Consumer Medicines Information (CMI)

*  Your Pregnancy

*  Week by Week

*  The Birth

*  Some Common Baby Problems

*  Pregnancy Problems

*  Infertility

*  Immunisation

*  Feeding Your Baby Considerations

*  Conception

*  Colic

*  Breast Feeding Considerations

*  Bottle Feeding Considerations

*  After Birth Considerations

When the birth is over, there are still other considerations which usually are put on the backburner in the time coming up to the birth.  You will need to visit your doctor for 6 weeks after the birth to be examined to ensure that all is well and your organs and insides have returned to normal.  You have just experienced a physically traumatic event and it is only natural that you will not be feeling quite back to normal in all areas.  You may have received stitches and feel that you will never feel the same again. Warm salty baths may help the area heal. Your naturopath may have some other creams to speed healing as well.

You could also experience crampy pain while your uterus contracts back to its normal size.  Urinating could be painful because of the tenderness in that region. See your doctor if you are experiencing extreme difficulties.  Moving your bowels could pose a problem as the last thing you want to do is to push again and risk tearing your stiches and the area. Ask your midwife or doctor for a suppository. Alternatively you should eat more fibre and plenty of fruits and vegetables. Also drink plenty of filtered water throughout the day.

You could also be concerned about your weight and shape. Admittedly, it does take some time to regain your pre-pregnant shape again. However, with exercise and proper eating you will soon be back to normal. Your uterus will also contract as you start breastfeeding.

Another concern for new mothers is the prospect of having sex after childbirth. It is a matter of starting again when you feel comfortable with it. At first the only things on your mind will be the soreness you feel and getting the stitches out. It is also advisable to avoid getting any infection in the area. As well as this, your vagina may not be as lubricated in the first month or so after childbirth. At this time it is probably wise to practice other forms of sex.

You may also be concerned about the size of your vagina after giving birth. With pelvic exercises, time and a little loving persistence you will regain your shape and size.

After Birth Considerations

If breastfeeding is not appropriate for you or your life, it is possible to bottle-feed. Mothers who wish to bottle-feed their babies should use a commercial infant formula.  These formulas are very similar nutritionally to breast milk. Your baby should grow and become strong and healthy in a similar way to breastfed babies.

There are many different varieties available and you can choose between ones based on cow’s milk or soya bean. Read the label carefully before making up the feed and contact your family doctor about how much or how often to feed your baby.
The advantages are that other people can help feed your baby which can be great for working mums.

Here are a few tips for a happy, healthy bottle-fed baby:

*  It is advisable to give your baby an infant formula until he is about 12 months of age or until he is eating regular meals.

*  Always sterilise the bottles and teats, and boil any water used for the milk mixture.

*  Check the expiry date on the formula.

*  Use formula within one month of opening the can.

*  Hold your baby close to you every time you give him the bottle.

*  Never leave your baby alone while feeding and don’t prop up your baby’s bottle while feeding.

*  Burp your baby during and after a feed.

*  When your baby has finished feeding throw away any left over milk, then rinse the bottle and teat with cold water. Do this immediately after each feed.

*  Your baby doesn’t need to finish all the milk in a bottle at each feed.

*  If formula based on cow’s milk appears to upset your baby, try milk based on soya bean. Speak with your doctor or our Pharmacist.

Young babies will usually take about 60 to 120mL of milk at each feed. They usually feed about every 3 or 4 hours.
As your baby gets older, he will gradually take more at each feed until he reaches about 180 to 250mL.

Bottle Feeding Considerations

This is one of most important things you can do for yourself and your new baby. However it is not always easy to get started, it is not necessarily instinctive. 

Here are a few tips for you:

*  Start early - within the first few hours.

*  Make sure someone experienced (a midwife) shows you how to do it properly.

*  Feed your child from both breasts

*  Make yourself comfortable before you begin

*  You will have plenty of mild if you eat a variety of foods each day as well as lots of filtered water

*  Demand feed your baby right away

*  Feed the baby for however long he or she wants to feed. However make sure your baby is actually swallowing and that the position is correct.

*  If your nipples are sore, something needs readjusting - his position or attachment.

*  Do not use milk from the bottle in addition to your breastmilk as this may lessen your supply. It could also encourage your child to prefer sucking on the teat and not your nipple

*  Feeding at night helps your milk supply and may help you sleep better.

*  Do not put any creams, lotions or ointments on your nipples. They emit a smell which attracts your baby.

Why Breastfeed?

*  Human breast milk is made for human babies, it is the most perfect food for them to have. It’s the right kind of milk for your baby.

*  Breast feeding brings about a special close feeling between mother and baby. The breast is a comfort to a baby when the child is not feeling well or experiencing some discomfort.

*  It is safe. The mother’s milk, especially the first milk (colostrum) has antibodies in it which helps protect the baby from many diseases and disorders.

*  Reduces the risk of SIDS (Sudden Infant Death Syndrome).

*  It is convenient. Mothers who breast feed don’t have to bother with sterilising bottles and teats or worry about the milk spoiling in warm weather.

*  It is nutritious. Breast milk contains all of the nutrients needed by the baby for the first 4 or 6 months of life. These nutrients are in the right amounts and in easily digested form.

*  Breast feeding is encouraged for the first year but after 4-6 months solids may also be introduced.

*  Breast feeding helps the mothers’ womb resume to normal shape faster.

*  It is cheaper.

*  The best advice about breast feeding is for you to be relaxed and calm, and enjoy your new baby. If you are having any problems breast feeding, seek help from your doctor or midwife.

Problems with breastfeeding

Blocked milk ducts:
Sometimes this can occur when the breast hasn’t emptied fully, you are not nursing your child in the correct position, missing feeds or the child is not nursing for long enough periods. Your breasts may feel uncomfortable. You can try to express some milk yourself.

Engorgement:
This can occur when your breasts are too full. This usually occurs when the milk first comes in. You can usually relieve it by having a warm shower and expressing some of the milk.
Sometimes the breasts are too tight for the baby to feed properly - just express a little before feeding to soften them up.

Sore nipples:
If your baby is not sucking correctly on your nipples, they can become sore. They will heal quickly if the position is corrected. If your nipples are cracked or blistered, feed on the other side. Nipples tend to heal quickly, so try to keep going with your breast feeding.

Too little milk:
Usually people worry about this for no reason. If your baby looks well, has clear skin and eyes, is wetting 7 - 8 nappies per day, having some bowel movements and is putting on weight you should be assured that you are feeding him or her enough. The more the breast is sucked and the more milk is withdrawn from it, the more milk there will be produced.

Is there anything You should be aware of?

Please see your doctor before taking any medications, these days you are able to breastfeed while taking a variety of medications but it is best to be sure. You definitely should not be smoking or have your baby anywhere near a smoker.

Weaning

This must be done properly and not rushed as you may stress yourself and your baby. Breastfeed for at least three months as it can give your child a good healthy start in life.  To avoid having to wean from a bottle as well, wean your child off breastmilk when he or she is ready to drink from a cup. This is usually when they are about 6 to 9 months old. However, there are no hard rules and if you and your child are both happy breastfeeding, continue to do so.

Take your time in weaning - ideally it should be done over 3 or 4 weeks.  Start to replace a feed with milk from a cup.
If your child puts up a fight or looks miserable with the idea. Do not push it - just give your breast again and try again at another feed. If however this continues, you and your partner will need to be a little firmer and not give your breast as an alternative. Eventually the child will accept this. They may still wish to breastfeed morning and night however, for a while.

Breast Feeding Considerations

What is it?

Acute abdominal pain probably caused by abnormal bowel functions and wind.

What to look for

Colic is thought to occur when the bowel in a baby contracts more regularly than an adult’s slower peristaltic movements. It is characterised by:

*  loud screaming lasting for hours, three or more days a week and the baby is usually difficult to comfort.

*  crying for long periods after a baby has been fed.

*  while crying, the baby draws his knees up over his stomach as if he has a stomach ache.

*  bowel movement or wind at the beginning or end of crying episodes.

It is very common for children to experience colic and although uncomfortable for the child and exhausting for the parents it is a relatively harmless condition that ends after the child is 4 months old.

Causes

The cause of colic is not known. Experts attribute it to any number of things, including an infant's immature digestive system, weaning the child too early, allergies, hormones in breast milk, and overfeeding. It is worsened when the baby cries as he or she takes in extra air which can exacerbate the problem.

Traditional Treatment

There is no actual cure for colic, although you can often find relief from many at-home remedies have proved helpful in soothing colicky babies. Always try to be calm and curb your anxiousness as this can inadvertently be communicated to your child and it will make the condition worse.

Do not ever punish a child with colic. If you feel you cannot cope, leave someone else with the child for a few moments while you relax calm yourself.

If you suspect your child has colic, call your paediatrician. After ruling out possible medical causes of prolonged crying, most doctors recommend simple remedies you can perform at home.

Some encourage parents to talk with other parents for support. Give the baby something safe to suck, this will distract them from the pain. Also rhythmic rocking or walking with the baby is soothing.

Alternative/Natural Treatments

Herbal Remedies - Teas made with herbs containing carminative oils, which reduce inflammation in the bowels and lessen gas production, may help a colicky child.  (Try teas made of chamomile, lemon balm, peppermint, or dill).

Homoeopathy - Homoeopathic medicine offers several over-the-counter colic remedies that are considered safe to use without prior consultation with a Homoeopath. Seek help from a professional if your child does not respond to a remedy within 24 hours.

Aromatherapy - Try massaging your child’s stomach with chamomile or peppermint in a clockwise direction. Never give aromatherapy oils to children younger than 2 weeks. (see our section on aromatherapy).

At-Home Remedies -

*  Be consistent with the ways in which you pacify the child

*  Give your baby things to distract him or her.

*  Motion can relieve colic. So take them for a walk, or drive or gently rock them.

*  White noise may soothe your child.

*  Wrap the child snugly in a blanket to provide a sense of security and comfort.

*  Use a warm water bottle to sooth the pain

*  Ask a relative or friend to take over when you feel yourself getting frustrated or exhausted.

When to seek further professional advice

*  your baby has never had colic before

*  bouts of colic are accompanied by fever, diarrhoea, vomiting, or constipation.

*  your baby's crying sounds painful, not fussy - indicating injury or illness is causing the distress.

*  your baby is older than three months and still acting colicky; behavioural problems or illness may be the cause.

*  your colicky child fails to gain weight and is not hungry, which suggests illness.

*  you're exhausted or fear stress might lead you to hurt your baby.

Colic

Each time a man ejaculates, he produces sperm. However, for women it is usually only once that she will be ready to conceive in the month. Usually a fortnight before the first day of your period, you will produce a single egg from your ovaries. The egg swims to the fallopian tubes and lives there for approximately 12 hours. If it is not fertilised at this time, it dies and is absorbed back into the cells of the tube and the cycle starts again.

If you have sexual intercourse around the time you ovulate there is a big chance of conception taking place. Once ejaculation has occurred, the sperm (there could be up to 1000 million of them) separate from the seminal fluid and move up towards the cervix. The strong sperm survive this journey and the weaker ones die.

The vagina is quite an acid environment for the sperm and it takes resilient ones to withstand it. By the time the sperm reach the fallopian tubes, there are only two thousand left. The sperm struggle and fight to be the one to fertilise the egg when it is released. The one that connects with the egg is the fittest and strongest and this is natures way of ensuring that unhealthy or damaged sperm are not able to fertilise an egg.

Fertilisation occurs when a sperm penetrates the outer surface of the egg. Once the egg is fertilised, the tail drops off and the rest of the sperm die. The egg and sperm each with there own genetic information now combine together and form a single nucleus.

All this genetic information will determine the sex and characteristics of your child. The nucleus divides into two and over the next 3 days will continue to divide until there are 64 cells.  As this is happening, the egg travels through the fallopian tube towards the uterus. After the seventh day, the egg is able to snuggle into the lining of the uterus - now it can be nurtured and a pregnancy can start.  Once this happens conception is complete. The egg can be nourished by the blood supply in the uterine lining. At this time the ovary is informed that fertilisation has occurred and it stops ovulation and the body also ceases menstruation.

Twins

Occasionally however, the egg divides into separate halves, instead of doubling the cells in a single cell. The two separate embryos will be identical twins as they started off from the same egg and sperm. Non-identical twins will occur when two egg cells are released at ovulation and are fertilised by two different sperm.

Most couples find it reasonably easy to conceive, however sometimes it may take up to two years or so before it occurs. Other couples have great difficulties in conceiving and the problem can be with either partners or both.

Conception

Four to Six Months Old

Your baby will be ready to start to eat solid food at about four to six months of age. You can prepare this yourself. There are good reasons for starting your child on solids at this age:

*  Baby may still be hungry after a milk feed;

*  It lets babies get to know different tastes and textures;

*  Babies need to learn how to swallow solid food.

*  Chewing also helps in the development of muscles in preparation for speech.

*  The iron stored by the liver since birth will be diminishing.

You can give your child the following quite safely 

*  Good quality natural fruit juice - 30 to 60 mL daily.

*  Cereal - Start with rice cereal with added iron. Mix about 1 to 2 teaspoons of cereal with a small amount of breast or formula milk in a dish. Make it thick like porridge and give to your baby at the same time each day. It may take a while for your baby to become used to this new taste sensation. You could also use a little mashed pasta, rice or other cereal food as the first solid food.  Don't add sugar or honey.  Always reed the cereal to your baby with a spoon.  Don't use baby biscuits, as they have to much sugar in them.

*  Fresh fruits - such as ripe banana, pear, pawpaw, rockmelon, peach or avocado.

*  Cooked fruits - try apple and pear. Try to grate harder fruits and vegetables.

*  Canned fruits - unsweetened or fruits in their own juices are the best and the easiest to use.

*  Cooked Vegetables (fresh is preferable) such as potato carrots zucchini broccoli pumpkin sweet potato marrow.  To cook - steam vegetables. Then mash, blend or sieve them.  Don’t add salt, Vegemite, Marmite or Promite or margarine or butter to vegetables.

*  Rice porridge

*  If your baby is under 6 months you may start with rice porridge and later add vegetables to rice porridge.

*  If your baby is over 6 months, you may add minced meat or fish as well.

*  Yoghurt - Use natural yoghurt and if needed, add fruit.

Helpful Hints

*  Always test the temperature of the food on the inside of your wrist before giving it to baby

*  It is not necessary to use salt

*  Always give solids after baby’s milk.

*  Don’t bombard your child with too much new food too soon. Give your baby only one new food every few days

*  If your baby doesn’t like a new food, that’s all right. Wait for a few days and try again.

*  It sometimes takes a while for babies to learn to eat from a spoon. Use a small teaspoon without sharp edges.

How much food does Your baby need?

Start baby with 2-4 teaspoons of solids at each meal and increase to roughly half a cup by 6 months, or according to your baby’s appetite.  

Do not become worried if your child won’t eat solids or won’t eat everything you give him. All babies are different - some need more food than others and some do not need to start solids until six months.  Do not force your child to eat, he will eat when he is hungry.

Six to Eight Months Old

At this age your baby needs to begin to learn how to chew even if he does not have teeth. Solids should play an increasingly important role in nutrition from now on.

*  Cereal - continue on using iron-fortified baby cereals at least until 9 months. Vita-Brits, Weet-Bix or porridge could be started after 9 months.

*  Egg yolk - You may also give your baby the yolk of an egg. Only give a little at a time until your baby gets used to it. You give it to your baby mixed with vegetables, or from a finger of toast dipped into yolk, or give just the plain yolk.

*  Vegetables - spinach, silver beet and green beans.

*  Meat

*  fish, steamed - make sure there is no skin or bones

*  chicken, finely chopped or pureed.

*  brains, mashed.

*  roast meat or steak - thin flakes scaped off the meat.

*  lamb’s fry.

*  Babies often enjoy chewing on a rusk.

*  Fruit juice - 60 to 12mls daily.

Teething usually starts between 6 and 9 months of age. They usually like to have something in their mouth to ease the pain and discomfort - a rusk is great.  They will also enjoy feeding themselves using their fingers or a safe spoon. They also love chewing on foods such as cooked carrot, celery, green beans, pumpkin; meat, fish, chicken, cheese; pieces of ripe banana, peach, pear, small pieces of orange, apple; sandwiches, toast.

Nine to Twelve Months Old

Babies at this age should be eating most of the same foods as you. But your should be cutting it up in small pieces or mashing it.

*  vegetables

*  fruit

*  pasta dishes

*  potato

*  bread

*  pudding

*  meat, fish, chicken

*  whole egg

*  rice dishes

Raw apple, celery or carrot should be grated.  Do not add extra salt or sugar to your baby’s food.  Don’t give fried foods.

*  Snack foods - Babies often like to munch on something between meals. Healthy options are pieces of soft fruit, plain cracker biscuits, toast or bread.

Avoid the following - sweet biscuits, sugary foods, sweetened fruit drinks, cordials and soft drinks, salty packet chips and crisps, nuts, peanuts, hard lollies, uncooked carrot or celery and whole peas.

Drinking from a cup

Between 6 and 9 months, your baby can start to learn to drink from a cup.  To help him/her learn, give him/her an unbreakable cup to play with and show him how to put it to his/her mouth. Then, add a little water, juice or milk and let him/her learn to use it.  It takes most babies some time to learn to drink from a cup. Don’t worry if he/she makes a mess.

One-year-olds

Each day your baby needs these foods to continue to grow to be strong and healthy:

*  Milk - either breast milk or 4 small cups

*  Wholegrain cereal, bread, rice or pasta - 3 servings

*  Yellow or dark green vegetables - 1 serving

*  Juice - 1 small cup

*  Other fruits and vegetables - 2 servings

*  Meat, fish, chicken, eggs, cheese or legumes - 1 or 3 servings

*  Filtered water to drink

If you are breast feeding, continue to breast feed for as long as you and your baby want to.  If bottle feeding, it’s a good idea to start taking your baby off the bottle by twelve months and offer milk from a cup.

*  Snacks - Most toddlers cannot eat very much at each meal and they get hungry between meals. So they like snacks. Some good ideas are:  pieces of fruit, fruit juice, peanut butter on plain cracker biscuits or bread, small pieces of cheese or cold meat, small cups of milk.  Avoid all sweet, refined or fatty snack foods.

Fluids and Vitamins

Water

It is good to offer your baby water regularly. They may not want it however. Do not add sugar or honey to the baby’s water.

Vitamins

Breast milk and recommended infant formulas contain all the vitamins your baby needs for the first 4 to 6 months.

Fruit juice

When baby is 4-6 months of age, you may wish to give some diluted fruit juice, especially in hot weather.

*  30mL fresh fruit juice in 30mL of cool boiled water.

*  Do not use syrup fruit juices.

Feeding Your Baby Considerations

It is normal for you and your child to come into contact with bacteria and viruses on a regular basis. Some of these microbes can cause serious problems.
Immunisation protects your baby from serious diseases and illnesses. It is safe and easy to administer.

How immunisation can help…

When you are vaccinated, your body responds by creating antibodies that defend it against that disease in the future. It builds up a defence system that destroys the bacteria and viruses before they cause illness.

Which diseases shoould you be immunised against…

Whooping Cough (pertussis) - this is an infectious disease spread by coughing and sneezing. Breathing becomes difficult with distinctive coughing spasms. This can be fatal for children and babies.

Diphtheria - this is a bacterial infection spread by droplets from the nose. The bacteria produces a toxin which spreads throughout the body and causes heart failure or paralysis.

Polio - a virus of the gastrointestinal area. A serious disease which is not under control however it can make another appearance if children are not vaccinated from it.

Tetanus - caused by a bacteria made toxin which is found in soil and animal manure. Serious side effects are spasms, lockjaw, breathing problems and convulsions.

Mumps - virus spread by saliva. Is serious if complications set in - such as swollen brain and infertility.

Measles - caused by a virus. Highly infectious and spread by coughing and droplets from nasal passages. Can have serious side effects and complications can cause encephalitis or pneumonia.

Rubella (German measles) - dangerous if spread to pregnant women. Therefore very important to have your child immunised against it.

Hib - a bacterial infection that can cause other more serious diseases in children and infants.

Hepatitis B - this immunisation is available for your baby. It is a virus that attacks the liver and can be the cause of liver cancer.

These diseases are very serious and can often be fatal. Your child needs protection from them from an early age.

When does Your Child need to be immunised …

Age and what to get immunised against…
2 months diphtheria, tetanus, whooping cough, polio, Hib.
4 months diphtheria, tetanus, whooping cough, polio, Hib
6 months diphtheria, tetanus, whooping cough, polio, Hib
12 months measles, mumps, rubella
18 months diphtheria, tetanus, Hib
4 - 5 years diphtheria, tetanus, whooping cough, polio
10-16 years measles, mumps, rubella, hep B
one month later hep B (2nd dose)
six months later hep B
15-19 diphtheria, tetanus
every 10 years diphtheria, tetanus

Are there any side effects involved…

• a slight fever
• a sore arm
• feeling a little unwell
• 
  

Are there times when you should not have your baby immunised…

Not many… Always tell your doctor if your child has a fever and is quite sick, is having any form of treatment that can affect their immune system, has a disease such as AIDS/HIV, Leukaemia, cancer. Your doctor will be able to recommend the appropriate course of action.

IMPORTANT NOTE: - There are some who worry that the whooping cough immunisation may cause brain damage in children. There have been studies conducted which show that this is probably not the case. If it were true, the chances would be less than one in a million. However, it is reported that for every 300 children who are not immunised against whooping cough and are unfortunate enough to catch the disease, two will probably develop encephalitis (inflammation of the brain) and one will die.

This points out that it is more important to get your child immunised.
Reference: The Australian Immunisation Handbook, 6th edition.

Immunisation

Infertility is the inability to conceive a child after a year or more of sexual intercourse without contraception.

What to look for

If after a period of unprotected intercourse, the couple cannot conceive, this is infertility. It can be because of either partner or both.  This can be very distressing for many couples and is taken as a sign of inadequacy. Please keep in mind being infertile does not necessarily indicate sterility.

Causes

Infertility in men can be the result of low sperm production, no sperm or sperm which do not swim as they should do as well as a tubes blockage.

In women, infertility can be caused by a failure to ovulate due to a hormone failure. Interruption of an egg's progress through the fallopian tube from ovary to uterus may also be a cause.  Women’s age is a factor: as after 35 years of age it is often more difficult to conceive. Being overweight, or underweight, can also play a role.

In both men and women, fertility can be diminished by psychological factors, such as anxietyand depression, and by environmental agents.

Treatment

Your doctor will perform many tests on both partners to determine the cause of the infertility.  There are not ways to increase the chances of conception.  Couples are often advised to have intercourse just before ovulation.  Ovulation can be induced with the use of fertility drugs or hormones.  Certain disorders occurring in men can be treated with a doctors help.
IVF (in vitro fertilisation) is an option for couples who are infertile. The egg is fertilised outside the woman's body, then placed in the womb or fallopian tube.

Alternative/Natural Treatments

A variety of alternative treatments may enhance fertility.

• Relaxation Techniques - Stress can often hinder conception and there are different relaxation techniques can reduce stress which sometimes contributes to infertility.

• Dietary Considerations - Zinc is important for fertility in both sexes; a supplement may help. Vitamin C has been shown to aid men whose sperm clump together, and it may improve sperm count. Ask for professional advice with regards to the appropriate doses.

• The diet of both partners should include plenty of fresh vegetables and fruit and a high potency multi-vitamin. Men need more vitamin C. Reduce the amount of caffeine and alcohol as they make the system more acidic.

• Herbal Treatments - As mentioned above, Zinc is often recommended as well as vitamin E. Take goldenseal, raspberry leaf or red clover tea.

Personal Care

For women:

• Don't douche.
• After intercourse, remain lying down for a few minutes.
• Avoid becoming too tired or too stressed.

For men:

• Avoid excessive alcohol.
• Stay healthy; a bad cold or flu can depress sperm count for up to three months.
• Keep testicles cool; avoid saunas, hot tubs, and close-fitting underwear.

When to seek further professional advice

• · you desire a child but have not conceived after a year of trying

Infertility

These are some of the things that you can expect during your pregnancy.

What to look for:

Your pregnancy is divided into three sections or trimesters:

1. from the start of your last period to week 14;
2. weeks 14 - 28; and
3. week 28 to birth.

You can expect some or all of these conditions in a normal pregnancy:

• in the first trimester - your period will stop; you may notice a strange taste in your mouth; increased need to urinate; minor weight gain; enlarged breasts; morning sickness or nausea.
• in the second trimester - more weight gain; stretching of the abdominal wall and pelvis; backache, constipation, heartburn, and foetal movement.
• in the third trimester - swollen limbs from fluid retention; leaking breasts; constipation; haemorrhoids; insomnia.

Pregnancy is a time of tremendous changes both physically and emotionally. These changes may come as a surprise or shock, but if you know in advance what is going to happen to you, you will be more prepared.  Now is the time for you to start seeing a qualified doctor specialising in conception and childbirth. He or she will step you through what to expect as your baby grows, the labour and how to cope with a newborn.

You must strive to keep as well as possible throughout your pregnancy. That means you need a balanced diet, appropriate exercise, plenty of rest, and a stress-free environment.  Never smoke or drink alcohol while you're pregnant, and avoid all drugs except those prescribed by your doctor.

We have listed some of the common complaints that are felt during your pregnancy and the treatments that you can have to ease them. If you are concerned about anything you are experiencing, do not hesitate to call your doctor.

ABDOMINAL PAIN
To relieve pains or cramps particularly, use a hot water bottle on the affected areas. You can also gently massage the areas with lavender oil. If you exercise regularly, you will strengthen and tone your abdominal muscles.

BACKACHE
Do not gain too much extra weight as this can put extra pressure on your back as well as hinder the birth. Do the appropriate exercises. Try not to take medications to relieve the pains; instead, use a hot water bottle. Special exercises to strengthen abdominal muscles can also help reduce backache.
Also be very particular about your posture - don’t slouch or lean too far back. Lie down or sit down wherever possible later on in the pregnancy. Wear special shoes or shoe inserts.
Sleep on a firm mattress.
Be careful when lifting heavy loads.
Massage... Sit backward on a straight chair. Lean over the back with your head resting on your crossed arms. Have someone massage with lavender oil.

BREAST DISCOMFORT
If your breasts leak fluid, use nursing pads in your bra. Wear a bra that gives your enlarged breasts proper support.

CONSTIPATION
Increased hormone levels can cause your digestive system to slow down and this causes constipation. To keep stools soft and bowel movements regular, get plenty of dietary fibre. Avoid using over-the-counter laxatives. Drink lots of fluids and exercise regularly.

CONTRACTIONS
Mild, painless uterine contractions usually start sometime after the 20th week of pregnancy. If they cause discomfort, try changing positions. If contractions start coming at regular intervals, notify your doctor.

CYSTITIS
See your doctor about the appropriate treatment for any urinary infection. However either drinking cranberry juice every day or taking the supplements can prevent this from occurring. (See also Urinary Problems.)
Always check with your doctor before taking any new supplements.

DIZZINESS AND FAINTNESS
Always try to work and place yourself where there is free air available such as near windows and doorways. Stand up or get out of bed slowly. If you're in a crowd and start feeling dizzy, step away and get some fresh air; if possible, lie down with your feet elevated or sit with your head between your knees.

EDEMA
Do not gain too much weight during your pregnancy. Try to avoid too much salt as this causes you to retain fluid. Put your feet up whenever possible. Wear support pantihose and avoid standing for long periods. Wear shoes that fit well and give good support - not high heals.

FATIGUE
Get a full night's sleep and rest with your feet up for at least 15 minutes several times a day. This can also be the result of a lack of iron in your system. If you notice you have cravings for red meat, spinach and eggs, see your doctor.

HEADACHES
Make sure you get enough rest - in fact these headaches are best treated by sleep, eat regularly, and drink six or more glasses of water daily. Avoid over-the-counter painkillers;
Try techniques such as yoga or meditation. Drink herbal teas and gently massage your temples with lavender oil.

HEARTBURN
Eat smaller, less spicy meals, avoid, greasy, sugary, and acidic foods. Stick to a bland, high-fibre diet, drink lots of fluids, and exercise daily. Don't lie down right after a meal. You may wish to raise the bedhead up a little as well.
After meals, drink tea made from chamomile, ginger, or fennel.

HEMORRHOIDS
Haemorrhoids may develop but they usually disappear after the birth. Avoid getting constipated. Eat a high-fibre diet to keep your movements soft, drink lots of fluids, and don't strain during bowel movements. To relieve haemorrhoidal itching or pain, try a warm bath. If they persist see your doctor who may prescribe a special cream.

LEG PAINS AND CRAMPS
Wear support hose during the day, and elevate your feet when resting, if possible. Have your legs massaged with lavender oil. Use a hot water bottle. If painful cramps persist, ask your doctor about calcium or magnesium supplements. It is comforting to know that they won’t last long.

MORNING SICKNESS
You may feel nauseated at any time of the day during the first trimester. Eating frequent light meals rather than three large meals. Keep your diet low in sweet and fatty foods. Drink plenty of fluids, and eat fresh fruits and vegetables, which are high in water content. Do not take antacids, but try vitamin B6.
Aromatherapy... Add the essential oils of lavender and mandarin to your bath. Peppermint and sandalwood are also good for nausea. Put on a handkerchief and inhale the scent.
Herbal teas are also very good.

MOUTH AND GUM DISCOMFORT
See your dentist before you get pregnant if possible or at least early in your pregnancy for a checkup and cleaning. Brush your teeth and tongue at least twice a day, and floss regularly.
Supplemental vitamin C, calcium, and coenzyme Q10 will strengthen your own teeth and ultimately your baby's. Always check with your doctor before taking supplements.

NASAL CONGESTION OR NOSEBLEEDS
Petroleum jelly or vasoline inserted in each nostril may help. Otherwise see your doctor if it becomes too uncomfortable. This problem should not last too long.

SKIN CHANGES
Chloasma, a darkening of the pigmentation on your face can be alarming but be rest assured it will disappear after the baby is born. It is best to stay out of the sun and to wear sunblock.
Lubricate dry skin around your abdomen with a moisturising cream and especially vitamin E cream; stretch marks usually fade and decrease after the birth.

TASTE CHANGES
It is normal to have cravings for strange foods during your pregnancy. Use mouthwash often; chewing gum or mints may to get rid of the strange tastes in your mouth. Iron supplements may leave a bad taste in your mouth.

VAGINAL DISORDERS
A thin, mild-smelling discharge is normal in pregnancy. Use sanitary napkins, but do not douche without your doctor's approval.  If your discharge is red or brown call your doctor immediately. Vaginal itching and soreness may indicate an infection, which requires treatment by your doctor.  Thrush is very common in pregnancy and may disappear without treatment after the baby is born. But if it is uncomfortable there are a number of home treatments that may help you. (See also Vaginal Problems.)

VARICOSE VEINS
Pregnancy puts extra strain on your legs. You can get the most benefit from wearing support pantyhose or stockings.
Exercise regularly, but don't stand for long periods. Raise your legs above hip level when sitting, if possible. Lie on your side in bed, or put a pillow under your feet. (See also Varicose Veins.)
Ask your doctor or a nutritional specialist about taking vitamin C supplements to strengthen blood vessels.

VISION CHANGES
If your eyes swell or change shape from fluid retention and hard contact lenses become uncomfortable, switch to soft lenses or glasses.

When to seek further professional advice

• you have severe nausea and vomiting
• you have vaginal spotting or bleeding.
• you have a fever and chills, backache, or blood in your urine.

Pregnancy Problems

Eczema

Eczema can quite often occur in babies up to about 4 months of age. It is usually milder than the type that occurs in adults. Your baby’s cheeks become rough and scaly and this can also occur in your child’s eyebrows and hair (cradle cap).
If infection sets in, the skin can become scaly, develop cracks and redness and weep.  Caused by overactivity of the sweat glands. This is usually grown out of in the first 6 months. You should stop using soap in his bath, ask your pharmacist about alternatives.

If the rash is particularly bad, you should limit the bathing to 2 times per week. Do not use baby creams and lotions.
Moisturise the skin with sorbolene cream. Your doctor may prescribe a very mild steroid cream which you can add to the sorbolene cream and apply to your baby’s skin. This is perfectly safe and will usually sooth the pain. A natural option is chamomile applied on babies head - do not use on children under 2 weeks old and always use one drop diluted in carrier oil. (see our section on Aromatherapy).

Cradle cap

Is a type of eczema, a build up of natural oils. This causes a dry scaly crust on your baby’s head. Petroleum jelly (vaseline) can help soften the scales and allow their removal.

Oral thrush

Baby’s immune system have not fully developed and can not often withstand infection of the candida albicans fungus. It most often occurs in their mouth. It will look like white milk curds stuck to the inside of the mouth. They will not be removed or scraped off however.  Thrush can be painful but more than likely your child will tolerate it. Your will need to speak to your doctor or pharmacist about specific products which will remove the thrush.

Also treat your nipples if breastfeeding as it can spread to you. You must also sterilise all feeding equipment and anything else your baby puts in his or her mouth. Change your sterilisation equipment you use for your feeding equipment often when your child has thrush.

Reflux

This can happen often in new babies. It occurs when your child vomits up most of the food swallowed. It is caused by a poorly formed valve between the gullet and the stomach. The valve usually rights itself as the child becomes older.

This can be a worrying time for parents as they worry if their child is putting on enough weight. The problem with reflux occurs when the vomiting becomes very regular and annoying, your baby does not put on weight. Usually the child will grow out of this problem in the first few months.

A few helpful hints are to adjust the baby’s resting position. Put the cot up at the head end about 30 degrees.

Bowel motions of a newborn

For breastfed children…
Your baby may have many motions per day or only one every few days. The motion may be yellow, green, brown or a combination of these. The consistency may be pasty, fluid or seedy. It will not normally be hard in texture.
If your child is passing hard stools, this is not normal. Another thing to look out for is overly fluid stools that resemble urine. See your doctor if this happens.

For bottle-fed children…
Bottle-fed babies will usually have more firmer stools and pass them more frequently - four times per day to once every couple of days. The colour of the stool will be more red-brown and green. They may become constipated or just simply pass harder stools.
If your child is passing watery stools - check with your doctor and take a sample of the stool with you.

Some Common Baby Problems

You will know when you are about to give birth because both you and your body will display some warning signs such as -

• an urge to clean up the house in readiness for the arrival of the baby.
• you may feel energetic and unsettled - wanting to keep on the move.
• you may feel excited, anxious or nervous about the birth
• you could lose some weight just before the birth
• your baby could stop moving as it’s room in the womb is restricted from the position it has taken up towards your pelvis.
• possibly a backache
• diarrhoea
• The ‘show’ - a small discharge of blood and mucus from your vagina
• your waters will break - this is the sac that holds the amniotic fluid surrounding your baby.

If you have a constant flow of blood from your vagina - this is not normal and you should see your doctor immediately.

The First Stage

Your uterus tightens and relaxes its muscles to start your cervix opening up. At first they will be only slight. Your baby’s head moves towards the cervix, helping it to open.

Contractions may vary with each woman. In an ideal situation contractions which last 20 - 30 seconds will occur every 20 - 30 minutes. Some women do not notice the contractions until they are about 10 minutes apart.

Your cervix gradually dilates (opens). When it is about 3 cm dilated you are said to be in established labour. At this time your midwife or doctor will examine your vagina and check for any complications and other routine observations. As your cervix opens, your contractions will come more frequently and they will last longer. Your cervix will need to be 10cm wide before it is fully open.

Eventually your contractions begin to get much closer together and they can be quite painful and strong. This is the transition period. At this time you will more than likely be quite irritable, nauseous, trembling and you may feel a strong urge to push.
If your waters haven’t broken yet, this could be when they do. Your baby is nearly ready to be born.

The Second Stage

The second stage is usually a relief for many women as this is when the pushing can start.
The cervix is fully dilated and you will feel an urge to push the baby out. Your baby is moving down the birth canal. Your contractions will be lasting for about 5 or 6 seconds. This part of the process may last about an hour for first time mothers.
Once the baby’s head can be seen from the vagina, it is almost over. Resist the urge to keep pushing hard as you will rip the area between your vagina and anus - the perineum.

Try to breathe in short breaths to deliver your baby’s head. Once the head is out just let the rest of the body come out naturally.

Tell the doctors in advance that you want the child placed onto your stomach before the umbilical cord is cut. This helps with the bonding of the child to you. Hold the child as soon as you can.

The Third Stage

This is the delivery of the afterbirth or placenta. This is controlled by the doctor or midwife. Your uterus will continue to contract to get rid of this, but you will not be able to feel it. Sometimes the doctors will give you an infection to hurry this up to reduce the risk of serious bleeding after birth.
Most mothers will experience some mucus or bleeding from the vagina for a few weeks after childbirth.

The Birth

Week by week changes you will experience... And developments in your womb.

Week 1:

Development of the Zygote
Day 1. During sexual intercourse Approx 300-500 millions sperm are deposited in the female genital tract... But only about 300-500 reach the area of fertilization. Fertilization occurs closest to the ovary. This is in the widest part of the fallopian tube. Once a sperm penetrates the egg, the surface of the egg changes to prevent multiple fertilization. The sperm and the egg begin to fuse together.
Day 2. The sex is determined after the sperm and egg have fused. The cell eventually splits into two cells. This two-cell stage occurs about 30 hours after fertilization.
Day 3. About 3 days after fertilizationThe 12- and 16- cell stages occur . This small clump of cells is referred to as the morula.
Day 5. About the fifth day the morula finally enters into the uterus. Fluid begins to enter until a single cavity is formed. When this cavity is formed, the embryo is called the blastocyst.
Day 7. Around day 6... Implantation into the uterine wall begins . The uterine lining is in a secretory phase at this point. The wall becomes spongy as the glands and arteries become coiled.

Week 2 - 4

Approx 22 days after conception your baby will have developed a heart beat, and is on its way to developing the digestive tract, sensory organs, and neural tube.The neural tube is what eventually becomes the Central Nervous System, consisting of the spinal cord and brain.
By the end of the first month of your pregnancy, your baby is smaller than a grain of rice.
What You might be Experiencing...

• frequent urination possibly with vomiting
• sleepiness
• flatulence
• nausea
• absence of menstruation
• emotional changes similar to PMS
• tenderness and fullness of breasts
• bloating
• heartburn
• food cravings
• indigestion,
• fatigue
• constipation

It is highly possible that you do not know that you are pregnant during the first couple weeks. However, It is possible that you will experience some of the signs of pregnancy.

Week 4

The embryo is attached to the lining of the uterus and is about 3 mm in length. You could see it with your eyes.

Week 5

The amniotic sac will have been formed.

Week 6

The embryo is not recognisable as a human being. But it has a spinal column, a large head and arms and legs. The sockets for its eyes have been formed. It is 1.3 cm long.
You may start to experience some symptoms such as breast tenderness and morning sickness.

Week 8

The embryo has all his or her major organs. The toes, fingers and features on the face are in the process of forming. The embryo is now considered a foetus. It is now more recognisable as a human. The length is about 2.5 cm.

Week 10

Fingers and toes are now webbed, the head remains larger than the body part. It has blood circulating through it.

Week 12

The uterus can just be felt above the pelvis. The foetus is about 7.5 cm long. It is more active. Nails and genitals are starting to appear.
You probably do not suffer from morning sickness any more.

Week 14

Your nipples may darken in colour and your breasts may stop feeling quite so tender. You will probably start to show from this time onwards.

Week 16

The foetus is moving vigorously but you may not be able to feel it.

Week 20

The uterus will have reached to level of your navel. You will now be able to feel the movements. The foetus now measures about 21 cm and is covered with fine hair. Eyelashes and eyebrows now have developed.

Week 24

Your foetus eyelids separate. Its length is about 33 cm

Week 28

The uterus reaches about halfway between the navel and the breastbone. If the foetus was born now, it could survive. It measures 37cm. The head is now reasonably in proportion to the body.

Week 32

The foetus is still very active. Most babies will have their head in the birth position.

Week 36

In most women, having babies for the first time, the head will have descended into the pelvic cavity and the uterus descends from under the rib cage as the baby’s head has moved down into the pelvis. It is about 46 cm.

Week 40

Pregnancy is full term. You can now breath easier, although you still may have pressure on your bladder.

Week by Week

The First Signs

• A missed period

The first and most obvious sign that you may be pregnant is a missed period. This however may be caused by other factors or it may simply be late.

•  Lighter periods

Some women continue to get their periods for a couple of months but they are lighter.

• Sore breasts

This can be a symptom in women who normally get sore breasts before their period. By six weeks, all women will experience an increase in the size of their breasts.

• Morning sickness

In the first six to twelve weeks, most women experience nausea or vomiting. It can be uncomfortable at any time of day.

• Frequent Urinating

You may find that you need to go to the toilet more often.

• Tastes in the mouth change

Some women may have a strange taste in their mouth and may even notice a dislike for alcohol, coffee, cigarette smoke and meat products.

• Emotionally Volatility

The hormones may wreak havoc on you at first and you may experience moodiness and stronger emotions than normal. If you experience any anxiety that lasts longer than the first trimester - speak with your doctor who may refer you to a counsellor for additional therapy.

Changes during the pregnancy

You will experience many physical changes during your pregnancy and many may come as a surprise to you. It is always best to be prepared for the changes so you are better able to cope with them and control them.

• Vaginal Discharge

this may increase during pregnancy. It is normal and does not usually require medical attention. If you notice it changing in odour or it becomes irritating - speak with your doctor.

• Constipation and heartburn

you will be experiencing an increase in the hormone progesterone which can affect the bowel and make it slower.

• Backache

this can become worse as the pregnancy continues on. Try to avoid high heeled shoes. Do not lean back to counteract the extra weight in your belly - this will put added pressure on your back.

• Haemorrhoids or piles

the blood flow from your legs and pelvis is blocked by pressure from the baby . If you are constipated, this can make it worse.

• Varicose veins

may appear for the first time. If you wear support stockings, they may not appear at all. Keep moving around as this can help the circulation.

• Scarring on the abdomen

commonly called stretch marks, these fine scars may also come on your buttocks, thighs and breasts. There are many natural products on the market that may be able to prevent them from forming or becoming too noticeable. Ask our pharmacist about them.

• Breast changes

will occur throughout your pregnancy. They may be tender and the nipples may grow and become darker in colour. They may eventually become more painful as more blood flows to them. Eventually prolactin is produced and this encourages the breast to make milk.

You may notice your breasts ‘leaking’ at around 5 to 6 months. After about five months your breasts should not grow much bigger.

• Your belly

will increase and this can be a problem for women who have always tried hard to maintain their weight at a slim level. You will put on extra weight besides the baby as your body prepares for the pregnancy and the birth.

What to eat during your pregnancy…

You should be eating a nutritious and varied diet in pregnancy as this is the best way of caring for yourself and your baby. You should not eat ferociously throughout your pregnancy in an effort to ‘eat for two’ as this will do more harm than good and make it difficult for you to give birth.

The following food groups provide you with the vitamins, minerals and protein you will need for a healthy pregnancy and baby.

• Vegetables and fruits.
• Breads, cereals, pasta and rice (wholegrain ).
• Milk about 900 ml daily or if you cannot tolerate milk or want to try something less fattening natural yoghurt about 200g, unprocessed cheese 35g or cottage cheese 300g. Ask your doctor about a supplement if you do not want to eat dairy products. This will give you your required Calcium.
• Lean proteins like fish, chicken, eggs, meat, liver, kidneys, nuts and pulses. Be aware that if you are only eating nuts and pulses for protein you will not be getting the iron, vitamin B12 or zinc which is required.
• Also ensure you are eating adequate Folic acid - present in liver, kidneys, green leafy vegetables, broccoli, nuts, brewers yeast, avocado and peas. Do not cook your vegetables until they are soft as this can destroy folic acid.

What do you need to avoid during pregnancy?

• ·Most medications may affect your unborn child - always check with your pharmacist or doctor before taking any drug either legal or otherwise.
• Alcohol - the occasional wine or beer will do no harm, but do not drink excessively. Do not drink spirits.
• Smoking - should be avoided and do not let anybody smoke in your presence.
• Caffeine - limit your intake to one per day.
• Soft cheeses - contain bacteria.
• Raw/'Blue' meat.
• Excessive exercise - although continue to do gentle exercises.

What about sex?

Some people think that having sex will hurt the baby. Normally sex is safe throughout the whole pregnancy. Sometimes you may not feel like having sex due to the discomforts and tiredness. But this usually does not last long.

Some women find that they become more sexual during this time in their lives and feel more sexy. If however, you have had complications with pregnancies in the past or are worried see your doctor about your concerns.

Your Pregnancy

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