PBC Expo Parenting Insights | 2016 Brisbane Edition

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The Magazine Team Editor in Chief Tim Wain Managing Editors Julie Rocke Katherine Waterhouse

Welcome T

here are many things about creating a new human life that will forever change yours. Every decision you make from the moment your baby enters the world,

or even earlier, is different. Your focus shifts and this amazing and beautiful little person soon colours your entire worldview.

One thing you’ll often hear is that being a parent doesn’t come with an instruction manual. That’s true. The only certainty is that it’s your choice to decide what’s best for you and your baby. Everybody offers their often contradictory opinions, and you may

Graphic Designer John Lagozzino Distribution & Not-for-profit Coordinator Debra Wain Sales Executives Nadine Hardwicke Belinda Dahan Gayle Hicks Advertising Enquiries Contact Sales on P 08 8242 8400 or nadine@pbcexpo.com.au

or read this magazine, we want you to feel better informed and more confident in your

All material appearing in this edition of Parenting Insights is copyright unless stated or it may rest with the provider of the supplied material.

PBC Expo Pty Ltd, takes all care to ensure information is correct at the time of printing, but accepts no responsibility or liability for the accuracy of any information contained in text or advertisements.

Views expressed are not necessarily endorsed by PBC Expo Pty Ltd.

parenting journey.

Copyright © PBC Expo 2016

find yourself unclear on where you can obtain unbiased and sound information.

That’s why we created this magazine. Just like the Pregnancy Babies & Children’s Expo it grew from; ‘we want to assist parents who are doing their absolute best to make sense of everything and the many options that are available to them’.

Facts, not opinions; from Australia’s leading and most authoritative voices.

Many of the contributors to these pages come from not-for-profit organisations or the academic world. Their primary goal is the health and wellbeing of you, your family and your baby – and that’s where all our interests align.

This magazine reflects the ethos of the Pregnancy Babies & Children’s Expo.

We believe we have an obligation to bring you and your baby together with the highest possible level of experts, information, services and products. When you attend the Expo

Beyond all this, we offer you an ever expanding library of knowledge on our website at pbcexpo.com.au There may not be an instruction manual for parenthood, but we’re on our way to delivering the next best thing.

Please, enjoy the read.

Greg & Julie Rocke PBC Expo Co-founders

Produced by PBC Expo Pty LTD PO Box 126 Semaphore SA 5019 Printing Graphic Print Group Circulation: 14,000 printed

Where Avenues of learning begin We believe childhood is a time for exploring, for creating, for discovering oneself and learning how to learn. It is a time for growing, meeting the world, and filling days with love and laughter.

Most important of all though, it is the time for being allowed to be a child.

• Passionate dedicated qualified professionals

• Care provided from 6 weeks of age to Kindergarten

• Government approved Kindergarten programs

• Kodaly Music Class and art classes included in the program

• Literacy, numeracy and school readiness programs

• Nutritious meals from our 5 Star kitchens

For further details and to find a centre near you visit

avenueschildcare.com.au

It’s always safety first!

Making up your babies cot SIDS & Kids

27

Product safety for under 5’s

32

12

and your consumer rights 5 first aid tips

37

Thinking secondhand?

44

Maybe think a second time 46

Safe travels Choosing the safest car restraint for your child

Common mistakes to avoid when fitting 52 a baby car seat or child safety restraint National burns awareness month 55

Health advice for the whole family IVF: What you need to know

6

Pregnancy symptoms

8

A practical guide to healthy

10

eating during pregnancy Pregnancy nutrition 12 Weighing up the options

14

Keeping your pelvic floor in good shape What is a midwife? 16 Gestational diabetes

18

14

52

Managing morning sickness 20 Am I in labour? 22 Tips to help minimise nipple 24 damage when breastfeeding The feed play sleep routine

26

Have you considered chiropractic care? 28 Immunisation Light for Riley 34

Breastfeeding 38

O

Blocked ducts and mastitis

and magazine we can also share some of their practical tips for you, your

National immunisation program schedule

The ‘heads up’ an cradle cap

35

40

Postnatal depression 42 Help your baby develop

43

during their vital first year Tips for introducing solid foods

48

ur priority has always been to find new ways to put you in touch with the best experts and services in the industry, and through our website

family, and friends.

Across the year we see thousands of families sharing the excitement of an impending or new arrival and we love being part of it. Wherever you are on your parenting journey, be it planning a family, already parents or parents-to-be,

Unlocking the secrets of nature play 50

our broad range of Exhibitors and experts, here in our magazine, and at our

Understanding toddler behaviour 54

Expos can help you make informed choices so you can decide what’s best

Want to breastfeed?

56

Australian Breastfeeding Association

for you and your family, year after year.

Don’t forget, you can go to our website at any time to read our Parenting Insights pages or join our social media communities.

Getting organised Pictures for prosperity

12

The importance of a quality nursing bra

13

pbcexpo.com.au BRISBANE 2016 | Parenting Insights

5

IVF: What you need to know

One in six Australian couples suffer from infertility. It’s important to remember not

everyone who is having trouble conceiving will need to undergo IVF (in vitro fertilisation).

What is in vitro fertilisation (IVF)?

How successful is IVF?

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

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

egg production. A doctor steps in at the right moment to extract

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

the eggs. These are then brought together with sperm in a

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

laboratory dish (rather than a woman’s fallopian tubes) to create

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

embryos. The embryo grows under laboratory conditions for five

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

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

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

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

Fortunately with IVF a lot of couples do get more than one

IVF has helped thousands of couples fall pregnant, however

embryo (blastocyst) formed in the laboratory. If you have more

there is no guarantee it will work for everyone.

than one healthy blastocyst you can freeze the remaining embryos to try again if implantation is unsuccessful, or to

When should you seek fertility help?

achieve a second pregnancy. Embryos can freeze well and over

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

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

naturally within about six months of trying, you should consider

potential is about the same as using a fresh embryo.

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

If IVF isn’t successful the first time, the first option is to use

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

any frozen embryos. If a couple aren’t pregnant after using their

pelvic pain or irregular periods.

frozen embryos the next step is to see their fertility specialist

Having trouble conceiving doesn’t automatically mean

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

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

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

situation and they will investigate why you’re not falling

couple to ensure their best possible chance of conception.

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

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

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

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

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

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

transferred to the woman to make sure that an embryo with

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

no detectable chromosomal abnormalities is placed back into

ovulation is normal.

the uterus. It doesn’t change the embryos you’ve got but it’s a

An ultrasound to check the uterus and ovaries may also be needed to check for any cysts or abnormalities that may affect fertility.

6

Parenting Insights | BRISBANE 2016

way to know which ones have a normal chromosomal make up and therefore are more likely to give you a healthy baby.

How can you increase your chance of IVF success?

If you have any ongoing medical conditions like asthma or

The best way to increase your chances of conceiving a baby

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

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

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

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

trying to conceive, or are pregnant.

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

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

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

important. Touching base with your GP for a general health

Trying to conceive naturally can be a time of ups and

check, eating a healthy balanced diet and exercising regularly

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

can boost your chances of having conceiving.

Melbourne IVF recommends where possible to plan when you’re

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

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

changes. Smoking or taking illicit drugs can also reduce your

is relatively stable if possible. Couples who undergo IVF have

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

to attend mandatory counselling and Melbourne IVF also has

you currently do.

supportive counselling as some couples need help along the way.

For men, alcohol intake of more than two standard drinks a

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

day can affect sperm quality so it’s important to moderate your

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

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

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

For women it’s a good idea to minimise alcohol intake when

uneventful, uncomplicated pregnancy.

you’re trying to conceive. No amount of alcohol has been proven to be safe during pregnancy, so you’re advised not to drink at all while you are pregnant.

Article courtesy of Bupa and Dr Scott Pearce, a senior specialist in Infertility & IVF, Gynaecology and Obstetrics For more helpful information and resources visit Bupa’s new health hub theblueroom.bupa.com.au

Before life changes forever.

Get Bupa.

If you’re starting a family, or adding to the brood, get Bupa Growing Family cover at least 12 months before your baby is born and be covered for: Your pregnancy including childbirth* A wide range of extras, including birthing classes and breastfeeding support# Private room cover plus extra benefits at Members First hospitals

bupa.com.au 134 135 | Bupa Stores

*IVF and assisted reproductive services are not fully covered. #At Bupa recognised providers.

BRISBANE 2016 | Parenting Insights

7

Pregnancy symptoms The symptoms of pregnancy can vary wildly in women.

Here are some of the more common experiences and ideas for how to manage morning sickness.

The first signs of pregnancy The first symptoms to show when you’re wondering ‘am I pregnant or not?’ are fatigue, going to the toilet a lot and sore, enlarging breasts. These three main symptoms become noticeable around the four or five week mark, which is usually when you first find out you’re pregnant. Some people might notice their urine takes on a funny smell, but that might take a second pregnancy to recognise.

While one woman might experience a range of symptoms, another might not have any at all. This isn’t a sign anything is wrong – the body reacts differently to pregnancy for everybody.

If you’ve been pregnant before, you may ‘feel pregnant’, or if you have some symptoms before your period is late you might decide to do a pregnancy test. Nowadays you don’t have to wait for your period to be late to take a home test, you can find out as early as four weeks. If the test turns up negative, don’t worry, it might be too early for the test you are using to detect the pregnancy hormones, but if it’s positive, you’re probably pregnant. The tests you buy in the pharmacy are generally pretty much as sensitive as the ones used in the doctors’ surgeries.

The first trimester The first 3 months (trimester) is a really important time; the baby is developing, the placenta is forming, and your body is adapting to being pregnant. At about 6 – 8 weeks morning sickness tends to kick in. Despite the misleading name, it can occur at, or last, through morning, noon and night. For some, nausea and tiredness can last right through until 20 weeks. It typically calms down by about 13 – 14 weeks.

Everyone’s experience is different but common symptoms include:

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Parenting Insights | BRISBANE 2016

• Fatigue

• Mood swings

• Nausea

• Food aversions or cravings

• Vomiting

• Increased sense of smell

• Change in appetite

• Heartburn

• Bloating

• Constipation

Managing morning sickness

Mood swings

Morning sickness is different for everyone. Some women might

Throughout pregnancy it’s common for women to experience

be lucky enough not to feel sick at all, others might have mild

ups and downs thanks to pregnancy hormones. It’s an exciting

nausea and some can feel very unwell. It’s the luck of the draw.

time, but hormones can cause emotional variations that are

It all comes down to the difference in hormonal fluctuations in

somewhat beyond your control. So if something annoys you,

pregnancy and your sensitivity to those hormonal fluctuations.

you may find that you are angrier than you would normally be,

We do say to people ‘talk to your mum’. A mother’s experience

or if something is a bit sad you may be more likely to cry when

may give an indication of the sort of symptoms and delivery

otherwise you wouldn’t, and if something is really good you may

you can expect.

be more excited than usual.

There is no one-size-fits-all cure for morning sickness. It’s down to what works for you. Listen to advice, try different things,

The third trimester

but ultimately do what makes you feel better. Some people find

The third trimester continues the growth phase and your baby

eating small amounts often can help manage nausea, others

bump, which may look and feel like a large basketball at this

find food makes them feel worse. You can try eating crystallised

stage, can start wearing you out. It might be hard to roll over in

ginger or taking ginger tablets, which can help to reduce nausea,

bed, stand from sitting or do some tasks around the home.

but if it’s bad enough you may need to take medication. There are medications your GP can prescribe that are quite safe to take

Some common symptoms at this stage include:

in pregnancy.

• Fatigue

• Heartburn

• Back ache

• Constipation

take the bus to work, can make their nausea worse. So it’s about

• Varicose veins

• Discomfort in the

trial and error and moving around in ways that don’t make your

• Sore feet

nausea worse.

• Shortness of breath

Managing fatigue

The tiredness may return and you might find yourself running

It’s just about getting sleep and not pushing yourself too hard.

to the toilet to pee more regularly as the baby’s head can

If you want to go to bed at 8.30 pm, go to bed and have a good

put extra pressure on your bladder. You might become short

night’s sleep. Your body is working much harder than it normally

of breath as your uterus gets larger and leaves less room for

does and it needs more rest. There may be mental exhaustion

your lungs to expand.

For some women certain smells, or activities like having to

too, so if you have an active job you may find it harder than

pelvis and hips • Swollen ankles

Try to take it easy during this stage, you’re at an exciting point

usual. Keeping mentally fit and rested is really important so

where you can start thinking about when you’re going to go

make the most of every opportunity to relax.

into labour. Put your feet up whenever you can, wear flat shoes and try using a heat pack to relieve back pain. It’s important to

The second trimester

take care of yourself by eating nutrient rich foods and keeping

By the time you get to the 13 – 14 week mark your baby will be

up some regular gentle exercise. Remember you’re nearly there

fully formed, but still very tiny. You’ve also got an established

so do whatever you can to make yourself feel comfortable.

placenta, and a growing uterus. It’s more about growth than development at this stage, and things stabilise in the body because of that. Now is the time when baby is growing big enough for organs to develop sufficiently so that he or she can survive out in the world. Typically morning sickness and fatigue

Article courtesy of Bupa For more helpful information and resources visit Bupa’s new health hub The Blue Room theblueroom.bupa.com.au

tends to ease from about 13 – 14 weeks and the second trimester tends to be a really nice time.

BRISBANE 2016 | 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, both your good 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 | BRISBANE 2016

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 contains an excellent

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

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

that might be contaminated with Listeria. These bacteria move into

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

the placenta and can cause premature birth or miscarriage.

small 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

cheese, 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 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

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

bacteria. Bacteria grow over time, so avoid eating food if it

flavoured beverages, cocoa and guarana energy drinks all

has been made more than 24 hours since being prepared.

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

Always 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

BRISBANE 2016 | Parenting Insights

11

Pictures for prosperity ver looked back at old photographs of previous

E

Capturing these

generations of your family and felt that connection of

moments by

continuity? Did you wonder about their stories?

cherishing a photo or choosing to briefly

Will future generations have the same questions?

write about it can be a

Start a new tradition and create a treasure for the future. With the

simple way of celebrating and

convenience and ubiquity of digital cameras, we’re taking more

sharing life’s experiences.

photos but doing less to preserve them.

Printing cherished photos is an important way to remember

70% of people we recently surveyed said they post photos to

our experiences – but you can take it to a whole new level.

social media or do nothing with them. Two thirds of people only

The Inicio Album provides you with hundreds of stickers

use their phone for photographs. A broken device or a forgotten

from which you or your child can choose what they want to

password and irreplaceable memories can be lost forever!

remember. By simply capturing our thoughts, noting what we

Maybe it’s time we did more to preserve our memories and leave a legacy of images and memories for the future.

A memory album filled with photos and mementos can tell

enjoyed and what we are good at, writing about our friends or relatives and special places we visited, we can record, remember, celebrate and share a wonderful life.

our stories and those of our children. Recording our milestones, small victories and thoughts does more than remind just ourselves of life’s wonderful adventures.

Article courtesy of Inicio Albums inicioalbums.com.au

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What’s the right time to start toilet training?

When your active baby learns to walk, they begin an amazing journey of exploration, rapid learning and growth. Change time can become a bit of a challenge as they just want to explore the world around them and don’t want to lie down for a change.

It is impossible to set an exact age to start toilet training. Some children are ready at 18 months, some not until 2 years or even later. There is no “right age” to start toilet training, it depends on where your child is at physically, emotionally and psychologically.

HUGGIES® Nappy-Pants allow bub to step into the nappy-pant to make change time a little easier and get them back to moving and exploring in a flash!

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At the newborn stage bub’s skin is delicate and sensitive. HUGGIES® Newborn Nappies are clinically proven to help prevent nappy rash and are endorsed by the Australian College of Midwives. The wetness indicator which changes colour from yellow to blue when wet on HUGGIES® Nappies can also help you know when to change. The HUGGIES® Newborn Nappy was awarded the 2015 Mother & Baby award for the disposable nappy category!

360 degree waistband

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Only brand with resealable sides

For more information go to huggies.com.au and join the Huggies® Baby Club

12 Parenting Insights | BRISBANE 2016

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 BRISBANE 2016 | Parenting Insights

13

Weighing up the options Keeping your pelvic floor in good shape during pregnancy, and taking into account all the possible childbirth scenarios, can help avoid problems later.

P

elvic floor health is often the last thing on a woman’s mind

• Constipation is common during pregnancy, and straining on

when she discovers she is pregnant. More pressing matters

the toilet can place further stress on the pelvic floor. Added

such as weight gain, stretch marks and returning to pre-baby

to this, a full, impacted bowel restricts the bladder’s holding

shape seem to occupy a large portion of their minds.

capacity, risking leakage. (Avoid constipation with a high-fibre

However, the rude shock of incontinence or prolapse after childbirth has many wishing they’d focused more on their pelvic floor - that unseen but vital group of muscles and connective

diet, good hydration, sensible exercise and learning pelvic floorfriendly toilet habits from a women’s health physiotherapist).

• Inappropriate high-impact or weight-training exercises can

tissue that holds up the uterus, bladder and bowel, and helps

further strain the pregnant pelvic floor. (These can be replaced

shut off the urinary and anal sphincters.

with low-impact exercises, controlled moves and lighter

The facts are startling; one in three women who have ever had a baby will be affected by urinary incontinence. When these

weights with increased repetitions).

• Childbirth itself places an enormous strain on the pelvic floor,

women reach the age of 50, they have a one in two chance of

particularly if the pushing stage is protracted. Less than half

incontinence, often due to prolapse.

of first-time mothers have unassisted deliveries, with 27.1

As many as one in four women have anal incontinence in

per cent undergoing a caesarean section and 23.3 per cent

late pregnancy (Johannessen, et al, 2013), with up to one in five

an instrumental vaginal birth (AIHW national core maternity

still suffering from anal incontinence one year after birth.

indicators aihw.gov.au/ncmi).

The pelvic floor takes much more than its fair share of stress

Lisa Westlake, physiotherapist, fitness professional and author,

during pregnancy and childbirth, making it more vulnerable than

said that, instead of women making a rigid plan about how they

other parts of the body during this period. This is because:

want their labour to progress, it might be helpful if they kept an

• The hormone relaxin is released, softening the body’s

open mind about possible labour scenarios.

tissues and ligaments so they expand to accommodate the growing baby. This, along with the increasing weight of baby and uterus, puts pressure on the pelvic floor, which, if not strong enough, may stretch and lose its elasticity, much like overstretched elastic. (Daily pelvic floor strengthening exercises are recommended to keep the pelvic floor strong).

14 Parenting Insights | BRISBANE 2016

'Rather than setting themselves up for potential disappointment, I suggest women do all they can to prepare themselves mentally and physically for labour, including sensible exercise, a positive mind set, and being educated about the different possibilities by appropriate, unbiased health professionals.'

“Talk to your doctor prior to delivery, and stay informed during

She did all she could to bring on a natural birth without need for

your labour as to your progress and options,” Westlake said.

induction – walking, expressing colostrum, acupuncture and

She also recommended the Continence Foundation of Australia’s

drinking raspberry leaf tea while pregnant.

free Pregnancy Pelvic Floor Plan app (downloadable from

However, when labour hadn’t started two weeks after her due

Google Play or the App Store), which has customised, pelvic

date, Rachael was induced – twice. Her labour required an

floor-safe workouts for pregnant and postnatal women.

episiotomy, forceps and an epidural.

She also encouraged women to seek out a women’s health and continence physiotherapist during pregnancy.

“A women’s health and continence physio will help you

“It was a difficult birth, and he had a pretty big head,” she said.

After the birth, Rachael had little control over her bladder.

“For the first couple of weeks I couldn’t do things like go into the

understand your pelvic floor, ensure you are exercising it

shops because I was scared I would suddenly lose complete

correctly, and help you safely and effectively regain your pelvic

control of my bladder and wet myself,” she said.

floor function after delivery.”

She recommended the free Pregnancy Guide booklet, downloadable from the Continence Foundation website, and encouraged women to visit the pelvic floor first website, which has a section devoted to exercises during pregnancy.

Her incontinence, she now realises, was further exacerbated by her excessive water intake. “Even though everyone says to drink more when breastfeeding, I overdid it!” she said.

A referral to a continence physiotherapist by her concerned midwife, and the resumption of pelvic floor exercises, saw a dramatic improvement in Rachel’s incontinence within a

Rachael Thompson’s story Vagina Diaries writer and director Rachael Thompson was

six-month period.

Rachael attributes her relatively swift recovery to the

acutely aware of the importance of her pelvic floor when she

excellent condition of her pelvic floor, the legacy of the

first became pregnant four years ago. She did her pelvic floor

strengthening work she’d done while pregnant.

exercises religiously while pregnant.

“My main concerns were to maintain my pelvic floor to avoid

“Without the pelvic floor exercises during pregnancy, my problems would have been much more severe,” Rachel said.

long-term damage, and avoid an episiotomy by doing perineal massage and stretching,” Rachael said.

Article courtesy of Maria Whitmore Continence Foundation of Australia and The Pregnancy Centre continence.org.au BRISBANE 2016 | Parenting Insights

15

What IS a midwife

and what can they do for me?

Y

ou are pregnant or trying to get

community based practices, called private

many care providers are involved in

pregnant and it is highly possible that

midwifery practice. These midwives

your care and whether or not you have

you don’t know what a midwife is. You

provide antenatal and postnatal care in the

private health insurance. Midwives quote

may also think that a midwife is some kind

community or the woman’s home and can

maximum costs for birth care at $2500

of nurse. Midwives are health professionals

provide birth care in a range of hospitals.

with Medicare rebates and private health

who have a single area of practice – the

The care, funded by Medicare and /or

rebates reducing this cost. Most midwives

childbirth period – and in fact they are a

private health insurance rebates, can

indicate their fees are less than this.

key care provider for women from their

start at any time during pregnancy and

Payment plans are also available in many

early pregnancy until their baby is six

continues to up to six weeks after birth.

practices.

weeks old.

Other benefits may include longer

So why have your own midwife?

antenatal consultations being available,

continuity of midwifery care, is one of

Having a midwife, who you see in

the ability to have your partner or family

the safest forms of care which provides a

pregnancy and is on call for you for

involved in your care, post birth care in

range of better outcomes for mother and

labour and birth and to six weeks after

your home daily for a week or more, post

baby. Yet many women do not know this

birth, means you know your birth care

birth services continuing for up to six

option even exists! Midwives traditionally

provider. Women having midwifery care

completed weeks, and possibly having

worked hospitals, where they provided

are more likely to have a normal birth,

more flexibility in your options for care.

care as shift workers, to different women,

breastfeed their baby, are less likely to

Midwives often provide services for water

in different areas. Over the last decade

have postnatal depression and are less

birth and also provide additional services

continuity of midwifery care began to

likely to have epidurals and inductions of

such as education classes.

be offered in hospitals, where it is called

labour.

Care from a known midwife and

1,2

caseload or Midwifery Group Practice (or

The cost of a midwife may also be

In conclusion, Midwifery care is now widely available across Australia.

MGP). This form of public funded care

significantly less than seeing a private

My Midwives offers a range of services

has been available in limited numbers to

obstetrician. The cost of antenatal and

including free pregnancy testing,

women seeking care in public hospitals.

postnatal care is based on the length

childbirth education, antenatal care, birth

of the consultation working similarly

and postnatal care. Our midwives work

mean that continuity of midwifery care

to when you see a GP and can also be

together with doctors, hospitals and other

can be provided much more widely

bulk billed. Birth care costs depend on

practitioners to develop the blend of care

through care from midwives based in

where you are having your baby, how

that works best for you.

However very recent changes now

McLachlan HL, Forster DA, Davey MA, Lumley J, Farrell T, Oats J, Gold L, Waldenstrom U, Albers L, Biro MA. COSMOS: COmparing Standard Maternity care with one-to-one midwifery support: A randomised controlled trial. BMC Pregnancy Childbirth 2008; 8: 35. 2Tracy SK, Hartz DL, Tracy MB, Allen J, Forti A, Hall B, White J, Lainchbury A, Stapleton H, Beckmann M, Bisits A, Homer C, Foureur M, Welsh A, Kildea S. Caseload midwifery care versus standard maternity care for women of any risk: M@NGO, a randomised controlled trial. The Lancet, Volume 382, Issue 9906, 1723 – 1732.

1

16 Parenting Insights | BRISBANE 2016

Article by Liz Wilkes CEO of the Midwifery and Maternity Provider Organisation • mmpoa.com.au

Colleen

Midwives & families Colleen

Approx. 20 weeks

Hi my name is Colleen and I am 28 years old. This is my first

Rachel, Leila & Baby Lola

pregnancy. I work as an accountant in Melbourne and my

We are a family of three

husband and I have recently bought our first home. We have had

Rachel, Leila and baby Lola.

some challenges with pregnancy, but have finally got there and

Lola is growing and teething now, so writing the beginning of

are very, very excited about this our first baby. I have been really

our story takes us back a little way. As you can imagine from the

fortunate so far, with no morning sickness or any other major

intro having a family was a very conscious choice for us. In order

problems. I attended the Pregnancy Babies & Children’s Expo in

for it to become a reality it required us to be proactive and fully

Melbourne with my mother and I am so happy that I did!

engaged. We were very fortunate in finding a team to support us

I went in to the Meet the Midwives lounge to talk about pregnancy and met Hannah from My Midwives Melbourne

through the journey of becoming pregnant.

The desire to be supported and empowered endured once

North. Hannah explained how My Midwives worked and both

pregnant so we set out to become fully informed of our options

mum and I thought it sounded like an amazing option for

and choices, which included attending the Pregnancy Baby &

my pregnancy and birth. I booked pretty much straight away

Children’s Expo in Melbourne. We looked around for our team

because My Midwives was an option for me where I would have

because it was extremely important to us to have continuity

continuity of care both during and post pregnancy, instead of

of care leading up to, during and post labour. We determined

seeing a different person for each hospital appointment.

that having a private midwife [a member of the Midwifery and

So far Hannah has been a wealth of information and I feel

Maternity Provider Organisation (MMPOA)] would ensure that we

that I know a lot more about my pregnancy, options for various

were able to have someone in the room who we trusted, who

tests and the choices available to me than I ever would have

knew us, was able to advocate for us and provide support and

otherwise. It is really important in your first pregnancy to know

guidance in line with our beliefs/values and desires for the birth.

about nutrition, exercise and the "dos and don’ts". At this stage, I

We found that having our midwives as part of ‘our birth

am hoping to work to pretty much the end of pregnancy to save

family’ helped make what could have been a scary and difficult

my leave and entitlements for that time.

experience a positive and ‘easy’ one. We felt well informed and

We are pretty excited and feel like we are starting to learn

engaged in all the decisions – that they were our decisions

a lot about labour and birth and what will happen. Whilst I get

– and that our midwives made sure we knew everything we

heaps of information from Hannah, I am also going to attend

needed to know. The postnatal care meant that care continued

antenatal classes with My Midwives to get more information

well and truly beyond the “normal” kind of hospital period so we

because I think with your first baby, it is really important to

felt like we had lots of support as we both adjusted to having a

get to know as much as you can. I can't wait to have my

new baby. Postnatal care is for the full six weeks after the birth of

baby with Hannah!

the baby and that is really just fantastic when sorting through the initial breastfeeding and baby woes.

BRISBANE 2016 | Parenting Insights

17

Gestational Diabetes increased risk of

How is Gestational Diabetes treated?

developing gestational

“The aim of treatment is to maintain your

diabetes if you:

blood glucose levels, or the levels of sugar

• are aged over 30

in your blood, within a normal range for

• have a family

the rest of your pregnancy,” Michelle said.

You have an

history of Type 2 diabetes • are overweight • are from certain ethnic backgrounds— Indigenous Australian, Torres

For most women this can be achieved by: • following a healthy diet — a dietitian will provide information to assist you • having a healthy weight gain during pregnancy • exercising regularly

Strait Islander, Indian, Vietnamese, Chinese, Middle Eastern, Polynesian

Approximately 1 in 10 women

or Melanesian

with gestational diabetes will require

• have had gestational diabetes in a previous pregnancy

Gestational diabetes mellitus (GDM) is a specific type of diabetes that only occurs during pregnancy. It is usually a temporary condition that goes away after the birth of the baby,

• have previously had difficulty carrying a pregnancy to term • have previously birthed a baby weighing more than 4 kg.

insulin injections during pregnancy to maintain normal blood glucose levels.

As gestational diabetes usually occurs later in pregnancy, your baby’s physical development is not affected.

However, because glucose crosses the placenta your baby is exposed to your

however can have significant effects

How is Gestational Diabetes diagnosed?

higher blood glucose levels.

for both mother and baby if not well

The Australasian Diabetes in Pregnancy

to produce more insulin and it is the extra

controlled throughout the pregnancy.

Society recommends testing for

insulin that causes your baby to grow

gestational diabetes in all pregnant

bigger and put on weight.

This stimulates your baby’s pancreas

A

women.

diabetes, usually between 24 and 28

be performed between 26 and 28 weeks

it can take several days for the baby to

weeks of pregnancy.

of pregnancy.

adjust,” Michelle said.

pproximately 1 in 20 pregnant women may develop gestational

“GDM occurs as a result of changes in

An Oral Glucose Tolerance Test will

“The oral glucose tolerance test

“In the first few days following birth, the baby will be closely monitored and

“The baby’s blood glucose levels may

hormone levels as pregnancy progresses,

involves taking a blood test before and

be tested regularly until their levels remain

which can interfere with how some

two hours after drinking a sugary drink,”

within normal range.”

women’s insulin works,” Mater Mothers’

Michelle said.

You can help your baby by:

Hospitals Parent Education Unit Manager Michelle O’Connor explains.

“Insulin helps the body to process

“This test may be performed earlier in your pregnancy if there is a clinical reason to do so.”

• Maintaining healthy blood glucose levels during pregnancy • breastfeeding within one hour of birth

glucose (sugar) from the blood into the

and continuing to feed, at least every

muscles for energy and into the liver for

three hours, until your milk comes in

storage and energy.”

(this usually occurs on the third day after birth).

18 Parenting Insights | BRISBANE 2016

Following a healthy diet, having a

What should I eat to reduce my risk?

Ongoing, regular contact with diabetes

healthy weight gain during pregnancy

• Base your meals on wholegrains,

educators, dietitians, specialists and

and exercising regularly will help to control your blood glucose levels during pregnancy.

“Gestational diabetes is primarily

lean proteins, fruits and vegetables.

• Choose a diet low in saturated fat –

pregnancy is important for good blood

choose low fat dairy foods, lean meats

glucose levels and best outcomes for

and skinless chicken, and limit biscuits,

mother and baby.

managed by following a healthy well-

chips, cakes, pastries, processed fried

balanced eating plan, taking into

and takeaway foods.

consideration carbohydrate intake and

attendance at antenatal clinics during

What happens after the birth?

• Include small amounts of the healthy

In most cases, gestational diabetes goes

physical activity,” Mater Mothers’ Hospitals

poly or monounsaturated fats and

away after birth, however, there is a 40

Senior Maternity Dietitian Elin Donaldson

oils such as canola, olive or sunflower

per cent chance of developing gestational

explains.

oils and margarines, avocado and

diabetes in your next pregnancy and an

unsalted nuts.

increased chance of developing Type

“If women cannot manage their blood glucose levels with diet and activity alone,

• Choose lower glycaemic index (GI)

2 diabetes later in life. Breastfeeding is

medication such as insulin (injections) or

carbohydrate foods such fresh fruit,

protective for the mother and you are less

metformin (tablets) is sometimes needed.”

grainy bread, low fat dairy foods, pasta,

likely to develop this condition if you are

basmati rice and low GI cereals.

able to breastfeed your baby.

Although some foods such as carbohydrates put glucose into our blood stream, cutting these foods out completely means cutting out all

• Eat regular meals and watch your portion size.

• Avoid high sugar drinks (e.g. cordials,

the nutritious goodness needed for a

soft drinks) and choose water as your

healthy pregnancy and a growing and

everyday drink.

developing baby.

You will be asked to repeat your glucose tolerance test six to eight weeks after your baby’s birth.

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

Baby budgeting made easy Manage & organise your options by creating your own lists

Keep track of purchases using the handy budget tool

Save your favourites for easy access, & share them with your friends & family online

Check out the news section for latest trends and helpful tips

mybabycompanion.com.au

BRISBANE 2016 | Parenting Insights

19

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

such as acupuncture and acupressure (similar to sea sickness)

this condition was more common in the morning and hence

with sea sickness bands also assisting some people. Ginger is

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

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

is sometimes ongoing throughout the day. For many woman it

quantities. Seeing a complementary therapist in your preferred

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

treatment spectrum from acupuncture to naturopathy and

resolved by 12 weeks when hormone levels begin to settle.

homeopathy is a method of treatment however this should also

However the variations are quite marked with some women

be discussed with your pregnancy care provider.

experiencing no symptoms at all and some experiencing the

For women who would prefer medical treatment there are

severe ‘hyperemesis gravidium’ which is characterised by

a number of medications which may ease the symptoms of

extremely severe symptoms often requiring hospitalisation for

nausea and vomiting of pregnancy. These require prescription by

dehydration. This condition has been made more well known

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

recently by HRH Princess 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.

20 Parenting Insights | BRISBANE 2016

Article by Liz Wilkes CEO of the Midwifery and Maternity Provider Organisation • mmpoa.com.au

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 | BRISBANE 2016

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 BRISBANE 2016 | Parenting Insights

23

Tips to help minimise nipple damage when breastfeeding M

any pregnant women express a desire to breastfeed their baby after they are born. Breastfeeding, although natural,

Establishing good technique A well-attached baby can help prevent many breastfeeding

is a learned skill for you and your baby but many mums report

problems, shouldn’t cause any nipple pain and drains the breast

that once they got the hang of it, they found it really enjoyable

well. This helps ensure a good milk supply so your baby grows well.

and rewarding.

When you begin breastfeeding, your nipples may be sensitive

Position yourself comfortably with back support, pillows supporting your arms and in your lap and your feet supported by

and you can expect some early nipple tenderness. A little time

a footrest if possible. Position your baby close to you so that they

and patience in the early stages, good attachment and taking

do not have to turn their head to reach your breast. Their mouth

care when getting baby on and off the breast should minimise

and nose should be facing your nipple.

sore, cracked nipples and this should cease to be a problem after the early weeks.

Here are some great tips that may assist in minimising damage to your nipples.

A poorly-attached baby can cause soreness, grazed or cracked nipples and this may lead to further problems including pain, stress, blocked ducts and mastitis. If not rectified, your nipples can develop cracks. Breastfeeding with a cracked nipple is often painful and cracked nipples may bleed during

Look out for early feeding cues Try to offer a feed before your baby starts crying. Waiting until

breastfeeds.

You and your baby will find a technique that works for you

your baby is crying is actually a late feeding cue and may cause

after some practice. Experiment with various positions until you

some stress, making it harder for them to attach. Early feeding

feel comfortable. To check that baby is attached well, look for

cues mean your baby is calm and they include:

these signs:

• Making sucking motions with their lips

• Chin is pressed into the breast and nose is clear or only just

• Opening and closing their mouth

touching the breast.

• Sticking out their tongue

• Your baby’s mouth is open quite wide and lips are not sucked in.

• Puckering of their lips.

• Tongue is forward over the lower gum (may be difficult to see

• Moving their head from side to side, as if looking for something • Putting their hands in the mouth and sucking on them

— don’t pull them away to check or you might detach him).

• Your baby has much of the areola in their mouth.

• There is no pain (new mums may feel a stretching sensation as the nipple adjusts to being drawn out).

24 Parenting Insights | BRISBANE 2016

Other tips you may find helpful: • You may notice your baby’s whole jaw moving they suckle and even their ears wiggling!

• They should not be sucking in air or slipping off the breast and cheeks should not hollow as they suck.

• After feeding, check your nipples for signs of stress, such as

• Before feeding, express a few drops of milk and smear on the nipple.

• If your breasts feel full and tender, massage your breasts gently and apply warmth, like a heat pack (ensuring it is not too hot) to help get your milk flowing.

red stripes or a squashed look. If you have these signs, double

• Leave your bra open for a few minutes until your nipples are dry.

check that your baby has latched on correctly during your

• Change nursing pads frequently. Consider washable nursing

next feed.

pads if disposable ones are chafing.

• Avoid using soap, shampoo, rough towels and anything else

Properly detaching your baby from your breast by breaking the

on your nipples that is drying or may damage the nipple skin.

suction with clean finger inserted in the corner of your baby’s mouth, before removing them from your breast is best. Allowing

Seek assistance early if you are having difficulties – this is really

your baby to self-attach as often as possible while you both learn

important and can prevent further problems from occurring.

will also give you the best chance of avoiding damaged nipples.

You can contact your medical adviser, a lactation consultant, child health nurse or an Australian Breastfeeding Association

Chose a good nipple balm

(ABA) breastfeeding counsellor. Information is also available

You may wish to use a nipple balm to keep the skin on the nipple

online at the ABA website breastfeeding.asn.au.

itself and around the areola hydrated. This is to help prevent dryness and keep your nipples in good condition, making it easier for your baby to latch on to.

Look out for a balm made with natural and organic oils so

Article courtesy of Michelle Vogrinec GAIA Skin Naturals

you don’t need to wash it off before a feed. It can be used during pregnancy if you have dry nipples and you’re your bubba is born, applying the nipple balm after each feed will help keep your nipples soothed, hydrated and protected.

BRISBANE 2016 | Parenting Insights

25

The feed play sleep routine arents face the awkward situation of having to make

P

The

decisions about how to manage family life with their own

pattern

babies when there are strongly held views about what is the

might include

best thing to do. On the one hand there are advocates for baby-

wrapping a little

led care where parents provide what it is they think the baby

baby or putting an

needs at the time. On the other hand routines of daily care are

older baby in a sleeping

suggested to be a more sustainable way of making sure that the

bag, and then putting the

baby feeds and sleeps well. But do they actually work? Following

baby to bed for a sleep. These

her packed out presentation on sleep and settling at Melbourne’s

patterns are adjusted with age, but follow

recent PBC Pregnancy & Newborn Special Edition Expo, Professor

the same general pattern throughout infancy.

Jane Fisher shares a gentle way to structure your baby’s time

Babies grow and flourish when their needs are well met, and

that is always successful. Some of the questions I am asked most

they thrive when they know what to expect. We know that when

often in my work as a clinical psychologist at a residential early

parents follow a feed play sleep routine of daily care, their babies

parenting service are about what a baby routine is and why are

cry and fuss less and are easier to care for when they are awake.

they important. There are many books, theories and parenting

When parents are under-slept ( because they are awake to care for

experts out there – each with a different opinion of what is right

the baby very frequently overnight and have no daytime rest), they

for your baby – which can not only make it difficult to know which

are less able to concentrate, plan or make decisions and are more

information is reliable as a new parent, it can also lead to a sense

likely to be irritable, agitated and downhearted.

of failure should a particular routine not go to plan with your child.

When babies are born, parents are encouraged to ‘feed on

Parents have to talk about many practical aspects of life together once they have a baby that did not need to be discussed

demand’. At the beginning of life it is a good idea to offer a feed

before. It can be difficult to agree on routines, but this is when your

when the baby wakes up or cries. As the baby grows, this can

baby’s wellbeing should be held in mind. Sometimes for example,

lead us to think that every cry means that the baby is hungry.

the parent whose hours of employment mean that they are home

This can lead to frequent short feeds interspersed with short naps.

after the baby is due to go to bed yet they still want to be able to

If babies do not have enough sleep they can become irritable,

see and play with them. This then leads to the baby being over-

and under-slept babies are less likely to feed well and grow.

stimulated, tired and difficult to settle and to an argument between

We are not usually told when ‘feed on demand’ should be

parents. It is important to remember that a baby is not an object

replaced with a pattern where feeds are separated by periods of

of entertainment and that babies benefit when their needs are put

play and enough sleep. At What Where We Thinking! (the award-

ahead of either parent’s preferences or wishes.

winning parenting program now available to new mums and dads as a blog and app), we believe that the best way to care for your baby and meet their needs of food, play time and sleep is to use a ‘feed play sleep’ routine of daily care.

The foundation of this pattern is that babies are fed when they wake and then have a play period, which might include enjoyable interactions with others, exploring or playing with a toy.

When they show tired cues, like rubbing their eyes, yawning or becoming irritable, it is time to follow a pattern the baby is used to.

26 Parenting Insights | BRISBANE 2016

Article courtesy of Professor Jane Fisher Jean Hailes Research Unit Director jeanhailes.org.au

The ‘What Were We Thinking!’ blog and app support mums and dads to parent with confidence. To read more from Jane Fisher, join the blog conversation or download the FREE iOS app, visit jeanhailes.org.au/what-were-we-thinking.

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 sidsandkids.org/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 sidsandkids.org BRISBANE 2016 | Parenting Insights

27

Advertorial

Have you considered chiropractic care?

Have you often wondered what chiropractic is? Is it safe? Is it effective?

Chiropractic care has an excellent safety record in Australia. Chiropractors are university trained, nationally regulated health professionals, trained to care for people across their lifespan, including infants and children.

What is chiropractic?

Chiropractic is a ‘hands on’ health care discipline, concerned with the diagnosis, treatment and prevention of disorders of

Are chiropractors regulated?

the neuro-musculoskeletal system and the effects of these

Yes. In Queensland chiropractors are regulated by the Australian

disorders on general health. Chiropractic focuses on manual care,

Health Practitioners Regulation Agency (AHPRA) via the Chiropractic

including spinal adjusting, mobilisation, soft tissue therapy and

Board of Australia, working in tandem with the Queensland Health

rehabilitation. Chiropractic also places an emphasis on nutrition,

Ombudsman. Like all other registered healthcare practitioners in

exercise, wellness, and healthy lifestyle improvements.

Australia, chiropractors must adhere to National Law and profession

Chiropractic care is a drug and surgery free modality

specific codes of conduct and guidelines.

of treatment.

Chiropractors provide patient-centered care and recognise

Is chiropractic safe?

the value and responsibility of working in collaboration with

Chiropractic Care has an excellent safety record in Australia.

other health care practitioners.

Both in Australia and around the world, chiropractic care is a low risk modality of health care. There are more than 12 million visits

How are chiropractors trained?

to chiropractors in Australia each year. Over 1 million of these are

Chiropractors in Australia are trained at University for a minimum

paediatric visits.1-2 Utilisation rates for chiropractic have increased

of five years full time in all basic sciences including: anatomy,

significantly in the past 20 years. During this time there have been

physiology, chemistry, physics, radiology, orthopaedics,

few, if any, serious adverse events reported in medical literature.

neurology, pharmacology and general diagnosis. Chiropractors are licensed to take and report on x-rays, with many taking their

Do I need a referral to see a chiropractor?

own x-rays on-site.

You do not need a referral to see a chiropractor.

As with other health professions, there are international and national standards of qualification required to practice in Australia.

28 Parenting Insights | BRISBANE 2016

Do chiropractors treat children?

Why choose chiropractic?

Yes. Many chiropractors see children in their practices. The

Every body has a nervous system that controls and coordinates

Chiropractic Board of Australia has developed a Code of Conduct

all the functions of life. Chiropractors look for any problems

for chiropractors which states, best practice with children and

affecting this system and use the most appropriate care and

young people involves placing the interests and wellbeing of

advice, to help you function better. This is why so many happy

the child or young person first and ensuring there is informed

families choose chiropractic care.

consent from the child’s parent or guardian.3 The risks of care and alternatives to care must be sufficiently explained to the

How do I locate my local chiropractor?

parent or guardian, and the chiropractor will identify ‘red flags’

You can locate your closest chiropractor by contacting the

particular to children and young people and investigate, manage,

Chiropractors’ Association of Australia (Queensland) Limited

co-manage, or refer to a medical practitioner as appropriate.

(CAAQLD) office.

Finally, practitioners will modify all care and treatment to suit the age, presentation and development of the patient.4 There are many great case studies and a growing body of research to support chiropractic care.

Chiropractic care has an excellent safety record with children.

Article courtesy of Chiropractors’ Association of Australia (QLD) caaq.com.au For further information regarding chiropractic care and your specific needs call (07) 3394 833 or email admin@caaq.com.au

Additionally, given the personal nature of chiropractic care, there is a high expressed satisfaction by parents / guardians seeking care of their children.

About CAA QLD The Chiropractors’ Association of Australia (Queensland) Limited (CAAQLD) is the premier body representing chiropractors in Queensland, and is the only state-based representative Association for Chiropractors in Queensland. As an Association, it is CAAQLD’s goal to empower Queenslanders to experience a healthier life through chiropractic care, and to uphold the highest standards of care and professionalism in research, education and practice.

References: 1. Xue Cl, Zhang AL, Lin V, Myers R, Polus B, Story D. Acupuncture, chiropractic and osteopathy use in Australia: a national population survey. BMC Public Health. 2008;8:105. 2. French S, Charity M, Forsdike K, Gunn J, Polus B, Walker B, et al. Chiropractic Observation and Analysis Study (COAST): providing an understanding of current chiropractic practice. Medical Journal of Australia.

2013;199(10):687-91. 3. Chiropractic Board of Australia. Professional code of conduct guidelines for chiropractors 2011 Available from: chiropracticboard.gov.au. 4. CAA National 23 May 2016.

Chiropractic Care has an excellent safety record in Australia. Available from: chiropractors.asn.au/resources/latest-news/item/634-chiropractic-care-has-an-excellent-safety-record-in-australia.

BRISBANE 2016 | Parenting Insights

29

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Product safety for under 5’s and your consumer rights

T

• Don’t purchase children’s products from markets – these are high risk areas • Check the Choice website for product tests and impartial information about specific products choice.com.au •

Be careful about using handed down

products or buying second hand. These products, although they may look like good value, may not meet the latest safety standards

he Office of Fair Trading cares about your rights a consumer

or be damaged in a way that may not be obvious. The

and about the safety of products directed towards small

safety instructions may also be missing. It might save a few

children. This is why we have attended the PBC Expo since day

dollars initially but cost a lot more if an injury is caused by an

one!

unsafe product

Children under five years of age are a high risk injury group. This

• Be aware of ‘hidden’ hazards (e.g. blind cords, ethanol

has been recognised by product safety regulators and most of

fireplaces, button batteries, magnets, soft sleeping surfaces,

the products directed to this age group must meet certain safety

unstable furniture)

standards. These include cots, portable cots, child restraints for

• Be careful about buying via the internet – do your homework

motor vehicles, baby walker’s prams and strollers, bath seats, toys

first as it may be difficult to get a refund from an overseas

for children under three, pool toys and dummies. You need to

supplier if the product proves to be unsafe!

be a smart shopper for nursery products and make purchasing

• Report any safety problems as soon as possible to the Office

decisions based on the safety of the product rather than what

of Fair Trading at safety@justice.qld.gov.au or the ACCC.

looks cool. Here are some tips to avoid buying unsafe products: • Check the Product Safety Australia website

What if something goes wrong?

productsafety.gov.au or fairtrading.qld.gov.au regularly

As a consumer you have certain rights to have a product

and search for the product you are most interested in

repaired, fixed or refunded at no cost under some circumstances,

• Check the Recalls Australia website recalls.qov.au to see if

such as:

any products you are interested in have been recalled in the

• You buy something but don’t realise that it’s broken or unsafe

past. If you have seen a product that has been recalled then

• You buy something but it breaks down or falls apart after a

you should report it to the Office of Fair Trading as quickly as possible safety@justice.qld.gov.au • Consider joining a parenting blog – a lot of really good information is exchanged via these blogs but make sure you can check the accuracy of any advice given

32 Parenting Insights | BRISBANE 2016

short time • You buy something but it doesn’t match how the business described it. It might be the wrong size, colour, shape or design • The business showed you a sample, but the actual product doesn’t match what you saw

Know your consumer guarantees • The business told you a lie about what their product could do, this might be from their salesperson, a sign or an ad

Visit the Office of Fair Trading’s website for more information on your guarantees as a consumer at fairtrading.qld.gov.au

• You are not automatically entitled to a refund if you change your mind about the product.

Read the paperwork (and keep it)

What to do if something has gone wrong:

Reading the paperwork will give you important details about a

• Stop using the product

product or service.

• Return it to the store or call the service provider as soon

Make sure that you:

as possible • Make sure you have proof of purchase, such as a receipt Take it with you when you return the goods.

• read and understand any contract before you sign it • keep a copy of anything you sign • read the instructions to learn how to safely use your product

If it is unsafe report it to the Office of Fair Trading:

• don’t try to fix a broken product (unless you are qualified to do so)

safety@justice.qld.gov.au

• don’t void the warranty by using products incorrectly – follow manufacturer’s instructions at all times.

Returning products Usually you have to take the goods back to where you bought

Care for your receipts

them from. However, if the goods are too expensive to return,

Some types of receipt paper can fade quickly. This might make it

the business must organise to collect them from you.

difficult to prove a purchase later on. Businesses do not need to

This might be because:

tell you how to care for your receipts.

• the goods are too big to easily move, like a TV or bed

You can care for your receipts by:

• you live a long way from where you bought the goods

• storing them carefully (away from light, heat,

• the goods are broken and you can’t move them.

abrasives or plastics) • taking a photocopy, scan or photo.

How to avoid a bad shopping experience

• You will need proof of purchase if you need to claim

Preventing a bad experience is far better than trying to fix

a refund on the product or service. The best proof of

problems later on. These simple tips will help you avoid a bad

purchase is the receipt, because it will usually itemise the

shopping experience:

products or services you bought.

Shop around

Talk to the business

Make sure you research your options before you buy an item.

Most businesses are happy to help if you have any complaints

Search the internet, look in catalogues, visit different stores, talk to

or problems. Talk to them and try to resolve it. Send your

shop staff and discuss your purchase with family and friends.

complaints in writing to the manager. Describe the problem and

Make sure you compare items on the basis of quality, safety

how you would like them to fix it. If this doesn’t work, you can

and cost. The cheapest item isn’t always the best (or safest) option.

lodge a complaint with the Office of Fair Trading.

Budget and spend sensibly

For more information on consumer rights and product

Make a budget to balance your income and expenses. Add up all

safety visit the ACCC website at accc.gov.au

of your expenses and compare them against your income. You can download a free budget planner from the qld.gov.au website.

BRISBANE 2016 | Parenting Insights

33

‘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, and he rapidly

‘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

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.

34 Parenting Insights | BRISBANE 2016

Article courtesy of Light for Riley facebook.com/lightforriley

National Immunisation Program Schedule Birth to 4 years of age – from February 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) • Measles, mumps and rubella (MMR) (to be given only if MMRV vaccine was not given at 18 months)

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)e

• Pneumococcal conjugate (13vPCV)

4 years (medically at risk)

• 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 BRISBANE 2016 | Parenting Insights

35

PRO

CEEDS

SUPPORT

DE

VELOPED BY

Mater +Mums

First iApsid T

courses s First Aid Tiny Heart ith the owered w p m e g lin ivers fee leave careg mergency y medical e n a e g a n a to m eir top confidence Here are th . e c fa t h ig r child m their baby o encies. st Aid emerg ir F n o m m 5 co tips for the

swelling of the area. Ice packs are not recommend for use for any injury above the neck and is a common misconception among

Burns

parents and caregivers. If your child appears limp, unresponsive,

If your little one sustains a burn, immediate intervention is

more tired then usual, has any clear fluid coming from ears or nose

recommended to prevent the injury from getting worse. It is so

or vomits within 4 hours of sustaining a head injury you must seek

important that cool running water is applied to the burn area for

emergency assistance immediately.

at least 20 minutes to stop the burning process and provide some pain relief. Next, ensure to elevate the limb to reduce swelling, pain

Poisoning

and cover the burn with a non-stick dressing. All burns on young

Accidental poisoning is common in young children aged one to

children should be assessed by a medical professional, especially

three; as they become more curious and begin to explore their

if your child’s burn is larger then a 50 cent coin or if the skin has

home environment. Poisons can be swallowed, spilt on the skin,

bubbled or come away from the area.

sprayed, splashed in the eye or inhaled. Most poisonings occur in the home or when visiting friends or family. Signs and symptoms

Choking

you should look out for are nausea, vomiting, drowsiness and

Choking is the most common reason for parents and caregivers

seizures. It is important that if you suspect your child to be

in Australia to call 000. There are two types of choking; partial

poisoned that you immediately call the Poisons Information Centre

and complete obstruction. Partial obstruction is where the object

on 13 11 26. Under no circumstances are you to induce vomiting.

causes laboured, noisy breathing, and a complete obstruction is where no air can come in or out. Treatment for partial obstruction

Fever

is to encourage the child to cough in order to dislodge the object.

Fever occurs when there is an increase in the child’s body

If you find that the airway is completely blocked, it is then crucial

temperature and is a typical response to infection. The normal

to dial 000. If the child is conscious proceed to give five sharp back

temperature for babies, children and adults is 37 °C. Fever is rare

blows between the shoulder blades, followed by five chest thrusts

in bubs under 6 months of age; as they have not developed the

between the nipples. In-between each back blow and chest thrust

mechanisms to fight infection and therefore a fever can be a

check to see if the airway has cleared.

sign of serious illness and should always be seen by a doctor.

The key treatment for managing a fever is to ensure that your

Head Injuries

child is hydrated, that they are not overheated and the use of

Often children will fall and bump their head resulting in a big egg

paracetamol and ibuprofen is monitored in accordance with

on their head. This is scary to see on your bub but never fear the

the recommended dosage.

treatment is clear. The big egg on their head can be treated with a cold compress of a face washer run under cold water and applied to the area. This will help to calm your child and also assist with

For more information visit tinyheartsfirstaid.com BRISBANE 2016 | Parenting Insights

37

Breastfeeding Blocked ducts and mastitis What are the differences between blocked ducts and mastitis?

Blocked duct

Side effects of blocked ducts and mastitis Blocked duct • Your milk supply from the affected breast may decrease

A blocked duct is an area or segment of the breast where milk

temporarily. This is normal—extra feeding or expressing will

flow is obstructed causing a tender lump or spot in the breast.

return your supply to normal.

Local symptoms: • Reddened area or segment of the breast which becomes tender, hard and painful.

• Occasionally there can be localised tenderness or pain

• You may express strings of thickened or fatty looking milk.

• After a blocked duct has resolved, it is common for the affected area to feel bruised or remain reddened for a week or so afterwards.

without an obvious lump.

Systemic symptoms: Occasionally a low grade fever may be present – less than 38.5 degrees Celsius

Mastitis • Milk supply from the affected breast may decrease temporarily. This is normal—extra feeding or expressing will return supply to normal.

Mastitis

• You may express strings of thickened or fatty looking milk.

Mastitis is an inflammation of the breast that can be caused

• After the mastitis has resolved, it is common for the affected

by obstruction, infection or allergy.

area to feel bruised or remain reddened for a week or so

Local symptoms:

afterwards.

• Reddened area or segment of the breast which becomes tender, hard and painful.

• Occasionally there can be localised tenderness or pain without an obvious lump.

• Usually more intense pain/heat/swelling than a blocked duct.

• Your breast milk may taste salty due to increased sodium and chloride content. If your baby is breastfeeding they may fuss due to this change in taste. If your baby is being tube fed they will not notice any difference.

• Your breast milk may occasionally contain blood or pus.

• There may be red streaks extending outward from the affected area.

Common causes of blocked ducts and mastitis

Systemic symptoms:

Blocked duct

• Fever of 38.5 degrees Celsius or greater • Flu-like symptoms—joint aches and pains, lethargy. Often rapid onset of symptoms.

38 Parenting Insights | BRISBANE 2016

Milk stasis (restricted milk flow) due to: • poor attachment or restricted feeding or expressing • tight or ill-fitting clothing

• consistently sleeping on one side causing pressure on the breast

breast after let-down. If your baby is not yet breastfeeding

• holding your breast tightly during feeding or expressing

continue to express and massage the breast over the blocked

• white spot on your nipple occluding nipple pore

area down towards the nipple.

• stress and fatigue • anaemia.

Mastitis Milk stasis (restricted milk flow) due to:

• Try feeding or expressing while leaning forward so gravity may aid in draining the breast.

After breastfeeding or expressing • If your baby has fed on the affected breast and a lump can

• delayed treatment of a blocked duct

still be felt, express after the feed until the breast feels well

• previous mastitis

drained. Massage over the affected area while expressing.

• damaged nipples • oversupply

• Apply a cold pack to the breast for 10 minutes after feeding or expressing to help reduce pain and inflammation.

• poor attachment during breastfeeds • poor general health

Pain medication

• poor hygiene—not changing your breast pads or washing

Take regular pain relieving medication if required—an anti-

your hands after changing nappies; contact with your baby’s

inflammatory such as ibuprofen (Nurofen) is preferred. If you

sticky eyes; and before handling your baby

are unable to take this type of medication take paracetamol as

• anaemia.

Breastfeeding management

directed on the box.

Antibiotics

(the same for both blocked ducts and mastitis)

• Antibiotics are not needed to treat a blocked duct.

General management

• However, if you have been unable to relieve the symptoms of a

• Breastfeed or express every two hours, or as frequently as possible, and empty your breasts well. Aim to keep the affected breast as well drained as possible.

• Rest.

• Eat nutritious foods and drink adequate fluids.

blocked duct after 12 to 24 hours or if you develop a fever, you should see your GP, as soon as possible, for further management.

• If antibiotics are required it is still safe to continue breastfeeding or expressing milk for your baby.

• Consider taking a probiotic to reduce the risk of thrush.

• Before breastfeeding or expressing—use heat and massage.

• Apply warm compresses to your breast—such as a warm pack or face washer rinsed in warm water.

• If expressing is becoming difficult and you feel very full and uncomfortable, try filling a bowl with warm water and add a handful of Epsom’s salts—one handful of salts per two litres of

To avoid further problems: • Do not wear bras, or other clothing, that are too tight.

• Avoid sleeping on your stomach.

• Do not go for long periods without either breastfeeding or expressing.

water—and submerge the affected breast in the water. If this is

• Rest when you are able.

too difficult, try soaking a washer in the solution and apply to

• Drink adequate fluids.

the affected breast. Rinse with fresh water prior to feeding or

• Ensure correct attachment.

expressing to remove the salty taste.

• Ensure the breast pump is positioned correctly,

• Massage the affected breast in a warm shower or try to hand express while under the warm water.

• Loosen your bra and any other constrictive clothing prior to feeding or expressing.

if you are expressing.

• Regularly examine your breasts for lumps and massage these while feeding or expressing.

• This is not the time to wean. You need to keep your breasts empty at this time in order to avoid a breast abscess.

While breastfeeding or expressing • Feed on the affected breast first. If the breast is too painful, start on the comfortable side then switch back to the affected

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

References Ramsay DT, Kent JC and Hartmann PE. Anatomy of the lactating human breast redefined with ultrasound imaging. J. Anat. 2005; 206: 525–34.

BRISBANE 2016 | Parenting Insights

39

The ‘heads up’ on cradle cap M

ild cradle cap affects nearly all babies at some point and in most cases is nothing

really to worry about. It is simply a form of

You can follow these easy steps: 1. Massage oil into your little one’s scalp using gentle, circular motions with just the tips of your fingers

dermatitis which causes inflammation in the

2. Leave the oil on until the cradle cap resembles soggy cornflakes

pores, trapping shed skin flakes, creating unsightly

3. To remove loose crusts, very lightly use a soft toothbrush but

yellowy patches, mostly on the crown of the head

don’t rub vigorously as this may be irritating and be careful

and sometimes in the eyebrows.

with baby’s fontanelles

Usually it only occurs in the first three months and up to 1 year, often clears by itself and is not contagious, but many parents prefer to remove it because they do not like the look or feel of it on their baby’s head.

To remove the cradle cap flakes, dermatologists often suggest

4. Comb flakes out of the hair 5. Wash with a mild baby shampoo to remove excess oil and loose flakes 6. Repeat daily if required

the application of a gentle oil followed by a mild shampoo. A pure

Some mums find that after initial oil treatment and switching to

vegetable or nut based oil suitable for babies can be really useful

gentle baby shampoo lessens the problem or may go away entirely.

in helping to remove cradle cap from little one’s scalps.

40 Parenting Insights | BRISBANE 2016

When choosing a shampoo, look for one that is soap and sulphate free and pH balanced so it doesn’t upset the natural protective oils of the scalp, which when disturbed can cause dryness and cradle cap.

And look for one with added moisturisers to keep the scalp in good condition.

Remember not to pick at the crusty bits as this can cause infections and severe cradle cap may require further attention by a medical professional so if concerned please seek medical advice particularly if it is bleeding or infected.

But generally, by following a gentle and nourishing hair care routine, you’ll soon be proud of bub’s ‘crowning glory’ once again.

Article courtesy of Michelle Vogrinec GAIA Skin Naturals

BRISBANE 2016 | Parenting Insights

41

Postnatal Depression D

epression

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

in mothers

if I had reached out for help sooner.

is real. In fact, it’s all around us. But it is hidden behind so much stigma and judgment that it’s very hard to speak up and own it. As a society, we put so many labels on people. It seems as though the label of “bad mother” is one of the worst anybody could wear.

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

Pregnancy and early parenthood are the most high risk times in a woman’s life for developing depression. If you are pregnant or have young children and you are unsure whether what you are feeling is within the realm of “normal motherhood”, you’re not alone. Reach out to a friend or family member and ask them to help you visit a GP to discuss the mental illness that is depression and the many different faces it wears.

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

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

Pregnancy and early parenthood are times of great change. It’s

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

normal to feel emotional or overwhelmed from time to time, but if

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

you are experiencing any of the symptoms below, it’s important to

somehow all of those windows mesh into one another to cover

discuss them with your doctor or another health professional.

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

• feeling empty/teary/exhausted/overwhelmed

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

• feeling guilty and inadequate

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

• diminished pleasure and/or interest in activities

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

(particularly those that you used to enjoy)

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

• loss of confidence and self esteem

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

• inability to cope

comforting, as was completely covering myself under the doona.

• sleep disturbance unrelated to baby’s needs

I remember feeling like I was always late, running behind and

• negative obsessive thoughts

never catching up. I remember the sleepless nights – lying awake

• change in appetite

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

• fear of being alone

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

• worrying about harming self or children

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

• wanting to be alone, withdrawing from social circle

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

• loss of concentration and memory

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

• difficulty with decision making

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

• crying for no reason

and screaming at them with rage that seemed to suddenly

• being irritable and moody

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

• feeling negative all the time

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

• thoughts of suicide or wanting to escape

was always telling me I was failing, that life was too hard and I was useless. It was there when I woke up in the morning, when I was

Where to go for help:

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

• Your GP, obstetrician, midwife or other

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

I think the hardest part of having postnatal depression was the fact I had to hide so much of it. Sure, I shared bits and pieces, but I was never able to show on a day-to-day basis just how much I was hurting on the inside. And, unfortunately for me, I believe that prolonged period of not speaking up and not getting help meant I had more obstacles and a longer road to travel towards wellness.

healthcare professional you trust • Perinatal Anxiety and Depression Australia (PANDA): National Helpline: Mon to Fri, 10am - 5pm AEST, 1300 726 306 panda.org.au • Peach Tree Perinatal Wellness (Qld) peachtree.org.au Article by Viv Kissane Co-founder and CEO of Peach Tree Perinatal Wellness Peach Tree provides weekly peer support groups for mothers experiencing perinatal mental illness in Brisbane.

For more information please email viv@peachtree.org.au

42 Parenting Insights | BRISBANE 2016

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

babysensory.com.au BRISBANE 2016 | Parenting Insights

43

Thinking secondhand?

Maybe think a second time The true cost of buying secondhand

W

e all know that having a baby can put a strain on the finances, especially with so many items to buy: cots, change

tables, prams, car seats … just to name a few. It can be tempting to pick up a secondhand bargain for some items, but before you do it’s important to consider what you’re actually buying.

Why buy new?

Most new products have to meet stringent safety standards, which are continually updated to ensure they are as safe for your baby

It can also be daunting the first time you use some nursery products for the first time and the great thing about new products is that they come with a full list of instructions on how to use them correctly and safely. Anyone who’s tried to assemble a cot or a pram knows they can be quite difficult to set up, and also to adjust or maintain. Always read the instructions and follow them closely to make sure your baby is safe and that the product is being used as intended. With a new product, you don’t have to worry about its history or whether it’s worn, torn or damaged. You also know it doesn’t have any faulty repairs, and safety is more important than saving a few dollars.

Products worth buying new every time Car seats, booster seats and child restraints are just like car designs in that they improve their safety requirements over the

as possible. A product which was thought to be safe two or three

years. All new car restraints must, by law, meet current Australian

years ago may now be considered a danger. New products that

Safety Standards, generally agreed by experts to be the best in

comply with these standards are clearly labeled, giving you peace

the world. With a secondhand product you’ll be unaware of its

of mind when you make your purchase.

history and if it’s been in an accident, it might no longer be safe.

If there is a fault, you know manufacturers have to fix it or

It only takes a small collision to damage or stress a harness or

refund your money. Under Australian Consumer law, product safety

seat shell, and the damage is usually not obvious. With a new

is regulated and your rights as a consumer are protected. Buying a

product, you know the plastics and materials have not degraded.

product secondhand does not give you this same protection.

Buying a new restraint means you can be totally sure it’s safe.

44 Parenting Insights | BRISBANE 2016

Don’t forget to ensure your seat is fitted correctly, new car restraints have full fitting instructions that you must follow to the letter, these are often missing from secondhand products.

Product developments ensure prams, strollers and joggers meet the ever changing needs of consumers who often use prams and accessories to improve their lifestyle. There should be two separate locking devices to prevent it from collapsing accidentally and new prams are designed with high-quality mechanisms to ensure your child’s fingers, arm, legs, head and body won’t be trapped. Locks on secondhand products might not work properly. It is also important that the wheel bearings are not worn, as this can cause ‘wheel-

Take the time to

wobble’ and even make brakes ineffective. While bearings can be

consider your options,

replaced, the cost can make the secondhand purchase not such a

research all the new products

bargain after all.

in the marketplace and perhaps most importantly, buy what you can afford so you can enjoy this time

Cots are one of the only mainstream products that are designed to

with the peace of mind that new products can provide.

be used without adult supervision and your baby will spend a lot of unsupervised time in their cot. For this reason, it’s vital that the cot is safe for them. Design standards for cots have dramatically improved in recent years. Standards are constantly reviewed to ensure the

Article courtesy of Baby Safety Program INPAA

latest designs minimise any risks. Older style cots designs are considered unsafe and do not meet safety standards unfortunately.

BRISBANE 2016 | Parenting Insights

45

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.

46 Parenting Insights | BRISBANE 2016

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

BRISBANE 2016 | Parenting Insights

47

Tips for introducing solid foods for babies and their parents. Learning the mechanics of taking food

What food do I need to be offering?

from a spoon, chewing and transferring it from the front of the tongue

Soft, pureed and easily

to the back of the mouth and then swallowing takes time and lots of

swallowed foods are ideal to start

practice. Don’t worry if, at first, all your baby seems to do is spit it out.

with. Don’t be disheartened if, at first,

Babies have more sensitive taste buds than adults so even the most

your baby isn’t too impressed.

subtle flavours can seem quite strong to a young baby.

A small amount on a soft, shallow plastic

Introducing solid food is a time of excitement and experimentation

spoon is preferable. Offer one solid meal of a few teaspoons each

T

he current recommendation from healthcare professionals is

day until your baby is looking for more. Let your baby guide you in

that babies should not be offered solid foods until they are six

how much they want to eat.

be their predominant source of nutrition in the first twelve months

parents are keen to hand over the onus of eating control to their

of life. Breastfeeding mothers and their babies still gain significant

child from the very beginning. But it is still important to monitor

health benefits by continuing to breastfeed for as long as they are

which foods, how much and the consistency of the food you

both happy to do so.

are offering. Babies can quite literally, bite off more than they can

months of age. Even after solids are introduced, milk still needs to

Baby led weaning is becoming very popular and some

chew and be at risk of choking.

Why offering solid food is important Breast milk or formula contains all the nutrients babies need for

How much and how often?

their body and brain to grow and develop in their first six months

There are no hard and fast rules about introducing solids.

of life. After this age, iron and zinc stores start to deplete and need

Other than taking it slowly and being sensitive to your baby’s

boosting through additional dietary intake. Extra kilojoules are also

responses. Offering one new food at a time is ideal; if they have

necessary to fuel growth in the second half of the first year.

any problems or reactions to a particular food then it is easier to identify which one it is likely to be.

What can happen if I offer my baby solids earlier or later than six months?

until your baby is used to it. If there are no problems, then you

There are no benefits to introducing solid foods prior to six

can grade them up to two meals each day and after a few more

months. Some parents believe that doing this will support their

days, offer three.

Start off by offering one solid meal each day for a few days

baby towards improved sleeping overnight. However, there is no guarantee that this will happen. Babies are still entitled to at least

From 6 – 7 months

one overnight breast or bottle feed until at least six months of age.

• Rice cereal mixed with breast milk or cooled boiled water. You can mix a little pureed apple or pear with this to see if it’s more

What about allergies?

Currently, there is no convincing evidence that delaying the introduction of solids past four to six months of age is protective

palatable to your baby.

• Pureed or very well mashed vegetables and a range of fruits.

Potato, pumpkin, carrots, sweet potato, zucchini are ideal.

against developing allergies. Babies who are not offered solid foods

Mashed (ripe) banana and avocado are perfect as first foods.

when they show signs they are ready can become a little delayed

• Milky solids such as custard and yoghurts. Be careful of sugar

in developing mastery of eating.

content and preferably buy unsweetened ones and flavour them yourself with a small amount of fruit instead.

When will I know if my baby is ready?

There is a range of classic readiness signs which babies show they are

From 7 – 8 months

ready to ingest more than just milk. Look for a combination of these:

• Offer more mashed, rather than finely pureed or sieved foods.

• When your baby can hold their head reasonably steady, has some upper body control and is able to sit upright.

• When they are showing interest when you and others are eating and they’re keen to do the same.

• When your baby does not seem satisfied with just milk feeds.

At around six months they may want to feed for longer, more frequently and not be as satisfied with what they’ve been having.

48 Parenting Insights | BRISBANE 2016

Your baby can be having three solid meals each day now. Aim for breakfast, lunch and dinner after their milk feeds.

• Offer a range of cereals, fruits, vegetables, meat and chicken and milky desserts. Two courses at lunch and dinner is common.

• A couple of tablespoons to ½ cup is an ideal volume at each meal time now.

From 8 – 12 months

It is important to establish meal time routines with your baby

• Foods chopped into small pieces, minced or in finger size

so they understand it is time to eat. There are many feeding

are popular with this age group. Self feeding is beginning,

utensils available which incorporate educational designs to take

so encourage your baby to explore their food and have some

the focus off the food and make feeding more engaging and fun

control over their meal times. Giving them a spoon to practice

for little ones.

with is a good idea. grains. Your baby’s brain growth at this age is significant and they

When can my baby eat the same food as everyone else in the family?

need lots of iron in their diet to fuel this.

From around 12 months of age, a family diet is ideal. Avoid

• Offer a range of fruits, vegetables, meats, cereals, pasta and

making your baby special meals which are different to the rest

How will I know when my baby has had enough to eat?

of the family’s.

• It is important to be sensitive to the cues or prompts your baby

dietary intake is sufficient for their needs. Weight gain slows

Check with your child health nurse to ensure your baby’s

will give which means they have had enough to eat. Overriding

after six months of age, to between 70 – 90 grams/week. It is

these or ignoring them can lead to overfeeding. Common signs

important to ensure your baby is either tracking on the same line or

of fullness include the following:

climbing on their percentile (growth) curves for their weight, head

• Turning away from the spoon as it is coming towards their mouth.

circumference and length. Dropping to a lower curve can indicate a

• Closing their mouth and not opening it in anticipation of the

need for improved nutrition.

next mouthful.

• Becoming upset, crying and restless when previously they have been interested and engaged.

• Vomiting, gagging and appearing sleepy. All of these cues are a baby’s best attempts to give clear signals that they have had sufficient.

Article courtesy of Philips AVENT Written by Jane Barry Registered Nurse, Midwife and Child Health Nurse Philips AVENT Baby feeding and wellbeing advisor sillybillyz.com.au

Mes Toddle sy r Tip: Try the

SillyBil lyz Me Bib. Pe ssy Eate rfect fo r r self-fe long an eders, d wide it’s enoug your c h to co hild to ver the kne es whil they are e seated to eat.

BRISBANE 2016 | Parenting Insights

49

Unlocking the secrets of nature play

50 Parenting Insights | BRISBANE 2016

How a child plays can have as much impact on their health and wellbeing as adequate nutrition. A new app developed by Queensland based not-for-profit, community organisation Nature Play is designed to help increase the time children spend participating in unstructured play outdoors.

ROW with Nature Play is helping parents grow happy

G

Neurologists have shown that babies enter this world with a fully

and healthy babies from birth to 3 years through offering

developed brain with all the neurons the baby needs to function.

ideas on how to play with their babies outside. This type of play

Babies have the neural functions they need to support the skills they

called ‘nature play’ can help children achieve key developmental

need to feed and bond.

milestones, build confidence and curiosity and even strengthen family bonds.

Program Manager Hyahno Moser is deeply involved in studying

But that is all. Every other skill we possess as adults is learnt from that point onwards.

That really brings home the importance of how babies

global research around the importance of nature play in growing

engage with their world in their formative 0 – 3 years. For children,

happy healthy kids, but is also witnessing it first hand through his

play is learning, and children learn mostly from trialling, testing

new baby boy Ralphie.

and mastering various experiences that help them develop the

Hyahno shares his story.

knowledge and skills they will need to carry them through the

‘In the first three years of a child’s life, every experience and

various stages of life.

every movement has a powerful impact on their development.

‘My little man Ralphie has only been in this world for 14 weeks

Time spent playing outdoors in nature creates an abundance of opportunities for children to learn, and support their growth across

and we are still getting to know each other - learning each other’s

all key developmental areas of childhood. It also enhances their

nuances and developing our family bonds, but I have already seen

general physical and emotional health and wellbeing and can even

how taking him outside to play in nature can both soothe and

improve their immunity.

stimulate him.

‘Ralphie can be upset and grizzly, frustrated and agitated, and at

As well as a great stress buster for parents and babies, research suggests that children who play outdoors share better, are more

this stage his parents may not always know exactly why he is upset…

content, curious, and confident, have more pleasant personalities,

in this moment of stress (for him and for us!), all we have to do is take

are more resilient and comfortable in a wide variety of settings and

him outdoors for a short while and his whole demeanour calms.

demonstrate sharper thinking.

‘At the same time Ralphie is calming down, I see his beautiful little

The GROW with Nature Play app details activities that can

eyes light-up with a different type of engagement - his arms and legs

happen in the backyard, the beach, the bush or the park as children

pump with excitement. I can see Ralphie soaking up the stimulation

grow through infancy and toddler stages. This explorative, creative,

of nature - the wind, the sounds, the movement, the vibrancy and

messy, social and active play becomes extremely important to

many shades of green, blue, white, orange and brown. Feeling the

support a child’s development and learning as they grow.

breeze, breathing the air, smelling the grass, hearing the birds.

‘Taking Ralphie outside is a sensory explosion for his developing

Hyahno summed up his, and Ralphies experience with the app.

‘When I go out into nature with little Ralphie he invites me into

brain, providing incredible stimulation of his senses through nature.

his world. If I accept his invitation, I get to revel in his wonder, in the

I can see the expression in his eyes, and am amazed at his every

amazement interest and intrigue on his face.

increasing level of focus, interest and enthusiasm.‘ Taking babies outside to play is a powerful tool – something that researchers across the globe are realising just how powerful and important this type of play is in raising happy and healthy kids.

‘I am sharing this experience with him. Right then and there our bond, our connection deepens.

‘For our little Ralphie, nature play is helping us lay the foundation for a super happy and healthy child.‘

The GROW with Nature Play app gives parents access to a range of age appropriate, outdoor play activities and why this type of play is so powerful for their babies.

GROW with Nature Play is created by Nature Play QLD and is available now on App Store and Google Play.

For more information visit natureplayqld.org.au

BRISBANE 2016 | Parenting Insights

51

Common mistakes to avoid when fitting a baby car seat or child safety restraint

52 Parenting Insights | BRISBANE 2016

One of the most important safety decisions you will make for your child is choosing a suitable car seat (Child Safety Restraint). This handy guide provides practical information to help you select the best car seat for your needs.

W

hile the following information provides some tips on how

Incorrect installation

to install a car seat, every car seat is different, and you must

With so many belts and straps, ensuring correct car seat

follow the manufacturer instructions for your particular model

installation can be confusing. You should always follow the

of car seat.

manufacturer’s instructions on how to fasten straps, making sure the car seat is secured tightly to your vehicle with no more than

TIP 1: Choosing the appropriate seat for your child’s needs

a couple of centimetres movement from back to front or side to

The first step to ensuring a properly fitted car seat is choosing the

you can consult a professional Child Safety Restraint fitting service.

side. If you do not feel confident installing the car seat yourself,

right size for your child. This means selecting a car seat that is appropriate for your child’s age and height and that conforms to

Installing the baby seat at an unsafe angle

Australian safety standards.

A properly installed infant carrier or rear facing car seat will keep

You should follow the national safety road laws and

your baby’s head positioned comfortably on the back of the car

manufacturer’s instructions on which car seat to use and keep using

seat. The preferred angle of a rear facing car seat base is 10 – 15°,

the car seat for as long as possible as the safest transport option.

for vehicles with a flatter car seat you can pack firmly rolled up

A common mistake parents make is progressing to the next

towels on the underside of the base to achieve the desired angle.

type of car seat based on age rather than height. Size of a child

Some car seats include levelling indicator lines that allow you to

can vary and not all 4 years olds are the same size. Children

gauge the correct angle.

should fit within the shoulder height marker advice for the specific model of car seat they are using.

Children require different types of car seats as they grow and each state in Australia requires children up to 7 years to be restrained in an appropriate restraint.

TIP 3: Practice using the harness and straps As well as providing safe and secure support, it is important that child car seats, harnesses and straps are correctly adjusted.

You will be dealing with straps every day, so it is highly recommended to test the ease of use before you make your

Age can be used as a guide: • Children under the age of six months must use a rear facing car seat • Children aged six months to four years can use either a rear facing car seat or a forward facing car seat

purchase.

Some car seats also feature harnesses that do not require threading / unthreading and enable automatic shoulder height repositioning. These are important features that make using a car seat easier and less stressful.

• Children aged four years to approximately seven years must travel in a forward facing car seat or booster seat • It is safest to keep your child rear facing for as long as possible.

TIP 4: ALWAYS choose a car seat that has been safety tested In a collision, infants, babies and children are extremely

TIP 2: Consider the height of the child

vulnerable if they are not properly secured in a car seat.

In addition to using age as a guide, current car seats feature a

Australia’s Standards for car seats are one of the toughest in the

shoulder height marker which dictates use.

world to ensure better protection for our children.

Your child should remain in a rear facing seat or position until

In Australia it is illegal to purchase or use a car seat that does

their shoulder is in-line or above the forward facing height marker.

not comply with the Australian /New Zealand Standard 1754.

Your child should remain in a forward facing seat until their

Always look for the certification mark AS/NZS:1754 on the car

shoulder height is above the upper shoulder height marker.

Choose the safest position for the car seat The safest placement of a car seat is on the rear seat of your vehicle in the center position, as it protects your child in the event of a side impact collision. Rear passenger side of your vehicle is an alternative

seat you choose for your child.

Article courtesy of Britax For more info on car restraint safety visit the Britax Car Restraint Safety Centre at all PBC Expos or visit britax.com.au

option. You should always install the car seat where there is an appropriate anchor point and according to the instructions in your vehicle’s owners’ manual. A professional fitter can also help to install your car seat in the safest position in your vehicle.

BRISBANE 2016 | Parenting Insights

53

Understanding toddler behaviour The toddler years may be a challenging time for parents. As toddlers mature and begin to explore the world they will experience a whole new range of emotions which may be difficult for them to manage. Your toddler may need your support to help manage some of these behaviours.

• Look for the opportunities to let them know when they are doing the right thing

What to remember about Toddlers • They are finding out how exciting the world is and how everything works • They are inquisitive and curious • They can’t see that their actions will have an effect on others or themselves • They are learning to regulate their emotions and feelings • They want to try and test everything • Have rapid mood changes • Have a short attention span • They are striving for independence • They will test their limits and capabilities These points are a normal part of toddler development and may cause parent concern.

A common response from toddlers is “No!”. This can give the impression that they don’t want to cooperate. Be reassured this is a normal part of learning about life e.g. negotiating, discipline, safety and rules.

What toddlers need from you: • love • security • to be safe • boundaries • time • play, have fun and be active together • lots of support and understanding to enable

• Offer labelled praise – describe what they have done well eg: Bella, well done, you picked up all your toys when I asked • Pick your battles – allow them to explore unless it is dangerous to themselves or others • Divert and distract from potential harm or unwanted behaviour • Give clear simple instructions • Allow opportunities to problem solve. Be available to help if needed • Engage with your toddler by spending time reading and playing • Encourage your toddler to help pack away after play • Allow toddlers a sense of independence, offering limited choices. e.g. Red shirt or blue shirt rather than entire contents of wardrobe • If they refuse to cooperate, it may be best to remove them from the situation. If there is immediate danger with what they are doing, (pulling on an electrical cord), calmly remove them from the danger. Explain after the risk of danger has passed • Help language development by encouraging toddlers to say words of things they are asking for. Remember this is prime time for learning language so talking and repeating words will help build their language

Remember: The way parents and carers respond to toddlers can influence how they progress through life.

The toddler years may be a challenging time for parents.

As toddlers mature and begin to explore the world they will experience a whole new range of emotions which may be difficult for them to manage. Your toddler may need your support to help manage some of these behaviours.

them to learn social skills

How to get the best out of your toddler • Be a positive role model • Celebrate their successes and achievements • Get down to their eye level 54 Parenting Insights | BRISBANE 2016

Article courtesy of Karitane karitane.com.au • Careline 1300 CARING (1300 227 464) Karitane respects each family has their own culture and parenting practices. This guide is an evidence based resource you may use in your parenting. Relationship building is essential and recognising what triggers the tantrum may allow you to step in before they occur.

Did you know?

88% of minor burns occur in the home and only 10% of Australians know the correct first aid treatment.

J

une is National Burns Awareness Month and is all about raising awareness of first aid treatment for minor burns. Severe

burn injury can be life threatening, and even small burns can be dangerous for the very young. Babies and young children have fragile skin. Their skin burns deeper and more quickly than adults and at lower temperatures.

First Aid Steps for Minor Burns Quick, effective and appropriate first aid can reduce the depth and size of the burn. Simply remember ‘Remove – Cool – Cover’.

REMOVE • Remove yourself out of any danger • Remove any clothing/or jewellery from burn area to allow effective cooling of the burn

COOL The most important step is to cool the burn, 20 minutes of cool running water will help stop the burning process.

• Cool the burn under cool running water for 20 minutes – Consider immersion or wet towels if running water unavailable – If water is not available use a hydrogel – NEVER use ice, butter, toothpaste or creams as these may make the burn worse.

COVER • For minor burns cover with a hydrogel, such as Burnaid®, to help relieve the pain • Cover with a clean dressing Seek medical assistance if clothing is stuck to the burn site or if it is larger than the palm of your hand.

The 2016 National Burns Awareness Month is brought to you by the Julian Burton Burns Trust with the support of Burnaid®.

Article courtesy of Julian Burton Burns Trust For more info or to donate visit burnstrust.com.au Always seek medical assistance for more serious burns. Burnaid® is for the first aid treatment of minor burns. Always read the label. Use only as directed. If symptoms persist, see your healthcare professional. BURNAID® is a registered trade mark.

BRISBANE 2016 | Parenting Insights

55

Want to breastfeed?

Australian Breastfeeding Association can offer support

M

ost Australian mothers want to breastfeed their babies and

soon as possible with your baby or if you aren't well enough

the 2010 Australian National Infant Feeding Survey

whether you would like your support person to do this with your

showed that 96% of mothers in Australia start out breastfeeding,

baby, and how you would like to manage potential concerns like

which is one of the highest initiation rates in the world.

questions about your baby's weight.

Breastfeeding is an important part of life, but despite this less

Breastfeeding education classes are another great way to

than half of Australian babies are exclusively breastfed at

prepare for breastfeeding. Along with a stack of information

3 months and less than a quarter at 5 months of age. This could

about the basics of breastfeeding and how it works, ABA

have an impact on many health outcomes for both mothers

breastfeeding education classes give expectant parents

and babies. Babies who are not breastfed can have an increased

information about what is normal when breastfeeding, and

risk of gastrointestinal, respiratory and ear infections and not

common problems and where to go for help. They also provide

breastfeeding is also associated with an increased risk of ovarian

partners and your support people with enough information to

and breast cancer.

help achieve your breastfeeding goals.

‘Breastfeeding is seen as so natural,

Lots of mums find it hard adjusting to motherhood. Having a support network of people around you who understand what

but it’s still a learned skill, and many

bad days are like can make life a lot easier. Even if you can't make

parents need a little help along the way.’

it to a breastfeeding class, you can become an ABA member on

It can be tempting to listen to people who tell us that we shouldn't

their website.

Most importantly, remember that if things aren't going the

invest too much time in the idea of breastfeeding in case it doesn't

way you expected, you are not alone. ABA’s Breastfeeding

work out. But that can mean we don't learn what the possible

Helpline is available 24 hours, and a trained volunteer will be

pitfalls are. The Australian Breastfeeding Association (ABA) suggest

there to support you. All volunteers are mothers who have

that in the same way that many parents write a birth plan to

breastfed their own children, and are offering their time from

communicate their wishes for different stages of labour and birth,

their own home.

expectant parents should write a breastfeeding plan.

A template can be found at breastfeeding.asn.au. It includes things like whether you would like to have skin to skin time as 56 Parenting Insights | BRISBANE 2016

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

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