Northern Rivers Baby and Beyond

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Photo: MyLense Photography Studio


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2017 BABY & BEYOND

CONTENTS 7. So you’re having a baby... 8. How do you know if you’re pregnant? 10. Things to do before the baby arrives 12. So many things you should no longer eat 14-16. Which hospital is best for you? 17. Methylation and the MTHFR gene 18-19. Deciding on a name / a few of our favourites 20. Maternity Choices, who are they, what do they do? 21. Sleep and settling 22. Vaccination The 2017 Baby & Beyond 23. Placenta encapsulation - say what? book is produced by the Northern Star, 66200 500. 24. What to do when you have mastitis While every care is taken to 25. Pregnancy and dentistry ensure the information herein is accurate and 26. Pelvic floor issues up-to-date it is imperative you follow the advice of 27. Top tips for your nursery your doctor. 28. Smart technology 29-30. Health service contact details. .

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PHOTO: MYLENSE PHOTOGRAPHY STUDIO

lassy, REaTIVE, lassIC

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Lismore and Byron Bay services the beautiful Northern Rivers District of N.S.W Specializing in Portraiture, Newborns, Maternity and Families.

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2017 BABY & BEYOND

SO YOU’RE HAVING A... Beautiful baby, boy, girl, as yet ungendered child, panic attack WHETHER you have only just decided to get pregnant or you’ve recently had confirmation that you are expecting, life as you know it is about to change. There’s so much to learn and the Baby Book aims to point you in the right direction, without shying away from tough or controversial issues. So many womens lives, and their childrens, are affected by the quality of care they receive at this crucial time and the decisions they make. Did you know, for example, that despite the fact that lying on your back while giving birth (in what is known as the lithotomy position) has been shown to significantly reduce the size of the birth canal, women are still giving birth like this every day. Perhaps doctors prefer this position as it makes it easier for them to observe the process and thus administer care but according to one of our contributors, Sally Cusack from Maternity Choices, birthing in this position can cause longer, more painful labours, making it difficult for the baby to

PHOTO: CHRIS MCQUEEN enter the world and occasionally result in the use of forceps. “It also increases the likelihood of shoulder dystocia where a baby’s shoulders get stuck. This is resolved by getting a woman to change position to all fours, but that is difficult if a woman is under epidural anaesthesia,” she said. This isn’t the most cheerful way to start life, nor a soft fluffy introduction to the

Baby Book but as Sally points out, this information is important and people need to know about it in order to precipitate broader change across the country. We would like to gratefully acknowledge Sally’s huge contribution to this issue in addition to Kirrah Stewart, for her thought provoking article on placenta encapsualtion, Nicole Paull for her tips on handling mastitis, Janelle Angel for her discussion on pelvic floor issues as well as our regular, fabulous contributors. Of course delivering this important information would not be possible without our advertisers and we encourage you to support them in return. We would also like to thank the photographers MyLense Photography, Chris McQueen and Rose Dadon for their gorgeous images. Please note: Nothing in this publication is formal medical advice. We encourage you to do your own research and seek your doctor’s advice before acting.

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SUSPICIOUS SYMPTOMS The early signs of pregnancy can occur surprisingly quickly BEFORE it even becomes apparent that you have missed your period you may suspect that you are pregnant. The early symptoms of pregnancy can start just a few weeks after conception and can vary greatly in their intensity, frequency and duration, depending on the individual. These include: Tenderness: One of the earliest signs of pregnancy is tenderness and swelling of the breasts. Some women become aware of this as soon as two weeks after conception. It is caused by hormonal changes that can make your breasts sore to touch or tingly, they may even feel fuller and heavier at this early stage. Tiredness: Fatigue and general tiredness are also noted among the early symptoms of pregnancy. When you are pregnant the level of the hormone progesterone begins to increase in your body. This sleep-inducing hormone can not only make you feel drowsy, but also lower your blood sugar levels and blood pressure. Bleeding and cramping: Often one of the first signs of pregnancy is a small amount of spotting or bleeding. This is widely known as

implantation bleeding and commonly occurs when a fertilised egg attaches to the lining of the uterus, about 10 to 14 days after fertilisation. If this occurs for you, you may notice that the bleeding comes earlier, is spottier and lighter in colour than your normal period. Some women also report experiencing abdominal cramping, similar to their normal period pain, early in their pregnancy. Morning sickness: Nausea experienced with or without vomiting is one of the classic symptoms of pregnancy and for some women the queasiness can begin as early as two weeks after conception. Nausea is said to be caused by the rapidly increasing levels of oestrogen in the body, which causes the stomach to empty at a slower pace. The waves of nausea can come on at any time and are often induced by a heightened sense of smell. Many odours, such as different perfume, cigarette smoke or the smell of certain foods cooking can set some women off. Cravings and aversions: Both food cravings

PHOTO: CHRIS MCQUEEN for unusual combinations of foods, as well as aversions to foods usually enjoyed are common when pregnant. Like most other symptoms of pregnancy, these food preferences can be attributed to hormonal changes, particularly in the first trimester when those changes are the most dramatic. Feeling faint and dizzy: As your blood pressure drops you may feel light-headed, faint or dizzy. Early in pregnancy, faintness also may be triggered by low blood sugar.

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Most parents expect having a baby will bring them closer together but research paints a very different picture: 92% of parents report increased conflict in baby’s first year, 67% a decline in relationship satisfaction and 17% say having a baby together lead to the end of their relationship according to Australian research by Wendy le Blanc. Thankfully, relationship strengthening programs are proven to work – The Gottman Institute found that just two 40-minute relationship-focused ‘preparing for parenthood’ sessions reduce the incidence of relationship distress and post-natal depression by about 60%. At Interrelate we are here to help couples strengthen their relationship and build a strong and sustainable foundation for “teamwork parenting”. In preparing for the arrival of a baby many couples participate in prenatal classes that revolve around the birth, post birth baby care and bonding but what many couples aren’t aware of is that preparation of the Couple Relationship for the arrival of a baby is just as important. Once baby arrives, life and relationships will never quite be the same and couples need a strong foundation to navigate the many challenges and joys that lie ahead – you are now parents for a lifetime.

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Our friendly team of highly skilled and experienced counsellors and group facilitators are here to support your relationship and family when it matters most. Contact us on 02 6623 2750 or lismore@interrelate.org.au for individual or relationship counselling, to book a place on our new relationship program specifically for pregnant couples – “Becoming Us” or other programs Our counsellors are based in Lismore, Mullumbimby, Ballina and Casino. Concession rates are available.

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2017 BABY & BEYOND

THINGS TO DO BEFORE THE BABY ARRIVES

Help is available if you’re struggling or having relationship problems IF THE arrival or impending arrival of a new baby is causing relationship problems, there is support available. Interrelate offers relationship counselling, individual or couples counselling to help you work with the change a small baby makes. Your whole world can change and they can help you understand the change, work on any relationship issues and support you as a parent to be the best parent possible. Interrelate counsellors are at Mullumbimby, Lismore, Casino and Ballina. The counsellors also offer perinatal groups and parenting programs such as Tune Into Kids, Circle of Security, Becoming Us parenting classes and My Kids and Me. Family Relationship Centre: Interrelate can also help you if you are thinking of separating from the other parent or have separated from the other parent. They can help you with referrals, information or assist you and the other parent to develop parenting arrangements in the best interest of the

PHOTO: MYLENSE PHOTOGRAPHY STUDIO children. As part of this process they provide a free three-hour seminar called Building Connections. This helps parents understand the impacts of family conflict and parental separation on children. Interrelate offers this service at Tweed Heads, Ballina, Casino, Lismore. They can also refer you to free legal advice.

In addition to this Interrelate provides information to parents and links parents to services in the region in relation to their identified needs. Parents may be struggling with housing, income, relationship issues, parenting issues etc. – this service can link you to the appropriate services close to your home. Do you need to improve your parenting skills? Interrelate offers parent education programs such as Being a Dad, Being a Mum, Parents not Partners, Step Parenting Effectively and How to Parent Teens. Are you impacted by distress or anxiety or other mental health concerns since the birth of your baby? Interrelate can help you with: • Counselling for individuals or couples. • Multi-cultural women's group (Lismore) PHONE NUMBERS Relationship Counselling, Parent Education or Support Groups, 6623 2750. Family Relationship Centre, 6623 2700.

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WE KNOW YOU’RE HUNGRY BUT... THERE are numerous foods you should avoid while pregnant, mostly due to the risk of salmonella and listeria poisoning, but also in order to avoid foods with a high mercury content. Unfortunately the list of foods to avoid is so extensive that it could be quite depressing, especially given that chocolate mousse is one to be cautious of, due to it’s potential to contain raw eggs. In very basic terms – you want to make sure that any meat you consume is fresh and thoroughly cooked, your salads are not pre-packaged, your milk must be pasteurised - not raw, only cheeses unlikely to contain listeria should be consumed, your eggs must be well cooked and your spices and herbs must be carefully chosen. In large doses a number of herbs such as fenugreek, juniper chiensis, saffron and ginger are thought to have abortifacient properties. Fish high in mercury such as shark, tuna, marlin and other predatory fish should also be avoided as mercury has the potential to cause

serious birth defects. Teratogenic is the term used for any compounds or substances that can disrupt the development of an embryo or foetus such as: alcohol, caffeine, especially during the first trimester, cocaine and methamphetamine (ICE), nicotine and DMAE medications. Lithium medications, at certain dosages, which are used to treat bipolar disorder can also cause issues. Obviously going off any medication requires medical supervision, do not attempt this alone. For more information refer to your doctor. Sources such as The NSW Food Authority and dietvsdisease.org are also good for food advice. According to the Food Authority, processed meats such as ham, salami, chicken and luncheon meat should not be eaten unless thoroughly cooked to at least 75 C and eaten soon afterwards. No raw meat should be eaten, nor should cold chicken etc used in sandwich bars. Pate and raw seafood are a no no. Soft and semi-soft cheeses such as brie, camembert, ricotta, fetta, and blue

PHOTO: MYLENSE PHOTOGRAPHY STUDIO cheeses should not be eaten unless thoroughly cooked to at least 75 C and eaten soon afterwards. Soft serve and fried ice cream can be scratched from your list as can chocolate mousse and fresh mayonnaise if they contain raw eggs - you will need to keep your fingers out of the cake and pancake batter too. Milk must be pasteurised and pre-prepared salads, including fruit salads such as those from salad bars are out. I’m really not sure what’s left.

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YOUR BIRTH CHOICES IN OUR region, families have a range of options for their maternity care, from conventional public hospital care to private midwifery care in the home. There is even one hospital that offers birth at home - Byron Central Hospital. Here are the options: Public hospital care with a team of midwives and doctors offering low to high risk care and surgical birth if required: Lismore Base Hospital, Grafton Base Hospital and The Tweed Hospital. This is the most widely available form of care. Care can also be shared with your GP or led by a private obstetrician at one of these hospitals. Public hospital continuity of care with a primary midwife who follows you through your pregnancy, birth and 4-6 weeks postpartum, water birth is also available, for normal risk pregnancies only: Byron Central Hospital (also offers homebirth), Murwillumbah Hospital, The Tweed Hospital, Lismore Base Hospital. Private continuity of midwifery care for homebirth provided by independent midwives. The Lismore Birth House supports homebirth, as well as birth in their private birth

rooms. Independent homebirth midwives can be found via the ‘Find a Home Birth Midwife Australia’ or ‘Midwives and Doulas of the Northern Rivers’ Facebook groups. GP shared care: Shared with the public hospital team of midwives at Grafton, Lismore or The Tweed Hospitals. Private obstetric care: At Grafton, Lismore or The Tweed Hospitals or John Flynn Private Hospital, Gold Coast. Antenatal and postnatal care for Aboriginal and Torres Strait women and partners of Aboriginal men is also available through the Aboriginal Maternal and Infant Health Service in Lismore. Birth care is provided at Lismore Base Hospital under the public hospital care (the first option listed above). Public hospital services in the Northern Rivers are located at: Grafton Base Hospital: Conventional public hospital care provided by a team of midwives and doctors, or shared with your GP or led by a private obstetrician. Water birth is also available. Lismore Base Hospital: Conventional public hospital care provided by a team of

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2017 BABY & BEYOND

HOSPITALS AND HOME midwives and doctors, or shared with your GP or led by a private obstetrician. Continuity of care with the Lismore Community Birthing Service is also available for normal risk women. Water birth also available. Byron Central Hospital: Continuity of care with Byron Community Birthing Service at the Birth Centre (water birth available) or at home. Murwillumbah District Hospital: Continuity of care with midwives at the Murwillumbah Birth Centre. Water birth available. The Tweed Hospital: Conventional public hospital care provided by a team of midwives and doctors, or shared with your GP, or led by a private obstetrician. Casino and District Hospital: Offers antenatal and postnatal care only. Closest available birthing services are at Lismore Base Hospital. Ballina Hospital: Offers antenatal and postnatal care only. Closest available birthing services are at Lismore Base Hospital. Kyogle Hospital: Offers antenatal and postnatal care only. Closest available birthing services are at Lismore Base Hospital. For public hospital birth services, women from the Maclean, Yamba regions need to

PHOTO: MYLENSE PHOTOGRAPHY STUDIO travel to Grafton. Women from Kyogle, Nimbin and Casino regions need to travel over to Lismore, as do women from the coastal regions of Ballina and Lennox Head. Private midwifery care for homebirth is also a possibility for these women.

Homebirth NSW Health has a policy advising health services how to incorporate a homebirth programme into a hospital’s maternity services and there are a number of these services around the country, including one at Byron Central Hospital. This service provides normal risk women with the option of birthing either at their birth centre or at home. One of the key reasons families seek out homebirth is they get the enormous benefits of continuity of care with a midwife. Extensive research around the world has found In continuity relationships, mothers and babies are more likely to survive the perinatal period, and hospital services save money with continuity of care as there is less need for interventions. The UK’s National Institute for Clinical Excellence actually recommends homebirth for some mums. They found this choice to have similar risk levels for first time mums, as compared with hospital birth, and it was actually safer for second time mums. Unfortunately publicly funded homebirth is only available for women in the Byron shire, but private midwives do practise in our region. Bron Moir from The Lismore Birth House heads up a team of registered midwives who attend births in families’ homes or at the Birth

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POSTNATAL SUPPORT House, which is a short drive from Lismore Base Hospital in the event a transfer is required. Other registered private midwives can also be found at the ‘Find a Home Birth Midwife Australia’ or ‘Midwives and Doulas of the Northern Rivers’ Facebook groups. Setting up Postnatal Support Ample support for mothers and babies in the early weeks and months is crucial for their recovery and adjustment to life together. However, with all the focus being on the birth, this crucial period is often not planned for. Families benefit enormously from making sure their first couple of months is covered with plenty of assistance from not only family, but expert support for establishing breastfeeding and keeping baby settled and minimising baby’s exposure to illness. Work out with your family how you can stay at home, and be kept company during this time. Make sure you have established connections with midwives or lactation consultants ahead of time to help you out. For women who have had conventional hospital care at Lismore, Grafton and The Tweed Hospitals, their postnatal care is provided by their local community health services.

women in the postnatal period where public services are insufficient. Over the phone support is available from the Australian Breastfeeding Association on 1800 686 268.

Have your say

PHOTO: ROSE DADON PHOTOGRAPHY Women from the continuity of care programmes at Lismore, Byron, Murwillumbah and Tweed receive their postnatal care in the home with their primary midwife who attended them during pregnancy and birth. Private midwives and lactation consultants are also available to support

If you would like to see more choices in your area, tell our Local Health District! When families speak up for change, our health service listens. Submit your feedback here: http://nnswlhd.health.nsw.gov.au/ about/northern-nsw-local-health-district /complaints-and-compliments/ And Maternity Choices would love to hear from you at: maternitychoicebyron @gmail.com Facebook: ■ Friends of NNSW LHD ■ Maternity Choices Australia, Byron Shire ■ Friends of LCMS (Lismore Community Midwifery Service) ■ Friends of Byron Community Birthing Service ■ Friends of Murwillumbah Birth Centre

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METHYLATION, FOLATE AND PREGNANCY Is the commonly held belief that taking folate is imperative correct? ONE Of the first things you are told when becoming pregnant is to take folic acid supplements - because active folic acid has been shown to protect the developing baby against Neural Tube Defects - this is true. New research, however, has revealed that a large percentage of women have a certain gene variation - the MTHFR mutation - which can cause them to have trouble metabolising folate and folic acid, if taken in its usual form. They may need to take the active form instead. MTHFR stands for methylene-tetrahydrofolate reductase. Both the enzyme and the gene variation have the same name which can get confusing. The MTHFR gene, is passed down from your parents while the enzyme converts folate you eat into the active form known as 5-MTHF this is the stuff needed to prevent birth defects. If you carry the MTHFR gene, your body may not be able to metabolise folic acid into

homocystine may contribute to or exacerbate heart disease and folate deficiency. Obviously, when your goal is to avoid Neural Tube Defects, active folate deficiency isn’t ideal. In short – if you carry the MTHFR gene, you will need to avoid consuming breads fortified with folate and taking folic acid supplements while pregnant, and instead take 5-MTHF or L-Methylfolate. This bypasses any MTHFR issues, and is shown to be effective at increasing plasma folate levels and reducing homocysteine concentrations. Sounds simple right? Well, before taking 5-MTHF there are a few factors to consider such as your B12 levels and risk of anxiety, bipolar or depression. So, as with any potentially life altering health issue, your doctor should be your first port of call. They can help you test for the gene and you can also order a test online from sites such as 23andMe and Ancestry.com. For more detailed information about MTHFR see www.dietvsdisease.org.

PHOTO: CHRIS MCQUEEN 5-MTHF, and excess unmetabolised folic acid accumulating in the blood can mask dangerous vitamin B deficiencies. Not only that, but one of the key functions of 5-MTHF is to break down, or recycle, homocysteine. Not enough 5-MTHF equals excess homocysteine, a naturally occurring amino acid thought to damage the lining of your arteries and other cells of the body. Excess

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DECIDING ON A NAME IS NO EASY TASK A name needs to last a lifetime, these simple tips help make it easier to choose CHOOSING a name for your baby can feel like a minefield so we have put together a few simple tips to help out. Keep it secret: If someone asks you if you have chosen a name, you can tell them that you have narrowed it down to a short-list but haven’t quite settled on one yet. It may be hard to keep the secret but can be one of the special things that only you and your partner share during the pregnancy. You like Ulrike, he likes Mary: Try to avoid unnecessary arguments by following this simple strategy. Sit down together with a pen and pad each, make a long list of names that you each like independently. Then swap your lists and choose a name from your partner’s list that you like and start a discussion from there. Look it up to check if you like it’s meaning. Choose the spelling carefully: While a

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different way of spelling can make your child’s name stand out, it may also mean a lifetime of literally spelling-out their name for them. Easy on the tongue: See how the full name rolls off the tongue. If there is too much alliteration going on, too many syllables or they are difficult to enunciate clearly, you may need to rethink one of the names. Also, to avoid schoolyard name calling, think about what rhyming words can be easily combined with the name. Name for life: Keep in mind that the name you give your child will last a lifetime. It should not only suit them as a baby, but a child, teenager, adult and as an elderly person too. Clarify the surname: Discuss the surname with your partner and ensure you’re both in agreement. The tradition is to give a baby PHOTO: CHRIS MCQUEEN

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2017 BABY & BEYOND

LOCAL NAMES WE LOVE The Northern NSW region is nothing if not creative and original Girls ■ Aja (it has an accent over the j and is pronounced Asia) ■ Althea ■ Anoushka ■ Arrow ■ Arya - game of thrones

PHOTO: MYLENSE PHOTOGRAPHY STUDIO

their dad’s last name but there’s no legal obligation to so they can have their mother’s or a combination of the two. The middle name: You don't legally have to choose a middle name but remember, if you do, make sure you put the initials together to ensure your child’s name doesn't spell something you don’t want it to. Let them know: If nine months hasn’t been enough time and you still haven’t chosen a name when the baby is delivered, don’t fret, parents of a new baby have 60 days after the baby is born to come up with a name for the child. Here’s a list of our favourite unusual Northern Rivers names These are loosely divided into boys and girls names but really, most of them could be either. Let’s face it, anything goes and if there’s one thing we’re proud of in Northern New South Wales it’s our creativity. ■ ABCDE (pronounced Ab-se-dee) ■ Archer ■ Explorer ■ Quinn ■ Whizdom (sic.)

■ Antigone ■ Brycin ■ Capri ■ Cedar ■ Ejypt ■ Emeilia ■ Fern ■ Khaleesi - game of thrones ■ Lazuli ■ Luna ■ Nissa ■ Syke ■ Sunshine ■ Solaris ■ Ulrike Boys ■ Atlas ■ Henley ■ Jeffro ■ Kell ■ Lennox ■ Scotland ■ Huntah ■ Waldo ■ Zephyr

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MATERNITY CHOICES Sally Cusack Did you know that if you have continuity of midwifery care your baby is more likely to survive the pregnancy, birth and postnatal periods, and you will need less interventions during birth? Did you know that less than 10% of families can access continuity of maternity care? This means that 90% of women can only access fragmented conventional maternity care with poorer outcomes than those offered by continuity of care. In the early 1990’s, women from across the country were becoming increasingly unhappy with the limited choices and fragmented care their birth services were offering. Yes, Australia has had access to the highest levels of medical care for birth for a long time, but mothers and babies weren’t seeing improved outcomes while health service costs were continuing to rise. Research from Australia and around the world was describing the type of care that families should have access to, such as continuity of care, but it was being ignored by government and health services. And so, Maternity Choices Australia (MCA formerly Maternity Coalition) was born with

the clear purpose to improve our maternity system to better meet the needs and choices of Australian women in the pregnancy, birth and postnatal periods. MCA is non-profit, non-political and non-sectarian and advocates for women’s choices in birth, as well as offering education and support. All of the work we do is as volunteers. We are a bunch of mums from the around the country with a passion for helping families access better birth services, and expert knowledge of evidence-based care, health policy and human rights law. The key reforms we work for are: ■ Continuity of care where women get allocated a primary midwife through their pregnancy, birth and postnatal period. This is evidence-based care that leads to the best outcomes for mothers and babies. ■ Health services involving women in the design of the care they provide (National health safety standard, Standard 2: Partnering with Consumers), and ■ We advocate for individual women who are seeking to have their needs met by their maternity service, or a whole community of women, eg if a service is under threat of

PHOTO: ROSE DADON PHOTOGRAPHY closure. Notable examples of MCA at work is the vital role it played in the reopening of the birth centre at Murwillumbah when it was closed suddenly in May 2015. Together with the women of the community we campaigned to have the service reopened within just 5 months. MCA also advocated for the introduction of water birth at Lismore Base Hospital. For more information see: www.maternitychoices.org.au, Facebook: Maternity Choices Australia, tune in to Pregnancy Birth and Beyond - available on itunes and broadcast nationally or PBDmedia.org.

Are you planning to start a family soon? Making sure your vaccinations are up to date before you fall pregnant is important for you, and your family’s future health. Diseases like whooping cough, measles and pneumococcal can be serious for your newborn.

Speak to your doctor today. Page 20.


2017 BABY & BEYOND

SLEEP AND SETTLING CHALLENGES Building a routine and reading your baby’s cues is the key to staying relaxed and in control

IT IS entirely natural for a baby in the first months of life to have variable sleep patterns, which may include many short sleeps, lasting just two to three hours, as well as the occasional longer ones. By four or five months old you will start to see a predictable pattern. Despite seeing patterns that may evolve, these patterns can quickly change and so do the strategies that support babies to sleep, settle or resettle. Babies need to wake often so that they can feed, as their stomach capacity is small. In the early months, the majority of babies wake, feed and return to sleep at least two to four times a night. Building routines with your child is important, however frustrations and difficulties can arise if you don’t read your baby’s cues. This in turn, can cause distress for both baby, you and the entire family. Around the age of five to six months, babies should start to need to be fed less, and may begin to wake just once or twice overnight, before returning to sleep quite quickly. Local postnatal support service Postnatal Angels recommend, in agreeance with the Australian Breastfeeding Association, that in the first six months having your baby’s sleeping area close enough that you

PHOTO: ROSE DADON PHOTOGRAPHY are able to easily respond to your baby’s cues, day or night will allow new parents to become relaxed, flexible and responsive to your baby’s needs. Postnatal Angels service offers sleep and settling home visits which can be a great support for new parents who are struggling, visit the website to find out more www.postnatalangels.com.au, Tory Peake 0434 531 687.

Are you pregnant and wanting to protect your newborn from whooping cough? Your baby can’t have a whooping cough vaccine until 2 months of age, which means he or she are at risk when they are most vulnerable. You can protect them by being vaccinated in your third trimester. The whooping cough vaccine is free for expecting mums.

Speak to your doctor today.

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2017 BABY & BEYOND

VACCINATION Thimerosal was removed or reduced from vaccines

IMMUNISATIONS have been developed to help people remain healthy and to prevent serious infections, by using the body’s natural defence response to build resistance to specific infections. The diseases that can be prevented by routine childhood immunisation are included in the National Immunisation Program (NIP) Schedule listed on the government’s Department of Health website at immunise.health.gov.au. How does immunisation work? When a person is vaccinated their immune system produces a response, in the same way their body would after exposure to a disease but without the person suffering symptoms of the disease. The objective is that if the immunised person comes in contact with that disease in the future, their immune system will respond fast enough to prevent the person developing the disease. Vaccines contain either a small dose of a live but weakened form of a virus, a small dose of non-live bacteria or virus, small parts of bacteria, or a small dose of a modified toxin produced by bacteria. Some vaccines may also contain either a small amount of preservative or a small amount of an antibiotic to preserve the vaccine. They may also contain aluminium salt, which helps produce a better immune response. How safe are vaccines? All vaccines currently available in Australia must pass stringent safety testing before being approved for use by the Therapeutic Goods Administration (TGA). This

testing is required by law and is usually done over many years during the vaccine's development. Before vaccines are made available to the general public, they are rigorously tested. These trials are strictly monitored for safety and approval processes for some vaccines can take up to 10 years. What childhood vaccines contain thimerosal? Thimerosal is a compound used in small quantities to prevent bacterial and fungal contamination of vaccines. Thimerosal is partly composed of mercury in the form of ethyl mercury. Mercury causes a toxic effect after it reaches a certain level in the body so whether or not it reaches a toxic level depends on the amount of mercury consumed and the person’s body weight. As a result of these concerns, in particular for newborn babies and very young children, thimerosal was removed or reduced from vaccines. All vaccines currently on the NIP for children under five years of age are now either thimerosal free or have only trace amounts of thimerosal. How long do immunisations take to work? In general, the normal immune response takes approximately two weeks to work, this means protection against an infection will not happen immediately after immunisation. Most immunisations need to be given several times to build long-lasting protection however some vaccines provide protection after only one dose.

Dr HOWArD CHILTON - THE BABY DOCTOr

Neonatologist And Paediatrician to Babies and Toddlers.

Bringing up a new baby or toddler is a joy and a privilege. But sometimes the reality can be daunting, or just different to how you thought it was going to be. I now have a weekly clinic in Bangalow and can help you and your baby with any of the many issues and worries that can occur, including: • Poor Sleep • Excessive Crying and Unsettledness • Colic • Reflux, Vomiting, Constipation • Solids and Spoon foods • Allergies and Rashes • Medical issues and aftercare. I have been looking after babies and their parents for 40 years at Sydney’s largest hospital campus as Director of Newborn Care at the Royal Hospital for Women in Sydney, at Sydney Children’s Hospital and the Prince of Wales. I have lived locally for the last 11 years and commute between here and Sydney. I believe in ‘responsive parenting’ and evidence-based information to help parents understand their baby’s needs. • Follow my ‘Blog about Babies’ on my website www.babydoc.com.au and Facebook page www.facebook.com/howardchilton. Join my 10,000+ followers!

Clinics on Fridays Page 22.

Author of ‘Baby on Board’ and ‘Your Cherished Baby’.

Minimal/Small gap after Medicare rebate

Appointments: 0497 643 273

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• Midwife and International Board Certified Lactation Consultant, Georgina Dowden is also available for consultations about breastfeeding.


2017 BABY & BEYOND

PLACENTA ENCAPSULATION There are some potential health benefits to eating your placenta

Kirrah Stewart B.ClinSci WHEN you have a baby, you’ll need to make a decision about what to do with your placenta. There are many differing beliefs and customs around what ‘should’ be done with it. Some cultures believe it needs to be buried, some people dehydrate the cord as a keepsake for the child, and placenta encapsulation is also becoming increasingly popular. Placenta encapsualtion is the process in which a placenta is steamed, dehydrated, ground to powder and poured into capsules to be swallowed. Over 4000 species of mammals consume their placenta straight after birth - even the herbivores! There is also historical evidence of placenta consumption (placentaphagy). According to the 1916 Lancet, there are reports as far back as 1556 of people consuming their placenta. The belief was that it helped with the production of milk. In China it is known as Zi He Che and has been used medicinally for over 2000 years. Many Traditional Chinese Medicine doctors believe it is a tonic to fortify the ‘qi’ and enrich the blood. Up until the end of the 19th century, it was quite common for European pharmacies to sell placenta powder. A study conducted in 1954 looked at women consuming their placenta to help with breastmilk production. Of the 210 women that took part in the study 86.2% had good or very good results. This

Many people believe there are health benefits to ingesting the placenta post-birth. This can be done via placenta encapsulation. PHOTO: CONTRIBUTED included an increase in breast size and an increase in quantity of milk - secretion and flow. Research conducted by Frederick Hammet, Harvard Medical School, demonstrated that the rate of growth of infants was enhanced when their breastfeeding mothers ingested desiccated placenta. The most recent study, published in November 2016 and conducted by the University of Nevada Los Vegas (UNLV), was the first randomised, double-blind and placebo-controlled study to investigate the effects of placenta consumption. Laboratory results showed a 7-fold higher concentration of iron in the placenta capsules versus the beef they tested. This is good news for mothers needing to increase their iron intake as placenta contains a bioavailable source of iron. ■ For more info contact Kirrah on 0429 308 851.

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2017 BABY & BEYOND

BREAST FEEDING PAINS Mastitis or an under-supply of milk? A lactation consultant can help.

APART from comical stories of discretely placed cabbage leaves, or Brussel sprouts when desperation strikes, people don’t tend to talk openly about mastitis. The uncomfortable condition plays out in many ways. It can include anything from: flu-like symptoms and red lumpy breasts to engorged breasts that are hot to touch, or generalised aches and pains. Nikki Paull is a qualified lactation consultant, child health nurse, midwife and parenting educator, with a special interest in feeding difficulties such as tongue and lip ties. When it comes to mastitis Ms Paull says: “My recommendation is to continue breastfeeding, try not to over stimulate the breast but make sure the baby empties the breast as much as possible. Keep up food and fluids, wear a comfortable bra or just go bra free, and if you’re having flu-like symptoms you need to see your GP for antibiotics. The option of a specific breastfeeding probiotic is also available as are Lethecin tablets, for ongoing support to help get rid of of the mastitis. “Another option is to try ultrasound treatment by a physiotherapist. My main suggestion is to not stop breast feeding while there is mastitis, as recurrent infections can turn into a breast abscess which needs to be treated by a breast surgeon.” “If people are having recurrent breast infections then it is advisable to have both mother and baby assessed by an experienced lactation consultant. Ms Paull’s service focuses on providing support for

PHOTO: ROSE DADON PHOTOGRAPHY families experiencing difficulties with breast or bottle feeding, care and management, and other issues such as attachment, positioning, under or oversupply of milk, small or premature babies, slow weight gain, use of lactation aids, as well as gentle sleep and settling strategies to suit your family situation and return to work strategies. No referral is required. “I can visit people in their homes or they can come to my clinic in Lismore,” said Ms Paull. There are also support groups available for mums of 0-6 month olds on Mondays from 10.15-11am and a feeding drop-in clinic for 0-12 months olds from 11-12pm. Bookings are essential and cost $10. The sessions are held at Gypsyfox studios, Level 3/16 Carrington St, Lismore, phone All About Bumps, Birth & Beyond on 0427604363.

Where children are everything

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careringchildrenscentre@gmail.com www.care-ringchildcare.com.au Page 24.

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2017 BABY & BEYOND

TOOTH ROT INEVITABLE? Ever wondered why women’s teeth degrade during pregnancy? THE OLD wives tale, “a tooth lost for every baby”, suggests that tooth loss and having a baby go hand-in-hand. People think the foetus draws calcium from the mother’s teeth, making them weak, but dentist Kim Davies from Bytes Dental in Ballina says this is not true: “The facts are that while pregnancy does involve hormonal changes, and hormonal changes mean gums are more vulnerable to plaque irritation, calcium is drawn from the mother’s diet first and then from the bones.” Unlike bones, our teeth stop forming at around 16 years of age. According to directionsindentistry.net, every single day small parts of our bones are naturally dissolved and then re-formed. Calcium is needed for this process and a deficiency of calcium can lead to weaker bones. “Pregnant mums may get Gingivitis (bleeding gums), and this can be more intense during pregnancy, but seeing a dentist for a professional clean can help, preferably in the second trimester,” said Dr Davies. “During the first trimester there can be a lot

of morning sickness and the embryo is in a critical stage of development so you should avoid unnecessary medications or dental work. But in the second trimester it’s safe to have dental work and the mother is usually quite comfortable in the dental chair. The third trimester is also safe, but the mother can be uncomfortable in the chair on her back as the foetus is bigger.” There are several reasons why new mothers have more cavities, including the affore mentioned morning sickness, acid reflux, changes in cleaning habits and changes in diet. Not all mothers suffer from morning sickness but even occasional vomiting brings up acidic stomach contents and acid can cause tooth enamel to dissolve. Acid erosion can also be caused by acid reflux - often the result of pressure on one’s stomach from the baby pushing on it. Dietary changes such as increased sugar intake due to cravings and forgetting to brush due to lack of sleep and total disruption to one’s normal routine are also factors.

PHOTO: KZENON

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Children need a lot of attention to help them feel comfortable at the dentist. Parents can help prepare children by playing a dentist game with dolls or teddy bears.

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2017 BABY & BEYOND

PELVIC FLOOR PROBLEMS Why you shouldn’t jump into exercise immediately after giving birth

The pelvic floor muscles are not the same as the abdominal muscles. Its important to know the difference. They do tend to work together but not always, especially after birthing.

GIVING birth opens up a whole new world for mums, from cute knitted booties and soft cotton blankies to relentless episodes of Peppa Pig and newly acquired incontinence issues. So if the constant urge to urinate, a prolapse, leakage, or lack of sleep is making you think everything is inside out and upside down: never fear, you are not alone and there is something you can do about it. Physiotherapist Janelle Angel from Bangalow Health and Wellbeing says the most common complaints women have post-birth relate to pelvic floor muscle weakness. In order to address this you need to make sure you are doing your pelvic floor exercises correctly, or you could make things worse. “It can be that women are having urinary or fecal incontinence leakage. Sometimes there’s a sensation of heaviness within the pelvic floor, which can be an indication of a prolapse, but it’s hard to diagnose without seeing someone,” Ms Angel said. Pelvic organ prolapse is the descent of the pelvic organ down from its usual anatomical position. Prolapse of the bladder, rectum and uterus are all possible post-birth. “There can also be ongoing pain as a result of tears and scar tissue, which can cause tightness and muscle

spasm,” she said. Ms Angel focuses on what can be done to address these issues so that womens’ lives don’t need to revolve around incontinence pads and the nearest toilet. “The pelvic floor muscles are not the same as the abdominal muscles. Its important to know the difference. They do tend to work together but not always, especially after birthing.” “Prevention is always better than a cure and it’s ideal to be assessed before the birth. “Women often see me with a bit of trepidation and may even be distressed about their pelvic floor problem. However, they commonly say afterwards, ‘I’m so glad I did, now I understand and know what to do about it’.” “You can start your pelvic floor exercises at any time. There’s a bit of a misunderstanding that you’ll get too tight and not be able to birth but you’d have to be the equivalent of an Olympic athlete for that.” “The thing that’s important to remember postnatally, with all the celebrity and media emphasis on flat tummies, is that high-impact activities and strong abdominal exercise is not actually recommended immediately after the birth. You need to wait a minimum of six weeks, at least, and it’s generally recommended you wait three, sometimes up to six months or longer, before doing strong, boot camp type exercise.”

Women’S,men’S &Pelvichealth

PhySiotheraPy Our expertise is in restoring the health of the bladder, bowels, pelvic floor, reproductive organs and pelvic region, as well as women’s health in general. Our treatment and guidance helps empower men, women and children to significantly improve or cure their health condition.

Women’s, men’s and Pelvic HealtH PHysiotHeraPy can HelP WitH many conditions including: • Pelvic floor strength and relaxation • Bladder and bowel control • Prolapse management • Pain relief • Sexual sensation and function • Surgery preparation and recovery

Pregnancy and Postnatal Health - back or wrist pain, abdominal muscle separation, adapting fitness routines, pelvic floor issues

For further enquiries or to make an appointment please phone Bangalow 02 66872337 | Murwillumbah 02 66 723818 or www.pelvichealthphysio.com.au Page 26.

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Women’s, Men’s and Pelvic Health Physiotherapy is the longest established, dedicated continence, pelvic floor and pelvic health physiotherapy practice, in the Northern Rivers region. There are two clinics - one in Bangalow and one in Murwillumbah, servicing the Lismore, Ballina, Byron Bay and Tweed areas.


2017 BABY & BEYOND

TIPS FOR YOUR NURSERY Make the room comfortable for yourself as well as your new bub SETTING up your baby’s room is, well, essential so we have put together a list of tips to help make it easier: Make it comfortable A comfortable chair next to your baby’s cot is important as you will spend more time than you can imagine in this space. Make sure you choose a chair that has good back and arm support. Prepare for the long hours A small table or little chest of draws located beside your chair, stocked with water, snacks and a good book or current magazine could make all the difference in the wee small hours. Make it safe and cosy A soft light on the table, just bright enough to stop you stubbing your big toe will allow you to see where you’re going when you get up to your new baby during the night. Give it a soundtrack Choose a selection of either soft music or white noise, this works like magic to sooth baby and help them settle back to sleep - and the bonus is, it detracts from all of the other household noise, like ticking clocks.

PHOTO: CHRIS MCQUEEN The well-planned change station A nappy station could be as simple as a change table with a hanging nappy sack, or a floor matt with a basket of necessities. The important thing is that it is convenient for you

and well equipped with all of the essentials you need for a nappy change. Having all your bits and pieces together will ensure that you never get stuck without something you need. Keep it bright and happy Bright, colourful pictures, wall stickers or mobiles in the room will stimulate your child’s curiosity as they become more alert; these things also help develop vision in infants. Talk, sing and read Babies love to hear your voice; reading to them from birth will help them to grow up with a positive association with books themselves. Keep a small pile of colourful books close to your chair so you can share story-time together. Learn a couple of fun songs to sing, or make up your own and sing to your baby whilst changing their nappy. Peace of mind A baby monitor close to your little one’s cot will give you piece of mind, so you can relax while they sleep. Further advice from local founder of Beetle Bottoms, Sarah Hill can be found at www.beetlebottoms.com

Need to organise a Birthday Party, Baby Shower, Christening, Naming Ceremony or Social Event? High Tea Ladies will come to you and exceed your expectations. Whether you decide on a High Tea, Mad Hatters Tea Party, Teddy Bears Picnic, Gourmet Picnic or just catering, we offer all inclusive packages.

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2017 BABY & BEYOND

NEW SMART BAND There are many apps available for new mums and now, there’s a band

Rebecca Lollback I’m not usually into gadgets and technology, but I thought I’d give the Nursery Project’s Mum+Bub Smartband a go, because, well, anything to try and make motherhood easier, right? My son (first baby) is now four months old. I wish I’d had this smartband when he was a new bub! He was a tiny newborn, so I spent a lot of time in those first few weeks writing down how much milk he’d had, when he was sleeping and how many nappies I’d changed. This smartband and the app would have made life a lot easier. That newborn phase is so hectic, it’s impossible to remember anything. With the app, you’re able to log breastfeeds, bottle feeds, breast pumping, nappy changes, naps and the baby’s weight. But I still find it useful now that he’s a bit older. I mostly use it to track his sleeping patterns, because I’m trying to get into a good routine (wishful thinking). It's also good to be able to log when he has his feeds, but there's no option to log solids, which I've just started him on. The other function I liked was the step tracker. My bub loves getting out in the pram and we go for walks most days. There were a lot of functions I didn’t use. You can get notifications (texts and incoming calls) to the smartband and you can wear it to bed and it tells you how much you’ve slept (is sleep even a thing when you’re a new

The Nursery Project’s Mum+Bub Smartband. PHOTO: CONTRIBUTED mother?). You can also log a lot of information about yourself – weight, medications, whether you kept to your diet, whether you exercised and how much water you drank that day. I felt like it was all a bit too much effort, but I can see that its point is to remind you to take care of yourself, as well as your baby. I think this smartband would be most useful to tech-savvy mums with brand new bubs. It could help you establish routines and – most importantly – retain all the details you tend to forget when you have a screaming baby on your hands.

Naomi’s

CraniosaCral and Healing

CraniosaCral Helps Heal trauma  from pHysiCal injury, to emotional trauma and beyond…. Craniosacral Therapy gently facilitates the natural healing and release of the body, within a space of stillness and relaxation. It works from the central nervous system out to every part of the body.

Naomi Tarrant Diploma in Craniosacral Therapy 160 Howards Grass Rd, Lismore • 0423 927 415 Page 28.

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Beneficial for the whole family, Craniosacral therapy can assist Mothers in pre and post natal stages, with issues relating to post-natal depression, sleep issues, anixety or stress. For young babies affected by reflux & colic, or having sleeping and feeding difficulties. For young children with bed wetting, digestive, behaviourial or learning difficulties or on the autisim spectrum.


2017 BABY & BEYOND

THE HEALTH SERVICES HOSPITALS ■ BALLINA DISTRICT HOSPITAL Cherry St, Ballina 2478 Phone: 02 6686 2111 ■ BONALBO HEALTH SERVICE Clarence Way, Bonalbo 2469 Phone: 02 6665 1203 ■ BYRON DISTRICT HOSPITAL Wordsworth St, Byron Bay 2481 Phone: 02 6685 6200 ■ THE CAMPBELL HOSPITAL, CORAKI Union St, Coraki 2471 Phone: 02 6683 2019 ■ CASINO & DISTRICT MEMORIAL HOSPITAL Hotham St, Casino 2470 Phone: 02 6662 2111 ■ KYOGLE MEMORIAL MULTI PURPOSE SERVICE 199 Summerland Way, Kyogle 2474 Phone: 02 6632 1522 ■ LISMORE BASE HOSPITAL Uralba St, PO Box 419, Lismore 2480 Phone: 02 6621 8000 ■ MURWILLUMBAH DISTRICT HOSPITAL Ewing St, M'bah 2484 Phone: 02 6672 1822 ■ NIMBIN MULTI PURPOSE SERVICE Cullen St, Nimbin 2480 Phone: 02 6689 1400 .

If you would like to be featured in next year’s Baby Book please contact the Northern Star on 6620 0500.

PHOTO: MYLENSE PHOTOGRAPHY STUDIO

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2017 BABY & BEYOND

NUMBERS YOU NEED ■ THE TWEED HOSPITAL Powell St, Tweed Heads 2485 Phone: 07 5536 1133 ■ URBENVILLE MULTI PURPOSE SERVICE 45 Beaury St, Urbenville 2475 Phone: 02 6634 1600 COMMUNITY HEALTH CENTRES ■ ALSTONVILLE COMMUNITY HEALTH Suite 4, Robertson Ct, Green St, Alstonville 2477 Phone: 02 6628 0849 ■ BALLINA COMMUNITY HEALTH Cnr Fox & Cherry Sts, Balling 2478 Phone: 02 6686 8977 ■ BANORA POINT COMMUNITY CENTRE Cnr Woodlands & Leisure Drives Banora Point 2486 Phone: 07 5524 9146 ■ BONALBO COMMUNITY HEALTH Clarence Way, Bonalbo 2469 Phone: 02 6665 1203 ■ CASINO COMMUNITY HEALTH Canterbury & North St, Casino 2470 Phone: 02 6662 4444 ■ CORAKI COMMUNITY HEALTH Surrey St, Coraki 2471

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Phone: 02 6683 2019 ■ EVANS HEAD COMMUNITY HEALTH Old School Site, Woodburn St, Evans Head 2473 Phone: 02 6682 4899 ■ KINGSCLIFF COMMUNITY HEALTH Turnock St, Kingscliff 2487 Phone: 02 6674 9500 ■ KYOGLE COMMUNITY HEALTH 199 Summerland Way, Kyogle 2474 Phone: 02 6632 2598 ■ LISMORE ADULT HEALTH 29 Molesworth St, Lismore 2480 Phone: 02 6620 2967 ■ LISMORE CHILD & FAMILY HEALTH 37 Oliver Ave, Goonellabah 2480 Phone: 02 6625 0111 ■ MACLEAN COMMUNITY HEALTH Union St, Maclean 2463 Phone: 02 6640 0123 ■ MURWILLUMBAH COMMUNITY HEALTH Cnr Wollumbin & Nullum St, Murwillumbah 2484 Phone: 02 6670 9400 ■ NIMBIN COMMUNITY HEALTH Cullen St, Nimbin 2480 Phone: 02 6689 1288

■ TWEED HEADS COMMUNITY HEALTH Florence St, Tweed Heads 2485 Phone: 07 5506 7540 ■ URBENVILLE COMMUNITY HEALTH 45 Beaury St, Urbenville 2475 Phone: 02 6634 1600 GP HELPLINE - AFTER HOURS SUPPORT If you or someone you care for has an urgent health concern at night or over the weekend and you are not sure what to do, there is an after hours GP helpline that can give you the reassurance and practical medical advice you need. The after-hours GP helpline is open when your GP may not be, on weekends and public holidays, 365 days a year. HOW TO USE IT: Step 1: Call 1800 022 222 Step 2: Your call will be answered by a registered nurse who will assess your condition and provide you with healthy information and assistance. If necessary, the nurse will transfer you to a GP on the phone. Step 3: The GP will talk with you, assess your condition, make a diagnosis and provide further medical advice.


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Farm living provides an ordinary life for foster kids HAVE you ever considered fostering a child, but then thought the job was too hard for an ordinary parent? Surely you need to be a superhero to be a foster carer? Turns out, you only need compassion and patience to be a superhero. Nathan and Emma Heckendorf are your ordinary parents, bringing up their three sons up on the family farm. But the family has found room in their home, and hearts, for children who do not have the same opportunities. The Heckendorfs originally thought they would be ineligible to foster due to having three children of their own, but lucky for everyone they were wrong. “Nathan and I felt we were in a stable good position with plenty of room and an outgoing life with our own children,” Emma said. “So when we found out we could apply even though we had biological children we thought, why not help kids in need?” Often, foster children haven’t experience ‘ordinary’ family life. What might seem boring and normal to you, could be a whole new experience for a disadvantaged child. “Living on a farm has the great advantage of freedom and relaxation,” Emma said. “If a child is frustrated they can get out and go for a run, ride bikes or play with the animals.” When fostering, you have a choice of care that you can provide. Nathan and Emma have provided short term, respite and long term placement. “Providing respite care is great, because you see the child as often as is needed to give their regular carer a break,” Emma said. “You and the children know they are coming back and

when, so you can plan ahead for activities and look forward to seeing each other.” “Carers are desperately needed so if you have the room, time, patience, and love to give just do it,” Emma said. “You won’t regret it and these children need you.” Challenge Foster Care currently has 31 foster care households and 32 children in care in Lismore. If you think you have what it takes to be a foster care superhero please email Challenge Foster Care fostercare@challengecommunity.org.au or call 1800 084 954.

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