All4Baby » Discovery https://all4baby.co.za From Pregnancy to birth to baby and beyond. The place to find, chat, and share. Wed, 16 Jul 2014 09:55:57 +0000 en-US hourly 1 http://wordpress.org/?v=161 Guidelines to a healthy pregnancy https://all4baby.co.za/pregnancy/planning-for-baby/521/guidelines-healthy-pregnancy/?utm_source=rss&utm_medium=rss&utm_campaign=guidelines-healthy-pregnancy https://all4baby.co.za/pregnancy/planning-for-baby/521/guidelines-healthy-pregnancy/#comments Wed, 30 Apr 2014 08:45:25 +0000 https://all4baby.co.za/?p=521 Bringing a new life into the world is a highlight of any person’s existence. Babies come into the world in a variety of circumstances, but whichever you are faced with, there is both joy and responsibility.

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By definition, pregnancy is the fertilisation and development of one or more offspring, known as embryo (first eight weeks) or foetus (thereafter), in a woman’s uterus.

There are few human processes that carry with them as many associated emotions as falling pregnant.

A pregnancy is divided into three trimester periods that are used to describe prenatal development. Pregnancy is different for every woman. Knowing what to expect will help you get ready for the months ahead.

Some women glow with good health and vitality during the first three months; others feel nauseous and exhausted.

The first trimester is often associated with the onset of morning sickness (usually from six weeks) and carries the highest risk of miscarriage (the natural death of the embryo or foetus).

As you enter your second trimester, the morning sickness and fatigue of the first three months should fade, leaving you feeling more energetic and like yourself again. The second trimester is when many women feel their best. Take advantage of this time to start planning for baby’s arrival. The baby’s development is rapid in the second trimester.

The third trimester comes with the challenges of carrying around the extra weight of your baby. Make sure you get enough rest and good quality nutrition. You’ll start thinking about your birth options at this time too.

All mothers desire the best for their children. Start before your baby is born by making wise lifestyle choices…

Early antenatal care

Check in with your gynaecologist or obstetrician early in your pregnancy for a risk assessment (at about seven to eight weeks).
This allows for a personalised approach and identification of any risk factors or early concerns.

Routine blood tests

Blood tests will be done at your first visit with your doctor or midwife. They are a routine part of antenatal care. Among these will be tests for checking your blood group, whether you are rhesus positive or negative, your immunity to rubella (German measles), for syphilis and hepatitis B, and for HIV. These tests are important as they allow for early intervention once abnormalities or presence of disease is picked up. Mothers-to-be who test HIV positive should start antiretroviral treatment straight away so they can reduce their chances of passing the virus to their babies.

Dietary guidelines

Improve your diet by eating twice as well, not twice as much. Right from conception your baby is in a critical period of growth, where he or she is largely dependent on your nutrition. Eat a wide variety of foods and eat regularly, without skipping meals, especially breakfast – morning sickness is often worse when your tummy is empty.

  • You need 1 200 mg of calcium every day to build your baby’s teeth and bones. Not getting enough could harm you, too – too little can cause bone density loss and tooth damage in mothers. Dairy products are great sources,or canned salmon, fortified cereals and spinach.
  • At least 85 mg a day of vitamin C may help you avoid preterm delivery, since vitamin C strengthens the amniotic membrane. Foods rich in vitamin C also enhance the absorption of iron, which is essential for the oxygen carrier haemoglobin. Up your Cs with guavas, broccoli, cranberries, citrus fruits and juices, kiwi, mangoes and tomatoes.
  • The fat in fish aids the development of the baby’s brain tissue and central nervous system. The best sources are the cold-water variety: pilchards, sardines, haddock and mackerel. Canola or flax oil, and linseeds are also excellent.
  • Most doctors recommend a daily prenatal multivitamin to cover you for any vitamin and mineral shortfalls.
  • Folic acid before and during pregnancy can reduce neural tube defects by up to 70%. Start three months before you plan to fall pregnant.
  • Food hygiene is vital. Food-borne illnesses can cause harmful infections as well as congenital disease, prematurelabour, miscarriage and foetal death. Avoid meats, fish and poultry (including eggs) that aren’t fully cooked; thoroughly rinse fresh fruits and vegetables; and wash hands, food preparation surfaces, cutting boards, dishes, and utensils that come in contact with raw meats with hot, soapy water.

Time to quit

Smoking is hazardous to an unborn baby as it decreases oxygen and blood supply to the foetus, and puts the baby at risk for growth restriction, low birth weight and respiratory problems. Plus, heavy smoking (more than 10 cigarettes a day) is associated with an increased risk of pregnancy loss, confirms a study in the New England Journal of Medicine.

It’s best to avoid alcohol altogether since it’s known to be an agent that causes malformation of an embryo. Foetal Alcohol Syndrome (FAS) is a birth defect caused by heavy alcohol consumption (usually in a binge pattern) during pregnancy. It is characterised by growth retardation, facial and neural abnormalities as well as malformation of other organ systems. The prevalence of FAS in certain areas of South Africa is the highest in the world.

Rest body and mind

Your mental health is just as important as your physical well-being – especially while preparing to be a parent. Rest as much as you can, particularly in the third trimester.

  • If you already have small children in the house, try to rest when they have their nap.
  • Never say no to an offer of help.
  • If you feel increasingly anxious or stressed, contact the South African Depression and Anxiety Group (www.sadag.org) for support, advice, free telephonic counselling or a referral to a psychologist in your area; or the Postnatal Depression Support Association (www.pndsa.co.za).

Regular exercise

Regular exercise can give you the strength and endurance you’ll need to carry the baby weight and help you handle the physical stress of labour. It boosts the circulation of blood and oxygen, and it will also make it much easier to get back into shape after your baby is born. Exercise boosts mood and can help to ward off depression.

You can usually continue to do the exercise you did before pregnancy, but check with your doctor, and avoid high-risk activities or contact sports.

Your pelvic floor is one of the key areas of focus during pregnancy as this is one of the muscle networks most impacted by the baby’s weight and childbirth. Pilates, aqua aerobics, low-impact walking or swimming are great choices.

Be sure to choose a qualified instructor with training specifically for pregnant women.

About the Author:Dr Noluthando Nematswerani is a Discovery Health Clinical Specialist. For more information on Discovery, visit www.discovery.co.za.

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The power of a mother’s touch – Kangaroo Mother Care https://all4baby.co.za/newborns-0-6-months/newborn-basics/237/power-mothers-touch-kangaroo-mother-care/?utm_source=rss&utm_medium=rss&utm_campaign=power-mothers-touch-kangaroo-mother-care https://all4baby.co.za/newborns-0-6-months/newborn-basics/237/power-mothers-touch-kangaroo-mother-care/#comments Wed, 09 Apr 2014 10:46:03 +0000 https://all4baby.co.za/?p=237 The best environment for a baby to thrive, is the mother's body. Kangaroo care should ideally start at birth, says public health physician, Dr Nils Bergman.

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Kangaroos are on to something. When they and other marsupials, keep their live but relatively undeveloped young in their pouches (marsupium) their joeys are able to complete their postnatal development in the best possible place.

About four million babies die each year in the first week of life, according to The Lancet; replicating the protective and nourishing environment of a Kangaroo pouch, through Kangaroo Mother Care, could help 25% survive, says Dr Nils Bergman, a public health physician specialising in Kangaroo Mother Care (KMC) in South Africa.

“The very best environment for a baby to grow and thrive, is the mother’s body,” says Dr Bergman. “When placed skin-to-skin on her mother’s chest, a baby receives warmth, protection and food, and its brain can develop optimally.”

Three components to Kangaroo Mother Care

Skin-to-skin contact should ideally start at birth, but is helpful at any time. It should be continuous day and night, but must be at least one hour to give benefit,” says Dr Bergman.

The next part of Kangaroo Mother Care is exclusive breastfeeding. That means that for an average mother, direct suckling by the baby from the breasts is all that is needed.  For very premature babies, expressing milk and addition of some essential nutrients may be necessary.

Thirdly: support to the mother-child dyad means that whatever is needed for the medical, emotional, psychological and physical wellbeing of mother and baby is provided to them, without separating them. This might mean adding ultramodern equipment if available, or intense psychological support in contexts with no resources. It can even mean going home very early.

The power of touch

In the past, parents of premature babies were excluded from care directly after birth, including the neonatal ICU. Now, it’s known that separation causes harm to all babies – especially preterm infants.

Recent science shows that parents’ presence has a positive influence on brain development, says Jill Bergman, who has promoted Kangaroo Mother Care for 24 years. “We are realising more and more from neuroscience that the parent as central to the healthcare team is not just essential for survival, it ensures a good start to life,” she says.

Processes optimised when baby stays in contact with mother

1. Regulation

The baby at birth is wide-awake for the first 60-90 minutes and experiencing certain sensations. He hears mom’s familiar voice, feels her heartbeat, smells the familiar scent of her and her breast milk. The baby feels safe and comforted by these sensory signs and so his body calms.

Heart rate, breathing and oxygen saturation, blood pressure and temperature all stabilise far faster on mom than when they are separated. Baby has his basic needs for warmth, food and protection met.

2. Bonding and attachment

Baby’s brain also calms, and all of the expected sensations are collected and fire pathways in the brain. The baby will feel safe and open his eyes to make contact with his mother. This is the start of early bonding, and emotional and social intelligence. As continued contact and breastfeeding continues, a secure attachment is formed, which is the basis of all future physical and psychological health.

3. Breastfeeding

“A baby in the right place is very competent!” says Jill Bergman. A proper latch ensures adequate nutrition, and stimulation of all of the essential hormones. The mother’s chest will warm automatically if her baby is cold, and even cool baby if too warm.

4. Sleep

During quiet sleep, all of these sensations collected will fire and wire circuits to the emotional brain (amygdala), be organised and sent back to the cortex when he wakes again, thus completing the brain circuits for healthy development. Sleep should not be disturbed.

Don’t cry for me

If a baby is separated from her mother early on, all those essential processes are disturbed and a stress response is created. When the baby cries, his heart rate and blood pressure goes up, and oxygen levels go down. The baby crying uses up more calories so is more likely to become hypoglycaemic; these calories are better used for growth.

“High levels of stress hormones for long periods of time are toxic to the neurons that make the brain work. The stress hormone cortisol makes more neurons die off at a faster rate. This disrupts and disturbs developing pathways and circuits. With prolonged stress after birth, the brain is measurably smaller one year later. The only difference between toxic and tolerable stress is the absence or presence of mother or father,” says Jill.

Kangaroo Mother Care babies benefit from better brain and emotional development, less stress, less crying, fewer brain bleeds, more settled sleep. They are more alert when awake and feel less pain from injections, the heart rate stabilises, more breast milk is produced and babies gain weight faster.

Ultimately babies can go home earlier when they have done Kangaroo Mother Care and have better brain and emotional development.

How to do Kangaroo Mother Care

Your baby only needs a nappy and cap. Put her on your bare skin – starting at birth – facing you, inside your shirt. Sit in a chair with cushions so you can be at a 30-40 degree angle to help baby’s breathing. Tuck her legs up in the foetal position. Put her hands near her face for self-soothing. Cover her and yourself. Your body will automatically warm up if your baby is cold or will cool down if your baby is hot. Relax, knowing that your body is the best place for her.

To do this for long periods with a small or premature baby, safe technique requires that the airway is secured, and the baby firmly wrapped against parent’s chest. In this way baby and parents can both sleep. When awake and feeding, the wrapper is loosened, allowing eye contact, and access to the breast.

For more details see the book Hold Your Prem by the Bergmans and www.kangaroomothercare.com

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Coming to terms with postnatal depression https://all4baby.co.za/newborns-0-6-months/234/coming-terms-postnatal-depression/?utm_source=rss&utm_medium=rss&utm_campaign=coming-terms-postnatal-depression https://all4baby.co.za/newborns-0-6-months/234/coming-terms-postnatal-depression/#comments Wed, 09 Apr 2014 10:22:18 +0000 https://all4baby.co.za/?p=234 Postnatal or postpartum depression (PPD), is a type of clinical depression which can affect women, typically after childbirth.

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Pregnancy and motherhood bring with them the most dramatic life changes that most women experience.

40 per cent of South African women affected

It’s a time of hope and happiness, but also of fatigue and feeling overwhelmed. Depression and anxiety are common during pregnancy, and may affect as many as 40 per cent of pregnant women in South Africa.

Risk factors

  • A conflicted pregnancy, e.g. unplanned, ill-timed
  • An ‘emotionally charged’ pregnancy, e.g. post-infertility pregnancies
  • A complicated pregnancy
  • Major stressful life events, e.g. a death in the family, miscarriage, relocation, losing your job
  • Stress relating to your income or home (socio-economic factors)
  • A lack of emotional support, especially from your family or partner
  • Previous depression

Taking care of yourself for your baby

“You are your baby’s most important person, so take care of yourself,” says the chairperson of the Post Natal Depression Support Association (PNDSA), Dr Bavanisha Vythilingum, who is also a specialist psychiatrist in a private practice.

“There is no shame in experiencing depression during pregnancy – acknowledging how you are feeling and seeking help to ensure your emotional well-being is one of the greatest gifts you can give your child.”

Baby blues that linger

Most new moms have ‘the blues’ shortly after birth. For a few days, you may feel anxious, tearful, tired and irritable. This is normal and should clear up in about two weeks. If you are so blue that you cannot care for your child or yourself, have thoughts of hurting either yourself or the baby and are sad for more than two weeks, you could have postnatal depression and should seek help as soon as possible.

Postnatal depression can develop slowly and at any time during the first year of your baby’s life. If left untreated, it can escalate and affect your interaction with your baby.

About the Author: Dr Noluthando Nematswerani is a Discovery Health Clinical Specialist. For more information on Discovery, visit www.discovery.co.za. You can also visit Discovery’s YouTube channel DiscoverySA for Medical Miracle stories.

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