Many mothers believe that it is their fault if their baby is yellow at birth and often fathers blame their wives for over indulging on oranges during her pregnancy and therefore there baby is yellow at birth. This is definitely a myth and through this article we will discover why.
Two thirds of newborn babies will become yellow after birth. The proper name for this is physiological jaundice, which in lay-men terms mean; normal-no cause for worry- jaundice or being yellow.
Jaundice is the yellowish color of the sclera (the white of the eye) and the skin due to bilirubin – yellow molecule – that builds up in the skin tissue. The severity of the jaundice depends on the balance between how fast these yellow-molecules are produced and how fast they are eliminated from the body. The yellow molecule (bilirubin) is a waste product when red blood cells are broken down.
But why would red cells need to be broken down?
To explain this phenomenon we will have a look at the mountaineers. When a mountaineer prepares for a hike up a very high mountain he needs to prepare himself by exercising at higher altitudes in order to thicken his blood. The thicker his blood the better his body can function and perform in conditions where less oxygen is available.
Now for your newborn baby it works the other way round. He comes from the womb where he gets ‘second-hand’ oxygen from you. Because of the low oxygen concentration, his blood needs to be thick in order to transport enough oxygen to his entire body. When your baby is born, he can breathe for himself and more oxygen is available, therefore doesn’t need his blood to be so thick anymore. In order to thin the blood extra red blood cells must be broken down and the waste product; the bilirubin (yellow molecule) will cause your baby’s complexion to be yellow.
If you compare a breastfed baby to a formula fed baby you will see that a breastfed baby seems to be yellow for longer. A formula fed baby will lose his yellow complexion round the 7th day where a breastfed baby could still be yellow after a month or two. This is normal and we call it breastfeeding-jaundice.
Why does a breastfed baby appear yellow for longer?
Breastmilk consists of an element that allows the baby to take up more of the yellow molecule from the baby’s intestines. The exact reason for this is not known but it has been shown that bilirubin acts as an anti-oxidant and therefore has many benefits for a baby.
It is important though that you don’t just wave it off as normal when you newborn baby is yellow. It is important to have a health care professional look at him or her to make sure that it does not develop into kernicterus which could be detrimental to your child.
So what to do? When you are discharged from hospital and you notice that your baby’s color worsens to a intenser yellow or your baby is not very responsive, feeding poorly, vomiting or breathing irregularly. Please consult a health care professional. You are more than welcome to see one of our nurses at the Mopani Pharmacy Primary Health Care Clinic.
Problem: “I just gave birth and there seems to be no breastmilk for my baby”
During the latter part of pregnancy the milk producing hormone (Prolactin) starts producing small amounts of breastmilk. Although the amount of milk is very small it is very precious because it contains high concentrations of proteins, fats, vitamins, minerals and antibodies. By the time a mother gives birth she will have approximately 30ml of breastmilk in her breasts and her baby will drink +- 5 ml during the first one to two feeds.
After the first few feeds your breasts need to start producing sufficient milk to satisfy your baby’s nutritional needs. This process is affected by a variety of factors. Giving birth before your due date, induction of labour, caesarean section, medication during labour, bad experiences while in labour or giving birth or your genetic build up; are all factors that can negatively affect the onset of copious milk production.
The main factor that enhances milk production is the stimulation of the nipple (baby suckling) and emptying of the breast. This is easier said than done…
Your baby comes into this world as a clean slate with hardly any experiences. She has never suckled for food before, she never had to swallow or digest anything but the amniotic fluid which surrounded her during her time in your womb. Now for the first time she needs to suckle on a nipple to get food and be satisfied. Although she is born with rooting and suckling reflexes the actual suckling on a nipple is something she needs to get used to and it can take a few tries to realize how she should suckle to be satisfied and full in the end.
And if you are a first time mommy; breastfeeding is a whole new experience for you too and you need to get used to the process as well.
Learning how to breastfeed is like learning to ride your bicycle. The more regularly you try and the longer you try for, the quicker you will see results; and when one position is painful or not comfortable, you wouldn’t continue cycling like that you will change the position to find a more comfortable way to cycle. The same principles apply to breastfeeding. Offer your baby the breast every time she shows signs of hunger and let her suckle until she is satisfied and releases the breast spontaneously. When she hurts you while suckling take her off and try again, sometimes changing the position in which you feed. If the pain continues or you have any concerns, please speak to a professional before deciding to go over to formula feeding.
We have products available in our pharmacy which may stimulate the milk production. Two very effective products are; Prolak and Fenugreek capsules. The active ingredient of these capsules will not affect your baby.
In the following articles we will discuss what hunger signals your baby will give and how you will know whether your baby is receiving enough milk.
‘My baby is a typical cry baby and at times it drives me up the wall’, ‘My baby is such a good girl, but for some reason she cries most afternoons non stop for hours and we just don’t know what to do anymore’
If these comments sound familiar, I want to assure you that you are not alone. These comments are often from parents whose babies suffer from colic. But do we really know what colic is, what is causing it and what we can do to help our little ones who suffer from it?
Newborn babies do go through periods where they appear abnormally irritable or cry for no reason. But it is important to look out for these symptoms if you suspect your baby is suffering from colic:
· She cries for long periods of time, despite your efforts to calm her down
· The symptoms appear around the same time each day or night and usually end abruptly
· She shows signs of gas causing discomfort and abdominal bloating
· She pulls her legs up to her stomach, gets a flushed face, clenched fist and wrinkled brow.
· She experiences frequent sleeplessness, irritability and fussiness
· Her cry is often high pitched (piercing)
Baby colic is defined as episodes of crying for more than three hours a day for more than three days a week for three weeks in an otherwise healthy baby between the ages of two weeks and four months. Babies normally cry an average of just over two hours a day. With colic, periods of crying most commonly happen in the late afternoon or evening for no obvious reason.
Colic is probably the worst pain your baby has experienced as yet, often caused by an acute abdominal pain with intense spasms and cramping. Because your baby cannot describe what the problem is, it is hard you to know what’s causing the pain or discomfort, and the only way for your baby to communicate with you, is through crying.
There are many theories about what might cause colic but even the experts can’t agree upon a single cause. It is clear however that colic is caused by different factors in different babies, for example:
· Your baby has never processed food before, the tummy and intestines are just learning how to function and the muscles that support digestion have not developed the right rhythm for moving food through the digestive tract. Furthermore, newborns lack the bacterial flora (probiotics) that develop over time to help with digestion and protect against infections.
· If you are breastfeeding some gas producing foods that you eat may be passed through the breast milk to your baby to cause gas and bloating.
· Babies often swallow air while feeding or crying, which increases gas and bloating
· Since your baby’s nervous systems is so immature, it is possible to get overloaded with unfamiliar sights and sounds. A baby that is overloaded often experiences more severe colic, fussiness, and difficulty sleeping later in the day or at night.
In general, the more activity (errands, visitors, T.V., phones, etc.) in baby’s day, the higher the chances of baby becoming colicky and fussy
If you have a colicky baby it is important for you to stay calm and familiarize yourself with some techniques that can help your baby calm down:
· Swaddle her with her legs flexed, this reminds her of the relaxed days she spent in the womb
· Carry her around in a sling (Snuggle Bug or Abba Babba or home made)
· Holding your baby on her side or stomach
· Swinging her once gently back and forth while supporting her head, making shushing sounds
· Breast feeding or using a pacifier
· Daddy can get involved by taking her for a drive in the car or use a vacuum cleaner in the room
Colic and the months of distress and sleeplessness that it brings to both you and your baby can leave you feeling frantic, frustrated, worried, exhausted, confused, guilty and inadequate. If your baby experiences colic, you will probably be looking for a safe, natural and effective colic remedy to ease your baby’s suffering. Here at Mopani Pharmacy there are several treatments available for baby colic. But please remember to consult a health care professional before you give your baby any medications, remedies or supplements.
Remember that your baby is getting accustomed to this world and, as she grows older, the colic will eventually subside. Her digestive systems will learn how to function well and the central nervous system will mature to handle stimulus more effectively. In the first three months of life, babies are not well-equipped to calm themselves. Therefore the most important thing your baby needs in the times where she is experiencing so much pain and discomfort is your love and closeness. You need to let your child know that no matter how bad life and circumstances get, you are close and won’t leave her to fend for herself.
2. Lawrence T.A., The Cause and Treatment of Newborn, Infant and Baby Colic, 2010
Pregnant with flu
The flu season is definitely in full swing and it seems that nobody can hide from the dreadful bug. Being pregnant is not making things much easier for you. Some studies have shown that your immune system (your body’s defense force) is slightly suppressed in pregnancy, which means that you are slightly more susceptible for colds and flu’s and that once you are infected it seems to linger for longer. Fortunately the common cold or flu won’t have negative effects on your baby; but when the infection develops into more serious symptoms and complications your baby could be at risk.
You are probably wondering; “How can I prevent myself from getting a cold or flu?” There are some simple things you can do which could reduce your chances of falling sick:
Avoid big crowds especially this time of year
Avoid going out on cold night to places that are not well insolated, such as open air restaurants, concerts and braai’s
Becuase you hands are the main vessels transporint germs and bugs, be sure to wash them often to avoid toucheing your nose, eyes or mouth too much
Avoid having contact with someone who has a cold
And of course there is the flu vaccine. It may be late in the season to have it now, but its worth discussing with your healthcare professional.
Often taking the necessary precautions is not enough to fight off the bugs, therefore it is good to know what kind of things you can do to boost your immune system and treat the symptoms.
There are certain immune boosters which are safe to use during pregnancy such as Oscillococinum & Stodal
Put an air humidifier in your room to provide extra moisture, which can help reduce congestion
Use salt water to gargle when you have a sore throat, the salt will kill the bacteria
Use a saline nasal spray during the day for a congested nose such as Flo
Even though you won’t feel like eating much, try to have at least four or five vegetables or fruits a day
Reduce the amount of wheat and dairy in your diet, it could cause more mucus to be produced and leave you more congested with a wet cough.
There are various anti-flu medications on the market so make sure you speak to one of our Mopani Pharmacists to ensure that they safe to use during your pregnancy.
It is important to contact your healthcare professional when you experience more severe symptoms such as; vomiting, high fevers, shaking chills, chest pain or coughing with thick, yellow-green mucus.
All is not negative and bad when you have a cold in pregnancy. It seems that while you have a cold, your body will produce antibodies against the virus; these antibodies will go through the placenta to your baby which will protect your baby for a while after birth, from these particular flu bugs.
B. Smulders and M. Croon, Veilig Zwanger, 2007
Sister Lilian, Swangerskap en geboorte boek, 2005
What does the Breast Crawl do for mother and baby?
The Breast Crawl is an incredible special and wonderful moment in which a mother and her baby can enjoy each other right after birth.
In the previous article we saw how a baby enjoys his mother with all the senses given to him before birth. He enjoys her smell, the sound of her voice, the taste of her nipple, the feel of her skin and especially admiring her face for the first time. It is not only a joyous occasion, this meeting between mother and her baby has a range of advantages for both of them;
The body temperature of baby is much better regulated when placed on his mother’s tummy; it becomes a heater for him. Compared to a baby that was taken away from her mother directly after birth, the baby who is on mommy’s tummy will have a much better body and skin temperature.
The regulated body temperature will lead to better metabolic adaptions. The blood sugar levels after 90 minutes will be significantly higher and the recovery from transient acidosis will be much faster. These two measures testify of reduced stress levels in baby.
In the Breast Crawl-position baby experiences sensations that are quite similar to what he was used to inside the womb. Therefore it is the perfect position to help comfort baby during the transition from life inside the womb to his existence outside. The smell and taste of the amniotic fluid and the sound of his mother’s heart beat and lungs expanding are only few of the things that he will recognize. A few studies have proven this by showing that a baby taken away from his mother directly after birth will be crying for a significantly longer time than a baby that is snuggling on his mother’s chest.
A baby that is put at his mother’s breast directly after birth and left there through his awake state will attach to the breast with more success than a baby that is removed from his mother after birth. The early suckling patterns will have an effect on the success and duration of breastfeeding.
For the mother the main advantage of this intimate moment of bonding between her and her baby, is the release of oxytocin, also referred to as the love hormone. Oxytocin is necessary to expel the placenta and to close off the many damaged blood vessels of the womb, which reduces the amount of post natal blood loss and prevents anemia.
From all these facts I conclude that a mother and her baby appear to be carefully adapted for these first few moments together. A mother’s feeling of love for her baby may not necessarily begin with birth or kick in with the first contact. But during the Breast Crawl, while resting skin to skin and gazing eye to eye, they begin to learn about each other on many different levels. For the mother, the first few minutes and hours after birth are a time when she is uniquely open, emotionally, to respond to her baby and to begin the new relationship. Suckling enhances the closeness and new bond between mother and baby.
Therefore there is no reason why every healthy mother and baby should not have the privilege to experience this wonderful occasion.
Did you know that most babies hardly need any help finding their mothers breast when placed on her tummy directly after birth? After a study was done in Sweden in 1987, this interesting phenomenon has been described in various studies around the world. The conclusion of these studies are that if your baby would be put on your tummy directly after a natural vaginal birth he would take about 15 minutes to make the first suckling and rooting movements, after about 35 minutes he will start putting his hand in his mouth and after about 55 minutes he should find the nipple and start suckling all by himself.
This phenomenon is called the ‘Breast Crawl’.
This is an amazing and intimate process to witness and or experience. It seems that an infant comes into life carrying a small computer chip with a set of instruction on “how to find your mommy’s breast”.
In this article, which will be the first of a few, I would like to explain how your baby can use all his or her senses to communicate with you in the first moments of his ‘out-of-the-womb’ life.
The experts are quite certain that smell is most important stimuli for your baby. He seems to prefer your breast unwashed with no creams or perfumes, and some amniotic fluid on the breast seems to attract him even more. He probable recognizes the unique amniotic fluid smells from being in the womb and that recognition seems to have a calming effect on your baby and it provides a basis for early individual recognition of the mother.
Babies can recognize their mothers face and follow it for a short distance. When babies are put on the breast directly after birth they will often lick it but appear uninterested otherwise. By allowing your baby to do the breast crawl he has the opportunity to look at your face and just stare for a while. This is a great moment for bonding between mother and child.
Your baby will have some amniotic fluid on his hands after birth. As he starts to suckle on them he uses the taste and smell of the amniotic fluid to make a connection with a certain fat substance on the nipple that is also present in the amniotic fluid. This encourages him to crawl towards the nipple and to start suckling on it.
A mother’s voice seems to be the most intense acoustic signal measured in the amniotic environment. A newborn prefers the sound of his mother and will also suckle for longer when he hears it. The breast crawl offers the best chance for baby to hear his mother’s natural voice which he will probably recognize from being in utero. Therefore it is important to talk to your baby when he is in your womb and to continue conversing in the early tender moments soon after birth.
Furthermore when your baby hears your heart beat this will have a calming effect on him and it reduces the amount of weight he will lose in the first day post partum.
Your touch helps your baby to maintain his temperature, which in its turn facilitates with metabolic adaptions like sugar levels and acid-base balances. It results in less crying, helps with boding, and improves immediate and long term breastfeeding success. It also causes oxytocin release in you which makes you feel good and prevents post partum bleeding.
To conclude I would encourage mothers and health professionals to give mother and baby those moments after birth to cherish and bond with each other. Avoid interference for the first hour after birth, if the baby is otherwise healthy and not showing any signs of distress. This time is most enjoyable and healthy for both mother and child.
Midwife: to 'be with women'
After reading the title, I am sure that a lot of you think; ‘What does it mean to be a midwife, and what is it that they do exactly?’ and you won’t be the first person to ask it, therefore I decided to write a short article on what midwives do.
History teaches us that midwives have always been around to help woman give birth. Before physicians where readily available to the man on the street, it was midwives that were the primary healers in their communities. They were the medicine woman of their own cultures, and assisted families and woman throughout their lives. Midwives were once the nutritionists, herbalists, doctors, ministers, counselors all rolled into one 'profession'. Many feel they were the first holistic practitioners.
Things have changed a lot since then, but the core definition for midwife remains the same; to ‘be with woman’ all though this is interpreted differently by different people and people groups. Over 70% of births around the world are attended by midwives but they are as diverse as the populations in which they live and work.
In the Netherlands, midwives deliver the majority of the babies either at home or in hospital, while in other countries midwives are not utilized to their full potential which often results in medical interventions shooting through the roof. The reason for this is that each country has a different view of midwifery, pregnancy and childbearing, and of how midwives work within their communities. These views are generally founded on one of two common models:
The Midwifery Model is an attitude about women and how pregnancy and birth should occur; the view is that pregnancy and birth are normal events until proven otherwise. It is an attitude of giving and sharing information, of empowerment, and of respecting the rights of a woman and her family to determine their own carei.
The Medical Model is an attitude that there is potential pathology in any given situation, and that medicine can assist to improve the situation. Medicine is also about teaching, informing, and prevention, but the power seems to be more with the provider rather than with the woman. i
I was privileged to have done a part of my training in the Netherlands where people believe in the Midwifery Model. By coming back home the contrast was so big and it was clear to me that a big percentage of our people believe the Medical Model when it comes to pregnancy and childbearing.
As a midwife I belief in the more modern definition: A midwife is the specialist for normal pregnancy, normal delivery and the postnatal period until the baby is 6 weeks old. She is fully trained, equipped and passionate to coach you during this time in your life. ii
We approach pregnancy and birth as normal life events. We offer personal and intimate care and provide you with information to empower you to make informed decisions. No waiting for appointments, no unnecessary interventions and enough time allowing you to be heard. Together we will work out the right way and place for your baby to be borniii
I believe that the development and birth of a newborn infant is an amazing and wonderful process. Midwives have the privilege of supporting and intensifying the experience for both mother and father to be. With of her extended knowledge of pregnancy, delivery and postpartum, she is responsible for the emotional and physical well-being of mother and child.
Did you know that an avocado needs 9 months to develop from a blossom to the actual fruit? And have you noticed the shape of a ripe/full grown avocado?
Maybe it is far fetched but I can’t help see similarities between avocados and pregnant mothers… They are both pregnant of a growing seed for 9 months and even have a similar shape. Now my question is: Is there any significance in these similarities?
This question led me to first find what avocados are, where they come from and where they grow. Then to research what nutrients they compile of and how do these effect pregnant mothers, their developing babies and growing infants.
What we generally don’t realize is that avocados are classified as a fruit – more specific a single seeded berry according to W. B. Storey5. They originated from the south central region of Mexico where they were referred to as “ahaucate” by the native people. After the westerners were introduced to the fruit in the 1500’s, the name evolved to “alligator pear” and at the turn of the century it got its name “avocado”1.
Avocados grow in humid and sub-humid tropical conditions, which makes our climate here, in and around Nelspruit, ideal for growing avocados. Since avocados are in season this time of year there is no reason why we shouldn’t make it a part of our diet, especially when we look at the nutritional value of the fruit.
The following figures are based on a serving size that is equivalent to 1/5 of a large avocado. Not all the nutrients are listed; only the ones that are relevant for pregnant women and infants.
Total fat 4.5g (of which mono and polyunsaturated 3.5g)
Important to note is that not all fat is bad; we need the good fats in order to have a healthy diet. Avocados are rich in fats, but of these; the biggest percentage are mono and polyunsaturated fats (the so called good fats). These fats are easily broken down in the body which makes it easier for the body to absorb and use them and it lowers cholesterol.
Sodium is the main component of salt. The average person has too much salt in his or her diet, which affects the cardiovascular system and has a direct effect on the blood pressure.
Potassium is a very important mineral for the proper functioning of all cells, tissues, and organs in the human body. Potassium is crucial to heart function and plays a key role in skeletal and smooth muscle contraction, making it important for normal digestive and muscular function. Too much salt may increase the need for potassium.3
Carbohydrates 3g (of which dietary fiber 2g)
Further more avocados are a good source for vitamin C, E, K and B6, riboflavin, thiamin, niacin, iron, folic acid, magnesium, zinc, manganese and copper.
There are 13 vitamins that the body absolutely needs and avocados contain 6 of those 13 vitamins2.
From the nutrient analysis I conclude that because avocados are fresh, natural and wholesome they are important for a nutritious, healthy and balanced diet. This is especially true during pregnancy and breastfeeding when a mother must be very careful of what she eats for all the goodness she takes in is transferred to her unborn child.
Avocado also makes a nutrient dense baby food rich in essential vitamins and minerals.
So go ahead and treat yourself to a avocado sandwich or salad regularly this winter.
5. W. B. Storey. What Kind of Fruit is the Avocado? California Avocado Society Yearbook 1973-74. Pages 70-71.
There is more to ‘carrying your newborn’
Sit in a quite corner and close your eyes. Imagine that you are drifting on the ocean, you are moving up and down with the swells; listen to your heart beating, your lungs expanding and deflating as you breathe, listen to the muffled sounds outside the room; people talking, cars passing by and music playing...
This is similar to what your baby hears while growing in utero; your heart beating, your lungs expanding and deflating, your voice etc. This is baby's peaceful and safe environment. Now imagine the change; from 9 months of no light, no loud sounds, no cold air, no clothes, no excreting, no eating, to being born into a whole new world with light, loud sounds, cold air, strange smells, hands touching and towels drying. Your baby needs to breathe by herself and suck on a foreign object in order to survive, she must get used to excreting into a nappy and crying to make her desires known.
When realizing all this it is not hard to understand that we as parents need to create a welcome environment which is similar to what she was accustomed to for the last 9 months.
Being born is your baby's first very stressful event and overstimulation can happen very easily during the first few days and weeks after birth. Things that add to her stress are; exposure to different people holding her and talking to her, bright lights, loud noises, cold air, various smells and smoke ect.
There are a few things parents could do to minimize this exposure and therefore make the transition to life outside of the womb less stressful:
Create a safe and peaceful environment for yourself and your baby while breastfeeding; make yourself comfortable in a sofa/chair or on your bed, dim the lights, have soothing background music and cover both of you with a blanket while you have skin to skin contact. With you being less anxious you will produce more milk, your child will be satisfied and will be more relaxed as she senses your peacefulness and joy. This leads to less cramps and a reduced risk of colic developing. This is not a golden rule which can guarantee that your child will not struggle with colic, but it does reduce the chances. A relaxed mother will have a relaxed influence on her child.
It is often best to bath your child in the late afternoon; this allows her to be active before her last feed and subsequently the night. After her bath; massage her with baby oil from head to toe. Your baby's primary love language is touch, therefore she will most probably respond by being more relaxed. This is also a perfect opportunity to involve dad. Take your time when preparing for her bath. The combination of the warm water, massage and your relaxed attitude will relax your baby and cause her to feel loved. This once again leads to a more relaxed and peaceful baby.
Find a way to carry your baby which works for both of you. But remember, the closer she can be to mommy or daddy the happier she will be. I have seen different methods and the one that stands out most, especially when I keep the theory, explained in the first paragraph in mind, is the material sling:
• Baby is placed on mommy or daddy's chest and the sling is wrapped and fastened around both of them. This allows baby to be near to one of her 2 favorite people.
• She will recognize the swaying movement of her mother, she will feel safe when hearing the sound of her mother's heart beating and breathing. This will have a soothing effect on her.
• The movement will improve your child's digestion and reduce the cramps and uneasiness that comes with it.
• It sooths a colic baby and it facilitates the bonding process especially between daddy and his child.
Parents often complain about their child being a typical cry baby and they find themselves at wits end, not knowing what to do or how to handle them. These babies are often crying to say: 'Please mommy and daddy, I've had enough I can't take this anymore'. If you are in this situation, take a step back and look at your baby's routine, is it a simple routine with as little as possible variation and exposure to the elements and other people?
Help to make your baby's transition as easy as possible by asking yourself the question: 'How is what I'm doing making my baby feel safe and loved?'