breastfeeding Archives - Nurtured Birth

Sore Nipples and Breastfeeding: What You Need To Know

Sore nipples are one of the more common concerns new mamas face when beginning their breastfeeding journey.

Breastfeeding is a wonderful, natural way for a mother to bond with her baby, and breast milk is recommended as the only source of food for a baby’s first six months of life.

Whilst the production of breast milk occurs naturally, the art of breastfeeding doesn’t always go smoothly.

For many mothers the experience is simple and straightforward, but for some it can become a painful ordeal.

Breastfeeding is a learned skill for both mother and baby, and there are bound to be some hiccups at the beginning. Sore nipples are often dismissed as part of the process but pain definitely isn’t something new mamas should ‘put up with’. Sore nipples can be so painful that a mother gives up breastfeeding altogether.

Find out what you need to know about sore nipples and breastfeeding, and what we recommend for prevention and support.

Pre-pregnancy breast soreness

Breasts, areolas and nipples come in all shapes and sizes and will change throughout a woman’s life cycle, from adolescence through to menopause. We need to have an awareness of what is normal for our breasts by doing regular breast checks so we can spot any unusual changes quickly.

Breast soreness is very common. It affects most women at some time in their lives, usually in the form of swelling, lumps, bumps, general aches and soreness. Commonly felt at varying times of the menstrual cycle, breast soreness is usually regarded as normal. The soreness will vary from woman to woman, so it is important to be aware of what is normal for you.

If there is any unusual pain, extreme pain, or changes in the breast tissues (with or without pain) it needs to be explored further. This could be due to other factors such as cysts, tumours or mastitis. Seek advice from a medical professional for further investigation into the source of pain and treatment.

Pregnancy breast soreness

During pregnancy, your breasts undergo many changes, influenced by hormonal fluctuations.

During the first trimester your breasts may feel generally sore and tender. The breasts often increase in size and as the pregnancy moves forward the areola and nipples will usually darken and become larger.

It is important to make sure to be fitted with the right style and size of bra during pregnancy, to prevent not just soreness but long-term damage to the breast tissue.

During the third trimester the breasts will begin to make colostrum in preparation for milk supply for the soon to be born baby. This can be seen as a shiny, clear discharge from the nipples.

Some women may hand express this colostrum after consultation with their midwife, obstetrician or doctor. In certain situations babies need supplementation after birth and a supply of colostrum in the freezer can be used instead of formula.

Breastfeeding soreness

Breastfeeding is biologically the normal way to feed mammal babies and the production of milk (lactation) occurs naturally after giving birth. Breast milk contains everything your baby needs for nutrition for the first six months of life.

Breastfeeding begins soon after birth, often with mum bringing the baby to her breast within minutes after birth. Babies left on their mothers bellies after birth have an innate instinct to seek out the breast, and will crawl up to the nipple.

In the first few days, your breasts will produce colostrum and this provides everything your baby needs. Within a few days, your milk ‘comes in’ and changes in volume and composition. This can cause some discomfort as breasts become full and engorged, and your baby is increasingly hungry and more demanding.

Breastfeeding shouldn’t be painful. But in the initial few weeks, at the beginning of a feed, there may be some discomfort when the baby first attaches to the breast. The sensation should subside within a short time and as the feed continues it should not be painful.

There can also be other issues such as engorgement, mastitis, nipple vasospasm, thrush and other infections. Nipples may appear bright pink or red in colour, bleeding, dry, flaky, or have a white rash (thrush).

Causes of sore nipples when breastfeeding

Sore nipples most often occur if the baby doesn’t have the proper attachment or ‘latch’ to the breast.This can cause cracking, splitting and bleeding of the nipple. Sometimes these sores are obvious, but small cracks can be hard to see, even if very painful.

There can be other issues such as a baby with tongue tie, incorrect use of breast pumps, or medical conditions such as dermatitis or an infection. In these cases it is important to seek help from a qualified professional to properly diagnose the problem and offer the right course of treatment.

Even if breastfeeding is going well problems can still arise. Nipple soreness can occur if mum or baby become complacent about latch, the baby has a growth spurt causing a sudden increase in feeds, or baby begins teething.

What can be done to help breastfeeding and sore nipples?

Even if you have breastfed before, breastfeeding each baby is new and can take some adjusting to. Being prepared for breastfeeding before you have your baby is a good foundation to understanding what can go wrong and what to do about it.

Nurtured Birth recommends Born To Breastfeed, a comprehensive and accessible breastfeeding guide for mothers, answering all your questions and providing support for challenges. You can purchase this through Nurtured Birth’s shop here.

Seek advice straight away! The best person to help is a lactation consultant. They will have specialist training and knowledge on breastfeeding issues. Your midwife, maternal & child health nurse, postnatal doula or paediatrician can also provide some support.
Consider attending breastfeeding classes during pregnancy to prepare yourself and your partner. You can also make contact with a lactation consultant so they will already be on hand to assist once the baby is born.
Try to feed on the baby’s first cues of being hungry, not waiting until they are crying. You can try putting the baby to the breast more often, expressing some milk prior to feed and offering the less sore side first.
Finding the proper positioning while feeding. Getting the right set up of chair, pillows, baby’s position to allow for correct attachment to the breast.
Keep nipples dry between feeds. Make sure to change nursing pads frequently and use 100% cotton for best airflow, not plastic lined ones.
After a feed leave some fresh breast milk on your sore nipples and keep them open to air for a few minutes. Pat dry gently.
Products like the BodyICE Breast Pads provide relief for sore nipples. You can purchase these cleverly designed pads that fit into your bra through Nurtured Birth’s website here.
Soothing products to assist with the pain and healing: after a feed apply a saltwater rinse to the nipple or try a warm cloth compress. A lanolin ointment that is 100% medical-grade is also safe to use on your nipples after a feed.
Check your expressing technique – some electric pumps can be too harsh and may need to be adjusted. Sometimes a manual pump or hand expressing can be gentler on sore nipples.
Nipple shields can be used for short periods of time to ease sore nipples. They often lead to future issues with poor attachment so need to be used with advice and careful consideration.
Some causes of sore nipples need medical intervention. Thrush can be treated with an ointment that is safe for baby, mastitis may need antibiotics so it does not become serious and lead to hospitalisation. Always seek out advice from a medical professional.

Where do I find help?

You can contact the following organisations for more information:

Lactation Consultants of Australia and New Zealand (LCANZ)

Australian Breastfeeding Association runs the National Breastfeeding Helpline 1800 686 268

Maternal and Child Health Line (24 hours) – 13 22 29

Nurtured Birth postnatal doula available for home visits in Melbourne, even during Covid-19 times.

Written by Sharon Clarke, Remedial Therapist at Nurtured Birth

Pregnancy Support And Dads: Supporting Your Partner

Most information about pregnancy focuses on the mama-to-be, but what about pregnancy support and dads? What role do dads take in supporting their partner during pregnancy?

Pregnancy is a time of celebration and excitement but there are also plenty of challenges. Dads play an important role in many ways during pregnancy, from conception all the way through to birth and beyond.

Believe it or not, dads supporting their pregnant partner is essential to her wellbeing, influences her birth experience and recovery afterwards. It also brings you together, strengthening your bond and creating a united team – your family.

How can you be the best support for your partner during pregnancy? Let’s focus on 5 important ways dads can offer support.

#1: Physical pregnancy support and dads

Pregnancy brings many physical changes, from morning sickness and tiredness to more physical effects such as sore joints and being unable to move easily.

You can provide physical support to your pregnant partner to help her cope with these changes. It might she needs to make lifestyle changes, such as healthy eating, giving up unhealthy habits or taking up exercise. You can join her in the move to a healthier lifestyle, and offer encouragement and support.

Pregnancy takes a physical toll on a woman’s body. Body aches and pains increase, she may get frustrated at not being able to do things easily, and feel generally uncomfortable all the time. Understand her physical limitations and be aware they will be constantly changing. Create opportunities for your partner to rest or provide caring support like a back massage or foot rub.

Some women may feel self-conscious about how their body is changing. This can change their feelings towards sex. Talk to your partner about how she is feeling and be positive with responses. There are many ways to be intimate within your relationship. Cuddles, hugs and kisses may be the perfect support plan for now.

You can also support your pregnant partner by promoting a slower lifestyle, such as reduce busy schedules andcut back on socialising. If there are other children in the family, you can take on more of their daily care to give your partner time to rest, meditate and prepare for birth, building a connection and bond with her baby.

#2: Emotional pregnancy support and dads

While often the attention is focused on the pregnant mama-to-be, dads can feel left out of the picture, a bit forgotten and ignored.

Announcing your pregnancy news is a shared joy and any other celebrations can involve you too. Pregnancy traditions such as baby showers or gender-reveal parties aren’t just for pregnant mamas – celebrating your new family together strengthens your bond as a couple.

Keep the lines of communication open. Often we wait until we’re asked to do something. Instead, specifically ask your partner to guide you in how to best support her. Make time to talk about how you’re both feeling about the birth and becoming parents. Ofter encouragement and reassurance and share your own concerns and worries, so you’re building a path of strength and resilience together.

Hormonal changes during pregnancy can make pregnant women emotional and teary one minute, but bubbly and vibrant the next. They can even seem completely irrational at times.

It is important to understand these hormonal changes are out of her control. They can cause mood swings, reduce her energy levels and increase her need for sleep. The best way to offer support is by being understanding, comforting and encouraging her to take breaks and naps. A show of affection by offering a simple hug can make her feel loved and supported.

#3: Practical pregnancy support and dads

Taking on the essential daily tasks is a great way for dads to take the pressure off their partner, especially if she is still working.

Pregnant women are giving so much of themselves to the growing baby they are often left depleted. You can assist or take over things like preparing meals, cooking, cleaning and washing, bathing other children.

Helping in this way is especially important when your pregnant partner is feeling particularly worn out or if certain cooking smells make her feel ill.

Brainstorm ways your partner is going to need support after the birth of your baby and plan ahead. Will you take on cleaning and cooking, or should you organise a cleaner and meal delivery? Go shopping with your partner for items like prams and car seats.

#4. Pregnancy support and dads

Being there from the start and being engaged is so important for dads. You can support your partner by attending pregnancy appointments such as ultrasounds and antenatal care check ups, helping to discuss options for care and planning your birth options.

Take a proactive interest in being informed about pregnancy, baby development and birth. There are many well researched blogs and websites for you to choose from.

Talk about the roles you will take on in parenting, what it means to you to be a parent and how you can share parenting roles. This can be a good time to work through any concerns about how you were raised and the things you want to avoid as a parent yourself.

Dads can talk to their unborn baby to begin building a connection. By the third trimester babies can recognise voices and love to hear talking and singing. You can talk to your baby in your partner’s belly, to help build a bond with the baby and start developing your family connection.

#5:Birth preparation support

Dads can be supportive by preparing themselves to be the birth partner their partner will need during labour and birth. Nurtured Birth offers a specific workshop for partners to encourage them to be the best birth partner.

You can read up on the process of labour, and the varied scenarios that can occur in labour. You can start to think about your role in the birthing process, making sure to ask questions during antenatal visits. This makes it clear to health professionals you’re involved and want to be included too.

Attend birth classes and be proactive in your involvement. Nurtured Birth offers tailored and in-depth private childbirth education sessions you can enjoy in the comfort of your own home. Having a doula support you and your partner through pregnancy can be a wonderful way to connect and work through your fears and expectations about birth.

During labour, make sure you are the best support by being her advocate and stay engaged with her choices and preferences. You can have an active role in birth by catching the baby, cutting the cord, supporting your partner to have a golden hour after birth, and enjoying skin to skin with your baby.

And finally…

You need to support yourself too. You still need to have some breaks yourself, if that’s time for exercise or visit friends or focus on a hobby. Make sure you self-care, whatever this might mean to you.

You can always reach out to other partners to share feelings, ideas and tips. This can be family and friends, or you can make connections through childbirth classes and parenting groups. There are lots of resources out there for expectant partners.

Need to talk to someone for more information and advice?

Call Pregnancy, Birth and Baby on 1800 882 436 to speak with a maternal child health nurse.

Raising Children Network, supported by the Australian Government, has videos, information and more available, such as the ‘Dads Guide to Pregnancy’. Go to raising children.net.au

Mensline Australia offers support and counselling services on 1300 78 99 78.

Beyond Blue offers support and advice for new dads on 1300 22 4636. You can download the book Emotional health and wellbeing: A guide for new dads, partners and other carers. There is a wealth of information and support on becoming a parent and what to expect.

PANDA National Helpline 300 726 306 for help for dads, parents and carers, specialising in prenatal and postnatal anxiety and depression.

Written by Sharon Clarke, Remedial Massage Therapist at Nurtured Birth

Home Birth During Covid-19

Home birth during Covid-19 is a choice many women are considering as they search for safe and alternative birth options.

Pregnancy is an amazing time as your baby grows inside your body and you prepare to welcome a new person into this world and into your family.

As your due date draws nearer there can naturally be some apprehension and uncertainty of what is to come during the birth.

This is even more so in 2020 as women seek support and care during pregnancy and birth during the Covid-19 pandemic.

Juliana Brennan is a private midwife, director of Mamatoto Midwives and a mother of three. She shares with us an amazing insight into the world of private midwifery and home birth during Covid-19.

How are you at this time?

Well, a bit more settled now, but like everyone else there was so much upheaval and concern over the health of all our community, my family and especially my elderly parents.

My biggest fear was not knowing much about the virus, the panic buying, children being taken out of school, social isolation and my son is in year 12…what is this going to mean for him?

I am glad we have had some restrictions lifted but I am still very much practicing social distancing to keep myself, my family and my clients safe.

What is it like for you as a midwife at the moment?

I’ve always been very busy and my practice is consistently booked out every month, however now I have been inundated with enquiries from women wanting home birth – even from women with very serious risk factors which normally excludes them from homebirth.

These women have reached out because they were only allowed one support person in labour at the hospital and they really wanted that extra support person as well as their partner.

Also they are fearful of contracting Covid-19 from the hospital setting…after all that’s where the really sick people will be…in hospital! So I have referred many women on to other midwives as I am already booked out until the end of October.

Many of my hospital shared care/hospital support clients who are experiencing an uncomplicated pregnancy have changed over to a homebirth. This is because they couldn’t have the support they wanted in the current hospital setting, but also they didn’t want themselves and their families possibly being exposed to Covid-19.

It’s a tricky situation as you really have to want to have a homebirth, and feel safe at home to be safe for a homebirth. Merely wanting to avoid a hospital for birth isn’t a good enough reason to have a homebirth.

I will still be careful in choosing my clients who are suitable for homebirth, both physically and emotionally.

What’s it like for prenatal clients who want to home birth during Covid-19?

We have moved most of our education and appointments to an online format via Zoom. Women we are meeting for the first time we would only see online. Our clients needing a check up we would see first online, then they would come into the clinic for a 10 minute visit for a check of blood pressure, baby’s growth and heartbeat.

My clinic in Clifton Hill, where I work alongside natural therapists on the first floor, was closed down. Below us is a hairdresser that also closed down.

My sister came to the rescue and allowed me to use her clinic in Kew. She stopped seeing her clients face to face, so her offices were free for me to use. I must say, I really like the space. My colleague Danielle works out of one office and I work out of the other…so we are both doubly lucky to be able to say hello to one another’s clients and of course catch up in between clients!

My new clinic room in Elwood at This is Life also closed down, so the lovely midwives from Mama allowed me to use their rooms…but now the Elwood clinic has reopened, so I am back there seeing my Bayside clients on a Saturday morning.

My clinic room in Chirnside Park at Koru Natural Therapies has remained open, so I have still been able to see my clients there too.

Of course adhering to the strictest hygiene, washing down beds, tables and changing linen in between clients and of course lots of handwashing!

Overall my prenatal clients all decided to self isolate as much as possible. Especially from 37 weeks…this was my recommendation. Many women were anxious I may have to change their birth plans if they were planning a homebirth, but I reassured them if they were willing to self isolate and so was I, then we were at very low risk of contracting Covid-19.

What changed significantly for the hospital system was the decision to allow only one support person in hospital. This meant one of my clients wanting a vaginal birth after two c-sections (VBAC2C) chose me to support her in hospital instead of her husband! What a responsibility!

For others it meant dropping women off at the emergency department and staying in close contact via phone or Zoom. Not ideal, but I completely understand the issues surrounding social distancing and protecting clients in hospitals and also hospital staff.

I do think two support people should be allowed in birth suites from now on…as Australia seems to have the infection under control much more so than other countries.

Have you adjusted your postnatal care?

Postnatally I am still happy to do face to face appointments, as long as clients and their families don’t have a cough, fever, or sore throat.

If they do, I arrange testing for them and wouldn’t visit if they had symptoms. This actually hasn’t happened…probably largely because my families all isolated fairly strictly prior to their births.

What is home birth during Covid-19 like?

For my clients it is self isolation from 37 weeks of pregnancy then the birth at home is the same.

My recommendation for women that have a fever in labour be transferred to hospital. Usually we would transfer anyway, after eliminating other reasons for fever such as dehydration.

This guideline has been debated amongst my colleagues; some feel we should still keep women home if they have Covid-19 symptoms if they don’t seem too unwell. My concern is leaving four hours after the birth and not being able to supervise all the time as well as the unknown effects of the virus on the unborn baby. In hospital the woman and baby would have constant supervision and care.

It is definitely an issue for me if hospital transfer is required. I did have one first-time mother needing a hospital transfer in labour…and of course I had to hand her over to the hospital staff. I kept in very close contact with her partner and he called me regularly to ask for my advice. It still isn’t the same as being ‘with woman’ and it saddened me deeply…as I am her main care provider and I develop a strong bond with my clients.

How are you navigating any possible Covid-19 pregnant or birthing woman?

The first thing to do is arrange testing and to self isolate until the results come back. If the woman presents with symptoms in labour I do have full PPE available.

So far none of my clients have had respiratory symptoms, so I haven’t had to worry about it. I think self isolating since 37 weeks has made all the difference.

What are the pros of a home birth during Covid-19?

Well staying out of hospital is definitely a positive!

If hospital is needed, not being able to take your primary care provider with you due to the one person support policy is a real issue. Continuity of care leads to good outcomes in birth, but Covid-19 is a real threat and hospitals have to enforce the rules!

What is birth like for healthy and well women at this time?

They are being exposed to hospital environments, then discharged home very early, with NO follow up except phone calls from maternal and child health nurses (MCHN). Some MCHN refused to visit, some GP’s wouldn’t do contact appointments.

Thankfully one of my colleagues was able to offer postnatal face to face care to many of these women which meant breastfeeding could be fully supported and of course she could weigh babies and make sure they were thriving. My own clients had the same care as they would have had before Covid-19.

What are the main challenges birthing women are facing with these new protocols?

Women who wanted two or more support people have had major issues adapting…many women choose to have private midwives at a hospital birth to advocate for them, and then facing this loss often meant changing to a home birth.

What are the main challenges for Independent Midwives in during this pandemic?

Making sure we don’t contract the virus! Keeping our clients safe! Hospital protocols around one support person.

Nurtured Birth would like to thank Juliana for her contribution to our blog.

If you are considering an independent private midwife for your pregnancy and birth, Juliana Brennan is very experienced and deeply caring.

Juliana can be contacted at Mamatoto Midwives for a comprehensive choice of maternity care options.

Juliana Brennan

Mamatoto Midwives

juliana@mamatotomidwives.com.au

0419 253 778

At Nurtured Birth we love supporting independent midwives and working alongside them to enrich the continuity of care we know through research it results in better birth outcomes, improving mothers experience antenatally and postnatally.

We love it when our clients thrive therefore we have developed our practice to compliment maternity care by offering a range of pregnancy care options with pregnancy massage, osteopathy, doula support, childbirth education, naturopathy, pre & postnatal yoga, mothers groups too.

All this is our heartfelt vision to enrich, nurture, nourish and support a mama’s pregnancy, birth and beyond.

Written by Sharon Clarke, massage therapist at Nurtured Birth

Spectacular capture at the top by Bree Downes

Giving Birth During Covid-19

Many women in our community are worried about how their maternity care will be affected by practices put in place when giving birth during Covid-19.

These protocols and procedures are due to hospitals and medical centres preparing for potentially large numbers of infected patients. Fortunately cases of Covid-19 have remained manageable in Australia.

For the pregnant, birthing and postnatal women in our community, Covid-19 has thrown them a curve ball. Even a straightforward and healthy pregnancy and birth comes with some apprehension. Now, women are concerned about how the new protocols and procedures will affect them and their connection within the health system.

So what does maternity care and birth during Covid-19 look like?

We asked Dr Danielle Wilkins, obstetrician and Director of Maternity Services at Cabrini Health, to give us an insight into what it is like for the women in her care during this pandemic.

Dr Wilkins answers all of our questions with an open and honest frankness relaying the message that pregnancy, birthing and the postnatal period can still be a beautiful and calm experience amidst Covid-19.

For women who are concerned about how their maternity care and birth during Covid-19 will look, this information can be a starting point to research options and make an informed decision about maternity care providers.

How are you coping during Covid-19?

What a roller coaster this year has been! The highs are seeing how optimistic, adaptable and focused pregnant women are when their lives are turned upside down.

The challenges are working with those who are finding these changes overwhelming and the lows are not knowing what is around the corner.

What’s it like for you as a doctor in the current situation?

This is such an emotional time. I found myself, like so many Australians, watching the international news in abject horror, unable to look away as my colleagues around the world try to fight this virus without protection, without rest and without success. I was losing sleep thinking about them day after day and night after night. So I had to listen to the same advice I have been handing out and I had to stop watching.

What’s it like for your prenatal clients in this time?

I have approximately 90 women who I am actively caring for at the moment. Since the restrictions in Australia started I have been keeping in touch with them much more closely than usual via a fortnightly email update. Through this I have kept them abreast of all the work that Cabrini has done to keep them safe and to keep them informed, negating any surprises.

I have introduced telehealth into Obstetrics which previously we thought would be of little or no benefit, and this has been pleasantly well received by those that have chosen to use it. I have encouraged all of my clients to make the informed choice themselves and to use the telehealth system as the safest option but if they prefer they can still come in for a face to face appointment.

I believe that providing them with relevant local information and also giving them options is helping them to navigate the situation.

What is the experience of women giving birth during Covid-19?

Fortunately we have yet to have a Covid-19 positive pregnancy in Victoria, nor have we had a positive partner or support person. Our women are able to have their one support person with them throughout their labour and their postnatal stay.

We are continuing to provide them with one-on-one midwifery support. The big changes have been for those women planning to have more than one support person with them, and for some women this was a very sudden change. But women are resilient!

We have received feedback about how comfortable it was just having the 4 people present for the birth. They are reassured they still have all the pain relief options available as needed.

Many of my clients were emotional about the postnatal stay, when relatives and friends would normally come to the hospital to meet the newborn. What has been striking is how rested the mums are, how connected they become with their midwife who has less juggling to do around visitors and how much easier they are finding it to breastfeed on demand.

What are the procedures in place for Covid-19 positive cases?

We have a statewide guideline for any Covid-19 positive pregnancy cases which we have adapted for Cabrini.

We have modified our largest room in the birth suite to accommodate anyone who is positive or suspected to be positive during labour and we have a guideline for partners and support people as well. These guidelines ensure the full support of the couple as well as the safety of all of our staff.

The trickier situation is the symptomatic Covid-19 positive partner or support person – this person will not be able to enter the hospital if they are symptomatic. This is a huge incentive for self isolation close to term.

Would the new mother stay together with her baby to breastfeed?

There was a wonderful success story out of Brisbane last week relating to this. The couple would need to wear gloves and a surgical mask when handling their newborn whilst they were considered to be infectious, but as long as they are well their baby will stay with them and they will be assisted with breastfeeding and encouraged to do so if that is their desire. We will encourage these families to return home as soon as it is safe to do so and provide them with telephone support once home.

What could a birthing woman expect during her time in hospital?

Women can expect one-on-one midwifery care, a large room to mobilise with an ensuite with shower. They will not be able to use nitrous and air for pain relief as it may increase the viral load in the room and put other staff at an increased risk.

The staff who provide their care will all be wearing full PPE (personal protection equipment). Whenever the woman and her support person move through a public part of the hospital they will be escorted by staff, will be required to wear a surgical mask, and asked not to touch anything along the journey.

We will discuss their wishes for pain relief and explain that there may be benefits to an epidural if they are considering one. This is because all procedures will take a little more time to be performed as safely as possible, and in the event of any emergency in obstetrics we like to be as prepared as possible.

A paediatrician will be present at the birth, as overseas data has suggested that the babies to Covid-19 positive women sometimes need some initial support to transition from inside to outside the uterus. This is only for a brief period in the vast majority of cases.

What is giving birth during Covid-19 like for women who are healthy and well?

Unchanged! We are wearing a little more PPE for births but that is not affecting our communication or support for women, nor our ability to provide one-on-one midwifery care. You can expect us to be wearing a clear visor, a surgical mask and a gown during the pushing stage of labour.

What are the main challenges women face with these new protocols? How are you finding their adaptation?

Women are finding their strengths, they are finding their way. Those that had different plans for support through their birth are spending prenatal time telehealthing with their support team and working together to develop strategies and plans for the different stages of labour and birth.

There is so much support for them already online and I have included a lot of this information in my newsletters to help support them. I am constantly impressed but not surprised by their determination and ability to adapt.

What is it like for women after they give birth during Covid-19?

This is a challenging time for first-time mums who are very nervous about not having the support of maternal and child health nurses, mother’s groups and in many cases their parents and families.

I am encouraging them prior to their labour and birth to make plans for accessing support, to be prepared and to know they can continue to link in via the phone and via telehealth. We may soon see an easing in restrictions which will put our first-time mums at ease I think.

Your final thoughts on what you believe it is important for people to know…?

Keep doing the right thing. Read what is relevant and don’t get overwhelmed by what isn’t. It is really important to remember that we are all in this together and we are all getting through it together because we are doing what is best. And remember to look up.

About Dr Danielle Wilkins

Dr Danielle is an obstetrician and the Director of Maternity Services at Cabrini Health. Her practice rooms are located at Cabrini Mother and Baby Centre. She offers individualised care to the twelve women she sees each month through her boutique obstetric practice.

Danielle graduated with honours from Monash University, trained at Monash Health and gained twelve months of obstetrics and gynaecology experience working in a busy unit in Ireland.

She spent nine years as the Director of Women’s Health training at Monash Medical Centre, and six years as the Discipline Coordinator for Women’s Health for Monash University. She was the Head of the Multiple Pregnancy Unit at Monash Health before moving to her current role at Cabrini.

Danielle has extensive experience caring for twin pregnancies and supporting women wishing to have a normal birth after a caesarean birth.

Dr Danielle Wilkins can be found at Cabrini Mother and Baby Centre, Cabrini Hospital Malvern, Level 2, 183 Wattletree Rd, Malvern

6 Top Tips To Prepare For Successful Breastfeeding

Successful breastfeeding is expected by most new mamas, because it’s … well, natural.

The truth is, since the beginning of time, new mamas naturally fed their babies after watching and learning from other women around them. It’s only been in our recent history that breastfeeding has come less naturally to new mothers.

Changes in social attitudes meant birth and breastfeeding became less visible. Our grandmothers, mothers and our own generation missed out on that vital firsthand experience of watching others go through these life-changing events.

It’s actually not surprising that today while most new mamas do breastfeed their newborns after birth, very few continue to exclusively breastfeed until 6 months.

We know how important breastfeeding is for babies and mothers, and getting it right from the start is key to a successful breastfeeding relationship.

If you are a mama-to-be who wants to prepare for breastfeeding, here are some valuable tips to ensure your journey is successful:

#1: Learn about successful breastfeeding before birth

Research indicates quality education about postnatal parenting and breastfeeding is the best step to ensure a successful breastfeeding experience.

Learning about breastfeeding before you give birth means you have the time and energy to actually take on the information. Trying to learn about breastfeeding when you and baby are recovering from birth can be overwhelming.

You’re also more likely to implement some of the other tips covered in this blog post. How you decide to learn about breastfeeding can be through attending a class, such as those the Australian Breastfeeding Association runs, antenatal classes at your hospital, or with a private lactation consultant (see tip #6 for more information).

#2: Understand normal newborn behaviour

I don’t think there’s a parent alive who hasn’t been in the presence of their newborn for the first 24 hours and thought ‘wow, we hit the jackpot with a quiet sleeping baby’. The first 24 hours or so after birth, a newborn tends to sleep a lot, feed a little, and maybe cry some too.

Then 1-3 days after birth, your baby is more awake and aware. They also realise food isn’t on tap anymore, are quite hungry and cry a lot more. They tend to want to feed very frequently.

This is actually very normal newborn behaviour. They have small tummies and need to feed often, especially as they’re helping to increase their food source – your milk supply.

Most new mamas aren’t prepared for this change in their baby. They feel they’re doing something wrong, their baby isn’t getting enough milk and that’s the reason for the crying and fussiness.

This stage doesn’t last, but it can be very frustrating and exhausting when it does. Being aware that this is very likely to happen, and being patient with yourself and your baby is a step toward getting through this stage.

#3: Who’s got your back?

In the months and weeks before giving birth, have a look around your immediate support network. Who do you know breastfed for at least 6 months, even beyond? Ask that mama questions about what she felt helped her the most.

It’s a good idea to discuss your intentions to successfully breastfeed with your partner, family and close friends. Research shows partner support is one of the biggest factors in new mamas continuing to breastfeed. If you feel your partner might be less supportive or concerned, get along to a breastfeeding class together. Talk to your partner about how important it is to have their support.

Think carefully about the people in your life who are less likely to be supportive. Many women find the older generation has a very negative attitude towards breastfeeding. It can be wise to be aware of this and have a frank discussion beforehand about your intention to breastfeed and expectation they will refrain from being negative about it.

#4: Create a successful breastfeeding plan

It’s likely you’re already preparing your birth bliss plan, the document that lists your intentions and preferences when you go into labour. Include your breastfeeding bliss plan on your birth plan too. This should state your preferences for the first hour after birth (see tip #5).

In the first hour after birth, your baby will likely be quiet and alert, which is the perfect state for the first breastfeed. Stay skin-to-skin with your baby and allow your baby to seek your nipple.

This can take a little time but all babies have an innate instinct to find their mother’s nipple very soon after birth. Ask care providers to refrain from touching or forcing your baby to take the nipple until they’re ready.

It should be said, most maternity hospitals support early breastfeeding when labour and birth has been uncomplicated. It’s usually when you or baby have needed medical intervention that breastfeeding can be interrupted.

Where appropriate, have skin-to-skin with your baby (or with your partner). Where possible, seek support to feed your baby directly from your breast. It can be useful to have on your birth preferences that your baby is not to be given any artificial nipples or formula unless medically indicated and with your consent.

Babies in special care nurseries can be given breast milk by oral syringe or feeding tube, so ensure all care providers are aware of your preferences. Speak to the hospital lactation consultant (or your own) about pumps and how to best keep up your supply if you’re separated from your baby for some time.

#5: Plan for a normal birth

Women have been giving birth since the beginning of humanity with minimal intervention. It’s only been in the last few centuries we’re started to interfere with the process. Mostly this has been with good intention, to prevent anything risky from happening.

Unfortunately, intervention during labour has consequences and often the time after birth is affected but least considered. During your baby’s first hour, if they are given skin-to-skin contact with you, this helps them to regulate their temperature and respiration, boosts their immunity, helps with the third stage, and improves successful breastfeeding rates.

Babies born to mamas who haven’t had pain medication are also more likely to breastfeed than those mamas who have. That being said, if you do need medical intervention or choose to have pain medication, you don’t have to miss your baby’s first hour.

See tip #4 above for suggestions on how to make that work for you and your unique situation.

#6: Call the breastfeeding expert

It might seem pre-emptive to hire a lactation consultant when you’re pregnant and not yet breastfeeding. But when it’s day three after birth and you’re in tatters because your baby is crying and won’t latch and it seems impossible to go on, you will be glad to have your LC on speed dial.

A lactation consultant is a breastfeeding specialist. They have special training and can help identify what’s not working and how to resolve it. Most early breastfeeding challenges can be fixed, with the right, qualified support.

If hiring a private LC isn’t possible, ask your midwife what support is offered by your hospital or through your local council. Keep the Australian Breastfeeding Association helpline number handy for help too.

At Nurtured Birth we are here to support you in your journey to breastfeed after birth and beyond. Find out more about us and our services here.

Author: Sam McCulloch, Wordsmith at Nurtured Birth

Easy Ways You Can Prepare For Pregnancy Now

How to prepare for pregnancy seems like a no-brainer. Sperm meets egg, cells divide, baby grows…it doesn’t seem that complicated.

But your journey to motherhood starts long before you see that positive pregnancy test. Whether you’re trying to conceive on your own or with medical assistance, preparing for pregnancy is an important step to take to ensure a healthy baby and pregnancy.

Before you get serious about creating a new little human, there are some things you and your partner should think about. If you’ve already started the baby-making process, don’t worry – it’s never too late to make changes to improve your lifestyle and health.

Preconception check-up

The health of each parent is one of the key components of improving your chances of conception and a healthy pregnancy.

It takes about two to three months to form mature sperm and eggs take about 100 days to mature before ovulation. This means your current fertility status is the result of your lifestyle, diet, environment and health from three or so months in the past.

So you can see, it’s important to be as healthy as possible even before conceiving a baby. It’s a good idea for you and your partner to have a health check up to find out if there is anything that interferes with conception or a future pregnancy.

This check-up should take into consideration your diet and lifestyle, your medical and family medical history, any health conditions you have, medications you take, and any previous pregnancies.

Any long-term existing health conditions should have a management plan and be under control before you fall pregnant.

As you prepare for pregnancy, it’s also a good idea to book an appointment to see your dentist. Gum disease has been linked to pregnancy complications such as preterm labour, gestational diabetes and preeclampsia. If you need any fillings or dental work done, it’s better to have it done before you’re pregnant.

Your naturopath and other practitioners can support you to improve your overall health and fertility, to prepare for a healthy pregnancy. Lou from Nurtured Birth explains that an initial consultation with a naturopath would usually involve gaining a comprehensive understanding of your current health condition, past health concerns and other factors which are important for optimal fertility.

Here are some lifestyle tips to look at:

Prepare for pregnancy with nutrition

As said earlier, your current fertility status is the result of the past few months diet and lifestyle. Having both you and your partner in peak nutritional health at the time of conception increases the chances of a healthy baby and pregnancy.

Your body needs a regular supply of nutrients for growth, energy and regeneration. These requirements increase during the beginning of pregnancy to the end, and then beyond in the time after birth as you recover and nourish your baby.

Prepare for pregnancy by boosting your daily nutrients through the food you eat. While the occasional treat is fine, your diet should be comprised of the highest quality foods possible. You can enjoy a balanced diet with protein, complex carbohydrates and healthy fats. As much as possible, avoid processed foods that provide empty calories with no nutritional value, such as biscuits and cakes. Instead aim to eat mostly vibrant, fresh fruit and vegetables.

A good place to start is to see your naturopath for an assessment of your current nutritional status.

This consultation would also include an analysis of your current food intake, with suggestions made to improve your diet. Your naturopath can work with you to create an individualised plan to ensure you get all the nutrition you and your partner need for a healthy conception.

Your baby also needs plenty of nutritional support, from the moment of conception. Adequate levels of vitamins and minerals are vital, including iron, calcium, iodine, omega-3 and selenium. Folate is very important as it helps to prevent spina bifida in babies.

Choose a prenatal supplement carefully or with the help of your naturopath. You may have specific needs which can’t be addressed by a generic prenatal supplement.

Healthy weight before pregnancy

If you are under or over your ideal weight, it’s important to address this before pregnancy if possible.

Being underweight can create problems for women trying to conceive, as it creates hormone imbalances that interfere with ovulation. Women in the underweight range are likely to take more than a year to conceive compared to women in the healthy weight range.

Being overweight can affect sperm motility and count so your partner’s weight also matters.

Conceiving at a healthy weight means pregnancy complications are also less likely to occur, and your baby has a better chance of being healthy at birth and into their future.

This means you are also likely to have a more positive birth experience. Why? Because health conditions increase your risk for complications that need medical intervention.

Prepare for pregnancy with exercise

How your body functions before you conceive can impact how your body copes with the changes that pregnancy and birth brings.

Exercise offers more than just physical fitness. You are learning how to work with your body, releasing feel-good hormones like endorphins, and paving the way to an easier labour and recovery after birth.

Don’t believe us? Studies have found that women who exercise during pregnancy have shorter labours and are less likely to need pain relief.

If you already exercise, you should be able to maintain your current program through most of your pregnancy. Be guided by your body and ensure you don’t overheat or push harder than your abilities.

Yoga, swimming and walking are brilliant ways to increase your exercise if you don’t do any. Yoga has the added benefit of helping you with the mind-body connection, something we’re big on at Nurtured Birth. You can find out more about Nurtured Birth’s prenatal classes here.

Quit smoking, alcohol & social drugs

We’re not here to judge but smoking, drinking alcohol, and taking drugs are the most problematic habits for overall health, fertility and pregnancy.

All of these substances can make it much more difficult to get pregnant and significantly increase the risk of miscarriage, birth defects and stillbirth.

Alcohol can harm a growing baby, causing birth defects, stillbirth and miscarriage. No one has been able to determine a safe level of alcohol consumption during pregnancy, so it’s wise to abstain altogether. Drinking alcohol can also bring down your partner’s sperm count, affecting his fertility as well.

The use of marijuana also decreases sperm density and motility and increases the number of abnormal sperm. Recreational and street drugs are dangerous for you and pose huge risks for your baby.

Women who smoke find they’re more likely to have problems getting pregnant and higher risks of miscarriage, stillbirth, preterm birth and low for weight babies. Smoking in men causes damage to the DNA in sperm, while also decreasing sperm count and motility.

Babies born to mothers who smoke are at risk of SIDs, as well as health problems in their future. Passive smoking is also a risk for pregnant women and babies, so now’s a good time for your partner to stop smoking.

Caffeine & caffeinated drinks/foods

Most adults drink caffeine in some form or another, whether it’s your morning cup of tea, the coffee you ‘need’ to get through the day, or soft drink, even chocolate! And yes, we think it’s important you watch your caffeine intake.

High intake of caffeine may interfere with your ability to conceive, increase the risk of miscarriage, and of having a baby with low birth weight.

It’s best to limit your intake of caffeine to 300mg a day or avoid it as much as possible. Swap to decaffeinated coffee, try herbal or rooibos teas, and avoid energy drinks which are high in both caffeine and sugar.

Prepare for pregnancy by chilling

You might not think your emotional and mental health is related to your fertility. After all, what your brain is doing shouldn’t affect sperm meeting egg, should it?

We all experience stress and emotional upheavals. Low levels of stress occasionally are normal, we adapt and move on. It’s when we’re going through persistent high levels of stress we start to see the effects, both physically and emotionally. This can also affect fertility, as your body produces stress hormones which impact reproduction, such as interrupting your cycle and decreasing sperm quality.

Not to mention making it less likely you have the time and inclination to actually have sex at the optimal fertile time, adding to the stress of trying to conceive. Managing stress can be easier said than actually done and often couples need solid support in place to help them ease back on the stresses in their lives. Counselling can be a powerful tool, alongside therapies such as massage, yoga and exercise.

Taking stock of your current mental health is important when preparing for pregnancy. It can help you to understand what areas of your life are overwhelmed and need support.

Pregnancy doesn’t just bring physical changes, you are transitioning into a family and this can have a profound impact on you and your relationship. Take the time to invest in communication with your partner to discover how you can support each other on this exciting journey.

At Nurtured Birth we are here to support you as you prepare for pregnancy. Find out more about us and our services here.

Author: Sam McCulloch, Wordsmith at Nurtured Birth