PBC Expo Parenting Insights | 2017

C O M P L I M E N TA R Y G I F T

PAR E N T I N G

Your magaFREE zine Pac

ked insigh with essen ts for tial of you every stag e r pare nting journ ey

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For all your pregnancy, newborn and baby needs SEE , TOUCH, TRY, ASK , LEARN.

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Parenting Insights Magazine Managing Editors Julie Rocke Katherine Waterhouse

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ince our first Expo in 1991 the Pregnancy

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every step of you parenting journey.

world. Their primary goal is the health and

The birth of a child, whether your first born or not, is one of life’s true watershed moments.

You will be presented with new ideas, new

healthy and happy child.

Even decisions you make prior to

wellbeing of you, your family and your baby – and that’s where all our interests align.

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It’s always safety first!

26

Making up your baby’s cot red nose – saving little lives

10

52

Safe travels Choosing the safest car restraint for your child

Nursery safety – Myth busters! 54 Water safety in Australia 62

Family health advice IVF: What you need to know

6

Pregnancy symptoms 8 10

A practical guide to healthy eating during pregnancy Keeping fit during pregnancy

14

Baby steps along the way

16

The stages of pregnancy Managing morning sickness

17

Gestational diabetes 18 Understand why it is important to try to avoid it, or control it, if it develops Adjusting to fatherhood

20

Am I in labour?

22

Tips for recovery after a caesarean

24

5 unexpected tips for babies with colic 30 Practical tips on caring for your newborn

62

36

Light for Riley 38 National immunisation program schedule 39 Welcome to the 4th trimester

40

Taking the sting out of nappy rash

42

20

Baby massage explained 43 Newborn bath basics 44 Postnatal depression 46 Help your baby develop during 50 their vital first year Getting started with toilet training

60

Baby feeding and care

possible to do with planning, pregnancy and parenting at our Expos.

Our website and this magazine give you the opportunity to dig deeper, discover and share your growing confidence as a parent with your family and friends.

The truth about breastfeeding 28 Expressing breast milk

32

Important tips for hygienic

34

handling of breast milk Taking the bite out of teething 48 Introducing solids:

O

ur priority is to put you in touch with the very best of everything

58

Purees vs baby led weaning

Every year we are privileged to see thousands of families being created and expanded, and we love being part of it. Wherever you are on your parenting journey, our broad range of Exhibitors and experts, here in our magazine, online and at our Expos can help you make informed choices so you can decide what’s best for you and your family.

We’ve helped in raising Australian families since 1991, we hope we can play

a role in connecting you with the best brands, services and information too.

Getting organised The importance of a quality nursing bra

12

Oh, and don’t forget the nappy bag

64

pbcexpo.com.au 2017 | Parenting Insights

5

IVF: What you need to know

One in six Australian couples suffer

What is in vitro fertilisation (IVF)?

from infertility. It’s important to

IVF is where hormones are given to stimulate a woman’s

remember not everyone who is having trouble conceiving will need to undergo IVF (in vitro fertilisation).

6

Parenting Insights | 2017

natural egg production. A doctor steps in at the right moment to extract the eggs. These are then brought together with sperm in a laboratory dish (rather than a woman’s fallopian tubes) to create embryos.

The embryo grows under laboratory conditions for five days, to

performed to remove a few cells from the embryo before it’s

the stage where it is called a blastocyst. This is the ideal time to

transferred to the woman to make sure that an embryo with

transfer the fertilised embryo back to a woman’s uterus.

no detectable chromosomal abnormalities is placed back into

IVF has helped thousands of couples fall pregnant, however there is no guarantee it will work for everyone.

the uterus. It doesn’t change the embryos you’ve got but it’s a way to know which ones have a normal chromosomal make up and therefore are more likely to give you a healthy baby.

When should you seek fertility help?

If you’re over 35 years old and you’re not falling pregnant

How can you increase your chance of IVF success?

naturally within about six months of trying, you should consider

The best way to increase your chances of conceiving a baby

seeing a fertility specialist. If you’re under 35, it’s recommended

either naturally or with IVF, is to avoid leaving it too late. A

you try for a year, unless you have any health concerns like

woman’s fertility starts to decline significantly by the time she is

pelvic pain or irregular periods.

35, so it’s ideal to start trying before then.

Having trouble conceiving doesn’t automatically mean

Your health – and your partner’s health too – are also really

you need IVF. Talk to a fertility specialist about your individual

important. Touching base with your GP for a general health

situation and they will investigate why you’re not falling

check, eating a healthy balanced diet and exercising regularly

pregnant. The doctor might arrange some tests for both of you.

can boost your chances of conceiving.

About a third of the time when a couple are having trouble

If you’re overweight, it’s a good time to make some lifestyle

falling pregnant it can be due to a sperm problem. The doctor

changes. Smoking or taking illicit drugs can also reduce your

will arrange for a sperm test to analyse numbers and function.

chances of falling pregnant so it’s best to quit if these are things

Women are usually asked to take a blood test to make sure

you currently do.

ovulation is normal.

An ultrasound to check the uterus and ovaries may also

For men, alcohol intake of more than two standard drinks a day can affect sperm quality so it’s important to moderate your

be needed to check for any cysts or abnormalities that may

drinking. Try for at least two to three alcohol-free days a week.

affect fertility.

For women it’s a good idea to minimise alcohol intake when you’re trying to conceive. No amount of alcohol has been proven

How successful is IVF?

to be safe during pregnancy, so you’re advised not to drink at all

IVF can be very successful for some couples, but again, one of

while you are pregnant.

the main factors is a woman’s age. If a woman is in her 20s or

If you have any ongoing medical conditions like asthma or

early 30s the chances of an embryo, known as a blastocyst, taking

diabetes, it’s important your condition is well managed, and there

in her womb is about 50 per cent. For women in their late 30s it’s

are asthma and diabetes medicines that are safe to use if you are

a bit lower at about 40 per cent. When a woman is over 40, the

trying to conceive, or are pregnant.

chances drop to around 25 per cent for each embryo transfer.

Fortunately with IVF a lot of couples do get more than one embryo (blastocyst) formed in the laboratory. If you have more

Significant emotional stress can also affect a woman’s period cycle and can impact on your chances of falling pregnant.

Trying to conceive naturally can be a time of ups and

than one healthy blastocyst you can freeze the remaining

downs, and IVF for many couples is an emotional journey too.

embryos to try again if implantation is unsuccessful, or to

Melbourne IVF recommends where possible to plan when you’re

achieve a second pregnancy. Embryos can freeze well and over

going to do IVF, to ensure that it’s at a time in your life which

90% will usually survive being thawed out, and their pregnancy

is relatively stable if possible. Couples who undergo IVF have

potential is about the same as using a fresh embryo.

to attend mandatory counselling and Melbourne IVF also has

If IVF isn’t successful the first time, the first option is to use any frozen embryos. If a couple aren’t pregnant after using their

supportive counselling as some couples need help along the way.

Overall, the objective is to ensure you’re as healthy as

frozen embryos the next step is to see their fertility specialist

possible, both mentally and physically, not only to help with

again to go over their treatment. It’s really an individual approach

conception, but to maximise your chances of having a healthy,

and their IVF cycle can be tweaked to meet the needs of the

uneventful, uncomplicated pregnancy.

couple to ensure their best possible chance of conception.

One of the other options is a more advanced IVF process known as advanced embryo selection. It’s where a biopsy is

Article courtesy of Bupa and Dr Scott Pearce, a senior specialist in Infertility & IVF, Gynaecology and Obstetrics 2017 | Parenting Insights

7

Pregnancy symptoms For many women the ‘diagnosis’ of pregnancy follows a few weeks of wondering “am I pregnant?” due to a range of small signals that things are changing in your body. For others, the changes occur much later and for a lucky few they travel through the whole journey wondering what the fuss is about. Midwives and other care providers often spend a good portion of their consultation time discussing the many signs and symptoms of pregnancy trying to allay concerns and describe what is normal.

Early days through the first trimester (12 weeks) Women who have been pregnant before often experience an “ah-ha” moment, noticing smells are different, or that they have an unusual taste in their mouth. The most obvious sign is that a period is missed with sore breasts, a common pre-menstrual sign, often continuing signifying some of the hormonal changes occurring in pregnancy. Wearing comfortable clothes may help to relieve the tender feelings. The other very common issue is extreme tiredness until it generally improves after 12 weeks.

Tiredness in these early stages can be difficult to explain when trying to conceal a pregnancy, and may only be relieved by many day time naps and early nights. A few other early issues include: • Frequent urination – as your baby grows in the early stages the pressure of the uterus has an impact on the bladder causing feelings of a frequent need to pass urine • Nausea and vomiting of pregnancy (Morning sickness) – hormonal and blood flow changes contribute to this very common problem which is often challenging to deal with.

Small frequent meals and at times complementary therapies such as ginger and acupuncture can help but medication is also occasionally needed • Vaginal blood loss – any blood loss should be reported to your care provider, but this is an common complaint in the first trimester

The middle period During the second trimester women often look and feel much better and appear to bloom. For the unfortunate ones where morning sickness continues during this period, they often also end up experiencing a number of other digestive problems: 8

Parenting Insights | 2017

• Constipation – can start due to the bowel slowing down in digesting food • Heartburn, indigestion and reflux – less room for the stomach and again slowed digestion • Haemorrhoids – from dilated blood vessels and straining to use the bowels

blood loss or gushes of fluid from the vagina. During this period it is also important to consider what the baby within is doing and to observe that baby is moving and that the overall level of movement at the same time each day is reasonably consistent.

A last obvious and common issue is abdominal cramping, which can occur as Braxton Hicks contractions (that occur in late

Other problems during this period include bleeding gums,

pregnancy and early labour) increase as the body gets ready for

bleeding noses, leg cramps, sore joints and restless legs.

labour to start. These cramps, including period like pain and back pain, are very common even before labour starts but need to be

The home stretch – 28 weeks until birth The list of common discomforts in the third trimester is nearly

discussed with your care provider.

Whilst pregnancy is a time of excitement and joy, some of

endless as pregnancy impacts nearly all the organs in the body

the symptoms discussed can have an impact on a woman’s

and hormonal changes are extensive. Mentally women often

ability to enjoy this special time. A good care provider who

start to become a little more anxious and frightened about

listens and provides some active solutions to the common

what is to come. As baby grows the uterus puts pressure on

discomforts is a really invaluable addition to your pregnancy

many parts of the pelvis and back pain is very common. The

journey.

growth of baby varies so, of course, the issues that occur also vary markedly. The problems of the early and middle part of pregnancy are often magnified and unfortunately as sleep is disturbed women start to feel very weary. Unusual symptoms should be discussed with your care provider including

Article courtesy of Liz Wilkes Liz is the Managing Director of My Midwives and the Pregnancy Babies & Children’s Expo Consultant Midwife.

She has been a midwife for over 20 years.

headaches, visual disturbances, itchy skin and rashes, vaginal

2017 | Parenting Insights

9

A practical guide to healthy eating during pregnancy

E

ating well when you are pregnant is important — a balanced diet, plus a supplement that contains folate and iodine is

essential. Following a healthier lifestyle is a positive change you can make at this time. You might like to start thinking about a general health overhaul as well as following a nourishing diet, getting more exercise, quitting smoking (if you smoke), and cutting back on alcohol. These are all helpful changes for you to make for both your health, as well as for your growing baby.

What should I be eating?

Folate Folate is needed for healthy growth and development. Taking folate reduces the chance of neural tube defects (e.g. spina bifida) in your baby. It is recommended that women trying to conceive take an extra 400 µg/day of folic acid. The best way to get this is from a supplement. It is important to take this at least one month before and three months after you become pregnant. You still need to eat foods that contain folate. Rich dietary sources of folate include green vegetables, fruit, and fortified cereals.

Iodine Iodine is a nutrient we need in very small amounts. It is part of thyroxine, a hormone of metabolism, growth and development.

We need more iodine when pregnant and breastfeeding. This is for growth and development, especially of your baby’s brain.

Mild iodine deficiency can lead to subtle cognitive and neurological problems. Studies show that the Australian population is mildly iodine deficient.

How much iodine do I need?

• pregnant women need 220 micrograms of iodine (also written as µg) • breastfeeding women need 270μg • all women should take a supplement with 150μg during pregnancy and breastfeeding.

How can I include iodine in my diet?

• regularly include fruit, vegetables, fish and iodised salt in your diet • these days breads and cereals are made with iodised salt, and some pregnancy and breastfeeding multivitamins – be sure to check the label.

10 Parenting Insights | 2017

Morning sickness Most women suffer from sickness early in their pregnancy.

Iron

This is usually due to hormonal changes of pregnancy and can

The amount of iron you need increases during pregnancy. Good

affect you at any time of the day. Symptoms usually disappear

dietary sources of iron include red meats, fortified breads and

or become much milder by around 16 weeks.

cereals, green leafy vegetables, legumes and some nuts. You

Some tips to help you manage your morning sickness include:

can help your body absorb more iron from non-meat sources

• eating small amounts every two hours as an empty stomach

by including Vitamin C rich foods at the same meal e.g. tomato, capsicum, citrus fruits and kiwifruit.

It can be hard to get enough iron from your diet. An iron supplement could be useful and may be recommended by your

can cause nausea • avoiding smells and foods that make you feel worse • eating healthier carbohydrate foods such as dry toast, crackers, breakfast cereals or fruit

dietitian, midwife or doctor.

• eating fewer fatty and sugary foods.

Fish, omega-3 and mercury

Listeria

Fish is an important part of your diet. It is an excellent source

When you become pregnant, it is important to be careful with food

of protein and is low in saturated fat. It also has high amounts

that might be contaminated with Listeria. These bacteria move into

of omega 3 and is a good source of iodine. However, a small

the placenta and can cause premature birth or miscarriage.

number of fish contain higher amounts of mercury. Food

Foods that might carry Listeria and should be avoided include:

Standards Australia New Zealand has set the following guidelines

• raw/ uncooked /smoked meat and seafood,

for safe fish intake during pregnancy and women planning a

ready to eat chilled seafood

pregnancy (1 serve = 150 g):

• deli meats, cooked cold meat, pate, meat spreads

• one serve per fortnight of shark (flake) or billfish

• leftovers (more than 24 hours after cooking)

(swordfish/broadbill and marlin) and no other fish

• pre-prepared salads, smorgasbords, buffets

that fortnight

• unpasteurised milk and soft serve ice cream

OR

• soft cheeses (brie, camembert, ricotta, feta, blue).

• one serve per week of orange roughy (Deep Sea Perch)

Hard cheeses like cheddar and tasty are safe processed

cheeses, plain cream cheese and plain cottage cheese

or catfish and no other fish that week OR

• two to three serves per week of any other cooked fish and seafood not listed above.

are fine if purchased sealed and stored in the fridge • unwashed raw fruit and vegetables • raw eggs or foods containing raw or partially cooked eggs.

Caffeine

It is easy to make safe choices by following these tips:

Limit drinks containing caffeine during pregnancy. Cola,

• freshly prepared and cooked foods have low levels of bacteria.

Mountain Dew soft drink, tea, coffee, chocolate, chocolate-

Bacteria grow over time, so avoid eating food if it has been

flavoured beverages, cocoa and guarana energy drinks all

made more than 24 hours since being prepared. Always

contain caffeine. It is best to not have more than three serves per day of these food and drinks.

reheat to steaming hot • raw fruit and vegetables should be washed thoroughly before eating

Alcohol There is no known safe level of alcohol intake during pregnancy.

Alcohol crosses the placenta and can lead to physical, growth and intellectual problems in some babies. It is recommended to

• Listeria is destroyed in normal cooking, so freshly cooked hot food is safe if eaten straight away • even those foods listed above that are higher risk can be eaten safely if heated above 74° C for over two minutes.

avoid all alcohol during your pregnancy.

Article courtesy of Mater Mothers’ Hospitals For further information on healthy eating during pregnancy, visit matermothers.org.au

2017 | Parenting Insights

11

The importance of a quality nursing bra

A

mong the more noticeable physical changes brought on by pregnancy are the changes to breasts, and with changes to

breasts, you need to consider changes to your choice of bra.

First off, you’ll need to say goodbye to traditional bras for a while. A standard bra doesn’t have room for the diaphragm to grow during pregnancy and they also generally have an underwire which is not recommended to wear whilst pregnant or nursing.

In comparison; a quality maternity bra, such as one made by Exhibitor Hotmilk, has soft cups and double the rows of hooks and eyes.

This allows room for the diaphragm to expand during pregnancy and lets you tighten the bra after the baby is born and the diaphragm settles. That means you’ll be more comfortable and have a beautifully supported silhouette!

But why no underwire? Underwires place pressure on the milk ducts and soft, tender tissue of the breast, they can potentially block milk flow and lead to plugged milk ducts. This can lead to nasty infections which in turn require antibiotics which can interrupt your breastfeeding routine.

A good maternity bra is designed to give you all the support you need – definitely in larger cup sizes too. Hotmilk’s use of technologically advanced power fabric, perfectly designed cup pattern structures, cotton-lined straps – ruched with satin bows of course, plus intensive research and testing on real pregnant women means superior fit and shape.

Seams and stitching across the nipple area or unlined bras can cause irritation to already sensitive and tender breasts. Hotmilk bras have either concealed seams or seams designed to avoid the nipple area to minimise the risk of chafing. Soft 100% cotton lining provides the ultimate in comfort and support and breathability.

The right choice of bra can lift your spirits and self-esteem too. Maternity lingerie that enables you to look and feel feminine, sexy and empowered is a factor as important as practicality. Being pregnant or a new mum has its challenges and wearing lingerie that makes you feel in any way frumpy or less than your best doesn’t help. The Hotmilk range features sexy, feminine styles made from exquisite fabrics and laces, embellished with satin and diamante.

Article courtesy of Hotmilk Lingerie au.hotmilklingerie.com

12 Parenting Insights | 2017

Keeping fit during Pregnancy Exercising and maintaining your

Caesarean deliveries have not been shown

fitness during pregnancy is vital, not

to offer protection against incontinence in

only for helping your body handle the

the long term if the pelvic floor muscles

extraordinary stresses and demands of pregnancy and childbirth, but

have been affected during pregnancy.

The good news is incontinence can be prevented or cured in most cases, with

Pelvic floor muscle exercises work best

to help your physical (and mental)

health professionals recommending pelvic

in conjunction with other daily healthy

recovery afterwards. This article offers

floor muscle exercises as the first line of

bladder and bowel habits, such as

an overview of how to exercise safely

defence (Fritel, et al., 2010; Price, et al.,

drinking up to two litres of fluid (preferably

during pregnancy, and where to go for

2010). These exercises are important for all

water, especially if you are breastfeeding),

men and women, but particularly pregnant

eating a healthy, balanced diet, and

women and women who have had a baby.

undertaking regular exercise to maintain

further information and /or help.

Pregnancy and the pelvic floor

a healthy weight.

prepare to be inundated with stories –

So how do I exercise my pelvic floor?

primarily bad – about stretchmarks, reflux,

Pelvic floor exercises can be done

How do I exercise and maintain my fitness during pregnancy?

swollen ankles and the lack of decent

anywhere, seated or standing.

Regular exercise during pregnancy is an

When you announce you are pregnant,

maternity wear.

What you won’t often hear though, are the stories of women losing control of their bladder and wetting their pants. It is

1. Visualise a muscular sling as the floor

essential way of helping your body handle

of your pelvis running from your tail bone

the increased demands on your joints,

to your pubic bone.

muscles, heart and lungs.

2. Lengthen your spine and relax

Regular exercise (at the right intensity)

something women should be told given

your shoulders. Focusing on your back

can help reduce back pain, improve or

research shows one in three women who

passage, lift and squeeze upwards and

maintain muscle tone, reduce leg cramps,

have ever had a baby will wet themselves

inwards as though you are trying to avoid

swelling and constipation, and improve

(Chiarelli, Brown, & McElduff, 1999), and the

passing wind, then bring that pelvic floor

sleep patterns. Women who exercise

more babies you have, the more likely you

lift through to the front, as though you are

regularly often feel better about themselves

are to leak urine.

also trying to stop the flow of urine.

and their changing body during pregnancy.

And while incontinence should not

3. Lift and squeeze your pelvic floor

be considered normal or a natural part of

for as long as possible. Aim to hold for

having a baby, pregnancy can lead to its

three seconds initially, building up to 10

Ideal exercises during pregnancy (if no complications)

onset due to several factors.

over time. Make sure you breathe normally

• walking

One such factor is the production of

throughout and ensure your shoulders,

• low impact aerobics

the hormone relaxin, which softens the

buttocks, thighs, hands and feet remain

• water aerobics

tissues in your body, allowing them to

relaxed.

• pregnancy exercise classes

expand as your baby grows. It also allows

4. Rest your pelvic floor for the

• cycling (on a stationary bike)

your pelvic floor to stretch during birth.

same amount of time as your lift, before

• swimming (freestyle not breaststroke)

The softening effect of relaxin,

repeating. Aim for three to five, or even

• light weight training (see your fitness

combined with the increasing weight of

10-second holds in one set. Repeat twice

your baby places pressure on your pelvic

more throughout the day.

instructor for assistance with your program)

urinary leakage. The pelvic floor muscles

or relax, or if you want to make sure

Exercises to avoid during pregnancy

and ligaments, which help to keep the

you’re using the correct technique,

• heavy weights

bladder shut, are also stretched at birth and

make an appointment with a continence

• bouncing – especially star jumps,

can be permanently lengthened.

professional.

floor muscles, makes you more at risk of

14 Parenting Insights | 2017

If you can’t feel your muscles hold

or similar activities

• contact sports

• high impact or jerky movements

• any activities or exercises

• prolonged bouncing, as this can

that cause pain • excessive twisting and turning activities • exercises that require you to hold your breath • exercises that involve standing on one leg for a period of time • pushing off with one leg at a time when

overstretch the pelvic floor muscles.

The Foundation has also written a booklet, The Pregnancy Guide, a FREE resource

Remember that pain or shortness of

for women and health professionals

breath should not be felt at any time.

available in hard copy or downloadable

STOP exercising and seek advice from

from the Continence Foundation of

your doctor or midwife if you experience

Australia website.

any of the following: • dizziness, faintness, headaches, blurred vision, nausea or vomiting

The Pelvic Floor First website pelvicfloorfirst.org.au has further information on safe exercises, as well

swimming – try to push off with both

• any kind of pain or numbness

as more detailed information on pelvic

feet when turning

• discomfort or feeling extremely tired

floor muscle exercises and causes and

• excessive breaststroke at the end of your pregnancy, as this puts stress on your pelvis • prolonged standing, static exercises

after you have exercised • vaginal bleeding, contractions, leaking

that involve sudden changes in direction • lifting your hip to the side while kneeling on your hands and knees • activities involving sudden changes in intensity • exercises that increase the curve in your lower back

Women can also phone the

of amniotic fluid (the water around your

FREE National Continence Helpline

baby), or reduced movements of your baby.

on 1800 33 00 66, which is staffed by continence nurse advisors who can

e.g. standing still and doing arm weights • highly choreographed exercises or those

symptoms of incontinence.

Where can I get more information?

offer advice, resources and referrals to

The Continence Foundation of Australia,

local clinics.

in conjunction with The Pregnancy Centre, has developed a FREE Pregnancy Pelvic Floor Plan app, which guides women through safe exercising during pregnancy

Article courtesy of Maria Whitmore Continence Foundation of Australia and The Pregnancy Centre continence.org.au

and the maintenance of bladder and bowel health.

2017 | Parenting Insights

15

Baby steps along the way The stages of pregnancy

W

hether you are pregnant for the first time or an experienced mum, every pregnancy will be unique. A normal pregnancy lasts between 37 and 42 weeks, usually an average of 40 weeks, with the weeks of pregnancy divided into three sections (or trimesters).

But what’s going on inside your growing belly during this time? Here’s what usually happens to you and your developing baby from day 1 to delivery.

First trimester Weeks 1 to 12 You – During the first trimester, pregnancyrelated hormone changes can affect your whole body.

When you are pregnant, your womb doesn’t shed its lining as it normally does at the end of your menstrual cycle, so you won’t have a period. So for some women, a missed period is the first sign of a pregnancy.

As well as a missed period, you might have other early symptoms of pregnancy, including: • tender or swollen breasts • needing to pass urine more often • tiredness due to hormonal changes • nausea and vomiting (morning sickness) • feeling bloated • mood swings • food cravings or aversions.

Not all women have all of these symptoms Your baby – In the first trimester, your baby’s body and organs develop quickly.

By the time you are 10 weeks pregnant all your baby’s body parts are present, if not quite fully developed.

There will be a heartbeat, and tiny fingernails on tiny hands, and a face with a profile.

Your baby gets nutrients from your blood through the placenta, while waste products from the baby are returned to your circulation to be removed from your body.

By the time you are 12 weeks pregnant your baby is about 60 mm long. At this stage, your baby’s forehead grows with the developing brain, the ears are forming, and the eyelids are still sealed shut to protect the developing eyes. The baby is also able to make a fist as its muscles and nerves start to work together.

Second trimester Weeks 13 to 27 You – Your pregnancy will start to show during the second trimester although exactly when this happens varies from woman to woman.

Any sickness or nausea usually gets better by the time you’re 16 to 20 weeks pregnant.

You may get backache, hip pain or pelvic pain because pregnancy hormones cause your ligaments and tendons to relax, and your posture may change as your baby grows.

You may first feel the baby move around 18 to 20 weeks, but this varies between women and may be a few weeks earlier if it’s not your first pregnancy.

The movements become much more vigorous and obvious as the baby gets bigger and stronger.

Your baby – In the second trimester, your baby’s organs grow larger and mature, muscles continue to form, and the skeleton starts to harden. The baby’s kidneys start to work and pass small amounts of urine.

By 19 weeks your baby is more active, is able to hear, and is covered in fine hair called lanugo. Your baby now has eyebrows and eyelashes; toenails have formed and unique footprints and fingerprints. By the end of the second trimester, your baby has a chance of surviving if born prematurely, but would need

Sources Australian Government Department of Health. Healthdirect. Pregnancy birth and baby [Online] [Accessed Jan 2015] Available from: pregnancybirthbaby.org.au womenshealth.gov Office on Women’s Health. US Department of Health and Human Services [Online] [Last updated Sept 2010, accessed Jan 2015] Available from: womenshealth.gov © Bupa Australia Pty Ltd January 2015. This information is intended as a guide only and should not be relied on as a substitute for professional medical advice. Bupa Australia Pty Ltd is not liable for loss or damage you suffer arising out of the use of or reliance on the information, except that which cannot be excluded by law. Consult your physician or other medical professional if you have questions.

16 Parenting Insights | 2017

intensive care. If you have a scan at this stage, it’s often possible to find out the baby’s gender.

Third trimester Weeks 28 to 40 You – This is the home stretch as many women give birth around 39-40 weeks.

Braxton Hicks contractions (practice contractions) can start in the second trimester, but are much more likely in the third. These can be mistaken for labour but the difference is that real labour contractions will continue to occur regularly. Braxton Hicks contractions only last about 25 seconds. You may find at this time that the extra weight you are carrying can make you tired. You may also get breathless as your expanded womb makes your lung capacity smaller. Some women have trouble finding a comfortable position to sleep in.

As your abdomen and breasts grow, you may get stretch marks. These are harmless and usually fade after the baby is born. Towards the end of your pregnancy, generally from 37 weeks onwards, your baby ’engages’ by moving into a ‘head down’ position into your pelvis, getting ready for delivery. This can cause pressure on your bladder and you may need to pass urine more often.

Your baby – Your baby’s lungs mature throughout the third trimester and by 32 weeks your baby is much more likely to survive if born prematurely. Your baby makes breathing movements, even though the lungs don’t work properly until birth.

Your baby gets bigger and bigger as it stores fat in preparation for life outside the womb. Your baby loses the lanugo, grows fine hair, their eyes can open and close, and their teeth may start growing under the gums. By the end of 37 weeks the baby is considered full term, and the baby’s organs can function on their own.

Finally…Delivery day!

The cervix will begin to get thinner and softer and open (dilate) to prepare for delivery. You may feel sharp pains as the cervix dilates and the countdown to the birth of your baby begins!

Article courtesy of Bupa bupa.com.au

Managing morning sickness

he term ‘morning sickness’ is used to describe a condition

T

Treatments can include a variety of complementary therapies

‘nausea and vomiting in pregnancy’. It was thought that this

such as acupuncture and acupressure (similar to sea sickness)

condition was more common in the morning and hence the

with sea sickness bands also assisting some people. Ginger is

name. However, in reality it can occur at various times, and is

thought to be useful by some women and can be used in small

sometimes ongoing throughout the day. For many woman it starts

quantities. Seeing a complementary therapist in your preferred

fairly early in pregnancy at around 6 weeks and is usually resolved

treatment spectrum from acupuncture to naturopathy and

by 12 weeks when hormone levels begin to settle. However the

homeopathy is a method of treatment however this should also

variations are quite marked with some women experiencing no

be discussed with your pregnancy care provider.

symptoms at all and some experiencing the severe ‘hyperemesis

For women who would prefer medical treatment there are

gravidium’ which is characterised by extremely severe symptoms

a number of medications which may ease the symptoms of

often requiring hospitalisation for dehydration. This condition has

nausea and vomiting of pregnancy. These require prescription by

been made more well known recently by Her Royal Highness

your midwife, GP or obstetrician and if the symptoms are serious,

The Duchess of Cambridge Catherine.

you should have further investigations to ensure your blood work and scans are normal.

Nausea and vomiting of pregnancy can be

When things are very bad, resting and sleep often can be

managed by eating small, bland snacks and

difficult but necessary and for an unfortunate few women regular

meals and trying to maintain a relatively stable blood sugar by ensuring protein and complex carbohydrates.

IV fluids in your local emergency department may be necessary.

As with all health related problems a care provider who is empathetic to your needs and understands what you are experiencing is an important addition. Time cures all and for most women, the feeling will not last all pregnancy.

Some women find a variety of foods, smells and other elements (fatigue, heat) make them feel worse. This condition is worse in conditions where the woman’s BHCG levels are higher, such as is the case early in pregnancy and with multiple pregnancies.

Article courtesy of Liz Wilkes Liz is the Managing Director of My Midwives and the Pregnancy Babies & Children’s Expo Consultant Midwife.

She has been a midwife for over 20 years.

2017 | Parenting Insights

17

Gestational diabetes

Understand why it is important to try and avoid it, or control it, if it develops.

Gestational diabetes affects

So what is gestational diabetes?

5% of pregnant women.

Insulin is a hormone produced by the

How can it complicate a pregnancy?

pancreas that enables the body to use

Uncontrolled elevated glucose levels

Gestational diabetes is a

sugar or ‘glucose’ as an energy source. In

in pregnancy results in mild to severe

condition that occurs in

pregnancy, it is normal for the cells of the

consequences for not only the mother

pregnant woman for a variety

pregnant mother to become a bit resistant

but especially her baby. If a woman

to insulin. This resistance is caused by

already has unmanaged diabetes at

hormones produced by the placenta and

conception or early in pregnancy, there

starts in the middle third of pregnancy

is already a 2 to 3 fold increase in the

and is usually diagnosed at

and peaks in the last third. This is a natural

chance of having a miscarriage. There is

about 28 weeks.

mechanism in the pregnant body to make

also a 3 to 4 fold increase in the rate of

the mother use more of her fat as a fuel

congenital abnormalities, such as heart

source, thereby making available more

abnormalities, spinabifida, abnormal

of her glucose and protein for her baby’s

development of the lower spine and

growth.

limbs, and facial clefts.

of reasons. It affects about 5% of pregnant women in Australia

Gestational diabetes therefore occurs

Then there are a number of problems

when the mother’s pancreas is unable to

as the pregnancy advances. The baby has

make enough insulin to overcome this

a higher chance of prematurity with all

resistance, and the glucose in her body

the consequences of a baby in a nursery

rises to higher levels. It is this chronically

needing oxygen, help with breathing, poor

elevated glucose level that causes many

sugar control, and problems with jaundice.

problems for the mother and the baby.

18 Parenting Insights | 2017

We know that the mother’s elevated

normally then the mother can possibly go

While fasting the mother takes a blood

glucose level causes excess nutrients to

up to a week past her expected delivery

test and then drinks a standard sugar

be passed to the baby making the baby

date. However sometimes the pregnancy

drink and a second blood test is taken

grow more than it should which is termed

may need to be induced earlier, often at

at 1 and 2 hours after the drink. Elevated

‘macrosomia’. It is good to have a nice

38 weeks, to ensure a safe outcome for

glucose levels imply gestational diabetes.

healthy baby, but too big makes it more

the mother and baby.

At this time it is so important for the

difficult to be delivered. So the caesarean

If gestational diabetes is poorly

mother to be given a full explanation

section rate is higher, and the mother

controlled in pregnancy, it can affect

and information, so that she can gain an

has to have a major operation that could

long-term development and function

understanding of the disease. She is then

perhaps have been avoided and born

of pancreatic and fat tissue in the

referred to a diabetic educator who will

vaginally there may be increased risks

child, continuing to adulthood. As a

discuss dietary changes.

of birth trauma to both the mother and

consequence these babies as adults have

her baby. Sometimes the placenta gets to

a higher chance of obesity and diabetes

than 40% of total calories, and spreading

its ‘used by date’ too soon and the baby

themselves at an earlier age. We call this

the load through the day, will make a

doesn’t get enough nutrients and fails to

the metabolic syndrome.

difference. So 3 small to moderate meals,

grow adequately. This is called growth

Limiting carbohydrate intake to less

and 3 or 4 snacks per day, is the goal,

restriction and the baby may need to be

Are you at risk?

concentrating on unprocessed low

born early.

Inherently people have a genetic

GI foods that have slower absorption

susceptibility to developing gestational

(more fruits, vegies and grains; less flour

Preeclampsia or ‘high-blood pressure

diabetes and there is not much you can

as in bread and pastries, and potatoes).

in pregnancy’, this condition alone

do about your genes! So firstly, you know

The mother will check her blood sugar

impacts on foetal growth, and in the

you are at increased risk if you belong to

levels on waking and then 2 hours after

mother can have serious consequences

a high risk ethnic group. Other risk factors

breakfast, lunch and dinner. The vast

if untreated, including fitting and stroke.

include a family history of diabetes, or

majority of women will control their

Polyhydramnios where there is excess

gestational diabetes in parents or siblings,

sugar levels adequately. Occasionally

fluid in the sac is another condition. As

a personal history of gestational diabetes

extra insulin is needed which is given as

the baby is floating in a large ‘swimming

in a previous pregnancy, if the mother

a single dose or as a number of injections

pool’, when labour does come it may

herself was born greater than 4.1kg in

throughout the day. Exercise can help too,

be in an unusual position and so unable

birth weight, or has had a baby herself

a moderate exercise program is sufficient

to be born vaginally. When the waters

weighing greater than 4.1kg.

and smoking is absolutely not a good

Gestational diabetes can also cause

break, they gush out fast, and if the head

And then there is weight, the most

idea! The better the control, the better all

is not low down ‘plugging the hole’ so to

important avoidable risk factor. If a

speak, the cord can be washed into the

woman has a BMI greater than 30 before

vagina and this is known as cord prolapse,

pregnancy, puts on excessive weight

management, most of the problems

an emergency situation, as the oxygen

in her pregnancy, or has a history of

related to gestational diabetes can be

supply is interrupted to the baby with dire

significant weight gain in her life, or

controlled and overcome, so the outlook

consequences.

has put on excessive weight between

is positive! But it is important for those

pregnancies, she is at a significant

who have had gestational diabetes, to

associated with GD, the mother will be

increased risk of developing

appreciate the increased risk of diabetes

seen more often during her pregnancy

gestational diabetes.

later on in life, and to have a yearly check

Because of all the problems

with extra ultrasounds and foetal

During pregnancy with good

with their GP.

of her pregnancy to check the baby’s

Testing for and managing gestational diabetes

growth and well-being. If the sugar

At around 26 to 30 weeks a test is done

control is good and the baby is growing

called a Glucose Tolerance Test (GTT).

monitoring particularly towards the end

the outcomes!

Article courtesy of Dr Grant Saffer

2017 | Parenting Insights

19

Adjusting to Fatherhood

Becoming a father can be one of the most life changing experiences in a man’s life.

Changes to the relationship with your partner, balancing work and family life, and learning to care for a newborn can be challenging.

Most dads will feel stressed at times as they navigate sleepless nights and major changes in relationships and routines. For some men the reality of fatherhood can be overwhelming. Just like mums, dads can also become distressed. Recent research reports 1 in 10 new dads will experience depression during pregnancy or the postnatal year.

20 Parenting Insights | 2017

L

ooking after yourself, your relationship and your baby are an important part of making a healthy transition to fatherhood.

Show your affection through touch and communication.

So what are the common concerns new dads experience, and

Kissing, cuddling and

how can dads help themselves and their family manage the

compliments are all great

first 12 months?

ways to let your partner know how you feel about her.

From my own research, the 3 most common concerns of new dads are:

Helping around the

‘Sex might be on hold for a while. Try not to be impatient because this might damage the intimacy between you in the long run’ SMS4dads

house and with the baby is another great way to help your relationship. Giving your

1. ‘Work and financial commitments concern me more now I have a family’

partner time-out can help provide a better environment for intimacy.

Feeling the extra pressure as the family’s primary provider is quite normal, particularly when work arrangements offer little flexibility.

In fact, 4 out of 5 of the dads in my study report financial

3. ‘I don’t understand what is wrong with my baby when he/she cries’

pressure and supporting the family as a main source of stress.

Understanding what your baby needs is a big concern for

Talking to your partner and employer about how to negotiate

new dads. Like any new job the best way to gain skills and

balance, especially in the early weeks can reduce expectations

confidence is hands-on experience! So make the time to

and pressure on you and help you to feel more relaxed.

take the parenting reins. Bathing, settling, reading, changing

Balancing work and family commitments can also be

nappies and playing are all great

stressful for new dads. Over half of the dads in the study felt

opportunities for dads to bond

they didn’t spend enough time with their baby. This can be a

with their new baby. Smiling,

tricky balance but the focus should be on the quality, not the

singing and chatting with your

quantity, of time spent with your new baby.

baby will teach them important emotional and social skills well

‘New parents often worry about money at this time. If you and your partner have an honest discussion about money, you may both feel better’ SMS4dads

‘Just because I am sucking my hands doesn’t always mean I am hungry.

SMS4dads

before they can comprehend a single word. One-on-one ‘daddy’ time can help build a strong father-infant connection and give mum a well-deserved break.

The new innovative SMS4dads program developed by the Fathers and Families Research Team at the University of Newcastle provides new dads and dads-to-be with great tips and advice direct to their mobile phone to help tackle these concerns and more.

2. ‘I am unsatisfied with the frequency of sexual activity in our relationship’ At first the excitement of a new baby can strengthen a couple’s emotional connection. But as sleepless nights and the reality of parenting kicks in a couple’s intimate relationship can suffer. Childbirth and motherhood is a big change for your partner too! Getting your sexual relationship back on track may take some time. In the meantime, there are other

Article courtesy of Peach Tree Perinatal Wellness peachtree.org.au Written by Jaime Wroe Researcher in the Fathers and Families Team at the Family Action Centre, University of Newcastle For more information visit SMS4dads.com or email jaime.wroe@newcastle.edu.au

ways to connect intimately with your partner.

2017 | Parenting Insights

21

Am I in labour?

As you enter the final stages of your pregnancy, your body will give signs that labour is approaching.

The following information should help you to understand these signs and make it easier for you to determine whether you are in labour.

22 Parenting Insights | 2017

S

ome of the signs and symptoms of going into

that your baby is distressed. You will need to ring the hospital

labour may include:

immediately and then come into the hospital.

• period-like cramps

• backache

• gush or trickle of water

• mucous discharge

as the membranes break • diarrhoea

or ‘show’ • contractions

Braxton Hicks contractions Braxton Hicks contractions are sometimes mistaken for labour.

These ‘practice’ contractions usually start halfway through the pregnancy and continue right through to the end. These

Engagement

contractions are often irregular and can be uncomfortable and

As you move closer to delivery, your baby’s head may drop and

tight. Braxton Hicks contractions usually increase in regularity

become engaged in your pelvis in preparation for labour. If you

and strength towards the end of your pregnancy, preparing your

are expecting your first baby, you may notice pressure in your

uterus for the birth. Sometimes it is difficult to distinguish between

groin and on your bladder beginning up to four weeks before the

these Braxton Hicks contractions and labour contractions. Below

birth. You may also notice that you can breathe a little easier and

are the common differences between the two.

have a little more appetite as your baby drops, and is not pushed up against your diaphragm and stomach quite so much. This is

Labour contractions

sometimes known as ‘lightening’, as women generally feel lighter.

True labour contractions usually increase in strength and duration. In order to time your contractions, time the interval

Show

between the start of one contraction to the start of the next.

During your pregnancy a mucous plug fills your cervix. Towards

Early labour contractions are often likened to period cramps

the end of pregnancy, the cervix becomes softer and this

with or without backache.

mucous plug may become loosened and start to come away.

The process of discharging this mucous is called a ‘show’ and

Braxton Hicks Contractions

Labour Contractions

might often contain streaks of blood or may also be brownish in

• usually irregular and short

• become regular with time

colour. This is different from any flow of fresh blood which you

• do not get closer together

• get closer together with time

would report immediately to your doctor or the hospital. The

• do not get stronger

• become stronger

show may continue over a period of hours or even days. It is one

• walking does not make them stronger

• walking makes them stronger

• lying down may make them go away

• lying down does not make them go away

• uncomfortable and tight – not painful

• painful

of the signs that your body is preparing for birth. Labour may begin in the next few days, hours or weeks following a show.

There is no need to phone the hospital if you have had a show.

Water breaking (rupture of membranes) This may occur at any time prior to the start of labour, or at any

How does labour start?

time during labour. The break may be low, near the opening

Labour can start in different ways. You may be start experiencing

of the uterus, and will produce a gush of amniotic fluid. If this

some period like pains or contractions. You might notice that

occurs, place a sanitary pad on and note the colour of the fluid.

these tightenings/contractions start to get stronger, closer and

Ring the hospital and tell the midwife that this has occurred. You

last longer than before. Or you might start with some back ache

will usually be asked to come in to the hospital.

or a stomach upset that gets stronger and develops into regular

Another type of amniotic fluid leak may occur higher up in the amniotic sack, or top of the uterus. This will be less obvious

contractions. In approximately 10 – 15% of women, labour will start when your membranes rupture. Contractions usually follow.

to you and you may only notice a trickle of fluid. Since many women have a heavy vaginal discharge or leak a small amount of

Should I call the hospital?

urine towards the end of their pregnancy and it is often difficult

You should call the hospital when:

to tell the difference. Urine is often yellow, where amniotic fluid is

• your waters break

usually clear, or has a pink tinge, and has a ‘sweet’ odour. If you

• you have bright blood loss

are unsure, ring the hospital.

• your contractions are regular and five minutes apart

If the colour of the fluid is green or brownish, it indicates that

• you are ready to come into hospital

your baby has passed a bowel motion (meconium) inside the uterus. It is very common to have meconium-stained amniotic fluid in a pregnancy over 41 weeks, but this may also be a sign

Article courtesy of Mater Mothers’ Hospitals For further information on labour, visit matermothers.org.au 2017 | Parenting Insights

23

Tips for recovery after a caesarean

A

fter a caesarean birth you will be uncomfortable for a few days. Taking regular pain relief is very important to your

recovery. Let your midwife know if you require any pain relief or

Walking will also help to reduce the swelling of your feet, relieve stiffness and the discomfort of trapped wind.

Please discuss any concerns with your doctor or midwife.

anti sickness medication. Your catheter, drip and wound drain

If you have not passed wind, or have some wind pain, try:

(if you have one) will be removed in the first one to two days

• pelvic rocking and knee rolling

depending upon your recovery.

• gentle wind massage: start at the lower right side of your

It is important to let your midwife and/or physiotherapist know

tummy, using a gentle slow circular motion as you slowly

if you are having difficulty passing urine, passing small amounts of

move up to waist level, move across the belly button and down

urine or having accidental loss of urine.

the left side

Maintaining good hygiene is important to prevent infection: • shower daily and dress in fresh clothes • do not use a hair dryer on the wound, as drying the wound delays the normal healing process • if your wound oozes fluid or blood — report this to

• standing, lean forward onto the end of the bed and do some gentle hip circles • warm showers • frequent walks • relax on the toilet in the “hips flexed” position.

your doctor or midwife immediately.

Postnatal exercises are especially important after a caesarean

How to protect your incision when you cough

section to get your muscles working again, but take things at a

Sit forward in a chair if possible. If in bed, bend your knees up.

gentle pace. The midwife or physiotherapist will tell you when

Place both hands over your wound, anchoring your fingers onto

you should begin them.

the pubic bone, with your forearms resting firmly across the abdomen. Draw in the pelvic floor and hold arms in firmly as

Mobility and exercises

you cough.

Initially after your operation you will be resting in bed. During

While still in bed, you can

this time it is important to do deep breathing and leg exercises

• take five or six deep, slow breaths each hour—relax your

regularly. Bed exercises and walking around will reduce the

shoulders as you exhale

likelihood of chest infections and blood clots in your legs.

• bend ankles up and down, tighten thigh and buttocks muscles

It is normal to have increased swelling of your hands and feet after

• gently draw in the pelvic floor muscles, pause, then let go

the birth. Continue to drink fluids, go to the toilet regularly and rest

• draw in the pelvic floor muscles before and as you move your

with your legs above the level of your heart.

legs, but always keep breathing—this protects your tummy from strain

24 Parenting Insights | 2017

• With both knees bent up, try slow, gentle:

during the labour. Either of these scenarios can occasionally

– pelvic rocking

leave a woman and her partner feeling disappointed, confused,

– knee rolling

distressed or feeling a loss of control.

• change the position you are resting in, often

It may be helpful to talk about these feelings with the doctor or

• aim to do these exercises two or three times each hour

midwife and have your questions answered. You may also like to

• if you are feeding your baby in bed, make sure you are not

speak with a pastoral care worker or the patient representative or

resting on your tailbone: – If sitting, put the back of the bed right up, place a small

you may wish to access a community support group that focuses on emotional wellbeing. This may be beneficial in the days/weeks

pillow / rolled up towel behind your lower back. Try not to

or even months after the birth of your baby. If you would like to

slide down the bed.

discuss any aspects of your operation or care please discuss with

– If lying on your side, make sure your head and neck

your obstetrician.

are supported on a pillow. Ensure that your body is not twisted; a pillow between your knees might feel more

Pain relief at home

comfortable.

If your pain increases after you go home you should consult your obstetrician, GP or nearest hospital. If you have any concerns

Planning for home

regarding your pain relief, safety of any medication or how the

On the day you go home you will be independently caring

medication is affecting you, please call your GP or pharmacist.

for yourself and your baby. Your pain will be controlled with medication and your wound will be free from signs of infection, ie. no redness or drainage. While you should be able to perform all the normal activities to care for yourself and the baby, you should avoid doing anything which will cause you significant discomfort.

Gradually you will be able to return to your full range of duties.

This can take a variable amount of time between two and six

Acknowledgments and references • Staff of Mater Mothers’ and Mater Mothers’ Private and Mater Private Hospital Redland • Mater Consumer Representatives Maternity Coalition • Caesarean Awareness Network Australia • Birthtalk: Support, Education and Celebration of Birth • Understanding NICE guidance—information for pregnant women, their partners and the public (2004) National Institute of Clinical Excellence

weeks. Listen to your own body.

Debriefing after birth

Article courtesy of Mater Mothers’ Hospitals For further information visit matermothers.org.au

For some women the decision to have a caesarean will be made weeks before the birth. For other women the decision is made 2017 | Parenting Insights

25

Making up your baby’s cot Sleep Baby in a safe cot in parents’ room for the first 6 –12 months of life

Use a safe cot that meets the current Australian Standard AS2172 Do not use pillows, doonas, soft toys, cot Use a safe mattress: firm, clean, flat

bumpers, or lambswools anywhere in the cot

(not tilted or elevated), right size for the cot Do not put your baby to sleep Sleep baby on back

on a water bed or bean bag

Keep head and face uncovered

Keep baby smoke free

Position baby’s feet at the bottom of the cot

Breastfeed baby if you can

Tuck blankets in firmly or use

Maintain a safe sleeping

a safe baby sleeping bag

environment night and day

For more information on Safe Sleeping, including information statements, visit rednose.com.au/section/safe-sleeping.

For information on the use of portable cots, what is a safe mattress and how firm should a mattress be, please refer to our Safe Sleeping FAQs at rednose.com.au 26 Parenting Insights | 2017

It is not normal for breastfeeding to hurt Many mothers feel some nipple pain that ceases beyond the initial attachment in the early weeks. If pain lasts beyond the initial

Night feeds are important for babies and mothers

attachment or if there are signs of nipple damage, these things

Prolactin (the hormone that tells the breast to make milk) is highest

usually mean that a baby is not attached well to their mother’s

at night, so night feeds are important for your milk supply. Babies

breast. If your nipple becomes sore after a period of comfortable

have small stomachs that need to be re-filled often, including

feeding, you may have a nipple infection. If breastfeeding hurts, get

during the night. Night feeds ensure that a mother and her baby

help as soon as possible. For example, call one of our breastfeeding

have close contact around the clock. This helps a baby’s fast-

counsellors on the Breastfeeding Helpline on 1800 686 268. The

growing brain.

earlier a breastfeeding problem is dealt with, the easier it is to fix. If a counsellor feels you need more help, she will suggest a lactation

Breastfeeding mothers get more sleep

consultant or a medical adviser.

During the first 3 months, parents of exclusively breastfed babies may actually sleep longer at night (by 40 minutes on average) than

Most mothers can produce enough breastmilk

parents of babies who are given formula. Giving formula at night

Most mothers can make more than enough milk for their baby

to try to get more sleep doesn’t work. It may make things worse

(or babies!). Indeed, having too much breastmilk is common. If a

(e.g. if your baby doesn’t react well to the formula). Missing night-

mother has a low milk supply it is usually because her baby is not

time breastfeeds can reduce your milk supply. In the time you

feeding often enough.

take to make up a bottle in the middle of the night, your baby may become more distressed. Once they get used to it, most mothers

Breast size has nothing to do with milk production

find they can pick up and feed their baby without waking fully.

Breast size depends on how much fatty tissue you have. The larger

Breastfeeding hormones help both mother and baby relax and

the breast, the more fatty tissue and vice versa. It is the amount of

get back to sleep quickly.

glandular (milk producing) tissue in your breast that matters. If you follow your baby’s lead and breastfeed whenever your baby shows that they need a feed (by squirming, grunting, mouthing their hands and nuzzling into your breast), you will have plenty of milk.

28 Parenting Insights | 2017

The truth about breastfeeding Taking your new baby home is a time of great excitement, yet not without its challenges; one of which can be breastfeeding. Below we share with you some truths to dispel a number of common myths about breastfeeding that can affect the breastfeeding relationship between you and your baby.

You don’t need to wait for your breasts to fill up with milk

Your breast is more than a dummy

You don’t need to wait a certain amount of time before putting

was invented to be an artificial breast! Babies don’t breastfeed just

your baby back to your breast – there is always milk there. Your

for food. This often comes as a surprise to parents, but babies go

breasts are making milk all the time. The rate is related to how

to the breast for many reasons — they may be hungry, thirsty, tired,

much your baby drinks. If they drink more/ less, your breasts will

hurt, over-stimulated, bored, lonely, in the mood for cuddles, etc.

make more/ less. So if your baby still seems hungry after a feed,

All are equally valid reasons to breastfeed.

A breast cannot be a dummy, as the dummy (like the bottle teat)

you can put them back to the breast and there will be more milk there for a top up.

How to separate fact from fiction?

• Speak to an ABA breastfeeding counsellor by calling

It is easy to tell how much breastmilk your baby is getting There are ways to tell whether your baby is getting enough (e.g. plenty of wet and dirty nappies, gaining weight, meeting

our Breastfeeding Helpline on 1800 686 268 • Look at the ABA website breastfeeding.asn.au and other ABA resources for current and accurate breastfeeding information

developmental milestones etc).

• Mix with other breastfeeding women

Soft breasts do not mean you have ‘lost’ your milk

• Seek a second (or third etc) opinion

Many mothers worry that they don’t have enough milk if their

• Be confident in your innate ability to breastfeed.

(e.g. attend ABA group get-togethers)

breasts feel soft, or if they cannot feel their let-down reflex. After

Nature has designed mothers and babies to breastfeed.

the early weeks, your body adjusts to your baby’s needs. The full feeling that you may have had in your breasts in the early weeks disappears. This simply means that your milk supply is now in sync with your baby’s needs. Some mothers never feel their let-down reflex. Fortunately there are other ways to tell when your let-down

Article courtesy of Australian Breastfeeding Association For more info visit breastfeeding.asn.au

reflex occurs. Your baby’s sucking changes from a shallow, quick suck to a deeper, more rhythmic suck and milk may drip from the other breast.

2017 | Parenting Insights

29

5

Unexpected tips for babies with colic

No one knows for sure what causes “uncontrollable crying in an otherwise healthy baby,” or why it tends to happen in the late afternoon or evening. More importantly, is there anything that new mothers can do about it?

What are the causes of colic?

Unfortunately, there isn’t a consensus as to what causes this frustrating behaviour. Mums can rest assured that it almost always goes away after 3 or 4 months. Over 60% of babies experience “colic” and only 1 in 10 still have it at 4 months of age.

It may also give you peace of mind to know that most doctors

According to one study 28% of parents who practiced infant massage felt that they were able to reduce their baby’s crying.

do not consider colic to be an illness or a symptom of a stomach ache, an allergy, or disease. There is no “cure,” for colic because

Create soothing sounds

recent research suggests that it is not an illness. Instead, it is a

The world is a noisy place for newborn babies. In fact, for some

behaviour – a result of the baby trying to adapt its nervous system

of the most sensitive little ones, loud noises might even be a

to the stress and stimulation of life outside the womb.

contributing factor in extended crying. The good news is that the

So, let’s look at 5 things that you can do to get through the tearful times and enjoy a positive experience with your baby.

opposite is also true; soothing sounds may calm your baby. Babies also respond to familiar voices. So, sing your baby a gentle lullaby or quietly hum while you sit together.

Try to relax Babies are super sensitive. Dealing with colic requires us to be calm

Get in motion

at a time when we feel the most stressed out. Remind yourself

Another way to re-create the baby’s sense of calm in the womb

that, even if your baby’s crying is frustrating and unnerving you,

is with calming movements. Other crying babies are calmed by

things will get better, naturally, in a few months. In the meantime,

smooth, rhythmic movements, like being rocked in a rocking chair,

anything that you can do to reduce stress in your, and your baby’s

hammock, or infant swing. You can also make it a point to get out

environment will help. Make sure that you get plenty of breaks

of the house every day with your baby. Not only will the motion

from caring for your child. If you can, seek support from your

calm your baby, but, it will also help you to feel relaxed, which will

partner, family, and close friends. Get out into nature and meet

create a virtuous cycle of positive emotions.

with other mums. Try to prioritise domestic tasks so you can spend

One of the myths about colic is that you can “spoil” your baby

more time focusing on providing a calm environment for the baby.

by responding to her cries or holding her too much. The evidence just doesn’t support this. Instead, it shows that colic can be

Try a gentle touch

overcome with patience, dedication and a sense of calm.

Anyone who has ever received a massage understands the power of touch to relieve stress. Well, massage isn’t just for adults – babies can benefit from massage as well! You don’t even need a “professional” to give your baby a massage. All you need is a warm bath, a quiet, dimly lit room and your own magical hands.

30 Parenting Insights | 2017

Article courtesy of Medela Australia medela.com

Expressing breast milk One thing you can always be sure of as a new parent is that there’s going to be a lot of experiences and things that you’ve probably never personally encountered before. Somewhere on that list you may well encounter expressing breast milk.

Why would I want to start expressing breast milk?

• If your baby was premature and unable

something only you can do for

to suck or you have been advised by

your baby. If you feel like you are trying

You may not want to express your breast

your healthcare professional that you

to channel a dairy cow, it is likely

milk, but you may need to. There are

should be expressing.

to lessen the experience.

many reasons for this, but some of the most common are:

How can I express?

What does expressing feel like?

• Being so full of milk that you need to

You have a choice of using a pump or

In a strange way, it feels like you imagine

expressing by hand. Some women find

it would. The pump creates a gentle

it impossible to express by hand; finding

and rhythmic pressure on the nipple

baby so you may want to express until

it awkward or difficult, others say they

and surrounding areola and is similar in

you “let down” and your flow slows to

prefer hand expressing as they find using

sensation to the baby sucking. Visually of

the point where your baby can suck

a pump uncomfortable. Some women

course, it is a different matter entirely.

more efficiently.

use a combination of techniques. How

Some babies have such a strong suck that

full you are, time restraints or location

in comparison a breast pump feels quite

can all affect choices.

gentle. However, for a woman whose

relieve some pressure.

• Your flow of breast milk is too strong for

• You would like your partner to feed your baby your expressed breast milk from a bottle.

There are no hard and fast rules

baby has not directly breastfed, because

when it comes to expressing – it’s all

of prematurity or illness, the breast pump

away from your baby for a while.

about what works for you. Pumps come

can, at first, feel quite strange.

• To build a storage bank for those

with a variety of options - manual, single

Expressing shouldn’t cause you pain

electric and twin electric. Depending on

or make you feel anxious. You should be

your individual needs, there is a suitable

relaxed and comfortable; so if things don’t

pump for you.

feel right, check the pump is correctly

• You are going out, working or will be

“just in case” occasions.

• If you are donating your breast milk to a milk bank.

assembled and all connections are tight.

• To boost your supply if you feel it is decreasing.

• If you need to take medication which is contraindicated with breastfeeding.

• If your baby is sick or in hospital.

32 Parenting Insights | 2017

Put your positive hat on

Also, remember to start pumping gently

A positive mind set is an important issue

and for manual pumps build up to the

with expressing breast milk. It will help

number of depressions on the lever to

you to feel more positive if you view

the point where you have a “let down”

expressing as a loving and nurturing act,

and your milk is flowing.

With an electric pump, you will be able to

• Suction will be affected if the funnel

adjust both the sucking pressure and the

and cushion of the pump are not

What does expressed breast milk look like?

firmly against your breast.

Mature milk looks very different to

duration of the sucking/pause cycles to replicate your own baby’s sucking action.

• Letting down itself can be almost

milk produced by mothers in the early

• If your breasts are very full of milk and

painful as the hormone oxytocin

newborn period. The early milk, or

you are engorged, expressing should

causes the milk to eject from the

colostrum, is low in volume but is a

come as a relief.

nipples there can be a stinging, sharp

perfect powerhouse of antibodies, fat and

feeling in both nipples. This is a separate

specific nutrients for a newborn.

• The pump funnel can feel cold when

sensation to that which is created by

first placed on the nipple/s.

• Some women describe feelings of sexual pleasure; others find this comparison almost laughable. Each woman and her own experience is unique.

• If you have very tender nipples, you

the pump itself.

• Expressing is not silent. The pump

underneath can appear watery. This can

can create audible sound.

lead mothers to thinking their milk is

• Find a comfortable chair, get yourself a drink and if possible, have your baby

initially but this should settle in less than

near you.

covering the nipple with the pump funnel and have it positioned centrally

fat rises to the top and the milk sitting

and your milk flowing into the bottle

may experience some nipple pain a minute. Make sure you are completely

Mature milk can appear quite watery with a bluish green tint. Given time, the

• You can try expressing one breast whilst your baby is feeding on the other.

• Be patient when you are expressing

over your nipple without pinching or

breast milk for the first few times.

compression.

It can take practice to become used

not strong enough, however, its nutrient composition is always perfect.

Article by Jane Barry Registered Nurse, Midwife and Child Health Nurse, BPM Australia philips.com.au/avent

to expressing and the mechanics of it can be a little tricky to start with.

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2017 | Parenting Insights

33

Important tips for hygienic handling of expressed breast milk Storage tips • Freshly pumped breast milk that you don’t want to use right

Tips on warming the milk • Warm breast milk in a bottle warmer (max. 34 to 37°C) or in

away should be placed in the refrigerator immediately. If you

a bowl of lukewarm water. Even though the milk may seem

express a second lot later on, you can add it to the first lot

a little too cool, it’s just the right temperature for your baby

once it has cooled. At the end of the day, you can freeze all the breast milk you have expressed in one container

• Never boil breast milk or heat it in the microwave. Valuable ingredients will be lost and your baby could scald its mouth.

• If you want to store breast milk in the refrigerator for a few days, place it on the lowest shelf at the back. This is the coldest part of the refrigerator. Never store bottles of breast milk on the refrigerator door • Label all containers with the date, so that you always use the oldest lots first

Cleaning tips • Clean everything that comes into contact with your breast, the breast milk or the baby’s mouth after every use: 1. Rinse everything with cold water.

2. Then wash it in warm soapy water.

3. Now rinse everything in clear water. Prior to the

Storage guidelines

first use, and once daily thereafter, boil all individual

• At room temperature 16 – 26°C Maximum 4 – 6 hours is optimal

components in a pan of water for five minutes.

• If hygiene conditions are very good, 6 – 8 hours is possible

Alternatively, place them on the upper shelf of the

• In the fridge ≤ 4°C Maximum 72 hours is optimal

dishwasher, or use a Quick Clean microwave bag.

• If the hygiene conditions are very good, 5 – 8 days is possible • In the freezer < -18°C 6 months is optimal • If the hygiene conditions are very good, 12 months is acceptable

Transportation tips • Keep breast milk as cool as possible during transportation, for example in a cool bag. Put this in the refrigerator the evening before and place the ice pack in the freezer. Put the expressing bottles on the bottom shelf of the fridge overnight.

Article courtesy of Medela Australia medela.com

34 Parenting Insights | 2017

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Practical tips on caring for your newborn When bringing your baby home for the first time you may feel excited but also nervous – each baby is different and they don’t come with their own manual. Mater Mothers’ Hospitals has provided some practical tips on getting through those first few weeks.

Baby girls can also have a small loss of blood from the vagina in the first week, like a small period. This usually lasts a few days only and there is a very small amount of blood.

For boys: Clean all around the folds of skin of the penis and scrotum, but leave the foreskin in place. If the foreskin is pulled back too early, scarring of the head of the penis may occur. The foreskin may take many years to roll down naturally. Boys can spray urine everywhere, so be very prompt when replacing the nappy.

Nappy changing • Gather everything you need and place it all within easy reach before you commence a nappy change so that you are not tempted to leave your baby unattended on a change table, for whatever reason.

• The height of the change table or any surface used for changing, or bathing, your baby should be just under the level of your bent elbow, so that your back stays straight.

• Always keep one hand on your baby, especially as they get older. At this point you could consider changing baby on a lower surface or a change mat on the floor.

• Encourage eye contact with your baby during nappy changing.

Please note: some babies, both boys and girls, can also have swollen breasts that feel quite lumpy and hard which may even ooze milk. Swollen breasts and vaginal blood loss in babies result from the hormones passing from the mother to the baby before birth. They are of no concern and usually resolve quickly.

Normal infant urine and bowel habits Urine You could expect that your baby will have one wet nappy on the first day, two on day two and three on day three, and so on until breastfeeding is established. Then you would expect approximately six to eight heavy wet nappies per day, with the urine a pale yellow in colour.

For girls: Wipe from front to back, wiping away any bowel motion or urine from their skin, leaving any protective mucous in the vagina.

If using disposable nappies it can sometimes be difficult to tell if the nappy is wet—feel the front and bottom of the nappy to check the crystals inside the nappy – if wet, they should feel full.

Some disposable nappies have a ‘wetness indicator’ which changes colour if the nappy is wet.

36 Parenting Insights | 2017

Bowels Your baby’s first bowel motions, called meconium, are black/dark green in colour and should occur within 24 hours of birth. After a

• There is a variation in the length of time it will take for the cord

few days of feeding the bowel motions change colour to brown/

to separate: however, this usually occurs between five and 15

green and then to a yellowish mustard colour which is loose with

days. When it is close to dropping off, you may notice old blood

small curds in it like cottage cheese.

around the base of the cord. It is normal for the cord to smell at

Your breast milk contains natural laxatives which prevent constipation. In the early days babies may have a bowel motion

this stage. Just clean as previously described.

• If the skin around the cord becomes red or hot to touch,

with every feed but this will slow down. The normal range of

looks inflamed, is offensive to smell or is noticeably draining

bowel motions is eight per day to one per week. If you have any

pus, show your midwife, nurse, doctor or child health nurse

concerns contact your midwife, doctor or child health nurse.

as soon as possible.

Formula fed babies are more prone to constipation. If this is a problem please seek assistance from your midwife, child health

Dressing your baby for climate

nurse or doctor.

• Dress your baby in similar weight clothes to yourself. The general rule is what you are wearing plus one layer, which is

Bathing

usually a light wrap. Hats should not be worn inside the house

• Gather everything you need and place it all within easy reach

once you are home from hospital as babies need to lose excess

before you start bathing your baby. Never leave your baby alone

heat from their heads and faces. If you have air conditioning

in the bath.

make sure the room does not become too cold — a room

• The temperature of the bath should be warm but not too hot.

temperature of around 24 – 26°C is appropriate.

You can place your elbow or wrist in the water to check the temperature — if it is comfortable then it should be suitable.

• Babies may only need to be bathed every second day in cooler weather but in warmer months a daily bath is recommended.

Weight • It is normal for your baby to lose some weight in the first few days, but they usually regain their birth weight by approximately two weeks of age. In hospital your baby will be weighed at birth

Cord care • The umbilical cord will feel cold and clammy, initially, and then will become quite dry and brown in colour.

• Wash your hands with soap and water before, and after, handling the cord.

• Check at each nappy change—there should be no blood loss.

and on discharge.

• If you wish to have your baby weighed after discharge there are several options, including: – Child Health Clinic — by making an appointment Some clinics have a drop-in area for self-weighing – Your GP.

• When re-dressing your baby, fold down the nappy. This helps keep the cord exposed to air (keeping it dry), reduces undue

Resources and contact numbers

pressure on the cord and prevents potential for infection

• Australian Breastfeeding Association 1800 686 268

through faecal contamination.

• Child Health 13 Health (13 432 584) ask for the child health nurse

• When bathing your baby wash the cord with water and dry gently when drying your baby.

• There are no nerve endings in the cord so you will not hurt

• Multiple Birth Association 1300 886 499 • National Prescribing Service Medicines Line 1300 888 763 • SIDS and Kids 1300 308 307

your baby when cleaning the cord.

Article courtesy of Mater Mothers’ Hospitals For further information visit matermothers.org.au

2017 | Parenting Insights

37

‘Our precious son passed away in our arms at just 32 days old. We were heartbroken.’

R

iley John Hughes was born a healthy and beautiful baby on February 13 2015. At four weeks old, he th

developed cold-like symptoms, and then a light cough. Riley was diagnosed with Whooping Cough (pertussis), and he

‘Riley may have lost his battle with this disease, but our family will keep fighting to ensure other families do not suffer from similar tragic circumstances.’ Catherine Hughes, Riley's Mum

rapidly worsened each day. He developed pneumonia, and on his fifth day in hospital, he couldn't fight any longer.

At the time of little Riley’s death, Whooping Cough Boosters during pregnancy were not regularly administered in Australia.

Since Riley’s death, the Australian state governments have announced free Whooping Cough booster shots for all pregnant women, reducing the chance of their newborn baby contracting Whooping Cough by 90%.

To honour Riley’s life, his family want to put an end to deaths from vaccine-preventable diseases, by raising awareness about the need for immunisation, particularly for adults who often aren't aware they require booster shots. They are also fundraising for Pertussis vaccine research via the Princess Margaret Hospital Foundation, Perth.

38 Parenting Insights | 2017

Article courtesy of Light for Riley facebook.com/lightforriley

National Immunisation Program Schedule Birth to 4 years of age – from November 2016

Child programs Age

Vaccine

Birth

• Hepatitis B (hepB)a

2 months

• Hepatitis B (hepB), diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, inactivated poliomyelitis (polio) (hepB-DTPa-Hib-IPV) • Pneumococcal conjugate (13vPCV) • Rotavirus

4 months

• Hepatitis B (hepB), diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, inactivated poliomyelitis (polio) (hepB-DTPa-Hib-IPV) • Pneumococcal conjugate (13vPCV) • Rotavirus

6 months

• Hepatitis B (hepB), diphtheria, tetanus, acellular pertussis (whooping cough), Haemophilus influenzae type b, inactivated poliomyelitis (polio) (hepB-DTPa-Hib-IPV) • Pneumococcal conjugate (13vPCV) • Rotavirusb

12 months

• Haemophilus influenzae type b and meningococcal C (Hib-MenC) • Measles, mumps and rubella (MMR)

18 months

• Diptheria, tetanus, pertussis (whooping cough) (DTPa) • Measles, mumps, rubella and varicella (chickenpox) (MMRV)

4 years

• Diphtheria, tetanus, acellular pertussis (whooping cough) and inactivated poliomyelitis (polio) (DTPa-IPV)

At-risk groups Aboriginal and Torres Straight Islanders

12 – 18 months (in high risk areas)e

• Pneumococcal conjugate (13vPCV)

12 – 24 months (in high risk areas)f

• Hepatitis A

6 months to less than 5 years

• Influenza (flu)

Other at-risk groups

6 months and over (medically at risk)

• Influenza (flu)

12 months (medically at risk)

• Pneumococcal conjugate (13vPCV)

4 years (medically at risk)e

• Pneumococcal polysaccharide (23vPPV)

Pregnant women (at any stage of pregnancy)

• Influenza (flu)

e

Footnotes to the National Immunisation Program (NIP) Schedule a. Hepatitis B vaccine: should be given to all infants as soon as practicable after birth.

The greatest benefit is if given within 24 hours, and must be given within 7 days. b. Rotavirus vaccine: third dose of vaccine is dependent on vaccine brand used.

Contact your State or Territory Health Department for details. c. Varicella vaccine: contact your State or Territory Health Department for details on the school grade eligible for vaccination. d. HPV vaccine: is for all adolescents aged between 12 and 13 years. Contact your State or Territory Health Department for details on the school grade eligible for vaccination.

e. Pneumococcal vaccine: i. Medically at risk children require a fourth dose of 13vPCV at 12 months of age and a booster dose of 23vPPV at 4 years of age. ii. Aboriginal and Torres Strait Islander children require a fourth dose of pneumococcal vaccine (13vPCV) at 12 – 18 months of age for children living in high risk areas (Queensland, Northern Territoy, Western Australia and South Australia). Contact your State or Territory Health Department for details. f. Hepatitis A vaccine: two doses of Hepatitis A vaccine for Aboriginal and Torres Strait Islander children living in high risk areas (Queensland, Northern Territory, Western Australia and South Australia).

Contact your State or Territory Health Department for details.

Further information and immunisation resources are available from the Immunise Australia Program website at immunise.health.gov.au or by contacting the infoline on 1800 671 811 © 2016 Commonwealth of Australia as represented by the Department of Health For updates to the National Immunisation Program schedule, refer to: immunise.health.gov.au/internet/immunise/publishing.nsf/Content/national-immunisation-program-schedule 2017 | Parenting Insights

39

Welcome to the 4th trimester!

P

regnancy has three trimesters, but newborn babies are so

Create a peaceful environment

small and vulnerable that for them, the first few months of life

The arrival of a new baby is a huge life transition, and it all

outside the womb are truly a “4th trimester” of pregnancy.

It is important during the 4 trimester to help babies make th

happens overnight. You need time to cope, so take it slow and lower your expectations about yourself. You will not “get it”

a gentle adjustment to their new world outside the womb. In

all and that’s OK. Just do the best you can, one day at a time.

the 40 weeks since conception, they have spent every moment

However, this doesn’t mean you have to tiptoe totally around the

in a warm and nurturing environment where every need was

baby – lower the sound levels and lights in the house, but don’t

attended to. Now, in the world outside the womb, they are

make a big effort to stay quiet during the day.

adjusting to a more varied and sometimes startling world of sound, colour and stimulation.

Breastfeed regularly The 4th trimester is the time to get started with breastfeeding.

Make the transition more like the womb

This is a critical opportunity to bond and enrich the baby’s health

In the 4th trimester, it is helpful to make the baby’s everyday

and nutrition with the minerals, micronutrients and immunity

experience feel as “womb-like” as possible. Wear your baby in

boosters that are part of “nature’s perfect baby food.” Keep in

a sling or baby-carrier to help mimic the feeling of being in the

mind that with breastfeeding, there is no “normal.” It’s not unusual

womb. Babies often prefer to be carried this way so they can feel

for newborns to breastfeed every 2–3 hours around the clock.

closely snuggled up to their mother’s body.

During breastfeeding, try doing as much skin-to-skin contact

Take care of yourself

as possible. This helps the baby’s senses feel calm and soothed.

Let go of all expectations about sleep and schedules and follow

Another way to help the baby feel relaxed is to take baths

the advice to sleep when baby sleeps – seriously! Getting

together – the warmth and water vibrations will remind the baby

enough rest should be one of your very top priorities. Keep in

of being in the womb. Life in the womb was full of motion, so

mind that as a new mum, your hormones are still unpredictable.

get moving. Take a walk, push a stroller, or drive in the car. Many

Don’t worry about skin breakouts, dry hair, or moments of

babies will fall asleep more easily if they are riding in a car seat or

frustration or ill temper. No one is judging – least of all your

in a baby carrier or even just being held on mum or dad’s chest

beautiful baby!

while quietly pacing through the house.

Just go with the flow – don’t stress about making mistakes.

Every day with a newborn is a huge learning experience as you build a relationship with this new amazing person in your life.

Article courtesy of Medela Australia medela.com

40 Parenting Insights | 2017

Taking the sting out of nappy rash!

Here are some handy hints: • Change your baby’s nappy often so the skin is kept fresh and clean.

This may mean a lot more nappy changes than normal during times when nappy rash is problematic.

there will be less residue that could be irritating. You could also try adding a cup of white vinegar to the final rinse cycle of your wash to break down any leftover soap residue and it will also keep the nappies

• Have “nappy free” time where

soft. If you are using modern cloth nappies

there is no nappy on to help

make sure you are changing them often or

the skin remain free of possible

you could try using a bamboo liner inside

irritants. Grab a waterproof

the nappy.

picnic blanket and lay bubs on

The remedial effects of natural

this so if there is an accident,

ingredients in skincare are well documented

it is easy to clean and won’t

and clinically proven, in particular the use

go everywhere.

of natural vegetable oils because of their

• Using liners in disposable nappies

emollient moisturising and skin protecting

may also benefit as they absorb

properties to help the skin maintain

wetness and keep it away from skin. Choose your disposable nappies carefully as many contain chemicals that

effective barrier functions. Look out for products containing: Avocado Oil – An emollient used to

some babies may find irritating. There

moisturise and soothe skin. Rich in many

are several eco-friendly nappies available

nutrients, including vitamins A and D, lecithin

now which may be more suitable and are

and potassium, it also contains essential

easy to purchase online.

fatty acids, which are useful for conditions

• It is important when washing your baby’s

N

Try using a liquid instead of a powder as

such as nappy rash and eczema.

Chamomile – known as ‘The Children’s

appy rash is very common and

nappy area that you check the skin folds

can pop up anytime no matter

and that you are very gentle as rubbing

Remedy” because it is helpful for soothing

the skin can cause friction and make

skin and is used on a wide range of

nappy rash worse.

complaints including eczema, irritation,

how diligent you are.

Nappy rash mainly occurs when baby’s skin is covered by a wet or soiled nappy for

• Avoid soap – it disrupts the skin barrier

redness and inflamed skin conditions such as nappy rash.

too long. ‘Too long’ can vary from one baby

by stripping away natural oils and

to other and maybe influenced by whether

causing dryness, which can make nappy

Calendula – is a favourite amongst

your baby is teething or unwell. Some

rash worse. Choose a soap-free cleanser

herbalists for its amazing ability to calm

babies will hardly get any nappy rash, while

as a gentle but effective option.

wounds very gently and effectively. It is very

• Wipes often have alcohol in them

soothing on irritated skin conditions, helping

others will get a lot, it depends on how sensitive their skin is.

Nappy rash is caused by germs on the baby’s skin, in faeces, urine and on clothing (including nappies) creating ammonia

and this can cause further pain and discomfort on damaged skin, so look

to reduce redness and calm nappy rash.

Aloe vera – is a skin nutrient renowned

for an alcohol–free wipe that also

for its soothing and hydrating action.

contains moisturising properties.

Aloe is used to soothe and moisturise

which can burn the skin. When the nappy

• Using a barrier balm to keep dampness

dry, damaged skin, minor cuts and burns

rubs on the irritated skin, it is exacerbated.

away from the skin can be beneficial.

and irritations like nappy rash, as well as

Often when babies are unwell, particularly

Be mindful not to rub vigorously as this

providing long-lasting moisturisation.

if they have diarrhoea, their skin seems to

can irritate the area, try to gently pat

become more sensitive. Other possible

the area to apply.

triggers include starting a new food,

• Use a talc-free powder to absorb

Thrush is an infection that may require additional treatment. It is important to seek medical assistance for any broken skin or

teething, chemicals in disposable nappies

excess moisture in your baby’s skin

rashes to ensure you know what it is and

or an infection on the skin such as thrush,

folds and keeps your baby drier.

how it should be treated.

which can make the rash worse.

• Changing cloth nappies often and

Eliminating the causes as much as possible

washing them in laundry liquids which

will help to minimise nappy rash.

are labelled for sensitive skin may help.

42 Parenting Insights | 2017

Article courtesy of Michelle Vogrinec GAIA Skin Naturals

Baby massage explained W

ith centuries of history behind it, massage has become increasingly popular in recent years

as a gentle and nurturing therapy which can, at the very least, enhance bonding between parents and their babies.

We believe there are other benefits too; including improving the quality and duration of baby’s sleep, improving relaxation and improving weight gain in pre-term infants.

Preparing for massage For newborns and young babies, start with a five minute massage.

Begin with the area where most babies are comfortable being handled, their legs.

For best results, keep one hand in contact with your baby at all times. Prepare by having the massage oil close by, and have a wrap or blanket to keep baby covered. Keeping physical contact

Essential oils are often too strong for newborn skin, so choose an unscented oil.

It is a wise precaution to ‘patch test’ any new product on

with baby helps them to take in their surroundings and avoid

baby’s skin to minimise risk of allergenic reaction, particularly if

being startled.

there are any known sensitivities in the family.

Where possible use long and flowing strokes, especially along the legs and arms. Use your full palm where you can. Smaller

Getting started

areas such as the soles of the feet, hands and the scalp area are

Just like adults, the right environment will help set the mood

important and small, circular movements with the pads of your

for baby’s massage. Dim the lights, play soft music (or sing) and

thumbs are an ideal technique.

remove potential interruptions like phones.

Babies over three or four months old, may want to be mobile and move around; so you may need to be a little inventive.

Always choose a time when baby is happy, alert and content; so avoid before (or directly following) a feed, when your baby is tired and do not massage your child if he/she is unwell.

Slowly build up your massage time from five minutes to ten

Choose a safe, flat surface to massage your baby. Speaking softly, outline the area to be massaged with some light strokes.

Take a few deep breaths to relax yourself prior to beginning and you’re ready to give your baby some special one on one time.

Warm a little of your chosen oil in your hands and begin to apply, starting at the legs. Massage downward from the thigh to

or more, as your baby becomes more accustomed to special

the foot. Massage each leg three to four times then repeat on the

bonding time.

other leg. Use the same long, flowing strokes down each arm.

For older babies and toddlers, massage time is great for communicating – hum, sing or chat away about what’s on your mind in a soothing yet expressive voice. Maintain eye contact

If your baby is unsettled, you may find that holding them in your arms is a great way to provide comfort while massaging.

Your child will soon learn that their ‘massage’ time is an

and watch for cues that your baby is enjoying the massage

extremely special shared time. Massage is an activity to be shared

experience.

by parents, grandparents and care-givers. Supervised massage involving an older sibling can be a great way to encourage

Massage oils

bonding and connecting.

A newborn baby has considerably thinner skin than an adult; and delicate skin demands care.

Selecting your baby massage oil carefully is important; and pure, cold pressed organic oils (such as jojoba or sunflower oils) are recommended. Oils help to lubricate the skin for better flow of

Article courtesy of Catherine Cervasio 2017© Catherine is a trained Infant Massage Instructor and holds a Diploma in Massage & Aromatherapy. She has over 20 years’ experience working in the field of natural and organic baby skincare.

For further information visit aromababy.com

movement as well as moisturising baby’s skin.

2017 | Parenting Insights

43

Newborn bath basics

H

Test the water temperature using a bath

in a towel to keep them warm. Start by

thermometer if you have one, or if you

wiping each eye with a separate piece of

don’t, use your wrist rather than your

cotton wool dampened with warm water,

hand, it should feel neither hot nor cold.

working from the inner corner outwards.

andling a wiggling, wet baby can feel

The recommended bath temperature for

Do not wash the eye itself.

a little awkward at first but with this

babies is about 36 –38°C.

Use a new piece to wipe around their mouth and nose, then another

handy step-by-step guide, you will be an

clean piece for their ears and face. Using

you have all the things you need within

Now you’re ready, the first step is to ‘top and tail’

arm’s reach of the bath.

Top and tail a newborn for the first month

neck, focusing on the skin folds, behind

prior to bathing to avoid cross infection,

the ears and under their arms where milk

Getting ready

as well as in between bathing to freshen

and fluff can get trapped. Take another

Choose a time of day when you’re not

their skin if you are not bathing every day.

piece and clean their ears and face.

expecting any interruptions. The bath

“Top and tailing” simply means to carefully

should be positioned somewhere stable,

wash your baby’s face, neck, hands and

in your baby’s ears or nose, just wipe

at a height where you can comfortably hold

nappy area without having to totally

what you can see.

your baby (a table is often best) and make

immerse your baby in water.

expert in no time! Before you start, ensure

another dampened cotton pad, clean their

Never put anything like a cotton bud

Tailing

sure you have access to running water.

Fill the bath with about 10 –13 cm of water

Topping

Washing your baby’s genitals, bottom and

or enough water to allow your baby to

Lay your baby down on the floor or change

nappy area is the ‘tailing’. Keeping your baby’s

settle in the water with their shoulders

table, with the clean cotton pads and bowl

upper body covered with a towel, remove

well covered. To avoid over drying your

of warm water nearby. Always use fresh

their nappy (watch out for the fountain!)

baby’s skin, add a squirt of a mild, baby

cotton pads when cleansing the separate

bath wash to the bath and swirl around

areas to avoid cross infection. Undress your

to some extent and are very delicate, so

with your hand.

baby down to their nappy and wrap them

cleaning this area requires special care.

44 Parenting Insights | 2017

Your baby’s genitals will self-clean

If your baby girl has had a very dirty

gently lower them into the bath, feet first,

You may want to apply a baby

nappy and poo has got within her vaginal

keep a close hold at all times. The water

moisturiser to lock in hydration and

area, with a fresh moist cotton pad, gently

should be covering their shoulders so

protect against dryness.

wipe the area from top to bottom, or front

they don’t get cold.

Put their nappy on. Applying a barrier cream to the nappy area to protect

to back and down the middle. Then with

Continue to keep a good grip and

a new clean cotton pad, wipe each side

support their head with one arm, as they

against the causes of nappy rash might

within her labia.

may get quite slippery when they are wet,

also be helpful. Products containing zinc

and use your other hand to sprinkle some

and castor oil are highly recommended

penis and scrotum area, avoiding pulling

water over your bub’s skin and gently

by medical professionals.

back the foreskin, and also wipe front to

wipe clean with a washer.

For an uncircumcised boy, wash the

Gentle touch and hearing your voice is a nice way to increase bonding. Singing

back. Don’t try to pull back his foreskin to

Washing their hair comes last so

clean. If circumcised, don’t wash the head

your baby doesn’t get cold. While most

or talking your baby through what you

of the penis until it’s healed.

newborns don’t have much hair, you

are doing as you bathe them can help to

can sponge what is there. To avoid

provide comfort and support. Now it is

cleaned and patted dry to avoid infection

getting eyes wet, tip the head back just

time to get dressed, wrap them up in a

and chaffing from damp skin particularly

a little. Supporting your baby’s head and

warm blanket and snuggle!

if you have a nice chubby baby!

neck, lift them out of the bath then place

Ensure all skin folds have been

If you are not continuing on to a bath, it’s also a good idea to use a barrier cream

on his back on a clean, dry, soft towel.

Wrap to warm and gently pat dry

on the nappy area to protect against the

your baby’s skin rather than rubbing.

causes of nappy rash. Dress your baby and

Pay attention to ensuring you dry in the

wrap them in a blanket to keep bubs warm.

skin folds and creases, including armpits,

Article courtesy of Michelle Vogrinec GAIA Skin Naturals

groin, under the chin, around the neck

Now for bath time!

and behind the ears, to avoid infection

Cradle your baby’s head with one arm,

or chaffing.

2017 | Parenting Insights

45

Postnatal depression epression in mothers is real. In fact, it’s all around us. But it is

D

my frustration that he didn’t understand what was going on with

hidden behind so much stigma and judgement that it’s very

me. I remember the disengagement with my two elder children,

hard to speak up and own it. As a society, we put so many labels

and screaming at them with rage that seemed to suddenly

on people. It seems as though the label of “bad mother” is one of

overcome me, as though someone had flipped a switch. But most

the worst anybody could wear.

of all, I remember the voice. The voice that didn’t go away, that

There was a time in my life when I became an expert at hiding

was always telling me I was failing, that life was too hard and I was

what was truly going on in my life, at pretending. My labour, birth

useless. It was there when I woke up in the morning, when I was

and the immediate weeks after having my third baby are a blurry

driving in the car, when I was in the shower, when I was talking

memory. I only seem to be able to recall windows in time, but

to people. I didn’t tell anyone about the voice or how it bullied

somehow all of those windows mesh into one another to cover

me into pieces.

a time span of three and a half years. The things I do remember?

I think the hardest part of having postnatal depression was the

I remember holding my baby close, loving her while I cried.

fact I had to hide so much of it. Sure, I shared bits and pieces, but

There was a lot of crying. I remember not wanting people to

I was never able to show on a day-to-day basis just how much I

come over to visit me. I remember feeling despair at my failure

was hurting on the inside. And, unfortunately for me, I believe that

to function, at not being able to get things like a basic phone call

prolonged period of not speaking up and not getting help meant I

done. I remember that sitting in the corner of my wardrobe was

had more obstacles and a longer road to travel towards wellness.

comforting, as was completely covering myself under the doona.

I can’t help but wonder what that journey would have been like

I remember feeling like I was always late, running behind and never catching up. I remember the sleepless nights – lying awake

if I had reached out for help sooner.

Pregnancy and early parenthood are the most high risk times

even as my baby slept. I remember not being able to eat for most

in a woman’s life for developing depression. If you are pregnant or

of the day, and then eating a whole block of chocolate and hating

have young children and you are unsure whether what you are

myself, then not eating again for the rest of the day. I remember

feeling is within the realm of “normal motherhood”, you’re

the anguish at not being able to communicate with my husband,

not alone.

46 Parenting Insights | 2017

Reach out to a friend or family member and ask them to help you

• loss of concentration and memory

visit a GP to discuss the mental illness that is depression and the

• difficulty with decision making

many different faces it wears.

• crying for no reason

The sooner you get help, the sooner you will be on your journey to a better place.

Pregnancy and early parenthood are times of great change.

• being irritable and moody • feeling negative all the time • thoughts of suicide or wanting to escape

It’s normal to feel emotional or overwhelmed from time to time, but if you are experiencing any of the symptoms below, it’s important to

Where to go for help:

discuss them with your doctor or another health professional.

• Your GP, obstetrician, midwife or other

• feeling empty/teary/exhausted /overwhelmed • feeling guilty and inadequate • diminished pleasure and/or interest in activities (particularly those that you used to enjoy)

healthcare professional you trust • Perinatal Anxiety and Depression Australia (PANDA): National Helpline

• loss of confidence and self esteem

Mon to Fri 10am – 5pm AEST,

• inability to cope

1300 726 306 | panda.org.au

• sleep disturbance unrelated to baby’s needs • negative obsessive thoughts

• Peach Tree Perinatal Wellness peachtree.org.au

• change in appetite • fear of being alone • worrying about harming self or children • wanting to be alone, withdrawing from social circle

Article by Viv Kissane Co-founder and CEO of Peach Tree Perinatal Wellness peachtree.org.au

2017 | Parenting Insights

47

Taking the bite out of teething

Teething When can teething begin?

Signs of teething

Babies can get their first tooth anywhere between 3 – 15 months,

• Rosy, flushed cheeks

but commonly between 4 – 9 months – although discomfort may

• Increased dribbling

start earlier. Dribbling at 3 – 4 months is usually as a result of your

• Tugging at ears

baby learning to put things in their mouth, which is part of normal

• Chewing on everything

development.

• Tender swollen gums • Irritability

What can you do to help?

• Disturbed sleep

• Rub your baby’s sore gums gently with your finger

• Poor appetite

• Give your baby a teething ring – either a soft rubber one,

• Loose, frequent stools

or the plastic type that are cooled in the refrigerator • If you think your baby is in pain, consider giving paracetamol as directed for the child’s age

• Sore red bottom or rash Note: Generally, teething does not cause a fever.

If your baby has a high temperature, see your doctor.

• Avoid hard sharp-edged toys that could damage teeth and gums.

Caring for baby’s teeth The importance of first teeth

What not to do

What many parents don’t realise is that emerging baby teeth need

• Don’t dip dummies or teething rings in honey or sweet foods, as

to be looked after as carefully as we look after our own teeth.

it may lead to dental decay (and honey shouldn’t be given to babies under 12 months for health reasons)

They will need to last your child until they are 5–12 years of age.

As well as their obvious importance for chewing and speaking,

• Don’t suck your baby’s dummy and give it back to them,

they help proper jaw development, and reserve the spaces for the

as you will transfer bacteria from your mouth to theirs

permanent teeth to come through later. Dental decay can result in babies losing teeth as early as 12 months.

48 Parenting Insights | 2017

Tips for cleaning teeth • Start cleaning when teeth appear. Gently wipe with a clean damp cloth at bath time.

• Progress to a small soft bristle toothbrush with water

Help your children brush their teeth twice a day after meals.

They need your help until they’re about 6 years old, and have the manual skills to do a proper job themselves.

(there are special brushes available for babies) • Hold the baby sitting against you facing the bathroom mirror so they can see their teeth being cleaned • Let your baby play with their toothbrush while they watch you brush your teeth

Visiting the dentist First visit to the dentist Children should have their first dental check-up at 1–2 years of age.

Routine checkups can be carried out by your usual family dentist.

• Start using a pea-sized amount of low-fluoride children’s toothpaste only when they have learnt to spit things out from

How long do baby teeth last?

their mouth

• The front baby teeth will last until the age of 5–7 years

• Limit the amount of sugary foods in their diet

• The back molars have to last until about 12 years of age

A condition called ‘nursing caries’ can result from allowing a baby

• Dentists advise having a protective coating, or fissure sealant,

to suck on a bottle of milk or sweetened juice for long periods

applied to the molars at around 7 years

during the day, or last thing at night. If a bedtime bottle is needed, use cooled boiled water instead (or cooled boiled water after the

What the dentist will look for?

bedtime bottle of formula).

• The number of baby teeth and their spacing and placement • How effectively teeth are being cleaned

Caring for your toddler’s teeth Sometime in the next 12 months you should take your child either to the dentist or to your Child Health Nurse for a dental check.

• Any changes in colour, or spotting of teeth, signifying early decay • About 20% of children have a type of decay called ‘nursing caries’, often related to dietary and feeding habits, particularly

Tips for cleaning teeth

use of a night time bottle.

• Use a special children’s toothbrush, small with extra-soft bristles • Always use gentle pressure, as brushing too hard can damage the gums • Use a junior-strength toothpaste until they’re about 6 years old.

This has a mild flavour, is low foaming and lower in fluoride if

Your attitude can help Be relaxed with your children when talking about the dentist.

Be careful not to use any negative words, and be sure not to pass on any feelings of fear or anxiety that you may have.

they swallow it by accident.

• Teach them how to rinse and spit, so they don’t swallow the toothpaste • Night time brushing is the most important, so don’t be tempted to let your children have a snack in bed. A bottle, a glass of milk, or even an apple, can undo all your good work • Try not to give too many sugary snacks between meals

Article courtesy of Children’s Panadol panadol.com.au/children This is an excerpt from the Children’s Panadol ‘The First Five Years’, a handy book specially developed to help answer those questions most commonly asked by parents with children aged 0-5 years.

Download it now or view it online at firstfiveyears.panadol.com.au

• Water or milk should be your child’s main drinks, but if you do serve fruit juice or cordial it is best to give it well diluted. It is also good to give it with some food rather than by itself, because the saliva produced from chewing will help to get rid of the sugar and neutralise the acids causing decay.

The content in this article was authored by journalist Kay Stammers BA Hons, TPTC and Child and Family Health Nurses Lindy Danvers RN, RM, M’craft, MHA and Sue Prescott RN, RM, M’craft, Grad. Dip Child Health in their personal capacity. The opinions expressed in this article are the authors’ own and do not necessarily reflect the views of GlaxoSmithKline Consumer Healthcare Pty Ltd (GSK). GSK does not control, monitor or guarantee the information contained in this article and does not endorse any views expressed herein. In no event shall GSK be responsible or liable, directly or indirectly, for any damage or loss caused or alleged to be caused by or in connection with the use of or reliance on any such content. Health related content in this article should not be used for diagnosing purposes or be substituted for medical advice. Always consult your professional healthcare providers before beginning any new treatment.

GSK assumes no responsibility or liability for any consequence resulting directly or indirectly for any action or inaction you take based on or made in reliance of the content in this article.

2017 | Parenting Insights

49

Help your baby develop during their vital first year

B

abies have an amazing capacity to learn, but there are so many

temperature. You can invite exploration by introducing your baby

things that parents can do to help their baby learn and develop.

to materials with different textures such as citrus fruits, fabrics and

Here are a few essentials that really do make a difference:

Tummy time. Five minutes of ‘Tummy Time’ two or three

household objects. However, if an object fits through a kitchen roll cylinder then it is not safe. Homemade or everyday objects must

times a day can have a positive effect on head shape and brain

be carefully supervised and removed from the cot during daytime

development. It also leads on to crawling, an intellectually important

naps and at bedtime.

milestone not to be missed. For babies who find tummy time

Touch. Studies show that lack of physical contact can lead to

uncomfortable, try placing baby on their tummy for a nappy

health, sleep and relationship disorders in later life. So take every

change or join them on the floor with a favourite toy, making funny

opportunity to hold, carry, rock, stroke, caress and cuddle and kiss

sounds to encourage them to lift their head.

your baby. Holding your baby close will also help you tune into their

Crawling. Crawling stimulates left and right brain development, improves overall health, stimulates the immune system and helps

needs and they will know that they are loved and wanted.

Exercise. Exercise is very important to keep your baby healthy

the eyes work together as a team (crucial for later reading). Activities

and to develop and strengthen muscles in preparation for sitting,

such as pillow-mountains, play tunnels and interesting toys placed

crawling and walking. Babies love rowing and cycling exercises

just out of reach will encourage your baby to crawl. Don’t worry if

and being massaged from head to toe. The best time to introduce

your baby crawls backwards. This just means that the muscles in

an exercise activity is just after a bath or nappy change when

his forearms are stronger than those in his legs!

your baby’s arms and legs are unrestricted by clothing. Besides

Language. Talk to your baby during daily routine activities such as feeding, bath time and nappy changing. Respond to any sounds

developing body awareness and coordination, exercise can also relieve stress and tension in the joints during growth spurts.

that your baby makes with praise and encouragement. Use simple

Ideas for play. Simple home-made toys are often more

speech that is easy for your baby to imitate and allow him time to

effective than bought toys. The advantage is that there is always

respond. Sing lullabies, songs and nursery rhymes to introduce new

room for adaptation and ingenuity. Here are some tried and tested

words and to encourage listening skills and repeat them regularly.

ideas that are really worth trying: fill a tissue box with ribbons or

Read and reread picture and story books that focus on sounds and

fabric to tempt your baby to investigate, put your hand inside a sock

rhymes. Make animal sounds – babies love them!

to make a talking puppet, partially fill a plastic container with pasta

Games. Time-honoured games such as ‘Pat-a-cake’, ‘Peek-aboo’ and ‘Pop goes the weasel’ are lovely ways to stimulate smiles and giggles. Research shows that having fun with baby improves

or rice (secure the lid) to make a musical instrument. Babies can see and hear the contents, but cannot swallow them.

There are hundreds of simple, but effective activities that can aid

socialisation skills and leads to a love of sports and games in later life.

learning and development, parents who want to find out more can

Textures. Mouthing and touching objects are fundamental

attend Baby Sensory classes. For details of Baby Sensory classes visit

ways in which babies learn about weight, taste, smell and 50 Parenting Insights | 2017

babysensory.com.au

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Safe travels Choosing the safest car restraint for your child

W

hat is the safest child restraint? It’s a question that’s

frequently asked, but one quite difficult to answer.

The short answer is ‘depends’. The full answer is a little more complicated and nuanced.

Ultimately there are many factors you’ll need to consider.

You could start by comparing all of the restraint makes and models on the market through a crash testing regime and judge them comparatively, but these would all be based

Relationship to vehicle

on the same vehicle seat geometry and collision simulation.

The child restraint you choose has to be compatible with your

The question then arises, would that accurately apply to your

vehicle. Some incompatibility issues may be minor inconveniences,

specific situation? Comparisons may help to some degree,

but others may affect your ease of use, functionality and collision

but there are other factors that need to be considered.

outcomes. Only you can decide the compromises you’re willing to make, so whenever possible always deal with a retailer that has

What contributes to a child restraint being safe?

some experience of the make and model of vehicle you drive or

There is a short list of basics to consider:

one who is willing to place the product into your car so you can

• How it interrelates to your vehicle seat and equipment • Harnessing at both lower body (hip area) and upper body (chest/shoulders) • Appropriate harness positioning choices for different length/height of the child.

• Side impact protection (Especially pertaining to the passenger’s head).

check all of the functionality aspects.

Harnesses The harnessing systems of all brands and models are similar – design standards ensure that – but the big difference can come from how readily they adjust in daily use. Harnesses need to be adjusted each time they’re used; not once in a while, every time.

It holds true, and it’s supported by the decades of experience we have with the parenting community, that if a harness is difficult to use, it often won’t be used correctly. Please take the time to check that the harness operates easily and reliably on the product you’re considering. The harness is your first line of defence in safety and every other aspect relies on it being correct. It absolutely needs to be done right every time.

52 Parenting Insights | 2017

Make a choice that will benefit you and your child and when you narrow down the list of the products you feel are appropriate, always focus on simplicity, functionality and ease of use factors.

Another thing to consider is that cushions, no matter how many are added, are not generally safety items. In fact, cushions can affect the safe use and operation of safety features like the Harness positioning Being able to change the configuration of the harness to ensure it’s suitable for the changing needs of your child as

harness! There’s a very good reason motorcyclists don’t have soft helmets, so remember that how something feels does not always match up with the safety it offers.

they grow is an essential consideration. Configurations to accommodate your child growing or alternatively reverting to

Extended use factors

smaller sizes for younger or smaller children are important. The

Something else that can affect your choice is the product’s

most common reconfiguration function relates shoulder strap

extended usable period. Rather than the number of years of use

height and the wider the variety of height settings a restraint has,

you can get with a multipurpose choice (‘convertible’) restraint;

the more it allows for appropriate harness set up.

this refers to how well it adds value to safety.

Impact protection

There are two areas you’ll need to focus on:

Technology and design advancements mean side impact

1. Extended rear facing (ERF) capability for infants

protection features are more comprehensive in contemporary models, offering higher levels of energy absorption and better positioning.

and younger children (possibly up to 30 months) 2. Extended six point harnessing capability (possibly up to 8 years)

Naturally some products are designed with additional features that can offer additional levels of safety when compared

Starting with ERF, all passengers are better protected if facing

to other products. However, most of the claims have not been

the rear during a frontal collision. While this may not always be

directly tested in comparison to others and which product will

desirable or practical for some parents when the child is getting

provide the safest environment under specific circumstances is

larger, it’s known to be safest. However, when you’re considering

still largely a matter of guesswork.

ERF, also factor in other vehicle safety matters. For example, in

Regardless of features, claims and their benefits, it is well recognised that most child restraints are, in some way, used incorrectly which can compromise their effectiveness and level

a wagon anything in the cargo area not secured is a potential missile and facing the rear may increase injury risk!

A restraint comparison of a six point harness with a standard

of protection. Simply, you can put your trust in claims that a

lap sash seat belt shows that the seatbelt sash is less likely to

particular restraint is the absolute best, but if you’re not using

remain in a proper position. This is particularly so if the child is

it correctly all those benefits could account for little.

short, fidgets, falls asleep or any combination thereof. A six point

It is often said that the safest restraint is the one you have

harness is the most reliable in this respect and may provide piece

when you use it correctly. We’re not trying to be flippant or

of mind until the child is around 8 years of age – an enormous

avoid answering the question that starts this article. We want

benefit over a standard lap and sash belt arrangement.

to highlight an area of great concern – generally speaking the biggest problem with child transit safety in Australia is not the

‘Let’s all travel safely’.

quality of the child restraint, but rather its incorrect use.

Australian and international standards aside, the most carefully designed and comprehensively equipped child restraint is useless unless it is correctly used.

Article courtesy of the child passenger safety technicians at ACRI acri.com.au

2017 | Parenting Insights

53

Nursery safety

Myth Busters!

• Gaps between bars must meet the current regulation,

Buying nursery products can be so challenging. The choice

(ie. 12 mm–30 mm or 50 mm – 95 mm). Gaps between

seems endless, emotions run high and it is difficult to work out

30 mm – 50 mm CAN trap a child’s limbs. Gaps above 95 mm

where to start. Friends and family are anxious to pass on their advice and experience, the internet is full of tips and the sheer number of products is seemingly infinite.

Misinformation also plays into decision making and a number of urban myths circulate. To assist consumers to understand we provide the following myth busters:

create head entrapments and fall through hazards.

• Always use a mattress to the recommended size of your cot.

The correct fitting mattress size is permanently stamped on the mattress base.

• Always follow the safe sleeping guidelines as per advice from red nose (SIDS).

• Always use a firm mattress.

Cots

Myth

Myth

It is a good idea to use cot bumpers in order to stop a baby

It is safe to use a cot that was used 25 years ago and has been in

hitting its head on the sides of the cot.

the family all that time. “It was good enough for me, so it will be sweet to use for my child”.

Truth Bumpers in a cot are totally unnecessary and actually increase

Truth

hazards. When infants are able to move around, cot bumpers

Cots older than 10 years are most likely unsafe and often contain

can become a suffocation hazard as the child face may come in

hazards such as decorative corners (strangulation hazard), easy

contact with it. Cot bumpers can also be used by the infant to

to move timber components, large gaps where a baby can be

climb out of the cot and may result in falls from the cot. Whilst

trapped and loose timber slots. Not all second hand cots are

cot bumpers are regularly sold by nursery retailers, they are a

unsafe but consumers should follow these tips:

completely unnecessary and a dangerous purchase.

• Make sure there are NO damaged parts.

• Ensure that there are assembly instructions with the cot and that you follow them when assembling the cot.

Keep soft objects, such as pillows, pillow-like toys, quilts, comforters, sheepskins, and loose bedding, such as blankets and non-fitted sheets, away from the infant’s sleep area to reduce the risk of SIDS, suffocation, entrapment, and strangulation.

54 Parenting Insights | 2017

Portacots Myth

been involved in a car

Putting an extra mattress into a portacot gives the baby

accident, you should NOT

a better sleeping surface.

use a second hand car seat /capsule.

Truth

The Australian Standard

Extra portacot mattresses create a dangerous hazard as the

regularly changes and

sides of a portacot are flexible. If the infant rolls between the

takes into consideration car

additional mattress and the portacot side, it may get trapped.

design changes meaning

An infant does not need a soft surface to sleep on and the

that the latest designs for car

mattress provided as part of the portacot is all that is needed as

seats /capsules are the safest.

a surface. The current Australian Standard for portacots requires

Old equipment is unlikely to meet

a warning to be prominently displayed on the portacot advising

these latest safety standards.

NOT to place additional mattresses in the portacot.

It is also strongly recommended to use an installation service provider to

Car seat safety

improve safer outcomes. For further information on car

Myth

seat safety contact

In winter it is wise to keep a baby well rugged up in the car

acri.com.au

by wearing things such as a puffy jacket.

About INPAA Truth

The Infant and Nursery

Safe car travel means that the seat belt or harness sits firm and

Products Alliance of

close to the babyâ&#x20AC;&#x2122;s body. Wearing a puffy jacket leaves a good

Australia (INPAA) is

chance for the air in the jacket to compress suddenly in an

committed to advocating

accident thus making the harness or seat belt ineffective. Cars

for the safe supply and use of

have heaters so use the heater in the car to keep the baby warm

nursery products in Australia. INPAA

and make sure that the baby is not wearing a puffy jacket.

assists suppliers by developing product guidelines to address hazards and to encourage

Myth

consumers to use products safely.

Grandparents donâ&#x20AC;&#x2122;t need a car seat for babies and infants as most of the driving is local.

Article courtesy of INPAA babysafety.com.au

Truth Many accidents occur close to home so a baby should always be in an appropriate car seat or capsule.

Myth It is safe to use a secondhand infant car seat or capsule.

Truth Unless you can be 100% certain that a car seat or capsule has NEVER been damaged through misuse, dropping or it has

2017 | Parenting Insights

55

s e n o e l t t i l g n i s i a R ! s n o i t s e u q s e s i often ra Whether youâ&#x20AC;&#x2122;re preparing for your new addition, wondering what you should be doing with your newborn or looking for information to help you with your toddler, Me and My Child Club can help!

Youâ&#x20AC;&#x2122;ll receive monthly emails through the different key development milestones for your child which offer valuable and helpful information.

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Introducing solids: Purees vs baby led weaning

ntroducing solids to your baby is an exciting, messy and

I

Traditional weaning

enjoyable milestone that marks the beginning of a long and

A traditional weaning approach usually begins with spoon

tasty journey. As adults, taking food to your mouth, biting,

feeding by parents of smooth purees and moves through to

chewing, and swallowing is automatic, but we must remember

lumps, chunks, finger foods and family foods. Infants are fed

that our little ones need to learn how to eat step by step.

with a spoon until they can communicate fullness. From around

Weaning has changed a lot over the past few generations

eight months, finger foods are offered and gradually increased to

and differs between cultures, for example mashed pasta as a first

replace spoon feeding. Variety is increased by adding one new

food in Italy and hand mashed mild curry in India.

food every few days to see if your baby has an adverse reaction.

Irrespective of the weaning method used, the goal is the same â&#x20AC;&#x201C; Start your baby on solid food at around six months and

With this method, parents are in control of the texture, variety and the pace of the meal.

have them consuming a nutritious family diet by twelve months.

It is the steps to get to family foods that may differ. Either

The benefits of a traditional approach are that your baby is likely

way, feeding your child should be an enjoyable and positive

to consume more variety in foods and be exposed to different

experience for both the parent and child.

flavours early in the weaning process. Iron and nutrient rich solids

There are two main approaches to introducing solids.

can be pureed and offered regularly to assist with confidence that

These feeding methods can be used solely or combined to

your baby consistently meets nutrient requirements. Mealtimes

suit the babyâ&#x20AC;&#x2122;s needs.

are less messy but making separate meals can be time consuming.

Increasing textures gradually means gagging is less frequent and parents can respond by using a texture their baby tolerates whilst increasing lumps in small steps.

Challenges that often arise during traditional weaning are; 1. Concerns that the process is moving at your pace rather than your babyâ&#x20AC;&#x2122;s. Introducing a range of finger foods by eight months will assist with seeing what texture and variety your child is ready for. You can then follow their lead with finger foods and continue to complement with selected puree or mash.

58 Parenting Insights | 2017

2. It is time consuming. Cooking, blending and often freezing

a BLW method as the focus is on learning to self feed, bite and

mashed foods and spoon feeding for the length of the meal is

chew first. This is fine as long as extra milk feeds are available

time consuming for parents, who let’s face it, have no spare time.

as needed and there are no growth or medical concerns. If you

3. Difficulty reading your babies fullness or ‘finished’ cues which may be subtle to start with. This is important to encourage.

are unsure, seek the advice of a health professional.

3. Mess … I repeat MESS! Feeding infants using any method is

Children who listen to their body and eat only what they need

messy, but when using BLW, plan for mess. Embracing it is

will find it easier to maintain a healthy weight as they grow up.

central to everyone’s enjoyment. Start with drop cloths, easy clean high chairs, full sleeve bibs and a newfound appreciation

Baby led weaning (BLW)

for your dog’s insatiable appetite. Clean your baby once at

This type of approach focuses on the independence of your baby

the end of the meal. Wiping throughout the meal is usually

taking food to their own mouth and consuming the quantity and

disruptive and disliked by babies.

variety they choose. You don’t puree foods, but rather offer them

4. Food allergy identification. Because of the introduction of many

foods from what everyone else is eating at family mealtimes.

foods simultaneously rather than a systematic exposure of new

This allows the baby time to learn the art of eating independently.

foods one by one, allergies may be harder to identify and treat.

Your baby is the only one to put food to its mouth using hands

Ensuring you know the ingredients of the foods your baby has

and when older, cutlery.

and using sensible steps to increase variety can help. Currently,

Benefits of this approach include independent eating sooner, a focus on learning to chew and managing foods rather than just

the recommendation is that you do not delay the introduction of solids that may cause allergy so this works well with BLW.

swallowing foods thus allowing babies to decide when they are full and what foods they would like to select. Family meals are

There is no one correct way to starting your baby on solids.

appropriate from day one so no separate cooking.

Knowing the benefits and challenges of these approaches can help

Adults need to show your baby how to eat and behave at the table so eating as a group becomes the norm. Families

you choose the method that will work best for you and your baby.

Often, a combination of the two feeding styles work well.

often embrace this stage and think of it as a chance to overhaul

You are able to have the best of both methods, whilst witnessing

how they eat and increase variety of healthy foods in their own

your child discover a delicious world of flavour and texture.

diet. They also tend to cut out junky extras in case baby wants the developing independence that accompanies it allows for an

For further information on toddler nutrition and weaning, visit:

opportunity to encourage communication, family bonding time

• Dietitians Association of Australia daa.asn.au

and the social interaction enjoyed with good food. This in turn

• Baby led weaning babyledweaning.com

creates a positive association integral to mealtimes.

• Traditional weaning – a brief overview with food suggestions

a taste. Whilst BLW assists in developing hand to mouth skills,

healthykids.nsw.gov.au/parents-carers/nutrition/ Challenges that often arise during BLW are; 1. Concerns around gagging and choking. However, speech

introducing-solids.aspx • Traditional weaning – a more in depth step by step guide

pathologists describe the presence of a sensitive gag reflex

kidshealth.schn.health.nsw.gov.au/sites/kidshealth.schn.health.

to protect infant airways as key. As with any infant eating,

nsw.gov.au/files/fact-sheets/pdf/baby039s-first-foods.pdf

supervision is essential but gagging is a typical part of learning to eat and should be expected. Choking should be infrequent if textures and food is being selected well and only your baby places food in their mouth. Knowledge of basic first aid can alleviate some parents’ concerns.

2. Wondering if the baby is consuming enough food. Typically,

Article by Lauren Gladman Accredited practicing dietitian (APD) specialising in infant, children and adolescent nutrition for 10 years.

Mum to Isla (2 years) and Finn (10 months).

Courtesy of Baby Mum-Mum Rice Rusks babymummum.com.au

babies will not consume much food for the first 2–3 months of BLW and then consumption will steadily begin to increase.

Swallowing larger volumes of food usually takes longer using

2017 | Parenting Insights

59

Getting started with toilet training Toileting your toddler may take time and patience. This is a developmental step and will only happen when they are ready. The following guide aims to share information around when your toddler may be ready and willing to participate in toilet training and provides some ideas on how to support them through this developmental stage.

When is toilet training possible?

Usually from the age of 2 years, of course this can vary, a toddler’s bladder and bowel has matured enough, that your toddler has developed voluntary control of the relevant muscles and they have the ability to communicate with you and therefore you may wish to attempt toilet training.

Getting started Your toddler will probably let you know which of the several options for getting started they prefer. Using a potty or chair enables them to feel more secure with their feet on the floor or alternately, a small set of steps with a non-slip base placed in front of a regular toilet can be used with a child size toilet insert. Some boys might prefer to stand in front of the toilet while others will prefer to sit to pass urine.

Signs that your toddler may be ready include: • Tells you or indicates they have wet their nappy • Trying to remove wet/soiled nappies themselves • Fewer wet nappies during the day • The ability to remain dry for 2 hours or more • You may notice they are dry when they wake up from a nap • Able to sit in one place for a few minutes • Showing an interest in using the potty and toilet

Article courtesy of Karitane karitane.com.au

60 Parenting Insights | 2017

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Water safety in Australia Implement layers of protection with the SwimSAFER message

What about groups of swimmers?

Where there is a group of children involved with the water, enough competent adult supervisors need to be appointed. The adults who are supervising must be vigilant water watchers, and must never leave their ‘post’ until replaced by another competent adult. Swim Australia’s Pool Watcher lanyard is a great aid for this essential task.

No measure can ever guarantee that children are safe in, on and around water. It is only human for adults to sometimes lapse in their supervision of children in the home or

Layer 2 – Be secure As proper supervision relies on people, it is never 100% reliable.

There will be times when caregivers are unable to actively supervise children every minute of the day. This is why barriers need to be in place to lessen the chances of children getting to the water hazard. Where possible the water hazard should be

while out and about. Children can and do find ways over fences,

removed (eg. empty wading pools when not in use and put them

and even those who have had swimming lessons can still

away). Where it is not possible to remove the water hazard it

drown. For this reason the SwimSAFER message promotes the

should be fenced or blocked. For home pools, this means a pool

application of various layers to protect children from drowning

fence that meets the relevant government requirements, at the

- if one layer ‘fails’ then there is another behind it that may save

very least. Key points to maximise barrier protection:

their life.

• the pool must be fully isolated from the house by a four-sides

The layers of protection are:

complying fence

• Be Aware • Be Secure

• self-closing and self-latching gates are used

• Be Confident • Be Prepared

• the fence and gate are checked regularly to ensure they are in

All the layers of protection need to be employed at the one time

good working order.

to ensure optimal water safety.

Children, however, can climb fences. Children as young as 2

Layer 1 – Be aware

years old, have drowned in backyard pools after using chairs,

SwimSAFER advocates constant supervision by a competent

bins, pot plants, eskies etc, to boost themselves up to open the

adult as the single most critical factor in drowning prevention.

gate or climb over. Ensure that there are no items in the yard that

Royal Life Saving Society Australia report that “the lack of direct

children could drag over and use to climb the fence. Outdoor

adult supervision is the main factor in 70% of toddler drowning

furniture must be secured or too heavy for a child to move.

deaths”.

Props which hold open a gate as a parent works in the yard,

Correct supervision entails:

have also lead to drowning. Never prop open gates – a child

• constant visual contact

slipping through or forgetting to remove the prop can easily lead

• being within arm’s reach of a non-swimmer and under 5s

to tragedy.

• not being distracted by anything eg. ringing phones and doorbells • being ready to respond quickly.

Please note: all too often, when parents have bought a new house with a pool – or started renting one – they have mistakenly believed that the pool fence and gate are in

Who is supervising?

good working order and/or compliant with government

When children are around water, accompanying adults must

regulations. Sadly, such an assumption has contributed to

know who is responsible for direct supervision. Children have

tragic consequences. New owners or renters should demand

drowned at aquatic venues because an adult has mistakenly

a Certificate of Compliance and always inspect the fence and

thought another adult was supervising.

gate for possible non-compliance regardless.

62 Parenting Insights | 2017

Layer 3 – Be confident

• No goggles: even the simplest thing like falling in without

Being able to swim well is one of the greatest gifts that can be

goggles can lead to drowning – it is very easy for children

bestowed upon a child – especially in Australia. Fun, healthy

to panic, and once this happens their survival rates of an

water-based opportunities abound. Equally, a high level of

accidental fall in decrease.

swimming and water safety skills are necessary for full,

• Tiring: children who are swimming well one minute, can

enjoyable participation – as part of a safer framework.

also get tired, panic and go under quite fast, so constant

For young children, the basic swimming and water safety

supervision of children who are swimming is essential.

skills include:

While swimming lessons do not substitute for proper

• water familiarisation, where small children explore and

supervision, learning to swim can make a huge difference if

become comfortable in water environments, developing a

your child accidentally falls in.

respect for the water • gaining confidence through various water activities which

Layer 4 – Be prepared

include and lead into – safe entries and exits – breath control

In immersion incidents, every second counts. Having an

– submersions – floating – propulsion with arms and legs

Emergency Action Plan in place can reduce panic and save vital

– turning – backfloating

time. Consider the following:

• developing the ‘strokes’ so that your child can efficiently cover much greater distances. The whole ‘learn to swim’ experience should be positive; free from fear of force, with a focus of skill

• If a child is missing, check the pool and other water hazards first. Seconds count!

• Have a phone poolside for emergency use only.

acquisition and safety around aquatic environments.

In the case of an emergency, dial 000 or 112 from As your child gets older, the chances are that they will be

mobile phones. The operator will ask you some important

exposed to potentially hazardous water situations that will

questions, including:

require them to be ‘stronger’ swimmers. Swim Australia

• the address where the ambulance is required;

recommends that children are able to complete a 400m swim

• what the problem is;

reasonably comfortably before they are deemed to be able

• how many people are injured;

to swim well. As this ability is developed, they should also be

• the patient’s age;

learning a variety of rescue skills.

• the patient’s gender;

Combined with learning the physical skills, the child is developing parallel water safety knowledge.

• if the patient is conscious; and • if the patient is breathing.

This ranges from knowing not to go near the pool unless with an adult through to swimming between the flags when at

The operator may provide you with advice to assist the

the beach.

patient while you are waiting for the ambulance; • It is important that you DO NOT HANG UP until the operator

Please note: no matter how well your child can swim,

tells you to. You may have to hold the line while an ambulance

they are never safe around water. There is no such thing

is dispatched.

as ‘drown-proof’ or ‘water-safe’.

If you haven’t already done so, revise, refresh or enrol yourself • Water temperature: a sudden immersion in cold water can

in a Cardio Pulmonary Resuscitation (CPR) course so you are

result in ‘cold shock’ which may lead to deep gasping, panic

prepared in case of an emergency. CPR accreditation is current

and inhalation of water. Even a child who can swim, can

for a year.

drown in the first 2–3 minutes due to cold shock.

• Turbulent water: children who are used to swimming in still water can panic if the water is choppy or swirling. Panic can easily cause a child to forget all of their swimming skills and go under.

• Clothing: wet clothes are extremely heavy and can add an extra 20 –25% of a child’s body weight. Clothed swimming practice in lessons is supported.

Article courtesy of Swim Australia swimaustralia.org.au Swim Australia is the leading national body for water safety Swim Schools across Australia. If you’re looking for water safety classes for toddlers and kids, find your nearest school online and enrol your child today.

2017 | Parenting Insights

63

Oh, and , don t forget the Nappy Bag o you’ve just found out you’re expecting, congratulations!

S

Removable bottle holders are just as important. Again, you should

Time to start researching everything you are going to need

look for one that is insulated, no insulation would mean your liquid

for your new baby. Prams, furniture, car seats, nappies … the list

will either roast or chill throughout the day, turning it effectively

is endless, and before you realise it, life becomes all about your

unusable, meaning baby has no food. Free parent tip: avoid this at all

expected arrival and less about you.

costs. You’ll quickly learn to appreciate how stressful this can be!

So what about you? Reward yourself. And in doing so make a

The third must-have for today’s parents are stroller hooks, the

life, that’s about to become more hectic than you ever imagined,

value of which is never fully understood. Two modest straps that

organised and stress free.

allow you to safely attach your nappy bag to the handle-bars of

The nappy bag, often considered unimportant or a luxury

your pram, not only free up your under-basket for other things

non-essential item, regularly finds itself at the very bottom of

but they also save your back from having to carry all day and

‘the list’ and sometimes not there at all. The functionality and

provide access to your bag at the perfect height while strolling.

versatility of today’s nappy bags are mind blowing and will not

Adjustable shoulder straps, extra insulated pockets, lined

only give you organisation and peace of mind when you’re out

wet-pockets, mobile phone compartment, integrated sleeves for

and about, you’ll look stylish in the process.

wipes and gels, key-finder keyrings and compartments for jars

Years ago, a nappy bag was the biggest bag you could find, the bigger the better. Mums and dads would fill them to the brim, often being too heavy to carry and they’d be found stuffed into the under basket of their pram.

Today, nappy bags are well thought out, meticulously

are just some of the features to look for that separate a basic bag from a life-changing bag.

The best bags on the market aren’t necessarily cheap, but they tend to come with all the bells and whistles and many are catwalk inspired by design, boasting the latest fashions, colours

segmented with multiple compartments, variable carry-handles

and fabrics making certain you don’t look like you’re carrying a

and many of the better ones include stroller hooks so you can

Santa sack!

leave the basket free for your shopping.

So what should you look for in a nappy bag? Undoubtedly the number one item is a removable and preferably lined change-

So surely it’s time to review that ‘list’ and add something to it that is for you. Reward yourself with a functional, stylish and sanity-saving nappy bag, you won’t look back.

mat. The toilet habits of a child and newborn are unpredictable and the likelihood you’ll find yourself near a five star changing room is rare, so a lined easy-to-clean change mat is imperative.

64 Parenting Insights | 2017

Article courtesy of Cara Frankish Mum with two kids age 2 and 4