Author: Louise Mannion

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Physiological Breast Engorgement

Between about day two and day five after birth, you might experience breast engorgement with increased blood circulation in the breasts and the secretion of more lymphatic fluid in the breast area. Your breasts can feel hard, swollen and warm, and may be slightly flushed. This is a positive sign as it tells you that your milk is ‘coming in’.

The first few days

For the first few days after giving birth, breasts remain soft and produce colostrum, the first milk. Colostrum comes in many colours and the amounts may seem small, but it is produced in just the right quantity. Colostrum is rich in immune factors that protect your newborn baby.

Within approximately 72 hours, you will notice changes in your breasts. They will become full, firm, warm, and perhaps tender as milk production increases and colostrum begins to change to mature milk. The term for this change in breast fullness is physiological engorgement.

Some women find that their breasts feel uncomfortable. Other women barely notice any change. Mild to moderate discomfort is common and normal. Usually this situation lasts for about 18 to 24 hours. However, each woman is different, so physiological engorgement may last for longer or shorter periods of time.

When will my breast milk come in?

Your breasts will adjust over time, producing exactly the right amount of milk for your baby. In cases of extreme or prolonged painful engorgement, seek help from a lactation consultant or healthcare professional. Your baby helps you manage the engorgement by removing milk frequently. This means you should breastfeed at least 8-12 times within 24 hours. If your baby is not latching properly or feeding frequently, your breasts may become overly full. You can also pump milk to relieve engorgement.

This fullness reduces the elasticity of the breasts and nipples, which can lead to latch difficulties and sore nipples.

Physiological engorgement should clear up within the first four to five days. If it persists, please consult a health professional who can support you. Continue to breastfeed frequently and unrestrictedly. The engorgement does not mean that you have an oversupply and it is important to have the baby frequently drain the breasts to avoid problems.

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Packing for Hospital Birth

Here are your must-haves and some nice-to-haves to pack for the hospital or birth centre. This list is a good starting point, but every hospital and birth centre does things differently. So ask ahead of time what they will supply and what you will need to bring from home.

What to pack for hospital for mum

  • Copy of your insurance documents
  • A birth plan that describes to your doctor and midwife how you would like your labour to proceed (epidural, natural, episiotomy and so on)
  • List of phone numbers of people to call, notebook and pen
  • Gym bag packed with a change of clothes, deodorant and toothbrush, also for Dad
  • Phone and chargers
  • Towel to sit on in the car (just in case your waters break)
  • Cash and change for vending machines

For mum to wear

  • 3 vest tops (you can wear them in the bath)
  • Yoga trousers
  • Comfortable socks
  • Cotton dressing gown
  • Comfortable slippers
  • Nursing sleep bras, bra pads
  • Underwear, underwear and more underwear
  • Belly bands/tube tops
  • Make-up bag, lotion, deodorant, toothbrush and toothpaste
  • Hair clips and hair bands
  • Brush
  • Hairdryer

What to pack for hospital for your baby

  • Babygro
  • Sleep suit
  • Socks and cap
  • Blanket
  • Going-home outfit
  • Baby car seat

 

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Breast Milk or Formula

Babies are born to breastfeed and breast milk is perfect not only for baby nutrition, but also for disease protection, immune system development and brain growth. It is important to know how feeding your baby formula can interfere with your breastfeeding success.

Recommendations

There are many factors that contribute to a woman’s decision to breastfeed. If you opt for breastfeeding over formula, there are many health benefits for you and your baby. And, of course, breastfeeding saves you a lot of money.

The World Health Organization (WHO) and other organisations recommend feeding your baby breast milk exclusively for the first six months, if possible, unless there is a medical reason for you to supplement. Your body was made to sustain your baby’s life. You grew your baby for nine months and now you can nourish them with your breast milk, the one and only natural and complete nutrition for human babies. No formula can duplicate the unique properties of breast milk.

Breastfeeding in the first two weeks

In the first few days after birth, some mums worry that their babies are not getting enough breast milk. Well-meaning friends and family may suggest that your baby be fed formula until your milk ‘comes in’. But in fact, a newborn’s stomach is so tiny (about the size of a marble) that it can only hold about a teaspoon of fluid at a time. That is the approximate amount of colostrum (first milk) that is available at each feed and exactly what babies need in those first days.

A few days after delivery, the colostrum will change into transitional milk (referred to as ‘milk coming in’) and then into mature milk, over a period of seven to ten days. Feeding the baby with a bottle or feeding formula can interfere with your milk production and, ultimately, with your breastfeeding success.

If you have questions about your supply, do not hesitate to contact your healthcare provider or a lactation consultant.

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Finding a Nursing Bra in the Right Size

Choosing a well-fitting, supportive maternity and nursing bra is important for your comfort as your body changes in preparation for your breastfeeding journey.

Benefits of different maternity bras

Wearing a bra that is too small for you can be an uncomfortable experience. It is difficult to know how much your breasts will change throughout the entire maternity and nursing experience as each woman’s body is unique and will change differently: some mums only gain one cup size, while others increase by three or more cup sizes. For this reason it is beneficial to wear well-designed bras and tank tops that will adapt to your body’s changing shape and provide a comfortable experience.

During the day a comfortable wire-free, seam-free and supportive nursing bra is the best option. You can start wearing this type of bra during pregnancy when you outgrow your regular bras. When you begin nursing, bras with full drop cups will allow you to breastfeed your baby easily and discreetly.

For easy feedings at night, you should choose a sleep bra that is comfortable, breathable and keeps breast pads in place.

What size nursing bra should I buy?

The first step to find the right bra for you is to get accurately measured, which can be done easily in the comfort of your home or by a professional at a shop. Every woman is unique and this calculation is the first and most important step.

After being measured, it is best to try on the bra to ensure a proper fit. This will also allow you to test the different bra features like hooks, full drop cups, clips, material, shape, support, discretion, etc.

While trying the bra, unhook the strap clips using only one hand to ensure ease of use. This is an important feature because you will need to open and close them regularly with one hand only while holding your baby.

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Birth Plan and Breastfeeding

Discussing and developing a birth plan with your partner, midwife and healthcare provider is a great way to explore your wishes relating to your birth experience. Review common birth procedures to learn more about best practices, possible alternatives and your own expectations. Keep breastfeeding in mind when creating your birth plan.

What is a birth plan?

Think of a birth plan as a wish list of options during labour, the birth and the time right after the birth (postpartum). Talk with your partner about how you would like your birth experience to be, then talk with healthcare providers about their care philosophy. State your preferences regarding pain relief and birth position, what should happen in the event of a caesarean section, and what to do if complications arise.

Keep breastfeeding in mind. Baby-friendly (and research-based) breastfeeding practices such as having your baby skin to skin on your abdomen immediately after delivery or continuous rooming-in make sure you have plenty of opportunities for early breastfeeding.

Your birth facility may have sample birth plans that you can use. However, even with a set plan it is impossible to know in advance how a birth will unfold. This is why it is important to be open to changes. Look at your birth plan as a communication tool that will help guide discussions and build trust between you and those who will be involved in your care.

Benefits of a birth plan

  • A personal birth plan provides clarity. It makes your wishes known and facilitates exchanges with your partner, doctor and midwife.
  • You will have a clear idea early on which of your wishes are feasible and which are not, enabling you to adjust accordingly. In discussing the plan with others, you may discover new alternatives.
  • If there is a change in shifts during the birth, a birth plan is very useful to help the new staff get up to speed.
  • It helps create the preconditions for successful breastfeeding after birth.

Numerous different templates of birth plans can be downloaded from the internet. Take time to complete your plan, either alone or with your partner. It can be a powerful tool for a positive birth experience.

 

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What Baby Products Will I Need?

With so many baby products on the market, it can be hard to know what you really need and what is just a nice extra. Here is a list of items you may find useful for the first year of your baby’s life.

Baby clothes

  • Small babies tend to live in all-in-one suits during their first few months.
  • Babygros or vests can be worn under all-in-ones if it is cold or on their own if it is hot. Short and long-sleeved versions are available for different times of the year.
  • One or two cardigans provide an extra layer of clothing.
  • If it is winter, your baby may need a coat. If you spend a lot of time in the car, choose one that is not too thick, otherwise there is a risk your baby will get too hot.
  • A soft, cosy cap will be essential when the weather is cool. If your baby was premature or the weather in summer is cool, a cotton jersey pull-on hat is also useful.
  • If you choose all-in-one suits that cover your baby’s feet, you will not need socks. They are very fiddly on newborn babies and tend to keep falling off anyway!
  • Cotton gloves prevent your baby from scratching their face. Some babies are born with long fingernails and you should wait until your baby has reached five or six weeks before cutting them. Burp cloths or cotton bibs come in handy to remove spills. You will also need a baby bath, soap, lotion, hooded towels and nappy liners.

Nappies

  • Newborn babies will need their nappies changed 10 to 12 times a day. Buy enough to keep you going for at least the first few days.
  • You will need a changing pad or table, as well as nappy sacks and wet wipes (or cotton wool).
  • If you are planning to use reusable nappies, you will need at least 15 of them. It is a good idea to have a packet of disposable nappies handy too, in case you get behind with the laundry during the early weeks.

Breastfeeding products

  • If you are breastfeeding, you will need nursing bras and breast pads.
  • You may want to use a nursing pillow to give you and your baby support while breastfeeding.
  • Lanolin cream helps with sensitive or dry nipples.
  • Hot/cold gel packs can help soothe sore or cracked nipples.

Breast pump, milk storage and feeding

  • If you choose to express your milk you will need a breast pump.
  • Breast milk storage bags or bottles are needed when using a breast pump.
  • To feed expressed milk to the baby, you should use a baby bottle. Calma by Medela may be the perfect option.
  • For cleaning bottles, teats and all parts that come into contact with your breasts, your breast milk or your baby’s mouth, sanitising is vital.

Feeding after six months

  • Bowls, baby utensils, sippy cups, bibs and a high chair are essential equipment for feeding your baby after six months.
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Precautions During Pregnancy

The choices you make during pregnancy should aim to balance the risks and benefits that any product or activity may pose to your pregnancy. If you are trying to get pregnant, it is a good idea to stick to some of the following rules, starting at least three months before conception.

Dyeing your hair: leave it for later

Hair dyes contain harsh chemicals that are absorbed by the scalp and may be passed on to your child. If you cannot do without colouring your hair, do it in the second trimester of your pregnancy.

Sunbathing and solariums: better to stay cool

To reduce any risks, experts advise against sunbathing for long periods and going to solariums. It is believed that UV rays break down folic acid, an important substance for the development of your baby. If you get too much sun you might get dehydrated or overheated, and due to hormonal changes your skin may react to the UV rays with unsightly spots.

Smoking: active and passive smoking can be extremely damaging

Tobacco products contain substances that harm your baby’s development. They impact the blood supply to the placenta, which can reduce the supply of oxygen and important nutrients to your baby, while also exposing it to toxic substances. This can result in slower development, hyperactivity and an increased risk of allergy. Furthermore, it dramatically increases the risk of sudden infant death syndrome (SIDS).

Alcohol: not a good idea

Try to avoid alcohol completely. Your baby will ingest the alcohol directly via the placenta. This can cause malformations and mental abnormalities, and may lead to learning disabilities and attention disorders later in life.

Coffee, cola, tea: try to reduce

Fighting your pregnancy fatigue with lots of coffee is not a good idea. Caffeine can harm your baby because it interferes with the absorption of calcium, iron and vitamin C, and is associated with a low birth weight. Two to three cups (approximately 300mg caffeine per day) are OK, but not more. Remember that cola, black tea and green tea also contain caffeine.

Exercise: keep active but do not overdo it

Brisk walking, swimming, aquanatal classes and cycling on a stationary exercise bike are good and safe forms of exercise, as long as you do not overdo it. Pregnancy yoga and Pilates are good for strengthening and toning, though you should find a registered, qualified teacher who is experienced in teaching pregnant women. A combination of aerobic exercise (swimming, walking) and strengthening / conditioning exercise (yoga, Pilates) is ideal.

If you are trying to get pregnant, it is a good idea to practise some of these safe and healthy habits starting at least three months before conception. Since every woman’s situation is different, seek advice from your obstetrician or midwife regarding specific questions.

 

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Legal Background: Your Rights at Work

The length of maternity leave and entitlements vary from country to country. In most countries, women have the right to return to work after maternity leave. Make sure that you are familiar with the law concerning your rights at work in your country – from your rights during pregnancy to when you return to work after maternity leave.

Maternity leave and entitlements in various countries

United Kingdom

In the UK, Statutory Maternity Leave is 52 weeks. It is made up of ‘Ordinary Maternity Leave’ – the first 26 weeks – and  ‘Additional Maternity Leave’ – the following 26 weeks. Statutory Maternity Pay is paid for up to 39 weeks.

Germany

If you are having a baby in Germany, you may qualify for Maternity Allowance. This is paid by the German State Health Insurance. It is financial support provided to pregnant women, from six weeks prior to delivery until eight weeks following delivery, a period referred to as the mandatory Mutterschutzfrist.

Canada

In many ways, Canada is a relatively supportive country, with new parents being able to take 52 weeks of parental leave from their jobs.

USA

In comparison, in the USA there is no government-mandated paid parental leave, although new parents are allowed 12 weeks of unpaid leave.

Going back to work

If you want to go back to work sooner, you will have to give the appropriate amount of notice. Tell your employer that you:

  • want to go back to work early
  • want to change the date when you go back

Not going back to work

If you decide not to return to work, you will need to give your employer the normal amount of notice. You will still be entitled to the full amount of maternity leave and pay.

Make sure you find out about your options and entitlements when it comes to maternity leave and pay.

 

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Finding and Instructing a Babysitter

Entrusting someone with the task of caring for your baby can be challenging. To be sure your child is in capable hands, you have to invest time and effort in finding a qualified babysitter. You will want to find a mature and friendly person with common sense who is genuinely fond of children.

 Getting recommendations from people you know and trust is your best bet for finding a reliable and capable babysitter. If you are new to the area and do not know how to go about finding a babysitter, ask your neighbours or co-workers for recommendations or ask staff at your local doctor’s surgery or day care centre for suggestions.

Interviewing babysitters and checking their references will help you narrow down your choices. Prepare a list of questions to ask ahead of time. Ask about a babysitter’s experience caring for children and whether they have taken a babysitter course. Consider inviting a babysitter over for a dry run while you are at home to familiarise them with your household and observe how they interact with your child. Instructing a babysitter is very important.

Babysitter instructions

Before you walk out the door, prepare the babysitter with the following information:

  • Go over your baby’s usual routine and your general house rules.
  • Make sure the babysitter knows where you will be and how to reach you at all times.
  • Provide an emergency phone list that includes your contact details and the numbers of neighbours, friends, relatives and your doctor for the babysitter to contact in an emergency.
  • Show the babysitter where emergency exits, smoke detectors and fire extinguishers are located.
  • If you have security systems, show the babysitter how to use them.
  • Show the babysitter where you keep the inside door keys in case a child locks themselves inside a room.
  • Let the babysitter know about any special problems your child may have, such as allergies to bee stings, certain foods or household products, or the need for medication at a specific time (explain and write down the directions).
  • Review your first-aid kit with the babysitter.

Let your babysitter know your expectations before you leave. If you do not want the babysitter to leave the house with your child, make that clear. If the babysitter can drive, let them know the rules about driving your child. If using the phone and having visitors are off limits, discuss those restrictions.