Pregnancy BUMP&baby issue 1 by BUMP&baby

PREGNANCY

Float into summer

WITH THESE HOT MATERNITY STYLES

GET READY FOR LABOUR! • How to know it’s started • Coping with contractions • Pain relief options

& baby ISSUE 01

YUMMY

Recipes from Nadia Lim

Breast advice for baby feeding NEWBORN SECRETS REVEALED! 10 things nobody warned you about

Predict your baby’s gender

PINK OR BLUE?

who e h

PREGNANCY COUNTDOWN

nursery your home for

IFC

Farmers has every nursery need for your new PRS0123_L

baby

new born nursery checklist

BathTime

SleepTime

FeedingTime

OntheGo

MUST HAVE

MUST HAVE BEDDING

MUST HAVE

Baby bath (1) Soft washcloth (10-12) Soft towels (6-8) Toiletries: baby wipes, cotton buds, barrier cream, shampoo & baby body wash Bath thermometer (1) Non slip bath mat (1) Grooming kit (1)

GOOD TO HAVE Bath toys (4-6)

PlayTime MUST HAVE Bouncer (1) Play gym/mat (1) Exerciser (1) Swing (1) Fabric books (3) Soft toy (Newborn) (2-5)

GOOD TO HAVE

Mattress protector (2-4) Fitted sheet & top sheet (4) Quilt/Blankets (2-4) Wrap (2-4) Swaddle (1)

FURNITURE Cot (1) New mattress (1)

GOOD TO HAVE Bassinet (1) Mobile (1) Night light (1)

ChangeTime MUST HAVE Change table (1) Change mat (1)

GOOD TO HAVE

Highchair (1) Bibs (8-12) Spill mat (2) Bottles (6-10) Teats (8-10) Bottle brush (1) Steriliser (1)/Bottle warmer (1) Nursing pads (6-12) Breast pump (1) Feeding pillow (1) Nipple cream (1) Burp cloth (6-12) Storage bag/Bottles (4-6) Teether (3-4) Nursing bras (3-4)

GOOD TO HAVE Soothers/Dummies (6-8)

Capsule/Convertible carseat (1) Stroller (1) Storm cover (1) Change bag (1) Carrier (1) UV shade (1) Pram blankets (2)

GOOD TO HAVE Baby view mirror (1) Pram toys (2-4) Pram liner (1-2)

Health&Safety MUST HAVE Baby gates (2) Thermometer (1) Play pen (1)

GOOD TO HAVE Baby monitor (1)

Nappy disposal unit (1)

Music (3)

shop in store and online at farmers.co.nz

PRS0123_R

Trust us with the l o v e of your life For over 40 years, we’ve provided more than full and part time care and education for babies, toddlers and preschoolers – we’ve provided a Kindercare family where we keep children safe, we share their discoveries, we guide their enquiry and we fill their days with love and fun. At Kindercare, you’ll discover: • A culture of kindness that fosters respectful care • Creative, flexible environments where learning happens through play • Specialised baby care – filled with sensory experiences • Skilled, responsive teachers who know and love your child • Home-cooked meals, active outdoor time and calm rest periods

se Becau en childr r matte

Call us or pop in for a visit and let’s see how we can help you. Locations in Auckland, Christchurch, Hamilton and Wellington

0508 546 3372 or visit www.kindercare.co.nz

® Registered Trademark Kimberly-Clark Worldwide, Inc. © KCWW. †Terms and conditions apply. KC1267

Nothing’s more delicate than your newborn’s skin, which is why HUGGIES® Newborn Nappies and Fragrance Free Wipes help keep their gentle skin perfect. HUGGIES® Nappies unique 3D UltraAbsorb® layer contains baby’s runny bowel movements and the wetness indicator turns blue when wet so you know it’s change time. They are clinically proven to help prevent nappy rash, and together with Wipes, are endorsed by Plunket. So you know they work best together for a happy comfy baby. Perfect.

Join the HUGGIES® Baby club and go into the draw to WIN a 6 month supply of HUGGIES® products† at huggies.co.nz

CONTENTS PREGNANCY

Issue 01

& CONCEPTION & PREGNANCY

QUICK FIX

A GOOD EGG (AND SPERM) Advances in genetic testing

HELLO! Meet our team and find out what’s hot this issue

THE WHOLE 9 MONTHS Our month-by-month pregnancy guide

JUST BUMPED INTO… New and noteworthy gear, research, and info for mums and bumps

DREAM A LITTLE DREAM Pregnancy dreams and what they mean

136

SUBSCRIBE AND WIN Get two issues for only $22

142

THE LAST WORD Words of wisdom to make you smile

LOVE YOUR LIFE

BLOOMIN’ BEAUTIFUL Rose-tinted beauty buys

SUN-KISSED SUMMER Show off this seasons's best-dressed bump

4 EASY WEEKNIGHT MEALS Delicious dinners from My Food Bag and Nadia Lim

EXPECTING STYLE Bump-friendly fashions from your favourite stores

SPLENDOUR IN THE GRASS A charming outdoor baby shower

THE BIG STRETCH A pregnancy rite of passage

FEEDING BABY’S BRAIN What to eat when you’re pregnant

REST ASSURED How to cope when you’re on bed rest

SURVIVING A SUMMER PREGNANCY Tips to help you handle the heat

PINK OR BLUE? Old wives’ tales about gender prediction Pregnancy BUMP & baby

CONTENTS

LABOUR & BIRTH

MATERNITY LEAVE: NEED TO KNOW All about parental leave entitlements

A TO Z OF PAIN RELIEF 26 options for coping with labour pain

READY, SET, PUSH! The three stages of labour explained

10 WAYS TO SOOTHE STITCHES Helping heal a tear down there

100

OUT & ABOUT WITH YOUR BABY Planning for stress-free outings

103

BABY ON BOARD Great gear to get you outside in style

104

10 THINGS NOBODY TELLS YOU ABOUT NEWBORNS Be prepared for little surprises

106

YOUR BABY’S FIRST JABS Facts about immunisation

110

YOUR GUIDE TO BREASTFEEDING Learning to feed your baby one step at a time

116

SOFT AS A BABY’S SKIN Newborn skincare and bathing

119

FIRST SIX MONTHS

GETTING TO KNOW YOUR NEWBORN What to expect those first days

a ppy

lish n

SUITCASE SAVVY Helpful products for your go-bag

YOUR NEWBORN

s st y

Tote

PACK YOUR BAGS What to take to hospital

SQUEAKY CLEAN Bubble up for bathtime fun

120

BORN TO RIDE Car seat safety for babies

124

SLEEP, BABY, SLEEP How much sleep does your baby need?

128

NAPPIES 101 Becoming a nappychanging pro

132

ON SOLID GROUND Baby’s first foods

Pregnancy is an exciting time. Pregnancy is exciting and a time of great change. At babycity we are here to share your journey from pregnancy through into motherhood. Our expert team is ready to listen and help with the many decisions you will make for your upcoming arrival. With an extensive range of brands and products focused on wellbeing, safety and lifestyle we can provide solutions that suit you, your baby and your life. Our Bub Club is a great way stay informed and up to date as you go through your pregnancy and beyond. We look forward to seeing you in store or visit us online.

baby essentials / carseats / strollers / nursery / clothing / toys and gifts www.babycity.co.nz

babycity Store Locations: WHANGAREI Okara Shopping Centre, Okara Drive AUCKLAND ALBANY Westfield, Don Mckinnon Drive BOTANY Botany Downs Shopping Centre, 588 East Chapel Road MT WELLINGTON Apex Mega Centre MANUKAU Manukau Supa Centa Cavendish Drive, NEW MARKET Rialto Centre Unit 2B, 153 Broadway PUKEKOHE The Zone, 14-28 Subway Road TE RAPA The Base Parade, Te Rapa Road, Hamilton FRASER COVE Fraser Cover Mall, 227 Fraser Street, Tauranga NEW PLYMOUTH Unit 2, 1 Smart Road PALMERSTON NORTH The Plaza, 75 Fitzherbert Avenue WELLINGTON CAPITAL GATEWAY 34-56 Thorndon Quay LOWER HUTT 18 Rutherford Street CLICK N’ COLLECT WEBSTORE 13 Lower Tyers Road, Ngauranga CHRISTCHURCH ADDINGTON Station Building, Tower Junction, Clarence Street NORTHWOOD Northwood Supa Centre, Main North Road, Belfast, Chistchurch DUNEDIN 84 Filleul Street

HELLO!

PREGNANCY

Issue 01 HOT RIGHT NOW The Bugaboo Buffalo by Diesel in Denim combines function with a whole lotta style – distressed, hand-ripped, and paint-splattered, just like your favourite jeans. This is one pram that’ll definitely raise eyebrows at the park. $2,380 from Babycity and Milk Store

Available from selected retailers or visit bumpandbaby.co.nz to subscribe. PUBLISHERS Tony and Aana Marinovich tony@bumpandbaby.co.nz aana@bumpandbaby.co.nz EDITOR Katherine Granich editor@bumpandbaby.co.nz ART DIRECTOR Emma Henderson design@bumpandbaby.co.nz ADVERTISING ENQUIRIES Tony Marinovich tony@bumpandbaby.co.nz ONLINE ENQUIRIES digital@bumpandbaby.co.nz social@bumpandbaby.co.nz

hances are, if you’ve picked up this magazine, you’re either pregnant or planning to be. Or perhaps you know someone who is newly pregnant, or you’re a grandma-to-be and you want to learn more. You’re in luck, because right now you’re reading New Zealand’s only pregnancy and early babyhood magazine, covering pre-conception right through to six months after your baby arrives. It’s an exciting time in the life of your family, and we’re honoured you chose BUMP & Baby to guide you on this special journey! Learning you’re pregnant is accompanied by a whirlwind of emotions and questions. What should I do first? What’s going on inside my body? What do I need to know? Where do I get more info? That’s where BUMP & Baby comes in. Whether you’re a first-time mum-to-be or expecting your third baby, every pregnancy is different, and your first priority is to make sure you’re up-to-date on the latest and safest news, advice, and information for a happy and healthy pregnancy and newborn. BUMP & Baby is a mum-to-be’s best friend, supportive coach, and wise mentor all rolled into one. Pregnancy is a journey, not a destination, and BUMP & Baby is your trusted travel guide. Enjoy the adventure!

Find us at facebook.com/bumpandbabynz for giveaways, helpful tips, cool products, the latest news, and advice from other mums-to-be.

Pregnancy BUMP & baby

The Media Barn 91 Moontide Road Kumeu Auckland 0892 New Zealand T: +64 9 412 5123 F: +64 9 412 5133 ONLINE bumpandbaby.co.nz facebook @bumpandbabynz instagram @bumpandbabynz pinterest @bumpandbabynz Tik Tok @bumpandbabymagazine PRINTER OVATO Limited Pregnancy BUMP&Baby ISSN 2463-283X is published bi-annually (2 issues per year) The opinions expressed and statements made in Pregnancy Bump&baby are those of the contributors and advertisers and do not necessarily represent the views of the publishers. Pregnancy Bump&baby, on behalf of itself and the authors, asserts copyright on all material appearing in Pregnancy Bump&baby and none of it shall be reproduced wholly or in part without the prior written consent of the publishers. The publishers reserve all rights in respect of all material received and accepted for publication. Pregnancy Bump&baby reserves the right to edit or abridge all articles, letters, or other material (solicited or otherwise) accepted for publication. While every care has been taken in the research and compilation of this publication, it is not intended to replace professional or medical advice. To the best knowledge of Pregnancy Bump&baby, all information herein is correct at the time of publication. Please contact your healthcare provider in the first instance for medical assistance and advice.

COVER PHOTO COURTESY QUEEN BEE • EDITOR'S PHOTO: NIGEL MARPLE CLOTHING: BREASTMATES.CO.NZ AND CARBONSOLDIER.COM

Editor's note

PREGNANCY BUMP&baby PUBLISHED BY TOTS TO TEENS PO Box 70 Level 1, 190 Main Road Kumeu, Auckland 0841 New Zealand

Remember that confidence you had as a kid? Get it back.

Confidence. Get it back. 0800 808 808 • tower.co.nz Pregnancy BUMP & baby

Just bumped into… The latest news, info, and gear for stylish mums, bumps, and babies YOU NEED THESE Window decals to remind fellow car parkers to leave room for you and your newborn? Yes, please. $3.50 for both, breastmates.co.nz

MILK TO GO Social media giant Twitter has a new perk for travelling female employees: Free breast milk delivery. Breastfeeding mums on business trips can courier their breast milk home to their babies on the company's dime. We're in favour of anything that makes breastfeeding easier for working mums!

MYTH

YOU CAN'T DRINK COFFEE WHEN YOU'RE PREGNANT.

Fact: According to the March of Dimes, it's okay to have one to two cups of coffee, or several cups of tea, each day during pregnancy – aim for no more than 200mg of caffeine a day. 12

Pregnancy BUMP & baby

NOTEWORTHY

TELL ME, WHAT PREGNANCY SYMPTOM ARE YOU HAVING THE MOST DIFFICULTY DEALING WITH?

I'M NOT ALLOWED ANY ALCOHOL, BUT I STILL FEEL LIKE I HAVE A HANGOVER EVERY MORNING.

GOOD READS Dream Baby Guide: Sleep, by Sheyne Rowley (Allen & Unwin $32.99), will equip you with the skills you need to get your baby to sleep confidently and independently, without an old-fashioned one-size-fits-all routine or controlled crying method. You Can't Give Vodka to a Baby and Other Parenting Myths, by Oliver Green (Upstart Press $24.99), is a tongue-in-cheek parenting manual full of advice you probably don't want to follow – but it'll sure make you laugh on days when parenting is getting you down.

30 years QUICK FACT

IS THE AVERAGE AGE OF ALL WOMEN GIVING BIRTH IN NEW ZEALAND.

MUSEUM PIECE The prototype of the world's first home pregnancy test was recently acquired by the The National Museum of American History in Washington, DC, USA. Called The Predictor, it was designed in 1967 by Margaret Crane, a graphic designer who was working at a pharmaceutical company at the time. It looked like a toy chemical set with a dropper, vial, rack and mirror, and packed into a small box modelled after the paper clip holder on Crane's desk, and delivered results in two hours rather than the two weeks women usually had to wait for a doctor's office to return results from a lab. Crane's invention wasn't in commercial production until a decade later. Pregnancy BUMP & baby

JUST A DROP HELPS A LOT myDroplet encourages all New Zealanders to give just a drop to help a number of key NZ charities around the country using an online platform that is so easy to use, even children can use it. Visit www.mydroplet.org.nz to find out more.

CRANKY PANTS Pregnancy is an emotional time, with over 65% of mumsto-be reporting heightened grumpiness, anger, and mood swings, particularly in the first and third trimesters. The good news? Your hormones are at fault, and your emotions will level out after your baby arrives.

When you're comfortable and relaxed, breast milk will flow easily, and the Philips Avent Comfort Breast Pump lets you sit in a natural, relaxed position while you're expressing – no need to hunch over. $299.99 from Babycity

Pregnancy BUMP & baby

For mums-to-be who don't want to chemically colour their hair during pregnancy, these specially formulated powders in six colours disguise greys and regrowth without fuss. Color Wow Root Cover Up, $49.90 from Farmers

QUICK FACT

6 hours and 2 minutes

IS THE AMOUNT OF TIME PER DAY DADS SPEND CARING FOR CHILDREN (MUMS CLOCK UP 10 HOURS AND 16 MINUTES OF CHILDCARE EACH DAY).

IMAGE TOP LEFT COURTESY QUEENBEECOM.AU

RELAX & PUMP

COVER UP

NOTEWORTHY CO-SLEEP SAFELY Keep your little one close by and safe at night with the Chicco Next2Me lightweight co-sleeping cot. Made from a soft, washable fabric and can be folded down easily for portability. Multiple height positions; converts to a crib for use to around six months. $499 from Babycity

QUICK FACT

ON AVERAGE, ONLY 5% OF BIRTHS TAKE PLACE ON THEIR DUE DATES. Most babies are born within a week before or after the due date, and a "normal" pregnancy can last anywhere between 38 and 42 weeks.

Your baby can also set the cradle rocking with their own body movements, helping them learn what their body is capable of.

BRING ON THE (FAKE) BELLY

LIGHT MY WAY With soft light and gentle classical music, the Chicco Goodnight Moon Night Light hangs from your baby's cot side with an adjustable strap. $49.99 from Babycity

A car valet service in China has made its group of male valets go through pregnancy sensitivity training, which involved the drivers wearing fake "pregnant belly" attachments and drinking lots of water to simulate the feeling of a full bladder when climbing in and out of the car, says Ubo founder Corrinne Zhao. The training was done to support the company's efforts to target working pregnant women. Personally, we think all men should go through pregnancy sensitivity training!

Y A-B CK-

Y BAB

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NOTEWORTHY

SMILE TIME

STRETCH

According to a new study, from the age of four months, babies smile in order to make the person they're interacting with smile in return — showing that early communication via smiling is often intentional. So if your baby is making you smile a lot, chances are, she's doing it on purpose!

MARK SOS A pregnant mum's best friend, Bio-Oil is the number one selling item in pharmacies and is the product most recommended by doctors for scars and stretch marks. 60ml $20.45 from pharmacies

IN THE SWING OF THINGS When your baby just won't settle, a swing can be a sanity saver. This one has tunes, nature sounds, a heartbeat, and vibration. Chicco Polly Swing Up $349.95 from chicco.com.au

PASS THE SALT

Suitable from birth, you can even operate it with a remote control.

Pregnancy BUMP & baby

Craving chippies, pretzels, and salty snacks? You're not alone, say Portuguese scientists who have identified salty foods as the most popular craving for pregnant women, and are investigating a correlation between salt levels and women's reproductive abilities.

Pregnant? Suffering from heartburn or reflux? Twitching & crawling sensations in your legs? Try Heartburn & Reflux Relief Includes ingredients that are traditionally used for the temporary relief of heartburn, reflux, acidity, bloating & indigestion.

Restless Legs Relief Includes ingredients that are traditionally used for the temporary relief of uncontrollable leg movement, night twitches, jerking limbs, growing pains, itching, crawling or tingling sensations.

Available from health food stores & pharmacies For more information go to www.martinandpleasance.co.nz Homeopathically prepared formulations. Always read the label and use only as directed. If symptoms persist, consult your healthcare professional.

Tips to understand

milk supply and q uality 1

LET BABY SUCKLE The more milk your baby takes, the more you make. The baby’s suckling stimulates the breasts to produce more milk.

BREASTFEED FOR SIX MONTHS

KEEP YOUR FLUIDS UP

DEMAND MAY GO UP AND DOWN

The ideal time to introduce solid food is at around six months, when your baby is showing signs of being ready for, and needing, extra food. It’s important for breastfeeding mums to stay hydrated. Be sure to drink frequently, preferably before you feel thirsty. Herbal teas are a great way to increase your fluid intake – try nettle tea as it is highly nutritious! Your baby may have times when they want more feeds. These hungry times are called growth spurts and are common at different ages, often at six and twelve weeks.

EAT WELL Breastfeeding mothers need three healthy meals a day, plus healthy snacks. Foods such as fruits and vegetables, oats, brown rice, quinoa, beans, eggs, fish, lamb, avocados and olive oil can help provide valuable nutrients to support baby growth and energy levels, and the wellbeing of mum.

ADDRESS STRESS AND TIREDNESS

TAKE RADIANCE FENUGREEK

T HO ICE PR

Stress and tiredness can affect your milk supply. Trying to rest and relax as much as possible may help. Take advantage of offers from friends and family to help cook or clean, and try to sleep when baby does, as much as possible. Take two to three times a day. Once an adequate level of milk production is reached, most women can discontinue using fenugreek and maintain the milk supply with adequate breast stimulation. However, some women may want to continue taking fenugreek until baby is weaned.

Talk to our caring staff to find out more. Offer ends November 30th 2015 or while stocks last. If you have any pre-existing medical conditions, consult a health professional prior to use. Always read the label and take as directed. If symptoms persist, see your healthcare professional. Sup plementary to a balanced diet. Do not use Fenugreek during pregnancy. TAPS PP7156.

$2490

100s + 25% extra FREE

www.health2000.co.nz

NOTEWORTHY

FOR THE LOVE OF SLEEP According to the National Sleep Foundation in the US, 78% of women reported more disturbed sleep during pregnancy than at other times. And while adults generally need between seven to nine hours of sleep a night, during pregnancy, you will likely need a few more hours of sleep, or a few short naps during the day. So go ahead and have a lie-down!

NEW APP ALERT Pregnacise's Pregnancy Workout App (www.pregnacise.net) is a unique week-by-week exercise plan that's been devised around the three trimesters of pregnancy. Designed to maximise your fitness so that your body is prepared for the job of giving birth, it's a complete set of exercise classes that you can carry around in your pocket.

QUICK FACT

WHAT'S GOING ON UP THERE NORTHLAND WOMEN AVERAGE 2.55 BIRTHS (COMPARED TO 2.02 NATIONWIDE).

SUMMER STYLE FILE

SNUGGLE IN Every baby needs a sweet cot quilt to snuggle with, and we love these whimsical animal designs. Nursery Rhyme quilts $69.99 each from Farmers

The new Breastmates Spring-Summer 2015-16 range of stylish maternity and breastfeeding clothing is launching now, with gorgeous bump-flattering fashions you'll love. Prices start from $49, available at breastmates.co.nz

Pregnancy BUMP & baby

he importance of the genetic health of both eggs and sperm at the time of fertilisation has long been recognised, and there has been an increasing understanding of the importance of the environment before and around the time of conception. The mum-to-be's environment can permanently change the function of a gene, influencing, for example, immunity and the risk of cancer in her child. Diet and nutrition are likely to play a role in this. While a baby's genes are inherited directly from its parents, how these genes express themselves is controlled through epigenetic changes to the DNA. The most commonly studied epigenetic changes researched are chemical marks called "methylation", which are placed on the genes and changes in methylation can often prevent expression of certain genes. Because methylation requires a defined set of nutrients, a mother's nutrition and diet before and during pregnancy can affect the setting of these changes, thus affecting the baby's gene function permanently. A mother's risk of miscarriage and the chance of having a baby with a chromosome abnormality such as Down syndrome increases when the mum is older than 35 and here in New Zealand, there's been a significant increase in the number of women having babies in their mid- to late-30s – yet the best chance of becoming pregnant is when a woman is in her mid-20s through to early 30s.

MELATONIN AND FERTILITY New research suggests that melatonin plays an important role in several physiological processes, including fertility. Melatonin is a hormone produced by the pineal gland in the brain. Recent studies indicate that healthy melatonin levels are necessary for optimal fertility, and that melatonin acts as an antioxidant in the ovaries, removing free radicals and preventing cellular damage. There is some evidence that melatonin improves embryo quality, presumably by improving egg genetic health. There was also some evidence of improved pregnancy rates if the woman takes a melatonin supplement during her cycle of IVF.

Pregnancy BUMP & baby

A good egg (and sperm) When you're trying to conceive, many factors are important, including the genetic health of your eggs and your partner's sperm. Dr Guy Gudex, fertility expert and Medical Director at Repromed, tells of advances in genetic testing techniques and how they apply to preconception and pregnancy.

GENETICS & PREGNANCY

AGE BEFORE BABY

Recent census data showed age 30 as the median age for women giving birth, with women aged 30-34 having 126 of every 1000 babies born. This is a significant change from the 1970s, when the median age of women giving birth was 25. Additionally, of every 1000 births today, 72 are to women aged 35-39 and 15 are to women aged 40-44. It's important to realise that at least 50% of human embryos are genetically abnormal, and this figure increases to 80% in women over age 40. These abnormalities lead to a lower implantation rate in natural conception as well as in procedures such as in vitro fertilisation (IVF). What this means is that as a woman ages, falling pregnant becomes difficult – for a woman age 40, it can take 12 months of "trying" to become pregnant.

EMBRYO TESTING The genetic testing of embryos for chromosome abnormalities is called Preimplantation Genetic Screening (PGS), and the technology that allows this has recently become quicker, cheaper, and more accurate. PGS involves removing a few cells from a day 5 embryo, then analysing the cells. The embryo is then frozen to allow time for the results to become available, and to be able to select the healthiest embryo. PGS is of particular interest to couples who are undergoing IVF and have experienced recurrent miscarriage, recurrent implantation failure, or where the mum is over the age of 35 and has a higher risk of a baby with a chromosome problem.

SPERM GENETIC HEALTH The genetic health of a dad-to-be's sperm is also important. Sperm DNA fragmentation increases in men who are aged 35 to 40 or older, and also in men who smoke or are obese. Increased sperm DNA damage is associated with reduced fertilisation rates, reduced embryo quality, and reduced pregnancy rates, as well as higher rates of miscarriage and childhood diseases. Assessing sperm DNA damage can help predict the chances of success with IVF and other assisted reproduction techniques. Testing is now available to assess both sperm DNA fragmentation and the level of aneuploidy (abnormal chromosome numbers) in sperm. Sperm DNA fragmentation is most commonly tested on a fresh sample of sperm, using the techniques Terminal Deoxynucleotidyl Transferase dUTP Nick End Labeling (TUNEL) or Sperm Chromatin Structure Assay (SCSA). DNA fragmentation testing costs $250-450 depending on the type of test used, and the results take two to three working days. A result of more than 20% of DNA fragmentation is considered abnormal. Pregnancy BUMP & baby

GENETICS & PREGNANCY

Sperm

Intracytoplasmic Sperm Injection (ICSI) is a method of in vitro fertilisation in which a single sperm is injected directly into an egg.

the fluid-filled space at the base of the baby's neck (nuchal thickness), and a maternal blood test which measures the levels of hormones B-HCG and PAPP-A. Nuchal thickness is increased when the baby has certain conditions. With NIPS, a negative result means that Egg Cell (Ovum) none of the chromosome SEEK conditions tested for were SUPPORT detected, and that no further Conception is invasive testing is required a complicated process unless recommended by Sperm Aneuploidy Testing (SAT) is now found in meat and particularly that depends on many your doctor or midwife. available in New Zealand, with the first test cheese products. A study factors, such as genetics If a positive result is done at Repromed Auckland in September from the UK shows that of egg and sperm, obtained, then usually an 2015 in partnership with IGENZ, a private eating fruits and vegetables condition of the uterus genetic testing laboratory based in Parnell. can improve fertility in men, amniocentesis or chorionic and the fallopian tubes, SAT is a diagnostic test to evaluate the with the ideal being more villus sample (CVS) will both parents' ages, be recommended. These percentage of sperm with chromosome than five servings per day. lifestyle choices, stress, highly accurate tests can abnormalities in a sperm sample. An existing disorders, and take place from as early increase in sperm with chromosome GENETIC SCREENING other factors that you as 10 weeks through to abnormalities has been associated with IN PREGNANCY may never even be aware 20 weeks of pregnancy. a decrease in pregnancy rates and a higher Non-Invasive Prenatal of. Embarking on miscarriage risk in couples undergoing IVF. Screening (NIPS) is another A scan at seven to 10 a pregnancy journey weeks of pregnancy can SAT can help in the reproductive genetic area where there has been can be very challenging, determine the gestational counselling of infertile couples in order to significant advances in so make certain you have date of your pregnancy; assess the optimal approach to helping genetic testing. When the right medical, however, it is still them conceive. In a couple with a history a woman becomes pregnant, emotional, and recommended that of recurrent miscarriage and recurrent some of the baby's DNA nutritional support to implantation failure at IVF, and in men crosses the placenta into the pregnant mums consider keep your anxiety levels having the 12-week with significantly impaired sperm maternal bloodstream. This down and to make the ultrasound scan to parameters, it is particularly useful. foetal blood can be detected best decisions for your check the baby's anatomy, in a sample of maternal blood, baby and your body. and the most important HOW TO IMPROVE and then analysed for some SPERM HEALTH of the conditions caused by scan at 18-20 weeks, to For men, lifestyle changes like quitting chromosome changes, such as Down check the baby's growth and physical development are normal. smoking and losing weight can help to syndrome, the most common chromosome reduce sperm fragmentation, as can condition seen in children and adults. NIPS EGG FREEZING treatment with antioxidants. Most studies can screen for: To try and overcome the issue of declining have confirmed that antioxidants have • Down syndrome (an extra chromosome 21) a favourable effect on sperm genetic health, • Edwards syndrome (extra chromosome 18) egg quality with advancing maternal age, egg freezing is being used more commonly including motility (the ability of sperm • Patau syndrome (extra chromosome 13) as a fertility preservation technique. A new to move properly through the female • Sex chromosome conditions such technique called vitrification has excellent reproductive tract to reach the egg), as Turner syndrome (X chromosome survival rates (as one of the difficulties of and can improve the chances of pregnancy missing) and Klinefelter syndrome with assisted conception. A diet containing (extra X chromosome) freezing eggs is that some don't survive the vitamin C, vitamin E, folic acid, zinc, and The majority of pregnant women in thawing process), and can help achieve comparable fertilisation and implantation selenium have all shown to have beneficial New Zealand undergo the publicly funded rates to that of fresh eggs. For a woman antioxidant effect. First Trimester Combined Screening under the age of 38, between 15 and 25 Conversely, a diet with a heavy intake (FTCS), commonly called the "12-week of meat and dairy products has been shown scan". FTCS includes an ultrasound at eggs need to be stored in order to conceive a single baby, which may involve more to decrease sperm quality. This may be between nine weeks and 13 weeks plus because of the increased saturated fats six days of pregnancy, which measures than one cycle of ovarian stimulation.

Pregnancy BUMP & baby

IMAGE TOP LEFT COURTESY REPROMED

Needle

At Repromed, our goal is to do whatever we can to help you realise your dream of having a child. Repromed is a fertility service specialising Dr Guy Gudex

Medical Director

in assisted reproductive technologies (ART) and is highly respected for it’s quality of care and innovative procedures. Repromed offers a full range of services including: • Fertility assessment/investigation

Dr Karen Buckingham

• Ovarian reserve testing (AMH) • Pre-implantation genetic diagnosis (PGD) • Pre-implantation genetic screening (PGS) • In Vitro fertilization (IVF) • Intra cytoplasmic sperm injection (ICSI)

Prof Neil Johnson

• Elective Egg Freezing for fertility preservation • Sperm freezing • Embryo freezing • Surgical sperm retrieval • Intrauterine insemination (IUI)

Prof Cindy Farquhar

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9 P re g n a n

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The whole

Pregnancy is a time of wonder – as in, "I wonder what's going on in there?" Whether you're a first-time mum and this is new territory, or you've had a baby before and need a refresher, here's our month-by-month pregnancy guide.

Pregnancy BUMP & baby

months

INSIDE INFO

ALL PREGNANCIES ARE DIFFERENT, AND ALL BABIES DEVELOP SLIGHTLY DIFFERENTLY. THIS GENERAL GUIDE WILL GIVE YOU AN OVERVIEW OF YOUR BODY AND BABY'S DEVELOPMENT, BUT KEEP IN MIND THAT THINGS MAY BE DIFFERENT FOR YOU. YOUR LMC OR MIDWIFE CAN GIVE YOU FURTHER INFORMATION ON WHAT'S GOING ON IN YOUR BODY DURING EACH STAGE OF YOUR PREGNANCY.

Pregnancy BUMP & baby

FACT

YOUR BABY'S GENDER IS DETERMINED AT THE MOMENT OF FERTILISATION.

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lthough pregnancy is commonly said to be for nine months, it's actually more like 40ish weeks (around 280 days) – a bit longer than nine months. To complicate matters even further, the 40 weeks of pregnancy are divided into three sections, called trimesters. The first trimester is weeks one to 12, the second trimester is weeks 13 to 27, and the third trimester is weeks 28 until birth – which generally happens somewhere around week 40 of pregnancy. Each trimester of pregnancy contains certain developmental stages and symptoms, and it's fascinating to know what is going on inside your pregnant body during every stage. Read on to find out more about your baby, your body, and your incredible pregnancy!

Month 1 (weeks 1-4)

Wow, you're pregnant – congratulations! Well, actually, you're not technically pregnant until your egg has been fertilised by sperm, and this is most likely to happen around the time of ovulation – generally about 14 days after the first day of your period. Yes, we're using a lot of weaselly words like "around the time" and "about 14 days". This is because every woman's menstrual cycle is different, and although the usual timing of pregnancy is based around a 28-day menstrual cycle, yours may be shorter or longer than that, or irregular from month to month. When your baby is conceived, it'll be about the size of a poppyseed – a small collection of cells which will multiply very quickly! By the end of week four, you may notice your period hasn't arrived, and voilà: NOW you're officially pregnant.

Pregnancy BUMP & baby

Passing the test

Confirming you're pregnant can be done through a blood test or urine test, both of which work by detecting the levels of the pregnancy hormone HCG (human chorionic gonadotropin) in your body. HCG levels increase quickly, doubling every day to two days for the first 10 to 12 weeks of pregnancy, then levelling off. A blood test can detect the exact level of HCG in your body (at the time of the blood draw), which can help to date your pregnancy if you're uncertain about when you conceived. Home pregnancy tests can't give you the level of HCG in your body, and each differs in its sensitivity to detecting HCG. If you use a home pregnancy test, follow the instructions for the clearest result. If your period is late and you've taken a home pregnancy test but the result is negative, wait a few days and try again – it may be that your HCG level wasn't high enough to be detected the first time around.

Early signs Implantation bleeding You may notice some Most pregnancy small spots of blood on symptoms don't your underwear, or light show up until bleeding which occurs earlier than your period around week would normally be due. six of pregnancy, This is "implantation but before that, bleeding", which occurs many pregnant when the fertilised egg women report attaches to the lining of uterus. Implantation feeling "off" or your bleeding is usually lighter fatigued, having in colour (pink or brownish tender breasts, rather than red). Implantation or feeling moody bleeding doesn't happen to everyone, but it can be an – similar to early pregnancy sign. period symptoms. Folic acid and iodine

tip

Wee on a stick The best time to take a home pregnancy test is first thing in the morning, the time when your urine will contain the most concentrated levels of HCG.

WHAT'S MY DUE DATE?

Folic acid helps to reduce the risk of your baby developing neural tube defects like spina bifida. Iodine is important for your baby's brain development. You can buy folic acid and iodine tablets at your local chemist, or your GP or midwife will give you prescriptions for folic acid and iodine tablets, which you should take from the time you find out you're pregnant. You should also eat folate-rich and iodine-rich foods (make sure they're cooked properly).

If you've just found out you're pregnant, you might be wondering how far along you are. There's a reason your GP would have asked you what the first date of your last period was – this day is counted as the first day of your pregnancy, even though you weren't technically pregnant on that date! To find out your due date, add 280 days to the date your last period started. Now, this isn't foolproof, because it assumes that your menstrual cycle is 28 days long. Due dates are only estimates, and on average, only 5% of births take place on their due dates.

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According to the Ministry of Health, pregnant women are eligible for free and subsidised maternity-related services in New Zealand if they:

+ are eligible for

publicly funded health and disability services in their own right OR their husband, civil union partner or de facto partner is a/an: New Zealand citizen OR New Zealand resident or permanent resident visa holder OR Australian citizen or Australian permanent resident visa holder who has been living, or who intends to live, in New Zealand for two years or longer OR refugee or

By now you've missed a period and possibly suspect you're pregnant, especially if you're experiencing some of those early pregnancy symptoms, like tiredness, tender breasts, and mood swings. You may have taken a home pregnancy test and seen a positive result, and hopefully you've visited your GP for confirmation of your pregnancy. So what's going on inside your still-flat stomach? This month, there will be massive changes inside your body, and your baby will more than quadruple in size, going from a tadpole-like embryo to having a recognisable body with arms and legs. You still can't see any external symptoms, but if you have an early pregnancy scan at the end of this month, which some midwives suggest in order to help date a woman's pregnancy, you'll be able to see something!

+ + + +

Signs and symptoms

How big is my baby?

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DO I QUALIFY FOR FREE MATERNITY CARE?

Month 2 (weeks 5-8)

During the second month of pregnancy is when most of the traditional pregnancy symptoms will make themselves known – sometimes uncomfortably so. Here are some symptoms you might experience: • Tender, enlarged, sensitive breasts • Larger, darker nipples • Nausea (morning sickness, which can occur at any time of the day or night) • A heightened sense of smell and intolerance of certain odors (aka "pregnancy nose") • Increased need to urinate • A metallic taste in your mouth • Tiredness and wanting to go to bed super-early or nap during the day • Mood swings and feeling more emotional than usual

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INSIDE INFO

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protected person, or is applying or appealing for refugee or protected person status, or is a victim or suspected victim of a people trafficking offence OR work visa holder able to stay in New Zealand for 24 consecutive months (time spent lawfully in New Zealand immediately before the start of the work visa counts toward the two year requirement) (work visas start on the person's first day in New Zealand) OR

life-support system) has started to develop, and your baby's cells are organising themselves into three layers, which are already earmarked for certain organs, systems, and parts of the body. It's amazing that the cells already have "assignments" this early in your baby's life! By the end of the second month (around week eight of your pregnancy), your baby will have grown to about the size of a raspberry – around 1.5cm in length.

Learn the lingo "Trimester", "LMC", "HCG", "scan", "foetus" – pregnancy has a language all of its own. But don't worry – by the time your baby is born, you'll know what How do I find an LMC? all of these words It's time to start looking for an (lead maternity caregiver), mean, and you'll LMC which for most women in New be speaking the Zealand will be a registered lingo like a pro. midwife. Yes, it probably feels

One of the most exciting things about pregnancy is learning how much your baby is growing from week to week! At the beginning of your second month of pregnancy, your baby will be about 3mm long, approximately the size of an apple pip. At this stage, the placenta (your baby's

quite early to be thinking about this – after all, you can't even see a baby bump yet! But New Zealand has a limited number of midwives, and in many areas of the country, it can be difficult to find one. Also, you want to have plenty of time to choose a midwife whose philosophy resonates with you, who you feel comfortable and confident with, and who is conveniently located and right for your

+ interim visa holder

who was eligible immediately before the interim visa was issued OR are pregnant with a child that is found to be a New Zealand citizen by birth. Partners of NZ Aid Programme students studying in New Zealand are eligible in their own right. If you're still not sure whether you qualify for free maternity care, talk to your GP, LMC, or get in touch with the Ministry of Health (0800 855 066).

+ + +

situation. So how do you find a suitable midwife? Here are some starting points: • Ask your GP for a list of local midwives • Visit www.findyourmidwife.co.nz, a website created by the New Zealand College of Midwives • Ask friends who have recently had a baby for their recommendation • Get in touch with your local hospital or birthing centre • Search the Register of Midwives at www.midwiferycouncil.health.nz

QUICK FACTS

WEEK 5: Your baby is the size of an apple pip (3mm) and the placenta is developing. WEEK 6: Your baby is the size of a pea (5mm) and has a beating heart. WEEK 7: Your baby is the size of a blueberry (1cm) and has visible arm and leg buds. WEEK 8: Your baby is the size of a raspberry (1.5cm, 1g) and is developing eyes, a nose, and ears. Pregnancy BUMP & baby

Month 3 (weeks 9-13)

You'll notice visible changes in your body this month, because your baby is reaching some significant developmental milestones. Your uterus, which is usually the size of your fist, will have grown to about the size of a grapefruit in order to accommodate your rapidly growing baby – who is now 10,000 times bigger than it was at conception. Your baby's body is recognisably human in shape, with a large head, torso, arms, and legs (and even fingers and toes). Its face is more defined, with eyes, eyelids, mouth, and nose. Its genitals have begun to form, although they aren't developed enough to be able to see the gender. The placenta, which is your baby's in-utero life-support system, is working to make nutrients for your baby and get rid of his or her waste products. Your baby is moving around a lot inside of you, although he or she is too small for you to be able to feel the movements just yet.

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at 12 weeks!

First trimester combined screening For many pregnant women, the first time they'll "see" their baby is at their first ultrasound, commonly called a "scan", at around week 12 of pregnancy. This is part of the first trimester combined screening,

WEEK 9: Your baby is the size of a grape (2cm, 2g) and has eyelids and earlobes. WEEK 10: Your baby is the size of an olive (3cm, 4g) and has vital organs (liver, kidneys, intestines, brain, lungs). WEEK 11: Your baby is the size of a feijoa (4cm, 7g) and has tooth buds, fingers, and toes. WEEK 12: Your baby is the size of a lime (5.5cm, 14g) and is developing reflexes like grasping and sucking. WEEK 13: Your baby is the size of a peach (8.5cm, 23g), has fingerprints and can get hiccups. Pregnancy BUMP & baby

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By now you're likely to be experiencing "morning" sickness, which can strike at any time, not just the morning. At the beginning of the second trimester (around week 14 of pregnancy, so after this month is over), this will start to let up. Ginger, sour lollies, and dry crackers are common nausea busters, but if you're finding that you feel sick all the time and you can't cope, or you're not able to keep food and water down at all, make sure to contact your LMC straightaway as you may have a more serious condition called hyperemesis gravidarum, which can lead to weight loss, malnutrition, and dehydration.

Now that your baby's basic physiology has formed, weight gain is the primary focus. During the third month of pregnancy, your baby will rapidly put on body weight and will more than quadruple in size yet again, growing from the size of a grape to the size of a peach. At the beginning of your third month of pregnancy, your baby will be about 2cm long, and by the end of the third month of pregnancy – around week 13 – your baby will be 8.5cm long.

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"Morning" sickness

How big is my baby?

QUICK FACTS

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which includes a blood test and a scan. Results from these are combined with other information like your age, weight and baby's gestational age (how many weeks pregnant you are) to find a screening result which can show whether there is a low or increased chance you might be carrying a baby with Down syndrome and other conditions. The blood test is best taken at 10 weeks, but can be taken between nine weeks and 13 weeks and six days. The ultrasound scan is best taken at around 12 weeks, but can be taken between 11 weeks and two days, and 13 weeks and six days. If your result shows that there is an increased chance that your baby has a condition, you will be offered further testing to see if baby actually has that condition or not. Your LMC will talk to you about first trimester combined screening and any results which need further discussion. For more info, visit www.nsu.govt.nz.

INSIDE INFO

Month 4 (weeks 14-17) FACT AS YOUR BABY AND BODY GROW, YOUR BODY Welcome to the second trimester, also known as the "golden zone" of pregnancy, because everything should get just that much better. Your morning sickness should start to ease around now, although for some women it continues for a little bit longer. Your moods should start to even out so you don't feel like crying at the drop of a hat. Your libido, which may have taken a nose dive during the first trimester, should come back. As your energy returns, now is when many pregnant women start feeling those "nesting" urges – planning the nursery, making a list of baby names, thinking about maternity leave, and wanting to get home repairs completed before the baby arrives. If you're planning to return to work after the birth, now might be the time to investigate childcare options – in larger cities, daycares can have long waiting lists. Get ideas now while you have the capacity to plan ahead!

RISES TO THE CHALLENGE BY PRODUCING MORE BLOOD TO SUPPORT YOUR UTERUS – DURING PREGNANCY, YOUR BLOOD VOLUME WILL INCREASE BY UP TO 50%.

How big is my baby?

Your baby's body has been somewhat disproportionate up until now, with your baby's head quite large compared to his or her body. From now on, your baby's head growth will slow down while his or her body's growth continues, so that by birth, your baby will be more proportionate – although his or her head is still bigger in proportion to his or her body than an adult's. At the beginning of your fourth month of pregnancy, your baby will be about 9cm long and weigh about 40g, and by the end of the fourth month, your baby will be about 13cm long, and will have more than doubled in weight to 100g.

A weighty issue

Many pregnant women find that they don't gain much weight during the first trimester due to the baby still being very small, and also because of morning sickness. Now that you are in the second trimester, you may find you start gaining weight, particularly as morning sickness abates and you feel more like eating. The Ministry of Health has developed weight gain recommendations for pregnant women based on their pre-pregnancy or early pregnancy (less than 10 weeks) BMI. Pre-pregnancy or early pregnancy BMI (kg/m²)

Total weight gain range

Less than 18.5 Between 18.5 - 24.9 Between 25.0 - 29.9 Equal to or over 30.0

12.5 kg–18 kg 11.5 kg–16 kg 7 kg–11.5 kg 5 kg–9 kg

QUICK FACTS

WEEK 14: Your baby is the size of a lemon (9cm, 40g) and can suck his or her thumb. WEEK 15: Your baby is the size of a nashi pear (10cm, 70g) and has taste buds. WEEK 16: Your baby is the size of an avocado (11.5cm, 100g) and has fingernails and toenails. WEEK 17: Your baby is the size of a mango (13cm, 140g) and his or her skeleton is changing from cartilage to bone.

What is the weight made up of?

If you gain 12.8kg during pregnancy, and you give birth to a baby weighing 3.5kg, here is what the total 12.8kg you gained is comprised of:

Seeing your baby for the first time is amazing and fascinating.

• Baby 3.5kg • Amniotic fluid 900g • Placenta 700g • Uterine growth 900g • Breast growth 1.1kg • Increased amount of blood 1.5kg • Increased amount of other body fluids 1.1kg

• Storage of nutrients (fat and protein) 3.1kg TOTAL WEIGHT GAIN 12.8kg

LINEA NIGRA

If you've noticed a dark line down the middle of your tummy (which may be up to 1cm wide and might cross your tummy button), you've been blessed with a linea nigra. This not-uncommon pregnancy side effect appears around the beginning of the second trimester and is caused by pigmentation due to hormonal changes. Don't panic – it will likely fade a few weeks after your baby is born.

Pregnancy BUMP & baby

INSIDE INFO

Take care as your bump grows, particularly as your centre of gravity shifts.

Month 5 (Weeks 18-22)

Little flutters

Hold on, eyebro

This month, your energy should continue If it's your first pregnancy, you might to increase, although you may also have start feeling your baby move around a few more aches and pains as your ligaments your fifth month of pregnancy. It may stretch. You may also experience two of start off feeling like little flutters or the less-pleasant side effects of pregnancy: gentle bumps, as though your stomach Heartburn and reflux. They often come at is growling (although without the the same time your appetite has started to accompanying noise!), or even like gas ramp up and cravings set in. Try to avoid – and you may not even notice for a while, preferably as close as possible to 19 weeks, triggers like spicy, fried, or fatty foods; eat or you'll suddenly realise what you're smaller meals more frequently; and keep you will have another routine ultrasound, feeling! As your baby grows, these commonly called the anatomy scan. This a supply of pregnancy-safe antacid tablets movements will become more discernible or liquid nearby. Check with your midwife scan assesses whether your baby is growing and you may even start to see a pattern or pharmacist about what is safe to take and developing normally. It takes around of when your baby is awake and asleep. during pregnancy. You may also 30 minutes, and during the Later on in pregnancy, you'll even be able experience mild oedema (swelling) scan, the technician will to see the movements from the outside, tip take various measurements of your feet and ankles. This is and your partner will particularly enjoy Gender and look for a number of normal, but if the swelling seems feeling your baby shifting and kicking. surprise to be more than mild or it doesn't characteristics, such as the go away, talk to your LMC as it can Tooth or consequences If you'd rather fluid around your baby, the be a sign of something more placenta, and your baby's Has your mouth become a disaster zone, find out your head, face, spine, heart, serious. The dreaded "preggy with bleeding gums, super-sensitive taste brain" can set in with a vengeance, baby's gender in stomach, bowels, kidneys, buds, and gagging every time you brush privacy or share bladder, and limbs. and you might find yourself your teeth? Pregnancy hormones aren't putting your car keys away This scan can be a little particularly kind to your gums, which the moment with in the fridge. uncomfortable because you become inflamed and swollen and tend family, ask the will need to have a full bladder to bleed even with the gentlest brushing. technician to beforehand – but the payoff How big is my baby? Your hormones are also responsible for write down the is that at this scan, if you wish your taste buds going a bit wild. And Your baby has grown enough that you're starting to look pregnant, gender and place to find out your baby's gender, gagging when you brush your teeth may which is a milestone for many it may be visible! Let the be a leftover from morning sickness, and it in a sealed mums-to-be. At the beginning of technician know before the is hormonal. All of these symptoms envelope for you scan whether you wish to find again this month, your baby is 14cm will ease when your baby is born, but until to take home. out the gender or not. Keep long and weighs around 140g then, keep brushing and flossing, and see in mind it may not be possible (about as much as a chicken your dentist if you notice any cavities or breast), and by the end of this month, to see the baby's gender due to the position other tooth difficulties (be certain to your baby is about 20cm long and weighs he or she is in, and other factors. tell your dentist you're pregnant). a whopping 450g – almost as much as a block of butter! He or she is covered in vernix, which is a greasy, cheeselike, white substance that protects your baby's skin from the surrounding amniotic fluid. This WEEK 18: Your baby is the size of a chicken coating will shed closer to the birth, but breast (14cm, 140g) and can yawn and hiccup. many babies are born with remnants of WEEK 19: Your baby is the size of a mango vernix on their skin. Your baby's sex organs are also becoming more easily discernible, (15cm, 225g) and is starting to grow hair! and if you're having a girl, her vaginal WEEK 20: Your baby is the size of a banana canal will have begun developing. If you're (16.5cm, 300g) and has eyebrows. having a boy, his testicles have begun to WEEK 21: Your baby is the size of a carrot (18cm, descend from his abdomen and will soon drop into his scrotum. 325g) and is practising swallowing and digesting.

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Pregnancy BUMP & baby

...

At between 18 and 20 weeks of pregnancy,

WEEK 22: Your baby is just smaller than a block of butter (20cm, 450g) and can now perceive light and dark.

Anatomy scan

QUICK FACTS

The secret to a better iron supplement. Absorption.

Significantly more iron is required during and after pregnancy. The safest way to supplement your iron is with a natural product. The average person’s body will dissolve and absorb 20% of most solid supplements, eliminating the remaining 80% and possibly causing unpleasant side effects such as constipation, gas and bloating. Dietary iron is absorbed at an average rate of 10%, while the iron in most supplements is absorbed at rates between 2% and 10%, depending on the forms of iron used. Because Floradix is a liquid solution it is absorbed more easily. And Floradix boasts one of the highest iron absorption rates of up to 25%, through the use of iron gluconate and yeast.

•

Non-constipating formula

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Highly absorbable iron gluconate

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Vitamin C increases iron absorption

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No alcohol, nuts, lactose, dairy or animal derivatives

•

No chemical preservatives, colourings or flavourings

TC062 TAPS PP6472

Floradix and gluten-free Floravital are a great way to help maintain the health and vitality of your mums-to-be and nursing mothers.

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Month 6 (Weeks 23-27) FACT 75% OF WOMEN DEVELOP OEDEMA Pregnancy has likely become very real

(MILD SWELLING AND PUFFINESS) DURING PREGNANCY. to you now, with your growing belly, the sensation of regular movements of your baby, and the numerous pregnancy can also hear you and your partner talking, the size of an avocado to the size of symptoms you're dealing with – some particularly if you're in a quiet environment. a watermelon. When you're ready to give birth, your uterus will extend from your wonderful and some not so much! Your Your baby doesn't have much body fat, but pubic area to the bottom of your rib cage. sixth month of pregnancy marks the end he or she is continuing to put on weight of the second trimester, which means After birth, your uterus will return to and grow, and by birth he or she should you're nearly two-thirds of the way have a bit of padding which will help keep its pre-pregnancy size and position within about six weeks – this process toward meeting your baby. You may your baby warm out in the world (with the have some aches and pains, particularly help of clothing, blankets, and cuddles). is called involution. in your lower abdomen as your ligaments continue to stretch to The eyes have it tip support your uterus. You might At this point in your pregnancy CONSTIPATION also be troubled with "restless you might notice your eyes feel One of side effects you might suffer Trouble leg syndrome" or leg cramps, red, dry, gritty, and even a little around this time is constipation. sleeping? which can be annoying and bit sore or crusty when you wake Try eating fibre-rich foods like Many mums up in the morning, and your might make getting to sleep whole-grain bread, cereals, brown swear by at night a bit trickier than contacts don't fit well or feel rice, and lentils , as they're high in usual. And as your bump grows, uncomfortable. You may also pregnancy vitamin B, and talk to your LMC your sleeping positions at night pillows, which have noticed that your eyesight or pharmacist if it isn't easing. might become difficult too, has worsened (particularly if are specially particularly if you're usually you wear glasses or contacts). designed to a stomach sleeper and you're These eye changes are the result trying to get used to sleeping support your of – you guessed it – pregnancy on your side and back. Use lots (Weeks 28-31) growing bump. hormones. Before you resort to of pillows and build yourself over-the-counter remedies, pay You're now officially in the third trimester, You can get full- a visit to your GP or optometrist, and on the home stretch of pregnancy! a nest to get more comfortable. body versions as some eye treatments are not You might not think there's any more How big is my baby? room for your uterus to grow, but believe suitable for pregnant women. or even belly At the beginning of this month, us, you'll get even bigger (and that's not wedges to help If you wear contacts, you might your baby is around 21cm long a bad thing). You'll feel a lot more activity have to switch to glasses for the you sleep more duration. And pregnancy is and weighs about 500g, and by from your baby this month, particularly as comfortably. the end of the month, he or she probably not the best time to he or she starts to run out of room inside of you. You might also start to feel Braxton will double his or her weight to invest in a new pair of glasses 900g and height to 38cm. Up until now, Hicks contractions, which are usually or a new contact prescription, as your your baby has been measured from crown painless and are not labour contractions eyesight will likely go back to normal to rump (the top of the head to the bottom – your stomach will harden and tighten for once your baby is born and your hormone of his or her bottom), but from the end of levels normalise. a moment, then return to normal. this month, he or she will be measured Your breasts continue to enlarge and you might also find your nipples are from head to toe. Your baby can sense light Your amazing uterus leaking colostrum (drops of creamy white and sound, so might squirm when you're Your uterus is about the size of a basketball vacuuming or listening to loud music, or substance which are your baby's first milk) right now – and from the beginning to the when the dog is barking – and your baby end of pregnancy, it will grow from about as your breasts prepare for feeding. You might also start to feel tired once more, as your growing body gives you a workout just moving through the day. Take frequent breaks and put your feet up when you can.

Month 7

QUICK FACTS

WEEK 23: Your baby is the size of an aubergine (21cm, 500g) and his or her lungs are developing and maturing. WEEK 24: Your baby is the size of an ear of corn (22cm, 680g) and has a fully formed face. WEEK 25: Your baby is the size of a head of broccoli (23cm, 750g) and has functioning vocal chords. WEEK 26: Your baby is the size of a head of lettuce (24cm, 900g) and his or her eyes are beginning to open. WEEK 27: Your baby is the size of a head of cauliflower (38cm head to toe, 950g) and can have dreams. 32

Pregnancy BUMP & baby

How big is my baby?

At the beginning of your seventh month, your baby is now 1kg and will be 41cm long from head to toe. His or her lungs are almost fully mature by now, and from now until the end of pregnancy, he or she will triple his or her weight – mostly from the accumulation of fat, which will ramp up now and continue through to birth. Your baby's brain is developing the ridges and wrinkles that allow for future expansion of brain tissue, and some critical connections are being made, so it's important that you

INSIDE INFO

QUICK FACTS

WEEK 28: Your baby is the size of a coconut (41cm, 1kg) and is learning to blink. WEEK 29: Your baby is the size of a cabbage (1.4kg, 43cm) and is accumulating more fat. WEEK 30: Your baby is the size of two punnets of strawberries (1.5kg, 44cm) and his or her brain is rapidly making connections. WEEK 31: Your baby is the size of a bag of sugar (1.6kg, 46cm) and can now perceive all five senses (sight, hearing, touch, taste, smell).

Month 8 (Weeks 32-35)

continue to take your pregnancy supplements and to eat well. It's around this time that your baby will also start shedding the lanugo hair that covers his or her body, which will be mostly gone by birth.

• Eat fibre-rich foods to avoid constipation. • Sit in a warm bath to reduce discomfort. • Talk to your LMC or pharmacist before

Those are not grapes

Belly bothers

We're sorry, but haemorrhoids (also called piles) are common during pregnancy, even if you've never suffered from them before. Pressure from your enlarging uterus coupled with increased blood flow to your pelvic area can cause the veins in your rectum to swell and bulge out of your anus, itching and burning when they are irritated. They can sometimes bleed, particularly when you are on the toilet or having a bowel movement. The good news is that they usually go away after your baby is born. But until then, try these tips: • Avoid sitting or standing for a long time. • Practise your pelvic floor exercises. • Prop your feet up on a stool while you have a bowel movement. n S oo

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trying home remedies or medications, as some aren't suitable for pregnant women.

As your baby grows, your belly button will have started stretching out and possibly even protruding, and by now it might feel like it's stretched to the max. You might also have itchy belly skin as your tummy continues to grow and stretch to accommodate your baby. Because your skin is stretching quite rapidly and over a relatively short period of time, it becomes moisture-deprived, and starts to itch. Moisturiser and body oil may help. Give yourself (or enlist your partner's help to give you) a tummy massage with body oil. If you feel an all-over itch that isn't related to stretchy skin, or you develop a rash on your tummy or abdomen, check with your midwife.

By now you may be feeling impatient for pregnancy to be over, but there's still a bit more time needed for your baby to grow and develop. Your baby is moving around a lot, and making you uncomfortable at times from pokes, jabs, and kicks – sometimes it may feel like he or she is using your bladder as a trampoline! Your body is still undergoing changes, and you might be experiencing occasional dizziness or faintness this month. Getting up too quickly can cause your blood pressure to drop quickly and make you feel lightheaded. Also, when your blood sugar dips – a common issue for pregnant mums – it can trigger a dizzy spell. Keep snacks on hand for quick relief, and if you are worried about any of your symptoms or you notice side effects that happen often, make sure to talk to your LMC or midwife.

How big is my baby?

At the beginning of this, your second-tolast month of pregnancy, your baby will weigh about 1.8kg and be 47cm long. At this stage your baby's growth is a bit slower than in early and mid-pregnancy, but it's steady, as your baby's body fills out. By the end of this month, he or she will weigh around 2.5kg and be about 48.5cm long. Things are getting cramped inside your uterus, as your baby does quite a lot of practising the skills he or she needs to survive outside of the womb – breathing, kicking, swallowing, and even sucking. If you have another ultrasound scan, you may even see your baby sucking his or her thumb!

Baby brain

Are you finding yourself forgetting things like where you put your car keys, or are

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WEEK 32: Your baby is the size of a bunch of grapes (1.8kg, 47cm) and can suck his or her thumb. WEEK 33: Your baby is the size of a pineapple (2kg, 47.5cm) and is developing his or her immune system. WEEK 34: Your baby is the size of a rock melon (2.2kg, 48cm), and if male, his testicles are descending into his scrotum. WEEK 35: Your baby is the size of a box of tissues (2.5kg, 48.5cm) and is settling into a head-down position.

you putting the milk in the cupboard and the cereal in the fridge? Many pregnant mums talk about "preggy brain", but the jury is out on whether this condition really exists. Some research asserts that a woman's brain cell volume does decrease during pregnancy. Others think that heightened forgetfulness is simply a result of hormonal changes. Still others point to sleep deprivation as the source of mummy brain fade. And it's possible that you aren't really any more absent-minded than usual, but because people always talk about preggy brain, you think you've got it. Whatever the reason, it'll lift following the birth of your baby, and you'll soon feel like your brain is working at full capacity again.

Wee, wee, wee all the way home

As your baby moves head-down and into the position in which he or she will be born, your uterus is placing more pressure than

WHOOPING COUGH VACCINE BOOSTER

Whooping cough is particularly tough on infants and young children – six out of 10 infected are admitted to hospital, with one of these six ending up in intensive care. A whooping cough vaccine booster for pregnant mums passes protection to their unborn baby and protects mum. This helps bridge the gap until baby's first immunisations are completed at five months of age. The vaccine is free for mums between 28 and 38 weeks of every pregnancy. The ideal timing is before 36 weeks, as your immune system needs time to respond to the vaccine and pass that protection on before your baby is born.

Pregnancy BUMP & baby

usual on organs below it – like your bladder. • Drink at least eight glasses of water a day – restricting your water intake because you think it will make you go to the loo more often can backfire and cause dehydration and urinary infections. • Do pelvic floor exercises to help prevent and correct incontinence. • Empty your bladder as completely as possible each time you wee. • Avoid constipation, as straining to have a bowel movement can put pressure on your pelvic floor muscles, weakening them.

Month 9 (Weeks 36-40)

You're really close to the end now, and it's more than likely you're ready for this pregnancy to come to an end. Aches, pains, niggles, sleepless nights, the ever-present need to go to the loo... Yes, it's time for this baby to come meet you! You may start feeling a bit apprehensive about the birth, although this might be juxtaposed with excitement and anticipation. Your uterus is right under your ribs now, and you've probably felt a few kicks and jabs in them by now. As for all those people who keep asking, "Haven't you had that baby yet?", you might feel quite irritable – understandable, as you're anxious, too!

How big is my baby?

At the beginning of this month, your baby will be about 2.7kg and 49cm long, almost as big as he or she will be at birth. Your baby's growth continues until the end of pregnancy, but will slow down a bit, as there isn't as much room as there used to be. You'll feel less kicking and more squirming and shifting around as your baby continues to flex his or her limbs. By the end of this month, your baby will weigh around 3.5-4kg – although it's possible he or she will be heavier or lighter,

as every baby is different. His or her height may be anywhere from 49-53cm, although again, could be longer or shorter.

Hail Caesar

More than 25% of births are by Caesarean section (C-section), and the percentage is higher for hospital births. It can be disappointing for mums-to-be who planned vaginal births to be told that a C-section is necessary. But it's important to remember that the best birth is one in which you and your baby are as safe as possible. Talk to your LMC about what you need to know about C-sections, and be kind to yourself if you do have one. After all, your baby will be born one way or another, and you'll soon be holding him or her in your arms no matter what method of arrival!

Better late than never

About 50% of all pregnancies last longer than 40 weeks, and first babies in particular are known to prefer making late entrances. For the most part, it's better if your baby stays put until he or she is ready to make an appearance. Talk to your LMC or midwife about her philosophy regarding overdue pregnancies. She should be able to tell you how long she would allow your pregnancy to continue without induction, and will monitor your pregnancy closely.

QUICK FACTS

WEEK 36: Your baby is the size of a head of romaine lettuce (2.7kg, 49cm) and his or her digestive system is developed. WEEK 37: Your baby is the size of a pumpkin (2.9kg, 50cm) and is inhaling and exhaling amniotic fluid to practise breathing. WEEK 38: Your baby is the size of a bundle of leeks (3.1kg, 51cm) and his or her pink skin has turned whitish. WEEK 39: Your baby is the size of a loaf of bread (3.3kg, 52cm) and continues to shed vernix in preparation for birth. WEEK 40: Your baby is the size of a watermelon (3.5kg, 53cm) and is ready to arrive!

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Help protect your baby.

Ask your family to get their whooping cough booster vaccination. Whooping cough can be life threatening in babies.1 Over 70% of newborns who have whooping cough caught it off a close family member.2,3 Because whooping cough is always in our community, make sure anyone who’s in close contact with your baby is vaccinated before they visit you.4,5

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Someone who loves your baby could give them whooping cough.

Ask them to get a booster vaccination now. What does whooping cough sound like?

www.boostrix.co.nz

1. Mattoo S, Cherry JD. Clin Microbiol Rev. 2005;18:326-382. 2. Zepp F et al. Lancet Infect. Dis. 2011;11:557–70. 3. Wendelboe AM et al. Pediatr. Infect. Dis. J. 2007;26:293–99. 4. Institute of Environmental Science and Research Limited. Pertussis report. April 2014. Available at https://surv.esr.cri.nz/PDF_ surveillance/PertussisRpt/2014/PertussisreportApril2014.pdf. Accessed 21 May 2014. 5. Ministry of Health. Immunisation Handbook 2014. Wellington: Ministry of Health;2014. Boostrix® (combined diphtheria, tetanus, and acellular pertussis (dTpa or Tdap) vaccine) is available as an injection. Boostrix is for booster immunisation of people aged 10 years and older against diphtheria, tetanus, and pertussis (whooping cough). Boostrix is government funded for 11 year olds as part of the national immunisation schedule, and for pregnant women between 28 and 38 weeks gestation (Category B1). It is also available as a private-purchase prescription medicine – you will have to pay normal doctor’s visit fees and a prescription charge. A trained pharmacist can also administer Boostrix to a person aged 18 years and older. A 0.5 mL dose contains not less than 2.5 LfU of diphtheria toxoid, not less than 5 LfU of tetanus toxoid, and three purified antigens of Bordetella pertussis (8mcg of pertussis toxoid, 8 mcg of filamentous haemagglutinin, and 2.5 mcg of 69 kDa outer membrane protein). Tell your healthcare professional if you are pregnant or breastfeeding to be informed of the benefits and risks of Boostrix. Boostrix should not be administered if you or your child are hypersensitive to any component of this vaccine or similar vaccines, or have had swelling or disease of the brain after previous pertussis (whooping cough) vaccination, or any problems with blood clotting or the nervous system (such as spasms, epilepsy and brain disease) after earlier immunisation against diphtheria or tetanus. Common side effects include fever, irritability, fatigue, malaise, headache, loss of appetite, vomiting and diarrhoea, and local reactions such as pain, redness, bruising, itching, or swelling at the injection site. If you or your child have side effects, see your doctor, pharmacist, or health professional. Additional Consumer Medicine Information for Boostrix is available at www.medsafe.govt.nz. Ask your doctor if Boostrix is right for you or your child. Boostrix is a registered trade mark of the GlaxoSmithKline group of companies. Marketed by GlaxoSmithKline NZ Limited, Auckland. Adverse events involving GlaxoSmithKline products should be reported to GSK Medical Information on 0800 808 500. TAPS NA731/AU14/BOO/0015/14a GSK00237

Dream a little dream

Crazy dreams interrupting your sleep? Many mums-to-be experience fascinating, frightening, and just plain freaky dreams during pregnancy. And because you’re waking frequently at night (toilet trips!), you’re able to recall your dreams more vividly than ever.

Pregnancy BUMP & baby

PREGNANCY SLEEP

lame those wild hormones if you like, fuelling your emotions and intensifying your dreams, but your pregnancy dreams may also be a way of coming to terms with your new role as a parent. Whether it’s a change in sleep patterns or fluctuating hormones, experts believe there are a number of dream themes that pregnant women experience. Here are a few you may have already had yourself.

FORGETTING THE BABY Dreams about losing your baby or forgetting your baby somewhere are very common, and quite possibly linked to your fear of not being ready to be a parent, or anxiety you may be feeling related to the responsibility of being a parent. You may feel unprepared to look after a baby and fearful about the unknown.

WATER Water is seen as a powerful theme, and could symbolise a feeling of new beginnings and new life, or a feeling of cleansing. Or it may be a representation of concerns you have about labour and childbirth. Watery dreams such as surfing in the ocean, floating in a pool, or puddles of rain may be a reflection of your physical thoughts and feelings of your baby moving in amniotic fluid or your waters breaking during labour.

EROTIC FANTASIES Sensuous dreams, often with someone other than your partner, are perfectly normal. You may be feeling insecure about your changing body and its effect on your sex life, or vulnerable and dependent on those around you. Your hormones are fluctuating, your blood flow is increasing, and you’re an emotional rollercoaster; it’s not surprising your dreams are a little wild!

JOURNEYS AND TRAVELLING

While sleep is supposed to be a pregnant woman's restful refuge, wild dreams during pregnancy may mean you wake up tired.

Both exhilarating and terrifying, these dreams could be about travelling through a maze of tunnels or corridors, visiting a foreign country, or driving on an endless road. They may represent feelings of being out of control, a fear of the unknown, or your reluctance to confront the unknown, an emotion typically experienced towards the end of your pregnancy. Pregnancy BUMP & baby

PREGNANCY SLEEP

Grown-up babies

LINKED TO YOUR LACK OF EXPERIENCE WITH A NEWBORN BABY OR FEAR OF HAVING TO LOOK AFTER ONE, DREAMS ABOUT GIVING BIRTH TO A GROWN-UP BABY OR A TODDLER ARE JUST YOUR MIND’S WAY OF DEALING WITH THIS. MUMS-TO-BE OFTEN DREAM ABOUT HAVING BABIES WHO CAN ALREADY WALK AND TALK, AS AN OLDER CHILD IS SEEN AS LESS FRAGILE AND EASIER TO MANAGE. BABY’S NAMES You probably spend a fair bit of your waking hours contemplating baby’s name, so it’s very possible these thoughts filter through to your dreams. Some cultures believe that the names they’re given in dreams are special, so you may want to consider some of the choices you dream up. Your mind does have a way of throwing in a few odd name choices, though.

CHEATING PARTNERS Many mums-to-be feel vulnerable and unattractive during pregnancy, and may feel that their body is no longer their own. Dreams in which their partner is having an affair or is with someone else may simply be feelings of vulnerability and insecurity.

GAMES AND SPORTS Dreaming about scoring the ultimate goal or winning an exciting game of snakes and ladders? These dreams could be symbolic of the excitement and anticipation you’re feeling while pregnant; a bit like the thrill of being pregnant, but knowing you’re going to have to wait until after labour to meet your new baby.

CHILDHOOD MEMORIES If you’re dreaming about your childhood home, or childhood friends appear in your dreams, these could symbolise your past self, as you farewell your old way of life and welcome your new life and new identity as a mum.

FURRY CREATURES These dreams may seem weird, but dreams about giving birth to a furry animal could represent your worry over bonding with your new baby. It’s only natural to feel a little nervous about the arrival of a new creature in your home.

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BABY’S GENDER

BUILDINGS

Unless you’re psychic, you’re unlikely to predict your baby’s gender in a dream. Instead, dreams about baby’s gender are probably linked to your hopes or your fears for either a girl or a boy.

Buildings or factories where things are manufactured could represent your own thoughts about your growing baby and your awareness of the changes taking place in your own body over the next nine months.

GIVING BIRTH TO TWINS

GIVING BIRTH, THEN GIVING IT BACK

If you’re feeling overwhelmed by the changes in your life that your newborn is likely to bring, dreams about multiple births could simply be these feelings of fear and lack of control, or a reflection of your anxiety about a baby being demanding.

LOSING TEETH Dreams about crumbling teeth, rotten teeth, or losing teeth are symbolic of losing control. This may be your feelings of stress about how pregnancy will affect your work or your relationship with your partner.

FEELING TRAPPED Nightmarish dreams about being trapped somewhere or locked in may simply be your feelings of helplessness and vulnerability, your lack of control, and a feeling that you will no longer have the freedom to do what you want.

Mums-to-be may be concerned about the health of their baby as it grows and develops during pregnancy. Dreaming about giving birth and then putting baby back could be a reflection of your desire to check that your baby is developing normally, and then placing your baby back in your uterus to continue growing.

CHILDBIRTH AND LABOUR As you near the end of your pregnancy, these dreams are more common. You may dream you have a beautiful experience; an easy, painless birth. Other times, your dreams may involve a long and painful labour, or you may dream about giving birth to an alien baby. Anxiety about birth is natural, and your dreams are a normal part of your mind’s preparation for this life-changing experience.

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The product most recommended by doctors for pregnancy stretch marks. Colmar Brunton, 2014

“When you look at how much your stomach is going to grow in pregnancy, you’re convinced that all that stretching has to leave its mark! But pretty much everyone I spoke to used Bio-Oil, so I began using it from about my second month, twice a day. I liked the fact that it absorbed well and left my skin looking phenomenal. Now that I know that there’s a great product for stretch marks out there I can’t keep quiet about it – I would absolutely recommend it!” Nicolette with Amy

Bio-Oil® helps reduce the possibility of pregnancy stretch marks forming by increasing the skin’s elasticity. It should be applied twice daily from the start of the second trimester. For comprehensive product information, and details of clinical trials, please visit bio-oil.com. Bio-Oil is available at pharmacies and selected retailers at the recommended selling price of $20.45 (60ml). Individual results will vary.

the big stretch Loathe them, embrace them, or be lucky enough to escape them altogether: Stretch marks are just one of the rites of passage many women will face during their pregnancy, says Tiffany Brown.

t’s estimated as many as 90% of women experience stretch marks, which are narrow streak-like lines that develop on the skin. Medically referred to as "striae gravidarum", they most often affect the abdomen as your skin stretches to accommodate your growing baby. In some cases the thighs, buttocks, hips and breasts can also be affected as your pregnancy progresses. Stretch marks tend to appear in places where large amounts of fat are stored, so you are more likely to experience them if you are overweight when you get pregnant, or if you gain more weight than is recommended during your pregnancy. Yet another good reason to get off the couch and try to resist those French fries! Pregnancy stretch marks are caused by the physical stretch of the skin, and the lack of sufficient time the skin has to adjust to the body expanding beneath it. This causes the skin to tear, with the resulting scar forming a stretch mark. Thin

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There is a second factor at play in the formation of stretch marks – though still under debate among experts – concerning those good old pregnancy hormones you hear so much about. It is suggested the hormones may relax the bonds between collagen fibres by holding more water in the skin, making it easier for the skin to tear. There are three stages to the formation of stretch marks, beginning with streaks that appear pink in colour and are often itchy. Skin around the marks may appear slightly flattened. Secondly, the marks enlarge and become a reddish or purplish colour, and lastly – after pregnancy – they will fade and become pale white or silver. Generally the marks will become considerably less noticeable by six to 12 months following your baby’s arrival. Why some women suffer more than others is somewhat of a mystery, although it’s generally agreed genetics play a role. If your mother or sisters had pregnancy stretch marks, then you are also likely to experience them. As mentioned, excess weight gain can be a contributing factor, so you’re more likely to develop stretch marks if you’re carrying multiple babies, a single very large baby, or if you have excess amniotic fluid during your pregnancy. The theory behind topical creams and ointments marketed to prevent pregnancy stretch marks is that by hydrating and conditioning the skin, thereby improving its elasticity and suppleness, you can help your skin to "keep pace" with your growing belly so it simply stretches with it rather than developing tears. Topically applied

ABOUT 90% OF WOMEN GET STRETCH MARKS SOMETIME AFTER THEIR SIXTH OR SEVENTH MONTH OF PREGNANCY, AND GENETICS DO PLAY A PART. products can also help reduce the itchiness that is often associated with stretching skin. Proponents of natural prevention strategies suggest a number of ways to prevent stretch marks, such as the twice-daily application of liquid coconut oil to the skin, massaging it in to the area to aid absorption and improve skin moisturisation. Castor oil is also recommended as a humectant to help the skin retain moisture. Daily or several times a week, apply a thick layer to the area, wrap tightly with plastic wrap and apply heat with a hot water bottle or similar for a minimum of 20 minutes. Other natural options include improving hydration levels by increasing your intake of water to two litres a day, and ensuring you eat a nutritious diet rich in vitamins C, E, zinc and silica. Vitamin E is also very important for improving skin

LOVE YOUR BODY

elasticity. Foods rich in vitamin E include almonds, olives, sunflower seeds, spinach, and avocados. Topical vitamin E products or oral supplements may also help. If you’re unable to prevent stretch marks from occurring, and they cause considerable distress, the marvels of modern medicine may have a solution for you. Visit a dermatologist or skin specialist who can discuss various treatment options to minimise their appearance. Topical medications such as Retin-A or glycolic acid may help, but be sure to wait until you are well and truly done with pregnancy and breastfeeding as these products are unsafe to use in either situation. Otherwise, laser treatments may help to alter your pigmentation so the marks are a better colour match with the rest of your skin, blending their appearance away. While you’re certainly not alone if

you’d prefer those pregnancy stretch marks to fade into obscurity along with your memories of morning sickness and other such pregnancy delights, it’s also true that some women consider their stretch marks to be a wonderfully affirming souvenir of pregnancy. Actress and mother-of-two Alyssa Milano recently said, "I love my stretch marks. Some people might see them as imperfections, but when you have a baby, those are your beauty marks." Fellow actress Jessica Alba feels the same, saying, "Even though some might consider them a flaw, I’ve learned to love my stretch marks. Pregnancy was the most incredible experience I’ve ever had. So I’ll take the stretch marks. I’ll take the cellulite I can never get rid of." And it’s not just celebrity mums flying the flag for finding joy in their altered

post-baby bodies. Online forums reveal countless women embracing their new forms, and – in true sisterhood solidarity – encouraging others to do the same. One anonymous blogger authored these words: "A mark for every breath you took, every blink, every sleepy yawn. One for every time you sucked your thumb, waved hello, closed your eyes and slept in the most perfect darkness. It isn’t very pretty anymore. Some may even think it’s ugly. That’s OK. It was your home. It’s where I first grew to love you, where I lay my hand as I dreamed about who you were and who you would be. It held you until my arms could, and for that, I will always find something beautiful in it." However you are inclined to view your personal marks of pregnancy, take heart that they represent the phenomenal and life-changing journey through pregnancy. Pregnancy BUMP & baby

SHOPPING

GREAT BUY!

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Soft and subtle blush gives your face a gentle, rosy glow.

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Bloomin' beautiful 9

Pregnancy BUMP & baby

Everything’s coming up roses – shades of blush, peony, strawberry, candyfloss, fuchsia, and peach add baby softness to your summer beauty.

MAIN IMAGE COURTESY GUERLAIN

1. Dr Hauschka Eyeshadow Solo in Delicate Rose $29 2. Karen Murrell Lipstick in Pink Starlet $29.99 3. Rimmel Lasting Finish Soft Colour Mono Blush in Pink Rose $11.50 4. L'Oréal Paris Colour Riche 30th Anniversary Lipstick in Erotique $23.99 5. Guerlain KissKiss Shaping Cream Lip Colour in Lady Pink $52 6. Elizabeth Arden Sunkissed Pearls Bronzer and Highlighter $69.99 7. Dr Hauschka Lipstick in Pink Topaz $49 8. Dr Hauschka Eyeshadow Solo in Ivory $29 9. Guerlain Rose Aux Joues Tender Blush in Pink Me Up $82 10. Benefit High Beam Luminescent Complexion Enhancer $49 11. Hello Kitty by OPI Nail Lacquer in Small + Cute $19.95

Makeup artist Luisa Petch from Glam Squad Limited says this is her favourite highlighter. It comes with bronzer as well, so it's good value.

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Take your baby bump to the beach with these soft yet sophisticated looks.

STYLE

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BEACH BUMPS ARE GLORIOUS, BUT IF YOU’RE NOT QUITE UP FOR BEARING ALL, STICK WITH A CLASSIC BLACK ONE PIECE THAT WILL BECOME A FOURTH TRIMESTER STAPLE.

FASHION DEHERE CAPTIONANDIA DELIQUAM CON EXPLICI UMET MA DOLUPT ATUR SAPE.

THE PATTERN AND POCKETS IN THIS TOP WILL GIVE YOUR BUMP A SLIM LINE.

PHOTOGRAPHY COURTESY OR QUEENBEE.COM.AU

STYLE

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GREAT BUY! Denim diva: Skinny Maternity Jeans in Soft Blue $79.99 from JeansWest

2 1 Purr-fectly comfortable: Feline Tee $115 and Profile Skirt $169 from Ketz-ke

Expecting style 3

Maternity clothing need not be shapeless and boring – check out these bump-friendly fashions from your favourite clothing retailers.

WE LOVE IT!

6 1. Wide Footbed Slides $59.99 from Ezibuy 2. Heart-throb Shorts $139 from Ketz-ke 3. Hero Dress $189 from Ketz-ke 4. Rachel Lyocell Dress $109 from JeansWest 5. Tie Neck Trapeze Dress $199.90 from Witchery 6. Wide Footbed Sandal $69.99 from Ezibuy

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Clinically proven to help build healthy babies If you’re thinking of starting a family, by the time you find out you’re pregnant, a little person is already coming to life. That’s why it’s recommended you start taking Elevit with Iodine as soon as you start trying for a baby. Only Elevit with Iodine is clinically proven to reduce the risks of neural tube defects like spina bifida by 92%1. It also contains essential nutrients, folic acid, iodine and iron. Visit www.elevit.co.nz for lots of helpful information, including interactive online tools designed to help you all the way through your pregnancy.

For more information visit www.elevit.co.nz

1. Czeizel Paed Drugs (2006) 2(6). Elevit with Iodine formulation is similar to that used in this study except that it contains iodine and not vitamin A. Always read the label and use strictly as directed. Supplementary to and not a replacement for a balanced diet. Bayer New Zealand Ltd, Auckland. TAPS 1516GA.

Feeding baby’s brain Which foods are best for pregnant mums to eat which will have a positive influence on their unborn baby’s developing brain? Penny Voigt gives you the inside scoop.

our baby’s brain starts forming only three weeks after conception, undergoing rapid changes between weeks 24 and the end of your pregnancy, with significant brain growth occurring from 34 weeks. Along with a well-balanced diet rich in fruits, vegetables, lean protein, healthy fats, low-fat dairy products, and whole grains, all of which are essential for supporting the growth and development of your baby, eating certain foods during your pregnancy can actually boost your baby’s brain development.

Omega-3s

Omega-3s are essential for your baby's neurological and early visual development. The two most beneficial omega-3s are

Pregnancy BUMP & baby

EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid). While EPA supports the heart, immune system and inflammatory response, DHA encourages proper formation of brain cells and brain tissue, boosts your baby’s brain power, encourages longer sleeping patterns following delivery, and helps prevent postnatal depression in new mums. Also used to make breast milk, research has shown that adding EPA and DHA to your diet when pregnant may reduce the risk of allergies in infants. Up to 97% of the omega-3s found in brain-cell membranes are made up of DHA. As your baby grows, it uses up the pregnant mum’s supply of omega-3s for the development of its own nervous system, leaving your body's supply depleted. As the body does not naturally manufacture DHA,

it’s vital to replace lost omega-3s. The recommended dose of DHA for pregnant and lactating women is 300mg per day. Food sources rich in EPA and DHA include algae, eggs, and cold-water fish like salmon, tuna, sardines, anchovies, and herring. Because of the high levels of mercury often found in these fish, taking purified fish-oil supplements is often the safest source of EPA and DHA, as these toxins are virtually eliminated during the manufacturing and processing of fish oil.

Healthy Fats

The brain is made up of 60% fat; fuelling it with healthy fats encourages a process called ketosis, which provides energy to the brain. Fats are an essential part of a healthy diet, but some fats are better than others. There are three types of

FEED YOUR BUMP

Eggs are rich in EPA and DHA – just make sure they're properly cooked before you eat them.

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fats: Saturated fats, trans fats, and unsaturated fats. The majority of fats that you consume should come from unsaturated fats, the healthiest kind. Providing vital nutrients that help build and develop cells in both your body and your baby’s, unsaturated fats include monounsaturated and polyunsaturated fats, as well as certain long-chain polyunsaturated fatty acids, which play an important role in the development of the brain, eyes, and nervous system.

A diet high in monounsaturated fats foods, and snack foods like biscuits, cakes, increases the production of acetylcholine, and sweets. While foods containing saturated a neurotransmitter that aids learning and fats often provide a source of protein and memory. Monounsaturated fats are also iron, it’s important you reduce your intake a good source of folate, otherwise known of saturated fats, as these can cause as folic acid, which helps protect your baby a build-up of cholesterol over time; no against birth defects. more than 6% of your daily kilojoule intake Out of your daily kilojoule intake, aim should come from saturated fats. Healthy to make up about 25% with unsaturated saturated fats can be found in lean beef, fats. The best source of cheddar cheese, and butter. Ju st say monounsaturated fats Found in products like cheese... can be found in mixed hydrogenated vegetable oil nuts, almonds, avocado, and processed foods, trans vegetable, olive or sunflower fats should be avoided as oils, while salmon, trout, they raise cholesterol levels. herring, walnuts, and The foods that contain trans soybeans offer a rich source fats are composed mostly of of polyunsaturated fats. empty calories and have Saturated fats are found little or no benefit to your in fatty meats, full-fat dairy or your baby’s body. Pregnancy BUMP & baby

suggests there may be some benefit to taking probiotics and prebiotics while pregnant. Regular supplementing may help with allergies like eczema in newborn babies and premature birth caused by infections in the birth canal.

Pregnancy BUMP & baby

Protein

Your body needs protein to build cells and

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An essential water-soluble nutrient usually grouped as part of the B-vitamin complex, choline plays a vital role in basic cellular structure, nutrient transport and metabolism. Although it is naturally synthesised in small amounts within the liver, a significant amount of choline must be consumed for good health. Choline is particularly important for women who are pregnant and breastfeeding, as this nutrient is vital in the development of the foetal brain and nervous system. Deficiency can lead to long-term learning disabilities and memory problems in children. Not enough choline can decrease blood vessel growth and hinder your growing baby’s brain. Choline naturally occurs in breast milk, but its presence is directly linked to mum’s dietary intake, so eating choline-rich foods should be a priority. Along with vitamins, minerals, and protein, eggs provide your baby’s brain with a good source of choline. Choline can also be found in liver, wheat germ, cod, Brussels sprouts, broccoli, shrimp, salmon, peanut butter and milk.

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Choline-Rich Foods

Ka le i s a g reat sou rce of fo

Probiotics and prebiotics help digest and utilise food in the best possible way. Probiotics (also called "friendly bacteria") are living micro-organisms, mostly bacteria that are similar to the beneficial microorganisms naturally found in our intestines. Prebiotics are the food for these friendly bacteria and are not digested by our bodies. They pass through our guts largely intact and ferment in part of the colon. Some foods naturally contain probiotics, and these include live yoghurt, fermented and unfermented milk, miso, and soy drinks. Prebiotics that help probiotics to flourish occur naturally in onions, bananas, barley, garlic, chicory, asparagus, artichokes, soybeans, and oats. Research

PROBIOTICS AND PREBIOTICS IN PREGNANCY

make hormones for your growing baby, and your baby needs protein to build the cells of its body, particularly during the second and third trimesters when baby grows more rapidly. Not only does protein intake affect a baby’s growth, it also affects the development of important organs, including the brain. Pregnant women need about 70g of protein per day. The best protein sources during pregnancy are low in saturated fat and high in other beneficial nutrients that support foetal growth. Fish and seafood are especially good sources, since they also

FEED YOUR BUMP

contain omega-3s that promote brain development. Lean meat, eggs, poultry and dairy products are good complete protein sources, containing all of the necessary amino acids in a single food. Vegetarian protein sources like beans, tofu and nuts may need to be paired with other sources in order to get the full complement of amino acids; beans and rice each contain different amino acids, but together provide all of them.

deficient babies may develop more slowly and display slow language learning and behavioural problems. Pregnant women need about 27mg of iron per day. Red meat is one of the best sources of iron, but you can get iron from legumes, vegetables, and grains too. Zinc supports normal growth and development during pregnancy and is essential for brain development. Studies

suggest that zinc deficiency may lead to delays in cognitive development and motor development. Shellfish, beef and other red meats are rich sources of zinc; oysters contain more zinc per serving than any other food. Talk to your doctor, LMC, or pharmacist a pregnancy supplement that contains the right amount of vitamins and minerals your body and your baby needs.

Vitamins and Minerals

During pregnancy, your growing baby gets all of the nutrients it needs from you, so you may need more vitamins and minerals than you did before. A healthy diet provides you with most of the nutrients you need during pregnancy, but it’s not always easy to get all you need from food alone. Vitamins and minerals that are vital for healthy development in your baby include folic acid, iron, calcium, vitamin D, zinc and iodine. Folic acid is critical before conception and during pregnancy as it helps close your baby’s neural tube so that birth defects like spina bifida do not occur. Dark green leafy vegetables like spinach and kale, as well as citrus fruits, beans, and whole grains are excellent sources of folic acid, vital for the healthy development of your baby’s brain. A lack of vitamin C during pregnancy can have serious consequences to the development of the foetal brain, leading to long-term damage. Citrus fruits are especially high in vitamin C, but leafy greens and many other fruits and vegetables are excellent sources too. Iodine is especially important; a nutrient found in every organ and tissue in your body, iodine is crucial for healthy brain development. Recent research suggests that iodine supplements taken during pregnancy may in fact help boost children’s IQ scores, and that a mild iodine deficiency can lead to decreased intellect in children. Dietary sources of iodine include seafood (fish, shellfish and seaweed), commercially prepared bread, iodised salt, sea meal custard, milk and eggs. During pregnancy, your body needs extra iron to cope with the increase in blood supply for your growing baby and placenta. Research suggests that iron-

Milk contains essential nutrients choline, iodine, and natural probiotics.

Pregnancy BUMP & baby

easy weeknight meals

Thai Roast Chook with Coconut Rice and Asian Spring Slaw

Pregnancy BUMP & baby

FOOD

Chicken Skewers with Satay Sauce and Coconut Yoghurt Dressing

These four delicious dinners from My Food Bag and Nadia Lim are tasty, healthy, and quick to prepare, the perfect solution to every pregnant mum’s weeknight dilemma: “What’s for dinner?” Pregnancy BUMP & baby

THAI ROAST CHOOK WITH COCONUT

RICE AND ASIAN SPRING SLAW

Serves 4-5 / Ready in: 65 minutes / Prep Time: 35 minutes Cook time: 45 minutes Thai Roast Chook • ½ cup Thai marinade • 1 whole free-range chicken, butterflied (see method) • 2 red onions, cut into 2cm-thick wedges

Dressing • 1 teaspoon sesame oil • 1 tablespoon soy sauce • 3 tablespoons lime or lemon juice • 1 tablespoon sweet chilli sauce

Asian Spring Slaw • 3-4 baby bok choy, washed and very finely sliced (leaves and stems) • 100g snow peas or sugar snaps, tips and stringy bit removed • 1-2 baby radishes, thinly sliced and cut into matchsticks • 2 spring onions, finely sliced

To Serve • Steamed coconut rice • 1 lime, cut into wedges

1. Preheat oven to 220°C. Line a large roasting dish with baking paper. 2. Pat chicken dry. To butterfly the chicken, place chicken on a chopping board, breast-side down. Use sharp kitchen scissors to cut down either side of the backbone, from the cavity opening end, right down to the neck. Discard backbone. Turn chicken over and push it down flat with both hands – the breast bones should crack a bit. Coat butterflied chicken with Thai marinade, rubbing it all over, as well as under the skin. Place chicken in prepared roasting dish. Arrange red onion wedges around the chicken. Drizzle with olive oil and season well with salt. Roast until chicken is cooked through, 35-45 minutes, basting occasionally with the juices. Remove from oven and set aside to rest for 10 minutes. 3. While chicken is cooking, make the rice to serve with the meal. 4. Prepare vegetables for slaw and mix all dressing ingredients together. Toss with raw vegetables just before serving. To serve: Carve roast chicken. Spoon some coconut rice, Asian spring slaw and roasted onion onto each plate, and serve with a piece of chicken. Spoon over any roasting juices from the dish and serve with a lime wedge to squeeze over just before eating. COCONUT RICE This makes enough coconut rice for six servings. You can halve this recipe to make enough coconut rice for three people. Combine 2 cups rice with 1½ cups coconut milk, 1½ cups water, water and a good pinch of salt in a medium pot. Bring to the boil, cover with a tight-fitting lid and reduce to very low heat to cook for 15 minutes, without lifting the lid at any time. Turn off the heat and leave to steam, still covered, for a further 8 minutes, before fluffing up with a fork. ENERGY 2797KJ (666KCAL) • CARBOHYDRATE 55.5G PROTEIN 48.1G • FAT 29.4G

Pregnancy BUMP & baby

FOOD

CHICKEN SKEWERS WITH SATAY SAUCE

AND COCONUT YOGHURT DRESSING Serves 4-5 / Ready in: 35-40 minutes / Prep time: 25 minutes Cook time: 20 minutes Chicken Skewers • 600g boneless, skinless chicken thighs, cut into 3cm pieces • 8-10 bamboo skewers, soaked in water for 10 minutes • 1 tablespoon oil Satay Sauce • ¼ cup crunchy peanut butter • 1-2 tablespoons sweet chilli sauce • ¼ cup coconut milk • 1 clove garlic, finely chopped • 1 tablespoon fish or soy sauce • 1 tablespoon lemon juice

Salad • 1 cos lettuce, chopped • 2-3 tomatoes, cut into wedges • 1 Lebanese cucumber, cut in half lengthways and thinly sliced • 1 red capsicum, thinly sliced • 2-3 spring onions, finely sliced • ½ cup roughly chopped coriander • ½ cup roughly chopped mint leaves • ¼ cup chopped roasted peanuts Coconut Yoghurt Dressing • ¼ cup natural yoghurt • ¼ cup coconut milk • 1 tablespoon lime or lemon juice • 1 tablespoon chopped mint or coriander To Serve • Steamed jasmine rice • 1 lime, cut into wedges • 1 chilli, finely sliced (optional)

Fish Tacos with Mango, Coriander And Tomato Salsa and Avocado Quinoa Salad

1. Start by cooking the rice to serve with the meal. While rice is cooking, prepare chicken. Pat chicken dry with paper towels and thread 3-4 pieces onto each bamboo skewer. Season with salt. Heat oil in a large fry-pan on medium heat. Cook chicken skewers for about 2-3 minutes on all sides, or until cooked through. Cover with tinfoil and set aside to rest on a plate. 2. While chicken is cooking, mix peanut butter, sweet chilli sauce, coconut milk, garlic, fish or soy sauce and lemon juice together in a small pot. Bring to a simmer while stirring, until heated through and slightly thickened. If mixture becomes too thick, thin it out with 2-3 tablespoons water. 3. Place salad ingredients in a serving bowl and toss together. Whisk dressing ingredients together and season to taste with salt and pepper. To serve: Spoon some rice and salad onto each plate. Top with a couple of chicken skewers and spoon over some satay sauce. Drizzle salad with coconut yoghurt dressing and serve with lime wedges to squeeze over just before eating. Sprinkle with chilli (if using). Tip: To speed up the cooking time for the chicken, you can place a lid on the fry-pan. ENERGY 2455KJ (585KCAL) • CARBOHYDRATE 52.1G PROTEIN 37.4G • FAT 25.1G Pregnancy BUMP & baby

FISH TACOS WITH MANGO, CORIANDER

AND TOMATO SALSA AND AVOCADO QUINOA SALAD

Serves 4-5 / Ready in: 25-28 minutes / Prep time: 20 minutes Cook time: 18 minutes Mango, Coriander and Tomato Salsa • flesh of 1 ripe mango, diced (alternatively you can use 425g canned mango) • 3 tomatoes, diced • ½ red onion, finely diced • Juice of 1 lemon • ½ cup roughly chopped coriander Avocado Quinoa Salad • ½ cup red quinoa • Pinch of salt • 1 cup water • ½ iceberg lettuce, roughly chopped • 1 avocado, sliced • ½ red onion, thinly sliced • ¼ –½ cup chopped coriander • Extra virgin olive oil and lemon juice, to dress

Fish Tacos • 600g boneless, skinless white fish fillets • 2 tablespoons plain flour • 1 tablespoon Cajun spice • 1 teaspoon salt • 2 tablespoons oil • 1 tablespoon butter • 12 taco shells • ½ cup natural unsweetened thick Greek yoghurt or sour cream

1. Preheat oven to 180°C. Combine all salsa ingredients together in a bowl. Season to taste with salt and set aside. 2. Place quinoa, salt and water in a small pot and bring to the boil. Stir, cover with a tight-fitting lid and reduce to lowest heat to cook for 12 minutes. Turn off heat and leave to steam, still covered, for a further 5 minutes. 3. Pat fish dry with paper towels and remove any remaining scales or bones. Cut into large 2cm-thick fingers. Combine flour, Cajun spice and salt in a dish; coat fish well in the flour mixture, shaking off any excess. Heat oil and butter in a large (preferably non-stick) fry-pan on medium heat. Cook fish in two batches for 1-2 minutes each side, or until just cooked through. Don't worry if the fish breaks up a little in the pan during cooking – it's nice to have smaller pieces that go a little bit crispier on the outside. Set cooked fish aside. 4. Heat taco shells in oven according to packet instructions (usually about 5 minutes at 180°C). Fluff up quinoa with a fork, combine with remaining salad ingredients and dress with the oil and lemon juice. To serve: Put salsa, quinoa salad, fish, taco shells and yoghurt or sour cream in the centre of the table. Let everyone build their own tacos: place a few pieces of fish into each shell and top with salsa and yoghurt or sour cream. Serve salad on the side. ENERGY 2548KJ (607KCAL) • CARBOHYDRATE 43.5G PROTEIN 35.9G • FAT 31.1G

Pregnancy BUMP & baby

FOOD

PIZZETTES WITH OLIVES, FETA,

OREGANO OIL AND GREEK SALAD

Serves 4-5 / Ready in: 35-40 minutes / Prep time: 25 minutes Cook time: 20-25 minutes Pizzettes • 1 cup tomato pizza sauce • 4 small wholemeal pita breads, cut in half horizontally to make 8 thin pizza bases • 2½ cups grated mozzarella • 2 handfuls baby spinach leaves • ½ cup Kalamata olives • 1 red capsicum, thinly sliced • 150g marinated artichokes, roughly chopped

Greek Salad • 2 Lebanese cucumbers, cut in half lengthways and thinly sliced • 1 punnet cherry tomatoes, cut in half • ½ small red onion, thinly sliced • 100g feta, crumbled • 1 tablespoon finely chopped oregano leaves • 1-2 tablespoons extravirgin olive oil • 1-2 tablespoons vinegar (e.g. red wine, white wine, balsamic)

Oregano Oil • 2 tablespoons extravirgin olive oil • 2 cloves garlic, minced • 1 tablespoon finely chopped oregano

To Garnish • ¼ cup roughly chopped basil leaves

1. Preheat oven to 220°C. Line two baking trays with baking paper. 2. Lay pita breads, cut-side-up, on prepared trays. Spread each base with tomato sauce and sprinkle over 1 cup of the mozzarella cheese. Scatter over spinach leaves, olives, capsicum and artichokes. 3. Mix extra virgin olive oil, garlic and oregano together and drizzle over each pizzette. 4. Sprinkle with remaining mozzarella. Bake for 12-15 minutes until bases are crispy, and cheese is melted and golden brown – you may have to move the pizzas around in the oven to ensure they cook and crisp up evenly. 5. While pizzas are cooking, prepare Greek salad. Toss all ingredients together and season to taste with salt and pepper. To serve: Garnish pizzettes with fresh basil leaves and place 1-2 pizzettes on each plate. Serve Greek salad on the side. ENERGY 2342KJ (558KCAL) • CARBOHYDRATE 29.5G PROTEIN 26G • FAT 36.8G

Pizzettes with Olives, Feta, Oregano Oil and Greek Salad

Extracted from Easy Weeknight Meals by My Food Bag & Nadia Lim. Published by Allen & Unwin. RRP$39.99. Available now. Pregnancy BUMP & baby

Even if you can't be physically active, it's important you keep an active mind.

Rest assured

Bed rest can be challenging, but with preparation and support, you will get through it.

ome women fantasise about being confined to bed for the duration of their pregnancy, where they can rest and watch TV and be legitimately lazy. But the reality of bed rest is that it can be boring, stressful, uncomfortable, and severely limiting. If you’ve been prescribed bed rest, you might be finding it far from enjoyable. Here are some tips for how to cope.

Stop the blame game

Lots of pregnant mums feel that they are

Pregnancy BUMP & baby

somehow to blame for ending up on bed rest. Know this: It is not your fault. You didn’t do anything to cause this. And bed rest is not meant to be a punishment, but a preventative, to give your body and your baby the best chances.

forums, do research, email friends and family, and even do some non-stressful work tasks. Take full advantage of the internet and use it as much as you can to take the load off and help you feel more in control.

The internet is your friend

Get emotional support

You may think there’s only so much you can do from bed, but in our technologically connected society, you really can get just about anything sorted out. You can shop online, order library books, read, watch TV shows and movies, play games, chat on

Bed rest can sap your strength and vitality, and can also make you feel very isolated, spending a great deal of time inside your own head, worrying about what might happen. Be aware of your moods – keep a mood journal so you can keep track of

COPING WITH BED REST

Naps ar

en ,b i ce ut

do, and what you are not allowed to do, and go from there. Do you have to stay in bed 24 hours a day? What position are you allowed to be in – do you need to be laying down, or can you recline against pillows? Are you allowed to get up for a shower, or do you need to stay reclined in the bath? Can you go up and down stairs? Can you lift anything, like a basket of laundry? Are you allowed to get up to make snacks? Every bed rest prescription is different depending on the pregnancy condition that your LMC is addressing, so be sure you understand what’s allowed, and work within those guidelines.

Call in favours

how you are feeling, and talk to your midwife if you find yourself becoming sad, depressed, and withdrawn. Reach out to friends and family to come visit or call you to check in. Online forums can be helpful to keep you from feeling like you’re alone while the world is moving ahead without you. And professional counselling can be a real help – many counsellors will hold appointments via Skype or telephone if you can’t find one who will come to your home.

Gather information

Find out what activities you are allowed to

Now is the time to ask for help from all of those wonderful, caring people in your life for whom you would do the same if they were in your situation. From running errands like grocery shopping, to meal preparation, to childcare if you have older children, when you tell people that you are confined to bed rest, they will undoubtedly tell you to ask them if you need help. Do it.

Set up for success

Gather what you'll need ahead of time. • Get your partner or a friend to set up a small chilly bin or mini fridge next to your bed with drinks, snacks, and lunch. • Stock a basket or box with stationery – diary, pen, sketch book, coloured

n' t o verdo it!

pencils, writing paper and stamps. • Keep your phone, phone charger, phone top-up card, and any remote controls nearby so you can reach them easily. • Keep emergency numbers handy, just in case. • Move the TV and DVD player, and any gaming consoles, into your room for the duration. Catch up on movies you’ve wanted to see, and subscribe to a DVD-delivery service like Fatso so you can have movies delivered right to your letterbox. • Stock up on library books (get someone else to pick them up and return them) – often you can order new books online from your local library and keep track of due dates. If you call your library and explain your situation, and possibly provide them with something in writing, you should be able to arrange for a friend or family member to use your library card on your behalf to check out and return books for you. • Keep a supply of magazines and other reading material, and ask friends and family to give you their magazines before recycling them. Even back issues can hold inspiration! • Depending on the nature of your work, you may be able to work remotely from home. Talk to your LMC and your employer about whether this is possible. • Ask friends to bring over easily reheated casseroles and meals, or investigate meal delivery services. • Home help services may be able to assist you with household tasks like meal preparation and cooking, household chores, cleaning, doing the dishes, laundry, gardening, pet care and dog walking, grocery shopping, and the like.

Get into a routine

To prevent yourself from feeling aimless and bored, set yourself a routine just as you would if you were still mobile. Try to stick to a normal day-and-night routine and break your day into increments – wake up, breakfast, shower or bath, read for an hour, cup of tea, call a friend, nap, lunch, etc.

Don’t nap too much

Try to sleep at regularly scheduled times, so you don’t confuse your natural sleeping and waking cycle. Pregnancy BUMP & baby

Surviving a summer pregnancy When the temperature cranks up, expectant mums can find it hard to cope. Penny Voigt has some tips to help you handle the heat.

re you feeling like one hot mama? It’s not surprising. Not only is your metabolic furnace firing up, but so is your baby’s. Pregnancy can make summer seem hotter than ever, and pregnant mamas are prone to overheating. With around 40% more blood pumping through your body, feeding the needs of your unborn baby, it’s a bit like having an onboard central heating system. If you’re struggling with a hotter-than-usual body, try some of these tried-and-true tips to help you cope with your summer pregnancy.

Pregnancy BUMP & baby

tip Put your feet up

Swollen legs and feet are common, particularly towards the end of your pregnancy, and are often made worse during hotter weather. Minimise your misery by elevating your legs and feet whenever you’re sitting down, or pop your feet into a tub of cool water, and be sure to wear comfortable shoes to support your feet when standing or walking.

tip Ditch the salt

While sodium is an important chemical element that works to regulate the temperature and pH levels in your body, too much salt can cause you to retain water, leaving you feeling puffy and swollen. Called oedema, fluid retention causes swelling in your hands, feet, and ankles, and only gets worse as summer heat rises. Don’t overdo it on your salt intake – a teaspoon a day is as much as you need. Check the salt content in processed and packaged foods, and drink plenty of fluids to flush out excess water and help keep cool.

BEAT THE HEAT

tip Dunk your bump SWIMMING IS A GREAT WAY TO COOL OFF, AND IT’S ALSO A REALLY GOOD LOW-IMPACT FORM OF EXERCISE. IF YOU’RE BATTLING WITH HIGH BLOOD PRESSURE, BEING IN SHOULDER-DEEP WATER ACTUALLY HELPS INCREASE BLOOD CIRCULATION AND RELIEVE SWELLING, WHICH HELPS LOWER YOUR BLOOD PRESSURE. YOUR BODY’S NATURAL BUOYANCY IN WATER TAKES THE STRAIN OFF PREGNANCY BACK ACHES, BRINGING IMMEDIATE RELIEF TO UNCOMFORTABLE MAMAS.

tip Top up

tip

Escape the sun

Avoid the midday heat; when the sun’s high, head for the indoors and crank up the fan or air conditioning. Get things done in the morning or late afternoon, and remember to slow down when it’s especially hot. An early morning stroll not only provides great cardio benefits, it’s the perfect time for some fresh air.

tip Not so swell

As with legs and feet, fingers tend to swell up too during pregnancy. If the swelling seems sudden (you’ve gone from slender to sausage fingers overnight), get yourself checked out by your GP or LMC, as this could be a sign of pre-eclampsia. Try eating foods like bananas that are high in potassium, use a cold compress on your hands, and drink plenty of water. It may pay to take your rings off before your fingers start swelling; that way, you’ll avoid having to get your rings cut off.

Pregnant mamas need to drink more liquids, especially on hotter days. Not enough water can make your pregnancy aches worse, cause swelling, and even trigger contractions. Be sure to sip water throughout the day; at least six to eight glasses. If the thought of another glass of water is too awful to bear, flavour it up by adding a slice of lemon or lime, a sprig of mint, and ice cubes. Try caffeinefree, herbal iced tea or mix a "mocktail" of crushed pineapple, coconut milk, yoghurt and banana, and blend until smooth (great for replacing electrolytes on scorching days). Water-rich fruits and vegetables like melons and cucumber will also help keep you hydrated.

tip Spray off

Feel like you’re melting? Keep cool and fresh with a water-filled spritz bottle. Spray a cooling mist on your face and the back of your neck for an instant refresher; it helps keep your skin hydrated too. Pop a cool washcloth on the back of your neck or forehead, stick your feet up, and chill out. Ever tried freezing your scarves? Wrap one of those around your neck to cool off quickly.

tip Cool and classy

What’s the best thing about a summer pregnancy? Cool, comfortable maternity clothes. For maximum comfort, choose loose-fitting, light-coloured clothing, preferably in cotton; cotton helps sweat evaporate so you don’t suffer rashes and chafing. Think soft cotton singlets, loosefitting T-shirts, flowing maternity dresses in natural fabrics and neutral colours, and linen maternity pants with a stretchy or drawstring waistband. And don’t forget underwear – full cotton panties and a maternity bra go a long way towards helping you feel cool and comfortable.

tip Pregnancy massage

If you’re feeling the heat, a pregnancy massage may be just the thing to cool you down. Based on the techniques of Swedish massage, a pregnancy massage helps reduce muscle tension, and improve blood flow and lymphatic drainage, which can reduce swelling and water retention. It’s also an ideal opportunity to completely relax, and even catch up on some sleep. Pregnancy BUMP & baby

BEAT THE HEAT

tip Forget flip-flops

Wearing comfortable shoes is an absolute must. Pregnancy hormones cause your ligaments and tendons (including those in your feet) to stretch, often causing swelling and pain. Steer clear of flip-flops; to support the extra weight your feet are carrying, choose sandals and shoes with arch support. You may even find your puffed-up feet need a half-size larger than normal. Summer is the perfect time to claim the office fan as your own.

tip Summer-proof your home and office WHETHER YOU’RE AT HOME OR STILL WORKING, IN YOUR COUNTDOWN TO BABY’S ARRIVAL, SUMMER-PROOFING YOUR HOME OR OFFICE CAN MAKE SUMMER MORE BEARABLE. KEEP CURTAINS OR BLINDS DRAWN IN ROOMS THAT GET DIRECT SUNLIGHT. OPEN WINDOWS IN THE EVENING TO LET THE BREEZE IN, AND STOCK UP ON HEAT-BEATING ESSENTIALS LIKE FANS, ICE-COLD WATER, AND COTTON CLOTHING. REDUCE THE HEAT IN YOUR HOME AND OFFICE (AND SAVE ENERGY) BY TURNING OFF AND UNPLUGGING APPLIANCES THAT ARE NOT IN USE. STRUGGLING TO SLEEP BECAUSE OF THE HEAT? CONSIDER MOVING TO A COOLER ROOM, ONE THAT FACES AWAY FROM THE SUN DURING THE DAY, AND SWAP POLY-COTTON SHEETS FOR 100% COTTON, WHICH BREATHES EASIER AND STAYS COOLER. tip

Slip, slop, slap

Sun worshippers, beware: Your pregnant body is prone to sunburn. Take care when you’re out in the sun. Opt for a higher SPF sun cream, and cover up your head and face with a wide-brimmed hat. Hormonal changes in your body can cause skin to discolour and darken, especially on your face, and is made worse by exposure to the sun. If you do have to go out in the sun, avoid midday heat, and be sure to top up your fluid intake, too.

Pregnancy BUMP & baby

tip Get a haircut

Bad hair day? Relax. Unfortunately, it’s perfectly normal. Pregnancy hormones have a lot to do with the condition of your hair. You may find it goes through a growth spurt, and its texture has probably changed too. Either way, summer’s a good time for a style update. Consider going for something a little shorter (and cooler!) and easier to manage once your baby arrives. Taking some weight off your head can help cool you down.

tip Siesta time

It doesn’t really matter what stage you’re at, sleep during pregnancy is something of a challenge. From morning sickness to hourly toilet trips, leg cramps to scary dreams, getting some shut-eye can seem near impossible. To recharge and refresh yourself, try napping during the hottest time of the day. Close curtains and blinds, turn the fan on, and relax. You don’t have to sleep, but allow yourself time to rest and re-energise. A 30- to 60-minute nap during the day does wonders, leaving you feeling more alert and invigorated.

tip Retail therapy

Sometimes you just have to go shopping! Places like the mall and movie theatres bring cooling relief when it’s scorching outside. Find reasons to spend time in air-conditioned spaces; catch up on a movie or get that baby shopping done while cooling off for a few hours.

tip Hit the road

If your summer plans include time away, break up road journeys with stops along the way to stretch your legs and walk around. Simple stretches every hour or so will help minimise swelling, heartburn, and leg cramps. Bring snacks, plenty of fluids, and a pillow to place in the small of your back when you sit down. To help blood circulation on longer journeys, try wearing compression stockings. And remember to give yourself time to relax and recharge your batteries while on your summer holiday.

WWW.GOSUPERFOOD.CO.NZ

Available from Pharmacies and Health Stores nationwide.

Pink or blue

While we make no claims about the accuracy or legitimacy of these pregnancy-related old wives’ tales, myths, and legends, they sure are fun to put to the test! High or low

If you're carrying your baby low, it's said to be a boy – but if you're carrying high, you're having a girl. Also, if you carry out in front, it's said to be a boy; while carrying more "in" and close to your body is said to be a girl.

Dry hands

If the skin on your hands is dry, this means you're having a boy.

Acne and blemishes

If your skin is prone to breakouts while you're pregnant, you're carrying a girl, as girls are said to "steal your beauty". How…kind?

Ask your midwife to tell you your baby's heart rate when you're at an antenatal appointment. If your baby's heart rate is under 140 beats per minute, you may be having a boy; while a heart beating faster than 140 beats per minute indicates a girl.

Sympathy weight gain

If your spouse is also gaining pregnancy weight, legends say that this means you're carrying a girl.

Bad morning sickness

Cold feet are another sign of having a boy, so if you feel you need extra socks, you might have a boy on the way.

If you have terrible morning sickness, particularly in the first trimester, this indicates you're having a girl. If you're not sick at all, you're having a boy.

Ring test

Keyed up

Cold feet

This one only works with a plain wedding band. Tie it to a string and have a friend suspend it over your tummy. If it swings back and forth, you're having a girl; swinging in circles means you're having a boy.

Hands up

Put your hands out in front of you. If they're palm up, you're having a girl; while if your hands are palm down, it's a boy.

Heartbeats

Pregnancy BUMP & baby

Get a friend to place a key in front of you. If you pick it up by the top part, you're having a boy; while picking it up by the notched bottom part means you're having a girl.

Face up to it

If your face gets fuller and rounder while you're pregnant, you're having a girl, but if it looks long and narrow, you're having a boy.

Garlic

This one is a little bit weird. Eat a clove of raw garlic. If you can smell it on your skin later, it's a boy. If you don't smell it, you're having a girl.

The legs have it

If you gain weight in your legs, you're having a boy; but if they stay slim, it's a girl.

Moody blues

If you're happy and cheerful when you're pregnant, you're having a boy; but if you're moody and grumpy, it's a girl.

Grace for girls

If you're graceful and move easily throughout pregnancy, this means you're having a girl, while becoming clumsy and unwieldy indicates a boy.

Side by side

Which side do you prefer to lie on? If it's your left side, you're having a boy; while if you rest on your right side, you're having a girl.

Hairy legs

If you find the hair on your legs is growing faster or thicker than usual, you might be having a boy.

TELL ME A TALE

Sweet or sour

If you’re craving chocolate, lollies, and sweet things, this means you’re having a girl ("sugar and spice and all things nice", apparently). If you crave salty or sour foods, this means you’re having a boy.

Pregnancy BUMP & baby

A HANGING SWING TABLE SERVED AS A WHIMSICAL AND PRETTY BEVERAGE BAR

BABY SHOWER

Splendour

i n the grass

Fine weather and fresh flowers lend grace and charm to this darling baby shower.

s soon as Jodie Cox and Kelly Warwick learned that their friend Denise Hoskin of Hamilton was expecting a baby, they knew that a very special baby shower was in order – and that they were just the friends to plan it. Jodie is the creative director of Wellington's Couture Candy Buffet Company, and Hamilton-based Kelly is a talented cake designer, while mum-to-be Denise is an "admirer of lovely things" who owns online party supply boutique Dots n Spots. With the talents of professional photographer Leah Hoskin added to the efforts, Denise's baby shower was bound to be beautifully styled and photographed – a true occasion to remember. Pregnancy BUMP & baby

KEEP IT SWEET AND SIMPLE FRESH-PICKED FÊTE The key to this

graceful garden party is simplicity. The understated colour palette, focusing on three key pastel colours and one metallic accent, underpins the party's theme and makes it easy for the hostesses to set the elegant, refined tone. Less is definitely more, so resist the temptation to go "all out" and instead concentrate on one or two aspects, such as flowers and colours, and bring in complementary details which will highlight the focal points rather than overwhelm them.

THE FLORAL THEME AND PASTEL COLOURS ARE CARRIED THROUGH THE REFRESHMENTS

Pregnancy BUMP & baby

BABY SHOWER

PHOTOGRAPHER: LEAH HOSKIN PHOTOGRAPHY (LEAH@LEAHHOSKINPHOTOGRAPHY.CO.NZ) • CAKE AND SWEETS: KELLY WARWICK (KELLYWARWICKCAKES.BLOGSPOT.CO.NZ) • PARTY SUPPLIES: DOTS N SPOTS (WWW.DOTSNSPOTS.CO.NZ) • PROPS: COUTURE CANDY BUFFET COMPANY (COUTURECANDYBUFFET.CO.NZ)

Vintage Queen Anne furniture makes for a charming display.

"Denise was unsure if baby was going to be a girl or a boy, so I decided to use a pastel colour scheme of pink, peach, and icy blue, accented with a splash of gold," Jodie explains. The sweet and simple colour scheme was carried through the refreshments, also in delicate and delectable pastels. The menu included rhubarb and ginger iced cordial (served in a clear glass urn), toffee bonbons, dainty macarons, sugar iced doughnuts, vanilla mousse delight in miniature glass jars topped with fairy floss, cupcakes, and fresh-baked meringue, all sweet treats in pale pastel colours with delicate accents and accessories from each of the three women's businesses. The setting at a local park's rose garden provided a beautiful outlook, with the addition of gorgeous fresh flowers such as white peonies, sweet avalanche, David Austin roses, and trendy succulents hanging in glass globes from the tree branches. The party was set up under a leafy tree to provide shade and highlight the outdoor ambience, with a hanging swing table as the whimsical and pretty beverage bar, and vintage Queen Anne furniture to hold the other refreshments and sweet treats. "It was a fabulous day and thoroughly enjoyed by all," says Jodie.

Hugs and kisses in the form of balloons are a loving touch.

Maternity leave: Need to know

In New Zealand, parental leave entitlements can be a bit confusing. Here’s a quick guide to what you need to know.

re you pregnant and working? If so, you may want to start thinking about your parental leave entitlements. New Zealand law allows pregnant mums-to-be and dads-to-be to take time off from work, without having to resign, to look after a child within its first year of life. It pays to have a clear understanding of your parental leave entitlements when planning how much time you’ll take off with your newborn baby.

months), different entitlements will apply. If you’ve worked for the same employer for more than 12 months but you don’t meet the average hours of work criteria, you will need to calculate your entitlement over six months, as you may still be eligible for parental leave under the six-month criteria. Parental leave can be taken multiple times, provided there is a six-month period between the date you returned to work and the expected birth date of your next child. You do still need to meet the employment eligibility criteria each time, though.

WHO IS ELIGIBLE FOR PARENTAL LEAVE?

WHAT PAID AND UNPAID LEAVE IS AVAILABLE?

Birth mothers are primarily entitled to paid parental leave provided you’ve worked for the same employer for an average of at least 10 hours a week, and at least one hour in every week or 40 hours in every month, in the six or 12 months immediately before your baby’s expected due date. Depending on how long you’ve worked for your employer (either six months or 12

Provided you meet the criteria under either the six or 12 months’ eligibility, you can apply for the following parental leave.

Your spouse or partner is entitled to either one week (for a spouse/partner meeting the six months’ eligible service) or two weeks (for a spouse/partner with 12 months of eligible service). In certain circumstances, you may transfer part of your maternity leave to your partner. Paternity leave can be taken between 21 days before the due date and 21 days after the birth.

Maternity leave

Extended leave of up to 52 weeks

You’re entitled to up to 16 continuous weeks of maternity leave and you may start this up to six weeks before your due date. Provided you and your employer agree,

For employees with 12 months’ eligible service, up to 52 weeks of continuous leave is available in the 12-month period after birth. This extended leave may be shared

Pregnancy BUMP & baby

you can start your maternity leave at any other time before your baby is due. Special leave

You’re entitled to up to 10 days of special leave before your maternity leave for reasons connected with pregnancy, like antenatal checks. Partner’s paternity leave

WORKING PARENTS

If you meet either the six or 12-month eligibility criteria, you’re entitled to 16 weeks of paid parental leave. To receive it, you must apply to your employer for parental leave, then apply to Inland Revenue (IRD) for parental leave payments. Paid leave must be taken at the same time as any unpaid leave you take. Currently the maximum payment is $516.85 per week before tax, but you’re entitled to either your gross weekly rate of pay (your pay before tax) or $516.85, whichever is lower.

WHEN DO PAYMENTS START? Your payment period starts when your parental leave starts; be it your maternity, your partner’s paternity, or your extended leave. When you apply for paid leave, you can choose when your payment starts, and payments will continue until the 16 weeks are complete. Your payments may stop earlier if you transfer the payment or part thereof to your partner or spouse; if you return to work before the end of your paid parental leave; if you resign from your job; or if your fixed-term agreement expires during your paid parental leave period.

HOW DO I APPLY FOR PARENTAL LEAVE? To apply for parental leave, you need to apply in writing to your employer at least three months before your expected due date. You should stipulate what type of leave you want, when you want the leave to start, and how long your period of leave will be. You also need to include any details about shared leave with your spouse or partner. You must attach a certificate, or a copy of a certificate, from your doctor or midwife stating when your baby is due.

WHAT IS MY EMPLOYER REQUIRED TO DO? Your employer has seven days after receiving your application for parental leave in which to ask for any required information which you may not have supplied. You must provide this information within 14 days. Once all information has been received, your employer must reply to your application within 21 days, stating whether or not you are entitled to take parental leave; your legal rights and obligations, particularly relating to when you can start your leave; and whether or not your job will remain open. It’s rare for an employer to decline leave, and if you disagree with your employer’s decision, you can request the Ministry of Business, Innovation, and Employment (MBIE) investigate the decision on your behalf.

• Providing goods or services for hire or reward under a contract for services. • Carrying on a business (a profession, trade, manufacturing operation, or an undertaking carried out for profit), including in partnership with another person, or • Working for a trust in a business carried on by the trust. If you are engaged in more than one type of self-employed work, where you do different types of work at the same time during a six or 12-month period, this is treated as one period of self-employment, and as such you would be eligible to apply for parental leave entitlements under the six or 12-month criteria, as long as any breaks between this work are no greater than 30 days.

HOW DO I APPLY FOR PAYMENTS? Parental leave payment applications are processed by Inland Revenue (IRD). Make an application for parental leave payments as soon as you have agreed on your leave arrangements with your employer. Your employer will need to verify your length of employment and salary details on the application form. Once completed, return the application form to IRD. IRD will advise you whether or not you are entitled to paid parental leave, how much you will receive, and when you will receive your payments.

SELF-EMPLOYED PARENTAL LEAVE ENTITLEMENTS If you are self-employed, you are eligible for parental leave payments provided you have worked an average of at least 10 hours a week over the six or 12 months prior to your expected due date. You also need to meet the definition of self-employment, which means you must have been:

BE S

Paid parental leave

YOU’RE ENTITLED TO UP TO 10 DAYS OF SPECIAL LEAVE BEFORE YOUR MATERNITY LEAVE FOR REASONS CONNECTED WITH PREGNANCY, LIKE ANTENATAL CHECKS.

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by both eligible parents, but the total leave taken must not be more than 52 weeks. Your partner or spouse’s one or two weeks of paternity leave is in addition to these 52 weeks. Extended leave can start any time after your maternity or paternity leave, but must be taken in one continuous period. You could finish your maternity leave, go back to work, and then take extended leave, provided you do so before your child is one year old. Your right to extended leave ends when your child turns one.

WHERE DO I FIND MORE INFORMATION?

If you’re still unsure, visit the Ministry of Business, Innovation, and Employment website (http://employment.govt.nz/er/ holidaysandleave/parentalleave) or submit your question on the FAQ Knowledgebase (http://employment.govt.nz/workplace/ knowledgebase) or phone the MBIE Contact Centre on 0800 20 90 20 during normal business hours. Pregnancy BUMP & baby

A to Z of pain relief Stressing about labour pain? Here are 26 options for coping with the pain of childbirth.

h, the pain. The painful pain. Many mums-to-be are understandably concerned about the level of pain they’ll experience during labour and birth, and spend a great deal of time worrying, fretting, and getting themselves worked up about what the pain will feel like, whether they’ll be able to handle it, and how they’ll cope. But there are a number of options you can try to help you to cope with labour pain.

is for Aromatherapy

Essential oils can be helpful during labour to relieve stress, aid breathing, and help you relax, as well as help with cramps, pain, and backache. Visit a reputable aromatherapist for advice, as some essential oils are not suitable for use during pregnancy.

is for Breathing

Most breathing techniques tend to be forgotten as labour intensifies; instead, many childbirth experts suggest listening to your own natural breathing rhythms to find a breathing pattern that’s right for you. That may be slow, deep breaths from your diaphragm; or faster, shallow breathing like a dog panting. Whichever you choose, breathing can help you focus on making each contraction a productive part of the birthing process.

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is for Compresses

Heat is a good way to ease aches and relieve pain during labour. Placing a hot compress, like a wheat bag or a hot water bottle, on your back, abdomen or groin area can alleviate some of the tension in these areas, helping you relax.

is for Distractions

To keep your breathing regular and help you stay calm, try focusing on something you can hear – your partner’s voice, a clock ticking or a piece of music – or something you can see – light reflecting off a window or a pattern on the wall.

is for Epidural

This highly effective anaesthetic blocks pain in the lower half of your body, by deadening the nerves carrying pain signals from your uterus and cervix to your brain. An epidural allows you to remain alert and be an active participant in your birth, while reducing the discomfort of childbirth.

is for Feeling

Some mums-to-be find it helpful to physically reach down and feel what is happening to their body – to put their hands on their stomachs or pelvis during contractions, or to feel their baby’s head crowning. Feeling how close your baby is can be motivating and encouraging. Don’t be afraid to feel – you can always wash your hands!

PREPARING FOR BIRTH

Labour is not something that is "happening" to you – it IS you. You can do this!

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is for Gas and Air

Also called “laughing gas”, Entonox (gas and air) is a colourless, odourless gas made up of half oxygen and half nitrous oxide that has a calming effect, taking the edge off labour pain rather than completely blocking it out.

is for HypnoBirthing

Based on the philosophy that nature intended for women to give birth relatively easily, but that the fear of childbirth incites physical pain, HypnoBirthing uses deep relaxation, visualisation, affirmations, self-hypnosis, and special breathing techniques to achieve a confident, calm, and peaceful birth.

Sometimes the simplest techniques, like counting your way through your contractions, can be the most effective.

is for Incantation

For many mums-to-be the biggest challenge of giving birth is allowing your body to do its work by giving up control of your mind. Birth affirmations and incantations are a powerful way to train your mind to let go of the control and allow your body to do the work, enabling a less challenging labour and childbirth.

is for Jiggle

Moving during labour takes pressure off the nerve endings in your back, and using gravity can help your uterus prepare for childbirth, shifting baby into the optimal birthing position. Swaying motions like walking, rocking on a birthing ball, and climbing stairs can be especially helpful.

is for Knowledge Knowledge is power, so knowing what’s happening to your body, being prepared for each stage of labour, understanding what's going on and why it hurts can be empowering and help keep you from getting scared.

PREPARING FOR BIRTH

is for Listening

Music is not only an excellent distraction, it also helps reduce the perception of pain and decrease anxiety. It has a calming effect on blood pressure and breathing, and is said to trigger the brain to release increased levels of the “happy hormones”, endorphins and dopamine.

is for Massage

A massage can release tension and loosen your muscles during labour. Firm, long strokes down the arms and thighs in time with your breathing, a gentle massage of your shoulders, back, legs and feet, or a light, rhythmic, circular stroking of your tummy can be calming.

is for Numbers

Counting your way through each breath can help you focus on regulating your breathing, essential for ensuring both you and baby are welloxygenated. As you breathe in, count slowly up to four. Breathing out, do the same again.

is for Own Your Birth

This is not something that is happening to you. This IS you. Mums who feel out of control and at the mercy of the unknown don’t cope. You ARE the contractions. You CAN work with them.

is for Pethidine

Derived from the opium plant, Pethidine is a synthetic form of morphine. It’s a strong painkilling drug that helps you to relax and, while it does not have any effect on the labour process, it changes your perception of the pain usually leaving you feeling sleepy and calm.

is for Quiet

Your birth environment has a huge impact on how you perceive your childbirth experience. Creating the perfect environment relies on feeling warm, safe, private, quiet, and dark; dim lights, low talking, a peaceful room, and quiet atmosphere help you to focus and allow you to listen to your body.

is for Reflexology

An ancient form of healing that teaches that specific parts of the body are associated with particular organs, glands and other parts of the body. A labour reflexology session involves pressure being applied to points on your feet and hands,

to stimulate the pituitary gland and induce hormones that speed up labour and ease pain.

is for Spinal Analgesia

A spinal analgesia or a spinal block differs from an epidural in that it’s delivered directly into the spinal fluid and it’s a one-time injection, rather than a continuous feed. Pain relief is felt immediately but lasts only a few hours, so it’s usually only an option if your delivery is likely to be quick.

is for TENS

TENS works by stimulating the body to produce more of its own natural painkillers or endorphins. Electrodes are taped onto your back and connected by wires to a small battery-powered stimulator, which you control to give yourself small, safe amounts of current through the electrodes, helping ease lower back pain.

is for Upright

Standing and squatting during labour allows you to take advantage of gravity, lengthens your trunk, and helps baby line up with the angle of your pelvis. Moving around can make your contractions feel less painful and more productive.

is for Visualisation

Used by athletes to naturally enhance performance, mental imagery or visualisation is highly effective in managing pain during labour. Mumsto-be can visualise each stage of their childbirth, mentally preparing themselves for how to behave in that situation, reducing anxiety and fear of the unknown.

is for Water

Many mums-to-be find relief from pain when their skin is stimulated by water. Warm water bottles or face cloths placed on your lower back can be comforting. A warm bath soothes and calms you, while taking a shower and directing the spray onto your lower back brings enormous relief from the pain.

is for XOXOXO

Giving birth is literally a labour of love. Brief your birth support team beforehand that you might need to be reminded of how much you are loved – with hugs, kisses, gentle touches, and words of encouragement, as well as focusing on the fact that very soon, you’ll be hugging and kissing your new baby!

is for Yoga Ball

A yoga ball is a great way to use gravity during childbirth, while still remaining supported and able to move around. Sway, bounce or rock on the ball, regularly changing positions, to help baby move into your pelvis. This rhythmic movement on the yoga ball also takes the pressure off your lower back and helps reduce any pain in that area.

is for Zzzzzzzzzz

Labour is the beginning of what will likely be a long, exhausting and intense process. Focusing all of your energy on the early stages of labour can leave you lacking stamina to cope throughout its progression. Get some sleep when you can and conserve your energy as much as possible. Pregnancy BUMP & baby

Pack your bags

You’re about to head away for the most life-changing trip ever: To the hospital or birthing centre! And like most trips away from home, you may be agonising over what to pack in your bag. Here’s our list of what you’re likely to need, but remember: Don’t overdo it. Your partner can always bring you what you need if you forget something.

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GETTING READY

Be sure to pack newborn-sized clothing for baby, but perhaps save the fancy outfits for when you're back home.

CLOTHING

FOR BABY

wrap to wear during labour • Tankini or bikini top if you want to wear it in the birthing pool • Slippers or a pair of thick socks for walking the corridors during labour • A dressing gown • 2 breastfeeding bras • 2 pairs maternity pyjamas (tops and pants) • Several pairs of cotton or disposable mesh underwear you don’t mind sacrificing to the cause • A comfortable going-home outfit – remember, you’ll still be wearing maternity clothing while your uterus shrinks, so don’t expect to fit into your prepregnancy jeans immediately • Comfortable, flat shoes

centre will provide nappies and blankets for your baby’s stay, but it pays to double-check • Capsule or convertible car seat (practise installation ahead of time) • Baby wipes (you can never have too many) • Burp cloths • 2 baby beanie hats • 2 onesies or singlets • 2 long-sleeved, long-legged all-in-one pyjamas • Scratch mittens • 2 pairs baby socks • Blankets for the ride home • Going-home outfit

• Short nightgown or birthing

TOILETRIES

• Toothbrush and toothpaste • Deodorant • Face wash • Shampoo and conditioner • Hairbrush • Body wash • Body lotion • Lip balm • Eye drops • Makeup

COMMUNICATION

• Mobile phone and charger • Top-up card if you’re on prepay • Camera, extra memory card,

tip

Have your infant capsule or car seat installed and your labour bag packed and in the boot of your car by 36 weeks – remember, babies can (and do) come early!

and charger • A journal or pen and paper, to record baby’s first feeds

ACCESSORIES

• Most hospitals and birthing

centres provide maternity pads, but you may want to bring your own, just in case • Breast pads • Glasses and case and/or contacts, lens case, and solution • Hair ties or clips

• Usually the hospital or birthing

FOR LABOUR

• Aromatherapy oils • Massage oil • Light snacks and drinks

(even if you don’t feel like eating, your partner might)

NICE TO HAVE

• Your own pillow • A breastfeeding cushion • Hair dryer and big bath towel from home

• Light reading material

(magazines, e-reader device)

• Music player loaded with your favourite tunes

FOR YOUR PARTNER

• Change of clothes • Swimming togs if they want

to join you in the birthing pool

• Mobile phone and charger • List of people to ring after the birth

• Snacks and drinks

tip

Call your birthing centre ahead of time and find out what items they provide for new mums and babies, and what they recommend you bring. Pregnancy BUMP & baby

LABOUR BAG BAGS OF STYLE In lightweight, super stylish tan leather, this ain't your mama's nappy bag. Isoki Hobo Angel Nappy Bag, $299.95 from bpmchildcare.co.nz

TWICE THE COMFORT Warm these thermal breast pads to stimulate milk flow, or cool to soothe sore breasts. Philips Avent 2-in-1 Thermopads $29.99 from Babycity

WIPE IT UP Keep your baby's bottom fresh and clean with baby wipes in a handy pop-up tub. Huggies Fragrance Free Thick Baby Wipes $6.99 from supermarkets

Suitcase savvy WE LOVE IT!

IT'S A WRAP Great for summer swaddling, using as a burp cloth, and even doubling as a breastfeeding cover, muslin wraps are indispensible. $29.95 from Nature Baby

SOOTHE & CALM Symmetrical teats respect the natural development of your baby’s palate and teeth. Philips Avent Orthodontic Soothers $17.99 from Babycity

GREAT BUY!

BUTTER ME UP An all-purpose cream that's great for labour massage and can help soothe sore nipples afterward. Mum's Butter $24.95 from Nature Baby

BOTTOM BALM Give nappy rash the boot with baby bottom-friendly Sudocream. 125g pot $16.99, 30gm tube $8.99 from pharmacies

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PILLOW PAL Position baby in just the right spot for breastfeeding and close cuddles with the Boppy Pillow in Woodsie print. $109.99 from Babycity

Fig. 1: Cutimus feveris

Fig. 2: Mummimus stressimax

Worried about your baby’s pain or fever? Pamol® Infant Drops are formulated especially to relieve pain and fever for babies aged under 12 months, while being gentle on little tummies. Pamol® is available at your pharmacy, so ask for it by name. And visit our helpful website at pamol.co.nz (or scan this QR code) for our expert advice on ways to relieve your baby’s symptoms … and your concerns.

Medicine made for kids

PAMOL® for the treatment of child pain and fever. Always read the label and use as directed. Incorrect use can be harmful. If symptoms persist see your healthcare professional. ®Registered Trademark. Aspen Pharmacare C/- Healthcare Logistics, Auckland. TAPS PP3698.

After nine months, it's finally time to meet your baby.

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LABOUR PARTY

Ready, set, push! Okay, maybe labour isn't exactly a party – but it is a special, exciting event! The three stages of labour are a natural process designed to guide your baby into the world.

Pregnancy BUMP & baby

very mum's experience of labour and birth is different, and unfortunately, it's impossible to predict what yours will be like – when it will start, how long it will last, what it will feel like. But generally, births follow a pattern of three stages, each defined by specific events and milestones.

First stage

The first stage of labour is the longest stage, lasting from six to 36 hours, and itself has three phases: Latent, active labour, and transition. The first stage of labour begins when your contractions start, and goes until your cervix is dilated to 10cm.

The latent phase (early labour) Early labour can last between eight and 16 hours (although it can be shorter or longer), and you may not even notice the first several hours. In the first stage of labour, your cervix needs to open (dilate) to its full capacity – about 10cm in diameter – so that your baby can be born. In order to help dilate your cervix, the muscles of your uterus contract and help to shorten and soften the cervix. In early labour, it will go from closed to being about 3-4cm dilated. Some women don't notice they're in early labour, or they may have mild symptoms such as a backache, dull ache in their pelvis, or cramps. Usually mums-to-be notice contractions as a reliable sign that they're in the first stage of labour. While Braxton Hicks contractions are irregular and generally painless, labour contractions are more regular (or fall into a pattern over the course of a few hours), painful, intense and frequent as time passes. Timing your contractions can help you to know how your labour is progressing. Keep track the old-fashioned way with a pen and paper – note the time at the start of the contraction, then at the end of the contraction, then at the start of the next contraction, etc. Note how long each contraction lasts and how long between each contraction. You may also wish to download a smartphone app which lets you (or your partner) track your contractions, which can be helpful as it'll do the calculating for you.

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PRE-LABOUR IN THE DAYS LEADING UP TO LABOUR'S START, YOU MAY NOTICE CHANGES IN YOUR BODY WHICH WILL TELL YOU THAT IT'S GETTING READY FOR YOUR BABY'S ARRIVAL: The ligaments in your pelvis may soften due to the hormone relaxin, which in turn can cause you to have a backache, pain in your pelvis or pubic region, and the feeling of waddling when you walk. Your baby may "drop" or engage in your pelvis, head-down,

in readiness for birth. This usually happens between 36 and 38 weeks for first-time mums. You may feel like sleeping, laying around, resting and not doing much, or you may feel like going to bed in the middle of dinner and you don't care what your dinner guests think. Many women have a burst of energy which manifests as "I need to get the garage cleaned out RIGHT NOW" or something similar, quite soon before labour. This is different from general pregnancy nesting, which you'll experience throughout pregnancy, in that it is intense,

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LABOUR PARTY

Your cervix needs to dilate to 10cm so your baby can be born.

Contractions during early labour are usually more than five to 10 minutes apart, lasting only from about 15 to 45 seconds. But every woman's rhythm and pace of labour is different. Contractions often start off feeling like strong period cramps, with pressure or tightening in your pelvis, and might be accompanied by lower back pain. Give your midwife a call to let her know you're in early labour, or if you aren't sure, call her anyway – she'll have a number of questions to ask you to help determine whether labour has started. Unless your midwife or LMC has given you other instructions, or you are concerned, it's usually best to stay at home during this phase of labour rather than going to the birthing centre or hospital. Walk around to help move things along (but don't overdo it), sit on a balance ball, rest to conserve your energy, eat, and drink as normally as you can. You should be able to talk and carry out your normal routine (although you may need to pause for contractions). To help you stay relaxed, try massage or TENS to give you some relief from the pain and help your body to go with the flow.

Active labour During active labour, your cervix dilates from about 3-4cm to the full 10cm. For a first-time mum, this stage of labour can last anywhere from eight to 14 hours, although it is different for everyone. Your contractions will be more powerful and intense, starting gradually and then building up to a peak before they dissipate. At this stage, contractions will also become more frequent, going from 60 to 90 emotional, and an inner drive that you can't ignore. You may have painless contractions (Braxton Hicks) or period-like cramps (false labour) which carry on for a bit, then fizzle out. You may find you're going to the toilet more often or have a mild upset tummy as your bowels and bladder empty in preparation for labour. Your cervix will become shorter, thinner, and softer, and the mucous plug in your cervix may come out. Called a "show" or "bloody show", the mucous looks a bit like jelly and is stained with blood.

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seconds long and from five minutes down to three minutes between them. Once you're in active labour, it's time to go to the birthing centre or hospital. Your midwife will have given you guidelines about when is an appropriate time to come in – usually when your contractions are every five minutes, last longer than 45-60 seconds, and have been getting stronger for the past two or three hours. Check with your midwife for her specific guidelines. At this stage, you might feel like you "go into yourself", withdrawing a bit from the world around you as you concentrate on what is happening within. You probably won't be able to talk through contractions, and you might feel like moaning or doing breathing exercises to get through them. Many women become more vocal as labour progresses, and may not realise they're making noise – or may not be able to help it. Your LMC has heard it all before, so don't feel embarrassed. Relaxation techniques are useful during this phase, so try sitting on a balance ball, massage, and breathing through the contractions as much as you can. It is natural to feel tense during contractions, but if you can try to relax your body and go with them, things will progress faster. You may also want pain relief during this stage, so talk to your LMC ahead of time, when you are making your birth plan, and decide what kinds of pain relief you are comfortable with so that if and when the time comes you will be prepared At some point during the active phase of labour, as you are moving into the next phase – transition – you may vomit or void your bowels. This is normal and does not mean you are sick – your body is preparing to concentrate on your baby's arrival.

Transition Transition is short, lasting from 30 minutes to an hour and a half. When you're in transition, you are very close to having your baby. Transition happens at the end of the active phase, when your cervix dilates from about 8-9cm to the full 10cm, and transition ends when your cervix is fully dilated or you feel the urge to push. Your contractions may be less frequent, but stronger and longer-lasting, coming in double waves or peaking, fading, peaking again, and then fading away. It's common

for your waters to break during or just before transition, and as your cervix becomes fully dilated. Transition can be intense, and the experience varies for mums-to-be. You may feel like you are zoned into your labour and don't notice anything around you – the feeling that if strangers came into the room, you wouldn't care that they were there – and you might only emerge from this insularity to say short sentences or even just words. You might not be able to focus on looking at anything else, and want to shut your eyes. You might feel like curling up with your head down, focusing on your body. You may want to shout, groan loudly, and feel impatient. You may be upset or emotional, and cry. You might feel shivery or shaky. And some women don't experience any of these things! It can be helpful for mums-to-be to be told when they're in transition, as often your midwife or LMC will recognise its telltale signs before you do. If you're planning to give birth without pain relief, transition may be the most difficult part of labour, as it is often the most trying and, to a degree, will take you beyond what you thought you could handle. It's important that you have good support to help you get through this stage. Knowing that transition means your baby is very close can help mums to get through the difficulties of this phase. Pregnancy BUMP & baby

During labour, you'll experience a number of different pain sensations, but your baby will definitely be worth the pain.

The second stage

When your cervix is fully dilated to 10cm, and you feel the urge to push, you've entered the second stage of labour. This stage of labour can last anywhere from a few minutes to a few hours, although for a first baby, it is usually an hour to an hour and a half. This is the phase where you will get a bit of a workout, actively using your abdominal and pelvic muscles in conjunction with your contractions to push

Pregnancy BUMP & baby

your baby out. Sometimes there is a lull between the first and second stage of labour – a few minutes to catch your breath before your body feels an overwhelming urge to start pushing. During the second stage of labour, you'll push your baby down past your pelvic bones, through the birth canal, and out of your body. At the end of this stage, you'll meet your baby!

Assume the position

The position you give birth in is a personal

choice, although some forms of pain relief or your baby's position may dictate that you are partially reclining with your legs in stirrups, for example, or in other positions in which your midwife or LMC will instruct you. In general, it is better if you can give birth in a position you find comfortable and conducive to pushing. Squatting, kneeling on all fours, leaning over the back of a chair, leaning on your partner, lying on your side, semi-sitting, laying over a birthing ball, a lunge pose,

LABOUR PARTY

TIPS FOR DADS-TO-BE What is an episiotomy?

AN EPISIOTOMY IS A DELIBERATE CUT TO THE PERINEUM, TO ENLARGE THE OPENING WHERE YOUR BABY WILL COME THROUGH AS HE IS BEING BORN. IT IS NOT USUALLY NECESSARY, BUT CAN SOMETIMES HELP. IT'S IMPORTANT TO ASK YOUR MIDWIFE OR LMC FOR HER PHILOSOPHY WITH REGARDS TO EPISIOTOMIES OR TEARING.

is d

ad -to - be is

goo

d at ma s sages!

Your baby's moment of birth may occur over the course of a few minutes, as he will emerge gradually and in stages. He will probably be born head-first during one push, then his shoulders and the rest of the

lly

The moment of birth

body will follow in the next push. Some women do push their babies out in a single push. Once your baby has been born, your LMC or midwife will place him directly on you, or will tell you to go ahead and pick him up yourself, for skin-to-skin contact. Some mums-to-be like to "catch" their babies as they are being born, or have their partner or another family member "catch" the baby, under the close supervision of the midwife. Your midwife will then give you a clean, dry towel to wrap around your baby and keep him warm. At this point, once your baby is born, the majority of the pain of labour will stop – just like that. You may feel suddenly clear-headed and relieved, and be able to talk and laugh and enjoy those first moments with your newborn. There may even be tears from you and the dad-to-be, but they're the happy kind of tears!

or even standing may be what you prefer at the time – your body will tell you, and your midwife will help you find the best position for the situation. Contractions last around five to six seconds, giving you the opportunity for two or three short pushes. Try to breathe through the pushes, as holding your breath while bearing down can cause you to feel faint. It's normal to make grunting or groaning noises while you push. You'll feel the pressure of your baby's head low in your pelvis. Listen to your body's urges, and listen to your midwife, who by this time will be "down at the business end" and able to see your baby's progress firsthand. If she tells you to stop pushing, listen. Some mums-to-be may want to have a mirror which they can use to look at their baby's head as it crowns. With each push, your baby may slip back a little, but it will gradually move down until its head is ready to be born. At this point, you may feel a stinging, burning sensation as your perineum (the skin between your vaginal opening and your anus) and your vaginal opening stretch. This is commonly called the "ring of fire", and this happens when your baby's head and body are born. Your midwife or LMC may ask you to stop pushing, and to take short breaths, which can help you resist the urge to bear down. Your midwife or LMC will take steps to minimise the risk of tearing, and will try to help your baby be born gently and slowly.

FOR DADS-TO-BE OR BIRTH SUPPORT PEOPLE, LABOUR CAN BE CHALLENGING IN A DIFFERENT WAY. WHILE THE MUM-TO-BE IS DOING QUITE A LOT OF HARD WORK, YOU MAY FEEL HELPLESS, WORRIED, UPSET, AND EVEN USELESS. But you are extremely important to the mum-to-be, even if you don't realise it. Your presence helps to centre and calm her, helps keep her focused, and lets her know that someone in the room cares for her deeply, which is immensely comforting. She may not ever say any of these things, but she needs you there, and your job is to be supportive and to give her the help she needs from you. Here are some ways you can help: Be fully present. Stop work, put down the TV remote, and be there with her. She is your number-one priority and if she needs you, you need to drop everything in an instant. Be aware of her birth plan and what she wants and doesn't want. During labour, she might not be able to advocate for herself, so discuss ahead of time when you can speak for her. Be her advocate. Familiarise yourself with the stages of labour ahead of time, so that you can understand what she's going through and help her get to the next step. Particularly during active labour and during the second stage of labour when she is pushing, you might need to be on hand to give massages, hold her hand, hold her legs, breathe with her, encourage her, and go through the experience with her. Be prepared for surprises. She may not want you anywhere near her. Don't take it personally. Yes, labour can last for a long time. While you may be bored, your role is to stay focused and present. No sneaking off to watch the rugby. If you're in it with her for the long haul, you'll need to eat, drink, and rest, too. Birth is intensely emotional, and you might hit a wall. Make sure you have some support lined up – call a friend who's been there for a pep talk if you need it.

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LABOUR PARTY

tip You may want to take your placenta

home with you. Your midwife will place it in a plastic bag and then inside a box. Many mums store their placentas in their freezers until choosing to plant it under a tree or otherwise – just make sure to mark the box clearly so no one thinks it's ice cream!

The third stage

You'd think that labour would be over now that your baby has emerged, but there's one more stage, which can take up to an hour: Delivering the placenta and membranes. Chances are you are so wrapped up in meeting your newborn that you don't notice how much time passes during this stage. Your baby may have emerged in what felt like a tidal wave of fluids and blood, and some mums-to-be are rather shocked at the third stage of labour, which is undoubtedly the goriest – but also quite fascinating, as you will get to see the organ that sustained your baby's life in the womb. At this point, your LMC or midwife will have clamped your baby's umbilical cord and severed it (or your partner may have had the honour of cutting the cord), leaving your baby with a little stump, which will gradually dry up and fall off. You will feel contractions begin again, but they are weaker and working for a different purpose – they are helping your uterus to contract, which expels the placenta in a short time. You may feel the urge to push again, and the placenta and membranes (the empty bag of waters attached to the placenta) will come out in the same way that your baby did, although usually far less painfully. To reduce the chances of post-partum

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haemorrhage, your LMC or midwife may give you an injection at this time, to help your uterus to contract. Your LMC may assist by pressing down on the top of your uterus and gently tugging the cut umbilical cord which is attached to the placenta inside your body. Your midwife may also help you to latch your baby to your breast, which can help to stimulate contractions. Skin-to-skin contact with your baby also helps to move things along. Once the placenta and membranes are out, your midwife will examine them thoroughly, checking for anything that may have been left inside, which can cause bleeding and serious infections.

After the birth

Once the placenta has been delivered, you may need stitches if you have had a tear or an episiotomy. Your LMC will do this, possibly giving you an injection of local anaesthetic to help numb your perineum while she stitches it up. Your midwife may want you to continue to try breastfeeding your baby, as his sucking can help your uterus continue to contract. Now your midwife will weigh and measure your baby, and dress him in his first nappy. If you have brought clothing to the hospital, she will dress the baby for you, or help you or your partner to dress him yourself if you want to. Your LMC or midwife will clean between

your legs and thighs where there may still be some blood or fluids from the birth. Then, while the new dad or your support person holds your baby, she will help you into the shower. You might feel shaky and exhausted, and need help showering. The showers at the birthing centre or hospital will either have a seat or a bench inside, and a moveable shower head on a cord which you can use to aim at your body while seated. Your midwife will help you to dress, with a thick maternity pad in your underwear, and sometimes two. You'll need to change this pad frequently during the first 24 hours following the birth, and the hospital or birthing centre will usually provide these pads, although you can bring your own too. Sometimes the hospital maternity pads don't have adhesive to attach them to your underwear, so be aware of this. Don't be embarrassed if you need help putting on your underwear or pyjamas. Sometimes new mums continue to feel quite shaky, as you have been through a major physical undertaking, so it is natural that your body needs time to recover. Your LMC or midwife won't mind giving you a bit of help and ensuring you're okay. You may want something to eat and drink, like tea and toast, or you may have packed light snacks – to help regain your strength, particularly if your labour was long. If you feel light-headed, see spots, feel faint, or if something doesn't "feel right", tell your LMC straightaway. Your LMC will continue to monitor you as you transition from the delivery room to the room where you'll be staying for the next few days. She'll check on you daily, as will the maternity nurses and charge midwives who are on duty – they will come in to check on you and your baby several times a day.

ready, set, go! The ride is about to start and what the future holds – no one knows. One thing is for sure, the ride will continue as your baby grows and learns. Making sure they get the best start in life is your goal, and it’s ours too. There’s so much to think about and so many questions – “What if I have trouble breastfeeding? How do I settle baby when she’s crying? When do I need to get him immunised?”. Plunket nurses are highly qualified and trained to deliver our free Well Child service, and are there to support you and your baby’s health and happiness.

PlunketLine 0800 933 922 | plunket.org.nz |

PlunketLine is also there for you 24/7 with advice and support whatever the time of day or night. It’s free, multi-lingual and you don’t need to be a Plunket client to use it. For all new parents in New Zealand, there’s even more Plunket can offer in your community, with services such as parenting courses, support groups and playgroups. Make sure your child gets the best start in life with Plunket. Register with Plunket on our website, on 0800 933 922, or through your local Plunket clinic. www.plunket.org.nz

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10 ways to soothe stitches “A tear down there” is feared by many mums-to-be, but stitches of the perineum are common after childbirth, and usually heal well. Penny Voigt shares 10 ways to care for your stitches and promote comfort and healing.

RECOVERING FROM C-SECTION STITCHES

If you've had a Caesarean section, you'll need at least 12 weeks to recover from the abdominal surgery. Try some of these tips to help speed up your recovery: • Avoid putting pressure on your abdominal area as it’s likely to be painful at first. • Use your hands or a pillow to support your incision when you cough, sneeze, or laugh. • Get up and move about, but avoid lifting anything heavy. • Try showering instead of soaking in a bath, at least for the first few weeks after delivery. • Keep your stitches clean and dry, patting them dry rather than rubbing.

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HELP WITH HEALING

WHAT’S NORMAL AND WHAT’S NOT?

f you’ve given birth vaginally, you may well have experienced some tearing of the perineum, or possibly needed an episiotomy. Thankfully, most tears are minor, but it’s not uncommon to require stitches following childbirth. And your lead maternity carer will confirm that the deeper the cut or tear, the longer the healing time necessary. There are a number of practical ways you can help the healing process.

1. ICE, ICE, BABY

If you think about it, it’s not that far-fetched: Applying ice wrapped in a towel to painful muscle tissue works for all parts of the body. So using a wrapped ice pack on your swollen, tender perineum, particularly within the first 24 hours following childbirth, can help relieve pain, tenderness, and swelling. Small bags of frozen veggies (peas and corn are great!) can be a lifesaver, or try placing your maternity pad in a sandwich bag inside the freezer for a few hours before use. Just be sure never to place ice or an ice pack directly on your skin – always wrap in a thin towel or face cloth first.

2. TOILET TIME

That first toilet trip following childbirth is memorable for many (and not in a good way). If you’re finding that using the toilet is painful, try some of these tips. Make sure you’re drinking enough fluids to avoid constipation, and don’t hold it in, as the problem will only get bigger! Try urinating in a warm water bath to take the sting out, or press a wad of clean toilet paper or tissues against your perineum when you bear down.

3. SOOTHE AND CLEANSE

The peri bottle (short for perineal cleansing) will soon become your new best friend. These unobtrusive plastic bottles can be bought at the chemist and may not appear to be anything special, but they provide tremendous relief. Fill your peri bottle with warm water just before you go to the toilet and gently squeeze it between your legs, spraying your undercarriage during and after for a cleansing and soothing rinse-off. Instead of wiping dry, pat your stitches using soft, clean toilet paper or tissues.

Generally it takes about six weeks to bounce back from a vaginal delivery, but it may take even longer for bruising, swelling, and stitches to heal completely. Get in touch with your health care provider or LMC if you experience any of the following symptoms: Increased pain or swelling (that is, you’re not feeling any relief from pain). Fever or signs of infection. Foul-smelling discharge from your vagina or stitches.

4. BEWITCHING HERBS

You may be a sceptic when it comes to trying herbal remedies, but there’s no doubt that the soothing qualities in witch hazel bring immediate relief. Consider filling your peri bottle with a mixture of half water, half witch hazel to use every time you urinate or when you need to cool the burn. Or add a few drops to your maternity pad or a compress to help reduce inflammation. Ice packs made of gauze soaked in witch hazel are an excellent combination.

your pelvic floor muscles not only helps speed up the healing process, it also improves bladder control which can weaken after childbirth. If you’re not entirely sure where your pelvic floor is, try mentally picturing the muscles around your vagina and bottom, then squeeze and tighten, holding these muscles for a few seconds at a time before releasing. Do this a few times each day to strengthen your pelvic floor muscles.

5. EXPOSE YOURSELF

8. SOAK YOUR TROUBLES AWAY

Keeping your stitches clean and dry reduces the chance of infection. That means washing more often than you normally would, changing your maternity pad regularly, and rinsing and patting dry your stitches each time you use the toilet. Wear cool cotton underwear or stock up on disposable mesh maternity panties that allow air flow while still holding your maternity pad in place.

6. PAD IT UP

On the subject of pads, you can’t beat the good, old-fashioned maternity pad. Maternity pads are longer, softer, and more absorbent than ordinary sanitary pads. Buy two or three packs to start, as you’ll need to change your pad every few hours in those first few days; post-birth vaginal bleeding is typically heavier than your average period, and you should avoid using tampons until you’re completely healed.

7. AND SQUEEZE

Increasing the blood flow to your perineum can help heal bruising. Regular exercise of

What could be better than soaking your sore bottom in warm water? Try running a shallow bath and soaking three times a day for 20 minutes at a time for the first seven days post-childbirth. The warm water helps relieve discomfort and ensures you keep your stitches clean. Remember to pat your stitches dry after your bath rather than rub them.

9. BLOW-DRY YOUR BOTTOM

Slightly unconventional, yes. But worth a try nonetheless. Blow-drying your vagina with your hair dryer on a low-heat setting for two to three minutes after soaking in the bath not only helps prevent bacteria growth, the warm, dry heat does wonders for a tender, swollen perineum.

10. PUT YOUR FEET UP

You’ve probably already heard it before, but it’s important you find time to rest. Ease yourself into your new routine and take time out to put your feet up. Accept offers of help from family and friends, and allow yourself the time to heal. Pregnancy BUMP & baby

By week two with your baby, your hormones are hopefully now regulating and you are getting the hang of newborn care.

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WELCOME, BABY!

Getting to know your newborn The birth of a new baby is extraordinary, but can be a completely overwhelming time in your life. Particularly for first-time parents, there are going to be surprises and unexpected hurdles along the way, explains maternity nanny and postnatal advisor Katie Thomas.

The first 24 hours Depending on the length of pregnancy and type of birth, your newborn baby will enter this world generally a shade of blue, quickly turning to pink, with a swollen face and eyes, possibly jaundice (a yellowish skin colour due to an excess of bilirubin in the blood), and covered in a little or a lot of vernix – a greasy, white, cream-cheese-like substance. A soft, fine layer of hair called lanugo may cover your baby to help hold the vernix on their skin, which together form a protection against the long immersion in amniotic fluid during pregnancy. Lumps and bumps, mild skin rashes, birthmarks, hormone spots, swollen genitals, and a pulsating, soft fontanelle on the top and back of your newborn's head are all completely normal, but somewhat disconcerting for new parents. Your LMC will be there to reassure you of what is normal, and to look out for any abnormalities. If your baby is born vaginally, their skull may have formed a strange-looking cone shape, as the bones moulded together Pregnancy BUMP & baby

WELCOME, BABY!

All going well during and after the birth, your baby will be placed on your chest while the placenta is delivered and the umbilical cord cut.

to allow passing through the birth canal; this will slowly adjust in the following few days as the bones gradually move. Babies born via Caesarean (C-section) usually have perfectly round heads.

The first few minutes

/ All going well during and after the birth, your baby will be placed on your chest while the placenta is delivered and the umbilical cord cut. An Apgar score is taken one minute and five minutes after birth, checking and recording your baby's Appearance, Pulse, Grimace (reflexes), Activity and Respiration. Your baby will let out a few cries and settle with your reassuring touch while gazing up into your eyes. Your new baby can see around 20-30cm, and is fascinated by faces and contrasting colours. Having crossed or bloodshot eyes can be alarming for parents, but this is normal and will generally go away within a few days. Newborns can usually hear loud and clear by the time they are born, being easily startled by loud noises, even their own cries! If you have had pain relief during labour, you may be drowsy, sedated, dizzy, itchy, nauseous, or have distorted vision. If the medication has crossed the placenta, the effects on the baby can be drowsiness, slow initial breastfeeding, inability to regulate body temperature and, in some cases, the baby's breathing can be affected (known as respiratory depression). These situations will be closely monitored by your LMC.

Instinctive reflexes

/ Instinctively, your baby has reflexes present from birth; they work as survival skills due to your

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newborn's lack of control over their body. These include the root reflex (turning to find food when anything brushes their cheek), sucking reflex (sucking on whatever is in their mouth), moro reflex (startling at loud noise or the sensation of falling), babinski reflex (flaring of toes when sole of foot is stroked), stepping reflex (walking movement when baby is held upright on flat surface), tonic reflex (baby turns head and same side arm reaches out when lying down), and grasping reflex (hand grasps finger or object when placed in palm).

The first latch

/ Within the first hour or two following birth, your baby will find your breast and gradually start sucking. Not all situations will allow this immediate breastfeeding to occur, and if bottle intervention or syringe feeding is needed, remember that breastfeeding may still be an option when the time is right. Stay as calm and positive as possible. The sooner they are able to latch on and suck, the sooner the hormones will be produced to begin the milk let-down process and the uterine contractions. These contractions, known as "after pains", are completely normal and are due to the involution of the uterus (contraction back to non-pregnant state). They should ease after two to three days, though it can take up to six weeks for your uterus to return to its normal size. The cramp-like pains are often worse while breastfeeding, as your baby's sucking triggers the release of the hormones that cause the contractions. The first milk your breasts produce is called colostrum; also known as "liquid

gold", as it is a thick, yellowy liquid full of nutrients and antibodies. After two to four days of colostrum, you will gradually start producing normal milk. Signs of this are breast fullness, leakage, warmth, swelling, heaviness, and tingling. Your baby will probably be very sleepy following birth, as adjusting to the outside world requires plenty of sleep within the first few days and weeks. Your newborn will be waking every two to three hours to feed, meaning multiple feeds throughout the day and night, so rest when you can.

Baby's first bath

/ Bathing your newborn baby can be a daunting exercise. Most babies love the water from the beginning, and it is a beautiful, calming activity for all, but some babies take a while to warm to bathing. Depending on where and how you birthed, your baby may be given a bath before you head home. Your midwife or nurse will be there to help and guide you if necessary, until you feel confident to do it alone.

Umbilical cord stump

/ The umbilical cord stump will dry up and fall off anywhere between seven days and six weeks after birth. So long as there is no sign of infection (thick, red skin around the base or yellowish pus), there is no reason for concern. Keeping it clean and dry, washing gently with fresh water, drying thoroughly, allowing time to air it out, and folding down the front of the nappy to avoid aggravating it will help the healing and falling off process.

First poos

/ Meconium is a greenishblack, thick, sticky, tar-like poo that your baby will be passing for the first few days. The colostrum will help baby pass the meconium, which has built up in their gut throughout pregnancy. Following this, the stools will gradually become a lighter greeny-yellow and be a lot easier to clean up!

WELCOME, BABY!

The first two weeks

Swaddling

/ Swaddling your baby in a wrap or muslin for sleep times can be extremely useful to help settle and ensure long, deep sleeps. The moro reflex is strong in most newborns and doesn't disappear for three to four months. Swaddling nice and snug means any startling caused by a noise, sensation, or change in sleep cycle will hopefully not wake your baby, as their arms can't instinctively fling outward. A newborn baby's ability to regulate their temperature is not developed at this stage, meaning you need to be aware and careful about appropriate clothing and their environment. A general rule is that your baby should be dressed in one more layer of clothing than you are.

Don't overdo it

/ Over this first week at home with your baby, you will find that friends and family start requesting visits and making offers to help. Be aware of your own feelings and needs and only accept help as you need it. Having close family or a friend over to mind the baby while you get some rest, or to clean, cook, or care for older siblings are all practical ways of welcoming help. Be clear with family and friends about timing and the nature of visits, as it is important to ensure you don't overdo it and miss out on vital rest time.

Getting the hang of it

/ By week two with your baby, your hormones are hopefully now regulating and you are getting the hang of newborn care.

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Your healing body

/ Lochia is the vaginal discharge you will experience following the birth. Containing blood, mucous, and uterine tissue, it will be bloody for the first few days, and then will gradually change to brownish or pink, then to yellowish. It should gradually ease and be gone in four to seven weeks. Engorgement is when you are producing greater quantities of milk to keep up with your baby's growth, meaning that your breasts can feel full, hard, hot, swollen, and painful. Feeding frequently and applying a warm compress or having a warm shower before feeding can help ease discomfort. Incontinence when sneezing or coughing, leaking breast milk (particularly when you hear your baby cry), and having pain when passing urine are all common (running warm water over your vagina or sitting backwards on the toilet seat can help).

Your baby's cries

/ All babies cry. It can be hugely upsetting to new parents when the cries are indecipherable and seem inconsolable. Crying is your baby's main method of communicating with you when they are in need. Whether your baby is hungry, has wind, is tired or overtired, is hot, cold, scared, or uncomfortable, they will most probably cry to let you know. Some people seem to easily tune in to these cries, while others use a process of elimination to figure out what their baby is attempting to communicate. As your baby gets older and you get more and more in sync with each other, you will find it easier to decipher these cries. If you are finding there is a period in the day of uncontrollable crying, and you believe colic or reflux may be an issue, talk to your midwife or health care provider.

The first month By one month, the sleep deprivation has really kicked in, and you probably feel like the night wakings are never going to end. It will get easier as your baby establishes a feeding and sleeping pattern. If you want to create a routine, now is a good time to encourage feeding at particular times, and setting a nighttime routine to help differentiate day and night can be really useful. Ensure you limit your baby's awake time, as a baby of this age can generally only cope with one to one-and-a-quarter hours awake. Getting out and about for walks is highly beneficial for you and baby. It's amazing what a change of scenery and fresh air can do.

Start as you mean to go on

/ Babies are very clever and learn habits extremely quickly. A "start as you mean to go on" approach is useful, particularly in terms of sleeping. Cuddling a newborn to sleep is one of the most wonderful feelings, and by all means, cuddle as much as your heart desires. But be aware that habits form from very early on, and putting a baby of this age to bed awake and allowing them to self-settle will mean fewer problems in the future, as they have developed healthy sleep associations.

Other people's opinions

/ Everyone has an opinion when it comes to babies, and this can be one of the biggest challenges to new mums. Books, the internet, hospital staff, family, and friends may overwhelm you with conflicting advice and theories. As much as people mean well and want to help, it is ultimately your baby and your choice. Do what feels right for you and your family, taking on board information you feel is relevant and helpful, but sticking with what you believe.

PHOTOGRAPHY PAGE 94: KARYN FLETT

Following birth, there is a huge shift in a new mother's hormone levels. Some levels increase with the production of milk, but many levels drop after the birth of the placenta, which was a factory for hormones during pregnancy. This can cause extreme emotions for an already tired and overwhelmed new mother. It is completely normal, and between 70-80% of mothers experience a drop in mood around three to six days after the birth of their baby. It is known as the "baby blues" and should pass after a few days with adequate rest and support from loved ones. If you still feel you are irritable, depressed, anxious, and tired but unable to sleep at around three to four weeks following the birth, you could have postnatal depression, and should seek help from your midwife or health care provider.

Out & about with your baby While it might seem daunting to a new parent, at some point you'll need to leave the house with your baby (for longer than just a jaunt to the letterbox!). Here are some tips to help you plan successful, stress-less outings. SHORT OUTINGS

MEDIUM-LENGTH OUTINGS

It's tempting to hibernate at home with your new baby, but eventually you'll find you really do need to leave the house – possibly for something essential! Mum-oftwo Toni recalls, "My first baby was four days old when I ran out of maternity pads. The supermarket was 1km down the road. I sweated the whole drive there, dashed in and out, and drove back, but my daughter slept in her capsule the entire time. Thank goodness for supermarket trolleys that you can put a capsule on. But it was still the most stressful 15 minutes of my life!" Start off with short trips, like to the post shop, supermarket, or bank, where there aren't big crowds and you can easily wear your baby in a sling or keep her in a capsule or pushchair. For these trips, it's a good idea to have a nappy bag in the car just in case, but you should only need some basics in your handbag or in the bottom of the pram – baby wipes (seriously, just plan on having them within arm's reach for the next five years), a dummy if your baby takes one, and possibly a burp cloth in case of unexpected spills. It's also a good idea to invest in a small nappy clutch that holds one or two nappies and a travel pack of baby wipes – they fit easily into your handbag and can just stay there for emergencies. Just don't forget to check the nappy sizes from time to time and switch out for bigger sizes as your baby grows, so you don't get caught out!

When you've mastered the short trips and you no longer feel like your breast pads are going to fall out while you balance holding your baby and opening your wallet, it's time to venture forth for longer – but still manageably short – outings. Coffee group, a proper supermarket shop (not just a quick in-and-out for essentials), even a movie (check your local cinema, as many have daytime special mums-and-bubs sessions where the lights are left on low and babies are welcome) are all possible, and even enjoyable, with your baby in tow. For these medium-length trips of an hour or two, you'll need a nappy bag. Many mums struggle to figure out just what they should pack for these times where they'll be away from their home base and expected to change nappies and feed baby without all the comforts of home. Relax – it's not as bad as you think it will be. Here's what we suggest you pack: • Nappies (one for each hour you'll be out, plus two or three extra) • Pack of baby wipes • Changing mat • Hand sanitiser • Plastic or biodegradable bags for dirty nappies • Nappy rash cream • 2 spare outfits (including socks – you'd be surprised how far poos can leak) • Spare dummy • Spare baby blanket

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• 2 burp cloths • Baby sunhat or winter hat • Baby sunscreen • Breastfeeding cover or poncho if desired • Travel pack of tissues • Breast pads • Small toy or book • Depending on your baby's age, any feeding paraphernalia necessary • Snacks and a water bottle for you We know it sounds like a lot, but remember, babies' clothing is small, so it shouldn't be too much of a burden.

GOING PLACES

IT'S TEMPTING TO HIBERNATE AT HOME WITH YOUR NEW BABY, BUT EVENTUALLY YOU'LL FIND YOU REALLY DO NEED TO LEAVE THE HOUSE.

LONGER OUTINGS Day trips, long car journeys, overnight visits – all are possible with forwardplanning and setting reasonable expectations of yourself and your baby. Packing for a longer trip is a bit more complicated with a baby, as they tend to require more equipment than adults. Start a few days ahead of time, jotting down what you need for your baby during the time period that corresponds to the time you'll be away from home. This will give you a guide to what to pack.

Pack your nappy bag as usual, and then for your baby's overnight or day-trip bag, pack the rest of the things that you think you'll need based on the list you made ahead of time. For an overnight trip, you may need bedding and a portacot (if the place you're staying doesn't provide this). It's a smart idea to pack spare bedding as well. Check that the tyres of your pram are inflated, and that you also have a small tyre pump and tyre repair kit stashed in the car. A baby carrier or sling can be incredibly helpful for travelling, particularly if you're

flying overseas and can't have a pushchair with you as you transit in airports and on and off planes. Breastfeeding your baby on takeoff and landing can help to equalise the pressure in their ears as the plane ascends and descends. Also, investigate airports to see where the parent rooms or quiet corners are located. If you are travelling alone with your baby, check with your airline whether you can request special assistance at the time of your booking – you may be able to obtain priority boarding or assistance with your luggage when disembarking. Pregnancy BUMP & baby

101

BREASTFEEDING IN PUBLIC

BLOWOUT KIT Also known as a "poonami", "poosplosion", "pootastrophe" – you get the idea, right? – blowouts can and do happen when you least expect them and when they are most inconvenient. Breastfed babies in particular seem to like to "save up" their poo for several days, and then unleash it all at once or over a short time period. Tasha says, "I took my four-month-old on a flight to Australia, and on the return flight, she pooped five times in three-anda-half hours. I used up every nappy, baby wipe, outfit, and blanket I had packed in the nappy bag. When we landed in Auckland, all that was clean was one singlet. I carried her off the plane wrapped snugly in my fleece jumper!" The Scout Motto "Be prepared" is critical here, and we recommend you do what you can to plan for a potential blowout – keeping in mind that, like Tasha, sometimes stuff happens that you have no control over, and your only option is to grin and bear it. Keep a blowout kit in your car, separate to your nappy bag, containing: • Five disposable nappies • Pack of baby wipes (80-packs are ideal)

• Two disposable change mats (one to change your baby and one to protect the car seat if needed on the way home) • Several supermarket bags (for dirty nappies and also dirty clothes) • Two baby blankets (to wrap your baby if their clothes are too dirty or you run out of spare outfits) • Hand sanitiser • Small air freshener spray or sample perfume atomiser (to mask the smell in the car so you can make it home without gagging) Check your blowout kit once a fortnight or so, and rotate the nappy sizes. Generally, a blowout kit is only needed in the first year or so – once your baby has started on solid foods after they're six months old, their poo will become firmer and more easily contained, and at that point, blowouts generally only happen if your baby is sick or intolerant of something they've eaten. A note of caution: If your baby is experiencing blowouts on a regular basis or you're worried they seem to have diarrhoea, get in touch with your GP at once to rule out something more serious.

Talk to friends MANY NEW MUMS ARE NERVOUS ABOUT

HOW TO COPE WHEN OUT WITH BABY. ASK FRIENDS TO SHARE THEIR EXPERIENCES AND YOU MIGHT FEEL BETTER! 102 Pregnancy BUMP & baby

One of the challenges many new mums fear is breastfeeding in public, particularly in the early days when you and your baby are still getting to know one another and learning to breastfeed. Erin says, "I took my one-month-old to a café to meet a friend and while we were having coffee, my son needed a feed. I was sitting on a narrow café seat trying to find space for my baby in my lap and manage a burp cloth and nursing bra. It was a bit awkward at first!" It's important that you feel comfortable feeding your baby, no matter where you are. Here are some things that might help: + Check out the café or venue when you arrive, and choose a spot where you'll be comfortable and feel confident, and have enough room to manoeuvre. + If you're worried about discretion, pack a nursing cover or poncho that can help keep you covered up while you're manoeuvring your baby and breasts. + Wear a nursing top and breastfeeding bra that are easy to feed in. + Practise at home, in front of a mirror so you can see what you look like – chances are you're not revealing as much as you think you are, as babies do a good job of covering you up while they're feeding! + Remember that breastfeeding is normal and natural. Your baby needs to be fed, and you have a right to feed him.

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Baby on board

CARRY AT ALL TIMES Chemical-free cleanups are always a good thing. WaterWipes $7.99 from supermarkets and pharmacies

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HEAT AND EAT Easily warm bottles or puréed food without electricity – boiled water does the trick. Philips Avent Thermal Bottle Warmer $54.99 from Babycity

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10 things nobody tells you about newborns

Those first few precious weeks with your newborn baby are a special time of getting to know one another. But be prepared for some surprises, says Breastmates founder and mum of two Frances McInnes.

hen you picture a newborn baby, what comes to mind? A beautiful, peaceful little being all swaddled up and sleeping peacefully, or cooing adorably while you give her a gentle bubble bath? While those rose-tinted moments of newborn life are pretty darn wonderful, most parents are unprepared for some of the less-mentioned characteristics that newborns can exhibit.

Their skin isn't perfect, and then it gets worse. From vernix

(that waxy substance that coats their skin in the womb), to flaky cradle cap you just want to pick at (DON'T), to red birth marks that gradually fade like stork bites on the backs of their necks, to blotchy patches as their circulatory system gets up to 100% capacity, newborn skin is not the dewy, perfect porcelain that we usually expect. And then just when it starts to come right, hormonal baby acne starts, and they'll have red bumps and little zits on their poor faces. Don't worry – it will get better. Eventually.

Newborns can look a bit funny at first. "My daughter was born

vaginally and had a terrible cone head," Kate remembers. "It looked so weird, I was

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afraid to take her hat off for three days after she was born!" Vaginal birth in particular can result in some squishedlooking newborn features, but they will eventually smooth out. And if your baby seems a bit scrunched up, remember they spent nine months comfortably squished inside your body, so it'll take a few days or weeks for them to start stretching out!

Their first poos are pretty horrifying. The first poo

and sometimes a few subsequent poos are usually blackish and thick, like tar – this is meconium, and it's just your baby's system processing what was ingested during the time they were in the womb. Be warned: Meconium poo can be really hard to clean, and it can stain clothing!

Subsequent bowel movements are pretty weird too. Breastfed babies in particular can have seedy, yellowish, mustardy poo which looks nothing like the breast milk they ingested. And don't get us started on the wind! Newborn babies can pass gas with their whole bodies, squirming and scrunching their torsos while their faces redden and their eyes squint. Yikes.

They can be born with a pelt. Babies in utero develop fine

hair on their bodies, called lanugo, which helps to keep them warm. They'll shed some of it as they grow and by the time they're born, particularly if they're close to their due date, they usually won't have much noticeable hair. But if they're a little early, and sometimes even if they are born on time, they may still have some lanugo hair on their bodies – which can be somewhat off-putting to new parents, who may be thinking, "Oh my God! My baby is hairy!" Don't worry, this hair will wear off after a little while, and they'll stop resembling a newborn puppy.

Their hair (on their head) falls out/rubs off. Even

babies who were born with a beautiful, full head of hair experience post-birth hair loss, and when they sleep or lay on their backs, they can rub the backs of their heads against the sheet or bouncinette and rub a little bald patch on the back of their head. It may look ugly for a few months while their hair grows in, but don't worry, it will grow back.

NEED TO KNOW

It can take aaaaaaages to wind them. When newborns drink milk,

they often start out desperately hungry, and gulp their milk along with copious quantities of air. By the time the feed has finished and they're sleepy and sated, that air is still rumbling around and ready to make them uncomfortable – unless you can wind (burp) them. And it can take a long time, many changes of position, and lots and lots of patting to get that wind out. Prepare to be in it for the long haul sometimes.

They can fall asleep while they're eating. Newborn babies sleep an awful lot, and sometimes, they can even fall asleep right in the middle of a feed, leaving Mum with uncomfortably full breasts. Mums resort to all kinds of things to help their newborns stay awake to feed – tickling their feet, undressing them, mid-feed nappy changes, stroking their cheeks... Whatever it takes, you want that feed to be finished so your newborn is full.

Newborns sleep a lot, but not for very long. While newborns

can sleep for 18 hours in the early days, they don't generally sleep for more than a couple of hours at a time. It's not until they are a few months (and even up to a year) old that their bodies are able to process enough food to keep them sated and able to sleep for more than a few hours before needing to wake and feed. The adage "Sleep when the baby sleeps" is true – get as much as you can so you don't burn out on their short sleep cycle.

You can't believe how much you love them. It can feel Newborns are adorable, but those early days can be just plain weird.

strange when you're pregnant with this unknown person, not really having an idea of what they'll be like and how you'll relate to them once they're born. But many parents report an immediate and visceral "rush" of feeling when meeting their newborn baby for the first time. And even if you didn't feel this incredible surge of love right away, it will come – be kind to yourselves as you get to know one another. One day you'll look at your baby and realise that you can't imagine life without them. Pregnancy BUMP & baby

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Your baby's first jabs The idea of purposefully giving your newborn baby injections might be quite upsetting, but immunisations are the most effective way to actively protect your child from preventable diseases.

mmunisation is the most effective way to actively protect your child from preventable diseases, such as whooping cough, tetanus and measles. The body uses specialised immune system cells and generates small molecules called "antibodies" to fight infections, but very young children's immune systems don't have the experience to mount effective responses against germ invaders. The first time we come across a germ, it takes a while for the immune response to get going, so we get sick. The next time we come across the same germ, the body will be able to remember the infection and mount a much faster response. Immunisation works in a similar way. Instead of the dangerous germ, vaccines are made of components of the germ that

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can't cause disease, or from weakened versions of viruses. Through the delivery of a vaccine, the immune system is taught to respond to the harmless version of the germ so that it can respond quickly when faced with a real infection and stop us from getting sick. The vaccine doesn't cause the disease, but teaches the immune system to recognise the invaders in the future. Teaching the immune system how to respond to germs before we are exposed to them gives us an advantage when we're faced with the real bug! Some of the diseases that we immunise against are very serious in young children. Some, like measles, are highly contagious and usually fairly mild, but pose a risk of serious complications. The safest and most effective way to ensure the good health of your child is to protect them from getting

the diseases at all. The immunisation schedule is structured to provide the best protection for our children when they are most at risk. Starting at six weeks, children can be protected from the potentially dangerous diseases that they may encounter. It is very important to stick to the schedule – not immunising your child increases the risk of them getting the infection, and not keeping up to date reduces the protection that the immunisation can provide.

TYPES OF IMMUNISATION There are two broad classes of immunisation – active or passive. Active immunisation involves the body generating its own specialised cells and antibodies to fight off the infection. This approach takes longer because it

IMMUNISATION

HOW WELL DOES IMMUNISATION WORK? Immunisation works very well to prevent a wide range of serious diseases. Sometimes, immunisation isn't completely successful and doesn't protect children completely. In cases like this, children can get the disease, but don't get as sick as they would if they weren't immunised. While vaccines can't provide 100% protection to all people, the more people who are immunised, the less the diseases will spread through the population. The people who are protected against the disease can protect the people who aren't by reducing the risk of exposure to the germs.

WHAT IMMUNISATIONS WILL MY CHILD RECEIVE? At six weeks, three months, and five months, your baby will receive three vaccines each time which cover a number of diseases.

Rotavirus Rotavirus is a highly contagious virus that infects the intestine (gut) causing gastroenteritis (diarrhoea and vomiting) in infants and young children. Without immunisation, almost all children in the world are infected by rotavirus before five years of age. Rotavirus is recognised as the most common cause of diarrhoea and dehydration in infants and young children in all countries.

tip MARK IT ON THE CALENDAR

If you're having a difficult time remembering when your baby is due for immunisations, you can create a personalised, printable immunisation calendar at www.immune.org.nz/baby-immunisation-calendar needs to generate the right response, but it teaches the immune system to remember how to respond to the germ if it is encountered in the future. This type of immunity lasts a long time. Passive immunisation involves passing ready-made antibodies directly into the person being immunised, allowing for immediate protection. Antibodies are passed from mothers to children across the placenta or through breast milk, and antibodies from donated human blood can also be directly injected. Mothers pass antibodies against diseases that they have

been exposed to on to their children, protecting their babies for a short time after birth. This type of immunisation is temporary and doesn't protect against all diseases. Expectant mothers are recommended to have a free whooping cough booster immunisation at between 28 and 38 weeks of pregnancy, ideally before 36 weeks, so they can pass whooping cough antibodies on to their baby and protect them from severe disease until newborns start their own immunisations at six weeks. Talk to your LMC or GP about scheduling this.

Diphtheria Diphtheria is a rare but serious infectious disease. The bacteria usually causes infection of the throat and nose but can also cause skin infections. While some cases may be mild, the bacteria can produce dangerous toxins that cause severe complications which can be lifethreatening. Such complications include heart trouble, paralysis, and kidney failure. Cases of diphtheria in New Zealand have declined significantly over the last century, with very few cases reported in the last 50 years.

Tetanus Also called lockjaw, tetanus is caused by the action of tetanus toxin released by a spore-forming bacillus called Clostridium tetani. The bacillus and spores are found the soil around the world. Many animals, in addition to humans, can carry the bacillus and its spores in their Pregnancy BUMP & baby

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IMMUNISATION

THE NATIONAL IMMUNISATION SCHEDULE

Below are the immunisations your child will receive in the first five months of life.

gastrointestinal tract and excrete them in faeces. Tetanus occurs after the bacillus and/or spores are introduced into the body through a wound and release a toxin that affects the nervous system. A person or animal with tetanus is not infectious. Having tetanus does not usually generate immunity to the disease.

semen, and vaginal fluids. People who are infected with hepatitis B can either develop an acute illness in which they become sick soon after infection or a chronic illness in which the illness does not begin to affect them for a longer period of time with more serious complications. People with chronic hepatitis B infection are likely to suffer from liver disease or liver cancer which can be life threatening. Infected infants and young children are at higher risk for developing chronic disease. Hepatitis B cannot be cured but can be prevented with a vaccine.

Pertussis Commonly known as

Haemophilus influenzae type B

whooping cough, pertussis is a highly infectious bacterial infection spread by coughing and sneezing. It causes severe bouts of coughing, which may be accompanied by vomiting and a whooping sound. Pertussis can last up to three months and is sometimes referred to as the "100 day cough". The symptoms are more obvious in children, because infants and adults are less likely to "whoop".

Hib disease is caused by the bacterium Haemophilus influenzae type B. Humans are the only host of these bacteria. Infants and children less than five years of age are especially vulnerable to Hib infections. Despite the similar name, Haemophilus influenzae type B is not the same as influenza/seasonal flu which is caused by viruses.

Polio Poliomyelitis is a highly contagious viral disease caused by three types of poliovirus (types 1, 2 and 3). Prior to the development of polio vaccines, nearly every person became infected, with the highest disease rate being in infants and young children. Infection can result in irreversible paralysis, usually of the leg muscles, but for 5-10% of acute flaccid paralysis cases the breathing muscles are paralysed and the person may die. Humans are the only host for polioviruses. Polio can be eradicated through immunisation. If every person is immune the polioviruses have no one to infect and will die out. Type 2 wild poliovirus was eradicated in 1999.

Pneumococcal disease is caused by the Streptococcus pneumoniae bacteria. There are 90 types of DISEASE: Pneumococcal Streptococcus pneumoniae producing IMMUNISATION: 1 injection a range of symptoms from relatively (Prevenar 13) minor to very serious. Some types are more likely to cause infections in particular parts of the body than others, such as the sinuses (sinusitis) and in the ear (otitis media or FIVE MONTHS middle ear infection). If the pneumococcal DISEASE: Rotavirus bacteria pass into the blood, they can IMMUNISATION: 1 oral vaccine cause pneumonia and invasive (RotaTeq) pneumococcal disease including bacteraemia (blood infection) and DISEASES: Diphtheria/Tetanus/ meningitis (inflammation of the Pertussis/Polio/Hepatitis B/ membranes covering the brain). Haemophilus influenzae type b

Hepatitis B Hepatitis B is a viral disease

FOR MORE INFORMATION

that attacks the liver. There are several types of viral hepatitis, labelled A, B, C, D, and E. Hepatitis B virus or HBV is very infectious and is spread from person to person through bodily fluids including blood,

• The Ministry of Health www.health.govt.nz • The Immunisation Advisory Centre www.immune.org.nz or 0800 IMMUNE • Plunket www.plunket.org.nz

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Pnuemococcal disease

SIX WEEKS

DISEASE: Rotavirus (start first dose before 15 weeks) IMMUNISATION: 1 oral vaccine (RotaTeq) DISEASES: Diphtheria/Tetanus/ Pertussis/Polio/Hepatitis B/ Haemophilus influenzae type b IMMUNISATION: 1 injection (INFANRIX-hexa) DISEASE: Pneumococcal IMMUNISATION: 1 injection (Prevenar 13)

THREE MONTHS

DISEASE: Rotavirus IMMUNISATION: 1 oral vaccine (RotaTeq) DISEASES: Diphtheria/Tetanus/ Pertussis/Polio/Hepatitis B/ Haemophilus influenzae type b IMMUNISATION: 1 injection (INFANRIX-hexa)

IMMUNISATION: 1 injection (INFANRIX-hexa) DISEASE: Pneumococcal IMMUNISATION: 1 injection (Prevenar 13)

REPRINTED WITH PERMISSION OF THE IMMUNISATION ADVISORY CENTRE AT THE UNIVERSITY OF AUCKLAND (WWW.IMMUNE.ORG.NZ)

Without immunisation, almost all children in the world are infected by rotavirus before five years of age.

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Your guide to breastfeeding Breastfeeding may seem daunting, but remember, both you and your baby will need to learn how to breastfeed successfully. Give yourselves some time to figure it out.

he Ministry of Health recommends exclusive breastfeeding for the first six months of your baby’s life. Exclusive breastfeeding means that, since birth, your baby has only had breast milk (from the breast or expressed) and prescribed medicines. Try to breastfeed your baby exclusively until they are around six months old. If your baby is exclusively breastfed, they don’t need water or any other drinks or food until they’re around six months old. After six months, exclusive breast milk is not enough on its own for your baby to grow and develop. You should start your baby on solid food and also continue breastfeeding until they’re at least one year old. When you’re away from your baby, try to ensure that they’re fed with expressed breast milk rather than infant formula.

their mothers as soon as they are born. This skin-to-skin contact with you after birth is good for your baby’s physical health and helps you to bond with each other. Skin-to-skin contact is the best way to keep baby at the right temperature and it encourages the baby to start breastfeeding. You and baby will spend some time recovering from the birth. Within an hour, your baby will start to show interest in breastfeeding. Baby will: • Feel the warmth of your body. • Feel your body rhythms. • Recognise your voice. • Smell the breast. • Start to push upwards towards the breast. • Open their mouth. • Suck their tongue. Your midwife will help you to position your baby for breastfeeding and make sure that baby has a good latch on your breast.

PREPARING FOR THE FIRST FEEDS

THE FIRST MILK: COLOSTRUM

Newborn babies are placed straight onto

It’s important in the first few days that

BREAST MILK = good for baby, good for you Breast milk is the perfect food for your baby because:

Breastfeeding is perfect for you too because:

to eat and drink for about the first six months. • It helps to protect your baby against colds, tummy bugs, infections and allergies. It also helps to protect your baby from dying suddenly in their sleep. • Breastfeeding helps your baby to feel safe and secure.

rest while you are feeding your baby. • It helps you to feel close to your baby. • It saves you time. • It’s free. • It may reduce your risk of some cancers and bone disease.

• It’s all that your baby needs

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• It gives you a chance to

your baby feeds whenever they need to, so that they get the first milk, or colostrum. Colostrum is the first milk that your baby gets. This special milk is yellow in colour and is thick and sticky. Colostrum protects your baby from infections and gives your baby their first food. Your baby feeds on colostrum for the first few days until your milk "comes in". This is when your breasts start making more milk and the milk changes from thick and sticky colostrum to the normal breast milk, which is thinner and whiter.

BABY’S HUNGER SIGNS Babies will show hunger signs when they are ready for a breastfeed. These may happen with eyes closed or open. The hunger signs are: • Rooting around with the mouth – opening the mouth and moving the head as if looking for the breast. • Sucking movements and sucking sounds – often quite soft sounds. • The tongue coming out of the mouth and almost licking the lips. • Hand-to-mouth movements. • Sucking the fingers or hand. • Opening the mouth and possibly turning the head in response to a touch around the mouth area. These signs are often called early hunger signs. If you miss these early hunger signs your baby will cry. Crying is a late hunger sign. Try to not let this happen, or your baby may be too upset to feed well.

HOW LONG ON EACH BREAST? Different women find different ways to breastfeed, but as a general guide: • Feed your baby from one breast for 20–30 minutes. • Change your baby’s nappy then feed your baby from the other breast. • Remember to start the next feed on the breast that you last fed from. • New babies need to feed about 8–12

NEWBORN KNOW-HOW

HOW TO BREASTFEED

times every 24 hours. This means that you will be feeding your baby during the night. Some days your baby will need more feeds. You will not run out of milk – if you feed your baby more, your breasts will make more milk.

DOES BABY HAVE A GOOD LATCH? Your baby’s chin will be touching the breast but their nose should be reasonably clear. Baby’s bottom lip will be turned outwards and not turned inwards. They’ll be sucking quite quickly, but once the milk starts to flow they’ll change to rhythmic, longer sucks with some short pauses. You’ll also start to hear baby swallowing – this will happen more as your milk

comes in and flows more. Your baby’s cheeks should stay rounded when sucking.

FEELING COMFORTABLE If it doesn’t feel comfortable – start again. Slip your finger into the corner of your baby’s mouth between their gums, with the soft side (not the nail) next to the lip so that you gently break the suction. If you let your baby suck the wrong way it can cause problems. If you feel pain in your nipples or breasts, ask your midwife for help.

POSITIONING YOUR BABY There are different ways that you can hold your baby to breastfeed – find the ones that are comfortable for you.

A good latch is the key to successful breastfeeding. Babies should be breastfed “tummy to tummy”. If you can see your baby’s tummy button, they’re not turned close enough to latch well. Make sure that: You bring baby in close. Baby’s head is tilted back. Baby’s mouth is wide open. Baby’s tongue is forward and right down. Baby’s chin touches your breast and baby’s nose lines up with your nipple. Gently tickle the top part of baby’s lip with your areola (the darker area around the nipple). Bring your baby to your breast quickly so the bottom lip is pushed back to form a suction cup. Let your baby take in a large mouthful of breast, not just the nipple.

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NEWBORN KNOW-HOW

PROBLEMS WITH BREASTFEEDING Sore nipples

You may have sore nipples until your breasts become used to breastfeeding. Nipples are usually most sore in the first week after baby’s birth. They should feel better seven to 10 days after baby’s birth. During that first week, the initial soreness should wear off 15–30 seconds after the baby has latched. If it doesn’t, ask your midwife for help. You may need help with positioning and latching your baby. If nipple soreness continues into the second week, or gets worse rather than better, get help. If there is a problem with baby’s latch this can be corrected, or the soreness may be due to another issue.

Cross-cradle position: It’s often easier to start breastfeeding by holding the baby in the cross-cradle position. This means that the baby’s head is supported with your hand at the base of their neck. The position of your hand is important as the baby needs to be able to tilt their head back slightly. Make sure that your arm or hand is not behind the baby’s head, or they might not be able to tilt it back. Your other hand is supporting your breast. Cradle hold: Once baby is latched well, you can change to a cradle hold, which might be more comfortable. Release your hold on your breast (unless it is very heavy and full, in which case you may need to support it during the feed – see the underarm/ rugby hold below) and move your arm gently around the baby. Underarm or rugby hold: The underarm or rugby hold can also be useful if your breasts are heavy, as the weight is partially supported by the baby. Also, using a lying-down

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have a local inflammation caused by a blocked milk duct or a more general breast infection (mastitis). It is better for you and baby if you continue breastfeeding. It is important to empty the sore breast; if this is too hard to begin with, feed from the other side until the sore side "lets down". position or the underarm or rugby hold Be sure to empty the sore side by feeding can be useful if you’ve had a Caesarean. or pumping. Massaging the sore area gently at the same time can help, as does warming BREASTS FEEL SORE AND HARD the breast before feeding. Emptying the (ENGORGEMENT) breast will help to reduce the blockage and Many women’s breasts start to feel full, sore keep your milk flowing. It is important that and hard as their milk supply increases (the you have bed rest for at least 24 hours and milk "comes in"). This feeling is most that you drink plenty of fluids. common three to five days after baby’s birth. Keep the sore area warm with a wheat If your breasts are really sore and hard, and pack or wrapped hot water bottle, or cold feel too full, it helps to put something cool pack if preferred – whatever will help you on them after a feed. This can reduce the to feel more comfortable. Your midwife hot, swollen feeling. or doctor may, if necessary, prescribe an If your baby is finding it tricky to get antibiotic to reduce the inflammation, a good latch, you can hand express a little milk but if caught early, this is not usually first. This will soften the areola (the darker necessary. Wear a supportive bra that area around the nipple) so that it’s easier for does not cause painful pressure. baby to latch – and less painful for you. Some babies will be able to empty both breasts every time they feed. Others will be BLOCKED MILK DUCTS OR MASTITIS full after one. Although babies often prefer Talk to your midwife or doctor straightaway one breast, make sure that baby feeds from if you feel unwell and part of your breast is both breasts throughout the day to avoid red or feels sore, hot, or lumpy. You may blocked milk ducts.

NEWBORN KNOW-HOW

tip

Look after yourself

YOU NEED TO LOOK AFTER YOURSELF WHILE BREASTFEEDING, WHICH MIGHT MEAN ASKING OTHERS TO HELP YOU. MAKE SURE THAT YOU EAT A WELL-BALANCED DIET AND DRINK LOTS OF WATER. AVOID ALCOHOL, CAFFEINE AND SMOKING, AS THESE CAN AFFECT YOUR MILK SUPPLY AND YOUR BABY’S HEALTH.

BREASTFEEDING IN PUBLIC Breastfeeding is the perfect way to feed your baby when you’re out. Breast milk is free, fresh, and requires no preparation. It’s your right to feed your baby anywhere, any time and any place. Some mums might be shy, but breastfeeding is part of everyday life – it’s not something that should be hidden away. Here are some tips if you feel a little uncomfortable. • Be relaxed. • Get the support of friends and whãnau. Ask them to sit with you in a café or on a bench in a shopping mall while you feed your baby. • Be comfortable. Before you start, make sure that you have somewhere to sit that is comfortable and has back support.

• Practise before you go out. Try breastfeeding your baby in front of a friend or the mirror to practise your technique and see what works best for you. • Wear the right clothing. Wear a breastfeeding or nursing bra that can be undone with one hand. Tops that are easy to pull down or push up can also help. If you want more privacy while you’re breastfeeding, you can cover up using a large wrap, muslin, shawl, or blanket draped around your shoulders • You could also try a baby sling or baby carrier. Make sure that your clothes are easily adjustable so that you can feed your baby without having to take the sling off.

DRINKING ALCOHOL Alcohol passes through your breast milk to your baby, so you should avoid it while you are breastfeeding. Drinking alcohol can also lower your milk supply and it might make your baby irritable, unsettled or sleepy, and not able to feed well. If you do have a few drinks, make sure that you avoid breastfeeding for at least a couple of hours afterwards. You could use expressed milk instead. If you choose to drink, make sure that your baby has someone looking after them who is alert to their needs and free from alcohol or drugs.

FOR MORE HELP OR INFO

IF YOU’RE WORRIED BABY ISN’T GETTING ENOUGH MILK Sometimes you may feel as if you don’t have enough milk. This is hardly ever the case. Babies normally have some breastfeeds close together (this is called cluster feeding). They also breastfeed more often when they’re going through a growth spurt. Sometimes they are fussy and unsettled, but that’s just because they are new babies and going through normal newborn unsettled periods. Remember that the more often breast milk is removed from the breast by a baby, the more milk will be produced.

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• Breastfeeding NZ YouTube Channel youtube.com/user/breastfeedingnz • Breastfeeding NZ Facebook Page facebook.com/breastfeedingnz • La Leche League lalecheleague.org.nz • HealthEd healthed.govt.nz • Ministry of Health health.govt.nz Reprinted with permission of The Ministry of Health (www.health.govt.nz)

Soft as a baby's skin How we love newborn babies! Their soft skin, delicious smell, gorgeous chubby cheeks… But soon after birth, many new parents are confronted with the unexpected: Baby acne, cradle cap, and the inevitably nerve-wracking first bath. SKIN SO SOFT? Have you heard the phrase, "skin as soft as a baby's"? New parents expect their baby's skin to be smooth and delicate, but often in the first months of life, hormonal changes mean that their complexions are less than perfect for a time, then settle down, then something else flares up. While your baby will undoubtedly be beautiful, his or her delicate, soft skin will undergo a few changes in the first months of life.

FLAKINESS AND DRYNESS Within a short time after your baby's birth, their skin may become dry and even flaky. This is natural, as they transition from the liquid-filled environment of the womb, where their skin was protected by vernix, to the air and the wearing of clothing. Newborn skin is prone to peeling for the first few weeks, but this will soon settle down.

BIRTH MARKS Newborn skin is quite translucent in appearance in the early days, but as your baby grows, his skin will thicken almost imperceptibly. You may see a number of birth marks on your newborn's skin, like stork bites (a red mark at the back of the head near the neck) or angel kisses (a red mark between your baby's eyebrows or on the top of their nose between the eyes). These will also fade in time and become less noticeable, and for stork bites, your baby's hair will soon grow to cover the spot anyway.

BABY ACNE Between two weeks and one month of your baby's life, you may notice angry-looking

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red bumps on their face which remind you of pimples. In fact, this is hormonal acne, which is a result of the hormones from your body leaving his body after birth. It is sometimes present at birth (you may see just a few spots), and it usually appears on the cheeks at first, moving to the forehead and chin, and sometimes your baby's upper back, shoulders, and upper chest. It can become reddened and more obvious when your baby cries, if he is hot, or if his skin becomes irritated by drool or spilling. Baby acne usually clears up within a few weeks, but if it lingers longer than about three months, visit your GP to check whether your baby might need a topical cream to help it clear up.

Babies love the bath, as it reminds them of being in the womb.

BATHTIME BONDING

BATHTIME SAFETY • Never, ever leave your baby

unattended in the bath, not even for a moment. If you must step away to answer the door or phone, wrap your baby in a towel and take him with you. • Don't put your baby in the bath while the water is still running, as it can quickly get too hot and too deep – wait until the tub is filled to the right level. • Only use infant-formulated products. Adult shampoos and soaps are too strong and sometimes too astringent. • One hand should be on your baby at all times, supporting her head and neck.

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Question HOW OFTEN DO I NEED TO BATHE MY BABY? ANSWER: YOU CAN BATHE YOUR BABY EVERY DAY IF YOU WISH, BUT UNTIL THEY'RE CRAWLING AND/OR EATING SOLID FOODS AT SIX MONTHS OF AGE, YOU REALLY ONLY NEED TO BATHE THEM ABOUT THREE TIMES A WEEK. BATHING YOUR BABY TOO OFTEN CAN DRY OUT HIS SKIN. MILIA You may have noticed tiny white bumps on your baby's skin, perhaps around their nose, chin, or on their cheeks, which were there at birth. These spots are called milia, and about 40-50% of newborns get them. Don't pick at them or put any cream on them – they'll go away by themselves in a few weeks.

EPSTEIN'S PEARLS When your baby opened her mouth to yawn or cry, you might have seen small white spots on her gums or the roof of her mouth. These are called Epstein's pearls, and they're similar to milia. They'll go away without any treatment in two to three weeks.

ECZEMA Also called atopic dermatitis, eczema is a skin rash that about 20% of babies can suffer from. It tends to show up on the cheeks and scalp, but can also appear on the arms, legs, chest, behind the knees, inside armpits and elbows, and in the creases of your baby's legs. Eczema looks like dry, scaly skin, and may have little red bumps which ooze when irritated. Eczema is itchy, and unfortunately, scratching makes it worse. It generally comes and goes but can be worse in the hot summer months and is irritated by some fabrics and things which rub against it. If you suspect your baby has eczema, see your GP for advice on how to treat it.

CRADLE CAP Your newborn might have a flaky scalp or greasy, yellowish patches beneath his hair, which look like dandruff scattered through his hair when you brush it. This is cradle cap, which is very common and usually clears up within six to 12 months. It's ugly, but it's harmless, and it's likely caused by hormones overstimulating your baby's

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on the floor (where you can easily reach them). You don't need much time – about five minutes is long enough to get your baby clean before the water cools down too much for them. • Gather everything you will need for bathtime, including a clean nappy and clean clothing for after the bath. • Prepare your baby's towel – lay it on the floor unfolded, so you can place oil-producing glands. If it bothers you, your baby straight into it. gently massage your baby's scalp with a soft brush or your fingers to loosen the • Fill the tub with only about 8-10cm scales, then shampoo and rinse, and gently of water – your baby should not be brush your baby's hair again with a soft submerged or immersed. • Put your baby into the bath feet-first, brush. Don't pick at it or use anything so he can get used to the sensation. harsh to try to get rid of it – over time, Gradually lay him in the tub, using it will gradually disappear. Talk to your GP if it seems to spread beyond your baby's one hand to support his head and neck. scalp, or if it seems itchy or bleeds at all. If you have an infant bath support which holds your baby on a slightly angled position, be aware that BATHTIME, BABY tip he can gradually slip down, Bathtime is a wonderful way for parents to bond with their Be sure to clean so keep repositioning him baby and become familiar with as needed. your baby's their little one's body. Babies • Use a cup or small pitcher genital area really to pour cupfuls of warm water love to be bathed, as the warm water reminds them of the well after each over your baby's exposed skin. womb and may even make nappy change • Wash your baby from top to bottom and from front to back. them drowsy and contented. – if baby wipes Start with mild baby shampoo don't do the SPONGE BATHS to wash his hair, then use baby Many newborns will have soap or baby body wash to job, use a soft clean the rest of his body. their first bath at the hospital facecloth and It may be easier to wash your or birthing centre before warm water. baby's hair with a wet, soapy going home with their somewhat shell-shocked face cloth rather than trying tip parents. While the nurse, to lather with shampoo like midwife, or LMC will show Check the water an adult. Also, you only need you the best techniques and temperature by the tiniest amount of shampoo soap – about the size of perhaps even encourage you dipping the inside or a 10-cent piece. to take over, repeating the of your wrist into • Rinse your baby with cupfuls occasion at home for the first it. It should be time can be nerve-wracking. of water to ensure all the soap For the first week or so, about 32˚ C or bubbles are washed off. consider a sponge-bath rather slightly warmer. • Carefully lift your baby from the bath – babies are slippery, than trying to wrestle the baby so ensure you have a good grip! bathtub or crouching over the tub in the bathroom. It'll be far less – and place him on the towel which you stressful for everyone and you'll feel more laid out ahead of time. It may be easier if another adult waits with the towel in their in control as you learn to handle your baby. arms, to receive your baby and wrap her up straightaway. HOW TO BATHE YOUR BABY While your newborn is very small, it is • Pat your baby's skin dry with a soft towel (do not rub). Then put a nappy on him and usually easiest to bath them in a baby bath placed on a towel on the table or dress him.

BATHTIME BONDING

FLOWER POWER Keep tabs on the temperature in your baby's room or bathwater (it floats too). Philips Avent Digital Bath and Room Thermometer $49.99 from Babycity

WE LOVE IT!

GONE FISHIN' The thermo-sensitive strip changes colour to indicate whether bath water is too cold, hot, or just right. Chicco Fish Bath Thermometer $11.95 from chicco.com.au

Squeaky clean $

GREAT BUY!

PUPPET PALS Organic terry cloth makes these soft friends perfect for washing and playing in the tub. Rabby and Doggo Washing Gloves $24.95 each from Nature Baby

STAY FLEXIBLE This portable baby bath folds together to store flat, and is easy to pop in the car or suitcase for travelling. Flexi-Bath $89.95 from Nature Baby

JUST FOR BABY Natural, organic ingredients are gentle on baby's skin. The Aromatherapy Company Baby Therapy Sleep Time Balm $12.99, Massage Oil $17.99, and 80g Soap $12.99 from pharmacies and department stores Pregnancy BUMP & baby

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Born to ride

One of the most important pieces of baby gear that you’ll need for your newborn is a car seat. Tiffany Brown explains what you need to know about car seat safety.

aby gear. It can be an overwhelming tide of anxiety and anticipation that characterises the wait for first-time parents as the arrival of a new baby approaches. Throw the sometimes agonising choice of cribs, cots, strollers, and car seats into the mix, and it's enough to send an emotional pregnant woman into a tailspin. And let's not forget our anxious dads-to-be – after all, you guys are meant to know how all this kit gets put together and works, right? If you find yourself scratching your head while facing a row of potential strollers in the baby store, or searching online in bewilderment for just the right kind of car seat, don't worry: You're not alone. Very few new parents enter the game knowing how to deal with the unique specifications of baby gear, and with so many options around these days, it's easy to get confused. The most important piece of kit you'll need once your baby arrives is the infant car seat, or capsule, for your vehicle. In some cases, you'll need to load your precious cargo into this seat and transport them safely only hours after they enter the world, so ensuring you have the right type of seat and you're confident about how to use it is a crucial preparatory step in the lead-up to arrival day. Experts recommend you do your research, acquire, fit, and practise with the seat at least four to six weeks prior to your due date. (Anecdotally, new parents agree that driving about with the capsule staring at you from the back seat is also good mental preparation for the life-changing event ahead.)

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So where to start? The NZ Transport Agency (NZTA) requires that all child restraints (including infant capsules) conform to one of three approved standards. The joint New Zealand/Australian Standard AS/NZ1754 is indicated by a tick mark. The European Standard ECE 44 is denoted by an "E" mark. The United States Standard FMVSS 213 is indicated by an "S" mark. As long as your infant capsule carries one of these three marks, you can be confident that you're complying with the law and providing your baby with the best restraint while in the car.

EXPERTS RECOMMEND YOU RESEARCH, ACQUIRE, FIT, AND PRACTISE WITH YOUR INFANT CAR SEAT AT LEAST FOUR TO SIX WEEKS PRIOR TO YOUR DUE DATE. Both European and USA standards have requirements for how the restraints are attached, denoted by the terms "LATCH" or "ISOFIX". LATCH (Lower Anchors and Tethers for Children) is an American system comprising of a strap attached to the car seat, or the detachable base of capsules, with a hook on each end. ISOFIX is an international standard attachment system which is typically rigid and fixed into the car seat frame. These attachments are designed to be used as an alternative to a standard fixing system, which uses seat

belt tethers and/or a locking clip to secure the base or seat. So which one of these systems is right for your little one? The first thing you need to know is if your vehicle is compatible with the LATCH or ISOFIX system. If it is, then you have the option of choosing a capsule or seat using this kind of attachment. Otherwise, the standard tether system is for you. It's very important you don't try to use both – just stick with one system, as per the manufacturer's instructions. While the LATCH or ISOFIX systems are not necessarily safer than using a seat belt/locking clip, they do help to reduce the otherwise high occurrence of incorrectly installed child seats. NZ Child Restraints (NZCR) is an organisation which aims to provide appropriate information for the correct use of child restraints. NZCR estimates that only one in every five child restraints is being used correctly in NZ, so anything you can do to ensure your baby's seat is fitted correctly is well worth it. NZCR's website www.childrestraints.co.nz is a valuable resource. If all of this already has you pulling your hair out or collapsing in a sobbing puddle on the garage floor, when it comes to the installation of your car seat, you can use the NZTA website to find a child restraint technician to do the hard work for you. Just go to www.nzta.govt.nz/safety/ vehicle-safety/safety-belts-and-restraints/ find-a-child-restraint-technician/ to find someone in your area. There's no shame in it: After all, this is your precious cargo we're talking about, and once they've arrived, there's nothing you won't do to protect them.

CAR SEAT SAFETY

Practise with a friend's baby or a doll so you can be confident that you understand how your car seat works.

There are two types of appropriate infant car seats – a portable capsule which is a rear-facing bucket seat with a carry handle and base, or a convertible car seat which allows for both rear- and forwardfacing. The rear-facing position – estimated to be 70% safer than forward-facing – is the safest for infants up to 24 months of age, and perhaps even older depending on the size of your little one. This is due to the relative size of a baby's head as it grows. At just two months of age, an infant's head equates to a quarter of their total body mass. The seat position protects a baby's head, neck and spine during an accident. When rear-facing, their body moves into the back of the seat shell

during impact, providing better protection and placing less strain on the head and neck than in a forward-facing impact. Needless to say, you should never place a child restraint into a seat fitted with airbags. Some parents express concern with a rear-facing seat that baby may become distressed not being able to see you. There are relatively inexpensive rearview mirrors that can be attached to the back seat so you can see each other, or place a photo of yourself on the back seat and talk to your baby to reassure them of your presence. Hiring an infant capsule costs around $50-$80, usually with an equivalent refundable bond at the time of booking.

Hire term is usually around six months, and many parents choose this option for their newborn to allow for a transitional period while getting used to their new cargo. A portable infant capsule allows easy transfer of your baby in and out of the car; your baby need not be woken up with buckling and re-buckling, and most capsules have a stroller frame option to fit the seat into – a blessing at malls or supermarkets, or even just going for a much-needed walk during those first months. Note that these frames cost extra, usually the same again on top of the car seat hire fee. Infant seat rental is currently available through a number of baby retailers including The Baby Factory Pregnancy BUMP & baby

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CAR SEAT SAFETY

70%

REAR-FACING IS SAFER THAN FORWARD-FACING and Baby On The Move. Your child has grown out of their infant capsule seat when their head is a minimum of 2.5cm above the top of the seat, or when their weight exceeds the seat manufacturer's recommendation. Car seat hire outlets also rent out convertible infant seats and booster seats, so if hiring works for your family, you may be able to continue with this arrangement right through to your child's eighth birthday, or when they reach 148cm in height, whichever comes first. Alternatively, you may choose to buy a new or secondhand car seat. Both need to conform to the standards mentioned above, but extra caution is needed with secondhand car seats. NZCR provides

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comprehensive advice when looking to buy a second-hand seat. Their six-point checklist includes looking at the manufacture date (some seats have a limited life span), looking for a valid standards sticker, an instruction booklet, a complete set of fittings, the known history, and for any obvious damage. Asking lots of questions can help alleviate any concerns the seat may have a history that's left it poorly compliant with acceptable standards. New infant car capsules and fixed convertible car seats are available from many baby retailers both in-store and online, and range in price from about $200 to $700. Important things to consider when choosing a new capsule or seat are

the standard the seat conforms to, the type of attachment – particularly what works for the vehicle you plan to use the seat in, and the age/weight range recommended by the manufacturer. Other features you might want to consider for your family's needs are how long the seat can be used for (is it able to be used from birth or will you need to invest in a capsule until your child is big enough to safely use the car seat?), the padding inserts around the child as they grow (how many are there, and can they be removed?), the ability to move head supports both horizontally and vertically with baby's growth, recline positions, and other accessories. There are a few exceptions to infant car seat law in NZ – when travelling in a vintage vehicle (first registered prior to 1955), or when travelling in a passenger service vehicle if no appropriate child restraint is available. Taxis and shuttles may be able to provide child restraints with 24 hours' notice, so ensure you plan ahead when using transport alternatives or travelling out of town without your own car. So, your new seat is chosen and fitted? Great! Now be sure to have a good few practice runs with it. Use a doll or borrow a willing friend's little one until you feel confident about how the child fits into the seat and how to fit the straps around them. The "pinch test" is currently the recommended strategy to ensure a good fit – if you can pinch the harness between two fingers, then there is too much slack in the seat's straps and they should be tightened further. Assure yourself you've well and truly mastered the art of the car seat prior to your new baby's arrival. That's one more tick on the list, and one less thing to be anxious about.

Sleep, baby, sleep Sleep deprivation: It comes with the territory. From the moment your new baby arrives, lack of sleep is inevitable. Wondering just when you can expect a good night’s sleep? Or how much sleep your little one needs? Our age-by-age guide for establishing good sleeping habits may be just the thing you need. 124

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GOOD NIGHT

THE BENEFITS OF SWADDLING

If you had your baby in hospital, chances are she’s already been swaddled. Swaddling involves wrapping a blanket snugly around your baby to make her feel safe and secure, similar to how she felt in your womb. Swaddling is believed to: • Help your baby sleep longer – she feels snug and warm. • Stop her from crying because of her startle reflex – her arm and leg movements are kept to a minimum. • Stop scratches from her little nails.

NIGHT AND DAY

NEWBORN TO THREE MONTHS

Although a newborn baby sleeps a lot, her sleep cycles are far shorter than yours: Three or four hours at a time, day or night; sleeping for about 18 hours in a 24-hour period. She’ll spend more time in rapid eye movement (REM) sleep – a light, easily disturbed sleep, and may look restless during sleep. She may twitch her arms and legs, smile, and make sucking noises while sleeping. Once your baby reaches six to eight weeks old, she’ll start sleeping for shorter spells during the day, and longer periods at night. She’ll still wake up to feed at night, but she’ll have more deep, non-REM sleep and less light sleep. Encouraging good sleeping habits can help your baby sleep for longer periods at night, possibly even right through. From as early as six weeks old, your baby can develop good sleeping habits. Try some of these tactics to help your baby settle.

LOOK FOR THE SIGNS At this stage of your baby’s life, she won’t be able to stay awake for longer than two hours at a time. Keeping her awake for any longer than that can cause her to become overtired and make it harder for you to get her to sleep. Look for these signs of tiredness – if you spot any of these, try putting her down to sleep: • Rubbing her eyes. • Flicking her ear with her hand. • Faint, dark circles under her eyes. • Whines and cries without provocation. • Blank stares. • Yawns and stretches. • Loses interest in her toys. • Becomes quiet and still. • Buries her face in your chest or turns away from objects or people. You’ll soon develop an awareness of her daily sleep patterns, and know instinctively when she needs a nap.

If your baby is a little night owl, wide awake when you’re ready for bed, you may need to start teaching her the difference between night and day. Establish a good daytime routine by: • Changing her clothes when she wakes up to signal the start of a new day. • Play with her when she wakes up. • Ensure she gets out into the daylight. • Make her daytime feeds a social time by singing and chatting to her as you feed her. • Keep the house and her room light. • Let her get used to everyday noises, like the TV or the washing machine. • Wake her gently if she dozes off during a feed. At night-time: • Keep quiet when you feed her. • Keep the room dark and quiet. • Try not to talk to her too much. • At the end of the day, change her into her pyjamas.

FALLING ASLEEP ON HER OWN When your baby is about six to eight weeks old, you can teach her how to fall asleep on her own. Try putting her down to sleep when she’s sleepy but still awake, and stay with her if you prefer until she falls asleep. You’ll need to do the same every time she wakes at night though, so you may want to try putting her down and leaving her alone to fall asleep. To reduce the risk of cot death, place your baby on her back to sleep in her cot or Moses basket. Don’t let your baby get too hot, and keep her head uncovered; blankets should be tucked in no higher than her shoulders. Place your baby in the "feet to foot" position – with her feet at the end of the cot. To settle your baby to sleep, try some of these tips: • Have some quiet time before you put her to bed; talk quietly or sing, read a story, and cuddle her. • Ensure she’s warm but not too hot; one extra layer more than you would wear is enough. • Pat, stroke or talk quietly to your baby. • If she’s distressed, pick her up and comfort her or feed her, then try to put her back down. Pregnancy BUMP & baby

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The morning routine

TO KEEP YOUR BABY’S ROUTINE ON TRACK EACH DAY: IF SHE’S SLEPT FOR MORE THAN 10 HOURS AT NIGHT, WAKE HER IN THE MORNING TO RESET HER DAILY CLOCK. • Giving her a gentle massage. • Kissing her good night and leaving

her to fall asleep on her own. Developing a bedtime routine means doing these things in the same order each night; even when your baby is not well, it’s important to maintain her normal routine.

SLEEP PROBLEMS

THREE MONTHS TO SIX MONTHS

By about three months, your baby should sleep for around 15 hours out of a 24-hour period, 10 of these at night. She may still be waking during the night, but should be sleeping for longer stretches. Her three daytime naps will drop to two when she reaches six months, and by this stage she is capable of sleeping through the night. At this age, your baby should start dropping her night-time feed and sleeping for six- to 12-hour stretches. Whether or not she does depends on her sleeping habits and a consistent routine.

ESTABLISH BEDTIME AND NAPTIME As your newborn baby develops and grows, you become more aware of her signs of sleepiness. Now that she’s a little older, establishing a specific bedtime and consistent naptimes can help regulate her sleep patterns. Bedtime for babies aged three to six months is usually between 7pm and 8.30pm. Avoid keeping your baby up any later than that or she could get overtired and you’ll find it difficult to put her to sleep. If she seems energetic and ready for an all-nighter, it’s probably already past her bedtime! Naptimes should be set the same as bedtimes, around a specific time each day. You’ll know what time works best for your

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baby; setting a consistent time each day for naps helps ensure she has time to recharge her batteries.

DEVELOP A BEDTIME ROUTINE You can develop a bedtime routine by: • Giving her a bath. • Changing her into her pyjamas. • Playing a quiet game. • Reading a bedtime story. • Singing a lullaby.

At this age, sleep problems may include transitioning to a cot and learning to sleep through the night. If your baby is unwell, it’s normal for sleep patterns to be disrupted, and she may want to nap at other times during the day, making her bedtime later than usual. Try to keep her bedtime routine the same each day, even if she starts waking up during the night when she usually sleeps through. Once baby is better, you can start getting naptimes back to normal again.

BABY SLEEP CHART

Wondering how much sleep your baby needs? Or when she’ll sleep through the night? How many naps are normal? Take a look at our age-by-age sleep chart for babies and children; just remember that all babies are different and some need more sleep than others. AGE

TOTAL SLEEP (HOURS)

NIGHT-TIME (HOURS)

NAPS (HOURS)

Newborn - 2 mths

16 - 18

8-9

7-9 (3-5 naps)

2 - 4 months

14 - 16

9 - 10

4-5 (3 naps)

4 - 6 months

14 - 15

4-5 (2-3 naps)

6 - 9 months

10 - 11

3-4 (2 naps)

9 - 12 months

10 - 12

2-3 (2 naps)

12 - 18 months

13 - 14

11 - 12

2-3 (1-2 naps)

18 months - 2 yrs

13 - 14

2 (1 nap)

2 - 3 yrs

12 - 14

10 - 11

1-2 (1 nap)

3 - 5 yrs

11 - 13

10 - 13

0-1

5 - 12 yrs

10 - 11

n/a

Naps usually stop by age 5

15 STYLES OF

YOGA MATS

FEATURED MAT: ELEPHANT

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TIME TO CHANGE

Nappies 101

One of the less-savoury but necessary parts of new parenting is learning how to become a nappy-changing pro. Here’s your guide to nappies from newborn through the first six months

t's hard to believe that something so tiny can go through close to 3,000 nappies in its first year! That's a lot of nappy changes. As a new parent it can start to feel like it's the only thing you're doing. The good news is, you won't be changing nappies forever.

HOW MANY NAPPIES DO I NEED? In the first few weeks after birth, your newborn baby will poo during or after every feed and wee every one to three hours. To avoid nappy rash, you'll need to change his nappy each time he poos and when his nappy becomes too wet. You can expect between eight and 12 nappy changes a day for the first few weeks. From about week three to week four, his bowels will begin working out their own routine and you may notice his poos slow down to around six to eight a day. Depending on whether your baby is breastfed or formula-fed, he can have several poos a day, or nothing for two or three days.

BREASTFED VS FORMULA-FED

Does my bum look big in this?

Baby poo comes in a rainbow hue of colours, textures and smells; you can tell a lot about your baby by what's in his nappy. In his first few days following birth, baby's poo is a sticky, green-black, tar-like substance called meconium, made up of mucus, amniotic fluid and anything ingested in utero. Meconium poo usually takes about two or three days to work through baby's system. Breastfed baby poo is mustard yellow, green, or brown in colour, typically seedy

and pasty in texture and may even be runny, resembling diarrhoea. Breastfed baby poo has a sweet smell, unlike regular poo, and it's not uncommon for breastfed babies to have eight to 10 poos a day. Formula-fed baby poo is similar to peanut butter in consistency, typically brown or yellow and paste-like. It's also noticeably smellier and larger in size. Formula-fed babies poo less often, usually only once a day.

NAPPY RASH The most common cause of nappy rash is wearing a wet or dirty nappy for too long. Baby's wee and bacteria in poo can irritate him, causing the skin under his nappy to become red, sore and spotty in patches. Other causes of nappy rash include friction from baby's nappy rubbing against his delicate skin, and a reaction to soap, baby wipes or the washing powder you use. Treat nappy rash immediately and help prevent nappy rash by: • Keeping baby's skin clean and dry. • Letting baby have "nappy free" time to allow air onto bottom. • Changing nappies as soon as they are wet and every time he poos. • Cleaning thoroughly at every nappy change, wiping from front to back. • Using warm water and unperfumed soap or disposable baby wipes to clean baby before putting on a new nappy. • Applying a thin layer of barrier cream to prevent moisture reaching his skin. • Avoid using plastic pants and talcum powder. Consult your GP or pharmacist if the rash persists or gets worse. Pregnancy BUMP & baby

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TIME TO CHANGE

NAPPY CHANGING KIT Changing nappies can be as simple or as elaborate as you make it, but here are a few essentials you’ll need: Nappy change area: Whether you choose a changing table or the floor, having a regular changing area means all of your nappy change items are within easy reach. Choose somewhere comfortable – a waist-high tabletop or a chest of drawers works well and helps prevent backache from stooping. Nappies: Deciding on which nappies to use comes down to personal choice and what’s best for you and baby. Whichever you choose, ensure nappies fit baby snugly to avoid any leakages and rubbing which can lead to nappy rash. Baby wipes: Disposable baby wipes clean and sanitise your baby, but warm water and cotton wool are just as effective, especially if baby’s skin is sensitive and prone to skin irritations or nappy rash. Barrier cream: A good barrier cream will help prevent nappy rash by protecting your baby’s skin from exposure to wet nappies.

NAPPY CHANGING TIPS Most newborn babies don’t enjoy nappy changing time, so getting his nappy changed quickly is usually a priority. As baby grows and learns to wriggle, nappy changing becomes a little more challenging. Here are our nappy changing tips: ORGANISE YOUR KIT: Ensure you have everything

you’ll need in your nappy changing area so you won’t have to leave baby unattended. Keep your baby wipes, clean nappy, barrier cream, and a change of clothes within easy reach to ensure a smooth nappy changing process. DISTRACTIONS: Keep a few toys on the change table or hang a mobile above your changing area. INVOLVE: Make nappy changing fun by involving your baby. Tickle him, move his legs, blow on his feet, or gently roll him from side to side. Nappy changing is an excellent time to interact with your baby (unless it’s the middle of the night when you want to keep him calm and quiet). KEEP CALM: Stay smiling even if baby is voicing his displeasure at having his nappy changed. Try singing quietly or saying a rhyme to distract baby.

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MIDDLE-OF-THE-NIGHT NAPPY CHANGES:

Many mums avoid changing baby at night as it may be harder to get him back to sleep afterwards. Unless his nappy has leaked or he’s done a poo, it may be best to just leave changing the nappy until morning. If you do need to change baby during the night, these tips may help: • Organise your changing area before bedtime so middleof-the-night nappy changes are smooth and speedy. • Try changing baby’s nappy mid-feed so you have time to settle him again with the last of his feed. • Keep baby warm while changing his nappy as a sudden change in his body temperature may upset him. • Use a night light to keep the room dim and avoid waking him fully.

BABY STEPS ideas for moving onto solids

4-6 months Carrot or Apple

}

6-9 months Spinach and Lentils or Apple and Banana

10 -12 months Weet-Bix wheat biscuits and Banana or Pumpkin and Rice

}

When your baby is ready for solids, start them on vegetables and fruits in a consistency that is fairly runny, this makes it easier for them to swallow and allows their tummies to get used to digesting things other than milk. Over the next few months you’ll be slowly able to introduce less pureed foods, but it’s important you feed your baby the appropriate consistency for their age. For more meal suggestions or nutrition advice, just call the team of highly qualified nutritionists at Sanitarium Nutrition Service, they’re ready to help. And best of all their advice is free!

Send your questions to nutrition@sanitarium.co.nz or call us on 0800 100 257 Deep.Limited SNS00075

On solid ground Starting your baby on solid foods is a messy yet special milestone both for babies and parents. Here’s when and how to get started with solids, and what foods your baby should try first.

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FIRST FOODS

our baby will show signs they’re ready for food at around six months old. This is an exciting new stage for you and your baby. You get to prepare meals for your little one, and they’ll have the fun of exploring new tastes and textures. You’ll also discover your baby’s food preferences, which may be different to others.

SIGNS THAT YOUR BABY IS READY FOR SOLID FOOD IF THEY:

• Seem hungry after breast or formula feeds. • Can hold their head up well. • Are interested in watching you eat – they reach

out, open their mouth when you’re eating, and put their hands and toys in their mouth. • Make chewing movements. • Easily open their mouth when you touch their lip with a spoon or bring food to their mouth, and their tongue doesn’t protrude and push the food out. • Move food to the back of their mouth and swallow.

tip

If your baby was born prematurely, they may not be ready for solid food at around six months. Your Plunket nurse can help you work out when to start offering your baby solid food, and will give you the information you need.

WHY YOU SHOULDN’T START SOLIDS TOO EARLY

• Your baby’s body won’t be ready for it. • They can’t swallow well enough until four to six months old.

• Their kidneys and digestion are not

developed enough to cope with solid foods. • They may not get all the milk (and the iron in it) they need to grow well. • They may also be more likely to get eczema, asthma, food allergies or respiratory infections. • Starting your baby on solid food will not necessarily help them to sleep better at night.

If your baby easily opens his or her mouth when you touch their lip with a spoon, they may be ready to start eating solid foods.

WHY YOU SHOULDN’T LEAVE STARTING SOLIDS TOO LATE From around six months of age, your baby needs the vitamins and minerals (especially iron) in solid foods to grow and learn. The nutrients in solid food help to build your baby’s developing brain and body.

YOUR BABY’S FOOD PREFERENCES Every baby is different, and it’s fun getting to know what sort of food your baby likes. Some babies will devour solid foods as soon as they’re given them, while others prefer to have just breast milk or formula for longer. Some babies eat everything offered, and others have clear likes and dislikes. Don’t worry too much about your baby’s food preferences. Keep offering a range of nutritious foods so they can learn to enjoy a variety of food tastes and textures.

HOW TO GET STARTED

Feeding your baby solids for the first time can be challenging, but there are several simple steps you can follow to help with the feeding process.

STEP-BY-STEP PROCESS

• SET THE SCENE: Choose a time when

you and your baby are relaxed and happy. Around lunchtime or early afternoon are good times. • START WITH MILK: Give them a breast or formula feed before solids, until your baby is eight to nine months old. This milk is still the most important part of their diet, so you want to make sure they get plenty. After eight or nine months, you can give them solids before milk. • KEEP YOUR BABY SAFE: Sit your baby in a highchair or on your lap. Stay with your baby while they’re eating, so you can help them if they choke. Avoid small, hard foods because your baby could choke on them. • OFFER FIRST TASTES: At first, offer one to two teaspoons of smooth, runny, slightly warm solids, once a day. Let your baby taste the food and suck it off the spoon. Your baby will get better at taking food off the spoon during the first week of feeding. • GIVE YOUR BABY TIME: Eating solids is complicated, and baby may spit out their first solid foods as they learn to get the food to the back of their mouth to swallow it. If your baby continues to spit out a food, wait for a few days and offer the food again, or try another food. • GRADUALLY OFFER NEW FOODS: To help your baby get used to a variety of tastes, gradually offer different foods. Even if a food tastes bland to you, it won’t taste bland to your baby. Pregnancy BUMP & baby

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• LET YOUR BABY DEVELOP THEIR

OWN TASTES: Babies like some tastes more than others. If your baby refuses a food, mix a little of the refused food with a food they like. Gradually increase the amount of the refused food until your baby gets used to the taste. If your baby continues refusing, take a break and try it again in a week or two. It may take up to 10 times before they develop a taste for it. • LET YOUR BABY MAKE A MESS: Your baby will have a great time handling their own food as they get bigger, and will learn how things work. Mealtimes can get messy. Babies often enjoy dropping food over the side of the highchair and watching it fall. Put some newspaper or plastic under their highchair to contain the mess.

HOW MUCH AND HOW OFTEN Your baby will let you know how much food they need. Start with one food at a time, and add a new food every two to four days. • Start with 1–2 teaspoons once a day, and slowly build up to ¼ of a cup. • Slowly increase the amount of solid food, following your baby’s appetite. • Once your baby is taking 2 tablespoons

to ½ a cup per feed, increase the number of meals a day. • Some babies are ready for two meals a day the second week after starting solid foods, and then three meals by the third week. • Each baby is different, and some eat more than others.

HOW TO TELL WHEN YOUR BABY HAS HAD ENOUGH When your baby wants to stop eating, they’ll turn their head away, push the food or your hand away, close their mouth or start crying. Let your baby’s appetite guide how much they eat. Don’t force them to eat all the food on their plate.

Making baby's food

WHEN YOUR BABY STARTS ON SOLIDS, THEY'LL NEED SMOOTH, RUNNY FOOD. YOU'LL ALSO NEED TO THINK ABOUT HEALTH AND SAFETY WHILE YOU'RE MAKING IT TOO.

HOW TO MAKE BABY’S FOOD

• To make your baby’s food smooth, use

a blender, mouli, or push the food through a fine sieve with a wooden spoon. • To thin the food down, add cooled water, breast milk, or if you are formula-feeding, add formula. • A great way to stock up on baby food is to cook a large amount, freeze portions in small containers or ice-cube trays, and use it over the next three to four weeks. • Food can be kept in the fridge for two days.

BABY’S FIRST FOODS

From six months old, your baby can try a range of foods. Your baby will cope best with one new food at a time and small amounts to start with. If you buy baby food, check the labels for the ages and stages they suit. As your baby gets older, you can start introducing more variety into their diet. Eventually, your baby will be able to eat the same foods as you. CEREALS & RICE: Iron-fortified baby rice or infant cereal, plain rice, congee Prep Check labels for the age and stage they suit. Purée. FRUITS: Apple, apricot, mango, pear, plum, ripe banana, avocado, pawpaw, peach. Prep Remove skins, pips, stones, and seeds. Cook fruit to soften, if necessary. Purée. BEANS AND PULSES: Dahl, baked beans, chickpeas, dried beans, peas, and lentils. Prep Cook and purée.

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MEAT: Beef, lamb, pork, chicken, and fish. Lamb’s liver is a good source of iron, but it is best to offer liver only once a week. Do not give salty meat such as corned beef, povi/pulu masima (salted brisket), and tinned fish as first foods. Prep Cook and purée. VEGETABLES: Kumara, potato, carrot, pumpkin, parsnip, kamokamo or marrow, taro, cassava, manioke(a), yam. Prep Remove skins, pips, and seeds. Cook vegetables to soften them. Purée.

HEALTH AND SAFETY

Hot food can burn your baby’s mouth. When heating frozen food, make sure it’s piping hot, then let it cool down before giving it to your baby. Test the temperature of the food by stirring the food with a spoon and then putting the back of the spoon on the inside of your wrist. It shouldn’t feel hot. Food cooked in a microwave oven keeps cooking after the microwave has stopped. If you use a microwave to heat your baby’s food, mix it well after heating, leave it for a few minutes, then mix it again before testing the temperature. If you taste food from the spoon your baby will use, you can pass on viruses and bacteria to your baby. It’s best to use a clean spoon to feed your baby. Viruses and bacteria can also be passed from your baby’s mouth into their food, so throw uneaten food away.

FIRST FOODS

FOOD ALLERGIES

DAIRY, SALT, AND SUGAR Wait until your baby is seven to eight months to give them dairy products such as cheese, yoghurt, and custard in home-cooked foods. However, some cans and jars of bought baby food have these foods in them. This is okay, because the food has been cooked at very high temperatures, making it easier for your baby to digest. Babies should not have salt, sugar, artificial sweeteners or butter added to their food. Hold off on feeding honey to your baby until they turn one. Honey sometimes contains a bacterium that causes serious illness (infant botulism) in babies under one. GOOD IRON SOURCES FOR BABY By six months, your baby will be starting to run low on the stores of iron they were born with. Some iron-rich foods suitable for this age are lamb, beef, chicken, and iron-fortified infant cereal. Foods high in vitamin C, such as fruit and vegetables, help your baby use iron from iron-rich food. Meat is a good source of protein and iron. While all meats contain iron that your baby can absorb easily, red meat contains more iron than white meat. To prepare meats, cook and purée them. Add vegetable water, meat juices or water to make them easy to eat. Another

way of preparing meat is to freeze uncooked meat and grate the frozen meat into your baby’s raw vegetables before cooking. Offer your baby meat at least 3–5 times a week, or see below for vegetarian options. Legumes, cereals, and green leafy vegetables also contain iron. However, the iron in plants (non-haem) is in a different form to the iron in meat (haem). The body cannot use non-haem iron as easily. Eating foods that are high in vitamin C helps the body to absorb more non-haem iron. If your baby is having a vegetarian diet, you might like to talk about their diet with your Well Child nurse.

Once your baby starts eating solids, it’s important they get enough iron as it will help your baby’s brain develop, and boost their learning and energy. It’s also important to see how your baby reacts to certain foods, so you know if they have a food allergy. The thought of food allergies can be scary, but there is little proof that you can protect your baby by holding off on giving your baby the foods that most often cause allergies, such as eggs, cows’ milk, fish, shellfish, soy, wheat, peanuts or other nuts. A good approach is to introduce one food at a time to your baby, and to add a new food every two to four days. That way, if your baby does react to a food, you’ll be able to work out which food caused the reaction. If your baby reacts to a food, see your doctor. If they have a serious reaction (swelling lips, mouth, tongue, face and/ or throat, dizziness, difficulty breathing and collapsing) call 111 for an ambulance. You should read more about food allergies before you start feeding your baby solids.

INTRODUCING SOLIDS WHILE BREASTFEEDING Once your baby reaches six months they may show signs they’re ready for solid food. • As your baby starts eating other foods, they may need fewer breast feeds but it is still an important part of their diet. • Until your baby is eight or nine months old, it’s best to give them breast milk before solid food. That way they’ll get all the milk they need to grow well.

CONTINUING TO BREASTFEED Breast milk is the only food babies need in the first six months. Plunket recommends that you continue to breastfeed baby until they are at least one year or older, and that you start introducing solid food around six months. Reprinted with permission of Plunket New Zealand (www.plunket.org.nz) Pregnancy BUMP & baby

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THE LAST WORD

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