Friday, 7 December 2012

First time home alone


What to do when your partner goes back to work and relative visits become less frequent, try not to worry, and remember you can call your gp, midwife or hv whenever you need to - they are used to it! You may try to leave the house with your baby this week, and it will take a lot longer to prepare than you originally thought! Follow these tips for a smoother run...
Try to feed baby immediately before leaving, as then baby probably wont cry from hunger for a good hour after you leave.
Change babies bum and put a bid on him immediately before the feed so less chance of spillage on his clothes!
Get your nappy bag ready in advance- you will need
Nappies (one for each hour you will be out is a good rule to follow)
Wipes
Your keys, phone, wallet etc...
Milk and bottle if not breastfeeding, poncho perhaps if you are breastfeeding and want a cover up.
Spare outfit for baby in case of leaks
Bibs
Camera- to capture those first moments!!
And don't forget baby :P

Baby Sleep
16-20 hours a day with no pattern.
It's still too early for a routine, so continue to feed on demand as your baby is too young to go hungry between feeds. By the end of this week he should be sleeping for slightly longer at night though, hurrah! To encourage baby to sleep more at night, try to make the nighttime feeds less interesting. Keep the room darkened, talk quietly and try not to liven baby up too much so he realises nighttime is a quiet time. On the flip side, during the day make sure its light and keep the tv and other background noises going, and dont let baby sleep for longer than 3 hours in one stretch,

Cot Death - minimising the risk

ALWAYS put your baby to sleep on his back, with his feet at the bottom of the cot so he cant wiggle down and get trapped under his covers. Make sure relatives etc know to put baby to sleep on his back, as this minimizes the risk of cot death by 75%, and older people are more likely to not know this and try to put baby on his front.
Don't smoke - smoking is the highest risk factor in cot death now all babies sleep on their backs. Don't smoke in your house, and keep smokey clothes away from the baby. Smokers should not co-sleep with their children as this increases their chance of cot death phenominally.
Breastfeed your baby- bottle fed babies are 3x more likely to suffer cot death than breastfed babies.
Keep baby cool - don't put too many blankets on baby, and he never needs a hat on when inside, he needs to lose some heat from his head. Ideally the temperature should be between 16-20'c. Get a nursery thermometer to keep track of the temp!

Baby Crying
Your baby may cry for 2-4 hours a day
Your baby will probably cry more and more each week until week 6 when it peaks and then will get better, honestly! Always offer milk first as this is likely to be the cause.

Milk
Your baby will take betweem 18-23oz a day, up to 3oz per feed, up to twelve feeds a day.
If you are breastfeeding you may find your nipples are a little sore, but over the next couple of weeks that should improve as your technique gets better. Nipple shields and creams can help with this problem.

Nappies a day...
wet - 8-12
pooey - 0-12


Washing Baby
You may try give baby his first bath around now. Don't expect too much, keep the bath shallow and top and tail him as usual. Put around 2-3inches of water in, and just try get him used to being in water rather than trying to actively clean him :) make sure the water is nice and warm, but not hot, always put the cold in first and last to minimise the risk of burning baby. Get someone to help the first few times as its a hard job to get used to, or buy a specially designed baby seat to help. Try for a couple of minutes at a time in the bath at first, though if baby hates it just 20 seconds is long enough, don't try to keep him in if he seems very upset. And never leave baby unattended!

Development
Baby will start to recognise your face this week, so pull gentle faces and coo at him. Also, continue to touch his palm and let him grasp you, every movement baby makes helps to strengthen his muscles!

Whats happening to you
You may find that you wee a little when you laugh or cough, but thats normal and should clear up by week 6, do your pelvic floor exercises ten times every time you feed your baby and you should be fine. Do this even if you had a section as your pelvic floor muscles will have become weakened by pregnancy.
Your breasts will probably be leaking a lot at the moment, just keep feeding on demand and use breast pads to avoid any embarrassment :)

New Mum


Bringing your baby home for the first time can be a scary prospect. 

In fact, the first few days and weeks are like a step into the unknown and it's easy to feel as if you're doing everything wrong. 

Try not to worry, though, because there's lots of advice and support available to help you adjust.

The checks

Who will come to see me after the birth?

The day after you leave hospital a community midwife will visit you at your home. A typical visit will last around 30 minutes, and she will arrange to visit you again within a few days. 


What checks will she carry out?

The first time she visits your midwife will want to do the following:
  • Check your baby's weight (you will need to undress your baby so that she can do this)
  • Make sure that the umbilical stump is healing well
  • Check that your baby is feeding well. If you are breastfeeding she may want to make sure that your baby is latching on correctly
  • Feel your tummy to make sure that your uterus is shrinking back to its normal size
  • If you had a c-section or needed any stitches she may want to check that you are healing well with no signs of infection.


When your baby is between 6 and 14 days old you will be offered the newborn heel prick test, known as 'the Guthrie test'. This involves making a tiny pin-prick in the heel of your baby's foot and collecting a drop of blood, which is used to cover four absorbent circles on a piece of card. This test is used to screen for some very uncommon health problems, including:


Parents are usually only contacted if there's a problem, but results are available from your GP or Health Visitor.

How many times will she visit?

Your midwife will visit regularly until your baby is around two weeks old. If she is happy that all is well with you and your baby she will then hand over your care to a Health Visitor, who is based at your GP Surgery. 

Initially your Health Visitor will visit you at home, but after the first visit you will need to bring your baby to regular baby clinics, so that his weight can be monitored and you can ask questions or discuss any concerns. 

Weaning


You may find it easiest to start with simple pureed or well-mashed foods. Try offering your baby one or two spoonfuls of the following:
  • Mashed or pureed vegetables, such as cooked carrot, parsnip, potato or sweet potato.
  • Mashed or pureed fruit, such as banana, cooked apple, pear or mango.
  • Baby cereal such as baby rice, sago, maize, cornmeal or millet. You can mix these with some of your baby's milk.
You can offer food to your baby before or after a milk feed, or in the middle of a feed if it works better. Pick a time that's good for both of you. If the food is hot, make sure you stir, cool and test it on the inside of your wrist before giving it to your baby.

It may take your baby a while to get used to these new flavours. Don't be surprised if she rejects the food or spits it out. Just try again later, or the next day. You can make the food a little blander by mixing it with a few teaspoons of your baby's milk.

At first, your baby may seem to eat very little. Be patient and remember it may take time for her to learn how to eat. As she develops more of a side-to-side, grinding motion, add less liquid to her food so the texture is thicker, with chunkier, soft lumps. This allows your baby to work on chewing, or gumming, and swallowing.

As your baby becomes used to fruits, vegetables and cereal, add a variety of other foods. Then gradually increase the number of times a day that she has solids. By the time your baby is about seven months old, she should be eating solids three times a day. A typical day's intake could include:
  • Breastmilk or formula milk.
  • Iron-fortified cereal. Check packaging for salt and sugar levels, though.
  • Vegetables. These can include potatoes, parsnips, broccoli, cauliflower, sweet potato, spinach and butternut squash.
  • Small amounts of meat, poultry, fish, yogurt, hard-boiled egg, well-cooked lentils and cheese. Don't give your baby brie, stilton and other mould-ripened or soft cheeses.
  • Fruit.
Remember that your baby's appetite will vary from one feed to the next. Watch out for cues that she's full. If she keeps her mouth shut, turns away, or starts playing with her food, she's probably had enough.

Some parents choose not to spoon feed their babies puree. They prefer to let their babies feed themselves. This is known as baby-led weaning.

If you would like to try baby-led weaning, offer your baby a selection of nutritious finger foods suitable for his age.

The easiest finger foods for young babies are those that are shaped like a chip, or have a handle, such as cooked broccoli spears. This is because when your baby first tries solids, he won't yet have developed a pincer grip. This will develop in the next few months, but for now, he can only clasp foods in his fists.

At first, your baby may just play with the food. He may grab pieces of food with his fist and start to suck on them. Carry on giving your baby breastmilk or formula milk in between mealtimes. As your baby gradually eats more solids, the number of milk feeds will start to decrease.

Preparing Food safely


Why is food hygiene important?
Cleanliness and food freshness is important once your baby starts to eat solid food. This is because babies' immune systems are less developed than adults'. Their tummies are vulnerable to bugs and infections.

The Department of Health says it's best to give your baby solid foods at six months. If you do choose to start your baby on solids before then, you should take extra care. Sterilise feeding spoons until your baby is six months old and wash your baby's bowls and feeding equipment in a dishwasher or very hot water. Use a clean tea towel or paper towels to dry them.

How clean do I need to be?

You don't need to create a kitchen that's a totally sterile environment. There's even evidence that our houses are too clean these days! However, it makes sense to follow these basic hygeine tips:
  • Wash your hands before you start to prepare meals for your baby.

  • Wash highchairs, bibs and eating areas in hot, soapy water.

  • If your baby is eating finger foods or eating with his hands, wash his hands before he eats his meals.

  • Change kitchen cloths and tea towels frequently.

How can I serve food safely?
When reheating baby food, make sure it is piping hot throughout. You should be able to see steam coming out. Let it cool down before you give it to your baby. Test a tiny bit of food on the inside of your wrist to see if it is a comfortable temperature before giving it to him.

Also, remember these tips:
  • If you're using a microwave to heat up food, stir it well to avoid hotspots.

  • Don't reheat your baby's food more than once.

  • Cook eggs until the yolk and white are solid.

  • Cook meats until they are no longer pink in the middle.

  • If food is frozen, defrost it thoroughly before you cook it, unless the food label says otherwise. Never refreeze something that has been defrosted.

How can I store food safely?
Follow these tips to make sure you store your baby's food safely:
  • If you're making batches of your baby's food in advance, cool them quickly and store them in the fridge. Freeze anything that won't be used within 24 hours.

  • If your baby leaves any food in his bowl after a meal, throw it away. Food that has been in contact with saliva contains bacteria that will multiply if kept.

  • Check the best-before and use-by dates on food that you give to your baby. If you have uneaten food left in a jar, you can keep it in the fridge for 24 hours after it's been opened. However, throw away leftovers that have been heated up once already and jars you have fed your baby from.

  • Check the temperature of your fridge. It should be between zero degrees C and five degrees C. Buy a fridge thermometer from a hardware shop if you haven't got one.

treatments for postnatal/ pyshcosis


Support and advice
The most important first step in managing postnatal depression is recognising the problem and then taking action to deal with it. The support and understanding of your partner, family and friends can play a big part in your recovery.

However, to benefit from this, it is important for you to talk to those close to you and explain how you feel. Bottling everything up can cause tension, particularly with your partner, who may feel shut out.
Support and advice from social workers or counsellors can be helpful. Self-help groups can also provide good advice about how to cope with the effects of postnatal depression, and you may find it reassuring to meet other women who feel the same as you.
Ask your health visitor about the services in your area.
Exercise
Exercise has been proven to help depression, and is one of the main treatments if you have mild depression.
Your GP may refer you to a qualified fitness trainer for an exercise scheme or you can find out more about starting exercise here.
Read more about exercise for depression.
Psychological treatments
Psychological therapies are usually recommended as the first line treatment for mild to moderate postnatal depression for women with no previous history of mental health conditions.
Some widely used psychological treatments are discussed below.
Guided self-help
Guided self-help is based on the principle that your GP can ‘help you to help yourself’.
For example your GP can provide self-help manuals detailing types of issues you might be facing and practical advice on how to deal with them. They also contain information on using cognitive behavioral techniques to help combat feelings of helplessness (see below for more information).
Your GP may also give details about an interactive computer programme, available via the internet, called ‘Beating the Blues’. This again takes a cognitive behavioral approach to battling depression.
Talking therapies
Talking therapies are where you are encouraged to talk through problems either one-to-one with a counsellor or with a group.
You can then discuss ways to approach problems in a more positive manner.
Two widely used talking therapies used in the treatment of postnatal depression are:
  • cognitive behavioural therapy
  • interpersonal therapy
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is a type of therapy based on the idea that unhelpful and unrealistic thinking leads to negative behaviour.
CBT aims to break this cycle and find new ways of thinking that can help you behave in a more positive way.
For example, thinking there is a perfect ideal of ‘motherly behaviour’ is both unrealistic and unhelpful. All mothers are human and humans make mistakes. It is neither necessary nor helpful to try and be “Super Mum”.
CBT is usually provided in 4-6 weekly sessions.
Interpersonal therapy
Interpersonal therapy (IPT) aims to identify whether your relationships with others may be contributing toward feelings of depression.
Again, IPT is usually provided in 4-6 weekly sessions.
Antidepressants
The use of antidepressants may be recommended if:
  • you have moderate postnatal depression and a previous history of depression
  • you have severe postnatal depression
  • you have not responded to counselling or CBT, or would prefer to try tablets first
A combination of talking therapies and an antidepressant may be recommended.
Antidepressants work by balancing mood-altering chemicals in your brain. They can help ease symptoms such as low mood, irritability, lack of concentration and sleeplessness, allowing you to function normally and helping you cope better with your new baby.
Contrary to popular myth, antidepressants are not addictive. A course usually lasts six to nine months.
Antidepressants take two to four weeks to start working, so it is important to keep taking them even if you do not notice an improvement straight away. It is also important to continue taking your medicine for the full length of time recommended by your doctor. If you stop too early, depression may return.
Between 50 and 70% of women who have moderate to severe postnatal depression improve within a few weeks of starting antidepressants. However, antidepressants are not effective for everyone. 
Antidepressants and breastfeeding
The selective serotonin reuptake inhibitors (SSRI) types of antidepressants are usually recommended for women who are breastfeeding. 
Tests have shown the amount of these types of antidepressants found in breast milk is so small it is unlikely to be harmful.
Side effects of SSRIs include:
  • feeling sick
  • blurred vision
  • diarrhoea or constipation
  • dizziness  
  • feeling agitated or shaky,
  • insomnia (not sleeping well) or feeling very sleep
These side effects should pass once your body gets used to the medication.
Discuss feeding options with your GP when you're making decisions about taking antidepressants.
Many mothers are keen to continue breastfeeding because they feel it helps them to bond with their child and boosts their self-esteem and confidence in maternal abilities. These are important factors in combating symptoms of postnatal depression.
Treating severe PND
Referral
You may be referred to a mental health team if your postnatal depression is severe, or does not respond to treatment. These teams are usually made up of a range of specialists, including psychologists, psychiatrists, specialist nurses and occupational therapists, and can provide intensive talking treatments such as psychotherapy.
If it is felt your postnatal depression is so severe you are at risk of harming yourself or your baby, you may be admitted to hospital or referred to a mental health clinic. If you have support available from your partner or family, it may be recommended they care for your baby until you are well enough to return home.
If you do not have support available to help you care for your baby, or your mental health team feels separation from your baby would adversely affect your recovery, you may be recommended for transfer to a specialised 'mother and baby' mental health clinic.
Your baby may have to sleep in a separate nursery until you are well enough to look after them. Once your symptoms begin to respond to treatment, your baby will sleep in your room.
Medication
A small number of women develop symptoms of psychosis after birth (being unable to tell the difference between reality and their imagination).
If this happens to you, you may be treated with a combination of:
  • mood stabling medications such as lithium or an anti-epileptic drug
  • an antipsychotic (this helps combat the symptoms of psychosis)
  • a tranquiliser, such as a benzodiazepine to help relax you
You cannot breastfeed while taking these types of medications so your baby will have to be bottle fed.
Electroconvulsive therapy (ECT)
Electroconvulsive therapy (ECT) may be recommended if you have severe postnatal depression, but is only used when antidepressants and other treatments have not worked.
If ECT is recommended, you will be given a general anaesthetic and medication to relax your muscles. Electrodes are  placed on your head and a pulse of electricity passed through your brain. Most people have either six or twelve sessions of ECT, normally with two sessions a week.
For most people ECT is effective in relieving severe depression, but it is necessary to take antidepressants afterwards to keep symptoms under control. It's unclear how ECT works, but the generally agreed view is that electricity changes the chemical composition of the brain in such a way as to elevate mood.
Some people experience unpleasant side effects after having ECT, including headaches and both short-term and long-term memory loss. Due to the risk of memory loss, your memory will be assessed at the end of each ECT session.
If it looks like your memory is being affected, or you experience other adverse side effects, then the ECT sessions will be stopped.

post natal depression/ post pychosis


You may feel:
  • guilty and ready to blame yourself for everything
  • exhausted and lacking in motivation
  • unable to enjoy yourself
  • trapped in your life
  • rejected
  • irritable
  • tearful
  • lonely
PND sometimes makes it hard for you to function in your daily life, as your energy ebbs away. You may not able to concentrate or remember things, so making decisions becomes a real challenge. PND often affects sleep. You may find you can't get to sleep, or are disturbed by early morning waking or vivid nightmares.

If you have PND, you may also suffer from:
  • panic attacks that cause a rapid heartbeat, sweating, sickness or fainting
  • stomach pains, headaches or blurred vision
  • a loss of appetite or the urge to comfort eat
  • suicidal feelings
  • a low sex drive
PND affects everyone differently. But if you are experiencing many of these feelings, and they are constant or getting worse, talk to your health visitor or GP. Don't try to cope on your own. The first step to feeling better is to recognise that you have PND. Then you can seek the help and treatment you need to recover.

Signs and symptoms of postpartum psychosis
Postpartum psychosis is a rare, but extremely serious disorder that can develop after childbirth. It is characterized by loss of contact with reality. Postpartum psychosis should be considered a medical emergency. Because of the high risk for suicide or infanticide, hospitalization is usually required to keep the mother and the baby safe.
Postpartum psychosis develops suddenly, usually within the first two weeks after delivery, and sometimes within 48 hours. Symptoms include:
  • Hallucinations (seeing things that aren’t real or hearing voices)
  • Delusions (paranoid and irrational beliefs)
  • Extreme agitation and anxiety
  • Suicidal thoughts or actions
  • Confusion and disorientation
  • Rapid mood swings
  • Bizarre behavior
  • Inability or refusal to eat or sleep
  • Thoughts of harming or killing your baby

Birthing plan


Birth plan notes

A birth plan is a way for you to communicate your wishes to the midwives and doctors who care for you in labour. It tells them about the type of labour and birth you'd like to have, what you want to happen, and what you want to avoid.

A birth plan is not set in stone. It needs to be flexible and acknowledge that things may not go according to plan. Write a plan which means your midwife doesn't feel she has her hands tied if complications arise during your labour.

You don't have to write a birth plan, but if you do, your midwife will help you. If you're not sure about a certain procedure, or if you prefer to keep your options open, talk to your midwife and then write it down.

Your birth plan is personal to you and should reflect your wishes and preferences. You may want to add details about your medical history, but your midwife will have your maternity notes, so will be aware of your circumstances. It's worth taking into account what's available at your local hospital or birth centre when you write your plan.

What research can I do before I start writing?
Gather as much information as you can before you start:
  • Join your local antenatal classes. Your midwife should offer you classes at your local health centre, surgery or hospital. Or there are also private classes available through the NCT. And you can also sign up for BabyCentre's free antenatal classes in our community.
  • Talk to mums who have had a hospital birth or who have had their baby at the birth centre you're going to. And if you're hoping for a home birth, chat to mums and dads who have been through it themselves. That way you'll learn how easy or difficult it was for them to get the kind of care they wanted.
  • Talk to your partner or the person who will be your birth partner. Make sure they fully understand the type of labour and birth you'd like to have. How do they see their role?
Once you've spoken to a few people and researched your choices, jot your birth wishes down on a piece of paper, as they come to mind. You can tidy them up later.

Your midwife may give you a special form for your birth plan, or there may be room in your notes. Keep a copy of your birth plan in your maternity notes so it's easy to find when you go into labour.

What should I include in my plan?
Here are some headings for your birth plan. Use the ones which are important to you and add extra headings for anything that's missing. Have a look in your maternity notes for additional suggestions.

If you've had a baby before and have had any past experiences that may affect this labour and birth, make sure you include them in your plan.

Your birth partner

Say who you want to have with you in labour. Do you want this person to stay with you all the time, or are there certain procedures or stages when you'd prefer them to leave the room? Would you like to talk to your birth partner in private about any interventions that are suggested? And would you like your birth partner to stay with you if you need an assisted birth or a caesarean?

Positions for labour and birth

Mention which positions you would like to use during labour and for your baby's birth. Also say how active you would like to be. Would you like to remain upright and mobile for as long as possible? Or perhaps you'd prefer to be upright in bed with your back propped up with pillows? Or you could specify that you want to lie on your side, be kneeling on all fours or standing or squatting.

Pain relief

Say what kinds of pain relief you would like to use, if any, and in what order. For example, you may prefer to try pethidine before an epidural.

You could mention breathing, relaxation, water, massage or a TENS machine as well as medical pain relief. And if there are any types of pain relief you wish to avoid using, make sure you write them down.

Speeding up labour

If your labour slows down, or is proving to be very long, do you want your midwife to use interventions to speed it up? Or would you prefer to wait and see what happens naturally?

Birth pool

If your hospital or midwife-led unit has a birth pool, or if you are hiring one for home use, write down whether you want to use it for pain relief or to give birth in, or both. Also let your midwife know if you want to have a managed or physiological third stage when you deliver the placenta.

Other equipment

Your hospital or birth centre may have wall bars, birth balls, mats or beanbags for use during labour. Or you may need to bring equipment in from home. Make a note of the type of equipment you would like to use in your plan.

Monitoring your baby's heart rate

If your pregnancy is straightforward your midwife will monitor your baby's heartbeat intermittently, about every 15 minutes, using a handheld device. Write down if you would like intermittent monitoring or continuous electronic monitoring (EFM) during which a belt is strapped around your waist.

Assisted birth

You might want to express a preference for forceps or ventouse if, at the end of labour, you need some help to give birth. Or you may be happy to see what your midwife or doctor recommends when the time comes.

Third stage (delivery of the placenta)

If you give birth in hospital it is likely that you'll be offered an injection to speed up the delivery of the placenta, called a managed third stage. You can choose to have the injection or you may prefer to have a natural third stage without drugs.

If you have a strong preference for someone to cut the umbilical cord, maybe your birth partner, say so. You could also mention if you would prefer delayed cord clamping. Delayed clamping usually happens if you are having a physiological third stage, but may also be possible with a managed third stage.

Skin-to-skin contact

You may wish for your baby to be placed directly onto your tummy straight after birth, or you may prefer for your baby to be cleaned up before she is handed to you.

Feeding your baby

Be clear about whether you want to breastfeed or bottle feed. Also be clear about whether your breastfed baby is allowed to have any bottles of formula. If you definitely don't want her to have formula, say so.

Unexpected situations

You may want to write down what you want to happen if your baby has to go to the special care baby unit (SCBU). Do you wish to care for him yourself as much as possible, and be transferred with him to another hospital if a transfer is necessary?

What if I have particular needs?
You may have special requirements that you want to mention in your birth plan. If you have a disability, write about the help you'll need in labour. Say whether there is any special equipment that would assist you.

If English isn't your first language and you need an interpreter, say so. Also let your midwife know if you need a sign language interpreter.

Include any religious requirements, such as customs you'd like to be carried out when your baby is born. Or you might require a special diet during your hospital stay. Write all of these things down. Health professionals are committed to being culturally sensitive and treating you as an individual.

I've written my plan. What happens next?
Show your birth plan to your midwife and ask her to go through it with you during one of your antenatal appointments, ideally before you are 36 weeks pregnant.

Discussing your plan with your midwife will give you the chance to ask questions and find out more about what will happen when you go into labour. Also, by listening to your preferences, your midwife will get to know you better and understand what's important to you.

Though a birth plan is helpful, labour and birth are unpredictable. Your midwife may need to recommend a course of action at any time which is not what you had originally hoped for. But this will always be in the best interests of you and your baby.


****Taken from BabyCenter**

Introducing a sibling


How do I handle introducing my 2-year-old to my new baby?
After the birth, arrange for your child to meet the baby as soon as possible. Have her caregiver ask if she wants to bring a special blanket for her new sibling or flowers or a drawing for her mom.

The hospital may seem unfamiliar and scary to your child, so keep visits short and flexible. Make sure a familiar adult is there whose only responsibility is your child. The caregiver may want to plan a special outing after the visit. Having somewhere fun to go makes it easier to leave Mom.
You may want to try to have your hands free when your child arrives so you can focus on greeting her before introducing her to the baby. But if she shows up while you're nursing, you can invite her over to check out the baby's feet and hands, even while he's eating. Once you introduce her to her sibling, allow your child as much contact with the baby as possible. Show her the baby's body and let her touch him.
How can I help my 2-year-old not feel threatened by the new baby?
If she seems concerned about you having enough attention to go around, do what you can to reassure her that she hasn't been replaced by this new baby. Prop a picture of her by your hospital bed and make sure she sees it. Ask her opinion about what the baby might be saying when he cries or which blanket she thinks the baby wants over him. Tell her stories of what she looked or sounded like when she was born. Take photos of her with the baby.

Some parents give their child a gift from the baby to help break the ice at that first meeting. However, doing this may stretch the limits of logic, even for a toddler And keep in mind that your children will be more likely to develop a close relationship if you let them find their own ways of bonding.

While it's normal for a child to feel uneasy about the addition of a new member to the family, don't assume that your firstborn will feel displaced by the new baby. Often, children are delighted and interested in the new baby and more confused about how their parent has changed.w

Preparing to breastfeed


Preparing to breastfeed
There’s no doubt that breast is best for your baby. So anything you can do to prepare for breastfeeding while you are pregnant is all to the good. Try these tips to be sure of getting a beautiful breastfeeding relationship started from birth:  Talk to other mums who are breastfeeding, or who have done it before.
Read up as much as you can
Contact local breastfeeding support organisations.
Try to attend a breastfeeding class or a preparation for breastfeeding session, some time during your pregnancy. These classes are offered by many hospitals and NCT as part of their antenatal classes.
The more you know about the how breastfeeding works and its benefits, the more likely you are to succeed at it.  Whether you think about it or not, your pregnant body is preparing itself for breastfeeding. That's one reason your breasts get so much bigger during pregnancy. Your milk ducts and milk-producing cells are developing, and more blood goes to your breasts than before.  Breast size has nothing to do with the ability to breastfeed successfully. Even if you stay small-breasted, you'll still be able to feed your baby all the milk he needs. 
You don’t need to do anything to prepare your breasts, the hormonal changes going on in your breasts during pregnancy are preparation enough. You don't need to use creams to soften your skin beforehand or express colostrum either. In particular, don't rub or scrub your nipples, this will only hurt you and make breastfeeding difficult.  The best preparation for breastfeeding is getting your partner to support you in your decision to breastfeed. This will help you and your baby to get off to a good start. You are more likely to breastfeed for longer if your partner is well-informed and supportive.  It will also help to have plenty of skin-to-skin contact with your baby when she is born. Skin-to-skin contact has been shown to increase the length of time that mums breastfeed for.  Even if you need a caesarean birth, you can still hold your baby against your skin soon after the birth with some help from your midwife. Your baby may wriggle to your breast and feed, or she may only smell, lick or nuzzle your breast. All these things will help you and your baby get breastfeeding off to a good start


Ideally, breastfeeding should begin as soon after birth as the baby is ready to nurse. A full-term healthy newborn's instinct to breastfeed peaks about 20 to 30 minutes after birth if he is not drowsy from drugs or anaesthesia given to his mother during labour and delivery. In the first hour, babies are in a quiet, alert state, and have an innate ability to latch on and suckle effectively. Research has shown that when most newborn infants are placed immediately on the abdomen of their mothers, they will find her breast and initiate suckling in less than 50 minutes. Separating the infant from his mother during this crucial time misses this first window of opportunity. The baby may then become drowsy and lose his natural urge to find the nipple, which may result in more difficulty in the initiation of breastfeeding. Therefore, ensuring that the baby has every opportunity to suckle in the first hour after birth will be one of the most important things that you can do to make sure your baby will have as much milk as possible.
It is important to understand that not being able to nurse the baby right after birth certainly does not doom you to trouble. If the baby has difficulty sucking or latching on when he finally does get to breastfeeding, ask for help from your midwife. 
Mothers who have caesarean births may find that nursing immediately after the baby is born is not possible. If the mother is given general anaesthesia, she will not be alert enough to handle her baby in the first hour after birth. Even if the mother receives an epidural so that she is awake, she will still be in theatre for a major portion of that first-hour window of time, and this may make breastfeeding during that time impractical. Rest assured though, many mothers who deliver via c section go on the breastfeed effectively.
It can be helpful for mothers to understand and appreciate the incredible value of colostrum, the translucent, yellow "pre-milk" that you will produce in the first few days. Colostrum, and the mature milk that follows, nourish and protect the baby much as the placenta did during pregnancy. Colostrum is low in fat and carbohydrates and high in protein, which is precisely the nutrient balance that the baby requires in the first days. Colostrum is easy to digest and contains living cells that serve to protect the newborn against bacteria, viruses, and allergens. Colostrum actually coats the intestinal lining and prevents the absorption of substances that trigger allergies. These factors also serve to stimulate and enhance the baby's own immune system, and research suggests the benefits may last his entire life. Furthermore, colostrum acts as an effective laxative, flushing meconium from the intestines, taking bilirubin, the substance that causes jaundice, along with it. And colostrum does not suddenly disappear when the mature milk comes in; rather, the transition to mature milk takes place over the first two weeks. That is why any milk you express during this time will usually appear more golden in color than milk expressed later on.
 Colostrum is produced in very small quantities (an average total of 7.4 teaspoons  per day, approximately 1.4 to 2.8 teaspoons per feeding.
Colostrum is so valuable that even the tiniest bit that you are able to give to your baby will be a priceless gift to him. It truly will be worth any effort you can make to give your baby colostrum.
You will need to nurse your baby as often as he is interested in feeding. At the very least, this should be every two to three hours during the day and every four to five hours at night for a total of eight to 12 feedings every 24 hours. Calculate the time between feedings from the beginning of one feeding to the beginning of the next. Most feedings usually last 20 to 40 minutes, but do not watch the clock during the feeding. When your baby is a newborn, especially during the first week, nursing sessions can sometimes seem to last so long that you barely have any time to get anything done before the next session begins. Before the mature milk comes in, some babies will nurse most of the day because they are hungry.
 Frequent feedings are normal and they are essential to ensure production of the greatest milk supply possible. The first month is a learning time for your new baby. During this month, he will perfect his nursing skills so that near the end of it, he will need less time to consume the same amount of milk. Keeping him near you at all times will help you to be aware of his early hunger cues (rooting, fussing, etc.) so that you can feed him without allowing him to work up into a hungry, stressful cry. Minimizing your baby's crying in this way will also be less stressful on you and the other members of your household.
Even though it can seem like it at first, you will not always spend all of your time nursing. Remember that you are recovering from giving birth at this point and you need to rest. Breastfeeding is nature's way of ensuring that you do so. The time between feedings will eventually stretch out and feedings will become more manageable. Your baby will establish more of a feeding pattern, which will make life more predictable. The patterns that he establishes, however, will be his patterns and will be appropriate to his unique emotional and physiological needs. And these patterns will change as he grows and matures.
This is a very sensitive time in your life. You are physically and emotionally vulnerable. The last thing you need as you begin breastfeeding is to be near anyone who undermines your efforts by expressing doubts or criticism. Breastfeeding may be the biological norm, but in our society there are still people who are not comfortable being around a breastfeeding mother and baby, and these people may be even more likely to be critical if there are any questions about your milk supply. This lack of ease with breastfeeding stems from a lack of understanding and sometimes a mistaken view of the breast as sexual. You deserve to have only positive support and encouragement now. You do not need any negativity that would undermine your confidence.
It can be difficult to distance yourself from unsupportive people during this otherwise exciting postnatal time, but remember that you have the right to structure your environment so that it is most conducive to successful breastfeeding, which is essential to the well-being of your b aby. Ultimately, the needs of your baby are far more important than the opinions of others. If you have difficulty fending off critical people, ask your partner or another support person to "run interference" for you
During the first weeks of breastfeeding, nurturing your child, breastfeeding, and caring for yourself will be your most important responsibilities. Other obligations do not matter nearly as much. If you have older children, you will certainly need to focus on them, too, but your new baby's needs and your own needs are paramount right now. Your partner or another caregiver can help you tend to your older children's basic needs during this time.
Although it is natural for your friends and family to want to visit to see the new baby and congratulate you, entertaining them can be a drain on you, and you may not feel free to nurse your baby with visitors present. Try to gently and politely discourage as many visits as possible.

To have enough energy for nursing and baby care, you need nutritious meals, sufficient fluids, and a lot of sleep. Never skip a meal. In fact, try to have several nutritious snacks throughout the day in addition to regular meals. In general, the quantity and quality of your diet is more important for you than it is for your milk supply. Your body will make good milk for your baby even if your diet is less than ideal. Eating foods that you enjoy and that are good for you will nourish both your body and your soul.
Drinking properly is every bit as important as eating properly. It is important to stay hydrated by drinking to thirst. Do not, however, drink large amounts of fluids with the idea that this will increase your milk supply. It does not work that way and ingesting too much liquid can actually reduce your supply.
Mothers have sometimes been told that they must drink milk to make milk. This is not true; milk is made from the nutrients we take in from many sources, not from drinking the milk of another species. Adult cows certainly do not drink milk and are able to lactate quite sufficiently.
Next to food and water, sleep is your most critical necessity. You need as much of it as you can get. Take at least one nap a day—preferably when the baby does. The baby will be awake during portions of what would otherwise be your normal sleeping time, so you will need to make up for this lost sleep. The best way to do this is to sleep when the baby does. When the baby falls asleep for a nap during the day, it may be tempting to use that time to catch up on, housework, and phone calls. But this is precious time that can be much better spent resting. It may be hard to simply drop off to sleep—you may be on edge wondering if the baby will suddenly wake up again. But it is important to learn not to worry about that and fall asleep as quickly as possible. If the baby wakes, you will, too, and you can try to nap again later. But if baby sleeps for a long time, you will get some valuable rest..

General description of night terrors


General Description of Night Terrors
Night terrors are a common disorder that affects about 3% of the population. They mainly affect younger children and are technically classified as one of the Parasomnia disorders. It occurs more with boys than with girls, and there is often a positive family history.
Night terrors (also called sleep terrors) are periods of extreme agitation with manifestations of intense fear, crying and screaming in the middle of the night. The difference between night terrors and a nightmare is that night terrors usually occur just a few hours after falling asleep. A nightmare tends to occur towards the end of the night or early morning, and will be remembered.
When a child has a night terror, arousal can be difficult. He or she might have their eyes open but will look straight through you, similar to someone sleepwalking. The child is not dreaming, but in a deep sleep. They will not be able to recall the incident in the following morning.
Night terrors seem to occur in cycles. They may happen every night for several weeks, then disappear for months at a time. They are also more common in children whose family members have a history of night terrors, sleep walking, sleep talking, or bed wetting. It is said that by the age of 8 years old, half the cases will have grown out of this, but about a third will continue into adolescence.
Night Terrors are now thought to be caused by increased brain activity, and the common thought among researchers is that a chemical trigger causes your brain to 'misfire'. These misfires can be caused by many factors such as stress and various other medical ailments.
Typical Symptoms
A sudden awakening from sleep. Persistent fear or terror that occurs at night, screaming, sweating and confusion. Normally accompanied with a very rapid heart rate and an inability to explain what happened.
Usually the person has no recall of any bad dreams or nightmares, but may have a vague sense of frightening images. Many people see spiders, snakes, tigers or even people in the room. They are unable to be fully awakened and are difficult to comfort, with no memory of the event on awakening the next day.
How serious are they?
Some people have episodes of night terrors that may occur less than once a month, and do not result in harm to the patient. In its severest form, the episodes occur nightly, and can result in physical injury to the patient or others. Consult your doctor if you are concerned.
Nightmares and Dreaming
Nightmares are quite common in young children, and usually occur sometime after 90 minutes of sleep. Typically, a child with a nightmare wakes up completely feeling very anxious, and usually remembers the content of the dream vividly.
Childhood nightmares normally require no treatment, except for reassuring the frightened child. Occasionally, when nightmares become more frequent or occur on a regular basis, it may be a sign of stress in the child's life or environment.
Also, the content of the bad dream or nightmare may be a clue to what is stressing the child. In extreme situations of persistent nightmares, it may warrant an evaluation of the child's social environment and psychological state.
The Main Points
  • Mainly affects children between 3 and 12 years old, but can occur at any age
  • It does tend to run in the family
  • Usually occurs 15 minutes to 1 hour after going to sleep
  • The child or person doesn't awaken and is unable to be comforted
  • Will not respond to the parents
  • Can last between 10 and 20 minutes
  • Doesn't remember the night time incidence
  • Increased occurrences during times of stress or over-active daytime activity
  • There is an 18% incidence of sleep walking and some children manage to actually leave their homes
  • Very important to protect the child from injury
  • Parents can be reassured that usually, night terrors will spontaneously disappear
Typically, children with night terrors are not in control, but are still awake. They may be sitting up in bed, appear frightened, staring with eyes wide open. They may also be sweating, breathing heavily, and complaining of seeing peculiar things or objects that are not really there. This period of terror may last for up to several minutes and then the child will usually go back to sleep. What distinguishes night terrors from nightmares is that the child does not recall the dream or event leading to the night terror, and in many cases, does not recall anything that has happened at all.
Although the exact cause of night terrors, nightmares, and other sleep disturbances is not understood, they are thought to be a result of waking up during a certain stage of the normal sleep cycle. Night terrors occur during the NON-REM sleep period. Nightmares, on the other hand, occur during another stage or during REM sleep. Night terrors are generally infrequent and usually stop on their own without specific treatment.
In rare cases where night terrors are frequent or associated with sleep walking, it is possible that specific medications may be required, but this occurs very rarely. In general, most children outgrow both nightmares and night terrors. Some people remember the following morning, but some don't. There is no explanation to why some have no recollection of the events.
Prevention and Possible Cures
  1. As Night Terrors usually occur between 15 minutes and an hour after the child falls asleep, gently awaken your child just before you go to bed yourself.
  2. Tuck them in and then say goodnight.
  3. Often, this disturbance of the sleep pattern will prevent them from having an attack that night. This needs to be repeated each night.
  1. Another approach:-
  2. Note the approximate time that a child has regularly attacks, then gently awaken the child, 15 minutes before he or she usually has the attack, then tuck them back into bed.
  3. If the above methods don't help and the attacks are violent, talk to your doctor about possible medication.
If you find that your child is experiencing a Night Terror, the best response is to hug and reassure them. Agree with everything they say or do. Don't shout and tell them they are only dreaming, as this only seems to upset them more and can have an adverse effect.

Night Terrors


Night terrors

Night terrors are common in children aged three to eight years old. A child who experiences night terrors may scream, shout and thrash around in extreme panic, and may even jump out of bed. Their eyes are open, but they are not fully awake.
The episodes usually occur in the early part of the night and can continue for several minutes, for up to 15 minutes.

Why they happen

Night terrors are more common in children with a family history of night terrors or sleepwalking behaviour.
A night terror attack may be triggered by:
  • anything that increases your child's amount of deep sleep, such as tiredness, fever or certain drugs
  • anything that makes your child more likely to wake from deep sleep, such as excitement, anxiety or sudden noise

What you should do

The best thing you can do if your child is having an episode of night terrors is to stay calm and wait until the episode passes, making sure your child is safe.
Night terrors can be frightening to witness, but they don't cause any harm to your child. You shouldn't attempt to wake them when they are having the episode.
Your child may not recognise you and may become more agitated if you try to comfort them.
Once your child has come out of the attack, it is safe to wake them and, if necessary, encourage them to use the toilet before settling them back to sleep.
If your child returns very quickly into deep sleep, they may have another episode. Making sure they are fully awake before they go back to sleep can break this cycle.
Your child will not remember the episode the next morning, but it may still help to have a general chat to find out if anything is worrying them and triggering their attacks. It also helps if they have a relaxing bedtime routine.
If the night terror attacks are frequent and occur at a specific time every night, you may find that waking your child breaks the cycle. Wake your child 15 minutes before the anticipated time of the attack every night for seven days. This can disrupt their sleep pattern enough to stop the attacks without affecting sleep quality.

When you should seek help

Most children grow out of night terrors. However, you should talk to your doctor if they are occurring several times a night or are very frequent (occurring most nights). Your GP will be able to check whether something is causing them that could be easily treated. For example, large tonsils could be causing breathing problems at night and waking your child.

High temperature in a child


A fever is a high temperature. As a general rule, in children, a temperature of over 37.5°C is a fever.
As a parent it can be very worrying if your child has a high temperature, however, it is very common and often clears up on its own.
A quick and easy way to find out if your child has a fever is to take their temperature using a thermometer.
What causes a high temperature?
Most fevers are caused by infections or other illnesses. A fever helps the body to fight infections by stimulating the immune system (the body’s natural defence against infection and illness).
By increasing the body’s temperature, a fever makes it more difficult for the bacteria and viruses that cause infections to survive. Common conditions that can cause fevers include:
  • flu
  • ear infections
  • roseola (a virus that causes a temperature and rash)
  • tonsillitis
  • kidney or urinary infections
  • common childhood illnesses, such as measles, mumps, chickenpox and whooping cough
Your baby’s or child’s temperature can also be raised during teething (when the teeth start to develop), following vaccinations or if they overheat due to too much bedding or clothing.
Read more about fever in young children.
When to seek urgent medical advice
You should contact your GP or health visitor urgently if your child:
  • is under three months of age and has a temperature of 38°C or above
  • is between three and six months of age and has a temperature of 39°C or above
  • is over six months and shows other signs of being unwell - for example, they are floppy and drowsy or you are concerned about them
If it isn’t possible to get in contact with your GP call your local out-of-hours service or NHS Direct on 0845 4647.
If your child seems to be well, other than having a high temperature - for example, if they are playing and attentive it is less likely that they are seriously ill.
Treating a fever
If your child has a fever, it’s important to keep them well hydrated by giving them plenty of cool water to drink. Even if your child isn’t thirsty, try to get them to drink little and often to keep their fluid levels up.
To help reduce your child’s temperature you can also:
  • keep them cool - by undressing them to their underwear (you can cover them with a cool, lightweight sheet)
  • keep their room cool - 18°C (65°F) is about right (open a window if you need to)
  • give them paracetamol or ibuprofen - you can’t give them both at the same time, but if one doesn’t work you may want to try the other later (always read the patient information leaflet to find out the correct dose and frequency for your child’s age)
More serious illnesses
A high temperature in children is sometimes associated with more serious signs and symptoms such as:
  • breathlessness
  • vomiting
  • rash
  • fits or seizures
Possible serious bacterial illnesses include:
  • meningitis - infection of the meninges (the protective membranes that surround the brain and spinal cord)
  • septicaemia - infection of the blood
  • urinary tract infection
  • pneumonia - inflammation of the tissue of the lungs which is usually caused by an infection
It's important to remember that potentially serious causes of fever are relatively rare.