot be excluded by law. Consult your physician or other medical professional if you have questions.
16 Parenting Insights | 2019
intensive care. If you have a scan at this stage, it’s often possible to find out the baby’s gender.
Third trimester Weeks 28 to 40 You – This is the home stretch as many women give birth around 39-40 weeks. Braxton Hicks contractions (practice contractions) can start in the second trimester, but are much more likely in the third. These can be mistaken for labour but the difference is that real labour contractions will continue to occur regularly. Braxton Hicks contractions only last about 25 seconds. You may find at this time that the extra weight you are carrying can make you tired. You may also get breathless as your expanded womb makes your lung capacity smaller. Some women have trouble finding a comfortable position to sleep in. As your abdomen and breasts grow, you may get stretch marks. These are harmless and usually fade after the baby is born. Towards the end of your pregnancy, generally from 37 weeks onwards, your baby ’engages’ by moving into a ‘head down’ position into your pelvis, getting ready for delivery. This can cause pressure on your bladder and you may need to pass urine more often. Your baby – Your baby’s lungs mature throughout the third trimester and by 32 weeks your baby is much more likely to survive if born prematurely. Your baby makes breathing movements, even though the lungs don’t work properly until birth. Your baby gets bigger and bigger as it stores fat in preparation for life outside the womb. Your baby loses the lanugo, grows fine hair, their eyes can open and close, and their teeth may start growing under the gums. By the end of 37 weeks the baby is considered full term, and the baby’s organs can function on their own.
Finally… Delivery day! The cervix will begin to get thinner and softer and open (dilate) to prepare for delivery. You may feel sharp pains as the cervix dilates and the countdown to the birth of your baby begins!
Article courtesy of Bupa bupa.com.au
Managing morning sickness
he term ‘morning sickness’ is used to describe a condition
T
Treatments can include a variety of complementary therapies
‘nausea and vomiting in pregnancy’. It was thought that this
such as acupuncture and acupressure (similar to sea sickness)
condition was more common in the morning and hence the
with sea sickness bands also assisting some people. Ginger is
name. However, in reality it can occur at various times, and is
thought to be useful by some women and can be used in small
sometimes ongoing throughout the day. For many woman it starts
quantities. Seeing a complementary therapist in your preferred
fairly early in pregnancy at around 6 weeks and is usually resolved
treatment spectrum from acupuncture to naturopathy and
by 12 weeks when hormone levels begin to settle. However the
homeopathy is a method of treatment however this should also
variations are quite marked with some women experiencing no
be discussed with your pregnancy care provider.
symptoms at all and some experiencing the severe ‘hyperemesis
For women who would prefer medical treatment there are
gravidium’ which is characterised by extremely severe symptoms
a number of medications which may ease the symptoms of
often requiring hospitalisation for dehydration. This condition has
nausea and vomiting of pregnancy. These require prescription by
been made more well known recently by Her Royal Highness
your midwife, GP or obstetrician and if the symptoms are serious,
The Duchess of Cambridge Catherine.
you should have further investigations to ensure your blood work and scans are normal.
Nausea and vomiting in pregnancy can be managed by eating small, bland snacks and meals and trying to maintain a relatively stable blood sugar by ensuring protein and complex carbohydrates.
When things are very bad, resting and sleep often can be difficult but necessary and for an unfortunate few women regular IV fluids in your local emergency department may be necessary. As with all health related problems a care provider who is empathetic to your needs and understands what you are experiencing is an important addition. Time cures all and for most women, the feeling will not last all pregnancy.
Some women find a variety of foods, smells and other elements (fatigue, heat) make them feel worse. This condition is worse in conditions where the woman’s BHCG levels are higher, such as is the case early in pregnancy and with multiple pregnancies.
Article courtesy of
Liz is the Managing Director of My Midwives and the Pregnancy Babies & Children’s Expo Midwife in Residence. She has been a midwife for almost 30 years. 2019 | Parenting Insights
17
Labour Pain Many women describe feelings of at best, apprehension and at worst, terror when they consider pain in labour. Midwives however know that whilst, yes, labour is challenging, it does not have to be an experience to fear.
18 Parenting Insights | 2019
For many women, with preparation, lots of self awareness and really good care from someone they know when they are in labour, it can be a life changing experience in a really positive way.
T
he best way to consider labour is that you will start with
This means that you should know the midwife with you which
minor changes, a mild period like pain, possibly back pain
can be achieved in a number of ways (public hospitals have ways
which is often accompanied by things like a sticky mucous
care is provided called “caseload” or “continuity of care”; private
discharge called a “show”, an increase in bowel motions and
midwives can go with you and admit you to hospital and provide
perhaps changes in emotions. Whilst you may want to speak to
your care through labour and a small number of obstetricians
your care provider, the beginning of labour changes, does not
may work with a midwife who provides in labour care).
mean birth is imminent and does not mean you need to rush into
Your labour intensifies toward transition, which is the last
hospital. In fact, research clearly demonstrates that staying home
part before your start to push and birth your baby. From 8cm to
in your own environment in early labour is best. Support by
10cm dilated requires focus, and good care from knowledgeable
phone or in person from your own midwife at this time is
care providers who understand active labour. Many women in
extremely reassuring.
this period may seek a change, and a good midwife will be able
Once labour contractions get more intense, they will
to offer a range of suggestions. At times, more pain relief may be
come regularly with 3 contractions occurring regularly in every
requested and at times, women will want anaesthesia such as an
10 minutes with the length of the contraction lasting around
epidural. Midwives will certainly understand and assist with these
1 minute.
requests. There are times where an epidural is useful for labours
If this is your first baby, it is fine to still be at home, in contact
that are long and for about 20% of women, there is a need for
with your care provider, making sure that they advise you the best
intervention in some way. However, that is a minority of labours
time to transfer to hospital, or birth centre if that is where you are
and it is important to recognise the times where this is needed
having your baby. If it is your second baby, this is generally the
rather than deal with all women as if they need help.
time to think about moving to your birth place.
We encourage women to seek preparation early in pregnancy,
Once you are in active or established labour many things can
but it is never too late to start before labour begins. Antenatal
assist, warm water either in the form of a shower or immersing in
education provided by an independent provider, Calmbirth or
a bath is very useful. TENS applied early in labour and increased
Hypnobirthing classes and other sources of information such as
during labour is also very useful. Heat packs and massage,
the MMPOA Facebook page can give you good tips about how
pressure points and Calmbirthing or Hypnobirthing techniques
to prepare.
are also good. However the most important tool is having a
Labour is not to be feared, it is a truly special and amazing
care provider with you that you know and trust, throughout the
process to bring your own baby into the world. Supported by
whole process.
a loving team, for the majority of women it is a special day to prepare for and welcome.
Article courtesy of
Liz is the Managing Director of My Midwives and the Pregnancy Babies & Children’s Expo Midwife in Residence. She has been a midwife for almost 30 years. 2019 | Parenting Insights
19
Tips for recovery after a caesarean
A
fter a caesarean birth you will be uncomfortable for a few days. Taking regular pain relief is very important to your
recovery. Let your midwife know if you require any pain relief or
Walking will also help to reduce the swelling of your feet, relieve stiffness and the discomfort of trapped wind. Please discuss any concerns with your doctor or midwife.
anti sickness medication. Your catheter, drip and wound drain
If you have not passed wind, or have some wind pain, try:
(if you have one) will be removed in the first one to two days
• pelvic rocking and knee rolling
depending upon your recovery.
• gentle wind massage: start at the lower right side of your
It is important to let your midwife and/or physiotherapist know
tummy, using a gentle slow circular motion as you slowly
if you are having difficulty passing urine, passing small amounts of
move up to waist level, move across the belly button and down
urine or having accidental loss of urine.
the left side
Maintaining good hygiene is important to prevent infection: • shower daily and dress in fresh clothes • do not use a hair dryer on the wound, as drying the wound delays the normal healing process • if your wound oozes fluid or blood — report this to
• standing, lean forward onto the end of the bed and do some gentle hip circles • warm showers • frequent walks • relax on the toilet in the “hips flexed” position.
your doctor or midwife immediately. Postnatal exercises are especially important after a caesarean
How to protect your incision when you cough
section to get your muscles working again, but take things at a
Sit forward in a chair if possible. If in bed, bend your knees up.
gentle pace. The midwife or physiotherapist will tell you when
Place both hands over your wound, anchoring your fingers onto
you should begin them.
the pubic bone, with your forearms resting firmly across the abdomen. Draw in the pelvic floor and hold arms in firmly as
Mobility and exercises
you cough.
Initially after your operation you will be resting in bed. During
While still in bed, you can
this time it is important to do deep breathing and leg exercises
• take five or six deep, slow breaths each hour—relax your
regularly. Bed exercises and walking around will reduce the
shoulders as you exhale
likelihood of chest infections and blood clots in your legs.
• bend ankles up and down, tighten thigh and buttocks muscles
It is normal to have increased swelling of your hands and feet after
• gently draw in the pelvic floor muscles, pause, then let go
the birth. Continue to drink fluids, go to the toilet regularly and rest
• draw in the pelvic floor muscles before and as you move your
with your legs above the level of your heart.
legs, but always keep breathing—this protects your tummy from strain
20 Parenting Insights | 2019
• With both knees bent up, try slow, gentle:
during the labour. Either of these scenarios can occasionally
– pelvic rocking
leave a woman and her partner feeling disappointed, confused,
– knee rolling
distressed or feeling a loss of control.
• change the position you are resting in, often
It may be helpful to talk about these feelings with the doctor or
• aim to do these exercises two or three times each hour
midwife and have your questions answered. You may also like to
• if you are feeding your baby in bed, make sure you are not
speak with a pastoral care worker or the patient representative or
resting on your tailbone: – If sitting, put the back of the bed right up, place a small
you may wish to access a community support group that focuses on emotional wellbeing. This may be beneficial in the days/weeks
pillow / rolled up towel behind your lower back. Try not to
or even months after the birth of your baby. If you would like to
slide down the bed.
discuss any aspects of your operation or care please discuss with
– If lying on your side, make sure your head and neck
your obstetrician.
are supported on a pillow. Ensure that your body is not twisted; a pillow between your knees might feel more
Pain relief at home
comfortable.
If your pain increases after you go home you should consult your obstetrician, GP or nearest hospital. If you have any concerns
Planning for home
regarding your pain relief, safety of any medication or how the
On the day you go home you will be independently caring
medication is affecting you, please call your GP or pharmacist.
for yourself and your baby. Your pain will be controlled with medication and your wound will be free from signs of infection, ie. no redness or drainage. While you should be able to perform all the normal activities to care for yourself and the baby, you should avoid doing anything which will cause you significant discomfort. Gradually you will be able to return to your full range of duties. This can take a variable amount of time between two and six
Acknowledgments and references • Staff of Mater Mothers’ and Mater Mothers’ Private and Mater Private Hospital Redland • Mater Consumer Representatives Maternity Coalition • Caesarean Awareness Network Australia • Birthtalk: Support, Education and Celebration of Birth • Understanding NICE guidance—information for pregnant women, their partners and the public (2004) National Institute of Clinical Excellence
weeks. Listen to your own body.
Debriefing after birth
Article courtesy of Mater Mothers’ Hospitals For further information visit matermothers.org.au
For some women the decision to have a caesarean will be made weeks before the birth. For other women the decision is made 2019 | Parenting Insights
21
Making up your baby’s cot Sleep Baby in a safe cot in parents’ room for the first 6 –12 months of life
Use a safe cot that meets the current Australian Standard AS2172 Do not use pillows, doonas, soft toys, cot Use a safe mattress: firm, clean, flat
bumpers, or lambswools anywhere in the cot
(not tilted or elevated), right size for the cot Do not put your baby to sleep Sleep baby on back
on a water bed or bean bag
Keep head and face uncovered
Keep baby smoke free
Position baby’s feet at the bottom of the cot
Breastfeed baby if you can
Tuck blankets in firmly or use
Maintain a safe sleeping
a safe baby sleeping bag
environment night and day
For more information on Safe Sleeping, including information statements, visit rednose.com.au/section/safe-sleeping. For information on the use of portable cots, what is a safe mattress and how firm should a mattress be, please refer to our Safe Sleeping FAQs at rednose.com.au 22 Parenting Insights | 2019
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FAVOURITE BABY SWADDLE
Foundations The Key to Baby Sleep With so much conflicting information regarding baby sleep, it’s no wonder parents can be left feeling confused and are left struggling. However, there are some key foundations you can try to put in place in order to give your baby, and yourself, the best chance of a good night’s sleep.
24 Parenting Insights | 2019
H
aving a newborn baby to love and care for brings some parents feelings of overwhelming joy and happiness. As their
• Respond to tired signs – learn to recognise your baby’s tired signs during the day. When your baby gets tired, they need to
little one happily feeds and sleeps, they marvel at the life they have
sleep. Common tired signs include becoming irritable,
created and the life they will all share together in the years ahead.
yawning and jerky arm and leg movements to name a few.
However, for others, the initial elation of their child’s arrival can
If your baby is kept up for too long, they will become overtired
quickly descend into a highly stressful and exhausting time
and over-stimulated very quickly and this makes it very difficult
for everyone involved. Sleep deprivation is a truly awful cycle
for them to fall asleep and stay asleep. Responding to tired signs
to be stuck in and unfortunately, so many families these days
promptly when they first appear will allow your baby to settle
continue struggling for weeks, months and even years after
much more easily into their sleep cycle. For all sleep day and
having their little one.
night for babies, we recommend the LOVE TO DREAM
Sleep deprivation for parents and babies is a huge issue that
Swaddle UP™. The unique arms-up design of the Swaddle
appears to be getting worse. But why? A significant factor, we
UP™ provides the most natural sleep position for your baby
believe, is that there is no consistent baby sleep education or
to fall asleep.
information available for new parents from the very start. So much of the information on baby sleep is conflicting and every which
• At home, have one consistent sleep space for your baby
way they turn, parents are being told something different and
– avoid putting your baby down to sleep in multiple locations
herein lies the issue. It’s no wonder parents lack confidence, feel
throughout the house. Having the one consistent sleep space,
confused and are left struggling.
usually a cot or a bassinet, will help create familiarity and a
An important part of parents having helpful education from
positive association for your baby from early on.
the start is understanding that a holistic approach is needed. For their baby to settle and sleep well, healthy and consistent
• Create the optimum sleep environment – your baby’s sleep
sleep foundations must be in place first. Babies thrive on and
space should be free of musical toys, hanging mobiles, play
need consistency, it makes them feel safe and secure and we
mirrors etc. as they all equate to noise, colour and movement.
want them to feel just that, always.
Don’t be lured by the promise on the packaging that they will
Here are just some of the key sleep foundations that we
help soothe your baby to sleep. They won’t!
educate families about. It’s essential you make sure your baby is cool and comfortable • Establish your baby’s “day” and “night” to be aligned with
when it’s hot and warm and cosy when it’s cold (babies who are
their 24-hour body clock – this means having a consistent
cold will not sleep well). You can achieve this by ensuring they
bed-time at night and get-up time in the morning. Your baby’s
are in the correct sleeping attire and adjusting the temperature of
circadian rhythm (and ours too as adults) is regulated by night
their sleep environment as needed. Choice of sleepwear is a very
and day and is finely tuned to a 24-hour body clock. Their
important aspect of an ideal sleep environment. One of the
day consists of naps when they are tired, interspersed with
many reasons we recommend the LOVE TO DREAM Swaddle
periods of awake time. At night, their body clock wants to be
UP™ swaddles is that they are available in four different
having one long continuous stretch of sleep for 12 to 13 hours
TOG factor ratings to cater for various climates and conditions
(with feeds throughout dependent on age). The ideal bedtime
– Lite (0.2 TOG), Original (1.0 TOG), Warm (2.5 TOG)
we recommend for babies is 6pm (6.30 pm for older toddlers).
and Extra Warm (3.5 TOG).
Morning wake-up should fall somewhere between 6am and 7am. Establishing these timings consistently will help your baby’s natural body clock fall into place. Be mindful also that your baby’s day naps don’t finish too late in the afternoon, otherwise this will impact the 6 pm bedtime.
Article by Maryanne Sayers & Steph Gouin For more information about safe sleep for your baby, head to rednose.com.au/section/safe-sleeping Courtesy of Love to Dream LoveToDream.com.au
2019 | Parenting Insights
25
It is not normal for breastfeeding to hurt Many mothers feel some nipple pain that ceases beyond the initial attachment in the early weeks. If pain lasts beyond the initial
Night feeds are important for babies and mothers
attachment or if there are signs of nipple damage, these things
Prolactin (the hormone that tells the breast to make milk) is highest
usually mean that a baby is not attached well to their mother’s
at night, so night feeds are important for your milk supply. Babies
breast. If your nipple becomes sore after a period of comfortable
have small stomachs that need to be re-filled often, including
feeding, you may have a nipple infection. If breastfeeding hurts, get
during the night. Night feeds ensure that a mother and her baby
help as soon as possible. For example, call one of our breastfeeding
have close contact around the clock. This helps a baby’s fast-
counsellors on the Breastfeeding Helpline on 1800 686 268. The
growing brain.
earlier a breastfeeding problem is dealt with, the easier it is to fix. If a counsellor feels you need more help, she will suggest a lactation
Breastfeeding mothers get more sleep
consultant or a medical adviser.
During the first 3 months, parents of exclusively breastfed babies may actually sleep longer at night (by 40 minutes on average) than
Most mothers can produce enough breastmilk
parents of babies who are given formula. Giving formula at night
Most mothers can make more than enough milk for their baby
to try to get more sleep doesn’t work. It may make things worse
(or babies!). Indeed, having too much breastmilk is common. If a
(e.g. if your baby doesn’t react well to the formula). Missing night-
mother has a low milk supply it is usually because her baby is not
time breastfeeds can reduce your milk supply. In the time you
feeding often enough.
take to make up a bottle in the middle of the night, your baby may become more distressed. Once they get used to it, most mothers
Breast size has nothing to do with milk production
find they can pick up and feed their baby without waking fully.
Breast size depends on how much fatty tissue you have. The larger
Breastfeeding hormones help both mother and baby relax and
the breast, the more fatty tissue and vice versa. It is the amount of
get back to sleep quickly.
glandular (milk producing) tissue in your breast that matters. If you follow your baby’s lead and breastfeed whenever your baby shows that they need a feed (by squirming, grunting, mouthing their hands and nuzzling into your breast), you will have plenty of milk.
26 Parenting Insights | 2019
The truth about breastfeeding Taking your new baby home is a time of great excitement, yet not without its challenges; one of which can be breastfeeding. Below we share with you some truths to dispel a number of common myths about breastfeeding that can affect the breastfeeding relationship between you and your baby.
You don’t need to wait for your breasts to fill up with milk
Your breast is more than a dummy
You don’t need to wait a certain amount of time before putting
was invented to be an artificial breast! Babies don’t breastfeed just
your baby back to your breast – there is always milk there. Your
for food. This often comes as a surprise to parents, but babies go
breasts are making milk all the time. The rate is related to how
to the breast for many reasons — they may be hungry, thirsty, tired,
much your baby drinks. If they drink more/ less, your breasts will
hurt, over-stimulated, bored, lonely, in the mood for cuddles, etc.
make more/ less. So if your baby still seems hungry after a feed,
All are equally valid reasons to breastfeed.
A breast cannot be a dummy, as the dummy (like the bottle teat)
you can put them back to the breast and there will be more milk there for a top up.
How to separate fact from fiction? • Speak to an ABA breastfeeding counsellor by calling
It is easy to tell how much breastmilk your baby is getting There are ways to tell whether your baby is getting enough (e.g. plenty of wet and dirty nappies, gaining weight, meeting
our Breastfeeding Helpline on 1800 686 268 • Look at the ABA website breastfeeding.asn.au and other ABA resources for current and accurate breastfeeding information
developmental milestones etc).
• Mix with other breastfeeding women
Soft breasts do not mean you have ‘lost’ your milk
• Seek a second (or third etc) opinion
Many mothers worry that they don’t have enough milk if their
• Be confident in your innate ability to breastfeed.
(e.g. attend ABA group get-togethers)
breasts feel soft, or if they cannot feel their let-down reflex. After
Nature has designed mothers and babies to breastfeed.
the early weeks, your body adjusts to your baby’s needs. The full feeling that you may have had in your breasts in the early weeks disappears. This simply means that your milk supply is now in sync with your baby’s needs. Some mothers never feel their let-down reflex. Fortunately there are other ways to tell when your let-down
Article courtesy of Australian Breastfeeding Association For more info visit breastfeeding.asn.au
reflex occurs. Your baby’s sucking changes from a shallow, quick suck to a deeper, more rhythmic suck and milk may drip from the other breast.
2019 | Parenting Insights
27
5
Unexpected tips for babies with colic
No one knows for sure what causes “uncontrollable crying in an otherwise healthy baby,” or why it tends to happen in the late afternoon or evening. More importantly, is there anything that new mothers can do about it?
What are the causes of colic? Unfortunately, there isn’t a consensus as to what causes this frustrating behaviour. Mums can rest assured that it almost always goes away after 3 or 4 months. Over 60% of babies experience “colic” and only 1 in 10 still have it at 4 months of age. It may also give you peace of mind to know that most doctors
According to one study 28% of parents who practiced infant massage felt that they were able to reduce their baby’s crying.
do not consider colic to be an illness or a symptom of a stomach ache, an allergy, or disease. There is no “cure,” for colic because
Create soothing sounds
recent research suggests that it is not an illness. Instead, it is a
The world is a noisy place for newborn babies. In fact, for some
behaviour – a result of the baby trying to adapt its nervous system
of the most sensitive little ones, loud noises might even be a
to the stress and stimulation of life outside the womb.
contributing factor in extended crying. The good news is that the
So, let’s look at 5 things that you can do to get through the tearful times and enjoy a positive experience with your baby.
opposite is also true; soothing sounds may calm your baby. Babies also respond to familiar voices. So, sing your baby a gentle lullaby or quietly hum while you sit together.
Try to relax Babies are super sensitive. Dealing with colic requires us to be calm
Get in motion
at a time when we feel the most stressed out. Remind yourself
Another way to re-create the baby’s sense of calm in the womb
that, even if your baby’s crying is frustrating and unnerving you,
is with calming movements. Other crying babies are calmed by
things will get better, naturally, in a few months. In the meantime,
smooth, rhythmic movements, like being rocked in a rocking chair,
anything that you can do to reduce stress in your, and your baby’s
hammock, or infant swing. You can also make it a point to get out
environment will help. Make sure that you get plenty of breaks
of the house every day with your baby. Not only will the motion
from caring for your child. If you can, seek support from your
calm your baby, but, it will also help you to feel relaxed, which will
partner, family, and close friends. Get out into nature and meet
create a virtuous cycle of positive emotions.
with other mums. Try to prioritise domestic tasks so you can spend
One of the myths about colic is that you can “spoil” your baby
more time focusing on providing a calm environment for the baby.
by responding to her cries or holding her too much. The evidence just doesn’t support this. Instead, it shows that colic can be
Try a gentle touch
overcome with patience, dedication and a sense of calm.
Anyone who has ever received a massage understands the power of touch to relieve stress. Well, massage isn’t just for adults – babies can benefit from massage as well! You don’t even need a “professional” to give your baby a massage. All you need is a warm bath, a quiet, dimly lit room and your own magical hands.
28 Parenting Insights | 2019
Article courtesy of Medela Australia medela.com
Welcome to the 4th trimester!
P
regnancy has three trimesters, but newborn babies are so
Create a peaceful environment
small and vulnerable that for them, the first few months of
The arrival of a new baby is a huge life transition, and it all
life outside the womb are truly a “4th trimester” of pregnancy. It is important during the 4 trimester to help babies make th
happens overnight. You need time to cope, so take it slow and lower your expectations about yourself. You will not “get it”
a gentle adjustment to their new world outside the womb. In
all and that’s OK. Just do the best you can, one day at a time.
the 40 weeks since conception, they have spent every moment
However, this doesn’t mean you have to tiptoe totally around the
in a warm and nurturing environment where every need was
baby – lower the sound levels and lights in the house, but don’t
attended to. Now, in the world outside the womb, they are
make a big effort to stay quiet during the day.
adjusting to a more varied and sometimes startling world of sound, colour and stimulation.
Breastfeed regularly The 4th trimester is the time to get started with breastfeeding.
Make the transition more like the womb
This is a critical opportunity to bond and enrich the baby’s health
In the 4th trimester, it is helpful to make the baby’s everyday
and nutrition with the minerals, micronutrients and immunity
experience feel as “womb-like” as possible. Wear your baby in
boosters that are part of “nature’s perfect baby food.” Keep in
a sling or baby-carrier to help mimic the feeling of being in the
mind that with breastfeeding, there is no “normal.” It’s not unusual
womb. Babies often prefer to be carried this way so they can feel
for newborns to breastfeed every 2–3 hours around the clock.
closely snuggled up to their mother’s body. During breastfeeding, try doing as much skin-to-skin contact
Take care of yourself
as possible. This helps the baby’s senses feel calm and soothed.
Let go of all expectations about sleep and schedules and follow
Another way to help the baby feel relaxed is to take baths
the advice to sleep when baby sleeps – seriously! Getting
together – the warmth and water vibrations will remind the baby
enough rest should be one of your very top priorities. Keep in
of being in the womb. Life in the womb was full of motion, so
mind that as a new mum, your hormones are still unpredictable.
get moving. Take a walk, push a stroller, or drive in the car. Many
Don’t worry about skin breakouts, dry hair, or moments of
babies will fall asleep more easily if they are riding in a car seat or
frustration or ill temper. No one is judging – least of all your
in a baby carrier or even just being held on mum or dad’s chest
beautiful baby!
while quietly pacing through the house.
Just go with the flow – don’t stress about making mistakes. Every day with a newborn is a huge learning experience as you build a relationship with this new amazing person in your life. Article courtesy of Medela Australia medela.com 2019 | Parenting Insights
29
Now you are a Dad, what type of Dad would you like to be? In mainstream Australia, Dads are traditionally encouraged to work and provide for the family and to be a Dad second. This is not everyone’s idea of being a Dad. Some Dads need and want options. Let’s explore some different types of Dad so
Responsible Dad is great at organising and following through For your newborn, you can organise and attend appointments like maternal and child health nurse, GP or immunisation, or arrange a babysitter – for a date night! As your child gets older, you can organise school supplies, arrange sport or music lessons and attend with your child. What can you do now? Start a family calendar (paper or digital) and get organising!
you can start thinking about the type of Dad you want to be and how to incorporate the elements that appeal to you at home, in the car, or in the playground. Try them for 5 minutes, an hour, all day, all week or forever!
Remembering Dad is always thinking about their child, what they need and what they want For your newborn, you can discover your baby’s routines, sleep signs and the best cuddling position they like to go to sleep – regardless of how sore your arms are! As your child get older, you can plan birthday parties, presents, know their favourite games, and what they love to do with their friends. What can you do now? Think about your child’s day and talk to your partner about what you both observed.
30 Parenting Insights | 2019
Nurturing Dad makes sure their child has all their basic needs met For your newborn, you can support your partner’s needs during breastfeeding, prepare the bottles for the day and share feeding (if not breastfeeding), do bath time, and pick out baby clothes for the day. As your child gets older, you can look after them when they are sick, stay home from work and take them to the doctor. What can you do now? Figure out if your child’s routine is meeting their needs.
Provider Dad is the traditional Dad who provides for the family and ensures they feel protected and safe For your newborn, when you go back to work, you can provide financially for the family. When you are at home, you can provide a nurturing, consistent and predictable home environment where your child feels safe, loved and able to thrive. As your child gets older, both parents may be working and providing so you can share this role. What can you do now?
Affectionate Dad expresses their love for their child
Go to work and get home to that cute kid ASAP!
Hugs, kisses and lots of “I love you”. Enough said. For any child at any age.
A great way to explore and share your experiences is with Dads groups in your community. Dads groups, just like Mums groups,
Interactive Dad loves to play, communicate and explore ideas with their child For your newborn, you can give cuddles when they are
are for Dads and their kids to meet up and talk about the unique role played by Dads. The information within this article is part of the Support for
happy or crying, play games, notice their reactions to people,
Fathers project at Relationships Australia Victoria which aims to
and recognise when they make eye contact.
provide information for Dads about fatherhood and relationships.
As your child gets older, you can role model managing
The project is funded by the Australian Federal Government.
emotions, encourage your child to be part of decision making, and read books together.
If you would like to be involved in the Support for Fathers project:
What can you do now?
• Complete our national survey
Watch your child’s behaviours. Think about what they do and don’t like.
surveymonkey.com/r/supportforfathers or • Contact Dominic Alford
Sharing Dad shares parenting roles with their partner
SupportForFathers@rav.org.au
For your newborn, you can share the bottle feeding (if not breastfeeding), tag-team getting up throughout the night, tagteam nappies and share the housework. As your child gets older, you can discuss parenting strengths
Article by Dominic Alford Support for Fathers Project Coordinator Relationships Australia Victoria relationshipsvictoria.com.au
and weaknesses with your partner and, as a team, decide on what roles to play in typical parenting scenarios. What can you do now? Work as a parenting team. You are in this together.
References: Relationships Australia Victoria 2018, Support for Fathers National Survey, Melbourne. The Department of Families, Housing, Community Services and Indigenous Affairs 2009, Introduction to working with men and family relationships guide, FaHCSIA, Canberra.
2019 | Parenting Insights
31
How to successfully combine breast and bottle feeding
W
hether you plan on combined
The NUK
feeding from the start, are going
Nature
back to work or just want to add some
Sense
flexibility to your routine, there are many
Bottle is
benefits of having a baby that can bottle
shaped liked
feed as well as breastfeed. ‘Although
a mothers’
it might sound simple enough, bottle
nipple while
rejection is a common issue that many
breastfeeding and
mums and bubs struggle with, particularly
features not one, but
if bub is exclusively breastfed for the
several tiny feeding holes,
first six months’ says NUK spokesperson
to replicate the numerous
Midwife Cath. Here are our top tips on
milk ducts in the breast.
how to transition from breast to bottle.
By choosing a teat shape that mimics nature, you reduce the risk
Start early
of nipple-confusion and increase the
‘Introduce one bottle a day within the first
chance of acceptance.
5-6 weeks. The first week is optimal.’ says Midwife Cath. ‘This will enable the baby
Choose the right teat size
to continue to take the bottle long term.
Make sure you have the basics right by
Always start a feed by breastfeeding and
choosing the correct teat size and Flow
then finish with the bottle, even if baby
Rate. The Flow Rate refers to the size of
only takes a small amount.’
the feed hole OR the quantity of holes on the teat. A small hole (or fewer holes)
It’s all about the nipple
will let the liquid down slowly. ‘This is
Choose a teat that best resembles your
optimal for breast milk and will allow you
nipple so baby does not experience nipple
to continue breastfeeding long term’ says
confusion and reject the bottle.
Midwife Cath. A medium or large hole
NUK_NS_MagStripAd_186x50mm_PR.pdf 1 8/01/2019 will 2:13:10let PMthe
Involve the family Bottle feeding allows other family members to help feed baby and enjoy those special bonding moments. ‘Dad can take over the night feed so mum can get more sleep. Now that’s a win-win situation!’ says Midwife Cath. Article courtesy of NUK® nuk.com.au
liquid down faster still.
2019 | Parenting Insights
33
Important tips for hygienic handling of expressed breast milk Storage tips • Freshly pumped breast milk that you don’t want to use right
Tips on warming the milk • Warm breast milk in a bottle warmer (max. 34 to 37°C) or in
away should be placed in the refrigerator immediately. If you
a bowl of lukewarm water. Even though the milk may seem
express a second lot later on, you can add it to the first lot
a little too cool, it’s just the right temperature for your baby
once it has cooled. At the end of the day, you can freeze all the breast milk you have expressed in one container
• Never boil breast milk or heat it in the microwave. Valuable ingredients will be lost and your baby could scald its mouth.
• If you want to store breast milk in the refrigerator for a few days, place it on the lowest shelf at the back. This is the coldest part of the refrigerator. Never store bottles of breast milk on the refrigerator door • Label all containers with the date, so that you always use the oldest lots first.
Cleaning tips • Clean everything that comes into contact with your breast, the breast milk or the baby’s mouth after every use: 1. Rinse everything with cold water. 2. Then wash it in warm soapy water. 3. Now rinse everything in clear water. Prior to the first use,
Storage guidelines
and once daily thereafter, boil all individual components
• At room temperature 16 – 26°C maximum 4 – 6 hours is optimal
in a pan of water for five minutes. Alternatively, place
• If hygiene conditions are very good, 6 – 8 hours is possible
them on the upper shelf of the dishwasher, or use a
• In the fridge ≤ 4°C maximum 72 hours is optimal
Quick Clean microwave bag.
• If the hygiene conditions are very good, 5 – 8 days is possible • In the freezer < -18°C 6 months is optimal • If the hygiene conditions are very good, 12 months is acceptable.
Transportation tips • Keep breast milk as cool as possible during transportation, for example in a cool bag. Put this in the refrigerator the evening before and place the ice pack in the freezer. Put the expressing bottles on the bottom shelf of the fridge overnight.
Article courtesy of Medela Australia medela.com
34 Parenting Insights | 2019
Teething symptoms and solutions Teething can be a difficult time, for infants and parents too. It can be frustrating to see your little one uncomfortable as their new teeth come through. NUK helps identify teething symptoms and ways to help soothe the pain.
When will my child grow its first teeth?
What about pain medication?
The first teeth will usually grow between six to eight months.
Consult your paediatrician. Taking pain and fever reducing
This may be a little painful. The pressure pain can be soothed by
medicine may help relieve some symptoms.
teething rings or a massage instrument, which makes it easier continue to use the soother. Just watch out in case teeth leave
When do I have to start brushing my child’s teeth? How often?
marks or even cracks in it, and replace the soother in this case.
When the first tooth is fully present, it can and should be cleaned.
for children to have the teeth break through. You can, however,
This is possible with a child toothbrush that is round, soft and
Teething Symptoms
adapted to a small child’s needs. You can also use a moist cloth
Drooling, biting, coughing, irritability and of course, crying,
wrapped around your finger. At the latest when the molars are
are common symptoms of teething. All babies will experience
present, around one year of age, the toothbrush should be used
teething differently; some won’t have any symptoms at all and
more intensely, and you should brush the child’s teeth together
will have a full mouth of teeth without any pain. For others, try
with the child. It will soon learn how to use the brush and then
these easy remedies:
later be able to clean its own teeth. Brush teeth as required. Generally, once per day until one year of age, and then twice
Teething Solutions
per day, as for adults.
Teething rings – Try a teething ring that you can refrigerate for freeze a teether as this too can cause pain on sensitive gums.
When should I take my child to a dentist for the first time?
Teethers with friendly designs or soft nubs can help baby
Once the first teeth sneak through, visit the dentist for a friendly
with additional comfort.
check-up. Try making this outing a fun event – bring along
Cold food – Cold yogurts, applesauce or frozen fruits can help
siblings or ask whether the dentist can move the chair up and
soothe sore gums. Serve in the NUK Fill & Freeze Pops for babies
down. Regular check-ups should be performed from two
over 10 months or use a feeder for babies from 6 months.
years old, when all teeth have grown. At first, check-ups can be
Always supervise while eating.
performed once a year and later twice a year like for an adult.
extra relief, the cooling effect will help numb the gums. Never
Lots of TLC – Without doubt, the easiest remedy to give to your child. Sometimes extra kisses and cuddles help soothe baby and are just as effective.
Article courtesy of NUK in partnership with Dr Hubertus von Treuenfels nuk.com.au 2019 | Parenting Insights
35
All the essentials a mum will need for the trip to the hospital Before the big day comes, give yourself some peace of mind and consider running through a hospital bag checklist. By preparing everything you’re going to need for the hospital in advance, you’ll ensure your labour, overnight stays and your little one’s first few days are as comfortable and carefree as they can possibly be.
Toiletries
Hospital Bag
Hairbrush & Hairdryer
Of course the first thing on a hospital bag checklist is the hospital bag! During your stay, don’t lose a single thing; bring together everything you need in one easily-carried overnight bag.
Despite what you might expect, there will be downtime in the ward and you can afford to bring a brush and dryer along to look after your hair.
Your toiletries bag should be packed with everything you might need for a few nights. There’s no need to neglect hair and skincare, but go light on the cosmetics; no one expects you to look like a front page model after childbirth. And don’t forget to include newborn toiletries on your baby checklist too!
iPod / Music Player & Charger For any downtime or for relaxation, your own music can really add a bit of home and comfort to the hospital and help you in your first hours and days post-birth.
Toothbrush & Toothpaste Nightwear Give yourself the best possible chance of comfort and grabbing a few hours sleep with your own nightwear from home.
Don’t rely on the hospital supplying these. Bring your own along to make sure you look after your dental health. Maintaining habits of self-care is a preventative measure against post-natal depression.
Dressing Gown Hospital wards can get cold! A dressing gown will help you on those midnight food runs, feeding sessions or trips to the bathroom.
Slippers / Thongs Vital for that unforgiving hospital linoleum, slippers will help keep your feet warm, while thongs will protect them when you use the shower.
Maternity Pads Maternity pads are an absolute necessity for our hospital bag checklist; they offer an extra level of absorbency and hygiene following labour.
Maternity Bras Providing comfort and a good range of movement, maternity bras offer much needed support in your early days of rest and recovery.
Breast pads create a barrier between your clothing / undergarments and your nipples. These are especially useful if you are experiencing leakage or sore and sensitive nipples.
Underwear Pack a mixture of underpants that are both comfortable and easy to take on /off and underpants that you won’t mind throwing out once you leave the hospital.
36 Parenting Insights | 2019
Make sure you have enough power to contact your loved ones and take your mobile phone charger.
Books & Magazines Towel & Face Washer Having extras on hand of either of these is a great way to bring a little more comfort into your washing up routine, and you never know what your hospital will or won’t provide.
Massage Oil & Relaxation Products Very much in the category of ‘optional’ on our hospital bag checklist, massage oils and relaxation products can take the edge off a tough labour and help you get back onto the road to recovery.
Support Pillow Your own pillow can offer familiarity and comfort, while a specialist pillow can provide back support and optimal position for breastfeeding during a lot of sitting up in bed.
Books and magazines can help to pass the time between sleeping, feeding and hospital visits.
Comfortable Clothes Not only does a change of clothes for your newborn make it onto the baby checklist, but it also certainly makes yours! A fresh change of clothes will help you feel great when you leave the confines of the hospital ward and head for home.
Shoes If your hospital is particularly draughty or the weather outside calls for it, you will be glad you packed a nice pair of warm, comfortable shoes for those times when you’re up and about for prolonged periods.
Blood Group Card Heat Pack & Water Bottle
Breast Pads
Mobile Phone Charger
Heat packs can alleviate muscle aches and pains while a water bottle is an absolute necessity for staying hydrated.
This might be included on your birth plan, but your blood group card is always helpful to have close at hand.
Medicare or Health Insurance Card Birth Plan A birth plan will be something you might have written up with your doctor or obstetrician. It can provide your medical staff with your preferences for birth and labour and those things that you wish for or need to avoid. An absolute must to tick off for your hospital bag checklist.
Having your medical card with you at all times is a must to ensure any paperwork is processed smoothly and without stress.
Article courtesy of Baby Bunting BabyBunting.com.au
Postnatal depression epression in mothers is real. In fact, it’s all around us. But it is
D
alone. Reach out to a
hidden behind so much stigma and judgment that it’s very
friend or family member
hard to speak up and own it. As a society, we put so many labels
and ask them to help
on people. It seems as though the label of “bad mother” is one of
you visit a GP to discuss
the worst anybody could wear.
the mental illness that is
There was a time in my life when I became an expert at hiding what was truly going on in my life, at pretending. My labour, birth and the immediate weeks after having my third baby are a blurry
depression and the many different faces it wears. The sooner you get help, the
memory. I only seem to be able to recall windows in time, but
sooner you will be on your journey to a
somehow all of those windows mesh into one another to cover
better place.
a time span of three and a half years. The things I do remember?
Pregnancy and early parenthood are times of great change.
I remember holding my baby close, loving her while I cried.
It’s normal to feel emotional or overwhelmed from time to time, but
There was a lot of crying. I remember not wanting people to
if you are experiencing any of the symptoms below, it’s important
come over to visit me. I remember feeling despair at my failure
to discuss them with your doctor or another health professional:
to function, at not being able to get things like a basic phone call
• feeling empty/teary/exhausted /overwhelmed
done. I remember that sitting in the corner of my wardrobe was
• feeling guilty and inadequate
comforting, as was completely covering myself under the doona.
• diminished pleasure and/or interest in activities
I remember feeling like I was always late, running behind and
(particularly those that you used to enjoy)
never catching up. I remember the sleepless nights – lying awake
• loss of confidence and self esteem
even as my baby slept. I remember not being able to eat for most
• inability to cope
of the day, and then eating a whole block of chocolate and hating
• sleep disturbance unrelated to baby’s needs
myself, then not eating again for the rest of the day. I remember
• negative obsessive thoughts
the anguish at not being able to communicate with my husband,
• change in appetite
my frustration that he didn’t understand what was going on with
• fear of being alone
me. I remember the disengagement with my two elder children,
• worrying about harming self or children
and screaming at them with rage that seemed to suddenly
• wanting to be alone, withdrawing from social circle
overcome me, as though someone had flipped a switch. But most
• loss of concentration and memory
of all, I remember the voice. The voice that didn’t go away, that
• difficulty with decision making
was always telling me I was failing, that life was too hard and I was
• crying for no reason
useless. It was there when I woke up in the morning, when I was
• being irritable and moody
driving in the car, when I was in the shower, when I was talking
• feeling negative all the time
to people. I didn’t tell anyone about the voice or how it bullied
• thoughts of suicide or wanting to escape
me into pieces. I think the hardest part of having postnatal depression was the fact I had to hide so much of it. Sure, I shared bits and pieces, but I was never able to show on a day-to-day basis just how much I was hurting on the inside. And, unfortunately for me, I believe that prolonged period of not speaking up and not getting help meant I had more obstacles and a longer road to travel towards wellness. I can’t help but wonder what that journey would have been like
Where to go for help: • Your GP, obstetrician, midwife or other healthcare professional you trust • Perinatal Anxiety and Depression Australia (PANDA): National Helpline: Mon to Fri, 10am – 5pm AEST, 1300 726 306 panda.org.au • Peach Tree Perinatal Wellness peachtree.org.au
if I had reached out for help sooner. Pregnancy and early parenthood are the most high risk times in a woman’s life for developing depression. If you are pregnant or have young children and you are unsure whether what you are feeling is within the realm of “normal motherhood”, you’re not
Article by Viv Kissane Co-founder and CEO of Peach Tree Perinatal Wellness peachtree.org.au 2019 | Parenting Insights
37
All you need to know about eczema-prone skin Eczema, what is it?
What causes eczema?
Eczema-prone skin is a skin barrier disorder that affects 1 in 5
Eczema is caused by a defect in the skin barrier which allows
children . It appears as extreme dry skin on the body and face
moisture loss and the door open to allergens. In children prone
and alternates between eczema flare-ups with red patches
to eczema, the immune system is also more sensitive to stimuli.
and periods of relief. Eczema can appear, from the age of two
This sensitivity, combined with demands related to allergens,
months. It decreases severity over time and often disappears
provokes an intense inflammatory reaction in the skin
spontaneously, usually around the age of five or six. Meanwhile,
(characterised by red patches and itching).
(1)
eczema will disrupt your baby’s day-to-day life, because it often translates to itching and discomfort. Eczema alternates between periods of flare-up and periods
A hereditary skin condition We also know nowadays that eczema-prone skin may be linked to
of respite. In fact, your baby may appear free of the condition
a genetic predisposition. There is a 40 – 50%(2) probability of a child
for a time and then it will show up as extremely dry skin on the
developing eczema before it turns two if one of its parents also
face and body, accompanied by localised patches of red skin and
suffers from the condition. This figure rises to 50 – 80%(2) when
itching sensations. The patches will appear on a baby’s cheeks,
both parents suffered from eczema.
scalp, neck folds and even arms and legs. As the child grows, the patches can be seen in skin folds, this time usually on
Preventing eczema: mission possible!
elbows, knees, wrists and eyelids.
If there is a family history, you can take effective preventive
The itching and discomfort associated with eczema
measures right from birth. The latest scientific studies have shown
flare-ups can persist at bedtime, which can cause difficulty
that the daily application of an emollient from birth onward in the
sleeping. Your baby’s quality of life can be affected, as itching
case of children with at least one eczema-prone skin parent
can result in chronic fatigue and increased irritability.
helps to reduce their risk of developing the symptoms of eczema
Early, long-lasting prevention is therefore key to your little one’s comfort.
38 Parenting Insights | 2019
by 33 – 50% (3).
So, there it is. Every day, protect your baby’s skin with a specific
Caring for your baby’s skin
baby-child fragrance-free emollient skincare (like Mustela
• To protect your baby skin and to stop itching, apply an
Stelatopia Emollient Cream or Balm). This is the best way to
emollient, lipid-replenishing skincare product specifically
replenish lipids in the skin and strengthen the skin barrier, thereby
formulated for babies and children, once a day after bathing
increasing the skin’s ability to defend itself against allergens that
your baby, on his face and body (twice a day in the case of
are responsible for skin problems.
extremely dry skin). Make sure it is gentle, hypoallergenic, and fragrance-free;
Practical day-to-day tips for caring for a baby with eczema
• Before you start, wash and dry your hands well, and then warm them by rubbing them together. Make little light massaging
After consulting your doctor to make sure that your baby is suffering from eczema, follow these simple tips.
movements with the cream (or balm); • In some cases, eczema is resistant, so emollients are not enough. In addition to emollients, a cream containing corticoids
Bathtime
should then be applied directly to the inflammatory flare-ups,
• Exchange your usual cleansing products for products
as prescribed by a doctor;
designed specifically for babies and children and formulated
• To prevent lesions when your child scratches an itchy patch,
for eczema-prone skin: gentle, hypoallergenic, and fragrance
cut his nails regularly.
and soap-free; • Bathtime should last no longer than 10 minutes and the water temperature should not exceed 35°C. A few drops of special baby / child bath oil suited to eczema-prone skin will compensate for the drying effect of hard water.
Article courtesy of Mustela in partnership with Dr Clarence de Belilovsky, a dermatologist and member of the Mustela Circle of experts. Mustela is a proud supporter of the Eczema Association Australasia. mustela.com.au
References: (1) Watson 2011, ISAAC 1998. (2) Böhme 2003, Taïeb 2008. (3) Eric L. Simpson 2014, Horimukai 2014.
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2019 | Parenting Insights
39
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Taking the sting out of nappy rash! Here are some handy hints: • Change your baby’s nappy often so the skin is kept fresh and clean. This may mean a lot more nappy changes than normal during times when nappy rash is problematic.
there will be less residue that could be irritating. You could also try adding a cup of white vinegar to the final rinse cycle of your wash to break down any leftover soap residue and it will also keep the nappies
• Have “nappy free” time where
soft. If you are using modern cloth nappies
there is no nappy on to help
make sure you are changing them often or
the skin remain free of possible
you could try using a bamboo liner inside
irritants. Grab a waterproof
the nappy.
picnic blanket and lay bubs on
The remedial effects of natural
this so if there is an accident,
ingredients in skincare are well documented
it is easy to clean and won’t
and clinically proven, in particular the use
go everywhere.
of natural vegetable oils because of their
• Using liners in disposable nappies
emollient moisturising and skin protecting
may also benefit as they absorb
properties to help the skin maintain
wetness and keep it away from skin. Choose your disposable nappies carefully as many contain chemicals that
effective barrier functions. Look out for products containing: Avocado Oil – An emollient used to
some babies may find irritating. There
moisturise and soothe skin. Rich in many
are several eco-friendly nappies available
nutrients, including vitamins A and D, lecithin
now which may be more suitable and are
and potassium, it also contains essential
easy to purchase online.
fatty acids, which are useful for conditions
• It is important when washing your baby’s
N
Try using a liquid instead of a powder as
such as nappy rash and eczema. Chamomile – known as ‘The Children’s
appy rash is very common and
nappy area that you check the skin folds
can pop up anytime no matter
and that you are very gentle as rubbing
Remedy’ because it is helpful for soothing
the skin can cause friction and make
skin and is used on a wide range of
nappy rash worse.
complaints including eczema, irritation,
how diligent you are. Nappy rash mainly occurs when baby’s skin is covered by a wet or soiled nappy for
• Avoid soap – it disrupts the skin barrier
redness and inflamed skin conditions such as nappy rash.
too long. ‘Too long’ can vary from one baby
by stripping away natural oils and
to other and may be influenced by whether
causing dryness, which can make nappy
Calendula – is a favourite amongst
your baby is teething or unwell. Some
rash worse. Choose a soap-free cleanser
herbalists for its amazing ability to calm
babies will hardly get any nappy rash, while
as a gentle but effective option.
wounds very gently and effectively. It is very
• Wipes often have alcohol in them
soothing on irritated skin conditions, helping
others will get a lot, it depends on how sensitive their skin is. Nappy rash is caused by germs on the baby’s skin, in faeces, urine and on clothing (including nappies) creating ammonia
and this can cause further pain and discomfort on damaged skin, so look
to reduce redness and calm nappy rash. Aloe vera – is a skin nutrient renowned
for an alcohol–free wipe that also
for its soothing and hydrating action.
contains moisturising properties.
Aloe is used to soothe and moisturise
which can burn the skin. When the nappy
• Using a barrier balm to keep dampness
dry, damaged skin, minor cuts and burns
rubs on the irritated skin, it is exacerbated.
away from the skin can be beneficial.
and irritations like nappy rash, as well as
Often when babies are unwell, particularly
Be mindful not to rub vigorously as this
providing long-lasting moisturisation.
if they have diarrhoea, their skin seems to
can irritate the area, try to gently pat
become more sensitive. Other possible
the area to apply.
triggers include starting a new food,
• Use a talc-free powder to absorb
Thrush is an infection that may require additional treatment. It is important to seek medical assistance for any broken skin or
teething, chemicals in disposable nappies
excess moisture in your baby’s skin
rashes to ensure you know what it is and
or an infection on the skin such as thrush,
folds and keeps your baby drier.
how it should be treated.
which can make the rash worse.
• Changing cloth nappies often and
Eliminating the causes as much as possible
washing them in laundry liquids which
will help to minimise nappy rash.
are labelled for sensitive skin may help.
42 Parenting Insights | 2019
Article courtesy of Michelle Vogrinec – Founder GAIA Skin Naturals
THE BENEFITS OF
baby massage for you and baby According to the International Association of Infant Massage, there is both research and anecdotal evidence from families which shows that there are many ways that babies and parents may benefit from infant massage.
Relaxation & constipation
petrochemicals, mineral oil, and artificial fragrances or heavy
The relaxation benefits are well known, from assisting with
scents. A natural edible plant-based oil, as recommended by the
sleep patterns, increased flexibility and muscle tone to calming
Infant Massage Association, is best.
and reduction of stress, but what may be lesser known is that
Mums who prefer not to use an oil may like to choose a
massage may assist in the relief of gas and colic, constipation,
baby moisturiser as a massage lotion instead. The moisturising
growing pains, teething and muscular cramps.
properties of shea butter, cocoa butter combined with nourishing organic oils make a lovely non-greasy alternative.
System stimulation Infant massage may also stimulate baby’s circulatory and
Of course, if an irritation occurs, stop using any product immediately and consult your medical professional.
digestive systems, hormonal and immune systems, coordination and balance, learning and concentration, muscular development
Other tips on getting started with baby massage
and growth and even their mind and body awareness, so
You don’t have to be an expert in baby massage. You and your
you may find it an important part of maintaining your baby’s
baby can benefit simply by setting up the scene and using gentle
total wellbeing.
touch, such as massaging moisturiser or massage oil into your baby’s arms, body and legs, then turn them over onto their
Communication & confidence
tummy and massage your moisturiser or oil into their back,
In addition to the physical benefits for the baby, interaction
perhaps after baby’s bath.
between parent and child during massage may promote bonding and secure attachment, verbal/non-verbal communication,
Another great time to offer infant massage is as part of baby’s
development of trust and confidence, and feelings of love and
bedtime routine. After a warm bath with a moisturising soap-
being valued, for both parties! This can be a particularly special
free wash (ideally one with calming oils like lavender, chamomile
time for dads that are away at work all day or an intimate
or ylang ylang), pop on some soothing music and spend a few
‘time-out’ for first-time mums struggling to adjust to the huge
minutes gently massaging your oil or moisturiser into their skin
demands of 24/7 parenting.
while telling a bedtime story and slowly getting them dressed. This routine often helps them relax and prepare for a peaceful
How to choose a massage oil, what to look for
night’s sleep!
Your midwife, maternal health nurse or medical professional can advise you on the best oil to use for your baby but definitely avoid using oils which are meant for adult use or adult massage,
Article courtesy of Michelle Vogrinec – Founder GAIA Skin Naturals
they are not suitable for babies. Choose an oil which is free from 2019 | Parenting Insights
43
Newborn bath basics
H
Test the water temperature using a bath
in a towel to keep them warm. Start by
thermometer if you have one, or if you
wiping each eye with a separate piece of
don’t, use your wrist rather than your
cotton wool dampened with warm water,
hand, it should feel neither hot nor cold.
working from the inner corner outwards.
andling a wiggling, wet baby can feel
The recommended bath temperature for
Do not wash the eye itself.
a little awkward at first but with this
babies is about 36 –38°C.
Use a new piece to wipe around their mouth and nose, then another
handy step-by-step guide, you will be an
clean piece for their ears and face. Using
you have all the things you need within
Now you’re ready, the first step is to ‘top and tail’
arm’s reach of the bath.
Top and tail a newborn for the first month
neck, focusing on the skin folds, behind
prior to bathing to avoid cross infection,
the ears and under their arms where milk
Getting ready
as well as in between bathing to freshen
and fluff can get trapped. Take another
Choose a time of day when you’re not
their skin if you are not bathing every day.
piece and clean their ears and face.
expecting any interruptions. The bath
“Top and tailing” simply means to carefully
should be positioned somewhere stable,
wash your baby’s face, neck, hands and
in your baby’s ears or nose, just wipe
at a height where you can comfortably hold
nappy area without having to totally
what you can see.
your baby (a table is often best) and make
immerse your baby in water.
expert in no time! Before you start, ensure
another dampened cotton pad, clean their
Never put anything like a cotton bud
Tailing
sure you have access to running water.
Topping
Washing your baby’s genitals, bottom and
or enough water to allow your baby to
Lay your baby down on the floor or change
nappy area is the ‘tailing’. Keeping your baby’s
settle in the water with their shoulders
table, with the clean cotton pads and bowl
upper body covered with a towel, remove
well covered. To avoid over drying your
of warm water nearby. Always use fresh
their nappy (watch out for the fountain!)
baby’s skin, add a squirt of a mild, baby
cotton pads when cleansing the separate
bath wash to the bath and swirl around
areas to avoid cross infection. Undress your
to some extent and are very delicate, so
with your hand.
baby down to their nappy and wrap them
cleaning this area requires special care.
SENSITIVE
SKIN
N OT
RM
FORMULAS
HI
N
D SULPHAT E AN
G
FUL
P
EE FR
SO A
Fill the bath with about 10 –13 cm of water
HAR
SH OR
HA
Nourishing care for pregnancy + new mum Worried about stretchmarks? Try GAIA’s Belly Butter and Belly Oil: Contains skin loving oils like rosehip, jojoba and wheat germ May help to reduce the appearance of stretch marks and the possibility of new ones Maintains skin suppleness and elasticity
GAIA’s Nipple Balm for new mum: For breastfeeding mothers to moisturise, soothe and protect the delicate nipple area No need to wash off before feeding Use after feeding to keep nipple area in good condition
www.gaiaskinnaturals.com 44 Parenting Insights | 2019
Your baby’s genitals will self-clean
If your baby girl has had a very dirty
gently lower them into the bath, feet first,
You may want to apply a baby
nappy and poo has got within her vaginal
keep a close hold at all times. The water
moisturiser to lock in hydration and
area, with a fresh moist cotton pad, gently
should be covering their shoulders so
protect against dryness.
wipe the area from top to bottom, or front
they don’t get cold.
Put their nappy on. Applying a barrier cream to the nappy area to protect
to back and down the middle. Then with
Continue to keep a good grip and
a new clean cotton pad, wipe each side
support their head with one arm, as they
against the causes of nappy rash might
within her labia.
may get quite slippery when they are wet,
also be helpful. Products containing zinc
and use your other hand to sprinkle some
and castor oil are highly recommended
penis and scrotum area, avoiding pulling
water over your bub’s skin and gently
by medical professionals.
back the foreskin, and also wipe front to
wipe clean with a washer.
For an uncircumcised boy, wash the
Gentle touch and hearing your voice is a nice way to increase bonding. Singing
back. Don’t try to pull back his foreskin to
Washing their hair comes last so
clean. If circumcised, don’t wash the head
your baby doesn’t get cold. While most
or talking your baby through what you
of the penis until it’s healed.
newborns don’t have much hair, you
are doing as you bathe them can help to
can sponge what is there. To avoid
provide comfort and support. Now it is
cleaned and patted dry to avoid infection
getting eyes wet, tip the head back just
time to get dressed, wrap them up in a
and chaffing from damp skin particularly
a little. Supporting your baby’s head and
warm blanket and snuggle!
if you have a nice chubby baby!
neck, lift them out of the bath then place
Ensure all skin folds have been
If you are not continuing on to a bath, it’s also a good idea to use a barrier cream
on his back on a clean, dry, soft towel. Wrap to warm and gently pat dry
on the nappy area to protect against the
your baby’s skin rather than rubbing.
causes of nappy rash. Dress your baby and
Pay attention to ensuring you dry in the
wrap them in a blanket to keep bubs warm.
skin folds and creases, including armpits,
Article courtesy of Michelle Vogrinec – Founder GAIA Skin Naturals
or chaffing.
SENSITIVE
SKIN
N
FORMULAS
HI
Ideal from birth to toddler and beyond Sensitive skin formulas Contains pure, natural and organic ingredients Free from sulphates, parabens and more Created by a mum Eczema friendly
D SULPHAT E AN EE FR
P
N OT
Gentle care for baby soft skin...naturally
G
FUL
Cradle your baby’s head with one arm,
RM
and behind the ears, to avoid infection
SO A
groin, under the chin, around the neck
Now for bath time!
HAR
SH OR
HA
2019 | Parenting Insights
45
Your guide to starting solids The most recent Australian Guidelines recommend the introduction of solid foods at around 6 months. The age of your baby is one indication that your baby will be ready for solid food, but there are a number of other visual cues to look out for.
How do I know my baby is ready? Young babies have yet to develop the skills needed to move solid foods around in their mouth and successfully swallow,
• First Bite! Sit facing your baby and hold the half-spoonful of
but by around 6 months of age, your baby will have developed
food about 30cm from his face. Get his attention and put the
the motor skills needed to sit up during feeding, draw food off a
spoon up to his mouth. For the first bite, try putting a dab of
spoon, and turn his head away when full.
food on their lip. If your baby is agreeable to that first taste, put the next bite into their mouth when they open it. Feed your
Look for these milestones: • Your baby has good head and neck control, and the ability to sit upright when supported; • You’ve noticed an increased appetite and the want for more milk at the end of a breastfeed;
baby as slowly or as rapidly as they want and always look for fullness cues. It’s all about the experience! • Try, try again. Don’t be surprised if your baby’s first taste pops right back out. It’s a natural reflex. If your baby seems unhappy about this experience, give it up for now and try again later.
• Your baby is opening their mouth when food is offered on a spoon; • Your baby moves their tongue backward and forward in a
Tips for introducing iron fortified infant cereals • Start with infant rice cereal. Baby can then progress to a
smooth rhythm when you put a spoon to their lips. This
wheat grain in a month or so. Offering only single-grain
allows them to draw food in and swallow it. It may take a
cereals at first lets you pinpoint any possible food sensitivities
few days to get used to eating from a spoon, but they will
or reactions – such as a rash, diarrhoea or vomiting – your
learn quickly!
baby may have to a new food; • Prepared cereal should never be fed from a bottle
Setting the stage for their first taste Here are a few tips for getting your baby ready to take that
— only from a spoon; • When first starting cereal, mixing with breastmilk is
first spoonful of baby food.
recommended. Move to a thicker consistency once you feel
• Breastfeed so they won’t be fussy or too hungry;
your baby is mastering the thin texture;
• Take your time. Choose a time of day you do not have to rush;
• Prepare only as much as you think he will eat. Don’t save cereal that’s been prepared, as it can grow bacteria very easily.
• Choose the appropriate spoon. Use a small baby-sized spoon that’s coated to protect your baby’s tender gums; • Sit baby in an upright infant seat or high chair, making sure his head is in an upright position, not tilted back; • Let them explore. Place a dab of puree or cereal on baby’s
If your baby is not showing these readiness signs and you are worried their appetite, growth and development are not progressing normally, it is advisable to seek advice from your doctor or dietitian.
high chair tray so they can “finger paint” with it and become familiar with its texture. Let your baby explore the feel and smell of the food. This is both fun and messy! Keep your sense of humour and keep the camera handy for pictures.
46 Parenting Insights | 2019
Article courtesy of Nestlé Start Healthy Stay Healthy For more information on introducing solids visit starthealthy.nestle.com.au
MAKING YOUR HOME KIDSAFE A child brings many changes into a home â&#x20AC;&#x201C; including a lot of mess and sleepless nights â&#x20AC;&#x201C; but there are also some changes that need to be made to help ensure your house is safe for your children.
48 Parenting Insights | 2019
W
What are some of the major injury hazards in the home?
common location where child injuries occur. Children spend the
Common injury hazards in the home include:
e often think of our homes as safe and secure places, so you may be surprised to learn that the home is the most
majority of their early years growing, playing and learning in the
• Fall hazards – things like stairs, furniture/nursery products
home environment, which is why it is important that you take
(e.g. change tables, high chairs, baby walkers, cots and
the time to identify and address any potential injury hazards in
prams) as well as windows and balconies
your home.
• Poisonous substances – items such as medication (prescription and over the counter), button batteries and
Making your home kid safe – where to start?
household cleaning products (bleach, dishwashing powder/
So you have a little one on the way or you have a little one who
tablets, toilet bowl discs etc.)
is on the move and starting to explore your house – where do
• Tip over hazards – large items of furniture like TV’s,
you start when thinking about making your home kid safe? The
bookcases and drawers can tip over if children climb
good news is that there are some simple steps you can take to
or pull on them
make your home a safer place for children.
• Strangulation hazards – loose, looped curtain and blind cords pose a major strangulation hazard in many homes
There are three main steps to consider:
• Choking hazards – small items like coins, buttons and toys
1. Spot the hazards
• Water hazards – children can drown in as little as a few
The first step in reducing the risk of injury is to spot any
centimetres of water so along with pools and spas, smaller
potential hazards that may exist in your home. It may sound
bodies of water like baths, buckets, Eskies with melted ice
like a funny idea, but Kidsafe suggests that you get down on
and even pets drinking bowls can pose a drowning hazard.
your hands and knees and crawl around your house – this
will allow you to view possible hazards from your child’s level.
It is important to note that as your child grows and becomes
Identifying all possible hazards in your home can be tricky,
more mobile they will have access to a whole new range of
however the good news is that Kidsafe Victoria has a handy,
hazards – this means that making your home kid safe will
free home safety checklist that you can download from
be a continuous process. When assessing the safety of your
kidsafevic.com.au to assist you.
home it is a good idea to not only think of what hazards
your child has access to now, but also what hazards they
2. Decide how to deal with the hazard This step depends on the type of hazard you are dealing with. Options may include removing the hazard you have
may have access to in the near future, to help keep them protected when they do become more mobile. By following these simple steps you can help
identified (e.g. removing a poisonous plant from the garden),
make your home a happy and safe environment for the
or guarding against the hazard (e.g. placing a stair gate at the
whole family.
top and bottom of the stairs or placing locks on cupboards that contain poisonous items). It is important that safety products (e.g. cupboard locks) aren’t relied upon on their own – these should always be used in conjunction with active
For more information and advice on home safety and a wide range of child injury topics, please visit kidsafevic.com.au
adult supervision to help keep children safe. 3. Make the changes It is important that you deal with the hazards you identify immediately – your children won’t be protected until safety measures have been put in place.
2019 | Parenting Insights
49
The essentials of baby play Opportunities for play The process of play is far more important that toys. However, toys are usually the main objects that babies play with because they have the advantage of being safe and specially adapted to their age and abilities. Toys that capture attention and provide endless entertainment include rattles, plastic tea sets, books with brightly coloured pictures and a toy telephone. Toys that help develop crucial skills such as problem-solving and perseverance include large plastic
P
bricks, balls, nesting cups and stackers. Toys that develop lay is fundamental
to healthy brain development. It
fine motor skills include puzzles and crayons. Toys that develop large motor skills include push-along or ride-on toys. Providing the best conditions for play does not mean purchasing the most expensive toys on the market.
lays the foundation for reading, writing, mathematical reasoning
â&#x20AC;&#x2DC;Very often, homemade or household objects offer the best value and will keep baby happy,
and problem solving. Play
interested and busy. However, if the object fits
provides an emotional outlet
through a kitchen roll cylinder it is not safe.â&#x20AC;&#x2122;
for tension and frustration and it is crucial to the socialisation process.
Homemade or everyday objects must be carefully supervised
In fact, play is so important that it has been globally
and removed from the cot during daytime naps and at bedtime.
recognised to be a fundamental human right. Play can be quiet or noisy, energetic or passive, social or
Play time with carers, extended family members and close friends can also be enriching. For example, they can show the baby
non-social, relaxed or serious, imaginative or purposeful. Play
how a new toy works or get involved in turn-taking activities such
may or may not require toys or equipment. It does not need an
as rolling a ball back and forth. Babies also know that they are loved,
end product. Play is a spontaneous, self-motivated activity that is
and fun to be around.
initiated and controlled by the baby. However, play at all levels must bring pleasure and fulfilment. If it is not fun, it is not play.
The process of play
Other types of play might include listening to stories or music, dancing, singing, rhymes and songs, bouncing games and peek-aboo. Including babies in household chores, taking them shopping, swimming, to the park or on a nature walk are also forms of play.
Most play involves use of the hands in some way, starting first with
In addition, going to a parent and baby group can offer scope for
swiping and then with proper reaching. These little experiments
social play and the opportunity for fun conversations to develop.
soon lead on to grasping, which means that objects can be brought to the mouth for further exploration. Mouthing generally decreases when babies start using their
The best opportunities for play usually occur during routine activities such as feeding, nappy changing, dressing, bath or bedtime. The simplest form of play involves
hands to explore and manipulate objects. With the development of
plenty of eye contact, facial expressions,
the pincer grip, babies waste little time in working out how to pick
vocalisations, smiles and words of
up the smallest object. At this time, parents must be extra cautious
encouragement.
about safety. Anything that is small enough to be swallowed should be removed and plug sockets should be covered up.
50 Parenting Insights | 2019
Article courtesy of Dr Lin Day Babysensory.com.au
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Safe travels Choosing the safest car restraint for your child
W
hat is the safest child restraint? It’s a question that’s
frequently asked, but one quite difficult to answer. The short answer is ‘depends’. The full answer is a little more complicated and nuanced. Ultimately there are many factors you’ll need to consider. You could start by comparing all of the restraint makes and models on the market through a crash testing regime and judge them comparatively, but these would all be based
Relationship to vehicle
on the same vehicle seat geometry and collision simulation.
The child restraint you choose has to be compatible with your
The question then arises, would that accurately apply to your
vehicle. Some incompatibility issues may be minor inconveniences,
specific situation? Comparisons may help to some degree,
but others may affect your ease of use, functionality and collision
but there are other factors that need to be considered.
outcomes. Only you can decide the compromises you’re willing to make, so whenever possible always deal with a retailer that has
What contributes to a child restraint being safe?
some experience of the make and model of vehicle you drive or
There is a short list of basics to consider:
one who is willing to place the product into your car so you can
• How it interrelates to your vehicle seat and equipment • Harnessing at both lower body (hip area) and upper body (chest/shoulders) • Appropriate harness positioning choices for different length/height of the child. • Side impact protection (Especially pertaining to the passenger’s head).
check all of the functionality aspects.
Harnesses The harnessing systems of all brands and models are similar – design standards ensure that – but the big difference can come from how readily they adjust in daily use. Harnesses need to be adjusted each time they’re used; not once in a while, every time. It holds true, and it’s supported by the decades of experience we have with the parenting community, that if a harness is difficult to use, it often won’t be used correctly. Please take the time to check that the harness operates easily and reliably on the product you’re considering. The harness is your first line of defence in safety and every other aspect relies on it being correct. It absolutely needs to be done right every time.
52 Parenting Insights | 2019
Make a choice that will benefit you and your child and when you narrow down the list of the products you feel are appropriate, always focus on simplicity, functionality and ease of use factors. Another thing to consider is that cushions, no matter how many are added, are not generally safety items. In fact, cushions can affect the safe use and operation of safety features like the
Harness positioning Being able to change the configuration of the harness to ensure it’s suitable for the changing needs of your child as
harness! There’s a very good reason motorcyclists don’t have soft helmets, so remember that how something feels does not always match up with the safety it offers.
they grow is an essential consideration. Configurations to accommodate your child growing or alternatively reverting to
Extended use factors
smaller sizes for younger or smaller children are important. The
Something else that can affect your choice is the product’s
most common reconfiguration function relates to shoulder strap
extended usable period. Rather than the number of years of use
height and the wider the variety of height settings a restraint has,
you can get with a multipurpose choice (‘convertible’) restraint;
the more it allows for appropriate harness set up.
this refers to how well it adds value to safety.
Impact protection
There are two areas you’ll need to focus on:
Technology and design advancements mean side impact
1. Extended rear facing (ERF) capability for infants
protection features are more comprehensive in contemporary models, offering higher levels of energy absorption and better positioning.
and younger children (possibly up to 30 months) 2. Extended six point harnessing capability (possibly up to 8 years)
Naturally some products are designed with additional features that can offer additional levels of safety when compared
Starting with ERF, all passengers are better protected if facing
to other products. However, most of the claims have not been
the rear during a frontal collision. While this may not always be
directly tested in comparison to others and which product will
desirable or practical for some parents when the child is getting
provide the safest environment under specific circumstances is
larger, it’s known to be safest. However, when you’re considering
still largely a matter of guesswork.
ERF, also factor in other vehicle safety matters. For example, in
Regardless of features, claims and their benefits, it is well recognised that most child restraints are, in some way, used incorrectly which can compromise their effectiveness and level
a wagon anything in the cargo area not secured is a potential missile and facing the rear may increase injury risk! A restraint comparison of a six point harness with a standard
of protection. Simply, you can put your trust in claims that a
lap sash seat belt shows that the seatbelt sash is less likely to
particular restraint is the absolute best, but if you’re not using
remain in a proper position. This is particularly so if the child is
it correctly all those benefits could account for little.
short, fidgets, falls asleep or any combination thereof. A six point
It is often said that the safest restraint is the one you have
harness is the most reliable in this respect and may provide piece
when you use it correctly. We’re not trying to be flippant or
of mind until the child is around 8 years of age – an enormous
avoid answering the question that starts this article. We want
benefit over a standard lap and sash belt arrangement.
to highlight an area of great concern – generally speaking the biggest problem with child transit safety in Australia is not the
‘Let’s all travel safely’.
quality of the child restraint, but rather its incorrect use. Australian and international standards aside, the most carefully designed and comprehensively equipped child restraint is useless unless it is correctly used.
Article courtesy of the child passenger safety technicians at ACRI acri.com.au
2019 | Parenting Insights
53
Thinking secondhand? Maybe think a second time The true cost of buying secondhand
W
e all know that having a baby can put a strain on the finances, especially with so many items to buy: cots,
change tables, prams, car seats … just to name a few. It can be tempting to pick up a secondhand bargain for some items, but before you do it’s important to consider what you’re actually buying.
Why buy new? Most new products have to meet stringent safety standards, which are continually updated to ensure they are as safe for your baby as possible. A product which was thought to be safe two or three years ago may now be considered a danger. New products that comply with these standards are clearly labelled, giving you peace of mind when you make your purchase. If there is a fault, you know manufacturers have to fix it or refund your money. Under Australian Consumer law, product safety is regulated and your rights as a consumer are protected. Buying a product secondhand does not give you this same protection.
54 Parenting Insights | 2019
Product developments ensure prams, strollers and joggers meet the ever changing needs of consumers who often use prams and accessories to improve their lifestyle. There should be two separate locking devices to prevent it from collapsing accidentally and new prams are designed with high-quality mechanisms to ensure your child’s It can also be daunting the first time you use some
fingers, arm, legs, head and body won’t be trapped. Locks
nursery products and the great thing about new products
on secondhand products might not work properly. It is also
is that they come with a full list of instructions on how
important that the wheel bearings are not worn, as this can
to use them correctly and safely. Anyone who’s tried
cause ‘wheel-wobble’ and even make brakes ineffective.
to assemble a cot or a pram knows they can be quite
While bearings can be replaced, the cost can make the
difficult to set up, and also to adjust or maintain. Always
secondhand purchase not such a bargain after all.
read the instructions and follow them closely to make
Cots are one of the only mainstream products that are
sure your baby is safe and that the product is being used
designed to be used without adult supervision and your
as intended. With a new product, you don’t have to worry
baby will spend a lot of unsupervised time in their cot. For
about its history or whether it’s worn, torn or damaged.
this reason, it’s vital that the cot is safe for them. Design
You also know it doesn’t have any faulty repairs, and
standards for cots have dramatically improved in recent
safety is more important than saving a few dollars.
years. Standards are constantly reviewed to ensure the
Products worth buying new every time Car seats, booster seats and child restraints are just like car designs in that they improve their safety requirements
latest designs minimise any risks. Older style cot designs are considered unsafe and do not meet safety standards unfortunately. Take the time to consider your options, research all
over the years. All new car restraints must, by law, meet
the new products in the marketplace and perhaps most
current Australian Safety Standards, generally agreed by
importantly, buy what you can afford so you can enjoy
experts to be the best in the world. With a secondhand
this time with the peace of mind that new products can
product you’ll be unaware of its history and if it’s been in
provide.
an accident, it might no longer be safe. It only takes a small collision to damage or stress a harness or seat shell, and the damage is usually not obvious. With a new product, you know the plastics and
Article courtesy of Baby Safety Program INPAA
materials have not degraded. Buying a new restraint means you can be totally sure it’s safe. Don’t forget to ensure your seat is fitted correctly; new car restraints have full fitting instructions that you must follow to the letter, and these are often missing from secondhand products.
2019 | Parenting Insights
55
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Around one in two toddlers are considered fussy eaters1 S-26 GOLD® TODDLER has been carefully formulated to help fill nutritional gaps in toddlers’ diets when dietary intakes may be inadequate. Supporting 4 key pillars of toddler nutrition with the Alula® Toddler PlatinumCare Complex™
Our nutritious milk drink provides a good source of age-appropriate vitamins and minerals to help support:
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Our most advanced formulation, S-26 GOLD TODDLER contains quality ingredients, including omega-3 DHA. With reduced* protein in keeping with expert recommendations2, it offers an energy level comparable# to regular cow’s milk and, importantly, does not contain sucrose, commonly known as ‘table sugar’. *S-26 GOLD TODDLER contains 1.3g/100mL of protein compared with previous formulation of 2.5g/100mL. #S-26 GOLD TODDLER has an energy level (270kJ/100mL) comparable to regular cow’s milk (avg. 277kJ/100mL) † One serve contains vitamins A, D and iodine to help support toddlers’ growth and development; iron to aid cognitive function; calcium contributes to the function of digestive enzymes; digestive enzymes facilitate digestion; zinc and vitamin C help support the immune system. As part of a varied diet.
Reference: 1. Department of Health and Human Services, 2014, Toddlers and Fussy Eating, Better Health Channel, https://www.betterhealth.vic.gov.au/health/healthyliving/ toddlers-and-fussy-eating, date accessed 19/12/2018. 2. Suthutvoravut, U. et al. Annals of Nutrition and Metabolism. 2015;67:119-132.
Introducing solids: Purees vs baby led weaning
I
ntroducing solids to your baby is an exciting, messy and
Traditional weaning
enjoyable stage of development that marks the beginning
A traditional weaning approach usually begins with spoon
of a long and tasty journey. As adults, taking food to your mouth, biting, chewing, and swallowing is automatic, but we must remember that our little ones need to learn how to eat step by step. Weaning has changed a lot over the past few generations
feeding by parents of smooth purees and moves through to lumps, chunks, finger foods and family foods. Infants are fed with a spoon until they can communicate fullness. From around eight months, finger foods are offered and gradually increased to replace spoon feeding. Variety is increased by adding one new food every few days to see if your baby has an adverse reaction.
and differs between cultures, for example mashed pasta as
With this method, parents are in control of the texture, variety
a first food in Italy and hand mashed mild curry in India.
and the pace of the meal.
Irrespective of the weaning method used, the goal is the same â&#x20AC;&#x201C; Start your baby on solid food at around six months and have them consuming a nutritious family diet by twelve months. It is the steps to get to family foods that may differ. Either
The benefits of a traditional approach are that your baby is likely to consume more variety in foods and be exposed to different flavours early in the weaning process. Iron and nutrient rich solids can be pureed and offered regularly to assist with confidence that your baby consistently meets nutrient requirements. Mealtimes
way, feeding your child should be an enjoyable and positive
are less messy but making separate meals can be time consuming.
experience for both the parent and child.
Increasing textures gradually means gagging is less frequent and
There are two main approaches to introducing solids. These feeding methods can be used solely or combined to
parents can respond by using a texture their baby tolerates whilst increasing lumps in small steps.
suit the babyâ&#x20AC;&#x2122;s needs. Challenges that often arise during traditional weaning are; 1. Concerns that the process is moving at your pace rather than your babyâ&#x20AC;&#x2122;s. Introducing a range of finger foods by eight months will assist with seeing what texture and variety your child is ready for. You can then follow their lead with finger foods and continue to complement with selected puree or mash. 58 Parenting Insights | 2019
2. It is time consuming. Cooking, blending and often freezing
a BLW method as the focus is on learning to self feed, bite and
mashed foods and spoon feeding for the length of the meal is
chew first. This is fine as long as extra milk feeds are available
time consuming for parents, who let’s face it, have no spare time.
as needed and there are no growth or medical concerns. If you
3. Difficulty reading your babies fullness or ‘finished’ cues which may be subtle to start with. This is important to encourage.
are unsure, seek the advice of a health professional. 3. Mess … I repeat MESS! Feeding infants using any method is
Children who listen to their body and eat only what they need
messy, but when using BLW, plan for mess. Embracing it is
will find it easier to maintain a healthy weight as they grow up.
central to everyone’s enjoyment. Start with drop cloths, easy clean high chairs, full sleeve bibs and a newfound appreciation
Baby led weaning (BLW)
for your dog’s insatiable appetite. Clean your baby once at
This type of approach focuses on the independence of your baby
the end of the meal. Wiping throughout the meal is usually
taking food to their own mouth and consuming the quantity and
disruptive and disliked by babies.
variety they choose. You don’t puree foods, but rather offer them
4. Food allergy identification. Because of the introduction of many
foods from what everyone else is eating at family mealtimes.
foods simultaneously rather than a systematic exposure of new
This allows the baby time to learn the art of eating independently.
foods one by one, allergies may be harder to identify and treat.
Your baby is the only one to put food to its mouth using hands
Ensuring you know the ingredients of the foods your baby has
and when older, cutlery.
and using sensible steps to increase variety can help. Currently,
Benefits of this approach include independent eating sooner, a focus on learning to chew and managing foods rather than just
the recommendation is that you do not delay the introduction of solids that may cause allergy so this works well with BLW.
swallowing foods thus allowing babies to decide when they are full and what foods they would like to select. Family meals are
There is no one correct way to starting your baby on solids.
appropriate from day one so no separate cooking.
Knowing the benefits and challenges of these approaches can help
Adults need to show your baby how to eat and behave at
you choose the method that will work best for you and your baby.
the table so eating as a group becomes the norm. Families often
Often, a combination of the two feeding styles work well.
embrace this stage and think of it as a chance to overhaul how
You are able to have the best of both methods, whilst witnessing
they eat and increase the variety of healthy foods in their own
your child discover a delicious world of flavour and texture.
diet. They also tend to cut out junky extras in case baby wants the developing independence that accompanies it allows for an
For further information on toddler nutrition and weaning, visit:
opportunity to encourage communication, family bonding time
• Dietitians Association of Australia daa.asn.au
and the social interaction enjoyed with good food. This in turn
• Baby led weaning babyledweaning.com
creates a positive association integral to mealtimes.
• Traditional weaning – a brief overview with food suggestions
a taste. Whilst BLW assists in developing hand to mouth skills,
healthykids.nsw.gov.au/parents-carers/nutrition/ Challenges that often arise during BLW are;
introducing-solids.aspx
1. Concerns around gagging and choking. However, speech pathologists describe the presence of a sensitive gag reflex to protect infant airways as key. As with any infant eating, supervision is essential but gagging is a typical part of learning to eat and should be expected. Choking should be infrequent if textures and food is being selected well and only your baby
Article by Lauren Gladman Accredited practicing dietitian (APD) specialising in infant, child and adolescent nutrition for 13 years. Mum to Isla (5 years) and Finn (3 years), with baby number 3 due in January 2019. Courtesy of Little Quacker rice snacks LittleQuacker.com.au
places food in their mouth. Knowledge of basic first aid can alleviate some parents’ concerns. 2. Wondering if the baby is consuming enough food. Typically, babies will not consume much food for the first 2–3 months of BLW and then consumption will steadily begin to increase. Swallowing larger volumes of food usually takes longer using
2019 | Parenting Insights
59
Getting started with toilet training Toileting your toddler may take time and patience. This is a developmental step and will only happen when they are ready. The following guide aims to share information around when your toddler may be ready and willing to participate in toilet training and provides some ideas on how to support them through this developmental stage.
When is toilet training possible?
Signs that your toddler may be ready include:
Usually from the age of 2 years, of course this can vary, a toddler’s
• Tells you or indicates they have wet their nappy
bladder and bowel has matured enough, that your toddler has developed voluntary control of the relevant muscles and they have the ability to communicate with you and therefore you may wish to attempt toilet training.
• Trying to remove wet/soiled nappies themselves • Fewer wet nappies during the day • The ability to remain dry for 2 hours or more • You may notice they are dry when
Getting started
they wake up from a nap
Your toddler will probably let you know which of the several
• Able to sit in one place for a few minutes
options for getting started they prefer. Using a potty or chair
• Showing an interest in using the potty and toilet
enables them to feel more secure with their feet on the floor or alternately, a small set of steps with a non-slip base placed in front of a regular toilet can be used with a child size toilet insert. Some boys might prefer to stand in front of the toilet while others will prefer to sit to pass urine.
60 Parenting Insights | 2019
Article courtesy of Karitane karitane.com.au
Australiaâ&#x20AC;&#x2122;s
most trusted brand*
1800 803 760
@Blackmores
Water safety in Australia Implement layers of protection with the SwimSAFER message
What about groups of swimmers? Where there is a group of children involved with the water, enough competent adult supervisors need to be appointed. The adults who are supervising must be vigilant water watchers, and must never leave their ‘post’ until replaced by another competent adult. Swim Australia’s Pool Watcher lanyard is a great aid for this essential task.
No measure can ever guarantee that children are safe in, on and around water. It is only human for adults to sometimes lapse in their supervision of children in the home or
Layer 2 – Be secure As proper supervision relies on people, it is never 100% reliable. There will be times when caregivers are unable to actively supervise children every minute of the day. This is why barriers need to be in place to lessen the chances of children getting to the water hazard. Where possible the water hazard should be
while out and about. Children can and do find ways over fences,
removed (eg. empty wading pools when not in use and put them
and even those who have had swimming lessons can still
away). Where it is not possible to remove the water hazard it
drown. For this reason the SwimSAFER message promotes the
should be fenced or blocked. For home pools, this means a pool
application of various layers to protect children from drowning
fence that meets the relevant government requirements, at the
- if one layer ‘fails’ then there is another behind it that may save
very least. Key points to maximise barrier protection:
their life.
• the pool must be fully isolated from the house by a four-sides
The layers of protection are:
complying fence
• Be Aware • Be Secure
• self-closing and self-latching gates are used
• Be Confident • Be Prepared
• the fence and gate are checked regularly to ensure they are in
All the layers of protection need to be employed at the one time
good working order.
to ensure optimal water safety. Children, however, can climb fences. Children as young as 2
Layer 1 – Be aware
years old, have drowned in backyard pools after using chairs,
SwimSAFER advocates constant supervision by a competent
bins, pot plants, eskies etc, to boost themselves up to open the
adult as the single most critical factor in drowning prevention.
gate or climb over. Ensure that there are no items in the yard that
Royal Life Saving Society Australia report that “the lack of direct
children could drag over and use to climb the fence. Outdoor
adult supervision is the main factor in 70% of toddler drowning
furniture must be secured or too heavy for a child to move.
deaths”.
Props which hold open a gate as a parent works in the yard,
Correct supervision entails:
have also lead to drowning. Never prop open gates – a child
• constant visual contact
slipping through or forgetting to remove the prop can easily lead
• being within arm’s reach of a non-swimmer and under 5s
to tragedy.
• not being distracted by anything eg. ringing phones and doorbells • being ready to respond quickly.
Please note: all too often, when parents have bought a new house with a pool – or started renting one – they have mistakenly believed that the pool fence and gate are in
Who is supervising?
good working order and/or compliant with government
When children are around water, accompanying adults must
regulations. Sadly, such an assumption has contributed to
know who is responsible for direct supervision. Children have
tragic consequences. New owners or renters should demand
drowned at aquatic venues because an adult has mistakenly
a Certificate of Compliance and always inspect the fence and
thought another adult was supervising.
gate for possible non-compliance regardless.
62 Parenting Insights | 2019
Layer 3 – Be confident
• No goggles: even the simplest thing like falling in without
Being able to swim well is one of the greatest gifts that can be
goggles can lead to drowning – it is very easy for children
bestowed upon a child – especially in Australia. Fun, healthy
to panic, and once this happens their survival rates of an
water-based opportunities abound. Equally, a high level of
accidental fall in decrease.
swimming and water safety skills are necessary for full,
• Tiring: children who are swimming well one minute, can
enjoyable participation – as part of a safer framework.
also get tired, panic and go under quite fast, so constant
For young children, the basic swimming and water safety
supervision of children who are swimming is essential.
skills include:
While swimming lessons do not substitute for proper
• water familiarisation, where small children explore and
supervision, learning to swim can make a huge difference if
become comfortable in water environments, developing a
your child accidentally falls in.
respect for the water • gaining confidence through various water activities which
Layer 4 – Be prepared
include and lead into – safe entries and exits – breath control
In immersion incidents, every second counts. Having an
– submersions – floating – propulsion with arms and legs
Emergency Action Plan in place can reduce panic and save vital
– turning – backfloating
time. Consider the following:
• developing the ‘strokes’ so that your child can efficiently cover much greater distances. The whole ‘learn to swim’ experience should be positive; free from fear of force, with a focus of skill
• If a child is missing, check the pool and other water hazards first. Seconds count! • Have a phone poolside for emergency use only.
acquisition and safety around aquatic environments. In the case of an emergency, dial 000 or 112 from As your child gets older, the chances are that they will be
mobile phones. The operator will ask you some important
exposed to potentially hazardous water situations that will
questions, including:
require them to be ‘stronger’ swimmers. Swim Australia
• the address where the ambulance is required;
recommends that children are able to complete a 400m swim
• what the problem is;
reasonably comfortably before they are deemed to be able
• how many people are injured;
to swim well. As this ability is developed, they should also be
• the patient’s age;
learning a variety of rescue skills.
• the patient’s gender;
Combined with learning the physical skills, the child is developing parallel water safety knowledge.
• if the patient is conscious; and • if the patient is breathing.
This ranges from knowing not to go near the pool unless with an adult through to swimming between the flags when at
The operator may provide you with advice to assist the
the beach.
patient while you are waiting for the ambulance; • It is important that you DO NOT HANG UP until the operator
Please note: no matter how well your child can swim,
tells you to. You may have to hold the line while an ambulance
they are never safe around water. There is no such thing
is dispatched.
as ‘drown-proof’ or ‘water-safe’. If you haven’t already done so, revise, refresh or enrol yourself • Water temperature: a sudden immersion in cold water can
in a Cardio Pulmonary Resuscitation (CPR) course so you are
result in ‘cold shock’ which may lead to deep gasping, panic
prepared in case of an emergency. CPR accreditation is current
and inhalation of water. Even a child who can swim, can
for a year.
drown in the first 2–3 minutes due to cold shock. • Turbulent water: children who are used to swimming in still water can panic if the water is choppy or swirling. Panic can easily cause a child to forget all of their swimming skills and go under. • Clothing: wet clothes are extremely heavy and can add an extra 20 –25% of a child’s body weight. Clothed swimming practice in lessons is supported.
Article courtesy of Swim Australia swimaustralia.org.au Swim Australia is the leading national body for water safety Swim Schools across Australia. If you’re looking for water safety classes for toddlers and kids, find your nearest school online and enrol your child today.
2019 | Parenting Insights
63
Tips for toddler tantRumS
The toddler years may be a challenging time for parents. As toddlers mature and begin to explore the world, they will experience a whole new range of emotions which may be difficult for them to manage. Your toddler may need your support to help manage some of these behaviours. This is all a normal part of toddler development, but these tantrums can cause parent concern. A common response from toddlers is “No!”. This can give the impression that they don’t want to cooperate. Be reassured this is a normal part of learning about
• Staying calmly with your toddler while the tantrum is happening may help them feel safe and secure • If you feel you are becoming frustrated, take a deep breath, step away from the situation to calm yourself or ask for help • Once the tantrum is over give your child a cuddle to reassure them. A tantrum can be frightening for a toddler • Acknowledge, name and talk about their feelings (e.g. ‘I understand you’re sad that you can’t have mummy’s keys’)
life e.g. negotiating, discipline, safety and rules.
What is a tantrum?
Outings with toddlers If you are going out with your toddler, for example shopping, plan
A tantrum is a toddler’s way of expressing and coping with feelings
ahead. To help make your outing as fun and productive as possible,
they can’t control, or understand. Here are some reasons that
here are some ideas:
tantrums can occur: • Anger • Jealousy • Tiredness • Frustration • Family conflict • Feeling insecure • Trouble with expressing themselves
Strategies that may help • Use distraction to redirect their attention • Limit use of the word ‘no’. If you must say ‘no’ give
• Ensure your toddler is not tired and it’s not time for a sleep • Ensure your toddler is not hungry and it’s not time for a meal • Give your toddler a healthy meal or snack before you go out • Make some healthy snacks and a drink to take with you • Take some activities along for your toddler • Where possible let your toddler help with the tasks of your outing, for example by getting items from the shopping list from the shelf • Try to have a routine where you finish with a small healthy treat or fun activity when they behave well. This gives them something to look forward to and rewards encouraged behaviour • If tantrums increase while you are out, take your toddler somewhere quiet until they have calmed down
them a simple reason why in a gentle, calm tone • Avoid further explanations
64 Parenting Insights | 2019
Article courtesy of Karitane karitane.com.au