Pregnancy BUMP&baby issue 3

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PREGNANCY

! IN W The ultimate

push present

& baby

ISSUE 03

REAL MUMS TELL

EAT YOUR GREENS! Recipes from Chelsea Winter

BABY SHOWER GIFTS

you’ll love ONE HOT MAMA Sultry summer styles

What do contractions REALLY FEEL LIKE?

WEIRD

(BUT NORMAL) THINGS ABOUT NEWBORNS

BABY SAFETY FOCUS: Strollers, car seats, bottles, & more

l u f i t u a e b y l l e B

YOUR AMAZING PREGNANCY JOURNEY


nursery

FTC0728_OCTL

your home for

Shop online at farmers.co.nz


nursery checklist

BathTime

SleepTime

FeedingTime

OntheGo

ESSENTIAL

ESSENTIAL BEDDING

ESSENTIAL

ESSENTIAL

Baby bath (1) Soft washcloth (6-8) Soft towels (4-6) Toiletries: baby wipes, barrier cream, shampoo & baby body wash Bath thermometer (1) Non slip bath mat (1) Grooming kit (1)

OPTIONAL Bath toys (2-4)

PlayTime OPTIONAL Bouncer (1) Play gym/mat (1) Exerciser (1) Swing (1) Fabric books (3) Soft toy (Newborn) (2-4) Music (3)

Mattress protector (2-4) Fitted sheet & top sheet (4) Blankets (2-4)

FURNITURE Cot (1) New mattress (1)

OPTIONAL Wrap (2-4) Swaddle (1) Bassinet (1) Mobile (1) Night light (1)

ChangeTime OPTIONAL Change table (1) Change mat (1) Nappy disposal unit (1)

Highchair (1) Bibs (6-8) Bottles (4-8) Teats (6-8) Bottle brush (1) Steriliser/Bottle warmer (1) Nursing pads (6-12) Breast pump (1) Burp cloth (4-8) Storage bag/Bottles (4-6) Teether (3-4) Nursing bras (3-4)

OPTIONAL Soothers/Dummies (6-8) Feeding pillow (1) Nipple cream (1) Spill mat (1)

Capsule/Convertible carseat (1) Stroller (1)

OPTIONAL Baby view mirror (1) Storm cover (1) Carrier (1) Change bag (1) UV shade (1) Pram toys (2-4) Pram liner (1-2) Pram blankets (2)

Health&Safety ESSENTIAL Thermometer (1)

OPTIONAL Baby monitor (1)

FTC0728_OCTR

new born


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Your essential breastfeeding companion Breast milk is, without doubt, best for your baby’s start in life. Our range of breast pumps are designed to help you in your breastfeeding journey, making it easier and as comfortable as possible to give your baby all the goodness of your breast milk for longer.

A healthy start, a healthy future Comfort single electric breast pump www.philips.co.nz/avent www.facebook.com/Philips.Avent.NewZealand


CONTENTS

&

PREGNANCY

Issue 03 QUICK FIX

LOVE YOUR LIFE

10

26

HELLO! A few words from our editor

INSURING YOUR FAMILY’S FUTURE Time to check your cover

12

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

17

WIN THE ULTIMATE PUSH PRESENT A diamond bracelet from Pascoes worth $3,699!

40

MIAMI HEAT Latest trends in summer maternity fashion

48

STYLISH SUMMERTIME Casual fashion for your bump

50

BREAST DRESSED New-season nursing bras

18

WHAT WE’RE READING Books for mums and bumps

20

SUBSCRIBE AND WIN Get two issues for only $22

136

DIRECTORY Shop til you pop

142

THE LAST WORD Words of wisdom to make you smile

52

SKINCARE: SAVE OR SPLURGE? Spring-clean your beauty routine

72

You need this chair.

52

54

EAT YOUR GREENS Four scrumptious recipes from Chelsea Winter

72

SHOWERED WITH LOVE New baby gifts mums and babies will love

74

TWICE AS NICE A gorgeous gender-reveal party

Yummy scrummy!

54 CONCEPTION & PREGNANCY

22

TRYING TO CONCEIVE? What you need to know

30

THE FIRST 14 WEEKS All about the first trimester

35

SHOULD YOU TAKE SUPPLEMENTS DURING PREGNANCY? Things to consider

37

FEELING THE BURN Reflux and heartburn

60

TESTING TIMES Antenatal screening tests

64

BRINGING YOUR BUMP TO WORK Coping with pregnancy at the office

68

A WEE PROBLEM Do your pelvic floor exercises!

80

GAINING WEIGHT THE HEALTHY WAY Eating for two? Pregnancy BUMP & baby

7


122

CONTENTS

Hey chick, own your birth!

92

YOUR NEWBORN

FIRST SIX MONTHS

98

118

EATING FOR FEEDING Nutrition for nursing mums

LABOUR & BIRTH

110

82

WHAT DO CONTRACTIONS REALLY FEEL LIKE? Real mums tell

86

INDUCING LABOUR Kick-starting birth

90

WHEN YOU NEED A BIT OF HELP Pregnancy interventions

92

GIVING BIRTH NATURALLY – YOUR WAY Birth techniques to consider

8

Pregnancy BUMP & baby

128

100

RECOVERING FROM BIRTH Healing hints to help your bits

104

10 QUESTIONS YOU SHOULD NEVER ASK A NEW MUM Just don’t go there

106

BOTTLE BASICS Using baby bottles safely

110

ALL BOTTLED UP Bottles and bottle-feeding equipment

112

BABY ON BOARD Car seat safety

FACE TIME How infants learn from facial expressions

122

CARING CHOICES Early childcare options

126

A WALK IN THE PARK Stroller buyers’ guide

128

THEY SEE US ROLLIN… Strollers, prams, and pushchairs, oh my!

82

130

5 WEIRD (BUT NORMAL!) THINGS ABOUT NEWBORNS Sometimes things get weird

132

FOR A GOOD NIGHT’S SLEEP Creating a sleepfriendly nursery

135

HUSH LITTLE BABY Sleep products to increase the ZZZ factor


Absorb nature’s gift.

As your baby relies on its nutrients from your blood, it’s imperative to maintain healthy iron levels while pregnant. Spatone is scientifically tested and shown to help maintain healthy iron levels during pregnancy.

•Gentle on the stomach •No mixing, no measuring •Less likely to constipate

Available from selected health food stores and pharmacies. Always read the label and use only as directed. McKenna, et al. Clinical and Laboratory Haematology, 2003, 25(2), 99-103* # Trefriw Wells Spa Ltd was a financial sponsor of this research. * Research was conducted on pregnant women.


HELLO!

Editor's note

I

PREGNANCY

Issue 03

Available from selected retailers or visit bumpandbaby.co.nz to subscribe.

TIED UP MAXI DRESS $74.90 FROM BREASTMATES.CO.NZ I lived in dresses through all my pregnancies, and when they double as breastfeeding clothing? That’s twice the reason to need this dress, in my opinion. Comfortable, stylish, NZ-designed, and the price is just right.

GAVISCON DUAL ACTION 300ML RRP$19.99 Heartburn and reflux? Check and check – I couldn’t eat anything with tomatoes in it for almost the duration of my pregnancy. Until I discovered this magical pink bottle and suddenly, pizza was back on the menu.

BIO-OIL 60ML RRP$20.45 It’s not just about stretch marks – it’s about that thirdtrimester, itchy, dry skin, stretched-out belly that needs something, ANYTHING, to feel more soft and supple and comfortable. This does the trick every time.

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

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Pregnancy BUMP & baby

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

EDITOR'S PHOTO: NIGEL MARPLE • CLOTHING BY BREASTMATES.CO.NZ

I’m nine months pregnant and trying to reach the keyboard of my laptop over a baby bump which isn’t so much in the way as it is, well, just THERE every minute of the day and night. I can’t see my feet when I stand up. Climbing the flight of stairs to the office leaves me embarrassingly out of breath. I’m in that zone where labour pains are looking more attractive than this persistent third-trimester backache. If you’re close to delivery, then you’ll know where I’m coming from. If you’re newly pregnant or in your second trimester, don’t worry, you’ll soon understand. Soon. In the lift today, I met another nine-months-pregnant woman on her way from seeing the midwife. She overbalanced as she stepped inside, and swayed for a moment before she caught herself on the handrail. “Oops, don’t fall!” I said, reaching out to help. “Maybe that’s what I need to get this baby moving out of here,” she replied, half-desperately. Our eyes met and we both smiled. Soon. Babies are on the way. Lives and relationships and futures are going to change. Pregnancy aches and pains and indignities will be a thing of the past. Tears of joy will be shed. Hearts will be so full of love you won’t believe it’s possible. You’ll get there, too. Soon.

My pregnancy must-haves

&


is all about PICK UP YOUR FREE COPY AT THE LIBRARY, DAYCARE, PLUNKET, KINDY, OR SCHOOL, OR VISIT TOTSTOTEENS.CO.NZ AND SIGN UP TO RECEIVE OUR WEEKLY E-NEWSLETTER!

TOTSTOTEENS.CO.NZ FACEBOOK.COM/TOTSTOTEENSNZ OCTOBER/NOVEMBER 2016

Childhood in New Zealand

Giveaways

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NZ'S MOST INFORMATIVE PARENTING MAGAZINE

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Choosing the right Great ideas for music teacherhelping Kiwi mums and dads to make their families' lives as healthy and happy as they can.

Playing outside Top outdoor toys for kids

Staying sane as a SAHM l Cyber-bullying: It’s not okay! l Whanganui River adventure l Straight talk: Learning to compromise l PICNIC TIME! ALFRESCO eats

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Just bumped into… The latest news, info, and gear for stylish mums, bumps, and babies

FACT

BABIES OPEN THEIR EYES INSIDE THE WOMB AND CAN SEE LIGHT FROM THE OUTSIDE. ALTHOUGH A BABY'S EYES CAN “SEE” LIGHT STARTING AROUND WEEK 16, THEIR PEEPERS AREN'T FULLY FORMED UNTIL ABOUT WEEK 20. THE EYES FIRST OPEN BETWEEN WEEKS 26 AND 28.

ON THE RIGHT TRACK Meet Elvie, the award-winning pelvic floor exercise tracker. Elvie connects to an app which guides you through fun, five minute workouts to strengthen and tone your pelvic floor. Each exercise was designed with the help of physiotherapists and experts. Think of Elvie as your most personal trainer – set tailored targets based on your strength and go from novice to guru in no time.

RRP$349, from Eastside Studio Parnell, Verve Wellness Tauranga, Total Body Gisborne, selected pharmacies or online at elvie.nz or 0800 235 435

1,000 DAYS TO RAISE A BUNDLE Plunket has launched an ambitious 1,000-day campaign to raise awareness of the vital role that the charity plays in the first 1,000 days of a child’s life. “The best research shows that what happens to a child in their first 1,000 days will influence their entire life,” Plunket Chief Executive Amanda Malu says. “The type of care that a child receives in that critical time can be the difference between a life of happiness, or a life of hardship. It will influence the adult that he or she will become and the path that child will follow. Plunket is in the unique position of being able to provide that all-important care in the first 1,000 days, with our nurses visiting the homes of 90% of all children born in New Zealand. Our 1,000 Days to Raise a Bundle campaign will help us to raise the $4 million that we need each year to continue our work in the community, and to ensure we’re able to provide these important services when and where they are needed.” raiseabundle.org.nz

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Pregnancy BUMP & baby


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'S A DEVELOPING BABY NG PI HEAR T STAR TS PUM . BLOOD AT SIX WEEKS , HT BY WEEK EIG S A BABY'S HEAR T BEAT REGULARLY ABOUT 160 TIM ES A M INUTE.

CLOSE TO YOUR HEART LoveLoops (loveloops. co.nz), a NZ online brand known for exquisite personalised jewellery, have just released the brand new LoveHearts Collection. Made with love here in NZ, these dainty little necklaces are simply stunning. Each LoveHeart is engraved with a single letter, and you can add as many LoveHearts as you like to your very own necklace. t3 Aven

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TRIED & TESTED The super-convenient Avent 3-in-1 Electric Steam Steriliser sits on your benchtop and uses natural steam (no chemicals or tablets) to sterilise baby bottles, teats, dummies, breast pumps, and more, killing 99.9% of harmful germs. Check out our editor’s thorough review at bumpandbaby.co.nz!

RP$20 9.9 9, philips.co.nz

for sto

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You know you’re a mum when… “YOU CONGRATULATE SOMEONE FOR BURPING!” ~ ANGIE

“YOU CARRY BABY WIPES WITH YOU EVERYWHERE.” ~ SCARLETT

Pregnancy BUMP & baby

13


NOTEWORTHY

TIMELESS MOMENTS

FACT

A TYPICAL PREGNANCY — MEASURED FROM OVULATION, NOT THE LAST MENSTRUAL PERIOD (WHICH IS STANDARD) — ACTUALLY LASTS ABOUT EIGHT MONTHS AND 24 DAYS, NOT NINE MONTHS.

We all know how quickly our little ones grow and change, and it can feel both heartbreaking and exciting at the same time. Children's portraitist Julia True understands the value of capturing precious moments as they pass. Using bold brush strokes, soft blush, and earthy hues, Julia transforms your favourite photo into a piece of art. Portraits start at $200. Instagram: @thejuliatrue or thejulztrue@gmail.com

Did you know HAD YOUR APPENDIX OR TONSILS OUT? A new study has shown that women who have their appendix or tonsils removed when they are young are more likely to get pregnant, and do so sooner, than the rest of the population. The study examined the medical records of women in the UK. Pregnancy rates were significantly higher among those who'd had an appendectomy (54.4%), tonsillectomy (53.4%), or both (59.7%) than those in the rest of the population (43.7%). “For many years medical students were taught that appendectomy had a negative effect on fertility,” said Sami Shimi of the University of Dundee. He added that the findings should not be taken as a sign that women should seek an appendectomy or tonsillectomy thinking it would increase their chances of becoming pregnant. “This research does not mean that removing a normal appendix directly increases fertility,” said Mr Shimi. “It does however mean that young women who need to have their appendix removed can do so without fear of the risk on future fertility.”

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Pregnancy BUMP & baby

HANDMADE WITH

$30 a set from facebook.com/Maminkanz

Maminka is where you'll find that beautifully handmade baby gift for your expecting daughter, friend, or sister! Sets include a bib, wooden teething ring, and burp cloth all made out of fun and funky 100% cotton fabrics. A gift handmade with love!


SUKIN PRODUCTS ARE <3 Natural

<3 Effective

<3 Affordable

<3 Australian made <3 Safe for babies and infants


NEW BABY SKINCARE RANGE

GOT BREAST MILK? Older babies who have started solids will enjoy this summertime treat – breast milk ice cream! YOU WILL NEED • 1 cup breast milk • 5 cups crushed ice • 75ml salt • One sandwich-sized and one large snaplock bag

FOR MUMS ONLY Booster Biscuit Mix for Breastfeeding Mums is packed with galactagogue ingredients oats, linseed, and brewer’s yeast to support breastfeeding mums. Add egg and butter and bake at home for delicious oaty biscuits you won’t want to share with anyone else. $9.90 from breastmates.co.nz

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Pregnancy BUMP & baby

HOW TO MAKE

1. Put the breast milk into the smaller snaplock bag. Seal tightly. 2. Fill the large bag with the ice, and sprinkle salt on top of the ice to help it keep its temperature. 3. Place the small bag of breast milk into the bag with the ice and salt, then seal the large bag. Massage the bag until the breast milk sets to ice cream consistency. Freeze to completely set.

HELP BRING THE PURPLE BUTTERFLY TO NZ The Neonatal Trust and Multiples New Zealand have partnered up to bring the “Purple Butterfly” sticker initiative to New Zealand. The Purple Butterfly sticker initiative was developed in the United Kingdom by Millie Smith after the passing of one of her newborn twin daughters. This emotional experience prompted Smith develop the Purple Butterfly sticker, which can be placed on cots and incubators in hospital to tell other parents and medical staff that the baby is part of a multiple pregnancy where not all of the other babies survived. Neil O’Styke, Executive Director of The Neonatal Trust, said, “The Purple Butterfly initiative is great and will assist families struggling with the process of mourning the loss of one child while also looking after and bonding with another.” Visit givealittle. co.nz/cause/purplebutterfly2nz/ donations to help raise the $5,000 needed to bring this initiative to NZ.

The baby care aisle of your supermarket just got a little greener thanks to Kiwi skincare company Skinfood, which has just released its first ever range for babies and young children. With products that are 100% natural and certified organic by ECOCERT, the Little Skinfood collection (RRP$11.99-$17.99) is easy on your budget as well as your baby's delicate skin. littleskinfood.co.nz


Fo llow us From our BUMP to yours… Join us for a little extra love for your bump each day!

Join 27,000 other BUMPs and new parents who love our exciting giveaways, plus the latest trends and advice on all things pregnancy and baby.

bumpandbaby.co.nz facebook.com/bumpandbabynz pinterest.com/bumpbabynz instagram.com/bumpandbabymagazine tiktok@bumpandbabymagazine

Pregnancy BUMP & baby

17


The latest thought-provoking and relevant books for expectant mums and newbie parents.

Golden Month, by Jenny Allison (Beatnik $30). If you're looking for a way to maximise the first few weeks following the birth of your baby, this little book has some great advice. It breaks down practical methods to caring for new mums and their newborns; perfect for mums, dads, relatives and caregivers alike. Hipster Baby Names, by Tobias Anthony (Smith Street Books $26.99). Do you live in the inner-city and own a fixed-gear bicycle? Do you have a passion for all things bespoke and esoteric? Are you currently in the throes of an epic craving for vegan cookies? Most importantly, are you expecting a baby? From historical figures and Greek mythology to literary references and pop-culture icons, these handpicked baby name ideas will become the trendiest monikers on the playground. Spilt Milk Yoga, by Cathryn Monro (Exisle $24.99). In 52 short chapters designed in an easy-to-read font especially for sleepdeprived new mums, this “companion to the inner journey of motherhood” will get you thinking deeply about being a mum and what it means to you – even in the not-so-nice times. Breathe, by Jean Hall (Quadrille $14.99). Are you breathing the wrong way? This portable book helps you correct and control your breathing, teaching simple methods to increase awareness and mindfulness. Great for mums preparing for childbirth as the techniques are helpful for promoting calm and relaxation. Oh Baby... Birth, Babies, and Motherhood Uncensored, by Kathy Fray (Random House NZ $45). First published in 2005, this guide for pregnant women and new mums has been revised and updated by its author, a midwife, to reflect current trends and info relating to medicine, parenting, and technology. A great Kiwi guide to early motherhood. The First Six Weeks, by Midwife Cath (Allen & Unwin $32.99). The first few weeks of a baby’s life can be challenging for any new parent, even if you’ve been there, done that! This practical, easy-to-read guide covers all aspects of a newborn’s first six weeks, from caring for your baby to coping with the sudden emotional and physical changes of new parenthood. Talking Baby, by Margaret Maclagan and Anne Buckley (Finch $24.99). The authors combine a comprehensive understanding of speech development with fascinating scientific facts – did you know that babies cry with an accent? – to offer practical suggestions and real-life examples of how parents can help their children to learn to talk, right from birth. Dr Libby’s Women’s Wellness Wisdom, by Dr Libby Weaver (Little Green Frog $39.95) This gorgeous book offers insight, knowledge and practical solutions for a holistic approach to optimal health and happiness. Different to anything Dr Libby has written before, it's beautifully illustrated, includes step-by-step guides, worksheets, real-life examples, and quotes to help uncover sources of challenges and empower women with the knowledge to better understand their bodies to create a healthy life.

Your Baby’s First Word Will Be Dada, by Jimmy Fallon (Hachette NZ $19.99). Everyone knows that fathers wage a secret campaign to ensure that their babies’ first word is “Dada” – but how does it work?

How It Works: The Dad, by JA Hazeley and JP Morris (Michael Joseph $21). The latest in the wildly popular Ladybird Book series of titles designed to help grown-ups cope with the world around them, the retro illustrations and tongue-in-cheek text are perfect for reading aloud… To other dads, over a beer, when the kids aren’t in earshot.

FOR NEW DADS

What we’re reading

IF YOU’RE LOOKING FOR A GIFT FOR A DAD-TO-BE, CHECK OUT THESE THREE AMUSING TITLES.

BOOKSHELF

My Dad Used to Be So Cool, by Keith Negley (Flying Eye Books $24.99). The child narrator of this picture book is sure his dad used to be in a rock band, and ride a motorbike – what happened to make him give it all up? Especially for dads who are worried they’ll lose their cool.


“MYI LOVE PALMER’S BELLY” As my belly continues to grow, I get really concerned about stretch marks. That’s why I’ve always trusted Palmer’s to keep my skin looking beautiful and healthy.

- JENNIFER LOVE HEWITT

Available in New Zealand from pharmacy, supermarkets and department stores. Wilson Consumer Products, Auckland 0800 651 044 * IRI INFOSCAN 52 WEEKS ENDING 7/12/15 F/D/Mx UNITS. ** 2011 Independent study conducted on Palmer’s Massage Lotion and Massage Cream For Stretch Marks

HYPOALLERGENIC • PARABEN-FREE • PHTHALATE-FREE • DERMATOLOGIST TESTED


SUBSCRIBE & WIN

We have the most amazing magazine subscription offers, including beautiful pregnancy packs and chances to win great prizes.

Yay, you’re pregnant! Choose from the following: Single issue hard copy or digital copy

Digital copy pregnancy bundles

2-issue subscription and PeekaBox combo

Subscribe at

BUMPANDBABY.CO.NZ


FIND IT ALL AT OUR MALL BATHING BOOKS & MAGS CLOTHING FEEDING & NURSERY PL AY & LE ARN FERTILIT Y HE ALTH & WELLNESS NAPPIES & CHANGING NURSERY OUT AND ABOUT SAFET Y SKINCARE SLEEP TEETHING & DUMMIES

GET EVERYTHING YOU NEED, WITHOUT LEAVING THE HOUSE Home to Kiwi mums’ favourite brands, BUMP&baby Mall (bumpandbabymall.co.nz) is your one-stop baby shop. PREGNANCY

&


As your fertility clock ticks onward, what can you do to help increase your chances of conceiving?

NATURE WAITS FOR NO ONE, AND THIS IS PARTICULARLY TRUE WHEN TRYING FOR A BABY. SO YOU MIGHT WANT TO LOOK INTO FERTILITY SCREENING NOW RATHER THAN LATER. 22

Pregnancy BUMP & baby


FERTILITY

Trying to conceive?

If you’re trying for a baby, what do you need to know beforehand? Dr Olivia Stuart, Fertility Specialist, Gynaecologist and Obstetrician at Fertility Associates Auckland, sheds some light.

K

iwi women are having their first baby later in life. We are being told to reach our career potential, be financially secure, and have a suitable partner before we start a family. This means that many women are hoping to become pregnant in their late 30s and early 40s, at a time when our fertility is already declining. My advice to all women considering having a baby in their 30s and 40s is to understand your own biological clock. Fertility Associates has developed an online tool to help identify a woman's chances of giving birth at any given age. It is also designed to help identify the right time to seek help if you are not getting pregnant. Check it out at biologicalclock.co.nz.

Helping you prepare

When trying for a baby, there are some important changes you can make to your lifestyle to increase your chances of having a healthy baby.

FOR WOMEN • Have a BMI of 20-25. A healthy body mass index (BMI) is associated with better fertility. Being overweight or underweight can reduce fertility, so it is important to keep your body weight within the normal healthy range. Body Mass Index (BMI) is an indication of your body weight and can be calculated by dividing weight (in kg) divided by your height (in metres squared). You should aim for a BMI of between 20 and 25, as this will optimise your chances of conception. Pregnancy in overweight women is associated with problems such

as diabetes and high blood pressure. Eat a healthy diet and get regular exercise. • Don’t smoke or do drugs. Smoking halves the chances of conceiving each month and doubles the chances of miscarriage. Nicotine patches and electronic cigarettes are not advised as they also contain some of the harmful chemicals in tobacco. Marijuana and other illicit drugs reduce your chances of pregnancy, increase your risk of miscarriage, and can be highly damaging to the unborn child. Discuss all your medications with your doctor. • Take appropriate supplements. Folic acid reduces the risk of neural tube defects such as spina bifida by over 90% when 0.8mg is taken daily, starting one month pre-conceptually and until 12 weeks gestational age. Particular groups of women require the higher 5mg daily dose of folate such as diabetics, those on anti-convulsants or a previous history of a baby with a neural tube defect. A pregnancy multi-vitamin may be needed if you feel your diet has deficiencies. Vitamin A is a known teratogen causing foetal abnormalities and should not be taken in women trying to conceive or during pregnancy. • Reduce alcohol and caffeine. Caffeine may reduce your chances of conceiving. There is no safe limit of alcohol during pregnancy. Small amounts of alcohol are probably not detrimental but excessive alcohol can reduce your chances of pregnancy by up to 60% and drinking during pregnancy can cause foetal abnormalities. I recommend not drinking while trying to conceive or during pregnancy. Pregnancy BUMP & baby

23


FERTILITY

WHEN TO SEEK HELP

MONTHS TRYING

18

When should I seek help?

One in four people experience infertility in New Zealand, so seeking help early is the best thing you can do. The average 36-year-old takes at least six months to conceive. So we recommend that women over 36 should wait no more than six months before seeking help. But if you are concerned at any age, don’t delay. Having a conversation with a specialist is the very best thing you can do to understand your options.

15 12 9 6 3

AGE 26

28

30

32

OK TO WAIT

• Update your immunisations. Make sure you have had a rubella immunisation. Rubella can damage unborn babies. Also, find out if you have had chicken pox. If not, consider immunisation. • Try acupuncture. Acupuncture can be very helpful as a stress-relief technique and can be beneficial to those trying for a baby.

FOR MEN

CHANCE OF PREGNANCY

• Don’t smoke or do drugs. Smoking and recreational drugs can reduce sperm quality. • Reduce alcohol intake. Decrease your alcohol intake to 20 units or less a week. Alcohol has also been shown to affect fertility. • Have a normal BMI. Keep active and stay slim. Obese men have sperm counts 22% lower, on average, when compared to their slimmer counterparts. Keep your body mass index (BMI) below 28. • Keep testes cool. Wear boxer shorts, not briefs, as this helps the testes to keep cool. Men in sedentary jobs can have poorer quality sperm because their testes are more prone to heating up. Keep your laptop off your lap! And don’t have a hot bath, sauna, or spa too frequently.

24

Things to consider before starting fertility treatment

• You are important. Knowing that you are going to have doctors and nurses available to you that can be called on throughout your treatment is vital. So look for a team that you feel comfortable with. • Consider starting immediately. Nature waits for no one, and this is particularly true when trying for a baby. If you are thinking of having a baby, consider taking up fertility screening immediately. • “Know how” is key. Each fertility case is unique; however, you want a clinic that can draw on local case studies and success rates. Their success is your success. • Use trusted fertility specialists. IVF treatment is a very complex procedure where every step must be precisely performed. Look for a clinic that has a qualified team of fertility specialists. Each clinic is unique – trusting that your chosen clinic is established and has a history of delivering local successful results is important to your own experience. • Understand the costs and investigate the payment options. Some clinics provide an option where you pay upfront for three

CHANCE OF BABY

38

CONSIDER ACTING

40

42

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TIME TO ACT

cycles and if you are not successful after three attempts, they refund a significant portion of the cost. Check out fertilitycover.co.nz. • Go for the best chance. When looking at costs, it is also important to go with the clinic that will give you the best chance of success, as repeat cycles will only add to the cost. • Technology matters. In order to obtain the best possible results, IVF treatments require the latest technology. You should check that the clinic has access to the most adequate equipment and the latest proven techniques for your treatment. • Support is key. You may not be telling many people, but having a core group of friends or family you can talk to when you need to is ideal. Counselling is often offered with fertility treatment, so read the fine print. Support may be included.

FACT

ONE IN FOUR PEOPLE EXPERIENCE INFERTILITY IN NEW ZEALAND, SO SEEK HELP EARLY.

Age is the most important factor when trying for a baby. A woman is most fertile in her 20s, when it can take about three to four months to conceive. As per the graph at left, you can see from 35 years onwards, there is a decline in the chance of conception per month.

WITH IVF - PER CYCLE

30% 20% UNASSISTED - PER MONTH

10%

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Understanding Age

50% 40%

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+ Age is important for women with 26

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normal fertility, and also for people needing fertility treatment.



Is it time to give your family's financial future a little check-up?

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PLANNING AHEAD

Insuring your family ’s future Whether you’re deciding how best to protect your family with a life insurance policy, health insurance to cover your new family’s medical needs, or you’re concerned about your job and considering an income protection plan, it’s essential you’re doing all you can to protect your family’s financial future.

A

s a new parent or a parent-to-be, your health and wellbeing and that of your family is important to you. And while insurance is not something you think about every day, the arrival of a new baby is a good time to take a closer look at just how much cover your family has.

Health insurance

When you weigh up whether or not you need health insurance, consider what it would cost to cover you and your family for major health expenses like surgery, as well as your day-to-day doctor visits. Thankfully, New Zealand’s public health system provides excellent cover in emergency and acute surgery situations. But for non-emergency and elective procedures, you’ll be assessed by the public health system and wait-listed, which means you could be put off for a week, a few months, or even years. Self-insuring is an option, provided you’re disciplined about putting money aside each month for health costs. But for most families with young children, health insurance is the obvious solution. There are a number of benefits to health insurance for families, most important of which is being able to get medical treatment for your family as soon as it’s needed. Health insurance lets your family get the treatment they need without having to wait. If you don’t already have health

insurance, you can take out a policy for you and your baby at the same time. For existing policies, it’s a good idea to add your new baby to your health insurance as early as possible, ideally within the first three months after birth. This is the grace period where you can add your baby without providing any medical statements. Adding your baby to your health insurance is usually a simple process of letting your health insurance provider know your baby’s name and birth date; there are no forms to fill in and, more importantly, no exclusions. Keep in mind, though, that any medical condition your baby is born with or that may develop in the first 90 days is considered congenital. Congenital conditions are usually excluded from a baby's health insurance cover.

Choosing health insurance

Generally, there are two main types of health insurance that offer varying levels of cover between the two. A major medical plan covers hospital and specialist cover only, but doesn’t cover day-to-day health costs. Comprehensive plans, on the other hand, offer a much wider range of cover, usually including major medical costs and day-to-day health costs like doctors’ visits, prescriptions, and dental. When choosing a health insurance provider, the cost of your health insurance will depend on the number of people Pregnancy BUMP & baby

27


PLANNING AHEAD

WHILE INSURANCE ISN'T SOMETHING YOU THINK ABOUT EVERY DAY, THE BIRTH OF A NEW BABY IS A GOOD TIME TO SEE HOW MUCH COVER YOU HAVE. Choosing life insurance

included in your policy, the level of cover (major medical versus comprehensive), and any excess (the amount you would need to pay towards the cost of each insurance claim). If you choose a higher excess, you usually pay a lower premium. Many health insurance providers offer additional family benefits like low-claim rewards, discounts for two or more children, or paying child rates until 21 years of age, so it’s worthwhile shopping around and comparing family benefits from a number of providers. If you think that health insurance is the right option for you and your family, there are a few ways you can help contain your costs. Most health insurance providers offer discounts for those who lead healthier lifestyles, like non-smokers or those who exercise regularly, so live well and save. Take advantage of group rates that may be available through your employer, or choose to pay a higher excess in order to save on your monthly premium. Get in early, because by taking out health insurance before you actually need it, you avoid being turned down for “pre-existing” conditions that can develop later on.

Life insurance

When you’re just starting out as a young family, it’s hard to imagine anything going wrong. But the reality is, the income you earn, the house you live in, and even the health of your children could be affected if something happened to the income provider in your family. It’s important to know that your family is protected in the event of an unexpected incident. Life insurance not only provides your family with an income if you pass away, it also covers your mortgage or rent payments and your loss of income if you’re unable to work due to illness or trauma.

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When deciding how much life insurance you need, consider your personal situation and how much your family would need if something happened to either you or your partner, and you were no longer able to provide an income. One rule of thumb is to ensure your life insurance provides between five and 10 times your annual income. But everyone’s situation is different, and the amount of insurance you need will depend on the following factors: • How much your family spends annually on things like housing, food, and clothing. • How much your family would need to cover large expenses, like university fees. • How much your partner earns to determine how much of your family’s expenses are covered by their earnings. • How much your investments and other assets are worth. • How much debt you currently have. With any life event – marriage, a new baby, divorce – it’s important you review your existing insurance to ensure you’re sufficiently covered or not paying too much for life insurance you don’t actually need. Any change in your life is a signal it’s time to review your life insurance. It’s a good idea to talk to an insurance adviser about your personal situation, and compare life insurance policies to ensure you’re getting the right cover for your particular needs.

Trauma or critical illness cover

Suffering a serious illness is understandably devastating. But having to deal with the financial burden of trying to provide for your family while you or your partner is ill can be a far greater strain. In most cases, someone who suffers from one of the four main illnesses (heart attack, heart disease, cancer, or stroke) can survive for years beyond the critical incident, but in many cases won’t be able to work. That means a significant change in the family's lifestyle. A trauma or critical illness insurance plan provides a one-off lump sum if you are diagnosed with a qualifying critical illness event. The plan can be purchased either in conjunction with a life insurance policy where a claim will reduce the life cover, or on its own as a stand-alone benefit.

These policies usually cover around 35 medical conditions including heart attacks, strokes, and cancers, any one of which may disable you for a period of time or permanently. The lump-sum payment can be used to cover your loss of earnings if you are unable to work, help fund additional medical care you may need, pay for home help or childcare, fund necessary modifications to your home, or simply be used to pay off debts like your mortgage. You decide on the level of cover you want to be paid out to you in the event you suffer a qualifying critical illness or trauma, and your premiums will be calculated accordingly. There are usually a number of optional features to these plans like a funeral benefit, additional cancer benefits, and a children’s benefit. Although children under the age of 16 can’t be covered by life insurance, there are a number of insurance providers that offer children’s trauma and illness cover that is designed to help pay for some of the expenses you would incur should your child have a major illness. Along with paying your medical expenses, this type of policy also protects your income should you need to take time off from work to look after your child. So your mortgage or household bills are covered while you focus on treatment and recovery. Children can normally qualify for this type of cover from age one up to 21.

Future insurability

Now you’ve arranged insurance cover for you and your partner, consider your child’s future insurability by securing their future ability to take out life insurance. Many insurance providers offer an option to have your child pre-approved before they turn 15, so that when they reach a certain age or a specific event happens, like getting married, they are guaranteed to be able to get life insurance. Even if they develop any severe illnesses during their childhood, it won’t impact their insurability as an adult. In return for a fairly low premium each month, you’re able to lock in your child’s future insurability option, without them having to provide any medical, financial, or occupational information if they opt to take out a life insurance plan. It’s a little bit of foresight that helps protect your child’s future and family.


Health cover for you and baby too Now your family’s getting bigger, you might want to think about the benefits of health insurance. That way, if your little bundle of joy becomes ill, you can be sure he or she will get the treatment they need when they need it. The same goes for you and the rest of the crew. Whatever the size of your family, you can bundle them all up in one policy. Easy. Talk to us about SmartCare+ • Get free cover for babies up to 6 months old. • List all your children on your policy and only pay for the first two. • Get an accommodation benefit if you need to accompany your child for treatment out of town. • Keep your kids on your policy up to age 25 at special rates.

Find out more at accuro.co.nz or call 0800 ACCURO (0800 222 876) facebook.com/Accurohealthinsurance | www.accuro.co.nz Terms and conditions apply.

ACC6950 10/16

CARING FOR THE HEALTH OF YOUR FAMILY FOR OVER 45 YEARS


The first

14 weeks

The first trimester of your pregnancy is a time of great change for your baby and for your body, says Tiffany Brown.

F

rom the first few weeks when the embryo is implanted in your uterus, right through to the 14-week mark when an ultrasound scan may clearly show you baby-like characteristics such as arms, legs, and even fingers and toes, this first trimester of your pregnancy is ultimately crucial for your baby’s development. It is also an important time for a pregnant woman and her partner to wrap their heads around what lies ahead. And it’s a time where you need to look after yourself, and be supported by those who love you, as you embark on both a physically and psychologically lifechanging journey towards parenthood.

HOW YOUR BABY GROWS WEEKS 1 TO 3

The medical definition of the pregnancy term of a 40-week gestation has conception occurring around two weeks after your last period starts. As such, weeks one to two are actually a “non-pregnant” time. During week three, however, fertilisation and implantation get that pregnancy ball rolling. Dad’s sperm gets together with Mum’s egg and forms a one-celled entity called a zygote, which typically has 23 chromosomes from each parent. These 46 chromosomes determine the sex, eye and hair colour, and to an extent the personality and intelligence of your little one.

WEEKS 4 TO 6

By around week four, the zygote has travelled down the fallopian tube to your uterus, and begins the process

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of implantation. This rapidly-dividing, two-sectioned cluster of cells, called a blastocyst, is forming an embryo inside, and a protective layer of cells on the outside. Once in contact with the uterine wall, the blastocyst burrows inside for nourishment. (Hurrah! Impantation!) Also beginning to form now is the placenta, which will produce hormones, provide nutrition, and deal with baby’s waste products in the coming weeks. As early as five weeks into the pregnancy, your baby’s brain, spinal cord, heart, and other organs begin to form. The embryo now consists of three layers. The ectoderm – or top layer – will form the skin, central and peripheral nervous systems, eyes, inner ears, and connective tissues. The central layer – or mesoderm – is the foundation of the heart, the early circulatory system, bones, muscles, kidneys, and much of the reproductive system. The endoderm, or inner layer of cells, becomes a mucous membrane-lined tube where your baby’s lungs, intestines, and bladder develop. Despite beginning the important business of forming all these essential body parts, your baby still looks rather like a tadpole at this point, and measures just about a quarter of a centimetre in length.

FIVE

Development continues to ramp up around week six. The neural tube running along your baby’s back closes, and if you have a scan at around this time, you should see a pulse where the chambers of the tiny heart are beginning to pump blood. Basic facial features start to take shape, with dark spots where the eyes will be, openings for the nostrils and pits to mark the ears. Baby’s body starts to curl into a “C”, and small buds appear, destined to become arms and legs.

WEEKS 7 TO 9

By the end of week seven, your baby is not quite as big as a cashew nut. Even still, their face is continuing to take shape, with nostrils becoming visible and eye lenses beginning to form. The brain continues to develop, as nerve cells reach out to each other, forming primitive neural pathway connections. The arm buds that appeared last week now look like tiny paddles. From around the eight-week mark through to about halfway, or 20 weeks, there will be rapid growth, including major development of the heart, brain, and the other body parts that were formed in the first few weeks. At eight weeks, your baby’s body starts to straighten out as arms and legs grow longer. Fingers, upper lip, and

weeks into pregnancy, your baby's brain, spinal cord, heart, and other organs begin to form. But it still looks more like a tadpole than a baby at this stage, and measures about a quarter of a centimetre long.


FOCUS: FIRST TRIMESTER

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What NOT to do in the first trimester WHETHER YOU KNOW YOU’RE PREGNANT OR NOT, GIVE THE BOOZE A SWERVE. YOUR BODY WILL THANK YOU FOR IT EITHER WAY. ALSO ON THE DON’T LIST IN THE FIRST TRIMESTER: Don’t smoke or take drugs. Don’t drink alcohol. Don’t take medications or nutritional supplements without checking they are safe for use in pregnancy. Don’t get over-heated. Don’t stress out. Don’t eat certain high-risk foods, like sushi (sigh!), soft-serve ice-cream, raw fish, pre-prepared deli meats, sandwiches, and salads, or any leftovers that have not been re-heated to piping hot (for a complete list of foods you are recommended to avoid during pregnancy, see health.govt.nz/ your-health/pregnancyand-kids/helpful-adviceduring-pregnancy).

+ + + + + +


nose are forming, along with the shellshaped parts of the ears. Most excitingly, the eyes are now visible as eyelids and ears continue to develop. By now the placenta has developed to the point of taking charge of producing hormones, giving many mums welcome relief from symptoms of morning sickness. Through the ninth week, baby’s arms grow in length and form bones, and begin to bend at the elbows. Wrists, ankles, fingers, and toes have also formed. Despite measuring a mere 20mm in length, your baby is looking distinctly more baby-like.

WEEKS 10 TO 12

Week 10 brings the development of the neck, as the head becomes more rounded and the eyelids begin to close to protect the developing eyes. All the vital organs are now formed and functional, and your baby is quite active now, swallowing fluid and kicking its arms and legs around. External genitalia form during week 11, and while the head still measures around half the length of your baby, the body is beginning a big growth spurt to catch up. If your baby is a girl, she has about two million eggs in her tiny ovaries. By the time she is born, this number will have dropped to about a million, and will continue to drop away as she grows up. (Now you can see why you might have

had a bit of a job conceiving her!) With all requisite parts now in place, your baby is officially described as a foetus. With low-set ears, fused eyelids and widely separated eyes, at 12 weeks along in your pregnancy your baby’s face now has a distinctly human profile. Reflexes are developing as foetal nerve cells multiply rapidly and synapses, or neural pathways, form. Baby can close their fingers, curl their toes, and clench their eye muscles.

WEEKS 13 TO 14

Fingernails have now been formed, and tiny fingerprints appear at the top of your baby’s fingers. Week 13 also sees your baby exercising the sucking muscles in their cheeks, practising their “rooting” instinct. This is the instinct that kicks in to guide your baby to search for your nipple for sustenance and comfort soon after birth. By week 14, your baby will measure around 8cm from crown to rump and weigh about 40 grams. The kidneys have begun to produce urine, which is released into the amniotic fluid. Fine, downy hair called lanugo begins to grow this week, protecting your baby’s ultra-thin skin. Hair on the head and eyebrows begins to grow too. Impulses in the brain are starting to direct facial expressions like squinting, frowning, and grimacing, exercising baby’s facial muscles.

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ALSO CALLED "MORNING SICKNESS", PREGNANCY NAUSEA MAY STRIKE AT ANY TIME AND IN VARYING DEGREES FROM AS EARLY AS THREE WEEKS.

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WHAT ABOUT MUM? Even though you may not become aware of your pregnancy until a few weeks have passed, it’s important to try to maintain a healthy lifestyle if you are in a position where you may become pregnant. Focus on getting your nutrition, exercise, and stress management in balance. This will stand you in great stead for pregnancy and caring for a young baby. A healthy, balanced diet is important to ensure you are in tip-top shape to nurture your baby to term. In utero, babies pull everything they need from their mum, and if you’re not sufficient in certain nutrients, your pregnancy can leave you in deficit, making it harder for you to recover from birth, and more difficult for you to care for your infant. Particularly focus on your iron, calcium, and energy stores, and seek guidance from a health practitioner or nutritionist with expertise in caring for women through pregnancy. The first physical change you’re bound to experience in the early weeks of your pregnancy is fatigue, or at least an increase in tiredness. Nausea is the next common symptom. Also called “morning sickness”, pregnancy nausea may strike at any time and in varying degrees from as early as three weeks. The biological explanation for tiredness and nausea gives the cause as the overwhelming task your body is undertaking. But the school of old wives’ tales may also give you some comfort. They speculate the body tires in order to provoke rest, which helps your baby grow through the magnificent early changes with plenty


FOCUS: FIRST TRIMESTER Your baby is growing and changing even before you get a positive test result!

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perinatal depression. If you feel down in the dumps for longer than a week, reach out to your healthcare professional, LMC (lead maternity carer), or even a sympathetic friend or family member. What you’re feeling is very normal, and there are solutions to getting back on track and enjoying the rest of your pregnancy. Exercise can help tremendously with fatigue, morning sickness and stress. Many mums manage to continue with their physical activity all the way through pregnancy. For the majority, however, it’s important just to try and maintain a regular, moderate level of activity. Walking, swimming, and yoga are perfect exercises to do through pregnancy, so try to work at least one of these pursuits into your daily

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of energy. And perhaps nausea kicks in to veer expectant mothers away from risky choices, particularly in relation to food consumption. Many women will experience pregnancy headaches, mostly caused by hormones and sometimes by postural changes. Drink plenty of water during the day, be mindful of your posture, avoid straining your eyes, and eat small, nutritious meals several times throughout the day. Neck, shoulder, face, or scalp massages can help, as can a warm or cool compress on your forehead or the back of your neck. Emotionally, you are experiencing an unprecedented time of change and anticipation. Many women struggle with such an emotional load, and may slide into

schedule, beginning in the first trimester. Another important component to a successful pregnancy is ensuring you manage to fit in some relaxation time. This is particularly relevant if you’re a career girl, have a busy lifestyle, or find it hard to “switch off”. Life as you know it carries on through the early part of pregnancy, and often you’ll choose not to let anyone know that you’re pregnant, adding another dimension of pressure to your rapidly changing world. Even the most chilled-out women can experience great emotional turmoil as they begin to come to terms with the enormous journey ahead of them. Pregnancy hormones also begin to kick in during the first trimester, bringing this immense emotional landscape into even sharper focus. Exercise can help get you into a meditative state (now there’s a nice “two birds, one stone” scenario!). Talk with your partner, family, or friends, create some “me time” to indulge in the activities that centre you, enjoy a relaxing bath at the end of the day, or use self-directed or guided meditation to soothe your busy mind and keep your spirit in balance. Again, getting into the habit of regularly relaxing in the first trimester will set you up well for the rest of your pregnancy. As you enter the second trimester, many women find their pregnancy symptoms ease off until the “big and uncomfortable” stage creeps up towards the end. If you are able, the second trimester is the perfect time to take a break. Many women go on holiday around this time, when comfort is at its peak, and find it a wonderful way to connect with their partner and prepare themselves both mentally and physically for the rest of their pregnancy and beyond.

Pregnancy BUMP & baby

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BEFORE, DURING & AFTER PREGNANCY SMART FISH OILS FOR “YOU” AND “YOUR BABY” FOR HEALTHY BRAIN & EYE

Nutrition for the brain for both Mum and baby Supports optimal gestational length and birth weight .1 Supports post-natal mood balance .2 Mumomega for Mum and baby before, during and after pregnancy. Eye Q Baby from 6 months - 2 years for healthy brain and eye.

Give your child the very best start in life; you can also help to keep yourself in the best health too. Equazen uses only the highest grade fish and evening primrose oils free of toxins. Always read the label and use as directed. Supplementary to a balanced diet. TAPS PP8483

Exceptional supplements proven by science and provided by nature. Mumomega and Eye q baby are available at pharmacies nationwide.

For more information contact Pharmabroker Sales Ltd , Albany Auckland Ph 415 5050 FREE Phone 0508 664455 REFERENCES 1. McGregor JA et al. Clinical Update A supplement to OBG Management July 2003S1-S12 2. Hibbein JR J Affect Discord 2002 ,69:15-29


NECESSARY NUTRIENTS

Should you take supplements during pregnancy? Iodine and folic acid are essential for pregnant mums, but there are other supplements you may want to consider, explains nutritionist Jessica Giljam-Brown (wellnessbyjessica.com).

T

he most important step you can take towards ensuring a healthy pregnancy and baby is to follow a nutrient-dense diet for the duration of your pregnancy. Nutrient supplementation during pregnancy can be thought of as an insurance policy to make sure you are getting the nutrients you need. Supplements can in no way replace a healthy diet – it is impossible to get everything you need in a tablet form – but they're a great way to top up on the essential nutrients for baby's development. There are two supplements which are labelled as essential for pregnancy the world over: Iodine and folate. Then there are also several other nutrients that are widely accepted as nutrients which should be supplemented during pregnancy due to their importance to foetal development. In most instances, it is best to get the nutrients you need from your food, but sometimes this just isn't practical or realistic. To get all the nutrients in the

found in seafood, seaweed, milk, eggs, and fortified cereals, it is a good idea to switch to iodised table salt during your pregnancy.

Folic acid

recommended amounts for the entirety of your pregnancy would take extremely careful planning and dedication. When morning sickness, fatigue, and cravings come into play, it's nice to know that you have the important nutrients covered.

Iodine

Iodine is essential for the development of baby's brain, nervous system, and thyroid, and should be supplemented throughout pregnancy and breastfeeding. It is recommended that pregnant and breastfeeding mothers take 150 micrograms per day as well as adding iodine-rich foods to their diet. Iodine is

Folic acid is critical in the formation of new cells and is particularly important when the foetus’s brain and spine are forming. Folic acid deficiency can cause spina bifida, a deformation of the spine which can lead to paralysis and lifelong complications. It is recommended that all pregnant women take a folic acid supplement (0.8mg/day) every day for one month before pregnancy and up until week 14 of the pregnancy. As soon as you make the decision to conceive or find out you are pregnant, you should start taking folic acid. Folic acid is found in dark green leafy vegetables, whole grains, and yeast extracts, so ensure to include lots of these in your diet too. Your primary healthcare provider or midwife can prescribe folic acid supplements for you. Pregnancy BUMP & baby

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NECESSARY NUTRIENTS

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especially recommended if you keep your skin covered, have pigmented skin – as you absorb less sunlight – or if you are pregnant during the majority of winter. Pregnant women should be getting a minimum of 4000 International Units of vitamin D each day. Your primary healthcare provider can prescribe you vitamin D supplements if it is likely that you are deficient.

Omega 3 fatty acids

Omega 3 fatty acids are essential for brain development for your baby, both before and after birth. These fatty acids also support the development of the immune system, and supplementation during pregnancy Zinc is needed for many biological has been shown to reduce allergies in the reactions in the body. It plays a critical role in the development of new cells baby later in life. and the formation of protein, as well as Omega 3 fatty acids are called “essential acids” because you must get them through supporting the immune system. It is very your diet, as the body can make very few of common for women to be zinc-deficient these fatty acids itself. Most people struggle during their pregnancy. The World Health to consume enough omega 3 Organisation estimates that as fatty acids normally, and it many as 80% of pregnant tip women are zinc deficient. becomes even harder during pregnancy when there is an During pregnancy, it is Some mums-to- increased need. Omega 3 fatty recommended to consume be have a hard acids are found in oily fish like 15mg of zinc per day; however, salmon, sardines, and mackerel, you may need more if you are time taking as well as walnuts, flax, and chia taking zinc and folic acid at particular the same time, as folic acid seeds. In order to get the pregnancy recommended amount of omega interferes with absorption. It is supplements 3 fatty acids (650mg/day), you recommended to supplement would need to eat approximately zinc up to 15mg/day and to because of 100 grams of salmon three increase dietary zinc too. Zinc morning is found in oysters, beef, lamb, times a week. For most pregnant sickness. pumpkin seeds, and leafy greens. mums, a supplement is more Take them realistic. When choosing a fish before bed and oil supplement, look for one Vitamin D plays a crucial role they might go which states that it has in the development of healthy down a bit more undergone mercury testing and bones and muscles, and normal is free from mercury. If you open easily than if you the bottle of fish oil tablets and nerve function in your baby. take them in they sell particularly fishy, then It is also important for this is a sign of a poor-quality maintaining a healthy the morning. supplement or one that has been pregnancy, as low vitamin D levels have been linked with on the shelf too long. Capsulated fish oil gestational diabetes, low birth weight, should smell clean, like fresh fish. and preeclampsia. Your skin makes vitamin D when Iron carries oxygen around the body, and exposed to sunlight, and is the main source of vitamin D. Vitamin D is also found in low levels can cause you to feel exhausted – even after a good sleep – and out of small amounts in eggs, butter, oily fish, and dairy products. Supplementation is breath after a short flight of stairs. During

Zinc

Vitamin D

Iron

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Pregnancy BUMP & baby

27mg IS HOW MUCH IRON PER DAY PREGNANT WOMEN NEED. pregnancy, you are supplying the baby with lots of iron, so you need to make sure that you keep your stores up. Animal products provide the most easily absorbed and utilised form of iron (haem iron). Plants are a good source of iron too, only the form in which it comes in is not as well absorbed by the body (non-haem iron). Pregnant women should be consuming 27mg of iron per day. The best way to get this is from your diet. Make sure to include red meat two to three times a week, as well as eggs, dark green leafy vegetables, and beans and lentils. If you don't eat animal products or simply don't eat meat very often, then it is important you supplement. The World Health Organisation recommends that iron is supplemented in all pregnant women as a deficiency can have a negative effect on brain development and cause low birth weight. While this list of supplements may be overwhelming, you can often find high-quality supplements designed for pregnancy which include all or most of the nutrients needed. When choosing a supplement, it is important that you take advice from a qualified nutrition practitioner. They can help you choose the right supplement and advise you of the right dose. In any health store or pharmacy you will find a large range of products and many different brands selling the same nutrient. Please remember that when it comes to supplements, more often than not the price reflects the quality. Never take a new supplement or medication until you are sure that it is safe for pregnancy or breastfeeding – talk to your midwife before you start a supplement which hasn’t been prescribed for you.


AVOIDING ACID REFLUX

Feeling the burn

Acid reflux, heartburn, or indigestion: No matter what you call it, the burning sensation in the middle of your chest or bottom of your throat after eating can become very unpleasant, explains nutritionist Jessica Giljam-Brown of wellnessbyjessica.com.

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ore than half of all mums-to-be will experience acid reflux at some point in their pregnancy. Acid reflux is when the stomach acid comes up into the oesophagus (the tube which goes from the mouth to the stomach). The oesophagus doesn't have a protective mucous layer like the stomach does, which is why you experience a burning feeling as the stomach acid touches the walls of the oesophagus.

WHAT IS IT? This not-so-lovely side effect of pregnancy happens for two reasons. Firstly, the hormone progesterone, produced by the placenta, causes muscles to relax in order for the uterus to stretch. However, this also causes the sphincter (valve) between the stomach and oesophagus to relax. When this sphincter relaxes, acid is able to move up into the oesophagus, when normally the Pregnancy BUMP & baby

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AVOIDING ACID REFLUX

WHAT ELSE CAN I TRY TO AVOID ACID REFLUX? sphincter would be tightly closed preventing stomach acid from passing. The second reason acid reflux occurs is because as your pregnancy progresses, your stomach gets compressed by other organs as the baby grows. While the stomach doesn't actually shrink, the space around it, in which it would normally stretch out to, has been compressed. As a result, less food can be consumed at one meal than earlier in pregnancy, if there is too much food and not enough space, then some will be pushed back towards to oesophagus.

WHY DID I GET IT? If you have a history of acid reflux before pregnancy, are overweight, or are having multiple babies, then you are at a much higher risk of suffering from acid reflux during your pregnancy. For most women, the acid reflux experienced during pregnancy won't have lasting health effects.

WHAT CAN I DO ABOUT IT? You don't need to suffer in silence if acid reflux is a problem for you. There are lots of things that can be done to prevent and reduce acid reflux to ensure you are as comfortable as possible throughout your pregnancy. Your primary care provider may choose to prescribe you antacids or medication to reduce the amount of acid that is produced by the stomach. Antacids work by neutralising the acid in the stomach, so that if the stomach liquid does come up the oesophagus, it won't burn. Reducing the production of stomach acid can help, as there will be less acid in the stomach to cause reflux. Carefully consider the use of these treatments, as both of these options may disrupt effective digestion. Stomach acid plays an important role in the breakdown of your food. If food leaves the stomach without being properly broken down by the stomach acid, it can lead to bloating and gas further down the digestive tract.

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Before resorting to medication, here are things you can try to minimise or prevent acid reflux: Chew your food properly: Wellchewed food is easier and faster to digest, meaning food will empty out of the stomach more quickly, preventing buildup which can result in acid reflux. Have small, frequent meals: Instead of three large meals, try having six smaller meals each day. This is especially appropriate if your acid reflux starts later in your pregnancy as the stomach becomes compressed. Eat sitting up: Let gravity help you. Sitting up helps the stomach acid to stay below the sphincter, between the oesophagus and stomach. Elevate the head of your bed: If acid reflux occurs at bedtime, then you can try elevating the head of your mattress by placing a few pillows underneath. This slight elevation is enough to use gravity in your favour to keep the stomach acid where it should be. Avoid eating two hours before bedtime: Allow your stomach sufficient time to empty before lying down to sleep. This will dramatically reduce the chance of acid reflux at night. Avoid smoking and secondhand smoke: It is well known that smoking during your pregnancy can have serious long-term effects on the health of your baby, but it

can also contribute to acid reflux. The nicotine in cigarettes causes the sphincter between the oesophagus and stomach to relax. If you would like help to quit smoking, talk to your primary health care provider or visit quit.org.nz for more information. Avoid trigger foods: There are many foods which are known to trigger acid reflux, including coffee, chocolate, alcohol, chilli, spices, garlic, raw onion, citrus fruit, tomatoes, soda, fizzy drinks including sparkling water, and black tea. Hard-to-digest meals such as protein-rich meals or particularly fatty meals like fish and chips may also trigger reflux, as these foods can sit in the stomach for a long period of time before they are digested and moved out of the stomach. Try keeping a food diary to see which foods are causing your reflux. Avoid peppermint tea and food flavoured with peppermint oil: Peppermint is well known for calming an unhappy digestive system, but calming the already relaxed sphincter at the top of the stomach will just make acid reflux worse. Don’t drink with your meals: It is best to drink water 30 minutes before or after eating, regardless if you suffer from acid reflux or not. Water dilutes the stomach acid making it less effective at digesting your food. Water with your meal may also cause your stomach to become over-full, causing acid reflux.


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Come out and play All-in-ones aren't just for babies. Playsuits are comfortable, practical, and keep everything covered . Plus they make your bump look so darn stylish. 42

Pregnancy BUMP & baby

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Pregnancy BUMP & baby


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FEED YOUR BUMP

Eat your greens! Green vegetables are not only nutritious, they are also a great source of vitamins and minerals which pregnant mums need to grow healthy babies. And summer is the perfect time to get your share of greens! These four recipes from Chelsea Winter’s new cookbook, Scrumptious, are not only easy to make, they’ll also give you a great dose of greens!

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COURGETTE, PEA & HALOUMI FRITTERS

tips Cooking the fritters over a slightly higher heat for a shorter time means that the egg cooks through before the courgette has a chance to go soggy, which can happen if the fritters are left to cook for too long. Pregnancy BUMP & baby

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COURGETTE, PEA & HALOUMI FRITTERS

Prep time: 10 minutes / Cook time: 15 minutes Serves: 4–6 as a light meal

Courgettes are one of my favourite vegetables – as long as they’re not overcooked! There’s that time of year when courgettes are everywhere and you seem to have more than you know what to do with – this is a wonderful and delicious way to use them up. If you don’t like peas, just leave them out – but I think they add a lovely pop of fresh sweetness to every bite! • ½ cup frozen peas • 1 kg courgettes, grated • 4 large free-range eggs • 150g haloumi, chopped into small pieces (or use crumbled feta) • ½ cup self-raising flour, sifted • zest of 1 lemon plus 2 tsp juice • ¼ cup chopped basil leaves • 2 tbsp finely chopped parsley • pinch chilli flakes (optional) • ½ tsp ground black pepper • rice bran or light olive oil for frying (optional) To serve • cooked streaky bacon (optional) • sour cream or crème fraîche (optional) • lemon wedges

1. Add the peas to a heatproof bowl and cover with just-boiled water. Leave for a couple of minutes, then drain and set aside. 2. Take small handfuls of the grated courgette and squeeze it as hard as you can over the sink, to get as much juice out as possible (to stop the fritters turning soggy). 3. Add the eggs to a large mixing bowl and beat or whisk for 30 seconds until frothy. Add the squeezed courgette, peas, haloumi (or feta), sifted flour, lemon zest and juice, basil, parsley, chilli flakes (if using) and pepper. Stir to combine evenly. 4. Place a large frying pan over a medium-high heat. When it’s hot, add a dash of oil (or if your pan is non-stick, test one without oil — you may not need it, and the fritters are just as nice without). Add heaped ¼-cup scoops of the mixture. Cook for 1–2 minutes until good and browned on one side, then turn over to cook the other side. Set aside on a wire rack to stop the bottoms going soggy while you cook the rest (an oven preheated to 50°C will keep them warm). 5. Serve as a side, or as a light meal piled with crispy bacon and topped with a dollop of sour cream or crème fraîche, with lemon wedges alongside.

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FRESH GREEN SALAD WITH VINAIGRETTE

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FEED YOUR BUMP

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FRESH GREEN SALAD WITH VINAIGRETTE

Prep time: 15 minutes / Serves: 6

There’s something special about a green salad done right. Fresh, crunchy and drizzled with delicious homemade vinaigrette. You can forget about store-bought salad dressings – it takes two minutes to whip one up at home with simple, quality ingredients. Vinaigrette • ¼ cup extra virgin olive oil • 1½ tbsp red wine vinegar • 1 tsp Dijon mustard • 1 clove garlic, crushed • ½ tsp sugar • ¼ tsp salt • ¼ tsp ground black pepper Salad • 1 iceberg lettuce, washed and leaves torn (or 2 baby cos lettuces) • 3 stalks celery, finely sliced (I like to use some of the baby leaves too) • 1–2 avocados, sliced • ½ cup roughly chopped mixed fresh herbs (such as parsley, dill, mint, coriander, chives, basil) • 2 spring onions, sliced • handful snow peas • ½ cucumber, sliced (optional)

1. To make the vinaigrette, stir everything together to combine. If you have a little jar, use this and shake it all up. Keep at room temperature until ready to serve. 2. To make the salad, add the ingredients to a serving bowl. Just before people tuck in, drizzle with 1–2 tablespoons of the dressing and toss to combine. 3. Leftover dressing can be kept in the fridge for a couple of weeks (feel free to double or triple the recipe so you always have some on hand). Bring to room temperature before using. Pregnancy BUMP & baby

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tips • T o make the fresh breadcrumbs, process a few slices of bread (I like a good gutsy bread like ciabatta, but you can use any) in a food processor. Or, chop very finely. • T his is a great dish to serve when you have guests – you can double or triple the recipe, and you can have it sitting there ready to go in a large roasting tray, then just bung it in the oven when you need it.

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CHEESY BAKED COURGETTES

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FEED YOUR BUMP

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CHEESY BAKED COURGETTES

Prep time: 20 minutes / Cook time: 15 minutes / Serves: 4–6

It’s a rare moment when Mike declares a vegetable to be the best thing on his plate – but that’s exactly what happened when I served up these delicious little jobbies. Quite possibly the best way to use up the glut of late summer harvest (and get ’em cheap) – and get veges into people who don’t like them. If you use the bacon these are a light meal in themselves with a salad, but they’re just as nice without the bacon as a side. • 500g courgettes, halved lengthways • 1 cup fresh breadcrumbs • ½ cup freshly grated Parmesan • 1 clove garlic, crushed • pinch chilli flakes • 3 tbsp extra virgin olive oil • salt and freshly cracked black pepper • 4 thick slices mozzarella (or Edam or Colby), cut into 1cm sticks • 3 –4 rashers bacon, rind removed, finely chopped (optional) • fresh basil to serve

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BEANS WITH ROASTED HAZELNUTS & FETA

Prep time: 5 minutes / Cook time: 15 minutes / Serves: 6 1. Preheat the oven to 210°C fan-bake and set a rack just above the centre of the oven. Line a roasting tray with baking paper. 2. Thinly slice the rounded bottom off each courgette half, so it has a stable little platform to sit on. Use a teaspoon to scrape out the pithy seeds and discard them, making a little trench (this is where the cheese will sit). Line them up side-by-side in the prepared tray. 3. Add the breadcrumbs to a bowl with the Parmesan, garlic, chilli and olive oil. Season with salt and pepper, and toss with clean hands to combine evenly. 4. Place 1–2 cheese sticks on each courgette half, then top with the crumb, packing it down. If using the bacon, sprinkle it on top. Season with a little more salt and pepper. 5. Bake for 15 minutes or until the crumb is golden brown and crispy. 6. Serve scattered with fresh basil, as a side with meat and salad, or by itself as a light meal if you’re using the bacon. These are nice with a little squeeze of lemon juice.

Recipes extracted from Scrumptious by Chelsea Winter, published by Random House NZ, RRP$50. Photography by Tam West.

This is a lovely simple way to serve green beans with a little extra zing, creaminess and crunch. This goes with anything and is fine served cold, too. • ½ cup whole hazelnuts • extra virgin olive oil for tossing and drizzling • salt and freshly cracked black pepper • 500–750g green beans • ½ cup water • 100g feta, crumbled • zest of 1 lemon plus a squeeze of juice

1. Preheat the oven to 180°C regular bake. 2. Add the hazelnuts to a roasting tray with a splash of olive oil. Season with salt. Bake in the oven for 10 minutes, or until fragrant and nutty (keep an eye on them as you do not want them to burn). Remove from the oven, cool, then chop roughly. 3. Snap or cut the stalk ends off the green beans. 4. Add the water to a large saucepan. Cover with a lid and place over a high heat. When the water is boiling, add the beans, cover again and cook for a couple of minutes. Shake the pan a few times during cooking so they cook evenly. They’re done when they’re tender and bright green, but still slightly crunchy. 5. Drain the beans, add 1 tablespoon olive oil and season with salt and pepper. Shake to coat. 6. Arrange on a platter, scattered with the chopped hazelnuts and feta. Finish with some fresh lemon zest, a squeeze of lemon juice and a drizzle of olive oil. Pregnancy BUMP & baby

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Testing times During your pregnancy you'll be offered a number of antenatal screening tests to check both you and your baby are healthy, explains Penny Voigt.

A

ntenatal screening tests look for signs of possible problems with your wellbeing and the way that your baby is developing. Although screening tests can’t detect all conditions, they can identify the presence of health conditions or diseases that may affect your pregnancy, and may be able to determine whether there is an increased chance of your baby having a particular problem. Choosing whether or not to have the screening tests is an important decision. To help you decide which tests are most helpful during your pregnancy, we’ve outlined some of the antenatal testing available during each of your trimesters.

"This will just be a little bit uncomfortable, dear!" is a phrase you may hear a few times during pregnancy...

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ANALYSE THIS

First Trimester: Weeks 0 - 14

Blood and urine testing At your first pregnancy check-up, your blood and urine will be tested. Your urine will be tested for bacterial and fungal infections, while your blood will be checked to determine: • Your blood group; • Your Rhesus factor to identify whether you are Rhesus positive or negative; • A full blood count to measure the level of iron, folates, and B12 in your blood; • Whether you have Rubella (German Measles) antibodies; • VDRL to check for sexually transmitted infections and an HIV-AIDS test; and • If you have diabetes or whether you are at risk for developing diabetes.

Screening for Down syndrome and other conditions During your first trimester, you'll be offered a combined screening that will indicate whether your baby has a low or an increased chance of having Down syndrome or another condition. The screening includes a blood test that will measure two specific biochemical markers present in your blood, and an ultrasound scan of your baby to measure the nuchal translucency of the fluid-filled space at the back of your baby’s neck. The best time for the blood test is when you are nine to 10 weeks pregnant, but it can be done right up until 13 weeks and six days of pregnancy. If you are already between 14 and 20 weeks pregnant, second trimester maternal serum screening is offered, which involves a blood test. An ultrasound scan of your baby is ideally done when you are 12 weeks pregnant, but it can be done at any time between 11 weeks and two days and 13 weeks and six days.

Harmony Prenatal Test A non-invasive alternative to first trimester prenatal screening is the Harmony Prenatal Test: A DNA-based blood screening test that evaluates the risk of Down syndrome (trisomy 21), trisomy 18, and trisomy 13, delivering accurate results from as early as 10 weeks of pregnancy. When you're pregnant, your blood contains fragments of your developing baby’s DNA. Using your

WHAT IS DOWN SYNDROME? Down syndrome is a lifelong condition that is present from conception. It occurs in approximately 1 in 1,000 births, and women of any age and ethnicity can have a Down syndrome baby. People with Down syndrome have an extra copy of chromosome 21, which results in learning difficulties and can cause health problems. While Down syndrome is the most common condition indicated by antenatal screening, other conditions indicated in the screening include Patau syndrome (called trisomy 13) and Edwards syndrome (called trisomy 18); also caused by extra copies of chromosomes, both conditions can lead to lifethreatening complications that severely affect the brain, heart, and kidneys. Results from your blood test and your baby’s scan are combined with factors such as your age and weight to determine the chance of your baby having one of the screened

blood sample taken at week 10 of your pregnancy or after, the DNA sample is analysed and test results are available within seven days. The Harmony test has a higher detection rate for trisomy 21 than combined first trimester screening but it is non-funded, so you will have to pay.

Other tests Regular checks that you can expect during the course of your pregnancy include blood pressure, urine, and weight, as well as the size of your baby bump and your baby’s heartbeat. These tests are done regularly to check that your baby is growing as expected and that you are not showing any signs of problems during your pregnancy.

Second Trimester: Weeks 14 – 30 Prenatal diagnostic testing While first trimester screening gives an

conditions; screening cannot tell you for sure though whether or not your baby has a condition. Your screening test results may also indicate that you have a higher risk of developing problems later on in pregnancy. Results should be available to you within seven to 10 days. A low chance result means there is very little chance that your baby has one of the screened conditions, while an increased chance result means there is a higher chance that your baby has one of the screened conditions. If you receive an increased chance result, your LMC or doctor will discuss what your results mean and help you decide whether to go forward with diagnostic testing. It’s important you have enough information to help you decide about screening and testing for Down syndrome and other conditions. If you need more information, ask your LMC, doctor, or specialist, or visit the National Screening Unit’s website (nsu.govt.nz). To find out more: • New Zealand Down Syndrome Association 0800 NZDSAI (0800 693 724) or nzdsa.org.nz • New Zealand Organisation for Rare Disorders nzord.org.nz

indication of an increased chance that your baby has a screened condition, prenatal diagnostic testing provides a 100% diagnosis of a chromosome abnormality. The most common types of prenatal diagnostic testing are chorionic villus sampling (CVS) and amniocentesis. The type of sample collected depends on how many weeks pregnant you are; before 14 weeks, a sample of the developing placenta is taken (chorionic villus sampling); from 15 weeks, a sample of amniotic fluid is taken (amniocentesis). As it is considered an invasive means of determining the presence or absence of a chromosome abnormality, prenatal diagnostic testing is usually only performed in certain situations.

Chorionic villus sampling (CVS) A CVS test may be recommended for women over 35 years old who have

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ANALYSE THIS

(such as trisomy 21 or Down syndrome), missing chromosomes (such as 45, X0 or Turner syndrome), deletions of portions of chromosomes, or re-arrangements of chromosomes (such as translocations).

Anatomy scan When you are around 18 to 20 weeks pregnant, you’ll be offered another scan where parts of your baby’s body will be measured to check that they are growing as expected. This is called the anatomy scan. It takes longer than other scans because there is a full set of measurements which need to be taken and recorded, so you may be at the radiology clinic for an hour or more. You may be able to find out your baby’s gender too, although sometimes babies don’t like to show their bits, so be aware it’s not always possible!

Diabetes screening

received an increased risk result on their first trimester screening, or who have a history of chromosomal or genetic disorders. CVS is performed earlier in pregnancy than amniocentesis, but carries a higher risk of miscarriage; approximately one in 100. Usually performed between 10 and 13 weeks of pregnancy, it involves inserting a thin needle through the skin on your abdomen or using a speculum through your vagina/cervix into the placenta to obtain a small amount of placental tissue from the developing pregnancy. At the same time, a scan is done to guide the position of the needle or speculum. As the placenta contains chorionic villi which usually have the same genetic makeup as your baby, the sample taken will be cultured in the laboratory and the chromosomes in the chorionic villi will be examined for any abnormalities. CVS results should be available within 10 to 14 days.

Amniocentesis Amniocentesis is usually performed from 15 weeks of your pregnancy, and involves inserting a thin needle through your abdomen into the amniotic sac (the fluid around your baby) to obtain a small amount of

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MOST PEOPLE TAKE PART IN SCREENING IN ORDER TO BE REASSURED THEY'RE HEALTHY, RATHER THAN WITH THE EXPECTATION THEY'RE NOT. amniotic fluid. The fluid contains cells that are shed from your baby’s lungs and bladder, and can be examined for their chromosomes. Results are usually available within two weeks.

Rapid FISH testing You can request a quicker result from your CVS or amniocentesis testing with the rapid FISH test (fluorescent in-situ hybridisation), although this test is non-funded so you will have to pay extra for this. Results from the rapid FISH test are usually available within 48 hours. As this test only examines chromosomes 13, 18, 21 and the sex chromosomes (X and Y), the most common abnormal chromosomes, this rapid result does still require confirmation with the long-term culture results, which are more reliable. A normal FISH result is reassuring, but it does not exclude all chromosome abnormalities. Abnormalities detected on CVS or amniocentesis include extra chromosomes

During your pregnancy you will have two opportunities to have diabetes screening. The first is your antenatal blood test and the second is when you are 24 to 28 weeks pregnant. The screening detects whether you have diabetes or are at risk of developing gestational diabetes.

Third Trimester: Week 30 onwards Late pregnancy scans Usually late pregnancy scans are only offered if problems were picked up during your earlier scans. Your midwife may request that you have a growth scan (to see how your baby is growing and to check it’s on track), a scan to determine that your amniotic fluid levels are optimal, or a scan to determine the position of your baby in the womb.

Screening for group B strep (GBS) If you have a higher risk of having group B strep, bacteria found normally in the intestine, vagina, and rectal area in about 25% of all healthy adult and pregnant women which can make your baby sick, a swab of your perineum (the area from the bottom of your vagina around to your anus) will be offered when you are 35 to 37 weeks pregnant. If you are found to have group B strep, you will be offered antibiotics while you are in labour to help protect your baby.


The Auckland Radiology Group has been serving the greater Auckland community for over five decades from Pukekohe in the south to Glenfield in the north. At ARG we are dedicated to excellence in Radiology services with the latest equipment, clear, accurate results and ongoing staff training. Most importantly, this also means offering you the best service in a calm and caring environment. With 22 Ultrasound rooms and our team of 25 sonographers, you can be assured of appointments within a short booking timeframe and all of your images will be reviewed and reported on by our Specialist Radiologists. Our 30 minute appointments allow your sonographer time to complete a thorough examination and you will be given a USB stick with key images from your scan. Please remember to take your referral with you. In NZ all residents are entitled to four difference types of obstetric scans which are partially funded by the NZ Government. These are:

The Dating Scan is offered between 6 and 10 weeks and is predominantly about confirming your accurate dates The Nuchal Translucency (NT) Scan between 12 weeks to 13 weeks 6 days

A Nuchal fold scan contributes to a risk assessment of your baby having Down’s Syndrome or other chromosomal abnormalities.

The Anatomy Scan between 18 – 20 weeks

This scan is often the one that most expectant parent feel excited about – not only because it’s a real milestone but also because your baby will be looking less like a vague shape and more like a baby! You should let the sonographer know at the beginning of the scan if you’d like to know the sex of your baby (occasionally baby may be lying in a way that means the sonographer cannot advise you on the sex). This is also the longest and most complex clinical exam. Your sonographer will be concentrating as they will want to ensure that they take all the required images and measurements for our radiologists to review. If there are any signs of problems, we’ll give your LMC a call and you will be offered another scan. Some of many things that they’ll be looking at are: • The spine and abdomen to see that everything is aligned and developed. • The size and shape of your baby’s heart (which is now the size of your fingernail) • Baby’s kidneys and bladder. • The stomach, which you should be able to see below the heart. • Your baby’s hands and feet.

Growth Scan at 32 – 41 weeks

This ultrasound scan checks that your baby is growing and developing healthily.

Ultrasound Branches: 101 Remuera Rd • Avondale • Glenfield Hauraki • Henderson • Howick • Kohimarama • Panmure Papakura • Ponsonby • Pukekohe • Queen St • Royal Oak

arg.co.nz


FACT

TREATING A WOMAN UNFAIRLY IN EMPLOYMENT BECAUSE SHE IS PREGNANT OR MAY BECOME PREGNANT IS UNLAWFUL.

From morning sickness and the office lavatories to what to do if your employer is treating you unfairly because you’re pregnant, working mumsto-be have a few things to think about, explains Penny Voigt.

70%

OF PREGNANT WOMEN GET MORNING SICKNESS, SO IT'S IMPORTANT THE OFFICE LOOS ARE CLEAN BECAUSE YOU MAY BE SPENDING A FAIR AMOUNT OF TIME IN THERE! 64

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OFFICE SPACE

Bri ngi bum ng yo p to ur wor k

I

f you’re working during your pregnancy, there are a number of important decisions you’ll need to make about your employment and your baby: Things like when to tell your boss you’re pregnant, when to stop working, how much parental leave you’re entitled to, how to cope with being pregnant at work, health and safety implications in your current role, and what to do if you feel you are being discriminated against because of your pregnancy.

WHEN TO TELL YOUR BOSS Most women wait until they’ve reached the 12-week mark, but the sooner you let your employer know, the more time you have to put into place any plans to cover your role while you’re away on maternity leave. You must give your employer at least

three months’ written notice before your expected date of delivery, in order to receive your maternity leave entitlement. Your notice must be accompanied by a medical certificate confirming your pregnancy and due date. You’ll also need to let your employer know if you intend to start your maternity leave early, with at least 21 days’ written notice.

HEALTH AND SAFETY IMPLICATIONS Under the Health and Safety in Employment Act, all employers are responsible for identifying and managing workplace hazards to employees. Your employer must ensure that you are not exposed to hazards that could affect your unborn child, like working in a cramped position, handling or moving heavy loads, or working in a hot atmosphere.

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OFFICE SPACE

Pregnancy discrimination TREATING A WOMAN UNFAIRLY IN EMPLOYMENT BECAUSE SHE IS PREGNANT OR MAY BECOME PREGNANT IS UNLAWFUL AND MAY BE CLASSED AS PREGNANCY DISCRIMINATION. THIS COULD INCLUDE ANY ONE OF THE FOLLOWING SITUATIONS WHERE A PREGNANT WOMAN IS: + Refused employment, promotion, or the opportunity to apply for a position. + Dismissed or made redundant. + Subjected to derogatory remarks. + Excluded from training, work functions, or other benefits. + Transferred to other jobs without consultation or their agreement. + Demoted. You have the right to question why you are being treated unfairly, and if you suspect it is because of your pregnancy, there are formal processes you can pursue. To familiarise yourself with your rights, visit the NZ Human Rights Commission website (hrc.co.nz) or call the Human Rights InfoLine on 0800 496 877. If your current role involves work that may be deemed unsafe for both you and your baby during pregnancy, your employer can transfer you to alternative duties, but your agreed terms and conditions of employment, including pay, will still apply. If you work shifts, you should be given the choice of not working night shifts for the duration of your pregnancy.

PARENTAL LEAVE ENTITLEMENTS To qualify for parental leave, you must have worked for the same employer for at least six or 12 months before your baby’s expected delivery date. During this time, you must also have worked for an average of at least 10 hours per week. How much parental leave and what type

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inform the boss today! you qualify for will depend on whether or not you are the primary caregiver, how many hours you have worked, and how long you have worked for. To work out your entitlements, visit mbie.govt.nz. While your employer is not obliged to pay you during your parental leave, you may qualify for government-funded payments provided you’ve been an employee, either with the same employer or more than one employer, or been self-employed, for an average of at least 10 hours a week for any 26 of the 52 weeks immediately before your baby’s due date. Your parental leave payments are for one continuous 18-week period and you need to apply to Inland Revenue for your parental leave payments. The maximum payment amount you’re entitled to is $516.85 per week before tax or your gross pay before tax, whichever is lower. You’re also entitled to take a total of up to 10 days’ unpaid special leave for reasons connected with pregnancy, which could include appointments with your midwife or doctor. Provided your spouse or partner has worked for the 12-month qualifying period, they are entitled to up to two weeks’ leave taken around the time of your baby’s birth. You can also transfer up to 18 weeks of your parental leave payments to your spouse or partner to extend their leave. Extended parental leave of up to one year, which includes your 18 weeks of primary carer’s leave, can also be taken, provided you have worked for the 12-month qualifying period.

COPING WITH MORNING SICKNESS AT WORK Morning sickness is an inevitable part of pregnancy, affecting around 70% of

USEFUL LINKS:

women. Starting as early as six weeks into pregnancy, morning sickness generally peaks around the eighth or ninth week. Having to cope with morning sickness while working is challenging. Here are a few tips to help you cope: • As your pregnancy hormones kick in, a heightened sense of smell can mean strong odours – like your co-worker’s perfume – can bring on your nausea. When you’re unable to open a window or to walk away, try sniffing something refreshing like lemon-scented spray or a sprig of rosemary. • Track when exactly you’re feeling your worst – if your nausea tends to hit you at the same time each day, try to identify what it is that makes you feel ill and avoid those triggers as much as you can – perhaps it’s lunchtime smells in the office canteen or the rubbish bin being emptied. • Schedule some holiday time around the seventh or eighth week into your pregnancy, when morning sickness is usually at its worst. • Ensure you’re drinking enough water each day – keep a bottle of water at your desk and take small sips or crunch on ice chips, even if it feels impossible to keep anything in your stomach. • Snacking on small amounts more often, especially bland, carb-rich snacks like crackers, dry cereal or pretzels, can help you deal with the nausea. Try adding a thin slice of ginger to hot water or tea, sipping flat ginger ale or snacking on ginger biscuits – ginger has long been regarded as a natural remedy for tummy issues. • Adjust your computer’s screen resolution to reduce eye strain, as it could be aggravating your nausea. Adjust your font size to something bolder and bigger, and change your background to a soft pink or light tan colour. Remember also to take short breaks from your computer – get up, walk around and focus your eyes on something else.

+ employment.govt.nz/leave-and-holidays/parentalleave + www.ird.govt.nz/yoursituation-ind/parents/ parents-paid-parental-leave.html + www.hrc.co.nz/ files/8214/2372/1661/19-Oct-2010_15-02-36_Your-rights-as-apregnant-worker.html + www.cab.org.nz/Pages/home.aspx


Protecting your baby starts before birth When you’re pregnant, free vaccines can help protect you and your new baby before they are fully immunised.

IMMUNISATION DURING PREGNANCY Influenza and whooping cough (pertussis) immunisations are recommended and free for all pregnant women in New Zealand. These types of vaccines are used internationally during pregnancy and are a very safe way to protect both mother and baby. Immunisation during pregnancy causes the mother’s immune system to make antibodies. The antibodies circulate in her blood stream to help protect her from getting sick. They also travel across the placenta into her baby’s blood stream and help protect the baby after birth, before baby has completed their first three immunisations. WHOOPING COUGH Babies, particularly those younger than 6 months of age, can get very sick or even die from whooping cough. Immunisation between 28 and 38 weeks of pregnancy can help protect your baby for up to 3 months after they are born. Babies then develop their own protection through immunisations at 6 weeks, 3 months and 5 months of age.

visit immune.org.nz or speak to your doctor or practice nurse for more advice. TAPS approval number: NA 8613

INFLUENZA (FLU) Pregnant women who get influenza have a much higher risk of developing complications like pneumonia, being admitted to intensive care, experiencing premature labour, and/or delivery problems. They also have a higher risk of dying from influenza than women who are not pregnant. Their unborn baby is more likely to be born small for age, become distressed in labour, and/or be delivered by caesarean. You can have the vaccine anytime during pregnancy, which will help protect your baby for up to 6 months after birth. The vaccine is free during the influenza season (usually early March to August). IMMUNISATION AND BREASTFEEDING Mothers pass some antibodies to baby in their breast milk - these don’t interfere with baby’s own immunisations and in fact may help them work better. You can continue your usual breastfeeding after baby receives immunisations, including the rotavirus vaccine. Mothers can be immunised themselves while still breastfeeding.


A wee problem If you’re suffering from urine leakage or prolapse, you’re not alone, and there are things you can do to improve your situation, explains pelvic health physiotherapist Liz Childs (tiaki.net.nz).

More than half of all women experience urinary leakage.


YOUR PELVIC FLOOR

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elvic floor muscle dysfunction, such as incontinence and prolapse, is often a difficult and embarrassing subject for women to discuss, both with friends and with their health professionals. As a result, it gets ignored and women end up suffering in silence, wearing pads, and restricting their activities rather than getting help. A 2013 survey in New Zealand found that more than half of all women have urinary leakage at some stage in their lives. 50% of all women who have had a baby have prolapse, and 30% have reduced sexual sensation. All these problems can be helped or even cured with appropriate pelvic floor muscle training, yet many women believe these problems are a normal consequence of factors such as giving birth and ageing. Pelvic floor dysfunction is common – you are not alone. However, it is not normal, and you can help yourself do something about it. Studies show that pelvic floor muscle training can have an 80% cure rate for stress incontinence, and there is good evidence that it can help reduce prolapse symptoms.

What are the pelvic floor muscles?

The pelvic floor muscles are a sheet of muscles at the base of the pelvis. They extend from the pubic bone at the front to the tailbone at the back. They are involved in: • Support of your pelvic organs (bladder, bowel and uterus), holding them in the right place. • Prevention of leakage from the bladder and bowel. • Control of problems such as frequency and urgency.

THERE IS GOOD EVIDENCE THAT PELVIC FLOOR MUSCLE TRAINING CAN HELP TO PREVENT PELVIC FLOOR DYSFUNCTION. IF YOU ALREADY HAVE PROBLEMS, IT CAN HELP TO CURE THEM. • Emptying of the bladder and bowel. • Sexual function. • Core stability around the pelvis and trunk.

Types of pelvic floor muscle dysfunction:

Bladder leakage: There are two types. Stress incontinence occurs if the pelvic floor muscles are weak and you may experience leakage of urine when you cough, sneeze, or strain, or during exercise such as running or jumping. Urge incontinence occurs when you get a sudden strong desire to get to the toilet and you may leak on the way, even if your bladder isn’t particularly full. Prolapse: If the pelvic floor muscles and/or supporting ligaments are weak, the pelvic organs may drop down. This can create a bulge inside the vagina, or a dragging, heavy sensation. The bulge may even be visible at the vaginal entrance. Bowel incontinence: Strong and coordinated pelvic floor muscles assist with bowel control, helping to prevent accidents. They also help prevent involuntary loss of wind, another common problem after childbirth. Sexual dysfunction: Strengthening your pelvic floor muscles can help improve sexual sensation and your ability to have an orgasm. (Sometimes after childbirth there can be pain with intercourse, and you may need to learn how to relax the pelvic floor, or loosen scar tissue).

What are the risk factors for pelvic floor muscle dysfunction?

Pregnancy and childbirth: Any woman who has ever had a baby should be doing pelvic floor exercises, and not just in the immediate post-birth period. They should be done regularly for the rest of your life. Even if you have had a Caesarean section, you should still be doing them, as hormone changes and the weight of the baby still have an impact on the pelvic floor, and can cause weakness.

Ageing: There is a general loss of muscle mass that occurs with ageing. It is important to keep all your muscles, including your pelvic floor, in good condition by doing regular exercise. Menopause: Hormone changes during and after menopause contribute to an increase in pelvic floor muscle dysfunction. Other lifestyle factors that impact on the pelvic floor: Constipation or straining, obesity, heavy lifting, inappropriate exercise, chronic coughing, disuse, being overweight.

Pelvic floor muscle training

There is good evidence that pelvic floor muscle training can help to prevent pelvic floor dysfunction. If you already have problems, it can help to cure them. Pelvic floor muscle training involves pelvic floor muscle strengthening, and making lifestyle modifications so that there is less pressure on the pelvic floor muscles. So how do you exercise the pelvic floor? • Sit comfortably in an upright chair OR lie on your back with knees bent and thighs, buttocks, and tummy relaxed. • Squeeze and lift around your vagina or back passage. Imagine you are trying to stop the flow of urine or stop passing wind. It is fine to feel a gentle pulling in of your lower abdominal muscles at the same time, but there should be no tightening of the buttock muscles, tilting of the pelvis, or sucking in of air. • If you are unsure about the technique, you could try to stop your flow of urine on the toilet. If you can do this, or you can slow it, you are using the correct muscles. Be aware though – this is a TEST ONLY. Do not exercise your pelvic floor muscles this way. • Start by holding for two to three seconds and gradually build up to 10-second holds. If your muscles are weak, you won’t be able to hold for long. • Allow a 10-second rest between each muscle contraction to avoid muscle fatigue. Pregnancy BUMP & baby

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Lifestyle modifications

Keep your weight within e a healthy range e Seek help if you suffer from constipation e Get medical advice to help with chronic cough e Try to activate your pelvic floor muscles before you cough, sneeze, lift, and when exerting yourself with daily activities

• Gradually build up to 10 repetitions of 10-second holds, with a 10-second rest between each one. This is one set, and you should aim for three sets a day. It may take three to four months to strengthen your pelvic floor muscles if they are weak. Once your muscles are strong, keep exercising them. Aim for one good set of pelvic floor exercises every day, forever, to ensure that you help to prevent future problems. Doing a few exercises once every few weeks just isn’t going to work.

WHEN SHOULD YOU SEEK HELP? It is important that you are exercising your pelvic floor muscles correctly. If you are having problems or are unsure, see a pelvic floor physiotherapist who has specialised training in this area. If you experience symptoms such as incontinence or prolapse after you have given birth, and it has not resolved within three months, you should seek help. In most cases problems will fully resolve with correct pelvic floor muscle training and advice on lifestyle changes. Even if it is many years since you gave birth, it is never too late to seek help.

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WHAT IS PELVIC FLOOR PHYSIOTHERAPY? A pelvic floor physiotherapist is a physiotherapist with additional specialised training in pelvic floor dysfunction. Treatment involves a thorough assessment, and education about your problem, using diagrams, drawings, and models. You will be given an individualised programme to get your pelvic floor muscles working as well as possible so that you have the best strength and endurance you can. You will also be taught how to use these muscles in a functional way. There will be advice on lifestyle modifications and appropriate general exercise, with appropriate adjustments, so you can keep up the type of activity you wish to do.

Safe exercise

Safe exercise during pregnancy and after birth: Hormone changes during pregnancy result in a softening of the pelvic ligaments and pelvic floor muscles. During childbirth, there is stretching, compression, and traction on surrounding structures as the baby passes through the birth canal. Care therefore needs to be taken with exercise during and after pregnancy, as some exercise can actually be harmful to the pelvic floor muscles and pelvic joints. Suitable exercise during and post pregnancy: • Walking • Low-impact aerobics • Water aerobics • Pregnancy exercise classes • Cycling • Swimming Check with your doctor or midwife if you are increasing your current exercise, to see if you need to take special precautions. Avoid strenuous exercise and drink plenty of water. Exercises to avoid in pregnancy: • Heavy weights • Bouncing – e.g. star jumps, trampoline • Contact sports – avoid after the first trimester • Excessive twisting or turning • Quick movements • Sudden changes of direction or intensity • Exercises that increase the curve in your lower back (your lumbar spine) • High impact activities

Urinary leakage during exercise:

Urinary leakage is very common in pregnancy. If you experience leakage while

you are exercising, stop doing the exercises that are causing it. Seek help from a pelvic floor physiotherapist.

Returning to exercise after birth

Start doing pelvic floor exercises a few days after you give birth. Start gently and slowly build it up. It is safe to start slowly returning to low-intensity exercise, such as walking, after one to two weeks. It is recommended that you wait at least four to six months before returning to high-impact exercise such as running. See a pelvic floor physiotherapist for further information.

Long-term pelvic floor safe exercise

Pelvic floor safe exercise is recommended for anyone who is at risk of, or is already experiencing, pelvic floor dysfunction. It can be difficult to work out exactly what is suitable for you. A good guideline is to avoid high-impact or high-intensity exercise, or anything that exerts a downward pressure on the pelvic floor. More detailed information regarding specific cardio, resistance, and core exercise is available at pelvicfloorfirst.org.au.

How to find a pelvic floor physiotherapist

Most larger DHBs have a Women’s Health department, where you will find specialised pelvic floor physiotherapists. There are also pelvic floor physiotherapists in private practice. Visit Physiotherapy NZ (physiotherapy.org.nz) and look under “Find a Physio”. Continence NZ also have a list of pelvic floor physiotherapists and continence physio providers. Visit continence.org.nz or call 0800 650 659 to find out more.


TRI-DIMENSIONAL

Pelvic-Floor Ultrasound This specialised ultrasound scan assesses the pelvic floor of women. Along with the recent advances and success of treatment of pelvic floor disorders there has been increasing demand for this scan. TRG Imaging is now offering Tri-dimensional Pelvic Floor Ultrasound at our Shakespeare Road practice in Milford. This scan is particularly useful in assessing pelvic floor disorders such as: • urinary or faecal incontinence • recurrent urinary tract infection • symptoms of obstructed defecation • selected cases of pelvic, vaginal or anal pain • pelvic organ prolapse When the scan is performed, the pelvic floor is assessed for dysfunction as well as levator ani (muscle) defects as a cause for the symptoms. The assessment is dynamic and provides you with direct feedback as the scan is being performed. The scan is multicompartmental using a combination of transabdominal, transvaginal and perineal ultrasound. It takes approximately one hour to perform this complex ultrasound examination. Our team are trained to make you feel at ease throughout each stage of the assessment. If you feel this assessment will be useful, we suggest you discuss this with your doctor or specialist first.

TO MAKE A BOOKING, PLEASE PHONE 09 486 1659 www.trgimaging.co.nz


Showered with love

Leave this page open around your friends and loved ones – these are the most beautiful new baby and new mama gifts you’ll love to receive!

RIGHT ANGLES Fresh geometric designs bring a trendy take to baby clothing. Teeny Weeny Jogger Pants 2-pack $24.99 from Farmers

LOOK & LEARN An original, eclectic piece of wall art that's contemporary and cool. Alphabetica Fabric Wall Decal Set $119-$359 from stickytiki.nz

WE LOVE IT!

BE SEATED For comfortable feeding time, even in the middle of the night. Home Republic "Copenhagen" Chair RRP$1199.95 from Adairs

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ALL RUGGED UP These luxury cotton baby blankets are soft and snug. If only they came in adult sizes! $137.51 each from zulunar.com


PRESENT DAY a nd pink

, o h m y!

WATCH OUT With built-in lullabies and a crystal clear video display, the VTech BM3500 is the best in baby monitors. RRP$249.95 from Baby Factory, Farmers, and The Warehouse

Ruffles an

d sp

ark

l

es

$

GREAT BUY!

BOTTOMS UP Who can resist a cute little baby rufflebum? Teeny Weeny Triangle Foil Print Harem Pants RRP$17.99 from Farmers

ALL SORTED Keep baby essentials handy and accessible with the Bugaboo Organiser, which attaches to your stroller with velcro tabs. RRP$88.95, bugaboo.com for stockists

PICTURE THIS Record the special moments in your baby's first year of life with this delightful set of 30 cards. Hairy Maclary and Friends: Baby's First Year Cards RRP$26, penguin.co.nz for stockists

PRECIOUS MOMENTS Keep track of baby's milestones and memories in this keepsake book. Kiwi Baby Record Book RRP$24.99 from batemanpublishing.co.nz WHALE TALE Stretchy soft all-in-one clothes are great for the early days with baby. Teeny Weeny Whale Print Long Sleeve Sleepsuit RRP$22.99 from Farmers

SWEET SOMETHINGS Adorable and natural, A Little Something for Baby from Earth Mama Angel Baby products are safe and natural. $59 from bellamama.co.nz

SWEATER SET Newborns need layers and cardis are perfect for any kind of weather. $68.73 each from zulunar.com

HATS OFF Suitable for all seasons, you can never have too many cotton knit baby beanies. $31.69 each from zulunar.com

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Twice AS NICE

What’s the best way to tell your friends and family the gender of your baby (or babies, plural, in the case of this gorgeous twin celebration)? Why, a shimmering, sparkling, confetti-filled gender reveal party, of course! Photographer and stylist Michele Phillips of What Dreams May Become shares her doubly special celebration.

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BABY SHOWER

"I wanted everything to be white and neutral, and of course a bit whimsical and boho too," mum-tobe Michele explains

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A simply sweet way to celebrate the new babies.

Top: Michele bought inexpensive carnations and displayed them in spray-painted jars Left: Guests wrote their guesses as to the babies' genders on special tags Right: Michele's vision of white and neutral with hints of boho whimsy

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BABY SHOWER

W

hen we found out we were having twins, my husband Steve and I both agreed that we wanted to find out the gender. Now, I am not someone who ever wants to know the gender of my babies before they're born. I love 'that moment' – you know, this one: "It's... A... GIRL!" But learning I was pregnant with twins was surprise enough, and finding out the gender or genders of my babies would help me to picture our family life and what it might be like. And what better way to share the big news than with a party? I loved the idea of being able to tell family and close friends all together at a gender reveal party. Steve and I found out the babies' genders when I was 19 weeks pregnant, a week before the party. We told no one, not even our other kids. Although it was special to share that knowledge between just the two of us, I also found it stressful, because I wear my heart on my sleeve. So I spent the week planning, crafting, and nesting, three of my favourite things. I wanted everything to be white and neutral, and of course a bit whimsical and boho too. When trying to figure out how to handle the actual "reveal" part of things, I knew I wanted to do something a little different than the usual gender-reveal cake (where the inside of the cake is coloured

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PHOTOGRAPHY AND PARTY STYLING: MICHELE PHILLIPS OF WHAT DREAMS MAY BECOME (WHATDREAMSMAYBECOME.CA). CAKE: KRISTIN’S CAKES (FACEBOOK.COM/KRISTINSCAKESABBOTSFORD). STAR AND HEART PRINTS: KARDZ KOUTURE (ETSY.COM/CA/SHOP/KARDZKOUTURE). LITTLE GIRL WHITE DRESS AND BOW TIE: ARROW AND LACE DESIGNS (ARROWANDLACEDESIGNS.COM). HARLAN’S FLORAL CROWN: JEODORE. LEATHER GARLAND, YARN BALL GARLAND, BLACK BALLOONS, TASSEL GARLANDS AND CAKE TOPPER ”HELLO WORLD”: CONFETTI AND SPARKLE (CONFETTIANDSPARKLEPARTYSHOP.COM).

"THERE WAS CONFETTI EVERYWHERE! WE LET ALL THE LITTLE ONES PLAY IN IT FOR A WHILE AND, TO BE HONEST, IT WAS KINDA MAGICAL."


BABY SHOWER

All that confetti took Michele and her husband two nights to cut and stuff in balloons!

pink or blue). So instead I chose huge black balloons which were filled with confetti. Steve and I spent two (yes, two!) evenings cutting confetti and stuffing it into the balloons! I was so nervous to make the actual announcement! It's one of those special moments life only gives you a few times. Man, it felt good to finally have our secret out and tell our closest friends and family, all at the same time. There was confetti everywhere! We let all the little ones play in it for a while and, to be honest, it was kinda magical. Deep down, I feel like I already knew there was a boy and a girl in this belly of mine. So when we found out, I can't say that either of us were surprised. It's already starting to feel like these two were always meant to be here. We are so excited and feel blessed beyond measure by these little gifts. Pregnancy BUMP & baby

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Gaining weight the healthy way Watching the number on the scale go up while you’re pregnant is natural – but it’s important to understand how much extra you really need to eat in order to stay healthy, explains nutritionist Jessica Giljam-Brown of wellnessbyjessica.com.

T

he weight gained in pregnancy is feared by some and used as an excuse to “eat for two” for others. It is essential to gain weight in order to have a healthy pregnancy, but gaining too much or not enough can have a negative effect on both you and baby. The key to maintaining a healthy weight during your pregnancy is to understand how much extra you really need to eat to support a healthy pregnancy.

WHERE'S THE WEIGHT GOING? As you see the numbers on the scale going up each month, you need to keep in mind that only a small percentage of this is new body fat. Your body is working extremely hard to grow a baby and the surrounding organs and systems needed to support this new life. The average weight gain in a pregnancy is about 12-14kg. The baby makes up 3-4kg of this, followed by a further 3.5kg in fat

stores which are laid down to ensure you have enough energy to support breastfeeding. The rest of the weight is due to the placenta (0.5kg), the uterus (1.5kg), amniotic fluid and fluid retention in the body (2.5kg), extra breast tissue (0.5kg), and increased blood volume (1.5kg). If you are underweight pre-pregnancy, then you can expect to gain a little more. This is your body’s way of compensating and making sure you have the necessary energy stores to support pregnancy and breastfeeding. If you fall into the overweight or obese category, then you are expected to gain a little less, as you already have the energy stores needed for pregnancy.

WHEN WILL I GAIN THE MOST WEIGHT? You can expect to gain very little weight, only 500g-3kg, in the first 16 weeks of your pregnancy. Some women may find that due to morning sickness they actually lose weight during this time. This is common

How much weight should I be gaining? THIS CHART CAN HELP GUIDE YOU AS TO HOW MUCH WEIGHT YOU SHOULD GAIN FOR YOUR BODY TYPE.

EARLY PREGNANCY BMI (KG/M²) Underweight (<18.5) Healthy weight (18.5-24.9) Overweight (25-29.9) Obese (>30)

tip Snack well Try pre-portioning and packing a lunch box of healthy snacks which you can eat during the day. Remember that you only need the equivalent of one or two extra snacks' worth of kilojoules each day during pregnancy.

WEIGHT GAIN RANGE e TOTAL kg – 18 kg e 12.5 kg – 16 kg e 11.5 7 kg kg e 5 kg –– 11.5 9 kg e

Talk to your healthcare provider for exact weight goals for your pregnancy. Also note that these figures increase if you are pregnant with multiple babies.

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BY THE NUMBERS

PREGNANCYFRIENDLY SNACKS AND MEALS WEEKS 16–32 EXTRA SNACK IDEAS

Peanut butter or hummus on two slices of whole grain toast 2 hard boiled eggs and a cup of carrot sticks 1 cup of full-fat natural yoghurt with 1 cup of fruit 1 cup of chia seed pudding 1 medium apple with 2 tbsp of nut butter for dipping Green smoothie made with milk or yoghurt, spinach, banana, and frozen berries Whole grain muesli with milk

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and your body will compensate for this loss during the next stage of your pregnancy. At around 16 weeks, you will notice a growth spurt and will gain about 0.5kg a week up until approximately week 32. Your weight gain will slow down as you reach the end of your pregnancy, with very little weight gain in the last four to six weeks.

ARE THERE COMPLICATIONS IF MY WEIGHT GAIN IS NOT OPTIMAL? Your primary care provider will use your weight throughout your pregnancy as a guide to how the rest of your health might be. If too much weight is gained throughout the pregnancy, you are putting yourself and baby at risk of complications such as gestational diabetes, preeclampsia, large birth weight, and high blood pressure, as well as a higher risk of post-pregnancy obesity. Gaining too little weight during pregnancy leads to just as many complications. If you and the baby are not getting enough energy (kilojoules), your baby won't be getting the nutrients it needs to grow, often resulting in a low birth weight and early birth. You may also find that you struggle with fatigue and dizziness during your pregnancy and difficulty breastfeeding post-birth.

HOW MUCH SHOULD I BE EATING? Your pregnancy diet should be made up of nutrient-dense real food. You're growing a whole human being, and this process

requires massive amounts of vitamins, minerals, fat, protein, and energy. The best way to give your baby what it needs to grow is to eat a diet made up of nutrient-dense, unprocessed food. Lots of fruit and vegetables, whole grains and legumes, nuts, seeds, oily fish, and some lean meat and dairy if you eat animal products. Try to avoid as many processed foods as possible. They are what are called "empty calories"; they provide small amounts of nutrients but lots of kilojoules (energy) – this is what will sabotage your efforts to maintain a healthy pregnancy weight. During the first 16 weeks of your pregnancy, you can continue eating a normal, healthy diet; there is no need to intentionally increase your food intake. After week 16 until week 32, your body needs approximately an extra 1255-1464kJ (300-350cal) per day, this equates to an extra snack each day. In the last 8 to 10 weeks, you need an extra 1674-1883kJ (400-450cal) per day. This can be done by adding in two medium-sized snacks, or one extra meal – an extra afternoon meal works well for many women. The demand for all nutrients increases during pregnancy, so when choosing your meals and snacks, remember that it’s more important to choose quality food over a large quantity of food. Nutrients which are especially important in pregnancy are protein, omega-3 fatty acids, iron, folate, iodine, and calcium. It’s a great idea to focus your extra snacks or meals around these nutrients as they are needed in much higher quantities than pre-pregnancy.

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WEEKS 32–40 EXTRA MEAL IDEAS

l Slice of roast vegetable

frittata made with eggs, roast sweet potato, and capsicum Oatmeal made with dried apricots and walnuts Avocado on whole grain toast with a poached egg Sardines and salad 1 medium baked sweet potato with ½ cup of guacamole 2 cups of homemade vegetable-based soup with pumpkin seeds on top Steak or salmon and salad

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Another important way in which to encourage a healthy weight during pregnancy is to continue to exercise. After the first trimester, many women find that their regular exercise has become uncomfortable. Instead of stopping exercise altogether, try to change the type of movement you do. Walking, swimming, yoga, pilates, cycling, dancing, and using light weights are all great options to help keep you fit and active. Exercise has a positive effect on your mood and helps to prepare your body for childbirth. If you keep up exercise four to seven times a week, it'll be much easier to return to your regular exercise routine and prepregnancy weight post-birth. Pregnancy BUMP & baby

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YOUR WORDS

“Painful but powerful.” ~ Kelly

“Very surreal, like nothing else you experience, ever.” ~ Caroline

“Contractions felt like excitement and nerves rolled into one. Each one felt like pain beyond words followed by relief that I'm a step closer to meeting the love of my life and giving me strength to get through the oncoming, even more powerful one.” ~ Jenny

What do contractions REALLY feel like? We asked real mums on our Facebook page to tell us in their own words what contractions really feel like. Their answers might surprise you!

“FOR ME IT WAS LIKE A ROLLING WAVE. THERE WAS A GRADUAL CRAMPING AND TIGHTENING SENSATION THAT GOT PROGRESSIVELY WORSE UNTIL IT PEAKED AND THEN EASED OFF… UNTIL THE NEXT ONE CAME ALONG.” ~ MICHELLE

“They felt like needing to go to the toilet and monthly pains rolled into one.” ~ Jen “EACH CONTRACTION STARTED WITH A BACKACHE THEN ROLLED AROUND TO MY STOMACH LIKE INTENSE, TIGHT, DRAGGING PERIOD PAIN. EBBED AND FLOWED, AND THEN IN TRANSITION FELT LIKE I WAS GOING TO DROWN IN THE WAVES.” ~ TAMSYN

“Like a really long bout of period pain that intensified as time went on.” ~ Marina “LIKE SOMEONE HAD TIED A ROPE AROUND MY MIDDLE AND WAS PULLING TIGHT.” ~ KASIA

“The pain was like really bad constipation, but because it was so low down, you couldn't even help ease it with a hot water bottle.” ~ Tracey “Painful tightening like intense, long-lasting period pains.” ~ Tracy “Intense tightening that came in waves.” ~ Shannon

“A gnawing, burning, tightening, dragging feeling. Worth every minute.” ~ Amie

“I TELL PEOPLE TO SQUEEZE THEIR ARM REALLY TIGHT FOR A SECOND AND THEN FOR A MINUTE. THAT'S WHAT CONTRACTIONS FEEL LIKE. MUSCLES TIGHTENING. THEY'RE REALLY TIGHT!” ~ JENNIFER



YOUR WORDS

“LIKE I WAS CONSTIPATED... THEN ROLLING WAVES OF PAIN AND TIGHTNESS IN THE FRONT OF MY STOMACH.” ~ SARAH

“Contractions feel like extremely severe period pain that, incredibly, manages to just get worse and worse. They are not fun. Although I was surprised how good you felt in between them. The pain was just instantly gone. Like it never happened.” ~ Veronica

“Slow tightening that got more intense – concentrating on breathing – leaning over the couch on tippy toes.” ~ Astrid “Contractions initially felt uncomfortable, niggly, and annoying, but they just kept coming, and increased in both frequency and intensity.” ~ Tsana “LIKE REALLY PAINFUL WAVES SLOWLY OR QUICKLY GETTING STRONGER. BUT WITH EACH CONTRACTION I KNEW MY BABY WAS GETTING CLOSER TO BEING IN MY ARMS AND I TRIED TO JUST ROLL WITH IT.” ~ EMMA

“Tight, excruciating cramping mainly in my lower back that was really intense. Then it would go away and I would brace myself for the next round.” ~ Tina

“A vice gripping my hips.” ~ Susan

“Incredibly strong muscle tightenings that took over my whole consciousness... But they have to be strong to get a baby out!” ~ Jessabel “THE BEST WAY TO DESCRIBE THE CONTRACTIONS WAS A DEEP, INTENSE PRESSURE, RATHER THAN A SHARP, INTENSE FEELING. YOUR BODY KNOWS WHAT TO DO, AND I JUST WENT WITH IT!” ~ REBECCA

“Contractions were like the worst cramps ever, but also exciting as it meant that soon I'd be meeting our baby! Once I got into a birthing pool, they got a whole lot more manageable.” ~ Anna “Tightening, strong cramps, with heaviness as delivery draws near.” ~ Tania “INTENSE PAIN WITH FEELINGS OF EXCITEMENT AND ANXIETY ALL WASHING OVER AND OVER ME.” ~ KAREN

“The pain was different than I thought. It was like a burning pain, but I could handle it. With the gas, I couldn’t feel it at all.” ~ Brenda

“A wave of pain. Just when I thought I couldn't bear it anymore, it subsided. It wasn't an ‘OMG something is wrong with me’ pain, though. It was a purposeful and constructive type of pain." ~ Sandra “MINE WERE LIKE AN AWFUL STOMACHACHE, THE KIND THAT MAKES YOU GHOSTLY WHITE AND HAS YOU ROLLING AROUND IN PAIN.” ~ CHERIE

“I remember describing them to my partner and midwife during labour... It was like someone had forced a fist up my bum and pushing and twisting it as hard as they could! Midwife said the word I was looking for was ‘ramming’!” ~ Paula “INTENSE, POWERFUL WAVES THAT SEEMED TO CHANNEL ALL MY ENERGY ON THE BABY.” ~ DONNA

“Reminded me of my misspent youth: The morning after dehydration and cramps and aches after a hard night out... Labour, like a hard night out, you say you'll never do again. But you do.” ~ Donna “IT WAS INTENSE, CRAMPING, POWERFUL WAVES OF PAIN, FOCUSED AROUND THE LOWER BACK AND REAR END, BUT IT FEELS LIKE IT AFFECTS YOUR ENTIRE BODY. IT'S NOT REALLY A LOCALISED PAIN AS SUCH.” ~ LINDA

“A building intense pain in my lower back and bum that peaked and then eased. Very painful and uncomfortable at the time, but knowing you are getting closer to seeing your baby is so worth it.” ~ Jaimee “LIKE RED HOT LAVA.” ~ SHIRLEY

"Being elbowed in my lower back repeatedly.” ~ Danae

JOIN THE CONVERSATION!

Visit facebook.com/bumpandbabynz to share more real-life experiences with other mums-to-be.

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"I was induced, so the contractions came on very quickly! Each one of them felt like my tummy being tightened with a belt a few sizes too small, and then released again.” ~ Amy



Some babies need a little encouragement to leave the womb for the world!

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KICK-STARTING BIRTH

Inducing labour Your induction is booked, you rock up to the hospital for your morning appointment, and you're out by lunch with a baby in your arms, right? Yeah, probably not, says Kelly Eden-Calcott.

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t's perfectly normal for pregnancy to be anywhere from 38 to 42 weeks, but in New Zealand, if you enter your 41st week, your midwife will probably start planning an induction. How convenient! No more guessing and waiting! You now have baby's birthday in an easy daytime slot between school drop-off and soccer. Hmm, not quite... Apart from the fact that hospitals often run late to start with, the induction process can take anywhere from four hours to two or three days. You might even be sent home in some cases. But once you start the induction, you're committed to getting that wee bub out (there's no backing out!), so pack your bags with a long stay in mind just in case. You'll want to bring some food, drink, and something to do, because you and your partner might be spending a few hours stuck in waiting rooms or birthing units with nothing much happening and nothing good on TV (if there even is one).

KICK-STARTING LABOUR

It seems strange, but experts still haven't figured out exactly what triggers labour. What they have worked out, though, are the hormones involved. So if you need it, your labour can be given a kick-start, or even completely created using synthetic hormones that mimic what your body naturally produces during birth. If you are overdue, over the age of 40, have health problems such as preeclampsia, diabetes, or serious bleeding in your pregnancy, or if your waters have broken but labour hasn't started, you will most likely be offered an induction. Around

20% of births in New Zealand are induced. Like any medical intervention, there are risks, and it's important you know what you’re signing up for. Waiting for labour to start naturally can seem scary, or annoyingly long, but unless you really need intervention, a natural birth is best by far for you and your baby.

WHAT TO EXPECT

Once you arrive for your appointment, there are usually three stages to any induction, which may be used separately or in combination. First the cervix needs to soften, thin out and open. Your midwife or doctor will rub a hormone gel called prostaglandin on the cervix and then you are usually free to walk around the hospital grounds while you wait for it to kick in. Some women feel periodtype pain in their back in this stage, and others have painful tightenings. This stage can feel long and tiring, which you are probably used to by now, having waddled around with a huge belly for a few weeks already, but make sure you eat and drink plenty of fluids. Remember, you're about to give birth, so treat yourself like an athlete before a race and hydrate, hydrate, hydrate! Sometimes a balloon catheter (a small plastic tube with a tiny balloon on the end) will be used to help put pressure on your cervix too. This first stage can take a few hours or a whole day – everyone responds differently.

WHEN THINGS GET STARTED Once the cervix has opened a small amount, the next stage can start. If your Pregnancy BUMP & baby

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KICK-STARTING BIRTH

However your baby's birth ends up happening, being well-informed will help you have a confident, calmer experience. waters haven't already broken, your midwife will use a tiny hook (like a crochet hook) to make a small hole in the membranes that keep your baby floating around in there. As the fluid leaks out, your baby's head will hopefully come down into your pelvis, ready to be born. This might bring on stronger contractions. Your baby is on the way! Finally, the doctor will put an IV line into your hand or arm and slowly release syntocinon (the synthetic form of your body's natural oxytocin) to get your labour going. Once this stage is started, you may or may not be able to move around much. Hooked up to the IV with a monitor on your tummy to keep an eye on your baby can make it tricky to get comfortable. Things are improving all the time, though, and many hospitals now have waterproof, wireless monitors which mean you can walk around and even get in a bath. So get up when you can, let gravity do its thing, and don't forget those fluids. You still might have a long time to go.

Hopefully your LMC will have a friendly smile while he or she is checking how far you've dilated...

HOW LONG WILL IT TAKE?

It can take two to three days for inductions to work, and sometimes they just don't work at all, which is when your midwife will discuss your options. Failed inductions often mean a Caesarean will be needed. Inductions are different for everyone, but generally women feel the contractions are more painful than a natural birth. Depending on what induction methods you have had and how much syntocinon was needed can affect your experience of birth. Rebecca expected a natural home birth with her fifth baby, but when her waters broke and 24 hours later nothing had progressed, she was booked in to be induced the next day. “It was nothing like my last births. It wasn't like a natural birth at all,” she recalls. Rebecca's labour took most of the day to start. She was given the full dose of syntocinon, and then it was full-on. “My contractions were very different to what I'm used to. More intense than my natural births. Because I'm experienced with birth, I can usually tell how far along I am. I was stunned to hear I was only 4cm

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dilated when it felt like I was almost 8cm. The contractions were long and close together, so I thought I was much further along. “I was much more in control in my previous births. I normally think, ‘I can do this!’ You get a break in between contractions and you can cope, but you don't get that with an induction. I don't normally need any pain relief, but I needed an epidural in the end.” Because inductions are medically controlled, there can be less gap in between contractions (two to three minutes) and the normal relaxing, zone-out endorphins a woman's brain produces in labour don't get produced with inductions. There's no easing into labour; it's all go from the start. Because of this, more women need epidurals than with natural deliveries. Unfortunately, this can lead to a bit of a medical intervention rollercoaster, where forceps/ventouse deliveries are more likely to be needed and there is a higher chance of a Caesarean.

AVOIDING INDUCTION

There are steps you can take to try to avoid inductions. Walking is a great way to help baby get into a nice low position. Some people find acupuncture and massage helpful. Stair climbing is also good to get baby into position and hopefully place pressure on your cervix. Make sure you choose safe options and check with your midwife before you start any methods to try to avoid having an induction. Before getting induced, you can also ask your midwife about having a stretch and sweep. This vaginal examination can stimulate the body to produce its own prostaglandin hormone and even though it's a bit uncomfortable, it may mean labour starts on its own. Dim the lights, move when you can, use the calming techniques you have planned, and have a good support person. An induction may not be the natural birth you were hoping for, but can still be a wonderful, special time for you and your new baby.


LET'S GET SOCIAL

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When you need a bit of help When it comes to delivering your baby, things don’t always go according to your birth plan. Sometimes medical intervention is necessary in order to ease baby’s entry into the world, explains Penny Voigt.

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n its simplest terms, an intervention means your midwife or doctor intervenes in the birth process to assist in delivering your baby. There are a number of ways this could happen: An assisted delivery by forceps or ventouse suction, an episiotomy, induced labour, or a Caesarean section. Whatever the

method, an intervention occurs when you are unable to give birth without assistance or your baby is in distress. As an expectant mum, it’s important you have a clear understanding about the risks and benefits of each of these interventions, so you can make an informed decision about what’s right for you and your baby.

INDUCED LABOUR If there are health reasons that pose a risk to either you or your baby, or you are overdue and past 41 weeks of pregnancy, your doctor may recommend bringing your labour on artificially instead of waiting for it to begin naturally. An induced labour is the process of starting your labour using drugs or other methods. An induction can be a lengthy process, lasting anywhere from 2 to 3 days up to delivering your baby within 24 hours of induction. Before being induced, your doctor or midwife will perform an internal examination to assess your cervix. Inserting a finger through the cervix to separate the membranes from the uterus without breaking them is called a stretch and sweep; it’s a gentle way of helping to start labour before an induction is performed. If the stretch and sweep does not start your labour, there are a number of other ways your doctor or midwife could induce your labour: Prostaglandin gel is a hormone gel that is placed in your vagina to help soften and open your cervix. It’s a slowworking gel and you may need more than one dose in order to start your labour. A balloon catheter is a small plastic tube with an uninflated balloon at the end. The catheter is inserted into your cervix and the balloon is inflated, putting pressure on the cervix and stimulating the release of prostaglandins which cause your cervix to dilate in preparation for delivery of your baby. An amniotomy or rupturing of membranes involves artificially breaking your waters to start your labour. Your doctor may insert a thin, plastic, hooked instrument through the cervix to break your amniotic sac. This form of induction can only be done if your cervix has begun dilating and baby’s head is low. Syntocinon Once labour has begun, if your contractions are too weak or irregular, you may be given syntocinon, a hormone that mimics your own natural hormone oxytocin. Syntocinon is given intravenously in small amounts until your contractions become strong and regular. Having an induction may mean you are unable to walk around freely or use a birthing pool.

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BIRTH AID

CAESAREAN SECTION A Caesarean section is a surgical procedure that allows a baby to be delivered via a surgical incision in the mother’s abdominal wall. A Caesarean is either planned, called an elective Caesarean, or unplanned, otherwise known as an emergency Caesarean. An emergency Caesarean is performed when baby or mother are in distress and a quick delivery is vital. There are a number of other reasons why an unplanned Caesarean section may be necessary: Labour is not progressing or moving forwards to make a vaginal birth possible. Baby’s head has not descended once the cervix has fully dilated. An induction has failed to bring on labour. Placenta praevia, where the placenta is situated in the lower part of the uterus or is covering the cervix. In the case of multiple pregnancies, babies in the breech position, or an overly large baby, an elective Caesarean may be recommended by your doctor or midwife. A Caesarean section will be undertaken with an epidural or spinal block, so the lower half of your body is numb while you remain awake. While you are totally conscious during

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the procedure, you will have little involvement in the delivery of baby. Whether it’s a scheduled Caesarean or an emergency decision, typically the procedure is straightforward and relatively quick, usually no more than 10 minutes followed by another 30 minutes of stitching you back up. During the procedure a short screen will be placed over your abdomen which will block your view of the actual surgery. Once your lower half is totally numb, the doctor will make a small incision in your lower abdomen, just above your pubic hair line, and another incision in the lower part of your uterus. The amniotic fluid is suctioned out and your baby is brought into the world – you’ll probably feel a bit of tugging as baby is pulled out. Excess mucous in baby’s respiratory tract will need to be suctioned out before you hear his first cry. Once the umbilical cord has been cut, the surgeon will remove your placenta and do a quick routine check of your reproductive organs. Then you are stitched up and ready to meet the newest little person in your life. Until the effects of your epidural or spinal block wear off, you’ll be unable to move around, so use this time to regain your energy. Once you are able to get out of bed, try walking around as moving will help speed up your recovery time.

ASSISTED DELIVERY If there are concerns about your baby’s heart rate, your baby is in a difficult position, or you’re too exhausted to help push your baby out, your doctor may assist the delivery of your baby using forceps or a ventouse. Surgical forceps have been used for hundreds of years as an effective and reliable means of assisting delivery. Not dissimilar in appearance to large spoons or tongs, forceps are designed to fit around the sides of your baby’s head; as you push with each contraction, your doctor will gently pull on the forceps to help guide your baby out of the birth canal. While forceps work well even if your contractions are weak or you’re finding it hard to push, you are more likely to have vaginal or perineal damage with this type of assisted birth, and will likely need an episiotomy. Forceps can also leave small marks on your baby’s face, but these will disappear shortly after birth. A ventouse is a plastic or metal cup attached by a tube to a suction device. The suction cup is attached to the top of your baby’s head and, during a contraction with the help of your pushing, baby is gently pulled through the birth canal. The ventouse is generally the preferred choice in assisted delivery, as it carries less risk of complications. With a ventouse-assisted birth, you are less likely to experience vaginal tearing or require an episiotomy, but baby may experience a small swelling on the head or have bruising which should disappear quite quickly.

EPISIOTOMY While the vagina and perineum are designed to stretch during childbirth, allowing baby’s head and body to move through the birth canal, many women have perineal tearing or require an episiotomy during delivery. An episiotomy is a small cut made to your perineum (the area between your vagina and anus) that is performed right before delivery to widen your vaginal opening. Once baby is delivered, the cut will be stitched up and the sutures will dissolve and fall out over the few weeks following birth. In the past, episiotomies were performed to prevent natural tearing of the perineum and to reduce the risk of foetal birth trauma. But today an episiotomy is only performed in the case of an assisted delivery with forceps, if baby is too large or in distress, or when baby’s shoulder gets stuck in the birth canal. In fact, women who tear naturally in delivery tend to recover in much the same time as those who have an episiotomy, and often experience fewer complications. As with any wound, your episiotomy cut will take time to heal, usually around seven to 10 days. Check your perineum daily to ensure there is no inflammation or any other signs of infection. To prevent infection and to help ease pain from the stitches you should: Change your maternity pad frequently. Place a cool gel pad or wrapped ice pack on your stitches for 10–20 minutes every few hours to help reduce swelling. Sit in a warm bath and pat your stitches dry afterwards. Pour water over your vagina when you urinate to help relieve any stinging or burning. Get up and walk around as much as you can and practice pelvic floor exercises to stimulate blood circulation into this area.

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Relaxing your body slows down the production of stress hormones.

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CHILDBIRTH CHOICES

Giving birth naturally – your way With all of the birth techniques available, how do you know which one is right for you? Penny Voigt explains.

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hether you decide on a water birth, hypnobirthing, Lamaze, the Bradley Method, the Alexander Technique, or a mixture of these, it’s important the birthing option you choose matches your own beliefs around childbirth and feels comfortable to you. To help you gain a clearer understanding of the various methods to choose from, here are some of the more common birthing techniques.

Water birth

A water birth is exactly that: Labour progresses in a waist-deep pool of clean, warm water, and baby is delivered either in the water or outside of the pool. The warm water is naturally relaxing and helps to alleviate some of the pain and

LAMAZE

pressure felt during labour. Along with reducing stress and anxiety, the warm water stimulates your body to produce pain-relieving endorphins, and it's agreed that women who labour in water are less likely to use medical pain relief. As your body is naturally buoyant in water, a water birth helps you move around easily and find a comfortable birthing position. During delivery, the sides of the pool provide support. It’s also easier to maintain an upright position and use gravity to assist baby in moving through your pelvis. The warm water softens the tissue of your perineum (the area between your vagina and anus), making it supple and allowing it to stretch to accommodate baby’s head as it passes through, while reducing the likelihood of an episiotomy. For your baby, a water birth provides a less traumatic transition from the warm,

“Knowledgeable parents making informed decisions” is the vision of Lamaze International, one of the most popular techniques for learning about pregnancy, birth and parenting. With a focus on increasing a mother’s confidence in her ability to give birth, classes help mums-to-be understand how to cope with pain and learn relaxation techniques, movement, and massage. Along with instruction on labour, birth, and the early postnatal period, classes cover focused breathing techniques, relaxation, and making informed decisions around any interventions that may be medically necessary. A typical Lamaze class consists of at least 12 hours of instruction, and women generally begin classes at the start of their seventh month of pregnancy.

watery surrounds of your womb to the outside world. Many people believe that babies born in water are calmer and tend to cry less, as the warm water allows baby to enter the world with less light and sound, and less of a dramatic change. During a water birth, you can still use gas and air if you find the warm water does not help to reduce painful contractions, but if you choose stronger pain relief like pethidine or an epidural, you will need to leave the birth pool.

Hypnobirthing

Founded on the principle that women are conditioned to fear childbirth and associate labour with excruciating pain, hypnobirthing embraces a different attitude to the way we think and talk about labour and birth. Hypnobirthing classes teach a simple program of self-hypnosis, special breathing techniques, relaxation, visualisation, and meditation that help women bring babies into the world in a calm and gentle way. The techniques used in hypnobirthing teach you ways to stay calm and in control during labour and birth. Hypnobirthing techniques focus on staying alert while at the same time shutting out the world and concentrating on your body, helping you relax even if you are in pain. Relaxing your body slows down the production of stress hormones like adrenalin that can inhibit the release of the labour hormone oxytocin and other endorphins. The best time to start hypnobirthing classes is between 25 and 29 weeks of pregnancy, as this will allow you enough time to practise the techniques you learn. It’s a good idea to bring your birthing partner along to classes as you’ll both learn breathing, relaxation, and visualisation techniques. Pregnancy BUMP & baby

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CHILDBIRTH CHOICES

The Bradley Method

With an emphasis on birth as a natural process, the Bradley Method encourages mothers to trust their own bodies. The primary goal of the Bradley Method is a natural, drug-free childbirth that promotes healthy mothers and babies. Developed in the late 1940s by Dr Robert Bradley, this birth technique relies on what are termed “the six needs of the labouring woman”, including deep and complete relaxation and abdominal breathing, quiet, darkness, solitude, physical comfort, and closed eyes. An intensive 12-week programme covers 12 units of instruction, and typically classes are started around your fifth month of pregnancy; the Bradley Method believes it takes months to prepare for childbirth and parenting, mentally, physically, and emotionally. Classes focus on diet and exercise throughout pregnancy, and mums-to-be are taught to manage labour pains through deep breathing, while the active participation of a birth partner as labour coach is supported. Along with prenatal nutrition and exercise, the classes teach a number of birthing positions to ease labour pains and prepare you for each stage of labour, and mums-to-be are taught to tune into their body and prepare themselves for a labour that avoids pain medication and intervention.

The Alexander Technique

The Alexander Technique teaches greater conscious awareness and control over how you sit, move, and react. It’s a simple and practical method that can enhance your comfort during pregnancy, labour, and recovery. By increasing awareness and bringing your attention to how it is you do what you do, you learn to suspend or even stop the habitual patterns which are not useful, and gradually replace those habits with better ones. By undoing patterns of tension or compression, you provide an opportunity for natural movement and natural postural reflexes to work. It's not uncommon to experience neck pain, lower back pain, carpel tunnel syndrome, and numbness in the hands as your body undergoes a number of changes during pregnancy. The Alexander Technique teaches you to work with your body’s structure, function, and new size to allow a greater freedom of movement. Learning to use your core spinal support can help you find a more comfortable position for walking, sleeping, sitting and bending. Using the principles of the Alexander Technique during labour and delivery helps you remain calm and focused, allowing you to turn the birthing process over to your body. Women are taught to use their own self-based body’s natural design during birth, recovery, breastfeeding, and care of baby. Lessons are ideally done weekly while pregnant.

LOTUS BIRTH

IT’S IMPORTANT THE BIRTHING OPTION YOU CHOOSE MATCHES YOUR OWN BELIEFS AROUND CHILDBIRTH AND FEELS COMFORTABLE TO YOU.

Also known as umbilical non-severance, lotus birth is the practice of leaving the umbilical cord uncut after birth so that baby remains attached to the placenta until the cord naturally separates, usually a few days after birth. Advocates of lotus birth believe that this prolonged contact is a time of transition that allows baby to slowly and gently let go of his attachment to his mother's body. However, medical research suggests there is some risk of bacterial infection, as the placenta at postdelivery stage is essentially dead tissue and has no circulation. If you are considering lotus birth, consult with your doctor or LMC.

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CHILDBIRTH CHOICES

Birthing POSITIONS

Birthing stool

k A birthing stool keeps you upright

while you’re pushing. The low height of a birthing stool helps flex your legs and expand the size of your pelvis, while the upright position of your body allows gravity to help baby move downwards. At the same time, a birthing stool allows your partner to provide support, either seated behind you or kneeling in front of you to help you maintain a comfortable position.

Standing k

Although standing helps gravity speed things up and has been shown to reduce labour pain, it can be tiring. It helps realign your pelvis and lengthen your body, which in turn helps baby line up with the angle of your pelvis. Walking, rocking from side to side, or rolling your hips can help baby move into the birth canal.

Hands and knees k

Similar to the position you would assume if you were washing the floor, keep your arms vertically below your shoulders, not too wide, and allow your body to rest on your arms. The hands and knees or all-fours position works well with the aid of a birthing ball. Arching your back from time to time can help reduce back pain, or try resting your upper body on a chair or birthing ball, while a cushion or pad beneath your knees can help you stay comfortable. During the final stages of labour, you may need to widen your knees in order to open up your pelvis.

SQUATTING OPENS YOUR PELVIS BY AS MUCH AS

30% MORE THAN LYING DOWN

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Lithotomy k

One of the most common birth positions, lithotomy means lying flat on your back or on a slight incline, sometimes with your legs in stirrups. While lithotomy is one of the few positions you can adopt if you have an epidural, it’s arguably not the best position for labour as it forces mum-to-be to push against gravity, it increases the pressure on the perineum often resulting in tearing or an episiotomy, and it places pressure on blood vessels leading to the uterus, limiting blood flow to your baby.

Side-lying k

Especially helpful if you're trying to avoid the lithotomy position, side-lying in the foetal position takes the pressure off your internal organs and blood flow to your baby, and can be used if you have had an epidural. Have your birth partner support your upper leg or use a partially deflated beach ball or large pillow between your legs to help support your upper leg. Side-lying is a good delivery position, and can help slow down a too-fast birth. Avoid using this position in the early stages of labour as it could slow down your labour.

Squatting k

Probably the best birth position for the second stage of labour, it does take some strength to maintain this position and it can be quite tiring. Hold onto a chair or onto your birthing partner, or squat against a wall to help you stay upright. Squatting opens up your pelvis by as much as 30% more than lying down. It also helps straighten the birth canal, allowing the pelvic bones to line up. Keep your weight on the back of your heels to allow the muscles in your perineum and vagina to relax and avoid tearing.

Kneeling k

Often used in conjunction with the hands and knees position, kneeling means to rest on your shins while your body remains upright. Swaying, rocking, or circling your hips and tilting your pelvis in this position can help relieve labour pain and guide baby into a better position. Leaning forward in this position helps reduce back pain during labour, and less pressure on your perineum means fewer tears and less chance of an episiotomy.

Birthing ball k

Using a birthing ball allows you to adopt different upright positions during the first stage of labour, while helping ease the pain of contractions. Sitting astride the ball, try rocking your pelvis from side to side or back and forth. Lean on your birthing ball from a kneeling position, or get into a hands and knees position and hug your birthing ball while lifting your bottom up.

Birthing bar

k

Use this attachment that can be added to most labour beds to help you get into a squatting position. When using a birthing bar, drop the foot of the bed and raise the head of the bed to allow gravity to help.

Sitting k

Sitting upright on a chair, on the toilet, or on a birthing ball or birthing stool, either facing forwards or backwards, helps open up your pelvis while allowing gravity to assist baby move downwards. Facing the back of the chair you are sitting on and leaning slightly forward can help relieve labour back pain, while rocking in this position helps baby move into a better birthing position. It’s also an ideal position if baby’s head is pushing against your spine as it encourages baby to move forward.


Every hug is doing your baby the world of good. You might not know it but hugging can lower their heart rate, help them relax and encourage brain development. Hugs can also help release oxytocin - the bonding hormone. The first hug your baby feels will be from you. Make sure the second hug is from us because HUGGIES® Newborn nappies have been specifically designed to provide comfort and protection for delicate young skin. HUGGIES® Nappies and Plunket believe in the power of hugs.

® Registered Trademark Kimberly-Clark Worldwide, Inc. © KCWW.

Family hugs work wonders


FOCUS ON NUTRITION

Eating for feeding

When you’re a breastfeeding mum, it’s important to make time for your own nutritional needs, says nutritionist Angela Phillips.

A

s busy mums, we put a lot of time into thinking of other people’s needs. Feeding our little ones is important and takes a lot of thought and energy, but it is equally important to put effort into thinking about your own diet, so you can do the best possible job as a mum.

PRIORITISE REGULAR MEALS A common trend I see with mums of littlies is lack of meal structure and over-snacking. For some, this results in losing excess weight, and for others, weight gain. For anyone, it often results in poorer overall nutrition quality. Missing meals is a dangerous trap and can lead to tiredness, over-hunger, and poor decision-making around food. Here are some tips to help with ensuring regular meals: • Plan your meals in advance – including snacks – and keep the plan on the fridge. • Online grocery shopping is an easy way to keep cupboards stocked, or use a service like My Food Bag to avoid having to think of what to make. • If you struggle to eat breakfast due to lack of to appetite or time, try a smoothie or yoghurt with a handful of oats stirred in. • Cook enough dinner to allow for leftovers for either lunches or dinners. • Have a variety of food options available to keep lunches interesting. • Keep some easy dinners on hand that can be thrown together last minute, as well as a frozen meal or two in the freezer for "one of those days". • Use a slow-cooker. On a busy day, dinner can be as simple as putting in some chicken pieces and pouring canned tomatoes on top!

LOSING WEIGHT TOO QUICKLY? If the demands of breastfeeding result in you losing weight too quickly, or your body

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weight drops below your ideal, you will need to work on boosting your food intake: • Ensure you are eating three meals plus two to three snacks per day. • Boost your meals by adding oils, nuts, seeds, cheese, dried fruit, etc. • Try a supplement shake such as Complan. • Use plenty of avocado, spreads, and dressings. • Avoid hot drinks, or drinking excessive fluids around meal times, as they may suppress your appetite. • If you’re very tired in the evenings, consider having your main meal at lunch. • Have milky drinks between meals, such as Milo, hot chocolate, or a chai latte.

STRUGGLING TO LOSE PREGNANCY WEIGHT? It's important to find the balance between eating to reach your healthy weight, and eating to get enough calcium, iron, and other important nutrients. Continue to eat a well-balanced diet, and: • Try to match food to hunger levels. Ask yourself, "Am I really hungry?" before having a snack, as tiredness, boredom, and stress often trigger the desire to eat. • Drink plenty of fluids as, at times, thirst can be mistaken for hunger. • Exercise regularly, and if you struggle to find the time, try "exercise snacks" – five- to 10-minute blocks of exercise throughout the day. • As above, plan meals and snacks.

• Packing a lunchbox can be helpful if you’re home a lot and find yourself looking in the pantry often during the day. • Chat to a dietitian/nutritionist to get an individualised plan.

HOW DO YOUR FOOD CHOICES IMPACT YOUR BABY? It's amazing to think that breast milk can provide enough nutrients for your baby to develop and grow. Most mums are aware that they need to optimise nutrition to meet their baby’s needs on top of their own, but it is also important to understand that the food you eat can impact your baby in other ways. There is evidence to show that food choices can make a difference to things like whether your baby suffers from colic, and a small, unpublished Australian study showed that a low-FODMAP diet reduced baby's crying by, on average, one hour per day. Always talk to a dietitian before trying this or any other "food interventions". If your baby has an allergy, the allergen may pass from your diet into your breast milk. Depending on the severity of the allergy, you may need to eliminate that allergen from your diet. Discuss this with your GP or dietitian. There is significant research investigating the impact that good bacteria can have on our overall health. Breast milk is teeming with good bacteria, so keep those goodies coming!


d e l b u

t n ow

o r T

GO FLORA REPAIR The kindest and easiest way to care for women’s health issues Available at all leading pharmacies and health stores nationwide. For our full range visit gohealthy.co.nz

? e r e h


It can take six to 12 weeks after birth for your body to heal.

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HEALING HINTS

Recovering from birth

Your body will need time to heal following the birth of your baby, explains Kelly Eden-Calcott.

I

thought I was pretty prepared for my first birth. And I was – it went how I expected it to (a bit earlier and quicker than I expected, but there weren't too many surprises). That is, until after the birth. All the after-birth books I had read were about caring for my baby. I had my burping techniques DVD, sleep sack, ergonomic baby carrier – I was ready! What I hadn't thought about was what my body would be doing. In my head, I imagined birth would go along the lines of: Delivery, baby in my arms, snuggly photos, and that’s it, all done. In reality, it was a bit different.

Straight after delivery I was too polite to yell, “Will you just get away from my vagina!” at my very nice midwife, but seriously, there was a lot of poking and prodding going on after you've already done all the hard work of pushing a baby out. They call it the third stage of

labour, which is when you deliver the placenta and your midwife will usually press down firmly on your stomach to check your uterus is contracting. Then you're checked for tears and, if you’ve torn or if you've had a episiotomy, you’ll be stitched up. To be fair, you'll be so busy greeting your new bub and feeling amazed that you might not register much of what is happening down there. It's all for your own good, after all. Your midwife wants to know you're not going to hemorrhage everywhere and have any bits left unattended, but still, it can be a bit of a surprise. First- and second-degree tears are common, usually in the perineal area between your vagina and anus, but they typically only need a few (if any) stitches and heal quickly. You'll probably be shaky, tired, sweaty, and bloody, and your not-so-private-anymore parts will hurt, but you should be able to get up and have a snack and a nice warm shower (with help if you've had a Caesarean section) before too long.

TEARS AND EPISIOTOMY

An episiotomy is a cut made to the perineum to make a wider opening for baby. Third- and fourth-degree tears are ones that extend to the rectum. These are painful and slower to heal than first- or second-degree tears, which involve skin and a little bit of muscle only. To care for and keep your wound clean, wipe front to back on the toilet, keep sanitary pads fresh by changing them at every toilet stop, and try sitz baths, drying yourself carefully afterwards by patting with toilet paper or a clean towel, never rubbing. Breastfeed laying down to aid your pain, and don't sit for long periods.

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HEALING HINTS

The first few days And then there's the discharge. Most women, not just me, are surprised by this. The midwife may warn you to pack maternity pads in your hospital bag if they’re not supplied by the hospital or birthing centre (and the fact they are mattress-sized should really be a clue), but with bleeding heavier than a normal period, it's a lot of discharge. Both vaginal and caesarean section births bleed vaginally, as it comes from the site where the placenta was attached and the shedding of the thick uterine wall that was cushioning your baby. You can't use a tampon until you are completely healed, so stock up on maternity pads, because you’ll experience at least two weeks of bleeding, probably even up to six weeks before it completely stops. The red, heaviest bleeding should stop by two weeks, though; if it doesn't, get checked straightaway by your midwife or GP. For the first few days, you might get extra little gushes of blood and contractions, especially when you breastfeed. It's just your uterus contracting back to its normal size, no need to worry. With all this blood, you won’t want to wear your best lace panties, so make cheap cotton granny undies your best friend. In the first 24 hours, wrapped ice packs or frozen maternity pads are fantastic for taking down swelling. Some people also use arnica for bruising or witch hazel wiped on with cotton pads (check with your midwife before using these). Everything stays swollen for a few days, but after 24 hours, what you can feel is usually swollen labia from excess fluid, and ice won't help. The fluid will disappear on its own in a couple of days. As soon as you feel you can, start doing your pelvic floor exercises. These weird little exercises are amazing. They not only help to fix your floppy pelvic floor so you don't leak wee when you laugh, but they also get your circulation going, which helps your stitches to heal faster and reduces swelling. Some women avoid them, thinking they will hurt, but they usually feel comfortable as long as you are doing them right. Weeing can be scary after birth, and pooing even worse. Ural sachets can neutralise the acid in your wee and make it less “stingy”. Some people wee in the bath in the first few days, or wee in the toilet while squirting water at your vagina to flush the wees away more quickly and minimise stinging. Sometimes the tiny nerves in your bladder can be temporarily damaged, so you might not get the urge to wee. It's important to go often anyway, like you did when you were pregnant. Grab some stool softeners if you need to, and whatever you do, don't hold on. It just gets bigger and more difficult to pass. Try to avoid getting constipated by making sure you eat well and drink lots of fluids. You can actually feel surprisingly energetic in the first few days after

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a vaginal birth, but this is not the time to redecorate the kitchen or catch up on paperwork. Resting and caring for your baby are your main jobs for now. So put down the paintbrush and the laptop, and rest. Post-birth healing is more a marathon than a sprint.

PELVIC FLOOR EXERCISES: Are you doing them right?

The first few weeks The postnatal period is just really leaky. Wee and little farts can sneak out when you move, milk leaks down your top, and then there's the hormonal crying and night sweats. There's not much you can do about it, except more pelvic floor exercises and lots of rest. Your biggest job now is resting and getting your perineum healed. As well as the witch hazel, breathable cotton knickers, keeping clean, and changing pads frequently, some doctors recommend sitz baths. A sitz bath is a shallow basin with warm water (you can buy them to go over your toilet seat) that you sit in for 20 minutes three times a day or, some say, every time you go to the toilet. Our bodies are amazing and, if there haven't been too many complications, you may be starting to feel normal again already. The more you rest, the more quickly you heal, so get someone to help for a few weeks with laundry, cooking, housework, and caring for older children. Avoid too many stairs, long walks, and vigorous exercise. Vaginal births can take six or more weeks to heal completely, and Caesarean sections 12 weeks at least. Your stitches, if you have them, will be itchy and still sore, but around three weeks post-birth, they will reabsorb and start to feel better. With mild tears, you may not feel them at all any more, even if there is scarring. Your midwife will check your stitches, but you need to keep an eye (or a nose) out for infection. If things start to feel worse, or if there is a bad smell, you may have an infection. This is not the time to feel embarrassed; it will get much worse left untreated. Some women find a trip to a women's health physiotherapist is helpful for post-birth healing. They can help with pelvic floor, swelling, healing of tears, and scarring, among other things. Don't put up with pain if it carries on. Get help.

do

• Lift and tighten internally (like you're holding a tampon in). • Some lower abdomen tightening is okay. • Think quality, not quantity. • Combining short holds and longer ones in little bursts throughout the day is better than trying to do 100 at once. • Keep your pelvis still.

don't

• Hold your breath. • Squeeze your butt, legs, or stomach. • Tuck up or move your pelvis. • Do too much. • Give up too soon – it takes around 12 weeks to start getting results.

CAESAREAN SECTION AS YOU RECOVER FROM SURGERY, YOU MAY FEEL GROGGY AND SICK FOR A FEW HOURS. YOU CAN GET UP (WITH YOUR MIDWIFE’S PERMISSION) AFTER SIX TO EIGHT HOURS, BUT REMEMBER, THIS WILL BE A LONG HEALING PROCESS. Pain should decrease after four to five days, but go slowly. No lifting for up to six weeks anything heavier than your baby. No vacuuming or driving for four to six weeks. Keep active and do pelvic floor exercises, but avoid any fitness programme or long walks until four to six weeks after surgery. You can purchase special underwear to help support your wound, and massage the wound gently after about three weeks.

+ + +

+

+


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

“When I fell pregnant I would lather myself in Bio-Oil. I thought, listen, if ever there’s a time to use Bio-Oil, this is it. I’d gotten stretch marks a few years ago when I put on a bit of weight, but when I was pregnant I didn’t get a single one. And now my friend’s just found out she’s pregnant so I’ve told her all about it. You know, I think girls just wanna look good. When you look good you feel good.” Lisa with Gia

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.


Qu es

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new mum

Um... WHAT did you just say to me?

ka

10

ld

o y u sho s n o u i t NEVER a s


JUST DON’T GO THERE

There are some things you really shouldn’t ask, says Frances McInnes of online maternity store Breastmates (breastmates.co.nz). Even if you think it’s okay, it’s not, so just don't.

even have time to tackle her domestic responsibilities. Hey, how about you offer to come over and help her “do nothing all day”?

ave you ever noticed how social etiquette is sometimes forgotten when talking to a new mum? Questions which ordinarily would be off-limits in everyday conversation seem to pop out of other people’s mouths without much thought behind them. These seemingly well-intentioned but ultimately unhelpful questions can open a floodgate of emotions for a new mum dealing with crazy hormones, sleep deprivation, and a tiny baby. Here are 10 questions to avoid asking a new mum at all costs.

Aside from verging on too personal, some women can’t breastfeed, decide not to, or are struggling to. Instead of sending her on a guilt trip, offer support for something that, contrary to popular belief, doesn’t come naturally to all women.

H

1 When are you due?

If in doubt as to the state of her womb, just don’t ask! Avoid referring to her size, body shape, or general appearance, as asking her this is tantamount to calling her fat. Also, keep in mind that baby bellies tend to hang around for a while after the baby has been born, and it can be tricky distinguishing between a pregnant tummy and a post-pregnancy belly.

2 Did you tear or need

to have stitches? This is definitely

overstepping the line of “too personal”. Unless she’s a really close friend and quite comfortable sharing the intimate details of her baby’s birth, she’s probably not going to want to get into a discussion about her nether regions. Just don’t go there.

3 Did you have a natural

birth? Whether or not she endured 12 hours of intense drug-free pain, decided

on an epidural, or had a C-section, she’s a superhero! Having respect for her choices is more important than judging her. Childbirth is fraught with unexpected complications, often veering crazily from the most perfect birth plan, and can leave new mums feeling guilty when things don’t work out as planned.

4 So, when are you going to

give this one a sibling? Most new

mums are far too busy concentrating on their new baby to begin planning another one. So avoid piling on the pressure when she’s already feeling overwrought. Give her time to recover from this baby’s birth before you start bulldozing her into the next one!

5 Does the baby sleep

through the night yet? Implying

that she’s doing something wrong because her baby doesn’t sleep through the night can transform even the most relaxed mum into an overly paranoid crazy woman. Newborn babies wake every few hours to feed, and sleep deprivation for new mums is part of the journey. All babies are different, and each one reaches these little milestones in their own time. And no, it’s not helpful to brag that your babies all slept through the night by six weeks of age. Just don’t mention it.

6 What do you get up to all

day? Clearly you’ve never had a new baby!

Her day will be taken up mostly with caring for her newborn, a full-time job in itself. If she’s lucky, she’ll manage a shower and to brush her teeth. If she’s really lucky, she may

7 Are you breastfeeding?

8 Is that baby eating

enough? Unless you’re a doctor,

nurse, or trained health professional, you shouldn’t be asking this question. If she’s already feeling anxious about breastfeeding, you’ll just be giving her something else to worry about. Babies who are thriving and growing are eating well.

9 Is he/she a good baby?

Look, there are no “good” or “bad” babies, just babies. And they’re all different! As much as we love them, they can be challenging, complicated, frustrating, and demanding. Avoid labelling her baby with something as narrow and judgemental as “good” or “bad”.

10 Are you getting much

sleep? Probably not! Most new mums

are up every few hours, with short bouts of sleep in between. Offering help in the form of cooking a meal or tidying her house is a practical means of supporting her or, better yet, offer to look after her baby and her house while she takes to her bed for some uninterrupted ZZZZZZ time!

GO AHEAD, ASK US ANYTHING!

Do you have an embarrassing question about pregnancy, labour, birth, or new motherhood? Ask and we’ll try to answer! Email editor@bumpandbaby.co.nz with your question, or find us on Facebook at facebook.com/bumpandbabynz and send us a message!

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e l t t Bo asics b

It can be challenging for mums who are using baby bottles to find accurate information on how to use them safely. Here are some answers to your frequently asked questions about using bottles.

Y

ou may be returning to work or simply want to have a night out with your partner, or perhaps it’s Dad’s turn to help with the nighttime feeds. Whatever your reason, choosing to feed your baby with a bottle is a personal decision, and it’s important that you have the right information to ensure you’re using bottles safely. New mums often don’t know where to begin when it comes to using baby bottles. Here are some answers to your frequently asked questions about getting started with bottles.

How many bottles do I need to buy?

Answer: This depends on personal preference, whether your baby is taking a bottle full-time or only occasionally, and how frequently you want to be washing and sterilising your bottles (once a day all at once, or after every time your baby has had a bottle). You need to have the right number and size of bottles for the amount of food your baby needs, and you need to have enough bottles to be sure to always have a clean bottle to feed at hand. A smaller 125ml bottle is ideal for the first eight weeks of your baby’s life, when younger babies eat smaller amounts but feed more frequently. Larger 260ml bottles are more appropriate for when your baby starts feeding less frequently or wanting to drink more than one 125ml bottle.

How many bottles of each size do I need? At what point do I switch from using smaller to larger bottles?

Answer: The younger the baby, the more frequent feeds they require per day. Thus the smaller 125ml bottles are a good option for young babies. The older the baby (from around eight weeks), the less feeds per day they require, so the less bottles you will need – but larger 260ml bottles will work better. When to switch bottle sizes is about the moment your baby is drinking more than a smaller bottle per feed. At this point, switching to a larger 260ml bottle is more sensible, so you can make a whole feed in one go instead of making one bottle and then needing to make a refill. Every baby is different, but usually around two months of age is when babies start to want a larger amount at their feed.

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FED IS BEST

GETTING STARTED WHEN YOU’RE GIVING YOUR BABY A BOTTLE, THERE ARE A FEW THINGS YOU NEED TO BE AWARE OF BEFORE BOTTLE PREPARATION.

+ Always clean and

sterilise all bottle feeding parts before each use. Wash your hands thoroughly and make sure your surfaces are clean before handling the sterilised equipment. Don’t use abrasive cleaning agents or anti-bacterial cleaners when you’re cleaning bottles and teats. To inspect the teat, pull it in each direction and look for cracks or punctures. Do NOT use a microwave for heating or defrosting breast milk. It can destroy important qualities of breast milk. It is also advised not to warm milk in a microwave, as this may cause uneven heating and could scald your baby. Alternatively, place the container of milk in warm water until the milk thaws. Warm it to body temperature in a bowl of hot water. Always check the milk temperature before feeding by squirting it onto the inside of your arm. Use the milk immediately and throw away any left over after the feed. It’s not safe to reheat or refreeze milk. Make sure that the bottle lids are not over-tightened.

+ + +

DON'T USE THE MICROWAVE TO HEAT OR DEFROST BOTTLES. YES, IT SEEMS LIKE THE MOST CONVENIENT OPTION, BUT IT'S NOT SAFE.

+ +

+ + +

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top tips Your baby will enjoy feeding from the bottle more if you smile and chat to them. Tilt the bottle so that the neck and teat fill up with milk before you carefully place the teat in your baby’s mouth – this avoids swallowing any air bubbles, which could cause gas. If your baby seems unsettled during the feed, the cause may be wind – try gently rubbing your baby’s back to encourage burping. Try to get into the habit of burping about halfway through the feed and after feeding – this can help to prevent spitting up.

How much should my baby be drinking? Answer: The scientific table below gives an indication of the average amount your baby will drink from the bottle or breast, by age. Please keep in mind that this is only a guide – your baby may drink more or less depending on a number of factors, so this should not be adhered to rigidly. With bottle-feeding, you can track amounts, which you cannot do if you are breastfeeding – but if you are breastfeeding there are other factors you should take into account to ensure your baby is receiving enough milk (wet nappies, steady weight gain, a baby who is well and happy). Talk to your GP, LMC, or Plunket nurse if you are concerned about how much your baby is drinking.

Baby’s age (months)

Number of feeds per day

Range of intake per feeding

<1

7-8

2-4 ounces (60-120ml)

1-3

5-7

4-5 ounces (120-180ml)

3-6

4-5

6-7 ounces (180-210ml)

6-9

3-4

7-8 ounces (210-240ml)

9-12

3

7-8 ounces (210-240ml)

Source: Delaney, AL and Arvedson, JC (2008). "Development of swallowing and feeding: Prenatal through first year of life." Developmental Disabilities Research Reviews, 14(2), 105-117.

What’s the difference between bottle materials?

Answer: With baby bottles, you usually get what you pay for – the el-cheapo supermarket bottles are not the safest choice. If you’re buying plastic bottles, check they are BPA-free. BPA stands for “bisphenol A”, a chemical which has been used to make plastics and resins. Some research has shown that BPA can leach into food or drinks from containers which are made with BPA, and exposure to BPA is a concern because there are possible health effects. Glass bottles should be made from pharmaceutical-grade glass which is heat-resistant and thermal shock resistant. Some baby bottles are made from food-grade stainless steel, which is durable and unbreakable. It’s your choice what you type of bottle you prefer for your baby.

How do I clean my bottles and teats?

Answer: If you have a dishwasher, ensure your bottles and teats are dishwasher safe. Place the small parts on the top rack of the dishwasher or in a special basket which sits in the top rack of your dishwasher and keeps small items from being tossed around during the cycle. Bottles and rings can also be hand-washed in the sink with plenty of hot, soapy water. When hand-washing teats, use only your fingers and warm soapy water. Avoid washcloths, sponges, and bottle/teat brushes with bristles that may tear the silicone. When your bottles are clean and rinsed, you can sterilise them by using an electric or microwave steam steriliser, or boil them in a pot on the stove for five minutes. Remember, your bottles must be fully disassembled and clean before you sterilise them. Also, there is no need to turn the teat inside out during washing and sterilising.

When can I stop sterilising bottles and just wash them with hot, soapy water?

Answer: Good hygiene is crucial in your baby’s first year. Babies’ immune systems are not yet mature enough to fight off all the harmful bugs that adult bodies can cope with, so they are more vulnerable to viruses, bacteria and parasitic infections. Steam sterilisation is recommended for at least the first 12 months of your baby’s life.


FED IS BEST

How do I know which teats my baby needs? Answer: Teats are available in different flow rates for your growing baby and often have numbers on them to indicate which stage they are for. Check the teat which comes with the bottle you have purchased, or check the packet for replacement teats to see which stage/age it is recommended for. Depending on the age of your baby, teats may have one, two, three, or four openings for fluid, which means your baby will be getting either a slow, medium, or fast flow. A newborn baby will normally need an extra-soft, newborn-flow teat. Younger babies need a slow flow, while older babies prefer a faster flow. Teats which are made for older babies may also be bite-resistant as babies love to chew everything in sight when their teeth start to come in. It is recommended that you use slower-flowing teats if you are feeding your baby expressed breast milk, and also for babies under the age of six months.

When do I move to the next step up in teats?

BOTTLE FEEDING POSITIONS As with breastfeeding, there are certain positions that will suit your baby better for bottle feeding. Hold your baby close to you on your lap in a semi-upright position so you can make eye contact. If necessary, put a pillow on your lap to raise your baby up. As with breastfeeding, alternate your hold positions from side to side. This will help your baby's eyes and neck to develop more equally. Try alternating halfway through the bottle after burping your baby. By doing this from the very start, your baby is less likely to choose a preferred side. The underarm or rugby-ball hold is a good choice if you’ve had a Caesarean, or if you have twins. Place a pillow across your lap to help support your baby in this position.

Answer: Different teats represent different fluid flow rates, from slow to faster. If you’re breastfeeding and feeding your baby expressed breast milk, it’s better to stay with a slower-flow teat. If your baby is becoming frustrated at mealtimes – you may notice them suckling hard and then pulling away and crying, then suckling hard again – or if they are taking longer than 20 to 30 minutes to finish a bottle, this may be an indication that the current flow is too slow. Try a teat with a higher flow rate and see if that helps. However, if your baby has let go of the teat and is spilling milk, is getting too much milk to swallow, or milk is dripping out from between their lips and the teat while they are drinking, the flow rate may be too fast and you should try a teat with a slower flow rate. You may also like to try variable-flow teats that can give slow, medium or fast flow using just the one teat, by turning the bottle so the flow mark is in line with the baby’s nose. The variable flow teat is also recommended for thicker liquids.

IT’S IMPORTANT THAT YOU HAVE THE RIGHT INFORMATION TO ENSURE YOU’RE USING BOTTLES SAFELY. How often do teats need to be replaced?

Answer: This depends on how often your baby is receiving a bottle. For babies who take the occasional bottle, teats may last longer, while if your baby is having bottles full-time, the teats will need to be replaced more often (every three months is recommended). Check them regularly for signs of wear and tear. If you notice cracks, tears, punctures (from little teeth!), or breaks, it’s time to replace the teat. Also watch for signs of discolouration, and if the liquid pours out of the teat in a stream, the hole or holes may have stretched and the teat needs replacing.

How do I store expressed breast milk?

Answer: When you’re using a breast pump, you might extract more milk than your baby can drink in one meal! Fortunately, you can easily store it for future use. Breast milk can be kept at room temperature for four hours or refrigerated immediately and stored on a shelf in the fridge (not in the door) for up to 48 hours. If you are storing milk in the fridge to add to during the day (if you are expressing a few times a day), you can add newly expressed milk to previously expressed milk, but only add milk that has been expressed into a sterilised bottle or breast milk container, and only make one batch of milk per day – don’t carry over. Also, don’t add freshly expressed breast milk to previously frozen milk or to milk that’s already in a container in the freezer. You can store breast milk in the freezer for up to three months, as long as it is stored in either sterilised bottles fitted with a sterilised screw ring and sealing disc, sterilised storage cups, or sterilised milk storage bags. Clearly label each container with the date and time it was expressed, and use older breast milk first.

tip Only store breast milk which has been collected with a sterilised breast pump.

GO AHEAD, ASK US ANYTHING! Do you have a question about infant feeding? Visit facebook.com/bumpandbabynz and ask other mums and our experts for advice!

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MILK MADE

All bottled up If you’re using baby bottles to feed your little one, here are the latest options and accessories.

AVENT NATURAL GLASS FEEDING BOTTLE The wide breast-shaped nipple promotes natural latch-on similar to the breast. Available from baby retailers

TOMMEE TIPPEE CLOSER TO NATURE BOTTLES With a breast-like teat, these bottles feature a special valve that allows the bottle to breathe and release the pressure from sucking faster, so baby will transfer from breast to bottle and back more easily. Available at baby retailers MAM ANTICOLIC BOTTLES Ventilation holes in the base regulate pressure balance and airflow, so milk flows undisturbed without air bubbles, reducing colic in 80% of babies who use it. Available from pharmacies and Baby City Stores

$

MEDELA CALMA BOTTLES When your baby breastfeeds, they create a vacuum and are able to suck, swallow, and breathe in their own individual rhythm. Calma is designed with this in mind, so your baby can maintain their natural sucking behaviour. Available from baby retailers and pharmacies

GREAT BUY! WE LOVE IT!

AVENT BOTTLE WARMER ON THE GO No power needed – a bottle warmer you can take anywhere! Boiled water in the thermos flask stays hot for up to six hours and can be used to warm multiple bottles. Available from baby retailers

AVENT COMFORT SINGLE ELECTRIC BREAST PUMP Designed so your milk flows directly from your breast into the bottle, even when you are sitting up straight – no need to lean forward. Available from baby retailers

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Protecting tiny tummies from harmful germs Good hygiene is crucial in baby’s first year. Sterilising is all about protecting your baby from harmful bacteria until their immune system is strong enough. Our steam sterilisers are quick, effective and chemical free.

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Baby on board

W

hen parenthood arrives, you might find yourself a mum-on-the-go enjoying a packed schedule of social engagements for yourself and bubs, or you may end up at home for days on end blocking out the world and just enjoying your new baby. Either way, for most new mums there will be some car travel in your life. Your priority is now going to be keeping your precious bundle as safe as possible out on the road.

GET IN EARLY As you’ll hear repeatedly at your antenatal classes and during your midwife visits, make sure you have a car seat fitted, organised, and ready to roll well before your due date. (After all, Dad will have enough to contend with when you go into labour without having to rush to the nearest baby store to collect the car seat you should have picked up weeks ago!) If you choose to rent your child’s first infant seat, some providers now give you a little grace on the rental to allow you to get the seat fitted with plenty of time to spare.

CAPSULES A capsule is the word commonly used to refer to your baby’s first car seat, which can slot into a “rocking” base in your car’s back seat. This unit can easily be transferred by a carry handle, so you can move your baby in and out of the car without having to strap, unstrap, and disturb them.

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hase, c r u p u rent, o y r e Wheth e- down, m d n a h or u se a r seat safety capsule and ca are paramount, explains Tiffany Brown.

Some brands of capsule are compatible with stroller frames, too, giving you maximum portability with your little one. Many people find this particularly advantageous considering the amount of time their newborn babies spend sleeping. A capsule seat will suit an infant from around 2kg up to 13kg in weight, depending on the model, and must always be fitted in a rear-facing position.

CONVERTIBLE CAR SEATS The other type of seat suitable for newborns is a convertible car seat, which can be positioned in either a rear- or a forward-facing position. The main advantage to these child restraints lies in future-proofing your car seat purchase. The restraints are strapped or tethered to the back seat using one of several internationally accepted methods, and can accommodate children up to a weight of 36kg. The down side? They are less portable than capsules, so you’ll find yourself disturbing baby by moving them in and out of the seat if you travel by car frequently. New Zealand law provides that children up to the age of seven should be restrained in an appropriate child’s car seat or booster seat. Seven- and eight-year-olds should be seated in a child restraint if one is available, and children up to the age of 14 must use seatbelts and sit in the back seat. It’s wise to keep these future requirements in mind when committing to the purchase of a car seat.


ON THE ROAD

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BUYING SECONDHAND BUYING SECONDHAND MAY SEEM LIKE A GREAT SOLUTION, ESPECIALLY FOR AN INFANT SEAT THAT YOU’RE ONLY GOING TO USE FOR A SHORT TIME. HOWEVER, YOU NEED TO EXERCISE EXTREME CAUTION. UNFORTUNATELY, NOT EVERYONE IS GOING TO BE HONEST ABOUT THE HISTORY OF THE SECONDHAND CAR SEAT THEY ARE SELLING. STANDARDS FOR APPROPRIATENESS AND SAFETY ARE UPDATED ALL THE TIME, SO AN OLDER SEAT, OR ONE MANUFACTURED ELSEWHERE, MAY NOT CONFORM TO THE MODERN IDEAL, EVEN IF IT’S BRAND NEW AND NEVER BEEN USED. Ask these questions before you buy secondhand: When was the car seat made? Check the manufacture date on the seat's shell. Don’t buy a seat that’s more than 10 years old, or whose manufacture date is missing or looks like it’s been changed. Does it have an expiry date? Look for a date, or markings that say “Do not use after”. Some car seats only have a limited lifespan of five to eight years. Which standards does the car seat conform to? Legally accepted standards in NZ are NZS 1754 (a black and yellow “S” mark safety sticker), AS/NZS 1754 (a red and white sticker with five “ticks”), or UK ECE 44.03 (orange or red sticker with an “E” and a number in a circle). If there is no sticker, don’t buy it. Does the car seat come with an instruction manual? If not, can you find the information you need

• •

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DIONO RADIAN RXT CONVERTIBLE $549 The Radian rXT takes your child from birth (2.5kg) to, forward-facing (36kg) and booster (54kg). Full steel framing provides unmatched strength and safety, while patented technology significantly reduces force affecting a child’s head, neck, and chest in an accident. Narrow fit allows for three across. Strength, style and comfort. Available exclusively from Baby on the Move

to fit the seat correctly online, or will a registered child restraint technician fit it for you? If not, don’t buy it. Are there missing parts? Parts may include locking clip, padded inserts, tether bolt, harness straps, a cover, or other accessories. If you’re unable to buy replacements for the car seat, it has expired and shouldn’t be used. Are you confident about the car seat’s history? If you suspect the seat may have been in an accident or mistreated, don’t buy it. Is there any obvious damage? Look for excessive sun-fading, mouldy straps that have been bleached and whose webbing is now weak, a torn or frayed harness, and cracks, splits, or white marks in the hard plastic parts of the shell. These characteristics indicate a seat whose ability to keep your child safe is compromised.

• •

CLEK FOONF The Foonf is designed with style and safety in mind. Easy to install, narrow enough to allow for three across (planning for the future!), and super-easy to use. Top that with innovative advanced safety features, extended rear -acing, forwardfacing use, and great colours, and you have the mother of all car seats you can use from day one. From RRP$899, see clekinc.com for stockists

RENTING Renting rather than buying is a good option if you’re a little undecided, to help with cashflow (expecting a newborn can be an expensive business!) or if you’d like to have the benefit of an infant capsule for a short time before investing in a car seat that will take your child through to their older years. The following list gives you information on car seat hire options and costs in New Zealand. Most retailers recommend booking as early as possible. A couple of months prior to your due date is best, and ensures you’ll get your pick of their available stock. Baby on the Move (babyonthemove.co.nz): Seats cost between $50 and $185 for six months, depending on the model. Baby Factory (babyfactory.co.nz): Capsule and bases cost $30 for one month, $40 for three months, or $50 for seven months, with a $40 refundable bond. Convertible car seats cost $50 per week for up to 10 weeks’ hire, with a $100 refundable bond. Sweet Beginnings (sweetbeginnings.co.nz): Capsule and bases cost $30 per week, $75 for one month, $120 for three months, and $185 for six months. Convertible car seats cost $40 per week, $55 per month, $90 for


ON THE ROAD

tip Not only should your baby's child restraint be properly installed from the get-go, ensure the straps are all appropriately adjusted for their body weight and size (unlike this little lady, whose straps need some adjustment to be safe!). You'll need to continue to check the straps every few weeks as they will require adjusting as your baby grows.

three months, and $150 for six months. They also offer a nationwide delivery and collection service for just $10. Baby Travel (babytravel.co.nz): Both capsule and bases and car seats cost $6 a day or $30 a week, with a $60 refundable bond. Hire Things (hirethings.co.nz): Capsule and bases from $25 per month, car seats

from $30 per month. Hire Things have locations all over the country. When buying or renting a car seat, most retailers offer the services of a trained child restraint technician to fit it, and instruct you how to use it properly. Take advantage of this service. You’ll have plenty to think about once baby arrives, and worrying about the seat is one less headache.

NOTE: PLUNKET IS DISCONTINUING THEIR CAR

SEAT RENTAL SERVICE. THIS SHOULD BE COMPLETELY PHASED OUT BY THE END OF 2016.

REAR-FACING IS SAFEST The New Zealand Transport Agency (NZTA) recommendation is to seat children in a rear-facing position until 24 months. Facing away from you and towards the rear of the car, your infant’s vulnerable spine, head, and neck are more protected in case of accident. A baby’s head accounts for about a quarter of their entire body. On impact, a rear-facing baby’s body moves back into the seat shell rather than forward and away from the safety of the seat. It’s vital never to fit a rearfacing seat into a seat with airbags. These could cause serious injury or suffocation in an accident. Pregnancy BUMP & baby

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Holy moly, this isn't quite what your infant wants to be confronted with straight after they're born!

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LOOK AT ME

Face time

Here’s how infants learn from facial expressions, explains Vanessa LoBue, Assistant Professor of Psychology at Rutgers University Newark.

F

aces and facial expressions have also become adept at differentiating a special power over us as between their mother’s face and the human beings. While friendly faces of strangers, looking longer at faces make us feel warm and images of their own mothers than at fuzzy, those of our opponents images of another woman. evoke fear or even anger. And within a matter of days, they will So, when do we as kids learn to learn to discriminate between different recognise faces and facial expressions? emotional facial expressions, like happy, And what lessons can be learned by parents sad and surprised faces. whose facial signals carry a massive Over the next few months, faces will amount of information for infants? become a newborn’s favorite stimulus as he As a researcher primarily interested or she acquires more and more expertise at in emotional development, identifying familiar faces. I’ve spent years studying how This response to faces infants and children come to INFANTS ARE will continue to grow over recognise faces and emotional By the time infants EXPERTS AT time. facial expressions. Newborns are five months old, they RECOGNISING will learn to match the image show a distinct preference for the faces of their mothers, ANY FACIAL of an emotional expression only hours after they (such as a sad face) with its EXPRESSIONS. corresponding vocal are born. THIS MIGHT expression (for example, a sad voice). By five years, THE BE WORTH newborns’ ability to recognise IMPORTANCE KEEPING IN and label facial expressions OF FACES FOR MIND WHEN approaches the competence CHILDREN of most adults. REACTING Decades of research from Researchers still aren’t many different labs suggest TO A SPIDER, sure how infants learn about that faces are quite special faces so quickly. Some argue A CURSE for infants right from birth. that infants have a biological WORD, OR AN predisposition to prefer faces To demonstrate this, researchers showed newborns from birth. Others ANNOYING right who were only nine minutes suggest that the massive RELATIVE. old paddles that contained the amount of experience image of a face or the image newborns get with faces right of a scrambled face. Researchers then away is enough to promote rapid learning. moved the paddles along their line of Others take a middle-of-the-road sight. Newborns followed the paddles approach, demonstrating that newborns with images of faces on them for longer aren’t attracted to faces specifically, but than paddles with scrambled faces. instead prefer looking at any pattern that Only a few hours later, newborns will is top-heavy, having more “stuff” on top. Pregnancy BUMP & baby

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LOOK AT ME

Where's my mummy? I'll know her face when I see it...

This preference does indeed attract them to faces early in life, but isn’t specific to faces until later on, after the infants gain more experience looking at faces.

Nevertheless, infants’ expertise with facial expressions becomes an extremely valuable tool for learning in the second half of the first year. Around eight to 12 months of age, infants learn that they can use information from other people’s faces – especially their mum’s – to help them figure out what to do in new situations. For example, when infants who are first learning to crawl and walk are presented with a possibly dangerous slope, they look to their mothers’ facial expressions for cues. They attempt to descend the slope only when their mothers offer an encouraging smile; they refuse when their mothers discourage them from going. Similarly, toddlers avoid new toys when mothers pose a fearful facial expression toward them. But they happily approach new toys when mothers show a smiling face.

NARROWING THEIR CHOICES This rapidly developing ability to identify different faces and facial expressions is of huge value for infants. However, this also leads to infants’ developing preferences

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for certain faces or an inability to identify some others. For example, shortly after birth, infants show a preference for looking at faces judged by adults to be “attractive” over “unattractive” faces. And one-year-olds even behave differently around people with more attractive faces, smiling and playing more with attractive adults than with unattractive adults. Perhaps even more surprising is that infants prefer the faces of their own race by three months of age, and have trouble distinguishing between faces of other races by nine months. Researchers call this phenomenon “perceptual narrowing”: It means that newborns’ brains are flexible enough to distinguish between a variety of different faces (even faces of different species) right from birth. But as they become experts at identifying the faces they see most often, they lose the ability to differentiate between faces that look different from the ones that are most familiar to them. In other words, they begin to have trouble deciding whether two faces of a different race are the same person, or two different people.

THE FACE YOU WEAR MATTERS The good news is that exposure to people from other races on a daily basis can erase this effect. For example, if children live in neighbourhoods where they are exposed to people of other races, they will maintain the ability to differentiate between their faces. Similarly, if infants get brief daily exposure to photographs of individuals of other races, they will maintain the ability to distinguish between them. The effect of perceptual narrowing can even be reversed if infants are exposed to pictures of faces from other races after six months of age. Given that a child’s world is filled with uncertainty, the faces of those who are most familiar to them can provide an important source of information about what’s safe and what’s dangerous; what might bring joy, and what might bring fear. And infants are experts at recognising any facial expressions. This might be worth keeping in mind when reacting to a spider, a curse word or an annoying relative. So, which face you would want to wear around your baby might be a question worth considering.

REPUBLISHED FROM THE CONVERSATION (THECONVERSATION.COM/FACETIME-HERES-HOW-INFANTS-LEARN-FROM-FACIAL-EXPRESSIONS-53327)

LEARNING IN THE FACE OF UNCERTAINTY


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Caring choices

When it comes to who’s looking after your baby, there are a number of childcare options – so which one will work best for your family? Here are four to consider.

I

n an ideal world, all mums would be able to choose to stay home full-time with their babies from birth for as long as they want to. But modern life isn’t ideal, and for a growing number of mums, returning to work while their babies are still young is a necessity. Whether you work full-time or part-time, from your home or from an office, there’s bound to be a childcare option which suits you – you just need time to investigate and make a decision you’re comfortable and confident with.

Nanny or nanny share

A nanny is a childcarer who comes into your home and cares for your child or children one-on-one. Nannies are usually trained in childcare and first aid and are more likely to be available for the hours you need them to be. Nannies can also do related housework such as light cleaning, cooking for the children, and the children’s laundry. The more experienced and qualified the nanny, the higher the hourly rate. Or you can share a nanny with another family or families (depending on how many children you have – keep in mind that babies need more hands-on care than older children). Nanny-sharing will bring down the cost, but there are other considerations – you'll likely need to rotate whose home the children spend the day at and you’ll need to work out what happens if your child is ill, who provides food and snacks, how to split payment if one family is on holiday and the other is not, etc.

tip If your nanny is taking your baby on outings using her own car, provide her with appropriate child restraints for her vehicle, and ensure you’re paying her mileage on top of her hourly rate.

REAL MUMS TELL: “I work part-time and have a nanny for my four-month-old son three days a week, where he gets one-on-one time and is cared for in my home. The nanny does all the things I would normally do with my son – takes him on outings, puts him down for a nap, feeds him, and plays with him. I like that he is in his home environment and can keep to his schedule. It is more expensive than other options but at this early stage of his life I am more comfortable knowing he is looked after by one single person and in my home.” ~ Jessica

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It's important you feel confident that your baby's caregiver will look after your little one with as much care as they'd look after their own.


GOOD HELP

Au pair

An au pair usually comes from a foreign country and lives in your home, providing childcare in return for accommodation, meals, and a weekly fee. Usually they are trained in childcare (although this can be quite minimal training, unlike nannies, so check with your agency) and first aid. Their hours can be quite flexible, as they are living with your family and fitting in with your family routine, so an au pair may be a good option for parents who work unusual hours or weekends. Usually au pairs are young women (not always, though!) who come to New Zealand for six months to a year, perhaps longer, with the intention of seeing the country and improving their English. Some au pairs work part-time while studying. While the cost of an au pair is comparable to daycare or in-home childcare, keep in mind you’ll also need to account for the costs of accommodation, meals, and a vehicle if you are asking the au pair to drive your child anywhere. Many families particularly enjoy the cultural learnings of having someone from a different country live with them and expose their children to a new language and customs.

tip Usually your au pair will be contracted to do a certain number of hours of childcare per week. If you want them to babysit so you can have a night out, be sure you’re paying for this or it’s negotiated as part of their regular hours.

REAL MUMS TELL: “For our first baby, we had a wonderful au pair from Germany who lived with us for six months and provided 30 hours of childcare each week. She was such a great helper to me as I was transitioning back to work when my daughter was five months old. We still keep in touch now! For our second baby, I needed to return to work when my son was only three months old, as I was heading up a big project. Again we had an au pair who cared for both children. She was young and energetic, and the care she provided for my kids during the day meant I didn’t have to worry and I could enjoy coming home in the evenings to enjoy my time with them guilt-free.” ~ Becky

98%

IS THE GOVERNMENT'S TARGET FOR CHILDREN PARTICIPATING IN EARLY CHILDHOOD EDUCATION (ECE) IN 2016. Pregnancy BUMP & baby

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GOOD HELP

53.9% Daycare

Some other names for “daycare” are early childhood centres, childcare centres, or preschools, and they provide care for children from birth to age five. Daycare ratios differ between centres depending on policies and the amount of qualified teachers they employ, but if they are looking after infants, they should have a lower teacher-to-baby ratio because babies require more hands-on care. Daycares can be open from early in the day (7.30am or sometimes earlier) to after business hours (5.30 to 6.30pm, and sometimes later) to accommodate the commutes of working parents. They can sometimes have part-time options, but are generally more popular for parents who work full-time. Because daycare centres usually have a number of teachers to look after the children, you won’t have to come up with a back-up plan if your childcarer is sick – that’s their responsibility. Staff are trained in first aid and qualified daycare teachers have training in education, not just childcare, so your child will have the benefit of caregivers with a background in early childhood education and theory.

tip Check out a few different daycare centres to find one which matches your family’s philosophy and needs, and ask friends for their experiences.

REAL MUMS TELL: “My daughter started at daycare when she was six months old. At first I was reluctant because the centre seemed to be so big, but I soon realised that it was the perfect place for her. The staff were engaged and did professional development so they were always upskilling, and there were a number of checks and balances in place to ensure my baby was always well looked after, fed, and changed. I could look in her record book at the end of each day and see when and how long she slept, what she ate, whether she was fussy, etc. Each baby was assigned a teacher who was their main caregiver and every day the teacher made a point to talk to me about how my daughter’s day went. I could call or visit any time and was always welcomed.” ~ Meena

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OF PRESCHOOL CHILDREN ATTEND FORMAL EARLY CHILDHOOD EDUCATION (ECE) AND CARE AND 44.1% ATTEND INFORMAL CARE

In-home childcare

An in-home childcarer looks after children in their home (and sometimes in one of the families’ homes), sometimes caring for one or more of their own children at the same time they care for yours and/or another family’s children. Usually the child-toadult ratio is one adult to no more than four children, including no more than two children under the age of two. They are usually trained in childcare and hold first-aid certificates as a requirement of working with their agency – you can ask to see this paperwork and they should have it on hand. Their homes are inspected regularly by their agency to ensure safety and childproofing. An in-home carer can be a cost-effective option for parents with infants who aren’t able to afford a one-on-one nanny but prefer a smaller home-based environment. They can usually provide flexible hours which can be helpful for parents who start work early or finish late.

tip Talk to potential in-home caregivers about their policies around sick days. Some will require you to pay if your child is sick and doesn’t attend on that day, but won’t charge if they are sick and can’t look after your child.

REAL MUMS TELL: “My son was cared for by an in-home childcarer from the age of four months, as I’m a single mum and went back to work after 14 weeks of maternity leave. I loved that he was in a home environment. There were three other children there – three-yearold twin girls from another family, and the caregiver’s own son, who was also three. The older children were lovely with the baby and I really appreciated that the caregiver treated my son like he was her own. They went on “everyday” outings like to the supermarket together, and to play groups and music groups. The agency we found her through had regular weekly events for other caregivers in the local area so they had a lot to do and were very supported.” ~ Rachael


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GETTING TO KNOW YOU

2 1 Cradle cap What is it: Dry,

Odd head shape

What is it: Does

your newborn have a conehead or a flat spot? Often newborns who arrive via a vaginal birth can have their heads squeezed and shaped in unexpected ways, and can even be a bit bruised from the journey. And the back-to-sleep message, while extremely important, does sometimes mean that your baby might develop a flat spot on the back of their head. How to deal: Most newborn heads will start to ease into their natural, more pleasing shape after a few days. And when it comes to flat-headedness, try holding your baby in your arms as they sleep, and give them tummy time when awake, alternating which side you place toys on.

When to worry:

Talk to your GP or midwife if your baby’s conehead doesn’t seem to be resolving naturally, or if you are noticing that the flat spot seems pronounced or won’t go away. Your baby may need a special helmet to correct their head shape.

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flaky, yellowy, oily patches of what looks like dead skin on your baby’s scalp – like bad dandruff that won’t go away. It’s very common and should disappear within your baby’s first six months, although sometimes you may see random patches after six months. It’s not harmful to your baby, but it is unsightly.

How to deal:

5 weird (but normal!) things about newborns Newborns are cute, cuddly, and oh-so-soft. But there are some strange things the books either didn’t mention or glossed over...

45

Rub olive oil on the patches a few times a week, and comb out the loose bits – but don’t pick at it.

Swollen genitals

Sorry, this one just needs time to resolve. But if you are finding patches on other areas of your baby’s body, such as under her arms or behind her knees, it could be eczema – and if you feel like the cradle cap is getting more severe or irritated, see your GP, as it may be an infection.

that their newborn baby boy’s genitals are, ahem, larger than life – particularly their scrotum, which can appear to be huge. For girls, their labia can appear puffy and swollen at birth. This is usually caused by extra fluid buildup in your baby’s body, another effect of those wonderful hormones you’ve passed on during pregnancy. How to deal: Wait it out – your baby should flush out the extra fluid in the first few days after birth, and then things will look a bit more proportionate. When to worry: If your baby’s genitals are still swollen after a few days, talk to your LMC, especially if your baby is a boy – it may be a condition called hydrocele, which can take a year or so to resolve.

When to worry:

What is it: Many new dads are chuffed to notice

3

Blowouts (aka projectile poo or poonami)

What is it: Every parent remembers the moment they went into the nursery

to greet their just-awake baby and discovered poo on every surface. Or changed a nappy and realised your baby not only has poo up her back, in her hair, and in her socks, but also her clothing will probably need to be burned as it’s beyond washing. Newborn poo is usually pretty liquidy, and those tiny, cute bottoms can actually project it across the room, which is surprising the first time! How to deal: Clean up in Aisle 4, obviously – but in future, keep a muslin, face cloth, or cloth nappy over your baby’s nether regions when you’re getting them ready for a fresh nappy (it might contain the poonami in a smaller space, at least). When to worry: Newborn poo should generally be greenish, brown, or yellow, with seedy particles in it. But if it’s giving your baby a rash, the colour is odd, or you see any blood in the poo, get in touch with your midwife, Plunket nurse, or GP straightaway.

Baby breasts

What is it: The same

pregnancy hormones which made you throw up in the supermarket and cry when you dropped a piece of chocolate on the floor may also give your baby little breasts or hard lumps under their nipples. How to deal: As your hormones work their way out of your baby’s body, so too will these mini-breasts go away. It may take some time, but they probably aren’t very noticeable to anyone but you, and they will decrease.

When to worry:

If your baby has any redness around the breast or nipple area, take their temperature to see if they have a fever – it could be a sign of something a bit more serious.


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A walk in the park Buying a stroller should be wheely simple, says Tiffany Brown. Here’s what you need to know.

P

ram. Pushchair. Buggy. Stroller. These different terms depend on vintage or manufacturer, but all are synonymous with the wheeled frame-and-seat unit used for children. And most of us find them indispensable in the management and transportation of our little ones. Modern parents have the Brits to thank for the easy mobility that comes with the investment in a pram/pushchair/buggy/ stroller. (And for ease of reading, I will simply refer to it as a “stroller” from now on.) The stroller was first designed by William Kent in 1733 at the request of the Duke of Devonshire, who instructed the architect and furniture designer to create a means of transport for his children. One hundred years later, baby carriages were being sold across America, and by 1840 the often ornate early models were extremely popular the world over. The stroller has morphed and altered in appearance and function through the ages, and nowadays there is a wide range of options available to us.

How many wheels?

Four-wheeled strollers theoretically give more stability and ease-of-pushing (think shopping trolley versus wheelbarrow). Generally the wheels on a four-wheeled

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model are smaller, which can be advantageous, and the unit is slimmer, enabling easier pushing through narrow shopping aisles and the like. Four-wheelers are well suited to shopping or negotiating carparks and city streets with baby in tow. Modern parents’ demand for a transportation system that went further than just pushing bubs about town heralded the advent of the three-wheeled stroller. Referred to as a “jogger” model, this stroller features a sturdy frame and large, robust tyres (one in the front and two at the rear) to allow for baby’s comfort not only at speed but also over rough terrain. Perfect for a family who enjoys regular road running or more adventurous pursuits such as hiking. Be aware, however,

that some jogger models are not actually built to jog with, so do your homework if you plan to run with your stroller.

One rider, or two?

Will you need to transport more than one child at a time? Okay, right now you’re likely to be focused on the needs of just one impending arrival. But one day in the not-so-distant future you just might have two little ones to transport from here to there. You might want to think about future-proofing your purchase at the outset. The old-school way to fit two kids in a stroller was to use a “twin” pram model with two seats side-by-side. With the obvious restrictions of unwieldy


BUYER'S GUIDE

It's good to road-test a few models before you commit to buying.

FACT

THE STROLLER WAS INVENTED IN ENGLAND IN 1733 BY WILLIAM KENT, AN ARCHITECT AND FURNITURE DESIGNER.

Facing me, or facing you?

manoeuvrability, and limited growing room for your elder child, it was only a matter of time before smart designers came up with better options for us. Inline strollers, for example, accommodate your little one in a carriage underneath, while an older child sits above in a toddler seat. There are now many available versions of a stroller system that takes your child from birth to toddlerhood. Your newborn rests easy in a capsule that fits to a car seat base, or a bassinet attachment on the stroller frame. Beyond the age of six months, your child upgrades to an alternative seat which fits to the same frame, and in some cases there is also an option to fit two seats when number two comes along.

A “reversible” stroller allows parents the flexibility to turn the baby seat inwards to face the parent, or out towards the footpath. It’s preferable to have a newborn or small infant facing you (particularly so you can see what they are doing and they can see you), but when they’re a little older, children might prefer to face outward and watch the world go by. Note also that as children get heavier, it will become increasingly difficult to push their weight when they face you, particularly in a three-wheeled model stroller. How long is the wheel base on your preferred stroller? The longer the base, the better the weight distribution and the easier the push. Strollers with inflatable (pneumatic) tyres will also need regular pumping, and keeping the tyres at the maximum fill will help the ease of pushing too. These strollers often come with a small handheld tyre pump you can keep in the storage basket underneath the stroller or in the boot of your car.

Oh! The places you’ll go

Rugged jogger-style strollers may not be exactly what you need, but if your family does tend to be on-the-go (and not just to the mall) an “all-terrain” stroller may well suit you. Dutch brand Bugaboo asserts itself as the inventor of the world’s first modular stroller, a design that breaks down into pieces rather than folding up “umbrella style”. The brand aims to provide families with the opportunity to “go out and explore the world”, with a range of jogger, all-terrain, reversible, and convertible strollers that also offer capsule and double seating options.

Up and down, in and out

It goes without saying that an easy-to-use stroller system can make life on the hectic newborn/coffee group circuit a lot easier. This piece of equipment gets lugged in and out of the car repeatedly, so you’ll want to make sure it’s easy enough for you to fold or break down, and light enough to lift in and out of the boot with ease. If you’re going to be on your own a lot with the baby, all the performance features of your stroller should ideally work as well with one hand as with two. As tempting as it is to do your shopping entirely online, it is highly recommended to road-test a few different stroller models before committing to a purchase. (If you can find a willing child to take along for the ride, even better.) How the stroller handles as you push it about will be a big factor in your buying decision. Wheels that swivel at the front can make manoeuvering easier, although large inflatable tyres can make the ride smoother for bubs. Does the handle extend or retract? For those on the taller or shorter sides, handle height can make a huge difference to your comfort factor. (Too long, and the vertically challenged among us have an uncomfortable stretch to make. Too short, and tall giraffes get kicked in the shins by the stroller frame every time they take a stride.) The incredible array of features available in today’s stroller selection would no doubt see William Kent’s jaw drop with amazement. From cup holders and snack trays through to sun covers and removable wheels, choose a model with the features that fit your lifestyle best and be confident your stroller investment will pay dividends throughout those precious early years. Pregnancy BUMP & baby

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They see us rollin’…

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S

etting up your nursery is one of the most exciting aspects of the journey into parenthood. Whether it’s your baby’s own nursery or a partitioned area in your bedroom, there’s so much to think about: What colour scheme or theme to go for? Which decorative mobile to buy? But your baby’s nursery also plays a vital role in establishing healthy sleep habits from the get-go. So here are some tips and advice on how to create that calm, relaxing environment for optimum sleep.

1

Blackout blinds

Investing in blackout blinds is a must. It’s one of the first things I recommend to families I work with. Whether it be blinds that are attached to the frame, or travel ones that you suction to the window, they are fundamental in creating an ideal sleeping environment. Babies sleep best in a dark room. We are biologically wired to sleep in darkness and the presence of even small amounts of light can interrupt the production of melatonin, our sleep hormone. Don’t worry about baby confusing day and night due to a dark room during their naps – they won’t if you do it right. To create a clear difference between day and night, ensure daytime awake periods are spent with bright lights (preferably natural), activity, noise, and interaction. Awake times (feeds) during the night should be dimly lit, quiet, and calm. Baby won’t get them mixed up and their sleep, both at night and during daytime naps, will benefit greatly. So popping up blackout blinds encourages longer daytime naps – and discourages early-morning wake-ups.

2

Sleep sacks

Sleep sacks are the perfect item for transition after swaddling. Not only are they a great cue to let your baby know it’s sleep time, but they are perfect if you are worried about your little one kicking off covers in the night and getting cold. You can get different tog weights for all seasons, which takes the stress out of having lots of loose blankets in the cot and constantly checking to make sure your baby is still covered and warm. A 2.5 tog is perfect for a standard room temperature.

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For a good night’s sleep Want to create a nursery that may actually help your baby to sleep? Sleep consultant Karen Biddlecombe of simplysleep.co.nz shares her top tips and go-to products to give your nursery that bedtime advantage.


SLUMBER HELPERS

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SLUMBER HELPERS

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7

5

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Swaddles

Pacifiers live up to their name in the first few months.

Swaddling is one of the best ways to settle your new baby in those first few months. It reduces the moro, or startle reflex, which minimises crying and will let baby sleep sounder and for longer. Swaddled babies experience less anxiety and fewer scratches to their face. It also lets baby feel secure and safe, as it replicates the sensation of being in the womb. I recommend swaddling the upper body fairly tightly and swaddling loosely from the waist down, so babies can freely move their legs and rest them in a frog-like position. Once your baby is around four months old and starting to roll over, or is getting out of the swaddle by themselves, then it’s time to transition. The best way to do this is to leave one arm out for one week, then leave both arms out for another week.

Room temperature

3

SOOTHERS/ DUMMIES

Babies have a strong sucking reflex, so therefore lots of babies love a dummy. Dummies also trigger the calming reflex which settles babies when they’re upset, letting them fall asleep easier. They are a great tool in babies' first few months; however, I would recommend weaning them off when they are approaching four months old to prevent it becoming a negative sleep association. I encourage families to use one to link sleep cycles during the day naps and occasionally at bedtime if they are very unsettled.

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The nursery temperature should be somewhere between 16-20˚C. A heater with a thermostat will help regulate this. If you are unable to adjust the temperature in the room to this range, dress your baby accordingly – dress your baby for sleep as you would dress yourself. Feel your baby’s body temperature by touching their chest or back. Remember, cold hands or feet are not an indicator that your baby is cold, as these are not areas you are adding layers to. A warm baby will sleep more soundly through the night, whereas a cold baby will seem more restless, move around the cot more, and wake more frequently at night.

6

Comforters/blankies

One of my favourite sleep aids is a comforter or blankie. I highly recommend introducing one at around four months. Comforters are what I would call a positive sleep association, as babies can find them easily in their cot or bassinet. Studies have shown that babies with a comforter are significantly more likely to sleep through the night than those without one. When your baby forms an attachment to a comforter, they are able to use it to self-soothe, which is essential for learning to sleep through the night. Comforters also play a major role in helping children cope and providing reassurance in times of stress, sickness, change or separation. Comforters really are a worthwhile investment. You might want to buy a spare just in case!

White noise

I love white noise and often encourage families I work with to use it in their baby’s room. Whether it’s an app on your tablet or an actual white noise machine, it has amazing benefits. The simplest one is its ability to drown out external noise such as traffic and morning birds. And it’s also great for internal disturbances, such as Daddy getting up early for work and noisy siblings getting ready for school! But another huge benefit of white noise is that it offers a sensory distraction for the subconscious mind to fixate on during the brief period of arousal between sleep cycles. What does that mean? Your baby is more likely to drift off back to sleep instead of crying for you every hour during the night, or waking after a 30-minute nap.

Night lights

I wouldn’t recommend night lights for all-night usage, as babies do sleep better in the dark. However, they are a great tool for those nighttime feeds. When you are feeding through the night, you want it to be as quiet and dimly lit as possible, but you do need to be able to see what you’re doing, especially when you’re changing nappies. But you should, however, be mindful of the colour of light you use. Blue and white lights are stimulants that actually boost attention and reaction times and this light will interfere with the production of melatonin, making it harder to fall back to sleep. The best colours to choose for a night light are red and orange. These are the same colours that feature in the sunset, which is nature’s own way of telling us to get ready for bed. Experts also believe that red would have been the only colour your baby would have seen in the womb.

9

Cots/bassinets

It’s super-important to use the cot or bassinet as a consistent place for all of your baby’s sleep. The idea is to create a sleep association, so your little one knows their cot or bassinet is for resting and that’s where all their sleep will take place. It’s also a good idea – and safer – to keep your baby’s cot or bassinet clutter-free. When they are old enough to have a comforter in with them, that is all they need. We want to send the message that the cot is for sleeping. Piling toys into their sleep space will distract and make it hard for them to focus on the task at hand – SLEEPING!


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