ParentsCanada Expecting Spring 2018

6

2018

TIPS FOR EATING

My, how you’re

BABY’S DEVELOPMENT, STEP-BY-STEP

What to bring to the hospital

SWEET SLUMBER

Getting your ZZZ’s

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in this issue

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EDITOR’S NOTE

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8

HOW YOU’VE GROWN! Your baby’s in utero development.

WOMAN AT WORK How to manage your pregnancy at work.

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UNDERSTANDING ULTRASOUND Your questions answered.

Shutterstock/© WAYHOME studio

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GOOD EATS You know your food info Tru or false?

SWEET SLUMBER Chasing the elusive good nite’s sleep.

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MOTHER’S MILK Good reasons to breastfeed.

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PACK YOUR BAGS! What to bring to the hospital.

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BREAK A SWEAT Exercise: what’s okay and what’s not in pregnancy.

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SPRING 2018

EDITOR-IN-CHIEF Katie Dupuis

editor’s message

ART DIRECTOR S. Dale Vokey

From the moment the plus-sign appears in the test window, the emotional rollercoaster begins. You flip-flop between excitement, fear, contentment and uncertainty. When you add in the morning sickness and the first trimester tiredness, it’s a crazy time.

If you’re anything like me, the positive test will turn you into a research maniac. You’ll start googling everything from baby names to birth plans, trying to make informed decisions about your pregnancy and how you plan to parent the little bean in your belly. When I found reliable websites and magazines, I went back to them over and over again, to seek out answers for my many, many questions. (Even six years after my first daughter, Sophie, was born, I still go back to the same parenting resources!) That’s what we aim for at ParentsCanada, and with this Expecting guide. We want to be there for you, when you’re unsure, when you’re worried, in the middle of the night, when you need a friend. We’ll try to be the (sassy, well-informed) pal you need as the weeks and months tick by, and we’ll be there for you long after you’re holding that little bundle in your arms.

Looking forward to getting to know you, and your new addition.

Congratulations!

V.P., DIRECTOR OF MARKETING AND INTERNET DEVELOPMENT David Baker

NATIONAL ACCOUNT MANAGERS Lori Dickson Meghan Bradley

Katie Dupuis – E D I T O R E DI TOR IAL B OAR D OF A DV I SO R S Donna Brown Wilson Clinical Nurse Specialist Perinatal Program, Sunnybrook and Women’s College Health Sciences Centre, Toronto Eric Goldszmidt, MD, FRCPC Deputy Anesthesiologist-in-chief, Mount Sinai Hospital, Toronto Andrea Skorenki, MD University of Alberta Department of Obstetrics and Gynecology Allison Tannis BSc, MSc, RHN, Nutritional Consultant, Whitby, Ont. P UB LIS H IN G IN FOR M AT I O N: Expecting is a controlled circulation publication edited for pregnant mothers. Expecting is distributed through our exclusive partnership with Thyme Maternity stores across Canada.

The information in Expecting is not a substitute for your doctor’s care.

SENIOR WEB STRATEGIST Matt Doris OPERATIONS DIRECTOR Bonnie Young

PUBLISHED BY:

PRESIDENT/PUBLISHER Jane Bradley 2010 Winston Park Drive, Suite 200, Oakville, ON L6H 5R7 Telephone: 289.291.7723 No part of this publication may be reproduced without permission of the publisher. ©2018

COVER SUPPLIED BY:

Meet cover girl Brittany – nearly 7 months pregnant when we shot this cover, carrying her second child & making pregnancy look as easy (and as stylish) as ever! Wearing a fit & flared, cold-shoulder maxi dress #408658 from Thyme Maternity’s June 2018 collection. Available at Thyme Maternity in stores and online in sizes S-XL. Visit thymematernity.com to shop the look.

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M y, h o w y o u ’ v e

G ·r· o ·w·n !

FeTAL DeveLoPMeNT by KAron West, rn

A guide to your bAby’s development in utero

4 weeks The embryo is just visible. › Development of the chorionic villi, from which the placenta is formed. › Production of the hCG hormone (human chorionic gonadotropin), which stops menstruation from occuring.

› The embryo will now make slight movements and is approximately two cm (3/5-inches) long. › The amniotic sac fills about two-thirds of the uterus, sealing in the amniotic fluid that surrounds and protects the fetus.

5 weeks The beginning of the embryo’s nervous system becomes evident as a ridge of tissue that will develop into the brain and spinal cord. › Initial formation of the heart with faint beats. The nose and cheeks begin to show under the eyes.

12 weeks The rapidly developing embryo is now called a fetus.

6 weeks The embryo grows to less than 1 cm in size (1/3-inch). › The spinal cord, brain, ears and eyes have started to develop. › The internal organs (lungs, digestive system, kidneys) begin to appear. › Tiny buds of arms and legs take shape.

7 weeks The major organs develop. › Distinct facial features appear with skin covering the eyes. › Definable arms and legs are visible, with the emergence of developing fingers and toes. › The muscles, bones and blood vessels begin to develop. The heart of the tiny embryo beats rapidly, at about 160 beats per minute.

8 weeks All of the major organs are nearly formed. › The head is very large in proportion to the body as rapid brain growth occurs.

9 to 13 weeks By 12 weeks, the fetus is a recognizable human being. › Gender was determined at conception, but now the sex organs begin to differentiate into male or female organs. The fetus starts exercising its muscles. › By the end of this trimester, the fetus is a tiny, fully formed human being, seven-anda-half centimetres (three inches) long, weighing one ounce.

16 weeks The fetus is very active. › Fine, downy hair begins to grow over the delicate, semitransparent skin. › Bone and circulatory growth continues rapidly. Finger- and toenails are present at this stage. › External genital organs are fully formed, and gender can be clearly distinguished.

20 weeks Fetus swallows amniotic fluid. › Kidneys produce fairly large quantities of urine, which is excreted into the amniotic fluid. › Hair appears on the scalp.

24 weeks At this stage, the fetus is termed viable (able to survive) and weighs about one- to one-and-a-half pounds. › There is very little body fat. › The skin is wrinkled and covered with a white, cheesy substance called vernix – this protects and lubricates the delicate skin. › You may now feel the baby’s vigorous movements.

28 weeks Your unborn child will spend the next few weeks laying down fat under the skin. ›The body undergoes rapid growth; size becomes more proportionate to the head. › Hiccupping is common; you experience this as a gentle, rhythmic sensation. › The baby’s lungs are beginning to function.

32 weeks A baby born at this stage in the pregnancy has a good chance of survival with intensive neonatal care. › The baby weighs about fourto four-and-a-half pounds.

36 to 40 weeks A great deal of fat continues to be laid down under the skin. › Your infant’s lungs have matured significantly in preparation for survival outside the womb. › The vernix is shed – although some might still be there at birth. › At this stage, your child is fully developed, with the characteristic features of the newborn infant.

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Your babY will begin to grow and change from the moment of conception.

Here’s what is happening inside your uterus, from the first day of pregnancy to the last.

3rd Trimester

1st Trimester

seven to nine months

First Day

one to three months

2nd Trimester four to six months

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Eats

Eating nutritious foods will benefit your baby for years to come.

by Allison TAnnis bsc, Msc, RHn

When it comes to eating during your pregnancy, you can’t just trust what you hear through the grapevine.

The truth is that your health and that of your baby’s is tightly linked with food. scientists have discovered that what you choose to eat now can affect the health of your baby for years to come. so what should you eat during pregnancy and which of the food rumours are true?

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Eat for two: FALSE

tEa iS hEalthy: FALSE

You only need to eat about 300 calories more per day during pregnancy – not double your caloric intake. But do eat up! It will take about 80,000 calories to carry your baby to term. Eat a well-balanced diet during pregnancy to ensure your weight doesn’t tip to either extreme, because it may lead to stunted growth and development in the womb.

When it comes to herbal teas, citrus peel, ginger, lemon balm, orange peel, rose hip, red raspberry leaf and peppermint are considered to pose little risk when consumed in moderation.

Black tea, however, contains caffeine and should only be consumed during pregnancy in moderation (maximum two to three cups per day).

SwEEtEnErS arE ok: FALSE The term ‘artificial sweetener’ should already raise red flags.

Artificial rarely means healthy.

Yet skipping the artificial sweetener packet at the coffee shop is not enough to keep this bad food out of your diet.

Artificial sweeteners are used in many everyday food products such as soft drinks, yogurt, desserts, fruit spreads, chewing gum, salad dressings, candy and items labelled ‘light’.

Shutterstock/© Africa Studio/© Jacek Chabraszewski

Ditch thE java: TRUE Coffee contains caffeine, which should be limited. The trickiest part is that caffeine is hiding in more than your cup of coffee; it is in nearly all chocolate products (brownies, ice cream, cookies), pop and tea. Currently, government and health organizations suggest that pregnant and lactating women should restrict their daily caffeine intake to 300 mg daily, yet new research suggests you should consume as little as 200 mg of caffeine per day.

no fiSh: FALSE Fish is in! Certain types of fish are good sources of omega-3 fats that your baby needs for proper brain and eye development.

Many women worry about eating fish, however, because it may contain mercury. Examples of fish that contain high levels of the beneficial omega-3 fatty acids, but are low in mercury, are anchovy, capelin, char, hake, herring, Atlantic mackerel, mullet, pollock, salmon, smelt, rainbow trout, and lake whitefish.

Fish that tend to contain higher levels of mercury include fresh and frozen tuna, shark, swordfish, marlin, orange roughy and escolar. Health Canada says pregnant or breastfeeding women should limit themselves to 150 grams per month (about one cup) of these types of fish.

But canned light tuna is fine for pregnant women to eat.

Women should, however, limit their consumption of canned albacore (sometimes called white) tuna to 300 g per week (about two cups).

wE Eat juSt finE: FALSE According to a Russian study, women do not eat enough of the right foods during pregnancy. Pregnant women do not eat enough vegetables, fruit, dairy products or protein.

Plus, they consume alarmingly low levels of folic acid and iron – two of the most important pregnancy nutrients. Proper nutrition during pregnancy can reduce the chances of birth defects, may reduce the risk of miscarriage, can alleviate pregnancy discomforts, improve birth weight and pregnancy duration, and may improve development of the brain and eyes of infants.

Eat right! It’s important for you and your baby. Focus on natural foods that are not processed or covered in fat or salt. Eat lots of leafy green vegetables, whole grains, nuts, beans and fruit.

And don’t forget a serving or two of fish each week, and a glass of milk to wash it down.

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The moment I found out I was pregnant, everything changed. These changes are so exciting, but one change I am concerned about is stretch marks. That’s why I trust Palmer’s to keep my skin beautiful.

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SweetSlumber Back and muscle pain During pregnancy, the ligaments in your body become looser so that your uterus can expand and eventually allow your baby to fit through your pelvis during delivery. This causes achy joints.

Once you add the weight of the baby to the mix, your back is begging for a break.

Frequent stretching can relieve some of this pain; round your back around your bump with your chin and knees tucked in, hold for a few seconds, then

release. Finish by placing your hands on your lower back and arch slowly.

Body pillows that support your bump and upper leg can take the pressure off your lower back at night. Acetaminophen, as opposed to ibuprofen, is safe to take for pain.

Leg cramps The physiological reason for leg cramps is complicated and not well understood, but can involve low calcium and high phosphate levels. The added

weight of pregnancy and inadequate potassium intake may also play a part. If you drink a lot of milk, try cutting back. Although milk contains high levels of calcium, it is also rich in phosphates. Try eating potassium-rich foods such as baked potatoes, avocados, spinach or bananas. Also, keep well-hydrated – and stretch your legs before bed and when you wake up. Do not take any vitamin supplements, unless on the reommendation of your physician.

Shutterstock/ © And-One

EVERYONE WILL TELL YOU THE SAME THING: ‘ SLEEP NOW, WHILE YOU CAN’

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For most pregnant women, a great sleep is easier said than done. Find out what’s going on inside your body and what you can do to make peace with your pillow.

BY D R . CO U R T N E Y M A N S E R

Shortness of breath At night, you may become short of breath when lying flat on your back or even on your right side. This is because a large vein called the inferior vena cava runs up the right side of your abdomen to your heart.

Lying on your back or right side can sometimes obstruct this vesicle, leading to diminished blood flow back to your heart, causing shortness of breath.

Try lying on your left side with your back extended. Always tell your physician if you experience

shortness of breath; this may be a sign of a more serious condition.

Frequent urination You may have noticed you’re urinating more frequently. Even in early pregnancy, the blood flow to your kidneys increases, resulting in frequent urination.

Decrease the amount of drinks that act as a diuretic, such as coffee and tea. Also, lean forward when you pee to ensure you have completely voided at each bathroom visit.

Heartburn Your enlarged uterus places pressure on your stomach and increases the time it takes for your stomach to empty.

Also, the valve between your stomach and esophagus becomes more lax, allowing food and acid to travel up into your esophagus. Try not to eat at least two hours before bed. Avoid caffeine (including chocolate), spicy foods and greasy/fatty foods as much as possible. Seep with two pillows instead of one. parentscanada.com 15

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SHE WORKS HARD FOR

the Money

Here’s how to get through the workday with baby on board.

BY LISA EVANS; Interview with DR. MARJORIE GREENFIELD

Morning sickness

Shutterstock/ © ivector

Tossing up your breakfast is one of the telltale signs of pregnancy. “One of the biggest challenges is wanting to keep things secret,” says Dr. Marjorie Greenfield, MD and author of The Working Woman’s Pregnancy Book. She says the key to managing morning sickness is to never be too full or too empty. Keep a stash of crackers or dry breakfast cereal at your desk so you have something to munch on at all times. Many women find ginger snaps or lemon wedges helpful. Scaling back meals, and eating several smaller snacks throughout the day, rather than three large meals, can also help.

If your desk is near the lunchroom, you may find certain odours trigger your nausea. You may have to request a temporary relocation.

“Sometimes you just can’t hide your pregnancy because you need certain accommodations at work,” says Dr. Greenfield.

Keep a bottle of mouthwash in your purse, which can help you feel better after throwing up.

Bring a change of clothes – an extra blouse or jacket – in case of emergency.

If your nausea is severe, consider talking to your doctor about medication.

Bathroom breaks “Combine going to the bathroom with some other task, such as a trip to the mail room, so it’s not completely obvious that you’re making a dent in the carpet between your office and the bathroom,” says Dr. Greenfield. Grab a seat by the door during meetings so you can make a quick, inconspicuous exit if the need to urinate – or vomit – arises.

Raging hormones Thanks to the hormone progesterone, which is the culprit of PMS symptoms – and which remains elevated during pregnancy, you may find yourself bursting into tears for no reason, or being easily irritated. “Women who are very sensitive to progesterone may be super emotional in early pregnancy,” says Dr. Greenfield.

To avoid coming across as unprofessional, tap into stress management techniques such as yoga, meditation and deep breathing.

Pregnancy brain Although Dr. Greenfield says

there’s no scientific evidence that cognitive functioning is affected during pregnancy, many women do report increased forgetfulness and difficulty focussing during pregnancy. Dr. Greenfield says this may have more to do with psychology than a physiological change. “A lot of women who have been super-focussed on their work before pregnancy get drawn inwards as the image of themselves changes from being a worker to a mom.” If you find your brain becoming increasingly forgetful, take a few minutes at the end of each workday to make a to-do list to help you stay focussed the next day.

Pregnancy fatigue Sneaking in naps at your desk probably isn’t the best option, but if adjusting your working hours to the part of the day when you feel the most energized is possible, this may be the best way to avoid fatigue. When you feel your energy waning, try taking a walk outdoors or chewing mint-flavoured gum. Getting enough sleep is also key, even if it means zonking out the minute you step through your front door.

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The baby news is still a secret!

FROM MORNING SICKNESS TO FOOD AVERSIONS, HORMONES AND FATIGUE, PREGNANCY IS RIDDLED WITH PROFESSIONALISM KILLERS. KEEPING UP APPEARANCES CAN BE ESPECIALLY TRYING DURING THE FIRST THREE MONTHS WHEN ‘MUM’S THE WORD’.

PLANNING AHEAD CAN HELP YOU MANAGE PREGNANCY SYMPTOMS.

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Understanding UltrasoUnds

They are more than just the first photos of your baby.

A n d r e A S ko r e n k i M d

eight to 12 weeks can be the most accurate way to figure out how far along you are. An early scan can predict the due date within five days, but one done in the third trimester can be off by as much as two to three weeks.

There is also a special type of ultrasound that screens for Down syndrome by measuring the thickness of an area on the baby’s neck, known as the nuchal translucency. This is done between 11 and 14 weeks and is paired with blood tests to give a risk score for Down syndrome.

Will i need AnoTHer ulTrAsound AfTer my 20-Week sCAn?

determines the number of babies and the position of the placenta.

Ultrasound pictures are made when high-frequency sound waves are aimed at tissues in your body using a transducer.

The speed that the sound waves bounce off different tissues and back to the transducer is used to generate a picture.

Ultrasound has been proven to be safe in many studies, but it is not totally harmless.

High-energy ultrasounds can cause tissue heating, which could be dangerous for an early pregnancy. But most pregnancy ultrasounds use much lower energy levels.

This ultrasound also looks for ‘soft markers’– mild abnormalities in the baby’s anatomy that can be variations of normal, but could also indicate an increased risk of a chromosomal disorder. If a soft marker is discovered, your doctor may recommend other tests or another ultrasound.

does everyone need To HAve An ulTrAsound?

It’s recommended to have a screening ultrasound when 18 to 22 weeks pregnant. This confirms the gestational age, and

CAn i HAve An ulTrAsound even eArlier?

The best time to see the baby’s anatomy is between 18 and 22 weeks; doing the scan earlier than that isn’t helpful. There are other reasons, however, to have an ultrasound earlier in the pregnancy. This is done to investigate bleeding or cramping and can identify a miscarriage or ectopic pregnancy.

If you are unsure about your dates, measuring the baby at

WHen CAn An ulTrAsound Tell us THe sex of THe bAby? Depending on the baby’s position, typically parents should be able to find out the sex from the technician during the 18week ultrasound. The technician can’t guarantee the gender of the baby – but sometimes boys make it fairly obvious! If you want a surprise at the birth, make sure you tell the technician before the scan.

Shutterstock/© KonstantinChristian

WHAT is An ulTrAsound? is iT sAfe?

Usually not. Your doctor may schedule regular ultrasounds to check your baby’s well-being if there is concern about how your baby is doing, or if you have certain medical conditions. This is done with a biophysical profile (BPP), which grades the baby on muscle tone, movement, amniotic fluid and breathing, with a score out of eight. A score of 8/8 is reassuring. Lower scores may require closer surveillance or even early delivery. Extra scans may also be done to measure the baby’s growth, check position or watch the placenta if it was too close to the cervix in the first ultrasound.

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REASONS to breastfeed

1 needed. It is available for Baby whenever,

Breast milk is ready-made, no preparation

wherever, and is always the right temperature.

BY JANET M. LANG RN, IBCLC, RLC

8 tally friendly option to explore.

Go green! Breastfeeding is an environmen-

9 breastfed babies.

Allergies are less likely in

2

Breast milk is easily digested, which means it causes less gas and is easier on Baby’s gut.

3 immunoglobulin. In

Breast milk contains

simple terms, these are antibodies that protect against viruses and bacteria by passive immunity from mother to baby.

4 cells. The presence of

Breast milk contains stem

stem cells is a quality of breast milk that can’t be duplicated.

Stem cells are made to heal and regenerate. It keeps baby healthy and happy.

1 0 benefits Mom, too.

Breastfeeding

It reduces the rates of breast cancer and ovarian cancer, and helps Mom return to her pre-pregnancy weight faster.

1 1 pay for a family

Breastfeeding will

vacation! By using your own milk, you can actually save $1,500 – $2,000 (or more!) each year.

5 that breastfed babies tend to

Breast milk research has shown

have higher IQs and faster brain development than babies who aren’t breastfed.

6 breastfeeding strengthens the The closeness and comfort of

Shutterstock/© Hibrida

bond with your baby. You can help build a secure, loving relationship.

7 breastfeeding doesn’t Contrary to rumours,

hurt. You may feel pulling as the baby suckles, but if it is painful, work to correct the latch.

parentscanada.com 27

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18-04-12 12:49 PM

Be prepared with a hospital stay checklist The time has come. You’re in labour. You grab your bag and head straight for the hospital. The last thing you should be doing is wondering if you have everything you need. To ease your mind, here are some things you may want to put in your bag in the weeks leading up to your big day.

• small amount of money

• comfortable, loose clothing

• warm socks (two or more pairs)

• hairbrush

• two nightgowns (that open from the front)

• slippers

• deodorant • super absorbent sanitary pads • tissues • earplugs

• provincial or territorial health insurance card • private health insurance documentation, if applicable (such as for a private room) • copy of your birth plan, if approved • cord blood collection kit (if you plan to store your baby’s cord blood) • picture or object you find comforting (helps with focussing and positive visualization during labour) • watch or smartphone • massage oil or lotion • hot water bottle • cold packs • moisturizing lip balm • camera and/or video camera, charged batteries and empty memory cards • extra pillows • MP3 player and headphones

• housecoat • two or more nursing bras • several pairs of inexpensive underwear

• smartphone, with phone numbers of family/friends • snacks and drinks • bathing suit (for joining you in the shower or tub to help you through contractions)

• makeup, in case you want to freshen up for visitors and photo ops • a laundry bag (for soiled clothing) • breast pump

• appropriate car seat (this is the law; you will not be allowed to leave the hospital without one properly installed in your vehicle) • package of diapers • undershirts, sleeper, hat

• change of clothes

• receiving blanket

• books, magazines, a deck of cards or other items to pass the time

• mittens (optional – to cover long nails/avoid scratching)

• snacks and drinks

• in winter, heavy blanket/ bunting bag

Shutterstock/ © Nina Buday,, © fizkes, © rSnapshotPhotos

• toothbrush and toothpaste

what to BriNg for your BaBy

• shampoo/soap

what to BriNg for your PartNer

what to BriNg for MoMMy

Pack your bags!

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18-04-12 1:06 PM

V O /P AT m S o U .c T a SI ad VI Can s nt re Pa

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ParentsCanada.com/POV

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18-04-16 1:51 PM

If you take it easy and listen to your body, you can be active even later in pregnancy and benefit. Being physically active can increase your sense of well-being and give you more stamina for labour – and for chasing after your little one!

by S u e R o d g e R S , A CC e

Break a BENEFITS OF EXERCISE IN PREGNANCY

INTENSITY: HOW HARD CAN I WORK OUT?

• Improved cardiovascular system, which provides more stamina for pregnancy, labour and birth.

This can be different for each person, but experts agree it is best to begin slowly and build up endurance and strength gradually.

You can use these easy methods to determine how hard you are working:

• Better circulation, which helps prevent varicose veins and leg cramps.

• Reduces risk for gestational diabetes.

Shutterstock PhotoMediaGroup

• Acts as a coping mechanism for reducing stress.

• Muscular conditioning exercises strengthen skeletal muscles, improve posture, strengthen abdominals and lower back, and condition muscles of the pelvis and legs – this helps with endurance during labour and birth.

• Helps ensure that you have a healthy weight gain.

Perceived exertion “self check” How hard you think you’re working.

Mild to moderate exertion is healthy.

A “talk test” If you can talk while you’re exercising, you’re not overdoing it.

WHICH WORKOUTS ARE BEST DURING PREGNANCY? This is the time to stop all contact sports and adventure sports (sorry to all the rugby players, dodgeball enthusiasts and horseback riders).

Try a variety of lower-impact activities such as: • swimming or prenatal aquafit classes • yoga • walking • light strength training • low-impact aerobics

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18-04-12 12:59 PM

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

An intelligent choice.

In more ways than one.

Your baby’s brain growth will be 85% complete by the age of three.

Nourish him today with DHA-enriched Enfamil A+®.

Your baby’s brain will never grow this fast again, so it’s an important time to support that growth with Enfamil A+. It has a clinically proven level of brain-nourishing DHA, a type of Omega-3 fat. Enfamil A+ is easy to digest and is our closest formula to breast milk. All reasons that help make it the #1 pediatrician-recommended formula brand.

whydha.ca enfamil.ca/whyenfamil Nourishing milestones at every stage stage.™

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Breastfeeding is best for babies © 2018 Mead Johnson & Company, LLC