Maternity Annual Galway 2014/2015

UNIVERSITY HOSPITAL GALWAY 2014/2015

Maternity

THE ULTIMATE PREGNANCY GUIDE

IN ASSOCIATION WITH

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GENERAL INFORMATION

TO UNIVERSITY HOSPITAL GALWAY INTRODUCTION

CONTENTS

Welcome to the Women’s and Children’s Directorate at University Hospital Galway (UHG). This Directorate comprises the Department of Obstetrics and Gynaecology and the Department of Paediatrics, to provide care for mothers and their children in a unified way. This hospital has a proud tradition of providing maternity care, paediatric, neonatal and gynaecological care to women. The staff are here to make your experience safe and rewarding. If you have any questions about your pregnancy, or the care of your child, do not hesitate to ask us. There are many services provided within this Directorate at the hospital, and this booklet is aimed at providing you with further information. Whatever service you require, we aim to ensure you are helped and facilitated in a caring manner.

ANTENATAL CARE Quality initiative Baby-friendly hospital initiative Admissions office Early pregnancy assessment unit (epau) Opd appointments Maternity out-patient clinics Midwives led clinics Physiotherapy department Nutrition and dietetics department Antenatal education programme Outreach antenatal groups Medical social work maternity department Your relationship throughout your pregnancy Teen parents support group Labour ward Antenatal ward (St Catherine’s)

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POSTNATAL CARE Neonatal intensive care unit (St Clare’s Ward) Postnatal ward (St Angela’s) Early transfer home Breastfeeding room Breastfeeding information

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GENERAL INFORMATION Registering the birth of your child Gynaecology department (St Monica’s Ward) Colposcopy department Gynaecological theatre Sexually transmitted disease clinic Visiting hours Coffee shop Telephones Discharge Chaplaincy service Security Electronic infant security system Personal property Letters and gifts Smoking Car park Nursing/midwifery philosophy Schedules

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Dr Geraldine Gaffney, Clinical Director Women’s and Children’s Directorate Ms Dawn Johnston, Group Director of Midwifery Ms Jane Whiriskey, Assistant Director of Midwifery/Nursing Women’s and Children’s Directorate Ms Bernadette O’Malley, Business Manager Women’s and Children’s Directorate Ms. Geraldine Keenan, Allied Health Professional Representative, Women’s and Children’s Directorate In the event of an emergency, please contact the switchboard at (091) 524 222 who will contact the appropriate team on duty.

DISCLAIMER: This brochure and contributions made herein have been carefully researched and are intended to act only as a guide for new parents. Independent medical advice should always be sought should you have concerns during, or after, your pregnancy. Whilst every effort has been made to ensure that the information contained in this brochure is accurate at the time of going to press, the publisher, maternity hospital, and the editor cannot take responsibility for inaccuracies or errors. The opinions expressed in the various contributions are the personal opinions of the contributors and are not necessarily the views or opinions of the publishers, the hospital nor the editor. The material contained in this brochure is not intended to constitute medical advice and all problems of a medical nature must be referred to medical staff at the hospital or other qualified medical practitioners. Advertisements within the publication are not endorsed by the hospital or the publisher. Any claims made within the advertisements are not endorsed by the hospital or the publisher.

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GENERAL INFORMATION UNIVERSITY HOSPITAL GALWAY ii

Antenatal Care QUALITY INITIATIVE The quality statement of the Obstetrics and Gynaecology Department, University Hospital Galway, is ‘Quality of service in this department is everyone’s business and embraces all aspects of care’.

The Obstetrics and Gynaecology Department, University Hospital Galway has successfully maintained ISO 9001; 2008 certification for 17 years. This certification ensures that there is a quality management system in place in the department that is regularly assessed by an external body (National Standards Authority of Ireland: NSAI) to ensure that only the highest standard and quality of service is strived for.

Many of our quality improvements are introduced as a result of patient feedback.

The Department of Obstetrics and Gynaecology strives to implement The National

Standards for Safer Better Healthcare published by HIQA. We promote healthcare that is up to date, effective and consistent for women and their families.

ADMISSIONS OFFICE The admissions office is located on the ground floor, near the main entrance to the Maternity OutPatients Department. On arrival at the hospital, all maternity and gynaecological patients should report directly to this office. At night, access is through the side maternity entrance, which is adjacent to the main hospital entrance. Ring the bell for assistance to gain access.

All gynaecology emergencies and pregnancies before 16 weeks should go to the emergency department situated to the right of the main entrance to the hospital.

OPD APPOINTMENTS Women are only seen on a referral appointment basis for all clinics.

Antenatal women are advised

Hours n o i s Admis ADMISSIONS OFFICE HOURS The Admissions Office is located on the ground floor, near the main entrance to the Maternity Out-patients Department. On arrival at the hospital, all maternity and gynaecological patients should report directly to this office.

THE OPENING TIMES ARE AS FOLLOWS: 08:00 to 17:00 : Monday to Thursday 08:00 to 13:00 : Friday Closed : Saturday/Sunday/Bank Holidays When the Admissions Office is closed, and you are a booked obstetric patient, please go directly to the Maternity Triage Unit located in the Labour Ward. At night, access is through the main maternity entrance, which is adjacent to the main hospital. Ring the bell for assistance to gain access. All gynaecology emergencies and or a pregnancy problem for women who are not yet booked to the hospital should be seen in the Emergency Department.

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BABY-FRIENDLY HOSPITAL INITIATIVE The Maternity Unit at University Hospital Galway, is a fully accredited Baby Friendly Hospital since 2006.

The Maternity Unit was redesignated as a Baby Friendly Hospital in 2012.

to book early in their pregnancy through their GP.

MATERNITY OUT-PATIENT CLINICS The Out-Patients Department/ Clinics aim to provide a high standard of care for both antenatal and gynaecological women. On attendance, you should first go to the registration area where you will be greeted by receptionists and have your registration details taken.

Women on their first visit appointment to the antenatal clinic will have a detailed history taken by midwifery staff, blood and urine samples together with blood pressure and weight checks and a general medical examination. This visit will normally take one-and-a-half to two hours to complete.

After history-taking, women have a choice of the following: ● Midwives Clinic ● Obstetric Clinic Follow-up appointments for all clinics should be made at the reception desk prior to departure.

The Out-Patient Department has

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FETAL ASSESSMENT UNIT Patients are offered a dating scan before 14 weeks and a 20-23 week anomaly scan. All scans are offered by appointment. When you attend for your antenatal first visit, you will not have a scan unless requested by your Consultant. You will be asked to make your appointment for your dating scan and your 20 – 23 week scan with the Scan Department before leaving the clinic. The Scan Department is situated just off the antenatal clinic area. Please read the ultrasound information leaflet which will be sent to you with your booking appointment letter.

Contact telephone no.: (091) 544537.

MIDWIFERY-LED CLINICS These clinics are provided by a team of midwives in conjunction with the obstetric-led antenatal clinics. They are run in conjunction with the obstetric-led antenatal clinics. The suitability of a woman who expresses an interest in attending the midwives clinic is determined by the consultant at her first visit to the antenatal clinic. At these clinics, care is provided by midwives throughout the antenatal period. Women who choose to attend these clinics have the option of attending the hospital on Tuesdays, Wednesdays and Fridays. The midwifery outreach clinics are in Oughterard and Tuam on Mondays, Doughiska on Wednesdays and Gort on Thursdays. For further information contact: (091) 544661 or (091) 544715.

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Physiotherapy promotes physical well-being during pregnancy, delivery and the postnatal period.

The physiotherapist, through group sessions and individual treatments, prepares women for the physical aspects of pregnancy, labour and motherhood. Specific musculoskeletal or continence issues are managed on an individual basis. Physiotherapy classes run in conjunction with the Parentcraft Department (see page iv). For further information, please contact the Physiotherapy Department by calling (091) 544525.

NUTRITION AND DIETETICS DEPARTMENT Nutrition during pregnancy is very important for you and your baby.

Expert advice is available from qualified dietitians as appropriate.

ANTENATAL EDUCATION PROGRAMME The Antenatal Education team would like to help you and your partner to prepare for Labour and Parenthood. All courses aim to provide a quality service by meeting you and your partners needs. There is a wide variety of courses available. Please book your classes on our website www. uhgmaternity.com It is advisable to book early. Any further queries: contact (091) 544210.

EARLY PREGNANCY CLASS It is advisable to attend the Early Pregnancy Class between 14 and 20 weeks’ gestation, or as early as possible. Topics discussed include: ● Health promotion ● Promotion of physical wellbeing in pregnancy ● Nutritional demands in pregnancy ● Minor disorders in pregnancy, e.g. morning sickness ● Development of the baby in the womb ● Introduction to breastfeeding

EARLY PREGNANCY ASSESSMENT UNIT (EPAU) The Early Pregnancy Assessment Unit (EPAU) is situated in the Admissions Department of the Maternity OutPatients at University Hospital Galway; it is staffed by a team of doctors, midwives, ultrasonographers and clerical staff in order to offer care, support and advice in a sensitive manner to women with problems such as bleeding and pain during their first 14 weeks of pregnancy.

The Early Pregnancy Assessment Unit at University Hospital Galway’s opening hours are as follows: ● Days: Monday, Tuesday, Thursday and Friday ● Hours: 9.00am to 12.00pm Telephone Number: (091) 893810 during the clinic opening hours. Women are seen strictly by appointment upon referral.

Health professionals are available to answer questions and includes a midwife, dietitian and physiotherapist.

GENERAL INFORMATION

PHYSIOTHERAPY DEPARTMENT

UNIVERSITY HOSPITAL GALWAY

baby-changing facilities.

Unavoidable delays can occur if the doctor urgently called to the labour ward/theatre. The standard of care, knowledge and experience of the staff in the clinic contributes to a high level of satisfaction.

Follow up appointments for all clinics should be made prior to discharge.

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GENERAL INFORMATION UNIVERSITY HOSPITAL GALWAY iv

PREPARATION CLASSES FOR LABOUR AND PARENTHOOD (FIRST-TIME MOTHERS)

POSTNATAL REUNION CLASS Class is held on a monthly basis at 10.30a.m. on the third Tuesday of each month. Mums and babies are welcome at six weeks post-delivery.

Health professionals involved in the class consist of a midwife, physiotherapist and dietitian.

It is best to attend the Antenatal Class between 28 and 32 weeks’ gestation. Some of the topics discussed are as follows: ● Fetal movement awareness ● Signs of labour ● Stages of labour ● Birth positions ● Tour of the Labour Ward ● Infant feeding ● Breathing, positioning and back massage for early labour ● Breathing for late first stage ● Postnatal care ● Caesarean section ● The role of the public health nurse ● The role of the partner ● Video of delivery ● Parenting

OUTREACH ANTENATAL GROUPS Tours of the Unit are arranged for the above groups via the Parentcraft Secretary at (091) 544210. If you have any special requirements, do not hesitate to contact the Parentcraft Department. We aim to meet your needs.

MEDICAL SOCIAL WORK MATERNITY DEPARTMENT If you are worried about any social difficulties relating to your pregnancy, illness, home, family or other personal problems, it may help to discuss these with our medical social worker. You can request the staff to contact the social worker on your behalf. To contact the social worker, call (091) 544089.

The classes are based on your needs. Your participation and comments are welcomed.

Location: Classes are held in the Physiotherapy Room, Ground Floor, Maternity Out-Patients Department, University Hospital.

Classes are held in the mornings, afternoons and evenings, however, early booking is essential to avoid disappointment.

Other classes that may be held include:

YOUR RELATIONSHIP THROUGHOUT YOUR PREGNANCY Pregnancy is a time when women can be physically and emotionally vulnerable and require increased support from family and friends.

Sometimes relationships are controlling or negative and women do not feel supported. If you feel scared, confused, afraid, demeaned, frightened or hurt, you may be in an

REFRESHER CLASS This class is for mothers who have already had a baby. It is held twice a month on alternative Tuesdays at 10.30am.

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WHAT YOU NEED TO BRING WITH YOU FOR YOUR STAY ● MOTHER Your medical record chart.

This maternity guide.

4 large packs maternity sanitary towels.

3 or more cotton nightdresses or pyjamas (an old nightdress or t-shirt is quite adequate for the Labour Ward).

Disposable/old large panties.

Dressing gown, slippers.

Toiletries: shower cap, soap, towels, face cloth, wash bag, etc. ● BABY 4 baby vests, 6 babygros, bibs or towels.

Baby towels for washing baby.

24 disposable nappies (extra will be required if baby is admitted to the Neonatal Intensive Care Unit).

1 roll cotton wool – option: baby wipes, baby cleansing lotion, Vaseline/Sudocrem.

Blanket and hat for going home, baby seat for car.

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WOMENONLY ANTENATAL CLASSES These classes are held for women only on Wednesdays at 9.30 a.m.

Content of classes is similar to couples classes. If this course suits you, please state at time of booking.

If you live a long distance from the hospital or have special needs or requirements, you can avail of a oneto-one session with the Parentcraft Teacher. Advanced booking is essential. Tel: (091) 544210.

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GENERAL INFORMATION

abusive relationship. Often abuse or control begins in pregnancy or can get worse. You will have an opportunity to discuss your relationship with a midwife at your booking-in/first visit to the hospital.

Also, if you would like to talk about your relationship in confidence, please call the Hospital Social Work Department on (091) 544089, your local Domestic Violence Support Service (Galway: (091) 585965; Mayo: (094) 903 5719; Clare: (065) 682 2435), or the Women’s Aid Freephone helpline: 1800 341 900.

TEEN PARENTS SUPPORT PROGRAMME

LABOUR WARD The staff of the Labour Ward in University Hospital Galway are dedicated to helping you and your family have the best possible experience at this special time. Our aim is to create a welcoming and supportive environment for you

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and your partner while creating a positive, supportive attitude towards birth. The rooms on the Labour Ward are single rooms with en-suite toilet facilities. The rooms are well-equipped with birthing equipment as well as birthing balls, bean bags and floor mats.

We promote the use of upright positions using birthing aids, moving around and the use of the bath for the first stage of labour.

Your partner is welcome to come to the Labour Ward with you. We do ask, however, that visiting is limited to one birth partner per woman. We offer some flexibility with visiting at the discretion of the senior midwife on duty on the Labour Ward.

We encourage you to prepare a birth plan, which, if not already discussed with your antenatal midwife/doctor, can be discussed on your arrival to the Labour Ward.

You are welcome to bring a radio or CD player with you if you wish to listen to music while on the ward.

You will be cared for by a qualified midwife while in labour and he/she may be assisted by a

midwifery student working under his/her supervision. He/ she will talk you through your options for: ● Positions for labour and birth ● Pain management options ● Monitoring in labour ● Management of the third stage of labour ● Provide support and care to you during labour The midwifery team are experienced in all types of birth and welcome discussion on your thoughts and feelings around your pregnancy and birth. If complications arise, the midwife will involve the obstetrician in your care. A team of obstetricians, paediatricians and anaesthetists are available 24 hours a day and will become involved in your care should a complication arise. Once you have had your baby, you will be made comfortable on the labour ward and given some privacy to enjoy your baby prior to transfer to St Angela’s the post natal ward.

UNIVERSITY HOSPITAL GALWAY

The Teen Parents Support Programme provides a support service for young parents living in Galway city and county under the age of 20. We provide information, advice and support for both parents in relation to finances, accommodation, health, education, parenting and family issues. We also provide specific antenatal classes to meet the needs of young parents and follow-up for two years afterwards, if required.

We are based at University Hospital Galway, close to the Maternity Unit on the ground floor of the building across the main car park (Old Nurse’s Home). Our contact details are (091) 544960.

Our office hours are 9.00am to 5.00pm, Monday to Friday. You can ask about us when you come for your first antenatal appointment at the antenatal clinic or pick up a leaflet there with our contact details. We can also help to link you with services in your local area if you live outside the county.

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GENERAL INFORMATION

Antenatal/Postnatal Care ANTENATAL WARD (ST CATHERINE’S) Women are admitted to St. Catherine’s Antenatal Ward for induction of labour and any complications that may arise during pregnancy. The staff on St. Catherine’s Ward offer advice, care and support to all women.

UNIVERSITY HOSPITAL GALWAY

NEONATAL INTENSIVE CARE UNIT (ST CLARE’S WARD)

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Just over ten per cent of babies require admission to the Neonatal Intensive Care Unit for a variety of reasons. The majority of these may be able to rejoin their mothers after 24 to 48 hours observation, unless medically indicated. However, some babies born prematurely or with a low birth weight (under 2.5kgs) will need to stay longer.

Mothers at risk of delivering prematurely are encouraged to visit the Neonatal Intensive Care Unit at any time. Every help and encouragement will be given to you to assist you with breast feeding or to express milk for your preterm baby. A mother’s room is available for mums who wish to stay with their baby prior to discharge. Should you need some support in coping with your emotions, feelings or managing some of the extra pressure of having your baby in

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the NICU, you may find it helpful to discuss these with the nursing staff or the medical social worker.

They will provide emotional support and practical advice, which can help you cope during your baby’s stay in hospital. If necessary ask any member of staff to make contact for you with the social worker or the contact number is (091) 544567.Postnatal Ward (St Angela’s) After delivery of your baby, both of you will be transferred to St. Angela’s Ward. You will be supported and advised with all aspects of care for you and your baby by staff midwives and student midwives under the supervision of the registered midwife.

During your stay, your baby will remain with you at all times to promote bonding and enhance the well-being of mother and baby, unless medically indicated. Your baby will be examined by the Paediatrician on the day after delivery and on the day of discharge. Women may avail of a postnatal class on the ward. You will be offered a hearing test for your baby during your stay.

EARLY TRANSFER HOME University Hospital Galway is committed to ensuring the safe early discharge home of healthy low-risk mothers and babies. This service gives choice to women who live within the boundaries of Galway city to avail of this early discharge home

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Postnatal education classes are held on the ward. These include exercises to strengthen you following delivery of your baby and to provide postural advice and tips around managing this in the longer term. Posters with the location and times of the classes are on the ward.

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provided that both mother and baby fit the criteria for discharge. Mothers may choose to go home following a minimum of eight hours to a maximum of 24 hours post-delivery.

This project is staffed by a team of midwives.

The mothers and babies who choose to take early discharge will receive their postnatal care in their homes by one of these midwives.

This service is up to day five and then the woman is referred to the public health nurse in the area. For more information please contact (091) 544661 or (091) 543480.

BREASTFEEDING ROOM There is a breastfeeding room in St Angela’s Ward on the ground floor.

Mothers are encouraged to use this facility as it will enhance the breastfeeding experience.

Breastfeeding Information ● Pregnant women and partners attending University Hospital Galway for antenatal care will be informed about the benefits and advantages of breastfeeding.

You may also benefit from advice and experiences from friends and family who have breastfed. ● Skin-to-skin contact between you and your baby will be encouraged from the moment of birth and baby will be encouraged to breastfeed as soon as possible after delivery. ● During your stay in hospital you and your baby will not be separated unless medically indicated. ● Baby-led feeding (demand feeding) will be practised for all babies unless medically indicated. ● No teats/dummies/soothers will be given to breast-fed babies. ● Be confident about your ability to breastfeed your own baby. ● You may contact the Postnatal

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Ward after discharge for advice and support, if necessary. Tel: (091) 544533/544551. ● Midwives are available to provide objective and consistent information to you and your family about the value of breastfeeding and the same support will be available from the public health nurses. ● Mothers will be informed while in hospital of the various breastfeeding support groups. ● La Leche League hold meetings in the Maternity Lecture Room every month. ● There is a drop-in breastfeeding clinic every Wednesday at 2.00 p.m. on St. Angela’s Ward for discharged mothers experiencing problems. Pregnant women welcome. The breastfeeding midwife can be contacted by calling (091) 893470 (you can leave a message on the answering machine).

USEFUL TELEPHONE NUMBERS ● La Leche: (091) 555866 ● Community Nutritionist: (091) 751131 ● Cuidiú: Contact Antenatal Educator at University Hospital Galway for contact details.

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It is the duty of the parent(s) to register the birth within three months of the date of the birth.

The Maternity Department at University Hospital Galway now offers you the facility to register your child’s birth prior to your discharge from hospital. The Birth Registration Office on St Angela’s Ward, University Hospital Galway, is open to in-patients only. Parents must now personally attend at the Registrar’s Office to register the birth. The registration takes about 15 minutes where the Registrar makes a record of the child’s personal details and the parent confirms that all details are correct by signing the register.

When attending an office to register a birth the below steps must be followed: ● Once your baby is born please complete the pink Birth Notification Form and leave this form in the Registration Office, St Angela’s Ward Maternity Department. Please do not leave the hospital without placing this form in the Registration Office on the hospital ward. ● Please note: If you fail to register your child’s birth prior to discharge from hospital you can attend the Registration Office on Newcastle Road within three months of the child’s birth. ● The parent(s) should contact the office (see contact details) prior to attending to register the child’s birth to ensure that the above form is available to the Registration Office. Submitting this form is step one of the registration procedure. ● The parent(s) must present in front of a Registrar to register the birth and be issued with the child’s Birth Certificate. If the parents were married abroad, they must present a marriage certificate. If the marriage

certificate is in a language other than English or Irish it must be translated. If a parent is divorced or separated, the relevant papers must be presented to the Registrar. ● Following this, Child Benefit is automatically activated provided the birth is registered within three months. Listed below are the particulars that will be registered. Please note that the Personal Public Service (PPS) number of parent(s) is essential as this will facilitate the efficient processing of Child Benefit payment. Suitable forms of identification are also essential.

When the birth has been registered the registration details will be automatically passed to the Department of Social Protection who will assign a PPS number to the child and process the Child Benefit claim. It is recommended, if the parent(s) have been previously married, are separated or divorced, that they contact one of the offices prior to registering a birth. Please do not hesitate to contact any of the offices as listed for advice on registering births or for any other queries regarding the civil registration of life events.

OPENING HOURS Registration Offices, 25 Newcastle Road, Galway, Tel: (091) 546 277 Monday to Friday: 10.00am to 4.30pm Registration Office, St Angela’s Ward, Obstetrics and Gynaecology Department, University Hospital Galway, Tel: (091) 542 879 Monday: 9.00am to 1.00pm and 2.00pm to 3.30pm Tuesday, Wednesday, Thursday: 9.00am to 1.00pm Friday: 9.00am to 1.00pm and 2.00pm to 3.30pm

GENERAL INFORMATION

Acceptable Forms of Photographic Identification ● Passport ● Driver’s Licence ● Refugee Applications Commissioner Client Card ● Current Student Identity Card ● National Age Card

REGISTERING THE BIRTH OF YOUR CHILD

UNIVERSITY HOSPITAL GALWAY

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GENERAL INFORMATION

General Information

UNIVERSITY HOSPITAL GALWAY

GYNAECOLOGY DEPARTMENT (ST MONICA’S WARD) Located on the first floor of the Maternity Unit. The ward caters for women with urological, gynaecological and early pregnancy problems. Patients requiring day case surgery can attend the Admissions Department in the days prior to surgery. This may ensure that their stay in hospital is reduced and an overnight stay may not be required. There is a post-operative recovery room in St

Monica’s Ward. Patients are cared for in this room after major surgery and return to their rooms the day after surgery. The staff midwives provide information, advice and support on a wide range of urological, gynaecological and early pregnancy problems.

COLPOSCOPY DEPARTMENT When women reach 25, they are entitled to attend their GP or Family Planning Clinic for a free smear every three years. You may

d G if t s n a s Letter Letters and gifts delivered to the hospital are brought round to the wards daily. Please ask your friends and relatives to write your full name and the name of your ward clearly on all correspondence. A letterbox for outgoing post is located on the ground floor near the main entrance to the general hospital. Due to bed space restrictions within the wards, we would request, if possible, that you inform your friends and relatives if they wish to deliver flowers to do so to your home.

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be referred to Colposcopy if your smear test reports changes in the cells from the cervix (neck of the womb). These changes are an early warning signal that cervical cancer might develop in years to come. At the Colposcopy Clinic, treatment is available that significantly reduces the risk of cervical cancer. If you are referred for Colposcopy, you will be sent detailed information with your appointment. The Colposcopy service is quality assured by the National Cancer Control Programme. To check your eligibility for a free smear, log on to www.cervicalcheck.ie or free phone: 1800 454555.

OBSTETRIC/ GYNAECOLOGICAL THEATRE The Gynaecological Theatre is situated on the first floor of the Maternity Unit, directly above the Labour Ward. If you need a Caesarean birth, this is where your operation will be performed.

There is also an emergency theatre situated in the Labour Ward. A

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accompanied by a midwife, you will be greeted by a theatre nurse who will explain all procedures to you.

If you have had a spinal or epidural anaesthetic, it is hospital policy to allow one person of your choice to accompany you during the operation.

An anaesthetist and anaesthetic nurse will also be with you throughout to ensure care, support, comfort and safety. A midwife will attend to your baby at birth.

A paediatrician will examine your baby if medically indicated after delivery and, unless special care is necessary (e.g. for prematurity), you will then be able to touch and cuddle your baby. The theatre staff aim to allow you as much contact as possible with your baby and hope your experience will be positive and rewarding. You will be transferred together to the postnatal ward.

SEXUALLY TRANSMITTED DISEASE CLINIC A Sexually Transmitted Disease Clinic is located on the grounds of University Hospital Galway.

A number of staff are available to discuss STDs such as AIDS in a confidential environment. Contact them on (091) 525200.

COFFEE SHOP A coffee shop where visitors can buy snacks and refreshments is situated on the ground floor at the main entrance to the general hospital.

TELEPHONES Please refrain from using telephones/ mobile phones after 10.00pm as respect to other women needing rest.

DISCHARGE You will be expected to vacate your bed/room as soon as possible on the day of discharge or when care

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PHYSIOTHERAPY SCHEDULE SESSION 1 SELF CARE: ● Dealing with musculoskeletal changes in pregnancy ● Posture ● Relaxation techniques SESSION 2 EARLY FIRST STAGE OF LABOUR: ● Dealing with contractions ● Breathing techniques ● Relaxation techniques ● Back massage

SESSION 3 LATE FIRST STAGE OF LABOUR: ● Dealing with contractions ● Practice of breathing techniques ● Relaxation techniques

GENERAL INFORMATION

ON TRANSFER TO THEATRE

SCHEDULES

SESSION 4 SECOND/THIRD STAGE OF LABOUR: ● How to push effectively ● Practice of breathing techniques ● Relaxation techniques

CLINICS SCHEDULE MONDAY AM ● Gynaecology – Dr S. Sarma ● Fertility – Dr D. Egan/Dr U. Conway (alternative weeks) ● Midwives Outreach – Ms J. Duggan C.M.M.11 Clinic, Oughterard MONDAY AM ● Gynaecology – Dr D. Egan/Dr U. Conway (alternative weeks) TUESDAY AM ● Urodynamics – Dr S. Sarma ● Antenatal – Dr D. Egan/Dr U. Conway (alternative weeks) ● Midwives Clinic – Ms J. Duggan C.M.M.11 TUESDAY PM ● Antenatal – Dr S. Sarma ● Midwives Clinic – Ms J. Duggan C.M.M.11 WEDNESDAY AM ● Combined Antenatal/ Endocrinology – Dr G. Gaffney/Prof F. Dunne (alternative weeks)

● Antenatal – Prof J. Morrison (alternative weeks) ● Midwives Clinic – Ms J. Duggan C.M.M.11 WEDNESDAY PM ● Gynaecology – Dr G. Gaffney ● Gynaecology – Dr M. O’Leary ● Midwives Clinic – Midwifery Team, Antenatal Clinic ● Midwives Clinic – Ms J. Duggan C.M.M.11 THURSDAY AM ● Antenatal – Dr K. Astbury ● Midwives Outreach Clinic, Ms J. Duggan C.M.M.11 Gort THURSDAY PM ● Gynaecology – Prof J. Morrison ● Gynaecology – Dr K. Astbury FRIDAY AM ● Antenatal – Dr M. O’Leary ● Midwives Clinic – Ms J. Duggan C.M.M.11

UNIVERSITY HOSPITAL GALWAY

Caesarean birth means that the baby is born through a surgical incision made in the mother’s abdominal wall and uterus (womb). It is performed either as an emergency or it is electively planned in advance.

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GENERAL INFORMATION

is completed to facilitate the efficient turnover of beds.

CHAPLAINCY SERVICE The Chaplaincy Department is serviced by chaplains from the Catholic Church and Church of Ireland. However, should you wish to meet a minister/ religious leader from any other denomination or faith, you can do so by contacting the Hospital Chaplain who will make the necessary arrangements. An oratory is located on the ground floor, off St. Catherine’s Ward.

SECURITY Security staff are on duty at the hospital 24 hours a day, while a closed-circuit security system (CCTV) is in operation. Women should note that all hospital personnel wear identity badges. If you are in any doubt about someone claiming to represent the hospital, either in the building or at home, always seek immediate verification.

ELECTRONIC INFANT SECURITY SYSTEM There is an electronic infant security system in the Obstetrics and Gynaecology Department.

UNIVERSITY HOSPITAL GALWAY

g Po n i s r Our Nu NURSING/MIDWIFERY PHILOSOPHY University Hospital Galway provides a range of acute and specialist services. It is situated close to, and has strong links with, the National University of Ireland Galway. Its mission focuses on providing a quality and caring hospital service.

As nurses/midwives in University Hospital, Galway, we are committed to excellence by focusing on holistic care for patients and families.

Accomplishment of our goals is guided by the following values and principles: WOMEN We value and respect the uniqueness of the individual’s worth, regardless of social or economic status, beliefs, or the nature of health problems.

We respect the woman’s dignity and right to privacy. We will safeguard and maintain confidentiality throughout all aspects of care in accordance with the law. We are committed to promoting a friendly atmosphere, where staff are approachable and the environment is one which helps to reduce the fears and anxieties of women and their families. We believe that women and their families have a right to participate in the decision making process. We believe that

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women have the right to care for their own needs, as far as their health status allows.

NURSES/MIDWIVES We as midwives/nurses are committed to the education of midwifery/nursing students by providing appropriate learning opportunities and supervision.

We are committed to ongoing professional development for all midwives/nurses, thus ensuring that we can maximise the health and social gain of the people we serve. Midwives are responsible and accountable for individual judgements as autonomous practitioners. We aim to provide evidence based, individualised midwifery/nursing care in partnership with the women, families and multi-disciplinary colleagues. As members of the interdisciplinary team, we are committed to health education and promoting positive health for all. We believe continuous evaluation is essential to assure quality in the delivery of care.

In a continually changing healthcare environment, we strive to constantly improve services and facilities for all women in our care by contributing to continuous improvements of the healthcare system.

This infant security system is the most comprehensive security system for protecting infants in maternity wards from abduction. The system protects infants through sophisticated and safe baby tags that provide an efficient deterrent against potential security threats. The special electronic baby tags are worn around the baby’s ankle. The system will provide the earliest warning that an infant has been removed from the control area without authorisation and it will facilitate tracking of the infant’s journey, recorded in real time in collaboration with all other hospital electronic surveillance equipment. If any baby that is tagged is taken outside the control area, an alert/audible alarm will be heard and registered on all personal computers at the midwives’ stations in all areas in the Maternity Unit and will be registered simultaneously on the security pager. Alert results in the automatic locking of all doors.

PERSONAL PROPERTY Patients are advised not to bring into the hospital personal items of value, such as cash, jewellery, valuable handbags, radios, TVs or dvd players. The hospital cannot accept liability for items of value that are lost or stolen unless deposited for safe-keeping.

SMOKING The hospital is a smoke-free zone, except for certain designated areas outside the hospital building. In the interest of patients’ health, visitors are prohibited from smoking within the hospital.

CAR PARK Fee-paying car park facilities are available to all patients and visitors. The hospital cannot take responsibility for vehicles that are damaged or stolen within the grounds.

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Fáil

te

UNIVERSITY HOSPITAL GALWAY FÁILTE

CLÁR ÁBHAIR

Fáilte isteach chuig Stiúrthóireacht na mBan agus na Leanaí in Ospidéil Choláiste na hOllscoil Gaillimh. Is éard atá sa Stiúrthóireacht an Roinn Cnáimhseachais agus Gínéiceolaíochta maille le Roinn na Péidiatrice a chuireann cúram ar fáil do mháithreacha agus dá leanaí ar bhealach comhaontaithe. Is cúis mhórtais don ospidéil an traidisiún atá inti cúram máithreachais, cúram péidiatrice agus cúram gínéiceolaíochta a sholáthar do mhná. Tá an fhoireann tiomanta an eachtra a bheidh agat a dhéanamh sábháilte sa chaoi is gur fearrde tú dá barr. Ná bíodh drogall ar bith ort ceist a chur orainn maidir leis an toircheas nó maidir leis an gcúram a gheobhaidh an leanbh. Cuirtear go leor seirbhísí ar fáil laistigh den Stiúrthóireacht seo san ospidéil agus is aidhm leis an leabhrán seo eolas breise a sholáthar. Cibé ar bith cén tseirbhís a bheas ag teastáil uait cinnteoimid go bhfaighidh tú cúnamh agus go réiteofar an bealach duit ar mhodh cásmhar.

CÚRAM RÉAMHBHREITHE Tionscnamh scothsheirbhíse Tionscnamh ospidéil áisiúil don leanbh Oifig iontrála Aonad measúnaithe luath-thoricis (epau) Coinní opd Clinicí na nothar seachtrach máithreachais Clinicí na gcnáimhseach Roinn fisiteiripe Roinn cothaithe agus bia-eolaíochta Clár oideachais réamhbhreithe Grúpaí réamhbhreithe thuismitheoirí déagóirí Obair shóisialta leighis Cúrsaí caidrimh le linn toirchis Clár tacaíochta do thuismitheoirí déagóra Barda luí seoil Barda réamhbhreithe (naomh catherine)

Dr Geraldine Gaffney Stiúrthóir Cliniciúil, Stiúrthóireacht na mBan agus na Leanaí.

Ms Dawn Johnston Grúpa Stiúrthóir Cnáimhseachais Ms Jane Whiriskey Stiúrthóir Cúnta Cháimhseachais/Altranais Ms Bernadette O’Malley, Bainisteoir Gnó Stiúrthóireacht na mBan agus na Leanaí.

Geraldine Keenan Ionadaí Gairmiúil Sláinte Chomhghuaillithe, Stiúrthóireacht na mBan agus na Leanaí.

I gcás éigeandála déan teagmháil le do thoil leis an Lasc-chlár ag (091) 524 222 agus déanfaidh siadsan teagmháil leis an bhfoireann chuí ar dualgas.

CÚRAM IARBHREITHE Aonad cúram nuabhreithe (barda naomh clare) Barda iarbhreithe naomh angela Luathaistriú abhaile Seomra beathú cíche Faisnéis faoi bheathú cíche FAISNÉIS GHINEARÁLTA Breith an linbh a chlárú An roinn gínéiceolaíochta (barda naomh monica) Roinn colpascópachta Obrádlann ghínéiceolaíoch Clinic na ngalar gnéas-tarchurtha Uaireanta cuairtíochta Siopa caife Teileafóin Scaoileadh Seirbhís séiplíneachta Slándáil Córas leictreonach slándála naíonáin Maoin phearsanta Litreacha agus bronntanais Caitheamh tobac Páirceáil carranna Fealsúnacht altranais/chnáimhseachais Sceidil na gclinicí

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SÉANADH: Chuathas go cúramach i mbun taighde le linn obair thairgthe an bhróisiúir seo agus a bhfuil scríofa ann agus tá sé i gceist go mbeadh sé ina threoir do thuismitheoirí nua agus ina threoir amháin. Má bhíonn imní ort roimh thoircheas, le linn toirchis nó i ndiaidh toirchis ba chóir duit dul sa tóir ar chomhairle neamhspleách leighis i gcónaí. Cé go ndearnadh gach iarracht lena chinntiú go raibh an fhaisnéis sa bhróisiúr seo cruinn tráth a chuaigh sé chuig an bpreas, ní féidir leis an eagarthóir ná leis an ospidéal máithreachais ná leis an eagarthóir freagracht a ghlacadh as míchruinneas nó as earráidí. Maidir leis na tuairimí a chuirtear in iúl i scríbhinní ar leith is tuairimí pearsanta na scríbhneoirí féin iad agus ní gá gurb ionann iad agus tuairimí an fhoilsitheora, an ospidéil nó an eagarthóra. Níl sé i gceist go nglacfaí leis an ábhar sa bhróisiúr seo mar chomhairle leighis agus ní mór gach fadhb a bhaineann le cúrsaí leighis a chur faoi bhráid fhoireann leighis an ospidéil nó faoi bhráid cleachtaitheoirí cáilithe leighis nach iad. Ní thugann an t-ospidéal ná an t-eagarthóir tacaíocht don fhógraíocht laistigh den fhoilseachán. Ní thugann an t-ospidéal ná an t-eagarthóir tacaíocht d’aon ní atá maíte san fhógraíocht laistigh den fhoilseachán.

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CÚRAM RÉAMHBHREITHE OSPIDÉIL NA H-OLLSCOILE GALLIMH xii

Cúram Réamhbhreithe TIONSCNAMH SCOTHSHEIRBHÍSE Seo a leanas an ráiteas um chaighdeán na roinne Cnáimhseachais agus Gínéiceolaíochta, Ospidéal Choláiste na hOllscoile Gaillimh: ‘Baineann caighdeán na seirbhíse sa Roinn seo le cách agus cuimsíonn sé gach gné de chúram cliaint.’

D’éirigh le Roinn an Chnáimhseachais agus na Gínéiceolaíochta, Ospidéal na hOllscoile, Gaillimh an deimhniúchán ISO 9001; 2008 a choinneáil ar feadh 17 mbliana. Cinntíonn an deimhniúchán sin go mbeidh córas bainistithe caighdeáin sa roinn a ndéanfaidh comhlacht seachtrach (an tÚdarás um Chaighdeáin Náisiúnta na hÉireann: ÚCNÉ) measúnú air go tráthrialta lena chinntiú go ndéanfar dícheall chun an caighdeán seirbhíse is airde a bhaint amach. Is toradh ar aiseolas othar go leor den fheabhas a rinneadh ar an gcaighdeán. Go bunúsach baineann an Roinn Cnáimhseachais agus Gínéiceolaíochta úsáid as an gCóras Bainistithe Caighdeáin ISO 9001: 2008 d’fhonn riachtanais shíorathraitheacha na n-othar, a bpáirtithe agus a dteaghlach a riar.

dhochtúirí, chnáimhseacha agus fhoireann cléireach a thugann cúram, tacaíocht agus comhairle ar mhodh íogair do mhná a bhfuil fadhbanna cosúil le cur fola agus pian acu le linn an chéad 14 seachtaine den toircheas.

Seo a leanas na huaireanta oscailte san Aonad Measúnaithe Luath-thoirchis in Ospidéal Choláiste na hOllscoile Gaillimh: Laethanta: Dé Luan, Dé Máirt, Dé Déardaoin agus Dé hAoine Uaireanta: 9.00 r.n. go 12.00 i.n.

Uimhir Theileafóin: (091) 893810 le linn uaireanta oscailte na clinice. Ní bheidh cruinnithe le mná ach amháin de réir coinne.

TIONSCNAMH OSPIDÉIL ÁISIÚIL DON LEANBH Tá an tAonad Máithreachais in Ospidéil Choláiste na hOllscoile Gaillimh creidiúnaithe go huile mar Ospidéil Áisiúil don Leanbh ó 2006 i leith.Sonraíodh an tAonad Máithreachais mar Ospidéal Áisiúil don Leanbh i 2012.

COINNÍ OPD Ní ghlactar le mná ach ar bhonn coinne tharchurtha i ngach clinic. Comhairlítear do mhná atá ag súil le breith coinne a chur in áirithe tríd an DG (dochtúir ginearálta) go luath sa tréimhse thoirchis.

OIFIG IONTRÁLA Tá an Oifig Iontrála suite ar urlár na sráide, gar don phríomhbhealach isteach chuig roinn na n-othar seachtracha máithreachais. Ar theacht chuig an ospidéal di ba chóir do gach othar máithreachais agus do gach othar gínéiceolaíoch a láithreacht a thuairisciú go díreach don oifig seo.

Seo a leanas na huaireanta oscailte: 8.00 r.n. go 5.00 i.n. Dé Luan go Dé Déardaoin 8.00 r.n. go 1.00 i.n. Dé hAoine Dúnta: Dé Sathairn/ Dé Domhnach/ Laethanta Saoire Bainc Sa chás go mbíonn an Oifig Iontrála dúnta, agus go bhfuil áit curtha in áirithe agat mar othar cnáimhseachais, téigh le do thoil díreach chuig an Aonad Triáise Máithreachais atá suite sa Bharda Luí Seoil Istoíche bíonn teacht ar na bardaí trí phríomhdhoras na roinne máithreachais in aice an phríomhospidéil. Bain cling as an gclog le cabhair a iarraidh chun teacht isteach. I gcás gach éigeandáil ghínéiceolaíochta agus, nó fadhb toirchis ba chóir don bhean nach bhfuil áit curtha in áirithe aici go fóill san ospidéal dul go dtí an Roinn Éigeandála AONAD MEASÚNAITHE LUATHTHOIRCHIS (EPAU) Tá an tAonad Measúnaithe Luath-thoirchis (EPAU) suite i Roinn an nIontrálacha de Roinn na n-Othar Seachtracha Máithreachais in Ospidéal Choláiste na hOllscoile Gaillimh; tá foireann lántiomnaithe ann idir

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Atreoraítear daoine chuig an aonad: ● ó GPanna (dochtúirí ginearálta) ● ó dhochtúirí na Roinne Timpiste agus Éigeandála ● ó Chomhairleoirí ● ó Chlinic Réamhbhreithe ● ó NCHDanna

CLINICÍ NA NOTHAR SEACHTRACH MÁITHREACHAIS Tá sé d’aidhm ag Clinicí/Ranna na nOthar Seachtrach cúram ar ardchaighdeán a chur ar fáil do idir mhná atá ag súil le breith agus mhná atá ag fáil cúraim Ghínéiceolaíoch. Ar do theacht i láthair ba chóir duit ar an gcéad ásc dul go dtí an ionad cláraithe; cuirfidh na fáilteoirí fáilte romhat agus glacfar le do shonraí cláraithe. Maidir le mná ar a gcéad chuairt dóibh de réir coinne ar an gclinic réamhbhreithe glacfaidh an fhoireann chnáimhseachais mion cur síos uathu faoina stair leighis; tógfar samplaí d’fhuil agus d’fhual, tomhaisfear brú fola agus seiceálfar meáchan; déanfar scrúdú ginearálta leighis agus measúnú ultrafhuaime. De ghnáth tógann sé ó uair go leith go dhá uaire an chloig chun a bhfuil le déanamh le linn na cuairte a chur i gcrích.

Nuair a bheidh a stair inste ag na mná roghnóidh siad ceann dá leanas: ● Clinic na gCnáimhseach ● Clinic na gComhairleach Tharlódh i gcás go gcuirfí glaoch práinneach ar dhochtúir freastal a dhéanamh ar an mBarda/ Obrádlann Luí Seoil go gcuirfí moill dosheachanta ar chliaint. Cuidíonn caighdeán an chúraim agus eolas agus taithí na bhfoirne sna clinicí le mórshásamh an chliaint san eachtra. Ba chóir coinní leantacha a dhéanamh i ndáil leis na clinicí uile sula n-imí tú abhaile.

AONAD MEASÚNAITHE FÉATAIS Cuirtear scanadh dátaithe ar fáil d’othair roimh 14 seachtaine sa tréimhse réamhbhreithe agus cuirtear scanadh aimhrialtachta ar fáil di sa 20ú-23ú seachtain.

Faightear gach scanadh de réir coinne. An tráth a dtagann tú ar an gcéad chuairt réamhbreithe ní dhéanfar scanadh ort mura mbeidh iarratas air déanta ag do Chomhairleach. Iarrfar ort do choinne le haghaidh an scanadh dátaithe agus le haghaidh scanadh an 20ú-23ú seachtain a dhéanamh leis an Roinn Scanacháin sula bhfágann tú an chlinic. Tá an Roinn Scanacháin suite díreach in aice le limistéar na clinice réamhbhreithe.

Léigh le do thoil an bhileog faisnéise faoin Aonad Measúnaithe Féatais a chuirfear chugat in éindí leis an litir faoi chur in áirithe na coinne. Uimhir theagmhála teileafóin: (091) 544537 CLINICÍ NA GCNÁIMHSEACH Déanann Bainisteoirí Cnáimhsí Cliniciúla 11 agus Cnáimhseacha Foirne maoirsiú ar na clinicí seo. Ritear iad in éindí leis na clinicí réamhbreithe faoi stiúradh cnáimhseoirí. An chéad uair a thugann bean cuairt ar an gclinic réamhbhreithe agus a chuireann in iúl go mbeadh suim aici freastal ar chlinic na gcnáimhseach (na mban cabhartha) déanann an comhairleach cinneadh faoi oiriúnacht na mná sin. Cuireann cnáimhseacha cúram ar fáil ar feadh thréimhse na réamhbhreithe sna clinicí sin. Beidh sé de rogha ag na mná a théann go dtí na clinicí sin an ospidéil a fhreastal ar an Máirt, ar an gCéadaoin agus ar an Aoine nó na clinicí for-rochtana cnáimseachais in Uachtar Ard a fhreastal ar an Luan nó na cinn sa nGort a fhreastal ar an Déardaoin. Le haghaidh tuilleadh faisnéise déan teagmháil le do thoil le: (091) 544661 nó (091) 544715. Beidh sé de rogha ag na mná a théann go dtí na clinicí sin an ospidéil a fhreastal ar an Máirt, ar an gCéadaoin agus ar an Aoine.

Bíonn na clinicí for-rochtana cnáimseachais in Uachtar Ard agus i dTuaim ar an Luan agus na cinn i nDabhach Uisce agus sa nGort ar an Déardaoin.

ROINN FISITEIRIPE Is trí Fhisiteiripe a chuirtear an dea-bhail fhisiciúil chun cinn le linn toirchis, le linn breithe agus tar éis breithe. Is í an fisiteiripeoir a ullmhaíonn mná le haghaidh ghnéithe fisiciúla de thoircheas, de thinneas chlainne agus de mháithreachas.

Is ar bhonn aonair a dhéanfar stiúradh ar cheisteanna sonracha faoi mhatánchnámharlachh nó faoi choinneálacht. Ritear ranganna fisiteiripe in éindí leis an Roinn Oiliúna Tuismitheoireachta (breathnaigh leathanach viii). Le haghaidh tuilleadh faisnéise déan teagmháil le do thoil leis an Roinn Fisiteiripe ag (091) 544525.

ROINN COTHAITHE AGUS BIA-EOLAÍOCHTA Is rud an-tábhachtach duitse agus do do leanbh an cothú le linn toirchis. Cuireann bia-eolaithe cáilithe sainchómhairle ar fáil de réir mar is cuí.

CLÁR OIDEACHAIS RÉAMHBHREITHE Ba mhaith leis an bhfoireann Oideachais Réamhbhreithe cabhrú leat agus le do pháirtí chun ullmhúchán a

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Ranganna Ullmhúcháin le haghaidh Tinneas Clainne agus Tuismíochta (máithreacha den chéad uair) Is fearr freastal a dhéanamh ar an Rang Réamhbhreithe idir seachtain 28 agus seachtain 32 den tréimhse iompair. Seo a leanas roinnt de na hábhair a phléifear: ● Feasacht faoi ghluaiseacht féatais ● Comharthaí tinnis chlainne ● Céimeanna tinnis chlainne ● Turas timpeall an Bharda Luí Seoil ● Beathú naíonáin ● Análú, suí agus suathaireacht droma i dtaca le tinneas clainne luath ● Análú don chéad chéim dheireanach ● Cúram Iarbhreithe ● Gearradh Caesarach ● Ról an Altra Shláinte Poiblí ● Ról an pháirtithe ● Físeán na breithe ● Tuismíocht Is ar do riachtanais atá na ranganna bunaithe.

Fáiltítear roimh rannpháirteachas agus roimh thuairimí de do chuidse.

Láthair: Beidh ranganna ar siúl sa Seomra Fisiteiripe, Urlár na Sráide, Roinn Máithreachais na nOthar Seachtrach, Ospidéil Choláiste na hOllscoile. Beidh siad ar siúl ar maidin, um thráthnóna agus istoíche agus tá sé den riachtanas rang a chur in áirithe go luath le nach gcaillfidh tú an seans. B’fhéidir go reáchtálfar ranganna eile mar a leanas: Rang Athnuachana Is rang é seo le haghaidh máithreacha a raibh leanbh acu cheana. Beidh sé ar siúl dhá uair in aghaidh na míosa gach dara Márta ag 10.30 r.n.

Ranganna le haghaidh ban Amháin Reáchtálfar na ranganna seo ar an Aoine ag 9.30 r.n. le haghaidh ban amháin. Beidh ábhar na ranganna seo cosúil le hábhar na ranganna do chuplaí. Má

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GRÚPAÍ RÉAMHBHREITHE FORROCHTANA Reáchtálfar turais threoraithe san Aonad do na grúpaí thuas faoi réir an Rúnaí maidir le hOiliúint Tuismitheoireachta ag (091) 544210.

Má tá aon riachtanas speisialta agat ná bíodh drogall ort dul i dteagmháil le Roinn na hOiliúna Tuismitheoireachta. Tá sé d’aidhm againn do riachtanais a riar.

OBAIR SHÓISIALTA LEIGHIS ROINN MÁITHREACHAIS Má bhíonn buairt ort faoi na deacrachtaí sóisialta a bhaineann le do thoircheas, le tinneas, le do bhaile agus le do theaghlach nó má tá fadhbanna pearsanta nach iad ag cur isteach ort b’fhéidir gurbh fhearrde thú na rudaí sin a phlé leis an oibrí sóisialta leighis. Tig leat a iarraidh ar bhall foirne dul i dteagmháil leis an oibrí sóisialta thar do cheann. Más mian leat dul i dteagmháil leis an oibrí sóisialta cuir glaoch ar (091) 544089.

CÚRSAÍ CAIDRIMH LE LINN TOIRCHIS D’fhéadfadh sé go mbeadh bean leochaileach ina mothúcháin le linn toirchis agus gur mó a theastódh uaithi tacaíocht ón teaghlach agus ó chairde sa tréimhse sin. In amanna bíonn smachtú nó diúltú i gceist sna caidrimh agus ní bhraitheann an bhean go bhfuil sí ag fáil tacaíochta. Má tá tú scanraithe nó má bhíonn mearbhall nó imní ort nó má bhraitheann tú díspeagtha nó loite b’fhéidir gur i gcaidreamh díblithe atá tú. Is minic a thosaíonn díbliú nó smachtú le linn toirchis agus tig leis éirí níos measa. Beidh deis agat cúrsaí caidrimh a phlé le cnáimhseach tráth a gcuirfidh tú coinne in áirithe/a dtugann tú an chéad chuairt ar an ospidéal. Ina theannta sin más mian leat dul i mbun cainte go rúnda maidir leis an gcaidreamh cuir glaoch le do thoil ar Roinn Obair Shóisialta an Ospidéil ag (091) 544089, ar an tSeirbhís Tacaíochta logánta um Fhoréigean Teaghlaigh (Gaillimh (091) 585965, Maigh Eo (094) 9035719, An Clár (065) 6822435 nó ar líne fónaimh Saorghlao Ghrúpa Cúnta na mBan: 1800 341 900.

CLÁR TACAÍOCHTA DO THUISMITHEOIRÍ DÉAGÓRA Cuirtear seirbhís tacaíochta ar fáil do tuismitheoirí óga faoi bhun 20 bliain d’aois a bhfuil cónaí orthu

i gcathair nó i gcontae na Gaillimhe tríd an gClár Tacaíochta do Thuismitheoirí Déagóra. Cuirimid faisnéis, comhairle agus tacaíocht ar fáil don bheirt tuismitheoirí maidir le cúrsaí airgeadais, cóiríochta, sláinte, oideachais, tuistithe agus teaghlaigh. Cuirimid ranganna réamhbhreithe ar fáil freisin chun riachtanais sonracha tuismitheoirí óga a riar agus breathnaímid ina ndiaidh go leantach ar feadh dhá bhliain ina dhiaidh sin más gá.

Táimid bunaithe in Ospidéal Choláiste na hOllscoile gar don Aonad Máithreachais ar urlár na sráide den fhoirgneamh atá ar aghaidh an phríomhchlóis pháirceála amach (Seanáras na nAltraí). Seo na sonraí teagmhála: (091) 544960.

Seo uaireanta oscailte na hoifige: 9.00 r.n. go 5.00 i.n., Luan go hAoine. Tig leat ár dtuairisc a chur nuair a bhíonn an chéad choinne réamhhreithe agat ag an gclinic réamhbhreithe nó tig leat bileog a fháil ansin ina bhfuil ár sonraí teagmhála.

D’fhéadfaimis tú a chur i dteagmháil le seirbhísí i d’áit cónaithe féin má tá cónaí ort taobh amuigh den chontae.

BARDA LUÍ SEOIL Tá an fhoireann i mBarda Luí Seoil Ospidéal Choláiste na hOllscoile, Gaillimh tiomanta cúnamh a thabhairt duit agus do do theaghlach lena chinntiú go mbeidh an eachtra a bheas agat ag an am speisialta seo chomh taitneamhach agus is féidir. Is é an aidhm atá againn timpeallacht fáiltiúil agus tacúil a chruthú duit agus do do pháirtí agus cur chuige dearfach maidir leis an mbreith a chinntiú ag an am céanna. Is Seomraí singile atá sa Bharda Luí Seoil maille le háiseanna leithris en-suite. Tá na seomraí feistithe go maith le trealamh breithe ar a n-áirítear liathróidí breithe, málaí pónaire agus mataí urláir. Cuirimid cleachtas an suí ceartdíreach chun cinn trí úsáid a bhaint as gléasanna cúnta breithe, as gluaiseacht mórthimpeall agus as an dabhach sa chéad chéim den tinneas clainne.

Beidh fáilte isteach chuig an mBarda Luí Seoil ag do pháirtí in éindí leat. Iarrtar ort áfach an chuairtíocht a bheith teoranta d’aon pháirtí breithe in aghaidh gach mná. Beidh roinnt solúbthacht i gceist maidir le cuairtíocht de rogha na chnáimhsí sinsearaí a bheidh ar dhualgas sa Bharda Luí Seoil.

Moltar duit plean breithe a ullmhú; murar phlé tú é cheana leis an gcnáimhseach/dochtúir réamhbhreithe is féidir é a phlé tráth a dtagann tú chomh fada leis an mBarda Luí Seoil. Tabhair raidió nó seinnteoir CD isteach leat agus fáilte más mian leat ceol a éisteacht nuair a bheidh tú ar an mbarda.

Beidh tú faoi chúram cnáimhsí cáilithe a fhad is a bheidh tinneas clainne ort agus tharlódh go mbeadh mac léinn cnáimhseachais faoi mhaoirseacht an té sin ag cabhrú leis/léi. Pléifidh sé/sí leat na roghanna a bheidh agat maidir le: ● Suíonna le haghaidh tinneas clainne agus breithe ● Roghanna maidir le bainistiú péine ● Monatóireacht le linn toirchis ● An tríú céim den tinneas clainne a bhainistiú ● Tacaíocht agus cúram a sholáthar duit le linn toirchis

CÚRAM RÉAMHBHREITHE

oireann an cúrsa seo duit abair amach le do thoil an tráth a gcuirfidh tú in áirithe é.

Ranganna Speisialta Má tá cónaí ort i bhfad ón ospidéal nó má tá riachtanais speisialta agat tig leat áis a bhaint as seisiún duine ar dhuine leis an múinteoir um oiliúint tuismitheora. Tá sé den riachtanas ranganna a chur in áirithe roimh ré. Teil: (091) 544210.

RANG ATHAONTAITHE IARBHREITHE Rithfear an rang ar bhonn míosúil ag 10.30 r.n. an 3ú Máirt i ngach mí. Fáilteofar roimh mháithreacha agus roimh linbh sé seachtaine tar éis na breithe. Beidh cnáimhseach, fisiteiripeoir agus bia-eolaí mar ghairmithe cúram sláinte ag gabháil d’obair an ranga.

OSPIDÉIL NA H-OLLSCOILE GALLIMH

dhéanamh le haghaidh Tinneas Clainne agus Tuismíochta. Aidhm gach cúrsa is ea seirbhís ar ardchaighdeán a chur ar fáil trí do riachtanais féin agus riachtanais do chomhpháirtí a riar. Tá réimse leathan cúrsaí ar fáil. cuir na ranganna in áirithe ar an suíomh idirlín www.uhgmaternity.com Tá sé inmholta iad a chur in áirithe go luath. Má tá aon cheist eile agat déan teagmháil le: (091) 544210.

Tá sé inmholta ranganna a chur in áirithe go luath sa tréimhse toirchis. Seo a leanas leagan amach an chláir: Rang Luath-Thoirchis Is inmholta freastal a dhéanamh ar an Rang LuathThoirchis idir seachtain 14 agus seachtain 20 den tréimhse iompair, nó a luaithe agus is féidir. Ar na hábhair a phléifear áirítear: ● Cur chun cinn sláinte ● Cur chun cinn an dea-bhaile fisiciúla le linn toirchis ● Éilimh bheathaithe le linn toirchis ● Trioblóidí ar bheag tábhacht le linn toirchis m.sh. tinneas maidine ● Forbairt an linbh sa bhroinn ● Réamheolas faoi bheathú cíche Bíonn gairmithe sláinte ar a n-áirítear bean chabhartha, bia-eolaí agus fisiteiripeoir ar fáil le ceisteanna a fhreagairt.

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CÚRAM RÉAMHBHREITHE OSPIDÉIL NA H-OLLSCOILE GALLIMH xiv

Tá taithí ag an bhfoireann chnáimhseachais ar gach cineál breithe agus tabharfar cluas éisteachta do do smaointe agus dá bhfuil ar do chroí maidir leis an toircheas agus leis an mbreith.

Má théann cúrsaí in aimhréidh cuirfidh an gcnáimhseach fios ar an gcnáimhseoir agus beidh tú faoina c(h)úram. Beidh foireann chnáimhseoirí, phéidiatraithe agus ainéistéisithe ar fáil 24 uaire in aghaidh an lae agus is faoina gcúram a bheidh tú sa chás go rachadh rudaí in aimhréidh. A thúisce a bhíonn an bhreith i gcrích cuirfear ar do shuaimhneas tú sa Bharda Luí Seoil agus beidh phríobháideachas agat ansin chun sult a bhaint as an leanbh. Moltar do mháithreacha atá i mbaol leanbh a shaolú roimh am cuairt a thabhairt ar Aonad Dianchúram na Nuabheirthe am ar bith.

Tabharfar gach cúnamh agus ugach duit do leanbh a chothú ar an gcíoch nó bainne cíche a thál don leanbh réamhaibí. Tá seomra máthar ar fáil do mháithreacha ar mian leo fanacht lena leanaí sula n-imí siad abhaile. Más amhlaidh go bhfuil cúnamh taca de dhíth ort chun smacht a fháil ar do mhothúcháin nó ar a bhfuil tú ag braistint nó chun na brúnna breise a ghabhann le leanbh a bhreith san Aonad Dianchúram na Nuabheirthe a riar, b’fhéidir go mb’fhearr duit na rudaí sin a phlé leis an bhFoireann Altranais nó leis an Oibrí Sóisialta Leighis. Cuirfidh siadsan comhairle, taca mothúcháin, nó moltaí praiticiúla ar fáil duit le gurbh fhearr a bheidh tú i riocht aghaidh a thabhairt ar an saol a fhad is a bheidh an leanbh ag fanacht san ospidéal. Más gá iarr ar bhall foirne ar bith teagmháil a dhéanamh leis an Oibrí Sóisialta Leighis ar do shon, nó déan tagmháil léi ag (091) 544567.

BARDA RÉAMHBHREITHE (NAOMH CATHERINE) Ligtear mná isteach i mBarda Réamhbhreithe Naomh Catherine le haghaidh induchtúchán tinnis chlainne, réamhobráide agus gearradh caesarach agus le haghaidh aon trioblóide a d’fhéadfadh teacht chun cinn le linn toirchis. Cuireann an fhoireann i mBarda Naomh Catherine comhairle, cúram agus tacaíocht ar fáil do gach máthair.

AONAD DIANCHÚRAM NA NUABHEIRTHE (BARDA NAOMH CLARE) Ní foláir ábhairín níos mó ná deich faoin gcéad de leanaí a thabhairt isteach chuig Aonad Dianchúram na Nuabheirthe ar chúiseanna éagsúla. Féadfaidh go bhfillfidh a bhformhór siúd ar na máithreacha tar éis 24 go 48 n-uaire an chloig d’faireachán mura mbeidh táscairí leighis ina choinne sin. Ach beidh ar roinnt leanaí a rugadh roimh am nó ar beag a meáchan breithe (faoi bhun 2.5kg) fanacht níos faide.

Moltar do mháithreacha atá i mbaol leanbh a shaolú roimh am cuairt a thabhairt ar Aonad Dianchúram na Nuabheirthe am ar bith. Más mian leat do leanbh a chothú ar an gcíoch le linn dó/ di bheith in Aonad Dianchúram na Nuabheirthe tabharfar gach cúnamh agus ugach duit. Tá seomra máthar ar fáil do mháithreacha ar mian leo fanacht lena leanaí. Más amhlaidh go bhfuil

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cúnamh taca de dhíth ort chun smacht a fháil ar do mhothúcháin nó ar a bhfuil tú ag braistint nó chun na brúnna breise a ghabhann le leanbh a bhreith san Aonad Dianchúram na Nuabheirthe a riar, b’fhéidir go mb’fhearr duit na rudaí sin a phlé leis an bhFoireann Altranais nó leis an Oibrí Sóisialta Leighis. Cuirfidh siadsan comhairle, taca mothúcháin, nó moltaí praiticiúla ar fáil duit le gurbh fhearr a bheidh tú i riocht aghaidh a thabhairt ar an saol a fhad is a bheidh an leanbh ag fanacht san ospidéal. l Iarr ar bhall foirne ar bith teagmháil a dhéanamh léi ar do shon. Nó dá mhalairt air sin is í (091) 544567 an uimhir theagmhála.

BARDA IARBHREITHE NAOMH ANGELA Tar éis do do leanbh bheith saolaithe aistreofar sibh beirt go dtí Barda Naomh Angela. Tabharfaidh cnáimhseach foirne agus cnáimhseach foghlama faoi mhaoirseacht na cnáimhsí cáilithe cúnamh agus comhairle duit i ngach gné den chúram a gheobhaidh tú agus an leanbh. Le linn duit bheith san ospidéal fanfaidh an leanbh leat an t-am go léir chun an nasc a chothú agus chun dea-bhail máthar agus linbh a fheabhsú, mura gcuireann táscairí leighis ina choinne. Déanfaidh Leanbhlia scrúdú ar an leanbh an lá tar éis na breithe agus ar lá do scaoilte.

Féadfaidh le mná áis a bhaint as rang iarbhreithe ar an mbarda. Tabharfaidh na mná cabhracha tuismitheoireachta agus na fisiteiripeoirí na ranganna sin ar bhonn comhpháirteach.

FISITEIRIPE: Reáchtáiltear ranganna oideachais iarbhreithe ar an mbarda. Bíonn i gceist leo sin cleachtaí chun tú a neartú tar éis bhreith an linbh agus comhairle agus leideanna a chur ar fáil duit chun iompar an choirp a bhainistiú san fhadtéarma. Tá póstaeir ann laistigh den suíomh agus tá amanna na ranganna ar an mbarda.

LUATHAISTRIÚ ABHAILE Tá Ospidéal Choláiste na hOllscoile Gaillimh tiomanta máithreacha agus leanaí ar ar éigean a bhfuil a sláinte i mbaol a scaoileadh abhaile go luath agus go sábháilte. Is tríd an tseirbhís seo a thugtar rogha do mhná a bhfuil cónaí orthu laistigh de theorainneacha chathair na Gaillimhe áis a bhaint as an deis um luathscaoileadh abhaile ar choinníoll go sásaíonn idir mháthair agus pháiste na critéir maidir le scaoileadh. Tig le máithreacha roghnú dul abhaile ocht n-uaire an chloig ar a laghad, nó ceithre huaire is fiche ar a mhéid, tar éis na breithe. Tá foireann cheathrar cnáimhseach gafa leis an tionscadal seo.

Maidir leis na máithreacha agus leis na leanaí a roghnaíonn luathscaoileadh gheobhaidh siad cúram iarbhreithe ina dtithe féin ó dhuine de na cnáimhseacha. Beidh an tseirbhís sin ar fáil go dtí an cúigiú lá agus ansin cuirfear an bhean ar aghaidh go dtí an altra sláinte poiblí sa cheantar.

Má tá tuilleadh faisnéis de dhíth ort déan teagmháil le (091) 544661 nó (091) 543480.

SEOMRA BEATHÚ CÍCHE Tá seomra le haghaidh beathú cíche i mBarda Naomh Angela ar urlár na sráide. Moltar do mháithreacha úsáid

a bhaint as an áis seo de bhrí go bhfeabhsóidh sé an eachtra is cothú ar an gcíoch.

FAISNÉIS FAOI BHEATHÚ CÍCHE ● Cuirfear in iúl do mhná torracha agus dá bpáirtithe a fhreastalaíonn ar Ospidéal Choláiste na hOllscoile Gaillimh le haghaidh cúram réamhbhreithe na sochair agus na buntáistí a bhaineann le beathú cíche. Ina theannta sin féadfaidh tú tairbhiú de chomhairle agus de thaithí cairde agus ball teaghlaigh a chothaigh leanbh ar an gcíoch. ● Molfar teagmháil craiceann le craiceann leis an leanbh a chleachtadh ó nóiméad na breithe agus spreagfar an leanbh chun beatha a ghlacadh ón gcíoch a luaithe agus is féidir tar éis na breithe. ● Le linn duit fanacht san ospidéal ní scarfar ó do leanbh tú mura mbeidh le tuiscint ó tháscairí leighis gurbh fhearr go scarfaí. ● Cleachtfar beathú atá tionscanta ag an leanbh (beathú ar éileamh) i gcás gach linbh mura mbeidh na táscairí leighis ina choinne sin. ● Ní thabharfar aon sine/ghobán/súraic do leanaí atá a bheathú ar an gcíoch. ● Bí muiníneach as d’inniúlacht do leanbh féin a chothú ar an gcíoch. ● Féadfaidh tú dul i dteagmháil leis an mBarda Iarbhreithe le haghaidh comhairle agus eolais tar éis scaoilte más gá. Teil: (091) 544533/544551. ● Beidh cnáimhseacha ar fáil chun faisnéis oibiachtúil agus comhsheasmhach a chur ar fáil duit agus do do theaghlach maidir le fiúntas beathú cíche agus cuirfidh na haltraí sláinte poiblí an tacaíocht chéanna ar fáil. ● Cuirfear máithreacha ar an eolas maidir leis na grúpaí tacaithe beathú cíche éagsúla le linn dóibh bheith san ospidéal. ● Tionólann La Leche League cruinnithe sa Seomra Léachta Máithreachais gach mí. ● Is féidir le máithreacha atá scaoilte amach ach a bhfuil trioblóidí ag cur isteach orthu bualadh isteach gan choinne sa chlinic beathú cíche a bhíonn ar siúl gach Céadaoin ag 2.00 i.n. i mBarda Naomh Angela. Tá fáilte roimh mhná torracha. Ìs féidir dul i dteagmháil leis an mbean chabhartha/ gcnáimhseach um beathú cíche ag an uimhir (091) 893470 (nó teachtaireacht a fhágáil ar an ngléas freagartha gutháin).

BREITH AN LINBH A CHLÁRÚ Tá sé de dhualgas ar an/na tuismitheoir(í) an bhreith a chlárú laistigh de thrí mhí ó dháta na breithe. Tá áis curtha ar fáil anois ag an Roinn Máithreachais in Ospidéal Choláiste na hOllscoile, Gaillimh chun breith an linbh a chlárú sula scaoilfear ón ospidéal tú. Tá an Oifig Clárúchán Breithe i mBarda Naomh Angela Ospidéal Choláiste na hOllscoile, Gaillimh, oscailte d’othair chónaithe amháin. Ní mór do thuismitheoirí freastal go pearsanta ar Oifig an Chláraitheora chun an bhreith a chlárú. Caitear thart ar 15 nóiméad chun an clárú a chur i gcrích; cuirfidh an Cláraitheoir sonraí pearsanta an linbh ar taifead agus deimhneoidh an tuismitheoir go bhfuil na sonraí ceart nuair a shíneoidh sé/sí an clár. Nuair a fhreastalaíonn tú ar oifig chun breith a chlárú ba chóir duit cloí leis na céimeanna a leanas: ● Ach an leanbh a bheith beirthe líon amach le do thoil Foirm Fhógartha na Breithe .i. an fhoirm bhándearg, agus fág í san Oifig Clárúcháin, Roinn Máithreachais Bharda Naomh Angela. Ná fág an

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COMHARTHAÍ AITHEANTAIS FHÓTAGRAFAIGH INGHLACTHA ● Pas ● Ceadúnas Tiomána ● Carta Cliaint an Choimisinéara um Iarratais do Dhídeanaithe ● Cárta Aitheantais Mac Léinn ● Carta Náisiúnta Aoise UAIREANTA CUARTAÍOCHTA Oifigí Clárúcháin, 25 Bóthar an Chaisleáin Nua, Gaillimh Teil: (091) 546 277 Luan go hAoine: 10.00 r.n.- 4.30 i.n. Oifig Clárúcháin, Barda Naomh Angela, an Roinn Cnáimhseachais agus Gínéiceolaíochta, Ospidéal Choláiste na hOllscoile, Gaillimh. Teil: (091) 542 879 Dé Luan: 9.00 r.n. go 1.00 i.n. agus 2.00 i.n. go 3.30 i.n.

Dé Máirt, Dé Céadaoin, Dé Déardaoin:

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AN ROINN GÍNÉICEOLAÍOCHTA (BARDA NAOMH MONICA) Tá sé ar an gcéad urlár den Aonad Máithreachais. Déanann an barda freastal ar mhná le fadhbanna úireolaíocha, gínéiceolaíocha agus luath-thoirchis. Más máinliacht mhionchúiseach a theastaíonn ón othar tig léi dul go dtí Roinn na nIontrálacha sna laethanta sula rachaidh sí faoin scian. Féadfar cinntiú mar sin go laghdófar an seal a chaithfidh sí san ospidéal agus b’fhéidir nach gá di fanacht thar oíche. Tá seomra athghabhála fuinnimh i ndiaidh obráide i mBarda Naomh Monica. Is sa seomra sin a thugtar cúram d’othair i ndiaidh mórobráidí máinliachta agus fillfidh siad ar a gcuid seomraí an lá i ndiaidh dóibh dul faoin scian. Cuireann na cnáimhseacha foirne faisnéis, comhairle agus tacaíocht ar fáil maidir le réimse leathan d’fhadhbanna úireolaíocha, gínéiceolaíocha agus luath-thoirchis.

UIMHREACHA TEILEAFÓIN ÚSÁIDEACHA ● La Leche: (091) 555866 ● Cothaitheach Pobail: (091) 751131 ● Cuidiú: Déan teagmháil leis an Oideoir Réamhbhreithe ag Ospidéal Choláiste na hOllscoile Gaillimh, le haghaidh sonraí teagmhála.

ROINN COLPASCÓPACHTA Nuair atá na 25 bliana slánaithe ag mná beidh siad i dteideal dul go dtí a ndochtúir ghinearálta (DG) nó go dtí Clinic Pleanála Clainne le haghaidh smearaidh shaor in aisce gach trí bliana. Cuirfear ar aghaidh go dtí clinic Colpascópachta tú má thugann tástáil an smearaidh as an gceirbheacs le fios go bhfuil athrú tagtha ar chillíní an cheirbheacs (muineál na broinne). Is luathchomhartha agus rabhadh na hathruithe sin gur féidir go mbeadh fás ar ailse cheirbheacsach sna blianta atá le teacht. Tá cóireáil ar fáil sa Chlinic Colpascópachta a laghdóidh go suntasach baol na hailse ceirbheacsaí. Má atreoraítear tú le haghaidh colpascópachta cuirfear faisnéis mhionsonraithe ar aghaidh chugat in éindí le fógra na coinne.

Deimhníonn an Clár Náisiúnta Rialaithe Ailse ardchaighdeán na seirbhíse Colpascópachta.

Chun a fháil amach an bhfuil tú i dteideal smearaidh shaor in aisce logáil isteach ag www. cervicalcheck.ie nó cuir glaoch saor in aisce chuig 1800 454555.

OBRÁDLANN CHNÁIMHSEACHAIS/ GHÍNÉICEOLAÍOCH Tá an Obrádlann Ghínéiceolaíoch suite ar an gcéad urlár den Aonad Máithreachais go díreach os cionn an Bharda Luí Seoil. Má theastaíonn gearradh Caesarach uait is anseo a dhéanfar an obráid. Ina theannta sin tá obrádlann éigeandála suite sa Bharda Luí Seoil. Ciallaíonn breith Chaesarach go saolaítear an leanbh trí ghearradh máinliachta a dhéantar i mballa bholg an mháthar agus san útaras (broinn). Is i gcás éigeandála a dhéantar

é nó ar mhodh neamh-éigeandálach tar éis réamhphleanála. Sula dtaga tú chomh fada leis an obrádlann tabharfaidh ainéistéisí cuairt ort d’fhonn an t-ainéistéiseach is fearr a d’fheilfeadh do do riachtanas a phlé leat. Féadfaidh ainéistéiseach ginearálta bheith i gceist sa chaoi go dtitfidh tú i do chodladh ar feadh na hobráide nó ainéistéiseach dromlaigh nó eipeadúrach sa chaoi go mbeidh tú i do dhúiseacht gan pian a mhothú. Nuair a thagann tú chomh fada leis an obrádlann cuirfidh altra obrádlainne fáilte romhat agus míneoidh sí na nósanna imeachta duit. Má bhí ainéistéiseach dromlaigh nó eipeadúrach agat is é polasaí an ospidéil cead a thabhairt do dhuine amháin de do rogha féin tú a thionlacan le linn na hobráide. Beidh ainéistéisí agus altra ainéistéiseach in éindí leat ar feadh an achair d’fhonn cúram, tacaíocht, compord agus sábháilteacht a chinntiú. Beidh cnáimhseach ag tabhairt aire do do leanbh ag am breithe..

CÚRAM RÉAMHBHREITHE

9.00 r.n. go 1.00 i.n.

Dé hAoine: 9.00 r.n. go 1.00 i.n. agus 2.00 i.n. go 3.30 i.n.

CLINIC NA NGALAR GNÉASTARCHURTHA Tá Clinic Galair GhnéasTarchurtha (GGT) suite ar fhearann Ospidéal Choláiste na hOllscoile Gaillimh. Beidh roinnt Ball foirne ar fáil chun GGTanna a leithéidí AIDS a phlé i dtimpeallacht rúnda. Déan teagmháil leo ag (091) 525200.

SIOPA CAIFE Tá siopa caife inar féidir le cuairteoirí sneacanna, bia agus deoch a cheannach suite ar urlár na sráide ar an bpríomhbhealach isteach chuig an ospidéal ginearálta.

TEILEAFÓIN Ná bain úsáid le do thoil as teileafón/fón phóca tar éis 10.00 i.n. le meas ar mhná eile a mbíonn scíth de dhíth orthu.

SCAOILEADH Tá súil leis go bhfágfaidh tú an leaba/an seomra a luaithe agus is féidir ar lá do scaoilte nó nuair a bheidh deireadh leis an tréimhse chúraim le go mbeidh deis ann na leapacha a chur in oiriúint go héifeachtach don chéad duine eile.

UAIREANTA CUARTAÍOCHTA De réir an pholasaí chuartaíochta ceadaítear cuairteanna ó 2.00 i.n. go 4.00 i.n. agus ó 6.30 i.n. go 8.30 i.n. go laethúil. Moltar gan níos mó ná dhá chuairteoir a ligean isteach ag aon am faoi leith le linn na dtréimhsí cuairtíochta. Caithfidh go mbeidh áitreabh an ospidéil fágtha ag cuairteoirí faoi cheann 9.00 i.n. B’fhéidir go n-iarrfar ar chuairteoirí imeacht leo tráth a mbíonn nósanna imeachta cnáimhseachais/leighis ar siúl ar mhaithe leis an bpríobháideachas. Ar mhaithe le príobháideachas daoine eile ní chuirfear aon áiseanna ar fáil do pháirtithe chun fanacht thar oíche sa Roinn Máithreachais.

SEIRBHÍS SÉIPLÍNEACHTA Is iad na Séiplínigh ón Eaglais Chaitliceach agus ó Eaglais na hÉireann chomh maith le hOibrí Cúram Tréadaigh a sheirbheálann sa Roinn Séiplíneachta.

Ach más mian leat bualadh le ministir/ceannaire reiligiúnach ó aon chreideamh nó sainchreideamh eile is féidir leat é sin a dhéanamh trí teagmháil

OSPIDÉIL NA H-OLLSCOILE GALLIMH

ospidéal le do thoil gan an fhoirm sin a chur isteach san Oifig Clárúcháin i mbarda an ospidéil. ● Tabhair do d’aire le do thoil: Má chliseann ort breith an linbh a chlárú sula scaoiltear ón ospidéal tú is féidir leat freastal ar an Oifig Clárúcháin ar Bhóthar an Chaisleáin Nua taobh istigh de thrí mhí tar éis bhreith an linbh. ● Ba chóir don/do na tuismitheoir(í) teagmháil a dhéanamh leis an oifig (sonraí teagmhála thíos) lena chinntiú go bhfuil an fhoirm thuasluaite ar fáil san Oifig Clárúcháin sula dtéann siad go dtí í chun breith an linbh a chlárú. Is é céim a haon de nós imeachta an chlárúcháin an fhoirm sin a chur isteach. ● Caithfidh na tuismitheoirí bheith i láthair an Chláraitheora chun an bhreith a chlárú agus chun glacadh leis an Teastas Breithe a eiseofar.

Más rud é gur pósadh na tuismitheoirí thar lear ní mór dóibh teastas pósta a thabhairt ar aird.

Más amhlaidh go bhfuil an teastas pósta scríofa i teanga eile seachas i mBéarla nó i nGaeilge ní mór é a aistriú. Má tá tuismitheoir colscartha nó scartha ní mór na páipéirí ábhartha a thabhairt ar aird don Chláraitheoir. ● Ina dhiaidh sin ar choinníoll go bhfuil an bhreith cláraithe laistigh de thrí mhí, cuirfear i ngníomh go huathoibríoch soláthar an tSochair Linbh.

Tá na sonraí a chlárófar liostáilte thíos. Tabhair faoi deara le do thoil go bhfuil sé den riachtanas Uimhir Phearsanta Seirbhíse Poiblí (UPSP ) an tuismitheora/na dtuismitheoirí a thabhairt toisc go n-éascóidh sin próiseáil éifeachtach na híocaíochta Sochar Linbh. Is den riachtanas freisin go dtabharfadh sí/siad comharthaí aitheantais oiriúnacha léi/leo.

Nuair a bheidh an bhreith cláraithe cuirfear sonraí an chláraithe ar aghaidh go huathoibríoch go dtí an Roinn Coimirce Sóisialaí; tabharfaidh siadsan Uimhir PSP don leanbh agus próiseálfaidh siad an tÉileamh ar Shochar Linbh. Moltar, má bhí an tuismitheoir/na tuismitheoirí pósta roimhe, nó má tá siad scartha nó colscartha go ngabhfaidh siad i dteagmháil le ceann de na hoifigí sula gcláróidh siad an bhreith. Ná bíodh drogall ort le do thoil teagmháil a dhéanamh le ceann de na hoifigí atá liostáilte le haghaidh comhairle faoi chlárú breithe nó le haghaidh freagra ar aon cheist eile a bhaineann le clárúchán sibhialta imeachtaí saoil.

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CÚRAM RÉAMHBHREITHE

a dhéanamh le Séiplíneach an Ospidéil; déanfaidh an duine sin na socruithe is gá. Tá aireagal suite ar urlár na sráide ar thaobh Bharda Naomh Catherine.

SLÁNDÁIL Bíonn foireann slándála ar dhualgas san ospidéal 24 uair in aghaidh an lae agus bíonn córas slándála ciorcad-gan-briseadh (CCTV) ag feidhmiú. Ba chóir do mhná a thabhairt dá n-aire go mbíonn suaitheantas aitheantais á chaitheamh ag pearsanra uile an ospidéil.

Má bhíonn tú in amhras faoi dhuine a deir go bhfuil sé/sí ag feidhmiú ar son an ospidéil, bíodh sé san fhoirgneamh nó sa bhaile, iarr fíorú láithreach i gcónaí.

CÓRAS LEICTREONACH SLÁNDÁLA NAÍONÁIN Tá córas leictreonach slándála naíonáin i bhfeidhm sa Roinn Cnáimhseachais agus Gínéiceolaíochta. Is é an córas slándála is cuimsithí atá ann chun naíonáin i mbardaí máithreachais a chosaint ar fhuadach. Is córas cosanta naíonáin é a bhaineann úsáid as clibeanna linbh sábháilte agus sofaisticiúla mar bhac éifeachtach i gcás aon bhagairtí slándála a d’fhéadfadh teacht chun cinn. Is timpeall rúitín an linbh a chuirtear na clibeanna speisialta leictreonacha linbh. Tabharfaidh an córas an rabhadh is luaithe sa chás go bhfuadófar naíonán as an limistéar rialaithe gan údarú agus éascóidh sé an tasc lorg an naonáin a leanúint trína aistear a thaifeadadh ar bhonn tob-uaire i gcomhar le trealamh faireacháin eile an ospidéil. Má bheirtear aon leanbh amach ón limistéar rialaithe, cloisfear rabhadh airdeallach agus déanfar taifead de sna ríomhairí pearsanta uile ag stáisiúin na gcnáimhseach i ngach limistéar den Aonad Máithreachais agus déanfar taifead go comhuaineach ar an nglaoire slándála. Tar éis an rabhaidh dúnfar na doirse uile.

MAOIN PHEARSANTA Comhairlítear d’othair gan earraí pearsanta luachmhara a leithéidí airgead tirim, seoda, málaí láimhe mórluachacha, raidiónna, gléasanna TV nó seinnteoirí DVD a thabhairt leo isteach san ospidéal. Ní féidir leis an ospidéal bheith faoi dhliteanas maidir le hearraí luachmhara a chailltear nó a ghoidtear mura gcuirtear i dtaisce faoi chumhdach iad.

OSPIDÉIL NA H-OLLSCOILE GALLIMH

CAITHEAMH TOBAC Is crios saor ó dheatach tobac an ospidéal cé is moite de limistéir ainmnithe áirithe lasmuigh d’fhoirgneamh an ospidéil. Ar mhaithe le sláinte na n-othar cuirtear cosc ar chuairteoirí tobac a chaitheamh taobh istigh den ospidéal.

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PÁIRCEÁIL CARRANNA Tá áiseanna páirceála carranna ar tháille ar fáil d’othair agus do chuairteoirí uile. Ní féidir leis an ospidéal freagracht a ghlacadh as feithiclí a ndéantar damáiste dóibh nó a ghoidtear taobh istigh dá limistéar.

FEALSÚNACHT ALTRANAIS/ CHNÁIMHSEACHAIS Cuireann Ospidéal Choláiste na hOllscoile Gaillimh réimse seirbhísí géarchéime agus speisialtóra ar fáil. Tá sé suite gar d’Ollscoil na hÉireann, Gaillimh agus tá naisc láidre aige léi. Tá sé mar mhisean aige seirbhís ospidéil chásmhar agus ardchaighdeánach a chur ar fáil. Mar altraí/ chnáimhseacha in Ospidéal Choláiste na hOllscoile táimid tiomanta seirbhís ar fheabhas atá dírithe ar chúram iomlánaíoch a sholáthar d’othair agus dá dteaghlaigh. Agus muid ag iarraidh na haidhmeanna sin a bhaint amach beidh na luachanna agus na prionsabail a leanas ina dtreoracha dúinn.

MNÁ Maidir le huathúlacht fhiúntas an duine cuirimid luach uirthi agus tugaimid urraim di is cuma an stádas sóisialta nó eacnamúil nó an creideamh nó cineálacha na bhfadhbanna sláinte atá ag an duine sin.

Tugaimid urraim do dhínit na mná agus dá gceart ar phríobháideachas.

Cloífimid leis an rúndacht agus tabharfaimid coimirce don rúndacht i ngach gné den chúram de réir an dlí. Táimid tiomanta timpeallacht chairdiúil a chothú inar féidir caint go héasca leis an bhfoireann agus ina gcuidíonn na dálaí uile le himní agus le buairt aigne na mban agus a dteaghlach a shuaimhniú. Creidimid go bhfuil sé de cheart ag mná agus ag a dteaghlaigh bheith rannpháirteach sa phróiseas cinnteoireachta.

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SCEIDIL SCEIDEAL FISITEIRIPE SEISIÚN 1  FÉINCHÚRAM: AG DÉILEÁIL LE HATHRUITHE MATÁNCHNÁMHARLAIGH LE LINN TOIRCHIS ● Iompar coirp ● Teicnící scíthe

SEISIÚN 3  AN CHÉAD CHÉIM DHEIREANACH DE THINNEAS CLAINNE: ● Ag déileáil le crapthaí ● Cleachtas teicnící análaithe ● Teicnící scíthe

SEISIÚN 2  AN CHÉAD CHÉIM LUATH DE THINNEAS CLAINNE: ● Ag déileáil le crapthaí ● Teicanící análaithe ● Teicnící scíthe ● Suathaireacht droma

SEISIÚN 4  AN DARA AGUS AN TRÍÚ CÉIM DE THINNEAS Clainne: ● Conas brú go héifeachtúil ● Cleachtas teicnící análaithe ● Teicnící scíthe

SCEIDEAL NA GCLINICÍ* DÉ LUAN R.N. ● Gínéiceolaíocht – Dr S. Sarma ● Torthúlacht – Dr D. Egan/ Dr U. Conway (seachtainí malartacha) ● Clinic For-rochtana – J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11, Uachtar Ard DÉ LUAN R.N. ● Gínéiceolaíocht – Dr D. Egan/ Dr U. Conway (seachtainí malartacha) DÉ MÁIRT R.N. ● Úraidinimic– Dr S. Sarma ● Réamhbhreithe – Dr D. Egan/ Dr U. Conway (seachtainí malartacha) ● Clinic na gCnáimhseach – J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11 DÉ MÁIRT I.N. ● Réamhbhreithe – Dr S. Sarma ● Clinic na gCnáimhseach – J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11 DÉ CÉADAOIN R.N. ● Réamhbhreithe/ Inchríneolaíocht Comhcheangailte – Dr G. Gaffney/an tOllamh F. Dunne (seachtainí malartacha) ● Réamhbhreithe – an tOllamh

J. Morrison (seachtainí malartacha) ● Clinic na gCnáimhseach – J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11 DÉ CÉADAOIN I.N. ● Gínéiceolaíocht – Dr G. Gaffney ● Gínéiceolaíocht – Dr M. O’Leary ● Clinic na gCnáimhseach – Foireann Chnáimhseachais, Clinic Réamhbhreithe ● Clinic na gCnáimhseach – J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11 DÉ DÉARDAOIN R.N ● Réamhbhreithe – Dr K. Astbury ● Clinic For-rochtana, J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11 Gort DÉ DÉARDAOIN I.N. ● Gínéiceolaíocht – An tOllamh J. Morrison ● Gínéiceolaíocht – Dr K. Astbury DÉ HAOINE R.N. ● Réamhbhreithe – Dr M. O’Leary ● Clinic na gCnáimhseach – J. Duggan Bainisteoir Cnáimhsí Cliniciúla 11

ALTRAÍ/CNÁIMHSEACHA Táimid mar altraí/cnáimhseacha tiomanta oideachas a chur ar na mic léinn altranais/chnáimhseachais trí mhaoirseacht chuí agus trí dheiseanna foghlama cuí a sholáthar dóibh. Táimid tiomanta oideachas leanúnach le haghaidh altraí/cnáimhseacha a chur chun cinn; cinntímid dá réir gnóthachan sláinte agus sóisialta na ndaoine a ndéanaimid freastal orthu a uasmhéadú. Bíonn Altraí/Cnáimhseacha mar chleachtóirí féinriartha freagrach as breithiúnais aonair.

I gcomhpháirtíocht leis na mná, le teaghlaigh agus lenár gcomhghleacaithe ildisciplíneacha tá sé d’aidhm againn cúram oilte altranais/chnáimhseachais a chur ar fáil a bheidh dírithe ar an duine aonair. Mar bhaill den fhoireann ildisciplíneach táimid tiomanta an t-oideachas sláinte agus cúram dearfach sláinte do chách a chur chun cinn. Creidimid go bhfuil sé den riachtanas measúnú leantach a dhéanamh le hardchaighdeán an tsoláthair chúraim a chinntiú. Ós rud é go mbíonn síorathrú ar dhálaí cúram sláinte bímid ag iarraidh i gcónaí seirbhísí agus áiseanna a fheabhsú do na mná uile a bhíonn faoinár gcúram trínár gcion a dhéanamh chun feabhsúchán leanúnach an chórais chúram sláinte a chinntiú.

20/10/2014 14:36

elcome W s ’ Editor

DESIGNER: Jane Matthews Jennifer Reid Colm McDermott PRODUCTION MANAGER: Mary Connaughton SALES DIRECTOR: Paul Clemenson SINCERE THANKS AND APPRECIATION TO EVERYONE WHO CONTRIBUTED TO THIS ISSUE. PARTICULAR THANKS GO TO THE FOLLOWING FOR THEIR HELP AND SUPPORT: Dolores Booth, Una Carr, Norma Deasy, Juliana Henry, Oonagh McDermott, Concepta McDonagh, Helen McLoughlin, Margaret Mulvanny, Maureen Nolan, Edel Nagle, May Quirke, and Jane Whiriskey ILLUSTRATIONS & PHOTOGRAPHY: ISTOCKPHOTO.COM, thinkstockPHOTOS.COM

maternity is published by Ashville Media Group, Old Stone Building, Blackhall Green, Dublin 7.

Tel: (01) 432 2200; Fax: (01) 672 7100 Email: info@ashvillemediagroup.com Web: www.ashville.com All rights reserved. Every care has been taken to ensure accuracy in the completion of this guide. The publishers cannot, however, accept responsibility for errors or omissions. Reproduction by any means in whole or in part without the permission of the publisher is prohibited. ©Ashville Media Group, 2012 All discounts, promotions and competitions contained in this magazine are run independently of maternity. The promoter/advertiser is responsible for honouring the prize. The information contained in this book is not a substitution for the examination, diagnosis and treatment by a qualified healthcare professional.

P

regnancy is such an exciting time in a person’s life. If you’ve just found out that you’re pregnant for the first time, you might be feeling a whole host of conflicting emotions: fear, excitement, trepidation, joy, anxiousness and much much more – and then of course there’s all the physical changes going on in your body to contend with! The important thing is to relax and enjoy this time. Nine months may feel like a very long time indeed, but believe us, they will pass very quickly indeed.

This handbook is to guide you through those nine months and beyond. The Maternity Annual has been guiding mums-to-be for over 15 years now, and this year we’ve given it a revamp and put all the information you need into a handbook form. Plus we’ve include an interactive Pregnancy Diary at the back of the handbook, which includes spaces for your appointments, contact numbers and any notes you have, plus lots of handy tips and advice for the big milestones of your pregnancy journey. Dotted throughout the handbook are hints and tips from mums who have been there – and let’s face it, nobody is better placed to help guide you through pregnancy than other mums!

Your first port of call in this handbook is our 40-week countdown, which tells you exactly what’s happening to your body and your baby each week of the nine-month countdown. Then the main body of the handbook takes you through the different stages of pregnancy, labour and birth, and early parenthood. We’ve assembled some expert advice and opinion on every step of your journey into parenthood to ensure that you get the most up-tothe-minute and useful advice possible.

Chapter six contains lots of really useful advice about parenting during the first six months of your baby’s life. How can I get my baby into a routine? How do I cope with issues like colic or reflux?

Not to mention all those little things that you might not have thought about – fiddly jobs like cutting your baby’s toenails, and most importantly, how to relax and have fun with your gorgeous little bundle!

We hope you enjoy reading through your new and improved maternity handbook – and we hope it becomes a valuable companion during your nine-month journey and early days of parenthood. All that’s left is to wish you the very best of luck with your pregnancy!

Penny Gray EDITOR

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EDITOR’S WELCOME

EDITOR: Penny Gray

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Contents 15 20

CHAPTER 1: HEALTHY PREGNANCY 18 21 22 24 27 30 32 34

2

Healthy Eating Gestational Diabetes Exercise Difficulties & Warning Signs Travel & Pregnancy Looking & Feeling Good Teens & Pregnancy Coping with Miscarriage

CHAPTER 2: PREPARING FOR BABY 38 39 40 43 45 46

Maternity Leave Budgeting for Baby Buying for Baby Hospital Bag Birth Plans Antenatal Classes

CHAPTER 3: LABOUR & BIRTH 50 52 54 55 57 58

Types of Births Pre-Labour Warning Signs Stages of Labour Pain Relief Assisted Birth Feelings about the Birth

IN ASSOCIATION WITH

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20/10/2014 16:32

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17” Alloy Wheels and Panoramic Sunroof* Terms and conditions apply. Images used are for illustrative purposes only. Every effort is made to ensure accuracy, however errors may occur and specifications may change without prior notice. Typical Finance example: ŠKODA Yeti OTRP €25,090 (includes dealer delivery charge €600). Deposit / Part Exchange €7,396.67. 36 monthly payments of €249. Optional Final Payment €9,796. Total hire purchase price €26,306.67 including acceptance fee (€75) and completion fee (€75). Minimum deposit is 10%. Subject to lending criteria. This offer is made under a hire purchase agreement. ŠKODA Finance is a trading style of Volkswagen Bank GmbH Branch Ireland, authorised by the Federal Financial Supervisory Authority in Germany and regulated by the Central Bank of Ireland for conduct of business rules.

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CONTENTS 4

CHAPTER 4: AFTER THE BIRTH

CHAPTER 5: FIRST DAYS

CHAPTER 6: LIFE WITH BABY

62 64 71 72 74

78 80 82 84 88 91

94 100 102 106 108 110 112 113 118 120 122 126 129

What Happens Now? Breastfeeding Tests for Baby Babies in Special Care Going Home & Public Health System

Caring for your Baby Vitamin D Registering your Baby Vaccinations Postnatal Depression Contraception

Your Baby’s First Six Months Babies & Sleeping Feeding Issues & Weaning First Aid & Infants Cranial Osteopathy Fun with Baby Photography Work & Childcare Car Safety Family Cars Designing a Nursery Directory Your Pregnancy Diary

Disclaimer: This brochure and contributions made herein have been carefully researched and are intended to act only as a guide for new parents. Independent medical advice should always be sought should you have concerns during, or after, your pregnancy. Whilst every effort has been made to ensure that the information contained in this brochure is accurate at the time of going to press, the publisher, maternity hospital, and the editor cannot take responsibility for inaccuracies or errors. The opinions expressed in the various contributions are the personal opinions of the contributors and are not necessarily the views or opinions of the publishers, the hospital nor the editor. The material contained in this brochure is not intended to constitute medical advice and all problems of a medical nature must be referred to medical staff at the hospital or other qualified medical practitioners. Advertisements within the publication are not endorsed by the hospital or the publisher. Any claims made within the advertisements are not endorsed by the hospital or the publisher.

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40 WEEK COUNTDOWN

40 own d t n Week Cou

step-by-step FOLLOW YOU AND YOUR BABY’S PROGRESS WITH OUR STEP-BY-STEP GUIDE TO THE 40 WEEKS OF PREGNANCY

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40 WEEK COUNTDOWN

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ester Trim

P

regnancy is divided into three phases, or trimesters. The first covers the time from conception to week 12 and is a vital stage in your baby’s development when all of the major organs begin to form. It is also a period when your baby is most vulnerable to harm, so it is important to look after your health, eat well and avoid alcohol and drugs.

WEEK 6

WEEKS 3-6 Once the egg has been fertilised by the sperm, it travels along the fallopian tube towards the uterus where it implants itself.

This process triggers the release of hormones, which in turn spark changes in your body to prepare for pregnancy. By week four, the fertilised egg, which is now a cluster of living cells, will separate into two. One part will form the embryo and amniotic sac and the other part will form the placenta, which will supply your growing baby with nutrients and oxygen via the umbilical cord.

While some women are aware that they’re pregnant almost from the moment of conception,

providing a vital link between you and your baby. As well as food and nutrients, drugs and nicotine can also be passed through to your baby.

Avoiding cigarettes, alcohol and other drugs is vital during this crucial time in your baby’s development.

most don’t suspect pregnancy until they miss a period in week five. By then, your baby’s nervous system is already beginning to develop and, to minimise the risk of spina bifida and neural tube defects, it is recommended that you take folic acid supplements from 14 weeks before conception until week 12 of pregnancy. If you haven’t begun taking folic acid, start to take it as soon as your pregnancy is confirmed.

The development of blood and blood vessels, bones, muscles and major internal organs has also begun. Some blood vessels will form the umbilical cord and connect to the placenta,

can S t s Fir

BABY: Although only the size of a coffee bean, your baby is recognisable as a human being even at this early stage. The cluster of living cells has now developed into an embryo. Your baby has a neck and head, a brain and a heart that is already beating, although it has only two chambers rather than the four that will soon develop. An ultrasound scan may even be able to pick up a heartbeat at this early stage. Tiny buds that will become arms and legs are already in place. The beginnings of a digestive system, kidneys and a liver have all started.

MUM: Your period is two weeks’ late.

You may have had a test at this stage or made a visit to your GP. You may be feeling nauseous and your breasts might feel tender. You may be feeling tired and might need to pass urine more often, especially at night.

WEEK 8 BABY: Your baby is now about the size of a grape. She will probably

WHEN DO I NEED A SCAN? Most women will be offered an ultrasound scan anytime between 12 and 22 weeks, depending on their hospital’s policy. This scan helps to check your baby is growing and developing normally. The baby’s growth is

8

calculated by measuring her head, abdomen and legs.

Chapter 40 week countdown.indd 8

02/09/2014 12:55:04

WEEK 10 BABY: Your baby is now about the size of an apricot. Development is now well underway with fingers and toes becoming more distinct and the facial features developing more. Your baby will be moving around and is about 4.5cm long and weighs about 5g.

MUM: Although not yet visibly pregnant, your uterus is by now the size of an orange. Now is a good time to invest in a well-fitting support bra, as your breasts will have already started to increase in size. Some women experience headaches that may be caused by dehydration and not eating enough due to morning sickness.

Try eating small amounts often and drinking plenty of water at regular intervals.

Chapter 40 week countdown.indd 9

2

40 WEEK COUNTDOWN

make her first movements this week, though you won’t feel them.

Her features, especially her eyes and mouth, are becoming more distinct. The eyes are covered by an intact skin, which will eventually split to become eyelids.

The limbs elongate and elbows and knees begin to appear. The internal organs are continuing their development and the heart has started its vigorous pumping.

Your baby will now be about 2.5cm long.

MUM: You may find you have lost a taste for some foods while you are craving others. You may also be suffering from nausea. Having some toast or crackers before you get out of bed to raise blood sugar levels and eating small frequent meals can help, as nausea is often worse when your stomach is empty. Extreme tiredness can also occur, so early nights are advised.

If you are having difficulty sleeping at night, take naps during the day whenever possible. Tiredness will subside as your pregnancy progresses. You may also feel faint due to a hormone imbalance that will settle after a little while. Try to avoid hot, stuffy areas.

nd

ester Trim

T

he second trimester (weeks 13 to 28) is often the most enjoyable phase, with many of the discomforts of early pregnancy having now passed. During the latter part of this phase you will first feel your baby move – one of the most exciting moments of your pregnancy.

WEEK 12 BABY: Your baby’s head is now fully formed. Eyes and eyelids are complete. Fingers and toes are fully

formed; arms have grown and nails have started to grow. Your child’s ovaries or testicles are distinguishable but not fully developed so a scan at this stage cannot determine the sex of the baby. The ribs and spine are beginning to harden into bone.

Baby’s length is now about 6.5cm, but she weighs only 18g.

MUM: By now you will start to feel a bulge above your pelvis and your uterus is the size of a grapefruit. At your first antenatal visit your doctor or midwife will be able to feel the uterus by external examination.

a t io n c i n u Comm COMMUNICATE WITH YOUR BABY Your baby can hear sounds from the outside. Talk to your baby and feel how he or she reacts when you play different types of music. Try singing to your baby and get your partner to sing or talk too.

9

02/09/2014 12:55:27

40 week countdown

On this visit your medical history will be taken, blood and urine tests are carried out, blood pressure is checked and you will be given some nutritional advice. A scan should take about ten minutes and is taken by a radiographer or specialist sonographer.

WEEK 14 Baby: Eyebrows and a little hair have grown. All of your baby’s organs, limbs, muscles, genitalia and bones have formed and the heartbeat is strong. She is now drinking some of the amniotic fluid and receiving all her nourishment through the placenta. She is now about 8cm long.

Mum: Many women who suffer from morning sickness begin to feel better by now. You may also feel less tired.

A dark line of pigment, the linea nigra, may form down the centre of your abdomen. This will fade after your baby is born. Your nipples and the area around them will darken considerably and your uterus will now be enlarging at a noticeable rate.

WEEK 16 Baby: Your baby is now fully formed and is growing rapidly. The rest of her time in the uterus will be spent growing and maturing until she is able to survive independently. Her eyes are still closed. Lanugo, a fine down, is starting to form all over her skin to keep her temperature stable and she is now about 16cm long.

Mum: For many, this is a time of increased energy. Your bump may be becoming more noticeable. You are likely to have more of an appetite, but don’t worry too much if you don’t feel like eating a lot – it is the quality and not the quantity of food that is important.

WEEK 18

10

Baby: By week 18, your baby now has a firm grip and even has fingerprints. She will be increasingly energetic at this time; as well as kicking she is also sucking, with some babies beginning to suck their thumbs before they are even born.

Chapter 40 week countdown.indd 10

She will now be about 20cm long.

Until now, your baby’s bones had been developing but were still soft.

This week, they begin to harden, or ossify. Some of the first bones to ossify are those in the clavicles and the legs.

Mum: By week 18, many women feel their baby move around for the first time. Some women also find that they feel flushed and perspire more than usual. This is due to the increased levels of blood circulating around your body, which is necessary to meet your baby’s demands.

WEEK 20 Baby: Buds for permanent teeth are forming behind those for baby’s milk teeth, which have already formed, and hair continues to grow on her head. A thick, greasy substance, called vernix, will cling to the downy hair on your baby’s skin, forming a protective barrier around her. Baby is now about 25cm long and you could still hold her in the palm of your hand. Your baby’s sex may be determined at this stage.

Mum: This is often one of the most exciting weeks in your pregnancy, when you may start to feel your baby’s movements. Some mothers describe them as ‘butterflies fluttering’.

WEEK 22 Baby: Your baby is still moving around a great deal and has probably settled into a fairly regular pattern of sleep and activity. Her fingernails are now almost fully formed.

Mum: You may find you have some swelling of your gums caused by the increased levels of hormones in your system.

WEEK 24 Baby: Your baby would have a chance of survival if born prematurely at this stage. However, she would need special care, as her lungs are not developed fully enough to cope with life outside the womb without help. This is a period of very rapid growth and your baby is now

about 32cm long and weighs over 1lb (2.2lbs = 1kg).

Mum: You will be gaining weight rapidly at this stage. You may also be feeling practice contractions for labour called Braxton Hicks. Week 24 usually marks another visit to your doctor or midwife. At this point your baby’s heart can be heard with a stethoscope. Your own heart is now doing 40 per cent more work than usual.

WEEK 26 Baby: Your baby’s eyes now open for the first time. At birth, your baby’s eyes will be blue and if they are going to change colour they will not do so until a few weeks after birth. Her body is covered with fine, downy hair and the skin is starting to change. Until now it has been thin and translucent but it is now becoming more opaque.

Mum: You may begin to notice stretch marks on your skin and most will fade after the birth.

Your baby is now pressing on your bladder, which means frequent trips to the bathroom.

WEEK 28 Baby: Your baby has now filled nearly all the space in your womb.

Most babies turn upside down at this point and seem to fit more comfortably. Your baby’s heartbeat speeds up when you speak and she will recognise your voice at birth.

Your baby’s length is now 38cm.

Mum: A small amount of colostrum (thin, yellow breast milk) may leak from your breasts at this time.

If your blood group is Rhesus negative, an antibody check will be taken. You may feel that you are putting on weight quite fast at this point. Swollen feet, legs, and fingers at the end of the day is common.

It is usually harmless, as long as your blood pressure is normal and you do not have protein in your urine. Put your feet up when you are resting and wear shoes that are comfortable.

02/09/2014 12:55:57

www.lyonstea.ie/decaf

* It is recommended that caffeine consumption should be limited whilst pregnant.

Lyons Decaf contains only 0.2% caffeine.

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01/09/2014 13:43:37

40 WEEK COUNTDOWN

3

rd

ester Trim

B

y the third trimester, weeks 29 to 40, your baby’s development is virtually complete. This phase can sometimes be the most uncomfortable as your body begins to feel the strain and by its end most women are eagerly awaiting the birth of their baby.

WEEK 30 BABY: You may not be aware of Braxton Hicks contractions, which are now happening at regular intervals, but your baby is probably very aware of these.

MUM: Your body is now beginning to feel the strain and you may find yourself getting tired and out of breath when climbing stairs. Try to maintain good posture when you are standing or sitting.

WEEK 32 BABY: Your baby is now fully formed. She is gradually putting on weight and both the vernix and the downy hair have started to disappear. She is now about 42cm long.

MUM: At each visit with your midwife or doctor, they will check your baby’s position as well as checking the baby’s heartbeat and rate of growth.

WEEK 34

12

BABY: You may now be able to distinguish your baby’s bottom from a foot or knee and will feel her movements more as she kicks or moves around. This is the period when your baby moves into the head-down position with her face towards your back. She will stay in this position until the birth. You may feel more pressure on your

Chapter 40 week countdown.indd 12

bladder and your pubic bone. Fluid is passing through your baby’s kidneys and this contributes to the amniotic fluid. Your baby’s mental processes are speeding up. She can now differentiate between dark and light and is bathed in a red glow when sunlight is on your tummy.

MUM: You may now be feeling a bit uncomfortable due to your baby’s bottom sticking up under your ribs or by her head bumping into your bladder. You may also be feeling quite breathless as your lungs are squashed by your expanding uterus.

This is a period of rapid growth, so eat small, frequent meals to keep energy levels high. Backache is a common symptom of this stage of pregnancy. Ensure that you don’t lift anything heavy, get plenty of rest and wear good support underwear.

WEEK 36 BABY: You will usually visit your midwife or doctor every week from now until the birth (please note that some hospitals encourage you

to visit at weeks 37, 39 and 40).

If this is your first pregnancy, the baby’s head will probably descend into your pelvis. This is known as ‘engaging’ and will be measured by your midwife. With subsequent births, the baby’s head will not usually engage until week 40. Your breathing will become easier, although you may find that you need to pass urine more often, and your sleep will be interrupted.

This is a time of major growth and your baby’s weight may be increasing by as much as 28g a day. After the baby has engaged, its larger body movements tend to be more limited, but you will still feel movement – at least ten movements in a 12-hour period.

MUM: All the rapid growth of this stage could result in you feeling quite hungry at this time. Because of the weight of your uterus pushing against your stomach, it is better to eat small snacks at regular short intervals instead of large meals.

This will help with indigestion and heartburn. Your body will be working extremely hard now, so you may feel hot and flushed as you have more blood circulating and you are burning more calories.

WEEK 38 BABY: Your baby’s movements may begin to feel different now. Instead of whole body movements, you may feel lots of jabs from the feet and knees.

However, you should continue to have at least ten baby movements in a 12-hour period.

If you have any lessening of

02/09/2014 12:56:44

40 week countdown

Quick Guide to Pregnancy movement, consult your doctor or midwife immediately. Your baby continues to put on weight and, although there is no air present in the lungs, she may be making shallow breathing movements in preparation for life outside the womb. In this way, amniotic fluid actually passes into the baby’s windpipe, giving her hiccups.

Mum: If your baby does have hiccups, you will feel them.

Although you will experience less movement as your baby becomes more cramped in the uterus, you will feel a strange buzzing sensation inside your vagina as the baby’s head moves against your pelvic floor muscles. Emotionally, you may begin to feel both excited and apprehensive as your due date approaches. The last weeks can sometimes be tedious and tiring as you are eager for the birth.

Your baby will be three times as heavy at birth as it was at 28 weeks and will weigh anything from 5.5lb to 11lb (2.5-5kg).

WEEK 40 Baby: Your baby is ready to be born. She is about 55cm long and weighs an average of 8lbs (3.6kg).

Your baby’s bowels are filled with greenish black meconium that will be her first bowel movement after birth.

Mum: Finally, the day you have been waiting for has almost arrived. By this time you are probably feeling fed up with being pregnant and are eager for the birth. You will feel sharp kicks under your ribs at either side and the presenting part presses through the softened, partially opened cervix. Your baby is ready to be born; but remember, some babies come sooner, and more arrive later, than the due date. Be patient, you’re almost there!

Chapter 40 week countdown.indd 13

Week

Baby

Mum

3-6

Nervous system develops

Positive pregnancy test

6

Brain & heart develops

Morning sickness begins

8

Heart begins beating

Tiredness & nausea hits

10

Fingers & toes develop

Uterus begins to grow

12

Head is fully developed

Energy begins to return

14

Baby is about 18cm long

Bump is now visible

16

Baby is fully formed

Your appetite grows

18

Bones begin to ossify

Blood volume increases

20

Baby’s sex may be seen

First movements felt

22

Fingernails are formed

Swollen gums may occur

24

Weighs over 1 pound

Heart is working 40% harder

26

Eyes begin to open

Baby presses on bladder

28

Baby is about 38cm long

Swollen feet & legs common

30

Baby feels Braxton Hicks

Posture may be affected

32

Baby puts on weight

Tiredness often returns

34

Kidneys function fully

Breathlessness can occur

36

Baby’s head descends

More pressure on bladder

38

Shallow breathing starts

May feel baby hiccuping

40

Weighs an average 8lbs

Get ready for B Day!

13

02/09/2014 12:57:17

Comfort with cuddles!

Donncha O’Callaghan launches Comfort Cuddle Guide to support first time Dads

R

ecent research conducted by Persil Non-Bio and Comfort Pure reveals that fathers are a bag of nerves when it comes to holding their baby for the first time. A lack of confidence means over half (55%) of new dads feel nervous when giving their little one those first important cuddles. (RedC Omnibus Research, January 2014) Whilst new mothers receive plenty of advice from other mums, fathers tend to feel inexperienced, leading to a confidence crisis when the little one arrives. The research goes on to show: ■ Just over half (55%) of dads in Ireland felt nervous holding or cuddling a new born baby for the first time.

■ A quarter of Dads (1 in 4) in Ireland did not know how to hold a baby for the first time.

■ 1 in 3 Dads in Ireland did not feel immediately comfortable holding their new born baby, with 1 in 5 claiming it took a week or longer to feel relaxed with the baby in their arms.

■ 1 in 5 dads in Ireland had never held a baby before holding their own.

“

I find cuddling is the best way to form a bond with your new born child, I really want to encourage parents - especially new Dads - to overcome any fears.

”

Donncha O’Callaghan

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Father of three Donncha O’Callaghan, has teamed up with Persil Non-Bio and Comfort Pure to launch the Cuddle Mastery Guide. Endorsed by the Irish Dermatology Nurse’s Association and British Skin Foundation the Guide helps new parents find the confidence to cuddle, comfort and soothe their little ones.

Donncha says – “I find cuddling is the best way to form a bond with your new-born child, I really want to encourage parents - especially new Dads - to overcome any fears.

As a Dad of three, I know it can be intimidating when you first meet your little one, but spending time learning what cuddles work best will really help to increase your confidence”.

www.persilandcomfort.co.uk/you-yourbaby/baby-athome/dads-cuddle-guide/

22/7/14 16:48:13 01/09/2014 13:47:21

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01/09/2014 13:46:08 22/7/14 16:33:59

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11/7/14 12:01:47

01/09/2014 13:55:04

Healthy Pregnancy

1 p C ha

ter

Healthy Pregnancy Keeping yourself and your baby healthy during pregnancy is vital for your own wellbeing and the baby’s development, as well as setting you up for a good birth experience and recovery. In this chapter you’ll find everything from healthy eating to pregnancy niggles and worries to keeping yourself feeling happy and relaxed.

17

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02/09/2014 13:06:00

Healthy Pregnancy

1

Introduction to

Healthy Eating Healthy eating is important at all stages of life, especially during pregnancy. Your baby gets all of its nutrients from what you eat so your diet can affect the health of your baby for its entire life. The best place to start is with a healthy balanced diet. If you have special

nutritional needs, such as following a vegan diet, allergies, being underweight at the start of your pregnancy or if you are a teenager who is still growing yourself, you may need specialist advice from a qualified dietitian.

?

Am I eating for two?

The big pregnancy myth is that you need to eat enough for two. The reality is, only 300-500kcal extra a day is needed in the second and third trimesters. This equates to an extra snack or two

Essential nutrients

a day in the later stages of pregnancy.

Folic Acid Folic acid reduces the risk of neural tube defects (NTDs) affecting the baby’s spinal cord.

Women who are of childbearing age and who are pregnant should take a folic acid supplement of 400ug per day, continuing it into the first 12 weeks of pregnancy.

If a mother has previously had an infant with a NTD, a supplement containing 4,000ug of folic acid is required per day to help prevent recurrence. As well as taking a folic acid supplement during pregnancy, women should also try to eat foods that are high in folate, such as green leafy vegetables, fortified breakfast cereals & fortified milk.

18

Iron & Vitamin C Iron is important to make extra blood for you and your baby throughout the pregnancy and prevent you becoming anaemic.

You need 15mg of iron from your meals every day and vitamin C helps absorb iron from the food you eat so try to include a source of vitamin C with your meal, such as a glass of orange juice, strawberries and veggies like broccoli and peppers. Limit

Chapter1_Maternity2015.indd 18

The table below is a guide on the amount of iron in commonly eaten foods: Foods rich in more easily Serving Size Iron absorbed HAEM IRON (g) content (mg)

RED MEAT Average portion* of lean beef Average portion* of lean lamb cutlets Average portion* of lean pork chops

120 120 120

3.2 2.5 1.6

POULTRY Average* chicken breast

120

1.3

FISH 1 small tin of sardines (canned in brine) 1 small tin of salmon Average portion* of cod

70 70 120

1.6 0.4 0.5

OTHER 2 small slices of black pudding

60

12

Foods rich in less easily Serving Size Iron absorbed NON-HAEM IRON (g) content (mg)

1 cup** of fortified breakfast cereal 1 small can of baked beans 1 cup** of boiled spinach 1 boiled egg 1 slice of wholemeal bread 1 cup** of boiled broccoli ¼ cup of dried fruit

30 140 90 50 36 85 25

2.4-4.2 1.9 1.4 1 0.9 0.9 0.6

Average portion guide – palm of hand* and 200ml disposable cup**

02/09/2014 13:06:24

Calcium Calcium is important for healthy teeth and bones. Your baby’s teeth will start to form as early as the sixth week of pregnancy. If you are not getting enough calcium, it is taken from your bones for the baby.

Pregnant women need 1000mg of calcium every day and pregnant teenage girls need 1300mg calcium daily. Include at least three portions every day of calcium such as milk or milk-based products. There are some foods that contain less calcium like spinach, sweet potatoes, rhubarb, beans, seeds and nuts, but you shouldn’t rely on these to supply all the calcium you need. If you are lactose intolerant then soy-based products fortified with calcium are a good source. If you have a low calcium intake, a calcium supplement may be needed.

VITAMIN D Vitamin D helps you use the calcium you eat and so is an essential component for bone health. Vitamin D is made from the sun’s rays and because of the poor UV light in Ireland from October to March, Vitamin D3 cannot be made in the skin then. Pregnant women need 10ug (400IU) of vitamin D every day. It is only found naturally in a few foods such as oily fish, some fortified cereals and fortified milks.

If you don’t have these foods in your diet, it is advised to take a low dose supplement containing 5ug of vitamin D3. If you are taking a pregnancy multivitamin supplement you are already getting enough vitamin D and should not “double up” by taking additional Vitamin D supplements.

Chapter1_Maternity2015.indd 19

HEALTHY PREGNANCY

tannins from tea or coffee with meals or phytates from high-fibre foods like bran and high-fibre cereals, as these may inhibit the absorption of iron. If you are vegetarian or vegan, talk to your dietitian to make sure you are getting enough iron. If your diet is low in iron, you may need to take an iron supplement for pregnancy.

ain G t h Weig You should not attempt to lose weight during pregnancy. Gaining at least 7kg (15lb) is necessary to cover the growth of your baby.

Average weight gain during pregnancy is 11-12.5kg (25-28lbs), mostly gained in the second half of your pregnancy. If you are overweight before pregnancy you should aim to gain a little less weight than normally expected, and if you are underweight before pregnancy aim to gain a little more weight during pregnancy. Your doctor, midwife or dietitian will be able to advise you.

HEALTHY SNACKS IN PREGNANCY

SUITABLE SNACK FOOD

SERVING SIZE (G)

CALORIES (KCAL)

(with honey)

43 (10)

100 (29)

1 cup* of bran type cereal

30

134

2 slices of wholemeal toast (with cheddar cheese & tomato)

70 (80)

160 (208)

1 small can of baked beans

140

111

Scrambled eggs (2 eggs, no milk)

120

192

1 pot low fat plain yogurt

125

71

1 cup* fortified low fat milk

200

84

1 cup* fortified full fat milk

200

120

1 small tin of tuna (in brine, drained)

70

80.5

1 small tin of salmon (in brine, drained)

70

105

1 fruit e.g. banana, apple or 2 mandarin oranges

100

95

Soda bread 1 slice

200ml disposable cup*

19

02/09/2014 13:06:55

HEALTHY PREGNANCY

FOOD SAFETY DURING PREGNANCY Omega-3 Fatty Acids Oily fish are high in Docosahexaenoic acid (DHA), important for developing your baby’s brain, nervous system and eyes.

You can include them in the diet by eating one portion of oily fish per week while you are pregnant. If you are vegetarian or vegan, you are advised to take a pregnancy specific omega-3 supplement.

WHAT ABOUT A MULTIVITAMIN SUPPLEMENT? A multivitamin is not necessary unless you do not have a balanced diet. If you choose to take a vitamin or mineral supplement, choose one specifically for pregnancy. Excessive intakes of supplements can be harmful and reduce the absorption of other nutrients.

● Eat only freshly cooked food and wellwashed freshly prepared fruit & vegetables.

If eating out, it is safer to order hot dishes. ● All uncooked and rare meats and seafood should be avoided due to the high risk of listeria & salmonella poisoning. ● Liver and liver products contain a high level of vitamin A, which can be harmful to your developing baby ● Deli meats and hotdogs may be contaminated with listeria bacteria, which might result in miscarriage or stillbirth. ● Raw eggs may contain salmonella. Some homemade salad dressings, ice-cream and custards may be made with raw eggs.

It is best to check with your server in a restaurant; if in doubt, avoid it. ● Avoid soft cheeses like Feta, Brie, Camembert and goats’ cheese and blueveined cheeses. They are safe to eat if they are labelled pasteurised. ● Consuming more than 200mg of caffeine a day has shown to have a negative effect on the infant’s birth weight. Generally two cups of coffee or up to four cups of tea a day is ok. ● Avoid refrigerated meat, vegetable or fish patés or meat spreads – for the same reason of listeria contamination. It is safe to eat the canned or shelf-stable versions.

A WORD ABOUT ALLERGIES Unless you are allergic to a particular food or ingredient, eg eggs, fish, milk or milk products, there is no evidence to suggest that avoiding certain foods during pregnancy protects the infant from developing food allergies in later life. If there is a strong history of nut allergy in the family, it is advisable to

● Avoid high mercury-containing fish such as swordfish, marlin, shark and ray. Limit fresh tuna to one serving a week (150g) or two 240g cans of tinned tuna per week. ● Alcohol crosses the placenta and can increase the risk of miscarriage and preterm delivery or lead to physical, growth and mental problems in your developing baby. The safest option is not to drink during pregnancy.

Gillian McConnell is a private dietitian with Inside Out Nutrition. Tel 085 770 8940 or log on to www.insideoutnutrition.ie

avoid peanuts.

20

Chapter1_Maternity2015.indd 20

02/09/2014 13:07:34

WHAT IS GESTATIONAL DIABETES? Gestational Diabetes Mellitus (GDM) is diabetes that starts or is first diagnosed in pregnancy.

Diabetes means that blood sugar levels in the form of glucose are too high. To keep your blood glucose levels normal during a pregnancy, your body has to make at least three times its normal amount of insulin to overcome the hormones made by the placenta. For most women, this extra insulin is enough to keep their blood glucose level in the normal range. For some pregnant women, however, even the extra insulin is not enough to keep their blood glucose level normal.

HOW IS GDM DIAGNOSED? Gestational diabetes can be picked up in pregnancy by a simple Glucose Tolerance Test between weeks 24 and 28. This is not a standard test everywhere so women need to ask for it if they feel they may be at risk. Most women who have gestational diabetes give birth to healthy babies, especially when they keep their blood glucose level under control, eat a healthy diet, get regular moderate physical activity and maintain a healthy weight However, Professor Fidelma Dunne, consultant endocrinologist at Galway University Hospital, points out that the condition can have serious implications for the mother and her baby. “In addition it can affect the future health of mother and infantif it’s not treated.

After pregnancy, mothers should be rescreened and a programme put in place to reduce the risk of developing diabetes in the future,” she advises.

may develop problems with their shoulders or breastbone, which often get broken during delivery. There is also an increased risk of babies of mothers with GDM being born with low blood sugar levels.

WHO IS MOST AT RISK OF DEVELOPING GDM? ● A family history of diabetes ● Body Mass Index (BMI) of over 25 ● Previous poor pregnancy outcome ● Women on steroids ● Previous baby over 4.5kg ● Polycystic Ovary Syndrome ● Unexplained infertility ● Polyhydramnios in current pregnancy ● Large baby in current pregnancy ● Non-Caucasian ethnicity ● Lifestyle factors like poor diet, infection, stress and smoking WHAT ARE THE POTENTIAL COMPLICATIONS? Mothers with GDM have an increased chance of developing blood pressure problems in pregnancy and of preeclampsia (a dangerous complication of pregnancy with high blood pressure and fluid retention) as well as a higher chance of delivery by Caesarean section.

They are at an increased risk of having excess fluid around the baby, which often leads to early delivery and babies born before full-term.

Babies of mothers with gestational diabetes are at risk of being born very large (over 4.5 kilograms).

This increases the chances of a difficult delivery and the need for neonatal unit care for the baby.

Where the labour is difficult, a baby

HEALTHY PREGNANCY

GESTATIONAL DIABETES

HOW IS IT TREATED? In approximately 70 per cent of women, gestational diabetes can be managed by 30 minutes of exercise per day and diet changes. All foods containing sugar need to be excluded and the carbohydrate portion in each meal needs to be reduced as carbohydrates get converted to sugar too. Carbohydrate foods are bread, cereals, pasta, rice and potato. In those who do not maintain normal blood sugar measurements on diet and exercise, insulin treatment is given. Insulin is discontinued once the baby is born.

WILL IT GO AWAY AFTER THE BABY IS BORN? While 82 per cent of cases go away after the pregnancy, a large study of mothers in the West of Ireland found that one year later, 18 per cent of these cases had either pre-diabetes or diabetes and three years later, the number with prediabetes or diabetes had risen to 30 per cent. The international literature quotes a 50 per cent diabetes rate within five years.

WHAT ABOUT FOLLOW-UP CARE? Women with GDM need to be followed up post-delivery at about 12 weeks .This is to establish whether the diabetes has gone away or not.

Each year thereafter women should have an assessment with their GP as they have a sevenfold increased chance of developing diabetes.

Words by Michelle McDonagh

For more information on gestational diabetes, the Diabetes Federation of Ireland have published an information leaflet, which is available to download at www.diabetes.ie

Chapter1_Maternity2015.indd 21

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03/09/2014 14:25:37

HEALTHY PREGNANCY

2

LOOKING AT

Fitness in Pregnancy

W

22

omen react to the news of pregnancy in different ways.

Some wonder should they be trying to stay in shape as much as possible, while others see it as a ticket to get off the treadmill for nine months and put their feet up!

Once pregnancy is confirmed, one of the common questions women have is whether they should exercise and what is safe to do. Before any exercise plan is implemented, it is important to consider your current exercise levels, how active you were before pregnancy, how you are feeling now that you are pregnant, what your fitness goals are, and if you have a history of any injuries. Discuss this with your GP, obstetrician and Chartered Physiotherapist as soon as you find

Chapter1_Maternity2015.indd 22

out that you are pregnant.

A healthy, low-risk pregnancy should enable you to continue your exercise routine. If you are very sick or have any medical conditions, such as poorly controlled diabetes or high blood pressure, seek advice on exercising from your obstetrician or GP during your first antenatal visit.

For previously active women, there is no evidence to suggest that your exercise regime should be discontinued. But your fitness goals during pregnancy should be aimed at maintenance rather than any dramatic gains. Be sensible when choosing the activities you continue to do; snow sports are not advisable because of the risk of falling.

Contact sports are also discouraged while pregnant.

For those who are not so active usually, a gradual build-up

BENEFITS OF EXERCISE IN PREGNANCY ● Promotes increased energy levels ● Relieves stress ● Improves sleep patterns ● Helps avoid excessive weight gain ● Strengthens your abdominal and back muscles ● Improves posture ● Prepares you for the physical exertion of labour

02/09/2014 15:05:08

● Walking is the gentlest form of exercise. It helps keep your lower back and abdominal muscles strong, as well as working the buttock and leg muscles. Many women can keep walking right up until they are due to give birth. Aim for at least 30 minutes per day. Try walking at lunchtime, to break up the day and prevent stiffness from too much deskbased sitting.

HEALTHY PREGNANCY

WHAT EXERCISE SHOULD I DO? of exercise is vital. Aim for lowimpact exercise such as walking or swimming, just three times per week, for 15-20 minutes per session.

As you get fitter and your energy increases, progress to five days per week for 30 minutes per session. The right intensity for this exercise is still being able to talk to a friend while exercising, if you are too out of breath to talk, you are probably pushing yourself too much.

Exercising with tender, swollen breasts is uncomfortable and can affect your posture. Get measured and invest in a good supportive bra or a sports bra. If you notice any pubic pain when swimming, or taking part in a class, stop exercising immediately and contact your Chartered Physiotherapist as soon as possible for a Pelvic Girdle Pain (PGP) assessment.

As your bump continues to grow, you may need to slow down, decrease your mileage, or consider alternative, more gentle ways to exercise. Your walking and running gait will change as your pregnancy progresses (your stride will shorten and your feet won’t lift as high) so be aware of the surface you are training on. Stop running and walk if you become aware of pain or Braxton Hicks contractions (rhythmic tightening of the lower abdomen – practice contractions).

● Workouts in the pool are very beneficial as the buoyancy of the water supports your bump while working your abdominal muscles. Even if you can’t swim, pool walking can be a good workout. This is particularly helpful in the later stages when the bump can feel very heavy.

● Pregnancy pilates or yoga classes can be very beneficial but ensure that your instructor is specifically trained, as the antenatal exercises differ from those for the normal population. It is recommended not to start a class until approximately 15-16 weeks, but you can continue right up until your due date. If you have any history of injury, tell your instructor before you start the class, so your progress can be monitored and kept within your painfree limits. Don’t be shy; if something feels uncomfortable, let them know as there are many modifications that can be made as your bump grows.

PELVIC FLOOR EXERCISES Pelvic floor strengthening exercises should be started as soon as your pregnancy is confirmed. These muscles have to support the weight of your growing uterus, and need to be gradually built up. Give yourself time everyday to practice. Your pelvic floor muscles are mostly deep muscles and connecting with them takes concentration.

1 2

Lie on your back with your knees bent up.

Breathe out to start. Now squeeze your back passage up towards your pubic bone, as if trying to stop yourself pass wind.

Now release your pelvic floor completely and let it drop back towards your tailbone. Practice this daily until it happens easily.

The hardest part of this exercise is relaxing the pelvic floor back again at the end of the contraction.

3

Hold for 3-5 seconds without breathing.

Jenny Branigan is a Chartered Physiotherapist at Total Physio in Sandyford. For more information, see www.totalphysio.ie

Chapter1_Maternity2015.indd 23

4

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02/09/2014 15:06:10

HEALTHY PREGNANCY

3

GUIDE TO

Pregnancy Niggles & Warning Signs

P

regnancy can bring with it all sorts of strange feelings and symptoms. But what is normal and what should you get checked out? The first rule of thumb is to get anything that you are worrying about checked out with your GP – even if it’s just to prevent any undue stress, which could be bad for you and for the baby.

MORNING SICKNESS Morning sickness is often the first symptom felt by newly pregnant women, and while it’s a sign that usually all is well, it’s not particularly pleasant!

Morning sickness can happen at any time of the day, and eases for most women at the start of the second trimester. Occasionally, women can suffer from morning sickness throughout the pregnancy or towards the end. If it is excessive; for instance, if you can’t keep anything down, you may be suffering from hyperemesis and could be at risk of dehydration.

Always consult your doctor or midwife if you are worried.

24

TRY THESE MORNING SICKNESS REMEDIES: ● Eat little and often. ● Have some plain biscuits or crackers at the side of the bed to nibble before you get up in the morning. ● Avoid strong smells that could make you nauseous. ● Avoid heavy meals and fatty foods.

Chapter1_Maternity2015.indd 24

● Some people find that ginger helps. Try nibbling on a few ginger biscuits if you are suffering from nausea. ● Keep hydrated by sipping water throughout the day.

If you are prone to sickness, carry a survival kit with you for ease of mind, to include a strong bag, some mouthwash, a couple of ginger biscuits and some mints.

ne d e r i T

ss

Along with queasiness, tiredness is one of the first, and most enduring, pregnancy symptoms for many. It can be at its height during the first and third trimesters. Try these tips to combat tiredness: GIVE YOURSELF A BREAK. Remember that you are growing a little person and your body is working hard! Have a nap if/ when you can. ASK FOR AND ACCEPT HELP FROM FRIENDS AND RELATIONS. If you feel excessively tired, ask your doctor or midwife to test for anaemia.

02/09/2014 15:06:39

TRY THESE STRATEGIES FOR MINIMISING PAIN AT HOME: ● Move slowly and carefully when doing everyday activities. However, don’t stop moving altogether, as the pain is often worse when you are lying down. ● Ask your physiotherapist for tummy and pelvic floor exercises that will improve the stability of your back and pelvis. ● A pelvic support belt can give immediate relief. ● Acupuncture can help, but ensure that your practitioner is experienced in dealing with pregnant women.

HEARTBURN A form of indigestion, heartburn is common among pregnant women, especially during the latter months when the sheer size of the baby and the uterus can create pressure in the abdomen area.

TRY THESE HEARTBURN REMEDIES: ● Avoid spicy or rich foods. ● Eat little and often. ● Chew your food slowly and thoroughly. ● If heartburn is worse at night, try sleeping propped up on pillows. ● Take regular, safe exercise, such as a walk. ● Some women find a glass of milk helps.

If you are really suffering, talk to your doctor about remedies that are safe during pregnancy, both over the counter and prescribed.

BACK PAIN The effects of relaxin and the pressure from the extra weight on your abdomen can cause back pain. In addition, your breasts feel heavier, and your posture can change, which also puts pressure on your back.

AVOID BACK PAIN WITH THIS ADVICE: ● Learn good posture. Stand tall (as if your head is being pulled from above), relax your shoulders and hold your weight evenly on both your feet. ● Swimming or prenatal yoga are both great for strengthening your back. ● Avoid lifting heavy objects or over- exercising. ● Talk to your doctor if the pain is bad or persists.

HEALTHY PREGNANCY

PELVIC PAIN Your body produces a hormone called relaxin during pregnancy, which softens your ligaments to help the baby move more easily through your pelvis during the birth process. Your pelvic joints may also move around more during pregnancy and just after birth, and this can cause inflammation and pain. This can cause a condition called Symphosis Pubis Dysfunction, or SPD, which is characterised by pain in the pubic area and groin. If you are suffering from SPD, your midwife or doctor will refer you on to a physiotherapist for treatment. There is also a condition called Pelvic Girdle Pain (PGP), which affects the back of the pelvis.

Pain can be concentrated on the buttocks or on the back. Again, a physiotherapist will help you deal with this pain.

● Wear good, lowheeled footwear.

● Support your lower back with pillows when sitting.

LEG CRAMPS Leg cramps are common towards the end of pregnancy, and although the exact cause is unknown, it’s thought that they can be due to tired muscles and increased pressure on the blood vessels and nerves in the legs.

TIPS TO AVOID LEG CRAMPS: ● Calcium and potassium are thought to help, so include milk-based products, green leafy vegetables and bananas in your diet. ● Gently stretch your legs before going to bed. ● A warm bath and a gentle leg massage in the evening could help. ● Slowly rotate your foot in both directions to improve circulation.

HAEMORRHOIDS Women who have suffered from haemorrhoids, or piles, during pregnancy often report that this was one of the worst symptoms of all! They are caused by a combination of pressure from the baby, hormone changes and constipation. To help, eat a well-balanced diet with plenty of fruit and veg to avoid constipation; take regular safe exercise; and drink eight glasses of water a day. Talk to your doctor if you feel you need a mild laxative. Your pharmacist or doctor can recommend a cream for use on painful haemorrhoids.

Chapter1_Maternity2015.indd 25

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02/09/2014 15:07:08

Healthy Pregnancy

Warning signs

While you should always report any discomfort or worries to your doctor or your midwife during your visits, if you experience any of the following, you must get go and get checked out as quickly as you can. Often they can be nothing, but if you are worried, you should always consult a professional. ● Bleeding Any cases of bleeding should be reported to your doctor or midwife. Even when it’s accompanied by abdominal pain, bleeding doesn’t necessarily mean a miscarriage, but if needed, your doctor will monitor your baby’s heartbeat. Later in pregnancy, bleeding could indicate an issue with the placenta called placenta praevia, where the placenta is lying on the bottom of the uterus. Always consult your doctor or midwife if bleeding occurs in the third trimester. ● Excessive Thirst While it is perfectly normal to need more water and liquids during pregnancy – and in fact, it’s healthy to keep yourself well hydrated – if you are constantly thirsty, you may have developed gestational diabetes. This is treated easily with lifestyle changes and diet in many cases, but you need to see your doctor to make sure you don’t require medication. ● Sudden and Severe Swelling Swelling is perfectly common in pregnancy, but sudden swelling, accompanied by severe headache, could be a sign of pre-eclampsia. Your doctor will test your urine for protein and check for high blood pressure.

Although relatively rare, pre-eclampsia is a serious condition that could require bed rest, medication or even early delivery. ● Itchy Skin Itchy skin due to stretching is common enough during pregnancy, but if you develop severe itching towards the end of your pregnancy, especially in your hands or feet, consult your doctor. This could indicate a liver complaint called cholestasis in pregnancy, which affects about 1 per cent of expectant mothers.

If you are diagnosed with this disorder, both you and your baby will be closely monitored for the remainder of your pregnancy, as premature labour is a possibility. ● Breathlessness It can be difficult to catch your breath towards the end of pregnancy as your baby is pushing up against your lungs, and space is at a premium in your abdomen. But severe breathlessness or pain in the chest should always be checked out, especially if you have a history of breathing difficulties such as asthma or repeated chest infections. ● Reduction in Movement One of the nicest moments during pregnancy is when you feel your baby move. It’s important to monitor your baby’s movements, especially during the last trimester. Talk to your midwife about counting and recording kicks. If you haven’t felt your baby move in a while, try drinking something cold and resting for a few minutes. ● Visual Disturbances Blurring, double vision, dimming, flashing lights or “floaters” could be a sign of high blood pressure and should be checked out immediately.

Joint Pain and Swelling Swelling in the joints, especially in the ankles and fingers, is a common complaint towards the end of your pregnancy. They can sometimes be painful, so try these tips to help alleviate swelling: ● Elevate your feet when sitting down. ● Avoid tight-fitting clothes. ● Consider wearing support stockings if you spend a lot of time on your feet. ● Drink plenty of water. ● Avoid standing or sitting for long periods of time. ● Continue gentle exercise like walking or swimming. ● If your fingers swell, remove any rings.

If excessive swelling occurs, consult your doctor immediately.

Braxton Hicks Braxton Hicks are sporadic uterine contractions than begin early in your pregnancy but women generally don’t notice until the later months. They are generally irregular and painless, although some women report that they can be uncomfortable at times. If they do become uncomfortable, try the following tips: ● Change your activity or position. ● Take a warm bath to help your body relax ● Braxton Hicks can sometimes be brought on by dehydration so try drinking some water. ● Practice your controlled deep breathing.

If you get more than four contractions an hour, and are less than 37 weeks’ pregnant, consult your doctor or midwife.

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03/09/2014 14:26:24

HEALTHY PREGNANCY

4

INTRODUCTION TO

Travel & Pregnancy

B

elieve it or not, travelling while you are pregnant is probably the easiest holiday you’ll ever have with your new baby! Once he or she is born, the amount of baby paraphernalia that will be essential for a simple holiday will be astounding. For now, your baby is safely tucked away in your abdomen, and requires little attention other than a gentle pat and some soothing words.

WHEN IS THE BEST TIME TO TRAVEL? You may find that the best time is during your second trimester, between 14 and 27 weeks. If you have had an uncomplicated pregnancy and expecting just one baby, it is generally safe to fly up until about 36 weeks. However, some airlines request written permission from your doctor anytime from 28 weeks, so it’s important to check your airline’s policy before booking. Staff can refuse you permission to fly at the gate, so if in doubt, it’s a good idea to have a letter from your midwife or doctor with you once you hit the third trimester.

IS FLYING SAFE? People who fly hundreds of times a year, such as flight attendants and business travellers, may be at a slightly higher risk of miscarriage or fetal abnormalities due to exposure to natural atmospheric radiation.

However, if you only fly a few times a year, the risk is negligible. It’s also important to consult your doctor before travelling if you have had any complications during your pregnancy, such as high blood pressure or bleeding, or have a history of premature labour.

Chapter1_Maternity2015.indd 27

WHAT ABOUT DEEP VEIN THROMBOSIS? Flying during pregnancy can slightly increase your risk of blood clots (thrombosis) and varicose veins.

Wearing support stockings when you fly can minimize your risk. Also, moving around the plane regularly and doing simple exercises like flexing your ankles can help keep your circulation flowing.

WHAT ABOUT TRAVEL VACCINATIONS? The general rule is, don’t travel anywhere that requires vaccinations while you are pregnant. If you know you need to travel but are trying for a baby, get vaccinated at least four weeks before getting pregnant. Finally, if you really have to go somewhere that requires vaccinations, talk to your doctor who can advise you on what vaccinations are safe and what aren’t.

HOW CAN I STAY COMFORTABLE? Be sure to wear comfortable clothes and shoes. If you can, request a seat in the middle of the plane over the wing, which tends to be the most stable part of the plane. An aisle seat will let you go to the toilet or stretch your legs easily. Sitting anywhere for a long period of time can make your feet and ankles swell, so be sure to get up and walk around as often as you can. In addition, take off your shoes and rest your feet on your carry-on luggage in front of you. Bring a pair of comfy socks to change into for long flights. Drink plenty of fluids during the flight, especially water, to counteract the dehydrating effects of flying. Avoid fizzy drinks or a heavy meal before flying, especially if you are suffering from heartburn.

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02/09/2014 15:07:46

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03/09/2014 16:06:57

HEALTHY PREGNANCY

5

INTRODUCTION TO

Looking & Feeling Good

J

ust because you’re pregnant doesn’t mean you have to abandon your love of fashion and beauty.

Maternity wear has come on in leaps and bounds since the days of tents and overalls, with even highfashion stores like Penneys and H&M stocking decent ranges of maternity wear. The introduction of maternity ranges in high street stores means that you can dress your bump on a budget too – but try these tips to make sure you get the most out of your maternity wardrobe.

SPEND ON GOOD UNDERWEAR Good underwear is especially vital when you’re pregnant, especially as your breasts swell. Many women find a softer bra without an underwire more comfortable as their pregnancy progresses – but this is up to you as there is no concrete evidence that wearing an underwire bra inhibits milk production (as was previously suspected). Get yourself fitted regularly during the pregnancy and for a nursing bra towards the end of your pregnancy.

On

WARDROBE

GET THE BASICS RIGHT Think about what you wear the most and buy accordingly. For instance, if you are having a baby in October or November, you’ll be spending most of your pregnancy during the summer months so t-shirts are essential. If you work in an office, then formal trousers or shirts might be needed more than jeans. Or if you spend a lot of time outside, a maternity jacket or coat is a good buy.

BORROW FROM FRIENDS Secondhand maternity clothes are often nearly new, so consider borrowing items like a dress or jeans from a friend.

FIVE ESSENTIAL STYLE BUYS

Long-sleeved top, €14, asos.com

Rib vest, €9, Next

Belly bands, €13.50, Mothercare

THINK FOOTWEAR There’s no need to ditch the high heels just yet, but you may find them more uncomfortable as your pregnancy progresses as your feet swell and your centre of gravity changes. Make sure you have suitable shoes for both leisure and work that are comfortable – these will be needed after the birth too!

Ultrasoft skinny jeans, €15, Penneys

ghstreet i H the

CHECK OUT YOUR LOCAL HIGH STREET STORES While there are some specialist maternity boutiques and baby shops out there such as Mothercare and Jojo Maman Bébé, lots of high street stores stock maternity ranges too, including Penneys, Dorothy Perkins, New Look, H&M, Debenhams (Red Herring), Topshop and Next. Go online too; Style Mama, Elora Maternity, Seraphine, Isabella Oliver, Babes with Babies, asos, Queen Bee

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Black dress, €29, Dorothy Perkins

and Bumps ‘n’ Babies all have great ranges.

Chapter1_Maternity2015.indd 30

02/09/2014 15:14:57

HEALTHY PREGNANCY

BEAUTY IN PREGNANCY

Morning sickness, stretchmarks, swollen ankles... there’s a lot about pregnancy that isn’t too glamorous. But even women who are unfortunate enough to suffer some of the more unpleasant pregnancy symptoms can get some of the nicer bits – such as glossy, full-bodied hair and glowing skin. In fact, some women can look and feel at their most beautiful during pregnancy, especially during the second trimester. And with a little bit of pampering, every woman can feel special right the way through the nine months. ● Keep things simple. If your skincare products are suitable for use during pregnancy, stick with them unless you encounter an issue such as sensitivity or acne. ● Switch to sensitive products. If you are suffering from sensitivity, simplify your routine and use natural, non-irritant products.

WARDROBE OUR TOP 5 BEAUTY ESSENTIALS

● Go natural. Knowing what you’re putting on your skin is vital when you are pregnant. A simple product such as a skincare oil (make sure it is suitable for use during pregnancy) is ideal for dry skin. ● Opt for mineral makeup. Mineral makeup “sits” on the skin and therefore is suitable for sensitive skin and for women who are wary of skin reactions with products that could be absorbed into the first few layers of the skin.

Garnier BB Cream, €14.99

Trilogy Rosehip Oil, €32.95

● Fake tan is safe during pregnancy, but some expectant mothers like to avoid tanning booths as the chemicals used in fake tan can be inhaled. It’s always best to opt for a tan containing natural ingredients, such as Tan Organic, €19.99 ● Hair loss slows down during pregnancy, which means that your hair may look thicker than ever. However, unfortunately that applies to unwanted body hair too! Tweezing, waxing and shaving are all safe during pregnancy, but avoid hair removal creams. And remember, you will return to your normal level of shedding about three to six months after giving birth. ● To dye or not to dye? Studies have shown that very little of the chemicals used in hair dye are absorbed into the scalp, but if you’re cautious, wait until the second trimester to colour your hair. Highlights minimise contact with the scalp as well. If in doubt, talk to your doctor or hair stylist.

Chapter1_Maternity2015.indd 31

Bio-Oil, from €9.99

Clarins Tonic Oil, €45

STRETCH MARKS ● The jury is still out on the question of stretch marks. Do creams and oils really work or are some women just destined to get stretch marks? Experts say that if you want to know if you will get stretch marks, then simply ask your mother if she has any. But fans of creams and lotions say it is possible to prevent them with the right products. ● One thing is for sure: the better condition your skin is in before pregnancy, the better chance you will have of your skin recovering quickly after giving birth. A good diet and keeping yourself well-hydrated will help keep your skin healthy both in and after pregnancy. ● You don’t need a specific stretch mark product. A good moisturiser rich in cocoa or shea butter will do a good job too. ● Remember to moisturise your whole body, concentrating on your abdomen, back (you stretch from the back) and breasts. Take the opportunity to give your legs and feet a massage at the same time.

Viviscal Maximum ● Get into the habit of Strength moisturising every day at the Supplements, same time. €49.95

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02/09/2014 15:15:16

HEALTHY PREGNANCY

6

ESPECIALLY FOR

Teen Mums

News e h t g Sharin Have you told anyone yet? Remember, while you might be slow to tell, you can get a lot of support from those around you. The dad might find it difficult to accept that you’re pregnant, or he might be thrilled. You won’t know until you tell him. He could surprise you! Whatever the reaction, at least you’ll know where you stand. Your Mam and Dad will nearly always come around after the initial shock. Just give them a chance. They care about you and that you’re ok. Tell a friend or two because sooner or later it’s going to become obvious. And it’s better if you decide when to tell people rather than people finding out through gossip.

Mostly friends will just want to support you.

It might be hard to get the words out, but generally the sooner you tell, the better.

Once they know, people can give you the ongoing support you really need. Give them

32

time and a chance to help and support you.

Chapter1_Maternity2015.indd 32

D

iscovering a positive pregnancy test is a massive event in anyone’s life, no matter who you are or what age you are. But when you’re young and unmarried, questions like telling your parents or wondering how you will cope with a tiny baby may spring immediately to mind. This feature will hopefully answer some of your questions. Make sure to read the other information in this guide on the practicals of being pregnant, giving birth and looking after your baby too.

WHAT ABOUT SCHOOL OR COLLEGE? Some of you reading this may be pregnant and still in school. Although this can be a very difficult time, try to remember that all of this will pass. By law you must remain in school until you’re 16 years of age and you have every right to continue in school after that and to get your Leaving Certificate. You cannot be expelled or asked not to attend school because you are pregnant. Both secondary schools and third-level colleges have staff whose job it is to support students. Some secondary schools have a Home School Liaison Co-ordinator or a School Completion Co-ordinator. Their job is to support pupils who find school difficult for any reason. Your class teacher and the career guidance teacher may also be able to help. Third level colleges have welfare officers and access officers whose role is to support students who are having difficulties in getting to college or staying in college. Check to see if you live in any of the areas in which the Teen Parents Support

02/09/2014 15:15:34

Most young mothers go back to live at home with their own family after having their babies. This can be great as you can get back on your feet with the help and support of your own parents.

However, there can be times when living at home can be hard: ● You may feel that your parents are interfering in the way you care for your baby. But your parents may feel that you need advice on childrearing. ● You may assume that there will be endless, free babysitting and childcare. But your parents may have a life of their own and may not want to give up their time. ● You are caring for your baby every day, very often with broken sleep, while juggling everything else that young people do. But your parents may want you to do more in the house as well. ● You may feel more adult now you have a baby and want to do your own thing without too many questions. But your parents want you to obey the normal house rules, if you are still a teenager under their roof. This may become even more of an issue if you are still at school. ● You now have your own income and want to spend it the way you decide. But your parents may want you to give money into the house to help with the household costs and also to learn to save for the future when you may be out on your own. ● If you find yourself in the situation where you are constantly fighting with your parents, try to get a good time to talk with them calmly about how you are feeling and how difficult it is to juggle being a mother, a daughter and a young person. ● Listen to their side of the story – they may be finding it difficult having a child in the house again (having thought they were finished with rearing children) and could be reluctant to get into it all again. They could also be finding it hard not to take over or don’t know how to treat you now that you are a mother but still also their child. ● Try to be honest when talking to each other and try to think up new ways of sorting out the problems. ● If things are so bad that you cannot sit down with your parents and have a calm chat about it, it may be worth thinking about bringing in a neutral person to help you work through the main issues. You could contact your local Teen Parents Support Programme, if there is one in your area, or Family Centre to explore what options are available to you in your area.

Information is extracted from Treoir’s Young Parent Survival Guide. Log on to www.treoir.ie for your own copy and for help and support.

Chapter1_Maternity2015.indd 33

Programme provides a service. If you live in Waterford city contact the Waterford Student Mothers Group on 051 8442200. If you do not live in any of these areas phone Treoir at LoCall: 1890 252 084 and an information officer will talk to you about your entitlements and what schemes exist to support you in your education. If you are in secondary school you may miss school for at least some time before and after the birth of your baby.

Ask your principal about the Home Tuition Scheme. This scheme means that a teacher can come to your home to keep you up to date with your class work. You can get nine hours’ tuition a week for at least 10 weeks and it’s free.

HEALTHY PREGNANCY

TWO FAMILIES, ONE HOME

WHAT ABOUT EXAMS? Even if you are in an exam year and your baby is due around exam time don’t give up. The Department of Education is very good at making individual arrangements to make sure you are comfortable during exams. Babies do not always arrive ‘on time’ and, even if yours does, special arrangements can be made for you to do your exams in the maternity hospital.

CHILDCARE Many young parents decide to return to school, training or college after they have their babies. If you think you will need a crèche put your baby’s name on the waiting list as soon as he or she is born. Community crèches are less expensive than private crèches so check out if there is one in your area.

Ask the manager if you can avail of the Community Childcare Subvention Scheme. Some third level colleges also have crèches that are subsidised. Ask your college about Student Access Funds and ask if there are any special funds to help you with childcare. The Society of St. Vincent de Paul has an Education Grant, which is a fund to help people to get into education, and that includes funding for childcare.

Contact them through their National Office on 01 838 6990 or info@svp.ie.

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02/09/2014 15:16:02

HEALTHY PREGNANCY

7

COPING WITH

Miscarriage

S

34

adly, miscarriage is common. According to the Miscarriage Association of Ireland, around one in five pregnancies end in miscarriage, with approximately 14,000 Irish women losing a baby each year. A miscarriage is most likely to happen in the early stages of pregnancy and the further along you are, the less chance there is of losing your baby.

A miscarriage occurs when a pregnancy is spontaneously lost before 24 weeks. After 24 weeks, a baby may be mature enough to survive outside the womb, although special care will be needed. Lots of women count the 12-week mark as a milestone in their pregnancy, but the odds of miscarrying actually reduce at an earlier stage. Using data from early ultrasound scans, the UK Miscarriage Association says that if your baby has a heartbeat at eight weeks, the chance of your pregnancy continuing normally is 98 per cent. At ten weeks it increases further to 99.4 per cent.

Although miscarriage is common, the majority of women go on to have healthy pregnancies – a

Chapter1_Maternity2015.indd 34

miscarriage does not necessarily mean there’s anything wrong with your fertility. But when it does happen, miscarriage can be an unhappy and frightening experience, particularly after you’ve started to enjoy your pregnancy and preparing for your new role as a mum.

WHY DOES IT HAPPEN? It’s really important to remember that a miscarriage is not your fault and you shouldn’t blame yourself if it happens. About 50 per cent of miscarriages in the first 12 weeks are thought to happen because of a chromosomal abnormality – and this is usually down to bad luck. It is unlikely to signify any underlying problems with either you or your partner. Other causes of miscarriage in the early stages of pregnancy can be imbalances in pregnancy hormones or immune system problems, and twin or multiple pregnancies also increase the chances of miscarriage. Miscarriage is more likely as you get older because your egg quality decreases with age. If you’re eating well, getting lots of

02/09/2014 15:16:23

Supporting your partner ● If your partner has a miscarriage you may feel helpless, but you can provide a vital role in loving and caring for her as you both recover. ● Don’t expect her to bounce back; even an early miscarriage takes time to recover from.

Will it happen to me?

Miscarriage after 12 weeks is much less common and happens in approximately one in 100 pregnancies.

The later a miscarriage is, the more likely your healthcare team will be able to determine what went wrong and offer you the right help and treatment for future pregnancies. Late pregnancy loss can be very hard to bear and you should be offered lots of support and counselling to help you recover. It can also help to mark your baby’s passing, whatever stage of pregnancy you were at. The Miscarriage Association of Ireland has memorial stones in various locations, dedicated to babies lost through miscarriage.

● Talking about what has happened helps you both heal – but don’t push her to discuss it if she’s not ready.

WHAT HAPPENS AFTER A MISCARRIAGE? You may feel tired and weepy following a miscarriage due to your hormones getting back to normal and the emotional toll. Try to rest when you can and take some time off work if possible. If your miscarriage is after 12 weeks it can take longer to adjust, physically and emotionally, but time is a great healer and most women go on to have another healthy pregnancy.

It can be hard for some women to think about trying again, while others want to get pregnant as soon as possible. Most doctors advise women to wait until they have had at least one period; this is to make it easier to calculate dates in the next pregnancy, not because you are more likely to miscarry again. It’s really down to you and your partner to decide in your own time and try when you both feel ready.

Whatever you decide, it’s helpful to know that the vast majority of women who have experienced a miscarriage go on to have a healthy baby; only one in 100 couples will experience recurrent miscarriages and be offered further investigations. Miscarriage, whilst a traumatic experience, is a very common one.

Talking to other people who have been through it and contacting support groups for advice and information will help you recover and enjoy a happy, healthy pregnancy in the future.

● If she had a miscarriage previously and is pregnant again, try to be understanding if she has any fears or is particularly protective over her pregnancy. Although the chances are she’ll give birth to a healthy baby, it’s completely normal for her to feel nervous.

Chapter1_Maternity2015.indd 35

Healthy Pregnancy

rest and following your GP’s advice, there’s not much else you can do to decrease the chance of miscarriage.

Drinking alcohol and smoking while you are pregnant does put you at a higher risk – but doing moderate exercise and having sex during pregnancy won’t.

Once you start to miscarry, there is little that can be done to prevent it and you may never find out exactly what caused it to happen. Although your pregnancy may appear to be progressing normally, the 12-week scan can sometimes reveal a missed miscarriage, which means that your baby died at some point in the first trimester but your body has not yet rejected the pregnancy.

● Ask her if she wants to remember the baby in some way; planting a tree or making a donation in memory of your loss may help. ● Eating healthily and getting some fresh air is beneficial – try cooking a nutritious meal and taking her out for a walk or to see a film when she feels up to it. ● Friends and family may try and avoid the subject, particularly with you, because they feel uncomfortable. If you want to talk, tell them so.

dvice A e r Mo Miscarriage Association of Ireland: www.miscarriage.ie A Little Lifetime Foundation: www.alittlelifetime.ie National Infertility and Support & Information Group (NISIG): www.miscarriage.ie UK Miscarriage Association: www.miscarriageassociation.org.uk Miscarriage Association of Northern Ireland: www.miscarriageassociationni.org.uk

35

03/09/2014 15:46:28

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Preparing for baby

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Chapter2_Preparing 2015.indd 37

02/09/2014 16:29:53

PREPARING FOR BABY

1

GUIDE TO

Maternity Leave

U

nder current legislation, you have to give your employer at least four weeks’ written notice of your intention to take maternity leave along with a medical certificate confirming the pregnancy. Most women tell their employer after the 12-week mark has passed, but if you work in a job that may pose risk to your pregnancy or you have health worries, it’s a good idea to tell your employer in confidence as soon as you can. Your employer is legally obliged to conduct a pregnancy risk assessment and this can only be organised once you have formally notified them of your pregnancy.

?

TO APPLY FOR MATERNITY BENEFIT, contact the Maternity Benefit section of the Department of Social Protection.

Tel: (01) 471 5898; Lo call: 1890 690 690; Email: maternityben@welfare.ie; Web: www.welfare.ie.

38

Chapter2_Preparing 2015.indd 38

WHAT AM I ENTITLED TO? You are entitled to 26 weeks’ maternity leave, with the option of a further 16 weeks’ unpaid leave, commencing no later than two weeks prior to your due date. If you find it too difficult to work during the final phase of your pregnancy, or your baby is born prematurely, you can commence your maternity leave up to 16 weeks prior to the end of the week the baby is due. Once your pregnancy is confirmed, you can take paid time off for medical visits associated with the pregnancy and antenatal classes, giving two weeks’ notice to your employer. ● ANNUAL LEAVE You are entitled to any public holidays that occur during your leave, so check your diary and add them up as you can tack an extra few days on to the end of your 26 weeks. You are also entitled to accumulate annual leave while on maternity leave, as time spent on maternity leave is treated as though you have been in full-time employment. ● PATERNITY LEAVE There is still no legal entitlement to paternity leave for fathers, leaving it entirely up to the discretion of employers, so it’s a good idea to notify your employer in advance and book a couple of weeks’ annual leave around the due date. Many employers are willing to be flexible with this leave, as you can’t be sure exactly when the baby will decide to make an appearance.

● RETURN TO WORK Make sure to give your employer at least four weeks’ written notice of your intention to return to work. Upon your return, you should be back in the same job with the same contract of employment. In the event that your employer can’t allow you to return to your job, they must provide you with suitable alternative work. ● MONEY TALK There is no legal obligation upon employers to pay you during maternity leave.

It depends on the terms of your contract and, these days, more and more employers are scrutinising their outgoings in order to cut what they deem to be unnecessary costs.

Whether you have a contractual agreement or not, you may qualify for Maternity Benefit, which is issued by the Department of Social Protection and has now been standardised at €230 for all new applicants. This benefit is also taxed. ● ADDITIONAL ADVICE For more information on your rights and entitlements visit www. citizensinformation.ie, www.equality. ie and www.welfare.ie, where you will find a wealth of information.

03/09/2014 14:32:18

PREPARING FOR BABY

2

INTRODUCTION TO

Budgeting for Baby

H

aving a baby is a major financial commitment for any couple, and it’s important to acknowledge this and put plans in place. The initial cost of having a baby (eg care costs if applicable and buying what your baby needs) can be high, but children cost money throughout their lives, and this cost only gets bigger as they get older. Studies have indicated that the cost of raising a child to the age of 21 can cost between €250,000 and €300,000.

Without getting bogged down in these high figures, it’s well worth putting into place some sort of budget system to make sure your baby is provided for in your monthly outgoings, by readjusting your current spending. Follow these steps to work out your budget: ● Add up your total monthly income in the household, allowing for maternity leave deductions. ● Make out a list of all your bills and expenses, using the previous month as a guide. Include discretionary spending and variables like food and petrol, ● Add to your list of expenses your baby’s most pressing needs, eg formula if you are not breastfeeding, nappies, wipes, clothes etc. Add in a set amount for possible medical costs too. ● If you are planning on returning to work, add childcare to the list of expenses, or if you are giving up work, adjust your income accordingly. ● Finally, add up your total expenses and deduct it from your income. If you don’t have a surplus, look at where you can cut down. Can you reduce discretionary spending? Budget more carefully with the weekly grocery shop? Get rid of a car?

Look at switching service providers to save money on your gas, electricity, phone, TV and broadband. ● If you have to make savings, start while pregnant so you are in a budgeting frame of mind before your baby arrives.

Chapter2_Preparing 2015.indd 39

Help e t a St There are supports available from the State should you need them: CHILD BENEFIT Universal child benefit is paid to all parents of children under the age of 16 regardless of income. If your child has a disability or is in full-time education, this benefit is extended to the age of 18.

The payment is €130 per child,

ONE-PARENT FAMILY

and you are automatically

PAYMENT (OPFP)

registered for this when you

Designed for mothers or

register the child’s birth.

fathers parenting alone, the OPFP is given to a parent

FAMILY INCOME

earning less than €425 a week.

SUPPLEMENT (FIS)

The amount depends on

FIS is a weekly tax-free

your earnings and number of

payment awarded to

eligible children. The age limit

employees with children

is slowly being reduced to the

who earn below a certain

age of seven, which means as

threshold. Self-employed

soon as your youngest child

people are not eligible. To

reaches the age of seven, you

qualify, you most have at

will no longer be eligible for

least one child who normally

the payment. As this is being

lives with you or is financially

brought in gradually, however,

supported by you; the child

you may still be eligible for

must be under the age of 18

older children depending on

or between 18 and 22 and

when you first applied for the

in full-time education. FIS

payment.

amounts are 60 per cent of the difference between your

For more on State benefits, log

income and the threshold for

on to www.citizensinformation.

your particular family size.

ie or www.welfare.ie

39

02/09/2014 16:40:55

PREPARING FOR BABY

3

GUIDE TO

Buying for Baby

W

ith baby comes a heck of a lot of luggage – who knew that such a tiny being would need so much “stuff ”? But while there are certain items that you really can’t do without, there are others that you mightn’t need for a while or you might

even be able to go without. And in these tight economic times, it’s well worth keeping things in perspective and knowing the ultimately it’s not necessary to have the very latest high chair or most expensive travel system – the important thing is that you have the right items for your baby and your budget.

ter a L Buy

SLEEPING The first consideration is where your baby is going to sleep. The traditional option is a Moses basket, but although these have many advantages – for one thing, they’re portable, so great for naps in the early days – some bigger babies grow out of them in as little as six weeks.

Some might be too big even at birth!

For longevity, a crib might be a better option, as it generally suits a baby up to six months. Going straight into a cot is another option. If the cot feels a little big for your baby, a cot divider is a good investment. A new mattress is recommended for each baby.

If this is your first baby, the sheer size of the list of baby equipment can be daunting. But remember you don’t need everything at once.

For instance, your baby won’t need a high chair until he or she is about six months old. Or if you have a Moses basket or crib, you won’t need a full-sized cot just yet. It’s also recommended that your baby sleep in with you for the first six months, so there is no need to have a full nursery or bedroom set up or decorated for your little one.

Finally, there’s no need to babyproof your house until your baby is

40

mobile – which won’t be for several months yet!

Chapter2_Preparing 2015.indd 40

INFANT CARSEAT A carseat is an essential first purchase if you are planning on driving your baby home from hospital. Choose one that’s rear facing, complies with safety standards and that’s suitable for a newborn baby. Practice strapping in and taking out the carseat before the baby is born.

02/09/2014 16:33:52

BABY BATH A baby bath isn’t an essential purchase but is useful if you are nervous about bathing a slippery newborn. Alternatively, there are inserts suitable for a standard bath that can help. A top and tail bowl is also not an essential purchase but useful when it comes to giving the baby a wash in the early days without going to the trouble of a full bath.

BABY SEAT It might not look like an essential buy, but a baby rocker or seat can be invaluable – not just because it gives you somewhere to put the baby when he or she is not feeding or sleeping.

A chair with an inbuilt vibration unit can be useful for fussy babies as well. Shop around for a chair, as they can range from as little as €20 up to €100+.

BABY MONITOR Good news – you don’t have to invest in a baby monitor until your baby is in a room by his or herself. A monitor allows you hear immediately if your baby is distressed, and gives peace of mind to parents who might be nervous of leaving baby by his or herself. Options include a straightforward audio system, a video

Chapter2_Preparing 2015.indd 41

PREPARING FOR BABY

TRAVEL SYSTEM A travel system grows with your baby, generally converting from a pram into a pushchair and might even accommodate your early carseat for ultimate portability. However, these can be expensive. A cheaper option is a pushchair that can recline completely for a new baby (babies under six months old should be reclined completely). Consider your needs when it comes to choosing a travel system. Will you use the pram function? Is size and weight an issue when it comes to opening and folding your choice? Would you like a system that allows you to attach baby’s carseat? Once you have worked out your needs, shop around for the best deal.

BUYING FOR BABY

COT

CAR SEAT

BABY BATH

TRAVEL SYSTEM

BABY SEAT

CHANGING STATION BEDDING

MONITOR

CLOTHING

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02/09/2014 16:34:22

PREPARING FOR BABY

monitor and an audio monitor that incorporates a sensor mat, which sets off an alarm if it senses the baby is having trouble breathing.

CHANGING STATION/MAT Some parents like to invest in a whole changing unit, but if you don’t have the space, this is not at all necessary. A baby can be changed anywhere, but for comfort and ease of use, a simple changing mat is a good investment. These can cost as little as €10-€15 and will be used almost constantly!

BABY’S CLOTHING Although it’s tempting to buy lots of little outfits, bear in mind that your baby will grow very fast, and for convenience’ sake, he or she will probably spend most of their early days in babygros. Look for 100 per cent cotton items if possible.

A basic wardrobe is 8-10 vests; 8-10 babygros, 2 hats, 2 scratch mittens, 2-3 cardigans, a snowsuit or jacket and 2-3 blankets for walks. Babies can grow out of the “newborn” size very quickly so it’s best to only have a couple of items in this size, and concentrate your budget on the 0-3 months age group.

BEDDING Whatever bed you decide upon for your baby, you will need sheets and blankets as well. Opt for cellular, cotton-rich blankets, which are less likely to overheat your baby. Four sheets and about four blankets should be plenty.

Remember you can swaddle with an ordinary blanket, so there’s no need for a separate swaddle blanket unless you want one. As your baby gets older, sleeping bags are a great option.

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PLAYMAT Babies really don’t need any toys

Chapter2_Preparing 2015.indd 42

BUYING ON A BUDGET

Looking to save money? Try these handy tips to ensure you get more bang for your buck ● Prioritise. Make a list and be strict in identifying what you really need. A baby swing, mobile and wardrobe of tiny outfits might be desirable but they’re not vital purchases. Ask yourself with every purchase, is this really essential? ● Borrow some items. Ask around to borrow items that will only be used for a short time, eg a Moses basket. ● Invest in other items. Think of how much use you will get out of certain items, eg a car seat is vitally important and will be used virtually every day. Another good item to invest in is a mattress for the cot. ● Plan ahead. Are you planning on having another baby in the near future? Consider items that can be used again or converted, eg a travel system with an option for a second seat or carrycot. ● Sell on. Remember that some items might have a good resale value, such as a travel system. ● Go secondhand. Check online and in your local paper for secondhand baby items, particularly goods that might not be used for long, such as a double buggy if you have children close in age. Remember that some things should be bought new, eg a car seat unless you know for

for at least six months – simply staring at you or listening to you talk and sing is all they need. But a good piece to invest in is a padded playmat for tummy time. As your baby grows, he or she will enjoy

certain that it hasn’t been in a carcrash. ● Ask for useful gifts. Remember that family and friends might want to buy your new baby a gift.

Ask for something useful instead of clothes that might not be worn.

For instance, could some club together to buy a baby chair or play mat? ● Try before you buy. If you want to try your baby in a sling, Babywearing Ireland offers a countrywide sling library, which allows you identify the best sling for your baby before you invest. For more, log on to www. babywearingireland.ie. ● Look for sales. Special offers and shop sales are great opportunities to get all you need for your baby. Look out for specials on nappies, wipes and creams in supermarkets too, so you can stock up for less.

reaching up for the toys and the features on the mat will encourage movement while on the tummy.

Mats vary in price from about €20 upwards so there is no need to spend lots of money on one.

02/09/2014 16:34:49

PREPARING FOR BABY

4

PACKING

Your Hospital Bag

O

n your first appointment at the hospital, you would have been handed a long list – what you should pack in your hospital bag for B-Day. This list is packed away until you reach the latter stages of your pregnancy and you suddenly realise that you really need to get your bag ready. Then, when you start looking at the various bits you need, the reality of giving birth really hits home! It’s exciting and nerve-wracking in equal measure!

To help make the job a little easier, we’ve answered some of the most common questions about packing your hospital bag, and supplied you with a definitive list for you and baby. It’s not that daunting, honest!

a ck t to P a h W It’s never too soon to be prepared, and it’s recommended that you have some sort of basic bag packed by the time you’re 32 weeks’ pregnant, or earlier if you’re expecting twins or are considered high-risk. Mums who end up in hospital earlier than expected stress the importance of being prepared – lists given to partners or family only go so far!

Chapter2_Preparing 2015.indd 43

HOW MUCH SHOULD I BRING? This is a bit of a balancing act. Make sure you have everything you need, but don’t over-pack as maternity hospitals are usually fairly crowded places and there’s little storage space.

Many mums recommend bringing the minimum of clothes for you and for baby, and then making sure that extras are in a convenient place at home, so your partner or a relation can bring them in as needed.

WHAT ABOUT A LABOUR BAG? It’s a really good idea to pack a separate bag for the labour ward. This should contain one to two button-down nighties (be prepared to throw these away, as they may get destroyed!), a light dressing gown, slippers, socks, big knickers in a dark colour, maternity pads, a dark towel, a bottle of water, snacks, a hair bobbin and a camera. Include

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02/09/2014 16:35:16

PREPARING FOR BABY

a see-through plastic bag for the baby, containing a vest, sleepsuit, hat, scratch mittens and nappy.

WHAT ABOUT THE MAIN BAG? Bring a carry-all or case the same size as hand luggage for a flight. This can contain the basics for you and for baby.

Handy things to include are a few packs of newborn vests and sleepsuits for your baby.

It’s quite common for new babies to spit up a lot, so you might find that you go through a lot of these in the early days!

A couple of newborn hats and scratch mittens are also essential. Bring one pack of nappies and have a couple of packets at home to be brought in as needed.

The one big essential for you is disposable knickers – or, even better, get a couple of packets of cheap knickers in as large a size as you can find – and maternity pads. Loose pyjamas or nightdresses that open at the front are also essential for breastfeeding. A spare plastic bag for sending home washing is also a good addition.

me g Ho n i o G Remember that you and baby will need clothes to wear when going home.

Pack a bag with your clothes and your baby’s first outfit and put it with the car seat (another essential!) for your partner to bring into the hospital when it’s time to go home.

PACKING CHECKLIST

IN YOUR HOSPITAL BAG: ● Three cotton nightdresses or loose pyjamas ● Two maternity bras ● Breast pads ● Nipple cream ● Two packets of maternity pads ● Dark-coloured towel and face cloth ● Light dressing gown and slippers or flip-flops ● Six pairs of old or disposable underwear ● Shower gel ● Shampoo and conditioner ● Toothbrush and toothpaste ● Deodorant ● Cleanser and moisturiser ● Make-up ● Hairbrush and bobbin ● Phone and charger ● Magazine or book ● Notepad and pen ● Coins for parking, snacks etc ● Witch hazel to soothe stitches IN YOUR LABOUR BAG: ● Copy of birth plan ● Details of any medication/ hospital notes

● An old nightgown ● Light dressing gown and socks ● Clean nightwear for after the birth ● Hair bobbin ● Lip balm ● Bottle of water and snacks ● Facial mist spray ● TENS machine ● Camera ● MP3 player ● Toiletries and towel ● Nappy, vest, babygro, hat and scratch mittens for baby IN BABY’S BAG: ● Six long-sleeved babygros or sleepsuits ● Six vests ● Bibs ● One pack of disposable newborn nappies ● Two cardigans ● Two hats ● Two pairs of scratch mittens ● One blanket ● Two soft baby towels ● One baby sponge ● Nappy cream ● Cotton wool

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02/09/2014 16:35:48

PREPARING FOR BABY

5

WRITING YOUR

Birth Plan

A

s your due date approaches, you will be starting to think about labour and birth, and how you would like your baby to be born.

It’s essential to arm yourself with as much information as possible, from this guide, your antenatal classes and other books and magazines.

This information will help you think about what sort of birth you ideally would like, and once you have this formulated in your head, it’s a very good idea to write it down in the form of a birth plan. This can then be given to your midwife and/or consultant.

However, remember that your and your baby’s safety are the main priority during labour and birth, so sometimes your ideal birth is not achievable. Try not to be too upset if this happens.

Some points to consider when writing your birth plan: LABOUR MANAGEMENT Think about whether you would like to stay at home for as long as possible or be in the hospital from early on in your labour. Some mums like to help the labour process by having a bath, using a birthing ball or walking around – if these appeal to you, talk to your midwife about whether this is possible. If you don’t want to be confined to the bed, you can ask for foetal monitoring only to be used if medically necessary.

BIRTH PARTNER Think about who you would like with you while you are in labour – this needn’t be your partner. Some women prefer a relative or a friend, or even a professional doula. This is your choice.

Chapter2_Preparing 2015.indd 45

PAIN RELIEF There are several methods of pain relief used in labour, eg epidural, pethidine, TENs – these are explained more fully in the next chapter. Some women would like to attempt a natural birth through

hypnobirthing or a TENs machine. Whether you would like to have an epidural or want a natural birth, it’s a very good idea to state this from the start.

irth B e h t After Think about your preferences for you and for baby after the birth.

Would you or your partner like skin-to-skin contact after birth?

Would you like to breastfeed immediately after birth? Would you like your partner cut the cord?

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PREPARING FOR BABY

TOP TIPS FOR YOUR BIRTH PLAN

Read and research as much as possible before drafting your birth plan ● Tell your birth partner your preferences well before the birth itself and make sure they know what you want and are willing to support and speak up for you. ● Give a copy of your birth plan to your midwife and/or consultant a few weeks before your due date. ● Pack a few copies of your birth plan in your labour bag. ● Remember to be flexible. Your birth plan is your ideal scenario but sometimes this isn’t possible.

❝❞ MY BIRTH PLAN TIPS

46

“My birth plan was a great opportunity to get my thoughts about childbirth and what I wanted down on paper. Things didn’t exactly go according to plan, but at least I had thought about what would happen and when.”

Aine, Mullingar

“I wanted a natural birth - or at least, as natural as possible - and giving my birth plan to the midwife about four weeks before my due date gave me the opportunity to discuss the options with her so she was aware of my preferences.”

Angela, Letterkenny

“Make sure your partner or birth partner gets a copy of your birth plan. Once you’re in the throes of labour, there’s no way you’ll remember what safe compartment in your bag you put it in!”

Mary, Co Kerry

“While your birth plan might be your ideal scenario, don’t get too upset if things don’t go according to plan. Your doctors and midwives want what’s best for you and for baby, so put your trust in them.”

Sophie, Dublin

Chapter2_Preparing 2015.indd 46

ANTENATAL CLASSES Antenatal classes are designed to give you information about pregnancy, labour and birth, and babycare. They’re also a great opportunity to meet other pregnant women and to discuss any worries you might have. It’s strongly advised to do a full course of antenatal classes on your first pregnancy, and some mums like to do a few classes as a “refresher” on subsequent pregnancies.

Maternity hospitals host antenatal classes that should be booked as early as possible (generally you book them in from about 30 weeks). Classes are held for pregnant women by themselves or with partners. There are also several private antenatal classes around the country, which vary in length from one day up to a course of classes. Topics covered in the course may include: ● Looking after your health during pregnancy ● Growth and development of the baby during pregnancy ● Options for labour and delivery ● Pain relief during labour ● When to go into hospital ● What to expect during labour ● Breastfeeding support and advice ● Emotional aspects of becoming a parent ● Physical care of your baby ● Returning to work/ childcare arrangements

02/09/2014 16:36:31

MERRION FETAL HEALTH Ultrasound for Women Consultant led centre of excellence in prenatal ultrasound conveniently located at 60 Lower Mount Street, adjacent to theNational Maternity Hospital. With our team of 5 consultant obstetricians obstetricians, all experts in fetal medicine and their carefully selected team of extremely experienced sonographers and clinic administrators administrators, we ensure the highest standard of patient care.

The newly renovated Georgian property offers a haven of comfort, privacy and medical excellence for its patients patients.

The clinic offers ultrasound scans for all stages of pregnancy • Early reassurance • Nuchal translucency • Anatomy • Growth We also offer gynaecological ultrasound • Pelvic ultrasound • Follicle tracking

We are delighted to announce our Early Pregnancy Clinic which provides dedicated ultrasound services for: • Confirmation and dating of pregnancy • Previous miscarriage • Reassurance • First trimester screening – Nuchal Translucency and HARMONY NIPT (Non Invasive Prenatal Test) (by appointment only) This clinic is available on a ‘walk-in’ basis or by appointment

“State-of-the-art equipment combined with highly qualified and experienced fetal ultrasound specialists allows Merrion Fetal Health to provide a fetal diagnostic service that is second to none.”

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01/09/2014 13:52:35

Labour & Birth

3 p C ha

ter

Labour & Birth

So that’s it – your 40 weeks are just about up and it’s time to think about labour and birth. In this chapter we look at alternative births, how to know when you’re in labour, what happens during labour and some things to note immediately after the birth.

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LABOUR & BIRTH

1

INTRODUCTION TO

Types of Birth which may be disappointing.

However, you will have worked for the best possible birth experience for you and your baby.

Women who have experienced another Caesarean birth after planning a VBAC often say they are glad that they tried.

ELECTIVE CAESARIAN SECTION While the majority of women deliver their baby without any complications, some women with complications, such as a low-lying placenta or who have a breech presentation, pre-eclampsia or very high blood pressure, may need to have a Caesarean section.

INDUCTION OF LABOUR

V

aginal delivery in a hospital is by far the most common type of delivery. However, there are other methods of delivery that may be suitable according to your individual circumstances. Talk to your consultant and/or midwife for more information.

VAGINAL BIRTH AFTER CAESARIAN (VBAC)

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If you have previously had a Caesarean, it may be possible to have a vaginal birth this time.

Some women feel they missed out on the experience of feeling their baby move out of their body, while others may want the faster recovery time of a vaginal birth, and to avoid surgery and its complications.

If you are interested in having a VBAC, firstly find out why you had a Caesarean birth last time.

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Most reasons for a Caesarean don’t necessarily repeat themselves, but it is essential to discuss your individual experience with your consultant or midwife.

The most common reason for repeated Caesareans in the past was the belief that the uterine scar may rupture during a vaginal birth.

Medical findings now show that this is extremely rare.

If you are aiming for a VBAC, learn as much as you can during the pregnancy. Consider going to antenatal classes designed for VBAC, which can prepare you both for the reality of labour and for a spontaneous labour. Classes can also give you more confidence in yourself and the birth process.

The chances of having a VBAC depend on several factors, the most important of which is spontaneous labour. In some cases you can plan and work for a VBAC and still end up having another Caesarean birth,

If you are between ten days and two weeks over your due date, your doctor may discuss the option of inducing your labour with the use of: ● Prostaglandin gel or pessaries inserted into the vagina to ripen your cervix. ● Artificial rupture of membrane (ARM), where a small hook is used to break your waters and start contractions. ● Oxytocin given by a drip to start contractions.

HOME BIRTH If you want a home birth, you will need to contact your hospital very early on to ask if they operate the service. If they don’t, you can contact an independent source for more information. Get in touch with the Homebirth Association of Ireland at www.homebirth.ie.

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LABOUR & BIRTH

2

GUIDE TO

Signs of Labour

Pre-

ur Labo

Signs

Although the following may indicate that labour is not far off, they are not actually part of the process itself: Braxton Hicks contractions are random ‘practice’ contractions that occur at various times throughout pregnancy. They are typically not painful and do not dilate the cervix as real contractions do. Pre-labour Braxton Hicks contractions can be quite strong and while everyone feels them differently, they are seldom accompanied by pain. If this is your first baby it may be hard to believe that they are not the real thing, but Braxton Hicks seldom continue regularly for more than 60 minutes. You may be aware of your baby’s head pressing down.

You may have a bout of diarrhoea, and some women also feel nauseous. Some women may experience a burst of energy a day or

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two before they go into labour.

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W

hen you see one of the following signs, you know that you’re going into labour: Contractions associated with the onset of labour may start off as cramptype pains (similar to period pains) and you may notice them in your stomach, back or thighs.

Some women have irregular pains for a whole day before they are in labour, while other women get regular pains from the start.

When you are in labour, the contractions will increase steadily, reach a peak, and then decrease again. In between, there should be a phase without any pain.

Labour is usually established when your contractions last for

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more than 40 seconds, occur every five to seven minutes over an hour and are beginning to become painful.

A ‘show’ is the release of the mucous plug that seals the cervix or opening to your womb. As the cervix starts to soften and open a little, the show comes away. It is usually sticky and jelly-like and may be streaked or tinged with blood. It is not, however, usual to lose a lot of blood with a show. If you find that you have lost quite a lot of blood, call your midwife or hospital immediately. The time between the show and the start of labour proper can be several days or just an hour or so, or anything in between.

For about ten per cent of women, the breaking of the waters is the first sign that labour is imminent.

When this happens some women feel a distinct ‘pop’ or ‘ping’ and then a gush of warm, clear fluid called ‘liquor’. Others just notice a gentle trickle. At this stage you should contact your midwife. For most women, though, the waters do not break until they are well into labour. If you are not sure if your waters have broken, it is advisable to wear a sanitary towel or pad and contact your midwife for advice.

Occasionally, the water may be a brown/yellow/ greenish colour, indicating that the baby has passed its first bowel motion. This means that your labour will need careful monitoring and therefore you should make your way to the hospital.

WHAT CAN I DO? ● Eat and drink as you want; small portions and light snacks are the easiest to digest. Once admitted into hospital, however, you may not be allowed to eat. ● Try taking a warm bath or shower to ease any aches or pains. ● Try to relax and concentrate on your breathing, which should be slow and steady – in through the nose and out through the mouth. Listen to some relaxing music or try to visualize holding your baby at the end of this process.

Remember that your body is designed to cope with labour and birth.

LABOUR & BIRTH

WHEN LABOUR STARTS

WHEN WILL I CALL THE MIDWIFE OR GO TO THE HOSPITAL? ● The right time to call your midwife and go to the hospital is when you feel you would be more relaxed if she was close by.

For some people, this is when contractions are still infrequent and for others it is not until they have strong contractions at five-minute intervals. Always contact the hospital if you experience any of the following: ● Excessive or abnormal vaginal bleeding aside from the standard “show” ● Concerns about the baby’s movements

● Alternate between walking and resting. If you can, try to get some rest to prepare you for labour.

● Severe abdominal pain

● Keep in contact with your birthing partner for support and reassurance.

● Any other worries or concerns about yourself or the baby

● Headaches or vision disorders

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LABOUR & BIRTH

4

INTRODUCTION TO

Stages of Labour

E

veryone is different and every labour is different. While some women say their labour was the most excruciating pain they’ve experienced, others have said it was not that bad and their feelings of elation made the pain forgettable. At the end of the day, whatever you do to prepare, you won’t know how labour will affect you and you will just have to wait and see. Perhaps the best advice is to keep an open mind!

It is important to note that all labours and births are different and the following is merely a guide.

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FIRST STAGE The onset of labour differs between many women. Some women experience mild, short, regular contractions that have a long interval between them, eg 20 minutes. As labour establishes, the contractions become shorter and more painful, last longer and have a shorter interval, eg every five to ten minutes. Some women start labour with contractions that are of long duration, feel painful and occur frequently, eg every five minutes. Massage, TENS machines, walking around and warm baths can help. As labour progresses, your contractions will be more frequent, occurring every two to four minutes and lasting up to 60 seconds. Start your breathing exercises and relaxation techniques. Find a position that is comfortable. You may request pain relief, if you need it, such as an epidural, injection or ‘gas and air’.

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placenta and membranes. This stage can last up to an hour. Relax – the worst is over.

SECOND STAGE Contractions will be more frequent and last up to 60 seconds. Once your cervix is dilated to 10cm, you will feel the urge to push with each contraction. If you’ve had an epidural, your midwife will tell you when to push and when to hold back. This stage can last from a few minutes to an hour. You may feel a burning sensation as the baby’s head becomes visible or ‘crowns’, stretching the birth canal. You will be asked to pant and stop pushing so the midwife can check everything is okay and to allow controlled delivery to avoid undue trauma to the perineum. The baby’s head will turn toward your leg, the baby will be delivered and placed on your tummy and the umbilical cord will be cut by the midwife.

AFTER BIRTH Some women may experience slight tearing of the perineum area during childbirth. Your midwife or doctor will stitch any tears directly after you give birth, as well as giving you a general examination, including your blood pressure and to check your blood loss. You may also feel some ‘after-pain’ – this is your uterus contracting back to its normal size and is nothing to worry about.

Ask your doctor for some pain relief if it is particularly painful. If circumstances allow and you request it, your baby can have skin-on-skin contact with you immediately after birth. If you are breastfeeding, you will give your baby a feed as soon as possible. Your baby will also be examined and weighed, and wrapped up to keep warm. Occasionally, babies might need a little help to take their first breath. If so, most recover within minutes and can then be placed skin-on-skin. However, if needed, the midwife can keep your baby under observation in the birth room. If your baby needs to be admitted to the neonatal ward, your caregiver will explain the reasons.

See the chapter on “Babies in Special Care” for more information.

!

BABIES IN SPECIAL CARE Learn about what to do if your

THIRD STAGE After a short pause, contractions come again around every five minutes so that you can deliver the

baby is admitted to the neonatal ward.

See Page

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LABOUR & BIRTH

5

GUIDE TO

Pain Relief

T

he first thing to do is to think about the methods available to help you cope with labour, as there are many different choices of pain relief and other remedies available.

It is important to be well informed of all of your options as you may change your mind on the day. Remember that help is available so don’t be afraid to ask for it.

❝❞ RELAX “I was terrified about giving birth from the minute I found out I was pregnant. The way I dealt with my fear was by educating myself on what I could do to help pain and how I could make the experience as good as possible.

I felt more in control that way.”

Jessica, Co Dublin

“I wanted minimal pain relief during labour, but I found it very beneficial to learn about what was available if I needed it.”

Patricia, Mayo

“Every labour is different. I found labour on my first child horrible, and I was dreading it with my second, but it was actually fine.

The important thing is, try not to panic!”

Steph, Co Clare

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TENS MACHINE

Transcutaneous electrical nerve stimulation (TENS), a popular form of pain relief during labour, is an application of painless electrical impulses through surface electrodes placed on the skin. The TENS machine consists of a small, battery-powered, handheld unit and two or four pads that are placed on your back. TENS works by stopping pain impulses from reaching your brain and by stimulating the body to produce its own natural painkillers called endorphins. To get the most benefit, it is recommended that you begin to use the TENS machine once you feel labour has started. TENS units are available for hire or purchase from Medicare Rental and Sales – call (01) 201 4900 or book online at www. medicare.ie.

ADVANTAGES: ● Most women find TENS provides good pain relief. ● TENS has no known side effects for you or your baby. ● Some hospitals have TENS machines available for use in the hospital.

ENTONOX

Entonox is an equal mixture of two gases (nitrous oxide and oxygen) and is commonly referred to as ‘gas and air’. It is the most widely used drug for helping women cope with labour. While Entonox won’t remove all the pain, it will give sufficient relief for most women. It is usually given through a mask that covers your nose and mouth or you can use a mouthpiece instead if you prefer.

ADVANTAGES: ● Effective within 15 to 20 seconds. ● It has no smell or taste. ● There are no known harmful side effects for you or your baby. ● You can remain mobile for as long as possible where portable cylinders are available.

DISADVANTAGES: ● Can make your lips feel dry. A lip cream is helpful in preventing this. ● Can make you feel lightheaded and voices can sound like echoes. ● Can make you feel nauseous – if this happens to you, stop using it and nausea should disappear quickly.

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03/09/2014 14:34:41

Labour & Birth

Pethidine

Epidural

Pethidine is a pain-relieving drug (from the opiates group), which is given by intramuscular injection.

The most effective form of drug pain relief, an epidural is only given after the onset of labour has been confirmed (usually by your midwife) and after a vaginal examination. It involves injecting a small amount of anaesthetic (and, commonly, a pain-relieving agent) outside the spinal cord. A small plastic catheter is placed through the needle. Top-up drugs can be given through this as you need them, or a small amount may be given continuously (like a drip). An epidural is given by an anaesthetist, takes about 15 minutes to insert and 15 to 20 minutes to become effective. Although an anaesthetist is available at all times, the epidural may be held up if your anaesthetist is delayed.

You don’t have to decide whether or not you would like an epidural until you are in labour. Very occasionally the midwife or doctor will recommend you have an epidural if you have high blood pressure or there are other pregnancy complications that the doctor or midwife will discuss with you.

Advantages ● It takes about 15 to 20 minutes to take effect and lasts for two to four hours. ● It helps most women to relax and reduces pain.

Disadvantages: ● Pethidine can make some women feel rather ‘drunk’, ‘distant’ and/or sleepy. * It may cause nausea and vomiting but an injection is usually given at the same time to counteract this effect. ● It can affect your baby by slowing down his/ her breathing at delivery, especially if given within two hours of your baby’s birth. If this happens, your baby may need an injection that works rapidly to reverse the effects and stimulate normal breathing. ● Pethidine may cause drowsiness in the baby, which can affect baby’s interest in feeding.

Advantages: ● Epidurals give the most effective pain relief.

Disadvantages: ● Most women experience mobility loss due to the anaesthetic drugs used. ● You will not be able to get out of bed during labour or for three to six hours after the birth of your baby. ● You will need to have a drip inserted in your arm to minimise the drop in blood pressure that an epidural can cause. ● It is more likely you will need a forceps or vacuum (ventouse) delivery but not necessarily a Caesarean section. ● A small tube may have to be passed into your bladder to drain urine as you may find it difficult to pass urine yourself, but this is usually not painful. ● Occasionally, some women (one per cent) get a severe headache as a result of the epidural, but this can usually be treated effectively.

Aromatherapy

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Essential oils are fast becoming a complementary means of coping with labour. The result is an overall satisfaction, with the aroma removing the ‘hospital smell’ and decreasing anxiety. Preparing to give birth begins in the mind and the earlier that positive associations and imagery are started, the more relaxed you will become.

There is a vast array of oils available on the market, such as Clary sage, which relieves tension and anxiety, and assists the uterus in effective contractions without artificially strengthening them. It has been suggested that it can ‘bring on’ your labour and, consequently, should be avoided during pregnancy. Lavender, neroli and rose are used to assist relaxation during labour. Suspend your chosen essential oil in a base oil, such as grapeseed, if they are to be applied to the skin. This blend can also be added to your bath water. It is essential that you seek advice from a certified aromatherapist as some oils are not suitable for use during pregnancy and labour or the dose may alter.

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Assisted Birth

W

hile complications are not common, some women do require some form of assistance during labour and birth, such as: ASSISTED DELIVERY If you have been pushing for a long time or the baby is in distress, your doctor may discuss using one of the following methods to deliver your baby safely: Forceps: This involves lying on your back with your feet elevated. You may be given a local anaesthetic if an episiotomy is performed to widen the vaginal opening.

As you push, the obstetrician will assist the baby out by using forceps.

Ventouse: A silicone cup (connected to a vacuum pump) is attached to the baby’s head. During contractions, while you are pushing, the obstetrician gently guides the baby out and assists with the delivery.

EMERGENCY CAESARIAN SECTION During labour, occasional complications arise that require your baby to be delivered by emergency C-section. A top-up epidural (in some cases a general anaesthetic) will be given before a small cut is made below your bikini line for your baby to be born via your abdomen.

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LABOUR & BIRTH

6

INTRODUCTION TO

BREATHING TECHNIQUES

Working on your breathing can have a positive effect on your birth experience. Here’s how to make the most of your breathing... ● Keeping your breathing slow and steady during labour will maximise the oxygen available to you and your baby. Learning how to concentrate and control your breathing can also help you handle contractions more easily. ● Breathing becomes shallow and fast when you are panicking, and your upper body becomes tight and rigid. This type of breathing reduces the amount of oxygen in your body and you can feel light-headed and out of control. You will also become exhausted within a short period of time – not ideal when you’re in labour. ● Focus on your breathing when you’re relaxed. Your in-breath matches your out-breath in length, and your breathing pattern is rhythmic. When going through a contraction, it’s

natural for your breathing to become faster, but try to keep it in a steady rhythm without becoming faster and faster. ● Try this exercise to regulate your breathing.

As you breathe in, count slowly to three, and count again when breathing out.

Choose whatever number is more comfortable for you.

Some people find it easier to breathe in for a count of three and breathe out for a count of four. Make sure you breathe in through your nose and out through your mouth. Simply focusing on your breathing will help regulate it. ● During labour, get your birth partner to breathe with you and help keep your breathing regular.

Practise this technique while you are pregnant and ask your birth partner to practise with you.

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LABOUR & BIRTH

7

DEALING WITH

Feelings about the Birth

W

hen you were pregnant you probably had a vision in your head of how you would like your labour and birth to progress.

Unfortunately, sometimes the reality is different from the plan, for a whole variety of reasons.

Due to safety reasons, your birth preferences sometimes may not

be possible, and your caregivers could change your plan suddenly during labour. They should always discuss this with you and your partner, but in certain circumstances it may not be possible. If you feel angry, confused, scared or bewildered by your birth experience, talk to the midwives, who can put you in touch with someone who can help. If you have already left the hospital, talk to your GP about

mplaint o C a Making Every hospital has a complaints procedure. Refer to your hospital handbook for details of the complaints process.

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Chapter3_Maternity2015.indd 58

post-birth counsellors, or contact your hospital in case there is a post-birth counsellor on staff REQUESTING YOUR NOTES You have a right to a copy of your notes, which may give you more insight into what happened during the birth. If you are thinking of making a complaint, it’s a good idea to get your notes first. You can apply for your birth notes through the Freedom of Information Officer or Patient Liaison Officer at your maternity unit. The notes are usually free of charge. You will need to provide the officer with enough information and identification to prove that you are the patient, as notes cannot be requested by a third party.

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After the birth

4 ter p a h C

After the Birth

Congratulations – you made it! So what now?

You are likely to stay in hospital for a few days, depending on the type of birth you had; this is an opportunity to get to know your little one, recover from the birth and get some valuable advice from the midwives. In this chapter you’ll learn about breastfeeding, what happens if your baby needs special care and some special tests for baby.

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AFTER THE BIRTH

1

AFTER THE BIRTH:

What Happens Now?

r Ba b y u o y g Meetin The first couple of hours with your newborn baby is a precious time, and one that you will remember for the rest of your life. Take the time to relax, feed your baby and take in every little detail of him/her. Plenty of skin-on-skin contact is important for both you and

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your baby at this time.

Chapter4_Maternity2015-after the birth.indd 62

O

nce the midwife is satisfied that everything is alright, you will be transferred to the ward. There, the midwives and care assistants will help you get to know and care for your baby, as well as recover from the birth. If you are a first-time mum and have had a normal, uncomplicated birth, you will most likely remain in hospital for three to five days. If you are a second-time

mum having had a normal, uncomplicated birth, the hospital stay generally lasts from two to three days. Some hospitals offer an Early Transfer Home Programme (ETHP). This is where you return home between six and 24 hours after delivery (as long as you and your baby are well) and a community midwife comes to your home for up to the following five days. Ask your hospital if this is available for you.

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01/09/2014 14:01:24

AFTER THE BIRTH

2

GUIDE TO

Beginning Breastfeeding

T

64

he decision of how to feed your baby is an important one that needs careful consideration.

More and more women are choosing to breastfeed in Ireland, but almost two thirds have stopped by the time their babies are three months old and many of these would have liked to breastfeed for longer. However, there are advantages to breastfeeding for even a short time and research shows that the longer you breastfeed the greater these advantages are for you, your baby, the environment and Irish society. Breastfeeding has many advantages for babies, their mothers, for society and for the environment.

Babies who are breastfed are less at risk of stomach upsets, coughs and colds, ear infections, diabetes, asthma and eczema, obesity and high blood pressure later in life. The health benefits of breastfeeding for mothers include less risk of breast and ovarian cancer and osteoporosis in later life and a faster return to pre-pregnancy figure. Breastfeeding also creates a special bond between mother and baby, is cheaper because less equipment is needed, and saves you time because you do not have to prepare bottles. The first milk your breasts produce is called colostrum.

This is usually produced in small amounts to meet the needs of your baby in the first few days of life.

Colostrum is very high in antibodies so is very important in helping your baby fight infections. As your milk supply develops the amount of milk increases and your breasts may feel fuller. This later milk also contains lots of antibodies and other ingredients to ward off illnesses as well as providing all the food and drink your baby needs to grow and develop.

Chapter4_Maternity2015-after the birth.indd 64

Sta g n i t t Ge

rted

Immediately after your baby is born he will be placed on your chest in skin-to- skin contact with you for his first cuddle. Most babies are very alert and anxious to suck soon after they are born. Holding him in skin-to-skin contact will give him time to find your breast and start to suckle. Your midwife will help you with this first breastfeed if you need it. Having your baby with you at all times while you are in the hospital (and when you go home) will help you learn your baby’s way of ‘asking’ for a feed or a cuddle etc. You will know he is looking for a feed when he starts making sucking noises and when he moves his head from side to side while opening and closing his mouth. Crying is a late indication of hunger.

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HOW TO ATTACH Some tips to help your baby attach: ● The baby’s whole body should be in contact with your upper body and facing your breast (his head and body should be in a straight line) with his nose at the level of your nipple.

AFTER THE BIRTH

POSITIONING YOU AND YOUR BABY

● Support his back and shoulders with your arm but leave his head free to tilt back when he starts feeding.

Correct positioning and attachment of your baby for breastfeeding will ensure that he gets plenty of breast milk and you will avoid getting sore nipples. Most of the problems experienced by breastfeeding mothers in the first few weeks (for example, sore nipples, engorgement, mastitis) occur either because the baby is not attached to the breast in the right way or because he is not being put to the breast often enough. Ask for help if you are unsure. ● If you are sitting down to feed, try to make sure that: Your back is straight and supported Your lap is almost flat Your feet are flat on the floor (you may need a footstool or a thick book) You have extra pillows, if needed, to support your back and arms or to help raise your baby to the level of your breast. ● Breastfeeding lying down is especially good for night feeds as you can rest while your baby feeds.

Try to lie fairly flat with a

Chapter4_Maternity2015-after the birth.indd 65

pillow under your head and your shoulder on the bed.

Lie well over on your side. A pillow supporting your back and another between your legs can help with this.

Once your baby is feeding well, you will be able to feed him comfortably anywhere without needing pillows.

There are various ways that you can hold your baby for breastfeeding. Whichever way you choose here are a few guidelines to help make sure that your baby is able to feed well: ● Make sure your baby is held close to you and across your chest.

● When he opens his mouth wide bring him onto the breast with his chin pointing forward and touching the breast below the nipple while allowing him to take in most or all of the areola (the dark area around the nipple) into his mouth (more below the nipple than above). ● You can encourage him to open his mouth wide by gently brushing his upper lip with your nipple.

When your baby is correctly attached to your breast you will notice that: ● His mouth is wide open and he has a big mouthful of breast ● His chin is touching your breast

● He should be facing the breast, with his head, shoulders and body in a straight line. His nose or top lip should be opposite the nipple. ● He should be able to reach the breast easily, without having to stretch or twist Remember always move your baby towards your breast rather than your breast to the baby.

● His bottom lip is curled back (you may not be able to see this) ● If you can see any of the areola (the brown skin around the nipple), more is visible above his top lip than below his bottom lip. ● His cheeks stay full and rounded during sucking. ● His sucking pattern changes from short sucks at the beginning to long deep sucks with pauses.

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02/09/2014 17:34:01

AFTER THE BIRTH

WHEN FEEDING HURTS Feeding should not be painful.

While you and your baby are learning to breastfeed you may feel some discomfort when the baby first attaches to the breast. This sensation should fade quickly after starting to feed and from then on it should feel comfortable. If it continues to hurt, this probably means that your baby is not attached properly. In this case, take him off by gently pressing your breast away from the corner of his mouth so that the suction is broken and then help him to re-attach.

If the pain continues, ask for help from your midwife, public health nurse, lactation consultant or La Leche League or Cuidiu volunteer.

How

now ...

K I do

... IF MY BABY IS DRINKING ENOUGH? Many new mothers worry that their baby is not getting enough food while breastfeeding. But there are a number of signs that your baby is thriving: ● Your baby is producing wet and dirty nappies. ● Your baby is putting on weight. ● Your breasts feel softer and lighter after feeding. ● You can hear your baby swallowing frequently and sucking steadily. ● Your baby is calm and satisfied

EXPRESSING MILK

Why you may need or want to express your milk: ● If you need to help your baby attach to a very full breast. ● If your breasts feel full and uncomfortable. ● If your baby is too small or sick to breastfeed. ● If you need to be away from your baby for more than an hour or two. ● If you are going back to work.

Whether you choose to hand-express or to express by hand/electric pump, the milk may take a minute or two to flow after you start expressing.

Express from one breast until the flow slows or stops. Change to the second breast and when the milk stops flowing from that breast return to the first breast and start again.

Repeat this several times until you can no longer get any milk from either breast.

To encourage your milk to flow while expressing, try the following: Try to be as comfortable and relaxed as possible. Sitting in a quiet room with a warm drink may help.

Have your baby close by. If this is not possible, have a photograph of your baby to look at instead.

If you can, have a warm bath or shower before expressing, or apply warm flannels to your breast (especially when you are learning to express).

Gently massage your breast. This can be done with your fingertips or by rolling your closed fist over your breast towards the nipple. Work around the whole breast, including underneath. Do not slide your fingers along your breast as it can damage the skin.

After massaging your breast, gently roll your nipple between your first finger and thumb. This encourages the release of hormones, which stimulate your breast to produce and release the milk.

As you get used to expressing your milk you will find that you do not need to prepare so carefully.

Just like breastfeeding, it gets easier with practice.

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AFTER THE BIRTH 68

HOW LONG SHOULD I BREASTFEED FOR? There are advantages to breastfeeding for even short periods. But to maximize the health, social, emotional, environmental advantages of breastfeeding, aim to continue for as long as you can. The way to ensure you and you baby get the most out of breastfeeding is to exclusively breastfeed for the first six months and then continue breastfeeding while also giving your baby nourishing solid foods until the baby is two years old or older.

GETTING HELP If you feel you need it, it’s important to seek help. Many hospitals offer breastfeeding support after the birth. Talk to your midwife or your GP about what’s available in your area.

Or you can contact your public health nurse (based in the local HSE Health Centre – see local telephone directory for number).

Public health nurses hold drop-in (no appointment necessary) well baby clinics and provide home consultation visits to mothers and babies.

Contact your local breastfeeding support group to receive information and support over the telephone or arrange to attend one of the local support group meetings. Mother- tomother breastfeeding support group meetings are organised and facilitated by HSE public health nurses and voluntary breastfeeding counsellors, mainly

by La Leche League and CuidiúIrish Childbirth Trust. In a few areas there are also non-affiliated voluntary mother-to- mother breastfeeding support group meetings that you can attend.

All La Leche League leaders and Cuidiu counsellors are mothers who have breastfed their own babies and who have completed an accredited training

Chapter4_Maternity2015-after the birth.indd 68

BREASTFEEDING WHEN OUT AND ABOUT

● Breastfeeding is the normal and natural way to feed your baby and you should feel proud and confident in your decision to breastfeed.

Your baby can look for food or comfort anywhere and at anytime. Feel free to offer your baby a breastfeed whenever and wherever he or she needs it. Breastfeeding makes it easy to go anywhere with your baby, particularly when you are travelling by car, bus, train or air. You don’t have to carry feeding equipment or worry about keeping bottles fresh and germ free. Remember:

● You don’t have to ask to breastfeed. You can breastfeed anywhere you and your baby want or need to. ● Make it easier for yourself by wearing trousers or a skirt with a jumper, sweatshirt or T-shirt that can be pulled up from the waist. If possible wear a maternity bra that can be opened from the front with one hand. ● Feed early. Don’t wait until your baby gets too hungry or distressed, that way you’ll both be more relaxed and feeding will go more

All information courtesy of the HSE. See www.breastfeeding.ie for more, or pick up a leaflet from your public health nurse, GP or maternity hospital.

programme. Even if you are not having problems, this is an excellent way to meet other mums and share your experiences.

Make contact with a private lactation consultant. There are an increasing number of International Board Certified Lactation Consultants (IBCLC) providing

private breastfeeding information and support. Consult your local telephone directory or the Association of Lactation Consultants in Ireland, www. alcireland.ie, to find out if there is an IBCLC-qualified lactation consultant in practice in your area – there is a cost for this service.

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AFTER THE BIRTH

3

INTRODUCTION TO

Baby’s Screening Tests

T

here are a number of screening tests for your baby that may be carried out during your stay in the hospital. If not, they may be done by your public health nurse.

HEARING SCREENING Some hospitals have introduced a hearing screening test shortly after birth. If your hospital does not offer this yet, your public health nurse will conduct a hearing test at a development check when your baby is older. If applicable, the hearing screen is usually done before you leave the hospital. The trained screener places a small soft tipped earpiece in the outer part of your baby’s ear, which sends clicking sounds down the ear. When an ear receives sound, the inner part, known as the cochlea, usually produces an echo. The screening test only takes a few minutes and does not hurt your baby. The hearing screening test will usually be done while your baby is asleep or settled in your arms. The results can be discussed with the screener immediately after the birth.

BLOODSPOT SCREENING The National Newborn Bloodspot Screening Programme identifies babies who may have rare but serious inherited conditions, which are treatable if detected early in life. The screening test is offered to all parents when the baby is about four days old.

All babies born in Ireland are offered screening for Phenylketonuria (PKU), Maple Syrup Urine Disease, Homocystinuria, Classical Galactosaemia, Cystic Fibrosis and Congenital hypothyroidism.

Screening your baby for all these

Chapter4_Maternity2015-after the birth.indd 71

conditions is strongly recommended.

If you are considering opting-out please discuss your reasons with the public health nurse. Your decisions will be recorded and you will be asked to sign an opt-out form.

The public health nurse or midwife will prick your baby’s heel using a special device to collect some drops of blood onto a special card.

When the sample is collected, the newborn screening card is sent to the Children’s University Hospital in Temple Street for testing.

Most babies will have normal test results. However, if the test results suggest that your baby might have one of the conditions, you will be contacted by a nurse or doctor; the time interval will range within five to seven days of the test or possibly up to four weeks depending on the condition. The test is not 100 per cent accurate, and your baby

will need to have more tests to confirm the result.

If the test results show that your baby does not have any of the conditions, you will not be contacted directly. However, you can ask the public health nurse for the results at your baby’s three-month health check.

The HSE is currently carrying out a review of storage and disposal policy for archived screening cards, in consultation with the Department of Health, the Data Protection Commissioner, and patient and clinical representative groups. For current policy, consult the HSE website at www.hse.ie or talk to your public health nurse.

Information on newborn tests courtesy of the HSE. For more information, log on to www.hse.ie

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03/09/2014 14:37:41

AFTER THE BIRTH

4

INTRODUCTION TO

Babies in Special Care

I

t’s estimated that over 4,500 babies are born prematurely in Ireland every year. Thankfully, medical care has improved so much that even after only 24 weeks of gestation, babies have a chance of survival. When your baby makes an earlier than expected appearance, it may come as a shock for parents who weren’t prepared to meet their child so soon. Quite often parents feel helpless, scared or guilty, in case it resulted from something that they did wrong – when of course it had nothing to do with that walk or the hot curry you ate that night. This feeling can be immediate, or may hit them once later, one they are home and settled.

Premature babies are classed as babies born before 37 weeks.

They are usually cared for in a Special Care Unit or the Neonatal Intensive Care Unit (generally for more critical cases).

Babies needing the intensive care of a Neonatal Unit may be transferred to a major maternity hospital, which can be even more scary and disruptive for the parents.

However, the staff on special care and neonatal unit are more than willing t talk to you about your baby and to facilitate bonding at every opportunity. If you need to know anything or want time with your baby, talk to the staff and ask them for help.

72

GET HELP If your baby has been born early and is in need of special care, Irish Premature Babies

Chapter4_Maternity2015-after the birth.indd 72

FIRST PERSON

ALLISON MOLLOY, founder of the Irish Premature Babies charity, shares her experience of having her two boys, Cillian (6) and Oisin (3), pre-term.

At 30 weeks, Allison Molloy went into labour with her first child, Cillian. “When the doctors lifted the baby out [he was born by c-section], I caught a fleeting glimpse of him. The doctors congratulated my husband and I on our little boy and he was taken off to the Neonatal Intensive Care Unit (NICU). My husband went with the baby.” After recovery, Allison was given a picture of her son, and a few hours later was allowed to see him. “I burst out crying. He was so tiny, nothing like the picture I had upstairs in the ward.” Without anywhere for mothers to stay in the NICU after being discharged, Allison returned every day to be

offers parents both practical support (invaluable if you have to travel to see your baby in a neonatal unit) and emotional support, as well as advice and information. The charity also runs a buddy system so that parents

with Cillian and she says she found great support from other mums in the same situation. “I was really lucky when I had my first baby that I met a group of wonderful mums and we are all still friends now.” Allison’s second child, Oisin, was also born prematurely. “It was difficult having a two-year-old at home wanting to be with mammy when I needed to be with the new baby when he was in the NICU. “Even though you know your baby is doing well and gaining weight, it can be so scary bringing them home for the first time as you still remember the frightening times,” says Allison on bringing her children from hospital. “You have to learn to be a mother and trust your instincts.”

ALLISON’S ADVICE: ● Take each day as it comes, some days will be better than others. ● Accept any help from family and friends. ● Premature birth can happen to any woman and it’s not your fault. ● Look after yourself as well, it is very easy to neglect yourself. during those difficult weeks and months. ● Accept any help from family and friends

of premature babies who are experiencing the same things can be put in touch with each other.

For more information, visit www.irishprematurebabies.com.

03/09/2014 14:38:06

RUTH KENNEDY gave birth to Sophie at 23 weeks and six days in June 2013 “I’d had a normal pregnancy and was feeling good, so we arranged a holiday in Orlando during my second trimester to do some shopping and relax. I’d just had a check and all was looking fine.

But when I was in Orlando about three days, I started having back pains and went into labour. Two days later, I gave birth to Sophie at 23 weeks and 6 days. We were very lucky to be where we were, as we were admitted to the Winnie Palmer neo-natal intensive care unit, which is one of the best in the world. Sophie was one pound, ten ounces, which is a good weight for that time, but she was very, very small, and she was on a ventilator for eight weeks. At the

beginning she’d stop breathing about every hour, and as time went on, it would be every two hours. The staff were great, they explained everything to us – that her lungs were not ready for the outside world yet, so this was why she’d stop breathing. I actually had the What to Expect app and it was spot on with the development – Sophie’s eyes were shut when she was born and about three weeks later the app told me that the baby’s eyes were opening and sure enough, two days later, Sophie opened her eyes!

On the down days, the nurse would say to us that all we were doing was watching her grow.

“We had some problems along the way. We were just about to get Sophie to the next level, where she’d be in a cot and we’d get to go home and she developed a highly dangerous lung infection, RSV, and had to be re-ventilated and put into

❝❞ Staff were excellent

“We were in Orlando until we were brought home on October 3rd; we then spent 28 days in the Rotunda. Again the staff couldn’t have been better – Irish staff are under a lot more pressure than the staff we had in America but they really give their all to the babies and the parents.

Ruth Kennedy

isolation for two weeks – the longest two weeks of our life.

We then were back to square one, moving her oxygen down slowly.

“We were in Orlando until we were brought home on October 3rd; we then spent 28 days in the Rotunda. Again the staff couldn’t have been better – Irish staff are under a lot more pressure than the staff we had in America but they really give their all to the babies and the parents.

“Looking back, we did go into a type of survival mode over the time spent in hospital.

We had great support from people at home – some friends did fundraisers to pay bills and mortgages so we didn’t have to worry about anything like that while we were in Orlando, and we used Skype to talk to family and show them the baby.

“I got involved with Irish Premature Babies because I found the support of other people who had gone through the same thing invaluable.

During low moments I liked seeing the pictures of babies who had been born very early and who were now celebrating their birthdays years later. It was reassuring. I had great support while I was going through it, and I’d like to pay that back to other mums.

“Sophie is now 14 months and thriving. She’s beginning to crawl and is even starting to catch up on her birth age.

We do have to have her eyes checked every six months because of the prematurity and the amount of oxygen used, and she has RSV injections too, as it’s so serious and I never want to see her like that again.”

AFTER THE BIRTH

FIRST PERSON

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02/09/2014 17:36:35

AFTER THE BIRTH

5

GUIDE TO

Going Home

A

fter a couple of days (up to five if you’ve had a Caesarian section), your doctor or midwife will talk to you about going home. On the day of discharge, you will be examined by a doctor and given any prescriptions, letters or advice, while your baby will also

be examined and discharged with any instructions needed. Your baby should be seen by the GP (or the consultant if requested) at two weeks and six weeks. You are also due a checkup at six weeks with the GP. YOUR PUBLIC HEALTH NURSE Once home, you are in the public health care system, and your public

elp H g n Getti Those first few days at home can be scary for new parents, especially if this is your first child. Don’t be afraid to ask for help - your public health nurse is there to guide you and help you with any issues you might have. The nurse can also refer you on if there are any problems that she/he cannot deal with. Your baby is due a check-up at two weeks and at six weeks, and you will have a check at six weeks, but if you have any health concerns

74

before that, contact your public health nurse or GP.

Chapter4_Maternity2015-after the birth.indd 74

health nurse will be in touch within a few days, usually 48 hours, to arrange a first visit.

The first visit often takes place at your home, and will include a chat about any worries of concerns you may have, a weigh in, the newborn screening blood test if it wasn’t done in the hospital and some information on facilities in your area and vaccination schedule. The public health nurse usually gives you a contact number if you have any questions or concerns as your child develops. As your child grows, your public health nurse is there to help with development questions and issues. Following the first visit, the developmental checking appointments can be offered at three months, nine months, 18-24 months, and aged three to three and a half. Parents can ask questions at these visits and request any follow-ups if they are needed.

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EARLY DAYS

5 ter p a Ch

Early Days

Arriving home with your newborn baby is a hugely exciting time – but it’s also a potentially scary time. How will you cope with such a tiny being to care for? What about registering your baby? And your own postbirth health? In this chapter you will learn about caring for your new baby as well as some of the practical issues like vaccinations and birth registration. We also take a look at the very real problem of post-natal depression – the signs to look out for and some of the ways in which you can help your mental health. Remember that your public health nurse is there to help and guide you during the early days.

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02/09/2014 17:42:19

EARLY DAYS

1

INTRODUCTION TO

Caring For Your Baby

T

he joy of arriving home with your baby, after being surrounded by professionals for the first days of your child’s life, can be overshadowed by nerves, particularly with your first child.

Rest assured, you will gain confidence over time through learning to look after your baby’s individual needs and responding to his cues.

BATHING YOUR BABY

BATHING YOUR BABY Newborn babies do not need bathing in the first few days of life. Topping and tailing your baby is sufficient for the first few times until you get used to bathing your baby.

When your baby is ready for a bath, set aside plenty of time, especially for the first few times.

It may take a few days to gain confidence, but try to relax and enjoy the activity. Talk and sing to him and try to make it a special time to bond with your child.

NAILS Baby nails do not require cutting in the first few weeks. Put loosefitting mittens on baby’s hands to stop him scratching his face.

When trimming baby’s nails, place his hand on a flat surface and cut the nails using a bluntedged scissors.

78

HAIR Some babies are prone to cradle cap, a dry, scaly condition of the scalp. Health professionals advise daily washing to prevent its occurrence. To wash baby’s hair:

Chapter5_Maternity2015_Early Days.indd 78

● Remember, babies don’t regulate their temperatures very well, so undress baby in stages, starting with the top part of the body. ● Pour a small amount of cold water first into the bath and then add warm water until the bath reaches a warm temperature. Test the temperature with your elbow or the inside of your wrist. ● Start with the top part of the body. Wrap baby in a towel and wash his face, eyes and hair. ● Remove his nappy and clean area with baby lotion. ● Remove the towel and, supporting baby’s shoulder with your left forearm, hook your hand under the armpit. ● Gently cradle baby’s legs with your right arm holding on to one thigh. Gently place baby

in the bath so that you are facing him. ● Keep him in the semiupright position with lower body immersed in the water and his head and shoulders out of the water. ● Holding him firmly with your left hand, wash baby with your right hand. Talk or sing to your baby all the time. ● When the washing is finished, lift your baby out of the water, placing your right hand under his bottom. Place baby in a towel and give him a cuddle. ● Dry him well. ● Never, ever, leave your baby alone in the bathroom at any stage. Ignore the doorbell and turn off your phone.

03/09/2014 14:39:22

EARLY DAYS

● Wrap the baby’s trunk in a towel and hold underneath your armpit. ● Place head over the bath and wash hair using a little amount of nonstinging shampoo. ● Rinse well and gently dry with a soft towel. ● If cradle cap does occur, apply a little baby oil in the evening and wash off the following day. Do not try to remove the scales with your fingernails, as this may give rise to a breakdown of the skin and result in infection.

EYES If baby’s eyes need cleaning (ie if there is a crust or discharge): ● Wash your hands. ● Dip a cotton-wool ball in boiled, cooled water. ● Squeeze out the excess. ● Start in the inside aspect of the baby’s closed eye, wiping towards the outer. ● Discard the cotton ball. ● Repeat for the other eye.

SKIN A newborn baby’s skin contains natural oils; there is no need to use soap products to wash your baby in the early weeks. Using only water, clean and dry all the skin creases, otherwise moisture in the creases may lead to irritation of the skin. At a later stage, you can add unperfumed products to the bath. The newborn baby may have a variety of spots, blotches or rashes on the skin. If you are concerned about any aspect of your baby’s skin, ask your public health nurse for advice.

THE UMBILICAL CORD The umbilical cord is cut and clamped following the birth of the baby. The remaining cord stump heals naturally; it dries, shrivels and falls off during the first two weeks of life. Leave the area around the cord stump uncovered as much as possible to encourage healing. Gently clean the cord at each change and fold baby’s nappy down below the stump until it heals. If you are concerned about redness or signs of infection at

Chapter5_Maternity2015_Early Days.indd 79

the site, contact your public health nurse for advice. A baby may be given a bath during this time.

BOWEL MOVEMENTS Baby’s first stool is called meconium and this is a dark green, sticky substance. The colour and consistency changes over the next

Si

few days depending on whether the baby is breast or bottle-fed.

The breastfed baby’s stool is light yellow in colour and may range from a pasty consistency through to something that looks like creamy soup. A breastfed baby rarely gets constipated, but the consistency of the stools may be affected by the

llness I f o gns

Consult your doctor immediately if: ● Your baby has a fever – temperature above 38°C (100°F) – if accompanied by a rash, especially red or purple spots that don’t disappear when pressed by a glass. ● Your baby has a high-pitched cry. ● Baby’s skin feels cold and he appears drowsy or is unusually quiet and limp. ● Your baby’s neck is rigid or stiff. ● Your baby has prolonged vomiting. ● Your baby has diarrhoea.

Always contact your doctor if you are concerned in any way. If your baby stops breathing, contact your hospital immediately for advice, or call 999 for emergency services.

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02/09/2014 17:42:58

EARLY DAYS

VITAMIN D food his mother eats. The stools of a bottle-fed baby range from a loose consistency through to a firm, brownish colour.

The latter type is the most common.

If your baby is constipated, give him cooled boiled water, but do not add sugar. In general, a baby’s bowel motion may change in colour and consistency without giving rise to any problem. If you are concerned, discuss it with your public health nurse. In a small number of cases it may be advisable to contact your doctor if there is a sudden change in consistency, colour and smell of the stools, accompanied by a feeling that your baby is unwell. Look out for the following: ● Watery stools ● Change in colour ● Increased frequency ● Very smelly ● Baby seems unwell MALE CIRCUMCISION Circumcision is an operation to remove the foreskin, which covers the penis, leaving the top of the penis exposed. Some parents circumcise their male babies for religious reasons. It is recommended that babies should not have this procedure within the first year of life unless medically indicated. Select a reputable surgeon for the procedure.

After the operation, follow instructions given by the surgeon.

In general, a baby recovers from the shock of surgery within 24 hours.

The baby’s penis is nearly always swollen and inflamed for a few days.

During this time, observe for signs of bleeding. Change baby’s nappy frequently to reduce the chance of infection. Expose to the air as much as possible. Refer back to the surgeon if you are concerned in any way.

Remember that female circumcision is illegal in this country

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It is now a public health policy that all infants born in Ireland must receive Vitamin D3 drops from birth, whether babies are breast- or bottle-fed. ● What is Vitamin D? Vitamin D is a fat-soluble vitamin that is needed for every cell in the body to function properly. When the sun shines on our skin, the body makes vitamin D. We need to top up our supply as often as possible. Sitting in the sunshine for more than 15 or 20 minutes per day is not recommended, as there is a direct connection between skin cancers and sun exposure. Furthermore, from October to March we see very little sunshine in Ireland. ● Infants and Vitamin D Infant skin is very sensitive and burns easily and should not be directly exposed to the sun. The Irish Cancer Society recommends that baby’s skin is not exposed to direct sunlight, and should be protected by clothing, shade and sunscreen. Therefore, infants do not have the capacity to safely get Vitamin D from the sun. Infants with African, AfroCaribbean, Middle-Eastern or Indian ethnic backgrounds are at even higher risk of vitamin D deficiency. Their stores of vitamin D may be particularly low when born, as their mother’s skin is not as efficient at making vitamin D from the amount and type of sunlight in Ireland. Exclusively breastfed infants are more at risk of Vitamin D deficiency than bottle-fed, however all infants are at risk of deficiency since their Vitamin D stores at birth are dependent on their mother’s vitamin D status during pregnancy.

Babies are also born with only 50 to 60 per cent of mum’s stores.

Research carried out at the National Maternity Hospital showed that no pregnant woman in the study met the recommended daily allowance for vitamin D. ● Why is Vitamin D important? Rickets, a condition that affects bone formation, has re-emerged in Ireland thanks to Vitamin D deficiency. Furthermore, it is now widely accepted that insufficient calcium and vitamin D in early childhood can lead to osteoporosis in later life. In Ireland we have very high rates of osteoporosis, with one in three Irish women over the age of 65 developing the disorder. This very important vitamin is also gaining lots of positive attention from the research community.

It is now being investigated for its role in autoimmune disease, Type 1 diabetes, and cancers. ● What about supplements? The recommended form of vitamin D supplement for infants is actually vitamin D3 (cholecalciferol).

It should be given as an oral supplement in a liquid or drop form and should contain only vitamin D3 – it should not contain any other vitamins. It should provide five micrograms (5ug) of D3 daily. Supplementing your baby is a very simple preventative health care strategy. Remember to give the drops daily.

Sylvia McShane is a public health nurse, barrister at law (Gray’s Inn) and freelance writer.

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EARLY DAYS

2

GUIDE TO

Registering Your Baby

A

side from running around catering for your newborn’s every whim, one of the most important tasks is to schedule an appointment with a Civil Registration Services Office of your choosing and formally register your child’s birth. Maybe you never expected your baby to come into this world attached to a string of boring paperwork, but the importance of registering comprehensive and accurate information about your child should become evident when you think about the amount of times this information will be used throughout the course of his or her life. Enrolling in school, exams, getting a job, getting a passport, submitting health and social welfare applications – these are all times when this information will be vital in the future. Another worthwhile reason is that upon registration your child will be issued with a Personal Public Service Number (PPSN), which will entitle you to receive Child Benefit Allowance for your child.

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WHAT IS THE PROCEDURE? The Civil Registration Act 2004 requires the parent or parents of a newborn child, not later than three months from the date of birth, to attend in person before any registrar of births, to provide such information as is required to register the birth and to sign the register of births in the presence of the registrar. All you need to do is to gather all the basic facts about both baby and parents and present them in person to a registrar of your choice.

Chapter5_Maternity2015_Early Days.indd 82

example, a passport or driving licence) as well as their Personal Public Service Numbers. These can be obtained from the Department of Social Protection if unknown. After these details have been recorded, you will need to provide the following details to complete registration of your baby:

WHAT DOES THE REGISTRATION OFFICE DO? A Birth Notification Form will usually be completed with the parent(s) by hospital staff. It outlines the information to be recorded in the Register of Births and is forwarded to a registration office to inform the registrar of the birth. These details are usually registered within two weeks so it is always worthwhile for you to call ahead to the Registration Office you have chosen and check that they have received the details before you arrive in person.

To register, the mother or father, or both, can attend. If the parents are unmarried the father must consent to have his details included, so it is advisable for both of you to attend.

Advanced contact is recommended if the mother has previously been married, or is separated or divorced.

WHAT SHOULD I BRING? Both parents must bring photographic identification (for

CHILD’S DETAILS ● The time, date and place of birth of the child. ● The gender of the child. ● The forename(s) and surname of the child. Ensure the surname(s) appearing in the Register of Births is correct so as to avoid any later confusion or difficulties.

PARENTS’ DETAILS The following details must be supplied separately for both the mother and the father at the time of registration: ● The forename(s) and surname of each parent at the time of the birth. ● Each parent’s birth surname. ● Each parent’s occupation described as accurately as possible. ● Each parent’s normal address at the time of birth. ● Each parent’s date of birth. ● Each parent’s marital status at the time of birth. ● The birth surname of the mother of each parent.

Having all these details ready when you are registering your baby will make it a quick and easy process and leave you with more time for figuring out the parts of parenthood that don’t require messy paperwork, but are rather just messy!

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EARLY DAYS

3

INTRODUCTION TO

Vaccinations

I

mmunisation is important for your child’s health and for the health of the children and adults your child will come into contact with.

Many of the diseases your child will be immunised against in the primary childhood schedule are potentially very serious, especially for a young infant, which is why your child is so young when she gets her immunisations.

All the recommended immunisations listed in the primary childhood immunisation schedule are free in Ireland. Your child will need five visits to your GP to complete their course of vaccines and be fully protected against serious diseases.

HOW DO VACCINES WORK? When your child is given a vaccine, their body responds by making antibodies, the same as if they had caught the disease but without getting sick. Their body then produces antibodies to destroy the vaccine, and these stay in your child’s body and protect them against the actual disease.

84

WHO ARE VACCINES GIVEN AT SUCH AN EARLY AGE? Vaccines are given at an early age because young babies are most vulnerable to these diseases and need to be protected as early as possible. For example, babies younger than six months are at the highest risk for serious complications of pertussis (six out of ten need to go into hospital, and nine out of ten deaths from whooping cough are in this age group). The MMR vaccine is not

Chapter5_Maternity2015_Early Days.indd 84

SCHEDULE OF VACCINATION

At Birth Two Months Four Months tions) Six Months tions) 12 Months 13 Months

Hospital or HSE clinic BCG GP 6 in 1 & PCV (two injections) GP 6 in 1 & Men C (two injec-

* BCG: * 6 in 1:

Bacille Calmette-Guerin (TB) vaccine Diphtheria, Haemophilus influenzae B (Hib), Hepatitis B, Pertussis (whooping cough), Polio and Tetanus vaccine Pneumococcal conjugate vaccine Meningococcal C vaccine Measles, Mumps, Rubella vaccine Haemophilus influenzae B vaccine

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EARLY DAYS

TREATING COMMON SIDE EFFECTS usually recommended for children under 12 months because it may not work properly.

WHAT WILL HAPPEN IF MY CHILD DOESN’T GET VACCINES? Basically, one of two things could happen: ● If your child goes through life without ever being exposed to these diseases, nothing would happen. ● If your child is exposed to any of these diseases, as a child or as an adult, there is a good chance that he or she will get the disease. Your child could get mildly ill and have to stay inside for a few days; or get very sick and have to go into hospital or at worst die.

Your child could also spread those diseases to others who are not protected, such as children who are too young to be vaccinated. Many people could get very sick and some could die if not enough people in your community are protected.

ARE VACCINES SAFE? The vaccines used in Ireland are safe.

All medicines can cause side effects, but with vaccines these are usually mild, like a sore arm or leg or a slight fever. Serious side effects to vaccines are extremely rare.

Research from around the world shows that immunisation is the safest way to protect your child’s health.

Your doctor or nurse can discuss the risks with you before giving your child their vaccines.

All the recommended vaccines used to protect children in Ireland are licensed by the Irish Medicines Board or the European Medicines Agency. They are allowed to be used only after they have been shown to be both effective and safe.

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WHAT ABOUT THE SCARE STORIES? We know that vaccines don’t cause autism, diabetes, multiple sclerosis, allergies, asthma or attention deficit disorder (commonly known as hyperactivity). However, when things happen to our children around the

Chapter5_Maternity2015_Early Days.indd 86

COMMON SIDE EFFECTS CAN INCLUDE: ● Soreness, swelling and redness in the area where the injection was given.. Fever (over 39.5°C) Headache or irritability.

WHAT TO DO ● Give paracetamol or ibuprofen to relieve aches and pains. ● Make sure clothes are not too tight or rubbing against the area where the injection was given. ● Do not overdress your baby. ● Make sure their room isn’t too hot. ● Give extra fluids to drink. ● Give paracetamol or ibuprofen to lower the fever or aches and pains TIPS ● Remember, if your child is very unwell after getting a vaccine, they may be sick for some other reason. Talk to your GP about this. ● Children do NOT usually need to take any medicine when they are given a vaccine. However, if your

child gets a fever (over 39.5°C) or is sore where the injection was given, you may give them paracetamol or ibuprofen. ● Remember, after having the MMR vaccine a fever may happen about six to 10 days later, so give paracetamol or ibuprofen then. ● The dose of paracetamol or ibuprofen recommended for your child is written on the bottle according to the child’s age. ● Please ask your pharmacist for sugar-free mixture of paracetamol or ibuprofen suitable for your child’s age. ● Using paracetamol or ibuprofen over a long period without advice from a doctor may be harmful.

Information in this section was adapted from the HSE booklet, Your Child’s Immunisation: A Guide for Parents. For your own copy, log on to www.immunisation.ie or contact your public health nurse or GP.

same time as they are immunised we can wrongly presume that there is a link. For example, the signs of autism usually become noticeable at about the age when children are given the MMR vaccine, but one does not cause the other. Because most children get immunised, those who have conditions such as autism, asthma or attention deficit disorder will probably have been immunised as well. Studies to see if children who have been immunised are more likely to have these conditions have shown that there is no link between the conditions and vaccines.

Extensive research into the MMR vaccine, involving thousands of children, was carried out in the UK,

the USA, Sweden and Finland.

This research showed that there is no link between MMR and autism. One study looked at every child born in Denmark from 1991 to 1998. During that time, 82 per cent of children born in Denmark received the MMR vaccine. The researchers looked at the records of over half a million children and found the risk of autism was the same in immunised children as in children who had not been immunised. Experts from around the world, including the World Health Organization, agree that there is no link between MMR and autism.

03/09/2014 14:40:48

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03/09/2014 17:36:08

EARLY DAYS

4

DEALING WITH

Postnatal Depression

P

ostnatal depression (PND) is an illness that happens as a result of having a baby.

It can happen after any birth and can last anywhere from three months to a year. If unrecognised, it can continue on into the second year.

The feeling of ‘baby blues’ comes on around the second or third day after giving birth. It is quite normal and very common. It usually only lasts for a day or two but in a number of women it could last up to a week. If it goes on for longer than ten days you should visit your GP as a small percentage of woman can get PND from delivery. Some of the symptoms include: ● Crying for no reason. ● Feeling tired and weary. ● Feeling cross and anxious. ● Feeling useless. ● Afraid to be left on your own with the baby. ● Trouble sleeping even though you are exhausted.

88

The most severe form of depression after childbirth is puerperal psychosis, where mum is very high, doing things out of the ordinary and having hallucinations. It is very rare and only affects one in 500.

The majority of women with puerperal psychosis develop symptoms within the first two weeks of delivery. It is caused by a chemical imbalance brought on by childbirth. The earliest signs are restlessness, irritability, insomnia and mild confusion.

Urgent medical intervention is needed if this condition is suspected.

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SIGNS AND CAUSES OF PND

SIGNS ● Lack of interest in yourself or your baby. ● Unable to cope with small things, finding everything an effort. ● Feeling that you are a bad mother. ● Afraid of being left alone with your baby. ● Feeling exhausted but unable to sleep. ● Feelings of hopelessness. ● Feeling angry, rejected and/or confused. ● Inability to concentrate, forgetfulness. ● Lack of interest in your appearance. ● Marked over-activity or under-activity is common. ● Lack of interest in sex. ● Obsessed with baby, not wanting anyone else to hold or mind the baby. ● Racing negative thoughts that you can’t stop. ● No interest in food, or over-eating. ● Feelings of panic or anxiety, not being able to relax. ● More often than not, mum does not realise that anything is wrong and it is up to her partner to notice many of these signals for PND.

CAUSES ● PND affects about 20 per cent of women in Ireland every year. It can develop after any pregnancy up to six months after giving birth; the most common occurrence seems to be six to ten weeks after delivery. ● We are not sure what causes PND and why it affects some mums and not others, but we do know certain things. Firstly, if there is a history of PND or clinical depression in your family then you might be more susceptible. It is very important to let your GP and public health nurse know so they can keep an eye on you after the birth. ● If a life-changing event happens while you are pregnant (i.e. a death in the family, moving house, losing your job), this can be a trigger for PND. A bad birth experience can also be a trigger; a lot of women draw up a birth plan but sometimes an emergency might occur that prevents this plan being used. Some women can take this as a sign of failure on their behalf and become fixated. ● We have all read about the amazing rush of love to expect the first time you see your baby. This does not happen to every woman straightaway. This let-down has been the starting point of PND for lots of women as they feel a sense of failure.

But, look at it this way: your baby is a stranger to you until he is born, and how many strangers do you fall in love with straightaway? ● Last but not least we come to ‘Supermum’: the woman who puts herself under pressure to be perfect. What Supermum needs to know is that no woman needs to do everything alone, and there are a number of places she can go for help.

03/09/2014 14:41:28

EARLY DAYS SEEK SUPPORT It is very important to go and see your doctor and to inform your public health nurse if you suspect you are suffering from PND. You might be encouraged to go on anti-depressants and, though most women dread being put on medication, new tablets have come a long way. If you are put on anti-depressants, you should see some improvement in about a week to ten days. PND is a very up and down illness (i.e. one good day, two bad days) but you will eventually notice that the bad days become fewer as you start to get better.

Some women prefer not to take tablets, and for this option you

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will need support. Most importantly, talk to your partner and extended family; their support is invaluable. It is truly essential that you realise you are not on your own going through this illness, and there are a number of things that your partner can do to help, such as: ● Be patient, supportive and encouraging. ● Reassure mum that she will recover. ● Encourage mum to talk about how she is feeling. ● Ask family and friends to help around the house. ● Ensure that she gets enough food and rest. ● Organise babysitting so that you can have some time together. ● Encourage time spent between

mum and baby to bond and get to know each other without feeling under stress. ● Be aware that mum may not be in the mood for sex but does need love and affection.

MEETING OTHER MUMS Nowadays many expectant mothers may be living away from home with little or no support; working almost right up until the baby is due and living in housing estates where everyone is out working all day. This can lead to feelings of isolation and loneliness, which can be worsened if mum has nobody to share these concerns with. I would encourage every new mum to join a mother

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02/09/2014 17:48:09

EARLY DAYS

HELPFUL SUGGESTIONS and toddler or baby group where they can meet other mums. At the very least, check and see if you have any friends or neighbours that you can call on if you need help.

The website, www.pnd. ie, is an Irish website dedicated to postnatal depression. Here you can read other women’s stories and their helpful suggestions.

There is also a discussion section where you can communicate with other mums around the country. You can also call Postnatal Depression Ireland (based in Cork) to see if there is a support group in your area. These small groups comprise of women who are going through different stages of PND and meet monthly and offer each other support.

Partners are also welcome to join these sessions. For areas without a support group, Postnatal Depression Ireland keep a file of mothers who have recovered from PND and are willing to offer their support to others. Contact us if you need help and support.

We all need someone to listen to us and counselling certainly has its place in the treatment of PND. Some women with very mild cases have found this to be a great help. However, be careful not to rush into anything before you are ready. Women with postnatal depression do get better. Professional, family and community support helps speed recovery.

Finally, if things are bad in the middle of the night and you have no one to talk to, please call the Samaritans (1850 609 090); they are there to listen and to help you.

● Accept there is a problem and you need help. ● Take life one day at a time. ● Try to find the positive in things – everything in your life is not always negative, even if it feels that way at the moment. It will be difficult at the start but do try. If you don’t look for the positive things in your life, you won’t see them. ● Be open about your feelings and worries with people you trust who will understand and won’t judge you. ● Try to get some exercise every day; even if it is only a walk around the block, fresh air really helps. ● Don’t try to be Supermum.

Caring for a baby 24 hours a day is exhausting; you are allowed to drop your standards for a while. ● Don’t be afraid to ask for help: it is not a sign of weakness.

People are only delighted to help. ● Eat a balanced diet, little and often. This will give you energy. ● Involve your partner as much as possible.

● Find time to have fun.

Accept genuine offers of help and go out with your partner or a friend, even if only for an hour. You will feel the benefit the next day. ● If you are having a bad day, get out of the house. Visit a friend or walk to the shop – a distraction really helps. ● We all have certain times during the day when we feel better so keep a diary of your moods, especially in an upswing. This helps you to see that your day isn’t all doom and gloom. ● Don’t be too hard on yourself or your partner.

Blaming yourself or others is not helpful to anyone, least of all you. Accept that life is tough at this time but it will get better. ● It can help to write down how you are feeling. This way you can get things off your chest – and you can always burn it afterwards.

Madge Fogarty is the founder and chairperson of Postnatal Depression Ireland. For further information on Postnatal Depression Ireland, call (021) 492 3162 or visit www.pnd.ie.

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EARLY DAYS

5

INTRODUCTION TO

Contraception

C

ontraception is probably the last thing on your mind after having a baby, but unless you are breastfeeding, your periods and your fertility return to normal about three weeks after giving birth, so it’s important to think through your options and discuss these with your partner.

In some ways, your contraceptive choices will depend on the issues relevant prior to your pregnancy: effectiveness, convenience, any side effects and any medical conditions you have or medicines you need to take.

One new factor is whether or not you are breastfeeding your baby.

If so, your periods are unlikely to return for at least six months, or as long as you continue feeding.

Breastfeeding significantly reduces a woman’s fertility, but unless you are very conscientious about never missing a feed, including at night, it’s not a completely reliable method of contraception, and becomes much less so after six months. Fortunately many contraceptive methods can be safely used when breastfeeding.

The exceptions are contraceptives containing oestrogen, such as the combined pill and vaginal rings and patches. Oestrogen affects milk flow and shouldn’t be used even if you’re only partially breastfeeding your baby.

What worked well before your pregnancy may be the right choice again, but another new decision is the possible timing of another baby. Longer-acting contraceptives, such as hormonal injections, implants, or a coil (either an intra-uterine device or

Chapter5_Maternity2015_Early Days.indd 91

system) may be a better alternative if you’re pretty sure you will not want another baby for some years, or if you think your family is complete.

It’s better not to make a possibly irreversible decision too soon, so wait until your baby is over a year old before opting for a sterilisation (tubal occlusion) or for your partner to have a vasectomy.

EARLY CHOICES If you have decided not to breastfeed you can start the pill, or use a vaginal ring or skin patch, from three weeks after birth. These can be very reliable methods of contraception, but you have to take them regularly. You can start the progesterone- only pill (“minipill”) any time after birth, whether you’re breastfeeding or not, but remember this needs taking at the same time each day so you’ll need to be organised even with a young baby to look after.

Your doctor or nurse can usually fit an implant or coil four weeks after either a vaginal or Caesarean birth and these options can be very useful if you want long-acting, very reliable and usually well- tolerated contraception that you don’t need to remember to use.

It is usually recommended to delay

starting the contraceptive injection until at least six weeks after delivery, since used earlier this may cause more heavy or irregular bleeding.

If you used a diaphragm or cap before your pregnancy, this can be used again after six weeks. You should check it’s correctly fitted with a doctor or nurse first, as your cervix (neck of the womb) and vagina change shape during pregnancy and birth. This is also appropriate if you have put on more than 3kg in weight.

Natural family planning is possible after you have had a baby, but you may find your cycle much less predictable, certainly for a year or so. You should discuss this option with an experienced Natural Family Planning (NFP) practitioner.

Contraceptive planning after you have had your baby is as important as before you became pregnant: think through your options, get advice, and make the best choice for your own circumstances.

Dr Julius Parker, general practitioner with HSF Health Plan’s free 24 hr GP advice line, answers health questions relating to young families. For more information on HSF health cash plans, please visit www.hsf.ie or Lo Call 1890 473 473.

91

02/09/2014 17:48:47

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Life with Baby

You’re over the first few weeks and settling into parenthood – what does the next six months bring? This is your guide to making the most out of parenthood over the next few months, as well as some valuable tips on getting your baby into a good sleeping routine and how to adjust your lifestyle to suit a family.

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LIFE WITH BABY

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GUIDE TO

The First Six Months

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ongratulations! Your precious bundle has arrived, and you’re about to embark on the most exciting journey of your life. Over the coming months you’ll see your baby develop and grow into a sturdy little person with a personality all of his or her own – in fact, your baby may even be preparing to move around unaided! This might be hard to imagine when you’re holding a tiny, slippery newborn in a hospital! All babies develop at different rates, and it’s important to remember that development is not a race. There are certain milestones that a baby will reach over the coming months – some will reach them more quickly than others. In particular, premature babies may reach their milestones closer to their adjusted age (the age they would be if they were born on their due date), or even later. Our month-to-month guide is simply an indication of what to expect.

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Your public health nurse will be able to help you gauge your individual baby’s development.

MONTH ONE It’s quite normal for a newborn to sleep most of the day, waking only for feeds. As your baby grows, you may find that your baby is more

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One of the biggest issues during the first few weeks is your baby’s weight. It is normal for your baby’s weight to drop up to 10 per cent over the first couple of days after birth, often while you are still in hospital. Your baby’s weight will be monitored by both your doctor and your public health nurse in your regular checkups, but you can help by noting down feeds and keep an eye on your baby’s nappies – regular wet and dirty nappies mean your baby is feeding well and

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thriving.

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likely to wake for longer during the night. Again, this is normal, but your baby will settle into a proper routine before too long.

The key is to be patient and to sleep when the baby sleeps. At birth, your baby can see objects close up – especially your face – and will shortly learn to recognize your smell. A gentle touch and soothing voice will help calm your baby, and you will see your baby react to bright light and noises.

MONTH TWO By the time your baby has reached its one month birthday, you might notice that he or she is more active and alert and is sleeping a little less. Your baby’s routine might feel exhausting at the moment, but remember that this won’t last forever. Over the course of the coming weeks, your baby will grow and develop and may even start stretching sleep

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time during the night. At this stage, your baby will be able to lift his or her head when lying on the stomach.

Short and frequent bursts of tummy time are important to encourage this development. You may even hear sounds from your baby other than crying, such as cooing. And this month you may even be rewarded for all your hard work by a smile!

MONTH THREE Your baby is getting increasingly active, and expanding his or her horizons beyond eating, sleeping and crying. Hopefully during this month your baby will show signs of staying alert for longer during the day and playing – which should eventually lead to longer sleeping times at night.

You may feel that you can interact more with your baby too, as smiles, coos and eye contact become more plentiful. This month your baby is showing more signs of being able to control his or her head. When on his or her tummy, your baby will be able to lift its head a little higher, and may even be showing signs of pushing the chest off the ground. Your baby may be showing more smiles and interacting with you during playtime and changing time.

MONTH FOUR Congratulations – you’ve made it through the first three months!

Many babies start to really settle down after three months, which may even mean something resembling a full night’s sleep for you – although this might be hugely different to your definition of a full night’s sleep before baby! Parents of colicky babies will also find that the symptoms are thankfully beginning to ease. Your baby is becoming more alert and sociable, and happy to smile and coo at anyone in vision. His or her head is becoming more sturdy, and by the end of this month, your baby may be able to hold its head steady when upright. Your baby may even be able to reach for and grasp a rattle.

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By the end of the first month, you may feel as though you’ve got the hang of feeding, and your baby has settled into a routine – but

LIFE WITH BABY

Spurts h t G ro w

suddenly baby wants to be fed all day long! This is a growth spurt, and will pass within a few days to a week. Babies hit their growth spurts at different times, but generally there is one between six and eight weeks, then at three months, six months and nine months. You may find that after a growth spurt your newborn baby doesn’t feel so newborn after all, and may even be bursting out of his or her clothes!

ESTABLISHING A ROUTINE

The first few weeks may feel like your baby will never settle into a routine. But following a simple routine such as eat/change/play/ sleep can help in the early days, and noting down when your baby wants to eat and sleep can aid you in understanding your baby’s natural routine. Then, establishing a simple bedtime ritual will help your baby distinguish between day and night. Regular events like a walk in the afternoon, or tummy time on the playmat can help too.

For more, see p100.

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LIFE WITH BABY

BABY’S EYE COLOUR MONTH FIVE This is really a lovely time for you and your baby. Every day your baby is discovering more about her world, and is happy to share all the new discoveries with his or her favourite person – you. Baby’s attention span is getting better too, and something as simple as a rattle or a toy (or even hands!) can captivate. You may find that your baby is putting toys and rattles into his or her mouth, so be careful to keep small objects out of reach. Your baby is getting stronger by the day, and should be able to support his or her own head when upright. When put on the tummy, your baby should be able to start pushing up on his or her arms – this may happen later, depending on the amount of tummy time the baby gets. Watch out too – the first sign of mobility is your baby being able to roll over, and this will come any time from the end of this month onwards.

Your baby will start to show signs that he or she needs more than milk feeds soon,

While African, African-American, Hispanic and Asian babies are generally born with brown eyes that stay brown, Caucasian babies are born with dark blue or grey eyes that may change several times before their first birthday. The final colour depends on the amount of melanin in the baby’s irises, which is dictated by genes. The more melanin in the irises, the darker the eyes will be. When your baby is born, the natural light kickstarts the melanin process in its eyes, which leads to the colour changes – this is the same process that turns your skin brown when you go into the sun. Most babies’ eye colours are established by the time they’re a year old, but some continue changing until they are three, and a few even into adulthood!

such as looking for more feeds or waking up more frequently at night. Solids are not recommended before your baby is four months old, or 17 weeks, but you should start sometime before your baby turns six months old. Some mothers find it easier to start introducing solids slowly from about five months, but every baby is different. Your public health nurse can guide you on when is the right time for

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weaning. For more, see p142.

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MONTH SIX Your baby is developing his or her own personality, and is becoming even more sociable. But be aware that some babies may develop anxiety around strangers at this stage. This is nothing to be alarmed about, and will pass in time. At home, games like peekaboo or a toy that makes noise can provide endless delight, as can exploration, such as pulling your hair and taking your glasses.

Your baby is also becoming more vocal – encourage this by talking

to your baby and answering his or her coos and babble. By the end of this month, your baby will be able to keep his or head level when pulled to sitting. He or she will also be able to make vowellike sounds and gurgle. Some babies may even be able to sit without support and bear weight on his or her legs when held upright. This can be encouraged by standing your baby on your lap as a game – just remember that your baby will tire easily.

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WHEN WILL MY BABY CRAWL? Babies generally learn to crawl anytime after seven months, but usually around nine months to a year. Crawling follows shortly after your baby is able to sit up unaided. However, because babies are now encouraged to sleep on their backs to help prevent Sudden Infant Death Syndrome (SIDS), some babies skip crawling altogether, and go straight to standing and cruising (holding on to furniture as they move around). Others “bum shuffle” – move around on their bottoms. Crawling is encouraged as it helps to develop coordination between the right and the left sides of the body, but if your baby has skipped crawling and is learning to coordinate both sides of the body, there is nothing to worry about. Consult your doctor or public health nurse if you are worried. To encourage crawling, get your baby used to tummy time from as early an age as possible. This will help develop the muscles needed for crawling.

As your child gets older, try putting toys and other desirable objects slightly out of his or her reach, to encourage your baby to move forward and reach out.

Rolling a towel under his or her chest will allow your baby look up and explore his or her surroundings. Get down in front of your child and encourage him or her to move towards you.

“Don’t listen to people who tell you that their baby was walking by x months and talking by y months - every baby is different and develops at different speeds.

If you are worried, talk to your GP or PHN, otherwise, relax and enjoy watching your baby grow.”

Louisa, Co Meath

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TEETHING BABIES

TEETHING Your baby’s first tooth appears anything between three and 12 months, with the seventh month being average. But teething can begin weeks and even months before the first tooth arrives – look out for these first signs of teething: ● Drooling – Excess saliva is a classic sign of teething. Use a bib and wipe baby’s chin frequently. ● Chewing – nipping at your finger or chewing on a toy or a spoon helps to relieve the pressure on her gums. ● Crying – Your baby will cry when his or her gums are hurting. If your baby winces when you gently touch his or her gums, she may need some pain relief. Talk to your pharmacist or doctor for natural and medical forms of pain relief. ● Changes in routine – Changes such as not being interested in food or waking in the night can point to teething. However, if these persist, talk to your doctor to rule out any illness.

❝❞ cool it “Keeping a teething toy in the fridge gave my baby great relief when she started teething. The cold numbed her gums, while the biting helped the tooth finally break through.

Jane, Co Dublin

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LIFE WITH BABY

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ESTABLISHING A

Sleeping Routine

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efore you have children, friends warn you about the lack of sleep, but you just can’t imagine the profound impact it can have on you, both physically and emotionally, until you’ve experienced it first-hand.

A lack of sleep can make everything else in your life harder to deal with and put a strain on relationships, so it’s no surprise that sleep has become the focus of many books and much discussion between parents.

There is a danger, though, that how long your baby sleeps at night can become a measure of how good a parent you are, and this just adds to the pressure.

How many times have you heard

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other mums talking smugly about their three-month-old sleeping ‘through the night’? It doesn’t make you feel good about yourself does it? You wonder what you’re doing wrong, why your baby is the only one waking hourly around the clock.

The unfortunate reality is that it’s completely normal for a baby to wake during the night in their first year, and mums who brag about their six-week-old ‘sleeping through’ are either hallucinating through lack of sleep, or just plain lucky. Expect your sleep to suffer initially, and expect routines to change as your baby grows – it’s quite normal, for instance, for new sleep issues to arise after six months in babies who had previously slept well.

Although some loss of sleep may

be inevitable, there are things you can do to try and settle into as comfortable a routine as possible.

There are myriad books and websites full of tips, suggestions and regimes, but do take all these with a pinch of salt. Yes, it can be useful to get ideas, but remember that parenting is hugely personal.

Any routine you introduce has to be workable, fit your family circumstances and, most importantly, feel right for you and your baby. Trust your instincts and feel confident in the choices you make for your family.

INTRODUCING A ROUTINE So just when and how do you go about introducing a routine?

Well, again, this varies from baby

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KEY INFORMATION FOR SAFE SLEEP

In Ireland, Sudden Infant Death Syndrome (also known as SIDS, or cot death) is the leading cause of death in babies aged four weeks to one year. It isn’t common (less than one in every thousand babies die from SIDS every year), and there are measures you can take to minimise risk.

● For safety when sleeping: Place your baby on their back to sleep, with their feet to the foot of the cot.

Always keep your baby in a smoke-free zone.

Keep your baby’s head uncovered when they sleep and don’t let them get too hot.

Never fall asleep with your baby on an armchair or sofa. ● Never let your baby sleep in your bed if anyone else in the bed: Is a smoker.

Has drunk alcohol or taken drugs.

Is excessively tired or has taken medication that makes them sleep more heavily. ● The safest place for your baby to sleep in the first six months is in a cot in your room. If your baby is unwell, seek medical advice immediately.

LIFE WITH BABY

to baby. Some will naturally fall into their own pattern and, if you are happy to let your baby lead the way, this can be a very gentle and natural way to do things.

If you are breastfeeding, it is particularly important to let your baby take the lead, as successful breastfeeding works on a supply and demand basis – you need to let your baby feed on demand in order for your body to produce the right amount of milk.

For others, the ‘go with the flow’ style of parenting may not be desirable, or even practical, and some kind of structure will need to be introduced. Recently, there has been a surge in popularity of the very rigid routines for new babies. These involve a strict, regimented approach to feeding and sleep, and incorporate a lot of controlled crying – where you ‘train’ your baby to sleep at certain times by leaving them to cry on their own (with regular checks) until they fall asleep.

These routines do work for some people, and having a detailed plan of action can be comforting, particularly for new or first-time parents lacking confidence. They have raised concerns, though, over the short and long-term emotional impact of leaving a baby to cry, and can certainly be very stressful to implement. They can also be restrictive – if you become dependent on your baby feeding and sleeping at precise times of the day, it doesn’t offer much flexibility in other parts of your life.

For most parents, there is a happy medium between letting your baby lead completely and enforcing a harsh daily timetable.

The key ingredient is consistency – you decide on a pattern that works for you and then you repeat it, every day, until it becomes a routine that your baby recognises, acting as a cue for sleep.

❝❞ PARENTS TIPS “My one big tip - and one that I admit I didn’t follow myself - is to sleep when the baby sleeps. It takes time to establish a sleep routine and you need to keep yourself rested and healthy in the meantime.”

Melissa, Cork “Establishing a night-time routine takes time. It’s important to remember that babies who sleep through the night from a few weeks old are a rarity! Be patient and stick to a set routine.”

Jenny, Athlone “I found it really beneficial to keep the bedroom for night-time sleep. I used her pram for daytime naps, and kept her crib for the night, just to try and establish a difference between night and day from the start.”

Lesley, Drogheda

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LIFE WITH BABY

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INTRODUCTION TO

Feeding Issues & Weaning

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hatever way you choose to feed your baby, be it bottle or breast, some complications may arise. More often than not any of these issues can be easily overcome; however, they can be distressing for both parents and the baby. Discomfort caused by gas is common and normal after feeding in the early months.

Here we describe eight common concerns that parents may encounter when feeding their infant.

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POSSETING Posseting and regurgitation are terms given to the milk a baby brings up after feeding. Although a little posseting is natural, if it happens regularly – more than four times a day – and your baby brings up more than just a little bit of feed, there may be a chance that your baby has reflux. If you suspect your baby is posseting

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too much, you should speak to your doctor or public health nurse.

VOMITING Vomiting is when your baby brings their entire feed back up. Vomiting usually happens a little longer after a feed than posseting and is a more forceful action with a larger volume and can smell unpleasant. Professor Eleanor Molloy is a consultant neonatologist at the National Maternity Hospital in Dublin. “You should contact your doctor if your baby is vomiting regularly, if it’s a large amount, if it’s green coloured or contains blood,” she says.

CONSTIPATION There is no “normal” when it comes to a baby’s bowel movements. If you’re concerned that your baby may be constipated, there are a couple of things to look for. Less frequent bowel movements than normal, obviously uncomfortable movements and hard, dry stools that are difficult to pass may be indicators

of constipation. Prof. Molloy suggests giving the baby some sugar water or even prune juice to increase intestinal movement and relieve constipation.

FAILURE TO THRIVE Most newborn babies lose a little weight straight after birth. It is considered normal for a baby to lose up to 10 per cent of their body weight, but they should soon begin to put weight on if they are feeding correctly. There’s also no ideal amount or rate at which they should gain weight due to the fact that all babies are different. However, a very low rate of weight gain may need to be investigated. If you have any worries, get your baby weighed regularly and your public health nurse will let you know if there’s any cause for concern.

BABY FEEDING CONSTANTLY A baby that wants to feed more than usual or for longer may

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REFLUX A baby’s digestive system is immature so posseting (a little spit-up) after a feed is normal, and eventually they outgrow it. Reflux occurs when the swallowed milk comes back up into the oesophagus or mouth and causes distress and irritation. Babies have a ring of muscle where the oesophagus joins the stomach. This muscular valve opens to let through milk the baby has swallowed, and closes to keep milk in the stomach. Babies usually get reflux because the ring of muscle hasn’t developed fully yet so milk and stomach acid can come back up the oesophagus, causing discomfort akin to heartburn in adults. Prof.

Molloy explains that reflux is difficult to diagnose in newborns. It usually presents itself from about three

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LIFE WITH BABY

be going through a growth spurt.

Common times for growth spurts are around nine days, two-three weeks, four-six weeks, three months, four months, six months and nine months. They usually last for two to three days at a time. During a growth spurt, breastfed babies nurse more often than usual, called cluster feeding. Cluster feeding usually happens in the evenings, but can occur any time during the day or in the middle of the night. Cluster feeding at night can become very tiresome but it’s perfectly normal. Cluster feedings do not mean that you have a low milk supply. Supplementing your baby with formula at this time will cause your body to produce less milk. Continuing with the cluster feeding will make sure your body is producing the right amount of milk for your baby. If your baby is formula fed, you may find he’s looking for a little more formula at the end of each feed during growth spurts. It can be tempting to start solids at an earlier age than recommended when a baby appears to be constantly hungry.

However, this rarely helps and if solids are given too early it can create additional problems.

CHILDHOOD ILLNESS

SYMPTOMS OF REFLUX ● Frequent posseting ● Happier when upright ● Refusing to feed or difficulty feeding ● Apparent abdominal pain

weeks of age onwards. If you suspect your baby suffers from reflux she advises bringing the baby to the GP where an antacid may be suggested.

Often babies with suspected reflux are treated with antacids and if their condition improves after a week the treatment is continued until they start solids or the stomach muscles strengthen.

LACTOSE INTOLERANCE Some newborns can have a mild lactose intolerance. The symptoms of this would be 5-10 episodes of diarrhoea in a day often accompanied by a nappy rash. Prof. Molloy recommends trying simeticone such as Infacol for a few days to see if this helps before trying a lactose-free formula or in the case of breastfeeding, altering the mother’s diet.

COLIC Colic is a term used to describe uncontrollable crying in an otherwise healthy baby often at the same time of day, frequently in the late afternoon or evening. It usually appears when the baby is two or three weeks old. It is defined as a baby younger than five months old who cries for more than three hours in a row on three or more days a week for at least three weeks. Colic

WHEN SHOULD I TAKE MY BABY TO SEE A DOCTOR? ● Bringing up milk or occasional vomiting after feeds is nothing to worry about. Immediate medical attention is required if you see: ● Green vomit ● Vomit containing blood ● Stools containing blood ● Baby is lethargic and uninterested in feeding

won’t cause your baby any longterm harm, but it’s a tough thing to go through for both babies and their parents. If your baby has colic, the abdomen may look enlarged.

You may notice that they alternately extend or pull up their legs and pass gas as they cry. It is important to bring a baby with suspected colic to the GP to check for any other medical reason for the crying. Colic tends to peak around six weeks, then improves significantly between months three and four. By five months it has generally resolved itself. In the meantime, comfort your baby as best you can and ask for help when you need it, as caring for a colicky baby can be very stressful. Colic is one of the great mysteries of baby life and there is not much scientific proof on what is effective in its treatment. Some experts believe that long bouts of colicky crying are a physical release for overstimulated babies. Prof.

Molloy wonders if colic might be another way of describing reflux.

It is a good idea to talk with your doctor about any feeding issues that arise, if only to rule out other causes and help determine the best course of action for your baby. And remember each baby is different, so listen to your baby’s needs Words by Dr Joanna Griffin

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Weaning ONCE YOUR BABY REACHES THE FOUR MONTH MARK, IT’S TIME TO START THINKING ABOUT MOVING HIM OR HER ONTO SOLIDS. HERE’S WHAT TO REMEMBER… feeding him or herself. While it’s a messy business, this is something to be encouraged!

Allow your baby to hold one spoon, while you try to spoon in most of their meal with another spoon. ● Be safe. Make sure that an adult is always with your baby when they’re eating. This is to give them encouragement, but more importantly to make sure they don’t choke.

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t is recommended that you start weaning when your baby reaches six months old if breastfed, and between four and six months if formula fed. Your public health nurse will be able to advise on the best time for your baby.

Don’t attempt to wean until your baby is at least 17 weeks old, as weaning too early puts the baby at risk of developing allergies.

First foods should be bland and runny in consistency. Ideal first foods include baby rice (mixed with breastmilk or formula), root vegetables like carrot and nonacidic fruit like stwed pear. Your baby will only take a spoon or two at first, but you can gradually build this up as your baby begins to get used to eating from a spoon. Remember you can mix your baby’s usual milk with any puree to make it more palatable.

TRY THESE TOP TIPS TO GET YOU STARTED COURTESY OF WWW.SAFEFOOD.EU:

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● A gentle start! If you can, pick a

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time when both you and your baby are relaxed to first introduce them to the spoon. ● One at a time. Introduce one food at a time. Allow your baby to get used to this food before starting another. ● Keep it clean. Anything you use to feed your baby needs to be kept very clean ● Test it yourself. When you’re feeding your baby a warm meal, heat it thoroughly, let it cool, stir it well and then test it yourself before giving it to them. ● Pace it. It takes time for your baby to learn how to move food around their mouth and swallow it, so try not to rush them. Let your baby set the pace. ● Try not to force-feed. Most babies know when they’ve had enough to eat. If you spend too much time persuading your baby to eat, they may start to refuse food as a way of getting attention. ● Let your baby help! At some point, your child will show an interest in

● Cook it yourself. Give your baby food you’ve prepared yourself as often as you can. It’s cheaper than buying jars of baby food and it means your baby will get used to eating like the rest of the family. Don’t add any salt (or sauces containing salt) to food your baby will be eating. ● Ice-cube trays. Prepare a family meal that’s suitable for baby too (remember not to add any salt). Freeze small portions of the meal in an ice-cube tray for later. Tip: Silicone trays are great as the frozen cubes pop out very easily. The cubes can be then stored in a labelled freezer bag. ● Safe re-heating. If feeding baby food that has been stored frozen, it must be heated to piping hot to kill all bugs and then allowed cool to before giving to baby. ● When you feed your baby re-heated food, make sure to throw out any leftovers - it’s not safe to reheat foods more than once. ● Variety is the spice of life. Over time, offer your baby a wide range of foods that you and your family normally eat. This can help to avoid fussiness later on.

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LIFE WITH BABY

FOODS TO AVOID:

● Regular cow’s milk is not suitable as a main drink for your baby until baby is one year old.

Cow’s milk can, however, be added to foods to soften them (e.g. mashed potato or cereal) from six months onwards.

Breastmilk or formula milk can also be added to foods to soften them. ● Raw eggs: There is a risk to baby of food poisoning from raw or partly cooked eggs. Cook them until both the yolk and the white of the egg are solid.

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● Whole or chopped nuts: Nuts carry a risk of choking for children under five. Crushed or flaked nuts are okay. ● Shark, Swordfish and Marlin: These fish contain levels of mercury that are unsuitable for babies and toddlers. ● Honey should never be given to babies under one year, as there is a risk of botulism poisoning. ● Added sugar: A baby does not need sugar added to food.

It will only give baby a taste for sweet things and could damage new little teeth.

● Sugary drinks or fruit juice juice: The best drinks for babies are milk either breast or formula and water. ● Salt should never be added to baby’s food: Having too much salt can be bad for baby’s kidneys. ● Gluten: If baby is weaned before six months, foods containing gluten should be avoided. Gluten is found in foods such as wheat, oats. Baby rice, fruit and vegetables are gluten free.

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LIFE WITH BABY

FOODS TO AVOID:

● Regular cow’s milk is not suitable as a main drink for your baby until baby is one year old.

Cow’s milk can, however, be added to foods to soften them (e.g. mashed potato or cereal) from six months onwards.

Breastmilk or formula milk can also be added to foods to soften them. ● Raw eggs: There is a risk to baby of food poisoning from raw or partly cooked eggs. Cook them until both the yolk and the white of the egg are solid.

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You don’t have to move heaven and earth ● Whole or chopped nuts: Nuts to carry a give risk of choking for your baby its first children under five. Crushed or naturally fltaste aked nuts are of okay. nutritious, ● Sugary drinks or fruit juice juice: The best drinks for babies delicious food. Just give are milk either breast or ● Shark, Swordfish and Marlin: formulaorganic and water.

These fishthem contain levels divinely of 188mm x 130mm (w x h) mercury that are unsuitable for baby food from Heavenly babies and toddlers. ● Salt should never be added Tasty Organics. to baby’s food: Having too much salt can be bad for baby’s ● Honey should never be given Each dish is made to babies under one year,tasty littlekidneys. from completely natural as there is a risk of botulism ingredients and nothing poisoning. ● Gluten: If babyelse, is weaned making thembefore justsixright months, foods for growing tastegluten should be containing ● Added sugar: A baby does buds and busy avoided. Gluten is found in not need sugar added to food. foods such as wheat, oats. Baby It will only give baby a taste for parents. rice, fruit and vegetables are sweet things and could damage gluten free. new little teeth.

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The ISPCC has to raise between 80-90% of its income through fundraising.

Irish Society for the Prevention of Cruelty to Children, 29 Lower Baggot Street, Dublin 2 T: 01 676 7960 Website: www.ispcc.ie Registered Charity Number: CHY 5102

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4

INTRODUCTION TO

First Aid & Infants

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sick baby is always scary, and we would recommend that if ever you’re worried about your child’s health that you visit the doctor. In an emergency situation, however, you may have to perform first aid yourself before medical back-up arrives. A first-aid course is essential for every parent – in fact, everybody – as it will give you confidence that you will know what to do in case of emergency.

BURNS Again, it can happen so easily – a bad burn from boiling water or accidentally touching a hot oven. Here’s what the Red Cross recommends: ● Cool minor burns under cold running water. ● Cover with clean cling film or a loose sterile (non-fluffy) bandage. ● Seek medical assistance if you are unsure of the severity of the burn.

BLEEDING Every child falls and cuts herself at some stage, but what if it’s severe

bleeding? Recommendations from the Red Cross: ● Blood loss should be treated as quickly as possible. ● Wear disposable gloves if available.

If there is NOTHING embedded in the wound: ● Press on the wound with your hand over a clean pad. ● Secure with a bandage. ● Raise the wound above the level of the heart. ● Call for ambulance.

If SOMETHING is embedded ● Do not press on the object. ● Instead, press either side of the object and build up padding around it before bandaging to avoid putting pressure on the object itself. ● Get the person to hospital as quickly as possible.

Irish Red Cross First Aid courses are run around Ireland each week. Prices start at €80 depending on course length and type. For more details call 1890 502 502 or visit www. redcross.ie

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Temperatures are common enough in small babies and toddlers, but as long as they respond to paracetamol, there is usually nothing to worry about.

However, some babies and children can suffer from febrile convulsions, fits that occur with a high temperature. Although they are terrifying to watch, they are rarely harmful. A febrile convulsion usually lasts for between 20 seconds and two minutes. If your baby suffers from a brief febrile convulsion, take her to a doctor or a hospital to be checked over and to confirm the cause of the fit. If the fit lasts for more than three minutes, call for an ambulance. If your baby has a brief febrile convulsion for the first time, take her to the accident and emergency department of your local hospital. A doctor can check her and help to confirm the cause of her fit. While your baby is having a febrile convulsion, loosen any tight clothing and remove anything that is in her mouth, such as a soother. Try not to restrain her in any way.

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CHOKING

A CHOKING INFANT It’s every parent’s nightmare – your baby is choking on a piece of food or worse, a toy that she has swallowed.

Follow this advice from the Red Cross: ● If an infant is unable to breathe, cough or cry and you suspect they have a severe obstruction in their throat: Lay them face down on your forearm, with head low and supporting the body and head. ● Give up to five back blows between the shoulder blades with the heel of your hand. ● If the obstruction is still present, turn the infant around give up to five chest thrusts, with two fingers in the middle of the chest. ● Continue this cycle of five back blows and five chest thrusts and if the obstruction still doesn’t clear, call an ambulance – but don’t leave the infant unattended. ● Continue the sequence until help arrives. ● Anyone who has been treated for choking in this way should be advised to see their doctor after the incident.

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PERFORMING CPR

FIRST AID ESSENTIALS

Cardiopulmonary Resuscitation, or CPR as it is commonly known, is a life-saving technique to be used on someone who is showing no signs of life. Chest compressions and rescue breaths help to keep oxygen-rish blood circulating and therefore prevent death or brain damage until medical help arrives.

How to perform CPR: ● STEP 1: Position the infant If there is bleeding, first get it under control and then place the infant on her back on a firm and flat surface. ● STEP 2: Open the airway Tilt the infant’s head back slightly and lift the chin.

Check for breathing. If she is not breathing, give two

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small rescue breaths through the mouth, covering the nose. If the infant is a baby, these breaths should only last about a second each. If the chest doesn’t rise, there is something caught in the airway, so follow the instructions for choking. ● STEP 3: Do 30 chest compressions Place the pads of two or three fingers just below an imaginary line linking the child’s muscles. Smoothly and firmly, press down about 1.5 inches, at a rate of about 100 a minute. ● STEP 4: Give two rescue breaths After the compressions, repeat two rescue breaths. ● Continue this routine of chest compressions and rescue breaths until help arrives.

● Paracetamol or ibroprofen (Calpol or Nuofen) for pain relief ● Bandages, including a roll of elastic wrap and plasters in assorted sizes ● Instant cold packs ● Disposable latex or synthetic gloves ● First-aid manual ● Sterile eyewash, such as a saline solution ● Triangular bandage ● Antibacterial ointment ● Home burns spray or gel

❝❞ PARENTS TIPS “I cannot recommend doing a first aid course enough. When Jessica was 18 months old, she choked on a piece of food, and it was the scariest time of my life. Luckily I knew what to do and everything was fine, but my blood runs cold when I think what could have happened.”

Mary, Leitrim “Keeping a good supply of firstaid essentials is a good idea for every house, but it’s essential if you have kids. Make it fun for them with coloured plasters and ones with cartoon characters on them.”

Sarah, Derry

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CRANIAL OSTEOPATHY & COMMON ILLNESSES

CRANIAL OSTEOPATHY Cranial osteopathy is a gentle, safe and effective treatment for pregnant women, babies and children, which works by holding structural strains in a position of ease and waiting for them to release themselves. Osteopaths are highly skilled in identifying and releasing even the most subtle imbalances in the body.

Despite the term cranial, cranial osteopathic techniques are applied to all parts of the body.

CRANIOSACRAL THERAPY CranioSacral Therapy was developed and pioneered by Osteopath John E. Upledger as a means of teaching cranial osteopathy to non-osteopathic practitioners. Both craniosacral therapy and cranial osteopathy are very similar from a treatment perspective.

STRUCTURAL STRAINS In pregnancy, when the baby has been pressed against part of the mother’s anatomy for long period of time the baby can mould to the structures around it. During birth, the baby’s ribcage twists and turns under compression and the soft bones of the skull bend, overlap and mould to help it pass through the birth canal. Babies born by emergency caesarean section are vulnerable to the same pressures of the uterus in the last few weeks of pregnancy and may have been stuck in the birth canal for some time, while babies born by elective caesarean section are not exposed to the pumping action of contractions and tend to lack movement in their diaphragm and drainage from their head. Due to these influences, many babies are born with misshapen heads that gradually unmould in the first few days of life, and it may or may not be visible if this unmoulding process is complete. Treatment is tailored to each individual baby as every baby is different; below are descriptions of the most common findings for each condition.

COLIC/WIND Colic generally begins at around two to three weeks of age. Crying starts 30-90 minutes after a feed or around the same time every day or night and can continue for hours.

In milder cases, the baby appears uncomfortable, moving constantly, grunting and unable to settle. Other signs are flatulence, explosive stools, loud abdominal gurgling, bloating, difficulty burping, arching the back and bringing the knees up to the chest. Common osteopathic findings of babies with colic are tensions in the diaphragm, compression of the cranial nerves that supply the stomach and contraction in the muscular walls of the gut. Parents report less crying, increased ability to bring up wind and a significant improvement in hours of restful sleep after osteopathic treatment.

INFECTIONS Osteopaths work to help babies and children who have recurrent ear, eye, sinus, chest, and throat infections to improve blood supply to the affected area and drainage away from it.

The lymphatic system is also worked on to boost immunity.

Parents report considerable improvement to the speed of recovery from infection and in most cases no recurrence of the problem.

SLEEP PROBLEMS Some babies only sleep for short periods and seem to be in a persistently alert state. It is rare that a young baby wakes purely out of habit so this disruption in their sleep patterns may be caused by mechanical strains in the head or chest. Often it’s necessary to release these structural strains before parents can establish a routine. Parents often report immediate improvement to sleep quality and quantity after osteopathic treatment.

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STICKY EYE/BLOCKED TEAR DUCT If your baby has persistent sticky eyes that have not responded to treatment from your doctor it is an indication that there is insufficient drainage from the head and face and they need cranial treatment. In most cases parents report a complete recovery after just one treatment even for babies up to three months old who have had it since birth.

REFLUX/SILENT REFLUX Reflux occurs when the valve at the entrance to the stomach fails to shut off properly allowing some of the stomach acid into the lower part of the oesophagus. It causes symptoms of heartburn and is accompanied by the spitting up of semi-digested milk; silent reflux is the term used for reflux that isn’t accompanied by spitting up. Parents will often report babies grimacing and crying during, or within the first 20 minutes of, feeding, and some report spontaneous gagging and empty retching.

Other possible signs of reflux are constant hunger and the need to continuously suck; alternatively babies can have a reduced appetite making them slow to put on weight.

Osteopathic treatment uses gentle techniques to release any distortions in the diaphragm and ribs aiming to improve the function of this valve and help to resolve reflux. Parents report babies appear more comfortable and spit up less after osteopathic treatment.

FEEDING DIFFICULTIES Babies who appear fussy and unable to settle on the breast or bottle may have an insufficient latch. Signs of an insufficient latch are: pain felt by the mother during breast feeding, babies who appear dissatisfied after a feed, “sleepy babies” who tire quickly and fall to sleep soon after they start feeding, babies who take a long time to feed (one feed merging into the next), and bottle-fed babies who do not take the expected quantity for their age. An insufficient latch may be due to mechanical stresses through the head, face and throat, and the nerves to the tongue may also be irritated as they exit the skull making sucking more difficult.

Breastfeeding mothers have reported a change in their baby’s latch after they have received osteopathic treatment.

TORTICOLLIS Torticollis can sometimes be accompanied by an asymmetrical head. It is important for babies to receive both physiotherapy and osteopathy as physiotherapy will give exercises and practical advice on how to encourage your baby to look the other way, and osteopathy uses gentle techniques to release and balance asymmetries in your baby’s head and neck in order to make these exercises more achievable. Parents have reported increased neck movement immediately after treatment in babies up to four months old.

Further Information For more information on conditions go to www.osteopathic-care.ie, for a full list of qualified osteopaths please refer to the website of the Osteopathic Council of Ireland www.osteopathy.ie and for patient testimonials go to www. osteopathic-care.ie/testimonials.php.

Claire Padgham B.Ost.Med. DO.ND trained in the UK and she is registered with the Osteopathic Council of Ireland. She has trained in Paediatric and Obstetric Osteopathy and now practices in Bishopstown, Cork. For further information please call 021 434 5955 or visit www. osteopathic-care.ie

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5 Fun with Baby

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hen your baby first comes home, it seems like all they do is eat, sleep and cry. But your new baby is taking in all her surroundings and learning literally by the minute. As the weeks move on, she will become more and more alert, and receptive to simple games and playtime. It’s important to take time during the day to play with your baby, as it’s the best way to bond and help with her development at the same time.

Your baby may be young, but her senses are developing fast. When playing with your baby, make sure to appeal to all the senses (apart from taste) – touch, sight, hearing and smell.

Remember that she is familiar

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with your face, voice and smell, and will respond and enjoy any activities with you. Try these ideas to inject some fun into your day.

GET DANCING! You may have noticed that your baby is soothed when you walk around with her in your arms. Try turning the walk into a gentle waltz-style dance, complete with slow twirls and turns. Your baby will love the movement and the fun of the activity. Just make sure to keep your baby’s back and head well supported throughout, and avoid any jerking or shaking movements. Your baby will also enjoy watching you dance, especially exaggerated movements with your arms or body!

RHYMES AND STORIES Even though your baby might seem

too young for stories, nursery rhymes and brightly coloured pictures will engage them from a very early age.

Go for baby books in bright primary colours, and point out the objects in the pictures. Soft cloth books are great for baby to grab and to play with by herself.

SHOW AND TELL Your baby will find all sorts of objects fascinating, from an empty plastic bottle to a kitchen utensil. Introduce your baby to different objects and let her touch and feel them. Just make sure the object is non-harmful for your baby.

SING LIKE YOU’RE WINNING You are your baby’s world right now and everything you do is fascinating and amazing. Even if you haven’t a note in your head, try singing to your

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baby. Children’s favourites like Old Macdonald and How Much Is That Doggy in the Window are always good, as are songs with actions, like Twinkle Twinkle or Head, Shoulders, Knees & Toes.

BABY MASSAGE

TICKLE TIME Your baby loves your touch, and gently tickling her tummy will get a great reaction, especially as she gets older. Kisses and tickles are the quickest route to those beautiful first smiles.

KIDDIE GAMES Games like Itsy Bitsy Spider and This Little Piggy appeal to baby’s sense of hearing and touch. If you need reminding of the words and actions, do a search on the internet.

BATHTIME FUN Your baby’s bathtime is a great opportunity for play. Try showing her simple toys like a rubber duck or simply splashing the water gently on her tummy. Take a facecloth full of water and gently squeezing it up and down her arms and chest. Follow with a massage (see box) or a game like This Little Piggy, and plenty of tickles and kisses.

GET CREATIVE! Remember the senses when introducing your baby to new things.

For instance, blowing bubbles can be the source of endless fascination for babies, as can examining something as simple as ribbon or a soft fabric.

A soft squashy ball or object can provide lots of fun, especially if you show your baby everything that can be done with it – try juggling, rolling or bouncing the ball, as well as letting to touch and squeeze it.

PEEK-A-BOO! Never underestimate the enjoyment that a baby gets out of this age-old game. Hide behind a towel and peep out. Make different faces as you pop your head out. Pretend it’s baby who’s disappeared: “Where’s baby?

There’s baby!” Hours of fun!

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● Touch is one of the most important senses for a young baby, and offers one of the best early bonding experiences for you both. As well making your baby feel calm and secure, baby massage can have many positive health benefits for your baby, such as relieving colic and wind, enhancing sleep, relaxing baby, and building immunity. There is also evidence to suggest that baby massage may help in relieving postnatal depression in new mothers. ● To get started, choose a time when your baby is calm and relaxed. After bathtime and before her bedtime feed is ideal.

Make sure the room is warm and your baby is comfortable.

Have everything you need close to hand, such as a warm towel, clothes to dress your baby in afterwards, a clean nappy, a simple natural massage oil (good olive oil or grape seed oil is ideal), and some cotton wool to remove excess oil. Perform a patch test on your baby’s arm to check for any reactions first; use a lotion if there is a reaction to the oil. ● Talk to your baby throughout and ask her for permission before massaging. This is a good opportunity to raise

awareness in your baby of the different parts of her body, by naming them and talking to her about them.

Keep the session to about five minutes in total. Your strokes should be soft and smooth, concentrating on each area before moving into the next. Begin with your baby’s chest and tummy, moving up the chest to the shoulders in a heart shape. Gently massage the tummy with the flat of your hand in a clockwise direction. Move on to your baby’s arms and legs, gently rolling your hands down each limb, not forgetting the fingers and toes. Count your baby’s fingers and toes, or use the opportunity to play This Little Piggy. Finish by gently putting your baby on her tummy and giving her back a soft massage. ● Go to www. babymassageireland. com for a baby massage instructor in your area. There is a discount under some health insurance schemes for baby massage courses; check this with your insurer and your instructor before proceeding.

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PHOTOGRAPHY

We have never lived in a more photo-centric time. With the simple equipment and easy editing that is part and parcel of digital photography anyone can, and does, have a go! Every little thing has become the subject of day-to-day photography, and there is no ‘little thing’ more important than your child. So how best to go about photographing your bundle of joy, your toddler, your ever-growing family? We have compiled a few tips to make it easier to get that flawless family photo or that perfect picture of play: ● Keep It Simple When you’re taking a photo all you see is a perfect moment with your child.

Yet, all too often, the end result is cluttered and completely misses the point. Try to use a neutral background, and a setting that gives your subject space to breathe. You want a photo of your child, right at this moment, but not necessarily the things that surround him or her.

Make the photo more dynamic by positioning the main action a little off-centre. ● Use Lines Use naturally occurring lines to attract attention to the main focus of your photo. A path or fence can draw the eye towards someone who otherwise might not have stood out so clearly.

Look particularly for an ‘S curve’ – a winding path or wave-like shape. This is seen as a graceful

definition to your pictures.

Speeding up the shutter speed – from half a second to a tenth of a second, for example – will help to capture your child’s movement while still looking incredibly natural.

line but still draws in the viewer forcefully. This can be particularly useful with smaller children. ● Look For Balance Arrangement of colours and shapes and the play of light and dark across your photo can make all the difference between a generic shot and one you’ll want to keep forever. Try to find patterns or symmetry in the scene, and shoot that. If you want to take a picture of more than one person – maybe your whole family, or your children playing together – narrow the space between them. Too much of a gap can split attention and lead to a less warm and less loving end product. ● Play With Shutter Speed There are few moments more precious than watching your child at play, but unfortunately activity often results in photos that are just one big blur. Experimenting with your camera’s shutter speed can bring

● Light! Light is perhaps the most important aspect of photography. Sometimes it’s better to take a quick shot rather than miss the moment entirely but, when you do have the time, feel free to plan the photo in advance and think about what time of day, or what position in a room, will give the best effect. The optimum time for photography is the ‘golden hour’ – right before sunset or right after sunrise. But make sure that the settings on your camera don’t take all of the warmth out of the evening rays. Tinker a little with settings before getting everyone together. ● Print ‘Em! Jackie Farrell, Marketing Manager, FUJIFILM Ireland reminds you to print your photos. “Many parents spend endless moments taking photos of their newborn and then forget to print, time moves on and they lose the memory as it is locked away in a camera or worse still, the image gets lost on a computer.”

LEAVING IT TO THE PROFESSIONALS If you’ve ever tried to take a family photograph with yourself in it you’ll know how hard it is to pose the family, press the button on the camera and try to dash back into place before the flash fires! A professional photographer has the right equipment and expertise for the job and is a qualified expert in lighting, posing and working with children.

Pregnancy portraits capture a beautiful time in your life, the beginning of your baby’s story. The professional will help you look your absolute best by posing you in the most flattering way and using digital retouching where necessary. The latest trend in baby photography is having a portrait session within two weeks of birth. It is at this time that a qualified photographer can create beautiful portraits of your baby fast asleep, be it curled up in your arms or snug in a basket. Newborn safety is a professional’s number one priority, so be sure you select a photographer experienced in working with newborns. If you are not sure at which age to photograph your baby, why not look for a Baby’s First Year plan, which offers multiple sessions throughout the first year. You will be certain to capture all their gorgeous milestones. Finally, don’t let your children grow up without printed portraits! CDs are no replacement for an archival printed, mounted and framed fine art portrait. Experts are saying an entire generation will grow up with no pictures as CDs degrade and computers fail.

Your professional portraits are priceless heirlooms that will be treasured for generations.

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6

INTRODUCTION TO

Work & Childcare

P

reparing for your return to work after having a baby can be a stressful experience, but there are several ways in which you can minimise the upheaval. You need to give your employer at least four weeks’ notice of your intention to return to work. While that’s legally all you’re obliged to give, it’s a good idea to decide when you want to return and inform your employer as early as you can, as it gives both of you plenty of time to prepare.

KEEPING IN TOUCH Some countries encourage ‘keeping in touch’ (KIT) days, allowing women to return to the office for up to ten days to keep abreast of any changes within the company without maternity leave coming to an end.

While there is no legal provision for KIT days in Ireland, an informal arrangement with your employer, or an occasional coffee with colleagues will give you the chance to a) show off your little bundle of joy, b) keep up with any changes that have happened, i.e. new projects or colleagues, and c) remind you of who you were before you became a mum!

CHILDCARE When you’re assessing your childcare situation, it’s important to factor in your finances. Costs can be prohibitive for a lot of parents, which is why the dynamic of who takes care of baby is changing, and is evident through the increase of stay-at-home dads. There are a few things to weigh up before you make your decision.

DO THE MATH ● What is your actual income from your job including salary, bonuses

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and perks (i.e. car, mobile phone, health insurance etc)? ● Now consider how much being in work costs you through transport, lunches, etc. ● Take one amount from the other. ● Do the same for your partner. ● Consider the cost of childcare. Does it make financial sense for you to work? For your partner?

You may have worked hard for your career and wish to stay working, and that’s perfectly understandable. If you are in line for a promotion or

salary increase, it’s workable in the short term. But if you’re working into negative equity (i.e. working to pay for childcare) and even supplementing the cost through your partner’s wage, it’s worth rethinking the situation and see if either parent could take a career break until you find a childcare option that works for your family. If you are a single parent, unfortunately your choices are more limited. In most cases, you may have to work if you’re receiving little or no support from the father of your child, but if you cannot work, there is help available. Visit citizensinformation.ie for details of your entitlements.

MENTAL PREPARATION Leaving your baby with someone else is something most mothers find very difficult. You’ve had at least six months to bond with your baby, and making the move from morning trips to the park, afternoon cuddles and lengthy evening bath times to a frantic hour in the mornings and tired evenings can be tough. It’s easy to blame yourself and feel guilty that you’re in some way letting down your baby or being a bad mother for

ding e e f t Breas Under section nine of the Maternity Protection Act 2004, if you are breastfeeding when you return to work, you are entitled to time off to breastfeed if your employer cannot provide suitable facilities onsite for you to do so. For more details on your options, the HSE have created a leaflet called ‘Breastfeeding and Work’, and it’s available from www.healthinfo.ie.

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working, either for financial or your own career reasons. If you’ve made the decision to return to work, take heart in realising that it’s the decision the mother of your baby (that’s you!) has made and that you know what’s best for your family. Plenty of women have made this decision and made it work for them. Just take it at your own pace and if you feel you’re struggling, speak to your partner and family or chat with friends and see how they manage.

Routine If you’re leaving your baby with a regular childminder, start a routine about a month before you return.

Build it up from one morning a week to at least three days just before you go back. By increasing gradually, it’ll help you build trust in your childminder and make it easier to hand your baby over in the longer term. Plus it’ll allow your baby to get used to being cared for by someone else. Separation anxiety can be crippling for mums going back to work, who might be feeling guilty about their decision and are forced to leave their baby while in distress. It’s a lot easier to walk out the door to work if your baby isn’t crying and you know they’re in safe hands.

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Work Situation If you are returning or returned to work and you’re finding it difficult in your new dual role as mammy and professional, talk to your employer. While we’re not there yet, the options for working mothers and parents have definitely become more favourable. Have a chat with your boss about your situation and possible options such as flexitime, a cut in hours or working from home. With the current market as it is, most employers are looking to cut costs in any way they can, so a day off a week for you will cut your overall salary but also reduce your childcare costs and make you feel more present in your baby’s day-today life.

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Choosing your childcare

Deciding on childcare appropriate to your needs is a major decision for any parent.

There are a number of factors that will make an impact on your final decision. These include: ● Your child’s age ● Whether you need full or part-time care and the hours you need (regular, daytime, evenings or weekends) ● Your budget

Sessional services: These services offer a planned programme consisting of up to three-and-a-half hours per session (such as a morning or an afternoon). Generally, they cater for children between two and six years of age. These services may also be provided for younger children. In order to provide a sessional childcare service, a recognised childcare qualification is required.

Sessional services include:

● Services available in your area. By law, preschool childcare facilities must be notified to, and be inspected by the Health Service Executive (HSE). More detailed information about the regulation of childcare service is available from your Local Health Office. Your City/ County Childcare Committee can provide a list of childcare providers in your area. They can also put you in touch with your local HSE pre-school officer.

● Montessori groups: which focus on individualised education, teaching social skills and maximising children’s development. They cater to children up to the age of six.

Types of childcare

● Playschools: which give children an opportunity to play with other children of a similar age, learn to share and take turns and to understand the rules of the classroom, such as listening.

Full-day care: This is a structured care service for more than three and a half hours per day. Providers care for children from three months to six years, depending on facilities and policies. Some may also include an after-school facility. In fullday care, sleeping arrangements and food preparation must meet standards laid down by the Health Service Executive.

Providers include day nurseries and crèches.

● Parent and toddler groups: where a group of parents, guardians or carers and children come together for supervised play and companionship for their parents. ● Naíonraí: which are nursery schools or playschools operating through Irish.

Childminders: Childminders care for children in the minder’s own home.

A childminder can care for up to five children under six years of age (including the childminder’s own). The service is usually offered for the full

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working day or for different periods during the day. Parents and childminders arrange their own terms and conditions. For more on childminding and finding a registered childminder in your area, check out Childminding Ireland’s website at www.childminding .ie ● Au pair: An au pair is a young person who is treated as a family member in exchange for certain services, such as a limited amount of light housework or help minding children. It is a voluntary arrangement between a private household and a private individual. The objective of the arrangement is to enable the au pair to experience a different culture and improve his or her foreign language skills.

There is no specific regulatory framework covering au pairs.

An au pair is not a professional nanny or childminder. Au pairs are not employees and there is no contract of employment between the host family and the au pair. The au pair is usually given room and board and paid weekly pocket money. There are specialist private agencies that can assist you to source an au pair.

AFFORDABLE CHILDCARE: Affordable childcare is intended to provide childcare for families on lower incomes, and also to support parents to return to work or education. This type of service is called a community childcare (not-for-profit) facility. Funding is available through the National Childcare Investment Programme (NCIP). For more information on affordable childcare services in your area, contact your local City/ County Childcare Committee.

TIPS ON FINDING THE RIGHT CHILDCARE

● Start looking early: It’s a good idea to start thinking about your childcare as early as you can, even while you are pregnant. Talk to other working parents with children, and try to get as many personal recommendations as possible. ● Do your research: Once you have decided what type of childcare you want, eg childminder or crèche, look into what sort of regulations or qualifications they should be adhering to. The more information you have about the type of facility you want, the better equipped you will be when visiting and making your decision. ● Consider your budget: Childcare facilities can differ in price from place to place so it’s a good idea to ring around and compare prices. ● Visit and ask questions: Make sure you visit the facility in question and ask lots of questions. Talk to the manager and visit the room in which your child will be minded.

A lot can be learned by watching the children at play. Bring your child with you if you can. If you are choosing a childminder, spend some time with him/her and observe other children in their care. Ask about accreditation, regulations, the types of facilities they have, staff qualifications and turnover, what they do with the

children all day, a typical day’s menu, adult to child ratio, and any other queries you might have. The more open and transparent a facility is to prospective new parents, the better. If you can get to talk to a parent with a child in that facility, all the better. ● Take your time: Make notes after your visit and take your time over making your decision – it’s important that you’re confident and happy with your decision. Try to visit a variety of childcare facilities and options so you know exactly what’s available. ● Keep involved: After you have returned to work, make sure you stay in touch with your childcare provider. He/ she should tell you at the end of each day what your child did and ate during the day.

If your child is in a crèche, attend parents’ evenings or meetings.

Some information taken from Citizens Information.

For more, log on to www. citizensinformation.ie and www.childmindingireland.ie

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03/09/2014 14:47:36

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LIFE WITH BABY 118

7

GUIDE TO

Car Safety

C

hildren are extremely vulnerable – a child left unrestrained can be killed at speeds of just five miles an hour – which makes ensuring your little bundle is secure in a car seat that is appropriate to their weight and height extremely important.

Research conducted by the Road Safety Authority (RSA) revealed that 246 children (aged up to 14 years) were killed on Irish roads between 1997 and 2009. Of these fatalities, two in five were passengers in a car or other vehicle. Almost one third (30%) of these fatalities were not using a seatbelt or child car restraint. A further 122 children who were seriously injured in a collision during this period were not properly restrained in the car.

In a crash at just 50km/hr (30 mph), an unrestrained child would be thrown forward with a force 30 to 60 times their body weight. They would be thrown about inside the vehicle, injuring themselves and quite possibly seriously injuring or even killing other people inside the vehicle. They are also likely to be ejected from the car through one of the windows.

It is not safe to hold a child on your lap. In a crash, the child could be crushed between your body and part of the car’s interior. Even if you are using a safety belt, the child would be torn from your arms – you would not be able to hold onto them, no matter how hard you try.

It is also dangerous to put a safety belt around yourself and a child (or around two children). The safest way for children to travel in cars is in a child seat that is suitable for their weight and height.

Since August 25th, 2003, drivers face up to four penalty points and

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a fine of up to 800 if convicted in court for a failure to observe the legal obligations with respect to the wearing of safety belts and child restraints.

TAKE TIME TO RESEARCH As many new parents will know, buying equipment for their new baby can be an overwhelming experience, with so many different products to buy and so much choice. However, spending time to research the right child car seat for both your child and your car is crucial, according to Brian Farrell, Communications Manager with the Road Safety Authority. “As a parent myself, I know that new parents are often bombarded with information in the weeks leading up to the birth of their child and find it difficult to know what to prioritise.

We recommend that parents give themselves plenty of time to choose their child car seat so that they can shop around, make sure they know

how to correctly fit it and have it in the car, ready to take the baby home from the hospital. Buying a child car seat a couple of months before the baby is born will give you plenty of time to choose the right one and to practise fitting it in the car. Remember, the golden rule for choosing a child car seat is making sure it is suitable for your child’s weight, height and age and that it conforms to the latest EU safety regulations.”

LEGAL REQUIREMENTS EU child safety protection law makes it compulsory for all children to travel in a child seat, booster seat or booster cushion, and where safety belts are fitted, they must be worn.

The specific legal requirements are as follows: ● As a driver, it is your responsibility to ensure that passengers in your car aged 17 or younger are properly restrained in the appropriate

03/09/2014 15:48:29

LIFE WITH BABY

seatbelt, booster seat, booster cushion or child car seat;

TOP TIPS FOR PARENTS

● Children under three years of age must not travel in a car or goods vehicle (other than a taxi) unless they are restrained in the correct child seat; ● Children aged three years or over who are under 150cm in height and weigh less than 36 kilograms (i.e. generally children up to 11/12 years old) must use the correct child seat, booster seat or booster cushion when travelling in cars or goods vehicles; ● Children over 3 years of age must travel in a rear seat in vehicles not fitted with safety belts; ● Rearward-facing child car seats must never be used in the front passenger seat of cars with an active airbag; ● Child car seats must be in accordance with EU or United Nations Economic Commission for Europe (UN-ECE) standards.

Brian Farrell says that many parents are unsure of their legal obligations when it comes to ensuring their child is properly restrained. “The law states that children up to 150cm in height and weighing less than 36kg, which is generally a child of around 11 or 12 years of age, must be in an appropriate child restraint. This is simply because young children are too small to be properly restrained by a seatbelt so it would provide little or no protection in the event of a crash.

It is the driver’s legal responsibility to ensure all passengers in their car aged up to 17 years of age must be in an appropriate child restraint, whether that’s a child car seat, a booster seat, booster cushion or seatbelt.”

SAFE JOURNEY, EVERY JOURNEY “According to the AA Motoring Trust, ensuring your child is properly restrained in a child car seat can reduce injuries by a factor of 90 to 95 per cent for rearward-facing seats and 60 per cent for forward-

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● Remember, it’s now EU law that all children must travel in an appropriate child seat, booster seat or booster cushion. ● The golden rule for choosing a child car seat is making sure it is suitable for your child’s weight, height and age and that it conforms to the latest EU safety regulations (look for the ‘E’ mark). Don’t use age as your only guide as every child is different. ● When buying a child car seat, make sure you go to a retailer who can show you how to fit it in your car. If the child car seat will be used in more than one car, make sure it’s compatible with those cars as well. ● Avoid using a second-hand child car seat or restraint unless you know its history. It may have

facing seats. So it’s vitally important that parents ensure their child is adequately restrained every time they get into the car, no matter how short the journey,” says Farrell. The RSA has produced a range of ‘Child Safety in Cars’ material to advise parents on how to select and install a child car restraint as well as outlining their legal responsibilities to do so. This is

been damaged in a previous collision, and although the damage may not be visible, it won’t provide the same level of protection for your child. If your seat is in a car that has had an accident, replace the seat immediately. ● Don’t move your child from a rearward-facing child car seat to a forward-facing child car seat too soon. If you’re unsure, also consult with your retailer before you buy your next child car seat. ● For information on how to keep your child safe in the car, visit www.rsa.ie/ childsafetyincars where a ‘Child Safety in Cars’ booklet and DVD are available free to order online or by phone at LoCall 1890 50 60 80.

available to download at www.rsa.ie/ childsafetyincars. You can also order a free ‘Child Safety in Cars’ booklet and DVD online or by phone at LoCall 1890 50 60 80. The RSA also regularly posts information on child safety in cars on their Facebook page at www.facebook.com/RSAIreland and on Twitter at www.twitter.com/ RSAIreland

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LIFE WITH BABY

CHOOSING A FAMILY CAR

Most parents spend hours agonising over the appropriate equipment for their little one and your first family car deserves no less time and consideration.

It can be a tricky decision to get right, particularly as it’s likely to be with you for quite some time.

Here are some pointers on what to consider before making the big purchase: ● Functionality What do you actually need your family car for? This is key if the family car is the sole vehicle of the home and therefore has to service a number of needs. If it’s just for one parent (plus kids and baby equipment), managing rush hour traffic and ease of fitting into challenging city centre parking spaces need not be top of the list. However if it’s likely to be used on a work commute as well as school runs, take that into account. ● Efficiency This leads into the question of mileage – if you’re driving to work or likely to face a lengthy daily commute

to childminders, crèche or school, make sure your chosen car is fuel efficient – petrol and diesel prices aren’t pretty these days so make sure you’re getting the most from your money. For a Moving People Vehicle (MPV), you should be looking for an average of around 35-40mpg. ● Safety first With a baby in a car comes a car seat, so you’ll need to make sure the car seat of your choice fits easily, comfortably and is accessible. There’s typically no issue with this if you have a MPV but if you have a smaller two-door model accessibility may be an issue. Most MPVs now come with Isofix mounting points as standard.

Take your car seat with you when viewing cars and make sure it fits comfortably and securely on the mounting points or on the seat if it’s not an Isofix car seat. ● Measure up As you may have noticed from friends or family with children, babies and toddlers come with a seemingly unending amount of paraphernalia. The most important piece of kit if you’re

heading out will probably be your pram or pushchair.

Measure it when fully collapsed and ensure there’s space in the back for it to fit comfortably. If you’re likely to take overnight trips and will be bringing a cot or bags remember to make sure there’s plenty of space - the back seat will be taken up with a lot more precious cargo and needs to be kept clear of large bulky items. ● The extras Added extras can make journeys go that bit more smoothly. UV-filtering tinted back windows or integrated sun-blinds will be welcome if you’re travelling during the summer. Some of the more deluxe models offer seat back DVD screens which can keep older children entertained and cries of ‘are we there yet’ quelled. For older kids in the driving seat, some models offer satnavs, in-built computers, deluxe sound systems and parking sensors – a design that can keep the whole family happy.

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LIFE WITH BABY

8

INTRODUCTION TO

Designing a Nursery

A

s soon as the nesting stage begins, your mind goes into nursery-planning overload. Thoughts of a beautiful, cosy room to which you can bring your baby home fill your mind, but as soon as you hit the shops the sheer choice can be overwhelming. A nursery needs to be calming for your baby as well as a space for you to enjoy.

Think child-friendly rather than childish and remember to stay true to your style. We’ve compiled tips on what to consider when planning a nursery and how you can take it from newborn right through to toddlerhood.

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PLANNING “First: de-clutter. Find a place for everything and donate the rest.

You will not believe how quickly your home will be re-cluttered once baby arrives,” explains interior designer Pamela McDonald. “Plan to decorate at least six to eight weeks

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before your due date as all odours must be eliminated before you bring baby home, and have the room filled with fresh air.” Pamela advises that you start by choosing a theme or colour scheme of three colours, max.

It’s easier to achieve a consistent look if you decide to go for a themed nursery, but be careful not to go over the top. Remember to keep the balance between rest and stimulation.

The easiest way to avoid theme overload is by creating a single point of focus and keeping the rest simple.

Keep the walls and floors neutral and add easily replaced accessories like wall stickers. If you have your heart set on themed wallpaper, keep it to just one wall. Be creative; everything you buy doesn’t have to be themed.

For instance, sheer drapes will create a princess theme or use a toy hammock to create a jungle look.

FUTURE-PROOFING Pick a theme that will last from baby to toddler. Flexibility is key. Think

about how your baby will use the bedroom in later years. Save money by investing in a good cot-bed, dresser and curtains that will grow with baby through to the toddler years. A top tip for getting baby to develop good sleeping habits is to invest in some blackout blinds, but remember to keep cords well out of reach. Clevamama’s ClevaSafe Blind Cord Safety Winders ( 6.99) ensure blind cords are secured and out of harm’s way.

“Buy a dresser with a changing mat space on top that can be used as a chest of drawers in a toddler’s room,” says Pamela, adding, “Wooden floors work best in a nursery. They are easy to clean, stain-proof and dust allergies are quickly eliminated. If you feel wooden floors are too dull for a nursery, add a rug for a pop of colour. Rugs are multi-purposeful as they can be used as a playmat too.”

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SAFETY “Safety is paramount,” cautions Pamela. “Keep lamps out of reach. Lamps get hot quickly and could cause a painful accident.

Lamp and blind cords must be short and secured tightly. Cover all electric sockets – babies are drawn to sticking their fingers into any hole they can.”

DESIGN The design and adding a personal touch is the fun part. If you already know the sex of your baby you can go ahead and add accessories that personalise your nursery. If not, you can choose to keep all accessories completely neutral or wait until baby is born and then add little decorative pieces that are special to your little one. “These could be framed images of siblings, a special outfit (like the coming-home outfit) or keep-sake cards for wall art,” suggests Pamela. “Create baby’s name using fabric lettering or bunting. Put up a bookshelf to store favourite books, old and new.”

Words by Rachel Murray

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COLOUR THEMES

Twitterlings mobile, €40.50, Little Dreamers

LIFE WITH BABY

STORAGE Storage can be one of the biggest issues in a nursery. A new baby comes with so much baggage, it’s hard to find a place for everything and keep the nursery neat and tidy at the same time.

In fact, gifts for a new baby can sometimes be enough to fill a nursery. “Think of how much storage you’ll need and multiply by two!” says Pamela. “A fully functional nursery means nappies, creams, wipes, baby gros and vests are kept within arm’s reach of your changing mat. Babies’ clothes are tiny, so maximise your wardrobe space by installing an extra rail.” Babies’ shoes are a bit like matching socks: easily lost, so invest in a shoe wall-hanger for easy access.

Trumpety Trunk the Elephant laser-cut paper picture, €44.70, Scamp Baby Gifts

SPACE SAVER

Under cot storage, €30, Next

SPACE SAVER Kids Scandinavia wardrobe, €153.99, Argos

ABOVE: Made with Love curtains, €xx, Mamas & Papas LEFT Cot-top changer, €85, Mamas & Papas BELOW Fabric letters, €12.50, Little Dreamers

LEFT Pirate-ship light, €115, Little Dreamers BELOW Ladybird Gliding Nursing Chair with Footstool, €219, Littlewoods Ireland

REPLACEABLE ACCESSORIES

Forest Friends wall sticker, €49, Peanut

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ADVERTISING FEATURE

BRING OUT THE CHILD IN YOU WI

A

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EA K I TH

t IKEA we are focused on the most important people in the world – our children! In the children’s section of IKEA you’ll find a big choice of children’s furniture, soft furnishings, toys and much more, all tested against the highest safety standards. It is through innovative product design and really understanding the needs and wants of its customers that IKEA strives to create a wonderful, everyday life at home. Children have a

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lot of work to do – like developing who they are, discovering the world and then starting their journey to independence. So having the right things at home can make it a little easier. From the day you bring them home until they’re almost all grown up, our children’s furniture will help you turn your home into the best possible playground.

RIGHT: Ensure your baby has a sound night’s sleep with the HENSVIK cot, €65, the durable materials in the cot base have been tested to ensure they give their body the support it needs. The HENSVIK cot can also be placed at two different heights for your baby’s comfort.

BELOW The KROKIG multicolour wall hook, €2.50, will allow your children to keep their room’s spick and span, hang the multi coloured wall hooks at a child friendly height so your children can learn to keep their things in tidy.

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ABOVE: The new STUVA loft bed combo, €358, is the perfect solution for your child’s room as it includes a loft bed, desk, wardrobe and an open shelf unit, coming in variety of colours this bed combo unit is ideal for providing children with their own space to read, do their homework or study.

The NANIG three-piece bed linen set, €18, is designed for cots and is available in soft materials and bright colours (pink and green) to stimulate your baby’s development.

ADVERTISING FEATURE

The TOVIG baby bouncer, €40, is ideal as your baby will feel stimulated by watching what’s going on around their environment from a safe and comfortable half sitting position in the baby bouncer.

It is easily transportable as it is lightweight and foldable.

The LEKA green baby gym, €30, is a perfect toy for a newborn baby, as it stimulates the baby’s senses. Reaching out for the toys is designed to stimulate the baby’s development of eye to hand coordination, while the movement of the mobile toys stimulates the baby’s eyesight.

Learning can be so much fun with IKEAs children’s toy and this DUKTIG Kitchen, €80, made from birch plywood, encourages role play which helps children to develop social skills by imitating grown-ups and inventing their own roles.

Let your child’s creativity run wild with the MALA easel, €20, the easel has a whiteboard on one side and a blackboard on the other side. The MALA easel is also foldable for ease of storage.

FOR MORE INFORMATION For more great products and lots of tips and inspiration visit IKEA Dublin’s Children’s department or visit www.ikea.ie. Make it a family day out and let the children enjoy IKEA’s forest-themed Småland crèche while you shop till you drop! At IKEA , children Conquer the playroom clutter with the KUSINER storage box, €6, this is a practical storage box for small items, this versatile box can also be folded away to save space when you are not using it.

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are really the most important people with the store providing an organic baby food range, microwaves and bottle warmers, bowls, bibs and full baby changing facilities! As we all know, happy kids are the answer to a happy home!

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DIRECTORY

Support & Advice tor c e Dir

y

A WEALTH OF INFORMATION, HELP AND SUPPORT IS AVAILABLE.

CHILDBIRTH, BREASTFEEDING AND/ OR SUPPORT FOR NEW MOTHERS Community Mothers Programme, First Floor, Park House, North Circular Road, Dublin 7.

Tel: (01) 838 7122 Web: www.hse.ie Cuidiú – Irish Childbirth Trust, Carmichael House, North Brunswick Street, Dublin 7.

Tel: (01) 872 4501 Web: www.cuidiu-ict.ie Home Birth Association of Ireland, 30 Cushla Downs, Monksland, Athlone, Co. Roscommon.

Tel: 087 164 0847, (0906) 405267 Email: enquiries@ homebirth.ie Web: www.homebirth.ie La Leche League of Ireland, Please refer to your local telephone directory.

Email: leader@ lalecheleagueireland.com Web: www. lalecheleagueireland.com

CHILDCARE SERVICES,

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The Childcare Directory Ltd, Burnaby Buildings, Church Road, Greystones, Co. Wicklow.

Tel: (01) 201 6000

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Email: info@childcare.ie Web: www.childcare.ie Childminding Ireland, Wicklow Enterprise Prak Wicklow Town Co. Wicklow.

Tel: 0404 64007 Email: info@childminding.ie Web: www.childminding.ie Early Childhood Ireland, Hainault House, Belgard Square, Tallaght, Dublin 24.

Tel: (01) 405 7100 Email: info@earlychildhood.ie Web: www.earlychildhood.ie

DEPRESSION AND MENTAL HEALTH Aware LoCall Helpline: 1890 303 302 Web: www.aware.ie Aware conducts support group meetings across the country. Manned by trained volunteers, their Depression Helpline is a listening service that operates Monday to Friday, 10.00am to 10.00pm. Aware also provide an email support service.

Please visit their website for more information.

Postnatal Distress Support Group Support Line: (021) 492 2083 (Tuesdays and Thursdays, 10.00am to 2.00pm) Email: support@pnd.ie Web: www.pnd.ie Monthly support meetings are held on the last Tuesday

of every month at Cork Maternity Hospital, Wilton, Cork.

FAMILY PLANNING Irish Family Planning Association National Pregnancy Helpline: 1850 495 051 Email: post@ifpa.ie Web: www.ifpa.ie

LONE PARENTS Doras Buí – A Parents Alone Resource Centre Bunratty Drive, Coolock, Dublin 17.

Tel: (01) 848 1872/4811 Email: info@dorasbui.org Web: www.dorasbui.org One Family, Cherish House, 2 Lower Pembroke Street, Dublin 2.

Tel: 01 662 9212 LoCall Info Line: 1890 662 212 Email: info@onefamily.ie Web: www.onefamily.ie

LoCall Info Line: 1890 252 084 Email: info@treoir.ie Web: www.treoir.ie Information and advice resource for unmarried parents,

MISCARRIAGE AND CHILD LOSS SUPPORT A Little Lifetime Foundation, Carmichael House, North Brunswick Street, Dublin 7.

Tel: (01) 872 6996 Email: info@alittlelifetime.ie Web: www.alittlelifetime.ie Irish Sudden Infant Death Association, Carmichael House, North Brunswick Street, Dublin 7.

Tel: (01) 873 2711 LoCall Helpline: 1850 391 391 Email: isida@eircom.net Web: www.isida.ie Miscarriage Association of Ireland, Carmichael House, North Brunswick Street, Dublin 7.

Tel: (01) 873 5702 Email: info@miscarriage.ie Web: www.miscarriage.ie

OPEN – One Parent Exchange and Network, 7 Red Cow Lane, Smithfield, Dublin 7.

Tel: (01) 814 8860 Email: enquiries@oneparent.ie Web: www.oneparent.ie

MULTIPLE BIRTHS

Treoir 14 Gandon House, Custom House Square, International Financial Services Centre IFSC, Dublin 1.

Tel: (01) 670 0120

Irish Multiple Births Association, Carmichael House, North Brunswick Street, Dublin 7.

Tel: (01) 874 9056 Email: info@imba.ie Web: www.imba.ie

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Cura, LoCall Helpline: 1850 622 626 Email: curacares@cura.ie Web: www.cura.ie PACT, Arabella House, 18D Nutgrove Office Park, Rathfarnham, Dublin 14.

Tel: (01) 296 2200 Crisis Pregnancy Line: 1850 673 333 Email: info@pact.ie Web: www.pact.ie

Support for Non-Nationals (Including Asylum Seekers) Cáirde, 19 Belvedere Place, Dublin 1.

Tel: (01) 855 2111 Email: healthworker@cairde.ie Web: www.cairde.ie The Lantern, 17 Synge Street, Dublin 8.

Tel: (01) 405 3868 Email: info@lanterncentre.org Web: www.lanterncentre.org Tallaght Intercultural Action, West Tallaght Resource Centre, 16 Glenshane Lawns, Tallaght, Dublin 24 Tel: (01) 452 2533 Email: tiai@ireland.com

Support for Asylum Seekers The Integration Centre, 18 Dame Street, Dublin 2.

Tel: (01) 645 3070 Email: info@ integrationcentre.ie Web: www.integration centre.ie

Tel: (01) 851 0840 Web: www.vincentians.ie

Support for Children and Parents Under Stress Barnardos, Christchurch Square, Dublin 8.

Callsave: 1850 222 300 Tel: (01) 453 0355 Email: info@barnardos.ie Web: www.barnardos.ie Childline, 24-hour Freephone Helpline: 1800 666 666 Text: ‘TALK’ to 50101 (2pm-10pm daily) Web: www.childline.ie Parentline, Carmichael House, North Brunswick Street, Dublin 7.

Tel: (01) 873 3500 LoCall: 1890 927 277 Email: info@parentline.ie Web: www.parentline.ie

Support for Families with Special Needs Asthma Society of Ireland, 42-43 Amiens Street, Dublin 1.

Helpline: 1850 445 464 (10am-1pm, Monday-Friday) Tel: (01) 817 8886 Email: office@asthma society.ie Web: www.asthmasociety.ie Cleft Lip and Palate Association of Ireland, 36 Woodlands Avenue, Dún Laoghaire, Co. Dublin.

Tel: 087 131 9803 Email: info@cleft.ie Web: www.cleft.ie

Spirasi, 213 North Circular Road, Dublin 7.

Tel: (01) 838 9664 Email: info@spirasi.ie Web: www.spirasi.ie

Down Syndrome Ireland, Citylink Business Park, Old Naas Road, Dublin 12.

Tel: (01) 426 6500 LoCall: 1890 374 374 Email: info@down syndrome.ie Web: www.downsyndrome.ie

The Irish Vincentians, Provincial Office, Sybil Hill, Raheny, Dublin 5.

Enable Ireland, 32F Rosemount Park Drive, Rosemount Business Park,

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Ballycoolin Road, Dublin 11.

Tel: (01) 872 7155 Email: communications@ enableireland.ie Web: www.enableireland.ie The Hope Project (Disability/Autism), St Joseph, Ballinabearna, Ballinhassig, Co. Cork.

Tel: (021) 488 8503 Email: info@hopeproject.ie Web: www.hopeproject.ie Irish Deaf Society, 30 Blessington Street, Dublin 7.

Tel: (01) 860 1878 Email: info@irishdeafsociety.ie Web: www.deaf.ie The Irish Society for Autism, Unity Building, 16/17 Lower O’Connell Street, Dublin 1.

Tel: (01) 874 4684 Web: www.autism.ie Irish Wheelchair Association, Áras Chúchulainn, Blackheath Drive, Clontarf, Dublin 3.

Tel: (01) 818 6400 Email: info@iwa.ie Web: www.iwa.ie Meningitis Research Foundation, 63 Lower Gardiner Street, Dublin 1.

Helpline: 1800 413 344 Tel: (01) 819 6931 Email: info@meningitisireland.org Web: www.meningitisireland.org National Council for the Blind, Whitworth Road, Drumcondra, Dublin 9.

Tel: 1850 334 353 Email: info@ncbi.ie Web: www.ncbi.ie

Directory

Support and Advice for an Unexpected Pregnancy

Email: info@womensaid.ie Advice and support for women and children experiencing domestic violence.

Other Useful Information and Advice Department of Justice and Equality, 94 St Stephen’s Green, Dublin 2.

Tel: (01) 602 8202 Lo-Call: 1890 221 227 Email: info@justice.ie Web: www.justice.ie Equality Authority, 2 Clonmel Street, Dublin 2.

LoCall: 1890 245 545 Tel: (01) 417 3336 ]Email: info@equality.ie Web: www.equality.ie Maternity Benefit Section, Department of Social Protection, McCarter’s Road, Ardarvan, Buncrana, Co. Donegal.

LoCall: 1890 690 690 Tel: (074) 916 4491 Email: maternityben @welfare.ie Web: www.welfare.ie Health Protection Surveillance Centre, 25-27 Middle Gardiner Street, Dublin 1.

Tel: (01) 876 5300 Email: hpsc@hse.ie Web: www.hpsc.ie Parental Equality, 15a Clanbrassil Street, Dundalk, Co.Louth.

Tel: (042) 933 3163 Web: www.parental equality.ie

Women’s Needs Women’s Aid, 5 Wilton Place, Dublin 2.

Helpline: 1800 341 900 (10am-10pm daily) Tel: (01) 678 8858

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maternity&

PR E G NA NC Y * BA BY * TO DDL E R & C H I L D

Ireland’s fInest parentIng magazIne

Introducing

www.maternityandinfant.ie Our brand-new website is the perfect sister to maternity & infant magazine!

Constantly updated, maternityandinfant.ie contains a mix of great advice from experts and fellow mums, competitions, celebrity gossip, fashion for both you and your children and great ideas about what to do today.

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k Parenting 3/9/14 10:39:35 16:40:25 04/09/2014

PREGNANCY DIARY

7 Diary y c an Pregn

My Pregnancy

KEEP A RECORD OF YOUR APPOINTMENTS AND ALL THE MILESTONES IN YOUR PREGNANCY JOURNEY – PLUS A HANDY STEP-BY-STEP GUIDE TO WHAT YOU NEED TO DO AND WHEN.

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PREGNANCY DIARY

Confirming Your Pregnancy APPOINTMENT CARD

Congratulations – you’ve just had a positive pregnancy test! Time to confirm it with your GP and get yourself organized. Your GP will give you a general check-over and talk to you about your options.

He/she will give you a referral letter if needed for your hospital.

DATE:

DOCTOR SEEN:

TESTS CONDUCTED:

NOTES:

What should I ask?

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● YOUR DUE DATE: your GP will ask you the date of your last period and will estimate your due date from then. Remember the date of your last period; you’ll be asked this again and again and again! ● ANY WORRIES OR CONCERNS HEALTHWISE: If you have any long-term health issue, your GP will advise you on how best to proceed, eg if there is a special clinic to attend or an obstetrician recommended for your condition. ● WHAT TO EXPECT: if this is your first pregnancy, you may be concerned about what to expect over the next few months. If you are worried, discuss this with your GP. In addition, if you have suffered problem pregnancies or miscarriages, your GP can advise you on the best course of action if you have any concerns between now and your first hospital appointment.

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Now your pregnancy is confirmed it’s time to make some decisions.

What care do I want? More importantly, what can I afford and do I have insurance to cover any of my care?

PUBLIC OR PRIVATE?

● DEPENDING ON YOUR HOSPITAL, you may have a choice between public and private care. Some hospitals also offer a semi-private option. Every woman is entitled to pregnancy care in the public health system, and our hospitals do an admirable job of dealing with the high numbers of pregnancies every year. Some women prefer a more personalized system of care, as offered under private or semi-private care. Under these schemes, it may be possible to choose your obstetrician or to opt for a ward with a smaller number of beds or even a private room (note: most hospitals don’t guarantee a specific ward or private room, but it’s done instead of a first come, first served basis for semi-private or private patients. Here’s what to consider: ● DO YOU HAVE HEALTH INSURANCE that will cover semi-private or private care?

If not, can you afford to pay for everything privately (your hospital will be able to advise of fees)? ● IF YOU DO HAVE HEALTH INSURANCE, it’s up to you to check that your policy covers what you want in the hospital of your choice – so make that call before you book into the hospital.

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PREGNANCY DIARY

Making Decisions COMBINED CARE

WHAT IS COMBINED CARE?

● COMBINED CARE is when you share the appointments between the hospital and your GP. As your GP knows your history and will be caring for you and your baby after the birth, many women prefer to build up this relationship now during pregnancy. A general schedule of appointments is as follows, although this can be changed as needed by your midwife/obstetrician/GP. In addition, if you have added health issues, such as gestational diabetes or high blood pressure, you can have an additional five GP visits.

See www.hse.ie for more.

GP TEL:

GP EMAIL:

● REMEMBER that you will probably have to pay a deposit (for semi-private) or a private consultancy fee upfront for the obstetrician of your choice – talk to your hospital about this. Some health insurance policies will pay for some of this, but if not, you can claim for 20 per cent of this on your medical expenses tax return at the end of the year. ● MOST IMPORTANTLY, make your decision quickly and ring up to book your first appointment.

There are increasing numbers of pregnancies in Ireland every year, and first appointments and popular obstetricians can book up very quickly.

❍ Before 12 weeks GP ❍ Before 20 weeks Hospital (booking-in visit)

❍ 24 weeks GP ❍ 28 weeks GP or Hospital

❍ 30 weeks GP ❍ 32 weeks Hospital ❍ 34 weeks GP ❍ 36 weeks Hospital ❍ 37 weeks GP ❍ 38 weeks Hospital ❍ 39 weeks GP ❍ 40 weeks Hospital ❍ You will also have a baby check at two weeks post-birth, and a check-up for both you and your baby at six weeks post-birth.

❝❞ HOW I TOLD MY PARTNER! “It was coming up to Father’s Day, so I waited and bought a “world’s best daddy” babygro as a present. The look on his face when he opened it up was priceless!”

Fiona, Dublin 13 “I didn’t have to break the news to him as we took the test together.

It was our third round of IVF and we had agreed it would be our last.

Jack is now three months old and our little miracle baby.”

Pamela, Co Waterford

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PREGNANCY DIARY

Before your first appointment So you’ve made your appointment – now it’s the waiting game! Your booking-in visit is generally made for between 12 and 15 weeks gestation, although this can vary from hospital to hospital, and from woman to woman. This can be a long wait, especially if it’s your first pregnancy, but there are a few things to bear in mind while you are waiting.

GET HEALTHY!

Now is the time to take care of yourself and your baby, as the first trimester is when your baby’s vital organs develop. Read Chapter 1 of this pregnancy guide carefully to learn how to look after you both through nutrition and exercise. If you haven’t been taking folic acid, start taking it immediately. Folic acid is recommended for three months before conceiving and for the first 12 weeks after conception. Take it easy! Your body is doing a lot of hard work growing a little person.

Most women experience tiredness during the first trimester. Take time out to relax when you can.

Early nights and avoiding stress are vital at this time.

MORNING SICKNESS

● EAT LITTLE AND OFTEN. Small meals of simple food can be easier to digest, and many women feel relief when there is something in their tummies. ● GINGER can be great for settling your tummy. Try nibbling on ginger biscuits or sip ginger tea or ginger ale. ● IF YOUR SICKNESS IS SEVERE in the mornings, try keeping a small, bland snack, such as crackers, beside your bed and eating these before you get up. ● REMEMBER that morning sickness can occur at any time of the day! Some find it worse in the evenings – this doesn’t mean there’s anything wrong! ● AVOID HEAVY, fatty food or eating late at night. ● KEEP A “FRESH MOUTH” kit with you at all times – brushing your teeth or sucking a mint can help if you throw up or are feeling nauseous. ● AVOID STRONG SMELLS or things that typically can upset your stomach, such as bumpy travel.

WHAT IF SOMETHING GOES WRONG? If you experience bleeding, discomfort or are worried in any way, your first port of call is your GP. He/she may refer you on to your maternity hospital’s Early Pregnancy Unit (EPU) or emergency department.

Bleeding can be common in early pregnancy so the important thing is not to panic. Always get any worries or niggles checked out.

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Chapter 00 Pregnancy Diary.indd 132

● FINALLY, remember that morning sickness is a reaction to the surge in hormone levels experienced during early pregnancy, so although it’s horrible, it can also be a sign that all is well!

NAUSEA TRIGGERS:

NAUSEA AIDS:

CAN I GET AN EARLY SCAN? Depending on hospital policy, you may be offered a scan during your booking-in visit to date your pregnancy. But if you can’t wait until this time, it is possible to get a private scan for a cost at a number of scanning clinics around the country. Generally this is not recommended before eight or nine weeks of gestation. For some women, however, it can be hugely reassuring to see that tiny heartbeat on the screen.

03/09/2014 10:52:17

NOTES BEFORE 1ST APPOINTMENT

Generally, your first hospital appointment takes up to two hours (your hospital will advise you of the time needed). Policies differ between hospitals, but generally you may have the following: Midwife consultation, Dating Scan, Doctor consultation

PREGNANCY DIARY

Your first hospital appointment NOTES BEFORE MY APPOINTMENT

● DURING YOUR CONSULTATION WITH THE MIDWIFE, your details and family history will be taken, and any areas of concern will be discussed. Your midwife will also discuss with you any information you need for a healthy pregnancy, such as nutrition, pre-natal care, breastfeeding and ante-natal classes. Depending on what’s available in your hospital, you may be able to opt now for midwife care or other specific methods of care. The midwife will also check things like your blood pressure, weight and urine sample. ● DEPENDING ON HOSPITAL POLICY, you may have your first scan at this visit. This is just a dating scan, to check that your dates are accurate and to give you a definite due date.

Remember – you must have a full bladder for this scan. ● FINALLY, you may have a consultation with a doctor, in which he/she will discuss any areas of concern raised by the midwife. This is also a chance for you to raise any issues or worries you may have, either with your own health or with the baby.

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PREGNANCY DIARY

APPOINTMENT CARD

FIVE QUESTIONS TO ASK AT YOUR FIRST VISIT

● When is my due date? ● Can I keep taking my medications/ supplements? ● What dietary or exercise advice should I follow? ● What is my schedule of hospital, doctor and scan visits? ● Is there a number I can call if I am worried or if there is an emergency?

DATE:

LOCATION:

WEEKS PREGNANT:

WHO DID I SEE?

TESTS PERFORMED:

NOTES:

EMERGENCY NUMBERS

MY SCAN PICTURE:

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PREGNANCY DIARY

Anomaly Scan

APPOINTMENT CARD

Depending on hospital policy, you may be offered an anomaly scan at around 1822 weeks of pregnancy. This is a detailed scan that checks your baby’s development and your placenta. It may also be possible to tell the baby’s gender at this scan (check your hospital’s policy, however.)

This scan will check:

● The shape and structure of your baby’s head ● Your baby’s face, especially for signs of a cleft lip ● Your baby’s spine, both along its length, and in cross section ● Your baby’s abdominal wall ● The placenta, umbilical cord and the amniotic fluid ● Your baby’s heart, and to make sure the four chambers are all working normally ● Your baby’s stomach ● Your baby’s kidneys and bladder, which are now working ● Your baby’s arms, legs, hands and feet If this is not offered as part of your hospital care, it is possible to have this done privately in a scanning clinic.

Or, if you want to find out your baby’s gender but this wasn’t possible at your hospital scan, some private scanning clinics offer a gender scan.

Chapter 00 Pregnancy Diary.indd 135

DATE:

WEEKS PREGNANT:

NOTES

MY SCAN PICTURE:

❝❞ SHOULD I FIND OUT THE GENDER?

YES NO

“Finding out we were having a girl made everything more real for us. We were able to talk seriously about names and started to consider her as a real baby. We even called her by name and sang to her at night!”

Helena, Co Donegal “There aren’t a lot of nice surprises in life, but finding out if your baby is a girl or a boy after labour is one of the nicest! The look of awe on my partner’s face when the doctor declared that we had a baby boy was something I’ll always remember!”

Cathy, Dublin 6

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PREGNANCY DIARY

24 week appointment APPOINTMENT CARD

Congratulations – 24 weeks is great milestone, as if born now, your baby has a decent chance of survival. At about this stage, your next appointment is due.

You would have been informed at your first appointment if this should be at the hospital or at your GP. At this stage in your pregnancy you should be feeling good, and with a visible bump, you can start really planning for your baby

DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

WHAT’S IN A NAME?

At 24 weeks pregnant, you can really start thinking of your bump as a baby that will be transforming your world very very soon! One of the most fun parts of pregnancy is thinking about baby names – here are 2014’s top names: BOYS: Jack James Daniel Conor Sean

GIRLS Emily Emma Sophie Ella Amelia

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*Source: BabyNamesofIreland.com

The most popular Irish-language names in 2014 are: BOYS: Aidan Daniel Sean Conor Dylan Niall Cian Darragh Liam Oisin

GIRLS: Siobhan Ava Aoife Anna Ciara Caoimhe Niamh Saoirse Maeve Keeva

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APPOINTMENT CARD

Now you are into your final trimester, your appointments are beginning to ramp up.

Expect an appointment with either your hospital or your GP every second week until 36 weeks and then every week until you give birth.

NoW is the time to…

Pack your hospital bag! Birth may feel like a long time away, but it is better to have your bag ready should you need it early for any reason. See p43 for more on what you need in your bag.

PREGNANCY DIARY

28 & 30 Week Appointments 28 Weeks DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

30 Weeks DATE:

DOCTOR/MIDWIFE SEEN:

❝❞ rest yourself “I really found myself slowing down at about 30 weeks pregnant. Rather than fighting it, I found that the odd early night or half day from work really paid off in my energy levels as the weeks rolled on.”

Marie, Greystones

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TESTS PERFORMED:

NOTES:

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PREGNANCY DIARY

32 & 34 Week Appointments APPOINTMENT CARD

Many women feel that their bumps “pop” around about now, and they start feeling very pregnant! You will also be experiencing lots of movement – remember to take note of this movement and if you notice any reduction in movement, contact your GP or hospital as soon as possible.

TURNING A BABY

● If you have been told that your baby is breech and you want to encourage him to turn, try these at-home tips (best tried after 32 weeks and before 35 weeks): ● Put something cold at the top of your bump to encourage your baby to turn away from the cold ● Put something warm or play soothing music at your pubic bone to encourage your baby to move closer to the warmth or music ● Try the breech tilt exercise, where you lift your hips higher than your head (stack pillows under your hips if it’s more comfortable) ● Going for a swim can also help as it keeps your pelvis and hips relaxed, encouraging turning. As always, talk to your doctor if you are worried.

DON’T FORGET…

…TO APPLY FOR YOUR MATERNITY BENEFIT IF YOU HAVEN’T ALREADY.

32 WEEKS DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

34 WEEKS DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

NOW IS THE TIME TO…

138

Take your antenatal classes! You will have been told of these at your booking-in visit. There are several private options available around the country. It’s recommended that both you and your partner attend these classes, unless otherwise specified.

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APPOINTMENT CARD

Congratulations! Once you have reached 37 weeks, you have reached full term, according to hospitals. However, full term is considered 40 weeks unless there are complications. These are the appointments to discuss birth preferences with your caregiver. For instance if you are having a Caesarian section, you mat be asked to book a date now. Or now is a good time to give your midwife or obstetrician a copy of your birth plan.

36 WEEKS

THINGS TO NOTE

Start reading up NOW on the early signs of labour and any warning signs that might indicate that something is wrong. See pxx for your guide to warning signs and niggles, and read the chapter on labour and birth.

PREGNANCY DIARY

36 & 37 Week Appointments DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

WHAT IS FALSE LABOUR?

False labour is a term often used by women to describe Braxton Hicks contractions.

What it really means is that the womb (uterine muscular walls) start to contact at irregular intervals. These tightenings can be a bit uncomfortable because as the muscle of the uterus tightens, it pushes the baby’s head lower into your pelvis causing pain and discomfort. These tightening start in late pregnancy and continue until you go into labour. The difference between these tightenings and the contractions of labour is firstly they are usually shorter and not as painful, and they are also more irregular and are most noticeable in the lower part of your abdomen. Labour pains are more painful, more regular and last up to a minute or so.

They also cause pain across the whole of your tummy, not just low down.

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37 WEEKS DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

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PREGNANCY DIARY

38, 39 & 40 Week Appointments APPOINTMENT CARD

At this stage you may be feeling very impatient indeed to get things started! Appointments now are weekly, and the tests performed in each appointment differ from woman to woman according to your needs. Start taking notes yourself on your progress as this may help if you suddenly go into labour. You may have more than three appointments according to your needs and if you go over your due date.

38 Weeks DATE:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

NOTES:

39 Weeks

40 Weeks

DATE:

DATE:

DOCTOR/MIDWIFE SEEN:

DOCTOR/MIDWIFE SEEN:

TESTS PERFORMED:

TESTS PERFORMED:

NOTES:

NOTES:

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THE DAY MY BABY WAS BORN

PREGNANCY DIARY

Labour & Birth The big day is finally here!

Whether you have gone into labour spontaneously or you have had some sort of intervention, use these pages to make any notes you might have or to record your baby’s birth story

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PREGNANCY DIARY

Early Days GETTING TO KNOW BABY

Congratulations! Your baby has arrived! Use these pages to note feeding times, nappy changes and any observations or tips.

❝❞ REST YOURSELF “Enjoy the time you have with your baby in the hospital.

Rather than rushing to get home, take the time to get to know your little one and have plenty of cuddles and newborn snuggles. They grow up too fast and this is the time for just you and your baby.”

Katy, Cork “Visitors are great, but make sure you get enough time to rest yourself. Remember that you’re recovering too, and you’re also dealing with a newborn. There will be plenty of time when you get home for all the relatives to meet the new addition.”

Fiona, Co Antrim

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“Don’t panic if you don’t get that immediate ‘rush of love’ for your new baby – it’s a bit of a myth. Giving birth is a massive event, even if it goes smoothly and according to plan and it can take time to adjust to life with a baby. Don’t expect anything of yourself; simply cuddle your baby and get to know him or her. The bond will come.”

Maria, Sligo

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PREGNANCY DIARY

BABY LIKES...

BABY DISLIKES...

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Postnatal Appointments MUM & BABY APPOINTMENTS

Under combined care, your baby is entitled to an appointment at two weeks and at six weeks old, and you are due a check-up at six weeks post birth.

The six-week milesTone

Congratulations! You’ve made it to six weeks as a proud parent to your lovely new baby! You will have noticed that a routine is now establishing, and your baby may even be showing signs of sleeping more during the night.

Don’t be discouraged if your baby doesn’t seem as fast in establishing a routine as some other parents claim their babies are – every baby is different and will develop at his/ her own pace. From now until they are three months, you will notice them getting bigger and sturdier, and it’s really then that they start getting a night/day routine more like us.

❝❞ check iT ouT!

“Use your six-week check to ask any questions you might have about your body after birth, eg can I start exercising? What about sex? What are my options re contraception?”

Aisling, Co Dublin

BaBy - 2 weeks DATE: DOCTOR/MIDWIFE SEEN: TESTS PERFORMED: NOTES:

BaBy - 6 weeks DATE: DOCTOR/MIDWIFE SEEN: TESTS PERFORMED: NOTES:

mum - 6 weeks DATE: DOCTOR/MIDWIFE SEEN: TESTS PERFORMED: NOTES:

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“My baby’s two-week check was a great chance to check that I was doing okay so far. His weight was checked and his general wellbeing was noted. After a few rollercoaster weeks as a first-time mum, it was great to get that reassurance!”

Martina, Portlaoise

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